Advances in Pediatrics RSS feed: Current Issue. Each year, Advances in Pediatrics brings you the best current thinking from the preeminent practitioners in your field. A distinguished editorial board identifies current areas of major progress and controversy and invites specialists to contribute original articles on these topics. These insightful overviews bring concepts to a clinical level and explore their everyday impact on patient care. Volume 57 Highlights (coming Fall 2010) Foundations of Pediatrics: Fuller Albright, MD Advances in the Management of Pain in Children: Chronic Pain Coccidiodomycosis Non-alcoholic Fatty Liver Disease Diabetic Ketoacidosis Therapeutic Use of Immunoglobulins Childhood Injuries: Accidents and Poisonings Advances in Pediatric Pharmacology, Therapeutics, and Toxicology Pediatric Outpatient Parenteral Antimicrobial Therapy: An Update Hemophilia Bridging Mental Health and Medical Care in Underserved Pediatric Populations: Three Integrative Models Ketogenic Diet The GH/IGF-1 Axis in Growth and Development: New Insights Derived from Animal Models Cochlear Implants Surgical Treatment of GERD Fetal Diagnosis and Surgical Intervention Controversies in the Evaluation of Young Children with Fractures Disaster Preparedness Editor-in-Chief: Michael S. Kappy Associate Editors: Lewis A. Barness, Leslie L. Barton, Enid Gilbert-Barness, and Moritz Ziegler http://www.advancesinpediatrics.com/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. Advances in Pediatrics0065-31015812011 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.advancesinpediatrics.com/article/PIIS0065310111000259/abstract?rss=yesContributors10.1016/S0065-3101(11)00025-9Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6ixxihttp://www.advancesinpediatrics.com/article/PIIS0065310111000260/abstract?rss=yesContents10.1016/S0065-3101(11)00026-0Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6xiiixixhttp://www.advancesinpediatrics.com/article/PIIS006531011100017X/abstract?rss=yesThe editors present volume 58 of Advances in Pediatrics. In keeping with our tradition of honoring those who contributed greatly to pediatrics, we feature Waldo Nelson, MD, a giant in our field, as our annual honoree in the “Foundations of Pediatrics” segment of this issue. The article by Chan is in keeping with our recent addition of articles on international health. As with the past issues, a variety of topics related to general pediatric care are presented, as well as topics related to infectious disease, endocrinology, surgery, pharmacology, and others. We welcome suggestions for topics to be included in future volumes of Advances in Pediatrics, and these may be communicated to us at: kappy.michael@tchden.org.IntroductionMichael S. Kappy10.1016/j.yapd.2011.03.016Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6xxixxihttp://www.advancesinpediatrics.com/article/PIIS0065310111000156/abstract?rss=yes How to describe a man who was mentor to many, editor supreme, taskmaster, husband, father, grandfather, great grandfather, and overall a powerful influence on pediatric education and clinical care in the world? One could simply recite his biography and accomplishments but that would simply be the facts; underlying them is a force in pediatrics felt even today by his disciples throughout the world and continual publication of his seminal text and the journal he devoted his expertise to for many years. Perhaps the best way to start is to discuss this influence and force and then give the so-called backstory of his personal and professional life.Waldo E. Nelson, MD (1898–1997) Giant of PediatricsVincent A. Fulginiti10.1016/j.yapd.2011.03.014Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6110http://www.advancesinpediatrics.com/article/PIIS0065310111000168/abstract?rss=yesTwenty years ago, when I (the author, K.C.) was a young medical student, a little girl asked the group of us who were working in rural Malawi, “Why can you who have so much not help us who have so little?” Twenty years ago, the challenge was identifying health as an issue. I remember speaking at a meeting of leaders in Malawi in the late 1990s about the specter of HIV/AIDS affecting both men and women, and was told that the disease was something seen only in Western countries.Developing Leadership in Global Child HealthKevin Chan10.1016/j.yapd.2011.03.015Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-61126http://www.advancesinpediatrics.com/article/PIIS0065310111000119/abstract?rss=yesIn the last several years there have been several reports with new nutritional recommendations for infants and children. These reports have included new ideas on how to prevent the development of atopic disease that suggest that the established practices of restricting the introduction of complementary foods to infants may promote atopic disease . There are new recommendations for iron supplementation for infants and toddlers that point out the importance of introducing iron-rich complementary foods much earlier in the diet of infants, particularly if they are exclusively breastfed . There are also new recommendations for increased supplements of vitamin D for infants, children, and adolescents . In addition, there are new recommended nutritional guidelines for children at risk for overweight hypercholesterolemia , and a new American Academy of Pediatrics (AAP) statement that questions the benefits of the addition of probiotics and prebiotics to the diet of healthy children . These new recommendations are reviewed in this article for pediatric health care providers.Update on Nutritional Recommendations for the Pediatric PatientFrank R. Greer10.1016/j.yapd.2011.03.010Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-62739http://www.advancesinpediatrics.com/article/PIIS0065310111000077/abstract?rss=yesPerhaps the biggest news in the immunization world over the past 2 years was the 2009 (H1N1) novel influenza A virus outbreak. The virus was initially identified to be the cause of influenza-like illness in two children in the United States during March and April 2009 and the cause of respiratory illness outbreaks in Mexico . The virus spread rapidly and within weeks cases were identified across the United States and in several countries around the world. On June 11, 2009 the Director General of the World Health Organization (WHO) Dr Margaret Chan declared a global pandemic. As of August 10, 2010, this has been updated to postpandemic status. This review focuses on discussing the 2009 pandemic briefly along with the global response in terms of vaccine development, recommendations for vaccination for the 2010–2011 influenza season, followed by other recent updates in adolescent and pediatric vaccines.Immunization Update IIIAyesha Mirza, Mobeen H. Rathore10.1016/j.yapd.2011.03.006Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-64164http://www.advancesinpediatrics.com/article/PIIS0065310111000090/abstract?rss=yesIn the summer of 1956, the first two members of the Parechovirus genus were isolated from Ohio children with diarrhea . Human parechoviruses (HPeVs) types 1 and 2, as they would eventually become known, were originally designated as the 22nd and 23rd members (Harris and Williamson strains, respectively) of the “enteric cytopathic human orphan (ECHO) group” or echoviruses (E22 and E23, respectively) . Over the next 50 years, the advent of molecular and genomic virology would provide tools for their in-depth characterization and the identification of other members of the Parechovirus genus . This article reviews past and current medical literature concerning the virology, epidemiology, clinical significance, and diagnosis of the HPeV.The Human Parechoviruses: An OverviewJosé R. Romero, Rangaraj Selvarangan10.1016/j.yapd.2011.03.008Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-66585http://www.advancesinpediatrics.com/article/PIIS0065310111000107/abstract?rss=yesFoster care was designed to provide temporary, nurturing environments to children while their caregivers (usually birth parents) receive services to help them facilitate eventual reunification. The number of children in foster care in the United States has been steadily increasing in the past 2 decades with more than 500,000 children in care on any given day . However, according to the US Department of Health and Human Services, Adoption and Foster Care Analysis and Reporting System (AFCARS), there has been a gradual decline in numbers since fiscal year (FY) 2007. In AFCARS Report #17, an estimated 424,000 children were in foster care in the United States on September 30, 2009. Since 2007, the number of foster children exiting the system has been greater than those entering. Overall, the number of children in foster care has declined to its lowest level since 2002, and the number of adoptions has increased to its highest level . The recent trend has been to (1) attempt to keep children with their birth families while providing family preservation services, (2) push for more timely reunification of families, and (3) commence concurrent planning early with the aim of expediting termination of parental rights and permanency preparation in cases where reunification is not possible . Despite this progress, there still are a large number of children in foster care who require quality health care assessments, treatment, and close monitoring.Care of the Foster Child: A Primer for the PediatricianClaudia Wang, Susan B. Edelstein, Lori Waldinger, Caroline M. Lee, Eraka Bath10.1016/j.yapd.2011.03.009Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-687111http://www.advancesinpediatrics.com/article/PIIS0065310111000041/abstract?rss=yesAnnie (identity disguised) is a student at one of the public high schools where a school-based health clinic (SBHC) is located in the building. Annie is called to the clinic during school to receive her second human papilloma virus (HPV4) vaccination. The medical assistant checking her into the clinic noticed that she has lost quite a bit of weight. When questioned further, Annie stated that she was not trying to lose weight. The medical assistant had her see the primary care provider in the clinic instead of only vaccinating her and sending her back to class. After a history and physical examination were obtained, the clinician notes that Annie has experienced polyuria and polydipsia. A urinalysis in the clinic displays glucosuria and ketonuria. Fortunately, she was not severely acidotic at this time. Ultimately, Annie was referred to endocrinology and diagnosed as having Type I diabetes.School-Based Health Centers: A Model for the Provision of Adolescent Primary CareSteven G. Federico, Wanda Marshall, Paul Melinkovich10.1016/j.yapd.2011.03.003Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6113121http://www.advancesinpediatrics.com/article/PIIS0065310111000089/abstract?rss=yesThe 1990s ended optimistically for the United States and for pediatric education: the country had accumulated a financial surplus, the pediatrics community had come together to deliberate the Future of Pediatric Education II, and medical education had a new paradigm (the Outcome Project). The past decade has been a tumultuous one, and optimism is now tempered by concerns and questions. Any attempt to discuss medical education needs to take into account the societal forces that affect health care, which is the context for medical education. Of the 10 issues addressed in this article, the first 5 are societal factors with implications for education; the last 5 are issues within medical education, with emphasis on pediatric education. The 10 are discussed individually but clearly interact and overlap. The order in which they are discussed is not intended to convey a rank of importance.The Past Decade in Pediatric Education: Progress, Concerns, and QuestionsKenneth B. Roberts10.1016/j.yapd.2011.03.007Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6123151http://www.advancesinpediatrics.com/article/PIIS006531011100003X/abstract?rss=yesThe past several decades have witnessed an increased awareness of mental health disorders and neurobehavioral problems in children . These behavioral issues now represent a growing portion of pediatric visits. Addressing and appropriately managing early-onset disorders may improve quality of life while providing hope that adult morbidity may be attenuated . Given the shortage of mental health providers and the concept of the pediatric practice as “medical home,” many pediatricians are poised to receive this population. Caring for this population of children is riddled with systemic obstacles. Lack of time, training, support, and compensation, together with poor integration of collaboration with mental health resources, all contribute to this challenge. Children’s mental health has become a priority issue for the American Academy of Pediatrics .Controversies Surrounding Pediatric PsychopharmacologyRobin Steinberg-Epstein, Teri Book, Sharon B. Wigal10.1016/j.yapd.2011.03.002Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6153179http://www.advancesinpediatrics.com/article/PIIS0065310111000132/abstract?rss=yesPatients and families suffering from intestinal failure are exposed daily to physical, emotional, and fiscal burdens that result in an immeasurable amount of distress . Intestinal failure occurs in these patients because of an inability of their bowel to meet fluid and/or nutritional needs required to sustain normal physiology and growth without parenteral nutritional support. In children, short-bowel syndrome (SBS) is the major cause of intestinal failure and results from both congenital disorders and extensive surgical resection. The common causes of SBS include intestinal atresia, abdominal wall defects (primarily gastroschisis), intestinal volvulus, long-segment Hirschsprung disease, complicated meconium ileus, and necrotizing enterocolitis (30% of cases and the most common cause).Management of Pediatric Intestinal FailureJeffrey J. Dehmer, Megan K. Fuller, Michael A. Helmrath10.1016/j.yapd.2011.03.012Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6181194http://www.advancesinpediatrics.com/article/PIIS0065310111000065/abstract?rss=yesInfantile hypertrophic pyloric stenosis (IHPS), the most common surgical condition producing emesis in infancy, was first described by Hirschsprung in 1888. Ramstedt performed the first successful pyloromyotomy in 1912; however, most cases were lethal at that time. Although advances in medical knowledge and care have resulted in minimal mortality and morbidity today, the cause of IHPS remains unclear . This article provides an update on IHPS, focusing on pathogenesis, diagnosis and treatment, descriptive epidemiology and associated risk factors, and current understanding of the role of genetics.Infantile Hypertrophic Pyloric Stenosis: Epidemiology, Genetics, and Clinical UpdateJudith D. Ranells, Jane D. Carver, Russell S. Kirby10.1016/j.yapd.2011.03.005Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6195206http://www.advancesinpediatrics.com/article/PIIS0065310111000181/abstract?rss=yesGrowth hormone (GH) has been used to treat patients with GH deficiency (GHD) since 1960 when it was originally extracted from cadaveric pituitary glands . In 1985, several cases of Creutzfeldt-Jakob disease were identified and attributed to pituitary-derived GH. Later that year, recombinant human GH (rhGH) was approved by the US Food and Drug Administration (FDA). The availability of an unlimited supply of rhGH improved access to therapy for children with GHD and the frequency of dosing increased from 3 times each week to 6 or 7 days each week . The increased supply of rhGH allowed investigation into treatment of multiple conditions associated with short stature not associated with GHD leading to FDA approval for treatment of children with growth failure associated with chronic renal insufficiency (1993), Turner syndrome (TS; 1996), Prader-Willi Syndrome (PWS; 2000), small for gestational age (SGA) without adequate catch-up growth (2001), idiopathic short stature (ISS; 2003), short stature homeobox (SHOX) deficiency (2006), and Noonan syndrome (NS, 2007). In addition, rhGH therapy was FDA approved for acquired immune deficiency syndrome (AIDS) wasting (1996), adult GHD (1996), and short bowel syndrome (2003) (). Guidelines for the use of GH therapy have been reported previously by the American Association of Clinical Endocrinologists (AACE), Growth Hormone Research Society (GRS), and The Lawson Wilkins Pediatric Endocrinology Society (LWPES) .rhGH Safety and Efficacy UpdateBradley S. Miller10.1016/j.yapd.2011.05.001Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6207241http://www.advancesinpediatrics.com/article/PIIS0065310111000053/abstract?rss=yesPrecocious puberty is one of the most common endocrine disorders seen by primary care physicians and continues to be a major source of concern for both parents and providers. Since the author’s previous review on this subject in Advances In Pediatrics in 2004 , there have been several reports that have added to the knowledge base and confirmed that signs of puberty in girls are appearing earlier than in the past in the United States as well as in other countries. In this article, the author reviews what pediatricians should know about the physical findings seen during normal puberty and their hormonal basis. The evidence that signs of puberty are appearing earlier than 30 to 40 years ago, at least in girls, and the major theories about why this might be occurring are also discussed. However, the key point to be made is that pediatricians should be able to recognize the benign causes of early breast and pubic hair development, which are, at least in the United States, far more common than the cases that might benefit from treatment. The current state of knowledge concerning the diagnosis and treatment of central (true) precocious puberty (CPP) and the red flags that might point toward one of the rare causes of gonadotropin-independent precocious puberty (GIPP) are then reviewed.Update on Precocious Puberty: Girls are Showing Signs of Puberty Earlier, but Most Do Not Require TreatmentPaul Kaplowitz10.1016/j.yapd.2011.03.004Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6243258http://www.advancesinpediatrics.com/article/PIIS0065310111000028/abstract?rss=yesThe understanding of seizures and epilepsy has grown tremendously in the past decade, and many more treatment options have become available. Yet, pediatric epilepsy still remains a great challenge for clinicians to manage. This article describes how seizures and epilepsy are understood and classified today and how to approach the management of patients with seizures and updates the pediatrician on the newest approaches to epilepsy treatment.Update on Pediatric EpilepsyAgnes H. Chen10.1016/j.yapd.2011.03.001Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6259276http://www.advancesinpediatrics.com/article/PIIS0065310111000144/abstract?rss=yesHearing loss is the most common congenital sensory impairment, with an incidence of 2 to 3 per 1000 live births. Approximately half of these newborns have severe-profound loss. Hearing loss can significantly hinder a child’s expressive and receptive communication and, as a result, be detrimental to cognitive, educational, and psychosocial development. Fortunately, with the advent of universal newborn hearing screening, which is now mandated in most states, hearing loss is usually discovered very early in life. This screening provides the opportunity to intervene in the nascent stages of childhood development. Early intervention has far-reaching impact not only in terms of furthering a child’s communication abilities, but also in its potential to change the direction of a child’s life.Hearing Loss and Cochlear Implantation in ChildrenPatricia J. Yoon10.1016/j.yapd.2011.03.013Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6277296http://www.advancesinpediatrics.com/article/PIIS0065310111000120/abstract?rss=yesIn the discipline of pediatric cancer biology, neuroblastoma signifies an oncologic conundrum given the clinical range with which it presents. Prognosis correlates with age and the degree of differentiation, and thus, outcomes vary from high rates of survival (with possible tumor regression) to recurrence and mortality. Although the standard of treatment is a combination of chemotherapy, radiation, and surgical resection, there is growing evidence that aggressive neuroblastomas are resistant to our therapies. To this end, research has been focused on the molecular mechanisms behind differentiation, cell survival and apoptosis, angiogenesis, and metastasis to elucidate where the process goes awry. The basis of this research has led to the development of novel therapies that are directed toward key targets, some of which are quite promising. While discussing clinical background, this article aims to provide a synopsis of the latest, up-and-coming developments in the field of neuroblastoma.NeuroblastomaNadja C. Colon, Dai H. Chung10.1016/j.yapd.2011.03.011Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6297311http://www.advancesinpediatrics.com/article/PIIS0065310111000272/abstract?rss=yesIndex10.1016/S0065-3101(11)00027-2Advances in Pediatrics 58, 1 (2011)Advances in Pediatrics581S0065-3101(11)X0002-6313317