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Allergologia Et Immunopathologia 2021Syndromic immunodeficiencies are a genetically and pathophysiologically heterogeneous group of inborn errors of immunity. These are characterized by multiple extra... (Review)
Review
BACKGROUND
Syndromic immunodeficiencies are a genetically and pathophysiologically heterogeneous group of inborn errors of immunity. These are characterized by multiple extra immune clinical symptoms and a wide range of immunological phenotypes with increased susceptibility to infections, autoimmune phenomena, immune dysregulation, organ-specific pathology, and malignancy.
OBJECTIVE
To increase the pediatricians' awareness of this multifaceted group of primary immunodeficiencies in children.
METHODS
A comprehensive review of genetic background and clinical symptomatology of syndromic immunodeficiencies as well as current diagnostic approach and treatment modalities.
RESULTS
From the pediatrician's perspective, an early-life diagnosis of syndromic immunodeficiencies, which is frequently indispensable for successful life-saving immunocorrection, poses a diagnostic challenge. Increased pediatricians' awareness to recognize signs and symptoms of these diseases in affected children is of paramount importance. Current advances in molecular biotechnology and immunogenetics, resulting in the implementation of newborn screening and new-generation sequencing, provide informative tools for definitive diagnosis and, in many new disease entities, for their definition and genotype-phenotype delineation and correlation.
CONCLUSIONS
A broad spectrum of clinical phenotypes in children with syndromic primary immunodeficiencies requires pediatrician's special attention, that is, individualized multidisciplinary approach under the supervision of a clinical immunologist.
Topics: Humans; Immunologic Deficiency Syndromes; Neoplasms; Pediatricians; Phenotype
PubMed: 34224226
DOI: 10.15586/aei.v49i4.200 -
Indian Journal of Pediatrics Apr 2020
Topics: Cardiology; Child; Humans; Pediatricians
PubMed: 32166606
DOI: 10.1007/s12098-020-03266-3 -
Advances in Pediatrics Aug 2022The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with... (Review)
Review
The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with developmental disabilities, while simultaneously catalyzing innovation. Children are vulnerable to the impacts of COVID-19, resulting in increased stress, anxiety, isolation, and health challenges, further amplified in autistic children and children with other neurodevelopmental disabilities. These children are uniquely vulnerable due to communication impairments, comorbid medical disorders, reduced adaptability, and reliance on therapeutic interventions. Abrupt reduction in services and access to care during the pandemic compromised physical and mental health and led to missed intervention opportunities at critical times. It is important to examine the effects that the pandemic triggered, address deficiencies, and recognize new opportunities to improve systems of care to prepare for unforeseen futures.
Topics: Autistic Disorder; COVID-19; Child; Humans; Mental Health; Pandemics; Pediatricians
PubMed: 35985716
DOI: 10.1016/j.yapd.2022.04.001 -
Pediatric Annals Mar 2021Paroxysmal supraventricular tachycardia (SVT) is the most common clinical arrhythmia in young patients. With an estimated prevalence of roughly 1 in 500 children, a... (Review)
Review
Paroxysmal supraventricular tachycardia (SVT) is the most common clinical arrhythmia in young patients. With an estimated prevalence of roughly 1 in 500 children, a pediatrician may knowingly or unknowingly see several patients who are affected each year. SVT symptoms can sometimes be vague or conflated with common pediatric complaints. Different forms of SVT are predominant at different ages, sometimes complicating timely recognition and referral. Differing pathophysiology and age distribution impact risk of complications such as heart failure, or rarely, sudden death. Treatment choices continue to evolve as new medications, monitoring devices, and ablation technologies continue to mature. This review focuses on the most common types of paroxysmal SVT: atrioventricular nodal reentrant tachycardia, atrioventricular reciprocating tachycardia, and Wolff-Parkinson White syndrome. Atrial arrhythmia mechanisms are also briefly outlined. It is meant to provide practical guidelines for the diagnosis and management of patients with SVT from infancy through adolescence. .
Topics: Adolescent; Child; Electrocardiography; Humans; Pediatricians; Tachycardia, Paroxysmal; Tachycardia, Supraventricular; Tachycardia, Ventricular
PubMed: 34038647
DOI: 10.3928/19382359-20210217-01 -
Pediatric Research Nov 2021Mental health (MH) conditions are highly prevalent, yet only marginal portions of children receive adequate services. Access to specialized mental healthcare is limited... (Review)
Review
BACKGROUND
Mental health (MH) conditions are highly prevalent, yet only marginal portions of children receive adequate services. Access to specialized mental healthcare is limited and, consequently, pediatricians remain the source of management and care of children with MH disorders. Despite this, research suggests that pediatricians report lack of access to training and support regarding MH care of youth, leading to discomfort with managing the population they are asked to treat. An additional barrier to care that has less research is perceptions regarding MH disorders among pediatricians. This scoping review aims to describe the state of science regarding perceptions and possible stigma towards MH in pediatric primary care.
METHODS
PsychInfo, PubMed Medline, Ovid Medline, CINAHL, and Embase were searched with terms related to stigma, pediatricians, and MH disorders. New research articles were included after review, which addressed stigma in pediatricians treating youth with MH disorders.
RESULTS
Our initial search produced 457 titles, with 23 selected for full-text review, and 8 meeting inclusion criteria, Nā=ā1571 pediatricians.
CONCLUSIONS
While a limited number of studies focus on physician-based perceptions/stigma, and even less data on pediatrician stigma towards MH, more studies are needed to explore how this impacts patient care.
IMPACT
In this scoping review, we sought to shed light on the limitations regarding MH care access, especially with the increasing need for care and not enough MH specialists, adding to an already tremendous burden pediatric primary care providers face daily. We also reviewed barriers to said care within pediatric primary care, including the potential for physician stigma towards MH diagnosis, treatment, and management. This review adds a concise summary of the current limited studies on stigma towards MH within primary care pediatricians and the importance of continued research into how perception and stigma affect patient care. This material is an original project and has not been previously published. This work is not submitted for publication or consideration elsewhere.
Topics: Adolescent; Attitude of Health Personnel; Child; Humans; Mental Health; Pediatricians; Primary Health Care; United States
PubMed: 33531675
DOI: 10.1038/s41390-020-01349-7 -
Pediatric Radiology Mar 2022
Topics: Humans; Pediatricians; United States
PubMed: 35015102
DOI: 10.1007/s00247-021-05272-9 -
Pediatrics Sep 2016School readiness includes not only the early academic skills of children but also their physical health, language skills, social and emotional development, motivation to... (Review)
Review
School readiness includes not only the early academic skills of children but also their physical health, language skills, social and emotional development, motivation to learn, creativity, and general knowledge. Families and communities play a critical role in ensuring children's growth in all of these areas and thus their readiness for school. Schools must be prepared to teach all children when they reach the age of school entry, regardless of their degree of readiness. Research on early brain development emphasizes the effects of early experiences, relationships, and emotions on creating and reinforcing the neural connections that are the basis for learning. Pediatricians, by the nature of their relationships with families and children, may significantly influence school readiness. Pediatricians have a primary role in ensuring children's physical health through the provision of preventive care, treatment of illness, screening for sensory deficits, and monitoring nutrition and growth. They can promote and monitor the social-emotional development of children by providing anticipatory guidance on development and behavior, by encouraging positive parenting practices, by modeling reciprocal and respectful communication with adults and children, by identifying and addressing psychosocial risk factors, and by providing community-based resources and referrals when warranted. Cognitive and language skills are fostered through timely identification of developmental problems and appropriate referrals for services, including early intervention and special education services; guidance regarding safe and stimulating early education and child care programs; and promotion of early literacy by encouraging language-rich activities such as reading together, telling stories, and playing games. Pediatricians are also well positioned to advocate not only for children's access to health care but also for high-quality early childhood education and evidence-based family supports such as home visits, which help provide a foundation for optimal learning.
Topics: Child; Child Development; Child Welfare; Health Status; Humans; Language Development; Pediatricians; Physician's Role; Schools; Socialization
PubMed: 27573085
DOI: 10.1542/peds.2016-2293 -
Pediatrics Aug 2019Congenital muscular torticollis (CMT) is a common postural deformity evident shortly after birth, typically characterized by ipsilateral cervical lateral flexion and... (Review)
Review
Congenital muscular torticollis (CMT) is a common postural deformity evident shortly after birth, typically characterized by ipsilateral cervical lateral flexion and contralateral cervical rotation due to unilateral shortening of the sternocleidomastoid muscle. New evidence is emerging on the pathogenesis of CMT, the negative long-term consequences of delaying intervention, and the importance of early identification and early intervention to maximize outcomes. Our purpose in this article is to inform pediatricians and health care providers about new research evidence and share selected recommendations and implementation strategies specifically relevant to pediatric practice to optimize outcomes and health services for infants with CMT.
Topics: Biomedical Research; Humans; Infant; Infant, Newborn; Parents; Pediatricians; Posture; Torticollis
PubMed: 31350358
DOI: 10.1542/peds.2019-0582 -
Journal of Health Care For the Poor and... 2022Food insecurity (FI) causes worse health and education outcomes for children. Screening for FI is feasible and acceptable during well-child visits. Standard protocols,...
Food insecurity (FI) causes worse health and education outcomes for children. Screening for FI is feasible and acceptable during well-child visits. Standard protocols, upon positive screen, refer families to community resources, such as food pantries, but followthrough rates are low. Good Apple (GA) was developed to deliver fresh produce and pantry staples to the homes of families facing FI, as identified by pediatricians. Good Apple uses a two-sided, self-sustaining business model: a subscription-based produce delivery service generates revenue from paying customers, which funds free grocery delivery services for families facing FI. The program works with (1) local farmers to rescue and redistribute unsold fruits and vegetables; (2) local food pantries to supplement deliveries with proteins, grains, and dairy; and (3) pediatricians who prescribe GA to families facing FI. Good Apple helps food pantries reach more clients; empowers pediatricians with closed-loop referrals; and delivers healthy food to families facing FI and transportation barriers.
Topics: Food Assistance; Food Insecurity; Food Supply; Humans; Pediatricians; Vegetables
PubMed: 35153233
DOI: 10.1353/hpu.2022.0034 -
Pediatric Annals Jun 2023
Topics: Humans; Mental Health; Primary Health Care; Pediatricians
PubMed: 37280001
DOI: 10.3928/19382359-20230508-01