news you choose to use or loose - scah.uct.ac.za...pulmonology update 2010 bronchiolitis - new sa...
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News you choose ..... to use or loose
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Road-to-Health book growth chart
WHO chart
international sample of children (not just USA)
all breastfed (unlike NCHS & CDC charts)
all healthy children
data longitudinal for ages 0-24 months
Z-scores!
same as standard deviations
-2 line ≈ -2 Z-scores ≈ 2 SDs ≈ 3rd centile ≈ “moderate”
-3 line ≈ -3 Z-scores ≈ 3 SDs ≈ 1st centile ≈ “severe”
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Infectious diseases
Important paper: Dheda K, et al. Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. Lancet 2010;375:1798-1807
Global guidelines update: World Health organization. Antiretroviral therapy for HIV infection in infants and children: Towards Universal access. Recommendations for a public health approach, 2010 revision.
http://whqlibdoc.who.int/publications/2010/9789241599801_eng.pdf
Forthcoming conference:3rd International Workshop on HIV Pediatrics, Rome, Italy, 17 – 20 July 2011
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Gastroenterology Guidelines and Position Statements
European Society for Paediatric Gastroenterology and Nutrition (ESPGHAN): http://espghan.med.up.pt
Enteral Nutrient Supply for Preterm Infants 2009
Paediatric Gastroesophageal Reflux Clinical Practice Guidelines 2009
Breastfeeding 2008
Complimentary Feeding 2009
North American Paediatric Gastroenterology and Nutrition (NASPGHAN): http://naspghan.org
Evaluation and Treatment of Constipation in Infants and Children 2006
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Neurology Great web-site American Academy of Neurology for
Practice Guidelines (strict evidence based data) http://www.aan.com/practice/guideline/
Examples Pharmacologic Treatment of Spasticity in Children and
Adolescents with Cerebral Palsy
(Jan 2010)
Evaluation of the Child with Microcephaly
(Sept 2009)
Diagnostic Assessment of the Child with Status Epilepticus
(Oct 2010)
Evaluation of Children and Adolescents with Recurrent Headache
(Feb 2008)
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Critical Care and Heart Diseases
PICU Survivor
I survived sepsis because my doctor ...
1. Recognised my sepsis early;
2. Immediately gave me oxygen;
3. Immediately gave me iv fluids;
4. Immediately gave me antibiotics;
5. Started dopamine early.
Thanks guys, you saved my life!!!!!! You were brilliant, fantastic, supreme….!!
(I was coached to say this!)
Remember the updated
“Surviving Sepsis” Guidelines!!
(www.survivingsepsis.com)
(www.wfpiccs.org)
http://www.survivingsepsis.com/
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Nephrology: New protocol for investigations of a UTI
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Nephrology Approach to incontinence and enuresis
See updated text in the Oxford Handbook of paediatrics,
7th edition
Recommended reading: Wright, A. Evidence-based
assessment and management of childhood enuresis.
Paediatrics Child Health. 2008;18:561-567
2 day workshop on ‘Bladder Blues” and Incontinence
Presented by the Children’s Continence Society, with
Anne Wright as a invited speaker
Applicable to all
Attached to the Refresher Course 2012
Details to follow
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Haematology-Oncology
Paediatric Haem-Onc Shared Care Update … Feb 12 at RCCH
South African Children’s Cancer Study Group (SACCSG) Workshop …
September 2 – 4 in Pretoria
43rd Annual Congress of the International Paediatric Oncology Society (SIOP) …
October 26 – 30 in Auckland, New Zealand
African continental meeting of SIOP in 2012 … March 21 – 23 in Cape Town
Celebrating African Excellence - Celebration de l’excellence Africaine
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Pulmonology Update 2010 Bronchiolitis - new SA guidelines SAMJ 2010 Hypertonic saline nebulisation effective to reduce
length of hospital stay and severity of illness Pneumonia in HIV-infected children – new WHO
guidelines Ampi and genta or ceftriaxone as empiric therapy Empiric cotrimoxazole for children 2 mnth to 1 yr Asthma Long acting B2 agonists are preferred add – on therapy
for children over 5 years uncontrolled on ICS (BADGER study NEJM 2010)
Fixed drug combinations preferable
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Pulmonology Update 2010 TB New WHO/ IUALTD guidelines in children for TB
treatment higher doses of all drugs 4 drug treatment for PTB in high HIV prevalence
areas or for extensive disease daily (not thrice weekly) treatment in high HIV
prevalence areas WHO new recommendation for TB diagnosis
PCR based test (Gene Xpert) as 1st line investigation for suspected PTB in areas of high drug resistance or high HIV prevalence
New WHO guidelines for prevention of TB in HIV-infected recommend up to 3 yrs of INH prophylaxis in those
who are not symptomatic for TB