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Translational Pediatrics

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https://www.readbyqxmd.com/read/29184821/approach-to-hypoglycemia-in-infants-and-children
#1
REVIEW
Kajal Gandhi
Hypoglycemia is a heterogeneous disorder with many different possible etiologies, including hyperinsulinism, glycogen storage disorders, fatty acid disorders, hormonal deficiencies, and metabolic defects, among others. This condition affects newborns to adolescents, with various approaches to diagnosis and management. This paper will review current literature on the history of hypoglycemia, current discussion on the definition of hypoglycemia, as well as etiologies, diagnosis, and management.
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184820/metabolic-syndrome-in-children-and-adolescents
#2
REVIEW
Dania Al-Hamad, Vandana Raman
Prevalence of metabolic syndrome in children and adolescents is increasing, in parallel with the increasing trends in obesity rates. Varying definitions of this syndrome have hindered the development of a consensus for the diagnostic criteria in the pediatric population. While pathogenesis of metabolic syndrome is not completely understood, insulin resistance and subsequent inflammation are thought to be among its main mechanistic underpinnings. Overweight and obesity are cardinal features, along with abnormal glucose metabolism, dyslipidemia, and hypertension...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184819/psychosocial-aspects-of-diabetes-management-dilemma-of-diabetes-distress
#3
REVIEW
Ruqiya Shama Tareen, Kinza Tareen
Diabetes mellitus (DM) is a debilitating chronic illness with complex pathophysiological, psychological, and quality of life (QoL) implications creating a constant state of turbulence. Some of these interconnections are apparent to healthcare providers and are easily addressed in a routine diabetic clinical care. However, a large number of these hidden factors that interplay with each other and impact on the physical outcomes of DM goes unnoticed by health care providers. This is a frustrating and lonely predicament for DM patients making it very difficult for them to manage their illness well...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184818/transition-of-care-for-patients-with-type-1-diabetes-mellitus-from-pediatric-to-adult-health-care-systems
#4
REVIEW
Elizabeth O Buschur, Bethany Glick, Manmohan K Kamboj
Planning for the transition from pediatric to adult healthcare is broadly understood to be beneficial to the quality of care of patients with chronic illness. Due to the level of self-care that is necessary in the maintenance of most chronic diseases, it is important that pediatric settings can offer support during a time when adolescents are beginning to take more responsibility in all areas of their lives. Lack of supportive resources for adolescents with chronic conditions often results in both decreased access to care and impaired health and function likely leading to increased medical costs later...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184817/role-of-a-registered-dietitian-in-pediatric-type-1-and-type-2-diabetes
#5
REVIEW
Tracie J Steinke, Elena L O'Callahan, Jennifer L York
Type 1 and type 2 diabetes are complex, chronic diseases that are best managed by a multidisciplinary care team. Type 1 diabetes is most commonly diagnosed in the pediatric population, although the prevalence of type 2 diabetes in youth is increasing rapidly. A registered dietitian (RD) is a critical member of the diabetes team who provides focused nutrition education from diagnosis and throughout routine follow-up care. Specifically in the pediatric population, the RD also assesses growth and development, as well as eating behaviors, food choices and meal patterns...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184816/type-1-diabetes-where-are-we-in-2017
#6
REVIEW
Melanie Copenhaver, Robert P Hoffman
Type 1 diabetes mellitus is a chronic state of insulin deficiency which results from destruction of beta cells by the immune system. The long term microvascular and macrovascular complications can be devastating. Since the discovery of insulin almost 100 years ago new medical therapies have improved the long-term survival for people with type 1 diabetes. Each year we come closer to discovering a cure but much work still needs to be done to eliminate this disease.
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184815/transient-hypothyroidism-in-the-newborn-to-treat-or-not-to-treat
#7
REVIEW
Neelakanta Kanike, Ajuah Davis, Prem S Shekhawat
Transient congenital hypothyroidism (CH) refers to a temporary deficiency of thyroid hormone identified after birth, with low thyroxine (T4) and elevated thyrotropin (TSH), which later recovers to improved thyroxine production, typically in first few months of infancy. Approximately 17% to 40% of children diagnosed with CH by newborn screening (NBS) programs were later determined to have transient hypothyroidism. Causes of transient CH are prematurity, iodine deficiency, maternal thyrotropin receptor blocking antibodies, maternal intake of anti-thyroid drugs, maternal or neonatal iodine exposure, loss of function mutations and hepatic hemangiomas...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184814/hypoglycemia-in-the-preterm-neonate-etiopathogenesis-diagnosis-management-and-long-term-outcomes
#8
REVIEW
Anudeepa Sharma, Ajuah Davis, Prem S Shekhawat
Glucose, like oxygen, is of fundamental importance for any living being and it is the major energy source for the fetus and the neonate during gestation. The placenta ensures a steady supply of glucose to the fetus, while birth marks a sudden change in substrate delivery and a major change in metabolism. Hypoglycemia is one of the most common pathologies encountered in the neonatal intensive care unit and affects a wide range of neonates. Preterm, small for gestational age (GA) and intra-uterine growth restricted neonates are especially vulnerable due to their lack of metabolic reserves and associated co-morbidities...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184813/disorders-differences-of-sex-development-dsds-for-primary-care-the-approach-to-the-infant-with-ambiguous-genitalia
#9
REVIEW
Justin A Indyk
The initial management of the neonate with ambiguous genitalia can be a very stressful and anxious time for families, as well as for the general practitioner or neonatologist. A timely approach must be sensitive and attend to the psychosocial needs of the family. In addition, it must also effectively address the diagnostic dilemma that is frequently seen in the care of patients with disorders of sex development (DSDs). One great challenge is assigning a sex of rearing, which must take into account a variety of factors including the clinical, biochemical and radiologic clues as to the etiology of the atypical genitalia (AG)...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184812/fertility-counseling-and-preservation-considerations-for-the-pediatric-endocrinologist
#10
REVIEW
Amanda J Saraf, Leena Nahata
Infertility is a distressing consequence of numerous pediatric medical conditions and treatments. The field of pediatric fertility preservation has expanded rapidly over the past decade, and clinical guidelines emphasize the importance of discussing infertility risk and fertility preservation options with patients and families in a timely manner. Understanding the various mechanisms and presentations of fertility issues across diagnoses is imperative to provide counseling to patients and families, and identify individuals who may benefit from fertility preservation...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184811/dermatologic-manifestations-of-endocrine-disorders
#11
REVIEW
Michael Lause, Alisha Kamboj, Esteban Fernandez Faith
The skin serves as a window for clinicians to understand, diagnose, and monitor endocrine disease. Dermatologic manifestations of endocrinopathies contribute significantly to an individual's health and quality of life. In this review, we outline various disorders of the hypothalamic-pituitary axis, thyroid gland, pancreas, adrenal gland, and androgen axis as well as hereditary endocrine syndromes. In acromegaly, glycosaminoglycan deposition contributes to a thickening of skin and soft tissue, which manifests as coarsening and enlargement of facial and acral structures...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184810/ophthalmic-manifestations-of-endocrine-disorders-endocrinology-and-the-eye
#12
REVIEW
Alisha Kamboj, Michael Lause, Priyanka Kumar
Disorders of the endocrine system usually manifest in a multi-organ fashion. More specifically, many endocrinopathies become apparent in the eye first through a variety of distinct pathophysiologic disturbances. The eye provides physicians with valuable clues for the recognition and management of numerous systemic diseases, including many disorders of the endocrine pathway. Recognizing ophthalmic manifestations of endocrine disorders is critical not only for rapid diagnosis and treatment, but also to prevent significant morbidity and mortality...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184809/review-of-prader-willi-syndrome-the-endocrine-approach
#13
REVIEW
Ryan Heksch, Manmohan Kamboj, Kathryn Anglin, Kathryn Obrynba
Prader-Willi syndrome (PWS) is a complex genetic disorder with implications on the endocrine and neurologic systems, metabolism, and behavior. Early in life, PWS is characterized by hypotonia and failure to thrive, followed by obesity and hyperphagia. Patients with PWS develop hypothalamic dysfunction which may lead growth hormone deficiency (GHD), hypogonadism, hypothyroidism, adrenal insufficiency, and poor bone mineral density (BMD). In addition to hypothalamic dysfunction, individuals with PWS have increased risk for obesity which may be complicated by metabolic syndrome and type 2 diabetes mellitus (T2DM)...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184808/recovery-of-steroid-induced-adrenal-insufficiency
#14
REVIEW
Areej K Younes, Noor K Younes
Secondary adrenal insufficiency can result from insufficient stimulation of the adrenal glands due to inadequate secretion or synthesis of adrenocorticotropic hormone (ACTH). This can be caused by hypopituitarism, central nervous system injury (tumors, radiation, and surgery) or long-term glucocorticoid therapy. Glucocorticoids were introduced in the 1950s, and have been used for their anti-inflammatory and other pharmacological effects, and also as replacement therapy for adrenal insufficiency. However, chronic glucocorticoid use may lead to suppression of the hypothalamic pituitary adrenal axis through negative feedback...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184807/zoledronic-acid-in-pediatric-metabolic-bone-disorders
#15
REVIEW
Sasigarn A Bowden, John D Mahan
Zoledronic acid (ZA), a highly potent intravenous bisphosphonate (BP), has been increasingly used in children with primary and secondary osteoporosis due to its convenience of shorter infusion time and less frequent dosing compared to pamidronate. Many studies have also demonstrated beneficial effects of ZA in other conditions such as hypercalcemia of malignancy, fibrous dysplasia (FD), chemotherapy-related osteonecrosis (ON) and metastatic bone disease. This review summarizes pharmacologic properties, mechanism of action, dosing regimen, and therapeutic outcomes of ZA in a variety of metabolic bone disorders in children...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184806/polycystic-ovary-syndrome-in-adolescence-diagnostic-and-therapeutic-strategies
#16
REVIEW
Manmohan K Kamboj, Andrea E Bonny
Controversy continues about the underlying etiopathogenesis, diagnostic criteria, and recommendations for polycystic ovary syndrome (PCOS) in adolescents. Recent literature has recognized these deficiencies and evidence based expert recommendations have become more available. The purpose of this chapter is to offer primary care providers a practical understanding and approach to the diagnosis and treatment of PCOS in adolescents. Although the presence of polycystic ovary morphology (PCOM) is included as a key diagnostic criterion of PCOS in adults, it is currently not recommended for the diagnosis in adolescents...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184805/growth-perturbations-from-stimulant-medications-and-inhaled-corticosteroids
#17
REVIEW
Erin Richardson, Tasa Seibert, Naveen K Uli
Stimulant medications for the treatment of attention deficit hyperactivity disorder (ADHD) and inhaled corticosteroids (ICS) for the treatment of asthma are two classes of medications that are commonly prescribed in pediatrics. Among other adverse effects of these medications, growth attenuation has long been a focus of investigation. With stimulants, growth deficits of 1-1.4 cm/year have been observed in the short term, mainly in the first 2 years of treatment, in a dose-dependent manner. Long-term studies on stimulants have reported divergent effects on growth, with many studies showing no clinically significant height deficits by adulthood...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/28795014/evaluation-and-management-of-lower-back-pain-in-young-athletes
#18
REVIEW
Dilip R Patel, Elizabeth Kinsella
Lower back pain in young athletes is a common problem. The prevalence of back pain from different causes in adolescent age group is between 20% and 30%. However, the incidence of low back pain in young athletes varies widely in different sports. Overuse injuries are the most common cause of low back pain in young athletes. In case of overuse injuries, the cause and effect relationship between back pain and specific condition is often difficult to establish. In adolescent athletes, the most common underlying identified cause of low back pain is lumbar spondylolysis...
July 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/28795013/management-of-diabetes-mellitus-in-children-and-adolescents-engaging-in-physical-activity
#19
REVIEW
Silpa Nadella, Justin A Indyk, Manmohan K Kamboj
Regular physical activity is an important component in the management of both type 1 and type 2 diabetes mellitus (T1DM and T2DM), as it has the potential to improve glycemic control, delay cardiovascular complications, and increase overall well-being. Unfortunately, many children and adolescents with diabetes do not partake in regular exercise and physical activity for multiple reasons. This review identifies the barriers to participation from the aspect of the patient, caregiver, and the healthcare provider...
July 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/28795012/chronic-kidney-disease-and-sports-participation-by-children-and-adolescents
#20
REVIEW
Vimal Master Sankar Raj, Dilip R Patel, Lakshmi Ramachandran
Individuals suffering from chronic kidney disease (CKD) deal with major morbidity and mortality including poor exercise tolerance. A variety of factors including anemia, poor muscle mass, cardiovascular changes and limited physical activity contribute to exercise intolerance. Studies suggest that early initiation of aerobic and resistance training improves the muscle function, ability to tolerate exercise and quality of life in CKD patients. A thorough medical examination and exercise testing are recommended before initiating an exercise regimen in individuals with CKD...
July 2017: Translational Pediatrics
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