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
