Atopic Dermatitis

1994 ◽  
Vol 15 (8) ◽  
pp. 327-332
Author(s):  
Candace S. Lapidus ◽  
Paul J. Honig
Keyword(s):  
Atopic Dermatitis ◽  
Los Angeles ◽  
Urban Areas ◽  
Pediatric Population ◽  
Pediatric Emergency ◽  
First Year ◽  
Pediatric Dermatology ◽  
Low Humidity ◽  
First Year Of Life ◽  
Do So

Introduction Atopic dermatitis, also referred to as atopic eczema, infantile eczema, allergic eczema, disseminated neurodermatitis, and prurigo Besnier, is a common and important cause of morbidity in children of all ages. A total of 22% of patients seen in pediatric dermatology clinics have atopic dermatitis. In 1969, Wingert et al reported that 4% of pediatric emergency room visits at the Los Angeles County General Hospital were due to atopic dermatitis, and this did not include patients seen for impetigo, a common complication of atopic dermatitis. The prevalence of atopic dermatitis in the pediatric population has increased over the past 3 decades from 3% to 10%, and it appears to be even higher in heavily populated urban areas. Pediatricians, therefore, must understand its pathogenesis and management. Epidemiology Sixty percent of children who have atopic dermatitis manifest their disease in the first year of life; 90% do so by age 5 years. A genetically prone individual may not manifest the disease until exposed to a particular environmental situation. Onset has been associated with relocation from a rural to an urban location or from a region of high to low humidity. The course of adopic dermatitis is difficult to predict, although one 15-year longitudinal study revealed that the disease persisted in 60% of cases.

A multinational study to compare prevalence of atopic dermatitis in the first year of life

2015 ◽  
Vol 26 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Eelco Draaisma ◽  
Luis Garcia-Marcos ◽  
Javier Mallol ◽  
Dirceu Solé ◽  
Virginia Pérez-Fernández ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
First Year ◽  
Multinational Study ◽  
First Year Of Life

scholarly journals Bivalirudin Use in an Infant With Persistent Clotting on Unfractionated Heparin

2011 ◽  
Vol 16 (2) ◽  
pp. 108-112
Author(s):  
Katherine M. Malloy ◽  
Tara A. McCabe ◽  
Robert J. Kuhn
Keyword(s):  
Unfractionated Heparin ◽  
Pediatric Population ◽  
Coronary Intervention ◽  
Thrombin Inhibitors ◽  
Thrombin Inhibitor ◽  
Direct Thrombin Inhibitors ◽  
First Year ◽  
Heparin Infusion ◽  
Percutaneous Coronary ◽  
First Year Of Life

ABSTRACT Bivalirudin is a direct thrombin inhibitor approved for use in adult patients with heparin-induced thrombocytopenia (HIT) undergoing percutaneous coronary intervention. Recently, its use in the pediatric population has increased due to its anti-thrombin-independent mechanism of action. As heparin products produce great inter- and intraindividual variability in pediatric patients, often due to decreased anti-thrombin concentrations in the first year of life, some practitioners have turned to direct thrombin inhibitors, such as bivalirudin, for more predictable pharmacokinetics and effects on bound and circulating thrombin. We report our experience using bivalirudin in a 2-month-old female with recurrent systemic thrombi despite continuous unfractionated heparin infusion. Due to the patient's inability to maintain therapeutic activated partial thromboplastin time (aPTT) values during heparin infusion, bivalirudin was initiated at 0.1 mg/kg/h and increased due to subtherapeutic aPTTs to a maximum of 0.58 mg/kg/h. Therapeutic aPTTs were achieved at the increased dose; however, the patient's worsening renal impairment with resultant drug accumulation and overwhelming sepsis on day 5 of therapy led to discontinuation of the infusion and the initiation of comfort measures.

scholarly journals 13 Evaluating Potential Overuse of Intravenous Hydration in Patients Hospitalized with Bronchiolitis

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e5-e5
Author(s):  
Vénitia Langlois ◽  
Chloé Sainte-Marie-Lestage ◽  
Anne-Claude Bernard-Bonnin ◽  
Nathalie Lucas ◽  
Pascal Bédard ◽  
...  
Keyword(s):  
Management Practice ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Local Order ◽  
First Year ◽  
National Guidelines ◽  
Oral Hydration ◽  
Intravenous Hydration ◽  
First Year Of Life ◽  
Local Guideline

Abstract Background Bronchiolitis is the primary cause of hospitalization in children during the first year of life. Respiratory support and hydration are the two pillars of management. Practice guidelines for bronchiolitis (NICE and CPS) recommend nasogastric (NG) hydration before intravenous (IV) fluids if oral hydration cannot be maintained. However, IV hydration remains the primary mode of hydration at our tertiary care pediatric centre. Objectives This is a resource stewardship project aiming to evaluate the baseline use of IV versus NG hydration in children 0-15 months hospitalized for bronchiolitis and requiring supplemental hydration. The secondary objective is to evaluate potential barriers to NG hydration for these children. Design/Methods Data was collected retrospectively for the 2017-2018 bronchiolitis season. A survey was sent to all the pediatric emergency (ED) physicians and nurses, pediatric hospitalists, ED fellows, pediatric residents and ward nurses. Results Among eligible patients (n=95), IV hydration was prescribed 52% of the time, compared to 48% NG hydration. Ninety-six percent (47/49) of IV hydration was initiated in the ED, while only 4% (2/49) was initiated on the ward. Among patients who began receiving hydration in the ED (80/95, or 84%), 41% (33/80) were hydrated via NG and 59% (47/80) by IV. In the survey, while 92% (57/62) of responding physicians claimed to be aware of national guidelines for bronchiolitis, only 67% (42/62) said that NG was the recommended mode of hydration. Among ED practitioners, 56% (19/34) were up-to-date on the recommendation. Two-thirds of all respondents (physicians and nurses) felt that NG hydration would be more acceptable to parents. Among nurses, 84% (38/45) felt that IV installation was a longer procedure to complete. Despite the existence of a local order set indicating NG hydration as the preferred hydration method, only 64% (40/62) of physicians were aware of its existence, and only 23% of these (9/40) actually use the guideline. Main reasons of disuse included forgetting the guideline exists and it not being easily available. In contrast, 93% of nurses were aware of the local guideline. Conclusion Intravenous hydration is overused among patients hospitalized with bronchiolitis at our centre, and the ED is the main setting where this occurs. There is a discrepancy between physicians’ theoretical knowledge of hydration guidelines and the application of these in reality. Barriers to the use of NG hydration can be amenable to a quality improvement (QI) intervention targeting improved knowledge and use of our local guideline, and this will be our focus going forward.

Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study)

2005 ◽  
Vol 35 (6) ◽  
pp. 733-740 ◽  
Author(s):  
M. M. Hagendorens ◽  
C. H. Bridts ◽  
K. Lauwers ◽  
S. van Nuijs ◽  
D. G. Ebo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atopic Dermatitis ◽  
First Year ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
First Year Of Life

scholarly journals Vitamin D Deficiency in Children Despite Correctly Applied Rickets Prophylaxis

2020 ◽  
Vol 70 (12) ◽  
pp. 4332-4335
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Calcium Absorption ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Serum Levels ◽  
First Year ◽  
Vitamin D Levels ◽  
The Mean ◽  
First Year Of Life

Vitamin D is essential for calcium absorption and for maintaining bone health in the pediatric population. We conducted a retrospective study to establish the profile of a child aged under 3 years old with vitamin D deficiency in the context of correct prophylaxis, on a cohort of 49 children from two general practitioner offices. From the study group 30.6% of children (15 cases) had low vitamin D levels. The mean serum 25(OH)D level was 41.5±16.6 ng/ml. Regarding nutrition in the first year of life, breastfeeding predominated (83.7% of patients), and only 8.16% of patients had clinical signs of rickets. So, low serum levels of vitamin D can also be found in children who have successfully received correct prophylaxis with vitamin D. Keywords: vitamin D, children, rickets

scholarly journals THE DYNAMICS OF THE LENGTH OF THE ANTERIOR-POSTERIOR EYE AXIS FOLLOWING THE EXTRACTION OF UNILATERAL CONGENITAL CATARACTS WITH THE IMPLANTATION OF INTRAOCULAR LENSES IN THE CHILDREN DURING THE FIRST YEAR OF LIFE

2017 ◽  
Vol 12 (1) ◽  
pp. 6-10
Author(s):  
L. A Katargina ◽  
T. B Kruglova ◽  
N. S Egiyan ◽  
O. B Trifonova
Keyword(s):  
Surgical Treatment ◽  
Pediatric Population ◽  
Optical Power ◽  
Intraocular Lenses ◽  
First Year ◽  
Congenital Cataracts ◽  
Before And After ◽  
First Year Of Life ◽  
Anterior Posterior ◽  
Anterior Posterior Axis

Introduction. Unilateral congenital cataracts in the children account for up to 16.0% of the total number of congenital cataracts diagnosed among the pediatric population. Aphakia is considered to be the most physiological method for the surgical treatment and correction of unilateral congenital cataracts in the combination with the implantation of intraocular lenses. The optical power of the lenses is calculated based on the results of evaluation of the dynamics of the length of the anterior-posterior eye axis in individual patients. Aim. The objective of the present study was to analyze the dynamics of the length of the anterior-posterior axis of the eyes in the children presenting with pseudophakia following the extraction of unilateral congenital cataract. Materials and methods. The study included a total of 77 children with unilateral congenital cataracts examined before and after the surgical treatment. Phacoaspiration in the combination with the implantation of intraocular lenses was performed in the patients at the age varying from 3 to 11 months. The infants underwent the ultrasound biometric study and the evaluation of the dynamics of the length of the anterior-posterior axis in the affected eye in comparison with that in the contralateral eye before they reached the age of 7 years. Results. The results of this study give evidence of marked variability of the dynamics of the length of the anterior-posterior axis of the eyes following the early surgical treatment of the children presenting with unilateral congenital cataracts. Conclusion. The differences in the tendency toward the change in the length of the anterior-posterior axis of the eyes following the surgical treatment of unilateral congenital cataracts in the children during the first year of life suggest the necessity of further in-depth investigations and the need for the regular follow-up of such patients for the purpose of choosing the proper approach to the correction of the refraction error and ametropia.

scholarly journals Assessing Neo-Natal Mortality Trends in Pakistan: An Insight Using Equity Lens

2020 ◽  
Author(s):  
Zainab Dawood ◽  
Naeem Majeed
Keyword(s):  
Neonatal Mortality ◽  
Urban Areas ◽  
Wealth Quintile ◽  
Risk Groups ◽  
First Year ◽  
Mortality Trends ◽  
Microsoft Excel ◽  
Graph Type ◽  
Natal Mortality ◽  
First Year Of Life

Abstract Background: Almost 2.5 million children died in the first year of life in the year 2017. These account for almost half of the total deaths of children under the age of five years. Overall, child mortality has declined over the past two decades. Comparatively, the pace of decline in neonatal mortality has remained much slow. Significant inequalities in health across a number of dimensions – including wealth, ethnicity, and geography – continue to exist both between and within countries, and these contribute to neonatal mortality. This study aims to quantify the magnitude of inequalities in neonatal mortality trends by wealth quintile and place of residence with province wise segregation. Methods: The study was done using raw data from the last three Pakistan Demographic & Health Surveys (20017-18, 2012-13 and 2006-7). The concentration curves were drawn in Microsoft Excel 365 using scatter plot as graph type while the frequencies were calculated using SPSS 24. Results: The situation of inequity across provinces and in rural vs urban areas has slightly declined, however, gross inequities continue to exist.Conclusions: Presentation of outcomes data, such as neonatal mortality in various wealth quintiles is an effective way to highlight the inequities amongst income groups as it highlights the vulnerable and at-risk groups. In other countries, rural-urban distribution, or ethnic groups may also reflect similar differences and help in identifying high-risk groups.

scholarly journals Mortality in a cohort of 3.1 million children, adolescents and young adults

2020 ◽  
Vol 74 (3) ◽  
pp. 260-268 ◽  
Author(s):  
Joel G Ray ◽  
Astrid Guttmann ◽  
Jose Silveira ◽  
Alison L Park
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Urban Areas ◽  
Demographic Variables ◽  
Adolescents And Young Adults ◽  
First Year ◽  
Preventive Strategies ◽  
Self Harm ◽  
First Year Of Life

BackgroundMany youth deaths occur in the first year of life, from prematurity and anomalies. Detailing mortality after age 1 year may differentially guide preventive strategies in children, adolescents and young adults.MethodsA cohort study in Ontario, Canada comprised 3 139 698 children born from 1990 to 2016. Adjusted HR (aHR) for death between 1 and 24 years were generated, comparing demographic variables and parity.ResultsAfter a median of 13.7 years of follow-up, 6930 deaths occurred between ages 1 and 24 years (incidence rate 17.0 per 100 000 person-years), peaking at age 23 years (43.7 per 100 000). The aHR for death was higher among males than females (1.44, 95% CI 1.37 to 1.51), rural versus urban areas (1.48, 95% CI 1.39 to 1.58), lowest versus highest income areas (1.39, 95% CI 1.29 to 1.51) and at parity 1 (1.16, 95% CI 1.10 to 1.23), parity 2 (1.34, 95% CI 1.23 to 1.45), parity 3+ (1.96, 95% CI 1.74 to 2.21), each relative to a child without an older sibling. Among males, the proportion of deaths due to injury jumped from 30% before age 15 years to 65% thereafter, and in females, from 28% to 51%. Intentional self-harm/assault explained 11% of injury-related deaths among males before age 15 years, and 20% thereafter, with respective figures of 18% and 17% for females. Deaths outside of hospital increased with age, from 35% at age 1 year, to 66% at age 22 years.ConclusionThere is a heightened susceptibility of dying starting at age 15 years, especially among males, from injury, and arising outside of hospital.

Infant perception of audiovisual synchrony in fluent speech

2012 ◽  
Vol 25 (0) ◽  
pp. 36
Author(s):  
Ferran Pons ◽  
David J. Lewkowicz
Keyword(s):  
Temporal Processing ◽  
Video Clip ◽  
First Year ◽  
Temporal Relations ◽  
Fluent Speech ◽  
Native Speech ◽  
First Year Of Life ◽  
Speech Events ◽  
Perceptual Narrowing ◽  
Do So

It is known that perception of audio–visual (A–V) temporal relations is affected by the type of stimulus used. This includes differences in A–V temporal processing of speech and non-speech events and of native vs. non-native speech. Similar differences have been found early in life, but no studies have investigated infant response to A–V temporal relations in fluent speech. Extant studies (Lewkowicz, 2010) investigating infant response to isolated syllables have found that infants can detect an A–V asynchrony (auditory leading visual) of 666 ms but not lower. Here, we investigated infant response to A–V asynchrony in fluent speech and whether linguistic experience plays a role in responsiveness. To do so, we tested 24 monolingual Spanish-learning and 24 monolingual Catalan-learning 8-month-old infants. First, we habituated the infants to an audiovisually synchronous video clip of a person speaking in Spanish and then tested them in separate test trials for detection of different degrees of A–V asynchrony (audio preceding video by 366, 500 or 666 ms). We found that infants detected A–V asynchronies of 666 and 500 ms and that they did so regardless of linguistic background. Thus, compared to previous results from infant studies with isolated audiovisual syllables, here we found that infants are more sensitive to A–V temporal relations inherent in fluent speech. Furthermore, given that responsiveness to non-native speech narrows during the first year of life, the absence of a language effect suggests that perceptual narrowing of A–V synchrony detection has not completed by 8 months of age.

The Changing Face of Anemia in Infancy

1994 ◽  
Vol 15 (5) ◽  
pp. 175-183
Author(s):  
Elinor A. Graham
Keyword(s):  
Iron Deficiency ◽  
Psychosocial Development ◽  
Low Income ◽  
Pediatric Population ◽  
Work Force ◽  
The United States ◽  
Iron Nutrition ◽  
First Year ◽  
Major Factors ◽  
First Year Of Life

Introduction The pattern of anemia in infancy is changing in North America. The major factors contributing to anemia include iron endowment at birth, adequacy of dietary iron, frequency of infection, and the genetic background of a child. The characteristics of all of these factors are changing in the pediatric population. As more premature infants survive, their inadequate birth endowment of iron results in iron deficiency at an earlier age. Because of widespread use of iron-fortified formulas or iron supplementation with breastfeeding, iron deficiency now causes less anemia in the first year of life. As iron nutrition of infants has improved, anemia associated with infection has been identified more frequently. Increased work force participation of mothers has resulted in more exposure to infections by infants in child care. An increase in the percentage of children who are of Asian and African genetic backgrounds has increased the prevalence of inherited hemoglobin disorders among children. Newborn screening for hemoglobinopathies has resulted in more frequent identification of these disorders. Decline in the socioeconomic status of children in the United States adds to the complexity of this picture. More than one factor often produces anemia in an infant from a poor family, and the anemia may have a greater impact on the psychosocial development of a child from a low-income background.

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