JAMA Paediatrics: Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy

Question  What are the most accurate evaluations for diagnosing cerebral palsy early?

Findings  In this systematic review of the literature, we found diagnosis can be accurately made before 6 months’ corrected age. Before 5 months’ corrected age, magnetic resonance imaging plus the General Movements Assessment or the Hammersmith Infant Neurological Examination are recommended; after 5 months’ corrected age, magnetic resonance imaging (where safe and feasible), the Hammersmith Infant Neurological Examination, and the Developmental Assessment of Young Children are recommended.

Meaning  Early diagnosis should be the standard of care because contemporary early interventions optimize neuroplasticity and functional outcomes.

Link to article here

NIHR Signal: Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events

Published on 11 July 2017

Adverse breathing events are about three times more common when using endotracheal tubes than laryngeal mask airways for infants under 12 months receiving non-urgent surgery.

Airway problems are common during anaesthesia in children, accounting for three quarters of critical incidents and a third of cardiac arrests. They are more frequent in younger children, especially infants under 12 months, who have smaller airways and rapidly use up their oxygen reserves.

Laryngeal mask airways have been used in adults and older children for over 35 years for minor and intermediate surgery. Many studies have shown them to have fewer airway-related complications than tubes. This Australian randomised controlled trial supported this, finding an adverse event rate of 53% with endotracheal tubes compared with only 18% with laryngeal mask airways.

Conventional anaesthesia teaching advises the use of endotracheal tubes in infants even for relatively minor surgery, to provide a secure airway, but incidents may be more common when placing or removing the tube than a laryngeal mask.

Link to article here

Notts. Safeguarding Children Board, Summer Newsletter now out

This edition contains feedback on the NSCB fabricated
and induced illness training, an introduction to the new
Notts. police CSE disruption team, a new NSCB/NCSCB
safer sleeping risk assessment tool and information about
the new healthy families teams as well as the usual
summary of multi-agency audit activity and an update as
to the Serious Case Review activities and findings in the
county. I trust you will find the content both interesting
and informative.

Link to newsletter here

National Paediatric Diabetes Audit Part 2: Hospital Admissions and Complications

This is the National Paediatric Diabetes Audit Report: Hospital Admissions, the second analysis of admissions data published by the Royal College of Paediatrics and Child Health. For the first time, data submitted by healthcare professionals working in paediatric diabetes units has been combined with Hospital Episode Statistics (HES) and data from the Patient Episode Database for Wales (PEDW) to provide a robust picture of diabetes-related admissions in England and Wales.

Link to report here

Report: Suicide by Children and Young People 2017

This report, from the The University of Manchester’s National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) examines the findings from a range of investigations such as coroner inquests, into the deaths by suicide of people aged under 25 between January 2014 and December 2015 in England and Wales, extracting information about the stresses they were facing when they died.

Data was collected from 922 suicides by people aged under 25 in England and Wales during 2014 and 2015. The information came from investigations by official bodies, mainly from coroners, who take evidence from families and professionals.

Link to report here

Nice Guidance: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people

Image: Google Images

Adalimumab, Etanercept & Ustekinumab are recommended as an option for treating plaque psoriasis in children and young people aged 4 years or older, only if the disease:

• is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and
• has not responded to standard systemic therapy, such as ciclosporin, methotrexate or phototherapy, or these options are contraindicated or not tolerated.

   

  Link to guidance here

Probiotics for recurrent abdominal pain in childhood

Journal or Paediatrics & Child Health

Worldwide, it is estimated that 13.5% of school-age children are affected by recurrent abdominal pain (RAP).  Although considered a relatively benign condition, RAP results in substantial morbidity, as well as concern for parents, and paediatricians. Pathophysiology, accurate diagnosis and optimal management remain unclear. Unsurprisingly, dietary approaches to RAP have been around since Apley’s original report of the condition in the 1950s. The good news is a recent systematic review and meta-analysis has identified at least one dietary intervention that appears beneficial, namely probiotics.

Link to article here