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The Pediatric Infectious Disease Journal Dec 2019New insights into the diagnosis, treatment and prevention of acute otitis media (AOM) have been gained in recent years. For this reason, the Italian Paediatric Society...
BACKGROUND
New insights into the diagnosis, treatment and prevention of acute otitis media (AOM) have been gained in recent years. For this reason, the Italian Paediatric Society has updated its 2010 guidelines.
METHODS
A literature search was carried out on PubMed. Only pediatric studies published between January 1, 2010 and December 31, 2018 in English or Italian were included. Each included study was assessed according to the GRADE methodology. The quality of the systematic reviews was assessed using AMSTAR 2. The recommendations were formulated by a multidisciplinary panel of experts.
RESULTS
Prompt antibiotic treatment is recommended for children with otorrhea, intracranial complications and/or a history of recurrence and for children under the age of 6 months. For children 6 months to 2 years of age, prompt antibiotic treatment is recommended for all forms of unilateral and bilateral AOM, whether mild or severe. Prompt antibiotic treatment is also recommended for children over 2 years with severe bilateral AOM. A watchful-waiting approach can be applied to children over 2 years with mild or severe unilateral AOM or mild bilateral AOM. High doses of amoxicillin, or amoxicillin-clavulanic acid for patients with a high risk of infection by Beta-lactamase producing strains, remain the first-line antibiotics.
CONCLUSIONS
AOM should be managed on a case-by-case basis that takes account of the child's age, the severity of the episode and whether it is unilateral or bilateral. In patients under 2 years, prompt antibiotic treatment is always recommended.
Topics: Acute Disease; Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Humans; Infant; Italy; Otitis Media; Pediatrics
PubMed: 31876601
DOI: 10.1097/INF.0000000000002452 -
BMC Medical Education Jan 2017Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component... (Review)
Review
BACKGROUND
Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps.
METHODS
A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions.
RESULTS
Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge.
CONCLUSIONS
Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program, social pediatric topics are integrated, taught and learned throughout the entire curriculum. Special attention needs to be given to the hidden curriculum and system barriers that may impede social pediatric education.
Topics: Canada; Child; Clinical Competence; Cost-Benefit Analysis; Curriculum; Education, Medical, Graduate; Humans; Intensive Care Units, Pediatric; Internship and Residency; Learning; Pediatrics; Social Environment
PubMed: 28086770
DOI: 10.1186/s12909-016-0845-4 -
The Ulster Medical Journal May 2016
Topics: Female; Hernias, Diaphragmatic, Congenital; Humans; Inappropriate Prescribing; Infant; Male; Orbital Cellulitis; Pediatrics; Practice Patterns, Physicians'; Symptom Assessment; Tomography, X-Ray Computed
PubMed: 27601769
DOI: No ID Found -
British Journal of Clinical Pharmacology Oct 2022Pharmacogenomics (PGx) relates to the study of genetic factors determining variability in drug response. Implementing PGx testing in paediatric patients can enhance drug... (Review)
Review
Pharmacogenomics (PGx) relates to the study of genetic factors determining variability in drug response. Implementing PGx testing in paediatric patients can enhance drug safety, helping to improve drug efficacy or reduce the risk of toxicity. Despite its clinical relevance, the implementation of PGx testing in paediatric practice to date has been variable and limited. As with most paediatric pharmacological studies, there are well-recognised barriers to obtaining high-quality PGx evidence, particularly when patient numbers may be small, and off-label or unlicensed prescribing remains widespread. Furthermore, trials enrolling small numbers of children can rarely, in isolation, provide sufficient PGx evidence to change clinical practice, so extrapolation from larger PGx studies in adult patients, where scientifically sound, is essential. This review paper discusses the relevance of PGx to paediatrics and considers implementation strategies from a child health perspective. Examples are provided from Canada, the Netherlands and the UK, with consideration of the different healthcare systems and their distinct approaches to implementation, followed by future recommendations based on these cumulative experiences. Improving the evidence base demonstrating the clinical utility and cost-effectiveness of paediatric PGx testing will be critical to drive implementation forwards. International, interdisciplinary collaborations will enhance paediatric data collation, interpretation and evidence curation, while also supporting dedicated paediatric PGx educational initiatives. PGx consortia and paediatric clinical research networks will continue to play a central role in the streamlined development of effective PGx implementation strategies to help optimise paediatric pharmacotherapy.
Topics: Child; Cost-Benefit Analysis; Humans; Netherlands; Pediatrics; Pharmacogenetics; Pharmacogenomic Testing
PubMed: 34907575
DOI: 10.1111/bcp.15181 -
European Neurology 2018Józef Brudziński's (1874-1917) contribution to the field of neurology is noteworthy and undeniable. His organizational efforts and research activity have earned him...
Józef Brudziński's (1874-1917) contribution to the field of neurology is noteworthy and undeniable. His organizational efforts and research activity have earned him the name of the "father of the Polish paediatrics". He described the Brudzinski reflex and Brudzinski neck sign. He proved that the symptoms of these conditions were caused by nerve root irritation and elevated CSF pressure. He also described cheek phenomenon and symphyseal sign.
Topics: History, 19th Century; History, 20th Century; Humans; Male; Neurology; Pediatrics; Poland
PubMed: 30089283
DOI: 10.1159/000492127 -
The Journal of Pediatrics May 2018
Topics: Adult; Aged; Biomedical Research; Career Choice; Female; Humans; Male; Michigan; Middle Aged; National Institute of Child Health and Human Development (U.S.); Pediatricians; Pediatrics; Societies, Medical; United States; Universities
PubMed: 29703371
DOI: 10.1016/j.jpeds.2018.01.061 -
Minerva Anestesiologica Feb 2018
Topics: Anesthesia; Child; Guidelines as Topic; Humans; Pediatrics
PubMed: 28901121
DOI: 10.23736/S0375-9393.17.12309-6 -
International Journal of Pharmaceutics Mar 2022The total number of paediatric formulations available only account for a small proportion of the full therapeutic plethora required to effectively treat paediatrics and,... (Review)
Review
The total number of paediatric formulations available only account for a small proportion of the full therapeutic plethora required to effectively treat paediatrics and, therefore, the availability of high quality medicines designed specifically for children remains an ongoing challenge. Currently, the World Health Organisation (WHO) report that around 50% of medication issued for long-term conditions are not taken as advised, whilst it has also been established that, in general practice, around one tenth of medicines prescribed for children are either off-label or unlicensed. Such off-label and unlicensed use is owing to the considerable anatomical and physiological differences observed between paediatric subsets. Identifying such differences, is essential for better informing paediatric drug development and assisting regulatory reviews, whilst ensuring safe and effective therapeutic concentrations of pharmacological substances. Points covered: The review discusses factors affecting the safety, toxicity and efficacy of paediatric drug delivery systems. The research highlights features of the gastrointestinal tract and reports anatomical and physiological differences between paediatrics and adults. Additionally, differences observed in paediatric pharmacokinetic profiles (absorption, distribution, metabolism and elimination) due to physiological differences are also discussed. Furthermore, this review considers the advantages and limitations of current paediatric specific dosage forms available and assesses the acceptability of innovative small flexible solid oral dosage forms. Lastly, this review highlights factors affecting paediatric medicine adherence and acceptability and discusses the techniques available to overcome barriers associated with non-adherence.
Topics: Adult; Child; Dosage Forms; Humans; Off-Label Use; Pediatrics; Pharmaceutical Preparations
PubMed: 35092832
DOI: 10.1016/j.ijpharm.2022.121501 -
Asia-Pacific Journal of Ophthalmology... 2018This article explores the development of retinal imaging, with particular emphasis on ultra-widefield imaging and the key concept of field of view. Two ultra-widefield... (Review)
Review
This article explores the development of retinal imaging, with particular emphasis on ultra-widefield imaging and the key concept of field of view. Two ultra-widefield imaging platforms are examined in detail-Optomap and Spectralis-noncontact imaging systems that include protocols for performing angiography in infants. Applications of ultra-widefield imaging are illustrated using case studies, including diagnosis, monitoring, and screening.
Topics: Fluorescein Angiography; Humans; Ophthalmoscopy; Optical Imaging; Pediatrics; Retina; Retinal Diseases
PubMed: 29888558
DOI: 10.22608/APO.2018100 -
Journal of Epidemiology and Community... Feb 2005Social paediatrics is an approach to child health that focuses on the child, in illness and in health, within the context of their society, environment, school, and...
Social paediatrics is an approach to child health that focuses on the child, in illness and in health, within the context of their society, environment, school, and family. The glossary clarifies the range of terms used to describe aspects of paediatric practice that overlap or are subsumed under social paediatrics and defines key social paediatric concepts. The glossary was compiled by a process of consultation and consensus building among the authors who are all members of the European Society for Social Paediatrics. Social paediatricians from outside Europe were included giving a more international perspective.
Topics: Child; Child Health Services; Health Promotion; Humans; Pediatrics; Sociology; Terminology as Topic
PubMed: 15650140
DOI: 10.1136/jech.2003.017681