Στην κατηγορία αυτή θα βρίσκεται άρθρα από την ελληνική και τη διεθνή βιβλιογραφία πάνω στην Παιδιατρική.

Ζητάμε προκαταβολικά συγνώμη γιατί λόγω ελλείψεως χρόνου πολλά άρθρα θα είναι στα αγγλικά.

Medical Evaluation of New Internationally Adopted Childre

On arrival, all children should have:
  • Thorough physical examination
  • Purified protein derivative test (may need to alter timing if child received bacille Calmette-Guérin vaccination within the previous several months or received repeated, recent purified protein derivative tests)
  • Hepatitis B surface antigen, surface antibody, and core antibody testing
  • HIV-I and -II enzyme-linked immunosorbent assay (ELISA) (consider DNA polymerase chain reaction in infants)
  • Assessment for syphilis—nontreponemal testing (rapid plasma reagin or Venereal Disease Research Laboratory test) for all adoptees. Treponemal testing (microhemagglutinin-treponema pallidum or fluorescent treponemal antibody absorbed) if history of exposure or positive nontreponemal test results
  • Assessment of stool for ova and parasites
  • Complete blood cell count
  • Lead level testing
  • Assessment for rickets: calcium, phosphorus, and alkaline phosphatase
  • Detailed review of immunization status, with testing as needed to confirm immunity
  • Detailed developmental assessment
  • Assessment of hearing and vision


On arrival, risks should be assessed and the following checked appropriately:

  • Hepatitis C ELISA for all children from Eastern Europe or Asia or those with history of risk factors
  • Thyroid function test for children with significant growth or developmental delays
  • Stool bacterial infection assessment for children with diarrhea or other gastrointestinal symptoms


Six months after arrival, all children should have:

  • Purified protein derivative test
  • Hepatitis B surface antigen, surface antibody, and core antibody testing
  • HIV-I and -II ELISA
  • Hepatitis C ELISA (for previously identified risk groups)

AAP Textbook of Pediatric Care

Introducing Solid Foods

Η εισαγωγή στερεών τροφών στα βρέφη από την Unisef και το NHS.

http://www.unicef.org.uk/Documents/Baby_Friendly/Leaflets/3/introducing-solid-foods.pdf

Recommendations for Prevention and Control of Influenza in Children, 2012–2013

ABSTRACT

The purpose of this statement is to update recommendations for routine use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. The key points for the upcoming 2012–2013 season are: (1) this year’s trivalent influenza vaccine contains A/California/7/2009 (H1N1)–like antigen (derived from influenza A [H1N1] pdm09 [pH1N1] virus); A/Victoria/361/2011 (H3N2)–like antigen; and B/Wisconsin/1/2010–like antigen (the influenza A [H3N2] and B antigens differ from those contained in the 2010–2011 and 2011–2012 seasonal vaccines); (2) annual universal influenza immunization is indicated; and (3) an updated dosing algorithm for administration of influenza vaccine to children 6 months through 8 years of age has been created. Pediatricians, nurses, and all health care personnel should promote influenza vaccine use and infection control measures. In addition, pediatricians should promptly identify influenza infections to enable rapid treatment, when indicated, to reduce morbidity and mortality.

Full article

Συχνά νοσήματα της σχολικής ηλικίας Back-to-School Illnesses

Πολύ ενδιαφέρουσες διαφάνειες για τα συχνότερα νοσήματα της σχολικής ηλικίας.

http://reference.medscape.com/features/slideshow/school

National Indicators of Child Well-Being: Good News and Bad News

Some important indicators are improving, but rates of child poverty continue to increase annually. 

America's Children in Brief: Key National Indicators of Well-Being is a report that integrates data on 41 medical and social indicators of child well-being from 22 federal agencies. The 2012 report reveals some surprising improvements, but also a continued rise in child poverty from 2009 to 2010.

Περισσότερα...

What is the Ideal Dose of Vitamin D for Term Neonates?

Vitamin D is essential for good bone health and insufficient levels are linked to rickets in children.[1 5] A resurgence of vitamin D insufficiency and nutritional rickets has been reported across many countries.[1] Studies in infants and children are also exploring the association between vitamin D insufficiency and type 1 diabetes mellitus as well as inflammatory diseases.[1 2] There are limited natural dietary sources of vitamin D and adequate sun exposure for the cutaneous synthesis of vitamin D is not easily determined for a given individual.[3] Therefore, the recommendations to ensure adequate vitamin D status have been revised to cover all infants, including those who are exclusively breastfed.[3]

Περισσότερα...

Improving Vision Screening in Kids

http://www.medscape.com/features/slideshow/vision-screen?src=mp&spon=38

The Gilles De La Tourette syndrome: the current status

Arch Dis Child Educ Pract Ed doi:10.1136/archdischild-2011-300585

Mary May Robertson, 1Department of Mental Health Sciences, University College, London

The article is available at: http://ep.bmj.com/content/early/2012/03/21/archdischild-2011-300585.abstract?papetoc

Abstract

Gilles de la Tourette syndrome (GTS) is characterised by multiple motor and one or more vocal/phonic tics. GTS was once thought to be rare, but many relatively recent studies suggest that the prevalence is about 1% of the worldwide community, apart from in Sub-Saharan Black Africa. Comorbidity and coexistent psychopathology are common, occurring in about 90% of clinical cohorts and individuals in the community. The most common comorbidities are attention deficit hyperactivity disorder, obsessive-compulsive behaviours, and disorder, and autistic spectrum disorders, while the most common coexisting psychopathologies are depression, anxiety and behavioural disorders such as oppositional defiant and conduct disorder. There has been an increasing amount of evidence to show that the quality of life in young people is reduced when compared with normative data or healthy control populations. It is widely accepted that most cases of GTS are inherited, but the genetic mechanisms appear much more complex than previously understood, as evidenced by many recent studies; indeed, there have been suggestions of ‘general neurodevelopmental genes’ which affect the brain development after which the ‘specific GTS gene(s)’ may further affect the phenotype. Other aetiopathogenetic suggestions have included environmental factors such as neuro-immunological factors, infections, prenatal and peri-natal difficulties and androgen influences. Few studies have addressed aetiology and phenotype, but initial results are exciting. The search for endophenotypes has followed subsequently. Intriguing neuroanatomical and brain circuitry abnormalities have now been suggested in GTS; the most evidence is for cortical thinning and a reduction in the size of the caudate nucleus. Thorough assessment is imperative and multidisciplinary management is the ideal. Treatment should be ‘symptom targeted’, and in mild cases, psycho-education and reassurance for the patient and the family may be sufficient. Behavioural treatments such as Comprehensive Behavioural Intervention for Tics including Habit Reversal Training have been shown to be significantly better than other behavioural/psychological treatments and ‘placebo’. Medication is often necessary for moderately affected individuals. In more severe cases, medical treatment is not simple and referral to an expert may be advisable. In general, neuroleptics and clonidine or guanfacine are the medications of choice for the tics. Other treatments which may be needed for loud and severe phonic tics include botulinum toxin. In severe adult GTS patients who are refractory to medication and other therapies, deep brain stimulation looks promising.

AAP Updates Childhood and Adolescent Immunization Schedules

Changes from the 2011 schedules include the following:

  • The 0- to 6-year-old schedule clarifies the administration of hepatitis B vaccine and hepatitis B immune globulin to infants weighing less than 2000 g and to infants weighing at least 2000 g whose mother is positive for hepatitis B surface antigen. This schedule also clarifies the timing of doses subsequent to the birth dose of hepatitis B vaccine.
  • The 7- to 18-year-old schedule clarifies use of the tetanus, diphtheria, and acellular pertussis vaccine for children aged 7 through 10 years who are not fully immunized with the childhood diphtheria, tetanus, acellular pertussis vaccination series.
  • The catch-up schedule includes guidance for the use of Haemophilus influenzae type b vaccine in persons at least 5 years of age.
  • The updated influenza vaccine footnotes now clarify vaccine dosing for the 2011 to 2012 season for children aged 6 months through 8 years and lists contraindications to the use of live-attenuated influenza vaccine.
  • The 2012 recommendations now include guidance for the use of measles, mumps, and rubella vaccine in infants aged 6 through 11 months who are traveling internationally.
  • Footnotes for hepatitis A now highlight administration of the second vaccine dose 6 to 18 months after the first dose. The 0- to 6-year-old schedule now includes a new yellow and purple bar describing hepatitis A vaccine recommendations for children at least 2 years of age.
  • The 2012 schedules offer guidance regarding routine administration of a booster dose of meningococcal vaccine (MCV4) and regarding administration of MCV4 to children in whom risk for meningococcal disease is increased. In the 0- to 6-year-old schedule, the MCV4 purple bar has been extended to represent licensure of Menactra (Sanofi Pasteur; MCV4-D) for use in children as young as 9 months.
  • The updated footnotes for human papillomavirus (HPV) vaccine now include a routine recommendation to vaccinate males with Gardasil (Merck; quadrivalent HPV vaccine).
  • The updated footnotes for inactivated poliovirus vaccine now note that this vaccine is not routinely recommended for US residents who are at least 18 years of age

Policy Statement

Game Changers in Pediatrics 2011

Medscape asked members of the Medscape Pediatrics Advisory Board and experts at Children's Hospital of Philadelphia (CHOP) to review the year in pediatric research. What were the "can't miss" studies and papers of 2011 that are changing clinical practice? We have summarized them and, based on interviews with these and other experts, noted why they are important and speculated about what this means to the world of primary care pediatrics. It should be noted -- this list is not all inclusive nor in order of importance because all are important and a truly comprehensive list would be impossible to construct.