https://wjps.bmj.com/, https://bmjpaedsopen.bmj.com/, https://adc.bmj.com/, https://fn.bmj.com/, https://ep.bmj.com/, ht

Paediatrics and Child Health at BMJ Group, London (2026)

05/09/2026

𝗔𝗿𝗲 𝗮𝗱𝗼𝗹𝗲𝘀𝗰𝗲𝗻𝘁𝘀 𝘁𝗵𝗲 “𝗙𝗼𝗿𝗴𝗼𝘁𝘁𝗲𝗻 𝗧𝗿𝗶𝗯𝗲” 𝗼𝗳 𝗲𝗺𝗲𝗿𝗴𝗲𝗻𝗰𝘆 𝗺𝗲𝗱𝗶𝗰𝗶𝗻𝗲?
Young people attend emergency departments for injuries, self-harm, mental health crises, acute illness and long-term condition flares. However, their care can fall between paediatric and adult services.

This viewpoint argues for a more adolescent-focused approach, including:
• Confidential spaces for assessment.
• Psychosocial screening as part of routine care.
• Training in communication, sexual health, eating disorders, safeguarding and consent.
• Greater involvement of young people in decisions about their healthcare.
• Seamless pathways that do not depend solely on age cut-offs.

Emergency departments can do more than treat the immediate problem—they can also help prevent future harm.

Read the full article in 𝘈𝘳𝘤𝘩𝘪𝘷𝘦𝘴 𝘰𝘧 𝘋𝘪𝘴𝘦𝘢𝘴𝘦 𝘪𝘯 𝘊𝘩𝘪𝘭𝘥𝘩𝘰𝘰𝘥:
𝙝𝙩𝙩𝙥𝙨://𝙖𝙙𝙘.𝙗𝙢𝙟.𝙘𝙤𝙢/𝙘𝙤𝙣𝙩𝙚𝙣𝙩/111/9/819

#𝗔𝗱𝗼𝗹𝗲𝘀𝗰𝗲𝗻𝘁𝗛𝗲𝗮𝗹𝘁𝗵 #𝗘𝗺𝗲𝗿𝗴𝗲𝗻𝗰𝘆𝗠𝗲𝗱𝗶𝗰𝗶𝗻𝗲

04/09/2026

𝗧𝗵𝗲 “𝗖𝗵𝗶𝗸 𝘀𝗶𝗴𝗻”: 𝗮𝗻 𝗶𝗺𝗽𝗼𝗿𝘁𝗮𝗻𝘁 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗰𝗹𝘂𝗲 𝗶𝗻 𝗮 𝗳𝗲𝗯𝗿𝗶𝗹𝗲 𝗶𝗻𝗳𝗮𝗻𝘁
This Images in Paediatrics report describes a 2-month-old infant receiving chemotherapy who developed high-grade fever, rash, pancytopenia and transaminitis.

The subsequent appearance of generalised hyperpigmentation with desquamation—and striking brownish-black discolouration over the tip of the nose—provided an important clue. A similar rash and viral illness with arthralgia were reported in family members, and chikungunya IgM was positive.

Recognising the “Chik sign” may help differentiate chikungunya from other febrile illnesses, particularly in endemic regions.

Read the full clinical picture:
𝙝𝙩𝙩𝙥𝙨://𝙖𝙙𝙘.𝙗𝙢𝙟.𝙘𝙤𝙢/𝙘𝙤𝙣𝙩𝙚𝙣𝙩/111/9/821

#𝗜𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝘂𝘀𝗗𝗶𝘀𝗲𝗮𝘀𝗲𝘀 #𝗧𝗿𝗼𝗽𝗶𝗰𝗮𝗹𝗠𝗲𝗱𝗶𝗰𝗶𝗻𝗲

03/09/2026

𝗢𝗻𝗲 𝗴𝗲𝗻𝗲𝘁𝗶𝗰 𝘃𝗮𝗿𝗶𝗮𝗻𝘁 - 𝗳𝗮𝗿 𝗺𝗼𝗿𝗲 𝘁𝗵𝗮𝗻 𝗷𝘂𝘀𝘁 𝗸𝗶𝗱𝗻𝗲𝘆 𝗱𝗶𝘀𝗲𝗮𝘀𝗲.

Hepatocyte Nuclear Factor 1 beta (𝗛𝗡𝗙𝟭𝗕) pathogenic variants cause a multisystem disorder, most commonly affecting the kidneys and pancreas. They are inherited in an autosomal dominant pattern, but up to half can arise de novo—so a negative family history does not exclude the diagnosis.

𝙏𝙝𝙞𝙨 𝙁𝙞𝙛𝙩𝙚𝙚𝙣 𝙢𝙞𝙣𝙪𝙩𝙚 𝙘𝙤𝙣𝙨𝙪𝙡𝙩𝙖𝙩𝙞𝙤𝙣 𝙤𝙛𝙛𝙚𝙧𝙨 𝙖 𝙥𝙧𝙖𝙘𝙩𝙞𝙘𝙖𝙡 𝙜𝙪𝙞𝙙𝙚 𝙩𝙤 𝙧𝙚𝙘𝙤𝙜𝙣𝙞𝙨𝙞𝙣𝙜 𝙖𝙣𝙙 𝙢𝙖𝙣𝙖𝙜𝙞𝙣𝙜 𝙘𝙝𝙞𝙡𝙙𝙧𝙚𝙣 𝙬𝙞𝙩𝙝 𝙃𝙉𝙁1𝘽-𝙧𝙚𝙡𝙖𝙩𝙚𝙙 𝙙𝙞𝙨𝙚𝙖𝙨𝙚.

Children may develop renal abnormalities, hypomagnesaemia, diabetes (MODY5), pancreatic abnormalities, liver dysfunction and, particularly with a 17q12 microdeletion, neurodevelopmental difficulties.

A child with an HNF1B variant needs multisystem assessment and lifelong, age-appropriate follow-up, rather than renal monitoring alone. The authors also highlight the importance of parental testing, genetic counselling and coordinated care across specialties.

𝙍𝙚𝙖𝙙 𝙢𝙤𝙧𝙚 𝙝𝙚𝙧𝙚: 𝙝𝙩𝙩𝙥𝙨://𝙡𝙣𝙠𝙙.𝙞𝙣/𝙚𝙆𝙙𝙐-_𝙬𝙎

02/09/2026

𝗪𝗵𝗲𝗻 𝗮 𝗰𝗵𝗶𝗹𝗱 𝗺𝗮𝘆 𝗵𝗮𝘃𝗲 𝗯𝗲𝗲𝗻 𝗽𝗼𝗶𝘀𝗼𝗻𝗲𝗱, 𝘄𝗵𝗶𝗰𝗵 𝗯𝗹𝗼𝗼𝗱 𝗮𝗻𝗱 𝘂𝗿𝗶𝗻𝗲 𝘁𝗲𝘀𝘁𝘀 𝗮𝗿𝗲 𝗿𝗲𝗮𝗹𝗹𝘆 𝗵𝗲𝗹𝗽𝗳𝘂𝗹?

Routine tests such as blood glucose, electrolytes and blood gas analysis often provide the key information needed for initial management. In selected cases, measuring the concentration of a specific toxin—such as paracetamol, salicylate or a toxic alcohol—can guide treatment.

However, drug-of-abuse screens can be misleading. They may produce false-positive or false-negative results, and a positive result does not necessarily mean that the substance caused the child’s symptoms.

This review explains how to select and interpret laboratory tests in children with suspected poisoning.

Read the full review in 𝘈𝘳𝘤𝘩𝘪𝘷𝘦𝘴 𝘰𝘧 𝘋𝘪𝘴𝘦𝘢𝘴𝘦 𝘪𝘯 𝘊𝘩𝘪𝘭𝘥𝘩𝘰𝘰𝘥:
𝙝𝙩𝙩𝙥𝙨://𝙖𝙙𝙘.𝙗𝙢𝙟.𝙘𝙤𝙢/𝙘𝙤𝙣𝙩𝙚𝙣𝙩/111/9/774

#𝗘𝗺𝗲𝗿𝗴𝗲𝗻𝗰𝘆𝗠𝗲𝗱𝗶𝗰𝗶𝗻𝗲

01/09/2026

𝗥𝗲𝘁𝗵𝗶𝗻𝗸𝗶𝗻𝗴 𝗱𝗶𝗮𝗯𝗲𝘁𝗲𝘀 𝗶𝗻𝘀𝗶𝗽𝗶𝗱𝘂𝘀 𝗶𝗻 𝗰𝗵𝗶𝗹𝗱𝗿𝗲𝗻

Assessing a child with polyuria and polydipsia can be diagnostically challenging. This practical review explores the transition from “cranial diabetes insipidus” to 𝘃𝗮𝘀𝗼𝗽𝗿𝗲𝘀𝘀𝗶𝗻 𝗱𝗲𝗳𝗶𝗰𝗶𝗲𝗻𝗰𝘆 (𝗔𝗩𝗣-𝗗) and from “nephrogenic diabetes insipidus” to 𝘃𝗮𝘀𝗼𝗽𝗿𝗲𝘀𝘀𝗶𝗻 𝗿𝗲𝘀𝗶𝘀𝘁𝗮𝗻𝗰𝗲 (𝗔𝗩𝗣-𝗥).

The authors highlight:
• Clinical features that may distinguish primary polydipsia from AVP-D.
• Why hypernatraemia should raise concern for AVP-D.
• The limitations—and potential alternatives—to water deprivation testing.
• The emerging role of copeptin in complex diagnostic cases.
• The importance of intracranial imaging and ongoing surveillance.
• Practical considerations in desmopressin treatment and adipsia.

A valuable update for paediatricians and clinicians assessing children with excessive thirst and urine output.

𝙍𝙚𝙖𝙙 𝙩𝙝𝙚 𝙛𝙪𝙡𝙡 𝙧𝙚𝙫𝙞𝙚𝙬: 𝙝𝙩𝙩𝙥𝙨://𝙖𝙙𝙘.𝙗𝙢𝙟.𝙘𝙤𝙢/𝙘𝙤𝙣𝙩𝙚𝙣𝙩/111/9/763

31/08/2026

Here's a puzzle every researcher studying children faces: if you see that breastfed kids do better at school, does breastfeeding actually cause that — or is something else going on, like the fact that mothers who breastfeed longer are also often more educated?

A new paper in Archives of Disease in Childhood tackles this with a simple but powerful tool: drawing a picture of your assumptions before you crunch any numbers. Think of it like a flowchart showing everything you believe might influence your results — family income, mum's education, the child's health — before you decide what to account for statistically.

Why does this matter? Because getting it wrong in either direction causes real problems. Leave out an important factor, and you might see a "fake" effect that isn't really there. But adjust for the wrong thing, and you can accidentally create a false signal or erase a real one — a mistake even experienced researchers make.

The authors walk through a real example — does breastfeeding really improve school performance years later? — and show, step by step, how drawing this simple picture first stops you from fooling yourself with the data. Their message: if you're already choosing which factors to control for, you're making assumptions about cause and effect either way, so it's better to draw them out and be upfront about it.

Read more on this interesting topic here: https://adc.bmj.com/content/early/2026/08/13/archdischild-2026-330279?utm_campaign=Usage&utm_id=BMJ162&utm_medium=social&utm_source=facebook

30/08/2026

Most children who receive botulinum toxin treatment for cerebral palsy-related muscle stiffness are treated in specialist hospital centres — but a new pilot from a London children's community service suggests there's another way.

A team running a twice-monthly Community Tone Management Clinic offered this treatment to children with more severe motor impairment, a group that's traditionally had less evidence behind their care. The results were encouraging: most children experienced meaningful pain relief, better sleep, and measurable improvements in joint movement — all without a single reported side effect, and with the same team following them from assessment through to recovery.

It's a small pilot, but it points to something bigger: care for children with complex needs doesn't always have to sit exclusively within tertiary hospitals. Keeping assessment, treatment and follow-up within one community-based team may offer a more joined-up, family-centred path forward.

Read the full letter here: https://adc.bmj.com/content/early/2026/08/24/archdischild-2026-330772?utm_campaign=Usage&utm_id=BMJ162&utm_medium=social&utm_source=facebook

29/08/2026

Can a clinical rule that works beautifully in one country be trusted everywhere?

The PECARN rule helps identify febrile infants ≤60 days at low risk of serious bacterial infection. A recent European validation also suggested that CRP could substitute for procalcitonin when PCT is unavailable.

But this letter raises an important caution.

The CRP-adapted rule had 97.8% sensitivity in Sweden—but only 92.2% in the MOFICHE (Europe) cohort. That means roughly 1 in 13 infants with serious bacterial infection could be classified as low risk.

And outside Europe and North America, the numbers may be even less reassuring: a Singaporean validation reported 88.9% sensitivity.

The message is important: clinical prediction rules travel only as well as the populations in which they are validated. Differences in infection prevalence and pathogens matter.

For Asian, African and LMIC settings, the authors argue for prospective, geographically diverse validation before widespread adoption.

Read this letter here: https://adc.bmj.com/content/early/2026/08/27/archdischild-2026-331282?utm_campaign=Usage&utm_id=BMJ162&utm_medium=social&utm_source=facebook

28/08/2026

Two smart oxygen systems. Which one is smarter?

Keeping a preterm baby’s oxygen saturation in the 91–95% target range is a constant balancing act.

This randomised crossover study compared two automated systems:

PRICO is a rule-based system that adjusts the baby’s oxygen every 30 seconds according to the SpO₂ reading.

CLiO₂ is an adaptive system that adjusts oxygen every second, considering how far and for how long SpO₂ moves away from the target.

The difference was striking: babies stayed within the target range for 76% of the time with CLiO₂ versus 62% with PRICO. CLiO₂ also reduced time above the target range (15% vs 30%), while both performed similarly in preventing low saturations.

The lesson is simple: when oxygen is being controlled automatically, the algorithm matters.

To know more, read here: https://fn.bmj.com/content/early/2026/08/26/archdischild-2026-330569

27/08/2026

Not every important paediatric question can be answered with a randomised trial. So how do we know whether an intervention actually worked?

This editorial introduces difference-in-differences (DID)—a way of using real-world data to estimate the effect of an intervention when randomisation isn’t feasible.

The idea is surprisingly simple: compare how things changed over time in a group that received the intervention with how they changed in a similar group that didn’t.

For paediatricians, this can be particularly useful for evaluating health policies, service changes and population-level interventions, where RCTs may be difficult or unethical.

But there is an important catch. DID only gives a credible causal answer if its key assumptions—especially “parallel trends” before the intervention—hold true.

The editorial offers a practical framework for deciding whether a DID study has really earned the conclusions it makes.

Read more on this editorial: https://adc.bmj.com/content/early/2026/08/25/archdischild-2026-330341?utm_campaign=Usage&utm_id=BMJ162&utm_medium=social&utm_source=facebook

Paediatrics and Child Health at BMJ Group

05/09/2026

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