Current concepts of polycystic ovary syndrome pathogenesis
Purpose of review This review provides a model for understanding polycystic ovary syndrome (PCOS) pathophysiology and updates the evidence on which it is based. Then, it highlights complimentary molecular genetic and epigenetic advances in understanding PCOS cause. Recent findings Important studies into PCOS cause built on the 2014 discovery of a novel regulatory protein variant that underlies the typical PCOS steroidogenic abnormalities: DENND1A.V2 (differentially expressed in normal and neoplastic development, isoform 1A, variant 2). Over 30 DENND1A gene variants have been found, the vast majority upstream of the co...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: SPECIAL COMMENTARIES Source Type: research

Training in pediatric surgical critical care
Purpose of review The purpose of this review is to describe education, training, certification of fellows in pediatric surgical critical care (PSCC). PSCC is a small but unique specialty within surgery. Education curricula focus on pediatric intensive care, neonatal intensive care, surgical intensive care, and pediatric surgical acute care. Attention is focused on the current state of SCC certification via the American Board of Surgery and future possibilities that could be implemented. Recent findings Because of the uniqueness of the specialty, the little literature that exists focuses on fellow experience including ...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: SPECIAL COMMENTARIES Source Type: research

The problem of vaccination refusal: a review with guidance for pediatricians
Purpose of review In the wake of multiple recent outbreaks of the measles and other vaccine-preventable diseases, it is crucial to understand and address parental concerns about vaccination. The purposes of this review are: to identify the causes of vaccine resistance, to elucidate the variables that have led to the success or failure of interventions to date, and to consider implications for pediatricians treating children whose parents are vaccination-resistant. Recent findings Recent research draws on insights from cognitive science to understand vaccine resistance and to develop more effective interventions. Studi...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Community health workers: improving population health through integration into healthcare systems
Purpose of review The purpose of this review is to describe the role, responsibilities, hiring, training, and retention of community health workers (CHWs) on clinical care teams in the United States. Recent findings CHWs are unique members of clinical care teams because of their ability to foster a deep trust and understanding with patients by sharing similar life experiences, participating in home visits, and providing constant support and advocacy. By partnering with CHWs, other clinical care members also gain a better understanding of their patients allowing them to deliver more culturally competent, patient/family...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Medications for constipation in 2020
Purpose of review Chronic constipation is a common problem that substantially impacts the quality of life of patients and families, healthcare professionals, and resources. The purpose of this review is to discuss the medications that are available for management of chronic constipation, including medications that have been approved by the FDA for adults, other been studied in pediatrics now, and might become available within the upcoming years. Recent findings Recent developments in the evaluation of childhood constipation are providing a better understanding into defecation disorders in children and not only new the...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: GASTROENTEROLOGY AND NUTRITION: Edited by Bradley Barth Source Type: research

Pancreatic complications in children with cystic fibrosis
Purpose of review The pancreas is highly affected in cystic fibrosis, with complications occurring early in childhood. This review highlights recent research in exocrine pancreatic function in the era of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies and discusses how these are affecting pancreatitis and exocrine pancreatic insufficiency (EPI) in children. Additionally, new research into exocrine--endocrine interactions sheds light on how CFTR dysfunction in ductal cells may affect beta cells. Recent findings Ivacaftor has disproved the hypothesis that EPI in children with cystic fibros...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: GASTROENTEROLOGY AND NUTRITION: Edited by Bradley Barth Source Type: research

Update on celiac disease
Purpose of review The purpose of this review is to describe current updates in celiac disease. Recent findings Recent developments in the understanding of the pathogenesis of celiac disease continue to emerge that may implicate the role of gluten exposure. Several studies have shown that the amount of gluten consumed by the infant may affect the age of onset of celiac disease in genetically predisposed individuals. New guidelines from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition allow serology-based celiac diagnosis, omitting endoscopic biopsies, in children. Recent data and updated gu...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: GASTROENTEROLOGY AND NUTRITION: Edited by Bradley Barth Source Type: research

Prevention of adverse drug effects: a pharmacogenomic approach
Purpose of review Adverse drug reactions (ADRs) are a serious burden and can negatively impact patient quality of life. One of these ADRs, anthracycline-induced cardiotoxicity (ACT), occurs in up to 65% of treated patients and can lead to congestive heart failure. Pharmacogenetic studies have helped to reveal the mechanisms of ACT and, consequently, inform current strategies to prevent ACT in the clinic. Recent findings Many pharmacogenetic studies have been conducted for ACT, but few have led to the development of clinical practice guidelines and clinical genetic testing for ACT. This is, in part, because of lack of ...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: CARDIOVASCULAR MEDICINE: Edited by Daniel Bernstein Source Type: research

CPR and AEDs save lives: insuring CPR--AED education and CPR--AED access in schools
Purpose of review Sudden cardiac arrest and sudden cardiac death are less common in children and adolescents than in the adult population. The outcomes from sudden cardiac arrest are generally quite poor in all ages and some data suggest that they are worse in the child and adolescent age group. In addition, the incidence of bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use is generally quite low although it is somewhat variable across communities. This review has been written in order to review the data for pediatric bystander CPR and AED use as it relates to out-of-hospital ca...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: CARDIOVASCULAR MEDICINE: Edited by Daniel Bernstein Source Type: research

Management of familial hypercholesterolaemia in childhood
Purpose of review All guidelines for the management of heterozygous familial hypercholesterolaemia in children and young people recommend statins to lower LDL-cholesterol (LDL-C) concentrations, to reduce the individual's adult risk of developing cardiovascular disease (CVD). Here, we review recent findings regarding the efficacy and safety of the use of stains in childhood. Recent findings As expected from their safety profile in adults, there is no evidence from short-term trials or long-term follow-up that statin use in children is associated with any adverse effects on growth, pubertal development or muscle or liv...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: CARDIOVASCULAR MEDICINE: Edited by Daniel Bernstein Source Type: research

The benefit of exercise in children with congenital heart disease
Purpose of review Children and adolescents with congenital heart disease (CHD) often have decreased exercise capacity and muscle mass. Exercise has numerous health benefits and can improve exercise capacity and muscle mass. As such, guidelines recommend 60 min of daily physical activity in the majority of pediatric CHD patients. Despite these known benefits and guidelines, children and adolescents with CHD often do not exercise regularly. The purpose of this review is to summarize the current literature on exercise in this population. Recent findings With recent advancements in the field, clinical focus in pediatric...
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: CARDIOVASCULAR MEDICINE: Edited by Daniel Bernstein Source Type: research

Editorial: Advances in Pediatric Cardiology 2020
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: CARDIOVASCULAR MEDICINE: Edited by Daniel Bernstein Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - September 10, 2020 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research

Fetal surgery and neonatal ICU admissions
Purpose of review Fetal intervention is a dynamic field with wide-reaching implications on neonatal ICU admissions and the care of neonates with congenital anomalies. The aim of this review is to summarize recent advancements in fetal surgery and provide a broad understanding of how these topics interrelate. Recent findings Advancements in prenatal imaging and diagnosis have dramatically expanded the indications for fetal intervention. Most recently, there has been a large focus on evaluating minimally invasive strategies of fetal intervention, notably fetoscopic surgery, and the use of stem cells for fetal treatment ...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: SPECIAL COMMENTARY Source Type: research

Management of neonates after postpartum discharge and all children in the ambulatory setting during the coronavirus disease 2019 (COVID-19) pandemic
Purpose of review The present coronavirus disease 2019 (COVID-19) pandemic has created additional challenges with an increased number of presumed healthy, full-term newborns being discharged at 24 h after delivery. Short lengths of stay raise the possibility of mother–infant dyads being less ready for discharge, defined as at least one of the three informants (i.e., mother, pediatrician, and obstetrician) believing that either the mother and/or infant should stay longer than the proposed time of discharge. This public health crisis has reduced the number of in-person well child visits, negatively impacting vaccin...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Recent advances in addressing vaccine hesitancy
Purpose of review To offer healthcare providers current, evidence-based approaches for addressing vaccine hesitancy to increase vaccine coverage and reduce the frequency of vaccine-preventable disease outbreaks. Recent findings Vaccine hesitancy is a growing problem with profound societal, economic, and medical consequences. Understanding the complexity of vaccine hesitancy can inform approaches to increasing vaccine uptake on both the individual and population levels. Notably, pediatricians play a critical role in increasing vaccine uptake due to their relationships with families. This doctor–patient relationsh...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Adolescent suicide: what can pediatricians do?
This article will review the changing rates of suicide, discuss recent literature on risk factors, identify methods to screen for suicidal thoughts and suggest an approach to counseling a suicidal patient. Finally, there will be a brief discussion on safety planning and public health measures to help reduce suicide rates. Recent findings Rates of attempted suicide and death by suicide have been increasing for more than a decade. Risk assessment of potential suicidality remains very challenging, as the risk factors are multifactorial. However, some common risk factors persist including sexual minority identification and ...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Treatment of cardiometabolic risk factors in patients with type 1 diabetes
This article reviews recent evidence on cardiometabolic risk factors and their management in youth with T1D. Recent findings Adolescents with T1D show early signs of vascular complications, as a result of several cardiometabolic risk factors. Poor glycemic control is one of the main risk factors and the main target of treatment. However, only a minority of adolescents with T1D reaches recommended targets for glycemic control. Hypertension, dyslipidemia, smoking, alcohol use, obesity and insulin resistance are other common cardiometabolic risk factors in this age group. Recent data confirm that screening for these risk f...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research

Obesity and insulin resistance in children
Purpose of review It is well known that obesity represents the main modifiable risk factor for insulin resistance in children and adolescents; obesity-induced insulin resistance in children is the most important risk factor for developing cardiovascular diseases and type 2 diabetes in adulthood. The mechanisms through which obesity causes insulin resistance are complex and not completely known to date. Recent findings In children, global adiposity is the main factor determining insulin resistance. Excessive fatty acids play a determinant role in the pathogenesis of insulin resistance in obese children, inducing an inc...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research

Update on adrenarche
Purpose of review Adrenarche is the pubertal maturation of the innermost zone of the adrenal cortex, the zona reticularis. The onset of adrenarche occurs between 6 and 8 years of age when dehydroepiandrosterone sulfate (DHEAS) concentrations increase. This review provides an update on adrenal steroidogenesis and the differential diagnosis of premature development of pubic hair. Recent findings The complexity of adrenal steroidogenesis has increased with recognition of the alternative ‘backdoor pathway’ and the 11-oxo-androgens pathways. Traditionally, sulfated steroids such as DHEAS have been considered to...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research

Diagnosis and management of pediatric metabolic bone diseases associated with skeletal fragility
Purpose of review The goal of this review is to give an overview of diagnosis and up-to-date management of major pediatric metabolic bone diseases that are associated with bone fragility, including nutritional rickets, hypophosphatemic rickets, osteogenesis imperfecta, Ehlers--Danlos syndrome, Marfan's syndrome, hypophosphatasia, osteopetrosis and skeletal fluorosis. Recent findings During the past decade, a number of advanced treatment options have been introduced and shown to be an effective treatment in many metabolic bone disorders, such as burosumab for hypophosphatemic rickets and asfotase alfa for hypophosphata...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research

Clinical expression of endocrine disruptors in children
Purpose of review Health status is the result of complex interaction between individual factors, general environmental factors and specific factors as nutrition or the presence of chemicals. Aim of this review is to point out the more recent knowledge covering the role of the endocrine disrupting chemical (EDC) on pediatric population wellbeing. Recent findings Prenatal, postnatal life and puberty are the three main temporal windows of susceptibility when EDCs may act. The mechanism is independent from dose or duration of exposition, sex, age or combination of chemicals and may also be transgenerational, affecting bot...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research

Use of sleeve gastrectomy in adolescents and young adults with severe obesity
Purpose of review The prevalence of pediatric obesity and its associated complications is increasing around the world. Treatment of obesity is challenging and metabolic and bariatric surgery (MBS) is currently the most effective treatment for this condition. At this time, vertical sleeve gastrectomy (VSG) is the most commonly performed bariatric procedure in adolescents. However, knowledge regarding the efficacy, safety, and durability of VSG in adolescents is still evolving. This review summarizes the most recent updates in the field of MBS particularly VSG in adolescents. Recent findings MBS is recommended to treat ...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research

PIK3CA vascular overgrowth syndromes: an update
Purpose of review Over the past decade many previously poorly understood vascular malformation disorders have been linked to somatic activating mutations in PIK3CA, which regulates cell survival and growth via activation of the mTOR1-AKT pathway. The goal of this article is to describe and provide an update on the clinical features, complications, and management strategies for the PIK3CA-related overgrowth spectrum (PROS). Recent findings PROS encompasses a heterogenous group of disorders with complications related to the tissues harboring the mutation. Vascular malformation syndromes, such as Klippel–Trenaunay ...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Pediatric mastocytosis
Purpose of review The current article highlights recent developments in the field of pediatric cutaneous mastocytosis. Mastocytosis is a spectrum of conditions that range from fleetingly benign to aggressively malignant. Through recognizing the natural progression of disease, the role of biomarkers and mutational analysis, treatment and risk of triggers, physicians can confidently stage, counsel and manage patients with pediatric cutaneous mastocytosis. Recent findings Many lesions of cutaneous mastocytosis are chronic with some resolving around the mid-teenage years. KIT mutations are found in the majority of pediatr...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Pediatric contact dermatitis: what's new
Purpose of review Allergic contact dermatitis (ACD) was once thought to be rare in children but recent studies have demonstrated that the prevalence of ACD is common and appears to be increasing in children. Current trends including toys, hobbies, and personal care products may play a role in potentially new allergen exposure or resurgence of certain allergens, making ACD a moving target in children. Recent findings ACD and atopic dermatitis can coexist and certain clinical features can help differentiate ACD from endogenous atopic dermatitis in children. It is important to consider ACD in children with recalcitrant a...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Trends in pediatric skin cancer
Purpose of review To inform pediatric providers of the clinical characteristics, underlying genetic drivers, and therapeutic options for skin cancer arising in childhood and adolescence. Recent findings The incidence of melanoma in pediatric patients has been declining in the past decades. Pediatric-specific diagnostic criteria should be utilized when assessing lesions concerning for melanoma to better account for the different presentations seen in pediatric disease compared with adults, such as an increased prevalence of amelanotic melanoma or frequent mimic of benign pediatric lesions. Pediatric melanoma often pres...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Pediatric nail disorders: a review
Purpose of review Nail disorders represent an uncommon subset of complaints seen in pediatric dermatology. There is a wide array of disorders that can affect the nail unit in children, including infectious, inflammatory, neoplastic, congenital, and traumatic processes. In order to enhance familiarity with pediatric nail conditions, we review the background and treatment of the more common entities seen in pediatric onychology, including onychomycosis, onychomadesis, nail psoriasis, trachyonychia, longitudinal melanonychia, onychophagia, and onychocryptosis. Recent findings Nail involvement in pediatric patients with p...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Hemangioma-related syndromes
Purpose of review There is a growing understanding of complications and anomalies associated with infantile hemangiomas. The current review will discuss recent clinical advances in syndromes associated with segmental hemangiomas, including PHACE and LUMBAR syndrome. In addition, the importance of recognizing visceral hemangiomatosis is highlighted. Recent findings Ongoing longitudinal studies of PHACE and LUMBAR syndromes associated with segmental infantile hemangiomas have led to improved diagnosis and recommendations for screening for associated anomalies. Characterization of a growing spectrum of associated anomali...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Congenital melanocytic nevi
Purpose of review To update pediatric providers on new developments in our understanding of the clinical presentation, genetics, and systemic risks associated with congenital melanocytic nevi (CMN). Recent findings CMN are primarily caused by sporadic postzygotic somatic mutations, most frequently in NRAS, and studies of the genetic underpinnings of CMN have demonstrated a diverse array of genetic drivers. The primary complications of large and giant CMN include neurocutaneous melanocytosis and malignant melanoma. Abnormalities in CNS MRI may predict a worse clinical course for patients and increased risk of melanoma....
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Editorial: Pediatric dermatology: skin signs of systemic disease
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: DERMATOLOGY: Edited by Albert C. Yan Source Type: research

Mycoplasma genitalium and Trichomonas vaginalis: addressing disparities and promoting public health control of two emerging sexually transmitted infections
Purpose of review Mycoplasma genitalium (M. genitalium) and Trichomonas vaginalis (T. vaginalis), sexually transmitted infections that remain non-reportable in the United States, may lead to pelvic inflammatory disease (PID) and adverse pregnancy outcomes if left untreated. Prevalence estimates have highlighted socioeconomic and racial/ethnic disparities in rates of infection. This review summarizes the recent literature on M. genitalium and T. vaginalis with a focus on the epidemiology, screening, and treatment of M. genitalium and T. vaginalis. Recent findings The burden of T. vaginalis testing remains on women. Ant...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research

Eating disorders in adolescent boys and young men: an update
Purpose of review To review the recent literature on eating disorders and disordered eating behaviors among adolescent boys and young men, including epidemiology, assessment, medical complications, treatment outcomes, and special populations. Recent findings Body image concerns in men may involve muscularity, and muscle-enhancing goals and behaviors are common among adolescent boys and young men. Recent measures, such as the Muscularity Oriented Eating Test (MOET) have been developed and validated to assess for muscularity-oriented disordered eating. Medical complications of eating disorders can affect all organ syste...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research

Supplement (mis)use in adolescents
Purpose of review Dietary supplement usage by adolescents has been on the rise in the last decade and is expected to continue to grow, although the evidence of their benefits in healthy individuals remains unclear. This review aims to spread awareness about the poorly regulated supplements and their effects on the health of adolescents to minimize medical hazards. Recent findings In this review, we have attempted to summarize some of the commonly consumed supplements, their alleged benefits, effects and side effects, along with the motivation that drives adolescents into consuming them. Summary The widespread use o...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research

Long-acting reversible contraception side effect management
This article seeks to equip primary care clinicians with the tools necessary to assess and manage common LARC-associated side effects. Recent findings Side effects are common with progestin-only LARC, and can precipitate early discontinuation of an otherwise effective, low-maintenance form of contraception. Abnormal uterine bleeding, pelvic pain, acne, and weight change are often cited as progestin-only LARC side effects, yet the causes are poorly understood despite extensive research. While most side effects improve with time, therapeutic interventions are available for patients with undesirable side effects that prefe...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research

Adolescent body image: influencing factors and the clinician's role
Purpose of review Body image is a crucial part of adolescent development for teens all over the world. Studies show that negative body image impacts many aspects of adolescent health and that anticipatory guidance about body image is important at the annual health maintenance exam visit. Weight bias is closely tied to body image and is associated with negative health effects as well; research shows weight bias is a problem throughout healthcare. The purpose of this review is to discuss influencing factors on adolescent body image and to explore interventions to promote positive body image. Recent findings Research sho...
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research

Editorial: Confidentiality: opening the door to optimal adolescent healthcare
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - July 30, 2020 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research

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