{"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}
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
Prarthana Khanna, Kaley Jenney, A. Tai, Jill L. Maron
{"title":"Salivary RNA sequencing highlights a sex-specific developmental time course towards oral feeding maturation in the newborn","authors":"Prarthana Khanna, Kaley Jenney, A. Tai, Jill L. Maron","doi":"10.21037/pm-21-45","DOIUrl":"https://doi.org/10.21037/pm-21-45","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":"41389079","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}
Berrin Ergun-Longmire, Patricia Vining-Maravolo, B. Graham, D. Greydanus
{"title":"A narrative review: treatment outcomes of central precocious puberty (CPP)","authors":"Berrin Ergun-Longmire, Patricia Vining-Maravolo, B. Graham, D. Greydanus","doi":"10.21037/pm-21-105","DOIUrl":"https://doi.org/10.21037/pm-21-105","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":"41415744","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}
K. McGrattan, Abigail Spoden, Abbey Sterkowitz, M. Gosa, Michael J Beckstrand, K. Hernandez
Background: Advancements in neonatal medicine have resulted in an increased prevalence of infants suffering from swallowing deficits. One method to treat these deficits is to provide thickened liquids through the use of anti-reflux formulas. However, little is known regarding the impact of common clinical conditions such as time since mixing, caloric density, and refrigeration on the thickness of these anti-reflux formulas. The aim of the investigation was to test the effect of clinical variables on thickness of two commonly used U.S. anti-reflux formulas (Enfamil A.R.™ and Similac Spit-Up ® ) in their ready to feed and powder formulations. Methods: Thickness of two anti-reflux formulas (Enfamil A.R.™ and Similac Spit-Up ® ) was tested in their 20 kcal/oz ready to feed formulation and at graduated caloric densities of their powder formulations (20–30 kcal/oz). Thickness was determined using International Dysphagia Diet Standardization Initiative (IDDSI) flow testing methodology and quantified as residual volume and thickness category (thin, slightly thick, mildly thick, moderately thick). Repeated-measures and two-way ANOVA was used to test the effect of formula variables on thickness. Results: Time after mixing did not impact thickness of 20 kcal/oz ready to feed formulations (Enfamil A.R.™, slightly thick, 1.3, 1.1–1.5 mL) (Similac Spit-Up ® , thin, 0.7, 0.4–0.8 mL) though it did for Enfamil A.R.™ powder formulations as characterized by an increase in thickness from thin to slightly thick over 30 minutes. Increasing caloric density of Enfamil A.R.™ caused a stepwise increase in thickness, with thicknesses ranging from slightly thick to moderately thick at the end of the 30-minute testing period across 20–30 kcal/oz formulations. Similac Spit-Up ® did not exhibit any change in thickness based on caloric density. Both Enfamil A.R.™ and Similac Spit-Up ® showed non-significant trends of increased thickness when tested cold after three hours of refrigeration, followed by thinning close to baseline values once the formula was re-heated. Conclusions: Although Enfamil A.R.™ is a valid slightly thick liquid option in its ready to feed formulation, the validity of its powder formulation to reach slightly thick designation is dependent on its caloric density. Future investigations examining the safety of this practice are warranted.
{"title":"Validity of anti-reflux formulas as a slightly thick liquid: effect of time, caloric density, and refrigerated storage on formula thickness","authors":"K. McGrattan, Abigail Spoden, Abbey Sterkowitz, M. Gosa, Michael J Beckstrand, K. Hernandez","doi":"10.21037/pm-21-44","DOIUrl":"https://doi.org/10.21037/pm-21-44","url":null,"abstract":"Background: Advancements in neonatal medicine have resulted in an increased prevalence of infants suffering from swallowing deficits. One method to treat these deficits is to provide thickened liquids through the use of anti-reflux formulas. However, little is known regarding the impact of common clinical conditions such as time since mixing, caloric density, and refrigeration on the thickness of these anti-reflux formulas. The aim of the investigation was to test the effect of clinical variables on thickness of two commonly used U.S. anti-reflux formulas (Enfamil A.R.™ and Similac Spit-Up ® ) in their ready to feed and powder formulations. Methods: Thickness of two anti-reflux formulas (Enfamil A.R.™ and Similac Spit-Up ® ) was tested in their 20 kcal/oz ready to feed formulation and at graduated caloric densities of their powder formulations (20–30 kcal/oz). Thickness was determined using International Dysphagia Diet Standardization Initiative (IDDSI) flow testing methodology and quantified as residual volume and thickness category (thin, slightly thick, mildly thick, moderately thick). Repeated-measures and two-way ANOVA was used to test the effect of formula variables on thickness. Results: Time after mixing did not impact thickness of 20 kcal/oz ready to feed formulations (Enfamil A.R.™, slightly thick, 1.3, 1.1–1.5 mL) (Similac Spit-Up ® , thin, 0.7, 0.4–0.8 mL) though it did for Enfamil A.R.™ powder formulations as characterized by an increase in thickness from thin to slightly thick over 30 minutes. Increasing caloric density of Enfamil A.R.™ caused a stepwise increase in thickness, with thicknesses ranging from slightly thick to moderately thick at the end of the 30-minute testing period across 20–30 kcal/oz formulations. Similac Spit-Up ® did not exhibit any change in thickness based on caloric density. Both Enfamil A.R.™ and Similac Spit-Up ® showed non-significant trends of increased thickness when tested cold after three hours of refrigeration, followed by thinning close to baseline values once the formula was re-heated. Conclusions: Although Enfamil A.R.™ is a valid slightly thick liquid option in its ready to feed formulation, the validity of its powder formulation to reach slightly thick designation is dependent on its caloric density. Future investigations examining the safety of this practice are warranted.","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":"49635101","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：