RESUMO
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.
Assuntos
Ácido Láctico/análise , Testes Diagnósticos de Rotina , Humanos , Sepse/diagnóstico , Sepse/terapiaAssuntos
Antibacterianos/uso terapêutico , Padrões de Prática Médica , Infecções Respiratórias/tratamento farmacológico , Medicina Estatal , Criança , Humanos , Seleção de Pacientes , Faringite/tratamento farmacológico , Guias de Prática Clínica como Assunto , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/etiologia , Sinusite/tratamento farmacológico , Reino UnidoRESUMO
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.
Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Lactente , Pescoço/diagnóstico por imagem , Encaminhamento e ConsultaAssuntos
Morte , Técnicas de Diagnóstico Neurológico/normas , Medicina Baseada em Evidências/normas , Unidades de Terapia Intensiva Pediátrica/normas , Neonatologia/normas , Guias de Prática Clínica como Assunto , Ressuscitação/normas , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reino UnidoRESUMO
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.
Assuntos
Serviços de Saúde do Adolescente/normas , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/terapia , Psiquiatria Infantil/normas , Pediatria/normas , Guias de Prática Clínica como Assunto , Psicologia da Criança/normas , Adolescente , Criança , Feminino , Humanos , Masculino , Reino UnidoRESUMO
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.
