Highlights from the literature
Paediatric updates for SPIRIT and CONSORT Setting up and running large multicentre network, randomised clinical trials (RCTs) in child health is hard work, expensive and time-consuming. To run the study within a robust research governance structure is crucial to scientific credibility, usefulness of the results and conclusions of the study, and reduces research waste. Reporting your work accurately and in a comprehensive and transparent way requires a structure and standardisation. So far, the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) and Consolidated Standards of Reporting Trials (CONSORT...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Tags: Miscellanea Source Type: research

Recurrent themes from paediatric mortality and morbidity: a network perspective 2021-2023
We write to raise awareness of common themes from paediatric death/incidents of harm from a network perspective. The governance group within Thames Valley & Wessex Paediatric Critical Care Operational Delivery Network formed in 2017. Our multidisciplinary body (paediatricians, trainees, paediatric intensivists and paediatric nurses) provides external support to paediatric serious incident investigations at network NHS trusts. We compose anonymised, one-page learning summaries approved at Trust level and shared to disseminate learning. Persistent tachycardia (PT) was the most common theme (60%) identified (figure 1). We...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Aldridge, P., Baldock, A. J., Baird, J., Elson, A., McGregor, S., Thames Valley & Wessex Operational Delivery Network Paediatric Critical Care Governance Group Tags: PostScript Source Type: research

Towards evidence-based medicine for paediatricians
Grey but important Grey days, grey food, grey water. Moving to grey is usually miserableness and boredom. It was the centrepoint of satire for a UK prime minister in the last millennium. Systematic reviewers though—they can absolutely love a bit of grey. The ‘grey’ literature is a term used to describe stuff that is a bit in the shadows. Reports and studies which are not entirely unpublished (those are the ‘file drawer’ papers), but have not been given the shiny acknowledgement of presentation in an academic conference or Learned Journal. The grey papers might be detailed reports or technical ...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Phillips, B. Tags: ADC Archimedes Source Type: research

Are term breech babies who undergo successful external cephalic version still at increased risk of developmental dysplasia of the hip?
Scenario A 36-hour-old neonate is undergoing their newborn and infant physical examination (NIPE). Antenatal scans showed that the baby was in the breech position at 36 weeks’ gestation. However, the mother underwent a successful external cephalic version (ECV) procedure at 37 weeks and had an uneventful normal vaginal delivery (with a cephalic presentation). There are no other risk factors for developmental dysplasia of the hips (DDH), and the baby’s hip examination using the Ortolani and Barlow manoeuvres is normal. You wonder whether the baby still requires referral for routine hip ultrasound. Structured cli...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Stock, J., Deshpande, S. A. Tags: ADC Archimedes Source Type: research

Young people consenting to medical research
Introduction: age-based consent for research The regulations and guidance regarding young people’s consent to participate in medical research are complex.1 Current regulations divide medical research into two types: research that involves the trial of a medication and research that does not (figure 1). Trials of medications are governed by the Medicines for Human Use (Clinical Trials) Regulations 2004,2 whereas other forms of medical research operate without statutory guidance. The statute states that anyone aged 16 years or older can consent to participate in a clinical trial. Those under the age of 16 cannot consen...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Davies, F., Fisher, H., Birchley, G. Tags: Viewpoint Source Type: research

Intravenous maintenance fluid therapy
For paediatricians of a certain age (including Archivist), their training in intravenous maintenance fluid therapy (IV-MFT) was based on a paper almost 70 years old. (Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics 1957;19:823–32). The recommendations were made from the calculated water requirement based on presumed energy expenditure of healthy breast fed infants. The equations used 1 mL of fluid provided for each kilocalorie expended and the electrolyte concentrations and glucose content of intravenous fluids were estimated to reflect the composition of human and cow&rs...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Tags: Miscellanea Source Type: research

Infantile myofibromatosis in a 5-month-old boy
A 5-month-old boy presented with a solitary occipital growth. The lesion was of hard consistency, immobile, painless, measuring 2x3 cm with no relevant lymph node involvement. The overlying skin was intact. There was no relevant family history. Ultrasound scan revealed a bony lytic lesion. Initial CT and MRIs were suspicious of Langerhans cell histiocytosis. The lesion was indenting into cerebellar hemispheres, contacting but not indenting the venous sinuses (figure 1). No abnormal brain parenchymal signal was identified. Histopathology examination showed interlacing fascicles of spindle cells with myofibroblastic morpholo...
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Mohammad, O., Jacoby, J., Tighe, M. P. Tags: Miscellanea Source Type: research

Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study
Conclusions For CYP across English hospitals, a sharp recovery followed a steep reduction in appendicectomy rates in April 2020, due to concerns with COVID-19 transmission. This builds on smaller-sized studies reporting the immediate short-term impacts. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Faitna, P., Harwood, R., Kenny, S. E., Viner, R. M., Aylin, P. P., Hargreaves, D. S., Bottle, A. Tags: Open access, COVID-19 Original research Source Type: research

National study on the risks of COVID-19 infection for paediatric kidney transplant recipients: a retrospective, cross-sectional study
Conclusion We report 10.4% of the UK paediatric renal transplantation population had documented COVID-19 infections with positive SARS-CoV-2 PCR RNA with 28% of those affected requiring hospitalisation. The increased incidence of AKI, particularly after the first wave of the COVID-19 pandemic, was possibly due to increased testing. There was low morbidity and mortality compared with the adult population. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Withers, C., Patel, R., Reynolds, B. C., Christian, M., Muorah, M., Tse, Y., Edwards, L., Yadav, P., Haq, S., Hegde, S., Callaghan, C. J., Bamford, A., Marks, S. D. Tags: COVID-19 Original research Source Type: research

Early educational attainment in children with major congenital anomaly in the UK
Conclusions These novel results demonstrate that poor educational attainment extends to children with urinary, limb and gastrointestinal CAs. We demonstrate the need for collaboration between health and education services to assess and support children with major CA, so every CA survivor can maximise their potential. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Wands, Z. E., Cave, D. G. W., Cromie, K., Hough, A., Johnson, K., Mon-Williams, M., Feltbower, R. G., Glaser, A. W. Tags: Original research Source Type: research

Patient and parent perspectives on paediatric cancer multidisciplinary team working and national advisory panels in the UK: a qualitative research study
Conclusion Several changes have been driven forward by this work, including the modification of NAP referral proformas to include additional information. Patient and parent perspectives are now embedded into a best practice model for the NAPs to promote personalised recommendations at national level. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Brown, S., Johnson, K., Gray, J., Bate, J. Tags: Original research Source Type: research

Pattern and prognostic factors for kidney function progression in survivors of children with acute kidney injury: a cohort study
Conclusions AKI and AKD are prevalent among critically ill children and pose substantial risk for non-recovery of kidney function among PICU survivors. A structural follow-up visit for AKI survivors to monitor kidney function progression is advocated. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Hui, W. F., Chan, V. P. Y., Cheung, W. L., Ku, S. W., Hon, K. L. Tags: Original research Source Type: research

Role of overnight oximetry in assessing the severity of obstructive sleep apnoea in typically developing children: a multicentre study
Conclusion Raised ODI3 and ODI4 predict OSA in TD children with high specificity but variable sensitivity. NPO may be an alternative to diagnose moderate-severe OSA if access to CRP is limited. Low sensitivities to detect mild OSA mean that confirmatory CRP is needed if NPO is normal. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Selby, A., Buchan, E., Davies, M., Hill, C. M., Kingshott, R. N., Langley, R. J., McGovern, J., Presslie, C., Senior, E., Shinde, S. S., Yuen, H. M., Samuels, M., Evans, H. J. Tags: Original research Source Type: research

Rate and predictors of insufficient sweat volume in very young infants after pilocarpine gel iontophoresis: prospective, population-based study
Conclusion QNS rates fulfilled the requirements, but predictors differed from those recommended by the Cystic Fibrosis Foundations guidelines. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Camargos, P., Bedran, R. M., Alvim, C. G., Sader, O. G. Tags: Original research Source Type: research

Air pollution and childhood respiratory consultations in primary care: a systematic review
Conclusions The evidence suggests CO, SO2, NO2, PM10 and PM2.5 are risk factors for respiratory diseases in children in primary care in the short term. However, given the heterogeneity of the studies, interpretation of these findings must be done with caution. PROSPERO registration number CRD42022259279. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - March 19, 2024 Category: Pediatrics Authors: Fonderson, M. S., van Meel, E. R., Bindels, P., Bohnen, A., Burdorf, A., de Schepper, E. Tags: Open access Original research Source Type: research