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.

How to interpret skin prick tests and serum-specific IgE in children and young people with food allergy
Food allergy is common, it can lead to significant morbidity andnegatively impacts on quality of life; therefore, it is vitally important we get the diagnosis right. However, making the diagnosis can be complex. Clinical history is the most important diagnostic tool and subsequent investigation may help confirm the diagnosis. The investigations available to most paediatric departments are skin prick testing and specific IgE so we will focus on these. Within this article we explore the evidence related to targeted testing and how to interpret these within the clinical context. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Ferris, K., Cowan, M., Williams, C., McAteer, S., Glancy, C., Callaghan, S. Tags: Interpretations Source Type: research

How to use Donath-Landsteiner test to diagnose paroxysmal cold haemoglobinuria (PCH)
Paroxysmal cold haemoglobinuria (PCH) accounts for around a third of cases of autoimmune haemolytic anaemia in children. PCH is caused by an autoantibody that fixes complement to red cells at low temperatures and dissociates at warmer temperatures (a biphasic haemolysin), triggering complement-mediated intravascular haemolysis. Named the Donath-Landsteiner (D-L) antibody after its discoverers, it is usually formed in response to infection and demonstrates specificity for the ubiquitous red cell P-antigen. A D-L test can be used to detect the presence of the D-L autoantibody in the patients’ serum. Here we discuss the...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Williams, J. D., Jayaprakash, R. K., Kithany, H., Tighe, M. P. Tags: Open access, Interpretations Source Type: research

Unarousable child with a short bowel
Unarousable child with short bowel A 4-year-old boy was admitted with progressive lethargy of a few hours’ duration and no other symptoms. His medical history was relevant for short bowel syndrome (SBS), following neonatal volvulus, with residual bowel length of 23 cm and intact ileocecal valve. He had similar self-limiting episodes in the past, after weaning parenteral nutrition, especially after eating large meals. The day before, he had consumed a large amount of apples. Arterial blood gas (ABG) analysis showed metabolic acidosis with normal lactacidaemia (pH 7.09, pCO2 19 mm Hg, pO2 101 mm Hg, HCO3 5.8 mmol/L, BE...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Cortellazzo Wiel, L., Conversano, E., Carlone, G., Di Leo, G., Gortani, G., Zanchi, C., Barbi, E. Tags: Epilogue Source Type: research

A bullous rash
­ A 3-year-old boy presented with a 5-day history of bullous skin lesions localised mainly in the upper and lower limbs and in the genital region (figure 1). Lesions were not pruritic nor painful and showed a central crust. There was no family history of skin disorders or autoimmune diseases. The child never had fever and his physical examination was otherwise unremarkable. Figure 1Bullous skin lesions forming around a central crust, localised in the upper and lower limbs. Questions What is the most likely diagnosis based on this clinical presentation? Bullous impetigo. Bullous pemphigoid. Linear IgA bullous der...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Migliarino, V., Di Mascio, A., Berti, I., Taddio, A., Barbi, E. Tags: Epilogue Source Type: research

Fifteen-minute consultation: Practical use of continuous glucose monitoring
Type 1 diabetes is a self-managed condition. Regular monitoring of blood glucose (BG) levels has been the cornerstone of diabetes management. Finger prick BG testing traditionally has been the standard method employed. More recently, rapid advancements in the development of continuous glucose monitoring devices have led to increased use of technology to help children and young people with diabetes manage their condition. These devices have the potential to improve diabetes control and reduce hypoglycaemia especially if used in conjunction with a pump to automate insulin delivery. This paper aims to provide an update on mai...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Soni, A., Wright, N., Agwu, J. C., Drew, J., Kershaw, M., Moudiotis, C., Regan, F., Williams, E., Timmis, A., Ng, S. M. Tags: Open access, Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: The child with obesity
We present a framework for the identification, assessment and management of childhood obesity by the non-specialist. We also offer strategies to initiate discussions about weight and to communicate effectively with patients living with obesity. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Low, A., Parry-Okeden, S., Ferguson, E. C., Wright, N., Elder, C. J. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute guide to managing oligoarticular juvenile idiopathic arthritis
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease affecting children and young people today. However, it is not a single disease entity, but an umbrella term that gathers together a heterogeneous collection of complex, chronic inflammatory conditions with oligoarticular JIA the most common form in both Europe and North America. Due to its relative rarity in daily practice and potential to mimic other conditions, oligoarticular JIA can present a diagnostic and management challenge to healthcare professionals in both primary care and general paediatrics. The aim of this article is to provide a ...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: McKenna, D., McLaughlin, D., Campbell, C., Mulholland, M., Thompson, A., Loughran, C., Jackson, P., Rooney, M. Tags: Best practice and Fifteen Minute Consultations Source Type: research

Fifteen-minute consultation: Recognition of sickle cell crises in the paediatric emergency department
Children with sickle cell disease can develop life-threatening and painful crises that require prompt assessment and efficient management by healthcare professionals in the emergency or acute care setting. Due to migration patterns and improved survival rates in high-prevalence countries, there is an increased tendency to encounter these patients across the UK. These factors warrant regular revisions in sickle cell crisis management, along with education for medical personnel and patients to improve clinical care and patient management. The focus of this article is on the initial assessment and management of acute paediatr...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Patel, S., Dadnam, C., Hewitson, R., Thakur, I., Morgan, J. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: How to manage eczema in children
This article aims to provide a concise, patient-focused summary of the assessment and management of childhood atopic eczema. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Constantinou, S., Evans, J., Goodwin, R. G. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Celebrating our wins
How do you feel when you leave work? Have you celebrated all your individual and collective achievements during the day, or do you leave thinking of those jobs left undone, those patients you could not find quite enough time for, the colleagues you brushed aside? We all have an innate negativity bias which means that we attend to and remember the negative parts of our days more than the positive. This evolutionary mechanism makes us strive to do better, but out of fear of the possible consequences of poor performance rather than the magnetic draw towards excellence. A working environment of ‘all sticks and no carrots...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Crosby, L., Finlay, F. Tags: Wellbeing at work Source Type: research

Fifteen-minute consultation: Childhood rumination syndrome
Rumination syndrome is a functional bowel disorder where stomach contents effortlessly regurgitate into the mouth. It is an entirely separate entity to gastro-oesophageal reflux disease and requires behavioural rather than pharmaceutical management. Symptoms usually respond well to treatment, though in extreme cases, patients may experience significant weight loss and require inpatient admission. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Winter, R., Velleman, S., Wiskin, A. E. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Highlights from this issue
Well, now, here’s a thing. After 12.5 years and, I calculate, 75 of these Epistles, it’s time for me to go. The first of these I co-wrote with our then Editor in Chief, Howard Bauchner, with the intention of framing the edition to give people a sense of what they’d be getting. As time went by people were kind enough to say that they enjoyed reading them—and my chatty way of spilling out what the edition had told me—so I continued. The journal has changed quite a bit. When I started as edition editor in 2010 we had between 5 and 8 articles in each 32 page issue. Now we have two or three times t...
Source: Archives of Disease in Childhood - Education and Practice - May 19, 2022 Category: Pediatrics Authors: Wacogne, I. D. Tags: Epistle Source Type: research

Adequate cool running water first aid decreases burn depth and skin grafting requirements in paediatric thermal burns
Review of: Griffin BR, et al. Cool running water first aid decreases skin grafting requirements in pediatric burns: a cohort study of two thousand four hundred ninety-five children. Ann Emerg Med, 2020; 75:75–85. Setting: Dedicated children’s burn centre, Queensland, Australia. Patients: 2495 patients aged 0–16 years (IQR 1–6 years) presenting as an inpatient or outpatient with a thermal burn between July 2013 and June 2016. Primary outcome: First aid administered and need for skin grafting. Adequate first aid defined as 20 minutes or more of cool running water, within 3 hours of injury. Secondary o...
Source: Archives of Disease in Childhood - Education and Practice - March 17, 2022 Category: Pediatrics Authors: Fleming, R., Bee, N. Tags: Picket Key publications in paediatrics: Picket Source Type: research

Metabolic mayhem. The advantage of keeping your nose both in the books and in the nappy!
This case presentation takes you on a journey of diagnostic hurdles, covering a common neonatal presentation: abdominal distention with failure to pass meconium, followed by a presentation in infancy with metabolic, renal and electrolyte abnormalities. The article provides a systematic approach to the different clinical problems, allowing interpretation of results, making differential diagnoses and deciding on investigations and management. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - March 17, 2022 Category: Pediatrics Authors: Buzakuk, B., van der Voort, J. Tags: Problem solving in clinical practice Source Type: research

Iron-deficiency anaemia: the perils of excessive milk-drinking
We describe the case of a 2-year-old girl presenting with non-specific symptoms, who was found to be iron-deficient and anaemic, in the context of excessive cow’s milk consumption. We explore the patient’s diagnostic journey, including a neurological deterioration and the link between her iron deficiency and the final diagnosis. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - March 17, 2022 Category: Pediatrics Authors: Machta, J., Trompeter, S., Yamamoto, A. K., Eisen, S. Tags: Problem solving in clinical practice Source Type: research