Current opinion in pediatrics最新文献

Tailoring ventilation and respiratory management in pediatric critical care: optimizing care with precision medicine. 在儿科危重症护理中剪裁通气和呼吸管理：用精准医学优化护理。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-02-12 DOI: 10.1097/MOP.0000000000001449

Francis-Olivier Beauchamp, Julie Thériault, Michaël Sauthier

{"title":"Tailoring ventilation and respiratory management in pediatric critical care: optimizing care with precision medicine.","authors":"Francis-Olivier Beauchamp, Julie Thériault, Michaël Sauthier","doi":"10.1097/MOP.0000000000001449","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001449","url":null,"abstract":"Purpose of review: Critically ill children admitted to the intensive care unit frequently need respiratory care to support the lung function. Mechanical ventilation is a complex field with multiples parameters to set. The development of precision medicine will allow clinicians to personalize respiratory care and improve patients' outcomes.Recent findings: Lung and diaphragmatic ultrasound, electrical impedance tomography, neurally adjusted ventilatory assist ventilation, as well as the use of monitoring data in machine learning models are increasingly used to tailor care. Each modality offers insights into different aspects of the patient's respiratory system function and enables the adjustment of treatment to better support the patient's physiology. Precision medicine in respiratory care has been associated with decreased ventilation time, increased extubation and ventilation wean success and increased ability to identify phenotypes to guide treatment and predict outcomes. This review will focus on the use of precision medicine in the setting of pediatric acute respiratory distress syndrome, asthma, bronchiolitis, extubation readiness trials and ventilation weaning, ventilation acquired pneumonia and other respiratory tract infections.Summary: Precision medicine is revolutionizing respiratory care and will decrease complications associated with ventilation. More research is needed to standardize its use and better evaluate its impact on patient outcomes.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"37 3","pages":"223-232"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-04-30 DOI: 10.1097/MOP.0000000000001466

引用次数: 0

Personalizing ICU liberation for critically Ill children: shaping the future of the ABCDEF bundle. 危重儿童个性化ICU解放：塑造ABCDEF捆绑的未来。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-04-02 DOI: 10.1097/MOP.0000000000001465

Jessica M LaRosa, Sapna R Kudchadkar

{"title":"Personalizing ICU liberation for critically Ill children: shaping the future of the ABCDEF bundle.","authors":"Jessica M LaRosa, Sapna R Kudchadkar","doi":"10.1097/MOP.0000000000001465","DOIUrl":"10.1097/MOP.0000000000001465","url":null,"abstract":"Purpose of review: Intensive care unit (ICU) liberation bundles aim to reduce acquired morbidities in the growing population of pediatric ICU survivors. This review will explore emerging precision medicine strategies to personalize the implementation of the ICU liberation bundle.Recent findings: The ICU liberation bundle, also known as the ABCDEF bundle, consists of six interrelated components: A: assess, prevent, and manage pain; B: spontaneous breathing trials; C: choice of analgesia and sedation; D: delirium assessment, prevention, and management; E: early mobility and exercise; F: family engagement and empowerment. Emerging research and technology are advancing personalized approaches to each component, enabling researchers and clinicians to optimize implementation based on patient-specific factors. Key innovations include automated screening and risk stratification using computational models, wearable technologies that detect bundle elements, and genetic assessments to evaluate disease risk and medication responses.Summary: This review provides an overview of the ICU liberation bundle for critically ill children and highlights opportunities to personalize each bundle element to enhance survivorship. By integrating advancements in precision medicine, clinicians and researchers can improve the quality of care for the growing population of PICU survivors, ultimately leading to better long-term outcomes.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"216-222"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The potential of artificial intelligence to transform medicine. 人工智能改变医学的潜力。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-03-19 DOI: 10.1097/MOP.0000000000001452

Grace Liberatore, Jack Brenner, Julian Franco, Ruth Milanaik

{"title":"The potential of artificial intelligence to transform medicine.","authors":"Grace Liberatore, Jack Brenner, Julian Franco, Ruth Milanaik","doi":"10.1097/MOP.0000000000001452","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001452","url":null,"abstract":"Purpose of review: Increased incorporation of artificial intelligence in medicine has raised questions regarding how it can enhance efficiency in concert with providing accurate medical information without violating patient privacy. Pediatricians should understand the impact of AI in terms of both their daily practice and the changing landscape of the medical field.Recent findings: Computer vision modeling and large language models have been designed for diagnostic and predictive health outcomes purposes; yet many still lack external validity and reliability. Artificial intelligence can also increase efficiency in electronic health record documentation. Despite potential benefits, legal and ethical concerns are raised with patient data that is stored and used by artificial intelligence models. More research is recommended before artificial intelligence is fully implemented into medical practice.Summary: Utilizing artificial intelligence in medical practice and medical education as supplemental tools, rather than in replacement of traditional methods, may result in more efficient medical practice and enhanced methods of studying. Yet, there needs to be a balance such that overreliance does not result in automatic trusting of potentially misinformation. Increased oversight and regulation of artificial intelligence in medicine is crucial to ensure legal and ethical approaches that protect patient privacy.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"37 3","pages":"289-295"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory syncytial virus vaccination: likely and less likely outcomes. 呼吸道合胞病毒疫苗接种：可能和不太可能的结果。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-03-19 DOI: 10.1097/MOP.0000000000001455

Dvir Gatt, Guy Hazan

{"title":"Respiratory syncytial virus vaccination: likely and less likely outcomes.","authors":"Dvir Gatt, Guy Hazan","doi":"10.1097/MOP.0000000000001455","DOIUrl":"10.1097/MOP.0000000000001455","url":null,"abstract":"Purpose of review: Respiratory syncytial virus (RSV) remains a leading cause of lower respiratory tract infections in infants, older adults, and high-risk populations. The recent approval of new RSV vaccines and monoclonal antibodies marks a turning point in RSV prevention. This review explores these advancements, their immediate and potential long-term effects, and the remaining challenges.Recent findings: Several novel RSV prevention strategies have been approved, including maternal RSVPreF vaccines, infant-targeted monoclonal antibodies like Nirsevimab, and vaccines for older adults. These interventions significantly reduce RSV-related hospitalizations, ICU admissions, and mortality, particularly in high-risk groups. Early evidence also suggests benefits in reducing wheezing during infancy; however, long-term impacts on asthma development remain uncertain. Challenges such as vaccine hesitancy and limited access in low-resource settings remain pressing issues that require sustained focus.Summary: RSV vaccines and monoclonal antibodies are expected to alter clinical management and public health by reducing severe disease burden and RSV transmission. Further research is needed to evaluate their long-term effects, including implications for asthma prevention and pediatric obstructive sleep apnea. Addressing access disparities and public acceptance will be critical for maximizing their global impact.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"259-265"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current scope of pediatric trauma video review and development of a Canadian program. 当前儿科创伤视频回顾的范围和加拿大程序的发展。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-03-19 DOI: 10.1097/MOP.0000000000001454

Suzanne Beno, Caitlin Ross, Melissa Lorenzo

{"title":"Current scope of pediatric trauma video review and development of a Canadian program.","authors":"Suzanne Beno, Caitlin Ross, Melissa Lorenzo","doi":"10.1097/MOP.0000000000001454","DOIUrl":"10.1097/MOP.0000000000001454","url":null,"abstract":"Purpose of review: Trauma video review (TVR) programs have become an essential component of trauma performance improvement programs, providing a novel lens on real-time clinical data driving education, research, and quality improvement (QI) in trauma resuscitations. This review aims to explore the current scope of TVR in pediatric trauma. We also describe the implementation and QI impact of the first pediatric TVR program in Canada, at The Hospital for Sick Children (SickKids) in Toronto, Ontario.Recent findings: TVR has demonstrated the ability to identify latent safety threats, improve adherence to advanced trauma life support (ATLS) and trauma checklists, and optimize critical interventions such as vascular access and intubation. Its use has revealed significant variability in team performance, time-based metric goals, and communication, enabling targeted QI initiatives. For example, structured prehospital to trauma team handover protocols and tools like T-NOTECHS have enhanced communication and teamwork in trauma resuscitations. Despite concerns around medicolegal risks and staff anxiety, TVR has been favorably received, with notable benefits outweighing potential drawbacks.Summary: TVR is emerging as a critical tool in pediatric trauma care, already demonstrating transformative QI integrated into existing performance improvement programs. Pediatric trauma programs should consider implementation within their local context.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"244-249"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current approaches to diagnosing acute appendicitis: pitfalls and progress. 当前诊断急性阑尾炎的方法：缺陷与进展。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-04-04 DOI: 10.1097/MOP.0000000000001472

Alisha S Ching, Anna Bauman, Michele M Carney

{"title":"Current approaches to diagnosing acute appendicitis: pitfalls and progress.","authors":"Alisha S Ching, Anna Bauman, Michele M Carney","doi":"10.1097/MOP.0000000000001472","DOIUrl":"10.1097/MOP.0000000000001472","url":null,"abstract":"Purpose of review: Pediatric appendicitis remains a common diagnostic challenge faced in the emergency department. In this review, we provide an update on recent literature regarding the diagnosis of pediatric appendicitis via labs, imaging, and clinical prediction scores, and provide a summary of key pitfalls in diagnosing this condition.Recent findings: Progress has been made in laboratory evaluation for the diagnosis of pediatric appendicitis with newer markers being under investigation, though standard markers such as white blood cell count and C-reactive protein remain prominent. From an imaging standpoint, there is emphasis on the use of ultrasound as the primary imaging modality, and creating new protocols for magnetic resonance imaging as a secondary imaging method if ultrasound is inconclusive. Clinical prediction scores continue to be a promising diagnostic tool with the literature indicating high specificity but rather low sensitivity. A wide array of diagnostic practices exist creating disparities in care, particularly with imaging.Summary: Pediatric appendicitis is a challenging diagnosis with ongoing research efforts focused on novel laboratory markers that are more sensitive and specific, prioritizing the use of nonionizing radiation imaging modalities, and improving reliability of clinical prediction scoring tools. Reducing disparities in care surrounding pediatric appendicitis should be a focus for future research.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"250-256"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current recommendations in the diagnosis and management of cannabinoid hyperemesis syndrome. 目前大麻素呕吐综合征的诊断和治疗建议。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1097/MOP.0000000000001464

Joshua Meyer, Michele M Burns

{"title":"Current recommendations in the diagnosis and management of cannabinoid hyperemesis syndrome.","authors":"Joshua Meyer, Michele M Burns","doi":"10.1097/MOP.0000000000001464","DOIUrl":"10.1097/MOP.0000000000001464","url":null,"abstract":"Purpose of review: Legalization and decriminalization of marijuana over recent years has led to a significant increase in the prevalence of cannabinoid hyperemesis syndrome (CHS). CHS can be a debilitating syndrome that provides unique challenges to healthcare providers in the both the inpatient and outpatient setting. Recent evidence has provided some insight into the pathogenesis of this syndrome and potential treatments in both the acute and chronic phases.Recent findings: Since identification of the syndrome in 2004, the only known treatment has been complete cessation of all delta-9-tetrahydrocannabinol (THC)-containing products. Recent evidence suggests that dopamine antagonists may be useful in the acute phase and outpatient treatment of underlying disorders like anxiety, depression and substance use disorder is critical to treatment success.Summary: While the epidemiology and pathogenesis of CHS remains largely unknown, recent evidence suggests that treatment of CHS must not only include management of acute episodes with IV fluid repletion, dopamine antagonists, capsaicin cream, and other, more traditional antiemetics, but also treatment of underlying conditions that may be contributing to chronic THC use such as anxiety, depression and substance use disorder.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"240-243"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The globalization of cystic fibrosis care. 囊性纤维化治疗的全球化。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-03-27 DOI: 10.1097/MOP.0000000000001458

Carlos E Milla

{"title":"The globalization of cystic fibrosis care.","authors":"Carlos E Milla","doi":"10.1097/MOP.0000000000001458","DOIUrl":"10.1097/MOP.0000000000001458","url":null,"abstract":"Purpose of review: The field of cystic fibrosis is experiencing dramatic changes, as the translation of a massive body of scientific knowledge accumulated from the day of the cloning of the CFTR gene has led to the identification of effective therapies to correct the basic defect. This has also allowed care providers and people with cystic fibrosis in low-income and middle-income countries (LMICs) to become more knowledgeable and proficient in cystic fibrosis cares.Recent findings: This review focuses on two main aspects highly relevant to understand the current status of cystic fibrosis in LMICs: The recognition of the universal occurrence of cystic fibrosis, as well as the varying incidence in different regions of the world, and the collaborative international efforts for dissemination of best care practices as an attempt to close gaps in care.Summary: As the field continues to change rapidly, multiple international efforts are attempting to close gaps and disparities clearly apparent between affluent countries and LMICs. However, these efforts are seriously hampered by limited access to effective therapies and most dramatically to CFTR modulator drugs.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"266-271"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Update on neonatal and infantile onset epilepsies. 关于新生儿和婴儿癫痫发作的最新情况。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-02-10 DOI: 10.1097/MOP.0000000000001448

Evelina Carapancea, Tristan T Sands, Maria Roberta Cilio

{"title":"Update on neonatal and infantile onset epilepsies.","authors":"Evelina Carapancea, Tristan T Sands, Maria Roberta Cilio","doi":"10.1097/MOP.0000000000001448","DOIUrl":"10.1097/MOP.0000000000001448","url":null,"abstract":"Purpose of review: Neonatal and infantile epilepsies represent a diverse group of disorders with significant neurodevelopmental impact, necessitating early diagnosis, and tailored treatment. Recent advancements in genetic research, phenotyping, and therapeutic development have reshaped the understanding and management of these conditions, making this review both timely and relevant.Recent findings: Next-generation sequencing has emerged as a cornerstone for diagnosing neonatal and infantile epilepsies, offering high diagnostic yields and enabling identification of etiology-specific phenotypes. Precision therapies, including sodium channel blockers, ganaxolone, and mammalian target of rapamycin (mTOR) inhibitors, target specific molecular mechanisms. Early initiation of treatment in conditions with a high risk of progressing to epilepsy, like vigabatrin in tuberous sclerosis complex, lower the incidence of infantile spasms and improve developmental outcomes. Drug repurposing has also provided effective options, such as fenfluramine in Dravet syndrome, with promising outcomes. Gene-based therapies, including antisense oligonucleotides and gene replacement, represent the new frontier for addressing the root causes of these disorders.Summary: The integration of genetic and molecular advancements is transforming the management of neonatal and infantile epilepsies, fostering precision-driven care. Continued research and innovation are essential to refine these strategies, optimize patient outcomes, and establish new standards of care.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"303-308"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0