Current opinion in pediatrics
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Food allergy, a growing clinical and public health problem in the United States and worldwide, is likely determined by multiple environmental and genetic factors. The purpose of this review is to summarize recent advances in food allergy genetic research. ⋯ Genetics in food allergy is a promising research area but is still in its infancy. More studies are needed to dissect susceptible genes of food allergy. A genome-wide association approach may serve as a powerful tool to identify novel genes related to food allergy. Furthermore, the role of gene-environment interaction, gene-gene interaction, and epigenetics in food allergy remains largely unexplored. Given the complex nature of food allergy, future studies need to integrate environment, genomics, and epigenomics in order to better understand the multifaceted etiology and biological mechanisms of food allergy.
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The focus on quality improvement has led to several types of initiatives in pediatric care; however, these programs may lead to potential unintended consequences. ⋯ Recognition and anticipation of the possible unintended consequences of guideline implementation is a critical step to harnessing all the benefits of quality improvement in practice.
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This review highlights recent publications on the use of the Internet as it relates to pediatric primary care, including its application to the pediatrician, teen, pediatric patient, and patients' parents. A brief overview of early work is introduced. ⋯ The Internet is more than an information repository and continues to affect the lives and health of the pediatric population, parents, and providers. The growth of and changes to the Internet over time bring online innovations that have yet to be studied.
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Curr. Opin. Pediatr. · Oct 2009
ReviewAssessment of pulmonary vasoreactivity in children with pulmonary hypertension.
With the current advance in understanding and treatment of pulmonary arterial hypertension in children, pulmonary vasoreactivity testing would navigate the treatment option. An inclusive review of the milestone studies and also recent literature over the last few years on the pulmonary vasoreactivity testing in children will provide the update on various available pulmonary vasodilator agents, markers related to vasoreactivity response, the implication of the testing result on child management and outlook for the long-term outcome. ⋯ The precise definition of pulmonary vasoreactivity testing remains debatable, particularly in children with pulmonary hypertension related to congenital heart defect. Defining the responder, in order to navigate the treatment option, is frequently dictated by institutional experience and facilities. Meanwhile, the criteria for responder in children with idiopathic pulmonary artery hypertension are reasonably consistent. In general, responders seem to have less severe disease and better prognosis.