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The sixth revolution in pediatric vaccinology: immunoengineering and delivery systems.
Abstract Infection is the predominant cause of mortality in early life, and immunization is the most promising biomedical intervention to reduce this burden. However, very young infants fail to respond optimally to most vaccines currently in use, especially neonates. In 2005, Stanley Plotkin proposed that new delivery systems would spur a new revolution in pediatric vaccinology, just as attenuation, inactivation, cell culture of viruses, genetic engineering, and adjuvantation had done in preceding decades. Recent advances in the field of immunoengineering, which is evolving alongside vaccinology, have begun to inc...
Source: Pediatric Research - September 13, 2020 Category: Pediatrics Authors: Soni D, Bobbala S, Li S, Scott EA, Dowling DJ Tags: Pediatr Res Source Type: research

What Are Potential Complications of Tattooing?
Discussion “Tattooing of skin via deposition of pigment particles and ink ingredients in the dermis changes normal skin into abnormal skin. Fortunately, this often causes no harm and no disease, although with important exceptions.” Tattoos can be inadvertent from road dirt, gunpowder, pencil graphite etc., but most are desired. Tattoos are common in many cultures and over time..They have been increasing in popularity in the United States over the past few years particularly with a younger, wider and more diverse population. Newsweek reported an 18-country study in 2018 which showed 46% of Americans have a tat...
Source: PediatricEducation.org - May 18, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

A Diagnostic Dilemma: Sometimes You ’ ll Never Know
Discussion It can be difficult to consider what is the problem when a health care provider is presented with a group of seemingly disparate signs and symptoms with a history and time course that do not match classic (or commonly atypical) disease presentations. Common things happen commonly, so when symptoms occur without the usual co-occurring symptoms, unusual symptoms or time courses, it can be challenging. The provider must develop a reasonable differential diagnosis and balance how far to go with the evaluation against how much to monitor the patient for new signs or symptoms which can provide new information. Patient...
Source: PediatricEducation.org - March 19, 2018 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Immunotherapy for arterial ischaemic stroke in childhood: a systematic review
Conclusions Immunotherapies are used in children with AIS, mainly as steroids for children with arteriopathy. However, there is currently little robust evidence to either encourage or discourage this practice. There is weak evidence consistent with the hypothesis that in certain children at risk, steroids may both reduce the risk of occurrent/recurrent stroke and enhance neurological outcomes. As the potential benefit is still uncertain, this indicates that a trial of steroids in childhood AIS may be justified.
Source: Archives of Disease in Childhood - April 19, 2017 Category: Pediatrics Authors: Edwards, H. B., Mallick, A. A., O'Callaghan, F. J. K. Tags: Clinical trials (epidemiology), Epidemiologic studies, Immunology (including allergy), Stroke, Child health Original article Source Type: research

BCG vaccination at birth and early childhood hospitalisation: a randomised clinical multicentre trial
Conclusions BCG vaccination at birth did not reduce the risk of hospitalisation for somatic acquired disease until 15 months of age in this Danish study population. Trial registration number NCT01694108, results.
Source: Archives of Disease in Childhood - February 16, 2017 Category: Pediatrics Authors: Stensballe, L. G., Sorup, S., Aaby, P., Benn, C. S., Greisen, G., Jeppesen, D. L., Birk, N. M., Kjaergaard, J., Nissen, T. N., Pihl, G. T., Thostesen, L. M., Kofoed, P.-E., Pryds, O., Ravn, H. Tags: Open access, Immunology (including allergy), Drugs: infectious diseases, Vaccination / immunisation, Pregnancy, Reproductive medicine, Child health Original article Source Type: research

Dilemma of managing asymptomatic children referred with 'culture-confirmed drug-resistant tuberculosis
Conclusions Bacteriological evaluation should not be performed in the absence of any clinical indication. If drug-resistant Mycobacterium tuberculosis is detected in an asymptomatic child with a normal chest radiograph, close observation may be an appropriate strategy, especially in settings where potential laboratory error and poor record keeping are constant challenges.
Source: Archives of Disease in Childhood - June 16, 2016 Category: Pediatrics Authors: Loveday, M., Sunkari, B., Marais, B. J., Master, I., Brust, J. C. M. Tags: Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Child health, Radiology, Sexual health, Clinical diagnostic tests, Radiology (diagnostics) Original article Source Type: research

Management of severe acute malnutrition in low-income and middle-income countries
Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environmental enteropathy, poor complementary feeding practices, and chronic and acute infections, contribute to the development of SAM. Careful anthropometry is key to making an accurate diagnosis of SAM and can be performed by village health workers or even laypeople in rural areas. The majority of children can be treated at home...
Source: Archives of Disease in Childhood - February 18, 2015 Category: Pediatrics Authors: Trehan, I., Manary, M. J. Tags: Editor's choice, Immunology (including allergy), ADC Global child health, HIV/AIDS, Malnutrition, Child health, Sexual health Source Type: research

Severe manifestations of extrapulmonary tuberculosis in HIV-infected children initiating antiretroviral therapy before 2 years of age
Conclusions Severe TB manifestations were observed among young HIV-infected children on ART.
Source: Archives of Disease in Childhood - October 12, 2014 Category: Pediatrics Authors: Walters, E., Duvenhage, J., Draper, H. R., Hesseling, A. C., Van Wyk, S. S., Cotton, M. F., Rabie, H. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Meningitis, Drugs: cardiovascular system, Infection (neurology), Ophthalmology, Child health, Infant health, Sexual health Original article Source Type: research

Unusual chest radiographic findings in children
A 9-year-old British Asian girl with asthma was referred by her general practitioner to outpatients with a 12-month history of dry cough and an abnormal chest radiograph. There was no history of recent travel, tuberculosis (TB) exposure or clinical features to suggest TB such as weight loss and night sweating. She received courses of antibiotics without improvement. She was fully immunised including BCG vaccine. She had chickenpox (varicella) infection aged 3 years. On assessment, she was found to have worsening nocturnal cough, frequent use of inhaled salbutamol, and dyspnoea, wheeze and cough on exertion. Systemic e...
Source: Archives of Disease in Childhood - Education and Practice - September 12, 2014 Category: Pediatrics Authors: Elemraid, M. A., Wacogne, I., Williams, H. Tags: Immunology (including allergy), Drugs: infectious diseases, Child health, Radiology, Asthma, Drugs: respiratory system, Clinical diagnostic tests, Radiology (diagnostics) Epilogue Source Type: research

Randomised controlled trials in child health in developing countries: trends and lessons over 11 years
Using a uniform systematic approach annually, we reviewed 1553 publications from randomised controlled trials in child health in developing countries published between July 2002 and June 2013. There were annual increases in such publications, from 38 in the 12 months to July 2003 to over 200 in each of 2012 and 2013. These trials involved children in 76 developing countries. Studies of nutrition (366 publications, 23.6%) and malaria (336 publications, 21%) predominated. 79% of nutrition trials have been of micronutrients (288 publications), with comparatively few publications related to macronutrient interventions or ...
Source: Archives of Disease in Childhood - June 12, 2014 Category: Pediatrics Authors: Duke, T., Fuller, D. Tags: Clinical trials (epidemiology), Immunology (including allergy), ADC Global child health, TB and other respiratory infections, Travel medicine, Tropical medicine (infectious diseases), Childhood nutrition, Obesity (nutrition), Reproductive medicine, Child Source Type: research

Fifteen-minute consultation: Bacillus Calmette-Guerin abscess and lymphadenitis
Bacillus Calmette–Guérin (BCG) vaccine contains a live attenuated strain of Mycobacterium bovis, which provides 64% efficacy against tuberculous meningitis and 78% efficacy against disseminated tuberculosis.1 A number of local adverse reactions are recognised (abscess, suppurative lymphadentitis, keloid formation). An increased number of local complications were reported in the UK and Ireland since the introduction of a new BCG strain in 2002.2 3 It is important to distinguish between a normal vaccine response, a local complication and the very rare cases of systemic BCG infection that occur with immunodeficie...
Source: Archives of Disease in Childhood - Education and Practice - May 14, 2014 Category: Pediatrics Authors: Riordan, A., Cole, T., Broomfield, C. Tags: Epidemiologic studies, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Meningitis, Vaccination / immunisation, Infection (neurology), Pregnancy, Reproductive medicine, Child health, Infant health, Rheumatology, Sexual health, Dermato Source Type: research

Lymphadenopathy in children: refer or reassure?
INTRODUCTION Fareed, a 15-year-old British boy of Pakistani origin, was brought to his general practitioner (GP). His parents had become concerned about a ‘lump’ which had recently appeared on his neck and had now been present for approximately 2 weeks. Fareed had been unwell in the last fortnight with a history of a mild fever, coryzal symptoms and a sore throat. These symptoms had resolved although he was still feeling quite tired. There was no history of night sweats, weight loss or pruritus and he had not noticed any unusual lumps in other places. There was no significant past medical history. Fareed w...
Source: Archives of Disease in Childhood - Education and Practice - May 14, 2014 Category: Pediatrics Authors: King, D., Ramachandra, J., Yeomanson, D. Tags: Oncology, Immunology (including allergy), TB and other respiratory infections, Vaccination / immunisation, Pain (neurology), Child health, Rheumatology, Sexual health, Dermatology, Ear, nose and throat/otolaryngology Review Source Type: research

On the edge of the film...
Question 1 Select one option from the following: Morgagni hernia Intramural gas Spigelian hernia Diaphragmatic eventration Chilaiditi's sign Free intraperitoneal gas Abdominal situs inversus Bochdalek hernia Question 2 Select one option from the following: Atpyical mycobacterial infection Mycoplasma pneumonia Metastatic malignancy Tuberculosis Lymphadenitis Previous BCG vaccination Neuroblastoma Cat scratch disease Introduction Review areas: in radiology these are areas on a radiograph where pathology can be easily overlooked. The term is usually applied to the chest radiograph (CXR) where review areas include behind the h...
Source: Archives of Disease in Childhood - Education and Practice - January 13, 2014 Category: Pediatrics Authors: Williams, H. Tags: Oncology, Oesophagus, Editor's choice, Immunology (including allergy), Drugs: infectious diseases, Pneumonia (infectious disease), TB and other respiratory infections, Vaccination / immunisation, Child health, Radiology, Clinical diagnostic tests, Radiolo Source Type: research

Factors associated with asthma among under-fives in Mulago hospital, Kampala Uganda: a cross sectional study
Conclusion: Maternal asthma, a history of allergy in the patient, use of gas for cooking, prematurity and high level of education of caretaker were significantly associated with asthma. There is need for studies to explore the role of the above factors in development and exacerbation of childhood asthma to provide information that can be used to design strategies for asthma prevention and control.
Source: BMC Pediatrics - Latest articles - September 11, 2013 Category: Pediatrics Authors: Rebecca NantandaMarianne OstergaardGrace NdeeziJames Tumwine Source Type: research

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