Abstract:
:The benefits of achieving a long term event free survival of 60-70% by using increasingly intense treatment regimens must be weighed against the increased risk of treatment toxicity. From 1985 to 1990, 1612 children with childhood acute lymphoblastic leukaemia (ALL) in the UK were treated on MRC UKALL X with intensive induction therapy, central nervous system directed therapy (cranial irradiation and intrathecal methotrexate), and continuing treatment for two years. There was a randomisation to receive blocks of additional intensification treatment at five weeks, 20 weeks, not at all, or both. The five year disease free survival was 71% for children randomised to two blocks of intensification, a 14% improvement on children randomised to no intensification treatment. Treatment related mortality in this national multicentre study has been analysed for induction and first remission (including those after intensification treatment). There were 38 induction deaths, 2.3% and 53 deaths in first remission, 3.3% (including those from a second malignancy). Thirty one (84%) of the induction deaths followed an infection: bacterial in 22 and fungal in nine. Thirty seven infective remission deaths occurred: bacterial in 11, viral in 16, fungal in seven, and three caused by Pneumocystis carinii pneumonia. Ten of these deaths followed a block of intensification treatment. The majority of noninfective remission deaths followed the development of a second tumour. Risk analysis for an induction death showed girls and children with Down's syndrome to be at greater risk. For deaths in first remission analysis showed an increased risk for bone marrow transplant (BMT) patients and children with Down's syndrome. There was no effect of age and leucocyte count for either group. Most significantly when BMT patients were excluded from the analysis, intensification treatment did not increase the risk of remission death.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Wheeler K,Chessells JM,Bailey CC,Richards SMdoi
10.1136/adc.74.2.101subject
Has Abstractpub_date
1996-02-01 00:00:00pages
101-7issue
2eissn
0003-9888issn
1468-2044journal_volume
74pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:OBJECTIVES:To determine if there had been changes in the size of the UK paediatric workforce and working patterns between 1999 and 2013. DESIGN:Analysis of prospectively collected datasets. SETTING:UK consultant paediatricians. INTERVENTIONS:Data from the Royal College of Paediatrics and Child Health's workforce cen...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-312055
更新日期:2017-02-01 00:00:00
abstract::The outcome of 12 children with classical maple syrup urine disease is reviewed. All patients presented in the neonatal period at ages varying from 5 to 21 (median 8) days. The time taken to make the diagnosis ranged from 1 day to longer than 9 months (median 7 days). Each survived his initial illness but 3 died later...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.57.12.918
更新日期:1982-12-01 00:00:00
abstract:AIM:In paediatrics drugs are prescribed as mg/kg doses to facilitate accurate dosing. Anecdotally, some drugs are prescribed in such a way that the volume to be given is difficult to measure which may lead to inaccuracies and potential for error. Locally, errors have been reported where there has been a misunderstandin...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.21
更新日期:2016-09-01 00:00:00
abstract:AIMS:To test the hypothesis that oxygen free radicals are mediators of excessive protein permeability in steroid responsive nephrotic syndrome. DESIGN:Case control study. SUBJECTS: PATIENTS:20 children with steroid responsive nephrotic syndrome; controls: 20 children admitted for elective surgery. SETTING:The paedi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.82.1.76
更新日期:2000-01-01 00:00:00
abstract::Six children are described who developed diarrhoea associated with Clostridium difficile during the course of haemolytic uraemic syndrome. The significance of this infection is discussed within the context of the pathophysiology of haemolytic uraemic syndrome. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.69.2.239
更新日期:1993-08-01 00:00:00
abstract::This study was carried out on the way in which children's beds were used by the specialty of paediatrics in a district general hospital. Five differing ways were found of interpreting the present Department of Health guidelines on health services information (Körner recommendations). These gave bed occupancy figures v...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.4.504
更新日期:1991-04-01 00:00:00
abstract::Clinical trials in children in resource-poor environments are essential for local health policy and practice to be relevant and evidence based. Research must be ethical, appropriate, relevant and of good quality. It should, where possible, benefit the subjects studied,the clinical, scientific and support staff involve...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2011-301476
更新日期:2012-09-01 00:00:00
abstract::Many children who present with these acquired impairments of communication have a clear preceding event such as an acquired brain injury from a road traffic accident. Children often respond differently in this situation to adult presentations. They may have a period of mutism when the prognosis might look poor and yet...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2014-306153
更新日期:2016-03-01 00:00:00
abstract::Production of platelet thromboxane B2, a stable metabolite of thromboxane A2, was measured in seven newborn infants with pulmonary hypertension during the first day of life. Platelet thromboxane B2 production was significantly lower than in 12 healthy controls but did not correlate with simultaneous blood gas values. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.2.195
更新日期:1987-02-01 00:00:00
abstract:AIM:To assess the value and safety of fasts for investigating hypoglycaemia or suspected metabolic disease. STUDY DESIGN:Review of all diagnostic fasts performed over a 2.5 year period. SETTING:The neonatal intensive care unit and programmed investigation unit at a tertiary referral centre for endocrinology and metab...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.2.115
更新日期:1996-08-01 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:OBJECTIVES:To investigate whether meningococcal C conjugate vaccine (MCCV) caused relapse in children with steroid-responsive nephrotic syndrome. DESIGN:A population-based study was conducted using an active surveillance system, developed to assess adverse events following vaccination, which linked hospital record inf...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.105247
更新日期:2007-10-01 00:00:00
abstract::Endogenous formation of thromboxane A2 and prostacyclin were evaluated in seven neonatates with persistent pulmonary hypertension by serial gas chromatographic mass spectrometric determination of their urinary metabolites dinor-thromboxane B2 and dinor-6-keto-prostaglandin F1 alpha, respectively. The patients were stu...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.7_spec_no.949
更新日期:1989-07-01 00:00:00
abstract::A postal survey of recently appointed consultant paediatricians was undertaken to determine whether they perceived their training had adequately equipped them for their current job. The response rate was 69% (207/299). After excluding replies from consultants trained outside the UK the analysis was carried out on 167 ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.71.4.381
更新日期:1994-10-01 00:00:00
abstract::Clinical observations and findings on imaging are reported in six newborns with symmetrical thalamic lesions (STL). In three cases the diagnosis was confirmed by postmortem examination. Characteristic observations in this series and 17 previously reported cases include no evidence of perinatal asphyxia, high incidence...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.1_spec_no.15
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:To assess psychological and social functioning and health related quality of life and its early determinants in children born with congenital diaphragmatic hernia (CDH). DESIGN:Cross-sectional follow-up study. SETTING:Outpatient clinic of a tertiary care hospital. PARTICIPANTS:33 CDH survivors aged 6-16 ye...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2008.156158
更新日期:2009-11-01 00:00:00
abstract::Seven children with precocious puberty were treated with cyproterone acetate and their adrenal function studied. In each child the drug caused significant adrenal hypofunction which was secondary to adrenocorticotrophic hormone suppression. None of these children had clinical evidence of adrenal hypofunction and it is...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.56.3.218
更新日期:1981-03-01 00:00:00
abstract::The role of disseminated intravascular clotting (DIC) in the pathogenesis of the bleeding diathesis kwashiorkor was investigated in 22 patients. According to the severity of the clinical and haematological findings, two grades of DIC were observed. A severe grade of DIC was shown in 6 cases (5 fatal) presenting with ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.50.4.308
更新日期:1975-04-01 00:00:00
abstract::A neonate developed complete thrombosis of the abdominal aorta after catheterisation of the umbilical artery. This was successfully treated with an intravenous infusion of streptokinase. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.9.1086
更新日期:1988-09-01 00:00:00
abstract:AIM:Childhood arthritis arises from several causes. The aim of this observational study is to compare the clinical and biological features and short-term outcome of different types of arthritis because they have different treatment and prognoses. METHODS:Children <16 years of age hospitalised in a French tertiary care...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/archdischild-2016-310594
更新日期:2017-04-01 00:00:00
abstract::Monthly increments of length, weight gain, and head circumference were recorded from birth to 4 years of age in 52 children with cystic fibrosis. At birth the children showed stunting. Standard deviation (SD) scores at birth for height, weight, and head circumference were -1.24, -0.72, and -1.82 respectively. Over the...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.72.2.150
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Respiratory viral infections precipitate exacerbations of chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease though similar data in non-cystic fibrosis (CF) bronchiectasis are missing. Our study aimed to determine the point prevalence of viruses associated with exacerbation...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2013-305147
更新日期:2014-08-01 00:00:00
abstract::There was much speculation about the potential impact of the Human Rights Act 1998 on established principles of health care practice. Now the statute has been "bedded in", predictions that existing good practice would not fall foul of the legislation provided it was demonstrable, have proved to be broadly accurate. Th...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2003.037218
更新日期:2004-05-01 00:00:00
abstract::The cases are described of eight children, five of them girls, who had epilepsy with myoclonic absences. The mean age of onset was 4.9 years. Brief episodes of loss of awareness with bilateral clonic jerking of the upper limbs were associated with rhythmic 3 cycles/second spike-wave discharges on electroencephalogram....
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.70.4.288
更新日期:1994-04-01 00:00:00
abstract::The output of the drug and the particle size produced by various nebulisers were assessed, and sensible nebulisation times for sodium cromoglycate calculated. Three of the four nebuliser systems tested produced over 80% of total drug output within the first five minutes of nebulisation. We suggest that five minutes is...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.9.1270
更新日期:1989-09-01 00:00:00
abstract::Polygraphic recordings were made on 10 preterm infants recovering from respiratory distress syndrome and 12 healthy preterm control infants at 40, 52, and 64 weeks' conceptual age to study the influence of respiratory distress syndrome on the development of the sleep apnoea profile. Two significant differences were fo...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.60.6.547
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Children receiving chemotherapy for acute lymphoblastic leukaemia (ALL) may be susceptible to skeletal morbidity. AIM:To determine the incidence and risk factors for skeletal morbidity in ALL children. PATIENTS AND METHODS:The medical records of all (n=186, boys=110) children presenting to a single centre ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2009.172528
更新日期:2010-10-01 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::Measurements of the resistance, time constant, and compliance of the respiratory system were made in 25 mechanically ventilated, preterm babies on 32 occasions, using the single breath technique. Patients were classified according to the level of respiratory resistance by reference to a population of 36 babies studied...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.61.12.1178
更新日期:1986-12-01 00:00:00
abstract::Twice daily sustained release theophylline gave satisfactory steady serum theophylline concentrations in asthmatic children aged 7 to 14 years. The children showed improvement in symptoms, less frequent waking at night, reduced use of beta agonist inhalers, and improved early morning peak flows while being treated wit...
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.59.12.1159
更新日期:1984-12-01 00:00:00