Latest news with #pediatric
Medscape
8 hours ago
- Health
- Medscape
Long-Acting Muscarinic Antagonists Aid Asthma Care in Kids
Long-acting muscarinic antagonists (LAMAs), as add-on therapy to inhaled corticosteroids, improved peak forced expiratory volume in 1 second (FEV1) and reduced exacerbations in children younger than 12 years with moderate-to-severe asthma. METHODOLOGY: Researchers conducted a meta-analysis to assess the efficacy and safety of LAMAs as add-on therapy to inhaled corticosteroids in children with moderate-to-severe asthma. They included four randomized controlled trials and two observational studies, comprising 1210 children (0.5-11 years), that evaluated tiotropium as LAMA of choice, with a median follow-up of 15 weeks. All participants received inhaled corticosteroids both before and after screening and randomization, with mean doses ranging from 228 μg to 480 μg of budesonide or an equivalent dose. The primary outcome was a change in FEV1. Other outcomes evaluated were peak FEV1, forced vital capacity (FVC), forced expiratory flow 25%-75% (FEF25%-75%), and asthma control assessed via interviewer-administered asthma control questionnaire (ACQ-IA) scores. TAKEAWAY: LAMAs at any dose significantly improved peak FEV1 (mean difference [MD], 86.16 mL; P < .01), with 5 μg tiotropium leading to a greater improvement (MD, 113.05 mL; P < .01). < .01), with 5 μg tiotropium leading to a greater improvement (MD, 113.05 mL; < .01). FEF25%-75% demonstrated significant improvements with LAMAs (MD, 0.2518 L; 95% CI, 0.1971-0.3064; P < .01), while peak FVC showed no significant change. < .01), while peak FVC showed no significant change. Treatment with LAMAs was associated with improved asthma control, as assessed by ACQ-IA scores (MD, -0.07; P < .01), and a reduced risk for exacerbations (risk ratio [RR], 0.75; P = .013). < .01), and a reduced risk for exacerbations (risk ratio [RR], 0.75; = .013). Treatment with LAMAs was associated with fewer adverse events than control (RR, 0.88; P = .021). No deaths were reported, and no adverse events led to treatment discontinuation in any of the included studies. IN PRACTICE: 'We found that LAMA as an add-on therapy to ICS [inhaled corticosteroids], with or without associated LABA [long-acting beta-agonists], is effective and safe for moderate and severe asthma in children aged 6-11, improving lung function parameters in spirometry and protecting against exacerbations,' the authors wrote. SOURCE: This study was led by Gabriel Bolner, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. It was published online on May 5, 2025, in Paediatric Respiratory Reviews . LIMITATIONS: This study included only patients with moderate-to-severe asthma or persistent symptoms, limiting the understanding of potential benefits for children with better-controlled asthma. Additionally, only one study included children aged 5 years or younger, making this population underrepresented in the pooled analysis. DISCLOSURES: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. No conflicts of interest were mentioned.
CTV News
6 days ago
- General
- CTV News
CHEO's innovations in treating kids with burn injuries
Ottawa Watch We tell you about innovations the hospital is making when it comes to treating pediatric burn injuries.
ABC News
27-05-2025
- Health
- ABC News
Health district tells inquest of protocol lapses after sepsis death of toddler Pippa Mae White
A western NSW health executive has told an inquest that his hospitals are still not consulting a sepsis diagnostic guide enough after a toddler died of the condition almost three years ago. Two-year-old Pippa Mae White died from the disease, and pneumonia, at Orange Hospital in central west NSW in June 2022. She initially presented at Cowra Hospital before being transferred later that night to the health facility in Orange. The inquest into her death previously heard her high heart rate alone at both facilities was considered in the "red zone" for a child likely infected with sepsis and required a rapid response, according to a NSW Health policy document. A rapid response triggers senior doctors to quickly attend and assess a patient, which was not activated at either hospital. The nurse at Cowra said she was aware of the paediatric sepsis pathway document but did not use it, while the nurse at Orange said she had never seen it. Executive director of quality, clinical safety and nursing at the Western NSW Local Health District (WNSWLHD), Adrian Fahy, gave evidence at the inquest on Tuesday. He said he was "concerned" the document was not used in Pippa White's care. "It's indeed quite remarkable," he told the inquest. "Sepsis training has been quite prevalent across NSW Health for a number of years." He said the WNSWLHD made optional training on detecting the condition mandatory since the young girl's death and has so far delivered 75 virtual sessions on the topic. The inquest heard hospitals across the district audited how often the sepsis pathway document was used in the care of patients who were diagnosed with the condition. Mr Fahy said despite an increasing trend, the hospitals were not using it in all cases. "What I think needs to happen is there needs to be a much stronger emphasis. "[And] where needed, having some difficult conversations around 'why wasn't a pathway included?'" Mr Fahy also gave evidence that the district made several changes to improve care since Pippa White died. He said an alert tool was being developed which would send a prompt to clinicians if the vital signs they are logging on the electronic medical record could indicate sepsis. The concern of a parent or carer will also be included in the new paediatric observation chart due to be released next month. "A specific question will be asked around 'do you feel your child is improving or deteriorating?'" Mr Fahy told the inquest. If it was the latter it would trigger an additional "yellow zone" criteria which could result in a clinical review within 30 minutes. The inquest heard Pippa White's mother, Annah White, attempted to activate the REACH initiative (recognise, engage, act, call, help) during her daughter's care without success. The system allowed family members or parents to escalate their concerns with hospital staff about the patient's condition, and prompt a review, which should occur within half an hour. Mr Fahy said the WNSWLHD had tried to make the initiative more obvious, such as clearly including it in local emergency response procedures. Hospitals had also put up posters about the initiative with a phone number and a QR code with a video that explained the process. The inquest continues on Wednesday.
Yahoo
11-05-2025
- Health
- Yahoo
'Like a punch in the gut': Trump threats halt Tucson provider's teen gender-affirming care
Tucson transgender teens and their parents were left in a lurch after they were notified their health care provider would no longer offer pediatric gender-affirming care following threats from the Trump administration. Parents and advocates said providers from El Rio Health, one of the region's most sought-after provider of pediatric gender-affirming care, called them to inform them of the halt in services. 'This was like a punch in the gut,' Derrick Fiedler said after he found out his 13-year-old son would no longer be able to receive care at El Rio. 'It wasn't entirely unexpected, but at the same time, you still hope that the people running these organizations ... you still have the hope that they're going to take a stand and do the right thing." The decision to stop offering gender-affirming care to patients under 18 years of age came after the U.S. Attorney General's Office issued a memorandum on April 22 enforcing an executive order President Donald Trump issued in January on transgender Americans and their families, said El Rio spokesperson Nathan Holaway. Holoway told The Arizona Republic in an email the memorandum seeks "to criminalize gender-affirming care for minors and committing the DOJ to prosecute offenders to 'the fullest extent possible' while encouraging 'whistleblowers' to report offenders directly to the Department of Justice.' The medical center confirmed it is not prescribing or dispensing pubertal suppressants or gender-affirming hormones for patients under 18 years of age. Gender-affirming care is 'life-saving health care for transgender people of all ages,' according to the Tucson Medical Center. This includes a range of care, from social transitioning, being referred to by the pronouns and by the name the person wants to be referred to, to medical interventions such as puberty blockers and gender-affirming hormone interventions or surgical intervention. It's already against the law for any child younger than 18 to get gender-affirming surgery in Arizona, and even in states where it is legal, such surgeries are rare, several studies have shown. A study by researchers at Johns Hopkins University, published Sept. 25, 2023, in the Cureus Journal of Medical Science, identified 108 such surgeries over three years in U.S. kids ages 17 and younger. The study looked at gender-affirming surgeries between 2018 and 2021 through the American College of Surgeons National Surgical Quality Improvement Program Pediatric database and found more than 90% were chest masculanization surgeries. For Fiedler, gender-affirming care helps provide his son with a thriving life. 'We all just want to do what's best for the kids and give them a full, flourishing life. And that's what gender-affirming care does,' he said. The Tucson-area provider is just one of a slew of providers who have halted services across the state following Trump's Jan. 28 executive order. Trump's executive order says that the United States will not fund, sponsor, promote, assist or support the "so-called transition of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures." The April memo from the U.S. attorney general refers to Trump's executive order and puts medical providers on "notice." It calls expanding access and rights of the transgender population a 'radical gender ideology' and criticizes the Biden administration for choosing an openly transgender pediatrician to serve as the U.S. assistant secretary of health, and for inviting trans influencers to the White House. The memo details how some trans children regret their decision to transition when they become adults. Russell Toomey, a professor of human development and family scienceat the University of Arizona, called out the memo for using 'derogatory' language, and said the research on regret shows the regret rate for adults who transitioned in childhood or adolescence is less than 1%, which he noted is "less than knee surgery regret or hip surgery regret." According to the Centers for Disease Control and Prevention, 3.3% of high schoolers identified as trans in 2023. Fiedler's son came out as transgender four years ago, when he was 9 years old. Before he socially transitioned, using a boy's name and physically presenting as a boy, his son would often feel 'down' and would cry, asking why he 'can't be normal like other kids?' After socially transitioning, 'it was like night and day,' Fiedler said, noting how much happier his son was. 'It was like a weight had been lifted off his shoulders.' About a year ago, Fiedler's son started showing the beginning signs of female puberty. So, they put him on a puberty blocker implant. Fiedler said his family is lucky that his son's implant is good for at least another year, and noted the immediate impact is not as great as those who need hormone replacement therapies. Other Tucson teens need care sooner. Veronica Camacho's 16-year-old daughter needs hormone-blocking injections in a couple of months. Camacho said El Rio was the best place in Tucson for gender-affirming care. Now, she is considering traveling as far as Mexico to access care for her daughter. 'She's terrified,' Camacho said about her daughter. 'We're hopeful that we can go get treatment somewhere else. But if she doesn't, then she would have to be put back into a body that she doesn't want to be in, that she's not comfortable or happy in. And it would just undo all the work that she has done to get where she is now.' Before transitioning, her daughter was suicidal, depressed, and struggling in school. After going on hormone blockers, her daughter's outlook on life improved dramatically. 'She went into her next school year confident and happy, and it was literally life-changing,' Camacho said. Camacho said that while the decision to stop offering gender-affirming care was not unexpected given the political climate, the lack of warning or communication from El Rio made the decision feel 'out of the blue.' Toomey studies LGBTQ+ youth populations with a specific focus on gender-diverse and trans youth populations. He said access to gender-affirming care is critical to those who need it. 'We have decades of research that have documented the mental health benefits, the physical health benefits of having access to this care,' Toomey said. Because the ban on accessing gender-affirming care is relatively new, Toomey said less is known about what an abrupt change, or halt in care, will do to someone's physical or mental health. But 'given what we know about mental health and the benefits of this medical intervention, an abrupt removal without any kind of transition period is likely to have devastating consequences for mental health, as well as physical health.' Some of those include new puberty symptoms or menopause-like symptoms, Toomey said. 'Unsafe, unwelcome': How transgender students at Mesa Public Schools feel about pronoun proposal Republic reporter Stephanie Innes contributed to this article. Reach the reporter at The Republic's coverage of southern Arizona is funded, in part, with a grant from Report for America. Support Arizona news coverage with a tax-deductible donation at This article originally appeared on Arizona Republic: Trump threats halt Tucson provider's teen gender-affirming care
CBC
07-05-2025
- Health
- CBC
Mothers, pathologist call for increased funding for Sask. children with permanent hearing loss
Social Sharing A government-funded pediatric program that helps children with permanent hearing loss says it needs more funding for speech language pathologists and other services. Mothers of children who need listening and spoken language therapy and rehabilitation services called for action at the legislature in Regina on Tuesday afternoon. One of those mothers, Breanne Arnold of Regina, said the Saskatchewan Pediatric Auditory Rehabilitation Centre (SPARC) is extremely important for her baby's auditory and communicative development. SPARC serves children with permanent hearing loss across Saskatchewan and is offered through the Saskatchewan Health Authority's hearing health program. Arnold's daughter Hadley was born deaf and had a cochlear implant operation at just nine months old. Hadley used to meet with a SPARC speech language pathologist twice a month in Regina, but past cuts to the program has made that impossible. "I've been traveling to Saskatoon for our therapies that are required for her to be successful with her cochlear implants," said Arnold, who has missed some of those appointments due to scheduling conflicts. Arnold said she wrote to Health Minister Jeremy Cockrill for more than a month, with no response. She told reporters she has three calls to action for the minister. "To increase funding to the cochlear implant program and pediatric hearing aid program. To hire additional qualified staff and reduce caseloads, including having a [cochlear implant] audiologist from Saskatoon travel to Regina to help those children in the south. To set up a satellite clinic to decrease travel burdens to [cochlear implant] recipients," Arnold said. Cockrill agreed to meet with the three mothers present at the legislature after question period. Brittney Senger — the Opposition NDP critic for the status of women, disabilities and community-based organizations — said parents should not have to pay out-of-pocket to travel for services their children need to be successful in their development. "This is about families. You don't anticipate when your child is born that they're going to have a disability. And frankly, at the end of the day, it's about accessing the services necessary," Senger said. "You envision a life for your child and then you're faced with all of these challenges and there needs to be adequate supports in place from the government to actually be able to support your family." 1 part-time pathologist for all of Sask. Kinley Winter, senior speech language pathologist with SPARC, told CBC that the program suffered provincial budget cuts in 2023, which led to a 75 per cent reduction in staffing. SPARC used to have two full-time speech pathologist positions, but Winter said there is now only one part-time position, which she holds. Winter has to travel a lot, and due to those costs, the program does not have the capacity to send her down to Regina from Saskatoon more than once a month. That means that to have the two monthly appointments children need, Regina families must travel to the Royal University Hospital in Saskatoon each month. Even though she is the only speech language pathologist with SPARC, Winter said she can only be paid for 18 hours a week under the program's budget. She said she is glad parents like Arnold are bringing the issue to the provincial government. "I've been encouraging families to advocate for their children and advocate for additional resources within the province," said Winter, who sees the benefits of SPARC's budget concerns being covered by the media. "I'm really glad that the families have opted to continue to take this forward and continue to advocate and try and make their voices heard — as I know that there are other families in the province that have children with other diagnoses that have been loud and have been able to advocate and get additional resources for their children. So I'm hopeful that this is going to follow the same path." During question period Tuesday, Cockrill said the government wants to make sure children have access to the services that they need. He admitted there's always more work to do, but said the government is committed to doing that work.
