Highlights from this issue

What the brochure says The WHO top ten list of threats to global health feature many directly relevant to children: climate change, pollution; vaccine hesitancy; dengue; COVID-19; influenza; antimicrobial resistance – all ‘deserving members’ of this unenviable top table, though

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Optimising therapeutic hypothermia Using the National Neonatal Research Database, Lara Shipley and colleagues studied infants≥36 weeks gestation who were admitted to UK neonatal units with moderate or severe hypoxic ischaemic encephalopathy (HIE). Between 2011 and 2016 there were 5059 infants.

Obesity and Gαs Variants

Mendes de Oliveira and colleagues now report in the Journal that variants in GNAS exons that encode the stimulatory G-protein alpha subunit (Gαs) have a strong genetic association with severe obesity, owing to reduced signaling by the melanocortin 4 receptor

Obesity and Gαs Variants

Mendes de Oliveira and colleagues now report in the Journal that variants in GNAS exons that encode the stimulatory G-protein alpha subunit (Gαs) have a strong genetic association with severe obesity, owing to reduced signaling by the melanocortin 4 receptor

Highlights from this issue

Therapeutic creep in provision of hypothermia for hypoxic ischaemic encephalopathy Three articles relate to the changing practices of UK clinicians in the provision of therapeutic hypothermia for hypoxic ischaemic encephalopathy (HIE). Lori Hage and colleagues report the clinical characteristics of

Pneumococcal Empyema

A 4-year-old girl was brought to the emergency department with a 4-day history of fever, cough, and lethargy. She was up to date with all childhood vaccinations. Three weeks earlier, she had had a presumed viral respiratory tract infection with

Losing Touch

We called it the “cold light.” It looked like a small blue button with a power cord attached to the end of it. At its center was a single round eye that emitted a light, crimson in color and piercing

Highlights from this issue

In deference to the equivocal A common (if not universal) human phenotype is the need for an answer—ideally a definitive, dichotomous one—a yes/no with no shades of grey. I don’t take sides on this nor am I being deliberately Machiavellian—conclusive

Base Editing in Progeria

“How much longer?” is a question all too familiar to parents. This is also a question that scientists ask themselves when trying to find a truly effective treatment for patients with the Hutchinson–Gilford progeria syndrome (HGPS) and other genetic diseases.

Casting a Wide Net

A 16-year-old girl presented to her pediatrician for evaluation of recent weight gain, irritability, weakness, and skin changes. Her mother reported that her daughter’s grades at school had declined and that she had left the cheerleading team owing to fatigue.

Highlights from this issue

Scene – 1953, provincial theatre: final act. Frisson of suspense ripples through audience. Main protagonist: detective inspector. ‘Why haven’t I realised before?’ Injured victim: ‘Why didn’t you just open your eyes’. Adversary-doppelgänger: Placing musket (softly but dramatically) on the floor. ‘So, you’ve finally foiled me. I thought

Involvement of community paediatricians in the care of children and young people with mental health difficulties in the UK: implications for case ascertainment by child and adolescent psychiatric, and paediatric surveillance systems

Objective To ascertain the extent to which community paediatricians are involved in the care of children with mental health conditions in order to determine which difficulties are appropriate for single or joint surveillance by the British Paediatric Surveillance Unit (BPSU)

Ewing’s Sarcoma

In 1920, during a meeting of the New York Pathological Society, James Ewing described an unusual tumor in a 14-year-old girl as a “diffuse endothelioma of bone.” The tumor had initially been diagnosed as an osteosarcoma, but its architecture, the

Examining the effects of pre-pregnancy weight and gestational weight gain on allergic disease development in offspring: a protocol for a population-based study using health administrative databases in Ontario, Canada

Introduction Over the last 20 years, excess maternal pre-pregnancy weight (overweight and obesity) and gestational weight gain have become the most common morbidities in pregnancy. These morbidities may pose a threat to fetal immunological development through associated metabolic dysfunction and

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Low grade intraventricular haemorrhage and cerebral palsy Nicky Hollebrandse and colleagues describe the neurodevelopmental outcomes at 8 years of almost 500 extremely preterm infants born before 28 week’s gestation and relate these to the presence and severity of intraventricular haemorrhage


Migraine is a ubiquitous neurologic disorder that is estimated to affect approximately 1 billion people worldwide, predominantly females. According to the Global Burden of Disease Study 2016, migraine is the second leading cause of disability and accounts for more disability

Editing the Mitochondrial Genome

Mitochondrial diseases are a heterogeneous group of disorders with varying clinical features caused by impaired function of the mitochondrial respiratory chain. The underlying cause can be gene mutations affecting either the nuclear DNA or the mitochondrial DNA (mtDNA), both of

Am I Racist?

R. was a teenager when his osteosarcoma came roaring back, with vertebral metastases that left him paralyzed and bed-bound. He’d been told he was going to die, but his mother, a tower of strength, was determined to keep things positive.

Highlights from this issue

Imaging the encephalopathy of prematurity Julia Kline and colleagues assessed MRI findings at term in 110 preterm infants born before 32 weeks’ gestation and cared for in four neonatal units in Columbus, Ohio. Using automated cortical and sub-cortical segmentation they

Bipolar Disorder

Mood fluctuations are common during normal daily life as a result of either stressful or pleasant events. However, severe and persistent mood swings that result in psychological distress and behavioral impairment may be symptomatic of an underlying affective disorder. Affective

Salicylate Toxicity

On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the


Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage.

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