Pub Date : 2025-02-19DOI: 10.1136/archdischild-2025-328585
{"title":"APPY trial: uncomplicated appendicitis - surgery or antibiotics?","authors":"","doi":"10.1136/archdischild-2025-328585","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328585","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 3","pages":"202"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1136/archdischild-2024-327493
Naomi Kemps, Clementien Vermont, Chantal D Tan, Ulrich von Both, Enitan Carrol, Marieke Emonts, Michiel van der Flier, Jethro Adam Herberg, Benno Kohlmaier, Michael Levin, Emma Lim, Ian Maconochie, Federico Martinón-Torres, Ruud Gerard Nijman, Marko Pokorn, Irene Rivero-Calle, Aleksandra Rudzāte, Maria Tsolia, Dace Zavadska, Werner Zenz, Henriette A Moll, Joany M Zachariasse
Background: White blood cell count (WBC) is a widely used marker for the prediction of serious bacterial infection (SBI); however, previous research has shown poor performance. This study aims to assess the value of WBC in the prediction of SBI in children at the emergency department (ED) and compare its value with C reactive protein (CRP) and absolute neutrophil count (ANC).
Methods: This study is an observational multicentre study including febrile children aged 0-18 years attending 1 of 12 EDs in 8 European countries. The association between WBC and SBI was assessed by multivariable logistic regression, adjusting for age, CRP and duration of fever. Additionally, diagnostic performance was assessed by sensitivity and specificity. Results were compared with CRP and ANC.
Results: We included 17 082 children with WBC measurements, of which 1854 (10.9%) had an SBI. WBC >15 had an adjusted OR of 1.9 (95% CI 1.7 to 2.1) for prediction of SBI, after adjusting for confounders. Sensitivity and specificity were 0.56 (95% CI 0.54 to 0.58) and 0.74 (0.73 to 0.75) for WBC >15, and 0.32 (0.30 to 0.34) and 0.91 (0.91 to 0.91) for WBC >20, respectively. In comparison, CRP >20 mg/L had a sensitivity of 0.87 (95% CI 0.85 to 0.88) and a specificity of 0.59 (0.58 to 059). For CRP >80 mg/L, the sensitivity was 0.55 (95% CI 0.52 to 057) and the specificity was 0.91 (0.90 to 0.91). Additionally, for ANC >10, the sensitivity was 0.55 (95% CI 0.53 to 0.58) and the specificity was 0.75 (0.75 to 0.76). The combination of WBC and CRP did not improve performance compared with CRP alone.
Conclusion: WBC does not have diagnostic benefit in identifying children with an SBI compared with CRP and should only be measured for specific indications.
{"title":"The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study.","authors":"Naomi Kemps, Clementien Vermont, Chantal D Tan, Ulrich von Both, Enitan Carrol, Marieke Emonts, Michiel van der Flier, Jethro Adam Herberg, Benno Kohlmaier, Michael Levin, Emma Lim, Ian Maconochie, Federico Martinón-Torres, Ruud Gerard Nijman, Marko Pokorn, Irene Rivero-Calle, Aleksandra Rudzāte, Maria Tsolia, Dace Zavadska, Werner Zenz, Henriette A Moll, Joany M Zachariasse","doi":"10.1136/archdischild-2024-327493","DOIUrl":"10.1136/archdischild-2024-327493","url":null,"abstract":"<p><strong>Background: </strong>White blood cell count (WBC) is a widely used marker for the prediction of serious bacterial infection (SBI); however, previous research has shown poor performance. This study aims to assess the value of WBC in the prediction of SBI in children at the emergency department (ED) and compare its value with C reactive protein (CRP) and absolute neutrophil count (ANC).</p><p><strong>Methods: </strong>This study is an observational multicentre study including febrile children aged 0-18 years attending 1 of 12 EDs in 8 European countries. The association between WBC and SBI was assessed by multivariable logistic regression, adjusting for age, CRP and duration of fever. Additionally, diagnostic performance was assessed by sensitivity and specificity. Results were compared with CRP and ANC.</p><p><strong>Results: </strong>We included 17 082 children with WBC measurements, of which 1854 (10.9%) had an SBI. WBC >15 had an adjusted OR of 1.9 (95% CI 1.7 to 2.1) for prediction of SBI, after adjusting for confounders. Sensitivity and specificity were 0.56 (95% CI 0.54 to 0.58) and 0.74 (0.73 to 0.75) for WBC >15, and 0.32 (0.30 to 0.34) and 0.91 (0.91 to 0.91) for WBC >20, respectively. In comparison, CRP >20 mg/L had a sensitivity of 0.87 (95% CI 0.85 to 0.88) and a specificity of 0.59 (0.58 to 059). For CRP >80 mg/L, the sensitivity was 0.55 (95% CI 0.52 to 057) and the specificity was 0.91 (0.90 to 0.91). Additionally, for ANC >10, the sensitivity was 0.55 (95% CI 0.53 to 0.58) and the specificity was 0.75 (0.75 to 0.76). The combination of WBC and CRP did not improve performance compared with CRP alone.</p><p><strong>Conclusion: </strong>WBC does not have diagnostic benefit in identifying children with an SBI compared with CRP and should only be measured for specific indications.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"191-196"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1136/archdischild-2024-327532
Julia Shumway, Jill Ellis, Alice Stephens, Bianca Lucia De Stavola, Ruth Gilbert, Ania Zylbersztejn
Objective: The objective is to describe age-specific cumulative incidence for hospital-recorded indicators of chronic health conditions (CHCs) in children with Down syndrome (DS) compared with children without DS.
Design: National birth cohort using hospital admission and death records.
Setting: National Health Service (NHS)-funded hospitals in England.
Population: Liveborn, singleton infants born in NHS-funded hospitals between 2003 and 2019.
Main outcome measures: Cumulative incidence of nine categories of hospital-recorded CHCs, multimorbidity and mortality.
Results: We identified 10 621 infants with DS among 9 631 646 liveborn, singleton infants (0.11%). Among children with DS, the cumulative incidence for any indicated CHC was 90.1% by age 16, as compared with 21.2% of children without DS. By age 16, a third of children (33.1%) with DS had CHCs affecting four or more body systems; only 6.0% of children without DS had CHCs indicated in more than one body system. The most common CHCs in children with DS were severe congenital heart defects, indicated in 57.2% (0.8% in children without DS). The estimated HR for mortality up to age 16 comparing children with versus without DS was 15.26 (95% CI: 14.15, 16.45).
Conclusions: Children with DS had a higher cumulative incidence for CHCs in each body system category and subcategory, at all ages, than children without DS. Multimorbidity and mortality were higher among children with DS. Administrative data can be used to examine the health needs and healthcare use of children with DS throughout childhood and adolescence.
{"title":"Hospital-recorded chronic health conditions in children with and without Down syndrome in England: a national cohort of births from 2003 to 2019.","authors":"Julia Shumway, Jill Ellis, Alice Stephens, Bianca Lucia De Stavola, Ruth Gilbert, Ania Zylbersztejn","doi":"10.1136/archdischild-2024-327532","DOIUrl":"10.1136/archdischild-2024-327532","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to describe age-specific cumulative incidence for hospital-recorded indicators of chronic health conditions (CHCs) in children with Down syndrome (DS) compared with children without DS.</p><p><strong>Design: </strong>National birth cohort using hospital admission and death records.</p><p><strong>Setting: </strong>National Health Service (NHS)-funded hospitals in England.</p><p><strong>Population: </strong>Liveborn, singleton infants born in NHS-funded hospitals between 2003 and 2019.</p><p><strong>Main outcome measures: </strong>Cumulative incidence of nine categories of hospital-recorded CHCs, multimorbidity and mortality.</p><p><strong>Results: </strong>We identified 10 621 infants with DS among 9 631 646 liveborn, singleton infants (0.11%). Among children with DS, the cumulative incidence for any indicated CHC was 90.1% by age 16, as compared with 21.2% of children without DS. By age 16, a third of children (33.1%) with DS had CHCs affecting four or more body systems; only 6.0% of children without DS had CHCs indicated in more than one body system. The most common CHCs in children with DS were severe congenital heart defects, indicated in 57.2% (0.8% in children without DS). The estimated HR for mortality up to age 16 comparing children with versus without DS was 15.26 (95% CI: 14.15, 16.45).</p><p><strong>Conclusions: </strong>Children with DS had a higher cumulative incidence for CHCs in each body system category and subcategory, at all ages, than children without DS. Multimorbidity and mortality were higher among children with DS. Administrative data can be used to examine the health needs and healthcare use of children with DS throughout childhood and adolescence.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"221-227"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Graves' disease: are we just delaying the inevitable?","authors":"Chloe Stevens, Shirley Langham, Rakesh Amin, Mehul Dattani, Caroline Brain, Catherine Peters","doi":"10.1136/archdischild-2024-327877","DOIUrl":"10.1136/archdischild-2024-327877","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"246-247"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1136/archdischild-2025-328592
{"title":"Highlights from the literature.","authors":"","doi":"10.1136/archdischild-2025-328592","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328592","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 3","pages":"248"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case of sapphire eyes with hearing loss: Waardenburg syndrome type 1 in a young girl.","authors":"Vishal Gaurav, Gaby Lalmuanpuii, Pavani Gowda, Aditi Guglani","doi":"10.1136/archdischild-2024-327905","DOIUrl":"10.1136/archdischild-2024-327905","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"243"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1136/archdischild-2024-327377
D Thisuri N De Silva, Tobias Strunk, Michael Petrovski, Nabeelah Mukadam, Kevin T Batty
{"title":"Compatibility of pentoxifylline injection with syringe and inline filters.","authors":"D Thisuri N De Silva, Tobias Strunk, Michael Petrovski, Nabeelah Mukadam, Kevin T Batty","doi":"10.1136/archdischild-2024-327377","DOIUrl":"10.1136/archdischild-2024-327377","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"245-246"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What do young voices tell us about medication needs during the transition to adult care?","authors":"Ashifa Trivedi, Sarah Mohamad, Merin Thoppil, Roshnee Patel, Shivani Sethi, Naiya Patel, Anne-Lise Goddings","doi":"10.1136/archdischild-2024-328085","DOIUrl":"10.1136/archdischild-2024-328085","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1136/archdischild-2025-328579
{"title":"Procalcitonin: confusing.","authors":"","doi":"10.1136/archdischild-2025-328579","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328579","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":"110 3","pages":"179"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1136/archdischild-2023-326625
Oluwasefunmi Akeju, Emily A Lees, Gayatri Amirthalingam, Mary E Ramsay, Andrew J Pollard
{"title":"Changes to the UK childhood immunisation schedule.","authors":"Oluwasefunmi Akeju, Emily A Lees, Gayatri Amirthalingam, Mary E Ramsay, Andrew J Pollard","doi":"10.1136/archdischild-2023-326625","DOIUrl":"10.1136/archdischild-2023-326625","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":"180-187"},"PeriodicalIF":4.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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