Acta paediatrica
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Review Case Reports
Acute pharyngitis: low adherence to guidelines highlights need for greater flexibility in managing paediatric cases.
To describe how physicians manage acute pharyngitis with respect to the clinical guidelines. ⋯ About 50% of the physicians did not adhere to the guidelines. Factors influencing adherence included physician training, years in practice and patients' nonmedical characteristics. It is suggested that the existing clinical guidelines should address additional modifiers that will make the more applicable in practice.
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To determine the effects of propofol for endotracheal intubation in neonates in daily clinical practice. ⋯ This study shows that high doses of propofol are needed to reach effective sedation in neonates for intubation, with hypotension as a side effect in a considerable percentage of patients. Further research in newborn patients needs to identify optimal propofol doses and risk factors for hypotension.
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Screening for a condition should only be undertaken if certain strict criteria are met. Congenital CMV (cCMV) is a leading cause of sensorineuronal hearing loss (SNHL) and meets many of these criteria, but is not currently screened for in the UK. Ganciclovir reduces CMV-induced progressive SNHL if treatment is begun in the first month of life. The Newborn Hearing Screening Programme (NHSP) has been shown to identify SNHL at the earliest possible age. The potential of integrating screening for cCMV into the NHSP is discussed to consolidate the link between screening, early diagnosis and management. ⋯ The early diagnosis and treatment of cCMV may prevent a small proportion of late SNHL. In the absence of any screening programme, we provide evidence that clinically targeted screening through the NHSP is a potential option in the UK, enhancing the diagnostic pathway and enabling appropriate early treatment to reduce long-term morbidity.
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Randomized Controlled Trial Comparative Study
Comparison of heart rate and oxygen saturation measurements from Masimo and Nellcor pulse oximeters in newly born term infants.
To compare heart rate (HR) measurements from Masimo and Nellcor pulse oximeters (POs) against HR measured via a three lead electrocardiograph (ECG) (HRECG ). We also compared peripheral oxygen saturation (SpO2 ) measurements between Nellcor and Masimo oximeters. ⋯ Both oximeters accurately measure HR. There was good agreement between SpO2 measurements when SpO2 ≥70%. At lower SpO2 , agreement was poorer.
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To describe how children and adolescents cope with pain and to examine the biopsychosocial factors that correlate with pain-related disability (PRD) in a sample of primary care patients. ⋯ Variance in PRD was partly explained by pain intensity, worrying and ability to reduce pain and by behavioural distraction, externalizing and catastrophizing. Future prospective longitudinal studies are needed to identify possible additional variables explaining PRD, establish causality and the potential benefits of addressing these variables in interventions in primary care.