Pediatric medicine (Hong Kong, China)最新文献

{"title":"Acanthosis nigricans in the pediatric population: a narrative review of the current approach to management in primary care.","authors":"Samara Pollock, Meghana Rajashekara Swamy, Elise Schlissel Tremblay, Lisa Shen","doi":"10.21037/pm-21-70","DOIUrl":"10.21037/pm-21-70","url":null,"abstract":"<p><strong>Objective: </strong>This narrative review aims to provide readers with a comprehensive overview of the current literature of acanthosis nigricans (AN) in the pediatric and adolescent population, including best practices for identifying the condition, with a focus on the recommended management in the primary care setting to enable early and enhanced intervention.</p><p><strong>Background: </strong>AN is frequently seen in obese and overweight children and adolescents. Current research suggests an association with insulin resistance, type 2 diabetes mellitus, and obesity, and often primary care physicians are the first point of contact for individuals with this dermatologic condition. However, identifying the condition at an early stage may be difficult.</p><p><strong>Methods: </strong>We identified case and cross-sectional studies, clinical trials, and literature reviews of pediatric AN for ages 0 to 18 years in the United States and internationally. We considered publications for background from before the year 2000 and publications for approach to management from after the year 2000.</p><p><strong>Conclusions: </strong>AN in the pediatric population can be a harbinger for underlying metabolic syndrome and insulin resistance. A thorough investigation and appropriate screening of children at risk, with a focus on early identification of the dermatologic condition and its associated comorbidities in the primary care setting, and early treatment is recommended to prevent long term consequences and decrease the risk of cardiovascular complications.</p>","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40702887","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":"Bronchopulmonary dysplasia (BPD): a change in perspective","authors":"G. Stichtenoth, E. Herting","doi":"10.21037/pm-22-53","DOIUrl":"https://doi.org/10.21037/pm-22-53","url":null,"abstract":"","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44909913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth factors and their roles in cardiac development and regeneration: a narrative review","authors":"G. Brown, Jihyun Jang, Deqiang Li","doi":"10.21037/pm-22-17","DOIUrl":"https://doi.org/10.21037/pm-22-17","url":null,"abstract":"","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42022725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborn jaundice—an introductory overview","authors":"D. K. Stevenson, R. Wong","doi":"10.21037/pm-21-79","DOIUrl":"https://doi.org/10.21037/pm-21-79","url":null,"abstract":"","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44695047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of rapidly growing recurrent extra-abdominal pediatric desmoid tumor: case report","authors":"A. Al-Hadidi, M. Almahariq, Samuel K. Osei, L. Gowans, A. Stallion","doi":"10.21037/pm-21-28","DOIUrl":"https://doi.org/10.21037/pm-21-28","url":null,"abstract":": Desmoid tumors are rare, benign soft tissue tumors that occur spontaneously, or less frequently, in patients with a genetic predisposition. With an unpredictable course, desmoid tumors are often locally aggressive and have a high rate of recurrence even after complete surgical excision. Desmoid tumors often become a chronic problem for patients, making them a major source of morbidity, and may even lead to mortality. Management of these tumors can be frustrating, with patients often requiring multiple modes of therapy in pursuit of a cure. We present a patient with a history of familial adenosis polyposis (FAP) who presented early on in life with an extra-abdominal desmoid tumor that proved to be a major source of morbidity during his childhood. We review a chronological approach to the management of our patients’ tumor with the resulting outcomes following each mode of therapy, which included observation, surgical resection, systemic therapy, and radiotherapy. Additionally, we review the currently literature with regards to the recommended management of desmoid tumors in different settings, including an in-depth discussion on the outcomes and failures of management following observation, systemic therapy with non-cytotoxic and cytotoxic therapies, surgical resection alone, radiation therapy (RT) alone, and a combination of surgical resection and RT.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41313739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol of the China Neonatal Genomes Project: an observational study about genetic testing on 100,000 neonates","authors":"Feifan Xiao, K. Yan, Huijun Wang, Bingbing Wu, L. Hu, Lin Yang, Wenhao Zhou","doi":"10.21037/pm-21-29","DOIUrl":"https://doi.org/10.21037/pm-21-29","url":null,"abstract":"Genetic diseases are caused by gene variants or chromosomal anomalies. Common genetic diseases include congenital defects, chromosomal disorders, and metabolic disorders. Approximately 5% of newborns will be diagnosed with a genetic disease prior to until 25 years of age (1). Genetic diseases during the neonatal period can influence neonatal mortality (2). The neonatal period (the first 4 weeks of a child’s life) is the most vulnerable time for a child’s survival. According to data from the World Health Organization, the global average neonatal mortality rate was 17 per 1,000 live births in 2019 (3). Kingsmore et al. (4) found that approximately 21% of deceased infants were diagnosed with genetic diseases. It has been reported that genetic diseases impose a substantial economic burden on healthcare system (5,6). Moreover, genetic diseases cause significant psychological burdens for patients and their families. Study Protocol","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47726297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of red blood cell distribution width in children with celiac disease","authors":"Orlando Cortes, T. Rabbani, R. Thomas, Kristen Cares","doi":"10.21037/pm-21-24","DOIUrl":"https://doi.org/10.21037/pm-21-24","url":null,"abstract":"Background: In adult studies, red blood cell distribution width (RDW) has been suggested to be a predictor of small intestinal atrophy in celiac disease (CD). Our goal is to assess whether RDW can similarly be used as a reliable marker of compliance and predictor of atrophy in pediatric patients with CD. Methods: We performed a retrospective study of children aged 1–17 years old diagnosed with CD from 2008–2018. We reviewed patient demographics, laboratory parameters prior to CD diagnosis, laboratory findings after management with gluten free diet, and histologic findings at the time of diagnosis. Results: Overall, 128 patients met inclusion criteria. No significant difference in RDW was found prior to diagnosis versus after treatment (13.3 vs . 13.1, P=0.590). In addition, RDW did not show clinical significance in detecting villous atrophy (13.4 vs . 13.2, P=0.113). However, further analysis revealed a statistically significant association among patients having a RDW >12.9 and presence of atrophy (P=0.04). Conclusions: There is a clear disparity between adult studies and pediatric studies in the usefulness in RDW as a predictive marker for intestinal atrophy and compliance in patients with CD, as RDW did not show clinical significance in detecting villous atrophy or compliance with a gluten free diet.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45217955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iterative and comprehensive mental health assessment and treatment planning: the mental health dashboard","authors":"P. Knapp","doi":"10.21037/pm-20-72","DOIUrl":"https://doi.org/10.21037/pm-20-72","url":null,"abstract":"Background: There is growing recognition of the prevalence of mental health disorders in children, and of the importance for recognition and selective prevention in the pediatric setting. Pediatric Primary Care Clinicians (PPCCs) need a tool to capture their observations, weigh risks against strengths, identify problems, and develop intervention plans, particularly when specialty mental health consultation is lacking or when referral for mental health treatment is difficult. Methods: A Mental Health Dashboard is described as an innovative clinical tool to organize information about the mental health of children. This tool considers the child’s life situation and clinical manifestations, organized in eight domains, and considering the child’s developmental level. The tool allows identifying symptom patterns of concern, as well as child and family strengths, and guiding intervention planning. Screening tools may augment and anchor the findings. Results: Case vignettes for a pre-school child with trauma, a school-age child with learning disability and symptoms of ADHD, and an adolescent with mood symptoms and substance use illustrate use of the Dashboard. Conclusions: Primary Care Clinicians, who know the patient and family, are positioned to identify emerging symptoms as well as family strengths, and to mobilize community resources for intervention planning when the option of specialty mental health referral is not indicated or is unavailable. The Mental Health Dashboard arrays observations and organizes an intervention plan.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44317678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyriform sinus fistula as a cause of acute suppurative thyroiditis presenting as hyperthyroidism in a teenager with neurofibromatosis 1: a case report","authors":"Erica Haught, S. Bendre","doi":"10.21037/PM-21-25","DOIUrl":"https://doi.org/10.21037/PM-21-25","url":null,"abstract":"A pyriform sinus fistula is a rare congenital anomaly that involves failure of obliteration of the third or fourth pharyngeal pouches during the embryological period. It is recognized as a cause of acute suppurative thyroiditis. We describe a case of a 14-year-old girl with Neurofibromatosis-1 that presented with malaise, sore throat, trouble sleeping, palpitations, dysphagia, and heat intolerance. Physical exam showed a tender thyroid nodule. Further evaluation revealed transient thyrotoxicosis. She had elevated free T4, low thyroid-stimulating hormone, and an elevated white blood cell count. A neck ultrasound and non-contrast computed tomography (CT) showed no evidence of a thyroid abscess. Radioactive iodine uptake revealed a cold nodule. Fine needle aspiration of the thyroid nodule diagnosed a thyroid abscess. Investigation of the anatomy during the direct laryngoscopy discovered a thyroid abscess caused by an infected pyriform sinus fistula. Antibiotics were given and the abscess was drained. After resolution of the infection, a hemi-thyroidectomy was performed to prevent re-infection. Acute thyrotoxicosis of unknown origin should prompt investigation for a thyroid infection and a primary cause such as a pyriform sinus fistula. If discovery of a pyriform sinus fistula is made, the fistula should be surgically removed after resolution of the infection in order to prevent recurrence of infection.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46949627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating mental health in the comprehensive care of children and adolescents: prevention, screening, diagnosis and treatment","authors":"Danielle Laraque-Arena, R. Stein","doi":"10.21037/PM-21-36","DOIUrl":"https://doi.org/10.21037/PM-21-36","url":null,"abstract":"© Pediatric Medicine. All rights reserved. Pediatr Med 2021 | http://dx.doi.org/10.21037/pm-21-36 The mental health of children and youth is an integral part of overall health and is a necessary cornerstone for lifelong well-being (1,2). For too long physical and mental health have been seen as independent of one another and the latter has been considered less important. In part, the past focus on physical health has been a reflection of the high mortality rates associated with infectious diseases and the primacy of improving survival, but as mortality rates have generally decreased, there has been increasing attention to helping children to thrive and consequently to the key role of mental health in their short and long-term well-being. These factors are fundamental to the genesis of our undertaking this special series of Pediatric Medicine. We did so with an eye toward focusing on the need for a comprehensive and global view of the status of children’s mental health. This series was conceptualized prior to the advent of the world-wide COVID-19 pandemic and the calls for social reckoning that have dominated the United States and many other countries facing racial, class, gender, and ethnic discrimination and violence. Acknowledging these seemingly unrelated global events is relevant because of their broad and sustained impact on the mental health of children (3-6). In the first instance, the pandemic has created particular conditions such as the closure of schools, the escalation of economic hardship and increased social isolation that have aggravated the socio-emotional stress borne by children and their families. Additionally, the recent pandemic of COVID-19 produced a keen appreciation of the extent to which mental health issues have intensified for children who are sequestered, often in tight enclosed spaces, or those who suffer the trauma of family illness and death, as well as other associated negative consequences of the pandemic. In the second instance, the outcry for social justice has unsurfaced long-standing conditions that reveal fundamental structural inequities, racism and stigma that impact the well-being of children (7,8). This is significant because racism/classism/ gender biases have been increasingly recognized as critical sources of psychological trauma affecting the mental health of children. At times these biases lead to recognizable psychiatric diagnoses such as post-traumatic stress disorder as well as poor health outcomes such as anxiety, depression and suicide (9,10). Myths and cultural attitudes have accompanied discussions of mental health for generations. It is notable that while these are ubiquitous, they differ across communities both in the degree to which they are recognized and in the ways with which they are approached and dealt. The stigma associated with mental health issues is prevalent in most communities and countries and significantly complicates the discussion of mental health in an international framewo","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47414399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}