Advances in smartphone photography (both quality and image transmission) may improve access to care via direct parent-to-clinician telemedicine. However, the accuracy of diagnoses that are reliant on parent-provided photographs has not been formally compared with diagnoses made in person. This study assessed whether smartphone photographs of pediatric skin conditions taken by parents are of sufficient quality to permit accurate diagnosis. Forty patient-parent dyads at a pediatric dermatology clinic at the Children’s Hospital of Philadelphia were enrolled to assess concordance between diagnoses made by an independent pediatric dermatologist based on in-person examination and those based on parental photographs. Half of the patient-parent dyads were randomized for a secondary analysis to receive instructions on how best to take photographs with smartphones. Clinicians were blinded to whether parents had received photography instructions. Half of the patient-parent dyads received a simple, 3-step instruction sheet on how best to take photographs using a smartphone (intervention group); the other half did not (control group).Among the 40 patient-parent dyads, overall concordance between photograph-based versus in-person diagnosis was 83%. There was no statistically significant effect of photography instructions on concordance.

In this era, smartphone photography by parents can accurately be used as a method to provide pediatric dermatologic care. This is especially useful if the patient lives far away and cannot reach a dermatologist soon.

Proton pump inhibitors are commonly used to treat gastro-esophageal reûux disease (GERD) and nonerosive GERD (NERD) in adolescents and adults. Despite the efficacy of available medications, many patients have persisting symptoms, indicating a need for more effective drugs. This phase-2, open-label, multicenter study aimed to assess the efficacy of dexlansoprazole delayed-release capsules in adolescents (age 12-17 y) for treatment of symptomatic NERD. Adolescents with endoscopically conûrmed NERD received a daily dose of 30 mg dexlansoprazole for 4 weeks. The primary end point was treatment emergent adverse events experienced by patients. Heartburn symptoms and severity were recorded daily in patient electronic diaries and independently assessed by the investigator, along with patient-reported quality of life, at the beginning and end of the study. Diarrhea and headache were the only adverse effects reported by patients. Dexlansoprazole-treated patients reported a median 47.3% of days with neither daytime nor nighttime heartburn. Symptoms such as epigastric pain, acid regurgitation, and heartburn improved in severity for 73-80% of patients.

These results suggest that air pollution exposure in e-waste recycling areas could result in an increase in heart rate and plasma norepinephrine, implying that e-waste air pollutant exposure impairs the sympatho-adrenomeduallary system in children.