Publications by authors named "Deepak Kamat"

142 Publications

Corticosteroids May Be Indicated in Children with Severe COVID-19 Disease.

Pediatr Ann 2021 07 1;50(7):e270-e271. Epub 2021 Jul 1.

San Antonio, TX.

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http://dx.doi.org/10.3928/19382359-20210701-01DOI Listing
July 2021

Pediatric Allergy Disorders.

Authors:
Deepak Kamat

Pediatr Ann 2021 May 1;50(5):e190. Epub 2021 May 1.

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http://dx.doi.org/10.3928/19382359-20210421-03DOI Listing
May 2021

Approach to Children with Hives.

Pediatr Ann 2021 May 1;50(5):e191-e197. Epub 2021 May 1.

Urticaria (or hives) is a pruritic and erythematous skin rash. Angioedema commonly occurs with urticaria. The term "chronic urticaria" is used when hives are present for more than 6 weeks. Acute urticaria is common in children, whereas chronic urticaria is rare. Causes of urticaria can be identified in many cases of acute urticaria with a thorough medical history. Laboratory evaluation may be needed to confirm the etiology of acute urticaria. Chronic urticaria is often idiopathic. Clinicians should avoid universal allergy testing for food allergens or aeroallergens in chronic urticaria as it usually does not help in identifying the cause, can lead to false-positive results, and unnecessary avoidance of allergens or foods. Urticarial vasculitis should be considered for lesions that are painful, present for more than 48 hours, leave scars/hyperpigmentation, or present with systemic symptoms such as fever, weight loss, and arthritis. Skin biopsy should be considered for suspected urticarial vasculitis. .
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http://dx.doi.org/10.3928/19382359-20210422-02DOI Listing
May 2021

Immune Responses in Patients with COVID-19: An Overview.

Pediatr Ann 2021 May 1;50(5):e222-e226. Epub 2021 May 1.

Since late 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has resulted in more than 143 million confirmed infections and more than 3 million deaths worldwide (as of publication time). In this article, we discuss current knowledge of immune responses that confer protection to more than 80% of the people who have been infected and possible mechanisms by which the virus escapes immune surveillance in people who develop severe disease and those who die from the disease. We also discuss the differences in the immune responses by which, in most children, the infection results in only mild disease, although causing severe disease in some adults. Understanding these differences in both the innate and adaptive immune responses among these people can lead to the development of biotherapeutic treatment modalities that could modulate immune responses to offer protection against SARS-CoV-2 and block the ability of the virus to cause severe disease or death in humans. .
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http://dx.doi.org/10.3928/19382359-20210421-02DOI Listing
May 2021

Allergic Broncho-Pulmonary Aspergillosis.

Pediatr Ann 2021 May 1;50(5):e214-e221. Epub 2021 May 1.

Allergic broncho-pulmonary aspergillosis (ABPA) is an immunologically mediated lung disease that usually occurs in people with a diagnosis of asthma or cystic fibrosis. It is a noninvasive lung disease caused by colonization of the airways with . In people who are susceptible, leads to an exaggerated immune response and ultimately pulmonary inflammation and lung damage. Patients with ABPA typically present with poorly controlled asthma, recurrent pulmonary infiltrates, and bronchiectasis. Diagnosis of ABPA is established based on a combination of clinical manifestations as well as laboratory and radiological evaluations. Delay in diagnosis can result in airway destruction and pulmonary fibrosis, which may result in significant morbidity and mortality. This article discusses the clinical characteristics, diagnosis, and management of patients with ABPA. It aims to serve as a tool for pediatricians to aid in early recognition of this debilitating disease and consider referral, facilitating early diagnosis and treatment. .
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http://dx.doi.org/10.3928/19382359-20210421-01DOI Listing
May 2021

Treatment for Severe Asthma in Children: What About Biologics?

Pediatr Ann 2021 May 1;50(5):e206-e213. Epub 2021 May 1.

Asthma is the most common pulmonary disease in children age 5 to 17 years. Asthma is characterized by chronic airway inflammation and heterogeneous clinical phenotypes. A small proportion of patients (approximately 5% to 10%) diagnosed with severe asthma are unable to achieve asthma control even with intensive therapy. Severe asthma in children is characterized by poor asthma control, uncontrolled symptoms, poor quality of life, disrupted school-related activities and increased risk of exacerbations, health care use, and morbidities due to asthma. Several new biologic agents targeting the mediators of asthma inflammation that are now approved are likely to improve asthma outcomes in children with severe asthma. This article outlines the various biologic agents currently approved for use in children. .
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http://dx.doi.org/10.3928/19382359-20210420-01DOI Listing
May 2021

Contact Dermatitis in Children.

Pediatr Ann 2021 May 1;50(5):e198-e205. Epub 2021 May 1.

Contact dermatitis (CD) is commonly encountered in the pediatric population. Allergic and irritant are the two forms of CD and both cause significant clinical problems in children, but they are often underrecognized. The skin lesions in CD may be polymorphic and closely mimic other common pediatric skin diseases. The diagnosis usually requires patch testing after obtaining a detailed history and performing a physical examination. Metals, fragrances, and certain preservatives are the most common causative agents in children. This article discusses the pathophysiology, diagnosis, and management of this common skin condition in the pediatric population. .
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http://dx.doi.org/10.3928/19382359-20210418-01DOI Listing
May 2021

Are Stethoscopes, Coats, and Pagers Potential Sources of Healthcare Associated Infections?

Glob Pediatr Health 2020 29;7:2333794X20969285. Epub 2020 Oct 29.

Children's Hospital of Michigan, Detroit, MI, USA.

We conducted a study to determine the rate of bacterial colonization of stethoscopes, coats, and pagers of residents at a pediatric residency training program as compared to that of badges, sleeves, and pagers of non-patient care staff (control group). Among 213 cultures obtained from 71 residents, 27 potential pathogens were isolated from 22 residents (27/213, 12.7%) as compared to 10 potential pathogens out of 162 samples obtained from 54 control participants (10/162, 6.2%) ( = .0375). The most common pathogen isolated from residents and control participants was methicillin sensitive (MSSA). The source of positive cultures among the residents was the stethoscope (8/22, 36.3%), pager (8/22, 36.3%), and coat sleeve (11/22, 50%). The rates of colonization with potential pathogens were higher among residents than control participants and about 12% of residents' stethoscopes, coats and pagers were colonized with bacterial pathogens. These are potential sources of nosocomial transmission of pathogenic organisms.
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http://dx.doi.org/10.1177/2333794X20969285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604979PMC
October 2020

Summer Buzz: All You Need to Know about Insect Sting Allergies.

Pediatr Rev 2020 Jul;41(7):348-356

UT Health San Antonio, San Antonio, TX.

Insect stings can generate a range of immune and clinical reactions. Most reactions are local and self-limiting. Allergic reactions to insect stings can occur at all ages, with or without previous stings. Individuals with a history of anaphylaxis carry a significant risk of life-threatening anaphylaxis with future stings. Health-care providers are often unaware of the tremendous clinical benefits of venom immunotherapy for these select patients. Scientific knowledge about the natural history, risk factors, and optimal therapy for insect sting allergies has improved considerably in recent years.
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http://dx.doi.org/10.1542/pir.2018-0358DOI Listing
July 2020

Pediatric Nephrology.

Pediatr Ann 2020 Jun;49(6):e248-e249

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http://dx.doi.org/10.3928/19382359-20200520-03DOI Listing
June 2020

Medical Anthropology in Pediatrics: Improving Disparities by Partnering with Families.

Pediatr Ann 2020 May;49(5):e222-e227

Cultural health beliefs and practices often affect accuracy of diagnoses, health care delivery, and treatment plan adherence, which can lead to health disparity. However, the effect of these belief systems, and acceptance of health care provider recommendations is not commonly discussed. As the proportion of patients from a variety of ethnic and cultural backgrounds increases, an awareness of these belief systems can help achieve better health outcomes. A provider who is flexible and can understand and possibly integrate traditionally non-Western approaches into their treatment plans may build a stronger bond of trust with their patient, thus building a bridge to better health and well-being. [Pediatr Ann. 2020;49(5):e222-e227.].
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http://dx.doi.org/10.3928/19382359-20200421-02DOI Listing
May 2020

A Review of Benign Congenital Anomalies.

Pediatr Ann 2020 Feb;49(2):e66-e70

Benign congenital anomalies are common in neonates. Some of these common benign congenital anomalies include preauricular pits, sacral dimples, supernumerary digits, accessory nipple, and natal teeth. It is important for health care providers who take care of newborns to recognize these benign anomalies so that unnecessary evaluations and investigations are not performed. However, some of these anomalies may be associated with clinically significant conditions. In this article, we discuss when further evaluation should be performed in babies presenting with these common benign congenital anomalies. [Pediatr Ann. 2020;49(2):e66-e70.].
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http://dx.doi.org/10.3928/19382359-20200121-03DOI Listing
February 2020

Care of The Newborn.

Pediatr Ann 2020 02;49(2):e64-e65

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http://dx.doi.org/10.3928/19382359-20200122-02DOI Listing
February 2020

Food Allergy: A Review.

Pediatr Ann 2020 Jan;49(1):e50-e58

Food allergy is an important public health problem that affects children and adults, and it has been increasing in prevalence in the last 2 to 3 decades. The symptoms can vary from mild to severe, and in extreme cases food allergy can lead to anaphylaxis, which is a life-threatening allergic reaction. Currently, there is no cure for food allergy. Management of food allergy includes allergen avoidance or emergency treatment. The eight most common food allergens are eggs, milk, peanuts, tree nuts, soy, wheat, crustacean shellfish, and fish, all of which are frequently consumed in the US. Thus, patients and their families must remain constantly vigilant, which can often be stressful. Moreover, nonallergic food reactions, such as food intolerance, are commonly mistaken as food allergies. This article highlights risk factors, natural history, diagnosis, and management of food allergy. [Pediatr Ann. 2020;49(1):e50-e58.].
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http://dx.doi.org/10.3928/19382359-20191206-01DOI Listing
January 2020

Angioedema.

Pediatr Ann 2019 Dec;48(12):e473-e478

Angioedema is a localized swelling of the skin and submucosal tissues and is generally benign and self-limiting. However, it can be life threatening if angioedema involves the upper airway, resulting in airway obstruction. Airway protection would be critical and lifesaving in patients with angioedema irrespective of the underlying etiology. Detailed history and physical examination can help identify the underlying mechanism of angioedema in an individual patient (ie, mast-cell versus bradykinin-mediated angioedema). Treatment of angioedema depends on the underlying etiology. Mast cell-mediated angioedema is generally responsive to steroids, antihistamines, and epinephrine (when indicated), unlike bradykinin-mediated disease. [Pediatr Ann. 2019;48(12):e473-e478.].
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http://dx.doi.org/10.3928/19382359-20191118-01DOI Listing
December 2019

Neonatal Hypoglycemia: A Review.

Clin Pediatr (Phila) 2019 11 26;58(13):1381-1386. Epub 2019 Sep 26.

UT Health San Antonio, San Antonio, TX, USA.

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http://dx.doi.org/10.1177/0009922819875540DOI Listing
November 2019

Severe Combined Immunodeficiency: A Guide for Primary Care Givers.

Clin Pediatr (Phila) 2019 09 7;58(10):1124-1127. Epub 2019 Jul 7.

3 UT Health Sciences Center San Antonio, San Antonio, TX, USA.

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http://dx.doi.org/10.1177/0009922819859867DOI Listing
September 2019

Concussion in Children.

Pediatr Ann 2019 Apr;48(4):e182-e185

Concussions are common in pediatric athletes, but they often go underreported. The topic of concussions has garnered much attention from the media recently, and this attention has resulted in the development of stricter guidelines for management of concussion by professional sporting leagues such as the National Football League and the National Hockey League. It is important to establish a clear understanding of the definitions, signs, and symptoms of concussion so that teachers, families, coaches, and physicians can better recognize it when it occurs. A concussion can interfere with school performance and interpersonal relationships, and the knowledge about long-term consequences of pediatric concussion is evolving. Proper management of concussion is critical to reduce the long-term sequelae, especially because there are no current means for prevention of concussion. [Pediatr Ann. 2019;48(4):e182-e185.].
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http://dx.doi.org/10.3928/19382359-20190326-01DOI Listing
April 2019

Common Annular Lesions in the Pediatric Population: Part 2.

Pediatr Ann 2019 Mar;48(3):e135-e138

Rash is a common chief complaint for patients presenting to their physician, especially within the pediatric field. The ability to distinguish characteristics of a rash, including morphology, distribution, and configuration, is critical to forming the differential diagnosis. This is the second article of a 2-part review that discusses the common rashes that present in an annular configuration. This articles discuss the presentation, diagnosis, and treatment of fixed drug eruptions, lupus erythematosus, erythema multiforme, urticaria, and erythema migrans. Although this review is not inclusive of all conditions that present with annular lesions, it can serve as a starting point for physicians managing a patient with these complaints. [Pediatr Ann. 2019;48(3):e135-e138.].
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http://dx.doi.org/10.3928/19382359-20190222-01DOI Listing
March 2019

Common Annular Lesions in the Pediatric Population: Part 1.

Pediatr Ann 2019 Feb;48(2):e92-e96

Dermatologic presentations can quickly become overwhelming for clinicians due to the vast number of causes for these conditions. Characteristics of a rash, such as shape, color, size, and distribution, can significantly narrow the differential diagnosis. A solid framework to organize these presentations is critical for correctly identifying and treating skin issues. The shape of a rash, for instance, can serve as a foundation from which to build complex differential diagnoses. Annular rashes in the pediatric population are common complaints requiring clinical evaluation. This article is the first part of a two-part review that discusses some of the most frequent causes of these annular lesions in the pediatric population. Knowledge of these rashes can drastically improve a physician's ability to manage dermatologic issues. [Pediatr Ann. 2019;48(2):e92-e96.].
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http://dx.doi.org/10.3928/19382359-20190114-01DOI Listing
February 2019

Intranasal Steroid Therapy for Allergic Rhinitis.

Pediatr Ann 2019 Jan;48(1):e43-e48

Allergic rhinitis (AR) is a common medical condition in children. It is associated with significant morbidity because symptoms can adversely affect quality of life. The goals of treatment of AR are to provide effective prevention as well as symptom alleviation. Pharmacotherapy is often necessary for the reduction of symptoms and the associated morbidity. Intranasal steroids (INS) are highly effective drugs for treatment of AR and are more efficacious compared to other medications used to treat AR such as antihistamines and leukotriene modifiers. Several formulations of INS are available, all of which have approximately the same efficacy and safety profile. The most common adverse effect is local irritation. Systemic absorption from nasal mucosa is low and thus systemic effects are rare. However, prolonged use of INS, especially in patients who are also using oral or inhaled steroids, can result in hypothalamic-pituitary-axis suppression. [Pediatr Ann. 2019;48(1):e43-e48.].
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http://dx.doi.org/10.3928/19382359-20181212-01DOI Listing
January 2019

Neonatal Dermatology.

Pediatr Ann 2019 01;48(1):e9-e10

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http://dx.doi.org/10.3928/19382359-20181210-02DOI Listing
January 2019

A physical symptom-based measure of quality of care for children affected by HIV/AIDS.

Vulnerable Child Youth Stud 2019 6;14(3):274-286. Epub 2019 May 6.

Carman and Ann Adams Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA.

Based on cross-sectional data of 1,625 children aged 6-18 years who were affected by parental HIV/AIDS in central rural China, we evaluated a physical symptom based measure of quality of care (QOC_PS) for these children. The QOC_PS has acceptable reliability estimates for children of both genders, at different age, and by orphanhood status. Known-group validation and construct validity analysis demonstrated a good validity of QOC_PS indicator. The QOC_PS score was significantly associated with psychosocial well-being measures among children. The physical symptom based measure provides a psychometrically appropriate indicator of quality of care for children affected by HIV/AIDS in China. It could be used as an alternative measure to assess quality of care in resource-poor settings where other objective measurements are not available or feasible. Future research is needed to further validate the scale among children in different living environments across various cultural settings.
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http://dx.doi.org/10.1080/17450128.2019.1612130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7518714PMC
May 2019

Restless Legs Syndrome in Children.

Pediatr Ann 2018 12;47(12):e504-e506

Restless legs syndrome (RLS) is a common pediatric condition that often goes undiagnosed. The genetics and pathophysiology of this sensorimotor condition are still not well understood. RLS can affect any part of the body, but the thighs and calves are the most commonly affected. Because of unpleasant sensations caused by RLS, these patients experience sleep disturbance and its consequences. The diagnosis of RLS is a clinical one. RLS occurs at a higher frequency and the symptoms are more severe in patients with iron deficiency; therefore, correcting iron deficiency improves the symptoms. Both pharmacologic and nonpharmacologic interventions can be effective in the treatment of children with RLS. However, in contrast to adults with RLS, most children with RLS are not treated with pharmacologic agents because the symptoms are not as severe as they are in adults. [Pediatr Ann. 2018;47(12):e504-e506.].
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http://dx.doi.org/10.3928/19382359-20181114-02DOI Listing
December 2018

Drug Allergy.

Pediatr Ann 2018 Oct;47(10):e419-e425

Drug allergy is commonly encountered in clinical practice. It is an immunological response to a pharmaceutical agent. The clinical presentation can vary from mild cutaneous reactions to life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Diagnosis is most often clinical, but investigations such as measurement of immunoglobulin E, patch testing, and skin biopsy may be required. In patients with a known drug allergy, the offending drug should be avoided. [Pediatr Ann. 2018;47(10):e419-e425.].
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http://dx.doi.org/10.3928/19382359-20180920-02DOI Listing
October 2018

Common Problems in General Pediatrics.

Pediatr Ann 2018 10;47(10):e388-e389

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http://dx.doi.org/10.3928/19382359-20180919-03DOI Listing
October 2018

Higher daily doses of caffeine lowered the incidence of moderate to severe neurodevelopmental disabilities in very low birth weight infants.

Acta Paediatr 2019 03 19;108(3):430-435. Epub 2018 Jul 19.

Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, MI, USA.

Aim: We determined the influence of cumulative dosing of caffeine citrate on the neurodevelopmental outcomes of low birth weight (VLBW) infants at 18-22 months of postmenstrual age.

Methods: This retrospective chart analysis was conducted at Detroit Medical Center, Michigan, USA. The 181 infants we included were born between January 2006 and December 2016, were less than 32 weeks of gestational age and weighed less than 1500 grams. Data on their perinatal and postnatal characteristics were retrieved from their medical records and they were assessed using the Bayley Scales of Infant Development - Third Edition.

Results: The 64 infants with no neurodevelopmental disability or a mild disability received a significantly higher average daily dose (mg/kg/day) of caffeine citrate with a median of 7.58 (range 2.7-12.2) mg/kg/day, than the 79 infants with a moderate to severe disability, who received a median of 6.47 (range 3.1-12.5, p = 0.01). The total cumulative dose had no effect on bronchopulmonary dysplasia or neurodevelopmental outcomes.

Conclusion: A higher average daily dose of caffeine citrate was associated with better neurodevelopmental outcomes of VLBW infants. However, the cumulative dose did not have an impact on their short-term or long-term outcomes. Further research is needed to confirm our findings.
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http://dx.doi.org/10.1111/apa.14465DOI Listing
March 2019

Heart Transplant in Children: What a Primary Care Provider Needs to Know.

Pediatr Ann 2018 Apr;47(4):e172-e178

Heart transplantation is offered to children with heart failure that is not amenable to medical or surgical therapy. Indications for heart transplant include unrepairable congenital heart disease, failed palliation of congenital heart disease, and cardiomyopathies. There has been tremendous progress in this field since the first heart transplant was performed in 1967. Each year, approximately 500 pediatric heart transplants take place worldwide. Pediatric heart transplant survivors are living longer with their initial transplant. Many pediatric practitioners are faced with caring for these patients before as well as after the heart transplant and, therefore, they should be knowledgeable about basic principles related to heart transplant. There are certain complications that are unique to this population, and medication side-effects, evaluation and management of a febrile illness, opportunistic infections, vaccination, pregnancy, and exercise recommendations are areas that require special consideration. [Pediatr Ann. 2018;47(4):e172-e178.].
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http://dx.doi.org/10.3928/19382359-20180319-01DOI Listing
April 2018

Back to Basics: Red Blood Cell Distribution Width: Clinical Use beyond Hematology.

Pediatr Rev 2018 Apr;39(4):204-209

Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI.

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http://dx.doi.org/10.1542/pir.2017-0118DOI Listing
April 2018

Autoimmune Hepatitis in Children.

Pediatr Ann 2018 Feb;47(2):e81-e86

Autoimmune hepatitis (AIH) is an immune-mediated, inflammatory liver disease. Clinical presentation of AIH in children is highly variable. It can present acutely, chronically, or silently. There are two main types of AIH-type 1 and type 2, which are differentiated and defined by the presence of specific autoantibodies. AIH eventually progresses to cirrhosis when left untreated, and occasionally even with treatment. AIH must be suspected and excluded in all children presenting with signs of acute, prolonged, or severe liver disease. The diagnosis of AIH is made by a combination of clinical manifestations, laboratory evaluation, histopathology, and the exclusion of other more common liver diseases. The best outcome for AIH is dependent on early diagnosis as well as early initiation of immunosuppressant therapy. [Pediatr Ann. 2018;47(2):e81-e86.].
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http://dx.doi.org/10.3928/19382359-20180126-01DOI Listing
February 2018
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