Pediatric thrombocytopenia has a wide differential diagnosis, and recently, genetic testing to identify its etiology has become more common. We present a case of a 16-year-old boy with a history of chronic moderate thrombocytopenia, who later developed constitutional symptoms and bilateral hand edema with cold exposure. Laboratory evaluation revealed evidence both of inflammation and elevated muscle enzymes. These abnormalities persisted over months. His thrombocytopenia was determined to be immune mediated. Imaging revealed lymphadenopathy and asplenia, and a muscle biopsy was consistent with tubular aggregate myopathy. Ophthalmology evaluation noted photosensitivity, pupillary miosis, and iris hypoplasia. Genetic testing demonstrated a pathogenic variant in STIM1 consistent with autosomal dominant Stormorken syndrome. Our case is novel because of the overlap of phenotypes ascribed to both gain-of-function and loss-of-function pathogenic variants in STIM1, thereby blurring the distinctions between these previously described syndromes. Pediatricians should consider checking muscle enzymes when patients present with thrombocytopenia and arthralgia, myalgia, and/or muscle weakness. Our case highlights the importance of both multidisciplinary care and genetic testing in cases of chronic unexplained thrombocytopenia. By understanding the underlying genetic mechanism to a patient’s thrombocytopenia, providers are better equipped to make more precise medical management recommendations.

OBJECTIVES:

Reduce postoperative hypothermia by up to 50% over a 12-month period in children’s hospital NICUs and identify specific clinical practices that impact success.

Almost 1 in 4 adolescents have a sexually transmitted infection (STI). These infections are preventable through safe sexual practices and routine screening. Pediatricians are the first line of clinical care for adolescents and are well positioned to offer sexual and reproductive health care counseling and services to their patients; yet, there is a paucity of sexual health screening provided at routine health supervision visits. This article addresses the epidemiology of STIs in adolescents, reviews the evidence of current clinical practice, presents recommended STI screening from government and medical agencies, and offers strategies to address barriers to providing care for adolescents and for sexual health screening in primary care.

Polycystic ovary syndrome (PCOS) is a common female reproductive disorder that often manifests during adolescence and is associated with disruptions in health-related quality of life. Prompt evaluation and clinical support after diagnosis may prevent associated complications and optimize overall health management. This article incorporates the most recent evidence and consensus guidelines to provide an updated review of the pathogenesis, clinical presentation, diagnostic evaluation, and management strategies for adolescents with this complex condition. We will review the recent international guidelines on PCOS; because the diagnosis of PCOS remains controversial, management of this condition is inconsistent. In 2019, PCOS remains a common, yet neglected, condition, in part, because of the lack of agreement around both diagnosis and management.

Youth suicide is a national and global public health crisis. Pediatricians can use primary and secondary prevention strategies to intervene with youth before or after the onset of suicidal behaviors. Universal suicide risk screening programs can be used to identify youth in medical settings who may otherwise pass through the health care setting with undetected suicide risk. Pediatricians are uniquely positioned to help foster resilience in their young patients and equip families of at-risk youth with safety plans and lethal means safety counseling. Pediatricians on the frontlines of this critical public health crisis require education and training in detecting suicide risk, managing those who screen positive, and connecting their patients to much needed mental health interventions and treatments. Evidence-based suicide risk screening and assessment tools, paired with interventions, are feasible and potentially life-saving in the medical setting.

As avid users of technology, adolescents are a key demographic to engage when designing and developing technology applications for health. There are multiple opportunities for improving adolescent health, from promoting preventive behaviors to providing guidance for adolescents with chronic illness in supporting treatment adherence and transition to adult health care systems. This article will provide a brief overview of current technologies and then highlight new technologies being used specifically for adolescent health, such as artificial intelligence, virtual and augmented reality, and machine learning. Because there is paucity of evidence in this field, we will make recommendations for future research.

Various states have legalized marijuana for medical purposes and/or decriminalized recreational marijuana use. These changes coincide with a decrease in perceived harmfulness of the drug and an increase in its use among youth. This change is of critical concern because of the potential harmful impact of marijuana exposure on adolescents. Marijuana use has been associated with several adverse mental health outcomes, including increased incidence of addiction and comorbid substance use, suicidality, and new-onset psychosis. Negative impacts on cognition and academic performance have also been observed. As the trend toward legalization continues, the pediatric community will be called on to navigate the subsequent challenges that arise with changing policies. Pediatricians are uniquely positioned to provide innovative care and educate youth and families on the ever-evolving issues pertaining to the impact of marijuana legalization on communities. In this article, we present and analyze the most up-to-date data on the effects of legalization on adolescent marijuana use, the effects of adolescent use on mental health and cognitive outcomes, and the current interventions being recommended for use in pediatric office settings.

In response to the growing impact of the current opioid public health crisis in the United States on adolescents and young adults, pediatricians have an expanding role in identifying opioid use early, preventing escalation of risky use, reducing opioid-related harms, and delivering effective therapies. Research and expert consensus suggest the use of brief interventions focused on reducing risks associated with ongoing opioid use and using motivational interviewing strategies to engage youth in treatment. Because fatal opioid overdose remains a major cause of opioid-related mortality among youth, delivering overdose education as part of any visit in which a youth endorses opioid use is one evidence-based strategy to decrease the burden of opioid-related mortality. For youth that are injecting opioids, safe injection practices and linkage to needle or syringe exchanges should be considered to reduce complications from injection drug use. It is crucial that youth be offered treatment at the time of diagnosis of an opioid use disorder (OUD), including medications, behavioral interventions, and/or referral to mutual support groups. The 2 medications commonly used for office-based OUD treatment in adolescents are extended-release naltrexone (opioid antagonist) and buprenorphine (partial opioid agonist), although there is a significant treatment gap in prescribing these medications to youth, especially adolescents <18 years of age. Addiction is a pediatric disease that pediatricians and adolescent medicine physicians are uniquely poised to manage, given their expertise in longitudinal, preventive, and family- and patient-centered care. Growing evidence supports the need for integration of OUD treatment into primary care.

A remarkable story which came to a climax on February 23 this year when OM Ireland took possession of the deeds to Lacken House as their new headquarters and ministry centre.

Canadian by birth, but Papua New Guinean at heart, Anna Stanton shares how God led her to serve with OM Ireland.

The Creative Arts team perform their Christmas show for school children all over Ireland in the course of three weeks.

OM Ireland and FCA Golf hold a four-day golf camp in Co. Westmeath, Ireland, to promote golf and the gospel.

Participants from all over the world joined together in Ireland for two weeks of training and outreach in partnership with local churches.

OM Ireland's two multi-media puppet shows perform over 75 times in schools around Ireland. The gospel message is expected to be heard by thousands.

St. Patrick's Day celebrates the patron saint of Ireland known for bringing Christianity to Ireland. Hundreds of years later, OM Ireland brings the same message.

OM Sweden joined OM Ireland for outreach over the Easter holiday in Carlow town.

OM Ireland's biggest outreach of the year teaches participants to commit their ways to Him and trust Him to act.

OM Ireland journalist Hannah Rueber volunteered for a school programme and witnessed something truly incredible.

One Irish family experienced the transforming love of God...one woman at a time.

Through training at OM, Rebecca became more confident sharing Jesus in her home country.

The opportunity to continue planting gospel seeds keeps drawing short-term outreach participants back to Ireland.

The Africa Trek team reaches out to the Damara people in Namibia.

Young men from African nations find their identity and destiny through hiking in Namibia with the Wilderness Therapy Programme.

Walvis Bay, Namibia :: Local women attend a challenging discipleship event on board Logos Hope

Two native Namibians stand as the only Christians in their community

A new missions experience in Namibia is not as much a programme as it is a journey.

An update about the flood damage in Eastern Australia

God changes teens' lives during TeenStreet Queensland in Australia at the beginning of July.

Peter* from MAP Australia has a Muslim friend who attended a church camp. His friend has never been the same since.

OM worker is amazed to see God change lives, as he peers over his book table on a busy Muslim street in Australia.

MAP Australia hosts Bound for Paradise, a week-long outreach to Muslims from the Persian Gulf in Queensland, Australia, from 25-29 August.

A former Afghan fighter discovers Jesus Christ in the Qur’an.

It matters not if we are from 200 countries; we are one in Christ and shall be for eternity. OMNI-team member Greg Kernaghan about ‘globalisation’.

OM Ukraine's sports team equips and trains churches in using non-traditional sports in their summer camps.

God restores a lost bag to the OM team during a short-term outreach to school children in northern Russia.

An OM Ukraine sports team member helps young Ukrainian women gain a healthier understanding and appreciation of the bodies God gave them.

A Ukrainian pastor responds to nearly 100 per cent unemployment in his village by starting biofuel and cash crop business enterprises.

The OM team in Odessa, Ukraine, regularly visits orphanages in the province, bringing love and the good news to children.

A Christian football coach experiences what he says is the best gift from God, something “so much more than winning”.

OM Ukraine's team in Odessa heads up the annual All-Ukrainian Day of Prayer for Orphans in the Odessa province.

During the summer months, OM Ukraine in Odessa facilitated a camp, during which the Lord touched the hearts of many children.

Ministering in a country at war is not fun – but a privilege. Ukraine is going through intense emotions and people are open to Kingdom conversations.

OM supported the Ukrainian Military Ministry in order to print trauma counselling books

A report of results: OM has been supporting church planting efforts and training local missionary teams to plant churches nearby and within the conflict area.

A 29 year old recounts how his family fled the war zone and came to stay at OM Odessa centre

A 17 year old high school student shares about how she fled from the war zone and came to stay at OM Odessa's centre.

Through the "Lighthouse" soccer team, Maksim Shlikov is reaching out to young orphanage graduates looking for meaning and hope.

A welder's life is renewed in Kaharlyk, Ukraine through a new business opportunity with OM.

Long-term follower of Jesus, Nikolay, stepped out in faith to help orphans in Ukraine, and partners with OM in this ministry to children.

Bus4Life is OM’s mobile missions centre to the unreached people of Central and Eastern Europe, bringing books and also participating in summer programmes, as it did in summer 2017.