Tillmanenevoldsen2027

Pediatricians care for many children with autism spectrum disorder who demonstrate a wide range of abilities and needs. This population is vulnerable because of lags in diagnosis, difficulty accessing services, overlooked medical conditions, behavioral difficulties during medical visits, parental stress, bullying, comorbid mental health issues, and variable transitional care moving from adolescence to young adulthood. Comprehensive care includes earlier recognition of symptoms with timely referral to early intervention services. It includes primary pediatricians partnering with the family, developmental pediatricians, and other specialists to reduce the vulnerabilities by medical advocacy, family education, and appropriate behavior intervention to improve functioning. Child abuse affects more than 10% of children in the United States. For most children it is the result of family dysfunction. Child abuse affects children from all socioeconomic classes. Pediatricians have an important role to play in prevention and early detection of abuse. There are sentinel injuries, now summarized as Clinical Prediction Rules that can guide the general pediatrician to take more definitive steps to suspect and report child abuse and neglect. Primary prevention should be part of the anticipatory guidance and support that pediatricians provide to all of their families. For migrant children, many obstacles stand in the way of them securing even the most basic of necessities, and many live with the constant threat of being returned to countries where their very lives are in danger. These children and families, many of whom have experienced multiple forms of trauma, both in their home countries and on the journey to the United States, have extensive needs (for medical, mental health, educational, and legal services) that are not being met. Although pediatric medical professionals cannot respond to all issues, they are well situated to assist these vulnerable children. selleck compound This article focuses on the health and health care challenges experienced by young and emerging adult gay men. Evidence is provided on the extent to which young and emerging adult gay men are disproportionally burdened by multidimensional health disparities, barriers to health care access, and inadequate provider-patient interactions. Recommendations are provided for health care providers and public health officials working with populations of emerging adult gay men that might have the greatest overall impact on improving this population's well-being and access to competent health care by increasing providers' awareness of the unique needs of young and emerging adult gay men. For decades, pediatricians have been concerned about the impact of media on the health and well-being of children and adolescents. Robust research has found an association between exposure to media violence and real-life aggression in children and teens. Other effects include desensitization, fear, and attitudes that violence is a means of resolving conflict. Ongoing research finds similar associations between exposure to video game violence and real-life attitude and behavior. Cyberbullying is an emerging threat to youth. Parents, pediatricians, schools, and government all have roles to play to mitigate the potential harmful effects of violent media on children and teens. Adverse childhood experiences (ACEs) are stressful or traumatic events that children experience before age 18 years. Studies have linked exposure to ACEs and negative health, and developmental and behavioral outcomes. Screening in pediatric medical settings provides a clear opportunity for early detection, intervention, and treatment. Providing anticipatory guidance on healthy relationships, sleep, exercise, nutrition, mindfulness, and nature is essential. Pediatric medical providers must screen and intervene. Primary care is the ideal setting for ACE screening because interacting with children and their families at regular intervals can allow patients and providers to develop a trusting relationship. Pediatricians need to adopt a strengths-based approach within their practices to better address their patients' health-related social needs. This approach becomes even more important as the pediatric population in the United States becomes increasingly diverse. Pediatricians must be cognizant of and address biases within their practices to maximize effectiveness of a strengths-based approach. With evidence mounting about their significance to health, a paradigm shift is needed to address health-related social needs by focusing on assets, not deficits. This shift will hopefully improve pediatric health outcomes which have languished in the United States, despite outspending other wealthy nations for decades. Microglia are the resident macrophages in the central nervous system (CNS), and they constitute 15-20% of the total glial populations. They have wide developmental and protective functions during brain injury, infection and tumorigenesis. Originally thought to derive from postnatal hematopoietic progenitors, it has recently been demonstrated that microglia originate from primitive myeloid progenitor cells that arise during early development from the embryonic yolk sac. Circulating monocytes infiltrate the CNS upon inflammatory conditions, such as cancer, primarily differentiating into macrophages and dendritic cells. Both resident and recruited microglia respond to environmental cues and actively participate in pathogenic processes, albeit their transcriptomic profiles contain significant differences suggesting distinctive roles. Metastatic brain tumors are the most common intracranial neoplasm in adults, with an estimate incidence 10 times higher than all primary brain neoplasms combined, and with dismal prognosis. Microglia is a major immune population associated with brain metastatic tumors in patients. They are proposed to play multiple, and sometimes opposing roles, in tumor progression. However, our ability to evaluate individual contribution of resident and recruited populations is hindered by the fact that they express overlapping sets of surface markers. Tracking and interrogating tissue-resident vs recruited microglia in the brain tumor microenvironment becomes critical to dissect their respective roles and gain a better understanding of the mechanism governing their interaction. In this chapter, we describe the utilization of genetic reporter mice to identify recruited brain microglia, offer a comparison between the genetic method and the most widely used flow cytometric approach, and discuss potential downstream applications to interrogate BMDM function in brain metastatic disease. © 2020 Elsevier Inc. All rights reserved.