Pediatric medicine (Hong Kong, China)最新文献

{"title":"Mixed methods analysis of reflective statements of residents following the developmental-behavioral pediatric rotation","authors":"Nicole Fledderman, Lillian J Slavin, Daniel D. Drevon, Neelkamal Soares","doi":"10.21037/pm-21-116","DOIUrl":"https://doi.org/10.21037/pm-21-116","url":null,"abstract":"Background: Reflection is important in the professional practice of medicine, and analyses of trainees' reflection papers have been utilized to evaluate training outcomes. This study was to determine the degree of reflection of residents completing the developmental-behavioral pediatrics (DBP) rotation, which provides a high degree of interprofessional and family-centered experiences. We sought to explore whether level of reflection was correlated with timing of the rotation [earlier or later in training year, before or since the coronavirus disease 2019 (COVID-19) pandemic]. Method(s): This retrospective study included deidentified reflection statements of Pediatrics (Peds) and Medicine-Pediatrics (Med-Peds) residents after their DBP rotation from 2017-2021. Level of reflection for each of four categories of prompts, leadership, interdisciplinary, family-centered, and equity (LIFE), which codifies 12 Maternal Child Health (MCH) competencies, and ideally reflect the principles of the DBP rotation. The prompts were coded using a five-point Castleberry rating. Result(s): Thirty-six residents completed reflections, 58% completed the rotation prior to the COVID-19 pandemic, and 44% completed the rotation early in their academic year. Mean Castleberry ratings were 3.2 [standard deviation (SD) =0.7], 2.7 (SD =0.8), 2.6 (SD =1.0), and 2.6 (SD =0.8) for LIFE, respectively. Wilcoxon rank-sum tests tested differences in Castleberry ratings for each facet of the LIFE framework by timing of rotation vis-a-vis the COVID-19 pandemic and early or late in the training year. We found statistically significant lower results for interdisciplinary (I) facet of the LIFE framework in those who completed the rotation late in the training year (W=214.50;P=0.02). Conclusion(s): Peds and Med-Peds residents reflect moderately on their DBP rotation, and more on leadership than other aspects integral to DBP practice. Future research is needed to compare reflections on the LIFE framework across different rotations, and thematic/sentiment analysis can reveal opportunities for guiding residents on the reflection process.Copyright © Pediatric Medicine. All rights reserved.","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":"47289768","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":"Challenges in the management of obesity in adolescents: an American perspective: a narrative review","authors":"E. Clemente, M. D. Cabral, Mackenna L. Senti, D. Patel","doi":"10.21037/pm-21-23","DOIUrl":"https://doi.org/10.21037/pm-21-23","url":null,"abstract":"Obesity is a preventable, yet costly disease, with an increasing incidence worldwide, with significant long-term implications for adverse health outcomes and burden on health care delivery systems (1-7). The lifetime medical cost is very high for a young child with obesity who in turn may suffer long-term health consequences in adulthood if not addressed early (8-16). The prevalence of obesity in the United States has doubled in the last two decades, with 1 in 5 adolescents aged 12 to 19 years old found to be obese (12). Most available published expert recommendations for treatment include a multidisciplinary approach with emphasis on diet, exercise and behavioral modification (13-16). In general, adherence to treatment guidelines is attainable; however, once puberty occurs, the obese adolescent will face an additional multitude of challenges affecting the physical, mental, and social aspects of health. Review Article","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":"46845152","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":"Necessity and limitations of paediatric research—a personal view","authors":"R. Korinthenberg","doi":"10.21037/pm-21-90","DOIUrl":"https://doi.org/10.21037/pm-21-90","url":null,"abstract":": The objective of this review is to present a personal view on the need of paediatric research and its practical and ethical boundaries. The review is based on the personal experience of a senior paediatric neurologist and head of a research ethics committee, taking into account selected references. In summary, the physical and psychological immaturity and developmental potential of children, especially at a young age, require specific, age-appropriate research methods and topics that differ from research on adults. Worldwide, many children still die from common and treatable diseases such as measles and pneumonia. On the other hand, new lifestyle-dependent diseases such as allergies, attention deficit disorder and obesity are rapidly increasing in number in industrialised countries. With the gradual elucidation of the genetic causes of rare diseases, interest in their treatment is also increasing. The necessary research includes age-related physiological and pathophysiological, pharmacological, psychosocial, educational, epidemiological and socio-economic studies. However, young children are not able to understand complex instructions and follow study protocols, which makes it difficult to conduct reliable and valid studies. In addition, the rarity of many paediatric diseases and the different age groups often require national and supranational research groups with the associated high costs. As children have limited capacity to understand and consent to the risks and benefits of their participation, they are considered particularly vulnerable persons who need to be protected in all types of research in accordance with international ethical regulations and laws. In conclusion, as research on children tends to be more complex and less often refinanced, public and private sponsors, regulators and public health systems are called upon to support the necessary research on children in any way they can. This is not only about developing new therapies for rare diseases in developed countries, but also affordable therapies for common diseases in poorer regions of the world.","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":"41505799","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 Swedish Neonatal Network for outcomes improvement","authors":"M. Norman, S. Håkansson","doi":"10.21037/pm-21-62","DOIUrl":"https://doi.org/10.21037/pm-21-62","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":"42817565","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":"International network for evaluating outcomes of neonates: outputs and future directions","authors":"P. Shah, T. Isayama, Kjell Helenius, L. San Feliciano, M. Beltempo, D. Bassler, S. Håkansson, F. Rusconi, N. Modi, M. Battin, M. Vento, M. Adams, L. Lehtonen, M. Norman, S. Kusuda, B. Reichman, K. Lui, Shoo K. Lee","doi":"10.21037/pm-21-73","DOIUrl":"https://doi.org/10.21037/pm-21-73","url":null,"abstract":"Ten neonatal networks from 11 countries—Australia, New Zealand, Canada, Finland, Israel, Japan, Spain, Sweden, Switzerland, the Tuscany region of Italy, and the UK—came together in 2012 to form the International Network for Evaluating Outcomes of Neonates (iNeo): an international collaboration of population-representative, national neonatal datasets. The result has been a powerful platform for epidemiological, outcomes-based, and applied health services and policy research. The network has successfully collaborated to evaluate variations in health service organization, practices, and outcomes, with an aim to harmonize processes and identify areas for quality improvement in the various countries. We have identified marked variations in outcomes such as mortality, severe neurological injury, and treated retinopathy of prematurity; and highlighted the important need for the neonatal community to harmonize criteria for diagnosing bronchopulmonary dysplasia. Despite marked changes in the respiratory management of extremely preterm neonates with the aim to avoid mechanical ventilation, judicious use of oxygen, and less invasive administration of surfactant, rates of bronchopulmonary dysplasia have continued to rise in most countries. This may be due to marked discrepancies in the diagnostic criteria for bronchopulmonary dysplasia in extremely preterm neonates. We were able to conduct a detailed survey of more than 300 neonatal units worldwide and link the responses with actual patient data to generate hypotheses to evaluate 23 † Names and affiliations of the iNeo investigators are provided in the Acknowledgments. Pediatric Medicine, 2021 Page 2 of 23 © Pediatric Medicine. All rights reserved. Pediatr Med 2021 | https://dx.doi.org/10.21037/pm-21-73 Background information Ten neonatal networks from 11 countries—Australia, New Zealand, Canada, Finland, Israel, Japan, Spain, Sweden, Switzerland, the Tuscany region of Italy, and the UK—came together in 2012 to form the International Network for Evaluating Outcomes of Neonates (iNeo): an international collaboration of population-representative, national neonatal datasets. The result is a powerful platform for epidemiological, outcomes-based, and applied health services and policy research. Our underlying goal in building this collaboration was to improve patient-oriented outcomes for neonates born very preterm (VPT, born before 32 weeks’ gestational age) and extremely preterm (EPT, born before 28 weeks’ gestation) around the world. As outlined by others in this article series, most of the networks involved in iNeo have well-established platforms for their own internal evaluation, benchmarking, and quality improvement activities. They also participate in many benchmarking activities both nationally and internationally. Since inception, iNeo has produced several high-quality outputs in the domains of outcomes evaluation, evaluation of care and practice similarities and differences between the networks, epidemi","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":"45520112","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":"Adjustment disorder in the pediatric population","authors":"George Alvarado","doi":"10.21037/PM-20-76","DOIUrl":"https://doi.org/10.21037/PM-20-76","url":null,"abstract":"Given the constantly changing array of stressors faced by children and adolescents throughout the course of development, adjustment disorder (AD) can serve as a valuable category to identify and understand these phenomena in the clinical setting. At the same time, the uptake and application of this diagnosis has been variable, at times underutilized due to concerns about clinical validity, as well as a dearth of diagnosis specific treatment options. This chapter will provide an up to date review of AD, including the epidemiology, etiology, and the diagnostic criteria updates in the Diagnostic Statistical Manual (DSM) used in the United States and the International Classification of Disease (ICD). Psychotherapeutic and psychopharmacology treatment options will be reviewed as well. Particular focus will be paid to the identification and treatment of AD in the Pediatric Primary Care Setting, as well as in the context of the COVID-19 pandemic. © 2022 Journal of Innovation Management. All rights reserved.","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":"46068080","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":"Laboratory testing for the diagnosis of neonatal and pediatric immune neutropenias: a narrative review","authors":"A. Cattaneo, L. Porretti","doi":"10.21037/pm-21-43","DOIUrl":"https://doi.org/10.21037/pm-21-43","url":null,"abstract":"Objectives: This review focuses on the role of anti-neutrophil antibodies in neonatal and pediatric neutropenias with particular regard to laboratory tests useful to detect them. Background: Neutropenia is a common medical problem for infants and children that can predispose them to the risk of bacterial infections. There are many causes for pediatric neutropenia, but at birth and for the first years of life, neutropenia is often attributable to immune mechanisms, either by the presence of auto or alloantibodies directed against human neutrophil antigens (HNA). The detection of these antibodies is a useful diagnostic tool to define immune-mediated neutropenia, which includes a variety of clinical conditions. Methods: PubMed was used to carry out a literature search for the last 10 years. In addition, pivotal papers on this topic, before 2010, were also considered. Conclusions: The detection and identification of anti-neutrophil antibodies with the techniques currently available are often laborious, difficult, and performed in specialized laboratories. Moreover, since neutrophils are fragile cells and difficult to preserve, several advances in laboratory procedures have been developed in the last years. The recent availability of new commercial assays, which do not require fresh cells, may represent an important step forward in neutrophil serology, as it could improve the standardization and availability of serological and genomic tests that can also be used in non-specialized laboratories. However, these assays still need to complete the necessary validations before replacing classical serological methods. 13","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":"46124973","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":"MIS-C is likely to be distinct from Kawasaki disease based on current studies: a narrative review","authors":"Chaozhong Tan, Fang Liu","doi":"10.21037/pm-20-113","DOIUrl":"https://doi.org/10.21037/pm-20-113","url":null,"abstract":"Background and Objective: Children with SARS-CoV-2 infection were paid little attention to during the early stages of the outbreak because of low morbidity as well as mild clinical symptoms. Since late April 2020, reports regarding Kawasaki-like syndrome and hyperinflammatory response in children associated with COVID-19 have rapidly emerged. Till now, no certain relationship between multisystem inflammatory syndrome in Children (MIS-C) and Kawasaki Disease (KD) has been determined, which should be explored through continuous study. Methods: In order to synthesize key findings for the objectives of this review, we searched English literature published up to November 16, 2020 using PubMed with the following keywords: Kawasaki disease 2020, Kawasaki-like disease, MIS-C, PIMS, PMIS and PIMS-TS. Key Content and Findings: Based on current researches, KD is regarded as an immune disorder induced by multiple unidentified pathogens, while MIS-C is confirmed to be associated with the infection of COVID-19. In addition, KD is popular in East Asian children under 3 years old, while MIS-C is reported more in older adolescents from Europe and North America. On the basis of multiple cohort studies, gastrointestinal symptoms, mechanical ventilation and inotropic support are more common in MIS-C. Instead, coronary arterial damage is more pronounced in KD. Moreover, the treatment regimen for MIS-C is more aggressive than KD because the cytokine storm is more violent and lasting. Conclusions: MIS-C is likely to be a distinct immunopathogenic illness associated with SARS-CoV-2 based on current studies, which could be used as a reference to help us better understand KD. In addition, MIS-C is an emerging syndrome for pediatricians, so the lack of relevant knowledge may result in under-diagnosis. Some individuals may fulfill full or partial criteria for KD but all should be reported if they meet the case definition for MIS-C. © 2022 AME Publishing Company. All right reserved.","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":"42655568","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":"Respiratory system abnormalities in Prader-Willi syndrome: a literature review","authors":"G. Com, Haripriya Santhanam, Berrin Ergun-Longmire","doi":"10.21037/pm-21-102","DOIUrl":"https://doi.org/10.21037/pm-21-102","url":null,"abstract":"Pediatric Pulmonology Medicine, University of Florida, Pensacola, FL, USA; Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA Contributions: (I) Conception and design: All authors (II) Administrative support: none; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final Approval of manuscript: All authors. Correspondence to: Berrin Ergun-Longmire, MD. Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA. Email: berrin.ergun-longmire@med.wmich.edu.","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":"47981834","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 impact of COVID-19 on the practice of pediatric cardiology: a narrative review","authors":"C. Chen, R. Grignani, Y. Lim, S. Quek","doi":"10.21037/pm-21-64","DOIUrl":"https://doi.org/10.21037/pm-21-64","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":"44470597","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}