Archives of Disease in Childhood
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Sudden unexpected death in infancy: aetiology, pathophysiology, epidemiology and prevention in 2015 Despite the fall in numbers of unexpected infant deaths that followed the ‘Back to Sleep’ campaigns in the early 1990s in the UK and many other countries, such deaths remain one of the largest single groups of deaths in the postneonatal period in many Western countries. Changes in the ways in which unexpected infant deaths are categorised by pathologists and coroners, and increasing reluctance to use the term ‘sudden infant death syndrome’, make assessment of nationally and internationally collected data on incidence potentially inaccurate and confusing. In this paper, we review current understanding of the epidemiology and aetiology of unexpected deaths in infancy, and current hypotheses on the pathophysiology of the processes that may lead to death. We also review interventions that have been adopted, with variable degrees of effectiveness in efforts to reduce the numbers of deaths, and new approaches that offer the possibility of prevention in the future.
Archives of Disease in Childhood - Tập 100 Số 10 - Trang 984-988 - 2015
HPV vaccination rate in French adolescent girls: an example of vaccine distrust Objectives To explore the clinical issues of human papillomavirus (HPV) vaccination to develop explanatory hypotheses for the low level of vaccination among adolescent girls in France where the full course coverage is low (<15%). Design We used semistructured interviews. Our qualitative and phenomenological procedure applied interpretative phenomenological analysis. Participants 16 physicians regularly faced with the prescription of HPV vaccine, represented several medical specialties (paediatrics, general practice, internal medicine, gynaecology), with hospitalist or private practices. Main outcome measures The results connect three superordinate themes grouping three concentric levels: within society, during the consultation and in the individual doctor’s feelings. Results The modalities and contents of the information about HPV vaccination raise questions about the limitations of the information doctors receive. The ineluctable association between sexuality and HPV vaccination explains their reluctance to raise topics considered to be private. The reasons for HPV vaccination illustrate the difficulty of arguing in favour of it. In view of the frequent parental reluctance, which weakens the parent–physician alliance, physicians must take responsibility for defending the benefits of vaccination. They nonetheless remain citizens whose opinions may implicitly echo the general reluctance, promoted by disinformation. In delaying or avoiding the subject of vaccination, they involuntarily become an instrument of anti-vaccination discourse.Conclusions It is imperative to improve the distribution of credible information about vaccination, unbiased and scientifically supported by a strong institutional position and to rethink the place of the clinician in the system of adolescent health and disease prevention in France.
Archives of Disease in Childhood - Tập 103 Số 8 - Trang 740-746 - 2018
With new prenatal testing, will babies with Down syndrome slowly disappear?
Archives of Disease in Childhood - Tập 94 Số 11 - Trang 823-826 - 2009
Linear growth following complicated severe malnutrition: 1-year follow-up cohort of Kenyan children Background Stunting is the most common manifestation of childhood undernutrition worldwide. Children presenting with severe acute malnutrition (SAM) are often also severely stunted. We evaluated linear growth and its determinants after medically complicated SAM. Methods We performed secondary analysis of clinical trial data ( NCT00934492) from HIV-uninfected Kenyan children aged 2–59 months hospitalised with SAM. Outcome was change in height/length-for-age z-score (HAZ) between enrolment and 12 months later. Exposures were demographic, clinical, anthropometric characteristics and illness episodes during follow-up. Results Among 1169 children with HAZ values at month 12 (66% of those in original trial), median (IQR) age 11 (7–17) months and mean (SD) HAZ −2.87 (1.6) at enrolment, there was no change in mean HAZ between enrolment and month 12: −0.006Z (95% CI −0.07 to 0.05Z). While 262 (23%) children experienced minimal HAZ change (within ±0.25 HAZ), 472 (40%) lost >0.25 and 435 (37%) gained >0.25 HAZ. After adjusting for regression to the mean, inpatient or outpatient episodes of diarrhoea and inpatient severe pneumonia during follow-up were associated with HAZ loss. Premature birth and not being cared by the biological parent were associated with HAZ gain. Increases in mid-upper arm circumference and weight-for-age were associated with HAZ gain and protected against HAZ loss. Increase in weight-for-height was not associated with HAZ gain but protected against HAZ loss. No threshold of weight gain preceding linear catch-up growth was observed. Conclusions Interventions to improve dietary quality and prevent illness over a longer period may provide opportunities to improve linear growth.
Archives of Disease in Childhood - Tập 104 Số 3 - Trang 229-235 - 2019
Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children
Archives of Disease in Childhood - Tập 95 Số 11 - Trang 877-882 - 2010
Acute and late coronary outcomes in 1073 patients with Kawasaki disease with and without intravenous γ-immunoglobulin therapy
Archives of Disease in Childhood - Tập 100 Số 6 - Trang 542-547 - 2015
Predicting IVIG resistance in UK Kawasaki disease The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.
Archives of Disease in Childhood - Tập 100 Số 4 - Trang 366-368 - 2015
Prevention and treatment of renal disease in Henoch-Schonlein purpura: a systematic review
Archives of Disease in Childhood - Tập 94 Số 2 - Trang 132-137
Season of birth as predictor of atopic manifestations
Archives of Disease in Childhood - Tập 76 Số 4 - Trang 341-344 - 1997
Indoor environmental risk factors in young asthmatics: a case-control study.
Archives of Disease in Childhood - Tập 73 Số 5 - Trang 408-412 - 1995
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