scholarly journals What’s new in musculoskeletal ultrasound in pediatric rheumatology?

2018 ◽  
Vol 20 (3) ◽  
pp. 371 ◽  
Author(s):  
Mihaela Spârchez ◽  
Daniela Fodor

Musculoskeletal ultrasound (MSUS) has become almost indispensable in the rheumatology settings nowadays, allowing early diagnosis, careful guidance during procedures such as joint injections and therapy monitoring. Nonetheless, the applicability of MSUS in pediatric population is still limited. Recently, a standardized MSUS examination procedure in pediatric patients with rheumatic diseases, definitions for synovitis and the sonographic features of joints in healthy children has been developed. Also, important data on age-related  vascularization and ossification of joints in children have been published. Much work still needs to be done in the field. As juvenile idiopathic arthritis seems to be the most common use of MSUS in pediatric rheumatology, specific definitions and assessment techniques for enthesitis, tenosynovitis, bone and cartilage damage in children are very much expected. In this article, we will review briefly the current evidence-based knowledge regarding MSUS potential applications in the pediatric rheumatology clinical practice, along with an overview of the recent information about US appearance of musculoskeletal structures in healthy children.

2016 ◽  
Vol 68 (3) ◽  
pp. 348-356 ◽  
Author(s):  
Paz Collado ◽  
Jelena Vojinovic ◽  
Juan Carlos Nieto ◽  
Daniel Windschall ◽  
Silvia Magni-Manzoni ◽  
...  

Author(s):  
Yvonne Rogalski ◽  
Muriel Quintana

The population of older adults is rapidly increasing, as is the number and type of products and interventions proposed to prevent or reduce the risk of age-related cognitive decline. Advocacy and prevention are part of the American Speech-Language-Hearing Association’s (ASHA’s) scope of practice documents, and speech-language pathologists must have basic awareness of the evidence contributing to healthy cognitive aging. In this article, we provide a brief overview outlining the evidence on activity engagement and its effects on cognition in older adults. We explore the current evidence around the activities of eating and drinking with a discussion on the potential benefits of omega-3 fatty acids, polyphenols, alcohol, and coffee. We investigate the evidence on the hypothesized neuroprotective effects of social activity, the evidence on computerized cognitive training, and the emerging behavioral and neuroimaging evidence on physical activity. We conclude that actively aging using a combination of several strategies may be our best line of defense against cognitive decline.


2019 ◽  
Vol 1 (8) ◽  
pp. 42-50
Author(s):  
A. V. Budkevich ◽  
L. B. Ivanov ◽  
G. R. Novikova ◽  
G. M. Dzhanumova

According to the authors, rationing the age-related EEG parameters in children should be based on personal psychical characteristics. A comparative analysis of personal psychical characteristics and electroencephalographic data was carried out in 300 apparently healthy children aged 3-15 years. According to this principle, two subgroups of conditionally healthy children in each age group were singled out: 1) with an immature attention function and 2) with an increased anxious background that do not reach the pathological level. Registration and analysis of EEG was performed by the Neurokariograf computer complex (MBN, Moscow) using mathematical processing methods.The EEG interpretation was based on the principle of assessing the functional state of a child's brain using a three-component model according to: 1) wakefulness level and its dissociation, 2) severity of signs of the EEG neurotic pattern, 3) directionality of formation of traits of the system-functional brain organization (severity of signs functional hypofrontality).lt was found the presence of EEG signs was indicative of a lower level of wakefulness in children with an immature function of attention in all age groups, compared with the indicators of the average population of group and children with an increased background of anxiety. Children with an increased background of anxiety have a tendency to prevalence and excessive spatial synchronization of the alpha rhythm. ln healthy children, the fact of a decrease in wakefulness and the presence of signs of anxiety in the clinic and in EEG patterns indicates individual personalities and should not be considered as pathology.


2018 ◽  
Author(s):  
Lorraine Tudor Car ◽  
Bhone Myint Kyaw ◽  
Josip Car

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.


2021 ◽  
pp. 000348942110333
Author(s):  
Courtney Ann Prestwood ◽  
Ashley B. Brown ◽  
Romaine F. Johnson

Objectives: Patients with vocal cord paralysis can experience feeding, respiratory, and vocal problems leading to disability and decreased quality of life. Current evidence suggests waiting a period of 12 months for spontaneous recovery before permanent interventions. This study aims to determine the time to recover spontaneously and vocal cord movement in a pediatric population and create a model for evidence-based patient counseling. Study Design: Retrospective longitudinal cohort study. Methods: The report is a single institution longitudinal study on vocal cord paralysis recovery. Patients were categorized based on spontaneous recovery with vocal cord movement or no recovery. Recovery rates were determined using the Kaplan-Meier method. Results: Of 158 cases of vocal cord paralysis over a 4-year period, 36 had spontaneous recovery with symptom improvement and motion return. The average recovery was 8.8 months for those who recovered, and 78% recovered within 9 months. Two groups emerged from the data: an early recovery group with spontaneous recovery before 12 months and a late recovery group after 12 months. Children with dysphonia and paralysis due to cardiac surgery were less likely to recover, and children with aspiration were more likely to recover. Children with gastrointestinal comorbidities were less likely to recover; however, those who did recover were more likely to have recovered after 12 months. Based on our model, there is about a 3% chance of recovery between 9 and 12 months. Conclusions: Patients should be counseled about earlier interventions. Waiting the conventional 12 months for only a 3% chance of spontaneous recovery without intervention or laryngeal EMG may not be the preferred option for some patients and their families.


Author(s):  
Julia Reinhard ◽  
Anna Slyschak ◽  
Miriam A. Schiele ◽  
Marta Andreatta ◽  
Katharina Kneer ◽  
...  

AbstractThe aim of the study was to investigate age-related differences in fear learning and generalization in healthy children and adolescents (n = 133), aged 8–17 years, using an aversive discriminative fear conditioning and generalization paradigm adapted from Lau et al. (2008). In the current task, participants underwent 24 trials of discriminative conditioning of two female faces with neutral facial expressions, with (CS+) or without (CS−) a 95-dB loud female scream, presented simultaneously with a fearful facial expression (US). The discriminative conditioning was followed by 72 generalization trials (12 CS+, 12 GS1, 12 GS2, 12 GS3, 12 GS4, and 12 CS−): four generalization stimuli depicting gradual morphs from CS+ to CS− in 20%-steps were created for the generalization phases. We hypothesized that generalization in children and adolescents is negatively correlated with age. The subjective ratings of valence, arousal, and US expectancy (the probability of an aversive noise following each stimulus), as well as skin conductance responses (SCRs) were measured. Repeated-measures ANOVAs on ratings and SCR amplitudes were calculated with the within-subject factors stimulus type (CS+, CS−, GS1-4) and phase (Pre-Acquisition, Acquisition 1, Acquisition 2, Generalization 1, Generalization 2). To analyze the modulatory role of age, we additionally calculated ANCOVAs considering age as covariate. Results indicated that (1) subjective and physiological responses were generally lower with increasing age irrespective to the stimulus quality, and (2) stimulus discrimination improved with increasing age paralleled by reduced overgeneralization in older individuals. Longitudinal follow-up studies are required to analyze fear generalization with regard to brain maturational aspects and clarify whether overgeneralization of conditioned fear promotes the development of anxiety disorders or vice versa.


1999 ◽  
Vol 13 (7) ◽  
pp. 599-603 ◽  
Author(s):  
Robert H Riddell

In the paediatric population, the associations ofHelicobacter pyloriwith gastritis, gastric ulcer, duodenitis and duodenal ulcer, and with duodenal gastric surface metaplasia and disorders of the D cell-G cell axis resulting in hypergastrinemia, are well established and in many ways resemble their counterparts in adults. Eradication ofH pyloriinvariably results in the reversal of these diseases with time. There are also suggestions that gastric surface metaplasia is more extensive in children withH pylori, and may be the site of duodenalH pyloriinfection and associated duodenal erosions or ulcers. There is no consensus as to whetherH pyloriin children is more or less severe than in adults. In one paediatric cohort,H pyloriwas associated with increased intensity of inflammation, while other studies suggest that acute inflammation may be less intense in children overall but that chronic inflammation may be increased in intensity, including lymphoid hyperplasia, which in turn may correlate with endoscopic nodularity. Lymphoid hyperplasia and nodular gastritis appear to be more frequent in children than in adults and usually regress followingH pylorieradication. However, in children, other diseases or morphological abnormalities, including some loss of glands (atrophy), occasionally intestinal metaplasia, lymphoproliferative diseases including low grade mucosal-associated lymphoid tissue lymphoma, lymphocytic gastritis and hypertrophic gastritis/Menetrier’s disease, are much less frequently associated withH pylorithan in adults. Other associations are rarely seen in children, primarily because the time required for these to develop takes the individual to adulthood; for example, while intestinal metaplasia occurs in the pediatric population, the complications of adenoma/dysplasia and carcinoma are rare. In adults, inflammatory and hyperplastic polyps, atrophic gastritis and pernicious anemia, and in some patients granulomas (granulomatous gastritis), may also be associated withH pyloriinfection. Greater awareness of the spectrum of diseases associated withH pylorimay well lead to their increased recognition in the paediatric population. Some diseases, particularly Crohn’s disease, but also human immunodeficiency virus infection, have a negative association withH pylorithat appears not to be simply a result of the excess antibiotic therapy that these patients receive. These variations in association and reactions toH pylori, some of which are age-related, may allow the different host responses toH pylorithat occur in humans to be examined.


Author(s):  
Irineu Loturco ◽  
Antonio Dello Iacono ◽  
Fábio Y. Nakamura ◽  
Tomás T. Freitas ◽  
Daniel Boullosa ◽  
...  

Purpose: The optimal power load is defined as the load that maximizes power output in a given exercise. This load can be determined through the use of various instruments, under different testing protocols. Specifically, the “optimum power load” (OPL) is derived from the load–velocity relationship, using only bar force and bar velocity in the power computation. The OPL is easily assessed using a simple incremental testing protocol, based on relative percentages of body mass. To date, several studies have examined the associations between the OPL and different sport-specific measures, as well as its acute and chronic effects on athletic performance. The aim of this brief review is to present and summarize the current evidence regarding the OPL, highlighting the main lines of research on this topic and discussing the potential applications of this novel approach for testing and training. Conclusions: The validity and simplicity of OPL-based schemes provide strong support for their use as an alternative to more traditional strength–power training strategies. The OPL method can be effectively used by coaches and sport scientists in different sports and populations, with different purposes and configurations.


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