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Five-year evaluation of a model to deliver scheduled outpatient care Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-13 Gina Johnson, Jessica Lloyd, Stephen W Turner
The benefit of an integrated child health service, where patient care is provided by joint working across primary and secondary care, has been recognised for almost 50 years,1 and is advocated today by many institutions including the Nuffield Trust,2 the King’s Fund3 and Royal College of Paediatrics and Child Health (RCPCH).4 Three models of integrated care in a paediatric outpatient setting have been
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Are children living with obesity more likely to experience musculoskeletal symptoms during childhood? A linked longitudinal cohort study using primary care records Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-12 Nicola Firman, Kate Homer, Gill Harper, John Robson, Carol Dezateux
Objective To assess whether there is a higher incidence of musculoskeletal consultations in general practice among children with obesity. Design Longitudinal Setting 285 north-east London general practitioners (GPs). Participants 63 418 (50.9% boys) Reception and 55 364 (50.8% boys) Year 6 National Child Measurement Programme (NCMP) participants, linked to GP electronic health records (EHRs). Main
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Semaglutide treatment for children with obesity: an observational study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-12 Elizabeth-Jane van Boxel, Saqib Rahman, Karen Lai, Nabil Boulos, Nikki Davis
Objective To assess efficacy and tolerability of semaglutide as a weight loss treatment for children living with comorbid obesity. Design Retrospective observational study of the first 50 children from a weight management service treated with semaglutide for at least 6 months. Setting A tertiary paediatric multidisciplinary weight management clinic in a UK hospital. Patients Aged 10–18 years old with
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Can critical care transport be safely reduced in children intubated during emergency management of status epilepticus in the United Kingdom: a national audit with case–control analysis Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-06 Philip Knight, Victoria Norman, Rochelle Gully, Dora Wood, Dusan Raffaj, Laura Riddick, Stephen Hancock, Sanjay Revanna, Mohammed Uvaise, Sasha Herring, Mark Worrall, Ashley Daye, Mark Terris, Cormac O'Brien, Ananth Kumar, Sophie Scott, Lisa Pritchard, Srinivasan Palaniappan, Charlotte Hughes, Michael J Griksaitis, Shelley Riphagen, Padmanabhan Ramnarayan
Objective This study describes the baseline clinical characteristics, predictors of successful extubation at referring hospitals and short-term outcomes of children intubated for status epilepticus and referred to United Kingdom (UK) paediatric critical care transport teams (PCCTs). Design Multicentre audit with case–control analysis, conducted between 1 September 2018 and 1 September 2020. Setting
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Information in summaries of product characteristics about use in children is limited and needs standardisation: a systematic analysis in Switzerland Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-06 Romy Tilen, Christoph Berger, Samuel Allemann, Henriette Meyer zu Schwabedissen
Background A considerable proportion of drugs administered to children are not authorised for this purpose, and consequently off-label use is common in paediatric care. Our aims were to quantify systematically the number of drugs authorised in Switzerland for use in children based on their current summary of product characteristics (SmPC) and to assess the quality of this information. Methods We used
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Staff experiences of wearing the Rainbow Badge in a paediatric hospital setting: a mixed-methods survey Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-05 Claire O'Dwyer, Anne Kehoe, Dee Shanahan, Warren O'Brien, Dani Hall
Objective This study aimed to assess staff’s experience of wearing the Health Service Executive (HSE) Rainbow Badge, a symbol of inclusion for LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning; + signifying inclusivity of all sexual and gender identities) people, in a paediatric hospital setting. Design This was a cross-sectional multisite observational study. Participants completed an
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Progressive multifocal leukoencephalopathy in children with HIV: still a challenge Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-04 Beatriz Sousa Nunes, Cláudia Marques-Matos, Carla Conceição, Tiago Milheiro Silva
A male teenager from Guinea-Bissau, in Portugal for 15 days, presented with a two-month history of progressive headache, decreased vision and left hemiparesis. On neurological examination, the left eye was inwardly and downwardly deviated, with limited abduction and elevation, and predominantly distal left hemiparesis was noted. His gait was mildly ataxic with spastic circumduction of his left leg
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Development of the Children’s ACuTe UltraSound (CACTUS) point-of-care ultrasound (POCUS)-accredited training in the UK: a descriptive study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-04 Michael J Griksaitis, Bogdana Zoica, Dusan Raffaj, Jennie Stephens, Avishay Sarfatti, Veena Rajagopal, Antonia Hargadon-Lowe, Jessica Green, Peter Shires, Louis Skevington-Postles, Patrick Davies
Point-of-care ultrasound (POCUS) is an established, evidence-supported tool that can be used in neonatal and paediatric medicine, offering clinicians immediate diagnostic insights, assessment of interventions and improved safety profiles and success rate of various procedures. Its effective use requires an established education programme, governance and standardisation to ensure competence in this
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Identifying empty salbutamol inhalers by weighing the canister Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Prasad Nagakumar, Teresa Evans, Susan Frost
Metered dose inhalers (MDIs), due to their reliability and ease of delivery of medications, have been commonly used in the treatment of asthma. The National Institute for Health and Care Excellence quality standards (2018) recommend assessment of adherence, medication review and inhaler technique at every asthma review. The MDIs contain a propellant along with an active drug to expel the labelled number
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Artificial food additives: hazardous to long-term health Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-29 John O Warner
Many additives, some of which have no nutritional value, can be legally used in processed foods. They intensify colour, thicken, increase shelf life and enhance flavour. Regulatory authorities issue approvals as safe within acceptable quantitative limits. Ultra-processed foods (UPFs) contain combinations of all these additives and are particularly attractive to children. Many publications suggest that
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Outpatient and primary care direct provocation challenges for antibiotic allergy in children Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-27 Anjum Grewal, Nicola Jay
Objective To evaluate the use of a questionnaire-based decision-making algorithm to triage children with reported antibiotic allergies to proceed directly to an oral provocation challenge. Design Cohort study. Setting Children aged 2–16 years attending paediatric emergency department over 1 year (1 June 2018 till 31 May 2019) or identified from four primary care centres in Sheffield with a recorded
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Birth weight and head circumference discordance and outcome in preterms: results from the EPIPAGE-2 cohort Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-26 Isabelle Guellec, Adelaide Brunet, Alexandre Lapillonne, Marion Taine, Héloïse Torchin, Geraldine Favrais, Géraldine Gascoin, Laure Simon, Barbara Heude, Pauline Scherdel, Gilles Kayem, Pierre Delorme, Pierre-Henri Jarreau, Pierre-Yves Ancel
Objective To determine whether the relative measurement of birth weight (BW) and head circumference (HC) in preterm infants is associated with neurological outcomes. Methods The EPIPAGE-2 Study included 3473 infants born before 32 weeks’ gestation, classified based on their Z-score of BW and HC on the Fenton curves as concordant (≤1 SD apart) or discordant (>1 SD difference). We defined four mutually
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Summary of recent advances in management of torus fracture of the distal radius in children Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-26 Maysoon Hussain, Dan Perry, Shrouk Messahel
Torus fractures of the distal radius are a common reason why children present to emergency department (EDs) and account for an estimated 500 000 ED attendances per year in the UK.1 Torus fractures account for up to 50% of all paediatric forearm fractures.2 They occur in skeletally immature children when the radius and/or ulnar experience a force resulting in bone compression rather than disruption
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Clubbing and hypoxia in an adolescent male Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-26 Josie Bradford, Gary James Connett
A 16-year-old male was referred to the haematologists to investigate his digital clubbing and polycythaemia (haemoglobin 171 g/L). He had no significant respiratory symptoms. On examination, he was obviously clubbed and had conjunctival congestion (figure 1). Oxygen saturations were 90%. An echocardiogram was normal. He was referred to the respiratory team for further investigation. His chest X-ray
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Mental health of caregivers of children with medical complexity: group-based trajectory modelling Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-22 Apsara Ali Nathwani, Nora Fayed, Sonia M Grandi, Julia Orkin, Eyal Cohen
Objective To describe the mental health trajectories of caregivers of children with medical complexity (CMC) and explore child characteristics associated with below-average caregiver mental health. Design A secondary analysis of prospectively collected data from 123 caregivers of children aged <16 years with medical complexity from a multicentre randomised trial conducted from December 2016 to June
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Early detection of gastrointestinal polyps and neoplasia following radiation for childhood-onset cancer Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-22 Gabby Atlas, Margaret Rosemary Zacharin
A massive and rapidly increasing burden of care exists for all physicians caring for the 80–90% of childhood cancer survivors. All paediatricians and general practitioners (GPs) seeing these adolescents must attain a sound knowledge of the risks, current and future, faced by these young people. Provision of improved care and appropriate surveillance during adolescence, with information for adult services
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Changing contexts of child health: an assessment of unmet physical, psychological and social needs of children with common chronic childhood illness Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-21 Raghu Lingam, Nan Hu, Elizabeth Cecil, Julia Forman, James Newham, Rose-Marie Satherley, Marina Soley Bori, Simon Cousens, Julia Fox-Rushby, Ingrid Wolfe
Background We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. Methods Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions
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Harry Potter’s extendable ear: reaching deaf children Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-21 Delilah O’Riordan, Tamsin Mary Holland Brown
New, affordable hearing devices for children with conductive hearing loss consist of a novel headset using bone conduction technology connected to a remote microphone, worn by the parent or teacher (figure 1).1 2 One young participant who benefited from the new technology referred to it as her ‘extendable ear’, a reference from Harry Potter3: > ‘If only we could hear what they’re saying!’ said Hermione
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Amiodarone in a rush: caution on speed of delivery and new guidance Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-20 Orijit Banerji, Alvin Schadenberg
A boy aged 11 months presented to his local hospital with a short history of being febrile with vomiting. He was found to be shocked with a pulsed broad complex tachycardia of around 240 and increased work of breathing. He was managed as per the APLS (Advanced Paediatric Life Support) protocol and had short-lived terminations after his first two shocks. He was loaded with amiodarone over 5 min prior
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Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-19 Adriana Vázquez-Vázquez, Abigail Smith, Faith Gibson, Helen Roberts, Gabrielle Mathews, Joseph Lloyd Ward, Russell M Viner, Dasha Nicholls, Francesca Cornaglia, Damian Roland, Kirsty Phillips, Lee D Hudson
Objective To systematically review the literature describing children and young people (CYP) admissions to paediatric general wards because of primary mental health (MH) reasons, particularly in MH crisis. Design PubMed, Embase, PsycINFO, Web of Science and Google Scholar were searched, with no restriction on country or language. We addressed five search questions to inform: trends and/or the number
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Hospital care in the first 10 years of life of children with congenital anomalies in six European countries: data from the EUROlinkCAT cohort linkage study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-19 Joan K Morris, Maria Loane, Charlotte Wahlich, Joachim Tan, Silvia Baldacci, Elisa Ballardini, Clara Cavero-Carbonell, Mads Damkjær, Laura García-Villodre, Mika Gissler, Joanne Given, Francesca Gorini, Anna Heino, Elizabeth Limb, Renee Lutke, Amanda Neville, Anke Rissmann, leuan Scanlon, David F Tucker, Stine Kjaer Urhoj, Hermien EK de Walle, Ester Garne
Objective To quantify the hospital care for children born with a major congenital anomaly up to 10 years of age compared with children without a congenital anomaly. Design, setting and patients 79 591 children with congenital anomalies and 2 021 772 children without congenital anomalies born 1995–2014 in six European countries in seven regions covered by congenital anomaly registries were linked to
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Point break: atraumatic first rib fracture in a surfer Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-19 Josie Bradford, Komal Raval, Joseph Jacoby, Edward Andrews
A 16-year-old boy presented to the emergency department with a 2-week history of atraumatic left-sided chest pain. This was following a surfing holiday involving 3–4 hours of sessions daily. His pain started after extending his arm while surfing. Initial investigations including ECG and bloods were unremarkable except for mildly raised alkaline phosphatase. Chest X-ray (figure 1) revealed possible
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Atoms Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Nick Brown
In the end, the only surprise was the lack of altercation, confrontation, heated exchange and counterpoint. Her approach taciturn yet deferential, his initial resistance to sharing the code melting like butter on San Antonio July tarmac in minutes. She could, in fact, almost sense contrition. ‘Why had no one asked before?’ nagged at first, but once she had the answers, she only looked forward. There
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Epidemiology of Robin sequence: geographical variation in the UK/Ireland Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Giles Atton, Diana Baralle
Pierre Robin sequence (PRS) is a rare congenital malformation sequence characterised by micrognathia, glossoptosis and upper airway obstruction, often in association with a wide U-shaped cleft palate.1 The aetiology of non-syndromic PRS (nsPRS) remains uncertain; however, non-isolated PRS can present as part of a wider syndromic diagnosis1 (syndromic PRS (sPRS)). PRS is reported to have a prevalence
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Anticipatory declarations for vaccination of the newborn Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Robert Wheeler
Earlier this year, a National Health Service Trust applied for anticipatory declarations relating to an unborn child.1 C was 37 weeks pregnant, HIV positive for over 20 years and had refused antiretroviral treatment during this pregnancy. The obstetricians were concerned that the newborn could be HIV positive. C was due to have elective caesarean section the following day. The application intended
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Nutritional blindness from avoidant-restrictive food intake disorder – recommendations for the early diagnosis and multidisciplinary management of children at risk from restrictive eating Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Sarah Schimansky, Haneen Jasim, Lucy Pope, Philippa Hinds, Daphin Fernandez, Paraskevi Choleva, Arundhati Dev Borman, Peta M Sharples, Todd Smallbone, Denize Atan
Avoidant-restrictive food intake disorder (ARFID) is an eating disorder characterised by limited consumption or the avoidance of certain foods, leading to the persistent failure to meet the individual’s nutritional and/or energy needs. The disordered eating is not explained by the lack of available food or cultural beliefs. ARFID is often associated with a heightened sensitivity to the sensory features
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Pulmonary function outcomes after tuberculosis treatment in children: a systematic review and meta-analysis Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Yao Long Lew, Angelica Fiona Tan, Stephanie T. Yerkovich, Tsin Wen Yeo, Anne B. Chang, Christopher P. Lowbridge
Background Despite tuberculosis (TB) being a curable disease, current guidelines fail to account for the long-term outcomes of post-tuberculosis lung disease—a cause of global morbidity despite successful completion of effective treatment. Our systematic review aimed to synthesise the available evidence on the lung function outcomes of childhood pulmonary tuberculosis (PTB). Methods PubMed, ISI Web
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Socioeconomic circumstances, health-related behaviours and paediatric infections: a mediation analysis Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Samuel Videholm, Sven Arne Silfverdal, Per E Gustafsson
Objective To examine how the effect of disadvantaged socioeconomic circumstances on the risk of paediatric infections is mediated by pregnancy smoking, excess weight during pregnancy and breast feeding in children under 5 years of age. Design A population-level, retrospective cohort study. The Swedish Medical Birth Register was combined with the National Patient Register, the longitudinal integration
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Genotype–phenotype correlations in paediatric and adolescent phaeochromocytoma and paraganglioma: a cross-sectional study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Amanda Seabrook, Anand Vasudevan, Kristen Neville, Brigitte Gerstl, Diana Benn, Janine Smith, Judy Kirk, Anthony Gill, Roderick Clifton-Bligh, Katherine Tucker
Phaeochromocytoma (PC) and paraganglioma (PGL) syndromes associated with germline pathogenic variants are associated with high morbidity and mortality. Establishing genotype–phenotype correlations within a young population is challenging due to their rare occurrence. Objective To describe genotype–phenotype correlations in paediatric and adolescent patients diagnosed with PC/PGL. To establish the incidence
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Perspectives of adult offspring of participants recruited to a randomised trial in pregnancy: a qualitative study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Nike Franke, Trecia Ann Wouldes, Gavin Thomas Lumsden Brown, Kim Ward, Jenny Rogers, Jane E Harding
Background Routinely assessed outcomes in paediatric health studies may not reflect families’ priorities. Increasing our understanding of childhood experiences of research participation may contribute to improving the quality of consent and better align study aims with the concerns of relevant communities. Objective To explore young adults’ views on their participation in medical research during their
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Parents’ understanding of medication at discharge and potential harm in children with medical complexity Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Axana Selzer, Fabian Eibensteiner, Lukas Kaltenegger, Michelle Hana, Gerda Laml-Wallner, Matthias Benjamin Geist, Christopher Mandler, Isabella Valent, Klaus Arbeiter, Thomas Mueller-Sacherer, Marion Herle, Christoph Aufricht, Michael Boehm
Objective Children with medical complexity (CMC) are among the most vulnerable patient groups. This study aimed to evaluate their prevalence and risk factors for medication misunderstanding and potential harm (PH) at discharge. Design and setting Cross-sectional study at a tertiary care centre. Study population CMC admitted at Medical University of Vienna between May 2018 and January 2019. Intervention
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Caregiver knowledge and attitudes relating to paediatric pneumonia and antimicrobial stewardship: a qualitative study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Nelson Huang, Lara Murphy, Sujane Kandasamy, Gita Wahi, Jeffrey M Pernica
Objective The objective of this study was to understand caregiver perspectives and experiences relating to the treatment of paediatric community-acquired pneumonia (CAP). Design, setting and patients This was a phenomenological qualitative study involving interviews with caregivers of young children in Hamilton, Ontario. Caregivers were asked open-ended questions relating to germ theory, pneumonia
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Pain in children with Bell’s palsy: secondary analysis of a randomised controlled trial Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Franz E Babl, Nitaa Eapen, David Herd, Meredith L Borland, Amit Kochar, Ben Lawton, Jason Hort, Adam West, Shane George, Andrew Davidson, John A Cheek, Ed Oakley, Sandy M Hopper, Robert G Berkowitz, Catherine L Wilson, Amanda Williams, Mark T MacKay, Katherine J Lee, Stephen Hearps, Stuart R Dalziel
Objective To describe the prevalence and severity of pain experienced by children with Bell’s palsy over the first 6 months of illness and its association with the severity of facial paralysis. Methods This was a secondary analysis of data obtained in a phase III, triple-blinded, randomised, placebo-controlled trial of prednisolone for the treatment of Bell’s palsy in children aged 6 months to <18
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Trends in inequalities in childhood overweight and obesity prevalence: a repeat cross-sectional analysis of the Health Survey for England Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Philip Broadbent, Yue Shen, Anna Pearce, Srinivasa Vittal Katikireddi
Objective To examine trends in socio-economic and ethnic inequalities in childhood overweight and obesity in the England between 1995 and 2019 in survey data and to compare these to administrative data. Design Observational repeated cross-sectional study using the Health Survey for England (HSE) and National Child Measurement Programme (NCMP). Outcome Age and sex standardised overweight, obesity and
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Life outcomes after paediatric kidney transplantation: a qualitative, biographical study in long-term survivors Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Valentin Ritschl, Tanja Stamm, Axana Selzer, Anna Boesendorfer, Fabian Eibensteiner, Lukas Kaltenegger, Erika Mosor, Maisa Omara, Natalie Vachuda, Lisa Sperl, Eva K Masel, Christoph Aufricht, Michael Boehm
Objective The objective of this study was to analyse the narrative life stories of children with end-stage kidney disease (ESKD) and their families to determine how health professionals can effectively support these children to achieve better life outcomes. Design Qualitative narrative biographic study. Setting We invited every long-term survivor of paediatric kidney transplants and their families
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Towards evidence-based medicine for paediatricians Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Bob Phillips
There will be many reading this who have wanted to display something visually impressive or meaningful so the world can enjoy it, seeking the right frame to fit and enhance it. There will hopefully be very few, ideally none, who have considered how to make a crime they have committed appear to have been undertaken by someone else. Somewhere in-between will number, probably, those who have written and
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Is shorter antibiotic treatment duration increasing the risk of relapse in paediatric acute focal bacterial nephritis? Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Nina Vaezipour, Katrina Evers, Hanna Schmid, Nicole Ritz, Alexandra Goischke
A 12-year-old girl presented with another episode of pyelonephritis. Her history was remarkable for multiple prior episodes of pyelonephritis over several months. Each episode was accompanied by flank pain and fever. Urine culture showed Escherichia coli on all occasions. Treatment for the first episodes was with oral cephalosporins for 10 days. Renal ultrasound did not show any abnormality of the
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Caring for the carers: the time has come to feed parents in hospital Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Helen Hare
We have, thankfully, moved on from the days when children were packed off to the hospital and parents were encouraged not to visit to avoid upsetting them. Nevertheless, it might come as a surprise to discover that, having spent the night on a fold-down hospital bed, parents cannot expect breakfast alongside their child. It has been almost 40 years since the European Parliament approved a proposal
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Freiherr von Münchhausen and the two syndromes bearing his name Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Eugen-Matthias Strehle
Freiherr von Münchhausen lived in Germany in the 18th century and was famous for telling fascinating stories about his military career. A contemporary of his, the writer Rudolf Erich Raspe, was inspired by these stories and created the fictional character Baron Munchausen who experienced incredible adventures. In the 1950s, the English physician Richard Asher used the name Munchausen syndrome (factitious
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UK paediatric trainee research involvement: A national mixed-methods survey to highlight opportunities and challenges Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Thiloka Ratnaike, Helen McDermott, Fiona McQuaid, Lucy Plumb, Eva Louise Wooding, Christopher William Course, Charlotte Jackson
Child health research is considered essential to paediatric training. However, due to service provision demands and workforce planning, research capacity within paediatric consultant contracts is declining.1 This affects paediatric trainees who perceive lack of leadership in this domain.2 Considering these concerns, in 2021, the Royal College of Paediatrics and Child Health (RCPCH) established the
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Variation in central venous catheter care and management: a review of UK paediatric oncology principal treatment centre practice Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Helen Blundell, Jessica Elizabeth Morgan, Eloise Neumann, Bob Phillips, Colin Thorbinson, Jessica Bate
Central venous catheters (CVCs) are commonly inserted in children and young people with a cancer diagnosis to administer systemic anticancer treatment and supportive care therapies. These devices require routine nurse-led cares such as dressing changes, flushing of the line and needleless access device changes. A prospective audit of UK principal treatment centres (PTCs) was undertaken to review current
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Diurnal salivary cortisol and cortisone concentrations in girls with Turner syndrome and healthy controls: a preliminary report Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Lily Jones, Julie Park, Silothabo Dliso, Daniel Hawcutt, Alena Shantsila, Gregory Y H Lip, Joanne C Blair
Turner syndrome (TS), in which there is loss of genetic material from the second X chromosome, affects approximately 1:2000 females. Life expectancy is reduced by at least 10 years.1 2 Approximately 50% of the increased mortality is due to cardiovascular disease which is primarily acquired in nature.2 Higher hair cortisol concentrations are reported in women with TS compared with healthy controls.3
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Preventing food allergy fatalities: epinephrine auto-injector doses in the BNFC Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 David Tuthill, Angela McFarlane
Foong et al have produced a helpful article on potential ways to reduce the risk of anaphylaxis across the community and healthcare settings.1 They highlight prescribing issues and the current BNF for Children (BNFC) listing of adrenaline/epinephrine auto-injector (AAIs) with the same dose of epinephrine, but with two different ‘change over’ weights for when to move up to the higher dose adult pens
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Reporting of participant ethnicity in paediatric randomised controlled trials in the UK Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Sarah Grantham-Hill, Hafsa Hassan, Alexandrea Harriott, Ming Lim, Kirsty Logan
Significant health disparities exist between ethnic minorities in the UK, including infant mortality and childhood obesity rates. As such, representation of minoritised populations in research is crucial to ensure representative evidence-based medicine.1 Reporting of race and ethnicity in published US paediatric clinical trials was suboptimal, even in highest impact journals, despite the US National
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A retrospective case review of young people referred for paediatric critical care transport following self-harm or a suicide attempt, 2015–2022 Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Caroline Borkett-Jones, Nitin Thakur, Prithwish Roy, Ali Clayton-Payne, Anna Erdunast, Simon Wilkinson, Hiren Mehta, Andrew J Jones
Mental health-related admissions to paediatric wards are increasing.1 The COVID-19 lockdown may have been a catalyst, with evidence suggesting that childhood depression increased during this period,2 but the mental health of the UK’s children and young people has been deteriorating since before the pandemic.3 The reasons behind this trend are likely to be complex and manifold; however, there has been
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Phoenix sepsis score: redefining paediatric sepsis Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
These four fascinating papers are worthwhile reading together because they are a great example of predictive score development and validation, working with large data (a data-driven approach) and working with a huge number of teams (Society of Critical Care Medicine (SCCM) Pediatric Sepsis Definition Task Force) across low to middle to high-income countries and giving generalisability. Sanchez-Pinto
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HARMONIE study: the next chapter in the respiratory syncytial virus story Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
What a magnificent trial. There were 235 centres from France, Germany and the UK recruiting over 8000 infants for a study of nirsevimab, which is a respiratory syncytial virus (RSV)-neutralising monoclonal antibody specially designed as a long-acting preparation. This has been approved for the prevention of RSV-related lower respiratory tract infections. Drysdale et al (N Engl J Med 2023;389:2425–2435
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Tale of a chest radiograph in Takayasu’s arteritis Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Anu K Punnen, Murugan Sudhakar, Sathish Kumar
A girl aged 11 years presented with a history of fever for 2 months. On examination, she had systemic hypertension. There was no pulse or blood pressure difference between the upper and lower limbs. The rest of the physical examination was reassuring. An initial diagnosis of fever of unknown origin (FUO) with systemic hypertension was considered. Chest X-ray revealed right parahilar infiltrates and
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Highlights from the literature Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
The rash and discomfort associated with chronic urticaria is often very hard to manage. Maurer M et al ( Lancet 2024;403 (10422:147–159 https://doi.org/10.1016/S0140-6736(23)01684-7) have presented two studies (PEARL one and PEARL two) examining the role of ligelizumab in patients who have had H1-antihistamine refractory chronic urticaria. This study included children of 12 years and above in a double
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Child mask mandates for COVID-19: a systematic review Arch. Dis. Child. (IF 5.2) Pub Date : 2024-03-01 Johanna Sandlund, Ram Duriseti, Shamez N Ladhani, Kelly Stuart, Jeanne Noble, Tracy Beth Høeg
Background Mask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic review to assess research on the effectiveness of mask wearing in children. Methods We performed database searches up to February 2023. The studies were screened by title and abstract, and
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Informed non-dissent for brain death testing in children: ethical and legal perspectives Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-17 Dominic Wilkinson, Christopher Miller, Stephen W Turner
A 14-year-old girl, Hana, is admitted to the paediatric intensive care unit following a sudden collapse at home. She is found to have sustained a severe haemorrhagic stroke. Despite emergency neurosurgical intervention, she deteriorates over several days. Her family have been struggling to accept the possibility that she would not recover. Hana remains unresponsive, has fixed dilated pupils and has
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High-dose intravenous immunoglobulin versus albumin 4% in paediatric toxic shock syndrome: a randomised controlled feasibility study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-15 Aurélie Portefaix, Carole Dhelens, Morgan Recher, Fleur Cour-Andlauer, Jérôme Naudin, Guillaume Mortamet, Nicolas Joram, Pierre Tissières, Tiphanie Ginhoux, Behrouz Kassai, Florent Boutitie, Delphine Maucort-Boulch, Etienne Javouhey
Purpose Toxic shock syndrome (TSS) is a rare disease responsible for significant morbidity and mortality. Intravenous immunoglobulin (IG) therapy in paediatric TSS could improve shock and organ failure, but more consistent efficacy and safety data are needed. Our objective was to determine whether a randomised clinical trial (RCT) assessing intravenous IG in TSS in children is feasible. Methods We
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Skeletal surveys in intubated patients: does UK clinical practice match national guidelines? Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-12 Gerard Leslie Peter Manning, Emma Sharpe, Alistair Calder, Joe Brierley
The investigation of suspected paediatric non-accidental injury in children under 2 years of age includes a skeletal survey, which is also indicated in older children on a case-by-case basis. In 2018, the UK national standards for the ‘radiological investigation of suspected physical abuse in children’ were updated by relevant radiology and radiography bodies and endorsed by the Royal College of Paediatrics
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Characteristics of children requiring admission to neonatal care and paediatric intensive care before the age of 2 years in England and Wales: a data linkage study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-12 Sarah E Seaton, Cheryl Battersby, Peter J Davis, Alan C Fenton, Josie Anderson, Tim J van Hasselt, Elizabeth Draper
Objective To quantify the characteristics of children admitted to neonatal units (NNUs) and paediatric intensive care units (PICUs) before the age of 2 years. Design A data linkage study of routinely collected data. Setting National Health Service NNUs and PICUs in England and Wales Patients Children born from 2013 to 2018. Interventions None. Main outcome measure Admission to PICU before the age of
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Review of implementation models for children’s sleep support services in the UK Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-12 Katie Jarvis, Anna Cartledge, Sarah Martin, Candi Lawson, Marissa Palmer, Vicki Beevers, Heather E Elphick
Sleep deprivation has a serious impact on physical and mental health. Children with neurodevelopmental disorders are frequently affected by chronic insomnia, defined as difficulty in either initiating sleep, maintaining sleep continuity or poor sleep quality which can lead to long-term detrimental effects on behaviour, learning and development. Interventions to address chronic insomnia in children
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Hyperpigmentation at diabetes technology sites may be indicative of evolving Addison’s disease Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-09 Rebecca J Moon, Amy C Rowland, Justin H Davies
A 12-year-old boy with type 1 diabetes mellitus and coeliac disease reported 2–3 months of skin darkening at his insulin pump cannula and continuous glucose monitor sites (figure 1). For the preceding 9 months, he had localised itching and redness, which had been managed as allergic contact dermatitis by a dermatologist. He continued to use the dressings and these symptoms had improved. Hyperpigmentation
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National study on the risks of COVID-19 infection for paediatric kidney transplant recipients: a retrospective, cross-sectional study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-09 Charlotte Withers, Rishil Patel, Ben C Reynolds, Martin Christian, Mordi Muorah, Yincent Tse, Liz Edwards, Pallavi Yadav, Shuman Haq, Shivaram Hegde, Chris J Callaghan, Alasdair Bamford, Stephen D Marks
Introduction During the COVID-19 pandemic, evidence emerged that immunosuppressed children were less affected by COVID-19 infections compared with immunosuppressed adults. The aim of our study was to investigate how COVID-19 infections affected paediatric kidney transplant recipients (pKTR) in the UK. Methods Questionnaires regarding COVID-19 infection data and care of pKTR during the COVID-19 pandemic
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Analysis of guideline recommendations for treatment of asthma exacerbations in children: a Pediatric Emergency Research Networks (PERN) study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-07 Simon Craig, Madeline Collings, Charmaine Gray, Javier Benito, Roberto Velasco, Mark D Lyttle, Damian Roland, Suzanne Schuh, Bashar Shihabuddin, Maria Kwok, Prashant Mahajan, Mike Johnson, Joseph Zorc, Kajal Khanna, Ricardo Fernandes, Adriana Yock-Corrales, Indumathy Santhanam, Baljit Cheema, Gene Yong-Kwang Ong, Thiagarajan Jaiganesh, Colin Powell, Gillian Nixon, Stuart Dalziel, Franz E Babl, Andis
Rationale There is significant practice variation in acute paediatric asthma, particularly severe exacerbations. It is unknown whether this is due to differences in clinical guidelines. Objectives To describe and compare the content and quality of clinical guidelines for the management of acute exacerbations of asthma in children between geographic regions. Methods Observational study of guidelines
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Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-07 Puji Faitna, Rachel Harwood, Simon E Kenny, Russell M Viner, Paul P Aylin, Dougal S Hargreaves, Alex Bottle
Objective To describe the COVID-19 pandemic’s impact on acute appendicitis management on children and young people (CYP). Design Retrospective cohort study. Setting All English National Health Service hospitals. Patients Acute appendicitis admissions (all, simple, complex) by CYP (under-5s, 5–9s, 10–24s). Exposure Study pandemic period: February 2020–March 2021. Comparator pre-pandemic period: February
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Wales Infants’ and childreN’s Genome Service (WINGS): providing rapid genetic diagnoses for unwell children Arch. Dis. Child. (IF 5.2) Pub Date : 2024-02-06 Emily Sloper, Jana Jezkova, Joanne Thomas, Kestra Dawson, Joseph Halstead, Jennifer Gardner, Katherine Burke, Sivakumar Oruganti, Jennifer Calvert, Jennifer Evans, Sarah Anderson, Sian Corrin, Caroline Pottinger, Oliver Murch
Introduction This study reviews the first 3 years of delivery of the first National Health Service (NHS)-commissioned trio rapid whole genome sequencing (rWGS) service for acutely unwell infants and children in Wales. Methods Demographic and phenotypic data were prospectively collected as patients and their families were enrolled in the Wales Infants’ and childreN’s Genome Service (WINGS). These data