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At least 559 records · Page 31Linked to original sources

PubMed1997

Paediatric burns in a rural South African district hospital.

OBJECTIVES: To describe the epidemiology, clinical features, management and outcome of children with burns admitted to a rural district hospital. DESIGN: A retrospective analysis of the case notes of consecutive cases of paediatric burns. SETTING: Hlabisa Hospital, KwaZulu-Natal-a 450-bed rural district hospital serving approximately 200,000 people. SUBJECTS: All cases of paediatric burns (age < 12 years) admitted to Hlabisa Hospital in 1994. MAIN OUTCOME MEASURES: Number of admissions, month of admission, age, sex, time to presentation, site of burn, complications, number of surgical procedures, adherence to management protocol and outcome. RESULTS: One hundred and forty-nine children presented to the outpatient department in 1994 and 88 (59%) were admitted. The median age of those admitted was 36 months with 66 (75%) aged less than 5 years; 42 (48%) were boys. Thirty-nine children (44%) were admitted during the four winter months of May to August. The average interval from the time of the burn to presentation at hospital was 42 hours (range 1-120). Sixty-eight burns (77%) were due to hot fluid or food burning the legs, trunk or arms. There was a high level of morbidity. Nineteen (22%) children developed wound infections, 5 (6%) developed contractures and 20 (23%) required a total of 32 surgical procedures. There was 1 death. Burns were responsible for more paediatric patient days spent in hospital than any condition other than malnutrition, and a longer length of stay was associated with delay in presentation. Children presenting within 24 hours of the burn had a mean length of stay of 12.8 days, compared with 25.2 days (P = 0.03) for children presenting 24 hours or more after the burn. Twenty of the 22 children who stayed for longer than 3 weeks or who required transfer were judged to have been managed inadequately in at least one respect compared with 3 of 48 who were discharged within 2 weeks or not transferred (P < 0.001). CONCLUSION: This study shows that paediatric burns are an important cause of morbidity and contribute significantly to inpatient stay in this rural setting. The lengthy delay from time of burn to presentation at hospital is of serious concern and our results show that this delay is associated with increased hospital stay. As most burns were due to spillage of hot fluids or food there seems to be significant potential for preventive interventions. Community-based studies would help to estimate the true incidence of burns and would contribute to an understanding of the reasons for delay in presentation. The information gathered is being used to inform the development of a burns prevention programme.

Burns↗

PubMed1997

Paediatric upper gastrointestinal endoscopy: a 2-year review.

OBJECTIVE: To review the paediatric upper gastrointestinal endoscopy service in a paediatric department in Hong Kong. METHODS: Records of all endoscopies undertaken in this department from May 1995 to January 1996 were retrieved and analysed. RESULTS: The commonest indication for upper endoscopy was dyspepsia with 88% positive histological findings. Helicobacter pylori (H. pylori) was found in 25% of this group of children. CONCLUSION: Paediatric upper gastrointestinal endoscopy service is invaluable in a paediatric department by providing useful diagnostic information which would otherwise be missed.

Child↗

PubMed1998

Paediatric exploratory ingestions of paracetamol.

AIM: To review paediatric exploratory ingestions of paracetamol presenting to Christchurch Hospital Emergency Department. METHOD: A retrospective review of all paediatric patients presenting with paracetamol ingestion over a 12 month period. RESULTS: During the study period there were 88 paediatric presentations for possible toxic ingestions involving paracetamol and 85 of these were exploratory self-ingestion. The male to female ratio was 43:42 and the mean age was 35 months. Paracetamol suspension was ingested in 79/85 cases and tablets in 6/85. The mean four hour plasma level was 162 mumol/L and all levels were well below the possible toxic level (1300 mumol/L). There was very poor correlation between estimated dose ingested and plasma level. CONCLUSION: Toxicity from paediatric exploratory ingestion of paracetamol is extremely rare. To reduce the potential for poisoning, bottles and prescriptions of paracetamol should have less than a total dose of 4 g. The authors recommend that unwitnessed exploratory ingestions of paracetamol in children require no treatment if the estimated maximum ingested dose is below 140 mg/kg. Above this dose, treatment is based on the result of a plasma paracetamol level drawn four hours after ingestion. Gastrointestinal decontamination should be reserved for the rare occasions of a definite witnessed ingestion of a dose exceeding 140 mg/kg.

Acetaminophen↗

PubMed2026

Evaluation of oral health-related quality of life following pulp therapy or extraction in paediatric patients: a systematic review.

BACKGROUND: Treatment decision between pulp therapy and extraction for compromised teeth in paediatric patients remains a topic of debate. While both approaches address the associated pain, their long-term impact on children's well-being remains unclear. This systematic review aimed to analyse and compare the impact of pulp therapy and extraction on OHRQoL in paediatric patients. METHODS: This review was conducted in accordance with PRISMA guidelines. A comprehensive search was performed in multiple electronic databases. Methodological quality and risk of bias were evaluated using the RoB 2 tool for randomised controlled trials, ROBINS-I tool for non-randomised trials, and the Newcastle-Ottawa Scale for observational studies. RESULTS: Seven studies comprising a total of 1367 participants met the inclusion criteria. The results indicated that pulp therapy was associated with superior OHRQoL outcomes compared to extraction. Children who underwent pulp therapy reported lower anxiety, better emotional well-being, and higher parental satisfaction. Given the heterogeneity among the studies, a narrative synthesis was performed. CONCLUSION: Pulp therapy may offer better OHRQoL outcomes than extractions in paediatric patients by preserving function, reducing anxiety, and minimising long-term complications. However, these findings should be interpreted cautiously since the available evidence was limited and of low to very low certainty. Further well-designed randomised controlled trials are required.

Children↗

PubMed2026

Effectiveness of chlorhexidine gluconate-impregnated dressings in preventing central line-associated bloodstream infection in a paediatric intensive care unit: A randomised controlled trial.

OBJECTIVES: To compare the effectiveness and dermatological safety of chlorhexidine gluconate (CHG)-impregnated dressings versus conventional transparent dressings in preventing central line-associated bloodstream infection (CLABSI) in paediatric patients admitted to a PICU. METHODS: A single-blind, randomised controlled trial with a 1:1 allocation ratio was conducted in a tertiary PICU. A total of 250 paediatric patients with a central venous catheter were included (125 per group). Patient characteristics, catheter-related variables, catheter dwell time and skin alterations were recorded. The primary outcome was CLABSI, defined according to CDC/NHSN criteria. Bivariate analyses and multivariable logistic regression were performed, including clinically relevant covariates related to catheter exposure, dressing type, and vaccination status. The trial was registered at ClinicalTrials.gov (NCT07175116). RESULTS: CLABSI incidence was significantly lower in the CHG group compared with the conventional dressing group (2.4% vs. 18.4%; p < 0.001). In multivariable analysis, CHG-impregnated dressings were independently associated with reduced CLABSI risk (OR = 0.15; 95% CI: 0.04-0.58). Longer catheter dwell time (OR = 1.13 per day; 95% CI: 1.04-1.22) and absence of complete vaccination (OR = 8.68; 95% CI: 2.48-30.47) were also associated with increased infection risk. Incomplete vaccination showed a similar trend without reaching statistical significance (OR = 6.48; 95% CI: 0.95-44.20). Skin alterations were more frequent in the CHG group (16.8% vs. 11.2%), predominantly in younger infants. CONCLUSIONS: CHG-impregnated dressings were associated with a significant reduction in CLABSI incidence in critically ill paediatric patients, although their use was linked to a modest increase in mild skin reactions. IMPLICATIONS FOR CLINICAL PRACTICE: CHG-impregnated dressings may be considered as part of a multifaceted infection prevention strategy, alongside appropriate catheter management, minimisation of catheter manipulation and proactive skin monitoring, with cautious and individualised use in infants.

Humans↗

PubMed2026

Perioperative analgesic efficacy of ultrasound-guided erector spinae plane block and posterior transversus abdominis plane block in paediatric patients undergoing open pyeloplasty: A prospective randomised trial.

PURPOSE: Open pyeloplasty in the paediatric population involves extensive tissue dissection and manipulation, resulting in significant postoperative pain. Ultrasound-guided fascial plane blocks have emerged as an important component of multimodal analgesia in abdominal surgeries. This study compared the analgesic efficacy of ultrasound-guided Erector spinae plane block (ESP) and posterior transversus abdominis plane (pTAP) block in children undergoing open pyeloplasty. METHODS: It is a prospective, randomised, double-blind study conducted at a single paediatric centre in a tertiary care hospital in Asia from January 2022 to June 2023. 40 ASA I-II children were randomised to receive either the ESP block (Group E) or the pTAP block (Group T). Both groups received 0.4 ml/kg, 0.2% ropivacaine with 1 mcg/kg dexmedetomidine. Children with an allergy to local anaesthetics, cardiac, renal or hepatic dysfunction and local site infection were excluded. The primary outcome was cumulative 24 h postoperative acetaminophen consumption. Secondary outcomes included the effects on intraoperative hemodynamics, perioperative opioid consumption, FLACC and Watcha scores, time to first rescue analgesia, and any block-related complications. RESULTS: Weight-normalised 24 h postoperative acetaminophen consumption was significantly lower in the ESP group (13.5 ± 4.7 mg/kg) compared to the pTAP group (25.4 ± 8.3 mg/kg), with a mean difference of -12 mg/kg (p < 0.001, 95%CI -16 to -7.6). The median time to first rescue analgesia was significantly longer in the ESP group (18 h [95% CI, 18-24]) than in the TAP group (9 h [95% CI, 6-12]), p < 0.001. Although FLACC scores were significantly lower in the ESP group at 30 min and 12 h postoperatively, the overall longitudinal analysis using a linear mixed-effects model showed no significant difference in the trend of FLACC scores over time between the two groups. There were no block-related complications. CONCLUSION: Ultrasound-guided ESPB provides better, longer-lasting analgesia than posterior TAP block in children undergoing open pyeloplasty. Hence, it may serve as an effective component of multimodal pain management in paediatric open pyeloplasty. CTRI REGISTRATION (CTRI/2022/04/041876) DATED 13/04/2022): https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=67747&EncHid=42257.14515&modid=1&compid=19.

Humans↗

PubMed2004

Surveillance for progressive intellectual and neurological deterioration in the Canadian paediatric population.

OBJECTIVES: To conduct active surveillance of the Canadian paediatric population for children who have a progressive intellectual and neurological deterioration to detect the occurrence of cases of Creutzfeldt-Jakob disease or variant Creutzfeldt-Jakob disease. CASE DEFINITION: Any child who is less than or equal to 18 years of age, who had a progressive loss of already attained intellectual/developmental abilities and development of abnormal neurological signs of greater than three months duration was eligible for inclusion. DURATION: July 1999 to July 2001. METHOD: Enhanced active surveillance system for progressive intellectual and neurological deterioration was implemented to detect, prospectively, among the Canadian paediatric population. Each month, all paediatricians and paediatric neurologists in Canada were mailed a reporting form. All reported cases were reviewed by the principal investigator who classified the cases into one of four predetermined categories. Cases where there was evidence of neurological and intellectual regression without known cause were reviewed by a panel. Reported cases were reviewed for the possibility of classic or variant Creutzfeldt-Jakob disease. RESULTS: Over 2200 physicians took part in this program. There was more than an 80% monthly return rate of the initial report form. Ninety-nine possible cases of progressive neurological and intellectual deterioration were reported. Sixty cases were classified as having a progressive neurological syndrome associated with intellectual deterioration. Fourteen cases were duplicates. One case of Creutzfeldt-Jacob disorder was found but no cases of the variant form of Creutzfeldt-Jacob disorder. Fifteen cases were felt not to meet the above-mentioned entry criteria.

Adolescent↗

PubMed2026

Diagnosis and management of very rare primary arrhythmia syndromes in children and adults: a Clinical Consensus Statement of the European Heart Rhythm Association of the ESC and the Association of Cardiovascular Nursing & Allied Professions of the ESC, endorsed by the Association for European Paediatric and Congenital Cardiology.

Very rare and ultra-rare primary inherited arrhythmia syndromes (IAS) represent a heterogeneous group of disorders associated with a significant risk of sudden cardiac death, often manifesting from foetal life to early adulthood. Current guidelines primarily address more common IAS and provide limited, non-specific recommendations for these rare entities, particularly in paediatric populations. This European Heart Rhythm Association Clinical Consensus Statement, developed in collaboration with the Association of Cardiovascular Nursing and Allied Professions and endorsed by the Association for European Paediatric and Congenital Cardiology, integrates available evidence with expert opinion. Recommendations were formulated through structured discussion and voting, following ESC consensus methodology, with a focus on clinically actionable gene-disease associations. The document provides a comprehensive framework for the diagnosis and management of very rare IAS, including calmodulinopathies, Andersen-Tawil syndrome, Timothy syndrome, TRDN-related disease, calcium release deficiency syndrome, and other atypical channelopathies. It highlights age-specific clinical presentations, the importance of genetic testing, and tailored therapeutic strategies, including pharmacological treatments, left cardiac sympathetic denervation, and selective use of implantable cardioverter-defibrillators. Special attention is given to paediatric considerations, foetal diagnosis, and the role of multidisciplinary care. The document also addresses arrhythmic risk in metabolic and cardiomyopathic conditions, as well as the importance of molecular autopsy and family screening in sudden unexplained death. This consensus document fills a critical gap by providing expert-driven, pragmatic guidance for the management of very rare IAS across the lifespan. It underscores the need for specialized care, international collaboration, and prospective registries to improve evidence generation, risk stratification, and patient outcomes in this vulnerable population.

Humans↗

PubMed1996

Paediatric nursing and research ethics: is there a conflict?

This paper briefly outlines the major ethical issues which need to be considered when conducting paediatric research. An overview of ethical theories and principles will highlight the difficulties which may be experienced when making decisions about children's competency to consent to participate in research. The congruency of the paediatric nurse as 'researcher' and 'practitioner' will be examined. Does the nurse involved in paediatric research experience a conflict between a commitment to research and safeguarding the interests and well-being of the child.

Child↗

PubMed2026

Approaches to thyroid nodules in paediatric cancer predisposition syndromes.

OBJECTIVE: The objective of this work was to summarize current evidence and practical management considerations for thyroid nodules in children and adolescents with cancer predisposition syndromes (CPSs), focusing on follicular cell-derived nodules and non-medullary thyroid carcinoma (NMTC). METHODS: We synthesized current paediatric guideline recommendations and recent cohort, pathology, and molecular studies addressing CPS-associated nodular thyroid disease, including PTEN hamartoma tumour syndrome (PHTS), DICER1 syndrome, familial adenomatous polyposis, and related endocrine neoplasia syndromes. RESULTS: Evidence quantifying syndrome-stratified malignancy risk among paediatric CPS patients presenting with nodules remains limited and is largely derived from mixed-age or retrospectively ascertained cohorts with surveillance and verification bias. High-resolution ultrasound (US) is central to risk stratification. US-guided fine-needle aspiration (FNA) is a cornerstone of evaluation yet frequently yields indeterminate results, particularly in follicular-patterned and encapsulated lesions (e.g. PHTS and DICER1 syndrome), and sampling error is accentuated in polyclonal multinodular disease. Molecular testing may aid aetiologic clarification and, in selected settings, risk refinement. However, panels optimized for sporadic adult disease may have reduced 'rule-out' utility in CPSs. Biochemical assessment (TSH ± free thyroxine) complements imaging, while routine thyroglobulin is not recommended, and thyroid autoantibodies should be viewed as adjunctive rather than directive markers in CPSs. CONCLUSION: Management of thyroid nodules in paediatric CPSs is best approached through integrated, multidisciplinary risk assessment that combines expert ultrasound, context-aware cytology and molecular interpretation, and shared decision-making. This review proposes a CPS-adapted, multidisciplinary risk assessment framework and highlights the need for prospective multicentre registries and harmonized protocols to define syndrome-specific outcomes and evidence-based thresholds for surveillance and intervention.

Humans↗

PubMed2000

Prevalence of nasopharyngeal antibiotic-resistant pneumococcal carriage in children attending private paediatric practices in Johannesburg.

OBJECTIVES: To determine the nasopharyngeal carriage rate, serogroups/types, and antibiotic resistance of Streptococcus pneumoniae in children attending paediatric practices in the private sector in Johannesburg and to relate patterns of resistance to antimicrobial exposure and other demographic characteristics in individual children. DESIGN: A total of 303 children aged from 1 month to 5 years were recruited from eight private paediatric practices in northern Johannesburg. Nasopharyngeal samples were taken and parent interviews were conducted. RESULTS: Pneumococci were isolated from 121 children (40%). The most common serotypes were 6B, 19F, 6A, 23F, 14, and 19A. Carriage was significantly associated with prior hospital admission (odds ratio 1.89) and day care attendance (odds ratio 2.31) and was negatively associated with antibiotic use within the previous 30 days. Antibiotic resistance was found in 84 isolates (69.4%); 45 (37.2%) were multiply resistant. One-third of the pneumococci showed intermediate level resistance to penicillin and 12.4% were highly resistant. There was a high level erythromycin resistance in 38% of the isolates. A total of 94/214 children (42%) had recently used antibiotics and were four times more likely to carry antibiotic-resistant pneumococci (P < 0.05). CONCLUSION: Pneumococcal resistance was significant in this group of children with easy access to paediatric services and antibiotic use. The implication of such high resistance for the treatment of pneumococcal diseases is that high-dose amoxicillin is the preferred empirical oral therapy for treatment of otitis media. Ceftriaxone or cefotaxime should be used in combination with vancomycin for the treatment of meningitis until a cephalosporin-resistant pneumococcal cause is excluded. Intravenous penicillin or ampicillin will successfully treat pneumococcal pneumonia in this population. Antimicrobial resistance among pneumococci colonising children in the private sector has increased dramatically in recent years.

Amoxicillin↗

PubMed1999

Totally implantable central venous access devices for paediatric oncology patients.

BACKGROUND: Totally implantable central venous access devices (ports) have been available for over 10 years but have not achieved widespread use in paediatric oncology patients. We reviewed our experience with these devices over 9 years to assess their safety and acceptability. PROCEDURE: We conducted a retrospective review of insertion technique and reasons for removal of all ports placed in paediatric oncology patients in this hospital between 1989 and 1996, with follow-up until 1998. Acceptability of both ports and external catheters was assessed by a questionnaire in a subgroup of families attending the oncology clinic. RESULTS: One hundred forty-nine ports were inserted during the study period. The median catheter life was 399 days (4-1,406), with a total of 69,342 catheter days. Sixty-nine percent of ports were removed electively at the end of treatment; 8% required removal because of infection and 5% because of blockage. No ports were accidentally dislodged or damaged. Children experienced significantly less restriction of activity with a port compared to an external catheter and greatly preferred the cosmetic appearance. The need for needle insertion to access the port was not seen as a disadvantage by most families. CONCLUSIONS: Ports can provide satisfactory central venous access for the majority of paediatric oncology patients, with a low risk of line-related complications and a high degree of acceptability to children and their parents.

Adolescent↗

PubMed2007

Effect of heat shock protein peptide DiaPep277 on beta-cell function in paediatric and adult patients with recent-onset diabetes mellitus type 1: two prospective, randomized, double-blind phase II trials.

BACKGROUND: Aim of this trial was to test whether heat shock protein peptide DiaPep277 treatment in adult and paediatric patients with recent-onset type 1 diabetes (T1D) is safe and whether it can preserve endogenous insulin production. METHODS: Two studies were performed in a prospective, multicentre, double-blind, placebo-controlled trial. Fifty adult (study p520, aged 16-44 years) and 49 paediatric patients (study p521, 4-15 years) with recent-onset T1D were treated subcutaneously at four different time points with 0.2 mg or 1.0 mg DiaPep277 versus placebo and followed for 18 months. Adult patients were treated with 0.2 mg, 1.0 mg or 2.5 mg DiaPep277 versus placebo. Stimulated C-peptide served as readout for functional beta-cell-mass. RESULTS: DiaPep277-treatment was not associated with severe side effects. No differences were found in placebo and DiaPep277 treated groups. In adults, a modest trend towards better maintenance of beta-cell function was observed in the 0.2 mg and 1.0 mg group, while there was significant loss of stimulated C-peptide in the placebo and 2.5 mg group. Paediatric patients with low HLA risk showed stable C-peptide levels until 13 months upon treatment with 1 mg DiaPep277. Despite similar stimulated C-peptide levels at baseline, children exhibited a more pronounced loss of beta-cell function over 18 months than adults (p = 0.0003). CONCLUSION: Administration of DiaPep277 seems safe and may have beneficial effects on C-peptide levels over time in some patients with T1D, but this finding was not accompanied by reduced HbA1c or insulin requirement. Studies with more patients and longer follow-up are needed to further study the effect of DiaPep277.

Adolescent↗

PubMed2003

Characteristics and adequacy of intravenous morphine infusions in children in a paediatric oncology setting.

BACKGROUND: Pain management is central in the care of patients in paediatric oncology. Intravenous (i.v.) morphine infusion is an important treatment modality. The objectives of this study were to identify the characteristics of children who receive i.v. morphine infusions in a paediatric oncology setting and to describe the effectiveness, tolerability, and limiting side-effects of this treatment. PROCEDURE: We prospectively collected evaluation charts for all morphine infusions in a paediatric oncology unit during a 4-year period, and reviewed the medical records of the patients. The incidence of breakthrough pain was used as a measure of the effectiveness of morphine treatment. For comparison, patients were grouped according to causes of pain; minor surgery, major surgery, tumour/disease, or treatment side-effects. RESULTS: Overall, 72 individuals (36% of all 201 patients diagnosed in the unit) were given morphine infusions. Patients with pain after major surgery suffered from more breakthrough pain than the other patients during the 1st day of morphine treatment even though their morphine consumption was almost twice as high (0.64 vs. 0.36 mg/kg, P < 0.001); 92% of these patients had solid tumours. Common morphine side-effects were vomiting (38%), nausea (32%), and constipation (24%). CONCLUSIONS: Patients who undergo major tumour surgery require extensive pain management to achieve acceptable post-operative pain relief. The routine of giving both a bolus dose and increasing the morphine dose at breakthrough pain should be encouraged. For the other patients studied, morphine infusions were considered to be adequate, but vomiting, nausea, and constipation might be reduced if prophylactic antiemetics and laxatives were given.

Adolescent↗

PubMed2003

European training programme in paediatric haematology and oncology.

The European Board of Paediatrics has recommended for all paediatricians a three-year Common Trunk training in basic paediatrics, followed for tertiary care specialists, by three years of training in the relevant specialty. Paediatric Haematology and Oncology is a complex specialty with a broad range of activities, ranging from the care of children with leukaemia and solid tumours including those of the central nervous system, to all types of non-malignant haematologic disorders and laboratory haematology pursuits. A modular training programme has been recommended to provide a broad standard of training across the whole specialty which should last at least 18 months, and a further period of 18 months that may be used flexibly to prepare trainees for their anticipated future careers.

Child↗

PubMed2002

A survey of paediatric occupational therapists in the United Kingdom.

The purpose of this study was to examine the work of paediatric occupational therapists in the UK, and to compare the results with similar surveys carried out in the US, Australia and Canada. A postal questionnaire survey was sent to 212 members of the National Association of Paediatric Occupational Therapists. Questions were asked about a wide range of issues pertinent to paediatric practice. The results showed that data collected in the UK are similar to those from the three other countries-- for example, in the unique areas of work, such as assessment for adaptive equipment, training in activities of daily living and fine motor skills training, and that there is also some overlap with other disciplines. The study had some limitations in terms of respondents accessed and scope of questions asked. It highlighted a number of areas for further research, one being to identify what undergraduate teaching needs to be made available to students who want to work with children. Several conclusions are drawn, principally that children's occupational therapists tend to remain in the specialization for several years and make good use of postgraduate courses to enhance their practice.

Australia↗

PubMed2001

Neuropathology of paediatric chronic intestinal pseudo-obstruction and related animal models.

Chronic intestinal pseudo-obstruction (CIP) in paediatric patients is due to heterogeneous aetiologies that include primary disorders of the enteric nervous system. These conditions are poorly delineated by contemporary diagnostic approaches, in part because the complex nature of the enteric nervous system may shelter significant physiological defects behind subtle or quantitative anatomical changes. Until recently, relatively few experimental animal models existed for paediatric CIP. However, the availability of rodent models, particularly novel mutants created in the last few years by genetic manipulations, has brought unprecedented opportunities to investigate molecular, cellular, physiological, and histological details of enteric neuropathology. Information gleaned from studies of these animals is likely to change diagnostic and therapeutic approaches to paediatric CIP and related conditions.

Animals↗

PubMed2006

Adolescents with acute lymphoblastic leukaemia: emerging from the shadow of paediatric and adult treatment protocols.

Adolescents and young adults (AYA) with acute lymphoblastic leukaemia (ALL) constitute a distinct population from children and older adults. Based on patterns of referral, they may be treated by either paediatric or adult oncologists. As a group, AYA with ALL have a worse survival and event-free survival (EFS) compared to that achieved by younger children. A systematic review of all published clinical trials, which provide data on treatment and outcome of adolescents with ALL, has been summarised in an effort to determine whether they should be treated on paediatric or adult type protocols. Adolescents appear to have a consistent survival advantage when treated on paediatric regimens.

Adolescent↗