Autologous haematopoeitic stem cell rescue (AHSCR) for severe rheumatic disease in children: guidance for BSPAR members--executive summary.
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Biomedical subjects
Publications and source records attributed to E Baildam.
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OBJECTIVE: To assess the long-term outcome of anterior knee pain diagnosed in childhood. METHOD: Forty-eight patients diagnosed with anterior knee pain in childhood were contacted by postal questionnaire 4-18 yr after initial presentation. RESULTS: The 22 respondents comprised 16 women and six men, with mean age at follow-up of 22 yr. Twenty of 22 (91%) still had knee pains, eight daily, two weekly and 10 occasionally. In 10 (45%) the pain affected their daily life and in eight (36%) it restricted their physical activities. Twelve (54%) used painkillers. Ten (45%) had developed other diagnoses: four had psoriasis and six arthritis, of whom one had ankylosing spondylitis. Fifteen (68%) had symptoms in other joints at follow-up. CONCLUSION: These results suggest that anterior knee pain that occurs in childhood may not be so benign a condition as thought.
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AIMS: To evaluate the efficacy and safety of nitrous oxide-oxygen for children with juvenile idiopathic arthritis (JIA) undergoing intra-articular corticosteroid injection. METHODS: A total of 55 consecutive patients with JIA undergoing intra-articular corticosteroid injection, using self administered nitrous oxide-oxygen for analgesia were studied. Patient, nurse, and parent pain scores were compared using a 0-10 cm visual analogue scale (VAS) immediately after the procedure. RESULTS: A total of 70 joints were injected in 55 patients (median age 13.54 years). The median pain score for patient, nurse, and parent was 1 (0-10 cm VAS). The mean rank patient score was 2.12, which was greater than the nurse score (1.97), which was greater than the parent score (1.91). These differences were significant. There were no serious adverse events in any patient. CONCLUSIONS: Nitrous oxide-oxygen provides safe and effective analgesia for intra-articular injection in children. In some cases, nurses and parents underestimated pain related to the procedure compared to the child.
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We report herein the results of the cross-cultural adaptation and validation into the British language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. A total of 440 subjects were enrolled: 219 patients with JIA (17% systemic onset, 41% polyarticular onset, 33% extended oligoarticular subtype, and 9% persistent oligoarticular subtype) and 221 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the British version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.