Archives of Disease in Childhood最新文献

{"title":"Complications of paediatric kidney transplantation: a paediatrician's review.","authors":"Abeer Alessa, Atessa Bahadori, Elizabeth Dale, Armando J Lorenzo, Ashene McKay, Chia Wei Teoh, Nithiakishna Selvathesan","doi":"10.1136/archdischild-2024-327710","DOIUrl":"10.1136/archdischild-2024-327710","url":null,"abstract":"<p><p>Kidney transplantation is the preferred treatment for children with end-stage kidney disease, offering notable improvements in long-term survival and overall quality of life. Nonetheless, paediatric transplant recipients are susceptible to a spectrum of complications that compromise allograft function and overall health. This review highlights key post-transplant complications to aid general paediatricians in recognising and managing these challenges in concert with nephrologists. Early post-transplant complications include surgical issues and electrolyte abnormalities. Infectious complications are most frequent during the first year post-transplant and include viruses such as cytomegalovirus, Epstein-Barr virus and BK virus, as well as urinary tract infections and <i>Pneumocystis jirovecii</i> pneumonia. These infections are largely related to the degree of immunosuppression and require close monitoring. Cardiovascular and metabolic conditions, including hypertension, hyperlipidaemia and post-transplant diabetes mellitus, are also prevalent and contribute to long-term morbidity. These issues often stem from pre-existing kidney disease and ongoing immunosuppressive therapy. Allograft rejection, whether antibody-mediated or T cell-mediated, continues to be a major threat to graft survival. Early detection through donor-specific antibody screening and timely biopsy is essential for prompt intervention. Additional challenges include increased cancer risk, particularly post-transplant lymphoproliferative disorder, and recurrence of primary kidney disease. By recognising these complications early, general paediatricians play a crucial role in multidisciplinary care, improving graft survival and patient outcomes.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"385-390"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538382","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":"Maternal postpartum mood and anxiety disorder symptoms and parent-reported infant health-related quality of life at 1 year: a cohort study.","authors":"Nicole Xin Hui Wong, Heidi L Allen, Jamie R Daw","doi":"10.1136/archdischild-2025-329394","DOIUrl":"10.1136/archdischild-2025-329394","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the association between maternal perinatal mood and anxiety disorder (PMAD) symptoms and infant health-related quality of life (HRQoL).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Maternal survey data representative of all live births in 2020 in three US states (Kansas, New Jersey and Virginia).</p><p><strong>Exposures: </strong>Early (4-6 months postpartum) and late (12-14 months postpartum) PMAD symptoms.</p><p><strong>Main outcome measures: </strong>Survey-weighted adjusted logistic regression models estimated the association between maternal PMAD symptoms and parent-reported infant HRQoL measures including overall health, physical limitations and multiple domains of growth and development at 12-14 months.</p><p><strong>Results: </strong>Maternal postpartum PMAD symptoms were associated with increased odds of parent-reported mediocre or bad infant health (9.4% v 4.3%, aOR 2.1 (1.1-3.9)) and at least one growth and development problem (19.2% vs 13.0%, aOR 1.7 (1.1-2.7)), but not with infant physical functioning. Differences in infant growth and development were larger for mothers with late postpartum PMAD symptoms compared with those with no or only early PMAD symptoms. Greater differences were also reported by parents experiencing anxiety symptoms compared with those with only depressive symptoms.</p><p><strong>Conclusions: </strong>Maternal PMAD symptoms were associated with perceived differences in infant health, growth and development, particularly in the late postpartum period. This association may arise from a causative relationship between PMAD and infant development: conversely, infant health concerns may drive PMAD symptoms. Both mechanisms support the need for screening, diagnosis and treatment for parental anxiety and depression beyond the early postpartum period.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"437-443"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145832849","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":"Pertussis, the pandemic and preventing future resurgences.","authors":"Shamez N Ladhani, Asma Khalil, Sharif A Ismail, Mary Elizabeth Ramsay, Gayatri Amirthalingam","doi":"10.1136/archdischild-2025-329263","DOIUrl":"10.1136/archdischild-2025-329263","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"381-382"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017129","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":"<i>Archives of Disease in Childhood</i>: Publishing papers to impact on practice 1926-2026.","authors":"R Mark Beattie","doi":"10.1136/archdischild-2025-329225","DOIUrl":"10.1136/archdischild-2025-329225","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"391-393"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145386146","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":"Non-pharmacological de-escalation techniques used to manage acute severe behavioural disturbance in children and adolescents presenting to emergency departments: secondary analysis of a randomised controlled trial.","authors":"Kate Klein, Christopher Selman, Amit Kochar, Deborah Shellshear, Meredith Louise Borland, Shane George, Shefali Jani, Doris Tham, Katherine Lee, Simon Craig, Franz E Babl, Elyssia M Bourke","doi":"10.1136/archdischild-2025-328921","DOIUrl":"10.1136/archdischild-2025-328921","url":null,"abstract":"<p><strong>Objective: </strong>To describe the frequency and nature of non-pharmacological de-escalation methods used for children and adolescents presenting to emergency departments (EDs) with acute severe behavioural disturbance (ASBD).</p><p><strong>Design: </strong>Secondary analysis of a randomised, controlled, open-label, multicentre trial of oral olanzapine versus oral diazepam for the management of ASBD.</p><p><strong>Setting: </strong>Nine EDs in Australia between October 2021 and November 2023.</p><p><strong>Participants: </strong>Children aged 9-17 years, for whom information on non-pharmacological de-escalation attempts was recorded, who ultimately required oral sedative medication to manage their ASBD.</p><p><strong>Main outcome measures: </strong>The frequency and nature of the use of non-pharmacological de-escalation methods for children and adolescents presenting to EDs in a state of ASBD.</p><p><strong>Results: </strong>There were 348 participants enrolled in the randomised controlled trial. This study reports on the 337 of 348 participants (97%) for whom information was recorded regarding non-pharmacological de-escalation attempts during the trial period. Verbal de-escalation was the most commonly attempted technique (96%) followed by active listening (75%). The frequency and nature of de-escalation techniques used were similar across the nine participating sites.</p><p><strong>Conclusions: </strong>A variety of non-pharmacological de-escalation strategies are used among patients who require oral sedative medication. There is a need for studies to investigate whether there are optimal first-line de-escalation strategies and to determine their effectiveness and order of use in children and adolescents presenting to EDs with ASBD.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"394-400"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181935","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":"Integrated social prescribing and Citizens Advice service in a secondary/tertiary children's healthcare setting.","authors":"Joanne C Blair, Cath Aitken, Debora Nolan, John Smith, Beth Aitken, Leah Villiers-James, Jackie Wotton, Jenny Dalzell","doi":"10.1136/archdischild-2025-329660","DOIUrl":"10.1136/archdischild-2025-329660","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"468-469"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146059014","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 journey as a patient advocate and how it has helped me beyond managing my health condition.","authors":"Shreya Uday","doi":"10.1136/archdischild-2025-329507","DOIUrl":"10.1136/archdischild-2025-329507","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"460-461"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285454","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-2026-330686","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330686","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"111 5","pages":"457"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715662","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 outbreak of pertussis in England (2023-2024) in the context of international resurgence.","authors":"Sharif A Ismail, Helen J Campbell, Joshua C D'Aeth, David Litt, Sonia Ribeiro, Emma J Heymer, Gayatri Amirthalingam","doi":"10.1136/archdischild-2025-329479","DOIUrl":"10.1136/archdischild-2025-329479","url":null,"abstract":"<p><strong>Objective: </strong>To describe the epidemiology of a large, national outbreak of pertussis in England in 2023-2024, and key control measures implemented.</p><p><strong>Design: </strong>Analysis of data for 2023-24 from multiple public health surveillance systems.</p><p><strong>Setting: </strong>England -national surveillance.</p><p><strong>Patients: </strong>All age groups but focusing on children and young people up to age 14 years.</p><p><strong>Interventions and main outcome measures: </strong>Laboratory-confirmed cases in the community, deaths and pertussis-related hospital admissions. National control measures implemented as part of outbreak response.</p><p><strong>Results: </strong>15 750 laboratory confirmed cases were reported in 2023-24, including 989 infants. Of 481 infants under 3 months, 12 died, of whom nine (75%) were born to mothers who were not vaccinated within the recommended timeframe in pregnancy. Incidence rates were highest among infants aged under 3 months. Most hospitalised pertussis cases were infants, but proportionately more hospitalisations in 2024 occurred in older age groups than expected based on earlier years. Whole genome sequencing indicated multiple lineages drove the increase. One isolate from 2023 and one from 2024 possessed 23s ribosomal RNA genotypes associated with macrolide resistance and this was confirmed phenotypically. Multiple control measures were implemented, including revisions to public health guidance and mobilisation work to promote childhood and prenatal vaccination uptake.</p><p><strong>Conclusion: </strong>Following a period of very low incidence during the COVID-19 pandemic, there was a large and rapid rise in pertussis cases across all age groups and geographies in England in 2023-24. Continued, high-quality surveillance and characterisation of circulating pertussis strains will be crucial to understanding evolving disease epidemiology postpandemic.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"411-417"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017125","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":"How accurate is point-of-care ultrasound for detecting paediatric appendicitis? A systematic review and meta-analysis.","authors":"Bethaney Miller, David McCreary, Jon Rees","doi":"10.1136/archdischild-2025-328953","DOIUrl":"10.1136/archdischild-2025-328953","url":null,"abstract":"<p><strong>Objectives: </strong>Primary: To evaluate the diagnostic accuracy of point-of-care ultrasound (POCUS) in the diagnosis of appendicitis in paediatric patients presenting with suspected appendicitis.Secondary: To investigate how the use of POCUS affects length of stay in the paediatric emergency department and CT utilisation.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) up until February 2025 for studies involving patients presenting to the paediatric emergency department with suspected appendicitis, who underwent POCUS. Studies were assessed for risk of bias using the Quality Assessment Tool for Diagnostic Accuracy Studies framework. The primary outcome of interest was the ability of POCUS to detect appendicitis in terms of sensitivity and specificity.</p><p><strong>Results: </strong>Eight studies were included encompassing 993 patients. Calculated pooled sensitivity was 85.6% (95% CI 68.9% to 94.1%) with a specificity of 90.2% (95% CI 86.5% to 93.0%). There was a wide range of reported sensitivities for POCUS, ranging from 53% to 100%. There was less variation in reported specificities that ranged from 82% to 95.2%. The studies analysed were of variable quality with the reference standard and flow and timing being the main areas subject to bias.</p><p><strong>Conclusions: </strong>Based on the findings of this systematic review and meta-analysis, it is reasonable to conclude that POCUS can be used as an effective tool to diagnose paediatric appendicitis. With a moderately high sensitivity, it may not be recommended to be used to exclude appendicitis based on POCUS findings alone. Further prospective studies evaluating the reliability of POCUS in excluding appendicitis, either alone or when combined with a clinical prediction rule, are required. Secondary findings from this study demonstrate that POCUS may result in a reduced length of stay in the paediatric emergency department and lead to a reduction in CT utilisation, though insufficient data were available to draw firm conclusions in relation to this.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"401-408"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312198","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}