Sample records for common pediatric problems

  1. Negative Affectivity is Common to Pediatric Behavioral Health Problems

    Directory of Open Access Journals (Sweden)

    Simone Behar


    Full Text Available A significant number of youth in the United States experience mental illness; within these youth, comorbidity is considered the rule, not the exception. Rather than treat each disorder distinctly, recent research examines common psychopathological processes shaping various presenting problems to simultaneously target deficits and excesses. Contemporary research hypothesizes that negative affectivity pervades multiple psychiatric problems in youth. The present study sought to examine negative affectivity in an intent-to-treat sample of young patients presenting at an outpatient clinic in an academic medical center. Young patients (n=54 with internalizing disorders, externalizing disorders, or both completed the Children’s Depression Inventory and the Screen for Childhood Anxiety and Related Emotional Disorders. MANOVA results indicated no significant difference between the groups. Additionally, no gender differences were found. Findings suggest negative affectivity is a core feature of psychopathology in general, and thus a valuable focus for transdiagnostic treatments.

  2. Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems. (United States)

    D'Alessandro, Donna; Kingsley, Peggy


    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library ( used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

  3. Common pediatric epilepsy syndromes. (United States)

    Park, Jun T; Shahid, Asim M; Jammoul, Adham


    Benign rolandic epilepsy (BRE), childhood idiopathic occipital epilepsy (CIOE), childhood absence epilepsy (CAE), and juvenile myoclonic epilepsy (JME) are some of the common epilepsy syndromes in the pediatric age group. Among the four, BRE is the most commonly encountered. BRE remits by age 16 years with many children requiring no treatment. Seizures in CAE also remit at the rate of approximately 80%; whereas, JME is considered a lifelong condition even with the use of antiepileptic drugs (AEDs). Neonates and infants may also present with seizures that are self-limited with no associated psychomotor disturbances. Benign familial neonatal convulsions caused by a channelopathy, and inherited in an autosomal dominant manner, have a favorable outcome with spontaneous resolution. Benign idiopathic neonatal seizures, also referred to as "fifth-day fits," are an example of another epilepsy syndrome in infants that carries a good prognosis. BRE, CIOE, benign familial neonatal convulsions, benign idiopathic neonatal seizures, and benign myoclonic epilepsy in infancy are characterized as "benign" idiopathic age-related epilepsies as they have favorable implications, no structural brain abnormality, are sensitive to AEDs, have a high remission rate, and have no associated psychomotor disturbances. However, sometimes selected patients may have associated comorbidities such as cognitive and language delay for which the term "benign" may not be appropriate.

  4. Complications in common general pediatric surgery procedures. (United States)

    Linnaus, Maria E; Ostlie, Daniel J


    Complications related to general pediatric surgery procedures are a major concern for pediatric surgeons and their patients. Although infrequent, when they occur the consequences can lead to significant morbidity and psychosocial stress. The purpose of this article is to discuss the common complications encountered during several common pediatric general surgery procedures including inguinal hernia repair (open and laparoscopic), umbilical hernia repair, laparoscopic pyloromyotomy, and laparoscopic appendectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Halitosis. A common problem]. (United States)

    Laine, M L; Slot, D E; Danser, M M


    Halitosis is a frequently occurring problem, the cause of which is generally to be found in the mouth. The challenge for oral health care providers is to diagnose it correctly and treat it effectively. Differential diagnosis is of great importance in making a distinction between halitosis which originates in the mouth and which does not originate in the mouth. Oral halitosis can be treated effectively by good oral health care. Plaque accumulation on the tongue is the most common cause of oral halitosis. Tongue cleansing, possibly in combination with a specific mouth wash, is consequently recommended as an element of oral hygiene care. Other oral health problems, such as periodontal disease, caries and ill-fitting removable dentures should be treated adequately to eliminate these problems as potential causes of halitosis.

  6. Common Sleep Problems (For Teens) (United States)

    ... Can I Help Someone Who's Being Bullied? Volunteering Common Sleep Problems KidsHealth > For Teens > Common Sleep Problems Print A A A What's in ... insomnia — trouble falling or staying asleep. The most common cause of insomnia is stress . But all sorts ...

  7. Radiographic evaluation of common pediatric elbow injuries

    Directory of Open Access Journals (Sweden)

    Steven F. DeFroda


    Full Text Available Normal variations in anatomy in the skeletally immature patient may be mistaken for fracture or injury due to the presence of secondary centers of ossification. Variations in imaging exist from patient to patient based on sex, age, and may even vary from one extremity to the other on the same patient. Despite differences in the appearance of the bony anatomy of the elbow there are certain landmarks and relationships, which can help, distinguish normal from abnormal. We review common radiographic parameters and pitfalls associated in the evaluation of pediatric elbow imaging. We also review common clinical diagnoses in this population.

  8. Data Commons to Support Pediatric Cancer Research. (United States)

    Volchenboum, Samuel L; Cox, Suzanne M; Heath, Allison; Resnick, Adam; Cohn, Susan L; Grossman, Robert


    The falling costs and increasing fidelity of high-throughput biomedical research data have led to a renaissance in cancer surveillance and treatment. Yet, the amount, velocity, and complexity of these data have overcome the capacity of the increasing number of researchers collecting and analyzing this information. By centralizing the data, processing power, and tools, there is a valuable opportunity to share resources and thus increase the efficiency, power, and impact of research. Herein, we describe current data commons and how they operate in the oncology landscape, including an overview of the International Neuroblastoma Risk Group data commons as a paradigm case. We outline the practical steps and considerations in building data commons. Finally, we discuss the unique opportunities and benefits of creating a data commons within the context of pediatric cancer research, highlighting the particular advantages for clinical oncology and suggested next steps.

  9. The Commons Problem: Alternative Perspectives. (United States)

    Edney, Julian J.


    Reviews four contrasting theories bearing on the concept of the commons dilemma, which deals with conflicts of individual v group interests over time. Focuses on the threats that commons problems pose to democratic principles in community structure. Discusses alternative directions for the resolution of resource crises. (Author/GC)

  10. The pediatric vaccine stockpiling problem. (United States)

    Truong, Van-Anh


    The U.S. has experienced many major interruptions of its pediatric vaccine production in the past decade. The Centers for Disease Control and Prevention (CDC) copes with these shortages by building a national stockpile of pediatric vaccines, which it makes accessible to the public in the event of a shortage. The management of this stockpile is difficult due to limited production capacity and long and unpredictable production interruptions. In this paper, we address policies for managing the stockpile. We provide sufficient conditions for the optimal policy to be a modified state-dependent base-stock policy, with the base-stock level decreasing in the pipeline inventory. Since the optimal policy is in general difficult to evaluate, we derive bounds on the optimal decision in each period. We develop an efficient policy that performs on average within 1% of optimality in simulations. We show that stocking the same supply of vaccine of every type can be over-conservative in some cases, and inadequate in others by large factors. We also quantify the substantial reduction in inventory level that can be achieved when there are multiple suppliers in the market. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Common Problems That Can Affect Your Voice (United States)

    ... near you Common Problems That Can Affect Your Voice Common Problems That Can Affect Your Voice Patient ... that traditionally accompany gastro esophageal reflux disease (GERD). Voice Misuse and Overuse Speaking is a physical task ...


    Directory of Open Access Journals (Sweden)

    Witold Landowski


    Full Text Available The main purpose of this article is to discuss the relation between the understanding of human being and the concept of common good. On the one hand, materialist and spiritualist concepts of man lead to the univocal understanding of bonum commune, on the other hand, dualist anthropology entails a breakdown of the unity of common good. The author reveals weak points of these approaches and undertakes an attempt of examining realist vision of man and its impact on the notion of bonum commune. He starts with analyzing the complex structure of human being, which includes the potential and actual nature of human person. Against the background of the personalist anthropology, the author concludes that the common good has not only a material or instrumental, but above all a personal dimension, which makes this good both common and non-antagonistic. [The article written in Polish

  13. Pediatric Acute Q Fever Mimics Other Common Childhood Illnesses (United States)

    Bart, Ingeborg Y.; Schabos, Yvonne; van Hout, Roeland W. N. M.; Leenders, Alexander C. A. P.; de Vries, Esther


    Knowledge of Q fever has increased over the last decades, but research has mainly focused on adults. Data in children are scarce, and current knowledge is mostly based on case reports. The aim of this study was to determine predictors for acute Q fever in children in the general population. We retrospectively studied all children tested for Coxiella burnetii by serology and/or PCR upon request of their general practitioner in the regional laboratory for Medical Microbiology of the Jeroen Bosch during the Q fever outbreak in the Netherlands between 2007 and 2011. A total of 1061 patients was analyzed. Influenza-like illness and respiratory tract infection were the most common presentations of acute Q fever, mimicking other common childhood illnesses. None of the reported symptoms was significantly related to a positive test outcome and therefore presenting signs or symptoms have no predictive value in diagnosing Q-fever in children. Only diagnostic tests are reliable. As the infection generally follows a mild and uncomplicated course, we question if the difficulty of recognizing pediatric Q fever is a problem worth solving. PMID:24520412

  14. Common Core: Solve Math Problems (United States)

    Strom, Erich


    The new common core standards for mathematics demand that students (and teachers!) exhibit deeper conceptual understanding. That's music to the ears of education professor John Tapper, who says teachers have overemphasized teaching procedures--and getting right answers. In his new book, "Solving for Why," he makes a powerful case for moving beyond…

  15. Common problems in endurance athletes. (United States)

    Cosca, David D; Navazio, Franco


    Endurance athletes alternate periods of intensive physical training with periods of rest and recovery to improve performance. An imbalance caused by overly intensive training and inadequate recovery leads to a breakdown in tissue reparative mechanisms and eventually to overuse injuries. Tendon overuse injury is degenerative rather than inflammatory. Tendinopathy is often slow to resolve and responds inconsistently to anti-inflammatory agents. Common overuse injuries in runners and other endurance athletes include patellofemoral pain syndrome, iliotibial band friction syndrome, medial tibial stress syndrome, Achilles tendinopathy, plantar fasciitis, and lower extremity stress fractures. These injuries are treated with relative rest, usually accompanied by a rehabilitative exercise program. Cyclists may benefit from evaluation on their bicycles and subsequent adjustment of seat height, cycling position, or pedal system. Endurance athletes also are susceptible to exercise-associated medical conditions, including exercise-induced asthma, exercise-associated collapse, and overtraining syndrome. These conditions are treatable or preventable with appropriate medical intervention. Dilutional hyponatremia is increasingly encountered in athletes participating in marathons and triathlons. This condition is related to overhydration with hypotonic fluids and may be preventable with guidance on appropriate fluid intake during competition.

  16. Congenital nasolacrimal duct obstruction: common management policies among pediatric ophthalmologists. (United States)

    Dotan, Gad; Nelson, Leonard B


    To study common management policies of congenital nasolacrimal duct obstruction (CNDLO) among pediatric ophthalmologists. A 21-question survey was sent to members of the American Association for Pediatric Ophthalmology and Strabismus in April 2014. The questions focused on treatment of CNLDO during the first year of life, primary and secondary surgical interventions, surgical techniques, and amblyopia assessment. One hundred twenty-seven members completed the survey and 121 responses were analyzed after replies of 6 candidates in training were excluded. Eighty-two percent of respondents instructed caregivers to massage the nasolacrimal duct during the first year of life; however, 55% did not perform the Crigler massage in the office. Outpatient probing was done by 17% of pediatric ophthalmologists who took the survey, almost all of whom (95%) have been in practice more than 10 years. Ninety-one percent recommended surgery for CNLDO close to the age of 1 year and 79% performed probing as initial treatment at that age. If treatment is delayed to the age of 2 years, 53% favored silicone tube intubation and/or balloon dacryoplasty. Following failed probing, silicone tube intubation was performed by 51% of practitioners. Ninety-one percent of respondents routinely checked refraction of infants with CNLDO and recommended reexamination even if initial assessment was entirely normal. This study highlights the striking lack of consensus among pediatric ophthalmologists in many aspects of management of CNLDO and allows practitioners to compare their practice patterns regarding CNLDO management with those of their peers; however, because it provides only the opinions of a limited group of pediatric ophthalmologists, it does not imply that less common practices are wrong. Copyright 2015, SLACK Incorporated.

  17. Electronic application in pediatric triage station system and the common problems of processing%电子叫号系统在儿科分诊中的应用及常见问题处理

    Institute of Scientific and Technical Information of China (English)



    Pediatric clinics to improve the environment, improve service quality and work efficiency, our hospital implemented the pediatric outpatient electronic triage station system, thus build the good environment treatment, improved the triage accuracy, reduce work and psychological pressure of nurses, nurses by correctly handling the problems of the electronic station system, make it play a better role, build a harmonious relationship between nurses and patients.%为改善儿科门诊就诊环境,提高服务质量及工作效率,我院实施了儿科门诊电子叫号系统分诊,由此构建了良好的就诊环境,提高了分诊正确率,减轻了护士工作及心理压力。护士通过正确处理电子叫号系统中的问题,使其更好地发挥了作用,构建了和谐的护患关系。

  18. [Typical problems in pediatric emergencies: Possible solutions]. (United States)

    Heimberg, E; Heinzel, O; Hoffmann, F


    Pediatric emergencies are rare and challenging for health care providers, parents, and patients. The purpose of this article is to highlight typical difficulties in the treatment of pediatric patients and to discuss potential solutions. This article is based on a selective literature search using PubMed and the experience of the authors in the field of simulation and pediatric emergencies. Inexperience with pediatric emergencies, uncertainty in technical skills, in the usage of pediatric equipment and in medication dosage as well as parental presence foster the perception of stress and potentially compromise the success of patient care. Beside implementation of simplified technical skill devices (e.g., intraosseous vascular access system, supraglottic airway devices, and alternative approaches for drug administration), there have been many efforts in recent years to improve patient safety. Tools for estimating body weight and precalculated drug-dosing charts have been implemented as well as standardized courses for guidelines, technical skills, and team-related skills have been established. To improve patient safety, regular training and implementation of a sustainable safety culture are mandatory.

  19. Problems and preferences in pediatric imaging

    Directory of Open Access Journals (Sweden)

    Brij Bhushan Thukral


    Full Text Available Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them.

  20. Evidence into practice: pediatric orthopaedic surgeon use of removable splints for common pediatric fractures. (United States)

    Boutis, Kathy; Howard, Andrew; Constantine, Erika; Cuomo, Anna; Somji, Zeeshanefatema; Narayanan, Unni G


    Removable splints when compared with circumferential casts in randomized trials have been shown to be a safe and cost-effective method of managing many common minor distal radius and fibular fractures. This study estimated the extent to which this evidence is being implemented in clinical practice, and determined the perceived barriers to the adoption of this evidence. A cross-sectional survey of practicing orthopaedic surgeon members of the Pediatric Orthopedic Surgeons of North America (POSNA) was conducted, using a 22-item online questionnaire, and distributed using a modified Dillman technique. Survey questions were derived from and validated by literature review, expert opinion, and pilot-testing on the targeted sample before implementation. Of the 826 eligible participants, 558 (67.6%) responded to the survey. Of these, 505 (90.5%) had completed a fellowship in pediatric orthopaedics, 335 (60.0%) worked in a university-affiliated setting, and 377 (67.6%) had been in practice for pediatric orthopaedic surgeons to change practice in keeping with the best evidence for these common and stable injuries. Level II.

  1. Off-Label Drug Use in Pediatric Practice: Unsolved Problems

    Directory of Open Access Journals (Sweden)

    A. R. Titova


    Full Text Available The widespread «off-label» drug use and the prescribing of unlicensed medicines in pediatric practice is a major health problem. The authors discuss actual regulatory and legal issues of «off-label» drug use in children in the US, Europe and Russia. The results of different population-based studies from many countries, showing the structure and frequency of «off-label» drug use in children, are summarized in this article. It is shown that such practice increases the risk of adverse drug reactions. The authors offer practical recommendations for a safer use of drugs in pediatric practice. The priority issue is conducting high quality clinical trials with the participation of children, improving national pharmacovigilance and the monitoring of off-label drug use, developing pediatric formularies, improving doctors’ knowledge and awareness of safety and efficacy of medicines in pediatric population.

  2. Pediatric hearing loss: common causes, diagnosis and therapeutic approach. (United States)

    Alzahrani, M; Tabet, P; Saliba, I


    Pediatric hearing loss limits the child ability to develop effective auditory and speech capabilities. Early rehabilitation of hearing loss results in higher levels of linguistic, academic and social skills. To achieve the best outcomes, proper and timely diagnosis is essential. The etiology of hearing loss can be classified according to its nature as sensorineural hearing loss (SNHL), conductive hearing loss (CHL) or mixed hearing loss (MHL). Congenital hearing loss could be genetic or non genetic (acquired), syndromic or non-syndromic. Hearing loss can be classified according to the severity into mild (26-40 dB HL), moderate (41-70 dB HL), severe (71-90 dB HL) and profound (more than 90 dB HL). Management of hearing loss is mainly influenced by the nature, the bilaterality, the severity and the age at diagnosis. Severe to profound bilateral SNHL can be managed by cochlear implantation (unilateral or bilateral), if picked up at early age while mild to moderate bilateral SNHL are easier to manage with conventional hearing aids. CHL has less impact on the speech development of the child. It is usually managed by correcting the underlying etiology such as otitis media with effusion or even surgically in cases of external ear atresia or ossicular malformations. Unilateral SNHL have fortunately no impact on the language development of the child and can be passed undiagnosed until preschool-aged children. The implementation of national newborn hearing screening programs has improved the management of affected children by rehabilitating them at early stages to allow for normal speech development. In this review article, we aim to highlight the most common causes of pediatric hearing loss, their character and presentation and to review the diagnostic and therapeutic approaches of a deaf child.

  3. Developmental and behavioral problems in pediatric primary care : Early identification

    NARCIS (Netherlands)

    van den Heuvel, Mathilda


    This thesis focuses on the early identification of developmental and behavioral problems in pediatric primary care. The social environment is considered a fundamental determinant of early child development. In our study countries with generous redistributive policies had a better organization of ear

  4. Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging

    NARCIS (Netherlands)

    P. Ciet (Pierluigi); H.A.W.M. Tiddens (Harm); P.A. Wielopolski (Piotr); J.M. Wild (Jim); E.Y. Lee (Edward); G. Morana (Giovanni); M. Leguin (Maarten)


    textabstractPediatric chest MRI is challenging. High-resolution scans of the lungs and airways are compromised by long imaging times, low lung proton density and motion. Low signal is a problem of normal lung. Lung abnormalities commonly cause increased signal intenstities. Among the most important

  5. Pediatrics (United States)

    Spackman, T. J.


    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  6. Hemorrhagic corpus luteum cysts: an unusual problem for pediatric surgeons. (United States)

    Spinelli, C; Di Giacomo, M; Mucci, N; Massart, F


    Hemorrhagic corpus luteum cysts (HCLC) constitute a common disorder in pediatric subjects undergoing surgical intervention. HCLCs especially develop in the early period after menarche, and they are commonly associated with dysfunctional ovulation. Retrospective analysis of surgery outcome of HCLC patients. Pediatric Surgery Unit, S. Chiara University Hospital. 13 girls with HCLC diagnosis. Surgical treatment of HCLCs. We reviewed the clinical presentation and outcome of 13 post-menarcheal girls surgically treated for HCLCs in the Pediatric Surgical Unit from 2002 to 2006. Primary presentation was persistent abdominal pain in 84.6% and acute abdominal pain in 15.4% of patients, respectively. Ultrasound examination showed complex ovarian masses in 77.23% cases and simple ovarian masses in 33.7% cases, respectively. Although laparoscopic excision of HCLC was performed in more than 45% cases, laparotomic approach was commonly required. After conservative surgery, ovarian size and viability were normal, as assessed by 6-month ultrasound scan. No recurrences of disease and regular menses were reported at 2 years follow-up. In pediatric subjects with HCLC that required surgical intervention, no complications or disorder recurrence were reported. In order to preserve ovarian function, conservative surgery has to be performed whenever feasible.

  7. Common ground, complex problems and decision making

    NARCIS (Netherlands)

    Beers, P.J.; Boshuizen, H.P.A.; Kirschner, P.A.; Gijselaers, W.H.


    Organisations increasingly have to deal with complex problems. They often use multidisciplinary teams to cope with such problems where different team members have different perspectives on the problem, different individual knowledge and skills, and different approaches on how to solve the problem. I

  8. MO-DE-207-04: Imaging educational program on solutions to common pediatric imaging challenges

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    Krishnamurthy, R. [Texas Children’s Hospital: Pediatric MRI Quality, Artifacts, and Safety (United States)


    This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children’s hospitals. The educational program will begin with a detailed discussion of the optimal configuration of fluoroscopes for general pediatric procedures. Following this introduction will be a focused discussion on the utility of Dual Energy CT for imaging children. The third lecture will address the substantial challenge of obtaining consistent image post -processing in pediatric digital radiography. The fourth and final lecture will address best practices in pediatric MRI including a discussion of ancillary methods to reduce sedation and anesthesia rates. Learning Objectives: To learn techniques for optimizing radiation dose and image quality in pediatric fluoroscopy To become familiar with the unique challenges and applications of Dual Energy CT in pediatric imaging To learn solutions for consistent post-processing quality in pediatric digital radiography To understand the key components of an effective MRI safety and quality program for the pediatric practice.

  9. common problems affecting supranational attempts in africa

    African Journals Online (AJOL)


    some of the common challenges, as evident in the foregoing analysis, facing ... direct binding effect of laws emanating from regional organisations on ... remains the apical decision-making body on matters relating to foreign policy, justice ... exercises supranational powers especially in relation to voting rules in the General.

  10. Addressing some Common Problems in Transcript Analysis

    Directory of Open Access Journals (Sweden)

    Patrick J. Fahy


    Full Text Available Computer conferencing is one of the more useful parts of computer-mediated communications (CMC, and is virtually ubiquitous in distance education. The temptation to analyze the resulting interaction has resulted in only partial success, however (Henri, 1992; Kanuka and Anderson, 1998; Rourke, Anderson, Garrison and Archer, 1999; Fahy, Crawford, Ally, Cookson, Keller and Prosser, 2000. Some suggest the problem is made more complex by failings of both technique and, more seriously, theory capable of guiding transcript analysis research (Gunawardena, Lowe and Anderson, 1997.We have previously described development and pilot-testing of an instrument and a process for transcript analysis, call the the TAT (Transcript Analysis Tool, based on a model originally developed by Zhu (1996. We found that the instrument and coding procedures used provided acceptable – sometimes excellent – levels of interrater reliability (varying from 70 percent to 94 percent in pilot applications, depending upon user training and practice with the instrument, and that results of pilots indicated the TAT discriminated well among the various types of statements found in online conferences (Fahy, et al., 2000.

  11. Constipation: A common problem in childhood

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    Bukarica Svetlana


    Full Text Available Introduction Constipation in children is defined as the infrequent and difficult passage of hard stool, not necessarily associated with infrequent stools. All healthy newborns have their first stool within the first 24 to 48 hours after birth. Intestinal transit time increases with age, therapy decreasing the frequency of stooling. Anatomy and Physiology of Anus and Rectum Acquisition of fecal continence requires: normal internal and external anal sphincters, puborectal muscle as well as intact sensory input from both the rectal vault and anal canal. Etiology and Differential Diagnosis During the first year of life, failure to have bowel movement every other day warrants evaluation. During infancy, constipation is usually due to dietary manipulations, malnutrition or some other functional abnormalities. Anatomic causes are found only in 5% of patients. Diagnosis and Therapy Diagnosis relies on history and physical examination. Digital rectal examination usually reveals a shorter anal canal with decreased sphincter tone. The rectal ampulla is dilated and filled with stool. Anorectal manometry is helpful in differentiating functional constipation from aganglionosis or other neurologic problems. Treatment varies depending on the underlying cause. Bowel retraining, aimed at establishing regular daily bowel movement, is of utmost importance in children. The response to treatment is usually dramatic. Conclusion Constipation in children causes anxiety in the family and successful treatment requires persistent reassurance and repeated reevaluation.

  12. Common musculoskeletal problems in the performing artist. (United States)

    Hansen, Pamela A; Reed, Kristi


    In this chapter we touched on a wide variety of unique musculoskeletal conditions in the musician and dancer. We outlined generalized methods of evaluation that stress the importance of the interdisciplinary approach in this highly specialized patient population and stressed the importance of specific involvement of the music or dance instructor in evaluation and management. We sought to emphasize the need to refer to specialized care early when in doubt of diagnosis or when usual first-line treatments fail. We gave examples of specific injury patterns common in these subgroups and suggestions for early management. Finally, we described some general principals for prevention of musculoskeletal injury in this group. A physician treating the performing artist must always keep in mind that in this unique patient population, their occupation is not only a means of earning a living, it is their passion. Artists make great sacrifice both physically and mentally to bring the world such immeasurable beauty. It is our responsibility to care for them in the most comprehensive and compassionate manner possible while informing them as honestly as possible about their treatment options.

  13. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites

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    Bisset, George S.; Crowe, James [Texas Children' s Hospital, Pediatric Radiology, Houston, TX (United States)


    Extremity pain represents one of the most common reasons for obtaining conventional radiographs in childhood. Despite the frequency of these examinations little is known about the incidence of diagnostic errors by interpreting pediatric radiologists. The purpose of this study was to develop a standard error rate of pediatric radiologists by double-reading of extremity radiographs (elbow, wrists, knees and ankles) in children presenting with a history of trauma or pain. During a 6-month period all major extremity radiographs (excluding digits) obtained at a large pediatric referral hospital for evaluation of pain or trauma were reviewed by two senior pediatric radiologists and compared to the official interpretation. All radiographs were interpreted initially by a board-certified pediatric radiologist with a Certificate of Added Qualification (CAQ). We reviewed 3,865 radiographic series in children and young adults 2-20 years of age. We tabulated misses and overcalls. We did not assess the clinical significance of the errors. There were 61 miss errors and 44 overcalls in 1,235 abnormal cases and 2,630 normal cases, for a 1.6% miss rate and a 1.1% overcall rate. Misses and overcalls were most common in the ankle. Interpretive errors by pediatric radiologists reviewing certain musculoskeletal radiographs are relatively infrequent. Diagnostic errors in the form of a miss or overcall occurred in 2.7% of the radiographs. (orig.)

  14. Common Occupational Health Problems In Disease Control In Nigeria

    African Journals Online (AJOL)

    Common Occupational Health Problems In Disease Control In Nigeria. ... laboratories, hazardous gases like ethylene oxide and nitrous oxides; physical agents like ... When duely exposed, health workers are at high risk of health problems like ...

  15. The Association between Pediatric NAFLD and Common Genetic Variants

    Directory of Open Access Journals (Sweden)

    Giuseppina Rosaria Umano


    Full Text Available Non-alcoholic fatty liver disease (NAFLD is one of the most common complications of obesity. Several studies have shown that genetic predisposition probably plays an important role in its pathogenesis. In fact, in the last few years a large number of genetic studies have provided compelling evidence that some gene variants, especially those in genes encoding proteins regulating lipid metabolism, are associated with intra-hepatic fat accumulation. Here we provide a comprehensive review of the gene variants that have affected the natural history of the disease.

  16. Methylisothiazolinone: An Emergent Allergen in Common Pediatric Skin Care Products

    Directory of Open Access Journals (Sweden)

    Megan J. Schlichte


    Full Text Available Recalcitrant dermatitis, such as that of the hands, face, or genitals, may be due to allergic contact dermatitis (ACD from ingredients in seemingly innocuous personal care products. Rising rates of allergy have been noted due to the preservative methylisothiazolinone (MI. This preservative is commonly found in skin and hair care products, especially wipes. This study evaluated the use of MI in products specifically marketed for babies and children and examined the associated marketing terms of such products. Ingredients of skin care products specifically marketed for babies and children were surveyed at two major retailers. Of 152 products surveyed, 30 products contained MI. Categories of products surveyed included facial or body wipes, antibacterial hand wipes, hair products, soaps, bubble baths, moisturizers, and sunscreens. Facial or body wipes and hair products were the categories with the greatest number of MI-containing products. MI-containing products were manufactured by a number of popular brands. Of note, products marketed as “gentle,” “sensitive,” “organic,” or “hypoallergenic” often contained MI, thus emphasizing the importance of consumer scrutiny of product choices. These findings reinforce the importance of educating parents and providing consumer decision-making advice regarding common skin care products, in order to help prevent ACD in children.

  17. Sleep Problems as Consequence, Contributor, and Comorbidity: Introduction to the Special Issue on Sleep, Published in Coordination With Special Issues in Clinical Practice in Pediatric Psychology and Journal of Developmental and Behavioral Pediatrics. (United States)

    Beebe, Dean W


    Despite long-standing public and scientific interest in the phenomenon of sleep, the current decade has shown tremendous growth in our understanding of the sleep of children who have medical or developmental conditions. To accommodate, promote, and guide that growth, Journal of Pediatric Psychology, Clinical Practice in Pediatric Psychology, and Journal of Developmental and Behavioral Pediatrics have published coordinated special issues, encompassing >30 relevant articles. This article introduces the special issue in Journal of Pediatric Psychology, highlighting papers that illustrate how sleep problems are not only commonly comorbid with childhood medical and developmental conditions; they are also likely caused by and contribute to these conditions. In doing so, these coordinated special issues guide clinical care and reveal opportunities for future research. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail:

  18. Building a common pediatric research terminology for accelerating child health research. (United States)

    Kahn, Michael G; Bailey, L Charles; Forrest, Christopher B; Padula, Michael A; Hirschfeld, Steven


    Longitudinal observational clinical data on pediatric patients in electronic format is becoming widely available. A new era of multi-institutional data networks that study pediatric diseases and outcomes across disparate health delivery models and care settings are also enabling an innovative collaborative rapid improvement paradigm called the Learning Health System. However, the potential alignment of routine clinical care, observational clinical research, pragmatic clinical trials, and health systems improvement requires a data infrastructure capable of combining information from systems and workflows that historically have been isolated from each other. Removing barriers to integrating and reusing data collected in different settings will permit new opportunities to develop a more complete picture of a patient's care and to leverage data from related research studies. One key barrier is the lack of a common terminology that provides uniform definitions and descriptions of clinical observations and data. A well-characterized terminology ensures a common meaning and supports data reuse and integration. A common terminology allows studies to build upon previous findings and to reuse data collection tools and data management processes. We present the current state of terminology harmonization and describe a governance structure and mechanism for coordinating the development of a common pediatric research terminology that links to clinical terminologies and can be used to align existing terminologies. By reducing the barriers between clinical care and clinical research, a Learning Health System can leverage and reuse not only its own data resources but also broader extant data resources.

  19. Magnetic resonance imaging in children: common problems and possible solutions for lung and airways imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ciet, Pierluigi; Tiddens, Harm A.W.M. [Erasmus Medical Center, Department of Radiology, Sophia Children' s Hospital, Rotterdam (Netherlands); Erasmus Medical Center, Department of Pediatric Pulmonology and Allergology, Sophia Children' s Hospital, Rotterdam (Netherlands); Wielopolski, Piotr A. [Erasmus Medical Center, Department of Radiology, Sophia Children' s Hospital, Rotterdam (Netherlands); Wild, Jim M. [University of Sheffield, Academic Radiology, Sheffield (United Kingdom); Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Departments of Radiology and Medicine, Pulmonary Divisions, Boston, MA (United States); Morana, Giovanni [Ca' Foncello Regional Hospital, Department of Radiology, Treviso (Italy); Lequin, Maarten H. [University Medical Center, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands)


    Pediatric chest MRI is challenging. High-resolution scans of the lungs and airways are compromised by long imaging times, low lung proton density and motion. Low signal is a problem of normal lung. Lung abnormalities commonly cause increased signal intensities. Among the most important factors for a successful MRI is patient cooperation, so the long acquisition times make patient preparation crucial. Children usually have problems with long breath-holds and with the concept of quiet breathing. Young children are even more challenging because of higher cardiac and respiratory rates giving motion blurring. For these reasons, CT has often been preferred over MRI for chest pediatric imaging. Despite its drawbacks, MRI also has advantages over CT, which justifies its further development and clinical use. The most important advantage is the absence of ionizing radiation, which allows frequent scanning for short- and long-term follow-up studies of chronic diseases. Moreover, MRI allows assessment of functional aspects of the chest, such as lung perfusion and ventilation, or airways and diaphragm mechanics. In this review, we describe the most common MRI acquisition techniques on the verge of clinical translation, their problems and the possible solutions to make chest MRI feasible in children. (orig.)

  20. Bullying involvement in primary school and common health problems


    Wolke, D; Woods, S; Bloomfield, L; Karstadt, L


    AIMS—To examine the association of direct (e.g. hitting) and relational (e.g. hurtful manipulation of peer relationships) bullying experience with common health problems.
METHODS—A total of 1639 children (aged 6-9 years) in 31 primary schools were studied in a cross sectional study that assessed bullying with a structured child interview and common health problems using parent reports. Main outcome measures were common physical (e.g. colds/coughs) and psychosomatic (e.g. ...

  1. Usability Testing Finds Problems for Novice Users of Pediatric Portals (United States)

    Britto, Maria T.; Jimison, Holly B.; Munafo, Jennifer Knopf; Wissman, Jennifer; Rogers, Michelle L.; Hersh, William


    Objective Patient portals may improve pediatric chronic disease outcomes, but few have been rigorously evaluated for usability by parents. Using scenario-based testing with think-aloud protocols, we evaluated the usability of portals for parents of children with cystic fibrosis, diabetes or arthritis. Design Sixteen parents used a prototype and test data to complete 14 tasks followed by a validated satisfaction questionnaire. Three iterations of the prototype were used. Measurements During the usability testing, we measured the time it took participants to complete or give up on each task. Sessions were videotaped and content-analyzed for common themes. Following testing, participants completed the Computer Usability Satisfaction Questionnaire which measured their opinions on the efficiency of the system, its ease of use, and the likability of the system interface. A 7-point Likert scale was used, with seven indicating the highest possible satisfaction. Results Mean task completion times ranged from 73 (± 61) seconds to locate a document to 431 (± 286) seconds to graph laboratory results. Tasks such as graphing, location of data, requesting access, and data interpretation were challenging. Satisfaction was greatest for interface pleasantness (5.9 ± 0.7) and likeability (5.8 ± 0.6) and lowest for error messages (2.3 ± 1.2) and clarity of information (4.2 ± 1.4). Overall mean satisfaction scores improved between iteration one and three. Conclusions Despite parental involvement and prior heuristic testing, scenario-based testing demonstrated difficulties in navigation, medical language complexity, error recovery, and provider-based organizational schema. While such usability testing can be expensive, the current study demonstrates that it can assist in making healthcare system interfaces for laypersons more user-friendly and potentially more functional for patients and their families. PMID:19567793

  2. Evaluation of pediatric foot problems: Part I. The forefoot and the midfoot. (United States)

    Manusov, E G; Lillegard, W A; Raspa, R F; Epperly, T D


    Foot problems in children can be the result of infection, trauma or overuse. Ingrown toenails, bunions, sesamoid disease, congenital overriding of the fifth toe, and fractures may occur in both adults and children. Some disorders, such as Freiberg's infarction and Kohler's disease, however, are unique to the pediatric population. The potential for adverse sequelae is greater in children than in adults. A thorough understanding of the anatomy of the pediatric foot and a systematic examination will facilitate the diagnosis of pediatric foot problems. A conservative approach to management will improve both compliance and outcome.

  3. Pediatric Health Mobility: Is it Only an Italian Problem? (United States)

    Paolella, Giulia


    Intra-regional, extra-regional and international health mobility are important phenomena for regional and national healthcare planning. Pediatric data on this topic are scarce. We therefore conducted a systematic literature search on the PubMed database. Because of the insufficiency of published data we also resorted to conference proceedings and publications retrieved by Google Scholar and Google search engines. Thirty-one articles were identified. Main components of patients mobility were looking for better quality and timely treatment, advanced technology, expertise, and major organization. Our analysis highlights that pediatric mobility causes relevant medical, sociological and financial consequences.

  4. Relation Between Frailty and Common Geriatric Problems in Elderly

    Directory of Open Access Journals (Sweden)

    Moatassem S Amer*, Sarah A Hamza*, Tamer M Farid*, Samia A AbdelRahman*, Hoda M Farid*, Heba G Saber*,Enas R Mohamed*, Randa A Mabrouk


    Full Text Available Background: There is a high prevalence of common geriatric problems (falls, urinary incontinence, visual and hearing impairment among frail elderly leading to more disability and functional impairment. Objectives: The aim of this study is to compare the prevalence of common geriatric problems between frail and non-frail elderly. Design: A Case control study. Participants: 90 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 2 groups: Group A (30 frail elderly females and 30 frail elderly males and Group B (30 healthy elderly subjects; 15 males and 15 females.Measurements: Comprehensive geriatric assessment, including detailed history of common geriatric problems as mentioned above, physical examination, and also assessment of frailty using modified Fried criteria ].Results: Hearing impairment, incontinence and falls were more prevalent in frail elderly with a highly difference between the two groups, with p values< (0.001,0.009,0.006 consequently, visual impairment was statistically significant in cases more than controls with p value (0.012. Conclusion: There is a significant positive relationship and high prevalence of common geriatric problems especially falls, urinary incontinence, visual and hearing impairment among frail elderly.

  5. Neural network approach for solving the maximal common subgraph problem. (United States)

    Shoukry, A; Aboutabl, M


    A new formulation of the maximal common subgraph problem (MCSP), that is implemented using a two-stage Hopfield neural network, is given. Relative merits of this proposed formulation, with respect to current neural network-based solutions as well as classical sequential-search-based solutions, are discussed.

  6. Strong Convergence Theorems of Common Elements for Equilibrium Problems and Fixed Point Problems in Banach Spaces

    Institute of Scientific and Technical Information of China (English)

    Xing-hui GAO; Hai-yun ZHOU


    In this paper,we consider hybrid algorithms for finding common elements of the set of common fixed points of two families quasi-φ-non-expansive mappings and the set of solutions of an equilibrium problem.We establish strong convergence theorems of common elements in uniformly smooth and strictly convex Banach spaces with the property (K).

  7. Approximate solutions of common fixed-point problems

    CERN Document Server

    Zaslavski, Alexander J


    This book presents results on the convergence behavior of algorithms which are known as vital tools for solving convex feasibility problems and common fixed point problems. The main goal for us in dealing with a known computational error is to find what approximate solution can be obtained and how many iterates one needs to find it. According to know results, these algorithms should converge to a solution. In this exposition, these algorithms are studied, taking into account computational errors which remain consistent in practice. In this case the convergence to a solution does not take place. We show that our algorithms generate a good approximate solution if computational errors are bounded from above by a small positive constant. Beginning with an introduction, this monograph moves on to study: · dynamic string-averaging methods for common fixed point problems in a Hilbert space · dynamic string methods for common fixed point problems in a metric space · dynamic string-averaging version of the proximal...

  8. Common pediatric cerebellar tumors: correlation between cell densities and apparent diffusion coefficient metrics. (United States)

    Koral, Korgün; Mathis, Derek; Gimi, Barjor; Gargan, Lynn; Weprin, Bradley; Bowers, Daniel C; Margraf, Linda


    To test whether there is correlation between cell densities and apparent diffusion coefficient (ADC) metrics of common pediatric cerebellar tumors. This study was reviewed for issues of patient safety and confidentiality and was approved by the Institutional Review Board of the University of Texas Southwestern Medical Center and was compliant with HIPAA. The need for informed consent was waived. Ninety-five patients who had preoperative magnetic resonance imaging and surgical pathologic findings available between January 2003 and June 2011 were included. There were 37 pilocytic astrocytomas, 34 medulloblastomas (23 classic, eight desmoplastic-nodular, two large cell, one anaplastic), 17 ependymomas (13 World Health Organization [WHO] grade II, four WHO grade III), and seven atypical teratoid rhabdoid tumors. ADCs of solid tumor components and normal cerebellum were measured. Tumor-to-normal brain ADC ratios (hereafter, ADC ratio) were calculated. The medulloblastomas and ependymomas were subcategorized according to the latest WHO classification, and tumor cellularity was calculated. Correlation was sought between cell densities and mean tumor ADCs, minimum tumor ADCs, and ADC ratio. When all tumors were considered together, negative correlation was found between cellularity and mean tumor ADCs (ρ = -0.737, P correlation between cellularity and ADC ratio. Negative correlation was found between cellularity and minimum tumor ADC in atypical teratoid rhabdoid tumors (ρ = -0.786, P correlation was found between cellularity and mean tumor ADC and ADC ratio. There was no correlation between the ADC metrics and cellularity of the pilocytic astrocytomas, medulloblastomas, and ependymomas. Negative correlation was found between cellularity and ADC metrics of common pediatric cerebellar tumors. Although ADC metrics are useful in the preoperative diagnosis of common pediatric cerebellar tumors and this utility is generally attributed to differences in cellularity of tumors

  9. Sublinear Space Algorithms for the Longest Common Substring Problem

    DEFF Research Database (Denmark)

    Kociumaka, Tomasz; Starikovskaya, Tatiana; Vildhøj, Hjalte Wedel


    a new and very simple algorithm, which computes a τ-additive approximation to the LCS in O(n2/τ) time and O(1) space. We also show a time-space trade-off lower bound for deterministic branching programs, which implies that any deterministic RAM algorithm solving the LCS problem on documents from......, the use of linear space is impractical in many applications. In this paper we show that for any trade-off parameter 1 ≤ τ ≤ n, the LCS problem can be solved in O(τ) space and O(n2/τ) time, thus providing the first smooth deterministic time-space trade-off from constant to linear space. The result uses......Given m documents of total length n, we consider the problem of finding a longest string common to at least d ≥ 2 of the documents. This problem is known as the longest common substring (LCS) problem and has a classic O(n) space and O(n) time solution (Weiner [FOCS'73], Hui [CPM'92]). However...

  10. Migrant differences in adolescents’ medicine use for common health problems

    DEFF Research Database (Denmark)

    Cantarero Arevalo, Lourdes; Andersen, Anette; Holstein, Bjørn Evald


    Aim: Despite the substantial proportion of adolescents use medicine for common health problems, prevalence of medicine use among adolescents with migrant background have rarely been documented, and the causal pathway continue to be poorly understood. The aim was to examine whether there are migrant...... differences in adolescents’ medicine use for common health problems, and if feeling safe at school, as a non-exposure to discrimination, explained these differences. Methods: Data derived from the 2006 Danish contribution to the World Health Organization collaborative study Health Behaviour in School......-aged Children (HBSC). Medicine use for headache, stomach-ache, difficulties getting to sleep and nervousness and feeling safe at school were self-reported. The population included boys and girls from ages 11 to 15 who were enrolled in the cross-sectional study. Included were 8480 ethnic Danes, 508 descendants...

  11. Vertigo in neurological practice (common problems of diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Olga Vladimirovna Kosivtsova


    Full Text Available Most patients with vertigo seek neurological advice. In spite of the availability of current examination techniques, a differential diagnosis of vertigo is not frequently made. The paper discusses the terminology and classification of vertigo and clinical methods for diagnosing central and peripheral vestibulopathies. It considers the common problems of management of patients with diseases of the central and peripheral vestibular systems, the use of piracetam and other drugs to stimulate rehabilitation.

  12. Common problems and coping solutions of university students in Taiwan

    Directory of Open Access Journals (Sweden)

    Mei-Chin Lin


    Full Text Available University life of today is full of challenges. News of school involved bad incidents has all become too common. In Taiwan, students are also faced with many pressures and problems. Problems such as academic stress, future job uncertainty, and interpersonal relationships are just some of the interrelated complications easily found in universities. To address this issue, the current mixed-method study uses a series of focus group sessions in order to solicit the various issues surrounding students’ day to day in-campus life challenges and their corresponding coping strategies. A survey questionnaire was then formulated from the results of the focus group sessions. A total of 123 valid surveys were collected. Data collected were analyzed together with their corresponding demographical backgrounds such as: gender, year level of study, place of living, working or non-working students, and course of study. Results show that the common students’ related complications are health problems, future career issues, lessons and examinations, learning difficulties, self-efficacy issues, interpersonal difficulties, time management, and stress causing issues. Statistical analyses were accomplished resulting to significant students’ school problems determining background factors such as students’ course of study, gender, working or non-working students, and place of living. While no significant differences were found on the common students’ coping strategies. Lastly, there seems to be a high correlation between the students’ problems and coping strategies within the stress causing issues, suggesting that stress related issues to be the root cause of major complications for university students in Taiwan.

  13. Chemical reaction optimization for solving shortest common supersequence problem. (United States)

    Khaled Saifullah, C M; Rafiqul Islam, Md


    Shortest common supersequence (SCS) is a classical NP-hard problem, where a string to be constructed that is the supersequence of a given string set. The SCS problem has an enormous application of data compression, query optimization in the database and different bioinformatics activities. Due to NP-hardness, the exact algorithms fail to compute SCS for larger instances. Many heuristics and meta-heuristics approaches were proposed to solve this problem. In this paper, we propose a meta-heuristics approach based on chemical reaction optimization, CRO_SCS that is designed inspired by the nature of the chemical reactions. For different optimization problems like 0-1 knapsack, quadratic assignment, global numeric optimization problems CRO algorithm shows very good performance. We have redesigned the reaction operators and a new reform function to solve the SCS problem. The outcomes of the proposed CRO_SCS algorithm are compared with those of the enhanced beam search (IBS_SCS), deposition and reduction (DR), ant colony optimization (ACO) and artificial bee colony (ABC) algorithms. The length of supersequence, execution time and standard deviation of all related algorithms show that CRO_SCS gives better results on the average than all other algorithms.

  14. Problems in the educational process during the pediatric surgery area teaching of fourth year medicine students

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López


    Full Text Available Very typical situations of the Pediatric Surgery Services in the Pediatric Hospital of Cienfuegos may interfere with the appropriate development of the educational process. Consequently, students might not master the principles of medical practice in the most common surgical diseases in children, thus limiting its further application in their professional performances as basic general practitioners. To obtain more accurate information on the causes of this phenomenon is considered to be paramount in order to search for practical solutions to improve the educational process and to fulfil the goals of the teaching stage. The contents on the following information sources are analyzed in this paper: documents for higher education and for medicine career, publications and papers presented in scientific events (directly or indirectly related to the practice of Pediatric Surgery and hospital statistics. This review was aimed at analyzing the situations that negatively affect the educational process during the pediatric surgery area teaching of fourth year medicine students.

  15. Pediatric drug-related problems: a multicenter study in four French-speaking countries. (United States)

    Prot-Labarthe, Sonia; Di Paolo, Ermindo R; Lavoie, Annie; Quennery, Stefanie; Bussières, Jean-François; Brion, Françoise; Bourdon, Olivier


    Pediatric intensive care patients represent a population at high risk for drug-related problems. There are few studies that compare the activity of clinical pharmacists between countries. To describe the drug-related problems identified and interventions by four pharmacists in a pediatric cardiac and intensive care unit. Four pediatric centers in France, Quebec, Switzerland and Belgium. This was a six-month multicenter, descriptive and prospective study conducted from August 1, 2009 to January 31, 2010. Drug-related problems and clinical interventions were compiled from four pediatric centers in France, Quebec, Switzerland and Belgium. Data on patients, drugs, intervention, documentation, approval and estimated impact were compiled. Number and type of drug-related problems encountered in a large pediatric inpatient population. A total of 996 interventions were recorded: 238 (24 %) in France, 278 (28 %) in Quebec, 351 (35 %) in Switzerland and 129 (13 %) in Belgium. These interventions targeted 270 patients (median 21 months old, 53 % male): 88 (33 %) in France, 56 (21 %) in Quebec, 57 (21 %) in Switzerland and 69 (26 %) in Belgium. The main drug-related problems were inappropriate administration technique (29 %), untreated indication (25 %) and supra-therapeutic dose (11 %). The pharmacists' interventions were mostly optimizing the mode of administration (22 %), dose adjustment (20 %) and therapeutic monitoring (16 %). The two major drug classes that led to interventions were anti-infectives for systemic use (23 %) and digestive system and metabolism drugs (22 %). Interventions mainly involved residents and all clinical staff (21 %). Among the 878 (88 %) proposed interventions requiring physician approval, 860 (98 %) were accepted. This descriptive study illustrates drug-related problems and the ability of clinical pharmacists to identify and resolve them in pediatric intensive care units in four French-speaking countries.

  16. Commons problems, common ground: Earth-surface dynamics and the social-physical interdisciplinary frontier (United States)

    Lazarus, E.


    In the archetypal "tragedy of the commons" narrative, local farmers pasture their cows on the town common. Soon the common becomes crowded with cows, who graze it bare, and the arrangement of open access to a shared resource ultimately fails. The "tragedy" involves social and physical processes, but the denouement depends on who is telling the story. An economist might argue that the system collapses because each farmer always has a rational incentive to graze one more cow. An ecologist might remark that the rate of grass growth is an inherent control on the common's carrying capacity. And a geomorphologist might point out that processes of soil degradation almost always outstrip processes of soil production. Interdisciplinary research into human-environmental systems still tends to favor disciplinary vantages. In the context of Anthropocene grand challenges - including fundamental insight into dynamics of landscape resilience, and what the dominance of human activities means for processes of change and evolution on the Earth's surface - two disciplines in particular have more to talk about than they might think. Here, I use three examples - (1) beach nourishment, (2) upstream/downstream fluvial asymmetry, and (3) current and historical "land grabbing" - to illustrate a range of interconnections between physical Earth-surface science and common-pool resource economics. In many systems, decision-making and social complexity exert stronger controls on landscape expression than do physical geomorphological processes. Conversely, human-environmental research keeps encountering multi-scale, emergent problems of resource use made 'common-pool' by water, nutrient and sediment transport dynamics. Just as Earth-surface research can benefit from decades of work on common-pool resource systems, quantitative Earth-surface science can make essential contributions to efforts addressing complex problems in environmental sustainability.

  17. Erectile Dysfunction ia a common problem in Interstitial Lung Disease

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Wijsenbeek, Marlies

    .6%) had co-morbid heart disease and/or manifest atherosclerosis, and 6 (11.8%) had diabetes mellitus (DM). 39 (76.5%) had fibrosing ILD on high-resolution CT-scan or lung biopsy (IPF n=24, Fibrosing NSIP n=7, unclassifiable ILD with fibrosis n=8). 35 ILD patients (70%) had ED, and 22 (44%) hereof had...... severe ED. Having a co-morbidity was not associated with increased risk of ED (OR 0,94, P=0,74).  Conclusion: Our data clearly demonstrate that ED is a common problem in ILD. Almost half of all patients in this study had severe ED. This is, to our knowledge, the first study to report on the occurrence...... of sexual problems among male patients with ILD. The rate of ED was comparable to that found among COPD patients in prior studies. Further research is needed in order to identify specific risk factors for ED among ILD patients....

  18. Analysis of 72-hour sterility of common pediatric continuous intravenous infusions. (United States)

    Piro, Christina C; Davis, Jennifer; Frelix, Arlesia; Grisso, Alison G; Sinclair-Pingel, Julie; Willingham, Harold; Wright, Lorianne; Potts, Amy L


    Patient morbidity and mortality associated with contaminated and improperly prepared sterile products has captured national attention. In response, both the United States Pharmacopeia (USP) and Centers for Disease Control (CDC) have published recommendations in an effort to minimize the risk of infection. While the CDC recommends that administration sets are not changed more frequently than every 72 hours, the USP recommends a maximum beyond use date of 48 hours. Neither organization provides specific guidance on expiration dating once the intravenous drug is dispensed. Likewise, neither addresses the length of time that a bag containing medication for continuous infusion may hang once administration to the patient has begun. We evaluated the sterility of medications that are commonly administered by continuous infusion to pediatric patients. Because frequent manipulation of infusion and administration sets may predispose the patient to adverse events, we evaluated sterility for extended beyond use dating up to 72 hours. Thirty-five common intravenous (IV) continuous infusions using 94 standard concentrations and diluents were identified. IV solutions were mixed using sterile technique in the laminar flow hood in accordance with USP guidelines. Medications were excluded for short stability, short durations of use or high cost. A sample from each solution was tested for contamination or bacterial growth at 72 hours. Any visible discoloration suggesting physical instability was also evaluated. None of the syringes or chambers resulted in contamination, bacterial growth or discoloration after 72 hours. This study provides sufficient data that these compounded sterile products may be stored using a beyond use date up to 72 hours for a number of commonly used continuous IV infusions in pediatric patients. In our institution, this allows for a more convenient and consistent change of both administration sets and continuous infusions at 72 hours to potentially minimize

  19. Preliminary 2D numerical modeling of common granular problems (United States)

    Wyser, Emmanuel; Jaboyedoff, Michel


    Granular studies received an increasing interest during the last decade. Many scientific investigations were successfully addressed to acknowledge the ubiquitous behavior of granular matter. We investigate liquid impacts onto granular beds, i.e. the influence of the packing and compaction-dilation transition. However, a physically-based model is still lacking to address complex microscopic features of granular bed response during liquid impacts such as compaction-dilation transition or granular bed uplifts (Wyser et al. in review). We present our preliminary 2D numerical modeling based on the Discrete Element Method (DEM) using nonlinear contact force law (the Hertz-Mindlin model) for disk shape particles. The algorithm is written in C programming language. Our 2D model provides an analytical tool to address granular problems such as i) granular collapses and ii) static granular assembliy problems. This provides a validation framework of our numerical approach by comparing our numerical results with previous laboratory experiments or numerical works. Inspired by the work of Warnett et al. (2014) and Staron & Hinch (2005), we studied i) the axisymetric collapse of granular columns. We addressed the scaling between the initial aspect ratio and the final runout distance. Our numerical results are in good aggreement with the previous studies of Warnett et al. (2014) and Staron & Hinch (2005). ii) Reproducing static problems for regular and randomly stacked particles provides a valid comparison to results of Egholm (2007). Vertical and horizontal stresses within the assembly are quite identical to stresses obtained by Egholm (2007), thus demonstating the consistency of our 2D numerical model. Our 2D numerical model is able to reproduce common granular case studies such as granular collapses or static problems. However, a sufficient small timestep should be used to ensure a good numerical consistency, resulting in higher computational time. The latter becomes critical


    Directory of Open Access Journals (Sweden)



    Full Text Available This observational study was done in Department of Pediatrics to see the sensitization pattern among 128 allergic children clinically identified. Eight common Allergens were selected for Skin Prick Testing (SPT. Results were analysed and correlated with other clinical factors. Overall, SPT positivity to one or more Allergen was found in 85.71% of study population. All common Allergen in decreasing order of proportion of sensitivity were cockroach(61.71%, house dust (58.59%, holoptelea (52.34%, prosposis (52.34%, parthenium (47.65%, A. fumigates (48.43%, A. alternate (42.96%, A. niger (38.28%. It was also found that 111 (86.7% patients had positive response to atleast 1 Allergen and poly - sensitization was more common, observed in 78.9% patients. As Burlingtonent clinical score increase from 8, there is increase in SPT positivity with different Allergens, but there is no rational trend between higher scores (8 - 12, 13 - 20 and >20 and SPT positivity. Group of patients, who shows seasonal variation of symptoms, family history of Allergy and residing in industrial areas etc, also showed variable SPT sensitization pattern.

  1. Migrant differences in adolescents’ medicine use for common health problems

    DEFF Research Database (Denmark)

    Cantarero Arevalo, Lourdes; Andersen, Anette; Holstein, Bjørn Evald


    -aged Children (HBSC). Medicine use for headache, stomach-ache, difficulties getting to sleep and nervousness and feeling safe at school were self-reported. The population included boys and girls from ages 11 to 15 who were enrolled in the cross-sectional study. Included were 8480 ethnic Danes, 508 descendants...... differences in adolescents’ medicine use for common health problems, and if feeling safe at school, as a non-exposure to discrimination, explained these differences. Methods: Data derived from the 2006 Danish contribution to the World Health Organization collaborative study Health Behaviour in School...... and 456 migrants. Logistic regression was applied to assess associations. Multi-level logistic regression was used to assess the independent effect of school cluster. Results: Immigrant girls reported the highest past-month prevalence of medicine use for the four ailments included in the analysis...




    The problem of the reasonableness, the volume and efficiency of medical intervention in the child’s body, in this case, preventive vaccines acquires in the ratio of benefits and risks particular importance. Sociological survey on matters safety of the vaccine has revealed some problems: insufficient knowledge of parents and insufficient work of with the mass media about the security measures at carrying out preventive vaccinations, on the part of medical personnel insufficient skills on preve...

  3. Prescription Writing Errors of Midwifery Students in Common Gynecological problems

    Directory of Open Access Journals (Sweden)

    Serveh Parang


    Full Text Available Background and aim: Giving improper prescriptions is common among medical practitioners, mostly graduates, in most communities even developed countries. So far, to our knowledge, no study has been conducted on prescription writing of graduate midwifery students. Therefore, this study aimed to detect prescription writing errors of midwifery students in common gynecological problems. Methods: In this descriptive cross-sectional study, 56 bachelor midwifery students, who had passed the theoretical and clinical courses of gynecology, were evaluated by Objective Structured Clinical Examination (OSCE. A demographic questionnaire and a standard checklist for writing the prescriptions and medications were used for data collection. SPSS Version 16 was used to carry out descriptive statistics. Findings: Most of the students were single, with the mean age of 23.0±1.7 years. Most errors were related to not recording the patients’ age and sex, diagnosis, chief complaint, and the prescriber’s name (observed in less than 10% of the prescriptions. The complete dosage schedule and drug name were stated only in 1.8±4.8 and 14±18.6 of prescriptions, respectively. In more than 93% of the cases, route of use and treatment duration were not recorded. Conclusion: According to the results, the number of prescription errors of midwifery students was high. Therefore, it is recommended to run educational courses on prescription writing skills (e.g. writing prescriptions based on World Health Organization (WHO guidelines for the midwifery students.

  4. Common tasks and problems in paediatric trauma radiology

    Energy Technology Data Exchange (ETDEWEB)

    Paertan, Gerald E-mail:; Pamberger, Petra; Blab, Edmund; Hruby, Walter


    Scope of this article is to give practical hints for the most common, typical and important topics of trauma radiology in children to those radiologists who are not exclusively occupied with paediatric imaging. Due to the increased radiation sensitivity of children compared with adults balancing radiation protection and necessary image quality is of utmost importance. Outlines for this optimisation process are given. Especially in imaging of the extremities perhaps the greatest difficulties are posed by the dynamically changing face of the immature, growing, only partially ossified skeleton. Lack of experience must be compensated by meticulous comparison with the normal skeletal development as shown in standard textbooks, and by knowledge of the radiological image of the developmental variants. Besides general remarks about paediatric trauma radiology, some important topics are discussed into more detail. Especially the elbow joint poses a challenge for those less experienced with its radiological appearance in children. More than in adults, ultrasound should remain the primary imaging modality of choice especially in the assessment of abdominal trauma, and CT be tailored to radiological and clinical findings. Imaging and diagnosis of non-accidental injury (NAI) may be a less common task for the general radiologist, however, the severe social implications of physical child abuse mandate a basic knowledge about the radiological symptoms and the imaging management of this problem for all physicians occupied with paediatric radiology.

  5. Common overuse tendon problems: A review and recommendations for treatment. (United States)

    Wilson, John J; Best, Thomas M


    There is a common misconception that symptomatic tendon injuries are inflammatory; because of this, these injuries often are mislabeled as "tendonitis."' Acute inflammatory tendinopathies exist, but most patients seen in primary care will have chronic symptoms suggesting a degenerative condition that should be labeled as "tendinosus" or "tendinopathy." Accurate diagnosis requires physicians to recognize the historical features, anatomy, and useful physical examination maneuvers for these common tendon problems. The natural history is gradually increasing load-related localized pain coinciding with increased activity. The most common overuse tendinopathies involve the rotator cuff, medial and lateral elbow epicondyles, patellar tendon, and Achilles tendon. Examination should include thorough inspection to assess for swelling, asymmetry, and erythema of involved tendons; range-of-motion testing; palpation for tenderness; and examination maneuvers that simulate tendon loading and reproduce pain. Plain radiography, ultrasonography, and magnetic resonance imaging can be helpful if the diagnosis remains unclear. Most patients with overuse tendinopathies (about 80 percent) fully recover within three to six months, and outpatient treatment should consist of relative rest of the affected area, icing, and eccentric strengthening exercises. Although topical and systemic nonsteroidal anti-inflammatory drugs are effective for acute pain relief, these cannot be recommended in favor of other analgesics. Injected corticosteroids also can relieve pain, but these drugs should be used with caution. Ultrasonography, shock wave therapy, orthotics, massage, and technique modification are treatment options, but few data exist to support their use at this time. Surgery is an effective treatment that should be reserved for patients who have failed conservative therapy.

  6. How many referrals to a pediatric orthopaedic hospital specialty clinic are primary care problems? (United States)

    Hsu, Eric Y; Schwend, Richard M; Julia, Leamon


    Many primary care physicians believe that there are too few pediatric orthopaedic specialists available to meet their patients' needs. However, a recent survey by the Practice Management Committee of the Pediatric Orthopaedic Society of North America found that new referrals were often for cases that could have been managed by primary care practitioners. We wished to determine how many new referral cases seen by pediatric orthopaedic surgeons are in fact conditions that can be readily managed by a primary care physician should he/she chose to do so. We prospectively studied all new referrals to our hospital-based orthopaedic clinic during August 2010. Each new referral was evaluated for whether it met the American Board of Pediatrics criteria for being a condition that could be managed by a primary care pediatrician. Each referral was also evaluated for whether it met the American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to an orthopaedic specialist, regardless of whether it is for general orthopaedics or pediatric orthopaedics. On the basis of these criteria, we classified conditions as either a condition manageable by primary care physicians or a condition that should be referred to an orthopaedic surgeon or a pediatric orthopaedic surgeon. We used these guidelines not to identify diagnosis that primary care physicians should treat but, rather, to compare the guideline-delineated referrals with the actual referrals our specialty pediatric orthopaedic clinic received over a period of 1 month. A total of 529 new patient referrals were seen during August 2010. A total of 246 (47%) were considered primary care conditions and 283 (53%) orthopaedic specialty conditions. The most common primary care condition was a nondisplaced phalanx fracture (25/246, 10.1%) and the most common specialty condition was a displaced single-bone upper extremity fracture needing reduction (36/283, 13%). Only 77 (14.6%) of the total cases met the strict

  7. Life years lost-comparing potentially fatal late complications after radiotherapy for pediatric medulloblastoma on a common scale

    DEFF Research Database (Denmark)

    Brodin, N. Patrik; Vogelius, Ivan R.; Maraldo, Maja V.


    The authors developed a framework for estimating and comparing the risks of various long-term complications on a common scale and applied it to 3 different techniques for craniospinal irradiation in patients with pediatric medulloblastoma. METHODS: Radiation dose-response parameters related...

  8. Increased Overjet In Growing Child, Problem Solving In Pediatric Dentistry


    Achmad, harun


    - Child orthodontic of treatment system today has given satisfactory results, but there are still difficult cases that proved to handle. This is because there are still some bad habits that accompany myofungsional on a child, such as sucking fingers, posture problems and the placement of the tongue when swallowing, and abnormal breathing patterns. Overjet is a horizontal relationship between maxillary and mandibular incisors. Normal range from overjet is 2-4 mm. I ncreased over...

  9. Identifying school performance problems in the pediatric office. (United States)

    Kelly, Desmond P; Aylward, Glen P


    The AAP has underscored the role and responsibility of pediatricians in screening their patients for developmental and learning problems and working with parents, schools, and other professionals to ensure that students with these problems receive appropriate educational and therapeutic interventions. We have proposed a model that is time-efficient and can be tailored to the level of interest and experience of the pediatrician. At a minimum, the primary care physician should elicit any parental concerns about school performance, affirm these, and direct the student and parents to appropriate resources in the community for further evaluation and intervention as necessary. Pediatricians who wish to understand more fully the nature and underpinnings of their patients' learning difficulties can formulate a preliminary diagnosis and develop a plan for treatment using a structured system of information gathering that can be combined with information about the child's medical status and supplemented by brief direct testing in the office setting. By following these approaches, primary care pediatricians can provide comprehensive care for their patients and their families in their medical home and also can derive considerable professional satisfaction.

  10. Basics of bone metabolism and osteoporosis in common pediatric neuromuscular disabilities. (United States)

    Yaşar, Evren; Adigüzel, Emre; Arslan, Mutluay; Matthews, Dennis J


    Bone modeling is a process that starts with fetal life and continues during adolescence. Complex factors such as hormones, nutritional and environmental factors affect this process. In addition to these factors, physical conditioning and medications that have toxic effects on bony tissue should be carefully considered in patient follow-up. Osteoporosis is a significant problem in pediatric population because of ongoing growth and development of skeletal system. Two types of osteoporosis are primary and secondary types and children with neuromuscular disabilities constitute a major group with secondary osteoporosis. Low bone mass in patients with cerebral palsy, spina bifida, and Duchenne muscular dystrophy cause increased bone fragility in even slight traumas. Maximizing peak bone mass and prevention of bone loss are very important to reduce the fracture risk in neuromuscular diseases. This article aims to review the determinants of bone physiology and bone loss in children with cerebral palsy, spina bifida, and Duchenne muscular dystrophy. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  11. Impact of Resident Surgeons on Procedure Length based on Common Pediatric Otolaryngology Cases (United States)

    Puram, Sidharth V.; Kozin, Elliott D.; Sethi, Rosh; Alkire, Blake; Lee, Daniel J.; Gray, Stacey T.; Shrime, Mark G.; Cohen, Michael


    Background Surgical education remains an important mission of academic medical centers. Financial pressures, however, may favor improved operating room (OR) efficiency at the expense of surgical education. We aim to characterize resident impact on the duration of procedural time using common pediatric otolaryngologic cases which do not necessitate a surgical assistant and assess whether other factors modify the extent to which residents impact OR efficiency. Study Design We retrospectively reviewed resident and attending surgeon total OR and procedural times for isolated tonsillectomy, adenoidectomy, tonsillectomy with adenoidectomy (T&A) and bilateral myringotomy with tube insertion between 2009 and 2013. We included cases supervised or performed by one of four teaching surgeons in children with ASA otolaryngology procedures. While residents may increase operative times, addressing other system-wide issues may decrease impact of time needed for education and added efficiencies of resident participation may exist throughout the perioperative period. Our model is applicable to surgical education across specialties. Level of Evidence 4 PMID:25251257

  12. [Antiphospholipid antibody syndrome in pediatric neurosurgery: a hemostasis problem]. (United States)

    Bocquet, R; Blanot, S; Dautzenberg, M D; Pierre-Kahn, A; Carli, P


    The case of a 11-year-old boy under anticoagulant therapy for a familial antiphospholipid antibody syndrome (SAAPF), who underwent surgery for a cerebrovascular malformation responsible for an intracerebral haematoma, is reported. Antivitamins K (AVK) were changed for unfractioned heparin (HNF), three days before. Heparin was discontinued two hours prior to surgery to obtain a normal peroperative coagulation. A vascular dural fistula was removed without any haemostatic problem. The neurological status rapidly returned to normal and tomodensitometry at day 1 showed a normal intracranial status. Heparin was readministered at h 16. Thrombocytopenia occurred at day 4 of heparin treatment. The change for a low weight molecular heparinoid, danaparoid (Orgaran), normalized the platelet count. The platelets aggregation tests were negative during thrombopenia. However, the test for antibodies against the PF4-heparin complex with the Elisa technique, was in favour of a heparin induced thrombocytopenia (TIH). In spite of its anecdotic occurrence due to cumulative thrombotic risks from the association of immunologic disorders (TIH and SAAPF), this case report underlines the value but also the risks of anticoagulant therapy in neurosurgery, when patients are at high risk for thrombosis.

  13. Special problems in aerosol delivery: neonatal and pediatric considerations. (United States)

    Cole, C H


    better replicas of infants' and children's anatomy (oropharynx, upper airways), and better in vitro lung models, plus utilization of realistic breathing patterns of infants and children will improve in vitro prediction of the in vivo dose delivered to lower airways. This would greatly facilitate selection of delivery systems under specific circumstances for infants and children of various ages). Safety profile, therapeutic efficacy, and efficiency of aerosolized medications delivered to infants and children need to be rigorously studied. This is particularly true for medications with potentially great benefit but possible adverse effects, such as inhaled glucocorticoid therapy in extremely premature infants. Common sense, ethics, and due respect for the same high standard of approval requirements of adults and older children should motivate further research in understanding and improving aerosol delivery in infants and young children.

  14. Innovation and problem solving: a review of common mechanisms. (United States)

    Griffin, Andrea S; Guez, David


    Behavioural innovations have become central to our thinking about how animals adjust to changing environments. It is now well established that animals vary in their ability to innovate, but understanding why remains a challenge. This is because innovations are rare, so studying innovation requires alternative experimental assays that create opportunities for animals to express their ability to invent new behaviours, or use pre-existing ones in new contexts. Problem solving of extractive foraging tasks has been put forward as a suitable experimental assay. We review the rapidly expanding literature on problem solving of extractive foraging tasks in order to better understand to what extent the processes underpinning problem solving, and the factors influencing problem solving, are in line with those predicted, and found, to underpin and influence innovation in the wild. Our aim is to determine whether problem solving can be used as an experimental proxy of innovation. We find that in most respects, problem solving is determined by the same underpinning mechanisms, and is influenced by the same factors, as those predicted to underpin, and to influence, innovation. We conclude that problem solving is a valid experimental assay for studying innovation, propose a conceptual model of problem solving in which motor diversity plays a more central role than has been considered to date, and provide recommendations for future research using problem solving to investigate innovation. This article is part of a Special Issue entitled: Cognition in the wild.

  15. Overlap, common features, and essential differences in pediatric granulomatous inflammatory bowel disease.

    NARCIS (Netherlands)

    Damen, G.M.; Krieken, J.H.J.M. van; Hoppenreijs, E.P.A.H.; Os, E. van; Tolboom, J.J.M.; Warris, A.; Yntema, J.L.; Nieuwenhuis, E.E.; Escher, J.C.


    Overlap in the clinical presentation of pediatric granulomatous inflammatory bowel disease may be substantial, depending on the mode of presentation. Chronic granulomatous disease (CGD) may present with granulomatous colitis, perianal abscesses, hepatic abscesses or granulomas, failure to thrive,

  16. NIH scientists map gene changes driving tumors in common pediatric soft-tissue cancer (United States)

    Scientists have mapped the genetic changes that drive tumors in rhabdomyosarcoma, a pediatric soft-tissue cancer, and found that the disease is characterized by two distinct genotypes. The genetic alterations identified in this malignancy could be useful

  17. Overlap, common features, and essential differences in pediatric granulomatous inflammatory bowel disease.

    NARCIS (Netherlands)

    Damen, G.M.; Krieken, J.H.J.M. van; Hoppenreijs, E.P.A.H.; Os, E. van; Tolboom, J.J.M.; Warris, A.; Yntema, J.L.; Nieuwenhuis, E.E.; Escher, J.C.


    Overlap in the clinical presentation of pediatric granulomatous inflammatory bowel disease may be substantial, depending on the mode of presentation. Chronic granulomatous disease (CGD) may present with granulomatous colitis, perianal abscesses, hepatic abscesses or granulomas, failure to thrive, an

  18. Common genetic variations in cell cycle and DNA repair pathways associated with pediatric brain tumor susceptibility

    DEFF Research Database (Denmark)

    Adel Fahmideh, Maral; Lavebratt, Catharina; Schüz, Joachim


    Knowledge on the role of genetic polymorphisms in the etiology of pediatric brain tumors (PBTs) is limited. Therefore, we investigated the association between single nucleotide polymorphisms (SNPs), identified by candidate gene-association studies on adult brain tumors, and PBT risk.The study...... cycle and DNA repair pathways variations associated with susceptibility to adult brain tumors also seem to be associated with PBT risk, suggesting pediatric and adult brain tumors might share similar etiological pathways....

  19. Common genetic variations in cell cycle and DNA repair pathways associated with pediatric brain tumor susceptibility

    DEFF Research Database (Denmark)

    Fahmideh, Maral Adel; Lavebratt, Catharina; Schüz, Joachim


    Knowledge on the role of genetic polymorphisms in the etiology of pediatric brain tumors (PBTs) is limited. Therefore, we investigated the association between single nucleotide polymorphisms (SNPs), identified by candidate gene-association studies on adult brain tumors, and PBT risk. The study...... cycle and DNA repair pathways variations associated with susceptibility to adult brain tumors also seem to be associated with PBT risk, suggesting pediatric and adult brain tumors might share similar etiological pathways....

  20. Common Problems of Mobile Applications for Foreign Language Testing (United States)

    Garcia Laborda, Jesus; Magal-Royo, Teresa; Lopez, Jose Luis Gimenez


    As the use of mobile learning educational applications has become more common anywhere in the world, new concerns have appeared in the classroom, human interaction in software engineering and ergonomics. new tests of foreign languages for a number of purposes have become more and more common recently. However, studies interrelating language tests…

  1. Common Problems and Solutions for Being Physically Active (United States)

    ... Problems & Solutions for Being Active - FAQs About Physical Activity Managing Your Medicines - Introduction - Taking Control of Your Medicines - Medicine Assistance Programs - Medicine Checklist - Medication Tracker Communicating with Professionals - Introduction - Preparing for Medical Visits - ...

  2. Common mental health problems and antiretroviral therapy adherence. (United States)

    Nel, Adriaan; Kagee, Ashraf


    This paper reviews the literature on various mental health problems and their impact on adherence to antiretroviral therapy (ART). Depression, anxiety disorders, and disorders related to substance abuse were identified as key role-players influencing adherence. The severity of symptoms related to these disorders was found to be inversely related to ART adherence, with the possible exception of post-traumatic stress disorder (PTSD). PTSD was found to have both positive and negative implications for adherence, with severity of symptoms ranging from health-protective concern to disabling distress. Possible solutions aimed at addressing the adverse effects of mental health problems on adherence are discussed. Routine screening in ART settings is suggested in settings where follow-up of positive screen scores are possible, along with the necessary interventions to resolve the disorder of concern. Suggested interventions include utilising psychotherapeutic treatment, both in isolation and in conjunction with medication, to address mental health problems. Furthermore, finding effective ways of marshalling social support is recommended for ensuring optimal adherence, and possibly mitigating the adverse effects of mental health problems. Further research is needed to find feasible ways of identifying, assessing and treating patients with mental health problems in resource-constrained settings where HIV prevalence is highest.

  3. The Domino Effect: Problem Solving with Common Table Games. (United States)

    Reimer, Wilbert


    Domino games are used to illustrate problem-solving techniques in a college principles-of-mathematics course. Students develop tables and use Pascal's triangle to find the total number of pips and the sum of numbers on the pieces. (DC)

  4. The Domino Effect: Problem Solving with Common Table Games. (United States)

    Reimer, Wilbert


    Domino games are used to illustrate problem-solving techniques in a college principles-of-mathematics course. Students develop tables and use Pascal's triangle to find the total number of pips and the sum of numbers on the pieces. (DC)

  5. Sleep problems and cognitive behavior therapy in pediatric obsessive-compulsive disorder have bidirectional effects. (United States)

    Ivarsson, Tord; Skarphedinsson, Gudmundur


    To investigate the presence of sleep problems and their reaction to CBT in pediatric obsessive compulsive disorder (OCD). Moreover, we investigated whether sleep problems predict the outcome of CBT on OCD-symptoms. 269 children and adolescents, age 7-17 years, with DSM-IV primary OCD that took part in the first step of a stepwise treatment trial, were assessed with regard to both individual sleep problems and a sleep composite score (SCS) using the Child Behavior Checklist (CBCL). Their OCD symptoms were rated using the Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS). We found elevated symptoms of sleep deprivation and nightmares before treatment. However most sleep problems (e.g. nightmares (p=.03), too little sleep (psleeping (pCBT treatment. Co-morbidities had no effect on the reduction of SCS. Moreover, elevated levels of sleep problems using the SCS (psleep problem at baseline (pCBT on the OCD symptoms. Sleep problems in paediatric OCD are frequent and interfere with treatment outcome. They need to be assessed using better methods in future trials. Moreover, lack of resolution of sleep problems need to be recognized and treated as it seems probable that continued sleep problems may have a negative impact on CBT efficacy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Climate change and the oil industry: Common problem, different strategies


    Skjaerseth, Jon; Skodvin, Tora


    Multinational corporations are not merely the problem in environmental concerns, but could also be part of the solution. The oil industry and climate change provide the clearest example of how the two are linked; what is less well-known is how the industry is responding to these concerns. This volume presents a detailed study of the climate strategies of ExxonMobil, Shell and Statoil. With an innovative analytical approach, the authors explain variations at three decision-making levels: withi...

  7. Low Back Pain - Management Perspective Of A commonly Encountered Problem

    Directory of Open Access Journals (Sweden)

    Parharaj S S


    Full Text Available Low Back pain is a very common symptom affecting the general population, incurring a huge annual societal cost. In spite of this, it remains very commonly misdiagnosed and maltreated. The majority of benign chronic low back pain patients suffer from a combination of myofascial frozen back syndrome with or without an overly of psychosocioeconomic factors. Neural compression causes are less frequent. A though evaluation of the patient to select the most rational therapeutic approach is necessary. In majority of the patients, a well planned out rehabilitation programme is useful. Surgery is indicated in a minority with neural compression or spinal instability, motivation is essential as rehabilitation and surgery have a high failure rate in inadequately motivated patients with psychosocioeconomic dysfunction.

  8. Ciguatera poisoning: a global issue with common management problems. (United States)

    Ting, J Y; Brown, A F


    Ciguatera poisoning, a toxinological syndrome comprising an enigmatic mixture of gastrointestinal, neurocutaneous and constitutional symptoms, is a common food-borne illness related to contaminated fish consumption. As many as 50000 cases worldwide are reported annually, and the condition is endemic in tropical and subtropical regions of the Pacific Basin, Indian Ocean and Caribbean. Isolated outbreaks occur sporadically but with increasing frequency in temperate areas such as Europe and North America. Increase in travel between temperate countries and endemic areas and importation of susceptible fish has led to its encroachment into regions of the world where ciguatera has previously been rarely encountered. In the developed world, ciguatera poses a public health threat due to delayed or missed diagnosis. Ciguatera is frequently encountered in Australia. Sporadic cases are often misdiagnosed or not medically attended to, leading to persistent or recurrent debilitating symptoms lasting months to years. Without treatment, distinctive neurologic symptoms persist, occasionally being mistaken for multiple sclerosis. Constitutional symptoms may be misdiagnosed as chronic fatigue syndrome. A common source outbreak is easier to recognize and therefore notify to public health organizations. We present a case series of four adult tourists who developed ciguatera poisoning after consuming contaminated fish in Vanuatu. All responded well to intravenous mannitol. This is in contrast to a fifth patient who developed symptoms suggestive of ciguatoxicity in the same week as the index cases but actually had staphylococcal endocarditis with bacteraemia. In addition to a lack of response to mannitol, clinical and laboratory indices of sepsis were present in this patient. Apart from ciguatera, acute gastroenteritis followed by neurological symptoms may be due to paralytic or neurotoxic shellfish poisoning, scombroid and pufferfish toxicity, botulism, enterovirus 71, toxidromes and

  9. Asymptotic behavior of two algorithms for solving common fixed point problems (United States)

    Zaslavski, Alexander J.


    The common fixed point problem is to find a common fixed point of a finite family of mappings. In the present paper our goal is to obtain its approximate solution using two perturbed algorithms. The first algorithm is an iterative method for problems in a metric space while the second one is a dynamic string-averaging algorithms for problems in a Hilbert space.

  10. Common feeding problems in babies and children: 2. (United States)

    Gilbert, P


    Weaning is the cause of much concern among first-time mothers. A milk-only diet is advised until 3-4 months of age. Health professionals should ensure the baby receives a sufficient and balanced diet during the weaning period, to meet the needs for energy and growth. Breast milk or infant formula should continue up to the age of at least one year. The weaning period is a good time to educate parents in good nutrition. A wide variety of foods should be the aim in child nutrition, but each different type needs to be started separately during weaning. Care is needed to ensure vegetarian babies receive enough proteins, vitamins and minerals (especially iron). Failure to thrive has a multitude of causes, and treatment must be that of the cause. Strictly vegan children who eat no dairy products will need added synthetic vitamin B12. Failure to thrive may be due to physical problems (eg choanal atresia), infection, vomiting, diarrhoea, anorexia, parental ignorance or poverty. Other causes include coeliac disease, cow's milk protein allergy, cystic fibrosis, severe eczema or asthma, or diabetes.

  11. Temperament and Common Disruptive Behavior Problems in Preschool. (United States)

    Martel, Michelle M; Gremillion, Monica L; Roberts, Bethan


    The study evaluated trait associations with common Disruptive Behavior Disorders (DBD), Oppositional Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD), during an understudied developmental period: Preschool. Participants were 109 children ages 3 to 6 and their families. DBD symptoms were available via parent and teacher/caregiver report on the Disruptive Behavior Rating Scale. Traits were measured using observational coding paradigms, and parent and examiner report on the Child Behavior Questionnaire and the California Q-Sort. The DBD groups exhibited significantly higher negative affect, higher surgency, and lower effortful control. Negative affect was associated with most DBD symptom domains; surgency and reactive control were associated with hyperactivity-impulsivity; and effortful control was associated with ADHD and inattention. Interactive effects between effortful control and negative affect and curvilinear associations of reactive control with DBD symptoms were evident. Temperament trait associations with DBD during preschool are similar to those seen during middle childhood. Extreme levels of temperament traits are associated with DBD as early as preschool.

  12. Immunity in society: diverse solutions to common problems.

    Directory of Open Access Journals (Sweden)

    Simon A Babayan

    Full Text Available Understanding how organisms fight infection has been a central focus of scientific research and medicine for the past couple of centuries, and a perennial object of trial and error by humans trying to mitigate the burden of disease. Vaccination success relies upon the exposure of susceptible individuals to pathogen constituents that do not cause (excessive pathology and that elicit specific immune memory. Mass vaccination allows us to study how immunity operates at the group level; denser populations are more prone to transmitting disease between individuals, but once a critical proportion of the population becomes immune, "herd immunity" emerges. In social species, the combination of behavioural control of infection--e.g., segregation of sick individuals, disposal of the dead, quality assessment of food and water--and aggregation of immune individuals can protect non-immune members from disease. While immune specificity and memory are well understood to underpin immunisation in vertebrates, it has been somewhat surprising to find similar phenomena in invertebrates, which lack the vertebrate molecular mechanisms deemed necessary for immunisation. Indeed, reports showing alternative forms of immune memory are accumulating in invertebrates. In this issue of PLoS Biology, Konrad et al. present an example of fungus-specific immune responses in social ants that lead to the active immunisation of nestmates by infected individuals. These findings join others in showing how organisms evolved diverse mechanisms that fulfil common functions, namely the discrimination between pathogens, the transfer of immunity between related individuals, and the group-level benefits of immunisation.

  13. A new iterative method for solving a system of generalized equilibrium problems, generalized mixed equilibrium problems and common fixed point problems in Hilbert spaces

    Directory of Open Access Journals (Sweden)

    Benjawan Rodjanadid


    Full Text Available In this paper, we introduce an iterative method for finding a common element of the set of solutions of a generalized mixed equilibrium problem (GMEP, the solutions of a general system of equilibrium problem and the set of common fixed points of a finite family of nonexpansive mappings in a real Hilbert space. Then, we prove that the sequence converges strongly to a common element of the above three sets. Furthermore, we apply our result to prove four new strong convergence theorems in fixed point problems, mixed equilibrium problems, generalized equilibrium problems , equilibrium problems and variational inequality.

  14. Convergence Theorem for Generalized Mixed Equilibrium Problem and Common Fixed Point Problem for a Family of Multivalued Mappings

    Directory of Open Access Journals (Sweden)

    J. N. Ezeora


    Full Text Available In this paper, a new hybrid iterative algorithm is constructed using the shrinking projection method introduced by Takahashi. The sequence of the algorithm is proved to converge strongly to a common element of the set of solutions of generalized mixed equilibrium problem and the set of common fixed points of a finite family of multivalued strictly pseudocontractive mappings in real Hilbert spaces. Furthermore, we apply our main result to convex minimization problem.

  15. Temporal Trends in Utilization of Transthoracic Echocardiography for Common Outpatient Pediatric Cardiology Diagnoses over the Past 15 Years. (United States)

    Sachdeva, Ritu; Travers, Curtis D; McCracken, Courtney E; Samai, Cyrus; Campbell, Robert M; Slesnick, Timothy C; Border, William L


    No data exist regarding the temporal trends in utilization of transthoracic echocardiography (TTE) in an outpatient pediatric cardiology setting. This study evaluates the trends in utilization of TTE for common diagnoses known to have low diagnostic yield and the factors influencing these trends. Patients evaluated at our pediatric cardiology clinics from January 2000 to December 2014 and discharged with final diagnoses of innocent murmur, noncardiac chest pain, benign syncope, and palpitations were included. Variables collected retrospectively included patient age, sex, insurance type, distance from clinic, and ordering physician's years of experience since fellowship. Of the 74,881 patients seen by 35 physicians, 36,053 (48.1%) had a TTE. The TTE rates increased from the beginning of 2000 to the end of 2004 (5.2% per year; P trends persisted after adjusting for all these factors. After an initial surge in TTE utilization from 2000 to 2004, there was a steady decline. This study identifies some important factors influencing these trends. This information could help design quality interventions, but additional factors need to be explored since the trends persist despite adjusting for these factors. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  16. Maternal psychosocial predictors of pediatric health care use: Use of the common sense model of health and illness behaviors to extend beyond the usual suspects. (United States)

    Moran, Tracy E; O'Hara, Michael W


    Determinants of pediatric health care use extend beyond the health status of the child and economic and access considerations. Parental factors, particularly those associated with the mother, are critical. The common sense model of health and illness behaviors, which was developed to account for adult health care use, may constitute a framework to study the role of mothers in determining pediatric health care use. In the common sense model, the person's cognitive representations of and affective reactions to bodily states influence health care decision-making. There is a growing literature that points to the importance of maternal psychopathology (reflecting the affective component of the common sense model) and maternal parenting self-efficacy (reflecting the cognitive component of the model) as important contributors to pediatric health care use. The implications of this conceptualization for future research and clinical practice are discussed.

  17. Child Neurology Education for Pediatric Residents. (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D


    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  18. Lead and cadmium levels of commonly administered pediatric syrups in Nigeria: A public health concern?

    Energy Technology Data Exchange (ETDEWEB)

    Orisakwe, Orish Ebere, E-mail: [Toxicology Unit, Department of Pharmacology,College of Health Sciences, Nnamdi Azikiwe University,Nnewi Campus. P.M.B. 5001, Nnewi, Anambra State (Nigeria); Nduka, John Kanayochukwu [Environmental Chemistry and Toxicology Research Unit, Pure and Industrial Chemistry Department, Nnamdi Azikiwe University, P.M.B. 5025, Awka Anambra State (Nigeria)


    Fifty different pediatric syrups were randomly sampled from patent medicine stores and pharmaceutical shops within Awka, in Anambra State between November 2007 and May 2008. Syrups were ashed before digestion using conc. aqua regia, HCl:HNO{sub 3} (3:1) and lead and cadmium were assayed with AAS 205A. Results revealed that 60 and 98% of the sample size had lead and cadmium respectively. The lead levels ranged from 0.01 in chloroquine to 1.08 mg/l in magcid suspension. The highest level of cadmium was seen in magcid suspension with concentration of 2.45 mg/l while lowest concentration of 0.01 in emzolyn and colipan. About 41.2% of the locally made syrup had none detectable levels of lead while all the syrup had detectable levels of cadmium. Lead levels ranged from 0.01 mg/l in cadiphen manufactured in Dholka, India to 0.09 in maxiquine made in England. About 68.8% of the imported syrups of the imported syrups had non detectable levels of lead. Chloramphenicol and zentel albendazole syrups had 0.60 and 0.88 mg/l of cadmium respectively. Bellis cough syrup showed the lowest level (0.01 mg/l) of cadmium. Only erythromycin suspension representing 6.3% had non detectable level of cadmium of the imported syrups. Due to the Cd and Pb levels found, we suggest that the behaviour scenario (here, self administration without medical assistance) should be properly taken under control. Along with this, contamination sources or vulnerable practices during syrups preparation should be also assessed in a tiered approach, towards the minimization of noxious presence in syrups and the promotion of quality of Nigerian-made products.

  19. An Integer Programming Formulation of the Minimum Common String Partition Problem.

    Directory of Open Access Journals (Sweden)

    S M Ferdous

    Full Text Available We consider the problem of finding a minimum common string partition (MCSP of two strings, which is an NP-hard problem. The MCSP problem is closely related to genome comparison and rearrangement, an important field in Computational Biology. In this paper, we map the MCSP problem into a graph applying a prior technique and using this graph, we develop an Integer Linear Programming (ILP formulation for the problem. We implement the ILP formulation and compare the results with the state-of-the-art algorithms from the literature. The experimental results are found to be promising.

  20. Promoting Access to Common Core Mathematics for Students with Severe Disabilities through Mathematical Problem Solving (United States)

    Spooner, Fred; Saunders, Alicia; Root, Jenny; Brosh, Chelsi


    There is a need to teach the pivotal skill of mathematical problem solving to students with severe disabilities, moving beyond basic skills like computation to higher level thinking skills. Problem solving is emphasized as a Standard for Mathematical Practice in the Common Core State Standards across grade levels. This article describes a…

  1. Common Types of Reading Problems and How to Help Children Who Have Them (United States)

    Spear-Swerling, Louise


    Patterns of reading difficulty provide an educationally useful way to think about different kinds of reading problems, whether those problems are mainly experiential in nature (e.g., those common among English learners) or associated with disabilities (e.g., those typical of children with dyslexia). This article reviews research on three common…

  2. Incorporating the Common Core's Problem Solving Standard for Mathematical Practice into an Early Elementary Inclusive Classroom (United States)

    Fletcher, Nicole


    Mathematics curriculum designers and policy decision makers are beginning to recognize the importance of problem solving, even at the earliest stages of mathematics learning. The Common Core includes sense making and perseverance in solving problems in its standards for mathematical practice for students at all grade levels. Incorporating problem…

  3. Debunking Common Sense and the Taken for Granted: A Pedagogical Strategy for Teaching Social Problems (United States)

    LeMoyne, Terri; Davis, Jean Marie


    In this article, the authors argue that one approach to teaching Introduction to Social Problems is to structure the course content around taken-for-granted beliefs that many students have about the social world. In doing so, the authors discuss the social construction of social problems, how sociology differs from common sense, and the importance…

  4. Mathematical problem solving and computers: Investigation of the effect of computer aided instruction in solving lowest common multiple and greatest common factor problems

    Directory of Open Access Journals (Sweden)

    Hande Çamlı


    Full Text Available This paper aims to determine the effect of computer aided instruction on students’ academic performance in solving Lowest Common Multiple and Greatest Common Factor problems and multiplicative structures. The study was held in the second semester of 2008 for five weeks with a total number of 102 sixth grade students. The research was carried out experimentally and a post test control group design method was used in this experimental study. An academic level test was used at the beginning of the study to compare the existing knowledge of experimental and control groups; and a post test and software developed by the researchers about the topic were used as data collection instruments in this study. The means of scores received in academic success test and post test were analyzed using t-test technique. The results of the study show that the use of computer support in teaching and learning Lowest Common Multiple and Greatest Common Factor problems and multiplicative structures in mathematics lesson may increase students academic success.

  5. Reflections on Ethics and Humanity in Pediatric Neurology: the Value of Recognizing Ethical Issues in Common Clinical Practice. (United States)

    Ronen, Gabriel M; Rosenbaum, Peter L


    Our goals in this reflection are to (i) identify the ethical dimensions inherent in any clinical encounter and (ii) bring to the forefront of our pediatric neurology practice the myriad of opportunities to explore and learn from these ethical questions. We highlight specifically Beauchamp and Childress's principles of biomedical ethics. We use the terms ethics in common clinical practice and an ethical lens to remind people of the ubiquity of ethical situations and the usefulness of using existing ethical principles to analyze and resolve difficult situations in clinical practice. We start with a few common situations with which many of us tend to struggle. We describe what we understand as ethics and how and why developments in technology, novel potential interventions, policies, and societal perspectives challenge us to think about and debate ethical issues. Individual patients are not a singular population; each patient has their own unique life situations, culture, goals, and expectations that need to be considered with a good dose of humanity and humility. We believe that using an ethical lens-by which we mean making an explicit effort to identify and consider these issues openly-will help us to achieve this goal in practice, education, and research.

  6. Pediatric IBD-unclassified Is Less Common than Previously Reported; Results of an 8-Year Audit of the EUROKIDS Registry

    NARCIS (Netherlands)

    Winter, D.A.; Karolewska-Bochenek, K.; Lazowska-Przeorek, I.; Lionetti, P.; Mearin, ML; Chong, S.K.; Roma-Giannikou, E.; Maly, J.; Kolho, K.L.; Shaoul, R.; Staiano, A.; Damen, G.M.; Meij, T. de; Hendriks, D.; George, E.K.; Turner, D.; Escher, J.C.


    BACKGROUND: Inflammatory bowel disease-unclassified (IBD-U) is diagnosed in approximately 10% of pediatric and adolescent onset IBD patients. The EUROKIDS registry (2004) initiated by the Porto IBD working group of ESPGHAN prospectively monitors diagnostic workup of newly diagnosed pediatric and ado

  7. Effective use of a common problem-solving process as an integral part of TQM. (United States)

    Pescod, W D


    Many organizations implement TQM programmes, but it is estimated that only 25 per cent of them can be classified as successful in terms of delivering the benefits that should be expected from them. Failure to create the conditions through systems and procedures which highlight problems in the organization and provide common approaches to solving them (such as an "in-company" problem-solving process) is often a main reason for such a low success rate. The benefits of successfully implementing the extensive use of a common problem-solving process and adopting a management style at all levels that supports, allows and encourages employees to use it are enormous. The problem-solving process should be an integral part of the TQM initiative and supported by ongoing training and facilitation, and used by management at all levels.

  8. Association of pediatric asthma severity with exposure to common household dust allergens

    Energy Technology Data Exchange (ETDEWEB)

    Gent, Janneane F., E-mail: [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Belanger, Kathleen [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Triche, Elizabeth W. [Brown University, Department of Community Health/Epidemiology, Providence, RI (United States); Bracken, Michael B. [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Beckett, William S. [Mount Auburn Hospital, Department of Internal Medicine, Cambridge, MA (United States); Leaderer, Brian P. [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States)


    Background: Reducing exposure to household dust inhalant allergens has been proposed as one strategy to reduce asthma. Objective: To examine the dose-response relationships and health impact of five common household dust allergens on disease severity, quantified using both symptom frequency and medication use, in atopic and non-atopic asthmatic children. Methods: Asthmatic children (N=300) aged 4-12 years were followed for 1 year. Household dust samples from two indoor locations were analyzed for allergens including dust mite (Der p 1, Der f 1), cat (Fel d 1), dog (Can f 1), cockroach (Bla g 1). Daily symptoms and medication use were collected in monthly telephone interviews. Annual disease severity was examined in models including allergens, specific IgE sensitivity and adjusted for age, gender, atopy, ethnicity, and mother's education. Results: Der p 1 house dust mite allergen concentration of 2.0 {mu}g/g or more from the main room and the child's bed was related to increased asthma severity independent of allergic status (respectively, OR 2.93, 95% CI 1.37, 6.30 for 2.0-10.0 {mu}g/g and OR 2.55 95% CI 1.13, 5.73 for {>=}10.0 {mu}g/g). Higher pet allergen levels were associated with greater asthma severity, but only for those sensitized (cat OR 2.41 95% CI 1.19, 4.89; dog OR 2.06 95% CI 1.01, 4.22). Conclusion: Higher levels of Der p 1 and pet allergens were associated with asthma severity, but Der p 1 remained an independent risk factor after accounting for pet allergens and regardless of Der p 1 specific IgE status.

  9. A comparison of several computational techniques for solving some common aeronomic problems (United States)

    Turco, R. P.; Whitten, R. C.


    Several numerical integration techniques for solving common aeronomic problems involving species rate equations are compared for speed and accuracy. A newer technique that defines families of species that are nearly conserved is found to be superior to an iterative technique when both methods are applied to simple test problems. The 'conservation' technique is also found to be more economical than the more complex Gear (1969) integration scheme for comparable accuracy.

  10. Time-Space Trade-Offs for the Longest Common Substring Problem

    DEFF Research Database (Denmark)

    Starikovskaya, Tatiana; Vildhøj, Hjalte Wedel


    The Longest Common Substring problem is to compute the longest substring which occurs in at least d ≥ 2 of m strings of total length n. In this paper we ask the question whether this problem allows a deterministic time-space trade-off using O(n1+ε) time and O(n1-ε) space for 0 ≤ ε ≤ 1. We give...

  11. [Technology of nitrous oxide/oxygen inhalation sedation and its clinical application in pediatric dentistry]. (United States)

    Zhong, Tian; Hu, Daoyong


    Dental fear is a common problem in pediatric dentistry. Therefore, sedation for pediatric patients is an essential tool for anxiety management. Nitrous oxide/oxygen inhalation sedation is a safe, convenient, effective way to calm children. The review is about the technology of nitrous oxide/oxygen inhalation sedation and its clinical application in pediatric dentistry.

  12. Weak and Strong Convergence of Algorithms for the Split Common Null Point Problem

    CERN Document Server

    Byrne, Charles; Gibali, Aviv; Reich, Simeon


    We introduce and study the Split Common Null Point Problem (SCNPP) for set-valued maximal monotone mappings in Hilbert space. This problem generalizes our Split Variational Inequality Problem (SVIP) [Y. Censor, A. Gibali and S. Reich, Algorithms for the split variational inequality problem, Numerical Algorithms, accepted for publication, DOI 10.1007/s11075-011-9490-5]. The SCNPP with only two set-valued mappings entails finding a zero of a maximal monotone mapping in one space, the image of which under a given bounded linear transformation is a zero of another maximal monotone mapping. We present three iterative algorithms that solve such problems in Hilbert space, and establish weak convergence for one and strong convergence for the other two.

  13. Some Problems in Proving the Existence of the Universal Common Ancestor of Life on Earth

    Directory of Open Access Journals (Sweden)

    Takahiro Yonezawa


    Full Text Available Although overwhelming circumstantial evidence supports the existence of the universal common ancestor of all extant life on Earth, it is still an open question whether the universal common ancestor existed or not. Theobald (Nature 465, 219–222 (2010 recently challenged this problem with a formal statistical test applied to aligned sequences of conservative proteins sampled from all domains of life and concluded that the universal common ancestor hypothesis holds. However, we point out that there is a fundamental flaw in Theobald's method which used aligned sequences. We show that the alignment gives a strong bias for the common ancestor hypothesis, and we provide an example that Theobald's method supports a common ancestor hypothesis for two apparently unrelated families of protein-encoding sequences (cytb and nd2 of mitochondria. This arouses suspicion about the effectiveness of the “formal” test.

  14. An algorithm for finding a common solution for a system of mixed equilibrium problem, quasi-variational inclusion problem and fixed point problem of nonexpansive semigroup

    Directory of Open Access Journals (Sweden)

    Liu Min


    Full Text Available In this paper, we introduce a hybrid iterative scheme for finding a common element of the set of solutions for a system of mixed equilibrium problems, the set of common fixed points for a nonexpansive semigroup and the set of solutions of the quasi-variational inclusion problem with multi-valued maximal monotone mappings and inverse-strongly monotone mappings in a Hilbert space. Under suitable conditions, some strong convergence theorems are proved. Our results extend some recent results in the literature.

  15. Co-Development of Internalizing and Externalizing Problem Behaviors: Causal Direction and Common Vulnerability (United States)

    Lee, Eunju J.; Bukowski, William M.


    Latent growth curve modeling was used to study the co-development of internalizing and externalizing problems in a sample of 2844 Korean fourth graders followed over four years. The project integrated two major theoretical viewpoints positing developmental mechanism: directional model and common vulnerability model. Findings suggest that (a) boys…

  16. Co-Development of Internalizing and Externalizing Problem Behaviors: Causal Direction and Common Vulnerability (United States)

    Lee, Eunju J.; Bukowski, William M.


    Latent growth curve modeling was used to study the co-development of internalizing and externalizing problems in a sample of 2844 Korean fourth graders followed over four years. The project integrated two major theoretical viewpoints positing developmental mechanism: directional model and common vulnerability model. Findings suggest that (a) boys…

  17. Proceedings of the third international symposium on fire economics, planning, and policy: common problems and approaches (United States)

    Armando González-Cabán


    These proceedings summarize the results of a symposium designed to address current issues of agencies with wildland fire protection responsibility at the federal and state levels in the United States as well as agencies in the international community. The topics discussed at the symposium included regional, national, and global vision of forest fires: common problems...

  18. Hierarchical Multiple Regression in Counseling Research: Common Problems and Possible Remedies. (United States)

    Petrocelli, John V.


    A brief content analysis was conducted on the use of hierarchical regression in counseling research published in the "Journal of Counseling Psychology" and the "Journal of Counseling & Development" during the years 1997-2001. Common problems are cited and possible remedies are described. (Contains 43 references and 3 tables.) (Author)

  19. Common Dermatoses in Children Referred to a Specialized Pediatric Dermatology Service in Mexico: A Comparative Study between Two Decades

    National Research Council Canada - National Science Library

    Del Pozzo-Magaña, Blanca Rosa; Lazo-Langner, Alejandro; Gutiérrez-Castrellón, Pedro; Ruiz-Maldonado, Ramón


    .... It is likely that these diseases might have changed their frequency. Material and Methods. Retrospective study in first-time patients referred to a pediatric dermatology service between January 1994 and December 2003...

  20. Analysis of common cytogenetic abnormalities in New Zealand pediatric ALL shows ethnically diverse carriage of ETV6-RUNX1, without a corresponding difference in survival. (United States)

    Pettit, Tristan; Cole, Nyree; Leung, Wingchi; Ballantine, Kirsten; Macfarlane, Scott


    The frequency of common cytogenetic abnormalities in pediatric acute lymphoblastic leukemia (ALL) is known to vary by geographic location and ethnic origin. This study aimed to determine the frequency of hypodiploidy, ETV6-RUNX1, BCR-ABL1, and MLL rearrangement within New Zealand's pediatric ALL population and to assess whether the frequency of these ALL prognostic markers varies according to ethnicity. The New Zealand Children's Cancer Registry provided information for all registered pediatric ALL patients that were diagnosed between 2000 and 2009, with medical records available for 246 patients. Each patient's medical record was reviewed to determine the frequency of hypodiploidy, ETV6-RUNX1, BCR-ABL1, MLL rearrangement, and cell lineage. Chi-square tests for independence were undertaken to compare the frequencies of cytogenetic abnormalities according to prioritized ethnicity. The frequency of cytogenetic ALL abnormalities in the New Zealand pediatric population were consistent with international reference values. A low frequency of ETV6-RUNX1 was evident for Maori pediatric ALL patients (5.4%, P = 0.018), when compared to Pacific peoples (21.1%) and non-Maori/non-Pacific peoples (27.4%). This has not impacted on outcome, however, with equivalent 5-year overall survival being observed in Maori (89.4%) compared to Pacific peoples (92.0%) and non-Maori/non-Pacific peoples (90.2%). A lower frequency of the favorable prognostic marker ETV6-RUNX1 was observed in Maori pediatric ALL patients. This did not translate into poorer survival. Future research into biological and nonbiological prognostic factors in this patient population may assist in explaining this finding. © 2017 Wiley Periodicals, Inc.

  1. Effect of sucrose in different commonly used pediatric medicines upon plaque pH in human subjects

    Directory of Open Access Journals (Sweden)

    Arun Sharma


    Full Text Available Introduction: This study was conducted with the aim to investigate the acidogenic potential of three commonly used pediatric medicines (benadryl syrup, crocin syrup, and novamox dry syrup upon plaque pH. Materials and Methods: The protocol used in the study followed the guidelines laid down at Scientific Consensus Conferences on methods for assessment of cariogenic potential of food, San Antonio, Texas. Ten young healthy adult volunteers were selected for the study. Subjects were refrained from brushing their teeth for 48 h and did not eat or drink for at least 2 ΍ h prior to each appointment. pH measurements were taken at baseline to determine resting plaque pH and at time interval of 5, 10, 15, 20, 25, and 30 min following a 1 min rinse with each medication. A pooled sample of plaque was removed from buccal / lingual surfaces, thoroughly mixed with 0.6 ml of double distilled deionized water and plaque pH was determined using a glass combination electrode. Data were compared with plaque pH changes after rinsing with control solution of 10 % sucrose and 10 % sorbitol. Analysis of minimum pH, maximum pH drop, and area under the baseline pH was computed for each medicine and for each case and the test of significance was conducted through the unpaired Student ′t′ test. Results: There was no significant difference between the benadryl syrup, crocin syrup, and sucrose solution as the medicines behaving essentially same as ten percent sucrose solution with respect to their potential to generate acids.

  2. A Research of the Employment Problem on Common Job-seekers and Graduates

    Institute of Scientific and Technical Information of China (English)

    Bai-Da Qu


    A problem on the employment market swarming with both multitudinous common job-seekers and graduates was studied. The employment situation in the market was analyzed firstly. Based on the analysis, the situation was dynamically modeled. The model was properly processed and simplified. A control model corresponding to the method was deduced. As a result, a control solution for the model is obtained, and an example with Simulink demonstrates the control effect. By means of the proposed method, an optimal control for the dynamic balance between multitudinous common job-seekers and graduates can be obtained.

  3. Creating a Pediatric Digital Library for Pediatric Health Care Providers and Families (United States)

    D'Alessandro, Donna; Kingsley, Peggy


    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library ( used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance. PMID:11861631

  4. [Pediatric emergencies in the emergency medical service]. (United States)

    Silbereisen, C; Hoffmann, F


    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  5. What Is a Pediatric Geneticist? (United States)

    ... Text Size Email Print Share What is a Pediatric Geneticist? Page Content Article Body Fortunately, most children ... with similar problems. What Kind of Training Do Pediatric Geneticists Have? Pediatric geneticists are medical doctors who ...

  6. Common chronic health problems and life satisfaction among Macau elderly people


    Hu, Sydney X. X.; Wai In Lei; Ka Kei Chao; Hall, Brian J.; Siu Fung Chung


    Aim: Most elderly people live with one or more health problems and their quality of life is affected. This study aimed to compare life satisfaction of elderly people living with common chronic medical illness compared with those without these health conditions in order to identify conditions that most affect life satisfaction of elderly people living in the community. Method: The data was collected by a questionnaire survey of 529 elderly living in community dwellings of Macau using a sing...

  7. The Split Common Fixed Point Problem for Total Asymptotically Strictly Pseudocontractive Mappings

    Directory of Open Access Journals (Sweden)

    S. S. Chang


    Full Text Available The purpose of this paper is to propose an algorithm for solving the split common fixed point problems for total asymptotically strictly pseudocontractive mappings in infinite-dimensional Hilbert spaces. The results presented in the paper improve and extend some recent results of Moudafi (2011 and 2010, Xu (2010 and 2006, Censor and Segal (2009, Censor et al. (2005, Masad and Reich (2007, Censor et al. (2007, Yang (2004, and others.

  8. Common psychiatric problems in homosexual men and women consulting family physicians.


    Myers, M. F.


    This paper describes the commoner psychiatric difficulties of homosexual patients seen in a family practice. It is written primarily to aid general practitioners in deciding who should be referred to a psychiatrist. Recent developments in the study of homosexuality indicate that homosexual persons are no more likely than heterosexuals to suffer psychiatric problems. Practical suggestions are made for management and counseling, and some of the misconceptions about the gay community are dispelled.

  9. The common property resource problem and the fisheries of Barbados and Jamaica (United States)

    Berkes, Fikret


    Common property resources (CPR) tend to be particularly susceptible to depletion and degredation. This creates problems for sustainable development and for resource stewardship in general since many of the key global resources are common property. The article explores the different definitions of CPR and the traps associated with the harvesting of CPR without understanding the social, economic, and environmental costs related to their exploitation. The commons problem may be approached in terms of a private property solution, the allocation of individual quotas to fishermen, or a communal property solution in which communities of fishermen basically manage their own fisheries. The offshore fishery of Barbados lends itself to the private property solution, and the inshore fishery of Jamaica, to the communal property solution. Drawing from case studies of Jamaica and Barbados fisheries, four principles of CPR use are proposed: (a) the solution of the CPR problem starts with the control of access to the resource, (b) increasing production from a CPR depends on the conservation of the resource base, (c) the sustainable utilization of a CPR is closely connected to the use of technology appropriate for the harvest, and (d) local-level management improves prospects for the sustainable use of a CPR. The case studies illustrate that there may be local, national, and international levels of interest over the resource. Hence, the successful management of such resources as Barbados and Jamaica fisheries requires that conflicting demands for the resources be taken into account, perhaps using a cooperative management approach.

  10. Longitudinal outcome and recovery of social problems after pediatric traumatic brain injury (TBI): Contribution of brain insult and family environment. (United States)

    Ryan, Nicholas P; van Bijnen, Loeka; Catroppa, Cathy; Beauchamp, Miriam H; Crossley, Louise; Hearps, Stephen; Anderson, Vicki


    Pediatric traumatic brain injury (TBI) can result in a range of social impairments, however longitudinal recovery is not well characterized, and clinicians are poorly equipped to identify children at risk for persisting difficulties. Using a longitudinal prospective design, this study aimed to evaluate the contribution of injury and non-injury related risk and resilience factors to longitudinal outcome and recovery of social problems from 12- to 24-months post-TBI. 78 children with TBI (injury age: 5.0-15.0 years) and 40 age and gender-matched typically developing (TD) children underwent magnetic resonance imaging including a susceptibility-weighted imaging (SWI) sequence 2-8 weeks post-injury (M=39.25, SD=27.64 days). At 12 and 24-months post- injury, parents completed questionnaires rating their child's social functioning, and environmental factors including socioeconomic status, caregiver mental health and family functioning. Results revealed that longitudinal recovery profiles differed as a function of injury severity, such that among children with severe TBI, social problems significantly increased from 12- to 24-months post-injury, and were found to be significantly worse than TD controls and children with mild and moderate TBI. In contrast, children with mild and moderate injuries showed few problems at 12-months post-injury and little change over time. Pre-injury environment and SWI did not significantly contribute to outcome at 24-months, however concurrent caregiver mental health and family functioning explained a large and significant proportion of variance in these outcomes. Overall, this study shows that longitudinal recovery profiles differ as a function of injury severity, with evidence for late-emerging social problems among children with severe TBI. Poorer long-term social outcomes were associated with family dysfunction and poorer caregiver mental health at 24-months post injury, suggesting that efforts to optimize the child's environment and

  11. The pediatric surgery workforce in low- and middle-income countries: problems and priorities. (United States)

    Krishnaswami, Sanjay; Nwomeh, Benedict C; Ameh, Emmanuel A


    Most of the world is in a surgical workforce crisis. While a lack of human resources is only one component of the myriad issues affecting surgical care in resource-poor regions, it is arguably the most consequential. This article examines the current state of the pediatric surgical workforce in low- and middle-income countries (LMICs) and the reasons for the current shortfalls. We also note progress that has been made in capacity building and discuss priorities going forward. The existing literature on this subject has naturally focused on regions with the greatest workforce needs, particularly sub-Saharan Africa (SSA). However, wherever possible we have included workforce data and related literature from LMICs worldwide. The pediatric surgeon is of course critically dependent on multi-disciplinary teams. Surgeons in high-income countries (HICs) often take for granted the ready availability of excellent anesthesia providers, surgically trained nurses, radiologists, pathologists, and neonatologists among many others. While the need exists to examine all of these disciplines and their contribution to the delivery of surgical services for children in LMICs, for the purposes of this review, we will focus primarily on the role of the pediatric surgeon. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Association of common cold with exacerbations in pediatric but not adult patients with tic disorder : A prospective longitudinal study

    NARCIS (Netherlands)

    Hoekstra, PJ; Manson, WL; Steenhuis, MP; Kallenberg, CGM; Minderaa, RB

    Cross-sectional data and case studies suggest a temporal relationship between fluctuations in tic severity and preceding infections. In this study, we aimed to examine this possible relationship in a prospective longitudinal design. Two groups of tic disorder patients were included, a pediatric

  13. Theory of mind mediates the prospective relationship between abnormal social brain network morphology and chronic behavior problems after pediatric traumatic brain injury. (United States)

    Ryan, Nicholas P; Catroppa, Cathy; Beare, Richard; Silk, Timothy J; Crossley, Louise; Beauchamp, Miriam H; Yeates, Keith Owen; Anderson, Vicki A


    Childhood and adolescence coincide with rapid maturation and synaptic reorganization of distributed neural networks that underlie complex cognitive-affective behaviors. These regions, referred to collectively as the 'social brain network' (SBN) are commonly vulnerable to disruption from pediatric traumatic brain injury (TBI); however, the mechanisms that link morphological changes in the SBN to behavior problems in this population remain unclear. In 98 children and adolescents with mild to severe TBI, we acquired 3D T1-weighted MRIs at 2-8 weeks post-injury. For comparison, 33 typically developing controls of similar age, sex and education were scanned. All participants were assessed on measures of Theory of Mind (ToM) at 6 months post-injury and parents provided ratings of behavior problems at 24-months post-injury. Severe TBI was associated with volumetric reductions in the overall SBN package, as well as regional gray matter structural change in multiple component regions of the SBN. When compared with TD controls and children with milder injuries, the severe TBI group had significantly poorer ToM, which was associated with more frequent behavior problems and abnormal SBN morphology. Mediation analysis indicated that impaired theory of mind mediated the prospective relationship between abnormal SBN morphology and more frequent chronic behavior problems. Our findings suggest that sub-acute alterations in SBN morphology indirectly contribute to long-term behavior problems via their influence on ToM. Volumetric change in the SBN and its putative hub regions may represent useful imaging biomarkers for prediction of post-acute social cognitive impairment, which may in turn elevate risk for chronic behavior problems.

  14. Resources for pediatric drug information. (United States)

    Zenk, K E


    Finding information on the use of drugs fro infants and children is becoming easier with the publication of excellent resources for pediatric and neonatal drug information. Useful pediatric texts and journals are listed. Texts are graded A and B. Category A books would be useful to include in a basic pharmacy library; Category B books are more comprehensive but expensive, or texts that are not as highly recommended as those in Category A. Some of the resources listed include: (1) Pediatrics--Nelson Textbook of Pediatrics, Rudolph's Pediatrics, Current Pediatric Diagnosis and Treatment, Manual of Pediatric Therapeutics; (2) Dosage Guides--The Pediatric Drug Handbook, Harriet Lane Handbook, Problems in Pediatric Drug THerapy; (3) Intensive Care--Textbook of Pediatric Intensive Care; (4) Infectious Disease--Report of the Committee on Infectious Diseases, Pocketbook of Pediatric Antimicrobial Therapy; (5) Poisoning--Handbook of Poisoning, Medical Toxicology; (6) Parenteral Nutrition--Manual of Pediatric Parenteral Nutrition; (7) Pregnancy and Lactation--Drugs in Pregnancy and Lactation; (8) Compounding--Handbook on Extemporaneous Formulation; (9) IV Administration--Guidelines for Administration of Intravenous Medications to Pediatric Patients; (1) Neonatology--Schaffers Diseases of the Newborn, Neonatology, Basic Management, On-Call Problems, Diseases, Drugs, Drug Therapy in Infants; (11) Pediatric Journals--Pediatrics, Journal of Pediatrics, American Journal of Diseases of Children, Pediatric Infectious Disease Journal, Pediatric Alert, Clinics in Perinatology, Pediatric Clinics of North America, Pediatric Clinical Oncology Journal, and Pediatric Surgery.

  15. BTEX air concentrations and self-reported common health problems in gasoline sellers from Cotonou, Benin. (United States)

    Tohon, Honesty Gbèdolo; Fayomi, Benjamin; Valcke, Mathieu; Coppieters, Yves; Bouland, Catherine


    To examine the relation between BTEX exposure levels and common self-reported health problems in 140 gasoline sellers in Cotonou, Benin, a questionnaire documenting their socioeconomic status and their health problems was used, whereas 18 of them went through semi-directed qualitative individual interviews and 17 had air samples taken on their workplace for BTEX analysis. Median concentrations for BTEX were significantly lower on official (range of medians: 54-207 μg/m³, n = 9) vs unofficial (148-1449 μg/m³, n = 8) gasoline-selling sites (p sellers from unofficial vs official selling sites (p sellers, leading to their, in some cases, preoccupying BTEX exposure.

  16. Algorithms of common solutions to quasi variational inclusion and fixed point problems

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shi-sheng; LEE Joseph H. W.; CHAN Chi Kin


    The purpose of this paper is to present an iterative scheme for finding a common element of the set of solutions to the variational inclusion problem with multi-valued maximal monotone mapping and inverse-strongly monotone mappings and the set of fixed points of nonexpansive mappings in Hilbert space. Under suitable conditions, some strong convergence theorems for approximating this common elements are proved. The results presented in the paper not only improve and extend the main results in Korpelevich (Ekonomika i Matematicheskie Metody, 1976, 12(4):747-756), but also extend and replenish the corresponding results obtained by Iiduka and Takahashi (Nonlinear Anal TMA, 2005, 61(3):341-350), Takahashi and Toyoda (J Optim Theory Appl, 2003,118(2):417-428), Nadezhkina and Takahashi (J Optim Theory Appl, 2006, 128(1):191-201), and Zeng and Yao (Taiwanese Journal of Mathematics, 2006, 10(5):1293-1303).

  17. Beyond Open Source Software: Solving Common Library Problems Using the Open Source Hardware Arduino Platform

    Directory of Open Access Journals (Sweden)

    Jonathan Younker


    Full Text Available Using open source hardware platforms like the Arduino, libraries have the ability to quickly and inexpensively prototype custom hardware solutions to common library problems. The authors present the Arduino environment, what it is, what it does, and how it was used at the James A. Gibson Library at Brock University to create a production portable barcode-scanning utility for in-house use statistics collection as well as a prototype for a service desk statistics tabulation program’s hardware interface.

  18. Are falls more common than road traffic accidents in pediatric trauma?Experience from a Level 1 trauma centre in New Delhi, India

    Institute of Scientific and Technical Information of China (English)

    Annu Babu; Amulya Rattan; Piyush Ranjan; Maneesh Singhal; Amit Gupta; Subodh Kumar; Biplab Mishra


    Purpose:The epidemiology of pediatric trauma is different in different parts of the world.Some researchers suggest falls as the most common mechanism,whereas others report road traffic accidents (RTAs) as the most common cause.The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi,India.Methods:Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry.All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included.Data were retrieved in predesigned proformas.Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21.Results:We had 300 patients over a 33 month period.Among them,236 (78.6%) were males and 64 (21.3%) females.Overall the predominant cause was RTAs in 132 (43%) patients.On subgroup analysis of up to 12 years age group (n =147),the most common cause was found to be RTAs again.However,falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall),catching up with RTAs (44.89%).Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 + 2.022.223 (74.33%) patients experienced trauma limited to one anatomic region only,whereas 77 (25.66%) patients suffered polytrauma.288 patients were discharged to home care.Overall,12 patients expired in the cohort.Median hospital stay was 6 days (range 1-182).Conclusion:Pediatric trauma is becoming a cause of increasing concern,especially in the developing countries.The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%);however,falls from height are showing an increasing trend as we move to younger age groups.Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and

  19. Individual and socio-demographic factors related to presenting problem and diagnostic impressions at a pediatric sleep clinic. (United States)

    Rubens, Sonia L; Patrick, Kristina E; Williamson, Ariel A; Moore, Melisa; Mindell, Jodi A


    Individual and socio-demographic factors have been found to be associated with sleep disturbances in children. Few studies have examined these factors among children presenting for care at pediatric sleep clinics. This study examined individual and socio-demographic factors in association with presenting problems and diagnostic impressions for new patients at an interdisciplinary pediatric sleep clinic. Data were collected from electronic medical records of 207 consecutive patients (54% male, 59% White, Meanage = 7.73, SD = 5.62). Older age, female gender, and White race were associated with higher likelihood of presenting with difficulty falling asleep; younger age, male gender, and Black race were associated with higher likelihood of presenting with obstructive sleep apnea (OSA)-related concerns. Older age was associated with diagnostic impressions of inadequate sleep hygiene, insufficient sleep, circadian rhythm disorder/delayed sleep phase disorder, periodic limb movement disorder/restless legs syndrome, and insomnia, while younger age was associated with provisional OSA and behavioral insomnia of childhood (BIC) diagnoses. Male gender was associated with provisional OSA. White race was associated with BIC. Age-based analyses were also conducted to further understand the findings within a developmental context. Age- and gender-related findings converged with prevalence literature on pediatric sleep disorders. Race was only associated with presenting concern and BIC, and one association for neighborhood disadvantage was found within the age-based analysis. Results suggest a potential service delivery gap, with racial/ethnic minority youth being less likely to present for sleep services, despite prevalence data on the increased likelihood of sleep disturbances among these youth. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. The Problems of the Identical Product Name on the EU Common Agrarian Market

    Directory of Open Access Journals (Sweden)

    Vojtěch TAMÁŠ


    Full Text Available The paper deals with the current problem of agrarian sector withinfluence mainly to food producers. It deals with their impact on changes ofagricultural producer’s position in a framework of food production systems.Concretely paper deals with the problems of risk related to milk products pricingdistortion due to possibility of substitution milk fat behalf vegetable fat. Togetherwith formation of such a risk, food producers are dealing with the other problem,which is using of the similar product name on the common market of EU. Problemis currently related to using the term “spread butter“, which is denoted as deceivebecause of harming a butter producers. There is an argument that by the influenceof currently used term might be those two products consider as a perfect substitutes,between which arise an elicitation of the cross substitution effect. On the Europeanenlarged market of the food could to several situations occur, particularly if there isan offer of the products of the similar, or even the same product name. This is veryoften visible on the EU common market, this naturally cause problems especially ifthe composition of the product and the production technology are completelydifferent. The solution of this problem is linked to the question of the economicalsubstitution, which is usually related to completely different products. This bringsabout damage to food producers on the first side, and also a deception of consumeron the second side. The example of such as situation is currently visible on theEuropean dairy market, concretely in the case of dairy products. In this article willbe explained the situation linked to problem of the Czech producers of “Spreadbutter”, which is a traditional Czech product and the producers of the “Traditionalbutter”.European Commission ruled in producers of “Traditional Favour” favour,which means that it will be no longer possible to sell products, with lower than 39%of milk fat, under the

  1. [Current problems in training of minimally invasive surgery: vision of residents in pediatric surgery]. (United States)

    Corona, C; Cano, I; Peláez, D; Fuentes, S; Tardáguila, A R


    Minimally Invasive Surgery (MIS) is getting more and more important in our specialty. However, the formation of the residents on MIS is, in many cases, irregular. The purpose of this study is to assess the state of training in MIS among the residents of Pediatric Surgery and their potential weaknesses. An electronic survey was distributed among 71 residents of Pediatric Surgery from 17 national hospitals. The response rate was 70.2%.100% of the residents are interested in a broadening of training activities in MIS. The main areas of interest are gastrointestinal (92%) and thoracic (47%) surgery. Only 57% have access to training facilities and less than half of them attend to courses and conferences. 80% believe that they are not given adequate attention from specialized associations. 52% think they should do rotations at referral centers, 86% that courses and seminars should be enhanced, and 44% that the responsibility of the resident in surgery should be increased. The main defects encountered in their training are scarce volume of patients, lack of financial support and overcoming the learning curve of surgeons in their services. Despite the advance of the MIS, resident's training in this discipline still has shortcomings, as expressed in their views. Knowledge of the current state of training should be the starting point for designing a training strategy that ensures adequate skills.

  2. Research priorities for non-pharmacological therapies for common musculoskeletal problems: nationally and internationally agreed recommendations

    Directory of Open Access Journals (Sweden)

    Windt Danielle


    Full Text Available Abstract Background Musculoskeletal problems such as low back pain, neck, knee and shoulder pain are leading causes of disability and activity limitation in adults and are most frequently managed within primary care. There is a clear trend towards large, high quality trials testing the effectiveness of common non-pharmacological interventions for these conditions showing, at best, small to moderate benefits. This paper summarises the main lessons learnt from recent trials of the effectiveness of non-pharmacological therapies for common musculoskeletal conditions in primary care and provides agreed research priorities for future clinical trials. Methods Consensus development using nominal group techniques through national (UK and international workshops. During a national Clinical Trials Thinktank workshop in April 2007 in the UK, a group of 30 senior researchers experienced in clinical trials for musculoskeletal conditions and 2 patient representatives debated the possible explanations for the findings of recent high quality trials of non-pharmacological interventions. Using the qualitative method of nominal group technique, these experts developed and ranked a set of priorities for future research, guided by the evidence from recent trials of treatments for common musculoskeletal problems. The recommendations from the national workshop were presented and further ranked at an international symposium (hosted in Canada in June 2007. Results 22 recommended research priorities were developed, of which 12 reached consensus as priorities for future research from the UK workshop. The 12 recommendations were reduced to 7 agreed priorities at the international symposium. These were: to increase the focus on implementation (research into practice; to develop national musculoskeletal research networks in which large trials can be sited and smaller trials supported; to use more innovative trial designs such as those based on stepped care and subgrouping for

  3. Pediatric Cardiomyopathies. (United States)

    Lee, Teresa M; Hsu, Daphne T; Kantor, Paul; Towbin, Jeffrey A; Ware, Stephanie M; Colan, Steven D; Chung, Wendy K; Jefferies, John L; Rossano, Joseph W; Castleberry, Chesney D; Addonizio, Linda J; Lal, Ashwin K; Lamour, Jacqueline M; Miller, Erin M; Thrush, Philip T; Czachor, Jason D; Razoky, Hiedy; Hill, Ashley; Lipshultz, Steven E


    Pediatric cardiomyopathies are rare diseases with an annual incidence of 1.1 to 1.5 per 100 000. Dilated and hypertrophic cardiomyopathies are the most common; restrictive, noncompaction, and mixed cardiomyopathies occur infrequently; and arrhythmogenic right ventricular cardiomyopathy is rare. Pediatric cardiomyopathies can result from coronary artery abnormalities, tachyarrhythmias, exposure to infection or toxins, or secondary to other underlying disorders. Increasingly, the importance of genetic mutations in the pathogenesis of isolated or syndromic pediatric cardiomyopathies is becoming apparent. Pediatric cardiomyopathies often occur in the absence of comorbidities, such as atherosclerosis, hypertension, renal dysfunction, and diabetes mellitus; as a result, they offer insights into the primary pathogenesis of myocardial dysfunction. Large international registries have characterized the epidemiology, cause, and outcomes of pediatric cardiomyopathies. Although adult and pediatric cardiomyopathies have similar morphological and clinical manifestations, their outcomes differ significantly. Within 2 years of presentation, normalization of function occurs in 20% of children with dilated cardiomyopathy, and 40% die or undergo transplantation. Infants with hypertrophic cardiomyopathy have a 2-year mortality of 30%, whereas death is rare in older children. Sudden death is rare. Molecular evidence indicates that gene expression differs between adult and pediatric cardiomyopathies, suggesting that treatment response may differ as well. Clinical trials to support evidence-based treatments and the development of disease-specific therapies for pediatric cardiomyopathies are in their infancy. This compendium summarizes current knowledge of the genetic and molecular origins, clinical course, and outcomes of the most common phenotypic presentations of pediatric cardiomyopathies and highlights key areas where additional research is required. URL: http

  4. Emergencies in orthodontics. Part 1: Management of general orthodontic problems as well as common problems with fixed appliances. (United States)

    Dowsing, Paul; Murray, Alison; Sandler, Jonathan


    Fixed appliance treatment is a popular treatment modality with a burgeoning increase in the numbers of children and adults realizing the benefits that can be gained. Appliance breakage is an unavoidable nuisance which is at best inconvenient, and at worst may result in significant pain or discomfort for the patient. General dental practitioners (GDPs) should have the practical knowledge of how to provide timely and appropriate orthodontic 'emergency treatment'. This will significantly reduce the sometimes considerable inconvenience and discomfort for both the patient and his/her parents, and the inevitable frustration for the clinician providing ongoing care. This first paper will deal with general orthodontic problems that commonly present, as well as some issues specific to fixed appliances. The second paper will deal with the other orthodontic appliances that may be encountered by GDPs in their daily practice. Clinical Relevance: Appropriate handling of an orthodontic 'emergency' by the general practitioner will, on many occasions, provide immediate relief of pain and distress for the patient. This will in turn allow treatment to continue moving in the right direction, thus allowing more efficient and effective use of valuable resources.

  5. Pediatric drugs in China:problems and countermeasures%中国儿童用药存在的问题及对策研究

    Institute of Scientific and Technical Information of China (English)

    孙利华; 尚阳; 唐密


    Taking the differences between the pediatric drugs and adult drugs as the starting-point,this article analyzes the main problems of the pediatric drugs in China,such as the shortage of the pediatric drugs. The causes of the problems mainly include high research and development cost of the pediatric drugs,their limited market capacity,difficulty in recruiting trial participants,the less clinical trial institutions in pediatrics,and governments′incentive polices on research and development of pediatric drugs did not really play their roles. The countermeasures to solve these problems mainly include introducing relevant policy to guarantee the re⁃search and development companies′profit,selecting appropriate varieties of the pediatric drugs to research and develop,promoting the establishment of pediatric clinical trial institutions as soon as possible,and establishing particular passage for pediatric drugs ap⁃proval,in order to provide references for the government when making policies on pediatric drugs.%本文以儿童用药与成人用药的不同之处为切入点,针对目前中国儿童用药存在的主要问题,如品种、剂型和规格缺乏等进行深入分析,指出导致中国儿童用药存在问题的原因主要包括儿科药品研发成本高、市场容量相对有限、临床试验受试者招募难、临床试验机构数量相对较少、政府关于儿科药品研发的激励政策尚未真正发挥作用,并对此提出及早出台相关政策以保障研发和生产儿科药品的利润空间、选择适宜的儿科药品研发品种、促进数量足以满足需求的儿童用药临床试验机构的及早建立、将儿科药品的审批列入特别通道的对策与建议,以期为中国制定儿童用药的相关政策提供参考。

  6. Common statistical and research design problems in manuscripts submitted to high-impact medical journals

    Directory of Open Access Journals (Sweden)

    Harris Alex HS


    Full Text Available Abstract Background To assist educators and researchers in improving the quality of medical research, we surveyed the editors and statistical reviewers of high-impact medical journals to ascertain the most frequent and critical statistical errors in submitted manuscripts. Findings The Editors-in-Chief and statistical reviewers of the 38 medical journals with the highest impact factor in the 2007 Science Journal Citation Report and the 2007 Social Science Journal Citation Report were invited to complete an online survey about the statistical and design problems they most frequently found in manuscripts. Content analysis of the responses identified major issues. Editors and statistical reviewers (n = 25 from 20 journals responded. Respondents described problems that we classified into two, broad themes: A. statistical and sampling issues and B. inadequate reporting clarity or completeness. Problems included in the first theme were (1 inappropriate or incomplete analysis, including violations of model assumptions and analysis errors, (2 uninformed use of propensity scores, (3 failing to account for clustering in data analysis, (4 improperly addressing missing data, and (5 power/sample size concerns. Issues subsumed under the second theme were (1 Inadequate description of the methods and analysis and (2 Misstatement of results, including undue emphasis on p-values and incorrect inferences and interpretations. Conclusions The scientific quality of submitted manuscripts would increase if researchers addressed these common design, analytical, and reporting issues. Improving the application and presentation of quantitative methods in scholarly manuscripts is essential to advancing medical research.

  7. BES-HEP Connections: Common Problems in Condensed Matter and High Energy Physics, Round Table Discussion

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, Eduardo [Univ. of Illinois, Urbana, IL (United States); Maldacena, Juan [Inst. for Advanced Study, Princeton, NJ (United States); Chatterjee, Lali [Dept. of Energy (DOE), Washington DC (United States). Office of Science. Office of High Energy Physics; Davenport, James W [Dept. of Energy (DOE), Washington DC (United States). Office of Science. Office of Basic Energy Sciences


    On February 2, 2015 the Offices of High Energy Physics (HEP) and Basic Energy Sciences (BES) convened a Round Table discussion among a group of physicists on ‘Common Problems in Condensed Matter and High Energy Physics’. This was motivated by the realization that both fields deal with quantum many body problems, share many of the same challenges, use quantum field theoretical approaches and have productively interacted in the past. The meeting brought together physicists with intersecting interests to explore recent developments and identify possible areas of collaboration.... Several topics were identified as offering great opportunity for discovery and advancement in both condensed matter physics and particle physics research. These included topological phases of matter, the use of entanglement as a tool to study nontrivial quantum systems in condensed matter and gravity, the gauge-gravity duality, non-Fermi liquids, the interplay of transport and anomalies, and strongly interacting disordered systems. Many of the condensed matter problems are realizable in laboratory experiments, where new methods beyond the usual quasi-particle approximation are needed to explain the observed exotic and anomalous results. Tools and techniques such as lattice gauge theories, numerical simulations of many-body systems, and tensor networks are seen as valuable to both communities and will likely benefit from collaborative development.

  8. Effective doses associated with PET-CT scans two common in pediatric patients; Dosis efectivas asociadas a dos exploraciones PET-CT habituales en pacientes pediatricos

    Energy Technology Data Exchange (ETDEWEB)

    Camacho Lopez, C.; Garcia Martinez, M. t.; Marti Vidal, J. f.; Falgas Lacuela, M.; Vercher Conejero, J. L.


    The main objective of this paper is to outline the effective dose (E) that can be given in two studies conducted PET-CT common for children, in the absence of standard protocols both at standardizing the way image acquisition in this field, as standard levels to guide us when it comes to associate a certain effective dose to pediatric PET-CT scan. These doses will be compared to an adult patient receiving the same type of examination, and consider the percentage of the total dose due to TC.

  9. Junk food seen at pediatric clinic visits: is it a problem? (United States)

    Frazier, Johnnie P; Land, Megan; Hsieh, Pei-Hsuan; Barratt, Michelle S


    To document the prevalence of junk foods seen at clinic visits. A cross-sectional 23-item survey of observed food items were completed by medical staff using a convenience sample of families from June 2, 2011 to March 2, 2012. The study was conducted in pediatric clinics affiliated with the University of Texas Medical School at Houston. A convenience sample consisting of 738 families with children from 4 months to 16 years old presenting for visits were included in the study. Children exclusively breast and formula fed was excluded. Junk food was observed 20.9% at the clinic visits. Junk food was often seen at clinic visits. There was a trend toward higher body mass index in patients whose families had junk food at the visit.

  10. Evaluation of the Pediatric Symptom Checklist as a screening tool for the identification of emotional and psychosocial problems (United States)

    Muzzolon, Sandra Regina B.; Cat, Mônica Nunes L.; dos Santos, Lúcia Helena C.


    OBJECTIVE To investigate the Brazilian version of Pediatric Symptom Checklist (PSC) as a screening tool to identify psychosocial and emotional problems in schoolchildren from six to 12 years old. METHODS Diagnostic test conducted in a public school of Curitiba, Paraná (Southern Brazil), to evaluate the PSC accuracy and consistency, considering the Child Behavior Checklist (CBCL) as the gold standard. Among 415 parents invited for the study, 145 responded to both PSC and CBCL. The results of the two instruments were compared. PSC and CBCL were considered positive if scores ≥28 and >70 respectively. RESULTS Among the 145 cases, 49 (33.8%) were positive for both PSC and CBCL. The ROC curve showed the PSC score of 21 as the best cutoff point for screening psychosocial and emotional problems, with a sensitivity of 96.8% and a specificity of 86.7%. Regarding the reference cutoff (score ≥28 points), the sensitivity was 64.5% and the specificity, 100.0%, similar to those found in the original version of the tool. CONCLUSIONS The Portuguese version of PSC was effective for early identification of emotional and/or psychosocial problems in a schoolchildren group and may be useful for pediatricians. PMID:24142319

  11. Tragedy of the Commons, Business Growth and the Fundamental Sustainability Problem

    Directory of Open Access Journals (Sweden)

    Edward J. Garrity


    Full Text Available This paper reviews the major issues involved in Hardin’s [1] tragedy of the commons, written over 44 years ago, and examines whether these issues are still relevant today. We assert that this model still provides important insight to aid in the solution to our global problems. In particular, we maintain that the underlying issues of growth against limits and bounded rationality are still not adequately recognized and addressed; this underlies many of the reasons for our unsustainable world. Examples from fisheries management are used to examine potential solutions and reveal weaknesses in current approaches. We show how our current, restricted mental models promote social injustice and blind us to developing sustainable solutions. Both the neo-liberal economic view of business that directly seeks growth and the new sustainable development view that indirectly supports growth are leading our global economy in the wrong direction and away from prosperity and sustainability. Current thinking has not realized Hardin’s message that sustainability is of the class of no technology solution problems. We conclude with recommendations to radically advance a new world view and business paradigm.

  12. Common problems in the elicitation and analysis of expert opinion affecting probabilistic safety assessments

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, M.A.; Booker, J.M.


    Expert opinion is frequently used in probabilistic safety assessment (PSA), particularly in estimating low probability events. In this paper, we discuss some of the common problems encountered in eliciting and analyzing expert opinion data and offer solutions or recommendations. The problems are: that experts are not naturally Bayesian. People fail to update their existing information to account for new information as it becomes available, as would be predicted by the Bayesian philosophy; that experts cannot be fully calibrated. To calibrate experts, the feedback from the known quantities must be immediate, frequent, and specific to the task; that experts are limited in the number of things that they can mentally juggle at a time to 7 {plus minus} 2; that data gatherers and analysts can introduce bias by unintentionally causing an altering of the expert's thinking or answers; that the level of detail the data, or granularity, can affect the analyses; and the conditioning effect poses difficulties in gathering and analyzing of the expert data. The data that the expert gives can be conditioned on a variety of factors that can affect the analysis and the interpretation of the results. 31 refs.

  13. Moving Forward with Common Core State Standards Implementation: Possibilities and Potential Problems

    Directory of Open Access Journals (Sweden)

    Liebtag, Emily


    Full Text Available The standards-based education reform has reshaped curriculum in the United States. This reform came about in large part as a result of the 1983 report A Nation at Risk (U.S. Department of Education, 1983, which urgently warned that something needed to be done to fix failing schools across the nation. This report undoubtedly transformed teaching and learning in schools, despite the fact that almost three decades later our nation still faces the problem of poor student achievement (Dee & Jacob, 2010; Toch, 2012. The No Child Left Behind Act (NCLB of 2001 was an attempt to use recommendations from the earlier report to reform education practices, but it had questionable success. The current attempt to address student achievement concerns written by the Council of Chief State School Officers (CCSSO and the National Governors Association Center for Best Practices (NGA is the Common Core State Standards (CCSS initiative (NGA & CCSSO, 2010. Although not fully implemented yet, there are already foreseeable advantages and disadvantages to the new standards. This perspective piece examines the possibilities and potential problems of this newest reform effort as it relates to social justice and the skills required for current and future educators to implement it.

  14. Common problems of clinical performance examination in breastfeeding instruction for nursing baccalaureate students. (United States)

    Chiu, Fang-Hui; Gau, Meei-Ling; Kuo, Sue-Chen; Chung, Ue-Lin


    The purpose of this study was to investigate the problems commonly seen in the clinical breastfeeding practice of undergraduate nursing students. The criterion for clinical performance examination was the instructional ability index for breastfeeding determined from the competency-based clinical performance examination in maternity nursing, a model developed by Chung et al. (2001). Simple random sampling was used to access 60 participants from the 213 baccalaureate students from the second year of a nursing department who had completed obstetric nursing education. The average age of the subjects was 20.73 years. Most subjects did not have experience either in breastfeeding or in instructing others about breastfeeding. The pass rate in the clinical examination was 26.67 % (n=16), and the difference was only in obstetrics nursing practicum scores and days of practice between pass and fail, with no significant difference in demographic data. The most common mistakes found during breastfeeding instruction by students included distinguishing the infant consciousness state fit for feeding, knowing when to stop feeding, identifying when the baby is hungry or satisfactied via behavioral cues, maternal posture (cradle and football holds, and side-lying), latching on techniques, assisting mother to correctly remove infant from the breast, and overriding test categories such as sepsis, interpersonal relationship, health teaching, physical jeopardy, and bonding. The results of this study can be used by instructors to improve their teaching design in breastfeeding education, as well as by undergraduate students of nursing departments to advance their ability to instruct others about breastfeeding.

  15. Identifying and attributing common data quality problems: temperature and precipitation observations in Bolivia and Peru (United States)

    Hunziker, Stefan; Gubler, Stefanie; Calle, Juan; Moreno, Isabel; Andrade, Marcos; Velarde, Fernando; Ticona, Laura; Carrasco, Gualberto; Castellón, Yaruska; Oria Rojas, Clara; Brönnimann, Stefan; Croci-Maspoli, Mischa; Konzelmann, Thomas; Rohrer, Mario


    Assessing climatological trends and extreme events requires high-quality data. However, for many regions of the world, observational data of the desired quality is not available. In order to eliminate errors in the data, quality control (QC) should be applied before data analysis. If the data still contains undetected errors and quality problems after QC, a consequence may be misleading and erroneous results. A region which is seriously affected by observational data quality problems is the Central Andes. At the same time, climatological information on ongoing climate change and climate risks are of utmost importance in this area due to its vulnerability to meteorological extreme events and climatic changes. Beside data quality issues, the lack of metadata and the low station network density complicate quality control and assessment, and hence, appropriate application of the data. Errors and data problems may occur at any point of the data generation chain, e.g. due to unsuitable station configuration or siting, poor station maintenance, erroneous instrument reading, or inaccurate data digitalization and post processing. Different measurement conditions in the predominantly conventional station networks in Bolivia and Peru compared to the mostly automated networks e.g. in Europe or Northern America may cause different types of errors. Hence, applying QC methods used on state of the art networks to Bolivian and Peruvian climate observations may not be suitable or sufficient. A comprehensive amount of Bolivian and Peruvian maximum and minimum temperature and precipitation in-situ measurements were analyzed to detect and describe common data quality problems. Furthermore, station visits and reviews of the original documents were done. Some of the errors could be attributed to a specific source. Such information is of great importance for data users, since it allows them to decide for what applications the data still can be used. In ideal cases, it may even allow to

  16. Return to work and occupational physicians' management of common mental health problems - process evaluation of a randomized controlled trial

    National Research Council Canada - National Science Library

    David S Rebergen; David J Bruinvels; Chris M Bos; Allard J van der Beek; Willem van Mechelen


    ...) to the Dutch guideline on the management of common mental health problems and its effect on return to work as part of the process evaluation of a trial comparing adherence to the guideline to care as usual...

  17. Convergence Theorems for a Common Point of Solutions of Equilibrium and Fixed Point of Relatively Nonexpansive Multivalued Mapping Problems

    Directory of Open Access Journals (Sweden)

    H. Zegeye


    Full Text Available We introduce an iterative process which converges strongly to a common point of set of solutions of equilibrium problem and set of fixed points of finite family of relatively nonexpansive multi-valued mappings in Banach spaces.

  18. A multi-model evaluation of aerosols over South Asia: common problems and possible causes (United States)

    Pan, X.; Chin, M.; Gautam, R.; Bian, H.; Kim, D.; Colarco, P. R.; Diehl, T. L.; Takemura, T.; Pozzoli, L.; Tsigaridis, K.; Bauer, S.; Bellouin, N.


    Atmospheric pollution over South Asia attracts special attention due to its effects on regional climate, water cycle and human health. These effects are potentially growing owing to rising trends of anthropogenic aerosol emissions. In this study, the spatio-temporal aerosol distributions over South Asia from seven global aerosol models are evaluated against aerosol retrievals from NASA satellite sensors and ground-based measurements for the period of 2000-2007. Overall, substantial underestimations of aerosol loading over South Asia are found systematically in most model simulations. Averaged over the entire South Asia, the annual mean aerosol optical depth (AOD) is underestimated by a range 15 to 44% across models compared to MISR (Multi-angle Imaging SpectroRadiometer), which is the lowest bound among various satellite AOD retrievals (from MISR, SeaWiFS (Sea-Viewing Wide Field-of-View Sensor), MODIS (Moderate Resolution Imaging Spectroradiometer) Aqua and Terra). In particular during the post-monsoon and wintertime periods (i.e., October-January), when agricultural waste burning and anthropogenic emissions dominate, models fail to capture AOD and aerosol absorption optical depth (AAOD) over the Indo-Gangetic Plain (IGP) compared to ground-based Aerosol Robotic Network (AERONET) sunphotometer measurements. The underestimations of aerosol loading in models generally occur in the lower troposphere (below 2 km) based on the comparisons of aerosol extinction profiles calculated by the models with those from Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) data. Furthermore, surface concentrations of all aerosol components (sulfate, nitrate, organic aerosol (OA) and black carbon (BC)) from the models are found much lower than in situ measurements in winter. Several possible causes for these common problems of underestimating aerosols in models during the post-monsoon and wintertime periods are identified: the aerosol hygroscopic growth and formation of

  19. Healthcare Professionals' Knowledge of Family Psychosocial Problems in Pediatric Cancer: A Pilot Study. (United States)

    Barrera, Maru; Rokeach, Alan; Yogalingam, Priyanga; Hancock, Kelly; Johnston, Donna L; Cataudella, Danielle; Cassidy, Marilyn; Punnett, Angela S; Shama, Wendy


    Best practice guidelines for the treatment of cancer now advocate for a child- and family-centered model of care and a psychosocial model of risk prevention. However, healthcare professionals (HCPs) report a number of barriers preventing the implementation of psychosocial care, including an absence of tools to help identify psychosocial problems within the family. The aims of this study are to (1) explore the psychometric properties of the Psychosocial Care Checklist (PCCL) and (2) test if the PCCL can differentiate the degree to which HCPs are aware of psychosocial problems within the family (patient, siblings, parents) of a child with cancer. Thirty-seven HCPs caring for a child with cancer completed the PCCL at time 1 (2-4 weeks after diagnosis) and 29 HCPs completed the PCCL at time 2 (2-3 weeks after). The PCCL had strong test-retest reliability for all domains (α > .60) and strong internal consistency for the total PCCL (α = .91). Interrater reliability was moderate for the oncologist-nurse dyad with regard to sibling knowledge (r = 0.56) and total psychosocial knowledge (r = 0.65). Social workers were significantly more knowledgeable than both nurses and oncologists about total family problems (P = .01) and sibling problems (P = .03). Preliminary findings suggest that the PCCL has adequate test-retest reliability and validity and is useful in differentiating the degree to which HCPs are aware of psychosocial problems within the family, with social workers being the most knowledgeable. Using the PCCL may help HCPs to identify psychosocial problems within the family and appropriately allocate psychosocial resources.

  20. Local Management as a Proposal for the Solution of Urban Planning Common Problems in Latin America

    Directory of Open Access Journals (Sweden)

    Verónica Sánchez García


    Full Text Available The scene of the majority of Latin American cities is hopeless due the crisis faced by this part of the world. The decisive factor was globalization because it forced an economical restructuring and the implementation of new ways of production. Cities had to reorganize to deal with and adapt to this system through “global cities.” This way, it was possible to strengthen certain groups or population areas while ignoring others. This generated and emphasized poverty, which, at the same time, created social and environmental segregation, insecurity, mobility, lack of housing and utilities, overspend, waste of materials and human resources, as well as other institutional difficulties. These were a constant and limited the equitable access to social opportunities.For this reason, every urban planning and prediction system should take into account realistic circumstances that foster solidarity, participation, consensus, and sustainability as the central concept of the strategy to implement. This is known as “local management.” To manage a city implies working together with public, private, and social sectors in order to solve everyday problems efficiently and wisely. This way, it is possible to prevent and solve the difficulties faced by the community while searching for a common good and the recovery of its citizenship.

  1. Video demonstrations seed alternative problem-solving techniques in wild common marmosets. (United States)

    Gunhold, Tina; Whiten, Andrew; Bugnyar, Thomas


    Studies of social learning and tradition formation under field conditions have recently gained momentum, but suffer from the limited control of socio-ecological factors thought to be responsible for transmission patterns. The use of artificial visual stimuli is a potentially powerful tool to overcome some of these problems. Here, in a field experiment, we used video images of unfamiliar conspecifics performing virtual demonstrations of foraging techniques. We tested 12 family groups of wild common marmosets. Six groups received video demonstrations (footage of conspecifics either pulling a drawer open or pushing a lid upwards, in an 'artificial fruit'); the other six groups served as controls (exposed to a static image of a conspecific next to the fruit). Subjects in video groups were more manipulative and successful in opening the fruit than controls; they were also more likely to use the technique they had witnessed and thus could serve as live models for other family members. To our knowledge, this is the first study that used video demonstrations in the wild and demonstrated the potent force of social learning, even from unfamiliar conspecifics, under field conditions.

  2. Borderline oxacillin-resistant Staphylococcus aureus (BORSA) - a more common problem than expected? (United States)

    Hryniewicz, Maria M; Garbacz, Katarzyna


    Borderline oxacillin-resistant Staphylococcus aureus (BORSA) represents a quite poorly understood and inadequately defined phenotype of methicillin resistance. BORSA strains show low, borderline resistance to penicillinase-resistant penicillins (PRPs), with oxacillin MICs typically equal to 1-8 µg ml-1, and in contrast to methicillin-resistant S. aureus (MRSA), do not have an altered penicillin-binding protein, PBP2a, encoded by the mecA or mecC gene. Their resistance is typically associated with hyperproduction of beta-lactamases or, in some cases, point mutations in PBP genes. BORSA cannot be classified as either truly methicillin-resistant or truly methicillin-susceptible strains. However, they are frequently misidentified, which poses an obvious epidemiological and therapeutic threat. BORSA strains are commonly isolated from humans and animals, and are found both in hospitals and in a community setting. The epidemiology and clinical presentation of BORSA infections seem to be similar to those for MRSA; these infections are usually more severe than those caused by methicillin-sensitive S. aureus (MSSA). Treatment of severe infections caused by BORSA may be ineffective, even with larger doses of oxacillin. The available evidence suggests that BORSA represent a frequently neglected problem, and their emergence in new environments implies that they need to be monitored and accurately distinguished from MSSA and MRSA.

  3. Heart rate variability in the assessment and biofeedback training of common mental health problems in children. (United States)

    Nada, Pop-Jordanova


    Heart rate variability (HRV) is a measure of the beat-to-beat variations in heart rate related to the work of autonomic nervous system. It may serve as a psychophysiological indicator for arousal, emotional state and stress level. We used this parameter in both the assessment and biofeedback training, for dealing with five groups of common mental health problem in school children (anxious-phobic, somatoform, obsessive-compulsive, attention deficit hyperactivity and conduct disorders). The obtained results were compared with healthy children at the same age. In order to define the four main characteristics of personality (extroversion/introversion, neuroticism/stability, psychopathological traits and honesty) Eysenck Personality Questionnaire was applied. Results showed significantly higher psychopathological traits in ADHD and somatoform group, lower extroversion in somatoform, higher neurotism in OCD and lower lie scores in ADHD and OCD groups. As HRV instrument we used Heart Math Freeze-Framer System. After 15 sessions of training, children from nearby all groups showed improved high and medium HRV which corresponded to the improved clinical outcome. Hereby, the best results were obtained for conduct and anxiety disorder, and the worst for ADHD.

  4. Cardiac intensive care of the adult with congenital heart disease: basic principles in the management of common problems. (United States)

    Perry, James; Lanzberg, Michael; Franklin, Wayne; Webb, Gary; Chang, Anthony C


    Although there has been an intense interest in the care of the adult with congenital heart disease (ACHD), these guidelines are usually not focused on the concepts of immediate postoperative care. The 2 most common perioperative complications are heart failure and atrial dysrhythmias. The broad etiological categories for ACHD and heart failure include primary pump failure (systolic dysfunction) and hypertrophy (diastolic dysfunction) of the right, left, or single ventricle. Some conditions with a pressure-loaded systemic right ventricle as well as patients with a functionally single ventricle may be particularly prone to develop heart failure; in others, right heart failure may occur in patients with Ebstein anomaly or with tetralogy of Fallot after corrective repair but with varying degrees of pulmonary insufficiency, and left heart failure can be a result of mitral or aortic insufficiency. The management of postoperative atrial tachycardia in the ACHD patient actually begins prior to surgery. Assessment of arrhythmia history, complete determination of risk, inducibility and arrhythmia substrate, preoperative planning of pacing sites, and optimal pacing strategies all assist to bring about optimal postoperative outcomes. Ideal perioperative care of the ACHD involves a multidisciplinary team of pediatric and adult cardiologists, pediatric and adult intensivists, cardiac surgeons, and nursing staff along with a myriad of adult subspecialists such as pulmonology, nephrology, endocrinology, and others including psychiatry.

  5. Acupuncture for Pediatric Pain

    Directory of Open Access Journals (Sweden)

    Brenda Golianu


    Full Text Available Chronic pain is a growing problem in children, with prevalence as high as 30.8%. Acupuncture has been found to be useful in many chronic pain conditions, and may be of clinical value in a multidisciplinary treatment program. The basic principles of acupuncture are reviewed, as well as studies exploring basic mechanisms of acupuncture and clinical efficacy. Conditions commonly treated in the pediatric pain clinic, including headache, abdominal pain, fibromyalgia, juvenile arthritis, complex regional pain syndrome, cancer pain, as well as perioperative pain studies are reviewed and discussed. Areas in need of further research are identified, and procedural aspects of acupuncture practice and safety studies are reviewed. Acupuncture can be an effective adjuvant in the care of pediatric patients with painful conditions, both in a chronic and an acute setting. Further studies, including randomized controlled trials, as well as trials of comparative effectiveness are needed.

  6. Management of pediatric uveitis (United States)

    Wentworth, Bailey A.; Freitas-Neto, Clovis A.


    Pediatric uveitis is a topic of special interest not only because of the unique diagnostic and therapeutic challenges but also because of the lifetime burden of vision loss if the problem is not adequately treated, as well as the economic and psychological toll on the family. Often, uveitis in children is discovered as part of a routine eye exam; this silent, insidious inflammation can be difficult to treat and can lead to further complications if not handled skillfully. Corticosteroids have long been the mainstay of therapy; however, the significant associated side effects mandate a corticosteroid-sparing therapeutic regimen in pursuit of remission. In this review, we cover the therapeutic options for pediatric uveitis, specifically focusing on the most common non-infectious varieties, juvenile idiopathic arthritis-associated uveitis and pars planitis. PMID:24991418

  7. Common problems in using, modifying, and reporting on classic measurement instruments. (United States)

    Daltroy, L H


    the principles are fairly simple. Keeping the principles in mind is half the battle when solving many common problems. The interested reader is referred to the texts referenced in this article and the one by DeVellis (1) for further discourse on this topic.

  8. What Is a Pediatric Allergist / Immunologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Allergist/Immunologist? Page Content Article Body If your ... immune system problems. What Kind of Training Do Pediatric Allergists/Immunologists Have? Pediatric allergists/immunologists are medical ...

  9. Perinatal complications, lipid peroxidation, and mental health problems in a large community pediatric sample. (United States)

    Mansur, Rodrigo B; Cunha, Graccielle R; Asevedo, Elson; Zugman, André; Rios, Adiel C; Salum, Giovanni A; Pan, Pedro M; Gadelha, Ary; Levandowski, Mateus L; Belangero, Síntia I; Manfro, Gisele G; Stertz, Laura; Kauer-Sant'anna, Márcia; Miguel, Eurípedes C; Bressan, Rodrigo A; Mari, Jair J; Grassi-Oliveira, Rodrigo; Brietzke, Elisa


    Replicated evidence indicates that perinatal complications are associated with increased markers of oxidative stress and with mental health problems in children. However, there are fewer reports on the impact of perinatal complications in later phases of development. We aimed to investigate the estimated effects of perinatal complications on levels of lipid peroxidation and on psychopathology in children and adolescents. The study is part of the High Risk Cohort Study for Psychiatric Disorders; the population was composed by 554 students, 6-14 years of age. Serum levels of malondialdehyde, a product of lipid peroxidation, were measured by the TBARS method. A household interview with parents and caregivers was conducted and included inquiries about perinatal history, the Child Behavior Checklist (CBCL), and parent's evaluation, using the Mini International Psychiatric Interview (MINI). We created a cumulative risk index, conceptualized as each individual's cumulative exposure to perinatal complications. Results indicate that perinatal complications were associated with higher levels of TBARS. After adjusting for age, gender, socio-economic status, CBCL total problems score, parental psychopathology, and childhood maltreatment, children exposed to 3 or more perinatal complications had an 26.9% (95% CI 9.9%, 46.6%) increase in TBARS levels, relative to the unexposed group. Exploratory mediation analysis indicated that TBARS levels partially mediated the association between perinatal complications and externalizing problems. In conclusion, an adverse intrauterine and/or early life environment, as proxied by the cumulative exposure to perinatal complications, was independently associated with higher levels of lipid peroxidation in children and adolescents.

  10. Sensitivity and specificity of the pictorial Pediatric Symptom Checklist for psychosocial problem detection in a Mexican sample. (United States)

    Leiner, Marie A; Puertas, Héctor; Caratachea, Raúl; Pérez, Héctor; Jiménez, Patricia


    Written questionnaires have been developed to assess children's risks of psychosocial problems based on parents' responses. However, the effectiveness of these questionnaires is limited in populations with low literacy rates, which are also among the most in need of improved mental health screening and care. The present study compared the sensitivity and specificity of a version of the Pediatric Symptom Checklist (PSC)--which contained pictorial descriptions in addition to written text--against the "gold standard" Child Behavior Checklist. We retrospectively analyzed 240 sets of questionnaires completed by the mothers or stepmothers of children who visited clinics in a Community Center in Ciudad Juarez, Mexico, between May and December 2007, under the Seguro Popular insurance program provided to Mexicans with the lowest socioeconomic status. Over 95% of the parental participants had less than a high school level of education. The pictorial PSC was a useful tool for screening for psychosocial impairment, with improved sensitivity and specificity in comparison to previous assessments of the written PSC in similar populations within the U.S. Optimal sensitivity and specificity were achieved when the threshold for clinical follow-up was lowered from 28 to 22 points. Questionnaires that include pictorial descriptions may be valuable for improvements of health screening in communities with low education levels.

  11. A Heuristic for the Job Scheduling Problem with a Common Due Window on Parallel and Non-Identical Machines

    Institute of Scientific and Technical Information of China (English)


    In this paper, we give a mathematical model for earliness-tardiness job scheduling problem with a common due window on parallel and non-identical machines. Because the job scheduling problem discussed in the paper contains a problem of minimizing make-span, which is NP-complete on parallel and uniform machines, a heuristic algorithm is presented to find an approximate solution for the scheduling problem after proving an important theorem. Two numerical examples illustrate that the heuristic algorithm is very useful and effective in obtaining the near-optimal solution.

  12. Heuristic methods for the single machine scheduling problem with different ready times and a common due date (United States)

    Birgin, Ernesto G.; Ronconi, Débora P.


    The single machine scheduling problem with a common due date and non-identical ready times for the jobs is examined in this work. Performance is measured by the minimization of the weighted sum of earliness and tardiness penalties of the jobs. Since this problem is NP-hard, the application of constructive heuristics that exploit specific characteristics of the problem to improve their performance is investigated. The proposed approaches are examined through a computational comparative study on a set of 280 benchmark test problems with up to 1000 jobs.

  13. One in Four Questioned Children Faces Problems Regarding Reintegration Into Physical Education at School After Treatment for Pediatric Cancer. (United States)

    Kesting, Sabine V; Götte, Miriam; Seidel, Corinna C; Rosenbaum, Dieter; Boos, Joachim


    Resumption of physical activity and reintegration into social surroundings after treatment for pediatric cancer is of high importance to recover from the burden of disease and treatment and to positively influence long-term health outcomes. Eighty-three children who had completed intensive treatment for pediatric cancer were surveyed regarding their participation in physical education at school (PES). The results show a concerning low rate of participation, particularly in children treated for pediatric bone tumors, and associated barriers. Reported reasons for quitting PES seem to be conquerable by individual and entity-related support to enable participation according to the children's desire.

  14. Diabetes mellitus en el anciano, un problema frecuente Diabetes mellitus present in elderly, a common problem

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    Marelys Yanes Quesada


    Full Text Available La presencia de diabetes mellitus en la población anciana es un problema de salud frecuente en la atención primaria. Es por ello que en el presente trabajo pretendemos revisar algunos elementos importantes de este tema. Esta entidad se presenta habitualmente en estos pacientes, oligosintomática o de manera atípica, y los objetivos terapéuticos dependen de la situación funcional del enfermo. En relación con el tratamiento no farmacológico, la educación, la dieta y el ejercicio físico constituyen los pilares básicos; y respecto a la terapéutica farmacológica, se deben evitar las sulfonilureas de acción prolongada y de gran potencia. Las biguanidas pueden ser usadas para mejorar la sensibilidad a la insulina, y los inhibidores de la alfa glucosidasa son los medicamentos de elección cuando predomina la hiperglucemia posprandial. Las tiazolidinedionas deben ser usadas con precaución en pacientes con riesgo cardiovascular, y el uso de insulina está indicado en circunstancias especiales. Siempre se debe tener presente el tratamiento de la comorbilidad, para así tratar integralmente al anciano con diabetes mellitus.Presence of diabetes mellitus in elderlies is a common health problem in primary care. Thus, the aim of present paper is to review some significant elements of this matter. This entity is habitually present in these patients in a olisymptomatic way of in a atypical form, and therapeutic objectives depend on functional status of patient. With regard to non-pharmacological treatment, the education, diet, and physical exercise are the main basis; and regarding the pharmacological therapeutics, sulfonylurea of lengthy action and very potent must to be avoided. Biguanides may be used to improve insulin-sensitivity, and a-glycosidase inhibitors are the choice drugs when there is a predominance of postprandial hyperglycemia. The thiazolidinediones must to be used with precaution in patients presenting with cardiovascular risk, and

  15. Identifying and addressing mental health risks and problems in primary care pediatric settings: a model to promote developmental and cultural competence. (United States)

    Godoy, Leandra; Carter, Alice S


    Young children, particularly uninsured children of color, suffer from mental health disturbances at rates similar to older children and adults, yet they have higher rates of unmet needs. To address unmet needs, efforts to identify mental health problems in primary care pediatric settings have grown in recent years, thanks in large part to expanded screening efforts. Yet, health disparities in early detection remain. Enhancing understanding of how early childhood mental health problems can be identified and addressed within pediatric settings is an important and growing area of research. The authors draw on theoretical models from public health policy, health psychology, and child development, including health beliefs, help seeking, transtheoretical, motivation to change, and dynamic systems, to better understand and address challenges to and disparities in identifying and addressing mental health problems in pediatric settings. These theories have not previously been applied to early mental health screening and identification efforts. Developmental and sociocultural considerations are highlighted in an effort to address and reduce higher rates of unmet needs among young, uninsured children of color. © 2013 American Orthopsychiatric Association.

  16. Antibiotic Resistance in Pediatric Urinary Tract Infections. (United States)

    Stultz, Jeremy S; Doern, Christopher D; Godbout, Emily


    Urinary tract infections (UTIs) are a common problem in pediatric patients. Resistance to common antibiotic agents appears to be increasing over time, although resistance rates may vary based on geographic region or country. Prior antibiotic exposure is a pertinent risk factor for acquiring resistant organisms during a first UTI and recurrent UTI. Judicious prescribing of antibiotics for common pediatric conditions is needed to prevent additional resistance from occurring. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase-producing organisms. Data regarding the impact of in vitro antibiotic susceptibility testing interpretation on UTI treatment outcomes is lacking.

  17. Groupwork as a Form of Assessment: Common Problems and Recommended Solutions (United States)

    Davies, W. Martin


    This paper reviews some of the literature on the use of groupwork as a form of assessment in tertiary institutions. It outlines the considerable advantages of groupwork but also its systemic associated problems. In discussing the problems, the paper considers issues such as "free riding" and the "sucker effect", issues associated with ethnic mix…

  18. Heegard-Berger and Cascade Source Coding Problems with Common Reconstruction Constraints

    CERN Document Server

    Ahmadi, Behzad; Simeone, Osvaldo; Poor, H Vincent


    For the HB problem with the CR constraint, the rate-distortion function is derived under the assumption that the side information sequences are (stochastically) degraded. The rate-distortion function is also calculated explicitly for three examples, namely Gaussian source and side information with quadratic distortion metric, and binary source and side information with erasure and Hamming distortion metrics. The rate-distortion function is then characterized for the HB problem with cooperating decoders and (physically) degraded side information. For the cascade problem with the CR constraint, the rate-distortion region is obtained under the assumption that side information at the final node is physically degraded with respect to that at the intermediate node. For the latter two cases, it is worth emphasizing that the corresponding problem without the CR constraint is still open. Outer and inner bounds on the rate-distortion region are also obtained for the cascade problem under the assumption that the side in...

  19. Optimization of Radiological Protection in Pediatric Patients Undergoing Common Conventional Radiological Procedures: Effectiveness of Increasing the Film to Focus Distance (FFD

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    Vahid Karami


    Full Text Available Background Increasing the x-ray film to focus distance (FFD, has been recommended as a practical dose optimization tool for patients undergoing conventional radiological procedures. In the previous study, we demonstrated a 32% reduction in absorbed dose is achievable due to increasing the FFD from 100 to 130 cm during pediatric chest radiography. The aim of this study was to examine whether increasing the FFD from 100 to 130 cm is equally effective for other common radiological procedures and performing a literature review of published studies to address the feasibility and probable limitations against implementing this optimization tool in clinical practice. Materials and Methods Radiographic examination of the pelvis (AP view, abdomen (AP view, skull (AP and lateral view, and spine (AP and lateral view, were taken of pediatric patients. The radiation dose and image quality of a radiological procedure is measured in FFD of 100 cm (reference FFD and 130 cm (increased FFD. The thermo-luminescent dosimeters (TLD were used for radiation dose measurements and visual grading analysis (VGA for image quality assessments. Results: Statistically significant reduction in the ESD ranged from 21.91% for the lateral skull projection to 35.24% for the lateral spine projection was obtained, when the FFD was increased from 100 to 130 cm (P0.05. Conclusion Increasing the FFD from 100 to 130 cm has significantly reduced radiation exposure without affecting on image quality. Our findings are commensurate with the literatures and emphasized that radiographers should learn to use of an updated reference FFD of 130 cm in clinical practice.

  20. Tumor necrosis factor-alpha is a common genetic risk factor for asthma, juvenile rheumatoid arthritis, and systemic lupus erythematosus in a Mexican pediatric population. (United States)

    Jiménez-Morales, Silvia; Velázquez-Cruz, Rafael; Ramírez-Bello, Julián; Bonilla-González, Edmundo; Romero-Hidalgo, Sandra; Escamilla-Guerrero, Guillermo; Cuevas, Francisco; Espinosa-Rosales, Francisco; Martínez-Aguilar, Nora Ernestina; Gómez-Vera, Javier; Baca, Vicente; Orozco, Lorena


    There is a great deal of evidence that points to the association of the tumor necrosis factor-alpha (TNF-alpha) gene as a common genetic factor in the pathogenesis of diseases that are caused by inflammatory and/or autoimmune etiologies. Two single nucleotide polymorphisms (SNPs) identified in the TNF-alpha promoter region have been associated with disease susceptibility and severity. We investigated whether -308G/A and -238G/A TNF-alpha polymorphisms were associated with asthma, systemic lupus erythematosus (SLE), and juvenile rheumatoid arthritis (JRA) in a pediatric Mexican population. In a case-control study of 725 patients (asthma: 226, JRA: 171, and SLE: 328) and 400 control subjects, the participants were analyzed using the allelic discrimination technique. The genotype distribution of both TNF-alpha polymorphisms was in Hardy-Weinberg equilibrium in each group. However, there were significant differences in the allele frequency of TNF-alpha-308A between the patients and the healthy controls. This allele was detected in 2.9% of the controls, 6.0% of asthmatic and JRA patients (p = 0.002 and p = 0.0086), and 6.7% of SLE patients (p = 0.00049); statistical significance was maintained after ancestry stratification (asthma: p = 0.0143, JRA: p = 0.0083, and SLE: p = 0.0026). Stratification by gender showed that the risk for the -308A allele in asthma and JRA was greater in females (OR = 4.16, p = 0.0008 and OR = 4.4, p = 0.0002, respectively). The TNF-alpha -238A allele showed an association only with JRA in males (OR = 2.89, p = 0.004). These results support the concept that the TNF-alpha gene is a genetic risk factor for asthma, SLE, and JRA in the pediatric Mexican population.

  1. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  2. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography ( ... more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional ...

  3. Pediatric Specialists (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  4. The Pediatric Urinary Tract and Medical Imaging. (United States)

    Penny, Steven M


    The pediatric urinary tract often is assessed with medical imaging. Consequently, it is essential for medical imaging professionals to have a fundamental understanding of pediatric anatomy, physiology, and common pathology of the urinary tract to provide optimal patient care. This article provides an overview of fetal development, pediatric urinary anatomy and physiology, and common diseases and conditions of the pediatric urinary tract.

  5. Variation in Common Preschool Sleep Problems as an Early Predictor for Depression and Anxiety Symptom Severity across Time (United States)

    Whalen, Diana J.; Gilbert, Kirsten E.; Barch, Deanna M.; Luby, Joan L.; Belden, Andy C.


    Background: Child and adolescent psychopathology has been linked to increased sleep problems, but there has been less investigation of this relationship in younger samples with early-onset psychopathology. This study examined three specific but commonly observed aspects of sleep behaviors in young children--(i) Sleep onset latency, (ii) Refusal to…

  6. Variation in Common Preschool Sleep Problems as an Early Predictor for Depression and Anxiety Symptom Severity across Time (United States)

    Whalen, Diana J.; Gilbert, Kirsten E.; Barch, Deanna M.; Luby, Joan L.; Belden, Andy C.


    Background: Child and adolescent psychopathology has been linked to increased sleep problems, but there has been less investigation of this relationship in younger samples with early-onset psychopathology. This study examined three specific but commonly observed aspects of sleep behaviors in young children--(i) Sleep onset latency, (ii) Refusal to…

  7. Pediatric Flexible Flatfoot; Clinical Aspects and Algorithmic Approach



    Flatfoot constitutes the major cause of clinic visits for pediatric foot problems. The reported prevalence of flatfoot varies widely due to numerous factors. It can be divided into flexible and rigid flatfoot. Diagnosis and management of pediatric flatfoot has long been the matter of controversy. Common assessment tools include visual inspection, anthropometric values, footprint parameters and radiographic evaluation. Most flexible flatfeet are physiologic, asymptomatic, and require no treatm...

  8. Family history in pediatric primary care. (United States)

    Trotter, Tracy L; Martin, Helen M


    The family history is a critical element in pediatric medicine and represents the gateway to the molecular age of medicine for both pediatric clinicians and their patients. The pediatric clinician has several opportunities to obtain a family history and multiple clinical and educational uses for that information. Available methods include paper and digital forms, classical pedigrees, online programs, and focused family history at the time of a new diagnosis or problem. Numerous barriers impede the application of family history information to primary pediatric practice. The most common barrier is the limited amount of time the typical primary care encounter allows for its collection. The family history can be used in many facets of pediatric practice: (1) as a diagnostic tool and guide to testing and evaluation; (2) to identify patterns of inheritance; and (3) as a patient-education tool. The most exciting future use of family history is as a tool for public health and preventive medicine. More accurately identifying children at risk for common chronic conditions such as diabetes, asthma, and cardiovascular disease could change the primary care clinician's approach to pediatric medicine.

  9. Prevalence of common canine digestive problems compared with other health problems in teaching veterinary hospital, Faculty of Veterinary Medicine, Cairo University, Egypt

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    Gamal M. H. Rakha


    Full Text Available Aim: The present study was conducted to ascertain the prevalence of common digestive problems compared to other health problems among dogs that were admitted to the teaching veterinary hospital, faculty of veterinary medicine, Cairo University, Egypt during 1 year period from January to December 2013. Also, study the effect of age, sex, breeds, and season on the distribution of digestive problems in dogs. Materials and Methods: A total of 3864 dogs included 1488 apparently healthy (included 816 males and 672 females and 2376 diseased dogs (included 1542 males and 834 females were registered for age, sex, breed, and the main complaint from their owners. A complete history and detailed clinical examination of each case were applied to the aids of radiographic, ultrasonographic, and endoscopic examination tools. Fecal examination was applied for each admitted case. Rapid tests for parvovirus and canine distemper virus detection were also performed. Results: A five digestive problems were commonly recorded including vomiting, diarrhea, concurrent vomiting with diarrhea, anorexia, and constipation with a prevalence (% of 13.6, 19.1, 10.1, 13.1, and 0.5 respectively while that of dermatological, respiratory, urinary, neurological, cardiovascular, auditory, and ocular problems was 27.9, 10.5, 3.3, 0.84, 0.4, 0.25, and 0.17 (% respectively. This prevalence was obtained on the basis of the diseased cases. Age and breed had a significant effect on the distribution of digestive problems in dogs (p0.05 on the distribution of such problems. Conclusion: Digestive problems were the highest recorded problems among dogs, and this was the first records for such problems among dogs in Egypt. Age, gender, and breeds had a significant effect on the distribution of the digestive problems in dogs while season had a non-significant effect on the distribution of such problems. The present data enable veterinarians in Egypt to ascertain their needs for diagnostic tools

  10. Non-diagnosis specific, but probably treatment relevant: Cognitive flexibility in common mental health problems

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Salkovskis, Paul M.

    problems has been developed. With outset in cognitive behavioural theory and therapy processes, we propose a theory for the role of cognitive flexibility within emotional problems. We believe that cognitive flexibility of the type required to make sense of situations previously regarded as dangerous......). As such most definitions of cognitive flexibility include the notion of shifting cognitive set as a basic premise, but the nature of the shifting is not always explicitly stated or defined. Thus, no detailed theory of the role of cognitive flexibility as a maintaining (or aetiological) factor of emotional...

  11. Common chronic health problems and life satisfaction among Macau elderly people

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    Sydney X.X. Hu


    Conclusion: Lowest life satisfaction was reported among Macau elderly people living with mobility related chronic medical illness. Policies and practices should pay more attention to mobility related health problems or issues of elderly people, such as eye health and neuromuscular weaknesses.

  12. Common Problems Experienced by First Year Alternatively Certified Teachers: A Qualitative Study (United States)

    Hung, Li-Ching; Smith, Cary Stacy


    The teacher shortage throughout the United States, especially in areas considered "at-risk," has reached an alarming level. Novice teachers often decide not to return after one year of service, with the number of teachers not returning doubling at five years. One possible means of overcoming these two problems is alternative…

  13. CTE and the Common Core Can Address the Problem of Silos (United States)

    Pearson, Donna


    There is no doubt but that the education realm is replete with silos of experts of one discipline or another whose knowledge and teachings do not normally crossover into others. Yet the Common Core's call for career and college readiness virtually requires such subject integration--especially between the disciplines we consider academic and those…

  14. Pediatric cardiac emergencies: Children are not small adults

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    Frazier Aisha


    Full Text Available Compared with adults, cardiac emergencies are infrequent in children and clinical presentation is often quite variable. In adults, cardiac emergencies are most commonly related to complications of coronary artery disease; however, in pediatric cases, the coronaries are only rarely the underlying problem. Pediatric cardiac emergencies comprise a range of pathology including but not limited to undiagnosed congenital heart disease in the infant; complications of palliated congenital heart disease in children; arrhythmias related to underlying cardiac pathology in the teenager and acquired heart disease. The emergency room physician and pediatric intensivist will usually be the first and second lines of care for pediatric cardiac emergencies and thus it is imperative that they have knowledge of the diverse presentations of cardiac disease in order to increase the likelihood of delivering early appropriate therapy and referral. The objective of this review is to outline cardiac emergencies in the pediatric population and contrast the presentation with adults.

  15. The Asthma-COPD Overlap Syndrome: A Common Clinical Problem in the Elderly

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    Amir A. Zeki


    Full Text Available Many patients with breathlessness and chronic obstructive lung disease are diagnosed with either asthma, COPD, or—frequently—mixed disease. More commonly, patients with uncharacterized breathlessness are treated with therapies that target asthma and COPD rather than one of these diseases. This common practice represents the difficulty in distinguishing these disorders clinically, particularly in patients with a history that does not easily differentiate asthma from COPD. A common clinical scenario is an older former smoker with partially reversible or fixed airflow obstruction and evidence of atopy, demonstrating “overlap” features of asthma and COPD. We stress that asthma-COPD overlap syndrome becomes more prevalent with advancing age as patients respond less favorably to guideline-recommended drug therapy. We review the similarities and differences in clinical characteristics between these disorders, and their physiologic and inflammatory profiles within the context of the aging patient. We underscore the difficulties in differentiating asthma from COPD in current or former smokers, share our institutional experience with overlap syndrome, and highlight the need for new research to better characterize and investigate this important clinical phenotype.

  16. Knuckle Pads—A common problem but good to treat by Laser (United States)

    Herold, Manfred; Russe-Wilflingseder, Katharina


    Knuckle pads are common skin lesions not disease associated and seen as thickended skin like nodules situated usually on the dorsal site of the proximal interphalangeal joints. Neither medical nor surgical procedures are very effective to remove knuckle pads. A women 22 years of age with knuckle pads on the fingers two and three on both hands which reoccurred after surgical resections was successful treated with a long pulsed Erbium:YAG laser. All four fingers were ablated within one single treatment. The aesthetic result was excellent and lasted at least for 18 months.


    Directory of Open Access Journals (Sweden)

    Korovaeva I.V


    Full Text Available This article discusses the flu, as one of the most common infectious diseases affecting humanity throughout its history. The data on the structure of A influenza virus and its variability is given historical background for most famous of the pandemics, which inflicted irreparable damage to the population of the Earth, are shown the basic stages of the study for influenza virus. Are considered the types of variability of the A virus influenza, its ability to overcome interspecies barriers that form the basis of pathogen escape from the immune response. The article shows the promising areas of modern prevention and treatment of this disease

  18. Common clinical problems in children living with HIV/AIDS: systemic approach. (United States)

    Merchant, Rashid H; Lala, Mamatha M


    Clinical manifestations in children living with HIV/ AIDS differ from those in adults due to poorly developed immunity that allows greater dissemination throughout various organs. In developing countries, HIV-infected children have an increased frequency of malnutrition and common childhood infections such as ear infections, pneumonias, gastroenteritis and tuberculosis. The symptoms common to many treatable conditions, such as recurrent fever, diarrhea and generalized dermatitis, tend to be more persistent and severe and often do not respond as well to treatment. The use of Anti Retroviral Therapy (ART) has greatly increased the long term survival of perinatally infected children so that AIDS is becoming a manageable chronic illness. As the immunity is maintained, the incidence of infectious complications is declining while noninfectious complications of HIV are more frequently encountered. Regular clinical monitoring with immunological and virological monitoring and the introduction of genotypic and phenotypic resistance testing where resources are available have allowed for dramatically better clinical outcomes. However, these growing children are left facing the challenges of lifelong adherence with complex treatment regimens, compounded by complex psycho-social, mental and neuro-cognitive issues. These unique challenges must be recognized and understood in order to provide appropriate medical management.

  19. Conscious Sedation: Emerging Trends in Pediatric Dentistry. (United States)

    Attri, Joginder Pal; Sharan, Radhe; Makkar, Vega; Gupta, Kewal Krishan; Khetarpal, Ranjana; Kataria, Amar Parkash


    Dental fear and anxiety is a common problem in pediatric patients. There is considerable variation in techniques used to manage them. Various sedation techniques using many different anesthetic agents have gained considerable popularity over the past few years. Children are not little adults; they differ physically, psychologically, and emotionally. The purpose of this review is to survey recent trends and concerning issues in the rapidly changing field of pediatric sedation. We will study the topic from the perspective of an anesthesiologist. It will also provide information to practitioners on the practice of conscious sedation in dentistry and will also outline the route of administration, pharmacokinetics, and pharmacodynamics of various drugs used.

  20. Pediatric intensive care. (United States)

    Macintire, D K


    To provide optimal care, a veterinarian in a pediatric intensive care situation for a puppy or kitten should be familiar with normal and abnormal vital signs, nursing care and monitoring considerations, and probable diseases. This article is a brief discussion of the pediatric intensive care commonly required to treat puppies or kittens in emergency situations and for canine parvovirus type 2 enteritis.

  1. Common Problems in NC PLC Programming%数控PLC编程常见问题

    Institute of Scientific and Technical Information of China (English)



    Many CNC systems have an open PLC, and provide corresponding ladder editing software, which can meet the needs of the secondary development, and achieve a variety of customization features. This paper introduces some problems in PLC programming what can be easily overlooked,such as dual-coil,subroutine calls,etc.%许多数控系统中都具有开放式PLC,并提供了对应的梯形图编辑软件,可满足二次开发需要,方便实现各种定制功能。介绍了PLC编程过程中容易被忽视的一些问题,如双线圈、子程序调用等问题。

  2. Non-invasive blood pressure measurement: values, problems and applicability in the common marmoset (Callithrix jacchus). (United States)

    Mietsch, M; Einspanier, A


    The common marmoset (Callithrix jacchus, C. j.) is an established primate model in biomedical research and for human-related diseases. Monitoring of cardiovascular parameters including blood pressure (BP) is important for the health surveillance of these experimental animals and the quantification of diseases or pharmaceutical substances influencing BP. Measurement guidelines for C. j. do not exist yet; therefore, the present study was carried out to establish a practicable protocol based on recommendations of the American College of Veterinary Internal Medicine (ACVIM). Furthermore, BP data of 49 marmosets (13.8-202.4 months of age) were obtained via high-definition oscillometry to further knowledge of physiological parameters and gender-related differences in this primate. The thighs proved to be the most suitable measurement localization, since systolic values were less variable (left 4.03 ± 2.90%, right 5.96 ± 2.77%) compared with the tail (12.7 ± 6.96%). BP values were similar in the morning and in the afternoon (P > 0.05). Data were highly reproducible within and between several sessions on three consecutive days (P > 0.05) as well as over the course of 20 months (P > 0.05). Furthermore, the measurement time for females was significantly shorter than for males (5:14 ± 1:59 min versus 6:50 ± 1:58 min, P = 0.007). Measurement recommendations for the common marmoset were successfully established. Standardized values enabled a reliable comparison of BP parameters, e.g. for cardiovascular, toxicological or metabolic research.

  3. Drilling-induced lateral shifts along pre-existing fractures: A common cause of drilling problems

    Energy Technology Data Exchange (ETDEWEB)

    Maury, V.; Zurdo, C.


    Two gas well collapses showed a peculiar failure mechanism. Excessive fluid levels and temperature variations during the ultimate drilling phase and later workovers induced microannuli and cementation damage. Abnormal fluid pressures from deeper gas- or water-bearing layers channeled through damaged cementation and increased the pore pressure in uphole faults or bedding joints. Thus the effective normal stress on faults was released, inducing shear displacements and casing deformation. Weakened casings were further collapsed by later fluid-level variations. It was then suspected that this mechanism also occurred in open holes during drilling. This was shown to be so with borehole televiewer tool (BHTV) images showing borehole lateral shifts. Although never mentioned in the past in the domain of borehole stability, this mechanism explains some poorly understood drilling incidents, such as tight-holes, problems to run in hole (RIH) or pull out of hole (POOH), and abnormal torques, in spite of no indications of instability, such as cavings. This mechanism can be mitigated by taking the necessary precautions during drilling and by the adequate selection of mud characteristics.

  4. Soil Degradation and Soil Value in Slovakia – Two Problems with Common Denominator

    Directory of Open Access Journals (Sweden)

    Radoslav Bujnovský


    Full Text Available Soil use is oft en accompanied by its degradation. Immediate reason of soil degradation in agriculture is the non-respecting the principles of good agricultural practice. Giving long-term precedence to production function over remaining ecological ones as well as supporting the land consumption for economy development by governmental bodies are next reasons of soil degradation and mirror the societal values and priorities.Soil provides many services that in soil science are defined as soil functions. Besides biomass production the soil provides ecological and socio-economic functions. Use of soil and its functions is closely linked to soil ecological, societal and economic values. Preference to economic interests together with reluctance to search compromise solutions is oft en manifesting in soil degradation. Economic valuation of soil and its ecological functions is considered a possible way for improvement of soil protection especially in modification of soil price at its permanent consumption. In spite of that financial values can not be used as a base for forming of ethical values, which are imminently connected with human approach towards soil and its degradation, and which are essentially needed by global society. Ethical human values, based on basic beliefs and convictions, influence of human attitude to the soil, and they influence on soil use can be considered as common denominator of soil degradation and soil value, respectively.

  5. Halitosis--a common medical and social problem. A review on pathology, diagnosis and treatment. (United States)

    Zalewska, A; Zatoński, M; Jabłonka-Strom, A; Paradowska, A; Kawala, B; Litwin, A


    Bad breath is a condition that has health and social implications. This paper provides a comprehensive review of the classification of halitosis, it's etiology, it's prevalence, diagnosis and treatment strategies for the condition. Halitosis is affecting about 25-30% of world's population. It includes categories of genuine halitosis, pseudo-halitosis and halitophobia. It is believed that in 80-90% of cases halitosis origins in the oral cavity and the most common causes are: gingival pathologies, caries and poor oral hygiene. Extraoral sources of halitosis are responsible for 10-20% of all cases and are caused by poor diet, alcohol abuse, tobacco smoking, certain drugs and diseases of other parts of digestive tract as well as some systemic conditions. Diagnostics of halitosis includes subjective methods (examiner's sense of smell) and objective methods (instrumental analysis). Simple, subjective examination is considered a "golden standard" in clinical practice. In case of pathological halitosis identifying the direct cause of halitosis is essential. After excluding, or after successful treatment, of all oral pathologies, in case of remaining fetor ex ore identification and treatment of halitosis often requires multidisciplinary approach. Many unknowns remain in causes and mechanisms of halitosis. It can significantly impair quality of life, social interactions, lead directly to depression,low self-esteem or other mood disorders, therefore it is important to properly identify, treat and continue research on halitosis.

  6. Dysphagia is a common and serious problem for adults with mental illness: a systematic review. (United States)

    Aldridge, Kristy J; Taylor, Nicholas F


    Adults with mental illness may experience a higher incidence of dysphagia and choking due to factors such as medication side effects and behavioural abnormalities. The aim of this study was to determine the frequency of dysphagia and the most effective interventions for this population. Studies published up to August 2010 were sought via a comprehensive electronic database search (CINAHL, PsycINFO, MEDLINE, PubMed, Cochrane, and Embase). Studies reporting dysphagia frequency or dysphagia intervention outcomes in adults with mental illness were included. Two reviewers independently assessed study eligibility and quality, and the results were synthesised descriptively. Ten studies were identified, each describing dysphagia frequency or death due to choking asphyxiation. No studies evaluating intervention effectiveness were identified. Study quality was limited by subjective assessment of outcomes. Six studies presented dysphagia frequencies ranging from 9 to 42% in varying subgroups. Four studies presented the frequency of choking asphyxiation death, including a large survey that concluded that adults with organic mental illness were 43 times more likely to die of this cause than the general population. Dysphagia is a common and significant cause of morbidity and mortality in adults with mental illness and our review found that there is a lack of studies evaluating the effectiveness of intervention techniques.

  7. Review for the generalist: evaluation of pediatric foot and ankle pain

    Directory of Open Access Journals (Sweden)

    Houghton Kristin M


    Full Text Available Abstract Foot and ankle pain is common in children and adolescents. Problems are usually related to skeletal maturity and are fairly specific to the age of the child. Evaluation and management is challenging and requires a thorough history and physical exam, and understanding of the pediatric skeleton. This article will review common causes of foot and ankle pain in the pediatric population.

  8. Pediatric parasomnias. (United States)

    Mason, Thornton B A; Pack, Allan I


    Parasomnias in childhood are common, and often more frequent than in adults. The large number of parasomnias underscore that sleep is not simply a quiescent state, but can involve complex episodes of movement, ranging from subtle to dramatic and complex. Clinicians should be aware that many pediatric parasomnias are benign, self-limited, and may not persist into late childhood or adolescence. Importantly, parasomnias in childhood often differ in type from adults. Nevertheless, parasomnias across ages can be classified as: 1) disorders of arousal (from non-rapid eye movement, or NREM, sleep); 2) parasomnias usually associated with REM sleep; and 3) other parasomnias. We detail here issues in the clinical diagosis, evaluation, and management of multiple pediatric parasomnias. The further study of parasomnias in children may help elucidate the multi-factorial etiologies of these fascinating conditions, shedding light on the potential genetic bases as well as environmental contributions.

  9. How common problems with estimating surface radiative fluxes impact snow simulations (United States)

    Lapo, K. E.; Lundquist, J. D.; Hinkelman, L. M.


    Net radiation provides most of the melt energy for seasonal snow, a critical water resource for many parts of the world. In many cases shortwave radiation is the dominant flux, but when it is reduced by factors such as high albedo, cloud cover, and topographic shading, longwave radiation can also contribute substantially to the surface energy balance. Methods for determining these surface fluxes include: numerical weather models, reanalysis, direct observations, satellite measurements, and empirical algorithms based on proxy data. Long- and shortwave irradiances are rarely measured in mountainous environments. Those measurements that are made in these locations are subject to difficult conditions, which often result in snow-covered instruments and tilted instrumentation or sloped installation surface. To avoid these problems, measurements may be taken from a more protected valley location, but this may lead to a mismatch between measurement and study site conditions, such as a fog covered valley observation used to force a simulation at a higher, fog-free elevation. Satellites are useful tools for observing surface fluxes over large areas. However, satellite data products can have problems with mixed pixels of clouds and no clouds. Finally, algorithms based on proxy data have known biases and errors, can lack cloud and topographic corrections, and may not represent the diurnal cycle or cloud cover variability. In this study, we explored four scenarios for estimating long- and shortwave surface irradiances that have known errors and assessed the impact of these errors on simulations of SWE. The four scenarios were: 1) improper instrument siting such as a tilted sensor or improper projection of observations onto sloped terrain, 2) biases and errors in surface irradiances characteristic of algorithms based on proxy data, 3) mixed pixels of cloudy and non-cloudy conditions resulting from a coarse spatial resolution in a satellite or reanalysis product, and 4) lack of


    Directory of Open Access Journals (Sweden)

    A. K. Shaposhnikov


    Full Text Available This article deals with Common Slavic rows of lexical oppositions with x ~ sk ~ šč, going back to primordial Indo-European sound clusters *sk or *ks, and presents an attempt at establishing laws and rules of their occurrence. There is one more Indo-European language, namely Albanian, in which there was a similar regular transition of etymological *sk, *ks into *h in initial, intervocal and final positions in the words. All examples of similar opposition known nowadays from ESSJA and other accessible publications are presented for further consideration of the similar phenomena. About 160 examples of different degrees of reliability  are submitted. The author deduces some rules on the basis of comparisons: 1 etymological initial *skregularly passed into *xbefore back vowels. Reconstruction of forms with s mobile is an anachronism. 2 etymological initial *skhas regularly changed into *ščbefore front vowels. 3 Etymological initial *skwas kept only after a prefix *ob-. 4 It is possible to explain preservation of etymological initial *skin some cases by a loss of a prefixal morpheme: *skъrbь  from *obskъrbь.  The mechanism of mutation seems to be as follows: skhas changed into ks(this stage of development: Sanskrit kṣoda  and Greek , and then by the notorious rule of RUKI kshas changed into khand later into x-. The etymological confluence skbefore a back vowel is kept only after prefix *ob(*obskalъ, *obskǫděti, *obskomina. Regular opposition initial x-: initial  šč-, can never  be sk-: šč-, therefore ščel’, ščyolka  correlate with oskal but skala,  skol  < *sъkala, *sъkolъ. In this case we have an etymological opposition *xo-: *sъ-ko-.

  11. Common-sense chemistry: The use of assumptions and heuristics in problem solving (United States)

    Maeyer, Jenine Rachel

    Students experience difficulty learning and understanding chemistry at higher levels, often because of cognitive biases stemming from common sense reasoning constraints. These constraints can be divided into two categories: assumptions (beliefs held about the world around us) and heuristics (the reasoning strategies or rules used to build predictions and make decisions). A better understanding and characterization of these constraints are of central importance in the development of curriculum and teaching strategies that better support student learning in science. It was the overall goal of this thesis to investigate student reasoning in chemistry, specifically to better understand and characterize the assumptions and heuristics used by undergraduate chemistry students. To achieve this, two mixed-methods studies were conducted, each with quantitative data collected using a questionnaire and qualitative data gathered through semi-structured interviews. The first project investigated the reasoning heuristics used when ranking chemical substances based on the relative value of a physical or chemical property, while the second study characterized the assumptions and heuristics used when making predictions about the relative likelihood of different types of chemical processes. Our results revealed that heuristics for cue selection and decision-making played a significant role in the construction of answers during the interviews. Many study participants relied frequently on one or more of the following heuristics to make their decisions: recognition, representativeness, one-reason decision-making, and arbitrary trend. These heuristics allowed students to generate answers in the absence of requisite knowledge, but often led students astray. When characterizing assumptions, our results indicate that students relied on intuitive, spurious, and valid assumptions about the nature of chemical substances and processes in building their responses. In particular, many

  12. Megacities air pollution problems: Mexico City Metropolitan Area critical issues on the central nervous system pediatric impact. (United States)

    Calderón-Garcidueñas, Lilian; Kulesza, Randy J; Doty, Richard L; D'Angiulli, Amedeo; Torres-Jardón, Ricardo


    The chronic health effects associated with sustained exposures to high concentrations of air pollutants are an important issue for millions of megacity residents and millions more living in smaller urban and rural areas. Particulate matter (PM) and ozone (O3) concentrations close or above their respective air quality standards during the last 20 years affect 24 million people living in the Mexico City Metropolitan Area (MCMA). Herein we discuss PM and O3 trends in MCMA and their possible association with the observed central nervous system (CNS) effects in clinically healthy children. We argue that prenatal and postnatal sustained exposures to a natural environmental exposure chamber contribute to detrimental neural responses. The emerging picture for MCMA children shows systemic inflammation, immunodysregulation at both systemic and brain levels, oxidative stress, neuroinflammation, small blood vessel pathology, and an intrathecal inflammatory process, along with the early neuropathological hallmarks for Alzheimer and Parkinson's diseases. Exposed brains are briskly responding to their harmful environment and setting the bases for structural and volumetric changes, cognitive, olfactory, auditory and vestibular deficits and long term neurodegenerative consequences. We need to improve our understanding of the PM pediatric short and long term CNS impact through multidisciplinary research. Public health benefit can be achieved by integrating interventions that reduce fine PM levels and pediatric exposures and establishing preventative screening programs targeting pediatric populations that are most at risk. We fully expect that the health of 24 million residents is important and blocking pediatric air pollution research and hiding critical information that ought to be available to our population, health, education and social workers is not in the best interest of our children.

  13. Pediatric Asthma (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  14. Pediatric Ophthalmologist (United States)

    ... Text Size Email Print Share What is a Pediatric Ophthalmologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Ophthalmologists Have? Pediatric ophthalmologists are medical doctors who ...

  15. A Two-Phase Heuristic Algorithm for the Common Frequency Routing Problem with Vehicle Type Choice in the Milk Run

    Directory of Open Access Journals (Sweden)

    Yu Lin


    Full Text Available High frequency and small lot size are characteristics of milk runs and are often used to implement the just-in-time (JIT strategy in logistical systems. The common frequency problem, which simultaneously involves planning of the route and frequency, has been extensively researched in milk run systems. In addition, vehicle type choice in the milk run system also has a significant influence on the operating cost. Therefore, in this paper, we simultaneously consider vehicle routing planning, frequency planning, and vehicle type choice in order to optimize the sum of the cost of transportation, inventory, and dispatch. To this end, we develop a mathematical model to describe the common frequency problem with vehicle type choice. Since the problem is NP hard, we develop a two-phase heuristic algorithm to solve the model. More specifically, an initial satisfactory solution is first generated through a greedy heuristic algorithm to maximize the ratio of the superior arc frequency to the inferior arc frequency. Following this, a tabu search (TS with limited search scope is used to improve the initial satisfactory solution. Numerical examples with different sizes establish the efficacy of our model and our proposed algorithm.

  16. [The neuropediatrician and the pediatric neurological emergencies]. (United States)

    García-Peñas, J J; Muñoz-Orduña, R


    Knowledge of the spectrum and frequencies of pediatric neurological emergencies presenting to an emergency department is vital in optimizing the quality of care delivered locally. To know the real incidence of pediatric neurological emergencies. We present an observational study of a cohort of histories of neurological emergencies at a pediatric tertiary hospital during a period of one year. On analysis of all emergencies (93,469 cases), 1,760 were neurological conditions. The commonest causes of consultation were acute paroxysmal episodes (48%), headache (41%) and gait disturbances (5%). Headache was the most often made diagnoses (39%), followed by acute non-epileptic paroxysmal episodes (20%) and e pileptic seizures (15%). Only 17% of patients needed hospital admission, being epilepsy the most frequent diagnoses involved (41%). The most common reasons for attending the pediatric emergency department are gastrointestinal and respiratory illnesses, neurological emergencies, and neonatal problems. Four illnesses, i.e. headaches, acute non-epileptic paroxysmal episodes, epileptic seizures and febrile convulsions, comprise nearly 85% of all the emergency visits of neurological origin. Neurological emergencies constitute a large percentage of pediatric emergencies. Guidelines developed for neurological emergencies should target the commonest presenting problem categories.

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed ... the thyroid gland. top of page How does the procedure work? With ordinary x-ray examinations, an ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed ... the thyroid gland. top of page How does the nuclear medicine procedure work? With ordinary x-ray ...

  19. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin


    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  20. Pediatric Obesity and Ear, Nose, and Throat Disorders (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric ... of self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, ...

  1. Other Common Problems (United States)

    ... Contact Us: Also see: VA Mental Health Connect with us return to top CONNECT Veterans Crisis Line: 1-800-273-8255 (Press 1) Social Media Complete Directory EMAIL UPDATES Email Address Required Button ...

  2. Other Common Problems (United States)

    ... Contact Us: Also see: VA Mental Health Connect with us return to top CONNECT Veterans Crisis Line: 1-800-273-8255 (Press 1) Social Media Complete Directory EMAIL UPDATES Email Address Required Button ...

  3. Pediatric Appendicitis. (United States)

    Rentea, Rebecca M; St Peter, Shawn D


    Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusively laparoscopic, with trials demonstrating better outcomes for children who undergo index hospitalization appendectomies when perforated. Nonoperative management has a role in the treatment of both uncomplicated and complicated appendicitis. This article discusses the workup and management, modes of treatment, and continued areas of controversy in pediatric appendicitis. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Aircraft transfer of pediatric patients with intractable cardiac or airway problems – single-institutional experience of a specialty hospital. (United States)

    Ando, Makoto; Takahashi, Yukihiro; Park, In-Sam; Tomoike, Hitonobu


    There is currently a well-established network for the allocation of donor organs for transplantation in Japan, and emergency patients are often transported by the "Doctor Helicopter". However, interhospital transfer of patients, which can require aircraft with specialized equipment, depends on arrangement by each responsible hospital. Since 2009 there were 41 interhospital aviation transfers of pediatric patients with intractable cardiac or airway diseases seeking surgical treatment at Sakakibara Heart Institute. Of these, 22 were newborns, 21 were on continuous drip infusion and 14 on mechanical ventilator support. In 15 cases (36.6%), a commercial airliner was used, with the remaining using chartered emergency aircraft (eg, local fire department helicopter, Self-Defense-Forces of Japan and the Doctor Helicopter). The median transfer time was 239 min for commercial airliners, 51 min for chartered aircraft departing directly from the referring hospital and 120.5 min for chartered aircraft departing from a nearby location. The efficiency of the transfer exemplified by the percentage of the time on board the aircraft was significantly lower for commercial airliners compared with chartered emergency aircraft. Further efforts and cooperation with government are required to obtain geographically uniform availability of carriers with optimal medical equipment to improve pediatric patient outcomes.

  5. [The loss of a common shared world. Ethical problems in palliative care for people with advanced dementia]. (United States)

    Hertogh, C M P M; The, B A M


    Person-centred (nursing home) care for people with dementia is a specific form of ('non cancer') palliative care. In order to elucidate how caregivers in nursing homes give shape to the nurse-patient relationship in people with advanced dementia and how they deal with the ethical questions that pose themselves in this realm of care ethnographial field research was conducted by two researchers in two Dutch nursing homes. It was found that in both facilities--despite differences in organization and quality of care--many forms of what Kitwood has termed 'malignant social psychology' were prevalent. A more detailed analysis of our research data revealed a relation--not only with staffshortages and a lack of professionalism--but also and primarily with the 'intrinsic complexity' of care giving in this field of palliative care. This complexity has its origin in the key problem of dementia, namely the loss of a common shared world of meaning. We discovered three features of this core problem: the dilemma(s) of truth speaking and truthfulness, the struggle to hold on to reciprocity in care giving and the paradoxes of normality nurses face in their treatment of people with dementia. In order to help caregivers cope with these problems we recommend to invest seriously in diverse forms of supportive care for nurses.

  6. Can You Teach a Teen New Tricks? Problem Solving Skills Training Improves Oral Medication Adherence in Pediatric Patients with Inflammatory Bowel Disease Participating in a Randomized Trial. (United States)

    Greenley, Rachel N; Gumidyala, Amitha P; Nguyen, Eve; Plevinsky, Jill M; Poulopoulos, Natasha; Thomason, Molly M; Walter, Jennifer G; Wojtowicz, Andrea A; Blank, Ellen; Gokhale, Ranjana; Kirschner, Barbara S; Miranda, Adrian; Noe, Joshua D; Stephens, Michael C; Werlin, Steven; Kahn, Stacy A


    Medication nonadherence is associated with higher disease activity, greater health care utilization, and lower health-related quality of life in pediatric inflammatory bowel diseases (IBD). Problem solving skills training (PSST) is a useful tool to improve adherence in patients with chronic diseases but has not been fully investigated in IBD. This study assessed feasibility, acceptability, and preliminary efficacy of PSST in pediatric IBD. Recruitment occurred during outpatient clinic appointments. After completion of baseline questionnaires, families were randomized to a treatment group or wait-list comparison group. The treatment group received either 2 or 4 PSST sessions. Youth health-related quality of life was assessed at 3 time points, and electronic monitoring of oral medication adherence occurred for the study duration. Seventy-six youth (ages 11-18 years) on an oral IBD maintenance medication participated. High retention (86%) and treatment fidelity rates (95%) supported feasibility. High satisfaction ratings (mean values ≥4.2 on 1-5 scale) supported intervention acceptability. Modest increases in adherence occurred after 2 PSST sessions among those with imperfect baseline adherence (d = 0.41, P 0.05). Phone-delivered PSST was feasible and acceptable. Efficacy estimates were similar to those of lengthier interventions conducted in other chronic illness populations. Older adolescents benefited more from the intervention than their younger counterparts.

  7. Psychological issues in pediatric obesity

    Directory of Open Access Journals (Sweden)

    Gurvinder Kalra


    Full Text Available Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

  8. Screening for psychosocial problems in children attending the pediatric clinic at king Khalid university hospital (KKUH in Riyadh (KSA

    Directory of Open Access Journals (Sweden)

    Ibrahim H Al-Ayed


    Conclusion: This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics.

  9. Strong Convergence Theorems for Solutions of Equilibrium Problems and Common Fixed Points of a Finite Family of Asymptotically Nonextensive Nonself Mappings

    Directory of Open Access Journals (Sweden)

    Lijuan Zhang


    Full Text Available An iterative algorithm for finding a common element of the set of common fixed points of a finite family of asymptotically nonextensive nonself mappings and the set of solutions for equilibrium problems is discussed. A strong convergence theorem of common element is established in a uniformly smooth and uniformly convex Banach space.

  10. Analysis of the pediatric orthopedic surgery questions on the Orthopaedic In-Training Examination, 2002 through 2006. (United States)

    Papp, Derek F; Ting, Beverlie L; Sargent, M Catherine; Frassica, Frank J


    Pediatric orthopedics has been a frequently tested topic on the Orthopaedic In-Training Examination (OITE). Our goal was to provide direction for resident education efforts by: (1) analyzing the exam's number, topics, and types of pediatric orthopedic surgery questions; (2) examining references cited in the postexam answer packet supplied by the American Academy of Orthopaedic Surgeons; and (3) examining the efficacy of the Orthopaedic Knowledge Update (OKU): Pediatrics 3 book as a source for answers to the pediatric orthopedic questions. We reviewed 5 years (2002 through 2006) of OITEs and the associated American Academy of Orthopaedic Surgeons' answer packets and assessed the OKU: Pediatrics 3 book for topic relativity. Each question was classified into 1 of 6 categories and labeled with a cognitive taxonomy level: 1 (simple recall), 2 (interpretation of data), or 3 (advanced problem-solving). The 6 categories included: (1) pediatric orthopedic knowledge; (2) knowledge of treatment modalities; (3) diagnosis; (4) diagnosis with recognition of associated conditions; (5) diagnosis with further studies; and (6) diagnosis with treatment. The overall percentage of pediatric questions was 14.1%. The most commonly addressed were pediatric elbow fractures, osteomyelitis, and scoliosis. The most common question types were categories 1 (pediatric orthopedic knowledge) and 6 (diagnosis with treatment). The most frequently referenced textbooks were Lovell and Winter's Pediatric Orthopaedics (31%) and Tachdjian's Pediatric Orthopaedics (16%). The most frequently referenced journals were the Journal of Pediatric Orthopaedics (American) (29%) and the Journal of Bone and Joint Surgery (American) (19%). Using only the OKU: Pediatrics 3 review textbook, 65% of the questions could be answered. Knowledge of the topics more likely to be tested may help the orthopedic educator direct a didactic curriculum geared toward the OITE and American Board of Surgery examinations. Although the

  11. First IDA Submittal for Transducer Element Design for Loosely Packed Planar Array Common Problem 1.1 (United States)


    FIRST IDA SUBMITTAL FOR TRANSDUCER ELEMENT DESIGN FOR LOOSELY PACKED PLANAR ARRAY CID COMMON PROBLEM 1. 1 Submitted to Conformal/Planar Array Project...R4JEN2’ TRACOR, INC. MID BAND 6..I ~JUUliL-UnLU i C.P. 1 5 INCH CIRCULRR HERD MIO BRINO LPz.3777 QP=E +iD L1oooo -i00 F -WFC 4q(TI’ ERT R-EC c-AE O ALPPE...8217 LcO [a x I. Cr l Z2) D zS x) q." L)I I Iu T~ xj Co4 C3= 1-L Z (nw x V O vV 5% C3 CD .* * -3x U l 1C .) uw wU -A CID .4 i I--I- U- 49 (1’)W uri J m LAJ 0


    Institute of Scientific and Technical Information of China (English)

    Liu Min; Zhang Shisheng


    In this article,we introduce a hybrid iterative scheme for finding a common element of the set of solutions for a generalized equilibrium problems,the set of common fixed point for a family of infinite k-strict pseudo-contractive mappings,and the set of solutions of the variational inclusion problem with multi-valued maximal monotone mappings and inverse-strongly monotone mappings in Hilbert space.Under suitable conditions,some strong convergence theorems are proved.Our results extends the recent results in G.L.Acedo and H.K.Xu [2],Zhang,Lee and Chan [8],Takahashi and Toyoda [9],Takahashi and Takahashi [10] and S.S.Chang,H.W.Joseph Lee and C.K.Chan [11],S.Takahashi and W.Takahashi [12].Moreover,the method of proof adopted in this article is different from those of [4] and [12].

  13. A Structured Curriculum for an Undergraduate Elective Clerkship in Pediatric Nephrology (United States)

    Rauch, Jerome S.; Schwartz, M. William


    An organizational structure was developed at the University of Pennsylvania School of Medicine for a pediatric nephrology elective. A study guide and format ensure that students have a common knowledge base--the lack of which has been a problem in electives--and allows them to participate in patient problems. (LBH)


    Directory of Open Access Journals (Sweden)

    Z. Keihanidoust MD


    Full Text Available Objective :Behavioral disorders of children and adolescents have long been a subject of discussion among researchers of pedology,   psychology, medicine and psychiatry and are also a commonly encountered complaint of patients referring to the pediatric neurology out patient clinics. The main purpose of the present study is to survey some organic disorders, e.g. temporal lobe epilepsy (non convulsive seizures and to investigate the role of some trace element deficiencies, in particular iron deficiency on the development of behavioral disorders seen in children.Materials & Methods:In this study all patients referring to the Imam Khomeini pediatric neurology out patient clinic with the chief complaint of behavioral problems, between October 1996 and January 1998 were  enrolled; they were individually interviewed and underwent physical examinations, completing the relevant questionnaires.Results:Overall 139 patients (92boys and 47 girls were enrolled and the data were analyzed using SPSS and Harvard's graphic package. Analysis revealed that the most common behavioral disorders documented were: Sleep problems, in 38 patients (27.3%, Irritability in 37(26.6%, aggressiveness in 28 (20.1% staring in 27 (19.4%, altercation in 27(19.4%. Non psychiatric problem was seen in 77 patients (62.6%; neurological examinations in 36(25.9% revealed abnormal findings; 103 patients (74-8% had abnormal findings in other systems. 105 patients (76.6% had abnormal EEG and 72 of them (51.9% had abnormal findings in brain imaging. Iron deficiency was found in 88 (63.2% of the patients.Conclusion:According to these findings, treatment of organic disorders in patients with behavioral problems, can lead to partial or total control of their problems, which could otherwise result in major disturbances and disruptions in their own and in their family's lives.Key words:behavioral problems, EEG, Imaging, Iron deficiency

  15. Relationship between problems related to child late effects and parent burnout after pediatric hematopoietic stem cell transplantation. (United States)

    Lindahl Norberg, Annika; Mellgren, Karin; Winiarski, Jacek; Forinder, Ulla


    A few studies have indicated that parents' reactions to a child's serious disease may entail long-term stress for the parents. However, further knowledge of its consequences is valuable. The aim of the study was to investigate the occurrence of burnout in a Swedish national sample of parents of children who had undergone HSCT and survived. Burnout (Shirom-Melamed Burnout Questionnaire) and estimations of the child's health status (Lansky/Karnofsky estimations and study-specific questions) were self-reported by 159 mothers and 123 fathers. In addition, physicians made estimations of the child's health status (Lansky/Karnofsky estimations). Nonparametric tests revealed that burnout symptoms occurred more often among fathers of children who had undergone transplantation within the last five yr compared to fathers of children with no history of serious disease (34.4% vs. 19.9%). Burnout among mothers and fathers was associated with the child's number and severity of health impairments up to five yr after the child underwent HSCT (Spearman's rho for mothers 0.26-0.36 and for fathers 0.36-0.61). In conclusion, chronic stress in parents after a child's HSCT seems to abate eventually. However, parents should be monitored and offered adequate support when needed. Moreover, the situation of fathers in the often mother-dominated pediatric setting should receive more attention in research as well as in the clinic.

  16. Molecular epidemiology of carbapenem resistant gram-negative bacilli from infected pediatric population in tertiary - care hospitals in Medellín, Colombia: an increasing problem. (United States)

    Vanegas, Johanna M; Parra, O Lorena; Jiménez, J Natalia


    Gram-negative bacilli are a cause of serious infections in the pediatric population. Carbapenem are the treatment of choice for infections caused by multidrug-resistant Gram-negative bacilli, but the emergence of carbapenem resistance has substantially reduced access to effective antimicrobial regimens. Children are a population vulnerable to bacterial infections and the emergence of resistance can worsen prognosis. The aim of this study is to describe the clinical and molecular characteristics of infections caused by carbapenem-resistant Gram-negative bacilli in pediatric patients from five tertiary-care hospitals in Medellín, Colombia. A cross-sectional study was conducted in five tertiary-care hospitals from June 2012 to June 2014. All pediatric patients infected by carbapenem-resistant Gram-negative bacilli were included. Clinical information for each patient was obtained from medical records. Molecular analyses included PCR for detection of bla VIM, bla IMP bla NDM, bla OXA-48 and bla KPC genes and PFGE and MLST for molecular typing. A total of 59 patients were enrolled, most of them less than 1 year old (40.7 % n = 24), with a previous history of antibiotic use (94.9 %; n = 56) and healthcare-associated infections - predominately urinary tract infections (31.0 %; n = 18). Klebsiella pneumoniae was the most frequent bacteria (47.4 %), followed by Enterobacter cloacae (40.7 %) and Pseudomonas aeruginosa (11.9 %). For K. pneumoniae, KPC was the predominant resistance mechanism (85.7 %; n = 24) and ST14 was the most common clone (39.3 % n = 11), which included strains closely related by PFGE. In contrast, E. cloacae and P. aeruginosa were prevailing non-carbapenemase-producing isolates (only KPC and VIM were detected in 1 and 3 isolates, respectively) and high genetic diversity according to PFGE and MLST was found in the majority of the cases. In recent years, increasing carbapenem-resistant bacilli in children has become in a matter

  17. 建筑节能设计的常见问题%Common Problems in Building Energy Efficiency Design

    Institute of Scientific and Technical Information of China (English)



    Building energy efficiency design is a complicated and meticulous work, composing of sev-eral simple links. Any problems with a simple link will cause the error. This paper summarizes eleven kinds of common problems in building energy efficiency, such as false data, incomplete building envelope items, inconsistencies existing in the drawings, calculations and records table of the same project, energy consumption index, dew point temperature calculation, the selection of design parameters, the use of prod-ucts, unreasonable building structure, design alteration, the setting and calculation of fire belt and the eco-nomics of building energy efficiency. The cause of the errors are analyzed with solutions.%建筑节能设计是一项繁琐、细致的工作,由一系列简单环节组成,任何一个简单环节出现问题,都会导致整个节能设计的错误。从假数据、围护结构部位缺项、图纸计算书备案表三者不一致、能耗指标、露点温度验算、设计参数取值、淘汰和限制使用的产品、构造不合理、设计变更、防火隔离带的设置与计算、节能经济性等十几个方面分析了建筑节能设计的常见问题,并提出了错误原因和解决方法。

  18. Indications for pediatric liver transplantation (United States)

    Esquivel, Carlos O.; Iwatsuki, Shunzaburo; Gordon, Robert D.; Marsh, Wallis W.; Koneru, Baburao; Makowka, Leonard; Tzakis, Andreas G.; Todo, Satoru; Starzl, Thomas E.


    Two hundred fifty pediatric (<18 years of age) patients underwent orthotopic liver transplantation because of end-stage liver disease and were given combination therapy with cyclosporine and prednisone. The most common indications for transplantation In decreasing order of frequency were biliary atresia, inborn errors of metabolism, and postnecrotic cirrhosis. The 5-year actuarial survival for the entire group was 69.2%. Age and diagnosis did not influence survival. Infections were the most common cause of death, followed by liver failure and cerebrovascular accident. The impact of retransplantation on survival depends on the indication. The survival is better when retransplantation is carried out after rejection than because of technical complications, and the latter has a better survival than does primary graft nonfunction. The difference in survival among these groups is statistically significant. The quality of life for 164 of 173 survivors is good to excellent; only nine children are currently experiencing medical problems. A persisent problem in pediatric transplantation is the scarcity of small donors. PMID:3316578

  19. Behavioral Problems in Juvenile Idiopathic Arthritis: A Controlled Study to Examine the Risk of Psychopathology in a Chronic Pediatric Disorder (United States)

    Chamanara, Elham; Raeeskarami, Seyed-Reza


    Children with juvenile idiopathic arthritis (JIA) are prone to the problems that can delay their psychosocial development; however, the existing literature has not reached a consensus on the psychological problems related to JIA. A total of 51 children and adolescents with JIA and 75 healthy controls aged 6 to 18 years were examined using the Child Behavioral Checklist (CBCL). Our results represented that 70 percent of JIA group reached “borderline clinical” range or “clinical” range in internalizing problems, while this percentage in the control group was 18 percent. In addition, our results indicated that JIA group has gotten significantly higher scores (more than twofold) in externalizing behaviors compared to control group. Furthermore, children with JIA showed higher rate of anxiety/depression, withdrawal/depression, somatic complaints, rule breaking behaviors, and aggressive behaviors as well as thought and social problems compared to control group (p < 0.001). As a conclusion, children and adolescents with JIA compared to healthy controls may show higher rate of both internalizing and externalizing problems. Furthermore, our novel findings on externalizing, social, and thought problems in JIA warrant further investigation on affected children who may be at greater risk of future psychopathologies. PMID:27656678

  20. Myocarditis - pediatric (United States)

    ... page: // Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  1. An analysis of concentration of sucrose, endogenous pH, and alteration in the plaque pH on consumption of commonly used liquid pediatric medicines

    Directory of Open Access Journals (Sweden)

    Sunitha S


    Full Text Available Background: Many parents are often unaware of the hidden, added sugars in many foods and drinks including pediatric liquid medicines; thus, hidden sugar in the form of pediatric medications has not been focused upon as cariogenic agents. Objective: (i assess concentration of sucrose in six pediatric drugs, (ii determine endogenous pH of these drugs, and (iii estimate drop in the plaque pH in the oral cavity in first 30 minutes after consumption of the drugs. Materials and Methods: Ten adult volunteers with mean age of 22 years were double blinded for the study. Concentration of sucrose was assessed by volumetric method at Department of Chemical Branch of Engineering. Endogenous pH and drop in the plaque pH after consumption of the drugs were assessed using digital pH meter. Statistical analysis: SPSS software was used to assess the pH level at different time intervals and expressed as mean ± SD. Changes in pH were assessed by one-way ANOVA followed by Wilcoxons signed rank test. P-value was set at 0.05. Result: There were varying amounts of fermentable sucrose detected in the drugs; all the drugs were acidic. There is a significant drop of plaque pH after consumption of the drug. Conclusion: These sweeteners along with their low endogenic pH form a high cariogenic formulation. Thus, nonsucrose (noncariogenic or sugar-free medications are needed to be prescribed along with proper oral hygiene care to the children under medication.

  2. Electronic medical records (EMRs), epidemiology, and epistemology: reflections on EMRs and future pediatric clinical research. (United States)

    Wasserman, Richard C


    Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to their use in scientific investigation. Particular issues include accuracy, completeness, comparability between settings, ease of extraction, and context of recording. Although these problems can be addressed through standard strategies for dealing with partially accurate and incomplete data, a longer-term solution will involve work with pediatric clinicians to improve data quality. As research becomes one of the explicit purposes for which pediatricians collect EMR data, the pediatric clinician will play a central role in future pediatric clinical research.


    Directory of Open Access Journals (Sweden)

    Z. Keihanidoust


    Full Text Available Objective : Behavioral disorders of children and adolescents have long been a subjectof discussion among researchers of pedology, psychology, medicine andpsychiatry and are also a commonly encountered complaint of patientsreferring to the pediatric neurology out patient clinics. The main purpose ofthe present study is to survey some organic disorders, e.g. temporal lobeepilepsy (non convulsive seizures and to investigate the role of some traceelement deficiencies, in particular iron deficiency on the development ofbehavioral disorders seen in children.Materials & Methods: In this study all patients referring to the Imam Khomeini pediatric neurologyout patient clinic with the chief complaint of behavioral problems, betweenOctober 1996 and January 1998 were enrolled; they were individuallyinterviewed and underwent physical examinations, completing the relevantquestionnaires.Results:Overall 139 patients (92boys and 47 girls were enrolled and the data wereanalyzed using SPSS and Harvard's graphic package. Analysis revealed thatthe most common behavioral disorders documented were: Sleep problems,in 38 patients (27.3%, Irritability in 37(26.6%, aggressiveness in 28 (20.1%staring in 27 (19.4%, altercation in 27(19.4%. Non psychiatric problem wasseen in 77 patients (62.6%; neurological examinations in 36(25.9% revealedabnormal findings; 103 patients (74-8% had abnormal findings in othersystems. 105 patients (76.6% had abnormal EEG and 72 of them (51.9%had abnormal findings in brain imaging. Iron deficiency was found in 88(63.2% of the patients.Conclusion:According to these findings, treatment of organic disorders in patients withbehavioral problems, can lead to partial or total control of their problems,which could otherwise result in major disturbances and disruptions in theirown and in their family's lives.

  4. Pediatric tracheomalacia. (United States)

    Fraga, Jose Carlos; Jennings, Russell W; Kim, Peter C W


    Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment. This article examines the published pediatric literature on TM, discusses the details of clinical presentation, evaluation, diagnosis, and a variety of treatments.

  5. Pediatric enteral nutrition. (United States)

    Axelrod, David; Kazmerski, Kimberly; Iyer, Kishore


    Common to all pediatric patients receiving enteral nutrition is the inability to consume calories orally. This is often secondary to issues of inadequate weight gain, inadequate growth, prolonged feeding times, weight loss, a decrease in weight/age or weight/height ratios, or a persistent triceps skinfold thickness <5% for age. Enteral nutrition requires enteral access. In the neonatal period the nasoenteric route is usually used. In pediatric patients requiring long-term enteral access, surgically, endoscopically, or radiologically placed percutaneous feeding tubes are common. Jejunal feeding tubes are used in pediatric patients with gastric feeding intolerance or persistent gastroesophageal reflux. Low-profile enteral access devices are preferred by most pediatric patients because of their cosmetic appearance. For most children, a standard pediatric polypeptide enteral formula is well tolerated. There are specialized pediatric enteral formulas available for patients with decreased intestinal length, altered intestinal absorptive capacity, or altered pancreatic function. Weaning patients from tube feeding to oral nutrition is the ultimate nutrition goal. A multidisciplinary approach to patients with short bowel syndrome will maximize the use of enteral nutrition while preserving parenteral nutrition for patients with true enteral nutrition therapy failure.

  6. Pediatric inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Karen A Diefenbach; Christopher K Breuer


    Inflammatory bowel disease is an important cause of gastrointestinal pathology in children and adolescents.The incidence of pediatric inflammatory bowel disease is increasing; therefore, it is important for the clinician to be aware of the presentation of this disease in the pediatric population. Laboratory tests, radiology studies,and endoscopic procedures are helpful in diagnosing inflammatory bowel disease and differentiating between Crohn's disease and ulcerative colitis. Once diagnosed,the goal of medical management is to induce remission of disease while minimizing the side effects of the medication. Specific attention needs to be paid to achieving normal growth in this susceptible population.Surgical management is usually indicated for failure of medical management, complication, or malignancy.Algorithms for diagnostic evaluation and treatment of pediatric inflammatory bowel disease are presented.The specific psychosocial issues facing these patients are also discussed in this review as are the future goals of research in the complex problem of pediatric inflammatory bowel disease.

  7. Ethical principles and legal requirements for pediatric research in the EU: an analysis of the European normative and legal framework surrounding pediatric clinical trials. (United States)

    Pinxten, Wim; Dierickx, Kris; Nys, Herman


    The involvement of minors in clinical research is inevitable to catch up with the lack of drugs labeled for pediatric use. To encourage the responsible conduct of pediatric clinical trials in the EU, an extensive legal framework has been developed over the past decade in which the practical, ethical, legal, social, and commercial issues in pediatric research are addressed. In this article, the European legal framework surrounding pediatric clinical trials is analyzed from the perspective of the major ethical concerns in pediatric research. The four principles of biomedical ethics will be used as a conceptual framework (1) to map the ethical issues addressed in the European legal framework, (2) to study how these issues are commonly handled in competent adults, (3) to detect workability problems of these paradigmatic approaches in the specific setting of pediatric research, and (4) to illustrate the strong urge to differentiate, specify, or adjust these paradigmatic approaches to guarantee their successful operation in pediatric research. In addition, a concise comparative analysis of the European regulation will be made. To conclude our analysis, we integrate our findings in the existing ethical discussions on issues specific to pediatric clinical research.

  8. Nocturnal Hypertension and Attenuated Nocturnal Blood Pressure Dipping is Common in Pediatric Lupus [version 2; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    J. Fallon Campbell


    Full Text Available Hypertension is an important manifestation of systemic lupus erythematosus (SLE but reports of prevalence vary between 20-70% in published reports of adult and pediatric patients. For both children and adults with SLE, the clinical diagnosis and management of hypertension has traditionally been based on guidelines developed for the general population. In clinical trials, the criteria used for defining participants with hypertension are mostly undefined. As a first step towards formally assessing the blood pressure (BP patterns of children diagnosed with SLE, 24-hr ambulatory BP monitoring data was analyzed on clinic patients who presented with prehypertension or stage I hypertension. In this pediatric SLE cohort (n=10, 20% met daytime criteria for a diagnosis of hypertension. Patterns of BP elevation varied widely with white coat, masked, isolated systolic, and diastolic nocturnal hypertension all identified. Nocturnal hypertension was detected in 60% and attenuated nocturnal BP dipping in 90% of both hypertensive and normotensive SLE patients. In SLE patients, the median nighttime systolic and diastolic loads were 25% and 15.5% compared with median daily loads of 12.5% and 11.5%. Daytime and nighttime systolic and diastolic BP load and nocturnal dipping was compared to a control population consisting of 85 non-SLE patients under 21 years old with prehypertension or stage 1 hypertension presenting to hypertension clinic. Median systolic BP dipped 5.3 mmHg in SLE patients compared to 11.9 mmHg in non-lupus (p-value = 0.001. Median diastolic BP dipped 12.9 mmHg versus 18.5 mmHg in non-lupus (p-value = 0.003. Patterns of BP dysregulation in pediatric SLE merit further exploration. Children with or without SLE displaying prehypertensive or stage 1 casual BP measurements had similar rates of hypertension by ambulatory BP monitoring. However, regardless of BP diagnosis, and independent of kidney involvement, there was an increased proportion with

  9. Process evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders. (United States)

    Arends, Iris; Bültmann, Ute; Nielsen, Karina; van Rhenen, Willem; de Boer, Michiel R; van der Klink, Jac J L


    Common mental disorders (CMDs) are a major cause of sickness absence. Twenty to 30% of the workers who return to work after sickness absence due to CMDs experience recurrent sickness absence. We developed the Stimulating Healthy participation And Relapse Prevention (SHARP)-at work intervention, a problem solving intervention delivered by occupational physicians (OPs), to prevent recurrent sickness absence in this worker population in The Netherlands. A process evaluation was conducted alongside a cluster-randomised controlled trial to (1) evaluate whether the SHARP-at work intervention was implemented according to the protocol and differed from treatment in the control group, and (2) to investigate the relationship between the key elements of the intervention and the effect outcome (i.e. recurrent sickness absence). We collected process data for both the intervention and control group on recruitment, reach, dose delivered, dose received, fidelity, context and satisfaction. Data on recurrent sickness absence was collected through the registry system of the collaborating occupational health service. The study was performed in the Netherlands, and between 2010 and 2012, 154 OPs and 158 participants participated. Compared to the control group, participants in the intervention group more frequently had two or more consultations with the OP (odds ratio [OR] = 3.2, 95% confidence interval [CI] = 1.2-8.8) and completed more assignments (OR = 33.8, 95% CI = 10.4-109.5) as recommended in the intervention protocol. OPs and participants were satisfied with the intervention and rated it as applicable. Several individual intervention components were linked to the effect outcome. The process evaluation showed that the SHARP-at work intervention was conducted according to the protocol for the majority of the participants and well-received by OPs and participants. Furthermore, the intervention differed from treatment in the control group. Overall, the results provide

  10. 儿童血液净化中心静脉导管常见并发症%Common complication of central venous catheter for pediatric blood purification

    Institute of Scientific and Technical Information of China (English)

    黄松明; 赵非


    Pediatric blood purification requires reliable access to the circulation.Central venous catheters play an important role in the delivery of pediatric blood purification.A central venous noncuffed,nontunneled catheter is the best choice for short-term(less than 3 weeks) blood purification.A cuffed,tunneled catheter is preferable to long term(more than 3 weeks) blood purification.However,there are many complications associated with central venous catheters,such as catheter-induced thrombosis,catheter-related infection,and central vein stenosis.This article reviews the prevention and treatment of complications most frequently occurring with central venous catheters.%良好的血管通路是儿童血液净化顺利开展的前提条件,中心静脉导管正逐渐成为一个重要的儿童血液净化通路.对于预期持续时间在3周内的血液净化,中心静脉临时导管是最佳选择;预期持续时间在3周以上的血液净化,建议使用中心静脉半永久导管.然而中心静脉导管会遇到诸如导管血栓、导管相关性感染、中心静脉狭窄等并发症,现就血液净化中心静脉导管常见并发症的预防和治疗进行综述.

  11. An update on pediatric endoscopy. (United States)

    Friedt, Michael; Welsch, Simon


    Advances in endoscopy and anesthesia have enabled gastrointestinal endoscopy for children since 1960. Over the past decades, the number of endoscopies has increased rapidly. As specialized teams of pediatric gastroenterologists, pediatric intensive care physicians and pediatric endoscopy nurses are available in many medical centers, safe and effective procedures have been established. Therefore, diagnostic endoscopies in children are routine clinical procedures. The most frequently performed endoscopies are esophagogastroduodenoscopy (EGD), colonoscopy and endoscopic retrograde cholangiopancreaticography (ERCP). Therapeutic interventions include variceal bleeding ligation, foreign body retrieval and percutaneous endoscopic gastrostomy. New advances in pediatric endoscopy have led to more sensitive diagnostics of common pediatric gastrointestinal disorders, such as Crohn's disease, ulcerative colitis and celiac disease; likewise, new diseases, such as eosinophilic esophagitis, have been brought to light.Upcoming modalities, such as capsule endoscopy, double balloon enteroscopy and narrow band imaging, are being established and may contribute to diagnostics in pediatric gastroenterology in the future.

  12. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology


    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  13. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan


    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  14. Redefining the Whole: Common Errors in Elementary Preservice Teachers' Self-Authored Word Problems for Fraction Subtraction (United States)

    Dixon, Juli K.; Andreasen, Janet B.; Avila, Cheryl L.; Bawatneh, Zyad; Deichert, Deana L.; Howse, Tashana D.; Turner, Mercedes Sotillo


    A goal of this study was to examine elementary preservice teachers' (PSTs) ability to contextualize and decontextualize fraction subtraction by asking them to write word problems to represent fraction subtraction expressions and to choose prewritten word problems to support given fraction subtraction expressions. Three themes emerged from the…

  15. Pediatric Sepsis. (United States)

    Prusakowski, Melanie K; Chen, Audrey P


    Pediatric sepsis is distinct from adult sepsis in its definitions, clinical presentations, and management. Recognition of pediatric sepsis is complicated by the various pediatric-specific comorbidities that contribute to its mortality and the age- and development-specific vital sign and clinical parameters that obscure its recognition. This article outlines the clinical presentation and management of sepsis in neonates, infants, and children, and highlights some key populations who require specialized care. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A randomized trial of teen online problem solving for improving executive function deficits following pediatric traumatic brain injury. (United States)

    Wade, Shari L; Walz, Nicolay C; Carey, JoAnne; Williams, Kendra M; Cass, Jennifer; Herren, Luke; Mark, Erin; Yeates, Keith Owen


    To examine the efficacy of teen online problem solving (TOPS) in improving executive function (EF) deficits following traumatic brain injury (TBI) in adolescence. Families of adolescents (aged 11-18 years) with moderate to severe TBI were recruited from the trauma registry of 2 tertiary-care children's hospitals and then randomly assigned to receive TOPS (n = 20), a cognitive-behavioral, skill-building intervention, or access to online resources regarding TBI (Internet resource comparison; n = 21). Parent and teen reports of EF were assessed at baseline and a posttreatment follow-up (mean = 7.88 months later). Improvements in self-reported EF skills were moderated by TBI severity, with teens with severe TBI in the TOPS treatment reporting significantly greater improvements than did those with severe TBI in the Internet resource comparison. The treatment groups did not differ on parent ratings of EF at the follow up. Findings suggest that TOPS may be effective in improving EF skills among teens with severe TBI.

  17. Antibiotic-associated diarrhea: therapeutic aspects and practical guidelines--an interdisciplinary approach to a common problem

    National Research Council Canada - National Science Library

    Lembcke, B; Kist, M; Lentze, M J; Bruns, J; Gesche, M; Herrmann, M; Gyr, N


    .... This paper implies therapeutic aspects and practical guidelines to raise awareness of these problems also in routine situations and to enable the persons and institutions involved on the various...

  18. A Hybrid Algorithm for Solving the Economic Lot and Delivery Scheduling Problem in the Common Cycle Case

    DEFF Research Database (Denmark)

    Ju, Suquan; Clausen, Jens


    The ELDSP problem is a combined lot sizing and sequencing problem. A supplier produces and delivers components of different component types to a consumer in batches. The task is to determine the cycle time, i.e. that time between deliveries, which minimizes the total cost per time unit. This incl......The ELDSP problem is a combined lot sizing and sequencing problem. A supplier produces and delivers components of different component types to a consumer in batches. The task is to determine the cycle time, i.e. that time between deliveries, which minimizes the total cost per time unit....... This includes the determination of the production sequence of the component types within each cycle. We investigate the computational behavior of two published algorithms, a heuristic and an optimal algorithm. With large number of component types, the optimal algorithm has long running times. We devise a hybrid...

  19. A hybrid algorithm for solving the economic lot and delivery scheduling problem in the common cycle case

    DEFF Research Database (Denmark)

    Clausen, Jens; Ju, S.


    The ELDSP problem is a combined lot sizing and sequencing problem. A supplier produces and delivers components of different types to a consumer in batches. The task is to determine the cycle time, i.e., the time between deliveries, which minimizes the total cost per time unit. This includes the d...... is both optimal and efficient. (c) 2005 Elsevier B.V. All rights reserved....

  20. Update on pediatric hyperhidrosis. (United States)

    Gordon, Jennifer R S; Hill, Samantha E


    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications.

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders ...

  2. Pediatric airway nightmares. (United States)

    D'Agostino, James


    Pediatric disorders that involve actual or potential airway compromise are among the most challenging cases that emergency department providers face. This article discusses the diagnosis and management of common and uncommon conditions in infants and children who may present with airway obstruction.

  3. Moral Dilemmas in Pediatric Orthopedics. (United States)

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y


    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result. Copyright 2015, SLACK Incorporated.

  4. Pediatric flexible flatfoot; clinical aspects and algorithmic approach. (United States)

    Halabchi, Farzin; Mazaheri, Reza; Mirshahi, Maryam; Abbasian, Ladan


    Flatfoot constitutes the major cause of clinic visits for pediatric foot problems. The reported prevalence of flatfoot varies widely due to numerous factors. It can be divided into flexible and rigid flatfoot. Diagnosis and management of pediatric flatfoot has long been the matter of controversy. Common assessment tools include visual inspection, anthropometric values, footprint parameters and radiographic evaluation. Most flexible flatfeet are physiologic, asymptomatic, and require no treatment. Otherwise, the physician should treat symptomatic flexible flatfeet. Initial treatment options include activity modification, proper shoe and orthoses, exercises and medication. Furthermore, comorbidities such as obesity and ligamenous laxity should be identified and managed, if applicable. When all nonsurgical treatment options faile, surgery can be considered. Our purpose in this article is to present a clinical algorithmic approach to pediatric flatfoot.

  5. Access to Medicines : Common problems, common solutions?

    NARCIS (Netherlands)

    Stephens, P.N.


    This thesis investigates four cross-cutting controversies in access to medicines – aspects of pharmaceutical R&D, equity, generics policy and scale up. Chapter 2 describes the state of pharmaceutical research and development (R&D). It finds that failure rates remain high with the probability of mark

  6. Access to Medicines : Common problems, common solutions?

    NARCIS (Netherlands)

    Stephens, P.N.


    This thesis investigates four cross-cutting controversies in access to medicines – aspects of pharmaceutical R&D, equity, generics policy and scale up. Chapter 2 describes the state of pharmaceutical research and development (R&D). It finds that failure rates remain high with the probability of

  7. Contact Dermatitis in Pediatrics. (United States)

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E


    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.].

  8. Common-lead problems related to allanite Th-U-Pb dating: Are muliple growth zones the problem or the solution? (United States)

    Burn, Marco; Lanari, Pierre; Engi, Martin


    Allanite Th-U/Pb dating has proved to be a powerful tool to unravel the timing of magmatic and metamorphic processes. Different techniques (ID-TIMS, LA-ICP-MS, SHRIMP/SIMS) and optimized algorithms for the calculation of ages have been concocted over the last 25 years. Major differences concern the correction of age data for the initial common lead incorporated in allanite, which is required to interpret single analyses in terms of geologically meaningful ages. Much like garnet, allanite commonly shows growth zoning. Analytical progress improving the spatial resolution is thus most welcome for dating allanite, as it allows spots in single growth zones to be measured, rather than an average of several growth zones in single grains or worse, over several grains (early ID-TIMS). Regarding the conversion of isotopic data to geological meaningful ages, spot age dating of allanite has developped from two opposite ambitions: (i) Single spot approach: Each analytical spot yields an age, which can be averaged over the same growth zone in order to obtain a more precise age; (ii) Isochron approach: Only groups of single spots analyzed together can reveal a correct age. The main differences between these approaches are the basic assumptions used for the interpretation of the ages. The single spot approach assumes that the the ratios of initial common lead incorporated in allanite is known, whereas for the isochron approach assumes that a single growth zone can be identified and hence only analyses from the same one are employed. We present an approach that combines the two ambitions to date metamorphic allanite: Th-U/Pb-data from LA-ICP-MS spot analysis, EPMA data and results of different imaging techniques are reported. The composition of initial lead incorporated in allanite is estimated from the Tera-Wasserburg and the Th-isochron diagram. Estimates of this initial lead composition in allanite show that the common lead fractions in allanite are variable. Case examples are

  9. Diabetes care provider perceptions on family challenges of pediatric type 1 diabetes (United States)

    Pediatric healthcare providers' perspectives on barriers to diabetes self-management among youth with type 1 diabetes and strategies to overcome them were explored qualitatively. Family conflict about diabetes care was viewed as a common problem, addressable by behavioral interventions to improve co...

  10. Sleep Problems Under-Reported by Parents in Iranian Children


    Shahla Afsharpaiman; Ali Bagheri Hagh; Mohammad Kolbadi Nejad; Susan Amirsalari; Mohammad Torkaman


    Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross - a sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics...

  11. Screening for distress, the 6th vital sign: common problems in cancer outpatients over one year in usual care: associations with marital status, sex, and age

    Directory of Open Access Journals (Sweden)

    Giese-Davis Janine


    Full Text Available Abstract Background Very few studies examine the longitudinal prevalence of problems and the awareness or use of clinical programs by patients who report these problems. Of the studies that examine age, gender and marital status as predictors of a range of patient outcomes, none examines the interactions between these demographic variables. This study examined the typical trajectory of common practical and psychosocial problems endorsed over 12 months in a usual-care sample of cancer outpatients. Specifically, we examined whether marital status, sex, age, and their interactions predicted these trajectories. We did not actively triage or refer patients in this study in order to examine the natural course of problem reports. Methods Patients completed baseline screening (N = 1196 of 1707 approached and the sample included more men (N = 696 than women (N = 498, average age 61.1 years. The most common diagnoses were gastrointestinal (27.1%, prostate (19.2%, skin (11.1% and gynecological (9.2%. Among other measures, patients completed a Common Problem Checklist and Psychosocial Resources Use questions at baseline, 3, 6, and 12 months using paper and pencil surveys. Results Results indicated that patients reported psychosocial problems more often than practical and both decreased significantly over time. Younger single patients reported more practical problems than those in committed relationships. Younger patients and women of all ages reported more psychosocial problems. Among a number of interesting interactions, for practical problems, single older patients improved more; whereas among married people, younger patients improved more. For psychosocial problems we found that older female patients improved more than younger females, but among males, it was younger patients who improved more. Young single men and women reported the most past-and future-use of services. Conclusions Younger women are particularly vulnerable to experiencing

  12. Drug repurposing in pediatrics and pediatric hematology oncology. (United States)

    Blatt, Julie; Corey, Seth J


    Drug 'repurposing', that is, using old drugs for new indications, has been proposed as a more efficient strategy for drug development than the current standard of beginning with novel agents. In this review, we explore the scope of drug repurposing in pediatric hematology oncology and in pediatrics in general. Drugs commonly used in children were identified using the Harriet Lane Handbook (HLH) and searched in PubMed for different uses. Additional drugs were identified by searching PubMed and for 'drug repurposing' or 'drug repositioning'. Almost 10% of drugs with primary uses in pediatrics have been repurposed in pediatric hematology oncology or pediatrics. The observant clinician, pharmacologist and translational bioinformatician, as well as structural targeting, will have a role in discovering new repurposing opportunities.

  13. Pediatric Ingestions: Emergency Department Management. (United States)

    Tarango Md, Stacy M; Liu Md, Deborah R


    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies.

  14. Pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Poussaint, Tina Y. [Department of Radiology, Boston, MA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Huisman, Thierry A.G.M. [Charlotte R. Bloomberg Children' s Center, Johns Hopkins Hospital, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD (United States)


    Among all causes of death in children from solid tumors, pediatric brain tumors are the most common. This article includes an overview of a subset of infratentorial and supratentorial tumors with a focus on tumor imaging features and molecular advances and treatments of these tumors. Key to understanding the imaging features of brain tumors is a firm grasp of other disease processes that can mimic tumor on imaging. We also review imaging features of a common subset of tumor mimics. (orig.)

  15. Problems

    Directory of Open Access Journals (Sweden)

    Yekini Shehu


    real Banach space which is also uniformly smooth using the properties of generalized f-projection operator. Using this result, we discuss strong convergence theorem concerning general H-monotone mappings and system of generalized mixed equilibrium problems in Banach spaces. Our results extend many known recent results in the literature.

  16. Concept maps which visualise the artifice of teaching sequence: Cognition, linguistic and problem-based views on a common teaching problem

    Directory of Open Access Journals (Sweden)

    David B. Hay


    Full Text Available This paper is concerned with the ways in which undergraduates are first introduced to Law of Contract in a University Law School. Concept mapping is used to document students’ changing understanding in the course of one first year undergraduate module. Forty seven students (the members of four tutorial groups made concept maps of “Law of Contract” at the start and at the finish of a twenty-four week study-programme and their maps were compared with two other concept maps made by their lecturer: 1 a map of the teaching sequence; 2 a map of the practices of Law of Contract. The analysis shows how the teaching sequence inscribes itself upon the students’ concept mapping structures even while this temporal pattern has little (or no genuine accord with the knowledge-shape of legal analysis. The paper explores two different approaches to concept map analysis: First the more traditional perspective of cognition (and cognitive-structure; second the “linguistic-turn”. Both of these highlight the “artifice of teaching sequence” but they locate this problem in different arenas. While the cognitive approach suggests that the problem is a general issue of student learning quality, the linguistic approach is more specific, suggesting that the problem is confined to the lesson planning which does not actually involve the students. This paper also concludes that while concept mapping shows the acquisition of a new vocabulary of legal concepts, the method itself is rather less useful for showing whether or not students are developing the skills of making judgement.

  17. A New Approach for the Approximations of Solutions to a Common Fixed Point Problem in Metric Fixed Point Theory

    Directory of Open Access Journals (Sweden)

    Ishak Altun


    Full Text Available We provide sufficient conditions for the existence of a unique common fixed point for a pair of mappings T,S:X→X, where X is a nonempty set endowed with a certain metric. Moreover, a numerical algorithm is presented in order to approximate such solution. Our approach is different to the usual used methods in the literature.

  18. Community pediatrics: the Rochester story. (United States)

    Haggerty, Robert J; Aligne, C Andrew


    There are so many problems facing children today (eg, violence, poor nutrition, substance abuse, teen pregnancy) that conventional medical care can only address a small portion of these concerns. Thus, to be optimally effective, pediatrics needs to be linked to other disciplines and programs that address these issues by using different paradigms. Robert Haggerty, the originator of the term "community pediatrics," reflects on how one can successfully practice community pediatrics in an academic setting and model it for young physicians while also improving the health of children at the community level. Here we tell the story of the years that Haggerty was chief of pediatrics at the University of Rochester and took on the challenge of fulfilling the department's responsibility to all children in the county. Because of his pioneering work, his tenure was heralded as a critical period in the development of the field of community pediatrics.

  19. Pediatric Integrative Medicine. (United States)

    McClafferty, Hilary; Vohra, Sunita; Bailey, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Niemi, Anna-Kaisa; Sibinga, Erica; Weydert, Joy; Yeh, Ann Ming


    The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to this mission, the American Academy of Pediatrics recognizes the increasing use of complementary and integrative therapies for children and the subsequent need to provide reliable information and high-quality clinical resources to support pediatricians. This Clinical Report serves as an update to the original 2008 statement on complementary medicine. The range of complementary therapies is both extensive and diverse. Therefore, in-depth discussion of each therapy or product is beyond the scope of this report. Instead, our intentions are to define terms; describe epidemiology of use; outline common types of complementary therapies; review medicolegal, ethical, and research implications; review education and training for select providers of complementary therapies; provide educational resources; and suggest communication strategies for discussing complementary therapies with patients and families. Copyright © 2017 by the American Academy of Pediatrics.

  20. Pediatric perspective on pharmacogenomics. (United States)

    Stevens, Adam; De Leonibus, Chiara; Hanson, Daniel; Whatmore, Andrew; Murray, Philip; Donn, Rachelle; Meyer, Stefan; Chatelain, Pierre; Clayton, Peter


    The advances in high-throughput genomic technologies have improved the understanding of disease pathophysiology and have allowed a better characterization of drug response and toxicity based on individual genetic make up. Pharmacogenomics is being recognized as a valid approach used to identify patients who are more likely to respond to medication, or those in whom there is a high probability of developing severe adverse drug reactions. An increasing number of pharmacogenomic studies are being published, most include only adults. A few studies have shown the impact of pharmacogenomics in pediatrics, highlighting a key difference between children and adults, which is the contribution of developmental changes to therapeutic responses across different age groups. This review focuses on pharmacogenomic research in pediatrics, providing examples from common pediatric conditions and emphasizing their developmental context.

  1. Pediatric urologic emergencies and urgencies. (United States)

    Leslie, Jeffrey A; Cain, Mark P


    The more common urologic problems seen in infancy and childhood that require urgent or emergent pediatric urologic referral are discussed, including a brief description of the usual presenting signs or symptoms, differential diagnoses, proper diagnostic work-up recommended before or at the time of referral, and the usual therapeutic course of management after evaluation by the urologist. These conditions include the acutely swollen scrotum, scrotal masses, penile swelling and erythema, exstrophy, hematuria, urinary retention, abdominal masses, and various genital abnormalities including interlabial masses, hypospadias with any degree of cryptorchidism, and ambiguous genitalia. This article is designed to provide the primary care practitioner with a focused review and a useful resource for managing children who have genitourinary abnormalities in the hospital or clinic setting.

  2. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg


    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  3. Pediatric neuroimaging in early childhood and infancy: challenges and practical guidelines (United States)

    Raschle, Nora; Zuk, Jennifer; Ortiz-Mantilla, Silvia; Sliva, Danielle D.; Franceschi, Angela; Grant, P. Ellen; Benasich, April A.; Gaab, Nadine


    Structural and functional magnetic resonance imaging (fMRI) has been used increasingly to investigate typical and atypical brain development. However, in contrast to studies in school-aged children and adults, MRI research in young pediatric age groups is less common. Practical and technical challenges occur when imaging infants and children, which presents clinicians and research teams with a unique set of problems. These include procedural difficulties (e.g., participant anxiety or movement restrictions), technical obstacles (e.g., availability of child-appropriate equipment or pediatric MR head coils), and the challenge of choosing the most appropriate analysis methods for pediatric imaging data. Here, we summarize and review pediatric imaging and analysis tools and present neuroimaging protocols for young nonsedated children and infants, including guidelines and procedures that have been successfully implemented in research protocols across several research sites. PMID:22524338

  4. Discussion on common problems in traditional Chinese medicine inspection with conventional HPLC method%常规HPLC法检验中药常见问题的探讨

    Institute of Scientific and Technical Information of China (English)



    Objective To discusse the common problems encountered during traditional Chinese medicine inspection with conventional High Performance Liquid Chromatography method (ODS column, ultraviolet detector). Methods These problems were analyzed with years of practices and experiences of the author in drug inspection. Results Methods and counter-measures were put forward to dissolve these common problems. Conclusion With the problems tackled case-by-case, reasonable adjustment of variable inspection conditions is an important way for problem solving.%目的 探讨常规高效液相色谱(HPLC)法(ODS柱,紫外检测器)检验中药中遇到的常见问题.方法 结合笔者近几年检验工作的实践和经验来展开分析讨论.结果提出了解决常见问题的方法和对策.结论 具体问题要具体分析,合理调整可变的检验条件是解决问题的重要途径.

  5. 小学生常见心理问题探讨%Study on Common Psychological Problems of Students

    Institute of Scientific and Technical Information of China (English)



    This paper analyzed the characteristics and reasons of primary common mental weariness.And then promoted some sug-gestions to overcome the above unhealthy psychology.These measures show good effects on practical teaching.%本文分析了小学生常见的厌学心理、从众心理以及逆反心理的特点和形成的原因,有针对性的提出了克服上述心理的方法和措施,在实际教学过程中取得了良好的效果。

  6. Analysis of common problems in Piano Teaching%钢琴教学中常见问题解析

    Institute of Scientific and Technical Information of China (English)



    学钢琴不仅要有耐心,也要讲艺术。万事开头难,钢琴初学者在初学时会出现一些问题,例如:弓腰驼背,端肩吊臂,绞脚绕腿,压腕抖腕,掌僵指硬等毛病,而要学好钢琴就必须在刚入门时打好基础,要改正平时所出现的毛病,要端正坐姿,放松胳膊,稳定手腕,支撑手掌,这样,才能在钢琴学习上取得好的成效。%Learn the piano not only to have the patience, also want to talk art. Everything is hard in the beginning, the piano for beginners in learning and there will be some problems, for example: hunchbacked, end shoulder arm twisted around the leg, foot pressure, wrist wrist, palm stiff refers to the hard problems, and to learn the piano to beginners to lay a good foundation, to correct usually appear wrong, to correct sitting posture, relaxed stability arm, wrist, support the palm, such, ability in the piano study obtains good result.

  7. Analysis of the Common Problems and Countermeasures of Municipal Road Construction%市政道路施工常见问题及应对探析

    Institute of Scientific and Technical Information of China (English)



    In today's rapid economic development, the urbani-zation process is also accelerating. Therefore, people also put forward higher requirements for the municipal road quality. This article presents the common problems often encountered in the municipal road construction technology in China, and analyzes and discusses the countermeasures of these common problems so as to provide reference for readers.%在经济飞速发展的今天,城市化的进程也在加快。因此,对市政道路的质量也提出了更高的要求。本文呈现了我国市政道路施工技术中常常遇到的问题,并分析和探讨了这些常见问题的应对措施,以供读者借鉴与参考。

  8. Pediatric MRI (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  9. Pediatric Terminology (United States)

    The National Institute of Child Health and Human Development (NICHD) is working with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other resea

  10. Pediatric uroradiology. 2nd rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Fotter, Richard (ed.) [Univ. Hospital Medical Univ. Graz (Austria). Div. of Pediatric Radiology


    Since the first edition of Pediatric Uroradiology, very significant advances have been made in the imaging and treatment of common and important pediatric urologic disorders such as vesicoureteric reflux, urinary tract infection, and upper urinary tract dilatation. This revised and extended version takes full account of the sometimes dramatic changes. Where appropriate, new contents have been included, e.g., on genetics, while other information that continues to be pertinent has been retained. This book describes in detail all aspects of pediatric uroradiology. While it is written primarily from the point of view of the radiologist, it includes essential information for the pediatrician, pediatric surgeon, and urologist. It is specifically designed to aid the clinician in decisions on imaging management. The newest techniques and the changing relevance of imaging and interventional procedures are presented, and the diverse problems associated with the changing anatomy, physiology, and pathophysiology from the newborn period to adulthood are explained. The whole spectrum of imaging features of agenesis, anomalies, dysplasia, parenchymal diseases, neoplastic diseases, stone disease, renal vascular hypertension, renal failure, renal transplantation, and genitourinary trauma is covered. Individual chapters are devoted to vesicoureteric reflux, urinary tract infection, upper urinary tract dilatation, voiding dysfunction, and neurogenic bladder. A new chapter on the clinical management of common nephrourologic disorders, with the subtitle 'guidelines and beyond,' explains how imaging is embedded in the whole process of clinical management today. Short conclusions are included at the end of chapters and sections to provide the reader with the key information on the specific topic under consideration. (orig.)

  11. CEMS烟气在线连续监测系统常见问题的探讨%Discussion on the Common Problems in CEMS

    Institute of Scientific and Technical Information of China (English)

    苏静; 吴海平; 王金奇


    简述CEMS的工作原理,提出CEMS工作中的常见问题,阐述常见问题的现象,剖析常见问题原因,并针对性的提出了应对措施。%This paper describes the principle of CEMS, analyzes the common problems occured in the system working and the reasons as well, and put forward the countermeasures.

  12. The Split Common Fixed Point Problem for a Family of Multivalued Quasinonexpansive Mappings and Totally Asymptotically Strictly Pseudocontractive Mappings in Banach Spaces

    Directory of Open Access Journals (Sweden)

    Ali Abkar


    Full Text Available In this paper, we introduce an iterative algorithm for solving the split common fixed point problem for a family of multi-valued quasinonexpansive mappings and totally asymptotically strictly pseudocontractive mappings, as well as for a family of totally quasi-ϕ-asymptotically nonexpansive mappings and k-quasi-strictly pseudocontractive mappings in the setting of Banach spaces. Our results improve and extend the results of Tang et al., Takahashi, Moudafi, Censor et al., and Byrne et al.

  13. Medical Comorbidities in Pediatric Headache. (United States)

    Jacobs, Howard; Singhi, Samata; Gladstein, Jack


    Comorbid conditions frequently occur in pediatric headaches and may significantly affect their management. Comorbidities that have been associated with pediatric headaches include attention-deficit or hyperactivity disorder, autism, developmental disabilities, depression, anxiety, epilepsy, obesity, infantile colic, atopic disorders, inflammatory bowel disease, and irritable bowel syndrome. The goal of this article is to review these comorbidities associated with pediatric headache, thereby empowering child neurologists to identify common triggers and tailor management strategies that address headache and its comorbidities. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Pediatric melanoma. (United States)

    Tracy, Elisabeth T; Aldrink, Jennifer H


    Childhood melanoma is a rare pediatric malignancy, with fewer than 500 new diagnoses annually. The incidence is increasing, particularly in the adolescent population. This review highlights the epidemiology, clinical presentation, and histopathologic challenges of pediatric melanoma. Surgical resection remains the cornerstone for localized and regionally advanced disease. Adjuvant therapies, including current options and potential novel therapeutics for this unique population will be discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Pediatric Dentistese


    Sharath Asokan; Sivakumar Nuvvula


    Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pe...

  16. Pediatric Anthropometry (United States)

    Klinich, Kathleen D.; Reed, Matthew P.

    Anthropometry is the measurement of human size, shape, and physical capabilities. Most pediatric anthropometry data are gathered to describe child growth patterns, but data on body size, mass distribution, range of motion, and posture are used to develop crash test dummies and computational models of child occupants. Pediatric anthropometry data are also used to determine child restraint dimensions, so they will accommodate the applicable population of child occupants.

  17. A pilot study of common health problems in smallholder pigs in Angónia and Boane districts, Mozambique

    Directory of Open Access Journals (Sweden)

    C. Matos


    Full Text Available Apilot survey was conducted in 2 districts in Mozambique to determine the most important health problems facing smallholder pig producers. While African swine fever is the most serious disease that affects pigs at all levels of production in Mozambique, it is likely that productivity is reduced by the presence of mange and gastrointestinal parasites, while in traditional systems the conditions are favourable for the development of porcine cysticercosis caused by the pork tapeworm Taenia solium, which poses a health risk to communities. Results of the pilot survey confirmed that, with the exception of African swine fever, ecto- and endoparasites are probably the most important health risks for producers. Porcine cysticercosis is more prevalent among pigs in traditional, free-ranging systems, while mange becomes a serious factor when pigs are permanently confined.

  18. Virtual Pediatric Hospital (United States)

    ... Assistant™ Last revised on February 22, 2017 Related Digital Libraries Pediatric - the general pediatrician's view of the Internet - a pediatric digital library and learning collaboratory intended to serve as a ...

  19. 检定原子荧光光度计常见问题分析%Atomic Fluorescence Spectrophotometer Calibration Common Problems

    Institute of Scientific and Technical Information of China (English)

    童诚; 吴银银; 马文


    This paper presents the common problems of possible atomic fluorescence spectrophotometer verification process .According to the working principle of the instrument and the experience , causes of the problems were analyzed , and specific solutions were proposed for different problems.It can guarantee accurate and reliable verification results .%提出了原子荧光光度计检定过程中可能出现的常见问题。根据经验和仪器的工作原理对问题产生的原因进行了分析,并针对不同问题给出了具体的解决措施。对实现检定结果的准确可靠具有较好的保证作用。

  20. Pediatric ophthalmology and childhood reading difficulties: Overview of reading development and assessments for the pediatric ophthalmologist. (United States)

    Collins, Megan E; Mudie, Lucy I; Inns, Amanda J; Repka, Michael X


    Reading difficulties are common in the pediatric population, and large socioeconomic disparities exist. In the United States 46% of white children achieved expected reading proficiency by the end of fourth grade, while only 21% of Hispanic and 18% of African American children were reading at the expected level. Reading is an involved cognitive process with many subskills; likewise, development of reading proficiency is a complex and continuous process. Failure to achieve reading proficiency or even early difficulty with reading can affect a child's academic performance for years to come. Some studies suggest reading proficiency may be related to later success in life. Although many problems with reading are not related to vision, a vision assessment is recommended for children with reading difficulties and a suspected vision problem. The process of reading development as well as the varied educational assessments of reading are presented here for pediatric ophthalmologists. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  1. Phylogenomic approaches to common problems encountered in the analysis of low copy repeats: The sulfotransferase 1A gene family example

    Directory of Open Access Journals (Sweden)

    Benner Steven A


    Full Text Available Abstract Background Blocks of duplicated genomic DNA sequence longer than 1000 base pairs are known as low copy repeats (LCRs. Identified by their sequence similarity, LCRs are abundant in the human genome, and are interesting because they may represent recent adaptive events, or potential future adaptive opportunities within the human lineage. Sequence analysis tools are needed, however, to decide whether these interpretations are likely, whether a particular set of LCRs represents nearly neutral drift creating junk DNA, or whether the appearance of LCRs reflects assembly error. Here we investigate an LCR family containing the sulfotransferase (SULT 1A genes involved in drug metabolism, cancer, hormone regulation, and neurotransmitter biology as a first step for defining the problems that those tools must manage. Results Sequence analysis here identified a fourth sulfotransferase gene, which may be transcriptionally active, located on human chromosome 16. Four regions of genomic sequence containing the four human SULT1A paralogs defined a new LCR family. The stem hominoid SULT1A progenitor locus was identified by comparative genomics involving complete human and rodent genomes, and a draft chimpanzee genome. SULT1A expansion in hominoid genomes was followed by positive selection acting on specific protein sites. This episode of adaptive evolution appears to be responsible for the dopamine sulfonation function of some SULT enzymes. Each of the conclusions that this bioinformatic analysis generated using data that has uncertain reliability (such as that from the chimpanzee genome sequencing project has been confirmed experimentally or by a "finished" chromosome 16 assembly, both of which were published after the submission of this manuscript. Conclusion SULT1A genes expanded from one to four copies in hominoids during intra-chromosomal LCR duplications, including (apparently one after the divergence of chimpanzees and humans. Thus, LCRs may

  2. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan


    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping...... of atypical inflammatory bowel disease (IBD) patients. Our aim was to identify the prevalence of atypical disease patterns in new-onset pediatric UC using the Paris classification....

  3. Pediatric contact dermatitis


    Sharma Vinod; Asati Dinesh


    Allergic contact dermatitis (ACD) in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and i...

  4. Evaluation of pediatric nephrolithiasis


    Kokorowski, Paul J.; Katherine Hubert; Nelson, Caleb P.


    Nephrolithiasis in the pediatric population is an important cause of morbidity worldwide. Presenting signs and symptoms are often considerably different from those in adults. Vague abdominal pain, hematuria, and urinary tract infection are more common in children than the classic colicky flank pain. Imaging of suspected cases should be undertaken with careful consideration of diagnostic accuracy and the potentially harmful effects of ionizing radiation. Because children with nephrolithiasis h...

  5. Sleep problems in children. (United States)

    Baweja, R; Calhoun, S; Baweja, R; Singareddy, R


    Sleep complaints and sleep disorders are common during childhood and adolescence. The impact of not getting enough sleep may affect children's' physical health as well emotional, cognitive and social development. Insomnia, sleep-disordered breathing, parasomnias and sleep disturbances associated with medical and psychiatric disorders are some of the commonly encountered sleep disorders in this age group. Changes in sleep architecture and the amount of sleep requirement associated with each stage of development should be considered during an evaluation of sleep disorders in children. Behavioral treatments should be used initially wherever possible especially considering that most pharmacologic agents used to treat pediatric sleep disorders are off-label. In this review we address the most common sleep problems in children/adolescents as they relate to prevalence, presentation and symptoms, evaluation and management.

  6. 静力压桩法的特点分析与常见问题%Characteristics analysis and common problems of static pressed pile method

    Institute of Scientific and Technical Information of China (English)



    The author introduces the static pressed pile method, combining with concrete project, analyzes the characteristics of the static pressed pile method, discusses the common problems in the static pressed pile construction, emphasizes on the attention problems in the static pressed pile construction, gets prospect on the developmen prospect of the static pressed pile.%对静力压桩法进行了介绍,结合具体工程实例,分析了静力压桩法的特点,探讨了静压桩施工中的常见问题,强调了静压桩施工中应注意的问题,对静压桩的发展前景进行了展望.

  7. 钻探凿井中常见问题的预防及处理%On prevention of common problems in drilling sinking and treatment

    Institute of Scientific and Technical Information of China (English)



    对钻探凿井中常见的问题如钻孔弯曲、卡钻、夹钻、钻进中钻具事故等作了描述,分析了这些问题的发生原因,进而提出了相应的预防措施和处理方法,从而确保钻探工作的高效进行,避免事故的发生。%The paper describes the common problems in the drilling sinking,such as the drilling hole crook,the sticking of drilling pipe,the jamming of drilling pipe,and accidents of drilling tools in the drilling process,analyzes the reasons for those problems,and points out the respective prevention measures and the treatment methods,so as to ensure the high-efficiency of the drilling and avoid the accidents.

  8. The cause exploration of common problems of engineering quality%工程质量常见问题的原因探究

    Institute of Scientific and Technical Information of China (English)



    From the construction units, design units, censorship, construction units, supervision industry and other aspects, this paper analyzed the cause of common problems of our construction industry project quality, and combining with the actual situation, proposed corresponding solu-tion measures, to reduce the emergence of engineering quality problems.%从建设单位、设计单位、审查机构、施工单位、监理行业等方面入手,分析了国内建筑行业出现工程质量问题的原因,并结合实际情况,提出了相应的解决措施,以减少工程质量问题的出现。

  9. Childhood Obesity for Pediatric Gastroenterologists (United States)

    Huang, Jeannie S.; Barlow, Sarah E.; Quiros-Tejeira, Ruben E.; Scheimann, Ann; Skelton, Joseph; Suskind, David; Tsai, Patrika; Uko, Victor; Warolin, Joshua P.; Xanthakos, Stavra A.


    Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology. PMID:23282941

  10. Common Sleep Problems (For Teens) (United States)

    ... sleep when a person has the most vivid dreams. Why Do Teens Have Trouble Sleeping? Research shows ... will look at your overall health and sleep habits. In addition to doing a physical examination, the ...

  11. Pediatric vasculitis. (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur


    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  12. 'Getting back to normal': the added value of an art-based programme in promoting 'recovery' for common but chronic mental health problems. (United States)

    Makin, Sally; Gask, Linda


    OBJECTIVES. The aim of this project was to explore the added value of participation in an Arts on Prescription (AoP) programme to aid the process of recovery in people with common but chronic mental health problems that have already undergone a psychological 'talking'-based therapy. METHODS. The study utilized qualitative in-depth interviews with 15 clients with persistent anxiety and depression who had attended an 'AoP' service and had previously received psychological therapy. RESULTS and discussion. Attending AoP aided the process of recovery, which was perceived by participants as 'returning to normality' through enjoying life again, returning to previous activities, setting goals and stopping dwelling on the past. Most were positive about the benefits they had previously gained from talking therapies. However, these alone were not perceived as having been sufficient to achieve recovery. The AoP offered some specific opportunities in this regard, mediated by the therapeutic and effect of absorption in an activity, the specific creative potential of art, and the social aspects of attending the programme. CONCLUSIONS. For some people who experience persistent or relapsing common mental health problems, participation in an arts-based programme provides 'added value' in aiding recovery in ways not facilitated by talking therapies alone.

  13. Pharmacologic Treatment of Pediatric Hypertension. (United States)

    Dhull, Rachita S; Baracco, Rossana; Jain, Amrish; Mattoo, Tej K


    Prevalence of hypertension is increasing in children and adolescents. Uncontrolled hypertension in children not only causes end organ damage but also increases the risk of adult hypertension and cardiovascular disease. Clinical trials have proven efficacy of antihypertensive medications in children. These medications are well tolerated by children with acceptable safety profile. The choice of agent is usually driven by underlying etiology of hypertension, profile of its side effects, and clinician's preference. This article will review currently available pediatric data on mechanism of action, common adverse effects, pediatric indication, recent clinical trial, and newer drugs in the common classes of antihypertensive medications.

  14. Dental traumatology: an orphan in pediatric dentistry? (United States)

    Andreasen, Jens Ove; Lauridsen, Eva; Daugaard-Jensen, Jette


    Traumatic dental injuries are very frequent during childhood and adolescence. In fact, 2 out of 3 children have suffered a traumatic dental injury before adulthood. This fact links dental traumatology to pediatric dentistry. Unfortunately, this is not reflected by active participation by pediatric dentists in acute treatment, follow-up, and research. To examine the status of pediatric dentistry in relation to dental trauma, a publication analysis was undertaken in 1980, 1990, 2000, and 2007 about trauma articles published in 4 pediatric journals: journal of Dentistry for Children, Pediatric Dentistry, The journal of Pedodontics, and the International journal of Pediatric Dentistry. This study shows an average publication rate of trauma articles of approximately 3 percent of all articles published and with no improvement in later decennia. If only clinical studies are considered (leaving out case reports), the publication rate is less than 1 percent--completely out of proportion to the size of the problem dental trauma impose in children.

  15. Primary pediatric gastrointestinal lymphoma

    Directory of Open Access Journals (Sweden)

    Ranjana Bandyopadhyay


    Full Text Available Background: Primary non-Hodgkin′s lymphoma (NHL of the gastrointestinal (GI tract is the most common extranodal lymphoma in pediatric age group. Yet, the overall incidence is very low. The rarity of the disease as well as variable clinical presentation prevents early detection when the possibility of cure exists. Materials and Methods: We studied six cases of primary GI NHL in pediatric age group with reference to their clinical presentation, anatomic distribution and histopathologic characteristics. Results: All were males except one. Intestinal obstruction was the presenting feature in 50%. Half the cases showed ileocaecal involvement, while large bowel was involved in 16%. Histology showed four cases of diffuse large B-cell lymphoma (DLBCL, one case of Burkitt lymphoma, and one Burkitt-like lymphoma. Immunohistochemistry for Tdt, CD20, CD3, CD30, bcl2, bcl6 confirmed the morphological diagnosis. Conclusion: Pediatric GI lymphoma commonly involves the ileocaecal region and presents with intestinal obstruction. A higher prevalence of DLBCL is found compared to other series. A high proliferative index is useful in differentiating Burkitt-like lymphoma from DLBCL.

  16. The efficacy and safety of the flexible fiber CO2 laser delivery system in the endoscopic management of pediatric airway problems: Our long term experience. (United States)

    Lee, Gi Soo; Irace, Alexandra; Rahbar, Reza


    To report the use of flexible fiber CO2 laser in the endoscopic management of pediatric airway cases. A retrospective review was conducted of patients who underwent CO2 laser-assisted airway procedures between September 2007 and January 2014 at a tertiary pediatric hospital. Sixty-eight patients underwent 80 procedures utilizing flexible fiber CO2 laser. Procedures included supraglottoplasty (n = 32), laryngeal cleft repair (type I [n = 10], type II [n = 7], type III [n = 6]), suprastomal granuloma excision (n = 6), cordotomy (n = 4), laryngeal neurofibroma excision (n = 4), laryngeal granulomatous mass excision (n = 1), subglottic stenosis excision (n = 6), division of glottic web (n = 2), subglottic cyst excision (n = 1), and supraglottic biopsy (n = 1). Ages ranged from 8 days to 21 years (median 11 months). No intraoperative or postoperative complications related to the use of laser were noted. The flexible fiber CO2 laser can be safely and effectively used to address a variety of pediatric airway lesions. Previously, the use of CO2 laser in minimally invasive airway surgery has been limited due to the articulating arm carrier, absence of a hand piece, and the direct line-of sight view required. The fiber allows the cutting beam to be directed at the site of the lesion and bypasses limitations posed by other laser systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. History of German pediatric cardiology. (United States)

    Heintzen, P


    Due to the isolation of German medicine in World War II accompanied by the destruction of many hospitals, German pediatricians did not show any serious interest in the treatment of children with congenital heart diseases, nor did they take notice of the progress achieved by Helen Taussig, Alfred Blalock and other cardiologists and surgeons in the western world. This problem was even worse in East Germany. Only a few German internists and forward-looking surgeons were able and ready to take care of this group of principally operable children in places like Bonn/Düsseldorf, Marburg/Munich, Berlin, and Hamburg. However, in the early 1950s some directors of pediatrics at university hospitals--largely motivated by the cardiac surgeons--allowed or even encouraged younger colleagues to concentrate on pediatric cardiology and to begin application of heart catheterization and angiocardiography. In 1960 a group of colleagues interested in pediatric cardiology met for the first time in Frankfurt and became the nucleus of the future "working group" (1969) and finally the "German Society of Pediatric Cardiology" (1974). By 1972 pediatric cardiology had been approved as an independent (sub)specialty. Colleagues and friends from surrounding countries (Austria, Great Britain, Sweden, Switzerland, and the Netherlands) and also from the US and some eastern countries were either members or regular guests during or between the meetings. Pediatric cardiology is now represented in Germany by specialized practitioners, trainees and assistants who work in both community and university hospitals, and in specialized departments. Due to the foresightedness of the Chief of Pediatrics, Prof. G. Joppich, the first Chair of Pediatric Cardiology was founded in Göttingen in 1960 under the direction of A. Beuren. Another model of interdisciplinary cooperation between pediatric cardiologists, bioengineers, mathematicians and computer scientists was established in Kiel in 1966. In other places

  18. Citation classics in pediatric orthopaedics. (United States)

    Varghese, Ranjit A; Dhawale, Arjun A; Zavaglia, Bogard C; Slobogean, Bronwyn L; Mulpuri, Kishore


    The purpose of this study was to identify the clinical pediatric orthopaedic articles with at least 100 citations published in all orthopaedic journals and to examine their characteristics. All journals dedicated to orthopaedics and its subspecialties were selected from the Journal Citation Report 2001 under the subject category "orthopedics." Articles cited 100 times or more were identified using the database of the Science Citation Index Expanded (SCI-EXPANDED, 1900 to present). The articles were ranked in a comprehensive list. Two authors independently reviewed the full text of each article and applied the inclusion and exclusion criteria to the list of articles. The 2 lists were then compared. All disagreements were resolved by consensus with input from the senior author. The final list of pediatric orthopaedic articles was then compiled. There were a total of 49 journals under the search category "orthopedics." Five journals were excluded as they were non-English journals. The remaining 44 journals were screened for articles with at least 100 citations. A total of 135 clinical pediatric orthopaedic articles cited at least 100 times were included. The most cited article was cited 692 times. The mean number of citations per article was 159 (95% confidence interval, 145-173). All the articles were published between 1949 and 2001, with 1980 and 1989 producing the most citation classics (34). The majority (90) originated from the United States, followed by the United Kingdom (12) and Canada (11). Scoliosis/kyphosis was the most common topic with 26 papers. The second most common subject was hip disorders (24). Therapeutic studies were the most common study type (71). Ninety-seven papers were assigned a 4 for level of evidence. The list of citation classics in pediatric orthopaedic articles is useful for several reasons. It identifies important contributions to the field of pediatric orthopaedics and their originators; it facilitates the understanding and discourse

  19. Bullying and victimisation are common in four-year-old children and are associated with somatic symptoms and conduct and peer problems. (United States)

    Ilola, Anna-Marja; Lempinen, Lotta; Huttunen, Jukka; Ristkari, Terja; Sourander, Andre


    There are few population-based studies on bullying behaviour among preschool children. The aims of the study were to investigate the prevalence of bullying behaviour among four-year-old children, as reported by their parents, the prevalence of types of bullying behaviour and the associations between bullying behaviour and psychosocial factors. This study was based on a population-based study sample of 931 children who attended their check-up at a child health clinic at four years of age. Parents completed the questionnaire about their child's bullying behaviour and risk factors during the check-up. Bullying behaviour, especially being both a bully and a victim, was a common phenomenon among four-year-old children. Being a bully or both a bully and victim were most strongly associated with conduct problems, while being a victim was associated with somatic symptoms and peer problems. Bullying behaviour was frequently found in preschool children and associated with a wide range of other problems, which indicate that routine checking of bullying behaviour should be included in child health clinic check-ups. Bullying prevention programmes are usually targeted at school-aged children, but this study highlights the importance of focusing already on preschool children. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Pediatric head injury. (United States)

    Tulipan, N


    Pediatric head injury is a public health problem that exacts a high price from patients, their families and society alike. While much of the brain damage in head-injured patients occurs at the moment of impact, secondary injuries can be prevented by aggressive medical and surgical intervention. Modern imaging devices have simplified the task of diagnosing intracranial injuries. Recent advances in monitoring technology have made it easier to assess the effectiveness of medical therapy. These include intracranial pressure monitoring devices that are accurate and safe, and jugular bulb monitoring which provides a continuous, qualitative measure of cerebral blood flow. The cornerstones of treatment remain hyperventilation and osmotherapy. Despite maximal treatment, however, the mortality and morbidity associated with pediatric head injury remains high. Reduction of this mortality and morbidity will likely depend upon prevention rather than treatment.

  1. 妇产科门诊病人常见心理问题分析%Analysis of Common Psychological Problems of Patients in Obstetrics and Gynecology Department

    Institute of Scientific and Technical Information of China (English)



    Objective To analyze the common psychological problems and the corresponding intervention measures in the outpatient department of Obstetrics and gynecology.Methods in 2013 March~2015 February,in the obstetrics and gynecology clinic of 680 patients as research materials; and the common psychological problems were investigated and analyzed; and psychological issues related to the proposed psychological interventions, and in February 2014 began to implement. The patients were evaluated by the self rating anxiety (SAS) self rating scale.Results In the implementation of psychological intervention, the scores of anxiety and satisfaction of the patients were significantly better than that of the psychological intervention (P< 0.05), with statistical significance. Conclusion Common psychological problem of Department of gynaecology and obstetrics patients implement effective psychological intervention measures to effectively avoid the occurrence of negative mood of patients, which to improve the diagnosis and treatment of patients with confidence and satisfaction are positive role in promoting.%目的:旨对妇产科门诊患者常见心理问题与对应干预措施进行系统分析。方法选择2013年3月~2015年2月在笔者单位妇产科门诊就诊的680例患者为研究资料;并就其常见心理问题进行调查分析;并就相关心理问题的提出心理干预措施,并于2014年2月开始实行。采用焦虑(SAS)自评量表对心理干预措施实施前后的患者进行评分。结果心理干预措施实施的,妇产科门诊患者就诊时的焦虑评分、满意度均优于心理干预措施实施前(P<0.05),具统计学意义。结论对妇产科门诊患者常见心理问题实施有效的心理干预措施对可有效避免患者负性心理的发生,这对提高患者诊治信心、满意度均具积极的促进作用。

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  3. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  6. Pediatric heart surgery - discharge (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  7. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  8. Pediatric sleep apnea (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  9. Children's (Pediatric) Nuclear Medicine (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  10. Pediatric tracheostomy. (United States)

    Campisi, Paolo; Forte, Vito


    Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway. Over the past half century, the primary indication for pediatric tracheostomy has shifted from acute infectious airway compromise to the need for prolonged ventilatory support in neurologically compromised children. The surgical technique, choice of tracheostomy tube, and post-operative care requires a nuanced approach in infants and young children. This article will review these topics in a comprehensive fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Pediatric biobanking

    DEFF Research Database (Denmark)

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T


    and data handling, and return of results as faced in 10 European countries. Because of the lack of comparative analyses of these topics, a pilot study was designed. Following a qualitative methodology, a questionnaire draft mostly including open-ended queries was developed, tested, and sent by e...... their own choices (n=26). Based on the collected data, dedicated recommendations are needed to govern unique ethical and regulatory issues surrounding pediatric biobanking.......Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking...

  12. 小儿(普)胸外科临床研究的现状与存在的问题%Current Situation and Problems in Pediatric Thoracic Surgery

    Institute of Scientific and Technical Information of China (English)



    小儿(普)胸外科医师面对的多为先天性疾病,这类疾病一般种类较多,但单病种病例数却较少。各种先天性畸形表现各异,甚至有些具有多年临床经验的医师终其一生也很难遇见。在成年人胸外科比较常见而且病例数较集中的疾病为肿瘤,但食管癌、肺癌等疾病在儿童中发生却非常罕见。此外,小儿(普)胸外科的发展也面临许多基础问题的挑战,如疾病的治疗受医学发展水平、患儿家庭经济状况、医疗保险体制及社会医学伦理,甚至对患儿性别重视程度等因素的影响,这便是小儿(普)胸外科必须面对的与成年人胸外科截然不同的特点。因此,需要加大对小儿(普)胸外科的普及力度,让小儿(普)胸外科从业医师接受专业培训,使更多医师掌握与认识小儿(普)胸外科的特点,以提高对专科疾病的诊治水平。%The most troubles have been encountered by pediatric thoracic surgeons were congenital diseases in practice.Pediatric thoracic surgeons will treat various types of deformities,but each single type of the deformities is very rare,maybe only one case of the troubles can be met by the pediatric surgeon with many years of practice which is an essential difference between adult and pediatric thoracic surgeons.The malignancy tumors which are very common in adult are very rare in children,such as esophageal cancer and lung cancer.In addition,pediatric thoracic surgeons are facing the challenge of many fundamental questions in the treatment of congenital diseases,for example,the level of social development,economic status of a family,health insurance system,social ethics,and even the attitude toward gender in a family.So it is necessary to train more pediatric thoracic surgeons in China to provide more professional service for the children in the future.

  13. Analysis of Common Problems on Western Language Copy Cataloging Using RDA%西文RDA套录编目常见问题辨析

    Institute of Scientific and Technical Information of China (English)



    This paper discusses the sources and characteristics of western language copy cataloging using RDA and the necessity and process of revising those data. Combining cataloging practice and based on Calis local rules, it also analyzes common problems on western language copy cataloging using RDA in libraries of regular colleges and universities, proposes solutions as well.%论文讨论西文RDA套录编目数据的来源和特征及对其修改的必要性和步骤,结合编目实践,基于CALIS本地规则,分析了普通高校在RDA套录编目中的常见问题并提出了解决方法。

  14. Analysis of the Common Problems in the Construction and Installation Engineering%建筑安装工程中常见问题的解析

    Institute of Scientific and Technical Information of China (English)



    新世纪,建筑行业是发展最迅速的行业,社会经济的高速发展,也令建筑行业迎来了它蓬勃发展的势头。本文详细了阐述了电气安装工程中重要环节的一些常见问题,并提出了针对性的建议。%In the new century, the construction industry is the fastest growing industries, and the rapid development of social economy also makes the construction industry ushered in the rapid development momentum. This article elaborates the imp-ortant link of some common problems in the electrical instal-lation engineering, and puts forward some pertinent sugges-tions.

  15. 微功率无线通信常见问题解决办法%Solutions to common problems in micro power wireless communication

    Institute of Scientific and Technical Information of China (English)



    国网公司在2013年底颁布了微功率无线互联互通标准,统一和规范了微功率无线技术标准,并开始在全国大力推广该技术方案.本文对微功率无线通信常见问题解决办法进行浅析.%At the end of 2013, the State Grid Corporation promulgated the standards of micro power wireless interconnection,unified and standardized the micro power wireless technology standards,and began to vigorously promote the technical program in the country.This paper analyzes the common problems of micro power wireless communication solutions.

  16. Common problems and their countermeasures of the tendering and bidding%招投标常见问题及对策

    Institute of Scientific and Technical Information of China (English)



    结合实践工作经验,从组织机构、招投标流程、招标文件编制、定标原则、资格预审等方面,分析了工程建设招投标工作中常见的问题,并提出了具体的解决措施,从而促进招投标市场的良性发展。%Combining with the practical work experience,from the organization,bidding process,bidding document compilation,scale principle, prequalification and other aspects,this paper analyzed the common problems in engineering construction bidding work,and put forward some spe-cific solutions,so as to promote the benign development of bidding market.

  17. Vitamin D deficiency in pediatric critical illness

    Directory of Open Access Journals (Sweden)

    Kiran B. Hebbar, MD, FCCM


    Conclusions: Vitamin D deficiency is common in the pediatric critical care population. Significant seasonal differences were noted even in the critically ill. The role of vitamin D in certain diseases like asthma in critically ill children merit further study.

  18. Missed Nursing Care in Pediatrics. (United States)

    Lake, Eileen T; de Cordova, Pamela B; Barton, Sharon; Singh, Shweta; Agosto, Paula D; Ely, Beth; Roberts, Kathryn E; Aiken, Linda H


    A growing literature suggests that missed nursing care is common in hospitals and may contribute to poor patient outcomes. There has been scant empirical evidence in pediatric populations. Our objectives were to describe the frequency and patterns of missed nursing care in inpatient pediatric settings and to determine whether missed nursing care is associated with unfavorable work environments and high nurse workloads. A cross-sectional study using registered nurse survey data from 2006 to 2008 was conducted. Data from 2187 NICU, PICU, and general pediatric nurses in 223 hospitals in 4 US states were analyzed. For 12 nursing activities, nurses reported about necessary activities that were not done on their last shift because of time constraints. Nurses reported their patient assignment and rated their work environment. More than half of pediatric nurses had missed care on their previous shift. On average, pediatric nurses missed 1.5 necessary care activities. Missed care was more common in poor versus better work environments (1.9 vs 1.2; P < .01). For 9 of 12 nursing activities, the prevalence of missed care was significantly higher in the poor environments (P < .05). In regression models that controlled for nurse, nursing unit, and hospital characteristics, the odds that a nurse missed care were 40% lower in better environments and increased by 70% for each additional patient. Nurses in inpatient pediatric care settings that care for fewer patients each and practice in a professionally supportive work environment miss care less often, increasing quality of patient care. Copyright © 2017 by the American Academy of Pediatrics.

  19. Does well-child care have a future in pediatrics? (United States)

    Coker, Tumaini R; Thomas, Tainayah; Chung, Paul J


    The most common adult chronic diseases affect 1 in 3 adults and account for more than three-quarters of US health care spending. The major childhood drivers of adult disease are distinctly nonmedical: poverty, poor educational outcomes, unhealthy social and physical environments, and unhealthy lifestyle choices. Ideally, well-child care (WCC) would address these drivers and help create healthier adults with more productive lives and lower health care costs. For children without serious acute and chronic medical problems, however, traditional pediatric preventive services may be largely ineffective in addressing the outcomes that really matter; that is, improving lifelong health and reducing the burden of adult chronic disease. In this article, we examine what role WCC has in addressing the major childhood drivers of adult disease and consider various models for the future of WCC within pediatrics.

  20. Pediatric lateral atlantodental interval: how much asymmetry is normal? (United States)

    Borders, Heather L; Junewick, Joseph J; Sherwood, John M; Macke, Michael R


    Imaging of the cervical spine is commonly performed in the pediatric patient population, typically after trauma, as well as for a variety of nontraumatic reasons. There are many challenges in the interpretation of these studies, particularly at the level of the atlantoaxial joint. We recognized a particular problem with assessing the lateral atlantodental interval in our emergency radiology department. Mild lateral atlantodental interval asymmetry in relatively asymptomatic patients was being interpreted as indicative of atlantoaxial rotatory fixation, which leads to the recommendation for dynamic computed tomographic examinations. The goal of this study was to define the reference range of the lateral atlantodental interval in pediatric patients to help avoid misinterpretation of radiographic findings and resultant excessive imaging.

  1. 工程结构设计中质量通病总结分析%Engineering structural design common quality problems analyzed

    Institute of Scientific and Technical Information of China (English)



    在建筑工程施工过程中,一旦发生结构质量隐患,后果将不堪设想,倘若多加注意,在结构设计中对可能影响到的结构质量隐患加以预防,那么就可以尽量消除结构隐患。文章结合多年的施工经验,就施工中容易产生的现浇钢筋砼楼板收缩产生裂缝、面层与装修的超重超载、构造柱和梁、柱和非承重墙的连接、梁贯通钢筋的连接、负弯矩钢筋导致裂缝等结构质量通病问题从设计方面进行总结分析,并针对这些对结构不利的情况提出可行的措施,不断提升设计水平,希望最大限度的降低施工过程中的安全隐患,对提高工程质量有所帮助。%In the building construction process, once the structure quality problems occur, the consequences would be disastrous, if pay more attention to prevention in the structural design of the structure may affect quality problems, then you can try to eliminate the structural problems. Combining years of construction experience, in-situ reinforced concrete floor construction is prone to shrinkage cracks, the surface layer of overweight and decoration overload, structural columns and beams, columns and non-load bearing walls, connecting through steel beams, negative moment reinforcement leads to cracks and other structural problems common quality problems were analyzed from the design and structure of these measures on the adverse circumstances feasible for, and improve the design level, want to maximize the reduction of security risks in the construction process, to improve project quality help.

  2. Secondary vocational students’ common psychological problems and tutoring strategy%中职学生常见学习心理问题及辅导策略

    Institute of Scientific and Technical Information of China (English)



    学习心理辅导是学校心理健康教育工作的重要内容之一,不良学习动机、消极学业自我概念、学习倦怠、学习自我监控能力弱等都是常见的学习心理问题,这些问题涵盖了从动机、态度、情感到能力等各个层面。学习心理辅导必须做到教师的全员参与,基于学生的个别差异,实施有针对性的辅导,同时关注积极心理,实现心理健康教育三级目标的协同。%The learning psychological counseling is an important content of school mental health education work, bad learning motivation, negative academic self-concept, learning burnout and learning self-monitoring ability weak and so on are common learning psychological problems, these problems ranging from such levels as motivation, attitude, emotion to ability. To study psychological counselling teachers must participate, based on the student's individual difference, the implementation of targeted tutoring, at the same time focus on positive psychology, realize the goal of psychological health education level of synergy.

  3. Common Quality Problems of INS Products and Its Preventive Measures%INS产品常见质量问题及其预防措施

    Institute of Scientific and Technical Information of China (English)

    邓忠伟; 赵小林; 刘向东


    简要介绍了塑料制品表面装饰技术模内嵌片(INS)的工艺流程,根据近几年产品开发和生产的实际经验,以汽车内饰件为例,分析了INS制品常见的片材皱褶、漏胶、开裂、压坏、气泡以及表面凹点等质量问题及其产生的原因,并提出了一些相应的预防措施,最后指出了INS工艺在我国的发展方向。%The process of the insert thermoforming-film to molding(INS),one kind of plastic products surface decoration technology was briefly introduced. Based on the developing and producing experience on real products in recent years,take automotive interior parts for example,the common quality problems of INS such as sheet folds,leakage,cracking,crushing,bubble and pits problems were analyzed,corresponding preventive measures were proposed. At last,the direction of the development of INS technique in our country was pointed.

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children’s (Pediatric) ... brain, chest, abdomen, pelvis and extremities. Tell your doctor about your child’s health problems, medications, recent surgeries ...

  5. Analysis And Improvement On Common Problems Of DCS Data Conifguration%DCS数据配置常见问题分析及改进

    Institute of Scientific and Technical Information of China (English)



    方家山核电工程中,采用了DCS全数字化控制。本文简要介绍了方家山核电工程DCS的基本架构与分层设计,以及一、二层通讯原理。由于方家山核电工程一、二层设备供应商不同,不同厂家平台的数据类型也不同,导致调试中多次出现由数据配置错误引起得问题。本文通过分析一、二层数据配置常见问题,提出了相应的故障分析及改进措施,对后期的机组调试维护有一定借鉴意义。%Fang Jia Shan nuclear power plant use DCS control system. This paper briefly describes the architecture of DCS system in the Fang Jia Shan nuclear power plant. It also describes the communication principle between Level1 and Level2. We use different manufacturers to design Level 1 and Level 2 system. Data types of different manufacturers are different, lots of problems caucused by the wrong data configuration happened during the commissioning phase. By analyzing the common problems on DCS data configuration, this paper proposed the corresponding improvements for the problems. The suggestions in the paper can provide valuable preference for commissioning and maintenance in the furture.

  6. Pediatric palliative care

    Directory of Open Access Journals (Sweden)

    Trapanotto Manuela


    Full Text Available Abstract The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pediatric patients experience all the clinical, psychological, ethical and spiritual problems that severe, irreversible disease and death entail. The international literature indicates a prevalence of incurable disease annually affecting 10/10,000 young people from 0 to 19 years old, with an annual mortality rate of 1/10,000 young people from birth to 17 years old. The needs of this category of patients, recorded in investigations conducted in various parts of the world, reveal much the same picture despite geographical, cultural, organizational and social differences, particularly as concerns their wish to be treated at home and the demand for better communications between the professionals involved in their care and a greater availability of support services. Different patient care models have been tested in Italy and abroad, two of institutional type (with children staying in hospitals for treating acute disease or in pediatric hospices and two based at home (the so-called home-based hospitalization and integrated home-based care programs. Professional expertise, training, research and organization provide the essential foundations for coping with a situation that is all too often underestimated and neglected.

  7. Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients

    Directory of Open Access Journals (Sweden)

    Mohamed Abd El-Aziz El-Gamasy


    Full Text Available Background: Trauma is a worldwide health problem and the major cause of death and disability, particularly affecting the young population. It is important to remember that pediatric trauma care has made a significant improvement in the outcomes of these injured children. Aim of the Work: This study aimed at evaluation of pediatric trauma BIG score in comparison with New Injury Severity Score (NISS and Pediatric Trauma Score (PTS in Tanta University Emergency Hospital. Materials and Methods: The study was conducted in Tanta University Emergency Hospital to all multiple trauma pediatric patients attended to the Emergency Department for 1 year. Pediatric trauma BIG score, PTS, and NISS scores were calculated and results compared to each other and to observed mortality. Results: BIG score ≥12.7 has sensitivity 86.7% and specificity 71.4%, whereas PTS at value ≤3.5 has sensitivity 63.3% and specificity 68.6% and NISS at value ≥39.5 has sensitivity 53.3% and specificity 54.3%. There was a significant positive correlation between BIG score value and mortality rate. Conclusion: The pediatric BIG score is a reliable mortality-prediction score for children with traumatic injuries; it uses international normalization ratio (INR, Base Excess (BE, and Glasgow Coma Scale (GCS values that can be measured within a few minutes of sampling, so it can be readily applied in the Pediatric Emergency Department, but it cannot be applied on patients with chronic diseases that affect INR, BE, or GCS.

  8. Incarcerated Pediatric Hernias. (United States)

    Abdulhai, Sophia A; Glenn, Ian C; Ponsky, Todd A


    Indirect inguinal hernias are the most commonly incarcerated hernias in children, with a higher incidence in low birth weight and premature infants. Contralateral groin exploration to evaluate for a patent processus vaginalis or subclinical hernia is controversial, given that most never progress to clinical hernias. Most indirect inguinal hernias can be reduced nonoperatively. It is recommended to repair them in a timely fashion, even in premature infants. Laparoscopic repair of incarcerated inguinal hernia repair is considered a safe and effective alternative to conventional open herniorrhaphy. Other incarcerated pediatric hernias are extremely rare and may be managed effectively with laparoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Pediatric Renal Neoplasms. (United States)

    Ranganathan, Sarangarajan


    Renal tumors in childhood consist of a diverse group of tumors ranging from the most common Wilms' tumor, to the uncommon and often fatal rhabdoid tumor. Diagnosis is based on morphologic features and aided by ancillary techniques such as immunohistochemistry and cytogenetics. Molecular techniques have helped identify a group of pediatric renal cell carcinomas that have specific translocations, called translocation-associated carcinomas. Differential diagnosis of the various tumors is discussed. Pathogenesis and nephroblastomatosis, the precursor lesions of Wilms tumor, also are discussed briefly, as are the handling of these tumor specimens and prognostic factors. Copyright © 2009 Elsevier Inc. All rights reserved.

  10. Pediatric contact dermatitis. (United States)

    Sharma, Vinod K; Asati, Dinesh P


    Allergic contact dermatitis (ACD) in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.

  11. Abdominal emergencies in pediatrics. (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E


    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  12. Pediatric contact dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Vinod


    Full Text Available Allergic contact dermatitis (ACD in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.

  13. Titanium elastic nailing in pediatric femoral diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Singh Roop


    Full Text Available Background: The need for operative fixation of pediatric femoral fractures is increasingly being recognised in the present decade. The conventional traction and casting method for management of pediatric femoral fractures is giving way for the operative stabilisation of the fracture. Methods : Thirty five pediatric patients in age group 6-14 years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for two years. The final results were evaluated using the criteria of Flynn et al. Technical problems and complications associated with the procedure were also analysed. Results : Overall results observed were excellent in 25, satisfactory in 8 and poor in 2 patients. Hospital time averaged 12.30 days in the series. All the fractures healed with an average time to union of 9.6 (6-14.4 weeks. Return to school was early with an average of 7.8 weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in three cases and restriction of knee flexion in 5 patients. There was no delayed union, infection or refractures. Per operative technical problems included failure of closed reduction in 2 cases and cork screwing of nails in one case. Conclusion : We believe that with proper operative technique and aftercare TENs may prove to be an ideal implant for pediatric femoral fracture fixation. The most of the complication associated with the procedure are infact features of inexact technique and can be eliminated by strictly adhering to the basic principles and technical aspects.

  14. Pediatric home healthcare: a paradox. (United States)

    Krepper, R; Young, A; Cummings, E


    Although parents may welcome having their ill child cared for at home, they are not prepared to compromise privacy and family rituals, nor share control of their child. The purpose of this article is to provide a snapshot of problems that parents have encountered with pediatric home healthcare. Home care parents offer suggestions for other parents and home healthcare nurses and agencies, encouraging them to be proactive in preventing potential problems.

  15. Pediatric vitiligo. (United States)

    Silverberg, Nanette B


    Vitiligo is a disease of pigment loss. Most investigators currently consider vitiligo to be a disorder that occurs as a result of autoimmune destruction of melanocytes, supported by identification of antimelanocyte antibodies in many patients, and the presence of comorbid autoimmune disease in patients with and family members of individuals with vitiligo. One-half of vitiligo cases are of childhood onset. This article presents a current overview of pediatric vitiligo including comorbidities of general health, psychological factors, therapeutic options, and long-term health considerations.

  16. Pediatric urticaria. (United States)

    Tsakok, Teresa; Du Toit, George; Flohr, Carsten


    Although urticaria is not a life-threatening disease, its impact on quality of life in children should not be overlooked. A systematic search of online databases, including Medline, was performed to inform a review aiming to equip clinicians with an evidence-based approach to all aspects of pediatric urticaria. This review hinges on an illustrative case and includes a summary table of studies pertaining to disease management in children. The multiple issues faced by patients, their families, and treating clinicians are highlighted, and the current literature on the presentation, natural history, investigation, and management of this poorly understood condition is assessed.

  17. Pediatric sellar and suprasellar lesions. (United States)

    Schroeder, Jason W; Vezina, L Gilbert


    Masses arising in the sella turcica and the suprasellar region are common in children. The type and frequency of the various lesions encountered in childhood differ from the adult presentation. This article reviews the embryology of the pituitary gland and its normal appearance in childhood as well as the imaging and clinical findings of the common and some of the uncommon lesions arising in the sella turcica, the pituitary stalk, the suprasellar cistern and the lower third ventricle in the pediatric population.

  18. Laser-assisted gingivectomy in pediatric patients: A novel alternative treatment


    G Gontiya; Bhatnagar, S; U Mohandas; S R Galgali


    Gingival enlargement is quite a common pathology in pediatric patients and may be inflammatory, noninflammatory, or a combination of both. Idiopathic gingival fibromatosis, although rare, is a slowly progressive benign enlargement that affects the marginal gingiva, attached gingival, and interdental papilla. The fibromatosis may potentially cover the exposed tooth surfaces, causing esthetic and functional problems. The treatment of gingival fibromatosis is essential because it causes difficul...

  19. The common problem analysis in the process of emergency infusion nursing%急诊输液护理过程中的常见问题分析

    Institute of Scientific and Technical Information of China (English)



    Objective:To analysis of common problems in the process of transfusion nursing emergency, and summarizes the prevention measures. Selection.Methods:in May 2011 to August 2012 transfusion room 100 cases of medical disputes occurred as analysis object, and the summary and analysis on the causes of medical disputes. Results:in emergency transfusion nursing of oral complaint cases,62.9% effective complaint,the content of the complaints include: insufficient standard infusion processes, piercing technology is not skilled nursing care responsibility is not strong, poor attitude, patient expectations of care services is too high, patients are not satisfied with transfusion related costs, etc.Conclusion:through the corresponding amount of measures to deal with the common problems in the process of emergency transfusion nursing, improve patient satisfaction.%目的:对急诊输液护理过程中常见的问题进行分析,并以此总结预防措施。方法:选取某院在2014年5月-2015年8月输液室发生的医患纠纷100例作为分析对象,并对其造成医患纠纷的原因进行总结和分析。结果:在急诊输液护理中有效投诉为62.9%,投诉的内容主要包括:输液流程不够规范,护理人员穿刺技术不熟练,护理责任不强、态度差,患者对护理服务的期望值过高,患者对输液相关的费用不满意等。结论:通过对应措施对急诊输液护理过程中的常见问题防控,提升患者满意度。

  20. Analysis of Common Problems in the Design of Gas Cylinders%气瓶设计常见问题分析

    Institute of Scientific and Technical Information of China (English)

    陈祖志; 薄柯; 续宏毅


    In this paper the common problems in design of gas cylinder are analyzed and summarized as follows: 1) the contents of design document were imcomplete; 2) both design attribute and appraisal attribute were not defined clearly; 3) the same design with series parameters was lack of standardization; 4) the guarantee value of material strength was not used standardly; 5) the minimum of burst pressure was calculated unscientifically; 6) the maximum of filling weight of cryogenic insulated cylinders was calculated without merit; 7) Valve selection was performed not based on codes and standards; 8) material selection of reinforced layer of fiber-wrapped cylinder was conducted not according to safety technical specifications. The problems mentioned above are analyzed and the corresponding suggestions are given, which could provide references for design of cylinders and document appraisal.%本文对目前气瓶设计存在的常见问题进行了总结归纳,归纳出的问题主要有设计文件内容不完善、设计属性和鉴定属性定义不明确、“同一设计、系列参数”设计不规范以及材料强度保证值取值、最小爆破压力计算、低温绝热气瓶最大充装量计算、阀门设计、纤维缠绕气瓶缠绕层选材几个方面,对每个方面的问题均作了剖析,并提出了解决问题的建议,可以为气瓶设计和设计文件鉴定工作提供参考。

  1. 医院人事档案管理的常见问题及对策%Common Problems and Countermeasures of Hospital Personnel File Management

    Institute of Scientific and Technical Information of China (English)



    Human resource is one of the most valuable resources in the hospital, which plays an important role in improving the service level and management level of the whole hospital, so the personnel files should be properly kept. At present, there are some common problems in hospital personnel file management, such as lack of personnel file consciousness, not comprehensive personnel file material content, backward management style, low business level of management personnel, etc. In this paper, these problems are analyzed in detail, and the strategies for improving hospital personnel file management are proposed from raising personnel archives management awareness, improving the efficiency of the personnel file management, improving the file management system, implementation of information management, paying attention to the file management personnel selection, etc.%人力资源是医院最宝贵的资源之一,对于提高整个医院的服务水平和管理水平具有重要作用,其人事档案应该被妥善保管。当前,我国医院普遍存在人事档案管理意识淡薄、人事档案材料内容不全面、管理方式落后、管理人员业务水平较低等问题,本文对这些问题进行了详细分析,又从提高人事档案管理意识、提高人事档案管理效率、健全档案管理制度、实施信息化管理、重视档案管理人才选拔等方面,探讨了改善医院人事档案管理的策略。

  2. Analysis of bacterial drug susceptibility of common enterobacteriaceae in pediatric patients%儿童患者中常见肠杆菌科细菌药敏分析

    Institute of Scientific and Technical Information of China (English)

    徐建民; 周丽银


    Objective To summarize the bacterial drug susceptibility of common enterobacteriaceae in pediatric patients and the epidemic status of the extended spectrum beta‐lactamases(ESBLs) during 2013 and 2014 in our hospital in order to guide the clini‐cal application of antibacterial drugs .Methods Routine methods of isolation and culture were performed and the distribution of en‐terobacteriaceae with resistance were statistically analyzed with the software .Results A total of 530 isolates were collected in the hospital in which was 32 .08% Klebsiella pneumonia and 38 .87% Escherichia coli .The most sensitive drug of Enterobacteriaeeae was carbapenems .ESBLs positive rate in Escherichia coli and Klebsiella pneumonia were 32 .04% and 20% .The difference was sta‐tistically significant (P<0 .05) .Conclusion Escherichia coli and Klebsiella pneumonia were the common enterobacteriaceae in pedi‐atric patients .Carbapenems remained very high activity against Enterobacteriaceae .However ,the carbapenems resistance strains have been appeared that should pay attention .Antibiotic therapy should be based on the guidance of bacteriology to select sensitive drugs .%目的:了解2013~2014年本院儿童患者中常见肠杆菌科的细菌药敏分析及产ESBL的肠杆菌科细菌的流行情况,为今后医院临床合理用药提供参考。方法常规方法分离培养临床病原菌,肠杆菌科菌株分布及其耐药性进行统计分析。结果共分离出常见肠杆菌科细菌530株,其中大肠埃菌占38.87%和肺炎克雷伯菌占32.08%,敏感性最高的抗菌药物为碳青霉烯类;超广谱β‐内酰胺酶(ESBLs)阳性的肠杆菌科细菌,大肠埃希菌阳性率为32.04%,肺炎克雷伯菌为20%,两者差异有统计学意义(P<0.05)。结论儿童肠杆菌科细菌感染中大肠埃菌和肺炎克雷伯菌占主要,两者ESBL导致的耐药问题也日趋严重,应引起重视。碳青霉烯类仍是肠

  3. Tropical pediatrics: 2002 to 2015. (United States)

    Santos Ocampo, Perla D; Santos Ocampo-Padilla, Cynthia


    It also presents the challenges that confront children in the tropics and their effects on the health of these children. These challenges include the technology divide, economic disparity, ecological changes, urbanization and industrialization, globalization, political instability, population explosion, and gender inequality. The paper paints a scenario of tropical pediatrics into the year 2015. Problems brought about by both underdevelopment and modernization, with urbanization and industrialization, will persist. Infectious diseases will continue to be the leading causes of deaths. The paper presents some significant achievements in the fight against tropical diseases and tries to predict what future progress will contribute to the alleviation of such diseases. The paper also outlines the commitment of the International Society of Tropical Pediatrics (ISTP) to improve the state of tropical pediatrics in the next 15 years.

  4. Patterns of Pediatric Maxillofacial Injuries. (United States)

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha


    Facial trauma in children and adolescents is reported to range from 1% to 30%. Because of many anatomical, physiological, and psychological characteristics of the pediatric population, maxillofacial injuries in children should be treated with special consideration that is attributable to certain features inherent in facial growth patterns of children. This study evaluated maxillofacial injuries in 726 children in terms of incidence, patterns of injury, causes, and treatment modalities and compared these parameters among 3 pediatric age groups. Intergroup differences were analyzed using Z test for 2 populations' proportion. The results showed that the incidence of pediatric maxillofacial injuries and fractures is higher than that reported elsewhere with male predominance. Soft tissue injuries are more frequently encountered in younger individuals, whereas the incidence of skeletal injuries increases with age. This study also revealed that certain etiologies, namely road traffic accidents, violence, bicycle, missiles, and industrial injures, increase with age; on the other hand, falls and puncture wounds are more common in younger children.

  5. Efficacy of levodropropizine in pediatric cough. (United States)

    De Blasio, Francesco; Dicpinigaitis, Peter V; De Danieli, Gianluca; Lanata, Luigi; Zanasi, Alessando


    Cough in children is among the most common problems managed by pediatricians, and occurs more frequently in preschool than in older children. Most acute episodes of cough are due to viral upper respiratory tract infections. The morbidity associated with acute cough in a child extends also to parents, teachers, and other family members and caregivers. Unfortunately, therapeutic options for acute cough in children are severely limited due to the absence of drugs shown to be effective antitussives with an acceptable safety profile. Agents used in the management of adult cough, such as narcotics (codeine, hydrocodone), the non-narcotic opioid dextromethorphan, first-generation, potentially sedating antihistamines, and decongestants such as pseudoephedrine, have all been deemed inadequate for treatment of acute pediatric cough on a risk/benefit basis. A growing body of evidence suggests that the peripherally acting antitussive, levodropropizine, may be an attractive alternative for the treatment of bothersome acute cough in children.

  6. Sexual Problems in Men (United States)

    Many men have sexual problems. They become more common as men age. Problems can include Erectile dysfunction Reduced or lost interest in sex ... problems may also be factors. Occasional problems with sexual function are common. If problems last more than ...

  7. Common Problems and Solutions of Water Quality of Pond Fish Production%池塘养鱼常见水质问题及解决方法

    Institute of Scientific and Technical Information of China (English)



    The water quality of pond is directly related to the fish development, health and benefits. The water conditions include water quantity and quality. In this paper, the water quality such as water quality items, water color standards, color identification were reviewed. Moreover, the common problems of pond fish production including abnormal pH value, high ammonia nitrogen, high nitrite, dissolved oxygen concentration, high hydrogen sulfide, cyanobacteria were analyzed in this paper so as to provide a reference for pond fish production.%池塘养鱼中水质的优劣直接关系到养殖效益的好环,除了有足够的水量外,更要具务相应的水质条件.论文对池塘养鱼水质指标、水色标准、水色辨别等方面做了总体概述,对池塘养鱼生产中常见的pH异常,氨氮偏高,亚硝酸盐过高,溶解氧浓度,硫化氢过高,蓝藻等问题及其发生的原因、来源、危害以及解决办法进行了解析,以期为做好水质管理,争取高产提供依据.

  8. 压力计量检定中常见问题及其对策分析%Analysis of Common Problems and Countermeasures in Pressure measurement

    Institute of Scientific and Technical Information of China (English)



    压力计量检定是保证工业生产的基础工作,能有效提升压力表检测结果的准确度和可靠性。主要分析了压力计量检定过程中的常见问题,包括步骤不严谨、压力表误差等,并提出了相应的解决措施,大大提高了压力计量检定结果的精确性。%The pressure measurement test is the basis of industrial production, can effectively improve the accuracy and reliability of the test results of the pressure gauge. Mainly analyzes the common problems in pressure metrological verification process, comprises the following steps is not rigorous, pressure gauge error, and proposed the corresponding solution measures, greatly improving the accuracy of pressure calibration results.

  9. 辅导员深度辅导典型问题分析%Analysis of Common Problems in College Counselors' Deep Counseling

    Institute of Scientific and Technical Information of China (English)



    深入辅导是增强高校思想政治教育工作实效性,促进大学生个性发展、健康成才的重要举措,是辅导员有效开展工作的必备能力。本文借鉴心理辅导的理论和方法,结合案例详细探讨了辅导员深度辅导工作中常见的三种典型问题,为辅导员有效、深入开展深度辅导工作提供新的思路。%The promotion of deep counseling is an important measure to improve the substantial results of the moral education in universities and to serve for enhancing the students' individu-ality development and self-actualization, which is also an essen-tial skill to effectively carry out the work of college counselors. This article applied the theories and methods of psychological counseling to discuss three common problems in deep counseling combined with cases, and to provide new ideas for the further de-velopment of deep counseling.

  10. Common Problem Analysis of Medical Technical Literature Translation%医学技术文献翻译常见问题探析

    Institute of Scientific and Technical Information of China (English)



    Medical technical literature translation is a demanding task for the translators, which means, in addition to master and apply translation skills, the translators have to be familiar with the word formation characteristics and writing characteristics of the medical literature. The common problems in the translation process include choice of words, clauses translation, long sentence translation, passive sentence translation, word order adjustment, adding/lessening words, etc.%翻译医学技术文献对译者要求较高,除需熟练掌握和运用翻译技巧外,还需掌握医学英语的构词特点,医学文献的行文特点。翻译过程中常见问题包括词汇选择、从句翻译、长句翻译、被动句翻译、语序调整、增译减译等。

  11. [Acute renal replacement therapy in pediatrics]. (United States)

    Gaillot, T; Ozanne, B; Bétrémieux, P; Tirel, O; Ecoffey, C


    In pediatric intensive care unit, the available modalities of acute renal replacement therapy include intermittent hemodialysis, peritoneal dialysis and continuous renal replacement therapies. No prospective studies have evaluated to date the effect of dialysis modality on the outcomes of children. The decision about dialysis modality should therefore be based on local expertise, resources available, and the patient's clinical status. Poor hemodynamic tolerance of intermittent hemodialysis is a common problem in critically ill patients. Moreover, many pediatric intensive care units are not equipped with dedicated water circuit. Peritoneal dialysis, a simple and inexpensive alternative, is the most widely available form of acute renal replacement therapy. However, its efficacy may be limited in critically ill patients. The use of continuous renal replacement therapy permits usually to reach a greater estimated dialysis dose, a better control of fluid balance, and additionally, to provide adequate nutrition. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  12. PBL教学法在儿童神经内科疾病临床见习中的应用%Experience of Problem-Based Learning in the Teaching of Neurology for Pediatric Clerkship

    Institute of Scientific and Technical Information of China (English)

    伍妘; 韩彤丽; 陈春红; 方方


    把以问题为基础的学习(PBL)教学的方法运用到儿童神经病学的教学工作中,取得了良好的教学效果,培养了学生独立自主的精神,可以提高学生在实际的临床环境中分析问题和解决问题的能力。但是,与传统的教学模式相比,PBL也有其局限性,并对教师提出了更高的要求。%The application of Problem-Based Learning (PBL) in pediatric neurology had obtained the good teaching effect. PBL stresses the encouragement of students to learn proactively as well as to improve their analytical and problem-solving skills in clinical situations. However, compared with the traditional teaching mode, PBL has its limitations, and puts forward higher requirements for teachers.

  13. Pediatric Suprasellar Tumors. (United States)

    McCrea, Heather J; George, Emilie; Settler, Allison; Schwartz, Theodore H; Greenfield, Jeffrey P


    The various childhood suprasellar tumors, while pathologically distinct, present similar clinical and surgical challenges as a result of their common anatomic location. These lesions are in close proximity to or may invade the optic nerve and chiasm, pituitary gland and infundibulum, hypothalamus, and third ventricle, leading to presenting features including visual field loss, impairment in visual acuity, endocrine dysfunction, and hydrocephalus. Though many suprasellar lesions are relatively benign in pathology, treatment may be complicated by high surgical morbidity resulting from damage to the hypothalamic-pituitary axis. Here we review the most frequent pediatric lesions occurring in the suprasellar region: craniopharyngioma, chiasmatic glioma, germ cell tumor, Rathke cleft and arachnoid cysts, pituitary adenoma, and histiocytosis. This review outlines both common presenting features and differentiating aspects of these lesions. It also includes classic radiographic presentations and treatment considerations for each lesion.

  14. Days out-of-role due to common physical and mental health problems: Results from the Sao Paulo Megacity Mental Health Survey, Brazil

    Directory of Open Access Journals (Sweden)

    Laura Helena Andrade


    Full Text Available OBJECTIVES: To investigate the relative importance of common physical and mental disorders with regard to the number of days out-of-role (DOR; number of days for which a person is completely unable to work or carry out normal activities because of health problems in a population-based sample of adults in the São Paulo Metropolitan Area, Brazil. METHODS: The São Paulo Megacity Mental Health Survey was administered during face-to-face interviews with 2,942 adult household residents. The presence of 8 chronic physical disorders and 3 classes of mental disorders (mood, anxiety, and substance use disorders was assessed for the previous year along with the number of days in the previous month for which each respondent was completely unable to work or carry out normal daily activities due to health problems. Using multiple regression analysis, we examined the associations of the disorders and their comorbidities with the number of days out-of-role while controlling for socio-demographic variables. Both individual-level and population-level associations were assessed. RESULTS: A total of 13.1% of the respondents reported 1 or more days out-of-role in the previous month, with an annual median of 41.4 days out-of-role. The disorders considered in this study accounted for 71.7% of all DOR; the disorders that caused the greatest number of DOR at the individual-level were digestive (22.6, mood (19.9, substance use (15.0, chronic pain (16.5, and anxiety (14.0 disorders. The disorders associated with the highest population-attributable DOR were chronic pain (35.2%, mood (16.5%, and anxiety (15.0% disorders. CONCLUSIONS: Because pain, anxiety, and mood disorders have high effects at both the individual and societal levels, targeted interventions to reduce the impairments associated with these disorders have the highest potential to reduce the societal burdens of chronic illness in the São Paulo Metropolitan Area.

  15. Pediatric allergy and immunology in Israel. (United States)

    Geller-Bernstein, Carmi; Etzioni, Amos


    After the geographic and sociodemographic settings as well as the health care in Israel are briefly described, the scope of pediatric allergy and immunology in Israel is presented. This includes specific disorders commonly encountered, the environment that induces symptoms, the specialists who treat them, and the common challenges of patients, parents, doctors, and allied health personnel who collaborate to manage the maladies and patient care. Allergies usually affect some overall 15-20% of the pediatric population. The main allergens are inhaled, ingested, or injected (insects stings). Generally, the incidence of the various allergens affecting children in Israel, is similar to other parts of the Western world. Owing to the high consanguinity rate in the Israeli population, the prevalence of the various immunodeficiency conditions (in the adaptive as well as the innate system) is higher than that reported worldwide. Pediatric allergists/immunologists also treat autoimmune disorders affecting the pediatric group. Pediatric allergy and clinical immunology are not separate specialties. The 25 specialists who treat children with allergic/immunologic diseases have undergone a basic training in Pediatrics. They also received an additional 2-yr training in allergy and clinical immunology and then have to pass the board examinations. They work mainly in pediatric allergy units, in several hospitals that are affiliated to the five medical schools in the country. Aside from clinical work, most of the centers are also heavily involved in clinical and basic research in allergy and immunology.

  16. Pediatric pain management: the multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Odell S


    Full Text Available Shannon Odell,1,2 Deirdre E Logan1,21Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 2Department of Psychiatry, Harvard Medical School, Boston, MA, USAAbstract: Chronic pain in children and adolescents is a growing problem and one that is increasingly being addressed with multidisciplinary treatment teams. This review summarizes different multidisciplinary clinics, focusing specifically on intensive pediatric pain rehabilitation centers. This review offers a summary of the challenges faced by these programs and areas for future study.Keywords: pediatric pain rehabilitation, pediatric chronic pain, interdisciplinary, pain associated disability

  17. Commentary on the use of acupuncture in chronic pediatric pain. (United States)

    Waterhouse, Michael; Tsao, Jennie C I; Zeltzer, Lonnie K


    The use of acupuncture for pain in pediatrics is a long-standing practice in Eastern cultures. Despite growing interest in the West, there has been relatively little systematic research on acupuncture for chronic pediatric pain. In particular, there is a paucity of randomized clinical trials testing the efficacy of acupuncture for chronic pain problems in pediatric populations. This commentary briefly reviews the history of acupuncture for pain and includes a summary of extant findings regarding potential mechanisms of its analgesic effects. Key areas for future research to advance the application of acupuncture to chronic pediatric pain problems are outlined.

  18. Diagnostic Approach to Pediatric Spine Disorders. (United States)

    Rossi, Andrea; Martinetti, Carola; Morana, Giovanni; Severino, Mariasavina; Tortora, Domenico


    Understanding the developmental features of the pediatric spine and spinal cord, including embryologic steps and subsequent growth of the osteocartilaginous spine and contents is necessary for interpretation of the pathologic events that may affect the pediatric spine. MR imaging plays a crucial role in the diagnostic evaluation of patients suspected of harboring spinal abnormalities, whereas computed tomography and ultrasonography play a more limited, complementary role. This article discusses the embryologic and developmental anatomy features of the spine and spinal cord, together with some technical points and pitfalls, and the most common indications for pediatric spinal MR imaging.

  19. [Acquired immunodeficiency syndrome in pediatric patients]. (United States)

    Molina Moguel, J L; Ruiz Illezcas, R; Forsbach Sánchez, S; Carreño Alvarez, S; Picco Díaz, I


    The object of this study was to determine how many of the patients treated at the Pediatric Odontology Clinic, a branch of the Maxillo-Facial Surgery Service at the Veinte de Noviembre Regional Hospital, ISSSTE, are VIH-positive of show serious manifestations of Acquired Immuno-Deficiency Syndrome (AIDS). For such purpose, 100 pediatric patients suffering from different systemic or local diseases were evaluated, the most common being hematological alterations. Results evidenced the presence of VIH in the blood of five of the pediatric subjects, all suffering from Hemophilia.

  20. Discussion on Some Problems of Smuggling Common Goods%走私普通货物、物品若干问题刍议

    Institute of Scientific and Technical Information of China (English)

    石东洋; 雷传平


    The crime of smuggling ordinary goods is one of the smuggling crimes which not only remains greatest relevance but concerns the daily life of people. Smuggling common goods, goods crime belongs to the economic crime, the crime and the current level of economic development is closely related to. After China's accession to the world trade organization, the trade system becomes more perfect, transparent, tariff level decreased gradually, trade barriers are eliminated, in this context, the smuggling cases are less and less, the profit space more and more thin, but check the goods risk is the rapid rise of crime. Smuggling ordinary goods, object of the crime, the standard of conviction, sentencing scale problems need to perfect legislation.%走私普通货物、物品罪是走私类罪中与人们日常生活关联性最大,也是最受人们关注的一种犯罪。走私普通货物、物品罪属于经济犯罪,其发案与我国当前的经济发展水平息息相关。我国加入世界贸易组织之后,贸易制度越加完善、透明,关税水平逐步下降,贸易壁垒有所消除,在这样的背景下,走私犯罪案件越来越少,其牟利空间越加稀薄,但查获犯罪风险却飞速上涨。因此,走私普通货物、物品罪的犯罪对象、定罪标准、量刑尺度等问题需要从立法上不断加以完善。

  1. What Is a Pediatric Rheumatologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Rheumatologist? Page Content Article Body If your child ... a pediatric rheumatologist. What Kind of Training Do Pediatric Rheumatologists Have? Pediatric rheumatologists are medical doctors who ...

  2. Malignancy and mortality in pediatric patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    de Ridder, Lissy; Turner, Dan; Wilson, David C


    BACKGROUND: The combination of the severity of pediatric-onset inflammatory bowel disease (IBD) phenotypes and the need for intense medical treatment may increase the risk of malignancy and mortality, but evidence regarding the extent of the problem is scarce. Therefore, the Porto Pediatric IBD...... working group of ESPGHAN conducted a multinational-based survey of cancer and mortality in pediatric IBD. METHODS: A survey among pediatric gastroenterologists of 20 European countries and Israel on cancer and/or mortality in the pediatric patient population with IBD was undertaken. One representative...... from each country repeatedly contacted all pediatric gastroenterologists from each country for reporting retrospectively cancer and/or mortality of pediatric patients with IBD after IBD onset, during 2006-2011. RESULTS: We identified 18 cases of cancers and/or 31 deaths in 44 children (26 males) who...

  3. Pioneers in pediatric psychology: integrating nutrition and child development interventions. (United States)

    Black, Maureen M


    As part of the Pioneers in Pediatric Psychology series, this article provides a brief personal account of Maureen Black's career as a pediatric psychologist. It traces the transition of the Society of Pediatric Psychology (SPP) from a section of the Division of Clinical Psychology of the American Psychological Association (APA) to an independent division of APA, which occurred during my presidency of SPP. The article addresses three aspects of pediatric psychology that have been central to my career: pediatric nutritional problems, global child development, and the advancement of children's health and development through policy-related strategies. The article concludes with Lessons Learned and Recommendations for the future of pediatric psychology. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail:

  4. The APA and the rise of pediatric generalist network research. (United States)

    Wasserman, Richard; Serwint, Janet R; Kuppermann, Nathan; Srivastava, Rajendu; Dreyer, Benard


    The Academic Pediatric Association (APA, formerly the Ambulatory Pediatric Association) first encouraged multi-institutional collaborative research among its members over 30 years ago. Individual APA members subsequently went on to figure prominently in establishing formal research networks. These enduring collaborations have been established to conduct investigations in a variety of generalist contexts. At present, 4 generalist networks--Pediatric Research in Office Settings (PROS), the Pediatric Emergency Care Applied Research Network (PECARN), the COntinuity Research NETwork (CORNET), and Pediatric Research in Inpatient Settings (PRIS)--have a track record of extensive achievement in generating new knowledge aimed at improving the health and health care of children. This review details the history, accomplishments, and future directions of these networks and summarizes the common themes, strengths, challenges, and opportunities inherent in pediatric generalist network research. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  5. Common overuse injuries in the young athlete. (United States)

    Pengel, K Brooke


    Pediatric overuse injury is a common complaint presenting to pediatricians. Overuse injury can affect the soft tissues or bone, and results from an imbalance between training and load to the tissues and recovery time. In the skeletally immature athlete, physeal and apophyseal tissue is particularly vulnerable to overuse resulting in different patterns of injury compared to adults. Awareness of age-dependent patterns of overuse is necessary for proper recognition, treatment, and prevention of injury. This article reviews the most common pediatric overuse injuries with emphasis on risk factors, diagnosis, and treatment. Guidelines for prevention are included, as this is the key component for successful management of overuse injury in pediatric athletes.

  6. [Management of asthma in a context of ambulatory pediatrics: relevance and possibility to avoid the problems. Gruppo de lavoro pediatri dell'Abruzzo Basilicata e Puglia]. (United States)

    Misticoni, G; Marchetti, F; D'Andrea, N


    41 pediatricians agreed to register on a very simple form, all the cases of children affected by bronchial asthma visited in their clinic during october 1993. The data included basic information related to the therapy prescribed, its duration, a judgement on the efficacy of symptoms control and the main problems encountered with the children and their families. 237 cases were reported (mean age 4.6 year, range 2 months-13 years). 80% of children were monitored by the pediatrician; 47% had allergic reactions. The main drug used for profilaxis is ketotifen, a compound without documented efficacy; the main route for drug administration (especially during acute attacks) is by mouth, instead of by aerosol, evidencing problems in the health education on practical skills. In fact the main problems encountered by doctors are related to the communication with patients and families. This survey represents also a research model for involving health care providers and easily and quickly obtaining a useful, methodologically sound and interesting picture of everyday practice.

  7. Pediatric dental chair vs. traditional dental chair: A pediatric dentist′s poll

    Directory of Open Access Journals (Sweden)

    Khushboo Barjatya


    Full Text Available Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator′s posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.

  8. Role of β-blocker therapy in pediatric heart failure. (United States)

    Patel, Akash R; Shaddy, Robert E


    Heart failure is becoming an increasingly common and significant problem in the field of pediatric cardiology. The numerous types of cardiomyopathies, and more recently, long-term survival of patients with congenital heart disease, have added to a growing patient population. Over the last several decades, our knowledge base regarding mechanisms of disease and therapeutic intervention in adult patients with heart failure has drastically changed. The most recent and important breakthrough in the pharmacologic treatment of heart failure has been the particular role of β-blocker therapy. This medication has led to significant improvements in survival and symptoms in adults, with less convincing findings in limited studies in pediatrics. The ability to study the benefits of this therapy in patients has been challenging owing to the heterogeneity of the patient population and lack of large sample sizes. However, as we investigate the mechanisms behind the disease process, the differences that exist between disease conditions and ages, and the significant alterations that may exist at the molecular and genetic level, our understanding of β-blocker therapy in pediatric heart failure will improve, and ultimately may lead to patient-specific therapy.

  9. Genetics of pediatric obesity. (United States)

    Manco, Melania; Dallapiccola, Bruno


    Onset of obesity has been anticipated at earlier ages, and prevalence has dramatically increased worldwide over the past decades. Epidemic obesity is mainly attributable to modern lifestyle, but family studies prove the significant role of genes in the individual's predisposition to obesity. Advances in genotyping technologies have raised great hope and expectations that genetic testing will pave the way to personalized medicine and that complex traits such as obesity will be prevented even before birth. In the presence of the pressing offer of direct-to-consumer genetic testing services from private companies to estimate the individual's risk for complex phenotypes including obesity, the present review offers pediatricians an update of the state of the art on genomics obesity in childhood. Discrepancies with respect to genomics of adult obesity are discussed. After an appraisal of findings from genome-wide association studies in pediatric populations, the rare variant-common disease hypothesis, the theoretical soil for next-generation sequencing techniques, is discussed as opposite to the common disease-common variant hypothesis. Next-generation sequencing techniques are expected to fill the gap of "missing heritability" of obesity, identifying rare variants associated with the trait and clarifying the role of epigenetics in its heritability. Pediatric obesity emerges as a complex phenotype, modulated by unique gene-environment interactions that occur in periods of life and are "permissive" for the programming of adult obesity. With the advent of next-generation sequencing techniques and advances in the field of exposomics, sensitive and specific tools to predict the obesity risk as early as possible are the challenge for the next decade.

  10. PET applications in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Shulkin, B. L. [Ann Arbor, Univ. of Michigan Medical Center (United States). Pediatric Nuclear Medicine Section


    This article summarizes the major PET studies which have been performed in pediatric patients to elucidate and characterize diseases and normal development. Issues special for the application of the technique in children, such as dosimetry, patient preparation, and image acquisition are discussed. Studies of central nervous system (CNS) development and pathology, including epilepsy, intraventricular hemorrhage, neonatal asphyxia, tumors, and effects on the CNS from treatment of other tumors are reviewed. These have contributed information fundamental to their understanding of CNS development and pathology. PET investigations into the pathophysiology of congenital heart disease have begun and hold great promise to aid their understanding of these conditions. The second major area in which PET has been applied is the study of non CNS neoplasms. Neuroblastoma has been investigated with tracers which explore basic biochemical features which characterize this tumor, as well as with tracers which explore biochemical events relatively specific for this malignancy. Other common and uncommon tumors of childhood are discussed. The PET technique has been shown useful for answering questions of clinical relevance for the management of these uncommon neoplasms. PET is likely to continue to aid their understanding of many pediatric diseases and may gain more widespread clinical acceptance as the technology continues to disseminate rapidly.

  11. Pediatric asthma controller therapy. (United States)

    Anselmo, Mark


    The treatment of children with asthma has historically relied upon expert opinion using data extrapolated from adult studies. Over the past few years, landmark studies have been completed providing healthcare professionals with evidence on which a reasonable approach can be made for children suffering from this common and serious disease. Asthmatic phenotype in children, unlike adults, tends to differ according to age, which must be taken into account as well as triggers, severity, and level of control. The care of the child with asthma is complex, but accumulating data have demonstrated that we are on the right path for optimizing control while reducing the burden of side effects. The newest Global Initiative for Asthma (GINA) guidelines, as well as recent updates from the landmark CAMP (Childhood Asthma Management Program) study and information from the PACT (Pediatric Asthma Control Trial) and budesonide/formoterol controller and reliever studies, along with recent comparisons of higher dose inhaled corticosteroids (ICS), and ICS/long-acting β(2)-adrenoceptor agonist (LABA) combination and leukotriene receptor antagonist (LTRA) therapies in children have clarified a few of the big questions in pediatric asthma. For children with asthma aged 5 years and older, the CAMP trial demonstrated that regular use of ICS reduces the frequency of symptoms; however, height was adversely affected and there is no evidence for altering the natural history of asthma. In patients aged 6 years and over whose asthma is uncontrolled on ICS alone, combination therapy with ICS and a LABA has been recently compared with the use of higher dose ICS and the addition of an LTRA in pediatric patients. The addition of a LABA statistically will be of most benefit; however, some children will have optimal control with doubling the baseline dose of ICS or addition of an LTRA. Use of budesonide/formoterol as a controller and reliever therapy extends the time to first exacerbation versus

  12. Snapshot of Pediatric Cancers (United States)

    ... Childhood Cancers Late Effects of Childhood Cancer Treatment Pediatric Supportive Care Unusual Cancers of Childhood Treatment Childhood ... Childhood Cancers Late Effects of Childhood Cancer Treatment Pediatric Supportive Care Unusual Cancers of Childhood Treatment Childhood ...

  13. Pediatric MATCH Infographic (United States)

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  14. American Pediatric Surgical Association (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine ... physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers . Depending ...

  16. Pediatric Celiac Disease (United States)

    ... of Pediatric Gastroenterology and Nutrition Nurses Print Share Celiac Disease Many kids have sensitivities to certain foods, and ... protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, consuming gluten ...

  17. Advances in multidetector CT diagnosis of pediatric pulmonary thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Thacker, Paul G. [Dept. of Radiology and Radiological Science, Medical University of South Carolina, Charleston (United States); Lee, Edward Y. [Divi. of Thoracic Imaging, Dept. of Radiology and Medicine, Pulmonary Division Boston Children' s Hospital, Harvard Medical School, Boston (United States)


    Although pediatric pulmonary thromboembolism is historically believed to be rare with relatively little information available in the medical literature regarding its imaging evaluation, it is more common than previously thought. Thus, it is imperative for radiologists to be aware of the most recent advances in its imaging information, particularly multidetector computed tomography (MDCT), the imaging modality of choice in the pediatric population. The overarching goal of this article is to review the most recent updates on MDCT diagnosis of pediatric pulmonary thromboembolism.

  18. Pediatric epidermoid cysts masquerading as ranulas: A case series. (United States)

    Reddy, Abhita; Kreicher, Kathryn L; Patel, Neha A; Schantz, Stimson; Shinhar, Shai


    Pediatric neck masses represent a variety of differential diagnoses. A common pathology in pediatric cystic neck tumors include ranulas, mucus retention cysts due to salivary gland obstruction. Epidermoid cysts are lesions infrequently encountered in the pediatric population and may appear similarly to ranulas on computed tomography imaging. MRI more easily differentiates these masses, and should therefore be the preferred imaging modality. Due to their distinct intraoperative management, ranulas and epidermoid cysts should be distinguished preoperatively through proper workup.

  19. Neonatal and pediatric esophageal perforation. (United States)

    Rentea, Rebecca M; St Peter, Shawn D


    Esophageal perforation (EP) is a rare complication that is often iatrogenic in origin. In contrast with adult patients in whom surgical closure of the defect is preferred, nonoperative treatment has become a common therapeutic approach for EP in neonates and children. Principles of management pediatric EP includes rapid diagnosis, appropriate hemodynamic monitoring and support, antibiotic therapy, total parenteral nutrition, control of extraluminal contamination, and restoration of luminal integrity either through time or operative approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Pediatric isolated bilateral iliac aneurysm. (United States)

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T


    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  1. Sleep in the Pediatric Population. (United States)

    Hintze, Jonathan P; Paruthi, Shalini


    This article provides an overview of common pediatric sleep disorders encountered in the neurology clinic, including restless legs syndrome, narcolepsy, parasomnias, sleep-related epilepsy, and sleep and headaches. An overview of each is provided, with an emphasis on accurate diagnosis and treatment. It is important in comprehensive neurologic care to also obtain a sleep history, because treating the underlying sleep condition may improve the neurologic disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Knee Problems (United States)

    ... BMI Calculator myhealthfinder Immunization Schedules Nutrient Shortfall Questionnaire Knee ProblemsPain, swelling, stiffness and "water" on the knee are common symptoms. Follow this chart for more ...

  3. Pediatric Headache: An Overview. (United States)

    Langdon, Raquel; DiSabella, Marc T


    Headache represents the most common neurologic disorder in the general population including children and is increasingly being recognized as a major source of morbidity in youth related to missed school days and activities. In this article, we take a holistic approach to the child presenting with headache with a focus on the detailed headache history, physical and neurologic examinations, and diagnostic evaluation of these patients. Clinical presentations and classification schema of multiple primary and secondary headache types in children are discussed using the International Headache Criteria (IHCD-3) as a guide, and a summary provided of the various treatment modalities employed for pediatric headache including lifestyle modifications, behavioral techniques, and abortive and preventive medications. Copyright © 2017 Mosby, Inc. All rights reserved.

  4. Pharmaceutical and chemical pediatric poisoning in Kuwait: a retrospective survey

    Directory of Open Access Journals (Sweden)

    Abahussain EA


    Full Text Available Past studies of pediatric poisoning in Kuwait have suggested differences at hospital level which could impact on the implementation of public health interventions. The objective was to compare pediatric poisoning admissions at general hospitals in Kuwait. Methods: Retrospective survey of all pediatric poisoning cases at the six general hospitals from January 2004 to December 2005. Case data were documented using ICD-10 criteria and the poisoning severity score. Aggregated data was also obtained from five private hospitals.Results: 978 children were admitted in public hospitals over 2004 and 2005 (no fatalities being 1.8% and 1.6% of all pediatric admissions (private hospitals admitted 293 cases. The majority of the poisoning cases came from Jahra hospital (>35%, the median age was 2.3 yrs, 93% of cases were under 6 yrs old and 71% were Kuwaiti. Two thirds of cases involved pharmaceuticals although this varied between hospitals with a tendency for more severe cases with chemical poisoning (p=0.011. Kerosene was an important problem at Jahra hospital (34.7% of chemical exposures. Non-opioid analgesics constituted 22.3% of medication exposures with hormones and drugs affecting the autonomic nervous system also common with some difference in pattern between institutions.Conclusion: Case demographics do not vary significantly between the hospitals but there are differences in the nature of toxic agents to which children are exposed suggesting that preventive and educational programs could be targeted to specific areas for maximal effect particularly with regard to household chemical and kerosene exposures.

  5. The common problem and nursing of newborns breastfeeding%新生儿母乳喂养常见问题及护理干预探讨

    Institute of Scientific and Technical Information of China (English)



    目的:观察新生儿母乳喂养过程当中发生的常见问题,并对其护理干预进行研究与探讨。方法:随机选取200例新生儿并按照产妇哺乳意愿分为研究组与对照组,研究组105例新生儿在6个月当中采用纯母乳喂养,对照组95例新生儿在6个月内选择人工喂养,对两组新生儿在6个月内的身长、体重、肥胖率以及产妇产后恢复情况等方面进行对比。结果:纯母乳喂养的研究组新生儿在身长、体重方面与对照组相比较高,发育较好,差异具有统计学意义(P<0.05);肥胖发生率方面,研究组与对照组相比较低,差异显著(P<0.05);在产妇的产后恢复方面,研究组的发生率较低,与对照组相比差异具有统计学意义(P<0.05)。结论:纯母乳喂养能够加强新生儿的身体机能发育,提高新生儿心智发育的情况,有效减少肥胖症的情况发生,对于产妇的产后恢复具有良好的效果,具有推广的价值。%Objective: Tp study the common problem and nursing of newborns breastfeeding. Methods: Choosed 200 nueborns to divide into study group and control ed group. The study group were fed with breastfeeding in 6 months, The control ed group were fed with artificial feeding. Compared the height, weight and rate of obesity and parturient recovery of these two groups. Results:The height, weight and rate of obsity of study group were bet er than control ed group (P<0.05). Conclusion:Newborns fed with breastfeeding can strengthen physical and mental development, and decrease obesity to extend in clinic.

  6. MO-D-BRB-02: Pediatric Treatment Planning II: Applications of Proton Beams for Pediatric Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hua, C. [St. Jude Childrens Research Hospital (United States)


    Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child’s brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. For bilateral retinoblastoma for example, an irradiated child has a 40% chance of developing a second cancer by age 50. The dosimetric tradeoffs made during the planning process are complex and require careful consideration for children treated with radiotherapy. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa

  7. Better outcome after pediatric resuscitation is still a dilemma

    Directory of Open Access Journals (Sweden)

    Sahu Sandeep


    Full Text Available Pediatric cardiac arrest is not a single problem. Although most episodes of pediatric cardiac arrest occur as complications and progression of respiratory failure and shock. Sudden cardiac arrest may result from abrupt and unexpected arrhythmias. With a better-tailored therapy, we can optimize the outcome. In the hospital, cardiac arrest often develops as a progression of respiratory failure and shock. Typically half or more of pediatric victims of in-hospital arrest have pre-existing respiratory failure and one-third or more have shock, although these figures vary somewhat among reporting hospitals. When in-hospital respiratory arrest or failure is treated before the development of cardiac arrest, survival ranges from 60% to 97%. Bradyarrthmia, asystole or pulseless electric activity (PEA were recorded as an initial rhythm in half or more of the recent reports of in-hospital cardiac arrest, with survival to hospital discharge ranging from 22% to 40%. Data allowing characterization of out of hospital pediatric arrest are limited, although existing data support the long-held belief that as with hospitalized children, cardiac arrest most often occurs as a progression of respiratory failure or shock to cardiac arrest with bradyasystole rhythm. Although VF (Ventricular fibrillation, is a very rapid, uncoordinated, ineffective series of contractions throughout the lower chambers of the heart. Unless stopped, these chaotic impulses are fatal and VT (Ventricular tachycardia is a rapid heartbeat that originates in one of the ventricles of the heart. To be classified as tachycardia, the heart rate is usually at least 100 beats per minute are not common out-of-cardiac arrest in children, they are more likely to be present with sudden, witnessed collapse, particularly among adolescents. Pre-hospital care till the late 1980s was mainly concerned with adult care, and the initial focus for pediatric resuscitation was provision of oxygen and ventilation, with

  8. Modeling pediatric vaccination guidelines in a data warehouse. (United States)

    Housman, Daniel; Greim, Julie; Morgan, Stephen J; Nelson, Sarah M; Flanagan, Tara; Martin, Kerry; Eskin, Michael; Einbinder, Jonathan S


    Frequent updates and complexity of vaccination schedules can make it difficult for pediatric practices to ensure adherence to immunization guidelines. To address this problem, Partners HealthCare System (PHS) has created a quality reporting utility to manage pediatric immunizations and to support quality improvement initiatives. The rules-based solution uses reference database tables to model the logic for each vaccine.

  9. Pediatric Acute Respiratory Distress Sydnrome : Fluid Management in the PICU

    NARCIS (Netherlands)

    Ingelse, SA; Wösten-van Asperen, RM; Lemson, J; Daams, JG; Bem, R.A.; van Woensel, JB


    The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric acu

  10. SOS! Ayuda para Padres: Una Guia Practica para Manejar Problemas de Conducta Comunes y Corrientes. (SOS! Help for Parents: A Practical Guide for Handling Common Everyday Behavior Problems.) Leader's Guide. (United States)

    Clark, Lynn

    This Spanish-language version of "SOS" provides parents with guidance for handling a variety of common behavior problems based on the behavior approach to child rearing and discipline. This approach suggests that good and bad behavior are both learned and can be changed, and proposes specific methods, skills, procedures, and strategies…

  11. SOS! Ayuda para Padres: Una Guia Practica para Manejar Problemas de Conducta Comunes y Corrientes. (SOS! Help for Parents: A Practical Guide for Handling Common Everyday Behavior Problems.) Leader's Guide. (United States)

    Clark, Lynn

    This Spanish-language version of "SOS" provides parents with guidance for handling a variety of common behavior problems based on the behavior approach to child rearing and discipline. This approach suggests that good and bad behavior are both learned and can be changed, and proposes specific methods, skills, procedures, and strategies…

  12. Vulvovaginitis and other common vulvar disorders in children. (United States)

    Rome, Ellen S


    Vulvovaginitis, labial adhesions, and other vulvar disorders occur commonly in children and can provoke high anxiety in both the parent and child. Performed correctly, the pediatric gynecologic examination can diagnose and treat, educate and reassure both parent and child. This examination requires patience, sensitivity, direct communication with the child as well as with the parent, and an open manner that inspires trust in both parties to manage a potentially anxiety-provoking situation. This chapter will review common vulvar disorders, including vulvovaginitis, lichen sclerosis et atrophicus, bubble bath vaginitis, labial adhesions, urethral prolapse, and other common problems. A discussion of childhood sexual abuse is beyond the scope of this chapter, with appropriate references available elsewhere. Practical pearls will be offered to make this exam easy for the primary care clinician and/or subspecialist.

  13. Quality of life of indian pediatric surgeons: Results of a survey (of indian association of pediatric surgeons members

    Directory of Open Access Journals (Sweden)

    M M Zameer


    Conclusion: This is the first study which objectively highlights that most surgeons are happy professionally and financially in due course of time and demolishes the common belief that pediatric surgeons are unsatisfied. It also acts as a point of reference and encouragement to newer aspirants in pediatric surgery.

  14. Common Warts (United States)

    Diseases and Conditions Common warts By Mayo Clinic Staff Common warts are small, grainy skin growths that occur most often on your fingers or hands. Rough to the touch, common warts also often feature a pattern of tiny ...

  15. Effects of Different Pediatric Drugs on the Color Stability of Various Restorative Materials Applicable in Pediatric Dentistry. (United States)

    Tüzüner, Tamer; Turgut, Sedanur; Baygin, Ozgul; Yilmaz, Nagehan; Tuna, Elif Bahar; Ozen, Bugra


    Background. The chronic recommendation of pediatric drugs could exhibit erosive and cariogenic problems. Objective. To evaluate the effects of different pediatric drugs on the color stability of various restorative materials. Methods. Five specimens (1 mm × 3 mm) were prepared and immersed in ten different pediatric drugs and agitated every 8 hours daily for 2 min up to 1 week. Between immersion periods, the samples were stored in artificial saliva. After 1-week period, ΔE(⁎) values were calculated. Two-way ANOVA and Fisher's LSD test were used for statistical analysis at a level of p pediatric dentistry.

  16. Pediatric Uveitis: Experience in Colombia. (United States)

    Lonngi, Marcela; Aguilar, María Camila; Ríos, Hernán Andrés; Aristizábal-Duque, Cristhian H; Rodríguez, Francisco José; de-la-Torre, Alejandra


    To describe the clinical features of uveitis in children treated at two ophthalmologic centers in Bogotá, Colombia, in a 13 year-period. Retrospective observational clinical record review of pediatric children with diagnosis of uveitis. In total, 310 children were evaluated, 51.9% were female, mean age of 10.1 years. Posterior uveitis was the most common location (58.7%), of insidious onset (87.4%) and chronic course (78.1%). The most common etiology was infection (58.4%) caused by toxoplasmosis (76.8%). There was a statistically significant difference in visual acuity between anterior (20/68) and intermediate uveitis (20/70), compared with posterior uveitis (20/434) (puveitis in Colombia, where infectious etiologies are the leading cause. It will improve awareness and knowledge of pediatric uveitis in developing countries, and contribute to the development of public health policies of pediatric visual health. Received 12 September 2015; revised 23 February 2016; accepted 25 February 2016; published online 18 May 2016.

  17. Clinical and Laboratory Characteristics of Pediatric Scorpion Stings: A Report From Southern Iran. (United States)

    Dehghankhalili, Maryam; Mobaraki, Hossein; Akbarzadeh, Armin; Yazdani, Reza; Nazemi, Abdolmajid; Ghaffarpasand, Fariborz; Mohammadi, Zahra; Shahrzad, Mohammad Esmaeil; Mohmudi, Forugh; Taghavi, Mohsen; Dehghankhalili, Saeed


    Scorpion stings are a major public health problem in many countries, particularly in pediatrics. Children are more susceptible to severe clinical manifestations of envenomation. The aim of this study is to determine the epidemiological and clinical characteristics of pediatric scorpionism in Hormozgan province of Iran during 2012. This was a cross-sectional study being conducted during 2010 in Hormozgan, the southern province of Iran. We included 350 patients admitted to emergency unit of the hospitals of 8 cities of Hormozgan with impression of scorpion envenomation. The clinical and epidemiological characteristics as well as the treatment and outcome were recorded. The prevalence rate of pediatric scorpion stings in the province was 1.8 in 1000 children. The mean age of the patients was 5.75 ± 4.54 (range, 1-18) years. There were 208 (59.5%) boys and 142 (40.5%) girls among the patients. The most common site of sting was sole to knee in 94 (26.8%) followed by hand in 61 (17.4%) and fingers in 47 (13.4%). The most common presenting symptom was vomiting in 236 (67.4%) followed by localized pain in 131 (37.3%), erythema in 120 (34.2%), and edema in 119 (33.9%). The highest and lowest frequency occurred in July (17.7%) and January (3.2%), respectively. Nocturnal envenomations (53.7%) were more common than diurnal (46.3%). Most of scorpionism were mild (83.4%) that all evolved to cure, without any deaths. The results demonstrate the pediatric scorpionism is a public health problem in Hormozgan province of Iran, and special attention should be paid to prevention and treatment.

  18. Antibiotic overusage and resistance: A cross-sectional survey among pediatric dentists

    Directory of Open Access Journals (Sweden)

    Sapna Konde


    Full Text Available Introduction: Most human orofacial infections originate from odontogenic infections and prescribing antibiotics has become a ubiquitous phenomenon. The World Health Organization (WHO has recognized the inappropriate, indiscriminate, and irrational use of antibiotics leading to antibiotic resistance as a global problem. Objective: The objective of this survey is to compare the antibiotic prescription pattern and the awareness of antibiotic resistance among Bachelor of Dental Surgery (BDS practitioners and pediatric dentists. Materials and methods: A hundred BDS practitioners and 100 pediatric dentists included in the study were given a questionnaire containing both open-ended and closed-ended questions. The questionnaire comprised information pertaining to antibiotic prescription for most common oral conditions, commonly prescribed antibiotics, their dosage, etc. Results: The majority of the practitioners prescribed antibiotics for managing oral diseases. On comparing the prescription patterns between the BDS practitioners and pediatric dentists, there was an overprescription in the BDS group for many conditions, which was statistically significant. Amoxicillin was the most commonly prescribed drug in both the groups. In the presence of an anaerobic infection, the most preferred drug was a combination of amoxicillin and clavulanic acid with metronidazole. With regard to the duration of antibiotic prescription, 74% BDS practitioners prescribed antibiotics as a 3-day course and 60% pediatric dentists resorted to a 5-day course, which was statistically significant. The awareness regarding antibiotic prophylaxis and antibiotic resistance was found to be adequate in both the groups. However, there was a general lack of awareness with regard to the guidelines for antibiotic prescribing in both the groups. Conclusion: Practitioners should prescribe antibiotics in accordance with the guidelines to curb antibiotic resistance, an emerging public health

  19. Hospital-based inter-professional strategy to reduce in-patient admissions and emergency department visits for pediatric asthma. (United States)

    Fleming, Karen; Kuzik, Brian; Chen, Chee


    Pediatric asthma is a common reason for emergency department (ED) visits and in-patient hospital admissions. Evidence demonstrates that asthma management initiated in the ED has limited benefit unless followed by ongoing coordinated inter-professional care (IPC). The Royal Victoria Hospital (RVH) of Barrie, Ontario, has developed a best practice model of care for pediatric asthma. Primary care providers and ED physicians are actively encouraged to refer children with any recurrent respiratory problems consistent with asthma to the Paediatric Asthma Clinic (PAC). Quarterly PAC visits with a certified asthma educator and a pediatrician include lung function measurement, written action plans and primary care provider communication. Ongoing outcome monitoring of patients receiving IPC has revealed that, compared with 12 months prior to enrolment in the PAC, patients show a two-thirds decrease in asthma-related ED visits and an 85% decrease in admissions. The PAC has contributed to an ongoing decline in the rates of pediatric asthma-related ED visits and admissions at RVH, which are currently less than half the rates seen at our peer hospitals. IPC for chronic diseases is best practice, and our model of care for pediatric asthma continues to provide critical data demonstrating and supporting the advantages of IPC in chronic disease management. RVH modifies practice and policy to meet best practices, optimizing the care provided to children with pediatric asthma.

  20. The Common Sense Model in early adolescents with asthma: Longitudinal relations between illness perceptions, asthma control and emotional problems mediated by coping

    NARCIS (Netherlands)

    Tiggelman, D.; Ven, M.O.M. van de; Schayck, O.C.P. van; Kleinjan, M.; Engels, R.C.M.E.


    Objective: The present study examined the longitudinal relations between illness perceptions and asthma control and emotional problems (i.e., anxiety, depression, stress), respectively, in adolescents with asthma. Furthermore, the mediating effects of asthma-specific coping strategies on these relat


    NARCIS (Netherlands)



    Objective.-To examine the impact of common mental illness on functional disability and the cross-cultural consistency of this relationship while controlling for physical illness. A secondary objective was to determine the level of disability associated with specific psychiatric disorders. Design.-A


    NARCIS (Netherlands)



    Objective.-To examine the impact of common mental illness on functional disability and the cross-cultural consistency of this relationship while controlling for physical illness. A secondary objective was to determine the level of disability associated with specific psychiatric disorders. Design.-A

  3. Pediatric nonaortic arterial aneurysms. (United States)

    Davis, Frank M; Eliason, Jonathan L; Ganesh, Santhi K; Blatt, Neal B; Stanley, James C; Coleman, Dawn M


    Pediatric arterial aneurysms are extremely uncommon. Indications for intervention remain poorly defined and treatments vary. The impetus for this study was to better define the contemporary surgical management of pediatric nonaortic arterial aneurysms. A retrospective analysis was conducted of 41 children with 61 aneurysms who underwent surgical treatment from 1983 to 2015 at the University of Michigan. Arteries affected included: renal (n = 26), femoral (n = 7), iliac (n = 7), superior mesenteric (n = 4), brachial (n = 3), carotid (n = 3), popliteal (n = 3), axillary (n = 2), celiac (n = 2), ulnar (n = 2), common hepatic (n = 1), and temporal (n = 1). Intracranial aneurysms and aortic aneurysms treated during the same time period were not included in this study. Primary outcomes analyzed were postoperative complications, mortality, and freedom from reintervention. The study included 27 boys and 14 girls, with a median age of 9.8 years (range, 2 months-18 years) and a weight of 31.0 kg (range, 3.8-71 kg). Multiple aneurysms existed in 14 children. Obvious factors that contributed to aneurysmal formation included: proximal juxta-aneurysmal stenoses (n = 14), trauma (n = 12), Kawasaki disease (n = 4), Ehlers-Danlos type IV syndrome (n = 1), and infection (n = 1). Preoperative diagnoses were established using arteriography (n = 23), magnetic resonance angiography (n = 6), computed tomographic arteriography (n = 5), or ultrasonography (n = 7), and confirmed during surgery. Indications for surgery included risk of expansion and rupture, potential thrombosis or embolization of aneurysmal thrombus, local soft tissue and nerve compression, and secondary hypertension in the case of renal artery aneurysms. Primary surgical techniques included: aneurysm resection with reanastomsis, reimplantation, or angioplastic closure (n = 16), interposition (n = 10) or bypass grafts (n = 2), ligation (n = 9), plication (n = 8), endovascular occlusion (n = 3), and nephrectomy (n = 4) in

  4. Pediatric hospital medicine core competencies: development and methodology. (United States)

    Stucky, Erin R; Ottolini, Mary C; Maniscalco, Jennifer


    Pediatric hospital medicine is the most rapidly growing site-based pediatric specialty. There are over 2500 unique members in the three core societies in which pediatric hospitalists are members: the American Academy of Pediatrics (AAP), the Academic Pediatric Association (APA) and the Society of Hospital Medicine (SHM). Pediatric hospitalists are fulfilling both clinical and system improvement roles within varied hospital systems. Defined expectations and competencies for pediatric hospitalists are needed. In 2005, SHM's Pediatric Core Curriculum Task Force initiated the project and formed the editorial board. Over the subsequent four years, multiple pediatric hospitalists belonging to the AAP, APA, or SHM contributed to the content of and guided the development of the project. Editors and collaborators created a framework for identifying appropriate competency content areas. Content experts from both within and outside of pediatric hospital medicine participated as contributors. A number of selected national organizations and societies provided valuable feedback on chapters. The final product was validated by formal review from the AAP, APA, and SHM. The Pediatric Hospital Medicine Core Competencies were created. They include 54 chapters divided into four sections: Common Clinical Diagnoses and Conditions, Core Skills, Specialized Clinical Services, and Healthcare Systems: Supporting and Advancing Child Health. Each chapter can be used independently of the others. Chapters follow the knowledge, skills, and attitudes educational curriculum format, and have an additional section on systems organization and improvement to reflect the pediatric hospitalist's responsibility to advance systems of care. These competencies provide a foundation for the creation of pediatric hospital medicine curricula and serve to standardize and improve inpatient training practices. (c) 2010 Society of Hospital Medicine.

  5. EUS in pediatric patients. (United States)

    Attila, Tan; Adler, Douglas G; Hilden, Kristen; Faigel, Douglas O


    The knowledge of EUS use in children is limited. We investigated the indications, feasibility, safety, and clinical utility of EUS in the management of pediatric GI, pancreatobiliary, and mediastinal diseases. Retrospective study. Two tertiary referral university hospitals. Consecutive children age younger than 18 years referred over a 7-year period for EUS evaluation. Forty EUS scans were performed in 38 children with a mean age of 13.5 years. The indications for pancreatobiliary endosonography were pancreatitis (n = 10), solid pancreatic mass (n = 7), cystic pancreatic mass (n = 1), cyst in the setting of chronic pancreatitis (n = 1), suspected annular pancreas (n = 1), celiac plexus block (n = 1), suspected common bile duct stone (n = 1), abdominal pain and atrophic pancreas (n = 1), ampullary adenoma (n = 1), and abnormal MRCP in a patient with jaundice (n = 1). The indications for gastric EUS were mucosal lesions (n = 2) and subepithelial lesions (n = 4). The indications for mediastinal endosonography were mediastinal masses/lymph nodes (n = 5). The remaining evaluations were performed for esophageal stricture (n = 1), unexplained abdominal pain (n = 1), unexplained abdominal pain with celiac axis block (n = 1), and perirectal fluid collection (n = 1). EUS-guided FNA (EUS-FNA) was performed in 12 (30%) cases and established the correct diagnosis in 9 (75%). EUS-guided fine-needle injections for celiac axis block were performed in 2 (5%) cases. The procedure was successful in all patients, and no complications related to sedation, EUS, or EUS-FNA were encountered. Retrospective study. EUS and EUS-FNA are feasible and safe and have a significant impact on the management of pediatric GI, pancreatobiliary, and mediastinal diseases.

  6. Irrational Prescribing of Antibiotics in Pediatric Outpatients: A Need for Change

    National Research Council Canada - National Science Library

    Edita Alili-Idrizi; Merita Dauti; Ledjan Malaj


    .... Respiratory tract infections in pediatric patients are a common cause of antibiotic prescribing which increases morbidity, mortality, patient cost and the likelihood for emergence of antibiotics...

  7. 水库除险加固工程施工常见问题探究%Common problems of construction of the reservoir's consolidation project

    Institute of Scientific and Technical Information of China (English)



    Water conservancy project in our country affecting the economic development and people's life, the progress of science and technology but also provides powerful motivation for water conservancy projects. For reservoir danger-eliminating and reinforcing the project, there are still many problems need to solve, this article mainly expounds these problems, and put forward the reasonable and scientific solutions.%我国水利工程关系着经济发展与人们的生活,科学技术的进步更是为水利工程提供了强大的动力.对于水库进行除险加固这一工程来说,还有很多的问题需要解决,本文主要阐述这些问题,并提出合理科学的解决措施.

  8. Relative luminance and figure-background segmentation problems: Using AMLA to avoid nondiscernible stimulus pairs in common and color blind observers

    Directory of Open Access Journals (Sweden)

    Julio Lillo Jover


    Full Text Available Four experiments evaluated AMLA temporal version accuracy to measure relative luminosity in people with and without color blindness and, consequently, to provide the essential information to avoid poor figurebackground combinations in any possible “specific screen-specific observer” pair. Experiment 1 showed that two very different apparatus, a sophisticated photometer and a common luxometer, provide equivalent measurements to compute: (1 screen gamma exponents and (2 relative luminance (Y/Yn of achromatic but not of chromatic stimuli. Experiments 2, 3 and 4 showed that the psychophysical task of AMLA temporal version provided, for any stimulus type, accurate relative luminance measurements. They were: equivalent to standardised photometric measurements for common observers (Experiment 2; similar to the expected distortions for simulated (Experiment 2 and real (Experiment 3 aged tritanomalous observers; concordant with the expected distortions of protanope observers (Experiment 4.

  9. Common problems and solutions of C programming teaching%C 语言教学中的常见问题和解决方案

    Institute of Scientific and Technical Information of China (English)



    A few of main problems, often contained during the C programming teaching activities , are listed in this paper.So it accounts for the facts of the problems particularly , considering both teachers and students.Then, it offers several ways to resolve problems mentioned above.It also provides good ideas for improving learning outcomes and quality of teaching of C programming.%本文从实际工作出发,阐明了在C语言教学活动中存在的主要问题,并从教师、学生两方面入手,对问题的成因进行了详细的分析,最后结合教学经验,提出解决方案,为提升学生学习效果,提升我校C语言教学质量做出有益探讨。

  10. Common Strategies of Avoiding Classified Discussions in ;Function Problems%函数问题中避免分类讨论的常见策略

    Institute of Scientific and Technical Information of China (English)



    函数是中学数学的一条主线,分类讨论的思想方法是中学数学最基本的方法之一。分类讨论思想具有明显的逻辑特点,解这一类问题需要学生有一定的分析能力和分类技巧。但在研究函数问题中,重视分类讨论思想应用的同时,也应防止见参数就讨论,有些函数问题能简捷解决的问题就不必分类讨论。%Function is a main line of high school mathematics, in which the idea of classified discussion is one of the most basic methods. The idea of classified discussion is of obvious logical characteristics, so certain analysis abilities and classification techniques are needed in solving such problems. In the research of function problems, at the same time of stressing the idea of classified discussion, cursory discussions at the sight of parame-ters should also be prevented, as some function problems can be solved simply and directly without classified discussions.

  11. Age Limit of Pediatrics. (United States)

    Hardin, Amy Peykoff; Hackell, Jesse M


    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  12. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  13. Children's (Pediatric) CT (Computed Tomography) (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  14. What Is a Pediatric Urologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Urologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors who ...

  15. What Is a Pediatric Gastroenterologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Gastroenterologist? Page Content Article Body If your child ... children, and teens. What Kind of Training Do Pediatric Gastroenterologists Have? Pediatric gastroenterologists are medical doctors who ...

  16. What Is a Pediatric Endocrinologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Endocrinologist? Page Content Article Body If your child ... the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors who ...

  17. What Is a Pediatric Neurosurgeon? (United States)

    ... Text Size Email Print Share What is a Pediatric Neurosurgeon? Page Content Article Body If your child ... childhood and adolescence. What Kind of Training Do Pediatric Neurosurgeons Have? Pediatric neurosurgeons are medical doctors who ...

  18. What Is a Pediatric Anesthesiologist? (United States)

    ... Text Size Email Print Share What is a Pediatric Anesthesiologist? Page Content Article Body If your child ... children undergoing anesthesia. What kind of training do pediatric anesthesiologists have? Pediatric anesthesiologists are physicians who have ...

  19. Laser gingivectomy for pediatrics. (United States)

    Kelman, Michelle M; Poiman, David J; Jacobson, Barry L


    Traditional gingivectomy procedures have been a challenge for pediatric dentists who confront issues of patient cooperation and discomfort. Treatment of pediatric patients must involve minimal operative and postoperative discomfort. Laser soft-tissue surgery has been shown to be well accepted by children. For the pediatric patient, the greatest advantage of the laser is the lack of local anesthesia injection and the associated pre- and postoperative discomfort. The following case report describes a gingivectomy procedure performed on a 14-year-old female.

  20. Regional anesthesia for pediatrics


    Türk, Hacer Şebnem; Işıl, Canan Tülay; Açık, Mehmet Eren; Ediz, Naim; Sayın, Pınar; Tombul, Merih; Oba, Sibel


    Objectives: Relevancy to regional anesthesia in pediatrics has increased, because it is complementary to general anesthesia, allows conscious postoperative analgesia without respiratory depression, technical difficulties have been defeated and new local anesthetics have been improved. Therefore we reported data of patients who underwent pediatric surgery and received regional anesthesia.Patients and methods: We retrospectively analyzed data of all patients, who were operated in the pediatric ...

  1. Pediatric facial nerve rehabilitation. (United States)

    Banks, Caroline A; Hadlock, Tessa A


    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  2. Find a Pediatric Dentist (United States)

    ... New Dentist Resources Volunteering in AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric ... Us Site Map Privacy Policy Terms of Use facebook twitter instagram

  3. Sedation for pediatric endoscopy. (United States)

    Lee, Myung Chul


    It is more difficult to achieve cooperation when conducting endoscopy in pediatric patients than adults. As a result, the sedation for a comfortable procedure is more important in pediatric patients. The sedation, however, often involves risks and side effects, and their prediction and prevention should be sought in advance. Physicians should familiarize themselves to the relevant guidelines in order to make appropriate decisions and actions regarding the preparation of the sedation, patient monitoring during endoscopy, patient recovery, and hospital discharge. Furthermore, they have to understand the characteristics of the pediatric patients and different types of endoscopy. The purpose of this article is to discuss the details of sedation in pediatric endoscopy.

  4. [Pediatric anesthesia: little children, big problems]. (United States)

    Grosjean, V; Veyckemans, F; Seghaye, M C; Hallet, C; Jastrowicz, J; Brichant, J F


    Infants and children are patients who are the most susceptible to benefit from a procedure in the ambulatory setting. However, some of these patients are at risk. They include infants, especially if premature, and children with sleep apnea syndrome or with current or recent upper respiratory infection. The present paper gives advices for an optimal anesthesic management of these young patients.

  5. Help Seeking and Access to Primary Care for People from “Hard-to-Reach” Groups with Common Mental Health Problems

    Directory of Open Access Journals (Sweden)

    K. Bristow


    Full Text Available Background. In the UK, most people with mental health problems are managed in primary care. However, many individuals in need of help are not able to access care, either because it is not available, or because the individual's interaction with care-givers deters or diverts help-seeking. Aims. To understand the experience of seeking care for distress from the perspective of potential patients from “hard-to-reach” groups. Methods. A qualitative study using semi-structured interviews, analysed using a thematic framework. Results. Access to primary care is problematic in four main areas: how distress is conceptualised by individuals, the decision to seek help, barriers to help-seeking, and navigating and negotiating services. Conclusion. There are complex reasons why people from “hard-to-reach” groups may not conceptualise their distress as a biomedical problem. In addition, there are particular barriers to accessing primary care when distress is recognised by the person and help-seeking is attempted. We suggest how primary care could be more accessible to people from “hard-to-reach” groups including the need to offer a flexible, non-biomedical response to distress.

  6. 普通高校新生常见心理问题分析及对策%Ordinary university freshman common psychological problem analysis and countermeasures

    Institute of Scientific and Technical Information of China (English)



    This paper USES the college students' personality questionnaire (UPI) of a normal 2, 3086 colleges and universities just entered the university mental health survey of 2014 freshmen. Screening results: I class 179 students, 5.81% of the total, and then to track I class students psychological counseling, through statistical analysis, it is concluded that college students psychological problems mainly concentrated in adaptability and family problems. Prompt university freshmen adaptability education and college mental health education should pay attention to these two aspects.%本文采用大学生人格问卷(UPI)对某普通二本高校3086名刚进大学的2014级新生进行心理健康普查。筛查结果:I类学生179人,占总人数5.81%,然后对I类学生进行追踪心理咨询,经统计分析,得出高校新生心理问题主要集中在新生适应性问题及家庭问题。提示大学新生入学适应性教育与高校心理健康教育应当注意这两个方面。

  7. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Appendicitis Images related to Children's (Pediatric) Ultrasound - Abdomen Videos related to Children's (Pediatric) Ultrasound - Abdomen Sponsored by Please note RadiologyInfo. ...

  8. Common Terms (United States)

    ... Print Page Text Size: A A A Listen Common Terms Below is a list of diabetes-related ... a skin condition characterized by darkened skin patches; common in people whose body is not responding correctly ...

  9. Safety Profile of Cough and Cold Medication Use in Pediatrics. (United States)

    Green, Jody L; Wang, George Sam; Reynolds, Kate M; Banner, William; Bond, G Randall; Kauffman, Ralph E; Palmer, Robert B; Paul, Ian M; Dart, Richard C


    The safety of cough and cold medication (CCM) use in children has been questioned. We describe the safety profile of CCMs in children pediatric (75.5%), and single-ingredient (77.5%) formulations were most commonly involved. AEs occurring in >20% of all cases included tachycardia, somnolence, hallucinations, ataxia, mydriasis, and agitation. Twenty cases (0.6%) resulted in death; most were in children pediatric liquid formulations were the most commonly reported products. These characteristics present an opportunity for targeted prevention efforts. Copyright © 2017 by the American Academy of Pediatrics.

  10. Apophyses and physeal equivalents in the pediatric pelvis

    Directory of Open Access Journals (Sweden)

    Vineet Tyagi


    Full Text Available Injuries to pediatric athletes are becoming increasingly common as children compete in more physically demanding sports. These athletic injuries may be acute or as the result of chronic overuse. Acute trauma may lead to damage to tendons, ligaments, and muscles, as well as their bony attachment sites. Infections such as osteomyelitis must also be considered in the differential of pediatric patients presenting with hip or groin pain. This review will discuss the normal muscular attachments to hip physes and physeal equivalents, as well as common injuries and their management. These findings are important to help with the diagnosis and treatment of pediatric patients who present with hip pain.

  11. Approximation of a Common Element of the Fixed Point Sets of Multivalued Strictly Pseudocontractive-Type Mappings and the Set of Solutions of an Equilibrium Problem in Hilbert Spaces

    Directory of Open Access Journals (Sweden)

    F. O. Isiogugu


    Full Text Available The strong convergence of a hybrid algorithm to a common element of the fixed point sets of multivalued strictly pseudocontractive-type mappings and the set of solutions of an equilibrium problem in Hilbert spaces is obtained using a strict fixed point set condition. The obtained results improve, complement, and extend the results on multivalued and single-valued mappings in the contemporary literature.

  12. Common Cold (United States)

    ... nose, coughing - everyone knows the symptoms of the common cold. It is probably the most common illness. In the course of a year, people ... avoid colds. There is no cure for the common cold. For relief, try Getting plenty of rest ...

  13. Current approaches to pediatric heart catheterizations

    Directory of Open Access Journals (Sweden)

    Philip A. Bernard


    Full Text Available Sedation for pediatric cardiac catheterization is a common requirement in many institutions. As the field of cardiac catheterization has evolved, the provision of sedation for these procedures has been varied. Increasingly the demand is for dedicated personnel focused on monitoring and delivery of sedation while in the catheterization suite. This article describes the considerations one must use when undertaking these cases.

  14. Comprehensive Management of Pediatric Cataract in Africa

    African Journals Online (AJOL)

    A description of the common causes, clinical presentation, methods of modern surgical ... Nigerian Journal of Ophthalmology / Jan‑Jun 2016 / Vol 24 / Issue 1. 2 .... phonetic sounds to pronounce letters. ..... Indian J Med Res 2010;131:559‑64. 10. .... 41. Kleinmann G, Zaugg B, Apple DJ, Bleik J. Pediatric cataract surgery with ...

  15. Diagnosis and management of allergic conjunctivitis in pediatric patients. (United States)

    Berger, William E; Granet, David B; Kabat, Alan G


    Allergic conjunctivitis (AC), although one of the most common ocular disorders in pediatric patients, is frequently overlooked, misdiagnosed, and undertreated in children. To guide pediatric health care professionals in the optimal diagnosis and management of AC in pediatric patients. To identify any existing best practice guidelines for the diagnosis and treatment of AC in pediatric patients, a review of the literature published between 2004 and January 2015 was conducted. Diagnosis and treatment algorithms and guidelines for pediatric patient referrals were then developed. A literature search to identify best practice guidelines for the treatment of AC in pediatric patients failed to return any relevant articles, which highlighted the need for best practice recommendations. Based on publications on adult AC and clinical experience, this review provides step-by-step guidance for pediatric health care professionals, including recognizing clinical features of AC, establishing a comprehensive medical history, and performing a thorough physical examination to ensure a correct diagnosis and the optimal treatment or referral to an eye care specialist or allergist when required. In addition to established drug treatments, the role of subcutaneous and sublingual immunotherapy is discussed to inform pediatric health care professionals about alternative treatment options for patients who do not tolerate pharmacotherapy or who do not respond sufficiently. The diagnostic and treatment algorithms and guidelines provided in this review help address the current literature and educational gap and may lead to improvements in diagnosis and management of pediatric AC.

  16. A Review of Common Problems in Design and Installation of Water Spray Cooling and Low Expansion Foam System to Protect Storage Tanks Containing Hydrocarbons Against Fires

    Directory of Open Access Journals (Sweden)

    Iraj Alimohammadi


    Full Text Available Tank fires are rare but carry significant potential risk to life and property. For this reason fire protection of tanks is critical. Fixed Low expansion foam and water spray cooling systems are one of the most effective and economical ways to reduce damages to a tank from fire. Such systems are currently installed in many companies but are not effective enough and require involvement of firefighters which in turn threaten their lives. This paper studies in a systematic way the problems of foam and cooling systems currently installed in a few domestic companies which operate storage tanks with focus on floating and fixed roof atmospheric tanks containing hydrocarbons and offers possible solutions for more efficient installation, design and operation of such systems.

  17. 科技期刊中IEEE文献著录的常见问题%Common problems in rererencing IEEE articles in sci-tecj periodicals

    Institute of Scientific and Technical Information of China (English)

    程建霞; 吕雪梅; 杨波; 王小唯


    以IEEE Computer Society析出文献为例,指出我国科技期刊对美国IEEE协会析出文献的著录中存在的问题和常见错误,分析造成错误的原因,对原始文献进行了正确的著录,并对一些信息缺失文献的著录提出了处理建议.%Common problems and errors in referencing IEEE articles in Chinese sci-tech periodicals are discussed. IEEE Computer Society bibliographic literatures are given as examples.This paper analyzes the reasons causing the errors, and corrects some original bibliographic literatures. Recommendations are made for referencing the literatures with missing items.

  18. Common Problems Arising from and Key Practices for Successive Cropping of Black Pepper%胡椒连作常见问题及其栽培技术

    Institute of Scientific and Technical Information of China (English)

    郑维全; 杨建峰; 郝朝运; 祖超; 李志刚; 鱼欢; 邬华松


    Problems arising from successive cropping of black pepper (Piper nigrum) were analyzed, such as weak growth vigor, low yield, deteriorated soil physic-chemical properties, serious attack of diseases and pests, etc. and some cultural practices for successive cropping of black pepper were put forward as technical reference for sustainable cultivation of black pepper.%结合作物连作障碍普遍因素,分析了胡椒连作生产出现的长势弱、产量低、土壤理化性状恶化等问题,提出了胡椒连作生产栽培技术,为胡椒产业可持续发展提供参考。

  19. A Review of Common Problems in Design and Installation of Water Spray Cooling and Low Expansion Foam System to Protect Storage Tanks Containing Hydrocarbons Against Fires

    Directory of Open Access Journals (Sweden)

    I. Alimohammadi


    Full Text Available Tank fires are rare but carry significant potential risk to life and property. For this reason fire protection of tanks is critical. Fixed Low expansion foam and water spray cooling systems are one of the most effective and economical ways to reduce damages to a tank from fire. Such systems are currently installed in many companies but are not effective enough and require involvement of firefighters which in turn threaten their lives. This paper studies in a systematic way the problems of foam and cooling systems currently installed in a few domestic companies which operate storage tanks with focus on floating and fixed roof atmospheric tanks containing hydrocarbons and offers possible solutions for more efficient installation, design and operation of such systems.

  20. 乡村公路常见问题及其防治措施%Common Problems of Rural Road and Prevention Measures

    Institute of Scientific and Technical Information of China (English)



    Rural road is an important part of traffic highway network construction in China. The new rural construction strategy greatly changed the face of the rural economy, of which the rural road construction provides a powerful motivation for rural economic development. But due to the construction and operation process, lack of the necessary survey and design, and the corresponding maintenance measures, the rural roads appeared a series of problems, which have seriously impacted the driving safety. Through investigating and analyzing the current situation of rural highway in the south area of Jiangxi province, this paper expounds the problems faced by the rural road and the causes, and puts forward some countermeasures.%乡村公路是我国交通公路网络建设的重要组成部分,新农村建设战略极大的改变了农村落后的经济面貌,其中乡村公路建设为农村经济发展提供了强大的动力。但由于建设过程及运营过程中,缺乏必要的勘察设计以及相应的养护措施,乡村公路出现了一系列的问题,严重影响了行车安全。本文通过调查分析赣南地区部分乡村公路的现状,阐述了目前乡村公路所面临的问题及其成因,提出了相应的防治对策。

  1. Making of a pediatric urologist

    Directory of Open Access Journals (Sweden)

    K V Satish Kumar


    A pediatric urologist by the virtue of definition would be a specially trained surgeon who would deal with urological diseases of children from newborn to adolescence (0-14 years. (In some instances e.g. exstrophy, renal transplant and continent procedures the age of treatment may even exceed up to 16 and above. He has the experience and the expertise to treat a child. Children are not miniaturized adults and newborns are not miniaturized children. Their physiology is different, they cannot always express their problems, answer questions and may not be cooperative during clinical examination.

  2. Common Problems and Countermeasures for Clinical Internship%临床实习生常见问题以及应对措施

    Institute of Scientific and Technical Information of China (English)



    临床实习是临床专业医学生教学的重要环节,是培养学生充分掌握基本理论、基本知识、基本技能,是理论联系实践、积累临床经脸的基础阶段,培养他们分析及解决问题的能力及临床操作技能的最佳途径之一,也是培养临床医学生向一名合格医生转变的重要教育过程.但随着人们法律意识的增强和思维方式的改变,医学生临床实习正面临着一些挑战和冲击,也是我们临床带教老师需要关注及期待解决的问题,如何保证和提高临床实习质量,已成为当前深化医学教学改革的重要研究课题之一%The clinical practice is the clinical teaching professional medical students, is the important link of the students master the basic theories,basic knowledge and skills, is the foundation stage of theory contacting practice, accumulating clinical experience. To cultivate their ability of analyzing and solving problems and clinical operational skills, which is one of the best ways, cultivate clinical medical students into a qualified doctor, which is an important process of education. But with the enhancement of the legal consciousness of people and the way of thinking of changing, medical students'clinical practice is facing some challenges and impact, also our clinical teachers need to concern and expectation to solve the problem, how to ensure and improve the quality of clinical practice, has become one of the important research topic for deepening the reform of medical education.

  3. 护理文书书写中常见的问题及防范对策%Common Problems and Countermeasures in the Writing of Nursing Documents

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the problems and improvement measures in the writing of nursing documents in our family. Methods The quality of the medical records of hospitals in the hospital from 7 to 2014, 182 in December, the existing problems were analyzed and the reasons were analyzed. Results The nursing documents had a direct relationship with the quality of nursing, clinical nursing management, nursing management and management. Conclusion To strengthen the quality control of nursing documents can ef ectively reduce the occur ence of defects, and to ensure the safety of patients and nursing. In strict accordance with the requirements of the specification to write al kinds of instruments, ef ectively improve the quality of nursing documents writing, protect the legitimate rights and interests of nurses, but also for the safety of the patient's life.%目的:探讨我科护理文书书写中存在的问题及改进措施。方法抽查2014年7月~12月182份在院运行病历护理文书的质量,对存在问题进行综合分析和原因追踪,采取多种措施进行改进。结果护理文书存在与护士自身的业务素质、临床资历、护理管理方式方法、资控力度有直接关系。结论加强护理文书的环节质控,可有效降低缺陷的发生,确保患者和护理安全。严格按照规范要求认真书写各类文书,有效提高护理文书书写质量,保护护士的合法权益,同时也能为患者的生命安全带来保障。

  4. Common ophthalmic problems of urban and rural postmenopausal women in a population sample of Raciborz district, a RAC-OST-POL Study

    Directory of Open Access Journals (Sweden)

    Wojciech Rokicki


    Full Text Available Introduction and objective. We wished to establish the prevalence of eye diseases and eye disease risk factors at postmenopausal age and to compare ophthalmic problems in urban and rural areas of Raciborz. Patients and methods. The study was performed in 2010. Out of the whole population of Raciborz, Poland, 10 percent (1750 of women were randomly selected for the reported study. Finally, ocular diseases, ophthalmic agents, health status (physical activity level, body mass index – BMI, reproductive history, the use of psychotropic drugs and hormone replacement therapy – HRT were recorded in 623 women. The women underwent visual acuity test and anterior segment examination, applanation tonometry and indirect ophthalmoscopy. Results. The mean age of the selected patients was 66.01±7.76 years, 275 (44% of them originating from rural and 348 (56% from urban regions. The average woman was obese (BMI=30.54±5.38 kg/m2, with near normal agility and reproductive history of 2.59±1.55 births, 147 (24% subjects remained under regular HRT support. According to the WHO, the visual acuity was classified as normal or near normal in 87.5%, while no blindness was recorded at all. Visual acuity depended, first of all, on lens status and was better among subjects with good agility (R=-0.31, p=0.001. Dry eye prevalence increased significantly over age of 67 years (p=0.000 and HRT seemed to be a dry eye protective factor (p=0.010. Except age, No other risk factors of cataract, other than age, were identified. Normal agility (p=0.003 and HRT (p=0.032 were associated with lower AMD (age-related macular degeneration prevalence rates. The differences between urban and rural participants were presented only in education, reproductive history, hypertension and frequency of ophthalmic examinations. Conclusions. Older adult women living in neighboring urban and rural areas present no differential in ophthalmic health problems.

  5. The expression and regulatory mechanism of miR-708 in pediatric common B-cell acute lymphoblastic leukemia%miR-708在儿童普通急性淋巴细胞白血病中的表达及调控机制

    Institute of Scientific and Technical Information of China (English)

    李雪; 李栋; 庄泳; 时庆; 魏伟; 张红; 鞠秀丽


    目的 检测普通急性淋巴细胞白血病(common-ALL)患儿中微小RNA(miRNA,miR)的差异性表达,并探讨miR-708的调控机制.方法 研究对象为34例common-ALL患儿及5例行骨关节病手术并排除肿瘤和血液系统疾病患儿的骨髓标本.应用微阵列基因芯片技术筛选common-ALL患儿样本中差异性表达的miRNA,应用茎环状逆转录引物的stem-loop实时荧光定量PCR技术进行验证.应用生物信息学预测、双报告基因检测、RT-PCR和Western blot等方法验证miR-708调控的靶基因及其表达.结果 在common-ALL患儿样本中检测的2006个miRNA中,miR-708、miR-181b和miR-210表达量分别为16.886±16.854、5.710±4.652和9.789±1.178,与正常对照组(1.872±0.339、1.276±0.531和1.005±0.080)相比表达均上调,差异均有统计学意义(P<0.05).miR-27a和miR-345表达量为0.524±0.085和0.675±0.086,与正常对照组(1.123±0.066和1.204±0.140)相比均下调,差异均有统计学意义(P<0.05).miR-708和miR-181b在高危组中表达水平为44.990±6.379和12.980±1.889,高于中危组和标危组(P<0.05).转染miR-708模拟物的人胚胎细胞株中CNTFR、NNAT和GNG12的表达水平均下降,而转染miR-708抑制剂组其表达升高.miR-708与CNTFR的结合区域位于3′-UTR端394~400 bp.结论 miRNA在调控儿童common-ALL发生发展的过程中发挥重要的作用,其中miR-708是高危型common-ALL重要的调控因子.miR-708通过结合靶基因的3′-UTR端,降低其靶基因表达水平.%Objective To evaluate the expression of microRNAs and reveal the regulatory mechanism of miRNA-708 in pediatric common acute lymphoblastic leukemia(ALL) (common-ALL). Methods The expressions of microRNAs in common-ALL patients were detected by microarrays in 3 pediatric common-ALL samples, and then verified by stem-loop quantitative RT-PCR in 34 common-ALL samples. The target genes of miR-708 were found by bioinformatics software, and verified by dual-luciferases reporter assay

  6. Economics of pediatric burns. (United States)

    Bass, Michael J; Phillips, Linda G


    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

  7. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... scan being performed, you will receive specific preparation instructions for what your child may eat and drink before the exam, especially ... Epilepsy Images related to Children's (Pediatric) Nuclear Medicine ... Videos related to Children's (Pediatric) Nuclear Medicine Sponsored by Please note RadiologyInfo. ...

  8. Pediatric Endocrinology Nurses Society (United States)

    ... Springs 2018! Wednesday, May 16, 2018 ​​​​​​​​​​​​​​​​​​​​​​​​​​​ Journal of Pediatric Nursing The Journal of Pediatric Nursing provides original, ...

  9. [Research in pediatrics]. (United States)

    Herrera-Márquez, Julia Rocío; González-Cabello, Héctor Jaime


    In the interest of encouraging the promotion of research done by physicians of the Instituto Mexicano del Seguro Social, in this supplement we publish articles written by residents of different specialties related to critical themes on pediatrics. These residents are guided by affiliated physicians from the Hospital de Pediatría del Centro Médico Nacional Siglo XXI.

  10. Surgical treatment of pediatric rhinosinusitis. (United States)

    Isaacson, G


    Pediatric rhinosinusitis is a common sequela of upper respiratory infections in children. It is usually a self-limited disease, sometimes requiring antibiotic therapy. Surgery may be indicated in children who suffer complication of acute rhinosinusitis, severe recurrent acute rhinosinusitis, rhinosinusitis in cystic fibrosis with or without polyposis, chronic rhinosinusitis refractory to maximal medical management, allergic fungal sinusitis, and paranasal sinus mucoceles. Surgical options include, adenoidectomy, sinus puncture and lavage, open surgical approaches, endoscopic sinus surgery, balloon sinuplasty, and turbinectomy or turbinate reduction. This paper reviews the anatomy and physiology of rhinosinusitis in children and current knowledge of the indications and best methods of surgical treatment.

  11. Pediatric gliomas as neurodevelopmental disorders. (United States)

    Baker, Suzanne J; Ellison, David W; Gutmann, David H


    Brain tumors represent the most common solid tumor of childhood, with gliomas comprising the largest fraction of these cancers. Several features distinguish them from their adult counterparts, including their natural history, causative genetic mutations, and brain locations. These unique properties suggest that the cellular and molecular etiologies that underlie their development and maintenance might be different from those that govern adult gliomagenesis and growth. In this review, we discuss the genetic basis for pediatric low-grade and high-grade glioma in the context of developmental neurobiology, and highlight the differences between histologically-similar tumors arising in children and adults.

  12. Comparative demography of an epiphytic lichen: support for general life history patterns and solutions to common problems in demographic parameter estimation. (United States)

    Shriver, Robert K; Cutler, Kerry; Doak, Daniel F


    Lichens are major components in many terrestrial ecosystems, yet their population ecology is at best only poorly understood. Few studies have fully quantified the life history or demographic patterns of any lichen, with particularly little attention to epiphytic species. We conducted a 6-year demographic study of Vulpicida pinastri, an epiphytic foliose lichen, in south-central Alaska. After testing multiple size-structured functions to describe patterns in each V. pinastri demographic rate, we used the resulting estimates to construct a stochastic demographic model for the species. This model development led us to propose solutions to two general problems in construction of demographic models for many taxa: how to simply but accurately characterize highly skewed growth rates, and how to estimate recruitment rates that are exceptionally difficult to directly observe. Our results show that V. pinastri has rapid and variable growth and, for small individuals, low and variable survival, but that these traits are coupled with considerable longevity (e.g., >50 years mean future life span for a 4-cm(2) thallus) and little deviation of the stochastic population growth rate from the deterministic expectation. Comparisons of the demographic patterns we found with those of other lichen studies suggest that their relatively simple architecture may allow clearer generalities about growth patterns for lichens than for other taxa, and that the expected pattern of faster growth rates for epiphytic species is substantiated.

  13. 数学分析教学中常见问题的解读%The Interpretation of Common Problems on Mathematical Analysis Teaching

    Institute of Scientific and Technical Information of China (English)



    “Mathematical Analysis”teaching is a topic that has been long discussed.In this paper, classic concepts of mathematical analysis teaching for natural interpretation,typical problems from a geometric or physical point of view for more visualizing,and philosophical concepts for a more in-depth thinking about the important concepts or theorems are discussed,in order to enhance students’interest in learning,improve their comprehension ability and innovation ability.%针对数学分析教学的经典概念作较本质的剖析,对典型问题从几何或物理的角度进行较形象的处理,并用哲学的思想对重要概念或定理作较深入的思考,借以提高学生的学习兴趣、理解能力与创新能力。

  14. The preliminary research for common Adaptability Problems of freshmen%大学新生常见适应性问题浅析

    Institute of Scientific and Technical Information of China (English)



    大学一年级是学生接受中等教育向高等教育的过渡阶段,是四年大学生活的重要转折点。但是很多学生在入学初不适应,普遍存在茫然、自卑、焦虑、孤独等常见心理现象,笔者根据近些年学生工作经验,就这个特殊时期学生易出现适应性问题的原因及对策进行初步探析。%First year in college is the transition from secondary to higher education of student, which is also an important turning point for the college life. But a few freshmen don’t adapt at first, among whom there are many mental phenomena existing such as loss, low self-esteem, anxiety, loneliness. Causes and countermeasures of adaptability problems in this special period were researched based on the student management experience of author in recent years.

  15. Study of Common Problems in C Language Beginners%初学者学习C语言中常见问题的探讨

    Institute of Scientific and Technical Information of China (English)



    C语言是编程领域中很有影响力的一种程序设计语言。它简洁、紧凑,使用方便、灵活,并且具备高级语言和低级语言的特征。由于C语言的编译系统对语法的检查不如其他语言那么严格,因此C语言对使用者的要求比较高。笔者结合实际教学中的经验,分类列举出C语言中常见的错误进行分析与探讨,以此对初学者给予借鉴。%C language is a very influential programming language in the field . It is concise, compact, easy, flexible, and has both the characteristics of high and low level languages. Because the examine of grammer by the compiling system of C language is not as strict as others ,it has higher standard for its users . Combined with my teaching experience, I list common mistakes in C lan-guage,then analysis and discuss, hoping helpful for beginners.

  16. Pediatric lung transplantation: 10 years of experience (United States)

    Camargo, Priscila C. L. B.; Pato, Eduardo Z. S.; Campos, Silvia V.; Afonso, José E.; Carraro, Rafael M.; Costa, André N.; Teixeira, Ricardo H. O. B.; Samano, Marcos N.; Pêgo-Fernandes, Paulo M.


    Lung transplantation is a well-established treatment for advanced lung diseases. In children, the diseases that most commonly lead to the need for a transplantation are cystic fibrosis, pulmonary hypertension, and bronchiolitis. However, the number of pediatric lung transplantations being performed is low compared with the number of transplants performed in the adult age group. The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults. PMID:24860860

  17. Xanthogranulomatous pyelonephritis: an uncommon pediatric renal mass

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Ethan A.; Dillman, Jonathan R. [University of Michigan Health System, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Styn, Nicholas; Wan, Julian [University of Michigan Health System, C. S. Mott Children' s Hospital, Department of Urology, Ann Arbor, MI (United States); McHugh, Jonathan [University of Michigan Health System, C. S. Mott Children' s Hospital, Department of Pathology, Ann Arbor, MI (United States)


    Xanthogranulomatous pyelonephritis (XGP) is a chronic suppurative infectious process that only rarely affects pediatric patients, and most commonly occurs in the setting of a large obstructing calculus. Histologically, XGP is characterized by the presence of chronic inflammation and lipid-laden macrophages. This case report illustrates the radiological, surgical, and pathologic findings in a young patient who presented to our institution for treatment of this uncommon condition. Although rare, xanthogranulomatous pyelonephritis is a clinically important entity that can affect pediatric patients. This condition should be considered in the differential diagnosis for an atypical-appearing renal mass. (orig.)

  18. Pediatric lung transplantation: 10 years of experience

    Directory of Open Access Journals (Sweden)

    Priscila C. L. B. Camargo


    Full Text Available Lung transplantation is a well-established treatment for advanced lung diseases. In children, the diseases that most commonly lead to the need for a transplantation are cystic fibrosis, pulmonary hypertension, and bronchiolitis. However, the number of pediatric lung transplantations being performed is low compared with the number of transplants performed in the adult age group. The objective of this study was to demonstrate our experience with pediatric lung transplants over a 10-year period in a program initially designed for adults.

  19. Escape Extinction and Negative Reinforcement in the Treatment of Pediatric Feeding Disorders: a Single Case Analysis. (United States)

    Voulgarakis, Harry; Forte, Solandy


    Pediatric feeding disorders are common among children with developmental disabilities and can have detrimental effects on growth and development. An escape extinction and negative reinforcement-based approach to treating food refusal was examined in a child with cerebral palsy. A changing criterion treatment design was implemented, which allowed the child to exit the treatment area contingent upon the acceptance and ingestion of a pre-determined number of bites. Food acceptance ranged from one to three bites at baseline and exceeded the pre-set criteria for mastery, at 14 bites during the final intervention phase.The study will contribute to the current literature on negative reinforcement procedures used in the treatment of pediatric feeding problems.The study will contribute to increasing the availability of literature pertaining to pediatric feeding problems among children with complex disabilities such as cerebral palsy.The intervention is brief with components to the treatment package which increases utility and ease of implementation.The study demonstrates the applicability of changing criterion design within clinical settings.

  20. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea syndrome: a randomized, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems. (United States)

    Nikolopoulou, Maria; Byraki, Anna; Ahlberg, Jari; Heymans, Martijn W; Hamburger, H L; De Lange, Jan; Lobbezoo, Frank; Aarab, Ghizlane


    Obstructive sleep apnea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomized placebo-controlled trial sixty-four OSAS patients (52.0± 9.6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with "insomnia", "excessive daytime sleepiness", "psychiatric sleep disorder", "periodic limb movements", "sleep apnea", "sleep paralysis", "daytime dysfunction", "hypnagogic hallucinations/dreaming", "restless sleep", "negative conditioning", and "automatic behaviour" (range of P values: 0.000-0.014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0.090-0.897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects. This article is protected by copyright. All rights reserved.

  1. Preventing Diabetes Problems (United States)

    ... Other Dental Problems Diabetes & Sexual & Urologic Problems Preventing Diabetes Problems View or Print All Sections Heart Disease & ... prevent or delay sexual and urologic problems. Depression & Diabetes Depression is common among people with a chronic, ...

  2. Single clear corneal incision for glaucoma drainage device shortening in pediatric glaucoma. (United States)

    Radke, Phillip M; Bitrian, Elena; Grajewski, Alana L


    Glaucoma drainage devices are commonly used for management of glaucoma in adults and children. With time, the position of the tube can change and cause damage such as corneal scarring, iris or lens contact, and uveitis. Most of these problems can be improved with tube shortening and/or excision of adherent iris or fibrous tissue. We describe a surgical technique that uses a single clear corneal incision to externalize and trim the shunt in pediatric patients. The technique has a short surgical. We review the indications and outcomes for this procedure in 13 eyes of 12 children who required shunt revision.

  3. Social pediatrics: weaving horizontal and vertical threads through pediatric residency. (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle


    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  4. Predictors of misunderstanding pediatric liquid medication instructions. (United States)

    Bailey, Stacy Cooper; Pandit, Anjali U; Yin, Shonna; Federman, Alex; Davis, Terry C; Parker, Ruth M; Wolf, Michael S


    Our objective was to determine the level of adult understanding of dosage instructions for a liquid medication commonly prescribed for children. Structured interviews were conducted with 373 adults waiting for an appointment at family medicine clinics serving low-income populations in Shreveport, La; Chicago; and Jackson, Mich, from July 2003-August 2004. Subjects were asked to read a prescription label for amoxicillin and explain how they would take the medication. Correct interpretation was determined by a panel of blinded physician reviewers who coded subjects' verbatim responses. Qualitative methods were used to determine the nature of incorrect responses. Twenty-eight percent of subjects misunderstood medication instructions. The prevalence of misinterpreting instructions among subjects with adequate, marginal, and low literacy was 18%, 34%, and 43%, respectively. Common causes for misunderstanding included problems with dosage measurement (28%; ie, tablespoon instead of teaspoon) and frequency of use (33%; ie, every 3 hours instead of every 6-8 hours). In an adjusted analysis that excluded literacy, African Americans were more likely to misunderstand instructions than Caucasians (adjusted odds ratio [AOR] 1.63, 95% confidence interval [CI]=1.02-2.61). When literacy was included in the model, the effect of race on misunderstanding was reduced and nonsignificant. Inadequate and marginal literacy remained independent predictors of misunderstanding (inadequate--AOR 2.90, 95% CI= 1.41-6.00; marginal--AOR 2.20, 95% CI=1.19-3.97). Misinterpretation of pediatric liquid medication instructions is common. Limited literacy is a significant risk factor for misunderstanding and could contribute to racial disparities. Instructions should be written in a concise manner and standardized to ensure comprehension.

  5. Pediatric Euthanasia and Palliative Care Can Work Together. (United States)

    Hanson, Stephen S


    Since the Netherlands produced the Groningen protocol describing the methods to be used for pediatric euthanasia and Belgium passed laws authorizing euthanasia for children who consent to it, the issue of pediatric euthanasia has become a relevant topic to discuss. Most rejections of pediatric euthanasia fall into 1 or more of 3 categories, each of which has problems. This article shows how several recent arguments against pediatric euthanasia fail to prove that pediatric euthanasia is unacceptable. It does not follow from this that the practice is permissible but rather that if one is to reject such a practice, stronger arguments will need to be made, especially in countries where adult euthanasia or assisted suicide is already permitted. © The Author(s) 2015.

  6. Pediatric Heart Failure in the Developing World. (United States)

    Ramakrishnan, Sivasubramanian


    The exact prevalence of heart failure among children of developing countries is not known, as the data is limited. The relative frequency of different causes of pediatric heart failure varies widely across different countries and even among different parts of large countries like India. Children of developing countries face a double burden of etiologies. Conditions such us congenital heart disease, myocarditis and cardiomyopathies are common causes of pediatric of heart failure. In addition, diseases like rheumatic heart disease, nutritional deficiencies, and other tropical diseases also result in heart failure among children of the developing countries. However, most of the developing countries have low resources and hence management of pediatric heart failure becomes challenging. Advanced therapies for heart failure are rarely used in children of developing countries and cardiac transplant remains a distant dream.

  7. [Causes and pathophysiology of pediatric obesity and its diagnostic criteria]. (United States)

    Ohzeki, Takehiko


    Recently, obesity has been listed as important health problems not only in adults but also in children. Prevalence of pediatric obesity has been rising in the last half century in most of the developed countries including Japan. In addition to changes in lifestyle, which are shown to have contributed greatly to promote weight gain in recent years, patients with some syndromes or diseases may have obesity as one of the manifestations of the disorders especially in childhood. Obese individuals are commonly accompanied by derangement in various organs, such as metabolic and cardiovascular systems, in children as well as adults. Diagnostic criteria for obesity-disease and metabolic syndrome were proposed on the basis of data obtained from Japanese children.

  8. Pediatric convulsive status epilepticus in Honduras, Central America. (United States)

    Molinero, Marco R; Holden, Kenton R; Rodriguez, Luis C; Collins, Julianne S; Samra, Jose A; Shinnar, Shlomo


    Convulsive status epilepticus (SE) in children is an important public health problem, particularly in low-resource countries. A surveillance study was performed with consecutive enrollment of all children presenting with convulsive SE to Hospital Escuela Materno-Infantil Emergency Department in Tegucigalpa, Honduras over a 13-week period in 2003. In the 47 children with SE, the mean age was 4.5 years and the median seizure duration was 95 min. Mortality and morbidity were higher in children from rural locations, with all six deaths and three cases of new neurologic abnormalities occurring in rural children who had acute symptomatic SE. We conclude that childhood SE is common in the low-resource developing country of Honduras. Given the long delays in obtaining initial treatment in pediatric emergency facilities, availability of prehospital treatment may be of particular importance in this setting.

  9. The development of pediatric anesthesia and intensive care in Scandinavia

    DEFF Research Database (Denmark)

    Nilsson, Krister; Ekström-Jodal, Barbro; Meretoja, Olli


    The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second...... World War. Relations for training and exchange of experiences between Scandinavian countries with centers in Europe and the USA were a prerequisite for development. Specialized pediatric practice was not a full-time position until during the 1950s, when the first pediatric anesthesia positions were...... created. Scandinavian anesthesia developed slowly. In contrast, Scandinavia pioneered both adult and certainly pediatric intensive care. The pioneers were heavily involved in the teaching and training of anesthetists and nurses. This was necessary to manage the rapidly increasing work. The polio epidemics...

  10. Student Commons (United States)

    Gordon, Douglas


    Student commons are no longer simply congregation spaces for students with time on their hands. They are integral to providing a welcoming environment and effective learning space for students. Many student commons have been transformed into spaces for socialization, an environment for alternative teaching methods, a forum for large group meetings…

  11. Pediatric critical care physician-administered procedural sedation using propofol: a report from the Pediatric Sedation Research Consortium Database. (United States)

    Kamat, Pradip P; McCracken, Courtney E; Gillespie, Scott E; Fortenberry, James D; Stockwell, Jana A; Cravero, Joseph P; Hebbar, Kiran B


    Increasing demand for pediatric procedural sedation has resulted in a marked increase in provision of pediatric procedural sedation by pediatric critical care physicians both inside and outside of the ICU. Reported experience of pediatric critical care physicians-administered pediatric procedural sedation is limited. We used the Pediatric Sedation Research Consortium database to evaluate a multicenter experience with propofol by pediatric critical care physicians in all settings. Review of national Pediatric Sedation Research Consortium database to identify pediatric procedural sedation provided by pediatric critical care physicians from 2007 to 2012. Demographic and clinical data were collected to describe pediatric procedural sedation selection, location, and delivery. Multivariable logistic regression analysis was performed to identify risk factors associated with pediatric procedural sedation-related adverse events and complications. A total of 91,189 pediatric procedural sedation performed by pediatric critical care physicians using propofol were included in the database. Median age was 60.0 months (range, 0-264 months; interquartile range, 34.0-132.0); 81.9% of patients were American Society of Anesthesiologists class I or II. Most sedations were performed in dedicated sedation or radiology units (80.9%). Procedures were successfully completed in 99.9% of patients. A propofol bolus alone was used in 52.8%, and 41.7% received bolus plus continuous infusion. Commonly used adjunctive medications were lidocaine (35.3%), opioids (23.3%), and benzodiazepines (16.4%). Overall adverse event incidence was 5.0% (95% CI, 4.9-5.2%), which included airway obstruction (1.6%), desaturation (1.5%), coughing (1.0%), and emergent airway intervention (0.7%). No deaths occurred; a single cardiac arrest was reported in a 13-month-old child receiving propofol and ketamine, with no untoward neurologic sequelae. Risk factors associated with adverse event included: location of

  12. Multiple antibiotic sensitivity in a pediatric population. (United States)

    Kamada, M M; Twarog, F; Leung, D Y


    Multiple antibiotic sensitivity (MAS), a common but complex clinical problem, has not been reviewed in the pediatric population. We evaluated 120 children with a history of MAS. The offending antibiotics were beta lactam (186 adverse reactions), sulfonamide (86 adverse reactions), macrolide (32 adverse reactions), erythromycin/sulfisoxazole (26 adverse reactions), aminoglycoside (2 adverse reactions), and tetracycline (2 adverse reactions). Urticaria occurred in 183 reactions, followed by polymorphous rash (n = 71), angioedema (n = 19), erythema multiform (n = 9), bronchospasm (n = 8), arthralgia (n = 7), serum sickness (n = 4), and laryngeal edema (n = 3), the mean age for the first reaction was 3 years (range 1 month to 13 years). Adverse reaction to three classes of antibiotics were noted in 22 patients, and two patients were noted to have adverse reactions to four or more antibiotic classes. Skin tests (ST) were performed in 98 children using penicillin G, a commercial benzyl penicilloyl polylysine, a minor determinant mixture, and a beta lactam analog. Positive ST were noted in 26% (31/120) of the MAS patients. Children with a history of MAS are likely to have true IgE-mediated reactions as documented by positive immediate hypersensitivity reactions to penicillin and/or its minor determinants. Therefore, MAS patients should be carefully evaluated for antibiotic sensitivity and not be assumed to have sensitivity to drug formulation as a basis for MAS.

  13. Pediatric blunt splenic trauma: a comprehensive review

    Energy Technology Data Exchange (ETDEWEB)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); Sullivan, Ashley N. [St. George' s University School of Medicine, Grenada, West Indies (Grenada); Bloom, David A. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); William Beaumont Hospital, Section of Pediatric Radiology, Department of Radiology, Royal Oak, MI (United States)


    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  14. Pediatric Selective IgM Immunodeficiency

    Directory of Open Access Journals (Sweden)

    Marc F. Goldstein


    Full Text Available Objective. Limited information exists on features of pediatric Selective IgM immunodeficiency (SIgMID. Previously published pediatric cases and 2 new cases are reviewed. Methods. English literature from PubMed and references from relevant articles were reviewed. Previously reported cases and 2 new cases from an allergy/immunology practice were analyzed. Results. Forty-nine reported cases of SIgMID presented with respiratory infections (77.6%, gastrointestinal disease (16.3%, skin disease (12.2%, and meningitis (8.2%. Mean serum IgM level was 16.5±13.8 mg/dL. Two patients were identified with SIgMID among 6300 active pediatric patients (0.03% presenting with asthma, vasomotor rhinitis, and recurrent respiratory infections. In the 51 cases reported, none developed lymphoproliferative disease nor evolved into panhypogammaglobulinemia; four fatalities were reported. Conclusions. The prevalence of SIgMID in our pediatric population was 0.03%. In general, respiratory infections are the common comorbid conditions. Death and autoimmune disease are uncommon complications of pediatric SIgMID.

  15. Prevention and Therapy of Pediatric Emergence Delirium: A National Survey. (United States)

    Huett, Christopher; Baehner, Torsten; Erdfelder, Felix; Hoehne, Claudia; Bode, Christian; Hoeft, Andreas; Ellerkmann, Richard K


    Although pediatric emergence delirium (ED) is common, preventive and therapeutic pharmacological treatment is the matter of an international controversial discussion and evidence on different options is partially vague. We therefore examined clinical routine in prevention strategies and postoperative therapy of ED with respect to clinical experience in pediatric anesthesia. A web-based survey was developed investigating routine management (prevention and treatment) of ED, facility structure, and patient population. The link was sent to all enlisted members of the German Society of Anesthesiology. We analyzed 1229 questionnaires. Overall, 88% reported ED as a relevant clinical problem; however, only 5% applied assessment scores to define ED. Oral midazolam was reported as standard premedication by 84% of respondents, the second largest group was 'no premedication' (5%). The first choice prevention strategy was to perform total intravenous (propofol) anesthesia (63%). The first choice therapeutic pharmacological treatment depended on clinical experience. Therapeutic propofol was preferentially chosen by more experienced anesthesiologists (5 to >20 patients per week, n = 538), while lesser experienced colleagues (propofol. Propofol is the preferred choice for pharmacological prevention and treatment of ED among German anesthesiologists. Further therapy options as well as alternatives to a midazolam-centered premedication procedure are underrepresented.

  16. Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis. (United States)

    Stubberud, Anker; Varkey, Emma; McCrory, Douglas C; Pedersen, Sindre Andre; Linde, Mattias


    Migraine is a common problem in children and adolescents, but few satisfactory prophylactic treatments exist. Our goal was to investigate the pooled evidence for the effectiveness of using biofeedback to reduce childhood migraine. A systematic search was conducted across the databases Medline, Embase, CENTRAL, CINAHL, and PsychINFO. Prospective, randomized controlled trials of biofeedback for migraine among children and adolescents were located in the search. Data on reduction of mean attack frequency and a series of secondary outcomes, including adverse events, were extracted. Risk of bias was also assessed. Forest plots were created by using a fixed effects model, and mean differences were reported. Five studies with a total of 137 participants met the inclusion criteria. Biofeedback reduced migraine frequency (mean difference, -1.97 [95% confidence interval (CI), -2.72 to -1.21]; P Biofeedback demonstrated no adjuvant effect when combined with other behavioral treatment; neither did it have significant advantages over active treatment. Only 40% of bias judgments were deemed as "low" risk. Methodologic issues hampered the meta-analyses. Only a few studies were possible to include, and they suffered from incomplete reporting of data and risk of bias. Biofeedback seems to be an effective intervention for pediatric migraine, but in light of the limitations, further investigation is needed to increase our confidence in the estimate. Copyright © 2016 by the American Academy of Pediatrics.

  17. Pediatric telephone advice: a new medical service in Israel. (United States)

    Sher, C; Mimouni, M; Weitzen, T; Waisman, Y


    Although controversy still exists about dispensing medical advice over the telephone, such services are widely offered by pediatricians in the USA. In Israel, however, such services have not yet been developed. In a joint project of the Moked Keshev (a private medical help line) at Magen David Adom (national ambulance service) and the Children's Medical Center of Israel, the first pediatric telephone advice service in Israel was established. In this study we analyzed 512 consecutive incoming calls received during the first 11 months of service operation. Of these, 42% of calls concerned children in the 1 month to 1 year age group. Unexpectedly, calls were almost evenly distributed throughout the week with a slight decrease on Fridays and Saturdays (sabbath), and 45.7% of the calls were received during the morning shift. The three most common reasons for contact were: of a general nature such as fever (23%), gastrointestinal problems (19%), and medical questions (18%). In only 20.7% of the cases were the patients advised to go to the nearest hospital emergency department, emphasizing the non-emergent nature of the calls. At the time of follow-up (within 24 h), patient status was assessed as: improved (73.7%), same (22.6%), and worse (3.8%). Of those who became worse, none required an emergency department evaluation. The present study demonstrates that a Pediatric Telephone Advice Service in Israel is technically functional, medically safe, and contributes to the health management of children.

  18. Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance

    Directory of Open Access Journals (Sweden)

    Silk Jennifer S


    Full Text Available Abstract Background Neuroimaging technology has afforded advances in our understanding of normal and pathological brain function and development in children and adolescents. However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI scanner to complete tasks is one common and significant problem. Task noncompliance is an especially significant problem in pediatric functional magnetic resonance imaging (fMRI research because increases in noncompliance produces a greater risk that a study sample will not be representative of the study population. Method In this preliminary investigation, we describe the development and application of an approach for increasing the number of fMRI tasks children complete during neuroimaging. Twenty-eight healthy children ages 9-13 years participated. Generalization of the approach was examined in additional fMRI and event-related potential investigations with children at risk for depression, children with anxiety and children with depression (N = 120. Essential features of the approach include a preference assessment for identifying multiple individualized rewards, increasing reinforcement rates during imaging by pairing tasks with chosen rewards and presenting a visual 'road map' listing tasks, rewards and current progress. Results Our results showing a higher percentage of fMRI task completion by healthy children provides proof of concept data for the recommended tactics. Additional support was provided by results showing our approach generalized to several additional fMRI and event-related potential investigations and clinical populations. Discussion We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols. While our findings may not directly support the effectiveness of the multiple reward compliance protocol, increased attention to how rewards are selected and delivered may aid cooperation with completing fMRI tasks Conclusion The

  19. [Robotics in pediatric surgery]. (United States)

    Camps, J I


    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  20. Spectrum of pediatric skin biopsies

    Directory of Open Access Journals (Sweden)

    Grace D′costa


    Full Text Available Background: Skin diseases are common in childhood and they are common reasons for pediatric visits to the hospital. In spite of this high occurrence, there are very few prospective studies addressing this issue. Aims: The present study was directed at determining the spectrum of dermato-pathological lesions encountered in a large general tertiary care hospital, over a two-year period. Materials and Methods: 107 cases formed the total sample studied, in a part prospective and part retrospective study. A detailed clinical history was recorded on a proforma prepared for the purpose and gross photographs were taken wherever possible. Results: Skin biopsies accounted for 7.29% of the total surgical pathology load, 55.44% of the total pediatric biopsies and 10.82% of the total number of skin biopsies. The age and sex distribution pattern revealed that the maximum number of biopsies (62.61% were of older children, with a male preponderance (57.94%. The anatomic distribution pattern indicated predominant involvement of the limbs (59.82%. The maximum numbers of cases were of infectious nature (24.29%; the most frequently encountered being borderline tuberculoid Hansen′s disease (8.4%. A positive correlation with the clinical diagnosis was obtained in 56.07% cases. Conclusions: Histopathology contributed to the diagnosis in a significant number of (82.23% cases, indicating its importance and utility.