Purpose of review Recent advances in the power, utility, and accessibility of artificial intelligence (AI) have enabled new methods of investigation in the biomedical sciences and opportunities to transform clinical workflows. As allergic conditions are among the most common chronic diseases affecting children, pediatric allergy represents a promising area for AI-augmented informatics methods to support molecular discovery, early identification, risk stratification, treatment customization, and longitudinal monitoring, as reviewed herein. Recent findings Recent pediatric allergy studies have applied informatics and AI methodologies across various data sources, including molecular and multiomic data, structured and unstructured electronic health record data, environmental exposures, diagnostic images, remote monitoring devices, and patient- and clinician-facing AI tools. Primarily still in the research phase, these approaches include biomarker discovery, disease phenotyping, risk stratification, prediction modeling, remote monitoring, and emerging chatbots for allergy education. Summary Although still relatively nascent within pediatric allergy, AI-augmented informatics shows promise for extracting usable information from complex data and developing tools aimed at personalizing disease detection and management. Most applications remain investigational, and continued progress will require transparency, rigorous validation, generalizability across diverse populations and health systems, feasibility of workflow integration, privacy protection, and longitudinal oversight to ensure continued safety and effectiveness.
Purpose of review Patella sleeve fractures are the most common patellar fracture in children yet remain frequently missed. Additionally, the options for their repair have grown. This review revisits how the injury is recognized and how the expanding range of fixation choices should be navigated. Recent findings Recent cohorts confirm that recognition rests on the examination rather than the radiograph, as the injury is frequently confused with Sinding-Larsen-Johansson syndrome. In sleeve fractures that are displaced or minimally displaced and in which the extensor mechanism is disrupted, operative treatment is recommended. Transosseous suture remains the most common technique, with suture anchors used for smaller fragments. No fixation method has proven superior, as no comparative trials have been conducted in pediatrics. Functional outcomes are good across treatment groups. However, patients with operative injuries return to sport more slowly, and hardware removal is common. Summary Patient outcomes depend less on the choice of fixation than on timely recognition. A high index of suspicion and knowledge of this type of injury help facilitate an accurate diagnosis. MRI-confirmed chondral injury and fracture-specific repair yield reliable outcomes. A delayed diagnosis remains the principal avoidable cause of treatment failure.
Purpose of review Eosinophilic gastrointestinal diseases (EGIDs) affecting the gastrointestinal tract outside of the esophagus are categorized as non-EoE EGIDs, and knowledge regarding their natural history and pathophysiology is rapidly advancing. This review synthesizes evolving mechanistic insights in non-EoE EGID immunopathogenesis, emerging paradigms of disease development, and how these insights influence potential therapeutic options for these conditions. Recent findings The prevalence of non-EoE EGIDs is rising, though overall prevalence remains much lower than that of eosinophilic esophagitis (EoE). Recent standardization of the nomenclature and histologic diagnostic thresholds for non-EoE EGIDs has facilitated progress in understanding the epidemiology, pathogenesis, and therapeutic targets of these conditions. Transcriptomic signatures of disease in the proximal tract, including the esophagus, stomach, and small intestine, are distinct from those in the colon, suggesting that segment-specific therapeutics may be appropriate. Mechanisms beyond eosinophilic inflammation, including mast cell activation, Th2 cytokine signaling, and structural remodeling, may also contribute to disease pathogenesis. Summary Mechanistic insights elucidated from extensive transcriptomic studies and clinical trials have revealed the broader type 2 pathophysiology of non-EoE EGIDs, thereby offering a valuable opportunity to identify novel therapeutic targets and inform the design of future clinical trials.
PURPOSE OF REVIEW:Fifth metatarsal fractures are the most common metatarsal injury in the pediatric population; however, their management is frequently extrapolated from adult protocols. This review explores the emergence of pediatric-specific classification systems and evolving evidence on surgical versus conservative treatment in skeletally immature patients. RECENT FINDINGS:Anatomical and developmental differences critically distinguish pediatric fractures from adult fractures. Recent pediatric classifications, including those by Herrera-Soto and Lee, improve upon the widely used Dameron/Lawrence-Botte system by recognizing the apophysis as a distinct entity and offering better prognostic correlation. Zone 1 avulsion fractures achieve near-universal healing with conservative management. Emerging evidence supports surgical fixation with intramedullary screws for Zone 2 (Jones) fractures in adolescent athletes, whereas prepubertal patients respond well to conservative treatment. Nutritional factors, particularly vitamin D deficiency and inadequate calcium intake, are increasingly being recognized as modifiable risk factors for stress fractures and delayed union. SUMMARY:The management of fifth metatarsal fractures should be individualized according to the fracture zone, skeletal maturity, and activity level. Pediatric-specific classifications offer improved diagnostic accuracy. Nutritional optimization should be integrated into comprehensive management protocols, and further pediatric-focused clinical trials are needed.
PURPOSE OF REVIEW:This review examines prevalence, diagnosis, and management strategies for cardiovascular risk factors including dyslipidemia, hypertension, and obesity in children and adolescents. As these risk factors begin in childhood and track into adulthood, early intervention is important in preventing cardiovascular disease, the leading cause of mortality in the United States. RECENT FINDINGS:The American Heart Association's Life's Essential 8 characterizes components of cardiovascular health including health behaviors (diet, exercise, sleep, tobacco use) and health factors (blood lipids, blood pressure, blood glucose, and weight). Optimizing these health metrics is associated with favorable overall and cardiovascular health (CVH) outcomes. In the United States, prevalence of hypertension, obesity, and cardiovascular disease is projected to rise over the next decade, while hypercholesterolemia is declining. While lifestyle modifications remain a cornerstone in care, new pharmacotherapeutic options have emerged for children over the past several years to treat dyslipidemia and obesity. SUMMARY:Pediatric clinicians have an important role in counseling and supporting CVH in children. This review examines aspects of CVH that are commonly managed in preventive cardiology programs, focusing on diagnostic evaluation and treatment strategies, highlighting new and emerging therapies for children and adolescents, including pharmacotherapy and latest research on effective lifestyle modifications.
