ADC Precis

Human Bocavirus

Ian Wacogne — Wed, 20 Aug 2008 19:54:32 +0000

In hospitalised Spanish children, Human Bocavirus (HBoV) - a type of parvovirus - was the second most commonly discovered viral infection after RSV, and was found in children with a variety of clinical presentations. Here.

Here’s another virus to add to my “I can’t test for it yet at my place” list - HBoV. Actually, it isn’t that long a list - the only other one on it is metapneumovirus. And oddly enough, now I come to look it up, this article - which started to make me wonder about metapneumovirus - is by the same authors.

So, are they just trawling their patients, finding new viral associations? Or is it really clinically significant - should it be something I test for? My usual question for this is: Will it change my management? And my answer? Perhaps. Why? Because of how I respond to adenovirus. During the middle of the yearly bronchiolitis epidemic I usually get one baby who doesn’t get better fast enough, and they begin to make me nervous. And then, after a day or two, I get an NPA which is positive for adenovirus. And then - and perhaps I’m wrong in this - I relax quite a bit, recognising that the clinical course is going to be about twice as long as RSV bronchiolitis. So, if I knew enough about these two viruses, maybe it would save me worrying, and more importantly, stop me investigating unnecessarily.

Leukaemia and lymphoma

Ian Wacogne — Wed, 20 Aug 2008 19:40:02 +0000

An ad hoc registration system in Greece suggests a high leukaemia rate compared to the rest of Europe, with a relatively normal lymphoma rate. Here.

Stool patterns in under four year olds

Ian Wacogne — Wed, 20 Aug 2008 19:37:00 +0000

These authors have used the ALSPAC cohort to look at the range of normality and changing patterns in stools in the first four years of life. Here.

You’ve got to admire a study which asks more than 12,000 parents about their child’s stools. This gives us some valuable data on what is normal, and also some simple data on what is not normal - for example black stools are hardly seen at all at any age. What I guess I might like to have seen, as a general paediatrician, is some data on:

how many of the children had been breast fed, and whether their stools are qualitatively different - experience suggests yes, but this would be great to pin down
how many of the children had been treated for constipation - which, one assumes, might tend to blunt the end of the distribution curve
how many of the parents thought that the stool pattern was normal or abnormal - which is something I find that parents struggle with a lot
whether medicines were changing the colour of the stools. For example, we’re usually fairly comfortable that iron turns stools black - does it always?

If I know ALSPAC I’m sure that about half of this is already in their database, so come on then…

Diabetes education

Ian Wacogne — Wed, 20 Aug 2008 19:25:57 +0000

In a pilot study of 5 day outpatient education courses in diabetes aimed at adolescents the authors found improvements in reported quality of life, but not in HbA1c. Here.

Gentamicin dosing

Ian Wacogne — Wed, 20 Aug 2008 19:19:20 +0000

Use of a prescribing aid improved accuracy of prescription of gentamicin. Here.

This begs an interesting question. We’ve mostly become familiar in the UK with the British National Formulary for Children - BNFc - to aid prescribing. The strength of this book lies in the highly repetitive way in which the information is structured, and although at first many people found it harder to use than the excellent Medicines for Children - which it replaced - most of us have got used to it. But is a standardised way the best way to describe the prescription of all medicines? Should we have different ways of describing some of our more complex prescriptions?

Mortality from RSV

Ian Wacogne — Wed, 20 Aug 2008 19:14:37 +0000

In an eight year study of mortality in a tertiary paediatric intensive care, risk of death from RSV significantly higher in those children with pre-existing morbidity, especially cardiac or respiratory. Here.

HSP and meningococcal B immunisation

Ian Wacogne — Wed, 30 Jul 2008 19:33:01 +0000

A surveillance program in New Zealand found no link between meningococcal B immunisation and the subsequent development of HSP. Here.

Exercise and Obesity

Ian Wacogne — Wed, 30 Jul 2008 19:30:31 +0000

A longitudinal study of the activity of children suggests that higher physical activity is associated with increased metabolic health, but not measures such as BMI or fatness. Here.

SUDI post mortems

Ian Wacogne — Wed, 30 Jul 2008 19:26:12 +0000

Of 546 post mortems carried out for Sudden Unexplained Death in Infancy in a tertiary institution over a decade, an explanation for death was found in 202. Here.

Tuberculosis epidemiology

Ian Wacogne — Tue, 29 Jul 2008 18:57:10 +0000

In the period 1999 to 2006, in England and Wales 3563 cases of tuberculosis were reported in a national surveillance program, of which 60% were primary pulmonary TB. Here.