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; Benchimol C; Reyes-Acevedo R; Genevray M; Bradley D et al.. Tolerability of up to 200 days of prophylaxis with valganciclovir oral solution and/or film-coated tablets in pediatric kidney transplant recipients at risk of cytomegalovirus disease. Paediatric transplantation; Feb 2017; vol. 21 (no. 1) 10. We recommend that children and young people should be monitored for CMV viral load at least monthly for 12 months post transplant if either donor or recipient are CMV positive (CMV D+R- / CMV D-R+ / CMV D (...) . No literature was sent to participants to avoid risk of bias. The process was iterative (participants able to change their views in subsequent rounds). Two rounds were undertaken. Standardisation of immunosuppressive and anti-infective drug regimens in UK Paediatric Renal transplantation: The Harmonisation Programme 4 Table 1 – PICO characteristics Population Intervention Comparison Outcome Study design Children ( 5 (maximum dose 5mg) on alternate days Azathioprine should be prescribed at 2 mg/kg daily from
describes millions of childhood deaths from preventable causes due to kids not being able to access care – see ‘ Millions of children are at risk of dying, the United Nations said on Wednesday, not of Covid-19, but of preventable causes. Unable to get care at hospitals that are straining to fight the virus, more than a million children aged 5 or younger will die every six months, UNICEF said in a report.’ Acknowledgements: thanks to Peter Doshi for the updates Conflicts of Interest: Both TJ and CH have (...) COVID-19: Have we forgotten our children in all this? COVID-19: Have we forgotten our children in all this? - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website COVID-19: Have we forgotten our children in all this? May 14, 2020 Carl Heneghan, Tom Jefferson UNESCO has produced a report on the . The main points are: ‘Most governments around the world have temporarily closed educational institutions
The medical evaluation of pre-pubertal children with suspected sexual abuse Child sexual abuse is an important and not uncommon problem. Children who have been sexually abused may present to a physician’s office, urgent care centre, or emergency department for medical evaluation. A medical evaluation can provide reassurance to both child and caregiver, identify care needs, and offer an accurate interpretation of findings to the justice and child welfare systems involved.  (...) ;Given the potential medico-legal implications of these assessments, the performance of a comprehensive evaluation requires both current knowledge and clinical proficiency. This position statement presents an evidence-based, trauma-informed approach to the medical evaluation of pre-pubertal children with suspected or confirmed sexual abuse. Keywords: Ano-genital examination; Child protection; Child sexual abuse; Forensic evidence; Sexually transmitted infections
are based largely on the disease experience in China, Europe, and the United States, the paediatric literature on COVID-19 is still in its infancy and will undoubtedly evolve. Canadian guidelines have been developed, notably by [ ] . This statement provides acute care guidance for community paediatricians working in both outpatient and inpatient settings. Clinical presentation Most children presenting with fever and cough do not require hospital care. However, as with adults, infected children may (...) that asymptomatic rates are probably significantly higher, given that all these studies were based solely on cases presenting with clinical features. One recent paper suggested that children younger than 5 years of age are more likely to experience severe COVID-19 symptoms than older children and should be promptly assessed [ ] . Emerging data also appear to suggest that while infants with COVID-19 generally experience mild symptoms, they are at higher risk for severe disease than other paediatric age groups
milder cases and a better prognosis than adults. Acta Paediatr 2020; online ahead of print: DOI: 10.1111/apa.15270. Cui Y, Tian M, Huang D, et al. A 55-day-old female infant infected with COVID 2019: Presenting with pneumonia, liver injury, and heart damage. J Infect Dis 2020; online ahead of print: DOI: 10.1093/infdis/jiaa113. Hong H, Wang Y, Chung H-T, Chen CJ. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatr Neonatol 2020;61(2):131-2 (...) Update on COVID-19 epidemiology and impact on medical care in children: April 2020 Update on COVID-19 epidemiology and impact on medical care in children: April 2020Update on COVID-19 epidemiology and impact on medical care in children: April 2020 | Canadian Paediatric Society A home for paediatricians. A voice for children and youth. Current: Update on COVID-19… Practice Point Update on COVID-19 epidemiology and impact on medical care in children: April 2020 Posted: Apr 29, 2020 The Canadian
of Children’s Diabetes Clinicians Clinicians Version 4, May 2018, Review 2021 Authors: SM Ng, E Williams , F Ackland, C Burren, J Edge, E Hind, A McAulay, Bill Lamb Treatment of Severe Hypoglycaemia Follow this page if child is unconscious or fitting (or also not responded from page 2) CHECK CAPILLARY BLOOD GLUCOSE AND CONFIRM HYPOGLYCAEMIA ( 25kg for 1mg glucagon by IM injection Glucagon is a fast acting drug and the child/adolescent should respond after 5 minutes. After the child has regained (...) for review of treatment, advice or education If child not improving: • If patients have protracted vomiting and are unable to tolerate oral fluids, hospital admission and IV glucose infusion must be considered, especially if a child has returned to the emergency department with further hypoglycaemia during the same intercurrent illness. • If a child/Adolescent remains unconscious on correction of BG consider cerebral oedema, head injury, adrenal insufficiency or drug overdose ssociation of Children’s
*)ti,ab OR (L asparaginase)ti,ab OR (L asparaginase*)ti,ab 19 4 ( (hyperglycaemia or hyperglycemia) ti,ab OR HYPERGLYCEMIA/) 21 23 (cyclosporine) ti,ab OR cyclosporine*ti.ab OR (tacrolimus,ti,ab OR (tacrolimus*)ti,ab OR (L asparaginase)ti,ab OR (L asparaginase*) AND (child*OR infant* OR pediatric* or Paediatric* )35 68 Glycosuria AND 35((steroids) ti,ab ) AND STEROID/ OR , Chemotherapy) ti,ab OR Transplant * ti,ab 4,5,6,7 ) 23 25 AND (child*OR infant* OR pediatric* or Paediatric* )35 26 1 (...) ( (hyperglycaemia or hyperglycemia) ti,ab OR HYPERGLYCEMIA/)20 35((steroids) ti,ab ) AND STEROID/ OR , Chemotherapy) ti,ab OR Transplant * ti,ab 4,5,6,7 ) 23 AND (child*OR infant* OR pediatric* or Paediatric* ) 133 28 Transplant * ti,ab 43 HYPERGLYCEMIA/ep AND (child*OR infant* OR pediatric* or Paediatric* ) 9 (Chemotherapy) ti,ab 6 AND 43 HYPERGLYCEMIA/ep AND (child*OR infant* OR pediatric* or Paediatric* ) 3 5 (STEROID/, 43 HYPERGLYCEMIA/ep AND (child*OR infant* OR pediatric* or Paediatric* ) 0 4(steroids) ti
Care of the Well Child-Newly Diagnosed with Type 1 Diabetes Version 4, Dec 2019 Review 2022 Authors: J Chizo Agwu, SM Ng, A Timmis, C Moudiotis, K. Matyka,, N.P.Wright, M. Kershaw S.Bahl, A. Alston . N Trevelyan Page of 7 1 ssociation of Children’s Diabetes Clinicians Clinical Guideline Care of the well child, newly diagnosed with Type 1 Diabetes Mellitus SETTING Insert hospital name FOR STAFF Medical and nursing staff PATIENTS Children with diabetes and their families (...) ssociation of Children’s Diabetes Clinicians References 1. British Society for Paediatric Endocrinology and Diabetes (BSPED) guidelines for the management of DKA. http://www.bsped.org.uk/professional/ guidelines/docs/DKAGuideline.pdf 2. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia. Report of WHO/IDF Consultation 2006. 3. Wang J, Miao D, Babu S, Yu J, Barker J, Klingensmith G et al. Prevalence of Autoantibody- Negative Diabetes Is Not Rare at All Ages and Increases
paediatrician. B. EMERGENCY MANAGEMENT IN A & E: 1. General Resuscitation: A, B, C. Airway Ensure that the airway is patent and if the child is comatose, insert an airway. If consciousness reduced or child has recurrent vomiting, consider inserting N/G tube, aspirate and leave on open drainage. Seek urgent anaesthetic review and discuss with a paediatric critical care specialist if the child or young person has a reduced level of consciousness and is unable to protect their airway. Breathing Give 100 (...) Examination - looking particularly for evidence of - ? cerebral oedema headache, irritability, slowing pulse, rising blood pressure, reducing conscious level N.B. papilloedema is a late sign. ? ? infection ? ? ? ileus (which is common in DKA) ? ? ? 3. WEIGH THE CHILD. If this is not possible because of the clinical condition, use the most recent clinic weight as a guideline, or an estimated weight from centile charts. Consider where the child or young person should be nursed – Children and young people
, cognitive behavioral therapy; CCAL, Camp Cope‐A‐Lot; CPRS, Conners’ Parent Rating Scales; FIQ, full scale IQ; IT, intervention group; MASC, Multidimensional Anxiety Scale for Children; PARS, Pediatric Anxiety Rating Scale; RCADS, Revised Child Anxiety and Depression Scale; RCMAS, Revised Children's Manifest Anxiety Scale; SCARED, Screen for Child Anxiety Related Disorders; SCAS, Spence Child Anxiety Scale; STAI‐C, State‐Trait Anxiety Inventory for Children; SWQ, Social Worries Questionnaire; TAU (...) , Ziviani, & Rodger, ; Gjevik, Eldevik, Fjæran‐Granum, & Sponheim, ; Lecavalier, ). The prevalence of anxiety among school‐aged children is of particular concern considering that anxiety during this period has a negative impact on intellectual functioning and academic achievement, and broadly on a child's overall school‐functioning (Mazzone et al., ; Wood, ). School may present students with ASD particular cognitive, social and behavioral challenges that may increase levels of anxiety, and conversely
reviewed by the Adolescent Health and Community Paediatrics Committees and the Child and Youth Maltreatment Section Executive of the Canadian Paediatric Society. Shazeen Suleman, Yasmine Ratnani, Christine Loock, Katrina Stockley, Susan Bennett, Radha Jetty, Katharine Smart, Sarah Gander; Canadian Paediatric Society, Social Paediatrics Section References Gupta RP, de Wit ML, McKeown D. The impact of poverty on the current and future health status of children. PaediatrChild Health 2007;12(8):667–72 (...) , Courtemanche DJ. The Little BEARS QI Questionnaire (All Ages): (Accessed April 30, 2020). Kenyon C, Sandel M, Silverstein M, Shakir A, Zuckerman B. Revisiting the social history for child health. Pediatrics 2007;120(3):e734-8. Fazalullasha F, Taras J, Morinis J, et al. From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice. PaediatrChild Health 2014;19(4):195–9. Morinis J, Levin L, Bloch G, Ford-Jones L; Social Pediatrics
British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Coronavirus (SARS-CoV-2) and COVID-19 in children with Inflammatory Bowel British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Coronavirus (SA 1 IBD Working Group British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Coronavirus (SARS-CoV-2) and COVID-19 in children with IBD Position Statement: Management of PIBD during the SARS-CoV-2 pandemic Specific (...) that children are safe to continue all IBD therapies during the coronavirus pandemic and that stopping medicines put children at risk of disease relapse. The international SECURE-IBD registry, a database curating cases of IBD patients infected with SARS-CoV-2 world-wide, shows that current outcomes for IBD patients do not vary substantially from outcomes from the general population . Reassuringly, first international paediatric data published by Turner et al. confirms that the small number of reported
??? MRI abdomen and pelvis with IV contrast May Be Appropriate (Disagreement) O MRI abdomen and pelvis without and with IV contrast May Be Appropriate O DTPA renal scan May Be Appropriate ??? MRI abdomen and pelvis without IV contrast Usually Not Appropriate O ACR Appropriateness Criteria ® 4 Antenatal Hydronephrosis–Infant ANTENATAL HYDRONEPHROSIS–INFANT Expert Panel on Pediatric Imaging: Brandon P. Brown, MD, MA a ; Stephen F. Simoneaux, MD b ; Jonathan R. Dillman, MD, MSc c ; Cynthia K. Rigsby, MD (...) with certainty. As a result, postnatal evaluation of these children is frequently performed. In an effort to standardize grading of antenatal hydronephrosis, the Society for Fetal Urology (SFU) introduced a five point grading system in 1988, based on degree of pelvic and calyceal dilation and the thickness of the parenchyma overlying the calices . Since its introduction, the SFU grading system has become the most widely used method to grade pediatric hydronephrosis . Subsequently, several alternative
. Hilton S. The child vomiting. In: Hilton S, Edwards D, eds. Practical Pediatric Radiology. Philadelphia, Pa.: BC Decker; 1994:297-299. 3. Ryan S, Donoghue V. Gastrointestinal pathology in neonates: new imaging strategies. Pediatr Radiol. 2010;40(6):927-931. 4. Hernanz-Schulman M. Imaging of neonatal gastrointestinal obstruction. Radiol Clin North Am. 1999;37(6):1163-1186, vi-vii. 5. Lilien LD, Srinivasan G, Pyati SP, Yeh TF, Pildes RS. Green vomiting in the first 72 hours in normal infants. Am J Dis (...) Child. 1986;140(7):662-664. 6. Strouse PJ. Disorders of intestinal rotation and fixation ("malrotation"). Pediatr Radiol. 2004;34(11):837-851. 7. Sizemore AW, Rabbani KZ, Ladd A, Applegate KE. Diagnostic performance of the upper gastrointestinal series in the evaluation of children with clinically suspected malrotation. Pediatr Radiol. 2008;38(5):518-528. 8. Hsiao M, Langer JC. Value of laparoscopy in children with a suspected rotation abnormality on imaging. J Pediatr Surg. 2011;46(7):1347-1352. 9
for investigation of seizures in children. Pediatr Neurosurg. 1992;18(2):105-116. 31. Lefkopoulos A, Haritanti A, Papadopoulou E, Karanikolas D, Fotiadis N, Dimitriadis AS. Magnetic resonance imaging in 120 patients with intractable partial seizures: a preoperative assessment. Neuroradiology. 2005;47(5):352-361. ACR Appropriateness Criteria ® 10 Seizures — Child 32. Wu WC, Huang CC, Chung HW, et al. Hippocampal alterations in children with temporal lobe epilepsy with or without a history of febrile convulsions (...) appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 5 Seizures — Child SEIZURES — CHILD Expert Panel on Pediatric Imaging: Christopher E. Dory, MD 1 ; Brian D. Coley, MD 2 ; Boaz Karmazyn, MD 3 ; Martin Charron, MD 4 ; Molly E. Dempsey, MD 5 ; Jonathan R. Dillman, MD 6 ; Matthew Garber, MD 7 ; Laura L. Hayes, MD 8 ; Kathryn Holloway, MD 9 ; Sarah S. Milla, MD 10 ; Molly E. Raske, MD 11 ; Henry E. Rice, MD 12 ; Cynthia K. Rigsby, MD 13 ; Joshua M. Rosenow, MD 14 ; Peter J. Strouse, MD 15
NICU care for infants born to mothers with suspected or proven COVID-19 NICU care for infants born to mothers with suspected or proven COVID-19NICU care for infants born to mothers with suspected or proven COVID-19 | Canadian Paediatric Society A home for paediatricians. A voice for children and youth. Current: NICU care for infants… Practice Point NICU care for infants born to mothers with suspected or proven COVID-19 Posted: Apr 6 2020 The Canadian Paediatric Society gives permission to print (...) 11, 2020. While mild or moderate disease is expected in a majority of paediatric patients, scarce data is available on the outcomes of pregnancies affected by the virus [ ] . This practice point addresses the care in the neonatal intensive care unit (NICU) for newborns born to mothers with suspected or proven COVID-19. Post-partum care for the COVID-positive mother and neonate: The symptomatic infant An infant who presents with respiratory distress at or within minutes of birth is most likely
Delivery room considerations for infants born to mothers with suspected or proven COVID-19 Delivery room considerations for infants born to mothers with suspected or proven COVID-19Delivery room considerations for infants born to mothers with suspected or proven COVID-19 | Canadian Paediatric Society A home for paediatricians. A voice for children and youth. Current: Delivery room… Practice Point Delivery room considerations for infants born to mothers with suspected or proven COVID-19 Posted (...) Society’s Fetus and Newborn Committee, Infectious Diseases and Immunization Committee, and Neonatal-Perinatal Section Executive; and the Society of Obstetricians and Gynaecologists of Canada. Principal author: Dr. Michael Narvey, Chair, Fetus and Newborn Committee, Canadian Paediatric Society References Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; doi: 10.1542/peds.2020-0702 Schwartz DA, Graham AL
the greatest burden of malnutrition with more than half of all stunted children and two‐third of all wasted children under 5 years of age living in Asia and over one‐third stunted children and a quarter of wasted children living in Africa (UNICEF, ). Childhood malnutrition is a major public health concern since it is associated with significant morbidity and mortality (WHO, ). The consequences of malnutrition among infants and children can be short‐term like morbidity, mortality and disability or long‐term (...) implementation of nutrition‐sensitive as well as nutrition‐specific interventions (Ruel, Alderman, & Maternal Child Nutrition Study Group, ). 2.2 Description of the intervention The existing WHO guidelines for the management malnutrition among children suggests the following (WHO, ): 1. Early identification of children with SAM in the community through active community screening by trained community health workers (CHWs) and community members. CHWs should measure the MUAC of infants and children under 5
Guidance on Providing Pediatric Well-Care During COVID-19 / Guidance on Providing Pediatric Well-Care During COVID-19 The American Academy of P ediatrics (AAP) strongly supports the continued provision of health care for children during the COVID-19 pandemic. Specifically , w ell-child care should be provided consistent with the (4th Edition) and the corresponding (Periodicity Schedule). Since the onset of the pandemic, a significant drop in well-child visits has resulted in delays in vaccinations (...) exam virtually, these telehealth visits should continue to be supported, followed by a timely in-person visit . Pediatricians should identify children who have missed well-child visits and/or recommended vaccinations and contact them to schedule in person appointments inclusive of newborns, infants, children , and adolescents. Pediatricians should work with families to bring children up to date as quickly as possible. State-based immunization information systems and electronic health records may