Medical Diseases

Henry Avocado Recalls Whole Avocados Because Of Possible Health Risk Henry Avocado Corporation is voluntarily recalling California-grown whole avocados sold in bulk at retail stores because they have the potential to be contaminated with Listeria monocytogenes. Henry Avocado is issuing this voluntary recall out of an abundance of caution due to positive test results on environmental samples taken during a routine government inspection at its California packing facility. There are no reported illnesses associated with this recall. Published March 24, 2019 at 08:02AM

North Country Smokehouse Recalls Ready-To-Eat Sausage Products due to Possible Foreign Matter Contamination

North Country Smokehouse Recalls Ready-To-Eat Sausage Products due to Possible Foreign Matter Contamination North Country Smokehouse, a Claremont, N.H. establishment, is recalling approximately 2,686 pounds of ready-to-eat sausage products that may be contaminated with extraneous materials, specifically metal. Published March 23, 2019 at 10:00AM

Tip Top Poultry, Inc. Recalls Fully Cooked, Diced Chicken Products due to Misbranding and Undeclared Allergens

Tip Top Poultry, Inc. Recalls Fully Cooked, Diced Chicken Products due to Misbranding and Undeclared Allergens Tip Top Poultry, Inc., a Rockmart, Ga. establishment, is recalling approximately 100 pounds of frozen, fully cooked diced white chicken meat products due to misbranding and undeclared allergens. Published March 23, 2019 at 10:00AM

Tip Top Poultry, Inc. Recalls Fully Cooked, Diced Chicken Products due to Misbranding and Undeclared Allergens

Two Brothers Pork Skins Recalls Pork Skin Products Due to Misbranding and Failure to Produce Under A HACCP Plan

Two Brothers Pork Skins Recalls Pork Skin Products Due to Misbranding and Failure to Produce Under A HACCP Plan Two Brothers Pork Skins, a Kannapolis, N.C. establishment, is recalling an undetermined amount of pork skin products because the products were produced without meeting the federal requirements to develop and implement a hazard analysis and system of preventive controls to improve the safety of the products, known as Hazard Analysis and Critical Control Points; the omission of safe handling instructions on the package; and due to misbranding. Published March 23, 2019 at 01:00AM

Highlights from this issue

Conflict, candour and reflection

There are many challenges to practising medicine well, not least keeping up to date with medical advances, implementing them within the time and financial restraints of ever expanding healthcare and avoiding over or under treatment while keeping the patient safe and avoiding criticism or complaints. In essence, considering the ‘whole patient’ and managing them using our knowledge, skills and experience which no longer equates to just the medical facts with increased recognition that skills like ‘openness’, ‘listening’, ‘transparency’ and enhanced communication are partly acquired by experience but can also be facilitated by training, mentoring and working in a positive and supportive environment. Multiple new areas of thinking have emerged as priorities—conflict resolution training, the duty of candour, learning from excellence, the need to reflect and active consideration of well being for ourselves, our patients and their families. These concepts need to be embraced as they will help

Disaster preparedness in French paediatric hospitals 2 years after terrorist attacks of 2015

Reducing healthcare conflict: outcomes from using the conflict management framework

Quality of life of extremely preterm school-age children without major handicap: a cross-sectional observational study

Air pollution and autism

It’s clear that genetics plays a major role in the aetiology of autistic spectrum disorder (ASD), but the genuine increase in prevalence over recent decades suggests that environmental factors are also responsible. If ASD is considered to be a neurodevelopmental disorder, rather than a social construct, then antenatal influences during early brain development may be important. Potential prenatal causes suggested thus far are many and varied, including paracetamol (Archivist Oct 2016 doi.org/10.1136/archdischild-2016–3 11 708), antidepressant drugs (Archivist March 2016 doi.org/10.1136/archdischild-2016–3 10 462), ultrasound (Archivist Sept 2018 doi.org/10.1136/archdischild-2018–3 15 816), season of conception (Lucina Dec 2016 doi.org/10.1136/archdischild-2016–3 12 102), and obesity, among many others. Several studies have hinted at a link with maternal air pollution exposure, but these have been inconsistent or inconclusive. ASD definitions have been imprecise, exposure indicators not

Health-related quality of life in congenital heart disease surgery in children and young adults: a systematic review and meta-analysis

Prediction of school outcome after preterm birth: a cohort study

Screening for coeliac disease in 1624 mainly asymptomatic children with type 1 diabetes: is genotyping for coeliac-specific human leucocyte antigen the right approach?

Surveillance for variant CJD: should more children with neurodegenerative diseases have autopsies?

Patterns of moderate and severe injury in children after the introduction of major trauma networks

Improving developmental care in primary practice for disadvantaged children

Our primary objective was to assess if sustained participation in continuous quality improvement (CQI) activities could improve delivery of ‘basic developmental care’ to disadvantaged children in primary care settings. Secondary objectives were to assess if delivery of developmental care differed by age and geographic location.Data were analysed using multivariable logistic regression and generalised estimating equations. 109 indigenous primary care centres across Australia from 2012 to 2014 and2466 client files from indigenous children aged 3–59 months were included. Outcome measures were delivery of basic developmental care.We found that the proportion of children who received basic developmental care ranged from 55% (advice about physical and mental stimulation of child) (1279, 55.1%) to 74% (assessment of developmental milestones) (1510, 73.7%). Ninety-three per cent (92.6%, 88) of children received follow-up care. Centres with sustained CQI participation (completed three or more c

Screentime and child health

The media are obsessed with the issue of 21st century children spending too much time staring at screens: some reports have amounted to a moral panic ( https://ift.tt/2EodNMh ). The release of a statement from the UK’s Royal College of Paediatrics and Child Health (RCPCH) was therefore welcome (rcpch.ac.uk/resources/health-impacts-screen-time-guide-clinicians-parents). It was based on a systematic ‘review of reviews’ which synthesised the large amount of evidence available (Stiglic N, Viner R. doi: 10. 1136/bmjopen- 2018–0 23 191). Rather than go back to the primary data, they identified 13 reviews of varying quality that had already done this. They assessed each review’s conclusions qualitatively, rather than doing further meta-analyses. Screentime use included television (TV), computers, tablets and smartphones. TV-watching predominated in most reviews. Different outcome domains were considered. With regards to obesity or adiposity, they concluded that there was a positive associati

Scurvy: still a threat in the well-fed first world?

We report three cases of scurvy in previously healthy children referred to us for leg pain and refusal to walk. All children had no significant medical history, symptoms had started months before and subtly advanced. Two of them presented with gingival hyperplasia and petechiae, another one reported night sweats and gingival bleeding in the past few weeks. Two had vitamin D deficiency, and all had microcytic anaemia (in one case requiring transfusional support). A nutritional screening revealed low or undetectable levels of ascorbic acid. This, along with the clinical and radiological findings, led to a diagnosis of scurvy. Vitamin C supplementation was started with rapid improvement of the children’s clinical condition. Scurvy is a rare disease in the ‘first world’, but there are anecdotal reports of scurvy in children without any of the known risk factors for this condition. In our cases, a selective diet was the only risk factor. from Archives of Disease in Childhood current issu

Diagnosing intralobar pulmonary sequestration

Making research central to good paediatric practice

There is evidence abroad of a cautious if not protective approach to research involving children and young people (CYP). We are sensitive to these views but believe they are based on a misconception that we must address together. In this introductory article we look at the complexities and risks of this research, how we must involving CYP and their families in the all aspects of research, how to seek valid consent and assent and how research findings should be reported. Considering how we should conduct this ongoing debate, we outline seven principles that we believe should underpin the necessary dialogue between all with legitimate interest. Our debate should be: (1) evidence informed: arguments should be supported by appropriate and reasonably accurate factual claims; (2) transparent about the grounds for decisions; (3) balanced: arguments should be met by contrary arguments; (4) conscientious: we must be willing to talk and listen, with civility and respect; (5) substantive: argumen

Big data and stratified medicine: what does it mean for children?

Stratified medicine in paediatrics is increasingly becoming a reality, as our understanding of disease pathogenesis improves and novel treatment targets emerge. We have already seen some success in paediatrics in targeted therapies such as cystic fibrosis for specific cystic fibrosis transmembrane conductance regulator variants. With the increased speed and decreased cost of processing and analysing data from rare disease registries, we are increasingly able to use a systems biology approach (including ‘-omics’) to screen across populations for molecules and genes of interest. Improving our understanding of the molecular mechanisms underlying disease, and how to classify patients according to these will lead the way for targeted therapies for individual patients. This review article will summarise how ‘big data’ and the ‘omics’ are being used and developed, and taking examples from paediatric renal medicine and rheumatology, demonstrate progress being made towards stratified medicine f

Early warning scores in paediatrics: an overview

Paediatric Early Warning Scores (PEWS)are used in hospitalised patients to detect physiological deterioration and is being used increasingly throughout healthcare systems with a limited evidence based. There are two versions in general use that can lead to a clinical response, either by triggering an action or by reaching a ‘threshold’ when graduated responses may occur depending on the value of the score. Most evidence has come from research based on paediatric inpatients in specialist children’s hospitals, although the range of research is expanding, taking into account other clinical areas such as paediatric intensive care unit, emergency department and the prehospital setting. Currrently, it is uncertain whether a unified system does deliver benefits in terms of outcomes or financial savings, but it may inform and improve patient communication. PEWS may be an additional tool in context of a patient’s specific condition, and future work will include its validation for different cond

Parry-Romberg syndrome and morphoea en coup de sabre

What is the optimal management for the asymptomatic twin after diagnosis of late-onset group B streptococcal disease?

Towards evidence-based medicine for paediatricians

Is high-concentration oxygen therapy more effective than targeted oxygen therapy in neonatal non-tension pneumothorax?

Alveolar echinococcosis in the liver of an adolescent boy

Highlights from the literature

Tyson Foods, Inc. Recalls Chicken Strip Products due to Possible Foreign Matter Contamination

Tyson Foods, Inc. Recalls Chicken Strip Products due to Possible Foreign Matter Contamination Tyson Foods, Inc., a Rogers, Ark. establishment, is recalling approximately 69,093 pounds of frozen, ready-to-eat chicken strip products that may be contaminated with extraneous materials, specifically pieces of metal. Published March 22, 2019 at 01:30AM

Tyson Foods, Inc. Recalls Chicken Strip Products due to Possible Foreign Matter Contamination

Hill's Pet Nutrition Expands Voluntary Recall of Select Canned Dog Food for Elevated Vitamin D

Hill's Pet Nutrition Expands Voluntary Recall of Select Canned Dog Food for Elevated Vitamin D Hill's Pet Nutrition today announced it is expanding its recall of select canned dog food products due to elevated levels of vitamin D. Published March 21, 2019 at 11:29PM

Better Made Snack Foods Issues Allergy Alert on Undeclared Milk In 10 Ounce $3.99 Original Potato Chips

Better Made Snack Foods Issues Allergy Alert on Undeclared Milk In 10 Ounce $3.99 Original Potato Chips The recall was initiated after it was discovered that a package of 10-ounce Original Potato Chips dated 10 AUG 2019 did not contain Original Potato Chips but instead contained Cheddar and Sour Cream Potato Chips which contain milk. Subsequent investigation indicates the problem was caused by a temporary breakdown in the company's production and packaging processes which may have affected 660 bags of 10-ounce Original Potato Chips. Published March 21, 2019 at 09:59PM

Century Snacks LLC Recalls Snak Club Honey Bliss Nut Mix Due to Undeclared Allergen