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  • ISSN: 2373-9312
    Volume 6, Issue 2
    Case Report
    Lynnette Mazur*, Jason Johnston, and Fatima Aly
    Our report summarizes the case of a girl presenting with symptoms suggestive of dermatomyositis after environmental exposure during Hurricane Harvey. Her symptoms were later diagnosed as contact dermatitis secondary to playing with slime, a substance sweeping the nation as a common toy. Given the increased exposure to slime in pediatric populations, we believe our report will appeal to pediatricians seeking more information about the effects of playing with slime and its possible sequelae. Our report will provide insight into ingredients used in various slime formulations as well as possible findings on physical exam. We were unable to find any reports concerning slime in review of current literature, but we did find a significant number of news reports pertaining to symptoms experienced in the pediatric population including but not limited to rashes, burns, and headaches.
    Late Diagnosed Fanconi Anemia and Practical Consequences
    8-year-old girl admitted for management of left hemi paresis. The CT scan supplemented with MRI angiography revealed ischemic lesions related to cerebral microangiopathy. The association of limb and kidney malformations, as well as the small size and pancytopenia had led us to anemia of fanconi.
    Research Article
    Thaizi Campos Barbosa*, Jonathan Souza, Matheus Morbeck Zica, Bharbara Karolline Rodrigues Silva, Francisco Winter dos Santos Figueiredo, Fernando Rodrigues Peixoto Quaresma, Fernando Adami, and Erika da Silva Maciel
    Introduction: Modern society is faced with limitations to practice physical activity, due to the lack of infrastructure, lack of time, lack of public safety and growth of sedentary activities that favor a sedentary lifestyle.
    Objective: Examined the relationship between motor performance and body composition of school children.
    Methods: A cross-sectional study was carried out with schoolchildren between 9 and 10 years of age from a public school in the city of Palmas, Tocantins, Brazil. We measured the Metabolic Equivalent, body composition and motor performance. For the analysis of association between variables, the Mann-Whitney test and Spearman correlation test were used.
    Results: The sample comprised 123 children with 65% being females, 57.72% was classified as appropriate regarding fat percentage and 62.61% as eutrophic for BMI. In relation to motor performance, 60.98% was below ideal. When the association between motor performance and gender was evaluated, it was observed that boys presented better indices than girls. Regarding the relationship between body composition and motor performance, it can be observed that the higher the body composition the lower the motor performance, mainly between cardiorespiratory endurance.
    Conclusion: The study showed a negative relationship between body composition and motor performance of schoolchildren in both sexes, thus, students with higher body weight and body fat have lower performance.
    DeeAnne Jackson, Pranaya Chilukuri, Chrystal Rutledge, Stacy Gaither, Kristine Sawyer, and Nancy M. Tofil*
    Objective: To provide training in the immediate response to newborn emergencies in a Level 1 newborn nursery, to assess the efficiency of this training for increasing the comfort level of pediatric residents and nurses in emergency recognition and response, and to identify systems issues that pose potential barriers to optimal patient care.
    Patients and methods: Two simulation cases were designed and implemented monthly. Case 1 was respiratory distress and apnea. Expected management included recognition of respiratory distress/apnea, calling for assistance, and effectively performing bag valve mask ventilation. Case 2 was a seizure related to hypoglycemia. Expected management included checking blood glucose level, inserting an intravenous catheter, and administering intravenous dextrose. Debriefing occurred after each scenario focusing on management, barriers to care and inter-professional communication. Pre- and post-training, participants completed surveys assessing comfort level with newborn medical emergencies.
    Results: Over a 10-month period, 40 learners (18 resident physicians (MD)/22 nurses (RN)) participated in training. There was a statistically significant improvement in perceived comfort level out of 5 from 3.74 ± 0.7 to 4.48 ± 0.42 (p <0.0001) for residents and nurses. Overall average confidence was higher for nurses than residents (4.26 ± 0.75 versus 3.89 ± 0.75; p = 0.02) both pre- and post-simulation. Learning themes included: emergency response process (n=11), teamwork focus (n=10), seizure management (n=10), and effective bag valve mask ventilation/troubleshooting (n=7). Training was successful in identifying nursery systems issues including a deficit in pediatrics resident knowledge of the hypoglycemia protocol and staff inability to locate the pediatric code cart and infant code button.
    Conclusions: Training of newborn nursery staff in the recognition and management of rare, newborn emergencies through simulation was successful in improving comfort level and identifying systems issues and strategies for improvement.
    Mariana González de Oliveira*, Marola Flores da Cunha Scheeren, Humberto Holmer Fiori and Joana S. Machry
    Objectives: To investigate whether changing maternal milk expression routine reduces exclusive mother's own milk (MOM) feedings rate at discharge for very low birth weight infants.
    Methods: Prospective observational cohort study with historic control, including infants with gestational age = 30 weeks and/or birth weight = 1500g. Patients were divided in two groups, according to maternal milk expression routine: at the hospital and at home (Group 1) or only at the hospital (Group 2). Main outcome was type of feeding at discharge (exclusive MOM, any MOM or formula). Independent variables were evaluated using Student's t test, Mann-Whitnney, and Fisher's exact test in univariate model. Variables with p <0.05 were included in a logistic regression model.
    Results: We followed 433 patients up until discharge, 147 in Group 1 and 286 in Group 2. Group 2 received prenatal steroids more frequently, had lower gestational age, higher frequency of enterocolitis and higher post menstrual age at discharge. They also received less exclusive MOM (48/147 vs 157/286, p = 0.01). There was no difference regarding formula. In logistic regression model, only post menstrual age remained independently associated with exclusive MOM feeding failure at discharge. Every additional week of hospitalization reduced in 10% the chance of receiving exclusive MOMfeedings at discharge (OR 0.89; CI 0.83-0.96; p=0.05).
    Conclusion: Reducing maternal milk expression and longer hospital stay are associated with reduction of exclusive MOM feeding at discharge. Each additional week of hospitalization reduced the chance of exclusive MOM feeding at discharge by 10%.
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