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Current Pediatric Reviews

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https://www.readbyqxmd.com/read/28814249/the-neurological-sequelae-of-neonatal-hyperbilirubinemia-definitions-diagnosis-and-treatment-of-the-kernicterus-spectrum-disorders-ksds
#1
Steven Shapiro, Jean Baptiste Le Pichon, Sean M Riordan, Jon Watchkoe
Despite its lengthy history the study of benign jaundice, hyperbilirubinemia and kernicterus suffers from a lack of clarity and consistency in the key terms used to describe both the clinical and pathophysiological nature of these conditions. This has led to multiple terms being used to describe similar conditions (i.e. kernicterus and chronic bilirubin encephalopathy) or the same term being used to describe different concepts (i.e. BIND as a descriptor of the signs of bilirubin neurotoxicity, mild kernicterus, or as a scale to assess bilirubin toxicity)...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28814248/pediatric-abdominal-trauma
#2
Tim Lynch
Abdominal trauma is present in approximately 25% of pediatric patients with major trauma and is the most common cause of unrecognized fatal injury in children. Pediatric abdominal trauma is typically blunt in nature with the spleen being the most common organ injured. Non-operative management is employed in over 95% of patients. Penetrating injuries are less common but often require operative management. Knowledge of specific mechanisms of injury aids the clinician in the diagnosis of specific injuries. Computed tomography (CT) is the gold standard in the identification of intra-abdominal injury...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#3
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28814246/approach-to-pediatric-traumatic-brain-injury-in-the-emergency-department
#4
Gurinder Sangha
Traumatic Brain Injury is a major cause of morbidity and mortality in the pediatric population affecting millions of people yearly. It is important that practitioners have the knowledge and skills to care for these complicated patients, as the initial care can significantly affect the course of the injury. We discuss the initial management of traumatic brain injury based on mild, moderate and severe presentations. Management strategies to address Intracranial Pressure and Cerebral perfusion pressure, the use of oxygenation and ventilation strategies, temperature, correction of metabolic abnormalities and seizure care are discussed...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28782473/importance-of-hemolysis-and-its-clinical-detection-in-neonates-with-hyperbilirubinemia
#5
Ronald J Wong, Vinod K Bhutani, David K Stevenson
Neonatal hyperbilirubinemia is generally a benign transitional phenomenon, and may even be a protective antioxidant mechanism for human neonates who may be vulnerable to the oxidative stress (compared to life in utero) encountered during birth an extra-uterine oxidative environment (1, 2). The pathophysiologic impact of neonatal unconjugated hyperbilirubinemia has been well reviewed in this supplement (see Jon fill-in). The severity of hyperbilirubinemia varies due to the magnitude of an imbalance between two major contributing processes: (i) an increase bilirubin production rate due to an increase in heme turnover (two to three times that of an adult) due to the degradation of fetal red blood cells (RBCs), which have a shortened lifespan, after birth (3, 4); and/or (ii) a diminished ability of the immature newborn liver to conjugate bilirubin and therefore excrete bilirubin in bile...
August 7, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28745216/insights-in-developmental-coordination-disorder
#6
Marie Farmer, Bernard Echenne, Regen Drouin, M Hamed Bentourkia
BACKGROUND: Developmental Coordination Disorder (DCD) is a neurological impairment occurring in nearly 6% of general population, and sometimes mimics other developmental disorders like Attention Deficit Hyperactivity Disorder (ADHD) or, in the most severe cases, intellectual deficiency. OBJECTIVE: We propose in this review a contribution on this matter in order to provide better insights in DCD including clinical symptoms and pathophysiological explanations that would identify this entity from others...
July 26, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28721815/conjunctival-icterus-an-important-but-neglected-sign-of-clinically-relevant-hyperbilirubinemia-in-jaundiced-neonates
#7
Jon Freeman Watchko, Abeer Azzuqa
BACKGROUND: Conjunctival icterus is a largely neglected physical sign that may be helpful in identifying neonates with clinically relevant hyperbilirubinemia by practitioners in the hospital and outpatient clinic or parents at home. OBJECTIVE: A recent NICU based study reported that conjunctival icterus is often a sign of significant (TSB ≥ 17 mg/dl) hyperbilirubinemia and TSB levels ≥ 76th-95th percentile on the Bhutani nomogram. In contrast, others report that conjunctival icterus, although frequently present at high TSB levels, may also be detected at lower TSB concentrations; suggesting instead that its absence may help to rule out significant hyperbilirubinemia...
July 18, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28721814/refractory-causes-of-kernicterus-in-developed-countries-can-we-eradicate-g6pd-deficiency-triggered-and-low-bilirubin-kernicterus
#8
Jon Freeman Watchko
BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency triggered and low-bilirubin kernicterus persist despite current prevention strategies. OBJECTIVE: Efforts to eradicate bilirubin induced brain injury in these two conditions will require novel approaches to riskassessment and hyperbilirubinemia evaluation. METHOD: In the case of G6PD deficency, a heightenedawareness of populations at risk on who expanded kernicterus preventio strategies can befocused including intensified parental engagement, education and counselling on neonataljaundice...
July 18, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28721813/mechanisms-involved-in-the-increased-hemolysis-in-the-fetus-and-newborn
#9
Giuseppe Buonocore, Serafina Perrone, Rodolfo Bracci
BACKGROUND: The suicidal death of erythrocytes should be considered a possible cause of hemolysis and plasma bilirubin overload when there is no evidence of an immune-mediated hemolytic anemia, no consumptive red blood cell disorder, no morphologic or laboratory data to suggest a problem of the red cell membrane, and no evidence of a quantitative or qualitative defect in hemoglobin synthesis. OBJECTIVE: In neonatal period, xenobiotics, cytokines, osmotic shock, energy depletion, oxidative stress, and variation of temperature may induce an alteration of balance between damaging and protecting factors which can be followed by red cell death...
July 18, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28721812/update-on-phototherapy-in-jaundiced-neonates
#10
Finn Ebbesen, Thor Willy Ruud Hansen, M Jeffrey Maisels
BACKGROUND: Even relatively low serum bilirubin concentrations can cause neurodevelopmental impairment in extremely low birth weight (EBWL) infants, while sequelae from hyperbilirubinemia in late preterm and term infants are rare and occur only at very high serum bilirubin lev-els. Phototherapy is the current treatment of choice. OBJECTIVE: To present an update on the most important issues involved in phototherapy for jaundiced infants. RESULTS: Light absorption by bilirubin in the skin transforms the native Z,Z-bilirubin to conformational photoisomers Z,E-bilirubin and E,Z-bilirubin and structural photoisomers E,Z-lumirubin and E,E-lumirubin...
July 18, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28637400/impulse-oscillometry-system-and-anthropometric-variables-of-preschoolers-children-and-adolesctents-systematic-review
#11
Maíra Seabra De Assumpção, Emília da Silva Gonçalves, Marina Simões Oliveira, José Dirceu Ribeiro, Adyléia Aparecida Contrera Dalbo Toro, Antonio Azevedo Barros-Filho, Maria Ângela Reis Góes de Monteiro, Camila Isabel Santos Schivinski
BACKGROUND: To identify the anthropometric variables in equations/reference values of impulse oscillometry system (IOS) parameters in preschoolers, children and adolescents. METHOD: Systematic search on the databases MEDLINE/Ovid, SCOPUS and SciELO using the key words "preschool, child and adolescent", "impulse oscillometry", "reference values" and its variations. RESULTS: This review considered a total of 13 articles. The studies presented height, weight, sex and age as the variables correlated to oscillometric parameters...
June 21, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28641549/relevance-of-cat-and-dog-sensitization-by-skin-prick-testing-in-childhood-eczema-and-asthma
#12
Kam Lun E Lun Hon, Kathy Yin Ching Tsang, Ting Fan Leung
BACKGROUND: Household animal dander has been implicated as aeroallergen in childhood atopic diseases. Many parents seek healthcare advice if household pet keeping may be detrimental in atopic eczema (AE) and atopies. AIM: We investigated if skin sensitization by cat/dog dander was associated with disease severity and quality of life in children with AE. METHODS: Demographics, skin prick test (SPT) results, disease severity (Nottingham eczema severity score NESS), Children Dermatology Life Quality Index (CDLQI), blood IgE and eosinophil counts of a cohort of AE patients were reviewed...
June 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28641548/pediatric-cutaneous-graft-versus-host-disease-a-review
#13
Connie R Shi, Jennifer T Huang, Vinod E Nambudiri
BACKGROUND: Graft versus host disease (GVHD) is a significant complication following hematopoietic stem cell transplantation in the pediatric population. The most common clinical manifestation of GVHD is in the skin. This article will present a review of key concepts related to pediatric cutaneous GVHD, including pathophysiology, clinical epidemiology, diagnosis, and treatment options. GVHD is an immune-mediated process characterized by an inflammatory immune response in acute GVHD and mixed inflammatory and fibrotic states in chronic GVHD...
June 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28578641/emollient-acceptability-in-childhood-atopic-dermatitis-not-all-emollients-are-equal
#14
Kam Lun E Lun Hon, J S C Kung, K Y C Tsang, Jasmine W S Yu, Vivian W Lee, T F Leung
Background Eczema or atopic dermatitis (AD) is a common chronic relapsing skin disease associated with impaired quality of life. Regular usage of moisturizer/emollient is the mainstay of management but acceptability of emollient is often suboptimal. We investigated if emollient acceptability is influenced by various clinical factors in AD. METHODS: A survey on frequency of emollient usage, brands, clinical factors including disease severity (Nottingham Eczema Severity Score, NESS), quality of life (Children Dermatology Life Quality Index, CDLQI), transpidermal water loss (TEWL), and skin hydration (SH) was performed...
June 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#15
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28215177/cutaneous-changes-in-neonates-in-the-first-72-hours-of-birth-an-observational-study
#16
Nayantara R Gandra, Harshita B Reddy, Tina P Katta
BACKGROUND: Variation in neonatal skin changes and presentation is a frequent occurrence. We studied the pattern of cutaneous manifestations in new-borns <72 hours of birth. METHOD: We included all live babies delivered in our hospital; Babies were categorised according to age, birth weight and gestational age. Neonates were examined within 24 hrs of birth and daily for skin lesions for 72 hrs. Skin lesions were categorised into physiological, transient eruptions, due to infections, congenital anomalies and miscellaneous...
February 16, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28215176/the-comparison-the-serum-strem1-levels-between-children-with-upper-and-lower-uti
#17
Samileh Noorbakhsh, Fahime Ehsanipour, Vida Zarabi, Zahra Movahedi, Nahid Rahimzadeh
Back ground: UTI is a common and important clinical problem in Iranian children which is often difficult on clinical grounds. Distinguishing the upper UTI from lower UTI is very important for clinician. The aim of this study was to determine the usefulness of serum STREM-1 level in patients with UTI to find out if it can use for distinguishing upper UTI from lower UTI or not. METHODS: In this prospective cross sectional study (2010-2011) we compared the serum level of STREM-1 (pg. /ml) in 36 proven UTI cases (24 upper and 12 lower UTI ) with 25 normal children (without UTI) in Rasoul Akram hospital Tehran, Iran...
February 16, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28117009/update-on-predicting-severe-hyperbilirubinemia-and-bilirubin-neurotoxicity-risks-in-neonates
#18
Pearl W Chang, Thomas B Newman, M Jeffrey Maisels
Extreme hyperbilirubinemia and kernicterus, though rare, continue to occur despite the adoption of universal screening. Unless they are known to have glucose-6-phosphate dehydrogenase deficiency, infants who currently develop kernicterus in high resource countries are often otherwise healthy newborns discharged from the well-baby nursery. In this review, we highlight risk factors that increase the risk of a newborn ≥35 weeks gestational age developing severe hyperbilirubinemia, as well as the risk factors that increase the hyperbilirubinemic infant's risk of kernicterus...
January 23, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28088898/metabolomic-shifts-following-play-based-activity-in-overweight-preadolescents
#19
Marco Meucci, Carlo Baldari, Laura Guidetti, Jessica Renee Alley, Caorl Cook, Collier Robert Scott
BACKGROUND: Play-based activities can be a positive intervention to increase participation of overweight children. Metabolomics can reveal elemental shifts in the metabolome, lending potential mechanistic explanations behind improvements in physiological systems. OBJECTIVES: To elucidate dose-response urinary metabolomic signature shifts in overweight preadolescents following four or eight weeks of supervised play-based activity versus a typical summer break control group...
January 13, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28071585/newborn-bilirubin-screening-for-preventing-severe-hyperbilirubinemia-and-bilirubin-encephalopathy-a-rapid-review
#20
Kalpana Bhardwaj, Tiffany Locke, Anne Biringer, Allyson Booth, Elizabeth Kathleen Darling, Shelley Dougan, Jane Harrison, Stephen Hill, Ana Johnson, Susan Makin, Beth Potter, Thierry Lacaze-Masmonteil, Julian Little
hyperbilirubinemia [2], every newborn should be assessed for the risk of developing severe hyperbilirubinemia with the help of predischarge total serum bilirubin or transcutaneous bilirubin measurements and/or assessments of clinical risk factors. The aim of this rapid review is 1) to review the evidence for 1) predicting and preventing severe hyperbilirubinemia and bilirubin encephalopathy, 2) determining the efficacy of home/community treatments (home phototherapy) in the prevention of severe hyperbilirubinemia, and 3) non-invasive/transcutaneous methods for estimating serum bilirubin level...
January 10, 2017: Current Pediatric Reviews
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