Reproductive carrier screening has been possible since the 1970s. Initially conducted by testing of blood analytes for carrier status for haemoglobinopathies and Tay Sachs disease, screening for an ever increasing number of conditions became possible by genetic testing from the late 1980s. The advent of genomic sequencing means that it is now possible to screen over 1000 genes, a process called expanded carrier screening.
Author Archives: Grand Rounds
Is long-term parenteral nutrition (LTPN) a step too far for children with severe neurological impairment (SNI)? Children with SNI are living longer and experiencing more gastrointestinal issues. However, clinicians remain hesitant to consider LTPN when enteral feeding fails in these patients.
Outcomes following the intensive care management of critically ill children have improved dramatically over the past few decades. Advances in the provision of intensive care has led to increased rates of survival, but for some children who experience critical illness there are lasting consequences.
Mental Health is an issue of growing concern across the community. This has been amplified through the COVID-19 pandemic. Child mental health is also an ongoing priority for the Melbourne Children’s Campus (MCC) and its three partners. The RCH treats many vulnerable patient groups (e.g., children with chronic illness, neurodevelopmental disorders, psychosocial challenges) with elevated risk of psychological and mental health difficulties. This extends across our inpatient and outpatient services and into the community. Despite this, mental health services can be fragmented and difficult to access.
Hand transplantation is a technique to reconstruct absent and functionless upper limbs using cadaveric donor limbs.
In the 20 years since the world’s first hand transplant, the technique has developed into a reliable and valuable option for carefully selected adult amputees. The downside is the need for immunosuppression with its inherent risks (metabolic, infective, neoplastic, and renal impairment) for the duration of the transplant.
The NAIDOC Week Grand Round will highlight how Wadja Aboriginal Family Place has provided excellence and leadership in health services to Aboriginal Children and their families at the Royal Children’s Hospital. Wadja works collaboratively in partnership in the areas of child health assessments, advocacy, liaison, research, mental health, education, and family support to improve the health and wellbeing of Aboriginal children and young people.
Tuberculosis is a major cause of child morbidity and mortality globally. Young children are at particular risk of severe and disseminated disease following exposure to a person with tuberculosis. Public health and clinical services, including in Victoria, focus on early detection and treatment of both disease and infection. There have been recent developments that potentially strengthen and decentralise services for tuberculosis.
We are unleashing the power of data to improve child health. The first such Centre in Australia is a hive of potential and ideas, realising the shared vision of our campus partners. We are using data to advance and humanise many different perspectives of paediatric patient care.
Pain is described as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. This definition from IASP guides clinicians to potential prevention and intervention points for a reduction in the experience of pain for our patients.
Use of the internet and social media is now almost ubiquitous amongst adolescents. Parents express concern about their children’s use of social media and the risk of exposure to both unwanted and sought-after content, especially sexual content. Negotiating the digital world and understanding who their children are communicating with is becoming more difficult for parents.