Role of procalcitonin in predicting complications of Kawasaki disease
Scenario A 2-year-old Japanese boy presented with a 3-day history of fever. He was lethargic and tachycardic, which made clinicians suspect sepsis. He was hospitalised for antibiotic treatment. On day 5, he developed bilateral conjunctivitis and erythematous lips. His cervical lymph nodes were enlarged, and erythema multiforme-like rashes were observed on the trunk. He was diagnosed with Kawasaki disease (KD), and intravenous immunoglobulin (IVIG) therapy was administered. He required two courses of IVIG as he did not respond to the initial treatment. He eventually developed coronary artery aneurysms (CAAs). On blood tests...
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Iio, K., Hanna, H., Beykou, M., Gale, C., Herberg, J. A. Tags: ADC Archimedes Source Type: research
Emotional work of getting help: a qualitative analysis of caregiver-perceived barriers to responding to childhood adversity
Conclusions
Caregivers highlighted a multitude of barriers to getting help for life challenges. Addressing these barriers will require services to become more flexible and codesign best approaches with families in ongoing partnership. Improving community knowledge of available services and building trusting relationships is the first step to overcoming these barriers. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Loveday, S., Balgovind, M., Hall, T., Goldfeld, S., Sanci, L., Hiscock, H. Tags: Original research Source Type: research
Fetal alcohol syndrome in the UK
Conclusions
The estimated incidence rate of FAS is lower than reported by similar studies and there was a wide variation in the age that cases were diagnosed. This, combined with the fact that many cases were notified and then withdrawn or excluded, suggests that in the UK there is a lack of consistency and certainty in diagnosing FAS. The study findings strongly support the need to educate key professionals involved in the care of infants and children at risk of FAS. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Burleigh, C. R., Lynn, R. M., Verity, C., Winstone, A. M., White, S. R., Johnson, K. Tags: Open access Original research Source Type: research
First randomised controlled study of two different approaches to treating retinoblastoma
Ninety nine percent of retinoblastomas occur in children less than 5 years and is the most common intraocular tumour. Archivist was fascinated to discover that most of today’s treatments for this tumour (unlike many other oncological tumours in children) have been implemented based on single-centre experiences in high-income countries and not the large randomised controlled trials (RCTs) from many centres that we know well from the large cancer networks. There is also an inequality in treatment when comparing to low-income and middle-income countries (LMIC) where there may be delayed diagnosis, difficulties in accept...
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Developmental and behavioural outcomes at 2 years in babies born during the COVID-19 pandemic: communication concerns in a pandemic birth cohort
Conclusion
24-month-old pandemic-born infants had largely similar developmental and behavioural scores compared with their prepandemic counterparts. Concerns have been raised in the communication developmental domain. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Byrne, S., Sledge, H., Hurley, S., Hoolahan, S., Franklin, R., Jordan, N., Boland, F., Murray, D. M., Hourihane, J., on behalf of the CORAL Study group, OMahony, McCallion, White, Lawler, Byrne, Fitzsimons Tags: Open access, COVID-19 Original research Source Type: research
Discharge criteria for inpatient paediatric asthma: a narrative systematic review
Conclusion
CLDs and ICPs in the care of paediatric inpatients with asthma are associated with improvements in LOS without increasing re-presentations or readmissions. Discharge criteria lack consensus and evidence base. Common criteria include bronchodilator frequency, oxygen saturations and respiratory assessment. This study was limited by a paucity of high-quality studies and exclusion of studies not published in English. Further research is necessary to identify optimal definitions for each discharge criterion. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Sudarmana, A., Lawrence, J., So, N., Chen, K. Tags: Original research Source Type: research
Infliximab for intensification of primary therapy for patients with Kawasaki disease and coronary artery aneurysms at diagnosis
Conclusions
Primary adjunctive high-dose 10 mg/kg infliximab treatment was associated with a greater likelihood of CAA regression in patients with CAA at the time of diagnosis. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Miyata, K., Bainto, E. V., Sun, X., Jain, S., Dummer, K. B., Burns, J. C., Tremoulet, A. H. Tags: Open access Original research Source Type: research
Embedding nurse home visiting in universal healthcare: 6-year follow-up of a randomised trial
Conclusions
Four years after completing the right@home programme, benefits were evident across home and school contexts. Embedding NHV in universal healthcare systems from pregnancy can offer long-term benefits for families experiencing adversity.
Trial registration number
ISRCTN89962120. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Price, A., Bryson, H., Mensah, F. K., Kenny, B., Wang, X., Orsini, F., Gold, L., Kemp, L., Bruce, T., Dakin, P., Noble, K., Makama, M., Goldfeld, S. Tags: Original research Source Type: research
Close intervention sessions complement intensive insulin therapy in paediatric diabetes: a longitudinal study
Conclusions
Compared with matched peers on MDI regimens, patients on pump therapy have lower expected HbA1c, an effect sustained for up to 8 years. Intensive re-education is associated with a significant drop in previously elevated HbA1c levels. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Foran, J., Egan, A., Somers, E., OConnell, S. M. Tags: Open access Original research Source Type: research
Case for funding of continuous glucose monitoring systems for patients with recurrent hypoglycaemia
Introduction Continuous glucose monitoring (CGM) allows real-time interstitial glucose monitoring, therefore reducing the need for regular fingerprick blood testing.1 CGM also informs users of glucose trend data and alarms, which warns users of high or low blood glucose readings. There is a paucity of evidence on the use of CGM in patients without diabetes, but early data suggest that CGM can reduce episodes of hypoglycaemia in conditions such as hyperinsulinism and metabolic disorders.1 2 Real-time CGM was shown to provide valuable insights into patterns of dysglycaemia, where rapid fluctuations were found in glucose leve...
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Ng, S. M., Dearman, S., Fisher, M., Mushtaq, T., Randell, T., on behalf of the British Society of Paediatric Endocrinology and Diabetes UK and the UK Childrens Hyperinsulinism Charity Tags: Viewpoint Source Type: research
Power of patient storytelling
Humans thrive on stories. They are how we make decisions, how we make sense of the world, how we figure out our place in it all. But in clinical settings, patient stories can be lacking. Medics are often thinly stretched and may only scratch the surface of their patients’ experiences. The system does not afford time for storytelling in a clinical setting when appointments are only 15 minutes long and there is a list of life-saving to-dos to be done. Patients themselves may be less willing to share with their doctors their full experience, afraid of taking up their already precious time or nervous to criticise those w...
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Purkiss, A.-M. Tags: Viewpoint Source Type: research
Impact of childhood burns on academic performance: a matched population-based cohort study
Conclusions
Young females hospitalised with a burn displayed poorer academic performance for reading compared with matched peers, while males and females were more likely to leave school earlier. Identifying unmet learning support needs of young burn survivors should be investigated. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Halim, N., Holland, A. J. A., McMaugh, A., Cameron, C. M., Lystad, R. P., Badgery-Parker, T., Mitchell, R. Tags: Open access, Editor's choice Original research Source Type: research
Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study
Conclusions
There were increases in new onset diabetes in children and a higher risk of DKA in the first COVID pandemic year. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Ponmani, C., Nijman, R. G., Roland, D., Barrett, M., Hulse, T., Whittle, V., Lyttle, M. D., on behalf of Paediatric Emergency Research United Kingdom and Ireland (PERUKI), Irwin, Goyos, Bull, Latif, Ranasinghe, Hartin, Dalzell, Jenkinson, Cantle, Bruce-No Tags: COVID-19 Paediatric Emergency Medicine Source Type: research
Do proton pump inhibitors increase the risk of serious infections?
Some readers will remember the various treatments for gastro-oesophageal reflux; many with questionable efficacy. Several of them (eg, metoclopramide, cisapride, cimetidine) are no longer advised for use or have even been withdrawn due to serious side effects such as drowsiness, extrapyramidal effects, serious QT abnormality predisposing to cardiac dysrhythmia or interaction with other drugs. The development of the proton pump inhibitors (PPIs) seemed to be the answer or partially helpful for the treatment of symptoms. It now appears that this group of drugs is associated with serious infections (infections requiring hospi...
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Short-term outcomes of South African children with multisystem inflammatory syndrome in children: a prospective cohort study
In this study, we investigate the short-term outcomes in children with MIS-C in Cape Town, South Africa.
Methods
This prospective observational cohort study included children <13 years who fulfilled the WHO case definition of MIS-C and were admitted to Tygerberg Hospital in Cape Town, South Africa between 1 June 2020 and 31 October 2021. Clinical features were recorded at baseline and at follow-up at the 6-week cardiology and 3-month rheumatology-immunology clinics, respectively.
Findings
Fifty-three children with a median age of 7.4 years (IQR 4.2–9.9) were included. There was a slight male predominance (30/53;...
Source: Archives of Disease in Childhood - September 19, 2023 Category: Pediatrics Authors: Lishman, J., Abraham, D. R., Fourie, B., Yunis, N. A., Redfern, A., van der Zalm, M. M., Rabie, H. Tags: ADC Global child health, COVID-19 Source Type: research
