Archives of Disease in Childhood最新文献

{"title":"Retrospective validation of the SPOT PEWScore using over 2 million inpatient observations.","authors":"Samiran Ray, Duncan Shepherd","doi":"10.1136/archdischild-2024-327393","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327393","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103771","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: High-flow oxygen therapy in moderate to severe bronchiolitis: a randomised controlled trial.","authors":"","doi":"10.1136/archdischild-2022-324697.corr1","DOIUrl":"https://doi.org/10.1136/archdischild-2022-324697.corr1","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091710","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":"Rollout of Martha's Rule: implications for care.","authors":"Jan Dudley, Stephen W Turner, Michael McKean, Jonathan Bamber, C Ronny Cheung","doi":"10.1136/archdischild-2024-327406","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327406","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046158","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":"Diagnosis journey for children with juvenile idiopathic arthritis: a qualitative study.","authors":"Aurelie Chausset, Caroline Freychet, Anne Lohse, Alexandre Belot, Etienne Merlin, Stephane Echaubard, Anne-Marie Schott, Jonathan Lachal","doi":"10.1136/archdischild-2024-327426","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327426","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to explore the journey to diagnosis and referral pathway from the onset of symptoms to the initial assessments at paediatric rheumatology (PR) centres, based on the experience of children with juvenile idiopathic arthritis (JIA) and their parents.</p><p><strong>Design: </strong>We conducted a qualitative study with semistructured interviews. Our qualitative and phenomenological procedure applied interpretative phenomenological analysis.</p><p><strong>Participants: </strong>19 families of children diagnosed with JIA 4-24 months before the study began (22 parents, 12 children>11 years), across 4 PR centres.</p><p><strong>Main outcome measures: </strong>The results highlight the contrasting feelings of children and their parents on the referral pathway and interactions with primary care physicians (PCPs).</p><p><strong>Results: </strong>Four superordinate themes emerged: (1) the journey undertaken by families from initially trivialising the first symptoms to a growing sense of urgency, (2) the perception gap between the families' growing disquiet and first medical interventions, (3) the lack of guidance from physicians prompting parents to initiate action and (4) the various elements of the care pathway that influenced the way the diagnosis was experienced and its impact.</p><p><strong>Conclusion: </strong>The psychosocial consequences of delayed diagnosis in JIA should not be underestimated, especially for adolescents. The views and experiences of children and their parents on the diagnostic journey should be implemented in training programmes and guidelines for PCPs. The development of online supports, integrating the latest medical knowledge with testimonials from families about their experiences, with a common language for physicians and the general population, can facilitate communication and empower families to navigate the healthcare system.</p><p><strong>Trial registration number: </strong>NCT05696340.Cite Now.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035058","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":"Natural history of spinal cord compression stage AFMS3 in infants with achondroplasia: retrospective cohort study.","authors":"Moira Shang-Mei Cheung, Alessandra Cocca, Charlotte H Harvey, Connor Stephen S Brett, Amaka C Offiah, Stephanie Borg, Nathan Jenko, Felice D'Arco, Dominic Thompson","doi":"10.1136/archdischild-2024-327035","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327035","url":null,"abstract":"<p><strong>Background and objective: </strong>Foramen magnum stenosis (FMS) is a common, serious complication of achondroplasia in infancy and associated with sudden infant death. The Achondroplasia Foramen Magnum Score (AFMS; 0-4) is used to classify the severity of stenosis to inform appropriate neurosurgical management. Infants with AFMS4 are referred for neurosurgery, while well children with AFMS3 undergo repeat MRI routinely after 12 months.As the natural history of children with AFMS3 is currently unclear, the objective was to review follow-up MRI scans of infants initially classified as AFMS3 to define more clearly the evolution of this degree of stenosis.</p><p><strong>Design: </strong>This retrospective cohort study, from two tertiary centres, included infants with a confirmed diagnosis of achondroplasia and AFMS3 on initial MRI who subsequently underwent repeat MRI or proceeded straight to neurosurgery.</p><p><strong>Results: </strong>Twenty-two cases satisfied the inclusion criteria. Mean age in months was 6.23 (SD±3.82) and 17.95 (SD±7.68) at baseline and follow-up scans, respectively. Follow-up MRI showed no change in 23% (N=5), improvement in 36% (N=8) to either AFMS1 (N=5) or AFMS2 (N=3). There was progression in 41% to AFMS4 (N=8). One case had neurosurgey without follow-up MRI (N=1).</p><p><strong>Conclusions: </strong>These results support MRI screening for FMS in infants with achondroplasia. Furthermore, infants with AFMS3 should undergo follow-up MRI as over 40% progress prompting neurosurgical intervention. There is currently no consensus on frequency or timing of screening for AFMS3 in achondroplasia; however, we suggest that guidance for follow-up imaging is modified to 6 months to detect progression earlier in this at-risk cohort.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035060","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":"Emerging art of doing less.","authors":"Ruud Gerard Nijman, Emily Cadman, Ian Maconochie","doi":"10.1136/archdischild-2023-326437","DOIUrl":"10.1136/archdischild-2023-326437","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138469763","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":"Use of intravenous immunoglobulin in toxic shock syndrome.","authors":"Simon Nadel","doi":"10.1136/archdischild-2024-326958","DOIUrl":"10.1136/archdischild-2024-326958","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141722947","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":"Birth defects in a rural province in Papua New Guinea.","authors":"Anna Toti, Beryl Vetuna, Veronica Kalit, Trevor Duke","doi":"10.1136/archdischild-2024-327200","DOIUrl":"10.1136/archdischild-2024-327200","url":null,"abstract":"<p><strong>Background: </strong>Globally, birth defects are the fourth most common cause of neonatal mortality. They cause substantial morbidity, and often long-term disability. Despite this, the impact of birth defects on public health has received little attention in low- and middle-income countries.</p><p><strong>Aims: </strong>To report the types, incidence and geographic distribution of birth defects in the East New Britain Province of Papua New Guinea.</p><p><strong>Methods: </strong>Data were collected over 3 years on newborns with birth defects seen at Rabaul Hospital, born anywhere in the province. Each affected newborn was examined, the anomaly diagnosed and classified. The exact home location was recorded to understand geospatial distribution. To calculate incidence, data were collected on all newborns with a congenital anomaly in a cohort of 2000 consecutive live births at Rabaul Hospital in 2019.</p><p><strong>Results: </strong>Over 3 years, 2018-2020, 137 newborns with birth defects were identified, born in any part of the province. Congenital heart defects, hydrocephalus, microcephaly, craniofacial anomalies, imperforate anus, trachea-oesophageal fistula and diaphragmatic hernia were the most common anomalies. Eight cases of Down syndrome and other chromosomal anomalies were identified. The incidence in 2019 was 14 per 1000 live births. Geographic mapping showed the highest number of cases in the region on the Gazelle Peninsula, the area around the active volcanos.</p><p><strong>Conclusions: </strong>This study provides insights into the incidence and types of birth defects in a rural island province and showed it was possible to map geospatial distribution to further explore epidemiology.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578846","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":"Neutrophil-to-lymphocyte ratio as a biomarker of acute pulmonary exacerbations in children with cystic fibrosis: a retrospective cohort study.","authors":"Nicole Wing Hei Tung, Claire Edmondson, Nicole Westrupp, Mark Rosenthal, Jane C Davies","doi":"10.1136/archdischild-2024-327056","DOIUrl":"10.1136/archdischild-2024-327056","url":null,"abstract":"<p><strong>Background: </strong>Neutrophils are key contributors to chronic airway inflammation in cystic fibrosis (CF) lung disease, although airway and blood-based neutrophil markers are seldom used. The neutrophil-to-lymphocyte ratio (NLR) is an accessible biomarker, the clinical utility of which has not been adequately studied.</p><p><strong>Objective: </strong>This study aimed to investigate the characteristics of the NLR in children with CF and its correlations with acute pulmonary exacerbations and spirometry.</p><p><strong>Design: </strong>A previous study had collected clinical data from children with CF for a 3-year period between 2016 and 2021. Retrospectively, NLR values were categorised according to patients' clinical status during blood sample collection as 'stable', 'acute pulmonary exacerbation' or 'elective admission for chronic clinical concern'.</p><p><strong>Main outcome measures: </strong>Demographic characteristics associated with the NLR; changes in NLR values in relation to clinical status; relationship between NLR and lung function.</p><p><strong>Results: </strong>141 children with CF were included. NLR values during clinical stability were higher in females and increased with age. For children admitted for intravenous antibiotics, NLR values significantly increased from clinical stability (median (IQR)=1.13 (0.75-1.51)) to acute pulmonary exacerbations (median (IQR)=1.50 (0.96-2.65), p=0.001), but similar changes were not observed in elective admissions. The NLR was not associated with lung function.</p><p><strong>Conclusions: </strong>The NLR demonstrated associations with clinical status in children with CF with significant elevations during acute pulmonary exacerbations. While its utility as a single-marker measure is limited, monitoring the NLR over time may help identify periods of increased inflammation.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320435","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":"Addressing common questions on food oral immunotherapy: a practical guide for paediatricians.","authors":"Aikaterini Anagnostou, Matthew Greenhawt, Pablo Rodriguez Del Río, Grant Pickett, Vibha Szafron, David Stukus, Elissa M Abrams","doi":"10.1136/archdischild-2023-326225","DOIUrl":"10.1136/archdischild-2023-326225","url":null,"abstract":"<p><p>Food allergy has been increasing in prevalence in most westernised countries and poses a significant burden to patients and families; dietary and social limitations as well as psychosocial and economic burden affect daily activities, resulting in decreased quality of life. Food oral immunotherapy (food-OIT) has emerged as an active form of treatment, with multiple benefits such as increasing the threshold of reactivity to the allergenic food, decreasing reaction severity on accidental exposures, expanding dietary choices, reducing anxiety and generally improving quality of life. Risks associated with food immunotherapy mostly consist of allergic reactions during therapy. While the therapy is generally considered both safe and effective, patients and families must be informed of the aforementioned risks, understand them, and be willing to accept and hedge these risks as being worthwhile and outweighed by the anticipated benefits through a process of shared decision-making. Food-OIT is a good example of a preference-sensitive care paradigm, given candidates for this therapy must consider multiple trade-offs for what is considered an optional therapy for food allergy compared with avoidance. Additionally, clinicians who discuss OIT should remain increasingly aware of the growing impact of social media on medical decision-making and be prepared to counter misconceptions by providing clear evidence-based information during in-person encounters, on their website, and through printed information that families can take home and review.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432207","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}