Trends in diagnostic tests ordered for children: a retrospective analysis of 1.7 million laboratory test requests in Oxfordshire, UK from 2005 to 2019
Conclusions
After an initial decline, laboratory test use by children in Oxfordshire demonstrated an apparent increase since 2012. Test use increased in outpatient and general practice settings, however remained steady in inpatient settings. Further research should examine the root causes and implications for test increases, and whether these increases are warranted. We encourage clinicians to consider the individual and systemic implications of performing blood tests in children. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Thomas, E. T., Withrow, D. R., Shine, B., Gill, P., Perera, R., Heneghan, C. Tags: Open access Original research Source Type: research
Association of maternal risk factors with infant maltreatment: an administrative data cohort study
Conclusion
Infants born to young mothers are at greater risk of infant maltreatment, and this association remained until age 28 years. These findings are important for ensuring public health interventions are supporting populations experiencing structural vulnerabilities with the aim of preventing maltreatment. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Smith, J. N., Guttmann, A., Kopp, A., Vandermorris, A., Shouldice, M., Harron, K. L. Tags: Original research Source Type: research
Potential benefits of prenatal diagnosis of TGA in Australia may be outweighed by the adverse effects of earlier delivery: likely causation and potential solutions
Conclusion
Among newborns undergoing ASO for TGA, prenatal diagnosis is associated with poorer early postoperative outcomes. In addition to minimising iatrogenic factors (such as planned births) resulting in earlier births, evaluation of other dynamics following a prenatal diagnosis which may result in poor fetal growth and earlier onset of spontaneous labour is important. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Namachivayam, S. P., Butt, W., Brizard, C., Millar, J., Thompson, J., Walker, S. P., Cheung, M. M. H. Tags: Editor's choice Original research Source Type: research
Diagnostic value of rapid test for malaria among febrile neonates in a tertiary hospital in North-East Nigeria: a prospective cross-sectional study
Conclusion
The RDT used in this study was not sensitive in the diagnosis of congenital or acquired neonatal malaria; therefore, microscopy remains the preferred method of diagnosis of neonatal malaria. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Adeniji, Y. R., Jalo, I., Okonkwo, I., Poksireni, M. R., Manga, M., Wariri, O., Alhassan, H. A., Warnow, E. I. Tags: Open access, ADC Global child health Source Type: research
Is telemedicine suitable for remotely supporting non-tertiary units in providing emergency care to unwell newborns?
Although the majority of term infants will breathe spontaneously at birth, the requirement for advanced resuscitation can be unpredictable, as can the precipitous delivery of an extremely preterm infant in a non-tertiary neonatal unit. Infants born in hospitals without a tertiary neonatal intensive care unit have a higher mortality which is a disparity that has been difficult to resolve.
Telemedicine, the use of videoconferencing software to connect those at the scene of a resuscitation to a remote clinician, can allow for real-time two-way communication between a local unit and a tertiary neonatal specialist. It has been ...
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Edwards, G., O'Shea, J. E. Tags: Review Source Type: research
Does parental influence survive the 'Teenage to Young Adult transition?
Children’s clinicians regularly observe their patients as they embark on adulthood. It is not uncommon to encounter parents who care for their incapacitated adult child. For children aged 16–17 years who lack capacity to make medical decisions (and who will remain forever incapacitated) their forthcoming majority brings with it, for their parents, the uncertainty of who will make those decisions. So it is not unusual to confront parents’ perplexity when told that their authority as a decision maker for their child, embodied in their parental responsibility, evaporates on the eighteenth birthday. In most c...
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Wheeler, R. Tags: Clinical law for clinical practice Source Type: research
Hospital discharge using salbutamol as required after acute attacks of wheeze in children: a service evaluation
Conclusions
These data suggest that with information to support the use of salbutamol on an as required basis after hospital attendance, children can be safely managed by their parents/guardians with much lower doses of salbutamol than those recommended in commonly used fixed dose weaning regimes. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Connett, G., Harper, S., Raut, B., James, D. Tags: Open access Original research Source Type: research
Time to treat the climate and nature crisis as one indivisible global health emergency
Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in T...
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Zielinski, C., on behalf of the authorship group listed below Tags: Open access Editorial Source Type: research
How do we use the opportunity of prenatal diagnosis of congenital heart disease to optimise outcome?
Transposition of the great arteries (TGA) is a cyanotic congenital heart lesion in which the connection of the aorta and pulmonary artery leaving the heart is reversed such that the right ventricle connects to the aorta and left ventricle to the pulmonary artery. Survival after birth is dependent on adequate mixing through the atrial communication and arterial duct. There has been a significant increase in the prenatal diagnosis of TGA. In the UK, much of this increase can be attributed to the introduction, in 2015, of an additional transverse view of the upper mediastinum, the three vessel and tracheal view, into the nati...
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Jowett, V. Tags: Editorial Source Type: research
Atoms
Cherry Picking Checkov’s The Cherry Orchard lit up the literary world at the dawn of the 20th century, its portrayal of the inexorable decline of the aristocracy and the lost sense of purpose of the bourgeoisie still resonates and is widely performed today. Though the pathway arguably doesn’t lend itself to standard modelling, (directed acyclic graphs welcome), the trails all end with the identification and consumption of (the perceived) best fruit. Shoegazingly, blushingly, we’ve all, at some point been guilty of the metaphorical equivalent, the weeding out of awkward data in place of the comfortable, co...
Source: Archives of Disease in Childhood - December 14, 2023 Category: Pediatrics Authors: Brown, N. Tags: Highlights from this issue 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 24, 2023 Category: Pediatrics Tags: Archivist 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 24, 2023 Category: Pediatrics Tags: Archivist Source Type: research
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 good to think about t...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Phillips, B. Tags: ADC Archimedes Source Type: research
Highlights from the literature
Drowning and ECMO: using the CARE guidelines for case reports There are many reporting guidelines for writing up your research and the EQUATOR website, houses them all (https://www.equator-network.org/reporting-guidelines/). In there is the CARE guideline for case reports (https://www.care-statement.org/). Lucina was impressed by the way a set of researchers used this statement, to address the issue of re-cooling and extracorporeal membrane oxygenation (ECMO) after drowning, hypothermia and out of hospital cardiac arrest (OHCA). MC Andre et al (Pediatric Critical Care Medicine 2023;24(9):e417-e424. DOI: 10.1097/PCC.0000000...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
The future of paediatrics: is progress plus achievable?
In September 2023, the shape of paediatric training in the UK is changing, with the Royal College of Paediatric and Child Health’s long anticipated progress plus curriculum. While the fundamental objectives of the curriculum remain the same, the training pathway will be streamlined from three discrete training levels into ‘Core’ and ‘Specialty’ Paediatrics, shortening the overall training time from 8 to 7 years. The pathway aims to be more flexible, allowing training experience to be tailored towards the desired career rather than aiming for similar skill sets through rigid clinical rotations,...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Harris, B., Bonner, K. Tags: PostScript Source Type: research
