Bubble Wrap PLUS – November 2023

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). 

This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

What are some of this month’s highlights?

Physicians often use proton pump inhibitors (PPIs) to treat infants with GER as it is often considered
a ‘safe treatment option’. Yet more and more studies show that this habit may not be without risks. In JAMA Pediatrics, Lassalle and colleagues studied the association between PPI use and the risk of serious infections (requiring hospitalization) in young children. They analysed the French National Health Insurance registry of all pregnancies and births from 2010 to 2018. They found that there was an increased risk of hospitalization in children who had had a PPI (with adjusted hazard ratios between 1.34 and 1.56). Even though exploring causality is impossible in such a methodology, the authors hypothesize several mechanistic explanations ranging from aspirations of bacteriologically contaminated gastric fluid to changes in the GI microbiome.

In another impressive study in the same journal, Jensen and colleagues published a population-based, case-control study of paediatric eosinophilic esophagitis (EoE) in Denmark (including all EoE cases among Danish residents born between 1997 and 2018). They identified 392 cases and selected 3637 sex- and year-of-birth-matched controls. Maternal and infant antibiotic use was associated with an increased risk of developing EoE in a dose-response manner, and the magnitude of association was highest for exposure near the time of delivery.

In the Pediatric Infectious Disease Journal, Guo and colleagues assessed the difference in clinical characteristics between viral pneumonia and Mycoplasma pneumoniae in a large Chinese cohort. They retrospectively identified 375 children with community-acquired pneumonia. Based on their findings, they developed a web-based, dynamic nomogram calculator. After inputting several clinical and biochemical characteristics, you can calculate the probability that the child has a Mycoplasma infection.

Vasovagal syncope (VVS) is a common type of syncope in paediatric practice. It can present in three ways: VVS-vaso-inhibited (decrease in BP alone), VVS-cardio-inhibited (decrease in HR alone) and VVS-mixed. In the European Journal of Pediatrics, Wang and colleagues studied 2513 patients between 3-18 years of age who presented with vasovagal syncope. Using a TILT test, they found that VVS-CI and VVS-M had a 203% and 175% increased likeliness, respectively, compared to VVS-VI. A study in Nature this week identified neural pathways, namely a subset of the vagal sensory neurons that connect the heart and the brain (NPY2R fibres), that induce syncope upon stimulation in mice. This provides an animal model for further study.

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!