Archives of Disease in Childhood最新文献

{"title":"Genital bleeding in prepubertal girls: a systematic review.","authors":"Yasmin Moore, Bryony Hopkinshaw, Briony Arrowsmith, Catherine White, Lily Gabriel","doi":"10.1136/archdischild-2024-327652","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327652","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review aims to collate evidence of the causes of genital bleeding, other than child sexual abuse and accidental injuries, presenting in prepubertal girls. It provides an update to the 2015 Royal College of Paediatrics and Child Health publication 'The Physical Signs of Child Sexual Abuse', an evidence-based review also known as the Purple Book.</p><p><strong>Methods: </strong>MEDLINE, EMBASE and Scopus databases were searched for studies published between March 2014 and June 2023. Eligible studies were primary studies reporting on genital bleeding with extractable data for prepubertal girls.</p><p><strong>Results: </strong>99 studies, describing a total of 672 prepubertal girls, met the inclusion criteria. The most common medical conditions with genital bleeding as a presenting feature were lichen sclerosus, infections and infestations, hormonal causes, urethral prolapse, vaginal foreign bodies and tumours. Meta-analysis was not possible due to the large heterogeneity of the studies.</p><p><strong>Conclusion: </strong>This review added further evidence to the 2015 edition of the Purple Book, describing the multiple medical conditions that may present with genital bleeding. Several of these conditions can mimic the presentation of child sexual abuse or may coexist with child sexual abuse.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852279","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":"No child is an enemy.","authors":"Trevor Duke","doi":"10.1136/archdischild-2024-328217","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328217","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845679","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":"Epidemiology of childhood invasive pneumococcal disease in Australia: a prospective cohort study.","authors":"Linny Kimly Phuong, Abigail Cheung, Tiarni Templeton, Tamrat Abebe, Zanfina Ademi, Jim Buttery, Julia Clark, Theresa Cole, Nigel Curtis, Hazel Dobinson, Nadha Shahul Hameed, Hayley Hernstadt, Samar Ojaimi, Ella Grace Sharp, Praisoody Sinnaparajar, Sophie Wen, Andrew Daley, Brendan McMullan, Amanda Gwee","doi":"10.1136/archdischild-2024-327497","DOIUrl":"10.1136/archdischild-2024-327497","url":null,"abstract":"<p><strong>Background: </strong>The widespread use of pneumococcal conjugate vaccines (PCV) has changed the epidemiology of invasive pneumococcal disease (IPD) in children globally.</p><p><strong>Methods: </strong>Multicentre prospective audit of IPD episodes from five paediatric hospitals in Australia over 5.5 years between 2016 and June 2021. Children (<18 years) with <i>Streptococcus pneumoniae</i> isolated from a sterile site were included.</p><p><strong>Results: </strong>There were 377 IPD episodes in 375 children: 338 (90%) had received ≥3 PCV doses; 42 (11%) had IPD risk factors. The most common presentations were complicated pneumonia (254, 67%), bacteraemia (65, 17%) and meningitis (29, 8%). Five (1%) children died.Serotype information was available for 230 (61%) episodes; 140 (61%) were 13vPCV vaccine serotypes (VTs). The majority (85%) of episodes of complicated pneumonia were due to a VT; predominantly 3, 19A, 19F. Children with risk factors were more likely to present with bacteraemia ± sepsis (42% vs 12%) and to have a non-vaccine serotype (NVT) (74% vs 32%). Resistance to ceftriaxone (meningitis cut-off) occurred in 17% of 23B isolates (n=12) and accounted for 22% (5/23) of meningitis cases.</p><p><strong>Conclusions: </strong>Complicated pneumonia is the most common IPD presentation. NVTs account for the majority of bacteraemia and meningitis episodes. High rates of ceftriaxone resistance for NVT 23B support the addition of vancomycin for empiric treatment of suspected meningitis.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"52-58"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339916","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":"Time to take it 'out' side: delabelling allergy to penicillin and other beta-lactams in children and young people.","authors":"Paul Turner","doi":"10.1136/archdischild-2024-327206","DOIUrl":"10.1136/archdischild-2024-327206","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"4-5"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666947","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":"Covert medication in children: an extrapolation from adult practice.","authors":"Robert Wheeler","doi":"10.1136/archdischild-2024-327417","DOIUrl":"10.1136/archdischild-2024-327417","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"6-7"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496949","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":"Research on child and adolescent health in low- and middle-income countries in 2023-2024.","authors":"Trevor Duke","doi":"10.1136/archdischild-2024-327876","DOIUrl":"10.1136/archdischild-2024-327876","url":null,"abstract":"<p><p>Between July 2023 and June 2024, there were 540 publications from randomised controlled trials (RCTs) in child and adolescent health in low- and middle-income countries (LMICs), identified using a standardised process that has been in use for 21 years. This year, trials addressed a wide range of diseases and conditions impacting the health, development and well-being of children, newborns, adolescents and mothers. The RCTs reflected old, new and neglected problems, the rapidly changing epidemiology and the evolving social and economic circumstances in many countries. They also highlighted local and global priorities in LMICs, as well as environmental factors contributing to poor child health and inequities. The trials tested new and refined treatments, diagnostics, vaccines, holistic management and prevention approaches, and explored many outcomes, including mortality, nutrition, psychosocial measures and development. The studies were conducted in hospitals and primary healthcare clinics, schools and communities. Some studies are of the highest quality, while others fall short. The implications are many, including the need for greater capacity for discriminating synthesis and translation of evidence at a national and local level in many LMICs. This involves resourcing and educational components, with implications for healthcare worker training in research translation, quality improvement and learning health systems. Paediatricians and child health nurses everywhere have a role to play.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"18-22"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279668","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":"Modifiable risk factors for developing otitis media with effusion in children under 12 years in high-income countries: a systematic review.","authors":"Aye Paing, Laura Elliff-O'Shea, John Day, Devavrata Joshi, Stephanie Arnold, Tamsin Holland Brown, Veronica Kennedy","doi":"10.1136/archdischild-2024-327454","DOIUrl":"10.1136/archdischild-2024-327454","url":null,"abstract":"<p><strong>Objective: </strong>To systematically assess the modifiable risk factors for developing otitis media with effusion (OME) in children under 12 years.</p><p><strong>Methods: </strong>We searched Embase, MEDLINE, INAHTA database, CENTRAL, CDSR and Epistemonikos for cohort studies with ≥40 children per arm/prognostic factor, published in English from 2000 to November 2022. We assessed risk of bias using the Quality in Prognosis Studies checklist, and overall evidence quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Outcomes were analysed as risk ratio (RR), OR or Peto OR.</p><p><strong>Results: </strong>Seven studies totalling 2 760 292 children were included. The evidence was very low quality. Fluid or pus discharge from ears (OR 2.1, 95% CI 1.01 to 4.35) and exposure to other children (RR 2.79, 95% CI 1.98 to 3.93) (OR 5.21, 95% CI 2.9 to 9.36) were strongly associated with development of OME. Coughs/colds ≥5 times (OR 1.91, 95% CI 1.22 to 2.99), breathing problems ≥5 times (RR 1.78, 95% CI 1.26 to 2.53) and ear infections (RR 1.95, 95% CI 1.39 to 2.72) in past year were associated with development of OME. Adenoid hypertrophy was strongly associated with development of fluctuating OME (recurrent OME) (OR 9.96, 95% CI 5.17 to 19.19). There was scare evidence for some potential modifiable risk factors, including breast feeding, household smoking, gastro-oesophageal reflux, dummy use and swimming.</p><p><strong>Conclusions: </strong>Upper respiratory tract infection, ear infection, adenoid hypertrophy and exposure to other children could be the predictors for development of OME. Further observational studies are needed to investigate other potential modifiable risk factors.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"45-51"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279666","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":"Adaptive and innovative study design in rare diseases.","authors":"Athimalaipet V Ramanan, James M S Wason","doi":"10.1136/archdischild-2024-327143","DOIUrl":"10.1136/archdischild-2024-327143","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"1-3"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261112","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":"Are lumbar punctures required for infants with bacteraemic urinary tract infections?","authors":"Farhan Ishraq, Rami Subhi","doi":"10.1136/archdischild-2024-327315","DOIUrl":"10.1136/archdischild-2024-327315","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"79-83"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475769","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":"National recommendations for the management of children and young people with IgA vasculitis: a best available evidence, group agreement-based approach.","authors":"Louise Oni, Caroline Platt, Matko Marlais, Liza McCann, Farah Barakat, Markus Hesseling, Hannah Cottis, Sue Protheroe, Gabrielle Haigh, Kerstin Nott, Julien Marro, Elizabeth King, Jane Kelly, Jill Sussens, Shirley Mulvaney, Thomas Whitby, Iona Morgan, Amita Sharma, Reem Al-Jayyousi, Chee Kay Cheung, Christopher Ng, Anthony David Lander, William Simmons, Charlotte Melling, Rebecca Grandison, Leanne Treitl, Alan D Salama, Jan Dudley","doi":"10.1136/archdischild-2024-327364","DOIUrl":"10.1136/archdischild-2024-327364","url":null,"abstract":"<p><strong>Objective: </strong>IgA vasculitis (IgAV) is the most frequently experienced subtype of vasculitis seen in children. Most children fully recover, however, complications including chronic kidney disease are recognised. The aim of this project was to use a best available evidence, group agreement, based approach to develop national recommendations for the initial management of IgAV and its associated complications.</p><p><strong>Methods: </strong>A fully representative multiprofessional guideline development group (GDG), consisting of 28 members, was formed and met monthly. Graded recommendations were generated using nationally accredited methods, which included a predefined scope, open consultation, systematic literature review, evidence appraisal, review of national or international guidelines and a period of open consultation. Audit measures and research priorities were incorporated.</p><p><strong>Results: </strong>The IgAV GDG met over a 14-month period. A total of 82 papers were relevant for evidence synthesis. For the initial management, four topic areas were identified with five key questions generating six graded recommendations related to classification, specialist referral and musculoskeletal involvement. For the associated complications, five topic areas with 12 key questions generated 15 graded recommendations covering nephritis, gastrointestinal and testicular involvement, atypical disease and follow-up. Open consultation feedback was incorporated. The guidelines were endorsed by the UK Kidney Association and Royal College of Paediatrics and Child Health and are available online.</p><p><strong>Conclusion: </strong>Despite IgAV being a rare disease with limited evidence, a national standardised approach to the clinical management for children and young people has been achieved. This should unite approaches to care and act as a foundation for improvement.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"67-76"},"PeriodicalIF":4.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387488","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}