• Title/Summary/Keyword: Pediatric practice

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Practical Approach of Rectal Bleeding in Children (진료실에서 유용한 혈변 환자에 대한 접근)

  • Kim, Jae Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup1
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    • pp.15-22
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    • 2008
  • Rectal bleeding is a common and worrisome problem in pediatric practice. The condition is usually alarming to patient and children. Although most cases are benign and self-limited, sometimes serious pathology also present in this manner. And severe rectal bleeding necessitates prompt diagnostic notice and appropriate treatment. The etiologies of rectal bleeding are somewhat specific to certain age group in children. Accurate history and through physical examination are paramount importance to help differentiate of the diverse etiologies causing rectal bleeding in children. This review describes patterns of rectal bleeding, historical and physical aspect, differentiation of clinical characteristics of rectal bleeding according to etiology, and diagnostic investigations.

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Nutritional Counseling for Obese Children with Obesity-Related Metabolic Abnormalities in Korea

  • Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.2
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    • pp.71-78
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    • 2017
  • Child obesity has become a significant health issue in Korea. Prevalence of obesity in school-age children in Korea has been alarmingly rising since 2008. Prevalence of obesity among infants and preschool-age children in Korea has doubled since 2008. Obese children may develop serious health complications. Before nutritional counseling is pursued, several points should be initially considered. The points are modifiable risk factors, assessment for child obesity, and principles of treatment. Motivational interviewing and a multidisciplinary team approach are key principles to consider in managing child obesity effectively in the short-term as well as long-term. Nutritional counseling begins with maintaining a daily log of food and drink intake, which could possibly be causing obesity in a child. Several effective tools for nutritional counseling in practice are the Traffic Light Diet plan, MyPlate, Food Balance Wheel, and 'Food Exchange Table'. Detailed nutritional counseling supported by a qualified dietitian is an art of medicine enabling insulin therapy and hypoglycemic agents to effectively manage diabetes mellitus in obese children.

Computerized intraligamental anesthesia in children: A review of clinical considerations

  • Baghlaf, Khlood;Elashiry, Eman;Alamoudi, Najlaa
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.197-204
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    • 2018
  • Pain control by means of local anesthesia is an intrinsic part of clinical practice in dentistry. Several studies evaluated intraligamental anesthesia using a computer-controlled anesthetic device in children. There is a need to provide a clinical guide for the use of computerized intraligamental anesthesia in children. Intraligamental anesthesia using a computer-controlled anesthetic device was found to cause significantly lower pain perception scores and lower pain-related behavior than traditional techniques. This device proven to be effective in restorative and pulp treatment in children; however, its effectiveness in primary teeth extraction is controversial. It is important to withdraw recommendations necessity of future studies concerning the side effects of computerized intraligamental anesthesia in children. The present study aims to review different clinical aspects of computerized intraligamental anesthesia in children along with the side-effects, type of local anesthesia and postoperative pain of this technique. This study provides dentists with a clinical guide for the use of computerized intraligamental anesthesia.

Factors Affecting Nursing Students' Perception on Pediatric Patient Safety Culture and Nursing Activity (간호대학생의 입원아동 안전간호활동 인식 영향 요인)

  • Park, Eunsook;Oh, Won-Oak;Kim, Mirim
    • Child Health Nursing Research
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    • v.23 no.4
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    • pp.534-542
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    • 2017
  • Purpose: The purpose of this study was to identify the factors that affect nursing students' perception of pediatric safety nursing activities for children during hospitalization. Methods: The study sample included 304 nursing students who had participated in pediatric nursing practice. Data were analyzed using SAS 9.3 program. Results: Regression analysis showed that the model's explanatory power was 37%. Safety policy and procedure, safety priority, disaster experience, and knowing a place of refuge were factors affecting the perception of safety nursing activities for children during hospitalization. Conclusion: Findings show that safety policy and procedures and safety priority are major factors that affect the perception of safety nursing activities and indicate that effective education programs on safety policy and procedure and safety priority are necessary to improve the perception of safety nursing activities.

Effects of nasopharyngeal microbiota in respiratory infections and allergies

  • Kang, Hyun Mi;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.64 no.11
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    • pp.543-551
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    • 2021
  • The human microbiome, which consists of a collective cluster of commensal, symbiotic, and pathogenic microorganisms living in the human body, plays a key role in host health and immunity. The human nasal cavity harbors commensal bacteria that suppress the colonization of opportunistic pathogens. However, dysbiosis of the nasal microbial community is associated with many diseases, such as acute respiratory infections including otitis media, sinusitis and bronchitis and allergic respiratory diseases including asthma. The nasopharyngeal acquisition of pneumococcus, which exists as a pathobiont in the nasal cavity, is the initial step in virtually all pneumococcal diseases. Although the factors influencing nasal colonization and elimination are not fully understood, the adhesion of opportunistic pathogens to nasopharyngeal mucosa receptors and the eliciting of immune responses in the host are implicated in addition to bacterial microbiota properties and colonization resistance dynamics. Probiotics or synbiotic interventions may show promising and effective roles in the adjunctive treatment of dysbiosis; however, more studies are needed to characterize how these interventions can be applied in clinical practice in the future.

Comparative Analysis of American Academy of Pediatrics and European Society of Hypertension Guidelines for the Diagnosis and Treatment of Pediatric Hypertension

  • Park, Se Jin;Shin, Jae Il
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.71-77
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    • 2021
  • Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.

Mechanism, clinical consequences, and management of dyslipidemia in children with nephrotic syndrome

  • Baek, Hee Sun
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.25-30
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    • 2022
  • Dyslipidemia in nephrotic syndrome (NS) is often characterized by marked increases in the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and other lipoproteins, such as very low-density lipoprotein, intermediate-density lipoprotein, and lipoprotein(a). It has been suggested that impaired catabolism of lipoproteins and cholesterol is mainly due to decreased lipoprotein lipase and hepatic lipase activity, and increased biosynthesis of lipoproteins in the liver. The management strategies for dyslipidemia in patients with NS consist of lifestyle modification, lipid-lowering agents represented by statins, second-line agents such as fibrates and bile acid sequestrants, and lipid apheresis. Compared with dyslipidemia in adult NS patients, whose risks of atherosclerotic disease and progressive renal injury are considered high, clinical data on dyslipidemia in pediatric NS patients are limited. Therefore, it is necessary to pay more attention to the evaluation and management of dyslipidemia in pediatric patients with NS in clinical practice.

Introducing the general management of glomerular disease from a pediatric perspective based on the updated KDIGO guidelines

  • Seon Hee Lim
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.55-63
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    • 2023
  • In 2021, a new chapter on the general management of glomerulonephritis (GN) was added to the Kidney Disease: Improving Global Outcomes (KDIGO). It emphasizes the importance of early general management of GN for improving long-term kidney outcomes and prognosis. The chapter introduces the management of glomerular diseases in 18 subchapters. Here, kidney biopsy for the diagnosis and evaluation of kidney function and the management of complications, such as hypertension, infection, and thrombosis, are presented. Moreover, the adverse effects of glucocorticoids and immunosuppressive therapy, which are commonly used drugs for glomerular disease, are mentioned, and a guideline for drug selection is presented. Each subtheme focused on items reflecting the interpretation of the "practice points" of the expert working group are introduced. In this review of the general treatment for GN in the KDIGO guidelines, excluding pregnancy and reproductive health, we focused on and compared various references pertaining to pediatric GN management.

Long-term Complications of Stevens-Johnson Syndrome on Permanent Teeth : A Case Report

  • Dabin Kim;Myeongkwan Jih;Nanyoung Lee
    • Journal of Korean Dental Science
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    • v.17 no.2
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    • pp.75-83
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    • 2024
  • Stevens-Johnson syndrome (SJS) is a severe adverse cutaneous drug reaction seen rarely in clinical practice. Although relatively rare, the condition can be fatal. Mainly, it is caused by side effects of certain medications. Previous reports have associated Stevens-Johnson syndrome with abnormal root development, but the other long-term dental complications have rarely been reported. In this case, the patient developed SJS at the age of 5, and abnormal root development of the maxillary and mandibular first molars and mandibular incisors was observed, as well as impaction of the mandibular canine and enamel hypomineralization of multiple teeth. Accordingly, appropriate restorative treatment and orthodontic treatment were performed, and the clinical characteristics of this symptoms and its treatment were discussed in more detail. We aim to highlight the need for dentists to be aware of the potential dental complications of SJS and to enable early diagnosis and management of the condition to avoid undesirable sequelae.

Four-Dimensional Thoracic CT in Free-Breathing Children

  • Hyun Woo Goo
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.50-57
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    • 2019
  • In pediatric thoracic CT, respiratory motion is generally treated as a motion artifact degrading the image quality. Conversely, respiratory motion in the thorax can be used to answer important clinical questions, that cannot be assessed adequately via conventional static thoracic CT, by utilizing four-dimensional (4D) CT. However, clinical experiences of 4D thoracic CT are quite limited. In order to use 4D thoracic CT properly, imagers should understand imaging techniques, radiation dose optimization methods, and normal as well as typical abnormal imaging appearances. In this article, the imaging techniques of pediatric thoracic 4D CT are reviewed with an emphasis on radiation dose. In addition, several clinical applications of pediatric 4D thoracic CT are addressed in various thoracic functional abnormalities, including upper airway obstruction, tracheobronchomalacia, pulmonary air trapping, abnormal diaphragmatic motion, and tumor invasion. One may further explore the clinical usefulness of 4D thoracic CT in free-breathing children, which can enrich one's clinical practice.