MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Paediatrics and Child Health' source. Thu, 09 Feb 2012 01:09:39 +0100 http://www.medworm.com/index.php?rid=5631035&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002824%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631035 Fri, 27 Jan 2012 06:16:38 +0100 5631035 http://www.medworm.com/index.php?rid=5631034&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100151X%2Fabstract%3Frss%3Dyes This article is about how such research is possible through the National Institute for Health Research; it is not about opportunities for basic medical and laboratory scientific research. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631034 Fri, 27 Jan 2012 06:16:38 +0100 5631034 http://www.medworm.com/index.php?rid=5631033&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002836%2Fabstract%3Frss%3Dyes Abstract: Swelling of the tissues surrounding the eye is a relatively common presentation in paediatric practice. Many of the mild, pre-septal cases of periorbital inflammation and infection are caused by insect bites, trauma and conjunctivitis. Frequently infection spreads from the ethmoid sinuses and invades orbital tissues. The distinction between pre-septal and orbital involvement can be difficult based on clinical examination only, and the research base supporting management of periorbital and orbital cellulitis is limited. This review addresses the role of investigations and the multi-disciplinary approach needed in order to establish accurate diagnosis, appropriate treatment and prevention of serious complications including blindness and venous sinus thrombosis. (Source: Paediatrics... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631033 Fri, 27 Jan 2012 06:16:38 +0100 5631033 http://www.medworm.com/index.php?rid=5631032&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001478%2Fabstract%3Frss%3Dyes Abstract: After long periods of vast child health disparities between industrialized countries and Resource-limited Settings (RLS) research has started to address and reduce the gap. It is well established worldwide, has yielded mutually rewarding collaborations and has a funding and career structure unthinkable even 25 years ago. Despite this progress, work remains to ensure academic and funding equity and ethical parity.This paper outlines the background to and history of research in RLS, illustrates the current situation and points to potential future developments. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631032 Fri, 27 Jan 2012 06:16:38 +0100 5631032 http://www.medworm.com/index.php?rid=5631031&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001223%2Fabstract%3Frss%3Dyes Conclusion. The present paper will provide recommendations to assist you in improving your writing style and presenting the content and will provide guidance to help you submit the best paper you can. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631031 Fri, 27 Jan 2012 06:16:38 +0100 5631031 http://www.medworm.com/index.php?rid=5631030&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001156%2Fabstract%3Frss%3Dyes This article aims to provide a step-by-step overview of the process of applying for research funding and will be most relevant to either a new academic joining a group or a young clinician wanting to establish their own research. We explain the types of funding available and the process by which one would choose the right funding body to apply to. We highlight the various people who should be involved in developing the research proposal and making a funding application, as well as the sources of support available to help the new researcher take their ideas forward. A checklist is also provided to reiterate the key points. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631030 Fri, 27 Jan 2012 06:16:38 +0100 5631030 http://www.medworm.com/index.php?rid=5631029&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001235%2Fabstract%3Frss%3Dyes Abstract: Why might the average paediatrician need to get involved in understanding statistics? What do they need to know? Are there simple rules that can be followed in determining the appropriate analyses? Where can help be found?These are the questions that we aim to answer in this short review of how to design and analyze research studies. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631029 Fri, 27 Jan 2012 06:16:38 +0100 5631029 http://www.medworm.com/index.php?rid=5631028&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001016%2Fabstract%3Frss%3Dyes Abstract: Children should not be harmed by their participation in clinical trials, therefore should no clinical trials be performed? This is a view that needs to be balanced as clinical trials provide the evidence we need to allow children safe and effective prescribing of medicines. Therefore, is it unethical not to involve this population in research? The main push in the last decade has been to increase the number of medicines tested in the paediatric population. This culminated in the European Union ‘Paediatric Regulation’ in 2007 that meant that all new medicines, appropriate for use in children, must be researched in this population. The current challenge facing paediatricians involved in research is balancing harm, legislative requirements against the need for evidence based med... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631028 Fri, 27 Jan 2012 06:16:38 +0100 5631028 http://www.medworm.com/index.php?rid=5631027&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722212000066%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5631027 Fri, 27 Jan 2012 06:16:38 +0100 5631027 http://www.medworm.com/index.php?rid=5507392&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002447%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507392 Fri, 16 Dec 2011 18:26:00 +0100 5507392 http://www.medworm.com/index.php?rid=5507391&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001466%2Fabstract%3Frss%3Dyes Tonsillectomy is one of the most frequently performed surgical procedures in UK children, accounting for about 20% of all operations performed by otolaryngologists. Tonsillectomy is performed with or without adenoidectomy and involves complete removal of the palatine tonsils including their capsule by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Adenotonsillectomy is performed in the UK only when there is a specific indication to remove the adenoids as well as the tonsils. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507391 Fri, 16 Dec 2011 18:26:00 +0100 5507391 http://www.medworm.com/index.php?rid=5507390&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002010%2Fabstract%3Frss%3Dyes Abstract: Overweight and obesity prevalence has dramatically increased during the last decade and reached epidemic dimensions. By 2030 it is expected that there will be 2.16 billion overweight individuals with 1.12 billion adults predicted to be clinically obese. Obesity is caused by both genetic and non-genetic factors. BMI as a common measure of obesity is a highly heritable trait with heritability estimates of ∼0.7 for both adults and children. Mutations in a few genes such as LEPR and MC4R identified by molecular genetic analysis in children are known to be involved in rare monogenic severe obesity. Their identification opened important insights in fundamental pathways, in particular the leptin-melanocortin pathway, involved in control of appetite and energy metabolism. However, the ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507390 Fri, 16 Dec 2011 18:26:00 +0100 5507390 http://www.medworm.com/index.php?rid=5507389&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000990%2Fabstract%3Frss%3Dyes This article is directed towards the early identification of the serious ocular problems which may arise in children. General screening and assessment are discussed, including important pointers in the history and examination. Selected topics include the baby who cannot see, refractive errors and strabismus, nystagmus, cloudy or prominent eyes, and trauma. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507389 Fri, 16 Dec 2011 18:26:00 +0100 5507389 http://www.medworm.com/index.php?rid=5507388&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002411%2Fabstract%3Frss%3Dyes Abstract: Retinopathy of prematurity (ROP) affects preterm infants. Here we describe its revised classification and the amended treatment indications which recommend treatment at an earlier ROP stage known as ‘prethreshold’. The three global ROP epidemics are briefly discussed. ROP sequelae are discussed under four headings: visual functions, strabismus, refractive state and the effect of ROP on the structures of the eye. While ROP is potentially blinding, in general, ophthalmic outcome is similar for preterm children who did not develop ROP or in whom this was only mild (stages 1 & 2). In the main their deficits are not functionally disabling, although treatment, to correct a refractive error, strabismus or amblyopia, may be required. The outcome for children who had severe, potential... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507388 Fri, 16 Dec 2011 18:26:00 +0100 5507388 http://www.medworm.com/index.php?rid=5507387&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001144%2Fabstract%3Frss%3Dyes This article aims to discuss the clinical assessment of hearing and provides an overview of the management options available in the treatment of hearing loss, including amplification, grommet insertion, bone anchored hearing aids and cochlear implantation. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507387 Fri, 16 Dec 2011 18:26:00 +0100 5507387 http://www.medworm.com/index.php?rid=5507386&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000515%2Fabstract%3Frss%3Dyes Abstract: Otitis Media with Effusion (OME, ‘glue ear’) is the commonest cause of childhood hearing loss. Because the condition fluctuates, initial management of otitis media with effusion is audiometric confirmation and quantification of any hearing loss involved, explanation to parents or carers and watchful waiting with continued audiometric monitoring.Neither medical treatments nor “complementary/alternative” treatments have been proven to be effective in the management of otitis media with effusion. Insertion of ventilation tubes (grommets) for children over 3 years of age with a bilateral hearing impairment associated with otitis media with effusion, who have failed watchful waiting, is effective in restoring hearing thresholds. The hearing returns to normal almost immediately... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507386 Fri, 16 Dec 2011 18:26:00 +0100 5507386 http://www.medworm.com/index.php?rid=5507385&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000904%2Fabstract%3Frss%3Dyes Orbital cellulitis predominantly affects children. This disease is potentially sight and life threatening and requires prompt recognition, investigations and treatment. An understanding of the anatomical features of the orbit its adnexa and neighbouring paranasal sinuses is essential in the evaluation and management of inflammations of the orbit. In this review the current aetiological factors, the clinical presentation, the differential diagnosis, complications, investigations and management of orbital cellulitis are presented. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507385 Fri, 16 Dec 2011 18:26:00 +0100 5507385 http://www.medworm.com/index.php?rid=5507384&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002733%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5507384 Fri, 16 Dec 2011 18:26:00 +0100 5507384 http://www.medworm.com/index.php?rid=5451030&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002393%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451030 Mon, 28 Nov 2011 18:39:52 +0100 5451030 http://www.medworm.com/index.php?rid=5451029&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100148X%2Fabstract%3Frss%3Dyes Fractures are common in children, and the highest incidence in each sex is around the time of peak height velocity. Vigorous physical activity is strongly associated with fracture at all ages, irrespective of bone density; fractures occurring without an obvious cause in a mobile child should raise concerns about bone fragility. The commonest cause is osteogenesis imperfecta (OI). Thus OI should be considered in a child who presents with a history of recurrent low trauma fractures. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451029 Mon, 28 Nov 2011 18:39:52 +0100 5451029 http://www.medworm.com/index.php?rid=5451028&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001727%2Fabstract%3Frss%3Dyes Abstract: Juvenile idiopathic arthritis (JIA) is characterized by joints with swelling, pain, and limitation of movement. The main principle of treatment is to control this active arthritis in order to prevent permanent damage. This review describes the different types of JIA, a stepwise approach to treatment according to the level of disease activity, and the medications used. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451028 Mon, 28 Nov 2011 18:39:52 +0100 5451028 http://www.medworm.com/index.php?rid=5451027&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001296%2Fabstract%3Frss%3Dyes Abstract: A very small proportion of children with rare autoimmune and rheumatological disorders, such as juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, juvenile dermatomyositis and other systemic vasculitides will respond neither to the classical anti-inflammatory and/or immunosuppressive treatments, nor to the new and emerging biologic response modifiers. This small group of children, usually with accumulated morbidity from both the progressive disease course and from long-term, multiple combined therapies are in on-going need for innovative treatments such as haematopoietic stem cell transplantation.Two forms of haematopoietic stem cell transplantation have been performed for autoimmune and rheumatological disorders over the last decade: firstly, re-infusion of th... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451027 Mon, 28 Nov 2011 18:39:52 +0100 5451027 http://www.medworm.com/index.php?rid=5451026&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001508%2Fabstract%3Frss%3Dyes Abstract: Juvenile Idiopathic Arthritis (JIA), is the commonest cause of chronic arthritis in childhood worldwide, has considerable morbidity and is a common cause of acquired visual loss in children due to the strong association with chronic anterior uveitis. The diagnosis is clinical and confidence in examination of the musculoskeletal system for synovitis is essential. Management of JIA is based on a combination of pharmacological interventions, physical and occupational therapy, and psychosocial support, managed by an experienced multidisciplinary team. The aim of therapy is to reach complete control of the disease, preserve the physical and psychological integrity of the child and to prevent any long-term consequence related to the disease or treatment. There is overwhelming research ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451026 Mon, 28 Nov 2011 18:39:52 +0100 5451026 http://www.medworm.com/index.php?rid=5451025&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001739%2Fabstract%3Frss%3Dyes This article will discuss the clinical presentations of paediatric bone and joint infections. The approach to clinical assessment, laboratory and radiological investigations, and management of these conditions, will be discussed. Caring for patients with bone and/or joint infections, often involves several specialities; emergency department doctors, general paediatricians, orthopaedic surgeons, radiologists, paediatric rheumatologists, and the paediatric physiotherapy teams. Early and close collaboration between teams will result in prompt investigation with age appropriate care. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451025 Mon, 28 Nov 2011 18:39:52 +0100 5451025 http://www.medworm.com/index.php?rid=5451024&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001430%2Fabstract%3Frss%3Dyes Abstract: Systemic lupus erythematous (SLE) is a rare, multi-system, autoimmune disorder. Juvenile-onset SLE (JSLE) differs from the adult form in terms of severity, variation in organ involvement and gender ratio. As well as being a challenging diagnosis to make in the younger age group, the management of JSLE compared to adult-onset SLE requires special consideration towards both the significant long-term consequences of the disease, and its onset during a crucial time in growth and development. The variety of genetic, autoantibody and host immune responses featuring in the disease results in a clinically heterogeneous phenotype. A personalized approach is required to provide optimal care for an individual’s needs and therefore an overview of generic rather than specific management gui... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451024 Mon, 28 Nov 2011 18:39:52 +0100 5451024 http://www.medworm.com/index.php?rid=5451023&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001740%2Fabstract%3Frss%3Dyes This article provides an overview of the important and common causes of back pain in children, and highlights key features in the history and examination that should raise suspicion of an underlying disorder and prompt further investigation. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451023 Mon, 28 Nov 2011 18:39:52 +0100 5451023 http://www.medworm.com/index.php?rid=5451022&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001752%2Fabstract%3Frss%3Dyes Abstract: Paediatricians and General Practitioners commonly diagnose and manage musculoskeletal symptoms in children. The spectrum of conditions which present with musculoskeletal symptoms and signs is wide, encompassing benign and very serious disorders. This review uses three case examples to illustrate the challenges in, and present a structured approach to, musculoskeletal examination. A simple validated screening examination (pGALS) and a new regional examination (pREMS) are presented. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451022 Mon, 28 Nov 2011 18:39:52 +0100 5451022 http://www.medworm.com/index.php?rid=5451021&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100254X%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5451021 Mon, 28 Nov 2011 18:39:52 +0100 5451021 http://www.medworm.com/index.php?rid=5350483&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001533%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350483 Thu, 27 Oct 2011 06:28:05 +0100 5350483 http://www.medworm.com/index.php?rid=5350482&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100179X%2Fabstract%3Frss%3Dyes Headache is a common symptom in children. Recurrent or persistent headache is most commonly due to one of three main headache types; migraine (with and without aura), tension headache and chronic daily headache. Headache has been reviewed in this journal at least twice in the last few years and there are many good reviews of headache and its treatment in the clinical journals. Headache including migraine affects up to 30% of the population and often begins in childhood. The classification system for headache introduced in 1998 by the International Headache Society has been updated and is widely used in research and clinical papers. Symptom overlap between the various headache syndromes is particularly common in children making clear definition difficult in clinical practice. This paper wil... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350482 Thu, 27 Oct 2011 06:28:05 +0100 5350482 http://www.medworm.com/index.php?rid=5350481&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001545%2Fabstract%3Frss%3Dyes Abstract: Clinical networks are important in paediatrics where single paediatricians often provide sub specialty services in DGHs. Training courses, regional special interest groups and audit all contribute to the development of strong clinical relationships between paediatric neurologists, general paediatricians and epilepsy specialist nurses which in turn enhances the care offered to children and their families. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350481 Thu, 27 Oct 2011 06:28:05 +0100 5350481 http://www.medworm.com/index.php?rid=5350480&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002204%2Fabstract%3Frss%3Dyes Abstract: Neonatal hydrocephalus is a complex disorder due to many different causes. This review seeks to encapsulate the management of neonatal hydrocephalus in the term neonate. The current treatments are explored and explained. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350480 Thu, 27 Oct 2011 06:28:05 +0100 5350480 http://www.medworm.com/index.php?rid=5350479&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001454%2Fabstract%3Frss%3Dyes Abstract: Duchenne muscular dystrophy (DMD) is the most common paediatric muscle condition. Affected boys show first symptoms around the age of 2–5 years with progressive muscle weakness and wasting leading to severe disability and reduced life span due to cardiac and respiratory complications.Although no curative treatment is currently available for this severe and fatal condition, over the last years, advances in general care, corticosteroids and worldwide dissemination of standards of care especially in respiratory and cardiac care have changed the natural course of DMD. Careful and timely management of the disease, its complications and psychosocial aspects is mandatory. Such interventions have been shown to improve quality of life and prolong survival, so that most of patients now r... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350479 Thu, 27 Oct 2011 06:28:05 +0100 5350479 http://www.medworm.com/index.php?rid=5350478&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001284%2Fabstract%3Frss%3Dyes Abstract: This review outlines a clinical approach to the evaluation of the floppy infant. Attention is drawn to the varied manner in which the condition can present, and emphasis is placed upon a detailed assessment of characteristic clinical findings. A distinction is drawn between central and peripheral causes for hypotonia. Guidance is given regarding the importance of evaluating the child for signs of weakness, which is an important marker of neuromuscular pathology. Reference is made to situations where peripheral pathology may mimic central disorders. A diagnostic algorithm is outlined for the investigation of neuromuscular disorders, and reference is made to the discrepancy in findings that often exists between electromyography and muscle biopsy findings. Attention is drawn to avai... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350478 Thu, 27 Oct 2011 06:28:05 +0100 5350478 http://www.medworm.com/index.php?rid=5350477&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001521%2Fabstract%3Frss%3Dyes Abstract: Viruses are the most common infectious cause of meningitis and encephalitis. There are a large number of viruses which may cause meningo-encephalitis either through primary infection or through secondary immune-mediated processes. The presentation of both viral meningitis and encephalitis is described along with features which may help identify the aetiology. Viral meningitis is most commonly caused by enteroviruses notably coxsackie viruses and usually follows a self-limiting course with significantly better outcomes than encephalitis. The most common form of viral encephalitis in the developed world is Herpes simplex encephalitis. This carries a poor prognosis particularly if treatment is delayed, with mortality rates of 70% if left untreated. The importance of testing for Herp... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350477 Thu, 27 Oct 2011 06:28:05 +0100 5350477 http://www.medworm.com/index.php?rid=5350476&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001259%2Fabstract%3Frss%3Dyes This article aims to provide a practical guide to the common causes of headache and their assessment in children. Contrary to popular belief, headaches are very common in children. The primary headache disorders, which include migraine and tension-type headache, account for the majority of headaches, while secondary headache, that is those with underlying pathology, are much less common. A thorough history and examination is the key to determining the cause and should be the most important means of reassuring the child and family that there is no serious cause for the headaches. To manage childhood headache you need to be able to distinguish the painful from the harmful, and therefore must recognize the common headache patterns and the signs and symptoms that may indicate serious intracran... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350476 Thu, 27 Oct 2011 06:28:05 +0100 5350476 http://www.medworm.com/index.php?rid=5350475&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211002290%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5350475 Thu, 27 Oct 2011 06:28:05 +0100 5350475 http://www.medworm.com/index.php?rid=5241098&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001442%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241098 Thu, 22 Sep 2011 18:42:34 +0100 5241098 http://www.medworm.com/index.php?rid=5241097&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001491%2Fabstract%3Frss%3Dyes Alfie was born following spontaneous labour at 29 weeks gestation. At a 20-week routine ultrasound scan he was noted to be small. Over the last few weeks there have been concerns about poor fetal growth. His mother was admitted 2 days earlier with pre-labour rupture of the membranes, and received antenatal Betamethasone. His birthweight was 850 g and he has been ventilated from birth. He was commenced on i.v. 10% dextrose, but this was replaced with a parenteral amino acid solution along with intravenous lipid (referred to as “TPN”), at 09.00 h this morning. He has an Umbilical Arterial Catheter (UAC) and a peripheral i.v. cannula. Blood glucose is 11 mmol/litre, sodium is 140 mmol/litre, blood gas is normal, FiO2 is 35% and systolic blood pressure is 45 mmHg. (Source: Paediatrics and ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241097 Thu, 22 Sep 2011 18:42:34 +0100 5241097 http://www.medworm.com/index.php?rid=5241096&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100120X%2Fabstract%3Frss%3Dyes This article is to highlight the reader the current neurosurgical management of the different types of spina bifida. It is to guide the reader so that late presentations can be avoided and early intervention can be offered to protect bladder, bowel and motor function. It will not talk about hydrocephalus. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241096 Thu, 22 Sep 2011 18:42:34 +0100 5241096 http://www.medworm.com/index.php?rid=5241095&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001211%2Fabstract%3Frss%3Dyes This article is not meant to be exhaustive and is meant to guide the reader and not inform about every possible nuance, complication, etc. The reader is encouraged to refer their patients to the teams for evaluation rather than referring them for a specific treatment. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241095 Thu, 22 Sep 2011 18:42:34 +0100 5241095 http://www.medworm.com/index.php?rid=5241094&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000357%2Fabstract%3Frss%3Dyes This article discusses the ways in which paediatricians can work with education services to support children and young people with Special Educational needs. Paediatricians may be involved in directly advising schools, writing formal advice for education departments and joining in relevant planned reviews. Partnership with parents and the involvement of children and young people themselves are vital. Advice should cover all areas of the child's health relevant to the child's success and integration in school and should always be understandable to both the education staff and the family. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241094 Thu, 22 Sep 2011 18:42:34 +0100 5241094 http://www.medworm.com/index.php?rid=5241093&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000345%2Fabstract%3Frss%3Dyes Abstract: The neurofibromatoses consist of at least three autosomal dominantly inherited disorders, neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis. For many years these conditions were inextricably linked as part of generalized neurofibromatosis (von Recklinghausen disease). Since 1987 with the separate localization of NF1 to chromosome 17q and NF2 (bilateral vestibular schwannoma) to 22q it has been possible to formally separate them. More recently the SMARCB1 gene on 22q has been confirmed as causing a subset of schwannomatosis. The last 20 years has seen a considerable improvement in our knowledge of the clinical and molecular features of these conditions. Both NF1 and NF2 provide the clinician with often complex management decisions. Childhood presen... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241093 Thu, 22 Sep 2011 18:42:34 +0100 5241093 http://www.medworm.com/index.php?rid=5241092&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000333%2Fabstract%3Frss%3Dyes Abstract: Management of the bladder and bowels in children and young people with physical disability has advanced significantly over recent years. Its importance goes beyond achieving full continence, although that has huge importance to the individuals and families concerned. Management of the bladder now strives to achieve a functional and safe urinary tract. This will protect the kidneys from urinary tract infection and avoid the devastating long term problems of renal failure. The investigation of children known to have neurological disability starts early. Regular review of bladder function is important. Medical management is regularly enhanced by active surgical management. The use of bladder augmentation and Mitrofanoff procedures can significantly improve symptoms and the quality o... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241092 Thu, 22 Sep 2011 18:42:34 +0100 5241092 http://www.medworm.com/index.php?rid=5241091&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000898%2Fabstract%3Frss%3Dyes Abstract: Reflective learning from vignettes of case histories of real children and families served by a Child Development Team (CDT) are used to explore the different roles and responsibilities of the paediatrician in relation to other members of the wider team. Very little qualitative research informs how teams should skill-mix and work efficiently to provide the complex, needs-led care that these children and their families require. Multi-disciplinary, inter-disciplinary and trans-disciplinary teams are discussed as differing models for aspects of CDT work. For teams to function effectively they need the following: shared goals, knowledge of their client base and population needs, up to date awareness of the evidence base underpinning their work and translated into practice, credible le... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241091 Thu, 22 Sep 2011 18:42:34 +0100 5241091 http://www.medworm.com/index.php?rid=5241090&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000412%2Fabstract%3Frss%3Dyes Abstract: Pre-school children presenting to developmental paediatric services because of concerns that they are not peer-equivalent is a well recognised clinical scenario, and yet the approach to investigation varies widely. Evaluation depends on thorough history taking, careful clinical examination and astute observation of social and play skills. An investigative pathway needs to be evidence-based but also pragmatic; tailored to the child whilst acknowledging the benefit of validated screening tests. Although the overall positive yield is small, it must not be forgotten that negative test results also have value. Both clinician and parents will be reassured by the exclusion of genetic, metabolic and structural aetiologies in their search for answers. It is increasingly acknowledged that ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241090 Thu, 22 Sep 2011 18:42:34 +0100 5241090 http://www.medworm.com/index.php?rid=5241089&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100206X%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5241089 Thu, 22 Sep 2011 18:42:34 +0100 5241089 http://www.medworm.com/index.php?rid=5149231&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001934%2Fabstract%3Frss%3Dyes The authors of the above article wish to draw readers’ attention to an error in the answer to Question 2 on page 239. The correct labelling for the correct answers should be C, D and E and should read: (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149231 Wed, 24 Aug 2011 20:58:27 +0100 5149231 http://www.medworm.com/index.php?rid=5149230&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001429%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149230 Wed, 24 Aug 2011 20:58:27 +0100 5149230 http://www.medworm.com/index.php?rid=5149229&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001181%2Fabstract%3Frss%3Dyes The incidence of Type 1 diabetes in children and young people is increasing with a prediction that prevalent cases in those aged less than 15 years will rise by 70%. With this increase, in the absence of an immediate “cure”, ways of helping children cope with the demands of diabetes and improving outcomes become essential. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149229 Wed, 24 Aug 2011 20:58:27 +0100 5149229 http://www.medworm.com/index.php?rid=5149228&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001247%2Fabstract%3Frss%3Dyes Abstract: The understanding of how mutations of the cystic fibrosis gene results in recurrent infection and the development of bronchiectasis is now well established. This review examines aspects of lung pathophysiology specifically, abnormal mucociliary clearance, inflammation and infection which are the basis of the daily symptoms encountered by people with cystic fibrosis. Other components of the lung epithelium and their potential contribution to cystic fibrosis disease are discussed. Therapeutic interventions which aim to target abnormal mucociliary clearance are summarized. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149228 Wed, 24 Aug 2011 20:58:27 +0100 5149228 http://www.medworm.com/index.php?rid=5149227&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000928%2Fabstract%3Frss%3Dyes Abstract: Although now rare in industrialized countries, severe acute malnutrition is unfortunately still common throughout the developing world and is a key contributor to both global childhood morbidity and mortality. This review describes the epidemiology of malnutrition and the presentation and pathophysiology of the severe syndromic forms – marasmus and kwashiorkor. The gold standards for diagnosis and management are detailed and the challenges of implementation in the basic healthcare systems of the developing world are discussed. As the leading cause of ill health in the world today, more effective treatment and prevention of malnutrition must be a priority for the global healthcare community. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149227 Wed, 24 Aug 2011 20:58:27 +0100 5149227 http://www.medworm.com/index.php?rid=5149226&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000953%2Fabstract%3Frss%3Dyes Abstract: Short bowel syndrome (SBS) is a common cause of intestinal failure in children. Children with SBS need careful fluid management in the initial post-operative period. Children with SBS may need parenteral nutrition (PN) in the short term until enteral feeding can be established and advanced. Medical and dietetic manipulation of feeds is necessary to advance enteral feeds and wean PN. In majority of the cases, PN can be weaned off completely and children can be established on long-term enteral feeding via nasogastric tube or gastrostomy. If enteral feeding cannot be advanced, referral for non-transplant surgery or if life-threatening complications develop, intestinal transplantation may be necessary. The survival of children with SBS has dramatically improved due to the medical and... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149226 Wed, 24 Aug 2011 20:58:26 +0100 5149226 http://www.medworm.com/index.php?rid=5149225&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100117X%2Fabstract%3Frss%3Dyes Abstract: Eczema is a chronic inflammatory dermatosis that affects 20% of the population in industrialized nations, and usually manifests in early childhood. The precise aetiology and pathogenesis of eczema are not yet fully understood, but a complex interaction between genetic and environmental factors has been implicated in the predisposition and development of the disease. Food allergy plays a pathogenic role in a subset of patients with eczema, primarily infants and children with severe eczema. Identifying this subset of patients and isolating the relevant food allergens requires a high index of suspicion based on a good clinical history, the use of appropriate laboratory tests, and in some cases, oral food challenges. Maternal dietary restrictions during pregnancy or lactation do not ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149225 Wed, 24 Aug 2011 20:58:26 +0100 5149225 http://www.medworm.com/index.php?rid=5149224&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000965%2Fabstract%3Frss%3Dyes Abstract: Many inborn errors of metabolism are treated by dietary modification. There are three main strategies. 1. Some disorders lead to deficiency of a crucial product, which can be supplied by a special diet. This is illustrated by the need for a continuous enteral supply of glucose in hepatic glycogen storage diseases. 2. In other disorders, dietary restriction can prevent the accumulation of a substrate to toxic levels. Examples include the use of a low-phenylalanine diet in phenylketonuria and a minimal-galactose diet in galactosaemia. 3. In many disorders, catabolism during minor illnesses can lead to acute problems. These can usually be prevented by maintaining a high intake of glucose, either orally or intravenously. For inborn errors without specific dietary treatment, nutrition... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149224 Wed, 24 Aug 2011 20:58:26 +0100 5149224 http://www.medworm.com/index.php?rid=5149223&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000916%2Fabstract%3Frss%3Dyes Abstract: Gastro-oesophageal reflux is very common in infancy. In most cases it is benign. It is important to differentiate physiological reflux from gastro-oesophageal reflux disease, which is gastro-oesophageal reflux with significant morbidity. This review summarizes the approach to infants with symptoms and signs of reflux, differential diagnosis, investigations with their limitations and non-pharmacological, pharmacological and surgical treatment. Most infants with gastro-oesophageal reflux do not need further investigation or medical management providing the infant is thriving. Severe cases require a careful diagnostic work up and consideration of the differential diagnoses, treatment of associated conditions and aggressive medical management of the reflux. Involvement of the multidi... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149223 Wed, 24 Aug 2011 20:58:26 +0100 5149223 http://www.medworm.com/index.php?rid=5149222&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001168%2Fabstract%3Frss%3Dyes Abstract: Nutrition and health are so interrelated that each has a bearing on the other. Malnutrition and undernutrition make children more vulnerable to infections and chronic illness. Similarly chronic illness can affect nutritional wellbeing adversely. The prevalence of malnutrition amongst children in hospital in the developed world is between 15 and 30%. Early Nutrition Support Team involvement and intervention can prevent and/or treat malnutrition by choosing appropriate nutritional interventions and help in early identification and prevention of central line infections. In addition they facilitate the appropriate initiation of parenteral nutrition and avoid unnecessary episodes of parenteral nutrition. Staff education is also a key role. This review explores malnutrition, the role o... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149222 Wed, 24 Aug 2011 20:58:26 +0100 5149222 http://www.medworm.com/index.php?rid=5149221&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001843%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5149221 Wed, 24 Aug 2011 20:58:26 +0100 5149221 http://www.medworm.com/index.php?rid=5134321&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001028%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134321 Sun, 31 Jul 2011 23:00:00 +0100 5134321 http://www.medworm.com/index.php?rid=5134320&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000977%2Fabstract%3Frss%3Dyes Community paediatricians and community nurses are caring for increasing numbers of children with life-limiting or life-threatening conditions. When these children deteriorate they may be admitted to hospital and cared for by an acute medical team who do not know them or the family, and decisions about life and death may need to be made rapidly with strangers. Occasionally these children may die suddenly at home possibly resulting in the place of death become a crime scene. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134320 Sun, 31 Jul 2011 23:00:00 +0100 5134320 http://www.medworm.com/index.php?rid=5134319&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000989%2Fabstract%3Frss%3Dyes Abstract: This review focuses on arrhythmias in children and youth occurring in the community. Case examples with illustrative ECGs are presented, differentiation of cardiac from non-cardiac syncope is discussed, and examples of significant misdiagnosis and mismanagement are given. Aside from detection, there is also a focus on prevention, particularly through the recognition of inherited arrhythmic syndromes and through family screening.Key educational messages regarding syncope are the importance of detailed clinical history and of eliciting family history of sudden death, and the potential to misdiagnose arrhythmic syncope as epilepsy, particular when it occurs at night. Note is made that most community sudden death in children occurs at night or rest. In investigating dilated cardiomyo... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134319 Sun, 31 Jul 2011 23:00:00 +0100 5134319 http://www.medworm.com/index.php?rid=5134318&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001922%2Fabstract%3Frss%3Dyes Abstract: This review discusses the presentation and management of acute sickle crises, highlighting which aspects of diagnosis and management can be undertaken in the community and which require urgent referral to hospital. GP’s, community nurse specialists, and community paediatricians should be aware of the different acute presentations in order to provide effective and safe care, and understand warning symptoms and signs which obligate assessment in hospital. It is also important that the parents have a good awareness of the symptoms and when and how to seek help. The common complications which may be encountered in an acute hospital setting are described together with recommendations for their management based on published evidence and the author’s experience. (Source: Paediatrics... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134318 Sun, 31 Jul 2011 23:00:00 +0100 5134318 http://www.medworm.com/index.php?rid=5134317&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000667%2Fabstract%3Frss%3Dyes Abstract: Sickle Cell Disease (SCD) is the commonest inherited disorder in England, affecting 1 in 2000 births, the majority born in London and of Black African family origins. Newborn bloodspot screening for SCD has now been implemented across the whole of England and this review considers the neonatal screening pathway and aspects of out-patient and community care which should be delivered within the comprehensive care networks. Morbidity and mortality during childhood has declined due to implementation of effective care programmes which include infection and stroke prophylaxis. Children still suffer from complications of SCD affecting long-term health, quality of life, self esteem, school performance, and attainment. Treatment options for long-term control of the disease include hydroxy... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134317 Sun, 31 Jul 2011 23:00:00 +0100 5134317 http://www.medworm.com/index.php?rid=5134316&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000473%2Fabstract%3Frss%3Dyes Abstract: Thalassaemias are the commonest single gene disorders in the world. They result from reduced synthesis of α or β-globin genes and can result in an asymptomatic carrier status, mild anaemia or severe anaemia which may result in intrauterine death or necessitate lifelong transfusion to sustain life. β-thalassaemia major is the most common of the most severe phenotypes. There has been significant improvement in clinical care particularly relating to transfusion safety and management of iron overload. Challenges remain to further improve care, quality of life and dealing with a globally rising incidence and prevalence of thalassaemias. This review gives an overview of the treatment of β-thalassaemia major and the management of its complications. (Source: Paediatrics and Child Hea... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134316 Sun, 31 Jul 2011 23:00:00 +0100 5134316 http://www.medworm.com/index.php?rid=5134315&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000485%2Fabstract%3Frss%3Dyes Abstract: von Willebrand factor has important functions in haemostasis linking platelets to the vessel wall and protecting FVIIIC. Reductions in quantity or functional activity can predispose to bleeding. Moderate and severe reductions in von Willebrand factor are generally caused by von Willebrand factor gene mutations (autosomal inheritance), but borderline values may be related to other factors such as blood group (perhaps ‘disorder’ rather than ‘disease’). The overall haemostatic balance of an individual determines bleeding risk which should be assessed by a thorough bleeding history including a scoring system. Appropriate testing should be performed in a haemophilia centre and routine screening tests are often normal. Family history may be helpful in children who have never ha... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134315 Sun, 31 Jul 2011 23:00:00 +0100 5134315 http://www.medworm.com/index.php?rid=5134314&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000655%2Fabstract%3Frss%3Dyes Abstract: Haemophilia is an inherited bleeding disorder associated with a deficiency of coagulation factors VIII or IX. The bleeding tendency is proportional to the degree of deficiency. The hallmark of the severe phenotype is recurrent and spontaneous bleeding into joints which can lead to crippling joint deformity and arthritis at an early age in the absence of effective treatment. The condition is inherited as an X-linked disorder although there is no family history in approximately one-third of cases and this represents a new mutation. In the absence of effective treatment, the prognosis is poor but the development of coagulation factor concentrates in the last few decades has transformed the outlook. Recombinant products are now increasingly regarded as the treatment of choice because... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134314 Sun, 31 Jul 2011 23:00:00 +0100 5134314 http://www.medworm.com/index.php?rid=5134313&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000679%2Fabstract%3Frss%3Dyes Abstract: Iron deficiency remains one of the world’s greatest public health problems. Globally it is the greatest contributor to anaemia, affecting 47% of pre-school age children and 25% of school age children worldwide, and is a major contributor to both physical and neuro-developmental morbidity.Iron deficiency results from inadequate intake, excess turnover or excessive loss. Whilst inadequate intake is the commonest cause of deficiency in children in the industrialized world, impaired absorption through malabsorption syndromes like inflammatory bowel disease and coeliac disease should also be considered. Blood loss additionally causes iron deficiency, the three most common causes of which are cows’ milk enteropathy, menstruation and hook worm infection.Prevention of iron deficiency... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134313 Sun, 31 Jul 2011 23:00:00 +0100 5134313 http://www.medworm.com/index.php?rid=5134312&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001624%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5134312 Sun, 31 Jul 2011 23:00:00 +0100 5134312 http://www.medworm.com/index.php?rid=5001964&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100076X%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001964 Thu, 30 Jun 2011 23:00:00 +0100 5001964 http://www.medworm.com/index.php?rid=5001963&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000734%2Fabstract%3Frss%3Dyes Subcutaneously injected allergen immunotherapy was first developed at St Mary’s hospital in London in 1911 with the mistaken belief that pollen produced toxin which induced hay fever (seasonal allergic rhino-conjunctivitis). It clearly had beneficial effects at a time when there was no other effective therapy. During the first half of the 20th century it was widely employed for many different allergic conditions including asthma but only in the 1950s did placebo-controlled clinical trials confirm efficacy for allergic rhinitis and asthma associated with grass pollen, tree pollen, house mite and subsequently cat and dog allergy. However, the indiscriminate use even in primary care resulted in a number of fatalities due to anaphylaxis. This led to the (then) Committee of Safety for Medicin... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001963 Thu, 30 Jun 2011 23:00:00 +0100 5001963 http://www.medworm.com/index.php?rid=5001962&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000722%2Fabstract%3Frss%3Dyes Abstract: The outcome of cardiac arrest in hospitalized infants and children is poor. However, cardiac arrest is often predictable based on many hours of hypoxaemia, hypotension and associated symptoms and signs (heart rate, respiratory rate, respiratory effort, neurological change) and staff concern. If intensive expert medical and nursing interventions are provided quickly before cardiac arrest, some deaths on wards outside the intensive care environment are preventable. Over the past decade, the introduction of rapid response and early warning systems in some large paediatric hospitals has reduced the incidence of unexpected cardiac arrest by some 40% and death by 20%. These systems enable any staff member (or parent) to summon urgent expert assistance to the patient’s bedside without... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001962 Thu, 30 Jun 2011 23:00:00 +0100 5001962 http://www.medworm.com/index.php?rid=5001961&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000187%2Fabstract%3Frss%3Dyes This article reviews the current knowledge about the different causes of rickets and provides guidelines on diagnosis and management. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001961 Thu, 30 Jun 2011 23:00:00 +0100 5001961 http://www.medworm.com/index.php?rid=5001960&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000175%2Fabstract%3Frss%3Dyes Abstract: Polycystic ovary syndrome is a spectrum of disorders consisting of chronic oligo-anovulation, androgen excess, obesity, insulin resistance and polycystic ovaries. The diagnosis carries life-long implications with increased risk for infertility, endometrial hyperplasia/carcinoma, metabolic syndrome, type 2 diabetes and cardiovascular disease. Lack of well-defined diagnostic criteria makes identification of this common condition challenging. Because of the varying clinical presentation and manifestation of PCOS, adolescent and young adult woman can present to a variety of healthcare professionals including general practitioners, general paediatricians, adult physicians, gynaecologists, dermatologists or endocrinologists (paediatric and adult). Treatment of adolescent girls with PCO... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001960 Thu, 30 Jun 2011 23:00:00 +0100 5001960 http://www.medworm.com/index.php?rid=5001959&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000746%2Fabstract%3Frss%3Dyes Abstract: The onset of puberty may be late – in the latter part of the predicted normal range or truly delayed – beyond this range. This is usually regarded as 13 years in girls and 14 years in boys. A height plot beyond the prepuberty phase limit on the UK-WHO 0–18 year charts also defines delayed puberty. The initial approach requires a detailed history and clinical examination to exclude other medical or psychological problems. The presence or absence or pubertal signs should be documented. Investigations should be targeted at ruling out any medical causes and determining whether the delay is due to central gonadotrophin deficiency or a gonadal disorder. Physiological or constitutional delay is more common in boys but is a diagnosis of exclusion. Treatment may be given using low d... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001959 Thu, 30 Jun 2011 23:00:00 +0100 5001959 http://www.medworm.com/index.php?rid=5001958&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000758%2Fabstract%3Frss%3Dyes Abstract: Metabolic syndrome (MetS) in adults is a well-established constellation of cardiometabolic risk factors related to obesity, and is associated with an increased risk of development of type 2 diabetes and cardiovascular disease. However, paucity of evidence for a unifying pathophysiologic mechanism and lack of a consensus definition until recently have resulted in controversies as to the relevance of the concept in clinical practice. Clustering of the risk factors is increasingly being recognized in children and adolescents with the rising prevalence of childhood obesity. Recent efforts at obtaining normative data of children for the components of MetS and a consensus definition for the use in childhood have enabled easier implementation of the concept in paediatrics. Emerging data... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001958 Thu, 30 Jun 2011 23:00:00 +0100 5001958 http://www.medworm.com/index.php?rid=5001957&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000138%2Fabstract%3Frss%3Dyes Abstract: Screening for congenital hypothyroidism has been available for more than 30 years. Recent developments have included improvements in lab TSH screening with lower cut-off points usually at 6 mU/litre, earlier commencement of levothyroxine therapy and high dose treatment regimens. Normalization of TSH levels during the first 2 years with frequent thyroid function testing is likely to be beneficial to outcome. Children with agenesis of the thyroid gland or low free T4 at diagnosis still show significantly reduced IQ results at assessment years later. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001957 Thu, 30 Jun 2011 23:00:00 +0100 5001957 http://www.medworm.com/index.php?rid=5001956&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000151%2Fabstract%3Frss%3Dyes Abstract: The pituitary gland releases hormones, which regulate growth, metabolism, reproduction and homeostasis. Hypopituitarism is diagnosed when there is impaired secretion of one or more of these hormones.Depending on the severity and number of hormone deficiencies present, the clinical features of hypopituitarism can vary considerably. Infants with multiple pituitary hormone abnormalities are frequently unwell in the neonatal period whereas children with isolated growth hormone deficiency tend to present later in childhood with growth failure.Children with clinical features suggestive of a diagnosis of hypopituitarism should undergo further investigations. The diagnosis is based on a combination of the following; clinical history and examination, baseline biochemical investigations, p... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001956 Thu, 30 Jun 2011 23:00:00 +0100 5001956 http://www.medworm.com/index.php?rid=5001955&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001338%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=5001955 Thu, 30 Jun 2011 23:00:00 +0100 5001955 http://www.medworm.com/index.php?rid=4940599&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000527%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940599 Tue, 31 May 2011 23:00:00 +0100 4940599 http://www.medworm.com/index.php?rid=4940598&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000424%2Fabstract%3Frss%3Dyes The Paediatric autopsy has been performed less frequently in recent years. Is this because the general public mistrusts the procedure in the light of the outcomes of the Redfern Report? Perhaps it is because clinicians and parents believe that non-invasive technologies can provide all necessary answers. In the past, well-meaning professionals have sheltered parents from the full implications of the procedure, and there is now an understandable suspicion of such secrecy. This review laments the decline of Paediatric autopsies, and provides a perspective for clinicians whose responsibility it is to ask parents for consent at the time of their loss. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940598 Tue, 31 May 2011 23:00:00 +0100 4940598 http://www.medworm.com/index.php?rid=4940597&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000436%2Fabstract%3Frss%3Dyes Abstract: Premature sexual maturation is a general term encompassing precocious puberty as well as several normal variants in both boys and girls. It is important to be able to determine the specific cause in order to formulate an appropriate plan of management.This review aims to describe the signs and symptoms of each variant, decide on the investigations needed to diagnose specific conditions and their cause, as the type of treatment has to be tailored to each individual condition. The primary goal of this article is to make the reader familiar with the concept of sexual precocity as well as the commonly encountered variants to enable him to differentiate between them and instigate appropriate management.Early sexual maturation causes a lot of anxiety to both parents and children and ma... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940597 Tue, 31 May 2011 23:00:00 +0100 4940597 http://www.medworm.com/index.php?rid=4940596&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000461%2Fabstract%3Frss%3Dyes Abstract: Jaundice is the most common clinical sign in neonatal medicine, but only rarely is it associated with bilirubin neurotoxicity or the harbinger of significant underlying disease. A resurgence of kernicterus and not infrequent delays in the diagnosis of hepatic, metabolic, endocrine, and genetic causes serve as reminders that current management of neonatal jaundice needs refinement. Phototherapy remains the mainstay of treatment of significant unconjugated hyperbilirubinaemia, and its optimal use should keep the level of jaundice below the threshold for exchange blood transfusion. In cases of isoimmune haemolysis high-dose immunoglobulin is indicated if the serum bilirubin is continuing to rise despite multiple phototherapy. For babies with prolonged jaundice investigation should b... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940596 Tue, 31 May 2011 23:00:00 +0100 4940596 http://www.medworm.com/index.php?rid=4940595&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221000257X%2Fabstract%3Frss%3Dyes Abstract: Infection is a leading cause of mortality and morbidity in the newborn. The smaller and more preterm the baby, the higher the risk of infection and its consequences. Early detection and prompt management are vital in the prevention of adverse consequences. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940595 Tue, 31 May 2011 23:00:00 +0100 4940595 http://www.medworm.com/index.php?rid=4940594&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002593%2Fabstract%3Frss%3Dyes Abstract: Necrotizing enterocolitis (NEC) is the most common serious gastrointestinal disorder affecting very preterm or very low birth weight infants. The risk is inversely proportional to gestational age and weight at birth. Fetal growth restriction and compromise may be additional specific risk factors. Postnatally, a variety of practices have been implicated in the pathogenesis of NEC including formula milk feeding, early and rapid advancement of enteral feed volumes, and exposure to H2-receptor antagonists. NEC, particularly severe NEC requiring surgical intervention, is associated with acute morbidity and mortality, prolonged hospital stay, and adverse long-term neuro-developmental outcomes. With the exception of feeding with human milk, only limited evidence is currently available t... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940594 Tue, 31 May 2011 23:00:00 +0100 4940594 http://www.medworm.com/index.php?rid=4940593&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002581%2Fabstract%3Frss%3Dyes Abstract: Echocardiographic assessment can be broadly divided into functional and structural assessment. Functional echocardiography in the hands of an appropriately trained neonatologist is an accessible and useful modality in the neonatal intensive care unit. This tool allows the neonatologist to assess various parameters, e.g. ventricular outputs and SVC flow, ventricular function, pulmonary pressures and ductus arteriosus and implement immediate management as result. It is essential that there is support from the paediatric cardiologist to prevent misdiagnosis of congenital heart disease and implement further management. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940593 Tue, 31 May 2011 23:00:00 +0100 4940593 http://www.medworm.com/index.php?rid=4940592&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221000260X%2Fabstract%3Frss%3Dyes Abstract: Debate about the importance of the pre-term patent ductus arteriosus (PDA) continues to rage. While consistently associated with a range of adverse outcomes, clinical trials of PDA treatment have failed to show an effect on those outcomes leading some to hypothesize that the PDA is an innocent physiological bystander. Ultrasound studies of PDA have suggested that the early post-natal haemodynamic impact in some babies may be much greater than previously thought but we still don’t know when to treat a PDA. Studies that have tested symptomatic or pre-symptomatic treatment are mainly quite dated and have not tested the effect of no treatment. Prophylactic treatment is the best-studied regimen but improvements in some short-term outcomes do not translate to any difference in longer... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940592 Tue, 31 May 2011 23:00:00 +0100 4940592 http://www.medworm.com/index.php?rid=4940591&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000369%2Fabstract%3Frss%3Dyes Abstract: Effective cardiovascular support for neonates requires an understanding of cardiovascular physiology that takes account of the developmental stages and knowledge of the available treatments. This review aims to provide physiologically-based recommendations for treatment, referring only to aspects of physiology that can be generally measured in neonates on neonatal units. This review is intended to give clinical staff who are new to neonatal intensive care an insight into how physiology and pharmacology can be balanced when tailoring care to individual babies. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940591 Tue, 31 May 2011 23:00:00 +0100 4940591 http://www.medworm.com/index.php?rid=4940590&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211001065%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4940590 Tue, 31 May 2011 23:00:00 +0100 4940590 http://www.medworm.com/index.php?rid=4765131&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000497%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765131 Sat, 30 Apr 2011 02:41:37 +0100 4765131 http://www.medworm.com/index.php?rid=4765130&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000321%2Fabstract%3Frss%3Dyes James, a 13-year-old boy is a tertiary referral for management of long-standing morbid obesity. He has participated in previous attempts at weight loss instigated by the local hospital dietetic department and also attended a 12-week course in the community offering psychological, activity and diet based intervention. Although he briefly slowed his rate of weight gain with the 12-week intervention he has since continued to gain weight inexorably. His current height is 168 cm, weight is 178 kg and he has a body mass index of 63 (Class 3 obesity). (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765130 Sat, 30 Apr 2011 02:41:37 +0100 4765130 http://www.medworm.com/index.php?rid=4765129&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000382%2Fabstract%3Frss%3Dyes This article examines the evidence base behind them and reinforces the call for a nationally coordinated setup programme. We make the distinction between scores as trigger events for rapid review from a high dependency or critical care outreach team and the multilayered approach to risk reduction which we envisage by which an effective, audited and quality assured early warning system might be established. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765129 Sat, 30 Apr 2011 02:41:37 +0100 4765129 http://www.medworm.com/index.php?rid=4765128&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002362%2Fabstract%3Frss%3Dyes Abstract: The number of children and young people receiving long term ventilation continues to rise, with increasing survival from intensive care, improvements in equipment and changing attitudes towards providing respiratory support. These children are also now largely at home rather than in hospital. However for those who have complex problems and are most dependent on ventilation, discharge can be a slow, difficult and costly process. There are a number of barriers to discharge for this group of children, including professional attitudes, problems with commissioning and funding, and establishment of care packages, in addition to complex social issues and difficulties with housing. Good discharge planning starts at the outset of establishing a child on long term ventilation, and aims to ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765128 Sat, 30 Apr 2011 02:41:36 +0100 4765128 http://www.medworm.com/index.php?rid=4765127&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002301%2Fabstract%3Frss%3Dyes Abstract: Flexible bronchoscopy is an integral part of tertiary paediatric respiratory practice. It has a mainly diagnostic role, from direct observation (anatomy and structure, airway contents, dynamics), and sampling (lavage, biopsy and brushings). There are also some therapeutic roles, mainly re-inflation of an atelectatic segment or lobe. Clinical situations that may require referral for consideration of a bronchoscopy include chronic or recurrent stridor, severe wheeze, chronic cough, recurrent pneumonia, and pneumonia that fails to resolve. Additionally, bronchoscopy is often required in children with chronic suppurative lung disease, patients ventilated in a paediatric or cardiac intensive care unit, and children who have undergone transplantation. Finally its use in research is inc... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765127 Sat, 30 Apr 2011 02:41:36 +0100 4765127 http://www.medworm.com/index.php?rid=4765126&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002404%2Fabstract%3Frss%3Dyes Abstract: The lungs are particularly vulnerable to infection; respiratory infections are common presenting features of primary immune deficiency (PID). Warning signs include recurrent, severe or invasive infections and poor weight gain. Understanding immune defects helps target investigations and management. Particular patterns of infection point to particular PIDs. Congenital antibody deficiencies are most common and feature recurrent pneumonia and bronchiectasis. Fungal pneumonia is seen in chronic granulomatous disease, lung abscesses are seen in Hyper IgE syndrome, and interstitial pneumonia in SCID and Hyper IgM syndrome. Lymphocyte subset analysis and specific antibody responses to vaccinations are useful investigations in addition to immunological measurements. Early diagnosis and r... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765126 Sat, 30 Apr 2011 02:41:36 +0100 4765126 http://www.medworm.com/index.php?rid=4765125&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002416%2Fabstract%3Frss%3Dyes Pneumonia is estimated to be the leading cause of mortality in children under five worldwide. Death is rare in developed countries but it remains a major cause of hospital admissions and of both acute and chronic morbidities. Understanding current management and recognition of complications is important to all paediatricians. The causative organism varies with age and differentiating between viral, bacterial and other causes can be challenging. Supportive care and antibiotic treatment are the mainstays of modern management. The evidence base to support treatment policy is remarkably weak.The incidence of both uncomplicated and complicated pneumonia is increasing, particularly that of empyema and necrotic lung disease. The management of complications has changed over recent years and remain... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765125 Sat, 30 Apr 2011 02:41:35 +0100 4765125 http://www.medworm.com/index.php?rid=4765124&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002337%2Fabstract%3Frss%3Dyes Abstract: Cystic fibrosis is a multi-system genetic disorder causing thick secretions, lung infection and pancreatic insufficiency. Optimizing respiratory health in children with cystic fibrosis depends upon meticulous attention to maintaining general health, in addition to preserving lung health. Maximizing nutrition and growth are essential as these are independent predictors of lung function and survival. Neonatal screening has enabled an earlier, more proactive approach to optimizing health. However the primary predictor of deterioration is the acquisition of the opportunistic bacterium Pseudomonas aeruginosa. Eradication of chronic infection with this organism is impossible, leading to lung destruction and shortened life expectancy for individuals with CF. The optimal strategies for m... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765124 Sat, 30 Apr 2011 02:41:35 +0100 4765124 http://www.medworm.com/index.php?rid=4765123&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000801%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4765123 Sat, 30 Apr 2011 02:41:35 +0100 4765123 http://www.medworm.com/index.php?rid=4660583&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000370%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660583 Thu, 31 Mar 2011 23:00:00 +0100 4660583 http://www.medworm.com/index.php?rid=4660582&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221100014X%2Fabstract%3Frss%3Dyes Nancy, aged 11 months, was referred to a paediatrician by her general practitioner. He has seen Nancy twice during the week with a fever and non-specific rash thought to be viral in origin. Nancy has now had a fever for 6 days and is irritable. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660582 Thu, 31 Mar 2011 23:00:00 +0100 4660582 http://www.medworm.com/index.php?rid=4660581&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001903%2Fabstract%3Frss%3Dyes This article summarises these conditions. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660581 Thu, 31 Mar 2011 23:00:00 +0100 4660581 http://www.medworm.com/index.php?rid=4660580&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001897%2Fabstract%3Frss%3Dyes Abstract: There is a critical shortage of organs for transplantation. Aggressive management of the potential organ donor in intensive care units will increase the availability of these organs. The physiological changes following brain death impose major problems for the intensivist. The cardiovascular instability that ensues has to be managed judiciously to ensure donor organs are in optimal condition for transplantation. The management includes optimizing fluid status and the use of inotropes using invasive monitoring. Arrhythmias should be prevented and electrolytes status should be carefully monitored. In the immediate period after brain death endocrinopathy may follow and hormonal replacement may be necessary. With growing needs for organs non-heart-beating patients are now considered ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660580 Thu, 31 Mar 2011 23:00:00 +0100 4660580 http://www.medworm.com/index.php?rid=4660579&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002283%2Fabstract%3Frss%3Dyes Abstract: Effective analgesia and sedation in the Paediatric Intensive Care Unit (PICU) encompasses the provision of physical comfort and caring for the psychological well-being of critically ill children. In the UK the most commonly used sedative and analgesic agents for critically ill children are midazolam and morphine; consensus clinical practice guidelines for the provision of sedation and analgesia in critically ill children were published in 2006 by the UK Paediatric Intensive Care Society.It is important to treat pain, and in addition to the obvious immediate effects of untreated pain there is increasing evidence that pain experienced early in life may result in long-term changes in neurosensory function. There are however emerging concerns that sedative and analgesic agents may th... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660579 Thu, 31 Mar 2011 23:00:00 +0100 4660579 http://www.medworm.com/index.php?rid=4660578&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001939%2Fabstract%3Frss%3Dyes Abstract: Extracorporeal membrane oxygenation is used for unresponsive cardiorespiratory failure in neonates, children and adults. There is good evidence of its efficacy in neonates and adults and as such it is reasonable that children are referred for ECMO when faced with severe cardiorespiratory failure.Whilst the average length of stay for survivors on ECMO is about one week patients who are in single organ failure i.e. respiratory failure have been looked after for many weeks on ECMO with successful outcomes. Patient selection is crucial to the success of any ECMO programme and the underlying functionality of the patient as well as the potential reversibility of the disease are good selection criteria for putting patients on ECMO.Overall ECMO results are very encouraging across the age... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660578 Thu, 31 Mar 2011 23:00:00 +0100 4660578 http://www.medworm.com/index.php?rid=4660577&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001915%2Fabstract%3Frss%3Dyes This article will review available devices to improve oxygenation and ventilation, their advantages and disadvantages, and help to guide physicians in the management of children with respiratory failure. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660577 Thu, 31 Mar 2011 23:00:00 +0100 4660577 http://www.medworm.com/index.php?rid=4660576&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002556%2Fabstract%3Frss%3Dyes Abstract: More than 25% of children survive to hospital discharge after in-hospital cardiac arrests, and 5–10% survive after out-of-hospital cardiac arrests. Cardio-pulmonary resuscitation differs in children from adults.Following the Airway, Breathing, Circulation format, this article reviews the physiology of paediatric cardio-pulmonary resuscitation. It addresses the appropriate interventions during cardio-pulmonary resuscitation, mechanisms of action of the drugs that are commonly used in advanced life support, and special resuscitation circumstances: premature and newly born infants, traumatic cardiac arrest, ECMO (Extracorporeal Membrane Oxygenation) CPR.New exciting discoveries in resuscitation science postulate that the key factor in improving outcomes of paediatric cardiac arres... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660576 Thu, 31 Mar 2011 23:00:00 +0100 4660576 http://www.medworm.com/index.php?rid=4660575&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001885%2Fabstract%3Frss%3Dyes This article summarizes clinical features, presentation, pathophysiology and diagnostic tests; and focuses in detail on the course and management of the disease. As meningococcal infection has two main manifestations: septicaemia with associated shock; and meningitis, this article mainly addresses management of meningococcal septicaemia and meningitis. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660575 Thu, 31 Mar 2011 23:00:00 +0100 4660575 http://www.medworm.com/index.php?rid=4660574&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000564%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4660574 Thu, 31 Mar 2011 23:00:00 +0100 4660574 http://www.medworm.com/index.php?rid=4585272&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002611%2Fabstract%3Frss%3Dyes The publisher regrets that in the above published paper the following corrections are necessary: : caption should read ‘Figure 1 Ileo-ceacal Crohn’s disease presenting as PR Bleeding’. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585272 Tue, 01 Mar 2011 00:00:00 +0100 4585272 http://www.medworm.com/index.php?rid=4585271&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002775%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585271 Tue, 01 Mar 2011 00:00:00 +0100 4585271 http://www.medworm.com/index.php?rid=4585270&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001940%2Fabstract%3Frss%3Dyes Charlotte is a 13-year-old female from London, who was diagnosed with Crohn's disease at the age of 8 years. She was initially treated with sulphasalazine (5 ASA derivative) and disease flares responded well to brief courses of oral corticosteroid therapy, the last 3 months ago. A trial of azathioprine (purine antimetabolite) was ceased 6 months ago due to side effects. At her latest gastroenterology review she had relapsing fistulising peri-anal disease and a plan was made to commence her on Infliximab (TNF-alpha blocker) therapy in 6 weeks time. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585270 Tue, 01 Mar 2011 00:00:00 +0100 4585270 http://www.medworm.com/index.php?rid=4585269&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001964%2Fabstract%3Frss%3Dyes This article reviews some of the most important childhood conditions where such signs should prompt further investigation. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585269 Tue, 01 Mar 2011 00:00:00 +0100 4585269 http://www.medworm.com/index.php?rid=4585268&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002568%2Fabstract%3Frss%3Dyes Abstract: There are many paediatric infections and infestations of the skin. There are clearly many more skin infections that can occur worldwide and as populations become more mobile can be acquired elsewhere and present in the UK. The following paper examines the common problems encountered in UK practice. Common bacterial problems such as cellulitis, impetigo and erysipelas; viral infections such as molluscum contagiosum, herpes simplex, viral warts, human herpes-6 infection; fungal infections such as tinea corporis and pityriasis versicolor and finally parasitic infections such as scabies and pediculosis are discussed from a pragmatic view point. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585268 Tue, 01 Mar 2011 00:00:00 +0100 4585268 http://www.medworm.com/index.php?rid=4585267&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001988%2Fabstract%3Frss%3Dyes Abstract: Paediatric psoriasis is a common disorder with significant morbidity. New advances in biologic therapy, as well as recent reviews assessing classification, have led to a greater understanding of the condition of psoriasis. Presented in this review article is an overview of the presentation of psoriasis as well as an up to date review of management options. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585267 Tue, 01 Mar 2011 00:00:00 +0100 4585267 http://www.medworm.com/index.php?rid=4585266&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221000199X%2Fabstract%3Frss%3Dyes Abstract: Acne vulgaris is a disorder of the pilosebaceous unit, characterized by comedones, inflammatory lesions and scars on the face and trunk. It presents a significant financial burden to the community and its psychosocial impact can be severe, life-altering and even life-threatening. Effective treatment can reduce the burden of disease but poorly considered therapy can be ineffective, costly and may also worsen non-compliance.In the management of acne, it is important to identify triggers, such as drugs, endocrinopathies and topical agents. Comedonal acne can respond well to topical retinoids. Mild to moderately inflammatory acne is usually initially treated with combination topical therapy, sometimes adding an oral antibiotic. Anti-androgen therapy can be helpful in females with seb... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585266 Tue, 01 Mar 2011 00:00:00 +0100 4585266 http://www.medworm.com/index.php?rid=4585265&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001861%2Fabstract%3Frss%3Dyes Abstract: Atopic dermatitis is a common condition that takes a significant time from the daily work of general paediatricians. The principles of Child Health apply well in the management of this condition including attention to details and a consideration for the impact on the quality of life of the child and family. The clinical assessment involves an enquiry about triggers as well as details of therapy. All should be done through a multidisciplinary approach and liaison with primary care.Regular daily topical emollients and intermittent topical corticosteroids are the cornerstone of therapy. Resistant eczema should raise the suspicion of secondary infection, usually staphylococcal or streptococcal, poor compliance and psychological factors. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585265 Tue, 01 Mar 2011 00:00:00 +0100 4585265 http://www.medworm.com/index.php?rid=4585264&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221000185X%2Fabstract%3Frss%3Dyes Abstract: Children frequently present with either a skin rash or skin lesion. It is important to be able to differentiate between well children and those that are systemically ill. A systematic approach with a comprehensive history and examination, along with appropriate investigations, enables clinicians to reach diagnosis. To support this approach a number of examples have been given. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585264 Tue, 01 Mar 2011 00:00:00 +0100 4585264 http://www.medworm.com/index.php?rid=4585263&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722211000229%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4585263 Tue, 01 Mar 2011 00:00:00 +0100 4585263 http://www.medworm.com/index.php?rid=4365695&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002349%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365695 Sat, 01 Jan 2011 00:00:00 +0100 4365695 http://www.medworm.com/index.php?rid=4365694&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002295%2Fabstract%3Frss%3Dyes Abstract: Dealing with complaints from patients and their families is a time-consuming and a stressful part of a paediatrician’s duties. Anxious parents do not always understand everything that has been said during a consultation and if communication is not direct and simple the problem is compounded. Clear and concise explanations and good medical record keeping are an important part of patient care and can help to avoid the misunderstandings that cause patient complaints and litigation. When complaints are made it is helpful for paediatricians to have a clear understanding of the hospital complaints procedures, so that they can contribute to the process effectively. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365694 Sat, 01 Jan 2011 00:00:00 +0100 4365694 http://www.medworm.com/index.php?rid=4365693&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002350%2Fabstract%3Frss%3Dyes Abstract: Newborn hearing screening is now a core NHS service and with a current yield of 5764 deaf babies it has been a remarkable achievement. It is premature to evaluate longer-term outcomes from the screen, but the eventual worth has been projected from the two programmes which pioneered universal neonatal hearing screening in the UK. A controlled trial in Wessex confirmed an incremental yield from neonatal screening and longitudinal follow up of three East London cohorts demonstrated a dramatic reduction in the age when deafness was confirmed following the introduction of the universal neonatal screen. The deaf children ascertained from these studies were aggregated as the principal participants in the Hearing Outcome Project. Children confirmed before 9 months had higher language lev... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365693 Sat, 01 Jan 2011 00:00:00 +0100 4365693 http://www.medworm.com/index.php?rid=4365692&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002325%2Fabstract%3Frss%3Dyes This article reviews the current practice of paediatric heart transplantation in the UK. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365692 Sat, 01 Jan 2011 00:00:00 +0100 4365692 http://www.medworm.com/index.php?rid=4365691&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001927%2Fabstract%3Frss%3Dyes Abstract: Children with Down syndrome (DS) have long been known to have an increased incidence of pulmonary arterial hypertension (PAH), but this has not been clearly understood until recently. DS patients have an increased incidence of congenital heart disease (CHD) and upper airway obstruction (UAO) amongst other co-morbidities. Even though CHD is usually quickly recognized in early infancy with current echocardiographic assessment and corrected with early surgery, many children with Down syndrome will still have ongoing PAH which may be unrecognized. A better understanding of the interplay between these conditions, managed by a multi-disciplinary team, is required to maximize their long term quality of life. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365691 Sat, 01 Jan 2011 00:00:00 +0100 4365691 http://www.medworm.com/index.php?rid=4365690&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002374%2Fabstract%3Frss%3Dyes Abstract: Hypoplastic Left Heart Syndrome comprises a spectrum of congenital heart abnormalities where there is underdevelopment of the left ventricle, in association with aortic and mitral stenosis or atresia together with a small ascending aorta. The babies’ systemic circulation is dependant on the right ventricle perfusing the body through a patent arterial duct. When the duct closes after birth acidosis and death occur through lack of systemic circulation.The introduction of Prostaglandin and intensive resuscitation techniques enabled these babies to survive. The development by Norwood of a three-stage complex palliative repair programme over the first few years of life has improved the survival rate at 1 year up to 75%. The Fontan procedure with a right ventricular dependant syste... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365690 Sat, 01 Jan 2011 00:00:00 +0100 4365690 http://www.medworm.com/index.php?rid=4365689&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001551%2Fabstract%3Frss%3Dyes This article explores the breadth and nature of cardiac problems in the teenage population and reviews the principles and aims of transition care. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365689 Sat, 01 Jan 2011 00:00:00 +0100 4365689 http://www.medworm.com/index.php?rid=4365688&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221000154X%2Fabstract%3Frss%3Dyes Abstract: Congenital heart disease {CHD} still accounts for significant morbidity and mortality, despite major advances in diagnosis and management. It predominantly manifests in the neonatal period and early infancy. Presentation is protean ranging from a well baby with a heart murmur to a baby in extremis. Although advances in antenatal ultrasonography and foetal echocardiography continue to improve detection rates a significant proportion of CHD is still undiagnosed at birth emphasizing the need for a detailed history and meticulous clinical examination. No reliable screening tool exists but pulse oximetry can be quite useful despite its relatively low sensitivity. Limb blood pressure values are quite variable in the newborn and hence should be interpreted with caution. Chest X-ray with... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365688 Sat, 01 Jan 2011 00:00:00 +0100 4365688 http://www.medworm.com/index.php?rid=4365687&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001848%2Fabstract%3Frss%3Dyes Abstract: Due to the presence of fetal haemoglobin and the patency of anatomical shunts the fetal circulation is perfectly adapted to intrauterine life, utilizing the placenta as the organ of gas exchange. Immediate adaptation must occur at birth as the lungs take over this role. Initially the pulmonary vascular resistance is high but pulmonary blood flow progressively increases in the newborn due to vasodilatation as a consequence of increased oxygenation and activation of pulmonary stretch receptors. Changes in the pulmonary vasculature are mediated through a number of vasoactive substances, including nitric oxide. Increased pulmonary blood flow leads to an increase in left atrial pressure with subsequent closure of the foramen ovale.In some babies this normal adaptation fails and persis... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365687 Sat, 01 Jan 2011 00:00:00 +0100 4365687 http://www.medworm.com/index.php?rid=4365686&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002659%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4365686 Sat, 01 Jan 2011 00:00:00 +0100 4365686 http://www.medworm.com/index.php?rid=4222794&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS175172221000226X%2Fabstract%3Frss%3Dyes The author wishes to correct misleading information given in the answer to Question 1 of his Self-assessment article which was published in Paediatrics & Child Health, volume 20, issue 3, pp. 146–150, 2010. The question and its correct answer are given below. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222794 Wed, 01 Dec 2010 00:00:00 +0100 4222794 http://www.medworm.com/index.php?rid=4222793&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002271%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222793 Wed, 01 Dec 2010 00:00:00 +0100 4222793 http://www.medworm.com/index.php?rid=4222791&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001149%2Fabstract%3Frss%3Dyes Case-based discussion (CbD) is an instrument used to assess doctors during foundation and specialty training. The purpose of this article is to guide paediatric trainers and trainees through the process of completing the CbD in a way which maximizes the benefits of the session for all. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222791 Wed, 01 Dec 2010 00:00:00 +0100 4222791 http://www.medworm.com/index.php?rid=4222790&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001563%2Fabstract%3Frss%3Dyes Abstract: Paediatric arrhythmias have diverse presentations and unique features. Arrhythmia diagnosis depends on knowing the possibilities, examining the relationship between the P waves and QRS complexes and pattern recognition. Ten clinical cases together with a dozen instructive electrocardiograms are presented to highlight important principles that all paediatricians should be aware of. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222790 Wed, 01 Dec 2010 00:00:00 +0100 4222790 http://www.medworm.com/index.php?rid=4222789&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001125%2Fabstract%3Frss%3Dyes Abstract: Safeguarding children is a core part of being a paediatrician. During their career they will see children, who may be abused or neglected, and will be asked to give their opinion and provide a medical report. They also have a duty to contribute to the multi-agency safeguarding process. This will require them to attend strategy discussions and child protection conferences in cases where medical opinion is critical to the decision making with regards to safeguarding those children. This review gives the readers an understanding of the process leading up to the child protection conference, who may attend and what to expect at the conference, and what outcome may be achieved. Lastly, how paediatricians could contribute and discharge their responsibility in this key area of child prot... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222789 Wed, 01 Dec 2010 00:00:00 +0100 4222789 http://www.medworm.com/index.php?rid=4222788&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001599%2Fabstract%3Frss%3Dyes Abstract: Physical abuse of children is common. Recognition can be difficult and the history given misleading. This paper gives some indication of the problems encountered, ways of investigating cases and some differential diagnoses. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222788 Wed, 01 Dec 2010 00:00:00 +0100 4222788 http://www.medworm.com/index.php?rid=4222787&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001587%2Fabstract%3Frss%3Dyes Abstract: Fabricated or Induced Illness (FII) is the preferred term for the form of abuse previously referred to as Munchausen Syndrome by Proxy. This review groups the varied behaviours that result in FII into six Physical Impact Categories (PICs). The age of identification of abuse is inversely related to the severity of physical impact, whereas the age of onset of abuse is early in life in all PICs. PIC 5 (High Toxicity Poisoning) and PIC 6 (Apparent Life-threatening Events) have very significant mortality for both index cases (17% and 12%) and siblings (19% and 57%). 94% of perpetrators are female. The majority of male perpetrators inflict the severest forms of FII (PICs 5 and 6). Intrinsic illness co-exists with FII in 3–56% of cases. Co-morbidity occurred in 15–63% of cases. In P... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222787 Wed, 01 Dec 2010 00:00:00 +0100 4222787 http://www.medworm.com/index.php?rid=4222786&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001575%2Fabstract%3Frss%3Dyes This article reviews the definition of and the evidence base for physical signs of CSA as well as the differential diagnosis and clinical management. As CSA is increasingly recognized, it is hoped that this knowledge will improve prevention. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222786 Wed, 01 Dec 2010 00:00:00 +0100 4222786 http://www.medworm.com/index.php?rid=4222785&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001538%2Fabstract%3Frss%3Dyes This article provides information on good practice in the interview, examination and collection of forensic samples when children/young people make complaints of having been sexually assaulted. It must be appreciated that those carrying out such examinations must have the necessary skills i.e. be able to carry out a full paediatric examination and appreciate the normal from abnormal when examining the genitalia. This requires a good knowledge of normal development from infancy to adolescence. They must appreciate the subtleties of taking forensic samples and how to process these in order to preserve evidence. They must be able to write a report and present evidence in court. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222785 Wed, 01 Dec 2010 00:00:00 +0100 4222785 http://www.medworm.com/index.php?rid=4222784&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002453%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4222784 Wed, 01 Dec 2010 00:00:00 +0100 4222784 http://www.medworm.com/index.php?rid=4015922&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001745%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015922 Thu, 30 Sep 2010 17:47:29 +0100 4015922 http://www.medworm.com/index.php?rid=4015921&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001150%2Fabstract%3Frss%3Dyes The parents of Mark, a 3-month old infant, have brought him to the clinic for assessment of a genital anomaly picked up at birth. The FP2 paediatrician had noticed an incomplete foreskin and a urethral opening terminating just proximal to the glans penis (). He has been thriving and has no other phenotypic abnormalities. The parents have come for advice as to the significance of the abnormality and whether surgical repair is advised. They would like to know details of current types of hypospadias repair, their success rates, possible specific complications and predicted long-term outcomes. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015921 Thu, 30 Sep 2010 17:47:29 +0100 4015921 http://www.medworm.com/index.php?rid=4015920&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210000703%2Fabstract%3Frss%3Dyes Abstract: Neutrophils are important leukocytes for host protection against bacterial and fungal pathogens. Neutrophil disorders can result from reduced numbers or function and the latter are the subject of this review. Defects of neutrophil function are rare but clinically important as they can result in severe and life-threatening disease. Chronic Granulomatous Disease and Leukocyte Adhesion Defect are the most common intrinsic neutrophil defects and are focused on here with a brief description of other functional defects. Practical guidelines for investigation and management are discussed. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015920 Thu, 30 Sep 2010 17:47:29 +0100 4015920 http://www.medworm.com/index.php?rid=4015919&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210000922%2Fabstract%3Frss%3Dyes Abstract: Meningitis is associated with significant mortality and morbidity in infants in the first 3 months of life. The most recent national surveillance study (1996–7) identified an overall mortality of 10% with 50% of cases having some form of disability at 5 year follow-up (24% serious); a risk of serious disability 16-fold higher than that of GP-matched controls. The mortality has declined over the last two decades but there has been no change in the long term morbidity. Despite this there have been no attempts to assess the quality of current diagnostic and management strategies. It seems likely that improved recognition, evaluation and treatment of bacterial meningitis in infants could lead to a reduction in mortality and morbidity. Similar analyses undertaken in the areas of pae... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015919 Thu, 30 Sep 2010 17:47:29 +0100 4015919 http://www.medworm.com/index.php?rid=4015918&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210000417%2Fabstract%3Frss%3Dyes Abstract: Herpes simplex virus is a common infection in childhood. Typically infections are asymptomatic or benign vesicular lesions or ulcers of the skin or lips. However, under certain circumstances such as in the newborn period, in occasional normal children, or in the immunocompromised child, systemic disease can occur involving the central nervous system and/or other organs. New knowledge is emerging about the underlying mechanisms that result in systemic HSV diseases in infants and some older children, but not others. Neonatal herpes results from a combination of high inocula of virus and immunological immaturity. HSV encephalitis in older children can be associated with genetic defects in innate immune responses. Characteristic herpetic lesions can be absent on occasions in the newb... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015918 Thu, 30 Sep 2010 17:47:29 +0100 4015918 http://www.medworm.com/index.php?rid=4015917&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210000351%2Fabstract%3Frss%3Dyes Abstract: Group A Streptococcus is a major cause of global death and morbidity. There has been much focus on the resurgence of severe and invasive forms in industrialized countries but most morbidity results from the non-suppurative sequelae of childhood infection in resource poor settings. Penicillin remains the main stay of treatment and prevention. In this article, we review the treatment of the varied manifestations of Group A streptococcal infection in childhood. (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015917 Thu, 30 Sep 2010 17:47:29 +0100 4015917 http://www.medworm.com/index.php?rid=4015916&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001198%2Fabstract%3Frss%3Dyes Abstract: Increased air travel to exotic destinations means increasing numbers of cases of malaria imported to the UK. The diagnosis needs to be considered early in those with symptoms who have recently visited an endemic area. The presentation is extremely variable and the risk of life-threatening complications high, close monitoring therefore as an inpatient is recommended while treatment is initiated. Treatment for severe malaria starts with intravenous quinine and courses can be completed with one of a choice of oral medications. Co-infection with bacteraemia is not uncommon and broad-spectrum antibiotics including gram negative coverage should be started in children with severe features while culture results are awaited.Currently uptake of prophylactic medication in travellers is poor... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015916 Thu, 30 Sep 2010 17:47:29 +0100 4015916 http://www.medworm.com/index.php?rid=4015915&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210000727%2Fabstract%3Frss%3Dyes Abstract: Periodic fever syndromes are rare disorders of the immune system characterized by episodes of systemic inflammation. Although there are similarities in the presentation, most of these disorders have a distinct pathophysiology and clinical features, with the duration of attacks aiding diagnosis. The precise classification can remain difficult in some cases. Recent advances in the understanding of the pathogenesis of periodic fever syndromes have led to the development of more effective therapies. Diagnosis requires a high degree of clinical suspicion, appropriate laboratory and molecular testing as well as investigations to exclude other causes. Diagnosis allows the use of targeted therapies and the avoidance of complications such as systemic amyloidosis. (Source: Paediatrics and ... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015915 Thu, 30 Sep 2010 17:47:28 +0100 4015915 http://www.medworm.com/index.php?rid=4015914&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210002155%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=4015914 Thu, 30 Sep 2010 17:47:28 +0100 4015914 http://www.medworm.com/index.php?rid=3967389&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001526%2Fabstract%3Frss%3Dyes (Source: Paediatrics and Child Health) Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=3967389 Tue, 31 Aug 2010 23:00:00 +0100 3967389 http://www.medworm.com/index.php?rid=3967388&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210000788%2Fabstract%3Frss%3Dyes Exposure to second hand smoke (SHS) is associated with several adverse health outcomes in children. Removing children from SHS exposure is a priority shared by policy makers and healthcare professionals alike. In addition to the burden of childhood illnesses, the children of parents who smoke are also at increased risk for becoming smokers in adulthood and this puts the young individual at increased risk for conditions likely to shorten their life span, e.g. malignancies, myocardial infarction, chronic obstructive pulmonary disease and stroke. Parents love their children and endeavour to provide a safe and healthy environment for their offspring and smokers know that SHS exposure is harmful to children () but approximately 40% of children in the UK continue to be exposed to SHS by their pa... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=3967388 Tue, 31 Aug 2010 23:00:00 +0100 3967388 http://www.medworm.com/index.php?rid=3967387&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001356%2Fabstract%3Frss%3Dyes Abstract: Promotion of emotional wellbeing should be a priority integral to all paediatric practice. The emotional environment may determine or merely influence children’s needs, but is always relevant.The root of children’s emotional state is the quality of their parental attachments, consideration of which should be routine. Children’s earliest experience of parental relationships determines their preconceptions of themselves and relationships, their foundations of verbal and non-verbal communication, and programming of the stress regulation system. It has a life-long influence on physical and psychological wellbeing, and on growth, development and behaviour.Recognition of the overriding priority for children of adequate attachment should ensure that establishment of secure foundat... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=3967387 Tue, 31 Aug 2010 23:00:00 +0100 3967387 http://www.medworm.com/index.php?rid=3967386&cid=s_38458_33_f&fid=38458&url=http%3A%2F%2Fwww.paediatricsandchildhealthjournal.co.uk%2Farticle%2FPIIS1751722210001605%2Fabstract%3Frss%3Dyes Abstract: It is now clear that a number of paediatric emergencies with a neurological presentation, including hemiparesis, visual loss, seizures and coma, commonly have a vascular basis which may not be obvious on CT scan. Although many children do well, as there is significant mortality as well as morbidity for childhood stroke, in addition to a high risk for recurrence, making a diagnosis in the acute phase important. Venography and arteriography (including the neck vessels if the intracranial vessels are normal) are usually indicated despite the problems i.e. contrast CT requires a high dose of radiation while emergency MR usually requires anaesthesia and conventional arteriography carries a small risk of stroke. Surgical decompression may be life-saving in ischaemic as well as haemorrh... Paediatrics and Child Health journals http://www.medworm.com/rss/comments.php?id=3967386 Tue, 31 Aug 2010 23:00:00 +0100 3967386