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The Ethics of Creating a Resource Allocation Strategy During the COVID-19 Pandemic

Pediatrics - Mié, 01/07/2020 - 13:17

The coronavirus disease 2019 pandemic has affected nearly every aspect of medicine and raises numerous moral dilemmas for clinicians. Foremost of these quandaries is how to delineate and implement crisis standards of care and, specifically, how to consider how health care resources should be distributed in times of shortage. We review basic principles of disaster planning and resource stewardship with ethical relevance for this and future public health crises, explore the role of illness severity scoring systems and their limitations and potential contribution to health disparities, and consider the role for exceptionally resource-intensive interventions. We also review the philosophical and practical underpinnings of crisis standards of care and describe historical approaches to scarce resource allocation to offer analysis and guidance for pediatric clinicians. Particular attention is given to the impact on children of this endeavor. Although few children have required hospitalization for symptomatic infection, children nonetheless have the potential to be profoundly affected by the strain on the health care system imposed by the pandemic and should be considered prospectively in resource allocation frameworks.

Severe Pediatric COVID-19 Presenting With Respiratory Failure and Severe Thrombocytopenia

Pediatrics - Mié, 01/07/2020 - 13:17

The novel severe acute respiratory syndrome coronavirus 2 is a worldwide pandemic. The severe morbidity and mortality associated with coronavirus disease 2019 has mostly affected the elderly or those with underlying medical conditions. We present a case of a 12-year-old girl with no past medical history who presented with fever, cough, and vomiting. Laboratory evaluation revealed severe thrombocytopenia and elevated markers of inflammation. The patient progressed to respiratory failure, and testing results for the severe acute respiratory syndrome coronavirus 2 returned positive. Because of the severity of her thrombocytopenia, she was treated with intravenous immunoglobulin and steroids with prompt improvement in platelets. The patient’s severe acute respiratory distress syndrome was managed with mechanical ventilation, inhaled nitric oxide, and then airway pressure release ventilation. After azithromycin and hydroxychloroquine were given without improvement, our patient received tocilizumab, an anti–interleukin-6 receptor antibody, and remdesivir, a broad antiviral agent, with significant clinical benefit soon afterward. Given that severe pediatric coronavirus disease 2019 is rare, we hope to inform pediatric providers on the clinical course and management considerations as this pandemic continues to spread.

Digital Advertising to Children

Pediatrics - Mié, 01/07/2020 - 13:17

Advertising to children and teenagers is a multibillion-dollar industry. This policy statement reviews the forms of advertising that children and teenagers encounter, including newer forms of digital marketing, such as sponsored content, influencers, data collection, persuasive design, and personalized behavioral marketing driven by machine learning. Parents and pediatric health care providers need to be aware of the ways different marketing messages reach children and teenagers, including Internet sites, social media, and mobile apps. Evidence suggests that exposure to advertising is associated with unhealthy behaviors, such as intake of high-calorie, low-nutrient food and beverages; use of tobacco products and electronic cigarettes; use of alcohol and marijuana; and indoor tanning. Children are uniquely vulnerable to the persuasive effects of advertising because of immature critical thinking skills and impulse inhibition. School-aged children and teenagers may be able to recognize advertising but often are not able to resist it when it is embedded within trusted social networks, encouraged by celebrity influencers, or delivered next to personalized content. This policy statement expresses concern about the practice of tracking and using children’s digital behavior to inform targeted marketing campaigns, which may contribute to health disparities among vulnerable children or populations. Pediatricians should guide parents and children to develop digital literacy skills to prevent or mitigate negative outcomes, but it is equally important that policy makers and technology companies embrace digital design, data collection, and marketing practices within today’s broad digital environment that support healthier decision-making and outcomes.

Electronic Documentation in Pediatrics: The Rationale and Functionality Requirements

Pediatrics - Mié, 01/07/2020 - 13:17

Clinical documentation is a fundamental component of the practice of medicine. It has significantly evolved over the past decade, largely because of the growth of health information technology and electronic health records. Although government agencies and other professional organizations have published position statements on the structure and use of electronic documentation, few have specifically addressed the documentation needs for the care of children. A policy statement on electronic documentation of clinical care by general pediatric and subspecialist providers by the American Academy of Pediatrics is needed. This statement provides insight on the unmet needs of key stakeholders to direct future research and development of the electronic media necessary to enhance the wellness of children and improve health care delivery. It also addresses the challenges and opportunities for efficient and effective clinical documentation in pediatrics.

Comorbilidad psiquiátrica y tratamiento hormonal en jóvenes transexuales

Mora Palma C, Guerrero Fernández J, González Casado I. Comorbilidad psiquiátrica y tratamiento hormonal en jóvenes transexuales. Evid Pediatr. 2020;16:28.

En adolescentes transgénero, la ideación suicida es menor si reciben tratamiento para frenar la pubertad

Aparicio Rodrigo M, Rivero Martín MJ. En adolescentes transgénero, la ideación suicida es menor si reciben tratamiento para frenar la pubertad. Evid Pediatr. 2020;16:31.

Encuesta on-line sobre los efectos del confinamiento en la salud de los niños y las niñas

Los estudios iniciados desde la plataforma KIDS-Corona en el Hospital Sant Joan de Déu Barcelona buscan responder preguntas en relación a la infección y enfermedad por SARS-CoV-2 en la población pediátrica. Actualmente existen pocos datos al respecto y parece que las niñas y niños podrían disponer de algún factor protector frente la enfermedad. Desde el Hospital Sant Joan de Déu se ha elaborado una encuesta participativa online para analizar los efectos del confinamiento sobre la salud de niños y niñas.

El objetivo general del estudio es conocer una serie de datos u opiniones de la población sobre unos temas relacionados con la COVID tales como la contagiosidad de la misma en los núcleos familiares, la percepción de riesgo en la salud de los niños, las consecuencias...

Los pediatras advierten de un otoño "complicado" a nivel asistencial si una segunda oleada de COVID-19 coincidiese con el VRS y la gripe

Para afrontar la primera oleada de SARS-CoV-2, el Sistema Nacional de Salud (SNS) tuvo que adaptarse a marchas forzadas y sin entrenamiento previo. Los expertos no descartan una segunda oleada que, por supuesto, ya va a encontrar un sistema más organizado, mejor preparado y más fuerte. “Las instituciones sanitarias deben desarrollar estrategias para asegurar la adecuada protección de los profesionales sanitarios, piedra angular en la detención de esta pandemia”, asegura la doctora Rosa Rodríguez Fernández, responsable de Hospitalización Pediátrica del Hospital Universitario Gregorio Marañón, durante su intervención “Medidas ante una segunda oleada de COVID-19” que ha cerrado el ciclo de ‘Jueves con la Ciencia’ organizado por la Asociación Española de Pediatría (AEP) y que “ ha facilitado a los profesionales sanitarios una oportunidad excelente para mantenerse informados y formados en las diferentes áreas de capacitación...

El Foro de Médicos de Atención Primaria exige la puesta en valor de la Atención Primaria

AEPAP - Mar, 30/06/2020 - 11:55
Fuente:  Foro de Médicos de Atención Primaria Fecha de publicación:  30 de Junio de 2020 Archivos adjuntos:  El Foro de Médicos de Atención Primaria exige la puesta en valor de la Atención Primaria Compartir en...

10º Curso práctico AEPap para residentes de pediatría

AEPAP - Vie, 26/06/2020 - 10:28

Es un curso dirigido al residente de Pediatría que ya ha realizado su rotación en Atención Primaria, con temas específicos que complementan su rotación por el centro de salud y su formación en Pediatría de Atención Primaria.

Organizado con talleres prácticos y seminarios de forma presencial durante día y medio de duración, se acompaña de actividades virtuales como seminarios, casos clínicos y foros. 

Hay disponibles 90 plazas, financiadas a través de becas por las diferentes federadas y empresas colaboradoras ( GSK España, Nestlé España y Laboratorios Ferring). El importe de la inscripción es de 275€.

 

Cuenta con la validación oficial de la Asociación Española de Pediatría (AEP).

 Preinscripción: hasta el 15 de julio de 2020

 

 

Boletín de preinscripción:  https://forms.gle/fC3vGnoXzqq8oHRW6

 Fechas de preinscripción: desde el 26 de junio al 15 de julio de 2020

 

Tipo de actividad:  Curso Organizador:  AEPap Lugar de celebración:  Colegio Oficial de Médicos de Madrid Fechas:  De 2 de Octubre de 2020 hasta 3 de Octubre de 2020 Dirección de correo electrónico:  cursoderesidentes@gmail.com

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