{"results":[{"id":"ss_63f995a84a7921597cac057e59c849debb2275eb","title":"The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk.","authors":[{"name":"D. Miglioretti"},{"name":"Eric A. Johnson"},{"name":"Andrew E. Williams"},{"name":"R. Greenlee"},{"name":"S. Weinmann"},{"name":"L. Solberg"},{"name":"H. Feigelson"},{"name":"D. Roblin"},{"name":"M. Flynn"},{"name":"N. Vanneman"},{"name":"R. Smith-Bindman"}],"abstract":"IMPORTANCE Increased use of computed tomography (CT) in pediatrics raises concerns about cancer risk from exposure to ionizing radiation. OBJECTIVES To quantify trends in the use of CT in pediatrics and the associated radiation exposure and cancer risk. DESIGN Retrospective observational study. SETTING Seven US health care systems. PARTICIPANTS The use of CT was evaluated for children younger than 15 years of age from 1996 to 2010, including 4 857 736 child-years of observation. Radiation doses were calculated for 744 CT scans performed between 2001 and 2011. MAIN OUTCOMES AND MEASURES Rates of CT use, organ and effective doses, and projected lifetime attributable risks of cancer. RESULTS The use of CT doubled for children younger than 5 years of age and tripled for children 5 to 14 years of age between 1996 and 2005, remained stable between 2006 and 2007, and then began to decline. Effective doses varied from 0.03 to 69.2 mSv per scan. An effective dose of 20 mSv or higher was delivered by 14% to 25% of abdomen/pelvis scans, 6% to 14% of spine scans, and 3% to 8% of chest scans. Projected lifetime attributable risks of solid cancer were higher for younger patients and girls than for older patients and boys, and they were also higher for patients who underwent CT scans of the abdomen/pelvis or spine than for patients who underwent other types of CT scans. For girls, a radiation-induced solid cancer is projected to result from every 300 to 390 abdomen/pelvis scans, 330 to 480 chest scans, and 270 to 800 spine scans, depending on age. The risk of leukemia was highest from head scans for children younger than 5 years of age at a rate of 1.9 cases per 10 000 CT scans. Nationally, 4 million pediatric CT scans of the head, abdomen/pelvis, chest, or spine performed each year are projected to cause 4870 future cancers. Reducing the highest 25% of doses to the median might prevent 43% of these cancers. CONCLUSIONS AND RELEVANCE The increased use of CT in pediatrics, combined with the wide variability in radiation doses, has resulted in many children receiving a high-dose examination. Dose-reduction strategies targeted to the highest quartile of doses could dramatically reduce the number of radiation-induced cancers.","source":"Semantic Scholar","year":2013,"language":"en","subjects":["Medicine"],"doi":"10.1001/jamapediatrics.2013.311","url":"https://www.semanticscholar.org/paper/63f995a84a7921597cac057e59c849debb2275eb","pdf_url":"https://europepmc.org/articles/pmc3936795?pdf=render","is_open_access":true,"citations":1364,"published_at":"","score":87},{"id":"ss_7bff973c4414d3fee48c48f446555003a4be6395","title":"International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics*","authors":[{"name":"B. Goldstein"},{"name":"B. Giroir"},{"name":"A. Randolph"}],"abstract":"","source":"Semantic Scholar","year":2005,"language":"en","subjects":["Medicine"],"doi":"10.1097/01.PCC.0000149131.72248.E6","url":"https://www.semanticscholar.org/paper/7bff973c4414d3fee48c48f446555003a4be6395","is_open_access":true,"citations":3396,"published_at":"","score":80},{"id":"ss_efa91798d336da98c0c4fdda04e2ea97726f255c","title":"Nelson Textbook of Pediatrics","authors":[{"name":"R. Behrman"},{"name":"R. Kliegman"},{"name":"H. Jenson"}],"abstract":"","source":"Semantic Scholar","year":1965,"language":"en","subjects":["Medicine"],"doi":"10.1136/adc.40.211.338","url":"https://www.semanticscholar.org/paper/efa91798d336da98c0c4fdda04e2ea97726f255c","pdf_url":"https://adc.bmj.com/content/archdischild/40/211/338.1.full.pdf","is_open_access":true,"citations":4218,"published_at":"","score":80},{"id":"ss_d1ce6aa46ae0c19e7a41fab18cc7a42bee0a27c6","title":"Nelson Textbook of Pediatrics.","authors":[{"name":"H. Pomerance"}],"abstract":"","source":"Semantic Scholar","year":1997,"language":"en","subjects":["Medicine"],"doi":"10.1001/archpedi.1997.02170400110025","url":"https://www.semanticscholar.org/paper/d1ce6aa46ae0c19e7a41fab18cc7a42bee0a27c6","is_open_access":true,"citations":2590,"published_at":"","score":80},{"id":"ss_e8648054632c49bad76e3d5f70c1cb302caba9a4","title":"Age Limit of Pediatrics","authors":[{"name":"Amy P. Hardin"},{"name":"J. Hackell"}],"abstract":"Pediatrics is a multifaceted specialty that encompasses children’s physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs.","source":"Semantic Scholar","year":2017,"language":"en","subjects":["Medicine"],"doi":"10.1542/peds.2017-2151","url":"https://www.semanticscholar.org/paper/e8648054632c49bad76e3d5f70c1cb302caba9a4","pdf_url":"https://pediatrics.aappublications.org/content/pediatrics/140/3/e20172151.full.pdf","is_open_access":true,"citations":483,"published_at":"","score":75.49},{"id":"ss_a7d8c8f8e9c381b258ecbbec6c7a7c436f72372c","title":"Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety","authors":[{"name":"R. Eijlers"},{"name":"E. Utens"},{"name":"L. Staals"},{"name":"P. D. de Nijs"},{"name":"J. Berghmans"},{"name":"R. Wijnen"},{"name":"M. Hillegers"},{"name":"B. Dierckx"},{"name":"J. Legerstee"}],"abstract":"BACKGROUND: Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reducing pain and anxiety in pediatric patients undergoing medical procedures. METHODS: On April 25, 2018, we searched EMBASE, MEDLINE, CENTRAL, PubMed, Web of Science, and PsycINFO with the keywords “VR,” “children,” and “adolescents.” Studies that applied VR in a somatic setting with participants ≤21 years of age were included. VR was defined as a fully immersive 3-dimensional environment displayed in surround stereoscopic vision on a head-mounted display (HMD). We evaluated pain and anxiety outcomes during medical procedures in VR and standard care conditions. RESULTS: We identified 2889 citations, of which 17 met our inclusion criteria. VR was applied as distraction (n = 16) during venous access, dental, burn, or oncological care or as exposure (n = 1) before elective surgery under general anesthesia. The effect of VR was mostly studied in patients receiving burn care (n = 6). The overall weighted standardized mean difference (SMD) for VR was 1.30 (95% CI, 0.68–1.91) on patient-reported pain (based on 14 studies) and 1.32 (95% CI, 0.21–2.44) on patient-reported anxiety (based on 7 studies). The effect of VR on pediatric pain was also significant when observed by caregivers (SMD = 2.08; 95% CI, 0.55–3.61) or professionals (SMD = 3.02; 95% CI, 0.79–2.25). For anxiety, limited observer data were available. CONCLUSIONS: VR research in pediatrics has mainly focused on distraction. Large effect sizes indicate that VR is an effective distraction intervention to reduce pain and anxiety in pediatric patients undergoing a wide variety of medical procedures. However, further research on the effect of VR exposure as a preparation tool for medical procedures is needed because of the paucity of research into this field.","source":"Semantic Scholar","year":2019,"language":"en","subjects":["Medicine"],"doi":"10.1213/ANE.0000000000004165","url":"https://www.semanticscholar.org/paper/a7d8c8f8e9c381b258ecbbec6c7a7c436f72372c","pdf_url":"https://journals.lww.com/anesthesia-analgesia/Fulltext/2019/11000/Systematic_Review_and_Meta_analysis_of_Virtual.25.aspx","is_open_access":true,"citations":402,"published_at":"","score":75.06},{"id":"ss_379f07b22b71ccd34c8d501494b5ea27d92ce4a8","title":"Artificial intelligence-based clinical decision support in pediatrics","authors":[{"name":"S. Ramgopal"},{"name":"L. N. Sanchez-Pinto"},{"name":"Christopher M. Horvat"},{"name":"Michael S. Carroll"},{"name":"Yuan Luo"},{"name":"T. Florin"}],"abstract":"Abstract Machine learning models may be integrated into clinical decision support (CDS) systems to identify children at risk of specific diagnoses or clinical deterioration to provide evidence-based recommendations. This use of artificial intelligence models in clinical decision support (AI-CDS) may have several advantages over traditional “rule-based” CDS models in pediatric care through increased model accuracy, with fewer false alerts and missed patients. AI-CDS tools must be appropriately developed, provide insight into the rationale behind decisions, be seamlessly integrated into care pathways, be intuitive to use, answer clinically relevant questions, respect the content expertise of the healthcare provider, and be scientifically sound. While numerous machine learning models have been reported in pediatric care, their integration into AI-CDS remains incompletely realized to date. Important challenges in the application of AI models in pediatric care include the relatively lower rates of clinically significant outcomes compared to adults, and the lack of sufficiently large datasets available necessary for the development of machine learning models. In this review article, we summarize key concepts related to AI-CDS, its current application to pediatric care, and its potential benefits and risks. Impact The performance of clinical decision support may be enhanced by the utilization of machine learning-based algorithms to improve the predictive performance of underlying models. Artificial intelligence-based clinical decision support (AI-CDS) uses models that are experientially improved through training and are particularly well suited toward high-dimensional data. The application of AI-CDS toward pediatric care remains limited currently but represents an important area of future research.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1038/s41390-022-02226-1","url":"https://www.semanticscholar.org/paper/379f07b22b71ccd34c8d501494b5ea27d92ce4a8","pdf_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668209","is_open_access":true,"citations":129,"published_at":"","score":69.87},{"id":"ss_2ef3597a7d75090d2d5342a05088569b18d18fd7","title":"Telemedicine in Pediatrics: Systematic Review of Randomized Controlled Trials","authors":[{"name":"Aashaka C Shah"},{"name":"S. Badawy"}],"abstract":"Background Telemedicine modalities, such as videoconferencing, are used by health care providers to remotely deliver health care to patients. Telemedicine use in pediatrics has increased in recent years. This has resulted in improved health care access, optimized disease management, progress in the monitoring of health conditions, and fewer exposures to patients with illnesses during pandemics (eg, the COVID-19 pandemic). Objective We aimed to systematically evaluate the most recent evidence on the feasibility and accessibility of telemedicine services, patients’ and care providers’ satisfaction with these services, and treatment outcomes related to telemedicine service use among pediatric populations with different health conditions. Methods Studies were obtained from the PubMed database on May 10, 2020. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In this review, we included randomized controlled trials from the last 10 years that used a telemedicine approach as a study intervention or assessed telemedicine as a subspecialty of pediatric care. Titles and abstracts were independently screened based on the eligibility criteria. Afterward, full texts were retrieved and independently screened based on the eligibility criteria. A standardized form was used to extract the following data: publication title, first author’s name, publication year, participants’ characteristics, study design, the technology-based approach that was used, intervention characteristics, study goals, and study findings. Results In total, 11 articles met the inclusion criteria and were included in this review. All studies were categorized as randomized controlled trials (8/11, 73%) or cluster randomized trials (3/11, 27%). The number of participants in each study ranged from 22 to 400. The health conditions that were assessed included obesity (3/11, 27%), asthma (2/11, 18%), mental health conditions (1/11, 9%), otitis media (1/11, 9%), skin conditions (1/11, 9%), type 1 diabetes (1/11, 9%), attention deficit hyperactivity disorder (1/11, 9%), and cystic fibrosis–related pancreatic insufficiency (1/11). The telemedicine approaches that were used included patient and doctor videoconferencing visits (5/11, 45%), smartphone-based interventions (3/11, 27%), telephone counseling (2/11, 18%), and telemedicine-based screening visits (1/11, 9%). The telemedicine interventions in all included studies resulted in outcomes that were comparable to or better than the outcomes of control groups. These outcomes were related to symptom management, quality of life, satisfaction, medication adherence, visit completion rates, and disease progression. Conclusions Although more research is needed, the evidence from this review suggests that telemedicine services for the general public and pediatric care are comparable to or better than in-person services. Patients, health care professionals, and caregivers may benefit from using both telemedicine services and traditional, in-person health care services. To maximize the potential of telemedicine, future research should focus on improving patients’ access to care, increasing the cost-effectiveness of telemedicine services, and eliminating barriers to telemedicine use.","source":"Semantic Scholar","year":2021,"language":"en","subjects":["Medicine"],"doi":"10.2196/22696","url":"https://www.semanticscholar.org/paper/2ef3597a7d75090d2d5342a05088569b18d18fd7","pdf_url":"https://pediatrics.jmir.org/2021/1/e22696/PDF","is_open_access":true,"citations":145,"published_at":"","score":69.35},{"id":"doaj_10.3390/curroncol32010033","title":"Engaging Nurses in Effective Cost of Care Conversations to Address Cancer-Related Financial Toxicity: Results from an Exploratory Survey","authors":[{"name":"Jean S. Edward"},{"name":"Amanda Thaxton Wiggins"},{"name":"Louis G. Baser"},{"name":"Haafsah Fariduddin"},{"name":"Joanna F. Doran"},{"name":"Monica F. Bryant"},{"name":"John A. D’Orazio"},{"name":"Kimberly D. Northrip"}],"abstract":"Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer\u003csup\u003e®\u003c/sup\u003e to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never screening for financial needs and nine for legal needs. Following the training, seven nurses stated they were likely to screen for financial/legal needs. At six months post-training, nurses had referred 85 patients/caregivers to financial/legal navigation services. Comfort levels in answering financial/legal questions increased by 6.5 points and knowledge scores increased by 1.7 points post-training. Most nurses recommended this training to other healthcare providers who work with patients with cancer and their caregivers. This study highlights the importance of providing oncology nurses with resources to engage in cost of care conversations and oncology financial legal navigation programs to mitigate the impact of cancer-related financial toxicity.","source":"DOAJ","year":2025,"language":"","subjects":["Neoplasms. Tumors. Oncology. Including cancer and carcinogens"],"doi":"10.3390/curroncol32010033","url":"https://www.mdpi.com/1718-7729/32/1/33","is_open_access":true,"published_at":"","score":69},{"id":"doaj_10.3390/children12050616","title":"Growth Failure in Children with Congenital Heart Disease","authors":[{"name":"Jihye Lee"},{"name":"Teresa Marshall"},{"name":"Harleah Buck"},{"name":"Mulder Pamela"},{"name":"Sandra Daack-Hirsch"}],"abstract":"\u003cb\u003eBackground/Objectives\u003c/b\u003e: Growth failure is a common complication in children with congenital heart disease (CHD), yet its underlying mechanisms and consequences remain incompletely understood. This review aims to provide a comprehensive overview of growth failure in children with CHD and outline a framework of factors contributing to this condition. \u003cb\u003eMethods:\u003c/b\u003e To lay the foundation for this narrative review, several databases were searched using broad search terms related to CHD and growth failure. \u003cb\u003eResults\u003c/b\u003e: Growth failure is most pronounced during the first year of life, but often improves after achieving hemodynamic stability through surgical or medical interventions. However, children with complex conditions, such as single-ventricle physiology or multiple heart defects, may experience persistent growth impairment due to chronic disease effects. Specific features of CHD—cyanosis, pulmonary hypertension, and low cardiac output—can further hinder growth by disrupting endocrine function and impairing musculoskeletal development. Long-term use of medications and exposure to repeated diagnostic procedures also contribute to growth failure. Beyond physical effects, growth failure profoundly influences neurodevelopment, psychosocial well-being, and survival outcomes. Based on our review, we have developed a knowledge map to better understand the complexities of growth failure in children with CHD. \u003cb\u003eConclusions\u003c/b\u003e: A thorough understanding of the multifaceted contributors to growth failure in CHD is essential for identifying high-risk children and devising strategies to support optimal growth. Integrating this knowledge into clinical practice can improve long-term outcomes for children with CHD.","source":"DOAJ","year":2025,"language":"","subjects":["Pediatrics"],"doi":"10.3390/children12050616","url":"https://www.mdpi.com/2227-9067/12/5/616","is_open_access":true,"published_at":"","score":69},{"id":"doaj_10.1016/j.epsc.2025.102972","title":"Spontaneous anastomosis of esophageal atresia without esophageal stricture formation: A case report","authors":[{"name":"S. Tan Tanny"},{"name":"S.E. Newman"},{"name":"M. Safe"},{"name":"W.J. Teague"}],"abstract":"Introduction: Spontaneous esophago-esophageal fistulization is a reported phenomenon in cases of complex esophageal atresia, however, short and long-term complications are common, including stricture formation. Case presentation: A male twin was born at 29 + 6 weeks gestation weighing 1103 g. Passage of a nasogastric tube was attempted but coiled in the upper esophagus, leading to a postnatal diagnosis of esophageal atresia with distal tracheo-esophageal fistula. At thoracotomy on day 1 of life, the tracheo-esophageal fistula was ligated without problems. Esophageal anastomosis to overcome a 1–1.5 vertebral body gap was attempted but abandoned following significant intraoperative anesthetic complications. Instead, the upper and lower esophageal ends were sutured closed and then apposed under tension using interrupted 4/0 Ethibond®. A contrast study on day 18 of life demonstrated spontaneous anastomosis of the esophageal ends, with reflux of contrast between the upper and lower esophagus, and no extraluminal contrast extravasation. Subsequent contrast studies at ages 4 weeks, 5, 10 and 13 months, and 2 years showed no anastomotic stricture. Upper gastrointestinal endoscopy at the age of 2 years showed no esophagitis. Gastro-esophageal reflux symptoms remain controlled with medication and no fundoplication has been performed. High resolution esophageal manometry at the age of 3 years demonstrated weak, but coordinated, distal peristalsis. At the age of 4.5 years, the patient is tolerating an unrestricted diet and has a growth curve that matches the curve of his twin sibling. Conclusion: In cases where primary esophageal anastomosis is not possible, opposing the upper and lower pouches with sutures may result in spontaneous esophageal anastomosis not necessarily associated with an anastomotic stricture.","source":"DOAJ","year":2025,"language":"","subjects":["Pediatrics","Surgery"],"doi":"10.1016/j.epsc.2025.102972","url":"http://www.sciencedirect.com/science/article/pii/S221357662500017X","is_open_access":true,"published_at":"","score":69},{"id":"doaj_https://doi.org/10.3126/ajms.v15i9.67674","title":"A comparative study to evaluate the efficacy of cisatracurium and rocuronium for endotracheal intubation in pediatric patients: A prospective randomized study","authors":[{"name":"Deepak R "},{"name":"Seema Shende "},{"name":"Namrata Jain "},{"name":"Sanyukta Paul "}],"abstract":"Background: Cisatracurium and rocuronium are non-depolarizing neuromuscular blockers with an intermediate duration of action and are used safely in short and intermediate-duration surgical procedures in the pediatric population.\r\n\r\nAims and Objectives: A prospective randomized study is to assess the efficacy of cisatracurium compared to rocuronium in terms of intubating conditions, clinical duration of action, hemodynamic parameters, and side effects in pediatric patients undergoing surgeries under general anesthesia.\r\n\r\nMaterials and Methods: In this study, 50 patients aged 2–12 years with the American Society of Anesthesiologists grades I and II were randomly allocated into two groups: Group I received injection cisatracurium 0.15 mg/kg IV and Group II received injection rocuronium 0.6 mg/kg IV for intubation. Intubating conditions by Cooper et al., score, TOF count, hemodynamic parameters, signs of histamine release, and complications if any were noted.\r\n\r\nResults: According to the Cooper et al., score, intubating conditions were excellent in 100% of patients in Group II and 84% of patients in Group I, which was statistically significant. The time required for the first maintenance dose was shorter in Group II (14.04±2.95 min) compared to Group I (20.08±3.68 min). Hemodynamic parameters and demographic profiles were comparable between the two groups. No associated signs of histamine release or any other complications were noted in either group.\r\n\r\nConclusion: We concluded that rocuronium 0.6 mg/kg provides better intubating conditions and a shorter duration of action compared to cisatracurium 0.15 mg/kg without any signs of histamine release in pediatric patients.","source":"DOAJ","year":2024,"language":"","subjects":["Medicine"],"doi":"https://doi.org/10.3126/ajms.v15i9.67674","url":"https://www.nepjol.info/index.php/AJMS/article/view/67674","is_open_access":true,"published_at":"","score":68},{"id":"doaj_10.1136/bmjpo-2024-002893","title":"Responding to the humanitarian crisis in Sudan","authors":[{"name":"Jeffrey Goldhagen"},{"name":"Safa E Elkrail"},{"name":"Ashraf Affan"}],"abstract":"","source":"DOAJ","year":2024,"language":"","subjects":["Pediatrics"],"doi":"10.1136/bmjpo-2024-002893","url":"https://bmjpaedsopen.bmj.com/content/8/1/e002893.full","is_open_access":true,"published_at":"","score":68},{"id":"ss_28e5c13a42775a34fea7a68d38829b751a2871ac","title":"Physical Activity in the Prevention of Childhood Obesity: The Position of the European Childhood Obesity Group and the European Academy of Pediatrics","authors":[{"name":"Justyna Wyszyńska"},{"name":"S. Ring-Dimitriou"},{"name":"D. Thivel"},{"name":"D. Weghuber"},{"name":"A. Hadjipanayis"},{"name":"Z. Grossman"},{"name":"R. Ross-Russell"},{"name":"Katarzyna Dereń"},{"name":"A. Mazur"}],"abstract":"Obesity affects an increasing number of children and adolescents. Physical activity (PA) is a significant factor in the prevention of excessive body mass in the pediatric population. A significant percentage of pediatric population do not attain the public health recommendation for PA, and typically, those with higher levels of PA have lower content of body fat than less active peers. Although the development of childhood obesity is multifactorial, the decline in energy expenditure is considered as one of the most important determinants of excessive body weight. The lack of intervention causes that excess body weight to remain stable from birth through childhood and adolescence to adulthood. Accordingly, public health interventions are needed to increase the level of PA in the pediatric population. The task force from the European Childhood Obesity Group and the European Academy of Pediatrics reviewed English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases, from 2018 to August 2020, and developed a consensus statement. This statement presents the role of PA in the prevention of excessive body weight and gives age-appropriate recommendations for PA and recommendations for school-based interventions, parents, and guardians.","source":"Semantic Scholar","year":2020,"language":"en","subjects":["Medicine"],"doi":"10.3389/fped.2020.535705","url":"https://www.semanticscholar.org/paper/28e5c13a42775a34fea7a68d38829b751a2871ac","pdf_url":"https://www.frontiersin.org/articles/10.3389/fped.2020.535705/pdf","is_open_access":true,"citations":127,"published_at":"","score":67.81},{"id":"ss_f315d871fd82abfa0027a119659211476b2edf24","title":"Perinatal-Neonatal Management of COVID-19 Infection — Guidelines of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP)","authors":[{"name":"D. Chawla"},{"name":"D. Chirla"},{"name":"S. Dalwai"},{"name":"A. Deorari"},{"name":"A. Ganatra"},{"name":"A. Gandhi"},{"name":"N. Kabra"},{"name":"Praveen Kumar"},{"name":"P. Mittal"},{"name":"B. Parekh"},{"name":"M. J. Sankar"},{"name":"T. Singhal"},{"name":"S. Sivanandan"},{"name":"P. Tank"},{"name":"Federation of Obstetric and Gynaecological Societies of India"},{"name":"National Neonatology Forum of India"},{"name":"I. Pediatrics"}],"abstract":"Justification During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. Process The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations. Objectives To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. Recommendations A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.","source":"Semantic Scholar","year":2020,"language":"en","subjects":["Medicine"],"doi":"10.1007/s13312-020-1852-4","url":"https://www.semanticscholar.org/paper/f315d871fd82abfa0027a119659211476b2edf24","pdf_url":"https://link.springer.com/content/pdf/10.1007/s13312-020-1852-4.pdf","is_open_access":true,"citations":121,"published_at":"","score":67.63},{"id":"ss_f9209bea7d5a291bc567461a6c02b332fe3d7dc9","title":"The Michigan Appropriateness Guide for Intravenous Catheters in Pediatrics: miniMAGIC.","authors":[{"name":"Amanda J. Ullman"},{"name":"Steven J. Bernstein"},{"name":"E. Brown"},{"name":"R. Aiyagari"},{"name":"Darcy Doellman"},{"name":"E. Faustino"},{"name":"Beth Gore"},{"name":"Jeffrey P. Jacobs"},{"name":"J. Jaffray"},{"name":"Tricia M. Kleidon"},{"name":"Prashant Mahajan"},{"name":"Craig A Mcbride"},{"name":"Kayce Morton"},{"name":"Stephanie Pitts"},{"name":"E. Prentice"},{"name":"Douglas C. Rivard"},{"name":"Erin E Shaughnessy"},{"name":"M. Stranz"},{"name":"Joshua Wolf"},{"name":"David Cooper"},{"name":"M. Cooke"},{"name":"C. Rickard"},{"name":"V. Chopra"}],"abstract":"OBJECTIVES Vascular access device decision-making for pediatric patients remains a complex, highly variable process. To date, evidence-based criteria to inform these choices do not exist. The objective of the Michigan Appropriateness Guide for Intravenous Catheters in pediatrics (miniMAGIC) was to provide guidance on device selection, device characteristics, and insertion technique for clinicians, balancing and contextualizing evidence with current practice through a multidisciplinary panel of experts. METHODS The RAND Corporation and University of California, Los Angeles Appropriateness Method was used to develop miniMAGIC, which included the following sequential phases: definition of scope and key terms, information synthesis and literature review, expert multidisciplinary panel selection and engagement, case scenario development, and appropriateness ratings by an expert panel via 2 rounds. RESULTS The appropriateness of the selection, characteristics, and insertion technique of intravenous catheters commonly used in pediatric health care across age populations (neonates, infants, children, and adolescents), settings, diagnoses, clinical indications, insertion locations, and vessel visualization devices and techniques was defined. Core concepts including vessel preservation, insertion and postinsertion harm minimization (eg, infection, thrombosis), undisrupted treatment provision, and inclusion of patient preferences were emphasized. CONCLUSIONS In this study, we provide evidence-based criteria for intravenous catheter selection (from umbilical catheters to totally implanted venous devices) in pediatric patients across a range of clinical indications. miniMAGIC also highlights core vascular access practices in need of collaborative research and innovation.","source":"Semantic Scholar","year":2020,"language":"en","subjects":["Medicine"],"doi":"10.1542/peds.2019-3474I","url":"https://www.semanticscholar.org/paper/f9209bea7d5a291bc567461a6c02b332fe3d7dc9","pdf_url":"https://pediatrics.aappublications.org/content/pediatrics/145/Supplement_3/S269.full.pdf","is_open_access":true,"citations":120,"published_at":"","score":67.6},{"id":"ss_2475c4f8e2ba8eeeb6d95c76bf07ce983f02f9a7","title":"Vaccine Hesitancy in Pediatrics.","authors":[{"name":"Andrea Lafnitzegger"},{"name":"Claudia Gaviria-Agudelo"}],"abstract":"Vaccine hesitancy is a growing complex and multifaceted phenomenon. It encompasses a wide spectrum of context-dependent attitudes and beliefs. Multiple factors influence parental decision-making including knowledge, sources of information, risk perception, trust, and individual experiences among others. This review focuses on describing the most common reasons that contribute to vaccine hesitancy among parents. Social media and the Internet have been described as major elements that can negatively influence parental decision-making regarding vaccines. The next focus is describing effective interventions that clinical providers can apply. Nonconfrontational and open discussions along with trusting and strong relationships between parents and providers seem to create a solid foundation toward vaccine acceptance. In addition, motivational interviewing is a helpful tool that has proven to be effective during these discussions. Ultimately, an individualized approach tailored to a specific community will likely be most effective in addressing vaccine hesitancy.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1016/j.yapd.2022.03.011","url":"https://www.semanticscholar.org/paper/2475c4f8e2ba8eeeb6d95c76bf07ce983f02f9a7","is_open_access":true,"citations":40,"published_at":"","score":67.2},{"id":"ss_a0233d836dc20bcb7442cd3dc51d4efb1de7b337","title":"Flynn JT, Kaelber DC, Baker-Smith CM, et al; SUBCOMMITTEE ON SCREENING AND MANAGEMENT OF HIGH BLOOD PRESSURE IN CHILDREN. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017; 140(3):e20171904","authors":null,"abstract":"","source":"Semantic Scholar","year":2017,"language":"en","subjects":["Medicine"],"doi":"10.1542/peds.2017-3035","url":"https://www.semanticscholar.org/paper/a0233d836dc20bcb7442cd3dc51d4efb1de7b337","pdf_url":"https://pediatrics.aappublications.org/content/pediatrics/140/6/e20173035.full.pdf","is_open_access":true,"citations":202,"published_at":"","score":67.06},{"id":"ss_71fc2fc5ee481d5085c688a1f2db8370ca3f9d1f","title":"Diagnosis and Management of Global Development Delay: Consensus Guidelines of Growth, Development and Behavioral Pediatrics Chapter, Neurology Chapter and Neurodevelopment Pediatrics Chapter of the Indian Academy of Pediatrics","authors":[{"name":"M. Juneja"},{"name":"Arpita Gupta"},{"name":"Smitha Sairam"},{"name":"Ridhimaa Jain"},{"name":"Monika Sharma"},{"name":"Anjana Thadani"},{"name":"Roopa Srinivasan"},{"name":"L. Lingappa"},{"name":"S. Ahmed"},{"name":"K. S. Multani"},{"name":"P. Buch"},{"name":"Nandita Chatterjee"},{"name":"S. Dalwai"},{"name":"M. Kabra"},{"name":"S. Kapoor"},{"name":"P. Patel"},{"name":"K. Girisha"},{"name":"M. Kulkarni"},{"name":"P. Kunju"},{"name":"P. Malhi"},{"name":"Z. Meenai"},{"name":"D. Mishra"},{"name":"N. Mundkur"},{"name":"M. Nair"},{"name":"S. Oommen"},{"name":"Chhaya Prasad"},{"name":"Arun Singh"},{"name":"L. Srivastava"},{"name":"P. Suman"},{"name":"R. Thakur"}],"abstract":"","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1007/s13312-022-2522-5","url":"https://www.semanticscholar.org/paper/71fc2fc5ee481d5085c688a1f2db8370ca3f9d1f","is_open_access":true,"citations":35,"published_at":"","score":67.05},{"id":"ss_d9f9e535adf62125a5865b09804903c589c51da3","title":"Society for Developmental and Behavioral Pediatrics Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents with Complex Attention-Deficit/Hyperactivity Disorder.","authors":[{"name":"W. Barbaresi"},{"name":"L. Campbell"},{"name":"Elizabeth A. Diekroger"},{"name":"T. Froehlich"},{"name":"Yi Hui Liu"},{"name":"Eva OʼMalley"},{"name":"W. Pelham"},{"name":"T. Power"},{"name":"S. Zinner"},{"name":"Eugenia Chan"}],"abstract":"Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder and is associated with an array of coexisting conditions that complicate diagnostic assessment and treatment. ADHD and its coexisting conditions may impact function across multiple settings (home, school, peers, community), placing the affected child or adolescent at risk for adverse health and psychosocial outcomes in adulthood. Current practice guidelines focus on the treatment of ADHD in the primary care setting. The Society for Developmental and Behavioral Pediatrics has developed this practice guideline to facilitate integrated, interprofessional assessment and treatment of children and adolescents with \"complex ADHD\" defined by age (12 years), presence of coexisting conditions, moderate to severe functional impairment, diagnostic uncertainty, or inadequate response to treatment.","source":"Semantic Scholar","year":2020,"language":"en","subjects":["Medicine"],"doi":"10.1097/DBP.0000000000000770","url":"https://www.semanticscholar.org/paper/d9f9e535adf62125a5865b09804903c589c51da3","is_open_access":true,"citations":101,"published_at":"","score":67.03}],"total":613102,"page":1,"page_size":20,"sources":["DOAJ","CrossRef","Semantic Scholar"],"query":"Pediatrics"}