Current opinion in pediatrics
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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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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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Curr. Opin. Pediatr. · Oct 2009
ReviewThe adult with congenital heart disease: medical and surgical considerations for management.
The purpose of the present review is to outline some of the challenges of surgical and medical management in the adult with congenital heart disease (CHD). ⋯ Adults with CHDs present difficult challenges in the preoperative, intraoperative, and postoperative setting. Regional centers of excellence with congenitally-trained cardiac surgeons, cardiologists, and other medical subspecialists are required to optimize outcome.