Paediatrics Topic Homepage
Paediatrics Overview
Paediatric medicine is the specialty that encompasses the care of young people below the age of 16.1 The period of a person's life from neonate to adolescent includes many developmental milestones, and the body undergoes many changes (physical growth and neurological and psychological development). For these reasons there are many sub-specialties within paediatrics (neonatology and perinatology, paediatric emergency medicine, paediatric rehabilitation medicine and paediatric equivalents of adult subspecialties).2
The physiology and metabolism of children is different from that of adults, although this...
... becomes less pronounced with age.3 Development and growth are exclusive to paediatric medicine; these milestones are useful to monitor the health of the child.3 It is however important to understand the physiology of the child at specific stages to allow for effective disease treatments.
Vaccination of children and adolescents is of particular importance for prolonged health, not only during childhood, but for the rest of the person's life. The effective use of vaccines has meant that the leading causes of European childhood mortality are non-infectious/non-cancerous disease and injury (transport accidents, congenital malformations and nervous system disorders).4
Childhood mortality rates are low in the western world; however, this is not the case in the developing world. In 2008 only five countries accounted for 49% of worldwide childhood mortality; India, Nigeria, Democratic Republic of the Congo, Pakistan, and China.5 This suggests that the need for adequate paediatric medicine in the developing world is a very real issue.
1. Candy D. et al. Clinical Paediatrics and Child Health. Elsevier Health Sciences. 2001 : 159.
2. Roberton D. Practical Paediatrics. Elsevier Health Sciences. 2007 :10.
3. Rudolf M. et al. Paediatrics and Child Health. Wiley-Blackwell. 2006 : 4.
4. Lyons R. The Epidemiology of Childhood Mortality in The European Union. Current Paediatrics. 2005 ; 15 (2) : 151-162.
5. Black R. et al. Global, Regional, and National Causes of Child Mortality in 2008: A Systematic Analysis. The lancet. 2010 ; 375 (9730) : 1969-1987.
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Atopic Dermatitis
Atopic dermatitis is a chronic inflammatory non-communicable skin disorder characterised by periods of exacerbations, interspersed with periods of apparent remission. This highly prevalent disease has a significant impact on the quality of life of both patients and carers.
The current understanding of atopic dermatitis is that there are two forms, extrinsic and intrinsic. The cause of the former is best understood. A hypersensitivity reaction to environmental allergens (food, air-borne particles, soaps, perfumes and fabrics) generates an inflammatory response which in turn generates the release of histamine that contributes to the development of pruritus. Intrinsic atopic dermatitis causes identical symptoms in the absence of an initial hypersensitive response.
The evidence available that supports disease modification in atopic dermatitis has been well documented; however currently there is no clear definition of disease modification in atopic dermatitis.
Clinical management of atopic dermatitis is dependent on the severity of patient’s symptoms, however all patients should receive help and advice to aid in lifestyle changes that will decrease the risk of a disease flare. In addition to this, treatment with non-pharmaceutical products such as emollients and pharmaceutical agents such as topical corticosteroids is standard practice.
The Atopic Dermatitis Knowledge Centre is developed in collaboration with Astellas Pharma Europe Ltd.
Enter the Atopic Dermatitis Knowledge Centre
August 2012 DERM/12/0009/EUd
Anti-Infectives Knowledge Centre
The last decade has seen an increase in the incidence and severity of Clostridium difficile infections (CDI), making it one of the most talked about disease topics with many recent congresses focusing on the disease.
As the leading cause of nosocomial diarrhoea in industrialised countries1 detection and treatment of CDI is extremely important. The ESCMID guidelines recommend that diagnosis is based upon both signs and symptoms and laboratory evidence of toxin producing C. difficile in stools.1,2 In addition antibiotic treatment to eradicate severe C. difficle infection is recommended in these guidelines.2
The management of systemic fungal infections is also a major challenge for healthcare professionals. Due to the invasive nature of fungal infections, many treatments are pre-emptive and are therefore initiated without identifying the specific fungus involved. Targeted approaches will become a more viable option as the speed and delivery of diagnostic methods improve.
The Anti-infectives Knowledge Centre aims to provide you with the most recent information in the areas of both CDI and systemic fungal infections with regularly updated content to help assist in the fight against these diseases.
The Knowledge Centre currently provides information on CDI, including:
- Prevalence – the incidence of CDI and the factors that have been attributed to the rise in these infections
- Symptoms – the symptoms of CDI, including how pseudomembranous colitis manifests
- Recurrence – the impact of recurring infection on patient outcomes
- Diagnosis – the importance of early diagnosis and the diagnostic tests available
- Treatment – treatment options recommended by the current ESCMID guidelines
Additional information on systemic fungal infections will be added soon.
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References
1. Crobach MJ, et al. Clin Microbiol Infect 2009; 15: 1053‐1066
2. Bauer MP, et al. Clin Microbiol Infect 2009; 15: 1067‐1079
Date of preparation November 2012 AI/12/0038/EUc
Anti-Infectives Knowledge Network
The Anti-infectives Knowledge Network (AIKN), an initiative by Astellas Pharma Europe Ltd, shares the expertise and experience of a number of Thought leaders in the area of anti-infectives.
Topics from EBMT 2013 covered include:
- Advances in prevention strategies for cytomegalovirus (CMV)
- Managing infectious complications in HSCT recipients
- Prophylaxis and management of fungal infections
- Advances and on-going challenges in managing invasive fungal infections
This is in addition to reports and sponsored presentations from ISICEM 2013 and our 2012 coverage from a number of meetings including ECCMID and ISHAM.
Additional content recently added to the Anti-infectives Knowledge Network includes:
- Slides shared by the faculty from the Seeing CDI differently CME-accredited meeting held in London, February 2013. This meeting was funded by Astellas Pharma Europe Ltd. Content was driven by a scientific steering committee
- Free downloadable 2012 ESCMID Guidelines Supplement for the diagnosis and management of Candida diseases and related slides for use in your own presentations
Future 2013 coverage will include congress reports and interactive presentations from ECCMID, EHA, ESOT and TIMM.
We encourage you to return regularly to read the news, clinical insights, and essential information from the latest congresses.
Click here to enter the Anti-infectives Knowledge Network.
Date of Preparation: May 2013 AI/13/0011/EUf
Drug News
CHERISH trial of RoActemra/Actemra (Genetech/Roche) shows sustained benefits for polyarticular Juvenile Idiopathic Arthritis
16-06-2013New data shows that RoActemra/Actemra (tocilizumab), from Genentech/Roche, is efficacious and leads to a sustained clinically meaningful improvement in children with polyarticular Juvenile...
Phase IIIb study of Vyvanse/Elvanse (Shire) shows significant benefits for treating young patients with ADHD
14-06-2013A Phase IIIb study comparing the efficacy and safety of the Attention Deficit Hyperactivity Disorder (ADHD) treatments shows Vyvanse/Elvanse (lisdexamfetamine dimesylate), from Shire provides...
CHMP recommends approval of Glivec (Novartis) to treat Ph+ ALL
01-06-2013The Committee for Medicinal Products for Human Use (CHMP) recommend that Glivec (imatinib), from Novartis, should be indicated for the treatment of paediatric patients with newly diagnosed...
Paediatrics Drug Data - A-Z
Possible searches include drugs or medicines (by brand, generic ingredient or drug class), diseases, conditions and more.
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Recent Drug Updates
INOmax 400 ppm mol/mol inhalation gas
02-04-2013INOmax, in conjunction with ventilatory support and other appropriate active substances, is indicated: - for the treatment of newborn infants ≥ 34 weeks gestation with hypoxic respiratory failure...
INOmax 800 ppm mol/mol inhalation gas
02-04-2013INOmax, in conjunction with ventilatory support and other appropriate active substances, is indicated: - for the treatment of newborn infants ≥ 34 weeks gestation with hypoxic respiratory failure...
CANCIDAS (formerly Caspofungin MSD)
29-03-2012• Treatment of invasive candidiasis in adult or paediatric patients. • Treatment of invasive aspergillosis in adult or paediatric patients who are refractory to or intolerant of...
Clinical Guidelines
Antibiotics for early-onset neonatal infection: Antibiotics for the prevention and treatment of early-onset neonatal infection
Aug 2012Early-onset neonatal bacterial infection (infection with onset within 72 hours of birth) is a..
... significant cause of mortality and morbidity in newborn babies. Parent organisations and the scientific literature report that there can be unnecessary delays in recognising and treating sick babies. In addition, concern about the possibility of early-onset neonatal infection is common.
This concern is an important influence on the care given to pregnant women and newborn babies. There is wide variation in how the risk of early-onset neonatal infection is managed in healthy babies.
Spasticity in children and young people with non-progressive brain disorders: Management of spasticity and co-existing motor disorders and their early musculoskeletal complications
Jul 2012This guideline covers the management of spasticity and co-existing motor disorders and their early..
... musculoskeletal complications in children and young people (from birth up to their 19th birthday) with non-progressive brain disorders.
Cerebral palsy is the most common condition associated with spasticity in children and young people. The incidence of cerebral palsy is not known, but its prevalence in the UK is 186 per 100,000 population, with a total of 110,000 people affected. The guideline covers the management of spasticity associated with cerebral palsy, but not all aspects of the management of cerebral palsy.
Online CME
The Basics - Abnormal Gait in Children
Apr 2013
... children.
Diagnosing osteosarcomas and brain tumours in children: communication skills - in association with the Department of Health
Apr 2013
... skills - in association with the Department of Health. For GPs, GP trainees, Foundation doctors.
Clinical Trials
Cranberry-lingonberry Juice Started During Acute Infection in Prevention of Urinary Tract Infections in Children
21-05-2013Cranberry and cranberry-lingonberry juice prevented urinary tract infections in children and in adults in our earlier clinical trials. The preventive effect was, however, observed late in the follow-up and the next recurrence was not prevented in children. The investigators hypothesize that cranberry-lingonberry juice..
... should be started already during the antimicrobial treatment of acute urinary tract infection in order to maximize the preventive efficacy of the juice. In addition, the investigators aim to find the explanation for the efficacy of cranberry-lingonberry juice by analyzing the concomitant changes in the chemical composition of urine and feces as well as the changes of gut microbiota.
Effectiveness of Osteopathic Manipulative Treatment in Pediatric Asthma (OMT)
10-05-2013Asthma is a highly prevalent chronic disease in children. Complementary and Alternative Medicine research on asthma showed a potential effect on pediatric patients. Studies looking at the effect of Osteopathic Manipulative Treatment seems to reveal positive results. The aim of study is to further explore the role of..
... OMT on asthma in a pediatric population.
Medical Videos
Medical Journal Abstracts
Prebiotic supplementation in preterm neonates: Updated systematic review and meta-analysis of randomised controlled trials
Clinical Nutrition
Jun 2013
Background & aims: Regular administration of prebiotic oligosaccharides promote beneficial gut flora in infants. We aimed to systematically review randomized controlled trials evaluating the safety and efficacy of prebiotic oligosaccharide supplementation in preterm infants ≤37 weeks of gestation. Methods: Available..
Cutpoints for mild, moderate, and severe pain on the VAS for children and adolescents – What can be learned from 10 million ANOVAs?
PAIN
Jun 2013
Cutpoints that classify pain-intensity into mild, moderate and severe levels are widely used in pain-research and clinical practice. At present there are no agreed-upon cutpoints for the visual analogue scale (VAS) in pediatric samples. We applied a method based on Serlin’s procedure that was previously only used for..
Medical Apps
Rapid Paediatrics and Child Health, 2nd Edition - £29.49
PediSafe Medications - £3.09
Oxford handbook of paediatrics - £34.99
The Oxford handbook of paediatrics - £34.98
Social Media
High temperature and urinary tract pain
on doc2docHigh temperature and urinary tract pain Please do not be in a hurry to start the antibiotics. A simple urine examination might have shown you that it ...
High temperature and urinary tract pain
on doc2docHigh temperature and urinary tract pain I agree - don't be in a hurry to start those particular anti-infective agents - Ofloxacin is probably 'OTT' as ...
High temperature and urinary tract pain
on doc2docHigh temperature and urinary tract pain Symptoms:High heat - a burning sensation in the urine The medicine used:TARIVID TABAMIKIN VIAL 1/5 GMDo ...
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