Bumper Bubble Wrap PLUS – July/August 2019

Cite this article as:
Anke Raaijmakers. Bumper Bubble Wrap PLUS – July/August 2019, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.20544

Here is our latest Bumper BubbleWrap Plus, combining July’s and August’s paediatric Journal Club Lists provided by Professor Jaan Toelen & his team of the University Hospitals in Leuven (Belgium). This comprehensive list of ‘articles to read’ from the last two months comes from 34 journals, including Pediatrics, The Journal of Pediatrics, Archives of Disease in Childhood, JAMA Pediatrics, Journal of Paediatrics and Child Health, NEJM, and many more. This list features answers to intriguing questions such as: ‘Which oxygen saturation leads to ROP?’, ‘How much do parents actually use their smartphones?’, ‘Does teaching of parents lead to less urine contamination rates?’ and ‘Is delayed cord clamping beneficial in elective caesarians?’. We hope you enjoy it!

You will find the list is broken down into four sections:

1.Reviews and opinion articles

Debate: Are Stimulant Medications for Attention-Deficit/Hyperactivity Disorder Effective in the Long-Term?

Cortese S, et al. J Am Acad Child Adolesc Psychiatry. 2019 Jun 26

Continuous Noninvasive Carbon Dioxide Monitoring in Neonates: From Theory to Standard of Care.

Hochwald O, et al.Pediatrics. 2019 Jun 27.

Hyperinsulinaemic hypoglycaemia-an overview of a complex clinical condition.

Kostopoulou E, et al.Eur J Pediatr. 2019 Jun 26.

Food allergy desensitisation: a hard nut to crack?

Chong KW, et al.Arch Dis Child. 2019 Jun 26.

The two extremes meet: pediatricians, geriatricians and the life-course approach.

Cesari M, et al.Pediatr Res. 2019 Jun 25.

What I Learned From My Childhood as a Patient: Internalized Messages About Bodies.

Robertson AD. JAMA Pediatr. 2019 Jun 24

Group B Streptococcus: Trials and Tribulations.

Davies HG, et al. Pediatr Infect Dis J. 2019 Jun;38(6S Suppl 1):S72-S76

Parasites in Human Stool: To Ignore or Not To Ignore?

Butters C, et al.Pediatr Infect Dis J. 2019 Jun;38(6S Suppl 1):S47-S51.

Dilemmas With Rotavirus Vaccine: The Neonate and Immunocompromised.

Chiu M, et al.Pediatr Infect Dis J. 2019 Jun;38(6S Suppl 1):S43-S46.

To LP or not to LP? Identifying the Etiology of Pediatric Meningitis.

Mijovic H, et al.Pediatr Infect Dis J. 2019 Jun;38(6S Suppl 1):S39-S42

Viral Bacterial Interactions in Children: Impact on Clinical Outcomes.

Diaz-Diaz A, et al.Pediatr Infect Dis J. 2019 Jun;38(6S Suppl 1):S14-S19.

Biomarkers for Infection in Children: Current Clinical Practice and Future Perspectives.

Stol K, et al.Pediatr Infect Dis J. 2019 Jun;38(6S Suppl 1):S7-S13.

Innate immunity and urinary tract infection.

Ching C, et al.Pediatr Nephrol. 2019 Jun 13

Stranded on Antipsychotics: Role of the Pediatric Clinician.

Ballard R, et al.Clin Pediatr (Phila). 2019 Jun 10:9922819853774

Update on adrenal steroid hormone biosynthesis and clinical implications.

Bacila IA, et al.Arch Dis Child. 2019 Jun 7.

Stimulating and maintaining spontaneous breathing during transition of preterm infants.

Dekker J, et al.Pediatr Res. 2019 Jun 19.

School Readiness.

Williams PG, et al. Pediatrics. 2019 Jul 22.

Controversies Surrounding the Pathophysiology of Tics.

Singer HS, et al. J Child Neurol. 2019 Jul 18:883073819862121.

Viral hepatitis.

Hardikar W. J Paediatr Child Health. 2019 Jul 17.

Two centuries of immunisation in the UK (part 1).

Lang S, et al. Arch Dis Child. 2019 Jul 4.

Two centuries of immunisation in the UK (part II).

Lang S, et al. Arch Dis Child. 2019 Jul 13.

Family Chaos and Asthma Control.

Weinstein SM, et al. Pediatrics. 2019 Jul 9.

Torsion of an Undescended Testis – A Surgical Pediatric Emergency.

Kargl S, et al. J Pediatr Surg. 2019 Jun 28.

Less invasive surfactant administration (LISA): chances and limitations.

Herting E, et al. Arch Dis Child Fetal Neonatal Ed. 2019 Jul 11.

2. Original clinical studies

Randomized Controlled Trial of Iron-Fortified versus Low-Iron Infant Formula: Developmental Outcomes at 16 Years.

Gahagan S, et al. J Pediatr. 2019 Jun 25.

Benefits of medical clowning in the treatment of young children with autism spectrum disorder.

Shefer S, et al.Eur J Pediatr. 2019 Jun 26.

Social Robots for Hospitalized Children.

Logan DE, et al.Pediatrics. 2019 Jun 26.

Tic Suppression in Children With Recent-Onset Tics Predicts 1-Year Tic Outcome.

Kim S, et al.J Child Neurol. 2019 Jun 26:883073819855531.

Delays in diagnosis of nephrotic syndrome in children: A survey study.

Hollis A, et al.Paediatr Child Health. 2019 Jul;24(4):258-262.

Shared decision making during antenatal counselling for anticipated extremely preterm birth.

Barker C, et al.Paediatr Child Health. 2019 Jul;24(4):240-249.

Parental preferences on diagnostic imaging tests for paediatric appendicitis.

Martinez-Rios C, et al.Paediatr Child Health. 2019 Jul;24(4):234-239

Neurologic Outcome After Prematurity: Perspectives of Parents and Clinicians.

Lemmon ME, et al.Pediatrics. 2019 Jun 27.

Development of the Serum α-Fetoprotein Reference Range in Patients with Beckwith-Wiedemann Spectrum.

Duffy KA, et al.J Pediatr. 2019 Jun 21

Positional plagiocephaly/brachycephaly is associated with later cognitive and academic outcomes.

Knight S. J Pediatr. 2019 Jul;210:239-242.

Confidentiality in the Doctor-Patient Relationship: Perspectives of Youth Ages 14-24 Years.

Zucker NA, et al.J Pediatr. 2019 Jun 20.

Characteristics Associated with Successful Weight Management in Youth with Obesity.

Gorecki MC, et al.J Pediatr. 2019 Jun 20.

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms.

Gantz MG, et al.Arch Dis Child Fetal Neonatal Ed. 2019 Jun 22.

Defining urinary tract infection by bacterial colony counts: a case for less than 100,000 colonies/mL as the threshold.

Tullus K. Pediatr Nephrol. 2019 Jun 20.

Cervical Spine Injury Risk Factors in Children With Blunt Trauma.

Leonard JC, et al.Pediatrics. 2019 Jun 20.

Immature neutrophils in young febrile infants.

Ramgopal S, et al.Arch Dis Child. 2019 Jun 20.

Recurrent Pneumococcal Meningitis in Children: A Multicenter Case-Control Study.

Darmaun L, et al.Pediatr Infect Dis J. 2019 Jun 17.

Educational intervention does not reduce non-invasive urine contamination rates in children presenting to the emergency department.

Jacob R, et al.J Paediatr Child Health. 2019 Jun 19.

Short Sleep Duration and Later Overweight in Infants.

Tuohino T, et al.J Pediatr. 2019 Jun 14.

Assessing the Efficacy of Very Early Motor Rehabilitation in Children with Down Syndrome.

Okada S, et al.J Pediatr. 2019 Jun 14.

Assessment and management of tic disorders and Tourette syndrome by Australian paediatricians.

Efron D, et al. J Paediatr Child Health. 2019 Jun 17.

Association of Sexting With Sexual Behaviors and Mental Health Among Adolescents: A Systematic Review and Meta-analysis.

Mori C, et al. JAMA Pediatr. 2019 Jun 17.

Mental Illness Among Youth With Chronic Physical Conditions.

Adams JS, et al.Pediatrics. 2019 Jun 14. pii: e20181819.

Predicting risk of underconfidence following maternity leave.

van Boxel E, et al.Arch Dis Child. 2019 Jun 14.

Children’s views on taking medicines and participating in clinical trials.

Nordenmalm S, et al.Arch Dis Child. 2019 Jun 14.

The Right Stuff: Priming Students to Focus on Pertinent Information During Clinical Encounters.

Stuart E, et al.Pediatrics. 2019 Jun 13.

Sleep macro-architecture and micro-architecture in children born preterm with sleep disordered breathing.

Chan M, et al.Pediatr Res. 2019 Jun 13.

How much do parents actually use their smartphones? Pilot study comparing self-report to passive sensing.

Yuan N, et al.Pediatr Res. 2019 Jun 13.

Neurodevelopmental and Academic Outcomes in Children With Orofacial Clefts: A Systematic Review.

Gallagher ER, et al.Pediatrics. 2019 Jun 12.

Diaphragm electromyography results at different high flow nasal cannula flow rates.

Jeffreys E, et al.Eur J Pediatr. 2019 Jun 11.

Challenges to Pertussis Control.

Edwards KM. Pediatrics. 2019 Jun 10.

Acellular Pertussis Vaccine Effectiveness Over Time.

Zerbo O, et al. Pediatrics. 2019 Jun 10.

Safety and Efficacy of Low Dose Domperidone for Treating Nausea and Vomiting Due to Acute Gastroenteritis in Children.

Leitz G, et al. J Pediatr Gastroenterol Nutr. 2019 Jun 7.

Endotracheal intubation skills of pediatricians versus anesthetists in neonates and children.

van Sambeeck SJ, et al.Eur J Pediatr. 2019 Jun 8.

Acid Suppression Therapy and Symptom Improvement (or Lack Thereof) in Children.

Boruta M, et al.Pediatrics. 2019 Jun 7.

Early Acid Suppression Therapy Exposure and Fracture in Young Children.

Malchodi L, et al.Pediatrics. 2019 Jun 7.

Fatigue in childhood chronic disease.

Nap-van der Vlist MM, et al.Arch Dis Child. 2019 Jun 7.

Patterns of Electrolyte Testing at Children’s Hospitals for Common Inpatient Diagnoses.

Tchou MJ, et al.Pediatrics. 2019 Jun 6.

A Prediction Model to Identify Febrile Infants ≤60 Days at Low Risk of Invasive Bacterial Infection.

Aronson PL, et al.Pediatrics. 2019 Jun 5.

Prediction Models for Febrile Infants: Time for a Unified Field Theory.

Kuppermann N, et al.Pediatrics. 2019 Jun 5.

The etiological evaluation of sensorineural hearing loss in children.

van Beeck Calkoen EA, et al.Eur J Pediatr. 2019 May 31.

Exome sequencing in the assessment of congenital malformations in the fetus and neonate.

Mone F, et al.Arch Dis Child Fetal Neonatal Ed. 2019 Jul;104(4):F452-F456.

Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis.

Wilson MR, et al. N Engl J Med. 2019 Jun 13;380(24):2327-2340.

Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.

Natarajan G, et al. Pediatrics. 2019 Jul 23.

Asymptomatic Pharyngeal Carriage of Kingella kingae Among Young Children in Vancouver, British Columbia, Canada.

Masud S, et al. Pediatr Infect Dis J. 2019 Jul 16.

Under-immunization of pediatric transplant recipients: a call to action for the pediatric community.

Feldman AG, et al. Pediatr Res. 2019 Jul 22.

Secular Trends in Pubertal Growth Acceleration in Swedish Boys Born From 1947 to 1996.

Ohlsson C, et al. JAMA Pediatr. 2019 Jul 22.

Male Pubertal Timing-Boys Will Be Men, but When?

Curtis VA, et al. JAMA Pediatr. 2019 Jul 22.

Association of Sleep Problems and Melatonin Use in School-aged Children.

Koopman-Verhoeff ME, et al. JAMA Pediatr. 2019 Jul 22.

Dietary Treatment with Extensively Hydrolyzed Casein Formula Containing the Probiotic Lactobacillus rhamnosus GG Prevents the Occurrence of Functional Gastrointestinal Disorders in Children with Cow’s Milk Allergy.

Nocerino R, et al. J Pediatr. 2019 Jul 18.

Observational study of cytomegalovirus from breast milk and necrotising enterocolitis.

Patel RM, et al. Arch Dis Child Fetal Neonatal Ed. 2019 Jul 20.

Pyuria as a Marker of Urinary Tract Infection in Neurogenic Bladder: Is It Reliable?

Su RR, et al. Pediatr Infect Dis J. 2019 Aug;38(8):804-807.

Does caffeine prevent incubation in babies with bronchiolitis who present with apnoea?

Hosheh O, et al. Arch Dis Child. 2019 Jul 20.

Fructose malabsorption in asymptomatic children and in patients with functional chronic abdominal pain: a prospective comparative study.

Martínez-Azcona O, et al. Eur J Pediatr. 2019 Jul 19.

Time course of nocturnal cough and wheezing in children with acute bronchitis monitored by lung sound analysis.

Koehler U, et al. Eur J Pediatr. 2019 Jul 18.

Assessing the appropriateness of the management of otitis media in Australia: A population-based sample survey.

Clay-Williams R, et al. J Paediatr Child Health. 2019 Jul 17.

Predictors for hospital admission of asymptomatic to moderately symptomatic children after drowning.

Cohen N, et al. Eur J Pediatr. 2019 Jul 16.

Rapid Influenza Testing in Infants and Children Younger than 6 Years in Primary Care: Impact on Antibiotic Treatment and Use of Health Services.

van Esso DL, et al. Pediatr Infect Dis J. 2019 Aug;38(8):e187-e189.

Respiratory Virus Epidemiology Among US Infants With Severe Bronchiolitis: Analysis of 2 Multicenter, Multiyear Cohort Studies.

Hasegawa K, et al. Pediatr Infect Dis J. 2019 Aug;38(8):e180-e183.

Association of Screen Time and Depression in Adolescence.

Boers E, et al. JAMA Pediatr. 2019 Jul 15.

DNA Viremia Is Associated with Hyperferritinemia in Pediatric Sepsis.

Simon DW, et al. J Pediatr. 2019 Jul 11.

Attention-Deficit/Hyperactivity Disorder Medication and Unintentional Injuries in Children and Adolescents.

Ghirardi L, et al. J Am Acad Child Adolesc Psychiatry. 2019 Jul 11.

Hyponatremia in children under 100 days old: incidence and etiologies.

Storey C, et al. Eur J Pediatr. 2019 Jul 13.

Neonatal Abstinence Syndrome and Associated Neonatal and Maternal Mortality and Morbidity.

Lisonkova S, et al. Pediatrics. 2019 Jul 12.

Effect of intrapartum antibiotics on the intestinal microbiota of infants: a systematic review.

Zimmermann P, et al. Arch Dis Child Fetal Neonatal Ed. 2019 Jul 11.

Management of Infants at Risk for Group B Streptococcal Disease.

Puopolo KM, et al. Pediatrics. 2019 Jul 8.

In preterm infants, does fluid restriction, as opposed to liberal fluid prescription, reduce the risk of important morbidities and mortality?

Abbas S, et al. J Paediatr Child Health. 2019 Jul;55(7):860-866.

Problems of feeding, sleeping and excessive crying in infancy: a general population study.

Olsen AL, et al. Arch Dis Child. 2019 Jul 3.

Hearing Loss With Congenital Cytomegalovirus Infection.

Foulon I, et al. Pediatrics. 2019 Jul 2.

Delayed Cord Clamping versus Early Cord Clamping in Elective Cesarean Section: A Randomized Controlled Trial.

Cavallin F, et al. Neonatology. 2019 Jul 2:1-8.

Prematurity as an Independent Risk Factor for the Development of Pulmonary Disease.

Fierro JL, et al. J Pediatr. 2019 Jun 28.

Clinical Characteristics of Primary HHV-6B Infection in Children Visiting the Emergency Room.

Hattori F, et al. Pediatr Infect Dis J. 2019 Jun 20.

3. Guidelines and Best Evidence

Risk of Meningitis in Infants Aged 29 to 90 Days with Urinary Tract Infection: A Systematic Review and Meta-Analysis.

Nugent J, et al.J Pediatr. 2019 Jun 20.

Medical care for migrant children in Europe: a practical recommendation for first and follow-up appointments.

Schrier L, et al.Eur J Pediatr. 2019 Jun 26.

Mask versus Prongs for Nasal Continuous Positive Airway Pressure in Preterm Infants: A Systematic Review and Meta-Analysis.

King BC, et al.Neonatology. 2019 Jun 4:1-15.

Heart Rate Monitoring in Newborn Babies: A Systematic Review.

Anton O, et al.Neonatology. 2019 Jun 27:1-12.

Impact of Cystic Fibrosis on Unaffected Siblings: A Systematic Review.

Chudleigh J, et al.J Pediatr. 2019 Jul;210:112-117.e9.

Probiotics for cow’s milk protein allergy: a systematic review of randomized controlled trials.

Qamer S, et al.Eur J Pediatr. 2019 Jun 22.

Do probiotics help babies with infantile colic?

Rivas-Fernández M, et al.Arch Dis Child. 2019 Jun 22.

A new simple formula built on the American Academy of Pediatrics criteria for the screening of hypertension in overweight/obese children.

Di Bonito P, et al. Eur J Pediatr. 2019 Jun 18.

A Simpler Prediction Rule for Rebound Hyperbilirubinemia.

Chang PW, et al.Pediatrics. 2019 Jun 13.

What evidence-based strategies have been shown to improve breastfeeding rates in preterm infants?

Hilditch C, et al.J Paediatr Child Health. 2019 Jun 22.

Fluids in the management of sepsis in children: a review of guidelines in the aftermath of the FEAST trial.

Dewez JE, et al. Arch Dis Child. 2019 Jul 20.

What paediatricians need to know about the updated 2017 American Heart Association Kawasaki disease guideline.

Phuong LK, et al. Arch Dis Child. 2019 Jul 3.

4. Case Reports

Acute ataxia in a healthy 19-month-old girl.

Jia JL, et al.Paediatr Child Health. 2019 Jul;24(4):218-220.

Recurrent Acute Septic Arthiris caused by Kingella Kingae in a 16-month-old boy

Chosidow A, et al.Pediatr Infect Dis J. 2019 Jun 20.

Hypotonia and Lethargy in a Two-Day-Old Male Infant.

Long AH, et al.Pediatrics. 2019 Jun 21.

‘A bugging feeling’: a live foreign body in the ear.

Calleja T. Arch Dis Child. 2019 Jun 8.

Somatic symptom disorder should be suspected in children with alleged chronic Lyme disease.

Peri F, et al.Eur J Pediatr. 2019 Jun 29.

When Acute Stridor Is More Than Croup.

Miller MR, et al. J Pediatr. 2019 Jul 11.

Spontaneous mediastinal abscess of curious causation.

Stratton H, et al. J Paediatr Child Health. 2019 Jul;55(7):873-874.

An Unusual Presentation of Failure to Thrive.

Baldwin KP, et al. Clin Pediatr (Phila). 2019 Jul 3:9922819857738.

 

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

Bubble Wrap Live 2019 – Article List

Cite this article as:
Team DFTB. Bubble Wrap Live 2019 – Article List, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.20064

At DFTB19, we had three great talks during the Bubble Wrap Live session. Whilst the videos and podcasts from these talks are still in the works, here’s the list of articles referenced for you to check out ahead of time.

5 Paediatric Emergency Papers

Edward Snelson @sailordoctor

PREDICT: Head Injury and Delayed Presentations to ED

Borland ML, et al. Delayed Presentations to Emergency Departments of Children With Head Injury: A PREDICT Study. Annals of Emergency Medicine, 2018;75 (1):1-10

Oral Prednisolone for preschool viral induced wheeze

Foster SJ, et al. Oral prednisolone in preschool children with virus-associated wheeze: a prospective, randomised, double-blind, placebo-controlled trial. The Lancet Respiratory Medicine. 2018;6(2):97-106

Clinical Prediction Rule for Febrile Infants under 60 days

Kupperman N, et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr.2019;173(4):342-351. doi:10.1001/jamapediatrics.2018.5501

Whole body CT for children with Trauma

Abe T, et al. Is Whole-Body CT Associated With Reduced In-Hospital Mortality in Children With Trauma? A Nationwide Study. Pediatr Crit Care Med. 2019 Jun;20(6):e245-e250. doi: 10.1097/PCC.0000000000001898.

ECLIPSE study

Lyttle MD, et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE). The Lancet . 2019;393(10186):2125-2134

 

5 General Paediatrics Papers

Susie Piper @chookiemama

Probiotics and Gastroenteritis

Freedman SB, et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. N Engl J Med 2018; 379:2015-2026 DOI: 10.1056/NEJMoa1802597

Acetaminophen and Febrile Seizure Recurrence

Murata S, et al. Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode. Pediatrics 2018; 142(5): pii: e20181009. doi: 10.1542/peds.2018-1009. Epub 2018 Oct 8.

Hi flow vs CPAP in SCN (HUNTER trial)

Manley BJ, et al. Nasal High‐Flow for Early Respiratory Support of Newborn Infants in Australian Non‐Tertiary Special Care Nurseries (The Hunter Trial): A Multicentre, Randomised, Non‐Inferiority Trial. J Paediatr Child Health. 2018;54:4-4. doi:10.1111/jpc.13882_4

Rudeness and Medical Performance

Riskin A, et al. The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics. 2015;136:487-495.

Katz D, et al. Exposure to incivility hinders clinical performance in a simulated operative crisis.

LEGO and poo!

Tagg A, et al. Everything is awesome: Don’t forget the Lego.  2018 Nov 22. doi: 10.1111/jpc.14309. [Epub ahead of print]

 

Paediatric Surgery Papers

Craig McBride @paedsurg

Tissue Paper: Paediatric Burn Wound Care

Brown E.A, et al. Impact of Parental Acute Psychological Distress on Young Child Pain-Related Behavior Through Differences in Parenting Behavior During Pediatric Burn Wound Care. J Clin Psychol Med Settings (2019). https://doi.org/10.1007/s10880-018-9596-1

Brown NJ, et al. Play and heal: Randomized controlled trial of Ditto™ intervention efficacy on improving re-epithelialization in pediatric burns. Burns. 2014;40:204–13.

Paper Planes: Telehealth in Paediatrc Surgery

Brownlee GL, et al. Telehealth in paediatric surgery: Accuracy of clinical decisions made by videoconference. J Paediatr Child Health. 2017;53(12)

Rees CM, et al. Probiotics for the prevention of surgical necrotising enterocolitis: systematic review and meta-analysis.

Sandpaper: Bullying & Discrimination in Surgery

Crebbin, W. , Campbell, G. , Hillis, D. A. and Watters, D. A. (2015), BDSH in surgery in Australasia. ANZ J Surg, 85: 905-909. doi:10.1111/ans.13363

Watters, D. A. (2015), Apology for discrimination, bullying and sexual harassment by the President of the Royal Australasian College of Surgeons. ANZ J Surg, 85: 895-895. doi:10.1111/ans.13362

 

 

DFTB20 will be held in Brisbane, Australia. If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

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Anticoagulation in children : Fiona Newall at DFTB18

Cite this article as:
Team DFTB. Anticoagulation in children : Fiona Newall at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.20144

Professor Fiona Newall is Director of Nursing Research at the Royal Children’s Hospital in Melbourne and has a special interest in anticoagulation in children. If you think that the only patients in a hospital that need anticoagulation are old people then you should watch this talk from DFTB18.

ConSEPT – the reveal: Stuart Dalziel at DFTB18

Cite this article as:
Team DFTB. ConSEPT – the reveal: Stuart Dalziel at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.20055

Given that DFTB18 was held in Melbourne it was important to highlight the work of PREDICT (the Paediatric Research In Emergency Department International Collaborative)* This talk, by Stuart Dalziel, centred around ConSEPT and the management of convulsive status epilepticus.

The missing component of clinical practice

Cite this article as:
Damian Roland. The missing component of clinical practice, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19685

This is an extract of the talk I gave at #DFTB19 highlighting an important research ethos – the full talk will be released via the Don’t Forget the Bubbles at a later date.

The Doctor” is a painting by Luke Fildes and was first exhibited in 1891.

The Doctor exhibited 1891 Sir Luke Fildes 1843-1927 Presented by Sir Henry Tate 1894 https://www.tate.org.uk/art/work/N01522

The artist had lost his son Philip at the age of one and the scenes reflects the admiration that he had had for the doctor who had looked out for him. 

For some the painting may represent a stereotypical view of medicine in the past – the doctor rubbing his chin in a wise fashion, the child prostrate on a make-shift bed. And there is a parent figure in the background, watching on anxiously. 

This painting has had a revival recently despite being over 100 years old. It highlights the triad of care we all know exists in paediatrics – the child, the parents and carers, and ourselves.

This triad has received increased attention recently. The need for child centered care in respect of their engagement and involvement in their care. The need for positive communication with families; we remember the cases where parents haven’t acted as their child’s advocates but forget the vast majority of cases when they have. We so often let parents down when we should have been, not just listening to them, but honestly hearing what they were saying. And most recently the doctors themselves. An understanding of the importance of wellbeing and the shackles of rudeness. 

There is a fourth component, as well. One which perhaps will never get the attention it deserves because it isn’t a visceral part of our clinical care. It’s something we know exists but are quite willing to ignore. It’s something that perhaps has more impact on our practice than we would like to admit. It’s the variability in the actual care or treatment we provide or the fact that it might not be necessary at all.

When I became chair of PERUKI, Paediatric Emergency Research United Kingdom and Ireland, the international sibling of PREDICT and daughter of PERN I’d a personal vision that I would drive the organization forward in delivering ground-breaking new research highlighting novel interventions that would really make a difference to patients. What actually occurred is that I have realised that perhaps PERUKI has an even more important roll. One that does obviously include the need to develop, innovate and implement but one also that highlights where we could, and should do, better. It’s some examples of variation and the need for no treatment I would like to share. 

So this is an original selection of PERUKI members and those who helped us get PERUKI off the ground. I’d like a chance to pay particular tribute to Mark Lyttle at this point who has worked tirelessly at the outset to drive forward many early projects and is consistently named checked by our research partners for his ceaseless enthusiasm at collaborating and engaging. PERUKI took part in a prioritisation process published in 2015 with members putting forward their preferred research agendas and PERUKI publishing the top 20 via a Delphi process.

Number 4 on this list was: what is the best IV medication for Acute Asthma. PERUKI started on this work with essentially a two phase examination of the management of wheeze in March 2013. In the first phase a written questionnaire was undertaken. PERUKI sites responded as departments and 183 consultants responded individually on their wheeze management.

In study 99 (54.1%) use salbutamol as first-line intravenous therapy, 52(28.4%) magnesium sulfate and 27 (14.8%) aminophylline; 87 (47.5%) give these sequentially depending on response and 30 (16.4%) give them concurrently. Overall, 146 (79.8%) continue inhaled bronchodilators while on intravenous therapy.

When commencing on intravenous bronchodilators there were 10 different infusion rates with over 10-fold variation between the lowest and highest.

Everyone tends to have their little foibles about which treatment they prefer. And given the range of phenotypes and genotypes that exist in our wheezy cohort in can’t be the case that there is only going to be one best fit treatment for all patients. But a 10-fold difference probably pushes the bounds of flexibility.

What makes this more interesting is the second study. Also completed at the time (March 2013) was a prospective observational study. Data was screened from all patients presenting with wheeze and a detailed proforma completed for those who received intravenous therapies.Of 3238 children, 101 received intravenous therapies. Intravenous magnesium sulfate (MgSO4) was used in 67 (60.9%), salbutamol in 61 (55.5%) and aminophylline in 52 (47.3%) of cases. 

In 35 cases (31.8%), two drugs were used together, and in 18 cases (16.4%), all three drugs were administered.

More than half used salbutamol as the first-line intravenous agent, while fewer preferred magnesium sulfate or aminophylline, suggesting equipoise regarding which is most efficacious. To investigate this, participants were asked whether they would enrol patients to a randomised controlled trial allocating salbutamol, aminophylline or magnesium sulfate as the first-line intravenous agent, to which 148 (80.9%) responded positively. Asking clinicians who are regularly prescribing acute medications is vital for study design and subsequent implementation of study findings. With all due respect to respiratory paediatricians the question that they may be interested in, or want to explore, may well be completely out of keeping with the practice habits of emergency and acute paediatricians. PERUKI have welcomed increased engagement with our specialty colleagues in the last year and we hope we will reap the benefits of this. 

So a clear example of variation. I feel uncomfortable. Is there any reason to believe this variation has improved 6 years on? We have a challenge as the evidence base is not as strong as we would like. We look to Simon Craig and his work on developing asthma outcomes here – a PERN study I am very proud that PERUKI is part of. 

So what about where we think there is only a small amount of variation (a nationally agreed algorithm for example). DO we need to improve practice and CAN we improve practice? The EcLIPSE study was published a mere month ago and I am proud of the Don’t Forget the Bubbles team  for being part of the process of sharing this information widely. The Eclipse study compared levetiracetam and phenytoin in the treatment of status epilepticus. It was published on exactly the same day as the ConSEPT trial a similar study from our PREDICT friends. The EcLIPSE paper is available open access and there is a Don’t Forget the Bubbles summary. I also recommend the reviews by Justin Morgenstein and Casey Parker 

The primary outcome was time from randomisation to cessation of all visible signs of convulsive activity, defined as cessation of all continuous rhythmic clonic activity, as judged by the treating clinician.

Much debate has centred on what EcLIPSE and ConSEPT showed and at the heart of this is the difference between superiority and non-inferiority.

If these studies do nothing else it will to be to have spread the word about this construct. Because it is really important that people don’t glaze over or think because this terminology is used it’s someones else’s problem to analyse. I think this undue deference to academics probably perpetuates variation in care. I am not saying the theory is easy but neither is managing a sick neonate with congenital heart disease and we completely commit ourselves to doing that. 

Superiority trials aim to demonstrate that one intervention is better than other. The statistics, by convention, dictate that a difference between the interventions needs to be defined. In the case of EcLIPSE because phenytoin stopped status 60% of time and it was felt Levetiracetam may terminate seizures at a 75% rate the statistics calculated that 140 patients would be needed in each group. IF a difference exists this difference is likely to be a difference that is real and not by chance alone.

If they had wanted to show that levetiracetam was only 1% better then 1000s of patients would probably have been needed as if there was no difference by chance it would easily be possible that levetiracetam happened to be 1% better in that cohort of patients. 

A few interesting facts come out of EcLIPSE.

The first is that the while this wasn’t a perfect observational study – i.e not all patients presenting were recruited across a wide range of hospitals over 1400 patients were screened. This is a good cohort of children with seizures. About 10% of those who needed second line treatment for status were first presentations of afebrile convulsions and 5% were as a result of CNS infection.

Median time from randomisation to start of infusion was 11 min (IQR 8–15) for levetiracetam and 12 min (8–17) for phenytoin

But median time from randomisation to seizure cessation was 35 min (IQR 20 to not assessable) in the levetiracetam group and 45 min (IQR 24 to not assessable) in the phenytoin group.

These interventions take time! 

In EcLIPSE convulsive status epilepticus was terminated by levetiracetam in 106 (70%) participants, and by phenytoin in 86 (64%) participants. Therefore by the statistics LEVETIRACETAM is NOT better

Because the results are broadly the same it doesn’t mean they are equal – a non-inferiority study looks at two drugs and aims to calculate what is the minimum number of patients needed to be recruited into each intervention arm to demonstrate that one drug is not more than a certain % worse than another. By convention that number is normally 10%. The reason why 10% is important is that in EcLIPSE while it appears levetiracetam may have passed this test if the study had been designed as a non-inferiority in the ConSEPT study levetiracetam only terminated seizures (albeit as different end point) 50% of time; 10% worse than phenytoin. We don’t know yet what the meta-analysis may show us but this is planned.

A further suggestion is should we consider adding in levetiracetam with phenytoin; we could but that might delay some RSI intervention even further without overall benefit in seizure termination further. This is messy area where the complexity of clinical practice hints the required precision of research head on.

It might well be that you are happy for others to research novel drugs and techniques. You may well be content in supporting research through signposting or perhaps recruiting patients yourself. I would ask though that research itself is not scary. There is false divide between the ivory tower academic and jobbing clinician. Both these terms probably tribal and derogatory in their own way. We should all care about how effective our treatments are and where variability in practice is not in the patient’s interest. It is no more or less important than the three figures in Luke Fildes picture but perhaps it is less visible. 

Through PERUKI I’d like to champion this cause to make research feel more accessible. We are not doing research because we like to, we are doing it because we have to. 

Bumper Bubble Wrap PLUS – May/June 2019

Cite this article as:
Anke Raaijmakers. Bumper Bubble Wrap PLUS – May/June 2019, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19367

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric journal club reading list  from Anke Raaijmakers working with Professor Jaan Toelen & his team of the University Hospitals in Leuven. 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 simply help you to keep an finger on the pulse of paediatric research.

This list features answers to intriguing questions such as: ‘Is it time to stop checking gastric residual volume in neonates?’, ‘Do we need to flush peripheral catheters?’, Is methotrexate a good drug to treat atopic dermatitis?’, ‘How long does the DTP vaccine provide protection?’, ‘Is routine ultrasound for the hip necessary after breech presentation?’, ‘For which children is team sport participation associated with better adult mental health?’,  ‘What is the outcome after a 10-min APGAR score of zero?’ and ‘What is the effect of online health information (Dr Google) on trust in pediatricians’ diagnoses?’.

You will find the list is broken down into four sections:

MAY PAPERS

1.Reviews and opinion articles

Glucocorticoids for Croup in Children.

Gates A, et al. JAMA Pediatr. 2019 Apr 29.

The role of objective tests to support a diagnosis of asthma in children.

Danvers L, et al. Paediatr Respir Rev. 2019 Feb 28.

Invasive group A streptococcal disease: Management and chemoprophylaxis.

Moore DL, et al. Paediatr Child Health. 2019 May;24(2):128-129.

Relaxation training for management of paediatric headache: A rapid review.

Thompson AP, et al. Paediatr Child Health. 2019 May;24(2):103-114.

Necrotizing Enterocolitis, Gut Microbiota, and Brain Development: Role of the Brain-Gut Axis.

Niemarkt HJ, et al. Neonatology. 2019 Apr 11;115(4):423-431.

Newborn screening for cystic fibrosis: Is there benefit for everyone?

Course CW, et al. Paediatr Respir Rev. 2019 Feb 28.

Ethical Issues in Perinatal Clinical Research.

Walsh V, et al. Neonatology. 2019 Apr 4;116(1):52-57.

Machine Learning in Medicine.

Rajkomar A, et al. N Engl J Med. 2019 Apr 4;380(14):1347-1358.

The child with an incessant dry cough.

Galway NC, et al. Paediatr Respir Rev. 2018 Aug 30.

2. Original clinical studies

Association of Rhinovirus C Bronchiolitis and Immunoglobulin E Sensitization During Infancy With Development of Recurrent Wheeze.

Hasegawa K, et al. JAMA Pediatr. 2019 Apr 1.

Respiratory Syncytial Virus, Rhinoviruses, and Recurrent Wheezing: Unraveling the Riddle Opens New Opportunities for Targeted Interventions.

Ramilo O, et al. JAMA Pediatr. 2019 Apr 1.

Effect of Gastric Residual Evaluation on Enteral Intake in Extremely Preterm Infants: A Randomized Clinical Trial.

Parker LA, et al. JAMA Pediatr. 2019 Apr 29.

Lack of Efficacy of Lactobacillus reuteri DSM 17938 for the Treatment of Acute Gastroenteritis: A Randomized Controlled Trial.

Szymański H, et al. Pediatr Infect Dis J. 2019 Apr 25.

Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics.

Kleidon TM, et al. J Paediatr Child Health. 2019 Apr 29.

The association between crowding within households and behavioural problems in children: Longitudinal data from the Southampton Women’s Survey.

Marsh R, et al.  Paediatr Perinat Epidemiol. 2019 Apr 29.

Genetic and Early-Life Environmental Influences on Dental Caries Risk: A Twin Study.

Silva MJ, et al. Pediatrics. 2019 Apr 26.

The Association of Paternal IQ With Autism Spectrum Disorders and its Comorbidities: A Population-Based Cohort Study.

Gardner RM, et al. J Am Acad Child Adolesc Psychiatry. 2019 Apr 23.

Rethinking ADHD intervention trials: feasibility testing of two treatments and a methodology.

Fibert P, et al. Eur J Pediatr. 2019 Apr 24.

Long-term effect of methotrexate for childhood atopic dermatitis.

Purvis D, et al. J Paediatr Child Health. 2019 Apr 23.

Sleep-Related Infant Suffocation Deaths Attributable to Soft Bedding, Overlay, and Wedging.

Erck Lambert AB, et al. Pediatrics. 2019 Apr 22.

Effect of Albuterol Premedication vs Placebo on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomies: The REACT Randomized Clinical Trial.

von Ungern-Sternberg BS, et al. JAMA Pediatr. 2019 Apr 22.

Duration of Immunity and Effectiveness of Diphtheria-Tetanus-Acellular Pertussis Vaccines in Children.

Domenech de Cellès M, et al. JAMA Pediatr. 2019 Apr 22.

Contribution of Sensory Processing to Chronic Constipation in Preschool Children.

Little LM, et al. J Pediatr. 2019 Apr 12.

Postvaccination Febrile Seizure Severity and Outcome.

Deng L, et al. Pediatrics. 2019 Apr 19.

The effect of pediatric patient temperament on post-operative outcomes.

Uhl K, et al. Paediatr Anaesth. 2019 Apr 18.

Adolescent and Young Adult Cancer Patients’ Experiences With Treatment Decision-making.

Mack JW, et al. Pediatrics. 2019 Apr 18.

Evaluation of referrals for short stature: A retrospective chart review.

Yue D, et al. Paediatr Child Health. 2019 May;24(2):e74-e77.

Respiratory Viruses Frequently Mimic Pertussis in Young Infants.

Damouni Shalabi R, et al. Pediatr Infect Dis J. 2019 May;38(5):e107-e109.

The Clinical Presentation of Pediatric Mycoplasma pneumoniae Infections-A Single Center Cohort.

Gordon O, et al. Pediatr Infect Dis J. 2019 Apr 10.

Paediatric reference intervals are heterogeneous and differ considerably in the classification of healthy paediatric blood samples.

Alnor AB, et al. Eur J Pediatr. 2019 Apr 17.

Investigating the need for routine ultrasound screening to detect developmental dysplasia of the hip in infants born with breech presentation.

D’Alessandro M, et al. Paediatr Child Health. 2019 May;24(2):e88-e93.

High-density Bacterial Nasal Carriage in Children Is Transient and Associated With Respiratory Viral Infections-Implications for Transmission Dynamics.

Thors V, et al. Pediatr Infect Dis J. 2019 May;38(5):533-538.

Children With Noncritical Infections Have Increased Intestinal Permeability, Endotoxemia and Altered Innate Immune Responses.

Sturgeon JP, et al. Pediatr Infect Dis J. 2019 Apr 10.

The Role of Patient and Parental Resilience in Adolescents with Chronic Musculoskeletal Pain.

Gmuca S, et al. J Pediatr. 2019 Apr 10.

Proband and Familial Autoimmune Diseases Are Associated With Proband Diagnosis of Autism Spectrum Disorders.

Spann MN, et al. J Am Acad Child Adolesc Psychiatry. 2019 May;58(5):496-505.

Breastfeeding in Infancy and Lipid Profile in Adolescence.

Hui LL, et al. Pediatrics. 2019 Apr 9. pii: e20183075.

Classic Metaphyseal Lesions among Victims of Abuse.

Adamsbaum C, et al. J Pediatr. 2019 Apr 5.

Postextubation Dysphagia in Pediatric Populations: Incidence, Risk Factors, and Outcomes.

Hoffmeister J, et al. J Pediatr. 2019 Apr 3. pii: S0022-3476(19)30243-4.

Pediatric Septic Arthritis of the Knee: Predictors of Septic Hip Do Not Apply.

Obey MR, et al. J Pediatr Orthop. 2019 Apr 3.

Association between hypotension and serious illness in the emergency department: an observational study.

Hagedoorn NN, et al. Arch Dis Child. 2019 Apr 4.

Association of In Vitro Fertilization With Childhood Cancer in the United States.

Spector LG, et al. JAMA Pediatr. 2019 Apr 1:e190392.

Prenatal Omega-6:Omega-3 Ratio and Attention Deficit and Hyperactivity Disorder Symptoms.

López-Vicente M, et al. J Pediatr. 2019 Mar 22.

Molecular Genetic Anatomy and Risk Profile of Hirschsprung’s Disease.

Tilghman JM, et al. N Engl J Med. 2019 Apr 11;380(15):1421-1432.

4. Case reports

Gaze Palsy: An Important Diagnostic Clue.

Madaan P, et al. J Pediatr. 2019 Apr 24.

When Posture Gives the Clue: “Jug Handle Deformity”.

Banerjee A, et al. J Pediatr. 2019 Apr 17.

A 10-year-old female with unilateral seventh cranial nerve palsy.

Gohal S, et al. Paediatr Child Health. 2019 May;24(2):69-71.

A boy with developmental regression.

MacLellan K, et al. Paediatr Child Health. 2019 May;24(2):67-68.

A Healthy Toddler With Fever and Lethargy.

Suri NA, et al. Pediatrics. 2019 Apr 5. pii: e20180412.

Acute encephalopathy associated with influenza infection: Case report and review of the literature.

Albaker A, et al. Paediatr Child Health. 2019 May;24(2):122-124.

JUNE PAPERS

2. Original clinical studies

Risk of invasive bacterial infections by week of age in infants: prospective national surveillance, England, 2010-2017.

Ladhani SN, et al. Arch Dis Child. 2019 May 30.

Impact of paediatric tonsillectomy perioperative management on pain, nausea and recovery: A prospective cohort study.

Richards J, et al. J Paediatr Child Health. 2019 May 29.

Efficacy and safety of systemic hydrocortisone for the prevention of bronchopulmonary dysplasia in preterm infants: a systematic review and meta-analysis.

Morris IP, et al. Eur J Pediatr. 2019 May 29.

Severe Acute Respiratory Failure in Healthy Adolescents Exposed to Trimethoprim-Sulfamethoxazole.

Miller JO, et al. Pediatrics. 2019 May 29.

Retrospective study of budesonide in children with eosinophilic gastroenteritis.

Fang S, et al.Pediatr Res. 2019 May 29.

Care for children with severe chronic skin diseases.

De Maeseneer H, Van Gysel D, et al. Eur J Pediatr. 2019 May 22.

Association of Team Sports Participation With Long-term Mental Health Outcomes Among Individuals Exposed to Adverse Childhood Experiences.

Easterlin MC, et al. JAMA Pediatr. 2019 May 28.

FEEDMI: A Study Protocol to Determine the Influence of Infant-Feeding on Very-Preterm-Infant’s Gut Microbiota.

Morais J, et al. Neonatology. 2019 May 27:1-6.

Association between early life (prenatal and postnatal) antibiotic administration and coeliac disease: a systematic review.

Kołodziej M, et al. Arch Dis Child. 2019 May 25.

The effect of follow-up after a negative double-blinded placebo-controlled cow’s milk challenge on successful reintroduction.

Schrijvers M, et al. Eur J Pediatr. 2019 May 24.

Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children: A Systematic Review.

Singendonk M, et al. J Pediatr Gastroenterol Nutr. 2019 Jun;68(6):811-817.

What does sleep hygiene have to offer children’s sleep problems?

Hall WA, et al. Paediatr Respir Rev. 2018 Nov 9.

Physiological effects of high-flow nasal cannula therapy in preterm infants.

Liew Z, et al. Arch Dis Child Fetal Neonatal Ed. 2019 May 23.

Treatment failure in children diagnosed with constipation in a paediatric emergency department in relation to Rome III criteria.

Eltorki M, et al. Paediatr Child Health. 2019 Jun;24(3):185-192.

Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD.

Curry AE, et al. Pediatrics. 2019 May 20.

Preparing for Discharge From the Neonatal Intensive Care Unit.

Gupta M, et al. Pediatrics. 2019 May 3.

Infant Deaths in Sitting Devices.

Liaw P, et al. Pediatrics. 2019 May 20.

Higher Sun Exposure is Associated With Lower Risk of Pediatric Inflammatory Bowel Disease: A Matched Case-Control Study.

Holmes EA, et al. J Pediatr Gastroenterol Nutr. 2019 May 15.

Genetic Associations Between Executive Functions and a General Factor of Psychopathology.

Harden KP, et al. J Am Acad Child Adolesc Psychiatry. 2019 May 15.

Accuracy of surgeon prediction of appendicitis severity in pediatric patients.

Yu YR, et al. J Pediatr Surg. 2019 Apr 24.

Outcomes related to 10-min Apgar scores of zero in Japan.

Shibasaki J, et al. Arch Dis Child Fetal Neonatal Ed. 2019 May 15.

Topiramate plus Cooling for Hypoxic-Ischemic Encephalopathy: A Randomized, Controlled, Multicenter, Double-Blinded Trial.

Nuñez-Ramiro A, et al. Neonatology. 2019 May 15;116(1):76-84.

Risk factors for development of urinary tract infection in children with nephrolithiasis.

Cetin N, et al. J Paediatr Child Health. 2019 May 14.

LISTERIA MENINGITIS IN DANISH CHILDREN 2000-2017: A Rare Event Even in a Country With High Rates of Invasive Listeriosis.

Vissing NH, et al. Pediatr Infect Dis J. 2019 May 15.

Cerebral oxygenation and blood flow in term infants during postnatal transition: BabyLux project.

De Carli A, et al. Arch Dis Child Fetal Neonatal Ed. 2019 May 13.

Machine Learning at the Clinical Bedside-The Ghost in the Machine.

Zorc JJ, et al. JAMA Pediatr. 2019 May 13.

Comparison of Machine Learning Optimal Classification Trees With the Pediatric Emergency Care Applied Research Network Head Trauma Decision Rules.

Bertsimas D, et al. JAMA Pediatr. 2019 May 13.

Adherence to metformin is reduced during school holidays and weekends in children with type 1 diabetes participating in a randomised controlled trial.

Leggett C, et al. Arch Dis Child. 2019 May 11.

Physicians’ Attitudes on Resuscitation of Extremely Premature Infants: A Systematic Review.

Cavolo A, Dierckx de Casterlé B, Naulaers G, et al. Pediatrics. 2019 May 10. pii: e20183972.

Young people’s experiences of brief inpatient treatment for anorexia nervosa.

Thabrew H, et al. J Paediatr Child Health. 2019 May 6.

Increasing the dose of oral vitamin K prophylaxis and its effect on bleeding risk.

Löwensteyn YN, et al. Eur J Pediatr. 2019 May 6.

Antibiotic Treatment in the First Week of Life Impacts the Growth Trajectory in the First Year of Life in Term Infants.

Kamphorst K, et al. J Pediatr Gastroenterol Nutr. 2019 Apr 15.

Abdominal Wall Pain or Irritable Bowel Syndrome: Validation of a Pediatric Questionnaire.

Siawash M, et al. J Pediatr Gastroenterol Nutr. 2019 May 2.

Virtual Reality for Pediatric Needle Procedural Pain: Two Randomized Clinical Trials.

Chan E, et al. J Pediatr. 2019 Jun;209:160-167.e4.

Paging Dr. Google: The Effect of Online Health Information on Trust in Pediatricians’ Diagnoses.

Sood N, et al. Clin Pediatr (Phila). 2019 May 1:9922819845163.

Nebulised surfactant to reduce severity of respiratory distress: a blinded, parallel, randomised controlled trial.

Minocchieri S, et al. Arch Dis Child Fetal Neonatal Ed. 2019 May;104(3):F313-F319.

Nasal High-Flow Therapy for Newborn Infants in Special Care Nurseries.

Manley BJ, et al. N Engl J Med. 2019 May 23;380(21):2031-2040.

Mometasone or Tiotropium in Mild Asthma with a Low Sputum Eosinophil Level.

Lazarus SC, et al. N Engl J Med. 2019 May 23;380(21):2009-2019.

Association of Gestational Weight Gain With Adverse Maternal and Infant Outcomes.

LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group, et al. JAMA. 2019 May 7;321(17):1702-1715.

Prepregnancy Body Mass Index, Weight Gain During Pregnancy, and Health Outcomes.

McDermott MM, et al. JAMA. 2019 May 7;321(17):1715.

4. Case reports

Playful Child, Dangerous Intruder: A Case of Silent Foreign Body Aspiration in a 13-Month-Old Boy.

Bradshaw J, et al. Clin Pediatr (Phila). 2019 May 25:9922819851265.

History Matters: A 20-Month-Old Child With Cough and Congestion.

Ellis S, et al. Clin Pediatr (Phila). 2019 May 21:9922819850484.

A Teenager With Painful Oral and Genital Lesions.

DiSantis F, et al. Clin Pediatr (Phila). 2019 May 21:9922819850478.

Hypothermia and Vomiting in a Newborn Without Prenatal Care.

Nichols K, et al. Clin Pediatr (Phila). 2019 May 21:9922819850485.

Vomiting and seizure following circumcision in an infant.

Fleming L, et al. Paediatr Child Health. 2019 Jun;24(3):146-147.

An interlabial mass-like lesion in an otherwise healthy newborn girl.

Navabi B, et al. Paediatr Child Health. 2019 Jun;24(3):143-145.

Blurry Vision and Irregularly Shaped Pupil in a 3-Year-Old Female.

Boye B, et al. Clin Pediatr (Phila). 2019 May 20:9922819850460.

Asymmetric Crying Facies Syndrome.

Ho KY, et al. J Pediatr. 2019 May 3.

Nicolau Syndrome: A Rare Complication following Intramuscular Injection.

Quincer E, et al. J Pediatr. 2019 May 3.

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