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Current Opinion in Pediatrics

Paolo Versacci, Duccio Di Carlo, Maria C Digilio, Bruno Marino
PURPOSE OF REVIEW: In the last 40 years, with a better understanding of cardiac defects, and with the improved results of cardiac surgery, the life expectancy of persons with Down syndrome has significantly increased. This review article reports on advances in knowledge of cardiac defects and cardiovascular system of persons with trisomy 21. RECENT FINDINGS: New insights into the genetics of this syndrome have improved our understanding of the pathogenetic mechanisms of cardiac defects...
July 14, 2018: Current Opinion in Pediatrics
Aakash Goyal
PURPOSE OF REVIEW: Eosinophilic esophagitis (EoE) is a relatively new disease but its understanding is evolving over a period of time. This review highlights recent advances in the understanding of pathophysiology, diagnostic modalities, short and long-term goals of therapy and novel therapeutic agents. RECENT FINDINGS: The prevalence of EoE is increasing. Upper endoscopy and biopsy remains the gold standard for diagnosing EoE but less invasive and more cost-effective testing has been under investigation...
July 14, 2018: Current Opinion in Pediatrics
Tanja Gonska
PURPOSE OF REVIEW: Genetic mutations are the primary cause for acute recurrent (ARP) and chronic pancreatitis in children. Further, our medical approach for many diseases is changing from a one-drug therapy to more individualized therapeutic strategies. In respect to the therapeutic management of ARP/chronic pancreatitis, this entails an understanding of the individual, mainly genetic, risk factors that led to pancreatitis disease. RECENT FINDINGS: New pancreatitis-associated genes are continuously emerging from increasingly large genetic cohort studies...
July 14, 2018: Current Opinion in Pediatrics
Andrea Volpe, Georgina Malakounides
PURPOSE OF REVIEW: A practical guide to different feeding tubes available for nutritional support in children, focused on indications, placement methods and complications. RECENT FINDINGS: Enteral nutritional support refers to the delivery of nutrition into the gastrointestinal tract distal to the oesophagus. Different feeding tubes are available for exclusive or supplemental nutritional support in children who are unable to independently sustain their own growth, nutritional and hydration status...
July 12, 2018: Current Opinion in Pediatrics
Talya Miller, David L Suskind
PURPOSE OF REVIEW: Nutritional interventions play a central role in the treatment and management of inflammatory bowel disease (IBD) in children. Although malnutrition is a common presenting sign of IBD, nutritional interventions have focused not only on correction of the malnourished state but also on treatment of the primary disease. RECENT FINDINGS: Exclusive enteral nutrition (EEN) has been the primary therapy utilized in pediatric IBD specifically, Crohn's disease...
July 12, 2018: Current Opinion in Pediatrics
Daniel Bernstein
No abstract text is available yet for this article.
July 3, 2018: Current Opinion in Pediatrics
Anastasia Harris, Lisa R Letourneau, Siri Atma W Greeley
PURPOSE OF REVIEW: Monogenic forms of diabetes have received increased attention and genetic testing is more widely available; however, many patients are still misdiagnosed as having type 1 (T1D) or type 2 diabetes. This review will address updates to monogenic diabetes prevalence, identification, treatment, and genetic testing. RECENT FINDINGS: The creation of a T1D genetic risk score and the use of noninvasive urinary C-peptide creatinine ratios have provided new tools to aid in the discrimination of possible monogenic diabetes from likely T1D...
May 24, 2018: Current Opinion in Pediatrics
Frinny Polanco Walters, Susan Hayden Gray
PURPOSE OF REVIEW: This review provides support for promoting the sexual health of adolescents and young adults with developmental disabilities, and particularly those with intellectual disabilities. It offers guidance for pediatricians on incorporating counseling on sexuality and reproductive healthcare, socially appropriate behavior, and sexual abuse prevention for adolescents and young adults with developmental disabilities into healthcare visits. Additionally, it provides resources for developmentally appropriate sexuality education in the home and community to allow access to the comprehensive sexual and reproductive healthcare patients deserve...
May 24, 2018: Current Opinion in Pediatrics
Emily Pluhar, Rebecca H Lois, Elvin Thomaseo Burton
PURPOSE OF REVIEW: This review summarizes the recent literature examining nonsuicidal self-injury (NSSI) in adolescents, with a particular focus on how primary care pediatricians (PCPs) might assess and intervene as a common first point of contact. This NSSI review is timely and relevant, given the prevalence rates among adolescents, as well as its link to suicidal behaviors. RECENT FINDINGS: NSSI is most prevalent among adolescents, with lifetime prevalence rates between 17 and 60%...
May 24, 2018: Current Opinion in Pediatrics
Youn Hee Jee, Jeffrey Baron, Ola Nilsson
PURPOSE OF REVIEW: Genome-wide approaches including genome-wide association studies as well as exome and genome sequencing represent powerful new approaches that have improved our ability to identify genetic causes of human disorders. The purpose of this review is to describe recent advances in the genetic causes of short stature. RECENT FINDINGS: In addition to SHOX deficiency which is one of the most common causes of isolated short stature, PAPPA2, aggrecan, C-natriuretic peptide, C-type natriuretic peptide (CNP), NPR2 (CNP receptor), protein tyrosine phosphatase, non-receptor type 11(PTPN11) (and other rasopathies), Fibrillin 1 (FBN1), IHH and BMP2 have been identified in isolated growth disorders with or without other mild skeletal findings...
May 18, 2018: Current Opinion in Pediatrics
Stephanie Sayres, Lisa Visentin
PURPOSE OF REVIEW: The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend exclusive breastfeeding for 6 months after an infant is born. Although the recommendations are well known, mothers face barriers that make breastfeeding difficult. This article reviews the recent literature on barriers to breastfeeding as well as strategies for pediatricians to use to help women overcome them. RECENT FINDINGS: The mode of delivery, mother's socioeconomic status, return to work, and prenatal breastfeeding education have been reported as factors that influence breastfeeding...
May 17, 2018: Current Opinion in Pediatrics
Shannon Fitzgerald, Amy DiVasta, Holly Gooding
PURPOSE OF REVIEW: Polycystic ovarian syndrome (PCOS) is a common endocrinopathy which can be difficult to treat in adolescents. Fortunately, early identification and treatment can help mitigate some of the metabolic complications. In this review, we reflect on recent literature regarding PCOS diagnosis, associated complications, and treatment options. RECENT FINDINGS: Although there are three well known criteria to diagnose PCOS, they can be difficult to translate to adolescence...
May 17, 2018: Current Opinion in Pediatrics
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
May 15, 2018: Current Opinion in Pediatrics
Jia Zhu, Temitope O Kusa, Yee-Ming Chan
PURPOSE OF REVIEW: To summarize advances in the genetics underlying variation in normal pubertal timing, precocious puberty, and delayed puberty, and to discuss mechanisms by which genes may regulate pubertal timing. RECENT FINDINGS: Genome-wide association studies have identified hundreds of loci that affect pubertal timing in the general population in both sexes and across ethnic groups. Single genes have been implicated in both precocious and delayed puberty...
May 15, 2018: Current Opinion in Pediatrics
Ramrada Lekwuttikarn, Joyce M C Teng
PURPOSE OF REVIEW: Childhood malnutrition is a major global health issue. It is often thought of as a developing world problem and therefore, underdiagnosed or misdiagnosed in developed countries. The delay in diagnosis and treatment can lead to increased morbidity and mortality. Cutaneous manifestations are often the initial presenting signs of nutritional deficiency. Early recognition is essential in timely initiation of the necessary interventions. This article will review pertinent cutaneous findings and systemic manifestations associated with common nutritional deficiencies...
May 15, 2018: Current Opinion in Pediatrics
Kristin Dayton, Jennifer Miller
PURPOSE OF REVIEW: Genetic obesity is responsible for up to 7% of severe childhood obesity. Although current Pediatric Endocrine Society guidelines recommend assessment of children with early-onset morbid obesity and hyperphagia for underlying genetic disorders, a vast majority of patients are not being appropriately screened for genetic obesity syndromes. RECENT FINDINGS: With advances in genetic testing, more genetic causes of obesity are being identified. Treatments are likely to be individualized, depending on the cause of the obesity, and must be targeted at addressing the underlying cause...
May 15, 2018: Current Opinion in Pediatrics
Joseph M Lam
PURPOSE OF REVIEW: An opportunistic mycosis is a fungal agent of low pathogenicity that specifically infects immunocompromised hosts. Advances in transplantation, preterm care, immunosuppressive therapies and intensive care, have lead to the emergence of pediatric patients with serious immunodeficiency who are vulnerable to nonpathogenic fungi. RECENT FINDINGS: The advent of the use of biologic agents in pediatric disease as well as the advances in care of preterm and immunosuppressed patients opens up a new cohort of patients at risk of opportunistic mycotic infections...
May 15, 2018: Current Opinion in Pediatrics
Laura M Hart, Georgina R Cox, Lucy Lees
PURPOSE OF REVIEW: Common adolescent mental disorders, such as depression, often go untreated and severely impact health and educational outcomes. The purpose of this review is to describe what is currently known about school-based mental health interventions and to describe a new intervention, Mental Health First Aid training. RECENT FINDINGS: Universal and selective prevention and treatment programmes have been widely evaluated, though population-level dissemination remains elusive...
May 15, 2018: Current Opinion in Pediatrics
Marcus Shaker, Robert G P Murray, Julianne A Mann
PURPOSE OF REVIEW: The skin barrier is a dynamic innate immune organ. This review summarizes the current understanding of how deficiencies associated with atopic dermatitis invite other atopic disorders of the allergic march. RECENT FINDINGS: Atopic dermatitis is characterized by skin barrier defects (such as mutations in filaggrin), intrinsic proallergic T-helper cell 2 immune dysregulation, and skin microbiome alterations. These factors promote the development of food allergy and asthma...
May 9, 2018: Current Opinion in Pediatrics
Sarah Pitts, Sara Forman
No abstract text is available yet for this article.
May 9, 2018: Current Opinion in Pediatrics
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