Awareness Of Pediatricians Research Articles

Pediatricians awareness of problems with inappropriate dosage forms for children

Pediatricians awareness of problems with inappropriate dosage forms for children

CT radiation dose awareness among paediatricians.

BackgroundThe radiation dose delivered from computed tomography (CT) scanning and the risks associated with ionising radiation are major concerns in paediatric imaging. Compared to adults, children have increased organ sensitivity and a longer expected lifetime in which cancer may develop. Therefore, it is important to investigate the awareness of paediatricians (referring physicians) regarding radiation doses and the associated risks.MethodsA multiple-choice survey was distributed among paediatricians in 8 hospitals in Riyadh, the capital of Saudi Arabia.ResultsAmong the 162 respondents, only 24 (15 %) were aware of the As Low As Reasonably Achievable (ALARA) principle. Approximately half (54 %) of the respondents believed that multi-slice CT delivered a low radiation dose, and 100 (62 %) of the respondents were not aware that radiation is considered carcinogenic by the Food and Drug Administration in the United States. Among the respondents, 110 (68 %) did not have any specific education regarding radiation during their training. There was an overall underestimation (83 %) of the CT radiation dose, and 70 % thought that magnetic resonance imaging (MRI) delivered some level of ionising radiation.ConclusionsAmong paediatricians in Saudi Arabian hospitals, there was a wide underestimation of the CT radiation dose and the associated risks for children. We should improve paediatricians’ knowledge about radiation doses. Radiologists, paediatricians, radiation technologists and medical physicists should work together to optimise CT guidelines and protocols to reduce the radiation risks for children.

The competence of physicians of medical organizations of pediatric profile in the field of ethical legal issues

The implementation of rights of under age patients in medical institutions to considerable extent is determined by the level of awareness of pediatricians about ethical legal issues related to children and adolescents. The article presents the results of survey of 239 pediatricians about rights of patients and duties of physicians. It is established that respondents are insufficiently informed about ethical legal issues and apply untimely knowledge about legal acts concerning rights of children-patients in their practice. It is established that awareness about ethical legal issues was higher among pediatricians with professional experience less than 10 years since disciplines of biomedical ethics and medical law were included into the program of prediploma training of pediatricians only in last decade. The direct relationship between competence of pediatricians in ethical legal issues and qualification was determined. The most of respondents are convinced in importance of advanced education in ethical and legal issues. It is necessary to include sections intended to increasing of legal competence of pediatricians.

Информированность врачей - педиатров в сфере организации профилактических осмотров несовершеннолетних

The article analyzes the results of the sociological survey on the awareness of pediatricians about organization of preventive examinations of minors. The questioning of 103 respondents of 7 medical institutions was conducted in 2015 in the Republic of Bashkortostan. A social portrait of pediatricians was obtained during the study. The survey results revealed gaps in specialists` knowledge of legal framework that regulates the preventive work and their low activity in maintaining such work.

Pediatrician and Parent Opinion on Nutrition in Infants Under 3 Years: Results of Pilot Survey Conducted in Central Federal District of the Russian Federation

Background: Rational nutrition management in infants under 3 years is an important part of their adequate development at this age and in future. Objective: Our aim was to evaluate awareness of pediatricians and parents concerning rational nutrition management in infants under 3 years. Methods : 300 pediatricians and 300 parents of infants under 3 years who live in Moscow, Ivanovo, and Yaroslavl were enrolled in pilot survey. Results: Pediatricians' recommendations on child nutrition management satisfied the majority of parents (252; 84%), however, less than half of families (135; 45%) followed them. In other cases the child's ration depended on mother's opinion on the matter (96; 32%) and on child's food preference. «Unhealthy» food such as groceries and provision, processed food, spices, seafood, fast food, chocolate, candies, and sweets as well as soda was included in child's ration at the age of 2 and its consumption frequency increased significantly at the age of 3. Pediatricians strongly recommended special dairy for infants from the age of 1 (known as the 3rd formula). In fact, only half of children in Moscow eat them, and 27–30% of children in Ivanovo and Yaroslavl. Conclusion: Harmful breach of nutrition management in infants under 3 years is detected. Evidently, parents are not competent on the question. Optimization of educational activities performed by pediatricians, medical stuff, and mass media is required.

Clinical and Molecular Genetic Features of Autoinflammatory Syndromes in Children

Objective : Our aim was to study the prevalence and clinical features of autoinflammatory syndromes among patients with systemic juvenile idiopathic arthritis. Methods : A prospective nonrandomized study was conducted. All its members have been studied for mutations in TNFRSF1A and NLRP3 genes by the sequencing method. Results : 90 children (27 boys, 63 girls) aged from 1 to 17 (average age 8.2) years, with a guide diagnosis: «Systemic juvenile idiopathic arthritis», were examined. As a result, 10 (14%) patients showed mutations in TNFRSF1A gene, leading to the development of TRAPS-syndrome (8 had the most common mutation of R92Q; 3 — not previously described mutations in NLRP3 gene). 2 patients had the diagnosis of CINCA/NOMID Syndrome, 1 — Muckle–Wells Syndrome. In three cases, mutations leading to the development of TRAPS-syndromethe were identified in the first line of descent. Classical examples of autoinflammatory syndromes such as cryopyrin-associated periodic syndrome (CAPS), and tumor necrosis factor receptor associated periodic syndrome (TRAPS). The data about their pathogenesis, clinical features, diagnosis and treatment is presented. Conclusion : It is shown that early detection and adequate treatment of patients with autoinflammatory syndromes, characterized by severe disease and serious prognosis, is difficult due to lack of awareness of pediatricians and unavailability of genetic diagnosis of these syndromes. The necessity of the development of a universal model of the diagnostic algorithm for identification of autoinflammatory syndromes using next-generation sequencing technologies is grounded.

Shock séptico en unidad de cuidados intensivos. Enfoque actual en el tratamiento

Essential therapeutic principles in children with septic shock persist over time, although some new concepts have been recently incorporated, and fully awareness of pediatricians and intensivists is essential.Fluid resuscitation is a fundamental intervention, but the kind of ideal fluid has not been established yet, as each of these interventions has specific limitations and there is no evidence supportive of the superiority of one type of fluid. Should septic shock persists despite adequate fluid resuscitation, the use of inotropic medication and/or vasopressors is indicated. New vasoactive drugs can be used in refractory septic shock caused by vasopressors, and the use of hydrocortisone should be considered in children with suspected adrenal insufficiency, as it reduces the need for vasopressors.The indications for red blood cells transfusion or the optimal level of glycemia are still controversial, with no consensus on the threshold value for the use of these blood products or the initiation of insulin administration, respectively. Likewise, the use of high-volume hemofiltration is a controversial issue and further study is needed on the routine recommendation in the course of septic shock. Nutritional support is crucial, as malnutrition is a serious complication that should be properly prevented and treated.The aim of this paper is to provide update on the most recent advances as concerns the treatment of septic shock in the pediatric population.

Evaluation of the knowledge, attitude and awareness in prevention of dental caries amongst paediatricians

Background: Early assessment of the oral health status of children has the potential to reduce or even eliminate oral diseases. Paediatricians are considered a perfect and reliable source for oral health control and prevention. In dentistry, clinical practice is directed towards attitudes that promote oral health and the paediatricians occupy a privileged position in this process. The purpose of this study was to evaluate the knowledge, attitude and awareness of paediatricians in the prevention of dental caries in 3 district quarters, India. Methods: A cross-sectional survey was undertaken among 123 registered paediatricians in Indian Academy of Paediatrics (IAP) Karnataka directory and digest 2011-2013, Karnataka society. Out of which, 42 did not participate as their email address were not available. 29 sets of questions were mailed to all 81 paediatricians. Results: The response rate of the survey was 90% (70 out of 81), a total of 59% felt that the frequency of Early Childhood Caries (ECC) in their O.P.D was at least once a week. 51% responded that bacteria causing dental caries cannot be transmitted between mother and child. 53% felt that 1 year would be ideal for first dental visit. 64% of pediatricians were not aware that fluoride dentifrices and dental sealants will prevent dental caries. Conclusions: In general, pediatricians’ knowledge, attitudes and awareness regarding oral health and prevention of dental caries was not satisfactory. It is essential to develop oral health information programs to pediatricians.

English

BACKGROUND: Spondyloepiphyseal dysplasia as a sign of untreated congenital hypothyroidism is rare nowadays due to implementation of neonatal screening and increased awareness of pediatricians to detect hypothyroidism earlier. But neonatal screening is not routinely done in the developing countries. Congenital hypothyroidism is still unrecognized in some parts of developing world. OBJECTIVE: To describe the clinical, radiographic features and to stress the importance of screening of hypothyroidism during infancy and childhood and its current management. METHODS: Detailed history, physical examination and investigations. CONCLUSION: This report underscores the importance of detailed family history and physical examination in the diagnosis of spondyloepiphyseal dysplasia due to untreated congenital hypothyroidism, which was not screened for hypothyroidism during neonatal life. Being a treatable cause, hypothyroidism should always be considered as differential diagnosis of spondyloepiphyseal dysplasia, especially if the patient belongs to the developing world.

Pain in cognitively impaired children: a focus for general pediatricians

Pain in children with cognitive impairment and cerebral palsy is a particularly relevant issue due to its high prevalence and impact on quality of life. We review available evidence about prevalence of pain, causes and specific treatment, recognition and use of specific pain scales, physiology, and consequences of pain in this subset of patients. Pain is very common and is a critical determinant of quality of life in children with cognitive impairment and cerebral palsy. The diseases and associated complications that frequently expose these patients to pain can be treated and pain prevented. For patients with communication difficulties, appropriate, effective, validated tools are available and should be used to diagnose pain in itself, to >choose analgesic treatment and to determine effectiveness of these therapies. The level of awareness of pediatricians towards this issue seems to be quite low.

Diagnosing Hunter syndrome in pediatric practice: practical considerations and common pitfalls

Mucopolysaccharidosis II (MPS II), or Hunter syndrome, is an X-linked lysosomal storage disorder caused by a deficiency in the enzyme iduronate-2-sulfatase. Affected patients suffer progressive damage to multiple organ systems and early mortality. Two thirds of patients also manifest cognitive impairment and developmental delays. MPS II can be extremely difficult to diagnose before irreversible organ and tissue damage has occurred because of an insidious onset and the overlap in signs and symptoms with common childhood complaints. This is particularly true of patients without cognitive impairment (attenuated phenotype). Although not curative, early treatment with enzyme replacement therapy before irreversible organ damage has occurred may result in the greatest clinical benefit. Here, the signs, symptoms, and surgical history that should trigger suspicion of MPS II are described, and the diagnostic process is reviewed with a focus on practical considerations and the avoidance of common diagnostic pitfalls. Once a diagnosis is made, multidisciplinary management with an extended team of pediatric specialists is essential and should involve the pediatrician or family practice physician as facilitator and medical home for the patient and family. Conclusion: Because routine newborn screening is not yet available for MPS II, the involvement and awareness of pediatricians, family practice physicians, and pediatric specialists is critical for early identification, diagnosis, and referral in order to help optimize patient outcomes.

Pediatricians Awareness of Sleep Issues in Children, a National Survey

Pediatricians Awareness of Sleep Issues in Children, a National Survey

Pott’s puffy tumor, intracranial, and orbital complications as the initial presentation of sinusitis in healthy adolescents, a case series

Pott's puffy tumor (PPT) and intracranial complications of sinusitis are considered rare in the post-antibiotic era. We present a series of pediatric patients who were diagnosed with these complications. The purpose of this study is to discuss the clinical presentations and imaging findings in order to increase awareness of pediatricians and radiologists. A computer search identified nine pediatric patients who were admitted to our hospital between October 2006 and July 2009. The patients' charts and imaging studies were reviewed. There were eight males (11-16years old) and one female (9years old). All patients presented with significant headache and fever. Only two patients had sinusitis symptoms. CT and MRI revealed sinusitis in seven patients. These patients were diagnosed with epidural abscess (six), subdural empyema (one), PPT (five), focal meningitis (six), and orbital cellulitis (four). Two patients did not have sinusitis on the day of admission, but were treated recently for sinusitis. These two patients presented with frontal epidural abscess, PPT, thrombosis of the superior sagittal sinus, and frontal bone osteomyelitis. All patients were treated with a multidisciplinary approach and had good outcome with no residual neurologic deficits. Complications of sinusitis are not rare in the studied population. The presentation may be misleading. Therefore, a high index of suspicion is needed, particularly in adolescent males who present with significant headache and fever. Evaluation with contrast-enhanced CT of the brain, sinuses, and orbits should be done first, followed by MRI examinations.

Practice Parameters in Child Neurology: Do Pediatricians Use Them?

We assessed pediatrician awareness of the parameter ''Evaluating the first non-febrile seizure in children'' and how the concepts of this parameter were incorporated into practice. Although most reported caring for children with seizures, 60% were not aware of the practice parameter. When given the clinical scenario of an otherwise healthy 8-year-old child with a first, unprovoked seizure, management was variable. Most (83%) would obtain an electroencephalography, and many (58%) would order an imaging study, usually a magnetic resonance imaging. However, most were also likely to order laboratory studies that were not indicated given the scenario and the practice parameter. This pilot study suggests that pediatricians may not be aware of this practice parameter and many may not be incorporating evidence-based recommendations regarding the evaluation of children with new-onset seizures.

Medication Management in Primary and Secondary Schools: Assessing the Practices and Opinions of Pediatricians

1)To assess the awareness of pediatricians regarding the potential problems caused by children taking their medications before or during school hours 2) To identify the types of interventions pediatricians use to manage these issues 3)To assess the views of pediatricians regarding how well the process of medication management is handled by the schools that their patients attend. METHODS Thirty-five pediatricians completed a questionnaire inquiring about their prescribing habits for children under the age of 18, their views on the possible effects medications may have on children while at school, and what they do to minimize problems that may be associated with taking or being under the influence of medications while at school. The largest group of responding physicians (42.9%; n = 15) selected "Somewhat Common" when asked how common it is that they prescribe medications that must be used before or during school hours. The majority of responding pediatricians surveyed (62%; n = 21) believe that taking medications at school can create special problems. The majority of respondents (59.4%; n = 19) disagree with the statement that "Medications in Illinois schools are well managed by a trained agent. These pediatricians utilize a variety of strategies to minimize problems caused by medication use during or before school, and the most common of these is the prescribing of sustained release products. Pediatricians who responded to a survey are aware of potential problems associated with children being under the influence of, or taking medications during school hours. As a result, many have devised ways to ameliorate and/or prevent potential problems.

Primary Immunodeficiency Disorders: Survey of Pediatricians in Kuwait

Early diagnosis of primary immunodeficiency disorders (PID) is critical so life saving interventions can be implemented to avoid significant morbidity and mortality. Unfortunately, they are frequently misdiagnosed, which results into significant delay in diagnosis. This study aimed to determine the knowledge and practice of pediatricians in Kuwait about PID. A 66-item self-administered questionnaire was designed and distributed to the pediatricians working at all six governmental hospitals to measure their knowledge and practice about PID. A total of 244 pediatricians (78.4%; 143 males and 101 females) participated in the study. The mean age of participants was 40 years, and the mean number of years working in pediatrics was 13 years. The mean overall score was 59.6%, whereas the mean score in clinical presentation section was 63%, in associated diseases and syndromes section 58%, and in laboratory investigations section 51%. Only 26% of the participants answered correctly at least 2/3 of the questions (67% of the questions). This survey demonstrates that there is universal deficiency in both the knowledge and practice of pediatricians in the field of PID. Implementation of strategies to improve the awareness of pediatricians about PID is critical so early therapeutic interventions can be done to improve the health and prevent morbidity and mortality.

From Research to Practice: Teacher and Pediatrician Awareness of Phenotypic Traits in Neurogenetic Syndromes

Pediatricians' and teachers' knowledge of physical, cognitive, and behavioral features associated with three genetic syndromes were assessed and the effectiveness of information sources about these syndromes evaluated. The surveyed sample included 53 pediatricians and 69 teachers from Northern and Central California. Respondents demonstrated limited knowledge regarding the physical phenotype of fragile X syndrome and significantly less knowledge of velo-cardio-facial syndrome (VCFS). In the cognitive and behavioral domains, significantly more was known about Down and fragile X syndromes than VCFS. Pediatricians and teachers make critical treatment and education decisions for children with these syndromes and would benefit from continued professional development about these syndromes through conferences, professional/association publications, in-service teacher training, and journals.

Thick transverse vaginal septum: expectant management followed by surgery

Young patients with obstructing vaginal septum usually present themselves soon after menarche with pelvic pain secondary to the development of hematocolpos. Due to the awareness of pediatricians and in some cases neonatologists the diagnosis of vaginal obstruction can be suspected in juvenile patients at a much younger age. Various improved imaging techniques (abdominal or perineal ultrasonography CT and MRI) may add to the accurate diagnosis (vaginal agenesis versus transverse vaginal septum). The gynecologist may then be tempted to surgically correct the obstruction as soon as possible. In our case presented hereafter we describe the advantage of postponing surgical procedures in young girls thus facilitating a later surgical procedure. (excerpt)

Nonketotic hyperglycinemia in Suleimaniah Children’s Hospital, Riyadh, Saudi Arabia

Nonketotic hyperglycinemia in Suleimaniah Children’s Hospital, Riyadh, Saudi Arabia

Aortic dissection in children and young adults: diagnosis, patients at risk, and outcomes

To heighten the awareness of pediatricians and pediatric cardiologists to aortic dissection, a potentially dangerous medical condition. We reviewed the charts of 13 patients, seen in four medical centers, who suffered acute or chronic aortic dissection over the period 1970 through 2000 whilst under the age of 25 years. There were seven male and six female patients, with the mean age at diagnosis being 12.1 years, with a range from one day to 25 years. Congenital cardiac defects were present in five patients, and Marfan syndrome in four. In three of the patients with congenital cardiac defects, aortic dissection developed as a complication of medical procedures. In three patients, dissection followed blunt trauma to the chest. We could not identify any risk factors in one patient. The presenting symptoms included chest pain in four patients, abdominal pain and signs of ischemic bowel in two, non-palpable femoral pulses in one, and obstruction of the superior caval vein in one. Angiography and magnetic resonance imaging were the main diagnostic tools. Overall mortality was 38%. Only six patients had successful surgical outcomes. Due to the rarity of aortic dissection a high index of suspicion is required to reach the diagnosis in a timely manner. It should be considered in young patients complaining of chest pain in association with Marfan syndrome, anomalies of the aortic valve and arch, and chest trauma.