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Pediatric Dermatology for People of Color. 有色人种儿科皮肤病学》。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240205-07
Muayad M Shahin, Henry T Quach, K. Marathe
When evaluating pediatric patients of color, it is essential to consider the unique diagnostic and treatment factors that apply to this population. Certain dermatologic conditions are more common in these patients, including postinflammatory hyperpigmentation, pityriasis alba, progressive macular hypomelanosis, tinea capitis, traction alopecia, keloids, hypertrophic scars, pseudofolliculitis barbae, acne keloidalis nuchae, and hidradenitis suppurativa. Furthermore, conditions such as vitiligo are more noticeable in people of color. This can lead to a significantly diminished quality of life, so these conditions should be quickly recognized and treated. Notably, inflammation can be difficult to recognize on the skin of people of color, which can lead to the underestimation of severity as well as inappropriate treatment. Treatment recommendations can also differ based on lifestyle or cultural norms, such as the use of tinted sunscreens and the consideration of hair care practices. Pediatricians should be aware of these conditions and treatment considerations to best treat pediatric patients of color. [Pediatr Ann. 2024;53(4):e146-e151.].
在对有色人种儿科患者进行评估时，必须考虑到适用于这一人群的独特诊断和治疗因素。某些皮肤病在这些患者中更为常见，包括炎症后色素沉着、白癣、进行性斑状色素减退症、头癣、牵引性脱发、瘢痕疙瘩、增生性疤痕、假性毛囊炎、瘢痕疙瘩和化脓性扁桃体炎。此外，白癜风等疾病在有色人种中更为明显。这可能会导致生活质量大大降低，因此应尽快识别并治疗这些疾病。值得注意的是，有色人种皮肤上的炎症可能很难识别，这可能导致低估严重程度和治疗不当。治疗建议也可能因生活方式或文化规范而异，如使用有色防晒霜和考虑头发护理方法。儿科医生应了解这些情况和治疗注意事项，以便为有色人种儿科患者提供最佳治疗。[2024;53(4):e146-e151.].
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引用次数: 0
Adolescent HIV Screening and Opt-Out Testing as a Standard of Care. 将青少年艾滋病筛查和选择性退出检测作为护理标准。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240205-03
Bako Orionzi
Despite the significant steps made in the diagnosis and treatment of HIV, there is still a notable amount of people living with HIV without being diagnosed, with a fair portion of these infections occurring in adolescents and young adults. For some individuals, by the time they are diagnosed they are living with advanced-staged disease, missing the opportunity for receiving antiretroviral treatment that would have markedly reduced their morbidity, mortality, and risk of transmission to others. Opt-out testing, or notifying the patient the test will be performed unless explicitly declined or deferred, increases the rates of testing while reducing the stigma of the disease. It is a universal recommendation for those between ages 13 and 55 years to have an HIV screening test. It should be standard of care for HIV tests in the adolescent population to be structured as an opt-out screening in both the ambulatory and acute care settings. [Pediatr Ann. 2024;53(4):e111-e113.].
尽管在艾滋病毒的诊断和治疗方面取得了重大进展，但仍有相当数量的艾滋病毒感染者没有得到诊断，其中相当一部分感染者是青少年和年轻成年人。对于一些人来说，当他们被确诊时，他们已经是晚期患者，错过了接受抗逆转录病毒治疗的机会，而这种治疗本可以显著降低他们的发病率、死亡率和传染给他人的风险。选择不接受检测，或通知患者除非明确拒绝或推迟，否则将进行检测，可以提高检测率，同时减少疾病带来的耻辱感。普遍建议 13 岁至 55 岁的人群接受艾滋病毒筛查检测。在门诊和急症护理环境中，对青少年人群进行艾滋病病毒检测应作为选择不接受筛查的标准护理。[2024;53(4):e111-e113.].
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引用次数: 0
Review of Current Concepts in Metatarsus Adductus. 跖骨内收的当前概念回顾。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240206-02
Jonathan Daniel Freedman, M. Eidelman, Elad Apt, P. Kotlarsky
Metatarsus adductus (MA), the most common congenital foot deformity, involves adduction of the forefoot at the tarsometatarsal joint, with normal hindfoot alignment. Early diagnosis is important because treatment is more successful if initiated before age 9 months. Treatment of MA depends on deformity severity, in which mild to moderate deformity can be treated conservatively. Current standard of care for severe or rigid deformity involves referral by primary care physicians to specialists for management by casting and splinting. Recently, several orthoses have demonstrated equal effectiveness to casting and may allow for primary care physicians to treat MA without the need for referral. In this review article, we provide an overview of MA and discuss diagnosis and treatment. We also discuss novel devices and suggest how they may affect the future management of severe and rigid MA. [Pediatr Ann. 2024;53(4):e152-e156.].
跖骨内收（MA）是最常见的先天性足部畸形，表现为前足在跗跖关节处内收，后足排列正常。早期诊断非常重要，因为如果能在 9 个月之前开始治疗，治疗效果会更好。马氏畸形的治疗取决于畸形的严重程度，轻度至中度畸形可采取保守治疗。对于严重或僵硬的畸形，目前的标准治疗方法是由初级保健医生转诊给专科医生，通过石膏和夹板进行治疗。最近，有几种矫形器显示出与石膏固定同等的效果，可以让初级保健医生无需转诊即可治疗 MA。在这篇综述文章中，我们概述了 MA 并讨论了诊断和治疗。我们还讨论了新型矫形器，并提出了这些矫形器可能对严重和僵硬型 MA 的未来管理产生的影响。[2024;53(4):e152-e156.].
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引用次数: 0
Pediatric Acne Vulgaris: A Guide for Recognition, Examination, Referral, and Treatment. 小儿痤疮：识别、检查、转诊和治疗指南》。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240205-05
Jennifer B Scott, Natalie G Allen, Andrea L Zaenglein
Acne is a common skin condition in adolescent patients but much less common in childhood. Pediatric providers should be familiar with the varying presentations in the pediatric population and recognize when additional physical signs of hyperandrogenism are present. This article details the pathogenesis and presentation of acne in infancy, mid-childhood, and preadolescence. The differential diagnosis is discussed and recommendations for initial workup, referral, and treatment are provided. [Pediatr Ann. 2024;53(4):e115-e120.].
痤疮是青少年患者常见的皮肤病，但在儿童时期则少见得多。儿科医疗人员应熟悉儿科人群的不同表现，并能识别高雄激素症的其他体征。本文详细介绍了婴儿期、儿童中期和青春期前期痤疮的发病机制和表现。文章讨论了鉴别诊断，并对初步检查、转诊和治疗提出了建议。[2024;53(4):e115-e120.].
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引用次数: 0
Criteria for Urinary Tract Infection in Children Younger Than Age 3 Years: A New Cutoff and New Criteria. 3 岁以下儿童尿路感染的标准：新临界值和新标准。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240316-01
Lolita Alcocer Alkureishi, J. Hageman
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引用次数: 0
Updates in Dermatology. 皮肤病学最新进展。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240206-01
Megha M Tollefson, Dawn Marie R. Davis
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引用次数: 0
Atopic Dermatitis in Children. 儿童特应性皮炎
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-04-01 DOI: 10.3928/19382359-20240205-02
Lacey L Kruse, Anthony J Mancini
Atopic dermatitis (AD) is extremely common in the pediatric population, and most children with AD will first present to their primary care provider (PCP). The PCP can recognize AD by its clinical features, including itch, a chronic relapsing course, and the characteristic eruption. The cornerstone of AD therapy is dry skin care, typically a short daily bath/shower followed by an emollient applied to all skin. Most children with AD will also require topical medications, such as topical corticosteroids and/or topical nonsteroidal therapies. For children with more severe disease, systemic agents, including several novel therapies, may be required. In managing AD, the clinician must monitor for side effects of medications as well as complications of the AD itself, the most common of which is secondary infection. An understanding of the pathogenesis, treatments, and complications of AD is essential for the PCP, as untreated (or undertreated) AD has a significant impact on the quality of life of affected children and their caregivers. [Pediatr Ann. 2024;53(4):e121-e128.].
特应性皮炎（AD）在儿科人群中极为常见，大多数患有 AD 的儿童都会首先到初级保健医生（PCP）处就诊。初级保健医生可以根据特应性皮炎的临床特征（包括瘙痒、慢性复发性病程和特征性糜烂）来识别特应性皮炎。干性皮肤护理是 AD 治疗的基础，通常是每天进行短时间的沐浴，然后在所有皮肤上涂抹润肤剂。大多数 AD 患儿还需要外用药物，如外用皮质类固醇激素和/或外用非类固醇疗法。对于病情较重的儿童，可能需要使用全身性药物，包括几种新型疗法。在管理 AD 时，临床医生必须监测药物的副作用以及 AD 本身的并发症，其中最常见的是继发感染。了解 AD 的发病机制、治疗方法和并发症对初级保健医生来说至关重要，因为未经治疗（或治疗不足）的 AD 会严重影响患儿及其护理人员的生活质量。[2024; 53(4):e121-e128.].
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引用次数: 1
Telehealth and Children with Medical Complexity. 远程医疗与医疗复杂的儿童。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-03-01 DOI: 10.3928/19382359-20240109-01
Ruchi Kaushik

Although use of telehealth may have begun centuries ago and has grown considerably through the 20th century, the coronavirus disease 2019 pandemic skyrocketed telemedicine's reach, including its use in pediatrics. The American Academy of Pediatrics endorses telehealth as a "critical infrastructure to efficiently implement the medical home model of care." Particularly for children with medical complexity (CMC), telehealth offers great promise to improve access to continuous, coordinated primary care, reduce time to pediatric subspecialty care, and support distance education for both pediatric providers and patients and their families. This article details the numerous benefits of telehealth to CMC with an emphasis on its use as an extender of the medical home, describes the venues in which telehealth augments access to safe, high-quality care, presents best practices in engaging in telehealth encounters, and enumerates barriers that may exacerbate current health inequities. We review current published telehealth patient-/caregiver-level, clinician-level, and payor-level outcomes while revealing research gaps and opportunities. [Pediatr Ann. 2024;53(3):e74-e81.].

尽管远程医疗的使用可能始于几个世纪前，并在 20 世纪得到了长足发展，但 2019 年冠状病毒疾病的大流行使远程医疗的覆盖范围急剧扩大，包括在儿科领域的使用。美国儿科学会赞同将远程医疗作为 "有效实施医疗之家护理模式的关键基础设施"。特别是对于病情复杂的儿童（CMC），远程医疗在改善持续、协调的初级医疗服务、缩短儿科亚专科医疗服务时间、支持儿科医疗服务提供者和患者及其家属的远程教育方面大有可为。本文详细介绍了远程医疗对儿童医疗中心的诸多益处，重点强调了远程医疗作为医疗之家延伸服务的用途，描述了远程医疗增加获得安全、优质医疗服务的途径，介绍了参与远程医疗会诊的最佳实践，并列举了可能加剧当前医疗不平等的障碍。我们回顾了目前已发表的远程医疗患者/护理人员层面、临床医生层面和付款人层面的成果，同时揭示了研究差距和机遇。[2024;53(3):e74-e81.].
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引用次数: 0
Navigating Difficult Conversations in Caring for Children with Medical Complexity. 在照顾病情复杂的儿童过程中引导困难对话。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-03-01 DOI: 10.3928/19382359-20240109-04
Patricia K DeForest

Pediatricians are faced with a multitude of difficult tasks each day for a variety of age groups. Providing medical care and support to children with medical complexity and their families adds additional challenges, including management of polypharmacy, therapies, complications, and difficult conversations. The relationship a family has with their pediatrician is extremely special and valuable. As such, pediatricians may find themselves guiding parents through decision-making without the proper training or tools. They may struggle with navigating the conversations to assist families in reaching a helpful conclusion. This article reviews three difficult situations that families of children with medical complexity may face and three different readily available and valuable frameworks to assist with navigating those difficult conversations. [Pediatr Ann. 2024;53(3):e99-e103.].

儿科医生每天都要面对不同年龄段儿童的各种棘手任务。为病情复杂的儿童及其家庭提供医疗护理和支持，又增加了额外的挑战，包括管理多种药物、治疗、并发症和艰难的对话。一个家庭与儿科医生的关系是极其特殊和宝贵的。因此，儿科医生可能会发现自己在没有适当培训或工具的情况下指导家长做出决策。他们可能会努力引导对话，帮助家庭达成有益的结论。这篇文章回顾了医疗复杂性儿童家庭可能面临的三种困难情况，以及三种不同的现成且有价值的框架，以帮助引导这些困难的对话。[2024;53(3):e99-e103.].
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引用次数: 0
Integrative Care for Children with Medical Complexities. 为病情复杂的儿童提供综合护理。
IF 1.1 4区 医学 Q3 Medicine
Pediatric Annals
Pub Date : 2024-03-01 DOI: 10.3928/19382359-20240108-01
Wisdeen Wu, Patricia K DeForest
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引用次数: 0
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