Acta paediatrica
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Knowledge of the spectrum and frequencies of pediatric emergencies presenting to an emergency department (ED) of individual developing countries is vital in optimizing the quality of care delivered locally. ⋯ A wide spectrum of paediatric illnesses was seen in the ED, with an overrepresentation of young children. This supports the decision to have either a separate pediatric ED or paediatric residents on the staff. The training curricula should emphasize the management of pediatric trauma, infections and asthma. Alternatively, developing guidelines for the five most common presenting complaints would account for 82% of all attendees and could be directed towards all staff on the ED.
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Clinical Trial
Conscious or deep sedation: a questionnaire regarding the experience of parents, children and staff during small bowel biopsy.
The paediatric clinics of Linköping and Norrköping, Sweden, have different procedures regarding premedication and sedation during small bowel biopsy in children with suspected or diagnosed coeliac disease. In Linköping deep sedation using intravenous propofol is the method of sedation being used and parents are not present during the biopsy procedure. In Norrköping conscious sedation using intravenous midazolam is the routine and parents stay with their child throughout the whole biopsy procedure. The aim of this study was to find out whether the preprocedural and procedural differences between the clinics affected the way in which the parents and children experienced the time before and during the biopsy procedure. ⋯ The children undergoing small bowel biopsy and their parents felt well taken care of during their visit to the two hospitals. The differences between the clinics regarding method of sedation and presence or absence of the parents did not seem to affect how the parents and children experienced the biopsy procedure.
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Instrumental dead space (iDS) is a major part of total dead space in newborns, and thus significantly determines effective alveolar ventilation. Continuous tracheal gas insufflation (CTGI) is a method for reducing the role of iDS, allowing a reduction in respiratory support and secondary lung injury. The literature and authors' experience with the method are reviewed. Major attention is paid to the risks in providing CTGI, optimal equipment and optimal management of CTGI.
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Some of the complex factors that can affect growth in weight but especially in height are discussed. It is emphasized that although due attention needs to be paid to diet and the regular provision of the extra macro- and micro-nutrients needed during catch-up growth, other considerations are just as important. ⋯ As well as dealing with the problem of poor sanitation and consequent frequent infection in developing countries, social stimulation and the restoration of a feeling of well-being and general happiness can be just as important.
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Case Reports
Incidence of hyponatraemia and hyponatraemic seizures in severe respiratory syncytial virus bronchiolitis.
To document the incidence and early evolution of hyponatraemia (serum sodium < 136 mmol l(-1)) associated with respiratory syncytial virus (RSV) bronchiolitis in infants requiring intensive care. ⋯ Hyponatraemia is common among infants with RSV bronchiolitis presenting to intensive care. Neurological complications may occur and fluid therapy in vulnerable infants should be tailored to reduce this risk.