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Current Pediatric Reviews

Alícia Dorneles Dornelles, Lisiane Hoff Calegari, Lucian de Souza, Patrícia Ebone, Tiago Silva Tonelli, Clarissa Gutierrez Carvalho
BACKGROUND: The unlicensed (UL) and off-label (OL) prescription of medications is common in paediatrics and does not constitute negligent practice, since there is often no approved alternative. AIM: to determine the current frequency of UL and OL prescriptions in children from one month to 12 years of age in a paediatric inpatient unit (PIU). METHODS: Observational, prospective study, reviewing the prescriptions of all patients admitted to the PIU in a university hospital in a single week in August 2014 and a single week in January 2015...
November 12, 2018: Current Pediatric Reviews
Alexander K C Leung, Amy A M Leung, Alex H C Wong, Kam Lun Hon
BACKGROUND: Breath-holding spells are common, frightening, but fortunately benign events. Familiarity with this condition is important so that an accurate diagnosis can be made. OBJECTIVE: To familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of children with breath-holding spells. METHODS: A PubMed search was completed in Clinical Queries using the key term "breath-holding spells". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews...
November 12, 2018: Current Pediatric Reviews
Henry C Lin, Nagraj Kasi, J Antonio Quiros
IMPORTANCE Alpha1-antitrypsin (AAT) deficiency is a common, but underdiagnosed genetic condition, affecting 1 in 1500 individuals, which can present insidiously with liver disease in children. Although clinical practice guidelines exist for the management of AAT deficiency, especially with regards to pulmonary involvement, there are no published recommendations that specifically relate to the management of the liver disease and monitoring for lung disease associated with this condition, particularly in children...
November 12, 2018: Current Pediatric Reviews
Beatriz Corredor, Mehul Dattani, Chiara Gertosio, Mauro Bozzola
Clinician generally use the term "tall stature" to define a height more than two standard deviations above the mean for age and sex. In most cases, these subjects present with familial tall stature or a constitutional advance of growth which is diagnosed by excluding the other conditions associated with overgrowth. Nevertheless, it is critical to be able to identify situations in which tall stature or an accelerated growth rate indicate an underlying disorder. A careful physical evaluation allows the classification of tall patients into two groups: those with a normal appearance and those with an abnormal appearance including disproportion or dysmorphism...
November 4, 2018: Current Pediatric Reviews
Catalina Bazacliu, Josef Neu
NEC is a devastating disease that, once present, is very difficult to treat. In the absence of an etiologic treatment, preventive measures are required. Advances in decoding the pathophysiology of NEC are being made but a more comprehensive understanding is needed for the targeting of preventative strategies. A better definition of the disease as well as diagnostic criteria are needed to be able to specifically label a disease as NEC. Multiple environmental factors combined with host susceptibility appear to contribute to enhanced risks for developing this disease...
November 2, 2018: Current Pediatric Reviews
G De Bernardo, D Sordino, C De Chiara, M Riccitelli, F Esposito, M Giordano, A Tramontano
Necrotizing enterocolitis is the most common cause of the postnatal critical conditions and remains one of the dominant cause of newborns' death in Neonatal Intensive Care. The morbidity and mortality associated with necrotizing enterocolitis remains largely unchanged and the incidence of necrotizing enterocolitis continues to increase. There is no general agreement regarding the surgical treatment of the necrotizing enterocolitis. In this paper, we want to evaluate the results obtained in our centre from different types of necrotizing enterocolitis's surgical treatment and to analyse the role of traditional X-ray versus ultrasound doppler imaging in the evolutionary phases of necrotizing enterocolitis...
November 2, 2018: Current Pediatric Reviews
Laila M Sherief, Reda Sanad, Alaa ElHaddad, Adel Shebl, Elhamy R Abdelkhalek, Eman R Elsafy, Tamer H Hassan, Nelly Raafat, Naglaa M Kamal, Eman I Attia
Introduction: Subtle neurocognitive deficits have been recently observed in Acute Lymphoblastic Leukemia (ALL) survivors. Aim: We aim to assess the neurocognitive functions of ALL survivors who had been treated with chemotherapy only using two different protocols, and to identify treatment-related risk factors. Patients and Methods: We carried a multicenter study involving 3 pediatric oncology centers on 100 children who were treated for ALL. Fifty patients were treated by the modified Children’s Cancer Group (CCG) 1991 protocol with low dose methotrexate and 50 children were treated by Total XV protocol with high dose methotrexate...
October 31, 2018: Current Pediatric Reviews
Jose Joao Name, Andrea Rodrigues Vasconcelos, Cristina Valzachi Rocha Maluf
BACKGROUND: Iron deficiency anemia (IDA) is a major public health problem worldwide. Iron bisglycinate chelate (FeBC) and polymaltose iron (FeP) are used for the treatment of IDA and exhibit good tolerability with a low incidence of adverse effects. However, these compounds have important differences in their structures and bioavailability. OBJECTIVE: To compare the efficacy of oral supplementation with FeBC and FeP in anemic children. METHODS: In this double-blind study, children aged 1 to 13 years who were diagnosed with IDA were randomly divided into two groups: i) FeBC, supplemented with iron bisglycinate chelate, and ii) FeP, supplemented with polymaltose iron (3...
October 2, 2018: Current Pediatric Reviews
Mong Tieng Ee, Bernard Thebaud
While the survival of extremely premature infants improved over the past decades, the rate of complications - especially for bronchopulmonary dysplasia (BPD) - remains unacceptably high. Over the past 50 years, no safe therapy has had a substantial impact on the incidence and severity of BPD. This may stem from the multifactorial disease pathogenesis and the increasing lung immaturity. Mesenchymal stromal cells (MSCs) display pleiotropic effects and showed promising results in neonatal rodents in preventing or rescuing lung injury without adverse effects...
September 10, 2018: Current Pediatric Reviews
E N Kontomanolis, Z Fasoulakis
DEFINITION: Hydrops fetalis (HF) or fetal hydrops is identified as an abnormal interstitial collection of fluid in at least 2 or more compartments of the fetal torso (peritoneal cavity, pleura, and pericardium). An alternative definition discusses about liquor accumulation in two fetal anatomical areas or an effusion in one site and anasarca. BACKGROUND: Parvovirus B-19 is a common childhood illness; the virus can cause fetal anemia, non-immune fetal hydrops, and spontaneous abortion and might lead to fetal demise...
August 20, 2018: Current Pediatric Reviews
Hassib Chehade, Umberto Simeoni, Jean-Pierre Guignard, Farid Boubred
Cardiovascular and chronic kidney diseases are part of non-communicable chronic diseases, the leading causes of premature death worldwide. They are recognized as having early origins through altered developmental programming, due to adverse environmental conditions during development. Preterm birth is increasingly recognized as such an adverse factor. Rates of preterm birth have increased the last decades, however, with the improvement in perinatal and neonatal care, a growing cohort have survived to the neonatal period and are now entering adulthood...
August 13, 2018: Current Pediatric Reviews
Marina Colella, Alice Frerot, Aline Rideau Batista Novais, Olivier Baud
Fetal Growth Restriction (FGR) is one of the most common noxious antenatal conditions in humans, affecting 10% of all pregnancies, inducing a substantial proportion of preterm delivery and leading to a significant increase in perinatal mortality, neurological handicaps and chronic diseases in adulthood. This review summarizes the current knowledge about the postnatal consequences of FGR, with a particular emphasis on the long-term consequences on respiratory, cardiovascular and neurological structures and functions...
July 11, 2018: Current Pediatric Reviews
Natalia Cartledge, Susan Chan
Atopic dermatitis and food allergy are common conditions of childhood that are closely linked. 30% of children with moderate to severe eczema suffer from food allergy and can present with different types of reactions: immediate or IgE-mediated reactions, delayed or non-IgE-mediated eczematous flares, or a combination of the two. A detailed history is very important when approaching such patients. The presence of IgE-mediated symptoms warrants investigation and management requires avoidance of the culprit allergen, an emergency care plan and appropriate follow up...
June 12, 2018: Current Pediatric Reviews
Silvia Nastasio, Marco Sciveres, Lorenza Matarazzo, Giuseppe Maggiore
Autoimmune hepatitis is a rare inflammatory disease of the liver that most frequently affects children and young adults. It is a multifactorial disease of unknown etiology, characteristically progressive in nature, and if left untreated, may lead to cirrhosis and terminal liver failure. It has been known for several decades now that immunosuppressive treatment convincingly alters the outcome of most patients with autoimmune hepatitis and as such it should be started as soon as diagnosis is made. Primary goals of treatment are: normalization of hepatocellular function, extinction of the hepatic necroinflammatory process, and maintenance of a stable remission, thus preventing progression to cirrhosis and its complications...
May 16, 2018: Current Pediatric Reviews
Goetz Wehl, Markus Rauchenzauner
BACKGROUND AND OBJECTIVE: Melkersson Rosenthal syndrome (MRS) is a rare disorder of unknown etiology and comprises the triad: orofacial edema, recurrent facial paralysis and lingua plicata. In the current literature confusing heterogeneity exists, mixing together the historically grown terms cheilitis granulomatosa or granulomatous cheilitis, Melkersson Rosenthal syndrome and the umbrella term orofacial granulomatosis (OFG). METHODS: We provide a systematic review comprising all three disease entities of orofacial granulomatosis using the computerized database "Pubmed Medline" entering the key words "orofacial granulomatosis" (141 references), "Melkersson-Rosenthal syndrome" (207 references), "granulomatous cheilitis" or "cheilitis granulomatosa" (102 references) back to 1956...
May 14, 2018: Current Pediatric Reviews
Rachel de Boer, Ruth Chalmers
It is has been suggested that the prevalence of food allergy has increased over the last few decades with estimates now suggesting between 3.9-8% of children are food allergic (Kattan, 2016). Studies also suggest that rates of food allergy resolution are slowing, meaning more children are remaining allergic for longer (Sicherer et al, 2014). The mainstay of food allergy management is dietary exclusion of known food allergen/s. Exclusion diets are frequently difficult for patients and their families to manage and the literature highlights that they impact negatively on quality of life (Valentine et al, 2011) ...
May 14, 2018: Current Pediatric Reviews
Stiefel Gary, Sadreddini Helyeh, Luyt David
Food allergy is common in children. An accurate diagnosis remains a key element in order to instigate an effective management plan. Traditional management strategies have relied on a reactive approach, with allergen avoidance, management of accidental ingestion and monitoring for resolution. Active management of food allergies relies on strategies to prevent food allergy through early introduction of allergenic foods and anticipatory testing. With an established food allergy diagnosis, active management through modifying the natural history, and risk management strategies can be instigated...
May 8, 2018: Current Pediatric Reviews
Rejin Kebudi, Hande Kizilocak
Febrile neutropenia is one of the major acute side effects of intensive treatment in pediatric cancer, necessitating prompt initiation of empirical broad-spectrum antibiotics. Patients may be classified as low or high risk according some risk factors (duration of neutropenia, depth of neutropenia, type of cancer, state of disease, bone marrow involvement, type of treatment, additional health problems). Initial evaluation of the febrile neutropenic child should include the history of the child, a detailed physical examination, blood culture (peripheral and catheter), urinalysis and culture, cultures of lesions...
May 8, 2018: Current Pediatric Reviews
Tom Marrs, K Sim
The growing burden of food allergy is being driven by environmental exposures and the potential role of gut micro-organisms (or 'microbiota') is hotly debated. Early culture-based studies outlined that imbalances between commensal gut constituents ('dysbiosis') early in life may raise the risk of developing allergic disease. A number of studies using animal models describe mechanisms by which specific bacterial taxa within the gut microbiota, their diversity and dietary substrates such as fibre may promote oral tolerance...
May 7, 2018: Current Pediatric Reviews
Adam Fox, George du Toit, Ru-Xin Foong
It is well known that there is a common interplay between atopic conditions and that having one atopic condition can predispose to the development of others. The link between asthma and food allergy has been well researched over the years; although the exact interplay between the two atopic conditions is yet to be fully described. Research suggests that children who have both asthma and food allergy are at greater risk of more severe asthmatic episodes. They are also at risk of food allergen triggered asthmatic episodes as well as food-allergen induced anaphylaxis...
May 7, 2018: Current Pediatric Reviews
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