The influence of ventilation on cardiac function. Spontaneous and mechanical ventilation induce changes in intrapleural or intrathoracic pressure and lung volume, which can independently affect the key determinants of cardiovascular performance: atrial filling or preload; the impedance to ventricular emptying or afterload; heart rate and myocardial contractility.

The Independent Review of gender identity services for children and young people (The Cass Review) was commissioned by NHS England to make recommendations about the services provided by the NHS to children and young people who are questioning their gender identity or experiencing gender incongruence and/or gender dysphoria.. In order to better understand the existing evidence base the Review ...

Background Idiopathic intracranial hypertension (IIH) is a potentially disabling condition. There is a lack of evidence and national guidance on how to diagnose and treat paediatric IIH, leading to variation in clinical practice. We conducted a national Delphi consensus via the Children’s Headache Network to propose a best-practice diagnostic and …

Introduction Global developmental delay (GDD) affects 1%–3% of the population of children under 5 years of age, making it one of the most common conditions presenting in paediatric clinics; causes are exogenous, genetic (non-metabolic) or genetic (metabolic). Recent advances in biotechnology and genetic testing mean that the investigations available to perform for children under 5 years are ...

Many additives, some of which have no nutritional value, can be legally used in processed foods. They intensify colour, thicken, increase shelf life and enhance flavour. Regulatory authorities issue approvals as safe within acceptable quantitative limits. Ultra-processed foods (UPFs) contain combinations of all these additives and are particularly attractive to children. Many publications ...

Most children in hospital who are clinically deteriorating are monitored regularly, and their treatment is escalated effectively. However a small, but significant, number of deteriorating children experience suboptimal outcomes because of a failure to recognise and respond to acute deterioration early enough leading to unintended harm. Tragically this occasionally can have fatal consequences ...

Background The epidemiology of congenital infections is ever changing, with a recent resurgence in syphilis infection rates seen in the UK. Identification of congenital infection is often delayed; early recognition and management of congenital infections is important. Testing modalities and investigations are often limited, leading to missed diagnostic …

Background Neonates are at major risk of sepsis, but data on neonatal sepsis incidence are scarce. We aimed to assess the incidence and mortality of neonatal sepsis worldwide. Methods We performed a systematic review and meta-analysis. 13 databases were searched for the period January 1979–May 2019, updating the search of a previous systematic review and extending it in order to increase ...

Conclusions Despite current literature lacking high quality methodologies and the need for caution when interpreting or extrapolating results, there is a clear general consensus that Makaton is effective in facilitating communication and social interaction in children and young people. It allows children flexibility in communicating in ways that suit them, increasing feelings of inclusivity ...

The content of Archives of Disease in Childhood is endorsed by the Royal College of Paediatrics and Child Health for Continued Professional Development in line with RCPCH CPD guidelines. Archives of Disease in Childhood is the flagship of BMJ’s paediatrics portfolio and has an open access companion journal, BMJ Paediatrics Open.For information about the Editor-in-Chief and editorial team ...