The Link - April 2024
Our April issue features the latest news and updates on pediatric care from Children's Mercy clinicians.
Evidence Based Strategies: Guidance for Acute Gastroenteritis
From assessing development to providing anticipatory guidance, many tasks need to be completed during the adolescent well-child visit. However, one aspect that should always be emphasized is the screening and treatment of adolescent major depressive disorder (MDD).
The prevalence among adolescents of MDD in the past year increased from 8.1% to 15% between 2009 and 2019. Unfortunately, data show that only 50% of adolescents with depression are diagnosed prior to adulthood. Specifically, in primary care, 2 of 3 teenagers with depression are not identified by their primary care provider and, therefore, do not receive treatment.
Wise Use of Antibiotics: Animal and Human Bites … How Do You Manage?
Now that the weather is nicer and kids are getting out more, you may start seeing more animal bites. In fact, an estimated 5 million human and animal bite wounds occur in the U.S. each year, accounting for about 1% of emergency department visits.1 What infections should you consider? When should you provide prophylaxis? Which antibiotic should you use? At what dose? For how long? When should you worry about rabies? This article has you covered!
Pediatric Bioethics: Exploring Artificial Intelligence in Health Care: First Look
Presently, a search of artificial intelligence (AI) in health care on the Google search engine returns about 693,000,000 results. Daily notifications indicate new uses for AI in health care. Recently, the health care consulting firm the Advisory Board Company published a story headlined “AI nurses? Inside Nvidia, Hippocratic AI’s new partnership.” The March/April 2024 issue of the American College of Healthcare Executives’ publication Healthcare Executive also addressed AI in its cover story, “Improving Patient Care and Safety with AI.” In addition, innumerable webinars, podcasts and conferences have incorporated AI as part of their discussions and learning.
Vaccine Update: Unpacking the Headlines: Key Takeaways from 2023-2024 RSV Season
Spring 2024 has brought exciting news in the realm of RSV protection. On March 7, the Centers for Disease Control and Prevention’s (CDC’s) Morbidity and Mortality Weekly Report (MMWR) included an analysis showing that immunization with nirsevimab (Beyfortus) was 90% effective in preventing infants from being hospitalized with respiratory syncytial virus (RSV).1 A month later on April 9, Pfizer announced positive top-line results from its phase 3 clinical trial for Abrysvo (bivalent RSVpreF vaccine) in adults 18 to 59 years of age at risk for developing severe RSV-associated lower respiratory tract disease (LRTD).2 Currently, Abrysvo is approved only for adults over age 60 (along with GSK’s Arexvy), as well as pregnant people during weeks 32 through 36 of gestation for protection of newborn infants in the first 6 months of life. The shared goal for both maternal RSVpreF vaccination and infant receipt of nirsevimab is to protect babies from getting severely ill with RSV during their first RSV season, as RSV is the leading cause of hospitalization for infants in the United States.1
Measles Toolkit for Parents and Providers
As of April 18th, there have been 125 measles cases in the United States across 18 states.1 While Kansas is not among these states, Missouri is, and we all know that every communicable disease is only one plane, train, car, or bus ride away. So far, 7 outbreaks (3 or more cases) have been reported in 2024 and most (69%) of cases are associated with an outbreak. We are already 3 outbreaks ahead of all of 2023. There have been 125 cases and 2/3 are in children with nearly half occurring in those <5 years of age. Most are unvaccinated, but there are a few that received 1 or even 2 doses. A reminder for us all that one dose, while effective, does not cause seroconversion in all children. Additionally, there are people, especially those with impaired immune systems, that do not mount a response to 2 doses. Hospitalization is common for people with measles with more than half requiring hospital admission this year. It is no surprise that the highest proportion (65%) needing admission are those <5 years of age.
Below are some resources from the Pediatric Pandemic Network (a HRSA grant funded network of children’s hospitals of which CM is a member) that we hope are helpful for your offices and your patients and families.