Osteogenesis imperfecta: treatment and surgical management
Purpose of review
Osteogenesis imperfecta is a disease with many different causes and clinical presentations. Surgery at a young age is the often required in order to improve the patients’ growth development and quality of life. This manuscript highlights the current approach to treat children with osteogenesis imperfecta. The main purpose of this review is to compare and discuss the latest surgical techniques and procedures.
Recent findings
Recent studies have indicated that telescoping intramedullary Faisser-Duval rods are one of the most suitable surgical devices to correct long bone deformities. The design...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research
Adolescent hip dysplasia: what are the symptoms and how to diagnose it
This article will focus mainly on the diagnosis of adolescent hip dysplasia. The standard for treatment of acetabular dysplasia in skeletally mature patients is the periacetabular osteotomy; however, nonoperative management and occasionally arthroscopic surgery can also be considered in cases of symptomatic borderline dysplasia. (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research
The nonoperative treatment of osteochondritis dissecans of the knee
Purpose of review
The purpose of this review is to update the reader on the controversial subject of osteochondritis dissecans (OCD) with a focus on nonoperative treatment indications, methods, and success rate.
Recent findings
Work by an international multicenter study group ROCK (Research in OsteoChondritis of the Knee) will be reviewed including new classifications systems of healing, arthroscopy, radiographs, and MRI, along with new evidence on off-loading bracing compared to restricted weight bearing.
Summary
The paucity of evidence behind OCD treatment of the knee can lead to confusion for doctors, ...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research
Targeting the Ras pathway in pediatric hematologic malignancies
Purpose of review
Ras pathway mutations are one of the most common type of alterations in pediatric hematologic malignancies and are frequently associated with adverse outcomes. Despite ongoing efforts to use targeted treatments, there remain no Food and Drug Administration (FDA)-approved medications specifically for children with Ras pathway-mutated leukemia. This review will summarize the role of Ras pathway mutations in pediatric leukemia, discuss the current state of Ras pathway inhibitors and highlight the most promising agents currently being evaluated in clinical trials.
Recent findings
Efficacy using RAF...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: HEMATOLOGY AND ONCOLOGY: Edited by Brigitte Widemann Source Type: research
New approaches to risk stratification for Wilms tumor
This article highlights the evolution of clinical and biological prognostic markers that have been applied in the treatment of Wilms tumor.
Recent findings
Historically, tumor stage and histology were the sole determinants of Wilms tumor treatment. Recent clinical trials conducted by the Children's Oncology Group (COG) and the International Society of Pediatric Oncology (SIOP) Renal Tumor Study Group have expanded the menu of prognostic factors to include histologic and volumetric response to therapy and tumor-specific loss of heterozygosity (LOH) at chromosomes 1p and 16q. Augmentation of therapy has been able to o...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: HEMATOLOGY AND ONCOLOGY: Edited by Brigitte Widemann Source Type: research
Global health disparities in childhood cancers
Purpose of review
The high cure rates of children with cancer in high-income countries (HICs) are due to the impact of biomedical innovations on children with highly fatal diseases. We discuss why these innovations have not benefitted most children with cancer globally and propose broad strategies to reduce these disparities.
Recent findings
Over 85% of children with cancer in HIC are cured while less than 20% in many low-income countries survive the disease. Hence, childhood cancer survival is poor globally since over 80% of children with cancer live in low-income and middle-income countries (LMICs). Inadequate...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: HEMATOLOGY AND ONCOLOGY: Edited by Brigitte Widemann Source Type: research
Advances in the classification and treatment of pediatric brain tumors
Purpose of review
Recent genetic and molecular findings have impacted the diagnosis, prognosis, and in some instances, treatment strategies for children with pediatric central nervous system tumors. Herein, we review the most up-to-date molecular findings and how they have impacted tumor classification and clinical care.
Recent findings
It is now recognized that aberrations of the mitogen-activated protein kinase pathway are present in the majority of pediatric low-grade glioma. Also, there has been the identification of recurrent histone H3 K27M mutations in diffuse intrinsic pontine and other midline gliomas. ...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: HEMATOLOGY AND ONCOLOGY: Edited by Brigitte Widemann Source Type: research
Immunotherapy approaches targeting neuroblastoma
Purpose of review
In the era of immune-oncology, a breakthrough in the field of pediatric solid tumor research has been the demonstration that immunotherapy for patients with high-risk neuroblastoma improves the event-free and overall survival. Immunotherapeutic approaches including a monoclonal antibody targeting the cell surface glycosphingolipid disialoganglioside and cytokines successfully eliminate minimal residual disease.
Recent findings
Since this seminal discovery, clinical trials evaluating immunotherapy in combination with chemotherapy and cellular therapies have begun to demonstrate effectiveness in ...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: HEMATOLOGY AND ONCOLOGY: Edited by Brigitte Widemann Source Type: research
Genetic consultations in cases of unexplained fractures and haemorrhage: an evidence-based approach
Purpose of review
When infants and young children present with suspected physical abuse, it is critical to follow standard guidelines and rule out alternative causes of fracture and haemorrhage. A multidisciplinary team involved in the initial evaluation typically includes paediatrics, radiology, child protective services and/or law enforcement, and in complex cases, haematology, neurology, and genetics. A comprehensive genetics consultation includes review of the history of present illness, birth and past medical history, review of growth curves, family history, physical examination, radiological findings, and when in...
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research
Editorial: Medical genetics, expert medical testimony, and suspected child abuse cases: a call for evidence-based standards in clinic and the courtroom
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - January 10, 2021 Category: Pediatrics Tags: EDITORIAL INTRODUCTIONS Source Type: research
Trauma patients in the pediatric ICU: rational use of a limited resource
Purpose of review
Traumatic injuries are a leading cause of pediatric mortality; pediatric ICUs (PICUs) are an important but potentially limited resource associated with high costs. In an era of rising healthcare costs, appropriate resource utilization is important. Here, we examine evidence-based guidelines supporting the management of pediatric traumatic injury outside of the PICU.
Recent findings
Historical management of solid organ injury and traumatic brain injury was focused on operative management. However, over the past four decades, management of solid organ injury has shifted from invasive management t...
Source: Current Opinion in Pediatrics - November 11, 2020 Category: Pediatrics Tags: SPECIAL COMMENTARY Source Type: research
Improving pediatric problem-based learning sessions in undergraduate and graduate medical education
Purpose of review
Problem-based learning (PBL) sessions have become common alternatives to traditional didactic-style sessions in medical education, including within pediatric education. The creation and execution of PBL sessions, however, can vary among institutions and even between educators at a given institution. Coupling the personal experiences of a recently-graduated medical student with that of a knowledgeable medical educator, the authors sought to analyze two PBL session experiences of the medical student during her second year with the goal of pinpointing specific elements that add value for both learners an...
Source: Current Opinion in Pediatrics - November 11, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research
An update on international practice variation in peanut introduction: conundrums, controversies, and a new direction
Purpose of review
Introduction of peanut during the first year of life is associated with an 81% relative risk reduction of developing peanut allergy in infants with severe eczema, egg allergy, or both. However, significant international variation exists in risk stratification prior to peanut introduction.
Recent findings
A policy-level screening approach, such as the one in the United States, is not practical and is associated with higher costs and more cases of peanut allergy over time, in contrast to international models that recommend universal early introduction without prescreening. In Australia, populatio...
Source: Current Opinion in Pediatrics - November 11, 2020 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research
‘Doc, will I ever eat steak again?’: diagnosis and management of alpha-gal syndrome
Purpose of review
Alpha-gal syndrome encompasses a constellation of symptoms associated with immune-mediated hypersensitivity responses to galactose-alpha-1,3-galactose (alpha-gal). The purpose of this review is to discuss our current understanding of the etiology, clinical symptoms, natural history, epidemiology, and management of alpha-gal syndrome.
Recent findings
Sensitization to alpha-gal is associated with bites from ectoparasites like the lone star tick Amblyomma americanum. Allergic reactions in alpha-gal syndrome are often delayed and inconsistent. The magnitude of the allergic response depends on co-fa...
Source: Current Opinion in Pediatrics - November 11, 2020 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
