The Age-Related Risk of Co-Existing Meningitis in Children with Urinary Tract Infection

Objective: The primary aim of this study was to determine age-stratified rates of co-existing bacterial meningitis in children with urinary tract infection (UTI). The secondary aims of this study were to determine the causative pathogens of UTI, and the clinical features and outcome of children with co-existing meningitis.Methods: Analysis of data collected over a nine-year period at a tertiary pediatric hospital in Australia. Study population: children below 16 years of age with culture-confirmed UTI and a paired CSF sample.Results: A total of 748 episodes in 735 cases were included in the final analysis. The commonest pathogens causing UTI were Escherichia coli (67.4%), Enterococcus faecalis (8.4%), Klebsiella oxytoca (3.5%) and Klebsiella pneumoniae (3.5%). Only two (1.2%; 95% CI: 0.15–4.36%) of 163 neonates (between 0 and 28 days of age) with UTI had co-existing meningitis. Both presented with pyrexia, irritability and lethargy, and recovered uneventfully with antibiotic treatment. There were no cases of co-existing meningitis among 499 infants (between 29 days and 12 months of age) with UTI (95% CI: 0.00–0.74%), or any of the 86 children aged 12 months or over (95% CI: 0.00–4.20%).Conclusions: These findings indicate that clinicians should have a low threshold to perform a lumbar puncture in neonates with UTI, as the risk of co-existing meningitis is not insignificant in this age group. In contrast, beyond the neonatal period, the risk is small and a more selective approach is warranted

Impact of COVID-19 pandemic on characteristics, extent and trends in child maltreatment in 34 Euro-CAN COST Action countries: a scoping review protocol.

Introduction While the factors commonly associated with an increased risk of child maltreatment (CM) were found to be increased during COVID-19, reports of actual maltreatment showed varying trends. Similarly, evidence regarding the impact of COVID-19 on CM within the European Cooperation on Science and Technology and Network Collaborative (COST) Action countries remains inconsistent. This scoping review aims to explore the extent and nature of evidence pertaining to CM within the countries affiliated with the Child Abuse and Neglect in Europe Action Network (Euro-CAN), funded by the COST. Methods and analysis Key electronic databases were searched to identify eligible papers, reports and other material published between January 2020 and April 2023: PubMed, EMBASE, PsycINFO, Social Policy and Practice, Scopus and Web of Science. To cover the breadth of evidence, a systematic and broad search strategy was applied using a combination of keywords and controlled vocabulary for four concepts: children, maltreatment, COVID-19 and Euro-CAN countries, without restrictions on study design or language. Grey literature was searched in OpenGrey and Google Scholar. Two reviewers will independently screen full-text publications for eligibility and undertake data extraction, using a customised grid. The screening criteria and data charting will be piloted by the research team.The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews will be followed to present the results. Results will be summarised in a tabular form and narratively. Ethics and dissemination This review will identify and summarise publicly available data, without requiring ethical approval. The findings will be disseminated to the Euro-CAN Network and reported to the COST Association. They will also be published in a peer-reviewed journal. This protocol is registered on Open Science Framework

Impact of COVID-19 pandemic on characteristics, extent and trends in child maltreatment in 34 Euro-CAN COST Action countries: a scoping review protocol

Introduction While the factors commonly associated with an increased risk of child maltreatment (CM) were found to be increased during COVID-19, reports of actual maltreatment showed varying trends. Similarly, evidence regarding the impact of COVID-19 on CM within the European Cooperation on Science and Technology and Network Collaborative (COST) Action countries remains inconsistent. This scoping review aims to explore the extent and nature of evidence pertaining to CM within the countries affiliated with the Child Abuse and Neglect in Europe Action Network (Euro-CAN), funded by the COST. Methods and analysis Key electronic databases were searched to identify eligible papers, reports and other material published between January 2020 and April 2023: PubMed, EMBASE, PsycINFO, Social Policy and Practice, Scopus and Web of Science. To cover the breadth of evidence, a systematic and broad search strategy was applied using a combination of keywords and controlled vocabulary for four concepts: children, maltreatment, COVID-19 and Euro-CAN countries, without restrictions on study design or language. Grey literature was searched in OpenGrey and Google Scholar. Two reviewers will independently screen full-text publications for eligibility and undertake data extraction, using a customised grid. The screening criteria and data charting will be piloted by the research team. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews will be followed to present the results. Results will be summarised in a tabular form and narratively. Ethics and dissemination This review will identify and summarise publicly available data, without requiring ethical approval. The findings will be disseminated to the Euro-CAN Network and reported to the COST Association. They will also be published in a peer-reviewed journal. This protocol is registered on Open Science Framework

What's bugging you? An update on the treatment of head lice infestation

Head lice infestation (pediculosis capitis) is a common problem in paediatric practice. It can cause considerable distress to children and their families and may lead to bullying and social stigmatisation. Therapy with "conventional" topical pediculicides with neurotoxic mode of action-such as malathion, permethrin, phenothrin and carbaryl-is increasingly associated with treatment failure as a result of the emergence of resistance within the parasite population. This review provides an overview of the natural history, clinical symptoms and diagnosis of head lice infestation. It also discusses general management principles and summarises the current data on novel treatment strategies, including wet combing, dimeticone, isopropyl myristate, benzyl alcohol, plant-based compounds and oral medication

To x-ray or not to x-ray? Screening asymptomatic children for pulmonary TB:a retrospective audit

<p>Objective Recent studies found that a chest x-ray (CXR) has limited value in the assessment of asymptomatic adults with tuberculosis (TB) infection. We aimed to determine in asymptomatic children with a positive tuberculin skin test and/or interferon-.release assay (TST/IGRA) whether a CXR identifies findings suggestive of pulmonary TB.</p><p>Design, setting and patients All children with TB infection (defined as TST >= 10 mm and/or positive IGRA) presenting to The Royal Children's Hospital Melbourne during a 54-month period were included. All CXRs were reviewed by a senior radiologist blinded to the clinical details. The medical records of those with radiological abnormalities suggestive of TB were examined to identify those who were asymptomatic when the CXR was done. Demographical data were also collected.</p><p>Results CXRs were available for 268 of 330 TB-infected children, of whom 60 had CXR findings suggestive of TB. Of the 57 for whom clinical details were available, 26 were asymptomatic. Of these asymptomatic children with radiological abnormalities suggestive of TB, 6 had CXR findings suggestive of active TB, 14 had CXR findings suggestive of prior TB and 6 had isolated non-calcified hilar lymphadenopathy. The six with findings suggestive of active TB represented 2.6% (95% CI 0.9 to 5.5%) of asymptomatic TST/IGRApositive children with evaluable CXRs. One child with isolated hilar lymphadenopathy had microbiologicallyconfirmed TB.</p><p>Conclusions In contrast to the results from studies in adults, a CXR identified a small but noteworthy number of children with findings suggestive of pulmonary TB in the absence of clinical symptoms.</p>

Alterations in the levels of an H1 DNA linker histone subtype in peripheral blood leukocytes from schizophrenia patients are linked with this disorder

AbstractSchizophrenia is an illness with severe social and familial impact. However, biomarkers related to chromatin that could help prognosis so as to prevent or attenuate the symptoms of first episodes and relapses of this malady  are either few or obscurely related. To this end, we decided to  analyze the chromatin constitution of certain  H1 DNA linker histone subtypes of schizophrenia patients, since this particular epigenetic chromatin parameter has not been previously studied with respect to this disorder. We examined the abundance of three histone H1 subtypes (also called variants), i.e., H1.0, H1.3, and H1.5, as well as the total histone H1 fraction in peripheral blood lymphocytes and neutrophils of hospitalized relapsed schizophrenic patients (inpatients), chronic outpatients on medication, first-episode patients, and normal control subjects. Of the three H1 subtypes  analyzed, H1.0 protein levels were found to be significantly lower in both lymphocytes and neutrophils of all patients that participated in the study. Total histone H1 levels were also found to be decreased in all patient cases. The fact that the changes in H1.0 levels and the total H1 fraction were observed regardless of state or phase of the disorder or the administered medication implies that these epigenetic changes are most probably intrinsically associated with the etiology of the illness. Due to the importance of the histone epigenetic profile in chromatin remodeling and gene expression, the observed non physiologiocal alterations of H1.0 levels and total H1 may contribute to the psychopathology of schizophrenia  by affecting the normal expression levels of certain genes. As this is the first time that a specific histone subtype is linked to schizophrenia, our work may serve as the basis for studying this disorder from a novel perspective, encompassing chromatin epigenetic research related to the histone protein subtypes/variants and as a novel source of biomarkers for this disorder

Urine sampling technique and urine culture isolates.

<p>Urine sampling technique and urine culture isolates.</p