Archives of disease in childhood
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To examine trends in hospital admissions for acute throat infection (ATI) and peritonsillar abscess (PTA) alongside tonsillectomy trends in children. ⋯ ATI admission rates have increased substantially in the past decade, but the majority of children are discharged after a short stay. PTA admission rates have remained stable. This suggests the severity of throat infection has not increased. Tonsillectomy rates in England have been declining overall but do not appear to be associated with this increasing trend in ATI admissions. The increase most likely reflects changes in primary care and hospital service provision.
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We sought to determine the yield of cardiac testing and to identify predictors of cardiac disease in infants with an apparent life-threatening event (ALTE). ⋯ This longitudinal study of an ALTE cohort revealed significant cardiac disease in <1% of patients. Prematurity was the only clinical predictor identified. ECG was sensitive for identifying significant cardiac disease, but routine testing warrants further investigation because of the low PPV.
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Up to 70% of children and teenagers referred to a paediatric gastroenterology centre with suspected inflammatory bowel disease (IBD) do not have the disease. ⋯ A diagnostic strategy in general paediatric practice of using a simple clinical case definition for suspected IBD in combination with a positive faecal calprotectin result increases the specificity to detect IBD and reduces the need for referral to a paediatric gastroenterology centre with a very low risk of missing cases.