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Current Pediatric Reviews

Claudio Spinelli
Thyroid tumors affect all age groups, including children and adolescents. Malignant cancer of the thyroid is a relatively uncommon disease in pediatric age. In the recent decades the incidence of paediatric differentiated thyroid carcinoma (DTC) has increased. DTC in paediatric age is rare and has an excellent prognosis. Compared to adult counterpart, DTC in childhood presents some different features as follows: larger volume at the diagnosis, more frequent multicentricity (both mono- and bilateral), earlier local involvement of soft tissue of the neck, earlier lymph node involvement, distant metastases 3-4 times more frequent (most often in the lungs and almost always functional) and more common post-operatory recurrence; nevertheless, the prognosis of DTC in childhood is better and the survival greater than in adult...
October 13, 2016: Current Pediatric Reviews
Pietro Ferrara, Chiara Guadagno, Annamaria Sbordone, Maria Amato, Giulia Spina, Giacomo Perrone, Maria Cristin Basile, Francesca Ianniello, Giovanna Carmela Fabrizio, Massimo Pettoello-Mantovani, Alberto Verrotti, Alberto Villani, Giovanni Corsello
Child maltreatment is a complex life experience happening when a parent or caregiver does an intentional or potential damage to a child, including acts of commission and omission. Child abuse is not an uncommon event, but it is not always recognized. Identifying the real number of maltreated children is a challenge because of the large variability in reported prevalence data across studies. Unfortunately, in the United States, it affects 1 in 8 children, by the age of 18 years, annually. Paediatricians may encounter a variety of forms of maltreatment such as neglect, emotional, physical and sexual abuse...
September 14, 2016: Current Pediatric Reviews
Mandeep Kumar Garg, Madhurima Sharma, Ritesh Agarwal, Ashutosh Aggarwal, Pankaj Gupta, Kushaljit Singh Sodhi, Arunaloke Chakrabarty, Niranjan Khandelwal
Allergic bronchopulmonary aspergillosis (ABPA) is an immunological lung disorder occurring due to hypersensitivity to fungus Aspergillus fumigatus. Early diagnosis of ABPA is desirable before the disease leads to irreversible damage and end stage lung disease. Diagnosis of ABPA is based upon a set of clinical, serological and radiological criteria. Radiology plays an important role not only in diagnosis but also in prognostication of the disease. However, a radiologist should also be familiar with the clinical spectrum and laboratory findings of the disease...
August 31, 2016: Current Pediatric Reviews
María Fernández-Ibieta
In Dysfunctional Voiding (DV), the patient contracts the external urethral sphincter or pelvic diaphragm (consisting of striated muscle) during voiding, contrary to normal physiological mechanism. In Flowmetry plus pelvic Electromyography (EMG), the perineal surface electrodes will show a persistent activity during voiding. The cause is believed to be the persistence of an immature bladder control. The overall prevalence of DV is estimated between 7 and 11% of girls of school age. Symptoms of DV comprises a range of symptoms, deriving from outlet obstruction, incomplete voiding and elevated Post Micturition Residual (PMR): from daytime urine leaks, nocturnal enuresis, Urinary Tract Infections (UTI), or Vesicoureteral reflux (VUR), to the final decompensation of upper urinary tract in extreme cases...
August 16, 2016: Current Pediatric Reviews
Sara Lunardi, Simona Maddaluno, Monica Barrani, Francesca Ginocchio, Stefano Parmigiani
BACKGROUND: Since 1980 a form of benign convulsion during mild gastroenteritis, called Convulsion With Gastroenteritis (CWG) has been described. However diagnostic criteria has not been well defined yet, given the similarity of CWG with other diseases of young age. OBJECTIVE AND METHODS: We here report a series of cases admitted at our hospital and propose a diagnostic score in order to help the Pediatrician to rapidly individuate the disease. RESULTS AND CONCLUSION: we try to propose a diagnostic score to help the clinician in diagnosing CWG and so avoiding as much as possible invasive procedures and reassuring parents...
August 10, 2016: Current Pediatric Reviews
Frank H Bloomfield
Fetal growth restriction (FGR) is associated with an increased incidence of fetal and neonatal death, and of neonatal morbidity. Babies born following FGR also are at risk of a range of postnatal complications, which may contribute to an increased incidence of disease later in life. There currently are no effective clinical interventions which improve perinatal survival, intrauterine growth and later outcomes of the FGR baby. Postnatal interventions aimed at promoting or accelerating growth in FGR babies to improve outcome, particularly neurodevelopmental outcomes, may further increase the risk of metabolic dysregulation and, therefore, the risk of developing chronic disease in adulthood...
August 8, 2016: Current Pediatric Reviews
Tommi Cooke, Tsz-Yin So
The United States Food and Drug Administration currently states that the use of stimulants in patients with tic disorders and/or family history of tic disorders including Tourette's syndrome is contraindicated. Patients with attention deficit hyperactivity disorder (ADHD), however, are at increased risk of tics regardless of stimulants use. After evaluating the most recent literature on the incidence of tic disorders in pediatric patients treated with stimulants for ADHD, it is reasonable to say that the incidence of tics and the severity of tics are not increased by the use of these medications...
July 28, 2016: Current Pediatric Reviews
György Csaba
Perinatally, the developmental window for the adjustment of hormone receptors to their target hormones is open. The hormonal imprinting which determines the relationship of hormones and receptors for life takes place in this time period. The recognition ability of developing receptors is not yet entirely specific, so they could be 'cheated' by false imprinters such as related hormones, drugs, environmental pollutants or certain food components and faulty imprinting may result. This causes a functional developmental abnormality, which then is manifested, at any later time in life, as the alteration of the binding capacity of hormone receptors...
July 8, 2016: Current Pediatric Reviews
Dalia Youssef, Azfar Niazi, Naim Alkhouri
The outcomes of liver transplantation in the pediatric population have improved significantly over the past two decades. As long-term survival improves, potential complications related to immunosuppression, delayed growth and development, and metabolic issues have started to be seen more commonly in long-term survivors. Hence, general pediatricians should to be aware of these potential complications in order to optimize the medical care and the quality of life for children with liver transplantation.
June 27, 2016: Current Pediatric Reviews
Despoina Gkentzi, Soultana Kolyva, Iris Spiliopoulou, Markos Marangos, Gabriel Dimitriou
BACKGROUND: Coagulase-negative staphylococci (CoNS) are the leading cause of late-onset sepsis in neonatal intensive-care units (NICUs). Despite adequate therapeutic levels and in vivo susceptibility, vancomycin is not always adequate in clearing CoNS bacteremias and other theurapeutic regimens are warranted especially when dealing with persistent CoNS bacteremias. METHODS: Retrospective analysis of neonates with persistent CoNS bacteremias in a tertiary NICU in two study periods (January 2006 to December 2007 and January 2011 to December 2012)...
June 3, 2016: Current Pediatric Reviews
Alpin D Malkan, Israel Fernandez-Pineda
BACKGROUND: The discovery and accurate diagnosis of a biliary tract mass in the pediatric population can prove to be extremely challenging. The purpose of this article is to give an overview of the evolution of management with regard to biliary tract rhabdomyosarcoma (RMS) in the pediatric population. METHODS: Clinical research related to biliary tract RMS in the pediatric population is reviewed, focusing on the diagnosis, staging and treatment. RESULTS: Over the past century the management of biliary tract RMS has transitioned through a spectrum of radical surgical procedures with poor outcomes...
January 17, 2016: Current Pediatric Reviews
Norah Yap, Tara Bharucha
Clinical signs alone are unreliable in the diagnosis of patent ductus arteriosus (PDA) in preterm infants, and therefore echocardiography remains the mainstay of diagnosis of this common condition. Echocardiography also facilitates understanding of the hemodynamic effects of a PDA, and thus aids in management decisions. Several echocardiographic parameters, including duct size, maximum ductal velocity, left atrial: aorta ratio, mitral inflow E:A ratio, and isovolumic relaxation time, have been utilized in the assessment of PDA, but no single measurement can be used in isolation to inform clinical judgement...
2016: Current Pediatric Reviews
Marcus P Haw
The ductus arteriosus is a fetal vascular connection between the pulmonary and systemic circulations. It fails to close after birth in a small number of term infants, and in a larger number of infants with cyanotic congenital heart disease. In contemporary practice the majority of patients present with a patent ductus arteriosus (PDA) are premature infants before the gestational age of 28 weeks. The surgical management of PDA in preterm infants is critical for optimal outcomes and is discussed in this article...
2016: Current Pediatric Reviews
Joseph J Vettukattil
The ductus arteriosus is a muscular artery connecting two elastic arteries with different resistances. It is a normal fetal structure that only becomes pathological if it remains patent after birth. A varied clinical impact is observed as some neonates may be asymptomatic, symptoms may be deferred until later in life, or the infant may be overtly symptomatic and present as early as the first days of life. Prematurity increases the likelihood of persistent ductal patency and is seen in about 30% of preterm infants...
2016: Current Pediatric Reviews
Sara E Rostas, Christopher C McPherson
Management of the patent ductus arteriosus (PDA) represents an ongoing challenge in the care of extremely premature neonates. Determining the optimal treatment strategy requires careful consideration of the potential risks and benefits of available therapies. Surgical ligation results in reliable ductal closure, but may result in numerous short-term complications and have a negative impact on long-term outcome. Intravenous indomethacin was the first pharmacologic agent widely utilized for PDA closure. Intravenous indomethacin effectively closes the ductus arteriosus and prevents pulmonary hemorrhage and severe intraventricular hemorrhage, but fails to mitigate short-term morbidities and improve long-term outcomes...
2016: Current Pediatric Reviews
Bennett P Samuel, Angela J Stuive, Dawn M Eding
The care of extremely premature neonates with suspected or confirmed diagnosis of patent ductus arteriosus (PDA) is a frequent challenge for pediatric nurses. It is important for nurses to have adequate knowledge of the normal postnatal changes in cardiovascular and pulmonary function to recognize any adverse symptoms. Nurses caring for these vulnerable neonates must have a thorough understanding of the pathophysiology of a PDA in order to assess, plan, and implement patient-centered care. Recognition of characteristic symptoms of PDA in a timely manner is essential for optimal management and outcomes...
2016: Current Pediatric Reviews
Eric J Kort
BACKGROUND: Patent ductus arteriosus (PDA) is a common factor complicating the care of the preterm infant, but controversy remains regarding the long term effects of PDA and iatrogenic closure of PDA. METHODS: Studies presenting data relevant to the relationship between PDA and mortality and morbidity were identified via a systematic literature review. These studies were classified based on PDA exposure in the case and control groups. The data was abstracted and summarized using linear modeling, resulting in summary estimates of mean effect size (odds ratio)...
2016: Current Pediatric Reviews
Zhen Han Tan, Vijay R Baral
The clinical management of a patent ductus arteriosus (PDA) in preterm newborns is a controversial topic, and despite nearly three decades of research, varying opinions remain. This dilemma stems from uncertain causal linkage between PDA and neonatal comorbidities, as well as the lack of clear evidence showing that benefits of treatment outweigh risks. There has been a general shift in the management of PDA in preterm newborns from early and aggressive closure to a more conservative approach of watchful waiting and spontaneous closure...
2016: Current Pediatric Reviews
Joseph J Vettukattil
No abstract text is available yet for this article.
2016: Current Pediatric Reviews
Meghana M Phiske
Vitiligo in children is a distinct subset of vitiligo and differs from adult vitiligo. Characteristic features include family history of autoimmune or endocrine disease, higher incidence of segmental vitiligo, development of early or premature graying, increased incidence of autoantibodies and poor response to topical PUVA. The exact prevalence of vitiligo in children varies between 0.1-4% of the world population and seems to be higher in India than in other countries and it occurs more frequently in females...
2016: Current Pediatric Reviews
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