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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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Interventions for treating wrist fractures in children. BACKGROUND: Wrist fractures, involving the distal radius, are the most common fractures in children. Most are buckle fractures, which are stable fractures, unlike greenstick and other usually displaced fractures. There is considerable variation in practice, such as the extent of immobilisation for buckle fractures and use of surgery for seriously displaced fractures. OBJECTIVES: To assess the effects (benefits and harms) of interventions (...) for common distal radius fractures in children, including skeletally immature adolescents. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group's Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, trial registries and reference lists to May 2018. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs comparing interventions for treating distal radius fractures in children. We sought data on physical function
Sedation of children undergoing dental treatment. BACKGROUND: Children's fear about dental treatment may lead to behaviour management problems for the dentist, which can be a barrier to the successful dental treatment of children. Sedation can be used to relieve anxiety and manage behaviour in children undergoing dental treatment. There is a need to determine from published research which agents, dosages and regimens are effective. This is the second update of the Cochrane Review first (...) published in 2005 and previously updated in 2012. OBJECTIVES: To evaluate the efficacy and relative efficacy of conscious sedation agents and dosages for behaviour management in paediatric dentistry. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 22 February 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 1) in the Cochrane Library (searched 22 February 2018); MEDLINE Ovid (1946
Fly control to prevent diarrhoea in children. BACKGROUND: Diarrhoeal disease accounts for millions of child deaths every year. Although the role of flies as vectors of infectious diarrhoea has been established, fly control is not often mentioned as an approach to decrease childhood diarrhoea. Theoretically, fly control for decreasing diarrhoea incidence can be achieved by intervening at four different levels: reduction or elimination of fly breeding sites; reduction of sources that attract (...) houseflies; prevention of contact between flies and disease-causing organisms; and protection of people, food, and food utensils from contact with flies. OBJECTIVES: To assess the impact of various housefly control measures on the incidence of diarrhoea and its related morbidity and mortality in children under five years of age. SEARCH METHODS: We searched electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase, CINAHL
Recombinant growth hormone therapy for cystic fibrosis in children and young adults. BACKGROUND: Cystic fibrosis (CF) is an inherited condition causing disease most noticeably in the lungs, digestive tract and pancreas. People with CF often have malnutrition and growth delay. Adequate nutritional supplementation does not improve growth optimally and hence an anabolic agent, recombinant human growth hormone (rhGH), has been proposed as a potential intervention. This is an update of a previously (...) published review. OBJECTIVES: To evaluate the effectiveness and safety of rhGH therapy in improving lung function, quality of life and clinical status of children and young adults with CF. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of latest search: 22 October 2018.We also
Assessment of rash in children Assessment of rash in children - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Assessment of rash in children Last reviewed: November 2018 Last updated: December 2018 Summary Childhood rashes are cutaneous eruptions of acute onset. Clinically, they may be categorised as maculopapular, pustular, vesiculobullous, diffuse/erythematous, or petechial/purpuric in nature. However, in many (...) aetiologies these forms may co-exist or evolve from one form to another. Initial considerations in evaluating a rash in children include its morphology, duration, and distribution. Age, sex, family history, medications, known allergies, and exposures are also of primary importance. Generally, rash in the absence of fever or systemic symptoms is not urgent. However, when fever or signs of illness are present, urgent evaluation and treatment must be considered. The differential diagnosis is extensive
Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock. BACKGROUND: Sepsis and septic shock are potentially life-threatening complications of infection that are associated with high morbidity and mortality in adults and children. Fluid therapy is regarded as a crucial intervention during initial treatment of sepsis. Whether conservative or liberal fluid therapy can improve clinical outcomes in patients with sepsis and septic shock remains unclear (...) . OBJECTIVES: To determine whether liberal versus conservative fluid therapy improves clinical outcomes in adults and children with initial sepsis and septic shock. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, intensive and critical care conference abstracts, and ongoing clinical trials on 16 January 2018, and we contacted study authors to try to identify additional studies. SELECTION CRITERIA: We planned to include all randomized controlled trials (RCTs), quasi-RCTs, and cluster RCTs comparing
Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. BACKGROUND: Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs). METHODS: For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web (...) of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants
Monitoring children and young people with, or at risk of developing Autosomal Dominant Polycystic Kidney Disease (ADPKD) Clinical Practice Guideline Monitoring children and young people with, or at risk of developing Autosomal Dominant Polycystic Kidney Disease (ADPKD) Authors: Dr Jan Dudley - Chair Consultant Paediatric Nephrologist, Bristol Professor Paul Winyard - Clinical Lead Consultant Paediatric Nephrologist, London Dr Matko Marlais - Clinical Lead Sub-specialty Trainee in Paediatric (...) Advisor in Medical Genetics, Cambridge Final Version: November 2018 Review Date: November 2023 Renal Association Clinical Practice Guideline Autosomal Dominant Polycystic Kidney Disease ADPKD – November 2018 2 Delphi Panelists: Professor Albert Ong, Professor of Renal Medicine, Sheffield Professor Neil Turner, Professor of Renal Medicine, Edinburgh Dr Catriona Shaw, Consultant Nephrologist, London Dr Yincent Tse, Consultant Paediatric Nephrologist, Newcastle Dr Heather Lambert, Consultant Paediatric
Management of meningococcal disease in children and young people MD 1 Estimate of child’s weight (1–10 yrs) Weight (kg) = 2 x (age in years + 4) MD 3 MD 4 Intubation (call anaesthetist and consult PICU) see BM 5 Consider using: Atropine 20 mcg/kg (max 600 mcg) AND Ketamine 1-2 mg/kg in shock or Thiopental (thiopentone) 3-5 mg/kg in RICP AND Suxamethonium 2 mg/kg (caution, high potassium). ETT size = age/4 + 4, ETT length (oral) = age/2 + 12 (use cuffed ET tube if possible). Then: Morphine (100 (...) www.meningitis.org CLINICAL FEATURES OF MENINGITIS? Do not perform Lumbar Puncture; Nil by mouth Take bloods, see Close monitoring for signs of ? Raised ICP ? Shock Perform LP if no contraindication DO NOT DELAY ANTIBIOTICS Repeated Review Children with MD can deteriorate rapidly. Deterioration detected? Do not perform Lumbar Puncture; Nil by mouth Anticipate, monitor and correct: ? Hypoglycaemia MD 6 ? Acidosis MD 7 ? Hypokalaemia MD 8 ? Hypocalcaemia MD 9 ? Hypomagnesaemia MD 10 ? Anaemia ? If bleeding
No Strong Evidence to Suggest that Non-Speech Oral Motor Treatments (NSOMT) Are an Effective Treatment for Children with Developmental Speech-Sound Disorders UTCAT3362, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title No Strong Evidence to Suggest that Non-Speech Oral Motor Treatments (NSOMT) Are an Effective Treatment for Children with Developmental Speech-Sound Disorders Clinical Question Will the use of non-speech (...) oral motor treatment (NSOMT) in children with speech-sound disorders help improve speech, compared to no treatment? Clinical Bottom Line There is no strong evidence to suggest that non-speech oral motor treatments (NSOMT) are an effective treatment for children with developmental speech-sound disorders. This is based on only three studies that were small in scale, which means that it is highly likely that participants in these studies were not representative of its target population, and which had
Brivaracetam (Briviact) - treatment of partial-onset seizures with or without secondary generalisation in children Published 10 December 2018 Product update SMC2113 brivaracetam, 10mg, 25mg, 50mg, 75mg, 100mg film- coated tablets; 10mg/mL oral solution; 10mg/mL solution for injection/infusion (Briviact®) UCB Pharma Ltd 9 November 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs (...) ) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated submission brivaracetam (Briviact ® ) is accepted for restricted use within NHSScotland. Indication under review: Adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in children from 4 years to =15 years of age with epilepsy. SMC restriction: for use in patients with refractory epilepsy and treatment should be initiated by physicians who have appropriate
eTool: Clinician's guide to recognition and early management of meningococcal disease in children Meningitis | Introduction Endorsed by the Royal College of Paediatrics and Child Health Endorsed by the College of Emergency Medicine Clinician's Guide to Recognition and Early Management of Meningococcal Disease in Children An interactive e-learning tool for doctors in training by Dr Nelly Ninis, St Mary’s Hospital, London; Dr Simon Nadel, St Mary’s Hospital, London; Linda Glennie, Meningitis (...) Research Foundation This e-learning tool for clinicians arose from the national study, Healthcare delivery and the outcome of meningococcal disease in children , which was conducted through the Royal College of Paediatrics and Child Health and Imperial College London, and funded by Meningitis Research Foundation. The principal investigator was Professor Michael Levin at Imperial College London. This is an educational tool, not an evidence-based guideline. It provides an opportunity to learn from real
Lessons from research for doctors in training: recognition and early management of meningococcal disease in children and young people Endorsed by Lessons from research for doctors in training by Dr Nelly Ninis, St Mary’s Hospital, London; Dr Simon Nadel, St Mary’s Hospital, London; Linda Glennie, Meningitis Research Foundation Recognition and early management of meningococcal disease in children and young people Edition 4 This handbook uses individual case histories as a basis for group (...) discussions and learning. The clinical management points are based on “Management of Meningococcal Disease in Children and Young People” (see inside back cover) incorporating the NICE Guideline Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management CG102.1 Contents SECTION 1 Introduction 2-3 SECTION 2 Clinical case histories: discussion and learning points 4-41 SECTION 3 Background to the Disease 42 n Disease burden 42 n Characteristics of meningococcal
Identifying Effective Approaches to Support Parents and Caregivers of Children with Fetal Alcohol Spectrum Disorder Rapid Synthesis Identifying Effective Approaches to Support Parents and Caregivers of Children with Fetal Alcohol Spectrum Disorder 12 October 2018 McMaster Health Forum 1 Evidence >> Insight >> Action Rapid Synthesis: Identifying Effective Approaches to Support Parents and Caregivers of Children with Fetal Alcohol Spectrum Disorder 60-day response 12 October 2018 Identifying (...) Effective Approaches to Support Parents and Caregivers of Children with Fetal Alcohol Spectrum Disorder 2 Evidence >> Insight >> Action McMaster Health Forum and Forum+ The goal of the McMaster Health Forum, and its Forum+ initiative, is to generate action on the pressing health- and social-system issues of our time, based on the best available research evidence and systematically elicited citizen values and stakeholder insights. We aim to strengthen health and social systems – locally, nationally
Supporting Parents in Making Informed Decisions in Relation to their Children?s Health Needs Rapid Synthesis Supporting Parents in Making Informed Decisions in Relation to their Children’s Health Needs 4 October 2018 McMaster Health Forum 1 Evidence >> Insight >> Action Rapid Synthesis: Supporting Parents in Making Informed-Decisions in Relation to their Children’s Health Needs 10-day response 4 October 2018 Supporting Parents in Making Informed Decisions in Relation to their Children’s Health (...) and suggestions. Citation Gao C, Waddell K, Wilson MG. Rapid synthesis: Supporting parents in making informed decisions in relation to their children’s health needs. Hamilton: McMaster Health Forum, 4 October 2018. Product registration numbers ISSN 2292-7999 (online)McMaster Health Forum 3 Evidence >> Insight >> Action KEY MESSAGES Questions • What are the most effective approaches for supporting parents in making informed decisions related to their children’s health needs? • What can be done to support
Oral Ondansetron Administration to Nondehydrated Children With Diarrhea and Associated Vomiting in Emergency Departments in Pakistan: A Randomized Controlled Trial 30392735 2018 11 05 1097-6760 2018 Nov 01 Annals of emergency medicine Ann Emerg Med Oral Ondansetron Administration to Nondehydrated Children With Diarrhea and Associated Vomiting in Emergency Departments in Pakistan: A Randomized Controlled Trial. S0196-0644(18)31269-1 10.1016/j.annemergmed.2018.09.011 We determine whether single (...) -dose oral ondansetron administration to children with vomiting as a result of acute gastroenteritis without dehydration reduces administration of intravenous fluid rehydration. In this 2-hospital, double-blind, placebo-controlled, emergency department-based, randomized trial conducted in Karachi Pakistan, we recruited children aged 0.5 to 5.0 years, without dehydration, who had diarrhea and greater than or equal to 1 episode of vomiting within 4 hours of arrival. Patients were randomly assigned (1
Salmonella infections in Canadian children Non-typhoidal Salmonella (NTS) infections are primarily transmitted by contaminated food or water or contact with carrier animals (particularly reptiles), and present with diarrhea. Antibiotics do not decrease the severity or duration of diarrhea and may increase the incidence of NTS carriage, so they should only be used with suspected or proven bacteremia or invasive infection. Typhoid/paratyphoid fever manifests as bacteremia within (...) 60 days of travel to resource-poor countries and presents with fever and variable abdominal complaints. Therefore, blood cultures are indicated for unexplained fever and a relevant travel history. When blood cultures are positive or when a child is unwell pending blood culture results, ceftriaxone is indicated. A switch to oral antibiotics (usually azithromycin) is often possible after blood cultures have cleared and the child is improved. Keywords: Non-typhoidal Salmonella; Typhoid/paratyphoid
Efficacy and Safety of Anti-D Immunoglobulins versus Intravenous Immunoglobulins for Immune Thrombocytopenia in Children: Systematic Review and Meta-analysis of Randomized Controlled Trials 30314658 2018 10 13 1097-6833 2018 Oct 09 The Journal of pediatrics J. Pediatr. Efficacy and Safety of Anti-D Immunoglobulins versus Intravenous Immunoglobulins for Immune Thrombocytopenia in Children: Systematic Review and Meta-analysis of Randomized Controlled Trials. S0022-3476(18)30974-0 10.1016/j.jpeds (...) .2018.07.065 To compare the efficacy and safety of intravenous immunoglobulins (IVIG) and anti-D immunoglobulin (anti-D) in pediatric immune thrombocytopenia (ITP). We conducted a systematic review and meta-analysis following PRISMA guidelines, including all randomized controlled trials that have assessed the efficacy and safety of anti-D and IVIG in children with ITP. We searched Medline, Embase, and Cochrane databases. Primary outcomes were the proportion of children achieving platelet count responses
Hydroxyurea for Children with Sickle Cell Anemia in Sub-Saharan Africa. BACKGROUND: Hydroxyurea is an effective treatment for sickle cell anemia, but few studies have been conducted in sub-Saharan Africa, where the burden is greatest. Coexisting conditions such as malnutrition and malaria may affect the feasibility, safety, and benefits of hydroxyurea in low-resource settings. METHODS: We enrolled children 1 to 10 years of age with sickle cell anemia in four sub-Saharan countries. Children (...) received hydroxyurea at a dose of 15 to 20 mg per kilogram of body weight per day for 6 months, followed by dose escalation. The end points assessed feasibility (enrollment, retention, and adherence), safety (dose levels, toxic effects, and malaria), and benefits (laboratory variables, sickle cell-related events, transfusions, and survival). RESULTS: A total of 635 children were fully enrolled; 606 children completed screening and began receiving hydroxyurea at a mean (±SD) dose of 17.5±1.8 mg per