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March 2008 Issue

3 Mar, 08 | by Ian Wacogne

This post collects together the precis of the major articles – perspectives, leading articles and original articles – in the March 2008 issue.

Perspectives

Tuberculin skin test

Shingadia and Novelli look at the 100 year history of the tuberculin skin test and note that it is not yet obsolete if used with clinical acumen. Here.

Drug doses

Hawcutt and Smyth look at the implications for children and medicines from the fact that doses cannot be scaled, and that separate trials need to be carried out in children to determine doses, efficacy, etc. Here.

End of Life Care

Gillis looks at the challenges in working with families at the end of children’s lives. Here.

Leading Articles

Emergency Care

Davies looks at the changing provision of emergency care for children in the UK. Here.

Reflux Nephropathy

Coulthard looks at the prevention of reflux nephropathy, and reflects on the ability of the UK NICE guidelines to prevent it. Here.

Original articles

Tuberculosis screening

Of 103 children seen for TB contact tracing screening, application of the recent UK NICE guideline, which includes gamma IFN testing, 23 would have had a different treatment to that determined by previous screening methods. Here.

Medical Abbreviations

In a review of 25 sheets used in handover of patients, 2286 abbreviations were used, many of which were non-standard, were not found in standard medical dictionaries, and were misunderstood by the doctors for which they were intended. Here.

Scaling of drug doses

None of three methods of scaling doses, based on dose per body surface area, body weight, and body weight to the power 0.75, were accurate in predicting the suggested dose from a formulary. Here.

Growth monitoring

After reviewing the literature this group present a set of criteria, with flow diagram, for referral of children for further assessment of their growth which detects 87.5% of children with Turner’s syndrome, and 76.5% of children with other disorders, with a false positive rate of 2%. Here.

Pneumococcal resistance

In 240 South American children with severe pneumococcal pneumonia, the presence of in-vitro resistance to penicillin did not predict treatment failure, suggesting that intravenous penicillin or ampicillin remains the treatment of choice. Here.

Nephrotic Syndrome

40 Sri Lankan children with steroid dependent nephrotic syndrome on alternate day prednisolone were randomised in a crossover trial. The occasions when they were increased to daily prednisolone were associated with significantly fewer relapses; 17.5% instead of 47.5%. Here.

Urinary Tract Infection

IN 363 Thai children with urinary tract infection, timing of voiding cystouretrogram – fewer or greater than 7 days after infection – made no difference to the prevalence of reflux detected. Here.

Hearing screening

In a survey of UK school entry hearing screening services, there is a small yield for hearing loss which may indicate the importance of a continuing role for this sort of screening. Here.

Short Report

Asthma

A screening cross-sectional study of 1758 Dutch children aged 7 to 10 found 130 (8%) with previously undiagnosed asthma, of whom a third – characterised as those with more highly educated mothers – declined to take them to a GP for further management. Here.

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