Update in Pediatrics

Contents
Editors and Contributors
Section Editors
Contributors
Part I: Update in Adolescent Medicine
	1: Update in Adolescent Medicine
		Adolescence 101
			What?
			Who/When?
			How?
		Psychosocial and Risk Behavior Assessment
			Order of Topics
			Indications for Use
			Interacting with Caregivers
			Navigating the Psychosocial Assessment
			Additional Interview Tips
			Breaking Confidentiality
		Eating Disorders
			Diagnostic Clarification
			Resources for Patients and Families
			Resources for Healthcare Providers
		Technology and Social Media
			The Changing Technological Landscape
			Medical and Developmental Health Concerns
			Mental, Emotional, and Social Challenges
			Electronic Health Record (EHR) Privacy
			Emerging Social Media Risks
			Resources for Patients and Families
			Resources for Healthcare Providers
		Substance Use
			SBIRT: Screening Brief Intervention Referral and Treatment
				Screening
				Brief Intervention
				Abstinence/No Substance Use: Positive Reinforcement
				Substance Use Without SUD: Brief Intervention
				Mild to Moderate SUD
				Severe SUD (Addiction)
				Acute Risk of Harm
			Referral to Treatment
			Prescribing Controlled Substances
			Resources for Healthcare Providers
		Sexually Transmitted Infections (STIs)
			STIs in Adolescent Medicine
			Assessing STI Risk
			STI-Related Consent and Confidentiality
			Screening and Testing Recommendations by Infection
			Updated STI Treatment Guidelines: Quick Reference
			Evaluation of Vaginal Discharge
			Safe Sex Practices and Prevention
			Tips on External Condom Use (Male (External) Condom Use 2022)
		Adolescent Sexual Health: An Overview
			Male-Bodied Reproductive Health
				Benign Variants
				Sexual Satisfaction and Sexual Dysfunction
			Female-Bodied Reproductive Health
				Benign Variants
			Sexual Satisfaction and Sexual Dysfunction
			Menstrual Cycle Irregularities
			Dysmenorrhea
			Polycystic Ovarian Syndrome
			Premenstrual Dysphoric Disorder
			Resources for Patients and Families
			Resources for Healthcare Providers
		Transitioning to Adult Healthcare
			Provider Readiness
			Family Readiness
			Youth Readiness
			Resources for Patients and Families
			Resources for Healthcare Providers
		References
Part II: Update in Pediatric Allergy
	2: Update in Pediatric Allergy
		Food Allergy
			Introduction
			Pathophysiology and Clinical Presentation
			Diagnosis
			Prevention and Management
		Atopic Dermatitis
			Introduction
			Pathophysiology and Clinical Presentation
			Diagnosis
			Management
		Allergic Rhinitis
			Introduction
			Pathophysiology and Clinical Presentation
			Diagnosis
			Management
		Anaphylaxis
			Introduction
			Pathophysiology and Clinical Presentation
			Diagnosis
			Prevention and Management
		References
Part III: Update in Pediatric Cardiology
	3: Update in Pediatric Cardiology
		Congenital Heart Disease: Epidemiology Update
		Late Outcomes
			Neurodevelopmental Outcomes in CHD
			Psychosocial Outcomes and Quality of Life in CHD
			Exercise in CHD
		Fetal Cardiology
			Fetal Cardiac Intervention
			Fetal Arrhythmia
		Cardiac Imaging
			Updates in Echocardiography
			The Growing Role of CMRI
			The Role of Cardiac Computed Tomography
		Interventional Cardiology
			Atrial Septal Defect Device Closure
			Pulmonary Valve Replacement
			Patent Ductus Arteriosus Occlusion in Premature Infants
		Genetic Testing in Pediatric Cardiology
			Genetic Aortopathies
				Marfan Syndrome
				Loeys-Dietz Syndrome
				Turner Syndrome
			Hypertrophic Cardiomyopathy
			Dilated Cardiomyopathy
			Sudden Cardiac Death and Inherited Arrhythmias
		Dyslipidemia
		References
Part IV: Update in Child Maltreatment
	4: Update on Child Maltreatment
		Introduction
			What Is Child Maltreatment?
			How Does Maltreatment Affect Children?
			Terminology and Definitions
			Identifying Maltreatment
			Clinical Approach to Physical Injuries That May Be Due to Maltreatment
				General Approach
				History
				Physical Examination
				Documentation
				Providing an Opinion on the Cause of Findings
		Physical Abuse
			Bruising
				Differential Diagnosis
				History
				Physical Examination
				Documentation of Physical Findings
				Medical Testing for Bruising
				Testing for Occult Injuries
			Fractures
				Differential Diagnosis
				History
				Physical Examination
				Medical Testing
			Head and Spine Injuries
				Differential Diagnosis
				History
				Physical Examination
				Medical Testing
			Abdominal Trauma
				History
				Physical Examination
				Medical Testing
			Burns
				Differential Diagnosis
				History
				Physical Examination
				Medical Testing
		Neglect
		Sexual Abuse and Assault
			Timing of Examination
			History
			Physical Examination
			Interpretation of Findings
			Documentation
			Forensic Evidence Collection
			Testing for Sexually Transmitted Infections
			Emergency Contraception
			Psychosocial Support
			Discharge and Follow-Up
		Commercial Sexual Exploitation of Children
		References
Part V: Update in Pediatric Critical Care
	5: Update in Pediatric Critical Care
		Introduction
		Patient Monitoring and Technology
			Near-Infrared Spectroscopy (NIRS)
			Capnography
			Continuous Electroencephalogram (EEG) Monitoring
			Bioinformatics
			Point-of-Care Bedside Ultrasound (US)
			Video Laryngoscopy
		Organ Systems-Based Updates
			Neurology
				Traumatic Brain Injury
				Pain, Agitation, and Neuromuscular Blockade
				Iatrogenic Withdrawal Syndrome
				Delirium
				Status Epilepticus
				Stroke
			Respiratory
				Acute Respiratory Distress Syndrome (ARDS)
				E-Cigarette and Vaping Product Use Associated Lung Injury (EVALI)
			Cardiology
				Cardiopulmonary Resuscitation
			Gastroenterology/Nutrition
				Nutritional Guidelines
				Stress Ulcer Prophylaxis
				Indirect Calorimetry
				Glycemic Control
			Hematology
				Transfusion Strategies
				Thromboprophylaxis
			Infectious Disease/Immunology
				Sepsis
				Coronavirus-19 Pandemic
		Quality Improvement
			Standardized Handover Tools
			Pediatric Early Warning Scores
			Patient Care Bundles
		Rehabilitation
		Palliative Care
		Education
			Courses
			Simulation
			Electronic Learning (E-Learning)
			Future Directions in Critical Care Education
		Health Care Inequities
		Conclusion
		References
Part VI: Update in Development
	6: Update in Infant Development
		Infant Mental Health: Awareness Among Physicians
		Serve and Return Interaction Shapes Brain Circuitry
		Overview of Social Emotional Development
		Hand in Hand: Growing Together Everyday: Social Emotional Milestones Overview
			0–3 Months
			4–6 Months
			7–12 Months
			13–18 Months
			19–24 Months
			25–36 Months
		Ages and Stages Developmental Milestones
			Six Areas of Child Development
			The Amazing World of Your Baby: An Overview of Baby’s Development Birth to 6 Months
				Your Baby at 1 Month
				Your Baby at 2 Months
				Your Baby at 3 Months
				Your Baby at 4 Months
				Your Baby at 5 Months
				Your Baby at 6 Months
			The Amazing World of Your Baby: An Overview of Baby’s Development at 7–18 Months
				Your Baby at 7–9 Months
				Your Baby at 10–12 Months
				Your Child Between 13 and 18 Months
			The Remarkable World of Your Toddler: An Overview of Your Toddler’s Development at 19–24 Months
				Your Toddler Between 19 and 24 Months
			The Remarkable World of Your Toddler: An Overview of Your Toddler’s Development at 25–36 Months
				Your Toddler Between 25 and 30 Months
				Your Toddler Between 31 and 36 Months
			The Busy World of Your Preschooler: An Overview of Your Preschooler’s Development at 36–48 Months
				Your Preschooler Between 36 and 48 Months
			The Busy World of Your Preschooler: An Overview of Your Preschooler’s Development at 48–60 Months
				Your Preschooler Between 48 and 60 Months
			So What Derails Early Development?
				Toxic Stress Derails Healthy Development
				Infants Most at Risk
			How Can This Information Change the Practice of Clinicians and Practitioners
		References
			Further Reading
	7: Update in Autism Spectrum Disorder
		Introduction
		Prevalence Update
		What Causes Autism?
			Genetics
			Epigenetic Factors
			Other Possible Causes/Risk Factors for ASD
		Assessment/Evaluation
			Screening Tools for ASD
			Physical Examination
			Investigations
			Common Differential Diagnosis and Co-occurring Diagnosis in ASD (see autism cormorbidities below for more details)
		Autism Comorbidities and Management
			Attention Deficit Hyperactivity Disorder
			Anxiety
			Anxiety Treatment
			Emotional Dysregulation (Irritability/Aggression)
			Treatment of Emotional Dysregulation (ED)
			Epilepsy
			Gastrointestinal Issues
			Sleep Problems
			Treatment for Sleep Disturbances
			Developmental Coordination Disorder (DCD)/Dyspraxia
				Treatment
			Tics and Tourette Syndrome (TS)
				Treatment
			Intellectual Disability
			Obsessive-Compulsive Disorder
				Treatment
			Eating Disorder
			Gender Identity
			Other Comorbidities
		Treatment of Autism
			Behavioural Approaches
			Biomedical Interventions
			A Brief Note on Complementary and Alternative Medical (CAM) Therapies
		Summary
		References
			Suggested Readings
Part VII: Update in Clinical Genetics
	8: Updates in Clinical Genetics
		Genetic Variants and Genetic Testing
		Exome and Genome Sequencing
		Genetic Testing
		Gaps and Recent Advances in Genetic Testing
		Interpretation of Genetic Test Results
		Prenatal Genetic Testing
		Approach to the Genetics Referral
		Updates to Treatments for Genetic Conditions
		Support and Resources for Clinicians and Families
		References
Part VIII: Update in Pediatric Emergency Medicine
	9: Pain and Sedation in the Emergency Department
		Introduction
		Pain Assessment
		Non-Pharmacologic Management of Acute Pain
		Pharmacologic Management of Acute Pain
		Mild Pain
		Moderate-Severe Pain
		Procedural Pain
		Sucrose Solution
		Topical Anesthetic Agents for Pain
		Procedural Sedation
		References
	10: Resuscitation
		Airway
		Medications
		Cardiopulmonary Resuscitation
		Post Cardiac Arrest Care
		References
	11: Sepsis
		Introduction
		Definitions
		Epidemiology and Risk Factors
		Etiology and Microbiology
		Pathophysiology
		Diagnosis
		Management
		Summary
		References
	12: Interfacility Transport of the Pediatric Patient
		Team Composition
			Definitions to Inform most Appropriate Paediatric Transport Service i.e. Patient ≥5 kg
		Transport Mode
		Preparation for Transport
		Supplies and Equipment
		References
	13: Pediatric Trauma
		Introduction
		Scope of Pediatric Trauma
		Pre-hospital Care
		The Trauma Team
			Primary Survey
			Airway
			Breathing
			Circulation
			Fluid Resuscitation and Hemorrhage
			Disability
		Exposure and Temperature control
		Adjuncts to Primary Survey
			Secondary Survey
			Traumatic Brain Injury (TBI)
			Thoracic Trauma
			Abdominal Trauma
		Summary
		References
Part IX: Update in Pediatric Endocrinology
	14: Update in Pediatric Endocrinology
		Adrenal Insufficiency
			Introduction
			Etiology
			Investigations
			Treatment
		Growth
			Introduction
			Clinical Evaluation of Growth
			Investigations in Children with Growth Failure
			Growth Hormone
			Other Therapies to Increase Final Adult Height
		Puberty
			Introduction
			Pubertal Control
			Precocious Puberty
			Pubertal Delay
			Environmental Exposures and Puberty
		Thyroid Disease
			Introduction
			Congenital Hypothyroidism
			Acquired Hypothyroidism
			Acquired Hyperthyroidism
		References
Part X: Update in Pediatric Gastroenterology
	15: Update in Pediatric Gastroenterology and Nutrition
		Reflux
			Diagnostic Considerations
			Management
		Eosinophilic Esophagitis
			Pathogenesis
			Presentation
			Management
				Diet
				Drugs
				Dilation
		Celiac Disease
			Introduction and Epidemiology
			Pathogenesis and Immunology
			Genetics and Risk factors
			Diagnosis
			Treatment
		Functional Gastrointestinal Disorders
			Background
			Neonate/Toddler Functional GI Disorders
				Functional Diarrhea
				Functional Constipation
			Functional Disorders of Childhood and Adolescence
				Functional Nausea and Functional Vomiting
				Functional Abdominal Pain Disorder and Irritable Bowel Syndrome
				Functional Constipation
		Inflammatory Bowel Disease
			Epidemiology
			Pathophysiology
			Clinical Presentation
			Extra-intestinal Manifestations
			Evaluation
			Histology
			Management
				Corticosteroids
				Enteral Nutrition Therapy
				Aminosalicylates
				Immunomodulators
				Biologic Therapies
				Surgical Management
			Outcomes
		Nutrition
		Intestinal Rehab and Short Gut Syndrome
			Definition and Pathogenesis
			General Management Approach
			Parenteral Nutrition Management
			Enteral Nutrition Management
			Central Access Preservation
			Surgery
			Transplant
		Endoscopy
			Esophagogastroduodenoscopy
				Foreign Body Ingestion
				Upper Gastrointestinal Bleeding
				Future Directions
			Endoscopic Retrograde Cholangiopancreatography (ERCP)
			Evaluation of the Small Intestine
			Colonoscopy
		References
	16: Updates in Pediatric Hepatology and Pancreatology
		Neonatal Cholestasis
			Background
			Pathogenesis
			Presentation
			Etiologies
			Diagnosis
			Management
		Pediatric Acute Liver Failure
			Pathogenesis
			Presentation
			Diagnosis
			Management
		Viral Hepatitis
			Hepatitis B
				Prevention
				Monitoring and Therapy
			Hepatitis C
				Screening
				Monitoring
			Other Viruses
		Nonalcoholic Fatty Liver Disease
			Background
			Pathogenesis
			Presentation
			Screening
			Diagnosis
				Laboratory Evaluation
				Radiologic Evaluation
				Histologic Evaluation
			Management
			Prevention
		Pancreatitis
			Presentation
			Etiologies
			Management
				Acute Pancreatitis
				Acute Recurrent Pancreatitis
				Chronic Pancreatitis
		References
Part XI: Update in Pediatric Hematology
	17: Update in Pediatric Hematology
		Introduction
		Iron-Deficiency Anemia
			Diagnosis of Iron Deficiency
			Development of Iron Deficiency in Children
			Treatment of Iron Deficiency Anemia
		Hydroxyurea in Sickle Cell Disease
		Iron Chelation in Thalassemia
		Transfusion Medicine Controversies: Transfusion Triggers and Age of Blood
			Red Cell Transfusion Triggers
			Age of Blood
		Management of Immune Thrombocytopenia
		Evans Syndrome
		Diagnosis and Management of DIC
		Developments in Hemophilia Treatment
			Long-Acting FVIII Products
				FVIII-Fc Fusion
				FVIII with Pegylated Liposomes
			Long-Acting FIX Products
				FIX-Fc Fusion
				FIX-Albumin Fusion
				Pegylated FIX
			Gene Therapy
		Oral Anticoagulants in Children
		Autoimmune Lymphoproliferative Syndrome (ALPS)
		Acquired Aplastic Anemia in Children
		Neutropenia
			Factors that Affect the Neutrophil Count
			Signs and Symptoms of a Neutropenic Child
			Management of a Neutropenic Patient
		Conclusion
		References
Part XII: Update in Pediatric Hospital Medicine
	18: Update in Pediatric Hospital Medicine
		Acute Viral Bronchiolitis
			Introduction
			Management
				High Flow Nasal Canula
				Cardiorespiratory and Pulse Oximetry Monitoring
				Post-Hospitalization Follow-Up
		Febrile Urinary Tract Infections in Young Infants
			Introduction
			Imaging After First Febrile UTI for Younger Infants
			Duration of IV Antibiotic Treatment of UTIs in Younger Infants
		Evaluation and Management of Febrile Infants
			Background
				Age 8–21 Days Old
				Age 22–28 Days Old
				Age 29–60 Days Old
				Procalcitonin
				Time to Discharge: A Review of Time to Culture Positivity
		Brief Resolved Unexplained Event (BRUE)
			Introduction
			Risk Assessment and Outcomes
			Management
		COVID-19 Pneumonia
			Introduction
			Diagnostic Evaluation:
			Treatment and Management of the Hospitalized Child with COVID-19 Pneumonia
				Anticoagulation
				Dexamethasone
				Remdesivir
		Multisystem Inflammatory Syndrome in Children (MIS-C)
			Introduction
			Case Definition and Diagnosis
			Cardiac Involvement
			Treatment
		Acute Hematogenous Osteomyelitis (AHO)
			Introduction
			Diagnosis
			Management
			Early Transition to Oral Antibiotics
			Treatment Duration
			Monitoring
		Hyperbilirubinemia
			Introduction
			Prevention
			Risk Assessment and Monitoring
			Management
			Escalation of Care
			Discharge and Follow-Up
		High Value Care
		References
Part XIII: Update in Pediatric Infectious Disease
	19: Update in Pediatric Infectious Disease
		Introduction
		The Management of Febrile Infants
			Pathogenesis of Neonatal Sepsis
				Bacteria
				Viruses
					Herpes Simplex Virus
					Enterovirus
					Cytomegalovirus (CMV)
				Advancing Diagnostic Tools
				Cost of Unnecessary Care
				Development of Guidelines
		Updates to Antibiotic Management in the Primary Care Setting
			When Less Is More
			Treatment of Community-Acquired Pneumonia (CAP) in Children
			Treatment of Urinary Tract Infection (UTI) in Children
			Treatment of Skin and Soft Tissue Infection (SSTI) in Children
		The Impact of the Covid-19 Pandemic on Pediatric Infections
			Pediatric Infection Prevention and Control
			Respiratory Syncytial Virus: The Rise and Anticipated Fall
			Enterovirus D68 and Acute Flaccid Myelitis
		Recent Challenges in Vaccine Hesitancy
			Vaccine Hesitancy Definition and Current State of Affairs
			Causes of Vaccine Hesitancy
				Impact of Covid-19 Pandemic
				Impact of Covid-19 on Vaccine Confidence
			HPV
			Solutions to Reducing Vaccine Hesitancy
			Case Scenario
			Conclusions on Vaccine Hesitancy
		Conclusions
		References
	20: SARS-CoV-2, COVID-19, and Children: Myths and Evidence
		Introduction
		Myth 1: Lockdowns Were a Necessary Response to the Spread of SARS-CoV-2
		Myth 2: We Needed to Protect Our Children from SARS-CoV-2
		Myth 3: Sequelae of SARS-CoV-2 Warranted Protecting Our Children from SARS-CoV-2 Infection
		Myth 4: Protecting Children Was Necessary to Prevent Their Spreading Infection to More Vulnerable Older Adults
		Myth 5: Natural Immunity Does Not Protect as well as Vaccine-Induced Immunity
		Myth 6: Vaccines for SARS-CoV-2 Are Safe and Effective for Children
		Myth 7: There Were No Better Courses Open than to Try Lockdowns, Masking Mandates, School Closures, and Vaccine Mandates
		Myth 8: There Was no Precedent for How to Respond to the SARS-CoV-2 Pandemic
		Myth 9: It Is Time to Move on, and Give Amnesty to Leaders Who Did Their Best to Protect Us
		Conclusions
		References
Part XIV: Update in Pediatric Nephrology
	21: Update in Pediatric Nephrology
		Introduction
		Evaluation and Management of Urinary Tract Infections in Children
			Background
			Pathogenesis
			Clinical Presentation
			Diagnosis
			Treatment of Acute UTI
			Urinary Tract Imaging
		Update in Vesicoureteral Reflux
			Introduction
			Diagnosis
			Antibiotic Prophylaxis
			Surgical Intervention
		Glomerular Diseases in Children
			Introduction
			Epidemiology
			Clinical Manifestations
			Diagnosis
			Management
			Prognosis
			Nephrotic Syndrome
		Acute Kidney Injury in Children
			Introduction
			Definition
			Epidemiology
			Etiology
			Prevention and Treatment
			Indications and Timing of KRT
			Prognosis
		Chronic Kidney Disease in Children
			Introduction
			Definition
			New Equations to Estimate GFR
			Advances in Markers of CKD Progression
		Update in Pediatric Hypertension
			Introduction
			Epidemiology
			Diagnosis
			Evaluation of Target Organ Damage
			Treatment
		Genetics and the Kidney
			Introduction
			Glomerular Diseases
			Ciliopathies
			Renal Tubular Disorders
				Congenital Anomalies of the Kidney and Urinary Tract (CAKUT)
			Nephrolithiasis
		References
Part XV: Update in Neonatalogy
	22: Updates in Neonatology
		Background
		Normal Newborn Care
			Neonatal Nutrition
				Benefits of Breastfeeding
				Contraindications to Breastfeeding
				Supplements with Breastfeeding
				Infant Formula
				Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD)
			Newborn Skin and Umbilical Cord Care
				Umbilical Cord Care
				First Newborn Cleaning
				Routine Bathing
				Diaper Care
			Newborn Screening
				Newborn Blood Spot Screening
				Hearing Screening Program
				Congenital Cardiac Disease
				Future Perspective
			Neonatal Resuscitation
		Common Neonatal Problems
			Prevention and Management of Procedural Pain in Neonates
				Scoring System
				Pain Management
			Neonatal Sepsis
				Diagnosis of Sepsis
				Management of Newborns >35-Weeks of Gestation at Risk for Sepsis
			Hypoxic Ischemic Encephalopathy
				Pathophysiology of HIE
				Diagnosis of HIE
				Management
				Prognosis
			Neonatal Hypoglycemia
				Definition of Hypoglycemia
				Use of Dextrose Gel
				Continuous Glucose Monitoring
			Neonatal Abstinence Syndrome
				Pathophysiology of NAS
				Clinical Manifestation
				Management
				Long-Term Management
				Other Drugs
				NAS in Preterm Infants
				Acquired Opioid or Benzodiazepam Dependency in Infants
		Prematurity
			Incidence and Risk Factors of Prematurity
			Grey Zone or Limit of Viability
			Initial Stabilization and Short-Term Morbidities
			Post Discharge Care of NICU Graduate
		References
Part XVI: Update in Pediatric Neurology
	23: Update in Pediatric Neurology
		Introduction
		Definitions and Classifications
			Epileptic Seizures and Epilepsy: Definitions and Current Concepts
		Focal Epilepsies in Children
		Epilepsy Syndromes in the Neonatal Period and in Infancy
			Inheritance
				Seizure Semiology and Evolution
			Benign Familial Neonatal Seizures
			Benign Familial Neonatal-Infantile Seizures (BFNIS)
			Benign Familial Infantile Seizures (BFIS)
			Epileptic Encephalopathy
			Early Infantile Epileptic Encephalopathy
				Seizure Semiology
				Inheritance
			Early Myoclonic Encephalopathy (EME)
				Seizure Semiology and Evolution
				Inheritance
			Epilepsy of Infancy with Migrating Focal Seizures (Malignant Migrating Partial Seizures of Infancy (MMPSI)
				Inheritance
			Infantile Spasms (IS)
				Seizure Semiology and Evolution
				Etiology
			Epilepsies of Early Childhood
			Generalized Epilepsy with Febrile Seizures Plus (GEFS+)
				Semiology
				Inheritance
			Severe Myoclonic Epilepsy of Infancy (SMEI, Dravet Syndrome)
				Seizure Semiology and Evolution
				Inheritance
			Acquired Epileptic Aphasia
				Semiology
				Treatment
			Clinical and Laboratory Evaluation of an Infant with Epileptic Encephalopathy
			Investigations
			The Role of Emerging Genetic Technologies
			Conclusion
		Epileptic Syndromes in the Pre-school and School Age Child
			Benign Epilepsy with Centro Temporal Spikes (BECTS)
				Seizure Semiology
				Diagnosis
				Treatment
				Prognosis
			Childhood Absence Epilepsy (CAE)
				Seizure Semiology
				Diagnosis
				Treatment
			Epileptic Encephalopathies in School Age Child
				Lennox Gastaut Syndrome
				Seizure Semiology
				Diagnosis
				Treatment
			Epileptic Syndromes in the Adolescent Child
				Juvenile Myoclonic Epilepsy (JME)
				Seizure Semiology
				Diagnosis
				Treatment
			Progressive Myoclonic Epilepsies (PME)
		Nonepileptic Paroxysmal Events
			Syncope
			Vasovagal Syncope
			Orthostatic Hypotension and Postural Orthostatic Tachycardia Syndrome (POTS)
			Stretch Syncope
			Self-Induced Syncope
			Reflex Anoxic Seizure
			Breathholding Spells
			Pseudosyncope
			Approach to the Investigation of Syncope
			Benign Neonatal Sleep Myoclonus (BNSM)
			Tic Disorders
			Non-epileptic Seizures
		Conclusion
		References
Part XVII: Update in Pediatric Oncology
	24: New Developments in the Treatment of Pediatric Acute Lymphoblastic Leukemia
		Immunophenotype
		Prognostic Factors
			Clinical Features
			Early Response to Therapy
			Genetic Features
				Aneuploidy
					Hyperdiploidy
					Hypodiploid
				Structural Alterations
				ETV6::RUNX1
				BCR::ABL1, t(9;22)
				KMT2A Translocations
				TCF3 Translocations
				iAMP21
				Genomic Profile
				BCR::ABL1-Like
				Genetics of T-ALL
		Current Treatment for Childhood ALL
			Risk-adapted Therapy
			CNS-directed Therapy
				Hematopoietic Stem Cell Transplantation (HSCT)
		Novel Therapy Approaches
			Immunotherapy
				Bispecific Antibodies
				Antibody Conjugates
				Chimeric Antigen Receptor (CAR) T-Cell Therapy
					Toxicities of CAR T Cell Therapy
			Precision Medicine Therapies
			New Cytotoxic Agents
				Bortezomib
				Clofarabine
				Nelarabine
			Moving Novel Therapies into Frontline Treatment
		Conclusions
		References
	25: Update in Solid Tumors of Childhood
		Imaging, Biopsy, and Surgical Considerations
		Delivery of Bad News
		Neuroblastoma
			Epidemiology, Pathophysiology, and Genetic Predisposition
			Presenting Symptoms
			Histology and Molecular Profile
			Staging
			Treatment and Outcomes
		Kidney Tumors
			Epidemiology, Pathophysiology, and Genetic Predisposition
			Presenting Symptoms
			Histology and Molecular Profile
			Staging
			Treatment and Outcomes
			Other Renal Tumors
		Sarcomas
			Bone Tumors
				Epidemiology, Pathophysiology, and Genetic Predisposition
				Presenting Symptoms
				Histology and Molecular Profile
				Staging
				Treatment and Outcomes
			Soft Tissue Sarcomas
				Epidemiology, Pathophysiology, and Genetic Predisposition
				Presenting Symptoms
				Histology and Molecular Profile
				Staging
				Treatment and Outcomes
		Rare Tumors
			Germ Cell Tumors
				Presenting Symptoms
				Histology and Molecular Profile
				Staging
				Treatment and Outcomes
			Liver Tumors
				Epidemiology, Pathophysiology, and Genetic Predisposition
				Presenting Symptoms
				Histology and Molecular Profile
				Staging
				Treatment, Outcomes, and Surveillance
			Other Tumors
				Retinoblastoma
				Adrenocortical Carcinoma
		Post-Treatment Care and Survivorship
			Treatment-Related Toxicities & Long-Term Follow-Up
			Psychosocial Impact
		Future Directions
		References
Part XVIII: Update in Pediatric Psychiatry
	26: Update in Pediatric Psychiatry
		Introduction
			Prevalence Data on Mental Illness in Youth
		SARS-CoV-2 and prevalence data on mental illness in youth: the “Mental Health Pandemic”
			Anxiety
			Depression
			Eating Disorders
			Social Media and Eating Disorder
			Sleep Disorders
		SARS-CoV-2: Mitigation Factors and Consequent Mental Health Concerns in Children and Youth
		Identifying and Managing Psychiatric Illness in Children and Adolescence
			Diagnostic Curiosity: The Psychiatric Assessment
		Changes in the DSMV for Child and Adolescent Psychiatric Disorders
			Neurodevelopmental Disorders
			Disruptive, Impulse-Control and Conduct Disorders
			Trauma and Stressor-Related Disorders
			Depressive Disorders
			Avoidant/Restrictive Food Intake Disorder (ARFID)
			DSM V Research Criteria
		Attention Deficit Hyperactivity Disorder (ADHD)
			Prevalence
			Diagnosis
			Treatment
			Clinical Point
		Depression
			Prevalence
			Diagnosis
			Suicide
			Treatment
			Safety
			Clinical Point
				SSRIs and Suicide Related Events
				Long Term Effects of SSRIs and Youth
				Non-suicidal Self-injury (NSSI)
		Anxiety
			Prevalence
			Diagnosis
			Treatment
			Clinical Point
				Obsessive Compulsive Disorder (OCD)
		Bipolar Disorder
			Prevalence
			Diagnosis
			Treatment
			Safety
			Clinical Point
		Schizophrenia and Other Psychotic Spectrum Disorders
			Prevalence
			Diagnosis
			Treatment
			Clinical Point
				Psychotic Experiences and Other DSMV Disorders
			Clinical Point 2
				Atypical Antipsychotics: Issue for Consideration
				Antipsychotics and Aggressive Behavior
				Adverse Effect Profile of SGAs
					Weight Gain and Obesity
					Diabetes
					Dyslipidemia
					Movement Disorders
		Substance Related Disorders in Children and Adolescents
			Prevalence
			Diagnosis
			Treatment
			Clinical Point
			Clinical Point—2
				Cannabis and Psychosis
		Screening Tools to Identify Children and Youth With Mental Health Concerns
			Anxiety
			Depression
				The Children’s Depression Inventory (CDI)
				The Beck Depression Inventory (BDI)
				The Patient Health Questionnaire 9 (PHQ-9)
				The Eating Disorders Examination Questionnaire (EDO-Q)
		SARS-CoV-2 and New Models of Mental Health Care Provision
		Clinical Note
			Atypical Presentations of Psychiatric symptoms
		Conclusion
		References
Part XIX: Update in Pediatric Rheumatology
	27: Update in Pediatric Rheumatology
		Introduction
		Musculoskeletal Assessment Tool: The pGALs—Pediatric Gait, Arms, Legs, and Spine (Foster et al. 2006)
		Update on Juvenile Idiopathic Arthritis
		Update on Non-inflammatory Musculoskeletal Pain
		Macrophage Activation Syndrome
		Multisystem Inflammatory Syndrome Temporally Associated with COVID-19
		Autoinflammatory Disease (Periodic Fever syndromes)
		Familial Mediterranean Fever
		Periodic Fever, Aphthous Stomatitis, Adenitis and Pharyngitis (PFAPA)
		Choosing Wisely in Pediatric Rheumatology
		Summary
		References
Index