Archives of Disease in Childhood最新文献

{"title":"Randomised placebo-controlled trial of triclofos versus melatonin for sedating children undergoing sleep EEG.","authors":"Priyamol T Mohanan, Ruchika Jha, Arjun Kurup, Sarvesh Kohli, Sachendra Badal, Krishna Moorthi Adhikari, Faiz Mh Ahmad, Amit Devgan, Vishal Sondhi","doi":"10.1136/archdischild-2024-327416","DOIUrl":"10.1136/archdischild-2024-327416","url":null,"abstract":"<p><strong>Objective: </strong>To determine the efficacy of addition of melatonin or triclofos to sleep deprivation as compared with sleep deprivation with placebo for conduct of successful sleep electroencephalogram (EEG) among children between 6 months and 12 years of age.</p><p><strong>Design, setting and patients: </strong>486 children aged between 6 months and 12 years who were uncooperative or referred for sleep EEG were enrolled for this double-blind, placebo-controlled randomised trial between 30 June 2022 and 31 March 2023.</p><p><strong>Intervention: </strong>On the day of sleep EEG, participants were sleep deprived by 25% of their regular sleep duration and then randomly assigned to receive either triclofos (50 mg/kg), melatonin (weight ≤15 kg=3 mg; weight >15 kg=6 mg) or placebo.</p><p><strong>Outcome: </strong>Primary outcome was the conduct of a successful sleep EEG.</p><p><strong>Results: </strong>486 children were randomly assigned to intervention with triclofos (n=165), melatonin (n=161) or placebo (n=160). Sleep EEG success (p<0.001) with different interventions was: triclofos=145/165(88%); melatonin=123/161 (76%) and placebo=65/160 (41%). Sleep EEG's success rate was better with triclofos than melatonin (OR=2.2; 95% CI 1.2 to 4.1) or placebo (OR=10.6; 95% CI 6.1 to 19.0). Melatonin was better than placebo in the rate of successful sleep EEG (OR=4.7; 95% CI 2.9 to 7.7). Beta artefacts were significantly more with triclofos (51/145) than melatonin (19/123) and placebo (12/65), but the readability of EEG was not impacted. Movement/unwanted arousal artefacts were significantly more with placebo (37/65) than with triclofos (37/145) and melatonin (34/123). Drug-related adverse events were comparable between triclofos and melatonin. Neither of the drugs was associated with any serious adverse events.</p><p><strong>Conclusions: </strong>Both triclofos and melatonin are individually better than sleep deprivation alone for conducting successful sleep EEGs. Triclofos is significantly better than melatonin for conducting sleep EEGs, with no significant increase in adverse events.</p><p><strong>Trial registration number: </strong>CTRI/2022/05/042479; Clinical Trials Registry of India.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"295-301"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695208","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":"Neonatal varicella: updates on post-exposure prophylaxis options.","authors":"Sowsan F Atabani, Kevin Brown, Gayatri Amirthalingam","doi":"10.1136/archdischild-2024-328269","DOIUrl":"10.1136/archdischild-2024-328269","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"324"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963669","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":"Highlights from the literature.","authors":"","doi":"10.1136/archdischild-2025-328756","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328756","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 4","pages":"328"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662316","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":"Medical malpractice.","authors":"","doi":"10.1136/archdischild-2025-328763","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328763","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 4","pages":"301"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662334","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":"Increasing incidence of Kawasaki disease and associated coronary aneurysm in Aotearoa New Zealand: a retrospective cohort study.","authors":"Ian Harrowell, Rachel Webb, Dug Yeo Han, Emma Best, Bryan Mitchelson, Nigel Wilson, Genevieve Ostring","doi":"10.1136/archdischild-2024-327772","DOIUrl":"10.1136/archdischild-2024-327772","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease (KD) is a childhood vasculitis which causes coronary artery aneurysms (CAA). There is a paucity of data regarding KD in Aotearoa New Zealand. We aimed to provide up-to-date epidemiological and clinical data about KD in the Auckland region.</p><p><strong>Methods: </strong>We conducted a retrospective population-based cohort study in the greater Auckland region between 2017 and 2021. Potential KD cases were identified from hospital discharge records, echocardiogram databases and intravenous immunoglobulin (IVIg) dispensing databases. Clinical records were reviewed and international diagnostic criteria were applied retrospectively.</p><p><strong>Results: </strong>A total of 161 cases of KD were identified (66.5% complete, 33.5% incomplete), with 84% aged under 5 years. Overall incidence (per 100 000/year under 5 years) was 20.4; this was highest in Asian (43.9) and Pacific (17.7) children. There was no significant difference in incidence between New Zealand European (10.1) and Māori (8.3) children. The mean yearly number of cases reduced during the start of the COVID-19 pandemic (37.6 vs 24.0, p=0.01). All children received at least one infusion of IVIg, with 20.5% receiving a second infusion. Twenty-seven children (16.9%) developed CAA. CAA was more common in children under 1 year, non-response to first dose of IVIg and Pacific children.</p><p><strong>Conclusion: </strong>Incidence of KD and rate of CAA were higher than previously reported, although case numbers reduced during the COVID-19 pandemic. There was a high incidence of KD among Pacific children, who were most likely to develop CAA. Research focusing on strategies to identify and treat those at highest risk of CAA remains a priority.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"302-307"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765711","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-toxigenic <i>Corynebacterium diphtheriae</i>: beware the chronic ulcer.","authors":"Nelson Wang, Eloise Silvester, Kimberly Davis","doi":"10.1136/archdischild-2024-328001","DOIUrl":"10.1136/archdischild-2024-328001","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"322-323"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999065","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":"Trends in neural tube defects in Scotland in 2000-2021 prior to the introduction of mandatory folic acid fortification of non-wholemeal wheat flour: a population-based study.","authors":"Amir Kirolos, Rute Vieira, Clara Calvert, Emily Griffiths, Rachael Wood","doi":"10.1136/archdischild-2024-328295","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328295","url":null,"abstract":"<p><strong>Objective: </strong>To describe the total birth prevalence of neural tube defects (NTDs) in Scotland in 2000-2021.</p><p><strong>Design: </strong>National, population-based study.</p><p><strong>Setting: </strong>Scotland, UK.</p><p><strong>Participants: </strong>Babies with an NTD and pregnancy outcome of live birth, stillbirth (≥20 weeks' gestation) or termination of pregnancy (any gestation), as recorded in the Scottish Linked Congenital Condition Dataset.</p><p><strong>Exposures: </strong>Year, maternal age group and maternal area-level deprivation quintile.</p><p><strong>Main outcome measures: </strong>The main outcome measure was the total birth prevalence of all NTDs and separately anencephaly and spina bifida (per 10 000 total births). The association between exposures and outcomes was investigated using Poisson regression.</p><p><strong>Results: </strong>In Scotland in 2000-2021, there were 1178 babies with a recorded NTD (436 anencephaly, 577 spina bifida) and 1 203 491 total births. The total birth prevalence of NTDs was 9.8 (95% CI 9.2, 10.4) per 10 000 total births. The prevalence was lower among babies born to mothers aged 30-39 years (compared with younger or older mothers) and those from less (compared with more) deprived areas. There was no evidence of change in the prevalence of NTDs (prevalence rate ratio (PRR) 1.01 (95% CI 0.997, 1.02), p=0.16) or spina bifida (PRR 0.99 (95% CI 0.98, 1.01), p=0.35) over the study period. The prevalence of anencephaly showed no change in 2000-2012, but increased in 2013-2021 (PRR 1.12 (95% CI 1.06, 1.19), p<0.001).</p><p><strong>Conclusions: </strong>The observed trends in anencephaly likely reflect increasing detection in early pregnancy. Current strategies are failing to equitably reduce NTDs in Scotland. Monitoring of future trends is needed to assess the impact of mandatory folic acid fortification.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646819","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":"Falling enthusiasm for paediatrics in South Korea: it couldn't happen here. Could it?","authors":"Kay Tyerman, Emma M Dyer, Cathryn Chadwick, Jonathan C Darling, Michael McKean, Stephen W Turner","doi":"10.1136/archdischild-2024-328293","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328293","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633224","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":"The sick child in art.","authors":"Trevor Duke","doi":"10.1136/archdischild-2025-328488","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328488","url":null,"abstract":"<p><p>There are at least 12 paintings from the late 17th to the early 20th centuries titled, 'The Sick Child'. They were painted by well-known and obscure artists from Holland, Norway, France, England, Spain, North and South America. Most depict infants, and some older children, always in their homes, most with the mother at the bedside. The Sick Child paintings are a window into the human condition before hospital treatment was the norm, and childhood illness and death were an experience common to almost all families. They depict the mother-child bond of love and protection, complex human emotions, and the hardship and vulnerability of children and families of those eras. There remains a role for art in health and medicine, even in the 21st century.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633225","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 and clinical profile of paediatric RSV infections: insights from a 6-year Australian cohort study.","authors":"Jane Tuckerman, Jeremy Anderson, Annette Alafaci, Paul V Licciardi, Andrew Steer, Ian Barr, Nigel W Crawford, Danielle Wurzel","doi":"10.1136/archdischild-2025-328666","DOIUrl":"10.1136/archdischild-2025-328666","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633216","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}