Archives of Disease in Childhood最新文献

{"title":"Parents' capacity to make decisions for their children.","authors":"Robert Wheeler","doi":"10.1136/archdischild-2025-328961","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328961","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336271","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":"Risk factors for recurrent attacks of wheeze in preschool children: a population-based cohort study in England.","authors":"David Lo, Claire Lawson, Jonathan Broomfield, Clare Gillies, Sharmin Shabnam, Erol A Gaillard, Hilary Pinnock, Jennifer Quint","doi":"10.1136/archdischild-2024-328375","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328375","url":null,"abstract":"<p><strong>Objective: </strong>To determine factors associated with recurrent attacks of acute wheeze in preschool children.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>English primary electronic health data from the Clinical Practice Research Datalink linked with hospital data from Hospital Episode Statistics.</p><p><strong>Participants: </strong>42 820 children aged 5 years or under with at least one acute wheeze presentation between 1 January 2013 and 31 December 2014.</p><p><strong>Exposures: </strong>Demographic and clinical variables including age, sex, ethnicity, deprivation quintile, clinical comorbidities and previous asthma medication prescriptions and acute attacks were included in multivariable analyses.</p><p><strong>Main outcome measures: </strong>Further healthcare presentation with an acute wheeze/asthma attack within 12 months.</p><p><strong>Results: </strong>Almost 40% (16 962/42 820) of children had a further attack within 12 months. The strongest predictors were hospitalisation with the index episode (RR 1.42; 95% CI 1.39 to 1.45) and an attack in the previous year (1.27; 1.22 to 1.32). Male sex (RR 1.06; 95% CI 1.03 to 1.08), South Asian ethnicity (1.08; 1.04 to 1.12), atopy (1.21; 1.18 to 1.24), prematurity (1.09; 1.04 to 1.14), increasing reliever prescriptions (1.04; 1.03 to 1.04), number of previous attacks (1.03; 1.02 to 1.04) and previous hospitalisation with wheeze (1.09; 1.05 to 1.14) were also associated with further attacks.Older age at presentation (RR 0.92; 0.91 to 0.93) and number of prescriptions for inhaled corticosteroids (0.96; 0.95 to 0.97) in the previous year were associated with lower risk for further attacks.</p><p><strong>Conclusions: </strong>Our findings can be used to aid clinical risk prediction for further attacks of wheeze in preschool children.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336276","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":"New programme to prevent bronchiolitis in infants.","authors":"Andrew J Pollard, Mary Elizabeth Ramsay, Conall Watson","doi":"10.1136/archdischild-2024-327844","DOIUrl":"10.1136/archdischild-2024-327844","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"573-574"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387489","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":"Pulmonary aspiration after activated charcoal in unintentional acute poisonings in childhood.","authors":"Johanna Ramirez-Romero, Claudia Cifuentes Zamalloa, Amaia Elorza Elena, Beatriz Azkunaga, Santiago Mintegi","doi":"10.1136/archdischild-2024-327478","DOIUrl":"10.1136/archdischild-2024-327478","url":null,"abstract":"<p><strong>Introduction: </strong>Although the administration of activated charcoal (AC) is considered safe, the associated risk of pulmonary aspiration explains certain reluctance of physicians to use this procedure. The objective of this study was to analyse the rate of pulmonary aspiration in children receiving AC after accidental ingestion of a toxic substance.</p><p><strong>Methods: </strong>We carried out a substudy of a multicentre prospective registry-based cohort study including children presenting with acute poisoning to 58 paediatric emergency department (EDs) members of the Spanish Society of Pediatric Emergency Medicine between 2008 and 2022 on certain previously designated days.</p><p><strong>Results: </strong>During the study period, we registered 1983 episodes corresponding to accidental ingestion of a toxic substance in patients less than 7 years old. Of them, 517 (26.1%) received AC, 167 (32.3%) via a nasogastric tube. In most cases, the substance swallowed was a medication (paracetamol, psychotropics, and cough and cold medications accounting for 91.6% of episodes) and 419 children (81%) were asymptomatic on arrival to the ED. Gastric lavage was performed in 81 cases (15.7%). After receiving AC, 448 children (86.6%) were managed as outpatients (329 after a less than 24-hour stay in the ED observation unit).All patients did well, and no cases of pulmonary aspiration were reported, regardless of the route of AC administration.</p><p><strong>Conclusions: </strong>The administration of AC to children after accidental ingestion of a toxic substance seems to be safe, regardless of the route of administration. Efforts are required to improve the ED management of these children.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"510-513"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969449","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":"Characteristics and outcomes associated with fidelity in the Family-Nurse Partnership in England: a data linkage cohort study.","authors":"Amanda Clery, Francesca Cavallaro, Eilis Kennedy, Ruth Gilbert, Katie L Harron","doi":"10.1136/archdischild-2024-327654","DOIUrl":"10.1136/archdischild-2024-327654","url":null,"abstract":"<p><strong>Objectives: </strong>To determine (1) which maternal and area characteristics are associated with reaching fidelity targets (the expected number of visits mothers should receive at each stage of the programme) in the Family-Nurse Partnership (FNP), and (2) whether achieving these fidelity targets affects outcomes.</p><p><strong>Design, setting and population: </strong>Cohort study of mothers enrolled in the FNP, aged 13-19 years, giving birth between April 2010 and January 2018 in England. Mothers were linked to their Hospital Episode Statistics and National Pupil Database records.</p><p><strong>Outcomes: </strong>We described whether mothers reached fidelity targets for each programme stage (pregnancy, infancy and toddlerhood) and explored the characteristics associated with reaching targets. We used generalised linear models to compare child and maternal outcomes between mothers who did and did not reach fidelity targets.</p><p><strong>Results: </strong>Of the 28 155 mothers enrolled, 58% completed the programme. Fidelity targets were met by 59% of mothers in pregnancy, 65% in infancy and 61% in toddlerhood. The median number of visits was 38 (median 43 hours contact time). Younger mothers, those with a history of unplanned hospital admissions for adversity and those with social care involvement received a greater number of visits. Meeting fidelity targets was associated with a reduction in subsequent births within 18 months and an increase in the number of children with unplanned hospital admissions for maltreatment or injury up to age 2.</p><p><strong>Conclusions: </strong>Achieving fidelity to the FNP is challenging, but family nurses are able to engage the most vulnerable mothers in the programme. More research is needed to understand whether fidelity to programme targets is a useful measure of mothers' experiences of intensive home visiting.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"545-550"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063204","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":"Elastosis perforans serpiginosa in a child with Down syndrome.","authors":"Javier Arellano, Catalina Melehuechun, Yamile Corredoira","doi":"10.1136/archdischild-2025-329047","DOIUrl":"10.1136/archdischild-2025-329047","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"577-578"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293247","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":"Highlights from the literature.","authors":"","doi":"10.1136/archdischild-2025-329158","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329158","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 7","pages":"582"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332373","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":"Long COVID: equity in research.","authors":"","doi":"10.1136/archdischild-2025-329167","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329167","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 7","pages":"527"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332374","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":"Treatment options for preventing autoimmune-mediated congenital heart block: a systematic review.","authors":"Abhishek Agarwal, Nikolaos Skoutelis, Yufeng Zhou, Reina Kawanami, Amandine Charras, Felice Occhigrossi, Umber Agarwal, Sophia Khan, Sarah Donegan, Daniel Hawcutt","doi":"10.1136/archdischild-2024-327570","DOIUrl":"10.1136/archdischild-2024-327570","url":null,"abstract":"<p><strong>Objective: </strong>Complete congenital heart block (CHB) due to anti-Ro/La antibodies in pregnancy can lead to adverse fetal outcomes and neonatal death. National and international guidelines do not recommend specific treatment for women identified with anti-Ro antibodies while pregnant.</p><p><strong>Design: </strong>Systematic review of studies of pregnant women with anti-Ro/La antibodies undertaking treatment(s) to prevent CHB. Studies solely focused on treating developing or established CHB were excluded.</p><p><strong>Main outcome measure: </strong>CHB incidence.</p><p><strong>Results: </strong>Of 1049 articles, 20 studies were eligible, of which 13 were retrospective. Sixteen studies contained usable data comparing various treatments (seven hydroxychloroquine (HCQ), six corticosteroids, two intravenous immunoglobulin (IVIG) and one each on combined HCQ and corticosteroids and plasmapheresis), including 2134 women and 2915 pregnancies. Meta-analysis was not possible due to heterogeneity. HCQ as primary prophylaxis showed protective effect on CHB incidence in four of five studies, whereas for preventing recurrence, only one study had a comparator arm, which showed a protective effect. Corticosteroids showed protective effect on CHB incidence as primary prophylaxis in two of three studies, whereas in recurrence, only one study showed protective effect. The IVIG study with a comparator showed no protective effect on CHB recurrence. Two studies (IVIG and plasmapheresis) had no comparator. The long-term toxicity of treatments was poorly investigated.</p><p><strong>Conclusion: </strong>HCQ showed the most evidence among various treatment options to prevent CHB in babies of women with anti-Ro/La antibodies. However, included studies had high risk of bias and imprecision. Future studies should be prospective, compare existing treatments and capture adverse effects.PROSPERO registration number CRD42023492934.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"556-565"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073579","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":"Chimeric antigen receptor T cell therapy in childhood leukaemia.","authors":"Stacie Shiqi Wang, Rebecca C Abbott, Maddie Gilsenan, Trevor Duke, Seong Lin Khaw","doi":"10.1136/archdischild-2024-328263","DOIUrl":"10.1136/archdischild-2024-328263","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T cell therapy is a promising form of adoptive cell therapy. This process re-engineers patient-derived T cells to express a hybrid receptor targeting a selected tumour-expressed antigen. CAR T cell therapy directed against the CD19 antigen has been highly successful in haematological malignancies that have failed other therapies, particularly relapsed B-cell acute lymphoblastic leukaemia (B-ALL). This review focuses on the numerous real-world aspects of treating children with B-ALL with CD19-targeted CAR T cell therapy. We discuss some of the considerations for clinicians including manufacturing time, administration and care of the patient receiving this novel therapy, toxicities and outcomes. We also discuss the therapeutic uncertainty many physicians now face of when to use CAR T cell therapy in the patient journey, especially when haematopoietic stem cell transplant is being considered.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"503-509"},"PeriodicalIF":4.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363346","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}