We evaluated families’ perspectives on the usability of virtual visits for routine gender care for trans youth during the COVID-19 pandemic. An online survey, which included a validated telehealth usability questionnaire, was sent to families who had a virtual Gender Clinic visit between March and August 2020. A total of 87 participants completed the survey (28 trans youth, 59 caregivers). Overall, usability was rated highly, with mean scores between “quite a bit” and “completely” in all categories (usefulness, ease of use, interface and interaction quality, reliability, and satisfaction). Caregivers reported higher usability scores compared to trans youth [mean (SD) 3.43 (0.80) vs. 3.12 (0.93), p = 0.01]. All families felt that virtual visits provided for their healthcare needs. A total of 100% of youth and caregivers described virtual appointments as safer or as safe as in-person visits. A total of 94% of participants would like virtual visits after the pandemic; families would choose a mean of two virtual and one yearly in-person visit with a multidisciplinary team. Overall, virtual gender visits for trans youth had impressive usability. Participants perceived virtual visits to be safe. For the future, a combination of virtual and in-person multidisciplinary visits is the most desired model.
The administration of high-fat diets, during 40 days to adult rats, provoked specific variations on serum and thymus fatty acids, as a consequence of differences in FA profile of their lipid sources. These results reflect the impact that eating habits have on health status. It is important to put emphasis not only on the reduction of total fat intake, but also on choosing healthy sources of fat, replacing saturated fatty acids by polyunsaturated and including oils with higher content of ω3 to keep a balanced ω6/ω3 ratio.
In this preliminary study of few patients, we have observed a potential usefulness of Supportan(®) in the compliance of concurrent RT-CHT in patients with H&N cancers; moreover, its administration was useful to maintain the initial biochemical nutritional profile.
Introduction: Hypervitaminosis D is a relatively uncommon etiology of hypercalcemia. Toxicity is usually caused by very high doses, mostly secondary to erroneous prescription or administration of Vitamin D, and less commonly, contaminated foods or manufacturing errors of vitamin D-containing supplements.
Case description: 16 year old male, previously healthy, presented with 2-week history of non specific symptoms (fatigue, gastrointestinal complaints). Investigations showed acute kidney injury and hypercalcemia (total calcium 3.81 mmol/L). Further diagnostic workup revealed markedly elevated 25-hydroxy-vitamin D levels (1910 nmol/L). He denied taking any vitamin D supplements; however, he reported consumption of creatine and protein supplements. Mass spectrometry analysis of the creatine supplement estimated a vitamin D content of 425,000 IU per serving (100 times the upper tolerable daily dose). A few months later, another previously healthy adolescent presented with severe hypercalcemia and acute kidney injury secondary to hypervitaminosis D. He was also using a creatine supplement from the same manufacturer brand and lot. Both patients were treated with IV hydration, calcitonin and pamidronate. They maintained normocalcemia after their initial presentation but required low-calcium diets and laboratory testing for months after this exposure.
Discussion: We present 2 cases of hypervitaminosis D caused by a manufacturing error of a natural health product which did not claim to contain vitamin D. The use of dietary supplements is highly prevalent; their use should be incorporated in anamnesis and considered a potential source of toxicity when an alternative source cannot be found, regardless of the product label.
Introduction. Newborn size is associated with intrauterine conditions. Genetic potential is expressed later; the canalization of growth is typically described up to 24 months of age.Objective. To describe the canalization of growth between 2 and 5 years of age in apparently healthy children with short stature at age 2 years.
Population and methods.Retrospective, cohort study. Children seen at a community teaching hospital between 2003 and 2019, who had a Z-score for height below -2 SDs for age and sex at age 2 years were included. Infants born preterm, with a low birth weight, and chronic conditions were excluded. Growth patterns were assessed. Canalization was defined as reaching a normal stature for the general population.Results. Sixty-four children were included; 37 (58%) showed canalization of growth at 5 years old (20 at 3 years, 8 at 4 years, and 9 at 5 years). The growth rate at 3 and 5 years of age was significantly higher among those who showed canalization compared to those who did not; a similar trend was observed at 4 years of age. Among 27 children with short stature at 5 years of age, 25 had at least 1 annual growth velocity below the 25th centile.
Conclusions.Most apparently healthy children with short stature at 2 years old reached a normal stature at 5 years old. The annual growth velocity allows to detect children at risk of not showing canalization.
Introduction. Under-diagnosis and underrecording of overweight and obesity in pediatrics is very common. Using an electronic medical record may be helpful. The objective was to establish the percentage of recording of this problem by primary care pediatricians and analyze if it was associated with the performance of ancillary tests. Methods. Cross-sectional study. The recording of this problem among overweight and obese pediatric patients and the presence of blood glucose, triglycerides, and high-density lipoprotein cholesterol results in obese patients were assessed. Results. A total of 7471 overweight and obese patients were included; this health problem was adequately recorded in only 19 %. Among all obese patients (n = 1957), 44 % had adequate recording of this health problem; 32 % had lab test results showing a significant association among outcome measures. Conclusions. The percentage of overweight and obesity recording and ancillary test performance was low. Recording was associated with a higher level of test ordering.
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