Respiratory syncytial viral infections cause considerable childhood morbidity, and in some countries significant mortality, especially in infants with pre-existing conditions such as bronchopulmonary dysplasia and congenital heart disease. Currently, there is no active vaccine and attempts to prevent and ameliorate the effects of infection are focused on passive immunization by human monoclonal antibodies. This review focuses on the clinical sequelae of respiratory syncytial viral infections in high-risk patients and discusses the effects of public health measures and passive immunization on medical and socioeconomic outcomes.
{"title":"Strategies for reducing the burden of respiratory syncytial virus in high-risk infants","authors":"Archanna Priyadarshi, A. Jaffe, T. Walls, J. Oei","doi":"10.2217/PHE.09.31","DOIUrl":"https://doi.org/10.2217/PHE.09.31","url":null,"abstract":"Respiratory syncytial viral infections cause considerable childhood morbidity, and in some countries significant mortality, especially in infants with pre-existing conditions such as bronchopulmonary dysplasia and congenital heart disease. Currently, there is no active vaccine and attempts to prevent and ameliorate the effects of infection are focused on passive immunization by human monoclonal antibodies. This review focuses on the clinical sequelae of respiratory syncytial viral infections in high-risk patients and discusses the effects of public health measures and passive immunization on medical and socioeconomic outcomes.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"391-406"},"PeriodicalIF":0.0,"publicationDate":"2009-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.31","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68241137","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}
Evaluation of: Spycher BD, Silverman M, Egger M, Zqahlen M, Kuehni CE: Routine vaccination against pertussis and the risk of childhood asthma: a population-based cohort study. Pediatrics 123(4), 944–950 (2009). Asthma is the most common chronic disease of childhood in developed countries and its prevalence has been increasing. It has been suggested that infant and childhood vaccinations may be contributing to the increasing prevalence of asthma. Since vaccination is universally recommended for infants, any association between infant vaccinations and the occurrence of a common serious condition, such as asthma, could be of considerable public health importance. Many studies have been conducted evaluating a possible association between vaccination and asthma and other allergic conditions. Spycher and colleagues recently published a study of whole-cell pertussis vaccination and risk of wheezing and asthma. The importance of this new study is that the investigators tried to overcome the limitations of previou...
Spycher BD, Silverman M, Egger M, Zqahlen M, Kuehni CE:百日咳常规疫苗接种与儿童哮喘风险:一项基于人群的队列研究。儿科学123(4)，944-950(2009)。哮喘是发达国家儿童最常见的慢性疾病，其患病率呈上升趋势。有人认为，婴儿和儿童接种疫苗可能是导致哮喘患病率上升的原因。由于普遍建议对婴儿接种疫苗，因此婴儿接种疫苗与哮喘等常见严重疾病的发生之间的任何关联都可能具有相当大的公共卫生重要性。已经进行了许多研究，评估疫苗接种与哮喘和其他过敏性疾病之间的可能联系。Spycher及其同事最近发表了一项关于全细胞百日咳疫苗接种与喘息和哮喘风险的研究。这项新研究的重要性在于，研究人员试图克服以往研究的局限性。
{"title":"Childhood vaccinations and asthma","authors":"F. Destefano","doi":"10.2217/PHE.09.27","DOIUrl":"https://doi.org/10.2217/PHE.09.27","url":null,"abstract":"Evaluation of: Spycher BD, Silverman M, Egger M, Zqahlen M, Kuehni CE: Routine vaccination against pertussis and the risk of childhood asthma: a population-based cohort study. Pediatrics 123(4), 944–950 (2009). Asthma is the most common chronic disease of childhood in developed countries and its prevalence has been increasing. It has been suggested that infant and childhood vaccinations may be contributing to the increasing prevalence of asthma. Since vaccination is universally recommended for infants, any association between infant vaccinations and the occurrence of a common serious condition, such as asthma, could be of considerable public health importance. Many studies have been conducted evaluating a possible association between vaccination and asthma and other allergic conditions. Spycher and colleagues recently published a study of whole-cell pertussis vaccination and risk of wheezing and asthma. The importance of this new study is that the investigators tried to overcome the limitations of previou...","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"307-310"},"PeriodicalIF":0.0,"publicationDate":"2009-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.27","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68241002","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}
Acute gastroenteritis commonly causes diarrhea and vomiting in children and adolescents, resulting in many outpatient clinic visits, emergency department visits and hospitalizations, often owing to dehydration that results from persistent diarrhea and vomiting. The use of antiemetics (medications that prevent nausea and vomiting) has been controversial for children with gastroenteritis. While antiemetics can cause adverse events, including more diarrhea, scientific evidence suggests that certain antiemetics, particularly ondansetron, can reduce vomiting and decrease the chance that a child will need intravenous fluids or have to be admitted to the hospital.
{"title":"Role of antiemetic drugs for the treatment of acute gastroenteritis in children","authors":"R. Vreeman","doi":"10.2217/PHE.09.32","DOIUrl":"https://doi.org/10.2217/PHE.09.32","url":null,"abstract":"Acute gastroenteritis commonly causes diarrhea and vomiting in children and adolescents, resulting in many outpatient clinic visits, emergency department visits and hospitalizations, often owing to dehydration that results from persistent diarrhea and vomiting. The use of antiemetics (medications that prevent nausea and vomiting) has been controversial for children with gastroenteritis. While antiemetics can cause adverse events, including more diarrhea, scientific evidence suggests that certain antiemetics, particularly ondansetron, can reduce vomiting and decrease the chance that a child will need intravenous fluids or have to be admitted to the hospital.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"337-341"},"PeriodicalIF":0.0,"publicationDate":"2009-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.32","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68241149","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 use of gastrointestinal decontamination (GID) has long been held as a primary tenet in the initial management of a poisoned pediatric patient. Although this approach seems logical, there is a lack of clinical evidence to indicate that GID use changes ultimate clinical outcome. Recent recommendations and guidelines have advised against routine use of any method of GID. With this in mind, the contraindications and safety precautions with each of these techniques deserve emphasized consideration. Recent research has endeavored to find more specific indications for GID in which clear clinical outcomes may be measured. With the removal of ipecac, the hunt for a safe and effective form of GID that can be used at home has also received research interest.
{"title":"Methods of hospital and prehospital gastrointestinal decontamination in children","authors":"David L. Eldridge","doi":"10.2217/PHE.09.34","DOIUrl":"https://doi.org/10.2217/PHE.09.34","url":null,"abstract":"The use of gastrointestinal decontamination (GID) has long been held as a primary tenet in the initial management of a poisoned pediatric patient. Although this approach seems logical, there is a lack of clinical evidence to indicate that GID use changes ultimate clinical outcome. Recent recommendations and guidelines have advised against routine use of any method of GID. With this in mind, the contraindications and safety precautions with each of these techniques deserve emphasized consideration. Recent research has endeavored to find more specific indications for GID in which clear clinical outcomes may be measured. With the removal of ipecac, the hunt for a safe and effective form of GID that can be used at home has also received research interest.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"359-367"},"PeriodicalIF":0.0,"publicationDate":"2009-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.34","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68241210","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}
Although vaccines are among the most effective public health interventions, safe delivery of safe vaccines is a priority in order to maintain public confidence and obtain maximum public health benefit. In order to assure that the vaccines we use are safe, adequate vaccine safety assessment is required on a global level. The purpose of this article is to review the current vaccine safety infrastructure, to identify deficits in the current systems and to identify approaches to improving the current infrastructure.
{"title":"Global trends and challenges in vaccine safety","authors":"S. Black, P. Zuber","doi":"10.2217/PHE.09.25","DOIUrl":"https://doi.org/10.2217/PHE.09.25","url":null,"abstract":"Although vaccines are among the most effective public health interventions, safe delivery of safe vaccines is a priority in order to maintain public confidence and obtain maximum public health benefit. In order to assure that the vaccines we use are safe, adequate vaccine safety assessment is required on a global level. The purpose of this article is to review the current vaccine safety infrastructure, to identify deficits in the current systems and to identify approaches to improving the current infrastructure.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"329-335"},"PeriodicalIF":0.0,"publicationDate":"2009-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.25","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68240940","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}
Subcutaneous immunoglobulin (SCIG) therapy is recognized as a standard treatment for primary antibody deficiency. SCIG is efficacious for the prevention of infections and is associated with a lower risk of systemic side effects, improved quality of life for patients and families and is preferred by children when compared with intravenous immunoglobulin replacement. For pediatric patients, SCIG is an ideal treatment modality that affords children and families more freedom and less disruption of important childhood activities. This article reviews the characteristics of SCIG to provide the pediatric practitioner with an understanding of the experiences their patients receiveing SCIG may encounter.
{"title":"Subcutaneous immunoglobulin therapy in pediatric primary antibody deficiency","authors":"M. Moore, J. Quinn","doi":"10.2217/PHE.09.17","DOIUrl":"https://doi.org/10.2217/PHE.09.17","url":null,"abstract":"Subcutaneous immunoglobulin (SCIG) therapy is recognized as a standard treatment for primary antibody deficiency. SCIG is efficacious for the prevention of infections and is associated with a lower risk of systemic side effects, improved quality of life for patients and families and is preferred by children when compared with intravenous immunoglobulin replacement. For pediatric patients, SCIG is an ideal treatment modality that affords children and families more freedom and less disruption of important childhood activities. This article reviews the characteristics of SCIG to provide the pediatric practitioner with an understanding of the experiences their patients receiveing SCIG may encounter.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"77 1","pages":"231-240"},"PeriodicalIF":0.0,"publicationDate":"2009-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.17","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68240858","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}
Infants with gastroesophageal reflux present with multiple symptoms, including irritability. When a physician is evaluating such an irritable infant, she/he would often prescribe a histamine 2 receptor antagonist blocker. When this fails, proton-pump inhibitors (PPIs) are often prescribed. Evidence demonstrates that there has been a fourfold increase in the use of PPIs, which may be prescribed in children as young as 2 weeks of age. This article addresses multiple issues: variable pharmacokinetics, risk of infection, absence of an adequate oral preparation, and lack of clear evidence to support the efficacy of PPIs in irritable infants. Extreme caution should be used in prescribing PPIs to this vulnerable age group, particularly those less than 6 months of age. Until more data are available, we suggest that PPIs should be used only in infants with well-documented gastroesophageal reflux disease or as part of a clinical trial.
{"title":"Prescribing proton-pump inhibitors to irritable infants: where is the evidence?","authors":"T. Gunasekaran, Shikha Singla, M. Dahlberg","doi":"10.2217/PHE.09.18","DOIUrl":"https://doi.org/10.2217/PHE.09.18","url":null,"abstract":"Infants with gastroesophageal reflux present with multiple symptoms, including irritability. When a physician is evaluating such an irritable infant, she/he would often prescribe a histamine 2 receptor antagonist blocker. When this fails, proton-pump inhibitors (PPIs) are often prescribed. Evidence demonstrates that there has been a fourfold increase in the use of PPIs, which may be prescribed in children as young as 2 weeks of age. This article addresses multiple issues: variable pharmacokinetics, risk of infection, absence of an adequate oral preparation, and lack of clear evidence to support the efficacy of PPIs in irritable infants. Extreme caution should be used in prescribing PPIs to this vulnerable age group, particularly those less than 6 months of age. Until more data are available, we suggest that PPIs should be used only in infants with well-documented gastroesophageal reflux disease or as part of a clinical trial.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"213-215"},"PeriodicalIF":0.0,"publicationDate":"2009-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68240875","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}
Respiratory infections are common in children and are responsible for serious morbidity, significant mortality and large healthcare expenditures worldwide. Three of the most common respiratory infections in children are bronchiolitis, croup and community-acquired pneumonia. Despite advances in the care of children with respiratory infections, shortfalls in the safe, timely, effective, efficient, equitable and patient-centered domains of quality remain. This article reviews and summarizes the advances that have improved the quality of care for bronchiolitis, croup and community-acquired pneumonia during the last 5 years and identifies shortfalls that must be addressed. In this article, we also discuss the future of the quality of care for pediatric respiratory infections.
{"title":"Quality of care for common pediatric respiratory infections: shortfalls and improvements","authors":"Keith J. Mann, J. Knapp","doi":"10.2217/PHE.09.26","DOIUrl":"https://doi.org/10.2217/PHE.09.26","url":null,"abstract":"Respiratory infections are common in children and are responsible for serious morbidity, significant mortality and large healthcare expenditures worldwide. Three of the most common respiratory infections in children are bronchiolitis, croup and community-acquired pneumonia. Despite advances in the care of children with respiratory infections, shortfalls in the safe, timely, effective, efficient, equitable and patient-centered domains of quality remain. This article reviews and summarizes the advances that have improved the quality of care for bronchiolitis, croup and community-acquired pneumonia during the last 5 years and identifies shortfalls that must be addressed. In this article, we also discuss the future of the quality of care for pediatric respiratory infections.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"261-269"},"PeriodicalIF":0.0,"publicationDate":"2009-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68240989","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":"Do parents who smoke really cause asthma or allergies in their children","authors":"T. Keil, M. Kulig","doi":"10.2217/PHE.09.19","DOIUrl":"https://doi.org/10.2217/PHE.09.19","url":null,"abstract":"","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"203-204"},"PeriodicalIF":0.0,"publicationDate":"2009-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68240891","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}
Recent research in anorexia nervosa has demonstrated specific and persistent neuropsychological deficits associated with specific, localized and unilateral abnormalities on neuroimaging. These point to an underlying neurobiological substrate, with a disconnection in neural circuitry being implicated. This article summarizes the most relevant studies presented at the 9th London International Conference on Eating Disorders and discusses the treatment implications.
{"title":"Neuroscience of anorexia nervosa: state of the art","authors":"S. Agrawal, B. Lask","doi":"10.2217/PHE.09.28","DOIUrl":"https://doi.org/10.2217/PHE.09.28","url":null,"abstract":"Recent research in anorexia nervosa has demonstrated specific and persistent neuropsychological deficits associated with specific, localized and unilateral abnormalities on neuroimaging. These point to an underlying neurobiological substrate, with a disconnection in neural circuitry being implicated. This article summarizes the most relevant studies presented at the 9th London International Conference on Eating Disorders and discusses the treatment implications.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"3 1","pages":"209-212"},"PeriodicalIF":0.0,"publicationDate":"2009-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.09.28","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68241047","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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