Πέμπτη 17 Φεβρουαρίου 2022

Running a paediatric ambulatory sleep service in a pandemic and beyond

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Abstract

OBJECTIVES

In response COVID-19, re-establishing safe elective services was prioritised in the UK. We assess the impact on face-to-face hospital attendance, cost, and efficiency of implementing a virtual sleep clinic (intervention 1) to screen for children requiring level 3 ambulatory sleep studies using newly implemented ENT-UK guidelines for obstructive sleep apnoea (OSA) investigation (intervention 2). Objectives: (1) compare the proportion of children attending sleep clinic undertaking a sleep study before and after implementation of these interventions; (2) compare clinic cancellations and first-time success rates of sleep studies before and after intervention.

DESIGN

Retrospective analysis.

SETTING

District general hospital paediatric sleep clinic.

PARTICIPANTS

Children aged 3 months to 16 years referred to sleep clinic by ENT for investigation of OSA over the 3-months immediately following interventions (1 June 2020 – 1 September 2020) to the same period in the previous year (1 June 2019 – 1 September 2019).

MAIN OUTCOME MEASURES

Number of children attending sleep clinic; date of birth / age of children attending sleep clinic; of number of children undergoing sleep study; diagnostic outcomes; number of appointment cancellations; number of first-time sleep study failures.

RESULTS

Post-intervention, there was a significant reduction in the proportion of children undertaking ambulatory sleep studies, and non-significant reductions in appointment cancellations and in first-time sleep study failures.

CONCLUSIONS

The introduction of the virtual sleep clinic meant that only those children requiring a sleep study attended a face-to-face appointment, which led to reduced face-to-face attendance. There were also unintended cost-effectiveness and efficiency benefits, with potential longer-term learning implications for the wider sleep community and other diagnostic services.

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Subclinical breast lymphedema as a possible risk of breast angiosarcoma

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2022 Feb 2:S1748-6815(22)00049-3. doi: 10.1016/j.bjps.2022.01.041. Online ahead of print.

NO ABSTRACT

PMID:35172950 | DOI:10.1016/j.bjps.2022.01.041

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Association Between Body Mass Index and Thyroid Cancer in Children With Thyroid Nodules

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jamanetwork.com

This cross-sectional study examines whether body mass index in children with thyroid nodules is associated with thyroid cancer and a greater likelihood of undergoing thyroid surgery.
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Patulous Eustachian tube: Deep breath for a diagnosis

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Ear Nose Throat J. 2022 Feb 17:1455613211051793. doi: 10.1177/01455613211051793. Online ahead of print.

ABSTRACT

Significance Statement: Eustachian tube disorders are common outpatient otologic presentations that can present a diagnostic challenge due to overlapping symptoms. This article will focus on patulous Eustachian tube, how the symptoms can overlap with those of Eustachian tube dysfunction, and the diagnostic insight offered by a close inspection of the tympan ic membrane.

PMID:35175873 | DOI:10.1177/01455613211051793

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