Abstract:
:Tonsillectomy is one of the commonest ENT paediatric procedures. Recovery is best achieved at home, and cost-effectiveness of the day case pathway is significant in tonsillectomy. This project scrutinised the local practice regarding the effectiveness of day case pathway in paediatric tonsillectomy in a large regional teaching hospital. The project aimed to improve the rates of day case tonsillectomy discharges, to increase compliance of postoperative care with guidelines, and to assess long-term sustainability of the new practice. The project looked prospectively at the pre-existing paediatric tonsillectomy day case practice (cycle 1) prior to implementing a multifaceted intervention. The intervention consisted of an evidence-based change to local day case tonsillectomy guidelines, improved lists' planning/management, and clinicians' education. Thereafter, the outcomes were measured in the short term (cycle 2-prospective data collection) and in the long term (cycle 3-retrospective data collection). The gathered data revealed an improvement in post-tonsillectomy day case discharge rates (both short and long term), without an increase in postoperative complications. Moreover, our intervention had effectively reduced sleep study requests and resulted in a significant increase in list profitability.Conclusion: The departmental practice in paediatric day case tonsillectomy was improved via evidence-based relaxation of day case criteria, improved list management, and clinicians' education. The interventions resulted also in a positive significant financial impact with no increase in postoperative complications. What is Known: • Tonsillectomy is a common paediatric ENT procedure, with significant applicability and cost-effectiveness of the day case pathway. • There is a lack of a clear general consensus on criteria for patients' suitability for day case tonsillectomy. What is New: • This quality improvement project carried out a methodical relaxation of day case criteria of day case tonsillectomy. • The new criteria along with enhanced list management and clinician education had safely improved the local post-tonsillectomy day case care.
journal_name
Eur J Pediatrjournal_title
European journal of pediatricsauthors
Atfeh MS,Richardson-May J,Rainsbury Jdoi
10.1007/s00431-018-3220-0subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1603-1608issue
11eissn
0340-6199issn
1432-1076pii
10.1007/s00431-018-3220-0journal_volume
177pub_type
杂志文章abstract:UNLABELLED:Cystic adenomatoid malformation of the lung (CAML) is a rare pulmonary maldevelopment resulting from an abnormal growth of the terminal bronchial structures. This study proposes a possible management of prenatally diagnosed CAML. A group of nine cases of CAML diagnosed prenatally between January 1990 and Dec...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s004310051233
更新日期:1999-11-01 00:00:00
abstract::Vascularization of the arms has been studied by impedance plethysmography (rheography) in eight children with Poland syndrome, a common malformation characterized by unilateral hand anomaly and ipsilateral aplasia of the inferior head of the pectoralis major muscle. A marked decrease of the velocity of the systolic in...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00496922
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abstract::Complex regional pain syndrome (CRPS) is a condition of unknown etiology characterized by autonomic, sensory, and motor disturbance. CRPS usually follows an injury in the affected limb, which is often trivial in nature. CRPS involving the facial region is rare, and there have been no previous descriptions in children....
journal_title:European journal of pediatrics
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abstract::Chronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by mutations of one of the subunits of phagocyte reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase leading to decreased or complete absence of neutrophil oxidative burst. We report the clinical and laboratory findings in tw...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-006-0211-3
更新日期:2007-02-01 00:00:00
abstract::Necrotizing enterocolitis (NEC) is usually considered to be a neonatal disease, and is rarely described beyond the newborn period. During the last 15 years, 19 infants from the Negev region, Israel, with NEC were beyond the neonatal age group (range = 34-616 days, median = 90 days). Of this group only 16% were born pr...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00442592
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abstract::The role of the type-2 T helper (Th2) cell-mediated immune response in the immunopathogenesis of atopic dermatitis (AD) is well documented. Whether polarized immunoresponse is confined to antigen-specific T cells or is distributed among all T cell subsets is still controversial. We investigated frequencies of interleu...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-006-0319-5
更新日期:2007-08-01 00:00:00
abstract::To reveal the influence of therapeutically induced changes of arterial blood pressure on cerebral circulation, pulsed Doppler measurements of blood velocity in the right internal carotid artery were performed in 23 neonates. A positive correlation between mean arterial blood pressure and time-averaged maximum blood ve...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00441596
更新日期:1987-09-01 00:00:00
abstract::Recombinant interleukin 2 (rIL2) was administered to a patient with Wiskott-Aldrich syndrome for the treatment of an intractable facial herpetiform lesion. This treatment appeared to be effective in suppressing the virus activity. At the same time, a transient improvement of the chronic eczematoid dermatitis was obser...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF01957224
更新日期:1993-12-01 00:00:00
abstract:OVERVIEW:In newborns with symptomatic congenital cytomegalovirus (CMV) infection, neuroimaging is the best available predictor of neurodevelopmental outcome. Cerebrospinal fluid (CSF) findings in congenital CMV infection have seldom been described. Neonates with central nervous system infections present high CSF Beta(2...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-006-0160-x
更新日期:2006-09-01 00:00:00
abstract:UNLABELLED:Concentrations of galactose (Gal) in plasma and galactose metabolites in red blood cells (RBC) were determined in 18 normal neonates and 249 others with hypergalactosaemia according to the Paigen method. Normal neonatal values for plasma Gal, RBC galactose-1-phosphate (Gal-1-P), RBC uridine diphosphate gluco...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/pl00008352
更新日期:2000-11-01 00:00:00
abstract:UNLABELLED:Essential fatty acid deficiency is well known in cystic fibrosis patients, but its pathogenesis remains unclear. It might be related to protein-energy malnutrition which is a common feature of cystic fibrosis or to some specific defects in fatty acid metabolism. To avoid the deleterious effects of protein-en...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s004310050750
更新日期:1997-12-01 00:00:00
abstract::Male pseudohermaphroditism (MPH) is defined as incomplete masculinization in patients with normal male karyotype (XY) and testicular histology. MPH encompasses a spectrum of female to male phenotypes and presents both diagnostic and technical challenges to the surgeon. Once gender is assigned, based on phenotype, adeq...
journal_title:European journal of pediatrics
pub_type: 杂志文章,评审
doi:10.1007/BF02125449
更新日期:1993-01-01 00:00:00
abstract::The aim of this study is to evaluate and compare mothers' and grandparents' feeding behaviours, the differences between the behaviours, the relationship between children's feeding problems and grandparents' feeding behaviours, as well as the relationship between grandparents' feeding behaviour and children's body mass...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-018-3244-5
更新日期:2018-12-01 00:00:00
abstract::Anthropometric indices (AI) have been known to be associated with age at menarche (AAM). The aim of this longitudinal study was to evaluate the changes in AI and its association with AAM in a community-based population in Iran. From among 10,192 women, we included 6818, aged ≥ 10 years, who were post-menarche at the t...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-020-03575-x
更新日期:2020-09-01 00:00:00
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journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-008-0703-4
更新日期:2009-01-01 00:00:00
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journal_title:European journal of pediatrics
pub_type: 临床试验,杂志文章
doi:10.1007/s00431-011-1486-6
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Impaired vitamin K status in cystic fibrosis (CF) has been considered as a newly emerged pathogenetic factor for reduced bone mineral density (BMD). OBJECTIVES:Our aim was to evaluate the effectiveness of vitamin K supplementation in managing bone formation abnormalities in children and adolescents with C...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-006-0132-1
更新日期:2006-08-01 00:00:00
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journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-003-1262-3
更新日期:2003-09-01 00:00:00
abstract::Three sibs with an inherited form of male pseudohermaphroditism are described. They were all born with ambiguous external genitalia but no diagnosis of a possible enzyme defect was made during childhood. First seen at the ages of 16, 14 and 10 years respectively, they were investigated in order to establish the pathog...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00441984
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journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF02138781
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journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF01957537
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journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF01957719
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journal_title:European journal of pediatrics
pub_type: 杂志文章
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abstract::Physiotherapists, occupational therapists, and speech therapists play a key role in the treatment of children with epilepsy. We performed a survey of therapists' knowledge of and attitudes towards epilepsy in two regions of Germany, the city of Leipzig and the rural district of Zwickau. Therapists of 29/68 (43%) outpa...
journal_title:European journal of pediatrics
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
abstract::The tendency of non-operative management of appendicitis let us explore the natural history of appendiceal carcinoids, compare them with appendicitis patients, and determine the possibility of deciding the extent of the surgery and post-operative follow-up on behalf of the intraoperative findings. A retrospective revi...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-018-3258-z
更新日期:2018-12-01 00:00:00
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journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00441860
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abstract::We have investigated four patients from three unrelated families with typical clinical and biochemical features of "late-onset" multiple carboxylase deficiency. All patients suffered from biotinidase deficiency (plasma biotinidase activities 1.4%-3% of normal). Intestinal absorption of biotin, measured in three of the...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/BF00491919
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abstract::Hypoparathyroidism is one of the recognized causes of late-onset neonatal hypocalcemia. Maternal hypercalcemic hyperparathyroidism has been shown to suppress fetal parathyroid glands, causing transient neonatal hypoparathyroidism. We report two siblings (6 years apart) with transient hypoparathyroidism presented with ...
journal_title:European journal of pediatrics
pub_type: 杂志文章
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更新日期:2008-04-01 00:00:00
abstract::The new coronavirus disease outbreak in 2019 (COVID-19) represents a dramatic challenge for healthcare systems worldwide. As to viral tropism, lungs are not the only COVID-19 target but also the heart may be involved in a not negligible percentage of the infected patients. Myocarditis-related cardiac dysfunction and p...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-020-03699-0
更新日期:2020-07-01 00:00:00
abstract::Patients with childhood-onset systemic lupus erythematosus (cSLE) are at risk of becoming short adults. To evaluate the growth patterns and risk factors of short final height, a retrospective study was conducted in 97 patients (87 females, 90%) with cSLE who grew from the time of diagnosis and reached their final heig...
journal_title:European journal of pediatrics
pub_type: 杂志文章
doi:10.1007/s00431-020-03910-2
更新日期:2021-01-03 00:00:00