| | Diagnostic Accuracy of 3D Ultrasound and Artificial Intelligence for Detection of Pediatric Wrist Injuries | Diagnostic Accuracy of 3D Ultrasound and Artificial Intelligence for Detection of Pediatric Wrist Injuries
Diagnostic Accuracy of 3D Ultrasound and Artificial Intelligence for Detection of Pediatric Wrist Injuries
Wrist trauma is common in children, typically requiring radiography for diagnosis and treatment planning. However, many children do not have fractures and are unnecessarily exposed to radiation. Ultrasound performed at bedside could detect fractures prior to radiography.
Fractures are the third leading cause of pediatric hospitalizations in Canada. Distal radius fractures account for up to 25% of fractures documented in children. Distal radius fractures typically occur in children falling on an outstretched hand and involve the metaphysis or physis. Depending on the area of injury, there can be a multitude of fracture patterns that affect treatment planning. Therefore, when children present to primary care clinics or emergency department (ED) with suspected wrist fractures, radiographs are the standard of care as they allow for precise examination of the anatomy. In most hospitals, routine radiographs are performed on patients with wrist trauma, but only half of the imaging reveals fractures. With the estimated cost of treating pediatric forearm fractures at $2 billion per year in the USA, streamlining care is desirable.,Obtaining radiographs in ED typically involves sending the patient to a separate diagnostic imaging area, where they wait in an additional queue, and transferring them back, a process which can add hours to an ED visit. If clinicians could determine at bedside who has a fracture and requires an X-ray, systemwide radiation doses and costs could be reduced and ED visits shortened.
The high sensitivity of 3D ultrasound and automated AI ultrasound interpretation suggests that ultrasound could potentially rule out fractures in the emergency department.
Journal Children
| 3 | | R485.00 |  |
| | Advisor high-definition HD Grid catheter for mapping accessory pathways in pediatrics | Advisor high-definition HD Grid catheter for mapping accessory pathways in pediatrics
Advisor high-definition HD Grid catheter for mapping accessory pathways in pediatrics
Overview Intracardiac mapping of accessory pathways has continued to evolve and contribute to high success rates for catheter ablations in pediatrics, ranging from 78% to 98%. Pediatric accessory pathways are common and historically have had a high cure rate with ablation. There are new techniques and technologies being developed to potentially increase efficacy of ablation with improved mapping. With 3-dimensional electroanatomic mapping, increasing point density improves the accuracy of substrate prediction and modeling, particularly as the course of atrioventricular (AV) accessory pathways can be variable, with oblique atrial and ventricular insertion sites or multiple pathways that make accurate mapping challenging. There may be a role in utilizing open-window mapping and the HD Grid catheter (Abbott Laboratories, Abbott Park, IL) to delineate difficult or refractory accessory pathways in pediatric. The Advisor high-density HD Grid catheter (Abbott Laboratories, Abbott Park, IL) allows for bipolar recordings on 2 orthogonal planes among 18 electrodes to facilitate both the identification of small-amplitude high-frequency electrical impulses and the direction of impulse propagation. Although several adult studies have shown the utility of the HD Grid for mapping arrhythmia substrate including accessory pathways, there is no knowledge of studies showing the utilization of the HD Grid for mapping accessory pathways in pediatrics. In this case series, the initial experience utilizing the HD Grid for mapping accessory pathways in the pediatric population is described and finds that the new technology allowing for bipolar orthogonal electrograms can be safely used in the pediatric population.
Authors Michael Nguyen, DO, Johannes C. von Alvensleben, MD, Martin Runciman, MD, FHRS,Kathryn K. Collins Journal Heart Rhythm Case Reports | 3 | | R420.00 | |
| | COVID-19 in Pediatrics | COVID-19 in Pediatrics
Overview In 2019, a novel coronavirus emerged called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). Initially identified in Wuhan, China, COVID-19 spread internationally and became a global pandemic. Most pediatric COVID-19 cases were milder than in adults, but in the early Spring of 2020, a new inflammatory syndrome emerged in children who had evidence of prior SARS CoV-2 infection, called Multisystem Inflammatory Syndrome in Children (MIS-C). As of March 2021, there were approximately 2,592,619 cases of COVID-19 in people under 18 in the United States and 300 deaths. Of all American cases, 2.1% were in children aged 0 to 4 years old, and another 10.2% were in those aged 5 to 17. Prevalence varies by age, with estimates ranging from 17% for children under 2 years old to 25% of children ages 6 to 10 years old, and 23% in 10 to 14 years old. The severity of the disease is generally lower for children, with only 1% to 5% of pediatric cases qualifying as severe versus to 10% to 20% in adults. This finding is thought to reflect the lower levels of angiotensin-converting enzyme 2 expression in alveolar cells, which is the mechanism by which SARS-CoV-2 enters cells. Being older than 12 years and having a high initial C-reactive protein (CRP) are risk factors for admission to a pediatric intensive care unit, and high CRP, leukocytosis, and thrombocytopenia are risk factors for organ dysfunction. Viral load and young age, specifically children under 1 year of age, are other risk factors for more severe disease. This study describes the features, diagnosis, and treatment of pediatric COVID-19 and MIS-C based on the data available at the time of publication.
Authors Case SM, Son MB
Journal Rheumatic Disease Clinics of North America | 3 | | R435.00 | |
| | Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study | Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study
Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study
Overview The spectrum of neurological and psychiatric complications associated with paediatric SARS-CoV-2 infection is poorly understood. This study aimed to analyse the range and prevalence of these complications in hospitalised children and adolescents. A national cohort study was conducted in the UK using an online network of secure rapid-response notification portals established by the CoroNerve study group. Patients were excluded if they did not have a neurological consultation or neurological investigations or both or did not meet the definition for confirmed SARS-CoV-2 infection (a positive PCR or respiratory or spinal fluid samples, serology for anti-SARS-CoV-2 IgG, or both). Individuals were classified as having either a primary neurological disorder associated with COVID-19 (COVID-19 neurology group) or PIMS-TS with neurological features (PIMS-TS neurology group). The denominator of all hospitalised children and adolescents with COVID-19 was collated from National Health Service England data. This study identified key differences between those with a primary neurological disorder versus those with PIMS-TS. Compared with patients with a primary neurological disorder, more patients with PIMS-TS needed intensive care, but outcomes were similar overall.
Authors Stephen T J Ray et al
Journal The Lancet Child & Adolescent Health | 3 | | R410.00 | |
| | HIV and Aids | HIV and Aids
Overview
HIV disease is caused by infection with HIV-1 or HIV-2, which are retroviruses in the Retroviridae family, Lentivirus genus. Human immunodeficiency virus (HIV) is a blood-borne virus typically transmitted via sexual intercourse, shared intravenous drug paraphernalia, and mother-to-child transmission (MTCT), which can occur during the birth process or during breastfeeding. The patient with HIV may present with signs and symptoms of any of the stages of HIV infection. No physical findings are specific to HIV infection; the physical findings are those of the presenting infection or illness. Examples of manifestations include acute seroconversion manifests as a flulike illness, consisting of fever, malaise, generalized rash, generalized lymphadenopathy is common and may be a presenting symptom. This course covers the screening, diagnosis, medication and management of Aids.
Author: Sharespike | 3 | | R425.00 | |
| | Bee Sting and Anaphylaxis | Bee Sting and Anaphylaxis
Bee Sting and Anaphylaxis
Overview Hymenoptera stings account for more deaths in the United States than any other envenomation. The order Hymenoptera includes Apis species, ie, bees (European, African), vespids (wasps, yellow jackets, hornets), and ants. Most deaths result from immediate hypersensitivity reactions and anaphylaxis. Severe anaphylactoid reactions occur occasionally when toxins directly stimulate mast cells. In addition to immunologic mechanisms, some injury occurs from direct toxicity. While most stings cause only minor problems, stings cause a significant number of deaths.
Target organs are the skin, vascular system, and respiratory system. Pathology is like other immunoglobulin E (IgE)–mediated allergic reactions. Anaphylaxis is a common and life-threatening consequence of Hymenoptera stings and is typically a result of sudden systemic release of mast cells and basophil mediators. Urticaria, vasodilation, bronchospasm, laryngospasm, and angioedema are prominent symptoms of the reaction. Respiratory arrest may result in refractory cases
This study aims to discuss the different stings, prognosis and emergency reactions and treatment thereto.
Author Sharespike | 3 | | R410.00 | |
| | Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy | Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy
Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy
Overview Children with autism spectrum disorders (ASD) are at risk for oral health disparities. With the dramatic rise in ASD prevalence to 1 in 54 children, it is likely that an increasing number of dental practitioners will encounter or be asked to treat children with ASD. This paper reviews explanations related to the increasing prevalence of ASD, provides reasons why children with ASD are at increased risk for poor oral health, and discusses unique interprofessional collaborations between dental practitioners and occupational therapists. Occupational therapists and dentists can work together to plan modifications to the dental environment or adapt dental protocols to reduce some of the barriers encountered by those with ASD, provide desensitization strategies before the clinic visit, or help a child with emotional regulation during clinical treatments.
Authors Dominique H. Como,Leah I. Stein Duker, José C. Polido and Sharon A. Cermak Journal Int. J. Environ. Res. Public Health | 3 | | R425.00 | |
| | Asthma Exacerbation Part 2 | Asthma Exacerbation Part 2
Asthma Exacerbation Part 2
Overview
Asthma is a common chronic disease worldwide and affects approximately 26 million persons in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children, and it is a common cause of hospitalization for children in the United States.
The pathophysiology of asthma is complex and involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness. The mechanism of inflammation in asthma may be acute, subacute, or chronic, and the presence of airway edema and mucus secretion also contributes to airflow obstruction and bronchial reactivity. Varying degrees of mononuclear cell and eosinophil infiltration, mucus hypersecretion, desquamation of the epithelium, smooth muscle hyperplasia, and airway remodelling are present. Physical findings vary with the severity of the asthma and with the absence or presence of an acute episode and its severity. Pharmacologic management includes the use of relief and control agents.
Author Sharespike | 3 | | R465.00 | |
| | Asthma Exacerbation Part 1 | Asthma Exacerbation Part 1
Asthma Exacerbation Part 1
Overview
Asthma is a common chronic disease worldwide and affects approximately 26 million persons in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children, and it is a common cause of hospitalization for children in the United States.
The pathophysiology of asthma is complex and involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness. The mechanism of inflammation in asthma may be acute, subacute, or chronic, and the presence of airway edema and mucus secretion also contributes to airflow obstruction and bronchial reactivity. Varying degrees of mononuclear cell and eosinophil infiltration, mucus hypersecretion, desquamation of the epithelium, smooth muscle hyperplasia, and airway remodelling are present. Physical findings vary with the severity of the asthma and with the absence or presence of an acute episode and its severity. Pharmacologic management includes the use of relief and control agents. Author Sharespike | 3 | | R465.00 | |
| | The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea | The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea
The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea
Overview The objective of this article is to review the role of the dentist in the early diagnosis of pediatric obstructive sleep apnoea (OSA) and to provide an in-depth review of the best evidence-based practices available to treat and/or to refer these patients for intervention. A narrative review was performed using indexed data bases (PubMed, Medline, EMBASE, OVID, Scopus and Cochrane) up to year 2020, and approximately 1000 articles were reviewed. The articles included were those with the best information provided. Detailed review of the literature suggests that the role of the dentist has been redefined owing to their expertise in the orofacial region. Every patient consulting a dental practice is not merely a dental patient; he/she also requires a comprehensive medical review. The role of the dentist is pivotal in pediatric patients once diagnosed with OSA; as the patients grow, growth modification can be achieved, and future management will be easier. Initiating dental treatments during growth can benefit patients two-fold, saving them from malocclusion, and intervening in orofacial structural growth can help to avoid cumbersome treatments, such as CPAP and various surgeries. Proper diagnosis and management of systemic illnesses can prevent compromised quality of life, delays in treatment, morbidity and, in some cases, mortality.
Authors: Hafiz M. Moin Anwer, Hamad N. Albagieh, Mythili Kalladka, Harmeet K. Chiang, Shaima Malik , Sean W. McLaren, Junad Khan
Journal: Saudi Dental Journal
| 3 | | R420.00 | |
| | Unstable Angina | Unstable Angina
Overview
Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which also includes ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Unstable angina is considered to be an ACS in which there is myocardial ischemia without detectable myocardial necrosis (ie, cardiac biomarkers of myocardial necrosis —such as creatine kinase MB isozyme, troponin, myoglobin—are not released into the circulation).
With unstable angina, symptoms may (1) occur at rest; (2) become more frequent, severe, or prolonged than the usual pattern of angina; (3) change from the usual pattern of angina; or (4) not respond to rest or nitro-glycerine. Symptoms of unstable angina are similar to those of myocardial infarction (MI).
The traditional term unstable angina was meant to signify the intermediate state between myocardial infarction (MI) and the more chronic state of stable angina. The old term pre-infarction angina conveys the clinical intent of intervening to attenuate the risk of MI or death. Patients with this condition have also been categorized by presentation, diagnostic test results, or course over time; these categories include new-onset angina, accelerating angina, rest angina, early postinfarct angina, and early post-revascularization angina.
This course deals with the causes and management of unstable angina.
| 3 | | R425.00 | |
| | Severe Distress – COVID 19 | Severe Distress – COVID 19
Severe Distress – COVID 19
Overview
Since the emergence of the 2019 novel coronavirus (SARS-CoV-2) infection in December 2019, the coronavirus disease 2019 (COVID-19) has rapidly spread across the globe. The clinical spectrum of patients with COVID-19 ranges from asymptomatic or mild symptoms to critical disease with a high risk of mortality.
Coronavirus disease 2019 (COVID-19) is the illness associated with the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was initially noted during an outbreak of respiratory illness in the population of Wuhan, the capital of Hubei province, China. The first cases were seen in November 2019, with COVID-19 quickly spreading throughout the city. The World Health Organization (WHO) was notified of the outbreak on December 31, 2019. The cases continued to spread outside of the area and then across the world. COVID-19 was reported as a global health emergency by the end of January 2020. As the worldwide case numbers increased, the WHO declared on March 11, 2020, that COVID-19 had reached the pandemic stage. The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.
| 3 | | R425.00 | |
| | Sceptic Shock Part 1 | Sceptic Shock Part 1
Overview
Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection, and organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score of 2 points or greater secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and comprises of an underlying circulatory and cellular/metabolic abnormality that is associated with increased mortality.
Patients with sepsis may present in a myriad of ways, and a high index of clinical suspicion is necessary to identify subtle presentations. The hallmarks of sepsis and septic shock are changes that occur at the microvascular and cellular level and may not be clearly manifested in the vital signs or clinical examination.
Patients with sepsis and septic shock require admission to the hospital. Initial treatment includes support of respiratory and circulatory function, supplemental oxygen, mechanical ventilation, and volume infusion.
In the past few decades, the discovery of endogenous mediators of the host response has led to the recognition that the clinical syndrome of sepsis is the result of excessive activation of host defence mechanisms rather than the direct effect of microorganisms. Sepsis and its sequelae represent a continuum of clinical and pathophysiologic severity.
Author Sharespike
| 3 | | R425.00 | |
| | Respiratory Distress Syndrome | Respiratory Distress Syndrome
Respiratory Distress Syndrome
Overview
Respiratory distress syndrome, also known as hyaline membrane disease, occurs almost exclusively in premature infants. The incidence and severity of respiratory distress syndrome are related inversely to the gestational age of the new-born infant.
Shortness of breath is a common complaint encountered by the EMS provider. We often hear it as part of a litany of other S/S or as a primary chief complaint. In either case SOB is never to be taken lightly and its causes should always be thoroughly investigated. My desire with this article is to give you some tips on how to streamline your treatment and formulate your thoughts as to how to proceed. In all cases the EMS team is responsible to respond to the needs of the patient. Hypoxia, regardless of the source needs to be vigorously addressed. The lungs need to be opened or cleared as determined by the physical exam. The cause of the SOB needs to be determined and addressed. Education and counselling of parents, caregivers, and families of premature infants must be undertaken as part of discharge planning. These individuals should be advised of the potential problems infants with respiratory distress syndrome may encounter during and after their nursery stay.
Author
Sharespike
| 3 | | R425.00 | |
| | Adolescent knee pain: fracture or normal? A case report. | Adolescent knee pain: fracture or normal? A case report.
Adolescent knee pain: fracture or normal? A case report.
Overview Knee injuries are the second to fourth most common injuries in youth soccer. In this population, sprains/strains, fractures and contusions are most common. Due to variations in the developing skeleton, it can be difficult to rule out fractures. We present a case of a 13-year-old presenting to the emergency department (ED) with patellar pain after pivoting during a soccer game. After radiographic clearance, he was allowed to return to sport. Following another fall and ED visit, his full leg was casted. He presented to a chiropractor after cast removal, who made recommendations for progressive rehabilitation owing to the lack of evidence for fracture on radiographs. We suggest a thorough history, physical and Ottawa knee rules to determine whether We suggest a thorough history, physical and Ottawa knee rules to determine whether radiographs are indicated in the management of a pediatric knee injury. Due to normal skeletal variance, we recommend bilateral radiographs and if findings are ambiguous, consultation with a radiologist to confirm clinical suspicions.
Authors: Melissa Corso and Scott Howitt
Journal: The Journal of the Canadian Chiropractic Association Volume 62 Issue 2 | 3 | | R465.00 | |
| | Probiotics and Protection of the Stomach | Probiotics and Protection of the Stomach
Probiotics and Protection of the Stomach
Overview Probiotics are living organisms and have beneficial effects when they colonize the body, assuming they can stay alive long enough to do so. Probiotic treatments are packed with bacteria, but once swallowed, their numbers are dramatically diminished by the stomach's acidity, lowering the chances of therapeutic effect. Probiotics can live or die under a variety of circumstances. One such circumstance is time. Some bacteria make spores which can live for many years and then blossom and grow. Most probiotics do not make spores, so they gradually die off if they do not find a comfortable place to grow, meaning a moist, warm friendly environment like the colon. Stomach acid is extraordinarily strong. It does and will kill most bacteria that get into the stomach each day. Antibiotics can also kill the bacteria in your body. So, how do you protect the probiotic bacteria you take, from this bacteria execution chamber which everyone has inside them?
Acknowledgements Du Pont Dinesco Capsugel R&D Team and Dr Keith Hutchison Elsevier – LWT Food Science and Technology | 2 | | R299.00 | |
| | Clinical Practice Guidelines: Pediatric Gastroenteritis | Clinical Practice Guidelines: Pediatric Gastroenteritis
Clinical Practice Guidelines: Pediatric Gastroenteritis
Overview Infective gastroenteritis in young children is characterised by the sudden onset of diarrhoea, with or without vomiting. Most cases are due to an enteric virus, but some are caused by bacterial or protozoal infections. The illness usually resolves without treatment within days; however, symptoms are unpleasant and affect both the child and family or carers. Severe diarrhoea can quickly cause dehydration, which may be life threatening (National Institute for Health and Care Excellence, 2009).
Oral rehydration therapy is replacement of fluids and electrolytes, such as sodium, potassium, and chloride necessary for normal physiological functions and is effective in 95% of cases of mild to moderate dehydration. Oral rehydration therapy is less invasive, less expensive, is associated with less morbidity and can be dispensed outside of the hospital setting, while being as effective as IV treatment (Medical Services Commission, 2010).
Acknowledgement Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Pain and Procedural Sedation | Clinical Practice Guidelines: Pain and Procedural Sedation
Clinical Practice Guidelines: Pain and Procedural Sedation
Overview “The management of acute traumatic pain is a crucial component of pre-hospital care and yet the assessment and administration of analgesia is highly variable, frequently suboptimal, and often determined by consensus-based protocols” (Gausche-Hill et al., 2014). Pain management is also frequently based on the assessment of need by a provider, rather than the requirements of patients. Historically only Entonox and morphine have been available for pre-hospital pain management in the local setting with the more recent introduction of ketamine. Availability of appropriate and effective treatment options, especially for non-ALS providers, remains a challenge.
Situations requiring procedural sedation and analgesia in the pre-hospital setting are common and may range from alignment of fracture to extrication and complex disentanglement during medical rescue. Until recently South African pre-hospital providers did not have agents suitable for this purpose, particularly in the setting of severe trauma and hypotension. As ketamine has been introduced into some scopes of practice providing safe and effective dissociative procedural analgesia has become a possibility. However, the use of procedural sedation and analgesia is not without risks and, at this time, no uniform practice has been suggested in the South African pre-hospital setting. Acknowledgement Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 4 | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 4
Clinical Practice Guidelines: Obstetrics and Gynaecology Part 4
Overview There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Acknowledgement Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynecology Part 3 | Clinical Practice Guidelines: Obstetrics and Gynecology Part 3
Clinical Practice Guidelines: Obstetrics and Gynecology Part 3
Overview There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Acknowledgement Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 2 | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 2
Clinical Practice Guidelines: Obstetrics and Gynaecology Part 2
Overview
There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Acknowledgement
Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynecology Part 1 | Clinical Practice Guidelines: Obstetrics and Gynecology Part 1
Clinical Practice Guidelines: Obstetrics and Gynecology Part 1
Overview
There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice. Acknowledgement
Journal: Clinical Practice Guidelines (July 2018) Publisher: Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Neonatal Resuscitation | Clinical Practice Guidelines: Neonatal Resuscitation
Clinical Practice Guidelines: Neonatal Resuscitation
Overview
Monitoring equipment for neonates and infants may not be uniformly available to all EMS providers. All ALS providers should have monitoring equipment appropriate for neonates. It is recommended that oximetry be used when resuscitation can be anticipated, when PPV is administered, when central cyanosis persists beyond the first 5 to 10 minutes of life, or when supplementary oxygen is administered. In summary, from the evidence reviewed in the 2010 CoSTR and subsequent review of delaying cord clamping and cord milking in preterm new-borns in the 2015 ILCOR systematic review, delaying cord clamping for longer than 30 seconds is reasonable for both term and preterm infants who do not require resuscitation at birth. It is recommended that the temperature of newly born non-asphyxiated infants be maintained between 36.5°C and 37.5°C after birth through admission and stabilisation. Targeted temperature management requires specific equipment and well established systems and protocol and system wide clinical governance. In neonates it may also require the establishment of dedicated, specialized and equipped retrieval teams.
Acknowledgement
Journal: Clinical Practice Guidelines (July 2018) Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Tuberculosis Part 2 | Tuberculosis Part 2
Overview
Tuberculosis (TB) (see the image below), a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. Classic clinical features associated with active pulmonary TB in elderly individuals with TB may not display typical signs and symptoms. The absence of any significant physical findings does not exclude active TB. Classic symptoms are often absent in high-risk patients, particularly those who are immunocompromised or elderly. It is important to isolate patients with possible TB in a private room with negative pressure.
Acknowledgements Authors:
Thomas E Herchline,Thomas E Herchline, Judith K Amorosa, Judith K Amorosa. | 3 | | R420.00 | |
| | Tuberculosis Part 1 | Tuberculosis Part 1
Overview Tuberculosis (TB) (see the image below), a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. Classic clinical features associated with active pulmonary TB in elderly individuals with TB may not display typical signs and symptoms. The absence of any significant physical findings does not exclude active TB. Classic symptoms are often absent in high-risk patients, particularly those who are immunocompromised or elderly. It is important to isolate patients with possible TB in a private room with negative pressure.
Acknowledgements Authors: Thomas E Herchline and Judith K Amorosa | 3 | | R420.00 | |
| | Diabetes Mellitus Part 2 | Diabetes Mellitus Part 2
Overview Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. Poorly controlled type 2 diabetes is associated with an array of microvascular, macrovascular, and neuropathic complications.
Microvascular complications of diabetes include retinal, renal, and possibly neuropathic disease. Macrovascular complications include coronary artery and peripheral vascular disease. Diabetic neuropathy affects autonomic and peripheral nerves.
This course focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA).
Acknowledgements Author:
Khardori | 3 | | R420.00 | |
| | Functional Communication Profiles in Children with Cerebral Palsy in Relation to Gross Motor Function and Manual and Intellectual Ability | Functional Communication Profiles in Children with Cerebral Palsy in Relation to Gross Motor Function and Manual and Intellectual Ability
Functional Communication Profiles in Children with Cerebral Palsy in Relation to Gross Motor Function and Manual and Intellectual Ability
Overview
The aim of the present study was to investigate communication function using classification systems and its association with other functional profiles, including gross motor function, manual ability, intellectual functioning, and brain magnetic resonance imaging (MRI) characteristics in children with cerebral palsy (CP). Multiple logistic regression analysis indicated that manual ability and intellectual functioning were significantly related with VSS and CFCS function, whereas only intellectual functioning was significantly related with SLPG functioning in children with CP.
Communication function in children with a peri-ventricular white matter lesion (PVWL) varied widely. In the cases with a PVWL, poor functioning was more common on the SLPG, compared to the VSS and CFCS. Compared to the children with bilateral spastic CP, the children with dyskinetic CP had more severe gross motor impairment, although there were no statistical differences in communication function between groups. Very strong relationships were noted among three communication classification systems that are closely related with intellectual ability. Compared to gross motor function, manual ability seemed more closely related with communication function in these children.
Acknowledgement
Authors Ja Young Choi, Jieun Park, Yoon Seong Choi, Yu-ra Goh and Eun Sook Park
Journal Yonsei Medical Journal
| 3 | | R425.00 | |
| | Pediatric Minor Head Injury 2.0: Moving from Injury Exclusion to Risk Stratification - Emergency Medicine Clinics of North America | Pediatric Minor Head Injury 2.0: Moving from Injury Exclusion to Risk Stratification - Emergency Medicine Clinics of North America
Pediatric Minor Head Injury 2.0: Moving from Injury Exclusion to Risk Stratification - Emergency Medicine Clinics of North America
Overview
ED and primary care provider visits for pediatric minor BHT continue to increase. Considerable variability exists in clinician evaluation and management of this generally low- risk population. CDRs should be used to assist providers in identification of very low-risk individuals, eliminating the need for cranial CT scans. The use of periods of observation before imaging can also decrease scanning rates. Outcome data from past retrospective studies as well as prospective data accumulated during the derivation and validation of the PECARN head injury decision rules for children less than 2 years and 2 to 18 years of age can be used to further risk stratify children with minor BHT who are at intermediate or high risk for ciTBI into more discrete categories.
Incorporation of decision aids into practice can be useful for increasing caregiver knowledge and accuracy of risk perception and improve provider identification of patient or caregiver preferences. This can help to facilitate shared decision-making regarding imaging or observation. For children in whom imaging is performed and is normal or shows only isolated linear skull fractures, the rates of deterioration and neurosurgical intervention are rare and, therefore, hospital admission can likely be avoided.
Acknowledgement
Author James (Jim) L. Homme, MD
Journal Emergency Medicine Clinics of North America
| 3 | | R425.00 | |
| | Prospective cohort study comparing quality of life and sexual health outcomes between women undergoing robotic, laparoscopic and open surgery for endometrial cancer | Prospective cohort study comparing quality of life and sexual health outcomes between women undergoing robotic, laparoscopic and open surgery for endometrial cancer
Prospective cohort study comparing quality of life and sexual health outcomes between women undergoing robotic, laparoscopic and open surgery for endometrial cancer
Overview
Endometrial cancer is the most common gynaecologic cancer in developed countries and has been increasing at a rate of over 2.5% per year in North America for the last decade [1]. Most women are diagnosed at an early stage and surgery is the primary treatment, including total hysterectomy, bilateral salpingo-oophorectomy and surgical staging, which can include pelvic and para-aortic lymph node assessment [2].
This online course aims at evaluating patient-reported outcomes (PROs) between women treated by laparoscopic, robotic and open approaches for endometrial cancer. Historically, the preferred surgical approach for treatment of endometrial cancer has been laparotomy. However, multiple randomized controlled trials (RCTs) comparing laparoscopy to laparotomy have reported decreases in postoperative complication rates and length of hospital stay in women undergoing laparoscopy [3–6]. Importantly, there appears to be no difference in disease-free and overall survival in those women treated by a minimally invasive approach [6,7]. Based on these findings, laparoscopy, and more recently robotic surgeries, have become standard surgical approaches for endometrial cancer.
It was concluded that minimally invasive approaches result in improved QOL beyond the short-term postoperative
Acknowledgement
Author Sarah E. Ferguson, Tony Panzarella, Susie Lau, Lilian T. Given, Vanessa Samouëlian, Christopher Giede, Helen Steedi, Tien Le, Ben Renkosinski, Marcus Q, Bernardini,
Journal
Gynecologic Oncology
| 3 | | R410.00 | |
| | Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that? | Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Overview
Oral corticosteroids (OCS) are a mainstay of treatment for asthma exacerbations, and short-term OCS courses were generally considered to be safe. Our study aimed at investigating the integrity of the HPA axis in children with persistent asthma or recurrent wheezing at the beginning of an inhaled corticosteroids (ICS) trial. Morning basal cortisol was assessed just before the beginning of ICS, and 30, 60, and 90 days later, using Immulite® Siemens Medical Solutions Diagnostic chemiluminescent enzyme immunoassay (Los Angeles, USA; 2006).
In all, 140 children (0.3-15 years old) with persistent asthma or recurrent wheezing have been evaluated and 40% of them reported short-term OCS courses for up to 30 days before evaluation. Out of these, 12.5% had biochemical adrenal suppression but showed adrenal recovery during a three-month ICS trial treatment. In conclusion, short-term systemic courses of corticosteroids at conventional doses can put children at risk of HPA axis dysfunction. ICS treatment does not impair adrenal recovery from occurring. Health practitioners should be aware of the risk of a blunted cortisol response upon
Acknowledgement
Authors Cristina B. Barra, Maria Jussara F. Fontes, Marco Túlio G. Cintra, Renata C. Cruz, Janaína A. G. Rocha, Maíla Cristina C. Guimarães and Ivani Novato Silva
Journal Revista Da Associação Médica Brasileira
| 3 | | R420.00 | |
| | Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials | Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials
Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials
Overview
We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. VDAART (N = 806) and COPSAC2010. (N = 581) randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs.
We conducted random effects combined analyses of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry. This combined analysis shows that vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OH)D level 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine the possibility of raising 25(OH)D levels to at least 30 ng/ml early in pregnancy or using higher doses than used in our studies
Acknowledgements
Authors Helene M. Wolsk, Bo L. Chawes, Augusto A. Litonjua, Bruce W. Hollis, Johannes Waage, Jakob Stokholm, Klaus Bønnelykke, Hans Bisgaard and Scott T. Weiss.
Journal PLoS One
| 3 | | R465.00 | |
| | Pregnancy following robot-assisted laparoscopic partial cystectomy and gonadotropin-releasing hormone agonist treatment within three months in an infertile woman with bladder endometriosis | Pregnancy following robot-assisted laparoscopic partial cystectomy and gonadotropin-releasing hormone agonist treatment within three months in an infertile woman with bladder endometriosis
Pregnancy following robot-assisted laparoscopic partial cystectomy and gonadotropin-releasing hormone agonist treatment within three months in an infertile woman with bladder endometriosis
Overview
Endometriosis is a benign disease defined as endometrial tissue implanting outside the uterine cavity and often causes dysmenorrhea, pelvic pain, dyspareunia and infertility. The prevalence of endometriosis has been reported in up to 50% of infertile women. This article serves to report an infertility case of deep-infiltrating bladder endometriosis conceiving following robot-assisted surgery and modified gonadotropin-releasing hormone agonist (GnRHa) treatment.
Case report: A 33-year-old infertile female presenting with dysmenorrhea was found to have a bladder mass by pelvic ultrasound. Cystoscopy revealed a protruding tumour from the posterior bladder wall, and endometriosis was highly suspected. Robot-assisted laparoscopic partial cystectomy was performed for the deep-infiltrating bladder endometriosis. With postoperative half-dose GnRHa treatment and timed intercourse, she got pregnant within 3 months.
It was concluded that robot-assisted complete resection of deep-infiltrating endometriosis and bladder repair immediately followed by GnRHa therapy and medical assistance improves reproductive outcomes efficiently in women with endometriosis-associated infertility
Acknowledgement
Author Shun-Jen Tan, Chi-Huang Chen, Shauh-Der Yeh, Yun-Ho Lin, Chii-Ruey Tzeng
Journal Taiwanese Journal of Obstetrics & Gynaecology
| 3 | | R435.00 | |
| | Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years | Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years
Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years
Overview
Dental fear and anxiety (DFA) is one of the major challenges in pediatric dentistry. The prevalence is estimated to approximately 9%. Using the children’s fear survey schedule dental subscale (CFSS-DS), 6.7% of a Swedish sample were assessed as being fearful DFA is a common reason for avoiding dental treatment, which over time, may result in deteriorated oral health. DFA among children has a complicated and multifactorial etiology. Several interacting factors, personal as well as environmental, contribute to the development of fear and anxiety in a dental care situation.
Psychological factors such as shyness and general fearfulness or immaturity have previously been investigated and found to be important. Cognitive ability as well as transmission of negative attitudes from parents or others are also pathways of DFA acquisition. Several studies have shown an association between parental and child DFA.
Acknowledgements
Authors Andreas Dahlander, Fernanda Soares, Margaret Grindefjord, and Göran Dahllöf
Journal Dentistry Journal Volume 7 Issue 3
Publisher PubMed
| 3 | | R460.00 | |
| | A Review of Pediatric Obstructive Sleep Apnea and the Role of the Dentist | A Review of Pediatric Obstructive Sleep Apnea and the Role of the Dentist
A Review of Pediatric Obstructive Sleep Apnea and the Role of the Dentist
Overview
Pediatric obstructive sleep apnea (POSA), considered most severe in the spectrum of sleep-disordered breathing (SDB), is highly prevalent and affects up to 1% to 4% of all children. Approximately 7 to 9 million children experience POSA, prompting the medical and dental communities to improve awareness for proper screening, diagnosis, and earlier treatment. According to the American Academy of Pediatric Dentistry (AAPD), signs of untreated POSA in school-aged children can include neurocognitive dysfunction such as aggressive behavior, symptoms that resemble attention deficit hyperactivity disorder, deteriorating school performance, bedwetting, developmental delay, and reduced quality of life. Various surgical and nonsurgical techniques are currently being used in the treatment of POSA. In this review, the etiology, epidemiology, and treatment considerations of POSA will be summarized with special emphasis on the dental provider’s role in identifying and treating POSA.
Authors: Jacy Stauffer, David M. Okuji, Guy C. Lichty, Rakesh Bhattacharjee, Fadra Whyte, Daniel Miller, Juveria Hussain
Journal: Journal of Dental Sleep Medicine Volume 5 Issue 4 2018
| 3 | | R460.00 | |
| | EcoHealth and the Determinants of Health: Perspectives of a Small Subset of Canadian Academics in the EcoHealth Community | EcoHealth and the Determinants of Health: Perspectives of a Small Subset of Canadian Academics in the EcoHealth Community
EcoHealth and the Determinants of Health: Perspectives of a Small Subset of Canadian Academics in the EcoHealth Community
Overview
EcoHealth is an emerging field that examines the complex relationships among humans, animals, and the environment, and how these relationships affect the health of each of these domains. Our previous research demonstrates that the academic EcoHealth literature had a low, uneven engagement with the determinants of health. Accordingly, to make sense of this gap, our research aim is to better understand the views of a small subset of the Canadian EcoHealth community about EcoHealth and the determinants of health relative to EcoHealth. We used a qualitative research design involving seven semi-structured interviews, which were analysed using thematic analysis.
Our findings suggest a tension across themes and a lack of conceptual engagement with the determinants of health. As we consider a future with rapid, unsustainable changes, we expect the identification and integration of the different types of determinants of health within EcoHealth to be imperative for EcoHealth to attain its goal of improving the health and well-being of humans, animals, and in the environment.
Acknowledgement
Author Aryn Lisitza and Gregor Wolbring
Journal International Journal of Environmental Research & Public Health Volume 15 Issue 8 | 3 | | R380.00 | |
| | Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series | Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series
Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series
Overview
Accidental and iatrogenic foreign body injuries to heart require immediate attention and its timely management is cornerstone to the life of an individual. We describe in detail five cases of Accidental and iatrogenic foreign body injuries to heart encountered between January 2013 and July 2016. Our series included the following: needle stick injury to the right atrium retained catheter fragments in the distal main pulmonary artery, right ventricle injury during catheterisation study, right ventricle injury during permanent pacemaker lead placement, device migration in atrial septal defect closure. Foreign bodies were removed from the cardiac cavities when the patient presented with features of infection, cardiac tamponade, anxiety, and haemodynamic instability. Foreign bodies in the heart should be removed irrespective of their location and symptomatology. Asymptomatic foreign bodies diagnosed immediately after the injury with associated risk factors should be removed; asymptomatic foreign bodies without associated risks factors or diagnosed accidentally after the injury also need surgical intervention to allay fears of anxiety in patient and their relatives, to prevent any late complications as well as for medico-legal purpose.
ACKNOWLEDGEMENTS:
Authors: Rupesh Kumar; Sandeep Singh Rana; Sanjay Kumar; Deepanwita Das; Monalisa Datta
Journal: J Clin Diagn Res (Journal of Clinical Diagnostic Research) Volume 11 Issue 3
Publisher: JCDR Research and Publications Private Limited | 3 | | R410.00 | |
| | Offspring sex impacts DNA methylation and gene expression in placentae from women with diabetes during pregnancy | Offspring sex impacts DNA methylation and gene expression in placentae from women with diabetes during pregnancy
Offspring sex impacts DNA methylation and gene expression in placentae from women with diabetes during pregnancy
Overview
We hypothesized that diabetes during pregnancy (DDP) alters genome-wide DNA methylation in placenta resulting in differentially methylated loci of metabolically relevant genes and downstream changes in RNA and protein expression.
We mapped genome-wide DNA methylation with the Infinium 450K Human Methylation Bead Chip in term fetal placentae from Native American and Hispanic women with DDP using a nested case-control design. Placentae from female offspring were 40% more likely to have significant gains in DNA methylation compared with placentae from male offspring exposed to DDP (p<0.001). Changes in DNA methylation corresponded to changes in RNA and protein levels for 6 genes: PIWIL3, CYBA, GSTM1, GSTM5, KCNE1 and NXN. Differential DNA methylation was detected at loci related to mitochondrial function, DNA repair, inflammation, oxidative stress.
In conclusion, we explain mechanisms responsible for the increased risk for obesity and type 2 diabetes in offspring of mothers with DDP
Acknowledgement
Author Jacqueline Alexander, April M. Teague, Jing Chen, Christopher E. Aston, Yuet-Kin Leung, Steven Chernausek, Rebecca A. Simmons and Sara E. Pinney
Journal
PLoS One Volume 13 Issue 2
Publisher
Crossmark
| 3 | | R425.00 | |
| | Simultaneous Detection of Key Bacterial Pathogens Related to Pneumonia and Meningitis Using Multiplex PCR Coupled With Mass Spectrometry | Simultaneous Detection of Key Bacterial Pathogens Related to Pneumonia and Meningitis Using Multiplex PCR Coupled With Mass Spectrometry
Simultaneous Detection of Key Bacterial Pathogens Related to Pneumonia and Meningitis Using Multiplex PCR Coupled With Mass Spectrometry
Overview
Pneumonia and meningitis continue to present an enormous public health burden and pose a major threat to young children. Among the causative organisms of pneumonia and meningitis, bacteria are the most common causes of serious disease and deaths. It is challenging to accurately and rapidly identify these agents.
Using the BP-MS method, we could accurately identify the expected bacteria without cross-reactivity with other pathogens. For the 11 target bacterial pathogens, the analytical sensitivity of the BP-MS method was as low as 10 copies/reaction. To further evaluate the clinical effectiveness of this method, 204 nasopharyngeal swabs from hospitalized children with suspected pneumonia were tested using this method.
We used real-time PCR and nested PCR to confirm positive results, with identical results obtained for 81.4% (136/167) of the samples. The BP-MS method is a sensitive and specific molecular detection technique in a multiplex format and with high sample throughput. Therefore, it will be a powerful tool for pathogen screening and antibiotic selection at an early stage of disease.
Acknowledgements
Authors Chi Zhang, Leshan Xiu, Yan Xiao, Zhengde Xie, Lili Ren and Junping Peng
Journal Frontiers in Cellular and Infection Microbiology Volume 8
Publisher Cross Mark
| 3 | | R460.00 | |
| | A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma | A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma
A Rare Cause of Abdominal Pain in Childhood: Cardiac Angiosarcoma
Overview
Cardiac angiosarcomas are extremely rare in childhood, they are rapidly progressive tumours that often present themselves as diagnostic dilemmas, resulting in delayed diagnosis. Also, extracardiac manifestations, including abdominal pain, are extremely rare in patients with intracardiac tumours. We herein present the case of a 15-year-old girl who presented with abdominal pain. Echocardiography and thoracic computed tomography showed right atrial mass.
Primary cardiac angiosarcomas in all age groups mostly occur in the right atrium. The most common complaints presented are dyspnea and chest pain, usually related to a malignant cardiac effusion. The pericardium is frequently involved with a right sided angiosarcoma; cardiac tamponade and pericardial effusion are common complications. Our patient had a massive pericardial effusion and malignant cells were seen in cytologic examination.
The patient underwent surgery, chemotherapy, and radiotherapy. Eight months after treatment, abdominal recurrence was detected. The abdominal mass was resected, and radiotherapy and new chemotherapy protocol were given. The present case illustrates a rare case of primary cardiac angiosarcoma posing a diagnostic dilemma in an adolescent girl. Acknowledgement
Authors Elvan Caglar Citak, MD, PhD; Murat Ozeren, MD; M. Kerem Karaca, MD; Derya Karpuz, MD; Feryal Karahan, MD; Eda , Bengi Yilmaz, MD; Yuksel Balci, MD; Pelin Ozcan Kara, MD; Rabia Bozdogan Arpaci, MD Journal Brazilian Journal of Cardiovascular Surgery
| 3 | | R460.00 | |
| | Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis | Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis
Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis
Overview
Paediatric chronic pain is relatively common in the world. Although cognitive behaviour therapy (CBT) has been shown to be efficacious in children and adolescents, it is generally recognized that availability and accessibility of CBT are limited. However, Internet-delivered cognitive-behavioural therapy (ICBT) performs better in these areas. This systematic review aims to evaluate the clinical effects of ICBT for chronic pain in youth when compared with the control treatments.
We searched electronic databases to identify randomized controlled trials that compared ICBT with the control therapy for paediatric chronic pain. The primary outcomes were 95% confidence intervals and mean difference or standardized mean difference in change of pain intensity and activity limitations. Four trials met the inclusion criteria with a total of 404 participants of whom 208 received ICBT. Compared with pre-treatment, children reported significant, medium to large benefits on pain intensity, activity limitations, and parental protective behaviours after receiving ICBT immediately. ICBT for physical and psychological conditions in youth with chronic pain is a full potential therapy; it can be successful on clinically effects and socioeconomic benefits.
Acknowledgement
Author Wen-Xin Tang, Lu-Feng Zhang, Yan-Qiu Ai and Zhi-Song Li
Journal Medicine (Baltimore).
Publisher Wolters Kluwer Health, Inc. | 3 | | R390.00 | |
| | Role of viral and bacterial pathogens in causing pneumonia among Western Australian children | Role of viral and bacterial pathogens in causing pneumonia among Western Australian children
Role of viral and bacterial pathogens in causing pneumonia among Western Australian children
Overview
Pneumonia is the leading cause of childhood morbidity and mortality globally. Introduction of the conjugate Haemophilus influenzae B and multivalent pneumococcal vaccines in developed countries including Australia has significantly reduced the overall burden of bacterial pneumonia.
Many respiratory pathogens that are known to cause pneumonia are also identified in asymptomatic children, so the true contribution of these pathogens to childhood community-acquired pneumonia (CAP) remains unclear. We aim to determine the contribution of bacteria and viruses to childhood CAP to inform further development of effective diagnosis, treatment and preventive strategies.
Nasopharyngeal swabs are collected from both cases and controls to detect the presence of viruses and bacteria by PCR; pathogen load will be assessed by quantitative PCR. The prevalence of pathogens detected in cases and controls will be compared, the OR of detection and population attributable fraction to CAP for each pathogen will be determined; relationships between pathogen load and disease status and severity will be explored.
Acknowledgement
Authors Natalie Mejbah Uddin Bhuiyan, Thomas L Snelling, Rachel West, Jurissa Lang, Tasmina Rahman, Meredith L Borland, Ruth Thornton, Lea-Ann Kirkham, Chisha Sikazwe, Andrew C Martin, Peter C Richmond, David W Smith, Adam Jaffe, Christopher C Blyth.
Journal BMJ Open Publisher Cross Mark | 3 | | R430.00 | |
| | Early Intervention for Children with Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research. | Early Intervention for Children with Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research.
Early Intervention for Children with Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research.
Overview
This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged <3 years, based on peer-reviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behavioural teaching methods into a developmental framework based on current scientific understanding of how infants and toddlers learn. The central role of parents has been emphasized and facilitating the generalization of skills beyond the familiar home setting. Our review identified several comprehensive and targeted treatment models with evidence of clear benefits. Although some trials were limited to 8- to 12-week outcome data, enhanced outcomes associated with some interventions were evaluated over periods as long as 2 years. Based on this review, recommendations are proposed for clinical practice and future research.
Acknowledgement:
Authors: Zwaigenbaum L, Bauman ML, Choueiri R, Kasari C, Carter A, Granpeesheh D, Mailloux Z, Smith Roley S, Wagner S, Fein D, Pierce K, Buie T, Davis PA, Newschaffer C, Robins D, Wetherby A, Stone WL, Yirmiya N, Estes A, Hansen RL, McPartland JC, Natowicz MR
Journal: Pediatrics. Publisher: American Academy of Pediatrics
| 3 | | R465.00 | |
| | Impact of malocclusion on oral health-related quality of life among schoolchildren | Impact of malocclusion on oral health-related quality of life among schoolchildren
Impact of malocclusion on oral health-related quality of life among schoolchildren
Overview
The aim of the present study was to evaluate the prevalence and impact of malocclusion on oral health-related quality of life (OHRQoL) among schoolchildren aged 8 to 10 years and their parents in Diamantina, a town in the southeast of Brazil. A cross-sectional study was conducted with a sample of 390 randomly selected children who were subjected to a clinical oral examination. The Dental Aesthetic Index was used to diagnose malocclusion and the need for orthodontic treatment.
Data analysis involved the nonparametric Kruskal-Wallis test and Spearman’s correlation coefficients. The variables were grouped into a hierarchy of categories ranging from distal to proximal determinants. Poisson regression analysis with robust variance was performed at each level to correlate the total CPQ (8–10) score with the independent variables. The prevalence of malocclusion was 78.7%. Crossbite remained significantly associated with a negative impact on OHRQoL. The prevalence of malocclusion was high in the sample investigated and exerted a negative impact on OHRQoL.
Acknowledgement
Author Soraia Pimenta de Araújo Guimarães, Uimarães, Kelly Oliva Jorge, Maria Jussara Fernandes Fontes, Maria Letícia Ramos-Jorge, Cíntia Tereza Pimenta Araujo, Efigênia Ferreira, Camilo Aquino Melgaço and Patrícia Maria Zarzar.
Journal Braz. Oral Res. July 2018, 32: e95 | 3 | | R425.00 | |
| | The Effects of Psychostimulants on Oral Health and Saliva in Children with Attention Deficit Hyperactivity Disorder | The Effects of Psychostimulants on Oral Health and Saliva in Children with Attention Deficit Hyperactivity Disorder
The Effects of Psychostimulants on Oral Health and Saliva in Children with Attention Deficit Hyperactivity Disorder
Overview
This study investigated the dental health problems and saliva characteristics of children under psychostimulant therapy for attention-deficit hyperactivity disorder (ADHD). The most frequently reported side effects of psychostimulants were decreased appetite, dry mouth, and increased fluid consumption. The prevalence of bruxism and dental erosion was higher in Groups 1 and 2 than in Group 3, but the differences were not significant. In Group 2, subjective dry mouth feel was reported by 32.5% of patients and 17.5% a very low SSFR.
ADHD and psychostimulant therapy do not appear to be significantly related to decreasing SSFR or protective saliva components against dental caries. However, a systematic investigation of the long-term safety of psychostimulants is needed. Bruxism and dental erosion prevalence were higher in the ADHD groups, the most effective method of maintaining dental health of children with ADHD is frequent appointments focusing on oral hygiene practices accompanied by dietary analyses. This study found that methylphenidate use had no significant effect on salivary pH, stimulated flow rate, buffering capacity, or biochemical content of the saliva.
Acknowledgement
Authors CÇ Ertugrul, Z Kirzioglu, E Aktepe and HB Savas
Journal Niger J Clin Pract
| 3 | | R425.00 | |
| | Trends in Pediatric Complicated Pneumonia in an Ontario Local Health Integration Network | Trends in Pediatric Complicated Pneumonia in an Ontario Local Health Integration Network
Trends in Pediatric Complicated Pneumonia in an Ontario Local Health Integration Network
Trends in Pediatric Complicated Pneumonia in an Ontario Local Health Integration Network
Overview
Following the introduction of 7-valent pneumo-coccal vaccine (PCV7), while overall rates of invasive pneumococcal disease and pneumo-coccal pneumonia in children declined, rates of empyema increased. We examined changes in the incidence of hospitalization for pediatric complicated pneumonia (PCOMP) in Eastern Ontario, Canada, particularly since the introduction of the 13-valent vaccine (PCV13). A retrospective chart review was carried out evaluating previously healthy children admitted with PCOMP, which included empyema, para-pneumonic effusion, necrotizing pneumonia, and lung abscess between 2002 and 2015.
The number of admissions per year rose most sharply between 2009 and 2012, corresponding to the period following introduction of PCV7 and then the occurrence of pandemic influenza A (H1N1). In children who likely received PCV13, the incidence of PCOMP returned to approximately pre-PCV7 levels. In contrast, rates of PCOMP in older children (who would not have received PCV13) remained elevated during the post-PCV13 time period. While rates of PCOMP, particularly in older children, remain elevated following the introduction of PCV13, this might be expected to resolve with more widespread vaccine coverage with PCV13 and herd immunity.
Acknowledgement
Author
Tahereh Haji , Adam Byrne and Tom KovesiD
Journal
Children (Basel)
Publisher Basel, Switzerland 2018
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867495/pdf/children-05-00036.pdf
| 3 | | R450.00 | |
| | Cross-tissue integration of genetic and epigenetic data | Cross-tissue integration of genetic and epigenetic data
Cross-tissue integration of genetic and epigenetic data
Cross-tissue integration of genetic and epigenetic data
Overview
Integration of emerging epigenetic information with autism spectrum disorder (ASD) genetic results may elucidate functional insights not possible via either type of information in isolation. Here we use the genotype and DNA methylation (DNAm) data from cord blood and peripheral blood to identify SNPs associated with DNA methylation (meQTL lists). Additionally, we use publicly available fetal brain and lung meQTL lists to assess enrichment of ASD GWAS results for tissue-specific meQTLs. ASD-associated SNPs are enriched for fetal brain and peripheral blood meQTLs .
This study integrating ASD GWAS results and meQTL maps provides insights about ASD etiology using data within and across tissue types. The CpG targets of ASD meQTLs across cord, blood, and brain tissues are enriched for immunerelated pathways, consistent with other expression and DNAm results in ASD, and reveal pathways not implicated by genetic findings. This joint analysis of genotype and DNAm demonstrates the potential of both brain and blood based DNAm for insights into ASD and psychiatric phenotypes more broadly.
Acknowledgement
Author Shan V. Andrews, Shannon E. Ellis, Kelly M. Bakulski , Brooke Sheppard, Lisa A. Croen , Irva Hertz-Picciotto, Craig J. Newschaffer, Andrew P. Feinberg, Dan E. Arking, Christine Ladd-Acosta & M. Daniele Fallin.
Journal Nature Communications URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654961/pdf/41467_2017_Article_868.pdf
| 3 | | R380.00 | |
| | Assessing malpractice lawsuits for death or injuries due to amniotic fluid embolism | Assessing malpractice lawsuits for death or injuries due to amniotic fluid embolism
Assessing malpractice lawsuits for death or injuries due to amniotic fluid embolism
Assessing malpractice lawsuits for death or injuries due to amniotic fluid embolism
Overview
Amniotic fluid embolism (AFE) is a pregnancy complication known to be extremely hard to diagnose, since it manifests itself abruptly and with no warning signs, presenting an incidence rate of about 1 in 40000 deliveries, and maternal morbidity and mortality ranging from 20% to 60%. Despite medical research having been conducted on such a syndrome, diagnostic procedures and treatment methods have not yet been clarified enough.
Specific biochemical markers have been produced in research laboratories, but their clinical value results to be limited, given how rapid the pathological process moves forward. At the time being, no diagnosis is feasible which may effectively prevent the disease from occurring. Certainly, a multi-disciplinary approach might contribute to saving the lives of mother and infant, as well as ensuring better life standards.
It becomes essential to further scientific knowledge of the causes of maternal death. In such a way, it will be possible to improve the quality standards of care and avert many pregnancy-related deaths. It is well-known how age of the mother also plays a role in determining the likelihood of developing AFE.
Acknowledgements
Authors S. Zaami , E. Marinelli and G. Montanari Vergallo
Journal Clin Ter 2017 Volume 168 Issue 3
| 3 | | R455.00 | |
| | More than kin, less than kind: one family and the many faces of diabetes in youth | More than kin, less than kind: one family and the many faces of diabetes in youth
More than kin, less than kind: one family and the many faces of diabetes in youth
More than kin, less than kind: one family and the many faces of diabetes in youth
Overview
Identification of the correct etiology of diabetes brings important implications for clinical management. In this report, we describe a case of a 4-year old asymptomatic girl with diabetes since age 2, along with several individuals in her family with different etiologies for hyperglycemia identified in youth. Genetic analyses were made by Sanger sequencing, laboratory measurements included HbA1c, lipid profile, fasting C-peptide, pancreatic auto-antibodies. We found a Gly178Ala substitution in exon 5 of GCK gene in three individuals co-segregating with diabetes, and type 1 diabetes was identified in two other individuals based on clinical and laboratory data. One individual with previous gestational diabetes and other with pre-diabetes were also described.
We discuss difficulties in defining etiology of hyperglycemia in youth in clinical practice, especially monogenic forms of diabetes, in spite of the availability of several genetic, laboratory, and clinical tools. In conclusion, the accurate molecular and clinical diagnosis has significant impact on clinical management of a multifaceted disease such as diabetes, especially when running on the same family.
Acknowledgement
Authors Luciana F. Franco, Renata Peixoto-Barbosa, Renata P. Dotto, José Gilberto H. Vieira, Magnus R. Dias-da-Silva, Luiz Carlos F. Reis, Fernando M. A. Giuffrida, and Andre F. Reis
Journal Arch Endocrinol Metab.
| 3 | | R390.00 | |
| | Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview | Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview
Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview
Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review
Overview
Cardiovascular evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published since 2016. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates. Despite the empirical debate regarding the cognitive benefit of de-worming for STH, the current ethical, clinical and health policy environments remain strongly skewed in favor of de-worming for child growth, prevention of anaemia and potentially avoidance of preventable cognitive deficits
Acknowledgement
Author
Noel Pabalan, Eloisa Singian, Lani Tabangay, Hamdi Jarjanazi, Michael J. Boivin, Amara E. Ezeamama
Journal PLoS Neglected Tropical Diseases
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5766095/pdf/pntd.0005523.pdf
Publisher Cross Mark
| 3 | | R465.00 | |
| | Pediatric multiple sclerosis: current perspectives on health behaviours | Pediatric multiple sclerosis: current perspectives on health behaviours
Pediatric multiple sclerosis: current perspectives on health behaviours
Pediatric multiple sclerosis: current perspectives on health behaviours
Overview
Pediatric-onset multiple sclerosis (POMS) accounts for -5% of all multiple sclerosis cases, and has a prevalence of -10,000 children in the USA. POMS is associated with a higher relapse rate, and results in irreversible disability on average 10 years earlier than adult-onset multiple sclerosis. Other manifestations of POMS include mental and physical fatigue, cognitive impairment, and depression. Health behaviours of physical activity, diet, and sleep may have potential benefits in POMS, and present a scoping review of the existing literature.
Physical activity participation was associated with reduced relapse rate, disease burden, and sleep/rest fatigue symptoms. Nutritional factors, particularly vitamin D intake, may be associated with relapse rate. Obesity has been associated with increased risk of developing POMS. POMS is associated with better sleep hygiene, and this may benefit fatigue and quality of life.
Participation in health behaviours, particularly physical activity, diet, and sleep, may have benefits for POMS. Nevertheless, there are currently no interventions targeting promotion of these behaviours and examining the benefits of managing the primary and secondary manifestations of POMS.
Acknowledgement
Author Elizabeth Morghen Sikes, Robert W Motl , Jayne M Ness
Journal Pediatric Health, Medicine and Therapeutics 2018:9 17–25
Publisher Dovepress
| 3 | | R450.00 | |
| | Non-invasive Brain Stimulation in Children with Unilateral Cerebral Palsy: a protocol and risk mitigation guide | Non-invasive Brain Stimulation in Children with Unilateral Cerebral Palsy: a protocol and risk mitigation guide
Non-invasive Brain Stimulation in Children with Unilateral Cerebral Palsy: a protocol and risk mitigation guide
Non-invasive Brain Stimulation in Children with Unilateral Cerebral Palsy: a protocol and risk mitigation guide Overview
Non-invasive brain stimulation has been increasingly investigated, mainly in adults, with the aims of influencing motor recovery after stroke. However, a consensus on safety and optimal study design has not been established in pediatrics. The low incidence of reported major adverse events in adults with and without clinical conditions has expedited the exploration of NIBS in children with paralleled purposes to influence motor skill development after neurological injury. Considering developmental variability in children, with or without a neurologic diagnosis, adult dosing and protocols may not be appropriate.
Combining our experiences has allowed us to improve our own protocols, with the immediate goal of child safety and the overarching goal to establish a consensus that helps to define best NIBS practice and practice guidelines
The purpose of this paper is to present recommendations and tools for the prevention and mitigation of adverse events (AEs) during NIBS in children with unilateral cerebral palsy (UCP). Consistent reporting of safety, feasibility, and tolerability will refine NIBS practice guidelines contributing to future clinical translations of NIBS.
Acknowledgement
Author Bernadette T. Gillick, Andrew M. Gordon, Tim Feyma , Linda E. Krach, Jason Carmel, Tonya L. Rich, Yannick Bleyenheuft and Kathleen Friel
Journal Frontiers in Pediatrics Volume 6 Article 56
Publisher Cross Mark https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864860/pdf/fped-06-00056.pdf
| 3 | | R455.00 | |
| | Lipofilling as refinement procedure in maxillo-mandibular malformations. | Lipofilling as refinement procedure in maxillo-mandibular malformations.
Lipofilling as refinement procedure in maxillo-mandibular malformations.
Lipofilling as refinement procedure in maxillo-mandibular malformations.
Overview
Maxillo-mandibular asymmetry has numerous aetiologies: congenital, traumatic, iatrogenic and post-oncologic. All patients in study were affected by maxilla-mandibular asymmetry and underwent orthognathic surgery for hard tissue correction of the deformity. Residual facial alterations were then treated with lipofilling refinement procedure. Good integration of the grafted fat was observed in the recipient sites. Retrospective analysis of photographic documentation showed progressive volumetric decrease for up to approximately 6 months after surgery; after that graft volume remained relatively stable. Mild oedema and bruising were frequent during the first post-operative week. No haematomas, infections, vascular or nervous injuries were recorded. Twenty-four patients (from 45) wanted a second procedure. A second fat transfer was performed in 22 cases, and a third in 2 cases. We demonstrated that the success of lipofilling is dependent on the treated aesthetic subunits of the face. Composite procedures using orthognathic surgery and autologous fat provide the surgeon with an additional, more customisable option for patients with maxillo-mandibular malformations.
Acknowledgement
Author:
D. CERVELLI, G. GASPARINI, A. MORO, S. PELO, E. FORESTA, F. GRUSSU, G. D’AMATO, P. DE ANGELIS, G. SAPONARO.
Journal:
ACTA OTORHINOLARYNGOLOGICA ITALICA
Publisher:
Università Cattolica del Sacro Cuore, Rome URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225791/pdf/0392-100X-36-368.pdf
| 3 | | R465.00 | |
| | Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome (case-control study) | Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome (case-control study)
Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome (case-control study)
Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome (case-control study)
Overview
Sudden infant death syndrome (SIDS) is the leading cause of post-neonatal infant death in high-income countries. Central respiratory system dysfunction seems to contribute to these deaths.
Excitation that drives contraction of skeletal respiratory muscles is controlled by the sodium channel NaV1.4, which is encoded by the gene SCN4A. Variants in NaV1.4 that directly alter skeletal muscle excitability can cause myotonia, periodic paralysis, congenital myopathy, and myasthenic syndrome.
Rare SCN4A variants that directly alter NaV1.4 function occur in infants who had died from SIDS. These variants are predicted to significantly alter muscle membrane excitability and compromise respiratory and laryngeal function. These findings indicate that dysfunction of muscle sodium channels is a potentially modifiable risk factor in a subset of infant sudden deaths.
Acknowledgement
Author Dogan Roope Männikkö, Leonie Wong, David J Tester, Michael G Thor, Richa Sud, Dimitri M Kullmann, Mary G Sweeney, Costin Leu, Sanjay M Sisodiya, David R FitzPatrick, Margaret J Evans, Iona J M Jeffrey, Jacob Tfelt-Hansen, Marta C Cohen, Peter J Fleming, Amie Jaye, Michael A Simpson, Michael J Ackerman, Michael G Hanna, Elijah R Behr, Emma Matthews
Journal
Vol 391 April 14, 2018
Publisher
Cross Mark https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899997/pdf/main.pdf
| 3 | | R470.00 | |
| | Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare | Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare
Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare
Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare
Overview
Inflammatory bowel disease is characterized by a chronic inflammatory state and is therefore associated with abnormalities in coagulation and a hyper-coagulable state. Cerebral venous sinus thrombosis is a rare complication of inflammatory bowel disease yet contributes significant morbidity and mortality to those affected. Early diagnosis is critical, as a delay in diagnosis portends a worse prognosis.
The study starts by discussing the case of a seventeen-year-old female who presented with ulcerative colitis flare and developed new-onset seizures, found to be caused by a large venous sinus thrombosis. Evidence-based medicine supports IBD to be an independent risk factor for venous sinus thrombosis, as numerous studies have demonstrated a correlation.
The mechanism for this is multi-factorial and incompletely understood. Most healthcare professionals are not aware of this correlation and may not know how to quickly and confidently identify venous sinus thrombosis on various imaging modalities. This paper seeks to highlight the relationship, as a delay in diagnosis of CVT portends a worse prognosis in these young, at-risk patients.
Acknowledgement Author L. M. Conners , R. Ahad, P. H. Janda, and Z. Mudasir
Journal Case Reports in Neurological Medicine
Publisher Hindawi | 3 | | R480.00 | |
| | Transition Needs of Adolescents With Sickle Cell Disease. | Transition Needs of Adolescents With Sickle Cell Disease.
Transition Needs of Adolescents With Sickle Cell Disease.
Transition Needs of Adolescents With Sickle Cell Disease.
Overview
This article describes how adolescents with sickle cell disease (SCD) perceive their ability to perform everyday tasks required for transition to adult health care and independent living. SCD negatively affects transition from pediatric to adult health care and independent living (Anie & Telfair, 2005).
The Adolescent Autonomy Checklist (AAC) was adapted to include skills associated with managing SCD (AAC-SCD) and was administered to adolescents during clinic visits. Participants indicated "can do already" or "needs practice" for 100 activities in 12 categories. Of 122 patients, the percentage of adolescents who needed practice was greatest in living arrangements (38.7%), money management (35.8%), vocational skills (29.6%), and health care skills (25.5%).
We found a significant effect of age and of cerebrovascular injury on the percentage of those who reported "needs practice" in multiple categories. We found no effect of gender and limited effect of haemoglobin phenotype on any skill category. Findings support the need for educational intervention to improve transition skills in adolescents with SCD.
Acknowledgement:
Author: Abel RA, Cho E, Chadwick-Mansker KR, D'Souza N, Housten AJ, King AA
Journal:
The American Journal of Occupational Therapy Volume 69 Issue 2
Publisher: AOTA Press
| 3 | | R455.00 | |
| | Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population | Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population
Diagnostic Approaches for Invasive Aspergillosis – Specific Considerations in the Pediatric Population
Diagnostic Approaches for Invasive Aspergillosis—Specific Considerations in the Pediatric Population
Overview
The Invasive aspergillosis (IA) is a major cause of morbidity and mortality in children with hematological malignancies and those undergoing hematopoietic stem cell transplantation. Similar to immune-compromised adults, clinical signs, and symptoms of IA are unspecific in the pediatric patient population. As early diagnosis and prompt treatment of IA is associated with better outcome, imaging and non-invasive antigen-based such as galactomannan or ß-D-glucan and molecular biomarkers in peripheral blood may facilitate institution and choice of antifungal compounds and guide duration of therapy.
The early and reliable diagnosis of IA is difficult in immune-compromised patients, in particular in the pediatric population. In patients in whom imaging studies suggest IA or another mold infection, invasive diagnostics such as broncho-alveolar lavage and/or bioptic procedures should be considered. Here we review the current data of diagnostic approaches for IA in the pediatric setting and highlight the major differences of performance and clinical utility of the tests between children and adults.
Acknowledgement
Author Thomas Lehrnbecher , Angela Hassler , Andreas H. Groll and Konrad Bochennek
Journal Frontiers in Microbiology
Publisher Cross Mark
| 3 | | R480.00 | |
| | Postoperative Pain in Children After Dentistry Under General Anesthesia. | Postoperative Pain in Children After Dentistry Under General Anesthesia.
Postoperative Pain in Children After Dentistry Under General Anesthesia.
Overview
The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use.
The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R = 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005).
In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics.
Acknowledgement
Author:
Wong M, Copp PE, Haas DA
Journal:
Anesthesia progress
Publisher:
American Dental Society of Anesthesiology
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675339/pdf/i0003-3006-62-4-140.pdf
| 3 | | R450.00 | |
| | How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis. | How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis.
How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis.
Overview The objective of this course is to perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression. Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were:
(1) intervention should be supervised physical activity,
(2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept,
(3) participants' ages ranged from 3 to 20 years, and
(4) a control or comparison group was included. There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies.
It was concluded that intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings. Acknowledgement Author:
Liu M, Wu L, Ming Q Journal:
PLoS One.
| 3 | | R410.00 | |
| | Medical Tourism. | Medical Tourism.
Overview
BACKGROUND: Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment.
OBJECTIVE:
This article provides an outline of the current research around medical tourism, especially its impact on Australians.
DISCUSSION:
Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad
Acknowledgement
Author:
Leggat P
Journal:
Australian family physician.
Publisher:
Focus Environmental
| 3 | | R360.00 | |
| | Standards of Psychosocial Care for Parents of Children With Cancer. | Standards of Psychosocial Care for Parents of Children With Cancer.
Standards of Psychosocial Care for Parents of Children With Cancer.
Overview
Parents and caregivers of children with cancer are both resilient and deeply affected by the child's cancer. A systematic review of published research since 1995 identified 138 studies of moderate quality indicating that parent distress increases around diagnosis, then returns to normal levels. Post-traumatic symptoms are common. Distress may be impairing for vulnerable parents and may impact a child's coping and adjustment. Moderate quality evidence and expert consensus informed a strong recommendation for parents and caregivers to receive early and ongoing assessment of their mental health needs with access to appropriate interventions facilitated to optimize parent, child, and family well being
Acknowledgement
Author:
Kearney JA, Salley CG, Muriel AC
Journal:
Pediatric blood and cancer.
Publisher:
Department of Health and Human Services.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066591/pdf/nihms797572.pdf
| 3 | | R380.00 | |
| | Teenage pregnancy: a psychopathological risk for mothers and babies? | Teenage pregnancy: a psychopathological risk for mothers and babies?
Teenage pregnancy: a psychopathological risk for mothers and babies?
Overview
Introduction: Teen pregnancy remains a public health problem of varying importance in developing and developed countries. There are risks and consequences for teen parents and the child on the medical and socioeconomic level.
Method:
We conducted a literature search on multiple databases, focusing on the risk and the consequences of teen pregnancy and childbearing. We used different combined keywords as teen pregnancy, teen mother, teenage parents, teenage childbearing, teenage mother depression. Our search included different type of journals to have access on different views (medical, psychological, epidemiologic).
Results:
The teen mothers are more at risk for postnatal depression, school dropout and bad socioeconomic status. The babies and children are more at risk for prematurity and low birthweight and later for developmental delays and behavior disorders.
Conclusion:
Pregnancy in adolescence should be supported in an interdisciplinary way (gynecologist, psychologist, child psychiatrist, midwives, pediatrician). We need further studies that allow targeting patients most at risk and personalizing maximum support.
Acknowledgement
Author:
Goossens G, Kadji C, Delvenne V
Journal:
Psychiatria Danubina
Publisher:
Medicinska naklada - Zagreb, Croatia
https://pdfs.semanticscholar.org/497f/6589d9e6821595fce5b9f486c47e62756df1.pdf
| 3 | | R420.00 | |
| | Sensitivity of plain radiography for pediatric cervical spine injury. | Sensitivity of plain radiography for pediatric cervical spine injury.
Sensitivity of plain radiography for pediatric cervical spine injury.
Overview
Pediatric patients with suspected cervical spine injuries (CSI) often receive a computed tomography (CT) scan as an initial diagnostic imaging test. While sensitive, CT of the cervical spine carries significant radiation and risk of lethal malignant transformation later in life. Plain radiographs carry significantly less radiation and could serve as the preferred screening tool, provided they have a high functional sensitivity in detecting pediatric patients with CSI.
We hypothesize that plain cervical spine radiographs can reliably detect pediatric patients with CSI and seek to quantify the functional sensitivity of plain radiography as compared to CT. We analyzed data from the NEXUS cervical spine study to assess the sensitivity of plain radiographs in the evaluation of CSI. We identified all pediatric patients who underwent plain radiographic imaging, and all pediatric patients found to have CSI. We then determined the sensitivity of plain radiographs in detecting pediatric patients with CSI. We identified 44 pediatric patients with CSI in the dataset with age ranging from 2 to 18 years old.
Plain radiography was highly sensitive for the identification of CSI in our cohort of pediatric patients and is useful as a screening tool in the evaluation of pediatric CSI.
Acknowledgement
Author:
Cui LW, Probst MA, Hoffman JR, Mower WR
Journal:
Emergency Radiology
Publisher:
Springer
https://cloudfront.escholarship.org/dist/prd/content/qt95p3x9hg/qt95p3x9hg.pdf?t=odi6kh&v=lg
| 3 | | R380.00 | |
| | Procedural Metacognition and False Belief Understanding in 3- to 5-Year-Old Children. | Procedural Metacognition and False Belief Understanding in 3- to 5-Year-Old Children.
Procedural Metacognition and False Belief Understanding in 3- to 5-Year-Old Children.
Overview
Some studies, so far limited in number, suggest the existence of procedural metacognition in young children, that is, the practical capacity to monitor and control one's own cognitive activity in a given task. The link between procedural metacognition and false belief understanding is currently under theoretical discussion. If data with primates seem to indicate that procedural metacognition and false belief understanding are not related, no study in developmental psychology has investigated this relation in young children. The present paper aims, first, to supplement the findings concerning young children's abilities to monitor and control their uncertainty (procedural metacognition) and, second, to explore the relation between procedural metacognition and false belief understanding. To examine this, 82 3- to 5-year-old children were presented with an opt-out task and with 3 false belief tasks. Results show that children can rely on procedural metacognition to evaluate their perceptual access to information, and that success in false belief tasks does not seem related to success in the task we used to evaluate procedural metacognition. These results are coherent with a procedural view of metacognition, and are discussed in the light of recent data from primatology and developmental psychology.
Acknowledgement
Author:
Bernard S, Proust J, Clément F
Journal:
PLoS One.
Publisher:
PLoS One.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4627761/pdf/pone.0141321.pdf
| 3 | | R390.00 | |
| | Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients, | Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients,
Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients,
Overview
Alcohol consumption has been clearly revealed by emergency department (ED) based studies to be risk factor to sustaining an injury. However, it remains unclear how acute alcohol consumption affects injury patterns to various body regions.
This study was therefore carried out to determine if acute alcohol consumption is associated with differences in injury pattern among young adult patients with traumatic injuries presenting to emergency medical services (EMS). The data for this study was a cross sectional retrospective review of prehospital patient care reports (PCRs) that evaluated injured patients who presented to a collegiate EMS agency from January 1, 2011 to December 31, 2012. More so, PCRs were reviewed independently by two abstractors to determine if the patient was documented to have acutely consumed alcohol proximate to his/her injury.
Results from the findings nevertheless revealed that alcohol users were more likely to present with injury secondary to assault, fall/trip, as well as an unknown mechanism of injury.
ACKNOWLEDGEMENT
AUTHORS: David J. Barton BS, Frank W. Tift MD, Lauren E. Cournoyer BS, Julie T. Vieth MBChB & Korin B. Hudson MD
JOURNAL: Prehospital Emergency Care
PUBLISHERS: Taylor & Francis online
URL: http://dx.doi.org/10.3109/10903127.2015.1076101 | 3 | | R350.00 | |
| | Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study. | Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study.
Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study.
OVERVIEW
There are evidences that drugs used in treating attention-deficit/hyperactivity disorder (ADHD) are efficacious in reducing symptoms of impulsivity and hyperactivity in children,1 but concerns have been expressed about possible adverse cardiovascular events with the first line treatment, methylphenidate.
Thus, the aim of this study was to determine whether treatment with methylphenidate in children and young people with attention-deficit/ hyperactivity disorder (ADHD) was associated with cardiovascular events. The design for this study was a self-controlled case series analysis meanwhile the setting was the Nationwide Health Insurance database, from 1 January 2008 to 31 December 2011, in South Korea. Participants of this study were 1224 patients aged =17 who had experienced an incident cardiovascular event and with at least one incident prescription for methylphenidate.
Major results of this study indicated that increased risk of arrhythmia was observed in all exposed time periods, that is, periods of treatment with methylphenidate - (incidence rate ratio 1.61, 95% confidence interval 1.48 to 1.74), and the risk was highest in the children who had congenital heart disease.
ACKNOWLEDGEMENT
AUTHORS: Ju-Young Shin, Elizabeth E Roughead, Byung-Joo Park, Nicole L Pratt
JOURNAL: Eighth International Congress on Peer Review and Scientific Publication
PUBLISHER: BMJ Group
URL: http://www.bmj.com | 3 | | R380.00 | |
| | Diagnosis and Management of Asthma in Children. | Diagnosis and Management of Asthma in Children.
Diagnosis and Management of Asthma in Children.
OVERVIEW
Asthma is a very common illness faced by children the world over. With that said, rather than escalating treatment in severe and problematic cases of childhood cancer, a more systematic approach is needed to find a solution to this problem. Elements of the systematic approach included a review of the diagnosis, adherence, the ability to take drugs correctly as well as the environment of the children in question.
The objective of this article was therefore to review other articles concerning the treatment and management of childhood asthma that should prompt a focused and urgent review of what trigger factors led to asthma attacks and whether the attacks were appropriately managed. Some of the articles that were reviewed during this research were obtained from PubMed and Cochrane database.
However, only articles related to the diagnosis and practical management of asthma were selected for this research. Also, small trials and case series were excluded if the findings had been subsumed into a meta-analysis or Cochrane review.
ACKNOWLEDGEMENT
AUTHORS: Andrew Bush, (paediatrics) and Louise Fleming (senior clinical lecturer)
JOURNAL: BMJ Journals
PUBLISHER: BMJ Open
URL: https://www.group.bmj.com
| 3 | | R400.00 | |
| | Early Language Intervention Using Distance Video-Teleconferencing: A Pilot Study of Young Boys With Fragile X Syndrome and Their Mothers. | Early Language Intervention Using Distance Video-Teleconferencing: A Pilot Study of Young Boys With Fragile X Syndrome and Their Mothers.
Early Language Intervention Using Distance Video-Teleconferencing: A Pilot Study of Young Boys With Fragile X Syndrome and Their Mothers.
Overview
Studies have found that responsive verbal language input from parents make an important contribution to early language development for typically developing children. The purpose of this study was thus to evaluate the effects of a naturalistic parent-implemented language intervention on the use of verbally responsive language by mothers of 6 young boys with fragile X syndrome.
The two intervention of this study were parent education sessions and clinician coaching delivered onsite by distance video-teleconferencing. The method used in carrying out this study was a single-case multiple baseline across participants to examine intervention effects on maternal use of language support strategies. Results from this study nevertheless suggested that mothers increased their use of utterances that followed into their child’s focus of attention and prompted child communication acts. The results further revealed that intervention effects were not observed for maternal contingent responses to child communication.
The study was concluded that intervention efficacy might be enhanced by incorporating an augmentative and alternative communication device for some children and a more concerted focus on increasing the frequency of child communication acts.
ACKNOWLEDGEMENT
AUTHORS: Andrea McDuffie, Ashley Oakes, Wendy Machalicek, Monica Ma, Lauren Bullard, Sarah Nelson, and Leonard Abbeduto
JOURNAL: American Journal of Speech-Language Pathology
PUBLISHER: American Speech-Language-Hearing Association (ASHA)
URL: http://www.asha.org/ | 3 | | R370.00 | |
| | Effect of Cognitive Load on Seating Posture in Children | Effect of Cognitive Load on Seating Posture in Children
Effect of Cognitive Load on Seating Posture in Children
OVERVIEW
It is often difficult for children to maintain their upright seating positions while performing cognitive tasks. Thus, it is imperative to understand the relationship that exists between cognitive tasks and postural seating positions to enable children carryout their tasks efficiently and effectively.
This study was therefore conducted among selected 4th-grade children in a Japanese elementary school. The objective of the study was to determine the muscle activity as well as body sway of children while performing cognitive tasks, arithmetic tasks precisely. While performing the arithmetic tasks, changes in muscle activities, as well as the center of pressure (COP), were recorded. It should be noted that electromyography was also recorded from the internal oblique and lumbor multifidus muscles whereas the COP was reported to have been measured with the use of a baropodometer that was placed on a stool.
Results from the findings nevertheless revealed that arithmetic tasks were not related to the EMG or COP changes in the children. It was therefore concluded that it was better to allow children to alter their seating postures when performing difficult tasks.
ACKNOWLEDGEMENT
AUTHORS: Go Igarashi, Chieko Karashima & Minoru Hoshiyama
JOURNAL: Occupational Therapy International
PUBLISHER: John Wiley and Sons Ltd
URL: www.wiley.com
| 3 | | R325.00 | |
| | Effectiveness of early pediatric dental homes: A scoping review. | Effectiveness of early pediatric dental homes: A scoping review.
Effectiveness of early pediatric dental homes: A scoping review.
OVERVIEW
This article is important to Dental Hygienists because the early pediatric dental home is a promising model to improve pediatric oral health based on clinical, behavioural, and cost effectiveness outcome measures.
Dental hygienists and other dental practitioners should encourage families with infants and toddlers to start seeing a dental professional no later than age one for routine professional oral health care
This scoping review examines literature on the effectiveness of early pediatric dental homes based on clinical, behavioural, and cost parameters. The existing body of evidence generally supports the effectiveness of early pediatric dental homes for improving clinical outcomes (i.e., dmft scores) and behavioral outcomes (i.e., including utilization of future dental care services), and offering potential cost savings. However, exact quantifications of the impact on clinical and behavioral outcomes as well as cost savings vary due to heterogeneity of study design and methodological considerations related to level of evidence. Current research generally substantiates the establishment of a dental home model as an effective practice to improve early pediatric oral health.
ACKNOWLEDGEMENT
AUTHORS: Jacqueline VanMalsen, BSc(DH), RDH; Sharon M Compton, PhD, RDH
JOURNAL: The Canadian Journal of Dental Hygiene
PUBLISHER: The Canadian Dental Hygienist Association
http://www.cdha.ca
| 3 | | R425.00 | |
| | Empowered to Play: A Case Study Describing the Impact of Powered Mobility on the Exploratory Play of Disabled Children. | Empowered to Play: A Case Study Describing the Impact of Powered Mobility on the Exploratory Play of Disabled Children.
Empowered to Play: A Case Study Describing the Impact of Powered Mobility on the Exploratory Play of Disabled Children.
OVERVIEW Play is one of the most significant activities, as well as the primary occupation of childhood. Play is equally a deeply fulfilling occupation especially when it is spontaneously initiated by the child. The objective of this qualitative study was therefore to investigate the impact of powered mobility on the exploratory play of two children with physical disabilities.
Data for this study was collected from the children, their parents and their siblings through participant observation and in-depth, informal interviews. Findings from this study however suggests that the provision of powered mobility is a key contributor promoting the participation of physically disabled children in exploratory play. This study was however limited because data was only confined to two months thereby affecting the depth of data gained that prolonged engagement would have offered.
This study therefore recommends for occupational therapy practice that occupational therapists advocate for easier access to powered mobility through governmental and policy means. The stud was concluded that further research needs to be conducted on the experiences of the caregivers on how these powered mobility devices have influenced their day-to-day occupations.
ACKNOWLEDGEMENT
AUTHORS: Amshuda Sonda & Pam Gretschel
JOURNAL: Occupational Therapy International
PUBLISHER: John Wiley & Sons
URL: http://onlinelibrary.wiley.com | 3 | | R330.00 | |
| | Evaluating intervention using time aids in children with disabilities. | Evaluating intervention using time aids in children with disabilities.
Evaluating intervention using time aids in children with disabilities.
OVERVIEW
Nowadays, children with difficulties in managing time in everyday life are at risk of delayed development of time-processing skills compared with their same-aged peers. Thus, Children with autism spectrum disorders (ASD) and children with attention deficit hyperactivity disorder (ADHD) have been reported to exhibit problems in time perception/time sense as compared with typically developing children.
The objective of this study was to evaluate complex intervention using time aids for children with intellectual and developmental disabilities who exhibit limitations in daily time management. The participants of this study were children aged between 6-11 who were suffering from conditions such as ADHD, autism spectrum disorders, mild or moderate intellectual disability, spina bifida, and cerebral palsy. This study equally used a Randomized Block and Waiting List control group design, with 25 children allocated to control and 22 to intervention group.
Results from this study indicated that Children in both groups gained significantly in time-processing ability between the first and second data collection, meanwhile the children in the intervention group improved time-processing ability significantly more than controls.
ACKNOWLEDGEMENT
AUTHORS: Gunnel Janeslätt, Anders Kottorp & Mats Granlund
JOURNAL: Scandinavian Journal of Occupational Therapy
PUBLISHER: Taylor and Francis online
URL: http://www.tandfonline.com
| 3 | | R450.00 | |
| | How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics. | How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics.
How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics.
OVERVIEW
Pain is a common experience in the daily lives of adolescents. However, headache, abdominal and musculoskeletal types of pain are the most common type of pain experienced by adolescents.
The objective of this research was to describe how different adolescents experience and manage pain in their daily life. Focus was however made their use of over-the counter analgesics. The design for this stud was qualitative semi structured interviews in which adolescents shared their experiences with pain, pain management and involvement of family and friends during pain. The participants of this study were 25 young people (both males and females) aged 15 to 16 from different junior high schools. These students were interviewed irrespective of their immigration background in their respective schools in Norway. The study was concluded that different involvement with the family during pain related to their pain perception and management by the adolescents.
At the end of the study it was recommended that Knowledge of the different ways of approaching pain is important when supporting adolescents and may be a subject for further research on the use of over-the-counter analgesics in the family.
ACKNOWLEDGEMENT
AUTHORS: Per Lagerløv, Elin Olaug Rosvold, Tanja Holager, Sølvi Helseth
JOURNAL: Stroke and Vascular Neurology
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com | 3 | | R425.00 | |
| | Introduction of complementary feeding before 4 months of age increases the risk of childhood overweight or obesity: a meta-analysis of prospective cohort studies. | Introduction of complementary feeding before 4 months of age increases the risk of childhood overweight or obesity: a meta-analysis of prospective cohort studies.
Introduction of complementary feeding before 4 months of age increases the risk of childhood overweight or obesity: a meta-analysis of prospective cohort studies.
OVERVIEW
The association between the age at introduction of complementary feeding and the risk of overweight or obesity during childhood has been hotly debated, but the result remains uncertain.
This meta-analysis of prospective cohort studies attempted to evaluate this association, as well as provide evidence for infant feeding recommendations. The PubMed, Embase, and Cochrane databases were systematically searched for relevant original articles published prior to March 1, 2015 that met predefined inclusion criteria. The pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated using fix-effect or random-effect models, which were chosen based on heterogeneity among studies. Ten articles consisting of 13 studies, where 8 measured being overweight as an outcome and 5 measured being obese, were included in this meta-analysis. There was a total of 63,605 participants and 11,900 incident cases in the overweight studies, and 56,136 individuals and 3246 incident cases in the obese studies.
The results of this study suggest that the introduction of complementary foods to infants before 4 months of age should be avoided to protect against childhood obesity.
ACKNOWLEDGEMENT
AUTHORS: Jing Wang et al.
JOURNAL: Nutrition Research
PUBLISHERS: Elsevier Inc
URL: https://www.elsevier.com | 3 | | R320.00 | |
| | Practice Issues. | Practice Issues.
OVERVIEW
It is important to note that the responses to the various questions are the views independently expressed and are not necessarily opinions shared by cpdexpress.co.za. As matters involving Ethics and the law are subject to interpretation, the responses cannot, in any way, be regarded as binding or necessarily endorsed by the regulatory authorities.
There are ethical dilemmas regarding patients, colleagues and associates that one doesn’t even consider until they become issues in their practice. There are many questions to be asked regarding ethics, touting, canvassing, advertising, competition and many other issues that need to be addressed and this article addresses most of them. | 3 | | R450.00 | |
| | Private Practice: The Do's And Don'ts. | Private Practice: The Do's And Don'ts.
Private Practice: The Do's And Don'ts.
OVERVIEW
You have studied extensively to become a healthcare professional in your field of study. You have learned and become adept at identifying a vast range of conditions. You can diagnose and effectively treat those conditions within the scope of the discipline.
Now you are faced with a plethora of dilemmas. What is fair value for your services? What appliances are appropriate and reasonable? What commercial and legal structures are appropriate for you? What influence may these commercial and legal structures have on your clinical recommendations? Who may have access to your record cards? What responsibility can you delegate to your staff? Who carries final responsibility for payment of your claims – member or medical aid? What constitutes anti-competitive behavior?
This is a very informative article that will help you to run your practice within the various guidelines. | 3 | | R400.00 | |
| | Recommendations for venous thromboembolism prophylaxis in pediatric trauma patients. | Recommendations for venous thromboembolism prophylaxis in pediatric trauma patients.
Recommendations for venous thromboembolism prophylaxis in pediatric trauma patients.
Overview
Venous thromboembolism also known as VTE has become increasingly very rampant. Nevertheless, the incidence is more common in children than in adults. Similarly, the incidence the incidence of VTE is higher in injured children than in the general population of uninjured hospitalized children.
To this effect, much scrutiny is therefore given to hospital acquired VTE as a qualitative initiative to prevent VTE. The hypothesis of this study is that several factors such as older age, injury severity, obesity, central venous catheter (CVC) use, Mechanical ventilation, inotrope use, blood transfusion, pelvic or lower extremity fracture, spinal cord injury, and intensive care unit stay have been associated with VTE in children.
The objective of this study is therefore to investigate when the benefit of pharmacologic prophylaxis to reduce the risk of VTE outweighs the risk, particularly the risk of bleeding. More so, the efficacy of anticoagulation to prevent VTE is unknown in this population. During the study, a modified Delphi method was used to develop consensus, according to previously published methodologies. According results of this study, most expert respondents agreed that ‘‘injured children who can walk may need routine VTE prophylaxis based on other factors.
ACKNOWLEDGEMENT
AUTHORS: Sheila J. Hanson, MD, MS, E. Vincent S. Faustino, MD, MHS, Arash Mahajerin, MD, MSCr, Sarah H. O’Brien, MD, Christian J. Streck, MD, A. Jill Thompson, PharmD, Toni M. Petrillo, MD, and john K. Petty, MD, Winston-Salem
JOURNAL: Journal of Trauma and Acute Care Surgery
PUBLISHERS: Wolters Kluwer
URL: http://journals.lww.com | 3 | | R385.00 | |
| | The Development of the Concept of Psychic Skin and Envelopes in Psychoanalytic Theories of Infancy. | The Development of the Concept of Psychic Skin and Envelopes in Psychoanalytic Theories of Infancy.
The Development of the Concept of Psychic Skin and Envelopes in Psychoanalytic Theories of Infancy.
OVERVIEW
This paper aims to review the topic of psychic envelopes and to sketch the main outlines of this concept in infancy. We first explore the origins of the concept in Freud's “protective shield” and then its development in adult psychoanalysis before going on to see how this fits in infancy with post-Bionian psychoanalysis and development. Four central notions guide this review:
Freud's “protective shield” describes a barrier to protect the psychic apparatus against potentially overflowing trauma. Anzieu's “Skin-Ego” is defined by the different senses of the body. Bick's “psychic skin” establishes the concept in relation to infancy. Stern's “narrative envelope” derives from the intersection between psychoanalysis and neuroscience.
Although it has received relatively little attention elsewhere, the concept of psychic envelopes is being used in psychoanalysis in France. The aim of the present article is to undertake a broad investigative review of this concept, and to specify its main characteristics, particularly as applied in understanding infant development. To facilitate this, we will focus on four notions in which the concept is rooted: the protective shield (Freud), the SkinEgo (Anzieu), the psychic skin (Bick) and the narrative envelope (Stern) | 3 | | R400.00 | |
| | Using coloured filters to reduce the symptoms of visual stress in children with reading delay. | Using coloured filters to reduce the symptoms of visual stress in children with reading delay.
Using coloured filters to reduce the symptoms of visual stress in children with reading delay.
OVERVIEW
Meares-Irlen Syndrome (MIS), which is also known as “visual stress” is one of the key visual causes of reading difficulties in children. Some of its symptoms include letters appearing to be blur, move around or go double, glare, as well as headaches.
The aim of this study was to compare the effect of two coloured-filter systems on the symptoms of visual stress in children with reading delay. The method used in carrying out this study was a pre-test, post-test, as well as a randomized head-to-head comparison of two filter systems on the symptoms of visual stress in school children. Hence, 68 UK mainstream school children with significant impairment in reading ability participated in this study. Results of this study however indicated that filter systems appeared to have a large effect on the reported symptoms between pre-and post-three-month time points.
Results from this study further indicated that reduction in symptoms, which appeared to be brought about using coloured filters, eased the visual discomfort experienced by these children when reading.
ACKNOWLEDGEMENT
AUTHORS: Priscilla Harries, Roger Hall, Nicola Ray and John Stein
JOURNAL: The Scandinavian Journal of Occupational Therapy
PUBLISHER: Taylor and Francis
URL: http://www.tandfonline.com | 3 | | R375.00 | |
| | Whole-Body MRI in Pediatric Patients with Cancer. | Whole-Body MRI in Pediatric Patients with Cancer.
Whole-Body MRI in Pediatric Patients with Cancer.
OVERVIEW
Statistics show that cancer is currently the leading cause of natural death in the pediatric populations of developed countries. It is however apparent that cure rates for cancers are greater than 70% in some cases when it is diagnosed in its early stages.
Recent advances in magnetic resonance imaging methods have markedly improved diagnostic and therapeutic approaches, while avoiding the risks of ionizing radiation that are associated with most conventional radiological methods, such as computed tomography and positron emission tomography/computed tomography. Also, the advent of whole-body magnetic resonance imaging in association with the development of metabolic- and function-based techniques has led to the use of whole-body magnetic resonance imaging for the screening, diagnosis, staging, response assessment, and post-therapeutic follow-up of children with solid sporadic tumours or those with related genetic syndromes.
This study is therefore a review of literature concerning the advantages, techniques, indications, and limitations of whole-body magnetic resonance imaging in the management of pediatric oncology patients are presented.
ACKNOWLEDGEMENT
AUTHORS: Marcos Duarte Guimarães, Julia Noschang, Sara Reis Teixeira, Marcel Koenigkam Santos, Henrique Manoel Lederman, Vivian Tostes, Vikas Kundra, Alex Dias Oliveira, Bruno Hochhegger and Edson Marchiori
JOURNAL: BioMed Central Cancer Imaging
PUBLISHER: BioMed Centra
URL: https://www.biomedcentral.com | 3 | | R425.00 | |