Current opinion in pediatrics最新文献

Diagnostic testing and antibiotic stewardship for pneumonia in children worldwide: current developments and next steps. 全球儿童肺炎的诊断检测和抗生素管理：当前发展和下一步。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-19 DOI: 10.1097/MOP.0000000000001484

Josephine S van de Maat, Andrew Redfern, Tigist Bacha, Jeroen Schouten, Esmée Ruizendaal

{"title":"Diagnostic testing and antibiotic stewardship for pneumonia in children worldwide: current developments and next steps.","authors":"Josephine S van de Maat, Andrew Redfern, Tigist Bacha, Jeroen Schouten, Esmée Ruizendaal","doi":"10.1097/MOP.0000000000001484","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001484","url":null,"abstract":"Purpose of review: Routine diagnostic tests for childhood pneumonia lack the accuracy to identify bacterial pneumonia, leading to inappropriate antibiotic prescription. Novel tests are being developed. Optimizing diagnostic strategies using available diagnostic tools and exploring the role of new tests is essential to improve antimicrobial stewardship (AMS) in children. This review provides an overview of advances in diagnostic testing for pediatric pneumonia and discusses how strategies can be optimized in different settings in order to improve AMS.Recent findings: All currently available tests for bacterial pneumonia are limited in their diagnostic accuracy. However, in settings with high baseline antibiotic prescription, routine diagnostics such as CRP or PCT-guided prescription can improve antibiotic use. Among the innovative tests, lung ultrasound with computer-aided detection and prediction models combining multiple tests holds most promise for low-resource settings. For high-resource settings, RNA signatures and next-generation sequencing are promising developments. The impact of innovative tests on AMS remains to be evaluated.Summary: Robust diagnostic and contextual research is needed to develop new diagnostic tests and to optimize current strategies for bacterial pneumonia in children. In order to tailor diagnostic approaches to specific settings, broad impact studies and stratification of risk groups are crucial.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324659","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

Oral JAK inhibitors for pediatric inflammatory skin disease. 口服JAK抑制剂治疗儿童炎症性皮肤病。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-10 DOI: 10.1097/MOP.0000000000001474

Erica B Lee, Kelly M Cordoro

{"title":"Oral JAK inhibitors for pediatric inflammatory skin disease.","authors":"Erica B Lee, Kelly M Cordoro","doi":"10.1097/MOP.0000000000001474","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001474","url":null,"abstract":"Purpose of review: JAK inhibitors have emerged as a promising new therapy for inflammatory skin disease, including in pediatric populations. However, due to their boxed warnings and lack of long-term safety and efficacy data, their specific role in the treatment ladder for various conditions remains to be determined.Recent findings: JAK inhibitors are currently approved for pediatric atopic dermatitis and alopecia areata with evidence of both efficacy and safety. They are currently being investigated for use in children with vitiligo, psoriasis, juvenile dermatomyositis, and hidradenitis suppurativa. So far, no significant safety concerns, especially regarding the FDA-mandated black box warnings, have been observed in pediatric patients being treated for inflammatory skin disease.Summary: JAK inhibitors provide clinicians and patients with another tool to consider when faced with challenging inflammatory skin diseases. Place in therapy amid the current armamentarium of available treatments for select skin conditions is evolving, as efficacy and safety data accumulates in trials and clinicians develop more real-world experience. As of now, use of JAK inhibitors should be considered on a case-by-case basis after a comprehensive assessment of the benefits and potential risks.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301298","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

Pediatric topical steroid withdrawal syndrome: facts, misconceptions and communicating with patients and families. 儿科局部类固醇戒断综合征：事实，误解和沟通与患者和家属。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-06 DOI: 10.1097/MOP.0000000000001479

Kathleen L Miao, Hsi Yen, Minnelly Luu

{"title":"Pediatric topical steroid withdrawal syndrome: facts, misconceptions and communicating with patients and families.","authors":"Kathleen L Miao, Hsi Yen, Minnelly Luu","doi":"10.1097/MOP.0000000000001479","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001479","url":null,"abstract":"Purpose of review: Topical corticosteroids (TCS) have long been a mainstay in treating pediatric atopic dermatitis (AD). Topical steroid withdrawal syndrome (TSWS) has garnered increasing public attention, driven largely by social media discourse. This review aims to provide guidance for clinicians to effectively address concerns about pediatric TSWS in order to optimally manage AD in children.Recent findings: An examination of the literature reveals several misconceptions surrounding TSWS. Research highlights the importance of standardized diagnostic criteria, caution with high- or inappropriate potency TCS, particularly in sensitive areas, and the need for provider-patient communication to improve therapeutic alliance.Summary: TSWS is gaining recognition, and the lack of consensus on diagnostic standards and similarities with AD flares can result in misdiagnosis. This review highlights practical, evidence-based clinical approaches to discuss TSWS with patients/parents. Strategies to prevent adverse effects from TCS include appropriate potency selection and duration of treatment, utilizing gradual tapering protocols with proactive maintenance therapy, and addition of nonsteroidal anti-inflammatory therapies. Moreover, fostering an open, empathetic doctor-patient relationship can reduce unwarranted phobia around corticosteroids and ensure that TCS continue to be used optimally to treat AD and other inflammatory skin conditions. Thorough clinical guidance is essential to address patient/parent concerns about TSWS while working together toward an effective treatment plan for skin disease.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301299","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

Eating disorders in Latino boys and young men: the role of sociocultural context in identification, assessment, and treatment. 拉丁裔男孩和年轻男性的饮食失调：社会文化背景在识别、评估和治疗中的作用。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-05 DOI: 10.1097/MOP.0000000000001477

Adrian J Hernandez, Carlos Melendez-Garcia, Emily Pluhar

{"title":"Eating disorders in Latino boys and young men: the role of sociocultural context in identification, assessment, and treatment.","authors":"Adrian J Hernandez, Carlos Melendez-Garcia, Emily Pluhar","doi":"10.1097/MOP.0000000000001477","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001477","url":null,"abstract":"Purpose of review: Existing research on eating disorders has predominantly centered on affluent, young White cisgender women, limiting providers' understanding of how sociocultural context influences the identification, assessment, and treatment of eating disorders among racial and ethnic minorities. Latino boys and young men remain a particularly understudied group in eating disorder studies, despite growing recognition of the prevalence of eating disorders within Latino populations. This review integrates a synthesis of current literature, epidemiological data, and multidisciplinary perspectives on sex and culture to outline how sociocultural factors, including cultural beliefs such as machismo, acculturation, and family dynamics, impact the development and expression of eating disorders in Latinos.Recent findings: Findings underscore that Latino boys and young men often present with atypical eating disorder symptoms, such as extreme dietary restrictions and excessive exercise aimed at achieving muscularity. Sociocultural factors (i.e., machismo, acculturative stress, and familial pressures) influence the manifestation and progression of these disorders. These influences are compounded by systemic barriers, such as limited access to culturally responsive care and a lack of awareness among providers regarding diverse eating disorder presentations.Summary: This review highlights the urgent need for culturally informed diagnostic frameworks and interventions to address the eating disorder experiences of Latino boys and young men.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301297","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

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