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Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: Alan T. Gibson Tags: Self-assessment Source Type: journals

Management of the child with difficult constipationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The treatment of constipation has been advanced by the availability of polyethylene glycol (macrogol) based laxatives. Removal of faecal impaction is a pre-requisite to the successful treatment of constipation, and, ten years ago this was accomplished by administration of enemas, often with sedation, or manual removal under anaesthesia. Nowadays, disimpaction can be achieved, in a highly cost-effective manner, in the majority of children by oral administration of high-dose macrogol (PEG) laxatives at home. Following disimpaction, maintenance treatment required juggling doses of osmotic and stimulant laxatives, whereas now,...
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: David C.A. Candy Tags: Personal Practice Source Type: journals

Assessment of the short childEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Short stature is a common problem presenting to the paediatric clinic and frequently causes a degree of psychological distress amongst parents and children. A systematic approach to the problem usually differentiates common variations of normal physiological growth and short stature due to chronic disease from less common endocrine pathology. A clear understanding of the factors influencing normal growth through infancy, childhood and puberty is an essential requirement if normality is to be distinguished from pathology. This review summarises factors involved in the attainment of normal growth and provides a fra...
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: Christopher Bidder, Justin Tobias Warner Tags: Occasional Review Source Type: journals

Prevention of unintentional injuries in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article highlights proven strategies for preventing many types of injuries in childhood. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: Elizabeth Towner, Julie Mytton Tags: Symposium: Accidents and Poisoning Source Type: journals

Early management of burns in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article is designed to give GPs, junior doctors, nursing staff and anyone not familiar with burns an overview of the current opinion and management of an acute burn. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: J. Yarrow, N. Moiemen, S. Gulhane Tags: Symposium: Accidents and Poisoning Source Type: journals

Fabricated or induced illness in children: The paediatrician's roleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: FII is an uncommon form of child abuse which challenges the very core of the doctor-patient relationship. The unspoken contract of “You tell me what's wrong and I'll do my best to help you.” is breached by a parent who fabricates their child's symptoms and sometimes even their physical signs. Anecdotally these diagnoses tend to be very delayed and children often suffer extreme harm in the process. In 2002 RCPCH produced the first definitive guidance on FII. In 2008 the Government produced updated guidance for all professionals which led to RCPCH producing a new Practical Guide in 2009. This paper incorporates...
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: Paul Davis Tags: Symposium: Accidents and Poisoning Source Type: journals

The management of paracetamol poisoningEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Paracetamol poisoning is a common presentation in paediatrics. Toxicity may cause hepatocellular injury, in certain cases progressing to fulminant liver failure. Young children appear less at risk of hepatotoxicity due to an increased metabolic capacity for paracetamol. A single dose of 150 mg/kg can cause hepatocellular damage. Children who ingest multiple supratherapeutic doses can accumulate significant concentrations and may suffer worse outcomes. Older children who intentionally overdose may also suffer worse outcomes, especially those who present late. The risk of hepatotoxicity after a single overdose can ...
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: Khairun Nain Bin Nor Aripin, Imti Choonara Tags: Symposium: Accidents and Poisoning Source Type: journals

Improving the outcome of severely head injured children in the UKEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Traumatic brain injury (TBI) causes significant morbidity and mortality in children. After the primary injury, subsequent physiological insults worsen morbidity and mortality and are particularly common in the pre-hospital setting. Management of severe TBI in hospital is largely focused on the prevention of secondary brain injury, the management of raised intracranial pressure and preservation of cerebral perfusion. Large potential improvements in outcomes for severely brain injured children are possible if the child's entire NHS journey is appreciated. The first hour of this journey is spent outside of hospital ...
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Authors: Philip Hyde, Kevin Morris Tags: Symposium: Accidents and Poisoning Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - November 1, 2009 Category: Pediatrics Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Anneli Wynn-Davies, Craig Smith Tags: Self-assessment Source Type: journals

Dying with a neurological condition in adolescenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Young adults with life-limiting and life-threatening neurological disorders are a unique group. The demands of symptom management are often complex, but perhaps no more so than in other age groups. In this article we wish instead to consider what is particular to adolescence. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Finella Craig, Margaret Comac, Rob George Tags: Personal Practice Source Type: journals

Prader–Willi syndrome: clinical features and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Prader Willi syndrome is a rare genetic disorder associated with extreme obesity, short stature, and learning disability. There is a characteristic behavioural phenotype. Understanding of the genetic mechanisms has expanded in recent years as new laboratory techniques have been developed. Nowadays the clinical diagnosis is normally made in infancy. Management focuses on improving nutrition in the early months, then restricting calories to limit rapid weight gain. Several endocrine problems are encountered and these are discussed. There is increasing experience of growth-hormone therapy both to increase longitudin...
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Nicholas P. Mann, Gary E. Butler Tags: Occasional Review Source Type: journals

The Mental Capacity Act 2005: consent in young people with learning difficultiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: A review and discussion of the provisions of the Mental Capacity Act 2005 (the Act) within the context of the treatment and consent thereto by young people with learning difficulties focussing on the following:(i) analysis of the term “young person” within the context of the Act;(ii) discussion of the key principles: Sections 1–4 of the Act;(iii) statutory defence to liability under section 5;(iv) Independent Mental Capacity Advocate;(v) the new Court of Protection.Reference to the Code of Practice and its application and significance for practitioners. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Jane Probyn Tags: Occasional Review Source Type: journals

Augmentative and alternative communication: a review of current issuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Augmentative and alternative communication (AAC) includes a range of approaches aimed at supporting or replacing speech for children and others for whom natural speech is not sufficient to meet their needs. For some children it also offers a support to the process of language learning. A wide range of medical conditions may lead to a child requiring AAC, either temporarily or on a more permanent basis. AAC systems may be unaided or aided, in the sense of requiring some form of equipment. They vary on the level of technology required from none to specialized computer-based devices offering synthesized speech outpu...
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Janice Murray, Juliet Goldbart Tags: Symposium: Special Needs Source Type: journals

Cochlear implantation in children: current statusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Cochlear implantation provides useful hearing for those too deaf to benefit from conventional hearing aids. About 370 such children are born each year in the England, and another 100 each year become deaf early in life and need an implant. Over the past 20 years, cochlear implantation has now become standard management for severe to profoundly deaf children, making the attainment of intelligible, age-appropriate spoken language an achievable goal for many. With earlier diagnosis of deafness as a consequence of newborn hearing screening, implantation is increasingly being undertaken in the first year of life, with...
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Sue Archbold, Gerard M. O'Donoghue Tags: Symposium: Special Needs Source Type: journals

Communication disorders in preschool childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Competence in the broad range of communication skills is essential for a full and varied life experience. Yet speech, language and communication difficulties are amongst the most common of all childhood difficulties and cause parents and professionals considerable concern. This brief review of common causes of communication disability provides information about aetiology, prevalence and current practice in direct and indirect treatment as well as educational contexts. The research base relating to intervention is limited, with very few studies that would meet the requirements of rigorous medical research. However...
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Vicky Slonims, Greg Pasco Tags: Symposium: Special Needs Source Type: journals

Diagnosing hearing problemsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Hearing loss is defined as the partial or total inability to hear sound in one or both ears. The impact of childhood hearing impairment is devastating; poor language development can impact on literacy skills, educational achievement, and subsequent income and socio-economic status. Universal neonatal screening is therefore the aim, with early diagnosis of hearing loss and early provision of hearing aids. However, not all hearing impairments manifest themselves at birth, and screening programmes must be complemented by services that can confirm and manage cases where impairment shows itself later. The aim of this ...
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: David W. Proops, A.N. Acharya Tags: Symposium: Special Needs Source Type: journals

Why are children deaf?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Hearing loss is the most common sensory deficit in childhood. Early detection and management of hearing impairment in children is essential to avoid any potential risk to speech and language development, communication, and learning. There are many potential causes for hearing loss in children, and these can be categorized by the site, severity, and aetiology of hearing loss. We detail many of the important causes of childhood hearing impairment. These include congenital genetic causes, congenital non-genetic causes, and acquired causes. The clinical assessment of a child with suspected hearing impairment requires...
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Authors: Neil K. Chadha, Rashmi Chadha, Adrian L. James Tags: Symposium: Special Needs Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - September 22, 2009 Category: Pediatrics Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Gary Connett, Clare Hollingworth Tags: Self-assessment Source Type: journals

Food refusal in the sensory-sensitive childEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 4-year-old boy, Thomas, attended a feeding clinic with his parents, both middle-class professionals. Thomas had no medical problems, but was refusing to eat and to chew solid foods. The parents reported that Thomas's food refusal meant that every mealtime took over an hour, with much coaxing, rewarding and bribery. The parents reported a history of force feeding, and admitted that they still shouted at Thomas when he ate or drank very slowly and that this frightened him. Thomas was currently fed blended or pureed food, mostly by his mother. He still drank milk, but very slowly. Some of the foods that he was fed he would ...
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Gillian Harris Tags: Personal Practice Source Type: journals

Using the UN Convention on the Rights of Children to improve the health of childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The United Nations Convention on the Rights of Children (UNCRC) is a comprehensive document in which 42 articles describe the civil, political, social, economic and cultural rights of children. It was passed by the UN in 1989, signed by the UK in 1990, and ratified by the UK in 1991. Each country that has ratified the convention is subject to a regular examination process, somewhat analogous to an audit, to assess its progress in implementing the UNCRC. In this paper we will consider how paediatricians can use the UNCRC, and the examination process, to improve the health and health care of children. Training, rai...
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Elspeth Webb, Lynn Horrocks, Anne Crowley, Nick Lessof Tags: Occasional Review Source Type: journals

Obese babies and young children: an approach to paediatric managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article offers a guide for paediatricians encountering obese infants and preschool children in the paediatric outpatient setting. The paediatricians' role includes addressing concerns about the aetiology; excluding a medical cause; looking for comorbidity; providing guidance around weight management and ensuring that it is safe; supporting colleagues providing lifestyle advice; and preventing obesity in children who are at high risk. A sensitive approach is crucial to helping parents and colleagues tackle the problem effectively. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Mary C.J. Rudolf Tags: Symposium: Nutrition Source Type: journals

Benefits and management of gastrostomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Gastrostomy feeding has become widespread as an effective means of preventing or reversing malnutrition in children with chronic illness. Gastrostomy should be considered in all patients with ‘long-term’ reliance on nasogastric tube feeding; while not clearly defined, this period is usually considered to be more than 6 weeks. Children with neurodisability represent the largest group of patients with gastrostomy; parents must be closely involved in the decision-making process that leads to tube feeding, understand the potential benefits and disadvantages, and be supportive of this intervention. There is a smal...
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: John W.L. Puntis Tags: Symposium: Nutrition Source Type: journals

An evidence based guide to weaning preterm infantsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: There have been national guidelines for weaning infants for many decades in the UK however none have addressed preterm infants until the COMA report of 1994 which gave brief recommendations. More recent publications don't include recommendations for preterm infants and it is acknowledged that for this group there is a need for separate guidelines; however none to date have been published. In this article the evidence base around weaning preterm infants is discussed and updated guidelines are suggested.It is suggested that preterm infants should be considered for weaning between 5 and 8 months uncorrected age to e...
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Caroline King Tags: Symposium: Nutrition Source Type: journals

The positive impact of dietitians in paediatric health careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Paediatric dietitians possess a unique set of skills which they bring to the multidisciplinary care team (MDT). This enables them to play a pivotal role in the detection, diagnosis and treatment of many paediatric diseases. Children in hospital are at risk of being malnourished, and this is more likely in children where there is established disease. An increasing number of children with a range of both acute and chronic diseases derive benefit from nutritional support. Paediatric dietitians can contribute to increased effectiveness in the detection and treatment of disease-related under-nutrition and faltering gr...
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Ruth M. Watling Tags: Symposium: Nutrition Source Type: journals

Breast-milk banking: evidence of benefitEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Human milk has evolved to provide the most appropriate nutritional and immunological support for newborn infants. In some situations, however, an individual mother is unable to meet the needs of her baby, for a variable length of time. In this situation donor milk, provided by a human milk bank, might be a better alternative than infant formula. There is evidence, particularly for preterm infants, that donor breast milk is better tolerated and carries a lower risk of necrotizing enterocolitis. Infection – particularly with viruses such as cytomegalovirus and HIV – may be transmitted in breast milk. This is a ...
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Authors: Alison Leaf, Rebecca Winterson Tags: Symposium: Nutrition Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - August 31, 2009 Category: Pediatrics Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Harriet Holme, Ashley Reece Tags: Self-assessment Source Type: journals

Food intolerance in children (non-allergenic food hypersensitivity)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Clair is a 12-year-old girl who has been under the care of outpatient paediatrics for 2 years. She initially presented with a combination of lower abdominal pain and epigastric pain with a clear history of heartburn. She had been investigated at that time – full blood count (FBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), liver function tests (LFTs), amylase, Helicobacter pylori antigen test, coeliac screen, stool reducing substances, stool for infection (including bacteria, ova, cysts and parasites) – all of which were negative. She was initially managed for gastritis and mild constipation with g...
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Colin Macdougall Tags: Personal Practice Source Type: journals

Recognizing and managing chronic musculoskeletal pain in childhoodEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Many young people have occasional musculoskeletal pains that are self-limiting and without consequence. A small number, however, do develop persistent pain that has significant impact on activity and lifestyle. It is important to recognize these pain conditions as early as possible to optimize rehabilitation and outcome. Medication has a role when part of a multidisciplinary framework, although there is little evidence for or against the effectiveness of most pharmacotherapy in children. There is strong evidence to support early targeted psychological and physical intervention, and an understanding that parental ...
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Jacqui Clinch Tags: Occasional Review Source Type: journals

Haematological disorders in Down syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Haematological abnormalities are common in children with Down syndrome. These are mostly benign. Neonatal changes include polycythaemia, neutrophilia and thrombocytopenia. In later childhood changes include secondary polycythaemia, red-cell macrocytosis, increased red-cell distribution width, leukopenia, and immune dysfunction. Transient myeloproliferative disorder occurs in about 5% and indicates a group at particularly high risk of subsequent leukaemia. A full blood count should be checked in all neonates with Down syndrome. Those with transient myeloproliferative disorder should be discussed with a paediatric ...
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Rebecca James, Sally Kinsey Tags: Symposium: Haematology Source Type: journals

Neonatal screening for haematological disordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Neonatal screening for haematological disorders has advanced over the last decade in England, with the phased implementation of a universal screening programme for the detection of sickle cell disease. Glucose-6-phosphate dehydrogenase deficiency and haemoglobin H disease are included in the universal newborn screening programmes in some parts of the world. Selective screening for haematological diseases should be considered in neonates with unexplained or prolonged hyperbilirubinaemia. Additionally, selective screening for haemostatic disorders is recommended in neonates at risk of hereditary bleeding disorders,...
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Lara N. Roberts, David C. Rees Tags: Symposium: Haematology Source Type: journals

The haematologist in neonatology II. Transfusion, red-cell and white-cell disorders in neonatesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Cytopenias are very common in neonates. We have focused on the common causes and their investigation and management. Transfusion of allogeneic blood components figures in the management of anaemia and thrombocytopenia, so several of its principles have been included here. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Shahera Rahman, Madeline Adams, Philip Connor Tags: Symposium: Haematology Source Type: journals

The haematologist in neonatology I. Thrombocytopenia, thrombosis and haemostasis in the neonateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Haemostatic problems, either thrombotic or bleeding, are common in sick neonates. Here we review the main clinical problems relating to bleeding and thrombosis, including interpretation of laboratory data. In this article we focus on the common or serious disorders, and consider both the cellular and humeral aspects of coagulation. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Shahera Rahman, Madeline Adams, Philip Connor Tags: Symposium: Haematology Source Type: journals

Understanding aplastic anaemia/bone-marrow failure syndromesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The term ‘aplastic anaemias/bone-marrow failure syndromes’ encompasses a heterogeneous group of disorders, including rare inherited genetic diseases and ‘acquired’ idiopathic aplastic anaemia, all characterized by failure of haematopoiesis. In the majority of these conditions the natural history is progressive, and the clinical spectrum includes non-haematological manifestations and a predisposition to cancer. Recent advances have identified mutations in more than 30 different genes which can be grouped into five functional cellular pathways in inherited bone-marrow failure syndromes. Some of these genes ...
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Momin Ahmed, Inderjeet Dokal Tags: Symposium: Haematology Source Type: journals

Childhood leukaemiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: As a group, acute leukaemias are the most common childhood malignancies, and continue to be an important cause of non-accident related childhood mortality. Fortunately, with modern chemotherapy the majority of children and young people with leukaemia can be cured. However, this treatment comes with a significant burden for our young patients and their families. Here, we review the essential and differential diagnostics and the initial management of children with suspected leukaemia, as relevant for secondary paediatric care. We will give a short overview of current treatment protocols for childhood acute lymphobl...
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Authors: Simon N. Bomken, H. Josef Vormoor Tags: Symposium: Haematology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - July 31, 2009 Category: Pediatrics Source Type: journals

Self-AssessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Question 1 An 11-year-old boy is referred by his GP with a history of intermittent fever for 4 or 5 days. He also started vomiting a day before his referral, and had been lethargic and had headaches since then. There was no history of diarrhoea, head injury, unusual drug ingestion, or skin rash. He was born and brought up in Gambia and had arrived in the UK 7 days earlier. There was no other significant past medical history. On arrival in the children’s assessment unit, his Glasgow coma scale (GCS) was 9, and he was just responding to painful stimuli. On examination, his blood pressure was 104/60 mm Hg, heart rate 100/m...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Vivek Mundada, Farah Mushtaq, Madeleine Ginns, T. Hildenrandt Tags: Self-Assessment Source Type: journals

Managing respiratory problems in Prader–Willi syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Children with Prader Willi syndrome (PWS) are at risk of developing both central and obstructive sleep apnoea in the context of dysfunctional respiratory control, a small upper airway and obesity. Growth hormone (GH) promotes body composition, psychosocial development and quality of life. Despite evidence of its stimulatory effect on the ventilatory drive, GH has been associated with unexpected nocturnal deaths in high risk patient groups such as the obese and those with pre existing respiratory problems. Using a case study, the present article explores issues around respiratory investigations, the safe use of GH...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Colin Wallis, Patrick Stafler Tags: Personal Practice Source Type: journals

Motivational interviewing to improve blood-glucose control in childhood diabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Motivational interviewing (MI) is a relatively new approach to counselling which has been developed largely in the addiction field. The method is patient-centred and helps resolve ambivalence about behaviour change whilst avoiding conflict and advice-giving by the clinician. This approach has qualities which seem particularly appropriate when dealing with teenagers. Recent evidence from clinical trials shows that motivational interviewing may be effective in facilitating healthier approaches to diet and exercise in young people and improved glycaemic control and quality of life in teenagers with diabetes. These f...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: John W. Gregory, Sue Channon Tags: Occasional Review Source Type: journals

Long-term outlook for children with type-1 diabetes, microalbuminuria and renal diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: As childhood-onset type-1 diabetes increases in incidence worldwide, its onset is shifting towards younger ages. Thus, the relative proportion of adolescents and young adults with a very long duration of type-1 diabetes may gradually increase. Early-onset diabetes may increase the lifetime risk for diabetic vascular complications, although there are other factors – such as long-term glycaemic control, puberty, and familial and genetic factors – which contribute to the overall risk. The focus of this minireview is the natural history of microalbuminuria in children and adolescents with type-1 diabetes. Late co...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Päivi H. Tossavainen, M. Loredana Marcovecchio Tags: Symposium: Diabetes Source Type: journals

Type-2 diabetes in childhood: incidence and prognosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Type-2 diabetes is a global public health concern, and young people have not escaped the epidemic. However, there is a paucity of information – particularly population-based data – regarding the incidence, prevalence, and natural history of type-2 diabetes in young people, with a lack of uniformity in case definition, data collection, and follow-up. In some populations, type-2 diabetes accounts for more than 50% of incident cases of diabetes in 10–18-year-olds, with the highest rates found in ethnic minority groups. The rise in youth-onset type-2 diabetes has been attributed to environmental factors such as...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Maria E. Craig, Chi-Yu Huang Tags: Symposium: Diabetes Source Type: journals

Insulin pumps for childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present some of our early experiences of insulin pump use and consider how CSII may develop in the future. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Vicky Alexander, Stephen Greene Tags: Symposium: Diabetes Source Type: journals

How to improve blood-glucose control in type-1 diabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Glucose control in UK children with diabetes is below the EU average, as shown in several multicentre studies over the last 10 years. There are many reasons, from social factors (high divorce rate in the UK, more single-parent families, more isolation) to medical causes (undue reliance on twice-daily premixed insulins, reluctant acceptance of poor HbA1c levels by some UK paediatricians and parents). Unfortunately, the long-term effects on shortened life expectancy, cardiovascular disease, blindness and renal failure mean that poor glucose control is no longer acceptable. This review seeks to review the evidence f...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Timothy G. Barrett, Nils P. Krone Tags: Symposium: Diabetes Source Type: journals

The epidemiology of childhood diabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: There are large differences between countries in the incidence of type 1 diabetes. Europe shows the greatest variation, with the highest incidence in the north-east and lowest in the south-west of the continent. Much of the variation can be explained by genetic differences, but there are notable exceptions and intriguing within-country variations which suggest environmental causes for the disease. One of the most interesting recent findings is a dramatic increase in diabetes (3.2% per year), predominantly in younger children. The incidence in Finland is now over five times greater than it was 50 years ago. Recent...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: Anna E. Long, Polly J. Bingley Tags: Symposium: Diabetes Source Type: journals

Clinical services for children with diabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Diabetes mellitus is one of the most common long-term conditions in childhood. The management of children and young people is predominantly carried out by general paediatricians with a special interest in diabetes, together with paediatric diabetes specialist nurses and dieticians. Various guidelines and recommendations have been published with the aim of improving standards and quality of care; however, surveys conducted in the United Kingdom at periodic intervals have regularly shown deficiencies in the provision of care for these children and young people. With intensification of insulin regimens, education of...
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Authors: K.P. Ramesh, Julie A. Edge Tags: Symposium: Diabetes Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - June 3, 2009 Category: Pediatrics Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 3-year-old girl presented to the Emergency Department with a 6-week history of a reluctance to walk, and a limp more pronounced in the morning. Prior to onset of these symptoms she had had 2 days of fever with some associated rhinorhoea and cough. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - May 15, 2009 Category: Pediatrics Authors: Nigel Crawford Tags: Self-Assessment Source Type: journals

Non-specific isolated persistent coughEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Cough is a common problem in childhood and generates much anxiety amongst parents. There are numerous different causes of cough in children and this article provides the reader with a logical approach, using a worked example, for its differential diagnosis. Non-specific isolated persistent cough is discussed. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - May 15, 2009 Category: Pediatrics Authors: Jenny Hughes, Michael D. Shields Tags: Personal Practice Source Type: journals