Pub Date : 2018-09-01DOI: 10.29245/2578-2940/2018/5.1135
Emma Barry, S. Smith
There has been increasing focus on the quality of primary care for children with large scale population studies in the US and Australia reporting adherence to clinical guidelines of approximately 40 to 60%1,2. In particular, there is limited evidence on the safety and effectiveness of prescribing for children2. Medicines are generally considered appropriate in an adult population when they have a clear, evidence-based indication, are well tolerated in the majority of patients and are cost effective. Medicines or prescribing patterns that do not fit this description can be considered inappropriate or potentially inappropriate and may include misprescribing, over prescribing and underprescribing3. Potential consequences for children may be inadequate chronic disease management and unplanned hospital admissions and even rarely can result in preventable deaths4.
{"title":"Potentially Inappropriate Prescribing in Children","authors":"Emma Barry, S. Smith","doi":"10.29245/2578-2940/2018/5.1135","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/5.1135","url":null,"abstract":"There has been increasing focus on the quality of primary care for children with large scale population studies in the US and Australia reporting adherence to clinical guidelines of approximately 40 to 60%1,2. In particular, there is limited evidence on the safety and effectiveness of prescribing for children2. Medicines are generally considered appropriate in an adult population when they have a clear, evidence-based indication, are well tolerated in the majority of patients and are cost effective. Medicines or prescribing patterns that do not fit this description can be considered inappropriate or potentially inappropriate and may include misprescribing, over prescribing and underprescribing3. Potential consequences for children may be inadequate chronic disease management and unplanned hospital admissions and even rarely can result in preventable deaths4.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86022683","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}
Traumatic injury is the leading cause of death in children ages 0 17 years1. Less than 10% of injured children receive care at a pediatric trauma center or children’s hospital due to limited resources, distance, and a regional absence of pediatric surgeons and/or specialists2. Pediatric trauma patients are often taken to the nearest emergency department (ED), even that ED may not be equipped to provide the best care specific to the pediatric trauma patient’s needs. For most of these EDs as well as prehospital transporters, pediatric trauma care, is a low-frequency, yet high-stakes, event that may generate significant anxiety among providers3. The limited resources and infrequent exposure makes it challenging for staff to maintain the skills necessary for efficient and successful care of the pediatric trauma patient. Pediatric Advanced Life Support (PALS) is an existing standardized resuscitation course but it offers minimal education in pediatric trauma care. Numerous studies have demonstrated the utility of in situ simulation-based training as both a tool for assessment and educational intervention with respect to trauma team function, efficacy, communication, and overall improvement in early trauma care provided, but few have evaluated its efficacy within the pediatric population4-7. The focus of this review is to provide the trauma community with an overview of the recent literature regarding the utility of simulation-based education initiatives within the field of pediatric trauma, encourage the application of these initiatives to rural or smaller community hospital settings, and discuss potential future research directions.
{"title":"Simulation-Based Education for the Rural Pediatric Trauma Team","authors":"Lilly Bayouth, S. Longshore, Moye Blvd, Greenville, Moye Blvd Ma, blockquote","doi":"10.29245/2578-2940/2018/5.1133","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/5.1133","url":null,"abstract":"Traumatic injury is the leading cause of death in children ages 0 17 years1. Less than 10% of injured children receive care at a pediatric trauma center or children’s hospital due to limited resources, distance, and a regional absence of pediatric surgeons and/or specialists2. Pediatric trauma patients are often taken to the nearest emergency department (ED), even that ED may not be equipped to provide the best care specific to the pediatric trauma patient’s needs. For most of these EDs as well as prehospital transporters, pediatric trauma care, is a low-frequency, yet high-stakes, event that may generate significant anxiety among providers3. The limited resources and infrequent exposure makes it challenging for staff to maintain the skills necessary for efficient and successful care of the pediatric trauma patient. Pediatric Advanced Life Support (PALS) is an existing standardized resuscitation course but it offers minimal education in pediatric trauma care. Numerous studies have demonstrated the utility of in situ simulation-based training as both a tool for assessment and educational intervention with respect to trauma team function, efficacy, communication, and overall improvement in early trauma care provided, but few have evaluated its efficacy within the pediatric population4-7. The focus of this review is to provide the trauma community with an overview of the recent literature regarding the utility of simulation-based education initiatives within the field of pediatric trauma, encourage the application of these initiatives to rural or smaller community hospital settings, and discuss potential future research directions.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89381496","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 : 2018-07-01DOI: 10.29245/2578-2940/2018/4.1130
Sudha Rathna Prabhu
Congenital hypothyroidism (CH) is one of the most common preventable and treatable cause of intellectual impairment in children. Among known etiologies dysgenesis due to abnormal anatomical development and dyshormonogenesis as a result of deranged physiological functioning of fetal thyroid gland. account for at least 90 % of causes of CH. While review of literature report thyroid dysgenesis as the most common etiology of CH currently focus is on iodine status adequacy in women before and during pregnancy and after delivery and lactation. Worldwide reports of previously iodine sufficient countries declared presently as iodine insufficient and recent publications of several Indian states consuming lesser amounts of iodized salt seem to indicate that iodine related pathophysiological factors are emerging as predominant etiologies of CH. The most vulnerable pregnant women and newborns are prone to be affected with iodine imbalances leading to pregnancy and perinatal related complications. Analysis of demographic, biochemical, clinical and statistical data by Indian Council of Medical Research (ICMR) in a multi-centric pilot study on congenital hypothyroidism has clearly shown that dyshormonogenesis is a leading cause of CH in neonates born in India. The need of the hour is to consider mandatory newborn screening for CH in all live newborns and further conduct country wise ethnic and culture oriented research studies with special emphasis on iodine status, genetic predispositions and lifestyle changes impact on all vulnerable populations and design effective early therapeutic strategies for management of CH to prevent intellectual impairment.
{"title":"Dyshormonogenesis Emerging as a Predominant Cause of Congenital Hypothyroidism in India - A Mini Review","authors":"Sudha Rathna Prabhu","doi":"10.29245/2578-2940/2018/4.1130","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/4.1130","url":null,"abstract":"Congenital hypothyroidism (CH) is one of the most common preventable and treatable cause of intellectual impairment in children. Among known etiologies dysgenesis due to abnormal anatomical development and dyshormonogenesis as a result of deranged physiological functioning of fetal thyroid gland. account for at least 90 % of causes of CH. While review of literature report thyroid dysgenesis as the most common etiology of CH currently focus is on iodine status adequacy in women before and during pregnancy and after delivery and lactation. Worldwide reports of previously iodine sufficient countries declared presently as iodine insufficient and recent publications of several Indian states consuming lesser amounts of iodized salt seem to indicate that iodine related pathophysiological factors are emerging as predominant etiologies of CH. The most vulnerable pregnant women and newborns are prone to be affected with iodine imbalances leading to pregnancy and perinatal related complications. Analysis of demographic, biochemical, clinical and statistical data by Indian Council of Medical Research (ICMR) in a multi-centric pilot study on congenital hypothyroidism has clearly shown that dyshormonogenesis is a leading cause of CH in neonates born in India. The need of the hour is to consider mandatory newborn screening for CH in all live newborns and further conduct country wise ethnic and culture oriented research studies with special emphasis on iodine status, genetic predispositions and lifestyle changes impact on all vulnerable populations and design effective early therapeutic strategies for management of CH to prevent intellectual impairment.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73563363","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 : 2018-07-01DOI: 10.29245/2578-2940/2018/4.1131
L. Benedict, Deeksha Sarma, A. Moulick, Randy M Stevens, V. Mahan, Pa, Philadelphia, blockquote
Cardiac risk factors in childhood are often overlooked in clinical practice, however cardiac risk factors can start before the child is even born. Maternal factors including diet, genetics, and smoking during gestation can all impact the long-term cardiac health of the offspring. Atherosclerosis starts as early as fetal life and can continue to develop in children with risks including high cholesterol. Current guidelines for screening of cholesterol in children, while improving in recent years, still allows years of damage to accumulate before identifying those at risk. Additionally, intervention for cholesterol and other known risks in children and adolescents are often avoided or started later than necessary for optimal cardiac health. Non-pharmacological approaches like diet and exercise for cholesterol and health management can be implemented very early in life, while many pharmacological options are approved for use in certain conditions as early as ages 8 to 10. Combating cardiac disease reaching endemic levels in the developed world will take an aggressive approach in management starting with identification early in life and utilizing the appropriate tools available, both medical and lifestyle.
{"title":"Identifying and Preventing Cardiac Risk Factors from Fetal Life","authors":"L. Benedict, Deeksha Sarma, A. Moulick, Randy M Stevens, V. Mahan, Pa, Philadelphia, blockquote","doi":"10.29245/2578-2940/2018/4.1131","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/4.1131","url":null,"abstract":"Cardiac risk factors in childhood are often overlooked in clinical practice, however cardiac risk factors can start before the child is even born. Maternal factors including diet, genetics, and smoking during gestation can all impact the long-term cardiac health of the offspring. Atherosclerosis starts as early as fetal life and can continue to develop in children with risks including high cholesterol. Current guidelines for screening of cholesterol in children, while improving in recent years, still allows years of damage to accumulate before identifying those at risk. Additionally, intervention for cholesterol and other known risks in children and adolescents are often avoided or started later than necessary for optimal cardiac health. Non-pharmacological approaches like diet and exercise for cholesterol and health management can be implemented very early in life, while many pharmacological options are approved for use in certain conditions as early as ages 8 to 10. Combating cardiac disease reaching endemic levels in the developed world will take an aggressive approach in management starting with identification early in life and utilizing the appropriate tools available, both medical and lifestyle.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79606917","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 : 2018-07-01DOI: 10.29245/2578-2940/2018/4.1126
Vugar Nabi Nabyev, Hakan Seneran, M. Aksoy, Ankara, Selcuklu, Kónya, blockquote
The congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disease caused by mutations in NTRK1 gene (neurotrophic tyrosine kinase receptor 1) located in chromosome 1q21-22, encoding the tyrosinase domain receptor high affinity nerve growth factor. It is characterized by anhidrosis, insensitivity to painful stimuli and mental retardation. Given their low prevalence and the few reported cases, it is important to know its main features to be considered in the differential diagnosis in pediatric practice. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. Early surgical treatment for long bone fractures to prevent pseudo arthrosis and to allow early weightbearing decreasing the risk of further osteopenia. The choice of appropriate antibiotics and surgical debridement in cases of infection might prevent further destruction of joints.
{"title":"Congenital Insensitivity to Pain Syndrome with Anhidrosis. Review of Literature","authors":"Vugar Nabi Nabyev, Hakan Seneran, M. Aksoy, Ankara, Selcuklu, Kónya, blockquote","doi":"10.29245/2578-2940/2018/4.1126","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/4.1126","url":null,"abstract":"The congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disease caused by mutations in NTRK1 gene (neurotrophic tyrosine kinase receptor 1) located in chromosome 1q21-22, encoding the tyrosinase domain receptor high affinity nerve growth factor. It is characterized by anhidrosis, insensitivity to painful stimuli and mental retardation. Given their low prevalence and the few reported cases, it is important to know its main features to be considered in the differential diagnosis in pediatric practice. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. Early surgical treatment for long bone fractures to prevent pseudo arthrosis and to allow early weightbearing decreasing the risk of further osteopenia. The choice of appropriate antibiotics and surgical debridement in cases of infection might prevent further destruction of joints.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84179642","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 : 2018-01-16DOI: 10.29245/2578-2940/2018/1.1108
Megan E. Gray, S. Shenoi, R. Dillingham
A recently published review of the pediatric Human Immunodeficiency Virus (HIV) continuum of care in Pediatric Clinics of North America discussed methods of HIV prevention for children and adolescents1. HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral medications in uninfected persons to prevent HIV infection, was mentioned in the review. The use of PrEP in high risk adolescent populations is an emerging practice. Significant knowledge gaps remain, but the available data to guide current practice is growing due to the vigorous state of PrEP research. A dedicated discussion of PrEP for select adolescents is merited.
{"title":"Pre-exposure Prophylaxis as HIV Prevention in High Risk Adolescents","authors":"Megan E. Gray, S. Shenoi, R. Dillingham","doi":"10.29245/2578-2940/2018/1.1108","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/1.1108","url":null,"abstract":"A recently published review of the pediatric Human Immunodeficiency Virus (HIV) continuum of care in Pediatric Clinics of North America discussed methods of HIV prevention for children and adolescents1. HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral medications in uninfected persons to prevent HIV infection, was mentioned in the review. The use of PrEP in high risk adolescent populations is an emerging practice. Significant knowledge gaps remain, but the available data to guide current practice is growing due to the vigorous state of PrEP research. A dedicated discussion of PrEP for select adolescents is merited.","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"11 1","pages":"5 - 10"},"PeriodicalIF":0.0,"publicationDate":"2018-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86676055","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":"Pre-exposure Prophylaxis as HIV Prevention in High Risk Adolescents.","authors":"Megan E Gray, Sheela V Shenoi, Rebecca Dillingham","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"2 1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36411058","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}
Pub Date : 2018-01-01Epub Date: 2018-12-31DOI: 10.29245/2578-2940/2018/6.1140
Wa Xian, Marcin Duleba, Yutao Qi, Rajasekaran Mahalingam, Matthew Vincent, Frank McKeon
A robust and reliable culture system of adult stem cells is essential for applying the cutting-edge technologies of drug screening, gene editing, and genomics to stem cell research necessary for breakthroughs in this field. In addition, personalized regenerative medicine based on autologous transplantation requires our ability to clone and expand the numbers of these stem cells in vitro. In comparison to the 3D "organoid" culture system that shows limited ability to propagate stem cells as the majority of cells are differentiated or transit amplifying cells, ground-state stem cell culture system is a novel technology that permits long-lived adult stem cells to maintain immaturity, self-renewal capacity, multi-potency and genomic stability despite long-term culturing in a 2D system. The robustness, reliability and easy-to-use features of this new technology bypass the deficiencies of 3D organoid culture systems and provided unlimited stem cell sources for research, therapeutic use, and drug discovery.
{"title":"Ground-State Stem Cells: A Novel Approach for Adult Stem Cell Research.","authors":"Wa Xian, Marcin Duleba, Yutao Qi, Rajasekaran Mahalingam, Matthew Vincent, Frank McKeon","doi":"10.29245/2578-2940/2018/6.1140","DOIUrl":"https://doi.org/10.29245/2578-2940/2018/6.1140","url":null,"abstract":"<p><p>A robust and reliable culture system of adult stem cells is essential for applying the cutting-edge technologies of drug screening, gene editing, and genomics to stem cell research necessary for breakthroughs in this field. In addition, personalized regenerative medicine based on autologous transplantation requires our ability to clone and expand the numbers of these stem cells <i>in vitro</i>. In comparison to the 3D \"organoid\" culture system that shows limited ability to propagate stem cells as the majority of cells are differentiated or transit amplifying cells, ground-state stem cell culture system is a novel technology that permits long-lived adult stem cells to maintain immaturity, self-renewal capacity, multi-potency and genomic stability despite long-term culturing in a 2D system. The robustness, reliability and easy-to-use features of this new technology bypass the deficiencies of 3D organoid culture systems and provided unlimited stem cell sources for research, therapeutic use, and drug discovery.</p>","PeriodicalId":92415,"journal":{"name":"Journal of pediatrics and pediatric medicine","volume":"2 6","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448798/pdf/nihms-1014053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37130183","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}
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