BACKGROUND AND AIMS Diagnosis of moderately impaired renal function is of particular importance in patients with cirrhosis of the liver. Whereas patients with a markedly impaired glomerular filtration rate can be diagnosed easily by elevated serum creatinine concentrations, moderately reduced renal function may be missed by this conventional parameter. Recently, cystatin C has been suggested as...

Background and aims: Diagnosis of moderately impaired renal function is of particular importance in patients with cirrhosis of the liver. Whereas patients with a markedly impaired glomerular filtration rate can be diagnosed easily by elevated serum creatinine concentrations, moderately reduced renal function may be missed by this conventional parameter. Recently, cystatin C has been suggested a...

A 47-year-old male patient with alcohol-related cirrhosis presented to the liver clinic complaint of repeated episodes hepatic encephalopathy (HE) manifested as a disturbance in sleep pattern, hypersomnia, impaired memory, mental confusion, and drowsiness (West Haven grade II/III). On evaluation, had Child-Pugh score 6 (CTP-A), hyperammonemia (>200 µg/dL), small low-risk esophageal varices, spl...

This paper considers parental duties of beneficence and non-maleficence to use prenatal genetic testing for non-treatable conditions. It is proposed that this can be a duty only if the testing is essential to protect the interests of the child i.e. only if there is a risk of the child being born to a life worse than non-existence. It is argued here that non-existence can be rationally preferred...

Aim—To detail the everyday occurrence of pain in non-communicating children with cognitive impairment. Methods—Thirty four parents of cognitively impaired verbally non-communicating children completed pain diaries over a two week period. Each day, for five defined periods, parents rated whether their child had been in pain, and if so, its severity and duration. Results—Twenty five (73.5%) child...

This study describes the relationship between parenting stress and behavior in children with Joubert syndrome, a rare genetic neurodevelopmental disorder. Parents (N = 43) reported severely impaired child adaptive behaviors. Most children did not show maladaptive behaviors, but a subset of approximately 20% displayed significant problems in areas such as inattention, overactivity, social withdr...

How well do hearing-impaired children speak after a Cochlear Implantation (CI) and how does their language acquisition proceed? The answer to these questions is inevitably that success depends on a number of factors: one of the critical factors is the age at implantation. In this paper we provide an overview of the phonological results of a longitudinal study of nine early-implanted Dutch speak...

The physical environment It is advisable to have a dedicated ward for children. It should be bright, clean, and colourful. You can use simple drawings to decorate the walls and ceilings. Colourful curtains and bedspreads will also brighten up the ward. If a child is visually impaired, it is necessary to make the area around them as free from obstacles as possible. Checking that the child is pro...

Münchausen syndrome by proxy (MSBP), is a psychiatric disorder, a particular form of child abuse. An impaired emotional relationship exists mainly between the mother and her child. According to the variety of victims' symptoms, all medicine doctors may deal with this syndrome in every day clinical practice. Still insufficient knowledge about the syndrome and its' rare consideration in the diffe...