Archives of Disease in Childhood最新文献

{"title":"Images in paediatrics: Pott's disease with spinal cord compression.","authors":"Camryn Gibbons, Rowena Staples, Alasdair P S Munro","doi":"10.1136/archdischild-2026-330910","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330910","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":"149001138","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":"Intravenous rehydration in children with severe malnutrition and severe dehydration: a systematic review and meta-analysis.","authors":"Juan Emmanuel Dewez, San Maurice Ouattara, Temmy Sunyoto, Christabel Kemunto Mogaka, Matthew E Coldiron, Hadiza Alhaji Sainna, Roberta Petrucci, Elizabeth C George, Kathryn Maitland","doi":"10.1136/archdischild-2026-330358","DOIUrl":"10.1136/archdischild-2026-330358","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy and safety of intravenous rehydration (IVR) versus oral rehydration (OR) strategies in children with severe acute malnutrition (SAM) and severe dehydration.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Setting: </strong>Lower-to-middle-income countries.</p><p><strong>Patients: </strong>Children with SAM are hospitalised with severe dehydration secondary to gastroenteritis.</p><p><strong>Interventions: </strong>Randomised trials of IVR and OR (standard of care) MAIN OUTCOME MEASURES: Primary: in-hospital mortality. Secondary: fluid overload events, development of shock requiring intravenous boluses, severe electrolyte abnormalities at 24 hours and day 28 mortality.</p><p><strong>Results: </strong>We identified three RCTs comprising 484 participants with severe malnutrition (72 had kwashiorkor, two had some risk of bias, and one had low risk of bias). The pooled risk ratio (RR) for in-hospital mortality for IVR versus OR is 0.71 (95% CI 0.46 to 1.10; I²=0.0%) with moderate certainty of evidence. No fluid overload events were reported, pooled RR 0.99 (95% CI 0.10 to 9.35). The pooled RR of severe hyponatraemia (sodium <125 or <130 mmol/L) at 24 hours was 0.66 (95% CI 0.44 to 0.99). Only one trial reported RR for shock development, hypernatraemia (sodium >145 mmol/L) or 28-day mortality with IVR versus OR (RRs 0.56, 95% CI 0.21 to 1.48; RR 2.05, 95% CI 0.50 to 8.58 and RR 0.85, 95% CI 0.44 to 1.65, respectively). Subgroup analyses for in-hospital mortality were carried out for region and risk of bias rating, giving p=0.85 and p=0.54 for heterogeneity, respectively.</p><p><strong>Conclusions: </strong>The estimated effect of using IVR versus OR in children with SAM with severe dehydration ranges from a 54% relative reduction to a 10% relative increase in the risk of death, with IVR resulting in fewer adverse events.</p><p><strong>Prospero registration number: </strong>CRD42025637956.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"866-872"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980237","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":"Air pollution and lung growth: the CHILL study.","authors":"","doi":"10.1136/archdischild-2026-331529","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331529","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"111 10","pages":"923"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001161","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":"Point-of-care decision rule for antibiotic prescriptions in young children with fever without source: an open cluster randomised trial.","authors":"David Malorey, Elsa Tavernier, Anne Drouard, Bénédicte Vrignaud, Marion Bailhache, Gael Guyon, Luigi Titomanlio, Camille Bréhin, Lydie Abalea, Alain Gervaix, Romain Basmaci, François Dubos, Antoine Tran, Marie Desgranges, Elise Launay, Christele Gras-Leguen","doi":"10.1136/archdischild-2025-329438","DOIUrl":"10.1136/archdischild-2025-329438","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether a point-of-care decision rule could safely reduce antibiotic prescriptions in children presenting with fever without source in emergency departments.</p><p><strong>Design: </strong>Open cluster randomised clinical trial (registered on ClinicalTrials.gov).</p><p><strong>Setting: </strong>Twenty-five European paediatric emergency departments participated from November 2018 to October 2021.</p><p><strong>Patients: </strong>Children aged 6 days to 36 months presenting with acute fever without source.</p><p><strong>Interventions: </strong>During the first year, all centres (or clusters) followed their usual care protocols. In the second year, centres were randomised 1:1 to either continue usual care or to adopt the decision rule based on age, clinical symptoms, urine analysis and point-of-care procalcitonin measurements. In the third year, all centres applied the decision rule.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was antibiotic exposure within 15 days. Secondary outcomes included morbidity and mortality assessed at day 15.</p><p><strong>Results: </strong>Among 4882 children (median age: 3 months, IQR 1-14), 2440 were in the usual care group and 2442 in the decision rule group. Serious bacterial infections occurred in 766 (15.7%) children, and invasive bacterial infections in 67 (1.4%). In the intention-to-treat analysis, 927 children (38.0%) received antibiotics within 15 days in the usual care group, compared with 641 (26.2%) in the decision rule group (OR 0.57; 95% CI 0.43 to 0.75; p<0.001). Morbidity and mortality rates were similar between groups (OR 0.83; 95% CI 0.57 to 1.22; p=0.34).</p><p><strong>Conclusions: </strong>The decision rule safely reduced unnecessary antibiotic use in young children with fever without source in emergency departments.</p><p><strong>Trial registration number: </strong>NCT03607162.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"858-865"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773267","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":"Semaglutide for obesity: a pill for every ill?","authors":"John Wl Puntis","doi":"10.1136/archdischild-2025-330170","DOIUrl":"10.1136/archdischild-2025-330170","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"838-839"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589592","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":"Infants at highest risk of herpes simplex virus disease who should start immediate empiric aciclovir.","authors":"Hermione Lyall","doi":"10.1136/archdischild-2025-329371","DOIUrl":"10.1136/archdischild-2025-329371","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"834-835"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275602","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":"Rethinking school absence: from individual diagnosis to population prevention.","authors":"Catherine Falconer","doi":"10.1136/archdischild-2025-330243","DOIUrl":"10.1136/archdischild-2025-330243","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"836-837"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147368880","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":"Harnessing real-world evidence in paediatric randomised controlled trials.","authors":"Ramiyya Tharumakunarajah, Nicola L Harman, Susanna Dodd, Yusupha Sinjanka, Helen Nabwera, Olufemi Olajide, Ian P Sinha","doi":"10.1136/archdischild-2025-329766","DOIUrl":"10.1136/archdischild-2025-329766","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"831-833"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058983","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":"Wrongful birth: basing choice on information.","authors":"Robert Wheeler","doi":"10.1136/archdischild-2025-330130","DOIUrl":"10.1136/archdischild-2025-330130","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"854-855"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969757","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":"Exophytic gingival lesion in a paediatric patient post-haematopoietic stem cell transplant.","authors":"Hoda Tayebi-Hillali, Lucía García-Caballero, Sheila Torrado González, Pedro Diz-Dios, Márcio Diniz-Freitas","doi":"10.1136/archdischild-2026-331301","DOIUrl":"https://doi.org/10.1136/archdischild-2026-331301","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":"149001136","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}