Archives of disease in childhood
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Each winter seasonal respiratory virus infections account for large variations in unplanned admission to UK paediatric intensive care units (PICU). The emergence of pandemic influenza A(H1N1) has been associated with a notable predominance in children and may be expected to have a significant impact on PICU provision. ⋯ Contingency measures for children needing paediatric intensive care are needed to absorb the likely increase in activity expected due to pandemic influenza this winter. Because of variations in provision by region, the role of paediatric retrieval services will be especially important.
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Review
Which clinical features distinguish inflicted from non-inflicted brain injury? A systematic review.
A systematic review of the scientific literature to define clinical indicators distinguishing inflicted (iBI) from non-inflicted brain injury (niBI). ⋯ This systematic review shows that apnoea and retinal haemorrhage have a high odds ratio for association with iBI. This review identifies key features that should be recorded in the assessment of children where iBI is suspected and may help clinicians to define the likelihood of iBI.
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Comparative Study
How well do vital signs identify children with serious infections in paediatric emergency care?
To determine whether vital signs identify children with serious infections, and to compare their diagnostic value with that of the Manchester triage score (MTS) and National Institute for Health and Clinical Excellence (NICE) traffic light system of clinical risk factors. ⋯ A combination of vital signs can be used to differentiate children with serious infections from those with less serious infections in a paediatric assessment unit and has comparable sensitivity to more complicated triage systems. The diagnostic value of combined vital signs and the NICE traffic light system remains to be determined in populations where the prevalence of severe illness is much lower.
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To understand more about the problems children with chronic fatigue syndrome (CFS) or myalgic encephalopathy (ME) experience with memory and attention, and to test the feasibility of quantitative measurement of both memory and attention. ⋯ Children with CFS/ME appear to experience problems with attention, which may have adverse implications for verbal memory. These cognitive problems may explain some of the educational difficulties associated with CFS.
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This study aims to provide a better understanding of the motivations and actions of parents of children with non-urgent injury or illness who attend the emergency department at a tertiary paediatric hospital seeking care. ⋯ This study displayed the accuracy of "parental triage," that is, parents assess their child's health and generally engage in appropriate care-giving and care-seeking behaviours before presenting to a paediatric emergency department. Highlighted are the deficiencies in current primary care services available to families and the perception that not all cases deemed as non-urgent by the emergency department are able to be dealt with in a primary care setting.