Online First

August 24, 2021

  • Original research
    Lead screening in children presenting to three hospitals in Lebanon
    Tharwat El Zahran, Hala Mostafa, Hani Hamade, Moustafa Al Hariri, Aed Saab, Hani Tamim, Rasha Tohme, Dany A Al Hamod, Durriyah Sinno, Rasha Dorothy Sawaya, Ziad Kazzi

    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.

August 23, 2021

August 20, 2021

August 19, 2021

August 18, 2021

August 02, 2021

July 27, 2021

July 26, 2021

  • Original research
    Palliative care for children with complex cardiac conditions: survey results
    Sidharth Vemuri, Ashleigh E Butler, Katherine Brown, Jo Wray, Myra Bluebond-Langner

    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 report
    COVID-19 in children with haematological malignancies
    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.

  • Letter
    Rise in children presenting with periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome during the COVID-19 pandemic
    Free
    Khuen Foong Ng, Joseph Morgan, Thomas Cutts, Isabel Duncan, Marion Roderick, Athimalaipet Ramanan, Anu Goenka
  • Voices
    What a birth mother wants paediatricians to know about diagnosing a fetal alcohol spectrum disorder
    Vincent Smith, Kenneth Jones
  • Review
    Future of machine learning in paediatrics
    Sarah LN Clarke, Kevon Parmesar, Moin A Saleem, Athimalaipet V Ramanan

    Summary of the potential role of Artificial intelligence in management of childhood disease.

  • Viewpoint
    From crisis to opportunity: parents and schools can come together to prioritise student health and well-being
    Free
    Christopher Bonell, Neisha Sundaram, Russell M Viner

July 21, 2021

July 20, 2021

  • Original research
    Care bundles to reduce unplanned extubation in critically ill children: a systematic review, critical appraisal and meta-analysis
    Paulo Sergio Lucas da Silva, Maria Eunice Reis, Daniela Farah, Teresa Raquel M Andrade, Marcelo Cunio Machado Fonseca

    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 research
    Impact of the COVID-19 pandemic on routine childhood immunisation in Colombia
    Free
    Jose Moreno-Montoya, Silvia Marcela Ballesteros, Jaid Constanza Rojas Sotelo, Clara Lucia Bocanegra Cervera, Pedro Barrera-López, José A De la Hoz-Valle

    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 research
    Infant Escherichia coli urinary tract infection: is it associated with meningitis?
    Aisling Rafferty, Richard J Drew, Robert Cunney, Désirée Bennett, John Francis Marriott

    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

July 13, 2021

  • Quality improvement
    Impact of a standardised parenteral nutrition protocol: a quality improvement experience from a NICU of a developing country
    Gul Ambreen, Vikram Kumar, Syed Rehan Ali, Uswa Jiwani, Waqar Khowaja, Ali Shabbir Hussain, Kashif Hussain, Syed Shamim Raza, Arjumand Rizvi, Uzair Ansari, Khalil Ahmad, Simon Demas, Shabina Ariff

    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

July 08, 2021

  • Original research
    Prediagnosis pathway benchmarking audit in patients with Duchenne muscular dystrophy
    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.

  • Original research
    Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study
    Free
    Jordan E Roberts, Jeffrey I Campbell, Kimberlee Gauvreau, Gabriella S Lamb, Jane Newburger, Mary Beth Son, Audrey Dionne

    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 research
    Smartphone videos to predict the severity of obstructive sleep apnoea
    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

  • Voices
    Being a personal health budget holder: becoming a ‘professional parent’
    Kate Woodthorpe

July 06, 2021

July 02, 2021

June 30, 2021

June 29, 2021

  • Original research
    Shock Index in the early assessment of febrile children at the emergency department: a prospective multicentre study
    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 On behalf of the PERFORM consortium

    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
    Childhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from Norway, Australia and Canada
    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.

June 28, 2021

June 22, 2021

  • Short report
    Delivering tertiary tuberculosis care virtually
    Louise Turnbull, Christine Bell, Stefanie Davies, Fran Child

    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.

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