Clinical action plans make a difference at point-of-care
Purpose of review
The purpose of this review is to provide an update to and roadmap for the practical implementation of various point-of-care clinical action plans for primary care providers.
Recent findings
Clinical action plans were first developed to address unmet, home preventive needs for the management of asthma. Over the past 10 years, the advancement of mobile health technologies, the recognition of at-risk populations, and the development of evidence-based concepts to guide the creation of patient education tools have expanded the implementation of clinical action plans for many diagnoses (e.g., functio...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research
How primary care providers can help prevent food allergies
Purpose of review
IgE-mediated food allergy rates have increased in recent decades, yet treatment options remain limited. Prevention strategies are thus essential. We will review recent research and consensus guidelines for food allergy prevention.
Recent findings
Research has continued to support that early introduction of allergens via the gastrointestinal tract induces tolerance and prevents development of food allergy. In contrast, allergen sensitization may occur via transcutaneous allergen exposure. This is supported by research that shows a decreased risk of food allergy with aggressive treatment of atopi...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research
Advancements and future directions in the teamwork, targets, technology, and tight control—the 4T study: improving clinical outcomes in newly diagnosed pediatric type 1 diabetes
This article will review our Teamwork, Targets, Technology, and Tight Control (4T) study that implements emerging diabetes technology into clinical practice with a team approach to sustain tight glycemic control from the onset of T1D and beyond to optimize clinical outcomes.
Recent findings
During the 4T Pilot study and study 1, our team-based approach to intensive target setting, education, and remote data review has led to significant improvements in hemoglobin A1c throughout the first year of T1D diagnosis in youth, as well as family and provider satisfaction.
Summary
The next steps include refinement of t...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research
Metabolic dysfunction-associated fatty liver disease in obese youth with insulin resistance and type 2 diabetes
Purpose of review
The aim of this review is to present the new definition of the disease, defining the epidemiology, risk factors with a particular attention to the role of insulin resistance (IR) and to define the main treatments explored.
Recent findings
Nonalcoholic fatty liver disease (NAFLD) was previously considered a primary liver disease, but it would be more correct to consider it a component of the metabolic syndrome (MetS) in which IR might play a key role. Based on these findings, it has been recently proposed to modify the classic term of NAFLD to metabolic dysfunction-associated fatty liver disease...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research
Progress in pediatric obesity: new and advanced therapies
Purpose of review
In this review, we discuss new medical and surgical options for the treatment of children and adolescents with obesity. We review the impact of COVID-19 on this vulnerable population. We also discuss the recent availability of screening tests for rare genetic causes of obesity.
Recent findings
COVID-19 increased the prevalence of obesity among children and adolescents. This population is at increased risk for severe disease. The field of pediatric obesity has benefited from the approval of two new antiobesity medications: liraglutide and setmelanotide. We discuss indications for their use. New ...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research
Insulin resistance in children
Purpose of review
Insulin resistance (IR) is a clinical condition due to the decline in the efficiency of insulin promoting glucose uptake and utilization. The aim of this review is to provide an overview of the current knowledge on IR in children, focusing on its physiopathology, the most appropriate methods of measurement of IR, the assessment of risk factors, the effects of IR in children, and finally giving indications on screening and treatment.
Recent findings
IR has evolved more and more to be a global public health problem associated with several chronic metabolic diseases.
Summary
Detecting a cor...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research
Monitoring of paediatric type 1 diabetes
This article reviews recent developments in methods used to monitor paediatric type 1 diabetes (T1D), including an examination of the role of glycated haemoglobin (haemoglobin A1c) and its limitations for long-term assessment of glycaemia in individual patients, self-monitoring of blood glucose, continuous glucose monitoring (CGM) systems and ketone monitoring.
Recent findings
Monitoring of glycemia and ketones, when indicated, is a cornerstone of paediatric T1D management and is essential to optimize glycaemic control. Ongoing technological advancements have led to rapid changes and considerable improvement in the ...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research
Editorial: Editorial introduction
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ENDOCRINOLOGY AND METABOLISM: Edited by Sally Radovick Source Type: research
The eyes have it: when skin findings prompt referral to ophthalmology
Purpose of review
Co-presentation of ocular and cutaneous conditions is common and prompt recognition of known associations may be imperative to sight-saving intervention. There are currently limited reviews in the pediatric literature addressing comorbid ocular and dermatologic presentations. Recent diagnostic and therapeutic advances have drastically altered the prognostic landscape for several disease states when recognition and referral are timely. The aim of this report is to examine important oculocutaneous disease associations with emphasis on management of ocular complications and appropriate referral practices...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: DERMATOLOGY: Edited by Carrie C. Coughlin Source Type: research
Photodermatoses: what's new
Purpose of review
The purpose of this review is to summarize and highlight the recent literature in photodermatoses. In the past year, there have been many developments in this heterogeneous group of conditions.
Recent findings
This review is divided by photodermatoses type, which include idiopathic photodermatoses, photodermatoses secondary to exogenous agents, photodermatoses secondary to endogenous agents (the porphyrias), and genodermatoses. The idiopathic photodermatoses section focuses on case series and reports highlighting new disease presentations or further disease characterization and new treatment st...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: DERMATOLOGY: Edited by Carrie C. Coughlin Source Type: research
Pearls and updates: cutaneous signs of systemic malignancy
Purpose of review
Children with systemic malignancies can present with concomitant dermatological manifestations. Cutaneous findings can occur before, during or after diagnosis. Recognizing these features can aid in diagnosis, inform prognosis, and help determine appropriate treatment. Following a review of the literature published over the past two years, we provide an update on cutaneous signs of pediatric systemic malignancies, concentrating on; leukemia cutis, lymphoma cutis, neuroblastoma, sarcomas, Langerhans cell histiocytosis and paraneoplastic syndromes.
Recent findings
Authors highlight the persistentl...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: DERMATOLOGY: Edited by Carrie C. Coughlin Source Type: research
Access to pediatric dermatology
Purpose of review
To identify factors that impact accessibility to pediatric dermatology and review healthcare delivery models that improve access and address these barriers.
Recent findings
Up to one-third of pediatric primary care visits include a skin-related problem, yet pediatric dermatology subspecialist services are highly inaccessible. Workforce shortages and geographic, sociocultural, and economic barriers perpetuate inaccessibility. Teledermatology expands care, particularly to underserved or geographically remote communities, and reduces healthcare-related costs. Federal legislation to support telehea...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: DERMATOLOGY: Edited by Carrie C. Coughlin Source Type: research
Tumor predisposition: what's the skin got to do with it?
This article reviews tumor predisposition syndromes with recently characterized skin findings and disorders for which early recognition and counseling can impact the course of disease.
Recent findings
Café au lait macules (CALMs) are important in many tumor predisposition syndromes, and ‘atypical’ CALMs are associated with constitutional mismatch repair deficiency and Fanconi anemia. Melanoma predisposition syndromes caused by pathogenic variants in POT1 and BAP1 are more recently described, and both are associated with Spitzoid tumors. Somatic pathogenic variants can cause segmental nevoid basal cell carcinoma...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: DERMATOLOGY: Edited by Carrie C. Coughlin Source Type: research
Stevens–Johnson syndrome in children
Purpose of review
The concept of Stevens–Johnson syndrome (SJS) in children is evolving. This manuscript reviews recent advances with the lens of new terminology namely infection-triggered reactive infectious mucocutaneous eruption and drug-induced epidermal necrolysis, with the objective of integrating this novel terminology practically.
Recent findings
Traditionally considered to exist on a spectrum with toxic epidermal necrolysis, SJS in children is more often caused or triggered by infections instead of medications. Proposed pediatric-specific terminology can be applied to literature to gain further insigh...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: DERMATOLOGY: Edited by Carrie C. Coughlin Source Type: research
Coronavirus disease pandemic and adolescent substance use
Purpose of review
Substance use is common in adolescence and has distinct developmental, cognitive, and health consequences. Over the last 2 years, the coronavirus disease 2019 pandemic has isolated adolescents, disrupted typical developmental milestones, and caused pervasive stress and anxiety. Healthcare providers can help by recognizing and addressing these effects on adolescent mental health and substance use. This update reviews the immediate effects of the pandemic on adolescent substance use, potential future implications, and opportunities to use new strategies to improve care for adolescents with problematic u...
Source: Current Opinion in Pediatrics - July 20, 2022 Category: Pediatrics Tags: ADOLESCENT MEDICINE: Edited by Sarah Pitts and Carly E. Guss Source Type: research
