-
Mashup Score: 27
In the United Kingdom (UK), preschool wheeze is usually defined as occurring in children aged one to five years old. Prevalence studies report a third of children experience at least one wheeze episode before the age of three, rising to half of all children by the age of six.1 These acute episodes represent a considerable healthcare burden, causing significant morbidity for affected children, parental stress and reduced productivity; with annual UK healthcare costs in-excess-of £53 million.2 3 The multifactorial nature of acute preschool wheeze (APSW) episodes are such that, in reality, this is an umbrella term; encompassing several phenotypes rather than a singular entity.1 In 2008, the European Respiratory Society Task Force recommended clinical phenotype categorisation as episodic viral wheeze (EVW) or multiple trigger wheeze (MTW).4 EVW is more common; typically associated with viral respiratory infections and minimal interval symptoms,4 whereas children with MTW are more commonly
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 51Improving inpatient paediatric de-labelling of allergies to beta-lactams: a quality improvement study - 4 day(s) ago
Objective To evaluate the implementation of an antimicrobial stewardship programme-led inpatient beta-lactam allergy de-labelling programme using a direct oral provocation test (OPT). Design One-year quality improvement study using a before–after design. Setting Free-standing tertiary care paediatric hospital. Patients Patients with a reported beta-lactam allergy admitted to the paediatric medicine inpatient unit. Interventions Following standardised assessment and risk stratification of reported symptoms, patients with a low-risk history were offered an OPT. Beta-lactam allergy labels were removed if a reported history was considered non-allergic or after successful OPT. Main outcome measures Removal of inappropriate beta-lactam allergy labels. Results 80 patients with 85 reported beta-lactam allergies were assessed. Median age was 8.1 years (IQR 4.8–12.9) and 34 (42%) were female. The majority (n=55, 69%) had an underlying medical condition. Amoxicillin was the most reported allergy
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 46Improving inpatient paediatric de-labelling of allergies to beta-lactams: a quality improvement study - 6 day(s) ago
Objective To evaluate the implementation of an antimicrobial stewardship programme-led inpatient beta-lactam allergy de-labelling programme using a direct oral provocation test (OPT). Design One-year quality improvement study using a before–after design. Setting Free-standing tertiary care paediatric hospital. Patients Patients with a reported beta-lactam allergy admitted to the paediatric medicine inpatient unit. Interventions Following standardised assessment and risk stratification of reported symptoms, patients with a low-risk history were offered an OPT. Beta-lactam allergy labels were removed if a reported history was considered non-allergic or after successful OPT. Main outcome measures Removal of inappropriate beta-lactam allergy labels. Results 80 patients with 85 reported beta-lactam allergies were assessed. Median age was 8.1 years (IQR 4.8–12.9) and 34 (42%) were female. The majority (n=55, 69%) had an underlying medical condition. Amoxicillin was the most reported allergy
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 3Parasitic infections: what do paediatricians need to know? - 9 day(s) ago
Parasitic infections and the medications used to treat them may be unfamiliar to many paediatricians. Parasitic infections, however, are not uncommonly seen in children in the UK. We summarise infections which are commonly seen, currently recommended treatment and practical guidance on formulations, adverse effects and treatment choice.
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 23D printing: a useful tool for safe clinical practice in children with complex vasculature - 10 day(s) ago
Background 3D printing has been used in different medical contexts, although it is underutilised in paediatrics. We present the first use of 3D printing in the management of three paediatric patients with complex renovascular disease. Methods Patient-specific 3D models were produced from conventional 2D imaging and manufactured using 3D polyjet printing technology. All three patients had different underlying pathologies, but all underwent multiple endovascular interventions (renal artery balloon angioplasty) prior to 3D printing and subsequent vascular surgery. The models were verified by an expert radiologist and then presented to the multidisciplinary team to aid with surgical planning. Results Following evaluation of the 3D-printed models, all patients underwent successful uni/bilateral renal auto-transplants and aortic bypass surgery. The 3D models allowed more detailed preoperative discussions and more focused planning of surgical approach, therefore enhancing safer surgical plann
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 8Multiple magnet ingestion causing volvulus - 10 day(s) ago
A 22-month-old boy presented to the emergency department with a 2-day history of constipation and a 1-day history of non-bilious vomiting. Examination showed a soft, distended abdomen with sluggish bowel sounds. Abdominal X-ray (figure 1) showed distended small bowel loops, lack of bowel gas distally and five foreign bodies in the right iliac fossa, likely magnetic beads from a sibling’s new toy, although the ingestion was not witnessed. Figure 1 Abdominal X-ray showing dilated loops of bowel …
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 15
Objective Recovery from acute wheeze and asthma attacks should be supported with safety netting, including treatment advice. We evaluated emergency department (ED) discharge practices for acute childhood wheeze/asthma attacks to describe variation in safety netting and recovery bronchodilator dosing. Design Two-phase study between June 2020 and September 2021, comprising (1) Departmental discharge practice survey, and (2) Analysis of written discharge instructions for caregivers. Setting Secondary and tertiary EDs in rural and urban settings, from Paediatric Emergency Research in the UK and Ireland (PERUKI). Main outcome measures Describe practice and variation in discharge advice, treatment recommendations and safety netting provision. Results Of 66/71 (93%) participating sites, 62/66 (93.9%) reported providing written safety netting information. 52/66 (78.8%) ‘nearly always’ assessed inhaler/spacer technique; routine medication review (21/66; 31.8%) and adherence (16/66; 21.4%) were
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 1
Background Internet use has increased and sleep and physical activity (PA) have decreased in recent years among adolescents. Besides sleep and PA, another determinant of future health for adolescents is education. Our aim was to evaluate the associations of excessive internet use (EIU), short sleep duration and low PA with both unexcused absences and medical absences during lower secondary school. Methods The School Health Promotion study is a national survey of adolescents conducted biennially in Finland. We used data collected in 2019, when EIU was assessed for the first time. Cumulative odds ratio analysis was conducted with unexcused absences and medical absences as outcome variables. Besides EIU, sleep duration and PA, the associations of maternal education and parental relations were assessed. Results The mean age of the 86 270 participants was 15.3 years. Girls scored higher than boys on EIU. In all, 34.7% of participants slept less than 8 hours per night during the school week,
Source: adc.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 1
A healthy, thriving 6-month-old girl presented with a peculiar patterning of ‘V’-shaped ridges found in all her fingernails excluding the thumbs (figure 1). Toenails were unaffected and examination of the parents did not demonstrate any similar pattern of nail ridging. Figure 1 Fingernail demonstrating V-shaped ridging. Her birth weight was 2.5 kg and there was oligohydramnios. Her mother’s haemoglobin and iron levels were normal. The infant was exclusively …
Source: adc.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 14
The decision to start home-blended feeds in gastrostomy-fed children can feel controversial. Blending home-prepared foods for administration through a gastrostomy tube, while logical in many ways, has been constrained by a lack of safety and efficacy data in comparison to decades of ‘real-world experience’ with enteral formulae. As a result, professional bodies such as the British Dietetic Association (BDA) and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition, while encouraging dietitians to support those home-blending, have stopped short of recommending its routine use.1 2 Despite this, increasing numbers of families are now choosing to give their tube-fed children home-blended food and standardised support may not be available for all. We therefore welcome the publication of data from the YourTube study. This prospective, multicentre cohort study of 180 gastrostomy-fed children in the UK (104 home-blended diets, 76 exclusive sterile formula at baseline) p
Source: adc.bmj.comCategories: General Medicine News, PediatricsTweet
Viewpoint What is the role of oral corticosteroids in the treatment of acute preschool wheeze Half of all <6y had episode Many phenotypes, many heterogenous studies RCTs so far failed to provide robust evidence to clarify clinical practice @DrShaunKiwi https://t.co/dm1H8HZ0Ak