Archives of Disease in Childhood最新文献

{"title":"Second opinions in the paediatric intensive care unit: a challenging opportunity.","authors":"Eva van Zanten, Marc van Heerde, Berber Kapitein","doi":"10.1136/archdischild-2024-327620","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327620","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727662","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":"Poisoning in adolescents in the UK: a review of enquiries to the National Poisons Information Service.","authors":"Annie Watt, Thomas Caparrotta, Sally Bradberry, Laurence Gray, Ruben Thanacoody, Gill Jackson, Euan A Sandilands","doi":"10.1136/archdischild-2024-327405","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327405","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to analyse enquiries received by the UK National Poisons Information Service (NPIS) regarding poisoning in adolescent patients.</p><p><strong>Design: </strong>A retrospective analysis of telephone enquiries regarding patients aged 10-18 years inclusive to the UK NPIS between 1 January 2015 and 31 December 2022. Data analysed included patient demographics, nature of the poisoning, agent(s) involved and poisoning severity.</p><p><strong>Results: </strong>A total of 29 750 enquiries were received, of which 66% were regarding female patients. The largest proportion overall involved intentional self-poisoning. These enquiries have significantly increased since 2019, particularly in patients aged 10-12 (2019: 71 (2.2%) vs 2022: 181 (4.3%); p<0.0001) and 13-15 (796 (24.3%) (2019) vs 1429 (33.9%) (2022); p<0.0001). Pharmaceutical agents were most often implicated, with paracetamol and non-steroidal anti-inflammatory drugs being most common. Enquiries involving these agents have significantly increased since 2019. Recreational drugs were only involved in 4.3% of enquiries. Most cases (87.6%) were of low toxicity, but 44 deaths were recorded during the study.</p><p><strong>Conclusions: </strong>Self-poisoning in adolescent patients is an important issue in the UK. NPIS enquiries regarding intentional self-poisoning have risen significantly since 2019 and the COVID-19 pandemic and increasingly involve younger patients aged 10-12 and 13-15 years. Easily accessible medicines are most often involved. With improved recognition and understanding of this problem, initiatives can be targeted to those most at risk.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690651","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":"Retrospective cohort observational study to assess the impact of as-required versus regular weaning inhaled salbutamol postattack wheeze plan in paediatric acute wheeze.","authors":"Dylan Whitaker, Kah Wee Teo, Karena Fraser","doi":"10.1136/archdischild-2024-328152","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328152","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690655","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":"Safe havens in health: standards of care for children and young people seeking asylum and refugees.","authors":"Yasmin Moore, Amy Stevens, Allison Ward, Andrew Graeme Rowland, Sarah Eisen","doi":"10.1136/archdischild-2024-328127","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328127","url":null,"abstract":"<p><p>This review outlines current literature regarding access to and quality of healthcare for children and young people seeking asylum and refugees in the UK. The multiple factors influencing their experiences are explored, alongside the optimal design of services to best address their needs. A consensus view of best practice is described in the form of service delivery standards for care delivered by paediatricians in emergency departments, inpatient, outpatient and other community settings.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673209","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":"Navigating the emergence of point-of-care diagnostics in paediatric emergency medicine.","authors":"Ruud Gerard Nijman, Eddy Lang, Nir Samuel, Ian K Maconochie","doi":"10.1136/archdischild-2024-327740","DOIUrl":"10.1136/archdischild-2024-327740","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"318-319"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103770","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":"Gender medicine and the Cass Review: why medicine and the law make poor bedfellows.","authors":"C Ronny Cheung, Evgenia Abbruzzese, Elaine Lockhart, Ian K Maconochie, Camilla C Kingdon","doi":"10.1136/archdischild-2024-327994","DOIUrl":"10.1136/archdischild-2024-327994","url":null,"abstract":"<p><p>In April 2024, the final report of the Cass Review, an independent review chaired by Dr Hilary Cass, was published, offering recommendations to improve gender identity services for children and young people in the UK. The core purpose of the Review was to improve care for children and adolescents. Commissioned by National Health Service England, the Review identified a weak evidence base for medical endocrine interventions and recommended that these treatments be provided within a structured research framework. The Review received widespread support from the clinical community. However, in July, the British Medical Association Council, without consulting its own members, unexpectedly passed a motion calling for a public critique of the Review, citing concerns over methodological weaknesses - a position it then softened following public criticism from members, concluding that their review would come instead from a position of neutrality.The original motion was based on two non-peer-reviewed online papers, prominently the work of McNamara <i>et al</i>-a paper which was written for a primarily litigious, rather than academic, purpose. We critically examine these sources and analyse the wider legal context in which they have been applied. We conclude that these sources misrepresent the Cass Review's role and process (specifically, by mistakenly comparing the Review to clinical practice guideline development), while many of the methodological criticisms directed at the Cass Review, including its use of evidence appraisal and systematic reviews conducted by University of York (UK), are unfounded.These misunderstandings, based on flawed and non-peer-reviewed analyses intended for legal (rather than clinical) purposes, jeopardise the implementation of crucial reforms in the care of gender dysphoric youth. The UK clinical community should move beyond these critiques and focus on the Cass Review's recommendations to establish a safer, more holistic and evidence-based service model for children and young people experiencing gender identity issues.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"251-255"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456699","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":"Short-term weight variability in infants and toddlers: an observational study.","authors":"Charlotte Margaret Wright, Ford Hope-McGill, Harshine Sivakanthan, Tim J Cole","doi":"10.1136/archdischild-2024-327659","DOIUrl":"10.1136/archdischild-2024-327659","url":null,"abstract":"<p><strong>Aims: </strong>To explore short-term weight variability in young children; (1) how it relates to expected weight gain and (2) how it is affected by age, time of day and dietary intakes and outputs.</p><p><strong>Methods: </strong>Twenty healthy infants aged 2-10 months and 21 healthy toddlers aged 12-35 months were weighed at home by their parents six times over 3 days. The toddlers' parents also recorded whether they had eaten, drunk, urinated or passed stool in the previous 2 hours. The primary outcome was 'noise': the within-subject weight SD pooled separately for infants and toddlers, compared with their expected weight gain over 4 or 8 weeks. Analysis by successive pairs of weights was used to assess the extent of short-term weight gain and loss associated with time of day and eating, drinking and excretion.</p><p><strong>Results: </strong>In infants, noise (117 g) was much less than the expected weight gain over 4 weeks (280-1040 g) but in toddlers, noise (313 g) was higher than the expected gain over 4 weeks (180-230 g) and around three-quarters the expected gain over 8 weeks (359-476 g). In toddlers, weight tended to fall overnight and rise by day, and recent eating and passage of stool were associated with increased weight gain, even after adjustment for time of day.</p><p><strong>Conclusions: </strong>In toddlers, the recorded weight may be 300 g higher or lower than the underlying weight trajectory, so that their weight gain based on measurements collected fewer than 8 weeks apart will often be misleading.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"283-286"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613860","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":"My gender-questioning child.","authors":"","doi":"10.1136/archdischild-2024-327247","DOIUrl":"10.1136/archdischild-2024-327247","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"320-321"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725007","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":"Full-cycle audit of the RCEM Best Practice Guidelines for the ingestion of super strong magnets in children using data from a UK prospective observational study.","authors":"Sierra Schaffer, Jonathan J Neville, Nigel J Hall","doi":"10.1136/archdischild-2024-327729","DOIUrl":"10.1136/archdischild-2024-327729","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"326-327"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943333","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":"Paediatric trauma and hypocalcaemia: a systematic review.","authors":"Mary-Beth Toner, Michael Coffey, Ulugbek Nurmatov, Stephen Mullen","doi":"10.1136/archdischild-2023-326576","DOIUrl":"10.1136/archdischild-2023-326576","url":null,"abstract":"<p><strong>Background: </strong>Trauma is a leading cause of mortality and morbidity in children worldwide. While adult studies have demonstrated hypocalcaemia's association with adverse outcomes, its impact on paediatric trauma patients remains understudied. This systematic review aims to investigate current evidence into the prevalence, clinical implications and associations of hypocalcaemia in paediatric trauma.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted searching four databases, grey literature and additional sources for original studies looking at outcomes for paediatric trauma patients with ionised calcium measurements before blood product administration. Exclusion criteria comprised studies which included patients with blood product administration prior to calcium measurement, case reports, case series, reviews and papers not available in English. The review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023432473. Data extraction was performed on included papers and quality assessment performed using Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Of 779 initial studies, two studies met inclusion criteria for detailed analysis. Both retrospective cohort studies originated in Israel and collectively included 568 patients. Hypocalcaemia incidence ranged from 5.3% to 19.8%. Although trends towards increased mortality, blood transfusion requirements and prolonged hospital stays were observed in patients with hypocalcaemia, statistical significance was not consistently achieved.</p><p><strong>Conclusion: </strong>Hypocalcaemia in paediatric trauma appears reduced in incidence compared with adult populations. Limited available studies suggest potential associations with adverse outcomes, although most were not statistically significant. Studies had small patient numbers, necessitating further prospective research to facilitate a clearer understanding. Insights from such studies can guide patient management and improve outcomes in this vulnerable population.</p><p><strong>Prospero registration number: </strong>CRD42023432473.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"265-269"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817050","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}