Archives of Disease in Childhood: Education & Practice Edition最新文献_第4页

An uncommon diagnosis for a common neonatal presentation 一个罕见的诊断常见的新生儿表现

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2017-01-13 DOI: 10.1136/archdischild-2016-311864

C. Oakley, S. Shebani

引用次数: 0

Diabetes insipidus and the use of desmopressin in hospitalised children 住院儿童尿崩症与去氨加压素的应用

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2017-01-10 DOI: 10.1136/archdischild-2016-310763

C. Elder, P. Dimitri

{"title":"Diabetes insipidus and the use of desmopressin in hospitalised children","authors":"C. Elder, P. Dimitri","doi":"10.1136/archdischild-2016-310763","DOIUrl":"https://doi.org/10.1136/archdischild-2016-310763","url":null,"abstract":"In February 2016, NHS England released a patient safety alert highlighting the associated mortality and morbidity when desmopressin is omitted in individuals with cranial diabetes insipidus (DI).1 Over a 7-year period, the UK National Reporting and Learning System had identified 76 near misses, 56 dosing errors leading to harm and 4 cases where desmopressin omission has resulted in severe dehydration and death.1 Gleeson et al ,2 concerned about the care of adult patients with DI when admitted to hospital, recently reported a retrospective audit in which desmopressin was missed or delayed in 88% of admissions in two-thirds of cases because medication was unavailable. Both publications raise awareness of the risks and call for improved education, easier access to desmopressin in the inpatient setting and heightened pharmacovigilance using increasingly popular e-prescribing to flag patients on desmopressin and alert endocrinologists to their admission.1 ,2\u0000\u0000To our knowledge, there are no comparable data available in paediatrics, but the risks of children with DI not receiving the care they require is a concern. Paediatricians increasingly face complex children, on multiple, often unfamiliar, drugs, requiring management from generalists or intensivists when admitted out of hours who may not have immediate access to specialist paediatric endocrinology. To compound the issue, paediatric staff are often familiar with the more common indication for desmopressin, enuresis and therefore may not identify it as a critical medication, increasing the risk of omission. These patients are often on concomitant glucocorticoid replacement, which may complicate matters further.\u0000\u0000It is therefore timely to review situations when the generalist or intensivist may come into contact with patients with DI and to summarise management strategies and pitfalls to avoid.\u0000\u0000DI describes polyuria and polydipsia occurring due to an inability to concentrate urine. Central or cranial DI occurs when there is …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75815264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Fifteen-minute consultation: assessment of a child with suspected shunt problems 15分钟的咨询:评估一个怀疑有分流问题的孩子

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2017-01-10 DOI: 10.1136/archdischild-2016-311078

Harpreet Singh Mangat, Chirag V. Patel, D. Rodrigues

引用次数: 0

Oral syringes with millilitre measurements are safer than dosing cups for administration of medication for children 对于儿童用药来说，毫升计量的口服注射器比量杯更安全

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-30 DOI: 10.1136/archdischild-2016-312289

Y. Moore, A. Iqbal

引用次数: 3

Management of children and young people with headache 儿童和青少年头痛的处理

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-20 DOI: 10.1136/archdischild-2016-311803

W. Whitehouse, S. Agrawal

{"title":"Management of children and young people with headache","authors":"W. Whitehouse, S. Agrawal","doi":"10.1136/archdischild-2016-311803","DOIUrl":"https://doi.org/10.1136/archdischild-2016-311803","url":null,"abstract":"Headache is very common in children and young people. The correct advice and treatment requires consideration of a wide differential diagnosis between primary and secondary headaches, and also of the different types of primary headache. The International Classification of Headache Disorders gives useful descriptions and diagnostic criteria that are especially useful for primary headaches. The National Institute for Health and Care Excellence (NICE) Clinical Guideline 150 provides evidence-based recommendations on treatments for adults and young people from age 12 years. However, the same principles can be applied to younger children when a specific diagnosis can be made. Key recommendations from the NICE Quality Standards include, establishing a precise diagnosis if possible, avoiding, diagnosing and treating medication overuse headache, and combining a triptan with a non-steroidal anti-inflammatory drug or paracetamol as the first-line acute/rescue treatment for migraine with or without aura. Although rare in children and young people, it is important to diagnose new daily persistent headache, as it responds poorly or not at all to medication; and paroxysmal hemicrania as it responds very well to indomethacin but not to other commonly used analgesics. When faced with difficulties in reaching a precise diagnosis or in finding effective therapies, further advice should be sought from a children's headache clinic or specialist.","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72760791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23

Integrating teaching into everyday clinical practice 将教学融入日常临床实践

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-16 DOI: 10.1136/archdischild-2016-311416

David A King, N. West, C. Elder

引用次数: 0

Tuberculosis (NICE clinical guideline 33) 结核病(NICE临床指南33)

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-14 DOI: 10.1136/archdischild-2016-310870

L. Turnbull, C. Bell, F. Child

{"title":"Tuberculosis (NICE clinical guideline 33)","authors":"L. Turnbull, C. Bell, F. Child","doi":"10.1136/archdischild-2016-310870","DOIUrl":"https://doi.org/10.1136/archdischild-2016-310870","url":null,"abstract":"The UK has one of the highest rates of tuberculosis (TB) in Western Europe.1 If current trends continue, with over 7500 cases per year,2 England will overtake the whole of the USA in the annual number of TB notifications within the next 2 years.3 TB disease in UK children is relatively rare with <5% cases affecting patients under the age of 15 years.2 Outside large conurbations, most paediatricians will see very few children with TB. However, the risk of progression from latent TB to TB disease and of TB meningitis or miliary TB is much higher in children, especially those under the age of 2 years.4 It is, therefore, important that paediatricians recognise children at risk of TB disease and the symptoms and signs with which they present.\u0000\u0000This article summarises the recently updated National Institute for Health and Care Excellence (NICE) guideline ‘Tuberculosis’ (NG33)5 ,6 published in 2016 (box 1). Several areas of this guideline are controversial and we will highlight these. Box 1 \u0000### Resources\u0000\u0000National Institute for Health and Care Excellence (NICE) guideline—NG33 Tuberculosis\u0000\u0000https://www.nice.org.uk/guidance/NG33\u0000\u0000Collaborative TB Strategy, Public Health England https://www.gov.uk/government/publications/collaborative-tuberculosis-strategy-for-england\u0000\u0000Information for the public (NICE)\u0000\u0000https://www.nice.org.uk/guidance/ng33/ifp/chapter/Tuberculosis\u0000\u0000Key recommendations in the updated guideline: \u0000\u0000Box 2 \u0000### Glossary of terms\u0000\u0000Mycobacterium tuberculosis complex (MTB complex)—A genetically related group of mycobacteria that can cause TB disease in …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79555690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 25

Metformin with insulin does not improve the glycaemic control of overweight/obese adolescents with type 1 diabetes 二甲双胍联合胰岛素不能改善超重/肥胖青少年1型糖尿病患者的血糖控制

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-14 DOI: 10.1136/archdischild-2016-312326

A. Lucas-Herald, K. Robertson

引用次数: 1

The 100 000 Genomes Project: What it means for paediatrics 10万人基因组计划:对儿科意味着什么

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-09 DOI: 10.1136/archdischild-2016-311029

Blanche Griffin, L. Chitty, M. Bitner-Glindzicz

{"title":"The 100 000 Genomes Project: What it means for paediatrics","authors":"Blanche Griffin, L. Chitty, M. Bitner-Glindzicz","doi":"10.1136/archdischild-2016-311029","DOIUrl":"https://doi.org/10.1136/archdischild-2016-311029","url":null,"abstract":"The 100 000 Genomes Project is a unique, national programme combining research and transformation of clinical care, by undertaking whole genome sequencing (WGS) in patients with rare diseases and cancer. Made possible by technological advances in next-generation sequencing1 and falling costs, this project aims to find the genes which cause a patient's rare disease and identify genetic changes which occur in the tumour of a child or adult with cancer, to understand the mechanism of disease and develop therapies to personalise treatment. Patients are recruited through the National Health Service (NHS) and their medical course is tracked for life through their NHS number with results fed back through routine NHS services. It will also lay the foundations for a new ‘genomic medicine’ service for the NHS.2 The project is coordinated by Genomics England, with participants enrolled through one of 13 NHS Genomic Medicine Centres (figure 1), covering all of England. Unlike genome projects in other countries3 that have yielded information on variants associated with common diseases and ancestry, the scale of the 100 000 Genomes Project is much greater. The ability to track long-term outcomes through the patients' NHS number provides a unique opportunity to link genomic and phenotypic data to hospital admissions (via hospital episode statistics) as well as lifelong response to interventions and treatments.\u0000\u0000\u0000\u0000Figure 1 \u0000Schema showing pathway from patient recruitment to results. Note the need for interaction between clinicians, scientists and geneticists working in multidisciplinary teams to deliver this new genomic medicine service. More detailed information can be found on the Genomics England website.2 GMC, Genomics Medicine Centre; GeL, Genomics England; MDT, multidisciplinary team meeting including clinical scientists, clinical geneticists and referring clinicians).\u0000\u0000\u0000\u0000Many children with a rare disease but no known underlying cause are eligible. A local clinical geneticist …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73137823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Fifteen-minute consultation: investigation and management of an infant with stridor 15分钟会诊:1例婴幼儿喘鸣的调查与处理

Archives of Disease in Childhood: Education & Practice Edition Pub Date : 2016-12-08 DOI: 10.1136/archdischild-2016-311286

E. Hoskison, J. Grainger

引用次数: 3