John diagnosed with autism at 18 months old presents to your developmental clinic at 30 months old. His mother reports developmental regression of previously acquired developmental milestones. He has now lost his previously acquired language skills and only makes incomprehensible babbles. He is otherwise clinically well and does not have any clinical seizures. You wonder […]
Category: archimedes
Unanswered Question: Is LDH a good predictor of malignancy in children?
A four-year old girl presents to the accident and emergency department with a history of being generally unwell for the preceding week and on examination is found to have cervical lymphadenopathy. In addition to a volley of tests, a Lactate Dehydrogenase (LDH) was requested by a registrar who had read that this was a predictor […]
Unanswered Question: Is cranio-sacral therapy useful in the management of crying babies?
An eight week old baby is admitted with mild bronchiolitis. His parents mention that he has always cried a lot and that he is having a course of cranio-sacral therapy to try and improve things. You wonder whether there is any evidence for this. […]
Unanswered Question: What is the long term outcome for antenatally drug exposed children?
Whilst attending the adoption panels it has become clear that many of the prospective parents ask about the antenatal drug exposure of the babies and what that means for the future for these children. They are given fairly vague advice and told that we can’t be sure of the outcome and so are left with […]
Is the use of Chest Physiotherapy Beneficial in Children with Community Acquired Pneumonia?
A 7 year old boy is admitted to the General Paediatric ward with a community acquired pneumonia affecting the right lower lobe. It is suggested on the ward round that we arrange chest physiotherapy to try and reduce the length of his hospital stay. We wonder if there is evidence to support the use of […]
What is the best treatment for empyema?
A 7 year old child with a history of cough and fever for 1 week, has bronchial breathing over her left lower zone on auscultation. A diagnosis of lobar pneumonia is made, confirmed on plain chest x-ray, and she is treated with appropriate intravenous antibiotics. However, she continues to have a spiking fever and develops […]
What is the best treatment for hyperkalaemia in a preterm infant?
A 720g neonate in the intensive care unit develops severe hyperkalaemia with cardiac arrhythmia. The Specialist registrar decides to give a Calcium Gluconate bolus and start an Insulin and Dextrose infusion. The new Registrar queries why Salbutamol and Ion Exchange resins were not considered as these therapies are frequently used in management of hyperkalaemia in […]
Fixing and Focussing
Imagine the situation: you’re in a clinic and in comes a 7 year old child with a belly ache. The ache has been there, on and off for 3 years. Investigations have been undertaken for at least 2 years, in two different centres, and have included blood, stool, radiological and invasive procedures. No clear diagnosis […]
Remember Rambo?
Back in 1982, when some of the readers of this journal were being tucked up in bed, others were doing the tucking-up and yet more had already fallen asleep in their armchairs, Sylvester Stallone wandered half-naked around the outskirts of a fictional US town in the film “First Blood”. However, this memorable character (John Rambo) […]