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    23390 results match your criteria Archives of Disease in Childhood[Journal]

    1 OF 468

    Role of ECMO in congenital diaphragmatic hernia.
    Arch Dis Child Fetal Neonatal Ed 2017 Nov 14. Epub 2017 Nov 14.
    Paediatric Surgery, Royal Hospital for Sick Children Edinburgh, Edinburgh, UK.
    Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology and low preductal saturations despite optimal ventilatory and inotropic support may be considered for extracorporeal membrane oxygenation (ECMO). Systematic reviews into the benefits of ECMO in CDH concluded that any benefit is unclear. Read More

    Analysis of unsuccessful intubations in neonates using videolaryngoscopy recordings.
    Arch Dis Child Fetal Neonatal Ed 2017 Nov 10. Epub 2017 Nov 10.
    Newborn Research Centre, Royal Women's Hospital, Melbourne, Victoria, Australia.
    Objectives: Neonatal intubation is a difficult skill to learn and teach. If an attempt is unsuccessful, the intubator and instructor often cannot explain why. This study aims to review videolaryngoscopy recordings of unsuccessful intubations and explain the reasons why attempts were not successful. Read More

    Objective cardiovascular assessment in the neonatal intensive care unit.
    Arch Dis Child Fetal Neonatal Ed 2017 Nov 10. Epub 2017 Nov 10.
    Department of Neonatology, The Rotunda Hospital, Dublin, Ireland.
    Traditionally, cardiovascular well-being was essentially based on whether the mean blood pressure was above or below a certain value. However, this singular crude method of assessment provides limited insight into overall cardiovascular well-being. Echocardiography has become increasingly used and incorporated into clinical care. Read More

    Individualised advance care planning in children with life-limiting conditions.
    Arch Dis Child 2017 Nov 10. Epub 2017 Nov 10.
    Department of Pediatrics, University of Groningen, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands.
    Introduction: In 2013, the Pediatric Association of the Netherlands launched an evidence-based guideline 'Palliative care for children'. To promote implementation in daily practice and hereby improve quality of paediatric palliative care, we aimed to develop a functional individualised paediatric palliative care plan (IPPCP) that covers physical, psychological, spiritual and social functioning, with great emphasis on the guideline's recommendations, advance care planning and patients' and parents' preferences and desires.

    Methods: A Dutch working group (28 individuals) with a strong multidisciplinary character developed a draft IPPCP, which was piloted retrospectively and prospectively. Read More

    Fifteen minute consultation: a child with a suspected drug allergy.
    Arch Dis Child Educ Pract Ed 2017 Nov 9. Epub 2017 Nov 9.
    Department of Paediatric Allergy, School of Medical Education, University of Newcastle, Newcastle, Newcastle upon Tyne, UK.
    Adverse drug reactions are common in children, but true drug allergy is rare. It can be difficult to determine whether signs such as skin rashes are caused by the underlying illness or medications prescribed. Accurate diagnosis is important for patient safety and optimal treatment. Read More

    Fifteen-minute consultation: liver disease in children.
    Arch Dis Child Educ Pract Ed 2017 Nov 9. Epub 2017 Nov 9.
    Paediatric Liver, GI and Nutrition Centre and MowatLabs, King's College London School of Medicine at King's College Hospital London, London, UK.
    Liver disease in children can present in many ways from the frequently encountered prolonged neonatal jaundice to the comparatively rare acute liver failure. In this article, we will discuss 'red flags' of liver disease, the initial investigations required and when to refer to a specialist liver centre. Across all presentations, the degree of elevation of alanine aminotransferase or aspartate aminotransferase provides only little diagnostic information. Read More

    Retrospective cohort analysis on pancreatic enzyme substitution in very low birthweight infants with postnatal growth failure.
    Arch Dis Child Fetal Neonatal Ed 2017 Nov 9. Epub 2017 Nov 9.
    Department of Neonatology, Center for Pediatric Clinical Studies, University Children's Hospital, Tuebingen, Germany.
    Objective: To evaluate the effects of pancreatic enzyme substitution (PES) in selected very low birthweight (VLBW) infants with poor postnatal growth despite intensified nutritional support.

    Design: Retrospective historic cohort study with matched controls.

    Setting: Single level III neonatal intensive care unit. Read More

    Referrals to a perinatal specialist palliative care consult service in Ireland, 2012-2015.
    Arch Dis Child Fetal Neonatal Ed 2017 Nov 9. Epub 2017 Nov 9.
    Paediatric Palliative Medicine, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
    Objective: To analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile.

    Design: A retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015.

    Setting: A consultant-led paediatric SPCS at Our Lady's Children's Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin. Read More

    Diagnostic accuracy of the D-dimer in children.
    Arch Dis Child 2017 Nov 8. Epub 2017 Nov 8.
    Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
    Background: We sought to measure the diagnostic accuracy of D-dimer in children with suspected pulmonary embolism (PE).

    Methods: We queried our electronic medical record for quantitative D-dimer values obtained in all children ages 5-17 over 10 years in our 10-hospital system. Patients who had a D-dimer obtained in the evaluation of PE underwent supervised chart review to extract baseline demographics (age, sex, ethnicity), medical history, laboratory data and imaging results. Read More

    Clinical characteristics of children evaluated for suspected pulmonary embolism with D-dimer testing.
    Arch Dis Child 2017 Nov 8. Epub 2017 Nov 8.
    Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
    Background: We sought to determine clinical variables in children tested for suspected pulmonary embolism (PE) that predict PE+ outcome for the development of paediatric PE prediction rule.

    Methods: Data were collected by query of a laboratory database for D-dimer from January 2004 to December 2014 for a large multicentre hospital system and the radiology database for pulmonary vascular imaging in children aged 5-17. Using explicit, predefined methods, trained abstractors, determined if D-dimer was sent in the evaluation of PE and then recorded predictor data which was tested for association with PE+ outcome using univariate techniques. Read More

    Clinical characteristics of children presenting with a suspicion or allegation of historic sexual abuse.
    Arch Dis Child 2017 Nov 7. Epub 2017 Nov 7.
    Department of Paediatrics, University College London Hospital, London, UK.
    Introduction: Police-recorded sexual offences against children and young people (CYP) increased 85% in the UK between 2010/2011 and 2014/2015. Many children delay disclosure, but little data are available regarding characteristics of CYP presenting with historic child sexual abuse (CSA).

    Aim: To identify the clinical and CSA-related characteristics of CYP presenting with a suspicion or allegation of historic CSA. Read More

    Cystic fibrosis newborn screening: outcome of infants with normal sweat tests.
    Arch Dis Child 2017 Nov 7. Epub 2017 Nov 7.
    Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.
    Newborn babies positively screened for cystic fibrosis (CF) (high serum immunoreactive trypsin (IRT) with DNA analysis) are referred for a diagnostic sweat test, which may be normal (sweat chloride <30 mmol/L). Unless two gene mutations are identified during Newborn screening (NBS), the babies are discharged from follow-up. We wished to check that none had subsequently developed symptoms suggestive of CF. Read More

    Evaluation of newborn sickle cell screening programme in England: 2010-2016.
    Arch Dis Child 2017 Nov 5. Epub 2017 Nov 5.
    School of Population Health and Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
    Objective: To evaluate England's NHS newborn sickle cell screening programme performance in children up to the age of 5 years.

    Design: Cohort of resident infants with sickle cell disease (SCD) born between 1 September 2010 and 31 August 2015 and followed until August 2016.

    Participants: 1317 infants with SCD were notified to the study from all centres in England and 1313 (99%) were followed up. Read More

    Oral injuries and occult harm in children evaluated for abuse.
    Arch Dis Child 2017 Nov 4. Epub 2017 Nov 4.
    Department of Emergency Medicine, University of Colorado School of Medicine, Seattle, Washington, USA.
    Objective: To determine the frequency of occult trauma in children with oral injury evaluated for physical abuse.

    Design: This was a retrospectively planned secondary analysis of a prospective, observational study.

    Setting: Emergency departments supported by 20 US child abuse teams in the Examining Siblings to Recognize Abuse (ExSTRA) network. Read More

    Early academic achievement in children with isolated clefts: a population-based study in England.
    Arch Dis Child 2017 Nov 2. Epub 2017 Nov 2.
    Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK.
    Objectives: We used national data to study differences in academic achievement between 5-year-old children with an isolated oral cleft and the general population. We also assessed differences by cleft type.

    Methods: Children born in England with an oral cleft were identified in a national cleft registry. Read More

    One-year outcomes following surgery for necrotising enterocolitis: a UK-wide cohort study.
    Arch Dis Child Fetal Neonatal Ed 2017 Nov 1. Epub 2017 Nov 1.
    National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
    Objective: The objective was to describe outcomes and investigate factors affecting prognosis at 1 year post intervention for infants with surgical necrotising enterocolitis (NEC).

    Design: Using the British Association of Paediatric Surgeons Congenital Anomalies Surveillance System, we conducted a prospective, multicentre cohort study of every infant reported to require surgical intervention for NEC in the UK and Ireland between 1 March 2013 and 28 February 2014. Association of independent variables with 1-year mortality was investigated using multivariable logistic regression analysis. Read More

    Comparative analysis of the scope of European Union paediatric investigation plans with corresponding orphan designations.
    Arch Dis Child 2017 Oct 31. Epub 2017 Oct 31.
    Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal.
    Background: Market forces may not be sufficient to stimulate research and development of medicines for small patient populations, such as children and patients with rare diseases. Both the European Union Orphan and Paediatric Regulations were introduced to address the unmet public health needs of these smaller patient populations through the use of incentives, rewards and obligations. Developers for new medicines for rare diseases must agree a paediatric investigation plan (PIP) or waiver with the European Medicines Agency's (EMA) Paediatric Committee (PDCO), and can also apply for an orphan designation (OD) from the EMA's Committee of Orphan Medicinal Products (COMP). Read More

    Diagnostic accuracy of three clinical dehydration scales: a systematic review.
    Arch Dis Child 2017 Oct 31. Epub 2017 Oct 31.
    Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.
    Objective: To systematically assess the diagnostic accuracy of the Clinical Dehydration Scale (CDS), the WHO Scale and the Gorelick Scale in identifying dehydration in children with acute gastroenteritis (AGE).

    Design: Three databases, two registers of clinical trials and the reference lists from identified articles were searched for diagnostic accuracy studies in children with AGE. The index tests were the CDS, WHO Scale and Gorelick Scale, and reference standard was the percentage loss of body weight. Read More

    Increasing admissions to paediatric intensive care units in England and Wales: more than just rising a birth rate.
    Arch Dis Child 2017 Oct 30. Epub 2017 Oct 30.
    Department of Health Sciences, University of Leicester, Leicester, UK.
    Objective: To determine the number of individual children admitted to Paediatric Intensive Care Units (PICUs) in England and Wales between 2004 and 2013 and to investigate potential factors for any change over time, including ethnicity.

    Methods: Anonymised demographic and epidemiological data were extracted from the Paediatric Intensive Care Audit Network (PICANet) database and analysed for all children resident in England and Wales admitted to PICUs of National Health Service (NHS) hospitals in those countries between 2004 and 2013. Population data, including births, were obtained from the Office of National Statistics and analysed. Read More

    Devices used for stabilisation of newborn infants at birth.
    Arch Dis Child Fetal Neonatal Ed 2017 Oct 27. Epub 2017 Oct 27.
    Department of Neonatology, James Cook University Hospital, Middlesbrough, UK.
    This review examines devices used during newborn stabilisation. Evidence for their use to optimise the thermal, respiratory and cardiovascular management in the delivery room is presented. Mechanisms of action and rationale of use are described, current developments are presented and areas of future research are highlighted. Read More

    Frequency, duration and cause of ventilator alarms on a neonatal intensive care unit.
    Arch Dis Child Fetal Neonatal Ed 2017 Oct 27. Epub 2017 Oct 27.
    Neonatal Services, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
    Objective: To investigate the frequency and cause of neonatal ventilator alarms. Neonatal ventilators frequently alarm and also disturb babies, parents and nurses. If frequent they may cause alarm fatigue and be ignored. Read More

    Validity of neurodevelopmental outcomes of children born very preterm assessed during routine clinical follow-up in England.
    Arch Dis Child Fetal Neonatal Ed 2017 Oct 27. Epub 2017 Oct 27.
    Section of Neonatal Medicine, Department of Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
    Objective: To determine the validity of assessing and recording the neurodevelopmental outcome of very preterm infants during routine clinical follow-up in England.

    Design: Children born <30 weeks gestation, attending routine clinical follow-up at post-term ages 20-28 months, were recruited. Data on neurodevelopmental outcomes were recorded by the reviewing clinician in a standardised format in the child's electronic patient record, based on a set of key questions designed to be used without formal training or developmental testing. Read More

    Fifteen-minute consultation: diabulimia and disordered eating in childhood diabetes.
    Arch Dis Child Educ Pract Ed 2017 Oct 27. Epub 2017 Oct 27.
    Department of Child Health, University Hospital of Wales, Cardiff, UK.
    Type 1 diabetes mellitus (T1DM) is a common chronic disease in children and young people. Living with diabetes can pose many challenges both medical and psychological. Disordered eating behaviours, intentional insulin omission and recognised eating disorders are common among young people with diabetes and are associated with increased risk of short-term and long-term complications and death. Read More

    The impact of out-of-hospital models of care on paediatric emergency department presentations.
    Arch Dis Child 2017 Oct 26. Epub 2017 Oct 26.
    Healthy London Partnerships, London, UK.
    Objective: To estimate the potential impact of enhanced primary care and new out-of-hospital models (OOHMs) on emergency department (ED) presentations by children and young people (CYP).

    Design: Observational study.

    Patients & Setting: Data collected prospectively on 3020 CYP 0â€"17. Read More


    Sleep disturbance in family caregivers of children who depend on medical technology.
    Arch Dis Child 2017 Oct 26. Epub 2017 Oct 26.
    Hospital for Sick Children, Toronto, Ontario, Canada.
    Objectives: Family caregivers of children who depend on medical technology (CMT) provide highly skilled care up to 24 hours per day. Sleep disruption places family caregivers at risk for poor health and related outcomes that threaten their long-term caregiving capacity. Few studies exist that have measured sleep in family caregivers, and most have relied entirely on subjective measures. Read More

    Compliance with nutrition screening in a children's hospital.
    Arch Dis Child 2017 Oct 26. Epub 2017 Oct 26.
    Department of Paediatric Gastroenterology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
    Introduction: There has been an increased emphasis on the nutritional care of children in hospital with the recognition that those admitted to hospital, particularly with chronic conditions, are at significant nutrition risk. However, although nutrition risk screening tools (NRST) are widely used in acute hospital settings compliance with their use is poorly reported.

    Methods: One-day cross-sectional audit of anthropometry/NRST records, Southampton Children's Hospital. Read More

    Variation in hospital mortality in an Australian neonatal intensive care unit network.
    Arch Dis Child Fetal Neonatal Ed 2017 Oct 26. Epub 2017 Oct 26.
    Research School of Population Health and Medical School, Australian National University, Acton, Australian Capital Territory, Australia.
    Background: Studying centre-to-centre (CTC) variation in mortality rates is important because inferences about quality of care can be made permitting changes in practice to improve outcomes. However, comparisons between hospitals can be misleading unless there is adjustment for population characteristics and severity of illness.

    Objective: We sought to report the risk-adjusted CTC variation in mortality among preterm infants born <32 weeks and admitted to all eight tertiary neonatal intensive care units (NICUs) in the New South Wales and the Australian Capital Territory Neonatal Network (NICUS), Australia. Read More

    2% chlorhexidine-70% isopropyl alcohol versus 10% povidone-iodine for insertion site cleaning before central line insertion in preterm infants: a randomised trial.
    Arch Dis Child Fetal Neonatal Ed 2017 Oct 26. Epub 2017 Oct 26.
    Department of Neonatology, The National Maternity Hospital, Dublin, Ireland.
    Objective: To determine whether 2% chlorhexidine gluconate-70% isopropyl alcohol (CHX-IA) is superior to 10% aqueous povidone-iodine (PI) in preventing catheter-related blood stream infection (CR-BSI) when used to clean insertion sites before placing central venous catheters (CVCs) in preterm infants.

    Design: Randomised controlled trial.

    Setting: Two neonatal intensive care units (NICUs). Read More

    Antimicrobial resistance in UK neonatal units: neonIN infection surveillance network.
    Arch Dis Child Fetal Neonatal Ed 2017 Oct 26. Epub 2017 Oct 26.
    Paediatric Infectious Diseases Research Group, St George's University of London, London, UK.
    Objective: To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK.

    Design: Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014.

    Setting: 30 neonatal units in the UK. Read More

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