The Role of Bariatric Surgery in the Management of Morbid Childhood Obesity
Abstract
The global obesity epidemic continues to progress. Overweight and obesity have increasingly been reported in childhood and their prevalence is rising rapidly on a global level. Globally, 22.6–23.8 % of children are now overweight, resulting in enormous health consequences to individuals and society. No other intervention has been able to replicate the degree and maintenance of BMI reduction and comorbidity improvement shown in the adult bariatric surgery literature. Marked improvements have been demonstrated across many organ systems, in particular across the cardiovascular and endocrine syst...
Source: Current Pediatrics Reports - October 22, 2015 Category: Pediatrics Source Type: research
Rheumatic Fever: What is New?
Abstract
Acute rheumatic fever (ARF) continues to be a major cause of death in developing countries. Recent publications summarised in this review highlight several potential markers suggestive of a diagnosis of ARF including many genetic polymorphisms. Handheld echocardiography proves to be a cost-efficient, portable tool that could aid earlier diagnosis of rheumatic heart disease especially in lower socio-economic populations where rates are higher. Simpler analgesic approaches to administering secondary prophylaxis such as local anaesthetic can improve adherence. Vaccines offer the ultimate solution to...
Source: Current Pediatrics Reports - August 3, 2015 Category: Pediatrics Source Type: research
Children Are Not Small Adults: Options for Pediatric Ventricular Assist Devices
Abstract
The number of children supported with ventricular assist devices (VADs) has grown rapidly over the last few years. VAD use in children holds the promise of improving the outcomes in pediatric end-stage heart failure; however, the risk–benefit profile inherent to VAD use is not uniform across all ages, sizes, and diagnoses. Device use in children has underscored a number of issues that distinguish pediatric and adult heart failure such as the high prevalence of complex congenital heart disease and the challenges inherent to supporting infants and small children. The use of VADs in children also ...
Source: Current Pediatrics Reports - August 3, 2015 Category: Pediatrics Source Type: research
Pediatric HIV: Progress on Prevention, Treatment, and Cure
Abstract
This review provides an update on current developments with prevention, treatment, and cure strategies in the field of pediatric HIV. There has been tremendous progress in the prevention and treatment of pediatric HIV infection. With new strategies for prevention of mother-to-child transmission, we are growing ever closer toward elimination of pediatric HIV, though challenges with retention
of pregnant woman and their HIV-exposed infants remain. Ongoing vigilance regarding the potential hazards of in utero ART exposure to infants continues with no significant alarms yet identified. ...
Source: Current Pediatrics Reports - July 21, 2015 Category: Pediatrics Source Type: research
Paediatric Acute Encephalitis: Infection and Inflammation
Abstract
Encephalitis is a multifaceted syndrome with a myriad of clinical presentations. It is defined as inflammation of the brain with functional disturbance. Infectious diseases, particularly viruses, and autoimmune disorders are the commonest causes in children. Young infants have the highest burden of disease for most infectious causes. Recent advances include the publication of international consensus guidelines, emergence of new aetiologies including human parechoviruses and better characterisation of known infectious causes, including enterovirus 71, which continue to cause large epidemics, death...
Source: Current Pediatrics Reports - July 20, 2015 Category: Pediatrics Source Type: research
Fetal Valvuloplasty for Critical Aortic Stenosis
We present a review of the most recently reported data and central aspects of our experience in the procedure. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - July 20, 2015 Category: Pediatrics Source Type: research
Atrial Septal Defect Device Closure in the Pediatric Population: A Current Review
Abstract
Atrial septal defects are the most common congenital cardiac defects. The natural history of an uncorrected atrial septal defect causes a shortened life expectancy due to right ventricular volume overload and associated congestive heart failure, atrial arrhythmias, and/or pulmonary vascular disease. Surgical closure of the atrial septal defect is a procedure with a long-standing history, and the maturing field of percutaneous closure of atrial septal defects by device implantation has established itself to be a feasible, minimally invasive, and safe procedure. Inherent limitations in devic...
Source: Current Pediatrics Reports - July 16, 2015 Category: Pediatrics Source Type: research
Cardiovascular Magnetic Resonance in Pediatric and Congenital Heart Disease: An Update on Recent Developments
This article critically reviews recently published reports related to pediatric and congenital CMR with sections on new techniques, congenital heart disease lesions, and cardiomyopathy. (Source: Current Pediatrics Reports)
Source: Current Pediatrics Reports - July 16, 2015 Category: Pediatrics Source Type: research
Technology and Type 1 Diabetes: Closed-Loop Therapies
Abstract
The concept of a closed-loop, automated insulin delivery system, with continuous glucose sensing and insulin delivery informed by a control algorithm without patient intervention, offers the potential to decrease the burden of diabetes management and modify the significant glycemic excursions associated with conventional therapy. Closed-loop technology represents a change in the treatment paradigm for diabetes as the transition is made from primarily self-management behaviors to automated insulin therapy, potentially relieving the burden and guilt of suboptimal glucose control. The advances in th...
Source: Current Pediatrics Reports - May 13, 2015 Category: Pediatrics Source Type: research
Diagnosis and Management of Osteoporosis in Children
Abstract
Childhood osteoporosis is an emerging health issue with ramifications that can persist into adult life. Osteoporosis can result from a genetic disorder (primary) or be secondary to another disease or treatment (secondary). It is defined by the presence of low trauma vertebral compression fractures or a combination of low bone mineral density and a clinically significant fracture history. All children, especially those with risk factors for secondary osteoporosis, should have their bone health monitored and optimised. Investigations such as dual X-ray absorptiometry, peripheral quantitative comput...
Source: Current Pediatrics Reports - April 9, 2015 Category: Pediatrics Source Type: research
Diabetes Complications in Childhood Diabetes: New Biomarkers and Technologies
Abstract
A major challenge in preventing vascular complications in diabetes is the inability to identify high-risk patients at an early stage, emphasizing the importance of discovering new risk factors, technologies, and therapeutic targets to reduce the development and progression of complications. Promising biomarkers which may improve risk stratification and serve as therapeutic targets include uric acid, insulin sensitivity, copeptin, SGLT-2, and Klotho/FGF-23. Non-invasive measures of macrovasuclar disease in youth include (1) pulse wave velocity to examine arterial stiffness, (2) carotid intima-medi...
Source: Current Pediatrics Reports - April 3, 2015 Category: Pediatrics Source Type: research
Recent Advances in Haemophilia Management
Abstract
Haemophilia is a life-threatening bleeding disorder characterised by recurrent, spontaneous bleeding episodes into muscles and joints leading to the development of painful, disabling haemophilic arthropathy. Significant improvements in the management of patients with haemophilia have occurred in the last four decades with the widespread availability of safe and effective clotting factor concentrates. Modern treatment of haemophilia is still associated with significant morbidity and recent advances in the care of patients with haemophilia including the development of modified clotting factor conce...
Source: Current Pediatrics Reports - March 28, 2015 Category: Pediatrics Source Type: research
Childhood Acute Lymphoblastic Leukemia: Toward Personalized Medicine
Abstract
Remarkable improvements in survival rates have made
childhood acute lymphoblastic leukemia (ALL) a success story within pediatric oncology. The excellent outcomes for many patients with ALL have resulted in part from risk stratification based on well-established clinical and disease features of prognostic significance. Despite the progress that has been observed, relapses occur unpredictably, and treatment can be associated with acute and long-term toxicity. This has prompted efforts to better tailor ALL therapy in individual patients. In recent years, there has been a growing expansion in...
Source: Current Pediatrics Reports - March 26, 2015 Category: Pediatrics Source Type: research
Hematopoietic Cell Transplantation and Sickle-Cell Disease: An Option for Everyone?
Abstract
There have been vast improvements in the care of patients with sickle-cell disease (SCD) such that patients are now surviving four times longer today than in the 1970s. This is largely due to improvements in supportive care therapies such as infection prophylaxis, vaccinations, and better pain management strategies. Hematopoietic cell transplantation (HCT) affords patients with SCD the only curative treatment and is usually reserved only for the most symptomatic of patients who have matched sibling donors. As more is learned about the natural progression of this disease, there has been a push tow...
Source: Current Pediatrics Reports - March 23, 2015 Category: Pediatrics Source Type: research
The Role of Registries and Tumor Banking in Rare Pediatric Tumors
Abstract
Rare pediatric tumors are a heterogenous group of tumors that are rare at any age, or rare in children and common in adults. These are orphan diseases which have not benefitted from the significant advances seen in other pediatric malignancies. To improve our understanding of these tumors, rare tumor registries and tissue repositories have been established. The development of registries has followed two different models: in Europe, the focus has been on large co-operative group registries that enroll the breath of rare tumors, while in the USA, individual rare tumor registries have predominated. ...
Source: Current Pediatrics Reports - March 14, 2015 Category: Pediatrics Source Type: research
