Archives of Disease in Childhood - Education and Practice This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

A common complaint... a rare disease!
A 2-year-old previously well child presented to the emergency department with temperatures and lethargy. He was pale and looked unwell. He received a fluid bolus and was commenced on intravenous ceftriaxone. Pus was discharging from his left ear with postauricular swelling and erythema. Given clinical concerns, urgent neuroimaging was arranged. Question 1 What does the CT scan of head show (figure 1)? Figure 1Enhanced CT showing external and middle ear infection with skull base osteomyelitis. Acute subdural collection Acute mastoiditis secondary to sinusitis Enhanced cerebral lesions Meningitis with abscess formatio...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Toner, M.-B., Molloy, S., Mallett, P., Thompson, A., Speirs, L. Tags: Epilogue Source Type: research

Dont just look at the surface: when mucosa tells more than the skin
A 13-year-old boy was admitted for a 4-day history of fever, malaise, sore throat and cough, treated with amoxicillin for 2 days. Physical examination revealed sparse targetoid cutaneous lesions, stomatitis with vesicles, blisters and mild conjunctival hyperaemia (figure 1). Blood tests showed an increase in erythrocyte sedimentation rate (92 mm/hour; normal value <20 mm/hour) and in C reactive protein level (4.8 mg/dL; normal value <0.5 mg/dL), while white cell count was 12.7 x 109/L (7 lymphocytes 7.2 x 109/L, neutrophils 3.32 x 109/L). In the following days, he developed preputial ulceration with painful micturiti...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Trombetta, A., De Nardi, L., Barbi, E., Declich, V., Dall'Amico, R. Tags: Open access Epilogue Source Type: research

Fifteen-minute consultation: oral ulceration in children
Conclusion Although a common presentation in children, diagnosis can be challenging. Thorough history taking is critical towards diagnosis and supports signposting to relevant specialities. Clinicians should be able to support first-line symptomatic management of oral ulceration. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Johnston, L., Warrilow, L., Fullwood, I., Tanday, A. Tags: Editor's choice, Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: Clinical pubertal assessment
This article aims to familiarise clinicians with the pubertal assessment, both the examination and interpretation. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Prentice, P. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: Child with an incidental finding of a fatty liver
This article will explain the steps to be taken when receiving such an ultrasound report. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Chan, J., Gupte, G. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: Decision-making pathway for neonatal vascular access
Newborn infants admitted for neonatal intensive and high dependency care are reliant on intravenous therapy for medications, hydration and nutrition. Adopting a structured approach to gaining neonatal vascular access can improve efficiency and potentially reduce complications. In this article, we discuss an algorithm for decision-making in neonatal vascular access. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Osmond, E., Williams, N. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

How to use autoantibodies in suspected paediatric rheumatic disease
Autoantibodies can be an important indicator of paediatric rheumatic disease and useful in establishing a diagnosis. However, autoantibodies may be requested in cases where the patient does not have clinical features strongly suggestive of a rheumatic disease. This can lead to further unnecessary investigations, specialist referral and undue anxiety for the family. The aim of this article is to provide guidance for when it is appropriate to request autoantibodies, which ones to perform and how to interpret the results. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Keightley, J., Walsh, J., Bland, R. M. Tags: Review Source Type: research

Highlights from this issue
Nick: My role here is easy: to describe the, now completed and breathtakingly slick, baton change between Education and Practice Edition Editors. After 11 years in the role, sculpting a journal unique in paediatrics, Ian Wacogne is handing over to Neelam Gupta. I already know about some of Neelam’s ideas and, though it’s not for me to spill any beans, can guarantee an exciting transition period and future. All that’s left for me is to thank Ian and to wish Neelam ‘lycka till’! Neelam: It is a privilege to take over the role of Edition Editor from Ian Wacogne and co-author this Epistle with Edi...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Gupta, N., Brown, N. Tags: Epistle Source Type: research

Intermittent cycled phototherapy may control peak serum bilirubin levels and reduce mortality in extremely low birthweight infants
Study design Design: Randomised controlled study. Allocation: Remote randomisation stratified by centre and risk (high-risk group: birth weight ≤ 750g and ventilated at enrolment; low-risk group: birth weight > 750g or not ventilated). Setting: 6 neonatal intensive care units in the USA. Patients: 128 extremely low birthweight (ELBW) infants receiving continuous phototherapy were compared with 128 ELBW infants receiving cycled phototherapy ≥15 min/hour. Primary outcomes Mean peak total serum bilirubin (TSB) level and total phototherapy hours through to day 14. Predischarge wave V latency brainstem auditory-evoked ...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Cameron, D., Burgess-Shannon, J. Tags: Key publications in paediatrics: Picket Source Type: research

Liraglutide does not provide sustainable results for weight improvement in adolescents with obesity
Review of: Kelly AS, Auerbach P, Barrientos-Perez M, et al. A randomised, controlled trial of liraglutide for adolescents with obesity. N Engl J Med 2020 May;382:2117–2128. DOI: 10.1056/nejmoa1916038. Allocation: Central randomisation using a web-based response system. Randomisation was stratified according to pubertal status and glycaemic status. Setting: 32 sites over five countries (Belgium, Mexico, Russia, Sweden and the USA). Intervention: All participants received lifestyle therapy. 125 were assigned to liraglutide and 126 assigned to the placebo group, receiving a volume matched equivalent. Patients: 251 parti...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Brady, C., Shaikh, M. G. Tags: Key publications in paediatrics: Picket Source Type: research

Gestational vitamin D supplementation does not reduce asthma incidence in children at 6-year follow-up
Study design: Follow-up study based on the previously published Vitamin D Antenatal Asthma Reduction Trial. This was a randomised, double-blinded, placebo-controlled trial. Study question: To determine whether high-dose vitamin D supplementation, taken during pregnancy, reduces the incidence of asthma and recurrent wheeze in offspring at 6-year follow-up. Setting: Three clinical sites—Boston Medical Centre, Washington University and Kaiser Permanente Southern California Region. Participants: 806 pregnant women, aged 18–39 years, and their offspring. Intervention: 4000 IU/day vitamin D or a placebo tablet. All w...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Tester, A. A., Bee, N. Tags: Key publications in paediatrics: Picket Source Type: research

Asking great questions
Have you ever thought about how important questions are at every level of clinical practice? Questioning leads to information discovery, whether this is as a learner or as a teacher. On a wider level, an organisation should ask questions of itself and the people within it in order to understand its current work and to innovate.1 A proactive approach to questioning is one adopted by large, successful companies2 and can be imitated in healthcare to improve teaching and learning at both individual and organisational levels. Who is asking a question? In order to develop empathic questioning, it is worth pondering that we all m...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Osmond, E., Couto, C. Tags: Learning and teaching Source Type: research

'I'm a doctor, not a teacher: the roles and responsibilities of paediatricians in relation to education
Introduction Medicine and teaching are intrinsically linked. Traditionally, medical education was an apprenticeship model, where practical experience superseded book learning and the student/teacher relationship was paramount.1 2 In recent years there has been increased professionalisation of medical education at both undergraduate and postgraduate levels. Although this development should be embraced, there is concern that clinical and educational roles are now often seen as separate and, at times, conflicting entities. Leonard H ‘Bones’ McCoy, the chief medical officer of the Starship Enterprise, was known to ...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Mulholland, M., McNaughten, B., Bourke, T. Tags: Editor's choice Learning and teaching Source Type: research

Co-producing a social determinants of health questionnaire for an urban population in community child health
We used quality improvement (QI) and co-production methodologies to explore how child health professionals can be helped to open up conversations about poverty and other social issues in a London community child health clinic between July and October 2019. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Singh, G., Damarell, A. Tags: Open access Quality improvement Source Type: research

NICE guideline review: fever in under 5s: assessment and initial management (NG143)
Background Feverish illness is one of the leading causes for a child to be seen by healthcare professionals, and is a major cause for hospital admissions. In 2007, the National Institute for Health and Care Excellence (NICE) published the original guidance on feverish illness in children (CG47). This was developed to aid healthcare professionals in their decision-making process while managing children aged <5 years with fever. This guidance has been revised multiple times in 2013 (CG160) and 2019 (NG143) and was updated in 2017. Information about the current guideline The current update (NG143) has made specific recomme...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Paul, S. P., Kini, P. K., Tibrewal, S. R., Heaton, P. A. Tags: Guideline review Source Type: research