ABSTRACT
The association between hyperlactataemia and poorer outcomes in acutely unwell adults and children is well recognised. Blood lactate testing has become readily available in acute settings and is considered a first-line investigation in international guidelines for the management of sepsis. However, while healthcare professionals do appreciate the value of measuring blood lactate in acute severe illness, its clinical significance and interpretation remain less well understood. In this paper, we present the evidence for the use of lactate as a diagnostic test and prognostic marker in acutely unwell children.
Subject(s)
Lactic Acid/analysis , Diagnostic Tests, Routine , Humans , Sepsis/diagnosis , Sepsis/therapyABSTRACT
Studying head and neck anatomy may be a distant memory and clinicians can struggle with how to approach neck lumps diagnostically. This article gives a brief guide to common (and rare but serious) causes of neck lumps in infancy, their identification and management.
Subject(s)
Head and Neck Neoplasms , Head and Neck Neoplasms/diagnosis , Humans , Infant , Neck/diagnostic imaging , Referral and ConsultationSubject(s)
Anti-Bacterial Agents/therapeutic use , Practice Patterns, Physicians' , Respiratory Tract Infections/drug therapy , State Medicine , Child , Humans , Patient Selection , Pharyngitis/drug therapy , Practice Guidelines as Topic , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , Sinusitis/drug therapy , United KingdomABSTRACT
We present a review of the Junior MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa) guideline, which provides paediatricians with a framework for managing Anorexia Nervosa in the inpatient setting.
Subject(s)
Adolescent Health Services/standards , Anorexia Nervosa/diagnosis , Anorexia Nervosa/therapy , Child Psychiatry/standards , Pediatrics/standards , Practice Guidelines as Topic , Psychology, Child/standards , Adolescent , Child , Female , Humans , Male , United KingdomABSTRACT
PURPOSE: To analyse and to compare how female patients are informed about adhesions and their related problems by surgeons preoperatively. METHODS: Over 8 weeks 105 patients (Germany) and 82 (UK) patients admitted for laparoscopic or open abdominopelvic surgery were interviewed preoperatively in a multi-centre study in Germany and the UK. 212 responses to an online survey were also analysed. RESULTS: Less than 50% of patients are made aware of adhesions. Even fewer patients were told about complications caused by adhesions. Lack of knowledge is cited by 46% of patients as a reason for health professionals not informing them about adhesions. 41% considered adhesions as not sufficiently important. Patients who had previously heard of adhesions were most commonly informed by physicians. CONCLUSIONS: There is lack of information among patients and physicians about adhesions and their complications. Written information before surgery and computer-based applications may help raise patient's awareness.