Gotowe bibliografie tematyczne / Paediatrics

Gotowa bibliografia na temat „Paediatrics”

Autor: Grafiati
Data publikacji: 4 czerwca 2021
Data aktualizacji: 20 kwietnia 2024

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Artykuły w czasopismach na temat "Paediatrics"

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Sewell, Jillian R. "Paediatrics and paediatric surgery". Medical Journal of Australia 176, nr 1 (styczeń 2002): 32. http://dx.doi.org/10.5694/j.1326-5377.2002.tb04265.x.

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ElBeltagi, Mohamed N., Verna Wall i Laure Marignol. "Planning target volume (PTV) margin practice patterns in adults and paediatrics among the Paediatric Radiation Oncology Society (PROS) members: an international survey". Journal of Radiotherapy in Practice 17, nr 4 (21.06.2018): 368–72. http://dx.doi.org/10.1017/s1460396918000146.

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AbstractAimEvolving data are showing the need of considering smaller planning target volume (PTV) margin in paediatrics compared with adults treated for the same body site. This study proposed to evaluate the current patterns of practice regarding the PTV margin in paediatric patients compared with adult patients through an international survey.Materials and methodsA four-item questionnaire was created to address the PTV margins for paediatrics and adults as part of a comprehensive survey. International Paediatric Radiation Oncology Society (PROS) members were selected to partake and were contacted via email.ResultsIn total, 43 responded to the survey. The majority of the responders have written guidelines for PTV margin while the majority of those who have guidelines do not have separate guidelines for paediatrics. The implemented PTV margin for paediatric patients was in the majority 3–5 mm for the head region and 5–10 mm for the torso region and the difference from the PTV margin implemented in adults was not statistically significant.ConclusionThe majority of responders employ a series of site-specific PTV margin protocols that are applied to both adults and paediatrics, and do not take into consideration patient age or size. These results highlight the need of a separate policy for PTV margin in adults and paediatrics in every institution.
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Bell, R. A. F. "Bailliere's Clinical Paediatrics: Paediatric Gastroenterology". Archives of Disease in Childhood 74, nr 3 (1.03.1996): 275. http://dx.doi.org/10.1136/adc.74.3.275-b.

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Redman, Melody Grace, Davide Carzedda, Nicola Jay, Simon J. Clark i Marie Rogers. "Searching for the true attrition rate of UK paediatric trainees". Archives of Disease in Childhood 106, nr 9 (12.02.2021): 903–5. http://dx.doi.org/10.1136/archdischild-2020-321415.

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ObjectiveTo quantitatively analyse the number of doctors leaving the paediatric specialty training (ST) programme in the UK, to assist with evidence-based workforce planning.DesignData were sought on those leaving the UK paediatrics training programme between 2014 and 2019 from Heads of Schools of Paediatrics and Freedom of Information Act requests.SettingRetrospective data analysis.Outcome measuresOverall attrition rate, attrition rate across level of training, attrition rate across geographical area, recorded reason for leaving.ResultsAll results must be interpreted with caution due to limitations in record keeping and analysis. The annual attrition rate across all ST levels between 2014 and 2019 is estimated at 3.7%–4.2% (ie, 749–845 trainees may have left the paediatric training programme over 2014–2019). No reason for leaving was recorded for three-quarters of individuals, around 630 doctors. Of those leaving paediatrics, significantly more (χ², p=0.015) did so at ST3 (20.3%) versus the next highest training year, ST2 (13.6%).ConclusionsThis project seems to demonstrate worryingly poor record-keeping of the true attrition rate of paediatric trainees by organisations responsible for workforce planning, including Health Education England, the Royal College of Paediatrics and Child Health and individual paediatric schools across the UK. To allow evidence-based workforce planning for the benefit of UK children, it is vital that accurate records on trainees who leave the training programme are kept and shared across the UK.
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Faulkner, Bethany, i M. Begoña Delgado-Charro. "Cardiovascular Paediatric Medicines Development: Have Paediatric Investigation Plans Lost Heart?" Pharmaceutics 12, nr 12 (2.12.2020): 1176. http://dx.doi.org/10.3390/pharmaceutics12121176.

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This work aimed to establish whether paediatric needs in cardiovascular diseases have been met by paediatric investigation plans (PIPs) produced since the development of the European Union Paediatric Regulation in 2007. The European Medicines Agency repository was searched for patterns in the development of paediatric medicines in general. Next, positive PIPs related to cardiovascular diseases were scrutinized for outcomes and compared to specific paediatric cardiovascular needs. In total, 1866 PIPs were identified with 12% corresponding to decisions taken for cardiovascular medicines. However, despite this therapeutic area having the greatest number of overall PIPs, only 14% of established needs in paediatric cardiovascular diseases were addressed by PIPs with positive decisions. Further, 71.9% of PIPs with decisions in cardiovascular disease corresponded to full waivers, so the product would not be studied in paediatrics. Despite the progress found in overall numbers of PIPs published, cardiovascular products are still commonly used off-label in paediatrics. Particularly, there is a need to develop products to treat heart failure and hypertension, two areas with clear unmet clinical needs in paediatrics. A case study on valsartan showed that industry, regulators, health technology assessment bodies, and prescribers should work together to reduce off-label use of paediatric cardiovascular diseases (CVD).
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Abdullah, Siti Nazira, Juani Hayyan Abdul Karaf, Vijayaprakash Rao A/L Ramanna, Najah Momin i Irfan Mohamad. "Parapharyngeal lipoma mimicking parotid tumour in a 4-year-old boy". Pediatria i Medycyna Rodzinna 17, nr 1 (5.03.2021): 72–76. http://dx.doi.org/10.15557/pimr.2021.0012.

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Parapharyngeal space tumour is rare in paediatrics. It can either be a primary tumour arising from parapharyngeal space structures, an extension from the surrounding structures or a metastatic tumour. In adults, salivary gland tumours and paragangliomas are common, while neurogenic tumours predominate in paediatrics. The delicate anatomy in the parapharyngeal space makes the diagnostic procedures more complex, especially in paediatrics. Although tissue biopsy can be obtained under sedation or local anaesthesia, it is histologically difficult to differentiate lipoma from liposarcoma. We present a paediatric case with a large parapharyngeal space mass in a 4-year-old boy and the management used.
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Kinsella, Anna. "4 Development of a workbook to guide pre-registration pharmacists through paediatric pharmacy training". Archives of Disease in Childhood 103, nr 2 (19.01.2018): e2.34-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.4.

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AimTo improve pre-registration pharmacist training and enthuse students in the area of paediatrics, within a teaching hospital.BackgroundThe pre-registration pharmacist training programme within the hospital allocates each student two weeks within paediatrics, which in the past has been poorly structured. During this time, the pre-registration pharmacist spent time shadowing pharmacists and accompanying them on ward visits. On occasions it was not always possible for the pre-registration pharmacist to accompany a pharmacist. In addition, some key paediatric medical conditions did not always present during their two weeks.MethodTo facilitate a more comprehensive training package a workbook, specific to paediatric clinical pharmacy was created. The booklet also contains brief introductory information about the wards and paediatric pharmacists, aims and objectives, and a reading list. The workbook is intended to be used as a ‘self-directed learning tool’, identifying clinical areas that the pre-registration student is expected to have a basic knowledge about, to help them prepare them for their exam and to give a good basic grounding in paediatrics. Different learning methods are used throughout the booklet to aid learning.The workbook includes, all with a paediatric perspective, common illnesses, immunisation, drug history taking, counselling children/parents, role of different members of the multi-disciplinary team, paediatric reference sources, calculations, renal function, pharmacokinetics in children, fluid prescriptions, use of unlicensed medicines in children, suitability of formulations, neonatal pharmacy and total parenteral nutrition.The students were briefed about the booklet at the start of their two weeks in paediatrics, and a discussion about progress at midway and at the end.Feedback was requested from each student (n=15), with a view to improving the booklet and enhancing their time spent within paediatric pharmacy.During the two weeks the students spent time in ‘general paediatrics’ and with specialist pharmacists, in tertiary paediatric services, experiencing the more complex pharmaceutical needs of these patients and the role of the specialist pharmacist.ResultsFeedback was received from eight students (53%). All of them had enjoyed the placement, found the booklet helpful in directing their learning and using their time productively, when they were unable to accompany a pharmacist. Of those who responded, all commented that the booklet was a novel idea not used within other clinical areas within the Trust, and that it should be considered to enhance training. In addition, the paediatric pharmacists agreed unanimously that the booklet has been an asset in assisting the training of the students.ConclusionThe development of a workbook, to enhance the training of pre-registration pharmacists in the clinical area of paediatrics, has been very well received by the students and pharmacists. In response to feedback, it is being further developed and may be used as template for use in other clinical areas within the Trust.
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Robertson, Eden G., Jennifer Cohen, Christina Signorelli, David M. Grant, Joanna E. Fardell i Claire E. Wakefield. "What instruments should we use to assess paediatric decision-making interventions? A narrative review". Journal of Child Health Care 24, nr 3 (26.08.2019): 458–72. http://dx.doi.org/10.1177/1367493519869717.

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There is an increasing number of shared decision-making (SDM) interventions in paediatrics. However, there is little consensus as to the best instruments to assess the feasibility and impact of these interventions. This narrative review aims to answer: (1) what feasibility, knowledge and decision-making instruments have been used to assess paediatric SDM interventions and (2) what are the psychometric properties of used decision-making instruments, guided by the ‘consensus-based standards for the selection of health measurement instrument’ criteria. We conducted a review of the peer-reviewed literature. We identified 23 studies that evaluated a paediatric intervention to facilitate SDM for a specific health decision. Eighteen studies assessed intervention feasibility, with a wide variability in assessment between studies. Twelve studies assessed objective knowledge, and four studies assessed subjective knowledge with all but one study aggregating correct responses. We identified nine decision-making instruments that had been assessed psychometrically, although few had been thoroughly evaluated. The Decisional Conflict Scale was the most commonly-used instrument and the only instrument evaluated in paediatrics. Our study revealed a lack of consistency in the instruments used to evaluate decision-making interventions in paediatrics, making it difficult to compare interventions. We provide several recommendations for researchers to improve the assessment of SDM interventions in paediatrics.
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Brännström, Inger. "Publishing ethics in paediatric research: A cross-cultural comparative review". Nursing Ethics 19, nr 2 (marzec 2012): 268–78. http://dx.doi.org/10.1177/0969733011419242.

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The present article aims to scrutinize publishing ethics in the fields of paediatrics and paediatric nursing. Full-text readings of all original research articles in paediatrics from a high-income economy, i.e. Sweden, and from all low-income economies in Sub-Saharan Africa, were reviewed as they were indexed and stored in Web of Science for the search period from 1 January 2007 to 7 October 2009. The application of quantitative and qualitative content analysis revealed a marked discrepancy in publishing frequencies between the two contrasting economies. Authors from 16 low-income economies in Sub-Saharan Africa, with at least one article stored, were obviously closely linked to co-authorships and foreign funding sources, predominantly from Europe and the USA. Statements concerning conflicts of interest were frequently missing (both regions), even when multiple financial sources, including companies, were involved. It is necessary to be aware of possible systematic bias when using electronic databases to search for certain topics and regions. Further research regarding publishing ethics in paediatrics and paediatric nursing is emphasized.
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Holland, Andrew J. A., Daniel T. Cass i John Pitkin. "Updates in medicine: paediatrics and paediatric surgery". Medical Journal of Australia 176, nr 7 (kwiecień 2002): 352–53. http://dx.doi.org/10.5694/j.1326-5377.2002.tb04442.x.

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Rozprawy doktorskie na temat "Paediatrics"

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Sylvester, Dianne. "Genes underpinning predisposition to childhood cancer". Thesis, The University of Sydney, 2020. https://hdl.handle.net/2123/22458.

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The genetic changes underpinning cancer predisposition in children are not clearly defined and warrant further research, as identification of a genetic contribution to a patient’s disease can be beneficial for patients and their families. With technological advances, it is now possible to discover a broad spectrum of genetic changes implicated in cancer predisposition by sequencing the genome. An analytical review of six publications utilising germline genome sequencing in paediatric oncology found that these studies differed in the selected childhood cancer diagnoses and the genes considered for interpretation, resulting in differences in the proportions of childhood cancer patients that were reported to carry clinically relevant pathogenic germline variants. In this study, childhood cancer patients that presented with phenotypes indicative of a genetic susceptibility to cancer, such as multiple cancer diagnoses, a family history of cancer and/or a genetic diagnosis, underwent germline exome sequencing. Sequencing data were analysed for rare germline variants in over 1000 cancer predisposition, cancer associated and DNA repair genes, that were predicted to cause a loss of function or to be deleterious. Almost one quarter of childhood cancer patients with features suggestive of a genetic predisposition to cancer were found to carry pathogenic or likely pathogenic germline variant/s in 12 known cancer predisposition genes. A rare variant burden analysis of 31 autosomal dominant cancer predisposition genes found that deleterious germline variants were significantly enriched in a cohort of 63 childhood cancer patients compared to a cohort of 1107 genetically matched healthy aged controls. Novel germline variants not previously associated with cancer predisposition were also detected in 10 genes in 16 childhood cancer patients. This study has expanded our understanding of cancer predisposition in children, by discovering the diagnostic potential of sequencing patients with defined phenotypic features, and by linking pathogenic or likely pathogenic germline variants in known predisposition genes with new cancer diagnoses. Ultimately, by combining the analysis of family pedigrees with functional gene studies and data-sharing, the significance of novel germline variants associated with the onset of cancer in childhood will be established. As more childhood cancer predisposition genes are identified and characterised, screening processes may be more routinely incorporated into paediatric clinical care.
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Star, Kristina. "Safety of Medication in Paediatrics". Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197323.

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Background: In paediatrics, the limited documentation to guide medication, the lack of suitable dosage forms, and the continuous development in childhood present a scenario where safety of medication is a particular challenge. Aim: To explore reported adverse drug reactions (ADRs) and the challenges in prescribing and administering medicines in paediatrics, in order to identify and suggest areas needing international surveillance within medication safety and improvement in the clinical setting. Methods: Four exploratory studies were conducted. Worldwide reporting of suspected ADRs (individual case safety reports, ICSR) with ages 0-17 years were examined overall. Twenty published case reports and ICSRs for adolescents, who developed a rare and incompletely documented ADR (rhabdomyolysis) during antipsychotic medicine use, were analysed in-depth. Prescribed doses of anti-inflammatory medicines were studied in a UK electronic health record database. Transcribed focus group interviews with 20 registered nurses from four paediatric wards in Sweden were analysed for factors that may promote or hinder safe medication practices. Descriptive statistics, multiple regression, and content analyses were used. Results: Although, skin reactions and anti-infective medicines were most frequently reported, and more reported in paediatric patients than in adults, medication errors and adverse reactions related to psychostimulant medicines were reported with increased frequency during 2005 to February 2010. The in-depth case analysis emphasised the need for increased vigilance following changes in patients’ medicine regimens, and indicated that ICSRs could contribute with clinically valuable information. Prescribed dose variations were associated with type of dosage form. Tablets and capsules were prescribed with a higher dose than liquid dosage forms. Six themes emerged from the interviews: preparation and administration was complex; medication errors caused considerable psychological burden; support from nurse colleagues was highly valued; unfamiliar medication was challenging; clear dose instructions were important; nurses handling medications needed to be accorded higher priority. Conclusions: Age-specific screening of ICSRs and the use of ICSRs to enhance knowledge of ADRs and medication errors need to be developed. Access to age-appropriate dosage forms is important when prescribing medicines to children. To improve medication safety practices in paediatric care, interdisciplinary collaborations across hospitals on national or even global levels are needed.
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Boss, Patricia M., i res cand@acu edu au. "Indicators of Satisfaction & Success For a Paediatric Outreach Nursing Service in Metropolitan Sydney, NSW". Australian Catholic University. School of Nursing, 2005. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp118.25102006.

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The purpose of this study was to determine the indicators of customer satisfaction and service success of a newly established paediatric outreach nursing service. Referring agents and care recipients were both consumers of the paediatric outreach nursing service. Both groups of consumers were surveyed to determine their satisfaction with the service delivery. Two satisfaction survey tools were developed to measure customer satisfaction. The tools were piloted and refined prior to distributing them. Both tools had a series of closed-ended questions and 3 open-ended questions. Eight service indicators were developed. These were designed to test the effectiveness of the service provided. The service indicators were piloted over two periods of three months and then modified based on the findings of the pilot period. The Paediatric Outreach Service (POS) is a positive service model for health care delivery. The survey results indicated that stakeholders were generally satisfied with the service delivery. When measured against service indicators that were developed for POS, the service performance was above average, with some opportunity to improve practice. Underpinned by a family-centered framework, POS has the capacity to empower children and their families in the planning and implementation of a management plan for the child’s illness. Such empowerment may lead families to practice better healthcare, develop better health-seeking practices and ultimately lead to healthier children. The results from this study has implications for nursing practice. The data obtained from this study may be useful to service providers considering commencing a paediatric outreach nursing service. Data may also be useful for existing service providers to use in order to review the aspects that consumers value against the service they currently provide. Keywords ambulatory care; paediatrics; home-nursing; community; evaluation; satisfaction; success; indicators
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Moore, Ryan. "International Normalised Ratio Monitoring in Children: Comparing the accuracy of portable point-of-care monitors to standard of care laboratory monitoring at Red Cross War Memorial Children's Hospital". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32880.

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Background. There is an increasing trend in the use of long-term oral anticoagulation therapy in children. Monitoring the international normalised ratio (INR) is an integral part in management of these patients, but standard laboratory testing of the INR presents challenges in this age group. Point-of-care INR monitors such as the Mission® PT/INR monitor provide advantages in efficiency and accessibility but have not been evaluated for accuracy in the South African paediatric setting. Objectives. This is a feasibility study with the aim to evaluate the accuracy of the Mission® PT/INR Monitor in comparison to standard laboratory INR measurement, in children presenting for INR testing. Methods. We compared the accuracy of the Mission® PT/INR monitor to the Sysmex Cs2100i laboratory analyser in 37 children aged between 1 year and 17 years, who presented for INR testing. The sample size was limited due to time constraints. 40 paired POC INR and laboratory INR values were obtained. Results. The majority of participants in the study were outpatients (62%) and required INR testing as part of screening in non-cardiac disease (81%) - the majority had chronic liver disease, and a minority were on warfarin therapy (13.5%). The mean INR value on the Mission® PT/INR was 1.49 (standard deviation (SD) 0.73) and was comparable to the Sysmex Cs-2100i (mean INR value 1.39 with SD 0.69). The Bland-Altman difference plot revealed good agreement. Bias between the two methods was 0.13 (SD 0.23). In total, 92.5% of POC INR values were within 0.5 units of laboratory INR value. Conclusion. The Mission® PT/INR point-of-care monitor has a clinically acceptable level of accuracy in children when compared with laboratory INR measurement, but larger studies are needed in the paediatric setting to evaluate patient safety and clinical outcomes. There is a need for implementing POC INR monitoring in outpatient settings but this practice will require robust assessment of infrastructure and quality control before application.
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Naidoo, Nayestha. "Neonatal Sepsis And Antibiotic Sensitivity Patterns At A South African Tertiary Nursery – Evolution Over A 15 Year Period". Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31063.

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Background Neonatal infection is an important cause of morbidity and mortality in babies. The causative pathogens and their antibiotic susceptibility patterns should be monitored so that treatment regimens can be adjusted to maintain efficacy and avoid selection of resistant organisms. Objectives To compare the incidence of culture positive neonatal sepsis; and to describe the pathogens and antibiotic resistance profiles for significant organsims over a 15-year period in a tertiary nursery in Cape Town. Methods Retrospective blood culture data for 12 months were collected at three time points over a 15-year period. Blood cultures from 2004, 2013 and 2017 were analysed. All neonates with growth on blood cultures were included. Results During 2004 a total of 817 (43.3% of total admissions) blood cultures were taken, 171 (9.1% of total admissions) were culture positive. The most common invasive organisms were Klebsiella pneumoniae (31.8% of invasive organisms), S.aureus (26.1%) and enterococcus species (7.3%). There were 102 contaminants (12.5% of total cultures) of which 7.8% were due to Coagulase-negative Staphylococcus (CONS). In 2013 a total of 1070 (46.8% of total admissions) blood cultures were taken, 124 (5.4% of total admissions) were culture positive. Common invasive organisms were Klebsiella pneumoniae (53.8% of invasive organisms), E. coli (12.8%) and S. aureus (10.3% ). Forty-six blood cultures were deemed contaminated (4.3% of all cultures) and of these 2.1% were due to CONS. In 2017, there were 581 blood cultures taken (26.5% of total admissions), 56 were culture positive (2.6% of total admissions). Commonly occuring invasive organisms were Klebsiella pneumoniae (32.4% of invasive organisms), Group B streptococcus (16.2%) and Acinetobacter (13.5%). Twenty-nine blood cultures were considered contaminated (5.6% of cultures) of which 1.7% were CONS. The gram-negative organisms showed an increasing resistance to penicillin, ampicillin and aminoglycosides but remained sensitive to carbapenems. Conclusions The initial reduction in positive blood cultures from 2004 to 2013 was primarily due to the reduction of contaminants, probably reflecting improved blood sampling techniques. The large reduction in Gram-negative organisms from 2013 to 2017 suggests improved infection control measures , but gram-negative organisms remained prominent in all three cohorts. Emergence of resistant organisms is concerning and in keeping with other nurseries worldwide. These data illustrate the need for antibiotic stewardship, infection control measures and ongoing surveillance.
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Lupton-Smith, Alison Rosalie. "An investigation into regional ventilation in infants and children; its distribution and determinants". Doctoral thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/24911.

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Changing body position is commonly used in the management of individuals with respiratory diseases and those receiving mechanical ventilation, in order to optimise ventilation and oxygenation. In acute respiratory distress syndrome (ARDS), prone positioning is reported to improve oxygenation by recruiting collapsed dorsal lung regions, although this has not been confirmed in children. Ventilation distribution is well established in adults as being gravity dependent. Clinical practice in the paediatric population has been guided by the notion that all children, irrespective of the presence or absence of disease and age, consistently demonstrate the opposite ventilation distribution pattern to adults and this pattern is said to occur until the second decade of life. Studies in the paediatric population are limited to a few reported from the 1980's, on very heterogeneous populations. With advances in technology, new methods of examining regional ventilation, such as electrical impedance tomography (EIT), have become available. Recent neonatal studies using EIT have reported a dissimilar ventilation distribution to the conventional paediatric pattern. Despite a growing number of studies examining the effects of various interventions on ventilation distribution, very few exist in infants and children older than 6 months of age. Furthermore, differing methodologies and the manner in which ventilation distribution is described and analysed makes pooling the available data in the paediatric population extremely difficult. An understanding of how ventilation is distributed under normal conditions is imperative when examining the effects of different interventions and medical conditions on ventilation distribution. This thesis aimed to describe the effects of body position, head position, age, and respiratory muscle activity on ventilation distribution in children between six months and nine years of age under normal conditions, with respiratory disease, neuromuscular disease, and during mechanical ventilation. Furthermore, the effect on ventilation distribution of prone positioning in children with ARDS was evaluated. Regional ventilation distribution was measured using thoracic EIT and respiratory muscle activity was measured using surface electromyography (sEMG) using standardised methodology. Results of a series of sub-studies indicate that ventilation distribution is more complex and variable than previously thought, with no standard "paediatric pattern" of ventilation. Overall, greater ventilation occurred in the right and dorsal lungs, respectively, in different positons. Head position did not affect regional ventilation in the children studied. Age had a variable effect on ventilation distribution, with healthy children under 12 months of age more likely to follow the paediatric pattern, particularly in side lying positions; however the response was not uniform. The presence of mechanical ventilation, disease state and respiratory muscle activity did not affect ventilation distribution with these children also showing variable patterns of regional ventilation distribution. Data suggests that turning children with ARDS into the prone position does not result in recruitment of the dorsal lung regions, but rather more homogenous ventilation throughout the lungs. Furthermore, results suggest that children with greater ventilation inhomogeneity at baseline are more likely to respond positively (improvement in oxygenation index) to prone positioning. This research provides novel insights into ventilation distribution and respiratory muscle activity in infants and children older than six months of age under a number of different conditions. These results contribute to a better understanding of the factors influencing the distribution of regional ventilation and the mechanisms by which prone positioning in ARDS may improve oxygenation in this population. These findings have potentially important clinical implications, as well as providing baseline data for future clinical studies. Given the variability observed, these studies highlight the potential clinical utility of EIT to monitor different interventions and outcomes. An important strength of the studies presented in this thesis, is that they were performed in a standardised manner, using relatively homogenous individual populations and validated measures of describing ventilation distribution. This methodology could provide a template for future studies in the paediatric population, to allow for comparison between studies.
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Githinji, Leah Nyawira. "Lung function in perinatally HIV-infected adolescents on antiretroviral therapy in Cape Town, South Africa". Doctoral thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31387.

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Background: Lung disease is a common complication of human immunodeficiency virus (HIV) infection in children and adolescents. As antiretroviral programmes have strengthened and HIV diagnosed earlier, survival of perinatally HIV-infected children has improved. Therefore, an increasing number of perinatally HIV-infected children are surviving into adolescence, with development of chronic multisystem disease including chronic lung disease (CLD). However, there is limited information on the determinants, spectrum and progression of lung disease. Lung function testing, an objective, non-invasive, reproducible tool, is useful in characterising CLD and in monitoring disease progression. Aim: To investigate the spectrum, determinants and progression of lung function in perinatally HIV-infected adolescents on antiretroviral therapy (ART) in Cape Town, South Africa. Specific objectives included describing the spectrum and determinants of lung function; investigating cardiopulmonary dysfunction and investigating progression of lung function over two years. Methods: The study population was from a prospective cohort, the Cape Town Adolescent Anti-retroviral cohort (CTAAC), that enrolled 515 perinatally HIV-infected adolescents on ART and 110 age-matched HIV-uninfected adolescents followed six-monthly for two years in Cape Town, South Africa. Eligibility criteria were adolescents, aged 9-14 years, with perinatally acquired HIV, who had been on ART for at least six months. Comprehensive lung function testing was done, and clinical and lung function data collected at baseline, 12 and 24 months. Results: At baseline, HIV-infected adolescents had lower forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, diffusing capacity for carbon monoxide, respiratory system compliance and functional residual capacity; and higher airway resistance and lung clearance index compared to HIV-uninfected adolescents, p< 0.05 for all. At 24 months, FEV1 and FVC remained lower in the HIV-infected compared to the uninfected, p< 0.05 for both. Impaired cardiopulmonary function was detected in 13% of HIV-infected adolescents and 8% of HIV-uninfected adolescents, p=0.136. Past PTB was significantly associated with a low cardiopulmonary function, OR 2.3, 95%CI 1.2-4.4. Conclusion: Perinatally HIV-infected adolescents had lower lung function and higher resistance and ventilation inhomogeneity compared to age-matched HIV-uninfected adolescents at baseline. Lung function tracked, remaining lower at two years. Previous PTB or severe LRTI were predictors of lower lung function. Co-existent cardiopulmonary dysfunction occurred in a minority. These data highlight respiratory disease risk in this vulnerable group and may inform policy to strengthen strategies to prevent and manage HIV-associated lung or cardiopulmonary disease. Four of the chapters (2-5) of this thesis are presented as published manuscripts. Chapter 1 encompasses an overview of the burden of HIV disease and the spectrum of HIV associated chronic lung disease in adolescents and the utility of lung function in the diagnosis of chronic lung disease. Study methodology is also detailed in this chapter. Chapter 2 (published manuscript) comprises a comprehensive review of published data on lung function (over and above the literature included in the individual papers) in HIV infected children and adolescents and summarises studies that have been done in Africa, USA, Europe and Asia. Chapter 3 (published manuscript) describes the spectrum and determinants of comprehensive lung function parameters (flow, volume, compliance, resistance, ventilation inhomogeneity) in perinatally HIV-infected adolescents with a comparator group of age-matched HIV-uninfected adolescents. Chapter 4 (published manuscript) further explores the prevalence and determinants of coexistent cardiopulmonary dysfunction in perinatally HIV-infected adolescents on ART. Chapter 5 (published manuscript) describes the progressive changes in spirometry over two years in perinatally HIV-infected adolescents compared to HIV-uninfected age matched controls. It also addresses the associations of low lung function, factors amenable to public health interventions. Chapter 6 is a summary of the study findings and recommendations.
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Horn, Alan Richard. "Early prediction of hypoxic ischaemic encephalopathy in newborn infants in a resource-limited setting". Doctoral thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/11188.

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Hypoxic ischaemic encephalopathy (HIE) after birth is an important cause of neonatal morbidity and mortality, particularly in resource-limited regions. Therapeutic hypothermia initiated within the first 6 hours of life, in settings that can offer neonatal intensive care, is a therapy that can reduce death or severe disability in newborn infants with moderate or severe HIE. Therapeutic hypothermia has not been shown to be safe or effective in low-resource settings where neonatal intensive care is not available; however, there are situations such as in some centres in South Africa, where limited neonatal intensive care (NICU) is available against a background of moderate neonatal mortality rates, relatively low socio-economic conditions and limited capacity for long-term follow-up. In such settings, accurate case definition and early prediction of HIE and outcome may assist with the appropriate allocation of resources. The amplitude-integrated electro-encephalogram (aEEG) is an ideal tool to use for prediction of outcome and the need for cooling, but it’s availability is limited, particularly at primary and secondary hospitals.
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Thompson, Mary Clare. "Neurodevelopmental outcome of the high risk infant in Cape Town". Doctoral thesis, University of Cape Town, 2000. http://hdl.handle.net/11427/25807.

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The outcome of high risk infants provides an important audit of neonatal care. This audit renders valuable information to clinicians, parents and health care planners. Available outcome data from the developing world are sparse and urgently needed. This work was compiled with three aims in mind: to provide data from Cape Town on outcome of high risk infants (including both infants of very low birthweight and infants who have survived hypoxic ischaemic encephalopathy); to evaluate selected early neurodevelopmental assessments of these infants; and to propose a protocol for their effective follow-up. Three separate cohorts were selected and studied in order to achieve these aims. A prospective six-year follow-up study of infants with birth weights less than 1250 g was undertaken at Groote Schuur Hospital's Neonatal Intensive Care Unit. The aim of the study was to document the morbidity, mortality and neurodevelopmental outcome of these infants. Of 235 liveborn infants, 143 (61 %) survived to discharge. Better survival was documented for infants who weighed more than 900 g and were over 30 weeks gestation and whose mothers attended antenatal care. One hundred and six infants (83% of survivors) underwent clinical assessment at one year of age and were evaluated with the Griffiths Scales of Mental Development. Ninety six (91 %) of these survivors were seen and tested at two years of age and 80 (76%) were seen at six years of age together with 70 matched controls who had normal birthweights. Of the 106 infants assessed at one year of age, six infants were diagnosed as cerebral palsied, six were globally developmentally delayed without signs of cerebral palsy and one infant showed significant motor delay with a normal developmental quotient. At two years of age one further infant had cerebral palsy and nine more infants were developmentally delayed. At six years of age five infants had cerebral palsy, one was intellectually disabled and three were intellectually borderline. The major disability rate at one year of age was 11%, at two years of age was 22% and at six years of age was eight percent. The incidence of low birthweight children with possible learning disability was three times that of their matched controls and overall, the low birthweight children scored significantly less in all developmental measures. Forty-five infants who developed hypoxic ischaemic encephalopathy after birth were studied prospectively. A numeric scoring system for the assessment of hypoxic ischaemic encephalopathy during the neonatal period which had previously been developed at Groote Schuur Hospital was tested. The value of the score in predicting neurodevelopmental outcome at one year of age was assessed. Thirty five infants were evaluated at 12 months of age by full neurological examination and the Griffiths Scales of Mental Development. Five infants were assessed at an earlier stage, 4 who died before 6 months of age and one infant who was hospitalised at the time of the 12-month assessment. Twenty three (58%) of the infants were normal, 17 (42%) were abnormal, 16 with cerebral palsy and one with developmental delay. 25 infants were re-evaluated at 3 years of age. 15 of these 25 had been normal at one year of age and were evaluated with ten controls who had had an uneventful perinatal course. The Hypoxic lschaemic Encephalopathy Score was highly predictive for outcome. The best correlation with outcome was a combination of the peak score and evaluation on day seven; giving a positive predictive value of 92% and a negative predictive value of 100% for abnormal outcome, with a sensitivity of 100% and specificity of 93%. At three years of age the HIE survivors without cerebral palsy scored as well as their matched controls on Griffiths developmental evaluation. In these normal survivors no correlation between severity of HIE and developmental quotient was demonstrated. Infants with neurodevelopmental abnormality need to start therapy early and because of this, should be detected as soon as possible. Currently, no widely accepted method of early evaluation exists. A Perinatal Risk Rating, the Dubowitz Neurological Assessment and the Infant Neuromotor Assessment were compared in terms of predicting neurodevelopmental outcome at one year of age. A cohort of 130 consecutive neonatal intensive care unit graduates were selected according to high risk criteria. Each infant was examined at term gestational age on the Dubowitz Neurological Assessment and a Perinatal Risk Rating was allocated. The study infants were seen again at 18 weeks corrected age, when an Infant Neuromotor Assessment was done, and at one year of age the Griffiths Scales of Mental Developmental and full neurological examination were carried out. Of the 130 infants assessed at term, all were seen at 18 weeks. Thereafter five were lost to follow-up and two died. The outcome of all the remaining 123 infants is known. Prediction of a normal outcome at 1 year of age on the Dubowitz Neurological Assessment was 96% and for the Perinatal Risk Rating, 98%, but for an abnormal outcome they predicted only 56% and 42% respectively. The Infant Neurological Assessment at 18 weeks of age predicted a normal outcome at one year in 99% and an abnormal outcome in 82%. Very low birthweight infants are at higher risk for cerebral palsy and intellectual disability. In Groote Schuur Hospital, at six years of age, the major disability rate for infants with birthweights less than 1250 g was eight percent. Forty percent of term infants who survived hypoxic ischaemic encephalopathy had cerebral palsy with associated intellectual disability. The use of the Perinatal Risk Rating is appropriate in newborn facilities where cranial ultrasound is available. Otherwise the Dubowitz Neurological Assessment is an appropriate screening tool in the newborn period. Use of the Hypoxic Ischaemic Encephalopathy Score is recommended for clinical evaluation, prognostication and risk rating. It is proposed that high risk infants should be evaluated at 18 weeks corrected age with the Infant Neuromotor Assessment at a tertiary centre. If this assessment is normal, the infant can then be discharged to community clinic follow-up. Infants with more than one deviant sign at this age need continued review and those with more than three signs should be referred for neurodevelopmental therapy to a comprehensive neurodevelopmental clinic. Even those high-risk infants whose assessments are normal should be enrolled in a pre-school centre at five years of age to facilitate detection of learning problems prior to school entry.
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Gray, Claudia Liesel. "The prevalence and patterns of IgE-mediated food allergy and sensitisation in South African children with atopic dermatitis". Doctoral thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/12874.

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Background: The prevalence of food allergy in South Africa is unknown, but previously thought to be low, particularly in black South Africans. We hypothesised that food allergies would be low in Xhosa patients, even those at increased risk of food allergy such as children with atopic dermatitis (AD). This study aimed to determine the prevalence of, patterns and risk factors for, IgE-mediated food allergy in South African children with moderate to severe AD. It is the first food allergy prevalence study in South Africa to utilise controlled food challenges and component analysis, and is unique for its comparison of food allergy patterns between ethnic groups in the same geographical area. Methodology: This was a prospective, observational study in a paediatric university hospital in Cape Town. Children with moderate to severe AD, aged 6 months to 10 years, were randomly recruited from the dermatology clinic. They were assessed for sensitisation and allergy by questionnaire, skin prick tests (SPT), Immuno Solid Phase Allergen Chip (ISAC) test and incremental food challenges. Sensitised patients were also tested for specific IgE by ImmunoCAP test. Results: One hundred participants (59 black Africans and 41 of mixed race) were enrolled, median age 42 months. There were high overall rates of food sensitisation (66%) and food allergy (40%). Egg (25%) and peanut (24%) were the most common allergies. Black participants had comparable sensitisation (69% vs 61%) but lower allergy rates (34% vs 46%) than mixed race participants. This was especially evident for peanut allergy (15% vs 37%, p=0.01). Early onset AD (< 6 months), severe eczema, and young age < 2 years were significant risk factors for food allergy. The ISAC test was less sensitive than SPT and ImmunoCAP tests. Only 42% of cases of perceived food allergy were confirmed as true food allergy.
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Książki na temat "Paediatrics"

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Evans, A. N. W. Paediatrics. Lancaster, England: MTP Press, 1986.

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Thomas, Roslyn. Paediatrics. Edinburgh: Churchill Livingstone, 1992.

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Rose, Stephen J. Paediatrics. London: Cavendish, 2002.

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Tim, Newson, i Budd Christine, red. Paediatrics. Wyd. 2. Edinburgh: Mosby, 2004.

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Thomas, Roslyn. Paediatrics. Wyd. 2. Edinburgh: Churchill Livingstone, 1997.

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Bhakthavalsala, Shyam. Paediatrics. Wyd. 3. Edinburgh: Mosby, 2008.

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Graham, Clayden, i Hawkins Richard 1949-, red. Paediatrics. London: Heinemann Medical, 1988.

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Tim, Newson, i Pang David, red. Paediatrics. Wyd. 3. Edinburgh: Mosby, 2008.

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1983-, Barnes Katy, i Bhakthavalsala Shyam, red. Paediatrics. Wyd. 4. Edinburgh: Elsevier, 2013.

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David, Harvey, red. Paediatrics. Edinburgh: Churchill Livingstone, 1986.

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Części książek na temat "Paediatrics"

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Merrick, Malcolm V. "Paediatrics". W Essentials of Nuclear Medicine, 277–96. London: Springer London, 1998. http://dx.doi.org/10.1007/978-1-4471-0907-5_12.

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Zuker, Ronald M. "Paediatrics". W Microvascular Reconstruction, 208–17. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70329-4_29.

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Hull, D. "Paediatrics". W A Practical Guide to Medicine and the Law, 199–216. London: Springer London, 1991. http://dx.doi.org/10.1007/978-1-4471-1863-3_13.

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Duvall-Young, Josephine. "Paediatrics". W Emergency, Acute and Rapid Access Ophthalmology, 95–101. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-92369-7_9.

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Elliott, Peter G. "Paediatrics". W MRCGP, 82–96. London: Springer London, 1989. http://dx.doi.org/10.1007/978-1-4471-1710-0_5.

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Johnson-Delaney, Cathy A. "Paediatrics". W Ferret Medicine and Surgery, 421–27. Taylor & Francis Group, 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742: CRC Press, 2016. http://dx.doi.org/10.1201/9781315371504-27.

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Combeer, Elizabeth, i Mitul Patel. "Paediatrics". W The Final FRCA Constructed Response Questions, 397–447. Wyd. 2. Boca Raton: CRC Press, 2023. http://dx.doi.org/10.1201/9781003388494-17.

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Sooriakumaran, Prasanna, Channa Jayasena, Anjla Sharman i Ruth Brown. "Paediatrics". W 100 Medical Emergencies for Finals, 187–200. London: CRC Press, 2024. http://dx.doi.org/10.1201/9781846196454-14.

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Heinz, Peter. "Paediatrics". W Instant Wisdom for GPs, 109–15. Boca Raton : CRC Press/Taylor & Francis Group, [2018] |Includes bibliographical references and index.: CRC Press, 2017. http://dx.doi.org/10.1201/9781315116808-17.

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Coyle, Paula, Eishaan Bhargava, Adnan Darr, Karan Jolly, Kate Stephenson i Michael Kuo. "Paediatrics". W ENT Vivas, 75–128. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781003247098-2.

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Streszczenia konferencji na temat "Paediatrics"

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"Paediatrics". W Proceedings of UK Radiological Conference 2020. The British Institute of Radiology, 2020. http://dx.doi.org/10.1259/conf-pukrc.2020.posters-g-paediatrics.

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"Paediatrics". W Proceedings of UK Radiological Conference 2019. The British Institute of Radiology, 2019. http://dx.doi.org/10.1259/conf-pukrc.2019.posters-paediatrics.

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"Paediatrics". W Proceedings of UK Radiological Conference 2016. The British Institute of Radiology, 2016. http://dx.doi.org/10.1259/conf-pukrc.2016.paed.

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"Paediatrics". W Proceedings of UK Radiological Conference 2017. The British Institute of Radiology, 2017. http://dx.doi.org/10.1259/conf-pukrc.2017.paed.

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"Clinical: Paediatrics". W Proceedings of UK Radiological Conference 2013. The British Institute of Radiology, 2013. http://dx.doi.org/10.1259/conf-pukrc.2013.paed.

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"Clinical: Paediatrics". W Proceedings of UK Radiological Conference 2014. The British Institute of Radiology, 2014. http://dx.doi.org/10.1259/conf-pukrc.2014.paed.

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"Clinical: Paediatrics". W Proceedings of UK Radiological Conference 2015. The British Institute of Radiology, 2015. http://dx.doi.org/10.1259/conf-pukrc.2015.paed.

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"Paediatrics Poster Presentations". W Proceedings of UK Imaging and Oncology Congress Online 2022. The British Institute of Radiology, 2022. http://dx.doi.org/10.1259/conf-pukrc.2022-o-paed-poster.

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"Poster Presentations - Paediatrics". W Proceedings of UK Radiological Conference 2018. The British Institute of Radiology, 2018. http://dx.doi.org/10.1259/conf-pukrc.2018.posters-paediatrics.

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"Paediatrics poster presentations". W Proceedings of UK Imaging and Oncology Congress Online 2023. The British Institute of Radiology, 2023. http://dx.doi.org/10.1259/conf-pukrc.2023-p-paedposter.

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Raporty organizacyjne na temat "Paediatrics"

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Scott, Ann, Joanna Duncan, David Tivey i Wendy Babidge. Paediatric deep brain stimulation. The Sax Institute, październik 2019. http://dx.doi.org/10.57022/iksx3206.

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This review aimed to assess the evidence around the use of deep brain stimulation (DBS) for paediatric patients with severe dystonia. It aimed to answer the following questions: 1) Is paediatric DBS safe, efficacious and cost effective when compared with best supportive care?, 2) Is DBS more safe or more effective for some types of paediatric dystonia than others? Are there agreed patient selection criteria?, 3) What models of care and service delivery or access and funding mechanisms are established to deliver paediatric DBS internationally?. The available evidence is limited but the growing body of level IV evidence generally supports use of DBS for improving motor function and disability. More data is needed that looks as other aspects of patient wellbeing.
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Wells, Hannah, i Paul Jones. Foreskin conditions in paediatric practice. BJUI Knowledge, grudzień 2022. http://dx.doi.org/10.18591/bjuik.0629.v2.

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Trimboli, Mariele, i Paul Jones. Foreskin conditions in paediatric practice. BJUI knowledge, marzec 2024. http://dx.doi.org/10.18591/bjuik.0629.v3.

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Danzig, Matthew R., i Jonathan S. Ellison. Operative interventions for paediatric renal calculi. BJUI Knowledge, czerwiec 2022. http://dx.doi.org/10.18591/bjuik.0284.

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Ariyanayagam, Rachel, i Bobby krishnachetty. PAEDIATRIC POST-OPERATIVE NAUSEA AND VOMITING. World Federation of Societies of Anaesthesiologists, sierpień 2022. http://dx.doi.org/10.28923/atotw.479.

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This tutorial covers the physiology of vomiting, risk factors for post-operative nausea and vomiting (PONV) in children, methods of risk reduction, and both pharmacological and non-pharmacological strategies for preventing and managing paediatric PONV.
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Peñaloza, Blanca. Does paediatric home care improve health outcomes in children? SUPPORT, 2017. http://dx.doi.org/10.30846/1701133.

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Paediatric home care for ill children has been developed for different diseases and with different models as an alternative to care based in hospitals. In this summary we present evidence for home care for children with acute physical conditions, home rehabilitation for children with traumatic brain injury, and home chemotherapy.
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Prescott, Marta, Caroline Boeke, Tendai Gotora, Haurovi William Mafaune, Wadzanai Motsi, Justin Graves, Alexio Mangwiro i Elizabeth McCarthy. Integration of EPI and paediatric HIV services for improved ART initiation in Zimbabwe. International Initiative for Impact Evaluation, lipiec 2017. http://dx.doi.org/10.23846/tw708.

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Emery, Kate, Yasmine Ali Abdelhamid i Kimberley Haines. Patient and Family Engagement in Adult and Paediatric Critical Care Research: A Scoping Review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, kwiecień 2024. http://dx.doi.org/10.37766/inplasy2024.4.0036.

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Moxham-Hall, Vivienne, Anton du Toit, Sallie Newell, Stuart Brentnall, Deshanie Rawlings i Eileen Goldberg. Proton beam therapy: A rapid review of the evidence since 2020. The Sax Institute, kwiecień 2023. http://dx.doi.org/10.57022/tjvf1783.

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The purpose of the report is to conduct a rapid review of the recent evidence (since 2020) on proton beam therapy (PBT) for: paediatric cancers, central nervous system (CNS) tumours, head and neck cancer and prostate cancer. The report aims to provide a rapid summary of the current knowledge about PBT’s effectiveness, safety, and potential advantages over conventional radiation therapy. The report includes evidence that has become available subsequent to the evidence submitted in the South Australian Health and Medical Research Institute (SAHMRI)’s Medical Services Advisory Committee (MSAC) application requesting Medicare Benefits Schedule (MBS) listing of PBT for paediatric and rare cancers (MSAC Application No. 1638). In addition, the report presents data on international benchmarking of PBT facilities per million population, and with consideration to Australia’s population and numbers of people with cancers recommended for public funding for PBT by MSAC.
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Alsuwais, Sara, Alanowd Alghaith, Richard Body i Simon Carley. Prehospital Management of Paediatric Traumatic Brain Injury: Protocol for A Systematic Review of Clinical Practice Guidelines. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, marzec 2024. http://dx.doi.org/10.37766/inplasy2024.3.0015.

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