Pediatric health, medicine and therapeutics最新文献

{"title":"Pediatric Autologous Hematopoietic Stem Cell Transplantation: Safety, Efficacy, and Patient Outcomes. Literature Review.","authors":"Anna Maria Testi, Maria Luisa Moleti, Alessia Angi, Simona Bianchi, Walter Barberi, Saveria Capria","doi":"10.2147/PHMT.S366636","DOIUrl":"10.2147/PHMT.S366636","url":null,"abstract":"<p><p>Autologous stem cell transplantation (auto-HSCT) is a part of the therapeutic strategy for various oncohematological diseases. The auto-HSCT procedure enables hematological recovery after high-dose chemotherapy, otherwise not tolerable, by the infusion of autologous hematopoietic stem cells. Unlike allogeneic transplant (allo-HSCT), auto-HSCT has the advantage of lacking acute-graft-versus-host disease (GVHD) and prolonged immunosuppression, however, these advantages are counterbalanced by the absence of graft-versus-leukemia. Moreover, in hematological malignancies, the autologous hematopoietic stem cell source may be contaminated by neoplastic cells, leading to disease reappearance. In recent years, allogeneic transplant-related mortality (TRM) has progressively decreased, almost approaching auto-TRM, and many alternative donor sources are available for the majority of patients eligible for transplant procedures. In adults, the role of auto-HSCT compared to conventional chemotherapy (CT) in hematological malignancies has been well defined in many extended randomized trials; however, such trials are lacking in pediatric cohorts. Therefore, the role of auto-HSCT in pediatric oncohematology is limited, in both first- and second-line therapies and still remains to be defined. Nowadays, the accurate stratification in risk groups, according to the biological characteristics of the tumors and therapy response, and the introduction of new biological therapies, have to be taken into account in order to assign auto-HSCT a precise role in the therapeutic strategies, also considering that in the developmental age, auto-HSCT has a clear advantage over allo-HSCT, in terms of late sequelae, such as organ damage and second neoplasms. The purpose of this review is to report the results obtained with auto-HSCT in the different pediatric oncohematological diseases, focusing on the most significant literature data in the context of the various diseases and discussing this data in the light of the current therapeutic landscape.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"197-215"},"PeriodicalIF":1.7,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/bd/phmt-14-197.PMC10239625.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9592702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracotomy in Children: Review from a Low-Income Country.","authors":"Hana Abebe Gebreselassie,&nbsp;Mekdelawit Mesfin Tadesse,&nbsp;Hanna Getachew Woldeselassie","doi":"10.2147/PHMT.S398368","DOIUrl":"10.2147/PHMT.S398368","url":null,"abstract":"<p><strong>Background: </strong>Thoracotomy is indicated for several congenital and acquired disorders in children. It is among the surgical procedures which require a well-trained and dedicated surgical, anesthesia and critical care team which can be difficult to assemble in a low-income country setup. As the pattern and outcome of thoracotomy in children remained unreported from such setting, this study aims to shed light on this matter.</p><p><strong>Methodology: </strong>A descriptive cross-sectional review was conducted. Children who have undergone thoracotomy for non-cardiac pathologies were included in the study. Demographic and clinical data were collected by chart review. Frequencies and percentages were used to describe categorical variables while mean, median, standard deviation and interquartile range were calculated for continuous variables.</p><p><strong>Results: </strong>A total of 68 patients were operated on in the study period, out of which 44 (64.7%) were males. The mean ages of the children at the time of diagnosis and procedure were 4.05 ± 3.9 years and 4.14 ± 4.03 years, respectively. The most common indication for thoracotomy was pulmonary hydatid cyst (17; 25%) followed by congenital lobar emphysema (11; 16.2%). Muscle sparing posterolateral thoracotomy was the most common approach in 66 (97.1%) patients. The analgesic medications that were used in the post-operative period were paracetamol, diclofenac, ibuprofen, tramadol and morphine. Combined analgesics were administered in two-thirds of the patients while a single analgesic was used in the rest of the children. No regional blocks were administered post operatively as pediatric size catheters were not available. The morbidity and mortality rates were found to be 11.8% and 8.8%, respectively.</p><p><strong>Conclusion: </strong>The most common indication for thoracotomy in this study was pulmonary hydatid cyst. The provision of post-thoracotomy analgesia in our institution is suboptimal as evidenced by no use of regional blocks and poor practice of administering multimodal analgesia. Thoracotomy was associated with fairly high morbidity and mortality.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"99-106"},"PeriodicalIF":0.0,"publicationDate":"2023-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/ba/phmt-14-99.PMC10019342.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with an Inadequate Volume of Expressed Milk Among Mothers of Preterm and Low Birth Weight Neonates Admitted to Neonatal Intensive Care Units of Government Hospitals in Addis Ababa, Ethiopia.","authors":"Misgana Hirpha Kedida, Hussen Mekonnen Asfaw, Fikirtemariam Abebe","doi":"10.2147/PHMT.S380807","DOIUrl":"10.2147/PHMT.S380807","url":null,"abstract":"<p><strong>Background: </strong>Around 15 million live newborns are born prematurely each year around the world before 37 weeks. One cause of inadequate nursing is prematurity. The goal of this study was to find parameters linked to an insufficient volume of expressed milk among mothers of preterm and low birth weight neonates at government hospitals in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>An nstitution-based cross-sectional study was conducted on a total of 124 mothers who were available in neonatal intensive care units during the study period in government hospitals that provided such units.</p><p><strong>Results: </strong>One-third of the responders (33.9%) were unable to express the necessary amount of milk. An inadequate volume of expressed breast milk was significantly associated with a baby's stable health status (AOR=0.24; CI=0.07-0.86), the fair (subcritical) health status of the baby (AOR=0.178; CI=0.04-0.76), worry about the volume of milk (AOR=7.50; CI=3.32-16.95), and worry about the baby's health status (AOR=4.63; CI=2.21-9.70).</p><p><strong>Conclusion: </strong>According to our findings, 33.9% of mothers were unable to express sufficient amounts of milk. To produce an adequate volume of expressed breast milk, health care workers must address mothers' psychological issues in the neonatal intensive care units and give all necessary care to prevent neonatal deterioration.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/f3/phmt-14-1.PMC9829976.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10533055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School Feeding and Nutritional Status of Students in Dubti District, Afar, Northeast Ethiopia: Comparative Cross-Sectional Study.","authors":"Kedir Hussein,&nbsp;Tefera Chanie Mekonnen,&nbsp;Foziya Mohammed Hussien,&nbsp;Tilahun Dessie Alene,&nbsp;Melese Shenkut Abebe","doi":"10.2147/PHMT.S412740","DOIUrl":"https://doi.org/10.2147/PHMT.S412740","url":null,"abstract":"<p><strong>Background: </strong>Providing food to the school children is an important means of compacting malnutrition especially in high food insecure areas. Our study was conducted to evaluate the association between school feeding and nutritional status among students in primary schools of Dubti district in Afar region.</p><p><strong>Methods: </strong>A comparative cross-sectional study was employed on 936 primary school students from March 15-31/2021. For data collection, structured questionnaire was administered by the interviewer. Descriptive statistics as well as logistic regression was conducted. WHO Anthro-plus software was used to compute anthropometric data. Adjusted odds ratio with 95% CI was calculated to identify the level of association. Variables with p-value <0.05 were taken as statistical level of significance.</p><p><strong>Results: </strong>A total of 936 primary school students, with 100% response rate, were included in the current study. The prevalence of stunting in school fed and non-school fed students was 13.7% 95% CI (11, 17) and 21.6% 95% CI (18, 25), respectively. The prevalence of thinness in school fed and non-school fed students was 4.9% 95% CI (3, 7) and 13.9% 95% CI (11, 17), respectively. Even though no record of overweight and obesity were found in non-school fed students, 5.4% 95% CI (3, 7) among school fed students was overweight/obese. Grade level, diet information source, media source availability, maternal age, the critical time for hand washing, and nutrition education were found to be predictors of malnutrition in both groups of students.</p><p><strong>Conclusion: </strong>The magnitude of stunting and thinness in school fed students is found to be lower, but overnutrition is higher than non-school fed. Grade level of students and diet selection information were determinants that affected the nutritional status of students. Coordinated education regarding good feeding practice, and personal as well as environmental hygiene should be given to the students and their families.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"217-230"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/4b/phmt-14-217.PMC10241172.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated V-Shaped Sternal Cleft - A Rare Chest Wall Malformation.","authors":"Dawit Seyoum Gebremariam,&nbsp;Asmamaw Miruts,&nbsp;Kibrom Gebreselassie Desta","doi":"10.2147/PHMT.S397462","DOIUrl":"https://doi.org/10.2147/PHMT.S397462","url":null,"abstract":"<p><p>Sternal cleft is a rare chest wall anomaly resulting from a failure of the lateral mesodermal folds to migrate to the midline, causing a cleft in the early stage of embryological development. This can be a complete or partial defect. It can also occur as an isolated anomaly or in association with other syndromes. Fetal sonographic diagnosis of this defect is possible, but less practiced. After birth, this defect can be easily diagnosed clinically because of the presence of paradoxical chest wall movement. The flexibility of the thorax is maximal and compression of the underlying structures is minimal during the neonatal and early infancy period, and this period is the preferred time for surgical repair. We report a 39-day-old infant who presented with an isolated V-shaped inferior sternal cleft, its surgical primary closure, and postoperative course.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/f0/phmt-14-81.PMC9994661.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9108759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Guillain-Barré Syndrome in a Resource Limited Setting: Clinical Features, Diagnostic and Management Challenges, and Hospital Outcome.","authors":"Mulugeta Sitot Shibeshi,&nbsp;Adane Alto Mengesha,&nbsp;Kefyalew Taye Gari","doi":"10.2147/PHMT.S401461","DOIUrl":"https://doi.org/10.2147/PHMT.S401461","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barré syndrome (GBS) is an acute immune-mediated peripheral neuropathy with a highly variable clinical course and outcome. There remain diagnostic and treatment challenges in resource limited settings. This study aimed to describe the clinical presentation, diagnostic and management challenges, and hospital outcome of children with GBS in southern Ethiopia.</p><p><strong>Methods: </strong>A retrospective chart review of children aged ≤14 years who were admitted with a diagnosis of GBS to Hawassa University Comprehensive Specialized Hospital from 2017 to 2021 was done. Medical records of 102 children who fulfilled the Brighton Criteria for GBS were reviewed, and data on demographic, clinical characteristics, investigation findings, treatment, and outcome were collected. Logistic regression analysis was done to determine factors associated with mortality.</p><p><strong>Results: </strong>The mean age of the study subjects was 7.25±3.91 years and 63.7% were male. Antecedent event was present in 48% of the cases, and the most common triggering factor was upper respiratory tract infection (63.8%). The mean Hughes disability score was 4.23±0.54, 4.48±0.71, and 4.03±0.86 at admission, nadir and discharge from hospital, respectively. Cranial nerve involvement was present in 27.5% of patients and bulbar palsy was the most common finding. Dysautonomia was observed in 57.8% of the participants. Sixty-three patients (61.8%) needed ICU care but only 43 of them (68.3%) were admitted to ICU. Similarly, 31 patients (30.4%) required respiratory support but only 24 of them (77.4%) were on mechanical ventilator. No patient had nerve conduction study. Only 5.9% of patients received IVIG. Thirteen patients (12.7%) died of GBS and the presence of respiratory failure was the only determinant of mortality [AOR = 11.40 (95% CI: 1.818, 71.52), p = 0.009].</p><p><strong>Conclusion: </strong>There is a gap in the diagnosis and management of children with GBS; and mortality from the disease is higher than reports from other settings.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"107-115"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/34/phmt-14-107.PMC10040339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9213344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Diabetes and Diabetic Ketoacidosis After COVID-19: Challenges Faced and Lessons Learnt.","authors":"Ashish Agarwal,&nbsp;Deepankar Bansal,&nbsp;Karthi Nallasamy,&nbsp;Muralidharan Jayashree,&nbsp;Vijai William","doi":"10.2147/PHMT.S384104","DOIUrl":"https://doi.org/10.2147/PHMT.S384104","url":null,"abstract":"<p><p>The coronavirus disease (COVID-19) pandemic affected the management and follow-up of several chronic ailments, including pediatric type 1 diabetes mellitus (T1DM). Restricted access to healthcare and fear of contracting the virus during medical facility visits resulted in poor compliance, irregular follow-up visits, treatment, and delayed diagnosis of complications in pediatric diabetes such as diabetic ketoacidosis (DKA). As such, the incidence of complicated DKA in resource-limited settings is high due to delayed presentation, poor compliance with therapy, and associated comorbidities such as malnutrition and sepsis. The pandemic had only added to the woes. The increased surge in DKA, in the face of limited resources, prompted clinicians to find alternative solutions to manage these children effectively. In this narrative review, we discuss the key challenges faced globally while caring for children with T1DM and DKA during the COVID-19 pandemic, and the lessons learned thereof.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"281-288"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/d4/phmt-14-281.PMC10488656.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcome of Jaundice and Its Associated Factors Among Neonates Treated in Neonatal Intensive Care Unit of Comprehensive and Specialized Hospitals of Southern Nations Nationalities and Peoples Region, Ethiopia 2022.","authors":"Christian Kebede,&nbsp;Beletech Fentie,&nbsp;Bethelihem Tigabu","doi":"10.2147/PHMT.S405453","DOIUrl":"https://doi.org/10.2147/PHMT.S405453","url":null,"abstract":"<p><strong>Introduction: </strong>Jaundice is a common problem that affects up to 50-60% of full-term babies and 80% of preterm babies. It is a benign condition, but sometimes it can cause profound complications and eventually death. Identifying the treatment outcome of jaundice and the factors affecting it is crucial to preventing the death associated with it.</p><p><strong>Objective: </strong>To determine the treatment outcome of jaundice and its associated factors among neonates treated in neonatal intensive care unit of comprehensive and specialized hospitals of SNNPR, Ethiopia, 2022.</p><p><strong>Methods: </strong>An institution-based retrospective follow up study was conducted from April 2018 to April 2022. The data was checked for completeness and then entered into Epi-data version 4.6 and exported to STATA version 17. The results were presented in frequencies and percentages for categorical variables as well as mean and median for continuous variables. A binary logistic regression model was used to estimate the effect of an independent variable and the outcome variable.</p><p><strong>Results: </strong>A total of 423 charts were reviewed, and 416 (98%) were included in the final analysis. Almost 91.3% (95% CI: 88.2, 93.7) of neonates had improved. Factors significantly associated with the treatment outcome were: residence (AOR = 0.36, 95% CI: 0.2, 0.8); origin of admission (AOR = 0.35, 95% CI: 0.2, 0.8); gestational age (AOR = 0.26, 95% CI: 0.1, 0.8); and total serum bilirubin level (AOR = 0.40, 95% CI: 0.2, 0.9).</p><p><strong>Conclusion and recommendation: </strong>Improvement was lower compared to other low and middle-income countries; more emphasis should be given to improving treatment outcomes in hospitals.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"237-247"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/e2/phmt-14-237.PMC10387238.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9910790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Death and Its Predictors Among Infants in Ethiopia: Multilevel Mixed-Effects Parametric Survival Analysis Using the 2019 Ethiopian Mini Demographic Health Survey.","authors":"Befekadu Oyato,&nbsp;Husen Zakir,&nbsp;Dursa Hussein,&nbsp;Tasfaye Lemma,&nbsp;Mukemil Awol","doi":"10.2147/PHMT.S402154","DOIUrl":"https://doi.org/10.2147/PHMT.S402154","url":null,"abstract":"<p><strong>Introduction: </strong>Three years ahead of the plan, Ethiopia has met Millennium Development Goal 4 of reducing under-five mortality. Additionally, the nation is on track to achieve the Sustainable Development Goal of putting an end to preventable child mortality. Despite this, recent data from the nation showed that there were 43 infant deaths for every 1000 live births. Moreover, the country has fallen short of the 2015 Health Sector Transformation Plan goal, with an anticipated infant mortality rate of 35 deaths per 1000 live births in 2020. Thus, this study aims to identify the time to death and its predictors among Ethiopian infants.</p><p><strong>Methods: </strong>This study used the 2019 Mini-Ethiopian Demographic and Health Survey data set to conduct a retrospective study. The analysis used survival curves and descriptive statistics. Multilevel mixed-effects parametric survival analysis was applied to identify the predictors of infant mortality.</p><p><strong>Results: </strong>The estimated mean survival time of infants was 11.3 months (95% CI: 11.1, 11.4). Women's current pregnancy status, family size, age of women, previous birth interval, place of delivery, and mode of delivery were significant individual-level predictors of infant mortality. Infants born with less than 24 months' birth interval had a 2.29 times higher estimated risk of death (AHR = 2.29, 95% CI: 1.05, 5.02). Infants born at home were 2.48 times more likely to die than those born in a health facility (AHR = 2.48, 95% CI: 1.03, 5.98). At the community level, women's education was the only statistically significant predictor of infant death.</p><p><strong>Conclusion: </strong>The risk of infant death was higher before the first month of life, typically shortly after birth. Healthcare programs should put a strong emphasis on efforts to space out births and make institutional delivery services more readily accessible to mothers in Ethiopia to address the infant mortality challenges.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"169-183"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/73/phmt-14-169.PMC10224721.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9598514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Screening Strategies for the Diagnosis of Adrenal Insufficiency in Children.","authors":"Sasigarn A Bowden","doi":"10.2147/PHMT.S334576","DOIUrl":"https://doi.org/10.2147/PHMT.S334576","url":null,"abstract":"<p><p>Adrenal insufficiency can arise from a primary adrenal disorder, secondary to adrenocorticotropic hormone deficiency, or by suppression of hypothalamic-pituitary-adrenal axis due to exogenous glucocorticoids. Diagnosis of adrenal insufficiency is usually delayed because the initial presentation is often subtle and nonspecific. Clinician awareness and recognition is crucial for timely diagnosis to avoid adrenal crisis. Current screening strategies for the diagnosis of adrenal insufficiency in children in various clinical situations are discussed in this review.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"14 ","pages":"117-130"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/3d/phmt-14-117.PMC10084833.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9659668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}