Primary care providers are often the first point of contact when there are concerns of child sexual abuse. The history is the key factor in making the diagnosis as most children who have experienced child sexual abuse do not have an abnormal anogenital examination. When anogenital symptoms precipitate concerns for sexual abuse, especially in the absence of a history of sexual abuse, it is important to be aware of conditions that mimic sexual abuse. Being familiar with such conditions allows the provider to determine appropriate management, differentiate an anatomical variant or medical condition from abuse, and provide reassurance to the patient and family. Unnecessarily reporting these cases can have detrimental effects on the patient and family. If any doubt arises, patients can be referred for further evaluation by an expert in child abuse. This article presents many common medical conditions that can mimic sexual abuse, with a focus on history, examination findings, and management. [Pediatr Ann. 2020;49(8)e334-e340.].Despite growing cautionary evidence against routine pharmacologic management of infant reflux, proton-pump inhibitors and H2-receptor antagonists are regularly asked for and prescribed at pediatric well-visits in the first year of life. It is important to distinguish between physiologic gastroesophageal reflux and gastroesopheal reflux disease, even though the symptoms can seem interchangeable and overlap with other normal developmental phenomena and common conditions, such as cow's milk protein intolerance. Careful history, ample anticipatory guidance, and nonpharmacologic intervention should be attempted before consideration of acid suppression therapy in the first year of life. If the general clinician feels medication is warranted in the absence of clear indicating medical comorbidities, consultation with a pediatric gastroenterologist should be considered. [Pediatr Ann. 2020;49(8)e329-e331.].
  Management of concomitant use of ART and TB drugs is difficult because of the many drug-drug interactions (DDIs) between the medications. This systematic review provides an overview of the current state of knowledge about the pharmacokinetics (PK) of ART and TB treatment in children with HIV/TB co-infection, and identifies knowledge gaps.
 
  We searched Embase and PubMed, and systematically searched abstract books of relevant conferences, following PRISMA guidelines. Studies not reporting PK parameters, investigating medicines that are not available any longer or not including children with HIV/TB co-infection were excluded. All studies were assessed for quality.
 
  In total, 47 studies met the inclusion criteria. No dose adjustments are necessary for efavirenz during concomitant first-line TB treatment use, but intersubject PK variability was high, especially in children <3 years of age.  https://www.selleckchem.com/products/cl-amidine.html  Super-boosted lopinavir/ritonavir (ratio 11) resulted in adequate lopinavir trough concentrations during rifampicin co-administration. Double-dosed raltegravir can be given with rifampicin in children >4 weeks old as well as twice-daily dolutegravir (instead of once daily) in children older than 6 years. Exposure to some TB drugs (ethambutol and rifampicin) was reduced in the setting of HIV infection, regardless of ART use. Only limited PK data of second-line TB drugs with ART in children who are HIV infected have been published.
 
  Whereas integrase inhibitors seem favourable in older children, there are limited options for ART in young children (<3 years) receiving rifampicin-based TB therapy. The PK of TB drugs in HIV-infected children warrants further research.
 Whereas integrase inhibitors seem favourable in older children, there are limited options for ART in young children ( less then 3 years) receiving rifampicin-based TB therapy. The PK of TB drugs in HIV-infected children warrants further research.
  Steroid use for COVID-19 is based on the possible role of these drugs in mitigating the inflammatory response, mainly in the lungs, triggered by SARS-CoV-2. This study aimed at evaluating at evaluating the efficacy of methylprednisolone (MP) among hospitalized patients with suspected COVID-19.
 
  Parallel, double-blind, placebo-controlled, randomized, phase IIb clinical trial was performed with hospitalized patients aged ≥ 18 years with clinical, epidemiological and/or radiological suspected COVID-19, at a tertiary care facility in Manaus, Brazil. Patients were randomly allocated (11 ratio) to receive either intravenous MP (0.5 mg/kg) or placebo (saline solution), twice daily, for 5 days. A modified intention-to-treat (mITT) analysis was conducted. The primary outcome was 28-day mortality. ClinicalTrials IdentifierNCT04343729.
 
  From April 18 to June 16, 2020, 647 patients were screened, 416 randomized, and 393 analyzed as mITT, MP in 194 and placebo in 199 individuals. SARS-CoV-2 infection was confirmed by RT-PCR in 81.3%. Mortality at day 28 was not different between groups. A subgroup analysis showed that patients over 60 years in the MP group had a lower mortality rate at day 28. Patients in the MP arm tended to need more insulin therapy, and no difference was seen in virus clearance in respiratory secretion until day 7.
 
  The findings of this study suggest that a short course of MP in hospitalized patients with COVID-19 did not reduce mortality in the overall population.
 The findings of this study suggest that a short course of MP in hospitalized patients with COVID-19 did not reduce mortality in the overall population.
  Data on the safety and efficacy of rifampin among people living with HIV or other health conditions has not been reported. We assessed completion, safety, and efficacy of four-months of rifampin vs nine-months of isoniazid among people living with HIV or other health conditions.
 
  We conducted post-hoc analysis of two randomized trials including 6859 adult participants with Mycobacterium tuberculosis infection. Participants were randomized 11 to 10 mg/kg/d rifampin or 5 mg/kg/d isoniazid. We report completion, drug-related adverse events, and active tuberculosis incidence among people 1) living with HIV; 2) with renal failure or receiving immunosuppressants; 3) using drugs or with hepatitis; 4) with diabetes mellitus; 5) consuming >1 alcoholic drink per week or current/former smokers; 6) with no health condition.
 
  Overall, 270 (3.9%) people were living with HIV (135 receiving ART), 2012 (29.3%) had another health condition, and 4577 (66.8%) had no condition. Rifampin was more often or similarly completed to isoniazid in all populations.