Group B Streptococcus (GBS) is the most common cause of early-onset neonatal sepsis and meningitis. In babies with no clinical suspicion of infection, who are at risk of early-onset invasive disease based on maternal risk factors, blood cultures are taken to detect bacteraemia. In our institution, lumbar punctures are performed in infants with clinical signs of sepsis but not in infants who are well at the time of screening. Between 2001 and 2014, there were 112,361 live births weighing >500 g, of whom 13,959 (12.4%) infants had a blood culture taken on the first or second day of life, and 1971 (14.1%) of these infants had lumbar punctures on these first two days of life. Fifty-three cases of early-onset GBS disease were identified. Only three patients with invasive GBS disease had no clinical suspicion for sepsis at the time of testing. Thus, the number of blood cultures taken to detect one case of GBS bacteraemia in an infant who is well at the time of testing was 3996.
2. Rand CM, Patwari PP, Rodikova, et al. Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation: analysis of hypothalamic and autonomic candidate genes. Pediatr Res. 2011; 70:375-8. 3. Bougneres P, Pantalone L, et al. Endocrine manifestations of the rapid-onset obesity with hypoventilation, hypothalamic, autonomic dysregulation, and neural tumor syndrome.Introduction Students presently rely on the internet both as a data source and for educational needs; therefore, medical education should embrace changes in the learning landscape in light of technological advancements [1]. The RCSI Paediatrics undergraduate programme utilises an e-learning platform to support and reinforce didactic teaching. A quality audit of RCSI's Paediatric e-learning platform was conducted 2015 to 2018. In 2015, 75% of students surveyed reported poor platform accessibility, difficulty finding the desired information, and out-dated content. Aim To identify effective ways of utilising an e-learning platform and improve support for learning and teaching online. Methods Students were surveyed (n=330) and stakeholder meetings (n=20) were conducted to discuss and better understand our learners and their learning needs. User reports from the e-learning platform indicated changes in users' frequency of access and duration online. Results Feedback in 2015 showed student engagement and satisfaction were poor. To address this problem, students were surveyed and asked to identify aspects of the e-learning environment they liked and which could be improved.Effort were made to identify e-learning platform areas requiring attention. By 2018 following implementation of platform improvements, there was a 79% increase in student visits.Improvements included usability, making the e-learning platform layout and organisation more user friendly; compatibility, improving compatibility across interfaces for better access on mobile devices; diversity, creating multimedia content allowing users to select the media options that best suit their learning needs; medical educational videos, created to demonstrate how to conduct a physical exam, take patient history, and communicate and interact with patients and their parents; and selfdirected learning, students take increasing responsibility for their learning [2]. Gaining independent learning skills aid students in becoming lifelong, self-directed learners [3]. Conclusion This audit aimed to improve medical students' user experience and create a helpful e-learning environment to prepare future paediatricians. The 2018 user reports and student feedback showed greater student satisfaction and higher e-learning engagement.
Patients with a palliative diagnosis were excluded from this study.Results 87 patients were discharged directly home in the 6 year study period. No patients died within 30 days of discharge. The median PIM 3 score was 0.0139 (IQR 0.0072-0.0347). Of patients admitted diagnoses were 41% Respiratory, 33% Peri-operative, 8% Cardiology, 6% Toxicology, 5% Neurology, 5% Gastrointestinal, 2% Allergy and 1% Trauma. 69 (79%) of patients had a past medical history. In 34 (39%) admissions patients had a tracheostomy. There were no discharges against medical advice. The primary team was informed of discharge for 84 (97%) patients. A documented follow-up plan was recorded for 46 (53%) patients. There was written communication with the patients general practitioner for 22 (25%) patients. 5 (6%) patients were discharged outside the hours of 9:00-17:00. Conclusions For the most part primary teams were informed and the majority of patients had follow-up arranged, however communication with the GP was poor. Following the results of this study a standardised template was introduced at our institution to improve the discharge process.
Aim Our aim was to describe the epidemiology of multisystem inflammatory syndrome in children (MIS‐C) in the Republic of Ireland, in the context of all cases of COVID‐19 in children, during the first year of the SARS‐CoV‐2 pandemic. Methods Cases of MIS‐C were identified by prospective surveillance in Irish hospitals from April 2020 to April 2021. Paediatric COVID‐19 cases and outbreaks in schools or childcare facilities were notified to and routinely investigated by Public Health. Univariate and bivariate analyses were carried out in Excel, Stata and JMP statistical package. Results Fifty‐four MIS‐C cases (median age 7.58 years; males 57%) were identified over the study period. MIS‐C incidence was higher in certain ethnicities (‘black’ 21.3/100,000 [95% CI 4.3–38.4]; and ‘Irish Traveller’ 14.7/100,000 [95% CI −5.7‐35.1]) than those of ‘white’ ethnicity (3.4 /100,000). MIS‐C cases occurred in three temporal clusters, which followed three distinct waves of community COVID‐19 infection, irrespective of school closures. Formal contact tracing identified an epidemiological link with a COVID‐19‐infected family member in the majority of MIS‐C cases (77%). In contrast, investigation of COVID‐19 school outbreaks demonstrated no epidemiological link with MIS‐C cases during the study period. Conclusion Efforts at controlling SARS‐CoV‐2 transmission in the community may be a more effective means to reduce MIS‐C incidence than school closures. Establishing a mandatory reporting structure for MIS‐C will help delineate the role of risk factors such as ethnicity and obesity and the effect of vaccination on MIS‐C incidence.
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