Stroke in children

2018 ◽  
Author(s):  
Bettina Henzi ◽  
Maja Steinlin
Keyword(s):  
Treatment Guidelines ◽  
Treatment Options ◽  
Specific Treatment ◽  
Future Research ◽  
Significant Delay ◽  
Delay In Diagnosis ◽  
The Public ◽  
Arterial Ischaemic Stroke ◽  
Paediatric Stroke ◽  
Socioeconomic Burden

Stroke in children is a rare, but terrifying disease and its lifelong sequelae weigh heavy on patients and families. It is also increasingly recognized as a socioeconomic burden, ongoing for many years after the acute manifestation. There is a significant delay in diagnosis of childhood stroke. This is caused by several factors: lack of awareness among the public and professionals, childhood-specific manifestations, numerous stroke mimics, and last but not least, limited access to emergency neuroimaging for children. Fast stroke recognition tools need adaption to the special needs in children. Childhood arterial ischaemic stroke differs in aetiology from adult stroke with cerebral vasculopathies being the leading cause and cardioembolic aetiology ranking second. However, treatment guidelines are largely based on adult guidelines and expert consensus. Future research has to put emphasis on understanding pathophysiology, defining specific treatment options, and providing evidence for treatment guidelines in paediatric stroke.

Paediatric stroke

2009 ◽  
Vol 29 (01) ◽  
pp. 88-90 ◽  
Author(s):  
G. deVeber
Keyword(s):  
Treatment Guidelines ◽  
Recurrence Risk ◽  
Current Treatment ◽  
Antithrombotic Treatment ◽  
The Past ◽  
Stroke Research ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis ◽  
Arterial Ischaemic Stroke ◽  
Paediatric Stroke

SummaryThe past decade has seen a dramatic increase in pediatric stroke research. However few studies have addressed anti-thrombotic safety or effectiveness. Three paediatric stroke guidelines combining research data with expert consensus have been published in the past five years. For most patients treatment recommendations are consistent. Newborns with arterial ischaemic stroke (AIS) rarely require antithrombotic treatment given their extremely low risk of recurrence. In children with AIS a substantial recurrence risk means that antithrombotic treatment is required unless contraindicated. Anticoagulation (heparins, warfarin) is recommended for possible or established dissection and cardiogenic embolism. Antiplatelet treatment is recommended for other children with AIS. For neonatal cerebral sinovenous thrombosis (CSVT) most centers provide initial anticoagulation in the absence of haemorrhagic contra indications, and otherwise, monitor for propagation. Children with CSVT, even with haemorrhagic infarction, more consistently receive anticoagulation, as in adults. While more studies are necessary, current treatment guidelines offer an interim option for guiding the treatment of paediatric stroke.

A comparison of risperidone and olanzapine in the acute treatment of persistent delusional disorder: Data from a retrospective chart review

2016 ◽  
Vol 33 (S1) ◽  
pp. S544-S544
Author(s):  
K. Kulkarni ◽  
R. Arasappa ◽  
K. Prasad ◽  
A. Zutshi ◽  
P. Chand ◽  
...  
Keyword(s):  
Chart Review ◽  
Second Generation ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Specific Treatment ◽  
Retrospective Chart Review ◽  
Delusional Disorder ◽  
Response To Treatment ◽  
Second Generation Antipsychotics ◽  
Competing Interest

IntroductionThere is a lack of pharmacological trials studying drug response in Persistent Delusional Disorder (PDD) to guide clinical practice. Available reviews of retrospective data indicate good response to second-generation antipsychotics, but even such data from India is sparse.Objectives and aimsWe aimed to compare the response of acute PDD to risperidone and olanzapine in our retrospective review.MethodsWe conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455) at our Center. We selected the data of patients prescribed either olanzapine or risperidone for the purpose of this analysis. We extracted data about dose, drug compliance and response, adverse effects, number of follow-up visits and hospitalizations. The study was approved by the Institute Ethics Committee.ResultsA total of 280/455 (61%) were prescribed risperidone and 86/455 (19%) olanzapine. The remaining (n = 89; 20%) had received other antipsychotics. The two groups were comparable in socio-demographic and clinical characteristics of PDD. Compliance was good and comparable in both groups (> 80%, P = 0.2). Response to treatment was comparable in both groups (85% partial response and > 52% good response, all P > 0.3). Olanzapine was effective at lower mean chlorpromazine equivalents than risperidone (240 vs. 391, P < 0.05).ConclusionOur study indicates a good response to both risperidone and olanzapine, if compliance to treatment can be ensured. In the absence of specific treatment guidelines for PDD, second-generation antipsychotics like risperidone and olanzapine offer good treatment options for this infrequently encountered and difficult to treat psychiatric disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Fibroelastolytic Papulosis in a Middle-Age Female: Presentation and Review of Treatment

2019 ◽  
Vol 3 (3) ◽  
pp. 215-218
Author(s):  
Carl Barrick ◽  
An Guo Michael Chin ◽  
Veronica Rutt ◽  
Nektarios Lountzis ◽  
Cynthia Bartus
Keyword(s):  
Treatment Guidelines ◽  
Treatment Options ◽  
Specific Treatment ◽  
Standard Of Care ◽  
Additional Treatment ◽  
Left Shoulder ◽  
Management Options ◽  
Clinical Presentations ◽  
Topical Retinoids ◽  
Previously Treated

Introduction:Fibroelastolytic papulosis (FEP) is a rare, benign, acquired cutaneous disease with a histopathology that shows variable fibrosis and elastolysis of the papillary dermis. FEP clinically presents as white-ivory to yellow papules and plaques commonly occurring on the neck. Prior to this date there have been no specific treatment guidelines for FEP, thus various management options are explored in this case report. Case Report:We present a 62-year-old female with an isolated ivory, cobblestoned plaque with open comedones on the left shoulder since childhood. The histopathology confirmed the diagnosis of FEP. The patient had been previously treated with topical clindamycin, salicylic acid, tretinoin, and tazarotene without success.Conclusion: This case demonstrates the importance of recognizing FEP, as clinical presentations can vary. FEP can be distressing to patients, and it is important to explore additional treatment options. Treatment options including topical retinoids and ablative lasers have been reported, but with limited and inconsistent success. However, due to the rarity of the disease there is currently no standard of care for the treatment of FEP and additional successful treatment options are needed.

scholarly journals Pain Dreams and Dream Emotions in Patients with Chronic Back Pain and Healthy Controls

2017 ◽  
Vol 10 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Michael Schredl ◽  
Aline Kälberer ◽  
Kai Zacharowski ◽  
Michael Zimmermann
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Chronic Back Pain ◽  
Treatment Options ◽  
Specific Treatment ◽  
Future Research ◽  
Chronic Lower Back Pain ◽  
Healthy Controls ◽  
Dream Emotions ◽  
Healthy Persons

Background: Although some theorists have suggested that pain sensations cannot be part of the dreaming world, research has shown that pain sensations occur in about 1% of the dreams in healthy persons and in about 30% of patients with acute, severe pain. Objective: The present study is the first to study pain dreams in patients with chronic pain. Method: A questionnaire was administered to 100 patients with chronic lower back pain and 270 controls. Results: The patients reported more pain dreams and more negatively toned dreams compared to healthy controls. In addition, patients reported more often that the dreamed pain persisted into waking state. Conclusion: In patients, pain dreams might be instigated by actual pain whereas for healthy persons pain dreams might be pain memories (self-experienced pain and/or seeing persons in pain). Future research should clarify how pain is processed during sleep. As patients with chronic pain experience negatively toned dreams, it will be beneficial to ask chronic pain patients about their dreams and, if necessary, offer specific treatment options like imagery rehearsal treatment.

Assessments of User Comments With “Alternative Views” as a Function of Media Trust

2020 ◽  
pp. 1-12
Author(s):  
Marlene Kunst
Keyword(s):  
Online Discussions ◽  
Future Research ◽  
Political Issues ◽  
Argument Quality ◽  
The Public ◽  
Mainstream Media ◽  
User Comments ◽  
Media Trust ◽  
Heuristic Information Processing

Abstract. Comments sections under news articles have become popular spaces for audience members to oppose the mainstream media’s perspective on political issues by expressing alternative views. This kind of challenge to mainstream discourses is a necessary element of proper deliberation. However, due to heuristic information processing and the public concern about disinformation online, readers of comments sections may be inherently skeptical about user comments that counter the views of mainstream media. Consequently, commenters with alternative views may participate in discussions from a position of disadvantage because their contributions are scrutinized particularly critically. Nevertheless, this effect has hitherto not been empirically established. To address this gap, a multifactorial, between-subjects experimental study ( N = 166) was conducted that investigated how participants assess the credibility and argument quality of media-dissonant user comments relative to media-congruent user comments. The findings revealed that media-dissonant user comments are, indeed, disadvantaged in online discussions, as they are assessed as less credible and more poorly argued than media-congruent user comments. Moreover, the findings showed that the higher the participants’ level of media trust, the worse the assessment of media-dissonant user comments relative to media-congruent user comments. Normative implications and avenues for future research are discussed.

Long-term survival of the nasal NK/T cell lymphoma

2008 ◽  
Vol 149 (17) ◽  
pp. 801-805
Author(s):  
Péter Rajnics ◽  
László Krenács ◽  
András Kenéz ◽  
Zoltán Járay ◽  
Enikő Bagdi ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Guidelines ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
Diagnostic Procedures ◽  
T Cell Lymphoma ◽  
Term Survival ◽  
Barr Virus ◽  
Significant Difference ◽  
Nk T Cell

The nasal NK/T cell lymphoma is a rare, extranodal non-Hodgkin lymphoma in western civilizations, which has poor prognosis. The Epstein–Barr virus can be detected in tumor cells in nearly all cases. There are no definite treatment guidelines in our days. There is no significant difference in survival between radiotherapy and chemotherapy according to Asian studies. In this case study we show our diagnostic procedures, our treatment options and we present the summary of this illness based on the data found in the literature.

Does Recent Academic Research Support Changes to Audit Reporting Standards?

2016 ◽  
Vol 30 (2) ◽  
pp. 255-275 ◽  
Author(s):  
Jean Bédard ◽  
Paul Coram ◽  
Reza Espahbodi ◽  
Theodore J. Mock
Keyword(s):  
Financial Reporting ◽  
Academic Research ◽  
Financial Statements ◽  
Future Research ◽  
Research Support ◽  
The Public ◽  
Market Participants ◽  
Information Gap ◽  
Public Company ◽  
Reporting Process

SYNOPSIS The Public Company Accounting Oversight Board (PCAOB), the International Auditing and Assurance Standards Board (IAASB), and the U.K. Financial Reporting Council (FRC) have proposed or approved standards that significantly change the independent auditor's report. These initiatives require the auditor to make additional disclosures intended to close the information gap; that is, the gap between the information users desire and the information available through the audited financial statements, other corporate disclosures, and the auditor's report. They are also intended to improve the relevancy of the auditor's report. We augment prior academic research by providing standard setters with an updated synthesis of relevant research. More importantly, we provide an assessment of whether the changes are likely to close the information gap, which is important to financial market participants and other stakeholders in the audit reporting process. Also, we identify areas where there seems to be a lack of sufficient research. These results are of interest to all stakeholders in the audit reporting process, as the changes to the auditor's report are fundamental. Additionally, our summaries of research on the auditor's report highlight where there is limited research or inconsistent results, which will help academics identify important opportunities for future research.

A Theoretical Framework of the Relationship between Public Accounting Firms and Their Auditors

2005 ◽  
Vol 17 (1) ◽  
pp. 1-22 ◽  
Author(s):  
Elizabeth Dreike Almer ◽  
Julia L. Higgs ◽  
Karen L. Hooks
Keyword(s):  
Future Research ◽  
Public Accounting ◽  
Accounting Firms ◽  
The Public ◽  
Sociology Of Professions ◽  
Rich Description ◽  
Public Accounting Firms ◽  
Current Article ◽  
The Relationship ◽  
Significant Attention

The behavior of auditors in the context of their employment by public accounting firms has received significant attention in the accounting literature. The current article extends this literature by providing a framework that identifies what auditing professionals contribute and receive as a result of their work efforts, as well as related influences. Using agency theory modified with fundamental ideas from the sociology of professions literature, we develop a model of the auditor-public accounting firm employment relationship. This framework is grounded in a timely, contextually rich description of the public accounting work environment, and the pressures and incentives faced by auditors. Propositions for future research are suggested that arise from understanding the auditor-firm relationship.

A benchmarking study of Indian seaports

2019 ◽  
Vol 13 (1) ◽  
pp. 88-102
Author(s):  
Sajeev Abraham George ◽  
Anurag C. Tumma
Keyword(s):  
Financial Performance ◽  
Future Research ◽  
Data Envelopment ◽  
Operational Parameters ◽  
Two Stage ◽  
Content Type ◽  
The Public ◽  
Port Authorities ◽  
Financial Performance Measures ◽  
The Government

Purpose The purpose of this paper is to benchmark the operational and financial performances of the major Indian seaports to help derive useful insights to improve their performance. Design/methodology/approach A two-stage data envelopment analysis (DEA) methodology has been used with the help of data collected on the 13 major seaports of India. The first stage of the DEA captured the operational efficiencies, while the second stage the financial performance. Findings A window analysis over a period of three years revealed that no port was able to score an overall average efficiency of 100 per cent. The study identified the better performing units among their peers in both the stages. The contrasting results of the study with the traditional operational and financial performance measures used by the ports helped to derive useful insights. Research limitations/implications The data used in the study were majorly limited to the available sources in the public domain. Also, the study was limited to the major seaports which are under the Government of India and no comparisons were carried out with other local or international ports. Practical implications There is a need to prioritize investments and improvement efforts where they are most needed, instead of following a generalized approach. Once the benchmark ports are identified, the port authorities and other relevant stakeholders should work in detail on the factors causing inefficiencies, for possible improvements in performance. Originality/value This paper carried out a two-stage DEA that helped to derive useful insights on operational efficiency and financial performance of the India seaports. A combination of the financial and operational parameters, along with a comparison of the DEA results with the traditional measures, provided a different perspective on the Indian seaport performance. Considering the scarcity of research papers reported in the literature on DEA-based benchmarking studies of seaports in the Indian context, it has the potential to attract future research in this field.

scholarly journals Molecular Subtypes and Precision Oncology in Intrahepatic Cholangiocarcinoma

2021 ◽  
Vol 10 (13) ◽  
pp. 2803
Author(s):  
Carolin Czauderna ◽  
Martha M. Kirstein ◽  
Hauke C. Tews ◽  
Arndt Vogel ◽  
Jens U. Marquardt
Keyword(s):  
Clinical Care ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Growth Factor Receptor ◽  
Treatment Modalities ◽  
Precision Oncology ◽  
Recurrence Rates ◽  
Isocitrate Dehydrogenase 1 ◽  
Liver Cancers

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients.

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