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Pediatric emerency

Robert Hegarty, Maesha Deheragoda, Emer Fitzpatrick, Anil Dhawan
The recognition of a pattern of steatotic liver injury where histology mimicked alcoholic liver disease but alcohol consumption was denied, led to the identification of non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease has since become the most common chronic liver disease in adults owing to the global epidemic of obesity. However, in pediatrics, the term NAFLD seems incongruous: alcohol consumption is largely not a factor and inherited metabolic disorders (IMD) can mimic or co-exist with a diagnosis of NAFLD...
February 19, 2018: Journal of Hepatology
V Iansante, R R Mitry, C Filippi, E Fitzpatrick, A Dhawan
Liver transplantation is the accepted treatment for patients with acute liver failure and liver-based metabolic disorders. However, donor organ shortage and lifelong need for immunosuppression are the main limitations to liver transplantation. In addition, loss of the native liver as a target organ for future gene therapy for metabolic disorders limits the futuristic treatment options, resulting in the need for alternative therapeutic strategies. A potential alternative to liver transplantation is allogeneic hepatocyte transplantation...
December 6, 2017: Pediatric Research
Rashmi S D'Souza, Lara Neves Souza, Alexander Isted, Emer Fitzpatrick, Sunitha Vimalesvaran, Corina Cotoi, Saista Amin, Nigel Heaton, Alberto Quaglia, Anil Dhawan
Long-term graft fibrosis occurs in the majority of pediatric liver transplant recipients. Serial biopsies to monitor graft health are impractical and invasive. The APRI has been evaluated in pediatric liver disease, but not in the context of post-transplantation fibrosis. We aimed to investigate the validity of APRI as a predictor of long-term graft fibrosis in pediatric liver transplant recipients. This was a retrospective, observational study of a cohort of children who underwent liver transplantation at King's College Hospital between 1989 and 2003, with a relevant dataset available...
March 2016: Pediatric Transplantation
Eirini Kyrana, Emer Fitzpatrick, Anil Dhawan
The chronic nature of liver diseases in children and adults merits close follow-up for disease progression and/or treatment evaluation. Disease progression involves injury to liver cells resulting in cell death, varying degrees of inflammation, steatosis depending on the insult, oxidative stress, and eventually fibrosis and cirrhosis unless the process is modified with treatment or spontaneous recovery. Inflammation, cell death, and fibrosis are the three major processes that determine the outcome of liver disease irrespective of the etiology...
2016: Nestlé Nutrition Institute Workshop Series
Jason J Emer, Sebastian G Bernardo, Olga Kovalerchik, Moneeb Ahmad
Urticaria multiforme is a benign cutaneous hypersensitivity reaction seen in pediatric patients that is characterized by the acute and transient onset of blanchable, annular, polycyclic, erythematous wheals with dusky, ecchymotic centers in association with acral edema. It is most commonly misdiagnosed as erythema multiforme, a serum-sickness-like reaction, or urticarial vasculitis. Since these three diagnoses represent distinct clinical entities with unique prognoses and management strategies, it is important that physicians distinguish urticaria multiforme from its clinical mimics in order to optimize patient care...
March 2013: Journal of Clinical and Aesthetic Dermatology
Sara E C Raftery, Mary P Clynes, Colleen O'Neill, Emer Ward, Imelda Coyne
Problem-based learning (PBL) is well established in health education. It is regarded as a constructionist approach to education that emphasizes students' active engagement with the learning process, self-direction, and learning in a meaningful context. This article details the experiences of nurse lecturers in one university in the Republic of Ireland during the introduction of a PBL module to students enrolled in a higher diploma in children's nursing program. All lecturers attended a three-day training program on the principles and processes of PBL...
July 2010: Nursing Education Perspectives
Richard H Lee, Kenneth W Lyles, Cathleen Colón-Emeric
BACKGROUND: Osteoporosis and seizure disorders are common diagnoses in older adults and often occur concomitantly. OBJECTIVE: The goal of this review was to discuss the current hypothesis for the pathogenesis of anticonvulsant-induced bone density loss and the evidence regarding the risk for osteoporosis and fractures in older individuals. METHODS: A review of the literature was performed, searching in MEDLINE and CINAHL for articles published between 1990 and October 2009 with the following search terms: anticonvulsant OR antiepileptic; AND osteoporosis OR bone density OR fracture OR absorptiometry, photon...
February 2010: American Journal of Geriatric Pharmacotherapy
Emer Fitzpatrick, Billy Bourke, Brendan Drumm, Marion Rowland
OBJECTIVE: Cyclic vomiting syndrome (CVS) is characterized by severe recurrent episodes of vomiting in an otherwise healthy child. Currently, there is no population data on the incidence of CVS. The aim of this study was to determine the incidence of CVS and to define the clinical characteristics of the condition at diagnosis. METHODS: Each pediatrician on the island of Ireland was surveyed on a monthly basis from January 1, 2005 to December 31, 2005 by the Irish Pediatric Surveillance Unit (IPSU) and was asked to report any incident cases of CVS according to the criteria outlined by the First International Symposium on CVS...
April 2008: American Journal of Gastroenterology
Céline Goulet, Linda Ward, Emile Lévy, Christine Colin
The progression of nursing research within clinical settings is lingering. Favouring the emer gence of a research culture in these environments requires concerted action; it is effectively the only way real change can occur. It is within this perspective that an association was made between the directions of the Nursing Faculty of the Université de Montreal, of the Research Center and Nursing Direction of the CHU Sainte-Justine (CHU). This experience is unique and deserves attention for the benefit of nurses and the advancement of the profession...
March 2006: Recherche en Soins Infirmiers
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