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Current Opinion in Pediatrics

Olga Yeliosof, Mariam Gangat
PURPOSE OF REVIEW: This review summarizes pituitary function, and the clinical presentation and treatment of hypopituitarism. RECENT FINDINGS: Updates in the field include new guidelines and meta-analyses on the diagnosis and treatment of select hormone deficiencies, novel treatment options, and advances in next generation sequencing technology. SUMMARY: Hypopituitarism is defined as partial or complete loss of a single or multiple pituitary hormones...
May 10, 2019: Current Opinion in Pediatrics
Ahmed Khattab, Ian Marshall
PURPOSE OF REVIEW: The most common enzyme defect associated with congenital adrenal hyperplasia (CAH) is 21-hydroxylase deficiency (21OHD). Glucocorticoid therapy aiming to suppress adrenocorticotrophic hormone (ACTH)-mediated hyperandrogenemia and to replace glucocorticoid deficiency, if indicated, remains the first line of management in CAH with or without mineralocorticoid replacement therapy and salt supplementation. We review interventions that may address unmet needs in the management of CAH...
May 1, 2019: Current Opinion in Pediatrics
Anna Gregorowski, Jane Simpson, Terry Y Segal
PURPOSE OF REVIEW: The current review aims to determine the recent evidence regarding cause, impact, effective treatment and prognosis of children and young people (CYP) affected by chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) at a time when the National Institute for Clinical Excellence guidelines in the United Kingdom are being reviewed and more research is called for worldwide. RECENT FINDINGS: CFS/ME is a debilitating illness with no clear cause...
April 30, 2019: Current Opinion in Pediatrics
Jonathan E Kohler, Richard A Falcone, Mary E Fallat
PURPOSE OF REVIEW: Access to care for children requiring pediatric general or specialty surgery or trauma care who live in rural areas remains a challenge in the United States. RECENT FINDINGS: The expertise of specialists in tertiary centers can be extended to rural and underserved areas using telemedicine. There are challenges to making these resources available that need to be methodically approached to facilitate appropriate relationships between hospitals and providers...
April 30, 2019: Current Opinion in Pediatrics
Amy E Lawrence, Peter C Minneci, Katherine J Deans
PURPOSE OF REVIEW: This review highlights progress in the management of pediatric ovarian neoplasms. Recent research has identified disparities in the management of patients with benign ovarian neoplasms based on a variety of factors. However, the long-term effects of unilateral oophorectomy have prompted an emphasis on ovary-sparing surgery (OSS) for benign masses. One of the challenges still facing providers is the preoperative differentiation between benign and malignant masses. RECENT FINDINGS: Recent studies highlight the variability in practice patterns surrounding the management of benign ovarian neoplasms...
April 24, 2019: Current Opinion in Pediatrics
Sage R Myers, Aaron J Donoghue
PURPOSE OF REVIEW: The pediatric resuscitation environment is a high-stakes, environment in which a multidisciplinary team must work together with patient outcomes dependent, at least in part, on the performance of that team. Given constraints of the environment and the nature of these events, quality improvement work in pediatric resuscitation can be challenging. Ongoing collection of accurate and reliable data on team performance is necessary to inform and evaluate change. RECENT FINDINGS: Despite the relative difficulty of quality improvement analysis and intervention implementation in the resuscitation environment, these efforts can have significant impact on patient outcomes...
April 24, 2019: Current Opinion in Pediatrics
Cameron Nereim, David Bickham, Michael Rich
PURPOSE OF REVIEW: To review the literature and provide a guide to assessing patients with problematic interactive media use (PIMU). RECENT FINDINGS: 0.3-1.0% of the world population meets criteria for internet gaming disorder (IGD). 26.8-83.3% of adolescents meeting criteria for internet addiction have comorbid attention-deficit/hyperactivity disorder. IGD is associated with increased anxiety and social anxiety/phobias. Group counseling, cognitive behavioral therapy, and sports intervention are associated with significant reductions in internet addiction...
April 24, 2019: Current Opinion in Pediatrics
Gideon Sandler, Akiko Yokoi, Andrea Hayes-Jordan
PURPOSE OF REVIEW: Nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) is a rare subgroup of malignancy in childhood that is composed of a variety of soft tissue and bony tumors. Prognosis for resectable localized disease is usually good and improved with systemic treatment. However, survival from locally advanced and metastatic disease remains poor. There have been numerous preclinical and clinical studies to define histopathology, biology, and genetic alteration of sarcomas. The purpose of this review is to clarify the progress in the management of NRSTS...
April 16, 2019: Current Opinion in Pediatrics
Atsuko Koyama, Lauren Middlebrooks, Adam Bullock
PURPOSE OF REVIEW: Adolescents and young adults continue to contribute to new HIV infections despite improved antiretroviral regimens and HIV preexposure and postexposure prophylaxis (PrEP and PEP). Knowledge about nonoccupational HIV PEP (nPEP) is relevant and important for all pediatricians as adolescents present under a variety of circumstances disclosing past sexual activity. RECENT FINDINGS: nPEP is effective in preventing HIV infection, and newer regimens have been shown to increase compliance amongst users, have less side effects, and lead to less HIV resistance...
April 9, 2019: Current Opinion in Pediatrics
Grace Z Mak, Jessica J Kandel
No abstract text is available yet for this article.
April 3, 2019: Current Opinion in Pediatrics
David N Cornfield
No abstract text is available yet for this article.
April 3, 2019: Current Opinion in Pediatrics
Jessica Lin, Nicholas Chadi, Lydia Shrier
PURPOSE OF REVIEW: Mindfulness, the practice of paying attention to the present moment, purposefully and nonjudgmentally, has been gaining popularity as adjunct treatment for adolescents with a range of physical and mental health problems. Research conducted in adults and emerging research conducted in adolescents has shown that mindfulness-based interventions can improve outcomes in several areas. The purpose of this review is to discuss recent research on the effects of mindfulness and suggest exercises that primary care clinicians can offer to their adolescent patients...
April 1, 2019: Current Opinion in Pediatrics
Kathleen Mealey, Laura M P Koenigs
PURPOSE OF REVIEW: Adolescent providers have a unique opportunity to interface with adolescents during a transformative time period. Optimizing vaccinations may protect teens against preventable but potentially deadly diseases. Healthcare providers must be aware of the evolving vaccination data and up-to-date recommendations for vaccinations. RECENT FINDINGS: In spite of the Center for Disease Control recommendations, there is a gap between the actual and desired vaccination rates of adolescents...
April 1, 2019: Current Opinion in Pediatrics
Dana Toy, Matthew S Braga, Matthew Greenhawt, Marcus Shaker
PURPOSE OF REVIEW: To provide an updated framework of management for allergic emergencies. RECENT FINDINGS: The most frequent causes of anaphylaxis include medications, foods, and stinging insects. Early and appropriate administration of epinephrine is critical to managing anaphylaxis. Although epinephrine is well tolerated and there is no absolute contraindication to using epinephrine in first-aid management of anaphylaxis, many patients at risk for anaphylaxis still fail to carry and use the medication prior to seeking emergency care...
April 1, 2019: Current Opinion in Pediatrics
Diana Chernikova, Irene Yuan, Marcus Shaker
PURPOSE OF REVIEW: Microbiota consist of symbiotic microscopic neighbors that interact on and within our bodies in diverse and incompletely understood ways throughout our lifetime. Though various associations with allergic disease have been described, clear effective therapeutic interventions to prevent allergy have been elusive. RECENT FINDINGS: The human microbiome is influenced by multiple factors, including: mode of infant delivery (vaginal vs. cesarean section), breastfeeding, diet, presence of siblings and pets, exposure to antibiotics and other medications (particularly antacids), lifestyle, and developmental context...
April 1, 2019: Current Opinion in Pediatrics
Samuel M Alaish, Alejandro V Garcia
PURPOSE OF REVIEW: Over the past 15 years, the Accreditation Council for Graduate Medical Education (ACGME) has significantly altered the regulatory framework governing fellowship training in pediatric surgery. The daily experiences of pediatric surgical trainees have been impacted by these changes, but training program directors and faculty have not developed a consistent approach to managing this shift. This review highlights the changes, which have occurred, analyzes the current state of fellowship training, and proposes potential strategies for management...
April 1, 2019: Current Opinion in Pediatrics
Calista M Harbaugh, Samir K Gadepalli
PURPOSE OF REVIEW: The purpose of this review is to explore the effects of the opioid crisis on pediatric patients in the postoperative setting and provide recommendations for well-tolerated opioid prescribing practices. RECENT FINDINGS: Opioid overdoses have increased among all age groups, predominantly related to overprescribing and accessibility of opioids in the home. Adverse risks of prescribed opioids include respiratory depression, gastrointestinal distress, accidental ingestion, intentional misuse, new chronic use, diversion to another user, and overdose...
April 1, 2019: Current Opinion in Pediatrics
Sarah Ullrich, Phyllis Kisa, Doruk Ozgediz
PURPOSE OF REVIEW: Two-thirds of the world's population lacks access to surgical care, many of them being children. This review provides an update on recent advances in global children's surgery. RECENT FINDINGS: Surgery is being increasingly recognized as an essential component of global and child health. There is a greater focus on sustainable collaborations between high-income countries (HICs) and low-and-middle-income countries (HICs and LMICs). Recent work provides greater insight into the global disease burden, perioperative outcomes and effective context-specific solutions...
April 1, 2019: Current Opinion in Pediatrics
Erica M Carlisle, Erin E Rowell
PURPOSE OF REVIEW: Rapid advancement in the field of pediatric surgery has resulted in unprecedented opportunities to advance the care of children. However, assuring that the highest quality, most appropriate care is available to all pediatric patients remains challenging. Regionalization of care has been proposed as a means of obtaining this critical goal. In this review, we discuss the ethical challenges associated with regionalization of pediatric surgical care. RECENT FINDINGS: Regionalization of pediatric surgical care is associated with improved patient outcomes...
April 1, 2019: Current Opinion in Pediatrics
Benjamin A Raby
PURPOSE OF REVIEW: This article reviews the progress in the search for the genetic determinants of severe asthma. RECENT FINDINGS: Twin studies estimate that approximately 25% of the phenotypic variability in asthma severity is determined by genetic factors, with the remainder determined by nongenetic factors including environmental and psychosocial factors, behavioral traits, and comorbidities. Most genetic association studies of asthma severity performed to date are underpowered and not designed to clearly distinguish asthma severity variants from asthma susceptibility variants...
March 20, 2019: Current Opinion in Pediatrics
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