Pediatrics

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Pediatrics

Resources for managing pediatrics patients

19  articles in this collection
Written by Camille Blouin, Audrey Mathieu, Janike Pelland, Marc-Antoine Tremblay, 

Postpartum Care and Breastfeeding

Delayed umbilical cord clamping does not seem to increase pathogens transmission. Leaving vernix caseosa in place 24h after birth can be considered due to the presence of antimicrobial peptides. The majority of neonatal infections are caused by the environment and droplet transmission from the mother and other relatives.  Physical separation at birth can be considered […]

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03/28/2020

Pediatric Multi-System Inflammatory Syndrome: A New Clinical Presentation in Children

The United States (including New York City) and the United Kingdom have recently reported cases of multi-system inflammatory syndrome in children and adolescents potentially associated with COVID-19. The NYC Health Department reported 15 patients hospitalized between April 17 and May 1 with symptoms consistent with this syndrome. The presentation varies between a typical Kawasaki disease, […]

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05/17/2020

Epidemiology and Transmission in Pregnancy

Epidemiology : Epidemiological and transmission tendencies are like those seen in non-pregnant adults.  Consistent with findings in non-pregnant adults, the cases were predominantly classified as mild or common in terms of severity. Lag time between onset of symptoms and diagnosis was directly related to the severity of the infection.   Transmission via the reproductive system […]

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04/05/2020

Youngsters’ Cases Characteristics

Longer incubation period was seen in children, thus reinforcing usage of preventive control interventions in time; Majority of positive patients had a confirmed case in their family members; Asymptomatic infections are more frequent than in adults; The most common finding in chest computed tomography (CT scan) was bilateral ground-glass opacity; Patients with pre-existing comorbidities could […]

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05/04/2020

Shared Decisions in Managing Neonates

Neonatal resuscitation: Could be performed either in a separate room or in the delivery room; If done in the delivery room, should at least be 6 feet/2m away from the mother. Infant placement: Can be placed either in a separate negative pressure room or in the same room; If mother wants to visit, she should […]

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05/04/2020

Carefully Resuscitating Newborns from Suspected or Confirmed Mothers

Generally: Assign a specific neonate resuscitation team to attend deliveries to minimize health care providers and non-infected mothers and infants’ exposure; Owing to an immature immune system, neonates, especially premature ones, could be at more risk of being infected postnatally; Predicting which infant will require intubation or deep suctioning is hard; consider airborne PPE for […]

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05/04/2020

Antimalarials Need Further Studies

Few papers suggested that viral replication in vitro was diminished by chloroquine, but those were only laboratory studies. It has not been supported by animal studies; Antimalarial drugs such as chloroquine and its derivatives are associated with significant adverse effects; Particularly in times of restricted supplies, unjustified and/or overuse can cause drug shortages for those […]

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05/04/2020

Are NSAIDs Safe with Children?

Fever in pediatric patients is usually managed using antipyretic medication like acetaminophen and ibuprofen; A review of case-control studies² proposed that NSAIDs could increase the risks of complications in cases of respiratory disease. The hypothesis lies in the inhibiting effect on cyclo-oxygenase, which diminishes white cells recruitment and making harder for the inflammation to resolve; No […]

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05/04/2020

Symptomatology in Neonates

In 33 neonates at risk or with COVID-19, four of them presented with shortness of breath, thus being the most common symptom; Two positive neonates experienced lethargy and fever and one had vomiting; All of the three positive patients developed pneumonia as shown on their chest x-ray; One patient who needed 11 days of NICU […]

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04/22/2020

Lab Tests and Severity of Infection in Children

A progressive lymphopenia < 1000 seems to be associated with a more severe disease; CRP (C-Reactive Protein) appears to be elevated in some cases, but could be explained by bacterial co-infection. Elevated PCT (procalcitonin) levels could also point out to a coinfection and should be included in the blood work. These patients might be more […]

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03/28/2020

Children Outcomes From a Systematic Review

  Children represent 1-5% of confirmed COVID-19 cases. In general, they present milder symptoms than adult patients, possibly accounted for by the fact that they have less comorbidities and a less mature angiotensin-converting enzyme (ACE). They have a lower mortality rate.   Pediatric patients could be discharged from hospital when body temperature is normal for […]

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03/26/2020

Advice for Families

Honest conversations with your kids about the situation and what you parents do to keep them safe is a key to stress management; Parents should maintain routine as much as possible; Pay special attention to social media exposure and misinformation. Choose trusted sources; Take the time to teach good preventive habits: handwashing techniques, washing surfaces […]

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04/17/2020

Characteristics of The Most Unwell Children

There is no gender difference.  The proportion of severe and critical illness in different age groups showed that children of < 1 year and 1-5 years old were more vulnerable than older children.  In this study, only 5.9% of patients had severe or critical illness, which is fewer than the adult population. However, there were more severe […]

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04/16/2020

Pediatricians Should Look for Those

Patients should be screened for Influenza virus, which could be a concomitant infection due to the season.  Most children were infected by intrafamilial transmission. Many patients who had mild symptoms had a brief fever, resolving after 24 hours.    This case series included ten children aging from three months to ten years old, who were […]

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04/16/2020

No Symptoms But High Viral Load

  Testing in the pediatric population should not depend on symptomatology, but rather on possible contact with the virus. Because of the lack of symptoms in children, proper isolation is more challenging and they represent serious risks for transmission in the community.     This case report describes a six months old hospitalized in Singapour.  He had positive testing for […]

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04/16/2020

Effects of Isolation on Children

Home confinement has negative effects on children physical and mental health. Strategies to maintain a regular schedule and access to psychiatrists should be provided to patients. Pediatricians should review red flags of psychiatric disorders in order to quickly identify and refer children with mental health problems due to isolation.   This information comes from two articles published in The Lancet […]

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04/16/2020

Acute Acro-Ischemic Lesions in Children

These acro-ischemic lesions were seen in healthy children/adolescents. They are mostly found on the toes, but also on the fingers and the plantar region. Generally, they do not affect all fingers and toes.  The lesions are rounded, multiple and measure a few millimeters but sometimes they can cover the entire toe/finger with a clear demarcation […]

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04/13/2020

Tips in Managing the NICU

Not all NICU-admitted neonates should be tested for SARS-CoV-2. It is mainly recommended to do testing if the child was exposed to infected people. In the settings of a confirmed infection, neonates could be discharged after three days without fever, resolution of anomalies on imagery, and a series of two negative tests for COVID-19. Social […]

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03/28/2020

Are 0-3 Years Old More at Risk ?

In pediatric patients, fever and dry cough were the most common symptoms. Less frequent symptoms included diarrhea, nasal congestion, dyspnea, abdominal pain and vomiting. Most children had mild symptoms.  The highest incidence of COVID-19 was found in children of less than three years old. Moreover, the two children who developed severe illness were in this […]

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03/26/2020