Table of contents
March 2022 - Volume 107 - 3
Atoms
- Highlights from this issue (17 February, 2022)
Editorials
- Paediatric emergency medicine (10 December, 2021)
Viewpoint
- Lethality of racism for Black children in the USA: a primer (8 January, 2021)
Covid-19
- Post-COVID economic recovery: women and children first … or last? (27 January, 2021)
Reviews
- Diagnosis and management of multiple sclerosis and other relapsing demyelinating disease in childhood (6 July, 2021)
Paper explores the diagnosis of MS (multiple sclerosis) in children and the latest management plans for the different types. A practical and applied approach.
- Future of machine learning in paediatrics (22 July, 2021)
Summary of the potential role of Artificial intelligence in management of childhood disease.
Paediatric emergency medicine
- Improving triage for children with comorbidity using the ED-PEWS: an observational study (21 July, 2021)
Through a secondary analysis, the authors assessed the value of the ED-Pediatric Early Warning Score (ED-PEWS) for triage of children with comorbidity. They found that ED-PEWS has a similar performance in children with and without comorbidity and improved triage in most cases.
- Interventions to reduce acute paediatric hospital admissions: a systematic review (2 August, 2021)
Systematic review of interventions and strategies aimed at preventing hospital admission among children and young people finds limited evidence to support their use.
Global child health
- Neurodevelopment in normocephalic children with and without prenatal Zika virus exposure (3 September, 2021)
A follow up study of infants born to mothers with pregnancy exposure to Zika virus showed infants who had been exposed to Zika virus but who had a normal head circumference had overall normal development, but all such Zika virus infants should undergo formal visual testing.
- Lead screening in children presenting to three hospitals in Lebanon (24 August, 2021)
This study in three hospitals in Lebanon studied blood lead levels in 90 children the mean blood lead level was 1.05 μg/dL. All values were below 5.0 μg/dL, a marked decrease compared to before a national ban on leaded gasoline in 2002. The study identified risk factors for higher blood lead levels, including living in a house aged 40 years or more, receiving traditional remedies, and a lower household income.
Original research
- Mucositis reduction with probiotics in children with cancer: a randomised-controlled feasibility study
(30 June, 2021)
This paper describes a feasibility study for an RCT of use of probiotics in reducing mucositis in paediatric cancer patients. It highlights the difficulties inherent in running an RCT of this nature in these patients.
- Inconsistencies in fertility preservation for young people with cancer in the UK (20 September, 2021)
This study highlights marked variation in provision and funding of fertility preservation services for children with cancer across the UK. Based on these findings, the authors argue that centralised NHS funding should be made available to ensure equitable provision of fertility preservation services and delivery of internationally acknowledged quality standards to all young people with cancer across the UK.
- Care bundles to reduce unplanned extubation in critically ill children: a systematic review, critical appraisal and meta-analysis (20 July, 2021)
Review to understand the evidence base for care bundles ie doing multiple improvements at once in children who are intubated to try and prevent unexpected extubation.
- Infant Escherichia coli urinary tract infection: is it associated with meningitis?(20 July, 2021)
Using a retrospective cohort design, the authors sought to determine the prevalence of co-existing bacterial meningitis in infants and young children in the presence of Escherichia coli urinary tract infection. In 314 patients with UTI and an LP performed, no cases of co-existing E. coli meningitis were identified.
- Palliative care for children with complex cardiac conditions: survey results (26 July, 2021)
There is perceived underutilisation of palliative care practitioners in UK paediatric cardiac care. This 2018 UK wide e-survey explores this, confirms it & suggests a more integrated approach with increased training of cardiac practitioners & more embedded palliative care practitioners, before end of life if at all possible.
- School academic performance of children hospitalised with a chronic condition (2 September, 2021)
This population-based cohort study using health administrative data examined academic performance in children with chronic conditions who were hospitalised. Compared to children who were not hospitalised, children hospitalized with a chronic condition underperformed in literacy and numeracy domains in grades 3, 5, and 7. A greater number of bed days or hospitalisations was associated with poorer academic performance.
Advocacy
- COVID-19 pandemic: health inequities in children and youth (11 February, 2021)
Voices
Archimedes
- Towards evidence-based medicine for paediatricians (17 February, 2022)
- Can diaphragmatic ultrasound be used to predict extubation failure? (8 November, 2021)
PostScript
Miscellanea
- Archivist: More on community acquired pneumonia: antibiotic resistance (17 February, 2022)
- Images in paediatrics: Severe acquired purpura fulminans in a child (20 August, 2021)
- Lucina: Highlights from the literature (17 February, 2022)
Electronic pages
- Should children be vaccinated against COVID-19? (3 November, 2021)
- Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study (8 July, 2021)
This single centre cohort study identifies clinical and laboratory findings that distinguish multisystem inflammatory syndrome in children (MIS-C) from other febrile illnesses in which MIS-C was considered but ultimately excluded. The most discriminative features of MIS-C included older age, conjunctivitis, oral mucosa changes, abdominal pain and hypotension, higher neutrophil/lymphocyte ratios and lower platelet counts.
- Impact of the COVID-19 pandemic on routine childhood immunisation in Colombia (20 July, 2021)
This population-based study showed that during the first six months of the COVID-19 pandemic, there was a 14% absolute reduction in early childhood immunizations among Columbian children compared to the same period during 2019. Children living in rural regions of Columbia were disproportionately affected.
- Learning lessons from the paediatric critical care response to the SARS-CoV-2 pandemic in England and Wales: a qualitative study (20 August, 2021)
Paediatric critical care response to the SARS-CoV-2 pandemic, what can we learn from the clinical leaders?
- Examining the interseasonal resurgence of respiratory syncytial virus in Western Australia (25 August, 2021)
Lockdowns associated with the COVID-19 pandemic have led to an unusual epidemiology for common childhood respiratory pathogens. In this paper, the epidemiology and clinical characteristics of summertime RSV infection in Western Australia are described.
- Final warning on the need for integrated care systems in acute paediatrics (16 September, 2021)
- Letter: Call for a universal PIMS-TS/MIS-C case definition (8 October, 2021)
- COVID-19 interventions in children: a balancing act (21 October, 2021)
- NHS 111 Clinical Assessment Services: paediatric consultations (25 October, 2021)
- Paediatric NHS 111 Clinical Assessment Services pilot: an observational study (7 December, 2021)
A paper highlighting the impact of volunteer Paediatric clinicians working within 111 during the initial pandemic in 2020. It highlights lower refferal onwards rates & higher proportions of patients/carers reporting that their problem was fully resolved.
- COVID-19 and delivery of difficult asthma services (2 November, 2021)
- Paediatric tic-like presentations during the COVID-19 pandemic (25 November, 2021)
- Ethical advice in paediatric care (29 November, 2021)
- Waning infant pertussis during COVID-19 pandemic (2 December, 2021)
Measures to prevent the spread of COVID-19 have also reduced other respiratory viral infections in children. This study from Sewden found that the number of infant pertussis infections also fell during the COVID-19 pandemic. The authors discuss the implications of this finding.
- SARS-CoV-2 transmission in schools in Korea: nationwide cohort study (2 December, 2021)
What role do schools play in transmitting COVID-19? This national study from Korea finds few children caught COVID-19 in school, most acquired it from household transmission. The authors discuss whether school closures are a useful way to interrupt COVID-19 transmission.
- Acute kidney injury in paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is not associated with progression to chronic kidney disease (3 December, 2021)
Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (also known as MIS-C) was first described just over one year ago. Data on morbidity and outcome are needed. Acute Kidney Injury occurred in 30% of children in this cohort, but all recovered.
- Child mortality in England during the first year of the COVID-19 pandemic (6 December, 2021)
Using data from the National Child Mortality Database, associations between deaths during and before the pandemic were explored.
- Impact of COVID-19 on carers of children with tracheostomies (9 December, 2021)
For those with complex care needs the challenges of Covid-19 have been heightened. Caregivers of children with tracheostomies describe the pressures placed on trust, communication and relationships and the challenges of delivering family centred care.