Pediatrics (all articles)
SR | Ultrasound‐guided arterial cannulation in the pediatric population
7 Mar, 2023 | 13:15h | UTCSummary:
This updated systematic review analyzed nine randomized controlled trials comparing ultrasound guidance to traditional methods of locating arteries for cannulation, such as palpation and Doppler auditory assistance.
The review found that ultrasound guidance probably improves first-attempt success rates, reduces the risk of complications such as hematoma formation, improves success rates within two attempts and the overall rate of successful cannulation, and reduces the number of attempts and duration of the cannulation procedure.
However, the review also notes that the evidence is only of moderate certainty due to the inability to mask the doctors performing the cannulation and the limited number of children studied. More research is needed to confirm the benefits of ultrasound guidance for arterial cannulation in different age groups of children.
Article: Ultrasound‐guided arterial cannulation in the paediatric population – Cochrane Library
Summary: Ultrasound use for insertion of arterial catheters in children – Cochrane Library
Myocarditis or pericarditis events after BNT162b2 vaccination in individuals aged 12 to 17 years in Ontario, Canada
7 Mar, 2023 | 13:13h | UTCSummary:
A population-based cohort study was conducted to estimate the incidence of reported myocarditis or pericarditis after BNT162b2 vaccination in adolescents aged 12 to 17 years in Ontario, Canada, and to describe the clinical information associated with these events. The study analyzed data from 1.65 million doses of BNT162b2 vaccinations administered between December 14, 2020, and November 21, 2021.
According to the study, 77 adolescents were reported to have developed myocarditis or pericarditis after receiving the vaccine, and there was a greater occurrence of these events among those aged 16 to 17 years compared to those aged 12 to 15 years. Additionally, adolescents with shorter intervals between vaccine doses had a higher incidence of myocarditis or pericarditis.
Most cases of myocarditis and pericarditis were mild, and the adolescents required either no treatment or were treated conservatively with nonsteroidal anti-inflammatory drugs.
Update on current contraceptive options | A case-based discussion of efficacy, eligibility, and use
7 Mar, 2023 | 13:06h | UTC
Position Statement | Chronic suppurative lung disease and bronchiectasis in children, adolescents and adults
7 Mar, 2023 | 13:04h | UTC
SR | Intermittent phototherapy versus continuous phototherapy for neonatal jaundice
7 Mar, 2023 | 12:59h | UTCSummary:
Phototherapy is a widely accepted first-line therapy for neonatal jaundice, and while continuous phototherapy is traditionally used, intermittent phototherapy has been proposed as an equally effective alternative with practical advantages such as improved maternal feeding and bonding. This systematic review compared intermittent vs. continuous phototherapy’s effectiveness and safety in treating neonatal jaundice.
The study included 12 randomized controlled trials involving 1600 infants, and found little or no difference between intermittent and continuous phototherapy in reducing bilirubin levels. Continuous phototherapy was found to be more effective in preterm infants, but the risks and potential benefits are unknown.
The review concludes that while there are theoretical benefits to intermittent regimens, large, well-designed, prospective trials are needed to determine whether intermittent and continuous phototherapy are equally effective and safe in both preterm and term infants.
Article: Intermittent phototherapy versus continuous phototherapy for neonatal jaundice – Cochrane Library
Summary: Intermittent phototherapy versus continuous phototherapy for neonatal jaundice – Cochrane Library
Cohort Study | Early pregnancy exposure to NSAIDs is associated with slightly higher risks of neonatal and maternal adverse outcomes
7 Mar, 2023 | 12:56h | UTCSummary:
A nationwide cohort study in South Korea, including 1.8 million pregnancies, investigated the association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during early pregnancy and neonatal and maternal adverse outcomes.
The study revealed that pregnant women exposed to NSAIDs during early pregnancy were at increased risk of oligohydramnios and had a slightly higher likelihood of having an infant with major congenital malformations and low birth weight. These risks remained elevated when comparing NSAIDs against acetaminophen or past users.
The study suggests that clinicians should weigh the need to prescribe NSAIDs in early pregnancy against the modest but possible risk of neonatal and maternal outcomes and consider prescribing nonselective NSAIDs for <10 days, with continued careful monitoring for any safety signals.
M-A | Oral iron supplementation and anemia in children according to schedule, duration, dose and cosupplementation
7 Mar, 2023 | 12:53h | UTCSummary:
The article is a systematic review and meta-analysis of 129 randomized trials on iron supplementation and anemia in children. The study aimed to identify the optimal schedule, duration, dose, and cosupplementation regimen for iron supplementation in children and adolescents aged under 20 years.
The results showed that frequent (3-7 times/week) and intermittent (1-2 times/week) iron supplementation could be equally effective at increasing hemoglobin and decreasing anemia, iron deficiency, and iron deficiency anemia.
The study supports WHO recommendations regarding the frequency, duration, and dose of iron supplementation, including 3 months annually of daily oral iron supplementation for children aged 6 months to 12 years living in regions with a high burden of anemia. However, it also suggests that weekly iron supplementation might be considered an alternative to the recommended daily regimen in some contexts, given evidence of similar efficacy.
Report | Economic impact of overweight and obesity to surpass $4 trillion by 2035
6 Mar, 2023 | 14:32h | UTCSummary:
A recent report from the World Obesity Federation has issued a warning that the number of people worldwide suffering from overweight or obesity could increase significantly by 2035, surpassing the 50% mark. The report, called the World Obesity Atlas 2023, also highlights the significant economic impact of this trend, estimating that the cost of overweight and obesity could reach $4.32tn annually by 2035, equivalent to almost 3% of the global GDP.
The report also identifies two groups that are particularly at risk: children and individuals from lower-income countries. Childhood obesity is a growing concern, as the report predicts it could double by 2035. Additionally, lower-income countries face a rapid increase in obesity prevalence, with nine out of 10 countries with the greatest expected increases in obesity coming from low or lower-middle income countries.
Report: World Obesity Atlas 2023
News release: Economic impact of overweight and obesity to surpass $4 trillion by 2035
Commentary: Report: Obesity could cost the world over $4 trillion a year by 2035 – STAT
Related:
Report: Tenfold increase in childhood and adolescent obesity in four decades
Global cost of obesity-related illness to hit $1.2tn a year from 2025
The Lancet Series: The Double Burden of Malnutrition
BTS Clinical Guidance | Prevention and management of community-acquired pneumonia in people with learning disability
6 Mar, 2023 | 14:34h | UTC
Consensus Paper | Management of respiratory distress syndrome
6 Mar, 2023 | 14:14h | UTC
M-A | Sugar-sweetened beverage consumption and weight gain in children and adults
6 Mar, 2023 | 14:04h | UTCNews Release: More evidence that sugary drinks cause weight gain – University of Toronto
Perspective | The other long Covid: the pandemic took young people’s present. What will it do to their future?
3 Mar, 2023 | 14:05h | UTC
RCT | Reducing social media use improves appearance and weight esteem in youth with emotional distress
3 Mar, 2023 | 14:04h | UTCSummary: The article discusses a randomized controlled trial conducted on 220 participants aged 17-25 to examine the effects of reducing smartphone social media use (SMU) on appearance and weight esteem in youth with emotional distress. The participants were divided into an intervention group (limited to 1 hr/day SMU) and a control group (unrestricted SMU). The study found that reducing SMU improved appearance and weight esteem in the intervention group, while the control group showed no significant change. The authors concluded that reducing SMU may be a feasible and effective method of improving body image in a vulnerable youth population and should be evaluated as a potential component in treating body image-related disturbances. It is worth noting, however, that the impossibility of blinding participants and the subjective nature of the endpoints make it difficult to draw definitive conclusions on the subject.
News Release: Reducing social media use significantly improves body image in teens, young adults – American Psychological Association
Commentary: How to help young people limit screen time — and feel better about how they look – NPR
Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland
3 Mar, 2023 | 13:51h | UTCSummary: The study aimed to determine the association between maternal diabetes and overweight/obesity and the risk of congenital heart defects (CHDs) in offspring. The study analyzed data from all children born in Finland between 2006 and 2016 and their mothers. Maternal type 1 diabetes (T1DM) was found to be associated with a significantly increased risk for any CHD, with an odds ratio of 3.71, whereas maternal overweight and obesity were associated with only a slightly increased risk for complex defects and left ventricular outflow tract obstruction. Maternal diabetes was responsible for 3.0% of offspring’s CHD, while maternal overweight and obesity were responsible for 0.7%, indicating weaker associations between maternal overweight and obesity and CHD in the offspring than previously reported.
Commentary from the author on Twitter
Proudly presenting our preprint (thread):
Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland https://t.co/rFnlNYPrgn 1/7
— Emmi Helle (@EmmiHelle) February 27, 2023
SR | Interventions for preventing and treating kidney disease in IgA vasculitis
3 Mar, 2023 | 13:47h | UTCInterventions for preventing and treating kidney disease in IgA vasculitis – Cochrane Library
Youth-onset type 2 diabetes: the epidemiology of an awakening epidemic
2 Mar, 2023 | 13:01h | UTCYouth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic – Diabetes Care
M-A | Thromboprophylaxis in patients with Fontan circulation
2 Mar, 2023 | 12:57h | UTCThromboprophylaxis in Patients With Fontan Circulation – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentary: Thromboprophylaxis in Patients With Fontan Circulation – American College of Cardiology
Commentary from the author on Twitter (thread – click for more)
🔥Hot off the press🔥Read our new paper about #Thromboprophylaxis in patients with #Fontan #circulation just published in @JACCJournals@ACCinTouch.
Article link: https://t.co/eeu6kT7PDH— Jef Van den Eynde (@JefVandenEynde) January 23, 2023
RCT | Impact of supplementation with milk–cereal mix during 6–12 months of age on growth at 12 months in Delhi, India
2 Mar, 2023 | 12:50h | UTCCommentary: High-protein supplementation improves linear growth in infants – 2 Minute Medicine
Brief Review | Acute rheumatic fever: recent advances
2 Mar, 2023 | 12:41h | UTCAcute Rheumatic Fever: Recent Advances – The Pediatric Infectious Disease Journal (free for a limited period)
Pediatric clinical practice adapted guidelines for management of nephrotic syndrome
1 Mar, 2023 | 14:01h | UTCPart 1: Steroid sensitive nephrotic syndrome
Part 2: Steroid-resistant nephrotic syndrome
IPNA Recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome
1 Mar, 2023 | 13:59h | UTCRelated:
WHO Report | A woman dies every two minutes due to pregnancy or childbirth
28 Feb, 2023 | 14:04h | UTCSummary: This new report by United Nations agencies shows that a woman dies every two minutes due to pregnancy or childbirth. The report covers maternal deaths from 2000 to 2020 and reveals that maternal deaths either increased or stagnated in nearly all regions of the world, with some regions experiencing major setbacks. The poorest parts of the world and countries affected by conflict continue to have the highest rates of maternal deaths. Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions aggravated by pregnancy are the leading causes of maternal deaths, which are largely preventable and treatable with access to high-quality healthcare. The COVID-19 pandemic may have further held back progress on maternal health. The report calls for urgent action to ensure every woman and girl has access to critical health services before, during, and after childbirth, so they can fully exercise their reproductive rights.
News Release: A woman dies every two minutes due to pregnancy or childbirth: UN agencies – World Health Organization
Commentaries:
Ambitious goal to slash maternal deaths in jeopardy – Nature
U.N.: Progress on reducing global maternal mortality has stalled since 2015 – STAT
Eight Hundred Women Die Every Day During Pregnancy or Childbirth – Health Policy Watch
Brief Review | Congenital infections: priorities and possibilities for resource-limited settings
1 Mar, 2023 | 13:32h | UTCCongenital Infections: Priorities and Possibilities for Resource-limited Settings – The Pediatric Infectious Disease Journal (free for a limited period)
Perspective | Gender dysphoria in young people is rising — and so is professional disagreement
28 Feb, 2023 | 13:55h | UTCGender dysphoria in young people is rising—and so is professional disagreement – The BMJ
News Release: Gender dysphoria is rising—and so is professional disagreement – BMJ Newsroom
Commentary on Twitter
More children and adolescents are identifying as transgender and are being offered medical treatment, especially in the US—but some providers and European authorities are urging caution because of a lack of strong evidence. @writingblock reports https://t.co/24aDMo7rb0
— The BMJ (@bmj_latest) February 26, 2023
RCT | 2-y outcomes confirm the harms caused by high prophylactic platelet transfusion thresholds in preterm infants
28 Feb, 2023 | 13:53h | UTCSummary: The study investigated the long-term outcomes of preterm infants who participated in a randomized trial of platelet transfusions at different threshold levels. Infants with platelet counts below 50×109/L were enrolled and randomized to either a higher threshold of 50×109/L or a lower threshold of 25×109/L. The study found that infants randomized to the higher threshold had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years compared to the lower threshold group. The study further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. The mechanisms by which platelet transfusions could mediate harmful effects remain unknown, but the study identified increased rates of intraventricular hemorrhage and bronchopulmonary dysplasia in the higher threshold group, which may contribute to the adverse outcomes observed.
Original Study: Randomized Trial: Platelet-Transfusion Thresholds in Neonates
Commentary from the author on Twitter (thread – click for more)
We already knew from the @PlaNeT2_trial that a higher prophylactic platelet transfusion threshold (<50) in preterm babies is associated with significantly increased mortality or major bleeding compared with a lower one (<25)… https://t.co/pJrE44BIIx
— Carmel Moore (@carmelmoore) February 22, 2023