Surgical, Patient, and Parental Considerations in the Management of Children with Differences of Sex Development
AbstractPurpose of ReviewThe goal of this review is to provide an overview of the controversies affecting care and outcomes of patients with disorders/differences of sex development (DSD). In recent years, there has been a significant paradigm shift in management of patients with DSD. Within this context, this review will then discuss key advances in DSD care.Recent FindingsImportant controversies to be cognizant of when caring for patients with DSD include DSD nomenclature, gender assignment, and timing of surgery. Within the last two decades, there have been dramatic advances in surgical techniques, understanding of pati...
Source: Current Pediatrics Reports - September 1, 2018 Category: Pediatrics Source Type: research
Management of Acute Liver Failure: A Pediatric Perspective
AbstractPurpose of ReviewPediatric acute liver failure is a rare, complex, rapidly progressing, and life-threatening illness. Majority of pediatric acute liver failures have unknown etiology. This review intends to discuss the current literature on the challenging aspects of management of acute liver failure.Recent FindingsCollaborative multidisciplinary approach for management of patients with pediatric acute liver failure with upfront involvement of transplant hepatologist and critical care specialists can improve outcomes of this fatal disease. Extensive but systematic diagnostic evaluation can help to identify etiology...
Source: Current Pediatrics Reports - September 1, 2018 Category: Pediatrics Source Type: research
Transitional Urology Care for Patients with Spina Bifida
AbstractPurpose of ReviewPatients with spina bifida require urologic care and follow-up throughout all phases of life. The transition from adolescence to adult care represents a high-risk time for these individuals and their families and can be challenging for providers. In this review, we seek to analyze the literature on spina bifida patients regarding issues pertinent to transition of their urologic care to adult clinics, providers, and hospitals, and to summarize the experience in the field to date.Recent FindingsExperience in transitioning spina bifida patients to adult care is increasing. Efforts to better define the...
Source: Current Pediatrics Reports - September 1, 2018 Category: Pediatrics Source Type: research
Bladder-Bowel Dysfunction in Children: Consequences, Risk Factors and Recommendations for Primary Care Interventions
AbstractPurposeThe goals of this paper are to review potential risk factors and emerging insights into nature of bladder-bowel dysfunction (BBD) and highlight a patient-centered approach to management, which can begin in the primary care setting.Recent Findings(1) BBD is documented in about half of patients with vesicoureteral reflux and increases potential for renal scarring. (2) Neurodevelopmental and environmental factors are associated with BBD and greater understanding of a neurocentric basis for BBD is emerging. (3) A patient-centered approach to care is required. The way in which children and adolescents understand ...
Source: Current Pediatrics Reports - July 10, 2018 Category: Pediatrics Source Type: research
Transitional Urology Care for Patients with Spina Bifida
AbstractPurpose of ReviewPatients with spina bifida require urologic care and follow-up throughout all phases of life. The transition from adolescence to adult care represents a high-risk time for these individuals and their families and can be challenging for providers. In this review, we seek to analyze the literature on spina bifida patients regarding issues pertinent to transition of their urologic care to adult clinics, providers, and hospitals, and to summarize the experience in the field to date.Recent FindingsExperience in transitioning spina bifida patients to adult care is increasing. Efforts to better define the...
Source: Current Pediatrics Reports - July 9, 2018 Category: Pediatrics Source Type: research
Recent Advances in the Evaluation, Medical, and Surgical Management of Pediatric Nephrolithiasis
AbstractPurpose of ReviewWith the recent rise in the incidence of pediatric nephrolithiasis, much work has focused on understanding the epidemiology and burden of this disease. We reviewed the recent literature to understand current hypotheses for increased kidney stone risk in children, define current best practices for imaging evaluation, assess surgical advances and outcomes, and evaluate up to date strategies for risk modification.Recent FindingsThe interactions of multiple risk factors comprise the exposome that may define future risk of nephrolithiasis. Computed tomography appears to be over-utilized in the acute pre...
Source: Current Pediatrics Reports - June 29, 2018 Category: Pediatrics Source Type: research
Screening for and Management of Chronic Kidney Disease for Children with Congenital Abnormalities of the Kidney and Urinary Tract
AbstractPurpose of ReviewCongenital abnormalities of the kidney and urinary tract (CAKUT) are the most common cause of chronic kidney disease (CKD) in children. Our objective is to review the current diagnosis and management of CAKUT, with a focus on kidney function outcomes.Recent FindingsThe rate of detection of CAKUT has increased with routine prenatal ultrasonography. Despite earlier detection, children with CAKUT are still at risk for future CKD. Several tools offer prognostic information on renal function, including traditional urinary testing for proteinuria and more contemporary biomarkers. Blood pressure monitorin...
Source: Current Pediatrics Reports - June 29, 2018 Category: Pediatrics Source Type: research
Surgical, Patient, and Parental Considerations in the Management of Children with Differences of Sex Development
AbstractPurpose of ReviewThe goal of this review is to provide an overview of the controversies affecting care and outcomes of patients with disorders/differences of sex development (DSD). In recent years, there has been a significant paradigm shift in management of patients with DSD. Within this context, this review will then discuss key advances in DSD care.Recent FindingsImportant controversies to be cognizant of when caring for patients with DSD include DSD nomenclature, gender assignment, and timing of surgery. Within the last two decades, there have been dramatic advances in surgical techniques, understanding of pati...
Source: Current Pediatrics Reports - June 18, 2018 Category: Pediatrics Source Type: research
Abnormal Uterine Bleeding in Adolescent Women
AbstractPurpose of ReviewTo review the current state of terminology, evaluation, and management of abnormal uterine bleeding (AUB) in adolescents.Recent FindingsThe current terminology classifies the causes of AUB under the mnemonic “PALM-COEIN”:Polyps,Adenomyosis,Leiomyoma,Malignancy/hyperplasia;Coagulopathy,Ovulatory dysfunction,Endometrial,Iatrogenic,Not yet classified. Heavy menstrual bleeding (HMB) is one manifestation of AUB. Complete menstrual, gynecologic, medical, and family histories, together with a thorough physical exam, are critical to the determination of the underlying cause of AUB. Initial laboratory t...
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
Caring for Transgender and Gender-Nonconforming Youth
AbstractPurpose of ReviewWe reviewed recently published literature around the care of transgender and gender-nonconforming youth. In this nascent area of medicine, there are few randomized controlled trials, but there are treatment guidelines that include expert opinion and best practices for a more standardized approach to care.Recent FindingsThe most significant article published the past year is the updated standards of care —“Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline”—which establishes a care framework with special emphasis on the import...
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
Bone Health Considerations for the Adolescent Female Athlete
AbstractPurpose of ReviewProvide an update on bone health considerations for adolescent female athletes.Recent FindingsThis review explores multiple topics related to bone health in adolescent female athletes, including bone development, facilitators of and risks to bone health, assessment of bone health, and implications for poor bone health in this population.SummaryBone health has important implications for sports performance and overall wellness among adolescent female athletes. Recent studies support the benefits of approaching bone health in this population with an experienced multidisciplinary care team including me...
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
Integrative Palliative Care and Management of Refractory Epilepsy
This article reviews the various treatment options for patients with refractory epilepsy and highlights the importance of palliative care.SummaryA child neurologist should participate as an integral part of the palliative care team in patients with refractory epilepsy to help guide the discussion about etiology, prognosis, and actively manages seizures as they work with other members of pediatric palliative care team towards improving the quality of life for the patient, caregiver, and family members. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
Opioid Use Disorders in Adolescents —Updates in Assessment and Management
AbstractPurpose of ReviewTo review information specific to adolescents regarding trends in opioid use, risk factors for opioid misuse, medical co-morbidity, and treatment updates.Recent FindingsAlthough opioid misuse in adolescents is uncommon, it is associated with morbidity and mortality such as hepatitis C and overdose. Adolescents commonly start with prescription opioid misuse before transitioning to heroin use. The existing literature supports the use of buprenorphine/naloxone for the treatment of adolescent opioid use disorders. Safe medication storage and disposal is important to decrease adolescent prescription opi...
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
Integrative Therapies to Support Pediatric Palliative Care: the Current Evidence
AbstractPurpose of ReviewThis review offers an evidence-based introduction to integrative therapies that can be used with children receiving palliative care and suggestions for how to incorporate these therapies into practice.Recent FindingsFor each integrative therapy discussed, recent research from both the pediatric and adult literature is summarized.SummaryIntegrative medicine offers a patient-centered approach to care that brings together conventional and complementary therapies. Evidence-based integrative therapies exist for many troublesome end-of-life symptoms, including pain, anxiety, nausea, and constipation, and...
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
Pediatric Palliative Care and the Pediatric Intensive Care Unit
AbstractPurpose of ReviewThe role of palliative care in pediatric critical care medicine is described, with a focus on communication practices, complex chronic medical disease, end-of-life care, and moral resiliency.Recent FindingsPalliative care medicine has an increasing presence in pediatric critical care medicine. The model for delivering quality palliative care from a primary to consultative role is evolving, as increasing numbers of patients and families benefit from this additional layer of care and advocacy. Palliative care medicine is complementary care at all levels and focuses on collaborating with families and ...
Source: Current Pediatrics Reports - June 1, 2018 Category: Pediatrics Source Type: research
