Current opinion in pediatrics最新文献_第2页

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

Precision medicine in the pediatric and neonatal intensive care units through genomics. 通过基因组学实现儿科和新生儿重症监护病房的精准医疗。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI: 10.1097/MOP.0000000000001471

Phan Q Duy, Benjamin Dylik, Engin Deniz

{"title":"Precision medicine in the pediatric and neonatal intensive care units through genomics.","authors":"Phan Q Duy, Benjamin Dylik, Engin Deniz","doi":"10.1097/MOP.0000000000001471","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001471","url":null,"abstract":"Purpose of review: Genome-wide sequencing technologies have revolutionized the understanding of human disorders and advanced precision medicine, especially for pediatric disorders. Here, we discuss the utility of genomic technologies in advancing the care of children admitted to the pediatric and neonatal intensive care units.Recent findings: Rapid molecular diagnosis permitted by genomic medicine has yielded clinically actionable findings that influence decision-making and facilitate timely therapeutic interventions. Identifying a genetic association provides a causal anchor to understanding disease biology at the single nucleotide resolution, revealing hidden biological heterogeneity that may be obscured by traditional imaging, laboratory, and pathological workup. The importance of a genetic diagnosis is further highlighted by the promise of gene therapy to correct the underlying genetic perturbation, as evidenced by the recent emergence of FDA-approved gene therapies for childhood genetic conditions.Summary: We predict that whole-genome sequencing, in conjunction with other omic technologies, will become critical diagnostic adjuncts in the clinical workup of critically ill children.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"37 3","pages":"211-215"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062652","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

Artificial intelligence impacts in education and pediatric mental health. 人工智能对教育和儿童心理健康的影响。

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.0000000000001453

Grace Liberatore, Alyssa Kim, Jack Brenner, Ruth Milanaik

{"title":"Artificial intelligence impacts in education and pediatric mental health.","authors":"Grace Liberatore, Alyssa Kim, Jack Brenner, Ruth Milanaik","doi":"10.1097/MOP.0000000000001453","DOIUrl":"10.1097/MOP.0000000000001453","url":null,"abstract":"Purpose of review: Increased accessibility of artificial intelligence to children has raised concerns regarding its effects on education and student mental health. Pediatricians should continue to be informed about the effects of artificial intelligence in their patients' daily lives, as artificial intelligence is becoming increasingly present.Recent findings: The use of artificial intelligence to create personalized study material illustrates a benefit of incorporating this technology into education. However, an overreliance on artificial intelligence could decrease students' problem-solving skills and increase plagiarism. Novel uses of artificial intelligence have also raised concerns regarding mental health. Deepfake technology, which utilizes artificial intelligence to create images, videos, and/or audio that appears real but is fabricated, can be viewed online by children, which could have negative mental health implications.Summary: Although artificial intelligence has the potential to revolutionize education at all levels, its use as an enhancement, not replacement, to current educational strategies is imperative. Both parents and students need to understand the limitations of artificial intelligence in education, and simultaneously prioritize developing the necessary cognitive skills strengthened throughout education. Pediatricians and parents should also be aware of the potentially dangerous material generated by artificial intelligence that can negatively impact children's mental health.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"296-302"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656336","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

Why some and not others? Understanding vascular phenotypes in genetic developmental lung diseases. 为什么是一些而不是另一些？了解遗传性发育性肺病的血管表型。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-03-28 DOI: 10.1097/MOP.0000000000001459

Lea C Steffes, Maya E Kumar, Nidhy P Varghese

{"title":"Why some and not others? Understanding vascular phenotypes in genetic developmental lung diseases.","authors":"Lea C Steffes, Maya E Kumar, Nidhy P Varghese","doi":"10.1097/MOP.0000000000001459","DOIUrl":"10.1097/MOP.0000000000001459","url":null,"abstract":"Purpose of review: Pulmonary vascular disease is more common in certain genetic developmental lung disorders. This review synthesizes clinical descriptions, molecular analyses, and single-cell transcriptional data to build a conceptual framework to help understand why some variants affect the vasculature while others primarily manifest with parenchymal disease.Recent findings: Genes predominantly expressed in endothelial and mesenchymal compartments ( TBX4 , FGF10 , FOXF1 , KDR ) commonly present with both parenchymal and pulmonary vascular disease, while epithelial-restricted genes ( SFTPC , ABCA3 , NKX2.1 ) typically manifest as parenchymal disease. Single-cell analyses reveal that compartment-specific expression patterns correlate with clinical phenotypes. Phenotypic variability, even among individuals sharing identical variants, suggests complex interactions between genetic modifiers, epigenetic factors, and developmental processes that remain poorly understood.Summary: Compartment-specific gene expression patterns fundamentally underlie the differential presence of vascular phenotypes in DEVLDs. Genetic advances and single cell technologies have revolutionized our understanding of these disorders, but we are in the early stages of translating this knowledge into meaningful clinical advances. Future efforts must bridge this gap to transform clinical care from supportive to targeted, disease-modifying treatment based on cell-specific molecular mechanisms.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"278-288"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763414","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

Pediatric pulmonology: medical frontiers advanced, borders blurred. 儿科肺科：医学前沿先进，边界模糊。

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.0000000000001467

David N Cornfield

引用次数: 0

Interventional pulmonology across the globe. 介入肺脏学。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-04-10 DOI: 10.1097/MOP.0000000000001470

Kubra Melike Bozkanat, Dirk Schramm

{"title":"Interventional pulmonology across the globe.","authors":"Kubra Melike Bozkanat, Dirk Schramm","doi":"10.1097/MOP.0000000000001470","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001470","url":null,"abstract":"Purpose of review: Pediatric interventional pulmonology (PIP) is an evolving subspecialty aiming at respiratory diseases in children through procedural interventions. This review discusses recent developments and challenges in global adoption of these advancements.Recent findings: Innovations such as ultra-thin cryoprobes and bronchoscopes allow for diagnostic and interventional procedures in pediatric airways. Cryotherapy demonstrates advantages in obtaining biopsies, treating airway stenosis, and extracting foreign bodies. Endobronchial ultrasound has improved the accuracy of diagnosing lymphadenopathy and pulmonary lesions, but its large size and high cost limit its use in resource-poor areas. Other newer techniques, such as tracheoesophageal fistula repair and endobronchial valves for air leaks, are promising but lack strong evidence for widespread adoption. Geographical and economic disparities impede progress, with high-income countries pioneering innovation, and low- and middle-income areas facing access and training challenges.Summary: While PIP does have the potential to be transformational, global disparities in its adoption are significant. International collaborations, standardized training, and resources are paramount. This can be achieved through virtual training platforms and global conferences that will help narrow the gaps, ensuring equitable PIP growth to benefit pediatric respiratory care globally.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"37 3","pages":"272-277"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994546","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

Precision decisions in pediatric airway management: addressing physiologic difficulty. 儿科气道管理中的精确决策：解决生理困难。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-06-01 Epub Date: 2025-03-07 DOI: 10.1097/MOP.0000000000001450

Laura Wylie, Kelsey A Miller, Joshua Nagler

{"title":"Precision decisions in pediatric airway management: addressing physiologic difficulty.","authors":"Laura Wylie, Kelsey A Miller, Joshua Nagler","doi":"10.1097/MOP.0000000000001450","DOIUrl":"10.1097/MOP.0000000000001450","url":null,"abstract":"Purpose of review: Precision medicine is based on the idea that treatment can be individualized for each patient in a given clinical environment. This review summarizes factors that should be considered when clinicians are creating individualized plans for intubation, specifically focusing on physiologically difficult airways. Recent literature identifying physiologic risk factors is summarized, and individual and system-level interventions that can potentially mitigate risk are reviewed.Recent findings: Physiologic derangements, most notably hypoxia and hypotension, have been associated with increased incidence of severe adverse events during intubation attempts. Individualized peri-procedural efforts to improve physiologic parameters through optimal oxygen delivery, fluid resuscitation, vasopressor administration, and thoughtful choice in rapid sequence intubation (RSI) medications may improve patient outcomes. Systems of care are being built around airway bundles, cognitive aids, and collaborations with airway teams to optimize outcomes.Summary: Providers should develop individualized care plans for their patients to optimize physiologic and anatomic parameters peri-intubation. The physiologically difficult airway affects the rate of first pass success and adverse events, therefore patients should be optimized prior to undergoing the procedure based on their clinical presentation and data.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"233-239"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623851","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