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Current Opinion in Pediatrics

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https://www.readbyqxmd.com/read/28383342/the-children-s-health-exposure-analysis-resource-enabling-research-into-the-environmental-influences-on-children-s-health-outcomes
#1
David M Balshaw, Gwen W Collman, Kimberly A Gray, Claudia L Thompson
PURPOSE OF REVIEW: The Children's Health Exposure Analysis Resource (CHEAR) is a new infrastructure supported by the National Institute of Environmental Health Sciences to expand the ability of children's health researchers to include analysis of environmental exposures in their research and to incorporate the emerging concept of the exposome. RECENT FINDINGS: There is extensive discussion of the potential of the exposome to advance understanding of the totality of environmental influences on human health...
April 5, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28379928/impact-of-multidisciplinary-teams-for-management-of-intestinal-failure-in-children
#2
Christina Belza, Paul W Wales
PURPOSE OF REVIEW: To review the recent literature related to the impact of an intestinal rehabilitation program (IRP) on the management of intestinal failure in children. RECENT FINDINGS: As publication of a systematic review of pediatric IRPs in 2013, there have been four publications further describing the impact of IRPs in children with intestinal failure. The results continue to support an improvement in survival and enteral autonomy, and a decrease in complications related to liver dysfunction, central venous catheters, and transplantation...
April 4, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28379927/grandparents-raising-grandchildren-a-primer-for-pediatricians
#3
William Ge, Andrew Adesman
PURPOSE OF REVIEW: To provide clinicians with a review of key considerations relating to the physical and behavioral well-being of children raised by their grandparents. RECENT FINDINGS: As the number of children being raised by their grandparents in the United States steadily increases, the needs of these families require greater attention. These children and their custodial grandparents face unique health, social, legal, and financial challenges. Children being raised by their grandparents are at higher risk for developmental and behavioral problems because of prior or current adverse family environments...
April 4, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28362667/implementation-strategies-in-pediatric-neurocritical-care
#4
Christopher Markham, Enola K Proctor, Jose A Pineda
PURPOSE OF REVIEW: Brain-directed critical care for children is a relatively new area of subspecialization in pediatric critical care. Pediatric neurocritical care teams combine the expertise of neurology, neurosurgery, and critical care medicine. The positive impact of delivering specialized care to pediatric patients with acute neurological illness is becoming more apparent, but the optimum way to implement and sustain the delivery of this is complicated and poorly understood. We aim to provide emerging evidence supporting that effective implementation of pediatric neurocritical care pathways can improve patient survival and outcomes...
March 30, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28346272/influenza-in-children
#5
Janienne Kondrich, Michele Rosenthal
PURPOSE OF REVIEW: We review the current information and evidence available on the global burden of disease in the pediatric population, clinical presentation and complications, testing, treatment, and immunization. RECENT FINDINGS: In addition to multiple other risk factors for influenza complications, children with neurologic and neuromuscular disorders are significantly higher risk for serious complications. In practice, there is no lower age limit for children with influenza who can be treated with oseltamivir...
March 24, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28338489/pediatric-pulmonary-medicine-then-and-next
#6
David N Cornfield
No abstract text is available yet for this article.
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28338488/respiratory-complications-management-and-treatments-for-neuromuscular-disease-in-children
#7
MyMy C Buu
PURPOSE OF REVIEW: To summarize current literature describing the respiratory complications of neuromuscular disease (NMD) and the effect of respiratory interventions and to explore new gene therapies for patients with NMD. RECENT FINDINGS: Measurements of respiratory function focus on vital capacity and maximal inspiratory and expiratory pressure and show decline over time. Management of respiratory complications includes lung volume recruitment, mechanical insufflation-exsufflation, chest physiotherapy and assisted ventilation...
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28338487/the-evolution-of-disease-chronic-lung-disease-of-infancy-and-pulmonary-hypertension
#8
Michael C Tracy, David N Cornfield
PURPOSE OF REVIEW: Bronchopulmonary dysplasia (BPD) or chronic lung disease of infancy BPD was originally described 50 years ago, in 1967 by Northway et al. This article possesses two fundamental objectives to provide: a brief historical perspective on BPD; and an update relative to current notions of epidemiology, pathophysiology, evaluation, and clinical management of BPD complicated by vascular disease. The review highlights areas of consensus and ongoing uncertainty. RECENT FINDINGS: The clinical cause and presentation of infants with BPD has evolved over the past several decades...
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28333695/pulmonary-manifestations-of-rheumatologic-diseases
#9
Michal Cidon, Manvi Bansal, Dominik Hartl
PURPOSE OF REVIEW: The present review intends to provide an overview of the diversity and complexity of pulmonary manifestations of rheumatologic diseases and gaps in knowledge to effectively manage them. RECENT FINDINGS: Diffuse lung disease in children with rheumatologic diseases represents a heterogeneous group of autoimmune disorders. Despite their significant morbidity and mortality, we have limited understanding about their pathogenesis. Here, we provide an overview of the pathophysiology and current management approach of these disorders, highlighting tools which assist with diagnosis, risk stratification and therapy...
March 22, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28333694/high-flow-nasal-cannula-therapy-beyond-the-perinatal-period
#10
Michael Lee, Joshua Nagler
PURPOSE OF REVIEW: High-flow nasal cannula (HFNC) is emerging as a means of oxygen delivery and respiratory support for a range of conditions outside the perinatal period. We aim to review the mechanisms of action and advantages of HFNC and to summarize current findings regarding clinical benefit in specific pediatric disease processes and in patients with significant respiratory distress. RECENT FINDINGS: Currently published studies outside the neonatal population demonstrate both safety and efficacy of this mode of respiratory support...
March 22, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28333693/pediatric-intestinal-failure-associated-liver-disease
#11
Cathleen M Courtney, Brad W Warner
PURPOSE OF REVIEW: The goal of this review is to provide updates on the definition, pathophysiology, treatment, and prevention of intestinal failure-associated liver disease (IFALD) that are relevant to care of pediatric patients. RECENT FINDINGS: Current literature emphasizes the multifactorial nature of IFALD. The pathogenesis is still largely unknown; however, molecular pathways have been identified. Key to these pathways are proinflammatory cytokines involved in hepatic inflammation and bile acids synthesis such as Toll-like receptor 4 and farnesoid X receptor, respectively...
March 22, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28323666/febrile-infant-update
#12
Kate Dorney, Richard G Bachur
PURPOSE OF REVIEW: The approach to febrile young infants remains challenging. This review serves as an update on the care of febrile infants less than 90 days of age with a focus on the changing epidemiology of serious bacterial infection (SBI), refinement of management strategies based on biomarkers, and the development of novel diagnostics. RECENT FINDINGS: There is high variability in the emergency department management of febrile young infants without significant differences in outcomes...
March 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#13
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
March 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319562/translating-biomarkers-from-research-to-clinical-use-in-pediatric-neurocritical-care-focus-on-traumatic-brain-injury-and-cardiac-arrest
#14
Andrew J Prout, Michael S Wolf, Ericka L Fink
PURPOSE OF REVIEW: Traumatic brain injury (TBI) and cardiac arrest are important causes of morbidity and mortality in children. Improved diagnosis and outcome prognostication using validated biomarkers could allow clinicians to better tailor therapies for optimal efficacy. RECENT FINDINGS: Contemporary investigation has yielded plentiful biomarker candidates of central nervous system (CNS) injury, including macromolecules, genetic, inflammatory, oxidative, and metabolic biomarkers...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319561/pediatric-enteric-neuropathies-diagnosis-and-current-management
#15
Maggie L Westfal, Allan M Goldstein
PURPOSE OF REVIEW: Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. RECENT FINDINGS: The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319560/rash-diagnostics-an-update-on-the-diagnosis-of-allergic-rashes
#16
Corinne Savides Happel
PURPOSE OF REVIEW: The purpose of this review is to summarize recent research regarding the diagnosis of allergic rashes and to suggest future directions for the promotion of accurate diagnosis and endotype specification. RECENT FINDINGS: Multiple cohort studies demonstrate that with appropriate clinical evaluation, drug allergy labels can be removed in up to 90% of cases. Genetic tests can predict severe adverse cutaneous drug reactions in some cases and in vitro tests are being sought to identify causative drugs in others...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319559/pediatric-solid-tumors-in-africa-different-biology
#17
John K M Nyagetuba, Erik N Hansen
PURPOSE OF REVIEW: To review the recent literature regarding biologic characteristics of pediatric solid tumors in African children. RECENT FINDINGS: Data regarding pediatric solid tumors in Africa, while increasing, remain sparse when considering the ethnic and geographic diversity of the continent. Recent work, especially regarding nephroblastoma in Kenya, has identified some biologic variability among local tribes but also when compared with North American tumors...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#18
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306630/nonoperative-management-of-appendicitis-in-children
#19
Joseph J López, Katherine J Deans, Peter C Minneci
PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy. RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306629/management-of-acute-asthma-exacerbations
#20
Erin K Stenson, Michael J Tchou, Derek S Wheeler
PURPOSE OF REVIEW: Herein, we review the current guidelines for the management of children with an acute asthma exacerbation. We focus on management in the emergency department, inpatient, and ICU settings. RECENT FINDINGS: The most recent statistics show that the prevalence of asthma during childhood has decreased in certain demographic subgroups and plateaued in other subgroups. However, acute asthma accounts for significant healthcare expenditures. Although there are few, if any, newer therapeutic agents available for management of acute asthma exacerbations, several reports leveraging quality improvement science have shown significant reductions in costs of care as well as improvements in outcome...
March 16, 2017: Current Opinion in Pediatrics
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