Sample records for vertically acquired paediatric

  1. Acquired vertical accommodative vergence. (United States)

    Klein-Scharff, Ulrike; Kommerell, Guntram; Lagrèze, Wolf A


    Vertical accommodative vergence is an unusual synkinesis in which vertical vergence is modulated together with accommodation. It results from a supranuclear miswiring of the network normally conveying accommodative convergence. So far, it is unknown whether this condition is congenital or acquired. We identified an otherwise healthy girl who gradually developed vertical accommodative vergence between five to 13 years of age. Change of accommodation by 3 diopters induced a vertical vergence of 10 degrees. This observation proves that the miswiring responsible for vertical accommodative vergence must not necessarily be congenital, but can be acquired. The cause and the mechanism leading to vertical accommodative vergence are yet unknown.

  2. Hospital-acquired Klebsiella pneumoniae infections in a paediatric ...

    African Journals Online (AJOL)

    Methods. A retrospective case control chart review of children admitted to the paediatric intensive care unit (PICU) in Grey's Hospital between July 2003 and December 2010, who developed a hospital-acquired Klebsiella pneumoniae infection, was undertaken to describe the trend in HAI in a newly commissioned PICU and ...

  3. Factors related to fatigue after paediatric acquired brain injury (ABI). (United States)

    van Markus-Doornbosch, F; de Kloet, A J; Berger, M A M; Lambregts, S A M; Wolterbeek, R; Vliet Vlieland, T P M


    To assess the degree of fatigue in children and youth after traumatic and non-traumatic brain injury (TBI and NTBI) and related factors. Follow-up study including patients with a hospital-based diagnosis of acquired brain injury (ABI), aged 4-20 years at onset and their parents. Parents and children (dependent on age) completed the Paediatric Quality of Life Inventory™ Multidimensional Fatigue Scale (PedsQL™ MFS), which measures general fatigue (GF), sleep/rest fatigue (SRF) and cognitive fatigue (CF). Additional assessments included the Child & Family Follow-up Survey (CFFS) and PedsQL™ 4.0 General Core Scales and sociodemographic and disease characteristics. Eighty-eight parents completed the PedsQL™ MFS 24-30 months after diagnosis, with 49/88 patients (56%) completing the child version. The median age of the patients was 11 years (interquartile range [IQR] = 7). There were 69 patients with TBI (16% moderate/severe TBI) and 19 patients with NTBI (16% moderate/severe NTBI). The median parent-reported and child-reported PedsQL™ MFS Total Scale Scores were 76.5 (SD = 16.4) and 78.5 (12.9), respectively (Spearman r = 0.450, p = 0.001). Apart from NTBI, increasing age and a single-parent household were significantly associated with more fatigue according to the parent-reported PedsQL™ MFS Total Score (and/or one or more sub-scale scores). Two years after onset, in particular, the parent-reported fatigue after NTBI was considerable. Moreover, older children and children from a single-parent household were found to have higher fatigue levels.

  4. Paediatric Acquired Recto –Vestibular Fistula: Experience In Accra ...

    African Journals Online (AJOL)

    The association of acquired recto-vaginal fistula (RVF) with the human immunodeficiency virus is increasingly being recognized and reported in the literature Congenital recto - vestibular fistulae associated with imperforate anus is not uncommon, but it is rare to see children with acquired recto - vestibular fistula. From 1997 ...

  5. Paediatric community-acquired septic shock: Results from the REPEM network study

    NARCIS (Netherlands)

    P. van de Voorde (Patrick); B. Emerson; B. Gómez (Borja); J. Willems; D. Yildizdas; I. Iglowstein; E. Kerkhof (Evelien); N. Mullen; C.R. Pinto; T. Detaille; N. Qureshi (Nadeem); J. Naud; J. de Dooy; R. van Lancker; A.G. Dupont (Alain); N. Boelsma; M. Mor; D. Walker; M. Sabbe (Marc); S. Hachimi-Idrissi; L. Da Dalt (Liviana); H. Waisman; D. Biarent; I.K. MacOnochie (Ian); H.A. Moll (Henriëtte); J. Benito (Javier)


    textabstractIntroduction and purpose of the study With this study we aimed to describe a "true world" picture of severe pae-diatric 'community-acquired' septic shock and establish the feasibility of a future prospective trial on early goal-directed therapy in children. During a 6-month to 1-year

  6. Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community-Acquired Paediatric Diarrhea

    Directory of Open Access Journals (Sweden)

    Savita Deorari


    Full Text Available OBJECTIVES: To evaluate the role of routine stool examination for all pathogens in paediatric nosocomial diarrhea (NAD and community-acquired diarrhea (CAD over a two-year period at Alberta Children’s Hospital and current practices in other Canadian hospitals. A secondary objective was to characterize features that may predict NAD or CAD etiology.

  7. Interventions for managing weight change following paediatric acquired brain injury: a systematic review. (United States)

    Shah, Emily; Lodh, Rajib; Siddell, Poppy; Morrall, Matthew C H J


    To systematically review literature reporting interventions for weight change following paediatric acquired brain injury (ABI). A systematic search of the literature was conducted using advanced search techniques. The retrieval identified 1562 papers, of which 30 were relevant. The total number of paediatric participants was 759. There is a paucity of higher quality evidence to support the use of weight change interventions following paediatric ABI. Substantial variation in screening, outcome measures, intervention, and reporting were demonstrated. Some support was found for the use of hypothalamic-sparing surgery as a method to prevent obesity following craniopharyngioma resection. There is a need for further study in this area to inform clinical and research practice; recommendations are given. © 2016 Mac Keith Press.

  8. Similar sponge-associated bacteria can be acquired via both vertical and horizontal transmission

    DEFF Research Database (Denmark)

    Sipkema, Detmer; de Caralt, Sònia; Morillo, Jose A


    Marine sponges host diverse communities of microorganisms that are often vertically transmitted from mother to oocyte or embryo. Horizontal transmission has often been proposed to co-occur in marine sponges, but the mechanism is poorly understood. To assess the impact of the mode of transmission...... on the microbial assemblages of sponges, we analysed the microbiota in sympatric sponges that have previously been reported to acquire bacteria via either vertical (Corticium candelabrum and Crambe crambe) or horizontal transmission (Petrosia ficiformis). The comparative study was performed by PCR......-DGGE and pyrosequencing of barcoded PCR-amplified 16S rRNA gene fragments. We found that P. ficiformis and C. candelabrum each harbor their own species-specific bacteria, but they are similar to other high-microbial-abundance sponges, while the low-microbial-abundance sponge C. crambe hosts microbiota of a very different...

  9. Impact of community-acquired paediatric rotavirus gastroenteritis on family life: data from the REVEAL study. (United States)

    Van der Wielen, Marie; Giaquinto, Carlo; Gothefors, Leif; Huelsse, Christel; Huet, Frédéric; Littmann, Martina; Maxwell, Melanie; Talayero, José M P; Todd, Peter; Vila, Miguel T; Cantarutti, Luigi; Van Damme, Pierre


    Rotavirus is the leading cause of acute gastroenteritis (AGE) and the most frequent cause of severe diarrhoea in children aged less than 5 years. Although the epidemiology of rotavirus gastroenteritis (RVGE) is well documented, there are few data on the impact of RVGE on the families of affected children. Data associated with the burden of RVGE, including number of working days lost, levels of parental stress, the need for alternative childcare arrangements and additional nappies used, were extracted from questionnaires completed by parents of children participating in a prospective, multicentre, observational study (Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in public health and society, REVEAL), conducted during 2004-2005 in selected areas of Belgium, France, Germany, Italy, Spain, Sweden, and the United Kingdom to estimate the incidence of RVGE in children aged less than 5 years seeking medical care as a result of AGE. 1102 children with RVGE were included in the present analysis. The proportion of RVGE cases that required at least one parent or other person to be absent from work was 39%-91% in the hospital setting, 44%-64% in the emergency department, and 20%-64% in primary care. Self-reported levels of parental stress were generally high (mean stress levels, > or = 5 on a 10-point visual analogue scale). Additional childcare arrangements were required in up to 21% of RVGE episodes. The mean number of nappies used per day during RVGE episodes was approximately double that used when the child was not ill. Paediatric RVGE cases cause disruption to families and parental stress. The burden of RVGE on children and their families could be substantially reduced by routine rotavirus vaccination of infants.

  10. Impact of community-acquired paediatric rotavirus gastroenteritis on family life: data from the REVEAL study

    Directory of Open Access Journals (Sweden)

    Talayero José MP


    Full Text Available Abstract Background Rotavirus is the leading cause of acute gastroenteritis (AGE and the most frequent cause of severe diarrhoea in children aged less than 5 years. Although the epidemiology of rotavirus gastroenteritis (RVGE is well documented, there are few data on the impact of RVGE on the families of affected children. Methods Data associated with the burden of RVGE, including number of working days lost, levels of parental stress, the need for alternative childcare arrangements and additional nappies used, were extracted from questionnaires completed by parents of children participating in a prospective, multicentre, observational study (Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in public health and society, REVEAL, conducted during 2004-2005 in selected areas of Belgium, France, Germany, Italy, Spain, Sweden, and the United Kingdom to estimate the incidence of RVGE in children aged less than 5 years seeking medical care as a result of AGE. Results 1102 children with RVGE were included in the present analysis. The proportion of RVGE cases that required at least one parent or other person to be absent from work was 39%-91% in the hospital setting, 44%-64% in the emergency department, and 20%-64% in primary care. Self-reported levels of parental stress were generally high (mean stress levels, ≥ 5 on a 10-point visual analogue scale. Additional childcare arrangements were required in up to 21% of RVGE episodes. The mean number of nappies used per day during RVGE episodes was approximately double that used when the child was not ill. Conclusions Paediatric RVGE cases cause disruption to families and parental stress. The burden of RVGE on children and their families could be substantially reduced by routine rotavirus vaccination of infants.

  11. Utility of routinely acquired primary care data for paediatric disease epidemiology and pharmacoepidemiology. (United States)

    Helms, Peter J; Ekins Daukes, Suzie; Taylor, Michael W; Simpson, Colin R; McLay, James S


    The majority of medicines prescribed for children are prescribed in primary care for common acute and chronic conditions. This is in contrast to prescribing in secondary care where the population of children admitted is small but where a large number of different medicines are prescribed to treat more serious and less common conditions. Data on prescribing was extracted from the General Practice Administration System for Scotland (GPASS) for the year November 1999 to October 2000 and prescribing patterns for children aged 0-16 years expressed as percentages. A comparison of age specific consultations for asthma, as an example of a common paediatric condition, was also made between two separate general practice data sets, the General Practice Research Database (GRPD) and the continuous morbidity recording (CMR) subset of GPASS. Of 214 medicines investigated for unlicensed and off-label prescribing no unlicensed prescribing was identified. Off-label prescribing due to age was most common among younger and older children. The most common reasons for off-label prescriptions were, in order of frequency, lower than recommended dose, higher than recommended dose, below the recommended age, and unlicensed formulation. Age and gender specific consultations for asthma were similar in the two representative databases, GPRD and CMR, both showing disappearance of the male predominance in the teenage years. Large primary care data sets available within a unified health care system such as the UK National Health Service (NHS) are likely to be broadly compatible and produce similar results. The prescribing of off-label medicines to children is common in primary care, most commonly due to prescribing out with the recommended dosage regimen.

  12. [Community acquired pneumonia in children: Treatment of complicated cases and risk patients. Consensus statement by the Spanish Society of Paediatric Infectious Diseases (SEIP) and the Spanish Society of Paediatric Chest Diseases (SENP)]. (United States)

    Moreno-Pérez, D; Andrés Martín, A; Tagarro García, A; Escribano Montaner, A; Figuerola Mulet, J; García García, J J; Moreno-Galdó, A; Rodrigo Gonzalo de Lliria, C; Saavedra Lozano, J


    The incidence of community-acquired pneumonia complications has increased during the last decade. According to the records from several countries, empyema and necrotizing pneumonia became more frequent during the last few years. The optimal therapeutic approach for such conditions is still controversial. Both pharmacological management (antimicrobials and fibrinolysis), and surgical management (pleural drainage and video-assisted thoracoscopic surgery), are the subject of continuous assessment. In this paper, the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases have reviewed the available evidence. Consensus treatment guidelines are proposed for complications of community-acquired pneumonia in children, focusing on parapneumonic pleural effusion. Recommendations are also provided for the increasing population of patients with underlying diseases and immunosuppression. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  13. Chest physiotherapy in paediatric patients hospitalised with community-acquired pneumonia: a randomised clinical trial. (United States)

    Lukrafka, Janice Luisa; Fuchs, Sandra C; Fischer, Gilberto Bueno; Flores, José A; Fachel, Jandira M; Castro-Rodriguez, Jose A


    Chest physiotherapy has been used to treat children hospitalised with pneumonia with no clear scientific evidence to support a beneficial effect. The objective of the current study was to evaluate the efficacy of chest physiotherapy as an adjuvant treatment in children hospitalised with acute community-acquired pneumonia. Children (aged 1-12 years) with a clinical and confirmed radiological diagnosis of pneumonia sequentially admitted to a tertiary children hospital were eligible for this study. Participants were randomly selected to receive a standardised respiratory physiotherapy (positioning, thoracic vibration, thoracic compression, positive expiratory pressure, breathing exercises and forced exhalation with the glottis open or 'huffing') three times daily in the 'intervention group' or a non-mandatory request to breathe deeply, expectorate the sputum and maintain a lateral body position once a day in the 'control group'. The primary outcomes were reduction in respiratory rate and severity score (respiratory rate, recession, fever, oxygen saturation and chest x-ray) from baseline to discharge. Secondary outcome was duration of hospitalisation. In all, 72 patients were randomly allocated to the intervention (n=35) or control (n=37) groups. There were no differences at admission on severity of pneumonia between groups. Respiratory rate and severity score significant decreased between admission to discharge within each group; however, there were no differences when comparing groups. Also, there was no significant difference in duration of hospitalisation between the control and intervention groups (6 vs 8 days, p=0.11, respectively). This clinical trial suggests that, in children hospitalised with moderate community-acquired pneumonia, chest physiotherapy did not have clinical benefits in comparison to control group.

  14. Improving child and parenting outcomes following paediatric acquired brain injury: a randomised controlled trial of Stepping Stones Triple P plus Acceptance and Commitment Therapy. (United States)

    Brown, Felicity L; Whittingham, Koa; Boyd, Roslyn N; McKinlay, Lynne; Sofronoff, Kate


    Persistent behavioural difficulties are common following paediatric acquired brain injury (ABI). Parents and families also experience heightened stress, psychological symptoms and burden, and there is evidence of a reciprocal relationship between parent and child functioning, which may be mediated by the adoption of maladaptive parenting practices. Despite this, there is currently a paucity of research in family interventions in this population. The aim of this study was to determine the efficacy of Stepping Stones Triple P: Positive Parenting Program (SSTP), with an Acceptance and Commitment Therapy (ACT) workshop, in improving child outcomes and parenting practices following paediatric ABI. Fifty-nine parents of children (mean age 7 years, SD 3 years, 1 month; 35 males, 24 females) with ABI (Traumatic injuries 58%, Tumour 17%, Encephalitis or meningitis 15%, Cardiovascular accident 7%, Hypoxia 3%) who were evidencing at least mild behaviour problems were randomly assigned to treatment or care-as-usual conditions over 10 weeks. Mixed-model repeated-measures linear regression analyses were conducted to compare conditions from pre- to postintervention on child behavioural and emotional functioning (Eyberg Child Behavior Inventory, Strengths and Difficulties Questionnaire) and dysfunctional parenting style (Parenting Scale). Assessment of maintenance of change was conducted at a 6-month follow-up. The trial was registered on Australian New Zealand Clinical Trials Registry (ID: ACTRN12610001051033, Significant time-by-condition interactions were identified on number and intensity of child behaviour problems, child emotional symptoms and parenting laxness and overreactivity, indicating significant improvements in the treatment condition, with medium-to-large effect sizes. Most improvements were maintained at 6 months. Group parenting interventions incorporating Triple P and ACT may be efficacious in improving child and parenting outcomes following

  15. Vertically acquired hepatitis C virus infection: Correlates of transmission and disease progression. (United States)

    Tovo, Pier-Angelo; Calitri, Carmelina; Scolfaro, Carlo; Gabiano, Clara; Garazzino, Silvia


    The worldwide prevalence of hepatitis C virus (HCV) infection in children is 0.05%-0.4% in developed countries and 2%-5% in resource-limited settings, where inadequately tested blood products or un-sterile medical injections still remain important routes of infection. After the screening of blood donors, mother-to-child transmission (MTCT) of HCV has become the leading cause of pediatric infection, at a rate of 5%. Maternal HIV co-infection is a significant risk factor for MTCT and anti-HIV therapy during pregnancy seemingly can reduce the transmission rate of both viruses. Conversely, a high maternal viral load is an important, but not preventable risk factor, because at present no anti-HCV treatment can be administered to pregnant women to block viral replication. Caution is needed in adopting obstetric procedures, such as amniocentesis or internal fetal monitoring, that can favor fetal exposure to HCV contaminated maternal blood, though evidence is lacking on the real risk of single obstetric practices. Mode of delivery and type of feeding do not represent significant risk factors for MTCT. Therefore, there is no reason to offer elective caesarean section or discourage breast-feeding to HCV infected parturients. Information on the natural history of vertical HCV infection is limited. The primary infection is asymptomatic in infants. At least one quarter of infected children shows a spontaneous viral clearance (SVC) that usually occurs within 6 years of life. IL-28B polymorphims and genotype 3 infection have been associated with greater chances of SVC. In general, HCV progression is mild or moderate in children with chronic infection who grow regularly, though cases with marked liver fibrosis or hepatic failure have been described. Non-organ specific autoantibodies and cryoglobulins are frequently found in children with chronic infection, but autoimmune diseases or HCV associated extrahepatic manifestations are rare.

  16. Does Stepping Stones Triple P plus Acceptance and Commitment Therapy improve parent, couple, and family adjustment following paediatric acquired brain injury? A randomised controlled trial. (United States)

    Brown, Felicity L; Whittingham, Koa; Boyd, Roslyn N; McKinlay, Lynne; Sofronoff, Kate


    To evaluate the efficacy of a behavioural family intervention, Stepping Stones Triple P (SSTP), combined with an Acceptance and Commitment Therapy (ACT) workshop in improving parent, family and couple outcomes following paediatric acquired brain injury (ABI). Fifty-nine parents (90% mothers) of children (mean age 7 years; 35 males, 24 females) with ABI. Participants were randomly assigned to a treatment (10-week group SSTP and ACT program) or a care-as-usual (CAU) control condition (10 weeks). Those in the CAU condition received the treatment after the waitlist period. Self-report measures of parent psychological distress, parent psychological flexibility, parenting confidence, family functioning, and couple relationship, assessed at: pre-intervention, post-intervention, and 6-months post-intervention. Post-intervention, the treatment group showed significant, small to medium improvements relative to the CAU group (at the p < .05 level) on parent psychological distress, parent psychological flexibility, parent confidence in managing behaviours, family adjustment,and number of disagreements between parents. Most improvements were maintained at 6-months. Parent skills training and ACT may be efficacious in improving parent, family, and couple outcomes in families of children with an ABI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Paediatric stroke

    African Journals Online (AJOL)


    Apr 2, 2011 ... ALVIN P NDONDO, MB ChB, FCPaed (SA), Cert Paediatric Neurology (SA). Consultant Paediatric Neurologist, Department of Paediatric Neurology, School of Child and Adolescent Health, Red Cross War Memorial Children's. Hospital, Cape Town. Alvin Ndondo is currently working as a paediatric ...

  18. Paediatric Neuroimaging

    African Journals Online (AJOL)

    Paediatric Neuroimaging Quiz Case. S Afr J Rad. 2015;19(2); Art. #873, 3 pages. Copyright: © 2015. The Authors. Licensee: AOSIS OpenJournals. This work is licensed under the Creative Commons. Attribution License. Read online: Scan this QR code with your smart phone or.


    African Journals Online (AJOL)

    examination of the abdomen at four specific locations: the right upper quandrant, left upper quadrant, suprapubic area. Role of focused assessment with sonography for trauma as a screening tool for blunt abdominal trauma in young children after high energy trauma. PAEDIATRIC SURGERY. W Tummers,1 J van Schuppen ...

  20. The global burden of paediatric heart disease

    DEFF Research Database (Denmark)

    Musa, Ndidiamaka L; Hjortdal, Vibeke; Zheleva, Bistra


    An estimated 15 million children die or are crippled annually by treatable or preventable heart disease in low- and middle-income countries. Global efforts to reduce under-5 mortality have focused on reducing death from communicable diseases in low- and middle-income countries with little...... to no attention focusing on paediatric CHD and acquired heart disease. Lack of awareness of CHD and acquired heart disease, access to care, poor healthcare infrastructure, competing health priorities, and a critical shortage of specialists are important reasons why paediatric heart disease has not been addressed...... in low resourced settings. Non-governmental organisations have taken the lead to address these challenges. This review describes the global burden of paediatric heart disease and strategies to improve the quality of care for paediatric heart disease. These strategies would improve outcomes for children...

  1. Trismus in the paediatric population. (United States)

    Shires, Peter M; Chow, Gabriel


    Trismus is a rare presentation affecting neonates, children, and adults. In newborns there are serious implications, with potential to affect feeding, cause airway problems, and make intubation difficult. Causes of trismus seen in the paediatric patient are discussed in this review article; they are divided into intra- and extra-articular types. The extra-articular group consists of congenital and acquired disorders. The acquired group includes infective causes such as tetanus, iatrogenic causes related to drugs, cancer or dental treatment, and trauma causing articulation difficulty or triggering a rare type of bone growth in myositis ossificans. Changes in the mouth resulting from oral submucous fibrosis can undergo malignant transformation. This review aims to raise awareness of potential causes of trismus in paediatric populations, helping clinicians identify the underlying pathology so appropriate strategies for treatment be applied, with the ultimate aim of improving long-term outlook and quality of life for affected children. © 2014 Mac Keith Press.

  2. Application of the 2012 revised diagnostic definitions for paediatric multiple sclerosis and immune-mediated central nervous system demyelination disorders

    NARCIS (Netherlands)

    van Pelt, E. Danielle; Neuteboom, Rinze F.; Ketelslegers, Immy A.; Boon, Maartje; Catsman-Berrevoets, Coriene E.; Hintzen, Rogier Q.

    Background Recently, the International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions for the diagnosis of immune-mediated acquired demyelinating syndromes (ADS) of the central nervous system, including paediatric multiple sclerosis (MS), have been revised. Objective To evaluate the

  3. Monitoring of rotavirus infection in a paediatric hospital by RNA ...

    African Journals Online (AJOL)

    During the spring of 1987 and the autumn of 1988, stool specimens were collected from infants and young children in the paediatric unit at H. F. Verwoerd Hospital, Pretoria, and examined for the presence of rotaviruses to assess the potential for hospital-acquired infection in the paediatric wards. Stool samples were also ...

  4. SAMJ Monitoring of rotavirus infection in a paediatric hospital by ...

    African Journals Online (AJOL)

    During the spring of 1987 and the autumn of 1988, stool specimens were collected from infants and young children in the paediatric unit at H. F. Verwoerd Hospital, Pretoria, and examined for the presence of rotaviruses to assess the potential for hospital-acquired infection in the paediatric wards. Stool samples were also ...

  5. Paediatric rhinitis

    DEFF Research Database (Denmark)

    Roberts, G; Xatzipsalti, M; Borrego, L M


    -based recommendations for the diagnosis and therapy of paediatric rhinitis. Rhinitis is characterized by at least two nasal symptoms: rhinorrhoea, blockage, sneezing or itching. It is classified as allergic rhinitis, infectious rhinitis and nonallergic, noninfectious rhinitis. Similar symptoms may occur with other...... conditions such as adenoidal hypertrophy, septal deviation and nasal polyps. Examination by anterior rhinoscopy and allergy tests may help to substantiate a diagnosis of allergic rhinitis. Avoidance of relevant allergens may be helpful for allergic rhinitis (AR). Oral and intranasal antihistamines and nasal...... decongestant, saline douches and nasal anticholinergics. Allergen-specific immunotherapy is helpful in IgE-mediated AR and may prevent the progression of allergic disease. There are still a number of areas that need to be clarified in the management of rhinitis in children and adolescents....

  6. Ethics, law and paediatric medicine. (United States)

    Waller, Louis


    Medicine is practised within an ethical and a legal framework. Doctors must obtain the broad consent of their patients before treatment begins, and tell them of their choices and the material risks inherent in treatment. Where children are the patients, it is their parents or guardians who must give their consent, unless the situation is an emergency or the children have been removed from parental custody and care. Today, mature teenagers may consent to their own medical treatment. Doctors must protect their patients' confidential information, however acquired. There are very limited exceptions where confidential information may be revealed, and a few where revelation is mandatory. Effective communication between doctors and their patients, or their parents, is of signal importance. © 2011 The Author. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  7. Common paediatric renal conditions

    African Journals Online (AJOL)


    Feb 1, 2012 ... Gertruida van Biljon, MB ChB, MMed(Paed), FCP (Paed) SA, Cert Paediatric Nephrology. Professor and Senior Consultant, Department of Paediatrics, Faculty of Health Sciences, University of Pretoria. Gertruida van Biljon is a full-time senior consultant in the Department of Paediatrics and Head of the ...

  8. Paediatrics: messages from Munich

    Directory of Open Access Journals (Sweden)

    Fabio Midulla


    Full Text Available The aim of this article is to describe paediatric highlights from the 2014 European Respiratory Society (ERS International Congress in Munich, Germany. Abstracts from the seven groups of the ERS Paediatric Assembly (Respiratory Physiology and Sleep, Asthma and Allergy, Cystic Fibrosis, Respiratory Infection and Immunology, Neonatology and Paediatric Intensive Care, Respiratory Epidemiology, and Bronchology are presented in the context of the current literature.

  9. Peer teaching in paediatrics - medical students as learners and teachers on a paediatric course. (United States)

    Schauseil-Zipf, Ulrike; Karay, Yassin; Ehrlich, Roland; Knoop, Kai; Michalk, Dietrich


    Peer assisted learning is known as an effective educational strategy in medical teaching. We established a peer assisted teaching program by student tutors with a focus on clinical competencies for students during their practical training on paediatric wards. It was the purpose of this study to investigate the effects of a clinical skills training by tutors, residents and consultants on students evaluations of the teaching quality and the effects of a peer teaching program on self assessed clinical competencies by the students. Medical student peers in their 6(th) year were trained by an intensive instruction program for teaching clinical skills by paediatric consultants, doctors and psychologists. 109 students in their 5(th) year (study group) participated in a peer assisted teaching program for training clinical skills in paediatrics. The skills training by student peer teachers were supervised by paediatric doctors. 45 students (control group) participated in a conventional paediatric skills training by paediatric doctors and consultants. Students from both groups, which were consecutively investigated, completed a questionnaire with an evaluation of the satisfaction with their practical training and a self assessment of their practical competencies. The paediatric skills training with student peer teachers received significantly better ratings than the conventional skills training by paediatric doctors concerning both the quality of the practical training and the support by the teaching medical staff. Self assessed learning success in practical skills was higher rated in the peer teaching program than in the conventional training. The peer assisted teaching program of paediatric skills training was rated higher by the students regarding their satisfaction with the teaching quality and their self assessment of the acquired skills. Clinical skills training by student peer teachers have to be supervised by paediatric doctors. Paediatric doctors seem to be more

  10. Paediatrics: Messages from Munich

    NARCIS (Netherlands)

    F. Midulla; E. Lombardi (Enrico); M.W.H. Pijnenburg (Mariëlle); Balfour-Lynn, I.M. (Ian M.); J. Grigg (Jonathan); K. Bohlin (Kajsa); F. Rusconi (Franca); P. Pohunek (Petr); E. Eber (Ernst)


    textabstractThe aim of this article is to describe paediatric highlights from the 2014 European Respiratory Society (ERS) International Congress in Munich, Germany. Abstracts from the seven groups of the ERS Paediatric Assembly (Respiratory Physiology and Sleep, Asthma and Allergy, Cystic Fibrosis,

  11. Handbook of Paediatrics

    African Journals Online (AJOL)

    Paediatrics and Child Health, University of Pretoria. Reviewing this excellent pocket handbook for the practice of paediatrics was a bitter-sweet experience. The editor, Professor. Cas Motala, passed away towards the end of last year, shortly after publication of the book. I was working with Cas on another project at the time ...

  12. Paediatric radiopharmaceutical administration

    DEFF Research Database (Denmark)

    Lassmann, Michael; Treves, S Ted; Borgwardt, Lise


    In 2008 the EANM published their paediatric dosage card. In 2011 the North American consensus guidelines recommended a set of administered activities for paediatric nuclear medicine. During the EANM congress in 2012 a working group of the EANM and the SNMMI met to study the possibility of harmoni...

  13. Safety in paediatric imaging

    Energy Technology Data Exchange (ETDEWEB)

    Carter, D.; Filice, I.; Murray, D.; Thomas, K. [The Hospital for Sick Children, Toronto, Ontario (Canada)


    Those of us working in a dedicated paediatric environment are aware of the important safety issues with regard to paediatrics. Our goal when working with paediatric patients, the goal is to obtain the best quality images while keeping patients safe and their distress to a minimum. This article will discuss some of the issues regarding paediatric safety in a diagnostic imaging department, including radiation doses and the risk to paediatric patients, reducing medication errors, safe sedation practice and environmental safety. Also discussed are some conditions requiring special consideration to maintain patient safety such as epiglottitis and suspected child abuse. Promotion of a patient/family-centered care system will create an environment of trust where parents or guardians will know that their children are being well cared for in a safe, effective environment. (author)

  14. Paediatric Malignancies | Joseph | African Journal of Paediatric ...

    African Journals Online (AJOL)

    malignancies. Other common malignancies included sarcomas 10(14.71%), neurofibromatosis 9(13.24%), nephroblastoma 8(11.77%), acute lymphoblastic leukaemia 5(7.35%) and retinoblastoma 4(5.88%). The less common paediatric malignancies were melanoma, invasive lobular breast carcinoma and squamous cell ...

  15. Paediatric talus fracture.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria


    Paediatric talus fractures are rare injuries resulting from axial loading of the talus against the anterior tibia with the foot in dorsiflexion. Skeletally immature bone is less brittle, with higher elastic resistance than adult bone, thus the paediatric talus can sustain higher forces before fractures occur. However, displaced paediatric talus fractures and those associated with high-energy trauma have been associated with complications including avascular necrosis, arthrosis, delayed union, neurapraxia and the need for revision surgery. The authors present the rare case of a talar neck fracture in a skeletally immature young girl, initially missed on radiological review. However, clinical suspicion on the part of the emergency physician, repeat examination and further radiographic imaging revealed this rare paediatric injury.

  16. Paediatric Anxiety Disorders

    Directory of Open Access Journals (Sweden)

    Beena Johnson


    Full Text Available Anxiety disorders are highly prevalent among children and are associated with serious morbidity. Lifetime prevalence of paediatric anxiety disorders is about fifteen percent. Social phobia, generalized anxiety disorder and separation anxiety disorder are included in the triad of paediatric anxiety disorders. Specific phobia, obsessive compulsive disorder and post-traumatic stress disorder are also commonly seen in children. Overprotection by parents, parental death or separation, female sex, low educational status, family history of anxiety disorder, financial stress in family and adverse childhood experiences are risk factors for the development of anxiety disorders. If not diagnosed and managed at the earliest, paediatric anxiety disorders can cause life threatening problems in the future. Hence early and scientific management of anxiety disorders is essential. Cognitive behavioural therapy is the effective evidence based treatment for paediatric anxiety disorders.

  17. African Journal of Paediatric Nephrology

    African Journals Online (AJOL)

    African Journal of Paediatric Nephrology is the official Journal of the African Paediatric Nephrology Association (AFPNA). The journal is dedicated to increasing awareness and knowledge of Paediatric nephrology in Africa and beyond. We publish research articles on renal diseases in children, on fluid and electrolyte ...

  18. African Journal of Paediatric Surgery

    African Journals Online (AJOL)

    The African Journal of Paediatric Surgery aims to promote research, post- graduate training and further education among Paediatric surgeons, Paediatric Surgical Trainees and paramedical personnel in the surgery of newborn infants and children particularly in Africa and other tropical regions of the world.AJPS welcomes ...

  19. [What's new in paediatric dermatology?]. (United States)

    Plantin, P


    Regular analysis of the major journals in dermatology and paediatrics has been used to select forty articles which are representative of the past year in paediatric dermatology. This selection is not exhaustive but rather reflects the interests of the author and also the dominant topics in paediatric dermatology in 2013-2014. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Constipation in paediatric oncology. (United States)

    Selwood, Karen


    Constipation is a common problem encountered by many children during treatment for childhood cancer. It can be distressing and impact on the quality of life for the child. However, the advice and information they and their families receive can vary enormously. The clinical practice group (a subgroup of the paediatric oncology nurses forum (PONF)) decided to examine the management of constipation throughout the paediatric oncology units in the UK. This paper presents the findings and the subsequent action taken and highlights the need for further work.

  1. Key paediatric messages from Amsterdam

    Directory of Open Access Journals (Sweden)

    Jonathan Grigg


    Full Text Available The Paediatric Assembly of the European Respiratory Society (ERS maintained its high profile at the 2015 ERS International Congress in Amsterdam. There were symposia on preschool wheeze, respiratory sounds and cystic fibrosis; an educational skills workshop on paediatric respiratory resuscitation; a hot topic session on risk factors and early origins of respiratory diseases; a meet the expert session on paediatric lung function test reference values; and the annual paediatric grand round. In this report the Chairs of the Paediatric Assembly's Groups highlight the key messages from the abstracts presented at the Congress.

  2. Key paediatric messages from Amsterdam (United States)

    Barben, Jürg; Bohlin, Kajsa; Everard, Mark L.; Hall, Graham; Pijnenburg, Mariëlle; Priftis, Kostas N.; Rusconi, Franca; Midulla, Fabio


    The Paediatric Assembly of the European Respiratory Society (ERS) maintained its high profile at the 2015 ERS International Congress in Amsterdam. There were symposia on preschool wheeze, respiratory sounds and cystic fibrosis; an educational skills workshop on paediatric respiratory resuscitation; a hot topic session on risk factors and early origins of respiratory diseases; a meet the expert session on paediatric lung function test reference values; and the annual paediatric grand round. In this report the Chairs of the Paediatric Assembly's Groups highlight the key messages from the abstracts presented at the Congress. PMID:27730186

  3. Acquired Techniques

    DEFF Research Database (Denmark)

    Lunde Nielsen, Espen; Halse, Karianne


    Acquired Techniques - a Leap into the Archive, at Aarhus School of Architecture. In collaboration with Karianne Halse, James Martin and Mika K. Friis. Following the footsteps of past travelers this is a journey into tools and techniques of the architectural process. The workshop will focus upon...

  4. Electrodiagnosis in paediatric ophthalmogenetics

    NARCIS (Netherlands)

    P.A. Pkarian (Patricia)


    textabstractIn the present overview, practical application of the visual evoked potential (VEP) in paediatric neuro-ophthalmology is described across a wide range of ophthalmogenetic disorders, including albinism, Pelizaeus-Merzbacher disease and spastic paraplegia. The VEP approach is based on a

  5. Nigerian Journal of Paediatrics

    African Journals Online (AJOL)

    The Nigerian Journal of Paediatrics a quarterly journal publishes original articles, brief reports on clinical and laboratory observations; case reports of substantive value; invited editorial annotations; invited papers on recent electronic clinical briefs, advances, clinical diagnosis, announcements (meetings, courses, job ...

  6. The paediatric neuropathic bladder

    African Journals Online (AJOL)

    nerves involved in the control of micturition (urination). In pathophysiological terms, a neurogenic bladder is caused by a spinal reflex arc that occurs when the bladder becomes autonomous from higher centres.[1] Paediatric neurogenic bladder dysfunction is most commonly caused by a congenital neural tube defect (NTD),.

  7. Paediatric palliative medicine

    African Journals Online (AJOL)

    end-of-life dilemmas in children, communication with children, counselling, breaking bad news, pain control, and self-care, and have been written by palliative care professionals currently working in paediatric palliative medicine in South Africa. There are few specialist services for children's palliative care in South Africa, ...

  8. Paediatric pain management

    African Journals Online (AJOL)

    cultural attitudes about pain, and the cognitive component of pain control.3 All of these ... applied to any patient, regardless of his/her age; however, paediatric pain expression is dependent on the child's level of cognitive development and .... pain.5 This approach involves the participation of the parent and the child during ...

  9. Handbook of Paediatrics

    African Journals Online (AJOL)

    Reviewing this excellent pocket handbook for the practice of paediatrics was a bitter-sweet experience. The editor, Professor. Cas Motala, passed away towards the end of last year, shortly after publication of the book. I was working with Cas on another project at the time and I know how delighted he was with this book.

  10. Community-Acquired Acute Kidney Injury in Critically Ill Children as ...

    African Journals Online (AJOL)


    Jun 28, 2017 ... Community-Acquired Acute Kidney Injury in Critically Ill Children as. Seen in the Emergency Unit of a Tertiary Hospital in Enugu, Southeast. Nigeria. Address for correspondence: Dr. OI Odetunde,. Paediatric Nephrology Unit, Department of Paediatrics,. College of Medicine, University of Nigeria/University ...

  11. Antimicrobial stewardship in paediatrics. (United States)

    Principi, Nicola; Esposito, Susanna


    Antibiotics are among the drugs most commonly prescribed to children in hospitals and communities. Unfortunately, a great number of these prescriptions are unnecessary or inappropriate. Antibiotic abuse and misuse have several negative consequences, including drug-related adverse events, the emergence of multidrug resistant bacterial pathogens, the development of Clostridium difficile infection, the negative impact on microbiota, and undertreatment risks. In this paper, the principle of and strategies for paediatric antimicrobial stewardship (AS) programs, the effects of AS interventions and the common barriers to development and implementation of AS programs are discussed. Over the last few years, there have been significant shortages in the development and availability of new antibiotics; therefore, the implementation of strategies to preserve the activity of existing antimicrobial agents has become an urgent public health priority. AS is one such approach. The need for formal AS programs in paediatrics was officially recognized only recently, considering the widespread use of antibiotics in children and the different antimicrobial resistance patterns that these subjects exhibit in comparison to adult and elderly patients. However, not all problems related to the implementation of AS programs among paediatric patients are solved. The most important remaining problems involve educating paediatricians, creating a multidisciplinary interprofessional AS team able to prepare guidelines, monitoring antibiotic prescriptions and defining corrective measures, and the availability of administrative consensuses with adequate financial support. Additionally, the problem of optimizing the duration of AS programs remains unsolved. Further studies are needed to solve the above mentioned problems. In paediatric patients, as in adults, the successful implementation of AS strategies has had a significant impact on reducing targeted- and nontargeted-antimicrobial use by improving

  12. Hospital-acquired Klebsiella pneumoniae infections in a paediatric ...

    African Journals Online (AJOL)

    Klebsiella pneumoniae in neonatal intensive care units (ICUs) has increased recently with numerous reports of outbreaks in neonatal. ICUs throughout South Africa (SA).[2] Investigations into these outbreaks have identified an underlying context characterised by overcrowding, understaffing and a breakdown in infection ...

  13. [New analgesics in paediatrics]. (United States)

    Avez-Couturier, Justine; Wood, Chantal


    There are a number of different types of analgesics in paediatrics. They must be used in accordance with the situation, the type of pain and the characteristics of the child. In all cases, strict compliance with the posology and the instructions for use is essential to avoid any risk of error. Finally, pharmacological, physical and psychological treatments are employed in a complementary manner, for the biopsychosocial management of the child's care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Litigation in paediatrics

    LENUS (Irish Health Repository)

    Murphu, JFA


    on the issue. This is understandable. Most individuals are healthy during their childhood and have less need of and less interaction with medical services when compared with adults. However, Paediatric litigation does happen and furthermore it is likely to increase in parallel with other specialties. Carroll and Buddenbaum1 have described the pattern of Paediatric litigation in the US. The annual incidence of malpractice claims has been quoted to be as high as 6.6 claims per 100 Paediatricians per year. Almost 30% of Paediatricians have been sued with many being sued on more than one occasion. Of these cases 36% were settled out of court, 33% were dropped by the plaintiff with the remainder going before the judiciary. The authors point out that in the US medical malpractice is a hotly debated issue. Litigation has a questionable impact on health care quality, cost, and access to services. The AMA believes that rising premiums are resulting in the curtailment of medical care particularly in states with high medico-legal rates. The Physician Insurers Association of America (PIAA) is a trade organisation which insures 60% of all private practicing physicians and surgeons has been a useful source of data. In the 20 year period 1985-2005 among a total of 214,226 claims there were 6363 (2.9%) Paediatric claims which ranked it 10th among the 28 specialties covered. The claims arose in equal numbers from the hospital and Paediatrician’s office settings. Common reasons for Paediatric litigation were errors in diagnosis (32%), incorrect performance of a medical or surgical procedure (13%), failure to monitor or manage a case effectively (10%) and medication error (5%). The top five medico-legal conditions were meningitis, routine infant or child checks, newborn respiratory problems, appendicitis and brain-damaged infants as a co-defendant with Obstetrics. Good quality information about litigation is important because the discussion among doctors is frequently confused by

  15. Whither paediatric dentistry? (United States)

    Murray, J J


    The objective of the British Society of Paediatric Dentistry is to promote the oral health of children. This objective is discussed from four different aspects. First, it is necessary to quantify the dental needs of children and to appreciate how these needs have changed over the last 20 years. Using information from national dental surveys, changes between 1973 and 1993 in the prevalence of dental caries, periodontal disease, accidental damage to anterior teeth and occlusal problems, are summarized. Secondly, the development in consultant posts and the specialty of paediatric dentistry are discussed. The impact of research gradings given to Dental Schools in Britain is the third aspect to be considered and its possible effect on research topics directly relevant to improving the oral health of children. Lastly the effect of public perceptions on our specialty must be considered. Although paediatric dentists may not hit the headlines, the public must be convinced that good oral health is the birthright of every child and that we are dedicated to preventing and treating oral disease in children.

  16. Paediatric trauma care

    Directory of Open Access Journals (Sweden)

    Sebastian van As A


    Full Text Available Background: Childhood trauma has become a major cause of mortality and morbidity, disability and socio-economic burden and it is expected by the World Health Organization (WHO that by 2020 it will be the number 1 disease globally. The WHO and UNICEF have published their third World Report on Child Injury Prevention in December 2008. Materials and Methods: A systematic review was performed on the history and magnitude of paediatric trauma worldwide. Additionally exciting developments and new trends were assessed and summarized. Results: Paediatric trauma is a growing field of clinical expertise. New developments include total body digital imaging of children presenting with polytrauma; targeted management of head injuries; conservative management of abdominal injuries in children and diagnostic laparoscopy, including the laparoscopic management of complications following the conservative management of solid organ injuries. Conclusion: Paediatric trauma has long been neglected by the medical profession. In order to deal with it appropriately, it makes sense to adopt the public health approach, requiring that we view child injuries similarly to any other disease or health problem. The greatest gain in our clinical practice with dealing with child injuries will result from a strong focus on primary (preventing the injury, secondary (dealing with the injury in the most efficient manner as well as tertiary prevention (making sure that children treated for trauma will be appropriately reintegrated within our society. By actively promoting child safety we will not only achieve a most welcome reduction in medical cost and disability, but also the ever-so-much desired decline of avoidable childhood misery and suffering.

  17. Metastatic paediatric colorectal carcinoma.

    LENUS (Irish Health Repository)

    Woods, R


    A 16-year-old girl presented to our unit with crampy abdominal pain, change in bowel habit, a subjective impression of weight loss and a single episode of haematochezia. She was found to have a rectosigmoid adenocarcinoma and proceeded to laparoscopic anterior resection, whereupon peritoneal metastases were discovered. She received chemotherapy and is alive and well ten month later with no radiological evidence of disease. Colorectal carcinoma is rare in the paediatric population but is increasing in incidence. Early diagnosis is critical to enable optimal outcomes.

  18. Paediatric respiratory infections

    Directory of Open Access Journals (Sweden)

    Mark L. Everard


    Full Text Available Pulmonary infections remain a major cause of infant and child mortality worldwide and are responsible for a substantial burden of morbidity. During the 2015 European Respiratory Society International Congress in Amsterdam, some of the main findings from peer-reviewed articles addressing this topic that were published in the preceding 12 months were reviewed in a Paediatric Clinical Year in Review session. The following article highlights some of the insights provided by these articles into the complex interactions of the human host with the extensive and dynamic populations of microorganisms that call an individual “home”.

  19. Paediatric respiratory infections. (United States)

    Everard, Mark L


    Pulmonary infections remain a major cause of infant and child mortality worldwide and are responsible for a substantial burden of morbidity. During the 2015 European Respiratory Society International Congress in Amsterdam, some of the main findings from peer-reviewed articles addressing this topic that were published in the preceding 12 months were reviewed in a Paediatric Clinical Year in Review session. The following article highlights some of the insights provided by these articles into the complex interactions of the human host with the extensive and dynamic populations of microorganisms that call an individual "home". Copyright ©ERS 2016.

  20. Aetiology and outcome of severe community-acquired pneumonia in ...

    African Journals Online (AJOL)

    Objective. To determine the aetiological agents and outcome of severe community-acquired pneumonia (SCAP) in children admitted to the paediatric intensive care unit (PICU) at Kalafong Hospital, Pretoria. Patients and methods. An audit was done after a protocol was implemented to identify the aetiological agents in ...

  1. Paediatric Autoimmune Liver Disease. (United States)

    Liberal, Rodrigo; Vergani, Diego; Mieli-Vergani, Giorgina


    In paediatrics, there are 2 liver disorders in which liver damage most likely stems from an autoimmune attack: 'classical' autoimmune hepatitis (AIH) and the AIH/sclerosing cholangitis overlap syndrome (also known as autoimmune sclerosing cholangitis, ASC). The presentation of childhood autoimmune liver disease (AILD) is non-specific and can mimic most other liver disorders. AIH is exquisitely responsive to immunosuppressive treatment, which should be instituted promptly to prevent rapid deterioration and promote remission and long-term survival. Difficult-to-treat or non-responsive patients should be treated with mycophenolate mofetil; if this fails then calcineurin inhibitors can be tried. Persistent failure to respond or lack of adherence to treatment result in end-stage liver disease. These patients, and those with fulminant liver failure at diagnosis, will require liver transplantation. ASC responds to the same immunosuppressive treatment used for AIH when treatment is initiated early. Abnormal liver function tests often resolve within a few months of treatment, although medium- to long-term prognosis is worse than that of AIH because bile duct disease continues to progress despite treatment in approximately 50% of patients. Ursodeoxycholic acid is usually added to conventional treatment regimen in ASC, but whether this actually helps arrest the progression of bile duct disease remains to be established. The pathogenesis of paediatric-onset AILD is not fully understood, although there is mounting evidence that genetic susceptibility, molecular mimicry and impaired immunoregulatory networks contribute to the initiation and perpetuation of the autoimmune attack. Liver damage is thought to be mediated primarily by CD4pos T-cells. While Th1 effector cells are associated with hepatocyte damage in both AIH and ASC, Th17 immune responses predominate in the latter where they correlate with biochemical indices of cholestasis, indicating that IL-17 is involved in the

  2. Nigerian Journal of Paediatrics: Editorial Policies

    African Journals Online (AJOL)

    2348032625989. Assistant Editors Dr. Afolabi Lesi FWACP (Paed) Professor of Paediatrics & Neurology Dept of Paediatrics Lagos University Teaching Hospital Lagos Nigeria +2348023002960. Dr. Austine I Omoigberale FWACP ...

  3. African Journal of Paediatric Nephrology: Journal Sponsorship

    African Journals Online (AJOL)

    African Journal of Paediatric Nephrology: Journal Sponsorship. Journal Home > About the Journal > African Journal of Paediatric Nephrology: Journal Sponsorship. Log in or Register to get access to full text downloads.

  4. Management of paediatric GERD. (United States)

    Vandenplas, Yvan


    Paediatric GERD is complicated to manage, as symptoms are diverse and often difficult to interpret. In infants, regurgitation is a common physiological condition. Nevertheless, when it occurs frequently (>4 times per day) and causes the infant distress, parents often seek medical help. In children 2-10 years of age, GERD is often considered to cause extra-oesophageal symptoms, despite the absence of hard evidence. Diagnostic investigations often lack solid validation and the signs and symptoms of GERD overlap with those of cow's milk protein allergy and eosinophillic oesophagitis. Reassurance, dietary treatment and positional adaptations are recommended for troublesome infant reflux. Anti-acid medication, mainly PPIs, is over-used in infants even though, in many children, reflux is not an acid-related condition. Moreover, evidence is increasing that PPIs cause adverse events such as gastroenteritis and respiratory tract infections. Management in children older than 10 years is similar to that in adults. Using prokinetics to treat nonerosive reflux disease remains only a promising theoretical concept, as no such molecule is currently available. Today, the adverse effects of each prokinetic molecule largely outweigh its potential benefit. Laparoscopic surgery is indicated in children who have life-threatening symptoms or in cases of drug dependence.

  5. [Toxicology screening in paediatrics]. (United States)

    Garcia-Algar, Óscar; Cuadrado González, Ainoha; Falcon, María


    The prevalence of acute or chronic exposure to substances of abuse in paediatric patients, from the neonatal period to adolescence, is not well established as most cases go unnoticed. Regardless of clinical cases of acute poisoning leading to visits to emergency room, the exposure is usually detected by a questionnaire to the parents or children. In the last few years, new validated analytical methodologies have been developed in order to detect parent drugs and their metabolites in different biological matrices. These biological matrices have different time windows for detection of the exposure: acute (i.e., urine, blood, oral fluid), and chronic (i.e., hair, meconium or teeth). The aim of this paper was to review the scenarios where the use of biological matrices is indicated for the detection of acute or chronic exposure to substances of abuse. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Sentinel lymph node biopsy in paediatric melanoma. A case series. (United States)

    Sánchez Aguilar, M; Álvarez Pérez, R M; García Gómez, F J; Fernández Ortega, P; Borrego Dorado, I


    The incidence of melanoma in children is uncommon, being particularly rare in children under 10 years-old. However, this disease is increasing by a mean of 2% per year. As in adults, the lymph node status is the most important prognostic factor, crucial to performing the selective sentinel lymph node biopsy (SLNB). We report 3 cases of paediatric patients of 3, 4 and 8 years-old, in which SLNB was performed for malignant melanoma. Paediatric age implies greater technical difficulty to the scintigraphy scan due to poor patient cooperation, with mild sedation required in some cases, and only being able to acquire planar images in other cases. SPECT/CT was only performed in the oldest patient. In our cases, SLNB was useful for selecting the least invasive surgery in order to reduce morbidity. Copyright © 2014 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  7. Paediatric endoscopy in Nigeria humble beginning | Ikobah ...

    African Journals Online (AJOL)

    In Nigeria, it is still at its infancy stage, though with increasing local interest. This is a report of the first Paediatric Endoscopy Workshop in Nigeria organized as a pre -conference by the Paediatric Association of Nigeria (PAN) and the Nigerian Society of Paediatric Gastroenterology, Hepatology and Nutrition (NISPGHAN).

  8. Paediatric and adult malignant glioma

    DEFF Research Database (Denmark)

    Jones, Chris; Perryman, Lara; Hargrave, Darren


    Gliomas in children differ from their adult counterparts by their distribution of histological grade, site of presentation and rate of malignant transformation. Although rare in the paediatric population, patients with high-grade gliomas have, for the most part, a comparably dismal clinical outcome...... to older patients with morphologically similar lesions. Molecular profiling data have begun to reveal the major genetic alterations underpinning these malignant tumours in children. Indeed, the accumulation of large datasets on adult high-grade glioma has revealed key biological differences between...... the adult and paediatric disease. Furthermore, subclassifications within the childhood age group can be made depending on age at diagnosis and tumour site. However, challenges remain on how to reconcile clinical data from adult patients to tailor novel treatment strategies specifically for paediatric...

  9. Singapore Paediatric Resuscitation Guidelines 2016 (United States)

    Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong


    We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation’s Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. PMID:28741003

  10. paediatric orofacial tumours: new oral health con- cern in paediatric ...

    African Journals Online (AJOL)


    Mar 1, 2014 ... Department of Oral Pathology/Oral Medicine, Univer- sity of Benin Teaching Hospital, Benin City, Nigeria. Results: Of the 1013 diagnosed lesions within the study period, there were 137 (13.5%) paediatric orofa- cial tumours, among which 71 (51.8%) cases occurred within the last 6 years (2005 to 2010).

  11. Science and ethics of human immunodeficiency virus/acquired immunodeficiency syndrome controversies in Africa. (United States)

    Brewster, David


    The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in Africa has raised important ethical issues for both researchers and clinicians. The most notorious controversy has been related to the zidovudine (AZT) trials in Africa in the late 1990s, in which the control groups were given a placebo rather than an effective drug to prevent vertical transmission. This raised concerns in the sponsoring country about exploitation of subjects, injustice and an ethical double standard between donor countries and resource-poor settings. However, the real double standard is between clinical practice standards in Western versus African countries, which must be addressed as part of the increasing global inequity of wealth both between countries and also within countries. There are important limitations to ethical declarations, principles and guidelines on their own without contextual ethical reasoning. The focus on research ethics with the HIV epidemic has led to a relative neglect of ethical issues in clinical practice. Although the scientific advances in HIV/AIDS have changed the ethical issues since the 1990s, there has also been progress in the bioethics of HIV/AIDS in terms of ethical review capability by local committees as well as in exposure to ethical issues by clinicians and researchers in Africa. However, serious concerns remain about the overregulation of research by bureaucratic agencies which could discourage African research on specifically African health issues. There is also a need for African academic institutions and researchers to progressively improve their research capacity with the assistance of research funders and donor agencies. © 2011 The Author. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.


    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of

  13. Anaesthetic management of paediatric adenotonsillectomy

    African Journals Online (AJOL)

    Anaesthesia Supplement: Anaesthetic management of paediatric adenotonsillectomy. S17. Vol 54 No 3 Supplement 1. S Afr Fam Pract ... From a risk-benefit perspective, tonsillectomy is an elective procedure with more than average ... Potential problems with adenotonsillectomy can be minimised by careful preoperative ...

  14. More about ... Paediatric emergency medicine

    African Journals Online (AJOL)

    More about ... Paediatric emergency medicine. What's new in toxicology? K H Balme, MB ChB ... and European Academies of Clinical. Toxicologists published new guidelines.4. These emphasise that patients .... in Australia and New Zealand – explanation and elaboration. A consensus statement from clinical toxicologists ...

  15. Nigerian Journal of Paediatrics: Submissions

    African Journals Online (AJOL)

    If digital images are the only source of images, ensure that the image has minimum resolution of 300 dpi or 1800 x 1600 pixels in TIFF format. ... Nigerian Journal of Paediatrics charges Nigerian Naira 5000 (USD25) on submission of manuscript as processing fees and Nigerian Naira 25,000 (USD125) publication fees on ...

  16. Methodologies to assess paediatric adiposity.

    LENUS (Irish Health Repository)

    Horan, M


    Childhood obesity is associated with increased risk of adult obesity, cardiovascular disease, diabetes and cancer. Appropriate techniques for assessment of childhood adiposity are required to identify children at risk. The aim of this review was to examine core clinical measurements and more technical tools to assess paediatric adiposity.

  17. Projetos de vida de adultos jovens portadores de HIV por transmissão vertical: estudo exploratório com usuários de um ambulatório de infectologia Life projects of young adults with HIV acquired by vertical transmission: an exploratory study with patients of an infectious diseases' outpatients department

    Directory of Open Access Journals (Sweden)

    Lédice Lino de Oliveira


    Full Text Available Esta pesquisa teve o intuito de conhecer os projetos de vida de jovens adultos que convivem com o HIV/aids a partir da transmissão vertical, com relação a: estudo, trabalho e constituição familiar. Outro objetivo foi o de conhecer sua vivência no que diz respeito à assistência recebida. Como instrumentos, foram utilizados: questionário sociodemográfico e entrevista semiestruturada. Foram realizadas 16 entrevistas com jovens de idade entre 18 e 22 anos, usuários de um ambulatório de um hospital público especializado na área de Infectologia. O material obtido nas entrevistas foi analisado segundo os princípios da análise temática. Foram encontradas seis categorias temáticas: estudo e escolaridade; trabalho e emprego; sexualidade e constituição familiar; vivência de preconceito; adesão ao tratamento; acolhimento. Os entrevistados referiram que a escola é importante meio para a inserção social e para a conquista da autonomia. O trabalho foi apresentado como principal fonte de subsistência e de independência. O exercício da sexualidade foi marcado pela situação de existência do HIV, determinando cuidados especiais; quanto à conjugalidade, os projetos dos entrevistados são variados: união informal, casamento oficial, vida sem cônjuge. No que diz respeito à maternidade/paternidade, os projetos são marcadamente influenciados pela portabilidade do HIV, despertando dúvidas e receios. Os entrevistados relataram a existência do preconceito em vários contextos. Quanto à adesão ao tratamento, revelaram a existência tanto de dificuldades como de mecanismos criados para enfrentá-las. O acolhimento por parte de familiares, amigos e profissionais da saúde foi considerado fundamental para o desenvolvimento e a manutenção de seus projetos de vida.This research had the intention to understand the life projects of young adults living with HIV/Aids infected through vertical transmission: how they deal with studies, work

  18. [Knowledge of health care ethics in paediatric residents]. (United States)

    Hernández González, A; Rodríguez Núñez, A; Cambra Lasaosa, F J; Quintero Otero, S; Ramil Fraga, C; García Palacios, M V; Hernández Rastrollo, R; Ruiz Extremera, M A


    Bioethics has been recently incorporated in to the educational programs of both medical students and medical residents as part of their curriculum. However, its training based on clinical practice is not well structured. To evaluate the knowledge of bioethics in Spanish paediatric residents, and to analyse how this relates to the medical education during graduate and post-graduate training. A questionnaire with 20 multiple choice questions was designed to evaluate the knowledge in basic ethics with potential implications in clinical practice. We evaluated the education received during graduate and post-graduate training, and the main ethical conflicts faced. A total of 210 completed questionnaires were received from medical residents in paediatrics from 20 different Spanish hospitals, of whom 47 of these were first year residents (R1), 49 were second year residents (R2), 57 were third year residents (R3), and the remaining 57 were final year residents (R4). The mean number of correct answers was 16.8 out of 20. No differences were found between residents in different years of training, nor were there any differences between the group that had received specific training in bioethics versus those who had not. Residents were more likely to give wrong answers related with informed consent, the law on the freedom of the patient, principles of quality of life, the case analysis system, and the dimension of distributive justice. Limitation of therapeutic efforts was identified as the main ethical problem faced in clinical practice by Spanish residents in paediatrics. Most of the knowledge of bioethics is acquired during graduate training, and improved very little throughout the period of medical residence. Our results suggest that efforts are required in organising and structuring the education in bioethics during the training of residents in paediatrics. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  19. Effects of continuing paediatric education in interpersonal communication skills.

    NARCIS (Netherlands)

    Dulmen, A.M. van; Holl, R.A.


    Paediatric care places great demands on interpersonal communication skills, especially as regards the handling of psychosocial issues. Recent shifts in paediatric morbidity and increases in patient empowerment furthermore emphasize the need for continuing paediatric education in communication

  20. Trends in paediatric health economic evaluation: 1980 to 1999


    Ungar, W; Santos, M


    Background: Although standard methods for conducting economic evaluations have evolved, little attention has been paid to their application in paediatrics. The Paediatric Economic Database Evaluation (PEDE) Project was conceived to promote research into paediatric health economic methods.

  1. Paediatric AIDS in Nigeria. (United States)


    The World Health Organization EPIMODEL computer program has projected that in 1993, there will be 41,023 cumulative cases of AIDS and 642,897 cumulative HIV infections among Nigerian adults. 1.2% of pregnant Nigerian women are reported to be HIV seropositive, 20-30% of whom can be expected to transmit HIV to their offspring. There are therefore many cases of pediatric HIV infection and AIDS in Nigeria. Infants and children can also be infected with HIV through the receipt of HIV-contaminated blood or blood products during transfusion, the use of unsterilized syringes and needles, and the use of contaminated instruments by traditional healers for circumcision, scarification, and tattoos. Vertical transmission, however, is the mode through which pediatric AIDS is most commonly spread. Preventive measures should therefore be directed toward promoting HIV risk reduction behaviors. Diagnosing AIDS and securing the laboratory confirmation of HIV infection are problematic in poor tropical countries like Nigeria. HIV-infected infants of unimpaired immunological status should be immunized with measles, injectable diphtheria/tetanus/pertussis, and inactivated polio virus vaccines. However, measles vaccine must not be given to an already immunocompromised patient. Likewise, BCG vaccination and oral live poliovaccine should not be given to HIV-infected children.

  2. Paediatric Medicines: Regulatory and Scientific Issues. (United States)

    Daousani, Chrysa; Karalis, Vangelis D


    In the past, dosage regimens authorized for adults were extrapolated to children relying mainly on empirical dosage adjustments. However, children are not small adults, but a distinct and heterogeneous group in terms of physiology, disease occurrence, pharmacokinetics, pharmacodynamics and also psychological, cognitive, and behavioral aspects. Even though it would be helpful to know the physiological changes and the special drug treatment needs in children, this task could not be performed due to ethical reasons. Important issues to consider for the development of paediatric drug products refer to the administration of the accurate dose, the use of the appropriate excipients, and acceptability. The latter is crucial and taste-screening methods (like electronic tongues) have been developed. A new era in paediatric medicines started with the entry into force of paediatric regulations. In the early '80s, the FDA started the set-up of a regulatory framework by authorizing issues like the Paediatric Rule, the Best Pharmaceuticals for Children Act, the Paediatric Research Equity Act, and the Food and Drug Administration Safety and Innovation Act. Similar efforts have been made in the EU, mainly through the entry into force of the Paediatric Regulation and the establishment of the Paediatric Committee, the Paediatric Investigation Plan, the Paediatric Use Marketing Authorization, and the European Paediatric Research Network. Other efforts to bridge the gap, between knowledge in adults and the children's special requirements, include the extrapolation concept of safety/efficacy aspects, the application of modeling/simulation approaches in paediatric drug development, and the development of a paediatric Biopharmaceutics Classification Scheme. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Hypnosis in paediatric respiratory medicine. (United States)

    McBride, Joshua J; Vlieger, Arine M; Anbar, Ran D


    Hypnotherapy is an often misunderstood yet effective therapy. It has been reported to be useful within the field of paediatric respiratory medicine as both a primary and an adjunctive therapy. This article gives a brief overview of how hypnotherapy is performed followed by a review of its applications in paediatric patients with asthma, cystic fibrosis, dyspnea, habit cough, vocal cord dysfunction, and those requiring non-invasive positive pressure ventilation. As the available literature is comprised mostly of case series, retrospective studies, and only a single small randomized study, the field would be strengthened by additional randomized, controlled trials in order to better establish the effectiveness of hypnosis as a treatment, and to identify the processes leading to hypnosis-induced physiologic changes. As examples of the utility of hypnosis and how it can be taught to children with respiratory disease, the article includes videos that demonstrate its use for patients with cystic fibrosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. What's new in paediatric dentistry? (United States)

    Vitale, M. C.


    Since the early 80's, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner. In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a "micro-invasive" dentistry and a "clean" surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.

  5. Thromboembolism in paediatric lupus patients. (United States)

    Levy, D M; Massicotte, M P; Harvey, E; Hebert, D; Silverman, E D


    Paediatric patients with systemic lupus erythematosus (SLE) and antiphospholipid antibodies (aPL), specifically lupus anticoagulants (LAC) are at high risk of developing thromboembolic events (TE). Our objectives were to determine the prevalence of TE in paediatric SLE patients with LAC and to determine if anticoagulation was effective to decrease morbidity, and prevent recurrent TE. We reviewed data on 149 paediatric SLE patients treated over 10 years. In all, 24 patients (16%) were LAC positive, and 21 TE occurred in 13 of these LAC positive patients (54% incidence of TE in LAC positive patients). The events were cerebral venous thrombosis (9), arterial stroke (3), deep venous thrombosis (4), pulmonary embolism (2), other venous event (1) and other arterial events (2). The median duration between SLE diagnosis and first TE was 15.2 months (range 0-62), and the median age at first TE was 15.1 years (range 11.4-18.4). Long-term anticoagulation was prescribed, and eight patients (62%) were transferred to adult care on lifelong oral warfarin; four (31%) remain under our care on lifelong warfarin, and one patient died of causes unrelated to her TE. No patient has been identified with deficiencies of protein C, protein S or antithrombin III. One patient is heterozygous for Factor V Leiden, and one is heterozygous for both the Prothrombin 20210A mutation and the MTHFR (methylene tetrahydrofolate reductase) mutation. Four patients had recurrent TE (31%), and three were not anticoagulated at the time of their second event. One patient had two recurrences on therapeutic anticoagulation. Thromboembolic events are prevalent in the LAC positive paediatric SLE population, and consideration for lifelong anticoagulation must occur after an initial TE.

  6. The importance of paediatric nutrition. (United States)

    Patience, Sara


    This articles looks at infant nutrition, from birth and through the first year of life. Good quality foods in infancy and childhood do not only promote optimum growth and development during that time, but also play a role in helping to prevent obesity and some diseases of adulthood, particularly non-communicable diseases, such as heart disease, type 2 diabetes and some cancers. Ensuring a good nutritional start for the paediatric population will help reduce morbidity and mortality later in life.

  7. Recent advances in paediatric gastroenterology. (United States)

    Hansen, Richard; Russell, Richard K; Muhammed, Rafeeq


    Over the last few years, many changes have been introduced in the diagnosis and management of paediatric gastrointestinal problems. This review highlights the recent developments in Helicobacter pylori infection, eosinophilic oesophagitis, coeliac disease and inflammatory bowel disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  8. Variations in injury characteristics among paediatric patients ...

    African Journals Online (AJOL)

    Variations in injury characteristics among paediatric patients following trauma: A retrospective descriptive analysis comparing pre-hospital and in-hospital deaths at Kamuzu Central Hospital, Lilongwe, Malawi.

  9. German registry of paediatric deep brain stimulation in patients with childhood-onset dystonia (GEPESTIM). (United States)

    Koy, A; Weinsheimer, M; Pauls, K A M; Kühn, A A; Krause, P; Huebl, J; Schneider, G-H; Deuschl, G; Erasmi, R; Falk, D; Krauss, J K; Lütjens, G; Schnitzler, A; Wojtecki, L; Vesper, J; Korinthenberg, R; Coenen, V A; Visser-Vandewalle, V; Hellmich, M; Timmermann, L


    Data on paediatric deep brain stimulation (DBS) is limited, especially for long-term outcomes, because of small numbers in single center series and lack of systematic multi-center trials. We seek to systematically evaluate the clinical outcome of paediatric patients undergoing DBS. A German registry on paediatric DBS (GEPESTIM) was created to collect data of patients with dystonia undergoing DBS up to the age of 18 years. Patients were divided into three groups according to etiology (group 1 inherited, group 2 acquired, and group 3 idiopathic dystonia). Data of 44 patients with a mean age of 12.8 years at time of operation provided by 6 German centers could be documented in the registry so far (group 1 n = 18, group 2 n = 16, group 3 n = 10). Average absolute improvement after implantation was 15.5 ± 18.0 for 27 patients with pre- and postoperative Burke-Fahn-Marsden Dystonia Rating scale movement scores available (p expiry were necessary in 15 patients at 3.7 ± 1.8 years after last implantation. Pre- and postoperative data on paediatric DBS are very heterogeneous and incomplete but corroborate the positive effects of DBS on inherited and acquired dystonia. Adverse events including relatively frequent IPG replacements due to battery expiry seem to be a prominent feature of children with dystonia undergoing DBS. The registry enables collaborative research on DBS treatment in the paediatric population and to create standardized management algorithms in the future. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  10. Paediatric pain management | Schellack | South African Family ...

    African Journals Online (AJOL)

    ... pain (VAP) scale in the same manner as adults. Nevertheless, their capacity to describe pain increases with age and changes throughout their developmental stages. This article provides an overview of paediatric pain management. Keywords: analgesic, paediatric pain, NSAID, opioid, non-opioid, paracetamol, ibuprofen ...

  11. Selection of paediatric patients for intensive care

    African Journals Online (AJOL)

    and children admitted to the paediatric intensive care unit. (PICU) at ... patients requiring ICU; all are admitted to a single paediatric. ICU (PICU). There is no .... Oncology patients with complications'. Upper airway obstruction. Cardiomyopathy. Epilepsy. Burns. Poisonings. Post cardiac arrest. Asthma. Complicated infectious ...

  12. African Journal of Paediatric Nephrology: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. Afr J Paed Nephrol is the official Journal of the African Paediatric Nephrology Association (AFPNA). The journal is dedicated to increasing awareness and knowledge of Paediatric nephrology in Africa and beyond. We publish research articles on renal diseases in children, on fluid and electrolyte ...

  13. Appendicitis in paediatric age group: Correlation between ...

    African Journals Online (AJOL)

    Introduction: Clinical diagnosis of appendicitis can be challenging, particularly in the paediatric age group. There is an increased risk of perforation in paediatrics; therefore, a need for sensitive and specific diagnostic tool is mandatory. Aim: The aim of this study is to evaluate the role of preoperative inflammatory markers in ...

  14. Processes of care in paediatric rehabilitation

    NARCIS (Netherlands)

    Siebes, R.C.


    In this thesis the paediatric rehabilitation treatment process in the Netherlands is described with a focus on the parents' perspective. To what extent are parents involved in the different stages of the paediatric rehabilitation treatment process? What is being done in treatment? Is there a clear

  15. Anaesthesia for Ambulatory Paediatric Surgery: Common ...

    African Journals Online (AJOL)

    BACKGROUND: Ambulatory surgical care accounts for over 70% of elective procedures in Northern America. Ambulatory paediatric surgical practice is not widespread in Nigeria. This report examined clinical indicators for quality care in paediatric ambulatory surgery using common outcomes after day case procedures as ...

  16. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten


    INTRODUCTION: Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare...

  17. Transfusion therapy in paediatric trauma patients

    DEFF Research Database (Denmark)

    Nystrup, Kristin Brønnum; Stensballe, Jakob; Bøttger, Morten


    Haemorrhage is a leading cause of death in paediatric trauma patients. Predefined massive transfusion protocols (MTP) have the potential to significantly reduce mortality by treating haemorrhagic shock and coagulopathy, in adhering to the principles of haemostatic resuscitation with rapid...... in paediatric trauma patients is challenging, and the optimal blood product ratio that will increase survival in massively bleeding paediatric trauma patients has yet to be determined. To date, only a few small descriptive studies and case reports have investigated the use of predefined MTP in paediatric trauma...... patients.MTP with increased FFP or PLT to RBC ratios combined with viscoelastic haemostatic assay (VHA) guided haemostatic resuscitation have not yet been tested in paediatric populations but based on results from adult trauma patients, this therapeutic approach seems promising.Considering the high...

  18. Improving Treatment Response for Paediatric Anxiety Disorders

    DEFF Research Database (Denmark)

    Ege, Sarah; Reinholdt-Dunne, Marie Louise


    Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying psychopat......Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying...... psychopathology of paediatric anxiety disorders indicate possibilities for improving treatment response. Using a critical review of recent theoretical, empirical and academic literature, the paper examines the role of information-processing biases in paediatric anxiety disorders, the extent to which CBT targets...... in improving response to CBT for paediatric anxiety disorders. Many important questions remain to be answered....

  19. Research article – Optimisation of paediatrics computed radiographyfor full spine curvature measurements using a phantom: a pilot study

    NARCIS (Netherlands)

    Daniel de Linde; Loris Franco; Catarina Serrenho; Peter Hogg; Ifrah Akhtar; José Antonio Garcia; Seraphine de Haan; Martine Thorskog; Cláudia Reis; Junior Ndlovu


    Aim: Optimise a set of exposure factors, with the lowest effective dose, to delineate spinal curvature with the modified Cobb method in a full spine using computed radiography (CR) for a 5-year-old paediatric anthropomorphic phantom. Methods: Images were acquired by varying a set of parameters:

  20. [The non-scrotal testes: current standpoints of the Paediatric Urology Workgroup of the Dutch Urological Association

    NARCIS (Netherlands)

    Gier, R.P.E. de


    Recently, in The Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine), three papers expressing with conflicting opinions on the management of primary and acquired non-scrotal testes (NST) in boys were published. In this paper, the Paediatric Urology Workgroup of the Dutch Urological

  1. Paediatric Dupuytren′s disease

    Directory of Open Access Journals (Sweden)

    Pradeoth Mukundan Korambayil


    Full Text Available Dupuytren′s disease of the hand has only been rarely reported in children and is rarer still in infants. Only a few histologically confirmed diagnoses are found in literature. We report a case in a 4-month-old infant with Dupuytren′s disease of palm and thumb who required surgery at 6 months of age. Histology confirmed the diagnosis of Dupuytren′s disease. The purpose of this report is to show the importance of differential diagnosis of nodules and fibrotic bands in children′s hands as paediatric patients may be seen by a variety of treating physicians, not only plastic surgeons or pathologists.

  2. Canadian Paediatric Neurology Workforce Survey and Consensus Statement. (United States)

    Doja, Asif; Orr, Serena L; McMillan, Hugh J; Kirton, Adam; Brna, Paula; Esser, Michael; Tang-Wai, Richard; Major, Philippe; Poulin, Chantal; Prasad, Narayan; Selby, Kathryn; Weiss, Shelly K; Yeh, E Ann; Callen, David Ja


    Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.

  3. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O


    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  4. Paediatric aesthetic dentistry: a review. (United States)

    Saha, R; Malik, P


    A number of conditions can lead to aesthetically unacceptable dentitions like dental caries, discoloration, trauma, early loss of teeth, misalignment and any abnormality of shape and size. Today we have a large number of solutions available for aesthetic problems in paediatric dentistry. But the biggest dilemma is: How to choose what is best for a particular patient and that situation? Through this review we try to precisely highlight the various options for aesthetic restorations along with their indications, advantages and disadvantages. A search and analysis of international works on aesthetics in paediatric dentistry is presented. A considerable number of studies have shown that people are more concerned about missing anterior teeth and their replacement than about posterior ones as aesthetics seems to be more important than function. Dental caries, although not life threatening, causes nagging pain and physical as well as psychological discomfort. Nevertheless, it is clear that the condition is complex and multifactorial and hence it is important to review the various approaches available to restore the lost aesthetics.

  5. Parental knowledge of paediatric vaccination

    Directory of Open Access Journals (Sweden)

    Borràs Eva


    Full Text Available Abstract Background Although routine vaccination is a major tool in the primary prevention of some infectious diseases, there is some reluctance in a proportion of the population. Negative parental perceptions of vaccination are an important barrier to paediatric vaccination. The aim of this study was to investigate parental knowledge of paediatric vaccines and vaccination in Catalonia. Methods A retrospective, cross-sectional study was carried out in children aged Results An association was observed between greater vaccination coverage of the 4:4:4:3:1 schedule (defined as: 4 DTPa/w doses, 4 Hib doses, 4 OPV doses, 3 MenC doses and 1 MMR dose and maternal age >30 years (OR: 2.30; 95% CI: 1.20–4.43 and with a knowledge of vaccination score greater than the mean (OR: 0.45; 95% CI: 0.28–0.72. The score increased with maternal educational level and in parents of vaccinated children. A total of 20.47% of parents stated that vaccines could have undesirable consequences for their children. Of these, 23.26% had no specific information and 17.83% stated that vaccines can cause adverse reactions and the same percentage stated that vaccines cause allergies and asthma. Conclusion Higher vaccination coverage is associated with older maternal age and greater knowledge of vaccination. Vaccination coverage could be raised by improving information on vaccines and vaccination.

  6. Current views and advances on Paediatric Virology: An update for paediatric trainees


    Mammas, Ioannis N.; Greenough, Anne; Theodoridou, Maria; Kramvis, Anna; CHRISTAKI, ILIANA; Koutsaftiki, Chryssie; KOUTSAKI, MARIA; Portaliou, Dimitra M; KOSTAGIANNI, GEORGIA; Panagopoulou, Paraskevi; Sourvinos, George; SPANDIDOS, DEMETRIOS A.


    Paediatric Virology is a bold new scientific field, which combines Paediatrics with Virology, Epidemiology, Molecular Medicine, Evidence-based Medicine, Clinical Governance, Quality Improvement, Pharmacology and Immunology. The Workshop on Paediatric Virology, which took place on Saturday October 10, 2015 in Athens, Greece, provided an overview of recent views and advances on viral infections occurring in neonates and children. It was included in the official programme of the 20th World Congr...

  7. Paediatrics in Singapore: the early days. (United States)

    Quak, S H


    Paediatric services in Singapore started at the end of the 19th century. Because of inadequate housing, poor sanitation and inadequate health services, malnutrition and infections were the main problems. Infant mortality was in excess of 300/1000. There were many prominent doctors who worked in extremely demanding environments in order to better the health of children at that time. Over the years, there has been a steady improvement of healthcare in Singapore and this has been mainly due to the foresight and hard work of the pioneers. With excellent primary healthcare and specialised paediatric centres, paediatric services in Singapore are among the best in the world.

  8. Framework conditions facilitating paediatric clinical research

    Directory of Open Access Journals (Sweden)

    Alfarez Deborah


    Full Text Available Abstract The use of unlicensed and "off-label" medicines in children is widespread. Between 50-80% of the medicines currently administered to children have neither been tested nor authorized for their use in the paediatric population which represents approximately 25% of the whole European population. On 26 January 2007, entered into force the European Regulation of Paediatric Medicines. It aims at the quality of research into medicines for children but without subjecting the paediatric population to unnecessary clinical trial. This article addresses ethical and legal issues arising from the regulation and makes recommendations for the framework conditions facilitating the development of clinical research with children.

  9. Anaesthesia for neurosurgical procedures in paediatric patients

    Directory of Open Access Journals (Sweden)

    Girija Prasad Rath


    Full Text Available Recent advances in neurosurgery, neuromonitoring and neurointensive care have dramatically improved the outcome in patients affected by surgical lesions of central nervous system (CNS. Although most of these techniques were applied first in the adult population, paediatric patients present a set of inherent challenges because of their developing and maturing neurological and physiological status, apart from the CNS disease process. To provide optimal neuroanaesthesia care, the anaesthesiologist must have the knowledge of basic neurophysiology of developing brain and effects of various drugs on cerebral haemodynamics apart from the specialised training on paediatric neuroanaesthesia. This article highlights on the perioperative management of paediatric neurosurgical patients.

  10. Acquired immune demyelinating neuropathies. (United States)

    Dimachkie, Mazen M; Saperstein, David S


    Acquired immune demyelinating neuropathies refer to a group of disorders that share overlapping sensory, motor, and autonomic clinical, laboratory, and electrodiagnostic features. It is important to recognize acquired immune demyelinating neuropathies as they are generally responsive to immunosuppressive or immunomodulatory therapies. This article reviews recently developed early prognostic tools in Guillain-Barré syndrome and discusses the evolving understanding of chronic demyelinating phenotypes with differing treatment responsiveness. While weakness and numbness progress over 2 to 4 weeks in Guillain-Barré syndrome, they continue to evolve beyond 8 weeks in chronic inflammatory demyelinating polyradiculoneuropathy and over 4 to 8 weeks in subacute inflammatory demyelinating polyradiculoneuropathy. Acquired immune demyelinating neuropathies present uncommonly as variants with predominance of ocular, bulbar, sensory, autonomic, or motor manifestations in addition to regional variants, such as paraparetic acquired immune demyelinating neuropathies. Establishing the correct diagnosis is important as these immune disorders differ in response to corticosteroids and other immunosuppressive therapies.

  11. Pneumonia - children - community acquired (United States)

    Bronchopneumonia - children; Community-acquired pneumonia - children; CAP - children ... Viruses are the most common cause of pneumonia in infants and children. Ways your child can get CAP include: Bacteria and viruses living in the nose, sinuses, or mouth may spread ...

  12. Acquired color vision deficiency. (United States)

    Simunovic, Matthew P


    Acquired color vision deficiency occurs as the result of ocular, neurologic, or systemic disease. A wide array of conditions may affect color vision, ranging from diseases of the ocular media through to pathology of the visual cortex. Traditionally, acquired color vision deficiency is considered a separate entity from congenital color vision deficiency, although emerging clinical and molecular genetic data would suggest a degree of overlap. We review the pathophysiology of acquired color vision deficiency, the data on its prevalence, theories for the preponderance of acquired S-mechanism (or tritan) deficiency, and discuss tests of color vision. We also briefly review the types of color vision deficiencies encountered in ocular disease, with an emphasis placed on larger or more detailed clinical investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Vertical Integration: Teachers' Knowledge and Teachers' Voice. (United States)

    Corrie, L.


    Traces the theoretical basis for vertical integration in early school years. Contrasts transmission-based pedagogy with a higher level of teacher control, and acquirer-based pedagogy with a higher level of student control. Suggests that early childhood pedagogy will be maintained when teachers are able to articulate their pedagogical knowledge and…

  14. Systemic Acquired Resistance


    Conrath, Uwe


    Upon infection with necrotizing pathogens many plants develop an enhanced resistance to further pathogen attack also in the uninoculated organs. This type of enhanced resistance is referred to as systemic acquired resistance (SAR). In the SAR state, plants are primed (sensitized) to more quickly and more effectively activate defense responses the second time they encounter pathogen attack. Since SAR depends on the ability to access past experience, acquired disease resistance is a paradigm fo...

  15. Laboratory-acquired brucellosis

    DEFF Research Database (Denmark)

    Fabiansen, C.; Knudsen, J.D.; Lebech, A.M.


    Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9......Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9...

  16. Impact of the European paediatric legislation in paediatric rheumatology: past, present and future. (United States)

    Ruperto, Nicolino; Vesely, Richard; Saint-Raymond, Agnes; Martini, Alberto


    Conducting clinical trials in paediatric rheumatology has been difficult mainly because of the lack of funding for academic studies and the lack of interest by pharmaceutical companies in the small and non-rewarding paediatric market. The situation changed dramatically a few years ago with the introduction of the Best Pharmaceuticals for Children Act in the USA and of specific legislation for the development of paediatric medicines (Paediatric Regulation) in the European Union (EU). The EU Paediatric Regulation had a positive impact in paediatric rheumatology-in particular, on the development of new treatments for children with juvenile idiopathic arthritis (JIA). Some problems remain, however, such as greater harmonisation of the regulatory aspects of medicines, how to handle me-too agents, how to conduct adequate pharmacokinetic studies and develop age-appropriate formulations, ethical problems in study review and implementation, and a change in the current JIA classification. The introduction of specific legislation, coupled with the existence of large international networks such as the Pediatric Rheumatology Collaborative Study Group (PRCSG at, covering North America, and the Paediatric Rheumatology International Trials Organisation (PRINTO at, covering more than 50 countries, has led to great advances in paediatric rheumatology. Future changes might increase the possibility of conducting trials with similar approaches in other paediatric rheumatological conditions and provide evidence-based treatments for children affected by rheumatic diseases.

  17. Acquired hemophilia A. (United States)

    Webert, Kathryn E


    Acquired hemophilia A is a rare, autoimmune disorder that is caused by autoantibodies that act as inhibitors to factor VIII. It is characterized by severe, unexpected bleeding that may be life-threatening. The incidence of acquired hemophilia A is ~ 0.2 to 1.48 cases per 1 million individuals per year. Acquired hemophilia A has been associated with several clinical conditions including pregnancy, autoimmune or collagen vascular disorders, malignancies, drugs, respiratory disorders, and infections. However, in ~ 50% of cases, no disease association is determined. Acquired hemophilia A should be suspected when a patient with no previous personal or family history of bleeding, presents with bleeding and an unexplained prolonged activated partial thromboplastin time (APTT) and other common causes of a prolonged APTT are ruled out. The treatment of acquired hemophilia A has two main goals: (1) to treat and/or prevent bleeding complications and (2) to eradicate the inhibitor. The recommended agents to be used for the treatment or prevention of bleeding in patients with acquired hemophilia A are the bypassing agents. Patients should be treated initially with corticosteroids, either alone or in combination with cyclophosphamide, to eradicate the inhibitor. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Cerebral lymphoma and HIV encephalitis in a case of paediatric AIDS, with pre-existing multicystic encephalomalacia. (United States)

    Keohane, C; Robain, O; Ponsot, G; Gray, F


    A case of intracerebral malignant B cell lymphoma associated with encephalitis typical of Human Immunodeficiency Virus (HIV) infection is described in a 4 year old child, with post-transfusion Acquired Immune Deficiency Syndrome (AIDS) and severe pre-existing cystic encephalomalacia. This report further documents B cell lymphoma as the commonest cause of an intracerebral mass, and an important cause of death in paediatric AIDS. That more than one pathological process may be responsible for neurological symptoms in paediatric AIDS is also emphasised.

  19. Evolution of MRI abnormalities in paediatric acute disseminated encephalomyelitis. (United States)

    Wong, Yu Yi M; van Pelt, E Daniëlle; Ketelslegers, Immy A; Catsman-Berrevoets, Coriene E; Hintzen, Rogier Q; Neuteboom, Rinze F


    Acute disseminating encephalomyelitis (ADEM) is an inflammatory demyelinating disease affecting the central nervous system and mainly occurs in young children. Children who initially presented with ADEM can be diagnosed with multiple sclerosis (MS) in case new non-encephalopathic clinical symptoms occur with new lesions on MRI at least three months after onset of ADEM. We aim to study the timing of MRI abnormalities related to the evolution of clinical symptoms in our Dutch paediatric ADEM cohort. The Dutch database for acquired demyelinating syndromes (ADS) was screened for children under age eighteen fulfilling the international consensus diagnostic criteria for ADEM. Children were eligible when the first MRI was performed within the first three months after onset of clinical symptoms and at least one brain follow-up MRI was available for evaluation. Forty-two children with ADEM were included (median age four years two months). All available MRIs and medical records were assessed and categorised as 'improved', 'deteriorated' and 'unchanged'. We found that during clinical recovery, new lesions and enlargement of existing MRI lesions occurred in the first three months in about 50% of the performed MRIs. In contrast, this was rarely seen more than three months after first onset of ADEM. We recommend to perform a brain MRI as a reference scan three months after onset. Follow-up imaging should be compared with this scan in order to prevent an incorrect diagnosis of MS after ADEM. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  20. Job satisfaction and burnout among paediatric nurses. (United States)

    Akman, Ozlem; Ozturk, Candan; Bektas, Murat; Ayar, Dijle; Armstrong, Merry A


    This study aims to determine factors of job satisfaction and burnout levels of paediatric nurses. A total of 165 nurses working in paediatric clinics completed the Minnesota job satisfaction scale and the Maslach burnout scale. Average scores of the emotional exhaustion and depersonalisation score were low, while personal accomplishment scores were high. A high level of job satisfaction, being married, increased age and a decreased number of assigned patients were significantly associated with a low level of burnout. Paediatric nurses experience burnout at significant levels. The most important variable that affected job satisfaction was income. The results of the study could guide development of strategies that might prevent or alleviate burnout of paediatric nurses. © 2016 John Wiley & Sons Ltd.

  1. African Journal of Paediatric Surgery: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr Aba Francis Uba Editor-in-Chief Paediatric Surgery Unit Department of Surgery Jos University Teaching Hospital P.M.B. 2076 Jos Plateau State Nigeria Phone: (234) 080371 54469. Email: ...

  2. Normal variants in the paediatric orthopaedic population. (United States)

    Molony, D; Hefferman, G; Dodds, M; McCormack, D


    Normal variations of lower limb development are a common source of parental concern and are commonly referred to paediatric orthopaedic clinics. To determine the proportion of children referred to a paediatric orthopaedic outpatients with potentially normal developmental variations, referral letters and case notes of children attending the paediatric orthopaedic clinic at our institution over three months were analysed and categorized according to the main reason for referral. The number with true orthopaedic pathology was documented. Variations of normal anatomy and physiology accounted for 53.1% of all new referrals seen at the clinic with intoeing and flexible flat feet being the commonest referrals in this category. The rate of true primary pathology was only 16.3%. Normal developmental variations form a significant proportion of all new referrals to paediatric orthopaedic clinics. These take time and resources to process. Strategies to minimise these referrals are needed.

  3. Paediatric nephrology: the last 50 years. (United States)

    Kausman, Joshua Y; Powell, Harley R


    In 1965, the specialty of paediatric nephrology was in its infancy. Following the development of a landmark collaborative research study, the International Study of Kidney Disease in Childhood in the mid-1960s, the first specialist societies were formed: the European Society of Pediatric Nephrology in 1967 and the American Society of Pediatric Nephrology in 1969. The extraordinary improvements in care delivered to children with kidney disease over the past 50 years are too broad to cover in any one paper. They traverse the spectrum of diagnosis, classification, therapeutics, social well-being and transition to adult care. We have selected four case scenarios to highlight these changes in key areas of paediatric nephrology: post-streptococcal glomerulonephritis, nephrotic syndrome, haemolytic uraemic syndrome and neonatal dialysis and childhood transplantation. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Paediatric palliative care: Theory to practice

    Directory of Open Access Journals (Sweden)

    Maryann Muckaden


    Full Text Available Paediatric palliative care is a holistic approach aimed at addressing the complex issues related to the care of children and families facing chronic life limiting illnesses. The needs of children are unique and often quite different from those of adults receiving palliative care. This review article outlines some of the salient features of paediatric palliative care which are relevant to all professionals caring for children with life limiting illnesses in their practice.

  5. [Community acquired pneumonia in children: Outpatient treatment and prevention]. (United States)

    Moreno-Pérez, D; Andrés Martín, A; Tagarro García, A; Escribano Montaner, A; Figuerola Mulet, J; García García, J J; Moreno-Galdó, A; Rodrigo Gonzalo de Lliria, C; Ruiz Contreras, J; Saavedra Lozano, J


    There have been significant changes in community acquired pneumonia (CAP) in children in the last decade. These changes relate to epidemiology and clinical presentation. Resistance to antibiotics is also a changing issue. These all have to be considered when treating CAP. In this document, two of the main Spanish pediatric societies involved in the treatment of CAP in children, propose a consensus concerning therapeutic approach. These societies are the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases. The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) has also been involved in the prevention of CAP. An attempt is made to provide up-to-date guidelines to all paediatricians. The first part of the statement presents the approach to ambulatory, previously healthy children. We also review the prevention with currently available vaccines. In a next second part, special situations and complicated forms will be addressed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  6. Phase Synchronization in Electroencephalographic Recordings Prognosticates Outcome in Paediatric Coma (United States)

    Nenadovic, Vera; Perez Velazquez, Jose Luis; Hutchison, James Saunders


    Brain injury from trauma, cardiac arrest or stroke is the most important cause of death and acquired disability in the paediatric population. Due to the lifetime impact of brain injury, there is a need for methods to stratify patient risk and ultimately predict outcome. Early prognosis is fundamental to the implementation of interventions to improve recovery, but no clinical model as yet exists. Healthy physiology is associated with a relative high variability of physiologic signals in organ systems. This was first evaluated in heart rate variability research. Brain variability can be quantified through electroencephalographic (EEG) phase synchrony. We hypothesised that variability in brain signals from EEG recordings would correlate with patient outcome after brain injury. Lower variability in EEG phase synchronization, would be associated with poor patient prognosis. A retrospective study, spanning 10 years (2000–2010) analysed the scalp EEGs of children aged 1 month to 17 years in coma (Glasgow Coma Scale, GCS, patients with a good outcome. PMID:24752289

  7. Paediatrics: the etymology of a name. (United States)

    Pearn, John


    Within the history of paediatrics is the history of the name used to describe it. The etymology of the word 'paediatrics' dates from its first written use, recorded as 'pädiatrik' in the German literature and as 'paediatric', later 'pediatric' in the USA, both first in 1850. Professor Robley Dunglison (1788-1869), the British and American medical lexicographer, first defined 'paediatria' as 'the treatment of the diseases of children' in 1855. 'Pediatric medicine' was promoted as a specialty in the USA in 1880. The oldest monumental inscription defining the specialty of 'paediatrics' in the UK is to be found on a plaque added (in 1950) to the memorial to Dr George Armstrong (1719-1789), a founder of the specialty of paediatrics, in Castleton Cemetery, Scottish Borders, Roxburghshire. 'Paediatrics' and 'child health', with subtle semantic distinctions, had become well established in the English-speaking world by the middle of the 20th century. This paper presents an interpretative chronology of the etymology of the descriptors of the specialty that enjoins all who care for children.

  8. Exploring resilience in paediatric oncology nursing staff. (United States)

    Zander, Melissa; Hutton, Alison; King, Lindy


    Resilience has been suggested as an important coping strategy for nurses working in demanding settings, such as paediatric oncology. This qualitative study explored paediatric oncology nurses' perceptions of their development of resilience and how this resilience underpinned their ability to deal with work-related stressors. Five paediatric oncology nurses were interviewed about their understanding of the concept of resilience, their preferred coping mechanisms, and their day-today work in paediatric oncology. Using thematic analysis, the interviews were subsequently grouped together into seventeen initial themes. These themes were then grouped into seven major aspects that described how the participants perceived resilience underpinned their work. These "seven aspects of forming resilience" contributed to an initial understanding of how paediatric oncology nurses develop resilience in the face of their personal and professional challenges. Several key strategies derived from the findings, such as improved rostering, support to a nurse's friend and family, and a clinical support nursing role, could be implemented at an organizational level to support resilience development within the paediatric oncology setting.

  9. Vertical axis wind turbines (United States)

    Krivcov, Vladimir [Miass, RU; Krivospitski, Vladimir [Miass, RU; Maksimov, Vasili [Miass, RU; Halstead, Richard [Rohnert Park, CA; Grahov, Jurij [Miass, RU


    A vertical axis wind turbine is described. The wind turbine can include a top ring, a middle ring and a lower ring, wherein a plurality of vertical airfoils are disposed between the rings. For example, three vertical airfoils can be attached between the upper ring and the middle ring. In addition, three more vertical airfoils can be attached between the lower ring and the middle ring. When wind contacts the vertically arranged airfoils the rings begin to spin. By connecting the rings to a center pole which spins an alternator, electricity can be generated from wind.

  10. Paediatric diagnostic audiology testing in South Africa. (United States)

    Moodley, Selvarani


    With the increased emphasis on the importance of early identification of paediatric hearing loss within developing countries such as South Africa and Nigeria there has been a recognition of the ethical obligation to ensure access to timely diagnostic and intervention services for children identified with hearing loss; regardless of their geographic or socioeconomic status. There are limited studies on diagnosis of paediatric hearing loss in a developing world context. The objective of this study was to determine processes used for diagnosis of paediatric hearing loss in South Africa, across the private and public healthcare sectors, and to profile the age of testing for each component of the diagnostic test battery. Diagnostic audiology testing data of 230 children enrolled in an early intervention programme was analysed to profile the reporting of diagnostic audiology testing as well as diagnostic audiology procedures employed. Results were analysed according to province as well as healthcare sector to compare diagnostic services across regions as well as healthcare sectors. The differences in audiology practice and tests employed with paediatric clients across the regions of Gauteng, Kwazulu Natal and Western Cape indicates that services across regions and across the public and private sector are not equitable. Each region is equally unlikely to complete a full, comprehensive diagnostic evaluation on paediatric clients. The age of testing highlights the increased age of diagnosis of hearing loss. Paediatric diagnostic audiology is a section of Early Hearing Detection and Intervention services that requires attention in terms of the appropriateness of procedures as well as equity of services. Further studies on diagnostic practice and resources in South Africa will provide information on factors that are preventing adherence to international best practice guidelines for paediatric diagnostic audiology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Post-operative pain management in paediatric surgery at Sylvanus ...

    African Journals Online (AJOL)

    ) versus GA during the first 48 h postoperative was US $23 versus $46. Conclusion: Our study showed that post-operative pain management in paediatric surgery is often not well controlled and paediatric loco regional analgesia technique is ...

  12. Imaging of intractable paediatric epilepsy

    Directory of Open Access Journals (Sweden)

    Sanjay Prabhu


    Full Text Available Approximately 20% of paediatric patients with epilepsy are refractory to medical therapies. In this subgroup of patients, neuroimaging plays an important role in identifying an epileptogenic focus. Successful identification of a structural lesion results in a better outcome following epilepsy surgery. Advances in imaging technologies, methods of epileptogenic region localisation and refinement of clinical evaluation of this group of patients in epilepsy centres have helped to widen the spectrum of children who could potentially benefit from surgical treatment. In this review, we discuss ways to optimise imaging techniques, list typical imaging features of common pathologies that can cause epilepsy, and potential pitfalls to be aware of whilst reviewing imaging studies in this challenging group of patients. The importance of multidisciplinary meetings to analyse and synthesise all the non-invasive data is emphasised. Our objectives are: to describe the four phases of evaluation of children with drug-resistant localisation-related epilepsy; to describe optimal imaging techniques that can help maximise detection of epileptogenic foci; to describe a systematic approach to reviewing magnetic resonance imaging of children with intractable epilepsy; to describe the features of common epileptogenic substrates; to list potential pitfalls whilst reviewing imaging studies in these patients; and to highlight the value of multimodality and interdisciplinary approaches to the management of this group of children.

  13. Neural correlates of paediatric dysgraphia. (United States)

    Van Hoorn, Jessika F; Maathuis, Carel G B; Hadders-Algra, Mijna


    Writing is an important skill that is related both to school performance and to psychosocial outcomes such as the child's self-esteem. Deficits in handwriting performance are frequently encountered in children with developmental coordination disorder. This review focuses on what is known about the neural correlates of atypical handwriting in children. Knowledge of the neural correlates is derived from studies using clinical case designs (e.g. lesion studies), studies using neuroimaging, and assessment of minor neurological dysfunction. The two functional imaging studies suggest a contribution of cortical areas and the cerebellum. The largest study indicated that cortical areas in all regions of the brain are involved (frontal, temporal, parietal, and occipital). The two lesion studies confirmed cerebellar involvement. The findings of the study on minor neurological dysfunction in children with writing problems correspond to the imaging results. The limited data on the neural substrate of paediatric dysgraphia suggest that at least a subset of the children with dysgraphia have dysfunctions in extensive supraspinal networks. In others, dysfunction may be restricted to either the cerebellum or specific cortical sites. © The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

  14. Drug resistance in the HIV-1-infected paediatric population worldwide: a systematic review. (United States)

    Rojas Sánchez, Patricia; Holguín, Africa


    Drug resistance monitoring of the paediatric HIV-1-infected population is required to optimize treatment success and preserve future treatment options. To explore the current knowledge of HIV drug resistance (HIVDR) in naive and pretreated HIV-1-infected paediatric populations across diverse settings and sampling time periods. PubMed database screened until May 2013. We selected publications including data on transmitted (TDR) and acquired drug resistance mutation (DRM) rates and/or pol sequences for HIVDR testing in paediatric patients. We recorded the children's country, age, study period, number of children with pol sequences, presence or absence of antiretroviral treatment (ART) at sampling time, viral region sequenced, HIVDR rate to the three main drug classes (single, double or triple), the considered resistance mutation list and performed assay, specimen type, HIV-1 variants and subtyping methodology when available. Forty-one selected studies showed HIVDR data from 2538 paediatric HIV-1-infected patients (558 naive and 1980 pretreated) from 30 countries in Africa (11), Asia (6), America (10) and Europe (3). Both TDR and DRM prevalence were reported in 9 studies, only TDR in 6 and only DRM in 26. HIVDR prevalence varied across countries and periods. Most studies used in-house resistance assays using plasma or infected cells. HIV-1 non-B variants were prevalent in 18 paediatric cohorts of the 24 countries with reported subtypes. Only five countries (Uganda, Spain, the UK, Brazil and Thailand) presented resistance data in ≥200 patients. Systematic and periodic studies among infected children are crucial to design a more suitable first- or second-line therapy. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail:

  15. Good long-term survival after paediatric heart transplantation

    DEFF Research Database (Denmark)

    Kruse, Charlotte Duhn; Helvind, Morten; Jensen, Tim


    The brain-death criterion was introduced in Denmark in 1990. The first Danish paediatric heart transplantation (HTx) was performed at Copenhagen University Hospital, Rigshospitalet, in Copenhagen in 1991. We describe our experiences during the first 20 years with paediatric HTx.......The brain-death criterion was introduced in Denmark in 1990. The first Danish paediatric heart transplantation (HTx) was performed at Copenhagen University Hospital, Rigshospitalet, in Copenhagen in 1991. We describe our experiences during the first 20 years with paediatric HTx....

  16. [A Paediatric Orthopaedic outpatient clinic referral patterns]. (United States)

    Moraleda, L; Castellote, M


    The aim of this study was to identify the commonest referrals to a paediatric orthopaedic outpatient clinic and, therefore, to be able to improve the paediatric residency program in managing musculoskeletal problems. Demographic data, referrals and final diagnosis were collected prospectively on all patients that were evaluated in a paediatric orthopaedic outpatient clinic. The majority of referrals were to evaluate musculoskeletal pain (37%), foot deformity (20%), spine deformity (15%), walking pattern (11%), alignment of the lower limbs (4%), and development of the hip (4%). A normal physical examination or a normal variation was observed in 42% of patients. A mild condition was observed in 17% of patients that should have only been referred to a paediatric orthopaedic clinic after failing to resolve pain with anti-inflammatories or physiotherapy. A mild deformity that only needed treatment if it became symptomatic was seen in 8% of patients. The majority of referrals were due to a normal variation or mild conditions that only required symptomatic treatment. Paediatric residency programs do not reflect the prevalence of musculoskeletal conditions in clinical practice. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  17. Acquired methemoglobinemia in infants

    Directory of Open Access Journals (Sweden)

    Mehmet Mutlu


    Full Text Available Objective: This study aimed to determine the etiologic factors of acquired methemoglobinemia in infants younger than three months in our region. Material and Methods: This study was carried out retrospectively in infants with methemoglobinemia admitted to Karadeniz Technical University, Pediatric Clinic, during the period 2000-2009. Infants with methemoglobinemia were identified according to the medical records or ICD-10 code. Results: Nine infants with acquired methemoglobinemia (8 male, 1 female were included in the study. Seven cases were associated with the use of prilocaine for circumcision, one case with the use of prilocaine-lidocaine for local pain therapy, and one case with neonatal sepsis caused by Staphylococcus aureus.Conclusion: Prilocaine should not be used in infants less than three months of age because of the risk of methemoglobinemia. Ascorbic acid is an effective therapy if methylene blue is not obtained. It should not be forgotten that sepsis caused by S. aureus may cause methemoglobinemia in infants.

  18. Acquired cystic kidney disease

    Energy Technology Data Exchange (ETDEWEB)

    Choyke, P.L. [National Institutes of Health, Bethesda, MD (United States). Dept. of Diagnostic Radiology


    Acquired cystic kidney disease (ACKD), also known as acquired renal cystic disease (ARCD,) occurs in patients who are on dialysis for end-stage renal disease. It is generally accepted that ACKD develops as a consequence of sustained uremia and can first manifest even before dialysis is initiated while the patient is still in chronic renal failure. The role of immune suppression, particularly in transplant recipients, in the development of ACKD, is still under investigation. The prevalence of ACKD is directly related to the duration of dialysis and the risk of cancer is directly related to the presence of cysts. Herein we review the current understanding of the pathophysiology and imaging implications of ACKD. (orig.)

  19. Community-acquired pneumonia. (United States)

    Falguera, M; Ramírez, M F


    This article not only reviews the essential aspects of community-acquired pneumonia for daily clinical practice, but also highlights the controversial issues and provides the newest available information. Community-acquired pneumonia is considered in a broad sense, without excluding certain variants that, in recent years, a number of authors have managed to delineate, such as healthcare-associated pneumonia. The latter form is nothing more than the same disease that affects more frail patients, with a greater number of risk factors, both sharing an overall common approach. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  20. Acquired hypofibrinogenemia: current perspectives

    Directory of Open Access Journals (Sweden)

    Besser MW


    Full Text Available Martin W Besser,1 Stephen G MacDonald2 1Department of Haematology, 2Department of Specialist Haemostasis, The Pathology Partnership, Addenbrooke’s Hospital, Cambridge, UK Abstract: Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient’s fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia. Keywords: Clauss fibrinogen assay, fibrinogen antigen, viscoelastic testing, ­gravimetric fibrinogen assay, PT-derived fibrinogen, functional fibrinogen, direct oral anticoagulant, dysfibrinogenemia, afibrinogenemia

  1. Acquired hypertrichosis lanuginosa

    Directory of Open Access Journals (Sweden)

    Kumar Pramod


    Full Text Available Acquired hypertirichosis lanuginose developed rapidly in a patient with no detectable malignancy. Soft, fine, downy hair growth was noticed on the face, ears, limbs and trunk. Bilaterally symmetrical vitiliginous macules were present on the ear and preauricular region. This case is reported because of its rarity, absence of any detectable malignancy and development of vitiligo, which to our knowledge has not been reported earlier.

  2. Paediatric urology training: what does the future hold? (United States)

    Burke, M J; Nason, G J; Aslam, A; Redmond, E; Kelly, M E; Giri, S K; Flood, H D


    Paediatric urology training is not a mandatory part of higher surgical training in urology in Ireland. It is predicted there will be a shortfall of surgeons trained in paediatric surgery in the coming years leading to a reliance on specialist paediatric surgical centres. The aim of this study was to assess the attitudes of urological trainees regarding the current state of paediatric urology training and to address the potential future changes to training structures. A voluntary anonymous internet-based survey was emailed to all urological trainees. Parameters assessed included sex, level of training, attitudes towards paediatric urology training and levels of competence regarding core paediatric urological procedures. 69.2 % (n = 18) responded to the survey. 94.4 % (n = 17) would favour mandatory paediatric training-of these, 52.9 % (n = 9) would favour this in a dedicated paediatric hospital with a paediatric urologist. 66.7 % (n = 12) would like to provide a paediatric urology service as a consultant. 55.6 % (n = 10) felt they were competent to perform circumcision or scrotal exploration independently and manage all associated complications. No trainee felt themselves to be competent to perform orchidopexy independently and manage all complications. Our study demonstrates a promising desire to provide paediatric services in the future. A greater emphasis on structured paediatric urology training is required to maintain the standard currently offered by adult urologists.

  3. Oral medicines for children in the European paediatric investigation plans

    NARCIS (Netherlands)

    van Riet-Nales, Diana A; Römkens, Erwin G A W; Saint-Raymond, Agnes; Kozarewicz, Piotr; Schobben, Alfred F A M; Egberts, Toine C G; Rademaker, Carin M A


    INTRODUCTION: Pharmaceutical industry is no longer allowed to develop new medicines for use in adults only, as the 2007 Paediatric Regulation requires children to be considered also. The plans for such paediatric development called Paediatric Investigation Plans (PIPs) are subject to agreement by

  4. Aetiological Patterns and Management Outcome of Paediatric Head ...

    African Journals Online (AJOL)

    Trauma is themost common cause of paediatric deaths. In75% of paediatric trauma deaths, head injury is responsible, and most are from falls. Recent reports from Nigeria, however, appear to indicate a predominance of road traffic accidents, instead of falls. To evaluate the aetiology of paediatric head trauma, management ...

  5. The undergraduate paediatric surgery curriculum in Nigeria – how ...

    African Journals Online (AJOL)

    Undergraduate paediatric surgery poses the challenges of teaching future doctors about surgical procedures in and the care of children, and about the intersection of the two.1. Formulating an undergraduate paediatric general surgery curriculum that will meet these challenges is not an easy task. Although paediatric ...

  6. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B


    It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  7. Impact of infection control training for interns on PICU-acquired bloodstream infections in a middle-income country. (United States)

    Ng, Yun Yun; Abdel-Latif, Mohamed El-Amin; Gan, Chin Seng; Siham, Anis; Zainol, Hasimah; Lum, Lucy Chai See


    The present study aimed to determine the impact of an extended infection control training programme, which was conducted for all interns posted to the Department of Paediatrics, on the incidence of paediatric intensive care unit (PICU)-acquired bloodstream infections (BSIs) in University Malaya Medical Centre, Malaysia. The development of nosocomial BSIs during the baseline period (1 January-31 October 2008) and intervention period (1 November-31 December 2009) was monitored. During the intervention period, all paediatric interns underwent training in hand hygiene and aseptic techniques for accessing vascular catheters. A total of 25 patients had PICU-acquired BSIs during the baseline period, while 18 patients had PICU-acquired BSIs during the intervention period (i.e. infection rate of 88 per 1,000 and 41 per 1,000 admissions, respectively). The infections were related to central venous catheters (CVCs) in 22 of the 25 patients who had PICU-acquired BSIs during the baseline period and 11 of the 18 patients who had PICU-acquired BSIs during the intervention period. Thus, the incidence rates of catheter-related BSIs were 25.2 per 1,000 CVC-days and 9.3 per 1,000 CVC-days, respectively (p low-cost intervention, resulted in a substantial reduction in the incidence of PICU-acquired BSIs.

  8. White matter changes in paediatric multiple sclerosis and monophasic demyelinating disorders. (United States)

    Longoni, Giulia; Brown, Robert A; MomayyezSiahkal, Parya; Elliott, Colm; Narayanan, Sridar; Bar-Or, Amit; Marrie, Ruth Ann; Yeh, E Ann; Filippi, Massimo; Banwell, Brenda; Arnold, Douglas L


    See Hacohen et al. (doi:10.1093/awx075) for a scientific commentary on this article. Most children who experience an acquired demyelinating syndrome of the central nervous system will have a monophasic disease course, with no further clinical or radiological symptoms. A subset will be diagnosed with multiple sclerosis, a life-long disorder. Using linear mixed effects models we examined longitudinal diffusion properties of normal-appearing white matter in 505 serial scans of 132 paediatric participants with acquired demyelinating syndromes followed for a median of 4.4 years, many from first clinical presentation, and 106 scans of 80 healthy paediatric participants. Fifty-three participants with demyelinating syndromes eventually received a diagnosis of paediatric-onset multiple sclerosis. Diffusion tensor imaging measures properties of water diffusion through tissue, which normally becomes increasingly restricted and anisotropic in the brain during childhood and adolescence, as fibre bundles develop and myelinate. In the healthy paediatric participants, our data demonstrate the expected trajectory of more restricted and anisotropic white matter diffusivity with increasing age. However, in participants with multiple sclerosis, fractional anisotropy decreased and mean diffusivity of non-lesional, normal-appearing white matter progressively increased after clinical presentation, suggesting not only a failure of age-expected white matter development but also a progressive loss of tissue integrity. Surprisingly, patients with monophasic disease failed to show age-expected changes in diffusion parameters in normal-appearing white matter, although they did not show progressive loss of integrity over time. Further analysis demonstrated that participants with monophasic disease experienced different post-onset trajectories in normal-appearing white matter depending on their presenting phenotype: those with acute disseminated encephalomyelitis demonstrated abnormal

  9. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten


    INTRODUCTION: Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare...... symptoms and paraclinical findings at the first demyelinating event in paediatric MS with those of an adult MS population. MATERIAL AND METHODS: A total of 18 subjects with onset of MS relapse before 16 years of age were retrospectively included in the study. Case records were reviewed for symptoms...... at disease onset, cerebrospinal fluid findings, magnetic resonance imaging (MRI) and evoked potentials at the first demyelinating event. These data were compared with similar nationwide data from adults in Denmark. RESULTS: The median age was 14 (range 10-15) years at the first demyelinating event...

  10. Diagnostic radiology in paediatric palliative care

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Preena; Koh, Michelle; Carr, Lucinda; McHugh, Kieran [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)


    Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options. (orig.)

  11. Is paediatric trauma severity overestimated at triage?

    DEFF Research Database (Denmark)

    DO, H Q; Hesselfeldt, R; Steinmetz, J


    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational...... follow-up study that involves one level I TC and seven local hospitals. We included paediatric (trauma patients with a driving distance to the TC > 30 minutes. The primary end-point was the proportion of trauma patients arriving in the TC. RESULTS: We included 1934...... trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post-injury (P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score (ISS) 9 vs. 14, P 

  12. [The electrocardiogram in the paediatric age group]. (United States)

    Sanches, M; Coelho, A; Oliveira, E; Lopes, A


    A properly interpreted electrocardiogram (ECG) provides important information and is an inexpensive and easy test to perform. It continues to be the method of choice for the diagnosis of arrhythmias. Although the principles of cardiac electrophysiology are the same, there are anatomical and physiological age-dependent changes which produce specific alterations in the paediatric ECG, and which may be misinterpreted as pathological. The intention of this article is to address in a systematic way the most relevant aspects of the paediatric ECG, to propose a possible reading scheme of the ECG and to review the electrocardiograph tracings most frequently found in the paediatric age group. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  13. Radiation dose and image quality for paediatric interventional cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Vano, E [Radiology Department, Medicine School, Complutense University and San Carlos University Hospital, 28040 Madrid (Spain); Ubeda, C [Clinical Sciences Department, Faculty of the Science of Health, Tarapaca University, 18 de Septiembre 2222, Arica (Chile); Leyton, F [Institute of Public Health of Chile, Marathon 1000, Nunoa, Santiago (Chile); Miranda, P [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Avenida Antonio Varas 360, Providencia, Santiago (Chile)], E-mail:


    Radiation dose and image quality for paediatric protocols in a biplane x-ray system used for interventional cardiology have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-20 cm of PMMA). Images from fluoroscopy (low, medium and high) and cine modes have been archived in digital imaging and communications in medicine (DICOM) format. Signal-to-noise ratio (SNR), figure of merit (FOM), contrast (CO), contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) have been computed from the images. Data on dose transferred to the DICOM header have been used to test the values of the dosimetric display at the interventional reference point. ESAK for fluoroscopy modes ranges from 0.15 to 36.60 {mu}Gy/frame when moving from 4 to 20 cm PMMA. For cine, these values range from 2.80 to 161.10 {mu}Gy/frame. SNR, FOM, CO, CNR and HCSR are improved for high fluoroscopy and cine modes and maintained roughly constant for the different thicknesses. Cumulative dose at the interventional reference point resulted 25-45% higher than the skin dose for the vertical C-arm (depending of the phantom thickness). ESAK and numerical image quality parameters allow the verification of the proper setting of the x-ray system. Knowing the increases in dose per frame when increasing phantom thicknesses together with the image quality parameters will help cardiologists in the good management of patient dose and allow them to select the best imaging acquisition mode during clinical procedures.

  14. A disjointed effort: paediatric musculoskeletal examination.

    LENUS (Irish Health Repository)

    Gill, Irwin


    Musculoskeletal (MSK) symptoms are a frequent cause of emergency department attendance for children, and while most often indicative of benign or self-limiting disease, such symptoms can occasionally be the first presentation of serious illness such as leukaemia or juvenile idiopathic arthritis. MSK examination, however, is often not included as part of the routine paediatric examination. The authors aimed to evaluate how often and how thoroughly MSK examination was performed during admissions to the paediatric ward and to compare it with the examination of other symptoms in relation to the presenting complaint and eventual diagnosis.

  15. Seizures in the paediatric emergency department. (United States)

    Lawton, Ben; Deuble, Natalie


    Seizures are a common presentation to emergency departments. Early intervention improves treatment response. Use of consensus guidelines is highly recommended to decrease drug side effects and reduce intensive care requirements. Benzodiazepines remain the mainstay of first-line treatment. Choice of drugs for second-line treatment is expanding and some important studies are currently underway to determine which of these agents has the best safety and effectiveness profile in children. © 2016 The Authors. Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  16. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten


    INTRODUCTION: Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare...... and the mean time to MS diagnosis was 1.7 years. The majority of children had sensory symptoms (47%; 95% confidence interval (CI): 23-72%) or optic neuritis (35%; CI: 14-62%) as their presenting symptoms. These results did not differ from the findings in adult MS subjects. Pleocytosis was present in 93% (CI...

  17. Paediatric Metabolic Conditions of the Liver

    Directory of Open Access Journals (Sweden)

    Elroy P. Weledji


    Full Text Available Paediatric metabolic disorders with the most clinical manifestations of deranged hepatic metabolism are discussed. The conditions which will be stressed are those for which effective treatment is available and early diagnosis is essential. Accurate diagnosis of other disorders for which no treatment is, as yet, available is also important as a guide to prognosis and for accurate genetic counselling. With the advancement in amniocentesis techniques there is a growing role for gene therapy. For selected metabolic disorders, paediatric liver transplantations have been successful.

  18. "Ready to Acquire"

    DEFF Research Database (Denmark)

    Yetton, Philip; Henningsson, Stefan; Bjørn-Andersen, Niels


    This article describes the experiences of Danisco (a global food ingredients company) as it followed a growth-by-acquisition business strategy, focusing on how a new CIO built the IT resources to ensure the IT organization was "ready to acquire." We illustrate how these IT capabilities expedited...... the IT integration following two acquisitions, one of which involved Danisco expanding the scale of its business and the other extending the scope. Based on insights gained from Danisco, we provide lessons for CIOs to realize business benefits when managing post-acquisition IT integration....

  19. Acquired cerebral dyschromatopsia. (United States)

    Green, G J; Lessell, S


    Color blindness developed in five patients apparently because of lesions in the posterior portions of both cerebral hemispheres. Three of them also had symptoms of prosopagnosia. The lesions were neoplastic in two and vascular in three of the patients. It would appear that bilateral, inferior, occipital lobe lesions may be responsible both for acquired cerebral dyschromatopsia and prosopagnosia. Evidence from experimental investigations in primates suggests that the areas of the cerebral hemispheres analogous to those involved in these patients, may be specialized for the processing of colored stimuli.

  20. Acquired epidermolysis bullosa

    Directory of Open Access Journals (Sweden)

    Maricel Sucar Batista


    Full Text Available Epidermolysis bullosa is a group of diseases or skin disorders genetically transmitted and it is characterized by the appearance of bullae, ulcers and skin wounds. It usually appears at birth or in the first months of life. This is a case of a 72-year-old female patient who comes to the dermatology department with skin lesions of 6 months of evolution. A skin biopsy was performed, taking a sample for direct and indirect immunofluorescence. Acquired epidermolysis bullosa of unknown etiology was diagnosed. Treatment was started with low-dose colchicine to increase it later, according to the patient’s tolerance and disease progression.

  1. Development of a leadership skills workshop in paediatric advanced resuscitation. (United States)

    Gilfoyle, Elaine; Gottesman, Ronald; Razack, Saleem


    Paediatric residency programs rarely prepare trainees to assume resuscitation team leadership roles despite the recognized need for these skills by specialty accreditation organizations. We conducted a needs-assessment survey of all residents in the McGill Pediatric Residency Program, which demonstrated that most residents had minimal or no experience at leading resuscitation events and felt unprepared to assume this role in the future. We developed an educational intervention (workshop) and evaluated immediate and long term learning outcomes in order to determine whether residents could acquire and retain team leadership skills in pediatric advanced resuscitation. Fifteen paediatric residents participated in a workshop that we developed to fulfill the learning needs highlighted with the needs assessment, as well as the Objectives of Training in Pediatrics from the Royal College of Physicians and Surgeons of Canada. It consisted of a plenary session followed by 2 simulated resuscitation scenarios. Team performance was evaluated by checklist. Residents were evaluated again 6 months later without prior interactive lecture. Learning was also assessed by self-reported retrospective pre/post questionnaire. Checklist score (assigning roles, limitations of team, communication, overall team atmosphere) expressed as % correct: initial workshop scenario 1 vs. scenario 2 (63 vs. 82 p learning in knowledge of tasks, impact and components of communication, avoidance of fixation errors and overall leadership performance (p leadership skills following an educational intervention as shown by both observational checklist scores and self-reported survey. The six-month follow-up evaluation demonstrated skill retention beyond the initial intervention. A control group suggested that these results were due to completion of the first workshop.

  2. [Acquired coagulant factor inhibitors]. (United States)

    Nogami, Keiji


    Acquired coagulation factor inhibitors are an autoimmune disease causing bleeding symptoms due to decreases in the corresponding factor (s) which result from the appearance of autoantibodies against coagulation factors (inhibitor). This disease is quite different from congenital coagulation factor deficiencies based on genetic abnormalities. In recent years, cases with this disease have been increasing, and most have anti-factor VIII autoantibodies. The breakdown of the immune control mechanism is speculated to cause this disease since it is common in the elderly, but the pathology and pathogenesis are presently unclear. We herein describe the pathology and pathogenesis of factor VIII and factor V inhibitors. Characterization of these inhibitors leads to further analysis of the coagulation process and the activation mechanisms of clotting factors. In the future, with the development of new clotting examination method (s), we anticipate that further novel findings will be obtained in this field through inhibitor analysis. In addition, detailed elucidation of the coagulation inhibitory mechanism possibly leading to hemostatic treatment strategies for acquired coagulation factor disorders will be developed.

  3. Learning-By-Being-Acquired

    DEFF Research Database (Denmark)

    Colombo, Massimo G.; Moreira, Solon; Rabbiosi, Larissa

    In this paper we study post-acquisition integration in terms of R&D team reorganization—i.e., the creation of new teams with both inventors of the acquiring and acquired firms—and assess its impact on knowledge transfer in the period that follows the acquisition. Drawing on social identity and self......-categorization theories, we argue that R&D team reorganization increases the acquired inventors’ use of the prior stock of technological knowledge of the acquiring firm after the acquisition. Furthermore, this effect is enhanced if acquired inventors have higher innovation ability relative to their acquiring peers...

  4. Reflections on six years in paediatric ART

    African Journals Online (AJOL)

    As part of my work at a primary care clinic in Khayelitsha, I started the paediatric arm of the antiretroviral therapy (ART) service in our clinic six years ago. When I first started, many children were being cared for by family members or foster carers because their mothers had died. This is now the exception, as most mothers ...

  5. Answer and discussion paediatric neuroimaging quiz case

    African Journals Online (AJOL)


    Jun 30, 2016 ... Dr Samuel Mannikam, Dr Thandi Buthelezi, Dr Philip Janse van Rensburg and Dr Ian. Haynes, however, the prize of R2000 was awarded to Dr Richard Busayo Ulatunji for the most inclusive answer. Answer and discussion paediatric neuroimaging quiz case. Read online: Scan this QR code with your.

  6. Strategies for optimisation of paediatric cardiopulmonary bypass

    NARCIS (Netherlands)

    Somer, Filip Maria Jan Jozef De


    The aim of this thesis is to address different aspects of paediatric cardiopulmonary bypass in detail and to propose modifications in order to reduce cardiopulmonary bypass related morbidity and by doing so, improve patient outcome. We will focus on four major items: (1) vascular access, (2) mass

  7. Paediatric Neurological Conditions Seen at the Physiotherapy ...

    African Journals Online (AJOL)

    Traumatic sciatic nerve palsy (29 %) was the second most common condition. Most of the patients (64.5 %) were referred from the Paediatric Outpatient Department of the same hospital with 56.5 % domiciled outside the hospital location but within Ekiti State. Cerebral palsy and traumatic sciatic nerve palsy are major health ...

  8. Outcome of paediatric intensive care survivors

    NARCIS (Netherlands)

    Knoester, Hendrika; Grootenhuis, Martha A.; Bos, Albert P.


    The development of paediatric intensive care has contributed to the improved survival of critically ill children. Physical and psychological sequelae and consequences for quality of life (QoL) in survivors might be significant, as has been determined in adult intensive care unit (ICU) survivors.

  9. Vitamin D deficiency: a paediatric orthopaedic perspective. (United States)

    Clarke, Nicholas M P; Page, Jonathan E


    At the turn of the last century, rickets (vitamin D deficiency) was one of the most common musculoskeletal diseases of the paediatric population presenting to physicians. Today, the most common referral pathway for these patients ends in a paediatric orthopaedic outpatient clinic. Vitamin D deficiency is a clinical entity that can affect all children and should be looked for in all children with musculoskeletal symptoms. The child at risk of rickets is now white, breastfed, protected from the sun and obese. Vitamin D deficiency can present as atypical muscular pain, pathological fractures or slipped upper femoral epiphysis. Obesity is linked with lower vitamin D levels; however, in the paediatric population, this does not necessarily equal clinical disorder. Vitamin D supplements can be used to reduce the risk of pathological fractures in the cerebral palsy child. It should also form part of the differential diagnosis in the work-up of nonaccidental injuries. Children with a low vitamin D present with a higher incidence of fractures from normal activities. Vitamin D levels need to be assessed before any form of orthopaedic surgery, as it can affect growth, both in the diaphysis of the bone and in the growth plate. Vitamin D levels are a key element in the successful practice of paediatric orthopaedics. It is not just the possible cause of disorder presenting to the clinician but also extremely important in ensuring the successful postoperative recovery of the patient.

  10. Ingested foreign bodies in the paediatric patient.

    LENUS (Irish Health Repository)

    O'Brien, G C


    BACKGROUND: Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention. AIMS: To establish clear guidelines for management of paediatric FB ingestion. METHODS: A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999. RESULTS: Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery. CONCLUSION: Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.

  11. A review of paediatric tuberculosis in Denmark

    DEFF Research Database (Denmark)

    Hatleberg, Camilla; Prahl, Julie B; Rasmussen, Jeppe Nørgaard


    Paediatric tuberculosis (TB) is a key indicator for recent transmission and presents a reservoir for the disease. We describe trends in epidemiology, microbiological characteristics and treatment outcome in Denmark between 2000 and 2009. Data was retrieved from the national TB surveillance system...

  12. Employing healthcare assistants in paediatric oncology units. (United States)

    Shelley, Helen; Coyne, Rachel


    This article examines the potential benefits of employing healthcare assistants in paediatric oncology departments. It explores the implications for role definition, workforce planning, training, regulation, accountability and delegation. The article considers whether this alternative to employing more registered nurses is an effective initiative that can improve services for children, young people and their carers.

  13. starting infants on antiretroviral therapy clinical: paediatrics

    African Journals Online (AJOL)

    CHARACTERISTICS OF CHILDREN STARTING ART. A literature review of 30 paediatric studies or treatment programmes found that children receiving ART ranged from infants aged 2 months to adolescents aged 15 years.5 Of 26 studies that reported age at ART initiation,. 19 (73%) showed a mean or median age at start ...

  14. SAJS 970 - Paediatric Surgery.indd

    African Journals Online (AJOL)

    Paediatric Surgery. Intussusception (IN) is a common cause of bowel obstruction in infants and children. Usually a combination of one symptom and two signs are noted: colicky pain, bloody stools, and a mass in the abdominal area.1,2. The diagnosis of IN is established by means of physical examination, a plain abdominal ...

  15. African Journal of Paediatric Surgery: Submissions

    African Journals Online (AJOL)

    The date of receipt at the Journal office of articles for publish will be appended when they are published. PREPARATION OF THE MANUSCRIPT Articles considered for publication in African Journal of Paediatric Surgery should comply with “Uniform Requirement for Manuscript Submitted to Biomedical Journals” published ...

  16. Paediatric surveillance of pertussis in 1998

    NARCIS (Netherlands)

    Melker HE de; Neppelenbroek SN; Schellekens JFP; Suijkerbuijk AWM; Conyn- van Spaendonck MAE; CIE; LIS


    Objective: To gain insight into the severity of pertussis in hospitalised cases. Methods: In 1998, hospitalisation data were collected through paediatric surveillance. Results: From 115 hospitalisation admissions collected, 55% of the patients were younger than 3 months of age and not vaccinated;


    African Journals Online (AJOL)

    *RTA = road traffic accident. Table 2: Sex Distribution Related to the Causes of Paediatric Trauma. Males Females. Causes. No. % No. %. Amputation of glans penis 3 16.7% - -. Avulsion of the ventral wall of the urethra 3 16.7% - -. Iatrogenic fistula 2 11.1% - -. Bladder injury from road traffic accident 1 5.6% 1 5.6%. Bladder ...

  18. Whole-body MRI in paediatric oncology

    NARCIS (Netherlands)

    Nievelstein, Rutger A J; Littooij, Annemieke S.

    Imaging plays a crucial role in the diagnosis and follow-up of paediatric malignancies. Until recently, computed tomography (CT) has been the imaging technique of choice in children with cancer, but nowadays there is an increasing interest in the use of functional imaging techniques like positron

  19. Organization of paediatric diabetes units in Italy. (United States)

    La Loggia, Alfonso


    Aim of this work is to give a realistic picture of the medical care situation in Italy and to verify its congruence with ISPAD and SIEDP guidelines and the law. In Italy diabetes is recognized as a disease of great social interest by a state act. Sixteen years after its approval, all of the Italian Regions have received the law n. 115/87 with the different acts. Nearly all regional acts provide for both the institution of specialized centres of paediatric diabetology and their individuation at local level. In Italy diabetological paediatric care is well distributed all over the national territory. Activities are operating in almost every region. Actually a lot of paediatric diabetology activities have no formal recognition and no operating autonomy and sometimes the person in charge of the activity is not a diabetologist paediatrician. In spite of what stated by ISPAD and SIEDP guidelines, this is the real situation. Perhaps in the future a larger presence of scientific societies involved in problems concerning sanitary politics about diabetes, will bring to an appreciable improvement of the quality of care system of paediatric diabetology.

  20. [Acquired uterine arteriovenous malformations]. (United States)

    Vandenbroucke, L; Morcel, K; Bruneau, B; Moquet, P-Y; Bauville, E; Levêque, J; Lavoue, V


    Uterine arteriovenous malformations (AVM) may be responsible for vaginal bleeding potentially life-threatening. They are most often acquired following uterine trauma (curettage, cesarean section, artificial delivery/uterus examination) in association with pregnancy or gestational trophoblastic disease. We report three cases of patients having uterine AVM after curettage. The diagnostic management is important to avoid differential diagnoses (intra-uterine retention, hemangioma, gestational trophoblastic disease). It is based on serum hCG measurement and Doppler ultrasound, then confirmed on dynamic angio-MRI, which tends to replace angiography as first-line. The therapeutic management in cases of symptomatic AVMs is mostly embolization which offers the possibility for childbearing. Current data on subsequent pregnancies is reassuring even if they remain limited. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  1. Acquired Porphyria Cutanea Tarda (United States)

    Koval, Andrew; Danby, C. W. E.; Petermann, H.


    Currently, the porphyrias are classified in four main groups: congenital porphyria, acute intermittent porphyria, porphyria cutanea tarda hereditaria, and porphyria cutanea tarda symptomatica. The acquired form of porphyria (porphyria cutanea tarda symptomatica) occurs in older males and is nearly always associated with chronic alcoholism and hepatic cirrhosis. The main clinical changes are dermatological, with excessive skin fragility and photosensitivity resulting in erosions and bullae. Biochemically, high levels of uroporphyrin are found in the urine and stools. Treatment to date has been symptomatic and usually unsuccessful. A case of porphyria cutanea tarda symptomatica is presented showing dramatic improvement of both the skin lesions and porphyrin levels in urine and blood following repeated phlebotomy. Possible mechanisms of action of phlebotomy on porphyria cutanea tarda symptomatica are discussed. ImagesFig. 1Fig. 2 PMID:14341652

  2. Paediatric HIV treatment failure: a silent epidemic

    Directory of Open Access Journals (Sweden)

    Jonathan M Bernheimer


    Full Text Available Paediatric antiretroviral treatment (ART failure is an under-recognized issue that receives inadequate attention in the field of paediatrics and within HIV treatment programmes. With paediatric ART failure rates ranging from 19.3% to over 32% in resource limited settings, a comprehensive evaluation of the causes of failure along with approaches to address barriers to treatment adherence are urgently needed.In partnership with the local Department of Health, a pilot programme has been established by Medecins Sans Frontieres (MSF in Khayelitsha, South Africa, to identify and support paediatric HIV patients with high viral loads and potential treatment failure. Through detailed clinical and psychosocial evaluations and adherence support with an innovative counselling model, treatment barriers are identified and addressed.Demographic and clinical characteristics from the cohort show a delayed median start date for ART, prolonged viraemia including a large number of patients who have never achieved viral load (VL suppression, a low rate of regimen changes despite failure, and a high percentage of pre-adolescent and adolescent patients who have not gone through the disclosure process.Stemming this epidemic of paediatric treatment failure requires programmatic responses to high viral loads in children, starting with improved “case finding” of previously undiagnosed HIV-infected children and adolescents. Viral load testing needs to be prioritized over CD4 count monitoring, and flagging systems to identify high VL results should be developed in clinics. Clinicians must understand that successful treatment begins with good adherence, and that simple adherence support strategies can often dramatically improve adherence. Moreover, appropriate adherence counselling should begin not when the child fails to respond to treatment. Establishing good adherence from the beginning of treatment, and supporting ongoing adherence during the milestones in these

  3. Estimating future trends in paediatric HIV (United States)

    Penazzato, Martina; Bendaud, Victoria; Nelson, Lisa; Stover, John; Mahy, Mary


    Background: Paediatric treatment continues to lag behind adult treatment and significant efforts are urgently needed to scale up antiretroviral therapy (ART) for children. As efforts to prevent mother-to-child transmission expand, better understanding of future trends and age characterization of the population that will be in need of ART is needed to inform policymakers, as well as drug developers and manufacturers. Methods: The Spectrum model was used to estimate the total number of expected paediatric infections by 2020 in 21 priority countries in Africa. Different ART scale-up scenarios were investigated and age characterization of the population was explored. Results: By 2020, new paediatric infections in the 21 countries will decline in all the scenarios. Total paediatric infections will also decline in the 21 high-burden countries, but with a differential effect by scenario and age group. On the basis of the optimal scale-up scenario, 1 940 000 [1 760 000–2 120 000] children will be expected to be living with HIV in 2020. The number of children dying of AIDS is notably different in the three models. Assuming optimal scale-up and based on 2013 treatment initiation criteria, the estimates of children to receive ART in the 21 high-burden countries will increase to 1 670 000 (1 500 000–1 800 000). Conclusion: By 2020, even under the most optimistic scenarios, a considerable number of children will still be living with HIV. Age-appropriate drugs and formulations will be needed to meet the treatment needs of this vulnerable population. Improved estimates will be critical to guide the development and forecasting of commodities to close the existing paediatric treatment gap. PMID:25409099

  4. Acute paediatric paraplegia: a case series review. (United States)

    Sharpe, Abigail N; Forsyth, Rob


    Paediatric paraplegia resulting from spinal cord pathology of any cause is rare; hence prognostic information for children less than 16 years is limited. This case series review aims to ascertain all cases of paediatric paraplegia from 1997 to 2012 in the former Northern Region of England. Children presenting with sudden paraplegia before the age of 16 years were multiply ascertained from databases in the regional paediatric neurology, neuroradiology, neuro-oncology and adult spinal injuries units. Data were obtained from retrospective case note review. A total of 44 cases (24 female) were identified. The incidence is estimated at 0.49 per 100,000 children under 16/year (95% confidence interval 0.41-0.57). Mean age of onset was 8.8 years and the most common aetiology was inflammatory. Twelve months post presentation, mortality was zero and a good outcome (defined as Gross Motor Function Classification System grades I or II) was seen in 66.6%. Motor outcome at 12 months was associated with the presence of bladder/bowel signs at presentation, previous viral illness and initial severity of paraplegia. Bladder signs at presentation were the strongest predictor of prognosis (OR for poor motor outcome 10.3). We were unable to demonstrate a relationship between aetiology and late outcome. Paediatric paraplegia is rare. Mortality rates are low and 66.6% have a good outcome with fully or nearly independent walking. Bladder signs are the strongest predictor of prognosis. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  5. The delivery of general paediatric surgery in Ireland: a survey of higher surgical trainees.

    LENUS (Irish Health Repository)

    Boyle, E


    The delivery of general paediatric surgery is changing in Ireland. Fewer paediatric surgical procedures are being performed by newly appointed consultant general surgeons, resulting in increased referrals to the specialist paediatric surgeons of uncomplicated general paediatric surgical problems. We surveyed current higher surgical trainees about their views on provision of paediatric surgical services.

  6. Impact of community-acquired paediatric rotavirus gastroenteritis on family life: data from the REVEAL study

    National Research Council Canada - National Science Library

    Van der Wielen, Marie; Giaquinto, Carlo; Gothefors, Leif; Huelsse, Christel; Huet, Frédéric; Littmann, Martina; Maxwell, Melanie; Talayero, José M P; Todd, Peter; Vila, Miguel T; Cantarutti, Luigi; Van Damme, Pierre


    .... Data associated with the burden of RVGE, including number of working days lost, levels of parental stress, the need for alternative childcare arrangements and additional nappies used, were extracted...

  7. Learning-by-Being-Acquired

    DEFF Research Database (Denmark)

    Colombo, Massimo Gaetano; Moreira, Solon; Rabbiosi, Larissa


    ’ use of the prior stock of technological knowledge of the acquiring firm after the acquisition. Furthermore, this effect is enhanced if the focal acquired inventor has high relative innovation ability but is weakened for acquired inventors with high ingroup collaborative strength. We construct a sample...

  8. British Thoracic Society Paediatric Pneumonia Audit: a review of 3 years of data. (United States)

    Bowen, Sarah-Jane M; Thomson, Anne H


    The British Thoracic Society (BTS) guidelines for the management of community-acquired pneumonia in children are used as the audit standard for the annual BTS Paediatric Pneumonia Audit. This report examines 3 years of data from this national audit, highlighting trends in clinical practice and the impact of the 2011 revisions to the BTS guidelines. The findings suggest an over-reliance on investigations to diagnose pneumonia and underuse of oral antibiotics, particularly amoxicillin. There is inappropriate use of chest physiotherapy, outpatient appointments and repeat chest x-rays. Increasing adherence to the BTS guidelines would improve care and also preserve valuable secondary care resources.

  9. Nitrous oxide provides safe and effective analgesia for minor paediatric procedures--a systematic review. (United States)

    Pedersen, Rie S; Bayat, Allan; Steen, Nick Phaff; Jacobsson, Marie-Laure Bouchy


    Pain and distress during minor hospital-related procedures is a familiar problem in many children. Inadequate relief of children's procedural pain and distress not only affects the experience of the children and their parents, but also adversely impacts procedural success. We aimed to review the safety and efficacy of nitrous oxide during brief, but painful paediatric procedures and to compare nitrous oxide with some of the commonly used pharmacological and non-pharmacological treatments for relieving anxiety and mild to moderate pain in Denmark. We searched MEDLINE (PubMed) and the Cochrane Database of Systematic Reviews with the MeSH term nitrous oxide combined with midazolam, surgical procedures minor, analgesia or conscious sedation. The references in the articles acquired that were not found in the MEDLINE search were further investigated. Only articles written in English and published after 1980 were included to ensure optimal data collection. Nitrous oxide is an effective sedative/analgesic for mildly to moderately painful paediatric procedures. Furthermore, it is safely administrated, particularly for short procedures (Nitrous oxide is a safe and effective method to achieve analgesia and sedation during minor, but painful procedures. It can be safely administered by a dedicated staff member. This helpful method is still underused in Denmark, and we believe that it could be an alternative or the first choice of treatment in emergency and paediatric departments.

  10. The value of routine chest radiographs in a paediatric intensive care unit: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Valk, J.W.; Ploetz, F.B.; Schuerman, F.A.B.A.; Vught, H. van [Dept. of Paediatric Intensive Care, Utrecht (Netherlands); Kramer, P.P.G.; Beek, E.J.A. [Dept. of Radiology, University Medical Centre, Wilhelmina Children' s Hospital, Utrecht (Netherlands)


    Background. In many paediatric intensive care units (PICUs) chest X-ray films (CXRs) are required as part of the daily examination or after completion of invasive procedures. Objective. First, to evaluate if the American College of Radiology (ACR) guidelines for adult patients are appropriate for paediatric pa- tients. Second, to assess the diagnostic efficacy of the CXRs. Materials and methods. One-hundred-seventy-four CXRs acquired in 74 patients, either routinely or after invasive procedures, were analysed. The indication of the obtained CXRs, or the absence of indication in patients in whom no CXRs was taken, was compared with ACR guidelines. The position of medical devices was evaluated. Changes in cardiopulmonary status were noted. Results. Sixty-seven percent of the CXRs were in accordance with the ACR guidelines, and in 74 % of pa- tients in whom no CXRs were taken this was also in accordance with these guidelines. Sixteen percent of the endotracheal tubes, 23 % of central venous lines and 15 % of nasogastric tubes were malpositioned. Changes in cardiopulmonary status, after the initial film, were noted in 63 %. Conclusions. The indications for the majority of CXRs in our PICU appeared to be in accordance with ACR guidelines. The high percentage of malpositioned tubes and lines and the number of cardiopulmonary changes on CXRs in a PICU underline the value of these films. Adjustments of the ACR guidelines for particular groups of paediatric patients may limit the number of CXRs taken and may further increase diagnostic efficacy. (orig.)

  11. Estimated risk of radiation-induced cancer from paediatric chest CT: two-year cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Niemann, Tilo [Cantonal Hospital Baden, Department of Radiology, Baden (Switzerland); University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Colas, Lucie; Santangelo, Teresa; Faivre, Jean Baptiste; Remy, Jacques; Remy-Jardin, Martine [University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Roser, Hans W.; Bremerich, Jens [University of Basel Hospital, Clinic of Radiology and Nuclear Medicine, Medical Physics, Basel (Switzerland)


    The increasing absolute number of paediatric CT scans raises concern about the safety and efficacy and the effects of consecutive diagnostic ionising radiation. To demonstrate a method to evaluate the lifetime attributable risk of cancer incidence/mortality due to a single low-dose helical chest CT in a two-year patient cohort. A two-year cohort of 522 paediatric helical chest CT scans acquired using a dedicated low-dose protocol were analysed retrospectively. Patient-specific estimations of radiation doses were modelled using three different mathematical phantoms. Per-organ attributable cancer risk was then estimated using epidemiological models. Additional comparison was provided for naturally occurring risks. Total lifetime attributable risk of cancer incidence remains low for all age and sex categories, being highest in female neonates (0.34%). Summation of all cancer sites analysed raised the relative lifetime attributable risk of organ cancer incidence up to 3.6% in female neonates and 2.1% in male neonates. Using dedicated scan protocols, total lifetime attributable risk of cancer incidence and mortality for chest CT is estimated low for paediatric chest CT, being highest for female neonates. (orig.)

  12. Vertical atlantoaxial dislocation


    Ramaré, S.; Lazennec, J. Y.; Camelot, C.; Saillant, G.; Hansen, S.; Trabelsi, R.


    An unusual case of vertical atlantoaxial dislocation without medulla oblongata or spinal cord injury is reported. The pathogenic process suggested occipito-axial dislocation. The case was treated surgically with excellent results on mobility and pain.

  13. Coordination in vertical jumping

    NARCIS (Netherlands)

    Bobbert, Maarten F.; van Ingen Schenau, Gerrit Jan


    The present study was designed to investigate for vertical jumping the relationships between muscle actions, movement pattern and jumping achievement. Ten skilled jumpers performed jumps with preparatory countermovement. Ground reaction forces and cinematographic data were recorded. In addition,

  14. ICU-Acquired Weakness. (United States)

    Jolley, Sarah E; Bunnell, Aaron E; Hough, Catherine L


    Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. Pediatric acquired brain injury. (United States)

    Bodack, Marie I


    Although pediatric patients are sometimes included in studies about visual problems in patients with acquired brain injury (ABI), few studies deal solely with children. Unlike studies dealing with adult patients, in which mechanisms of brain injury are divided into cerebral vascular accident (CVA) and traumatic brain injury (TBI), studies on pediatric patients deal almost exclusively with traumatic brain injury, specifically caused by accidents. Here we report on the vision problems of 4 pediatric patients, ages 3 to 18 years, who were examined in the ophthalmology/optometry clinic at a children's hospital. All patients had an internally caused brain injury and after the initial insult manifested problems in at least one of the following areas: acuity, binocularity, motility (tracking or saccades), accommodation, visual fields, and visual perceptual skills. Pediatric patients can suffer from a variety of oculo-visual problems after the onset of head injury. These patients may or may not be symptomatic and can benefit from optometric intervention. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  16. Hybrid vertical cavity laser

    DEFF Research Database (Denmark)

    Chung, Il-Sug; Mørk, Jesper


    A new hybrid vertical cavity laser structure for silicon photonics is suggested and numerically investigated. It incorporates a silicon subwavelength grating as a mirror and a lateral output coupler to a silicon ridge waveguide.......A new hybrid vertical cavity laser structure for silicon photonics is suggested and numerically investigated. It incorporates a silicon subwavelength grating as a mirror and a lateral output coupler to a silicon ridge waveguide....

  17. Composition of vertical gardens


    Sandeva, Vaska; Despot, Katerina


    Vertical gardens are fully functional gardens in areas where there is less oxygen and space, ideal for residential and urban cities where there is no vegetation; occupy a special place in interiors furniture. The gardens occupy an important aesthetic problem. Aesthetic task in vertical gardens can be achieved by forming sectors of identification in the urban landscape through the choice of a particular plant spatial composition and composition, to create comfort and representation in commu...

  18. Paediatric UK demyelinating disease longitudinal study (PUDDLS

    Directory of Open Access Journals (Sweden)

    Likeman Marcus


    Full Text Available Abstract Background There is evidence that at least 5% of Multiple sclerosis (MS cases manifest in childhood. Children with MS present with a demyelinating episode involving single or multiple symptoms prior to developing a second event (usually within two years to then meet criteria for diagnosis. There is evidence from adult cohorts that the incidence and sex ratios of MS are changing and that children of immigrants have a higher risk for developing MS. A paediatric population should reflect the vanguard of such changes and may reflect trends yet to be observed in adult cohorts. Studying a paediatric population from the first demyelinating event will allow us to test these hypotheses, and may offer further valuable insights into the genetic and environmental interactions in the pathogenesis of MS. Methods/Design The Paediatric UK Demyelinating Disease Longitudinal Study (PUDDLS is a prospective longitudinal observational study which aims to determine the natural history, predictors and outcomes of childhood CNS inflammatory demyelinating diseases. PUDDLS will involve centres in the UK, and will establish a cohort of children affected with a first CNS inflammatory demyelinating event for long-term follow up by recruiting for approximately 5 years. PUDDLS will also establish a biological sample archive (CSF, serum, and DNA, allowing future hypothesis driven research. For example, the future discovery of a biomarker will allow validation within this dataset for the evaluation of novel biomarkers. Patients will also be requested to consent to be contacted in the future. A secondary aim is to collaborate internationally with the International Paediatric Multiple Sclerosis Study Group when future collaborative studies are proposed, whilst sharing a minimal anonymised dataset. PUDDLS is the second of two jointly funded studies. The first (UCID-SS is an epidemiological surveillance study that already received ethical approvals, and started on the 1st

  19. Paediatric UK demyelinating disease longitudinal study (PUDDLS). (United States)

    Absoud, Michael; Cummins, Carole; Chong, Wui K; De Goede, Christian; Foster, Katharine; Gunny, Roxanna; Hemingway, Cheryl; Jardine, Philip; Kneen, Rachel; Likeman, Marcus; Lim, Ming J; Pike, Mike; Sibtain, Naomi; Whitehouse, William P; Wassmer, Evangeline


    There is evidence that at least 5% of Multiple sclerosis (MS) cases manifest in childhood. Children with MS present with a demyelinating episode involving single or multiple symptoms prior to developing a second event (usually within two years) to then meet criteria for diagnosis. There is evidence from adult cohorts that the incidence and sex ratios of MS are changing and that children of immigrants have a higher risk for developing MS. A paediatric population should reflect the vanguard of such changes and may reflect trends yet to be observed in adult cohorts. Studying a paediatric population from the first demyelinating event will allow us to test these hypotheses, and may offer further valuable insights into the genetic and environmental interactions in the pathogenesis of MS. The Paediatric UK Demyelinating Disease Longitudinal Study (PUDDLS) is a prospective longitudinal observational study which aims to determine the natural history, predictors and outcomes of childhood CNS inflammatory demyelinating diseases. PUDDLS will involve centres in the UK, and will establish a cohort of children affected with a first CNS inflammatory demyelinating event for long-term follow up by recruiting for approximately 5 years. PUDDLS will also establish a biological sample archive (CSF, serum, and DNA), allowing future hypothesis driven research. For example, the future discovery of a biomarker will allow validation within this dataset for the evaluation of novel biomarkers. Patients will also be requested to consent to be contacted in the future. A secondary aim is to collaborate internationally with the International Paediatric Multiple Sclerosis Study Group when future collaborative studies are proposed, whilst sharing a minimal anonymised dataset. PUDDLS is the second of two jointly funded studies. The first (UCID-SS) is an epidemiological surveillance study that already received ethical approvals, and started on the 1st September 2009. There is no direct patient

  20. Clostridium difficile infection diagnosis in a paediatric population: comparison of methodologies. (United States)

    Hart, J; Putsathit, P; Knight, D R; Sammels, L; Riley, T V; Keil, A


    The increasing incidence of Clostridium difficile infection (CDI) in paediatric hospitalised populations, combined with the emergence of hypervirulent strains, community-acquired CDI and the need for prompt treatment and infection control, makes the rapid, accurate diagnosis of CDI crucial. We validated commonly used C. difficile diagnostic tests in a paediatric hospital population. From October 2011 to January 2012, 150 consecutive stools were collected from 75 patients at a tertiary paediatric hospital in Perth, Western Australia. Stools were tested using: C. Diff Quik Chek Complete, Illumigene C. difficile, GeneOhm Cdiff, cycloserine cefoxitin fructose agar (CCFA) culture, and cell culture cytotoxin neutralisation assay (CCNA). The reference standard was growth on CCFA or Cdiff Chromagar and PCR on isolates to detect tcdA, tcdB, cdtA, and cdtB. Isolates were PCR ribotyped. The prevalence of CDI was high (43 % of patients). Quik Chek Complete glutamate dehydrogenase (GDH) demonstrated a low negative predictive value (NPV) (93 %). Both CCNA and Quik Chek Complete toxin A/B had poor sensitivity (33 % and 29 % respectively). Molecular methods both had 89 % sensitivity. Algorithms using GDH + Illumigene or GeneOhm reduced the sensitivity to 85 % and 83 % respectively. Ribotype UK014/20 predominated. GDH NPV and GeneOhm and Illumigene sensitivities were reduced compared with adult studies. Quik Chek Complete and CCNA cannot reliably detect toxigenic CDI. A GDH first algorithm showed reduced sensitivity. In a high prevalence paediatric population, molecular methods alone are recommended over the use of GDH algorithm or culture and CCNA, as they demonstrate the best test performance characteristics.

  1. Medication communication between nurses and doctors for paediatric acute care: An ethnographic study. (United States)

    Borrott, Narelle; Kinney, Sharon; Newall, Fiona; Williams, Allison; Cranswick, Noel; Wong, Ian; Manias, Elizabeth


    To examine how communication between nurses and doctors occurred for managing medications in inpatient paediatric settings. Communication between health professionals influences medication incidents' occurrence and safe care. An ethnographic study was undertaken. Semi-structured interviews, observations and focus groups were conducted in three clinical areas of an Australian tertiary paediatric hospital. Data were transcribed verbatim and thematically analysed using the Medication Communication Model. The actual communication act revealed health professionals' commitment to effective medication management and the influence of professional identities on medication communication. Nurses and doctors were dedicated to providing safe, effective medication therapy for children, within their scope of practice and perceived role responsibilities. Most nurses and junior doctors used tentative language in their communication while senior doctors tended to use direct language. Irrespective of language style, nurses actively engaged with doctors to promote patients' needs. Yet, the medical hierarchical structure, staffing and attendant expectations influenced communication for medication management, causing frustration among nurses and doctors. Doctors' lack of verbal communication of documented changes to medication orders particularly troubled nurses. Nurses persisted in their efforts to acquire appropriate orders for safe medication administration to paediatric patients. Collaborative practice between nurses and doctors involved complex, symbiotic relationships. Their dedication to providing safe medication therapy to paediatric patients facilitated effective medication management. At times, shortcomings in interdisciplinary communication impacted on potential and actual medication incidents. Understanding of the complexities affecting medication communication between nurses and doctors helps to ensure interprofessional respect for each other's roles and inherent demands

  2. [Evaluation of varicella complications through a retrospective hospital survey in a paediatric center over 16 years in France]. (United States)

    Mallet, E; Maitre, M; Delalande-Dutilleul, L; Marguet, C; Mouterde, O


    Evaluation of the varicella severity through a prevalence study of hospital admissions justified by a complication directly related to the onset of an acute episode of varicella. Retrospective study in one paediatric center in France with a follow-up of a paediatric cohort from April 1987 to December 2002. This general paediatric hospital recruits children from a 400,000 inhabitants area. Inclusion criterion: diagnosis main or associated of varicella. congenital or acquired immunodepression, including long-term oral high dosage steroid therapy. Three hundred and forty-three (343) complications of varicella were reported in 309 children hospitalised for a symptom in relationship with varicella. Most of children (75%) were asthma crisis, were mostly noticed since 1995. Two deaths occurred. These data collected over 16 years as part of a retrospective survey of a paediatric cohort show that varicella, often considered as a mild disease, can be responsible for severe complications in young immunocompetent children. The digestive complications (30%) are the main complication in our study with existence of gingivitis-stomatitis but also lower digestive manifestations (erosive gastritis aspect through endoscopy). These data have all the more to be taken into account because a vaccine, developed for healthy children, is now available in France. A national survey of hospitalised varicella has been set up since March 2003.

  3. Paediatric conscious sedation: views and experience of specialists in paediatric dentistry. (United States)

    Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L


    The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.

  4. A comparison of paediatric dentists' and general dental practitioners' care patterns in paediatric dental care. (United States)

    Schorer-Jensma, M A; Veerkamp, J S J


    The aim of this study was to compare the care patterns of paediatric dentists and general dentists in the dental treatment of children in the Netherlands. A case control study was completed based on the financial records of one of the largest Dutch health insurance companies. After medical ethical approval the dental records from 2004, 2005 and 2006 of 16 paediatric dentists were used and compared with the records of general practitioners with the same number of insured paediatric patients from the same age and urbanisation level. Preventive, diagnostic and restorative care for four consecutive age groups (children up to aged 11 yrs, more extractions (pchildren until aged 8 yrs and performed more restorations (p=0.02) in children up to 6 yrs of age. There was no significant difference in the care pattern of the dentists for the oldest age group (12-17 yrs). The care-index for paediatric dentists and general dentists from this research was comparable with Dutch epidemiological studies. Compared with general dentists, paediatric dentists have a more extensive treatment approach when treating children. In the youngest age groups the differences are the most pronounced. Further studies are needed to clarify whether the cause is the needs of the patient or an attitude of supervised neglect by the general dentists.

  5. Current views and advances on Paediatric Virology: An update for paediatric trainees. (United States)

    Mammas, Ioannis N; Greenough, Anne; Theodoridou, Maria; Kramvis, Anna; Christaki, Iliana; Koutsaftiki, Chryssie; Koutsaki, Maria; Portaliou, Dimitra M; Kostagianni, Georgia; Panagopoulou, Paraskevi; Sourvinos, George; Spandidos, Demetrios A


    Paediatric Virology is a bold new scientific field, which combines Paediatrics with Virology, Epidemiology, Molecular Medicine, Evidence-based Medicine, Clinical Governance, Quality Improvement, Pharmacology and Immunology. The Workshop on Paediatric Virology, which took place on Saturday October 10, 2015 in Athens, Greece, provided an overview of recent views and advances on viral infections occurring in neonates and children. It was included in the official programme of the 20th World Congress on Advances in Oncology and the 18th International Symposium on Molecular Medicine, which attracted over 500 delegates from the five continents. During the Workshop, the topics covered included the challenges of vaccine implementation against human papillomaviruses in countries under financial crisis, strategies for eradicating poliomyelitis and its 60th vaccine anniversary, as well as the debate on the association between autism and vaccination against measles, mumps and rubella. Among the non-vaccine related topics, emphasis was given to viral infections in prematurely born infants and their long-term outcomes, new paediatric intensive care management options for bronchiolitis related to respiratory syncytial virus, the clinical implications of hepatitis B virus and cytomegalovirus genotyping, the Ebola virus threat and preparedness in Paediatric Emergency Departments, oral, oropharynx, laryngeal, nasal and ocular viral infections and Merkel cell polyomavirus as a novel emerging virus of infancy and childhood. In this review, we provide selected presentations and reports discussed at the Workshop.

  6. Paediatric Burns in the Acute Phase: Specific Aspects


    Grisolia, G.A.; Pinzauti, E.; Pancani, S.; Pavone, M.


    This paper deals with specific aspects of paediatric burns in the acute phase and considers how the treatment of burned children differs from that of burned adults. The epidemiology of paediatric burns is reviewed. Particular aspects of the treatment of burned children are presented, with regard to treatment at the site of the accident, first aid, resuscitation, and local treatment. The importance of the accurate assessment of paediatric burns is stressed.

  7. Institutional review boards' attitudes towards remuneration in paediatric research

    DEFF Research Database (Denmark)

    Flege, Marius M; Thomsen, Simon F


    Remuneration in paediatric research poses an ethical dilemma. Too large a sum might cause parents to enrol their children in research projects with no benefit for the child, whereas too modest a sum might hamper recruitment. The institutional review boards have the responsibility to only approve...... remuneration in paediatric trials with ethically sound research plans. However, little is known about which factors influence institutional review boards' evaluation of remuneration in paediatric research....

  8. Minimum equipment guidelines for paediatric prehospital care (United States)

    Cheng, A; Hartfield, D


    Prehospital care has become a well-defined specialty service in Canada, with various levels of paramedics providing specialized care to children before their arrival to hospital. The equipment required may vary according to the needs of the population being served and the level of training of the paramedics who are providing the care. The present statement provides a current list of the minimum equipment recommended for the provision of prehospital care to neonatal and paediatric patients. The most notable change to the present guideline is the addition of an automated external defibrillator, which has been added to reflect the most recent version of the paediatric advanced life support recommendations for the provision of basic life support. PMID:22379382

  9. Dental fluorosis in the paediatric patient. (United States)

    Atia, Gahder-Sara; May, Joanna


    Exposure to excessive fluoride intake during the early childhood years can disrupt the normal development of enamel, resulting in dental fluorosis. This varies in severity, ranging from white opacities in mild cases to more severe black and brown discoloration or enamel pitting. This article aims to give the reader a better understanding of the aetiology, diagnosis and subsequent treatment of dental fluorosis in the paediatric patient. Fluorosis can have a marked effect on dental aesthetics. The prevalence of fluorosis in the United Kingdom may increase following the publication of Delivering Better Oral Health, published by the Department of Health in 2007, which suggested changes to fluoride levels in children's toothpastes. This article highlights the importance of accurate diagnosis of fluorosis and also explains the treatment options available to paediatric patients.

  10. Outcome of paediatric intensive care survivors


    Knoester, Hendrika; Grootenhuis, Martha A; Bos, Albert P.


    The development of paediatric intensive care has contributed to the improved survival of critically ill children. Physical and psychological sequelae and consequences for quality of life (QoL) in survivors might be significant, as has been determined in adult intensive care unit (ICU) survivors. Awareness of sequelae due to the original illness and its treatment may result in changes in treatment and support during and after the acute phase. To determine the current knowledge on physical and ...

  11. Review: behaviour management techniques in paediatric dentistry. (United States)

    Roberts, J F; Curzon, M E J; Koch, G; Martens, L C


    Behaviour management is widely agreed to be a key factor in providing dental care for children. Indeed, if a child's behaviour in the dental surgery/office cannot be managed then it is difficult if not impossible to carry out any dental care that is needed. It is imperative that any approach to behavioural management for the dental child patient must be rooted in empathy and a concern for the well being of each child. Based on various presentations given at Congresses of the European Academy of Paediatric Dentistry (EAPD), documents reviewing behaviour management prepared by the Clinical Affairs Committee of the EAPD, and written submissions to the Executive Board of the EAPD, a review of the various approaches to the behaviour management of the child dental patient was completed. All aspects of non-pharmacological behavioural management techniques described in the literature over the past 80 years were reviewed. There is a very wide diversity of techniques used but not all are universally accepted by specialist paediatric and general dentists. Wide cultural and philosophical differences are apparent among European paediatric dentists that seem difficult to bridge when forming agreed guidelines. Accordingly, this review highlights those behaviour techniques that are universally accepted such as tell, show, do (TSD) or positive reinforcement, but nevertheless describes the most commonly mentioned techniques for which there are descriptions in the literature. A wide variety of behavioural management techniques are available to paediatric dentists which must be used as appropriate for the benefit of each child patient, and which, importantly, must take into account all cultural, philosophical and legal requirements in the country of dental practice of every dentist concerned with dental care of children.

  12. Imaging of accidental paediatric head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Phua Hwee [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Lim, Choie Cheio Tchoyoson [National Neuroscience Institute, Department of Neuroradiology, Singapore (Singapore)


    Head trauma is the most common form of injury sustained in serious childhood trauma and remains one of the top three causes of death despite improved road planning and safety laws. CT remains the first-line investigation for paediatric head trauma, although MRI may be more sensitive at picking up the full extent of injuries and may be useful for prognosis. Follow-up imaging should be tailored to answer the specific clinical question and to look for possible complications. (orig.)

  13. Developmental and acquired dyslexias. (United States)

    Temple, Christine M


    Marshall (1984) highlighted potential parallels between children with developmental disorders of reading and adults who had acquired reading disorders. He advocated the use of a cognitive neuropsychological framework in the investigation of children with developmental abnormalities of cognition, including those with developmental dyslexias. Developmental phonological dyslexia has been extensively described and is a pervasive disorder. The relationship between reading difficulty and phonological difficulties evident in explicit oral phonological tasks continues to be a focus for debate. Clear cases of developmental deep dyslexia have now been described and the syndrome has also been described as characterising early reading development in Williams syndrome (WS), where there are also semantic errors in other domains, including naming and receptive vocabulary and there may be a generalised difficulty with the activation of fine grain semantic specifications. In the domain of number, highly selective reading disorders characterised by high rates of semantic errors have been documented, indicating that semantic reading errors can be domain-specific. They can occur to number words despite intact ability to read Arabic numbers and they can occur to Arabic numbers and number words despite intact ability to read words in other domains. Current models of reading written words do not allow for such material-specific dissociation. Developmental surface dyslexia has also been described in a range of countries, languages and orthographies. Descriptions of cases for whom there is no phonological impairment in reading have generated contrary evidence for theories suggesting that phonological impairment underlies all developmental dyslexia. As reading develops in Williams Syndrome, phonological reading skills may improve with over-reliance on these leading to surface dyslexia. Surface dyslexia has also been reported in cases of developmental amnesia in which there are semantic

  14. Peer Teaching in der Pädiatrie - Evaluation eines studentischen Tutoriats im Blockpraktikum Kinderheilkunde [Peer Teaching in Paediatrics - Medical Students as Learners and Teachers on a Paediatric Course

    Directory of Open Access Journals (Sweden)

    Karay, Yassin


    Full Text Available [english] Background: Peer assisted learning is known as an effective educational strategy in medical teaching. We established a peer assisted teaching program by student tutors with a focus on clinical competencies for students during their practical training on paediatric wards. It was the purpose of this study to investigate the effects of a clinical skills training by tutors, residents and consultants on students evaluations of the teaching quality and the effects of a peer teaching program on self assessed clinical competencies by the students.Methods: Medical student peers in their 6 year were trained by an intensive instruction program for teaching clinical skills by paediatric consultants, doctors and psychologists. 109 students in their 5 year (study group participated in a peer assisted teaching program for training clinical skills in paediatrics. The skills training by student peer teachers were supervised by paediatric doctors. 45 students (control group participated in a conventional paediatric skills training by paediatric doctors and consultants. Students from both groups, which were consecutively investigated, completed a questionnaire with an evaluation of the satisfaction with their practical training and a self assessment of their practical competencies. Results: The paediatric skills training with student peer teachers received significantly better ratings than the conventional skills training by paediatric doctors concerning both the quality of the practical training and the support by the teaching medical staff. Self assessed learning success in practical skills was higher rated in the peer teaching program than in the conventional training. Conclusions: The peer assisted teaching program of paediatric skills training was rated higher by the students regarding their satisfaction with the teaching quality and their self assessment of the acquired skills. Clinical skills training by student peer teachers have to be supervised

  15. [The latest in paediatric resuscitation recommendations]. (United States)

    López-Herce, Jesús; Rodríguez, Antonio; Carrillo, Angel; de Lucas, Nieves; Calvo, Custodio; Civantos, Eva; Suárez, Eva; Pons, Sara; Manrique, Ignacio


    Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation. This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  16. Mineral trioxide aggregate in paediatric dentistry. (United States)

    Srinivasan, Vidya; Waterhouse, Paula; Whitworth, John


    The aim of this study was to present a review of the reported literature on: (i) the physical and chemical properties; and (ii) clinical applications of mineral trioxide aggregate (MTA) in the practice of paediatric dentistry. Electronic literature search of scientific papers from January 1993 to June 2008 was carried out on the MEDLINE, Embase, Entrez Pubmed, and Scopus databases using specific key words. The search yielded 448 papers, out of which 100 were identified as conforming to the applied criteria. These papers formed the basis of the review and the clinical scenarios presented which demonstrate the application of MTA in the practice of paediatric dentistry. Paediatric dentists have successfully employed MTA in a variety of endodontic/restorative applications since the late 1990s. Clinical impressions have generally been favourable and support the findings of laboratory and animal-based investigations. Very few clinical studies have been reported so far in humans, and although these have been positive, the body of research is currently insufficient to enable a meaningful systematic review and meta-analysis.

  17. Paediatrics and the doctor-soldier. (United States)

    Pearn, John H


    Sick and injured children, like combatants wounded by shot and shell in war, are disproportionately represented in the tallies of both man-made and national disasters. Paediatricians have a particularly proud heritage of military service, a nexus dating in Australia from the early 19th century. This paper traces this link between service to children in peacetime and the care of servicemen, women and children in times of war and disaster. The extraordinary record of Australian 'paediatric' doctors who also served in the Gallipoli Campaign (1915) is documented as an illustration of this duality. Paediatricians who serve in the Defence Reserves and in civilian non-government organisations which respond to disasters and civil wars have special credentials in their advocacy for the protection of children enmeshed in conflict or disaster. Such applies particularly to the banning of the recruitment and use of child soldiers; support for children caught up in refugee and illegal immigrant confrontations; and continued advocacy for greater international compliance with the Ottawa Convention to ban the use of anti-personnel landmines. Volunteering for such service must occur in cold 'down time', ensuring that paediatricians are trained in disaster and conflict response, when such challenges inevitably confront the paediatricians of the future. © 2012 The Author. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Perception of dental aesthetics in paediatric dentistry. (United States)

    Vale, T; Santos, P; Moreira, J; Manzanares, M C; Ustrell, J M


    Assessing the perception of the aesthetic components of the oral health by paediatric patients at different stages of the child psychological development of Piaget. Twenty children aged between 21 months and 11 years, of both sexes, patients of a private clinic, were selected. The present study group consisted of patients treated for oral pathologies. A set of similar supplies was given to all children and they were asked to do a drawing, whose theme was "beautiful teeth and ugly teeth". The drawings were evaluated according to the classification of the cognitive development of Piaget. Children of all ages clearly represent their perception of what "beautiful teeth" and "ugly teeth" are. These representations provide the dental professional a clear vision of the child's feeling about dental aesthetics. The drawings are a useful source of information for assessing the aesthetic perception of paediatric patients. The knowledge of the children's aesthetic perception is relevant to paediatric dentists because children are conscious about their dental aesthetic appearance and that of the other children.

  19. Percutaneous Nephrolithotomy for Paediatric Stone Disease

    Directory of Open Access Journals (Sweden)

    Hüseyin Çelik


    Full Text Available We evaluated the outcomes and complications occurring following percutaneous nephrolithotomy (PCNL procedures performed in paediatric patients. There were 291 paediatric patients (293 renal units included in the current study and who underwent PCNL in our clinic between March 1999 and December 2014. We evaluated stone burden, duration of surgery and complications, success (stone-free rate, residual fragments and auxilliary procedures, and follow-up details. The stone-free rate following PCNL was 88.3%. Early postoperative complications included excessive bleeding and transfusion in nine patients, and prolonged urinary extravasation following removal of the nephrostomy tube and requiring JJ stent placement in eight patients. The mean time to catheter removal was 2.8 days and the mean hospitalisation time was 3.5 days. The aim of kidney stone treatment is to achieve minimal kidney damage with the highest success rate. Therefore, minimally invasive procedures are important in the paediatric age group where life expectancy is high. PCNL is a safe and effective procedure for the treatment of kidney stones in children.


    Directory of Open Access Journals (Sweden)

    Pradeep Raghavendra Kulkarni


    Full Text Available BACKGROUND The aim of the study is to determine the utility of chest sonography in common paediatric diseases and to present chest sonography images with possible explanation for the same. MATERIALS AND METHODS This retrospective study was conducted in Department of Paediatric Medicine, Bharati Medical College, Sangli. The patients admitted in paediatric ward, NICU, PICU with respiratory complaints and findings were subjected to chest sonography after chest x-ray. The chest sonography images were interpreted and an attempt was made to correlate with findings of chest xray. The information given by chest sonography was analysed and possible cause of image was evaluated. RESULTS The chest sonography appearances were found to be specific and in certain instances more informative than chest x-ray. It can differentiate between collapse and consolidation easily. The limitation of chest sonography was- it can assess only peripheral lung regions with inability to assess deeper lesions, especially with aerated peripheral lung. CONCLUSION The chest sonography is superior to chest x-ray in diagnosing minimal effusion and minimal pneumothorax. Also, when there is difficulty in differentiating pulmonary from pleural pathology. Though, chest sonography cannot replace chest x-ray, it is very useful additional investigation and often times very helpful with additional diagnostic information.

  1. The decision to integrate vertically in health care organizations. (United States)

    Mick, S S; Conrad, D A


    A scheme to help health care managers make decisions regarding vertical integration (and deintegration) strategies and to alert health care managers to a more analytic view of vertical integration that may help avoid costly mistakes is presented. Central to the decision-making scheme is the comparison between the costs of purchasing goods and services from (and selling them to) other organizations and the costs of acquiring (and supplying) the same goods and services within one's own organization. Whether outside or inside an organizational boundary, these costs (called transaction costs) may be important in determining whether vertical integration is an appropriate organizational strategy (Williamson 1975).

  2. Learning-by-Being-Acquired

    DEFF Research Database (Denmark)

    Colombo, Massimo Gaetano; Moreira, Solon; Rabbiosi, Larissa


    In horizontal acquisitions, the post-acquisition integration of the R&D function often damages the inventive labor force and results in lower innovative productivity of acquired inventors. In this paper we study post-acquisition integration in terms of R&D team reorganization-i.e., the creation......’ use of the prior stock of technological knowledge of the acquiring firm after the acquisition. Furthermore, this effect is enhanced if the focal acquired inventor has high relative innovation ability but is weakened for acquired inventors with high ingroup collaborative strength. We construct a sample...

  3. Community-acquired bacterial meningitis

    NARCIS (Netherlands)

    van de Beek, Diederik; Brouwer, Matthijs; Hasbun, Rodrigo; Koedel, Uwe; Whitney, Cynthia G.; Wijdicks, Eelco


    Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma

  4. Diel vertical migrat..

    African Journals Online (AJOL)


    Jan 24, 2002 ... crustacean zooplankton but also in a Wide array of different marine zooplankton groups. (Russell 1927, McLaren 1963). Thus there is no doubt that ..... cooperation during field work and for their fruitful discussion on the draft manuscript. REFERENCES. Bayly lAE 1986 Aspects of diel vertical migration in ...

  5. Vertical market participation

    DEFF Research Database (Denmark)

    Schrader, Alexander; Martin, Stephen


    Firms that operate at both levels of vertically related Cournot oligopolies will purchase some input supplies from independent rivals, even though they can produce the good at a lower cost, driving up input price for nonintegrated firms at the final good level. Foreclosure, which avoids this stra...... this strategic behavior, yields better market performance than Cournot beliefs...

  6. Hunting Voronoi vertices

    NARCIS (Netherlands)

    Ferrucci, V.; Overmars, Mark; Rao, A.; Vleugels, J.


    Given three objects in the plane, a Voronoi vertex is a point that is equidistant simultaneously from each. In this paper, we consider the problem of computing Voronoi vertices for planar objects of xed but possibly unknown shape; we only require the ability to query the closest point on an object

  7. Vertical shaft windmill (United States)

    Grana, D. C.; Inge, S. V., Jr. (Inventor)


    A vertical shaft has several equally spaced blades mounted. Each blade consists of an inboard section and an outboard section skew hinged to the inboard section. The inboard sections automatically adjust their positions with respect to the fixed inboard sections with changes in velocity of the wind. This windmill design automatically governs the maximum rotational speed of shaft.

  8. Profile and Outcome Analysis of Paediatric Admissions into a ...

    African Journals Online (AJOL)

    Mortality rate was 36.5% while 63.5% were transferred to the paediatric wards for further management. TBI accounted for the largest number of deaths (26.3%) in the unit, followed by burns (15.8%) and intracranial tumours (10.5%). Conclusion/ Recommendation: Paediatric admissions in our general intensive care unit are ...

  9. Weight-band dosing tables: simplifying paediatric art | Nuttall ...

    African Journals Online (AJOL)

    One of the obstacles to scaling up paediatric antiretroviral therapy (ART) coverage in resource-limited settings is the relative complexity of paediatric dosing. There is a need to simplify ART in order to facilitate treatment initiation and ongoing management of infants and children by health care providers, as well as to support ...

  10. Development of a subspecialty cardiology curriculum for paediatric ...

    African Journals Online (AJOL)

    Background: Malawi has a high burden of paediatric cardiac disease but a limited number of health providers familiar with these chronic diseases. Given the rising number of Malawian postgraduate paediatric trainees at the University of Malawi College of Medicine, we sought to remedy this lack of basic cardiology training ...

  11. The Manchester Triage System in paediatric emergency care

    NARCIS (Netherlands)

    M. van Veen (Mirjam)


    textabstractIn the first part of the thesis performance of the Manchester Triage System in paediatric emergency care was evaluated. In chapter 1 we reviewed the literature to evaluate realibility and validity of triage systems in paediatric emergency care. The Manchester Triage System was used to

  12. Primary cardiac tumours in a paediatric population: An experience ...

    African Journals Online (AJOL)

    Background: To observe the histopathological spectrum of primary cardiac tumours in paediatric population those came in Pathology Department over a period of last 16 years. Materials and Methods: During the time period of 16 years (1995-2010), we had received 16 cases of primary cardiac tumours in paediatric patients ...

  13. Sedation for paediatric auditory electrophysiology in South Africa

    African Journals Online (AJOL)

    The variety of medical locations requiring sedation services includes radiology, dentistry, paediatric inpatient services, emergency departments and nuclear medicine.1 Added to this is the periodic need for sedation with diagnosis in allied medical professions such as optometry, audiology and physiotherapy. In paediatric ...

  14. Paediatric Refractive Errors in an Eye Clinic in Osogbo, Nigeria ...

    African Journals Online (AJOL)

    Paediatric Refractive Errors in an Eye Clinic in Osogbo, Nigeria. Isawumi Michaeline, Agboola Sheriff, Ayegoro Bimbo. Abstract. Background: Paediatric ophthalmology is an emerging subspecialty in Nigeria and as such there is paucity of data on refractive errors in the country. This study set out to determine the pattern of ...

  15. Pattern Of Paediatric Malignancies Seen At The Radiotherapy ...

    African Journals Online (AJOL)

    Background: Paediatric tumours are seen by the radiotherapist following referral from other specialists. Patients seen by the radiotherapists may not conform to the full spectrum seen in the hospital. Objective: To review the pattern of presentation of paediatric malignancies seen at the radiotherapy department of the UCH, ...

  16. glomerular filtration rate profiles in paediatric patients on cancer

    African Journals Online (AJOL)


    May 28, 2013 ... The glomerular filtration rate (GFR) is widely accepted as the best index of renal function in patients. Chemotherapy is the mainstay of treatment in the paediatric oncology unit at the Kenyatta National Hospital. Objectives: To determine the glomerular filtration rate profiles of paediatric oncology patients and ...

  17. Good long-term survival after paediatric heart transplantation

    DEFF Research Database (Denmark)

    Kruse, Charlotte Duhn; Helvind, Morten; Jensen, Tim


    The brain-death criterion was introduced in Denmark in 1990. The first Danish paediatric heart transplantation (HTx) was performed at Copenhagen University Hospital, Rigshospitalet, in Copenhagen in 1991. We describe our experiences during the first 20 years with paediatric HTx....

  18. HIV infection, tuberculosis and workload in a general paediatric ward

    African Journals Online (AJOL)

    Aim. To describe the impact of HIV infection and tuberculosis on the workload of a general paediatric ward at Red Cross War Memorial Children's Hospital in 2007. Methods. Prospective descriptive surveillance of the patient composition of a general paediatric ward over a 1-year period. Results. Median bed occupancy was ...

  19. A practical approach to anaesthesia for paediatric liver transplantation

    African Journals Online (AJOL)

    A practical approach to anaesthesia for paediatric liver transplantation. Jenny Thomas, M McCulloch, W Spearman, T Butt, A Numanoglu. Abstract. Anaesthesia for paediatric liver transplantation requires meticulous attention to detail, an understanding of the disease process leading up to the need for transplantation, and an ...

  20. Bacteraemia in a paediatric oncology unit in South Africa

    NARCIS (Netherlands)

    van de Wetering, M. D.; Poole, J.; Friedland, I.; Caron, H. N.


    To identify the morbidity and mortality due to infections in a South African paediatric oncology unit, and to identify risk factors associated with first bacteraemic episodes in this unit. A retrospective cohort study was done in a large regional referral paediatric cancer centre from 1991-1995, of

  1. Paediatric surgical abdominal emergencies in a north central ...

    African Journals Online (AJOL)

    Background/objective Paediatric surgical abdominal emergencies (PSAEs) account for 2.4–3.1% of all ... of Surgery, Division of Paediatric Surgery, University of Ilorin Teaching Hospital,. PO Box 5291, Ilorin 240001, Nigeria .... There were four cases each of high and intermediate anomalies, whereas three cases were low ...

  2. Paediatric admissions and outcome in a general intensive care unit ...

    African Journals Online (AJOL)

    Paediatric admissions and outcome in a general intensive care unit. HY Embu, SJ Yiltok, ES Isamade, SI Nuhu, OO Oyeniran, FA Uba. Abstract. Background: It is believed that intensive care greatly improves the prognosis for critically ill children and that critically ill children admitted to a dedicated Paediatric Intensive Care ...

  3. [Materials for the paediatric resuscitation trolley or backpack: Expert recommendations]. (United States)

    López-Herce Cid, Jesús; Rodríguez Núñez, Antonio; Carrillo Álvarez, Ángel; Zeballos Sarrato, Gonzalo; Martínez Fernández-Llamazares, Cecilia; Calvo Macías, Custodio


    Cardio-respiratory arrest (CPA) is infrequent in children, but it can occur in any place and at any time. This fact means that every health care facility must always have the staff and material ready to resuscitate a child. These recommendations are the consensus of experts of the Spanish Paediatric and Neonatal Resuscitation Group on the material and medication for paediatric and neonatal resuscitation and their distribution and use. CPR trolleys and backpacks must include the essential material to quickly and efficiently perform a paediatric CPR. At least one CPR trolley must be available in every Primary Care facility, Paediatric Intensive Care Unit, Emergency Department, and Pre-hospital Emergency Areas, as well as in paediatric wards, paediatric ambulatory areas, and radiology suites. This trolley must be easily accessible and exclusively include the essential items to perform a CPR and to assist children (from newborns to adolescents) who present with a life-threatening event. Such material must be familiar to all healthcare staff and also include the needed spare parts, as well as enough drug doses. It must also be re-checked periodically. The standardisation and unification of the material and medication of paediatric CPR carts, trolleys, and backpacks, as well as the training of the personnel in their use are an essential part of the paediatric CPR. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  4. Use of Zoledronic Acid in Paediatric Craniofacial Fibrous Dysplasia

    Directory of Open Access Journals (Sweden)

    Chiara Di Pede


    Full Text Available We describe a case of a paediatric patient affected by mandibular fibrous dysplasia (FD with severe and chronic pain who was successfully treated with zoledronic acid (ZOL: a third-generation bisphosphonate. Further research is needed to assess its safety and efficacy as a treatment option for FD in the paediatric population.

  5. Paediatric lung function testing : determinants and reference values

    NARCIS (Netherlands)

    Koopman, Marije


    Paediatric lung function tests provide objective measures in diagnosis and follow-up of lung diseases, and give insight in the pathophysiology of lung growth and development. In the first part of the thesis, paediatric lung function tests were used to investigate determinants of lung growth and

  6. Liver Transplant in Paediatrics | Popoola | Journal of the Obafemi ...

    African Journals Online (AJOL)

    Paediatric liver transplantation is a very interesting and challenging field. In the past 2 decades, it has become widely accepted as an established therapeutic measure for managing children with end stage liver disease. Liver diseases are responsible for less than 1% of morbidity and mortality in the paediatric age group in ...

  7. Anaesthesia for paediatric cataracts in developing countries - a ...

    African Journals Online (AJOL)

    Consequently, several centres have developed different approaches for the administration of anaesthesia in the management of these paediatric cataracts. Ketamine alone or with adjunct local anaesthesia is widely used. There is a real need for paediatric anaesthesia resources (human and material) in many developing ...

  8. Paediatric surgical abdominal emergencies in a north central ...

    African Journals Online (AJOL)

    Background/objective Paediatric surgical abdominal emergencies (PSAEs) account for 2.4–3.1% of all paediatric admissions. The causes of PSAEs vary worldwide, and the management is challenging, often with unimaginably poor outcome if not carefully handled. The aim of this study was to determine the patterns and ...

  9. Exciting times: Towards a totally minimally invasive paediatric ...

    African Journals Online (AJOL)

    Following on from the first paediatric laparoscopic nephrectomy in 1992, the growth of minimally invasive ablative and reconstructive procedures in paediatric urology has been dramatic. This article reviews the literature related to laparoscopic dismembered pyeloplasty, optimising posterior urethral valve ablation and ...

  10. Video laryngoscopy in paediatric anaesthesia in South Africa ...

    African Journals Online (AJOL)

    Video laryngoscopy in paediatric anaesthesia in South Africa. LN Nienaber. Abstract. This article provides a summary of the types of video laryngoscopes available in South Africa, and highlights some interesting paediatric cases in which video laryngoscopes were used at the Steve Biko Academic Hospital, Pretoria.

  11. Diffusion-weighted MRI in paediatric oncology: lymphoma and nephroblastoma

    NARCIS (Netherlands)

    Littooij, A.S.


    The aim of this thesis was to assess the value of MRI including DWI in paediatric lymphoma and nephroblastoma. Part I - lymphoma The use of FDG-PET/CT in staging paediatric lymphoma is generally incorporated into current guidelines.However, the most important disadvantage of FDG-PET/CT is the use of

  12. Paediatric trauma care | Cywes | South African Medical Journal

    African Journals Online (AJOL)

    Paediatric trauma care varies in different countries. In South Africa injury is the leading cause of death in the 5 - 14-yearold age group - 1,5 - 3,8 times higher than in the USA. In 1978 the Child Safety Centre was established and prospectively collected data on paediatric injuries. The various types of injuries are discussed.

  13. Outcome of tube thoracostomy in paediatric non-traumatic pleural ...

    African Journals Online (AJOL)

    Objective: Management of pleural fluid collection not due to trauma increases workload of the paediatric thoracic surgeons, while delay or inappropriate treatment worsens the prognosis of the disease. This study aimed at assessing the outcome of therapeutic tube thoracostomy in non-traumatic paediatric pleural fluid ...

  14. Fate of abstracts presented at Association of Paediatric Surgeons of ...

    African Journals Online (AJOL)

    Background: The purpose of this study was to examine the characteristics of abstracts presented at the annual scientific meetings of Association of Paediatric Surgeons of Nigeria and their final publication rate. Materials and Methods: All abstracts accepted for presentation at the Association of Paediatric Surgeons of Nigeria ...

  15. Paediatric electronic infusion calculator: An intervention to eliminate infusion errors in paediatric critical care. (United States)

    Venkataraman, Aishwarya; Siu, Emily; Sadasivam, Kalaimaran


    Medication errors, including infusion prescription errors are a major public health concern, especially in paediatric patients. There is some evidence that electronic or web-based calculators could minimise these errors. To evaluate the impact of an electronic infusion calculator on the frequency of infusion errors in the Paediatric Critical Care Unit of The Royal London Hospital, London, United Kingdom. We devised an electronic infusion calculator that calculates the appropriate concentration, rate and dose for the selected medication based on the recorded weight and age of the child and then prints into a valid prescription chart. Electronic infusion calculator was implemented from April 2015 in Paediatric Critical Care Unit. A prospective study, five months before and five months after implementation of electronic infusion calculator, was conducted. Data on the following variables were collected onto a proforma: medication dose, infusion rate, volume, concentration, diluent, legibility, and missing or incorrect patient details. A total of 132 handwritten prescriptions were reviewed prior to electronic infusion calculator implementation and 119 electronic infusion calculator prescriptions were reviewed after electronic infusion calculator implementation. Handwritten prescriptions had higher error rate (32.6%) as compared to electronic infusion calculator prescriptions (pharmacy interventions. Use of electronic infusion calculator for infusion prescription significantly reduced the total number of infusion prescribing errors in Paediatric Critical Care Unit and has enabled more efficient use of medical and pharmacy time resources.

  16. Vertical gastroplasty: evolution of vertical banded gastroplasty. (United States)

    Mason, E E; Doherty, C; Cullen, J J; Scott, D; Rodriguez, E M; Maher, J W


    The objective of this paper is to summarize the goals, technical requirements, advantages, and potential risks of gastroplasty for treatment of severe obesity. Gastroplasty is preferred to more complex operations, as it preserves normal digestion and absorption and avoids complications that are peculiar to exclusion operations. The medical literature and a 30-year experience at the University of Iowa Hospitals and Clinics (UIHC) provides an overview of vertical banded gastroplasty (VBG) evolution. Preliminary 10-year results with the VBG technique currently used at UIHC are included. At UIHC the VBG is preferred to other gastroplasties because it provides weight control that extends for at least 10 years and the required objective, intraoperative quality control required for a low rate of reoperation. It is recommended that modifications of the operative technique not be attempted until a surgeon has had experience with the standardized operation--and then only under a carefully designed protocol. Realistic goals for surgery and criteria of success influence the choice of operation and the optimum, lifelong risk/benefit ratio. In conclusion, VBG is a safe, long-term effective operation for severe obesity with advantages over complex operations and more restrictive simple operations.

  17. Sigmoid plate dehiscence: Congenital or acquired condition?

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Zhaohui, E-mail: [Capital Medical University, Beijing Tongren Hospital, No 1 Dong Jiao Min Street, Dongcheng District, Beijing 100730 (China); Li, Jing, E-mail: [Capital Medical University, Beijing Tongren Hospital, No 1 Dong Jiao Min Street, Dongcheng District, Beijing 100730 (China); Zhao, Pengfei, E-mail: [Capital Medical University, Beijing Friendship Hospital, No 95 Yongan Road, Xicheng District, Beijing 100050 (China); Lv, Han, E-mail: [Capital Medical University, Beijing Friendship Hospital, No 95 Yongan Road, Xicheng District, Beijing 100050 (China); Dong, Cheng, E-mail: [Capital Medical University, Beijing Friendship Hospital, No 95 Yongan Road, Xicheng District, Beijing 100050 (China); Liu, Wenjuan, E-mail: [Jining No. 1 People' s Hospital, No. 6 Health Street, Jining 272100 (China); Wang, Zhenchang, E-mail: [Capital Medical University, Beijing Friendship Hospital, No 95 Yongan Road, Xicheng District, Beijing 100050 (China)


    Highlights: • CT with multiplanar reformations can accurately display the sigmoid platet dehiscence. • The prevalence of sigmoid plate dehiscence was no significant difference among different age groups. • The size of sigmoid plate bony defects were not statistically different among different age groups. • The sigmoid plate dehiscence is more commonly a congenital than an acquired condition. - Abstract: Background and purpose: The imaging features of sigmoid plate dehiscence-induced pulsatile tinnitus have been presented. The origin of the sigmoid plate dehiscence, however, remains unclear. Our aim was to assess the prevalence and extent of sigmoid plate dehiscence on computed tomography (CT) images in multiple age groups to determine whether this condition is more likely to be congenital or acquired. Materials and methods: We retrospectively reviewed contrast-enhanced CT images of sigmoid plates of temporal bones in 504 patients. Each temporal bone was characterized as normal or dehiscent. Patients were then subcategorized into four age groups, and the prevalence and extent of dehiscent sigmoid plates in each group were calculated and compared. Results: Overall, 80 patients had sigmoid plate dehiscence, nine of whom had it bilaterally. In successively older age groups, the prevalences of sigmoid plate dehiscence were 18.9%, 20.1%, 14.5%, and 12.7%, respectively. Respective average anteroposterior bony defect diameters were 3.7 ± 1.7, 3.0 ± 1.3, 3.1 ± 1.5, and 3.0 ± 1.1 mm. Respective average vertical bony defect diameters were 3.6 ± 2.3, 2.6 ± 1.2, 3.2 ± 1.5, and 3.0 ± 1.7 mm. The prevalence and extent of sigmoid plate dehiscence were not statistically different among the four age groups. Conclusions: The similar radiologic prevalence and extent of dehiscent sigmoid plates among the age groups suggest that the dehiscence is more commonly a congenital than an acquired condition.

  18. The need of paediatric dentistry specialists in Pakistan. (United States)

    Khan, Farhan Raza; Mahmud, Sadia; Rahman, Munawar


    In the last decade, a rapid increase has been observed in the number of dentists due to establishment of a number of dental colleges in Pakistan. Very few of these institutions have Paediatric Dentistry Department. Similarly, no postgraduate Paediatric Dentistry training program exists in the two major provinces of the country. The objectives of this study were to map the pattern of paediatric dentistry services provided by the clinicians in teaching institutions and private practices. A cross-sectional study was conducted at dental departments of academic institutions and selected dental practices in Karachi. There was a statistically significant difference in preferences, selection of dental materials and pattern of paediatric dentistry services provided by the teaching dentists compared to the private practitioners. Both the teaching and non-teaching dentists need to update themselves in the provision of Paediatric Dentistry services such as fluoride application and fissure sealant placement.

  19. Pancreaticoduodenectomy in children: optimising outcome of uncommon paediatric procedures.

    LENUS (Irish Health Repository)

    Yeap, B H


    Contemporary surgical practice is increasingly dominated by subspecialisation in response to improved outcome from high volume centres, though uncertainties persist for uncommon paediatric procedures. Three paediatric pancreaticoduodenectomies performed at Our Lady\\'s Children\\'s Hospital, Dublin, over a period of 9 years were evaluated to substantiate their continuing performance by paediatric rather than adult pancreatic surgeons. With ages ranging from 18 months to 8 years old, the mean operating time was 263 minutes, while the average hospital stay was 12 days. There was no perioperative mortality, although complication rate was 100%. Re-operation was required in 33%. The long term outcome of this small paediatric cohort was comparable to adult series despite the low patient accrual, underscoring the advantages of a multidisciplinary approach afforded by tertiary paediatric institutions for intricate yet infrequent operations in children.

  20. Voluntary Informed Consent in Paediatric Oncology Research. (United States)

    Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M


    In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. © 2015 John Wiley & Sons Ltd.

  1. High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

    NARCIS (Netherlands)

    Morsing, IE; Tinnevelt, Marcel; Jansen, Nicolaas J.G.; Koomen, E


    High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation

  2. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten


    at disease onset, cerebrospinal fluid findings, magnetic resonance imaging (MRI) and evoked potentials at the first demyelinating event. These data were compared with similar nationwide data from adults in Denmark. RESULTS: The median age was 14 (range 10-15) years at the first demyelinating event......: 66-100%) of paediatric MS subjects, 77% (CI: 46-95%) had an elevated IgG index and 85% (CI: 55-98%) had oligoclonal bands in the cerebrospinal fluid. MRI showed characteristic white matter lesions in all children (CI: 80-100%). CONCLUSION: MS symptoms at the first demyelinating event and diagnostic...

  3. Practical body MRI-A paediatric perspective. (United States)

    Olsen, Oystein E


    This review is aimed at practicing radiologists and technicians, and seeks to explore the main factors influencing quality in body magnetic resonance imaging (MRI), paediatric in particular. Important considerations include the selection of voxel size, striking the right balance between achievable signal-to-noise ratio (SNR) versus allowable motion artefact when adjusting the acquisition time, and optimising image contrast, which often is inherently different compared with adult pathologies. Based on this, optimisation of staple pulse sequences, and a practical approach to body imaging, will be discussed in more detail.

  4. Juvenile idiopathic arthritis: the paediatric perspective

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, Alison [Birmingham Children' s Hospital, Department of Adolescent Rheumatology, Birmingham (United Kingdom); McDonagh, Janet E. [Birmingham Children' s Hospital, Institute of Child Health, Birmingham (United Kingdom)


    Paediatric rheumatology is a relatively new specialty that has developed rapidly over the last 30 years. There have been major advances, which have included improvements in the classification and management of juvenile idiopathic arthritis (JIA). The former has led to enhanced international collaboration with disease registries, multicentre research and the development of new therapeutic agents. This has resulted in improved disease control and remission induction in many. There is, however, still significant morbidity associated with JIA during childhood, adolescence and adulthood, and challenges for the future include early identification of those with a poorer prognosis, appropriate administration of safe therapies and optimizing outcomes as young people move through adolescence into adulthood. (orig.)

  5. The Investigation of Proptosis in Paediatric Practice

    Directory of Open Access Journals (Sweden)

    Ms Sayantani Ghosh


    Full Text Available A retrospective review of 65 cases of paediatric proptosispresenting to a rural teaching hospital in India, from February2006 to June 2008. There were 17 cases with orbital cellulitisand 15 with retinoblastoma. We report the history, clinicalexamination, radiological findings and diagnosis. Most caseshad a characteristic history and pathognomonic eye signs.Computer Tomography (CT correlated with histopathology inmost cases. CT is widely available, even within a remotesetting, and is a convenient investigation. Thus, a detailedhistory, clinical examination and CT scan were the mostfruitful approach to the diagnosis of childhood proptosis inthis series.

  6. Somatically acquired structural genetic differences

    DEFF Research Database (Denmark)

    Magaard Koldby, Kristina; Nygaard, Marianne; Christensen, Kaare


    Structural genetic variants like copy number variants (CNVs) comprise a large part of human genetic variation and may be inherited as well as somatically acquired. Recent studies have reported the presence of somatically acquired structural variants in the human genome and it has been suggested...... with age.European Journal of Human Genetics advance online publication, 20 April 2016; doi:10.1038/ejhg.2016.34....

  7. Citation context and impact of ‘sleeping beauties’ in paediatric research (United States)

    Završnik, Jernej; del Torso, Stefano; Blažun Vošner, Helena


    Objectives ‘Sleeping beauties’, i.e. publications that are not cited for a long while, present interesting findings in science. This study analysed the citation trends of sleeping beauties in paediatric research. Methods The study used bibliometric software to analyse the papers citing sleeping beauties in paediatric research, to understand the context in which paediatric sleeping beauties were finally cited and the impact of these sleeping beauties on paediatric research. Results Two paediatric sleeping beauties, addressing medical homes and the transition from paediatric to adult health care, respectively, awakened in response to organizational needs. Both presented novel concepts of paediatric service organization that became important because of an increased need for optimization of services. Conclusion All sleeping beauties bring new knowledge that becomes important only after several years. Paediatric sleeping beauties exhibited unique characteristics; however, their presence in paediatric research shows that knowledge acquisition in paediatrics resembles that in other disciplines. PMID:27834306

  8. Paediatric Halitosis and Helicobacter pylori Infection. (United States)

    Yilmaz, Ayse Esra; Bilici, Meki; Tonbul, Alparslan; Karabel, Musemma; Dogan, Guzide; Tas, Tugba


    To compare the presence of Helicobacter pylori (H. pylori) infection by stool antigen test in children with and without halitosis. Comparative study. Department of Paediatrics, Fatih University Hospital, Ankara, Turkey, between December 2008 and June 2009. Fifty-three patients aged between 3-15 years who presented to paediatrics outpatient clinic with halitosis and 55 healthy children aged between 4-15 years without halitosis were included in the study. Halitosis was confirmed with organoleptic test. Stool antigen test was performed in both groups. Intergroup proportions were compared using chisquare and Fisher exact tests with significance at p halitosis and 12 of 55 healthy controls (21.8%). The rate of positive H. pylori stool antigen test results were similar between two groups (p > 0.05). Twoweeks eradication treatment was administered to 11 patients with H. pylori infection and halitosis. After treatment, the symptoms of 8 patients with halitosis (72.7%) completely resolved and persisted in 3 patients (27.3%). Seven of the 11 patients who were administered eradication treatment also had abdominal pain along with halitosis. Both symptoms completely resolved in all those patients after treatment. Although no statistically significant difference existed between the rate of H. pylori infections among those with and without halitosis. Eradication treatment was found beneficial in the treatment of children with halitosis and positive H. pylori stool antigen test.

  9. The imaging of paediatric thoracic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael A.; Westra, Sjirk J. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Wallace, E.C. [UMass Memorial Medical Center and University of Massachusetts Medical School, Department of Radiology, Worcester, MA (United States)


    Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity. (orig.)

  10. A paediatric X-ray exposure chart

    Energy Technology Data Exchange (ETDEWEB)

    Knight, Stephen P, E-mail: [Department of Medical Imaging, Royal Children' s Hospital, Brisbane, Queensland (Australia)


    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

  11. Priority setting in paediatric preventive care research. (United States)

    Lavigne, Mikael; Birken, Catherine S; Maguire, Jonathon L; Straus, Sharon; Laupacis, Andreas


    To identify the unanswered research questions in paediatric preventive care that are most important to parents and clinicians, and to explore how questions from parents and clinicians may differ. Iterative mixed methods research priority setting process. Toronto, Ontario, Canada. Parents of children aged 0-5 years enrolled in a research network in Toronto, and clinicians practising in Toronto, Ontario, Canada. Informed by the James Lind Alliance's methodology, an online questionnaire collected unanswered research questions in paediatric preventive care from study participants. Similar submissions were combined and ranked. A consensus workshop attended by 28 parents and clinicians considered the most highly ranked submissions and used the nominal group technique to select the 10 most important unanswered research questions. Forty-two clinicians and 115 parents submitted 255 and 791 research questions, respectively, which were combined into 79 indicative questions. Most submissions were about nutrition, illness prevention, parenting and behaviour management. Parents were more likely to ask questions about screen time (49 parents vs 8 clinicians, ppreventive care from the perspective of parents and clinicians were identified. These research priorities may be important in advancing preventive healthcare for children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Paediatric nurses' identification of violence against children. (United States)

    Pabiś, Małgorzata; Wrońska, Irena; Slusarska, Barbara; Cuber, Tomasz


    This paper is a report of an evaluation of paediatric nurses' assessment and diagnostic skills and interventions used for child maltreatment. The use of violence against children occurs in all environments worldwide. Therefore, broader theoretical and practical knowledge related to this issue is needed in health care to facilitate more accurate identification of child maltreatment in order to instigate implementation of appropriate care for these children. The study was based on cross-sectional data obtained with a convenience sample of 160 Registered Nurses employed at paediatric wards at two large cities in Poland (response rate 80%). Data collection took place between December 2005 and March 2006. The research tool was a questionnaire form designed on the basis of international literature concerning battered child syndrome. Battered child syndrome seems to be a relatively common phenomenon, as a great majority of participants (86·25%) had encountered it in their practice. The form of child maltreatment which was most often mentioned (by 30·00% of participants) was neglect. Almost three-quarters of the nurses (61·25%; n = 98) said that they had been involved in providing care for a maltreated child. Nurses should work with maltreated children on an individualized basis, combined with interdisciplinary cooperation with specialists from related disciplines concerned with the issue. There appears to be a need for specialized training for nurses to increase their competence in working with maltreated children and their families. © 2010 Blackwell Publishing Ltd.

  13. The neurophysiology of paediatric movement disorders. (United States)

    McClelland, Verity M


    To demonstrate how neurophysiological tools have advanced our understanding of the pathophysiology of paediatric movement disorders, and of neuroplasticity in the developing brain. Delineation of corticospinal tract connectivity using transcranial magnetic stimulation (TMS) is being investigated as a potential biomarker for response to therapy. TMS measures of cortical excitability and neuroplasticity are also being used to investigate the effects of therapy, demonstrating neuroplastic changes that relate to functional improvements. Analyses of evoked potentials and event-related changes in the electroencephalogaphy spectral activity provide growing evidence for the important role of aberrant sensory processing in the pathophysiology of many different movement disorders. Neurophysiological findings demonstrate that children with clinically similar phenotypes may have differing underlying pathophysiology, which in turn may explain differential response to therapy. Neurophysiological parameters can act as biomarkers, providing a means to stratify individuals, and are well suited to provide biofeedback. They therefore have enormous potential to facilitate improvements to therapy. Although currently a small field, the role of neurophysiology in paediatric movement disorders is poised to expand, both fuelled by and contributing to the rapidly growing fields of neuro-rehabilitation and neuromodulation and the move towards a more individualized therapeutic approach.

  14. Prolonged acquired neutropenia in children. (United States)

    Sheen, Jiunn-Ming; Kuo, Ho-Chang; Yu, Hong-Ren; Huang, Eng-Yen; Wu, Chih-Chiang; Yang, Kuender D


    Acquired neutropenia is not uncommon in childhood. This study investigated the risk factors associated with developing prolonged acquired neutropenia. We reviewed 66,062 hospital admission medical records from the 5-year period January 1, 2002 to December 31, 2006 to identify neutropenic patients, with and without follow-up of their neutropenic course until December 31, 2007. After excluding patients with malignancy, collagen disease, bone marrow failure, prematurity, hereditary disease, congenital neutropenia, immunodeficiency, or status post-liver transplantation, 735 admissions with acquired neutropenia were included in our study. A total of 474 patients with 735 admissions had moderate or severe neutropenia during the 5-year period. Among the 252 acquired neutropenia patients who had follow-up for at least 1 month, 226 patients recovered within 3 months, while 26 patients remained neutropenic after 3 months. Of these 26 patients, 14 recovered after 1 year. An absolute neutrophil count of thrombocytosis (OR: 5.76, 95% CI: 1.78-18.58), and age thrombocytosis, and CMV infection. Neutropenic infants with CMV infection may require antiviral therapy to prevent prolonged acquired neutropenia. (c) 2009 Wiley-Liss, Inc.

  15. [MRI enterography in the assessment of paediatric Crohn's disease]. (United States)

    Alvarez Beltran, M; Barber Martinez de la Torre, I; Segarra Cantón, O; Redecillas Ferreiro, S; Castellote Alonso, A; Infante Pina, D


    To determine the usefulness of MRI enterography for assessing the extension and activity of paediatric Crohn's disease. MRI findings were compared with clinical, biological, endoscopic and other imaging data. Studies of MRI enterography use in patients younger than 18 years of age were reviewed. Patients received 500-1000mL of polyethylene glycol one hour before examination (1.5-TMR). T2 HASTE sequences with or without fat saturation, T2 true-FISP, T1 with fat saturation, pre- and post gadolinium-enhanced VIBE sequences, and dynamic and diffusion HASTE were acquired. Thickening of the bowel wall, mucosal enhancement, and extra-luminal complications were evaluated. Five MRI patterns (normal, fibrosis, mild, moderate, and severe transmural activity) were defined. Findings were compared with PCDAI scores, inflammatory parameters, and endoscopic and histological results. Twenty-two studies were reviewed. Optimal intestinal distension was present in 82% of the cases. Mild side effects were observed in 12% of patients. There was a significant relationship between MRI patterns and PCDAI scores (P=.002), sedimentation rate (P=.006) and serum PCR levels (P=.047) and a non-significant relationship with the histology (P=.571). MRI enterography correctly assessed the ileal (80%) and colonic (66%) extension. Extra-luminal complications unrelated to MRI classification (P=.274) were reported in 86.4% of studies. There was a significant relationship between MRI patterns and PCR, sedimentation rate, and PCDAI scores. MRI enterography showed excellent agreement with ileoscopies, and allowed endoscopically non-accessible areas to be assessed, as well as the diagnosis of extra-luminal complications without irradiation. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. GPS, su datum vertical.

    Directory of Open Access Journals (Sweden)

    Esteban Dörries


    Full Text Available La introducción de la metodología GPS en aplicaciones topográficas y geodésicas pone en notoria evidencia la clásica separación de sistemas de referencia en horizontal y vertical. Con GPS el posicionamiento es tridimensional, pero el concepto de altura difiere del clásico. Si se desea utilizar la información altimétrica debe contemplarse la ondulación del geoide.

  17. Acquiring taste in home economics?

    DEFF Research Database (Denmark)

    Stenbak Larsen, Christian

    that the pupils were encouraged to use their senses: listen to things frying, touch the meat to check if it was done and taste the food in the process of seasoning it. But while some children learned what the teachers expected: to produce well tasting food, others learned to cook very salty and hot food...... appreciated by the group of boys, and others again learned to stick with their idiosyncrasies when pressured by the teacher. Conclusions: Children were acquiring taste in the home economic lessons, but not only the kind of tastes that the teacher had planned for. This leads to reflections on the very complex...... process of taste acquiring and to a call for further research into taste acquiring in complex real life contexts as home economics lessons....

  18. [Quality of initial trauma care in paediatrics]. (United States)

    Ibáñez Pradas, Vicente; Pérez Montejano, Rut


    Trauma care in Spain is not provided in specific centres, which means that health professionals have limited contact to trauma patients. After the setting up of a training program in paediatric trauma, the aim of this study was to evaluate the quality of the initial care provided to these patients before they were admitted to the paediatric intensive care unit (PICU) of a third level hospital (trauma centre), as an indirect measurement of the increase in the number of health professionals trained in trauma. Two cohorts of PICU admissions were reviewed, the first one during the four years immediately before the training courses started (Group 1, period 2001-2004), and the second one during the 4 years (Group 2, period 2012-2015) after nearly 500 professionals were trained. A record was made of the injury mechanism, attending professional, Glasgow coma score (GCS), and paediatric trauma score (PTS). Initial care quality was assessed using five indicators: use of cervical collar, vascular access, orotracheal intubation if GCS ≤ 8, gastric decompression if PTS≤8, and number of actions carried out from the initial four recommended (neck control, provide oxygen, get vascular access, provide IV fluids). Compliance was compared between the 2 periods. A P<.05 was considered statistically significant. A total of 218 patient records were analysed, 105 in Group 1, and 113 in Group 2. The groups showed differences both in injury mechanism and in initial care team. A shift in injury mechanism pattern was observed, with a decrease in car accidents (28% vs 6%; P<.0001). Patients attended to in low complexity hospitals increased from 29.4% to 51.9% (P=.008), and their severity decreased when assessed using the GCS ≤ 8 (29.8% vs 13.5%; P=.004), or PTS≤8 (48.5% vs 29.7%; P=.005). As regards quality indicators, only the use of neck collar improved its compliance (17.3% to 32.7%; P=.01). Patients who received no action in the initial care remained unchanged (19% vs 11%%; P=.15

  19. And the Winner is - Acquired

    DEFF Research Database (Denmark)

    Henkel, Joachim; Rønde, Thomas; Wagner, Marcus


    that then commercialize the innovation. To this end we analyze an innovation game between one incumbent and a large number of entrants. In the first stage, firms compete to develop innovations of high quality. They do so by choosing, at equal cost, the success probability of their R&D approach, where a lower probability...... accompanies higher value in case of success—that is, a more radical innovation. In the second stage, successful entrants bid to be acquired by the incumbent. We assume that entrants cannot survive on their own, so being acquired amounts to a prize in a contest. We identify an equilibrium in which...


    Bibi, Shawana; Bibi, Saima; Gilani, Syed Yasir Hussain; Shah, Syed Raza Ali; ul Haq, Anwar; Billo, Abdul Ghaffar


    Hyponatremia is the most commonly encountered electrolyte disorder in children. In our country the epidemiology of hospital acquired hyponatremia has hardly ever been explored whereas the administration of hypotonic IV fluids is widely practiced here. Therefore we pioneered to conduct this study to determine the frequency of hospital acquired hyponatremia. This was a cross sectional study carried out at Aga Khan University Hospital, Karachi in paediatric ward and ICU over a period of 12 months. All children (>1 month and patients who had a drop in serum sodium during hospitalization. Informed consent was taken from parents and collected data was recorded on a pro forma. A total of 865 patients were enrolled in the study. Hyponatremia was recorded in 405 patients on admission (46.8%) while hospital acquired hyponatremia was documented in 240. children (27.7%). Out of these 142 (59.2%) were male and 98 (40.8%) were female. Mean age of children in hospital acquired hyponatremia group was 60.67 months. Severity of hospital acquired hyponatremia was recorded as mild in 191 (79.6%), moderate in 35 (14.6%) and severe in 14 (5.8%) children. Major disease categories included gastrointestinal disorder (30.4 %), respiratory illness (12.5%), oncological disease (16.3%), cardiovascular disease (11.7%), infectious disease (9.2%) and neurological illness (8.3%). Hospital acquired hyponatremia is frequently encountered in our hospitalized children with majority of them receiving hypotonic IV solutions.

  1. Relationship Ethics Between Paediatric Nurses and Patients

    Directory of Open Access Journals (Sweden)

    O. E. Baksansky


    Full Text Available The article deals with the problem of establishing communication between the paediatric nursing staff and their patients. It emphasizes the vital role of communication in the treatment process; analyzes the communication types and the typology of nurses offered by R. I. Hardy. The article shows how important the skill of understanding and listening to the patient is and what positive effect it has on establishing a psychological contact. Qualities obligatory for a nurse include patience and the ability to control oneself. This is hard to achieve because of a high degree of emotional stress, which arises as a result of communicating with patients, along with an increased irritability, exactingness and ailing touchiness. In the end, the personality, the style and methods of work and professional characteristics of a medical nurse are a necessary element of effective treatment together with correct diagnostics and prescriptions.

  2. Inpatient paediatric rehabilitation in chronic respiratory disorders. (United States)

    Jung, Andreas; Heinrichs, Irmela; Geidel, Christian; Lauener, Roger


    Inpatient pulmonary rehabilitation programs have evolved from tuberculosis sanatoriums to modern medical centres providing standardized comprehensive care in a multidiciplinatory environment. Goals of rehabilitation programs for children and adolescents include restoration of professional activity, improvement of health condition, compliance and disease management as well as restoration of quality of life. Eligibility for an intervention is assessed by defined social and medical criteria. Comprehensive pulmonary rehabilitation programs provide a wide range of health care recourses, including diagnostic procedures, specific medical care, educational interventions and a multiprofessional team. Paediatric rehabilitation programs for chronic respiratory diseases, such as asthma or cystic fibrosis, have been shown to reduce symptoms, increase aerobic fitness and physical strength, improve pulmonary function and inflammation and enhance compliance, self-management, quality of life and psychological symptoms. Regional climatic effects have demonstrated an additional positive effect on the rehabilitation outcome. In addition, first evidence suggests an overall reduction of health care costs. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Ibuprofen in paediatrics: pharmacology, prescribing and controversies. (United States)

    Moriarty, Camilla; Carroll, Will


    Ibuprofen, a propionic acid derivative, is a non-steroidal anti-inflammatory drug. The oral formulation is widely used in paediatric practice and after paracetamol it is one of the most common drugs prescribed for children in hospital. The treatment of fever with antipyretics such as ibuprofen is controversial as fever is the normal response of the body to infection and unless the child becomes distressed or symptomatic, fever alone should not be routinely treated. Combined treatment with paracetamol and ibuprofen is commonly undertaken but almost certainly is not helpful. This article aims to describe the indications and mode of action of the drug, outline its pharmacokinetics and highlight the important key messages regarding its use in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  4. Bordetella pertussis infection in paediatric healthcare workers. (United States)

    Cunegundes, K S A; de Moraes-Pinto, M I; Takahashi, T N; Kuramoto, D A B; Weckx, L Y


    An increased incidence of pertussis has been observed recently in adults, and healthcare workers (HCWs) are considered a risk group for transmission to infants. Prevalence of recent pertussis infection was assessed in HCWs from a paediatric department of a tertiary care hospital in Brazil. Serum pertussis toxin IgG antibodies were measured by enzyme-linked immunosorbent assay. Of 388 HCWs included in the analysis, 6.4% had serology suggestive of recent infection. Medical residents [odds ratio (OR): 4.15; 95% confidence interval (CI): 1.42-12.14; P = 0.009] and those working >40 h a week (OR: 3.29; 95% CI: 1.17-9.26; P = 0.024) had increased risk of pertussis infection. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. Paediatric oncology research nursing: improving the service. (United States)

    Beane, Carol; Auld, Liz

    This article focuses on a paediatric oncology research nursing team, who highlighted potential gaps in their service provision because of the fact that both team members were part time. It discusses the processes undertaken once issues that were essential to maintain the smooth running of the service were highlighted. In today's climate of clinical governance, which facilitates the improvement and maintenance of high standards of patient care, nurses are required to demonstrate evidence of providing a high-quality service. By producing new documentation and consequently two standards, the oncology research team provided evidence of its endeavour to not only deliver a high level of care to children and families partaking in research studies, but also show written evidence of so doing. This evidence could be audited as a way of measuring service provision, to allow the team to make further developments and changes.

  6. Coblation resection of paediatric laryngeal papilloma. (United States)

    Rachmanidou, A; Modayil, P C


    To demonstrate the successful treatment of laryngeal papillomatosis in a 32-month-old girl, using coblation (radio-frequency ablation) resection. A 32-month-old girl was referred to the ENT out-patients clinic due to a hoarse cry and a very croaky voice since birth. Under general anaesthesia, fibre-optic airway endoscopy revealed a large papillomatous lesion involving the anterior glottis, which was reported as a laryngeal papilloma on histological analysis. This was later excised using an Evac 70Xtra wand. The patient made an uneventful post-operative recovery, and there were no signs of recurrence on repeated airway endoscopies at three and 18 months. Coblation (radio-frequency ablation) is a promising surgical technique for the treatment of paediatric laryngeal papillomatosis. The main advantages of this technique include limited damage to underlying tissues and a bloodless field.

  7. Common paediatric conditions of the lower limb. (United States)

    Dobbe, Ashlee M; Gibbons, Paul J


    Growing children are susceptible to a number of disorders to their lower extremities of varying degrees of severity. The diagnosis and management of these conditions can be challenging. With musculoskeletal symptoms being one of the leading reasons for visits to general practitioners, a working knowledge of the basics of these disorders can help in the appropriate diagnosis, treatment, counselling, and specialist referral. This review covers common disorders affecting the hip, the knee and the foot. The aim is to assist general practitioners in recognising developmental norms and differentiating physiological from pathological conditions and to identify when a specialist referral is necessary. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  8. Paediatric radiology from a psychosocial lens

    Directory of Open Access Journals (Sweden)

    Tracy Sharbaugh


    Full Text Available Globally, hospitals and medical centres have a reputation of causing individual patients an increased level of anxiety, stress and pain owing to their foreign environments, intimidating examinations and rigorous treatments. Because of children’s cognitive and developmental levels of understanding and communication, they are more susceptible to increased levels of stress and trauma associated with medical examinations and hospitalisation. Certified Child Life Specialists (CCLSs are professionals trained in child development and family systems expertise who work directly with children and families to meet their psychosocial and emotional needs in order to help them overcome some of life’s most challenging events, including hospitalisation, illness and trauma. This article aims to address the history of the child life profession and the significance of child life in a paediatric imaging unit, and to discuss the current and future status of psychosocial services in South Africa.

  9. Action, prevention and epidemiology of paediatric obesity

    DEFF Research Database (Denmark)

    Lissau, Inge


    UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...... prevention studies, all of which are performed outside Denmark. Thus, this paper is not a classical review but rather a highlight of some aspects that the author finds important. The latest Danish national figures show a marked increase in the prevalence of obesity, especially among young men-a sevenfold...... increase from 1987 to 2000 (0.7 to 4.9%). Among young women aged 16-24, the increase is threefold in the same period. Among teens, the prevalence has increased by 2-3 times in recent decades. Nevertheless, compared to other European countries and the US, Denmark has a relatively low prevalence of obesity...

  10. New hazards in paediatric poisoning presentations.

    LENUS (Irish Health Repository)

    Moore, C


    Accidental ingestion is an important preventable cause of childhood morbidity. All accidental ingestion presentations (n = 478) to a tertiary paediatric ED from January 2010 to December 2011 were analysed. These results were compared with a similar study in the same institution ten years previously in 2001 and showed that while accidental ingestions constituted a higher proportion of presentations (0.5% in this study v 0.45% in 2001), fewer had investigations performed (21% v 35%) and fewer were admitted (7% v 20%). Accidental ingestions account for 0.5% of presentations and are an important focus of home safety information for parents and guardians. Paracetamol (n = 67, 14%) and liquid detergent capsules (n = 44, 9.2%) were the two most common substances implicated in these presentations, and have the potential to cause severe morbidity and mortality.

  11. Diagnosis and Management of Paediatric Hepatitis C Virus Infection ...

    African Journals Online (AJOL)

    Diagnosis and Management of Paediatric Hepatitis C Virus Infection. ... Without accurate diagnosis and follow up, these children cannot be offered optimal care, and are at risk ... Keywords:Acute infective hepatitis;Catalase; LiverFunction Tests ...

  12. Palliative care in paediatric oncology in nursing education. (United States)

    Guimarães, Tuani Magalhães; Silva, Liliane Faria da; Santo, Fátima Helena Espírito; Moraes, Juliana Rezende Montenegro Medeiros de; Pacheco, Sandra Teixeira de Araújo


    To identify and understand the view of students regarding palliative care in paediatric oncology during a graduate programme. Exploratory research with a qualitative approach conducted in a school of nursing in Rio de Janeiro. Data were collected from September to November 2014, through semi-structured interviews with 20 students enrolled in the last period of a graduate programme. The data were subjected to thematic analysis. The results produced two thematic units: the (un)preparedness of nursing students regarding palliative care in paediatric oncology and how the subject of palliative care in paediatric oncology is approached in the graduate programme. The students mentioned difficulties in providing this care and their lack of exposure to the topic during their graduate studies. They stated strategies to prepare for the provision of care, and talked about how the subject should be addressed in their curricular programme. It is necessary to expand discussions on palliative care in paediatric oncology during the nurses' graduate programme.

  13. Bounded rationality alters the dynamics of paediatric immunization acceptance

    National Research Council Canada - National Science Library

    Oraby, Tamer; Bauch, Chris T


    ... "rational" decision model that are often described as "bounded rationality". However, the impact of such cognitive effects in the context of paediatric infectious disease vaccines has received relatively little attention...

  14. An Analysis of Disorders seen at the Paediatric Neurology Clinic ...

    African Journals Online (AJOL)


    45.3%), cerebral palsy (36.0%), neuro-muscular disorders (4.5%) and mental retardation. (4.5%). ... Correspondence: Dr I. A. Lagunju, Department of Paediatrics, University College Hospital, Ibadan. ... considerable burden on the family, society.

  15. Paediatric palliative care - the role of the GP

    National Research Council Canada - National Science Library

    Armitage, Nicole; Trethewie, Susan


    Background: Paediatric palliative care (PPC) is a growing specialty area in Australia and many families aim to care for their child at home as much as possible, including during the terminal phase. Objective...

  16. Interruption handling strategies during paediatric medication administration. (United States)

    Colligan, Lacey; Bass, Ellen J


    Interruptions are a part of many hospital settings. During medication administration, interruptions have been shown to lead to medication errors. Understanding interruption management strategies during medical management could lead to the design of interventions to reduce and mitigate related errors. Semi-structured interviews with paediatric nurses in an in-patient setting were used to identify types of interruptions, strategies for safe medication administration and interruption management, as well as factors influencing the interruption management strategy choice. Nurses also worked through use cases and provided verbal protocols about their strategies. To confirm and refine a framework for interruption handling, on-the-job observations were also conducted. Four case studies of medication administration highlight four interruption handling strategies. Three allow the interruption: 1) the primary task is suspended so that the higher priority secondary task may be engaged immediately; 2) multi-task by dividing attention between the primary and secondary tasks; and 3) mediating the interruption with an action that supports resumption of the primary task. The fourth blocks the interruption, keeping attention on the primary task (blocking). Interviews and on-the-job observation suggest that nurses dynamically assess the primary and (interrupting) secondary tasks. They prioritise task execution based on both risk and workflow efficiency assessments. Specific interruption handling depends on both task and experience related factors. Paediatric nurses have developed sophisticated strategies to manage interruptions and maintain patient safety and work efficiency during medication administration. To support a more resilient healthcare system, interruption management strategies should be supported through process, task support tools and education.

  17. Sixth Nerve Palsy in Paediatric Intracranial Hypertension. (United States)

    Reid, Julia E; Reem, Rachel E; Aylward, Shawn C; Rogers, David L


    The purpose of this study was to report the incidence and describe the characteristics of sixth cranial nerve (CN VI) palsy in paediatric patients with intracranial hypertension (IH). A retrospective chart review of central Ohio children diagnosed with IH over the 3-year period from 2010 to 2013 was conducted. IH without identifiable cause was defined as idiopathic intracranial hypertension (IIH), whereas IH with identifiable pathologic aetiology was deemed secondary intracranial hypertension (SIH). A subset of patients with CN VI palsy was identified. Data collected included patient age, gender, past medical history, aetiology of SIH, ophthalmic examination, lumbar puncture results, neuroimaging results, and response to treatment. Seventy-eight children with intracranial hypertension were included in the study. Nine (11.5%) children (four males, five females; median age 14, range: 3-18) were found to have a unilateral (n = 2) or bilateral (n = 7) CN VI palsy. Five children had IIH; the remaining four had SIH from cerebral venous sinus thrombosis (n = 2) and infection (n = 2). The mean lumbar puncture opening pressure for the nine patients with CN VI palsy was 40 cm H2O (range: 21-65 cm H2O). Papilloedema was present in 8/9 (89%) patients. One patient required a lumboperitoneal shunt, and two others required optic nerve sheath fenestrations in addition to medical management. All cases of CN VI palsy resolved with treatment. In our primary service area, the incidence of CN VI palsy is approximately 12% among paediatric IH patients. The majority of cases with CN VI palsy presented with papilloedema and all cases resolved with treatment of intracranial hypertension.

  18. Eliminating paediatric infections and keeping mothers alive

    Directory of Open Access Journals (Sweden)

    Gray G


    Full Text Available The global plan of reducing the number of new child HIV infections and a reduction in the number of HIV-related maternal deaths by 2015 will require inordinate political commitment and strengthening of health systems in Sub-Saharan Africa where the burden of HIV infections in pregnant women is the highest. Preventing HIV infection in women of child-bearing age and unwanted pregnancies in HIV-positive women forms the cornerstone of long-term control of paediatric HIV infections. To achieve the goal of eliminating paediatric HIV infection by 2015, health systems strengthening to address prevention of mother-to-child HIV transmission cascade attrition and focusing on the elimination of breastmilk transmission is critical. Understanding the pathogenesis of breastmilk transmission and the mechanisms by which antiretroviral therapy impacts on transmission through this compartment will drive future interventions. Identifying and retaining HIV-positive pregnant women in care and committed to long-term antiretroviral therapy will improve maternal outcomes and concomitant reductions in maternal mortality. Research assessing the natural history of HIV infection and long-term outcomes in women who interrupt antiretroviral therapy post-weaning is urgently required. Data on the outcome of women who opt to continue the long-term use of antiretroviral therapy after initiating therapy during pregnancy will determine future policy in countries considering option B+. The prevalence of antiretroviral resistance and impact on survival in infants who sero-convert whilst receiving neonatal prophylaxis, or are exposed to maternal HAART through breastmilk at a population level, are currently unknown. In addition to the provision of biomedical interventions, healthcare workers and policy makers must address the structural, cultural and community issues that impact on treatment uptake, adherence to medication and retention in care.

  19. Acquired tracheo-oesophageal fistula.

    Directory of Open Access Journals (Sweden)

    Shah C


    Full Text Available Acquired tracheo-oesophageal fistula is rare. The most common causes are tuberculosis and malignancy. Here we report a patient who had come with dysphagia and aspiration pneumonia with paratracheal lymphnodes on X-ray chest and was diagnosed to have a tracheo-bronchial fistula on barium studies. Transtumoral intubation by pull-through method was carried out.

  20. Offshore vertical wind shear: Final report on NORSEWInD’s work task 3.1

    DEFF Research Database (Denmark)

    Pena Diaz, Alfredo; Mikkelsen, Torben; Gryning, Sven-Erik

    .6 Results input into satellite maps The nature of the offshore vertical wind shear is investigated using acquired data from the NORSEWInD network of mast and wind lidar stations. The importance of the knowledge of the vertical wind speed profile and wind shear is first illustrated for the evaluation...... of power outputs. Background related to the parametrization of the vertical wind speed profile and the behavior of the vertical wind shear in and beyond the atmospheric surface layer is presented together with the application of the long-term atmospheric stability parameters for the analysis of the long......-term vertical wind speed profile. Observed vertical wind shears are illustrated for all NORSEWInD wind lidar and meteorological stations in terms of wind shear roses, distributions, and diurnal and monthly evolutions. A multi-variational correlation analysis is performed to study the vertical wind shear...

  1. Tracing Sydenham's chorea: historical documents from a British paediatric hospital


    de Martino, D.; Tanner, A.; Defazio, G.; Church, A J; Bhatia, K.P.; Giovannoni, G.; Dale, R. C.


    Sydenham's chorea (SC) became a well defined nosological entity only during the second half of the nineteenth century. Such progress was promoted by the availability of large clinical series provided by newly founded paediatric hospitals. This paper analyses the demographic and clinical features of patients with chorea admitted to the first British paediatric hospital (the Hospital for Sick Children, Great Ormond Street, London) between 1852 and 1936. The seasonal and demographic characterist...

  2. Referral of paediatric patients follows geographic borders of administrative units

    DEFF Research Database (Denmark)

    Kofoed, Poul-Erik; Riiskjær, Erik; Ammentorp, Jette


    This observational study examines changes in paediatric hospital-seeking behaviour at Kolding Hospital in The Region of Southern Denmark (RSD) following a major change in administrative units in Denmark on 1 January 2007.......This observational study examines changes in paediatric hospital-seeking behaviour at Kolding Hospital in The Region of Southern Denmark (RSD) following a major change in administrative units in Denmark on 1 January 2007....

  3. Paediatric cyclical Cushing's disease due to corticotroph cell hyperplasia.

    LENUS (Irish Health Repository)

    Noctor, E


    Cushing\\'s disease is very rare in the paediatric population. Although uncommon, corticotroph hyperplasia causing Cushing\\'s syndrome has been described in the adult population, but appears to be extremely rare in children. Likewise, cyclical cortisol hypersecretion, while accounting for 15 % of adult cases of Cushing\\'s disease, has only rarely been described in the paediatric population. Here, we describe a very rare case of a 13-year old boy with cyclical cortisol hypersecretion secondary to corticotroph cell hyperplasia.

  4. Vertical Protocol Composition

    DEFF Research Database (Denmark)

    Groß, Thomas; Mödersheim, Sebastian Alexander


    composition, and it is truly commonplace in today’s communication with the diversity of VPNs and secure browser sessions. In fact, it is normal that we have several layers of secure channels: For instance, on top of a VPN-connection, a browser may establish another secure channel (possibly with a different...... end point). Even using the same protocol several times in such a stack of channels is not unusual: An application may very well establish another TLS channel over an established one. We call this selfcomposition. In fact, there is nothing that tells us that all these compositions are sound, i.......e., that the combination cannot introduce attacks that the individual protocols in isolation do not have. In this work, we prove a composability result in the symbolic model that allows for arbitrary vertical composition (including self-composition). It holds for protocols from any suite of channel and application...

  5. Vertical cavity laser

    DEFF Research Database (Denmark)


    The present invention provides a vertical cavity laser comprising a grating layer comprising an in-plane grating, the grating layer having a first side and having a second side opposite the first side and comprising a contiguous core grating region having a grating structure, wherein an index......, an index of refraction of the second low-index layer or air being less than 2; and a thickness of the cap layer and a thickness of the grating layer, and a pitch and a duty cycle of the grating structure are selected to obtain a resonance having a free-space resonance wavelength in the interval 300 nm to 3...... microns, the cap layer comprises an active region configured to generate or absorb photons at the free-space resonance wavelength by stimulated emission or absorption when a sufficient forward or reverse bias voltage is applied across the active region, a thickness of the first low-index layer is less...

  6. Free-breathing contrast-enhanced T1-weighted gradient-echo imaging with radial k-space sampling for paediatric abdominopelvic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Chandarana, Hersh; Block, Kai T.; Winfeld, Matthew J.; Lala, Shailee V.; Mazori, Daniel; Giuffrida, Emalyn; Babb, James S.; Milla, Sarah S. [New York University Langone Medical Center, Department of Radiology, New York, NY (United States)


    To compare the image quality of contrast-enhanced abdominopelvic 3D fat-suppressed T1-weighted gradient-echo imaging with radial and conventional Cartesian k-space acquisition schemes in paediatric patients. Seventy-three consecutive paediatric patients were imaged at 1.5 T with sequential contrast-enhanced T1-weighted Cartesian (VIBE) and radial gradient echo (GRE) acquisition schemes with matching parameters when possible. Cartesian VIBE was acquired as a breath-hold or as free breathing in patients who could not suspend respiration, followed by free-breathing radial GRE in all patients. Two paediatric radiologists blinded to the acquisition schemes evaluated multiple parameters of image quality on a five-point scale, with higher score indicating a more optimal examination. Lesion presence or absence, conspicuity and edge sharpness were also evaluated. Mixed-model analysis of variance was performed to compare radial GRE and Cartesian VIBE. Radial GRE had significantly (all P < 0.001) higher scores for overall image quality, hepatic edge sharpness, hepatic vessel clarity and respiratory motion robustness than Cartesian VIBE. More lesions were detected on radial GRE by both readers than on Cartesian VIBE, with significantly higher scores for lesion conspicuity and edge sharpness (all P < 0.001). Radial GRE has better image quality and lesion conspicuity than conventional Cartesian VIBE in paediatric patients undergoing contrast-enhanced abdominopelvic MRI. (orig.)

  7. Direct Observation of Ultralow Vertical Emittance using a Vertical Undulator

    Energy Technology Data Exchange (ETDEWEB)

    Wootton, Kent


    In recent work, the first quantitative measurements of electron beam vertical emittance using a vertical undulator were presented, with particular emphasis given to ultralow vertical emittances [K. P. Wootton, et al., Phys. Rev. ST Accel. Beams, 17, 112802 (2014)]. Using this apparatus, a geometric vertical emittance of 0.9 ± 0.3 pm rad has been observed. A critical analysis is given of measurement approaches that were attempted, with particular emphasis on systematic and statistical uncertainties. The method used is explained, compared to other techniques and the applicability of these results to other scenarios discussed.

  8. Fast tracking in paediatric cardiac anaesthesia : an update.

    Directory of Open Access Journals (Sweden)

    Lake Carol


    Full Text Available A care plan in which cardiac surgical patients progress quickly through the perioperative course to hospital discharge is often referred to as a Fast Track. Such care plans have been used extensively in adult cardiac patients but are also applicable to paediatric patients. Although no randomised controlled trials are available to document a reduction in hospital costs and avoidance of iatrogenic complications with paediatric fast tracks, many healthcare administrators encourage their use. Fast Track clinical guidelines usually include same day surgery, use of short- acting anaesthetic drugs, early extubation, effective pain management, and reduced intensive care unit stays. These protocols are certainly appropriate for simple procedures such as repair of atrial or ventricular septal defects or ligation of a patent ductus arteriosus. However, many paediatric cardiac anaesthesiologists consider that all paediatric patients without significant pulmonary or residual cardiac pathology can be managed using expedited postoperative protocols. Essential components in a "fast track" protocol include use of minimally invasive surgical techniques, modified ultrafiltration during cardiopulmonary bypass, transoesophageal echocardiography to evaluate the cardiac repair, and postoperative pain control. Using such techniques, 80-90% of paediatric patients can be extubated in the operating room or within 2-4 hours postoperatively. Despite the opinions of recognised experts, an appropriately sized and powered multicentre, controlled, randomised, prospective study is still needed to conclusively document the efficiency and effectiveness of the Fast Track in paediatric cardiac patients.

  9. Accuracy and interrater reliability of paediatric emergency department triage. (United States)

    Allen, Amy R; Spittal, Matthew J; Nicolas, Caroline; Oakley, Ed; Freed, Gary L


    To determine the accuracy and reliability of triage of children in public hospital EDs using the Australasian Triage Scale (ATS). This is the first study to examine these issues in paediatric triage following the 2007 development of the Emergency Triage Education Kit (ETEK) to foster accurate and consistent application of the ATS. A convenience sample of 167 triage nurses working at three general hospitals and one speciality paediatric hospital in greater metropolitan Melbourne assigned triage ratings for nine paediatric clinical scenarios using the ATS. Scenarios were derived from the ETEK or from other published sources. Kappa was used to assess interrater reliability within and between hospitals. Triage nurses correctly assigned triage scores to an average of 5.3 of nine paediatric clinical scenarios. Accuracy in specific hospitals ranged from a low of 15% on one scenario, to 100% accuracy on a different scenario at a different hospital. Interrater reliability within and across the EDs studied was found to be kappa = 0.27. Both accuracy and interrater reliability were marginally higher at the speciality paediatric hospital. Our findings demonstrate inconsistencies in the accuracy and reliability in which sick children presenting to EDs receive triage scores both within and across hospitals. These results suggest the need for improvements either in current triage nurse training or training resources. Use of the ETEK alone has not resulted in high levels of paediatric triage accuracy or reliability. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  10. Survey on sedation in paediatric dentistry: a global perspective. (United States)

    Wilson, Stephen; Alcaino, Eduardo A


    Paediatric dentists receive training in sedation during their advanced education training, but evidence suggests that this training varies widely. The purpose of this study was to survey members of the International Association of Paediatric Dentistry (IAPD) and the European Academy of Paediatric Dentistry (EAPD) on their opinion on pharmacological and other behavioural management techniques and their training related to provision of oral health care of paediatric patients in the dental setting. A request was made for access to the IAPD and EAPD membership email addresses. The responses were recorded anonymously and data uploaded into spss (version 9) and analysed using descriptive analysis and chi-square with and without tabulation processes. A total of 311 respondents of 1973 targeted individuals answered the survey. The response rate was 16%. The majority of the respondents came from the continent of Europe, Asia, and the Americas. The most frequent type of sedation was general anaesthesia (52% of the respondents), followed by nitrous oxide (46%) and then oral sedation (44%). At least 91% of the respondents indicated that they were interested in the development of continuing education on the topic of sedation. Paediatric dentists around the world use relatively few behaviour management techniques, including pharmacological management. There is a definite interest in continuing education in the area of sedation. The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  11. Specialist paediatric dentistry in Sweden 2008 - a 25-year perspective. (United States)

    Klingberg, Gunilla; Andersson-Wenckert, Ingrid; Grindefjord, Margaret; Lundin, Sven-Ake; Ridell, Karin; Tsilingaridis, Georgios; Ullbro, Christer


    International Journal of Paediatric Dentistry 2010; 20: 313-321 Background. Paediatric dentistry in Sweden has been surveyed four times over the past 25 years. During this period postgraduate training, dental health, and the organization of child dental care have changed considerably. Aim. To investigate services provided by specialists in paediatric dentistry in Sweden in 2008, and to compare with data from previous surveys. Design. The same questionnaire was sent to all 30 specialist paediatric dental clinics in Sweden that had been used in previous surveys. Comparisons were made with data from 1983, 1989, 1996 and 2003. Results. Despite an unchanged number of specialists (N = 81 in 2008), the number of referrals had increased by 16% since 2003 and by almost 50% since 1983. There was greater variation in reasons for referrals. The main reason was still dental anxiety/behaviour management problems in combination with dental treatment needs (27%), followed by medical conditions/disability (18%), and high caries activity (15%). The use of different techniques for conscious sedation as well as general anaesthesia had also increased. Conclusions. The referrals to paediatric dentistry continue to increase, leading to a heavy work load for the same number of specialists. Thus, the need for more paediatric dentists remains.

  12. Diagnostic reference levels for paediatric radiography in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Kiljunen, T.; Jaervinen, H.; Parviainen, T.; Komppa, T. [Radiation and Nuclear Safety Authority - STUK, Helsinki, (Finland). Radiation Practices Regulation; Savolainen, S. [Helsinki University Central Hospital, Helsinki (Finland). Dept. of Radiology


    The Radiation and Nuclear Safety Authority (STUK) in Finland has responsibility to set the national Diagnostic Reference Levels (DRLs) for the most common radiological examinations. Paediatric patients deserve a special attention due to the higher radiation risk compared with adults. The purpose was to present a method which takes into account patient size when setting DRLs in paediatrics. The overall data used in the study consisted of patient doses collected from eight hospitals: for 700 chest examinations, 100 micturating cystourethography (MCU) fluoroscopy examinations and 10 - 30 other conventional or fluoroscopy examinations. The method established by the National Radiation Protection Board (UK) for setting DRLs was found to produce extra uncertainty in the procedure and it was also troublesome to use. Reference levels for paediatric chest examinations could be given as linear curve on half logarithmic scale as a function of patient projection thickness. STUK has been collecting the data on paediatric patient doses in almost 30 Finnish hospitals as the current available data is insufficient and partly outdated. The collection is carried out by a questionnaire in which hospitals record paediatric patient doses of chest, skull, sinus, abdomen, pelvis and micturating cystourethography examinations. The DRLs will be given during the year 2005 for the most common paediatric radiographic examinations.

  13. Errors by paediatric residents in calculating drug doses. (United States)

    Rowe, C; Koren, T; Koren, G


    Errors in calculating drug doses in infants and small children can cause morbidity and mortality, especially with agents exhibiting a narrow therapeutic window. A previous study from this institution has detected potential life threatening errors in calculations performed by trainees while writing prescriptions. To verify whether the true incidence of trainees' errors in prescribing can be explained by impaired calculation skills in written tests. A tertiary paediatric hospital; educational rounds for core paediatric residents. Two anonymous written tests, which included calculations of doses similar to those performed at the paediatric bedside; one was conducted in 1993 and one in 1995. Thirty four paediatric residents participated in 1993 and 30 in 1995. A substantial number of trainees in both years committed at least one error. In general, there was no correlation between the length of training (0 to 4 years) and likelihood of making a mistake. Three trainees in 1993 and four in 1995 committed 10-fold errors. These seven residents committed significantly more errors than the rest of the group in each of the tests separately. All seven were in their first two years of training, and six were in their first year of residency. A substantial proportion of paediatric trainees make mistakes while calculating drug doses under optimal test conditions. Some trainees commit 10-fold errors, which may be life threatening. The results of these anonymous tests suggest that testing of calculations skills should be mandatory, and appropriate remedial steps should follow to prevent paediatric patients receiving wrong drug dosages.

  14. Pattern of paediatric trauma in Sokoto, North West Nigeria

    Directory of Open Access Journals (Sweden)

    Muhammad Oboirien


    Full Text Available Background: Paediatric trauma has become a major cause of mortality, disability and socioeconomic burden in developing countries and the World Health Organization (WHO projects that by 2020 it will be the leading disease globally. This study described the pattern of paediatric injuries seen at a regional trauma center in North West, Nigeria. Settings and Design: Trauma centre of a tertiary hospital in North-Western Nigeria. Materials and Methods: A retrospective look at the trauma register for records of paediatric trauma from January to December 2010 was performed. Information obtained include age and sex, causes and pattern of injury. The limit of 16 years was set for paediatric in our centre. Results: The numbers of paediatric trauma seen over the 12-month period were 567 out of a total of 3984 trauma cases representing 14.2%. The number of males was 407(71.8% and females were 160(28.2% with M: F ratio of 2.5:1. The mean age was 7.77 and standard deviation of 0.19. Road Traffic Accidents (RTA and Domestic injuries representing 44.8 and 42.0%, respectively, were the commonest causes of injuries. Laceration and bruises, head injuries including extremities were the commonest types of injuries seen. Conclusion: Road traffic accidents and domestic injuries as common causes of paediatric trauma need to be ′addressed by the authorities′ so as to reduce the burden of trauma on the vulnerable children in our society.

  15. Bed Utilisation in an Irish Regional Paediatric Unit A Cross-Sectional Study Using the Paediatric Appropriateness Evaluation Protocol (PAEP)

    LENUS (Irish Health Repository)

    Ó hAiseadha, Coilín


    Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources.

  16. Vertical allometry: fact or fiction? (United States)

    Mahmood, Iftekhar; Boxenbaum, Harold


    In pharmacokinetics, vertical allometry is referred to the clearance of a drug when the predicted human clearance is substantially higher than the observed human clearance. Vertical allometry was initially reported for diazepam based on a 33-fold higher human predicted clearance than the observed human clearance. In recent years, it has been found that many other drugs besides diazepam, can be classified as drugs which exhibit vertical allometry. Over the years, many questions regarding vertical allometry have been raised. For example, (1) How to define and identify the vertical allometry? (2) How much difference should be between predicted and observed human clearance values before a drug could be declared 'a drug which follows vertical allometry'? (3) If somehow one can identify vertical allometry from animal data, how this information can be used for reasonably accurate prediction of clearance in humans? This report attempts to answer the aforementioned questions. The concept of vertical allometry at this time remains complex and obscure but with more extensive works one can have better understanding of 'vertical allometry'. Published by Elsevier Inc.

  17. Occupationally Acquired American Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Maria Edileuza Felinto de Brito


    Full Text Available We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL: one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples and characterized as Leishmania (Viannia naiffi through an indirect immunofluorescence assay (IFA with species-specific monoclonal antibodies (mAbs and by multilocus enzyme electrophoresis (MLEE. Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis.

  18. Utility of blood cultures in children admitted to hospital with community-acquired pneumonia. (United States)

    Davis, Tessa R; Evans, Hannah R; Murtas, Jennifer; Weisman, Aimee; Francis, J Lynn; Khan, Ahmed


    The aim of the study was to assess the utility of blood cultures in children admitted to hospital with community-acquired pneumonia. The primary outcome was the number of positive blood culture results, and secondary outcomes included the effect of positive blood culture results on management, and the identification of other clinical/biochemical variables that could predict blood culture results or the course of illness. A retrospective data analysis was carried out on all children admitted to Gosford Hospital during the 2-year period from July 2013 to June 2015. Included were patients under 16 years old who had a diagnosis-related group code of pneumonia. A review of blood culture results, chest X-ray, serology, C-reactive protein and white cell count and clinical outcomes were analysed. There were 215 paediatric admissions with a diagnosis of pneumonia during the 2-year study period. A blood culture was collected in 82.3% (177/215). Although seven had a positive blood culture, only two of these were finally reported as true positives and both were Streptococcus pneumoniae. Both patients were treated with a cephalosporin and demonstrated clinical improvement. No changes were made to their treatment based on the blood culture results. Blood cultures have a low yield and do not appear to be helpful when collected in all patients admitted to hospital with community-acquired pneumonia. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  19. [Acquired disorders of color vision]. (United States)

    Lascu, Lidia; Balaş, Mihaela


    This article is a general view of acquired disorders of color vision. The revision of the best known methods and of the etiopathogenic classification is not very important in ophthalmology but on the other hand, the detection of the blue defect advertise and associated ocular pathology. There is a major interest in serious diseases as multiple sclerosis, AIDS, diabetes melitus, when the first ocular sign can be a defect in the color vision.

  20. Emotional attention in acquired prosopagnosia (United States)

    Lucas, Nadia; Mayer, Eugene; Vuilleumier, Patrik


    The present study investigated whether emotionally expressive faces guide attention and modulate fMRI activity in fusiform gyrus in acquired prosopagnosia. Patient PS, a pure case of acquired prosopagnosia with intact right middle fusiform gyrus, performed two behavioral experiments and a functional imaging experiment to address these questions. In a visual search task involving face stimuli, PS was faster to select the target face when it was expressing fear or happiness as compared to when it was emotionally neutral. In a change detection task, PS detected significantly more changes when the changed face was fearful as compared to when it was neutral. Finally, an fMRI experiment showed enhanced activation to emotionally expressive faces and bodies in right fusiform gyrus. In addition, PS showed normal body-selective activation in right fusiform gyrus, partially overlapping the fusiform face area. Together these behavioral and neuroimaging results show that attention was preferentially allocated to emotional faces in patient PS, as observed in healthy subjects. We conclude that systems involved in the emotional guidance of attention by facial expression can function normally in acquired prosopagnosia, and can thus be dissociated from systems involved in face identification. PMID:19401380

  1. Relationship between CCR5(WT/Δ32)heterozygosity and HIV-1 reservoir size in adolescents and young adults with perinatally acquired HIV-1 infection. (United States)

    Martínez-Bonet, M; González-Serna, A; Clemente, M I; Morón-López, S; Díaz, L; Navarro, M; Puertas, M C; Leal, M; Ruiz-Mateos, E; Martinez-Picado, J; Muñoz-Fernández, M A


    Several host factors contribute to human immunodeficiency virus (HIV) disease progression in the absence of combination antiretroviral therapy (cART). Among them, the CC-chemokine receptor 5 (CCR5) is known to be the main co-receptor used by HIV-1 to enter target cells during the early stages of an HIV-1 infection. We evaluated the association of CCR5 (WT/Δ32) heterozygosity with HIV-1 reservoir size, lymphocyte differentiation, activation and immunosenescence in adolescents and young adults with perinatally acquired HIV infection receiving cART. CCR5 genotype was analysed in 242 patients with vertically transmitted HIV-1 infection from Paediatric Spanish AIDS Research Network Cohort (coRISpe). Proviral HIV-1 DNA was quantified by digital-droplet PCR, and T-cell phenotype was evaluated by flow cytometry in a subset of 24 patients (ten with CCR5 (Δ32/WT) genotype and 14 with CCR5 (WT/WT) genotype). Twenty-three patients were heterozygous for the Δ32 genotype but none was homozygous for the mutated CCR5 allele. We observed no difference in the HIV-1 reservoir size (455 and 578 copies of HIV-1 DNA per million CD4 + T cells in individuals with CCR5 (WT/WT) and CCR5 (Δ32/WT) genotypes, respectively; p 0.75) or in the immune activation markers between both genotype groups. However, we found that total HIV-1 DNA in CD4 + T cells correlated with the percentage of memory CD4 + T cells: a direct correlation in CCR5 (WT/Δ32) patients but an inverse correlation in those with the CCR5 (WT/WT) genotype. This finding suggests a differential distribution of the viral reservoir compartment in CCR5 (WT/Δ32) patients with perinatal HIV infection, which is a characteristic that may affect the design of strategies for reservoir elimination. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Dose estimation for paediatric cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Curci Daros, K.A.; Bitelli Medeiros, R. [Sao Paulo Univ. Federal (Brazil); Curci Daros, K.A.; Oliveira Echeimberg, J. de [Centro Univ. Sao Camilo, Sao Paulo (Brazil)


    In the last ten years, the number of paediatric computed tomography (CT) scans have increased worldwide, contributing to higher population radiation dose. Technique diversification in paediatrics and different CT equipment technologies have led to various exposure levels complicating precise evaluation of doses and operational conditions necessary for good quality images. The objective of this study was to establish a quantitative relationship between absorbed dose and cranial region in children up to 6 years old undergoing CT exams. Methods: X-ray was measured on the cranial surface of 64 patients undergoing CT using thermoluminescent (T.L.) dosimeters. Forty T.L.D.100 thermoluminescent dosimeters (T.L.D.) were evenly distributed on each patients skin surface along the sagittal axis. Measurements were performed in facial regions exposed to scatter radiation and in the supratentorial and posterior fossa regions, submitted to primary radiation. T.L.D. were calibrated for 120 kV X-ray over the acrylic phantom. T.L. measurements were made with a Harshaw 4000 system. Patient mean T.L. readings were determined for position, pi, of T.L.D. and normalized to the maximum supratentorial reading. From integrating the linear T.L. density function (?) resulting from radiation distribution in each of the three exposed regions, dose fraction was determined in the region of interest, along with total dose under the technical conditions used in that specific exam protocol. For each T.L.D. position along the patient cranium, there were n T.L. measurements with 2% uncertainty due to T.L. reader, and 5% due to thermal treatment of dosimeters. Also, mean T.L. readings and their uncertainties were calculated for each patient at each position, p. Results: Mean linear T.L. density for the region exposed to secondary radiation defined by position, 0.3{<=}p{<=}6 cm, was {rho}((p)=7.9(4)x10{sup -2}+7(5)x10{sup -5}p{sup 4.5(4)} cm{sup -1}; exposed to primary X-ray for the posterior fossa

  3. Ethnic diversity outpatient clinic in paediatrics

    Directory of Open Access Journals (Sweden)

    Dahhan Nordin


    Full Text Available Abstract Background The health status of chronic sick ethnic minority children in the Netherlands is unequal compared with indigenous Dutch children. In order to optimize the health care for these children a specific patient-oriented clinic in ethnic-cultural diversity: the Mosaic Outpatient Clinic (MOC was integrated in the general Paediatric Outpatient Departments (POPD of three hospitals in Amsterdam. Methods Feasibility of the MOC, factors influencing the health care process and encountered bottlenecks in health care were studied in ethnic minority children with asthma, diabetes type 1 or metabolic disease originating from Morocco, Turkey and Surinam. Feasibility was determined by the number of patients attended, support from the paediatric medical staff and willingness of the patients to participate. Influences on the health care process comprised parents' level of knowledge of disease, sense of disease severity, level of effort, linguistic skills, health literacy, adherence to treatment and encountered bottlenecks in the health care process. Moreover, the number of admissions and visits to the POPD in the years before, during and after the MOC were analysed. Results In 2006 a total of 189 ethnic minority children were seen. Integration of the MOC within the general POPD of the hospital is feasible. The ability of the parents to speak and understand Dutch was found to be 58%, functional health literacy was 88%; sufficient knowledge of disease and sense of disease severity were 59% and 67%, respectively. The main bottlenecks in the healthcare process: poor knowledge of disease, limited sense of disease severity and low health literacy in the parents proved to be the best predictors for decreased adherence. After attending the MOC there was a decrease in the number of admissions and visits to the POPD for asthma while the number of visits increased in patients with diabetes and the amount of no-shows decreased in patients with a metabolic

  4. Paediatric admissions and outcome in a general intensive care unit

    Directory of Open Access Journals (Sweden)

    Embu Henry


    Full Text Available Background: It is believed that intensive care greatly improves the prognosis for critically ill children and that critically ill children admitted to a dedicated Paediatric Intensive Care Unit (PICU do better than those admitted to a general intensive care unit (ICU. Methods: A retrospective study of all paediatric (< 16 years admissions to our general ICU from January 1994 to December 2007. Results: Out of a total of 1364 admissions, 302 (22.1% were in the paediatric age group. Their age ranged from a few hours old to 15 years with a mean of 4.9 ± 2.5 years. The male: female ratio was 1.5:1. Postoperative admissions made up 51.7% of the admissions while trauma and burn made up 31.6% of admissions. Medical cases on the other hand constituted 11.6% of admissions. Of the 302 children admitted to the ICU, 193 were transferred from the ICU to other wards or in some cases other hospitals while 109 patients died giving a mortality rate of 36.1%. Mortality was significantly high in post-surgical paediatric patients and in patients with burn and tetanus. The length of stay (LOS in the ICU ranged from less than one day to 56 days with a mean of 5.5 days. Conclusion: We found an increasing rate of paediatric admissions to our general ICU over the years. We also found a high mortality rate among paediatric patients admitted to our ICU. The poor outcome in paediatric patients managed in our ICU appears to be a reflection of the inadequacy of facilities. Better equipping our ICUs and improved man-power development would improve the outcome for our critically ill children. Hospitals in our region should also begin to look into the feasibility of establishing PICUs in order to further improve the standard of critical care for our children.

  5. Paediatric admissions and outcome in a general intensive care unit. (United States)

    Embu, Henry Y; Yiltok, Simon J; Isamade, Erdoo S; Nuhu, Samuel I; Oyeniran, Olushola O; Uba, Francis A


    It is believed that intensive care greatly improves the prognosis for critically ill children and that critically ill children admitted to a dedicated Paediatric Intensive Care Unit (PICU) do better than those admitted to a general intensive care unit (ICU). A retrospective study of all paediatric (< 16 years) admissions to our general ICU from January 1994 to December 2007. Out of a total of 1364 admissions, 302 (22.1%) were in the paediatric age group. Their age ranged from a few hours old to 15 years with a mean of 4.9 ± 2.5 years. The male: female ratio was 1.5:1. Postoperative admissions made up 51.7% of the admissions while trauma and burn made up 31.6% of admissions. Medical cases on the other hand constituted 11.6% of admissions. Of the 302 children admitted to the ICU, 193 were transferred from the ICU to other wards or in some cases other hospitals while 109 patients died giving a mortality rate of 36.1%. Mortality was significantly high in post-surgical paediatric patients and in patients with burn and tetanus. The length of stay (LOS) in the ICU ranged from less than one day to 56 days with a mean of 5.5 days. We found an increasing rate of paediatric admissions to our general ICU over the years. We also found a high mortality rate among paediatric patients admitted to our ICU. The poor outcome in paediatric patients managed in our ICU appears to be a reflection of the inadequacy of facilities. Better equipping our ICUs and improved man-power development would improve the outcome for our critically ill children. Hospitals in our region should also begin to look into the feasibility of establishing PICUs in order to further improve the standard of critical care for our children.

  6. Protected Vertices in Motzkin trees


    Van Duzer, Anthony


    In this paper we find recurrence relations for the asymptotic probability a vertex is $k$ protected in all Motzkin trees. We use a similar technique to calculate the probabilities for balanced vertices of rank $k$. From this we calculate upper and lower bounds for the probability a vertex is balanced and upper and lower bounds for the expected rank of balanced vertices.

  7. Knowledge and use of evidence-based nutrition : a survey of paediatric dietitians

    NARCIS (Netherlands)

    Thomas, DE; Kukuruzovic, R; Martino, B; Chauhan, SS; Elliott, EJ


    Objective To survey paediatric dietitians' knowledge and use of evidence-based nutrition (EBN). Design Cross-sectional survey using reply-paid questionnaires. Subjects Paediatric dietitians in Australian teaching hospitals. Main outcome measures Age, sex, appointment, clinical practice, research

  8. Validation of a Paediatric Early Warning Score: first results and implications of usage

    NARCIS (Netherlands)

    Fuijkschot, J.; Vernhout, B.; Lemson, J.; Draaisma, J.M.T.; Loeffen, J.L.C.M.


    Timely recognition of deterioration of hospitalised children is important to improve mortality. We developed a modified Paediatric Early Warning Score (PEWS) and studied the effects by performing three different cohort studies using different end points. Taking unplanned Paediatric Intensive Care

  9. Population pharmacokinetics of intravenous clonidine for sedation during paediatric extracorporeal membrane oxygenation and continuous venovenous hemofiltration

    NARCIS (Netherlands)

    Kleiber, Niina; Mathôt, Ron A. A.; Ahsman, Maurice J.; Wildschut, Enno D.; Tibboel, Dick; de Wildt, Saskia N.


    AIMS Clonidine is used for sedation in the paediatric intensive care unit. Extracorporeal membrane oxygenation (ECMO) provides temporary support if respiratory and cardiac function is threatened. ECMO influences the pharmacokinetics of drugs. Clonidine during paediatric ECMO cannot be effectively

  10. Population pharmacokinetics of intravenous clonidine for sedation during paediatric extracorporeal membrane oxygenation and continuous venovenous hemofiltration

    NARCIS (Netherlands)

    Kleiber, N.; Mathot, R.A.A.; Ahsman, M.J.; Wildschut, E.D.; Tibboel, D.; Wildt, S.N. de


    AIMS: Clonidine is used for sedation in the paediatric intensive care unit. Extracorporeal membrane oxygenation (ECMO) provides temporary support if respiratory and cardiac function is threatened. ECMO influences the pharmacokinetics of drugs. Clonidine during paediatric ECMO cannot be effectively

  11. [Epidemiological changes of paediatric urolithiasis in Tunisia]. (United States)

    Alaya, Akram; Nouri, Abdellatif; F Najjar, Mohamed


    The clinical and biological characteristics of urolithiasis in children are still evolving in our country. Since the eighties no study has been conducted to determine incidence of urolithiasis in Tunisia. To define the current status of urolithiasis in Tunisian children. The records of 414 children with urolithiasis treated between 1983 and 2007 were found in a multi-centric study which took into consideration to age, sex, and history diagnosis and physical, laboratory, and radiologic findings. Clinical and biological date were performed in 344 cases. Stone analysis was performed by spectrophotometry. The incidence of paediatric urolithiasis has steadily decreased from 0.7/ 10 000 of the child population / year in 1991-1994 to 0.1 cases/10 000 children/ year in 2007. There was a continuous decrease in bladder stone over the past 25 years (47.1% in 1982-1986 Vs 10.2% in 2002-2007). Stones were homogeneous in 31.4% of cases. The main component was calcium oxalate stones in 36.4% of the cases. Since the eighties the increase of oxalates stones (15.6% in eighties Vs 51.5% actually) were with depends to purines and struvite stones. Epidemiologic characteristics of the urinary lithiasis (sex, age, localization and composition) have changed in Tunisia, due to the the improvements of standard of living. The occidentalization of the nutritional practices and the receding of the culinary traditions gave birth to new risks of urolithiasis characterized by the emergence of calcium oxalate stones.

  12. Depression in paediatric chronic fatigue syndrome. (United States)

    Bould, Helen; Collin, Simon M; Lewis, Glyn; Rimes, Katharine; Crawley, Esther


    To describe the prevalence of depression in children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and investigate the relationship between depression in CFS/ME and clinical symptoms such as fatigue, disability, pain and school attendance. Cross-sectional survey data using the Hospital Anxiety and Depression Scale (HADS) collected at assessment. Specialist paediatric CFS/ME service in the South West. Children aged 12-18 years with CFS/ME. Depression was defined as scoring >9 on the HADS depression scale. 542 subjects had complete data for the HADS and 29% (156/542) (95% CI 25% to 33%) had depression. In a univariable analysis, female sex, poorer school attendance, and higher levels of fatigue, disability, pain, and anxiety were associated with higher odds of depression. Age of child and duration of illness were not associated with depression. In a multivariable analysis, the factors most strongly associated with depression were disability, with higher scores on the physical function subscale of the 36 item Short Form (SF-36). Depression is commonly comorbid with CFS/ME, much more common than in the general population, and is associated with markers of disease severity. It is important to screen for, identify and treat depression in this population.

  13. Paediatrics and psychoanalysis--Miss Anna Freud. (United States)


    Miss Anna Freud died during the winter at the age of 86. She had been a pioneer in the understanding of children through psychoanalysis and a great champion of the rights of children. Her life began in Vienna as the youngest child of Sigmund Freud, and her early work with children was in Austria. In 1938, because of the Nazi régime and even though she was nursing her father during his terminal illness, she had to escape with him to London. Her work with homeless children and with those in residential nurseries in London during the second world war is well known, as is her work on child development and psychopathology in the postwar years. But one less well known aspect of her life that was of immense importance to a few fortunate British paediatricians was the 'paediatric group' that she ran for over a quarter of a century and which Dr Christine Cooper recalled at the memorial meeting in London earlier this year. PMID:6344806

  14. Nasojejunal tube placement in paediatric intensive care. (United States)

    McDermott, Ann; Tomkins, Natalie; Lazonby, Gill


    Nasojejunal delivery of enteral feeds is a safe and effective alternative to parenteral nutrition in critically ill children in whom intra-gastric feeding is usually poorly tolerated. A guideline for bedside placement of nasojejunal tubes (NJTs) was developed by a mulit-disciplinary group. An audit of practice was carried out following implementation of the guideline. During the audit period 27 NJTs were successfully passed in 21 patients. The result of this innovation has been early initiation of nasojejunal feeding and an increase in bedside placement of NJTs within the PICU. Paediatric radiologists have reported a reduction in requests for NJT placement under X-ray screening and there has been a reduction in the use of medication and X-ray to place NJTs. Based on the audit data, 58 per cent of the children would have definitely or probably commenced parenteral nutrition had NJT placement and feeding been unsuccessful. The audit also demonstrated that 26 out of 27 nurses and doctors reported they found the guidelines easy or very easy to follow. Reducing variations in practice through the use of guidelines increases the frequency of jejunal feeding. This benefits critically ill patients by improving tolerance of enteral feeding for better nutritional outcomes.

  15. Impact of child death on paediatric trainees. (United States)

    Hollingsworth, Clare E; Wesley, Carla; Huckridge, Jaymie; Finn, Gabrielle M; Griksaitis, Michael J


    To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death. A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ2 test. A p value of child, although 190/284 (67%) had no training in child death. 118/248 (48%) of trainees were given a formal debrief session following their most recent experience. 203/251 (81%) of trainees reported one or more symptoms or behaviours that could contribute to a diagnosis of ASR/PTSD. 23/251 (9%) of trainees met the complete criteria for ASR and 13/251 (5%) for PTSD. Attending a formal debrief and reporting feelings of guilt were associated with an increase in diagnostic criteria for ASR/PTSD (p=0.036 and pchild. The feeling of guilt should be identified and acknowledged to allow prompt signposting to further support, including psychological assessment or intervention if required. Clear recommendations need to be made about the safety of debriefing sessions as, in keeping with existing evidence, our data suggest that debrief after the death of a child may be associated with the development of symptoms suggestive of ASR/PTSD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.


    Directory of Open Access Journals (Sweden)



    Full Text Available Purpose: To evaluate the demography, aetiology, type and outcome of paediatric ocular trauma in tertiary centre in Malaysia. Method: We retrospectively studied 118 eyes from 117 patients over a period of 36 months (January 2006 to December 2008. All ocular injuries in patients aged 12 and below seen in the Ophthalmology Department for the first time were included in thisstudy. Results: Mean age of patients was 6.1±3.0 years. 68 cases (58.2% occurred in pre-school children, whereas 49 (41.9% in school-aged children. Boys accounted for 65.8% of cases. There was no predilection for either right or the left eye. 47% of cases (56 patients occurred in Malay. Most of the injuries took place at home when the children were alone (p<0.05. Sharp objects were the commonest cause (45 cases, 38.1%. The majority of cases (103, 87.3% were considered preventable. The frequency of open and closed globe injury was similar. Hyphema was more common in closed globe injury compared to open globe injury (p<0.05. Other associated injuries such as cataract, vitreous hemorrhage and retinal hemorrhage are similar between the two groups. Visual outcome is generally poor with only 34 eyes (28.8% had no visual impairment. Conclusion: Ocular trauma in children is an important cause of visual loss. Most cases occurred at home and were preventable. Prevention through education is the best approach.

  17. Radionuclide studies in paediatric nephro-urology

    Energy Technology Data Exchange (ETDEWEB)

    Piepsz, Amy E-mail:


    The main tool of radionuclide techniques applied to paediatric uro-nephrology is the quantitation of function, which is an information not easily obtained by other diagnostic modalities. The radiation burden is low. Drug sedation is only rarely needed, whatever the age of the patient. Accurate determination of glomerular filtration rate can be obtained by means of an intravenous injection of Cr-51 EDTA and one or two blood samples. Tc-99m DMSA scintigraphy is an accurate method for evaluation of regional cortical impairment during acute pyelonephritis and later on, for detection of permanent scarring. Tc-99m MAG3 renography is nowadays a well-standardized method for accurate estimation of the split renal function and of renal drainage with or without furosemide challenge. This technique is particularly indicated in uni- or bilateral uropathies with or without renal and/or ureteral dilatation. Direct and indirect radionuclide cystography are two alternative modalities for X-ray MCUG. Their relative place in the strategy of management of vesicoureteral reflux is discussed.

  18. Paediatric analgesia in an Emergency Department.

    LENUS (Irish Health Repository)

    Hawkes, C


    Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. An audit including 145 patients followed this. 55.6% of patients with major fractures received analgesia after a median time of 54 minutes, which improved to 61.1% (p = 0.735) after 7 minutes (p = 0.004). Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.

  19. [Eosinophilic esophagitis: increasing incidence in paediatric population]. (United States)

    Braga-Tavares, Hugo; Teles, Andreia; Nogueira, Rosete; Cardoso Rodrigues, Fernando; Costa, Cristina


    Eosinophilic Esophagitis has been increasingly diagnosed and results from a chronic esophagic inflammation with eosinophilic infiltrate. Evaluation of the diagnosed paediatric cases in our centre between 2004 and 2008 and revision of current literature on this subject. Four caucasian boys, aged eight to fifteen years old, were diagnosed with Eosinophilic Esophagitis. They presented with disphagia and food impaction and endoscopic findings included multiple concentric rings (pseudo-trachea pattern) and friable mucosa. All of them had mucosal eosinophil counts higher than 20 eosinophils/high-powered field and were given corticosteroids, either topic or systemic (one case) with therapeutic success. The diagnosis of Eosinophilic Esophagitis must be considered in presence of disphagia, food impaction or gastroesophageal reflux symptoms refractory to treatment. Endoscopic evaluation may be normal and the diagnosis is based on histological findings, making biopsy mandatory whenever clinically suspected. The increasing incidence of the last years associated with the high recurrence rate will lead to future prevalence increased both in child and adulthood.

  20. Bilateral orbital complications of paediatric rhinosinusitis. (United States)

    Singh, S K; James, E; Sabarigirish, K; Swami, H; Sood, Tarun


    The spread of infection from the ethmoid sinuses to the orbit occurs directly through a congenital dehiscence of the lamina papyracea or via haematogenous spread through ophthalmic venous system. Hence orbital complications of paediatric rhinosinusitis are usually unilateral at presentation. We describe three children with bilateral orbital cellulitis that occurred as a complication of rhinosinusitis without intracranial spread of the infection. The children ranged in the age group from 4 to 7 years. All these children had a prolonged hospital stay from 14 to 25 days and underwent multiple surgical procedures to drain the subperiosteal abscess. These children presented to the hospital with bilateral orbital cellulitis without significant past history. All of them on radiological evaluation showed subperiosteal abscess involving only one orbit. They were taken up for functional endoscopic sinus surgery and the subperiosteal abscess was drained endoscopically with partial removal of lamina papyracea. One case required second surgery despite good recovery for two days post first surgery. Two cases had severe unilateral visual loss at presentation but both recovered dramatically after the surgery. All cases had uneventful recovery with no residual disability. The purpose of this article is to discuss the reasons for bilateral orbital complications of rhinosinusitis at initial presentation despite the previous hypothesis of unilateral involvement.

  1. Parental involvement in paediatric cancer treatment decisions. (United States)

    McKenna, K; Collier, J; Hewitt, M; Blake, H


    This study investigated parents' information needs and involvement in decision-making processes affecting the care of children diagnosed with cancer. Interviews and questionnaires were used to assess parental satisfaction in 50 mothers and 16 fathers responsible for 58 children in an English Paediatric Oncology Unit. Parents reported that doctors contributed almost twice as much to the decision-making process as they did, but parental satisfaction was positively correlated with the amount of information provided when giving informed consent. Satisfaction about their involvement in this process relied heavily upon the level of support received from others. Parents consenting to their child's involvement in non-randomised trials perceived themselves to be under greater pressure from others during the decision-making process while those whose children were further along the treatment trajectory were more uncertain about decisions previously made. Findings indicate that the accessibility, support, information and degree of control afforded to parents by healthcare professionals impacts upon their satisfaction with both the decision-making process and their confidence in the decisions thus made. Information and support tailored to parents' specific needs may therefore enhance satisfaction with clinical decision making and reassure parents about decisions made in the long-term interest of their child's health.

  2. Current practice in paediatric basic life support

    Directory of Open Access Journals (Sweden)

    Heczková Jana


    Full Text Available Introduction. Although the incidence of cardiac arrest in children is much lower than in adults, the condition is still considered a major health problem with a very low chance for survival. As in adults, the timely provision of cardiopulmonary resuscitation (CPR in children is crucial. Current guidelines for CPR in children were published along with the guidelines for CPR in adults in 2015. As in previous years, they are based on consensus provided by International Liaison Committee on Resuscitation (ILCOR. Guidelines of particular ILCOR member councils may vary and reflect regional characteristic such as different access to health care, education methods or willingness of population to provide emergency assistance. Moreover, the conditions requiring CPR in children are characterized not only by different incidence, but also by aetiology or techniques used for different age groups. Therefore, emphasis is put on simplicity and feasibility as well as on consistency with adult guidelines to improve retention of the paediatric sequences. Nurses may be first rescuers not only in health care facilities. Better understanding of CPR guidelines might help them to improve their ability to detect conditions requiring CRP and also initiate and provide effective emergency care.

  3. Gait and Lower Limb Observation of Paediatrics (GALLOP): development of a consensus based paediatric podiatry and physiotherapy standardised recording proforma. (United States)

    Cranage, Simone; Banwell, Helen; Williams, Cylie M


    Paediatric gait and lower limb assessments are frequently undertaken in podiatry and physiotherapy clinical practice and this is a growing area of expertise within Australia. No concise paediatric standardised recording proforma exists to assist clinicians in clinical practice. The aim of this study was to develop a gait and lower limb standardised recording proforma guided by the literature and consensus, for assessment of the paediatric foot and lower limb in children aged 0-18 years. Expert Australian podiatrists and physiotherapists were invited to participate in a three round Delphi survey panel using the online Qualtrics(©) survey platform. The first round of the survey consisted of open-ended questions on paediatric gait and lower limb assessment developed from existing templates and a literature search of standardised lower limb assessment methods. Rounds two and three consisted of statements developed from the first round responses. Questions and statements were included in the final proforma if 70 % or more of the participants indicated consensus or agreement with the assessment method and if there was support within the literature for paediatric age-specific normative data with acceptable reliability of outcome measures. There were 17 of the 21 (81 %) participants who completed three rounds of the survey. Consensus was achieved for 41 statements in Round one, 54 statements achieved agreement in two subsequent rounds. Participants agreed on 95 statements relating to birth history, developmental history, hip measurement, rotation of the lower limb, ankle range of motion, foot posture, balance and gait. Assessments with acceptable validity and reliability were included within the final Gait and Lower Limb Observation of Paediatrics (GALLOP) proforma. The GALLOP proforma is a consensus based, systematic and standardised way to collect information and outcome measures in paediatric lower limb assessment. This standardised recording proforma will assist

  4. Paediatric entrance doses from exposure index in computed radiography (United States)

    Vano, E.; Martinez, D.; Fernandez, J. M.; Ordiales, J. M.; Prieto, C.; Floriano, A.; Ten, J. I.


    Over the last two years we have evaluated paediatric patient doses in projection radiography derived from exposure level (EL) in computed radiography (CR) in a large university hospital. Entrance surface air kerma (ESAK) for 3501 paediatric examinations was calculated from the EL, which is a dose index parameter related to the light emitted by the phosphor-stimulable plate, archived in the Digital Imaging and Communications in Medicine (DICOM) header of the images and automatically transferred to a database using custom-built dedicated software. Typical mean thicknesses for several age bands of paediatric patients was estimated to calculate ESAK from the EL values, using results of experimental measurements with phantoms for the typical x-ray beam qualities used in paediatric examinations. Mean/median ESAK values (in µGy) for the age bands of images used for the (indirect) measurements were 1724 for chest without a bucky, 799 for chest with a bucky, 337 for abdomen and 641 for pelvis. The methodology we describe could be applicable to other centres using CR as an imaging modality for paediatrics. Presently, this method is the only practical approach to automatically extract parameters contained in the DICOM header, for the calculation of patient dose values for the CR modality.

  5. Smartphone applications in paediatric radiology: availability and authority. (United States)

    Shelmerdine, Susan C; Lynch, Jeremy O


    With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families.

  6. Smartphone applications in paediatric radiology: availability and authority

    Energy Technology Data Exchange (ETDEWEB)

    Shelmerdine, Susan C. [Great Ormond Street Hospital, Specialist Registrar in Clinical Radiology, Department of Clinical Radiology, London (United Kingdom); Lynch, Jeremy O. [Chelsea and Westminster Hospital, Specialist Registrar in Clinical Radiology, Department of Clinical Radiology, London (United Kingdom)


    With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families. (orig.)

  7. Breaking bad news: an interview study of paediatric cardiologists. (United States)

    Birkeland, Anna-Lena; Dahlgren, Lars; Hägglöf, Bruno; Rydberg, Annika


    Technical developments in paediatric cardiology over the last few decades have increased expectations on professionals, demanding of them more emotional competence and communicative ability. The aim of this study was to examine the approach of paediatric cardiologists in informing and communicating with the family of the patient. A qualitative interview method was first tested in a pilot study with two paediatric cardiologists. There were nine subsequent semi-structured interviews that were carried out with paediatric cardiologists. A researcher performed all the interviews, which were taped, transcribed, decoded, and analysed. Among paediatric cardiologists, how to break bad news to the family is an important concern, evident in findings regarding the significance of trust and confidence, the use of different emotional positions, and a common ambition to achieve skills to handle the situation. There is a need for reflection, education, and sharing of experiences. The cardiologists desire further development of teamwork and of skills in medical students and residents for delivering bad news. Doctors are expected to cope with the complexities of diagnoses and decisions, while simultaneously being sensitive to the feelings of the parents, aware of their own emotions, and able to keep it all under control in the context of breaking the bad news to the parents and keeping them informed. These conflicting demands create a need to expand the professional role of the doctor by including more training in emotional competence and communicative ability, beginning in medical school and continuing through consultancy.

  8. Finally in Italy the School of Specialisation in Paediatric Dentistry! (United States)

    Marzo, G


    After over two decades of discussions, promises and indecisions, the year 2016 marked the birth of the School of Specialisation in Paediatric Dentistry, which is now a reality. The importance of dental post-graduate specialisation schools has been debated since the Degree Course in Dentistry was established. Previously, in Italy only two dental branches - Oral Surgery and Orthodontics - had obtained the recognition that a School of Specialisation entails. Today, with specific training and the newly- established hyper-specialisation in Paediatric Dentistry, the future of the profession is brighter than ever. This will allow dental professionals to provide the best cure to our young patients but it especially marks and recognises the importance of prevention in general. Having established a Specialty School in Paediatric Dentistry is also important to keep the pace with the other European countries where this postgraduate course has been already offered for many years. In my opinion, training professionals with a solid specialisation based both on cultural insights and hands-on clinical activities translates into the possibility of making true prevention. The ultimate goal of paediatric dentists, as well as paediatricians, is certainly to treat young patients but also and above all to accompany them toward an adulthood possibly free of pathologies. With an eye to a future where Paediatric Dentistry will be at the core of dental and orthodontic prevention, I wish great success to all the many specialisation schools established within the Italian Universities.

  9. Evaluation of words in child-paediatric dentist communication. (United States)

    Caglar, K; Sandalli, N; Kirant, B; Kuscu, O O


    Aim of the present study is to demonstrate which words are widely used by children and a paediatric dentist during different dental procedures in conjunction with behaviour shaping in paediatric dentistry. Twenty children aged between 3.5 and 10.5 (10 F, 10 M) visiting the clinic of Yeditepe University were enrolled for the study. An audio recorder was hidden in the operatory room, the paediatric dentist was blind. The procedure was randomised as for each child only one appointment was recorded (one patient-one appointment-one procedure). Age, gender, appointment type, details of procedure performed were recorded. At the end of every session, records were investigated regarding verbal communication. The paediatric dentist used a total of 5,005 words during the trial with minimum of 13 and max of 518 words in a session (mean 211.8 ± 153.1). There were no significant differences in the words used by the child and the practitioner regarding gender, session, and duration of being acquainted with (p>0.05). Regarding age groups, preschoolers (3.5-6 yrs old) significantly used more words than the schoolers (7- 10.5 yrs old) (pPaediatric dentists should be careful and selective in communication with children as well as using an age-appropriate language.

  10. Treatment policies among Israeli specialists in paediatric dentistry. (United States)

    Gordon, M; Gorfil, C; Segal, S; Mass, E


    This was to evaluate some suggested diagnostic procedures, treatment policies and professional attitudes of specialists in paediatric dentistry, in light of the periodically published guidelines by The American Academy of Pediatric Dentistry, The European Academy of Paediatric Dentistry and The British Society of Paediatric Dentistry. Using a structured questionnaire, 67% of the Israeli specialists in paediatric dentistry, who agreed to participate in this study, were personally interviewed. Only 7.5% of the participants reported that they carry out pulp capping of primary teeth in cases of pulp exposure. Over 50% reported restoring teeth after pulpotomy with preformed crowns. Most indicated sealing pit and fissures after considering depth and morphology of the fissures and correlation with the patient's risk to caries. Cleaning teeth after eruption of the first tooth was suggested by 75.5% of the participants. A striking majority (96%) claimed that they restored permanent anterior teeth with composite resins and most used these materials for occlusal restoration in both primary and permanent posterior teeth. Most specialists advocated the use of amalgam in proximal posterior restorations. The presence of a parent in the operatory/surgery was preferred by 85% of the dentists. Israeli specialists in paediatric dentistry mostly comply with the mentioned guidelines. Further studies of this nature should also be encouraged in other countries to emphasize the importance of monitoring compliance with established and evidence based guidelines.

  11. Understanding the responsibilities and obligations of the modern paediatric surgeon. (United States)

    Beasley, Spencer W


    The modern paediatric surgeon needs to be competent in multiple domains that extend well beyond their clinical and technical expertise. This article, based on the Journal of Pediatric Surgery Lecture at the BAPS Congress (2014), explores some of these less well understood responsibilities and obligations, including professionalism, leadership, effective clinical teaching, and research. The consequence of falling short in these areas includes risks to our profession as a whole as well as compromising our ability to provide our patients with the best clinical care. Paediatric surgeons have a responsibility to influence the configuration of services to improve the quality of care and equity of access to specialist services for all children in their region. Evidence presented shows how a well-organised and funded regional paediatric surgical service allows children to receive quality treatment closer to home and is reflected in better clinical outcomes, less unnecessary surgery, and fewer complications. A paradigm for support to emerging countries as they increase the capacity and infrastructure of their paediatric surgical services is proposed. The way we judge ourselves and others should relate to our performance across the full scope of roles that a responsible and committed paediatric surgeon is expected to display. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Patient Doses in Paediatric Fluoroscopic Examinations in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Servomaa, A.; Komppa, T.; Heikkila, M.; Parviainen, T


    Dose-area products (DAP) in paediatric fluoroscopic examinations were measured at paediatric clinics in three university hospitals. The purpose was to provide supplementary data for development of reference doses, and for determination of relations between patient size and dose, in examinations involving both radiography and fluoroscopy for paediatric patients of various ages. The number of paediatric patients was 217. The most common fluoroscopic examinations were: micturating cystourethrography (MCU), 103 patients; barium enema (anography), 39 patients; barium meal and follow, 20 patients; and oesophagus, nine patients. Data on the patients and examination techniques, and the dose-area products are reported for various examinations and age groups. In the MCU examinations the mean DAP values were 560{sup 2} for the age group of 0 years: 910{sup 2} for the age group of 1-4 years; 880{sup 2} for the age group of 5-9 years; and 4600{sup 2} for the age group of 10-15 years. The radiation doses to which paediatric patients are exposed in fluoroscopic examinations vary over a large scale, even within narrow age bands, and comparisons between the doses are difficult because of wide ranges in patient size. This indicates the need for developing a method for taking account of the effects of patients size before deriving reference doses. (author)

  13. Sudden cardiac death: clinical evaluation of paediatric family members. (United States)

    Tomaske, Maren; Keller, Dagmar I; Bauersfeld, Urs


    To evaluate paediatric relatives of first- and non-first-degree family victims with a history of premature sudden cardiac death (SCD) or aborted cardiac arrest (ACA). Thirty-six consecutive referred families after SCD (n = 29) or ACA (n = 7) of a family member were analysed. Referral was either due to an inherited heart disease identified after autopsy, post-event, or family evaluation (n = 20 families) or due to sudden unexplained death (SUD, n = 16 families). In 3 of 16 (19%) SUD families, an inherited heart disease was diagnosed by evaluation of the paediatric relatives. In 5 of 25 (20%) referred paediatric relatives of SUD families, an inherited heart disease was identified, mainly sinus node dysfunction (n = 3). A total of 13 of 33 (39%) referred paediatric relatives of families with known inherited heart disease were affected, mainly with cardiomyopathy (n = 5) and primary electrical disease (n = 7). Prevention of SCD was initiated in 16 of the affected children by implantation of an antibradycardia device (n = 3), an implantable cardioverter defibrillator (ICD, n = 6), and/or antiarrhythmic medication (n = 8). Appropriate and successful ICD discharges occurred in four. A stepwise, comprehensive clinical investigation of SCD or ACA families identifies a substantial number of paediatric relatives at risk of SCD. This allows for targeted prevention by effective treatments and evaluation of further relatives.

  14. The use of Hall technique preformed metal crowns by specialist paediatric dentists in the UK


    Roberts, A; McKay, A; Albadri, S


    Examines treatment planning involving Hall technique preformed metal crowns by specialists in paediatric dentistry. Explores clinical situations in which specialists in paediatric dentistry feel it is appropriate or not to fit Hall technique preformed metal crowns. Investigates which types of carious lesions are being treated with Hall technique preformed metal crowns by specialists in paediatric dentistry.

  15. The use of ketofol for procedural sedation in paediatric bone marrow ...

    African Journals Online (AJOL)

    The aim of this study was to evaluate the safety and efficacy of ketamine/propofol combination in procedural sedation for the bone marrow biopsy and intrathecal chemotherapy in paediatricpatients in the paediatric oncology ward. Methods: Fourteen paediatric oncology patients at the Paediatric oncology ward of the Lagos ...

  16. A retrospective audit of paediatric surgical admission in a sub-urban ...

    African Journals Online (AJOL)

    Summary. Background: Data on utilization of paediatric surgical ser- vices and the burden of paediatric surgical diseases in the. West African subregion is scarce. Methodology: This retrospective study describes paediatric surgical admissions in a Nigerian teaching hospital between. January 1998 and December 2002.

  17. Occupationally acquired tuberculosis: what's known. (United States)

    Bowden, K M; McDiarmid, M A


    Tuberculosis (TB) morbidity and mortality have increased substantially since the mid-1980s in areas with a high prevalence of medically underserved populations, human immunodeficiency virus, foreign-born persons, residents of long-term care facilities and crowded correctional institutions, and alcoholics and intravenous-drug abusers. The occupational risk has likewise increased for those exposed to these high-risk people in the course of their work. The magnitude of the occupational hazard is present unclear, although implications are disturbing. We used available data bases containing occupational exposure information, and telephone surveys, in an attempt to elucidate the magnitude of risk of occupationally acquired TB. We obtained up-to-date employee conversion rates at high-risk institutions, identified changing rates of TB infection and disease over time, documented high conversion rates following accidental exposures, and revealed a relative lack of reported TB disease and deaths. Numerous barriers to worker protection against TB are identified and recommendations are made to reduce the risk of occupationally acquired tuberculosis.


    Schindler, Bettina; Vriends, Noortje; Margraf, Jürgen; Stieglitz, Rolf-Dieter


    The few studies that have explored how flying phobia is acquired have produced contradictory results. We hypothesized that classical conditioning plays a role in acquiring flying phobia and investigated if vicarious (model) learning, informational learning through media, and experiencing stressful life events at the time of onset of phobia also play a role. Thirty patients with flying phobia and thirty healthy controls matched on age, sex, and education were interviewed with the Mini-DIPS, the short German version of the Anxiety Disorders Interview Schedule (DSM-IV diagnostic criteria) and the Fear-of-Flying History Interview. Fifty Percent of patients with flying phobia and 53% of healthy controls reported frightening events in the air. There was no significant difference between the two samples. Thus there were not more classical conditioning events for patients with flying phobia. There also was no significant difference between the two samples for vicarious (model) learning: 37% of flying phobia patients and 23% of healthy controls felt influenced by model learning. The influence of informational learning through media was significantly higher for the clinical sample (70%) than for the control group (37%). Patients with flying phobia experienced significantly more stressful life events in the period of their frightening flight experience (60%) than healthy controls (19%). Frightening experiences while flying are quite common, but not everybody develops a flying phobia. Stressful life events and other factors might enhance conditionability. Informational learning through negative media reports probably reinforces the development of flying phobia. Clinical implications are discussed. © 2015 Wiley Periodicals, Inc.

  19. Paediatric radiation oncology in the care of childhood cancer: A position paper by the International Paediatric Radiation Oncology Society (PROS). (United States)

    Kortmann, Rolf-Dieter; Freeman, Carolyn; Marcus, Karen; Claude, Line; Dieckmann, Karin; Halperin, Edward; Esiashvili, Natia; Paulino, Arnold; Mahajan, Anita; Seiersen, Klaus; Ahern, Verity; Ricardi, Umberto; Carrie, Christian


    Paediatric malignancies are a challenge for the radiation oncologist due to their rarity, the great variety of histological types, and the complexity of treatment concepts that evolve over time. The Paediatric Radiation Oncology Society (PROS) is the only internationally operating society for paediatric radiation oncology. The objectives of PROS are to set a world-wide standard of excellence with respect to radiation oncology aspects in curing children and adolescents with cancer, to provide a forum for communication between radiation oncologists, and to exchange information with all professionals involved in the management of paediatric and adolescent cancer. Challenges include the need to promote education and support practice in low and middle income countries (LMIC) as well as the cost and availability of modern treatment technologies for all but most especially these countries. Collaborations with other societies that include for example the education programmes provided jointly with ESTRO, and the upgraded technical platform of the PROS web site offer new possibilities to enhance the efficacy of PROS in education and support of paediatric radiation oncology practice world-wide. PROS has made an important contribution to the management of childhood malignancies over the past decade and new and developing collaborations between PROS and other societies or organizations will ultimately lead to a reduction in world-wide health care inequalities. Copyright © 2016. Published by Elsevier Ireland Ltd.

  20. Review of simulation in paediatrics: The evolution of a revolution

    Directory of Open Access Journals (Sweden)

    Rahul eOjha


    Full Text Available Recent changes in medical education have highlighted the importance of experiential learning. Simulation is one model that has gained significant attention in the last decade and has been widely adopted as a training and assessment tool in medical education. Paediatric simulation has been utilized to teach various skills including resuscitation and trauma management, procedural skills and team training. It is also a valuable tool for health care educators, as it allows learners to achieve competence without putting patients at risk. Recent literature demonstrates increased retention of knowledge and skills after simulation based training. Further research is required to improve current simulation curriculums, develop validated assessment tools and to demonstrate improved clinical outcomes after simulation based training. We conducted an online search of original and review articles related to simulation and paediatric medical education and provide an overview of the role and utility of simulation in paediatrics.

  1. Paediatric oral biopharmaceutics: key considerations and current challenges. (United States)

    Batchelor, Hannah K; Fotaki, Nikoletta; Klein, Sandra


    The complex process of oral drug absorption is influenced by a host of drug and formulation properties as well as their interaction with the gastrointestinal environment in terms of drug solubility, dissolution, permeability and pre-systemic metabolism. For adult dosage forms the use of biopharmaceutical tools to aid in the design and development of medicinal products is well documented. This review considers current literature evidence to guide development of bespoke paediatric biopharmaceutics tools and reviews current understanding surrounding extrapolation of adult methodology into a paediatric population. Clinical testing and the use of in silico models were also reviewed. The results demonstrate that further work is required to adequately characterise the paediatric gastrointestinal tract to ensure that biopharmaceutics tools are appropriate to predict performance within this population. The most vulnerable group was found to be neonates and infants up to 6 months where differences from adults were greatest. © 2013.

  2. Computational hybrid anthropometric paediatric phantom library for internal radiation dosimetry

    DEFF Research Database (Denmark)

    Xie, Tianwu; Kuster, Niels; Zaidi, Habib


    covering statistical distributions of body morphometry in the paediatric population. The paediatric phantoms of the Virtual Population Series (IT'IS Foundation, Switzerland) were modified to match target anthropometric parameters, including body mass, body length, standing height and sitting height...... to create 1100 female and male phantoms with 10th, 25th, 50th, 75th and 90th body morphometries. Evaluation was performed qualitatively using 3D visualization and quantitatively by analysing internal organ masses. Overall, the newly generated phantoms appear very reasonable and representative of the main...... characteristics of the paediatric population at various ages and for different genders, body sizes and sitting stature ratios. The mass of internal organs increases with height and body mass. The comparison of organ masses of the heart, kidney, liver, lung and spleen with published autopsy and ICRP reference data...

  3. A concept analysis of holistic nursing care in paediatric nursing

    Directory of Open Access Journals (Sweden)

    A.A. Tjale


    Full Text Available Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative and contextual research design was used. An evolutionary concept analysis was undertaken to clarify the concept “holistic nursing care” in paediatric nursing in three Johannesburg hospitals. Rodgers’ (1989, 2000 evolutionary method was utilised to analyse the concept.

  4. Collaboration between paediatric surgery and other medical specialties in Nigeria

    Directory of Open Access Journals (Sweden)

    Philemon E Okoro


    Full Text Available Background: The quality of service and success of patient care and research in most fields of medicine depend on effective collaboration between different specialties. Paediatric surgery is a relatively young specialty in Nigeria and such collaborations are desirable. This survey assesses the nature and extent of collaboration between paediatric surgery and other specialties in Nigeria. Materials and Methods: This is a questionnaire survey carried out in November 2008 among paediatric surgeons and their trainees practising in Nigeria. Questionnaires were distributed and retrieved either by hand or e-mailing. The responses were then collated and analysed using the SPSS 17.0. Results: Forty-seven respondents were included in the survey. Forty-five (95.7% respondents thought that there was inadequate collaboration and that there was a need for an increased collaboration between paediatric surgery and other specialties. Anaesthesia, paediatrics and radiology are among the specialties where collaborations were most required but not adequately received. Collaboration had been required from these specialties in areas of patient care, training and research. Reasons for inadequate collaboration included the paucity of avenues for inter-specialty communication and exchange of ideas 33 (70.3%, lack of awareness of the need for collaboration 32 (68.1%, tendency to apportion blames for bad outcome 13 (27.7%, and mutual suspicion 8 (17%. Conclusion: There is presently inadequate collaboration between paediatric surgery and other specialties in Nigeria. There is a need for more inter-specialty support, communication, and exchange of ideas in order to achieve desirable outcomes.

  5. Informed consent for paediatric clinical trials in Europe. (United States)

    Lepola, Pirkko; Needham, Allison; Mendum, Jo; Sallabank, Peter; Neubauer, David; de Wildt, Saskia


    Paediatric clinical trials are often conducted as multinational trials. Informed consent or assent is part of the ethics committee approval for clinical trials. The consent requirements vary between countries due to national laws and regulations, which are not harmonised in Europe. These discrepancies can present challenges for paediatric clinical trials. The aim of this study was to assemble these consent and assent requirements across the European Economic Area. The collated national requirements have not been publicly available before, despite a real need for this data. National consent and assent requirements for paediatric clinical trials were analysed and collated for 25 European Union Member States and 2 European Free Trade Association countries until the end of 2014. The data were retrieved from existing databases and through communication with the competent authorities and selected ethics committees. Results from a literature search for international or national guidelines, declarations and conventions and academic societies' publications served as comparison material. Consent and assent requirements are heterogeneous across these countries. We compiled our findings in 'The Informed Consent and Assent Tool Kit', a table including 27 national consent and assent requirements listed by individual country. Wide variation in paediatric consents and assents presents challenges for multinational paediatric trials in Europe. The toolkit is available for all those involved in paediatric clinical trials and ethics committees, providing a new platform for proactive feedback on informed consent requirements, and may finally lead to a needed harmonisation process, including uniform standards accepted across Europe. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  6. Paediatric Drug Development and Formulation Design-a European Perspective. (United States)

    Van Riet-Nales, Diana A; Kozarewicz, Piotr; Aylward, Brian; de Vries, Rutger; Egberts, Toine C G; Rademaker, Carin M A; Schobben, Alfred F A M


    The availability of licensed paediatric drugs is lagging behind those for adults, and there is a lack of safe formulations in suitable doses that children are able and willing to take. As a consequence, children are commonly treated with off-label or unlicensed drugs. As off-label and unlicensed drug use are associated with a greater risk for harm than on-label drug use, a range of global initiatives have been developed to realize "better" medicines for children. This review describes the challenges and achievements of the European Union to realize this goal, with a focus on paediatric drug development and formulation design. In 2007, a European Paediatric Regulation was installed enforcing companies to consider children in the early development of drugs with a new drug substance, for a new indication or with a new route of administration. The Regulation, e.g. requires companies to develop a paediatric investigation plan discussing the proposed clinical trials in children of different ages and the formulations for future marketing. Since 2013, the pharmaceutical design of any newly marketed paediatric drug should comply with the "Guideline on the Pharmaceutical Development of Medicines for Paediatric Use." Companies should, e.g. justify the route of administration, dosage form, formulation characteristics, safety of excipients, dosing frequency, container closure system, administration device, patient acceptability and user information. In this review, the guideline's key aspects are discussed with a focus on novel formulations such as mini-tablets and orodispersible films, excipients with a potential risk for harm such as azo dyes and adequate user instructions.

  7. Paediatric surgery: trends in UK surgical trainees' operative experience. (United States)

    Youngson, G G; Adams, S; Winton, E


    This study assesses the effects of the reconfiguration of postgraduate surgical training and changes to work patterns through legislation within UK on the operative experience of trainees completing specialty training in paediatric surgery. Data were collected from the consolidation record of operative experience submitted by every candidate sitting the Intercollegiate Specialty Board Examination in Paediatric Surgery in UK from 1996 through 2004. A number of index procedures were chosen as surrogates of the overall operative experience and underwent detailed analysis. These comprised operations performed in the following categories: Neonatal Surgery, General Paediatric Surgery, Paediatric Urology, Paediatric Oncology, and Emergency Paediatric Surgery. Sixty-three sets of data comprising 12,866 operations were ultimately identified as being suitable for analysis. The average number of operations performed annually by trainees increased over the study period as did the number in each of the operative categories. The number of operations performed with senior assistance or supervision increased over this period by an average of 12.5%. This trend was also evident in emergency surgery where the average number of sample procedures performed by trainees increased by 28% over the study period. In 1995, reforms to the training grade within UK reduced the time spent in specialist training from a previously unregulated period to 72 months of higher surgical training. Subsequent directives in response to health and safety legislation have further abbreviated the length of time spent at the workplace, initially to 72 hours and more recently to 58 hours per week. This combination has been generally perceived throughout the surgical community as prejudicial to acquisition of clinical and operative competence. This study, however, fails to endorse this perception and suggests to the contrary that perhaps through increased delegation, the volume of training operations is being

  8. [Acute renal failure in paediatric oncological disease]. (United States)

    Stefanowicz, Joanna; Maciejka-Kapuścińska, Lucyna; Rückemann-Dziurdzińska, Katarzyna; Drozyńska-Duklas, Magdalena; Zurowska, Aleksandra; Balcerska, Anna


    Acute renal failure (ARF) in children with malignancies is a rare clinical situation, but nonetheless it is a serious life threatening condition. It may arise from different clinical situations and may be caused by various factors. The aim of the study was to determine the frequency, aetiology and the course of ARF in children treated for malignancies in the Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk. A group of 586 pediatric oncology patients treated between 1992 and 2004 were enrolled in a retrospective study. ARF was diagnosed in 29 cases including: 12 patients with prerenal course of ARF (11 due to septic shock and 1 due to dehydration), 16 patients with intrinsic renal aetiology of ARF (as a complication after cisplatinum and carboplatinum therapy in 2 children, in 2 cases after methotrexate, as a consequence of bilateral nephrectomy due to nephroblastoma in 1 patient and in 11 children with tumour lysis syndrome, including 5 patients with neoplasmatic infiltration of kidneys) and postrenal ARF in 1 patient as a first symptom of a tumour located in the small pelvis (Rhabdomyosarcoma). Renal replacement therapy (dialysis) was necessary in 11 children. Among 29 analysed children, in 20 cases renal failure was reversible. Due to appropriate treatment, ARF in course of tumour lysis syndrome is nowadays reversible. ARF due to septic shock or cytostatics nephrotoxicity is a significant therapeutic problem. In most of the cases it is irreversible. 1. ARF in these studies occurred in 29 out of 586 children with malignancies (4.9%). 2. Prerenal and renal ARF were the most frequent forms. 3. Implementation of tumour lysis prophylaxis in the treatment of children with blood system proliferative diseases reduces the incidence of ARF. 4. In cases of ARF in children's malignancies close cooperation between paediatric oncologist and nephrologist is necessary.

  9. Pharmacokinetics of isepamicin in paediatric patients. (United States)

    Scaglione, F; Viganò, A; Colucci, R; Zampaglione, N; Lin, C C; Cutler, D; Guerciolini, R; Elliott, M; Affrime, M; Radwanski, E


    The pharmacokinetics of isepamicin were evaluated in 50 paediatric patients ranging from newborn to 13 years old. Children with subdivided according to age: Group I (6-13 years); Group II (4 months to 6 years); Group III (16 days to 4 months); and Group IV (newborn to 16 days). All patients received isepamicin 7.5 mg/kg every 12 hours except those in Group IV who received 7.5 mg/kg once daily. Isepamicin was administered initially as an intravenous 30-minute infusion and then either intravenously or intramuscularly for between 4 and 12 days. Plasma samples were obtained after the first or second dose on day 1 at 0, 0.5, 1, 4, 6, 8 and 12 hours after the initiation of dosing and at 0.5 and 12 hours on other dosing days. Additional samples were collected in the Group IV patients at 18, 20 and 24 hours. Isepamicin showed a similar plasma concentration-time profile in Groups I, II and III (children from 16 days to 13 years), and in these groups the profile was generally similar to that observed in adults. Neonates up to the age of 16 days (Group IV) showed a distinctly different pharmacokinetic profile: a significantly larger AUC, longer half-life, lower Cmax and lower total body clearance. Isepamicin 7.5 mg/kg administered once daily to children less than 16 days old and twice daily to children aged 16 days to 13 years appears to be pharmacokinetically appropriate. The drug was very well tolerated by children of all age groups.

  10. Clinical repigmentation patterns in paediatric vitiligo. (United States)

    Gan, E Y; Gahat, T; Cario-André, M; Seneschal, J; Ezzedine, K; Taïeb, A


    Repigmentation is an essential outcome measure in vitiligo. However, clinical studies describing vitiligo repigmentation patterns are lacking. To assess and clearly define the repigmentation patterns in a series of patients with vitiligo, correlating these with clinicoepidemiological characteristics. Patients with vitiligo seen at least at twice (initial consultation and follow-up visit) in the Department of Paediatric Dermatology, Hôpital Pellegrin des Enfants, Bordeaux University Hospital from 2006 to 2014 were included. Clinical photographs and case records were reviewed. There were 109 patients (64 female, 45 male) mostly with Fitzpatrick skin type III (n = 67, 61%). The majority had nonsegmental (n = 71, 65%) or segmental vitiligo (n = 29, 27%). In total 172 representative vitiligo lesions were analysed. Overall, a combined pattern of repigmentation was most commonly seen (n = 106, 62%). The combined pattern occurred more frequently in patients with segmental vs. nonsegmental vitiligo (P = 0·009), whereas the diffuse pattern was more frequent in the latter (P = 0·007). Diffuse repigmentation was the predominant pattern on the eyelids (P < 0·001). We observed a new pattern in sites with few to absent hair follicles, which we propose to call 'medium spotted repigmentation'. This begins as circular macules of repigmentation, wider than 5 mm in diameter, which, from the outset, are larger than the initial macules of perifollicular repigmentation. This study is limited by its retrospective nature and small sample size for subgroup assessment. The combined pattern of repigmentation was most frequently observed. Medium spotted repigmentation is a new pattern, which will benefit from larger studies for a better understanding. © 2016 British Association of Dermatologists.

  11. Portfolios for assessment of paediatric specialist registrars. (United States)

    Melville, C; Rees, M; Brookfield, D; Anderson, J


    In 1997 the Royal College of Paediatrics and Child Health introduced portfolios to guide and monitor the learning of specialist registrars. We studied their value for assessment. Using Bigg's SOLO criteria we devised a marking scheme based on 6 domains of competence: clinical, communication, teaching and learning, ethics and attitudes, management and evaluation, and creation of evidence. We rated portfolios according to quality of evidence presented and expectations by year of training. We similarly assessed trainee performance in the annual record of in-training assessment (RITA) interview. Specific advice based on the results of the first portfolio assessments was circulated to all trainees, instructing them to increase the structure and decrease the bulk of portfolios. A second sample of portfolios was reviewed a year later, using similar evaluations, to determine the effects. A total of 76 portfolios were assessed in year 1 by a single rater; 30 portfolios were assessed in year 2 by 2 independent raters. The quality of documentation improved from year 1 to year 2 but there was no significant increase in portfolio scores. The inter-rater correlation coefficient of the portfolio assessment method was 0.52 (Cohen's kappa 0.35). The inter-rater correlation coefficient of the RITA interview was 0.71 (Cohen's kappa 0.38). There was moderate inter-assessment correlation between portfolios and RITA interviews (kappa 0.26 in year 1 and 0.29 in year 2). Generalisability analysis suggested that 5 successive ratings by a single observer or independent ratings by 4 observers on the same occasion would be needed to yield a generalisability coefficient > 0.8 for overall portfolio rating. This method of portfolio assessment is insufficiently reliable as a sole method for high stakes, single-instance assessment, but has a place as part of a triangulation process. Repeated portfolio assessment by paired observers would increase reliability. Longer term studies are required to

  12. Immunisation practices in centres caring for children with perinatally acquired HIV: A call for harmonisation. (United States)

    Bamford, Alasdair; Manno, Emma C; Mellado, Maria Jose; Spoulou, Vana; Marques, Laura; Scherpbier, Henriette J; Niehues, Tim; Oldakowska, Agnieszka; Rossi, Paolo; Palma, Paolo


    Current national immunisation schedules differ between countries in terms of vaccine formulation, timing of vaccinations and immunisation programme funding and co-ordination. As a result, some HIV infected paediatric population may be left susceptible to vaccine preventable infections. Vaccines used in healthy population should be subjected to high quality ethical research and be explicitly validated for use in children with special vaccination needs such as those infected with HIV. This survey was completed to assess current vaccination practices and attitudes toward vaccination among pediatricians who care for vertically HIV infected children. An online questionnaire was completed by 46 experts in paediatric HIV-infection from the Paediatric European Network for Treatment of AIDS (PENTA). Data were collected between November 2013 and March 2014. 46units looking after 2465 patients completed the questionnaire. The majority of units (67%) reported that common childhood immunisation were administered by the family doctor or local health services rather than in the HIV specialist centre. Vaccination histories were mostly incomplete and difficult to obtain for 40% of the studied population. Concerns were reported regarding the use of live attenuated vaccines, such as varicella and rotavirus, and these were less frequently recommended (61% and 28% of the units respectively). Monitoring of vaccine responses was employed in a minority of centres (41%). A range of different assays were used resulting in diverse units of measurement and proposed correlates of protection. Vaccination practices for perinatally HIV-infected children vary a great deal between countries. Efforts should be made to improve communication and documentation of vaccinations in healthcare settings and to harmonise recommendations relating to additional vaccines for HIV infected children and the use of laboratory assays to guide immunisation. This will ultimately improve coverage and vaccine induced

  13. Anti-TNF agents for paediatric psoriasis. (United States)

    Sanclemente, Gloria; Murphy, Ruth; Contreras, Javier; García, Hermenegildo; Bonfill Cosp, Xavier


    Psoriasis is a chronic skin disease that may develop at any age. Estimates for the United States and Europe suggest that psoriasis accounts for 4% of skin diseases in children. In most cases, the condition is mild and can be treated with creams. However, a small percentage of children have moderate to severe disease that requires drugs, such as ciclosporin or methotrexate, and some will require injections with newer biological agents, such as anti-TNF (tumour necrosis factor) drugs. Anti-TNF drugs (among them etanercept, infliximab, and adalimumab) are designed to reduce inflammation in the body caused by tumour necrosis factor. Evidence for the safety and efficacy of these biological agents in paediatric psoriasis is lacking. To assess the efficacy and safety of anti-TNF agents for the treatment of paediatric psoriasis. We searched the following databases up to July 2015: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 6), MEDLINE (from 1946), Embase (from 1974), and LILACS (from 1982). We also searched 13 trials registers and checked the reference lists of included studies and key review articles for further references to relevant randomised controlled trials (RCTs). We handsearched conference proceedings and attempted to contact trial authors and relevant pharmaceutical manufacturers. We searched the US Food and Drug Administration's and European Medicines Agency's adverse effects databases. All relevant RCTs that evaluated the efficacy and safety of anti-TNF agents for the treatment of chronic plaque psoriasis in individuals less than 18 years of age. Two review authors independently checked titles and abstracts and performed data extraction and 'Risk of bias' assessment of the included studies. One review author entered data into Review Manager (RevMan), and a second review author checked the data. We also attempted to obtain unclear data from the trial authors where possible.Our primary

  14. Lymphoma in acquired generalized lipodystrophy. (United States)

    Brown, Rebecca J; Chan, Jean L; Jaffe, Elaine S; Cochran, Elaine; DePaoli, Alex M; Gautier, Jean-Francois; Goujard, Cecile; Vigouroux, Corinne; Gorden, Phillip


    Acquired generalized lipodystrophy (AGL) is a rare disease thought to result from autoimmune destruction of adipose tissue. Peripheral T-cell lymphoma (PTCL) has been reported in two AGL patients. We report five additional cases of lymphoma in AGL, and analyze the role of underlying autoimmunity and recombinant human leptin (metreleptin) replacement in lymphoma development. Three patients developed lymphoma during metreleptin treatment (two PTCL and one ALK-positive anaplastic large cell lymphoma), and two developed lymphomas (mycosis fungoides and Burkitt lymphoma) without metreleptin. AGL is associated with high risk for lymphoma, especially PTCL. Autoimmunity likely contributes to this risk. Lymphoma developed with or without metreleptin, suggesting metreleptin does not directly cause lymphoma development; a theoretical role of metreleptin in lymphoma progression remains possible. For most patients with AGL and severe metabolic complications, the proven benefits of metreleptin on metabolic disease will likely outweigh theoretical risks of metreleptin in lymphoma development or progression.

  15. Acquired Functional Asplenia in Sarcoidosis (United States)

    Stone, Richard W.; McDaniel, Willie R.; Armstrong, Earl M.; Young, Roscoe C.; Higginbotham-Ford, Edith A.


    Sarcoidosis is a recently identified cause of functional asplenia that can be diagnosed by radionuclide imaging. A 31-year-old woman with a five-year history of histologically compatible sarcoidosis was found to have nonvisualization of the spleen on technetium 99m sulfur colloid (radiopharmaceutical) liver-spleen scan. This scintigraphic finding was accompanied by poikilocytosis and Howell-Jolly bodies in the peripheral blood smear. A subsequent gallium 67 citrate scan reflected an abnormal increase in concentration of activity in the spleen, suggesting an active inflammatory process. Based upon this constellation of findings, it was concluded that acquired functional asplenia is the result of reticuloendothelial cell replacement via infiltration of the spleen by epithelioid cell granulomas of active sarcoidosis. This case also illustrates the reversibility of functional asplenia of sarcoidosis following adrenocorticosteroid therapy. Functional asplenia in sarcoidosis is now found to have a recognizable radionuclide imaging pattern. ImagesFigure 1Figure 2Figure 3 PMID:3908697

  16. A practical approach to paediatric emergencies in the radiology department

    Energy Technology Data Exchange (ETDEWEB)

    Turner, Nigel McBeth [University Medical Centre, Utrecht, Division of Perioperative Care and Emergency Medicine, Wilhelmina Children' s Hospital, Utrecht (Netherlands)


    Acute life-threatening events involving children in the radiology department are rare. Nonetheless, radiologists should be competent in the relatively simple procedures required to maintain or restore vital functions in paediatric patients, particularly if their practice involves seriously ill or sedated children. This article gives a practical overview of the immediate management of paediatric emergencies that the radiologist is likely to encounter, using a structured (ABCD) approach. Emphasis is given to the early recognition of respiratory embarrassment and shock, and early intervention to prevent deterioration towards circulatory arrest. The management of cardiorespiratory arrest, anaphylaxis and convulsions in children is also addressed. (orig.)

  17. Radiographic appearances of uncommon paediatric implants and devices

    Energy Technology Data Exchange (ETDEWEB)

    Urquia, Arlen; Watson, Tom A.; Arthurs, Owen J. [Great Ormond Street Hospital NHS Foundation Trust, Department of Radiology, London (United Kingdom)


    As childhood survival of chronic illness improves, long-term implanted devices will be encountered more frequently in routine radiology. In our paediatric tertiary referral hospital, we have come across several types of implanted devices that were not confidently recognised or identified by front-line staff and were often only identified by discussion with the patient, family or clinical team. This pictorial review highlights the appearance of nonvascular devices on paediatric radiographs in order to help clinicians identify the most frequent complications and to improve awareness of these important devices. (orig.)

  18. Adverse drug reactions from psychotropic medicines in the paediatric population

    DEFF Research Database (Denmark)

    Aagaard, Lise; Hansen, Ebba H


    of these products in childhood. Little evidence has been reported about the adverse drug reactions (ADRs) of these medicines in practice. As spontaneous reports are the main source for information about previously unknown ADRs, we analysed data submitted to a national ADR database. The objective was to characterise......ABSTRACT: BACKGROUND: The prescribing of psychotropic medicines for the paediatric population is rapidly increasing. In attempts to curb the use of psychotropic medicine in the paediatric population, regulatory authorities have issued various warnings about risks associated with use...

  19. Trade Liberalisation and Vertical Integration

    DEFF Research Database (Denmark)

    Bache, Peter Arendorf; Laugesen, Anders Rosenstand

    producers face decisions on exporting, vertical integration of intermediate-input production, and whether the intermediate-input production should be offshored to a low-wage country. We find that the fractions of final-good producers that pursue either vertical integration, offshoring, or exporting are all......We build a three-country model of international trade in final goods and intermediate inputs and study the relation between four different types of trade liberalisation and vertical integration. Firms are heterogeneous with respect to both productivity and factor (headquarter) intensity. Final-good...... increasing when intermediate-input trade or final-goods trade is liberalised. Finally, we provide guidance for testing the open-economy property rights theory of the firm using firm-level data and surprisingly show that the relationship between factor (headquarter) intensity and the likelihood of vertical...

  20. Horizontal and Vertical Line Designs. (United States)

    Johns, Pat


    Presents an art lesson in which students learn about the artist Piet Mondrian and create their own abstract artworks. Focuses on geometric shapes using horizontal and vertical lines. Includes background information about the artist. (CMK)

  1. Vertical axis wind turbine airfoil (United States)

    Krivcov, Vladimir; Krivospitski, Vladimir; Maksimov, Vasili; Halstead, Richard; Grahov, Jurij Vasiljevich


    A vertical axis wind turbine airfoil is described. The wind turbine airfoil can include a leading edge, a trailing edge, an upper curved surface, a lower curved surface, and a centerline running between the upper surface and the lower surface and from the leading edge to the trailing edge. The airfoil can be configured so that the distance between the centerline and the upper surface is the same as the distance between the centerline and the lower surface at all points along the length of the airfoil. A plurality of such airfoils can be included in a vertical axis wind turbine. These airfoils can be vertically disposed and can rotate about a vertical axis.

  2. Acquired heart conditions in adults with congenital heart disease: a growing problem. (United States)

    Tutarel, Oktay


    The number of adults with congenital heart disease is increasing due to the great achievements in the field of paediatric cardiology, congenital heart surgery and intensive care medicine over the last decades. Mortality has shifted away from the infant and childhood period towards adulthood. As congenital heart disease patients get older, a high prevalence of cardiovascular risk factors is encountered similar to the general population. Consequently, the contribution of acquired morbidities, especially acquired heart conditions to patient outcome, is becoming increasingly important. Therefore, to continue the success story of the last decades in the treatment of congenital heart disease and to further improve the outcome of these patients, more attention has to be given to the prevention, detection and adequate therapy of acquired heart conditions. The aim of this review is to give an overview about acquired heart conditions that may be encountered in adults with congenital heart disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  3. Backward integration, forward integration, and vertical foreclosure


    Spiegel, Yossi


    I show that partial vertical integration may either alleviates or exacerbate the concern for vertical foreclosure relative to full vertical integration and I examine its implications for consumer welfare.

  4. Ability of medical students to calculate drug doses in children after their paediatric attachment

    Directory of Open Access Journals (Sweden)

    Oshikoya KA


    Full Text Available Dose calculation errors constitute a significant part of prescribing errors which might have resulted from informal teaching of the topic in medical schools. Objectives: To determine adequacy of knowledge and skills of drug dose calculations in children acquired by medical students during their clinical attachment in paediatrics.Methods: Fifty two 5th year medical students of the Lagos State University College of Medicine (LASUCOM, Ikeja were examined on drug dose calculations from a vial and ampoules of injections, syrup and suspension, and tablet formulation. The examination was with a structured questionnaire mostly in the form of multiple choice questions.Results: Thirty-six (69.2% and 30 (57.7% students were taught drug dose calculation in neonatal posting and during ward rounds/ bed-side teaching, respectively. Less than 50% of the students were able to calculate the correct doses of each of adrenaline, gentamicin, chloroquine and sodium bicarbonate injections required by the patient. Dose calculation was however relatively better with adrenalin when compared with the other injections. The proportion of female students that calculated the correct doses of quinine syrup and cefuroxime suspension were significantly higher than those of their male counterparts (p<0.05 and p<0.01, respectively; Chi-square test. When doses calculated in mg/dose and mL/dose was compared for adrenalin injection and each of quinine syrup and cefuroxime suspension, there were significant differences (adrenaline and quinine, p=0.005; adrenaline and cefuroxime, p=0.003: Fischer’s exact test. Dose calculation errors of similar magnitude to injections, syrup and suspension were also observed with tablet formulation.Conclusions: LASUCOM medical students lacked the basic knowledge of paediatric drug dose calculations but were willing to learn if the topic was formally taught. Drug dose calculations should be given a prominent consideration in the undergraduate medical

  5. [Self-medication, self-prescription and medicating «by proxy» in paediatrics]. (United States)

    Valenzuela Ortiz, María; Sánchez Ruiz-Cabello, Francisco Javier; Uberos, José; Checa Ros, Ana Fátima; Valenzuela Ortiz, Cristina; Augustín Morales, María Carmen; Muñoz Hoyos, Antonio


    Self-prescribing or medicating 'by proxy' is not an autonomous, free and voluntary decision in the case of children. On the contrary, in this case it is based on the subjective interpretation of symptoms made by the mother or by a third person who is legally responsible for the minor. In our opinion, to analyse this situation is of great importance in order to know the determining factors, perceptions, and realities related to this problem. Our proposal is to perform a prospective observational study for analysing maternal and familiar determinant factors related to self-prescribing and self-medicating 'by proxy' in paediatrics. A validated survey was developed to be applied to mothers of children aged 0 to 14 who are users of the Paediatric Emergency Department in a hospital. A total of 1,714 mothers were recruited in a random period of time. This sample included 345 mothers who exclusively self-medicated their children (case group), and 1,369 mothers (control group) who did not meet this requirement. The overall percentage of medicating 'by proxy' was 32.8%. There is a significant association between self-medicating and educational level of the mother, the number of children, and the birth order among siblings. Neither maternal age nor social-occupational level are related to this problem. Most frequently used drugs include antipyretics and 'anticatharrals', usually administered as a monotherapy. Our results seem to indicate that the educational level and the parental experience acquired with previous children could generate the required confidence in parents to choose the medication by themselves. Almost 85% of these drugs come from the 'home first-aid kit.' Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Effectiveness of hand-washing teaching programs for families of children in paediatric intensive care units. (United States)

    Chen, Yong-Chuan; Chiang, Li-Chi


    The authors developed a video-centred teaching program based on social learning principles to demonstrate hand-washing technique. A comparison was made between families who viewed the video and families who were taught the same techniques with the aid of an illustrated poster in terms of compliance and improvement in hand-washing skills. Nosocomial infections are a significant cause of morbidity and mortality in paediatric intensive care unit patients. Hand hygiene is considered the most important preventive action against hospital-acquired infections. A number of studies have shown that increased compliance with hand-washing guidelines for health-care workers leads to decreases in nosocomial infection rates. Furthermore, recommendations have been made to ensure that parents who visit their children in intensive care units wash their hands first. Quasi-experimental time series. Compliance and accuracy measurements were collected during one to five visits following the initial teaching intervention. A total of 123 families, who visited paediatric intensive care units, were recruited and assigned to two groups - one experimental (61 families) and the other a comparison group (62). Participants in the comparison group were taught hand-washing skills using simple illustrations. A 20-item hand-washing checklist was used to examine hand-washing compliance and accuracy. No significant differences were noted in terms of demographics between the two groups. Results from a general estimated equation analysis showed that families in the experimental group had higher compliance and accuracy scores at statistically significant levels. The video-based teaching program was effective in increasing compliance and accuracy with a hand-washing policy among families with children in intensive care units. The education program is a simple, low-cost, low technology intervention for substantially reducing the incidence of nosocomial infection.

  7. Faecal Calprotectin in Suspected Paediatric Inflammatory Bowel Disease

    NARCIS (Netherlands)

    Degraeuwe, Pieter L. J.; Beld, Monique P. A.; Ashorn, Merja; Canani, Roberto Berni; Day, Andrew S.; Diamanti, Antonella; Fagerberg, Ulrika L.; Henderson, Paul; Kolho, Kaija-Leena; Van de Vijver, Els; van Rheenen, Patrick F.; Wilson, David C.; Kessels, Alfons G. H.

    Objectives: The diagnostic accuracy of faecal calprotectin (FC) concentration for paediatric inflammatory bowel disease (IBD) is well described at the population level, but not at the individual level. We reassessed the diagnostic accuracy of FC in children with suspected IBD and developed an

  8. The King-Denborough syndrome in the paediatric patient.

    African Journals Online (AJOL)

    Syndromic vignettes in anaesthesia. The King-Denborough syndrome in the paediatric patient. Maharaj R. Department of Anaesthetics, Nelson R Mandela School of Medicine. Clinical Fellow, St Andrews Burns and Plastics Unit. Chelmsford, Essex, UK. Osborne IJS. Clinical Fellow, St Andrews Burns and Plastics Unit, ...

  9. The hospital costs associated with acute paediatric burn injuries

    African Journals Online (AJOL)

    optimal, holistic care to patients with burns and complex wounds, it requires dedicated, multidisciplinary specialist personnel and well-equipped facilities. To date, no studies have been undertaken to investigate the true cost of managing paediatric burn injuries and their sequelae in South Africa (SA). Managing a major burn ...

  10. Reducing paediatric ventilator-associated pneumonia – a South ...

    African Journals Online (AJOL)

    There has been a decline in ventilator-associated pneumonia (VAP) in the paediatric intensive care units of developed countries. Previous studies at the Red Cross War Memorial Children's Hospital give an incidence of VAP of >40/1 000 ventilator days, identifying VAP as a priority area for practice improvement. We outline ...

  11. Current practice of adolescent preventive services among paediatric ...

    African Journals Online (AJOL)

    Association to elicit information on residents' current practice regarding screening adolescents for specific morbidities. Results. A total ... practice and training to emphasise preventive paediatrics and other issues pertinent to adolescent care. S Afr J Child .... in Nigeria. The strength of this study includes its high response rate.

  12. Paediatric interventional radiology | Chaudry | SA Journal of Radiology

    African Journals Online (AJOL)

    Paediatric interventional radiology (IR) is a rapidly developing subspecialty, seeking to meet the increasing demand for image-guided minimally invasive procedures. The wide range of procedures performed and the conditions treated reflect the varying ages and complexity of the patient population. This article reviews the ...

  13. Interpretation of Chemical Pathology Test Results in Paediatrics ...

    African Journals Online (AJOL)

    At any time we interprete paediatric chemical pathology test results we must take into consideration a number of factors, which are related with and restricted to ... which include; blood sample collection process, method of sample analyses or measurement techniques, are the basis for the reference interval or range that are ...

  14. A retrospective study of paediatric medicolegal autopsies at the ...

    African Journals Online (AJOL)

    Medicolegal death is the term used to describe any violent, unclear or suspicious death that must be subjected to legal investigation. The aim of ... A total of 551 childhoods MLA were recorded during the period under review, accounting for 12.3% of all medicolegal autopsies and 96% of all paediatric autopsies. Of this total ...

  15. Reasons For Cancellation of Elective Paediatric Surgery Cases ...

    African Journals Online (AJOL)

    The bio-data on; clinical diagnosis and reasons for cancellation were documented. The study period was 18 months (March 2006- August 2007). Causes of cancellation were grouped into patients' factors (group A), parental factors (group B), and institutional factors (group C) There were 437 elective paediatric surgery ...

  16. Nigerian Journal of Paediatrics 2013;40(2)

    African Journals Online (AJOL)



    Sep 1, 2012 ... Mukherjee DK. Growth and De- velopment. In: Parthasarathy A,. Menon PSN, Nair MKC, Bhave S, eds. Partha's Fundamentals of. Paediatrics, First Edition. Jaypee. Brothers Medical Publishers, New. Delhi, India. 2007; 62-95. 11. Robinson TN, Dietz WH. Weight. Gain: Overeating to Obesity. In: Rudolph CD ...

  17. Perspectives on Paediatric Surgical Admissions at El Obeid Hospital ...

    African Journals Online (AJOL)

    Background: Data on the burden of paediatric surgical diseases at Western Sudan are unknown. Objectives: To determine the burden and pattern of childhood surgical problems presenting to a General Surgical Unit at Western Sudan. Patients and Methods: The records of all children aged 15 years and below admitted to ...

  18. Paediatric burns anaesthesia: the things that make a difference

    African Journals Online (AJOL)


    Oct 21, 2014 ... Anxiety usually increases with each visit to theatre, and good psychological ... Department of Anaesthesia, Paediatric Anaesthesia Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa. *Corresponding author .... Breathing: It is important to look, listen and feel. This includes ...

  19. Paediatric endocrine disorders as seen at the University of Benin ...

    African Journals Online (AJOL)

    Background: In most developing countries, data on the prevalence and distribution of paediatric endocrine disorders is lacking. Objective: To describe the pattern of endocrine disorders seen in the Department of Child Health, University of Benin Teaching Hospital (UBTH), Benin City, Nigeria between 2004 to 2013.

  20. Assessment of Parents' Satisfaction with Paediatric Surgery Services ...

    African Journals Online (AJOL)

    Ademuyıwa O Adesoji

    Items 1 - 14 ... Assessment of Parents' Satisfaction with Paediatric Surgery. Services at a Tertiary ... of Medicine & Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria, 2Department of Psychiatry, College of Health. Sciences, Obafemi ... hospital management and staff and can be used as a template for improving the ...

  1. A practical approach to paediatric emergencies in the radiology department

    NARCIS (Netherlands)

    Turner, Nigel McBeth

    Acute life-threatening events involving children in the radiology department are rare. Nonetheless, radiologists should be competent in the relatively simple procedures required to maintain or restore vital functions in paediatric patients, particularly if their practice involves seriously ill or

  2. Glomerular filtration rate profiles in paediatric patients on cancer ...

    African Journals Online (AJOL)

    Background: An accurate estimation of renal function in children is important in optimising the dose of many drugs used in paediatric oncology for allowing clinical monitoring of the nephrotoxic effects of cytotoxic agents such as cisplatin. The glomerular filtration rate (GFR) is widely accepted as the best index of renal ...

  3. Apartheid and healthcare access for paediatric systemic lupus ...

    African Journals Online (AJOL)

    South Africa (SA) still faces the legacy of apartheid: the history, politics and economics have a lasting, indelible effect on the health of its people. Here, we discuss the challenges of caring for patients with chronic disease, focusing on paediatric systemic lupus erythematosus (SLE), as a framework for evaluating the structural ...

  4. Paediatric Hand Injuries At The Lagos University Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out. Objectives: To determine the ...

  5. Paediatric thoracoscopy: State of the art | Van Niekerk | South ...

    African Journals Online (AJOL)

    Many advanced procedures, including lobectomy, repair of tracheo-oesophageal fistula, excision of mediastinal tumours and diaphragmatic hernia repairs, are being done routinely in paediatric surgery centres around the world. This article reviews the state of the art of thoracoscopic surgery in children. The author selected ...

  6. Availability of non- and low- fluoride paediatric toothpastes in ...

    African Journals Online (AJOL)

    Objective: Some studies in Nigeria have shown a high prevalence of fluorosis. This study looks at toothpastes manufactured locally to determine the availability and affordability of low- fluoride paediatric toothpastes in Nigeria. Method: Toothpastes manufactured locally in Nigeria which bear the Nigerian Agency for Food ...

  7. A review of paediatric anaesthetic-related mortality, serious adverse ...

    African Journals Online (AJOL)

    morbidity and mortality is the child's disease or condition. Anaesthetic-related causes are conversely infrequent.11 ... Collaborative, prospective collection through paediatric-specific databases facilitates the accurate ... Patient memory of events during general anaesthesia. Disability or incapacity. Musculoskeletal, joint and.

  8. African Journal of Paediatric Surgery - Vol 11, No 3 (2014)

    African Journals Online (AJOL)

    Oesophageal foreign body in children: 15 years experience in a tertiary care paediatric centre · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A Singh, M Bajpai, SS Panda, K Chand, M Jana, A Ali, 238-241 ...

  9. Paediatric cochlear implantation | MÜLLER | Continuing Medical ...

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 21, No 10 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Paediatric cochlear implantation. AMU MÜLLER, DJH WAGENFELD ...

  10. Reliability and validity of triage systems in paediatric emergency care

    NARCIS (Netherlands)

    M. van Veen (Mirjam); H.A. Moll (Henriëtte)


    textabstractBackground. Triage in paediatric emergency care is an important tool to prioritize seriously ill children. Triage can also be used to identify patients who do not need urgent care and who can safely wait. The aim of this review was to provide an overview of the literature on reliability

  11. Post-operative intensive care admission of paediatric surgical ...

    African Journals Online (AJOL)

    A retrospective study of all paediatric surgical patients aged 15 years and below, admitted into the Intensive Care Unit (ICU) of the University of Ilorin Teaching Hospital (UITH) following surgery was carried out, covering a period of 10 years. Demographic information, surgical procedures performed, indications for intensive ...

  12. Paediatric intensive care is feasible in a neonatal department

    DEFF Research Database (Denmark)

    Jensen, Anne-Mette Bæk; Lundstrøm, Kaare E.; Reinholdt, Jes


    Intensive care of infants below one year of age has been centralized in a paediatric intensive care unit (PICU) related to the neonatal intensive care unit (NICU) at Rigshospitalet, the University Hospital in Copenhagen in eastern Denmark (approximately 2.5 million inhabitants) since 2002. The aim...

  13. The practice of paediatric cardiology in Nigeria: A Review | Chinawa ...

    African Journals Online (AJOL)

    Methods: A search for published works on practice of paediatrc cardiology in Nigeria was performed using Google and Pub Med. The Cochrane Database of Systematic Reviews was also searched. The areas of focus were historical facts, burden of the problem, organization, factors militating Paediatric cardiology practice ...

  14. A practical approach to anaesthesia for paediatric liver transplantation

    African Journals Online (AJOL)


    The cause of the liver failure: is this acute hepatic failure or end-stage liver disease? ... Anaesthesia for paediatric liver transplantation requires meticulous attention to detail, an understanding of the disease process leading up to the need for ... valvular lesions (Alagilles), and occasionally biventricular failure.3,4,5 They are ...

  15. 5 ARTICLE Departments of Dietetics and Paediatric Surgery ...

    African Journals Online (AJOL)

    7. Ottery FD. Bidirectional interplay of nutrition and chemotherapy. Cancer & Nutrition: Prevention and Treatment. Nestle Nutrition Workshop Series Clinical 81 Performance. Program 2000; Vol. 4: 183-206. Basel: Reinhardt Druck, 2000. 8. LugdVicente HL. Paediatric surgery handbook. Mayaguez, Puerto Rico: University of.

  16. HIV transmission during paediatric health care in sub- Saharan ...

    African Journals Online (AJOL)

    HIV transmission during paediatric health care in sub- Saharan Africa – risks and evidence. David Gisselquist, John J Potterat, Stuart Brody. Abstract. Health care systems in sub-Saharan Africa are challenged not only to improve care for the increasing number of HIV-infected children, but also to prevent transmission of HIV ...

  17. Paediatric cardiac anaesthesia in sickle cell disease: a case series ...

    African Journals Online (AJOL)

    Paediatric patients with SCD and congenital heart defects may require anaesthesia for corrective cardiac surgery on cardiopulmonary bypass (CPB). During the perioperative period these high-risk patients may suffer significant complications when exposed to the conditions that favour erythrocyte sickling. This case series ...

  18. Mortality Pattern within Twenty-Four Hours of Emergency Paediatric ...

    African Journals Online (AJOL)

    BACKGROUND: Mortality among emergency paediatric admissions within the first 24 hours is high in resource- poor nations. Measures to reduce the childhood mortality rate can only be effectively planned and implemented when the causes and magnitude of this problem are well defined. OBJECTIVE: To determine the ...

  19. Indications for HIV testing in paediatric surgical patients | Masache ...

    African Journals Online (AJOL)

    HIV testing is done in paediatric surgical patients at Queen Elizabeth Central Hospital, when HIV infection is suspected to be the underlying cause of the clinical presentation or contributing to morbidity. We conducted a retrospective, descriptive analysis of children with surgical conditions under the age of 15 who underwent ...

  20. Stool viruses among paediatric patients from a Nairobi clinic, Kenya ...

    African Journals Online (AJOL)

    Stool viruses among paediatric patients from a Nairobi clinic, Kenya. C Forbes, M Hawkes, S Nesbitt. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM.

  1. Paediatric cancers at Butare University Teaching Hospital in Rwanda

    African Journals Online (AJOL)

    Paediatric cancers at Butare University Teaching Hospital in Rwanda. ... Background: Cancer is an important cause of mortality in many of the economically developed nations of the world. More than 10% of all ... The peak incidence of cancer was found in the 0-5 years age group and accounted for 21 patients (58, 3%).

  2. Nigerian Journal of Paediatrics 2013;40(2)

    African Journals Online (AJOL)



    Jun 6, 2012 ... Oyelami OA, Adeodu OO. Department of Paediatrics and Child ... where childhood cancer too often is detected too late for effective treatment ... Patients whose case files were missing or those with incomplete data were excluded from the study. The results from two centres were compared. Results. At AKTH ...

  3. Paediatric chronic kidney disease | van Biljon | South African ...

    African Journals Online (AJOL)

    Doctors use various guidelines on paediatric chronic kidney disease (CKD) for managing their patients according to the availability of resources. As with adolescent and adult patients, CKD in children can also progress to end-stage renal failure – the time course being influenced by several modifiable factors. Decline in ...

  4. RADIOLOGICAL TIPS Coronal views of the paediatric mandibular ...

    African Journals Online (AJOL)

    We discuss 4 cases seen over the last 18 months at Red Cross War. Memorial Children's Hospital in an effort to highlight the importance of routinely reviewing coronal views of the mandibular condyle when interpreting trauma-related computerised tomography brain (CTB) studies in a paediatric setting. The mandible is the ...

  5. Factors influencing choice of paediatrics as a career among medical ...

    African Journals Online (AJOL)

    =0.030). None of the male students but 12 of the ... of factors included encouragement by teaching or clinical staff, role models in the specialty, job ... chosen paediatrics after their clerkship rotation in 4th year; only 2 of these were male.

  6. Paediatric Endocrine Disorders at the University College Hospital ...

    African Journals Online (AJOL)

    Subjects/Methods: A review of records of children who presented at University College Hospital, Ibadan with paediatric endocrine disorders from 2002 to 2009 was ... Rickets and metabolic disorders constituted 56.4% of patients; Diabetes mellitus was diagnosed in 12.8%, adrenal disoders in 10.6%, pubertal disorders in ...

  7. Paediatric rheumatology clinic population in Southeast Asia: are we different? (United States)

    Arkachaisri, Thaschawee; Tang, Swee-Ping; Daengsuwan, Tassalapa; Phongsamart, Gun; Vilaiyuk, Soamarat; Charuvanij, Sirirat; Hoh, Sook Fun; Tan, Justin Hung Tiong; Das, Lena; Ang, Elizabeth; Lim, Wendy; Chan, Yiong Huak; Bernal, Christine B


    To examine the descriptive epidemiology of the patient population referred to paediatric rheumatology centres (PRCs) in Southeast Asia (SEA) and to compare the frequency of conditions encountered with other PRC populations. A web-based Registry for Childhood Onset Paediatric Rheumatic Diseases was established in 2009 and seven PRCs in four SEA countries, where paediatric rheumatologists are available, participated in a prospective 24 month data collection (43 months for Singapore). The number of patients analysed was 4038 (788 from Malaysia, 711 from the Philippines, 1943 from Singapore and 596 from Thailand). Over 70% of patients evaluated in PRCs in Malaysia, the Philippines and Thailand had rheumatic diseases (RDs), as compared with one-half of the proportion seen in Singaporean PRCs, which was similar to the Western PRC experience. Among RDs diagnosed (n = 2602), JIA was the most common disease encountered in Malaysia (41%) and Thailand (61%) as compared with systemic vasculitides in the Philippines (37%) and Singapore (35%) among which Henoch-Schönlein purpura was the most prevalent. SLE and related diseases were more common, but idiopathic pain syndrome and abnormal immunological laboratory tests were rarer than those seen in the West. JIA subtype distributions were different among countries. Among non-RDs (n = 1436), orthopaedic and related conditions predominated (21.7-59.4%). The frequencies of RDs seen by SEA PRCs were different from those in the West. Systemic vasculitides and SLE were common in addition to JIA. Paediatric rheumatologist availability and healthcare accessibility partially explain these observed discrepancies.

  8. Bacteria isolated from the airways of paediatric patients with ...

    African Journals Online (AJOL)

    Knowledge of which bacteria are found in the airways of paediatric patients with bronchiectasis unrelated to cystic fibrosis. (CF) is important in defining empirical antibiotic guidelines for the treatment of acute infective exacerbations. Objective. To describe the bacteria isolated from the airways of children with non-CF ...

  9. Cardiac Arrest after Local Anaesthetic Toxicity in a Paediatric Patient

    Directory of Open Access Journals (Sweden)

    Liana Maria Torres de Araújo Azi


    Full Text Available We report a case of a paediatric patient undergoing urological procedure in which a possible inadvertent intravascular or intraosseous injection of bupivacaine with adrenaline in usual doses caused subsequent cardiac arrest, completely reversed after administration of 20% intravenous lipid emulsion. Early diagnosis of local anaesthetics toxicity and adequate cardiovascular resuscitation manoeuvres contribute to the favourable outcome.

  10. Sedation practices for Australian and New Zealand paediatric oncology patients. (United States)

    Barnes, C; Downie, P; Chalkiadis, G; Camilleri, S; Monagle, P; Waters, K


    Paediatric oncology patients often require repeated bone marrow aspirates and lumbar punctures. These procedures commonly require sedation and analgesia. The Australian and New Zealand College of Anaesthetists and the American Academy of Pediatrics have published guidelines that provide recommendations on monitoring and staffing requirements during sedation of paediatric patients. A survey was conducted of the oncology units in Australia and New Zealand in order to compare current practices with published guidelines. Telephone interviews were conducted with nursing or medical staff members. Fourteen oncology units collectively perform approximately 130 procedures each week, of which 74% are performed under general anaesthesia. Of the remainder, most are performed using conscious sedation. Most units adhere to published recommendations regarding equipment and staffing during procedures performed under sedation. Only a minority of units follow guidelines regarding documentation; fasting requirements; observation and documentation of vital signs during and after the procedure; and obtaining informed consent for procedures performed using sedation. Sedation practices among paediatric oncology units in Australia and New Zealand vary. None of the units fully adhere to published guidelines on childhood sedation. Paediatric oncology units should be familiar with the content of these guidelines and make an informed decision as to their usefulness, both in directing best clinical practice, and in supporting current practice in the event of medico-legal challenge.

  11. Paediatric oncology nurse education: the development of a national framework. (United States)

    Tomlinson, Deborah


    It is recognized that there is a need for specialist nursing courses in a range of paediatric nursing specialities. Paediatric oncology nurses are facing challenges with clinical advances and the need for specialized care. At present there are no available courses in Scotland offering preparation for nurses working in a paediatric oncology setting. This project, supported by Macmillan Cancer Relief, addresses this deficit by developing a comprehensive framework for a small and widely dispersed speciality. Information on the needs and expectations of nurses and service managers in this field was obtained through postal questionnaires and focus groups. Due to the need for collaboration between higher educational institutions and service colleagues the views of educators were also established through questionnaires and semi-structured interviews. Problematic practice issues were cited and these issues were further discussed and recognized as the main educational needs. Availability and accessibility of education were of great importance. The framework developed aims to provide ongoing opportunities for continuing professional development within this speciality. Development of the educational framework is required to provide a course accessible to a wide geographical area of nurses. A National Framework for Paediatric Oncology Nurse Education was developed in response to views of experts working in the field, to the views of other stakeholders and to what is known about needs and preferences of children with cancer and their families.

  12. paediatric endocrine disorders at the university college hospital

    African Journals Online (AJOL)

    O.O. Jarrett1, B.O. Ogunbosi1 and O.O. Ayoola2. 1. Department of Paediatrics, University College Hospital, Ibadan, Nigeria. 2. Endocrine Science Research Group, University of Manchester, Royal Manchester Children's Hospital,. Manchester, UK. Correspondence: Dr. Omolola Ayoola. Endocrine Science Research Group,.

  13. Heart Failure among Paediatric Emergencies in Calabar, South ...

    African Journals Online (AJOL)

    A study of heart failure among paediatric emergencies in the University of Calabar Teaching Hospital, Calabar, was prospectively carried out over a period of 9 months in the Children's Emergency Room (CHER). Two hundred & thirty four out of 1512 admissions presented with heart failure giving a prevalence of 15.5%.

  14. Factors influencing the outcome of elective paediatric orthopaedic ...

    African Journals Online (AJOL)

    were found to be statistically significant factors adversely affecting the surgical wound outcome. We conclude that most of the factors that predicted poor outcome in this study were patient and environment-related and are preventable. There is need to upgrade facilities in health institutions in Nigeria. Key words: paediatric ...

  15. How to Improve Outcome of Paediatric Cataract Surgery in Nigeria ...

    African Journals Online (AJOL)

    Paediatric cataract is an important problem all over the world. In developing countries, it is a major cause of childhood blindness resulting in a considerable level of morbidity, economic loss, and social burden. Managing cataracts in children remains a challenge because treatment is often difficult, due to the several ways in ...

  16. The use of alternative lipid emulsions in paediatric and neonatal ...

    African Journals Online (AJOL)

    Lipid emulsions are an important part of paediatric parenteral nutrition as they provide energy, fat soluble vitamins and are a source of essential fatty acids. Soya bean based oil emulsions have however been identified as one of the major causative factors in the development of PN related cholestasis. The newer lipid.

  17. Paediatric palliative care providers' experiences in rural KwaZulu ...

    African Journals Online (AJOL)

    [12] Consequently, this paper makes no claims that ndings are replicable or generalisable. Qualitative. Dilemmas of telling bad news: Paediatric palliative care providers' experiences in ... of their lives became more challenging for the caregivers because they were not prepared for cultural complexities. In view of the ndings.

  18. Imaging of intractable paediatric epilepsy | Prabhu | SA Journal of ...

    African Journals Online (AJOL)

    Approximately 20% of paediatric patients with epilepsy are refractory to medical therapies. In this subgroup of patients, neuroimaging plays an important role in identifying an epileptogenic focus. Successful identification of a structural lesion results in a better outcome following epilepsy surgery. Advances in imaging ...

  19. Pattern of paediatric ophthalmic admissions into the Ogun State ...

    African Journals Online (AJOL)

    The possibility of rubella aetiology of the cataract could not be ruled out in these patients. There is a need for sustained commitment to immunization. The availability of ophthalmic microsurgical instruments will improve the surgical care of patients with a view to better visual outcome. Nigerian Journal of Paediatrics 2002; ...

  20. The value of case management in paediatric palliative care

    NARCIS (Netherlands)

    Verberne, L.M.


    In the Netherlands around 4000 – 6700 children with life-limiting diseases could benefit from paediatric palliative care (PPC). However, adequate PPC is often absent due to the lack of continuity and coordination of care and limited expertise among healthcare professionals (HCP). Consequently, many

  1. Factors affecting outcome of emergency paediatric abdominal surgery

    African Journals Online (AJOL)

    Conclusion: intestinal obstruction was the commonest acute abdominal emergency in children. The high rates of postoperative morbidity observed could be attributed to delayed presentation to hospital. Key Words: Paediatric, emergency, abdominal surgery, outcome. Nigerian Journal of Surgical Research Vol.5(1&2) 2003: ...

  2. Paediatric solid tumours in Nigerian children: A changing pattern ...

    African Journals Online (AJOL)

    The following study was a 5-year retrospective review of paediatric solid tumours as seen at the Jos University Teaching Hospital, Nigeria. Objective: To determine the relative frequencies of childhood solid malignant tumours in Jos, Central Nigeria and compare with reports of previous studies both locally and abroad.

  3. Paediatric meningitis and hearing loss in a developing country ...

    African Journals Online (AJOL)

    The purpose of this study was to establish audiology referral protocols for post meningitis paediatric populations in two academic hospitals in Gauteng, South Africa. Specific objectives of this study included determining if audiological assessment referrals were made following infection; determining the time of referral post ...

  4. Paediatric femur fractures at the emergency department: accidental or not?

    NARCIS (Netherlands)

    Hoytema van Konijnenburg, Eva M. M.; Vrolijk-Bosschaart, Thekla F.; Bakx, Roel; van Rijn, Rick R.


    Only a small proportion of all paediatric fractures is caused by child abuse or neglect, especially in highly prevalent long bone fractures. It can be difficult to differentiate abusive fractures from non-abusive fractures. This article focuses on femoral fractures in young children. Based on three

  5. The Management of Anorectal Injuries in a Nigerian Paediatric ...

    African Journals Online (AJOL)

    Background Anorectal injuries are rare in children. Recently there has been an increasing trend towards primary repair without proximal colostomy. This is a review of our experience with anorectal injuries in children in a paediatric tertiary centre in Nigeria. Patients and Methods All children 15 years or below managed for ...

  6. Unmet needs in paediatric psychopharmacology : Present scenario and future perspectives

    NARCIS (Netherlands)

    Persico, Antonio M.; Arango, Celso; Buitelaar, Jan K.; Correll, Christoph U.; Glennon, Jeffrey C.; Hoekstra, Pieter J.; Moreno, Carmen; Vitiello, Benedetto; Vorstman, Jacob|info:eu-repo/dai/nl/304817023; Zuddas, Alessandro


    Paediatric psychopharmacology holds great promise in two equally important areas of enormous biomedical and social impact, namely the treatment of behavioural abnormalities in children and adolescents, and the prevention of psychiatric disorders with adolescent- or adult-onset. Yet, in striking

  7. The diagnostic pathway in complex paediatric neurology: A cost analysis

    NARCIS (Netherlands)

    Nimwegen, K.J.M. van; Schieving, J.H.; Willemsen, M.A.A.P.; Veltman, J.A.; Burg, S. van der; Wilt, G.J. van der; Grutters, J.P.C.


    BACKGROUND: The diagnostic trajectory of complex paediatric neurology may be long, burdensome, and expensive while its diagnostic yield is frequently modest. Improvement in this trajectory is desirable and might be achieved by innovations such as whole exome sequencing. In order to explore the

  8. Paediatric laparoscopic hernia repair: Ex vivo skills in the reduced ...

    African Journals Online (AJOL)

    With repeated attempts trainee's timings and accuracy improved until by the 10th repair they were no different from benchmark consultant scores. Conclusion: A simple, procedure specifi c ex-vivo training model has been evaluated for laparoscopic hernia training in paediatric surgery. The results suggest improvements in ...

  9. Recombinant-activated factor VII in the paediatric cardiac surgery ...

    African Journals Online (AJOL)

    V Agarwal, KE Okonta, PS Lal. Abstract. Background: The control of excessive bleeding after paediatric cardiac surgery can be challenging. This may make the use of recombinant-activated factor VII (rFVIIa) in preventing this excessive bleeding, after adopted conventional methods have failed, desirable. Our aim is to ...

  10. Paediatric burns in a rural South African district hospital

    African Journals Online (AJOL)

    Objectives_ To describe the epidemiology, clinical features, management and outcome of children with burns admitted to a rural district hospital. Design. A retrospective analysis of the case notes of consecutive cases of paediatric burns. Setting. Hlabisa Hospital, KwaZulu-Natal - a 450-bed rural district hospital serving ...

  11. Does size matter? : bridging and dose selection in paediatric trials

    NARCIS (Netherlands)

    Cella, Massimo


    “Does size matters? Bridging and dose selection in paediatric trials” investigates the use of pharmacokinetic (PK) modelling to support dosing recommendation in children during drug development. To date, empiricism still leads the choice of the dose to administer to children during clinical trials.

  12. The pattern of paediatric burn injuries in Southwestern, Saudi Arabia ...

    African Journals Online (AJOL)

    Background: Burn injuries constitute a major concern in the paediatric age group with respect to morbidity and mortality particularly among children in developing countries. Burn injuries represent an extremely stressful experience for both the burn victims as well as their families. Objectives: To identify the pattern and ...

  13. Paediatric pelvic fractures: how do they differ from adults?

    NARCIS (Netherlands)

    Hermans, E.; Cornelisse, S.T.; Biert, J.; Tan, E.C.T.H.; Edwards, M.J.R.


    BACKGROUND: The aim of this article was to review the incidence, presentation, treatment and complications of paediatric pelvic fractures of children who were admitted to our level 1 trauma centre and to compare them with our data from adult pelvic fracture patients. METHODS: We conducted a

  14. Video laryngoscopy in paediatric anaesthesia in South Africa ...

    African Journals Online (AJOL)

    This article provides a summary of the types of video laryngoscopes available in South Africa, and highlights some interesting paediatric cases in which video laryngoscopes were used at the Steve Biko Academic Hospital, Pretoria. South Afr J Anaesth Analg, 2011;17(6):363-368 ...

  15. Review of Paediatric Admissions In Mongomo Provincial Hospital ...

    African Journals Online (AJOL)

    Review of Paediatric Admissions In Mongomo Provincial Hospital, Wele Nzas, Equatorial Guinea. Nnamdi B Onyire. Abstract. Background: The author was part of the Technical Aid Corps team of the Nigerian Government to Mongomo Provincial Hospital, Wele Nzas province of Equatorial Guinea, between May 1997 and ...

  16. Epidemiology and management of paediatric head injury in eastern ...

    African Journals Online (AJOL)

    Conclusions: In urban areas of Nepal, RTAs like vehicular crashes, motor cycle accidents, and pedestrian hit by moving vehicle are more common and in rural areas fall from height are commoner. We need to develop child safety legislations and risk-specific intervention programs in Nepal. African Journal of Paediatric ...

  17. Post-Neonatal Hypoglycaemia and Paediatric Emergency Room ...

    African Journals Online (AJOL)

    Post-Neonatal Hypoglycaemia and Paediatric Emergency Room Admissions: A Study In The University Of Port Harcourt Teaching Hospital. ... All cases of hypoglycaemia were detected by both methods of estimation. The commonest diseases diagnosed in the study population, irrespective of the plasma glucose level, were ...

  18. Paediatric primary care in Europe: variation between countries

    DEFF Research Database (Denmark)

    van Esso, Diego; del Torso, Stefano; Hadjipanayis, Adamos


    Although it is known that differences in paediatric primary care (PPC) are found throughout Europe, little information exists as to where, how and who delivers this care. The aim of this study was to collect information on the current existing situation of PPC in Europe....

  19. Prevalence of uncomplicated malaria in a paediatrics outpatient ...

    African Journals Online (AJOL)

    The main presenting signs were pyrexia (84.5%), splenomegaly (38%) and hepatomegaly (14%). Malaria was the leading cause of paediatrics outpatient clinic attendance followed by acute respiratory infection and diarrhoeal disease. Though malaria occurred throughout the year, majority of the cases were seen during the ...

  20. African Journal of Paediatric Nephrology - Vol 1, No 1 (2014)

    African Journals Online (AJOL)

    Pattern of renal diseases in children admitted into the paediatric ward of Federal Medical Center, Asaba · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. B Ezeonwu, C Okike, T Oguonu, O Nwankwo, 8-11 ...

  1. Adalimumab for the treatment of refractory noninfectious paediatric uveitis. (United States)

    Muñoz-Gallego, Alicia; Barral, Estefanía; Enríquez, Eugenia; Tejada, Pilar; Barceló, Ana; de Inocencio, Jaime


    To report the experience of our center with the use of adalimumab (ADA) for the treatment of severe refractory noninfectious paediatric uveitis. The study is a retrospective case series of all paediatric patients with refractory uveitis who were treated with ADA at the Paediatric Uveitis Unit of our center from 2008 to 2015. We present 12 patients (6 Juvenile idiopathic arthritis-associated uveitis, 4 idiopathic panuveitis, 1 early-onset sarcoidosis-associated panuveitis, and 1 intermediate uveitis), with uveitis in 19/24 eyes. Once ADA therapy was started, all the patients presented improved activity according to Standardization of Uveitis Nomenclature (SUN) criteria. Nine out of the 12 patients had structural damage before ADA could be started: cataract (n = 4), glaucoma (n = 2), cystic macular edema (n = 1), exudative retinal detachment (n = 1), and optic disk edema (n = 5). Visual acuity improved or maintained stable in 17/19 affected eyes, and only 2 eyes decreased its visual acuity because of structural damage, which was already present before ADA therapy. In our experience, ADA presents a good safety profile and is efficacious in the treatment of paediatric patients with different forms of refractory noninfectious uveitis.

  2. Playing Into Injuries: Paediatric Trauma in a Nigerian Hospital ...

    African Journals Online (AJOL)

    Background: Childhood trauma is a common problem worldwide and a leading cause of death in developed countries. High number of paediatric traumas encountered in emergency department and orthopaedic clinic stimulated this study to find why many children are traumatized and to document the pattern of injury in ...

  3. Ethical key issues and fundamental rights in paediatric research. (United States)

    Altavilla, Annagrazia


    This article is aimed at describing the methodology of "ethical reasoning" that finally led TEDDYNoE (Task-force in Europe for Drug Development for the Young) to propose the integration of international human rights law to develop coherent and exhaustive ethical recommendations on paediatric research at a European level. A large number of ethical guidelines and texts of varying legal force existing in the field of clinical research and in particular related to paediatrics are analysed. Differences and non-coordinated implementation are pointed out. Differences, tensions or outright contradictions among the provisions of these texts can generate confusion leading to the adoption of different ethical standards across Europe. In this context, the real challenge is to ensure that each child involved in a clinical trial in the EU territory may rely directly on the same principles and rights. Taking international human rights law as the main starting point to develop a coherent framework for paediatric research that incorporates all the relevant ethical considerations and existing guidelines is a way of achieving this objective. The implementation, at national and local level, of the "European Ethical Recommendations" (Eudralex 2008 vol. 10), based on international human rights law, seems to be the next step in facilitating a coordinated approach to the application of the Directive 2001/20/EC, as well as developing quality and ethically sound paediatric research.

  4. Continuing education of paediatric nurses in Vojvodina, Serbia. (United States)

    Brestovacki, Branislava; Milutinovic, Dragana


    The purpose of this study was to identify the need and degree of interest for continuing education of paediatric nurses at the Institute for Child and Youth Health Care of Vojvodina. Descriptive study with prospective approach, which involved the use of surveys to elicit data collection. Data were collected during January and May of 2008. In this study 94% of paediatric nurses who participated in the study have secondary education in nursing, and 80% have not attended any forms of continuing education thus far, and 8% had presented papers at national seminars. No forms of continuing education were found dominant, while nurses with less years of work experience, showed statistically much greater interest in continuing education. Paediatric nurses in this study show the need for moral, ethical, and financial support from their supervisors and employers to realize their interest in continuing education, in accordance with their individual abilities. Information about the specific educational needs of paediatric nurses in terms of content and methods provide a valuable guide for planning the effective continuing education programs, seminars, and professional conferences for improving clinical practice and providing exemplary nursing care to children. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. The paediatric suprasellar cistern as an important CT review area

    African Journals Online (AJOL)


    difficult due to the constraints of cost and availability. CT is fairly ubiquitous in modern times and is often the first imaging modality used in paediatric patients requiring neuroradiological evaluation. Pathology is often subtle on CT compared with MRI and care- ful review of images by the radiologist is necessary to make ...

  6. paediatric ureteric calculi: in-situ extracorporeal shock wave lithotripsy

    African Journals Online (AJOL)

    Objective To evaluate prospectively the efficacy of in-situ extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteric calculi in the paediatric age group. Patients and Methods Twenty children (aged 2.2 16 years) with 22 ureteric stones were evaluated and treated with in-situ ESWL using the Dornier S lithotripter ...

  7. Radiation dose in paediatric computed tomography: risks and benefits

    African Journals Online (AJOL)

    The best available risk estimates suggest that paediatric CT will result in significantly increased lifetime radiation risk over adult CT. Studies have shown that lower milliampere-second (mAs) settings can be used for children without significant loss of information. Although the risk–benefit balance is still strongly tilted toward ...

  8. Impact of the learning environment on career intentions of paediatric ...

    African Journals Online (AJOL)

    Background. High childhood disease burdens in South Africa (SA) prioritise the need for careers in paediatrics. Experiences of junior doctors during internship may influence career trajectories in a direction that is discordant with national health priorities. Objective. To explore the influence of the learning environment and ...

  9. Creating a child-friendly environment in paediatric ophthalmology ...

    African Journals Online (AJOL)

    In most developing countries particularly in Nigeria, the paediatric ophthalmology subspecialty is still at its infancy especially in terms of human resources, equipment and infrastructure. It is therefore important to bring to notice the importance of creating a child friendly eye care environment while putting up an eye care unit.

  10. Iatrogenic medication errors in a paediatric intensive care unit in ...

    African Journals Online (AJOL)

    [10] Furthermore, medication dosages in the PICU are often calculated on the basis of an estimated weight or body surface area. Dosing is almost always parenteral,. This open-access article is distributed under. Creative Commons licence CC-BY-NC 4.0. Iatrogenic medication errors in a paediatric intensive care unit in ...

  11. Discharge from hospital against medical advice among paediatric ...

    African Journals Online (AJOL)

    Background: The reasons underlying discharge against medical advice by Paediatric patients varies from place to place. Discharge against medical advice is frustrating to the medical personnel and deprives the patient of adequate medical care. This study aims to determine the prevalence and factors associated with ...

  12. CT scanning may adversely influence choice of surgery in paediatric ...

    African Journals Online (AJOL)


    lesions based on contrast enhance- ment characteristics, but caution is advised in assuming that all nodules are neoplastic. Introduction. The literature presents two views regarding the treatment of paediatric papillary thyroid carcinoma. There are those supporting conservative sur- gical procedures and those supporting.

  13. Paediatric spirometry guideline of the South African Thoracic Society ...

    African Journals Online (AJOL)

    Spirometry forms an important component in the diagnosis and management of pulmonary diseases in children. In the paediatric setting, there are ... an altered mental state[10] or learning difficulties[2,3]. • chest .... When maximal expiration is met, fill up the lungs again by taking another quick, deep breath. ×. ✓. Repeat for a ...

  14. Paediatric pancreatic problems: A five-year experience | Lahoti ...

    African Journals Online (AJOL)

    Background: To analyse a tertiary care experience with various pancreatic problems in the paediatric age group and clarify the frequency of various pancreatic diseases in the same patient population as well as the role of surgical or conservative management in their treatment. Patients and Methods: All patients with clinical ...

  15. Current practice of adolescent preventive services among paediatric ...

    African Journals Online (AJOL)

    Background. There has been a growing recognition of the challenge of Nigerian adolescents' health issues and the need to address it. Adolescent preventive services (APS) constitute an effective mechanism to reduce adolescent morbidities. Objective. To evaluate the current practice of APS among Nigerian paediatric ...

  16. Prevalence of HIV seropositivity in paediatric surgical patients at the ...

    African Journals Online (AJOL)

    ... a hernia and severe cachexia. Conclusion: Prevalence of HIV seropositivity is very low among paediatric surgical patients at NAUTH. Routine screening of patients is not necessary and should not form part of the policy. We recommend routine counselling of parents and provision of facilities for precautionary measures as ...

  17. Paediatric Palliative Care and Intellectual Disability--A Unique Context (United States)

    Duc, Jacqueline K.; Herbert, Anthony Robert; Heussler, Helen S.


    Background: Paediatric palliative care is a nuanced area of practice with additional complexities in the context of intellectual disability. There is currently minimal research to guide clinicians working in this challenging area of care. Method: This study describes the complex care of children with life-limiting conditions and intellectual…


    African Journals Online (AJOL)


    and contributes to drug resistance. Finally, appropriate antimalarial drugs for treatment should be given free to all malaria positive children. Keywords: Malaria, paediatric patients, parasite density, prevalence, laboratory diagnosis, treatment. INTRODUCTION. The bare facts are that malaria is a public health problem in more ...

  19. Paediatrics hiv/aids: Clinical presentation and practical ...

    African Journals Online (AJOL)

    Paediatrics hiv/aids: Clinical presentation and practical management Challenges in Sokoto, Nigeria. ... Abstract. Background: Implications of continuing HIV/AIDS pandemic in Nigeria is very grave for children. Lack of ... Thirty- six (87.8%) patients had protein – energy malnutrition (PEM), marasmus constituting 58%.

  20. Paediatric surgery in the RSA - practice and training | Millar | South ...

    African Journals Online (AJOL)

    A survey of the current practice 'of general paediatric surgery in South Africa and Namibia was conducted by tneans of a postal questionnaire. One hundred and eighty-one replies were obtained (52%). Analysis showed that although surgeons are located predominantly in the major cities, 18% practised in the larger towns ...

  1. admission patterns and outcomes of paediatric patients admitted at ...

    African Journals Online (AJOL)

    OBJECTIVE To determine patterns of admissions due to diarrhea and their outcomes of paediatric patients at Muhimbili National Hospital (MNH). METHODOLOGY A hospital-based prospective study including all children admitted to the Diarrhea Unit during the study period. Data was collected using content analysis ...

  2. An Analysis of Disorders seen at the Paediatric Neurology Clinic ...

    African Journals Online (AJOL)

    METHODS: All children presenting at the paediatric neurology clinic of the University College Hospital, Ibadan, Nigeria over a period of 20 months were prospectively studied. Diagnoses were made from detailed history, thorough physical examination, with particular emphasis on the central nervous system and appropriate ...

  3. Perioperative Factors Affecting Fast Tracking in Paediatrics Cardiac ...

    African Journals Online (AJOL)


    including weaning time from mechanical ventilation and extubation: in a paediatric cardiac patients ... Majority of patients had congenital heart disease that accounted for 93.6% of all cases while chronic rheumatic .... repair (ICR) for all both cyanotic and acyanotic congenital heart diseases and valve replacement (VL) or.

  4. A longitudinal study of MUAC as a measure of paediatric ...

    African Journals Online (AJOL)

    Royal Hampshire County Hospital, Winchester, UK. It had been noted that there was very minimal provision for malnourished children in the town (total population in Yei was estimated at 185,000 in 2011). Successive teams from the link therefore assessed the levels of acute paediatric malnutrition in order to supply data to ...

  5. A practical approach to anaesthesia for paediatric liver transplantation

    African Journals Online (AJOL)


    improved outcomes of both the graft and the patient. In more recent years, the use of reduced size and living related organs has increased the donor pool for infants and children. Paediatric liver transplantation in South Africa, up until the present time, has been centered at the Red Cross Children's Hospital in. Cape Town ...

  6. Lecturer, Department of Child Health and Paediatrics, KK Kamar ...

    African Journals Online (AJOL)


    Oct 1, 2001 ... S. О. Луауа, MBChB, MMed (Paed) (Nrb), FDERM (USA), Lecturer, Department of Child Health and Paediatrics, K.K. Kamar, BVM (Nrb),. Msc (Medical ... agents responsible for it and; to recommend the correct mode of treatment in school children attending a .... chemotherapy, antibiotics, HIV/AIDS, poverty,.

  7. Evaluation of a proposed clinical case definition of paediatrics ...

    African Journals Online (AJOL)

    Objective: To evaluate the proposed criteria against the laboratory parameters and to identify the clinical features with the highest predictive value in the diagnosis of paediatric AIDS. Design: A cross sectional study. Setting: Kenyatta National Hospital, Nairobi. Results: More than twenty three per cent of the children studied ...

  8. HIV infection, tuberculosis and workload in a general paediatric ward

    African Journals Online (AJOL)

    HIV-TB co-infection prevalence rates in hospitalised children; to determine the proportion of hospitalised HIV-infected children who required high care; to describe the proportion of deaths associated with HIV and/or TB; and to relate workload to the level of nursing cover in a general paediatric ward over a 1-year period in a ...

  9. Elevated visual motion detection thresholds in adults with acquired ophthalmoplegia (United States)

    Acheson, J; Cassidy, L; Grunfeld, E; Shallo-Hoffman, J; Bronstein, A


    AIMS—To test the hypothesis that in patients with acquired chronic bilateral ophthalmoplegia, abnormal retinal image slippage during head movements would result in abnormal thresholds for visual perception of motion.
METHODS—Five patients (two males and three females) with ophthalmoplegia were included in the study. The average age was 44 years (range 30-69 years). The aetiology of ophthalmoplegia was myasthenia gravis (MG; n=2), chronic progressive external ophthalmoplegia (CPEO; n=2), and chronic idiopathic orbital inflammation. Visual motion detection thresholds were assessed using horizontal and vertical gratings (spatial frequency) set at thresholds for visibility. The grating was then accelerated at 0.09 deg/s2. The subject's task was to detect the drift direction of the stimulus.
RESULTS—Visual motion detection thresholds were raised to a mean of 0.434 deg/s (SD 0.09) (mean normal value 0.287 deg/s (SD 0.08)) for horizontal motion; and to a mean of 0.425 deg/s (SD 0.1) (mean normal value 0.252 deg/s (SD 0.08)) for vertical motion. The difference in values for both horizontal and vertical motion detection were statistically significant when compared with age matched controls; p <0.023 for horizontal motion and p<0.07 for vertical motion (two tailed t test).
CONCLUSION—Abnormally raised visual motion thresholds were found in patients with ophthalmoplegia. This may represent a centrally mediated adaptive mechanism to ignore excessive retinal slip and thus avoid oscillopsia during head movements.


  10. Changes in Quality of Health Care Delivery after Vertical Integration. (United States)

    Carlin, Caroline S; Dowd, Bryan; Feldman, Roger


    To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data were assembled by the health plan's informatics team. Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care-sensitive admissions increased when the acquisition caused disruption in admitting patterns. Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. © Health Research and Educational Trust.

  11. Gestation and the evolution of vertical stance bipedal humans

    Directory of Open Access Journals (Sweden)

    D.S. Robertson


    Full Text Available During mammalian gestation a change in maternal stance alters the velocities of maternal blood flows and results in a changed rate of delivery and distribution of nutrients required to form the bone and tissue in various parts of a developing foetus. The latter in turn results in change in the extent and position of tissue and bone formation in the foetus. It is shown that such changes would, over many generations, alter the physical characteristics of the ancestor offspring under conditions where the pregnant maternal ancestor normally exhibiting horizontal stance was constrained to adopt a vertical stance for all or most of the gestation period. This behaviour produced the physical characteristics seen in humans and other Hominidae primates, including the vertical stance and bipedalism of the former accompanied by increase in skull and brain size. The manner in which difficulties of giving birth as the change from horizontal stance to vertical stance proceeded from generation to generation, limited survival is discussed andreasons for the adoption of this behaviour are proposed. The induction of evolutionary change and the operation of natural selection through alterations in the characteristics of embryo/foetus of an animal, induced by physical, chemical, mechanical or behavioural means, is shown to be feasible. The changes are not related to the Lamarckian principle of inheritance of acquired characteristics as the changes described occurred before birth and are not related to any physical or mental characteristics already present in or acquired during the lifetime of the breeding pair.

  12. Vertical saccades in dyslexic children. (United States)

    Tiadi, Aimé; Seassau, Magali; Bui-Quoc, Emmanuel; Gerard, Christophe-Loïc; Bucci, Maria Pia


    Vertical saccades have never been studied in dyslexic children. We examined vertical visually guided saccades in fifty-six dyslexic children (mean age: 10.5±2.56 years old) and fifty-six age matched non dyslexic children (mean age: 10.3±1.74 years old). Binocular eye movements were recorded using an infrared video-oculography system (mobileEBT®, e(ye)BRAIN). Dyslexic children showed significantly longer latency than the non dyslexic group, also the occurrence of anticipatory and express saccades was more important in dyslexic than in non dyslexic children. The gain and the mean velocity values were significantly smaller in dyslexic than in non dyslexic children. Finally, the up-down asymmetry reported in normal population for the gain and the velocity of vertical saccades was observed in dyslexic children and interestingly, dyslexic children also reported an up-down asymmetry for the mean latency. Taken together all these findings suggested impairment in cortical areas responsible of vertical saccades performance and also at peripheral level of the extra-ocular oblique muscles; moreover, a visuo-attentionnal bias could explain the up-down asymmetry reported for the vertical saccade triggering. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Attitudes towards fever amongst UK paediatric intensive care staff. (United States)

    Brick, Thomas; Agbeko, Rachel S; Davies, Patrick; Davis, Peter J; Deep, Akash; Fortune, Peter-Marc; Inwald, David P; Jones, Amy; Levin, Richard; Morris, Kevin P; Pappachan, John; Ray, Samiran; Tibby, Shane M; Tume, Lyvonne N; Peters, Mark J


    The role played by fever in the outcome of critical illness in children is unclear. This survey of medical and nursing staff in 35 paediatric intensive care units and transport teams in the United Kingdom and Ireland established attitudes towards the management of children with fever. Four hundred sixty-two medical and nursing staff responded to a web-based survey request. Respondents answered eight questions regarding thresholds for temperature control in usual clinical practice, indications for paracetamol use, and readiness to participate in a clinical trial of permissive temperature control. The median reported threshold for treating fever in clinical practice was 38 °C (IQR 38-38.5 °C). Paracetamol was reported to be used as an analgesic and antipyretic but also for non-specific comfort indications. There was a widespread support for a clinical trial of a permissive versus a conservative approach to fever in paediatric intensive care units. Within a trial, 58% of the respondents considered a temperature of 39 °C acceptable without treatment. Staff on paediatric intensive care units in the United Kingdom and Ireland tends to treat temperatures within the febrile range. There was a willingness to conduct a randomized controlled trial of treatment of fever. What is known: • The effect of fever on the outcome in paediatric critical illness is unknown. • Paediatricians have traditionally been reluctant to allow fever in sick children. What is new: • Paediatric intensive care staff report a tendency towards treating fever, with a median reported treatment threshold of 38 °C. • There is widespread support amongst PICU staff in the UK for a randomized controlled trial of temperature in critically ill children. • Within a trial setting, PICU staff attitudes to fever are more permissive than in clinical practice.

  14. High-alert medications in a French paediatric university hospital. (United States)

    Bataille, Julie; Prot-Labarthe, Sonia; Bourdon, Olivier; Joret, Perrine; Brion, Françoise; Hartmann, Jean-François


    High-alert medications (HAMs) are medications that are associated with a high risk of serious harm if used improperly. The objective of this study was to identify paediatric HAM used in our institution and to identify safety measures for their use. The list of HAM and the list of safety measures that were introduced in our department were based on (1) a literature search; (2) a survey of health care professionals in our department including doctors, head nurses, nurses and pharmacists; and (3) the drug steering committee. We found four lists of HAM based on a literature search, including 27 classes of pharmaceutical agents, and 63 common drug names. The response rate of the survey was 20.7% (230 of 1113). Some of the HAMs included in our list were not identified by the literature search. These included neuroleptic drugs, anti-malarial agents, antiviral agents, anti-retroviral agents and intravenous acetaminophen. The drug steering committee selected 17 HAM and highlighted 53 safety measures involving seven broad aspects of pharmacological management. This project was part of the new safety strategies developed in a paediatric hospital. We set out to make a list of HAM relevant to paediatrics with additional safety measures to prevent medication errors associated and a 'joker' system. The various safety measures, such as double-checking of HAM prescriptions, should be reviewed during the year following their implementation. This list, which was developed in our hospital specifically for use in paediatrics, can be adapted for use in other paediatric departments. © 2014 John Wiley & Sons, Ltd.

  15. The use of ethanol in paediatric formulations in New Zealand. (United States)

    Svirskis, Darren; Toh, Meiyen; Ram, Sanyogita


    Children's right to access safe and effective medicines is recognised globally. Ethanol, used in paediatric liquid formulations as a solvent and preservative, is associated with safety concerns with respect to both acute ingestion and chronic exposure. In addition, families may have cultural or religious values making ethanol use inappropriate when alternatives are available. International guidelines aim to reduce, and if possible eliminate, the use of ethanol in paediatric medicines. Guidelines on labelling vary globally, limiting the ability of health professionals and patients to make informed decisions on appropriate medicines. This study aimed to explore the availability of ethanol-containing medicines for use in the paediatric population in New Zealand and to discuss findings alongside international guidelines. Forty-seven paediatric liquid medicines were identified containing ethanol. The ethanol concentration could be determined in 35 of these medicines and ranged from 0.6 % v/v to an alarming 76 % v/v ethanol. If recommended dosing instructions are followed, the ethanol consumed per dose is not expected to cause acute toxic effects. The medicines identified are indicated for both acute and chronic use, including digoxin (10.1-11.4 % v/v ethanol) which is used in patients of all ages, including preterm neonates. Stronger guidance should be provided to reduce the use of ethanol in paediatric medicines, in New Zealand and globally. If ethanol is used, full disclosure of its presence and concentration on the product label is essential to enable prescribers and patients to make informed decisions on the most suitable pharmaceutical formulations.


    Directory of Open Access Journals (Sweden)

    Satish D. Shet


    Full Text Available BACKGROUND Control of childhood blindness is one of the priorities identified for achieving the goals of Vision-2020 by WHO. This is considered a priority because blind-years (number of years that a blind person lives after going blind due to childhood blindness are second only to cataract and half of childhood blindness is avoidable (treatable/preventable. Paediatric cataract accounts for 12% of the 1.4 million blind children globally. The prevalence of childhood cataract has been reported as 1 to 15 cases in 10,000 children in developing countries. Compared to industrialised countries, this figure is 10 times higher. Early detection and timely treatment of various childhood disorders such as congenital cataract are the most crucial factors for successful outcome. A suitable measure to address amblyopia and posterior capsule opacification post operatively is imperative for successful visual rehabilitation of such children. The objectives of this study were- 1 To study the clinical profile of paediatric cataract. 2 To evaluate the visual outcome after cataract surgery in these patients. 3 To evaluate different causes of visual impairment following management. MATERIALS AND METHODS A prospective study conducted at Karnataka institute of medical sciences department of ophthalmology from October 2015 to September 2016. All children below 14 years of age presenting with cataract will undergo thorough ophthalmologic examination and cataract surgery. RESULTS The results of the present study with 25 paediatric patients (36 eyes indicates that excellent vision can be expected after cataract surgery and posterior chamber IOL implantation coupled with appropriate amblyopia therapy. CONCLUSION The paediatric cataract patients are referred from primary health centers, and district hospital from north Karnataka to KIMS Hubli. All paediatric patients are from lower socio economic status. Early detection of cataracts and referrals to the ophthalmologist can

  17. Paediatric medulloblastoma cells are susceptible to Viscum album (Mistletoe) preparations. (United States)

    Zuzak, T J; Rist, L; Eggenschwiler, J; Grotzer, M A; Viviani, A


    Medulloblastoma constitute more than 20% of all paediatric brain tumours and are the most common malignant brain tumours in children. Adjuvant chemotherapy has seen a strong increase in the use of complementary medicine for cancer treatment. Evidence for cytotoxic and apoptotic effects of Viscum album (Mistletoe) in vitro is available, however, no data concerning paediatric tumours, especially paediatric brain tumours, has been provided so far. In order to compare the receptiveness of medulloblastoma cells to different Viscum album preparations, in vitro cytotoxic effects of eight Viscum album extracts on four different paediatric medulloblastoma cell lines were analysed by MTT-Tests. Lectin contents of the extracts were determined to correlate them with the mitochondrial activity of mistletoe-treated cells. Flowcytometric analyses with Annexin V-FITC staining were carried out to quantify the amount of apoptotic cells compared to necrotic and viable cells. Data obtained with the medulloblastoma cell lines, Daoy, D342, D425 and UW-288-2, treated with Viscum album preparations from eight dissimilar host trees (Iscucin Abietis, Pini, Populi, Mali, Salicis, Crataegi, Quercus and Tiliae), indicated a significant growth-inhibition of all cell lines, yet the cell susceptibility was dissimilar against the different extracts. The decrease in mitochondrial activity and increase in apoptosis correlated with the lectin content of the used preparation in a dose-dependent manner. These in vitro results show that paediatric medulloblastoma cells respond to Viscum album preparations, by undergoing cell death through apoptosis and that this growth-inhibition correlates with the lectin content of the used preparation.

  18. 17 CFR 210.8-06 - Real estate operations acquired or to be acquired. (United States)


    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Real estate operations acquired or to be acquired. 210.8-06 Section 210.8-06 Commodity and Securities Exchanges SECURITIES AND... Statements of Smaller Reporting Companies § 210.8-06 Real estate operations acquired or to be acquired. If...

  19. Indications for admission, treatment and improved outcome of paediatric haematology/oncology patients admitted to a tertiary paediatric ICU.

    LENUS (Irish Health Repository)

    Owens, C


    BACKGROUND: Overall survival in paediatric cancer has improved significantly over the past 20 years. Treatment strategies have been intensified, and supportive care has made substantial advances. Historically, paediatric oncology patients admitted to an intensive care unit (ICU) have had extremely poor outcomes. METHODS: We conducted a retrospective cohort study over a 3-year period in a single centre to evaluate the outcomes for this particularly vulnerable group of patients admitted to a paediatric ICU. RESULTS: Fifty-five patients were admitted a total of 66 times to the ICU during the study period. The mortality rate of this group was 23% compared with an overall ICU mortality rate of 5%. 11\\/15 patients who died had an underlying haematological malignancy. Twenty-eight percent of children with organism-identified sepsis died. CONCLUSIONS: While mortality rates for paediatric oncology patients admitted to a ICU have improved, they are still substantial. Those with a haematological malignancy or admitted with sepsis are most at risk.

  20. Extended-spectrum β-lactamase-producing bacteria caused less than 5% of urinary tract infections in a paediatric emergency centre. (United States)

    Jacmel, Lisa; Timsit, Sandra; Ferroni, Agnès; Auregan, Clémentine; Angoulvant, François; Chéron, Gérard


    The last decade has seen a significant increase in extended-spectrum β-lactamase (ESBL) secreting organisms responsible for paediatric urinary tract infections (UTIs), particularly in community-acquired infections. These expose patients to the risks of antibiotic treatment failure and renal scarring. This prospective study examined the prevalence and risk factors of febrile ESBL UTIs and their treatment in the paediatric emergency department of a university hospital. In this prospective observational study, all children from 0 to 16 years of age with febrile UTIs were included from May 2012 to April 2013. Cases with and without ESBL involvement were compared. Of the 474 diagnosed febrile UTIs, 22 (4.6%) with a 95% confidence interval (95% CI) of 2.9-6.9 were due to an ESBL-producing organism. Escherichia coli was found in 85% of cases. Significant odds ratios (OR) for ESBL urinary tract infections were prior hospitalisation (OR 4.1, 95% CI 1.6-10.8), urinary tract abnormalities (OR 3.9, 95% CI 1.5-10.2) and previous antibiotic treatment (OR 3.1, 95% CI 1.2-8.8). All ESBL urinary tract infections had positive outcomes. The prevalence of febrile ESBL urinary tract infections was less than 5% in a paediatric emergency department. This low rate was not high enough to justify changing our guidelines. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.