Paediatrics and Child Health RSS feed: Current Issue. Paediatrics and Child Health is the continuously updated review of paediatrics and child health (formerly Current Paediatrics ) Paediatrics and Child Health is an authoritative and comprehensive resource that provides all paediatricians and child health care specialists with up-to-date reviews on all aspects of hospital/community paediatrics and neonatology, including investigations and technical procedures in a 4-year cycle of 48 issues. The emphasis of the journal is on the clear, concise presentation of information of direct clinical relevance to both hospital and community-based paediatricians. Contributors are chosen for their recognized knowledge of the subject. The journal is abstracted and indexed in Current Awareness in Biological Sciences. The layout of the journal, including the design and colour, enables fast assimilation of key information. For ease of reference, Paediatrics and Child Health is available in print and online formats. Formerly Current Paediatrics http://www.paediatricsandchildhealthjournal.co.uk/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Paediatrics and Child Health1751-7222203March 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722210000260/abstract?rss=yesEditorial Board10.1016/S1751-7222(10)00026-0Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8iihttp://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209003473/abstract?rss=yesAbstract: Bone tumours are a rare group of heterogeneous malignancies. Osteosarcoma and Ewing's sarcoma are the commonest of these, usually occurring in the absence of an underlying cause. Peak incidence occurs in adolescence. Patients and families commonly report delays prior to referral for appropriate investigation. There must be a high index of suspicion for those presenting with increasing, unexplained or persistent bone pain or tenderness, particularly pain at rest or limp. Rapid referral to a specialist oncological orthopaedic surgeon in a cancer centre is essential for suspected spontaneous fracture or suspicious radiographic appearances. Bone tumours should be managed within a multidisciplinary team in a cancer centre. Bone tumours are treated as a systemic disease and treatment incorporates neoadjuvant chemotherapy, primary tumour therapy (surgery radiotherapy or radiotherapy alone) followed by adjuvant chemotherapy. Treatment within a clinical trial is considered standard of care. Several new agents are the subject of ongoing research. Children and young adults with bone tumours require lifelong monitoring for potential late complications of treatment.Update and review of the management of bone tumoursC.S. Siller, I.J. Lewis10.1016/j.paed.2009.12.002Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Symposium: Oncology103108http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209002741/abstract?rss=yesAbstract: Germ cell tumours (GCTs) are a heterogeneous group of predominantly midline tumours uniquely occurring from birth to late adulthood. All are believed to arise from the totipotent primordial germ cell. In childhood, ∼50% are gonadal and ∼50% extragonadal (∼20% intracranial and ∼30% extracranial) and clinical presentation depends on tumour site. Teratomas account for ∼50% of all paediatric GCTs and are considered benign in childhood. Malignant GCTs often secrete the tumour markers alpha-fetoprotein (AFP) and human chorionic gonadotrophin (ß-HCG), which may help in diagnosis and follow-up. Management involves complete surgical resection for teratomas and non-metastatic gonadal tumours. In the UK, chemotherapy is reserved for stage 2–4 extracranial malignant GCTs, resulting in >90% five-year overall survival (OS). Radiotherapy is rarely indicated for extracranial disease. Intracranial tumours typically occur in the pineal or suprasellar region. Intracranial germinomas are cured in >90% cases with radiotherapy or combined chemo-radiotherapy. About two-thirds of non-germinomatous intracranial tumours are cured with combined chemo-radiotherapy. Current issues relating to the management of teenagers and young adults (TYAs) with GCTs and implications of tumour biology are highlighted in this review.Germ cell tumours in children and adolescentsMatthew Jonathan Murray, James Christopher Nicholson10.1016/j.paed.2009.10.006Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Symposium: Oncology109116http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722210000156/abstract?rss=yesAbstract: Brain and spinal tumours in children present serious diagnostic challenge for a wide range of practitioners, are common enough to appear regularly as a problem for rehabilitation in hospital, community and school. The range of treatments and their consequences are identified and explored in the way they are selected and delivered to young children versus older children as a consequence of their impact upon brain development. The specific clinical approaches to different tumour types and the impact of their anatomical presentation, biological characteristics are described including spinal cord tumours. The importance of integrating clinical research with daily clinical practice is emphasized especially the importance of obtaining tissue from tumours suitable for biological characterization for clinical practice and translational research. The current challenges and likely lines of development for optimizing the care pathway for children and young people are discussed and the challenge of making progress in diffuse pontine brainstem glioma is used as an example of the ongoing need to use research based strategies as a basis for optimized clinical care.Brain and spinal tumours: contemporary challenges in clinical practiceRichard Grundy, David Walker10.1016/j.paed.2010.01.003Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Symposium: Oncology117122http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209002716/abstract?rss=yesAbstract: Cytotoxic chemotherapy is the principal means by which children with cancer are cured. Paediatric use began with antimetabolites such as aminopterin to induce remission in acute lymphoblastic leukaemia in 1948. Sixty-one years later the majority of children with cancer receive chemotherapy. This article describes the development of the paediatric cooperative study groups producing trials in the U.K., reviews the common chemotherapy drugs in use in childhood cancer treatment and describes the principles of the chemotherapy pathway in cancer treatment as applied to children.Principles of chemotherapyMartin William English10.1016/j.paed.2009.10.003Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Symposium: Oncology123128http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS175172220900273X/abstract?rss=yesAbstract: Improvements in overall childhood cancer survival over the last four decades have been due to improved multimodal therapeutic regimes and supportive care. Symptoms are related to disease, procedures, treatments such as chemotherapy regimens and the overall experience of cancer. These symptoms are viewed as subjective indicators of distress which impact on the child's quality of life and therefore require a rational approach to management. This review explores the reasons why symptom management during chemotherapy is necessary, assessment of symptoms in children and young people and current approaches to management of common symptoms which are reported by children and professionals as being distressing. These are nausea and vomiting, pain, mucositis and fatigue.Symptom management during chemotherapyDilini Rajapakse10.1016/j.paed.2009.10.005Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Symposium: Oncology129134http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209002728/abstract?rss=yesAbstract: The increasing number of paediatric cancer survivors in the last few decades has focused attention on minimizing long-term effects caused by oncological therapy without compromising survival rates. Loss of reproductive function is one of the most distressing potential adverse consequences of successful treatment. Several new reproductive techniques are now available for fertility preservation in these patients. Predicting the risk to fertility for an individual of a planned course of treatment is extremely difficult, particularly in the pediatric population. In this review we discuss the practical and ethical issues that must be addressed so that our patients can benefit from these new technologies. Multidisciplinary teams, specialized centers and decisions made in the “child and young person's best interests” form the basis of the optimal approach to fertility preservation.Practical and ethical issues for fertility preservation for children and young people with cancerMara M. Andres, W. Hamish B. Wallace10.1016/j.paed.2009.10.004Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Occasional Review135142http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209002704/abstract?rss=yesAbstract: The evaluation of vulvovaginitis, which is common in pediatric practice, depends on the pubertal development of the patient, keeping the possibility of sexual abuse in mind. Prepubescent girls are especially susceptible to vulvovaginitis because of anatomic and hormonal factors and because of their tendency to have poor local hygiene. If symptoms persist despite hygienic measures vaginal secretions should be investigated microbiologically and specific antimicrobial treatment prescribed accordingly. When the major complaint is of perineal pruritus, especially at night, empirical treatment with Mebendazole can be considered. In adolescents, who usually present with vaginal discharge, pruritus or dysuria, the pH of vaginal secretions should be tested and the secretions should be examined under the light microscope and sent for microbiological investigations. Physiologic leukorrhea is a common cause of vaginal discharge in adolescents. In the sexually active adolescent a complete pelvic examination with speculum should be performed including evaluation of endocervical specimen for sexually transmitted pathogens. Treatment is then directed at the specific cause. The diagnosis of one sexually transmitted disease necessitates investigation for others and treatment of the partner.VulvovaginitisTamar Stricker10.1016/j.paed.2009.10.002Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Personal Practice143145http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209003278/abstract?rss=yesSelf-assessmentShekar Kesavelu10.1016/j.paed.2009.11.006Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8Self-assessment146150http://www.paediatricsandchildhealthjournal.co.uk/article/PIIS1751722209001565/abstract?rss=yesInstitute of Child Health, London Thursday 23 April 2009Abstracts from the Paediatric Research Society and the Academic Paediatrics Association (GBI)10.1016/j.paed.2009.06.006Paediatrics and Child Health 20, 3 (2010)2010-03-01Paediatrics and Child Health2010-03-01203S1751-7222(10)X0003-8e146e152