Abstract:
PURPOSE OF REVIEW:The purpose of this review is to describe current concepts on inflammation, immunity and insulin resistance. Metabolic and immune systems are closely involved in inflammation and significantly contribute to the pathology seen in the pediatric intensive care unit. The ability of insulin to decrease hepatic glucose production, suppress adipose tissue lipolytic rate, stimulate skeletal muscle glucose uptake, suppress protein breakdown and increase protein synthesis is critical to maintain metabolic function. Hence, a better understanding of these regulatory mechanisms and the alterations leading to dysfunction will set the basis for a better metabolic and immune support of critically ill patients. RECENT FINDINGS:Inflammation can be elicited by infection (sepsis) through pathogen associated molecular patterns (PAMPs) or through danger associated molecular patterns (DAMPs) as a response to an insult (systemic inflammatory response syndrome; SIRS) in the absence of infection. Mitochondrial DAMPs and PAMPs share the same pattern recognition receptors. These receptors act also as nutrient sensors, and in the presence of fatty acids will induce an inflammatory cascade that affects insulin signaling with development of insulin resistance. Lipotoxicity is emerging as a significant contributor to the development of insulin resistance. SUMMARY:Insulin resistance is an adaptive mechanism that prioritizes utilization of energy for immune response in the presence of infection or injury. A better understanding of the complex interactions between metabolism, inflammation and immunity in critically ill children will lead to appropriate metabolic and immune support of these patients.
journal_name
Curr Opin Pediatrjournal_title
Current opinion in pediatricsauthors
Dhar A,Castillo Ldoi
10.1097/MOP.0b013e3283464b3esubject
Has Abstractpub_date
2011-06-01 00:00:00pages
269-74issue
3eissn
1040-8703issn
1531-698Xjournal_volume
23pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:An understanding of vaccine safety is important for all immunization providers, who have responsibilities to identify, report, and prevent adverse events. RECENT FINDINGS:New analytic methods can provide more rapid information on adverse events compared with traditional observational studies. Some ad...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e3283350425
更新日期:2010-02-01 00:00:00
abstract::A careful history and physical examination will help to differentiate between encopresis with or without constipation and fecal incontinence caused by anatomic or organic disease. Most children with encopresis with or without functional constipation require no or minimal laboratory workup. Successful treatment of enco...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-200210000-00002
更新日期:2002-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The term 'dual diagnosis' most commonly refers to the combination of severe mental illness and substance-use disorder (SUD). It is estimated that 7-10 million people in the USA alone have at a minimum one psychiatric disorder in addition to a SUD. As many of the psychiatric illnesses implicated have t...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e3283504fbf
更新日期:2012-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Diaper dermatitis is the most common cutaneous diagnosis in infants. In this review, common causes of diaper dermatitis and similarly presenting conditions will be covered, as well as updates on treatments of common diaper dermatitides. RECENT FINDINGS:There have been recent advancements in the treat...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e32835585f2
更新日期:2012-08-01 00:00:00
abstract::Large and unusually large von Willebrand factor (vWf) multimers may be responsible for systemic platelet aggregation in thrombotic thrombocytopenic purpura (TTP). This possibility is supported by studies that show deficient vWf-cleaving metalloproteinase and increased platelet-vWf binding during TTP episodes. In acute...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-200002000-00005
更新日期:2000-02-01 00:00:00
abstract::Food allergy or hypersensitivity is defined as an adverse reaction to food protein which is immune mediated. Without standard definitions and reliable tests for many forms of allergic disease of the bowel, studies are difficult to interpret. The proceedings of a recent workshop on the classification of adverse immunol...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-200010000-00006
更新日期:2000-10-01 00:00:00
abstract::In this section we review four broad topics in pediatrics: atopic disease, rhinitis and conjunctivitis, upper respiratory tract infections, and insect stings and snake bites. The first three topics comprise three of the most commonly encountered problems in pediatric practice. Although the fourth topic accounts for a ...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-199410000-00018
更新日期:1994-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To emphasize an exploration of mechanisms of kidney stone disease based on a molecular understanding of excess urinary excretions of calcium, oxalate, cystine, and uric acid. RECENT FINDINGS:Hypercalciuria is discussed relative to mutations in the renal chloride genes CLCN5 and CLCNKB, WNK kinases, A...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-200404000-00013
更新日期:2004-04-01 00:00:00
abstract::Risk factors for infant development are considered in three areas: infant temperament, postpartum depression, and prenatal cocaine exposure. Investigations of all three areas indicate that contextual characteristics of infant development must be incorporated into models attempting to link early risk factors with later...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-199408000-00009
更新日期:1994-08-01 00:00:00
abstract:PURPOSE OF REVIEW:First-time parents often turn to friends and family for advice regarding feeding, sleeping, bathing, diapering and toilet training, and childhood illnesses. Unfortunately, parents may at times be given incorrect and potentially dangerous advice as several widely embraced parenting practices are no lon...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000835
更新日期:2019-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Inherited disorders of calcium and phosphate homeostasis have variable presentation and can cause significant morbidity. An understanding of the mode of inheritance and pathophysiology of these conditions will help in the diagnosis and early institution of therapy. RECENT FINDINGS:Identification of g...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章
doi:10.1097/MOP.0000000000000064
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Major advances in our understanding of the genetic basis of neuroblastoma, and the role somatic alterations play in driving tumor growth, have led to improvements in risk-stratified therapy and have provided the rationale for targeted therapies. In this review, we highlight current risk-based treatmen...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000296
更新日期:2016-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Juvenile myasthenia gravis is a relatively rare autoimmune neuromuscular disorder. The pathophysiology of juvenile myasthenia gravis is similar to that of adult myasthenia gravis, though there remain important differences regarding presentation and therapeutic options. We review the pathophysiology, c...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e328365ad16
更新日期:2013-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Osgood-Schlatter disease (OSD) is one of the most common causes for anterior knee pain in children and adolescents resulting from a traction apophysitis of the tibial tubercle. While a peak in boys aged 12-15 years old was well documented, there seems to be no difference in sex distribution nowadays. ...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000842
更新日期:2020-02-01 00:00:00
abstract::The biology of the X chromosome is unique, as there are two Xs in females and only a single X in males, whereas the autosomes are present in duplicate in both sexes. The presence of only a single autosome, which can occur as a result of an error in meiotic segregation, is invariably an embryonic lethal event. Monosomy...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-200108000-00010
更新日期:2001-08-01 00:00:00
abstract::Necrotizing enterocolitis is an overwhelming gastrointestinal emergency that primarily afflicts premature infants born weighing less than 1500 g. Despite years of investigation, the etiology remains unclear, and accepted prevention and treatment strategies are lacking. Studies published over the last year have provide...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-200104000-00004
更新日期:2001-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Spondylolysis is a common cause for back pain in the adolescent athlete. Increased awareness of the presentation of this subset of patients can aid in optimal outcomes. This paper aims to review the typical presentation of spondylolysis in the adolescent with specific focus on the adolescent athlete. ...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e32834255c2
更新日期:2011-02-01 00:00:00
abstract::This review highlights advances in our understanding of the genetic basis for alopecia areata. New findings in trichothiodystrophy, Bazex syndrome, and Netherton's syndrome are also discussed. Finally, abnormalities of the hair, such as atrophic midline bald patches, generalized follicular hamartoma, and loose anagen ...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/00008480-199608000-00013
更新日期:1996-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne illness in the United States. The pathogenesis, ecology, and epidemiology of Lyme disease have been well described, and antimicrobial treatment is very effective. There has been controversy about whether infection can persis...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000167
更新日期:2015-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The present coronavirus disease 2019 (COVID-19) pandemic has created additional challenges with an increased number of presumed healthy, full-term newborns being discharged at 24 h after delivery. Short lengths of stay raise the possibility of mother-infant dyads being less ready for discharge, define...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000931
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Lung disease in cystic fibrosis (CF) results from chronic airway infection and inflammation leading to progressive bronchiectasis and respiratory failure. Bacterial pathogens, including Pseudomonas aeruginosa, Staphylococcus aureus, and Burkholderia cepacia, are known contributors. Recent studies usin...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e32834604f2
更新日期:2011-06-01 00:00:00
abstract:PURPOSE OF REVIEW:We present data from recently conducted research regarding the diagnosis of blunt cervical spine injury (CSI) in children. RECENT FINDINGS:Research in the prehospital setting to evaluate the need for cervical spine immobilization in children, regardless of clinical findings or mechanism of injury, su...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e3283527035
更新日期:2012-06-01 00:00:00
abstract::Major advances in the genetic understanding of the limb-girdle (LGMD) and congenital (CMD) muscular dystrophies have led to a new, genetically based classification of these disorders. The definition of the complex of dystrophin-associated proteins on a biochemical and subsequently genetic level has greatly accelerated...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The prevalence of pediatric atopic dermatitis (AD) has increased throughout the world, now ranging from 10 to 20% in developed countries. Pediatric patients with AD make up a substantial proportion of patients seen by general pediatricians, allergists, dermatologists, and other specialists. As such, t...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000109
更新日期:2014-08-01 00:00:00
abstract:PURPOSE OF REVIEW:We present data from recently conducted research on the diagnosis and management of skin and soft tissue infections (SSTIs) in children. RECENT FINDINGS:Current research in the area of SSTIs (cellulitis and abscess) has focused on the use of ultrasound, risk factors associated with bacteremia, antibi...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000213
更新日期:2015-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Simulation has been widely adopted as a training and assessment tool in medical education. Conventional teaching methods may be inadequate to properly train healthcare providers for rare but potentially lethal events in pediatrics such as trauma and respiratory arrest. Recent studies suggest pediatric...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0b013e32832b32dc
更新日期:2009-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Enteroviruses cause a wide variety of diseases with neurologic, respiratory, skin, and gastrointestinal findings. The purpose of this review is to clarify changes in the classification of enteroviruses, provide information about recent disease outbreaks, and to summarize progress toward the treatment ...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000303
更新日期:2016-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Joint hypermobility is a common, although largely ignored physical sign. Joint hypermobility is often asymptomatic but may be a feature of an underlying genetic disorder with systemic manifestations. The present article presents a comprehensive approach to considering joint hypermobility and clinicall...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章,评审
doi:10.1097/MOP.0000000000000541
更新日期:2017-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Environmental factors, such as drugs, chemicals, or abnormal concentrations of natural metabolites, induce birth defects. Environmental effects on cardiogenesis have been little studied in contrast to neurogenesis. This review presents evidence on three environmental factors: alcohol, the drug lithium...
journal_title:Current opinion in pediatrics
pub_type: 社论,评审
doi:10.1097/MOP.0b013e32833e2723
更新日期:2010-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review will be covering dysfunctional voiding, its diagnosis, and treatment options. This will focus primarily on dysfunctional voiding rather than all lower urinary tract dysfunction and we will focus on some of the newer findings and progress within this disease. RECENT FINDINGS:Dysfunctional ...
journal_title:Current opinion in pediatrics
pub_type: 杂志文章
doi:10.1097/MOP.0000000000000980
更新日期:2020-12-10 00:00:00