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Pediatrics in Review Jul 2023Every child should have a baseline hematology evaluation with hemoglobin and hematocrit levels starting at age 12 months, or younger if clinically indicated. Although... (Review)
Review
Every child should have a baseline hematology evaluation with hemoglobin and hematocrit levels starting at age 12 months, or younger if clinically indicated. Although history and physical examination provide key information needed to diagnose blood disorders, the addition of a complete blood count (CBC) with differential count and reticulocyte count allows the clinician to narrow the differential diagnosis and tailor the subsequent evaluation. The interpretation of CBC results is a skill that requires practice. Every clinician can learn to identify possible diagnoses before consulting a specialist. This review provides a step-by-step approach for CBC interpretation with tools to help the clinician diagnose and interpret the most common blood disorders seen in the general pediatric clinic or inpatient setting.
Topics: Child; Humans; Infant; Pediatricians; Diagnosis, Differential; Physical Examination; Referral and Consultation
PubMed: 37391639
DOI: 10.1542/pir.2021-005273 -
Pediatric Clinics of North America Oct 2023Pharmacogenomics, where genomic information is used to tailor medication management, is a strategy to maximize drug efficacy and minimize toxicity. Although pediatric... (Review)
Review
Pharmacogenomics, where genomic information is used to tailor medication management, is a strategy to maximize drug efficacy and minimize toxicity. Although pediatric evidence is less robust than for adults, medications influenced by pharmacogenomics are prescribed to children and adolescents. Evidence-based guidelines and drug label annotations are available from the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Pharmacogenomics Knowledgebase (PharmGKB). Some pediatric health care facilities use pharmacogenomics to provide dosing recommendations to pediatricians. Herein, we use a case-based approach to illustrate the use of pharmacogenomic data in pediatric clinical care and provide resources for finding and using pharmacogenomic guidelines.
Topics: Adolescent; Adult; Humans; Child; Pharmacogenetics; Pediatricians
PubMed: 37704356
DOI: 10.1016/j.pcl.2023.05.010 -
No Shinkei Geka. Neurological Surgery Nov 2023The goal of initial management of any pediatric emergency patient is to rapidly assess and resuscitate the condition and provide radical therapeutic intervention while...
The goal of initial management of any pediatric emergency patient is to rapidly assess and resuscitate the condition and provide radical therapeutic intervention while determining treatment priorities. While resuscitation is performed safely and reliably, the patient's condition should be reevaluated on an ongoing basis to determine the efficacy of the treatment. This systematic and logical approach is necessary. If the physician is unfamiliar with the examination of infants, it is most ideal to request pediatrician prior to transport, and to collaborate in the evaluation of the pediatric patient's condition and the securing of intravenous routes. In case of traumatic patient, it is advisable to notify the relevant departments in advance, such as the transfusion department and operating room. The patient's age and weight should be confirmed and accommodated. The most commonly observed symptoms in the initial treatment of children are seizures and disturbance of consciousness. Since children are particularly prone to seizures and since they can appear as a symptom of various diseases, it is necessary to differentiate the primary disease. The severity of the disturbance of consciousness depends on the types and duration of the seizures and the degree of status epilepticus making them highly urgent. Collaborate with the pediatrician because of the wide variety of differential diseases. The response to seizures and recognition of child abuse will be summarized at the end of this section.
Topics: Infant; Child; Humans; Seizures; Status Epilepticus
PubMed: 38011873
DOI: 10.11477/mf.1436204845 -
Pediatric Clinics of North America Oct 2023The goal of newborn screening is to identify medical conditions that can cause significant morbidity and/or mortality if not treated early in life. Pediatricians often... (Review)
Review
The goal of newborn screening is to identify medical conditions that can cause significant morbidity and/or mortality if not treated early in life. Pediatricians often play a vital role in the initial disclosure of newborn screening results and coordination of confirmatory testing, treatment, and referral to specialty care. The goal of this article is to provide an overview of current newborn screening in the United States, focusing on the various disorders, their manifestations, the newborn screening process, the confirmatory testing, and treatments. Some practical considerations will be discussed as well.
Topics: Infant, Newborn; Humans; Neonatal Screening; Pediatricians; Referral and Consultation
PubMed: 37704344
DOI: 10.1016/j.pcl.2023.06.003 -
Children (Basel, Switzerland) Jan 2024The neonatal airway is often difficult to secure, whether the practitioner responsible for managing the airway is a neonatologist, pediatrician, anesthesiologist,...
The neonatal airway is often difficult to secure, whether the practitioner responsible for managing the airway is a neonatologist, pediatrician, anesthesiologist, another specialist or an advanced practice provider [...].
PubMed: 38255395
DOI: 10.3390/children11010082 -
Pediatrics Mar 2024Understanding why children die is necessary to implement strategies to prevent future deaths and improve the health of any community. Child fatality review teams (CFRTs)... (Review)
Review
Understanding why children die is necessary to implement strategies to prevent future deaths and improve the health of any community. Child fatality review teams (CFRTs) have existed since the 1970s and provide a necessary framework to ensure that proper questions are asked about a child's death. CFRTs provide a vital function in a community to ensure that preventable causes of deaths are identified. Pediatricians are necessary members of CFRTs because they provide medical expertise and context around a child's death. All CFRTs should have pediatric physician representation, and results from team meetings should inform public policy at all levels of government. Pediatricians should be supported in their efforts to be present on CFRTs, and they should use data from team meetings to help advocate for implementing prevention strategies.
Topics: Child; Humans; Pediatricians; Public Policy; Child Mortality
PubMed: 38374813
DOI: 10.1542/peds.2023-065481 -
JAMA Jun 2024
PubMed: 38842839
DOI: 10.1001/jama.2024.7515