LITTLE GAME, BIG GAIN: AN ACTIVITY BASED INTERVENTIONAL PROGRAM TO ENHANCE PSYCHOMOTOR FUNCTIONAL ABILITY IN CHILDREN WITH DCD

Developmental coordination disorder (DCD) is considered as a disorder of children where they are unable to perform various skills which need fine motor coordination.Every child identified to have DCD shouldbe given interventions.This could be possible by simple games which makes them confident and moreover helps in improving their motor performance.Various interventional therapies have been identified to deal with the issue.

Approach to Neuropathic Pain

Neuropathic pain is a common chief complaint encountered by neurologists and primary care providers. It is caused by disorders involving the somatosensory nervous system. The clinical evaluation of neuropathic pain is challenging and requires a multifaceted systematic approach with an emphasis on a thorough history and physical examination to identify characteristic signs and symptoms. Ancillary laboratory investigations, targeted imaging, and electrodiagnostic studies further help identify underlying etiologies to guide specific treatments. Management of neuropathic pain encompasses treating the underlying pathology as well as symptomatic control with nonpharmacological, pharmacological, and interventional therapies. Here, we present an approach to help evaluate patients with neuropathic pain.

Local Treatments in the Unresectable Patient with Colorectal Cancer Metastasis: A Review from the Point of View of the Medical Oncologist

For patients with isolated liver metastases from colorectal cancer who are not candidates for potentially curative resections, non-surgical local treatments may be useful. Non-surgical local treatments are classified according to how the treatment is administered. Local treatments are applied directly on hepatic parenchyma, such as radiofrequency, microwave hyperthermia and cryotherapy. Locoregional therapies are delivered through the hepatic artery, such as chemoinfusion, chemoembolization or selective internal radiation with Yttrium 90 radioembolization. The purpose of this review is to describe the different interventional therapies that are available for these patients in routine clinical practice, the most important clinical trials that have tried to demonstrate the effectiveness of each therapy and recommendations from principal medical oncologic societies.

Fontan Fenestration and the Role of the Covered Stent

Key Points : • Interventional therapies directed at fenestration closure in the Fontan patient must rely on good hemodynamic data • The Large Optimus-CVSTM stent is an additional armamentarium for fenestration closure however, longer term follow up is needed • Multi institutional studies defining the long-term benefits of fenestration closure and outlining fenestration management guidelines may help improve the long-term morbidity and mortality in this group of patients.

SUMOylation as a Therapeutic Target for Myocardial Infarction

Myocardial infarction is a prevalent and life-threatening cardiovascular disease. The main goal of existing interventional therapies is to restore coronary reperfusion while few are designed to ameliorate the pathology of heart diseases via targeting the post-translational modifications of those critical proteins. Small ubiquitin-like modifier (SUMO) proteins are recently discovered to form a new type of protein post-translational modifications (PTM), known as SUMOylation. SUMOylation and deSUMOylation are dynamically balanced in the maintenance of various biological processes including cell division, DNA repair, epigenetic transcriptional regulation, and cellular metabolism. Importantly, SUMOylation plays a critical role in the regulation of cardiac functions and the pathology of cardiovascular diseases, especially in heart failure and myocardial infarction. This review summarizes the current understanding on the effects of SUMOylation and SUMOylated proteins in the pathophysiology of myocardial infarction and identifies the potential treatments against myocardial injury via targeting SUMO. Ultimately, this review recommends SUMOylation as a key therapeutic target for treating cardiovascular diseases.

Tips for managing post-inflammatory hyperpigmentation of acne

Post-inflammatory hyperpigmentation (PIH) is a reactive hypermelanosis, profoundly common in the Asian skin. The post-acne sequelae may have profound effects on the patients’ mental status, sometimes even more than the acne itself, as they are long lasting and sometimes treatment refractory. PIH occurs secondary to release of inflammatory mediators such as prostaglandins and interleukins in acne which stimulate melanogenesis. There are a multitude of therapeutic modalities available for the treatment of PIH associated with acne. Treating acne and PIH simultaneously would be a logical approach. Epidermal PIH usually responds to topical skin lightening agents which are the first line in these cases. Patients refractory to topical and oral treatment modalities usually have dermal PIH and may be offered interventional therapies. These therapies can be utilized simultaneously along with conventional therapies to hasten up the results, as combination treatment works synergistically by multipronged action at different pathways of etiopathogenesis. The patients with dermal PIH refractory to standard treatment may require other adjunctive therapies such as chemical peels, PRP, and lasers. This review provides an insight into rational and holistic approach to the management of the underlying acne, early customized treatment along with correction of underlying nutritional deficiencies, and lifestyle modifications in effective treatment of PIH.

Difficult pain

A child in pain needs not only appropriate medical treatment, but specific attention to psychosocial, cultural, and spiritual issues in order to allow meaningful exploration of wider fears or concerns. Management requires a collaborative, multimodal approach; optimal use of non-pharmacological strategies, targeted analgesic pharmacotherapy, and if necessary, specific interventional therapies. Although managing pain is only one aspect of providing palliative care for children, however, it is a core task. The experience of severe pain demands an individual’s whole attention, leaving little chance of addressing wider psychosocial or existential concerns while it remains uncontrolled. Difficult pain is a highly prevalent symptom among children with life-limiting conditions (LLC). It is complex, usually multifactorial and multifaceted. It is encountered in every dimension; the physical perception and experience of pain will be dictated by the existential and psychosocial context in which it occurs for the individual child.

Behandeling van spasticiteit met enkele overwegingen naar sport toe

Treatment of spasticity with some considerations regarding sport Spasticity is a possible side effect in patients with a central nervous system pathology and it affects more than 12 million people worldwide. Spasticity can have an important impact on the quality of life and sporting activities. Spasticity only needs to be treated if there is spasticity associated pain and/or (expected) limited function. Primarily triggering factors of spasticity must be treated. A multidisciplinary approach containing a combination of medication and physical therapy is recommended in the treatment of spasticity. If this approach remains insufficient, interventional therapies can be taken into consideration, although they should always be combined with rehabilitation to reduce (the) spastic tone/spasticity. Sports and exercising should not be merely seen in the context of therapy and/or rehabilitation but also as a crucial aspect of a healthy lifestyle, in particular for people ‘at risk’ for inactivity. Therefore, it is important to fill the gap between rehabilitation and sustainable sports practice for the rehabilitator.