• Journal of Dental Anesthesia and Pain Medicine
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• 제20권5호
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• pp.303-312
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• 2020

Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.447-450
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• 2023

Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

• Clinical and Experimental Pediatrics
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• 제63권11호
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• pp.429-430
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• 2020

• 대한소아치과학회지
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• 제34권1호
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• pp.43-52
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• 2007

현재 우리나라는 치과의사 전문의제도가 도입되고 저출산 고령화 사회로의 급속한 이행 등 여러 이유로 소아치과 전문의 수급에 관한 연구가 절실한 실정이다. 본 연구는 소아치과 전문의 수요추계에 적합한 모형을 모색할 목적으로 의료인력 수급에 관한 타 분야의 기존 연구들을 고찰하여 다음과 같은 결과를 얻었다. 1. 소아치과 전문의의 수요추계는 의료수요에 근거한 방법을 적용하는 것이 적절할 것으로 사료되었다. 2. 추계 모형에 필요한 독립변수로는 크게 유병율, 수진율, 의뢰율 출산율, 생산성, 연간 진료일수 등이 있었으나, 이러한 변수들에 대입하기 위한 기초자료가 부족한 것으로 나타나, 이를 보완할 설문조사와 전문가 의견조사가 필요할 것으로 판단되었다. 3. 독립변수는 각 특성에 적합한 회귀모형을 설정하여 추계하고, 가중치를 주어 추계 모형에 반영해야 할 것으로 판단되었다. 향후 추계 모형에 대입하기 위한 독립변수의 생성과 추계연구, 전문가의 검증과정이 추가로 필요하며 이를 토대로 소아치과 전문의 수요를 추계하여야 할 것으로 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.291-292
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• 2016

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.122-128
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• 2008

Roughly one third of medical problems in children are related to the musculoskeletal system. Most of these problems are common and can be precisely diagnosed. For these problems, nonoperative treatment or reassurance can be given by the pediatrician. Occasionally, a problem needs surgical treatment, but a precise diagnosis must be made. There is little agreement about what types of orthopedic problems a primary care pediatrician should understand in order to effectively care for children. Many pediatric residencies lack an organized teaching curriculum that effectively covers these topics or that includes a required pediatric orthopedic rotation. In this article the authors delineate pediatric orthopedic problems that require recognition and urgent surgical treatment and are relatively common, but have different treatment options (observation, conservative treatment, and surgery) depending on their natural history. Whenever possible, the diagnosis should be made before a decision to refer is made. An accurate diagnosis allows the pediatrician to discuss the natural history of the condition properly. Referral to the wrong specialty can needlessly generate expensive tests and further delay in treatment or generate inappropriate treatment. The parents can be reassured rather than waiting to hear the same information from another physician. In particular, orthopedic problems are known to generate pressure from the parents to seek specialty consultation for reassurance. It is important to communicate to the specialist that the reason for the referral is for parental reassurance rather than for further work-up or treatment. After a proper diagnosis, communication directly between the pediatrician and the appropriate specialist can often avoid an unnecessary referral, and avoid unnecessary tests. The authors reviewed our experience at our outpatient clinic over last 1 year and found that it is useful to classify conditions as common or uncommon, and whether they require surgical or nonsurgical treatment. Many conditions fall in between. The following is a discussion of some of these more important or common conditions.

• International Neurourology Journal
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• 제22권4호
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• pp.287-294
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• 2018

Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

• 대한정형도수물리치료학회지
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• 제10권1호
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• pp.129-145
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• 2004

Many physical therapy who graduate department of physical therapy interested in physical therapy specialist. The boundary of physical therapy specialist is consist of 7 parts; CCS(Cardiopulmonary Certified Specialist), ECS(Clinical Electrophysiologic Certified Specialist), GCS(Geriatric Certified Specialist), NCS(Neurologic Certified Specialist), NCS(Neurologic Certified Specialist), OCS(Orthopaedic Certified Specialist), PCS(Pediatric Certified Specialist), SCS(Sports Certified Specialist). So the purpose of this study was to investigate of undergraduate student's interest about the area of special physical therapy and its academy. The data were collected from May 17 to 24, 2004 and 158 valid questionnaires were obtained and analyzed. It was for undergraduate students who major in physical therapy in college and university which are located in Busan, Ulsan and Kyoungnam province. The result is follows: 1. The research about the study of physical therapy after graduation was that 45.5% of female thought that they going to study as possible as they can was the best. In the case of men, 54.3% of male thought that they going to study was the best. 2. The result about recognition of special physical therapy was that 62.0% of people answered CCS, 69.6% of people answered GCS. The most familiar part of special physical therapy at course of school curriculum was that 88.0% of people answered OCS, and 84.2% of people answered NCS. 3. The result about the most interesting part of special physical therapy was that 68.6% of male and 36.1% of female answered OCS. On the other hand, the least part that people doesn't care was that 41.2% of male answered PCS, and 41.0% of female answered CCS. 4. About educational matters of special physical therapy and its academy was that 60% of answered 'Not enough'. An answer to question of special physical therapy and its academy's educational necessity. At the a course of faculty and clinical practice was that 58.9% of answered 'somewhat necessary'. After graduation, study a plan of special physical therapy was that 59.5% of answered 'immediate academy'. 5. Recognize scale in alternation physical therapy, think of extend physical therapy's territory is 'necessary of extend territory' was 78% the highest answer. 57.6% of answered was concerned about alternating physical therapy, and want to study.

• 호스피스학술지
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• 제5권2호
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• pp.54-63
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• 2005

The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

• 대한치과마취과학회지
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• 제13권3호
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• pp.103-110
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• 2013

Background: Recently the use of sedation by pediatric dentists in Korea is increased. This study describes training programs about sedation practices in Korean pediatric dentistry residency program. Methods: A questionnaire was filled in by participants of Korean Academy of Pediatric Dentistry on 17th-18th August, 2008. Also the data about sedation practices of the training institution is collected by phone call. Results: Seventy two percent of respondents used sedation. Most of them used sedation with agents under 25% of their patients. Distribution of ages in patients sedated with agents was 3 years, 4-5 years, under 2 years, 6-10 years, and more than 10 years. Determinative factors of using sedation were behavior management, number of visiting, amount of treatment and general condition, and oral route was the most favorable route. Sixty six percent of them have failed on sedation, and thity percent of them have rarely failed on sedation. Only fifty percent of dentists using sedation completed the cardiopulmonary resuscitation course. Conclusions: For safety, dentists using sedation need to be educated about emergency equipment and management. Especially medication dose, use frequency and the detail related to treatment procedure should be discussed carefully. Also putting a patient under general anesthesia and taking emergency measures should be discussed with Korean Dental Society of Anesthesiology.