Current Problems in Pediatric and Adolescent Health Care最新文献

英文中文

Integrating environmental risk factors into pediatric cancer care: Laying the groundwork for improved outcomes and primary prevention 将环境风险因素纳入儿科癌症护理：为改善结果和初级预防奠定基础

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-09-01 DOI: 10.1016/j.cppeds.2025.101821

Nicole M. Wood , Omar Shakeel , Juan A. Ortega-Garcia , Mark D. Miller

Childhood cancer incidence has steadily risen both in the United States and worldwide, yet its environmental contributors remain underrecognized in clinical care. Children and cancer survivors are particularly susceptible to environmental exposures due to their unique physiology and the long-term health vulnerabilities that follow cancer treatment. Although exposures to substances such as pesticides, air pollution, and household chemicals are linked to increased cancer risk, limited clinical frameworks and clinician training leave oncologists underprepared to address growing environmental health concerns from families.

A holistic pediatric oncology environmental health program in Murcia, Spain offers a scalable vision for embedding the environment into longitudinal cancer care. In the United States, survey data from two large academic pediatric cancer centers revealed strong clinician interest in addressing environmental health in pediatric oncology, leading to the development of a consultative model. Workshops and a standardized environmental health history tool, adapted for clinical use and integration into the medical record, have laid the groundwork for implementation of an environmental consult service across 3 care settings: cancer predisposition clinics, survivorship programs, and as requested. These efforts aim to reduce family anxiety, offer actionable risk-reduction strategies, and empower primary teams with the knowledge to engage in meaningful conversations.

The patient-centered tools, interdisciplinary training, and structured integration into clinical workflows are designed to strengthen environmental health knowledge and practice of pediatric oncologists in the United States.

在美国和世界范围内，儿童癌症发病率稳步上升，但其环境因素在临床护理中仍未得到充分认识。儿童和癌症幸存者由于其独特的生理机能和癌症治疗后的长期健康脆弱性，特别容易受到环境暴露的影响。虽然接触杀虫剂、空气污染和家用化学品等物质与癌症风险增加有关，但有限的临床框架和临床医生培训使肿瘤学家在解决家庭日益增长的环境健康问题方面准备不足。西班牙穆尔西亚的一个整体儿科肿瘤环境健康项目提供了一个可扩展的愿景，将环境嵌入到纵向癌症护理中。在美国，来自两个大型学术儿科癌症中心的调查数据显示，临床医生对解决儿科肿瘤学中的环境健康问题有浓厚的兴趣，这导致了咨询模式的发展。研讨会和标准化的环境健康史工具，适用于临床使用并整合到医疗记录中，为在三种护理环境中实施环境咨询服务奠定了基础：癌症易感诊所、幸存者项目和要求。这些努力旨在减少家庭焦虑，提供可操作的降低风险战略，并使初级团队具备参与有意义对话的知识。以患者为中心的工具、跨学科培训和临床工作流程的结构化整合旨在加强美国儿科肿瘤学家的环境卫生知识和实践。

{"title":"Integrating environmental risk factors into pediatric cancer care: Laying the groundwork for improved outcomes and primary prevention","authors":"Nicole M. Wood , Omar Shakeel , Juan A. Ortega-Garcia , Mark D. Miller","doi":"10.1016/j.cppeds.2025.101821","DOIUrl":"10.1016/j.cppeds.2025.101821","url":null,"abstract":"<div><div>Childhood cancer incidence has steadily risen both in the United States and worldwide, yet its environmental contributors remain underrecognized in clinical care. Children and cancer survivors are particularly susceptible to environmental exposures due to their unique physiology and the long-term health vulnerabilities that follow cancer treatment. Although exposures to substances such as pesticides, air pollution, and household chemicals are linked to increased cancer risk, limited clinical frameworks and clinician training leave oncologists underprepared to address growing environmental health concerns from families.</div><div>A holistic pediatric oncology environmental health program in Murcia, Spain offers a scalable vision for embedding the environment into longitudinal cancer care. In the United States, survey data from two large academic pediatric cancer centers revealed strong clinician interest in addressing environmental health in pediatric oncology, leading to the development of a consultative model. Workshops and a standardized environmental health history tool, adapted for clinical use and integration into the medical record, have laid the groundwork for implementation of an environmental consult service across 3 care settings: cancer predisposition clinics, survivorship programs, and as requested. These efforts aim to reduce family anxiety, offer actionable risk-reduction strategies, and empower primary teams with the knowledge to engage in meaningful conversations.</div><div>The patient-centered tools, interdisciplinary training, and structured integration into clinical workflows are designed to strengthen environmental health knowledge and practice of pediatric oncologists in the United States.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 9","pages":"Article 101821"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Foreword - Moving toward prevention of childhood cancers 前言-儿童癌症的预防。

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-09-01 DOI: 10.1016/j.cppeds.2025.101837

Mark D. Miller MD

引用次数: 0

A systematic review of residential proximity to upstream oil and gas development and childhood, adolescent and young adult cancer risk 一项关于上游油气开发与儿童、青少年和年轻人癌症风险的系统综述。

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-09-01 DOI: 10.1016/j.cppeds.2025.101838

Eric C. Stewart , Nicholaus P. Johnson , Cassandra J. Clark , Catherine Metayer , Nicole C. Deziel

Objective

Upstream oil and gas development (OGD) can release carcinogenic and radioactive agents into air and water. This review summarizes evidence on the relationship between residential proximity to upstream OGD and cancer risk among children, adolescents, and young adults (CAYA).

Methods

We systematically searched PubMed and Embase through April 25, 2025, for original, peer-reviewed epidemiologic investigations of residential proximity to upstream OGD and cancer in CAYA (≤25 years). We excluded studies of downstream activity, those lacking CAYA-specific results, and non-English publications. Two reviewers independently screened records, extracted data, and assessed risk of bias with a World Health Organization tool.

Results

From 3274 screened articles, 10 met inclusion criteria. Four case-control studies, all United States-based (Pennsylvania n = 3, Colorado n = 1), used individual-level proximity metrics during defined temporal windows and controlled for confounders. Six ecological studies (Ecuador n = 4, Croatia n = 1, Pennsylvania n = 1) used area-based density or binary exposure metrics with limited confounder adjustment. All studies assessed hematopoietic malignancies. All case-control studies observed positive associations between OGD proximity and cancer with three reporting elevated leukemia risk. Two studies from different states reported highly similar leukemia risk in the closest OGD buffer zones (Colorado: 3 km OR 2.07, 95 % CI 1.08-3.74; Pennsylvania: 2 km OR 1.98, 95 % CI 1.06-3.69). Ecologic study findings were mixed, including elevated risks for hematologic and central nervous system cancers. Limitations include few studies, imprecise exposure metrics, and potential residual confounding.

Discussion

Despite limited evidence, the majority of studies reported positive, statistically significant associations between OGD and childhood cancer, most consistently for leukemia, supporting efforts to reduce OGD proximity to children.

目的：上游油气开发会向大气和水体中释放致癌物和放射性物质。这篇综述总结了居住靠近上游OGD与儿童、青少年和年轻人（CAYA）癌症风险之间关系的证据。方法：我们系统地检索了PubMed和Embase，截至2025年4月25日，检索了CAYA（≤25年）中居住邻近上游OGD和癌症的原始同行评审流行病学调查。我们排除了下游活性研究、缺乏caia特异性结果的研究和非英文出版物。两名审稿人独立筛选记录，提取数据，并使用世界卫生组织的工具评估偏倚风险。结果：在筛选的3274篇文章中，10篇符合纳入标准。四项病例对照研究均以美国为基地（宾夕法尼亚州n = 3，科罗拉多州n = 1），在规定的时间窗口内使用个人水平接近指标，并控制混杂因素。6项生态学研究（厄瓜多尔n = 4，克罗地亚n = 1，宾夕法尼亚州n = 1）使用基于区域的密度或二元暴露指标，并进行有限的混杂校正。所有的研究都评估了造血恶性肿瘤。所有病例对照研究均观察到OGD邻近与癌症呈正相关，其中3例报告白血病风险升高。来自不同州的两项研究报告了最近的OGD缓冲区的白血病风险高度相似（科罗拉多州：3公里OR 2.07, 95% CI 1.08-3.74；宾夕法尼亚州：2公里OR 1.98, 95% CI 1.06-3.69）。生态学研究结果好坏参半，包括血液学和中枢神经系统癌症的风险增加。局限性包括研究较少、暴露指标不精确和潜在的残留混淆。讨论：尽管证据有限，但大多数研究报告了OGD与儿童癌症之间积极的、统计学上显著的关联，其中最一致的是白血病，这支持了减少OGD与儿童接触的努力。

{"title":"A systematic review of residential proximity to upstream oil and gas development and childhood, adolescent and young adult cancer risk","authors":"Eric C. Stewart , Nicholaus P. Johnson , Cassandra J. Clark , Catherine Metayer , Nicole C. Deziel","doi":"10.1016/j.cppeds.2025.101838","DOIUrl":"10.1016/j.cppeds.2025.101838","url":null,"abstract":"<div><h3>Objective</h3><div>Upstream oil and gas development (OGD) can release carcinogenic and radioactive agents into air and water. This review summarizes evidence on the relationship between residential proximity to upstream OGD and cancer risk among children, adolescents, and young adults (CAYA).</div></div><div><h3>Methods</h3><div>We systematically searched PubMed and Embase through April 25, 2025, for original, peer-reviewed epidemiologic investigations of residential proximity to upstream OGD and cancer in CAYA (≤25 years). We excluded studies of downstream activity, those lacking CAYA-specific results, and non-English publications. Two reviewers independently screened records, extracted data, and assessed risk of bias with a World Health Organization tool.</div></div><div><h3>Results</h3><div>From 3274 screened articles, 10 met inclusion criteria. Four case-control studies, all United States-based (Pennsylvania <em>n =</em> 3, Colorado <em>n =</em> 1), used individual-level proximity metrics during defined temporal windows and controlled for confounders. Six ecological studies (Ecuador <em>n =</em> 4, Croatia <em>n =</em> 1, Pennsylvania <em>n =</em> 1) used area-based density or binary exposure metrics with limited confounder adjustment. All studies assessed hematopoietic malignancies. All case-control studies observed positive associations between OGD proximity and cancer with three reporting elevated leukemia risk. Two studies from different states reported highly similar leukemia risk in the closest OGD buffer zones (Colorado: 3 km OR 2.07, 95 % CI 1.08-3.74; Pennsylvania: 2 km OR 1.98, 95 % CI 1.06-3.69). Ecologic study findings were mixed, including elevated risks for hematologic and central nervous system cancers. Limitations include few studies, imprecise exposure metrics, and potential residual confounding.</div></div><div><h3>Discussion</h3><div>Despite limited evidence, the majority of studies reported positive, statistically significant associations between OGD and childhood cancer, most consistently for leukemia, supporting efforts to reduce OGD proximity to children.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 9","pages":"Article 101838"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

The relationship of dietary folate, folic acid, and childhood cancer 膳食中叶酸、叶酸与儿童癌症的关系

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-09-01 DOI: 10.1016/j.cppeds.2025.101820

Yijin Xiang , Joseph L. Wiemels , Eric M. Nickels

Folate (vitamin B9) is an essential micronutrient and plays a critical role in one-carbon metabolism, DNA synthesis, and epigenetic regulation, particularly during early embryonic development. While the preventive role of maternal periconceptional folate intake against neural tube defects as well as other birth defects is well established, growing evidence suggests that folate status may also influence childhood cancer risk. In this review, we examine the biological mechanisms linking folate to childhood cancer, with a focus on acute lymphoblastic leukemia (ALL). We synthesize findings from population-wide natural experiments, observational studies, and meta-analyses, with particular attention to timing, dosage, and source of folate intake. Meta-analyses consistently report protective associations between maternal folic acid supplementation and childhood ALL, while evidence for natural dietary folate is more limited and less consistent. Genetic variants in folate metabolism pathways, particularly in the MTHFR gene, may modify these associations, and gene–environment interactions are increasingly recognized as important. Maternal folate status during the periconceptional period has also been linked to changes in offspring DNA methylation and potentially to long-term health outcomes, including at specific epigenetic loci such as IGF2 and ZFP57, as well as across the epigenome. The overall evidence supports the continued promotion of adequate maternal folate intake. Future research should prioritize causal inference methods, epigenome-wide analyses, and greater inclusion of underrepresented populations to clarify the role of folate in childhood cancer etiology.

叶酸（维生素B9）是一种必需的微量营养素，在单碳代谢、DNA合成和表观遗传调控中起着关键作用，特别是在胚胎早期发育过程中。虽然孕妇孕产期叶酸摄入对神经管缺陷和其他出生缺陷的预防作用已得到证实，但越来越多的证据表明，叶酸水平也可能影响儿童患癌症的风险。在这篇综述中，我们研究了叶酸与儿童癌症的生物学机制，重点是急性淋巴细胞白血病（ALL）。我们综合了人群范围内的自然实验、观察性研究和荟萃分析的结果，特别关注叶酸摄入的时间、剂量和来源。荟萃分析一致报告了母亲补充叶酸与儿童ALL之间的保护关联，而天然膳食叶酸的证据则更为有限，也不那么一致。叶酸代谢途径的遗传变异，特别是MTHFR基因，可能会改变这些关联，基因-环境相互作用越来越被认为是重要的。孕产期母亲叶酸水平也与后代DNA甲基化的变化有关，并可能与长期健康结果有关，包括特定的表观遗传位点，如IGF2和ZFP57，以及整个表观基因组。总体证据支持继续促进充足的母体叶酸摄入。未来的研究应优先考虑因果推理方法，全基因组分析，并更多地纳入代表性不足的人群，以阐明叶酸在儿童癌症病因学中的作用。

{"title":"The relationship of dietary folate, folic acid, and childhood cancer","authors":"Yijin Xiang , Joseph L. Wiemels , Eric M. Nickels","doi":"10.1016/j.cppeds.2025.101820","DOIUrl":"10.1016/j.cppeds.2025.101820","url":null,"abstract":"<div><div>Folate (vitamin B9) is an essential micronutrient and plays a critical role in one-carbon metabolism, DNA synthesis, and epigenetic regulation, particularly during early embryonic development. While the preventive role of maternal periconceptional folate intake against neural tube defects as well as other birth defects is well established, growing evidence suggests that folate status may also influence childhood cancer risk. In this review, we examine the biological mechanisms linking folate to childhood cancer, with a focus on acute lymphoblastic leukemia (ALL). We synthesize findings from population-wide natural experiments, observational studies, and meta-analyses, with particular attention to timing, dosage, and source of folate intake. Meta-analyses consistently report protective associations between maternal folic acid supplementation and childhood ALL, while evidence for natural dietary folate is more limited and less consistent. Genetic variants in folate metabolism pathways, particularly in the <em>MTHFR</em> gene, may modify these associations, and gene–environment interactions are increasingly recognized as important. Maternal folate status during the periconceptional period has also been linked to changes in offspring DNA methylation and potentially to long-term health outcomes, including at specific epigenetic loci such as <em>IGF2</em> and <em>ZFP57</em>, as well as across the epigenome. The overall evidence supports the continued promotion of adequate maternal folate intake. Future research should prioritize causal inference methods, epigenome-wide analyses, and greater inclusion of underrepresented populations to clarify the role of folate in childhood cancer etiology.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 9","pages":"Article 101820"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Editorial Board Page 编委会页面

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-08-01 DOI: 10.1016/S1538-5442(25)00121-X

引用次数: 0

Foreword: Issue 2 the primary care providers role: From vascular tumors/malformations to cancer, both survivorship and end of life care 前言：第2期初级保健提供者的作用：从血管肿瘤/畸形到癌症，生存和临终关怀

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-08-01 DOI: 10.1016/j.cppeds.2025.101825

引用次数: 0

The primary care providers role in high-risk pediatric cancer care 初级保健提供者在高危儿童癌症护理中的作用

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-08-01 DOI: 10.1016/j.cppeds.2025.101824

Wilson File M.D., MMEdL, Melissa Mark M.D., Linda Pegram M.D.

Pediatric oncology has seen significant advancements in survival rates over the past decade, yet cancer remains the leading cause of disease-related mortality in children in the United States. In 2024, an estimated 15,000 new pediatric cancer cases were expected, with approximately 10% resulting in death. High-risk cancers, including high-grade gliomas and metastatic solid tumors, present ongoing challenges in treatment and care. This article emphasizes the critical role of primary care providers (PCPs) in the pediatric cancer continuum, particularly in supporting families through initial diagnosis, treatment, and bereavement.

PCPs often serve as the first point of contact for families, making their role in disclosing a cancer diagnosis pivotal. Effective communication strategies are essential to help families navigate the emotional landscape of a cancer diagnosis and to outline subsequent steps in care. The impact of childhood cancer extends beyond the patient, significantly affecting siblings who may experience emotional distress and unmet informational needs.

A pediatric cancer diagnosis has significant psychosocial implications for families and PCPs play a key role by providing a supportive environment for open discussions about cancer and its effects on family dynamics. If curative treatment is no longer possible and there is a shift toward palliative care, it can be helpful for PCPs to maintain continuity of care and support during end-of-life scenarios.

By fostering strong therapeutic relationships and remaining engaged throughout the cancer journey, PCPs can play a vital role in enhancing the overall well-being of pediatric cancer patients and their families, ultimately bridging the gap between specialized oncology care and the medical home.

在过去的十年中，儿童肿瘤学在生存率方面取得了重大进展，但癌症仍然是美国儿童疾病相关死亡的主要原因。2024年，预计将有1.5万例新的儿科癌症病例，其中约10%导致死亡。高风险癌症，包括高级别胶质瘤和转移性实体瘤，在治疗和护理方面面临着持续的挑战。这篇文章强调了初级保健提供者（pcp）在儿童癌症连续体中的关键作用，特别是在通过初始诊断、治疗和丧亲支持家庭方面。pcp通常是家庭的第一个联络点，这使得他们在披露癌症诊断方面的作用至关重要。有效的沟通策略对于帮助家庭应对癌症诊断带来的情绪波动以及勾勒出后续护理步骤至关重要。儿童癌症的影响超出了患者本身，严重影响到可能经历情绪困扰和信息需求未得到满足的兄弟姐妹。儿童癌症诊断对家庭具有重要的心理社会意义，pcp通过提供一个支持性环境，公开讨论癌症及其对家庭动态的影响，发挥了关键作用。如果治愈性治疗不再可能，并且转向姑息治疗，那么pcp在生命末期情景中保持护理和支持的连续性是有帮助的。通过培养强大的治疗关系并在整个癌症过程中保持参与，pcp可以在提高儿科癌症患者及其家庭的整体福祉方面发挥至关重要的作用，最终弥合专业肿瘤护理和医疗家庭之间的差距。

{"title":"The primary care providers role in high-risk pediatric cancer care","authors":"Wilson File M.D., MMEdL, Melissa Mark M.D., Linda Pegram M.D.","doi":"10.1016/j.cppeds.2025.101824","DOIUrl":"10.1016/j.cppeds.2025.101824","url":null,"abstract":"<div><div>Pediatric oncology has seen significant advancements in survival rates over the past decade, yet cancer remains the leading cause of disease-related mortality in children in the United States. In 2024, an estimated 15,000 new pediatric cancer cases were expected, with approximately 10% resulting in death. High-risk cancers, including high-grade gliomas and metastatic solid tumors, present ongoing challenges in treatment and care. This article emphasizes the critical role of primary care providers (PCPs) in the pediatric cancer continuum, particularly in supporting families through initial diagnosis, treatment, and bereavement.</div><div>PCPs often serve as the first point of contact for families, making their role in disclosing a cancer diagnosis pivotal. Effective communication strategies are essential to help families navigate the emotional landscape of a cancer diagnosis and to outline subsequent steps in care. The impact of childhood cancer extends beyond the patient, significantly affecting siblings who may experience emotional distress and unmet informational needs.</div><div>A pediatric cancer diagnosis has significant psychosocial implications for families and PCPs play a key role by providing a supportive environment for open discussions about cancer and its effects on family dynamics. If curative treatment is no longer possible and there is a shift toward palliative care, it can be helpful for PCPs to maintain continuity of care and support during end-of-life scenarios.</div><div>By fostering strong therapeutic relationships and remaining engaged throughout the cancer journey, PCPs can play a vital role in enhancing the overall well-being of pediatric cancer patients and their families, ultimately bridging the gap between specialized oncology care and the medical home.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 8","pages":"Article 101824"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

That spot is not a hemangioma: Identifying other vascular anomalies for the primary care provider 该斑点不是血管瘤：为初级保健提供者确定其他血管异常

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-08-01 DOI: 10.1016/j.cppeds.2025.101822

Katherine D Watson , Melisa Ruiz Gutierrez , Sally J Cohen-Cutler

Vascular anomalies are a broad spectrum of disorders that can be challenging to recognize, risking misdiagnosis. Primary care providers are often the first to evaluate these lesions and must distinguish between more common hemangiomas and rarer vascular malformations that require different management. With the growing availability of treatment approaches including medical therapies, timely referral and ongoing care with a specialty multidisciplinary vascular anomalies clinic is crucial for optimizing outcomes. This primer provides an overview of key diagnostic features, classification, and initial management strategies for primary care teams suspecting a new vascular anomaly diagnosis.

血管异常是一种广泛的疾病，很难识别，有误诊的风险。初级保健提供者往往是第一个评估这些病变，必须区分更常见的血管瘤和罕见的血管畸形，需要不同的处理。随着包括医学治疗在内的治疗方法的不断增加，及时转诊和多学科血管异常专科诊所的持续护理对于优化结果至关重要。本引物提供了关键的诊断特征，分类和初级保健团队怀疑新的血管异常诊断的初步管理策略的概述。

引用次数: 0

Cancer survivorship for the PCP 癌症幸存者的PCP

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-08-01 DOI: 10.1016/j.cppeds.2025.101823

Sharon L. Conner MSN, APRN, FNP-C , Wilson File MD, MMEdL

The number of childhood cancer survivors (CCS) in the United States exceeds 500,000 and continues to rise¹. While recurrence risk diminishes over time, the prevalence of late effects from cancer treatment increases with age and affects over 60% of survivors2, 3. Primary care providers (PCPs) are ideally positioned to manage the long-term health needs of CCS, yet many feel ill-equipped due to a lack of concise guidelines4, 5. This article provides a comprehensive overview for PCPs on managing late effects in CCS. Key areas of focus include general health maintenance, psychological and neurocognitive care, immune function and vaccinations, as well as monitoring for endocrine, cardiovascular, pulmonary, and secondary malignancies. Emphasis is placed on regular screenings and lifestyle modifications. We advocate for proactive PCP involvement in the surveillance and management of late effects associated with childhood cancer treatment.

在美国，儿童癌症幸存者（CCS）的数量超过50万，并且还在继续上升。虽然复发风险随着时间的推移而降低，但癌症治疗的晚期效应随着年龄的增长而增加，影响超过60%的幸存者。初级保健提供者（pcp）在管理CCS的长期健康需求方面处于理想地位，但由于缺乏简明的指导方针，许多人感到装备不足4,5。本文提供了pcp在CCS中管理后期效应的全面概述。重点领域包括一般健康维护、心理和神经认知护理、免疫功能和疫苗接种，以及内分泌、心血管、肺部和继发性恶性肿瘤的监测。重点是定期检查和改变生活方式。我们提倡积极主动的PCP参与监测和管理与儿童癌症治疗相关的晚期效应。

引用次数: 0

Advancing Quality Improvement and Pediatric Primary Care 2025 《推进质量改进和儿科初级保健2025》。

IF 3.7 4区医学 Q1 PEDIATRICS

Current Problems in Pediatric and Adolescent Health Care

Pub Date : 2025-07-01 DOI: 10.1016/j.cppeds.2025.101843

William T. Gerson M.D

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Current Problems in Pediatric and Adolescent Health Care

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀