Paediatric Nephrology in Africa
AbstractPurpose of ReviewWe highlight the unique facets of paediatric nephrology in Africa in terms of the spectrum of kidney diseases, available diagnostic and treatment modalities, kidney healthcare financing options, paediatric nephrology manpower and the contribution of geography and demographics.Recent FindingsPaediatric acute kidney injury in Africa is now commonly due to sepsis rather than gastroenteritis. Steroid-sensitive form of nephrotic syndrome is far more common than was two decades ago.SummaryThe hot arid climate in North Africa and the tropical climate in most of sub-Saharan Africa, and the high rate of con...
Source: Current Pediatrics Reports - October 25, 2021 Category: Pediatrics Source Type: research
Short-term Cardiovascular Complications of Multi-system Inflammatory Syndrome in Children (MIS-C) in Adolescents and Children
AbstractPurpose of ReviewWe provide the readers with a review of cardiac complications in children with multi-system inflammatory syndrome in children (MIS-C) and its short-term outcomes.Recent FindingsRecent reports described the acute cardiac manifestations of MIS-C in children and provided a glimpse of the short-term outcomes.SummaryChildren with MIS-C have been reported to acutely have variable degrees of cardiac findings including abnormal cardiac enzymes, abnormal electrocardiographs, decreased systolic function, coronary artery abnormalities from coronary dilation to giant aneurysms, mitral valve regurgitation, tric...
Source: Current Pediatrics Reports - October 22, 2021 Category: Pediatrics Source Type: research
Obesity in Children with Kidney Disease
AbstractPurpose of ReviewWe review the epidemiology, aetiology and consequences of obesity in children with chronic kidney disease (CKD).Recent FindingsCKD in children has traditionally been associated with failure to thrive. However, with increasing global childhood obesity rates, more children with CKD are now overweight than underweight. Recent large cohort studies have allowed a greater understanding of the role of obesity in cardiovascular morbidity and other adverse outcomes in children with CKD.SummaryObesity is common in the paediatric CKD population with a multifactorial aetiology, including exposure to corticoste...
Source: Current Pediatrics Reports - October 20, 2021 Category: Pediatrics Source Type: research
Current Insights Into the Pathophysiology of Multisystem Inflammatory Syndrome in Children
AbstractPurpose of ReviewWe highlight the new clinical entity multisystem inflammatory syndrome in children (MIS-C), the progress in understanding its immunopathogenesis, and compare and contrast the clinical and immunologic features of MIS-C with Kawasaki disease (KD).Recent FindingsStudies show immune dysregulation in MIS-C including T lymphocyte depletion and activation, T cell receptor Vbeta skewing, elevated plasmablast frequencies, increased markers of vascular pathology, and decreased numbers and functional profiles of antigen-presenting cells.SummaryMIS-C is a late manifestation of infection with SARS-CoV-2 associa...
Source: Current Pediatrics Reports - October 19, 2021 Category: Pediatrics Source Type: research
True Resilience: A Look Inside COVID ’s Effect on Children with Medical Complexity and Their Families
AbstractPurpose of ReviewVulnerable children with medical complexity are silent victims of the COVID-19 pandemic, impacted by lack of resources and sick caregivers. In this article, we examine ways in which the pandemic has increased the significant difficulties already experienced by these patients and their families. Increased awareness will lead to improvement in the disparities experienced by this population and improve the ability of healthcare providers to care for them.Recent FindingsThe number of children living with medical complexity is rapidly increasing. They face unique circumstances which can lead to compromi...
Source: Current Pediatrics Reports - October 9, 2021 Category: Pediatrics Source Type: research
The Role of Telemedicine in Child and Adolescent Healthcare in India
AbstractPurpose of ReviewWe highlight the evolution and use of telemedicine in child and adolescent healthcare in India, in pre and post pandemic eras.Recent FindingsThe latest research endorses telemedicine as a successful strategy in resource-limited settings to provide accessible and equitable healthcare.SummaryTelemedicine was initiated in India in 2001. The pandemic restrictions resulted in an increase in its use. The national telemedicine and telepsychiatry guidelines facilitated and enabled its widespread use. Telehealth was used by private and public health establishments, in urban, rural, and remote areas. It was ...
Source: Current Pediatrics Reports - October 8, 2021 Category: Pediatrics Source Type: research
Welcoming Healthcare Into Our Virtual Meeting Rooms: Perspective and Perseverance in Pediatric Rheumatology
AbstractPurpose of ReviewWe highlight practice changes adopted to increased use of telemedicine, look at precision, and accuracy in using a virtual visit to evaluate and treat rheumatic disease, and describe our shift in engaging patients and their families in supporting our research aims.Recent FindingsTelemedicine visits increased substantially with the start of the SARS-CoV-2 pandemic. With this change came the need for significant advances to our telemedicine practices to allow for quality patient visits and continued research collection.SummaryTelemedicine will continue to be an area of increasing importance and has b...
Source: Current Pediatrics Reports - October 4, 2021 Category: Pediatrics Source Type: research
The Expansion of Pediatric Care Through Digital Technology
AbstractIn this commentary, we hope to offer examples of how technology is building connections and agencies are working creatively to reduce disparities in digital technology access to improve the lives of children and adolescents across the globe. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - October 2, 2021 Category: Pediatrics Source Type: research
Demystifying the Nephron: a Call to Action
AbstractPurpose of ReviewThere is growing concern among educators regarding the difficulty in recruitment of trainees to pediatric nephrology, and the importance of developing a strong foundational knowledge in nephrology for all pediatric trainees. This review highlights the factors that may influence trainee interest in nephrology, as well as what educators can do to demystify nephrology.Recent FindingsA large percentage of fellowship positions go unmatched in pediatric nephrology in the USA. Adult nephrologists have faced similar workforce concerns and have worked to overcome perceived barriers to trainee interest.Summa...
Source: Current Pediatrics Reports - September 26, 2021 Category: Pediatrics Source Type: research
Animal, Human, and 23Na MRI Imaging Evidence for the Negative Impact of High Dietary Salt in Children
We present animal, human, and23Na MRI evidence associated with the negative impact of high dietary salt in children. Special focus is placed on novel23Na MRI imaging which reveals the important concept of a third compartment for sodium storage in soft tissue. Finally, we make recommendations on who should not be on a low salt diet.SummaryA high salt intake predisposes children and AYA to considerable morbidity. We exhort the reader to engage in advocacy efforts to curve the incidence and prevalence of high salt-related life-limiting conditions. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - September 18, 2021 Category: Pediatrics Source Type: research
Telehealth for the Care of Complex Chronic Pediatric Patients in Latin America and the Caribbean: Narrative Review
This article is a review of the most significant productions on the care of pediatric patients with complex and/or rare chronic diseases in the field of telehealth, produced in Latin America and the Caribbean. It inquires about accessibility to health, its efficiency for the care of chronic and rare diseases, its acceptability/resistance by users (health teams and patients), and the standardization-evaluation of telecare processes.Recent FindingsThe formation of reference networks for patients with chronic and rare diseases.SummaryThe incorporation of ICTs in comprehensive patient care is carried out mainly through home te...
Source: Current Pediatrics Reports - September 4, 2021 Category: Pediatrics Source Type: research
Newest Diabetes-Related Technologies for Pediatric Type 1 Diabetes and Its Impact on Routine Care: a Narrative Synthesis of the Literature
AbstractPurpose of ReviewThis review aims to address the actual state of the most advanced diabetes devices, as follows: continuous subcutaneous insulin infusions (CSII), continuous glucose monitoring systems (CGM), hybrid-closed loop (HCL) systems, and “Do-it-yourself” Artificial Pancreas Systems (DIYAPS) in children, adolescents, and young adults. This review has also the objective to assess the use of telemedicine for diabetes care across three different areas: education, social media, and daily care.Recent FindingsRecent advances in diabetes technology after integration of CSII with CGM have increased the p...
Source: Current Pediatrics Reports - August 20, 2021 Category: Pediatrics Source Type: research
IgA Vasculitis: a Review and Update on the Management of Renal and Extrarenal Disease, Highlighting What ’s New for Biomarkers and Treatment
AbstractPurpose of ReviewThis review summarizes recent advances in biomarker discovery and treatment of renal and extrarenal IgA vasculitis (IgAV), formerly known as Henoch-Sch önlein purpura.Recent FindingsElevated levels of urinary IgA and serum galactose-deficient IgA1 at presentation are associated with risk of developing renal involvement. Elevated neutrophil to lymphocyte ratios at presentation may also indicate increased risk of renal but also gastrointestinal involvement. Rituximab has been beneficial in retrospective studies in the treatment of corticosteroid refractory IgAV nephritis. Although large studies ...
Source: Current Pediatrics Reports - August 17, 2021 Category: Pediatrics Source Type: research
Electroencephalographic Monitoring Technology Role in Remote Ped Intensive Care Units in Rio de Janeiro, Brasil
AbstractPurpose of ReviewNeurological monitoring of pediatric patients, presents itself as a problem due to technical aspects and the necessity of specialized personnel. We evaluated the contribution of telemedicine (tele-EEG) in the diagnosis and monitoring of children admitted to the pediatric services in the state of Rio de Janeiro.Recent FindingsGeneral scientific literature indicates that this technology has become accessible for quick and accurate diagnoses at an affordable cost.SummaryWe carried out a retrospective study in which we reviewed electroencephalographic reports done in children and adolescents, in the ho...
Source: Current Pediatrics Reports - July 14, 2021 Category: Pediatrics Source Type: research
Evaluating the Educational Impact of Telehealth on Adolescent Medicine Trainees: a Qualitative Approach
AbstractPurpose of ReviewTelehealth has been swiftly incorporated into clinical practice since the onset of the COVID-19 pandemic, with limited understanding of how it affects trainees ’ educational experiences. Our study evaluates the impact of telehealth on clinical education in pediatric and Adolescent Medicine trainees during the pandemic.Recent FindingsPrevious literature on telehealth focused on provider and patient perceptions in addition to clinical education for students, though none has evaluated the experiences of medical residents and fellows in Adolescent Medicine.SummaryTrainees reported enhanced opport...
Source: Current Pediatrics Reports - July 13, 2021 Category: Pediatrics Source Type: research
Telemedicine in Pediatric Intensive Care Units: Perspectives From a Brazilian Experience
AbstractPurpose of ReviewTo present the implementation of a telemedicine project (TeleICU) in pediatric intensive care units (ICU) throughout different Brazilian regions.Recent FindingsAlthough telemedicine in pediatric ICUs has shown evidence of benefit in numerous studies with potential to 18 mitigate existing disparities, in Brazil, its use is still under development. Brazil has several opportunities for implementing this resource since, according to the National Registry of Healthcare 20 Establishments (NRHE), there is a discrepancy in the density of pediatric intensive care physicians per patient and the availability ...
Source: Current Pediatrics Reports - July 12, 2021 Category: Pediatrics Source Type: research
Overview of Telemedicine Services in Mongolia
AbstractPurpose of ReviewTo highlight some achievements made through usage of telecommunication technologies in Mongolia as an example of a developing country with remote areas.Recent FindingsTelemedicine can be implemented not only for remote monitoring, diagnosing, and treating purposes but also can be effectively used for delivering knowledge and consultation services via modern technologies.SummaryTele-health services can be successfully added to the traditional approach of physicians, especially in the countries with a vast territory with distant areas. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - July 9, 2021 Category: Pediatrics Source Type: research
Simulation as an Educational Tool in the Pediatric Cardiac Intensive Care Unit
AbstractPurpose of ReviewThis review highlights the use of simulation as an educational tool in the highly specialized pediatric cardiac intensive care unit (PCICU).Recent FindingsHealthcare simulation is used in high acuity medical environments to test healthcare systems. Healthcare simulation can improve team training, patient safety, and improve medical decision-making. Complex physiologies in the PCICU demand effective teamwork to consistently deliver high-quality patient care. Simulation-based PCICU learning objectives depend on a structured cognitive load framework to account for individual learner abilities, team co...
Source: Current Pediatrics Reports - May 25, 2021 Category: Pediatrics Source Type: research
Where There Is (No) Smoke, There Is Still Fire: a Review of Trends, Reasons for Use, Preferences and Harm Perceptions of Adolescent and Young Adult Electronic Cigarette Use
AbstractPurpose of the reviewTo review the current prevalence, trends, perceptions, and effects of e-cigarette or vaping product use associated lung injury (EVALI) on e-cigarette use among US adolescents and young adults.Recent findingsCOVID-19 diagnosis was more likely among the current/ever dual cigarette and e-cigarettes users, as well as ever e-cigarette only users. Additionally, the EVALI outbreak may have influenced harm perceptions, as daily nicotine vaping declined significantly from 2019 to 2020, and more youth and young adults perceived vaping as harmful.SummaryThe prevalence of e-cigarette use, specifically flav...
Source: Current Pediatrics Reports - May 10, 2021 Category: Pediatrics Source Type: research
Avoidant/Restrictive Food Intake Disorder (ARFID): Its Medical Complications and Their Treatment —an Emerging Area
AbstractPurpose of ReviewAvoidant/restrictive food intake disorder (ARFID) is a relatively new psychiatric and eating disorder diagnosis that most often emerges in childhood. Due to ARFID ’s diagnostic infancy, its medical complications are just starting to be delineated in the literature, and some are extrapolated from the medical manifestations of malnutrition in anorexia nervosa, restricting subtype (AN-R). Pediatric patients with ARFID can have a myriad of physical complaints, most commonly gastrointestinal, that prompt them to seek medical evaluation; thus, familiarity with its medical manifestations is importan...
Source: Current Pediatrics Reports - April 6, 2021 Category: Pediatrics Source Type: research
Medical Care for Adolescent Males Who Have Sex with Males
AbstractPurpose of reviewThis paper reviews the most recent literature describing the bio-psycho-social challenges that may be faced by adolescent males who have sex with males (AMSM) and outlines recommendations for screening, medical and psychosocial concerns, and prevention for this population.Recent findingsEmerging research has demonstrated that adverse childhood experiences (ACEs) disproportionately affect AMSM, which can impact lifelong psychosocial functioning. In addition, significant medical advances in HIV prevention should be incorporated into primary care for adolescents and young adults at risk for HIV.Summar...
Source: Current Pediatrics Reports - April 4, 2021 Category: Pediatrics Source Type: research
How Do you Focus on Quality of Life When Kids Cannot Go to School or Outside?
AbstractPurpose of ReviewThis paper seeks to explore the definitions of quality of life and its application to pediatric research and clinical practice. This paper also highlights some of the imperfections in evaluating patient-reported outcomes designed to measure quality of life in pediatrics. Additionally, this paper explores some of the unique challenges in promoting quality of life during the COVID-19 pandemic.Recent FindingsThere are numerous different measurement scales to examine quality of life in children of different ages, and with a variety of disease states.SummaryDespite the number of quality of life measurem...
Source: Current Pediatrics Reports - March 12, 2021 Category: Pediatrics Source Type: research
Current Research and Viewpoints on Internet Addiction in Adolescents
AbstractPurpose of ReviewThis review describes recent research findings and contemporary viewpoints regarding internet addiction in adolescents including its nomenclature, prevalence, potential determinants, comorbid disorders, and treatment.Recent FindingsPrevalence studies show findings that are disparate by location and vary widely by definitions being used. Impulsivity, aggression, and neuroticism potentially predispose youth to internet addiction. Cognitive behavioral therapy and medications that treat commonly co-occurring mental health problems including depression and ADHD hold considerable clinical promise for int...
Source: Current Pediatrics Reports - January 9, 2021 Category: Pediatrics Source Type: research
The Basics of Ventilator Waveforms
AbstractPurpose of ReviewKnowledge of ventilator waveforms is important for clinicians working with children requiring mechanical ventilation. This review covers the basics of how to interpret and use data from ventilator waveforms in the pediatric intensive care unit.Recent FindingsPatient-ventilator asynchrony (PVA) is a common finding in pediatric patients and observed in approximately one-third of ventilator breaths. PVA is associated with worse outcomes including increased length of mechanical ventilation, increased length of stay, and increased mortality. Identification of PVA is possible with a thorough knowledge of...
Source: Current Pediatrics Reports - January 5, 2021 Category: Pediatrics Source Type: research
Impact and Clinical Implications of Prematurity on Adaptive Immune Development
AbstractPurpose of ReviewDetail normal adaptive immune maturation during fetal and neonatal life and review the clinical implications of arrested immune development.Recent FindingsAdvancements in the field of immunology have enabled investigations of the adaptive immune system starting during fetal life. New insights have drawn important distinctions between the neonatal and adult immune systems. The presence of diverse immunologic responses in the perinatal period suggests the importance of in utero immune development. Disruption of immune maturation due to premature birth may have significant implications for clinical pa...
Source: Current Pediatrics Reports - October 26, 2020 Category: Pediatrics Source Type: research
Current Practices and Updates in Neonatal Resuscitation
AbstractPurpose of ReviewTo outline our current neonatal resuscitation practices and discuss changes that have occurred in the field since the International Liaison Committee on Resuscitation (ILCOR) guidelines were published in 2015.Recent FindingsThere have been interesting developments in delayed cord clamping, heart rate assessments, and oxygen delivery.SummaryNew developments continue to emerge in the field of neonatal resuscitation, some of which have been adopted into mainstream practice, while others still require more research to establish efficacy and safety. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - October 23, 2020 Category: Pediatrics Source Type: research
How Should the Preterm Infant Grow?
This report is an update of the topic previously reviewed for this journal.Recent FindingsNew intrauterine growth curves including BMI are now available for preterm infants. Extrauterine growth curves (post-natal) are available for BMI as well, but these types of curves for weight, length, and head circumference are not current or are under development. Body composition data for preterm infants is emerging but still limited to measurements at birth and corrected term age. The present recommendations for dietary intake do not allow for the necessary “catch-up” growth after the period of inadequate nutrition of p...
Source: Current Pediatrics Reports - October 17, 2020 Category: Pediatrics Source Type: research
Pediatric Palliative Care and the PICU: Where We Have Been and Where We Are Going
AbstractPurpose of ReviewThis review provides pediatric intensivists and other pediatric clinicians a review of pediatric palliative care, focusing on its integration into the pediatric intensive care unit (PICU) and outlining vital skills for the intensivist.Recent FindingsPediatric palliative care is a relatively young but growing field and is becoming increasingly available at many children ’s hospitals. However, there has been a shortage of palliative care physicians historically (Lupu, J Pain Symptom Manag. 40(6):899–911,2010). Palliative care teams are multidisciplinary and focus on assisting the PICU wit...
Source: Current Pediatrics Reports - September 21, 2020 Category: Pediatrics Source Type: research
Neurodevelopmental Outcomes in Congenital Heart Disease: A Review
AbstractPurpose of ReviewWe review the etiologies of neurodevelopmental outcomes in patients with congenital heart disease.Recent FindingsDevelopmental delays have been identified in patients with congenital heart disease (CHD). Though historically neurodevelopmental morbidity in patients with CHD was thought to be surgically related, recent advances in imaging technology and the ability to prospectively provide longitudinal follow-up indicate multiple complex etiologies of neurodevelopmental delay in this group. It has been suggested that alterations in cerebral perfusion is related to cerebral dysgenesis and immaturity. ...
Source: Current Pediatrics Reports - September 20, 2020 Category: Pediatrics Source Type: research
Adjunctive Neuroprotective Therapies for Treatment of Hypoxic-Ischemic Encephalopathy (HIE)
AbstractPurpose of ReviewTo highlight emerging adjunctive neuroprotective agents for treatment of hypoxic ischemic encephalopathy (HIE).SummaryHIE is a common cause of neonatal neurologic morbidity and mortality. Therapeutic hypothermia is a standard therapy, but neuroprotection is incomplete. There are several potential adjunctive agents that can be used to augment neuroprotection when combined with hypothermia.Recent FindingsSeveral recent studies have evaluated the use of adjunctive therapies that, when used in combination with therapeutic hypothermia, may improve short- and long-term outcomes. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - September 14, 2020 Category: Pediatrics Source Type: research
Burnout in the Paediatric Intensive Care Unit
AbstractPurpose of ReviewBurnout syndrome is characterised by depersonalisation, emotional exhaustion, and low personal accomplishment. This paper seeks to discuss the prevalence of burnout in the paediatric intensive care unit (PICU), contributing factors, and potential interventions.Recent FindingsThere is marked variation in the reported prevalence rates for burnout syndrome among healthcare workers, but PICU physicians appear to be at increased risk. There is currently insufficient evidence to support any one intervention to ameliorate the symptoms of burnout syndrome, but a multifaceted approach with systematic interv...
Source: Current Pediatrics Reports - September 5, 2020 Category: Pediatrics Source Type: research
Current Trends and Critical Care Considerations for the Management of Single Ventricle Neonates
AbstractPurpose of ReviewThe diagnostic capabilities, palliative procedures, and critical care therapies for neonates with single ventricle heart disease have rapidly evolved. We aimed to review current trends for intensivists and cardiologists caring for this population.Recent FindingsEnhanced diagnostics and 3-dimensional modeling can be instrumental in planning care pathways for these neonates. Additionally, the ability to palliate many of these patients with catheter-based therapies rather than traditional surgical approaches has allowed for reduced morbidity. There are significant improvements in the understanding of ...
Source: Current Pediatrics Reports - September 1, 2020 Category: Pediatrics Source Type: research
Recent Advances in Simulation for Pediatric Critical Care Medicine
AbstractPurpose of ReviewThis review highlights the emerging fields of simulation research by tying innovation into principles of learning and process improvement.Recent FindingsAdvances have been made in both educational simulation and simulation for quality improvement, allowing this versatile modality to be more broadly applied to healthcare and systems.SummarySimulation in pediatric critical care medicine continues to evolve. Although the majority of simulation is focused on learner education, emerging research has broadened to focus on patient- and system-centered outcomes, leading to improvement in the quality of car...
Source: Current Pediatrics Reports - August 27, 2020 Category: Pediatrics Source Type: research
Preparing the Child with End-Stage Renal Disease for a Renal Transplant: the Pre-transplant Assessment
AbstractPurpose of ReviewWe review the pre-transplant assessment of the renal transplant candidate, highlighting specific issues that are unique to the pediatric patient.Recent FindingsThe pre-transplant assessment consists of a thorough history and physical examination, supplemented by laboratory evaluations based on a systems-based approach. Considerations that are unique to the pediatric population include the assessment of immunization, nutritional and developmental status, as well as for underlying urological abnormalities that require management prior to transplantation.SummaryA thorough and complete pre-transplant a...
Source: Current Pediatrics Reports - July 24, 2020 Category: Pediatrics Source Type: research
Advances and Current Issues in Adolescent Sleep
This article aims to review and highlight recent advances in these areas.Recent FindingsThere is a greater understanding of the natural tendencies of adolescent sleep towards circadian phase delay. New research has better delineated the effects of artificial light and school start times, on sleep and circadian phase. There have also been updates about the diagnosis and management of narcolepsy, obstructive sleep apnea, and idiopathic hypersomnia.SummaryGreater understanding of how light exposure affects the circadian system allows for more concrete recommendations about managing electronics exposure. Growing evidence sugge...
Source: Current Pediatrics Reports - July 8, 2020 Category: Pediatrics Source Type: research
Medication-Induced Nephrotoxicity in Children
AbstractPurpose of ReviewThe purpose of this article is to review common mechanisms of drug-induced nephrotoxicity (DIN) while highlighting some of the common medications in each category, as well as risk factors and preventative strategies with a focus on mitigating the risks of kidney injury with the use of potentially nephrotoxic medications in children.Recent FindingsThere have been recent reports about DIN associated with well-established and newer medications based on pathogenic mechanisms, new biomarkers being researched to identify DIN, and the recent development of standardized phenotypes to characterize DIN.Summa...
Source: Current Pediatrics Reports - July 4, 2020 Category: Pediatrics Source Type: research
Telemedicine: a Bridge Over Knowledge Gaps in Healthcare
AbstractPurpose of the ReviewThe purpose of the review is to describe the Brazilian Telemedicine University Network RUTE concerning the Special Interest Group of Children and Adolescents, the new SIG-COVID19-BR activities for continuing medical education, and to update relevant information regarding diagnosis and treatment, using digital technologies.Recent FindingsA total of 145 sessions of video and webconferences were held with the participation of 6575 health professionals, including medical students, interns, and residents. Major topics involved the healthcare of children and adolescents were combined with the emergen...
Source: Current Pediatrics Reports - June 30, 2020 Category: Pediatrics Source Type: research
Pediatric Delirium: a Review of Current Diagnosis and Management in the Intensive Care Setting
We describe preventative management, current screening tools, and treatment strategies for pediatric intensive care unit (PICU) delirium.Recent FindingsWhile there is ongoing research regarding medication efficacy for the treatment of delirium, there has been an increased emphasis on screening and prevention strategies.SummaryPICU delirium is an underappreciated diagnosis that is associated with increased morbidity and increased length of stay. Strategies to minimize risk of delirium, early recognition of delirium, and mitigation strategies combined with education and engagement of both medical staff and families are of ut...
Source: Current Pediatrics Reports - June 26, 2020 Category: Pediatrics Source Type: research
Correction to: The ICU Liberation Bundle and Strategies for Implementation in Pediatrics
Table 2 of the original version of this article unfortunately was not formatted well, making it unclear for readers. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - June 22, 2020 Category: Pediatrics Source Type: research
New Decade: “New” Devices for “Old” Drugs
This article reviews e-cigarettes and how they are changing the use and abuse of nicotine and THC and discusses the latest knowledge of the effects of these substances upon adolescents. Concurrent trends in the increased potency and legality of marijuana in the USA are discussed as well as suggestions for how to proactively work with adolescents around the issue of substance use.Recent Findings“Vaping” is changing the usage patterns of nicotine and marijuana, exposing youth to new dosages and potential effects.SummaryIncreased nicotine and THC exposure is erasing public health gains, leading to new drug-related...
Source: Current Pediatrics Reports - June 20, 2020 Category: Pediatrics Source Type: research
The Future of Paediatric Nephrology —Genomics and Personalised Precision Medicine
AbstractPurpose of ReviewThis review aims to outline the current state of precision medicine in paediatric nephrology with a focus on how genomics will impact on patient care in the future.Recent FindingsBroader availability of genomic sequencing, direct-to-consumer genetic testing, a growing list of genes implicated in childhood-onset kidney disease, patient-specific kidney organoid models of disease and pharmacogenomics will all shape the future for patients with kidney disease.SummaryThere is a bright future for patients with kidney disease as greater understanding of the pathogenetic mechanisms of disease will result i...
Source: Current Pediatrics Reports - June 8, 2020 Category: Pediatrics Source Type: research
Cyberbullying and Adolescents
AbstractPurpose of ReviewCyberbullying is an aggressive behavior involving a type of electronic communication intending to harm a victim that can have profound effects on adolescents. This review examines the epidemiology, issues from cyberbullying, presentation to care of its victims, and proposed interventions to this behavior.Recent FindingsThere are a variety of physical and psychological effects on victims of cyberbullying that can include recurrent abdominal pain, headaches, and difficulty with sleep. In addition, victims have higher rates of anxiety, depression, suicidal ideation, and a lower level of well-being. Un...
Source: Current Pediatrics Reports - June 2, 2020 Category: Pediatrics Source Type: research
The ICU Liberation Bundle and Strategies for Implementation in Pediatrics
AbstractPurpose of ReviewWe briefly review post-intensive care syndrome (PICS) and the morbidities associated with critical illness that led to the intensive care unit (ICU) liberation movement. We review each element of the ICU liberation bundle, including pediatric support data, as well as tips and strategies for implementation in a pediatric ICU (PICU) setting.Recent FindingsNumerous studies have found children have cognitive, physical, and psychiatric deficits after a PICU stay. The effects of the full ICU liberation bundle in children have not been published, but in adults, bundle implementation (even partial) resulte...
Source: Current Pediatrics Reports - May 15, 2020 Category: Pediatrics Source Type: research
Strategies in the Management of Adolescent Obesity
AbstractPurpose of ReviewWe review the current options to manage adolescent obesity which include nutrition, physical activity, behavior modification, sleep management, pharmacotherapy, and surgery. Since lifestyle interventions alone are often not effective in adolescents, a multi-disciplinary treatment approach is necessary in management.Recent FindingsMedications (often used off-label) and metabolic/bariatric surgery are effective treatment strategies to treat adolescents with severe obesity.SummaryThe use of pharmacotherapy and surgery is limited due to lack of pediatric obesity tertiary care centers. With more centers...
Source: Current Pediatrics Reports - April 26, 2020 Category: Pediatrics Source Type: research
Long-Term Metabolic Consequences of Intrauterine Growth Restriction
AbstractPurpose of ReviewTo summarize recent findings on the associations of intrauterine growth restriction (IUGR) and long-term metabolic consequences such as obesity, type 2 diabetes (T2D), and cardiovascular diseases and the underlying mechanisms.Recent FindingsRecent evidence suggests that metabolic diseases such as obesity, T2D, hypertension, and coronary artery disease are related to developmental programming in fetal period and early childhood. Rapid postnatal catch-up growth is also an important factor that contributes to the development of these long-term metabolic complications. The underlying mechanisms include...
Source: Current Pediatrics Reports - April 2, 2020 Category: Pediatrics Source Type: research
The Changing Adolescent: a Biopsychosocial and Behavioral Perspective
(Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - March 30, 2020 Category: Pediatrics Source Type: research
Baby B and Baby Doe —Their Lasting Effect on Parents’ Scope for Medical Decision-Making for Their Children
AbstractPurpose of ReviewThere have been several widely publicized legal cases about the limits of parental decision-making for their children. We examine the two very similar cases dating back to the 1980s that still provide legal precedents and constrain parental decision-making for newborns: Baby Doe in the USA, and Baby B in England.Recent FindingsThe US and English legal systems significantly constrain parental decision-making, even to the extent of preventing decisions that some clinicians may feel to be in the child ’s best interests. This is true for decisions to either limit care or continue care.SummaryLega...
Source: Current Pediatrics Reports - March 12, 2020 Category: Pediatrics Source Type: research
Fetal Cardiac Intervention: a Review of the Current Literature
AbstractPurpose of ReviewCongenital heart disease (CHD), the most common of birth defects, can be serious enough to require a lifetime of medical care including multiple surgeries or other interventions.Recent FindingsAdvances in ultrasound technology and a better understanding of the progression of CHDs have made it possible to intervenein utero. This early-stage intervention allows the still plastic cardiovascular system to return to a more normal trajectory thus sparing the newborn from negative consequences to morbidity and mortality.SummaryFetal cardiac intervention (FCI) has been successful altering the course of rig...
Source: Current Pediatrics Reports - February 14, 2020 Category: Pediatrics Source Type: research
Correction to: Providing Compassionate End of Life Care in the Setting of Mechanical Circulatory Support
The original version did not include the correct affiliations as noted by the authors in their proofs which can be seen below. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - February 4, 2020 Category: Pediatrics Source Type: research
APRV vs Oscillation
AbstractPurpose of ReviewWe compare the effectiveness of a conventional mode of ventilation, airway pressure release ventilation with non-conventional high frequency ventilation in achieving safety, comfort and liberation in infants and children requiring mechanical ventilation.Recent FindingsMechanical ventilatory support is important to the care of infants and children with acute respiratory failure. A paucity of high-level evidence exists to support one single ventilator strategy. A better understanding of the nuances of conventional and non-conventional modes of ventilation is needed to provide safe and effective venti...
Source: Current Pediatrics Reports - January 24, 2020 Category: Pediatrics Source Type: research