Abstract:
OBJECTIVE:Children with Down syndrome are at high risk of obstructive sleep apnoea (OSA) and screening is recommended. Diagnosis of OSA should be confirmed with multichannel sleep studies. We aimed to determine whether home pulse oximetry (HPO) discriminates children at high risk of OSA, who need further diagnostic multichannel sleep studies. DESIGN:Cross-sectional prospective study in a training sample recruited through three UK centres. Validation sample used single-centre retrospective analysis of clinical data. PATIENTS:Children with Down syndrome aged 0.5-6 years. INTERVENTION:Diagnostic multichannel sleep study and HPO. MAIN OUTCOME MEASURES:Sensitivity and specificity of HPO to predict moderate-to-severe OSA. RESULTS:161/202 children with Down syndrome met quality criteria for inclusion and 25 had OSA. In this training sample, the best HPO parameter predictors of OSA were the delta 12 s index >0.555 (sensitivity 92%, specificity 65%) and 3% oxyhaemoglobin (SpO2) desaturation index (3% ODI)>6.15 dips/hour (sensitivity 92%, specificity 63%). Combining variables (delta 12 s index, 3% ODI, mean and minimum SpO2) achieved sensitivity of 96% but reduced specificity to 52%. All predictors retained or improved sensitivity in a clinical validation sample of 50 children with variable loss of specificity, best overall was the delta 12 s index, a measure of baseline SpO2 variability (sensitivity 92%; specificity 63%). CONCLUSIONS:HPO screening could halve the number of children with Down syndrome needing multichannel sleep studies and reduce the burden on children, families and health services alike. This approach offers a practical universal screening approach for OSA in Down syndrome that is accessible to the non-specialist paediatrician.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Hill CM,Elphick HE,Farquhar M,Gringras P,Pickering RM,Kingshott RN,Martin J,Reynolds J,Joyce A,Gavlak JC,Evans HJdoi
10.1136/archdischild-2017-314409subject
Has Abstractpub_date
2018-10-01 00:00:00pages
962-967issue
10eissn
0003-9888issn
1468-2044pii
archdischild-2017-314409journal_volume
103pub_type
杂志文章abstract:OBJECTIVE:To establish whether changes of lung transfer for carbon monoxide (TLCO) are related to the phase of IgA nephropathy. METHODS:Respiratory function was tested in 12 children with IgA nephropathy assessed by percutaneous renal biopsy. This was done during acute exacerbations or haematuria-free phases of the di...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章
doi:10.1136/adc.74.3.236
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To simultaneously record tracheal and oesophageal pH in mechanically ventilated children to determine: (1) the feasibility and safety of the method; (2) the incidence of gastro-oesophageal reflux (GOR) and pulmonary contamination; and (3) their associated risk factors. DESIGN:Prospective study. SETTING:Paed...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.1.46
更新日期:1996-07-01 00:00:00
abstract:AIMS:To determine whether current and postpartum maternal depression and low maternal intelligence are risk factors for malnutrition in children. METHODS:In rural South India 72 children with malnutrition were identified from a central register; 72 controls were matched for age, gender, and residence. RESULTS:Major d...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2002.009738
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To examine the prevalence of dysnatraemias among children admitted for paediatric surgery before and after a change from hypotonic to isotonic intravenous maintenance fluid therapy. DESIGN:Retrospective consecutive time series intervention study. SETTING:Paediatric surgery ward at the Children's Hospital in...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-318555
更新日期:2020-10-28 00:00:00
abstract:AIMS:To determine whether delayed capillary refill time (>3 seconds) is a useful prognostic indicator in Kenyan children admitted to hospital. METHODS:A total of 4160 children admitted to Kilifi District Hospital with malaria, malarial anaemia, acute respiratory tract infection (ARI), severe anaemia (haemoglobin <50 g...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2003.032516
更新日期:2004-10-01 00:00:00
abstract::A novel form of severe, X linked mental retardation associated with alpha thalassaemia (ATR-X syndrome) has recently been described. Two affected cousins are described, one of whom has an unusually mild haematological phenotype. HbH inclusions, which are the hallmark of this disease, were only detected in the peripher...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.70.5.439
更新日期:1994-05-01 00:00:00
abstract::A gross T cell lymphocytosis developed in an otherwise healthy 5 year old girl and has persisted for nearly 3 years. It is associated with neutropenia and seems to be typical of a rare adult disorder that may be a type of T cell chronic lymphocytic leukaemia. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.8.635
更新日期:1983-08-01 00:00:00
abstract::A 5.7 year old boy with alpha 1-antitrypsin deficiency developed intractable ascites after liver transplantation. Conservative treatment was unsuccessful and after 18 days concentrated ascitic fluid was reinfused intravenously using a Gambro haemofilter. The ascitic loss resolved rapidly. This new method of ultrafiltr...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.8.988
更新日期:1991-08-01 00:00:00
abstract::Seventy six children, 18 boys and 58 girls, aged 0-15.9 (median 1.0) years, with acute pyelonephritis were prospectively studied with a technetium-99m dimercaptosuccinic acid (DMSA) scan during infection and two months later. Fifty nine of these children were also studied two years after the infection. Seventeen child...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.70.2.111
更新日期:1994-02-01 00:00:00
abstract::Asthma has little, if any, significant effect on attained adult height. Untreated asthma results in a delay of puberty by approximately 1.3 years, and pubertal delay is likely to explain the majority of apparent growth failure in asthmatics. All currently available inhaled corticosteroids (ICS) result in growth suppre...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2003.014365
更新日期:2004-01-01 00:00:00
abstract::A child with idiopathic pulmonary haemosiderosis for three years required three monthly transfusions. Circulating avian, gliadin, and reticulin antibodies suggested the diagnosis of gluten enteropathy, and jejunal biopsy showed subtotal villous atrophy. During 15 months on a gluten free diet his growth and behaviour i...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.5.513
更新日期:1987-05-01 00:00:00
abstract::Circulating erythroid progenitors (BFU-E) in five anaemic preterm infants (haemoglobin less than 100 g/l) were about 2 and 4.4 times as abundant as in 10 preterm infants who were not anaemic and five healthy adults, respectively, and were significantly more responsive to low concentrations of recombinant human erythro...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.7_spec_no.810
更新日期:1991-07-01 00:00:00
abstract::In a study of 256 families, among whom were twins, midparent-adult son correlations for height, weight, and combined skinfold measurements were 0.67, 0.47, and 0.23 respectively. The corresponding midparent-adult daughter correlations were 0.63, 0.42, and 0.24. Midparent-growing offspring correlations were highest for...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.54.11.877
更新日期:1979-11-01 00:00:00
abstract:OBJECTIVE:To ascertain mortality from 1 to 18 years, and predictors of mortality. DESIGN:Long-term follow-up of population cohort born 1989-1992. SETTING:Births in South East Thames Region. PATIENTS:346 children with bilateral cerebral palsy (CP). INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Mortality; pred...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2009.172841
更新日期:2011-11-01 00:00:00
abstract::The management of neonatal jaundice can be made much easier using simple methods that increase the radiant energy in the range 420 to 480 nm. Two groups of infants being treated for physiological jaundice during a period of 6 months were compared. The first group received treatment from two unmodified phototherapy uni...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.6.406
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Chronic fatigue syndrome (CFS) in children is a controversial diagnosis with unclear aetiology, ill defined but likely increasing incidence, and debatable clinical management options. However these children experience real and considerable suffering. Appropriate research in this clinical population is sparse...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.88.10.894
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:In volume guarantee ventilation with the Dräger Babylog 8000 ventilator, inspiratory and expiratory flows are monitored and the expiratory tidal volume calculated following each inflation. The pressure for the next inflation is modified to ensure the expired tidal volume is close to the set value. AIM:To in...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.061390
更新日期:2005-08-01 00:00:00
abstract::We report three cases of Hurler's disease in which glaucoma developed in early childhood. We draw attention to the fact that glaucoma may be a commonly unrecognised early complication of this condition. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.9.1091
更新日期:1988-09-01 00:00:00
abstract:AIM:To produce a growth reference for British children with Williams syndrome. METHODS:The children and adults recruited into the study were all affiliated to the Williams Syndrome Foundation, a parent support group founded in 1979. They have all been shown to have a deletion of chromosome 7q11.23. One growth nurse (W...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2006.107946
更新日期:2007-07-01 00:00:00
abstract::A 6-week-old girl with fever, hypernatraemia, dehydration, and polyuria failed to concentrate urine in response to exogenous vasopressin administration. There was no family history of nephrogenic diabetes insipidus. When she was 15 months old, the infusion of vasopressin did not produce an increase in urinary cyclic-A...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.11.unknown
更新日期:1978-11-01 00:00:00
abstract::A quantitative morphological assessment was carried out of the cellularity and staining properties of the cells of the layers of the human cerebellar cortex, both in the normal child and in 41 children suffering from a series of disorders including mental retardation. A computerized image analyser and highly standardi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.12.964
更新日期:1976-12-01 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::Twenty two babies under 1 year old were referred for evaluation of suspected epileptic seizures. Nine were found to have epilepsy. In the other 13--all developing normally, aged up to 10 months--the spells were non-epileptic paroxysmal events (NEPE). They consisted of five patterns of movement: (1) eye blinking; (2) '...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.73.4.342
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:Infections with multidrug-resistant organisms (MDROs) such as Gram-negative bacteria have high morbidity and mortality with limited treatment options. Colistin, an antibiotic active against MDRO, was rarely used due to frequent adverse effects, but its use has now been recommended among adults. In this study,...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-318067
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:To determine if administration of oral prednisolone to preschool children with acute wheeze alters respiratory outcomes. DESIGN:Double-blind, randomised, placebo-controlled equivalence trial. SETTING:Three hospitals in New Zealand. PATIENTS:477 children aged 24-59 months with acute wheeze associated with r...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2020-318971
更新日期:2020-10-16 00:00:00
abstract::In depth confidential inquiries on all post-perinatal infant deaths were carried out for two years in North and Southern Derbyshire District Health Authorities in order to explore why the postperinatal death rates and cot death rates have been consistently higher in Southern than in North Derbyshire. It was found that...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.12.1421
更新日期:1991-12-01 00:00:00
abstract::UK guidelines for HIV post-exposure prophylaxis (PEP) in adults have recently been updated. Indications for PEP have been modified and there has been a change in the recommended antiretroviral therapy for adults to a combination of raltegravir with tenofovir and emtricitabine (Truvada). Raltegravir and tenofovir are n...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,实务指引
doi:10.1136/archdischild-2015-309297
更新日期:2017-01-01 00:00:00
abstract::Sleep related arterial oxygen desaturation has been described in clinically stable young adults with cystic fibrosis. The incidence and severity of nocturnal oxygen desaturation in children during infective exacerbations and the changes that occur with treatment were examined. Forty five children with proved cystic fi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.69.2.197
更新日期:1993-08-01 00:00:00
abstract:AIMS:To describe the clinical features, diagnosis and management of children with tuberculosis in the United Kingdom and Republic of Ireland. METHODS:Cases of culture-confirmed and clinically diagnosed tuberculosis were reported to the British Paediatric Surveillance Unit from December 2003 to January 2005. RESULTS:3...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2007.133645
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To describe current practice during stabilisation of children presenting with critical illness to the district general hospital (DGH), preceding retrieval to intensive care. DESIGN:Observational study using prospectively collected transport data. SETTING:A centralised intensive care retrieval service in Eng...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2008.151266
更新日期:2010-09-01 00:00:00