Rifampin urinary excretion to predict serum targets in children with tuberculosis: a prospective diagnostic accuracy study
Conclusions
Urine spectrophotometry correlated with a clinically relevant serum target for rifampin, representing a step toward personalised dosing for children in TB-endemic settings. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Thomas, T. A., Lukumay, S., Yu, S., Rao, P., Siemiatkowska, A., Kagan, L., Augustino, D., Mejan, P., Mosha, R., Handler, D., Petros de Guex, K., Mmbaga, B., Pfaeffle, H., Reiss, R., Peloquin, C. A., Vinnard, C., Mduma, E., Xie, Y. L., Heysell, S. K. Tags: ADC Global child health Source Type: research
Simplifying CFTR modulation therapy in cystic fibrosis
When The Archivist started practicing paediatrics, the predicted age of survival for a child with cystic fibrosis (CF) was 15 years of age. Treatment was pancreatic enzyme supplementation, physiotherapy for airway clearance and antibiotics. By the1990s lung transplant, inhaled tobramycin and DNAse became available. Once the CF protein and CF genes were identified, median predicted survival was 44 years with 53% patients surviving over 18 years. The main problem is a defect of the CF transmembrane conductance regulator (CFTR) protein. In the 2020s CFTR modulators have had a major impact on CF management in some cases doubli...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Diagnosing early-onset neonatal sepsis in low-resource settings: development of a multivariable prediction model
Conclusions
Our clinical prediction model achieved high sensitivity with low specificity, suggesting it may be suited to excluding early-onset sepsis. Future work will validate and update this model before considering implementation within the Neotree. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Neal, S. R., Fitzgerald, F., Chimhuya, S., Heys, M., Cortina-Borja, M., Chimhini, G. Tags: Open access, ADC Global child health Source Type: research
Managing challenges in congenital CMV: current thinking
Congenital human cytomegalovirus (CMV) infection is the most common congenital infection, affecting around 1 in 200 infants in high-income settings. It can have life-long consequences for up to one in four children, including sensorineural hearing loss and neurodisability. Despite the frequency of congenital CMV and the severity for some children, it is a little-known condition by pregnant women, families and healthcare providers. Timely diagnosis of CMV infection in pregnancy is important to facilitate consideration of treatment with valaciclovir, which may reduce the risk of transmission to the fetus or reduce the severi...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Jones, C. E., Bailey, H., Bamford, A., Calvert, A., Dorey, R. B., Drysdale, S. B., Khalil, A., Heath, P. T., Lyall, H., Ralph, K. M. I., Sapuan, S., Vandrevala, T., Walter, S., Whittaker, E., Wood, S., for the UK Congenital CMV Infection Collaboration (UK Tags: Review Source Type: research
Assessing autism spectrum disorder in children with a background of maltreatment: challenges and guidance
There may be some similarities in the presentation of children who have autism spectrum disorder (ASD) and those exposed to maltreatment affecting assessment and diagnosis. Overlapping characteristics include difficulties understanding and maintaining relationships, sensitivity to routine and hyper-reactivity to sensory inputs. Children who have been maltreated are at increased risk of various developmental vulnerabilities with both environmental and genetic factors being relevant. The existing epidemiological evidence has found that looked-after children are more likely to screen positively for neurodevelopmental disorder...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Wilkinson, S., Evans, S., DeJong, M. Tags: Review Source Type: research
Conversion therapy: change the law not the person
As paediatricians, we have a duty to represent and advocate for the health and well-being of the children and young people we protect. Despite being a bright and vibrant community, the lesbian, gay, bisexual and transgender (LGBT) population is known to have inferior health outcomes, especially with respect to mental health issues including depression, low self-esteem and self-harm.1 We can reduce this inequality by empowering them with health information and stopping their marginalisation within society. Conversion therapy is an umbrella terminology for any psychological, physical or spiritual interventions which aim to c...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Talbot, J., Finlay, F. Tags: Viewpoint Source Type: research
Precision decisions: tailoring decision-sharing in contemporary paediatric healthcare
Decision-making in paediatric health is evolving from an era of paternalism to an approach centred on the interests and preferences of patients and parents.1 2 The character of decision-making for children has also changed dramatically. The evidence base is rapidly shifting, patient complexity is high and innovative medical and technological advances make chronic diseases more manageable, although often at the expense of invasive, potentially burdensome therapies. Decisions are often time critical and at a pivotal nexus of life and death. This landscape of paediatric decision-making is shaded in grey, with uncertainties, a...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Siegel, B., Moynihan, K. Tags: Editorial Source Type: research
COVID-19-associated croup severity in Australian children
The Omicron variant of SARS-CoV-2 has been linked to upper airway manifestations, including laryngotracheobronchitis, or croup.1–3 Croup from any cause is a common reason for hospital presentation in children and can cause serious morbidity.3 The current literature examining COVID-19-associated croup mostly describes the differences in clinical course and outcomes between SARS-CoV-2 variants; there is little data comparing SARS-CoV-2 croup to other respiratory viruses.1–5 Thus, we conducted an Australian single-institution observational study comparing the clinical features and outcomes between COVID-19-associa...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Lai, T. C., Walker, P. J. B., Schrader, S., McMinn, A., Tosif, S., Crawford, N. W., Cheng, D. R. Tags: COVID-19 PostScript Source Type: research
Correction: Invasive bacterial infection in children with fever and petechial rash in the emergency department: a national prospective observational study
Storch-De-Gracia P, Fernández JL, Velasco R, et al. Invasive bacterial infection in children with fever and petechial rash in the emergency department: a national prospective observational study. Arch Dis Child 2023;108:445–450.
In the author list for this article, the Research Group of the Spanish Society of Paediatric Emergencies (RISEUP-SPERG) should also have been credited as an author group. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Tags: Correction Source Type: research
Atoms
OK. I’ll come clean. Occasionally, I procrastinate. Both editorially and clinically if an acute situation doesn’t demand an instant response. There it is, I’ve said it now: out in the open for all to see. This, though, can be advantageous, so let me add a few lines of defence. This verb (state of being, literally in Latin, to leave until tomorrow) has, rather unfairly found use largely pejoratively. Just think of the euphemisms: ‘laboured’, ‘sluggish’, ‘blunted’, ‘lethargic’, ‘manacled by inertia’, and so on... But, I counter parry, these similes...
Source: Archives of Disease in Childhood - July 19, 2023 Category: Pediatrics Authors: Brown, N. Tags: Highlights from this issue Source Type: research
Highlights from the literature
Long term survivors of childhood cancer At the beginning of Lucina’s career, 5 year survival rates for many childhood cancers were not great, but over the last few decades this has improved significantly with overall survival rates at 5 years being over 85%. What happens after 5 years (known as late mortality)? Dixon SB et al (Lancet 2023; 401:10386:1447–1457. https://doi.org/10.1016/S0140-6736(22)02471-0) have looked at specific causes of late mortality and risk reduction through modifiable lifestyle and cardiovascular risk factors. This retrospective cohort study was from 31 US and Canadian cancer hospital ba...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Assessment of mental health presentations to the paediatric emergency department: a poorly standardised process
Children and young people (CYP) frequently present to paediatric emergency departments (PEDs) in mental health (MH) crises.1 Suicide is one of the leading UK causes of CYP death, while the prevalence of MH issues rose from 10.8% to 16% in 7–16 years old between 2017 and 2020.1 An accurate, objective and standardised assessment is crucial to stratify risk and facilitate timely, effective and individualised treatment. Recent National Institute for Health and Care Excellence (NICE) guidance discourages the use of rapid assessment matrices (RAMs), increasing reliance on individual clinician expertise.2 We aimed to evalua...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Malley, M., Hall, M., Parry, G., Sutton, H., Costelloe, M. Tags: PostScript Source Type: research
Integration of services for children
The year 2022 saw the establishment of Integrated Care Systems (ICSs) in England. According to the Health Foundation,1 ICSs are the centrepiece of the biggest legislative overhaul of the National Health Service in a decade. The aim is to bring together general practice, hospitals and local authorities. Local ICS initiatives will be developed by place-based partnerships.2 ICSs must say how they will address the needs of children and young people in their 5-year plans, with local consultation and the involvement of children and families. The National Children’s Bureau concluded that ‘taken together, we believe th...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Turner, S., Downham, M., Colver, A., Craig, M., Paynter, A., Pearson, P. Tags: PostScript Source Type: research
Oral paracetamol dosing in hospitalised children in the UK
Paracetamol dosing for children in UK hospitals causes debate and disagreement between clinicians. We think that the current recommendations in the British National Formulary for Children (BNFC) for oral paracetamol contribute to this. The doses recommended for all indications, except postoperative pain, are based on the age of the child rather than their weight.1 We understand that the BNFC reflects the recommended dose for over-the-counter (OTC) use of paracetamol and therefore needs to be easy for parents to use, however, additional information about suitable doses for hospitalised children is needed. We decided to surv...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Craske, J., Gill, A. Tags: PostScript Source Type: research
For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review
Conclusions
There are limited data on interventions to improve medication safety in paediatric ward rounds, with all published data being small scale, either quality improvement or audits, and locally derived/delivered. Good-quality interventional or robust quality improvement studies are required to improve medication safety on ward rounds.
PROSPERO registration number
CRD42022340201. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: King, C., Dudley, J., Mee, A., Tomlin, S., Tse, Y., Trivedi, A., Hawcutt, D. B., on behalf of the Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacist Group Joint Standing Committee on Medicines Tags: ADC Drug Therapy Source Type: research
