While health care professionals remain on high alert for COVID-19 and all its variants, many pediatricians also witnessed a respiratory syncytial virus (RSV) surge this past summer, typically a winter illness.1 Now that winter is almost here, this is what you should know about pneumonia. A majority of CAP is viral, including influenza, RSV, enterovirus, and others, but we have to remember the bacterial causes that include Streptococcus pneumonia, Haemophilus influenzae and Streptococcus group A. CAP is one of the most common serious infections in children and is responsible for a significant number of outpatient visits and hospitalizations.2 Many patients present with fever and cough, so how do you decide who has pneumonia and who should be treated with antibiotics? Jana Carnazzo is on the editorial advisory board of Contemporary Pediatrics®, an assistant clinical professor at Creighton University School of Medicine, and a pediatrician with Children's Physicians in Omaha, Nebraska.
[...]individuals in low-income communities and minorities have limited access to services necessary to diagnose ASD.4 Only 60% of pediatricians screen children for developmental delays despite the recommendation from the American Academy of Pediatrics (AAP) to perform screenings at 18- and 24-month well visits. Screening for ASD Pediatricians have a plethora of ASD screening tools available, such as the Ages and Stages Questionnaires, the Communication and Symbolic Behavior Scales, the Parents Evaluation of Developmental Status, the Screening Tool for Autism in Toddlers and Young Children, and M-CHAT-R/F. Over the past few years, several AI-related technologies have been developed to improve medical care.10 Addition ally, investigators have had some promising results using sensors to analyze facial expressions, vocalizations, touch sensitivity, eye tracking, movements, and interactions with robots to try to identify children with ASD. A study published in March 2020 validated Cognoa's system on 375 patients over the course of 2 years, indicating that the system could identify children with ASD with sensitivity and specificity as high as 90% and 83%, respectively.18 More recently, the company completed a double-blind clinical trial at 14 sites around the United States, using an improved algorithm to gather data for submission to the FDA.
A practicing pediatrician offers his take on the coronavirus situation from the ground here in the United States.
Department of Pediatrics, New York University (NYU) Winthrop Hospital, and professor of Pediatrics at NYU Long Island School of Medicine, Mineola, New York Since the first report of an outbreak of respiratory disease in Wuhan, China, in December 2019 caused by a novel coronavirus (SARS CoV2), coronavirus disease (COVID-19) has reached pandemic proportions The Centers for Disease Control and Prevention (CDC) established the following definition for MIS-C:3 * An individual aged 21 years and younger with fever for 1 or more days, laboratory evidence of inflammation, and illness requiring hospitalization with multisystem (2 or more) organ involvement (cardiac, renal, hematologic, gastrointestinal, dermatologic, neurologic), AND * No alternative plausible diagnosis, AND * Evidence of current or recent SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR), serology or antigen test, or exposure to a suspected or confirmed COVID-19 case within the 4 weeks prior to the onset of symptoms Ripha-gen and colleagues described 8 previously healthy children aged 4 to 14 years from Evelina London Children\u0027s Hospital who presented with hyperinflammatory shock and features similar to atypical Kawasaki disease (KD), KD shock syndrome (KDSS), or toxic shock syndrome (TSS) in mid-April 2020 4 Of the 8 cases, 6 were children of African-Caribbean descent, most were teenagers, and 5 were males A series of 10 children aged 3 to 16 years (mostly teenagers) from Bergamo, Italy, presenting between February 18 and April 20, 2020, with what the authors labeled as severe Kawasaki-like disease was published in the Lancet on May 13, 2020 5 By definition, these children met the 2017 American Heart Association criteria for KD or incomplete KD with 5 or more days of fever, compatible rash, and mucous membrane findings, but the overall picture was not consistent with classic KD
Compared with adolescents who use e-cigarettes with relatively low or no nicotine concentrations, those who use e-cigarettes with higher nicotine concentrations are more likely to progress to more frequent and intense combustible cigarette smoking and vaping.
The case for medical marijuana in children is just getting started. Here’s how pediatricians can navigate the complexities and discomfort of this issue and address the risks and benefits of pharmaceutical cannabinoids for their patients.
Two pediatricians discuss the 10 commandments of obesity prevention for children and where the focus for treating obesity in childhood should be.
Premature cellular aging induced by glucocorticoids during puberty may cause children’s bone loss, osteoporosis, and fracture risk later in life.
A meta-analysis of 12 studies of the risk of death after a brief resolved unexplained event (BRUE) found that such an event does not increase an infant’s risk of dying during his or her first year. The American Academy of Pediatrics (AAP) introduced BRUE, a sudden alteration in an infant’s breathing, color, tone, or responsiveness, as a replacement for “apparent life-threatening event” (ALTE) in a 2016 clinical practice guideline.
Infection with human rhinovirus (HRV) confirmed by polymerase chain reaction (PCR) does not decrease the likelihood of concurrent urinary tract infection (UTI) in infants aged from 1 to 90 days old, according to a study in well-appearing febrile infants in this age group.
Urinalysis is extremely sensitive and specific for screening for urinary tract infections (UTIs) in febrile infants aged 60 days and younger, especially when the UTI is associated with bacteremia, a recent study showed.
A 5-month-old previously healthy, full-term female presented to a pediatric emergency department with 2 weeks of left leg swelling. Her parents denied any history of trauma, pain, fevers, weight loss, and easy bruising or bleeding, and family history was negative for cancer. The patient had been feeding and eliminating well.
Parental refusals of protocols in the newborn nursery do happen. Providers need to know how to respond to parents with patient-centered yet medically safe care for their newborns.
A study in children with mild traumatic brain injury found that concentrations of 5 salivary microRNAs (miRNAs) identified prolonged concussion symptoms with 85% accuracy, suggesting that the answer to this question is “yes.”
Dr. Michael Burke has selected 10 articles published during the last 12 months in Contemporary Pediatrics that he says are worth a second look.
Children who view movies with gun violence are more interested in guns and violence than their peers who do not have this exposure, a recent experiment showed.
A healthy full-term newborn presented with a prominent sacral dimple within an oval patch. Ultrasound showed no evidence of spinal anomalies, and the child was discharged home. Three days later, the patch became elevated, red, and moist appearing, and she was brought to the emergency department (ED) for further evaluation of the “growing blister.”
Outpatient pediatric providers have an essential role in the ongoing monitoring and care of a child with failure to thrive (FTT). Here’s how routine growth assessments help to identify FTT and determine effective multidisciplinary treatment.
Pediatricians need a better understanding of the effects of early puberty for girls beyond adolescence into adulthood.
