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Untimely care: How the modern logics of coverage and medicine compromise children’s health and development

M LaRusso, DF Gallego-Pérez, CE Abadía-Barrero. Untimely care: How the modern logics of coverage and medicine compromise children’s health and development, Social Science & Medicine, 2022, 114962, DOI: 10.1016/j.socscimed.2022.114962.

  • Coverage problems for controversial conditions exist across health care systems.
  • Modern medicine fails to support new and controversial conditions like PANS/PANDAS.
  • Despite being insured, many children face barriers to diagnosis and treatment.
  • The modern logics of medicine and coverage fail to provide care in PANS/PANDAS.
  • Failures to care result in developmental disruptions in children with PANS/PANDAS.
Children With PANS May Manifest POTS

Chan A, Gao J, Houston M, Willett T, Farhadian B, Silverman M, Tran P, Jaradeh S, Thienemann M, Frankovich J. Children With PANS May Manifest POTS. Frontiers in Neurology. Vol 13, 2022 DOI: 10.3389/fneur.2022.819636

  • 204 patients: mean age of PANS onset was 8.6 years, male sex (60%), non-Hispanic White (78%).
  • Evidence of POTS was observed in 19/204 patients (9%). 5/19 have persistent POTS
  • Those with PANS & POTS were more likely to have
    • comorbid joint hypermobility (63 vs 37%, p = 0.04)
    • chronic fatigue (42 vs 18%, p = 0.03)
    • family history of chronic fatigue, POTS, palpitations and syncope
  • Showed a PANS flare was significantly associated with an exacerbation of POTS symptoms (OR 3.3, 95% CI 1.4–7.6, p < 0.01)
Pediatric neuropsychiatric syndromes associated with infection and microbiome alterations: clinical findings, possible role of the mucosal epithelium, and strategies for the development of new animal models
Hoffman KL, Cano-Ramírez H. Pediatric neuropsychiatric syndromes associated with infection and microbiome alterations: clinical findings, possible role of the mucosal epithelium, and strategies for the development of new animal models. Expert Opin Drug Discov. 2022 May 11. doi: 10.1080/17460441.2022.2074396. Epub ahead of print. PMID: 35543072.
“Although data from existing animal models are consistent with an important role for anti-neuronal antibodies in PANS triggered by GAS infection, we lack models for identifying pathophysiological mechanisms of PANS associated with other infectious and non-infectious triggers. The authors propose a strategy for developing such models that incorporates known vulnerability and triggering factors for PANS into the modeling process. This novel strategy should expand our understanding of the pathophysiology of PANS, as well as facilitate the development of new pharmacological treatments for PANS and related syndromes.”