The Link - May 2024
Our April issue features the latest news and updates on pediatric care from Children's Mercy clinicians.
Evidence Based Strategies: First Steps of Identifying Musculoskeletal Infections in Children
Musculoskeletal (MSK) infection is a major cause of morbidity in the pediatric population and often requires hospitalization and prolonged antibiotic use. The annual incidence of MSK infection-related hospitalization is five to 10 cases per 100,000 children. Diagnoses affecting children in this category include osteomyelitis, septic arthritis, and pyomyositis. Osteomyelitis and septic arthritis in pediatric populations often occur due to hematogenous spread of the causative organism. The most common organism is Staphylococcus aureus in all age groups. Often, children with methicillin-resistant S. aureus are more ill-appearing and have more pronounced fever than those with methicillin-sensitive S. aureus. Kingella kingae, more commonly seen in infants and preschool-aged children, can have more insidious onset. Early diagnosis is important in preventing further spread, sepsis and complications such as growth plate disturbances.
State of the Art Pediatrics: Precision Medicine – Where Are We Today? The GOLDILOKS® Clinic- Genomic- and Ontogeny-Linked Dose Individualization and cLinical Optimization for KidS
Background: Have your patients asked about testing to see which medication will work best for them? Pharmacogenetic (PGx) testing is rising in popularity among patients and providers. While many parents are willing to use a medication for their child to treat illness, parents are often worried about potential side effects and don’t want to “experiment” with different medications without first knowing if that medication will work.
For some children, it can take a while to find the “just right” dose of a medication. PGx is a type of precision medicine that factors in a child’s unique genetic makeup to guide medication dosing. This information can help tailor their treatment to maximize benefit while minimizing risk.
Mental Health: Some Attention to Inattention
Attention deficit hyperactivity disorder (ADHD) is a common pediatric condition in the U.S. Prevalence estimates in children and adolescents have nearly doubled since the early 1990s, to the current rate of about 10.5%. This article serves as a practical guide for ADHD diagnosis and treatment in the general practitioner’s office.
Vaccine Update: Global Vaccine Efforts Result in Significant Impact Over the Last Fifty Years
A new study by the World Health Organization (WHO) demonstrates that an estimated 154 million lives have been saved by global vaccination efforts over the past 50 years through the Expanded Programme on Immunization (EPI), now named the Essential Programme on Immunization. The 50-year anniversary of this program was felt to be an important timepoint to assess the impact of the program, so a modeling study was completed to estimate the global and regional public health impact of vaccines provided by the EPI. The EPI was founded in 1974 by the World Health Assembly with a goal of vaccinating all children against diphtheria, measles, pertussis, polio, tetanus, tuberculosis and smallpox. Currently, the EPI aims for universal immunization against 13 diseases and, in certain situations or regions, an additional 17 diseases. The program aims to reach infants, children, adolescents and adults. When the EPI was founded, fewer than 5% of the world’s infants had access to routine vaccination. Currently, 84% of infants across the globe are vaccinated, with three doses of diphtheria, tetanus and pertussis vaccine used as a marker for immunization coverage. Of the 154 million lives saved, an estimated 101 million are children from birth to 1 year of age, and 95% of total lives saved are of children under the age of 5 years. The study, published in The Lancet, reveals that immunizations have the largest impact of any health initiative ever.1 The measles vaccine leads with the biggest impact in reducing infant mortality and is estimated to account for 60% of the lives saved, or 94 million lives. Vaccines against 14 diseases (diphtheria, Haemophilus influenzae type B, hepatitis B, Japanese encephalitis, measles, meningitis A, pertussis, invasive pneumococcal disease, polio, rotavirus, rubella, tetanus, tuberculosis and yellow fever) account for a reduction in infant mortality by 40% globally and 50% on the African continent.