Mamina Turegano, MD, FAAD

Most viewed in the last 7 days from JAMA Pediatrics: This JAMA Pediatrics Patient Page describes peanut allergy guidelines and the importance of giving peanut protein to young children to prevent development of an allergy. https://ja.ma/4dQUKJh

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TIDBIT TUESDAY! Types of Medical Research By Shelene Giles, CEO FIG Education Evidence-Based Medicine • Clinical & scientific evidence • Clinical experience & expertise • Patient’s values, needs & choices Evidence-based medicine is the practice that relies on scientific evidence for guidance and decision making in the medical community. An evidence-based practice relies on the partnership of hard scientific evidence, clinical expertise, and the individual patients’ needs and choices. This results in the best patient outcomes. Evidence-based medicine integrates clinical experience and patient values with the best available research information. It is a movement that aims to increase the use of high-quality clinical research in clinical decision making. Evidence-based medicine requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning in which caring for one’s own patients creates the need for clinically relevant information about the diagnosis, prognosis, therapy, and other clinical and health care issues. #nurse #ot #pt #Legalnurseconsultant #Casemanagement

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June issue of Indian Pediatrics is online. PRESIDENT’S PAGE Healing Our Planet: A Call to Action From the Pediatric Community – GV Basavaraja 515 INVITED COMMENTARY Biomarkers in Acute Kidney Injury: The Hope, the Hype and the Promise – Sriram Krishnamurthy 517 Immune Thrombocytopenia- Will it Stay or go Away? – Vibha Bafna 519 ORIGINAL ARTICLES Plasma Neutrophil Gelatinase-Associated Lipocalin (2-0) Index: A Precise and Sensitive Predictor of Acute Kidney Injury in Children Undergoing Cardiopulmonary Bypass – Hanan El-Halaby... 521 Clinical Outcome and its Predictors in Children With Newly Diagnosed Immune Thrombocytopenia –Parameswary Singaravadivelu... 527 Effect of Antenatal Oral Vitamin D Supplementation on Serum 25(OH)D Concentration in Exclusively Breastfed Infants at 6 Months of age – Prashant Prabhakar... 533 Postnatal Growth at 64 Weeks Postmenstrual Age in Preterm Infants Delivered < 34 Weeks’ Gestation – Apoorva Kutar.... 540 Translation and Validation of Hindi Version of Adolescent Peer Relation Instrument for Bullying Victimization – Priyanka Choudhary... 545 Spectrum of Genital and Extragenital Anomalies in Malformation Syndromes Associated With 46, XY Disorders of Sex Development - Shaymaa Raafat... 551 Early Lung Ultrasound Scores in Neonates With Respiratory Distress - R Aiswarya... 558 Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Including Matched Sibling and Alternate Donor Transplants –Aditya Kumar Gupta... 564 JOURNAL CLUB Early Treatment of Patent Ductus Arteriosus with Ibuprofen EBM Viewpoint – Deepak Chawla 571 Pediatric Cardiologist’s Viewpoint – Sakshi Sachdeva 573 Pediatrician’s Viewpoint – Sumaira Khalil 574 SPECIAL ARTICLE Congenital Hyperinsulinism – Notes for the General Pediatrician – Maria Salomon Estebanez, Chris Worth, Indraneel Banerjee 578 CHILD HEALTH TECHNOLOGY A Refashioned Head Cover Device of Personal Protective Equipment to Facilitate Conventional Auscultation – Thirunavukkarasu Arun Babu, Vijayan Sharmila 585 REMINISCENCES FROM INDIAN PEDIATRICS: A TALE OF 50 YEARS Strengthening School Health Services in India: Why and How? – Chandrakant Lahariya 587 CLINICAL CASE LETTERS Zoonoses Presenting as Head and Neck Swellings – Elizabeth KE... 591 Necessity of Improvised Antenatal Testing for Rh Isoimmunization –Suman SR... 594 Near-Fatal Aortoesophageal Fistula Following Button Battery Ingestion - Shilpa Abraham... 597 CORRESPONDENCE Multicentric Trial Across India to Evaluate the Impact of Temperature Variation on Neonatal Dehydration - Aditya Bhatt, Somashekhar Nimbalkar 599 Prevalence and Predictors of Celiac Disease in Children With Constipation - Rupali Bavikar, Rajesh Kulkarni 599 Unveiling the Link: Celiac Disease Prevalence in Constipated Children - Rajan Kumar, Ehtesham Ansari 600 AUTHORS’ REPLY - Rajesh Kumar Meena, Manish Narang 600 CLIPPINGS: PEDIATRIC NEPHROLOGY 601 NEWS IN BRIEF 602 https://lnkd.in/gB2VvE82

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Most viewed in the last 7 days from JAMA Pediatrics: This Viewpoint discusses the need for universal standards of recording and measuring phototherapy administered to infants to monitor for potential adverse effects in the long term. https://ja.ma/3W2rNDy

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How much do GLP-1 agonists affect gastric emptying? Our meta-analysis in 📕AJG found only mild delay associated with GLP-1 meds compared to placebo. 🍳Solids: ⬆️emptying half-time of ~36 minutes 🥤Liquids: No significant delay Gastric emptying delay by GLP-1 agonists appears limited in magnitude relative to standard pre-anesthesia fasting ⏰ 👉 A liquid-only diet on the day before procedures while continuing GLP-1 therapy would represent the most sensible approach to pre-operative management Link to article📄 https://lnkd.in/exNv7_cZ

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Want to create a Center for Excellence for managing #psoriasis? In this Medscape commentary Michael Garshick (a #cardiologist at NYU Langone Health), Leah Howard, J.D. (CEO of National Psoriasis Foundation) and I discuss how assessing #cardiovascular risk is such an important component for managing #psoriatic disease. The most common comorbidity in psoriasis is #cardiometabolic disease such as #obesity, #atherosclerosis, #diabetes, and #hyperlipidemia which are the leading causes for excess #mortality in our patients. Details at: https://lnkd.in/eSEwrmgh

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The Sequence for the week of 4/29-5/5 talks about a previously unreported repeat expansion founder mutation causing Spinocerebellar ataxia type 4 (SCA4). SCA4 is a rare subtype of SCA characterized by ataxia and nerve pain and numbness that has never before been associated with repeat expansions. This could mean an entirely new way to utilize testing and treatments for SCA4! #genetics, #publicpolicy, #geneticcounseling, #precisionmedicine, #translationalmedicine, #genetictesting, #geneticresearch, #genomesequencing, #spinocerebellarataxia, #SCA, #SCA4

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"In this video, Dr. Calabrese and Dr. Bret Scher delve into the details of her findings, showcasing how a ketogenic diet offers a promising alternative to traditional antidepressant medications. Key Takeaways: • Ketogenic diets can lead to rapid and sustained remission of depression and anxiety. • Potential for dietary interventions to complement or surpass traditional psychiatric treatments. • The importance of exploring metabolic approaches in mental health care." https://lnkd.in/g-ZcwE2H

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This study will change my practice: Feitong Lei and colleagues found that higher buprenorphine doses in the first 30 days of treatment are associeted with lower mortality for the subsequent 365 days. Not surprisingly, 8-16 mg was more effective than <8 mg--but there was actually also a substantial decrease in mortality associated with first-month doses >16 mg. We need to be prescribing higher doses right from the start in order to increase retention and reduce relapse.

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We are finally getting some answers ladies!!!!! We now know insulin resistance develops due to decreased levels of estrogen in peri/postmenopausal women! Insulin resistance makes it harder to use sugars/ carbs as immediate energy and stores more as fat! For so many years women have been told to accept it, eat less, workout more, try this try that blah blah blah, or to just accept it. But we know central obesity leads to metabolic syndrome, cardiac and lipid disorders so how can we keep telling women to accept it! Well research is here and we do have medications to treat it of course lifestyle and diet changes help, but if you want a medication to kickstart your weight loss there are options! Metformins been around for years well tolerated, affordable, well studied, and now is being studied even further for not only its effects in menopausal weight loss but also longevity medicine. Metformin seems to have antinflammatory effects that are cardiovascularly beneficial! https://lnkd.in/gH5q7W_y

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Adolescent diabetes care: the power of GLP-1 medications What I envision is for physicians to embrace a comprehensive approach to metabolic health, especially when treating adolescents. It is crucial to be open to all available treatments and to initiate conversations about GLP-1 receptor agonists. By doing so, we can begin to address insulin resistance and type 2 diabetes more effectively in this young population. Physicians need to expand their knowledge about these medications and consider their potential benefits. For instance, the TODAY2 study provides valuable insights into type 2 diabetes in adolescents and highlights the efficacy of these treatments. It’s important for us as medical professionals to stay informed and proactive, given that our training may not have covered these newer developments extensively. Furthermore, assessing your patients thoroughly is essential. Obtain their lab results and avoid assumptions that they will simply outgrow their conditions. Don't shy away from discussions about potential treatments out of fear of causing harm. Many teens are struggling significantly with metabolic health issues, and their parents often feel lost in how to support them. As physicians, we must take the lead in ordering labs, discussing insulin resistance, exploring medication options, and considering prescriptions when appropriate. Karla Lester, M.D., FAAP is a pediatrician, certified life and weight coach, and diplomate, American Board of Obesity Medicine. Link in bio or visit https://lnkd.in/eEgKJj_6 #TeenHealth #MetabolicHealth #GLP1Medications #InsulinResistance #AdolescentDiabetes #DiabetesCare #TODAY2Study #PhysicianTips #TeenDiabetes #HolisticHealth

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Hepatitis D is a liver disease caused by infection with hepatitis D virus. This JAMA Patient Page describes hepatitis D infection and its risk factors, outcomes of acute and chronic infection, diagnosis, treatment, and prevention. https://ja.ma/3UISomL

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Forget about learning how to formulate a differential diagnosis or comprehensive treatment plan for these future "doctors" - just like we saw in Nazi Germany, physicians in the US today are no longer prioritizing learning to become healers, rather they must denounce medical ethical principles, which prioritize the sanctity of individual human life, and instead they must pledge alegience to racist dogma, dutifuly embrace critical social ideology and by all means necessary, justify the desecration of the hippocratic oath to dehumanize the patient for the sake of their "progressive" collective goals. ... "Stanford Medical School sprinkles lessons on "microaggressions," "structural racism," and "privilege" throughout its curriculum. Residents at Yale Medical School must complete an "Advocacy and Equity" sequence focused on "becoming physician advocates for health justice," while those in the infectious disease program must complete additional lessons on "Diversity, Equity, and Antiracism." Columbia Medical School promotes an "Anti-bias and Inclusive" curriculum by encouraging educators to use "precise, accurate language." Instead of "women," guidelines for the curriculum state, faculty should refer to "people with uteruses." https://lnkd.in/gxstNgJq

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The correlation linking Atopic Dermatitis and the aging process is explored in this study. Clinical observations and the underlying mechanisms are investigated. Discover more at the provided link. #DermatologyResearch #SkinHealth

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Hepatitis D is a liver disease caused by infection with hepatitis D virus. This JAMA Patient Page describes hepatitis D infection and its risk factors, outcomes of acute and chronic infection, diagnosis, treatment, and prevention. https://ja.ma/3vWSL4W

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Lajos Pusztai, MD, DPhil, of Yale University School of Medicine and chair of SWOG’s breast cancer research committee, was my mentor at MDACC in 2005. He presented at ASCO 2004 on a new prognostic tool known as RSClin N+. RSClin N+ combines information from the OncotypeDX 21-gene Recurrence Score (RS) assay with clinical and pathologic factors to estimate recurrence risk and predict benefit from adjuvant chemotherapy for premenopausal or postmenopausal patients who have hormone receptor-positive (HR+), HER2-negative breast cancer with 1-3 involved lymph nodes. The web-based RSClin prognostic tool has been available for several years to estimate recurrence risk and predict chemotherapy benefit in patients with HR+, HER2-negative breast cancer that is node-negative. Working with data from more than 5,000 participants in the SWOG S8814 and S1007 RxPONDER clinical trials, Pusztai’s team in collaboration with researchers at Exact Sciences set out to develop and validate a complementary tool for 1–3-node-positive patients in this disease setting. In their analysis, RSClin N+ provided more accurate risk assessments and better estimates of chemotherapy benefit than those provided by either the RS alone or the clinical-pathologic factors alone. Validating the RSClin N+ tool with external data confirmed that its risk estimates were prognostic and were concordant with observed risk. (abstract 508). Once again, I appreciate the wonderful information he shared at ASCO 2024 and your help as I navigate this journey with breast cancer.

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