Case report dealing with a torticollis induced by JIA

Neonatal encephalopathy (NE) presents as reduced consciousness, often with seizures, abnormal tone, feeding and respiratory difficulties. The most common cause is secondary to a hypoxic-ischaemic event. However, there are many important diagnoses that can also present as NE, so-called ‘hypoxic ischaemic encephalopathy (HIE) mimics’. This paper, aimed at paediatric trainees, aims to describe clinical situations in which a diagnosis other than HIE should be suspected, the differential diagnoses to consider and appropriate investigations.

A 16-year-old girl with a background of systemic lupus erythematosus (SLE) and resultant end-stage kidney disease (ESKD) presents 1 month post deceased donor kidney transplantation with fever, abdominal pain, back pain and arthralgias.Her temperature was 39.3C, heart rate 100 bpm and blood pressure 116/65 mm Hg.Her abdomen was soft with normal bowel sounds but had tenderness in her right lower quadrant on deep palpation overlying her allograft site.The rest of her examination was unremarkable.Initial investigations revealed a new normocytic normochromic anaemia (haemoglobin: 95 g/L), acute kidney injury (serum creatinine increased to 82 umol/L from a baseline of 50-60 umol/L) and elevated C-reactive protein (58.6 mg/L).A transplant kidney ultrasound (figure 1) was performed, showing a new lateral perinephric complex cystic fluid collection.An abdominal MRI (figure 2) was done, showing a lateral septated cystic lesion (2.44.23.6 cm) and an anteromedial ill-defined heterogeneous mass (72.98.3 cm) associated with inflammatory changes.

Updated national guidance was issued in October 2023 based on the lessons learnt during COVID-19 in 2020 for the management of children in hospital with viral respiratory tract infections. This includes the application of isolation, segregation, mask wearing and testing for respiratory viruses in the emergency acute unscheduled care pathway. This should ensure that services are maintained, and transmission of respiratory viruses is reduced within the hospital settings.

Inhalers are the mainstay of asthma treatment, but are responsible for a disproportionately high level of carbon emissions compared with other aspects of healthcare. There is a growing interest among CYP in discussing the environmental impact of their treatment with healthcare staff. In this article, we outline an individualised approach to modifying asthma treatment to be more sustainable. We explore options including prescribing dry powder inhalers over pressurised metered dose inhalers, choosing inhaler devices with lower carbon footprints, improving disposal and recycling of inhalers, and optimising basic asthma care through routine reviews, prescription management and during exacerbations.

Paediatric resuscitation is a key skill for anyone in medicine who is involved in the care of children. Basic and advance paediatric life support courses are crucial in teaching those skills nationwide in a way that is memorable, protocolised and standardised. These courses are vital in the dissemination and upkeep of both theoretical and practical knowledge of paediatric resuscitation, with their primary aim being the return of spontaneous circulation. While sustaining life is important, preserving a life with quality, one with good functional and neurological outcomes should be the gold standard of any resuscitative attempt. Good neurological outcomes are dependent, in large part, on how well the postresuscitation stage is managed. This stage does not start in the intensive care unit, it starts at the point at which spontaneous circulation has been reinstated. The aim of this paper is to provide a basic overview of the main strategies that should be followed in order to minimise secondary brain injury after successful resuscitation attempts.

Judicious use of autoantibodies in paediatrics can be challenging. Autoimmune conditions can present with a wide range of signs and symptoms, many of which are non-specific. In combination with clinical features and laboratory findings, autoantibodies can facilitate diagnosis and in certain cases inform prognosis. Evidence for use of autoantibodies to guide and monitor treatment is limited. Caution is necessary when interpreting adult studies. We summarise the use of autoantibodies in paediatric practice with a guide on how they may be used.