The clinical need for better treatments as well as the significant progress in understanding the pathophysiology of inflammation on one hand, and the progressive development of biotechnology on the other, were the driving force for the emergence of new treatments for autoimmune disorders at the beginning of the 21st century, heralding the ‘age of biologic response modifying agents’ or biologics. This new class of drugs, although in use for just over a decade, has revolutionized the treatment of many inflammatory disorders, such as rheumatic, connective tissue disorders, autoimmune and autoinflammatory diseases. They have already made an immense impact on the quality of life of patients experiencing many years of combined immunosuppressive and anti-inflammatory treatments for chronic and often debilitating diseases. As these drugs were developed with the aim of altering specific components in the immune system function and, in particular, the inflammatory response, it is not surprising that infectious comp...
{"title":"An overview of infectious complications in children on new biologic response-modifying agents","authors":"M. Abinun","doi":"10.2217/PHE.10.57","DOIUrl":"https://doi.org/10.2217/PHE.10.57","url":null,"abstract":"The clinical need for better treatments as well as the significant progress in understanding the pathophysiology of inflammation on one hand, and the progressive development of biotechnology on the other, were the driving force for the emergence of new treatments for autoimmune disorders at the beginning of the 21st century, heralding the ‘age of biologic response modifying agents’ or biologics. This new class of drugs, although in use for just over a decade, has revolutionized the treatment of many inflammatory disorders, such as rheumatic, connective tissue disorders, autoimmune and autoinflammatory diseases. They have already made an immense impact on the quality of life of patients experiencing many years of combined immunosuppressive and anti-inflammatory treatments for chronic and often debilitating diseases. As these drugs were developed with the aim of altering specific components in the immune system function and, in particular, the inflammatory response, it is not surprising that infectious comp...","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"509-517"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.57","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68243471","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}
Chronic renal impairment in children with cancer may be caused by the malignant process itself or result from adverse effects of treatment including cytotoxic drugs, radiotherapy, surgery or supportive treatment. Although severe renal chronic disease is uncommon, occurring in only 0.8% of long-term survivors of childhood cancer, 1.9% of all cases of established renal failure are due to malignancy and 0.8% to drug nephrotoxicity. The relative risk of severe renal chronic disease (compared with siblings) is 8.1, and that of renal failure or the need for dialysis is 8.9. The cytotoxic drugs most likely to cause important chronic nephrotoxicity are ifosfamide and cisplatin, both of which are used widely in many solid tumors and may cause chronic glomerular and/or renal tubular toxicity in 30–60% of treated children. Significant renal toxicity is less frequent with other chemotherapeutic drugs, but may result from treatment with carboplatin, methotrexate and nitrosoureas. Other cytotoxic drugs occasionally cau...
{"title":"Nephrotoxicity of cancer treatment in children","authors":"R. Skinner","doi":"10.2217/PHE.10.60","DOIUrl":"https://doi.org/10.2217/PHE.10.60","url":null,"abstract":"Chronic renal impairment in children with cancer may be caused by the malignant process itself or result from adverse effects of treatment including cytotoxic drugs, radiotherapy, surgery or supportive treatment. Although severe renal chronic disease is uncommon, occurring in only 0.8% of long-term survivors of childhood cancer, 1.9% of all cases of established renal failure are due to malignancy and 0.8% to drug nephrotoxicity. The relative risk of severe renal chronic disease (compared with siblings) is 8.1, and that of renal failure or the need for dialysis is 8.9. The cytotoxic drugs most likely to cause important chronic nephrotoxicity are ifosfamide and cisplatin, both of which are used widely in many solid tumors and may cause chronic glomerular and/or renal tubular toxicity in 30–60% of treated children. Significant renal toxicity is less frequent with other chemotherapeutic drugs, but may result from treatment with carboplatin, methotrexate and nitrosoureas. Other cytotoxic drugs occasionally cau...","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"519-538"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.60","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68243490","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}
Streptococcus pneumoniae kills nearly 1 million children before their fifth birthdays each year, mostly in the developing world. Current pneumococcal vaccines provide effective, serotype-specific protection, yet no licensed vaccine today offers broad coverage against all of S. pneumoniae’s more than 90 serotypes. Although low-income countries are beginning to gain access to these lifesaving vaccines via assistance from global health partnerships, such vaccines are otherwise unaffordable for poorer nations due to the relative complexity and the high costs associated with their development and production. Over the long term, new vaccines are needed that can maximize protection in the developing world and that even the poorest countries can sustainably afford without assistance. To this end, PATH’s pneumococcal vaccine project is working with public- and private-sector partners to develop safe, affordable and effective vaccines against S. pneumoniae tailored to meet the needs of infants and children in the d...
Children with disease that are admitted to hospitals are vulnerable to an inadequate intake of energy and essential nutrients. Therefore, adequate diet is important to meet their growing energy needs and to help reduce malnutrition-related incidence of morbidity and mortality. An effective nutritional support among pediatric patients in the clinical setting depends largely on accurate estimation of energy requirements. Hence, recommendation for calorie intake based on measurements of total energy expenditure of pediatric patients is highly warranted. Currently, numerous assessment methods for determining energy expenditure are available and feasible for use among children. However, it is important for clinicians to understand the strengths and limitations of these different techniques in order to optimize the outcome during recovery of their patients. Advocating appropriate recommendation is essential for the enhancement of nutritional support management for patients in a cost-effective manner.
{"title":"Predicting energy requirements of pediatric patients with disease: which methods are appropriate?","authors":"S. Tan, B. Poh, R. Jamal, I. Noor","doi":"10.2217/PHE.10.51","DOIUrl":"https://doi.org/10.2217/PHE.10.51","url":null,"abstract":"Children with disease that are admitted to hospitals are vulnerable to an inadequate intake of energy and essential nutrients. Therefore, adequate diet is important to meet their growing energy needs and to help reduce malnutrition-related incidence of morbidity and mortality. An effective nutritional support among pediatric patients in the clinical setting depends largely on accurate estimation of energy requirements. Hence, recommendation for calorie intake based on measurements of total energy expenditure of pediatric patients is highly warranted. Currently, numerous assessment methods for determining energy expenditure are available and feasible for use among children. However, it is important for clinicians to understand the strengths and limitations of these different techniques in order to optimize the outcome during recovery of their patients. Advocating appropriate recommendation is essential for the enhancement of nutritional support management for patients in a cost-effective manner.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"42 1","pages":"479-489"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.51","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68242279","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}
Male hypogonadism results from inadequate testicular function manifested by the impairment of both testosterone secretion and spermatogenesis. Hypogonadism has several etiologies. Hypogonadotropic hypogonadism (HH) results from hypothalamic–pituitary disorders leading to a complete or partial deficiency in gonadotropin-releasing hormone (GnRH) secretion from hypothalamic neurons, or gonadotropin secretion from anterior pituitary, or defects in GnRH receptor at the pituitary. All situations result in low or normal serum gonadotropin levels and low serum testosterone levels. Congenital HH can occur isolated (idiopathic HH) or in association with olfactory dysfunction (Kallmann’s syndrome). Gonadotropin deficiency can also occur with other pituitary hormone deficiencies. Most of the congenital isolated HH are still idiopathic. However, defects in more than ten genetic loci with multiple modes of inheritance, accounting for monogenic and occasionally oligogenic presentations were found in approximately 30% of...
{"title":"Male hypogonadism: childhood diagnosis and future therapies","authors":"V. Brito, Karina Berger, B. Mendonca","doi":"10.2217/PHE.10.50","DOIUrl":"https://doi.org/10.2217/PHE.10.50","url":null,"abstract":"Male hypogonadism results from inadequate testicular function manifested by the impairment of both testosterone secretion and spermatogenesis. Hypogonadism has several etiologies. Hypogonadotropic hypogonadism (HH) results from hypothalamic–pituitary disorders leading to a complete or partial deficiency in gonadotropin-releasing hormone (GnRH) secretion from hypothalamic neurons, or gonadotropin secretion from anterior pituitary, or defects in GnRH receptor at the pituitary. All situations result in low or normal serum gonadotropin levels and low serum testosterone levels. Congenital HH can occur isolated (idiopathic HH) or in association with olfactory dysfunction (Kallmann’s syndrome). Gonadotropin deficiency can also occur with other pituitary hormone deficiencies. Most of the congenital isolated HH are still idiopathic. However, defects in more than ten genetic loci with multiple modes of inheritance, accounting for monogenic and occasionally oligogenic presentations were found in approximately 30% of...","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"539-555"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.50","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68242267","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":"Alcohol and its effect on fetal development: what do we know?","authors":"G. I. Gallicano","doi":"10.2217/PHE.10.48","DOIUrl":"https://doi.org/10.2217/PHE.10.48","url":null,"abstract":"","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"459-462"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.48","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68242634","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":"Bone health in children with neuromuscular disorders: current opinions and future directions","authors":"S. Bowden, J. Mahan","doi":"10.2217/PHE.10.49","DOIUrl":"https://doi.org/10.2217/PHE.10.49","url":null,"abstract":"","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"463-465"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.49","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68242646","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}
Physical activity and fitness are increasingly recognized as important outcomes in the follow-up and treatment of patients with juvenile idiopathic arthritis. In the past, major concerns were on the detrimental effects of physical exercise; now evidence is growing on the beneficial effects of exercise. The purpose of these exercise programs is to promote a more active lifestyle and/or enhance physical fitness. This article will review the findings of recent studies in juvenile idiopathic arthritis in the area of physical fitness, physical activity and training. It is advised that clinicians are discussing appropriate levels of physical activity (daily participation in >60 min of moderate-to-vigorous physical activity) with their patients in clinical consultations.
{"title":"Physical fitness, activity and training in children with juvenile idiopathic arthritis","authors":"T. Takken","doi":"10.2217/PHE.10.54","DOIUrl":"https://doi.org/10.2217/PHE.10.54","url":null,"abstract":"Physical activity and fitness are increasingly recognized as important outcomes in the follow-up and treatment of patients with juvenile idiopathic arthritis. In the past, major concerns were on the detrimental effects of physical exercise; now evidence is growing on the beneficial effects of exercise. The purpose of these exercise programs is to promote a more active lifestyle and/or enhance physical fitness. This article will review the findings of recent studies in juvenile idiopathic arthritis in the area of physical fitness, physical activity and training. It is advised that clinicians are discussing appropriate levels of physical activity (daily participation in >60 min of moderate-to-vigorous physical activity) with their patients in clinical consultations.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"499-507"},"PeriodicalIF":0.0,"publicationDate":"2010-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.54","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68243340","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}
Kelly Blankenship, Craig A Erickson, Kimberly A Stigler, David J Posey, Christopher J McDougle
Aripiprazole was recently US FDA-approved to treat irritability in children and adolescents with autistic disorder aged 6-17 years. There are currently only two psychotropics approved by the FDA to treat irritability in the autistic population. This drug profile will discuss available studies of aripiprazole in individuals with pervasive developmental disorders, two of which led to its recent FDA approval. We will discuss the efficacy, as well as the safety and tolerability of the drug documented in these studies. In addition, the chemistry, pharmacokinetics, metabolism and mechanism of action of aripiprazole will be reviewed.
{"title":"Aripiprazole for irritability associated with autistic disorder in children and adolescents aged 6-17 years.","authors":"Kelly Blankenship, Craig A Erickson, Kimberly A Stigler, David J Posey, Christopher J McDougle","doi":"10.2217/phe.10.45","DOIUrl":"https://doi.org/10.2217/phe.10.45","url":null,"abstract":"<p><p>Aripiprazole was recently US FDA-approved to treat irritability in children and adolescents with autistic disorder aged 6-17 years. There are currently only two psychotropics approved by the FDA to treat irritability in the autistic population. This drug profile will discuss available studies of aripiprazole in individuals with pervasive developmental disorders, two of which led to its recent FDA approval. We will discuss the efficacy, as well as the safety and tolerability of the drug documented in these studies. In addition, the chemistry, pharmacokinetics, metabolism and mechanism of action of aripiprazole will be reviewed.</p>","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 4","pages":"375-381"},"PeriodicalIF":0.0,"publicationDate":"2010-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/phe.10.45","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29703768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transient tachypnea of the newborn (TTN) is a frequently encountered form of neonatal respiratory distress. The underlying mechanism of pathology involves residual lung fluid that is delayed in clearance. TTN primarily occurs soon after birth and can last from 48 to 72 h. Risk factors for TTN include maternal asthma, male sex, macrosomia, polycythemia, maternal diabetes and cesarean section. Treatment is often supportive with observation and potential oxygenation. Infants with TTN carry an increased risk for developing chronic asthma. Clinicians providing obstetrical care should prepare parents for this potential. Clinicians providing neonatal care must be familiar with the background and course of this common disease.
{"title":"Transient tachypnea of the newborn: common in the nursery, implications for beyond","authors":"Christian L. Hermansen","doi":"10.2217/PHE.10.35","DOIUrl":"https://doi.org/10.2217/PHE.10.35","url":null,"abstract":"Transient tachypnea of the newborn (TTN) is a frequently encountered form of neonatal respiratory distress. The underlying mechanism of pathology involves residual lung fluid that is delayed in clearance. TTN primarily occurs soon after birth and can last from 48 to 72 h. Risk factors for TTN include maternal asthma, male sex, macrosomia, polycythemia, maternal diabetes and cesarean section. Treatment is often supportive with observation and potential oxygenation. Infants with TTN carry an increased risk for developing chronic asthma. Clinicians providing obstetrical care should prepare parents for this potential. Clinicians providing neonatal care must be familiar with the background and course of this common disease.","PeriodicalId":88627,"journal":{"name":"Pediatric health","volume":"4 1","pages":"427-431"},"PeriodicalIF":0.0,"publicationDate":"2010-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/PHE.10.35","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68242239","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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