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Current Opinion in Pediatrics

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https://www.readbyqxmd.com/read/28323666/febrile-infant-update
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28306628/pediatric-spinal-cord-injury-without-radiographic-abnormality-in-the-era-of-advanced-imaging
#10
Caitlin A Farrell, Megan Hannon, Lois K Lee
PURPOSE OF REVIEW: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. RECENT FINDINGS: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28134707/low-milk-supply-and-the-pediatrician
#11
Sarah W Riddle, Laurie A Nommsen-Rivers
PURPOSE OF REVIEW: Human milk is the optimal food for human infants, and provides many diverse and well described benefits for both mother and infant. Low milk supply, whether perceived or actual, is one of the most common reasons why mothers stop breastfeeding. Breastfeeding mothers often seek out the guidance and support of their pediatrician in evaluating and resolving milk production concerns. RECENT FINDINGS: Recent evidence supports the importance of breastfeeding for maternal and child health in both developing and developed countries...
January 27, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28134706/big-and-disparate-data-considerations-for-pediatric-consortia
#12
Jeanette A Stingone, Nancy Mervish, Patricia Kovatch, Deborah L McGuinness, Chris Gennings, Susan L Teitelbaum
PURPOSE OF REVIEW: Increasingly, there is a need for examining exposure disease associations in large, diverse datasets to understand the complex determinants of pediatric disease and disability. Recognizing that children's health research consortia will be important sources of big data, it is crucial for the pediatric research community to be knowledgeable about the challenges and opportunities that they will face. The present review will provide examples of existing children's health consortia, highlight recent pooled analyses conducted by children's health research consortia, address common challenges of pooled analyses, and provide recommendations to advance collective research efforts in pediatric research...
January 27, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28107209/nephropathic-cystinosis-an-update
#13
Koenraad R Veys, Mohamed A Elmonem, Fanny O Arcolino, Lambertus van den Heuvel, Elena Levtchenko
PURPOSE OF REVIEW: Over the past few decades, cystinosis, a rare lysosomal storage disorder, has evolved into a treatable metabolic disease. The increasing understanding of its pathophysiology has made cystinosis a prototype disease, delivering new insights into several fundamental biochemical and cellular processes. RECENT FINDINGS: In this review, we aim to provide an overview of the latest advances in the pathogenetic, clinical, and therapeutic aspects of cystinosis...
January 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28107208/environment-susceptibility-windows-development-and-child-health
#14
Robert O Wright
PURPOSE OF REVIEW: To illustrate the role of the exposome in child health while highlighting unique aspects of this research pertinent to children, such as the time dependency of environmental exposures on fetal programming, as well as the time-dependent nature of child behavior, diet, and motor function, which alter the probability of exposure to different compounds. Future environmental health research will be more hypothesis generating but will also need to heed lessons learned from other 'omic' sciences...
January 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28092283/inherited-disorders-of-tubular-transport
#15
Michel Baum
No abstract text is available yet for this article.
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28092282/neonatal-palliative-care
#16
Elvira Parravicini
PURPOSE OF REVIEW: A significant number of newborns are affected by life-limiting or life-threatening conditions. When prolongation of survival is no longer a goal, or prognosis is uncertain, a plan of care focused on the infant's comfort is essential. The aim of this article is to review the most recent and relevant literature regarding neonatal palliative care (NPC). RECENT FINDINGS: A variety of perinatal and NPC programs are described, but most programs focus exclusively on end-of-life care...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28092280/challenges-and-opportunities-to-enhance-global-drug-development-in-neonates
#17
Alexandra M Smith, Jonathan M Davis
PURPOSE OF REVIEW: This study reviews the history of neonatal drug development, recent legislative efforts designed to facilitate the study of therapeutic agents in neonates, and future steps necessary to advance drug development. RECENT FINDINGS: Although many federal regulations have been introduced over the past 15 years to encourage pediatric and neonatal drug development, the majority of medications that are used in the Neonatal Intensive Care Unit are not approved by the Food and Drug Administration (FDA) for use in neonates...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28085684/continuous-noninvasive-monitoring-in-the-neonatal-icu
#18
Rakesh Sahni
PURPOSE OF REVIEW: Standard hemodynamic monitoring such as heart rate and systemic blood pressure may only provide a crude estimation of organ perfusion during neonatal intensive care. Pulse oximetry monitoring allows for continuous noninvasive monitoring of hemoglobin oxygenation and thus provides estimation of end-organ oxygenation. This review aims to provide an overview of pulse oximetry and discuss its current and potential clinical use during neonatal intensive care. RECENT FINDINGS: Technological advances in continuous assessment of dynamic changes in systemic oxygenation with pulse oximetry during transition to extrauterine life and beyond provide additional details about physiological interactions among the key hemodynamic factors regulating systemic blood flow distribution along with the subtle changes that are frequently transient and undetectable with standard monitoring...
January 12, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28085683/oxygen-saturation-targeting-by-pulse-oximetry-in-the-extremely-low-gestational-age-neonate-a-quixotic-quest
#19
James J Cummings, Satyan Lakshminrusimha
PURPOSE OF REVIEW: A collaboration of comparative effectiveness research trials of pulse oximeter saturation (SpO2) targeting in extremely low-gestational-age neonates have begun to report their aggregate results. We examine the results of those trials, collectively referred to as the Neonatal Oxygenation Prospective Meta-analysis or NeOProM. We also discuss the uncertainties that remain and the clinical challenges that lie ahead. RECENT FINDINGS: The primary outcome from NeOProM was a composite of death or disability at 18-24 months corrected age...
January 12, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28059902/does-quality-improvement-work-in-neonatology-improve-clinical-outcomes
#20
Dan L Ellsbury, Reese H Clark
PURPOSE OF REVIEW: Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. RECENT FINDINGS: Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants...
January 5, 2017: Current Opinion in Pediatrics
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