What's New | Decker

Oppositional defiant disorder (ODD) has a high prevalence and substantial morbidity
Diagnosis of ODD is based on a careful history, interview, mental status examination, and collateral information from school.
Disruptive mood dysregulation disorder is a new DSM-5 diagnosis that should be carefully considered in the differential diagnosis of children and adolescents with ODD
Genetic and neuroimaging studies have examined the possible neurobiological basis of ODD, but to date there is no definitive biomarker or biological findings in ODD.
Parent behavioral management training and psychosocial interventions are the cornerstone of treatment planning for ODD.

Contemporary understanding of ventricular mechanics with identification of the structure and function of the ventricular myocardial band
Detailed description of the anatomic proximity of cardiac structures and how knowledge of this proximity helps prevent intraoperative complications and damage to critical cardiac structures
Comprehensive description of aortic root anatomy and mechanics and application of how this anatomy dictates performance of transcatheter aortic valve replacement

Many iatrogenic withdrawal syndromes have been identified, the most common of which is opioid or benzodiazepine withdrawal. Generally speaking, the approach to treating opioid and/or benzodiazepine withdrawal is to provide enough medication to saturate target receptors, followed by a period of gradual dose reduction to allow the body to return to a state of homeostasis.
The Neonatal Abstinence Score (NAS) was designed to assess withdrawal symptoms in infants with multiple drug exposure during pregnancy. Because the NAS was validated in infants, it is not applicable in older children with iatrogenic withdrawal. In recent years, withdrawal assessment tools for pediatrics have been developed for iatrogenic withdrawal to provide an objective assessment of withdrawal.
There have been no randomized clinical trials that have compared the efficacy of various weaning strategies. However, a recent multicenter clinical trial, named the RESTORE trial, examined the effects of a standardized sedation protocol in pediatric intensive care units.

Many iatrogenic withdrawal syndromes have been identified, the most common of which is opioid or benzodiazepine withdrawal. Generally speaking, the approach to treating opioid and/or benzodiazepine withdrawal is to provide enough medication to saturate target receptors, followed by a period of gradual dose reduction to allow the body to return to a state of homeostasis.
The Neonatal Abstinence Score (NAS) was designed to assess withdrawal symptoms in infants with multiple drug exposure during pregnancy. Because the NAS was validated in infants, it is not applicable in older children with iatrogenic withdrawal. In recent years, withdrawal assessment tools for pediatrics have been developed for iatrogenic withdrawal to provide an objective assessment of withdrawal.
There have been no randomized clinical trials that have compared the efficacy of various weaning strategies. However, a recent multicenter clinical trial, named the RESTORE trial, examined the effects of a standardized sedation protocol in pediatric intensive care units.

Early recognition of shock is difficult but essential for preservation of cellular and organ function and survival. The earliest clinical signs are nonspecific, with the initial inflammatory response including tachycardia, fevers, or cool or clammy skin.
The approach to shock ultimately requires understanding and correcting its etiology (eg, antibiotics and source control for sepsis, thrombectomy after massive pulmonary embolus, hemorrhage control after trauma, and so forth). However, until these are diagnosed and addressed directly, clinicians ultimately have three approaches in their armamentarium: volume expansion, vasopressors, and cardioactive agents.
The PAC was introduced in 1970. Its use increased over the next 3 decades and eventually was considered the standard of care for most critically ill patients. However, the use of PACs declined rapidly after the results of the randomized, controlled trial published in the New England Journal of Medicine revealing no benefit in high-risk surgical patients.

Many iatrogenic withdrawal syndromes have been identified, the most common of which is opioid or benzodiazepine withdrawal. Generally speaking, the approach to treating opioid and/or benzodiazepine withdrawal is to provide enough medication to saturate target receptors, followed by a period of gradual dose reduction to allow the body to return to a state of homeostasis.
The Neonatal Abstinence Score (NAS) was designed to assess withdrawal symptoms in infants with multiple drug exposure during pregnancy. Because the NAS was validated in infants, it is not applicable in older children with iatrogenic withdrawal. In recent years, withdrawal assessment tools for pediatrics have been developed for iatrogenic withdrawal to provide an objective assessment of withdrawal.
There have been no randomized clinical trials that have compared the efficacy of various weaning strategies. However, a recent multicenter clinical trial, named the RESTORE trial, examined the effects of a standardized sedation protocol in pediatric intensive care units.

Child Psychiatry