Asunto(s)
Síndrome de Lemierre , Trombosis de los Senos Intracraneales , Streptococcus constellatus , Antibacterianos/uso terapéutico , Niño , Humanos , Venas Yugulares , Síndrome de Lemierre/complicaciones , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/tratamiento farmacológico , Trombosis de los Senos Intracraneales/diagnósticoAsunto(s)
Sepsis Neonatal/diagnóstico , Streptococcus pneumoniae/aislamiento & purificación , Antibacterianos/administración & dosificación , Femenino , Gentamicinas/administración & dosificación , Humanos , Recién Nacido , Sepsis Neonatal/tratamiento farmacológico , Sepsis Neonatal/fisiopatología , Penicilina G/administración & dosificación , Serogrupo , Resultado del TratamientoAsunto(s)
Antagonistas Adrenérgicos beta/administración & dosificación , Hemangioma/tratamiento farmacológico , Enfermedades del Prematuro/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Timolol/administración & dosificación , Administración Tópica , Hemangioma/patología , Humanos , Recién Nacido , Enfermedades del Prematuro/patología , Neoplasias Cutáneas/patologíaAsunto(s)
Traumatismos del Nacimiento/terapia , Clavícula/lesiones , Fracturas Óseas/terapia , Traumatismos del Nacimiento/diagnóstico , Clavícula/diagnóstico por imagen , Diagnóstico Tardío , Fracturas Óseas/congénito , Fracturas Óseas/diagnóstico por imagen , Humanos , Recién Nacido , Masculino , Radiografía , Factores de RiesgoRESUMEN
Enteroviral meningitis in infants and children commonly leads to hospital admission. Diagnosing viral meningitis can be difficult clinically. We examined the usefulness of enteroviral polymerase chain reaction (PCR) testing using cerebrospinal fluid (CSF) samples on clinical practice by comparing positive enteroviral CSF PCR cases (n = 39/136) to negative controls using both clinical outcomes and laboratory parameters. A positive result correlated with a reduced admission to high dependency unit, reduced the duration of antibiotics and a shorter length of stay (P < .05). Adjusted CSF white cell count > 5/µL correlated with positive PCR (P < .05) but would have missed 32% of cases of enteroviral meningitis. Following these findings, an algorithm for the management of suspected viral meningitis has been introduced.
Asunto(s)
Infecciones por Enterovirus/diagnóstico , Infecciones por Enterovirus/virología , Enterovirus/aislamiento & purificación , Meningitis Viral/diagnóstico , Meningitis Viral/virología , Adolescente , Niño , Preescolar , Enterovirus/genética , Femenino , Humanos , Lactante , MasculinoAsunto(s)
Servicios de Laboratorio Clínico/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/terapia , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Anticuerpos Antifúngicos/inmunología , Sedimentación Sanguínea , Niño , Inglaterra , Heces/química , Pruebas Hematológicas/estadística & datos numéricos , Humanos , Infliximab/sangre , Laboratorios , Complejo de Antígeno L1 de Leucocito/análisis , Metiltransferasas/sangre , Orosomucoide/metabolismo , Saccharomyces cerevisiae/inmunología , Pruebas Serológicas/estadística & datos numéricos , Encuestas y Cuestionarios , Tioguanina/sangre , ViscosidadRESUMEN
Nutrition in the postnatal period is essential to achieve optimal growth and maintain biochemical normality. Feeding growth-restricted premature neonates remains a big challenge for pediatricians and neonatologists. The choice of milk is one of the biggest challenges. Breast milk is recommended, although feeding with preterm formulas can ensure a more consistent delivery of optimal levels of nutrients. The timing of introduction of feeds and the rate of advancement of those feeds in preterm infants are both topics of significant controversy. Early feeding is advantageous because it improves the functional adaptation of the gastrointestinal tract and reduces the duration of total parenteral nutrition. A faster rate of advancement will also reduce the duration of need for parenteral nutrition. Despite this, enteral feeding is often delayed and is often slowly increased in high-risk infants because of a possible increased risk of necrotizing enterocolitis (NEC). Growth-restricted neonates are at increased risk of developing NEC due to a combination of antenatal and postnatal disturbances in gut perfusion. If enteral feeding is introduced earlier and advanced more quickly, this may lead to increased risk of NEC, but slower feeds extend the duration of parenteral nutrition and its risks and may have adverse consequences for survival, growth, and development. Premature infants pose a significant nutritional challenge. Overall, we would suggest the preferential use of human breast milk, early minimal enteral feeds, and standardized feeding protocols with cautious advancements of feeds to facilitate gastrointestinal adaptation and reduce the risk of NEC, however further research is needed.
RESUMEN
Accidental hanging is rare in childhood but is often fatal. Window blind cords pose a particular and unique risk to young children in the UK, accounting for one to two deaths annually. These accidents are frequently associated with non-adherence to the safety instructions provided by the manufacturers. Early discovery of the child and initiation of effective cardiopulmonary resuscitation at the site of the incident are likely to improve the outcome. Prolonged suspension, children who are pulseless at first contact by the emergency paramedic responder, and patients with prolonged periods of remaining in asystole before return of spontaneous circulation after starting cardiopulmonary resuscitation are unlikely to have intact neurological survival. Management in the hospital includes early airway protection by intubation, maintenance of normal oxygen saturation, normothermia, active control of clinical and sub-clinical seizures, and strict electrolyte and glucose regulation. Child safeguarding concerns should be considered when children have asphyxial injuries, and other signs of child physical abuse should be actively looked for. There is a need for stronger legislation in the UK to prevent some of these accidents, especially those relating to window blind cords.