Archives of Disease in Childhood最新文献

{"title":"New UK screen time guidance for under-5s is a necessary but insufficient response.","authors":"Robert C Hughes","doi":"10.1136/archdischild-2026-330766","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330766","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103028","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":"Creation of the MRCPCH exam.","authors":"Thomas Lissauer, Graham Clayden, Alan Craft, Daniel Crane, Vasanta Nanduri","doi":"10.1136/archdischild-2026-331105","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331105","url":null,"abstract":"<p><p>This review describes the creation of the MRCPCH exam; its importance in the formation of the RCPCH 30 years ago and the innovative changes made when it was created. Also considers the changes made since then and possible changes in the future.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102884","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":"Interventions delivered in healthcare settings to promote vaping cessation in children and young people (under the age of 18 years): a scoping review.","authors":"Melvin Hoo Chuin Shen, Melissa Mae Gabriel, Nathan Wilde, Louise Brennan, Rachel Isba","doi":"10.1136/archdischild-2026-331027","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331027","url":null,"abstract":"<p><strong>Objectives: </strong>To identify and map interventions delivered in healthcare settings to promote vaping cessation among children and young people (CYP) under 18 years.</p><p><strong>Design: </strong>Scoping review conducted in accordance with Joanna Briggs Institute (JBI) methodology and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The review protocol was preregistered and published in <i>BMJ Open</i>.</p><p><strong>Data sources: </strong>Five electronic databases (MEDLINE, Embase, Web of Science, Cochrane Library, CINAHL), clinical trial registries and grey literature sources were searched from January 2004 to February 2026.</p><p><strong>Eligibility criteria: </strong>Sources reporting cessation interventions for CYP under 18 years who currently vape, delivered by healthcare professionals within clinical or community healthcare settings. All study designs and grey literature were eligible.</p><p><strong>Results: </strong>Eight sources were included: five reporting cessation or treatment interventions and three evaluating screening approaches all conducted in North America. All five cessation interventions used multicomponent approaches combining behavioural and pharmacological elements. Nicotine replacement therapy (NRT) was used in four sources. Quit rates ranged from 16.7% to 37%, with considerable variation in how 'abstinence' was defined and measured and limited use of biochemical verification. Uptake of cessation support was consistently low across sources. Vaping-specific language and adapted screening tools consistently improved clinical capture rates.</p><p><strong>Conclusions: </strong>Healthcare-based vaping cessation for under-18s is at an early stage of development. No included study tested a structured multicomponent cessation pathway within routine clinical encounters, and no pharmacotherapy trials have been conducted specifically in under-18s. Adequately powered trials recruiting under-18s, prospective evaluation of clinical pathways and research within different healthcare systems are urgently needed.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102923","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 do we diagnose dysfunctional breathing (breathing pattern disorder) in children and young people: an eDelphi consensus.","authors":"Kenneth A Macleod, Ruth Stewart, Donald S Urquhart","doi":"10.1136/archdischild-2026-330393","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330393","url":null,"abstract":"<p><strong>Objective: </strong>To assess current UK expert knowledge of breathing disorders, commonly referred to as dysfunctional breathing or breathing pattern disorders, in children and young people (CYP) with a view to constructing a clinical assessment tool for validation in this population.</p><p><strong>Design: </strong>Modified three-stage eDelphi process.</p><p><strong>Setting: </strong>Experts from UK paediatric respiratory centres INTERVENTIONS AND MAIN OUTCOME MEASURES: Responses over three stages were used to achieve consensus on aspects of this condition such as the accepted name, reported symptoms, clinical signs, usual patient characteristics and comorbidities. The a priori threshold for consensus was 75% of those who selected 'somewhat agree', 'agree' or 'strongly agree' on a 7-point Likert scale.</p><p><strong>Results: </strong>39 participants (physiotherapists, nurses and doctors) participated in round 1, with 29 completing round 3. While no clear consensus was agreed between the two most popular names for this condition-dysfunctional breathing or breathing pattern disorder-there was a strong consensus on the common clinical features. Ten clinical features were agreed to be consistent with dysfunctional breathing/breathing pattern disorder, with 6 descriptive terms, 12 common phrases used by CYP and 7 signs and symptoms.</p><p><strong>Conclusions: </strong>There is currently no validated diagnostic tool for breathing disorders in CYP. This eDelphi consensus provides a basis for the future development of a clinical tool for use in primary, secondary and tertiary settings to aid the assessment of CYP with suspected dysfunctional breathing/breathing pattern disorder.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079557","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":"In children with trisomy 21, does routine polysomnography identify asymptomatic obstructive sleep apnoea?","authors":"Lucy Yurek","doi":"10.1136/archdischild-2026-331131","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331131","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079604","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":"Corticosteroid use in children with community acquired sepsis: a multicentre prospective cohort study.","authors":"Elliot Long, Gregory J G Nolan, Amanda Williams, Shefali Jani, Simon Craig, Amit Kochar, Meredith Louise Borland, Natalie Phillips, Shane George, Stuart Dalziel, Eunicia Tan, Anna Lithgow, Emma Whyte, Sarah McNab, Ben Gelbart, Warwick Butt, Thomas Rozen, Marino Festa, Simon Erickson, Subodh Ganu, Sainath Raman, Stephen Hearps, Franz E Babl","doi":"10.1136/archdischild-2025-330072","DOIUrl":"https://doi.org/10.1136/archdischild-2025-330072","url":null,"abstract":"<p><strong>Objectives: </strong>Corticosteroids in paediatric sepsis have the potential to improve outcomes, yet there is little supporting evidence regarding efficacy, choice of agents, dose or timing of administration. We describe the patterns of corticosteroid use in children hospitalised with suspected community-acquired sepsis.</p><p><strong>Design: </strong>This observational study used data from the multicentre multicountry Sepsis Epidemiology in Australian and New Zealand Emergency Departments study, collected from 2021 to 2023.</p><p><strong>Patients: </strong>Participants were children aged 0 to <18 years with suspected sepsis admitted to the hospital through 11 emergency departments in Australia and New Zealand.</p><p><strong>Main outcome measures: </strong>We report agent, dose and factors associated with administration for any corticosteroid administered within the first 24 hours of hospitalisation.</p><p><strong>Results: </strong>5119 children had suspected sepsis with a median age of 1.6 years and in-hospital mortality of 1.0% (52/5119). The Phoenix sepsis criteria were met by 4.9% (252/5119) with mortality of 12.7% (32/252). Corticosteroids were used in 9.6% (489/5119) children overall and in 31.3% (79/252) meeting Phoenix sepsis criteria. The most commonly used corticosteroid was dexamethasone (69.5%, 340/489), followed by hydrocortisone (25.4%, 124/489) with considerable variation in preferences overall and between study sites. Factors that were associated with corticosteroid use were: older age, more than one comorbidity, elevated initial lactate, large volume fluid resuscitation and any vasopressor use.</p><p><strong>Conclusions: </strong>Children with suspected community acquired sepsis frequently received treatment with corticosteroids. Dexamethasone and hydrocortisone were the most used agents, with the vast majority used outside of the setting of fluid or catecholamine-refractory shock.</p><p><strong>Trial registration number: </strong>ACTRN12621000920897.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079580","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":"Bacterial detection in paediatric cancer patients with febrile neutropenia, from conventional microbiological testing to advanced molecular techniques: a scoping review.","authors":"Emilie Clifton, Damaris Condy, Helen Groves, Thomas Waterfield","doi":"10.1136/archdischild-2026-331063","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331063","url":null,"abstract":"<p><strong>Introduction: </strong>Febrile neutropenia (FN) is a common complication of cancer treatment and carries a risk of bacterial bloodstream infection. Current diagnostic approaches have limitations, underscoring the need for improved methods. This review maps evidence on diagnostics for bacteraemia in paediatric FN, focusing on peripheral blood cultures (BCs) in children with central venous catheters, repeat BC strategies and emerging molecular diagnostics and biomarkers.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with Joanna Briggs Institute methodology and reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. MEDLINE, Embase and Web of Science were searched for primary research published since 2011 evaluating diagnostic techniques for bacteraemia in children with cancer and FN. Study selection was performed independently by two reviewers. Data on study characteristics, diagnostic methods and performance were extracted.</p><p><strong>Results: </strong>Of 1641 records, 33 studies (8993 FN episodes) were included: biomarker assays (n=20), BC (n=7) and molecular diagnostics (n=6). Evidence for routine peripheral BC was limited and conflicting. A temporal decline in BC diagnostic yield was observed, associated with increasing contamination. Molecular diagnostics consistently detected more pathogens than conventional culture, although evidence of clinical benefit remains limited. No biomarker demonstrated sufficient accuracy for standalone use. Methodological heterogeneity limited comparative analysis.</p><p><strong>Conclusion: </strong>BCs remain the diagnostic gold standard for bacteraemia in paediatric FN. Repeated BCs beyond 72 hours are unlikely to benefit clinically stable patients. Molecular diagnostics and biomarkers are promising adjuncts but require further evaluation through standardised prospective multicentre studies. Integrating pathogen detection with host response biomarkers should be considered to improve diagnostic accuracy.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079569","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":"Does earlier initiation of growth hormone therapy improve outcomes in children with Silver-Russell syndrome?","authors":"Eleonora Vulpe, Chris Gale, Cheryl Battersby","doi":"10.1136/archdischild-2026-331250","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331250","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057355","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":"Coming wave of subacute sclerosing panencephalitis: a call for a global registry.","authors":"Tal Gilboa, Itamar Cohen, Ariel Tenenbaum, Oren Gordon","doi":"10.1136/archdischild-2026-331576","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331576","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057269","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 are the children and young people attending the UK's first ketamine-induced uropathy clinic for under 16s?: an early insight into sociodemographic features.","authors":"Natasha Goss, Harriet Jane Corbett, Liz Brewster, Gwendolyn Cowley, Rachel Isba","doi":"10.1136/archdischild-2026-330727","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330727","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023772","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}