August 04, 2021
August 02, 2021
- Original researchRetinal nerve fibre layer and ganglion cell layer changes in children who recovered from COVID-19: a cohort study
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.
- Original researchInterventions to reduce acute paediatric hospital admissions: a systematic review
Systematic review of interventions and strategies aimed at preventing hospital admission among children and young people finds limited evidence to support their use.
July 27, 2021
July 26, 2021
- Original researchPalliative care for children with complex cardiac conditions: survey results
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.
July 22, 2021
- Short reportCOVID-19 in children with haematological malignancies
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.
- ReviewFuture of machine learning in paediatrics
Summary of the potential role of Artificial intelligence in management of childhood disease.
July 21, 2021
- Original researchImproving triage for children with comorbidity using the ED-PEWS: an observational study
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.
July 20, 2021
- Original researchCare bundles to reduce unplanned extubation in critically ill children: a systematic review, critical appraisal and meta-analysis
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.
- Original researchImpact of the COVID-19 pandemic on routine childhood immunisation in Colombia
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.
- Original researchInfant Escherichia coli urinary tract infection: is it associated with meningitis?
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.
July 19, 2021
July 16, 2021
July 15, 2021
- Short reportPaediatric headbox as aerosol and droplet barrier
- ReviewEvidence-based practice in cognitive–behavioural therapy
Exploring and explaining the evidence for cognitive behavioural therapies in children and young people.
July 13, 2021
- Quality improvementImpact of a standardised parenteral nutrition protocol: a quality improvement experience from a NICU of a developing country
Standardised parenteral nutrition formulations are widely used in neonatal intensive care for convenience and safety. This retrospective investigation compares individualised versus standardised feeds in a LMIC setting, in the context of a a quality improvement study. Use of standardised feeds made on site was a feasible alternative to individualised prescription.
July 09, 2021
- Original researchPierre Robin sequence causes position-dependent obstructive sleep apnoea in infants
Obstructive sleep apnoea is common in babies with Pierre-Robin sequence. In the majority of babies, side and prone positioning can alleviate the degree of OSA without the need for further intervention.
- Original researchSocial and ethnic group differences in healthcare use by children aged 0–14 years: a population-based cohort study in England from 2007 to 2017
Population-based retrospective cohort study using individual linked data from 2007 to 2017 show social and ethnic group differences in children’s use of healthcare services in England, with deprivation associated with higher emergency and lower scheduled care use.
- Original researchImplementing spirometry and fractional exhaled nitric oxide testing in childhood asthma management in UK primary care: an observational study to examine training and implementation cost and impact on patient’s health use and outcome
Is FeNO testing in primary care cost effective? Yesℏ The average training cost for the 27 primary care clinical members was £1,395. The average cost to implement and deliver the tests-guided asthma review among the 612 included children was £22.
July 08, 2021
- Original researchPrediagnosis pathway benchmarking audit in patients with Duchenne muscular dystrophy
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.
- Original researchDifferentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study
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.
- Original researchSmartphone videos to predict the severity of obstructive sleep apnoea
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
July 06, 2021
- Original researchLow-level laser therapy for oral mucositis in children with cancer
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.
- ReviewDiagnosis and management of multiple sclerosis and other relapsing demyelinating disease in childhood
Paper explores the diagnosis of MS (multiple sclerosis) in children and the latest management plans for the different types. A practical and applied approach.
July 02, 2021
June 30, 2021
- Original researchMucositis reduction with probiotics in children with cancer: a randomised-controlled feasibility study
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.
June 29, 2021
- Original researchShock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study
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 researchChildhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from Norway, Australia and Canada
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.
June 28, 2021
- Original researchPharmacokinetics and safety/tolerability of isoniazid, rifampicin and pyrazinamide in children and adolescents treated for tuberculous meningitis
Children with TB meningitis do poorly, and this paper examines the pharmacokinetics of a commonly used drug combination to understand if drug factors contribute.
June 22, 2021
- Short reportDelivering tertiary tuberculosis care virtually
A weekly virtual clinic with MDT discussion between between district paediatricians and a tertiary TB team showed that:45% children received care closer to home. Median time from presentation to treatment reduced by 28%. 21% more children diagnosed before developing symptoms.
June 21, 2021
- Original researchChild mortality in England during the COVID-19 pandemic
Child mortality was lower in 2020 than in 2019 . Older children and those from Black, Asian and minority ethnic groups were more likely to have a SARS-CoV-2 positive test.
- Original researchMental healthcare for children with chronic conditions: a qualitative study
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.
June 17, 2021
- Clinical law for clinical practiceProviding beds for children
- Original researchImpaired grip strength in children with congenital heart disease
Physical fitness is an important aspect of wellness. In 569 long term survivors of CHD surgery both grip strength & health-related physical fitness (a 5 parameter composite) were reduced but the reductions were unrelated. Grip strength is easily assessed but is not a surrogate for the more complex tool.
- Original researchListeria infection in young infants: results from a national surveillance study in the UK and Ireland
Who needs empirical treatment for Listeria infection? This national surveillance study found that invasive listeriosis in young infants in the UK and Ireland is rare and presented only in the neonatal period. Use of amoxicillin as part of empiric treatment for sepsis and meningitis in infants over 1 month of age may be unnecessary.
June 16, 2021
- Original researchPrevalence of monogenic disease in paediatric patients with a predominant respiratory phenotype
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.