ARTICLE CRITIQUES


 


 


Newborn with a Scalp Lesion


            The article presents an image of a newborn infant with a lesion and proceeds to discussing the diagnosis of the abnormality in the newborn. The article discusses the conditions, causes, complications and some forms of treatment of “aplasia cutis congenita”, the disease of the patient. The article states that this disease is a complex disorder that can sometimes involve other abnormalities in the cardiovascular, gastrointestinal, genitourinary, and central nervous systems of the person suffering from it. It has no established causes but several factors such as teratogens, genetic, trauma and compromised skin perfusion can contribute to the presence of the condition.  (2006) states that defects in the skin that develop early in gestation may heal before delivery and may occur as an atrophic or parchment-like scar while less mature defects manifest as ulcerations. Most lesions appear in the scalp vertex but defects may also manifest on the face, trunk, or limbs. Langerhans cell histiocytosis affects many organ systems and the scalp manifests scaling patches. Sebaceous nevus is characterized by yellowish and hairless lesions in the scalp or face. Neonatal herpes manifests as scalp ulceration while transient bullous dermolysis is a disease characterized by development of blisters in the epidermal layer of the skin. Focal dermal hypoplasia is common in women and is characterized by skin abnormalities. Treatment may include gentle cleansing, ointment, antibiotics, excision with primary closure, use of tissue expanders, skin and bone grafts, and complete osseous regeneration (2006).


Childhood Discipline: Challenges for Clinicians and Parents


 


 


            The article tackles childhood discipline as a responsibility of both parents and clinicians. The article works on the notion that family physicians and pediatricians often fail to incorporate topics about discipline in their well-child examination sessions with parents. It also affirms that discipline is a vital element of a child’s normal development thus, it should be done properly. Accordingly, the article first explains the biological and psychological factors leading to misbehavior in children. Then, the article elaborates on the principles of discipline. It argues that discipline should be based on the age and level of understanding of the child, severity of offense and should be consistent, to be effective. Furthermore, the article identifies the methods, advantages and risks of the different types of discipline such as positive reinforcement, punishment, extinction, verbal punishment and corporal punishment. The last part of the article discusses the ways on how clinicians and parents can openly talk about discipline in children without actually imparting scrutiny and criticism of parenting skills. The article concludes that since discipline is an important element of the social and emotional development of the child, it should be an integral part of preventive health program for children.  (1989) agrees with the arguments of the article by saying that discipline is the concern of parents, educators and governments. It should not only be a response to bad behavior in children but should also be a way to teach children on how they would be able to effectively deal with life and cope with problems ().


 


Clinical Presentations of Parvovirus B19 Infection


            The article discusses the different clinical manifestations of Parvovirus B19. Infection with the virus usually results to mild, cold-like symptoms but certain conditions are said to be associated with the virus. Erythema infectiosum, the most obvious manifestation of B19 infection, affects children aged 4 to 10 years old.  (1992) claims that this infection starts with a low-grade fever and general feeling of discomfort. Rashes would appear after 7 to 10 days starting from the cheeks and spreading to the trunk and extremities in a lacy pattern. This infection does not require any oral treatment but calamine lotion and cold water can soothe itching (). Arthropathy is a complication of erythema infectiosum which affects the knees, joints, ankles and wrists. This infection may be treated with a nonsteroidal anti-inflammatory drug. Transient aplastic crisis occurs when B19 virus infects those people with iron deficiency anemia, HIV, sickle cell disease, spherocytosis and thallassemia. This is fatal infection that requires multiple blood transfusions. Furthermore, parvovirus B19 infection can persist in those people who are unable to develop normal immune response and with the absence of antibodies. Chronic red cell aplasia may be addressed by immune globulin therapy. “Gloves and socks syndrome” mostly affects young adults and is characterized by abnormal redness and swelling of the hands and feet. Patients also suffer fever and pains in the joints. Finally, hydrops fetalis occurs when a woman infected with B19 becomes pregnant and infects the infant. The highest risk can be found in the second trimester of pregnancy because of increased hematopoiesis in the liver. Fetal blood sampling and transfusions are required when hydrops fetalis occur in the infant.



Credit:ivythesis.typepad.com


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