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Current Opinion in Pediatrics | Page 2

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
Selma F Witchel, Anne Claire Burghard, Rachel H Tao, Sharon E Oberfield
PURPOSE OF REVIEW: Polycystic ovary syndrome (PCOS) is often difficult to diagnose in adolescents. Recent recommendations and concepts regarding the diagnosis and treatment of PCOS in the adolescent girl are considered. RECENT FINDINGS: The diagnosis of PCOS in adolescents should be primarily based on clinical and biochemical signs of hyperandrogenism and presentation with irregular menses. Because of the similarity of normal pubertal development and features of PCOS, the diagnosis should be deferred until at least 2 years following menarche...
August 2019: Current Opinion in Pediatrics
Preneet Cheema Brar, Brenda Kohn
PURPOSE OF REVIEW: The purpose of this review is to present recent data that defines our current understanding of the role of the gut microbiome in the development of T2DM. RECENT FINDINGS: Recent studies focus on the physiology and molecular pathways of the gut microbiome-host interaction. Short-chain fatty acids (SCFAs) derived from the fermentation of plant-based nonsoluble fiber bind to G-protein-coupled receptors (GPR) GPR 41 and GPR 43 to induce enteroendocrine molecules that control appetite, and to upregulate intestinal gluconeogenesis gene expression that controls glucose regulation...
August 2019: Current Opinion in Pediatrics
Carmela Dayrit-Castro, Kimberly Tantuco, Irene Lara-Corrales
PURPOSE OF REVIEW: Patients seen at pediatric rheumatology are at increased risk of immediate and long-term consequences from sun exposure. The objective of this review is to build awareness of the need of sun protection in pediatric rheumatology patients. RECENT FINDINGS: Sun exposure can lead to disease exacerbations in many rheumatic diseases. There is well documented literature linking the chronic use of immunosuppressants with long-term risk of skin cancer...
August 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...
August 2019: Current Opinion in Pediatrics
Sarah Pitts, Sara F Forman
No abstract text is available yet for this article.
August 2019: Current Opinion in Pediatrics
Mary Ann de Banate, Jack Maypole, Matthew Sadof
PURPOSE OF REVIEW: We review the literature to help the reader better understand the latest thinking on how best to identify, coordinate and fund care for children with medical complexity, a medically fragile high-cost subpopulation of children and youth with special healthcare needs. RECENT FINDINGS: Proprietary and public algorithms have been developed to identify children with medical complexity. Research on families and healthcare providers of children with medical complexity have identified essential components of effective care coordination...
August 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...
June 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...
June 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...
June 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...
June 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...
June 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...
June 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...
June 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...
June 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...
June 2019: Current Opinion in Pediatrics
Grace Z Mak, Jessica J Kandel
No abstract text is available yet for this article.
June 2019: Current Opinion in Pediatrics
Christopher D Baker
PURPOSE OF REVIEW: Modern medical advances have resulted in an increased survival after extremely preterm birth. However, some infants will develop severe bronchopulmonary dysplasia (BPD) and fail to wean from invasive or noninvasive positive pressure support. It remains unclear which infants will benefit from tracheostomy placement for chronic ventilation. Once the decision to pursue chronic ventilation has been made, questions remain with respect to the timing of tracheotomy surgery, optimal strategies for mechanical ventilation, and multidisciplinary care in both the inpatient and outpatient settings...
June 2019: Current Opinion in Pediatrics
Shaina M Willen, Mark Rodeghier, Michael R DeBaun
PURPOSE OF REVIEW: Asthma is common in children with sickle cell disease (SCD) and appears to be associated with increased morbidity. Providers caring for children with SCD have struggled with the question of whether asthma exists as a true comorbidity or whether certain aspects of the chronic inflammatory disease gives children with SCD an asthma-like phenotype. RECENT FINDINGS: Clinical signs and symptoms seen in children with asthma in the general population, such as wheezing, airway hyperresponsiveness, atopy, elevated leukotrienes, and abnormal lung function are seen in children with SCD both with and without a diagnosis of asthma...
June 2019: Current Opinion in Pediatrics
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