Disease Knowledge Centres

  • Paediatrics - Disease Topic 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.

Latest Multi Media

A Presentation on the Innovations in Minimal Access Paediatric Surgery

Paediatrics Drug Data - A-Z English

Drug Updates

Boots Ibuprofen 6 Months Plus 100mg/5ml Suspension Strawberry Flavour
For the fast and effective reduction of fever, including post immunisation pyrexia and the fast and effective relief of mild to moderate pain, such as a sore throat, teething pain, toothache, earache, headache, minor aches and sprains.
Simple Linctus Paediatric Sugar Free
For the management of a mild non-specific cough.
WILZIN Hard Capsules
Treatment of Wilson’s disease.

Latest Drug News

Intuniv (Shire) shows positive response for children with ADHD - 13-01-2012
A new trial has assessed the efficacy and safety of Intuniv (guanfacine extended release), from Shire, as an adjunct to psychostimulants in children and adolescents diagnosed with ADHD who had a suboptimal response to a psychostimulant alone. Participants continued their stable dose of psychostimulant given in the morning and were randomised to receive Intuniv in the morning, Intuniv in the evening, or placebo. Subjects receiving Intuniv plus a psychostimulant showed significantly greater improvement from baseline to endpoint, as measured by the ADHD-Rating Scale IV total score, compared with subjects receiving placebo plus a psychostimulant. In particular, the inattention subscale rating and the hyperactivity/ impulsivity subscales of the ADHD-RS-IV showed significantly greater improvements from baseline in subjects receiving Intuniv with a psychostimulant compared with subjects receiving placebo plus psychostimulant. Significant benefits of adjunctive administration were observed whether Intuniv was administered in the morning or evening. No new safety signals emerged. See: "A Controlled Trial of Extended-release Guanfacine and Psychostimulants for Attention-deficit/hyperactivity disorder" by Timothy E. Wilens et al. Journal of the American Academy of Child and Adolescent Psychiatry, Volume 51, Issue 1 (January 2012)(doi:10.1016/j.jaac.2011.10.012)
FDA finds ADHD drugs have no link to Cardiovascular problems - 02-11-2011
The US FDA has announced that a large, recently-completed study in children and young adults treated with medication for Attention-Deficit/Hyperactivity Disorder (ADHD) has not shown an association between use of certain ADHD medications and adverse cardiovascular events. These adverse cardiovascular events include stroke, heart attack (myocardial infarction or MI), and sudden cardiac death. The study was conducted with 1,200,438 children and young adults (aged 2-24 years) and only found 7 serious cardiovascular events in current users, suggesting no evidence of increased risk of serious cardiovascular effects among children and young people who use ADHD medications. The final study report has also been released. See: "ADHD Drugs and Serious Cardiovascular Events in Children and Young Adults" William Cooper et al. New England Journal of Medicine DOI: 10.1056/NEJMoa1110212

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Latest Clinical Trials

International Safety and Efficacy Study of Aztreonam Lysinate for Inhalation (AI) in Cystic Fibrosis Patients
The purpose of this study is to see if a 28-day course of AI is safe and effective for cystic fibrosis (CF) patients with lung disease due to Pseudomonas aeruginosa (PA) infection.
Effect of Glycine in Cystic Fibrosis
The aim of this study is to evaluate if glycine, orally administered in a daily dose of 0.5 g/kg during 8 weeks, can ameliorate the airway inflammation in children with cystic fibrosis, as compared with placebo. During all of the study children will receive their usual treatment for cystic fibrosis.

Latest Journal Publications

Pediatric blood & cancer
Background: Survival for childhood acute lymphoblastic leukemia (ALL) has reached 80–90%. Future improvement in treatment success will involve new technologies and medication, adding to the pressure on limited financial resources. Therefore a retrospective cost-effectiveness analysis of ALL treatment with chemotherapy only according to the two most recent Dutch Childhood Oncology Group treatment protocols was performed. The most recent protocol ALL10 included more expensive medication (pegasparaginase) and implemented a new diagnostic technique (minimal residual disease levels) compared to the previous ALL9 protocol. Procedure: Fifty children from a single center cohort were included. All direct medical costs made during treatment, including those in satellite hospitals, were determined. Costs per life year saved (LYS) were calculated. The cost-effectiveness ratio of the most recent treatment protocol was determined. LYS were calculated based on national 5-year event-free survival. Results: Mean total costs were between $115,858 (ALL9) and $163,350 (ALL10) per patient. Hospital admissions (57%) and medication (11–17%) were important drivers of overall costs, and were higher in the most recent protocol ALL10. Costs per LYS were $1,962 (ALL9) and $2,655 (ALL10) and the cost-effectiveness ratio was $8,215. Conclusion: Treatment of childhood ALL with chemotherapy only is well within accepted ranges of cost-effectiveness. The use of new technology and more expensive medication in the most recent protocol ALL10 lead to higher costs but more LYS. In future (ALL) treatment protocols, costs in relation to effects should be taken into account in order to establish more cost-effective disease management without jeopardizing survival and quality of life.
International journal of nephrology
Posterior urethral valves occur in 1 : 5000 live births. Despite the high prevalence, the few children that survive do poorly, with over 50% progressing to ESRD in 10 years. The gold standard for post-natal diagnosis is voiding cystourethrography, while pre-natal diagnosis is dependent on routine screening ultrasonography. Despite the ability to identify features of bladder outlet obstruction early in fetal development, there is no consensus on how to incorporate early detection into current screening protocols. There has yet to be a marker that allows prediction of obstruction in the absence of or prior to radiographic evidence of obstruction. With our current screening strategy, the majority of interventions are performed well after irreversible damage has occurred. Improved mortality and long term morbidity from posterior urethral valves and congenital bladder outlet obstruction will likely remain unchanged until it is possible to intervene prior to the onset of irreversible renal damage. New biologic markers and improved instrumentation will allow for more effective diagnosis and intervention at earlier stages of fetal development.

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Paediatrics