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Biomedical subjects

A Riordan

Publications and source records attributed to A Riordan.

9 recordsLinked to original sources
PubMed2007

Hyponatraemia and hypokalaemia during intravenous fluid administration.

BACKGROUND: Hospital-acquired hyponatraemia is associated with excessive volumes of hypotonic intravenous fluids and can cause death or permanent neurological deficit. METHODS: A cross-sectional survey was carried out in 17 hospitals on all children receiving intravenous fluids during 1 day of a specified week in December 2004. RESULTS: 77 of 99 children receiving intravenous fluids received hypotonic solutions and 38% received >105% of fluid requirements. 21 of 86 children were hyponatraemic, but the electrolytes of only 79% had been checked in the preceding 48 h. CONCLUSIONS: Intravenous fluids should be used with caution as regards the tonicity and volume administered, and with appropriate monitoring of serum electrolytes.

Adolescent↗
PubMed2003

Decline in mortality, AIDS, and hospital admissions in perinatally HIV-1 infected children in the United Kingdom and Ireland.

OBJECTIVE: To describe changes in demographic factors, disease progression, hospital admissions, and use of antiretroviral therapy in children with HIV. DESIGN: Active surveillance through the national study of HIV in pregnancy and childhood (NSHPC) and additional data from a subset of children in the collaborative HIV paediatric study (CHIPS). SETTING: United Kingdom and Ireland. PARTICIPANTS: 944 children with perinatally acquired HIV-1 under clinical care. MAIN OUTCOME MEASURES: Changes over time in progression to AIDS and death, hospital admission rates, and use of antiretroviral therapy. RESULTS: 944 children with perinatally acquired HIV were reported in the United Kingdom and Ireland by October 2002; 628 (67%) were black African, 205 (22%) were aged > or = 10 years at last follow up, 193 (20%) are known to have died. The proportion of children presenting who were born abroad increased from 20% in 1994-5 to 60% during 2000-2. Mortality was stable before 1997 at 9.3 per 100 child years at risk but fell to 2.0 in 2001-2 (trend P < 0.001). Progression to AIDS also declined (P < 0.001). From 1997 onwards the proportion of children on three or four drug antiretroviral therapy increased. Hospital admission rates declined by 80%, but with more children in follow up the absolute number of admissions fell by only 26%. CONCLUSION: In children with HIV infection, mortality, AIDS, and hospital admission rates have declined substantially since the introduction of three or four drug antiretroviral therapy in 1997. As infected children in the United Kingdom and Ireland are living longer, there is an increasing need to address their medical, social, and psychological needs as they enter adolescence and adult life.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Diagnosis of primary human herpesvirus 6 and 7 infections in febrile infants by polymerase chain reaction.

Primary human herpesvirus 6 (HHV-6) and 7 (HHV-7) infections were identified in febrile children by qualitative and quantitative polymerase chain reaction (PCR) assays. Diagnosis was based on the differential detection of viral DNA in peripheral blood mononuclear cells (PBMC), but not in saliva. Six of 41 febrile infants, but none of seven non-febrile controls, were identified with primary infections (three HHV-6, three HHV-7). These children had significantly higher viral loads in PBMC (HHV-6, median 24213 genomes/10(6) PBMC; HHV-7, median 6,040,000 genomes/10(6) PBMC) than DNA-aemic, saliva PCR positive children (HHV-6, median 1606 genomes/10(6) PBMC, p < 0.01; HHV-7, median 7089 genomes/ 10(6) PBMC, p < 0.05). Viral DNA was detected in serum by PCR in only 50% of primary infections. All three children with primary HHV-7 infection had febrile convulsions. Thus PCR, including quantitative assays, may identify primary HHV-6 and HHV-7 infections when an appropriate combination of clinical specimens is used.

DNA, Viral↗
PubMed1995

Hearing assessment after meningitis and meningococcal disease.

A method to increase audiology referral after meningitis or meningococcal disease was audited in 89 children. A standardised proforma increased referrals from 78% to 96% over a two year period. However, only 73% of children had a hearing test. The major reason for hearing not being tested changed from non-referral to non-attendance.

Child↗
PubMed1994

Primary cutaneous infection by Aspergillus ustus in a 62-year-old liver transplant recipient.

We report the first case of primary cutaneous aspergillosis caused by Aspergillus ustus, a species that seldom infects human beings. The patient, a 62-year-old liver transplant recipient with end-stage hepatitis C-induced cirrhosis, was receiving the experimental immunosuppressive drug FK-506. Trauma to the skin of the right arm from tape and from an arm board holding intravenous and intraarterial catheters in place and to the left leg from an occlusive knee brace may have contributed to this unusual mycosis. The patient's cutaneous aspergillosis responded to a combination of intravenous amphotericin B and topical terbinafine cream. Although the patient died shortly thereafter from hepatic failure, there was no evidence of systemic aspergillosis.

Aspergillosis↗
PubMed1994

Congenital peripheral neuropathy presenting as apnoea and respiratory insufficiency.

A seven-week-old girl presented with recurrent apnoeic episodes and respiratory insufficiency. The child was hypotonic, weak, areflexic and had a paradoxical movement of the right hemidiaphragm. Cranial nerve and sphincter function was normal; there was no fasciculation. Nerve conduction studies showed a severe axonal sensory and motor peripheral neuropathy. Biopsy of the sural nerve revealed marked axonal atrophy. The infant is now over two years of age, is ventilator-dependent and has clinical and electrophysiological evidence of further progression of one of the earliest reported presentations of a congenital peripheral neuropathy.

Apnea↗
PubMed1993

Children who are seen but not referred: hearing assessment after bacterial meningitis.

Bacterial meningitis is an important cause of hearing loss in children. Previous studies have shown that a proportion of survivors of childhood bacterial meningitis do not have a formal hearing assessment. To confirm this finding amongst children treated for bacterial meningitis in our hospital, a retrospective audit was performed. The hospital case notes and community audiological records were examined to see how many children were referred for hearing assessment after their illness, and how many actually attended. Between 1984 and 1991, 194 children were directly admitted to our hospital with bacterial meningitis. Thirteen children died, and hearing assessment was carried out on 135 of the 181 survivors (75%), 15 of whom had evidence of sensorineural hearing loss. The major reason for hearing not being assessed was non-referral (31 out of 46 cases), 12 children did not attend for assessment despite referral, and three moved shortly after discharge. Thirty of the children remaining in the area who had no assessment (69.7%) were however seen in hospital out-patients. Routine referral for hearing testing at discharge, with re-referral at out-patient attendance, could help increase the number of children assessed after bacterial meningitis.

Aftercare↗
PubMedDate not supplied

Pets and diseases.

Pet ownership is very common. Pets contribute to the physical and mental wellbeing of their owners but do have the potential to cause disease. These diseases are uncommon but recognition that disease could be because of a family pet will lead to correct management for both the patient and the pet and may prevent further disease.

Adult↗