Archives of Disease in Childhood最新文献

{"title":"Positive parenting and obesity: the INSIGHT study.","authors":"","doi":"10.1136/archdischild-2025-329645","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329645","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 10","pages":"804"},"PeriodicalIF":3.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084892","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":"Consensus statement on the need for a specialist service for paediatric saliva control in neurodevelopmental disabilities.","authors":"Charlie Fairhurst, Belinda Crowe, Katherine Martin, Sarah O'Donnell, Lakhbinder Pabla, Ravi Sharma, Paul Nixon, Vijay Santhanam, Claire McLarnon, Vijay Palanivel, Anne Breaks, Apostolos Papandreou","doi":"10.1136/archdischild-2025-329098","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329098","url":null,"abstract":"<p><p>Poor saliva control (sialorrhoea) represents a considerable burden to paediatric patients with neurodevelopmental disabilities, contributing significantly to both physical and psychological problems. Despite a significant proportion of paediatric patients with cerebral palsy (up to ~44%) and other neurological conditions suffering from sialorrhoea, no coordinated pathways for specialist clinics exist on a formal basis within the NHS.Several management strategies exist, ranging from conservative measures, enteral and transdermal medications, intraglandular botulinum toxin injections through to glandular and/or ductal surgery. Anti-cholinergic medications such as glycopyrronium bromide and transdermal hyoscine hydrobromide are effective but have frequent adverse effects, meaning they are unsuitable or contraindicated in some patients. More invasive procedures, such as intraglandular botulinum toxin injections and surgical interventions, are highly effective but require specialist clinics in a controlled setting.Therefore, a specialist interest group was set up to agree recommendations for equitable service delivery in line with current literature and recommendations from the National Institute for Health and Care Excellence and the American Academy for Cerebral Palsy and Developmental Medicine in order to address this current unmet need. The results of these recommendations are reported here.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079504","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":"Breast milk and eye discharge: practical advice, or old wives tale?","authors":"Sam Millar, Matthew Jones, Sebastian Jason Gray","doi":"10.1136/archdischild-2025-329203","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329203","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079534","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":"Child death in the emergency department: experience from a 10-year retrospective review.","authors":"Pamela Jump, Bethany McDermott, Clarissa Chase, Kate Pryde, Daniel R Owens","doi":"10.1136/archdischild-2025-329375","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329375","url":null,"abstract":"<p><strong>Objective: </strong>To describe the demographic characteristics, causes and temporal patterns of child deaths occurring in a paediatric emergency department (ED) over a 10-year period.</p><p><strong>Design: </strong>Single-centre retrospective observational study.</p><p><strong>Setting: </strong>A major trauma centre in the UK with a standalone paediatric ED.</p><p><strong>Patients: </strong>58 children aged 0-17 years who died in the ED or were brought in dead between January 2014 and December 2023.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>Causes of death, demographics, seasonal and diurnal variation, parental presence and safeguarding concerns.</p><p><strong>Results: </strong>Median age at death was 2 years. The highest proportion of deaths occurred among infants under 1 year (36%) and adolescents aged 13-17 years (31%). Leading causes of death included sudden unexpected deaths (26%), infections (24%) and acute medical or surgical conditions (16%). Overall mortality was highest during winter months (29%), notably due to infections (50% of infection-related deaths). Sudden unexpected deaths showed clear early morning peaks, with 40% occurring between 04:00 and 07:59. Adolescents (13-17 years) represented 31% of deaths, predominantly due to infections and suicide or self-harm. Parental presence during resuscitation was high (83%). Prior safeguarding concerns were documented in 28% of cases, rising to 100% in deaths due to inflicted injury or abuse.</p><p><strong>Conclusions: </strong>Child deaths in the ED present distinct patterns differing from national childhood mortality statistics, emphasising sudden and acute conditions. Recognising these unique characteristics can guide improvements in clinical practice, ED-specific bereavement support, targeted staff training and resource allocation for periods of highest risk.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074438","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":"Best interests: the domain of the living.","authors":"Robert Wheeler","doi":"10.1136/archdischild-2025-329264","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329264","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063451","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":"Neurodevelopmental differences and adversity in children with extreme amounts of excess weight.","authors":"Elaine Burfitt","doi":"10.1136/archdischild-2025-328844","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328844","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063436","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":"Validating the PECARN rule to identify febrile infants at low risk of serious bacterial infections: an international validation study.","authors":"Ioannis Orfanos, Sanne Vrijlandt, Eline van der Walle, Chantal D Tan, Daan Nieboer, Tobias Alfvén, Jorge Sotoca Fernandez, Matilda Elliver, Kristina Elfving, Federico Martinón-Torres, Benno Kohlmaier, Werner Zenz, Marieke Emonts, Ruud Gerard Nijman, Enitan Carrol, Erik Eklund, Henriette A Moll, Rianne Oostenbrink","doi":"10.1136/archdischild-2024-328246","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328246","url":null,"abstract":"<p><strong>Objective: </strong>To externally validate the Paediatric Emergency Care Applied Research Network (PECARN) rule for identifying febrile infants aged <60 days at low risk of serious bacterial infections (SBIs) and assess the utility of the rule with C reactive protein (CRP) instead of procalcitonin (PCT).</p><p><strong>Methods: </strong>Secondary analysis of data from the Management and Outcomes of Fever in Children in Europe (MOFICHE) study (12 paediatric emergency departments in eight European countries, January 2017 to April 2018) and a Swedish study (four paediatric emergency departments, January 2014 to December 2020). Previously healthy febrile infants aged ≤60 days were included. We validated the original PECARN rule in a Swedish subcohort (2018-2020) and explored an adapted version using CRP in the full Swedish and MOFICHE cohorts.</p><p><strong>Results: </strong>The Swedish subcohort (2018-2020) included 536 febrile infants with an SBI prevalence of 11%. The original PECARN rule showed a sensitivity of 96.6% (95% CI 88.1 to 99.6), specificity of 61.9% (95% CI 57.4 to 66.3), negative predictive value (NPV) of 99.3% (95% CI 97.4 to 99.8) and positive predictive value (PPV) of 23.5% (95% CI 21.4 to 25.8). The full Swedish cohort (2014-2020) included 2237 infants and the MOFICHE cohort of 512 infants with 12% and 10% SBI prevalence, respectively. Using CRP <20 mg/L instead of PCT, the adapted PECARN rule showed a sensitivity of 97.8% and NPV of 99.4% in the Swedish cohort, and sensitivity of 92.2% with an NPV of 98.3% in the MOFICHE cohort.</p><p><strong>Conclusions: </strong>The PECARN rule demonstrated high NPV (similar to the derivation cohort) and high potential in ruling out SBIs in two new European cohorts. The rule maintained good performance with CRP instead of PCT, supporting the potential use of CRP in settings where PCT is unavailable.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032704","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":"Massive transfusion protocols: do they have a role in neonatal intensive care units?","authors":"Louise Guolla, Connie Williams, Anthony K Chan, Mary Woodward","doi":"10.1136/archdischild-2025-329130","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329130","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032645","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":"A vaccine emergency-when to overrule parental refusal of vaccination at birth for prevention of vertical transmission of hepatitis B virus?","authors":"Robindra Basu Roy, Stephane Paulus, Dominic F Kelly, Harpreet Brrang, Alison Taylor, Gareth Tudor-Williams, Eleni Nastouli, Ashis Banerjee, Marieluise Horne, Edward P K Parker, Ahmed ElSharkawy, Sema Mandal, Mary Elizabeth Ramsay, Andrew J Pollard, Julian Savulescu, Dominic Wilkinson","doi":"10.1136/archdischild-2025-328641","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328641","url":null,"abstract":"<p><p>Hepatitis B virus (HBV) is a potentially chronic infection that can be transmitted from mother to child with the risk of developing cirrhosis, liver failure and hepatocellular carcinoma. There is a safe and effective vaccine to prevent vertical transmission that is recommended to be given as soon as possible after birth and within 24 hours.When a woman with HBV refuses the birth dose of HBV vaccine for her baby, infectious diseases and safeguarding teams are asked to provide urgent opinions on whether this crosses the threshold for triggering child protection mechanisms.We consider a low-infectivity HBV vertical transmission scenario where there is parental refusal of HBV vaccination and focus on ethical arguments for and against overruling parental refusal in the child's best interests. As an additional resource for clinical and safeguarding teams, we also include the anonymised transcript of the only available UK court judgement to our knowledge that addresses the issue of decline of HBV vaccine to prevent vertical transmission.We propose a dialogue process for managing scenarios where a pregnant woman with HBV has concerns about vaccinating her baby when born, which is the basis of the current UK Health Security Agency guidance.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022772","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":"New dosing regimen of oral iron for iron deficiency anaemia in children.","authors":"David Tuthill, Neil A Caldwell, Paula Sutton, Leah Hamilton, Jean MacKershan, Mark P Tighe","doi":"10.1136/archdischild-2025-329389","DOIUrl":"https://doi.org/10.1136/archdischild-2025-329389","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005810","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}