Archives of Disease in Childhood最新文献

{"title":"Graves' disease: are we just delaying the inevitable?","authors":"Chloe Stevens, Shirley Langham, Rakesh Amin, Mehul Dattani, Caroline Brain, Catherine Peters","doi":"10.1136/archdischild-2024-327877","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327877","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613856","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":"Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study.","authors":"Joanna F Dipnall, Jane Lyons, Ronan Lyons, Shanthi Ameratunga, Marianna Brussoni, Frederick P Rivara, Fiona Lecky, Amy Schneeberg, James E Harrison, Belinda J Gabbe","doi":"10.1136/archdischild-2024-327096","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327096","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the moderating effects of socio-demographic social determinants of health (SDH) in the relationship between types of childhood hospitalisation (ie, none, injury, non-injury, injury+non-injury) and academic performance.</p><p><strong>Design, setting and patients: </strong>Children residing in Wales 2009-2016 (N=369 310). Secure Anonymised Information Linkage databank linked Tagged Electronic Cohort Cymru (five data sources) from the Wales Electronic Cohort for Children.</p><p><strong>Main outcome measure: </strong>Binary educational achievement (EA) measured across three key educational stage time points: grade 6 (mean age 11 years, SD 0.3), 9 (mean age 14 years, SD 0.3) and 11 (mean age 16 years, SD 0.3).</p><p><strong>Results: </strong>Of the 369 310 children, 51% were males, 25.4% of children were born in the lowest two Townsend deciles. Females were more likely to meet EA than males (adjusted risk ratio (aRR) (95% CI): 1.047 (1.039, 1.055)). EA was lower for injury admissions in males and any admission type in females (interactions: female×non-injury 0.982 (0.975, 0.989); female×injury+non-injury 0.980 (0.966, 0.994)). Children born into a more deprived decile were less likely to achieve EA (0.979 (0.977, 0.980)) and worsened by an injury admission (interactions: townsend×injury 0.991 (0.988, 0.994); Townsend×injury+non-injury 0.997 (0.994, 1.000)). Children with special educational needs (SEN) were less likely to meet EA (0.471 (0.459, 0.484) especially for an injury admission (interactions: SEN×injury 0.932 (0.892, 0.974)).</p><p><strong>Conclusion: </strong>SDH moderated the impact of hospital admission type on educational outcomes prompting future investigation into the viability of in-hospital routine screening of families for SDH and relevant post-hospital interventions to help reduce the impact of SDH on educational outcomes post-hospitalisation.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613846","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":"Compatibility of pentoxifylline injection with syringe and inline filters.","authors":"D Thisuri N De Silva, Tobias Strunk, Michael Petrovski, Nabeelah Mukadam, Kevin T Batty","doi":"10.1136/archdischild-2024-327377","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327377","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563869","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":"Cascade testing effectively identifies undiagnosed sickle cell disease in The Gambia: a quality improvement project.","authors":"Etienne Deans-Louis, Angela Allen, Stephen John Allen","doi":"10.1136/archdischild-2024-327311","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327311","url":null,"abstract":"<p><strong>Objective: </strong>Sickle cell disease (SCD) has a high mortality during childhood in many low and middle-income countries (LMICs). Early diagnosis improves outcomes but newborn screening is not well established in LMICs. Cascade testing may be feasible and effective in identifying undiagnosed SCD and carriers of haemoglobin (Hb) S.</p><p><strong>Design: </strong>Quality improvement project using existing clinic and laboratory resources.</p><p><strong>Setting: </strong>The Haematology Clinic at the Edward Francis Small Teaching Hospital, Banjul, The Gambia.</p><p><strong>Participants: </strong>Families of index cases with SCD.</p><p><strong>Methods: </strong>Hb phenotype was determined in full or half-siblings of a SCD index case over a 6-week period using the HemoTypeSC test and confirmed by Hb electrophoresis.</p><p><strong>Main outcome measure: </strong>Identifying undiagnosed SCD.</p><p><strong>Results: </strong>Of 102 families invited, 31 (30%) attended during the study period and 53 siblings were tested. Except for one indeterminate test, HemoType SC agreed with Hb electrophoresis. Ten (19%; 95% CI 10 to 32) siblings were diagnosed with HbSS, 25 (47%; 34 to 60) as carriers (HbAS) and 18 (34%; 23 to 48) were unaffected (HbAA). Some symptoms and signs of SCD occurred significantly more frequently in HbSS than in HbAA and HbAS, but none was sufficiently common to help in identifying children for testing.</p><p><strong>Conclusions: </strong>Cascade testing was effective in identifying undiagnosed HbSS as well as children carrying the sickle cell gene. In routine care settings in LMICs, cascade testing facilitated by point-of-care tests may be feasible and affordable in increasing the detection of SCD and improving outcomes through earlier diagnosis.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543304","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":"Complications of excess weight seen in two tier 3 paediatric weight management services: an observational study.","authors":"Katherine Hawton, Louise Apperley, Jennifer Parkinson, Meghan Owens, Claire Semple, Lauren Canvin, Alanna Holt, Shelley Easter, Kate Clark, Kim Lund, Ellie Clarke, James O'Brien, Dinesh Giri, Senthil Senniappan, Julian P H Shield","doi":"10.1136/archdischild-2024-327286","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327286","url":null,"abstract":"<p><strong>Background: </strong>Children and young people living with severe obesity experience a range of complications of excess weight (CEW); however the prevalence of complications is not well defined. We have evaluated baseline characteristics and CEW of patients from two UK tier 3 paediatric weight management services.</p><p><strong>Methods: </strong>All new patients aged 2-17 years seen from March 2022 to February 2023 were included. Baseline demographic data was collected, and patients screened for CEW. PedsQL-4.0 questionnaires were used to assess health-related quality of life (HRQL).</p><p><strong>Results: </strong>185 patients were included, median age 14.3 years (range 3.3-18.0), 50.8% were girls. Of the patients, 73.8% were white British, with a significant excess of patients living in the most deprived decile (41.4%). Median body mass index SD score was +3.55 (IQR 3.11-3.90) and median body fat was 49.3% (IQR 42.3%-55.1%). Autistic spectrum disorder, attention deficit hyperactivity disorder and learning difficulties were vastly over-represented.Dyslipidaemia was the most common (51.6%) complication, followed by hypertension (28.9%), metabolic dysfunction-associated steatotic liver disease (17.8%), obstructive sleep apnoea (9.0%) and idiopathic intracranial hypertension (4.3%). Mean glycated haemoglobin was 35.0 mmol/mol (IQR 33-38). 8.1% had type 2 diabetes mellitus. Many of these complications were detected through screening in CEW clinics.Both child-reported (mean 51.9/100) and parented-reported (47.8/100) HRQL scores were low. Mental health problems were common: 26.2% with anxiety and 7.7% with depression.</p><p><strong>Conclusions: </strong>This study demonstrates the significant and profound mental and organ-specific pathology resulting from severe obesity in childhood, highlighting the clinical necessity for CEW clinics. A rigorous approach to identify complications at an early stage is essential to improve long-term health outcomes.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543306","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":"Hospital-recorded chronic health conditions in children with and without Down syndrome in England: a national cohort of births from 2003 to 2019.","authors":"Julia Shumway, Jill Ellis, Alice Stephens, Bianca Lucia De Stavola, Ruth Gilbert, Ania Zylbersztejn","doi":"10.1136/archdischild-2024-327532","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327532","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to describe age-specific cumulative incidence for hospital-recorded indicators of chronic health conditions (CHCs) in children with Down syndrome (DS) compared with children without DS.</p><p><strong>Design: </strong>National birth cohort using hospital admission and death records.</p><p><strong>Setting: </strong>National Health Service (NHS)-funded hospitals in England.</p><p><strong>Population: </strong>Liveborn, singleton infants born in NHS-funded hospitals between 2003 and 2019.</p><p><strong>Main outcome measures: </strong>Cumulative incidence of nine categories of hospital-recorded CHCs, multimorbidity and mortality.</p><p><strong>Results: </strong>We identified 10 621 infants with DS among 9 631 646 liveborn, singleton infants (0.11%). Among children with DS, the cumulative incidence for any indicated CHC was 90.1% by age 16, as compared with 21.2% of children without DS. By age 16, a third of children (33.1%) with DS had CHCs affecting four or more body systems; only 6.0% of children without DS had CHCs indicated in more than one body system. The most common CHCs in children with DS were severe congenital heart defects, indicated in 57.2% (0.8% in children without DS). The estimated HR for mortality up to age 16 comparing children with versus without DS was 15.26 (95% CI: 14.15, 16.45).</p><p><strong>Conclusions: </strong>Children with DS had a higher cumulative incidence for CHCs in each body system category and subcategory, at all ages, than children without DS. Multimorbidity and mortality were higher among children with DS. Administrative data can be used to examine the health needs and healthcare use of children with DS throughout childhood and adolescence.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543316","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":"Case of sapphire eyes with hearing loss: Waardenburg syndrome type 1 in a young girl.","authors":"Vishal Gaurav, Gaby Lalmuanpuii, Pavani Gowda, Aditi Guglani","doi":"10.1136/archdischild-2024-327905","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327905","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543305","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":"Effectiveness of paediatric asthma hubs: a clinical pilot study.","authors":"Ali Hakizimana, David K H Lo, Damian Roland, Vinayak K Rai, Lesley Danvers, Rachel Rowlands, Molla Imaduddin Ahmed, Reeta Herzallah, Erol A Gaillard","doi":"10.1136/archdischild-2023-326635","DOIUrl":"https://doi.org/10.1136/archdischild-2023-326635","url":null,"abstract":"<p><strong>Background: </strong>Children and young people (CYP) with asthma in the UK are at higher risk of poor outcomes compared with other high-income European countries due to factors including poor access to high-quality asthma reviews, diagnostic testing and inconsistent postattack reviews. The Leicester Integrated Care Board funded the first UK pilot asthma hub for CYP, to investigate the feasibility and effectiveness of hubs, in providing postattack reviews along with providing asthma education, the opportunity to carry out diagnostic lung function tests and optimise treatment.</p><p><strong>Methods: </strong>Clinical pilot study including CYP aged 4-17 years referred to the hub with uncontrolled asthma or postattack from November 2021 to April 2022. CYP received a structured clinical assessment including National Institute for Health and Care Excellence (NICE) first-line diagnostic investigations for asthma including spirometry, bronchodilator reversibility (BDR) and fraction of exhaled nitric oxide (FeNO).</p><p><strong>Results: </strong>Of 312 CYP referred (mean age 8.6±3.2 years; 42% women), 266 (85.3%) attended their appointment. Median time from referral to review was 2 days (IQR 1-3). Three CYP (1.1%) were severely unwell at review and required further hospital treatment. In the 231 CYP who completed first-line tests, asthma was confirmed for 73 (31.6%) based on NICE diagnostic criteria for CYP. Twenty-two per cent of children with normal baseline spirometry had ≥12% BDR.</p><p><strong>Conclusion: </strong>Paediatric asthma hubs are a feasible model of care to deliver CYP postasthma attack reviews and identify high-risk patients requiring further treatment. Spirometry, BDR and FeNO testing allowed diagnostic confirmation in a significant proportion of CYP.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543307","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":"Predictive performance of cerebrospinal fluid parameters for diagnosis of meningitis in infants: a cohort study.","authors":"Christine O'Leary, Laure F Pittet, Rachael Beaumont, Laura Constable, Andrew Daley, Isabelle Hodge, Susan E Jacobs, Arrabella King, Catherine Tan, Nigel Curtis, Amanda Gwee","doi":"10.1136/archdischild-2024-327628","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327628","url":null,"abstract":"<p><strong>Background: </strong>The gold standard for diagnosis of meningitis is the isolation of a pathogen from cerebrospinal fluid (CSF) by culture or PCR. However, treatment is routinely commenced based on CSF findings prior to microbiological results. This study determined the predictive value of CSF parameters for diagnosing bacterial and viral meningitis in young infants.</p><p><strong>Methods: </strong>Multicentre retrospective (2010-2020) cohort study of 1088 CSF results from infants aged 0-90 days. The predictive value of CSF parameters (white blood cell count (WCC), neutrophil, protein, glucose) was evaluated in 538 meningitis cases (39 bacterial, 499 viral) compared with controls with negative CSF microbiological testing and no prior antibiotics.</p><p><strong>Results: </strong>For bacterial meningitis, the sensitivity of the commonly used CSF WCC cut-off of 20×10⁶/L for neonates, 15×10⁶/L for infants 1-2 months old and 5×10⁶/L for infants 2-3 months old was 89%, 91% and 86% and the specificity was 78%, 77% and 61%, respectively. CSF protein levels ≥1 g/L in neonates and ≥0.8 g/L in infants aged 1-3 month, or CSF neutrophils ≥2×10⁶/L, independently increased the likelihood of bacterial meningitis (positive likelihood ratios ≥5 and ≥3, respectively). 3 of 39 cases of bacterial meningitis would have been missed using the commonly used WCC cut-offs alone. However, two would have been identified using CSF protein and neutrophil thresholds. All CSF parameters were poor at identifying viral meningitis.</p><p><strong>Conclusion: </strong>A single CSF parameter cannot reliably diagnose bacterial meningitis. For identification of bacterial meningitis, elevation of CSF WCC, neutrophil count or protein levels above threshold values improves accuracy of diagnosis.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543317","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":"Should next-generation sequencing be considered as a first-line genetic investigation for children with early developmental impairment?","authors":"Frederica Sarantis, Aisosa Osas Guobadia, Marwa A Bebars, Rachana Varma, Jonathon A A Holland, Thiloka Ratnaike","doi":"10.1136/archdischild-2024-327752","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327752","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543318","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}