Current opinion in pediatrics最新文献

Current approaches to diagnosing acute appendicitis: pitfalls and progress.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-07 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":"https://doi.org/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":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","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

Personalizing ICU liberation for critically Ill children: shaping the future of the ABCDEF bundle.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-03 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":"https://doi.org/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":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","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

What we know about screen time and social media in early adolescence: a review of findings from the Adolescent Brain Cognitive Development Study.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-02 DOI: 10.1097/MOP.0000000000001462

Jason M Nagata, Christopher M Lee, Jacqueline O Hur, Fiona C Baker

{"title":"What we know about screen time and social media in early adolescence: a review of findings from the Adolescent Brain Cognitive Development Study.","authors":"Jason M Nagata, Christopher M Lee, Jacqueline O Hur, Fiona C Baker","doi":"10.1097/MOP.0000000000001462","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001462","url":null,"abstract":"Purpose of review: To review recent literature based on Adolescent Brain and Cognitive Development (ABCD) Study data of over 11 000 participants about screen time and social media use in early adolescence, including epidemiology, trends, and associations with mental and physical health outcomes.Recent findings: Time spent on screens and social media has risen among early adolescents (aged 9-15 years), and these increasing trends have been more pronounced since the COVID-19 pandemic. Both cross-sectional and 1-2-year follow-up data show that higher screen use, particularly social media, video games, video chat, videos, and texting, is associated with a range of mental health symptoms, including depression, anxiety, eating disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity, and disruptive behavior disorders, although effect sizes vary. Screen time is also associated with sleep problems and various cardiometabolic risk factors. Parents' own screen use and restriction of bedroom and mealtime screen use are associated with lower early adolescent screen time and problematic use.Summary: Analyses of current ABCD Study data reveal increasing use of screens and social media across early adolescence, with sociodemographic disparities in screen use as well as numerous associations between screens and adverse mental and physical health effects.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763406","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.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-02 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":"https://doi.org/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":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","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

Contraception updates for adolescents.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-02 DOI: 10.1097/MOP.0000000000001463

Anna Carleen, Ashley Ebersole

{"title":"Contraception updates for adolescents.","authors":"Anna Carleen, Ashley Ebersole","doi":"10.1097/MOP.0000000000001463","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001463","url":null,"abstract":"Purpose of review: To discuss updated guidelines for the provision of contraception to adolescents, review several contraceptive methods that have entered the market in recent years, and summarize insights from the literature that can assist clinicians in providing accurate, destigmatized contraceptive counseling to patients of all sizes.Recent findings: The 2024 United States Selected Practice Recommendations (US SPR) and United States Medical Eligibility for Contraceptive Use (US MEC) guidelines include changes to recommendations for contraception use in persons with various health conditions, and new advice for management of implant-associated breakthrough bleeding, pain control for intrauterine device (IUD) insertions, and counseling for patients who take testosterone. Subcutaneous Depo-Provera usage increased during the COVID-19 pandemic, and multiple studies demonstrate favorable patient experiences with it. Annovera, Miudella, Opill, Phexxi, Slynd, and Twirla are newer contraceptives which have distinct features that may make them attractive options for some patients. Contraception-related weight changes continue to be an active area of research. With the Food and Drug Administration (FDA) recommending broader BMI inclusion criteria, providers can expect more information about safety and efficacy of new contraceptives in individuals across the weight spectrum.Summary: Updated evidence-based guidelines and several new contraceptive options should empower providers to provide patient-centered contraception counseling to patients with a variety of health conditions and contraceptive preferences.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763323","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.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1097/MOP.0000000000001447

引用次数: 0

HPV vaccine hesitancy in the United States.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-01 Epub Date: 2025-01-22 DOI: 10.1097/MOP.0000000000001441

Riya Joshi, Alexandra Kilinsky

{"title":"HPV vaccine hesitancy in the United States.","authors":"Riya Joshi, Alexandra Kilinsky","doi":"10.1097/MOP.0000000000001441","DOIUrl":"10.1097/MOP.0000000000001441","url":null,"abstract":"Purpose of review: Human papillomavirus (HPV) is the most common STI and accounts for roughly 37 000 HPV-associated cancers annually in the United States. Despite documented safety and effectiveness of the HPV vaccine, vaccination rates should be higher. We summarize literature surrounding vaccine hesitancy, a main reason for suboptimal vaccine coverage. We aim to describe the complex factors that lead to hesitancy in order to support improvement of vaccination rates in our communities.Recent findings: Studies document sustained immunogenicity and effectiveness 10 years post HPV vaccination. Vaccine coverage was rising until 2022, when initiation declined. Primary reasons for hesitancy are: perceived lack of provider recommendation, a lack of parental knowledge and necessity especially if an adolescent is not sexually active, and safety concerns. The COVID-19 pandemic challenged access to care and exacerbated vaccine-related discourse. Studies of hesitant adopters reveal that social processes, including conversations with community members, have a substantial impact on decisions to vaccinate.Summary: We highlight recent literature behind parental hesitancy toward the HPV vaccine, focusing on concerns about its necessity and safety, exacerbated by medical mistrust and misinformation. We summarize findings of successful educational outreach and community-based interventions to improve vaccination rates in the postpandemic social media era.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"198-204"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064337","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

Reimagining apnea monitoring in the neonatal ICU. 新生儿ICU呼吸暂停监测的重新构想。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-01 Epub Date: 2024-12-11 DOI: 10.1097/MOP.0000000000001432

Emily Jeanne, Ruben Alvaro, Wissam Shalish

{"title":"Reimagining apnea monitoring in the neonatal ICU.","authors":"Emily Jeanne, Ruben Alvaro, Wissam Shalish","doi":"10.1097/MOP.0000000000001432","DOIUrl":"10.1097/MOP.0000000000001432","url":null,"abstract":"Purpose of review: This review outlines the prevalence and complications of apneas and intermittent hypoxemic events in preterm infants, examines current monitoring limitations in neonatal ICUs (NICUs), and explores emerging technologies addressing these challenges.Recent findings: New evidence from the Prematurity-Related Ventilatory Control (Pre-Vent) study, which analyzed cardiorespiratory data from 717 extremely preterm infants, exposes the varying frequency, duration, and severity of apneas, intermittent hypoxemia, bradycardias, and periodic breathing during hospitalization, and highlights the negative impact of intermittent hypoxemia on pulmonary outcomes at discharge. Although traditional monitoring methods cannot differentiate between apnea types and quantify their burden, recent advancements in sensor technologies and data integration hold promise for improving real-time detection and evaluation of apneas in the NICU. Notably, small wearable mechano-acoustic sensors could improve apnea monitoring through continuous detection of airflow and respiratory efforts. Additionally, integrating bedside physiological data with modalities such as near-infrared spectroscopy, diaphragmatic activity, and electrical impedance tomography could help predict adverse outcomes by monitoring regional oxygen saturation and lung function in relation to apneas.Summary: Enhancing our understanding of neonatal apneas and overcoming the current limitations in apnea monitoring through advanced sensor technologies and data integration could lead to more personalized management and improved outcomes for preterm infants.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"173-181"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001337","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

Utilizing preterm infant body composition assessments to guide neonatal nutrition. 利用早产儿身体成分评估指导新生儿营养。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-01 Epub Date: 2025-01-02 DOI: 10.1097/MOP.0000000000001434

Catherine O Buck

{"title":"Utilizing preterm infant body composition assessments to guide neonatal nutrition.","authors":"Catherine O Buck","doi":"10.1097/MOP.0000000000001434","DOIUrl":"10.1097/MOP.0000000000001434","url":null,"abstract":"Purpose of review: The use of body composition to assess the quality of infant growth may add valuable information to pediatric clinical care. Preterm infants have differences in their fat and muscle mass development compared with infants born at term, which may be related to their early nutritional exposures. This review focuses on recent studies examining early nutrition in preterm infants and related body composition outcomes in the newborn period and beyond.Recent findings: Overall, the evidence shows that early nutrient delivery in parenteral nutrition and through formula supplementation or human milk fortification is associated with increased fat-free mass or lean mass in early life. However, future research is needed to fully understand the link between these body composition changes and longitudinal outcomes in preterm infants.Summary: Inclusion of body composition assessments in preterm infant nutrition research is critical to understand the factors associated with differences in adiposity and lean mass development in preterm infants. Medical fragility in preterm infants limits the routine use of body composition assessment tools which are currently validated, and additional studies are needed to thoroughly assess other methods which may be more feasible to integrate into bedside routine.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"191-197"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001648","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

Reversal of Roe v. Wade and implications of legal restrictions for neonatal care.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-04-01 Epub Date: 2025-02-07 DOI: 10.1097/MOP.0000000000001445

Christine E Bishop, Maya Manian

{"title":"Reversal of Roe v. Wade and implications of legal restrictions for neonatal care.","authors":"Christine E Bishop, Maya Manian","doi":"10.1097/MOP.0000000000001445","DOIUrl":"10.1097/MOP.0000000000001445","url":null,"abstract":"Purpose of review: This review examines the implications of the 2022 Dobbs v. Jackson Women's Health Organization decision on neonatal care and explores how legal restrictions on abortion are influencing medical practices for neonates and the broader healthcare landscape for neonates.Recent findings: The Dobbs decision has led to increased uncertainty and challenges in both maternal and neonatal healthcare. Restrictive abortion laws are associated with higher infant mortality rates, increased health disparity, and increased care provider ethical dilemmas and moral distress due to legal uncertainty surrounding the care of infants. However, current changes in federal and state law regarding abortion do not change the previously established standard of care for neonates. Other federal legal statutes potentially addressing the care of neonates have existed for over 20 years and have had minimal effect on the practice of neonatology, because there is no record of federal enforcement actions or federal case law to clarify how the law should be interpreted.Summary: While restrictive abortion laws primarily affect women and pregnant people's health care, indirect effects on neonatal care are becoming more common. There are other laws and policies with greater potential to regulate care for infants at the federal and state level. Professional medical standards remain the guiding framework in neonatal care. Clinicians can mitigate legal concerns through knowledge and advocacy.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"165-172"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363899","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