Journal of paediatrics and child health
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J Paediatr Child Health · Dec 2005
Retrospective review of the management of simple febrile convulsions at a tertiary paediatric institution.
To review the medical records of children presenting to a tertiary paediatric emergency department (ED) with febrile convulsions over a 3-year period in order to assess quality of clinical practice. ⋯ Although many children who present to the hospital with simple febrile convulsions are managed appropriately, a large number are overinvestigated and overtreated, based on the clinical experience of the treating doctor. In these cases, medical record documentation can be improved. A clinical guideline based on our local fever guideline is suggested.
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J Paediatr Child Health · Sep 2005
Sleep-related breathing disorder in Duchenne muscular dystrophy: disease spectrum in the paediatric population.
Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease with death usually occurring because of respiratory failure. Signs of early respiratory insufficiency are usually first detectable in sleep. ⋯ The prevalence of SRBD in DMD is significant. There is a bimodal presentation of SRBD, with OSA found in the first decade and hypoventilation more commonly seen at the beginning of the second decade. Polysomnography is recommended in children with symptoms of OSA, or at the stage of becoming wheelchair-bound. In patients with the early stages of respiratory failure, assessment with polysomnography-identified sleep hypoventilation and assisted in initiating NIV.
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To evaluate prevalence, age, position, predisposing factors, bacteriology, clinical features and outcomes of children with subdural empyema (SDE) and brain abscess (BA). ⋯ The mortality rate of intracranial suppuration is low, but morbidity remains high. A high degree of suspicion is needed to diagnose and treat intracranial infections early.
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J Paediatr Child Health · Sep 2005
Volume-targeted ventilation and arterial carbon dioxide in neonates.
To review the arterial carbon dioxide tensions (PaCO(2)) in newborn infants ventilated using synchronized intermittent mandatory ventilation (SIMV) in volume guarantee mode (using the Dräger Babylog 8000+) with a unit policy targeting tidal volumes of approximately 4 mL/kg. ⋯ Infants ventilated with volume guarantee ventilation targeting approximately 4 mL/kg (range: 2.9-5.1) have acceptable PaCO(2) levels at the first blood gas measurement and during the first 48 h of life; and avoid severe hypo- or hypercapnoea over 90% of the time.
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J Paediatr Child Health · Aug 2005
Diagnosing symptomatic urinary tract infections in infants by catheter urine culture.
Diagnosing infantile urinary tract infection (UTI) is difficult due to contamination during urine collection. Catheterization is convenient but diagnostic criteria (colony-forming units per millilitre (CFU/mL)) is controversial, especially in uncircumcised males. ⋯ Unlike suprapubic tap urine, catheter urine culture has to be interpreted against the clinical context or pretest probability and in terms of probability. In the scenario of a febrile infant where the pretest probability of UTI was about 5%, UTI was highly likely if counts exceeded 10(5)/mL, and unlikely if counts were below 10(4)/mL in uncircumcised boys. In female infants, UTI was highly likely if counts were >10(4) CFU/mL, but lower counts could not exclude UTI.