Pediatrics international : official journal of the Japan Pediatric Society
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The purpose of the present paper was to assess efficiency of treatment and long-term functional outcome of complex regional pain syndromes (CRPS) in children who were treated in the chronic pain clinic at a major tertiary hospital in Israel. ⋯ CRPS in children and adolescents is still underdiagnosed, although many of the epidemiologic features of pediatric CRPS are similar in different countries/cultures. Early recognition and management is the major factor in improving outcome and preventing resistant CRPS, but even children with delayed diagnosis still have a good outcome. The management of this disease by an experienced multidisciplinary team is recommended. Because psychosocial factors play an important role, it is recommended to provide psychological evaluation and cognitive behavioral treatment as soon as possible.
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Comparative Study
Positive and negative work characteristics associated with burnout among primary care pediatricians.
There is little research regarding specific work features that might cause chronic stress and burnout among primary care pediatricians. The aim of the present study was first, to assess specific negative and positive characteristics of the job that might be related to burnout; and second, to compare burnout levels and work characteristics among board-certified versus general pediatricians; and clinic directors versus non-directors. ⋯ The absence of positive job features (e.g. autonomy, recognition for one's work and utilization of skills) may be more important in causing burnout than the presence of negative characteristics (e.g. overload, demanding and noisy parents). It is consistent with recent suggestions that in the presence of positive features, employees can better tolerate stressful aspects of the job and still feel motivated and engaged.
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Sepsis is characterized by a systemic inflammatory response. Its development and outcome are associated with host defense, pathogenicity of the microorganism and genetic polymorphisms. Genetic polymorphisms of the immune system genes have been shown to have a close relationship with the clinical outcomes of sepsis. Angiotensin-converting enzyme (ACE) plays a major role in the host defense against invading pathogens. It is therefore likely that polymorphisms in the ACE gene may have an important effect on determining the development and the outcome of sepsis. ⋯ DD genotype may play a positive role against the development of sepsis in healthy children.