Pediatric medicine (Hong Kong, China)最新文献

{"title":"Pharmacotherapeutic options for children with COVID-19: a narrative review","authors":"Qiaofeng Ye, Guangfei Wang, Huang Yidie, Jinmiao Lu, Junqi Zhang, Zhu Lin, Yiqing Zhu, Xiaoxia Li, Jianger Lan, Ziwei Li, Yubing Liu, X. Zhai, Guoying Huang, Zhiping Li","doi":"10.21037/PM-20-103","DOIUrl":"https://doi.org/10.21037/PM-20-103","url":null,"abstract":"Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic with major concerns on finding effective ways for clinical management. In this review, we searched available publications on the pharmacological treatment options for children with COVID-19. In total, 104 case reports and 15 cohort studies were included for analysis. For children, commonly applied medications were categorized into five main types: antivirals, antibacterials and antifungals, anti-inflammatories, anticoagulants, and vasopressors. Inhaled interferon was the most used antiviral in cohort studies, while hydroxychloroquine (HCQ) or chloroquine (CQ) was the most in case reports. Different from adult patients, special consideration should be given to COVID-19 children diagnosed with multisystem inflammatory syndrome (MIS-C). Besides direct antiviral treatment, pharmacological care managing the inflammatory process comprises a great part of the treatment protocol. In addition to commonly used glucocorticoids, intravenous immunoglobulin (IVIG), and aspirin, some biologics could be considered as potential treatment. Anakinra, an interleukin-1 (IL-1) receptor antagonist, is highly recommended by the American College of Rheumatology as a safe treatment for children with MIS-C. The IL-6 receptor antagonist, tocilizumab, is also a potential treatment option. This review offers a comprehensive overview of the common medications used in clinical settings all over the world, but should be referred to with caution and flexibility depending on the actual condition of a specific patient. © Pediatric Medicine. All rights reserved.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42672972","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":"An exploratory approach to defining and measuring child health and well-being with parents and grandparents","authors":"K. Bogard, Victor Ortiz-Cortes, Shaneah Taylor, R. Jackson, Rebecca Belmonte","doi":"10.21037/PM-20-110","DOIUrl":"https://doi.org/10.21037/PM-20-110","url":null,"abstract":"Background: The study engaged parents and grandparents to define child health and well-being in their local context, develop domains","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48695703","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":"Contemporary strategies in stem cell transplantation for chronic granulomatous disease","authors":"Sima T. Bhatt, M. Malhotra, J. Bednarski","doi":"10.21037/PM-20-106","DOIUrl":"https://doi.org/10.21037/PM-20-106","url":null,"abstract":": Chronic granulomatous disease (CGD) is an inherited immunodeficiency characterized by recurrent, often life-threatening, infections and a dysregulated immune response. Through early diagnosis, infection surveillance, and prophylactic antimicrobials, survival has improved with greater than 90% of patients living into early adulthood. Despite this improvement, nearly 50% of patients with CGD do not survive past 30 years of age. Furthermore, compounding morbidities from infections and inflammatory disease significantly compromise quality of life. Allogenic hematopoietic stem cell transplantation (HSCT) is curative for CGD. Advances in stem cell transplant, including use of alternative donors and reduction in acute and late toxicities, have improved outcomes leading to expanded use of transplant for chronic granulomatosis disease. Reduced toxicity and reduced intensity conditioning (RIC) regimens are increasingly utilized with excellent disease free and overall survival (OS). We review approaches for HSCT in patients with CGD, including impact of patient and donor characteristics on outcomes, conditioning regimens that have demonstrated success, and continued challenges of transplant-related morbidity and post-transplant autoimmunity.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46070986","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":"Strategies to optimize enteral feeding and nutrition in the critically ill child","authors":"S. Irving, Ben D. Albert, N. Mehta, V. Srinivasan","doi":"10.21037/PM-21-6","DOIUrl":"https://doi.org/10.21037/PM-21-6","url":null,"abstract":"The provision of nutrition therapy is an integral component of care for the critically ill child. Essential factors to consider include a child’s evolving metabolic needs accounting for age, underlying disease, co-morbidities and the severity of illness. This includes the implications that the stress response has on concurrent energy requirements during hospital admission. To ameliorate the impact of the stress response nutrition therapy is a crucial aspect of this care. Scientific support for early enteral nutrition is strong yet application in clinical practice remains challenging. Enteral nutrition for children who require vasoactive medications is a long-standing question despite evidence suggesting it can be well-tolerated and beneficial in pediatric critical illness. Studies suggest improved clinical outcomes, decreased length of hospitalization and decreased mortality in certain populations. The aim of this narrative review is to discuss the physiology of metabolic derangements that occur during critical illness, outline how to determine optimal nutrition prescription, and discuss benefits of early enteral nutrition. Considerations of particular populations, such as the postoperative surgical patient, and the patient requiring vasoactive medications will also be discussed.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43932800","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":"Engaging community and governmental partners in improving health and mental health outcomes for children and adolescents impacted by HIV/AIDS in Uganda.","authors":"Wilberforce Tumwesige,&nbsp;Phionah Namatovu,&nbsp;Ozge Sensoy Bahar,&nbsp;William Byansi,&nbsp;Mary M McKay,&nbsp;Fred M Ssewamala","doi":"10.21037/pm-20-86","DOIUrl":"https://doi.org/10.21037/pm-20-86","url":null,"abstract":"<p><p>The African region remains the world's most affected region in the HIV epidemic. A related consequence of HIV/AIDS in sub-Saharan Africa (SSA), including in Uganda, is the high prevalence of children and adolescents who have lost one or both parents to this virus or who have been perinatally infected. Guided by the Practical, Robust Implementation and Sustainability (PRISM) framework, this paper describes the strategies by which we have engaged community and government partners in research using three NIH-funded randomized clinical trials testing an evidence-based combination intervention aimed at improving health and mental health outcomes among children and adolescents impacted by HIV/AIDS in Uganda. We specifically lay out four strategies that have been used to facilitate stakeholder engagement, namely consultative meetings, stakeholder accountability meetings, training of key players (task-shifting), and policymaker engagement. We emphasize that community collaborations and partnerships are especially critical when implementing combination interventions that require a high level of communication and coordination among multiple implementation partners. We underline that building and sustaining long-term relationships and communication with the stakeholders can allow the researchers to successfully design rigorous studies that are responsive to local needs and can make a difference especially in low-resource settings. Finally, we highlight that the process of engagement and collaboration can be guided by conceptual frameworks.</p>","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/4b/nihms-1689050.PMC8159177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39035321","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":"E-cigarette exposures, respiratory tract infections, and impaired innate immunity: a narrative review.","authors":"Aleks Kalininskiy, Julie Kittel, Nicholas E Nacca, Ravi S Misra, Daniel P Croft, Matthew D McGraw","doi":"10.21037/pm-20-97","DOIUrl":"10.21037/pm-20-97","url":null,"abstract":"<p><p>Electronic cigarettes (e-cigarettes) are commonly used devices by adolescents and young adults. Since their introduction, the popularity of e-cigarettes has increased significantly with close to twenty percent of United States high school students reporting current use in 2020. As the number of e-cigarette users has increased, so have reports of vaping related health complications. Overall, respiratory tract infections remain one of the top ten leading causes of death in the US for every age group. Specific to the pediatric population, lower respiratory tract infections are the leading cause for hospitalization. This review highlights the current evidence behind e-cigarette exposure and its association with impaired innate immune function and the risk of lower respiratory tract infections. To date, various preclinical models have evaluated the direct effects of e-cigarette exposure on the innate immune system. More specifically, e-cigarette exposure impairs certain cell types of the innate immune system including the airway epithelium, lung macrophage and neutrophils. Identified effects of e-cigarette exposure common to the lung's innate immunity include abnormal mucus composition, reduced epithelial barrier function, impaired phagocytosis and elevated systemic markers of inflammation. These identified impairments in the lung's innate immunity have been shown to increase adhesion of certain bacteria and fungi as well as to increase virulence of common respiratory pathogens such as influenza virus, <i>Staphylococcus aureus</i> or <i>Streptococcus pneumoniae</i>. Information summarized in this review will provide guidance to healthcare providers, policy advocates and researchers for making informed decisions regarding the associated respiratory health risks of e-cigarette use in pediatric and young adults.</p>","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/e7/nihms-1691206.PMC8177080.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39067624","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":"Mental health and non-communicable diseases","authors":"N. Gray, J. Klein","doi":"10.21037/PM-20-84","DOIUrl":"https://doi.org/10.21037/PM-20-84","url":null,"abstract":"Children and adolescents need environments and systems that prevent mental health and developmental disorder problems, comprehensive primary care that is able to respond early to their needs, and methods of compassionate mental health care when other interventions fail. This paper provides an overview of the history of child and adolescent mental health practices and prevailing themes that connect mental health with the wider field of non-communicable disease (NCD) prevention and treatment. Inclusion of mental health as part of the World Health Organization NCD agenda has raised global awareness of mental health issues, including the need for continued de-stigmatization, clinician training, and access to essential medicines. The policy arena for mental health is complex, and we reflect on missed opportunities for meaningful integration of mental health within holistic life-course oriented healthcare delivery systems. We explore bidirectional links between physical and mental health, and the impact of social determinants and early childhood experiences on morbidity and mortality. We examine the prevention of mental health problems, noting risk factors shared with other NCDs, and reflect on mental health treatment—with and without the use of medicines—underlining the importance of universal health coverage (UHC) for children and adolescents’ mental health and wellbeing. Considerable work is needed to better integrate mental health and other NCD related care into front-line primary health care delivery, and to include a true life-course approach to NCD prevention and treatment for children and youth.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45205239","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":"Anti-U hemolytic disease of the fetus and newborn managed by multiple intrauterine transfusions: a case report and review of the literature","authors":"Jonathan C Li, M. S. Hwang, S. Emery, J. Watchko, J. Ibrahim","doi":"10.21037/pm-21-72","DOIUrl":"https://doi.org/10.21037/pm-21-72","url":null,"abstract":": The U-antigen is part of the MNS blood group. Named for its almost universal expression, a U-negative phenotype is reported in ~1% of individuals of African descent. The spectrum of IgG-mediated anti-U hemolysis includes alloimmune disease of the fetus and newborn. The clinical presentation among affected newborns ranges from mild anemia to erythroblastosis fetalis. We present a case of maternal anti-U positivity and severe middle cerebral artery (MCA) Doppler concerning for anti-U hemolytic disease of the fetus and newborn managed by multiple intrauterine transfusions (IUTs). Uniquely, this case reports the lowest critical maternal anti-U titer to-date resulting in clinically significant fetal anemia. We also searched the literature using the general term “anti-U hemolytic disease” in PubMed to provide a review of case presentations, management methods, and outcomes. The maternal critical anti-U titer was initially 32 at 25 weeks and progressed to 64 by date of delivery. The initially normal fetus, at the 83rd growth percentile at 24 weeks, developed severe range MCA Doppler indices at 26 weeks [peak systolic velocity 59.9 cm/sec, 1.72 multiples of the median (MoM)]. The first percutaneous umbilical cord blood sampling (PUBS) at 26 5/7 weeks revealed a hemoglobin (Hgb) of 8.9 g/dL, 6.7% reticulocytes. IUTs were initiated for severe fetal anemia and predicted Hgb loss, four in total. Intrauterine growth restriction (<5%) developed by 36 weeks, prompting delivery by repeat cesarean section for non-reassuring fetal status. In conclusion, we successfully managed a case of severe anti-U-mediated fetal anemia by IUT performed via both fetal intravascular and intraperitoneal routes using donated U-negative blood. We identified 14 reports of anti-U hemolytic disease of the fetus and newborn that feature a broad range in clinical severity. Anti-U hemolytic disease of the fetus and newborn is a rare, but potentially serious condition and should be managed in accordance with Rh alloimmunization guidelines. Antibody titers are inconsistently associated with clinical severity of disease. Surveillance with MCA Doppler and IUT with donated U-negative blood have shown promising outcomes.","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41579032","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":"Bronchopulmonary dysplasia with focus on early prediction and treatment: a narrative review","authors":"H. Verder, Zhan-kui Li, R. Ramanathan, H. Clark, D. Sweet, P. Schousboe, Nikolaos Scoutaris, Povl Verder, C. Heiring","doi":"10.21037/pm-21-98","DOIUrl":"https://doi.org/10.21037/pm-21-98","url":null,"abstract":"","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49613246","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":"The Canadian Neonatal Network: development, evolution, and progress","authors":"M. Beltempo, P. Shah, Shoo K. Lee","doi":"10.21037/pm-21-80","DOIUrl":"https://doi.org/10.21037/pm-21-80","url":null,"abstract":"","PeriodicalId":74411,"journal":{"name":"Pediatric medicine (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46263290","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}