Archives of disease in childhood
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To evaluate the epidemiology of infectious meningitis in children in a Lyme borreliosis (LB) endemic area, and to study how clinical and laboratory characteristics may distinguish between different types of childhood meningitis. ⋯ LM was diagnosed in two-thirds of children with infectious meningitis in this LB endemic area. Distinct clinical characteristics distinguished the majority of children with LM from children with non-Lyme aseptic meningitis and bacterial meningitis.
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Hypertensive crisis is categorised into hypertensive urgency and hypertensive emergency. The present work aimed to determine the effect of different gradings of blood pressure (BP) ratios in predicting the severity of paediatric hypertensive crisis. ⋯ dDBP and dSBP ratios may serve as BP parameters in predicting the severity of paediatric hypertensive crisis. A dSBP ratio greater than 20% may indicate a critical point for severe hypertensive crisis in children.
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Paediatric intensive care (PIC) services have been centralised to a significant extent in Britain in the past two decades. As part of centralisation, PIC retrieval teams were developed to transport critically ill children from district general hospitals to regional paediatric intensive care units. This review aims to summarise the current state of retrieval in Britain, with reference to the past and possible directions for the future. While significant progress has been achieved, and PIC retrieval has now become a clinical service in its own right, the coming years present unique opportunities as well as challenges for the specialty.
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Encephalitis is an uncommon but potentially devastating neurological syndrome with different aetiologies including direct central nervous system infection with different agents (most commonly viral) and those mediated by the immune system. Whilst there have been several recent publications and guidelines on the management of bacterial central nervous system infections in adults and children, viral infections have been relatively neglected. ⋯ For these reasons, we have reviewed the literature on encephalitis and have formulated a suggested management strategy for children with suspected, clinically diagnosed and proven encephalitis. We have excluded neonates, as encephalitis in this age group has different clinical features and is beyond the scope of this review.