Changes in liver structure are an important issue in chronic hepatopathies.Until the end of the 20 th century,these changes could only be determined by histological analyses of a liver specimen obtained via biopsy.The...Changes in liver structure are an important issue in chronic hepatopathies.Until the end of the 20 th century,these changes could only be determined by histological analyses of a liver specimen obtained via biopsy.The well-known limitations of this technique(i.e.,pain,bleeding and the need for sedation)have precluded its routine use in follow-up of patients with liver diseases.However,the introduction of non-invasive technologies,such as ultrasound and magnetic resonance imaging,for measurement of liver stiffness as an indirect marker of fibroses has changed this situation.Today,several noninvasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness.This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children,and discusses their features in comparison to the"historical"tools.展开更多
Hypomagnesaemia is a common finding that occurs in hospitalised patients and can be caused by renal or extrarenal wasting. Because it is not routinely tested, even severe hypomagnesaemia can be missed. In cases of ext...Hypomagnesaemia is a common finding that occurs in hospitalised patients and can be caused by renal or extrarenal wasting. Because it is not routinely tested, even severe hypomagnesaemia can be missed. In cases of extrarenal wasting, the kidney can decrease its magnesium excretion to very low levels. A systematic diagnostic approach allows the proper diagnosis and treatment of hypomagnesaemia. We report on a 72-year-old Caucasian male patient with repeated drops and amyosthenia caused by severe hypomagnesaemia. In this report, we discuss the pathophysiology, clinical signs, diagnostic investigation and treatment of magnesium depletion.展开更多
Aims: To compare prevalence, reasons, motivations, initiation, perceived helpfulness, and communication of complementary and alternative medicine (CAM) use between two tertiary children’ s hospitals. Methodology: A s...Aims: To compare prevalence, reasons, motivations, initiation, perceived helpfulness, and communication of complementary and alternative medicine (CAM) use between two tertiary children’ s hospitals. Methodology: A study, using a face-to-face questionnaire, of 500 children attending the University Hospital of Wales, Cardiff, UK was compared to an identical study of 503 children attending the Royal Children’ s Hospital, Melbourne, Australia. Results: One year CAM use in Cardiff was lower than Melbourne (41% vs 51% ; OR = 0.67, 95% CI 0.52-0.85), reflected in non-medicinal use (OR = 0.41, 95% CI 0.29-0.58) and general paediatric outpatients (OR = 0.38, 95% CI 0.21-0.67). Compared to Melbourne, factors associated with lower CAM use in Cardiff included families born locally (father: OR=0.58, 95% CI 0.44-0.77) or non-tertiary educated parents (mother: OR = 0.54, 95% CI 0.38-0.77). Cardiff participants used less vitamin C (OR = 0.31, 95% CI 0.18-0.51) and herbs (OR= 0.49, 95% CI 0.34-0.71), attended less chiropractors (OR = 0.25, 95% CI 0.06-0.37) and naturopaths (OR = 0.08, 95% CI 0.02-0.33), but saw more reflexologists (OR = 3.33, 95% CI 1.08-10.29). In Cardiff, CAM was more popular for relaxation (OR = 1.92, 95% CI 1.03-3.57) but less for colds/coughs (OR = 0.4, 95% CI 0.27-0.73). Most CAM was self-initiated (by parent) in Cardiff and Melbourne (74% vs 70% ), but Cardiff CAM users perceived it less helpful (OR = 0.46, 95% CI 0.31-0.68). Non-disclosure of CAM use was high in Cardiff and Melbourne (66% vs 63% ); likewise few doctors/nurses documented recent medicinal CAM use in inpatient notes (0/21 vs 2/22). Conclusions: The differences in CAM use may reflect variation in sociocultural factors influencing reasons, motivations, attitudes, and availability. The regional variation in use and poor communication highlights the importance of local policy development.展开更多
Toxic epidermal necrolysis (TEN) is very rare in the newborn period. So far, three cases of TEN in newborns have been reported worldwide. We report a premature infant of 27 weeks’ gestational age with TEN at 4 weeks ...Toxic epidermal necrolysis (TEN) is very rare in the newborn period. So far, three cases of TEN in newborns have been reported worldwide. We report a premature infant of 27 weeks’ gestational age with TEN at 4 weeks of age. Sepsis treated by an antibiotic combination regimen preceding the TENwas a common feature of all four cases. In our patient, coagulase-negative staphylococci could be identified by blood culture, whereas the previously reported patients suffered from Klebsiella pneumoniae sepsis or Escherichia coli sepsis. Possibly, the uniform association with septic infection in the cases of TEN in the neonatal period might hint at a causal association, thus differentiating it from TEN in older children or adults.展开更多
文摘Changes in liver structure are an important issue in chronic hepatopathies.Until the end of the 20 th century,these changes could only be determined by histological analyses of a liver specimen obtained via biopsy.The well-known limitations of this technique(i.e.,pain,bleeding and the need for sedation)have precluded its routine use in follow-up of patients with liver diseases.However,the introduction of non-invasive technologies,such as ultrasound and magnetic resonance imaging,for measurement of liver stiffness as an indirect marker of fibroses has changed this situation.Today,several noninvasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness.This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children,and discusses their features in comparison to the"historical"tools.
文摘Hypomagnesaemia is a common finding that occurs in hospitalised patients and can be caused by renal or extrarenal wasting. Because it is not routinely tested, even severe hypomagnesaemia can be missed. In cases of extrarenal wasting, the kidney can decrease its magnesium excretion to very low levels. A systematic diagnostic approach allows the proper diagnosis and treatment of hypomagnesaemia. We report on a 72-year-old Caucasian male patient with repeated drops and amyosthenia caused by severe hypomagnesaemia. In this report, we discuss the pathophysiology, clinical signs, diagnostic investigation and treatment of magnesium depletion.
文摘Aims: To compare prevalence, reasons, motivations, initiation, perceived helpfulness, and communication of complementary and alternative medicine (CAM) use between two tertiary children’ s hospitals. Methodology: A study, using a face-to-face questionnaire, of 500 children attending the University Hospital of Wales, Cardiff, UK was compared to an identical study of 503 children attending the Royal Children’ s Hospital, Melbourne, Australia. Results: One year CAM use in Cardiff was lower than Melbourne (41% vs 51% ; OR = 0.67, 95% CI 0.52-0.85), reflected in non-medicinal use (OR = 0.41, 95% CI 0.29-0.58) and general paediatric outpatients (OR = 0.38, 95% CI 0.21-0.67). Compared to Melbourne, factors associated with lower CAM use in Cardiff included families born locally (father: OR=0.58, 95% CI 0.44-0.77) or non-tertiary educated parents (mother: OR = 0.54, 95% CI 0.38-0.77). Cardiff participants used less vitamin C (OR = 0.31, 95% CI 0.18-0.51) and herbs (OR= 0.49, 95% CI 0.34-0.71), attended less chiropractors (OR = 0.25, 95% CI 0.06-0.37) and naturopaths (OR = 0.08, 95% CI 0.02-0.33), but saw more reflexologists (OR = 3.33, 95% CI 1.08-10.29). In Cardiff, CAM was more popular for relaxation (OR = 1.92, 95% CI 1.03-3.57) but less for colds/coughs (OR = 0.4, 95% CI 0.27-0.73). Most CAM was self-initiated (by parent) in Cardiff and Melbourne (74% vs 70% ), but Cardiff CAM users perceived it less helpful (OR = 0.46, 95% CI 0.31-0.68). Non-disclosure of CAM use was high in Cardiff and Melbourne (66% vs 63% ); likewise few doctors/nurses documented recent medicinal CAM use in inpatient notes (0/21 vs 2/22). Conclusions: The differences in CAM use may reflect variation in sociocultural factors influencing reasons, motivations, attitudes, and availability. The regional variation in use and poor communication highlights the importance of local policy development.
文摘Toxic epidermal necrolysis (TEN) is very rare in the newborn period. So far, three cases of TEN in newborns have been reported worldwide. We report a premature infant of 27 weeks’ gestational age with TEN at 4 weeks of age. Sepsis treated by an antibiotic combination regimen preceding the TENwas a common feature of all four cases. In our patient, coagulase-negative staphylococci could be identified by blood culture, whereas the previously reported patients suffered from Klebsiella pneumoniae sepsis or Escherichia coli sepsis. Possibly, the uniform association with septic infection in the cases of TEN in the neonatal period might hint at a causal association, thus differentiating it from TEN in older children or adults.
