Archives of Disease in Childhood最新文献

{"title":"Intellectual conflicts of interest and the ongoing controversy on guidelines regarding gender-affirming care.","authors":"Richard Santen","doi":"10.1136/archdischild-2025-328741","DOIUrl":"10.1136/archdischild-2025-328741","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":"149001198","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":"Ethical considerations for semaglutide use in children.","authors":"Nanette Ryan, Dominic Wilkinson, Julian Savulescu","doi":"10.1136/archdischild-2025-329747","DOIUrl":"10.1136/archdischild-2025-329747","url":null,"abstract":"<p><p>Semaglutide, marketed as Ozempic, Wegovy and Rybelsus, has rapidly become one of the most prominent medications of recent years. Initially approved in 2021 for type 2 diabetes in adults, semaglutide is now authorised for obesity management in adults and children in several countries, including Germany, the UK, Denmark and the United Arab Emirates. Despite this broad regulatory approval, its paediatric use remains a subject of debate. Advocates highlight its potential to reduce cardiovascular risk and prevent obesity-related illness, while critics emphasise uncertainties about long-term safety, efficacy and impacts on child development.This paper examines the ethical challenges raised by prescribing semaglutide to children, focusing on access barriers, stigma and the neglect of structural determinants of obesity, and provides ethical recommendations for clinicians aimed at mitigating harm, supporting autonomy and promoting children's health.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"849-853"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909694","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":"Extent to which local authorities will exercise their parental responsibility.","authors":"Robert Wheeler","doi":"10.1136/archdischild-2026-330651","DOIUrl":"10.1136/archdischild-2026-330651","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"856-857"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209955","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":"Health-related quality of life in children with Robin sequence following Tübingen palatal plate treatment in infancy.","authors":"Hannah Kiefer, Christian F Poets, Cornelia Wiechers, Ann-Cathrine Neukamm, Andreas Naros, Hannah Finke, Karen Birgit Kreutzer","doi":"10.1136/archdischild-2026-330540","DOIUrl":"10.1136/archdischild-2026-330540","url":null,"abstract":"<p><strong>Objective: </strong>Children with Robin sequence (RS) are characterised by micrognathia/retrognathia, glossoptosis and upper airway obstruction, often resulting in hypoxemic episodes and growth failure, potentially impairing their health-related quality of life (HRQoL). Few studies, however, have yet tried to objectively quantify HRQoL in children with RS. The aim of this cohort study was to investigate HRQoL in children with RS 7-11 years after treatment with the Tübingen palatal plate (TPP) in infancy.</p><p><strong>Methods: </strong>Using two generic health-related QoL-questionnaires from the parental and child perspective (KINDL-R and KDISCREEN-52) and also the cleft-specific CLEFT-Q questionnaire for children, HRQoL was assessed in 17 children with isolated RS (mean age 8.5 years) and compared with that of 24 children with a cleft palate (± cleft lip, no RS; mean age 8.1 years). Results were also compared with data from a representative European reference cohort.</p><p><strong>Results: </strong>HRQoL was similar in children with clefts and those with RS and better than that of the reference cohort. In the subscales 'Bullying' (proxy 47%, self 65%) and 'Financial Resources' (proxy 65%, self 71%) the proportion of children with above average results was even three to four times larger than in the reference population (16%).</p><p><strong>Conclusion: </strong>These results suggest a good HRQoL at primary school age in these children following TPP therapy in infancy.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"897-903"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing child poverty policy is central to improving vaccination coverage.","authors":"Ben Kasstan-Dabush, Helen Bedford, Helen Skirrow","doi":"10.1136/archdischild-2026-330450","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330450","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001196","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":"Unexpected deaths in infancy: how understanding of causes and prevention has developed over 100 years.","authors":"Anna Pease, Peter Fleming, Peter Blair","doi":"10.1136/archdischild-2025-329765","DOIUrl":"10.1136/archdischild-2025-329765","url":null,"abstract":"<p><p>As <i>Archives of Disease in Childhood</i> approaches its 100th anniversary, we describe in this article how the understanding of the aetiology, epidemiology, parent-infant interactions and approaches to prevention of unexpected deaths in infancy has evolved over the century.We have been involved in research into unexpected infant deaths, support of bereaved families and prevention of such deaths since 1976 (PF), 1992 (PB) and 2006 (AP).</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"843-848"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145826777","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":"Outcomes of paediatric medical stabilisation admissions for restrictive eating disorders: a multicentre evaluation.","authors":"Juliet Banks, Damian Wood, Helen Riches, Sophie Preece, Claire Knight, Jack Roffe, Meghana Kulkarni","doi":"10.1136/archdischild-2025-330149","DOIUrl":"10.1136/archdischild-2025-330149","url":null,"abstract":"<p><p>Eating disorders (ED) are associated with mortality and morbidity. The outcomes of a short refeeding admission on a paediatric ward have not previously been evaluated in a UK setting. The aim was to describe the patient population and identify key outcomes to develop a standard data set.A retrospective cohort analysis of 85 children and young people (CYP) from 2 UK hospitals. Patients included were 0-18 years, admitted for a restrictive ED from January 2018 to September 2022 where length of stay was >1 day. Cases were most often midadolescent (15.1 years, IQR=2.7) females (n=73, 85.9%) and the most common diagnosis was anorexia nervosa (AN)-(n=41, 48.8%).Discharge to community treatment was the most common outcome (n=51, 61.4%) with the remainder transferred to onward inpatient care. Medical instability was present in n=22 (25.9%). The median length of stay was 21.0 days (IQR=23.0). Nutritional supplements were required for one in three CYP either orally (n=30, 36.1%) or via a nasogastric tube (n=25, 30.1%). Biochemical refeeding syndrome was seen in n=20 (24.1%). A diagnosis of AN or lower % median body mass index on admission was both associated with transfer for further inpatient care (p<0.05).This study provides baseline data of core outcomes to inform a multicentre dataset and offer valuable information when counselling CYP and families. It also provides services with baseline outcomes to work to improve the care and outcomes of CYP with restrictive EDs.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"885-890"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607778","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":"Incidental finding of thoracic lesion detected on chest radiograph.","authors":"Ciaran Fergus O'Toole, Mark Tighe","doi":"10.1136/archdischild-2025-330131","DOIUrl":"10.1136/archdischild-2025-330131","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"926"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760360","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":"Associations between deprivation and postneonatal cerebral palsy over 35 years: a population-based longitudinal study.","authors":"Oliver Perra, Róisín Keenan, Claire Kerr","doi":"10.1136/archdischild-2025-329398","DOIUrl":"10.1136/archdischild-2025-329398","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral palsy (CP) is a non-progressive condition involving movement and muscle tone difficulties due to injury to the developing brain. Most cases arise around birth, but a smaller proportion (postneonatal CP) experience brain injuries between 29 days and 2 years of age. Causes of postneonatal CP are often modifiable and may be more prevalent in socio-economically deprived areas, yet few studies have investigated this issue. We addressed this gap using a population-wide CP register in Northern Ireland.</p><p><strong>Methods: </strong>We conducted a retrospective study linking births between 1981 and 2016 to area-level deprivation data. Bayesian regression models assessed associations between deprivation, postneonatal CP and related outcomes.</p><p><strong>Results: </strong>Postneonatal CP declined steadily across the study period (IRR=0.89; 89% uncertainty interval (UI) 0.85 to 0.93), especially among individuals from the most deprived backgrounds. While the odds of infection-related postneonatal CP decreased overall, these did not decrease among CP individuals from deprived backgrounds, who also displayed higher odds of postneonatal CP due to head injuries (OR=2.72, 89% UI 1.09 to 5.30). Postneonatal CP was associated with higher odds of severe motor impairment (OR=1.47, 89% UI 1.07 to 2.00), intellectual delay (OR=2.54, 89% UI 1.83 to 3.55) and seizures (OR=2.55, 89% UI 1.84 to 3.56).</p><p><strong>Discussion: </strong>Although prevalence has declined, socioeconomic inequalities remain in the causes and consequences of postneonatal CP. These findings highlight the need for targeted public health interventions and further research to address persistent disparities and prevent modifiable causes of CP.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"873-878"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing complexity in children with life-limiting conditions in England: an analysis of national routine data.","authors":"Bethan Page, Stuart William Jarvis, Lorna K Fraser","doi":"10.1136/archdischild-2026-330504","DOIUrl":"10.1136/archdischild-2026-330504","url":null,"abstract":"<p><strong>Introduction: </strong>The number of children with life-limiting conditions has risen in recent decades, partly due to medical advances enabling increased survival. It is unclear how the medical complexity of this population has changed.</p><p><strong>Aim: </strong>To use quantitative analyses of routinely collected healthcare and administrative data from 2003 to 2022 to assess the complexity of children with a life-limiting condition (0-19 years) over time.</p><p><strong>Methods: </strong>National hospital data in England (Hospital Episode Statistics) were used to identify children aged 0-19 years with a life-limiting condition from 2003/2004 to 2022/2023. Data were linked with community pharmacy data. Indicators of medical complexity were assessed based on the domains of the medical complexity framework: number of life-limiting and chronic conditions, number of main specialties involved, number of medications, healthcare use and technology dependence (gastrostomies, tracheostomies, jejunostomies) with trends summarised descriptively and associations assessed using multivariable ordinal logistic regression.</p><p><strong>Results: </strong>Most indicators of complexity increased over time, including numbers of health conditions, specialties, technology dependence, emergency department attendances and emergency admissions. Technology dependence rose, particularly for gastrostomies (3505 to 15 949). Children seen by three or more specialties increased from 3096 to 19 312. Rising healthcare use reflected both increasing numbers of children with life-limiting conditions and increasing complexity among individual patients. Increasing age, increasing deprivation and Bangladeshi and Pakistani ethnicity were associated with greater complexity.</p><p><strong>Conclusions: </strong>Healthcare providers must allocate resources to address the increasing complexity of need in children with life-limiting conditions. No data were available on family impacts or family-identified needs.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"904-909"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}