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    23609 results match your criteria Archives of Disease in Childhood[Journal]

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    Accuracy of five formulae to determine the insertion length of umbilical venous catheters.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 17. Epub 2018 Mar 17.
    Newborn Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia.
    Introduction: Umbilical venous catheter (UVC) placement is a common neonatal procedure. It is important to position the UVC tip accurately at the first attempt to prevent complications and minimise handling. Catheters positioned too low need to be removed, but catheters positioned too high may be withdrawn in a sterile fashion to a safe position. Read More

    Detection of exhaled carbon dioxide following intubation during resuscitation at delivery.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 17. Epub 2018 Mar 17.
    MRC & Asthma UK Centre in Allergic Mechanisms in Asthma, King's College London, London, UK.
    Objectives: End tidal carbon dioxide (ETCO) monitoring can facilitate identification of successful intubation. The aims of this study were to determine the time to detect ETCOfollowing intubation during resuscitation of infants born prematurely and whether it differed according to maturity at birth or the Apgar scores (as a measure of the infant's condition after birth).

    Design: Analysis of recordings of respiratory function monitoring. Read More

    Eleven years of retinopathy of prematurity in one neonatal intensive care unit in Jakarta, Indonesia.
    Arch Dis Child 2018 Mar 17. Epub 2018 Mar 17.
    Department of Pediatrics, Beatrix Children Hospital, Universitair Medisch, Groningen, The Netherlands.
    Background: Retinopathy of prematurity (ROP) is a well-known complication in preterm infants. Data on the incidence of ROP in Indonesia, in relation to birth weight (BW) and gestational age (GA), are limited.

    Objective: To report the incidence of ROP in one of the oldest and largest neonatal intensive care unit (NICU) in Indonesia. Read More

    Reliability of anthropometric measurements in children with special needs.
    Arch Dis Child 2018 Mar 17. Epub 2018 Mar 17.
    The George Institute for Global Health, University of Oxford, Oxford, UK.
    Objective: To determine the reliability of anthropometric and body composition measurements in children with special needs.

    Design: Observational study.

    Setting: Specialist support schools (primary and secondary) in Manchester, UK. Read More

    How to use… a blood film.
    Arch Dis Child Educ Pract Ed 2018 Mar 17. Epub 2018 Mar 17.
    Department of Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, UK.
    The diagnostic relevance of the blood film cannot be underestimated in the assessment of children with suspected primary or secondary haematological conditions. The blood film not only serves as a diagnostic tool but also allows for screening, monitoring of disease progression and therapeutic response in children with a variety of haematological conditions. This article outlines the appearance of normal paediatric and neonatal blood films. Read More

    , what do paediatricians need to know?
    Arch Dis Child 2018 Mar 15. Epub 2018 Mar 15.
    The newly recognised and emerging fungal species,, has caused worldwide invasive infections and has been implicated in difficult to control hospital outbreaks. Challenges are encountered in the correct identification of this fungus as commonly used phenotypic and biochemical methods fail to differentiatefrom otherspecies. Its resistance profile, over 90% of isolates are fluconazole resistant and 35% are resistant to amphotericin, confronts clinicians with the restricted arsenal of antifungals and concerns about optimal treatment. Read More

    The paediatrician and the management of common gynaecological conditions.
    Arch Dis Child 2018 Mar 15. Epub 2018 Mar 15.
    Department of Endocrinology, Alder Hey Childrens NHS Foundation Trust, Liverpool, UK.
    Paediatric gynaecology is an emerging discipline. Since 2000, there has been an advanced training programme in paediatric gynaecology available for obstetric and gynaecology trainees; additionally, a set of clinical standardsfor the care of paediatric and adolescent patients has been developed by The British Society of Paediatric and Adolescent Gynaecology (BritSPAG). BritSPAG is a multidisciplinary group of professionals including gynaecologists, paediatricians, paediatric urologists and endocrinologists. Read More

    Paediatric outcomes and timing of admission.
    Arch Dis Child 2018 Mar 15. Epub 2018 Mar 15.
    Neonatal Unit, Sheffield Teaching Foundation Hospitals Trust, Sheffield, UK.
    Studies of adult patients have demonstrated that weekend admissions compared with weekday admissions had a significantly higher hospital mortality rate. We have reviewed the literature to determine if the timing of admission, for example, weekend or weekday, influenced mortality and morbidity in children. Seventeen studies reported the effect of timing of admission on mortality, and only four studies demonstrated an increase in those admitted at the weekend. Read More

    Which observed behaviours may reassure physicians that a child is not septic? An international Delphi study.
    Arch Dis Child 2018 Mar 15. Epub 2018 Mar 15.
    Emergency Department, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.
    Objective: In an attempt to improve the diagnosis of sepsis in children, diagnostic aids have concentrated on clinical features that suggest that sepsis is present. Clinicians need to be able to clinically rule out sepsis as well as rule it in. Little is known about which features are consistent with wellness and/or absence of sepsis. Read More

    Development of a gastroschisis core outcome set.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 14. Epub 2018 Mar 14.
    National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
    Objective: Outcome reporting heterogeneity impedes identification of gold standard treatments for children born with gastroschisis. Use of core outcome sets (COSs) in research reduces outcome reporting heterogeneity and ensures that studies are relevant to patients. The aim of this study was to develop a gastroschisis COS. Read More

    Evaluation of the congenital hypothyroidism screening programme in Iran: a 3-year retrospective cohort study.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 14. Epub 2018 Mar 14.
    Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran.
    Objective: To evaluate the newborn screening programme for congenital hypothyroidism (CH) in Iran from diagnosis to management and follow-up for 3 years from 2011 to 2014.

    Design: Retrospective cohort.

    Setting And Patients: Seventeen university districts were randomly selected from 30 provinces. Read More

    Elevated platelet counts in a cohort of children with moderate-severe osteogenesis imperfecta suggest that inflammation is present.
    Arch Dis Child 2018 Mar 13. Epub 2018 Mar 13.
    Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
    Background: Elevated platelet counts are observed in cancer, autoimmunity and inflammation with concurrent illness. Proinflammatory cytokines are elevated in murine osteogenesis imperfecta (OI) models. We hypothesised that platelet counts might be elevated in children with moderate-severe OI. Read More

    Feasibility of using touch screen technology for early cognitive assessment in children.
    Arch Dis Child 2018 Mar 13. Epub 2018 Mar 13.
    Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
    Objective: To explore the feasibility of using a touch screen assessment tool to measure cognitive capacity in toddlers.

    Design: 112 typically developing children with a median age of 31 months (IQR: 26-34) interacted with a touch screen cognitive assessment tool. We examined the sensitivity of the tool to age-related changes in cognition by comparing the number of items completed, speed of task completion and accuracy in two age groups; 24-29 months versus 30-36 months. Read More

    Off-label use of tacrolimus in children with Henoch-Schönlein purpura nephritis: a pilot study.
    Arch Dis Child 2018 Mar 13. Epub 2018 Mar 13.
    Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Shandong University, Jinan, China.
    Background: Tacrolimus is used off-label in the treatment of Henoch-Schönlein purpura nephritis (HSPN) in children, with limited evidence-based data. Based on clinical empirical experience and mechanism of action, tacrolimus might be promoted as treatment for childhood HSPN. The objectives of this pilot study were to assess its effectiveness and safety, and to explore the potential impact of CYP3A5 genotype. Read More

    Diagnosis of sporadic neurofibromatosis type 2 in the paediatric population.
    Arch Dis Child 2018 Mar 13. Epub 2018 Mar 13.
    Oxford Centre for Genomic Medicine, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
    Objective: Onset of symptoms in severe sporadic neurofibromatosis type 2 (NF2) is typically within childhood; however, there is poor awareness of presenting features in young children, potentially resulting in delayed diagnosis and poorer outcome. We have reviewed presentation of sporadic paediatric NF2 to raise awareness of early features, highlighting those requiring further investigation.

    Design: Patients diagnosed with NF2 at age ≤16 and seen between 2012 and 2015 were notified via the British Paediatric Neurology Surveillance Unit or identified through the English NF2 service. Read More

    Acute hyperkinetic movement disorders in Italian paediatric emergency departments.
    Arch Dis Child 2018 Mar 8. Epub 2018 Mar 8.
    Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
    Introduction: Limited data exist on epidemiology, clinical presentation and management of acute hyperkinetic movement disorders (AHMD) in paediatric emergency departments (pED).

    Methods: We retrospectively analysed a case series of 256 children (aged 2 months to 17 years) presenting with AHMD to the pEDs of six Italian tertiary care hospitals over a 2-year period (January 2012 to December 2013).

    Results: The most common type of AHMD was tics (44. Read More

    Health-related quality of life and its determinants in paediatric arterial ischaemic stroke survivors.
    Arch Dis Child 2018 Mar 8. Epub 2018 Mar 8.
    Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
    Objective: Health-related quality of life (HRQL) instruments are patient or proxy-reported outcome measures that provide a comprehensive and subjective assessment of patient's well-being and hence vital for health outcomes evaluation. A clear and thorough understanding of HRQL and its determinants is especially important to appropriately guide health-improving interventions. In this study, HRQL of paediatric arterial ischaemic stroke survivors was assessed using guidelines recommended for interpretation and reporting of the patient-reported outcome data. Read More

    What factors influence recruitment to a birth cohort of infants with Down's syndrome?
    Arch Dis Child 2018 Mar 8. Epub 2018 Mar 8.
    The NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK.
    Objective: To understand how to maximise recruitment of young infants with Down's syndrome (DS) into research through qualitative interviews with parents and care providers. In complex neonatal and genetic conditions such as DS, frequently diagnosed after birth, parents may go through a period of adaptation. These factors need consideration when overcoming barriers to recruitment. Read More

    Predictors of extubation readiness in preterm infants: a systematic review and meta-analysis.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 8. Epub 2018 Mar 8.
    Department of Pediatrics, Neonatal Division, McGill University Health Center, Montreal, Quebec, Canada.
    Context: A variety of extubation readiness tests have already been incorporated into clinical practice in preterm infants.

    Objective: To identify predictor tests of successful extubation and determine their accuracy compared with clinical judgement alone.

    Methods: MEDLINE, Embase, PubMed, Cochrane Library and Web of Science were searched between 1984 and June 2016. Read More

    Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea: calgranulin-C versus calprotectin stool tests.
    Arch Dis Child 2018 Mar 7. Epub 2018 Mar 7.
    Department of Paediatric Gastroenterology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Objective: Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for inflammatory bowel disease (IBD) than calprotectin, since it is only released by activated granulocytes. We compared calgranulin-C and calprotectin to see which of the two tests best predicted IBD in children with chronic abdominal pain and diarrhoea.

    Design: Delayed-type cross-sectional diagnostic study. Read More

    Evaluation of 'TRY': an algorithm for neonatal continuous positive airways pressure in low-income settings.
    Arch Dis Child 2018 Mar 7. Epub 2018 Mar 7.
    Paediatric Department, College of Medicine, Blantyre, Malawi.
    Background: Non-invasive respiratory support using bubble continuous positive airway pressure (bCPAP) is useful in treating babies with respiratory distress syndrome. Despite its proven clinical and cost-effectiveness, implementation is hampered by the inappropriate administration of bCPAP in low-resource settings. A clinical algorithm-'TRY' (based on Tone: good; Respiratory distress; Yes, heart rate above 100 beats/min)-has been developed to correctly identify which newborns would benefit most from bCPAP in a teaching hospital in Malawi. Read More

    Pharmacokinetic study of isoniazid and pyrazinamide in children: impact of age and nutritional status.
    Arch Dis Child 2018 Mar 7. Epub 2018 Mar 7.
    National Institute for Research in Tuberculosis, Chennai, India.
    Objectives: To evaluate pharmacokinetics of first-line antitubercular drugs, isoniazid (INH) and pyrazinamide (PZA), with revised WHO dosages and to assess its adequacy in relation to age and nutritional status.

    Design: Observational study.

    Setting: This study was conducted at Sarojini Naidu Medical College, Agra, and National Institute for Research in Tuberculosis, Chennai. Read More

    Clinician's gaze behaviour in simulated paediatric emergencies.
    Arch Dis Child 2018 Mar 7. Epub 2018 Mar 7.
    Department of Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, UK.
    Aim: Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency.

    Methods: Clinicians from four clinical areas undertook a simulated emergency. Read More

    Abusive head trauma and the triad: a critique on behalf of RCPCH of 'Traumatic shaking: the role of the triad in medical investigations of suspected traumatic shaking'.
    Arch Dis Child 2018 Mar 6. Epub 2018 Mar 6.
    Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, Cardiff, UK.
    The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice. Read More

    Hypothermia for perinatal asphyxia: trial-based quality of life at 6-7 years.
    Arch Dis Child 2018 Mar 6. Epub 2018 Mar 6.
    National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
    Objective: To assess the impact of hypothermic neural rescue at birth on health-related quality of life (HRQL) in middle childhood.

    Design: Six-year to 7-year follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) Trial.

    Setting: Community study including a single parental questionnaire to collect information on children's HRQL. Read More

    Endocarditis in children and adolescents with congenital heart defects: a Norwegian nationwide register-based cohort study.
    Arch Dis Child 2018 Mar 6. Epub 2018 Mar 6.
    Division of Paediatric and Adolescent Medicine, Oslo Universitetssykehus, Oslo, Norway.
    Objectives: Congenital heart defects (CHD) are the most common birth defects worldwide and are an important cause of morbidity and early death. A significant number of deaths occur among patients with infections. CHDs predispose to the development of infective endocarditis (IE) and represent a risk factor for increased mortality due to IE. Read More

    Fifteen-minute consultation: Supporting colleagues through a serious incident or complaint.
    Arch Dis Child Educ Pract Ed 2018 Mar 6. Epub 2018 Mar 6.
    Newcastle Neonatal Service,, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
    Being involved in a complaint or serious incident can be a huge stress for a doctor, whether a trainee or consultant. When affected, it is important to be able to look for the support of a colleague or a more senior person, and just as importantly, those not directly involved need to know what to do to provide support. In this piece I consider what 'support' really means, I provide some tips on what to do and what not to do, and I consider how incidents and complaints can need different approaches. Read More

    Impact of acute otitis media clinical practice guidelines on antibiotic and analgesic prescriptions: a systematic review.
    Arch Dis Child 2018 Mar 3. Epub 2018 Mar 3.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
    Background: Clinical practice guidelines focusing on judicious use of antibiotics for childhood acute otitis media (AOM) have been introduced in many countries around the world.

    Objective: To systematically review the effects of these guidelines on the prescription of antibiotics and analgesics for children with AOM.

    Methods: Systematic searches of PubMed, Embase and Cochrane Library from inception to 6 June 2017 using broad search terms. Read More

    Cognitive outcome in childhood of birth weight discordant monochorionic twins: the long-term effects of fetal growth restriction.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 2. Epub 2018 Mar 2.
    Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
    Aim: Intrauterine growth restriction (IUGR) is associated with poorer outcomes in later life. We used a monochorionic twin model with IUGR in one twin to determine its impact on growth and neurocognitive outcomes.

    Methods: Monochorionic twins with ≥20% birth weight discordance born in the north of England were eligible. Read More

    Delivery of positive end-expiratory pressure to preterm lambs using common resuscitation devices.
    Arch Dis Child Fetal Neonatal Ed 2018 Mar 2. Epub 2018 Mar 2.
    The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
    Background: In neonatal resuscitation, a ventilation device providing positive end-expiratory pressure (PEEP) is recommended. There is limited information about PEEP delivery in vivo, using different models of self-inflating bag (SIB) at different inflation rates and PEEP settings.

    Methods: We compared PEEP delivery to intubated preterm lambs using four commonly available models of paired SIBs and PEEP valves, with a T-piece, with gas flow of 8 L/min. Read More

    'So why didn't you think this baby was ill?' Decision-making in acute paediatrics.
    Arch Dis Child Educ Pract Ed 2018 Mar 1. Epub 2018 Mar 1.
    Sheffield Children's Hospital, Sheffield, UK.
    Determining severity of illness and undertaking an adequate risk assessment is a fundamental part of acute paediatric practice. This review highlights physiology, communication, heuristics and external elements as factors which influence decision-making and discusses how incidence of disease and seniority of clinician impact might influence outcomes. Read More

    More medicines for children: impact of the EU paediatric regulation.
    Arch Dis Child 2018 Feb 28. Epub 2018 Feb 28.
    European Medicines Agency, London, UK.
    Introduction: This paper focuses on the authorisation of new medicines, new indications and new pharmaceutical forms or strengths for use in children and also on the availability of paediatric information in the product information of centrally authorised medicinal products following the enforcement of the Paediatric Regulation on 26 January 2007.

    Objectives: To investigate whether the Paediatric Regulation has led to more medicines available for children in the European Union (EU) and if more information on paediatric use is now available in the product information of medicines authorised via the centralised procedure.

    Materials And Methods: We retrospectively analysed the centrally authorised medicinal products in the EU that had an approval for an initial marketing authorisation, a type II variation, or a line extension during the years 2004-2006 and 2012-2014. Read More

    Limb hypertrophy: a skin vascular malformation and bilateral hydroureteronephrosis in a neonate.
    Arch Dis Child Educ Pract Ed 2018 Feb 28. Epub 2018 Feb 28.
    Neonatal Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
    The second daughter of two healthy non-consanguineous parents, born at 37 weeks, presented with a large 3×2 cm abdominal angiomatous formation on her left flank, associated with left leg hypertrophy, macrodactyly of both feet with syndactyly of the second and third finger of the right food and left polydactyly (figure 1). Her neurological development and cardiopulmonary function were normal; she had no gastrointestinal or skeletal problems. Her weight was 3195 g (75th-90th centile). Read More

    Fifteen-minute consultation: The child with an incidental finding of low IgA.
    Arch Dis Child Educ Pract Ed 2018 Feb 23. Epub 2018 Feb 23.
    Paediatric Infectious Diseases and Immunology, Royal Hospital for Children, Glasgow, UK.
    Low or absent immunoglobulin A (IgA) levels are frequently found in children in whom immunodeficiency is not suspected. IgA deficiency is the most common primary immunodeficiency disorder in the UK affecting approximately 1 in 600 people. Isolated IgA deficiency is often identified coincidentally when investigating a child for conditions such as coeliac disease. Read More

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