Current Issue : April - June Volume : 2014 Issue Number : 2 Articles : 7 Articles
Background. Current health services interventions focus on the treatment of the musculoskeletal impairments of cerebral palsy\r\n(CP). The goal of this study was to explore whether the severity of physical symptoms correlates with psychosocial quality of\r\nlife (QOL) among pediatric patients with CP. Methods. A sample of 53 caregivers of children with CP was surveyed and health\r\nstatus information was extracted from patient medical records. Descriptive analysis explored the association between the main\r\noutcome variable, psychosocial QOL (CP QOL-child), and patient demographics, comorbidity (e.g., visual, hearing and feeding\r\nimpairments, language delays, and epilepsy), CP severity (GMFCS), and the receipt of family centered care (MPOC-20). Results.\r\nChild psychosocial QOL decreased with increasing comorbidity but was not associated with CP symptom severity or anymeasured\r\ndemographic factors. Reporting high levels of family centered care (FCC) was associated with higher psychosocial QOL in\r\nunivariate analysis but was not significant when controlling for comorbidities. Conclusion. There is no clear connection between\r\nsymptom severity and psychosocial QOL in childrenwithCP. Comorbidity however is strongly associatedwith psychosocial QOL.\r\nFocusing on reducing CP comorbidities could have a positive impact on psychosocial QOL....
Background.While increasing evidence links environments to health behavior, clinicians lack information about patients� physical\r\nactivity levels and lifestyle environments. We present mobile health tools to collect and use spatio-behavioural lifestyle data for\r\npersonalized physical activity plans in clinical settings. Methods.The Dyn@mo lifestyle intervention was developed at the Sainte-\r\nJustine University Hospital Center to promote physical activity and reduce sedentary time among children with cardiometabolic\r\nrisk factors. Mobility, physical activity, and heart rate were measured in free-living environments during seven days. Algorithms\r\nprocessed data to generate spatio-behavioural indicators that fed a web-based interactive mapping application for personalised\r\ncounseling. Proof of concept and tools are presented using data collected among the first 37 participants recruited in 2011. Results.\r\nValid accelerometer data was available for 5.6 (SD = 1.62) days in average, heart rate data for 6.5 days, and GPS data was\r\navailable for 6.1 (2.1) days. Spatio-behavioural indicators were shared between patients, parents, and practitioners to support\r\ncounseling. Conclusion. Use of wearable sensors along with data treatment algorithms and visualisation tools allow to better\r\nmeasure and describe real-life environments, mobility, physical activity, and physiological responses. Increased specificity in\r\nlifestyle interventions opens new avenues for remote patient monitoring and intervention....
Background. Erythrocyte sedimentation rate (ESR) is a valuable laboratory tool in evaluation of infectious, inflammatory, and\r\nmalignant diseases. Red blood cells in outside from the body precipitate due to their higher density than the plasma. In this study\r\nwe discuss the IVIG effect on ESR in different diseases and different ages. Methods and Materials. Fifty patients under 12 years old\r\nwho had indication to receive IVIG enrolled in this study. Total dose of IVIG was 2 gr/kg (400mg/kg in five days or 2 gr/kg in single\r\ndose). ESR before infusion of IVIG and within 24 hours after administration of the last dose of IVIG was checked. Results. 23 (46%)\r\npatients weremales and 27 (54%) were females. The mean of ESR before IVIG was 31.8�±29.04 and after IVIG it was 47.2�±36.9; this\r\ndifference was meaningful (?? = 0.05). Results of ESR changes in different age groups, 6 patients less than 28 days, 13 patients from\r\n1 month to 1 year, 20 patients from 1 to 6 years old, and 11 patients from 6 to 12 years have beenmeaningful (?? = 0.001, ?? = 0.025,\r\nand ?? = 0.006, resp.). Conclusion. In patients who are receiving IVIG as a therapy, ESR increased falsely (noninflammatory rising);\r\ntherefore use of ESR for monitoring of response to treatment may be unreliable. Although these results do not apply to neonatal\r\ngroup, we suggest that, in patients who received IVIG, interpretation of ESR should be used cautiously on followup....
Aims. Kawasaki disease is an acute systemic vasculitis and is the most common cause of acquired heart disease in children in\r\nthe developed world. This review aims to synthesise recent insights into the disease and provide an update for clinicians on\r\ndiagnostic and treatment practices. Methods.We conducted a review of the literature exploring epidemiology, aetiology, diagnosis,\r\nandmanagement of Kawasaki disease.We searched MEDLINE,Medline In-Process, Embase, Google Scholar, and reference lists of\r\nrelevant articles. Conclusions. Kawasaki disease is a febrile vasculitis which progresses to coronary artery abnormalities in 25% of\r\nuntreated patients. The disease is believed to result froma genetically susceptible individualââ?¬â?¢s exposure to an environmental trigger.\r\nIncidence is rising worldwide, and varies widely across countries and within different ethnic groups. Diagnosis is based on the\r\npresence of fever in addition to four out of five other clinical criteria, but it is complicated by the quarter of the Kawasaki disease\r\npatients with ââ?¬Å?incompleteââ?¬Â presentation. Treatment with intravenous immunoglobulin within ten days of fever onset improves\r\nclinical outcomes and reduces the incidence of coronary artery dilation to less than 5%. Given its severe morbidity and potential\r\nmortality, Kawasaki disease should be considered as a potential diagnosis in cases of prolonged paediatric fever....
Kawasaki disease (KD) is a systemic vasculitis and can develop multiple organ injuries including kidney and urinary tract\r\ninvolvement. These disorders include pyuria, prerenal acute kidney injury (AKI), renal AKI caused by tubulointerstitial nephritis\r\n(TIN), hemolytic uremic syndrome (HUS), and immune-complex mediated nephropathy, renal AKI associated with either\r\nKawasaki disease shock syndrome or unknown causes, acute nephritic syndrome (ANS), nephrotic syndrome (NS), renal tubular\r\nabnormalities, renal abnormalities in imaging studies, and renal artery lesions (aneurysms and stenosis). Pyuria is common in\r\nKD and originates from the urethra and/or the kidney. TIN with AKI and renal tubular abnormalities probably result from renal\r\nparenchymal inflammation caused by T-cell activation. HUS and renal artery lesions are caused by vascular endothelial injuries\r\nresulting fromvasculitis. Some patients with ANS have immunological abnormalities associated with immune-complex formation.\r\nNephromegaly and renal parenchymal inflammatory foci are detected frequently in patients with KD by renal ultrasonography and\r\nrenal scintigraphy, respectively. Although the precise pathogenesis of KD is not completely understood, renal vasculitis, immunecomplex\r\nmediated kidney injuries, or T-cell immune-regulatory abnormalities have been proposed as possible mechanisms for the\r\ndevelopment of kidney and urinary tract injuries....
Type 2 diabetes (T2D) was an adult disease until recently, but the rising rates of obesity around the world have resulted in a younger\r\nage at presentation. Children who have T2D have several comorbidities and complications reminiscent of adult diabetes, but these\r\nare appearing in teens instead of midlife. In this review, we discuss the clinical presentation and management options for youth with\r\nT2D.We discuss the elements of lifestyle intervention programs and allude to pharmacotherapeutic options used in the treatment\r\nof T2D youth.We also discuss comorbidities and complications seen in T2D in children and adolescents....
Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover\r\n(LSVRO) incidents involving children aged 0ââ?¬â??15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries\r\nfrom the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study\r\ninclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk\r\nfactors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5\r\nyears, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies\r\nidentified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with\r\nLSVRO injury. Vehicles were most commonly driven by a familymember, predominantly a parent. Conclusion.There are a number\r\nof modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been\r\nidentified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance\r\nsystems), housing design (physical separation of driveway and play areas), and behaviour (driver behaviour, supervision of young\r\nchildren) are discussed....
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