Validating clinical practice guidelines for the management of children with non-blanching rashes in the UK (PiC): a prospective, multicentre cohort study

Waterfield, Thomas; Fairley, Derek; Lyttle, Mark D; McKenna, James; Roland, Damian; Corr, Michael; McFetridge, Lisa; Mitchell, Hannah; Woolfall, Kerry; Lynn, Fiona; Patenall, Bethany L.; Kitching, Amy; Rotheram, Matthew; Robinson, Gisela; Brassey, Paula; Hartshorn, Stuart; Wane, Rachel; Dangerfield, Jo; Hayes, Michael T.; McFarlane, Rebecca; Armstrong, Helen; Smith, Sally A.; VanHeyningen, Carl; Wilson, Esther; Kehler, Lisa; Gough, Christopher M.; Scott, Fraser; Backhouse, Claire; Gomes, Sylvester; Wood, Darryl; Maney, Julie-Ann; Johnson, Graham; Foster, Steven; Bloom, Ben; Lancaster, Andrew; Gray, Sebastian; Ramlakhan, Shammi; Gardner, Sharryn; Floyd, Sharon; Cleaver, Chris; MacFarlane, Susan; Bell, Claire L.; Nyirenda, Maggie; Bayreuther, Jane; Ijaz, Asim; Rogers, Natalie; Wilson, Shawn; Diment, Sarah; Boulind, Caroline; Allison, Kathryn; Petenall, Bethany; Shields, Michael

doi:10.1016/s1473-3099(20)30474-6

Cited by 15 publications

(18 citation statements)

References 15 publications

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“…Petechiae have been more commonly reported among MenB infections and less commonly among serogroups Y and W [4, 14]. A recent study from the UK, where meningococcal MenB and MenC vaccination is implemented, found IMD now to be a rare cause of petechiae in children presenting with fever [22].…”

Section: Discussionmentioning

confidence: 99%

Atypical presentation of Neisseria meningitidis serogroup W disease is associated with the introduction of the 2013 strain

et al. 2021

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Since 2015, the incidence of invasive meningococcal disease (IMD) caused by serogroup W (MenW) has increased in Sweden, due to the introduction of the 2013 strain belonging to clonal complex 11. The aim of this study was to describe the clinical presentation of MenW infections, in particular the 2013 strain, including genetic associations. Medical records of confirmed MenW IMD cases in Sweden during the years 1995-2019 (n = 113) were retrospectively reviewed and the clinical data analysed according to strain. Of all MenW patients, bacteraemia without the focus of infection was seen in 44%, bacteraemic pneumonia in 26%, meningitis in 13% and epiglottitis in 8%, gastrointestinal symptoms in 48% and 4% presented with petechiae. Phylogenetic analysis was used for possible links between genetic relationship and clinical picture. The 2013 strain infections, particularly in one cluster, were associated with more severe disease compared with other MenW infections. The patients with 2013 strain infections (n = 68) were older (52 years vs. 25 years for other strains), presented more often with diarrhoea as an atypical presentation (P = 0.045) and were more frequently admitted for intensive care (P = 0.032). There is a risk that the atypical clinical presentation of MenW infections, with predominantly gastrointestinal or respiratory symptoms rather than neck stiffness or petechiae, may lead to delay in life-saving treatment. 8Olof Säll et al.

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Section: Discussionmentioning

confidence: 99%

Atypical presentation of Neisseria meningitidis serogroup W disease is associated with the introduction of the 2013 strain

et al. 2021

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“…When modern scientists compare the physical characteristics of children with HSP to those of healthy children, they discover that children with HSP have the largest percentage of yin deficit, indicating that children with partial yin deficiency are more prone to HSP [ 12 ]. According to literature [ 13 ], the percentage of HSP children with a balanced TCM constitution was 36.94 percent, 33.78 percent had a partial yin deficit, and 53.57 percent had a partial yin deficiency, and the second was Qi insufficiency.…”

Section: Related Workmentioning

confidence: 99%

Analysis of Nursing Effect of Children with Henoch-Schonlein Purpura Based on the PDCA Nursing Model

Qin

Zhang

2021

Computational and Mathematical Methods in Medicine

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By applying the PDCA model to the care of children with Henoch-Schonlein purpura, the nursing process can be divided into four stages: planning, execution, inspection, and treatment. According to the age characteristics and disease progression of pediatric patients, a complete nursing plan is formulated to efficiently implement the nursing content and improve the nursing effect. This paper studies the application of the PDCA nursing model in the nursing of children with Henoch-Schonlein purpura and statistically analyzes the disappearance of skin rash, joint pain relief, disappearance of urine protein, disappearance of gastrointestinal symptoms, etc. Finally, this paper combines the experiment to evaluate the intervention effect of this nursing model and provides reference for the follow-up care of children with Henoch-Schonlein purpura. From the results of experimental research, it can be known that PDCA nursing can improve the comfort of children with Henoch-Schonlein purpura, shorten the time for symptom disappearance, and speed up the recovery process.

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“…5 21 The findings of the parent study from which the data in this analysis are drawn (the PiC study) further support this, demonstrating that an abnormal WCC, neutrophil count or elevated CRP were all poorly specific for MD (0.67, 029 and 0.73), respectively. 22 These specificities were significantly lower than that of the LAMP test (specificity 0.97, p<0.0001).…”

Section: Discussionmentioning

confidence: 83%

Loop-mediated isothermal amplification for the early diagnosis of invasive meningococcal disease in children

et al. 2020

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BackgroundRapid molecular diagnostic testing has the potential to improve the early recognition of meningococcal disease (MD). The aim of this study was to report on the diagnostic test accuracy of point-of-care loop-mediated isothermal amplification (LAMP) in the diagnosis of MD.DesignData were collected prospectively from three UK emergency departments (ED) between November 2017 and June 2019. Consecutive children under 18 years of age attending the ED with features of MD were eligible for inclusion. The meningococcal LAMP test (index test) was performed on a dry swab of the child’s oropharynx. Reference standard testing was the confirmation of invasive MD defined as positive N. meningitidis culture or PCR result from a sterile body site (blood or cerebrospinal fluid).ResultsThere were 260 children included in the final analysis. The median age was 2 years 11 months and 169 (65%) children were aged 5 years or younger. The LAMP test was negative in 246 children and positive in 14 children. Of the 14 children with positive LAMP tests, there were five cases of invasive MD. Of the 246 children with negative LAMP tests, there were no cases of invasive MD. The sensitivity of LAMP testing was 1.00 and the specificity was 0.97. The negative and positive predictive values were 1.00 and 0.36, respectively. The positive likelihood ratio was 28.3.DiscussionNon-invasive LAMP testing using oropharyngeal swabs provided an accurate fast and minimally invasive mechanism for predicting invasive MD in this study.Trial registration numberNCT03378258.

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Validating clinical practice guidelines for the management of children with non-blanching rashes in the UK (PiC): a prospective, multicentre cohort study

Abstract: Validating clinical practice guidelines for the management of children with nonblanching rashes in the United Kingdom.

Cited by 15 publications

References 15 publications

Atypical presentation of Neisseria meningitidis serogroup W disease is associated with the introduction of the 2013 strain

Atypical presentation of Neisseria meningitidis serogroup W disease is associated with the introduction of the 2013 strain

Analysis of Nursing Effect of Children with Henoch-Schonlein Purpura Based on the PDCA Nursing Model

Loop-mediated isothermal amplification for the early diagnosis of invasive meningococcal disease in children

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