Towards evidence-based medicine for paediatricians
Lumps or granules? You may well enjoy a lump of sugar in your tea, a fine cucumber sandwich and a round of croquet. Or you could prefer a sprinkling of the more crystalline version beaten with butter, vanilla essence, flour and salt and baked lightly into shortbread, eaten before a roaring fire. Neither really has any relevance to if you should consider—when looking at a piece of evidence synthesis—if it is reasonable to lump the studies together or split them into separate grains. When you are considering one of the key questions in a systematic review1—how did they synthesise the data—it can be go...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Phillips, B. Tags: ADC Archimedes Source Type: research
Does baclofen for the management of spasticity increase the risk of seizures?
Scenario A 6-year-old boy with cerebral palsy (CP) (Gross Motor Function Classification System III) is attending the complex tone clinic. He was born at 28 weeks after a stormy neonatal course. He was subsequently diagnosed with periventricular leucomalacia and focal epilepsy. He is prescribed levetiracetam and has remained seizure free now for 6 months. He has increased tone (spasticity) in his lower limbs, which is impacting on activities of daily living, such as dressing. You wish to start baclofen for tone management. However, his mother is anxious as she read on a parent website that baclofen can cause seizures. Struc...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Malalla, H., Gorman, K. M. Tags: ADC Archimedes Source Type: research
Children who benefit families
This article provides a descriptor to recognise the part played by a child in their family’s history. Children can confer benefit on their families. The notion of a ‘saviour sibling’ catches the eye; not least because this provides a... (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Formstone, M., Wheeler, R. Tags: Viewpoint Source Type: research
Educational achievement to age 11 years in children born at late preterm and early term gestations
Conclusions
There is a strong association between LPT and education at age 5 years, which remains strong and statistically significant through age 11 years for mathematics but not for other key subjects. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Copper, C., Clare Copper, Waterman, A., Nicoletti, C., Pettinger, K., Sanders, L., Hill, L. J. B. Tags: Original research Source Type: research
Blended diets for tube-fed children and young people: a rapid review update
Conclusion
Nutritional content, food hygiene and viscosity of food blends are important considerations for professionals and families to ensure safe practice when using blended diets for enteral feeding. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Phillips, G., Coad, J. Tags: Original research Source Type: research
Perceived influence of commercial milk formula labelling on mothers feeding choices in Great Britain: a qualitative study
Conclusions
CMF legislation in GB should be updated to restrict brand advertising and the use of on-pack text and images that mothers perceive as indicating products have a closer similarity to breast milk. Greater input from HCPs was desired by new mothers and would support them to make more informed choices about CMF. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Conway, R., Ritchie, I., Esser, S., Steptoe, A., Smith, A. D., Llewellyn, C. Tags: Open access Original research Source Type: research
When a Kasai portoenterostomy goes wrong
The first job Archivist had in paediatrics was working as an SHO on the gastroenterology ward in a children’s hospital in Manchester. There were rows of children with biliary atresia, small for their age, jaundiced with large swollen abdomens usually post Kasai portoenterostomy (KPE) or a few waiting to go for surgery. Pale white stools, once seen, will never be forgotten. Post-surgery, we were waiting for the jaundice to clear a sign of success and a failed Kasai operation meant liver transplant. The first liver transplant in children was in 1963 which was unfortunately unsuccessful. Fortunately, now, graft and pati...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Psychiatric disorders in paediatric-onset immune-mediated inflammatory diseases: a nationwide Danish study
Conclusion
Patients with pIMID are at increased risk for a broad spectrum of psychiatric disorders both before and after onset of pIMID. The results support the need for awareness of psychiatric morbidity in this young patient group and the need for coordinated healthcare for those with comorbid states. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Jansson, S., Malham, M., Carlsen, K., Ingels, H., Jorgensen, M. H., Virta, L. J., Kolho, K.-L., Rask, C. U., Wewer, V. Tags: Original research Source Type: research
Variation in access and prescription of vedolizumab and ustekinumab in paediatric patients with inflammatory bowel disease: a UK-wide study
Conclusions
There is widespread use of vedolizumab and ustekinumab across the UK, although practice is highly variable. Access to therapy appeared to differ substantially. There is a growing disparity between international guidelines and real-world practice. Establishing early and effective therapy in all patients remains a priority. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Auth, M. K.-H., Ashton, J. J., Jones, K. D. J., Rodrigues, A., Thangarajah, D., Devadason, D., Lee, G., Ayaz, M., Lee, H. M., Kammermeier, J., BSPGHAN IBD Biologics Survey Contributors, Lee, Swann, Garrick, Torrente, Deb, Doble, Paul, Coelho, Zamvar, Naru Tags: Original research Source Type: research
Public awareness of childhood, teenager and young adult cancer signs and symptoms in Great Britain: a cross-sectional survey
Conclusions
Public awareness of childhood cancer risks and symptoms is substantially lower compared with adult cancer awareness in Great Britain. These findings indicate knowledge and awareness gaps among the general public, highlighting the need for a child cancer awareness campaign. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Liu, J.-F., Shanmugavadivel, D., Ball-Gamble, A., Stewart, A., Walker, D., on behalf of Child Cancer Smart Awareness Campaign Tags: Open access, Press releases Original research Source Type: research
Role of urine culture in paediatric patients with cancer with fever and neutropenia: a prospective observational study
Conclusions
UTI is an infrequent cause of infection in these patients. Urinalysis is indicated only in children with febrile neutropenia with urinary signs/symptoms and in asymptomatic patients with a history of urinary tract disease or unknown history. When urine is collected, UC should be requested regardless of the result of the urinalysis. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Alonso-Cadenas, J. A., Sancosmed Ron, M., Herrero, B., Lera Carballo, E., Lassaletta, A., Rodrigo, R., de la Torre, M., On behalf of the Spanish Pediatric Emergency Research Group (RISeuP-SPERG) Tags: Original research Source Type: research
Tunnelled external versus implanted port central venous catheters in paediatric oncology: a systematic review and meta-analysis
Conclusion
This study shows that PORTs associate with a reduced risk of infectious and mechanical complications, and a lower overall risk of removal, compared with tunnelled external CVCs in children with cancer. Further work is required to confirm these findings in a prospective randomised trial and to compare cost implications and acceptability to patients and caregivers. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Neville, J. J., Aye, H. M., Hall, N. J. Tags: Editor's choice Original research Source Type: research
Risk of suicide in children and adolescents in the emergency department--is universal screening the answer?
Conclusion
Based on this review, using a suicide screening tool can help detect patients at risk who would otherwise have been missed. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Alrisi, K., Alnasif, N., Nazeer, A., Shareef, J., Latif, F. Tags: Paediatric Emergency Medicine Source Type: research
Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review
Background
Size at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps.
Methods
We searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association.
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Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Jamaluddine, Z., Sharara, E., Helou, V., El Rashidi, N., Safadi, G., El-Helou, N., Ghattas, H., Sato, M., Blencowe, H., Campbell, O. M. R. Tags: Open access, ADC Global child health Source Type: research
Positive urine cultures
We now have a culture-free reference standard for identifying bacterial presence in clinical specimens; the 16S ribosomal ribonucleic acid (rRNA) gene PCR sequencing process. The 16 s rRNA gene has a unique structure and can help classify bacteria from genus down to phylum levels. Traditionally, diagnosing urine infections starts with linking the symptoms to the urine sample dipstick testing (looking especially for leukocytes and nitrites), microscopy and then urine culture. Interpreting the results depend on the type of urine sample obtained (bag, clean catch, catheter sample or suprapubic aspiration (SPA)), evidence of a...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
