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https://www.readbyqxmd.com/read/28092280/challenges-and-opportunities-to-enhance-global-drug-development-in-neonates
#1
Alexandra M Smith, Jonathan M Davis
PURPOSE OF REVIEW: This study reviews the history of neonatal drug development, recent legislative efforts designed to facilitate the study of therapeutic agents in neonates, and future steps necessary to advance drug development. RECENT FINDINGS: Although many federal regulations have been introduced over the past 15 years to encourage pediatric and neonatal drug development, the majority of medications that are used in the Neonatal Intensive Care Unit are not approved by the Food and Drug Administration (FDA) for use in neonates...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28090473/three-year-old-male-with-multiple-dieulafoy-lesions-treated-with-epinephrine-injections-via-therapeutic-endoscopy
#2
Christina L Baldwin, Michael Wilsey
Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28090467/early-infant-feeding-practices-may-influence-the-onset-of-symptomatic-celiac-disease
#3
Shailja Vajpayee, Shiv Dayal Sharma, Rajkumar Gupta, Alok Goyal, Aakash Sharma
PURPOSE: To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD. METHODS: It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28081320/pityriasis-rosea-a-natural-history-of-pediatric-cases-in-thecentral-anatolia-region-of-turkey
#4
Emine Çölgeçen, Çiğdem Kader, Yılmaz Ulaş, Pınar Öztürk, Öznur Küçük, Mehmet Balcı
BACKGROUND/AIM: This study aimed to evaluate the demographic, clinical, and epidemiological features of pityriasis rosea (PR) in a cohort of 46 children in Yozgat, a city in the Central Anatolia Region of Turkey. MATERIALS AND METHODS: Forty-six children with PR were monitored at regular intervals (1, 2, 4, and 12 weeks) for 3 months from the time of diagnosis. A complete evaluation of the patient was performed at each visit. RESULTS: The average age of patients at time of diagnosis was 12 ± 3...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079916/adolescent-shin-pain
#5
Jeremy Korsh, Douglas Matijakovich, Charles Gatt
Shin pain is a common complaint in adolescent athletes. The term "shin splints" has historically been applied to these patients. Shin splints, more often than not, refers to a stress reaction of the tibia from overuse. Overuse injuries occur when repetitive microtrauma to the bone exceeds the biologic healing potential. Diagnosis is based on typical history and physical examination findings. Plain radiographs and advanced imaging are rarely necessary but can provide valuable prognostic information. Treatment consists of adequate rest and exercise modification...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28076664/sensitization-predicts-asthma-development-among-wheezing-toddlers-in-secondary-healthcare
#6
Nienke A Boersma, Ruud W H Meijneke, Johannes C Kelder, Cornelis K van der Ent, Walter A F Balemans
INTRODUCTION: Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. AIM: This study examines the predictive value of sensitization to inhalant allergens among wheezing toddlers in secondary healthcare for the development of asthma at school age (≥6 years). METHODS: Preschool children (1-3 years) who presented with wheezing in secondary healthcare were screened on asthma at school age with the International Study of Asthma and Allergies in Childhood questionnaire...
January 11, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28074279/identification-and-clinical-course-of-166-pediatric-cardiac-tumors
#7
Lin Shi, Lanping Wu, Huijuan Fang, Bo Han, Jialun Yang, Xiaojin Ma, Fang Liu, Yongwei Zhang, Tingting Xiao, Min Huang, Meirong Huang
: The aim of this study was to investigate the pathological classifications, clinical features, and natural history of pediatric cardiac tumors to provide a basis for the selection of an appropriate therapeutic method. The medical records of in- or outpatients with cardiac tumors at four hospitals were classified to analyze various types of tumor growth locations, clinical manifestations, surgical indications, and long-term follow-up results. There were 166 patients, including 158 with primary cardiac tumors, six with metastatic cardiac tumors, and two with unclassified cardiac tumors...
January 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28069269/clinical-considerations-for-blunt-laryngotracheal-trauma-in-children
#8
REVIEW
Jeffrey Cheng, Matthew Cooper, Elisabeth Tracy
OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. REVIEW METHODS: A medical librarian was utilized. RESULTS: 329 titles and abstracts were identified, and 50 reports were included...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#9
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28066962/outcomes-among-hiv-infected-children-initiating-hiv-care-and-antiretroviral-treatment-in-ethiopia
#10
Zenebe Melaku, Sileshi Lulseged, Chunhui Wang, Matthew Lamb, Yoseph Gutema, Chloe Teasdale, Solomon Ahmed, Tsigereda Gadisa, Zelalem Habtamu, Abubaker Bedri, Ruby Fayorsey, Elaine J Abrams
Globally, the scale-up of antiretroviral treatment represents one of the greatest successes in the history of global health. By the end of 2014 an estimated 15 million individuals, including more than 800,000 children younger than 15 years, initiated antiretroviral therapy (ART).(1) While pediatric treatment still lags behind adult successes, many countries, particularly in Southern Africa, have reported high rates of ART initiation, diminishing mortality and markedly improved health outcomes among children with HIV...
January 9, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28065519/enhancing-pediatric-trainees-and-students-knowledge-in-providing-care-to-transgender-youth
#11
Stanley R Vance, Madeline B Deutsch, Stephen M Rosenthal, Sara M Buckelew
PURPOSE: To enhance pediatric trainees' and students' knowledge of the psychosocial and medical issues facing transgender youth through a comprehensive curriculum. METHODS: During the 2015-2016 academic year, we administered a transgender youth curriculum to fourth-year medical students, pediatric interns, psychiatry interns, and nurse practitioner students on their 1-month adolescent and young adult medicine rotation. The curriculum included six interactive, online modules and an observational experience in a multidisciplinary pediatric gender clinic...
January 5, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28064391/survey-of-family-history-taking-and-genetic-testing-in-pediatric-practice
#12
Robert A Saul, Tracy Trotter, Kerry Sease, Beth Tarini
Family health history collection and genetic testing are core elements for the successful translation of genomics into primary care practice. Yet, little is known about how pediatric providers implement these elements in practice. We surveyed the membership of the American Academy of Pediatrics regarding family health history (FHH) collection and genetic testing in the primary care setting. Three hundred forty-nine (349) responses were analyzed with the initial response rate of 43.3%. Four principal findings were noted-(1) family health history is still recognized as a critical part of the medical evaluation; (2) perceived obstacles for FHH are time in obtaining the FHH and concerns about the family's knowledge of their FHH; (3) a 3-generation family history is out of the scope of routine care and alternate methods should be considered; (4) most primary care providers (PCPs) do not feel comfortable ordering, interpreting, and counseling regarding current genetic testing...
January 7, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28062243/extramedullary-relapse-of-acute-lymphoblastic-leukemia-presenting-as-abnormal-uterine-bleeding-a-case-report
#13
Diana T Robillard, Matthew A Kutny, Joseph H Chewning, Janeen L Arbuckle
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Relapse of ALL occurs in 15-20% of patients, with 2-6% occurring exclusively in extramedullary sites. Relapse of ALL in gynecologic organs is extremely rare. CASE: We present a case of a 12 year old with a history of ALL who was referred to the pediatric gynecology clinic with abnormal uterine bleeding. She was determined to have an extramedullary uterine relapse of her ALL. SUMMARY AND CONCLUSION: Abnormal uterine bleeding in the setting of childhood malignancy is a frequent reason for consultation to Pediatric and Adolescent Gynecology services...
January 3, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28060134/severe-hyponatremia-in-a-single-center-series-of-84-homogenously-treated-children-with-acute-lymphoblastic-leukemia
#14
Szymon Janczar, Beata Zalewska-Szewczyk, Wojciech Mlynarski
Electrolyte abnormalities are hallmark metabolic disturbances during the treatment of acute lymphoblastic leukemia (ALL). Hyponatremia is an ominous laboratory sign in the setting of neoplasia. We analyzed the incidence, risk factors, associations, specific interventions and outcomes of severe hyponatremia in a single-center series of children with ALL. The incidence of severe hyponatremia, defined as serum sodium levels below 130 mmol/L on at least 2 of 3 consecutive days, was 11.9%. History of hyponatremia episode is associated with neurologic complications (P=0...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28060114/factors-associated-with-noncompliance-with-long-term-follow-up-care-among-pediatric-cancer-survivors
#15
Katie A Devine, Adrienne Viola, Peter Capucilli, Olle Jane Z Sahler, Jeffrey R Andolina
Most childhood cancer survivors do not receive risk-based care through a survivorship program, but factors associated with dropping out of care are unclear. This study aimed to identify characteristics of pediatric cancer survivors who do not return to a cancer center survivorship program for recommended care after at least 1 visit compared with those who continue to attend. Patient characteristics (demographics, school functioning, psychiatric history) and treatment characteristics (diagnosis, treatment) were abstracted from medical records for all eligible patients...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28058158/a-rare-cause-of-proptosis-in-childhood-langerhans-cell-histiocytosis
#16
Mustafa Vatansever, Esra Vatansever, Erdem Dinç, Ayça Sarı, Tuba Kara
A three-year-old male patient was admitted to the clinic with proptosis in his right eye. He had a history of fever with an unknown etiology. In examination, right proptosis was observed and an immobile mass was palpated at the lateral wall of the right orbita. Eye movement was unrestricted in all directions and anterior and posterior segment examination was normal in both eyes. On computed tomography, diffuse bone destruction and expansion was observed in the right orbital lateral wall and other cranial bones...
August 2016: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28057843/diphenhydramine-for-acute-extrapyramidal-symptoms-after-propofol-administration
#17
James Sherer, Tomas Salazar, Kevin B Schesing, Shannon McPartland, Jeffrey Kornitzer
Extrapyramidal symptoms are an uncommon but well-recognized side effect after the administration of general anesthesia in patients without a significant neurologic history. Several case reports implicate propofol as the likely causative agent producing these symptoms, which include ballismus, dystonia, choreoathetosis, and opisthotonus. Currently, there is no clear consensus on first-line treatment of these symptoms. In each of the published cases, anticholinergic medications and benzodiazepines were central to initial management, although the speed and extent of symptom resolution were variable...
January 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28052798/diagnosis-and-management-of-allergic-conjunctivitis-in-pediatric-patients
#18
William E Berger, David B Granet, Alan G Kabat
BACKGROUND: Allergic conjunctivitis (AC), although one of the most common ocular disorders in pediatric patients, is frequently overlooked, misdiagnosed, and undertreated in children. OBJECTIVE: To guide pediatric health care professionals in the optimal diagnosis and management of AC in pediatric patients. METHODS: To identify any existing best practice guidelines for the diagnosis and treatment of AC in pediatric patients, a review of the literature published between 2004 and January 2015 was conducted...
January 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28052534/metformin-a-review-of-its-history-and-future-from-lilac-to-longevity
#19
REVIEW
Inas Thomas, Brigid Gregg
Metformin is a widely prescribed medication that has been used to treat children with type 2 diabetes in the United States for the past 15 years. Metformin now has a variety of clinical applications in pediatrics, and its potential clinical uses continue to expand. In addition to reviewing the current understanding of its mechanisms of action including the newly discovered effects on the gastrointestinal tract, we will also discuss current clinical uses in pediatrics, including in type 1 diabetes. Finally, we examine the existing state of monitoring for metformin efficacy and side effects and discuss prospective future clinical uses...
February 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28047857/su-c-207a-01-a-novel-maximum-likelihood-method-for-high-resolution-proton-radiography-proton-ct
#20
C Collins-Fekete, R Schulte, L Beaulieu, J Seco
PURPOSE: Multiple Coulomb scattering is the largest contributor to blurring in proton imaging. Here we tested a maximum likelihood least squares estimator (MLLSE) to improve the spatial resolution of proton radiography (pRad) and proton computed tomography (pCT). METHODS: The object is discretized into voxels and the average relative stopping power through voxel columns defined from the source to the detector pixels is optimized such that it maximizes the likelihood of the proton energy loss...
June 2016: Medical Physics
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