Post-concussion Syndrome and Neurologic Complications
AbstractPurpose of ReviewThis review seeks to describe the clinical manifestations of and management approach to post-concussion syndrome and other neurologic sequelae of concussion including post-traumatic headache, concussive convulsions, and chronic traumatic encephalopathy.Recent FindingsMost children with concussion recover within 1 month but symptoms persist beyond that in patients with post-concussion syndrome. After a limited period of cognitive and physical rest, gradual reintroduction of activities, including aerobic exercise, helps to relieve concussive and post-concussive symptoms. A variety of treatment appr...
Source: Current Pediatrics Reports - January 19, 2018 Category: Pediatrics Source Type: research
Pediatric Neurology in Resource-Limited Settings: a Systematic Review
AbstractPurpose of ReviewThe goal of this review is to provide a succinct summary of issues related to the practice of child neurology in resource-limited settings. Questions addressed in this review include the comparative epidemiology of neurologic disorders affecting children in low-resource settings, changes in epidemiology over time, challenges posed by neurologic disorders in these settings, and health system-based solutions to those challenges.Recent FindingsA number of recent epidemiological studies including the Global Burden of Disease studies have elucidated key differences in the epidemiology of neurologic diso...
Source: Current Pediatrics Reports - January 19, 2018 Category: Pediatrics Source Type: research
Cannabidiol in Pediatric Epilepsy
AbstractPurpose of ReviewTo summarize current understanding of the role of endocannabinoids as well as exogenous cannabinoids such as tetrahydrocannabiniol and cannabidiol in the functions of the body, including the brain, and to explore the role of cannabidiol in the treatment of pediatric epilepsy.Recent FindingsPreviously, the evidence supporting the role of cannabidiol in the treatment of epilepsy was largely anecdotal. In 2017, two randomized, placebo-controlled, clinical trials suggested that cannabidiol may be effective in the treatment of epilepsy, though conclusions about both seizure reduction and adverse effects...
Source: Current Pediatrics Reports - January 17, 2018 Category: Pediatrics Source Type: research
Disaster Preparedness: Meeting the Needs of the Pediatric Population
AbstractPurpose of ReviewThe purpose of this review is to determine how to make the most efficient use of pediatric care resources during a disaster in the hope of minimizing the potential impact of a disaster on the pediatric population.Recent FindingsChildren are known to be especially vulnerable to a disaster because of physiologic, psychologic, and developmental differences from adults. This is further complicated by the fact that most planners do not account for these differences when managing an event.SummaryDisaster response involves coordinating resources on many levels, from what is available to care for children ...
Source: Current Pediatrics Reports - November 6, 2017 Category: Pediatrics Source Type: research
Pediatric Tachyarrhythmias: Diagnosis and Management
AbstractPurpose of ReviewThe purpose of this paper is to review the presentation, mechanism and acute management of pediatric tachyarrhythmias and to discuss current updates in the literature.Recent FindingsIn 2015, the AHA updated the PALS guidelines to include lidocaine as a first line agent alongside amiodarone in the management of ventricular tachycardia. A recent study re-addressed the safety of the use of adenosine on heart transplant patients with supraventricular tachycardia (SVT). Also, there have been recent studies which explored alternative prevention modalities for postoperative junctional ectopic tachycardia ...
Source: Current Pediatrics Reports - November 4, 2017 Category: Pediatrics Source Type: research
Complications of Emerging Oncology Therapies Requiring Treatment in the Pediatric Intensive Care Unit
AbstractPurpose of the ReviewThe development of immunotherapies has resulted in significant improvements in survival for children with cancer and congenital blood disorders. The purpose of this review is to guide the recognition and treatment of significant side of effects three increasingly used immunotherapies —T cell-mediated therapies, immune checkpoint inhibitors, and anti-GD2 antibodies.Recent FindingsCytokine release syndrome (CRS) is a cytokine-induced systemic inflammatory state secondary to chimeric antigen receptor T cells (CAR –T cells), a therapy used for relapsed and refractory leukemia. CRS can range fro...
Source: Current Pediatrics Reports - October 28, 2017 Category: Pediatrics Source Type: research
Early Prevention and Treatment Interventions for Childhood Obesity
AbstractPurpose of ReviewChildhood obesity is a challenge that pediatric providers face daily in the clinical setting. As a multifactorial chronic illness, obesity is complex, with numerous possible prevention, and treatment strategies. Clinical interventions in the primary care setting address factors such as promoting healthy behaviors from the beginning of life, increasing parental understanding of weight status and its relationship to health, dietary behaviors, screen time, and physical activity. These behaviors can be addressed through counseling and intervention tools, such as motivational interviewing. These interve...
Source: Current Pediatrics Reports - October 23, 2017 Category: Pediatrics Source Type: research
Recent Advances in Pediatric Acute Respiratory Distress Syndrome (PARDS)
AbstractPurpose of ReviewThe purpose of this review is to summarize the recent literature on pediatric acute respiratory distress syndrome (PARDS). This review will focus on, but not be limited to, literature using the recent definition of PARDS established by the Pediatric Acute Lung Injury Consensus Conference (PALICC) group in 2015.Recent FindingsMortality rates for PARDS have recently decreased to 10 –15%. Clinical trials in PARDS have (1) emphasized the relative importance of early oxygenation in predicting mortality; (2) suggested a role for protocolized sedation in patients managed with extracorporeal membrane oxy...
Source: Current Pediatrics Reports - October 12, 2017 Category: Pediatrics Source Type: research
Pediatric Traumatic Brain Injury: an Update on Management
This article reviews the pathophysiology, evaluation, and management of pediatric TBI, as well as highlights recent updates in the literature. Traumatic brain injury (TBI) is a leading cause of death and permanent disability worldwide, and its prevalence presents a significant public health concern. Since the second edition of the Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents was released, several recent studies have broadened our understanding of pediatric TBI.Recent FindingsWhile there remains a paucity of high-level evidence on which to base precise co...
Source: Current Pediatrics Reports - October 6, 2017 Category: Pediatrics Source Type: research
Pediatric In-Hospital Cardiac Arrest and Cardiopulmonary Resuscitation
The objective of this review is to convey current knowledge regarding pediatric in-hospital cardiac arrest (IHCA) and cardiopulmonary resuscitation.Recent FindingsRates of survival after pediatric IHCA have improved substantially over the last two decades. This has been largely driven by early recognition and transfer of deteriorating patients to intensive care units prior to cardiac arrest and an enhanced understanding of the importance of delivering high-quality CPR and post-resuscitation care. Areas of active inquiry include CPR quality monitoring methods, physiology-guided CPR, assisted ventilation during CPR, extracor...
Source: Current Pediatrics Reports - September 27, 2017 Category: Pediatrics Source Type: research
Risk Stratification and Surgical Advances in Pediatric Solid Tumors
AbstractPurpose of the ReviewHere we discuss the risk stratification schemas of several of the common malignant pediatric solid tumors and also some of the technical advances in the surgical management of these children.Recent FindingsSignificant improvement has been made in the outcome for children with cancer over the past 60 years with overall survival increasing from about 30% to currently over 80%. Yet, 20% of children with cancer still do not survive their disease. With an increasing array of therapeutic options, each of which having not only anticancer activity but also potential acute and long-term toxicity, the ...
Source: Current Pediatrics Reports - August 2, 2017 Category: Pediatrics Source Type: research
The Intestinal Microbiome and Childhood Obesity
AbstractPurpose of ReviewPediatric obesity has reached epidemic proportions worldwide. The community of microbes inhabiting the human intestine affects differential nutrient absorption, metabolism, and weight status. However, the majority of our knowledge is derived from animal models and adults with obesity. This review discusses the role of the intestinal microbiome in the development and modification of pediatric obesity, with a focus on opportunities for modification of the microbiome through alteration of environmental factors.Recent FindingsRecent evidence suggests that obesity is associated with phylogenetic changes...
Source: Current Pediatrics Reports - August 2, 2017 Category: Pediatrics Source Type: research
Promising Policies for Early Obesity Prevention
This article discusses three main policy levers to impact obesity in early childhood, specifically through child care: main funding streams, Quality Rating Improvement Syst ems (QRIS), and child care licensing regulations. These efforts, coupled with a holistic view of health outside of the child care setting, will best support children’s physical and emotional well-being, promote whole-child development, and address fundamental social determinants of health. Lastly, the article discusses unintended consequences that can arise from some of these approaches. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - July 13, 2017 Category: Pediatrics Source Type: research
Pediatric Motility Disorders
AbstractPurpose of ReviewPediatric gastrointestinal motility disorders are a heterogeneous group of enteric nervous system disorders that continue to cause difficulties in children. The pathophysiology, diagnosis, and treatments of the most common disorders of the esophagus, stomach, small intestine, and colon will be discussed to understand the interplay between motility and sensory functions and the effect on gastrointestinal motility.Recent FindingsMuch remains unanswered in the pathogenesis of the majority intestinal motility disorders. Research has started to explore targeted gene mutations as potential causes of cong...
Source: Current Pediatrics Reports - July 10, 2017 Category: Pediatrics Source Type: research
A Move to Conservativism in Pediatric Urology
AbstractPurpose of ReviewTo define the evidence on the move to conservative treatment in four areas of pediatric urology: laparoscopic ureteric clipping in non-functioning duplex kidney, management of multicystic dysplastic kidney (MCDK), intravesical botulinum toxin injection in detrusor over activity, and risk stratification of gonadal tumors in disorders of sexual development.Recent FindingsLaparoscopic ureteric clipping has been validated in one preliminary study. Lesser investigation and non-operative management of MCDK has been validated. An increasing body of evidence showing botulinum toxin injection can effectivel...
Source: Current Pediatrics Reports - July 10, 2017 Category: Pediatrics Source Type: research
