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 5 years, with vomiting and/or diarrhoea and/or decreased intake with signs of moderate or severe dehydration or clinical concern for hypoglycaemia were eligible. MAIN OUTCOME MEASURES:The primary outcome was to describe the relationship between triage POC ketones to the two Gorelick Scales. Secondary outcomes were to examine the response of ketone levels to fluid/glucose administration and patient disposition. RESULTS:One-hundred and ninety-eight patients were included; median age 1.8 years. The median triage ketones were 4.6 (IQR 2.8-5.6) mmol/L. A weak correlation was identified between triage ketones and the 10-point Gorelick Scale (Spearman's ρ=0.217, p=0.002), however no correlation between triage ketones and the 4-point Gorelick Scale was identified. Those admitted had median triage ketones of 5.2 (IQR 4-6) mmol/L and repeat ketones of 4.6 (IQR 3.3-5.7) mmol/L compared with 4.2 (IQR 2.4-5.3) mmol/L and 2.9 (IQR 1.6-4.2) mmol/L in those discharged home. CONCLUSION:No correlation between triage POC ketones and the 4-point Gorelick Scale was established. POC ketones at triage have poor accuracy for predicting hospital admission. The elevated profile of POC ketones in non-diabetic children with acute illness suggests a potential target of tailored treatments for further research.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Durnin S,Jones J,Ryan E,Howard R,Walsh S,Dawkins I,Blackburn C,O'Donnell SM,Barrett MJdoi
10.1136/archdischild-2019-318425subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1157-1161issue
12eissn
0003-9888issn
1468-2044pii
archdischild-2019-318425journal_volume
105pub_type
杂志文章abstract::An infant with chronic cytomegalovirus hepatitis and a child with atypical Alagille's syndrome had vitamin D deficiency rickets due to malabsorption. Both received ultraviolet irradiation. This treatment corrected biochemical abnormalities and healed the rickets. In the infant use of a sunlamp at home maintained norma...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.4.617
更新日期:1989-04-01 00:00:00
abstract::Premature newborn rabbits, delivered on day 27 of gestation, were treated with tracheal deposition of dry artificial surfactant containing dipalmitoyl phosphatidylcholine and unsaturated phosphatidylglycerol (7:3), or crude natural surfactant prepared by centrifugation of lung wash from adult rabbits. Before receiving...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.10.758
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVES:To assess factors associated with granting of the Disability Living Allowance (DLA) for Down syndrome. DESIGN:Cross-sectional survey. SETTING:Families with a child with Down syndrome enrolled in a community-based trial of vitamin supplementation. PARTICIPANTS:156 children with trisomy 21 (59% male, 20% no...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.112839
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To explore how parents navigate urgent and emergency care (U&EC) services when their child <5 years old has a feverish illness, their views of that experience and whether services are meeting their needs and triaging in line with national guidance. DESIGN:Parents of a febrile child <5 years old contacting a...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2010.210096
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To describe the recent trends in demographic, clinical and microbiological characteristics and outcome of treatment in paediatric cases of tuberculosis. DESIGN:National surveillance study. SETTING:England and Wales. PATIENTS:All children under the age of 16 years reported with tuberculosis to the national ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2008.139543
更新日期:2008-12-01 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::A term female infant was admitted to the intensive care unit with the diagnosis of tetralogy of Fallot with critical pulmonary stenosis. On the seventh day of life a long saphenous line was inserted that remained without complications until seven days later when the infant appeared septic. A lumbar puncture demonstrat...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.10_spec_no.1201
更新日期:1992-10-01 00:00:00
abstract::In 1973 a survey was conducted among 12 year old children living in a defined area of South Wales. In 1988 the survey was repeated in the same area, again among 12 year old children. Questionnaires were completed for all 965 children in the population sample; peak expiratory flow rates were performed on them all, and ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.10.1452
更新日期:1989-10-01 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::In 3-day fat balances, 7 of 8 infants had appreciably more steatorrhoea when they were fed Cow and Gate V formula than when they were fed SMA. The mean fat excretion (+/- SEM) expressed as a percentage of the amount ingested on Cow and Gate V was 28-1 +/- 3-9 compared with 10-5 +/- 2-3 on SMA. Gas-liquid chromatograph...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.50.8.654
更新日期:1975-08-01 00:00:00
abstract::Twenty-one babies of 34-41 weeks' gestational age with birth asphyxia (5 minute Apgar score less than or equal to 5 or umbilical artery pH less than or equal to 7.2) were studied during the first two days of life to find out whether the urinary excretion of tubular markers of renal function is of value in the early di...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.10_spec_no.1021
更新日期:1990-10-01 00:00:00
abstract::A 12 year old boy presented with primary nocturnal enuresis. Investigation showed extensive bilateral nephrocalcinosis of no obvious or recognised cause. Persistent severe renal hypercalciuria was confirmed by an intravenous calcium infusion. Idiopathic hypercalciuria is not a common cause of nephrocalcinosis and has ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.7.1055
更新日期:1989-07-01 00:00:00
abstract::Breast fed infants may be at greater risk of mother to infant hepatitis B virus infection compared with formula fed infants. We studied 85 infants born to 84 hepatitis B surface antigen positive mothers (only two of whom were hepatitis B e positive), and who had received immunisation against hepatitis B virus. Our res...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.60.10.972
更新日期:1985-10-01 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::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: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:AIMS:To investigate the differences in perception of quality of life between parents of chronically ill children and paediatricians at diagnosis and follow up. Quality of life was assessed using the (HUI3). METHODS:Longitudinal study (July 1999-January 2002) of 37 paediatricians and 181 parents of patients (children a...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.051722
更新日期:2005-05-01 00:00:00
abstract:AIMS:To investigate whether infants who died of SIDS were more likely to have higher acute and lifetime average exposures to outdoor carbon monoxide (CO) and nitrogen dioxide (NO2) than comparison healthy infants. METHODS:A total of 169 case and 169 matched control infants born between 1988 and 1992, were studied. CO ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.057091
更新日期:2005-07-01 00:00:00
abstract:AIMS:To compare the respiratory health and function at 8 to 9 years of age of a total population based cohort of 300 very low birthweight (VLBW) children with that of two classroom controls (n = 590) matched for age and sex. STUDY DESIGN:Cohort study with controls. SETTING:Schools throughout Scotland. RESULTS:The VL...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.74.3.188
更新日期:1996-03-01 00:00:00
abstract::Plasma testosterone was estimated by radioimmunoassay in 60 children with disorders of sexual development before and after stimulation with human chorionic gonadotrophin (HCG). In 21 children the testosterone levels after 3 and 5 daily injections of 1000 units HCG were compared and good correlation was found between t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.8.596
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:Cyclosporine A (CsA) has been widely used in children with steroid dependent and steroid resistant nephrotic syndrome (NS) because of its efficacy in relieving these patients from systemic side effects of steroids. However, its long term use is controversial, since chronic CsA induced nephropathy (CsAN) may ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2005.080960
更新日期:2006-08-01 00:00:00
abstract::A case of partial trisomy of the long arm of chromosome 3 (3q21 leads to qter) is described. The clinical findings are compared with those in 5 previously reported cases. There is hirsutism and characteristic facial dysmorphism, the common features of which are a square-shaped face, prominent nasal bridge, everted nos...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.54.2.135
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:To examine the policy, administration, and supervision of medicine administration in primary schools within the Greater London area (GLA). DESIGN:A prospective survey using postal questionnaires sent to 172 randomly selected primary schools within the GLA. PARTICIPANTS:Head teachers of primary schools. RES...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2003.047258
更新日期:2004-11-01 00:00:00
abstract::The proportion of babies colonised with gentamicin resistant Gram negative organisms in a nursery over a 30 month period did not correlate with the quantity or duration of aminoglycosides used, but it did correlate with two indicators of workload: the number of baby days and a score based on the level of nursing care ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.5.533
更新日期:1988-05-01 00:00:00
abstract::In a family in which the father carried a balanced translocation between chromosomes 15 and 22 two of his children had Prader-Willi syndrome and an unbalanced chromosome complement, having lost the proximal bands from the long arm of chromosome 15. His four other surviving children were normal but carried a balanced t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.8.841
更新日期:1987-08-01 00:00:00
abstract::The aim of the study was to investigate the effect of a protein restricted diet on renal function and growth of children with chronic renal failure. In a multicentre prospective study 56 children (aged 2-18 years) with chronic renal failure were randomly assigned to the protein restricted (0.8-1.1 g/kg/day) or the con...
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.68.3.371
更新日期:1993-03-01 00:00:00
abstract::The relationship between the insulin-breakfast interval, postprandial increase in blood glucose, and glycaemic control was studied in 58 children with diabetes. Patients recorded insulin-breakfast intervals in a home diary over a seven day period, and during a 24 hour period at the weekend provided eight serial capill...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.71.3.248
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. AIMS:To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.86.2.91
更新日期:2002-02-01 00:00:00
abstract::Zinc absorption was measured in 37 children with malnutrition using the oral zinc tolerance test (22.5 mg elementary zinc) and the results compared with those of a group of healthy control subjects. The increase in plasma zinc was significantly lower in patients with marasmic kwashiorkor than in the control group. The...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.11.1608
更新日期:1989-11-01 00:00:00
abstract::Providing evidence-based interventions for infants and children is important in paediatric intensive care, where decision making impacts most acutely on morbidity and mortality. However, despite the major progress of medicine in the 21st century, we still lack this evidence for majority of the decisions we make. In th...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2013-304871
更新日期:2014-11-01 00:00:00