Ethnic differences and inequities in paediatric healthcare utilisation in the UK: a scoping review
Discussion
While the current evidence base can assist policy makers to identify inequities in paediatric healthcare utilisation among certain ethnic groups, we outline recommendations to improve the validity, generalisability and comparability of research to better understand and thereby act on ethnic inequities in paediatric healthcare. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Zhang, C. X., Quigley, M. A., Bankhead, C., Bentley, T., Otasowie, C., Carson, C. Tags: Open access, COVID-19 Review Source Type: research
New treatments in spinal muscular atrophy
Spinal muscular atrophy (SMA) is a severe neurodegenerative condition due to recessive mutations in the SMN1 gene resulting in insufficiency of survival motor neuron (SMN) protein. Lack of SMN protein results in irreversible degeneration of lower motor neurons and consequential muscle atrophy and weakness. SMN2, a SMN1 homologue, produces low levels of functional SMN protein with the potential to partially compensate SMN1 loss. Several compounds have been shown to successfully restore SMN protein production in motor neurons, either by enhancing SMN2 gene function or by direct replacement of the SMN1 gene. Clinical trials o...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Gowda, V. L., Fernandez-Garcia, M. A., Jungbluth, H., Wraige, E. Tags: Review Source Type: research
Surrogacy: of Byzantine complexity
Surrogacy describes the practice whereby ‘...One woman carries a child for another person with the intention that the child should be handed over at birth’. How might this arrangement impinge on clinical care? Recent evidence indicates uncertainty in this area of practice.1 A married English couple, unable to conceive, entered a contract in America whereby for payment a surrogate mother was found, then successfully inseminated artificially with the husband’s sperm.2 When birth was imminent all three adults came to England; the baby was born in hospital in 1985. A few hours later, the mother left her newbo...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Wheeler, R. Tags: Clinical law for clinical practice Source Type: research
Characteristics and predictors of persistent symptoms post-COVID-19 in children and young people: a large community cross-sectional study in England
Conclusions
One in 23 5–11 year-olds and one in eight 12–17 year-olds post-COVID-19 report persistent symptoms lasting ≥3 months, of which one in nine report a large impact on performing day-to-day activities. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Atchison, C. J., Whitaker, M., Donnelly, C. A., Chadeau-Hyam, M., Riley, S., Darzi, A., Ashby, D., Barclay, W., Cooke, G. S., Elliott, P., Ward, H. Tags: Open access, COVID-19 Original research Source Type: research
Hospital bed replacement for acute care of children at home during the COVID-19 pandemic through a Hospital-in-the-Home programme
Conclusions
COVID-19-positive children at high risk or with moderate symptoms can be managed safely via HITH at home, the ideal place for children during the pandemic. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Bryant, P. A., Lawrence, J., Boyce, S., Simpson, C. M., Sinclair, G., Chong, C., Lewis, P., Lee, S., Hughes, R., Dalton, S., Lacey, C., Nisbet, L. C., Smith, T. E., Chapman, S., Lakshminarayanan, S., Hurd, K., Smith, K., Savill, B., Ibrahim, L. F. Tags: COVID-19 Original research Source Type: research
Atoms
It was only after the trunk was disinterred... Swathed in fluorescent peach reflective stripes, the search party had set off, torches aloft, in the penumbral half-light, eager, zestful and optimistic. Their task, the exhumation and recovery of a box of documents from confidential lab work undertaken by M15 during the height of the Kong offensive had seemed straightforward enough at the outset. This initial impression, though, proved naïve. The forest was denser, the tracks fainter, the maps less reliable and the mosquitos more aggressive than the ‘initial surveys’ had led them to believe. As dawn approa...
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: Brown, N. Tags: Highlights from this issue Source Type: research
Highlights from the literature
Hibernating bears Brown bears hibernate for 4–7 months a year. They are big animals, and during this time are clearly immobile. It is very interesting that they do not get deep vein thrombosis (DVT) or venous thromboembolic phenomenon (VTE). Lucina found this fascinating and so Jennifer Abassi [JAMA. doi:10.1001/jama.2023.7143] who has summarised a paper recently published by Thienel M et al [Science 2023;380;178–187. DOI: 10.1126/science.abo5044]. This team explained the bear animal model. They have identified a protein on platelets that down regulates during periods of immobility. Using mass spectrometry prot...
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Breathing by example
Asthma is the most common chronic disease in children, affecting 1 in 11 children in the UK. Inhaled corticosteroids (ICS) form the foundation of asthma management, with well-controlled asthma associated with little or no need for short-acting bronchodilators (ie, salbutamol).1 Research consistently highlights that non-adherence to preventer inhalers is associated with poor outcomes1; the number of ICS canisters used per year is inversely related to the rate of death due to asthma.2 When searching the internet for photos of children issuing inhalers, search engine results almost exclusively depict a salbutamol inhaler atta...
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: Kimber, K., Equi, A. Tags: PostScript Source Type: research
Urethroliths - a rare complication of urethral reconstruction
A 15-year-old boy, a member of a dance troupe, presented to the outpatient clinic with a 4-month history of dull scrotal pain and stress incontinence. He had complete bladder exstrophy epispadias complex identified at birth and underwent bladder reconstruction (modified Kelly procedure) at 6 months of age. At 17 months of age, neourethral reconstruction had been undertaken using flaps from pubic skin and he achieved urinary continence. Physical examination revealed multiple hard, gritty, mobile masses in the scrotal sac beside the right testis and an ultrasound examination showed multiple calcified masses in scrotum (scrot...
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: Suresh Babu, J., Puthenveettil Yesodharan, H. Tags: Miscellanea Source Type: research
Robustness of reported postacute health outcomes in children with SARS-CoV-2 infection: a systematic review
Conclusions
The robustness of reported postacute SARS-CoV-2 infection health outcomes in children is seriously limited, at least in all the published articles we could identify. None of the studies provided evidence with reasonable certainty on whether SARS-CoV-2 infection has an impact on postacute health outcomes, let alone to what extent. Children and their families urgently need much more reliable and methodologically robust evidence to address their concerns and improve care. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: Hirt, J., Janiaud, P., Gloy, V. L., Schandelmaier, S., Pereira, T. V., Contopoulos-Ioannidis, D., Goodman, S. N., Ioannidis, J., Munkholm, K., Hemkens, L. G. Tags: Open access, COVID-19 Original research Source Type: research
Factors related to adverse long-term outcomes after mild traumatic brain injury in children: a scoping review
Conclusions
The most researched risk factors are sex, age and mechanism of injury, but their effects have been estimated inconsistently and did not show a clear pattern. The most studied outcomes are recovery patterns and symptom severity. However, these may not be the most important outcomes for clinicians and patients. Future primary studies in this area should focus on patient-important outcomes. Population-based prospective studies are needed that address prespecified hypotheses on the relationship of risk factors with given outcomes to enable reliable prediction of long-term adverse outcomes for childhood mTBI. (Sourc...
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: Ijaz, S., Scott, L., Dawson, S., Wilson, R., Jackson, J., Birnie, K., Redaniel, M. T., Savovic, J., Wright, I., Lyttle, M. D., Mytton, J. Tags: Open access Original research Source Type: research
Interventions in primary and community care to reduce urgent paediatric hospital admissions: systematic review
Conclusions and implications
New out-of-hospital models of urgent care for children need to be introduced and evaluated without delay.
PROSPERO registration number
CRD42021274374. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: Dick, S., MacRae, C., McFaul, C., Wilson, P., Turner, S. W. Tags: Original research Source Type: research
Reference centiles for infant sleep parameters from 4 to 16 weeks of age: findings from an Irish cohort
Conclusions
Reference centiles up to 4 months of age in infants highlight the gradual decrease in daytime sleep and large increases in night-time sleep, which occur in tandem with increasing lengths of sleep episodes. These reference centiles provide useful sleep values for infant sleep trajectory occurring in early life and may be helpful for parents and clinicians.
Trial registration number
NCT03381027. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: O Sullivan, M. P., Livingstone, V., Korotchikova, I., Dempsey, E. M., Murray, D. M., Boylan, G. B. Tags: Original research Source Type: research
Low yield from imaging after non-E. coli urine tract infections in children treated in primary care and emergency department
Conclusion
In this largest published group of infants and children diagnosed in primary and emergency care not requiring admission, non-E. coli UTI was not associated with a higher yield from renal tract imaging. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Authors: Tse, Y., Pickles, C., Owens, S., Malina, M., Peace, R., Gopal, M. Tags: Original research Source Type: research
Childhood origins of adult disease
Early childhood lung infection predicts adult respiratory morbidity. What about adult mortality? Allison JP et al [Lancet 2023;401:1183–93 https://doi.org/10.1016/ S0140-6736(23)00131-9] have examined, prospectively collected data, from the Medical Research Council National Survey of Health and Development. This team has examined the risk of premature death in adulthood associated with early childhood lower respiratory tract infections. This is truly a magnificent national longitudinal (nearly over eight decades) observational cohort study from a population born in March 1946 in Wales, Scotland, and England examining...
Source: Archives of Disease in Childhood - May 18, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
