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Current Pediatric Reviews

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https://www.readbyqxmd.com/read/29422005/the-role-of-point-of-care-ultrasound-in-the-injured-paediatric-patient
#1
Victor Istasy, Drew Thompson, Mirielle Gharib, Rodrick Lim
The focus of this review is to examine the current state of paediatric Point of Care Ultrasound (POCUS) in the injured patient. POCUS has become useful across various medical specialties owing to its ease of use, reproducibility and non-ionizing qualities. Point of care ultrasound has advanced over the past years and has proven to be an extremely useful adjunct in the injured child. Discussion will center around the challenges on when and how to best utilize POCUS. This includes but is not limited to: detection of peritoneal free fluid, pneumothoraces, hemothoraces, pericardial effusions, a wide array of fractures, lung contusions and many other applications...
February 1, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29380702/biological-and-genetic-features-of-neuroblastoma-and-their-clinical-importance
#2
Nevim Aygun
Neuroblastoma derived from primitive cells of the sympathetic nervous system typically develops in the adrenal medulla or paraspinal ganglia. Neuroblastoma usually occurs sporadically, but familial cases are also observed. ALK and PHOX2B germline mutations can cause hereditary neuroblastoma, while a common genetic variation in chromosome 6p22 is associated to sporadic neuroblastoma. However, the aetiology of sporadic neuroblastoma is not exactly known. This embryonic malignancy generally represents the second most common solid tumour after central nervous system tumours throughout the world in childhood...
January 28, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29366421/radial-polydactyly-what-s-new
#3
Laura M Perez-Lopez, Diego Gutierrez-de la Iglesia, Marisa Cabrera-Gonzalez
Thumb duplication, also called radial or preaxial polydactyly, is classified as an alteration of the radio-ulnar axis (anterior-posterior) in the formation and differentiation of the hand plate, according to the Oberg, Manske and Tonkin classification. Polydactyly is the most frequently observed congenital hand malformation. Radial polydactyly is reported as the most frequent type of hand polydactyly in Caucasians, and it is also relatively frequent in American and Asian patients. The incidence of radial polydactyly is 1 in every 3,000 live births...
January 23, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29366420/predictors-of-non-alcoholic-liver-disease-in-ethnically-diverse-overweight-children-and-adolescents
#4
Pamela Botero
OBJECTIVES: To study the relationship between non-alcoholic fatty liver disease (NAFLD) and sleep, physical activity (PA), and screen-time habits/behaviors among a multiethnic sample of overweight children/adolescents. METHODS: A retrospective medical chart review (6/2013-7/2014) identified 209 patients (7-21 years old) who were overweight/obese (BMI > 85th% for age/sex). A follow-up telephone survey was completed among 130 of these patients' parents to obtain information on sleep, screen-time, PA habits, and socio-demographics...
January 23, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29366419/iron-supplementation-with-iron-sulfate-versus-iron-bisglycinate-chelate-in-preterm-newborns
#5
Rossana Bagna, Elena Spada, Raffaella Mazzone, Paola Saracco, Tatiana Boetti, Elena Andrea Cester, Enrico Bertino, Alessandra Coscia
BACKGROUND: Strategies to prevent anaemia in preterm newborns include drawing fewer blood samples, the use of recombinant human erythropoietin and iron supplementation. Although iron sulphate is the most commonly used pharmaceutical formulation for iron supplementation, there are few studies comparing different iron salts in newborns. OBJECTIVE: To compare the efficacy of iron bisglycinate chelate to iron sulfate in preterm newborns receiving erythropoietin. SUBJECTS AND METHODS: Three-hundred newborns of gestational age ≤32 weeks were enrolled: 225 were supplemented with iron sulfate (3 mg/kg/day) and 75 were supplemented with iron bisglycinate chelate (0...
January 23, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29345597/pediatric-markers-of-adult-cardiovascular-disease
#6
Micah Olson, Melissa Chambers, Gabe Shaibi
Cardiovascular disease (CVD) is the leading cause of mortality in the United States . Atherosclerotic CV events do not occur until adulthood, except in the context of rare genetic disorders such as homozygous familial hypercholesterolemia. However, the atherogenic process that leads to CVD begins in childhood and progresses throughout the lifespan . The degree of atherosclerosis early in life is associated with established risk factors for CVD (e.g. family history, obesity, dyslipidemia), indicating that the development and progression of atherosclerosis in childhood is driven by genetic as well as environmental factors...
January 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29345596/the-coronary-artery-risk-detection-in-appalachian-communities-cardiac-project-an-18-year-review
#7
Eloise Elliott, Christa Lilly, Emily Murphy, Lee A Pyles, Lesley Cottrell, William A Neal
The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project is a chronic disease risk factor surveillance, intervention, and research initiative aimed at combating the unacceptably high prevalence of heart disease, diabetes, and other chronic illnesses in West Virginia. The initial goal of the CARDIAC Project when it was implemented in elementary schools in West Virginia during the 1998-1999 school year was to identify dyslipidemic children and their parents, and apply novel intervention strategies...
January 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29345595/hospital-management-of-severe-hypertriglyceridemia-in-children
#8
Ambika Ashraf, Badhma Valaiyapathi
Severe hypertriglyceridemia (HTG), i.e., triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines for treatment of children and adolescents with severe HTG. Management often includes hospital admission, fasting followed by fat free diet until the triglyceride (TG) levels are below 1000 mg/dL. Insulin infusion lowers TG levels in patients, especially in those with diabetes. Plasmapheresis is a limited option due to its restricted availability and scarcity of studies on its efficacy and safety in children...
January 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29332588/treatment-strategies-for-hypercholesterolemia
#9
Sarah Clauss, Jacob Hartz
Atherosclerotic disease is a leading cause of morbidity and mortality in adults and is generally thought of as only affecting adults. However, the pathologic changes in vessels leading to atherosclerosis, and an increased risk of cardiovascular disease, have been shown to begin in early adolescence. There is a growing body of literature suggesting that earlier treatment, through lifestyle changes and pharmacotherapy, can help reduce this risk.
January 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29332587/lysosomal-acid-lipase-deficiency-could-dyslipidemia-drive-the-diagnosis
#10
Ornella Guardamagna, Federica Guaraldi
LAL-deficiency (LAL-D) is a rare and systemic condition, secondary to LIPA gene mutations, responsible for lysosomal accumulation of cholesteryl esters and triglycerides, whose manifestations are very heterogeneous in terms of age of onset, severity and type of clinical and radiological manifestations. Dyslipidemia, hepatomegaly and hepatosteatosis with increased levels of transaminases are the most common features. The increased risk of premature atherosclerosis and cardiovascular disorders,, secondary to a generalized alteration of lipid profile and lipoprotein dysfunction associated with LAL-D, has been increasingly pointed out...
January 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29149811/withdrawn-testing-actions-of-a-multi-action-emollient-patient-acceptability-efficacy-skin-biophysiology-and-staphylococcal-isolation
#11
Kam Lun E Lun Hon
Article withdrawn by the publisher.
November 16, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29032759/predictable-and-preventable-historical-and-current-efforts-to-improve-child-injury-prevention
#12
Karen E Forward, Rod Lim, Eman Loubani
Childhood injuries are a global epidemic. Accidents resulting in childhood injury and death were first identified as a concern over a century ago. However, "accidents" leading to injury were not recognized as being predictable and preventable until more recently. Over the past seventy years, the concepts behind injury prevention were developed, and impressive reductions in childhood mortality were noted in countries such as Sweden, a world leader in multi-focal and targeted injury prevention strategies. Following their example, other countries have been called upon to improve and expand their injury prevention measures...
October 10, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29098965/orthopedic-injuries-in-pediatric-trauma
#13
Eman Loubani, Rodrick Lim, Debra Bartley
Trauma remains the leading cause of death in children, of which the majority of patients have orthopedic injuries. The range of injured bones is various, each requiring knowledge and expertise to appropriately manage in a timely fashion. The importance of a systematic approach to the pediatric polytrauma patient is paramount. This chapter will highlight orthopedic issues important to the pediatric polytrauma patient including the unique anatomy and properties of pediatric bone. A systematic approach to the pediatric polytrauma patient will also be discussed...
September 11, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28847287/analgesia-for-children-in-acute-pain-in-the-post-codeine-era
#14
Naveen Poonai
Acute pain is one of the most common presenting complaints in pediatric patients presenting to the emergency department. Recently, concern about the safety of narcotics such as codeine has sparked a renewed interest in opioids such as morphine and intranasal fentanyl. Consequently, opioids are being increasingly used in the clinical setting. Despite this, there is ample evidence that clinicians are less willing to offer opioids to children compared to adults. The reasons for this are multifactorial but nevertheless, the provision of adequate analgesia in children is echoed by a several academic societies as a priority for comprehensive care...
August 28, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28847288/maternal-empowerment-an-underutilized-strategy-to-prevent-kernicterus
#15
Richard P Wennberg, Jon F Watchko, Steven M Shapiro
Kernicterus is a common cause of death and morbidity in many low-middle income countries (LMICs) and still occurs in affluent nations. In either case, the immediate cause is delayed treatment of severe hyperbilirubinemia. In the West, a provider driven "systems approach" has been widely adopted to identify babies at risk prior to discharge from birthing centers with follow up monitoring based on the serum bilirubin level at time of discharge. System failures contributing to kernicterus in affluent countries are related to lack of follow up planning, bad advice by providers, and delays in care seeking by parents...
August 27, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28814249/the-neurological-sequelae-of-neonatal-hyperbilirubinemia-definitions-diagnosis-and-treatment-of-the-kernicterus-spectrum-disorders-ksds
#16
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
#17
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
#18
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
#19
Sheena Belisle, Elena Hochstaler, Rodrick Lim, 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/the-importance-of-hemolysis-and-its-clinical-detection-in-neonates-with-hyperbilirubinemia
#20
Ronald J Wong, Vinod K Bhutani, David K Stevenson
Background: Hyperbilirubinemia is a benign transitional phenomenon that occurs in 60% to 80% of all term infants. The degree of hyperbilirubinemia and hence risk for developing bilirubin-induced neurologic dysfunction or BIND is dependent upon two major processes: (i) bilirubin production and its elimination. Objective: The aim of this review is to address the importance of hemolysis and its clinical detection in neonates with hyperbilirubinemia. Results: In newborns, an increased bilirubin production rate due to hemolysis is often the primary cause of hyperbilirubinemia during the first week of life...
August 7, 2017: Current Pediatric Reviews
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