 | | HIV and Aids Part 2 | HIV and Aids Part 2
Overview
HIV (Human Immunodeficiency Virus) is a virus transmitted through sexual contact, shared needles, and from mother to child during childbirth or breastfeeding. It belongs to the Retroviridae family. All patients who are diagnosed with HIV should be initiated on ART as soon as possible.
HIV can also lead to complications like dementia and chronic diarrhea with weight loss (HIV wasting syndrome).
Exceptions to this include patients presenting with cryptococcal meningitis (CM) or central nervous system tuberculosis (tuberculous meningitis (TBM) or tuberculoma).
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| | HIV and Aids Part 1 | HIV and Aids Part 1
Overview
HIV (Human Immunodeficiency Virus) is a virus transmitted through sexual contact, shared needles, and from mother to child during childbirth or breastfeeding. It belongs to the Retroviridae family. Symptoms vary depending on the stage of infection and these include: - Acute stage, which resembles the flu, with fever, malaise, and a generalized rash;
- Asymptomatic stage which generally, has no symptoms.
- Lymphadenopathy, which presents with swelling of lymph nodes, which can be a primary symptom.
- AIDs, which is the advanced stage marked by severe infections or cancers.
HIV can also lead to complications like dementia and chronic diarrhea with weight loss (HIV wasting syndrome).
Sharespike Knowledge Studio | 3 | | R485.00 | |
| | Ebola Virus Infection | Ebola Virus Infection
Overview
Ebola virus is one of at least 30 known viruses capable of causing viral hemorrhagic fever syndrome. The genus Ebolavirus currently is classified into 5 separate species: Sudan ebolavirus, Zaire ebolavirus, Tai Forest (Ivory Coast) ebolavirus, Reston ebolavirus, and Bundibugyo ebolavirus. The outbreak of Ebola virus disease in West Africa from 2014 to 2016, involving Zaire ebolavirus, was the largest outbreak of Ebola virus disease in history.
As of September 17, 2019, an active outbreak of Ebola virus disease in the Democratic Republic of the Congo (DRC) had resulted in 3,034 confirmed and 111 probable cases of Ebola virus disease, including 2,103 attributable deaths. An experimental vaccine has been credited with limiting the outbreak’s scope.
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| | Effectiveness of speech therapy in treating vocal blocking tics in children with Tourette syndrome: Two case reports | Effectiveness of speech therapy in treating vocal blocking tics in children with Tourette syndrome: Two case reports
Effectiveness of speech therapy in treating vocal blocking tics in children with Tourette syndrome: Two case reports
Overview A tic is a sudden, rapid, recurrent, and non-rhythmic motor movement or vocalization, which can be distinguished from other involuntary movements by its typical clinical characteristics. Tics are commonly sparse, but in some patients, they can be almost continuous. The frequency, intensity, number, complexity, and type of tics typically “wax and wane.” Tics can be situational, and they can be temporarily controlled. There is often a premonitory urge or tension preceding tics, which means a person’s ability to sense in advance that a tic is about to occur. The level of this urge varies across patients. Tourette syndrome is characterized by at least two motor tics and one vocal tic, which persist for over a year. Infrequently, tics can manifest as blocking tics in speech when they prevent a person from starting to speak or interrupt their speech flow. Vocal blocking tics (VBTs) resemble stuttering, and they can be difficult to differentiate from each other. A previous report described two patients with severe VBTs who did not benefit from stuttering-therapy-based speech therapy and were treated effectively with cannabis-based medicine. Here, we present the cases of two patients, seven- and nine-year-old boys, who benefited from speech therapy in which stuttering therapy techniques were used. Detailed descriptions of the interventions are included. Further research is needed to test the effectiveness of speech therapy in treating VBTs in a larger group of children with Tourette syndrome.
Journal Clinical Child Psychology and Psychiatry | 3 | | R475.00 | |
| | Social Communication Delay in an Unbiased Sample of Preschoolers with the FMR1 Premutation | Social Communication Delay in an Unbiased Sample of Preschoolers with the FMR1 Premutation
Social Communication Delay in an Unbiased Sample of Preschoolers with the FMR1 Premutation
Overview The FMR1 premutation (FXpm) involves CGG expansions of 55-200 repeats and is linked to health issues like FXTAS and FXPOI. FXTAS affects 40% of males and 15% of females with FXpm, while FXPOI affects 20%-30% of affected women. Neuropsychiatric symptoms such as anxiety, mood disorders, and social challenges are also common in FXpm individuals. Despite its prevalence in the general population (1:151-291 females and 1:468-845 males), most FXpm carriers remain unaware of their genetic status due to lack of population screening. Understanding the clinical phenotype during childhood has been limited, thus hindering the development of clinical guidelines for screening and intervention. This study aims to explore the social communication profile of children with the FXpm, given that social communication difficulties in adults with FXpm are well-documented and linked to reduced psychosocial functioning. By characterizing these challenges during early childhood, the study seeks to emphasize the importance of early screening and intervention to improve outcomes.
Journal Journal of Speech, Language, and Hearing Research | 3 | | R485.00 | |
| | Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: A Single-center Experience | Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: A Single-center Experience
Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: A Single-center Experience
Overview Thrombosis is an increasingly recognized complication of childhood malignancy and its treatment. The incidence and etiology of pediatric cancer-related thrombosis is still not well understood. The aim of this study was to evaluate the prevalence of common prothrombotic genetic conditions in children with cancer, the frequency of thrombosis, and the role of inherited thrombophilia in the development of thrombosis in a pediatric oncology population.
Forty-seven children (36 treated for haematological malignancies and 11 for solid tumours) with a median age of 8.8. years (range 0.4 – 19.3 years) were included in the study. Genetic polymorphisms of Factor V Leiden (G1691A), prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T were determined by real-time polymerase chain reaction-based DNA analysis.
It was concluded that thrombosis is an important complication of childhood cancer. The risk of thrombosis may be increased in patients with Factor V Leiden. In the absence of consensus guidelines, our results support the recommendation for thrombophilia screening in children with cancer.
Journal
Acta Medica Academica | 3 | | R485.00 | |
| | Early Diagnosis on ADHD: Is it Possible? | Early Diagnosis on ADHD: Is it Possible?
Early Diagnosis on ADHD: Is it Possible?
Overview Early diagnosis of ADHD is crucial to prevent significant functional impairment and economic burden. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. These symptoms can lead to various degrees of functional impairment across different settings. Individuals with undiagnosed ADHD are at higher risk of facing challenges such as imprisonment, depression, and drug misuse. If left undiagnosed and untreated, ADHD can impose a significant economic burden on society. Research in Mexico aimed to assess the accessibility to timely diagnoses for children and adolescents with ADHD, along with their primary caregivers. This pioneering study was conducted in two phases at specialized mental health services. The findings suggest that starting the Access Pathway where signs and symptoms of ADHD are first detected, particularly in schools, can prevent children from suffering the consequences of late diagnosis. School-based mental health service models have been successfully tested in other regions, making them a viable option to shorten the time required to obtain a timely diagnosis and mitigate the negative consequences associated with ADHD.
Journal: BMC Health Services Research
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| | Associations of Symptom Severity of Mentally ill parents on family functioning and children’s mental health | Associations of Symptom Severity of Mentally ill parents on family functioning and children’s mental health
Associations of Symptom Severity of Mentally ill parents on family functioning and children’s mental health
Overview Parental mental illness has a negative impact on children’s mental health. Often, the entire family structure suffers from the consequences of parental illness. The consequences of mental illness impact not only the affected persons themselves, but also the family environment (Perez et al., 2018). Especially children of mentally ill parents have been studied regarding their risk for psychopathology. Children of families with parents with mental illness also use a broad spectrum of mental health care, school-based support, and youth welfare services even if they are not yet diagnosed as having a mental disorder. Parental mental health problems constitute a significant risk for children’s mental health. Children of mentally ill parents have a significantly increased risk of developing a mental illness over the course of their childhood or adolescence compared to the general population. If a parent suffers from mental illness, the child is two to three times more likely to be mentally ill as well, with the risk elevating to a fivefold when both parents are affected The results of this study s underline the importance of personalized interventions in terms of parental symptom severity to minimize negative outcomes for children and the whole family.
Journal: Psychology 2024
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| | Imaging findings of primary lung tumors in children | Imaging findings of primary lung tumors in children
Imaging findings of primary lung tumors in children
Overview
Pediatric lung tumors are primarily discussed in the surgical literature. However, there is limited research on their imaging findings, and only a few tumor types have been documented. This article aims to describe the imaging features of primary lung tumors in children. Primary lung tumors are uncommon in children and have a different histologic spectrum than adult lung tumors, which changes with age. Metastases and congenital lung masses constitute a substantial proportion of lung neoplasms in children. The incidence of primary, metastatic, and congenital/inflammatory lesions is reported to be 1:5:60. The most prevalent metastatic tumors in the lungs are Wilms tumor and osteosarcoma. Primary lung masses may be located in the tracheobronchial tree or parenchyma. Additionally, parenchymal involvement may occur secondarily through local invasion of mediastinal or chest wall masses. The symptoms associated with lung masses are non-specific, and there is no correlation between tumor size and malignancy. The most common tumors observed in this study were IMT and PPB, respectively. IMT is highly associated with calcification.
Journal
Diagnostic and Interventional Radiology
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| | Autism Spectrum Screening Checklist (ASSC): The Development of a Scale to Identify High-Risk Individuals within the Children’s Mental Health System | Autism Spectrum Screening Checklist (ASSC): The Development of a Scale to Identify High-Risk Individuals within the Children’s Mental Health System
Autism Spectrum Screening Checklist (ASSC): The Development of a Scale to Identify High-Risk Individuals within the Children’s Mental Health System
Overview Autism Spectrum Disorder (ASD) is a complex childhood onset neurodevelopmental disorder that has become the fastest growing developmental disability. Due to the increased demand for diagnostic assessments and subsequent increased wait times, standardized screening as part of regular clinical practice is needed. More specifically there is an important need for the development of a more streamlined screening tool within an existing assessment system to identify those at greatest risk of having ASD. The ASSC scale provides an initial screen to help identify children and youth at heightened risk for autism within larger populations being assessed as part of routine practice. The main goal for the development and implementation of the ASSC scale is to harness the power of the existing interRAl assessment system to provide a more efficient, effective screening and referral process. This will ultimately help improve patient outcomes through needs-based care.
Journal Frontiers in Psychiatry Volume 12 | 3 | | R495.00 | |
| | Learning Disabilities Elevate Children’s Risk for Behavioral-Emotional Problems | Learning Disabilities Elevate Children’s Risk for Behavioral-Emotional Problems
Learning Disabilities Elevate Children’s Risk for Behavioral-Emotional Problems
Overview
Our purpose was to study the frequency of behavioural-emotional problems among children identified with a learning disability (LD).
The study analysed the effect of the severity of LD and gender on the number of behavioural-emotional symptoms reported by teachers and parents. Alarmingly high percentages of children, irrespective of LD type, demonstrated behavioural-emotional problems: more than 37% in Affective, Anxiety, and Attention- Deficit/Hyperactivity Disorder (ADHD) problems. Contextual variation was large, as more problems were reported by teachers than by mothers. The unique effects of gender and LD type were rare, but the results raised concern for those with MD-only, especially boys. The results underscore the need to draw attention to the importance of assessing children with LD for behavioural-emotional problems and emphasize the importance of teachers’ awareness of behavioural-emotional problems among students with LD and cooperation among child, teacher, and parents in assessment and support planning.
Journal: Journal of learning Disabilities 2022 Volume 55 Issue 6
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| | Visual outcomes and safety profile of intraocular lens implantation versus aphakia in children with microspherophakia with no subluxation | Visual outcomes and safety profile of intraocular lens implantation versus aphakia in children with microspherophakia with no subluxation
Visual outcomes and safety profile of intraocular lens implantation versus aphakia in children with microspherophakia with no subluxation
Overview The objective of this is to study the visual, refractive and surgical outcomes of intraocular lens (IOL) implantation versus aphakia in children with microspherophakia. Retrospective, comparative, non-randomised interventional study. Methods: All consecutive children with microspherophakia who satisfied the inclusion criteria were included. The eyes that underwent in-the-bag IOL implantation and those that were left aphakic were included in groups A and B, respectively. The postoperative visual outcomes, IOL stability and complications during the follow-up period were studied. The survival analysis (p value 0.18) was comparable in each group and in conclusion In-the-bag IOL is an option, which can be considered in selected cases of microspherophakia in developing nations where regular follow-up and economic constraints are a major concern.
Journal BMJ Open Ophthalmology – Pediatric Ophthalmology Volume 8 – Issue 1 | 3 | | R465.00 | |
| | Telemedicine for Pediatric Nephrology: Perspectives on COVID-19, Future Practices, and Work Flow Changes | Telemedicine for Pediatric Nephrology: Perspectives on COVID-19, Future Practices, and Work Flow Changes
Telemedicine for Pediatric Nephrology: Perspectives on COVID-19, Future Practices, and Work Flow Changes
Overview Although the use of telemedicine in rural areas has increased steadily over the years, its use was rapidly implemented during the onset of the coronavirus disease 2019 (COVID-19) crisis. Due to this rapid implementation, there is a lack of standardized work flows to assess and treat for various nephrotic conditions, symptoms, treatment modalities, and transition processes in the pediatric population. To provide a foundation/suggestion for future standardized workflows, the authors of this report have developed standardized workflows using the Delphi method. These workflows were informed based on results from cross-sectional surveys directed to patients and providers. Most patients and providers were satisfied, 87% and 71%, respectively, with their telemedicine visits. Common issues that were raised with the use of telemedicine included difficulty procuring physical laboratory results and a lack of personal warmth during telemedicine visits. The workflows created based on these suggestions will both enhance safety in treating patients and allow for the best possible care.
Authors Rupesh Raina, Nikhil Nair, Aditya Sharma, Ronith Chakraborty, and Sarah Rush, Delphi Panelists | 3 | | R465.00 | |
| | An Implicit–Explicit Framework for Intervention Methods in Developmental Language Disorder | An Implicit–Explicit Framework for Intervention Methods in Developmental Language Disorder
An Implicit–Explicit Framework for Intervention Methods in Developmental Language Disorder
Overview
The growing interest in framing intervention approaches as either implicit or explicit calls for a discussion of what makes intervention approaches engage each of these learning systems, with the goal of achieving a shared framework. This tutorial presents evidence for the interaction between implicit and explicit learning systems, and it highlights the intervention characteristics that promote implicit or explicit learning as well as outcome measures that tap into implicit or explicit knowledge. This framework is then applied to eight common intervention approaches and notable combinations of approaches to unpack their differential engagement of implicit and explicit learning.
Many intervention characteristics (e.g., instructions, elicitation techniques, feedback) can be manipulated to move an intervention along the implicit–explicit continuum. Given the bias for using explicit learning strategies that develops throughout childhood and into adulthood, clinicians should be aware that most interventions (even those that promote implicit learning) will engage the explicit learning system. However, increased awareness of the implicit and explicit learning systems and their cognitive demands will allow clinicians to choose the most appropriate intervention for the target behaviour. | 3 | | R485.00 | |
| | Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review | Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review
Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review
Overview
The purpose of this study was to investigate comorbidity prevalence and patterns in childhood apraxia of speech (CAS) and their relationship to severity. In this retroactive cross-sectional study, medical communication-related comorbidities were regressed on CAS severity as rated by speech-language pathologists during diagnosis. The relationship between CAS severity and the presence of four common comorbid conditions was also examined using ordinal or multinomial regressions. Children with comorbid intellectual disability (78.1%), receptive language impairment (72.5%), and nonspeech apraxia (37.3%; including limb, nonspeech oromotor, and oculomotor these comorbidities. However, children with comorbid autism spectrum disorder (33.6%) were no more likely to have severe CAS than children without autism.
Comorbidity appears to be the rule, rather than the exception, for children with CAS. Comorbid intellectual disability, receptive language impairment, and nonspeech apraxia confer additional risk for more severe forms of CAS. Findings are limited by being from a convenience sample of participants but inform future models of comorbidity.
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| | Childhood Adverse Events and the Long-Term Effects on Mental Health | Childhood Adverse Events and the Long-Term Effects on Mental Health
Childhood Adverse Events and the Long-Term Effects on Mental Health
There has long been an association between family history and mental illness; however, recently researchers have focused on the correlation between childhood adverse events and mood disorders, specifically bipolar disorder. This study shows there is a strong correlation between CAE and PB, specifically, sexual abuse in females, maternal separation, economic difficulty and a family history of mental illness.
The findings suggest that females that experience childhood adverse events may be at a higher risk for developing bipolar disorder and the clinical outcome of bipolar disorder may also be affected by the type and number of childhood adverse events.
The results also suggest that schizophrenic spectrum disorders, bipolar disorder and major depressive disorder are associated with different childhood adverse events. Females who have recollections of childhood abuse are at an increased risk for depressive symptoms associated with bipolar disorder. Psychosocial interventions that are geared towards limiting childhood adverse events may reduce the incidence of mental illness, specifically bipolar disorder. | 3 | | R465.00 | |
| | 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
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| | Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation | Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation
Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation
Overview
The poor physical health of people with mental illness has long been established. A 15–20-year mortality gap arises from factors such as the likelihood of developing noncommunicable diseases, unhealthy lifestyle behaviors, reduced access to and provision of physical health care, and side-effects of medication.
This has been labeled an international human rights scandal, since a large proportion of this risk is preventable. In recognition of these disparities, international health bodies have produced guidance to address poor physical health, including the World Health Organization, World Psychiatric Association, and a Lancet Psychiatry Commission.
The use of physical activity interventions in mental health care for adults has a large academic evidence base and numerous examples of real-world implementation. However, the use of physical activity within mental health care for children and young people (CYP) has received less attention to date.
The key conclusions from this article, suggest there is an increasingly strong evidence base for the benefits of using physical activity interventions to improve, prevent, and manage physical and mental health outcomes in CYP with mental illness. However, more work needs to be done to improve the evidence base, refine its implementation into standard mental health care, and develop strategies for large-scale dissemination of such interventions across various care and cultural contexts.
The Association for Child and Adolescent Mental Health JCPP Advances | 3 | | R485.00 | |
| | 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 | |
| | 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
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| | 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.
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| | 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.
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| | Septic Shock Part 1 | Septic 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 | |
| | 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.
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.
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.
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.
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.
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | 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 | |
| | 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
| 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
| 3 | | R460.00 | |