Safety and parents´ acceptance of ultrasound contrast agents in children and adolescents – contrast enhanced voiding urosonography and contrast enhanced ultrasound

Aims: To evaluate the safety of the contrast enhanced voiding urosonography (ceVUS) and contrast enhanced ultrasound (CEUS) in children and adolescence and to receive data about parents’ acceptance of intravesical and intravenous application of sulfur hexafluoride.Material and methods: In this prospective, single centre study conducted over a 1 year study period, parents of 56 children (f/m=32/24; mean age 3.1 years; range 3 weeks - 15.9 years) with ceVUS and of 30 children (f/m=15/15; mean age 10.5 years; range 2 months - 17.7 years) with CEUS agreed to be included. A standardized telephone survey about the acceptance of the parents during and after the procedure as well as the adverse events (AE) were conducted within three days of the examination.Results: The parents would agree with the use of both ceVUS and CEUS as a diagnostic tool again in 96% (54/56) or 100% (30/30) of the cases, respectively and 92.9% (52/56) would prefer ceVUS to voiding cystourethrography (VCUG). In addition, 83.3% (25/30) would prefer CEUS to CT and 73.3% (22/30) would prefer CEUS to MRI. AE were reported in 3.6% after ceVUS (2/56; skin rash, mild fever) and in 3.3% after CEUS (1/30; vomiting). AE were subacute and self‑limited.Conclusions: The vast majority of parents prefer ceVUS and CEUS to VCUG, CT or MRI because of the safety profile of the contrast agent and diagnostic accuracy.

“Homoeopathic Perspective of Attention Deficit Hyperactivity Disorder - Hyperactive Type – A Review”

Attention Deficit Hyperactivity Disorder (ADHD) is commonly diagnosed neuropsychiatric condition affecting the children and adolescence. Nearly 8 percent of school - going children were diagnosed as ADHD and mostly as hyperactive type. More than 60 percent of children with ADHD were progressed to grow with the symptoms into adulthood which causes significant impaired academic achievements, poor interpersonal skills, disordered social activities, and various psychiatric disorders like learning disability, substance abuse, mood disorders, disruptive behavior disorder, etc., Homoeopathy a unique system of medicine which provides a beneficial effect on the human body through its ultra-diluted and potentized drug substances adopting holistic approach. There are reliable sources where homoeopathy proves its efficacy in treating ADHD children. This article provides a cluster of remedies derived through repertorisation considering only the symptoms of ADHD hyperactive type which will be helpful in cases where the individualization of the child is difficult to achieve. Considering the symptomatology of ADHD hyperactive type mentioned in DSM V criteria the most indicated remedies among various remedies were Medorrhinum, Nux. Vom, Carcinosinum, Hyoscyamus, Anacardium, Chamomilla, Veratrum. Album, Coffea Cruda, Tarentula etc.

Emotion Regulation and Self-Criticism in Children and Adolescence: Longitudinal networks of transdiagnostic risk factors

Adolescence is a time of heightened risk for the development of psychopathology. Difficulties in emotion regulation and heightened levels of self-criticism are two processes that have been proposed as critical risk factors. Considering the accumulating evidence that risk factors rarely work in isolation, there is a pressing need to examine how self-criticism and emotion regulations strategies interact. The present study utilizes a network analysis approach to address this goal. One-hundred and thirty-five children and adolescence (ages 8-15) completed daily-diaries every evening for 21 days (total N of assessments = 2564), reporting self-criticism and use of emotion regulation strategies focused on negative and positive emotions. Network analysis was applied to estimate contemporaneous, temporal, and between-person networks. Results show that emotion regulation strategies are generally positively associated with each other at the within and between individual levels. As predicted, self-criticism was positively associated with rumination and dampening at the between and within-person networks; unexpectedly, problem-solving also clustered with them in the contemporaneous network. Moreover, problem-solving led to next-day increases in rumination and dampening, whereas self-criticism led to next-day increases in rumination but decreases in dampening. Finally, distraction in response to negative affect was closely tied with strategies that up-regulate positive affect. Collectively, these results shed light on the complex pathways through which self-criticism and emotion regulation interact over time.

Delayed Anastomotic Urethroplasty in Children and Adolescence with Pelvic Fracture Urethral Injury (PFUI): Experiences in Two Centers of Reconstructive Urethral Surgery in Indonesia

Introduction: Incidence of pediatric pelvic fracture urethral injury (PFUI) is rare. This study reviews the experience of anastomotic urethroplasty surgery in children and adolescence PFUI in the last 3 years in two center of reconstructive urethral surgery in Indonesia. Method: This study retrospectively reviewed PFUI cases in Hasan Sadikin Hospital and Saiful Anwar Hospital from 2013-2016. The data cases were analysed base on aetiology of the trauma, urethral gap, and previous operations. The operation time and intra operative additional procedure to achieve tension free anastomotic was also noted. Result: A total 31 children and adolescence patients with PFUI were recorded in two institutions. Twenty patients were in Hasan Sadikin Hospital while 11 patients were in Saiful Anwar Hospital. The trauma mechanisms for PFUI were 28 (90.3%) cases due to motorcycle accidents and 3 (9.7%) cases due to high falls accidents. All patients underwent delayed urethral reconstruction in median 6 months (3-72). The median operation time was 150±101 minutes for children and 160±50.5 minutes for adolescence. The average length of the urethral gap in children cases was 2.8±1.2 cm, meanwhile 4±1.9 cm for adolescence cases. In order to achieve the tension free of anastomotic urethroplasty, 5 (16.1%) of PFUI patients underwent crural separation, 16 (51.6%) patients underwent inferior pubectomy and 3 (9.7%) patients for supracrural re-routing. Posterior pubectomy with omental wrap via transpubic approach was performed in one patient. The success rate for children cases was 83.3% and 88% for adolescence cases. Thus, the overall success rate after anastomotic urethroplasty for pediatric PFUI was 83.9%. Conclusions: In short-term follow up, delayed repair urethral reconstructive surgery by transperineal and transpubic anastomotic urethroplasty in children and adolescence with PFUI achieved a significant good result and showed promising outcome.

Spinal pain increases the risk of becoming overweight in Danish schoolchildren

Spinal pain is common in adolescence, and overweight in children and adolescence is an increasing public health problem globally. Since musculoskeletal pain is a known barrier for physical activity which potentially can lead to overweight, the primary objective of this study was to determine if self-reported lifetime spinal pain in 2010 was associated with being overweight or obese in 2012 in a cohort of 1080 normal-weighted Danish children, aged 11–13 years at baseline. Overweight was based on body mass index measured by trained staff. Spinal pain was self-reported by questionnaires during school hours. Estimates were adjusted for relevant covariates. The 2-year incidence rate of overweight was 5.3% (95% CI 3.98–7.58) for children with spinal pain at baseline versus 1.6% (95% CI 0.19–5.45) for children without. There was stepwise and statistically significant increased risk of overweight with increasing frequency of pain and for having pain in more than one part of the spine. Despite the short follow-up time where only 40 children developed overweight, these results indicate that spinal pain might increase the risk of subsequent overweight.

The Silence of Female Sexual Offending: A Public Health Issue

The idea that females can engage in sexually predatory behavior against children and adolescence is difficult to convey to the lay pubic since most of society believes the notion defies conventional ways of viewing the gendered nature and roles that women traditionally perform. Despite this, scholars and researchers examining child sexual abuse are beginning to report on silent offenders (women and young females) and their victimizations that have been largely ignored by criminal justice personnel who are responsible for holding sex offenders accountable. We argue that female sex offending is more common than believed and is both a criminal justice and a public health issue. We also argue that until society recognizes that sex offending is not a gendered crime, more cases will escape the attention of both criminal justice and public health systems that are in positions to punish and treat where appropriate.

Introduction

Mental illnesses are more common than cancer, diabetes, or heart disease. Ongoing research has advanced knowledge on the underlying biology, prevention, and treatments for mental illnesses. Unfortunately, most people who need treatment do not receive it. This chapter provides an introduction to serious mental health disorders in children and adolescents and addresses barriers to people receiving effective treatments. It addresses federal efforts focused on earlier identification of mental illness and improving access to effective treatments. While this book focuses on diagnosing mental illness in children and adolescence, Chapter 1 puts into context what children and adolescents need for good mental health; the importance of partnering with youth and caregivers, addressing issues from a strengths perspective, and engaging in culturally sensitive practice; and the importance of understanding that people are not their mental illness. Finally, an overview of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the overall structure of the book is provided.