Autism: considerations for transitions of care into adulthood
Purpose of review The steady rise in number of youth diagnosed with autism spectrum disorder (ASD) has led to the need to examine transition of care considerations specific to ASD. Improved understanding and guidance addressing these needs will allow pediatric and adult providers to work together to optimize social, medical, and occupational outcomes for these patients. Recent findings Health-care transition is a delicate time when children with ASD outgrow the services of pediatric programs and enter a fragmented healthcare system that is unfamiliar, insufficiently knowledgeable, and underfunded for their needs. Sum...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Measles: taking steps forward to prevent going backwards
This article aims to educate the reader about the measles virus and its clinical presentation, the MMR vaccine and its overwhelming success, and the concerning current national and international trends in measles outbreaks. Importantly, we focus on positions proposed by hesitant vaccinators and determine how medical providers can participate in productive conversation about vaccination to better gain trust and guide improved shared clinical decision-making. (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Palliative care for pediatric intensive care patients and families
This article reviews current evidence and best practices for integrating palliative care into the pediatric intensive care unit (PICU), with a focus on surgical patients. Recent findings Palliative care is best integrated in a tiered approach, with primary palliative care provided by the PICU and surgical providers for all patients and families, including basic symptom management, high-quality communication, and end-of-life care. Secondary and tertiary levels of care involve unit or team-based ‘champions’ with additional expertise, and subspecialty palliative care teams, respectively. PICU and surgical provi...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: SURGERY: Edited by Nikunj K. Chokshi Source Type: research

The economics of a pediatric surgical ICU
Purpose of review The purpose of this review is to describe quality and financial economic principles that form the foundation for complex care delivery systems for the critically ill pediatric surgical population. Recent findings Advances in neonatology along with innovation in surgical techniques in children led to the need to care for more complex postoperative surgical patients. Several studies have demonstrated improved outcomes in specialized pediatric centers. Furthermore, there is some evidence to suggest that there is overall financial benefit with decreased costs and more efficient resource use to pediatric ...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: SURGERY: Edited by Nikunj K. Chokshi Source Type: research

Extracorporeal membrane oxygenation in the pediatric population – who should go on, and who should not
Purpose of review The role of extracorporeal membrane oxygenation (ECMO), a method of providing cardiorespiratory support in instances of cardiac or respiratory failure, in neonates and children continues to expand and evolve. This review details the current landscape of ECMO as it applies to neonates and children. Recent findings Specifically, this review provides the most recent evidence for which patients should be considered for the various forms of ECMO including venovenous ECMO, venoarterial-ECMO, and extracorporeal cardiopulmonary resuscitation. Specific topics to be discussed include indications and contraindi...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: SURGERY: Edited by Nikunj K. Chokshi Source Type: research

Emerging issues in the ethical utilization of pediatric extracorporeal membrane oxygenation
Purpose of review As we have refined our extracorporeal membrane oxygenation (ECMO) capabilities and enhanced our ability to care for children with illnesses previously deemed lethal, the patient populations for whom ECMO is a medically appropriate intervention have expanded. Such expansion has prompted consideration of evolving ethical issues. In this review, we highlight several of the emerging ethical issues in pediatric ECMO. Recent findings Expansion of ECMO into increasingly diverse pediatric populations has prompted several ethical questions. First, some have found that there are specific clinical settings in w...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: SURGERY: Edited by Nikunj K. Chokshi Source Type: research

Pediatric burn care: new techniques and outcomes
Purpose of review Thermal injury is a leading cause of morbidity and mortality in children. This review highlights the current management of thermal injury and its complications. Recent findings Many recent advances in burn care have improved the outcomes of patients with thermal injury; however, variability does exist, and there are many opportunities for improvement. This review will highlight the complexity of issues encountered along the continuum of care for thermal injury patients. Accurate estimation of total burn surface area (TBSA) of a burn continues to be a challenge in pediatric patients. Variability conti...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: SURGERY: Edited by Nikunj K. Chokshi Source Type: research

Tuberculosis in children: screening, diagnosis and management
Purpose of review The present review focuses on recent advances and current challenges in screening, diagnosis and management of tuberculosis (TB) in children, encompassing TB infection and TB disease, and public health priorities for screening and family engagement. Recent findings Although awareness has improved in recent years that children in TB endemic areas suffer a huge disease burden, translation into better prevention and care remains challenging. Recent WHO guidelines have incorporated screening of all household contacts of pulmonary TB cases, but implementation in high incidence settings remains limited. Im...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: PULMONOLOGY: Edited by David N. Cornfield Source Type: research

Manifestations of pulmonary aspergillosis in pediatrics
Purpose of review Aspergillus spp. cause a clinical spectrum of disease with severity of disease dependent on degree of immune compromise, nature and intensity of inflammatory host response, and/or underlying lung disease. Chronic pulmonary aspergillosis encompasses a spectrum of diseases including aspergilloma, Aspergillus nodules, chronic cavitary pulmonary aspergillosis, chronic fibrosing pulmonary aspergillosis, and subacute invasive pulmonary aspergillosis. Allergic bronchopulmonary aspergillosis (ABPA) paradoxically is an immune hypersensitivity manifestation in the lungs that almost always occurs in the setting of...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: PULMONOLOGY: Edited by David N. Cornfield Source Type: research

Cystic fibrosis transmembrane conductance receptor modulator therapy in cystic fibrosis, an update
Purpose of review Cystic fibrosis transmembrane conductance receptor (CFTR) modulators are a new class of drugs that treat the underlying cause of cystic fibrosis. To date, there are four approved medications, which are mutation-specific. Although the number of mutations that respond to these agents is expanding, effective CFTR modulators are not available to all cystic fibrosis patients. The purpose of this article is to review the approved CFTR modulators and discuss the mutations that can be treated with these agents, as well as, review the long-term benefits of modulator therapy. Recent findings More people with c...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: PULMONOLOGY: Edited by David N. Cornfield Source Type: research

Vaping in adolescents: epidemiology and respiratory harm
Purpose of review This review highlights epidemiologic changes in e-cigarette use in adolescents, discusses recent advances in aerosolized nicotine delivery, and provides and updated profile of research related to the lung-specific harm of e-cigarettes. Recent findings In the past decade, nicotine-containing e-cigarettes have emerged as the most popular tobacco and nicotine delivery modality among adolescents in the United States.1 The surge in popularity of these devices has coincided with an outbreak of vaping-related lung injury, bringing e-cigarette use to national attention, and creating a great deal of confusion...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: PULMONOLOGY: Edited by David N. Cornfield Source Type: research

Editorial: Pediatric Pulmonology 2020, replacing fear with hope!
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: PULMONOLOGY: Edited by David N. Cornfield Source Type: research

Long-term complications of acute kidney injury in children
Purpose of review The current review will describe the current evidence and mechanisms of acute kidney injury (AKI) as a risk factor for long-term kidney complications, summarize the rationale for AKI follow-up and present an approach to monitoring children with AKI. Despite emerging evidence linking AKI with risk for long-term kidney and cardiovascular outcomes, many children who develop AKI are not followed for kidney disease development after hospital discharge. Better understanding of long-term complications after AKI and practical algorithms for follow-up will hopefully increase the rate and quality of post-AKI moni...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: CRITICAL CARE Source Type: research

Renal replacement therapies for infants and children in the ICU
Purpose of review Pediatric acute kidney injury (AKI) in critically ill patients is associated with increased morbidity and mortality. Emerging data support that the incidence of pediatric AKI in the ICU is rising. For children with severe AKI, renal replacement therapy (RRT) can provide a lifesaving supportive therapy. The optimal timing to deliver and modality by which to deliver RRT remain a point of discussion within pediatric (and adult) literature. This review discusses the use of RRT for pediatric patients in the ICU. We discuss the most recent evidence-based methods for RRT with a focus on continuous RRT. Recent...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: CRITICAL CARE Source Type: research

Novel biomarkers of acute kidney injury in children: an update on recent findings
Purpose of review The clinical diagnosis of acute kidney injury (AKI) relies largely on changes in serum creatinine; a delayed biomarker. Research in children has been focused on developing novel AKI biomarkers, which can improve the prediction, early detection and diagnosis of kidney injury, as well as our understanding of AKI pathophysiology. In this review, we describe recently published studies on urine or blood biomarkers of AKI. The mechanistic relevance of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, interleukin (IL)-18, liver-type fatty acid binding protein, tissue inhibitor of met...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: CRITICAL CARE Source Type: research

Firearm-related injuries in children and adolescents: an emergency and critical care perspective
Purpose of review Firearms are a leading cause of death and injury in children, especially in the United States. Many of these injuries present to emergency departments and pediatric ICUs, prompting a need for updated prevention, interventions, and trauma-informed care. This review explores the evidence for prevention and screening for access to firearms, types of injuries, and considerations for mass casualty events. Recent findings Firearm-related injuries lead to over 20 000 emergency department visits annually in children and carry a higher risk of severe injury or death. Screening high-risk patients for access ...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: EMERGENCY MEDICINE Source Type: research

Vaping implications for children and youth
Purpose of review The development and uptake of E cigarettes are a relatively recent phenomenon. Because of aggressive marketing, attractive designs, enticing flavors and primarily reactionary legislation, we are now seeing soaring rates of adolescent vaping with associated consequences. This review explores how E cigarettes work, their health implications, epidemiology among youth and current regulatory strategies. Recent findings Recently, the Center for Disease Control and Prevention reported that 27% of high school students had used a tobacco product within the last month, the majority being E-cigarettes in 20.8% ...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: EMERGENCY MEDICINE Source Type: research

Clinical event debriefing: a review of approaches and objectives
Purpose of review This review explores four different approaches and clarifies objectives for debriefing after a clinical event in the emergency department. Psychological debriefing aims to prevent or reduce symptoms of traumatic stress and normalize recovery. Psychological first aid helps team members provide each other with pragmatic social support. Debriefing for simulation-based education promotes learning by team members. Quality improvement approaches and after action reviews focus on systems improvement. Recent findings Qualitative studies have begun to explore interactions between clinical staff after a signif...
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: EMERGENCY MEDICINE Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - May 6, 2020 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research

A clinical update on vaccines: focus on determinants of under-immunization and special considerations for adolescents
Purpose of review The current article reviews recent literature related to pediatric and adolescent vaccination, specifically focusing on social determinants of under-immunization, expanding adolescent immunization rates, and new recommendations surrounding the meningococcal serotype B vaccine (MenB). Recent findings Vaccine refusals and vaccine-preventable diseases have been rising in some parts of the world, and appear to be linked to household factors, such as a family's socioeconomic status. Adolescents have lower immunization rates than younger children. Newer vaccines targeted at adolescents, such as the MenB va...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Update on penicillin allergy delabeling
Purpose of review To review phenotyping and risk classification of penicillin allergy and provide an update on penicillin allergy delabeling strategies for primary care. Recent findings Beta-lactams are considered the treatment of choice for a wide range of bacterial pathogens; however, many patients receive second-line agents due to being labeled as having an allergy to penicillin. This approach can lead to antibiotic resistance and inferior health outcomes. While 10% of the population is labeled as penicillin allergic, penicillin anaphylaxis occurs in less than 1% of patients. For patients with delayed benign skin r...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Environmental mixtures and children's health: identifying appropriate statistical approaches
We present methods to identify the most relevant exposures among a high-multitude of variables, via shrinkage and variable selection techniques, and identify the overall mixture effect, via Weighted Quantile Sum and Bayesian Kernel Machine regressions. We then describe novel extensions that handle high-dimensional exposure data and allow identification of critical exposure windows. Summary Recent advances in statistics and machine learning enable researchers to identify important mixture components, estimate joint mixture effects and pinpoint critical windows of exposure. Despite many advantages over single chemical app...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: THERAPEUTICS AND TOXICOLOGY: Edited by Robert Wright Source Type: research

Review on the role of socioeconomic status in child health and development
Purpose of review This review presents findings from recent studies investigating the role of socioeconomic status (SES) in child development. Studies on associations between SES and different parameters of physical and psychological health, on interventions and possible resilience factors are reviewed. Recent findings Several cross-sectional and longitudinal studies demonstrate social disparities in child behavior and health. They underline the detrimental effects of low SES on child development. Some studies also highlight the potentially adverse effects of early diseases or vulnerabilities on later career and socia...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: THERAPEUTICS AND TOXICOLOGY: Edited by Robert Wright Source Type: research

Metabolomics and adductomics of newborn bloodspots to retrospectively assess the early-life exposome
Purpose of review Exposomics studies can measure health-relevant chemical exposures during a lifetime and estimate the ‘internal’ environment. However, sampling limitations make these features difficult to capture directly during the critical neonatal time period. Recent findings We review the use of newborn dried bloodspots (DBS) archived from newborn screening programs for exposomic analysis in epidemiological children's health studies. Emerging ‘omics technologies such as adductomics and metabolomics have been adapted for DBS analysis, and these technologies can now provide valuable etiological in...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: THERAPEUTICS AND TOXICOLOGY: Edited by Robert Wright Source Type: research

Prevention of recurrent urinary stone disease
Purpose of review Urinary stone disease (USD) is increasing in prevalence and recurrence is common. In pediatrics, most stones are composed primarily of calcium with the highest incidence observed in adolescents. Given the morbidity associated with USD, an in depth review of current management strategies is of paramount importance to highlight the data supporting the recommended treatments and the knowledge gaps which still exist. Recent findings Several interventions for the management of recurrent calcium USD in children have been recommended based on primarily adult studies. These interventions include modification...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEPHROLOGY: Edited by Michel Baum Source Type: research

Urologic treatment of nephrolithiasis
Purpose of review The purpose of this review is to describe the options and recent developments in the urologic treatment of nephrolithiasis in children. The prevalence of nephrolithiasis in children has increased over time. The urologic treatment of nephrolithiasis ranges from observation to medical expulsive therapy with an alpha blocker for a stone in a ureter to a variety of procedures for stone removal. Recent findings Observation for small, asymptomatic renal stones is a reasonable strategy in children. Medical expulsive therapy with an alpha blocker may have a beneficial effect for passage of ureteral stones in...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEPHROLOGY: Edited by Michel Baum Source Type: research

Dietary risk factors for urinary stones in children
Purpose of review As the incidence of urinary stone disease in children is increasing, identifying dietary risk factors becomes vitally important, especially in the context of targeting interventions to reduce risk for stone formation. Indiscriminant dietary restrictions are not appropriate for paediatric patients. Recent findings Although large, prospective studies are still needed to better quantify dietary risk factors for paediatric stone formers, a number of smaller studies provide data to identify common risk factors to help prevent stone formation, while minimizing inappropriate dietary restrictions. Summary ...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEPHROLOGY: Edited by Michel Baum Source Type: research

Inherited conditions resulting in nephrolithiasis
Purpose of review Prevalence of pediatric urolithiasis is increasing, which is definitively visible in increasing numbers of presentations in emergency or outpatient clinics. In pediatric patients, a genetic or metabolic disease has to be excluded, so that adequate treatment can be installed as early as possible. Only then either recurrent stone events and chronic or even end-stage kidney disease can be prevented. Recent findings The genetic background of mostly monogenic kidney stone diseases was unravelled recently. In hypercalcuria, for example, the commonly used definition of idiopathic hypercalciuria was adopted ...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEPHROLOGY: Edited by Michel Baum Source Type: research

Evaluation of a child with suspected nephrolithiasis
Purpose of review As the incidence of nephrolithiasis in children doubles every 10 years it is becoming a common disease associated with significant morbidity along with considerable economic burden worldwide. The aim of this review is to summarize current data on the epidemiology and causes of renal stones in children and to provide a frame for the first clinical evaluation of a child with suspected nephrolithiasis. Recent findings Dietary and environmental factors are the driving force of changing epidemiology. Diagnosis should be based on medical history, presenting signs, examination, first laboratory and radiolog...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEPHROLOGY: Edited by Michel Baum Source Type: research

Editorial: Pediatric nephrolithiasis
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEPHROLOGY: Edited by Michel Baum Source Type: research

Lifelong pulmonary sequelae of bronchopulmonary dysplasia
Purpose of review To summarize the current literature evaluating long-term pulmonary morbidity among surviving very preterm infants with bronchopulmonary dysplasia (BPD). Recent findings BPD predisposes very preterm infants to adverse respiratory signs and symptoms, greater respiratory medication use, and more frequent need for rehospitalization throughout early childhood. Reassuringly, studies also indicate that older children and adolescents with BPD experience, on average, similar functional status and quality of life when compared to former very preterm infants without BPD. However, measured deficits in pulmonary ...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Serial clinical observation for management of newborns at risk of early-onset sepsis
Purpose of review Current management approaches for asymptomatic neonates at risk of early onset sepsis remain controversial. Strategies based entirely on clinical observation (SCO, serial clinical observation) have gained consensus. Recent findings We briefly compare different strategies for managing asymptomatic newborns suggested in four high-income countries. Then this review details the existing differences in carrying out the SCO in the United Kingdom, the USA, and Italy; the experiences from the studies performed using the SCO; and open questions regarding this strategy. Advantages and limitations of SCO are al...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Neonatal functional echocardiography
Purpose of review The role of echocardiography has dramatically changed over the past decade and use of functional echocardiography has become increasingly popular among neonatologists and pediatric intensivists in making clinical decisions in sick infants and children. The purpose of this review is to outline the current capabilities and limitations of functional echocardiography, best practices for its clinical application, and evidence for its utility. Recent findings Functional echocardiography can provide direct assessment of hemodynamics at bedside and can be used as a modern hemodynamic monitoring tool in the n...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Less invasive surfactant administration: best practices and unanswered questions
Purpose of review The purpose of this review is to describe current concepts in the field of Less Invasive Surfactant Administration (LISA). The use of continuous positive airway pressure (CPAP) has become standard for the treatment of premature infants with respiratory problems throughout the world. However, if CPAP fails, technologies like LISA are needed that can combine surfactant delivery and spontaneous breathing with the support of noninvasive modes of ventilation. Recent findings LISA with thin catheters has been in use in Germany for more than 15 years. In the last 5 years, there was substantial interest in t...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Point-of-care ultrasound in the neonatal ICU
Purpose of review Point-of-care ultrasound (POCUS) is an emerging clinical tool in the neonatal intensive care unit (NICU). Recent literature describing the use of POCUS for various applications in the NICU has garnered increased interest among neonatologists. Recent findings Diagnostic applications for POCUS in the NICU include the evaluation and serial monitoring of common pulmonary diseases, hemodynamic instability, patent ductus arteriosus (PDA), persistent pulmonary hypertension of the newborn (PPHN), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH), among others. Procedural applications inc...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Stem-cell therapy for bronchopulmonary dysplasia
Purpose of review Clinical trials of mesenchymal stem/stromal cell (MSC) therapy for bronchopulmonary dysplasia (BPD) are underway. A thorough understanding of the preclinical work that underpins these trials is critical for neonatal practitioners to properly evaluate them. Recent findings Significant progress has been made in understanding that MSCs have anti-inflammatory and proangiogenic effects, and that these can be mediated by the noncellular exosome fraction of MSCs. Summary In rodent hyperoxia models of BPD, MSCs have a proangiogenic effect mediated largely by vascular endothelial growth factor and shift th...
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Editorial: What does innovation look like?
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: NEONATOLOGY AND PERINATOLOGY: Edited by Tara M. Randis and Thomas A. Hooven Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - March 9, 2020 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research

The cannabidiol conundrum: potential benefits and risks of cannabidiol products for children
Purpose of review Since the federal ban on hemp products was lifted in December 2018, cannabidiol (CBD), a nonpsychoactive cannabinoid derived from hemp, has become increasingly popular and accessible. CBD is sold in the form of oils, tablets, and foods in locations including gas stations, cafés, and drug stores. Despite a lack of reliable evidence, many parents praise its purported therapeutic effects on a variety of childhood ailments. Recent findings Epidiolex was the first CBD-based medication to be approved by the US Food and Drug Administration in 2018 for the treatment of two rare and severe forms of epi...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Digital sextortion: Internet predators and pediatric interventions
Purpose of review Sextortion is defined as the act of coercing people into sending explicit images of themselves and subsequently blackmailing victims with the public release of said images. Prosecutions of sextortion cases involving minors have increased almost two-fold in the past 5 years. The purpose of this review is to explore the literature regarding the behavior of both victims and perpetrators, the effects on victims, and the support resources available for clinicians, victims, and parents. Recent findings Sextortion begins as an unassuming request for personal pictures and quickly escalates. Minors targeted b...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Rotavirus vaccination in the neonatal intensive care units: where are we? A rapid review of recent evidence
Purpose of review Rotavirus is a leading cause of viral acute gastroenteritis in infants. Neonates hospitalized in neonatal intensive care units (NICUs) are at risk of rotavirus infections with severe outcomes. The administration of rotavirus vaccines is only recommended, in the United States and Canada, upon discharge from the NICU despite rotavirus vaccines being proven well tolerated and effective in these populations, because of risks of live-attenuated vaccine administration in immunocompromised patients and theoretical risks of rotavirus vaccine strains shedding and transmission. We aimed to summarize recent evide...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Grace Lee Source Type: research

Understanding the impact of state vaccination laws on exemption rates
Purpose of review This review summarizes the current state of school-entry vaccination requirements and related exemption policies in the United States and examines recent changes to these policies. Recent findings With recent infectious disease outbreaks in the United States, there has been heightened awareness on unvaccinated individuals, and the state-level policies that allow individuals to be exempted from school-entry vaccination requirements. Between 2015 and 2017, there have been eleven states that have altered their policies regarding school-entry vaccination requirements and related reporting for which no fo...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Grace Lee Source Type: research

Evidence-based strategies to increase vaccination uptake: a review
Purpose of review To summarize evidence-based strategies for improving pediatric immunization rates including physician behaviors, clinic and public health processes, community-based and parent-focused interventions, and legal and policy approaches Recent findings Studies continue to show the effectiveness of audit and feedback, provider reminders, standing orders, and reminder/recall to increase immunization rates. Provider communication strategies may improve immunization rates including use of a presumptive approach and motivational interviewing. Centralized reminder/recall (using a state Immunization Information S...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Grace Lee Source Type: research

Advances in vaccinating immunocompromised children
Purpose of review Immunocompromised children are a largely under-vaccinated population and are vulnerable to acquiring vaccine-preventable infections (VPIs). A variety of factors contribute to poor vaccine coverage including: severity of underlying illness, sporadic contact with primary care physicians, and lack of awareness among specialty providers regarding vaccination status. In this review, we report recent data regarding incidence of VPIs, new approaches to vaccine use, rates of vaccine coverage, and strategies to optimize vaccine administration in immunocompromised populations. Recent findings Pediatric transpl...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Grace Lee Source Type: research

Resurgence of measles in the United States: how did we get here?
Purpose of review In September 2019, the United States was at risk of losing measles elimination status due to several large-scale outbreaks resulting in more than 1200 confirmed cases across 31 states. This resurgence caps approximately 10 years of increasing incidence, marked by a highly publicized outbreak in 2015 associated with Disneyland when an infected traveler from the Philippines unknowingly spread the virus to susceptible park visitors and the recently ended large outbreak in undervaccinated Orthodox Jewish communities in New York City and Rockland counties. This review highlights current literature elucidatin...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Grace Lee Source Type: research

Toward precision adjuvants: optimizing science and safety
Purpose of review The gradual replacement of inactivated whole cell and live attenuated vaccines with subunit vaccines has generally reduced reactogenicity but in many cases also immunogenicity. Although only used when necessary, adjuvants can be key to vaccine dose/antigen-sparing, broadening immune responses to variable antigens, and enhancing immunogenicity in vulnerable populations with distinct immunity. Licensed vaccines contain an increasing variety of adjuvants, with a growing pipeline of adjuvanted vaccines under development. Recent findings Most adjuvants, including Alum, Toll-like receptor agonists and oil-...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: INFECTIOUS DISEASES AND IMMUNIZATION: Edited by Grace Lee Source Type: research

Polydactyly a review and update of a common congenital hand difference
Purpose of review The purpose of this review is to describe various forms of hand polydactyly and their different treatment approaches. Hand polydactyly is commonly classified as ulnar (small finger) or radial (thumb). Polydactyly can be sporadic, genetic, and/or associated with syndromic conditions. Recent findings Both ulnar and radial polydactyly can be surgically treated to optimize hand aesthetics and function. Timing of surgery is based on multiple factors, most notably including safety of anesthesia and socialization of the affected child. The pediatrician should be aware of potential associated conditions, suc...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research

Knee orthopedic problems in newborns and infancy: a review
We present the reader with insight on the most common disorders of the knee in newborns and infants. Knee issues in this population may confuse the first contact physicians due to certain peculiarities of the immature immune system, small size and underdevelopment of joint anatomy. Data presented here are recent and significant, and something to bear in mind when caring for children of this age. Recent findings With the advent of new diagnostic methods, a shift in the causative agent of pediatric knee infections has been noted. Minimally invasive methods such as arthrocentesis and arthroscopy are successfully employed i...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research

Osgood–Schlatter disease: a 2020 update of a common knee condition in children
Purpose of review Osgood–Schlatter disease (OSD) is one of the most common causes for anterior knee pain in children and adolescents resulting from a traction apophysitis of the tibial tubercle. While a peak in boys aged 12–15 years old was well documented, there seems to be no difference in sex distribution nowadays. This may result from increased participation of young females in high-impact sports. This review provides an up-to-date account on contemporary prophylaxis as well as diagnostic and therapeutic approaches. Recent findings Numerous studies have examined risk factors for OSD. These include body...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research

Clubfoot for the primary care physician: frequently asked questions
Purpose of review This review aims to provide primary care physicians with updates on recent literature regarding clubfoot and answer questions asked by parents and caregivers of children with clubfoot. The topics discussed include prenatal counseling, relapse after Ponseti treatment, long-term outcomes following successful treatment of clubfoot, and the effect of diagnosis and treatment on the parent or caregiver. Recent findings Clubfoot is one of the most commonly searched orthopaedic conditions on the internet by parents. There is a lack of evidence-based guidelines on clubfoot worldwide. Recent systematic reviews...
Source: Current Opinion in Pediatrics - January 9, 2020 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research