E. Clemente, M. D. Cabral, Mackenna L. Senti, D. Patel
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
{"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}
: 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.
{"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}
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
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
{"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}
G. Com, Haripriya Santhanam, Berrin Ergun-Longmire
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.
{"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}
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