Abstract:
BACKGROUND:Recent research in febrile neutropaenia (FN) has focused on reducing the intensity of treatment for those thought to be at low risk of significant morbidity or mortality. This has not led to a reduced burden of treatment for either families or healthcare systems. An alternative approach is to discharge all patients who remain well after 48 hours of inpatient treatment, either with no ongoing treatment or with appropriate antibiotics if the cultures are positive. This paper aimed to demonstrate that this approach is safe. METHODS:Patients treated according to this approach in a single centre were reviewed retrospectively, with a random selection of patients from a 4-year period. Data were collected according to the Predicting Infectious Complications of Neutropenic sepsis in Children with Cancer dataset. In addition, all septic deaths over a 10-year period were reviewed in the same manner. RESULTS:179 episodes of FN were reviewed from 47 patients. In 70% (125/179) of episodes, patients were discharged safely once 48-hour microbiology results were available, with only 5.6% (7/125) resulting in readmission in the 48 hours following discharge. There were no septic deaths in this cohort.There were 11 deaths due to FN over the 10-year study period. Almost all patients were identified as severely unwell in the early stages of their final presentation or had a prolonged final illness. CONCLUSION:This paper indicates that the policy described provides a balance between safety and acceptability. Further work is needed to demonstrate non-inferiority and cost-benefit.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Seneviratne N,Yeomanson D,Phillips Rdoi
10.1136/archdischild-2019-317908subject
Has Abstractpub_date
2020-09-01 00:00:00pages
881-885issue
9eissn
0003-9888issn
1468-2044pii
archdischild-2019-317908journal_volume
105pub_type
杂志文章abstract::Three of five children who were born to consanguineous parents developed Guillain-Barré syndrome before they were 3 years old. The syndrome is rare in early childhood and we suggest that there may be a genetic element in the pathogenesis. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.9.1078
更新日期:1991-09-01 00:00:00
abstract::Cryptosporidium spp are a cause of diarrhoea in toddlers. Symptoms and routes of transmission were investigated in a prospective case-control study in the city and surroundings of Basel, Switzerland. Twenty one (4.6%) out of 455 children with diarrhoea who attended paediatric and general practices from June to Septemb...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.4.445
更新日期:1990-04-01 00:00:00
abstract::The adrenal glands of 41 fresh stillbirths were studied and a 'stress response' pattern could be seen in 28. In these glands the stress response was characterised by compact cell change, lipid depletion, excess pyroninophilia, and dilatation of the very prominent granular endoplasmic reticulum. Scattered areas of cyto...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.10.769
更新日期:1978-10-01 00:00:00
abstract:BACKGROUND:Our current understanding regarding the aetiology of infantile acute liver failure largely derives from studies conducted by regional liver units. This may introduce selection bias and therefore not provide a true reflection of the wider population. METHODS:Every coagulation screen with a prothrombin time ≥...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-317360
更新日期:2020-08-01 00:00:00
abstract::Reverse triiodothyronine (rT3), triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) values were measured by radioimmunoassay in 40 children with congenital hypothyroidism who were being given levothyroxine (0.05-0.35 mg/day) and in 14 normal controls. In 15 of the children with hypothyroidism ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.59.1.30
更新日期:1984-01-01 00:00:00
abstract::Fifty-one children with a bacteriologically proven urinary tract infection had both an intravenous urogram (IVU) and a micturating cystogram. The IVU was normal in 35. Only 6 of these children showed reflux in the cystogram, affecting 7 of the 70 ureters at risk. Since reflux on its own does not cause renal damage, wh...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.11.893
更新日期:1976-11-01 00:00:00
abstract::Pharmacogenomics research is becoming more prevalent in both academia and the pharmaceutical industry. While some discoveries have been integrated into practice and are benefiting patient care, these successes have been limited given the vast amount of research undertaken. However, the advances in high-throughput geno...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2012-302852
更新日期:2013-03-01 00:00:00
abstract::This study examines the relationship between medical and functional severity of disability and levels of self esteem and self concept in 79 young people with spina bifida. Greater feelings of global self worth and of self esteem in physical appearance were associated with greater severity of disability. This was only ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.73.1.48
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:To develop and test patient-reported experience measures (PREMs) for children and young people in a specialist paediatric hospital setting. DESIGN:Six PREMs were developed and tested by children and young people for children and young people aged 8-11, 12-13 and 14-16 years in inpatient and outpatient settin...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2017-313032
更新日期:2018-03-01 00:00:00
abstract::The transport characteristics of the placenta, which favour higher phenylalanine concentrations in the fetus than in the mother, and regression data of head circumference at birth against phenylalanine concentration at conception in maternal phenylketonuria (PKU), suggest that treatment of maternal PKU should ideally ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.11.1346
更新日期:1991-11-01 00:00:00
abstract::We studied the effects on the family of childhood chronic renal failure by contrasting children with varying degrees of severity of illness with healthy controls. Disruption of family life was most common in families with the more severely ill children (on hospital haemodialysis) and there was a tendency for more ment...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.7.821
更新日期:1988-07-01 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::Non-accidental injury should be suspected and excluded in any infant found to have intracranial and retinal haemorrhage of unknown aetiology. This can be a sensitive issue for both medical staff and parents. We present a case in which the underlying cause of intracranial and retinal haemorrhage was fibromuscular dyspl...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.84.3.263
更新日期:2001-03-01 00:00:00
abstract::Somatomedin activity was assayed in the plasma of children suffering from protein calorie malnutrition by a bioassay using rat cartilage and expressed as sulphate uptake ratio. The sulphate uptake ratio was particularly reduced in kwashiorkor. In marasmus there was a slight reduction and the levels were still in the n...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.54.1.62
更新日期:1979-01-01 00:00:00
abstract::Mortality before surgery must be taken into account when comparing the surgical mortality of atrial redirection procedures (Mustard's or Senning's operation) and the arterial switch operation for patients with complete transposition. This is because the switch operation is usually performed within the neonatal period ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.6.549
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Acute respiratory infections (ARI) cause 3 million deaths in children worldwide each year. Most of these deaths occur from pneumonia in developing countries, and hypoxaemia is the most common fatal complication. Simple and adaptable indications for oxygen therapy are important in the management of ARI. The c...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2008.138362
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes w...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2013-304277
更新日期:2014-02-01 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::A boy with the dysmorphic features of Noonan's syndrome and pulmonary valve stenosis who had evidence of hypoparathyroidism and abnormal T lymphocyte numbers in the neonatal period is reported. He had a normal karyotype but molecular analysis revealed a submicroscopic deletion within chromosome 22q11, the region delet...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.68.2.187
更新日期:1993-02-01 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 establish the relationship between serum point-of-care (POC) ketones at triage and moderate-to-severe dehydration based on the validated Gorelick Scales. DESIGN, SETTING AND PATIENTS:Prospective unblinded study from April 2016 to February 2017 in a paediatric emergency department. Patients aged 1 month to...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-318425
更新日期:2020-12-01 00:00:00
abstract::In a cohort of 14 children with identical cardiac xenografts, two boys developed acute myeloid leukaemia 11 and 16 months respectively after the operation. A dedicated working group designed a scheme intending to take care of all aspects of the situation. This article focuses on preferred strategies towards patients, ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.88.5.435
更新日期:2003-05-01 00:00:00
abstract:AIM:To compare the growth patterns of breast fed and formula fed Italian infants in the first 12 months of life using World Health Organisation (WHO) reference data. METHODS:The growth patterns of 73 breast fed infants (36 male, 37 female) and 65 formula fed infants (35 male, 30 female) were compared. Solid foods were...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.81.5.395
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To estimate the diagnostic accuracy of chest radiography in the detection of chest lymphadenopathy in children with clinically suspected pulmonary tuberculosis. METHODS: DESIGN:Prospective cross sectional study. SETTING:A short stay ward in a children's hospital in South Africa. PATIENTS:Consecutive child...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.062315
更新日期:2005-11-01 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::A method for securing umbilical catheters is described. It has been used successfully in over 350 babies. It is a simple and rapid method that allows for easy repositioning and, unlike some established techniques, has no potential for damage to the preterm baby's skin. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.7_spec_no.750
更新日期:1988-07-01 00:00:00
abstract::Fifteen per cent of children treated with growth hormone (GH) are receiving treatment for Turner syndrome, but few results are available on final height in the UK. In this study, data were obtained from the UK KIGS database for 485 girls with Turner syndrome who were treated from 1986, allowing an audit of practice an...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.80.3.221
更新日期:1999-03-01 00:00:00
abstract:AIMS:To document the patterns of presentation and outcome of severe anticholinesterase insecticide poisoning in children requiring intensive care. METHODS:Retrospective case note review of all 5541 children admitted to the paediatric intensive care unit (PICU) of a university hospital during the 10 years from January ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.86.5.352
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:In a national study of Australian children aged 11-12 years old, we examined the (1) prevalence and characteristics of hearing loss, (2) its demographic risk factors and (3) evidence for secular increases since 1990. METHODS:This is a cross-sectional CheckPoint wave within the Longitudinal Study of Australia...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2017-313505
更新日期:2018-06-01 00:00:00
abstract:AIM:To evaluate gastric emptying in girls with Turner's syndrome to detect if gastrointestinal motor dysfunction was present. SUBJECTS:Thirteen girls (mean age 8.1 years) with Turner's syndrome, seven girls with familial short stature (6.1 years), and eight control girls (7.6 years). METHODS:Gastric emptying studies ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.5.440
更新日期:1996-11-01 00:00:00