scholarly journals Differential Diagnosis of Vertigo in Children

2019 ◽  
Vol 02 (01) ◽  
pp. 21-26
Author(s):  
Anita Bhandari ◽  
Arpana Goswami
Keyword(s):  
Differential Diagnosis ◽  
Management Strategy ◽  
Pediatric Patients ◽  
Age Groups ◽  
Clinical History ◽  
Chief Complaint ◽  
Balance Disorders ◽  
Peripheral Vestibulopathy ◽  
Delay Of Treatment

Abstract Introduction Vertigo and balance disorders can affect all age groups. It is common to misdiagnose the cause of dizziness in children, which eventually results in the delay of treatment. The purpose of this study was to review the clinical characteristics and neurotological evaluation of vertigo in patients younger than 16 years and assist in making a differential diagnosis for children with vertigo and balance disorders. The differential diagnosis can help determine the correct management strategy to treat vertigo and imbalance in pediatric patients. Methods Children and adolescents presenting with a chief complaint of vertigo or unsteadiness to Vertigo and Ear Clinic, Jaipur, were selected for this study on the basis of clinical history, physical examination, and neurotological evaluation. Results A total of 90 patients with a mean age of 10.67 years were evaluated. The most common cause associated with vertigo or dizziness was found to be vestibular migraine seen in 38 participants of this study. This was followed by unilateral peripheral vestibulopathy in 15 patients, bilateral peripheral vestibulopathy in 11 patients, and central vestibulopathy in 6 patients. Vertigo was also seen to be associated with various other disorders. Conclusion Vertigo in children must be recognized as a definite symptom, which should be taken seriously by the clinician and family. Pediatric vertigo can be due to many etiologies. History and evaluation are the only way to diagnose the etiology and site of lesion. This will prevent misdiagnosis and delay in the treatment, which can ultimately lead to deterioration of the quality of life.

scholarly journals Differential Diagnosis and Treatment of Itching in Children and Adolescents

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 919
Author(s):  
Seok-Young Kang ◽  
Ji-Young Um ◽  
Bo-Young Chung ◽  
Jin-Cheol Kim ◽  
Chun-Wook Park ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Objective Assessment ◽  
Age Groups ◽  
Treatment Modalities ◽  
Systemic Diseases ◽  
Skin Disorders ◽  
Pharmacokinetics And Pharmacodynamics

Itching is prevalent in children with skin disorders and associated with effects on their mood, quality of life, and social functioning. Surprisingly, there are no data on childhood prevalence of pruritus in the general population. The aim of this article is to explore the epidemiology, clinical manifestation, and treatment for itch (pruritus) in the pediatric population (from infancy to adolescence), and to be helpful to primary care physicians who assess and diagnose pediatric patients with itching. In this study, we searched for specific keywords using PubMed and MEDLINE (Ovid) and, then, refined the retrieved searches for each cause and treatment. As a result of reviewing the literature, atopic dermatitis was shown to be the most common cause of itching, especially during infancy and through preschool. Not only skin disorders but also systemic diseases, drugs, and postburn states can predispose an individual to itching in childhood. There are traditional and newly developed treatment modalities for itching in pediatric patients. However, because the pharmacokinetics and pharmacodynamics of childhood are different from those of adults, the medications for itching have to be applied carefully for these age groups. There are many areas to be elucidated regarding the prevalence and objective assessment of pruritus in pediatric patients. Moreover, the safety profiles of medications in the pediatric population need to be better understood. Further studies to investigate itching in childhood are warranted.

scholarly journals An approach of clinical pharmacist pertaining to solve drug related problems in pediatric patients

2020 ◽  
Vol 9 (8) ◽  
pp. 1263
Author(s):  
S. Suwitha ◽  
Mohammed Fardan ◽  
Aswathy M. Shaji ◽  
Jimmer Joe ◽  
K. Hasif ◽  
...  
Keyword(s):  
Clinical Pharmacist ◽  
Prospective Observational Study ◽  
Pediatric Patients ◽  
Age Groups ◽  
Pharmacist Intervention ◽  
Drug Related Problems ◽  
Dose Selection ◽  
Level Of Involvement ◽  
Drug Choice

Background: The objectives of the study were to assess the outcomes of clinical pharmacist intervention in solving drug related problems in pediatric patients and to identify the drug related problems in accordance with the causes observed.Methods: It was a prospective observational study done over a period of six months (October 2019 to March 2020) at Apollo children’s hospital in Chennai.Results: Total of 480 subjects were enrolled into the study, out of which 248 were male children and 232 were female children. The patients were divided into 4 age groups. In this study 60.41% pediatric patients were prescribed with less than 5 drugs 290 (60.41%). Drug related problems which were identified during the study was classified according to Pharmaceutical Care Network Europe (PCNE) and drug-related problem (DRP) classification (v9.00). The most frequent DRP was drug choice problem 37 (33.33%). The total number of caused drug related problems was 73 and same number of interventions was given by clinical pharmacist. The most frequent cause of drug related problems was identified as dose selection 31 (42.46%). Outcomes of interventions revealed that 70 (95.89%) problems were solved overall.Conclusions: In this study, clinical pharmacist’s level of involvement has shown interesting results. Moreover, they play an essential role in improving patient safety and outcome, reducing cost and providing quality of care for ill patients.

scholarly journals Periostin as a predictor of uncontrolled asthma and lung function decrease in patient of different age groups

2021 ◽  
Vol 27 (4) ◽  
pp. 71-79
Author(s):  
A. V. Kamaev
Keyword(s):  
Pearson Correlation ◽  
Age Groups ◽  
Statistical Processing ◽  
Clinical History ◽  
Uncontrolled Asthma ◽  
Pearson Correlation Test ◽  
Open Prospective Study ◽  
Control Loss ◽  
Serum Periostin

Introduction. Uncontrolled bronchial asthma (BA) increases risk of hospitalizations, future exacerbations and decreases quality of life; factors improving the probability to achieve BA control are under study.Methods and materials. The open prospective study included 104 patients of three groups: children (6—11 years, n=38), adolescents (14—17 years, n = 35) and adults (25 — 50 years, n = 31). Inclusion criteria: BA duration >12 month, uncontrolled asthma, absence of acute respiratory infection for 14 days. Clinical history, respiratory function and sampling (serum and nasal brushings) for periostin assay were performed on Visit 1. Maintenance therapy correction and triggers avoiding recommendations were made. Two further visits 6 months apart were done. Statistical processing included ANOVA (Kruskall — Wallis test) and Pearson correlation test. Differences were considered significant when p<0.05.Results. 75 % of «Children» group,70.6 % of «Adolescents» and 53.6 % of «Adults» had achieved BA control. Obesity, non-atopic phenotype, FEV1 <65 % of predicted were risk factors of uncontrolled BA. Serum periostin levels were highest in uncontrolled BA subgroup, Me [Q25; Q75] =32.9 [28.6; 39.1] ng/ml. Nasal periostin levels were highest in «Adolescent» group: 9.8 [4.8; 11.2] ng/ml. Nasal periostin and low FEV1 had moderate reverse correlation (r=—0.61).Conclusion. Serum and nasal periostin levels could indicate treatment efficacy and prognose future risks of BA control loss.

scholarly journals Fibrosing arthropathy in juvenile scleroderma

2021 ◽  
Vol 15 (2) ◽  
pp. 64-68
Author(s):  
D. A. Dibrov ◽  
M. N. Starovoitova ◽  
O. V. Desinova
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Pediatric Patients ◽  
Disease Course ◽  
Disease Phenotype ◽  
Skin Tightening ◽  
Main Symptom ◽  
Pathogenetic Therapy ◽  
Juvenile Scleroderma

The group of scleroderma diseases includes a number of clinical entities, the main symptom of which is skin tightening. Scleroderma is a prominent example of these diseases, characterized by excessive synthesis and deposition of collagen in organs and tissues. A patient with juvenile systemic scleroderma with induration of the skin and underlying tissues, and persistent contractures of large joints since childhood, is described. This clinical example illustrates disease course peculiarities and differential diagnosis of systemic and limited (focal) scleroderma and scleroderma-like conditions in pediatric patients. The feasibility of pathogenetic therapy aimed at improving patient's the quality of life with formed disease phenotype is shown.

Ego Psychoanalytic Rorschach Interpretation

2017 ◽  
Vol 38 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Irving B. Weiner
Keyword(s):  
Differential Diagnosis ◽  
Sequence Analysis ◽  
Treatment Planning ◽  
Well Being ◽  
Adjustment Difficulties ◽  
Behavioral Features ◽  
Defensive Style ◽  
Cognitive Slippage ◽  
Interpretive Process

Abstract. This article concerns the utility of ego psychoanalytic perspectives in Rorschach interpretation. Psychoanalytic ego psychology focuses on how people cope with events in their lives and how effectively they can meet challenges to their sense of well-being. The way people deal with experienced distress constitutes their defensive style and determines to a large extent what kind of person they are. Adequate defenses against anxiety promote comfortable and productive adjustment, whereas ineffective defenses typically cause adjustment difficulties and susceptibility to psychological disorders. In Rorschach assessment, the nature and effectiveness of a person’s defensive style can often be identified with a sequence analysis that integrates the structural, thematic, and behavioral features in the protocol. In particular, the sequential quality of responses, especially preceding and following instances of cognitive slippage, can help identify causes of upsetting concerns, defensive efforts to alleviating these concerns, and the adequacy of these defensive efforts in restoring equanimity. This interpretive process is illustrated with attention to implications for differential diagnosis and treatment planning in the Rorschach protocol of a 20-year-old suicidal woman.

Hydrocephalus-related quality of life as assessed by children and their caregivers

2020 ◽  
Vol 26 (4) ◽  
pp. 353-363 ◽  
Author(s):  
Kathrin Zimmerman ◽  
Bobby May ◽  
Katherine Barnes ◽  
Anastasia Arynchyna ◽  
Elizabeth N. Alford ◽  
...  
Keyword(s):  
Posttraumatic Stress ◽  
Traumatic Stress ◽  
Pediatric Patients ◽  
Emotional Health ◽  
Social Emotional ◽  
Proxy Report ◽  
Cognitive Health ◽  
The Mean ◽  
Anxiety Depression

OBJECTIVEHydrocephalus is a chronic medical condition that has a significant impact on children and their caregivers. The objective of this study was to measure the quality of life (QOL) of children with hydrocephalus, as assessed by both caregivers and patients.METHODSPediatric patients with hydrocephalus and their caregivers were enrolled during routine neurosurgery clinic visits. The Hydrocephalus Outcomes Questionnaire (HOQ), a report of hydrocephalus-related QOL, was administered to both children with hydrocephalus (self-report) and their caregivers (proxy report about the child). Patients with hydrocephalus also completed measures of anxiety, depression, fatigue, traumatic stress, and headache. Caregivers completed a proxy report of child traumatic stress and a measure of caregiver burden. Demographic information was collected from administration of the Psychosocial Assessment Tool (version 2.0) and from the medical record. Child and caregiver HOQ scores were analyzed and correlated with clinical, demographic, and psychological variables.RESULTSThe mean overall HOQ score (parent assessment of child QOL) was 0.68. HOQ Physical Health, Social-Emotional Health, and Cognitive Health subscore averages were 0.69, 0.73, and 0.54, respectively. The mean overall child self-assessment (cHOQ) score was 0.77, with cHOQ Physical Health, Social-Emotional Health, and Cognitive Health subscore means of 0.84, 0.79, and 0.66, respectively. Thirty-nine dyads were analyzed, in which both a child with hydrocephalus and his or her caregiver completed the cHOQ and HOQ. There was a positive correlation between parent and child scores (p < 0.004 for all subscores). Child scores were consistently higher than parent scores. Variables that showed association with caregiver-assessed QOL in at least one domain included child age, etiology of hydrocephalus, and history of endoscopic third ventriculostomy. There was a significant negative relationship (rho −0.48 to −0.60) between child-reported cHOQ score and child-reported measures of posttraumatic stress, anxiety, depression, and fatigue. There was a similar significant relationship between caregiver report of child’s QOL (HOQ) and caregiver assessment of the child’s posttraumatic stress symptoms as well as their assessment of burden of care (rho = −0.59 and rho = −0.51, respectively). No relationship between parent-reported HOQ and child-reported psychosocial factors was significant. No clinical or demographic variables were associated with child self-assessed cHOQ.CONCLUSIONSPediatric patients with hydrocephalus consistently rate their own QOL higher than their caregivers do. Psychological factors such as anxiety and posttraumatic stress may be associated with lower QOL. These findings warrant further exploration.

Leukemia Support Groups: How Are They Doing?

1997 ◽  
Vol 4 (5) ◽  
pp. 407-412
Author(s):  
Donna Corwin Moss
Keyword(s):  
Quality Of Life ◽  
Support Groups ◽  
Age Groups ◽  
Cancer Treatments ◽  
Future Directions ◽  
Course Of Illness ◽  
New Concepts ◽  
Sources Of Support ◽  
Practical Impact

Background Support groups help their participants to cope with the emotional and practical impact of their illnesses. Methods The effectiveness of the Leukemia Society of America support groups in enhancing the quality of life for their participants is reviewed. The groundwork, purpose, and structure of such groups, as well as alternate sources of support, are presented. Evaluation and future directions for oncology groupwork are discussed. Results Support groups complement the therapies provided by clinical practitioners and scientists by addressing the additional needs of cancer patients over the course of illness and survival. Conclusions New concepts and methods that address the needs of specific age-groups and incorporate the newly generated data on cancer treatments will further enhance the benefits provided by support groups.

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