Abstract:
OBJECTIVE:To describe the pathways by which children with cancer present to a shared care oncology unit. DESIGN:A population-based retrospective cohort study of children diagnosed with cancer between the years 2004 and 2014. SETTING:District General Hospital with a level 2 Paediatric Oncology Shared Care Unit. PATIENTS:93 children aged 0-15 years . OUTCOME MEASURES:Time to presentation (TTP) was defined as time from initial symptoms to time seen by secondary paediatrics. Time to diagnosis (TTD) was defined as time from initial symptoms to diagnosis at a Principal Treatment Centre. Patient pathways to diagnosis were mapped and routes for different cancers were compared. RESULTS:Only 2/93 cases (2.1%) in 10 years were referred via the 2-week pathway. Most presentations were acute via immediate general practitioner (GP) referral or self-referral to the emergency department 62/93 (67%). Leukaemia presented acutely and via the GP more often than via self-presentation to the emergency department 21/28 (75% vs 25%), while solid tumours were self-referred to the emergency department 21/34 (62% vs 38%) more often than via the GP. TTP and TTD were calculated for 87 patients. Wilms' tumour demonstrated the shortest median TTP of 7 days and TTD of 16 days. Lymphoma had the longest TTD, with TTP 107 days and TTD 120 days. Pathways to diagnosis via other specialties were longer. CONCLUSION:The majority of children diagnosed with cancer present via acute services, with the route varying between tumour types. Only two cases in 10 years were referred via the 2-week pathway, thus challenging its relevance in the paediatric population.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Roskin J,Diviney J,Nanduri Vdoi
10.1136/archdischild-2015-308765subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1131-5issue
12eissn
0003-9888issn
1468-2044pii
archdischild-2015-308765journal_volume
100pub_type
杂志文章abstract::Clinically useful criteria were found by studying immunological functions on admission in 15 African children with acute hepatitis (AH) (11 of whom were HBsAg positive) and in 11 children with fulminant hepatic failure (FHF) (8 of whom were HBsAg positive), and by comparing these results with normal controls. Nine of ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.57.4.277
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Faecal impaction is frequently observed in children with chronic constipation. The term megarectum is often used to describe this finding. AIM:To evaluate rectal functioning and rectal measures in constipated children with a filled rectum, in order to define the terms faecal impaction, enlarged rectum, and ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.83.1.52
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:The management of subclinical hypothyroidism (SH) is still controversial, as the benefit to risk ratio of prolonged L-thyroxine therapy is not clear cut. Some authors have shown abnormalities of myocardial function and structure in adults with SH, which could be reversed by L-thyroxine therapy. As SH frequen...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.88.11.1005
更新日期:2003-11-01 00:00:00
abstract:RATIONALE:Accurate weight measurements are essential for both growth monitoring and drug dose calculations in children. Weight can be accurately measured using calibrated scales in resource-rich settings; however, reliable scales are often not available in resource-poor regions or emergency situations. Current age and/...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-309645
更新日期:2017-01-01 00:00:00
abstract:AIM:To examine evolution of the physical characteristics of Marfan's syndrome throughout childhood. METHODS:40 children were ascertained during the development of a regional register for Marfan's syndrome. Evolution of the clinical characteristics was determined by repeat evaluation of 10 patients with sporadic Marfan...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.76.1.41
更新日期:1997-01-01 00:00:00
abstract::The validation of measurement of cerebral blood volume (CBV) and cerebral blood flow (CBF) using near infrared spectroscopy (NIRS) against jugular venous occlusion plethysmography is described. Repeated measurements in six infants were made using both techniques simultaneously. A close relationship between the two mea...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.4_spec_no.407
更新日期:1992-04-01 00:00:00
abstract::Increased emphasis on strict glycaemic control of insulin dependent diabetes mellitus (IDDM) in young patients may be expected to cause increases in rates of significant hypoglycaemia. To evaluate whether this is the case for a large population based sample of IDDM children and adolescents rates of severe (coma, convu...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.78.2.111
更新日期:1998-02-01 00:00:00
abstract::The case is reported of an infant with hyperammonaemia secondary to severe distal renal tubular acidosis. A clinical association between increased concentrations of ammonia in serum and renal tubular acidosis has not previously been described. In response to acidosis the infant's kidneys presumably increased ammonia s...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.77.5.441
更新日期:1997-11-01 00:00:00
abstract::There is little high quality evidence on which to base the management of bone and joint infections in children. This pragmatic practice note aims to provide a consensus framework of best current practice prior to the availability of data from large national randomised controlled trials. For straightforward infection i...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2011-301089
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Long term growth hormone (GH) treatment in children with idiopathic short stature (ISS) results in a relatively small mean gain in final height of 3-9 cm, which may not justify the cost of treatment. As it is unknown whether GH treatment during puberty adds to final height gain, we sought to improve the cost...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.87.3.215
更新日期:2002-09-01 00:00:00
abstract::A picture archiving and communication system (PACS) is a computerised means of replacing the roles of conventional radiological film. This review describes the Hammersmith PACS, and discusses the advantages and disadvantages of PACS systems. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.83.1.82
更新日期:2000-07-01 00:00:00
abstract::Diabetes mellitus was observed in 29 of 448 patients with thalassaemia major attending seven Italian centres. Twelve patients, at onset of clinical diabetes, presented with an asymptomatic glycosuria, 13 with ketosis, and four with ketoacidosis. All were diagnosed after 1979, at a mean age of 17 years. Mean age at dia...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.1.58
更新日期:1988-01-01 00:00:00
abstract::Susceptibility to infections is a well known feature of Down's syndrome. The possible relation between this predisposition and the serum concentrations of the IgG subclasses was studied in 38 children with Down's syndrome aged 1-12 years. An age matched group of 50 healthy children served as controls. The serum concen...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.5.628
更新日期:1992-05-01 00:00:00
abstract::Fifty Asian immigrant mothers who would have expected to breast feed their infants had they remained in rural Asia were studied. There was a striking reduction in the incidence and duration of breast feeding on arrival in the United Kingdom, and a fall in the age of weaning. The availability of an alternative to human...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.8.608
更新日期:1976-08-01 00:00:00
abstract::After their first episode of febrile convulsions, 195 previously healthy children, aged 6--30 months, were given either diazepam or phenobarbitone for a year. Each child was assigned at random to one of the two medications: children admitted on even days were given a suppository containing 5 mg diazepam every 8 hours ...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.53.8.660
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence of microcephaly in infants admitted to the neonatal intensive care units (NICUs) in eight private hospitals in south-eastern and midwestern Brazil, from 2011 to 2015. DESIGN:Observational, cross-sectional study in a cohort of neonates. SETTING:Eight private NICUs situated in the c...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/archdischild-2016-311541
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To study the clinical characteristics and predictors of mortality from snake bite envenomation in children. DESIGN:Prospective observational study with a one-group cohort design. SETTING:Paediatric intensive care unit of a tertiary care hospital in South India. SUBJECTS:The study cohort consisted of 145 ch...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311142
更新日期:2017-05-01 00:00:00
abstract:AIMS:To compare physiological and autonomic responses to acute hypoglycaemia in diabetic children in pre-, mid-, and post-pubertal stages of development. METHODS:Twenty seven children (8 pre-pubertal, 7 mid-pubertal, 12 post-pubertal) with type 1 diabetes were studied. Hypoglycaemia was induced by insulin infusion unt...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.052035
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To define better the adult phenotype and natural history of Noonan syndrome. DESIGN:A prospective observational study of a large cohort. RESULTS:Data are presented for 112 individuals with Noonan syndrome (mean age 25.3 (range 12-71) years), who were followed up for a mean of 12.02 years. Mutations in PTPN1...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.104547
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:The epidemiology of congenital infections is ever changing, with a recent resurgence in syphilis infection rates seen in the UK. Identification of congenital infection is often delayed; early recognition and management of congenital infections is important. Testing modalities and investigations are often lim...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2020-318841
更新日期:2021-02-01 00:00:00
abstract::This paper reviews the diagnostic features of cluster headache-like disorder and describes its presentation in childhood. Case note summaries of patients with this condition are presented in the context of a brief summary of the literature. Four patients (two girls; aged 12 to 15 years) with cluster headache-like diso...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.81.6.511
更新日期:1999-12-01 00:00:00
abstract::Hospital clowning is a programme in healthcare facilities involving visits from specially trained actors. In the paediatric intensive care unit (PICU), clowning may appear inappropriate and less intuitive. The patient could appear too ill and/or sedated, the environment too crowded or chaotic and the parents too stres...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2016-311583
更新日期:2017-07-01 00:00:00
abstract:AIMS:To investigate whether sagittal synostosis (SS) has consequences for children's mental and psychomotor development, and whether surgery has any impact on this. METHODS:The study involved 28 children with SS who underwent corrective surgery at a mean age of 8.0 (SD 7.16) months, and 28 normal controls. All the chi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2003.035824
更新日期:2005-04-01 00:00:00
abstract::This study describes the pattern of oxygen consumption (VO2), rectal temperature (Tr), and acral skin temperature (Tac) in sleeping and resting (awake) burned children nursed in a thermoneutral environment. Measurements of respiratory gas exchange (VO2 and carbon dioxide production (VCO2)) were made using an open circ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.71.1.31
更新日期:1994-07-01 00:00:00
abstract::Atypical, non-diarrhoea associated haemolytic uraemic syndrome (D-HUS) is a heterogeneous disorder with a generally poor outcome, although this view has now been questioned. The clinical and laboratory features of 23 children with D-HUS, representing a third of all patients with HUS seen during the last 26 years, were...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.76.6.518
更新日期:1997-06-01 00:00:00
abstract::Gross neuropathy consequent upon selective malabsorption of vitamin B12 was diagnosed in a 6 year old Bangladeshi girl brought to Great Britain for further investigation of an unexplained illness of three years' duration. The initial peripheral blood count was normal. Treatment with vitamin B12 has led to substantial ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.59.6.575
更新日期:1984-06-01 00:00:00
abstract::Serum IgG antibodies to teichoic acid and alpha toxin from Staphylococcus aureus were measured in 62 patients with cystic fibrosis by enzyme linked immunosorbent assays. The patients were followed up for 12-24 months in a prospective study. Raised titres were found exclusively in patients chronically colonised with S ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.9.905
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVES:Children's exposure to racism via caregiver experience (vicarious racism) is associated with poorer health and development. However, the relationship with child healthcare utilisation is unknown. We aimed to investigate (1) the prevalence of vicarious racism by child ethnicity; (2) the association between ca...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2017-313866
更新日期:2018-09-01 00:00:00
abstract::Eleven very low birthweight babies being ventilated for respiratory problems during the first week of life developed air leaks on 22 occasions. On 16 out of 19 occasions the infants showed increases in urinary excretion of vasopressin after these events and on 10 occasions out of 13 there was a rise in the plasma argi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.11.1259
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Chronic abdominal pain (CAP) is common among schoolchildren, but risk factors for its onset are still largely unknown. AIMS:To determine the frequency of onset of CAP in schoolchildren and investigate risk factors for its development. METHODS:1411 schoolchildren aged 11-14 years were recruited from schools...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2006.115089
更新日期:2007-12-01 00:00:00