DISEASES OF CHILDREN FOR NURSES
CHAPTER 1 INTRODUCTION OF CHALLENGES WITH PEDIATRIC DISEASES 1 INTRODUCTION 2 ACCESS TO HEALTH SERVICES 3 POVERTY AND SOCIAL PROBLEMS 4 ADOLESCENTS PREGNANCY AND ABORTION 5 ETHNICITY 5 MENTAL DISORDERS 5 DEPRESSION 6 SUICIDE 7 BULLYING 7 SOCIAL MEDIA 8 CHILD ABUSE 8 SUBSTANCE ABUSE 9 ADOPTION AND FOSTER CARE 9 ENVIRONMENTAL TOXINS 10 NATURAL DISASTERS 10 CHILD INJURY 10 BREASTFEEDING 11 CHRONIC ILLNESSES AND NON-COMMUNICABLE DISEASES 11 EARLY GENETIC AND PRENATAL DIAGNOSIS 12 PREMATURITY AND LOW BIRTH WEIGHT 13 CONGENITAL ANOMALIES 13 MALIGNANCY 14 MEDICAL FUTILITY AND END-OF-LIFE-CARE 14 HOW TO INTERACT WITH A SICK CHILD 16 CONCLUSION 17 ACKNOWLEDGEMENT 17 REFERENCES 17 CHAPTER 2 POSITIVE AND NEGATIVE OUTCOMES OF SEXTING 30 INTRODUCTION 30 SEXTING: POSITIVE AND NEGATIVE OUTCOMES 31 CONCLUSION 33 CONSENT FOR PUBLICATION 34 CONFLICT OF INTEREST 34 ACKNOWLEDGEMENT 34 REFERENCES 35 CHAPTER 3 THE ROLE OF INTEGRATED SERVICES IN THE CARE OF CHILDREN AND YOUNG PEOPLE WITH NEURODEVELOPMENTAL DISORDERS AND CO-MORBID MENTAL HEALTH DIFFICULTIES: AN INTERNATIONAL PERSPECTIVE 37 INTRODUCTION 38 EVIDENCE-BASED DIAGNOSIS OF NDEBID 41 ANALYSIS OF INTEGRATED CARE 41 The Negative Impact of Disjointed Services for CYP With NDEBIDs and Co-Morbid Mh Disorders 41 Inefficient Multiple Assessments 41 Confusing Multiple Referral Pathways 42 Delays in Accessing the Required Assessment and Treatment 43 Conflicts Among Professionals 43 Barriers to Integrated Care for CYP with NDEBIDs and Additional MH Difficulties 44 Strategic Difficulties in Service Commissioning, Funding and Planning 44 Limited Evidence-Base 46 Difficulties Related to Professionals 47 Benefits of Integrated Care for CYP with NDEBIDs and Co-Morbid MH Difficulties (Box 1) 48 User Preference and Satisfaction 48 Improved Equity of Access and Reduced Time to Point-of-Care 48 Improved Care Efficiency 49 Improved Protection for More Vulnerable Children 49 Improved Transitional Care Services for Young People? 50 Improved Understanding and Cooperation Among Professionals 51 Reduced Impact of Mental Health Stigma 51 Alignment with Emerging Government Policy 52 Integrated Services in the Context of Low and Middle Income Countries 52 Significant Needs 52 Resource Gaps 53 Limited Evidence-Base 54 DESIRABLE FEATURES OF INTEGRATED SERVICES FOR CYP WITH NDEBID AND CO-MORBID MENTAL HEALTH DIFFICULTIES 54 Joint Service Commissioning 55 Adequate and Ring-Fenced Funding 56 Effective Service Planning and Implementation 56 Evidence-Based Practice 57 Continuity of Support 58 Effective and Motivated Strong Leadership 58 Professional Training and Continuous Development 59 Parents’ Training and Psychoeducation 60 SUCCESSFUL EXAMPLES OF INTEGRATED SERVICES FOR OTHER CHRONIC DISORDERS 62 CONCLUSION 62 CONSENT FOR PUBLICATION 64 CONFLICT OF INTEREST 64 ACKNOWLEDGEMENT 64 REFERENCES 64 CHAPTER 4 EPIDEMIOLOGICAL EVIDENCE FOR INFLUENCES OF NON-GENETIC TRANSGENERATIONAL INHERITANCE ON CHILD AND ADOLESCENT DEVELOPMENT 73 INTRODUCTION 74 NOMENCLATURE 74 EXPERIMENTAL EVIDENCE 74 Toxic Metal Exposure 75 Endocrine Disruptors 75 HUMAN OBSERVATIONAL STUDIES 76 Prospective Pedigree 76 Retrospective Pedigree 76 PRECONCEPTION EXPOSURES 77 Famine and Glut 77 ?verkalix and Uppsala 77 Other Famines 78 Nutrition in Guatemala 79 Preconception Smoking Effects 80 Preconception Radiation Exposure 81 Other Preconception Exposures 82 PRENATAL EXPOSURES 82 Maternal Exposures in Pregnancy 82 Teratogens and Carcinogens 82 Famine 83 Cigarette Smoking 85 Effects of Grandmothers’ Exposures in Pregnancy on the Grandchild 86 The Example of DES 86 Famine during Grandmother’s Pregnancy 87 The Dutch Hunger Winter 87 The Chinese Famine 1959-61 87 Grandmother Smoked During Pregnancy 88 Radiation 93 DISCUSSION 94 General Results 94 Consistency (Replication) 95 Specificity 95 Temporality 95 Biological gradient 95 Plausibility 95 Coherence 96 Experimental Evidence 96 Evidence from Biomarkers 96 CONCLUSION 97 APPENDIX 97 ABBREVIATIONS 98 CONSENT FOR PUBLICATION 99 CONFLICT OF INTEREST 99 ACKNOWLEDGEMENTS 99 REFERENCES 99 CHAPTER 5 CLINICAL APPROACHES TO GENETIC EPILEPSIES IN CHILDREN 107 INTRODUCTION 108 CLINICAL AND DIAGNOSTIC APPROACH 109 MOLECULAR GENETIC WORK-UP 112 ILLUSTRATIVE DISEASES 115 Channelopathies 115 General Aspects 115 Illustrative Disease: Dravet Syndrome 116 Transportopathies 117 General Aspects 117 Illustrative Disease: GLUT1 Deficiency Syndrome 118 Disorders of the Intermediate Metabolism 119 General Aspects 119 Illustrative Disease: ALDH7A1 Deficiency 119 Disorders of Neuronal Cellular Cycle and Signaling 120 General Aspects 120 Illustrative Diseases: Disorders of mTOR and GATOR1 Pathways 120 Disorders of Synaptic Vesicles Trafficking and Release 121 General Aspects 121 Illustrative Disease: STXBP1 Encephalopathy 122 Disorders Involving Neuronal Structural Proteins 122 General Aspects 122 Illustrative Disease: PCDH19-Related Epilepsy 123 Disorders of Synaptic Secreted Proteins 123 General Aspects 123 Illustrative Disease: LGI1-Related Epilepsy 123 Chromosomopathies and Pathogenic Copy Number Variants 124 General Aspects 124 Illustrative Disease: 15q132–133 Microdeletion Syndrome 124 CONCLUSION 125 LIST OF ABBREVIATIONS 125 CONSENT FOR PUBLICATION 127 CONFLICT OF INTEREST 127 ACKNOWLEDGEMENT 127 REFERENCES 127 CHAPTER 6 MEDICAL AND SOCIAL OUTCOMES IN THE MANAGEMENT OF CARDIAC DISEASES IN CHILDREN 130 INTRODUCTION 131 EPIDEMIOLOGY OF CARDIAC DISEASES IN CHILDREN 131 MEDICAL AND SOCIAL OUTCOMES 133 EFFECTS OF MANAGEMENT 133 MENTAL HEALTH 134 THE SOCIAL OUTCOMES OF CARDIAC DISEASES MANAGEMENT 134 THE POSITIVE SOCIAL OUTCOMES OF MANAGEMENT 134 MORBIDITY AND MORTALITY 134 ECONOMIC BURDEN OF PEDIATRIC HEART DISEASES 135 Economic Burden 136 Factors that Contribute to the Increased Economic Burden of Cardiovascular Diseases in Children 138 Late Referral and Diagnosis 138 Poor Health Financing 138 Lack of Health Insurance or Social Welfare System 139 The Complexity of the Diseases Process and Intervention 139 Health System Challenges 139 Family Composition and Socioeconomic Status 140 Medical Litigation/Malpractice Cost 140 CONCLUSION 141 CONSENT FOR PUBLICATION 141 CONFLICT OF INTEREST 141 ACKNOWLEDGMENTS 141 REFERENCES 141 CHAPTER 7 MECONIUM STAINED NEWBORN 145 INTRODUCTION 145 ETIOLOGY 147 Etiology and Risk Factors for MSAF 148 MECONIUM ASPIRATION SYNDROME 149 Pathophysiology of MAS 149 Fetal Hypoxia 150 Mechanical Obstruction of Airways 151 Surfactant Inactivation 151 Inflammation and Chemical Pneumonitis 151 Persistent Pulmonary Hypertension 152 Secondary Infection 152 Clinical Features 152 Diagnosis 154 Management 155 Neonatal Management in the Delivery Room 155 Management Beyond the Delivery Room 156 Supportive Therapy and General Measures 157 Respiratory Support 157 Mechanical Ventilation 158 High-Frequency Ventilation 158 Surfactant Therapy 159 Corticosteroid Therapy 159 Antibiotics 160 Inhaled Nitric oxide 160 Extracorporeal Membrane Oxygenation 160 Future Therapy 161 CONCLUSION 162 ABBREVIATIONS 162 CONSENT FOR PUBLICATION 163 CONFLICT OF INTEREST 163 ACKNOWLEDGMENTS 163 REFERENCES 164 CHAPTER 8 TRANSIENT TACHYPNEA OF THE NEWBORN 169 INTRODUCTION 169 Dynamics of Fetal Lung Fluid 170 ETIOLOGY 173 CLINICAL FEATURES 174 LABORATORY FINDINGS 175 DIFFERENTIAL DIAGNOSIS 176 MANAGEMENT 177 PREVENTION 178 PROGNOSIS 178 CONCLUSION 178 CONSENT FOR PUBLICATION 178 CONFLICT OF INTEREST 178 ACKNOWLEDGEMENT 178 REFERENCES 179 CHAPTER 9 FETAL TUMORS: DIAGNOSIS AND MANAGEMENT 182 INTRODUCTION 183 THE MOST COMMON PRENATAL TUMORS 183 Intracranial Tumors 184 Teratoma 184 Glioma 185 Other Intracranial Tumors 185 Thoracic Tumors 185 Congenital Cystic Adenomatoid Malformation (CCAM) 186 Broncho-Pulmonary Sequestration (BPS) 186 Pleuro-Pulmonary Blastoma (PPB) 187 Interstitial Lung Tumors (ILTs) 187 Heart Rhabdomyoma 187 Pericardial Teratomas 188 Other Thoracic Tumors 188 Intra-Abdominal and Pelvic Tumors 188 Kidney Tumors 189 Hepatic Tumors 189 Pelvic Tumors 190 Other Significant Tumors and Malignancies 192 Neuroblastoma 192 PRENATAL DIAGNOSTIC TOOLS 193 Imaging Modalities 193 Ultrasonography 193 Magnetic Resonance Imaging 194 Prenatal Tissue Sampling 194 Genetic Studies