Eating Disorders and Pregnancy: The Case of Anorexia

The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

Child’s Point of View vs.Adult’s in Melville’s Early Two Stories

This paper aims to study the functions of two different points of view from the perspective of narratology,namely,the point of view of the adult and the one of the child,in two of Herman Melville’s early stories.By contrasting these two functions of the different perspectives,the author of this paper draws the conclusion that the child has a unique and significant perspective in Melville’s works.

Mapping the Child’s Grey Interior:Authenticity of Plague Narrative in The Great Plague

The Great Plague:The Diary of Alice Paynton,London 1665-1666 adopts the realistic painting style and direct writing to the painful experience,describes the situation of the Great Plague in London truly from the perspective of children,and breaks people’s cognitive expectation of children’s literature,the construction of children’s Gray inner world is completed behind the true description of the Great Plague in London with the true brushwork,which presents a different world of childlike innocence.Despite the importance of epidemics writing in literature,the child’s diary perspective of them is one of the least developed of Plague Narrative.Only when authenticity and the child’s grey interior are integrated will we reveal a true picture of society as it was.

Clinical Analysis of 60 Cases of Children's Anorexia Treated with Massage

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Unusual manifestations of gastric inflammatory fibroid polyp in a child

AIM:Inflammatory fibroid polyp (IFP) is a rare benign lesion that may occur throughout the digestive tract.IFP is more commonly found in the antrum of the stomach in particular. It mostly affects adults at the average age of 60 years.These polyps are able to cause abdominal pain,gastrointestinal bleeding,intestinal obstruction or intussusception.In this paper we report a case of gastric TIP with unusual presenting features. METHODS:A child with gastric IFP was described and the literature was reviewed, RESULTS:A 4-year-old girl presented with fever for 2 months,arthralgia of knees and ankles,iron defidency anemia, and hypoalbuminemia.Her stool examination was positive for occult blood.The upper gastrointestinal study demonstrated a large Iobulated mass at the upper part of gastric body.Partial gastrectomy en blocwith this 5 cm×8 cm mass was subsequently performed.Pathological examination was consistent with IFP.Following the mass excision,her fever abruptly declined and disappeared together with anemia and arthralgia.She remained asymptomatic and the abdominal ultrasonography performed at the 24-month follow-up demonstrated no recurrence of the tumor. CONCLUSION:The etiopathogenesis of IFP still remains unclear,The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose,The inflammatory symptoms found in this patient support the hypothesis of inflammatory benign lesions of IFP.

Education Fair： Discussion on Implementing the Continuing Education to Achieve ＂No Child Left Behind＂ Equitable Education

Confucius＇s ＂No Child Left Behind＂ education ideology which was put forward two thousand years ago reflected the importance of education for educators and the simple pursuit of educational equity at that time. Education Fair is the current composition content of China＇s basic education dream. Practicing ＂No Child Left Behind＂ education is the cornerstone to achieve China＇s fair education dream. Making implementing continuing education in order to achieve ＂No Child Left Behind＂ equitable education as a research issue, based on analyzing the status and problems of educational equity issues under the perspective of NCLB, the author explored the realistic way through multi-channel and diverse continuing education to achieve ＂No Child Left Behind ＂equitable education.

Natural history of children with mild Crohn’s disease

BACKGROUND There is a small and poorly studied population of patients with mild and limited Crohn’s disease(CD),who either spontaneously enter remission and can discontinue therapy,or be maintained on milder anti-inflammatory treatment.AIM To identify a group of children with mild CD who were not escalated to immunomodulators(azathioprine,mercaptopurine,or methotrexate)or biologics(infliximab or adalimumab)within the first two years after their Crohn’s diagnosis and outline the natural history and phenotypic features of these patients.METHODS In a retrospective chart review of the inflammatory bowel disease database at Boston Children’s Hospital we reviewed all the mild CD patient’s clinic visits,laboratory studies,and procedures for the duration of time they were followed at the center.Patients were included if they had clear diagnosis of Crohn’s disease,and they were not escalated to immunosuppressive therapies for at least 2 years after the date of diagnosis.These mild CD patients were compared to controls diagnosed at a similar time,that were treated with immunomodulators or biologics.Data that was abstracted included:Age at diagnosis,sex,disease location utilizing the Paris classification,medical treatment,surgical treatment,endoscopic findings,histology,and hospitalizations.We also analyzed differences in the phenotypic features between those with mild CD and those with moderate to severe disease.RESULTS Out of 1205 patients with CD diagnosed between 1990 and 2013,we identified 29 patients that met the inclusion criteria,and they were matched with 58 controls.There were no significant differences between the disease behaviors at presentation,with approximately 90%of patients in each group having inflammatory disease.However,patients with mild disease were more likely to have disease limited to the colon(31%vs 12%,P=0.03).In contrast,patients with moderate to severe disease(aka control group)were more likely to have ileocolonic disease(70%vs 45%in the mild group,P=0.02).Of the 29 patients,only 8 required medication escalation to immunomodulators during the period of follow-up.The primary indication for escalation to immune suppressive therapies was corticosteroid dependence.We also found that patients treated without immunomodulators or biologics for mild CD continue to exhibit histologic intestinal inflammation.Of the 29 patients,three developed significant complications of ileal disease,though only one required surgical intervention during the period of follow-up.CONCLUSION We identified a cohort of children with mild CD,who were able to avoid the institution of immune suppressive therapies for several years,and generally had good outcomes during the period of follow-up.While a subset of these patients will eventually require either immunosuppression or surgery,the majority of them have a good quality of life despite having low-grade intestinal inflammation.Importantly,this subset of patients has managed to avoid the potential toxicities of immune suppression for several years.The majority of these patients have either colonic disease with minimal small bowel involvement or limited ileal disease.

Liver cirrhosis in a child associated with Castleman's disease: A case report

BACKGROUND Castleman's disease(CD)is a lymphoproliferative disorder.TAFRO syndrome is classified as a variant of CD based on its key clinical manifestations of thrombocytopenia,anasarca(generalized edema and pleural effusion),fever(pyrexia),reticulin fibrosis in the bone marrow and the proliferation of megakaryocytes,and organomegaly(such as hepatosplenomegaly and multiple lymphadenopathies);TAFRO syndrome is mainly reported in Japanese patients.To our knowledge,this is the first pediatric case report detailing a CD-associated disorder progressing to cirrhosis.CASE SUMMARY A 10-year old male patient presented with fever and anemia.Six months before hospitalization,he had remarkable abdominal distention.Subsequently,he visited a clinic for a fever that lasted 5 d.The physical findings were marked hepatosplenomegaly and cervical lymphadenopathy.A blood test revealed leukocytosis,microcytic anemia,aspartate aminotransferase-dominant transaminase elevation,high levels of C-reactive protein,polyclonal hypergammaglobulinemia,and high levels of interleukin-6 and vascular endothelial growth factor.Abdominal contrast computed tomography and magnetic resonance imaging suggested cirrhosis,which was confirmed by liver histology.Histological findings in the enlarged hepatic lymph nodes revealed both hyperplasia and atrophy of lymphoid follicles with some vascular hyperplasia and moderate plasmacytosis between the lymphoid follicles,which is compatible with lymph node histology in TAFRO syndrome.Prednisolone was not effective in reducing the patient’s symptoms;therefore,the patient was prescribed tocilizumab.To date,the patient remains free of fever and continues to receive tocilizumab.CONCLUSION We described the clinicopathological features of TAFRO syndrome to highlight the clinical presentation of this rare disease in a pediatric case.

Knowledge, Attitudes and Practices of Infertile Women on Child Adoption in Douala (Cameroon)

Background: The aim of the study was to evaluate the knowledge, attitude and practices on child adoption among infertile women in Douala (Cameroon). Methods: It was a prospective descriptive study of six months duration at the General Hospital and the Dawn Medical Foundation Clinic. Patients of the gynecologic unit presenting with infertility were included. A questioner was administer to each patient with the following variables: Age, marital status, profession, level of education, past gynecologic history, number of children, type and the duration of infertility. Their knowledge, attitude and practice toward child adoption were investigated. Data collected was analyzed using the statistical software EPI-INFO 6.04 and R. p value < 0.05 was considered to be statistically significant. Results: Among the 300 women included, 269 (89.7%) had already heard about adoption, 62.1% through the media. Seventeen percent knew who to meet in order to adopt a child in Cameroon. Two hundred and thirty patients (76.7%) were in favor of adoption but 48.7% of them didn’t want to adopt a child. One percent of patient had adopted a child. The attitude towards adoption was significantly influenced by the duration of infertility of more than 10 years (p = 0.0014). Among women who have at least one child 9.4% wanted adoption against 21.4% who did not want adoption (p = 0.0305). Among women aged between 25 and 30 years, 28.2% wanted to adopt a child against 79.1% who did not want it (p = 0.000). Eighty five percent of women who had secondary infertility did not want to adopt against 44.7% who wanted it (p = 0.0003). Conclusion: The level of knowledge is high in educated patient. However, many women don’t know the right procedure and the structures in charge of adoption. Their attitude is favorable but the practice of adoption remains low.

Kaposi’s Disease (KS) in a Senegalese Child Living with HIV

Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.

Parents＇ Experiences of When an Adult Child Is Seriously III--＂lt Does Not Matter That It Is a Grown-Up Person, They Are Still Your Child＂

Purpose and Topic： A longer life expectancy is expected to rise continuously in all populations on all continents. Older parents are at risk of having to accompany their adult children through a severe illness, sometimes even to their death. The present study investigates the experiences of being a parent to an adult child with a severe illness and what support was helpful during the child＇s period of illness. Method： A qualitative approach with in-depth interviews which were analyzed using content analysis. Results： The results showed that a common perception was that it is very special to have a child with a severe illness. The underlying elements of existential experience and the relationship both influenced the parents＇ conceptions of life and permeated the whole situation. There were four areas that the parents found important and influenced how they could manage the situation： having information, participation, strategies to cope with the situation, and support. Conclusions： Accompanying an adult child through a severe and potentially fatal disease in the context of a growing elderly population will become an increasingly frequent problem. So far there is limited research in this area and more research should be a high priority in the future.

Child Spinal Cord Compression without Trauma about 113 Cases in Senegal

Introduction: No-trauma spinal cord compressions are serious conditions not often described in children population. This study will discuss the epidemiological, clinical, biology and radiology assessment, the etiologies, the therapeutic and evolutionary aspects of this condition in children in Senegal. Patients and Methods: 113 children aged between 15 months and 18 years were managed in a 10 years period (from January 2005 to July 2015) for a non-traumatic spinal cord compression (average 8.3 years). Results: There was 66 males (58%) and 47 females (42%) with sex ratio of 1.40. The main reasons for consultation were spinal deformity (90 %). The syndrome was complete in 52 patients (46%) and incomplete in 61 patients (54%). Plain radiography performed in 63 patients. The CT scan was performed in 21 patients and myelography performed in 4 patients. MRI was performed in 22 patients. There was intradural extramedullary process (33.33%), the extradural lesions (14.28%) and intramedullary process (28.57%). Dorsal lesions were predominant (46%) followed by the lumbar spine (27%). The majority of the etiology was Pott’s disease (80%) followed by tumors (17%). Spondylitis to banal germs (2%) and parasitic spinal cord compression (1%) were rare. The histology of 6 patients was revealed 5% neurofibroma Type II, 5% extramedullary intradermal arachnoid cyst, 5% intramedullary arachnoid cyst with cytochemistry of the CSF—like content, 5% Anaplastic pilocytic astrocytoma, 5% ganglioneuroma I terminal cone and 5% meningothelial meningioma. Pott’s disease has been cured by TB chemotherapy associated with a corset in 88.89% of cases. 2 patients of this group had benefited fixation after laminectomy. 68% of the patients had a favorable recovery, and 20% had completely recovered after an average of 7 months of treatment and three (3) patients had died. The compression by bilharzias is be cured by myelotomy and praziquantel with a favorable outcome. We have 94.74% decompressive laminectomy or laminotomy with tumor resection and four (4) Patients of this group benefited fixation;the patients who had intramedullary tumor benefited myelotomy and tumor resection;3 patients in this group had benefited fixation after laminectomy 58% of patients had good recovery and 1 pateint had died. Conclusion: In Africa, particularly in the tropics, Pott’s disease remains the first etiology followed by vertebra-medullary tumors for no traumatic spinal cord compression of child.

Eagle’s Syndrome in Children: A Case Report

Eagle’s syndrome is a collection of symptoms caused by styloid process elongation or calcification of the stylohyoid ligament, measuring more than 2.5 centimeters. It is a radio-clinical entity characterized by a heterogeneous polymorphic symptomatology most often involving headaches, facial pain, dysphagia and a foreign body sensation in the throat. Its management is mainly surgical. It is a rarely diagnosed condition in children. Here we report a typical case of Eagle’s syndrome which was diagnosed in a 14-year-old child with a history of chronic right unilateral pharyngeal discomfort, odynophagia and oropharyngeal foreign body sensation. CT scan showed a long left styloid process. The patient underwent surgical removal of the elongated styloid process externally. The outcome was favorable after surgery.

Marked Improvement in China's Maternal and Child Health

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A Judicial Empirical Study on the Principle of “the Best Interests of the Child”——From the Principles of National Conventions to the Building of Adjudication Norms

“The best interests of the child”is an essential principle of the Convention on the Rights of the Child.Due to the abstractness and ambiguity of this principle,its application is inevitably subject to the judge’s personality.Through empirical analysis,we can find that the judicial documents invoking the principle of“the best interests of the child”by Chinese courts show a significant increase in the number of disputes,types of disputes,and pronounced regional characteristics.The application of this principle by the courts is highly consistent with the judicial interpretative documents issued by the Supreme People’s Court.The invocation of this principle plays the role of interpreting the provisions of the law,the value basis for discretion,and the value orientation for shaping new rules in adjudication.At the same time,it is plagued by a lack of guidelines for the application of principles,invocations that serve the will of judges,and imperfect thinking in weighing the various factors involved.The application of this principle should be improved by setting normative standards for the principle of“the best interests of the child”,increasing case guidance for invoking the principle,and enhancing the professionalism of judges.

Recurrent hemoptysis in pediatric bronchial Dieulafoy’s disease with inferior phrenic artery supply:A case report

BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmonary arteries,which is different from chronic inflammatory injury of the airway in adult patients.The internal thoracic artery,subclavian artery,and intercostal artery are known to be involved in the blood supply to the BDD lesion in children.CASE SUMMARY We report a case of BDD in a 4-year-old boy with recurrent hemoptysis for one year.Selective angiography showed a dilated right bronchial artery,and anastomosis of its branches with the right lower pulmonary vascular network.Bronchoscopy showed nodular protrusion of the bronchial mucosa with a local scar.Selective embolization of the bronchial artery was performed to stop bleeding.One month after the first intervention,the symptoms of hemoptysis recurred.A computed tomography angiogram(CTA)showed another tortuous and dilated feeding artery in the right lower lung,which was an abnormal ascending branch of the inferior phrenic artery(IPA).The results of angiography were consistent with the CTA findings.The IPA was found to be another main supplying artery,which was not considered during the first intervention.Finally,the IPA was also treated by microsphere embolization combined with coil interventional closure.During the one-year follow-up,the patient never experienced hemoptysis.CONCLUSION The supplying arteries of the bleeding lesion in children with BDD may originate from multiple different aortopulmonary collateral arteries,and the IPA should be considered to reduce missed diagnosis.CTA is a noninvasive radiological examination for the screening of suspected vessels,which shows a high coincidence with angiography,and can serve as the first choice for the diagnosis of BDD.

Let Each Child Have a Role to Play——A teacher's experiences in human rights education

The future of a country and society belongs to children and youngsters. As a primary school teacher, I keenly feel the need to educate our children in human rights, so that they will develop in an all-round way, morally, intellectually and physically. Over the past few yeas, I have tried to incorporate education in human rights into activities in