Current opinion in pediatrics
-
Curr. Opin. Pediatr. · Apr 2012
ReviewUpdate on the management of simple febrile seizures: emphasis on minimal intervention.
We summarize recent clinical reviews and updated American Academy of Pediatrics (AAP) clinical guidelines for the management of children with simple febrile seizures. ⋯ If a child who is fully immunized according to the recommended schedule presents with a simple febrile seizure, minimal intervention should be the norm. Routine blood tests and routine lumbar punctures are usually unnecessary, and the risks of neurodiagnostic procedures (imaging or EEG), prophylactic antipyretics and anticonvulsants far outweigh their potential benefits.
-
Acute kidney injury (AKI) is associated with increased risk of morbidity and mortality in critically ill children and adults. Neonates remain an understudied group, although previous evidence suggests that this association holds true for them as well. ⋯ AKI is an independent risk factor for poor outcomes in critically ill neonates. Our ability to improve outcomes for these patients depends on heightened awareness of this issue both at the bedside as well as in research, commitment to using standardized AKI definitions in order to pool and compare data more effectively and improvement in our diagnostic methods with better AKI biomarkers so that we can identify AKI and intervene much earlier in the disease course.
-
Curr. Opin. Pediatr. · Feb 2012
ReviewQuality improvement interventions to prevent healthcare-associated infections in neonates and children.
Healthcare-associated infections cause substantial harm to hospitalized neonates and children. Efforts that prevent these infections are a major focus of current patient safety initiatives. This review focuses on the reports of quality improvement interventions to prevent central line-associated bloodstream infections (CLABSIs) in neonates and children. ⋯ Quality improvement interventions to reduce CLABSI are an important component of patient safety initiatives. Future studies of quality improvement interventions to reduce HAI among hospitalized neonates and children will benefit from further investigation of methods to enhance reliable implementation of evidence-based practices, factors that enable multicenter collaboratives to be more successful, and better understanding of the causes of heterogeneity in the results at different centers.
-
The purpose of this review is to describe the new DNA sequencing technologies referred to as next-generation sequencing (NGS). These new methods are becoming central to research in human disease and are starting to be used in routine clinical care. ⋯ Here we discuss how whole-exome sequencing and whole-genome sequencing are used in basic research and clinical care. These new techniques promise to speed research and affect how healthcare is delivered.
-
Curr. Opin. Pediatr. · Jun 2011
ReviewProtecting the future: neuroprotective strategies in the pediatric intensive care unit.
Brain injury is the leading cause of death in pediatric intensive care units, and improvements in therapy and in understanding the pathogenesis are urgently needed. This review presents recent advances in the understanding of neuroprotective therapy and brain-specific monitoring for critically ill pediatric patients. ⋯ Protection of the pediatric brain from both a primary insult and the common subsequent secondary injury is essential for improving long-term neurologic outcomes. Whereas monitoring technology is being constantly modified, it must be proven efficacious in order to understand the utility of new and presumed neuroprotective therapies like hypothermia and avoidance of hyperoxia.