The effects of stimulant medications on children’s growth velocity

Objective: This study sought to determine whether relationships exist between stimulant medications and children’s growth velocity.Methods: The investigators conducted a retrospective review of 280 charts of pre-pubertal children with attention-deficit hyperactivitydisorder (ADHD) who were prescribed stimulant medications for a minimum of 1 year. The children were patients in a university childdevelopment/ADHD clinic. Results: The average growth velocity across all genders and ages was 5.72 cm/year (females 5.53 cm/year,males 5.28 cm/year). The majority of the children had growth velocities in the 25-50th percentiles for age. Conclusion: This study didnot find evidence of significant effect on growth velocity in children with ADHD treated with stimulant medications. Our results concurwith the majority of other studies of growth in children taking stimulant medications for ADHD management. It supports our continuedprescription of stimulant medications without concern for slowed or stunted growth in our patients with ADHD

Parents’ knowledge of and opinions about healthcare laws and technology in primary care

Purpose Historically, parents have demonstrated poor understanding of adolescent healthcare laws. This study assessed US parents’ current knowledge and opinions about technology facilitated physician–adolescent communication and applicable laws to enhance transition to adult health care.Methods A brief survey in two low-income academic paediatric clinics asked parents about their knowledge of health care and laws, and their opinions about technology facilitated contact between physicians and adolescents.Results Almost all parents (96.7%) have internet access at home, work or via a mobile device. Only 44.1% approved of having a physician directly contact their child about annual examinations, immunisations or to discuss issues of sexuality. Half (55.4%) were aware that adolescents could receive confidential sexuality information and treatment without parents’ permission. Only one-third (32.2%) approved of a specific technology for direct communication.Conclusions Parents are divided about direct physician–adolescent contact. Future plans to engage adolescents to understand their health will require parental education and involvement on the value of physician–adolescent communication

An analysis of healthcare providers' online ratings

Background Many websites allow consumers to evaluate their healthcare experience yet scant data exist that explore the type and content of reviews. Objective To evaluate and describe online healthcare provider reviews. Methods We analysed 16 703 ratings on 6101 providers from four US cities. Ratings spanned five categories and an overall provider score. We also performed text analyses of narrative commentary (n = 15 952). Results Providers had a high mean score for each category (3.7_4.0 out of 5). Higher overall scores were associated with higher staff (adjusted odds ratio (aOR) 3.0, 95% CI 2.9_3.0, P< 0.01) and punctuality scores (aOR 2.1, 95% CI 2.05_2.15, P< 0.01). Review frequency was inversely associated with scores, (aOR 0.94, 95% CI 0.92_0.96, P<0.01). Analyses of narrative commentaries revealed more positive than negative terms (P< 0.01). Conclusions Online ratings were largely positive. Future research must discern how online surveys affect patient referrals, provider reputations and patients' perceptions of quality of care

Disease severity-specific neutrophil signatures in blood transcriptomes stratify COVID-19 patients

Background!#!The SARS-CoV-2 pandemic is currently leading to increasing numbers of COVID-19 patients all over the world. Clinical presentations range from asymptomatic, mild respiratory tract infection, to severe cases with acute respiratory distress syndrome, respiratory failure, and death. Reports on a dysregulated immune system in the severe cases call for a better characterization and understanding of the changes in the immune system.!##!Methods!#!In order to dissect COVID-19-driven immune host responses, we performed RNA-seq of whole blood cell transcriptomes and granulocyte preparations from mild and severe COVID-19 patients and analyzed the data using a combination of conventional and data-driven co-expression analysis. Additionally, publicly available data was used to show the distinction from COVID-19 to other diseases. Reverse drug target prediction was used to identify known or novel drug candidates based on finding from data-driven findings.!##!Results!#!Here, we profiled whole blood transcriptomes of 39 COVID-19 patients and 10 control donors enabling a data-driven stratification based on molecular phenotype. Neutrophil activation-associated signatures were prominently enriched in severe patient groups, which was corroborated in whole blood transcriptomes from an independent second cohort of 30 as well as in granulocyte samples from a third cohort of 16 COVID-19 patients (44 samples). Comparison of COVID-19 blood transcriptomes with those of a collection of over 3100 samples derived from 12 different viral infections, inflammatory diseases, and independent control samples revealed highly specific transcriptome signatures for COVID-19. Further, stratified transcriptomes predicted patient subgroup-specific drug candidates targeting the dysregulated systemic immune response of the host.!##!Conclusions!#!Our study provides novel insights in the distinct molecular subgroups or phenotypes that are not simply explained by clinical parameters. We show that whole blood transcriptomes are extremely informative for COVID-19 since they capture granulocytes which are major drivers of disease severity