Current opinion in pediatrics
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In this review, we discuss the recent advances in our understanding of the cause, pathogenesis, presentation, diagnosis, treatment, and prognosis of interstitial lung disease (ILD) in children. ⋯ Children's interstitial lung diseases are rare diffuse lung diseases resulting from a variety of pathogenic processes that include genetic factors, association with systemic disease processes, and inflammatory or fibrotic responses to stimuli. There are unique causes and presentations seen in infancy. Diagnosis in these disorders is made by the summation of clinical, radiologic, and pathologic findings.
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Curr. Opin. Pediatr. · Jun 2011
ReviewRecent progress in understanding pediatric pulmonary hypertension.
Pulmonary artery hypertension (PAH) in children contributes significantly to morbidity and mortality in diverse pediatric cardiac, lung, hematologic and other diseases. Advances in pulmonary vascular biology over the past few decades have significantly expanded therapeutic strategies; however, many unique issues persist regarding our understanding of pediatric PAH. ⋯ Despite many advances, long-term outcomes for children with PAH remain guarded and substantial challenges persist, especially with regard to understanding mechanisms and approach to severe PAH. Future studies are needed to develop novel biomarkers, clinical endpoints and interventions for young children with diverse causes of PAH.
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Curr. Opin. Pediatr. · Jun 2011
ReviewAdvances in simulation for pediatric critical care and emergency medicine.
Routine integration of simulation into healthcare education and practice has gained momentum. Simulation is particularly important to acute and critical care pediatrics, as it offers alternative methods of training for high-risk and/or lower-frequency events in children. This review will discuss the recent advances in simulation education for pediatric critical care and emergency medicine and assess its potential for future growth through these subspecialties. ⋯ High-fidelity simulation is emerging as a powerful tool for pediatric emergency medicine and critical care education through both individual and team-based training exercises. Programs can be tailored to meet specific institutional needs and budget limitations. As pediatric simulation-based programs evolve, further progress is anticipated in acute and critical care outcomes.
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Curr. Opin. Pediatr. · Jun 2011
ReviewAntibiotic prophylaxis and the prevention of surgical site infection.
Surgical site infection (SSI) is one of the most common complications of surgery in both adults and children. The purpose of the present review is to highlight the progress in the understanding of SSIs and the current role of antimicrobial prophylaxis (AMP). ⋯ Improvement in the perioperative care of children has reduced both the incidence and outcomes of SSI. However, several controversies still exist in the use of AMP in children. Future work by pediatricians, pediatric surgeons, and pediatric infectious disease specialists will enable us to better understand the specific indications and appropriate AMP in children.
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Curr. Opin. Pediatr. · Apr 2011
ReviewEvaluation and management of critically ill children with acute kidney injury.
This review will highlight recent studies on the diagnosis of acute kidney injury (AKI), review the differential diagnosis, highlight the importance of cumulative fluid overload and provide key management strategies for the pediatric patient with AKI. ⋯ Categorical definitions of AKI have shown that higher AKI portends poor outcomes even with adjustment for severity of illness and other confounders. Cumulative fluid overload independently predicts poor outcomes. Strategies to prevent and/or treat fluid overload are likely to improve outcomes.