Pub Date : 2020-06-01DOI: 10.29245/2578-2940/2020/2.1157
D. Ricke, Nicole Gherlone, Philip Fremont-Smith, P. Tisdall, M. Fremont-Smith
Multisystem Inflammatory Syndrome in Children (MIS-C) is appearing in infants, children, and young adults in association with COVID-19 (coronavirus disease 2019) infections of SARS-CoV-2. Kawasaki Disease (KD) is one of the most common vasculitides of childhood. KD presents with similar symptoms to MIS-C especially in severe forms such as Kawasaki Disease Shock Syndrome (KDSS). The observed symptoms for MIS-C and KD are consistent with Mast Cell Activation Syndrome (MCAS) characterized by inflammatory molecules released from activated mast cells. Based on the associations of KD with multiple viral and bacterial pathogens, we put forward the hypothesis that KD and MIS-C result from antibody activation of mast cells by Fc receptorbound pathogen antibodies causing a hyperinflammatory response upon second pathogen exposure. Within this hypothesis, MIS-C may be atypical KD or a KD-like disease associated with SARS-CoV-2. We extend the mast cell hypothesis that increased histamine levels are inducing contraction of effector cells with impeded blood flow through cardiac capillaries. In some patients, pressure from impeded blood flow, within cardiac capillaries, may result in increased coronary artery blood pressure leading to aneurysms, a well-known complication in KD.
{"title":"Kawasaki Disease, Multisystem Inflammatory Syndrome in Children: Antibody-Induced Mast Cell Activation Hypothesis","authors":"D. Ricke, Nicole Gherlone, Philip Fremont-Smith, P. Tisdall, M. Fremont-Smith","doi":"10.29245/2578-2940/2020/2.1157","DOIUrl":"https://doi.org/10.29245/2578-2940/2020/2.1157","url":null,"abstract":"Multisystem Inflammatory Syndrome in Children (MIS-C) is appearing in infants, children, and young adults in association with COVID-19 (coronavirus disease 2019) infections of SARS-CoV-2. Kawasaki Disease (KD) is one of the most common vasculitides of childhood. KD presents with similar symptoms to MIS-C especially in severe forms such as Kawasaki Disease Shock Syndrome (KDSS). The observed symptoms for MIS-C and KD are consistent with Mast Cell Activation Syndrome (MCAS) characterized by inflammatory molecules released from activated mast cells. Based on the associations of KD with multiple viral and bacterial pathogens, we put forward the hypothesis that KD and MIS-C result from antibody activation of mast cells by Fc receptorbound pathogen antibodies causing a hyperinflammatory response upon second pathogen exposure. Within this hypothesis, MIS-C may be atypical KD or a KD-like disease associated with SARS-CoV-2. We extend the mast cell hypothesis that increased histamine levels are inducing contraction of effector cells with impeded blood flow through cardiac capillaries. In some patients, pressure from impeded blood flow, within cardiac capillaries, may result in increased coronary artery blood pressure leading to aneurysms, a well-known complication in KD.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81967766","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}
Pub Date : 2019-07-01DOI: 10.29245/2578-2940/2019/5.1154
T. Durá-Travé
{"title":"Treatment of Childhood Obesity: Old Proverbs that are Still Alive","authors":"T. Durá-Travé","doi":"10.29245/2578-2940/2019/5.1154","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/5.1154","url":null,"abstract":"","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89316825","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}
Pub Date : 2019-07-01DOI: 10.29245/2578-2940/2019/4.1150
E. Reynolds, C. Bell, Debbie Grider, Tx, Houston, Lexington, Ky, blockquote
Introduction: During nonnutritive suck, infants must intermittently swallow. When a swallow occurs, it must interact with respiration in 2 main ways. We have previously labeled HOW the interaction occurs as “swallow-breath interaction” (SwBr), and WHERE in the respiratory cycle the swallow occurs as “phase of respiration incident to swallow” (POR). We have described SwBr and POR in preterm infants with and without bronchopulmonary dysplasia and term infants with neonatal abstinence syndrome. Objective: The objective of this work is to describe SwBr and POR in term infants (TRM) and compare those findings to our previous study of low-risk preterm (LRP) infants. Method: Suckle, swallow, nasal airflow and chest movement were recorded during nonnutritive suck in 12 TRM infants, collecting 94 swallows. SwBr and POR for each swallow were characterized by our previously described method. Generalized estimating equations were developed to relate the 3 types of SwBr and 5 types of POR to gender, birth weight, gestational age, postmenstrual age (PMA), and weeks post-first nipple feed. The percentages of SwBr and POR were compared to 16 LRP infants, with 176 swallows over 35 encounters. Results: TRM infants had more swallows with attenuated respiration (AR) with advancing weeks post-first nipple feed and fewer swallows occurring with obstructive apnea (OA) in males and with increasing birth weight. More swallows occurred at mid-expiration (ME) with increasing gestational age, PMA, and male gender and at mid-inspiration (MI) with increasing weeks post-first nipple feed. Fewer swallows occurred at MI in males. Infants in the LRP group studied before 35 weeks PMA were different from TRM infants but become indistinguishable from TRM infants as PMA approached 40 weeks. SwBr and POR in LRP infants progress towards improved feeding efficiency and safety. These results are similar to studies of nutritive feeding. Conclusion: SwBr and POR during nonnutritive suck in LRP infants become more like TRM infants with advancing PMA. Because the same brainstem centers are activated in both nutritive and nonnutritive suck, investigation of swallow during nonnutritive suck may provide similar information as nutritive feeding with easier analysis.
{"title":"Swallow-Breath Interaction and Phase of Respiration with Swallow During Nonnutritive Suck in Term Infants and Preterm Infants Approaching Term Adjusted Age","authors":"E. Reynolds, C. Bell, Debbie Grider, Tx, Houston, Lexington, Ky, blockquote","doi":"10.29245/2578-2940/2019/4.1150","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/4.1150","url":null,"abstract":"Introduction: During nonnutritive suck, infants must intermittently swallow. When a swallow occurs, it must interact with respiration in 2 main ways. We have previously labeled HOW the interaction occurs as “swallow-breath interaction” (SwBr), and WHERE in the respiratory cycle the swallow occurs as “phase of respiration incident to swallow” (POR). We have described SwBr and POR in preterm infants with and without bronchopulmonary dysplasia and term infants with neonatal abstinence syndrome. \u0000Objective: The objective of this work is to describe SwBr and POR in term infants (TRM) and compare those findings to our previous study of low-risk preterm (LRP) infants. \u0000Method: Suckle, swallow, nasal airflow and chest movement were recorded during nonnutritive suck in 12 TRM infants, collecting 94 swallows. SwBr and POR for each swallow were characterized by our previously described method. Generalized estimating equations were developed to relate the 3 types of SwBr and 5 types of POR to gender, birth weight, gestational age, postmenstrual age (PMA), and weeks post-first nipple feed. The percentages of SwBr and POR were compared to 16 LRP infants, with 176 swallows over 35 encounters. \u0000Results: TRM infants had more swallows with attenuated respiration (AR) with advancing weeks post-first nipple feed and fewer swallows occurring with obstructive apnea (OA) in males and with increasing birth weight. More swallows occurred at mid-expiration (ME) with increasing gestational age, PMA, and male gender and at mid-inspiration (MI) with increasing weeks post-first nipple feed. Fewer swallows occurred at MI in males. Infants in the LRP group studied before 35 weeks PMA were different from TRM infants but become indistinguishable from TRM infants as PMA approached 40 weeks. SwBr and POR in LRP infants progress towards improved feeding efficiency and safety. These results are similar to studies of nutritive feeding. \u0000Conclusion: SwBr and POR during nonnutritive suck in LRP infants become more like TRM infants with advancing PMA. Because the same brainstem centers are activated in both nutritive and nonnutritive suck, investigation of swallow during nonnutritive suck may provide similar information as nutritive feeding with easier analysis.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86318009","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}
Pub Date : 2019-06-25DOI: 10.29245/2578-2940/2019/3.1146
T. Bourgeois, C. Griffith, E. Johnson, B. Leblanc, B. Melancon, blockquote
This review’s purpose is to identify barriers on adherence of treatment guidelines in the management of pediatric Acute Otitis Media (AOM). The American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) released revised AOM practice guidelines in 2013. These guidelines address diagnosis and management of AOM in healthy pediatric patients from six months to 12 years of age. AOM is the most common reason children are prescribed antibiotics1. Previous and continued antibiotic overuse presents increasing problems pertaining to antibiotic resistance, overall children’s health, and healthcare costs2. This guideline recommends treatment should be based on presenting signs and symptoms with severity being key in treatment, while conserving antibiotic use. This guideline includes diagnostic criteria, promotes the use of pneumatic otoscopy, and provides appropriate treatment regimens based on findings. Despite this, there is evidence that these guidelines are not being followed in multiple disciplines that provide care to this population. A comprehensive review of the literature obtained from several databases, produced 650 articles after inclusion and exclusion criteria was applied. In order to include the highest possible level of research, the articles were individually reviewed, and 19 articles were included in this review. Major barriers identified included factors regarding providers, parents, AOM severity and complications, concerns for follow-up care, and other clinical related factors. This literature review identified and compares these multidisciplinary barriers in hope of understanding reasons for the lack of guideline adherence and possibly help facilitate behavioral changes to improve patients’ wellbeing.
{"title":"Barriers to Current Guidelines in the Management of Pediatric Acute Otitis Media","authors":"T. Bourgeois, C. Griffith, E. Johnson, B. Leblanc, B. Melancon, blockquote","doi":"10.29245/2578-2940/2019/3.1146","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/3.1146","url":null,"abstract":"This review’s purpose is to identify barriers on adherence of treatment guidelines in the management of pediatric Acute Otitis Media (AOM). The American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) released revised AOM practice guidelines in 2013. These guidelines address diagnosis and management of AOM in healthy pediatric patients from six months to 12 years of age. AOM is the most common reason children are prescribed antibiotics1. Previous and continued antibiotic overuse presents increasing problems pertaining to antibiotic resistance, overall children’s health, and healthcare costs2. This guideline recommends treatment should be based on presenting signs and symptoms with severity being key in treatment, while conserving antibiotic use. This guideline includes diagnostic criteria, promotes the use of pneumatic otoscopy, and provides appropriate treatment regimens based on findings. Despite this, there is evidence that these guidelines are not being followed in multiple disciplines that provide care to this population. \u0000A comprehensive review of the literature obtained from several databases, produced 650 articles after inclusion and exclusion criteria was applied. In order to include the highest possible level of research, the articles were individually reviewed, and 19 articles were included in this review. Major barriers identified included factors regarding providers, parents, AOM severity and complications, concerns for follow-up care, and other clinical related factors. This literature review identified and compares these multidisciplinary barriers in hope of understanding reasons for the lack of guideline adherence and possibly help facilitate behavioral changes to improve patients’ wellbeing.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88701654","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}
Pub Date : 2019-05-31DOI: 10.29245/2578-2940/2019/3.1148
R. Parmar, Hardik Patel, S. Dalai, Ahmedabad, Gujarat, Seattle, Washington., blockquote
Whole sporozoite vaccination (WSV) is considered a gold standard for inducing and providing sterile protection against Plasmodium infection. Multiple doses of immunizations with radiation-attenuated sporozoites (RAS) is essential for establishing complete sterile protection against Plasmodium infection in mice as well as in humans. In our recently published article1, we have shown that the pattern of vaccination with RAS determines the degrees of protection in mice and frequent immunization with RAS in optimum time duration helps in generating minimum threshold liver-stage (LS) specific CD8+ T cell memory responses leading to sterile protection. Further, we have shown that the alterations in successive RAS immunization could possibly affect the induction of sterile protection. In summary, animals receiving four successive doses generated 100% sterile protection. However, three successive doses with the same parasite inoculum as four doses, could induce sterile protection in ∼50% mice. Interestingly, mice immunized with the same 3 doses, but with longer gap, could not survive the challenge.
{"title":"Whole Sporozoite Vaccination: Duration between Successive Immunization Dictates the Fate Of Protective Immunity","authors":"R. Parmar, Hardik Patel, S. Dalai, Ahmedabad, Gujarat, Seattle, Washington., blockquote","doi":"10.29245/2578-2940/2019/3.1148","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/3.1148","url":null,"abstract":"Whole sporozoite vaccination (WSV) is considered a gold standard for inducing and providing sterile protection against Plasmodium infection. Multiple doses of immunizations with radiation-attenuated sporozoites (RAS) is essential for establishing complete sterile protection against Plasmodium infection in mice as well as in humans. In our recently published article1, we have shown that the pattern of vaccination with RAS determines the degrees of protection in mice and frequent immunization with RAS in optimum time duration helps in generating minimum threshold liver-stage (LS) specific CD8+ T cell memory responses leading to sterile protection. Further, we have shown that the alterations in successive RAS immunization could possibly affect the induction of sterile protection. In summary, animals receiving four successive doses generated 100% sterile protection. However, three successive doses with the same parasite inoculum as four doses, could induce sterile protection in ∼50% mice. Interestingly, mice immunized with the same 3 doses, but with longer gap, could not survive the challenge.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88782595","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}
Pub Date : 2019-03-01DOI: 10.29245/2578-2940/2019/2.1136
E. Englander
Developmental factors and cyberbullying have not been a major focus in the field; most strikingly, the experiences that young children have with technology have been studied far less, relative to their adolescent peers. Prevalence estimates comparing younger and older children are problematic for several reasons; first, researchers have no consensus definition of cyberbullying, and second, prevalence estimates vary so widely that drawing conclusions is difficult. Access to technology is only another factor among several that likely influences the prevalence of cyberbullying, and it appears to vary with age. Access to cell phones and digital technology in adolescence is related to both victim availability and prevalence of cyberbullying itself. Among younger students, those under 12 years old, one study has found that cell phone ownership increases the risk of being both a cyberbully and a cyberbully/victim significantly. One factor that may mediate the impact of cell phone ownership is education on the appropriate and accurate use of digital technology. This type of education has been neglected in elementary schools, but evidence suggests it may be helpful in reducing cyberbullying.
{"title":"Childhood Access to Technology and Cyberbullying","authors":"E. Englander","doi":"10.29245/2578-2940/2019/2.1136","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/2.1136","url":null,"abstract":"Developmental factors and cyberbullying have not been a major focus in the field; most strikingly, the experiences that young children have with technology have been studied far less, relative to their adolescent peers. Prevalence estimates comparing younger and older children are problematic for several reasons; first, researchers have no consensus definition of cyberbullying, and second, prevalence estimates vary so widely that drawing conclusions is difficult. Access to technology is only another factor among several that likely influences the prevalence of cyberbullying, and it appears to vary with age. Access to cell phones and digital technology in adolescence is related to both victim availability and prevalence of cyberbullying itself. Among younger students, those under 12 years old, one study has found that cell phone ownership increases the risk of being both a cyberbully and a cyberbully/victim significantly. One factor that may mediate the impact of cell phone ownership is education on the appropriate and accurate use of digital technology. This type of education has been neglected in elementary schools, but evidence suggests it may be helpful in reducing cyberbullying.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76802230","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}
Pub Date : 2019-03-01DOI: 10.29245/2578-2940/2019/2.1143
S. Aroskar
I was on my morning rounds at the hospital. While examining a complex case, I asked my resident doctors to fetch Nelson textbook of pediatrics (Bible of pediatrics) from the ward. My grey cells were amnestic about the pathophysiology of the disease of this not so common a case. My whole unit was instantly glued to their smartphones in a jiffy. They were uploading on google and enlightening me with quantum of information that the windows of my brain could not download it in one go. Whoa!!
{"title":"The Evolution of Pediatric Practice","authors":"S. Aroskar","doi":"10.29245/2578-2940/2019/2.1143","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/2.1143","url":null,"abstract":"I was on my morning rounds at the hospital. While examining a complex case, I asked my resident doctors to fetch Nelson textbook of pediatrics (Bible of pediatrics) from the ward. My grey cells were amnestic about the pathophysiology of the disease of this not so common a case. My whole unit was instantly glued to their smartphones in a jiffy. They were uploading on google and enlightening me with quantum of information that the windows of my brain could not download it in one go. Whoa!!","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74198643","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}
Pub Date : 2019-02-10DOI: 10.29245/2578-2940/2019/1.1142
W. Eldridge
Kratom is a legal, widely-available herbal supplement with opioid-like properties increasingly used by those with opioid dependence to self-treat opioid withdrawal. Kratom binds to opioid receptors and can induce withdrawal, dependence, and toxicity. Classification of Kratom as an opioid is controversial. The search for non-opioid alternatives for the treatment of opioid dependence has intensified in the current opioid epidemic. Kratom is heavily advertised as one such safe non-opiate alternative and has been used by pregnant women with chronic opioid use resulting in neonatal abstinence syndrome. Kratom cannot be detected on routine toxicology screening. As kratom use becomes more widespread, pediatric populations will likely be impacted and pediatricians should familiarize themselves with its pharmacology and adverse effects to appropriately counsel parents and care for kratom-exposed patients. This article reviews kratom’s pharmacology, uses, potential benefits as a therapeutic, and risks for pediatric patients.
{"title":"Kratom: An Opioid-like Herbal Supplement Pediatricians Should Know About","authors":"W. Eldridge","doi":"10.29245/2578-2940/2019/1.1142","DOIUrl":"https://doi.org/10.29245/2578-2940/2019/1.1142","url":null,"abstract":"Kratom is a legal, widely-available herbal supplement with opioid-like properties increasingly used by those with opioid dependence to self-treat opioid withdrawal. Kratom binds to opioid receptors and can induce withdrawal, dependence, and toxicity. Classification of Kratom as an opioid is controversial. The search for non-opioid alternatives for the treatment of opioid dependence has intensified in the current opioid epidemic. Kratom is heavily advertised as one such safe non-opiate alternative and has been used by pregnant women with chronic opioid use resulting in neonatal abstinence syndrome. Kratom cannot be detected on routine toxicology screening. As kratom use becomes more widespread, pediatric populations will likely be impacted and pediatricians should familiarize themselves with its pharmacology and adverse effects to appropriately counsel parents and care for kratom-exposed patients. This article reviews kratom’s pharmacology, uses, potential benefits as a therapeutic, and risks for pediatric patients.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81796642","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}
Pub Date : 2018-11-01DOI: 10.29245/2578-2940/2018/6.1139
S. Amr, C. Loffredo, supMarlene, Baltimore, Maryland, Washington Dc, blockquote
Hepatocellular carcinoma (HCC) is on the rise worldwide and in the US, and despite emerging treatment modalities, its overall prognosis remains poor; therefore, there is a need for preventing its development globally. The major factors contributing to HCC development, namely, infections with hepatitis B and hepatitis C viruses, alcoholic cirrhosis, aflatoxin-contaminated food, non-alcoholic fatty liver disease, metabolic syndrome, and smoking are modifiable; and prevention intervention can start in childhood. Vaccination for hepatitis B, screening for and treatment of hepatitis C and intravenous drug users, education to avoid fatty liver, alcoholism, and substance use were shown to be effective ways to curb HCC incidence. A focus on reducing early childhood adversity and training young children to make healthy decisions has been strongly recommended as a prevention strategy to reduce most of HCC risk factors.
{"title":"Preventing Hepatocellular Carcinoma: The Case for Childhood Intervention","authors":"S. Amr, C. Loffredo, supMarlene, Baltimore, Maryland, Washington Dc, blockquote","doi":"10.29245/2578-2940/2018/6.1139","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/6.1139","url":null,"abstract":"Hepatocellular carcinoma (HCC) is on the rise worldwide and in the US, and despite emerging treatment modalities, its overall prognosis remains poor; therefore, there is a need for preventing its development globally. The major factors contributing to HCC development, namely, infections with hepatitis B and hepatitis C viruses, alcoholic cirrhosis, aflatoxin-contaminated food, non-alcoholic fatty liver disease, metabolic syndrome, and smoking are modifiable; and prevention intervention can start in childhood. \u0000Vaccination for hepatitis B, screening for and treatment of hepatitis C and intravenous drug users, education to avoid fatty liver, alcoholism, and substance use were shown to be effective ways to curb HCC incidence. A focus on reducing early childhood adversity and training young children to make healthy decisions has been strongly recommended as a prevention strategy to reduce most of HCC risk factors.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"41 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89518154","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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