P KZN BRONCHIOLITIS X ASTHMA - AND MORE

 Conclusion

The homozygous variant IRAK4 rs4251513 genotype was constantly associated with post‐bronchiolitis asthma and asthma medication in school‐aged children.

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Birth weight increases with birth order despite decreasing maternal pregnancy weight gain

Claudia Bohn, Mandy Vogel, Tanja Poulain, Ulrike Spielau, Cornelia Hilbert, Wieland Kiess, Antje Körner

Version of Record online: 15 October 2020

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Febrile children in the Emergency Department: Frequency and predictors of poor outcome

Elliot Long 

 

Tom Solan 

 

David J. Stephens 

 

Luregn J. Schlapbach 

 

Amanda Williams 

 

Wai Chung Tse 

 

Franz E. Babl

First published: 30 September 2020

 

https://doi.org/10.1111/apa.15602

Funding information:

This study was supported in part by a National Health and Medical Research Council Centre of Research Excellence Grant for Pediatric Emergency Medicine (GNT1058560), Canberra, ACT, Australia. EL was supported by a Melbourne Children's Clinician‐Scientist Fellowship. FEB was supported by a National Health and Medical Research Council Practitioner Fellowship.

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Abstract

Aim

To evaluate the frequency and predictors of poor outcome in febrile children presenting to the Emergency Department.

Methods

Retrospective observational study from the Emergency Department of The Royal Children's Hospital, Melbourne, Australia. All children with presenting complaint of fever or triage temperature >38°C over a 6‐month period were included. Poor outcome was defined as: new organ dysfunction or the requirement for organ support therapy (inotrope infusion, mechanical ventilation, renal replacement therapy and extra‐corporeal life support). Predictors evaluated were as follows: initial vital signs, blood tests and clinical scores. Odds ratio, sensitivity, specificity and area under the receiver‐operating characteristics curve were calculated for each predictor variable.

Results

Between Jan‐June 2019, 6217 children met inclusion criteria. Twenty‐seven (0.4%) developed new organ dysfunction, 10 (0.2%) required organ support therapy (inotrope infusion in 5, mechanical ventilation in 6, renal replacement therapy in 1, extra‐corporeal life support in 1). Odds of new organ dysfunction, requirement for inotropic support and mechanical ventilation were higher with abnormal initial vital signs, blood tests and clinical scores, though overall test characteristics were poor due to infrequency.

Conclusion

Poor outcomes were uncommon among febrile children presenting to the Emergency Department. Vital signs, blood tests and clinical scores were poor predictors.

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Association of Type 1 Diabetes and School Wellbeing

Diabetologia

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• This study examined the association of type 1 diabetes with school well-being among Danish children. The authors analyzed data from a population-based cohort study (n=436,439 children, of whom 1499 had type 1 diabetes). Compared with the background population, children with type 1 diabetes expressed more peer support and reported more often having a headache. Children with poor glycemic control had worse outcomes on the well-being measures compared with the background population, even after adjustment for socioeconomic status.

• In this large Danish study, children with type 1 diabetes felt well supported in school. Children with poor glycemic control, however, had worse psychological school-related well-being than the background population.

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"To be free is to have achieved your life." #######################