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mercredi 11 novembre 2020
Clinical management of sickle cell liver disease in children and young adults
Liver involvement in sickle cell disease (SCD) is often referred to as sickle cell hepatopathy (SCH) and is a complication of SCD which may be associated with significant mortality. This review is based on a round-table workshop between paediatric and adult hepatologists and haematologists and review of the literature. The discussion was prompted by the lack of substantial data and guidance in managing these sometimes very challenging cases. This review provides a structured approach for the diagnosis and management of SCH in children and young adults. The term SCH describes any hepatobiliary dysfunction in the context of SCD. Diagnosis and management of biliary complications, acute hepatic crisis, acute hepatic sequestration and other manifestations of SCH are discussed, as well as the role of liver transplantation and haemopoietic stem cell transplantation in the management of SCH.
from ADC Online First https://ift.tt/32xEbiA
mardi 10 novembre 2020
lundi 9 novembre 2020
jeudi 5 novembre 2020
lundi 2 novembre 2020
Prioritising paediatric staff and space so every child has access to care
Paediatric and child health services must be protected from redeployment of staff and space in the future to safeguard the welfare of vulnerable and unwell children. Across the NHS, there was rapid reconfiguration in response to the COVID-19 pandemic. As children are rarely clinically affected by the disease, paediatric staff and services were often considered lower priority and therefore were reassigned to support the pandemic response. This was the right thing to do at the time. However, it is clear that children have disproportionately suffered during this period and they must now be prioritised.
Between April and July 2020, we collected weekly data from paediatric services about the impact of COVID-19 (see ). Our study found that in this period, up to 10% of all paediatric staff were not available to work (eg, shielding). Up to 22% of junior paediatric medical staff (on the tier 1 rota) were redeployed to adult...
from ADC Online First https://ift.tt/3254wnP
vendredi 30 octobre 2020
jeudi 29 octobre 2020
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