بایگانی برچسب برای: children

Imaging.Acute.Abdomen.in.Children.[taliem.ir]

Imaging Acute Abdomen in Children

Abdominal pain or symptoms related to the gastrointestinal, urinary or genital tract are common complaints and frequent reason for admission of children in the emergency department (ED) . Despite the relatively benign nature of the most common diseases treated in the paediatric ED, there are some clinical entities that can have adverse outcomes. How high is the index of suspicion among clinicians for such serious pathologies and how well aware are they of recent advances in their diagnosis and treatment? What are the clinical pitfalls to be avoided? One issue is to detect the child with a rare and potentially severe condition among all children with more common diagnoses in the ED. A second issue is the management of abdominal diseases in very young children, who often present with less specifc signs. A third issue is more and more often the admission of children soon after the onset of the frst symptoms. In this situation, the repetition of initially normal examinations could be necessary. The mechanisms of intra-abdominal diseases can be of vascular, obstructive or infectious origin. The causes vary with the age of the child, although almost all causes can be seen at any age. For example, intussusception usually occurs in children 2 months to 2 years of age. When it is described (rarely) in older children, an underlying disease has to be searched.
Pediatric.Cytopathology.A.Practical.Guide.[taliem.ir]

Pediatric Cytopathology

Fine needle aspiration (FNA) is a reliable, minimally invasive, cost effective technique for obtaining samples from superficial and deep mass lesions for pathologic evaluation. Despite these advantages, physicians in the USA have been slow to embrace FNA as a primary diagnostic modality in the pediatric population . Obstacles to the acceptance and use of FNA include diagnostic challenges posed by the overall rarity and spectrum of tumors seen in children and adolescents, the experience and biases of clinicians and pathologists, and practical and technical considerations. Cytopathologists who are experienced in the performance and interpretation of FNAs may have limited familiarity with the spectrum and morphologic appearances of tumors seen in the pediatric population. Conversely, pediatric pathologists who are familiar with the histologic features and differential diagnosis of tumors encountered in children and adolescents often have little experience performing and/or interpreting FNAs. Likewise, clinicians who have extensive experience performing endoscopic or endobronchial ultrasound guided FNAs may have little experience with endoscopy or bronchoscopy of pediatric patients, and vice versa. These factors can impact the quality of the specimen and/or interpretation and lead to the need for a second procedure in order to arrive at a definitive diagnosis, thereby limiting the value of FNA as a diagnostic modality . Practical considerations include the cognitive and emotional maturity of the child or adolescent, and the need for immobilization, sedation, or anesthesia. Alone or in combination, these and other challenges and limitations have contributed to reluctance on the part of both pathologists and clinicians to promote the use of FNA as a primary diagnostic modality in the pediatric population.
Hematological.Disorders.in.Children.Pathogenesis.[taliem.ir]

Hematological Disorders in Children

Hematopoietic stem cells (HSCs), which are responsible for producing all blood cell types, frst appear in the early stage of embryonic development and transit through several different tissues, including the yolk sac, aorta-gonadmesonephros (AGM) region, placenta, and fetal liver, before colonizing in the bone marrow where they reside throughout the individual’s life. HSCs, characterized by the ability to self-renew and generate all types of blood cells, are supported by their specifc environment called niches and depend on many developmental signaling pathways, molecules, and cytokines for their generation, maintenance, and expansion. Any disruption in this well-balanced system may cause aberrant HSC production, leading to malignant hematopoiesis. Leukemic stem cells (LSCs), originally identifed using xenograft models of acute myeloid leukemia (AML), are a distinct cell population that can initiate leukemia in immunodefcient mice. LSCs are thought to emerge from HSCs or hematopoietic progenitors after obtaining multiple genetic changes that provide aberrant growth advantage and self-renewal ability. The emergence of LSCs is a multi-step event, including genetic diversifcation and clonal selection, resulting in genetic heterogeneity among leukemic cells. LSCs generally exist in the immature CD34+CD38- leukemic population in most cases of AML and share some features with normal HSCs. However, recent studies have shown that in acute lymphoblastic leukemia (ALL), LSCs exist in B-lineagecommitted progenitors expressing CD19. In contrast to that in AML, in which LSCs generate leukemic cells in a hierarchical order with LSCs at the top, leukemia propagation in ALL is better explained by a stochastic model.
Gastroesophageal.Reflux.in.Children.GER.in.Children.[taliem.ir]

Gastroesophageal Reflux in Children

Determination of the exact prevalence of gastroesophageal reflux (GER) and GER disease (GERD) at any age is virtually impossible mainly because symptoms are not specifc, not all patients seek medical help, many patients are not (fully) investigated, and prospective data are limited. Many epidemiologic studies evaluated in infancy the frequency of regurgitation which is a common physiologic symptom in the frst months of life with a spontaneous recovery in nearly all infant. Many other esophageal and extraesophageal symptoms and signs of GER(D) have been reported, but sensitivity and specifcity are low, the causal relation is uncertain, and there is a lack of diagnostic gold standard technique. While reflux occurs physiologically at all ages, there is also a continuum between physiologic GER and GERD leading to different manifestations and complications depending on individual sensitivity and perception, defense mechanisms, mucosal resistance, and possible genetic influence. In selected population such as children with neurological impairment, cystic fbrosis, and esophageal atresia, severe persisting GER and esophageal complications have been frequently reported. Whether early treatment of GER(D) signifcantly changes, the incidence or severity of symptoms and complications in adults is uncertain.
Endocrine.Surgery.in.Children.[taliem.ir]

Endocrine Surgery in Children

This chapter reviews the embryology, anatomy, and physiology of the thyroid gland with special emphasis on how these topics relate to surgical conditions and surgical decision-making. First, thyroid development is reviewed since it is the essential foundation to understand thyroid anatomy. Next, the anatomy of the thyroid, its blood supply and its relationship to nearby nerves are reviewed to understand the conduct of thyroid operations and the risks and complications of those operations. Finally, the details of the thyroid gland’s principle function—the synthesis and secretion of thyroid hormones—are considered. Understanding these normal physiologic functions and their control provides insight into the diagnostic evaluation and treatment of thyroid diseases. Parathyroid gland embryology, anatomy, and function are reviewed in Chap. 5.
Marketing And Media Communications Targeted To Children As.[taliem.ir]

Marketing And Media Communications Targeted To Children As Consumers

Marketing and media communication targeted to children as consumers is recently a topic of discussion in order to increase children consumer protection. Considering that children and youth spend a lot of time in media environment (Multi-tasking process), it is important to map the environment, including both the traditional marketing communication ways (TV, radio, DVD video-games) and the new methods that are increasingly being preferred by children and youth (e.g. product placement, viral marketing, guerilla marketing, internet and social network environment, interactive games and quizzes, commercial website entertainment). Children are referred to as primary target group in the given communication, that is, the advertised products are addressed to they, as well as secondary target group, that is, the products are addressed to other members of the family, but the message focuses upon children as they significantly influence the shopping process in the family. This marketing communication mix, which consists of advertising, sales promotion, personal selling, public relations, uses both traditional as well as new tools and techniques which target the children's segment. In this paper, we focus on the traditional marketing techniques applied by the media environment (e.g. repetition, celebrity endorsements, and premiums) as well as new techniques emphasizing their application in educational practice.
Marketing And Media Communications Targeted To Children As[taliem.ir]

Marketing And Media Communications Targeted To Children As Consumers

Marketing and media communication targeted to children as consumers is recently a topic of discussion in order to increase children consumer protection. Considering that children and youth spend a lot of time in media environment (Multi-tasking process), it is important to map the environment, including both the traditional marketing communication ways (TV, radio, DVD, video-games) and the new methods that are increasingly being preferred by children and youth (e.g. product placement, viral marketing, guerilla marketing, internet and social network environment, interactive games and quizzes, commercial website entertainment). Children are referred to as primary target group in the given communication, that is, the advertised products are addressed to they, as well as secondary target group, that is, the products are addressed to other members of the family, but the message focuses upon children as they significantly influence the shopping process in the family. This marketing communication mix, which consists of advertising, sales promotion, personal selling, public relations, uses both traditional as well as new tools and techniques which target the children's segment. In this paper, we focus on the traditional marketing techniques applied by the media environment (e.g. repetition, celebrity endorsements, and premiums) as well as new techniques emphasizing their application in educational practice.
Effects of exercise training on blood lipids and lipoproteins in children and[taliem.ir]

Effects of exercise training on blood lipids and lipoproteins in children and adolescents

The following review aims to describe what is known about the effects of exercise training in children and adolescents on the following blood lipids and lipoproteins: total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglycerides (TG). Only studies that described mode, frequency, duration and intensity of the exercise were included in the review. The results of the studies reviewed were equivocal. Clearly the effects of exercise training on the blood lipid and lipoprotein levels of normolipidemic children and adolescents are equivocal. Of the 14 studies reviewed, six observed a positive alteration in the blood lipid and lipoprotein profile, four of the studies observed no alteration in the blood lipid and lipoprotein profile and one study observed a negative effect on HDL-C but an overall improvement in the lipid and lipoprotein profile due to the decrease in the TC/HDL ratio. It appears that methodological problems present in the majority of the exercise training studies limits the ability to make a conclusive, evidence based statement regarding the effect exercise training has on blood lipid levels in normolipidemic children. Most of the research design flaws can be linked to one or more of the following: small numbers of subjects in each study, low or no representation of girls, inclusion of both boys and girls in the subject pool, inclusion of boys and girls at different maturational stages in the subject pool, exercise training regimes that do not adequately control for exercise intensity, exercise training regimes that do not last longer than 8 weeks and exercise training studies that do not have an adequate exercise volume to elicit a change. Ideally, future research should focus on longitudinal studies which examine the effects of exercise training from the primary school years through adulthood