Archives of disease in childhood
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Multicenter Study
Epidemiology of paediatric renal stone disease in the UK.
The previous epidemiological study of paediatric nephrolithiasis in Britain was conducted more than 30 years ago. ⋯ There has been a shift in the epidemiology of paediatric renal stone disease in the UK over the past 30 years. Underlying metabolic causes are now the most common but can be masked by coexisting urinary tract infection. Treatment has progressed, especially surgically, with sophisticated minimally invasive techniques now employed. All children with renal stones should have a metabolic screen.
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Multicenter Study
Chloramphenicol or ceftriaxone, or both, as treatment for meningitis in developing countries?
To determine in children with meningitis whether there is any difference in mortality and neurological sequelae using chloramphenicol as first line treatment, with a change to ceftriaxone if chloramphenicol resistance is shown in vitro, compared to using ceftriaxone as first line treatment, with a change to chloramphenicol if there is no evidence of in vitro resistance. ⋯ Using a third generation cephalosporin as first line treatment is effective in dealing with the problem of poor outcomes from meningitis due to Haemophilus influenzae that is resistant to chloramphenicol, and a strategy of changing to chloramphenicol if in vitro susceptibility is shown will reduce the use of expensive third generation cephalosporins without comprising on clinical outcomes. This highlights the urgent need to reduce the costs of third generation cephalosporins, to improve bacteriological services in developing countries, and to introduce effective and affordable vaccines against H influenzae and Streptococcus pneumoniae.
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Multicenter Study
Evaluation of cultural competence and antiracism training in child health services.
To evaluate the acceptability and effectiveness of cultural competence and antiracism training to professionals providing services to ill or disabled children. ⋯ Appropriate cultural competence and antiracism training is both effective and acceptable in child health services.
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Multicenter Study
The incidence of hypoglycaemia in children with type 1 diabetes and treated asthma.
To investigate whether treatment of coexisting asthma has any effect on the incidence of hypoglycaemia and on glycaemic control in children with type 1 diabetes. ⋯ Diabetic children with treated asthma have significantly fewer episodes of hypoglycaemia and better glycaemic control compared to children with diabetes alone. This observation needs further investigation but raises an interesting question. Do the drugs used to treat asthma, in particular beta agonists, have the therapeutic potential to reduce hypoglycaemia and facilitate an improvement in glycaemic control?
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Multicenter Study
Maternity advice survey: sleeping position in Eastern Europe. MAS Study Group for WHO EURO region.
To identify hospitals in Eastern Europe promoting front infant sleeping position. ⋯ A total of 489 hospitals in 20 countries responded. Preferred position in normal care units was back (26.6%), front (1. 8%), side (65%), or combination/none (6.6%). Corresponding recommendations at discharge were 17.4%, 3.5%, 73%, and 6.1%.