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Current Pediatric Reviews

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https://www.readbyqxmd.com/read/29149811/testing-actions-of-a-multi-action-emollient-patient-acceptability-efficacy-skin-biophysiology-and-staphylococcal-isolation
#1
Kam Lun E Lun Hon
AIM: Eczema or atopic dermatitis (AD) is associated with itch, sleep disturbance, impaired life quality, reduced skin hydration, impaired epidermal barrier function and colonization by Staphylococcus aureus (SA). We investigated an emollient with claimed multi-actions on barrier repair, antihistaminergic and antimicrobial effects. METHODS: Consecutive AD patients were recruited. Swabs and cultures from eczematous areas, disease severity (SCORAD), quality-of-life (Children Dermatology Life Quality Index, CDLQI), skin hydration (SH), and transepidermal water loss (TEWL) were obtained before and 4-week following usage of the emollient...
November 16, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29032759/predictable-and-preventable-historical-and-current-efforts-to-improve-child-injury-prevention
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28745216/insights-in-developmental-coordination-disorder
#11
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
#12
Abeer Azzuqa, Jon Freeman Watchko
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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