Archives of Disease in Childhood最新文献

{"title":"Endothelial activation in sepsis: the SPOT study.","authors":"","doi":"10.1136/archdischild-2025-329644","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329644","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 10","pages":"831"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084876","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":"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":"768-772"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","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":"Research collaboration to benefit child health: PaeCH of an idea.","authors":"Elizabeth Whittaker, Sejal Saglani","doi":"10.1136/archdischild-2024-327307","DOIUrl":"10.1136/archdischild-2024-327307","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"763-765"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075540","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":"Initial effectiveness and safety data on intravenous ferric derisomaltose for iron deficiency anaemia management in paediatric gastroenterology patients: a multicentre retrospective cohort study.","authors":"Laura Gianolio, Shaun Emmitt, Maureen Nwabueze, Peter Gillett, Victoria Merrick, Rosalind Rabone, Kat Armstrong, Catherine Paxton, Ewan Swann, Prithvi Rao, Arun Urs, Zuzana Londt, Dominique Schluckebier, Natalia Nedelkopoulou, Akshay Kapoor, Shishu Sharma, Momina Khalid, Mike Thomson, Paul Henderson, David C Wilson, Priya Narula, Richard K Russell","doi":"10.1136/archdischild-2024-328215","DOIUrl":"10.1136/archdischild-2024-328215","url":null,"abstract":"<p><strong>Objective: </strong>Iron deficiency anaemia (IDA) is common in paediatric gastroenterology with intravenous iron increasingly utilised. While adult data are published for ferric derisomaltose (FDI), no paediatric data exist. Our aim was to assess the effectiveness and safety profile of FDI in paediatric gastroenterology.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Two UK referral centres (Edinburgh and Sheffield).</p><p><strong>Patients: </strong>All paediatric gastroenterology patients who received FDI from June 2020 to June 2023.</p><p><strong>Main outcome measures: </strong>Haematological and biochemical parameters were collected before and at 1, 3, 6 and 12 months after treatment, when available, together with the need for repeated FDI infusions and FDI adverse events.</p><p><strong>Results: </strong>Sixty-five patients were identified (54% male; median age 12.8 years, IQR 9.6-15.2), receiving 78 FDI infusions. After a single infusion, 38/59 (64%) patients (effectiveness analysis) completely corrected their anaemia and 6/59 (10%) improved from moderate-severe to mild anaemia. Median haemoglobin increased from 92 (IQR 85-108) to 126 (IQR 115-132) g/L at 1 month (p<0.001) and peaked at 12 months (134 g/L, IQR 125-142; p<0.001) post infusion. A second infusion was performed in 12/59 (20%) patients with 9/12 correcting their anaemia. No significant biochemical alterations, including hypophosphataemia, were detected. Overall, 4/65 (6%) patients (safety analysis) experienced adverse events, with three discontinuing FDI infusion.</p><p><strong>Conclusions: </strong>Our real-world data reveal FDI is rapidly and persistently effective in correcting IDA in paediatric gastroenterology. No significant biochemical alterations or new safety signals were identified.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"793-799"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974432","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":"Who decides: should the UK limit access to paediatric critical care?","authors":"Miriam R Fine-Goulden, Joe Brierley","doi":"10.1136/archdischild-2023-326539","DOIUrl":"10.1136/archdischild-2023-326539","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"847-848"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514484","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":"Oral systemic corticosteroids in children with acute asthma exacerbations: a systematic review and network meta-analysis.","authors":"Shunsuke Amagasa, Shu Utsumi, Kie Okajima, Satoko Uematsu","doi":"10.1136/archdischild-2024-327523","DOIUrl":"10.1136/archdischild-2024-327523","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy differentials among corticosteroid regimens by type, dosage and duration, we conducted a systematic review and network meta-analysis of randomised controlled trials (RCTs).</p><p><strong>Methods: </strong>We searched four databases from their inception to March 2024 and included RCTs that evaluated oral corticosteroids for asthma exacerbations in young people aged <21 years. We compared six regimens (dexamethasone (DEXA) 0.3 mg/kg/day administered for 1 day, DEXA 0.6 mg/kg/day for 1 day, DEXA 0.6 mg/kg/day for 2 days, prednisolone (PSL) 1.0 mg/kg/day for 3 days, PSL 1.0-1.5 mg/kg/day for 5 days and PSL 2.0 mg/kg/day for 5 days). Primary outcome was relapse within 14 days, defined as unplanned visit to an emergency department or primary care physician.</p><p><strong>Results: </strong>Eleven studies involving 2353 patients were analysed in our quantitative synthesis. There were no significant differences in the relapse rates among 15 comparisons of six regimens. As part of the results, the network estimate showed that DEXA (0.3 mg/kg/day×1 day) compared with PSL (1.0 mg/kg/day for 3 days) had a risk ratio (RR) of 0.99 (95% CI 0.56 to 1.74), and DEXA (0.6 mg/kg/day for 2 days) compared with PSL (1.0-1.5 mg/kg/day×5 days) had an RR of 1.29 (95% CI 0.84 to 1.98). The certainty of the evidence for the included comparisons was low to very low.</p><p><strong>Conclusion: </strong>In this network meta-analysis, there were no significant differences in the efficacy of commonly used corticosteroid regimens for acute exacerbations in childhood asthma. Short-term oral DEXA may be an acceptable alternative to a longer course of PSL.</p><p><strong>Prospero registration number: </strong>CRD 42023449189.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"824-831"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246131","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":"Evaluating the diagnostic accuracy of smartphone video clips against polysomnography for paediatric obstructive sleep apnoea.","authors":"Cal McLean, Zachary Jones, Joseph Eliahoo, Parviz Habibi","doi":"10.1136/archdischild-2024-327775","DOIUrl":"10.1136/archdischild-2024-327775","url":null,"abstract":"<p><strong>Background: </strong>The gold standard of paediatric obstructive sleep apnoea syndrome (OSAS) diagnosis is overnight polysomnography (PSG). Validated screening methods for paediatric OSAS are limited. Increasingly, concerned parents record videos that capture behaviours indicative of OSAS. We aimed to compare the diagnostic accuracy of a standardised sleep video analysis tool (Videosomnography Analysis for Paediatric Sleep Apnoea (VAPS)) against PSG for paediatric OSAS.</p><p><strong>Methods: </strong>Children aged 2-12 years consecutively referred for suspected OSAS underwent PSG. Parents recorded two 1 min videos of their child's sleep during PSG, and for two nights at home post-PSG. Videos were scored for the presence of nine behaviours indicative of OSAS. PSG was scored independently and compared with VAPS scores.</p><p><strong>Results: </strong>Total VAPS Score had good discriminatory ability between PSG-diagnosed clinically non-significant (n=63) and clinically significant (n=48) OSAS, with an area under the receiver operating characteristic (ROC) curve of 81.99%. Scores of ≥3 had a sensitivity of 92% (specificity=49%) and scores of ≥7 had a specificity of 89% (sensitivity=40%). The area under the ROC curve rose to 85.45% when parents confirmed they were able to capture their child's worst breathing. For this subset, VAPS Score of ≥3 had a sensitivity of 96% (specificity=44%) and scores≥7 had a specificity of 89% (sensitivity=50%).</p><p><strong>Discussion: </strong>VAPS Score may be useful in triaging patients suspected of paediatric OSAS to the appropriate physiological sleep investigations or treatment options, where a score of ≤2 is considered low risk, 3-6 medium risk and ≥7 high risk, for paediatric OSAS.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"832-836"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293248","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":"Role of complete blood count in the diagnosis of culture-proven neonatal sepsis: a systematic review and meta-analysis.","authors":"Emily Hyde, Mark Anthony, Stephen Kennedy, Manu Vatish","doi":"10.1136/archdischild-2025-328523","DOIUrl":"10.1136/archdischild-2025-328523","url":null,"abstract":"<p><strong>Objective: </strong>Neonatal sepsis is a significant cause of morbidity and mortality, particularly in preterm infants. Despite its routine use in adults, the diagnostic utility of complete blood count (CBC) in neonatal sepsis remains debated. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of CBC parameters for neonatal sepsis.</p><p><strong>Methods: </strong>This review was registered at PROSPERO (CRD42023476510). MEDLINE, Embase, CINAHL and the Cochrane Library were searched from database inception to 28 October 2024. Observational studies of neonates with sepsis, published in English, were included. Pooled diagnostic accuracy metrics were calculated for CBC parameters, including the white cell count (WCC), neutrophil count and immature-to-total neutrophil ratio (ITR). Bias was assessed using a modified QUADAS-2 tool.</p><p><strong>Results: </strong>Functional CBC parameters like ITR and mean neutrophil volume (MNV) showed moderate diagnostic accuracy. Pooled analysis revealed that an ITR >0.20 had 66.3% sensitivity and 85.4% specificity for neonatal sepsis. MNV also showed promising diagnostic utility, but substantial heterogeneity across studies (I²>0.80) limited its generalisability. Traditional parameters like the WCC and platelet count had lower diagnostic accuracy.</p><p><strong>Conclusions: </strong>The CBC is a rapid, cost-effective test requiring minimal blood volume, making it a practical adjunct in neonatal diagnostics. Functional parameters like ITR and MNV show the potential to complement existing approaches but are insufficient as stand-alone diagnostic tools. Further research is needed to validate their clinical utility and address heterogeneity in study designs.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"811-818"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141214","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":"Towards evidence-based medicine for paediatricians.","authors":"Bob Phillips","doi":"10.1136/archdischild-2025-329643","DOIUrl":"10.1136/archdischild-2025-329643","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"844"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068954","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":"Association between hospitalised childhood pneumonia and follow-up chest radiographs in high-risk populations: a secondary analysis of a multicentre randomised controlled trial.","authors":"Hing Cheong Kok, Stephanie T Yerkovich, Gabrielle B McCallum, Keith Grimwood, Ian Brent Masters, Nicholas Fancourt, Siew Moy Fong, Anna M Nathan, Catherine A Byrnes, Robert S Ware, Nachal Nachiappan, Noorazlina Saari, Peter S Morris, Tsin Wen Yeo, Victor M Oguoma, Jessie Anne de Bruyne, Kah Peng Eg, Bilawara Lee, Mong How Ooi, John W Upham, Paul J Torzillo, Anne B Chang","doi":"10.1136/archdischild-2024-328111","DOIUrl":"10.1136/archdischild-2024-328111","url":null,"abstract":"<p><strong>Objective: </strong>As children hospitalised with community-acquired pneumonia (CAP) are at risk of persistent chest radiograph (CXR) abnormalities and respiratory sequelae, we investigated factors associated with incomplete CXR resolution at 4 weeks and 12 months post-discharge in children from populations at high-risk of chronic lung disease.</p><p><strong>Design: </strong>Secondary analysis-multicentre, placebo-controlled, randomised controlled trial.</p><p><strong>Settings and patients: </strong>324 children aged 3 months to ≤5 years hospitalised with radiographic-confirmed CAP were enrolled from seven hospitals in Australia, New Zealand and Malaysia. After 1-3 days of intravenous antibiotics, then 3 days of oral amoxicillin-clavulanate, they were randomised to extended (13-14 days) or standard (5-6 days) courses of antibiotics.</p><p><strong>Intervention: </strong>CXRs were performed at admission, 4 weeks, and 12 months post-discharge and reviewed in a blinded manner.</p><p><strong>Main outcome measures: </strong>Radiographic changes of pneumonia at 4 weeks and 12 months post-discharge compared with admission CXRs.</p><p><strong>Results: </strong>Among children with interpretable CXRs, incomplete resolution was seen in 42/253 (17%) at 4 weeks, and 29/212 (14%) at 12 months. Characteristics at admission associated with incomplete CXR resolution at 4 weeks were previous pneumonia hospitalisation (adjusted odds ratio [OR_adj])=6.46, 95% confidence interval [CI] 2.21 to 18.85) and increasing age (OR_adj=0.60 per-year, 95% CI 0.38 to 0.94). Continuing respiratory symptoms/signs at 4 weeks post-discharge was also associated with incomplete resolution (OR=5.63, 95% CI 2.38 to 13.32). At 12 months, previous pneumonia hospitalisation was associated with persistent incomplete CXR resolution (OR=4.03, 95 % CI 1.25 to 13.02).</p><p><strong>Conclusion: </strong>In high-risk settings, younger age, those with previous pneumonia hospitalisation, or ongoing respiratory symptoms/signs 4 weeks post-discharge from hospitalised CAP may be associated with incomplete CXR resolution. Consequently, follow-up imaging and monitoring may be warranted in these children.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"786-792"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973729","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}