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Current Opinion in Pediatrics

Paul Wolujewicz, M Elizabeth Ross
PURPOSE OF REVIEW: An update is presented regarding neural tube defects (NTDs) including spina bifida and anencephaly, which are among the most common serious birth defects world-wide. Decades of research suggest that no single factor is responsible for neurulation failure, but rather NTDs arise from a complex interplay of disrupted gene regulatory networks, environmental influences and epigenetic regulation. A comprehensive understanding of these dynamics is critical to advance NTD research and prevention...
August 12, 2019: Current Opinion in Pediatrics
Douglas G Postels, Ariane Soldatos, Kerri L LaRovere
PURPOSE OF REVIEW: Acute central nervous system (CNS) infections in children result in significant mortality and neurologic morbidity worldwide. This article summarizes the recent pediatric literature published on outcomes measures used after acute infectious meningitis, encephalitis, and cerebral malaria, and highlights ongoing research efforts to standardize outcomes measurements. Search terms were geared toward functional, cognitive, behavioral, and other outcome assessments. RECENT FINDINGS: Recent data suggest that, depending on microbiological cause, there are differences in currently used outcome measures following acute CNS infections...
August 12, 2019: Current Opinion in Pediatrics
Matthew B Neu, Kevin M Bowling, Gregory M Cooper
PURPOSE OF REVIEW: Identifying pathogenic variation underlying pediatric developmental disease is critical for medical management, therapeutic development, and family planning. This review summarizes current genetic testing options along with their potential benefits and limitations. We also describe results from large-scale genomic sequencing projects in pediatric and neonatal populations with a focus on clinical utility. RECENT FINDINGS: Recent advances in DNA sequencing technology have made genomic sequencing a feasible and effective testing option in a variety of clinical settings...
August 12, 2019: Current Opinion in Pediatrics
Catherine Gooch, Nathaniel H Robin, Anna C E Hurst
No abstract text is available yet for this article.
August 5, 2019: Current Opinion in Pediatrics
Ian C Coulter, Rob J Forsyth
PURPOSE OF REVIEW: To provide a summary of recent developments in the field of paediatric traumatic brain injury (TBI). RECENT FINDINGS: The epidemiology of paediatric TBI with falling rates of severe TBI, and increasing presentations of apparently minor TBI. There is growing interest in the pathophysiology and outcomes of concussion in children, and detection of 'significant' injury, arising from concern about risks of long-term chronic traumatic encephalopathy...
August 5, 2019: Current Opinion in Pediatrics
Susan Solecki, Enitan Adegite, Renee Turchi
PURPOSE OF REVIEW: The purpose of this review is to highlight the emerging smoking behaviors and varied tobacco products elevating public health concerns related to the exposure of these potentially harmful substances in the adolescent population. RECENT FINDINGS: Although adolescent smoking of traditional cigarettes has declined in the last 40 years, the inhalation of other nicotine-containing products using alternative methods and devices, such as smoking electronic cigarettes, using hookahs, vaping, and JUULing are dramatically on the rise in the adolescent population...
August 5, 2019: Current Opinion in Pediatrics
Paul Kruszka, Cedrik Tekendo-Ngongang, Maximilian Muenke
PURPOSE OF REVIEW: Dysmorphic features result from errors in morphogenesis frequently associated with genetic syndromes. Recognizing patterns of dysmorphic features is a critical step in the diagnosis and management of human congenital anomalies and genetic syndromes. This review presents recent developments in genetic syndromes and their related dysmorphology in diverse populations. RECENT FINDINGS: Clinical findings in patients with genetic syndromes differ in their heterogeneity across different population groups...
July 31, 2019: Current Opinion in Pediatrics
Sara Hassan, Vicky Lee Ng, Amal Aqul
PURPOSE OF REVIEW: Long-term survival is now the rule rather than the exception for infants and children who undergo liver transplantation for end-stage liver disease, metabolic liver conditions and a variety of other indications. Pediatricians and primary care providers play vital roles in the care and management of this patient population. The purpose of this review is to highlight key aspects important to the care of the pediatric liver transplant recipient. RECENT FINDINGS: Significant advances in immunosuppressive therapies and surgical techniques have contributed to improved graft and patient survival rates, shifting the focus beyond immediate survival to strategies to minimize comorbidities related to long-term immunosuppression during growing years, attend to patient and parent-reported outcomes and enhance quality of life...
July 31, 2019: Current Opinion in Pediatrics
Vittoria Rossi, Brendan Lee, Ronit Marom
PURPOSE OF REVIEW: The purpose of this review is to outline the current understanding of the molecular mechanisms and natural history of osteogenesis imperfecta, and to describe the development of new treatments for this disorder. RECENT FINDINGS: The introduction of next-generation sequencing technology has led to better understanding of the genetic cause of osteogenesis imperfecta and enabled cost-effective and timely diagnosis via expanded gene panels and exome or genome sequencing...
July 29, 2019: Current Opinion in Pediatrics
Antonio Martinez-Lopez, Luis Salvador-Rodriguez, Trinidad Montero-Vilchez, Alejandro Molina-Leyva, Jesus Tercedor-Sanchez, Salvador Arias-Santiago
PURPOSE OF REVIEW: To provide an update of vascular malformation syndromes by reviewing the most recent articles on the topic and following the new International Society for the Study of Vascular Anomalies (ISSVA) 2018 classification. RECENT FINDINGS: This review discusses the main features and diagnostic approaches of the vascular malformation syndromes, the new genetic findings and the new therapeutic strategies developed in recent months. SUMMARY: Some vascular malformations can be associated with other anomalies, such as tissue overgrowth...
July 29, 2019: Current Opinion in Pediatrics
Margaret Sherin, Joseph Waters
PURPOSE OF REVIEW: This review will address the need for adolescent contraception, compare the benefits of long-acting reversible contraceptives (LARC) with non-LARC methods, discuss unique barriers to LARC for adolescents, and provide physicians with latest recommendations for counseling adolescents on contraception. RECENT FINDINGS: The United States has the highest adolescent birth rate of any developed country at 18.8 births per 1000 females aged 15-19 years...
July 29, 2019: Current Opinion in Pediatrics
Sylvia Del Castillo, Robert E Shaddy, Paul F Kantor
PURPOSE OF REVIEW: This review highlights recent advances in the diagnosis and management of children with heart failure. We emphasize the clinical approach to patient care in the areas of acute decompensated heart failure, chronic heart failure, and failure of the patient with single ventricle physiology. RECENT FINDINGS: Important guidelines regarding the recognition and management of heart failure in children have been proposed and adopted, providing guidance for early recognition and ongoing management...
July 29, 2019: Current Opinion in Pediatrics
Naire Sansotta, Diego G Peroni, Simone Romano, Anna Rugiano, Pierluigi Vuilleumier, Giuseppe Baviera
PURPOSE OF REVIEW: There is growing evidence encouraging the use of probiotics in many conditions in children. However, given the wide number of probiotics available and contradictory data in the literature, the health-care provider is often faced with uncertainness about whether or not to use probiotics and which one(s) to choose. We here review current hypotheses regarding the efficacy and safety of probiotics and evaluate the available data on the use of probiotics in most common diseases in children...
July 26, 2019: Current Opinion in Pediatrics
Mark K Friedberg, Sushma Reddy
PURPOSE OF REVIEW: We aim to review select literature pertaining to congenital heart disease (CHD)-induced right ventricular (RV) function and failure. RECENT FINDINGS: We review recent findings pertaining to children and adults with repaired tetralogy of Fallot (rTOF), systemic RV and hypoplastic left heart syndrome (HLHS). We emphasize pathophysiological mechanisms contributing to RV dysfunction in these conditions, the risk factors for adverse outcomes and the continuing challenges in treating these patients...
July 25, 2019: Current Opinion in Pediatrics
Zoe C Schmiechen, Katherine A Weissler, Pamela A Frischmeyer-Guerrerio
PURPOSE OF REVIEW: The prevalence of food allergy is rising globally. This review will discuss recent discoveries regarding the immunologic mechanisms that drive the initial sensitization and allergic response to food antigens, which may inform prevention and treatment strategies. RECENT FINDINGS: Tolerance to food antigens is antigen-specific and promoted by oral exposure early in life and maternal transfer of immune complexes via breast milk. IgG can inhibit both the initiation and effector phases of allergic responses to food antigens in mice, and high levels of food-specific IgG4 are associated with acquisition of tolerance in humans...
July 22, 2019: Current Opinion in Pediatrics
Laura D'Addese, Anna Joong, Michael Burch, Elfriede Pahl
PURPOSE OF REVIEW: To provide an international perspective and current review of pediatric heart transplantation (PHTx). RECENT FINDINGS: Waitlist survival and long-term outcomes in PHTx continue to improve. Strategies to maximize donor pool utilization include ABO incompatible listing for infants and expanded donor-to-recipient weight ranges. However, there is a high degree of practice variation internationally, from listing strategies and donor acceptance practices to chronic immunosuppression regimens, long-term graft surveillance, and consideration for retransplantation...
July 22, 2019: Current Opinion in Pediatrics
Daniel Bernstein
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of the state of cardiac regenerative medicine, including the unique opportunities and challenges in its application to pediatric patients. RECENT FINDINGS: There has been a rapid proliferation of clinical studies using stem cells in adults with heart failure, yet little convincing evidence of clinically significant improvement. Readers will develop an understanding of the current limitations of stem cell treatments and the challenges to be overcome before they can achieve successful clinical translation...
July 17, 2019: Current Opinion in Pediatrics
Bradley Jerson, Katherine Lamparyk, Miranda A L van Tilburg
PURPOSE OF REVIEW: Vomiting can be a primary symptom or associated with various other functional gastrointestinal disorders (FGIDs). The purpose of this review was to discuss the evidence for psychological treatments for vomiting in pediatric FGID. RECENT FINDINGS: Vomiting of functional origin is an increasingly recognized symptom among children and adolescents. It is highly aversive and associated with disability and poor quality of life. Cognitive behavioral therapy, lifestyle modification (especially sleep), diaphragmatic breathing, and hypnosis can be helpful in preventing vomiting episodes and reducing disability...
July 17, 2019: Current Opinion in Pediatrics
Beth D Kaufman, Harvey J Cohen
PURPOSE OF REVIEW: Advanced heart failure in children is characterized by dynamic clinical trajectories, uncertainty of prognosis, and intermittent need for difficult decision-making, often related to novel therapeutic interventions with uncertain impact on quality of life. This review will examine the current role of palliative care to support this unique population. RECENT FINDINGS: Pediatric heart failure patients commonly die in ICUs with high burden of invasive therapies together with end of life care needs...
July 17, 2019: Current Opinion in Pediatrics
Gulseren Akyuz, Kardelen Gencer-Atalay, Pinar Ata
PURPOSE OF REVIEW: Fibrodysplasia ossificans progressiva (FOP) is an extremely rare and severely disabling autosomal dominant disease that is yet to be clearly understood. The purpose of this review is to present recent literature on pathophysiology, clinical features, diagnosis and treatment of FOP. RECENT FINDINGS: FOP is characterized by congenital great toe deformity and progressive heterotopic ossifications in connective tissue. Heterotopic ossifications occur after painful flare-ups that can arise spontaneously or can be triggered by minor trauma...
July 8, 2019: Current Opinion in Pediatrics
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