Archives of disease in childhood
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Case Reports
20 mm lithium button battery causing an oesophageal perforation in a toddler: lessons in diagnosis and treatment.
Swallowed button batteries (BB) which remain lodged in the oesophagus are at risk of serious complications, particularly in young children. The authors report a 3-year-old child, who rapidly developed an oesophageal perforation, following the ingestion of a 20-mm lithium BB which was initially mistaken for a coin. A thoracotomy and T-tube management of the perforation led to a positive outcome. BBs (20 mm) in children should be removed quickly and close observation is required as the damage initiated by the battery can lead to a significant injury within a few hours.
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To report the oral corticosteroid-sparing effect of omalizumab in children with severe asthma. ⋯ A 16-week therapeutic trial of omalizumab allowed a significant reduction in daily prednisolone dose and was associated with improvements in asthma control and quality of life in 34 children with severe asthma. Similar benefits were seen in children both above and below 12 years of age. These uncontrolled data are very encouraging. There is an urgent requirement for a multicentre randomised placebo-controlled trial of omalizumab in children with severe asthma, with reduction in oral corticosteroid dose as the primary outcome measure.
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To investigate what data are available on the National Health Service (NHS) experience of children and young people (0-24 years), and how their experience compares with that of older patients. DESIGN AND DATA SELECTION: Review of 38 national surveys undertaken or planned between 2001 and 2011, identified by the Department of Health (2010). Detailed analysis performed on the most recent completed surveys covering primary, inpatient and emergency care, and children's services. ⋯ Despite the current focus on services for young people and the importance of patients' views in improving services, the voice of under 16s is not included in most national surveys. Despite high levels of overall satisfaction, young adults report a poorer experience of care than older adults.
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Multicenter Study
Inpatient care for children with diabetes: are standards being met?
Hospital inpatient care is frequently mentioned by parents as unsatisfactory for children with diabetes. Ward staff are now less familiar with diabetes, as admissions are less common and diabetes management is more intensive. ⋯ This first audit of children's diabetes inpatient care organisation demonstrates that some standards can be achieved, but others, such as having children's nurses on every shift in EDs, lack of dietetic advice to ward staff, and liaison with the diabetes team quickly out of hours, are more challenging. Further planned audit outcomes are to produce patient and parent literature for children admitted to hospital and to refine the standards further.