Violence against children is always wrong and often has a lifelong impact on physical, cognitive and social development. Working to prevent violence and sustain peace for children, including by prioritising action on SDG 16, is crucial to progress all other SDGs and build healthier, safer and prosperous societies. The report found that in , only a tiny fraction of Official Development Assistance ODA by major donors to the Pacific and Timor-Leste, including New Zealand, was spent on activities targeted at ending violence against children.
Our Pacific partners need much more support than they currently receive. So, while violence against children is harmful to children, it is also harmful to all of society and has significant negative financial impacts. These include programmes to change cultural norms in rural communities, school education programmes which focus on respectful relationships, and the establishment of safe houses for women and children.
However, there is still much to be done. Give Now. Thus we propose some tips that avoid the use of GA in most of our young patients, including the use of topical anesthetics and cooling systems, large laser spot size and high frequencies, early and frequent treatment with parents present, and the "introduction" and "pressure" techniques, among others. Lasers have been the treatment of choice for Port-wine stain PWS.
However, only one type of laser is not a panacea for all PWS malformations. This is may be due to the great heterogeneity of phenotypic presentation of this congenital anomaly as color, depth, and the site of the lesion. For the treatment of PWS , flash lamp-pumped pulsed dye laser, carbon dioxide, argon, krypton, copper bromide, frequency-doubled neodymium:yttrium-aluminum-garnet Nd:YAG , and also intense pulsed light sources can be used.
This was a comparative therapeutic study for the treatment of facial port-wine stain.
The sessions were done every 4 weeks for six sessions and follow-up after 3 months, then assess the response before and after the sessions and at the end follow-up period objectively degree of improvement, Photo comparison and subjectively Patient satisfaction. Fourteen out of nineteen patients completed all sessions of the treatment, and the other five patients were defaulted from the study due to different causes, including marriage, poor compliance for treatment, and for unknown causes. They were 13 The mean age of patients was Three patients There was no hypertrophy in any of the lesions.
All facial PWSs lie along the distribution of the trigeminal nerve.
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Four patients The color of PWSs was pink-red in eight patients The improvement score for the halves of. Long-term psychological impact and perceived efficacy of pulsed-dye laser therapy for patients with port-wine stains. The rationale for treatment of patients with port-wine stain PWS birthmarks has focused on the belief that eventual soft-tissue hypertrophy and negative psychological effects might be diminished or avoided.
Pulsed-dye laser PDL therapy has become widely accepted as the treatment of choice for PWS , and a variety of studies have been conducted that evaluate its short-term efficacy. Long-term data regarding outcome and patient satisfaction are lacking. Our objective was to evaluate the long-term efficacy of pulsed-dye laser therapy from the patient's perspective. A survey was mailed to all patients or parents of minor patients whose last known laser treatment was performed between January 1, , and January 1, Patients were asked to quantify changes in their PWS as well as their psychological well-being.
A formal qualitative analysis was performed on their written comments as well. A total of surveys were mailed to the most recent address available by the patient record. The mean age of respondents was The mean number of years since last treatment was 7. On a point scale indicating their likelihood of recommending treatment to someone similarly affected, the mean score was 7.
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Men were significantly and consistently less. A common factor suppresses thickening in young women with malar area port wine stains and delays low density lipoprotein elevation: is it estrogen? Port wine stains in the malar area of the face can develop thickening in early adult life. We began a study with a hypothesis that this thickening can be associated with elevation of low density lipoprotein. Low density lipoprotein levels in the subjects were compared to age and sex matched controls randomly selected from the general Dermatology clinic.
The younger subjects with thickening demonstrated significantly higher low density lipoprotein levels than their controls p. The subjects without thickening also consisted mainly of women. The low density lipoprotein levels in the older age groups, whether thickened or not, demonstrated no significant difference in low density lipoprotein levels between subjects and controls.
This led to a new hypothesis that there is a factor in a subgroup of young adult women with malar port wine stains that suppresses thickening and delays the elevation of low density lipoprotein and that this factor might be estrogen. The implications of this hypothesis are that it could define a marker for a subset of the population that might be protected from the diseases associated with early elevation of low density lipoprotein and provide a source of cutaneous tissue for studying the basic science of this protection although limited by cosmetic considerations.
Future laboratory research to test the new hypothesis might include testing blood of women with malar port wine stains with or without thickening for estrogen and other sex hormones. It might also include skin biopsies to study receptors for estrogen, other sex hormones, and angiogenic factors in malar port wine. Nd:YAG laser combined with gold nanorods for potential application in port-wine stains : an in vivo study.
Neodymium:yttrium aluminum garnet Nd:YAG lasers exhibit considerable potential for treating deeply buried port-wine stains. However, the application of Nd:YAG laser is limited by its weak absorption to blood. This in vivo study tested the efficacy and safety of utilizing thiol-terminated methoxypolyethylene glycol-modified gold nanorods PEG-GNRs to enhance the absorption of Nd:YAG laser to blood.
Mouse mesentery and dorsal skinfold chamber DSC model were prepared to analyze the thermal responses of a single venule without anatomic structures, as well as blood vessels in the complex structure of the skin, to laser light. After the injection of 0. The laser pulse required for blood coagulation and complete vasoconstriction decreased by Therefore, combining PEG-GNRs with Nd:YAG laser may be effective and safe for inducing an obvious thermal response of blood vessels under low energy density and minimal pulse conditions.
No studies have reported on the differences in efficacy outcomes resulting from the use of different laser spot sizes in the treatment of PWS by PDL. Thus, an in vivo investigation into the differences in safety and efficacy of treatment between two spot sizes 7 vs. Cryogen spray cooling and 1. Therapeutic outcomes were evaluated by visual and chromametric evaluation 3 months after the final treatment. Average blanching rates were Pulsed-dye laser PDL is the gold standard treatment for port-wine stains but it is painful. To limit pain in small children, sedation may be given.
We sought to determine the efficacy of this approach and the risks of sedation, as well as the level of satisfaction of parents. A retrospective study was conducted in our dermatology department in children treated with PDL while under sedation. The efficacy of treatment was evaluated by comparing pictures of lesions before and after treatment and using a questionnaire sent to the parents. In all, laser sessions were performed with sedation.
Comparison of photographs showed an improvement rate of 6. The mean parent satisfaction score was 6. Adverse events were reported in In our study, PDL for port-wine stains was effective, with good improvement of lesions.
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Pain was controlled thanks to sedation with one serious adverse event. The parents indicated a positive impression. This study suggests that the procedure may be proposed for small children in order to reduce pain, with a good risk-benefit ratio for sedation. More studies are needed to better qualify pain management for children under PDL treatment. Methods: Data from 20 patients with port-wine stains and corneal pachymetry readings was collected prospectively by the author in an institutional referral-based practice.
Results: Newly obtained dermatologic, corneal pachymetry, fundus ophthalmoscopic, ocular and orbital venous Doppler ultrasonography, and magnetic resonance imaging findings in patients with the Sturge-Weber syndrome or isolated port-wine stains , along with published data, reveal diffusely thickened tissues and neural atrophy in all areas associated with venous congestion.
Conclusions: Contrary to traditional understanding, signs and symptoms in the Sturge-Weber and related syndromes, including both congenital and acquired port-wine stains , are shown to arise from effects of localized primary venous dysplasia or acquired venous obstruction rather than neural dysfunction, differentiating these syndromes from actual phacomatoses. Effects of focal venous hypertension are transmitted to nearby areas via compensatory collateral venous channels in the above conditions, as in the Parkes Weber syndrome.
A novel underlying etiology—prenatal venous thrombo-occlusion—is proposed to be responsible for the absence of veins with persistence and enlargement of collateral circulatory pathways with data in the literature backing this offshoot hypothesis. The mechanism for isolated pathologic. Nd:YAG laser-induced morphology change and photothermal conversion of gold nanorods with potential application in the treatment of port-wine stain. However, the clinical effectiveness is limited because of the weak absorption of blood to Nd:YAG laser.
The aim of this study is to obtain the optimal irradiation conditions to effectively destroy vascular lesions with the assistance of PEG-modified gold NRs to enhance blood absorption of Nd:YAG laser.
Gold NRs after exposure to Nd:YAG laser were characterized using absorption spectra and transmission electron microscope images. The tissue-like phantom containing a glass capillary with blood was prepared and exposed to Nd:YAG laser to investigate the laser energy density and pulse number required for blood coagulation before and after the addition of gold NRs in blood. After injection of gold NRs into the bloodstream 4. Our findings provide an experimental guide for choosing laser parameters and gold NRs concentration for the treatment of deeper and larger PWS with the assistance of PEG-modified gold NRs in vivo in the future.
Port-wine vascular malformations and glaucoma risk in Sturge-Weber syndrome. Treatment of the capillary vascular malformation port-wine stain in Sturge-Weber syndrome with the use of a laser is helpful cosmetically.
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However, concerns have been raised that laser obliteration of port-wine stains may result in ocular hypertension. The aim of this study was to review clinical features and management of ocular complications of SWS and assess the effects of dermatological laser treatment on the incidence of glaucoma or ocular hypertension.
This retrospective cohort study was conducted in an institutional setting. All patients had involvement of the face.
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Patients who underwent skin laser to the port-wine vascular malformation were analyzed further. Forty-one Sturge-Weber syndrome patients with port-wine vascular malformation were analyzed.
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Glaucoma was observed in 24 patients Of these, 18 Of the 41 patients, 28 Mean age of laser commencement was 5 years range, 0. Thirteen did not undergo laser treatment. This retrospective review did not find evidence to suggest that laser treatment of port-wine vascular malformations causes glaucoma or that it can worsen a preexisting ocular hypertension or glaucoma.
Statistical analysis was inconclusive. Climate variability and Port wine quality. Recent warming trends for Portugal have been found to be steepest in winter and spring and more pronounced for minimum than for maximum values of temperature Miranda et al, These trends and associated changes in temperature and precipitation regimes may exert strong influences on agriculture systems.
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For instance, high values of the North Atlantic Oscillation NAO index have been shown to significantly reduce precipitation over Iberia and therefore induce low yield wheat crops in Portugal Gouveia and Trigo, A vintage wine is made from grapes that were grown and harvested in a single specified year and is classified as such because of the above average quality, a status that is attributed by Port houses in their best years. The Douro region presents distinctive climatic, topographic and soil characteristics. While the latest factors are fixed in time, the former may considerably change from year to year, exposing the Port wine productions to a large risk associated to interannual and intra-seasonal climatic variations.
It is therefore to be expected that high quality wines are generally associated to optimum climatic conditions.