Journal articles: 'Paediatric problem'

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Peng, Wan-Sheng, Lian Wang, Hui Zhang, Zhen Zhang, Yu-Meng Wu, Xu Sang, Rui Zhou, Jia-Li Xu, and Xin Chen. "Application of virtual scenario simulation combined with problem-based learning for paediatric medical students." Journal of International Medical Research 49, no. 2 (February 2021): 030006052097921. http://dx.doi.org/10.1177/0300060520979210.

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Objectives To examine the application and effects of virtual scenario simulation combined with problem-based learning (PBL) in teaching paediatric medical students. Methods Participants were 300 paediatric medical students randomly divided into a study group and control group. Students in the study group were taught using virtual scenario simulation combined with PBL; students in the control group were taught using conventional teaching methods. Academic performance, knowledge of paediatrics, self-evaluation of comprehensive ability and degree of learning satisfaction were evaluated. Results Students in the study group showed considerably higher academic performance and noticeably higher classroom performance. Paediatric knowledge, comprising initiating communication, collecting information, giving information, understanding the paediatric patient and concluding communication, was higher for students in the study group. The degree of learning satisfaction was higher for students in the study group. Conclusion Virtual scenario simulation combined with PBL can effectively improve students’ academic performance, mastery of paediatric knowledge, comprehensive ability evaluation and learning satisfaction. The broader application of this approach should be explored for medical student education.

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Street, Jessica R., Joanna C. E. Wright, Kelvin L. Choo, John F. Fraser, and Roy M. Kimble. "Woodstoves uncovered: a paediatric problem." Burns 28, no. 5 (August 2002): 472–74. http://dx.doi.org/10.1016/s0305-4179(02)00046-3.

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Berezhnaya, Irina V., Mariia A. Simakova, and Irina N. Zakharova. "Obesity is an important paediatric problem that paediatricians and endocrinologists should address together." Pediatrics. Consilium Medicum, no. 4 (December 15, 2021): 346–50. http://dx.doi.org/10.26442/26586630.2021.4.201354.

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The increasing incidence of obesity in children and adolescents with its negative health consequences is one of the global problems of paediatrics and paediatric endocrinology. Approaches to the management of obese children are being developed and scientific and practical programmes for prevention and treatment are being established. Correctly assessing the risks of obesity in the long term and knowing how to influence them can help to reduce these risks. The primary care physician's priority is to make a diagnosis of overweight and obesity in children and to determine appropriate screening and treatment according to current clinical guidelines and known scientific evidence. The aim of this review is to briefly describe the risk factors, current epidemiological features of obesity and to provide a primary screening plan for children with exogenous obesity to assist the practicing paediatrician and paediatric endocrinologist.

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Kim, Lawrence H., Deborah A. Maze, Susan Adams, Sarah Guitonich, Siobhan Connolly, Anne Darton, and Andrew J. A. Holland. "Paediatric treadmill injuries: an increasing problem." Medical Journal of Australia 191, no. 9 (November 2009): 516. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02918.x.

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Gough, Joy. "Cracking a complex problem." Archives of Disease in Childhood 105, no. 7 (June 14, 2019): 694. http://dx.doi.org/10.1136/archdischild-2019-316862.

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Gough, Joy. "Cracking a complex problem." Archives of Disease in Childhood 105, no. 7 (July 30, 2019): 695–96. http://dx.doi.org/10.1136/archdischild-2019-317605.

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Gough, Joy. "Cracking a complex problem." Archives of Disease in Childhood 105, no. 10 (August 20, 2019): 991–92. http://dx.doi.org/10.1136/archdischild-2019-317677.

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&NA;. "Hypertension in paediatric patients - no minor problem." Drugs & Therapy Perspectives 6, no. 1 (July 1995): 9–11. http://dx.doi.org/10.2165/00042310-199506010-00004.

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Gupta, S., A. Gandhi, and R. Manikonda. "Accidental nicotine liquid ingestion: emerging paediatric problem." Archives of Disease in Childhood 99, no. 12 (September 8, 2014): 1149. http://dx.doi.org/10.1136/archdischild-2014-306750.

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Chavan, Rahulkumar N., Bhargav Chikkala, Cinjini Das, Somak Biswas, Diptendra Kumar Sarkar, and Sushil Kumar Pandey. "Anorectal Malformation: Paediatric Problem Presenting in Adult." Case Reports in Surgery 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/625474.

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This is a case report of 22-year-old girl admitted with abdominal distension, vomiting, and chronic constipation since birth. Abdomen was distended, and perineal examination revealed imperforate anus with vestibular fistula (ARM). So far worldwide very few cases have been reported about anorectal malformation presenting in adulthood, and thus extremely little data is available in the literature about an ideal management of anorectal malformation in adults. In our case in the treatment instead of conventional procedure of posterior sagittal anorectoplasty (PSARP) anal transposition was done and till two years after the definitive treatment during follow-up patient has been doing well with Kelly’s score of six. Our experience suggests that anal transposition provides satisfactory outcome in adults presenting late with anorectal malformation.

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Monintja, H. E., W. T. Karjomanggolo, and R. Sutejo. "Postgraduate Paediatric Education in Indonesia." Paediatrica Indonesiana 19, no. 1-2 (June 16, 2017): 47. http://dx.doi.org/10.14238/pi19.1-2.1979.47-55.

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Previously the objectives of the postgraduate training program throughoutIndonesia were not clearly defined. The problems which served as objective determinants were also not defined. At present the Indonesian Paediatric Association, with her Board of Specialists, has succeded in laying down the fundamental of the curriculum of Indonesian Paediatrician. The government as well as the Indonesian Paediatric Association now realize that the postgraduate paediatric education system should be a "system approach" to solve health problems in IndonesiaThe objectives of the training of paediatricans in the Department of Child Health Medical School University of Indonesia has been described in another monograph.To achieve the objectives the learning experience is as follows :1. Assignment in the wards and field practice areas, 2. Case presentations3. Death Conference, 4. Problem case discussion 5. Chart (medical records) discussion, 6. Emergency duties, 7. Guest lectures, 8. Home lectures, 9. Journal readings, 10. Experience in education, 11. Experience in research.

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Irga, Ninela, Malgorzata Mysliwiec, Marcelina Osak, Malgorzata Szmigiero-Kawko, Elzbieta Adamkiewicz-Drozynska, and Radoslaw Jaworski. "Transient hyperglycaemia – an underestimated problem of paediatric oncohaematology." Archives of Medical Science 4 (2012): 672–77. http://dx.doi.org/10.5114/aoms.2012.30291.

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Giovannini, M., E. Verduci, D. Ghisleni, E. Salvatici, E. Riva, and C. Agostoni. "Enterobacter Sakazakii: An Emerging Problem in Paediatric Nutrition." Journal of International Medical Research 36, no. 3 (May 2008): 394–99. http://dx.doi.org/10.1177/147323000803600303.

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Greenberg, David, Christine C. Chiou, Ronald Famigilleti, Tzielan C. Lee, and Victor L. Yu. "Problem pathogens: paediatric legionellosis—implications for improved diagnosis." Lancet Infectious Diseases 6, no. 8 (August 2006): 529–35. http://dx.doi.org/10.1016/s1473-3099(06)70553-9.

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Tomaszewski, Ryszard, and Barbara Czasławska. "Paediatric flatfoot." Pediatria i Medycyna Rodzinna 16, no. 4 (December 31, 2020): 368–72. http://dx.doi.org/10.15557/pimr.2020.0066.

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Paediatric flat feet are a serious therapeutic problem. During the child’s development, the foot is subject to the processes of anatomical and physiological modifications. In small children, the flat foot is a physiological variant. The assessment of the flat foot deformity is based on clinical examination, a podoscope examination and possibly radiological evaluation. Only from the age of about 3 years is it possible to consider the implementation of treatment, initially conservative with rehabilitation and possibly orthotics. Some patients require treatment with analgesics, anti-inflammatory drugs or physiotherapy due to the pain they experience, especially in the hindfoot. The lack of progress in conservative treatment requires consideration of surgical treatment, which must be individually adjusted. Arthroereisis, possibly combined with the elongation of the Achilles tendon, is the most commonly used treatment. In fixed deformities or congenital flat feet, corrective bone procedures are also performed, usually combined with soft tissue procedures.

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pietrabissa, riccardo, and vincenzo stefano luisi. "what is the role of biomechanics in cardiac surgery?" Cardiology in the Young 14, S3 (October 2004): 1–3. http://dx.doi.org/10.1017/s104795110400647x.

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cardiac surgery is a discipline aimed at restoring the best cardiac function of diseased hearts. it is often necessary to implant devices, and surgical tools are of great help in achieving faster and safer procedures. paediatric cardiac surgery is a more recent specialization of cardiac surgery. in paediatric cardiac surgery, the problem is usually related to congenital malformations, consisting in the main of anatomical abnormalities which produce, among other problems, poor oxygenation of the blood, high cardiac afterload, cardiac failure, hemodynamic problems during growth, and so on. the paediatric cardiac surgeon uses his skill and experience to determine the optimal correction in each individual case. in many cases, however, it is not easy to predict the effects of the given surgical procedure that, for success, depends on many different parameters.

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Krastiņš, Jēkabs. "Acute Kidney Injury – An Underestimated Problem In Pediatric Intensive Care / Akûts Nieru Bojâjums — Nenovçrtçta Problçma Bçrnu Intensîvajâ Terapijâ." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 68, no. 5-6 (December 1, 2014): 207–15. http://dx.doi.org/10.2478/prolas-2014-0025.

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AbstractAcute kidney injury (AKI) frequently occurs in critically ill children and adults, with 5-20% of patients experiencing an episode during their stay in an intensive care unit. AKI rarely is an isolated event and is associated with a broader spectrum of diseases, including sepsis and respiratory insufficiency, and often progresses into multiorgan dysfunction syndrome. Despite recent advancements in renal replacement therapy (RRT), mortality among patients who sustain AKI complicated by multiorgan dysfunction appears to have remained unchanged and is estimated at approximately 50%. Recent clinical evidence suggests that AKI is not only an indicator for severity of illness, but that it also leads to earlier onset of multiorgan dysfunction with profound effects on mortality rates. The aim of this paper is to inform medical professionals involved in the paediatric intensive care of recent advances in AKI diagnosis and management. Studies were identified from MEDLINE (OVID), PubMed, and the Cochrane Library for topics relevant to AKI. There is limited evidence in paediatrics regarding effective therapy for acute kidney injury, a significant problem in the paediatric intensive care unit that extends length of stay, duration of mechanical ventilation, and overall mortality. Sublethal kidney injury may be contributing to overall morbidity. Prospective clinical trials are needed to evaluate specific diagnostic aids, such as biomarkers, and therapeutic strategies like early initiation of continuous RRT in children with fluid overload

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Evans, C., H. Reece-Smith, and HW Grant. "Paediatric surgical training for general surgical trainees: a trainee's experience." Bulletin of the Royal College of Surgeons of England 92, no. 2 (February 1, 2010): 54–55. http://dx.doi.org/10.1308/147870710x485783.

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'The provision of GPS [general paediatric surgery] in the DGH [district general hospital] setting is reaching a crisis. The underlying problem is a failure to train and recruit general surgeons with appropriate paediatric skills and experience.

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Senturia, Y. D., and C. S. Peckham. "HIV infection in children: sizing up the paediatric problem." Paediatric and Perinatal Epidemiology 1, no. 2 (October 1987): 143–51. http://dx.doi.org/10.1111/j.1365-3016.1987.tb00103.x.

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Kim, L., D. Maze, S. Adams, S. Giutronich, and A. Holland. "BA07Pï¿½PAEDIATRIC TREADMILL INJURIES IN NSW: AN INCREASING PROBLEM." ANZ Journal of Surgery 79 (May 2009): A8. http://dx.doi.org/10.1111/j.1445-2197.2009.04914_7.x.

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Hamill, James, and Spencer W. Beasley. "TRAINING IN PAEDIATRIC TRAUMA: THE PROBLEM OF SAFER SOCIETIES." ANZ Journal of Surgery 76, no. 7 (July 2006): 596–99. http://dx.doi.org/10.1111/j.1445-2197.2006.03781.x.

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Hutson, John M. "TRAINING IN PAEDIATRIC TRAUMA: THE PROBLEM OF SAFER SOCIETIES." ANZ Journal of Surgery 76, no. 7 (July 2006): 541. http://dx.doi.org/10.1111/j.1445-2197.2006.03825.x.

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Martino, F., D. Agotini, E. Martino, O. Mannarino, R. Forcone, M. Ciabatta, and O. Giardini. "P20 Preliminary screening about “cholesterol problem” in paediatric age." Atherosclerosis 145 (July 1999): S16. http://dx.doi.org/10.1016/s0021-9150(99)90166-1.

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Roberts, R. G., and R. M. Jones. "Paediatric tonsillectomy and PONV - big little problem remains big!" Anaesthesia 57, no. 6 (May 14, 2002): 606–25. http://dx.doi.org/10.1046/j.1365-2044.2002.265819.x.

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Williams, K., A. Scheinberg, V. Moyer, and C. Mellis. "Using an evidence-based approach to a paediatric problem." Journal of Paediatrics and Child Health 39, no. 2 (March 2003): 139–44. http://dx.doi.org/10.1046/j.1440-1754.2003.00112.x.

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Price, E. W. "Endemic elephantiasis as a paediatric problem in the tropics." Annals of Tropical Paediatrics 7, no. 2 (June 1987): 77–81. http://dx.doi.org/10.1080/02724936.1987.11748479.

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Standing, Joseph F., and Catherine Tuleu. "Paediatric formulations—Getting to the heart of the problem." International Journal of Pharmaceutics 300, no. 1-2 (August 2005): 56–66. http://dx.doi.org/10.1016/j.ijpharm.2005.05.006.

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Miller, Tracie L. "Nutrition in paediatric human immunodeficiency virus infection." Proceedings of the Nutrition Society 59, no. 1 (February 2000): 155–62. http://dx.doi.org/10.1017/s0029665100000185.

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The nutritional condition of children with human immunodeficiency virus (HIV) infection continues to be a problem both in developed and developing countries. HIV-infected children grow below normal standards in both height and weight when compared with HIV-exposed non-infected children. These patterns persist over time. It is possible that acute infectious episodes and increased HIV viral burden contribute to decrements in all growth variables. Potential aetiologies for abnormal growth include inadequate dietary intake, gastrointestinal malabsorption, increased energy utilization and psycho-social problems. It is likely that all these factors contribute to the growth problems of these children to some extent. With the development of protease inhibitor anti-retroviral therapy and highly-active anti-retroviral treatment regimens, children with HIV infection in developed countries are living longer with a chronic illness. New nutritional problems have arisen with the development of the fat redistribution syndrome or lipodystrophy. Emerging problems are now being recognized, with the development of insulin resistance and truncal obesity which may potentially lead to premature cardiovascular disease.

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Khanam, Afroza, Gulshan Akhtar, Farhana Hossain, Nurun Nahar Chowdhury, and Md Abdur Rahman. "Pattern of Otolaryngological Diseases among Paediatric Population Attending ENT OPD in a Tertiary Care Centre, Dhaka." Delta Medical College Journal 5, no. 1 (February 4, 2017): 30–34. http://dx.doi.org/10.3329/dmcj.v5i1.31434.

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Background: Ear, nose and throat diseases are serious public health problems affecting all age groups. These include problem of hearing, speech, phonation, breathing, swallowing, smell and taste and protection of lower respiratory passage.Objective: There is lack of data on paediatric ENT diseases in our country and their consequences. This study was undertaken to determine the hospital prevalence of ENT diseases among paediatric population.Materials and method: This is an observational study which included 430 children presenting with ENT problem in the Department of ENT OPD, in a Tertiary Care Centre at Dhaka, Bangladesh from January 2013 to December 2013.Results: The current study was conducted among children aged 0-15 years attending ENT OPD with common otolaryngological problems. Prevalence of ENT disease was more common among male children (52.79%) mostly belonging to 0-5 years (male 52.86% and female 42.36%). Vast majority of these children belonged to lower middle class family (52.32%) with inadequacy of basic health care needs. Diseases of the ear (39.75%) were most common followed by throat problems (33.71%) and nasal diseases (26.51%).Conclusion: Otitis media (acute and chronic), rhinitis and tonsillitis were most prevalent ENT disorder among the selected paediatric population. So clinicians should be familiar with these conditions to prevent potential morbidity and to create parental awareness.Delta Med Col J. Jan 2017 5(1): 30-34

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McDougall, Rosalind, Lynn Gillam, Merle Spriggs, and Clare Delany. "The zone of parental discretion and the complexity of paediatrics: A response to Alderson." Clinical Ethics 13, no. 4 (July 25, 2018): 172–74. http://dx.doi.org/10.1177/1477750918789998.

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Alderson critiques our recent book on the basis that it overlooks children’s own views about their medical treatment. In this response, we discuss the complexity of the paediatric clinical context and the value of diverse approaches to investigating paediatric ethics. Our book focuses on a specific problem: entrenched disagreements between doctors and parents about a child’s medical treatment in the context of a paediatric hospital. As clinical ethicists, our research question arose from clinicians’ concerns in practice: What should a clinician do when he or she thinks that parents are choosing a treatment pathway that does not serve the child’s best interests? Alderson’s work, in contrast, focuses on the much broader issue of children’s role in decision-making about treatment and research. We argue that these different types of work are zooming in on different aspects of paediatric ethics, with its complex mix of agents, issues and relationships. Paediatric ethics overall needs a rich mix of approaches, investigating a range of different focal problems in order to further understanding. The zone of parental discretion is not incompatible with valuing children’s rights and views; its focus is a different element of a complex whole.

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Islam, Dr Md Nazrul, Dr Soheli Alam, Dr A. M. Shahinoor, Dr Mohammad Mahabubul Alam, Dr Shahin Reza, Dr Mafia Afsin Laz, Dr Md Zamil Hossain, Dr Suman Bikram Adhikari, Dr Taslima Akter, and Dr Mohammad Saiful Islam. "hildhood Constipation: A Global Problem and its Management Guideline." Scholars Journal of Applied Medical Sciences 11, no. 02 (February 23, 2023): 420–28. http://dx.doi.org/10.36347/sjams.2023.v11i02.024.

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Introduction: Background: Constipation is a symptom, not a disease, every person in this world experiences constipation at some point in their real life. However, the prevalence of constipation in childhood is more but it is still under-appreciated in paediatric age group. Considering childhood constipation being one of the underappreciated and mismanaged health problems, the faculty members of paediatric surgery department, BSMMU approved a consensus of guideline of management of childhood constipation. It thus assists health care workers in the management of all of the children with constipation in all the level of care i.e. primary, secondary, and tertiary care. Methods: The faculty members of paediatric surgery department of BSMMU addressed the problem of constipation in infants and children who had no previously established medical condition. To develop the initial evidence-based guideline, articles on constipation published in English were found using Medline, Embase and Cochrane Database of Systematic Reviews. Result: The guidelines provide recommendations for the diagnostic evaluation of children presenting with constipation and treatment of children with functional constipation to standardize and improve their quality of care. In this study, two guidelines were developed, the first guideline for the evaluation and treatment of infants <6 months. The second guideline is for the evaluation and treatment of children > 6 months of age. Conclusion: Constipation is globally underappreciated problem and should be evaluated thoroughly. Constipation due to functional or organic cause should be identified. Management protocol should be adapted as per the guideline shown in fig. 1 and fig. 2. Emphasis should be laid on toilet-training, feeding habit and importantly in counselling particularly related to long term usage of medical therapy.

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Tsarev, Sergey V. "Chronic rhinitis in children is not a local problem." Meditsinskiy sovet = Medical Council, no. 1 (March 21, 2021): 182–86. http://dx.doi.org/10.21518/2079-701x-2021-1-182-186.

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Allergic rhinitis is the most common pathology among all allergic diseases. The article presents the epidemiologic and pathogenetic issues of the allergic rhinitis. The underdiagnosis of allergic rhinitis and its underestimation as a systemic pathology were observed in various countries. The importance of allergic rhinitis in paediatric practice, its impact on the quality of life, studies, and cognitive abilities is considered. The extranasal manifestations of the disease, as well as the role of allergic rhinitis in the development of increased respiratory viral morbidity are assessed. The differences between allergic and vasomotor rhinitis (non-allergic non-infectious rhinopathy) are analysed. Frequent interdependence and interaction of the allergic and vasomotor rhinitis are stressed. The signs of nonspecific hyperreactivity of the upper respiratory tract affected by the allergic rhinitis are presented. The role and importance of decongestants in the treatment of both allergic and vasomotor rhinitis are discussed in detail. Vasoconstrictors would help reduce hyperemia and nasal mucosa oedema, reduce the level of mucus secretion, improve the drainage of paranasal sinuses, normalizing the pressure in them. The use of a combination drug – a sympathomimetic combined with a local antihistamine agent would be the most appropriate treatment for patients with AR. The use of intranasal combination therapy for allergic rhinitis is justified: a sympathomimetic phenylephrine combined with a blocker of H1-histamine receptors dimethindene. The insights into the safety and efficacy of above drug combination in paediatric practice are presented. The use of a combination intranasal drug based on phenylephrine and dimethindene in patients with allergic rhinitis is justified in paediatric practice as both symptomatic and pathogenetic treatment. It is also advisable to administer it to treat acute respiratory viral diseases, in the post-viral period with situational exacerbations of the vasomotor component.

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Murugan, Sashen, Pano Parris, and Mike Wells. "Drug preparation and administration errors during simulated paediatric resuscitations." Archives of Disease in Childhood 104, no. 5 (November 9, 2018): 444–50. http://dx.doi.org/10.1136/archdischild-2018-315840.

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IntroductionVery few studies have assessed drug preparation and administration errors during paediatric resuscitation. Current evidence suggests that medication errors in paediatrics are a serious problem. The aim of this study was to evaluate drug preparation and administration errors incurred during the simulated resuscitation of paediatric patients.MethodsThis was a prospective observational study performed in the emergency department of a tertiary-level hospital. Teams consisting of two emergency doctors were tasked with preparing and delivering medication during simulated emergency scenarios. Preparation processes were video recorded. All phials, syringes and administered volumes were collected and analysed to determine the accuracy of drug preparation and delivery. Deviations from intended volumes were calculated.Main resultsA total of 96 dosages were recorded from 24 participants. Most errors were identified in the withdrawal of drug phase (prior to dilution) (13 of 96 doses had a >20% error), and the administration of medication phase (20 of 96 doses had a >20% error). Overall the median time taken to deliver each drug was 79 s (IQR 59, 100 s). The largest percentage errors were seen when a large syringe was used to withdraw or administer a small volume of medication.ConclusionThe study clearly demonstrated that there were significant errors in the preparation and administration of medication. Training in the preparation and administration of paediatric medications should be available for all emergency nurses and doctors. Correct syringe choice may reduce these errors—smaller syringes should be used for withdrawing or administering smaller volumes.

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Hlavatá, A. "The Reality of the Management in Patients with Rare Inborn Metabolic Diseases In Slovakia / Realita starostlivosti o pacientov so zriedkavými vrodenými metabolickými chorobami v SR." Acta Facultatis Pharmaceuticae Universitatis Comenianae 60, Supplementum-VIII (March 1, 2013): 16–21. http://dx.doi.org/10.2478/afpuc-2013-0003.

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Recently, from 6,000 to 8,000 rare diseases have been registered, of which over 1,000 are inherited metabolic diseases. In Slovakia, a nationwide newborn screening for phenylketonuria − an inherited metabolic disease that occurred frequently in our country − has been performed over the last 40 years. Special workplaces in Bratislava, Banská Bystrica and Košice were set up to provide optimal availability of treatment for patients with phenylketonuria. Today, Inherited Metabolic Diseases Centre in Children's Faculty Hospital in Bratislava uses the laboratories at the Department of Laboratory Medicine and Molecular Genetics at the 2nd Paediatrics Department. When finalizing the diagnosis, we cooperate with the Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine and University Hospital in Bratislava. However, international cooperation is needed. Clinical and ambulatory care of patients with inherited metabolic diseases is in the centre distributed to the paediatric and neurological departments. In recent years, the problem of inherited metabolic diseases has no longer been just a paediatric problem. While in past the majority of patients did not live to adulthood, today, thanks to new drugs and therapeutic procedures, it has been changed. Improving the knowledge of the pathogenesis, diagnosis and especially substitution therapy, patients can reach the age of adulthood and they can even be diagnosed in adulthood. The paper provides personal experience with the treatment of inherited metabolic diseases in Slovakia, mainly the substitution therapy.

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Omran, Ahmed, Dalia Elimam, Keith A. Webster, Lina A. Shehadeh, and Fei Yin. "MicroRNAs: a new piece in the paediatric cardiovascular disease puzzle." Cardiology in the Young 23, no. 5 (February 26, 2013): 642–55. http://dx.doi.org/10.1017/s1047951113000048.

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AbstractCardiovascular diseases in children comprise a large public health problem. The major goals of paediatric cardiologists and paediatric cardiovascular researchers are to identify the cause(s) of these diseases to improve treatment and preventive protocols. Recent studies show the involvement of microRNAs (miRs) in different aspects of heart development, function, and disease. Therefore, miR-based research in paediatric cardiovascular disorders is crucial for a better understanding of the underlying pathogenesis of the disease, and unravelling novel, efficient, preventive, and therapeutic means. The ultimate goal of such research is to secure normal cardiac development and hence decrease disabilities, improve clinical outcomes, and decrease the morbidity and mortality among children. This review focuses on the role of miRs in different paediatric cardiovascular conditions in an effort to encourage miR-based research in paediatric cardiovascular disorders.

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Vannah, W. M., J. R. Davids, D. M. Drvaric, Y. Setoguchi, and B. J. Oxley. "A survey of function in children with lower limb deficiencies." Prosthetics and Orthotics International 23, no. 3 (December 1999): 239–44. http://dx.doi.org/10.3109/03093649909071640.

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Function and prosthesis technical problems were surveyed in 258 experienced paediatric lower-limb prosthesis wearers. The two-part survey form consisted of the modified Prosthesis Evaluation Scale and the core module of the American Academy of Orthopaedic Surgeons/Council of.Musculoskeletal Specialty Societies (AAOS/COMSS) Lower Limb Outcomes instrument. Eighty-eight percent (88%) of these paediatric subjects were able to wear their prosthesis more than 9 hours/day; only 3 subjects (1%) were not able to wear their limb at all. The average distance walked per day was reported to be 5.24 kilometres. Sixteen percent (16%) reported pain as “moderate” or worse. A majority reported not having a problem with perspiration, however, 20% had problems serious enough to limit prosthesis wearing time significantly. The most common reasons for temporary loss of limb use were pain (62 responses) and prosthesis failure (59 responses), followed by tissue breakdown (42 responses) and perspiration (30 responses). In general, the paediatric population achieves full use at a high rate, is much more active than the adult population, and experiences less limb pain.

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Yılmaz, Medine, Hatice Yıldırım Sarı, Meltem Ünlü, and Perihan Yetim. "Investigating intercultural effectiveness of paediatric nurses in a Turkish hospital." British Journal of Nursing 29, no. 3 (February 13, 2020): 152–58. http://dx.doi.org/10.12968/bjon.2020.29.3.152.

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Background: Cultural competence, an important part of patient-centred care, has been on the nursing agenda for many years. Aim: The aim of this study was to measure the intercultural effectiveness level of paediatric nurses, and to explore relationships between the level of intercultural effectiveness and some sociodemographic variables in paediatric nurses. Method: The study was conducted at İzmir Tepecik Training and Research Hospital's children's clinics in Turkey. A convenience sample of 98 paediatric registered nurses practising at the hospital was evaluated. To collect the study data, a sociodemographic characteristics questionnaire, a Cultural Approach in Nursing Care form and the Intercultural Effectiveness Scale (IES) were used. Results: The participating paediatric nurses' intercultural effectiveness levels were moderate, the problem they experienced most was the language problem and although many of them had not received adequate training in cultural care, based on their experiences, they regarded themselves as culturally competent. Conclusion: Cultural competence is vital in multi-ethnic and multicultural societies. Cultural competence training should be provided to nurses during nurse education, or in-service training during their professional life.

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Constantino, Diogo M. C., Luis Machado, Marcos Carvalho, João Cabral, Pedro Sá Cardoso, Inês Balacó, Tah Pu Ling, and Cristina Alves. "Redisplacement of Paediatric Distal Radius Fractures: What is the Problem?" Journal of Children's Orthopaedics 15, no. 6 (December 2021): 532–39. http://dx.doi.org/10.1302/1863-2548.15.210111.

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Purpose Distal radius fractures represent one of the most common fractures in children. Our purpose is to analyze risk factors for redisplacement in children with distal radius fractures treated by means of closed reduction and plaster cast immobilization. Methods Retrospective study, including children under the age of 17 years, who underwent closed manipulation and cast immobilization for a distal third radius fracture, between 2012 and 2015. Preoperative radiographs were reviewed for initial translation, angulation and shortening, distance of the fracture from the physis, degree of fracture obliquity and the presence of an ulna fracture. Postoperative radiographs were analyzed for translation, angulation and shortening, as well as the quality of closed reduction. Cast index, gap index and three-point index, were measured on the postoperative radiographs. Redisplacement and re-intervention during follow-up were registered. Results A total of 26 patients were included in this study. Comparison between post-reduction and immediate post-cast removal radiographs did not show any statistically significant difference between translation or shortening. Coronal (p = 0.002) and sagittal (p = 0.002) angulation showed a statistically significant difference, but both median values remained below cut-off values for redisplacement. Redisplacement was observed in four patients. Only one patient underwent remanipulation. All four had full remodelling and proper radiological alignment at final follow-up. Quality of reduction was found to be a statistically significant risk factor for redisplacement (p = 0.013). Conclusion Closed reduction and cast immobilization under general anaesthesia yields good results in the treatment of distal forearm fractures in paediatric patients. Quality of reduction was the only risk factor that we found to be predictive of redisplacement. Level of Evidence Level III – Retrospective comparative study

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Lohana, P., S. Hemington-Gorse, C. Thomas, T. Potokar, and YT Wilson. "Paediatric injuries due to home treadmill use: an emerging problem." Annals of The Royal College of Surgeons of England 94, no. 2 (March 2012): 121–23. http://dx.doi.org/10.1308/003588412x13171221501942.

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INTRODUCTION The use of home exercise equipment is increasing and treadmills are becoming more popular. This has brought with it an emerging but preventable problem. We present our experience, highlight the importance and promote public awareness of this type of injury. To our knowledge this has not been reported previously in the UK. METHODS A retrospective review was conducted of the medical records at two regional burn units of children who sustained treadmill-related injuries between July 2003 and July 2009. Data on patient demographics, mechanism of injury, management, surgical intervention and outcome were recorded. RESULTS Twenty-nine children (15 boys, 14 girls) sustained treadmill-related injuries. The mean age was 3.8 years (range: 1–13 years). All injuries occurred at home and the majority of children trapped their hand under the running belt when an adult was using the machine. Most of the injuries were to the upper limb (97%) with less than 1% of the total body surface area burnt. More than two-thirds of patients had deep burns and 17 (58%) required surgical intervention. Five patients developed hypertrophic scars. All patients achieved a good functional outcome. CONCLUSIONS Treadmills can pose a significant danger to children. These injuries are preventable. Regulatory authorities, manufacturers and parents should take steps to prevent this emerging health problem.

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Katz, Sherri Lynne, Manisha Witmans, Nicholas Barrowman, Lynda Hoey, Santana Su, Deepti Reddy, and Indra Narang. "Paediatric sleep resources in Canada: The scope of the problem." Paediatrics & Child Health 19, no. 7 (August 1, 2014): 367–72. http://dx.doi.org/10.1093/pch/19.7.367.

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Rastogi, Aayushi, and Umesh Kapil. "Non-alcoholic Fatty Liver Disease in Children: An emerging Public health problem in India." Indian Journal of Community Health 32, no. 2 (June 30, 2020): 330–36. http://dx.doi.org/10.47203/ijch.2020.v32i02.005.

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NAFLD was earlier believed to be the disease of adults only however in 1983, the existence of this disease was seen in paediatric population. Nearly four decades have passed since the first description of the Paediatric NAFLD (P-NAFLD), yet it is one of the areas which is given least priority in the country. The P-NAFLD is reversible and can be prevented by lifestyle and behaviour modification and hence there is a need to this review highlights the importance of P-NAFLD in the country and need for formulating strategies for prevention and control of P-NAFLD in the country. All published articles in the MEDLINE database on P-NAFLD in India were included. The important findings were summarized and critically analysed. The existing review suggests, the prevalence of P-NAFLD is uncertain in the country. NAFLD is a phenotypic product of complex interaction of heredity (nature) and environment (nurture). This review summarizes the importance of P-NAFLD in India and discusses the predisposition of these risk factors in Indian children. Further population-based studies on prevalence and incidence are required on general paediatric population to quantify the magnitude of the disease in India for better management of the condition.

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Stilwell, Philippa Anna, Gareth Stuttard, Robert Scott-Jupp, Adrian Boyle, Simon Kenny, and Ian Maconochie. "Paediatric NHS 111 Clinical Assessment Services pilot: an observational study." Archives of Disease in Childhood 107, no. 3 (December 7, 2021): e14-e14. http://dx.doi.org/10.1136/archdischild-2021-322908.

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ObjectiveTo determine the feasibility and impact of having paediatric clinicians working in the Clinical Assessment Services (CAS) within NHS 111, a national telephone advice service.DesignObservational study.SettingSix NHS 111 providers across England with CAS where volunteer paediatric clinicians (doctors and advanced nurse practitioners (ANPs)) worked between May and December 2020. A data reporting framework was used to compare the outcomes of calls taken by paediatric vs non-paediatric clinicians.PatientsUnder 16-year-olds prompting calls to NHS 111 over the study period.Main outcome measuresThe disposition (final outcome of calls) taken by paediatric versus non-paediatric clinicians, paediatric clinicians’ and patient experience.Results70 paediatric clinicians (66 doctors and 4 ANPs) worked flexible shifts in six NHS 111 providers’ CAS over the study period: 2535 calls for under 16-year-olds were taken by paediatric clinicians and 137 008 by non-paediatric clinicians. Overall, disposition rates differed significantly between the calls taken by paediatric versus (vs) non-paediatric clinicians: 69% vs 43% were advised on self-care only, 13% vs 18% to attend emergency departments (EDs), 13% vs 29% to attend primary care, 1% vs 4% to receive an urgent ambulance call out and 4% vs 6% referred to another health service, respectively. When compared with recent (all age) national whole data sets, the feedback from calls taken by paediatricians noted a greater proportion of patients/carers reporting that their problem was fully resolved (92% vs 27%).ConclusionsIntroducing paediatric specialists into NHS 111 CAS is likely to increase self-care dispositions, and reduce onward referrals to primary care, ED and ambulances. Future work will evaluate the impact of a national paediatric clinical assessment service to which specific case types are streamed.

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Dekhici, Latifa, and Khaled Belkadi. "A Bi-Objective Paediatric Operating Theater Scheduling." International Journal of Healthcare Information Systems and Informatics 18, no. 1 (June 1, 2023): 1–15. http://dx.doi.org/10.4018/ijhisi.323451.

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In this paper, a bi- objective Operating Theater scheduling is proposed. The problem is subject to order and assignment constraints. The first objective is the minimization of the operating theater opening total time also called makespan in manufacturing systems while the second is to maximize constraints satisfaction. The scheduling problem is considered as a two-stage hybrid flow shop with blocking. Several metaheuristics are compared: the firefly algorithm, bats algorithm, particles swarm optimization and local search. In addition to the care specific qualitative and quantitative parameters, the average deviation from the lower bound is used in order to confirm the effectiveness of the methods. The implementation is done on the operating theater of the paediatric hospital of Oran when it is properly and improperly sized.

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Esser, Kayla, Bryn Badour, Paul Davis, Kate Langrish, Pamela Chan, Michelle Shouldice, Carolyn Beck, Judy Van Clieaf, Andrew Baker, and Julia Orkin. "79 Impact of COVID-19 wave 3 paediatric inpatient unit closures on transfers to tertiary care paediatric hospital." Paediatrics & Child Health 27, Supplement_3 (October 1, 2022): e38-e38. http://dx.doi.org/10.1093/pch/pxac100.078.

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Abstract Background During Wave 3 of the COVID-19 pandemic, 15 community hospital paediatric inpatient units (comprising 167 beds) in Toronto were directed to close by the Greater Toronto Area (GTA) Hospital Incident Management System (IMS) Command Centre to increase adult inpatient bed capacity. All paediatric patients from closed inpatient units were redirected to a single tertiary care paediatric hospital, which increased capacity to accommodate these additional patients through activation of surge plans, while community hospitals redeployed resources to fill much needed gaps in adult care. Objectives The objective was to describe patient characteristics of all transfers during the closure to explore the impact of community paediatric inpatient unit closures on transfers to the tertiary hospital. Design/Methods A chart review of all transferred patients was conducted during the mandated closure and subsequent reopening. Transfers excluded ICU-level transfers as these were not impacted by IMS mandated closures. All transfers were categorized as requiring tertiary care (i.e. would typically be transferred) or not requiring tertiary care (i.e. only transferred due to the closure). Variables collected included sending hospital, admitting diagnosis, patient age, hospital disposition, and length of stay. Data was collected until the last paediatric unit reopened. Quality improvement project approval was granted by the institution. Results A total of 858 patients were transferred to the tertiary hospital during the 67 day closure; of those, 530 were transferred solely to increase adult bed capacity (i.e. were categorized as patients requiring non-tertiary care). The majority of patients were admitted to general paediatrics (52%), and 39% went to a surgical inpatient unit. Most patients (68%) admitted had a length of stay between 24 and 72 hours. A third of patients admitted were under 2 years old, and a third were over 12 years old. The top three diagnoses for admission were infections, gastrointestinal issues, and general surgery. Two-thirds (60%) of transfers from closed sites came from three sites. Conclusion More than half of the transfers occurred solely due to the mandated closures, and transfers returned to a stable volume once all sites re-opened. The GTA hospital system was able to respond to the mandated closure effectively through clear high-level communication, escalation processes and structures as well as responsive, real-time problem solving. Closures increased potential adult inpatient capacity by 6740 bed days and demonstrated an unprecedented system-wide approach to the provision of integrated paediatric care across the region.

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Hare, Lucy, G. A. Amos Burke, and Suzanne D. Turner. "Resistance to Targeted Agents Used to Treat Paediatric ALK-Positive ALCL." Cancers 13, no. 23 (November 29, 2021): 6003. http://dx.doi.org/10.3390/cancers13236003.

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Non-Hodgkin lymphoma (NHL) is the third most common malignancy diagnosed in children. The vast majority of paediatric NHL are either Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), anaplastic large cell lymphoma (ALCL), or lymphoblastic lymphoma (LL). Multi-agent chemotherapy is used to treat all of these types of NHL, and survival is over 90% but the chemotherapy regimens are intensive, and outcomes are generally poor if relapse occurs. Therefore, targeted therapies are of interest as potential solutions to these problems. However, the major problem with all targeted agents is the development of resistance. Mechanisms of resistance are not well understood, but increased knowledge will facilitate optimal management strategies through improving our understanding of when to select each targeted agent, and when a combinatorial approach may be helpful. This review summarises currently available knowledge regarding resistance to targeted therapies used in paediatric anaplastic lymphoma kinase (ALK)-positive ALCL. Specifically, we outline where gaps in knowledge exist, and further investigation is required in order to find a solution to the clinical problem of drug resistance in ALCL.

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Oracz, Grzegorz. "Small patient – big problem. Diagnostics and treatment of gastroesophageal reflux in infants and young children." Medycyna Faktów 14, no. 1 (March 31, 2021): 69–77. http://dx.doi.org/10.24292/01.mf.0121.9.

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Gastroesophageal reflux is the movement of gastric contents into the esophagus. Is one of the most common motility disorders in children. In newborns and infants predominant is physiological reflux caused by immaturity of digestive tract. Gastroesophageal reflux disease is reflux that causes complications and/or esophagitis. Article presents actual gastroesophageal reflux disease diagnostic and treatment recommendations according to the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines.

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M.K.Osminina, M. K. Osminina, I. A. Dronov I.A.Dronov, S. S. Telkova S.S.Telkova, A. V. Skvortsov A.V.Skvortsov, and N. S. Podchernyaeva N.S.Podchernyaeva. "Vaccination of children with autoimmune rheumatic diseases. Current state of the problem." Voprosy praktičeskoj pediatrii 16, no. 3 (2021): 72–83. http://dx.doi.org/10.20953/1817-7646-2021-3-72-83.

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Vaccination of children with autoimmune rheumatic diseases is a significant problem since infectious diseases remain the main cause of complications of anti-rheumatic therapy and one of the leading causes of death in this category of patients. This review presents current information on the frequency of comorbid infections, the accumulated experience of vaccination in children with autoimmune rheumatic diseases. The recommendations of The European League Against Rheumatism (EULAR) for vaccination in paediatric patients with rheumatic diseases are presented in detail. The presence of rheumatic disease is not an exception for vaccination, it is recommended for all children following national guidelines. Non-live vaccines are effective and safe in paediatric patients with rheumatic diseases. Live vaccines are not recommended for patients receiving high doses of glucocorticoids, immunosuppressive and biologics therapy due to the risk of infectious complications. Vaccination against pneumococcal infection and seasonal influenzais are hihgly recommended. Key words: vaccination, children, autoimmune rheumatic diseases, guidelines, review

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Esposito, Susanna, Giampiero Ricci, Riccardo Gobbi, Claudio Vicini, Fabio Caramelli, Silvia Pizzi, Agatina Fadda, Salvatore Ferro, and Giuseppe Plazzi. "Diagnostic and Therapeutic Approach to Children and Adolescents with Obstructive Sleep Apnea Syndrome (OSA): Recommendations in Emilia-Romagna Region, Italy." Life 12, no. 5 (May 16, 2022): 739. http://dx.doi.org/10.3390/life12050739.

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Obstructive sleep apnoea syndrome (OSA) in paediatrics is a rather frequent pathology caused by pathophysiological alterations leading to partial and prolonged obstruction (hypoventilation) and/or intermittent partial (hypopnoea) or complete (apnoea) obstruction of the upper airways. Paediatric OSA is characterised by daytime and night-time symptoms. Unfortunately, there are few data on shared diagnostic-therapeutic pathways that address OSA with a multidisciplinary approach in paediatric age. This document summarizes recommendations from the Emilia-Romagna Region, Italy, developed in order to provide the most appropriate tools for a multidisciplinary approach in the diagnosis, treatment and care of paediatric patients with OSA. The multidisciplinary group of experts distinguished two different ‘step’ pathways, depending on the age group considered (i.e., under or over two years). In most cases, these pathways can be carried out by the primary care paediatrician, who represents the first filter for approaching the problem. For this reason, it is essential that the primary care paediatrician receives adequate training on how to formulate the diagnostic suspicion of OSA and on what criteria to use to select patients to be sent to the hospital centre. The relationship between the paediatrician of the patient and her/his parents must see a synergy of behaviour between the various players in order to avoid uncertainty about the diagnostic and therapeutic decisions as well as the follow-up phase. The definition and evaluation of the organizational process and outcome indicators of the developed flow-chart, and the impact of its implementation will remain fundamental.

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Shevchuk, D. V., A. M. Bilochenko, and L. V. Shevchuk. "Pelvic varices in paediatric surgical practice: current state of the problem." Paediatric Surgery. Ukraine 52-53, no. 3-4 (December 27, 2016): 81–89. http://dx.doi.org/10.15574/ps.2016.52-53.81.

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Kagura, J., K. K. Ong, L. S. Adair, J. M. Pettifor, and S. A. Norris. "Paediatric hypertension in South Africa: An underestimated problem calling for action." South African Medical Journal 108, no. 9 (August 28, 2018): 708. http://dx.doi.org/10.7196/samj.2018.v108i9.13317.

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Journal articles on the topic 'Paediatric problem'

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