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Pediatric Clinics of North America

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https://www.readbyqxmd.com/read/30031504/overview-of-pediatric-rheumatology-for-the-primary-care-provider
#1
EDITORIAL
Suzanne C Li, Gloria C Higgins
No abstract text is available yet for this article.
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031503/pediatric-rheumatology-a-field-of-great-progress
#2
EDITORIAL
Bonita F Stanton
No abstract text is available yet for this article.
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031502/transitions-in-rheumatic-disease-pediatric-to-adult-care
#3
REVIEW
Stacy P Ardoin
Although it has been widely acknowledged for more than two decades that transition from pediatric to adult care is a vulnerable time for adolescents and young adults with rheumatic diseases, current primary and subspecialty care transition and transfer processes remain inadequate. Barriers to improving transition include complex health care systems, neurodevelopmental challenges of adolescents and young adults, and insufficient transition-related education and resources for health care providers. Standardized, evidence-based transition interventions are sorely needed to establish best practices...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031501/general-nutrition-and-fitness-for-the-child-with-rheumatic-disease
#4
REVIEW
Sharon Bout-Tabaku
As a result of new medications and therapeutic approaches, most children with rheumatic diseases are no longer at risk for growth failure which results from chronic inflammation and prolonged corticosteroid treatment. However, obesity, poor nutrition, and insufficient exercise are still problems which increase risks for poor bone, cardiovascular, and general health. Diet should be monitored and modified as appropriate; supplemental calcium and Vitamin D should be provided. Obesity and poor physical fitness can be ameliorated by an exercise program that should become part of a more healthy lifestyle...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031500/complications-of-treatments-for-pediatric-rheumatic-diseases
#5
REVIEW
Gloria C Higgins
Medications to treat children with rheumatic disease include disease-modifying antirheumatic drugs, glucocorticosteroids, and biologic response modifiers that target mediators and cells involved in autoimmunity and inflammation. Although usually well-tolerated, such medications have many possible side effects, of which primary care and emergency providers should be aware. Both disease and immunosuppression contribute to susceptibility to unusual and opportunistic infections, in addition to usual childhood infections for which these children should receive all applicable nonlive vaccines...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031499/pediatric-pain-syndromes-and-noninflammatory-musculoskeletal-pain
#6
REVIEW
Jennifer E Weiss, Jennifer N Stinson
Chronic musculoskeletal pain (CMP) is one of the main reasons for referral to a pediatric rheumatologist and is the third most common cause of chronic pain in children and adolescents. Causes of CMP include amplified musculoskeletal pain, benign limb pain of childhood, hypermobility, overuse syndromes, and back pain. CMP can negatively affect physical, social, academic, and psychological function so it is essential that clinicians know how to diagnose and treat these conditions. This article provides an overview of the epidemiology and impact of CMP, the steps in a comprehensive pain assessment, and the management of the most common CMPs...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031498/chronic-nonbacterial-osteomyelitis-and-chronic-recurrent-multifocal-osteomyelitis-in-children
#7
REVIEW
Yongdong Zhao, Polly J Ferguson
Chronic nonbacterial osteomyelitis (CNO) is an innate immune system disorder that predominantly affects children. It can present as part of a syndrome or in isolation. It presents as bone pain with or without fever or objective swelling at the site. It is difficult to diagnose. Laboratory studies can be normal, whereas a biopsy reveals sterile osteomyelitis. Osteolytic or sclerotic bone changes may be seen on radiographs. However, MRI is more sensitive for detecting CNO and is considered the gold standard for monitoring the disease...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031497/scleroderma-in-children-and-adolescents-localized-scleroderma-and-systemic-sclerosis
#8
REVIEW
Suzanne C Li
Scleroderma is a rare disease that has two main forms: localized scleroderma (LS) and systemic sclerosis (SSc). Both are chronic diseases, can present in different patterns (subtypes), and are associated with extracutaneous involvement in pediatric patients. Morbidity and mortality is much worse for juvenile SSc with patients at risk for life-threatening lung, heart, and other visceral organ fibrosis and vasculopathy. Mortality is extremely rare in juvenile LS, but morbidity is common, with patients at risk for severe disfigurement and functional impairment...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031496/juvenile-idiopathic-inflammatory-myopathies
#9
REVIEW
Adam M Huber
The juvenile idiopathic inflammatory myopathies (JIIM) are a group of rare, chronic, autoimmune illnesses that affect muscle and, to a lesser extent, skin. The presence of new-onset weakness and, in juvenile dermatomyositis, typical rahes, should lead to consideration of these diagnoses. Careful evaluation to exclude alternative diagnoses is needed. Investigations include a variety of blood tests, imaging, and possibly muscle biopsy. Validated clinical assessments are available for monitoring. Standard treatment includes corticosteroids and methotrexate and often extends beyond 1 year...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031495/systemic-lupus-erythematosus-sj%C3%A3-gren-syndrome-and-mixed-connective-tissue-disease-in-children-and-adolescents
#10
REVIEW
Stacey E Tarvin, Kathleen M O'Neil
Juvenile systemic lupus erythematosus (jSLE), mixed connective tissue disease (jMCTD), and Sjögren syndrome (jSS) are systemic autoimmune and inflammatory disorders with distinct patterns of organ involvement. All are characterized by autoantibody formation, with antinuclear (ANA) and anti-double-stranded DNA common in jSLE, ANA with high-titer ribonucleoprotein antibody in jMCTD, and Sjögren syndrome A and Sjögren syndrome B antibodies + ANA in jSS. Recognition, monitoring, and management for primary care providers are discussed, focusing on the role of primary physicians in recognizing and helping maintain optimal health in children with these potentially life-threatening diseases...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031494/systemic-juvenile-idiopathic-arthritis
#11
REVIEW
Jennifer J Y Lee, Rayfel Schneider
Systemic juvenile idiopathic arthritis (sJIA) is a distinctive subtype of juvenile idiopathic arthritis, characterized by fever and arthritis, often accompanied by rash, sometimes by generalized lymphadenopathy, hepatosplenomegaly, and serositis. The diagnosis requires adequate exclusion of infectious, oncologic, autoimmune, and autoinflammatory diseases. Macrophage activation syndrome, a serious and potentially fatal complication of sJIA, requires prompt evaluation and treatment. Newer biologic agents, particularly interleukin-1 and interleukin-6 inhibitors, are highly effective and have transformed the treatment approach by reducing the use of systemic glucocorticoids...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031493/juvenile-spondyloarthritis-a-distinct-form-of-juvenile-arthritis
#12
REVIEW
Pamela F Weiss, Robert A Colbert
Juvenile spondyloarthritis (SpA) is a distinct form of juvenile arthritis characterized by male predominance and adolescent onset. Clinical manifestations include lower extremity and sacroiliac joint arthritis, enthesitis, and subclinical gastrointestinal inflammation. Juvenile SpA is an immune-mediated inflammatory disease long recognized as associated with HLA-B27, which may be related to the microbial environment as suggested by its coexistence with reactive arthritis and psoriasis. Treatment of peripheral arthritis includes nonsteroidal anti-inflammatory drugs, joint injections, and disease-modifying agents, whereas treatment of axial disease may necessitate a tumor necrosis factor inhibitor biologic agent...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031492/juvenile-idiopathic-arthritis-oligoarthritis-and-polyarthritis
#13
REVIEW
Courtney B Crayne, Timothy Beukelman
Juvenile idiopathic arthritis (JIA) comprises a group of heterogeneous diseases further divided into various categories based on shared clinical presentation, laboratory markers, and disease prognosis. Extra-articular complications include uveitis and growth abnormalities. Disease course and prognosis vary with respect to each JIA category and subsequently guide respective treatment. Over the past few decades, considerable treatment advances have significantly reduced the morbidity associated with childhood arthritis...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031491/pathogenesis-of-pediatric-rheumatologic-diseases
#14
REVIEW
Kathleen E Sullivan
The pathogenesis of pediatric rheumatologic conditions varies with the specific disorder; however, certain commonalities are seen: altered migration of cells into tissues, production of inflammatory mediators, and enhanced activation of cells. Autoantibodies signal loss of tolerance and B and T cells may be seen on pathologic evaluation. Neutrophils are commonly observed in tissues for many diseases and are recruited through the activation of endothelial cells. These cellular infiltrates define the inflammatory response character and in some cases provide a therapeutic framework...
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30031490/the-approach-to-the-child-with-joint-complaints
#15
REVIEW
Kathleen A Haines
This article focuses on creating an orderly approach to history taking, examination, and ordering appropriate investigations when caring for a child with joint complaints. It classifies complaints as those with and without pain, swelling, or fever and of short or long duration. It recommends an approach to the physical examination and both suggests and discourages various laboratory and imaging studies.
August 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29803288/benign-hematology
#16
EDITORIAL
Michael U Callaghan
No abstract text is available yet for this article.
June 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29803287/living-up-to-its-name-advances-in-benign-hematology
#17
EDITORIAL
Bonita F Stanton
No abstract text is available yet for this article.
June 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29803286/management-of-epistaxis-in-children-and-adolescents-avoiding-a-chaotic-approach
#18
REVIEW
Peter Svider, Khashayar Arianpour, Sean Mutchnick
This article provides an organized foundation that facilitates the management of acute epistaxis and an understanding of features that merit further diagnostic workup. Prompt management, including measures such as holding pressure and using nasal packing, takes precedence over comprehensive diagnostic workup. Severe, recurrent, and posteriorly based bleeds should prompt consideration of alternate interventions and expert consultation.
June 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29803285/acquired-aplastic-anemia-what-have-we-learned-and-what-is-in-the-horizon
#19
REVIEW
Süreyya Savaşan
Acquired aplastic anemia (aAA) characterized by peripheral pancytopenia and bone marrow aplasia is a rare and serious disorder. Differential diagnosis includes constitutional bone marrow failure syndromes and myelodysplastic disorders. Autoimmune reaction to altered hematopoietic stem cells highlights the underlying mechanism. Matched related donor allogeneic hematopoietic stem cell transplantation is the ideal pediatric treatment; alternative approaches include immunosuppressive therapy and use of eltrombopag...
June 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29803284/red-blood-cell-enzyme-disorders
#20
REVIEW
Rachael F Grace, Bertil Glader
Mature red blood cells are reliant on the glycolytic pathway for energy production and the hexose monophosphate shunt for cell protection from oxidative insults. The most common red blood cell enzyme disorders are characterized by hemolysis but with wide clinical variability. Glucose-6-phosphate dehydrogenase deficiency is the most common red cell enzyme disorder worldwide. Frequent clinical presentations include neonatal jaundice and episodic hemolysis after exposure to oxidative stress. Symptoms of pyruvate kinase deficiency and other glycolytic enzyme disorders include neonatal jaundice, chronic hemolytic anemia, gallstones, and transfusion-related and transfusion-independent iron overload...
June 2018: Pediatric Clinics of North America
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