Current opinion in pediatrics最新文献_第8页

Blenderized tube feeding in pediatrics - current evidence, guidelines, and considerations. 儿科混合管喂养--当前证据、指南和注意事项。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2024-10-01 Epub Date: 2024-06-04 DOI: 10.1097/MOP.0000000000001377

Lindsay Allen, James Min, Wenjing Zong

引用次数: 0

Prenatal and postnatal evaluation of differences of sex development: a user's guide for clinicians and families. 产前和产后性别发育差异评估：临床医生和家庭用户指南》。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI: 10.1097/MOP.0000000000001388

Erica M Weidler, Brielle Ochoa, Kathleen van Leeuwen

{"title":"Prenatal and postnatal evaluation of differences of sex development: a user's guide for clinicians and families.","authors":"Erica M Weidler, Brielle Ochoa, Kathleen van Leeuwen","doi":"10.1097/MOP.0000000000001388","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001388","url":null,"abstract":"Purpose of review: Differences of sex development (DSD) are a group of chromosomal, gonadal, and anatomic conditions that are not often diagnosed during pregnancy. Families and clinicians need diagnostic guidance that supports all aspects of the care from the prenatal to postnatal period.Recent findings: Noninvasive prenatal screening (NIPS) is obtained by sampling cell-free fetal DNA in the mother's bloodstream in the first trimester. While its primary purpose is to screen for genetic aneuploidies, it is also used to determine the sex of the fetus. When screening ultrasound shows genital anatomy that is discordant with the sex determination by NIPS, a DSD workup is warranted. The use of this relatively new screening tool may result in a higher number of prenatal referrals than in the past.Summary: This review summarizes suggested prenatal counseling, neonatal management, and postnatal workup of the most common DSD diagnoses. All of these diagnoses are rare, but the common features that families face are addressed with particular emphasis on psychosocial support and a measured shared decision-making approach.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"36 5","pages":"547-553"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11408751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281751","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

Acute rheumatic fever and rheumatic heart disease: updates in diagnosis and treatment. 急性风湿热和风湿性心脏病：诊断和治疗的最新进展。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2024-10-01 Epub Date: 2024-07-22 DOI: 10.1097/MOP.0000000000001384

Joselyn Rwebembera, Andrea Beaton

{"title":"Acute rheumatic fever and rheumatic heart disease: updates in diagnosis and treatment.","authors":"Joselyn Rwebembera, Andrea Beaton","doi":"10.1097/MOP.0000000000001384","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001384","url":null,"abstract":"Purpose of review: To summarize the latest developments in rheumatic fever and rheumatic heart disease (RHD) prevention, (early) diagnosis, and treatment.Recent findings: The revised Jones criteria have demonstrated increased sensitivity and specificity for rheumatic fever diagnosis in high-risk populations. The management of rheumatic fever remains symptom-based, with no treatment options proven to alter the disease course or prevent chronic RHD. The revised World Heart Federation (WHF) guidelines for the echocardiographic diagnosis of RHD encourage task-shifting of RHD screening, extending reach in endemic regions. These guidelines also present an A-D classification of RHD and provide recommendations for the management of early disease. Integrated models for RHD screening within existing health structures are emerging and automated intelligence is showing potential to support RHD screening and diagnosis. Innovative strategies to foster adherence and equitable access to secondary prophylaxis, such as re-examination of the efficacy of oral penicillin, trials of longer acting penicillin formulations and implants are underway. There is renewed interest and investment in a well tolerated and effective GAS vaccine.Summary: We are living in a time of possibility with global acceleration to address the prevailing burden of RHD. Together, we can ensure that RHD does not once again fall off the global health agenda, until equitable elimination has been achieved.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"36 5","pages":"496-502"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281746","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

Management of undescended testis. 睾丸下垂的治疗

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI: 10.1097/MOP.0000000000001387

Seth Saylors, Tolulope A Oyetunji

{"title":"Management of undescended testis.","authors":"Seth Saylors, Tolulope A Oyetunji","doi":"10.1097/MOP.0000000000001387","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001387","url":null,"abstract":"Purpose of review: Describe why this review is timely and relevant.Undescended testis, or cryptorchidism, is a common diagnosis encountered by pediatricians that requires timely collaboration with pediatric surgical specialists to optimize outcomes for these patients. As this topic continues to be heavily researched, it is imperative to understand current recommendations and emerging management options including new surgical techniques, as well as common pitfalls in care highlighted in the literature.Recent findings: Describe the main themes in the literature covered by the article.This review primarily examines current practice in management including delays in surgical referral, with unnecessary imaging being a key factor that delays time to surgery. This review briefly discusses the diagnosis of undescended testis and the various surgical techniques used including the more recently proposed laparoscopic staged traction orchiopexy (Shehata technique). The ineffectiveness of hormonal therapy is also addressed.Summary: describe the implications of the findings for clinical practice or research.This review emphasizes prompt evaluation and diagnosis of undescended testis to facilitate appropriately timed surgical intervention, which plays a major role in outcomes for these patients. Identifying patients at risk of delayed referral is an area of focus for improvement, along with better resource utilization with fewer imaging. Familiarization of surgical options can also facilitate better patient education and provider understanding of risks/benefits.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"36 5","pages":"554-561"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281750","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

Pearls for practice from the 2023 allergy immunology joint task force on practice parameters GRADE and institute of medicine based atopic dermatitis guidelines. 2023 年过敏免疫学联合工作组实践参数 GRADE 和基于医学研究所的特应性皮炎指南中的实践要点。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2024-10-01 Epub Date: 2024-06-18 DOI: 10.1097/MOP.0000000000001381

Alexandra E Conway, Navya Kartha, Chaitanya Maddukuri, Marcus S Shaker

{"title":"Pearls for practice from the 2023 allergy immunology joint task force on practice parameters GRADE and institute of medicine based atopic dermatitis guidelines.","authors":"Alexandra E Conway, Navya Kartha, Chaitanya Maddukuri, Marcus S Shaker","doi":"10.1097/MOP.0000000000001381","DOIUrl":"10.1097/MOP.0000000000001381","url":null,"abstract":"Purpose of review: To review the updated 2023 Allergy Immunology Joint Task Force on Practice Parameters (JTFPP) GRADE and Institute of Medicine (IOM) Based Guidelines for the management of atopic dermatitis.Recent findings: Topical corticosteroids and/or calcineurin inhibitors are recommended in individuals with atopic dermatitis refractory to moisturizer alone and may be used to maintain remission after acute flare control is achieved. Calcineurin inhibitors are a class of immunosuppressants used to effectively manage different autoimmune disorders. Bleach baths and allergen immunotherapy may be beneficial for individuals with moderate-to-severe disease, while elimination diets, azathioprine, methotrexate, mycophenolate, and systemic corticosteroids are not recommended. Dupilumab is strongly recommended for refractory atopic dermatitis. Oral Janus kinase (JAK) inhibitors carry significant risks; however, this class of medicines may be considered in cases of severe or refractory atopic dermatitis with intolerance to dupilumab. Patient preferences regarding cost, availability, feasibility, and tolerability should be integrated into all treatment plans using a shared decision-making approach.Summary: The 2023 JTFPP Atopic Dermatitis Guidelines offer up-to-date guidance for the management of atopic dermatitis of varying severity in infants, children, and adults.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"570-580"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491214","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

Hereditary hemorrhagic telangiectasia - pediatric review. 遗传性出血性毛细血管扩张症--儿科综述。

IF 3.6 3区医学

Current opinion in pediatrics Pub Date : 2024-09-10 DOI: 10.1097/mop.0000000000001398

Ionela Iacobas,Adrienne M Hammill

{"title":"Hereditary hemorrhagic telangiectasia - pediatric review.","authors":"Ionela Iacobas,Adrienne M Hammill","doi":"10.1097/mop.0000000000001398","DOIUrl":"https://doi.org/10.1097/mop.0000000000001398","url":null,"abstract":"PURPOSE OF REVIEWHereditary hemorrhagic telangiectasia (HHT) diagnostic and management approach for pediatrics underwent significant advances over the last couple of years.RECENT FINDINGSIn 2020, new guidelines for HHT were published that included a pediatric section thus attracting special focus into the childhood presentation.SUMMARYCuracao criteria are specific, but not sensitive enough in children. Genetic testing is encouraged for all family members even if asymptomatic. Standardized scoring for epistaxis is strongly encouraged, as it allows monitoring and can stratify therapeutic approaches. Early screening for pulmonary and brain visceral arteriovenous malformations (AVMs) in pediatric patients with confirmed genetic alterations of HHT should be instituted. Graded trans-esophageal echocardiogram with agitated saline contrast can be used as screening method for pulmonary AVMs. As pulmonary AVMs can develop throughout lifetime, guidelines recommend repeated screening even in asymptomatic patients at least every 5 years. Signs of stroke in childhood are more subtle than in adults. Cerebral imaging in early childhood can identify brain AVMs that may benefit from early intervention. Embolization of high-risk pulmonary and cerebral AVMs should be performed at specialized centers even at pediatric age. One or two classic HHT telangiectasia can be considered diagnostic in children. Antibiotic prophylaxis with dental procedures continues to be recommended.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"21 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191083","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

Pearls for practice from the 2023 joint task force anaphylaxis practice parameter. 2023 年联合工作组过敏性休克实践参数的实践要点。

IF 3.6 3区医学

Current opinion in pediatrics Pub Date : 2024-09-04 DOI: 10.1097/mop.0000000000001397

Chaitanya Maddukuri,Navya Kartha,Alexandra E Conway,Marcus S Shaker

{"title":"Pearls for practice from the 2023 joint task force anaphylaxis practice parameter.","authors":"Chaitanya Maddukuri,Navya Kartha,Alexandra E Conway,Marcus S Shaker","doi":"10.1097/mop.0000000000001397","DOIUrl":"https://doi.org/10.1097/mop.0000000000001397","url":null,"abstract":"PURPOSE OF REVIEWTo share important highlights on the management of anaphylaxis from the latest 2023 practice parameter.RECENT FINDINGSThe 2023 Allergy Immunology Joint Task Force on Practice Parameters (JTFPP) anaphylaxis practice parameter provides updated anaphylaxis guidance. Criteria for the diagnosis of anaphylaxis are reviewed. The parameter highlights that while anaphylaxis is not more severe in younger children, age-specific symptoms can vary. Activation of emergency medical services may not be required in patients who experience prompt resolution of symptoms following epinephrine use and caregivers are comfortable with observation. For children weighing <15 kg, the anaphylaxis parameter suggests the clinician may prescribe either the 0.1 mg or the 0.15 mg epinephrine autoinjector, with the 0.3 mg autoinjector prescribed for those weighing 25 kg or greater. In patients with heart disease, discontinuing or changing beta blockers and/or angiotensin converting enzyme inhibitors may pose a larger risk for worsened cardiovascular disease compared with risk for severe anaphylaxis with medication continuation. Furthermore, in patients with a history of perioperative anaphylaxis, shared decision-making based on diagnostic testing and clinical history is recommended prior to repeat anesthesia use. Beyond the recent parameter update, novel contemporary therapies can decrease risk of community anaphylaxis.SUMMARYThe 2023 JTFPP Anaphylaxis Guidelines offer up-to-date guidance for the diagnosis and management of anaphylaxis in infants, children, and adults.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"10 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224851","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

Secondary hypogammaglobulinemia: diagnosis and management of a pediatric condition of clinical importance. 继发性低丙种球蛋白血症：一种具有重要临床意义的儿科疾病的诊断和治疗。

IF 3.6 3区医学

Current opinion in pediatrics Pub Date : 2024-09-03 DOI: 10.1097/mop.0000000000001396

Daniel DiGiacomo,Sara Barmettler

引用次数: 0

Non-IgE-mediated drug-induced hypersensitivity reactions in pediatrics. 儿科非 IgE 介导的药物超敏反应。

IF 3.6 3区医学

Current opinion in pediatrics Pub Date : 2024-08-20 DOI: 10.1097/mop.0000000000001395

Timothy G Chow,Anum F Muzaffar,Santiago Alvarez-Arango

{"title":"Non-IgE-mediated drug-induced hypersensitivity reactions in pediatrics.","authors":"Timothy G Chow,Anum F Muzaffar,Santiago Alvarez-Arango","doi":"10.1097/mop.0000000000001395","DOIUrl":"https://doi.org/10.1097/mop.0000000000001395","url":null,"abstract":"PURPOSE OF REVIEWDespite their prevalence and potential severity, non-IgE-mediated drug-induced hypersensitivity reactions (DHRs) are under-researched and poorly defined, particularly in children. Presentations range from mild cutaneous reactions to severe systemic diseases, with pathophysiological mechanisms and reliable diagnostic markers not well established. The lack of validated tests often leads to permanent drug restrictions, reliance on second-line drugs, and increased costs. Focusing on recent advancements and areas needing further research, this review aims to enhance children's recognition, diagnosis, and management of non-IgE-mediated DHRs.RECENT FINDINGSRecent studies have enhanced the understanding of immediate and delayed non-IgE-mediated drug reactions. Key findings include the Mas-related G protein-coupled receptor X2 in mast cells and the identification of HLA alleles linked to severe cutaneous adverse reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Improved diagnostic techniques, including skin testing, show promise in identifying immediate and delayed non-IgE DHRs. Additionally, research highlights the impact of cofactors, drug metabolites, and co-infections on these DHRs and explores potential biomarkers for predicting reaction severity.SUMMARYNon-IgE-mediated DHRs are a significant cause of morbidity and treatment changes in pediatric patients. Recent research underscores their clinical presentations and mechanisms, paving the way for more precise diagnostic and therapeutic strategies to improve patient outcomes.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"17 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191097","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

Echocardiographic strain imaging in the pediatric heart: clinical value and utility in decision making. 小儿心脏超声心动图应变成像：临床价值和决策实用性。

IF 3.6 3区医学

Current opinion in pediatrics Pub Date : 2024-08-16 DOI: 10.1097/mop.0000000000001394

John P Martinez,Gulnigor Ganieva,Jamie K Harrington

{"title":"Echocardiographic strain imaging in the pediatric heart: clinical value and utility in decision making.","authors":"John P Martinez,Gulnigor Ganieva,Jamie K Harrington","doi":"10.1097/mop.0000000000001394","DOIUrl":"https://doi.org/10.1097/mop.0000000000001394","url":null,"abstract":"PURPOSE OF REVIEWSpeckle tracking echocardiography (STE)-derived measures of myocardial mechanics, referred to herewithin as strain measurements, directly assess myocardial contractility and provide a nuanced assessment of ventricular function. This review provides an overview of strain measurements and their current clinical value and utility in decision making in pediatric cardiology.RECENT FINDINGSStrain measurements are advancing understanding of how cardiac dysfunction occurs in children with acquired and congenital heart disease (CHD). Global strain measurements can detect early changes in cardiac function and are reliable methods of serially monitoring systolic function in children. Global strain measurements are increasingly reported in echocardiographic assessment of ventricular function alongside ejection fraction. Research is increasingly focused on how strain measurements can help improve clinical management, risk stratification, and prognostic insight. Although more research is needed, preliminary studies provide hope that there will be clinical benefit for strain in pediatric cardiology management.SUMMARYStrain measurements provide a more detailed assessment of ventricular function than conventional measures of echocardiographic functional assessment. Strain measurements are increasingly being used to advance understanding of normal and abnormal myocardial contractility, to increase sensitivity to detect early cardiac dysfunction, and to improve prognostic management in children with acquired and CHD.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"119 1","pages":"512-518"},"PeriodicalIF":3.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191085","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