Thermometry in paediatric practice

Body temperature is commonly measured to confirm the presence or absence of fever. However, there remains considerable controversy regarding the most appropriate thermometer and the best anatomical site for temperature measurement. Core temperature is generally defined as the temperature measured within the pulmonary artery. Other standard core temperature monitoring sites (distal oesophagus, bladder, and nasopharynx) are accurate to within 0.1-0.2 degrees C of core temperature and are useful surrogates for deep body temperature. However, as deep-tissue measurement sites are clinically inaccessible, physicians have utilised other sites to monitor body temperature including the axilla, skin, under the tongue, rectum, and tympanic membrane. Recent studies have shown that tympanic temperature accurately reflects pulmonary artery temperature, even when body temperature is changing rapidly. Once outstanding issues are addressed, the tympanic site is likely to become the gold standard for measuring temperature in children.     

Biomarkers in paediatric research and practice

Children's health is, to a large extent, a function of their environment. Infectious agents remain the leading cause of death and disability in the world. In contrast, many of the new morbidities--asthma, intellectual impairments, behavioural problems, and cancer--are linked with industrial pollutants or other environmental influences. Our understanding of the risk factors for many diseases is incomplete, but it is widely recognised that disability and death result largely from interactions of environmental factors, broadly defined, and host susceptibility.     

Thermometry in paediatric practice.

Body temperature is commonly measured to confirm the presence or absence of fever. However, there remains considerable controversy regarding the most appropriate thermometer and the best anatomical site for temperature measurement. Core temperature is generally defined as the temperature measured within the pulmonary artery. Other standard core temperature monitoring sites (distal oesophagus, bladder, and nasopharynx) are accurate to within 0.1-0.2 degrees C of core temperature and are useful surrogates for deep body temperature. However, as deep-tissue measurement sites are clinically inaccessible, physicians have utilised other sites to monitor body temperature including the axilla, skin, under the tongue, rectum, and tympanic membrane. Recent studies have shown that tympanic temperature accurately reflects pulmonary artery temperature, even when body temperature is changing rapidly. Once outstanding issues are addressed, the tympanic site is likely to become the gold standard for measuring temperature in children.     

Renal stones in paediatric practice

Renal stones in children differ greatly from those in adults both in presentation, aetiology and treatment. This review highlights the critical aspects of paediatric stones that are particularly relevant for the general paediatrician and their practice.     

Current practice in paediatric videofluoroscopy

Use of the videofluoroscopy swallow study (VFSS), also known as the modified barium swallow (MBS), continues to increase in children. This article reviews the scope and limitations of the examination, explores the current techniques and illustrates some of the main findings. As moving images are key to the understanding of the use of this technique short videos are available in the on-line version of this paper.Electronic Supplementary Material Supplementary material is available in the online version of this article at and is accessible for authorized users     

Cardiac arrhythmias in paediatric practice

Clinical data of patients with cardiac arrhythmias managed between May 1986 and March 1988 were reviewed to determine their mode of presentation and clinical course. Of the 5,768 admissions, 62 (1.07%) patients had arrhythmias. During the same period, 21 patients were managed as outpatients with 13 being new referrals. Thirty-eight patients had undergone corrective cardiac procedures, 8 others had congenital heart lesions, 3 were associated with acquired cardiac pathology and the remaining had isolated arrhythmias. The cardiac arrhythmias were: right bundle branch block 36, premature atrial and ventricular contractions 15, supraventricular tachycardia (SVT) 15, atrioventricular (AV) block 7, sinus bradycardia 3, atrial fibrillation 2, ventricular tachycardia and fibrillation 2, Wolff-Parkinson-White syndrome without SVT 2, bradytachyarrhythmia 1. There were 3 patients with foetal SVT, one persisting till day 1. High grade AV block occurred in 2 patients post-surgically and needed pacing. Only 2 others were symptomatic. Other than the 38 patients who underwent corrective procedures (2 had balloon valvuloplasty for pulmonary stenosis), 8 others had structural heart disease. There was 1 sudden death and 5 died from their primary heart disease.     

Adolescent medicine in paediatric practice

Adolescents are a growing area in paediatric practice in both hospital and community settings. They make up around one quarter of the practice of many paediatricians. Yet until recently there has been little formal interest in young people's health in the UK. The situation is now changing, particularly following the publication of the "National Service Framework for children, young people and maternity services", which places a major emphasis on adolescent health. Given that this area is relatively new to many paediatricians, this article aims to provide an overview of the range of health problems that affect young people, to provide practical advice for working with this group in paediatric practice, and to outline current and future opportunities for training in adolescent health in the UK.     

Biomarkers in paediatric research and practice.

Children's health is, to a large extent, a function of their environment. Infectious agents remain the leading cause of death and disability in the world. In contrast, many of the new morbidities--asthma, intellectual impairments, behavioural problems, and cancer--are linked with industrial pollutants or other environmental influences. Our understanding of the risk factors for many diseases is incomplete, but it is widely recognised that disability and death result largely from interactions of environmental factors, broadly defined, and host susceptibility.     

Adolescent medicine in paediatric practice.

Adolescents are a growing area in paediatric practice in both hospital and community settings. They make up around one quarter of the practice of many paediatricians. Yet until recently there has been little formal interest in young people's health in the UK. The situation is now changing, particularly following the publication of the "National Service Framework for children, young people and maternity services", which places a major emphasis on adolescent health. Given that this area is relatively new to many paediatricians, this article aims to provide an overview of the range of health problems that affect young people, to provide practical advice for working with this group in paediatric practice, and to outline current and future opportunities for training in adolescent health in the UK.     

Advanced paediatric life support in practice

Paediatric resuscitation guidelines provide a framework allowing resuscitation teams to work in a coordinated fashion to provide timely resuscitation to the collapsed child. Effective resuscitation systems include early recognition of sick children, communication systems, training of parents and healthcare professionals, provision of equipment and direct clinical care to the critically ill child. Clinical outcomes may be improved by early recognition and timely intervention to prevent further deterioration. If collapse has occurred effective and timely management is essential to optimize outcomes.     

Congenital haemorrhagic disorders in paediatric practice

Summary Clinical and diagnostic laboratory findings are described in all cases of haemophilia A and 2 cases of haemophilia B. Bleeding from the umbilical stump, an unusual feature, was noted in 2 cases of haemophilia A and one case of haemophilia B. In all the patients with haemophilia A, haemostasis was achieved by the transfusion of a single unit of fresh blood or plasma. The control of bleeding in haemophilia B was difficult and required many transfusions.