Journal of paediatrics and child health最新文献

{"title":"Swallowing and Oral-Sensorimotor Characteristics in a Sample of Young Hospitalised Children With Severe Acute Malnutrition.","authors":"Casey Jane Eslick, Alta Kritzinger, Marien Alet Graham, Esedra Krüger","doi":"10.1111/jpc.16790","DOIUrl":"https://doi.org/10.1111/jpc.16790","url":null,"abstract":"<p><strong>Aim: </strong>To describe swallowing and oral-sensorimotor characteristics in a sample of young hospitalised children with severe acute malnutrition (SAM).</p><p><strong>Methods: </strong>The Schedule of Oral-motor Assessment was used to compare oral-sensorimotor skills of 45 hospitalised patients with SAM (M = 15.98 months; SD = 8.03), to pairwise-matched controls (M = 15.96 months; SD = 8.08). Participants were matched for age, gender, TB, HIV-status, socio-economic status including maternal education, paternal employment, housing and transport access. Caregivers reported demographic information, feeding practices and behaviours during feeding.</p><p><strong>Results: </strong>In comparison to controls (n = 6; 13.3%), participants with SAM (n = 25; 55.6%) presented with significantly more oral-sensorimotor difficulties (p < 0.001), across all consistencies except liquids from the trainer cup and bottle. Difficulties included jaw opening and stabilisation, tongue and lip control for chewing, bolus formation and transport, sustained bite and uncoordinated swallowing. Delayed sitting development significantly correlated with uncoordinated swallowing and head extension on puree and cup drinking, and multiple swallows on puree and semi-solids. Force-feeding and slow swallow initiation in semi-solids significantly correlated. Disruptive feeding behaviours and higher levels of food refusal at the beginning of meals were reported. Clinical signs of aspiration were identified.</p><p><strong>Conclusions: </strong>Oral-sensorimotor dysfunction and possible aspiration were observed in 55.6% of participants with SAM. Safe swallowing function for overall health and nutritional recovery is emphasised. Under-identification of oral-sensorimotor difficulties, lack of referral to speech-language therapists and disruption to continuity of care warrants further research.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Side Effects of Hydroxychloroquine in a Patient With Idiopathic Pulmonary Hemosiderosis.","authors":"Didar Ağca Cengiz, Abdurrahman Erdem Başaran, Betül Bankoğlu Parlak, Irmak Tanal Şambel, Ayşen Bingöl","doi":"10.1111/jpc.70001","DOIUrl":"https://doi.org/10.1111/jpc.70001","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary hemosiderosis (IPH) is a rare interstitial lung disease. Glucocorticosteroids and hydroxychloroquine are the most commonly used treatments. Although neuropsychiatric side effects related to hydroxychloroquine use are seen in adult cases, only one paediatric patient has been reported in the literature.</p><p><strong>Case presentation: </strong>We report a case of a 6-year-old girl with IPH, who developed neuropsychiatric symptoms, including restlessness, confusion and myoclonic movements, after the therapeutic use of hydroxychloroquine.</p><p><strong>Conclusion: </strong>With increasing knowledge and experience of interstitial lung disease, the use of hydroxychloroquine treatment is increasing. It is important to remember that hydroxychloroquine is a central nervous system stimulant, and neuropsychiatric side effects may be seen in children. This report highlights the importance of recognising potential neuropsychiatric side effects in paediatric patients using hydroxychloroquine, especially when combined with corticosteroids or other risk factors.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Perinatal Factors and Family Sociodemographic Characteristics With Cardiometabolic Health in Pre-Adolescence: Cross-Sectional Results From Healthy Growth Study.","authors":"Ioanna Nakaki, Aikaterini M Kontochristopoulou, Costas Anastasiou, George Moschonis, Anela Halilagic, Yingting Cao, Eva Karaglani, Yannis Manios","doi":"10.1111/jpc.16791","DOIUrl":"https://doi.org/10.1111/jpc.16791","url":null,"abstract":"<p><strong>Aim: </strong>Study the influence of a variety of perinatal factors on the presence of metabolic syndrome and its parameters in prepubertal age, considering socio-demographic factors, sex, Tanner stage and weight status of the preadolescent.</p><p><strong>Methods: </strong>Data collected from the cross-sectional Healthy Growth Study (2007) in students from four prefectures of Greece and their families. Cardiometabolic risk factors (waist circumference, blood pressure and blood indices) and perinatal data (from parents and health records) were collected. Single and a multiple logistic regression performed to assess the associations with cardiometabolic risk in preadolescence. Dependent variables included waist circumference, blood glucose, HDL-C, TG, blood pressure and metabolic syndrome presence, while independent variables encompassed perinatal factors categorised as pre-pregnancy, during and post-pregnancy.</p><p><strong>Results: </strong>2666 pre-adolescents (mean age 11.2 year) participated in the study. After adjustment for parental educational level, family income, sex, Tanner stage and weight category, maternal pre-pregnancy weight was positively associated with high waist circumference (OR, 95% CI 1.02 (1.00-1.04)), low HDL-C levels (OR, 95% CI 1.01 (1.00-1.03)) and metabolic syndrome (OR, 95% CI 1.02 (1.00-1.05)). Timing of solid foods' introduction was positively associated with high waist circumference (OR, 95% CI 1.09 (1.01-1.08)), gestational age with high glucose levels (OR, 95% CI 1.12 (1.04-1.19)), smoking (OR, 95% CI 1.07 (1.00-1.14)) and alcohol consumption (OR, 95% CI 2.35 (1.05-5.27)) during the first trimester of breastfeeding with high glucose levels and low HDL-C levels, respectively. Number of previous miscarriages was positively associated with low HDL-C levels (OR, 95% CI 1.28 (1.04-1.57)). Gestational age was negatively associated with high waist circumference (OR, 95% CI 0.87 (0.80-0.95)) and iron supplementation in the third pregnancy trimester negatively association with high TG levels (OR, 95% CI 0.34 (0.12-0.91)).</p><p><strong>Conclusions: </strong>Maternal weight, perinatal behaviours, infant feeding and miscarriages influence pre-pubertal cardiometabolic health, independent of sociodemographics, sex, Tanner stage and weight.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on Hospital Admissions for Children With Developmental Disadvantages: A Western Sydney Metropolitan Hospital Experience on Health Inequity.","authors":"Lanxin Li, Habib Bhurawala, Anthony Liu","doi":"10.1111/jpc.16798","DOIUrl":"https://doi.org/10.1111/jpc.16798","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the impact of Sydney's COVID-19 lockdown on children with developmental disadvantages and reflect on current clinical practice.</p><p><strong>Methods: </strong>Retrospective data was collected from a western Sydney metropolitan hospital's electronic database and patients. We reviewed all children with Autism Spectrum Disorder (ASD), Cerebral Palsy (CP) or Intellectual Disability (ID) admitted 36 months prior to and after lockdown policy being implemented.</p><p><strong>Results: </strong>The prevalence of hospital presentation was reduced during the lockdown period. The average length of stay (LoS) increased by approximately 1.5 folds. Comparatively, the average LoS of the general paediatric population increased minimally. Seizures, asthma, and upper respiratory tract infections were the three commonest issues for hospital admissions in both periods. COVID-19 infection accounted for 4% of admissions in the lockdown period. Around 20.8% of patients with disadvantages were admitted with more than two major issues. None of these patients had concurrent COVID-19 infection.</p><p><strong>Conclusions: </strong>Children with developmental disabilities experience greater disadvantages during lockdown. The likely reasons include inequity caused by increased barriers to healthcare service. The indirect benefit of reducing infection transmission during lockdown was not reflected in our patient group, contributing to the disease burden. Chronic diseases remain the most common causes of admissions in all periods, suggesting the essentiality of improving chronic disease management in future clinical practice.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child With Bilateral Lucencies on Chest X-Ray: What Is the Diagnosis?","authors":"Gloria Tze Yan Lau, Richard Warne, Stephen Oo","doi":"10.1111/jpc.70002","DOIUrl":"https://doi.org/10.1111/jpc.70002","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating an Uninformative Genomic Test Result: A Practical Guide.","authors":"Laura St Clair, Claire Wong, Christopher Elliot, Kristi J Jones, Margit Shah, Sarah Josephi-Taylor, Sarah Sandaradura, Lesley Adès, Janine Smith, Rani Sachdev, Alan Ma","doi":"10.1111/jpc.16792","DOIUrl":"https://doi.org/10.1111/jpc.16792","url":null,"abstract":"<p><strong>Background: </strong>Although genomic testing is increasingly standard of care for diagnosing children and adults with genetic conditions, over 50% of genomic testing will return an uninformative result.</p><p><strong>Aim: </strong>To provide a practical guide for paediatricians on how to approach an uninformative genomic test result, and the pathways which may be available to uncover a genetic diagnosis for their patients.</p><p><strong>Methods: </strong>Input from multiple genetics healthcare professionals including genetic counsellors, the literature, and a general paediatrician were used to construct this guide. We also provide a hypothetical case vignette, to further demonstrate the various options for a patient after receiving an uninformative result.</p><p><strong>Results: </strong>There are several reasons why an underlying genetic diagnosis may not be diagnosed with current testing, including incomplete phenotyping, a different underlying genetic mechanism requiring specialised testing, and limitations in knowledge at the time of the test.</p><p><strong>Conclusion: </strong>Uninformative results are very common, and it is important to understand these results in the context of the limitations of genomic testing. General paediatricians play an important role in supporting families through their diagnostic odyssey, as well as reassessing the phenotype, referring for sub-specialty inputs, and discussion with local genetics services for consideration of alternative testing options or enrolment into research pathways.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Chemical Restraint\" for Children and Adolescents in Victoria.","authors":"Daryl Efron, Connie Wu, Chidambaram Prakash, Mandy Donley","doi":"10.1111/jpc.16800","DOIUrl":"https://doi.org/10.1111/jpc.16800","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No-Biopsy Diagnosis of Coeliac Disease in Children Without Anti-Endomysial IgA Antibody Testing: Combining Anti-Tissue Transglutaminase IgA and Anti-Deamidated Gliadin IgG Antibodies.","authors":"Marsus Pumar, Sharon Choo, Jeremy Rosenbaum, George Alex, Shaun S C Ho","doi":"10.1111/jpc.16801","DOIUrl":"https://doi.org/10.1111/jpc.16801","url":null,"abstract":"<p><strong>Aim: </strong>To determine the utility of anti-tissue transglutaminase IgA antibodies (tTG-IgA) and anti-deaminated gliadin peptide IgG antibodies (DGP-IgG) in detecting coeliac disease (CD) and whether DGP-IgG can replace anti-endomysial IgA antibody in the European Society for Paediatric Gastroenterology Hepatology and Nutrition no-biopsy approach in diagnosing CD.</p><p><strong>Methods: </strong>Children aged < 19 years who had paired tTG-IgA and DGP-IgG performed and had a gastroscopy with biopsies between 1 March 2016 and 31 October 2020 were retrospectively reviewed.</p><p><strong>Results: </strong>Of 1206 patients who fulfilled the study criteria, 298 (24.7%) patients were diagnosed with CD. Fifteen patients with IgA deficiency were excluded from any tTG-IgA analysis. tTG-IgA had sensitivity and specificity of 93.5% and 92.0%, respectively, in detecting CD, while DGP-IgG had sensitivity of 97.0% and specificity of 86.7%. tTG-IgA ≥ 10x upper limit of normal (ULN) alone had a specificity of 99.3% and a positive predictive value (PPV) of 96.8%. An optimal DGP-IgG threshold was identified to be 70 U/mL (3.5x ULN) based on > 99% specificity in detecting CD. When tTG-IgA ≥ 10x ULN was combined with DGP-IgG ≥ 3.5 ULN, the PPV in diagnosing CD was 98.5%. DGP-IgG performed well in detecting CD in 126 children aged < 3 years, with all patients with CD having an elevated DGP-IgG (sensitivity 100%).</p><p><strong>Conclusions: </strong>Combined tTG-IgA ≥ 10x ULN and DGP-IgG ≥ 3.5x ULN provided a high PPV (98.5%) in diagnosing CD. DGP-IgG testing can potentially replace EMA testing in those children with tTG-IgA ≥ 10x ULN. Future studies should evaluate DGP-IgG testing as a sequential test.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for Bronchiectasis: Experience and Outcomes at Starship Children's Hospital, Auckland, New Zealand.","authors":"Clara Watson, Dug Yeo Han, Catherine A Byrnes, James Hamill, Philip Morreau, Elizabeth Edwards","doi":"10.1111/jpc.16775","DOIUrl":"https://doi.org/10.1111/jpc.16775","url":null,"abstract":"<p><strong>Background: </strong>Surgical management for bronchiectasis is uncommon. This study reviewed the experience of bronchiectasis surgery and subsequent outcomes at a tertiary paediatric centre over a 20 year period.</p><p><strong>Methods: </strong>Retrospective audit of children aged < 18 years who underwent bronchiectasis surgery at Starship Children's Hospital between 2001 and 2021. Cases were identified from clinical coding, with demographics, pre-operative investigations and outcomes obtained from clinical records.</p><p><strong>Results: </strong>Nineteen children (11 females, 42% Pasifika, 26% Māori and 26% New Zealand European) were included. Mean age of bronchiectasis diagnosis was 6.3 years (range 2.1-13.9 years) and mean age of surgery was 8.5 years (range 2.6-15.9 years). Indications for surgery included localised bronchiectasis (n = 7), main burden of multilobar disease in one lobe (n = 5) and persistent lobar collapse (n = 3). Pre-operative investigations included chest computerised tomography scan (68%), bronchoscopy (37%) and overnight oximetry (42%). One child underwent documented pre-operative clinical optimisation. For children with bronchiectasis < 5 years (n = 11), 81% demonstrated improved symptoms, 9% were unchanged and 9% deteriorated. All children with bronchiectasis > 5 years had symptomatic improvement. The mean number of daily symptoms decreased by 2.4 (p < 0.0001).</p><p><strong>Conclusion: </strong>Lobectomy resulted in significant symptomatic improvement in 89% of children. However, pre-operative work-up was variable. The study highlights the importance of establishing a protocol for identification of children with bronchiectasis who would benefit from surgery and developing a consistent preparatory approach to ensure optimal and equitable outcomes.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural Changes of Late Talkers During the Covid-19 Pandemic, One Year Follow-Up From a Community Sample.","authors":"Tuba Çelen Yoldaş","doi":"10.1111/jpc.16796","DOIUrl":"https://doi.org/10.1111/jpc.16796","url":null,"abstract":"<p><strong>Aim: </strong>Global threats to child health and well-being, compounded by the COVID-19 pandemic, have put child development at grave risk. This study aimed to observe the behavioural changes of children with isolated language delays from a paediatric outpatient clinic as a community sample during the pandemic with a 1-year follow-up.</p><p><strong>Methods: </strong>Patients admitted to the paediatrics outpatient clinic due to isolated language delays were included in the study. The Ages and Stages Questionnaire and Child Behaviour Checklist-1½-5 were implemented at baseline and 1 year later. All families were provided with information on developmental supportive strategies and called at 3-month intervals for follow-up.</p><p><strong>Results: </strong>Eighty-three children were initially included in this prospective study and completed with a 66.3% retention rate after 1 year. The mean initial age of the children was 30 ± 5.1 months. Internalising behaviour problems were high enough for concern at the baseline and all behavioural problem scores decreased after 1 year (p < 0.001). The initial proportion of children with borderline or clinical internalising problems also decreased from 69.1% to 5.5% after 1 year, and most children had normal language development.</p><p><strong>Conclusions: </strong>Late talkers experienced some behavioural problems during the pandemic, and the language and behaviour outcomes of these children who attended the paediatric clinic were better after the 1-year follow-up, even during the COVID-19 pandemic. The management of language delays in young children in crisis should include providing families with developmental support strategies consistently through the paediatric healthcare system to optimise child developmental and behavioural functioning.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}