: A 2014 survey showed nutritional management could be improved in Belgian pediatric departments. This follow-up survey aimed to: (1) list allied health resources/staffing in Belgian pediatric departments, (2) survey nutritional screening and follow-up, and (3) identify barriers. : A nationwide survey (February-April 2021) via national and regional pediatric associations. : 61/90 (67.8%) of Belgian pediatric departments responded (80.1% of all Belgian pediatric hospital beds); 60.7% of the respondents were from larger centers (LCs, ≥20 beds). A dietitian was present in 80.3% of all responding units (LCs vs. smaller centers (SCs): = 0.133), compared to 46.5% in the 2014 survey. Most dietitians seldom or never participate in ward rounds (86.9%) and participate only ad hoc to case discussions (72.1%). Systematic nutritional screening is implemented in 32.8% of pediatric departments. The screening tool STRONGkids is used in 30% of responding centers, compared to 21% in 2014. The most common barriers to conducting nutritional screening were lack of time (59.0%), a lack of knowledge (47.5%), and a lack of staff (42.6%). In French-speaking centers (FrCs), a positive screening result most often led to referral to a dietitian (86.7%), whereas in Dutch-speaking centers (DuCs), it more frequently resulted in a discussion with the pediatrician about nutritional management (54.3%) than referral to a dietitian (34.8%). Nutritional follow-up after discharge is most often conducted by a physician, with or without the involvement of a dietitian (95.1%), rather than a dietitian alone (3.3%). Malnutrition management barriers included "no barriers" (50.8%), a lack of knowledge (34.4%), a lack of reimbursement (24.6%), and a lack of time (24.6%). The barriers remain largely unchanged compared to 2014. : The increasing availability of dietitians and the use of a screening tool in pediatric departments suggest an encouraging but limited improvement in nutritional care in Belgium. Persistent barriers that have remained unchanged since 2014 continue to hinder substantial advancements in nutritional care.
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http://dx.doi.org/10.3390/nu17040718 | DOI Listing |
J Clin Rheumatol
March 2025
From the Department of Pediatric Rheumatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical School.
Objectives: Our study aimed to identify potential predictors for additional systemic involvement in patients with noninfectious uveitis, specifically focusing on their demographic, etiological, clinical, and laboratory data features from the pediatric rheumatology perspective.
Methods: Patients with noninfectious uveitis before the age of 18 years and followed up for at least 3 months in 2 tertiary centers of pediatric rheumatology and ophthalmology departments were included in the study. Demographics, etiology, clinical features, laboratory data, and treatments administered were evaluated and compared based on the etiology (idiopathic and systemic disease-related uveitis [SD-U]) and the use of biologic disease-modifying antirheumatic drugs.
Pediatr Infect Dis J
March 2025
Divisions of Pediatric Emergency Medicine and Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas.
Background: Infection is a leading cause of death after pediatric heart transplants (PHTs). Understanding of common pathogens is needed to guide testing strategies and empiric antibiotic use.
Methods: We conducted a 3-center retrospective study of PHT recipients ≤18 years old presenting to cardiology clinics or emergency departments (EDs) from 2010 to 2018 for evaluation of suspected infections within 2 years of transplant.
Neurology
April 2025
School of Law, University of Virginia, Charlottesville.
This consensus position statement of the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America updates prior 1994 and 2007 position statements on seizures, driver licensure, and medical reporting. Key consensus positions include the following: (1) in the United States, national driving standards promulgated through a system such as the Uniform Law Commission would reduce confusion and improve adherence with state driving standards; (2) state licensing criteria for medical conditions should be promulgated by regulations and guidelines based on enabling legislation rather than in statutes themselves and should be developed by medical advisory boards working in collaboration with departments of motor vehicles; (3) licensing criteria should be equitable, nondiscriminatory, objective, and compatible with comparable risks in other populations; (4) a minimum seizure-free interval of 3 months should ordinarily be required before driving in all cases and should be extended in individual cases based on review of favorable and unfavorable features by medical advisory boards; (5) individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to reoccur in the future may not require a seizure-free interval before resuming driving; (6) individuals with previously well-controlled epilepsy who experience seizures due to short-term interruptions of antiseizure medications in the setting of hospitalization or practitioner-directed medication-titration may not require a seizure-free interval before driving once previously effective levels of antiseizure medications have been resumed; (7) patients and practitioners should pause driving during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced; (8) individuals whose cognition or coordination is impaired due to medications used to prevent seizures should refrain from driving; (9) health care practitioners should be allowed but not mandated to report drivers who pose an elevated risk; but (10) neither a decision to report a patient suspected of being at elevated risk nor a decision declining to report a patient suspected of being at elevated risk should be subject to legal liability; (11) nations, states, and municipalities should provide alternative methods of transportation and accommodations for individuals whose driving privileges are restricted due to medical conditions.
View Article and Find Full Text PDFSci Transl Med
March 2025
Vaccine and Gene Therapy Institute, Oregon Health & Science University, Beaverton, OR 97006, USA.
Congenital cytomegalovirus (cCMV) is the leading infectious cause of neonatal neurological impairment worldwide, but the viral factors enabling vertical spread across the placenta remain undetermined. The pentameric complex (PC), composed of the subunits gH/gL/UL128/UL130/UL131A, has been demonstrated to be important for entry into nonfibroblast cells in vitro. These findings link the PC to broad cell tropism and virus dissemination in vivo, denoting all subunits as potential targets for intervention strategies and vaccine development.
View Article and Find Full Text PDFIndian J Gastroenterol
March 2025
Departments of Pediatrics, Giza, Egypt.
Background And Objectives: Kasai-portoenterostomy (KPE) is the initial attempt to restore the bile flow and salvage the native liver in biliary atresia (BA) patients. Cholangitis is a frequent complication after KPE and adequate treatment impacts the long-term outcome. The aim of our study is to assess the severity of cholangitis episodes in a cohort of BA patients post KPE, identify the causative agents, using several diagnostic methods, as well as to assess the tolerability and efficacy of our antimicrobial protocol.
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