Archives of Disease in Childhood最新文献

{"title":"Spotting childhood abdominal tumours: a systematic review and meta-analysis of the clinical presentation.","authors":"Lorna Ni Cheallaigh, Jo-Fen Liu, Ashley Ball-Gamble, David Walker, Timothy A Ritzmann, Dhurgshaarna Shanmugavadivel","doi":"10.1136/archdischild-2025-329097","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329097","url":null,"abstract":"<p><strong>Background: </strong>We performed a systematic review and meta-analysis to identify pre-diagnostic symptoms/signs for childhood abdominal tumours to inform ongoing efforts to achieve earlier diagnoses of childhood cancers.</p><p><strong>Methods: </strong>Medline (OVID), Embase (OVID) and PubMed were searched for studies published between January 2005 and December 2023, including children (<18 years) diagnosed with abdominal tumours, with no language restrictions. Pooled proportions of symptoms/signs were calculated. Sub-analyses were performed according to tumour location and age.</p><p><strong>Results: </strong>133 eligible studies were identified, totalling 8611 cases. The most frequently reported symptoms/signs were abdominal mass (39.3% (31.5% to 47.5%)), pain (14.5 (10.9% to 18.5%), abdominal swelling/distension (7.2% (3.3% to 12.1%)), haematuria (7.2% (2.9% to 6.2%)), fever (3.9% (2.2% to 5.9%)) and/or hypertension (2.6% (1.4% to 4.2%)).For adrenal tumours, precocious puberty (20.6% (2.8% to 46.8%)), Cushing's syndrome (16.4% (5.9% to 30.1%)) and/or hypertension (12% (2.8% to 25.3%)) were reported.For liver tumours, abdominal mass (42.9% (0.0% to 100.0%)), abdomen mass and/or discomfort (16% (0.0% to 73.1%)), hepatomegaly (9.7% (0.0% to 60.7%)), abdominal swelling/distension (9.4% (0.0% to 64.0%)) and/or abdominal pain (7.7% (0.0% to 28.3%)) were reported.For renal tumours, abdominal mass (49.7% (39.0% to 60.5%)), abdominal pain (12.3% (8.5% to 16.6%)), haematuria (10% (7.4% to 13.0%)), abdominal swelling/distension (5.4% (1.5% to 11.2%)), hypertension (4.7% (2.5% to 7.5%)) and/or fever (3.5% (1.9% to 5.5%)) were reported.For neuroblastoma, abdominal mass (24% (7.0% to 46.4%), abdominal swelling/distension (9.2% (0.0% to 27.9%)), fever (7.4% (0.3% to 20.4%)), hepatomegaly (4.8% (0.0% to 19.8%)), anaemia/pallor (4.1% (0.0% to 13.3%)), abdominal pain (4% (0.0% to 13.4%)), screening/antenatal screening (3.4% (0.4% to 8.2%)) and/or opsoclonus-myoclonus-ataxia syndrome (2.7% (0.0% to 8.3%)) were reported.</p><p><strong>Conclusions: </strong>The clinical presentation of childhood abdominal tumours varies according to location and tumour type. These variations in presentation should be used to guide interventions to facilitate earlier diagnosis, such as the UK's new Child Cancer Smart campaign.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-therapeutic male circumcision: a clinical and legal perspective on minimum standards of practice in the UK.","authors":"Jan Dudley, Christopher Miller, Joshua Plaut, Mansur Ali, Robert Wheeler","doi":"10.1136/archdischild-2025-329019","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329019","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences at the receiving end.","authors":"Nick Brown","doi":"10.1136/archdischild-2025-329207","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329207","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of measles antibodies in children with cancer: results of a 2024 UK service evaluation.","authors":"Claire Cuerden, Rebecca Cordery, Kevin E Brown, Paul T Heath, Jessica Bate","doi":"10.1136/archdischild-2025-328968","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328968","url":null,"abstract":"<p><strong>Objective: </strong>To assess measles seroprevalence and testing practices in children with cancer in the UK.</p><p><strong>Design: </strong>Multicentre evaluation of measles serology data for children on active treatment for cancer between January and March (Q1) 2024.</p><p><strong>Setting: </strong>Eleven UK paediatric oncology centres (eight principal treatment centres and three shared care units).</p><p><strong>Patients: </strong>Children aged <18 years on active cancer treatment with measles serology data at diagnosis and/or following revised UK Health Security Agency guidance in Q1 2024.</p><p><strong>Results: </strong>A total of 695 eligible patients were included with a median age of 5.2 years (IQR 3.3-10.8 years). Baseline measles serology was tested in 545 patients with 89.0% positive for IgG antibodies. Cross-sectional testing of patients in Q1 2024 was undertaken in 289 patients with 78.5% measles seropositivity. Of the 121 patients tested at both time points who were measles seropositive at diagnosis, 23 (19.0%) were seronegative at retest. Most patients who lost pre-existing humoral immunity had an underlying diagnosis of leukaemia (n=16) followed by non-solid central nervous system (CNS) tumour (n=3), CNS tumour (n=2), lymphoma (n=1) and other (n=1). Although the odds of losing immunity were higher in haematological malignancy groups, this was not statistically significant (OR=1.44, 95% CI 0.52 to 3.99).</p><p><strong>Conclusions: </strong>Children with cancer can lose pre-existing humoral immunity to measles during treatment. Variability in testing practices and rising measles cases nationally requires a standardised approach. Retesting measles serostatus during national outbreaks is important to identify susceptible patients who may require postexposure intravenous immunoglobulin.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pharmacological de-escalation techniques used to manage acute severe behavioural disturbance in children and adolescents presenting to emergency departments: secondary analysis of a randomised controlled trial.","authors":"Kate Klein, Christopher Selman, Amit Kochar, Deborah Shellshear, Meredith Louise Borland, Shane George, Shefali Jani, Doris Tham, Katherine Lee, Simon Craig, Franz E Babl, Elyssia M Bourke","doi":"10.1136/archdischild-2025-328921","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328921","url":null,"abstract":"<p><strong>Objective: </strong>To describe the frequency and nature of non-pharmacological de-escalation methods used for children and adolescents presenting to emergency departments (EDs) with acute severe behavioural disturbance (ASBD).</p><p><strong>Design: </strong>Secondary analysis of a randomised, controlled, open-label, multicentre trial of oral olanzapine versus oral diazepam for the management of ASBD.</p><p><strong>Setting: </strong>Nine EDs in Australia between October 2021 and November 2023.</p><p><strong>Participants: </strong>Children aged 9-17 years, for whom information on non-pharmacological de-escalation attempts was recorded, who ultimately required oral sedative medication to manage their ASBD.</p><p><strong>Main outcome measures: </strong>The frequency and nature of the use of non-pharmacological de-escalation methods for children and adolescents presenting to EDs in a state of ASBD.</p><p><strong>Results: </strong>There were 348 participants enrolled in the randomised controlled trial. This study reports on the 337 of 348 participants (97%) for whom information was recorded regarding non-pharmacological de-escalation attempts during the trial period. Verbal de-escalation was the most commonly attempted technique (96%) followed by active listening (75%). The frequency and nature of de-escalation techniques used were similar across the nine participating sites.</p><p><strong>Conclusions: </strong>A variety of non-pharmacological de-escalation strategies are used among patients who require oral sedative medication. There is a need for studies to investigate whether there are optimal first-line de-escalation strategies and to determine their effectiveness and order of use in children and adolescents presenting to EDs with ASBD.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the role of out-of-home care in addressing prenatal drug exposure among children.","authors":"Marni Brownell, Kathleen S Kenny, Kayla Frank","doi":"10.1136/archdischild-2025-328950","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328950","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crusted scabies in an adolescent with atopic dermatitis.","authors":"Nikolay G Kochergin, Lyailya N Kayumova, Alsu A Valeeva","doi":"10.1136/archdischild-2025-329416","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329416","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Directed psychoeducational tool to prevent psychological sequelae following paediatric intensive care admission: a prospective randomised controlled study (the 4PICU study).","authors":"Katy Bridges, Bea Vickers, Rebecca Bethany Mitting, Mehrengise Cooper, Elena Garralda, Simon Nadel","doi":"10.1136/archdischild-2025-328691","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328691","url":null,"abstract":"<p><strong>Objective: </strong>To determine if an age-appropriate intervention is more effective than treatment as usual (TAU) in reducing post-traumatic stress disorder (PTSD) symptoms in parents/guardians of children discharged from paediatric intensive care unit (PICU).</p><p><strong>Design: </strong>A two-arm, parallel-group, single-centre randomised controlled trial.</p><p><strong>Setting: </strong>PICU, St Mary's Hospital, London, UK.</p><p><strong>Patients: </strong>Children admitted to the PICU between July 2021 and September 2022, with a length of stay >24 hours, and a corrected gestational age of >36 weeks at the time of PICU admission, up to <16 years of age. Parents/guardians were required to be >18 years old. We predefined subgroups of children as those <4 years and those ≥4 years.</p><p><strong>Intervention: </strong>An age-appropriate educational booklet given at PICU discharge and a targeted telephone call at 6 weeks posthospital discharge.</p><p><strong>Main outcomes and measures: </strong>Parental PTSD symptoms 6 months after PICU discharge, measured by the Impact of Events Scale-Revised (IES-R).</p><p><strong>Results: </strong>679 children were admitted to PICU, 212 were eligible for enrolment, 81 declined and 131 were included, of which 126 completed the study. 64 were randomised to TAU and 62 to intervention. 6-month questionnaires were returned by 60 families (36 from TAU group and 24 from intervention group (p=0.049)). There was no significant difference in IES-R scores between the TAU and intervention groups overall (IES-R score 37 vs 17 (p=0.132)). The ≥4-year intervention group had lower IES-R scores compared with TAU (13 in intervention vs 42 in TAU (p=0.008)). There was no difference in the <4-year group or in any secondary outcome.</p><p><strong>Conclusions: </strong>This intervention was effective in reducing PTSD symptoms in parents of children ≥4 years after PICU discharge.</p><p><strong>Trial registration number: </strong>NCT04635449.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis.","authors":"","doi":"10.1136/archdischild-2024-327909.corr1","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327909.corr1","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised trials in child and adolescent health in low- and middle-income countries in 2024-2025.","authors":"Trevor Duke","doi":"10.1136/archdischild-2025-329562","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329562","url":null,"abstract":"<p><p>Each year hundreds of randomised controlled trials are conducted in low- and middle-income countries addressing issues in clinical paediatrics and in child and adolescent health. The topics are as diverse as the problems facing children around the world in 2025. This year, 600 trial publications were included in an annual compilation. Many of these studies build on pre-existing evidence and may lead to change in practice or policy. The 600 publications come from all regions of the world.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}