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Latest & greatest articles for children
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on children or other clinical topics then use Trip today.
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Prenatal and infant exposure to ambient pesticides and autism spectrum disorder in children: population based case-control study. OBJECTIVE: To examine associations between early developmental exposure to ambient pesticides and autism spectrum disorder. DESIGN: Population based case-control study. SETTING: California's main agricultural region, Central Valley, using 1998-2010 birth data from the Office of Vital Statistics. POPULATION: 2961 individuals with a diagnosis of autism spectrum
Psychological interventions for parents of children and adolescents with chronic illness. BACKGROUND: Psychological therapies for parents of children and adolescents with chronic illness aim to improve parenting behavior and mental health, child functioning (behavior/disability, mental health, and medical symptoms), and family functioning.This is an updated version of the original Cochrane Review (2012) which was first updated in 2015. OBJECTIVES: To evaluate the efficacy and adverse events of (...) psychological therapies for parents of children and adolescents with a chronic illness. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, PsycINFO, and trials registries for studies published up to July 2018. SELECTION CRITERIA: Included studies were randomized controlled trials (RCTs) of psychological interventions for parents of children and adolescents with a chronic illness. In this update we included studies with more than 20 participants per arm. In this update, we included interventions
Communication with children and adolescents about the diagnosis of their own life-threatening condition. When a child is diagnosed with a life-threatening condition, one of the most challenging tasks facing health-care professionals is how to communicate this to the child, and to their parents or caregivers. Evidence-based guidelines are urgently needed for all health-care settings, from tertiary referral centres in high-income countries to resource limited environments in low-income and middle (...) -income countries, where rates of child mortality are high. We place this Review in the context of children's developing understanding of illness and death. We review the effect of communication on children's emotional, behavioural, and social functioning, as well as treatment adherence, disease progression, and wider family relationships. We consider the factors that influence the process of communication and the preferences of children, families, and health-care professionals about how to convey
Communication with children and adolescents about the diagnosis of a life-threatening condition in their parent. Many adults diagnosed with a life-threatening condition have children living at home; they and their partners face the dual challenge of coping with the diagnosis while trying to maintain a parenting role. Parents are often uncertain about how, when, and what to tell their children about the condition, and are fearful of the effect on their family. There is evidence that children (...) are often aware that something is seriously wrong and want honest information. Health-care professionals have a key role in supporting and guiding parents and caregivers to communicate with their children about the diagnosis. However, the practical and emotional challenges of communicating with families are compounded by a scarcity of evidence-based guidelines. This Review considers children's awareness and understanding of their parents' condition, the effect of communication around parental life
Type 2 diabetes in children Type 2 diabetes in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Type 2 diabetes in children Last reviewed: February 2019 Last updated: March 2019 Summary A progressive disorder due to a deficit in both insulin secretion and insulin action, with obesity being the primary cause in children. Often asymptomatic and diagnosed by screening in a high-risk individual (e.g., family (...) history, obesity, acanthosis nigricans) or incidentally (e.g., glycosuria found after a school or sports examination). The development of insulin resistance and glucose intolerance can be prevented by lifestyle modifications that correct obesity in children. Goals of treatment are to promote weight loss and exercise capacity, decrease acanthosis nigricans, normalise glycaemia and haemoglobin A1c (goal is <53 mmol/mol [7%]), and prevent long-term complications (e.g., hypertension and dyslipidaemia
Trends in cause-specific mortality among children aged 5-14 years from 2005 to 2016 in India, China, Brazil, and Mexico: an analysis of nationally representative mortality studies. BACKGROUND: With global survival increasing for children younger than 5 years of age, attention is required to reduce the approximately 1 million deaths of children aged 5-14 years occurring every year. Causes of death at these ages remain poorly documented. We aimed to explore trends in mortality by causes of death (...) in India, China, Brazil, and Mexico, which are home to about 40% of the world's children aged 5-14 years and experience more than 200 000 deaths annually at these ages. METHODS: We examined data on 244 401 deaths in children aged 5-14 years from four nationally representative data sources that obtained direct distributions of causes of death: the Indian Million Death Study, the Chinese Disease Surveillance Points, mortality data from the Mexican Instituto Nacional de Estadística y Geografía
Viral gastroenteritis in children Viral gastroenteritis in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Viral gastroenteritis in children Last reviewed: February 2019 Last updated: March 2019 Summary Associated with substantial morbidity in developed countries. Continues to be a cause of significant mortality in developing countries. Presents with vomiting and diarrhoea (with or without fever, nausea (...) mucus in stool age <5 years poor personal hygiene exposure to people with gastroenteritis day-care attendance winter months poverty lack of immunisation against rotavirus lack of breastfeeding immunodeficiency Diagnostic investigations clinical examination serum electrolytes, urea, creatinine FBC stool microscopy stool culture enzyme immunoassay (EIA) for detection of viral antigen stool electron microscopy Treatment algorithm ACUTE Contributors Authors Clinical Professor of Pediatrics
Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years (Sick Day Rules) 1 Version 4, Feb 2018 Review 2021 Authors: SM Ng, A Soni, JC Agwu, JA Edge, JH Drew, C Moudiotis, NP Wright, M Kershaw, MC Gardner, L Connellan, W Assam ssociation of Children’s Diabetes Clinicians Clinicians SETTING FOR STAFF Medical and nursing staff PATIENTS Children and young people with diabetes mellitus Contents 1. Introduction 2 2. Importance of Local ‘Sick-Day’ Rules 2 3 (...) . Ketone testing 2 4. Fluid Management 3 5. Out of hours diabetes advice 4 6. Diabetes Self Management Education 4 7. General Rules for Managing Diabetes During Illness 4 7.1. Using sick day doses on pump therapy 7 7.2. Management of infections usually associated with hypoglycaemia eg. gastroenteritis ... 7 8. References 8 9. Appendix: Patient Advice Leaflet…………………………………………………………………...10 Clinical Guideline Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years
Ciclosporin (Verkazia) - for the treatment of severe vernal keratoconjunctivitis in children Final Appraisal Recommendation Advice No: 0219 – February 2019 Ciclosporin (Verkazia ® ) 1 mg/ml eye drops, emulsion Submission by Santen UK Limited Additional note(s): ? AWMSG considered that ciclosporin (Verkazia ® ) satisfied the AWMSG criteria for orphan status. In reaching the above recommendation AWMSG has taken account of the appraisal documentation prepared by the AWMSG Secretariat (reference (...) within NHS Wales for the treatment of severe vernal keratoconjunctivitis in children from 4 years of age and adolescents (until the age of 18). Statement of use: No part of this recommendation may be reproduced without the whole recommendation being quoted in full and cited as: All Wales Medicines Strategy Group Final Appraisal Recommendation – 0219: Ciclosporin (Verkazia ® ) 1mg/ml eye drops, emulsion February 2019
Antibiotic Treatment and Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children: A Systematic Review and Meta-analysis 30720508 2019 02 07 1528-1140 2019 Jan 31 Annals of surgery Ann. Surg. Antibiotic Treatment and Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children: A Systematic Review and Meta-analysis. 10.1097/SLA.0000000000003225 MINI: The present meta-analysis demonstrates that, although limited by a lower efficacy compared to surgery, NOM (...) with antibiotics could be considered a safe option for adults and pediatric patients with uncomplicated appendicitis, as it is successful in almost 75% of cases, and does not statistically increase the perforation rate. The aim of this meta-analysis was to summarize the current available evidence on nonoperative management (NOM) with antibiotics for uncomplicated appendicitis, both in adults and children. Although earlier meta-analyses demonstrated that NOM with antibiotics may be an acceptable treatment
Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline 30707039 2019 02 01 1535-4970 199 3 2019 Feb 01 American journal of respiratory and critical care medicine Am. J. Respir. Crit. Care Med. Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline. e5-e23 10.1164/rccm.201812-2276ST Home oxygen therapy is often required in children with chronic respiratory conditions. This document provides an evidence (...) -based clinical practice guideline on the implementation, monitoring, and discontinuation of home oxygen therapy for the pediatric population. A multidisciplinary panel identified pertinent questions regarding home oxygen therapy in children, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach to rate the quality of evidence and strength of clinical recommendations. After considering the panel's confidence
The use of ultrasound guidance for perioperative neuraxial and peripheral nerve blocks in children. BACKGROUND: The use of ultrasound guidance for regional anaesthesia has become popular over the past two decades. However, it is not recognized by all experts as an essential tool, perhaps because it is unclear whether ultrasound reduces the risk of severe neurological complications, and the cost of an ultrasound machine (USD 22,000) is substantially higher than the cost of other tools (...) . This review was published in 2016 and updated in 2019. OBJECTIVES: To determine whether ultrasound guidance offers any clinical advantage when neuraxial and peripheral nerve blocks are performed in children in terms of decreasing failure rate or the rate of complications. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and two trial registers up to March 2018 together with reference checking to identify additional studies and contacted study authors to obtain additional trial information. SELECTION
Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial. Importance: There are currently no approved treatments for peanut allergy. Objective: To assess the efficacy and adverse events of epicutaneous immunotherapy with a peanut patch among peanut-allergic children. Design, Setting, and Participants: Phase 3, randomized, double-blind, placebo-controlled trial conducted at 31 sites in 5 (...) countries between January 8, 2016, and August 18, 2017. Participants included peanut-allergic children (aged 4-11 years [n = 356] without a history of a severe anaphylactic reaction) developing objective symptoms during a double-blind, placebo-controlled food challenge at an eliciting dose of 300 mg or less of peanut protein. Interventions: Daily treatment with peanut patch containing either 250 μg of peanut protein (n = 238) or placebo (n = 118) for 12 months. Main Outcomes and Measures: The primary
Parenteral versus oral iron therapy for adults and children with chronic kidney disease. BACKGROUND: The anaemia seen in chronic kidney disease (CKD) may be exacerbated by iron deficiency. Iron can be provided through different routes, with advantages and drawbacks of each route. It remains unclear whether the potential harms and additional costs of intravenous (IV) compared with oral iron are justified. This is an update of a review first published in 2012. OBJECTIVES: To determine (...) the benefits and harms of IV iron supplementation compared with oral iron for anaemia in adults and children with CKD, including participants on dialysis, with kidney transplants and CKD not requiring dialysis. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Register of Studies up to 7 December 2018 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference
Effectiveness of provision of animal-source foods for supporting optimal growth and development in children 6 to 59 months of age. BACKGROUND: Adequate nutrients early in life promote cognitive development and are critical for proper growth and functioning. The effect of individual nutrients consumed through food is often not the same as consuming the same nutrients in supplementary form due to 'food synergy', the biological and chemical interrelations that occur between nutrients. Animal (...) in children aged 6 to 59 months. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL, 18 other databases, and three trials registers up to August 2018. We also contacted authors and known experts in the field for assistance in identifying ongoing or unpublished data, and searched the reference lists of included studies and reviews, and websites of relevant organizations, for other studies that may not have been captured by our electronic searches. SELECTION CRITERIA: We included randomized
Efficacy of ArmeoÂ® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children With Hemiplegic Cerebral Palsy. 29059068 2019 02 15 2019 02 15 1537-7385 97 3 2018 03 American journal of physical medicine & rehabilitation Am J Phys Med Rehabil Efficacy of Armeo® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children With Hemiplegic Cerebral Palsy. 164-169 10.1097/PHM.0000000000000852 The aim of this study was to examine the efficacy of Armeo robotic (...) therapy, compared with conventional therapy, on upper limb function in children with hemiplegic cerebral palsy. Thirty children with hemiplegic cerebral palsy, with ages ranging from 6 to 8 yrs, were selected for this randomized controlled study and randomly assigned to two groups. The study group (n = 15) received 12 wks of Armeo robotic therapy (45 min/session, 3 days/wk) and the control group (n = 15) received conventional therapy for the same period. The measured outcomes were the Modified
Constipation in children Constipation in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Constipation in children Last reviewed: January 2019 Last updated: February 2019 Summary Childhood constipation is typically characterised by infrequent bowel evacuations, large stools, and difficult or painful defecation. Symptoms may result from low fibre, poor nutrient, and/or insufficient water intake, which leads (...) to excessive hardening of the stool. This often starts as an acute problem but can progress to faecal impaction and chronic constipation. Particularly in young children, any cause of painful defecation may provoke active withholding. Withholding may worsen the constipation and lead to a vicious cycle. Duration of constipation and amount of stool burden may depend on capacity of the child's rectum, the degree of megarectum, and other factors including rectal sensory function. After faecal disimpaction
Faecal incontinence in children Faecal incontinence in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Faecal incontinence in children Last reviewed: January 2019 Last updated: February 2019 Summary Involuntary defecation at inappropriate times, occurring after the typical age of completed toilet training (generally 4 years). In most cases, caused by overflow soiling associated with chronic constipation (...) and severe faecal impaction in an otherwise healthy child without underlying anatomical abnormalities. May have a significant negative impact on the quality of life for the child and the family. A thorough history and physical examination are the crux of diagnosis. Laboratory and radiological studies may be used on a case-by-case basis to determine the underlying aetiology. The goal of therapy is for patient to stool 1 to 3 times per day in the toilet with no episodes of soiling. Treatment involves