30 results match your criteria: "The Royal London Children's Hospital[Affiliation]"

Background: In rare diseases, limited access to services and rare disease experts may force families to act as medical advocates for their child; they can volunteer to support clinician-initiated research or initiate and lead research themselves. Ketotic Hypoglycemia International (KHI) is a new, global organization for families affected by idiopathic ketotic hypoglycemia (IKH) and is run solely by volunteers. Doing research together, families and international experts in a collaborative process such as at KHI, also referred to as patient and public involvement and engagement (PPIE) or extreme citizen science, is often praised for its positive effects on the research and the stakeholders involved.

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Ustekinumab is an effective therapy for adult Crohn's disease (CD), but data in paediatric CD patients are scarce. The aim of the study was to describe the real-life effectiveness and safety of ustekinumab in paediatric CD. This is a multicentre review of children with Crohn's disease treated with ustekinumab.

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Objectives: The objective of this study was to explore the correlation between paediatric Crohn's disease (CD) characteristics, bone health and growth parameters at diagnosis and follow-up.

Methods: Retrospective data was collected for 47 children aged 4-16 who were newly diagnosed with CD between January 2018 and December 2019. Mean follow-up time was 2.

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Sick children often have a decreased appetite and experience vomiting and diarrhea; however, hypoglycemia (plasma glucose concentration ≤50 mg/dL or 2.8 mmol/L) is rare. Ketotic hypoglycemia (KH) is the most common cause of hypoglycemia presenting to an Emergency Department in a previously healthy child between 6 months and 6 years of age.

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Objective: Continuous glucose monitoring (CGM) is the standard of care for glucose monitoring in children with diabetes, however there are limited data reporting their use in hyperinsulinaemic hypoglycaemia (HH). Here, we evaluate CGM accuracy and its impact on quality of life in children with HH.

Methods: Real-time CGM (Dexcom G5 and G6) was used in children with HH aged 0-16years.

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Article Synopsis
  • The study investigates the characteristics and natural history of primary sclerosing cholangitis related to inflammatory bowel disease (PSC-IBD) diagnosed before age 6, referred to as very early onset IBD (VEO-IBD) compared to those diagnosed later.
  • A total of 69 children were analyzed, finding that while most had ulcerative colitis, the VEO-PSC-IBD group had a higher incidence of PSC/autoimmune hepatitis overlap syndrome.
  • Results suggest that VEO-PSC-IBD has similar initial characteristics to later-onset PSC-IBD but presents with a milder disease course, particularly regarding biliary complications.
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European society of Clinical Microbiology and Infectious Diseases guidelines on diagnosis and treatment of brain abscess in children and adults.

Clin Microbiol Infect

January 2024

European Society of Clinical Microbiology and Infectious Diseases, Study Group for Infections of the Brain (ESGIB), Basel, Switzerland; Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Scope: These European Society of Clinical Microbiology and Infectious Diseases guidelines are intended for clinicians involved in diagnosis and treatment of brain abscess in children and adults.

Methods: Key questions were developed, and a systematic review was carried out of all studies published since 1 January 1996, using the search terms 'brain abscess' OR 'cerebral abscess' as Mesh terms or text in electronic databases of PubMed, Embase, and the Cochrane registry. The search was updated on 29 September 2022.

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Background: Hyperinsulinism (HI) due to dysregulation of pancreatic beta-cell insulin secretion is the most common and most severe cause of persistent hypoglycemia in infants and children. In the 65 years since HI in children was first described, there has been a dramatic advancement in the diagnostic tools available, including new genetic techniques and novel radiologic imaging for focal HI; however, there have been almost no new therapeutic modalities since the development of diazoxide.

Summary: Recent advances in neonatal research and genetics have improved our understanding of the pathophysiology of both transient and persistent forms of neonatal hyperinsulinism.

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Article Synopsis
  • Ulcerative proctitis (UP) is a rare form of ulcerative colitis in children, with the study analyzing clinical features and outcomes of 196 diagnosed patients aged under 18 from 2016 to 2020.
  • Most patients presented with symptoms like bloody stools and abdominal pain, and the study found that higher initial disease activity scores (PUCAI) were linked to worse outcomes, including the need for more aggressive treatments.
  • By the end of the study, nearly half of the patients showed disease progression, and only a small percentage required colectomy, highlighting the challenges in managing UP in pediatric patients.
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Background: Liaison psychiatry provision for children and young people in England is poorly evaluated.

Aims: We sought to evaluate paediatric liaison psychiatry provision and develop recommendations to improve practice.

Method: The liaison psychiatry surveys of England (LPSE) cross-sectional surveys engage all liaison psychiatry services in England.

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New developments and therapies in pediatric endocrinology.

Eur J Pediatr

April 2023

Department of Pediatrics, Spaarne Gasthuis, Haarlem/Hoofddorp, The Netherlands.

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Importance: Functional abdominal pain disorders (FAPDs) can severely affect the life of children and their families, with symptoms carrying into adulthood. Management of FADP symptoms is also a financial and time burden to clinicians and health care systems.

Objective: To systematically review various randomized clinical trials (RCTs) on the outcomes of cognitive behavioral therapy (CBT), educational support, yoga, hypnotherapy, gut-directed hypnotherapy, guided imagery, and relaxation in the management of FAPDs.

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Background And Aims: To date, there are no systematic pharmacokinetic [PK] data on vedolizumab in paediatric inflammatory bowel disease [IBD]. We report results from HUBBLE, a dose-ranging, phase 2 trial evaluating the PK, safety and efficacy of intravenous vedolizumab for paediatric IBD.

Methods: Enrolled patients [aged 2-17 years] with moderate to severe ulcerative colitis [UC] or Crohn's disease [CD] and body weight ≥10 kg were randomized by weight to receive low- or high-dose vedolizumab [≥30 kg, 150 or 300 mg; <30 kg, 100 or 200 mg] on Day 1 and Weeks 2, 6 and 14.

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Few studies have addressed whether proactive therapeutic drug monitoring (TDM) results in improved clinical outcomes in children with inflammatory bowel disease (IBD) treated with anti-tumour necrosis factor. The aim of this study was to investigate the impact of using proactive TDM in this patient group.Pilot single-centre observational study to accrue data on patients managed with proactive TDM.

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Objective: The phenotype mediated by HNF4A/HNF1A mutations is variable and includes diazoxide-responsive hyperinsulinaemic hypoglycaemia (HH) and maturity-onset diabetes of the young (MODY).

Design: We characterised an international multicentre paediatric cohort of patients with HNF4Aor HNF1Amutations presenting with HH over a 25-year period (1995-2020).

Methods: Clinical and genetic analysis data from five centres were obtained.

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Objectives: Adult studies suggest that patients with isolated colonic Crohn disease (L2 CD) exhibit unique characteristics differentiating them from patients with ileo-caecal (L1) CD and ulcerative colitis (UC). We aimed to characterize clinical features and outcomes of paediatric patients with L2.

Methods: Retrospective data was collected through the Porto Inflammatory Bowel Disease group of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) on Paediatric patients with L2, L1 or UC at different time-points.

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Diazoxide is the first-line treatment in children with hyperinsulinaemic hypoglycaemia (HH); however, limited information is available on the duration of diazoxide treatment in children who require over 2 years of it. Hence, we retrospectively reviewed the clinical and biochemical aspects, as well as the duration of therapy and neurodevelopmental assessment, in genetically uncharacterised diazoxide-responsive HH patients admitted to a tertiary hospital over the last 16 years, who had successfully discontinued diazoxide and remained euglycaemic. To exclude transient HH forms, only patients that required diazoxide for over 2 years were studied.

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Article Synopsis
  • This study evaluated the safety and effectiveness of adalimumab in treating children aged 4-17 with moderate-to-severe ulcerative colitis who were not responding to current medications.
  • It involved a double-blind clinical trial across 24 hospitals in 10 countries, where children received either high-dose or standard-dose adalimumab over a period of weeks, with subsequent treatment based on their response.
  • The main outcomes measured were the proportion of patients achieving remission at week 8 and week 52, comparing those on adalimumab treatment to external data on adult placebo responses.
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Latest Developments in the Management of Nut Allergies.

Curr Treat Options Allergy

June 2021

Section of Allergy, Immunology and Retrovirology, Baylor College of Medicine, Houston, TX USA.

Purpose Of Review: In this review, we sought to describe the most recent advances in the dietary and medical management of peanut and tree nut allergy, including selective introduction and immunotherapy.

Recent Findings: Dietary updates include changes to labeling laws, improved information sources, and new apps for buying foods in shops and overseas to better protect individuals with nut allergies. There are still issues in the management of nut allergies in schools, such as parents having to resort to packed lunches instead of school meals and patients experiencing bullying.

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