SEARCH · PubMed Health

Results for “PAEDIATRICS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed2004

Best paediatric evidence; is it accessible and used on-call?

BACKGROUND: Paediatricians wanting to use evidence based medicine (EBM) strategies, need to be able to track down and critically appraise evidence. This requires access to quality filtered resources (for example, Cochrane Library), bibliographic databases (for example, Medline), and paediatric journals. AIMS: To determine whether paediatricians have access to these resources when on-call and if they use them to answer clinical questions. METHOD: A telephone survey of paediatric and neonatal units was performed during November 2001. The "paediatrician-on-call" was asked whether they could access Medline, Cochrane, and paediatric journals, and if they used these when on-call. RESULTS: Paediatric trainees were available in 87 of the 97 units contacted. All except one had access to Medline; although only 56 (64%) could do this near their ward. Eighty had access to Cochrane. Thirteen (15%) could not gain access to their library out-of-hours. All except one department had local guidelines, with 71% having >15 guidelines. Access to any of the top seven "best evidence" paediatric journals varied from 64% to 100%. Only 26% of trainees had read the evidence based section of Archives of Disease of Childhood, Archimedes. Many trainees claimed to use guidelines when on-call (61; 70%), but few used Medline (14; 16%). CONCLUSIONS: Paediatric trainees mostly have access to facilities to help them to track down and critically appraise evidence. However, few of them have used it to help make clinical decisions when on-call. Many of the doctors contacted said they used local guidelines as their source of information on-call.

Child↗

PubMed2004

Evaluation of the Paediatric Index of Mortality in children managed on adult intensive care units.

OBJECTIVE: To evaluate the performance of the Paediatric Index of Mortality (PIM) in children cared for in adult intensive care units (ICUs) in district general hospitals in the South West Region of England. DESIGN AND SETTING: An observational survey of all children admitted to adult ICUs in 15 district general hospitals between November 2000 and August 2002. For comparison, data were also collected from the regional paediatric ICUs between November 2000 and March 2002. RESULTS: Data were collected from 374 children admitted to adult ICUs and 850 children admitted to the regional paediatric ICU. There were significant differences in the patient characteristics between the two groups. In the adult ICU paediatric population, PIM discriminated well between death and survival (Az ROC = 0.96 (95% confidence interval, 0.93 to 0.99)) and calibrated well across deciles of risk (goodness of fit chi2 = 4.55 (8 df), p = 0.8). CONCLUSIONS: PIM performs well as a risk adjustment method in children whose entire care remains in the adult ICU of a district general hospital. This is important should the Paediatric Intensive Care Audit Network (PICAnet) decide to extend its data collection beyond paediatric intensive care units to other units caring for critically ill children.

Adolescent↗

PubMed2005

A survey of clinical academic staffing in paediatrics and child health in the UK.

BACKGROUND: The state of academic paediatrics in the United Kingdom is a source of anxiety in view of anecdotal reports of loss of identity within medical schools and reductions in staffing levels. AIMS: To measure the current numbers and recent changes in clinical academic staff in all university departments of paediatrics in the UK. METHODS: A questionnaire was sent to all 24 university departments of paediatrics where undergraduates are taught, and to the postgraduate institute of paediatrics. RESULTS: Full responses were obtained from 24 medical institutions. In the past five years there has been an overall 7.2% decline in clinical academic staff, but among lecturers there has been a 26% reduction. Nine of 24 departments had undergone changes in name with at least some loss of paediatric identity. In 12 of 24 centres it was felt that the research assessment exercise had resulted in some, or severe, detriment. CONCLUSIONS: This study confirms the recent loss of academic training positions, leading to a serious concern about the future of academic paediatrics in some UK centres.

Academic Medical Centers↗

PubMed1993

Consultant paediatric outreach clinics--a practical step in integration.

Ten years' experience of paediatric outreach clinics is reviewed and evaluated. The advantages and disadvantages of paediatric outreach and its possible place in the new era of contracting and more developed community paediatric services are discussed. It is concluded that paediatric outreach increases parental and professional choice and access to paediatric consultant services, increases service flexibility, reduces unnecessary hospital visits, and enables more rational and relevant clinical decision making. Outreach is particularly relevant in areas of deprivation where paediatric needs are greatest.

Child↗

PubMed1998

Errors by paediatric residents in calculating drug doses.

BACKGROUND: Errors in calculating drug doses in infants and small children can cause morbidity and mortality, especially with agents exhibiting a narrow therapeutic window. A previous study from this institution has detected potential life threatening errors in calculations performed by trainees while writing prescriptions. OBJECTIVES: To verify whether the true incidence of trainees' errors in prescribing can be explained by impaired calculation skills in written tests. SETTING: A tertiary paediatric hospital; educational rounds for core paediatric residents. METHODS: Two anonymous written tests, which included calculations of doses similar to those performed at the paediatric bedside; one was conducted in 1993 and one in 1995. RESULTS: Thirty four paediatric residents participated in 1993 and 30 in 1995. A substantial number of trainees in both years committed at least one error. In general, there was no correlation between the length of training (0 to 4 years) and likelihood of making a mistake. Three trainees in 1993 and four in 1995 committed 10-fold errors. These seven residents committed significantly more errors than the rest of the group in each of the tests separately. All seven were in their first two years of training, and six were in their first year of residency. CONCLUSIONS: A substantial proportion of paediatric trainees make mistakes while calculating drug doses under optimal test conditions. Some trainees commit 10-fold errors, which may be life threatening. The results of these anonymous tests suggest that testing of calculations skills should be mandatory, and appropriate remedial steps should follow to prevent paediatric patients receiving wrong drug dosages.

Clinical Competence↗

PubMed2002

Aetiology of congenital and paediatric cataract in an Australian population.

BACKGROUND/AIM: Paediatric cataract is a major cause of childhood blindness. Several genes associated with congenital and paediatric cataracts have been identified. The aim was to determine the incidence of cataract in a population, the proportion of hereditary cataracts, the mode of inheritance, and the clinical presentation. METHODS: The Royal Children's Hospital and the Royal Victorian Eye and Ear Hospital have a referral base for almost all paediatric patients with cataracts in south eastern Australia. The database contains cases seen over the past 25 years. The medical histories of these patients were reviewed. RESULTS: 421 patients with paediatric cataract were identified, which gives an estimated incidence of 2.2 per 10,000 births. Of the 342 affected individuals with a negative family history, 50% were diagnosed during the first year of life, and 56/342 (16%) were associated with a recognised systemic disease or syndrome. Unilateral cataract was identified in 178/342 (52%) of sporadic cases. 79 children (from 54 nuclear families) had a positive family history. Of these 54 families, 45 were recruited for clinical examination and DNA collection. Ten nuclear families were subsequently found to be related, resulting in four larger pedigrees. Thus, 39 families have been studied. The mode of inheritance was autosomal dominant in 30 families, X linked in four, autosomal recessive in two, and uncertain in three. In total, 178 affected family members were examined; of these 8% presented with unilateral cataracts and 43% were diagnosed within the first year of life. CONCLUSIONS: In the paediatric cataract population examined, approximately half of the patients were diagnosed in the first year of life. More than 18% had a positive family history of cataracts. Of patients with hereditary cataracts 8% presented with unilateral involvement. Identification of the genes that cause paediatric and congenital cataract should help clarify the aetiology of some sporadic and unilateral cataracts.

Australia↗

PubMed1996

Vulnerability of paediatric myocardium to cardiac surgery.

OBJECTIVE: Myocardial injury is an important cause of mortality and morbidity after paediatric cardiac surgery. Data obtained from studies in animals imply that juvenile myocardium is more resistant to the effects of ischaemia and reperfusion than adult myocardium but there is little confirmatory evidence in the clinical setting. DESIGN: Prospective observational study of biochemical markers of myocardial injury in a paediatric population undergoing cardiac surgery. SETTING: Tertiary referral centre for paediatric cardiac surgery. PATIENTS: Forty patients undergoing paediatric cardiac surgery of varying complexity including closure of atrial and ventricular septal defects and arterial switch for simple transposition. A control group included patients undergoing thoracotomy for closure of a patent ductus arteriosus or repair of a coarctation. INTERVENTIONS: Serial measurements of myoglobin, the MB isoenzyme of creatine kinase (CK-MB), and the highly specific markers of myocardial damage cardiac troponin T (cTnT) and I (cTnI) were made before and 1, 6, 24, and 48 to 72 hours after operation. RESULTS: There were significant increases in myoglobin and CK-MB, but not cTnT or cTnI, in the control group. There were significant increases in the four biochemical markers in all the cardiac operations but especially in the ventricular septal defect and transposition group. Increases in CK-MB and cTnT were about five times greater than those previously reported in adult patients. CONCLUSIONS: (i) Cardiac troponins are more specific markers of myocardial injury in paediatric cardiac surgery than myoglobin and CK-MB. (ii) Paediatric myocardium seems to be more vulnerable to injury during cardiac surgery than adult myocardium.

Adult↗

PubMed1995

Adult and paediatric size bronchoscopes for bronchoalveolar lavage in mechanically ventilated patients: yield and side effects.

BACKGROUND: Bronchoalveolar lavage is considered a safe procedure. When performed in the mechanically ventilated patient, however, potentially harmful effects on respiratory and haemodynamic functions have been reported in which the size of the bronchoscope may play a part. Two different size bronchoscopes (adult and paediatric) were therefore investigated with regard to bronchoalveolar lavage yield and side effects. METHODS: Twenty mechanically ventilated patients underwent bronchoalveolar lavage with both adult and paediatric bronchoscopes in a randomised sequential manner. RESULTS: In a total of 45 pairs of bronchoalveolar lavage procedures no difference was noted between adult and paediatric bronchoscopes with regard to total cell yield, differential cell count, and microbiological results. Peak intratracheal pressure increased with the adult bronchoscope only. Systemic arterial pressures increased more with the adult than with the paediatric bronchoscope. PaO2 decreased with the adult but not with the paediatric bronchoscope. CONCLUSIONS: The paediatric bronchoscope offers a comparable bronchoalveolar lavage yield in mechanically ventilated patients to the adult bronchoscope, while the respiratory and haemodynamic side effects are significantly lower than with the adult size instrument.

Bronchoalveolar Lavage Fluid↗

PubMed1995

Adenosine, methacholine, and exercise challenges in children with asthma or paediatric chronic obstructive pulmonary disease.

BACKGROUND: Bronchial hyperreactivity to methacholine is present in children with asthma and other types of paediatric chronic obstructive pulmonary disease (COPD), while hyperreactivity to exercise is more specific for asthma. Adenosine 5'-monophosphate (AMP) is a potent bronchoconstrictor and, like exercise, may provoke asthma by activating mast cells. This study investigated the suitability of AMP as a specific challenge for asthma in children. METHODS: Bronchial provocation challenges with methacholine and AMP were performed in a double blind fashion using tidal breathing in 51 children with asthma, 21 with paediatric COPD of various types, and in 19 control children. Each subject also underwent a standardised exercise challenge after inhalation challenges were completed. Sensitivity and specificity curves were constructed and the intersection point of sensitivity and specificity for each type of challenge was determined. RESULTS: When the asthmatic patients were compared with the children with COPD, the intersection points for AMP, exercise and methacholine were 90%, 85%, and 50%, respectively. When compared with the controls the same intersection points were 98%, 84%, and 92%, and when children with paediatric COPD were compared with controls they were 55%, 50%, and 82%. CONCLUSIONS: Methacholine distinguishes both asthma and paediatric COPD from controls with a sensitivity of 82-92%, but does not distinguish between asthma and paediatric COPD; exercise and AMP distinguish asthma from controls with a sensitivity and specificity of 84-98% but they also distinguish asthma from paediatric COPD with a sensitivity and specificity of 85-90%. AMP inhalation is a practical aid for diagnosing asthma and distinguishing it from COPD in children of all ages.

Adenosine Monophosphate↗

PubMedDate not supplied

Case definitions for paediatric AIDS: the Zambian experience.

For the purpose of surveillance of the acquired immunodeficiency syndrome (AIDS) in developing countries, the World Health Organization (WHO) has recommended criteria for the clinical case definition of AIDS in adults and children. In a preliminary examination of children in Zambia a number of patients with obvious AIDS did not fit the published WHO case definition for paediatric AIDS. Based on this the Zambia National AIDS Surveillance Committee designed local criteria for the clinical case definition of paediatric AIDS. We compared the Zambian criteria with the WHO criteria for the diagnosis of paediatric AIDS by studying 134 consecutively admitted children to one of the paediatric wards at the University Teaching Hospital in Lusaka. Twenty-nine of the patients were HIV-1 seropositive and 105 were HIV-1 seronegative. Among the 29 HIV-seropositive patients, the Zambian criteria identified 23, and the WHO criteria identified 20 children as having AIDS. The 105 HIV-seronegative children were classified as having AIDS in 9 cases by the Zambian criteria and in 38 cases by the WHO criteria. These results give the Zambian criteria for the diagnosis of AIDS a sensitivity of 79.3%, a specificity of 91.4% and a positive predictive value of 86.8% compared to a sensitivity of 69%, specificity of 64% and a positive predictive value of 38% for the WHO criteria. The current WHO criteria are inadequate for the diagnosis of paediatric AIDS. The need to refine the WHO criteria for the diagnosis of paediatric AIDS is discussed.

AIDS Serodiagnosis↗

PubMed2006

La cuerda dulce--a tolerability and acceptability study of a novel approach to specimen collection for diagnosis of paediatric pulmonary tuberculosis.

BACKGROUND: Recent data demonstrate the utility of the string test for the diagnosis of sputum-scarce HIV-associated TB in adults. We hypothesized that, if well-tolerated by children, this simple tool might offer a breakthrough in paediatric TB diagnosis. Thus the objective of this study, undertaken in the paediatric service of the Hospital Nacional Dos de Mayo, Lima, Perú, was to determine the tolerability and acceptability of the string test to paediatric TB suspects, their parents and nursing staff. METHODS: 22 paediatric subjects aged 3-14 years (median 8) under investigation for TB were invited to undergo 2 string tests (four-hour downtime each). Subjective and objective pain and discomfort rating scales were used to assess the perception of the subject, parent and attending nurse. RESULTS: Patients as young as 4 years tolerated the procedure extremely well with 84% willing to undergo a second procedure. Peak discomfort at the time of swallowing and of string retrieval was mild (30% of maximum possible score) and brief as judged by visual analogue ratings and objective indicators. Good concordance of parent/child and objective/subjective ratings strengthened the validity of these findings. CONCLUSION: The string test is well tolerated and achievable for most paediatric TB suspects as young as 4 years. A formal prospective paediatric efficacy study is now needed.

Adolescent↗

PubMedDate not supplied

Growth and growth hormone secretion in paediatric Cushing's disease.

Although paediatric Cushing's disease is rare, it is associated with severe morbidity in childhood and presents a major diagnostic and therapeutic challenge for the paediatric endocrinologist. Growth failure remains an important feature of paediatric Cushing's disease, both at diagnosis and after successful treatment. However, the development of specific diagnostic tests and important therapeutic advances has contributed significantly to the current management. Transsphenoidal pituitary surgery (TSS) is now accepted as first-line therapy for both adult and paediatric Cushing's disease, offering the best opportunity for cure while preserving normal pituitary function. The cure rate following TSS in our centre is currently 62%; therefore, a significant proportion of children following TSS will remain uncured. Our favoured second-line therapy is pituitary radiotherapy, which is effective, rapid and appears to spare anterior pituitary function, with the exception of GH secretion. Growth failure was a symptom at diagnosis in 74% of patients; mean height SDS -1.81 (-0.28 to -4.17) compared with mean BMI SDS 2.29 (1.72-5.06). Height velocity (HV) was also subnormal; range 0.9-3.8 cm/yr. Chronic hypercortisolaemia suppresses linear growth and a history of symptoms for >2 years was obtained in 72% of our paediatric patients with Cushing's disease. In our series, 9 out of 10 patients did not demonstrate catch-up growth 0.64 years after TSS or pituitary radiotherapy and peak serum GH level to glucagon/ITT stimulation was 0.5-20.9 mU/l. Assessment of GH secretion over a period of 6 to 108 months after cure of paediatric Cushing's disease suggests that impaired GH secretion may persist into adult life. Investigation of possible GHD is performed in our unit in all post-cure patients who do not show optimal catch-up growth. If GH secretion is subnormal, GH replacement is started early and continued until final height, when GH secretion is reassessed. In our series of 10 patients, 9 received GH therapy, combined in 3 with a GnRH analogue to arrest puberty. The results of this treatment were satisfactory with mean height deficit compared with target height improving significantly from mean -1.72 +/- 1.26 SDS at diagnosis to -0.93 +/- 1.13 SDS (p=0.005) at final height or latest assessment, indicating that a favourable final height can be achieved.

Journal Article↗

PubMed1999

Epidemiology of paediatric cancer in Hong Kong, 1982 to 1991. Hong Kong Cancer Registry.

OBJECTIVE: To review the data of paediatric cancer that had been collected by the Hong Kong Cancer Registry from 1982 through 1991. DESIGN: Cross-sectional retrospective study. SETTING: Hong Kong. PATIENTS: Children aged 15 years or younger. MAIN OUTCOME MEASURES: The types of cancer were classified into 12 diagnostic groups according to morphology (following the International Classification of Diseases for Oncology M-code). The incidences of the different types of cancer were obtained with reference to the Hong Kong population aged 15 years or younger. Data collected between 1989 and 1991 were checked by paediatric oncologists from the Hong Kong Paediatric Haematology and Oncology Study Group. RESULTS: A total of 1756 cases of paediatric cancer were registered during the 10-year period. The incidence of cancer was 144.3 new cases per million children. Leukaemia was the most common form of childhood cancer (40.0%), followed by brain tumour (16.3%), and lymphoma (10.8%). The relative frequencies of neuroblastoma (2.4%) and Wilms' tumour (3.5%) were lower than those reported from western countries. CONCLUSION: The incidences and types of paediatric cancer in Hong Kong are similar to those in western countries. Collaboration with paediatric oncology groups should provide more accurate information on the incidence and survival rates of children with cancer in Hong Kong.

Journal Article↗

PubMed2003

Mortality among HIV-infected paediatric patients in Barbados.

Since the onset of the HIV epidemic, AIDS has become the leading cause of mortality in the paediatric age group in many developing countries. The main objective of this study was to review the mortality in HIV-infected paediatric patients in Barbados. It is a retrospective analysis of the hospitalization course of HIV-infected paediatric patients aged < 16 years who died during a 15-year period of surveillance. Using a specific database, information pertaining to number and duration of hospitalizations, and cause of death were analyzed. There were 39 (65%) deaths among 60 HIV-infected patients diagnosed during the period of study. Twenty-one (54%) were male and 18 (46%) were female. Twenty-seven (69%) case records were retrieved for analysis. The highest mortality (56%) was among patients aged < 1 year and between 1989 and 1995. Hospitalizations averaged three per patient. No patient received anti-retroviral therapy. Nineteen (70%) patients died during hospitalization on the paediatric ward. Lower respiratory tract infections suspected to be Pneumocystis carinii, gastroenteritis and septicaemia were the most frequent diagnoses at the time of death. The annual mortality ranged between 0 and 1.7 (mean 0.7) per 1000 live births. The overall mortality rate was high among HIV-infected paediatric patients, with lower respiratory tract infections being implicated as a major contributing cause of death. Results of this study definitely indicate a need for improved resources in the management of paediatric HIV/AIDS cases, especially focussing on the availability and administration of anti-retroviral therapy.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Blood transfusion practice indicated by paediatric intensive care specialists in response to four clinical scenarios.

OBJECTIVE: Several clinical guidelines exist for blood transfusion in adults but only one refers to children. There are no guidelines for blood transfusion in critically ill children and the paediatric intensive care specialist's approach is unknown. We wished to evaluate the approach toward blood transfusion among a group of paediatric intensive care specialists. METHODS: All certified paediatric intensive care specialists from the Israeli society of pediatric intensive care medicine were requested to complete a questionnaire, which described four hypothetical common scenarios in paediatric intensive care units. In each case, the physicians were asked to denote the haemoglobin threshold at which they would prescribe a blood transfusion and the transfusion volume they would use. The specialists were also asked for their reasons for increasing their haemoglobin threshold for blood transfusion. RESULTS: The questionnaire was posted to twenty six paediatric intensive care specialists, twenty one of whom responded (i.e. 80.8%). There was a wide variation for each scenario in both the suggested haemoglobin thresholds for transfusion (varying by 20-50 g/L) and the transfusion volume (varying by 10-20 mL/kg). The reasons given for increasing their blood transfusion threshold included, in order of importance, shock, haemodynamic instability and hypoxaemia. CONCLUSIONS: There is a marked variability among paediatric intensive care specialists regarding both the threshold haemoglobin level at which blood transfusion is prescribed as well as the volume used.

Journal Article↗

PubMed2005

Bacteriological study of paediatric and adult chronic suppurative otitis media.

Chronic suppurative otitis media (CSOM) is one of the commonest illnesses in ENT practice which requires medical attention all the more in children of poor socio-economic status having in past inadequate treatment and negligent medical care. The present study was conducted to find out the various aerobic and anaerobic microorganisms associated with CSOM in paediatric and adult cases and their current antimicrobial susceptibility pattern as a guide to therapy. Samples were collected from 109 clinically diagnosed cases of CSOM and processed according to standard protocols. Out of 74 paediatric CSOM cases, 72 (97.2%) were bacterial culture positive while out of 35 adult CSOM cases, 28 (80%) were culture positive. Bilateral CSOM was slightly more common in adults (25%) than paediatric (21.4%) age group. Polymicrobial nature of CSOM was noted in both paediatric (70.8%) and adult (71.4%) cases while number of organisms isolated per lesion was slightly higher in adults (2.5) as compared to paediatric (1.95) cases. In paediatric CSOM, Staphylococcus aureus was the commonest aerobic isolate while in adult CSOM, Pseudomonas aeruginosa was the commonest one. Among anaerobes Peptostreptococcus spp. was commonest in CSOM where as Prevotella melaninogenica in adult CSOM. Sensitivity of S. aureus to cefuroxime was 72.2% while that of gram negative bacilli was higher to cefotaxime (90 to 100%). Among anaerobes higher sensitivity was seen to metronidazole (98.6%), clindamycin (95.7%) and chloramphenicol (98.6%). In view of the polymicrobial etiology of CSOM, prompt appropriate antimicrobial therapy can effectively reverse the disease process thereby preventing longterm sequelae.

Adult↗

PubMed1993

Evolution of paediatric oncology over the years: overview with a focus on sub-Saharan Africa and examples from the Kenyan experience.

In this paper on "The Evolution of Paediatric Oncology Over the Years", a historical perspective is outlined regarding the subspecialty of paediatric oncology on a global basis. The evolution of paediatric oncology units and their role in the progress of cancer management in children is highlighted. It is noted that success in the management of cancer in adults has followed the footsteps of breakthroughs and success in paediatric oncology. The epidemiology of cancer in children in sub-Saharan African and the development of paediatric oncology are also highlighted. The development of a paediatric oncology unit at the Kenyatta National Hospital in Nairobi, Kenya has been focused on, pointing out challenges, constraints and success that are associated in the initiation and nurturing of such units in developing countries. Lastly, Burkitt's lymphoma is singled out for discussion to illustrate problems that are abound in cancer management in children in sub-Saharan Africa.

Africa South of the Sahara↗

PubMed1996

Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian Paediatric Society.

OBJECTIVE: To assist physicians in providing guidance to parents regarding neonatal circumcision. OPTIONS: Whether to recommend the routine circumcision of newborn male infants. OUTCOMES: Costs and complications of neonatal circumcision, the incidence of urinary tract infections, sexually transmitted diseases and cancer of the penis in circumcised and uncircumcised males, and of cervical cancer in their partners, and the costs of treating these diseases. EVIDENCE: The literature on circumcision was reviewed by the Fetus and Newborn Committee of the Canadian Paediatric Society. During extensive discussion at meetings of the committee over a 24-month period, the strength of the evidence was carefully weighed and the perspective of the committee developed. VALUES: The literature was assessed to determine whether neonatal circumcision improves the health of boys and men and is a cost-effective approach to preventing penile problems and associated urinary tract conditions. Religious and personal values were not included in the assessment. BENEFITS, HARMS AND COSTS: The effect of neonatal circumcision on the incidence of urinary tract infection, sexually transmitted diseases, cancer of the penis, cervical cancer and penile problems; the complications of circumcision; and estimates of the costs of neonatal circumcision and of the treatment of later penile conditions, urinary tract infections and complications of circumcision. RECOMMENDATION: Circumcision of newborns should not be routinely performed. VALIDATION: This recommendation is in keeping with previous statements on neonatal circumcision by the Canadian Paediatric Society and the American Academy of Pediatrics. The statement was reviewed by the Infectious Disease Committee of the Canadian Paediatric Society. The Board of Directors of the Canadian Paediatric Society has reviewed its content and approved it for publication. SPONSOR: This is an official statement of the Canadian Paediatric Society. No external financial support has been received by the Canadian Paediatric Society, or its members, for any portion of the statement's preparation.

Canada↗