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Frontiers in Pediatrics

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https://www.readbyqxmd.com/read/28725641/mechanisms-mediating-pediatric-severe-asthma-and-potential-novel-therapies
#1
REVIEW
Aldara Martin Alonso, Sejal Saglani
Although a rare disease, severe therapy-resistant asthma in children is a cause of significant morbidity and results in utilization of approximately 50% of health-care resources for asthma. Improving control for children with severe asthma is, therefore, an urgent unmet clinical need. As a group, children with severe asthma have severe and multiple allergies, steroid resistant airway eosinophilia, and significant structural changes of the airway wall (airway remodeling). Omalizumab is currently the only add-on therapy that is licensed for use in children with severe asthma...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28713799/the-use-of-ambulatory-blood-pressure-monitoring-as-standard-of-care-in-pediatrics
#2
REVIEW
Caitlin G Peterson, Yosuke Miyashita
Hypertension (HTN) is a significant global health problem, responsible for 7.5 million deaths each year worldwide. The prevalence of HTN is increasing in the pediatric population likely attributed to the increase in childhood obesity. Recent work has also shown that blood pressure (BP) tends to track from childhood to adulthood including BP-related target organ damage. In the last 25-30 years, pediatric use of ambulatory blood pressure monitoring (ABPM) has been expanding mainly in the setting of initial elevated BP measurement evaluation, HTN therapy efficacy follow-up, and renal disease...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28713798/incidence-and-severity-of-prescribing-errors-in-parenteral-nutrition-for-pediatric-inpatients-at-a-neonatal-and-pediatric-intensive-care-unit
#3
Theresa Hermanspann, Mark Schoberer, Eva Robel-Tillig, Christoph Härtel, Rangmar Goelz, Thorsten Orlikowsky, Albrecht Eisert
OBJECTIVES: Pediatric inpatients are particularly vulnerable to medication errors (MEs), especially in highly individualized preparations like parenteral nutrition (PN). Aside from prescribing via a computerized physician order entry system (CPOE), we evaluated the effect of cross-checking by a clinical pharmacist to prevent harm from PN order errors in a neonatal and pediatric intensive care unit (NICU/PICU). METHODS: The incidence of prescribing errors in PN in a tertiary level NICU/PICU was surveyed prospectively between March 2012 and July 2013 (n = 3,012 orders)...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28706894/developmental-origins-and-nephron-endowment-in-hypertension
#4
REVIEW
Shari Gurusinghe, Anita Tambay, Christine B Sethna
Primary hypertension continues to be one of the main risk factors for cardiovascular disease worldwide. A stable intrauterine environment is critical for the future development and health of the fetus. The developing kidney has been found to be especially vulnerable during this time period, and epidemiological studies have demonstrated that an adverse in utero environment is associated with an increased risk of hypertension and chronic kidney disease. Macro- and micronutrient deficiencies as well as exposure to tobacco, alcohol, and certain medications during gestation have been shown to negatively impact nephrogenesis and reduce one's nephron number...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28702452/bronchial-or-laryngeal-obstruction-induced-by-exercise
#5
Ayoub Bey, Sophie Botti, Laurianne Coutier-Marie, Claude Bonabel, Stéphanie Metche, Silvia Demoulin-Alexikova, Cyril Etienne Schweitzer, François Marchal, Laurent Coffinet, Iulia Ioan
A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs) after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28680875/echocardiographic-evaluation-of-patent-ductus-arteriosus-in-preterm-infants
#6
REVIEW
Romaine Arlettaz
Patent ductus arteriosus (PDA) is part of the typical morbidity profile of the preterm infant, with a high incidence of 80-90% in extremely low birth weight infants born before 26 weeks of gestation. Whereas spontaneous closure of the ductus arteriosus (DA) is likely in term infants, it is less so in preterm ones. PDA is associated with increased mortality and various comorbidities including cardiac failure, need for respiratory support, bronchopulmonary dysplasia, pulmonary or intracranial hemorrhage, and necrotizing enterocolitis; however, there is no proven causality between these morbidities and the presence of DA...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28680874/the-potential-benefits-of-applying-recent-advances-in-esophageal-motility-testing-in-patients-with-esophageal-atresia
#7
REVIEW
Nathalie Rommel, Maissa Rayyan, Charlotte Scheerens, Taher Omari
Infants and children with esophageal atresia commonly present with swallowing dysfunction or dysphagia. Dysphagia can lead to a range of significant consequences such as aspiration pneumonia, malnutrition, dehydration, and food impaction. To improve oral intake, the clinical diagnosis of dysphagia in patients with esophageal atresia should focus on both the pharynx and the esophagus. To characterize the complex interactions of bolus flow and motor function between mouth, pharynx, and esophagus, a detailed understanding of normal and abnormal deglutition is required through the use of adequate and objective assessment techniques...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28676849/bloodstream-infection-incidence-of-different-central-venous-catheters-in-neonates-a-descriptive-cohort-study
#8
Gerdina H Dubbink-Verheij, Vincent Bekker, Iris C M Pelsma, Erik W van Zwet, Vivianne E H J Smits-Wintjens, Sylke J Steggerda, Arjan B Te Pas, Enrico Lopriore
Central venous catheters (CVCs) in neonates are associated with a risk of central line-associated bloodstream infections (CLABSI). Most reports on the incidence of CLABSI in neonates focus on umbilical venous catheters (UVCs) and peripherally inserted central catheters (PICCs). We evaluated the incidence and risk factors for CLABSI in a cohort of neonates with femoral venous catheters (FVCs), UVCs, and PICCs, with a gestational age ≥34 weeks born between January 1, 2006 and June 30, 2013. We included 2,986 neonates with a total of 656 catheters...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674685/risk-factors-prophylaxis-and-treatment-of-venous-thromboembolism-in-congenital-heart-disease-patients
#9
REVIEW
Michael Silvey, Leonardo R Brandão
Congenital heart disease (CHD) is a common condition in the pediatric population, affecting up to 1% of all live births (i.e., around 40,000 newborns/year in the United States). Although CHD does have a wide range of severity, by the age of 5 years approximately 80% of patients will require at least one surgical intervention to achieve a complete/palliative cardiac repair. Today, in light of their much-improved surgical survival, the care of these patients focuses on morbidity prevention and/or treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674684/effect-of-fetal-sex-on-maternal-and-obstetric-outcomes
#10
REVIEW
Mohammed Al-Qaraghouli, Yu Ming Victor Fang
Fetal sex plays an important role in modifying the course and complications related to pregnancy and may also have an impact on maternal health and well-being both during and after pregnancy. The goal of this article is to review and summarize the findings from published research on physiologic and pathologic changes that may be affected by fetal sex and the effect of these changes on the maternal and obstetrical outcomes. This will help create awareness that fetal sex is not just a random chance event but an interactive process between the mother, the placenta, and the fetus...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674683/infusion-of-sibling-marrow-in-a-patient-with-purine-nucleoside-phosphorylase-deficiency-leads-to-split-mixed-donor-chimerism-and-normal-immunity
#11
Laura Yeates, Mary A Slatter, Andrew R Gennery
Purine nucleoside phosphorylase (PNP) deficiency, a rare autosomal recessive metabolic disease causes combined immunodeficiency and developmental delay, hypotonia, and spasticity. Patients present with recurrent infections associated with T-lymphocytopenia, characteristically presenting later than patients with classical severe combined immunodeficiency (SCID). PNP, with adenosine deaminase (ADA), is part of the purine salvage pathway. The only curative therapy is hematopoietic stem cell transplantation. Myeloablative conditioning is recommended to prevent rejection caused by residual immune function...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674682/the-microbiome-and-blood-pressure-%C3%A2-can-microbes-regulate-our-blood-pressure
#12
REVIEW
Souhaila Al Khodor, Bernd Reichert, Ibrahim F Shatat
The surfaces of the human body are heavily populated by a highly diverse microbial ecosystem termed the microbiota. The largest and richest among these highly heterogeneous populations of microbes is the gut microbiota. The collection of microbes and their genes, called the microbiome, has been studied intensely through the past few years using novel metagenomics, metatranscriptomics, and metabolomics approaches. This has enhanced our understanding of how the microbiome affects our metabolic, immunologic, neurologic, and endocrine homeostasis...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674681/myalgic-encephalomyelitis-chronic-fatigue-syndrome-diagnosis-and-management-in-young-people-a-primer
#13
REVIEW
Peter C Rowe, Rosemary A Underhill, Kenneth J Friedman, Alan Gurwitt, Marvin S Medow, Malcolm S Schwartz, Nigel Speight, Julian M Stewart, Rosamund Vallings, Katherine S Rowe
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674680/giant-gastric-bezoar-complicating-congenital-esophageal-atresia-repaired-by-gastric-interposition-a-case-report
#14
Archana Chacko, Brent I Masters, Alan Isles
We describe a giant gastric phytobezoar in a child with repaired congenital esophageal atresia. At age two, a gastric interposition (pull-up) procedure was performed for severe and recurrent esophageal strictures. For 12 months post-gastric interposition, he experienced frequent respiratory illnesses requiring hospital admissions but it was not initially appreciated that these episodes were likely secondary to recurrent aspiration from a gastric bezoar with "spill-over" aspiration.
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28670577/crohn-s-strictures-moving-away-from-the-knife
#15
REVIEW
Emily Stenke, Billy Bourke, Ulla Knaus
Crohn's disease (CD) is a lifelong inflammatory bowel disease with a rapidly rising incidence in the pediatric population. A common complication of CD is the development of fibrotic strictures, which may be present at initial diagnosis or develop many years later. Clinical presentation depends on stricture location and degree of obstruction, and strictures frequently contain a mixture of inflammatory and fibrotic tissue. Histological examination of Crohn's strictures shows thickening of the muscular layers and the submucosa, where increased collagen deposition by activated myofibroblasts is concentrated around islands of smooth muscle cells and at the superficial margin of the muscularis propria...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28670576/neonatal-meningitis-overcoming-challenges-in-diagnosis-prognosis-and-treatment-with-omics
#16
REVIEW
Scott M Gordon, Lakshmi Srinivasan, Mary Catherine Harris
Neonatal meningitis is a devastating condition. Prognosis has not improved in decades, despite the advent of improved antimicrobial therapy and heightened index of suspicion among clinicians caring for affected infants. One in ten infants die from meningitis, and up to half of survivors develop significant lifelong complications, including seizures, impaired hearing and vision, and delayed or arrested development of such basic skills as talking and walking. At present, it is not possible to predict which infants will suffer poor outcomes...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28660179/monitoring-cerebral-and-renal-oxygenation-status-during-neonatal-digestive-surgeries-using-near-infrared-spectroscopy
#17
Jonathan Beck, Gauthier Loron, Claire Masson, Marie-Laurence Poli-Merol, Eliane Guyot, Camille Guillot, Nathalie Bednarek, Caroline François
BACKGROUND: Depending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS) is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause. OBJECTIVE: Evaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28649564/primary-ciliary-dyskinesia-an-update-on-clinical-aspects-genetics-diagnosis-and-future-treatment-strategies
#18
REVIEW
Virginia Mirra, Claudius Werner, Francesca Santamaria
Primary ciliary dyskinesia (PCD) is an orphan disease (MIM 244400), autosomal recessive inherited, characterized by motile ciliary dysfunction. The estimated prevalence of PCD is 1:10,000 to 1:20,000 live-born children, but true prevalence could be even higher. PCD is characterized by chronic upper and lower respiratory tract disease, infertility/ectopic pregnancy, and situs anomalies, that occur in ≈50% of PCD patients (Kartagener syndrome), and these may be associated with congenital heart abnormalities...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28649563/symptomatic-congenital-cytomegalovirus-infection-in-children-of-seropositive-women
#19
Ines Mack, Marie-Anne Burckhardt, Ulrich Heininger, Friederike Prüfer, Sven Schulzke, Sven Wellmann
Cytomegalovirus (CMV) is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV) transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV) contribute to a much greater proportion of symptomatic cCMV than was previously thought. Here, we describe a case of symptomatic cCMV infection in the newborn of a woman with proven immunity prior to pregnancy...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28649562/umbilical-cord-blood-nos1-as-a-potential-biomarker-of-neonatal-encephalopathy
#20
Jun Lei, Cristina Paules, Elisabeth Nigrini, Jason M Rosenzweig, Rudhab Bahabry, Azadeh Farzin, Samuel Yang, Frances J Northington, Daniel Oros, Stephanie McKenney, Michael V Johnston, Ernest M Graham, Irina Burd
BACKGROUND: There are no definitive markers to aid in diagnosis of neonatal encephalopathy (NE). The purpose of our study was (1) to identify and evaluate the utility of neuronal nitric oxide synthase (NOS1) in umbilical cord blood as a NE biomarker and (2) to identify the source of NOS1 in umbilical cord blood. METHODS: This was a nested case-control study of neonates >35 weeks of gestation. ELISA for NOS1 in umbilical cord blood was performed. Sources of NOS1 in umbilical cord were investigated by immunohistochemistry, western blot, ELISA, and quantitative PCR...
2017: Frontiers in Pediatrics
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