Despite apparent disagreement in the scholarly literature on standards of pediatric decision making, a recognition that similar norms underpin many of the dominant frameworks motivated a June 2022 symposium "Best Interests and Beyond: Standards of Decision Making in Pediatrics" in St Louis, MO. Over the course of this 3-day symposium, 17 expert scholars (see author list) deliberated on the question "In the context of US pediatric care, what moral precepts ought to guide parents and clinicians in medical decision making for children?" The symposium and subsequent discussion generated 6 consensus recommendations for pediatric decision making, constructed with the primary goals of accessibility, teachability, and feasibility for practicing clinicians, parents, and legal guardians. In this article, we summarize these recommendations, including their justification, limitations, and remaining concerns.
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http://dx.doi.org/10.1542/peds.2023-061832 | DOI Listing |
JAMA Dermatol
January 2025
Department of Dermatology, University of Pennsylvania, Philadelphia.
Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.
Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.
Women Health
January 2025
Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
In this study, we investigated the factors that influence families' decision-making processes about whether to carry a pregnancy to term or to terminate it in cases of fetal anomalies. A questionnaire was administered to 25 participants who chose to terminate their pregnancy and 25 participants who chose to carry their pregnancy to term. Among the sociodemographic characteristics investigated, only monthly income significantly differed between the groups ( = .
View Article and Find Full Text PDFThe management of massive irreparable rotator cuff tears is commonly debated without consensus. With reverse shoulder arthroplasty often reserved for the older patient (older than 60 years) with rotator cuff arthropathy, treatment of the younger patient population (younger than 60 years) without arthritis is more complex. When determining a surgical approach, the clinical presentation including history and physical examination plays a vital role in the decision tree.
View Article and Find Full Text PDFRheumatol Int
January 2025
Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, 95661, USA.
Women are disproportionately affected by chronic autoimmune diseases (AD) like systemic lupus erythematosus (SLE), scleroderma, rheumatoid arthritis (RA), and Sjögren's syndrome. Traditional evaluations often underestimate the associated cardiovascular disease (CVD) and stroke risk in women having AD. Vitamin D deficiency increases susceptibility to these conditions.
View Article and Find Full Text PDFJ Clin Sleep Med
December 2024
Université de Paris-Cité, AP-HP, Hôpital Robert Debré, Service de Physiologie Pédiatrique-Centre du Sommeil, INSERM NeuroDiderot, Paris, France.
This study presents two cases of central sleep apnea syndrome in children, highlighting the utility of assessing ventilatory control stability, particularly loop gain and central chemosensitivity in treatment decision-making. In the first case, elevated loop gain for oxygen correlated with periodic breathing, leading to successful treatment with supplemental oxygen in a 13 year-old boy with Prader-Willi-like syndrome. Conversely, in the second case, dealing with a 10 year-old girl with tumor in the brainstem-spinal cord junction, reduced loop gain prompted treatment with nocturnal non-invasive ventilation.
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