Table of contents

February 2022 - Volume 107 - 2





Clinical law for clinical practice

Paediatric emergency medicine

  • Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study (22 June, 2021)
    Nienke N Hagedoorn, Joany M Zachariasse, Dorine Borensztajn, Elise Adriaansens, Ulrich von Both, Enitan D Carrol, Irini Eleftheriou, Marieke Emonts, Michiel van der Flier, Ronald de Groot, Jethro Adam Herberg, Benno Kohlmaier, Emma Lim, Ian Maconochie, Federico Martinón-Torres, Ruud Gerard Nijman, Marko Pokorn, Irene Rivero-Calle, Maria Tsolia, Dace Zavadska, Werner Zenz, Michael Levin, Clementien Vermont, Henriette A Moll

    EU multicentre ED study of presenting vital signs in >5000 febrile children with an association between "shock index" and serious illness, but low sensitivity limits utility in screening.

Original research

  • Food protein-induced enterocolitis syndrome in the British Isles (26 August, 2021)
    Gary Stiefel, Cherry Alviani, Nadeem A Afzal, Aideen Byrne, George du Toit, Audrey DunnGalvin, Jonathan Hourihane, Nicola Jay, Louise Jane Michaelis, Michel Erlewyn-Lajeunesse

    Using data obtained through the BPSU, Stiefel et al report the incidence of Food Protein-induced Enterocolitis Syndrome (FPIES) in 2019 in UK, and suggest there may be significant under-recognition of this type of food allergy.

  • Low-level laser therapy for oral mucositis in children with cancerEditor's Choice (6 July, 2021) Free
    Melody Grace Redman, Katherine Harris, Bob S Phillips

    A meta-analysis and systematic review of safety and efficacy of using low-level laser therapy for oral mucositis in paediatric cancer patients - as the title says. Looks promising but more data are required regarding efficacy, and the availability and cost of such an approach.

  • Mental healthcare for children with chronic conditions: a qualitative study (21 June, 2021)
    Renee Jones, Harriet Hiscock, Danielle Wurzel, Kung-Ting Kao, Jeremy L Freeman, Jemimah Ride

    Parents of children with chronic illness want paediatricians to proactively discuss mental health issues when physical illness is being reviewed in clinic. they also identified barriers to accessing mental health services in this qualitative study.

  • Prevalence of monogenic disease in paediatric patients with a predominant respiratory phenotype (16 June, 2021)
    Dan Dai, Mei Mei, Liyuan Hu, Yun Cao, Xiaochuan Wang, Libo Wang, Yulan Lu, Lin Yang, Xinran Dong, Huijun Wang, Bingbing Wu, Liling Qian

    This manuscript reports on the prevalence and clinical characteristics of monogenic disease in paediatric patients with a predominant respiratory phenotype. And that exam sequencing is a valuable tool for this with 140 positive cases in a cohort of 971.

  • Smartphone videos to predict the severity of obstructive sleep apnoea (8 July, 2021)
    Rahul J Thomas, Samuel Dalton, Katharine Harman, Julie Thacker, Rosemary S C Horne, Margot J Davey, Gillian M Nixon

    Smartphones are increasingly used by parents to capture their child's abnormal respiratory sounds. This study suggests these videos may be useful as a screening tool for obstructive sleep apnoea and deciding which children should have polysomnography

  • Childhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from Norway, Australia and Canada (29 June, 2021)
    Laura L Oakley, Annette K Regan, Deshayne B Fell, Sarah Spruin, Inger Johanne Bakken, Jeffrey C Kwong, Gavin Pereira, Natasha Nassar, Kari M Aaberg, Allen J Wilcox, Siri E Håberg

    This registry based study demonstrates a link between seizures in childhood and prenatal exposure to maternal influenza. This relationship was strong for febrile seizures, but not statistically significant for children with epilepsy.

  • Prediagnosis pathway benchmarking audit in patients with Duchenne muscular dystrophy (8 July, 2021)
    Vasantha Lakshmi Gowda, Miguel Fernandez, Manish Prasad, Anne-Marie Childs, Imelda Hughes, Sandya Tirupathi, Christian Gaudentius Engelbert Lourens De Goede, Declan O’Rourke, Deepak Parasuraman, Tracey Willis, Samira Saberian, Ian Davidson

    General paediatricians are getting better at diagnosing DMD but need to be aware of the more subtle symptoms of DMD and diagnose it earlier be aware of the rarer presentations.


  • Bibliography of published COVID-19 in children literature (6 May, 2021)
    Philippa Anna Stilwell, Alasdair P. S. Munro, Emre Basatemur, Nishanthi Talawila Da Camara, Rachel Harwood, Damian Roland

    A paper that describes the dynamic changes in global volume of literature relating to Covid-19 in children and young people published over the first six months of the pandemic. Two thirds of all papers published described just nine patients or fewer.

  • Childhood acute respiratory illnesses: will normal inadequate services be resumed? (8 January, 2021)
    Prasad Nagakumar, Andrew Bush, Atul Gupta
  • Retinal nerve fibre layer and ganglion cell layer changes in children who recovered from COVID-19: a cohort study (2 August, 2021)
    Barbara Burgos-Blasco, Noemi Güemes-Villahoz, Laura Morales-Fernandez, Ignacio Callejas-Caballero, Pilar Perez-Garcia, Juan Donate-Lopez, Jose Tomas Ramos-Amador, Julian Garcia-Feijoo

    We still have much to learn about the longer term effects on children of Covid19 infection. In this report, abnormalities in the retina of children with proven Covid19 infection are identified, though in the absence of any clear visual problems, adding the visual system to the list of systems potentially requiring long term monitoring following infection with this virus.

  • New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic (27 May, 2021)
    Heli Salmi, Santtu Heinonen, Johanna Hästbacka, Mitja Lääperi, Paula Rautiainen, Päivi J Miettinen, Olli Vapalahti, Jussi Hepojoki, Mikael Knip

    A Finnish retrospective cohort study of two datasets: children with Type 1 diabetes (T1D) admitted to PICU and children with T1D registered to the Finnish Pediatric Diabetes Registry. They found that more children with T1D had severe DKA at diagnosis during the pandemic. This stems from delay in presentation and diagnosis rather than a consequence of SARS-CoV-2 infection.

  • COVID-19 in children with haematological malignancies (22 July, 2021)
    Gerard Cathal Millen, Roland Arnold, Jean-Baptiste Cazier, Helen Curley, Richard Feltbower, Ashley Gamble, Adam Glaser, Richard G Grundy, Laura Kirton, Lennard Y W Lee, Martin G McCabe, Claire Palles, Bob Phillips, Charles A Stiller, Csilla Varnai, Pamela Kearns

    Children have a very low risk of developing severe SARS-CoV-2 infections. Early in the pandemic it became clear from the experiences in China, Italy and Spain that this was also true for children with cancer. Not so for adult patients particularly those with haematological malignancies who were considered to be 'extremely vulnerable'. The recommendation however, from the UK's national Childhood Cancer and Leukaemia group (CCLG) in 2020 was that, other than particularly high risk patients (those with multiply relapsed disease or undergoing bone marrow transplant or CAR-T therapy) children with cancer, including those with haematological malignancies, need not be considered extremely vulnerable. This clearly written, concise paper by Millen et al compares patients with haematological and non-haematological malignancies enrolled on the UK Paediatric Coronavirus Cancer Monitoring Project from March 2020 until Feb 2021 and supports that recommendation.

  • Feasibility and parental perception of home sleep studies during COVID-19: a tertiary sleep centre experience (22 September, 2021)
    Susan Jones, Ross Hanwell, Tharima Chowdhury, Jane Orgill, Kirandeep van den Eshof, Michael Farquhar, Desaline Joseph, Paul Gringras, Federica Trucco