Highlights for the Management of a Child with Hypertension

Over the past several decades, childhood hypertension has undergone a considerable conceptual change, as hypertension is a predictor of future development of cardiovascular disease in adults. Childhood hypertension has distinctive features that distinguish it from hypertension in adults. Pediatric hypertension is often secondary. It is widely believed that therapeutic intervention at an early age favorably modifies the long-term outcome of hypertension. Despite its significance as a cause for morbidity, childhood hypertension is underdiagnosed and less studied with many basic issues remaining contentious

Pilot study: evaluation of the use of the convergent interview technique in understanding the perception of surgical design and simulation

BACKGROUND: It is important to understand the perceived value of surgical design and simulation (SDS) amongst surgeons, as this will influence its implementation in clinical settings. The purpose of the present study was to examine the application of the convergent interview technique in the field of surgical design and simulation and evaluate whether the technique would uncover new perceptions of virtual surgical planning (VSP) and medical models not discovered by other qualitative case-based techniques. METHODS: Five surgeons were asked to participate in the study. Each participant was interviewed following the convergent interview technique. After each interview, the interviewer interpreted the information by seeking agreements and disagreements among the interviewees in order to understand the key concepts in the field of SDS. RESULTS: Fifteen important issues were extracted from the convergent interviews. CONCLUSION: In general, the convergent interview was an effective technique in collecting information about the perception of clinicians. The study identified three areas where the technique could be improved upon for future studies in the SDS field

Therapeutic Options for the Treatment of Hypertension in Children and Adolescents

Primary hypertension in children is increasing in prevalence with many cases likely going undiagnosed. The prevalence is currently estimated at between 3%–5% in the United States and may be higher in certain ethnic groups. Primary hypertension, once felt to be rare in children, is now considered to be about five times more common than secondary hypertension. This review provides information to guide physicians through an organized approach to: 1) screening children and adolescents for hypertension during routine visits; 2) using normative percentile data for diagnosis and classification; 3) performing a clinical evaluation to identify the presence of co-morbidities; 4) initiating a plan of care including subsequent follow-up blood pressure measurements, therapeutic lifestyle changes and pharmacologic therapies

Pharmacokinetics of oral valganciclovir solution and intravenous ganciclovir in pediatric renal and liver transplant recipients

M.D. Pescovitz, R.B. Ettenger, C.F. Strife, J.R. Sherbotie, S.E. Thomas, S. McDiarmid, S. Bartosh, J. Ives, M.R. Bouw, J. Bucuvalas. Pharmacokinetics of oral valganciclovir solution and intravenous ganciclovir in pediatric renal and liver transplant recipients. Transpl Infect Dis 2010: 12: 195–203. All rights reservedIn an open-label, prospective, pharmacokinetic assessment, we evaluated total drug exposure (area under the curve [AUC]) of intravenous (IV) ganciclovir (GCV) and oral (p.o.) valganciclovir when normalized for body surface area (BSA) in pediatric liver ( n =20) and renal ( n =26) transplant patients Reference doses for IV GCV (200 mg/m 2 ) and p.o. valganciclovir (520 mg/m 2 ) were based on adult doses, and adjusted for BSA initially, and BSA and renal function (estimated via creatinine clearance [CrCL]) thereafter. Renal transplant patients received GCV on days 1–2, valganciclovir 260 mg/m 2 on day 3, and valganciclovir 520 mg/m 2 on day 4. Liver transplant patients received twice daily GCV from enrollment to day 12, and then valganciclovir twice daily on days 13–14. GCV pharmacokinetics were described using a population pharmacokinetic approach. Type of solid organ transplant (kidney or liver) had no effect on GCV pharmacokinetics. Median GCV exposure following valganciclovir 520 mg/m 2 was similar to that with IV GCV, and to that reported in adults. Patients <5 years of age had AUC values approximately 50% of those compared with older age ranges; dosing based on both BSA and CrCL increased drug exposure in younger patients. A dosing algorithm based on BSA and CrCL should be tested in future studies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78598/1/j.1399-3062.2009.00478.x.pd

Growth characteristics in individuals with osteogenesis imperfecta in North America: results from a multicenter study.

PurposeOsteogenesis imperfecta (OI) predisposes people to recurrent fractures, bone deformities, and short stature. There is a lack of large-scale systematic studies that have investigated growth parameters in OI.MethodsUsing data from the Linked Clinical Research Centers, we compared height, growth velocity, weight, and body mass index (BMI) in 552 individuals with OI. Height, weight, and BMI were plotted on Centers for Disease Control and Prevention normative curves.ResultsIn children, the median z-scores for height in OI types I, III, and IV were -0.66, -6.91, and -2.79, respectively. Growth velocity was diminished in OI types III and IV. The median z-score for weight in children with OI type III was -4.55. The median z-scores for BMI in children with OI types I, III, and IV were 0.10, 0.91, and 0.67, respectively. Generalized linear model analyses demonstrated that the height z-score was positively correlated with the severity of the OI subtype (P &lt; 0.001), age, bisphosphonate use, and rodding (P &lt; 0.05).ConclusionFrom the largest cohort of individuals with OI, we provide median values for height, weight, and BMI z-scores that can aid the evaluation of overall growth in the clinic setting. This study is an important first step in the generation of OI-specific growth curves

The Implications of the Acquisition of a New Nationality for the Right of Return of Palestinian Refugees

This article examines the legal consequences of the acquisition of a new nationality for the right of return of Palestinian refugees. The article argues that since the right of return is independent of the refugee status, the cessation of the latter should not necessarily abrogate the former. By examining the underpinnings of the right of return to one’s own country, especially the link between the individual and her territory, this article argues that this link is somehow weakened in a situation of naturalization in a different country. However, this weakening of the link should not automatically lead to the deprivation of rights. The circumstances that lead refugees to leave their country of origin, the circumstances preventing their return, and the decisions made by the individuals in view of their available options should be examined

Gender stereotypes in television advertising in the Middle East: Time for marketers and advertisers to step up

© 2020 Kelley School of Business, Indiana University Gender stereotypes, which are particularly harmful to women, have historically been prevalent in advertising, prompting some governments and brands to regulate conventional gender portrayals. This study examines current gender portrayals in television advertising in the Middle East, and specifically in the countries of the Gulf Cooperation Council (GCC), because of the increasing importance accorded to women\u27s empowerment in some of these countries. Building on similar studies elsewhere, we analyze the content of 111 distinct television advertisements aired over a week by a major TV channel in the region. Our analysis reveals that while depictions of certain aspects, such as role (familial/nonfamilial) and location (home/occupational setting), gently nudged traditional stereotypes by portraying women in nonfamilial roles and in occupational settings, depictions of background (female/male/children) and product type further reinforced traditional stereotypes. Based on these findings, we offer specific recommendations to marketers and advertisers in the region

Pediatric transplantation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75084/1/j.1600-6143.3.s4.6.x.pd