Articles: child.
-
Eur J Trauma Emerg Surg · Dec 2024
Review Meta AnalysisDiagnostic accuracy of ultrasound versus X-ray for distal forearm fractures in children and adolescents: a systematic review and meta-analysis.
Utilizing ultrasound for the detection of distal forearm fractures in children presents a potential safe and radiation-free alternative compared to X-ray. ⋯ Our study indicates that ultrasound exhibits exceptionally high accuracy in the detection of distal forearm fractures in children and adolescents. It can be employed safely to either confirm or rule out a fracture, thus circumventing the need for potentially harmful radiation exposure in this vulnerable population. Future research endeavors should focus on establishing a universally accepted protocol for training and scanning methods to standardize practices and eliminate disparities in diagnostic procedures.
-
Observational studies have linked low vitamin D (VD) levels to increased asthma attacks in children. Subsequent meta-analyses of adults and children revealed that VD treatment might benefit asthmatic patients by reducing the incidence of exacerbations. Therefore, this review aims to analyze the effects of VD supplementation in reducing asthma exacerbations in children. ⋯ Vitamin D supplementation can lower the occurrence of exacerbations in children with asthma, along with the improvement of FEV1.
-
Review
Recommendations for Clinicians to Combat Environmental Disparities in Pediatric Asthma: A Review.
Asthma is a common and complex lung disease in children, with disproportionally higher prevalence and related adverse outcomes among children in racial and ethnic minority groups and of lower socioeconomic position. Environmental factors, including unhealthy housing and school-based exposures, can contribute to increased asthma morbidity and widening disparities. This underscores a significant environmental justice issue and suggests the need for clinical interventions to reduce sources of environmental exposures and ultimately diminish the observed disparities in childhood asthma. ⋯ Racial, ethnic, and socioeconomic disparities exist in asthma morbidity in children, and such disparities are driven in part by environmental factors at the housing and school level. Clinicians can make evidence-based recommendations to drive effective exposure reduction strategies to mitigate asthma morbidity and reduce observed disparities.
-
Pediatric neurocritical care teams care for patients and families facing the potential for significant neurologic impairment and high mortality. Such admissions are often marked by significant prognostic uncertainty, high levels of parental emotional overload, and multiple potentially life-altering decision points. In addition to clinical acumen, families desire clear and consistent communication, supported decision-making, a multidisciplinary approach to psychosocial supports throughout an admission, and comprehensive bereavement support after a death. ⋯ Decision-making requires its own ethical framework, with substitutive judgment giving way to the best interest standard as well as "good parent" narratives. When a child dies, bereavement support is often needed for the broader community. There will always be a role for specialist palliative care consultation in the pediatric neurocritical care unit, but the care of every patient and family will be well served by improving these primary palliative care skills.
-
Review
Systemic Psychotherapy: An Introduction to Its Theoretical Foundations and Clinical Practice.
Systemic therapy (ST) was approved as a further psychotherapy approach in line with the German Psychotherapy Directive's requirements in 2020 for adults and in 2024 for children and adolescents, and is thus covered by statutory health insurance. ⋯ ST broadens the scope of treatment options for mental disorders, with a specific focus on their social context.