Ariel O Mace, Jessica Ramsay, James Totterdell, Andrew C Martin, Julie Barnett, Jade Ferullo, Briony Hazelton, Paul Ingram, Julie A Marsh, Peter Richmond, Yue Wu, Thomas L Snelling
{"title":"FeBRILe3: Risk-Stratification and Diagnosis of Serious Bacterial Infections in Febrile Infants Less Than 3 Months Old.","authors":"Ariel O Mace, Jessica Ramsay, James Totterdell, Andrew C Martin, Julie Barnett, Jade Ferullo, Briony Hazelton, Paul Ingram, Julie A Marsh, Peter Richmond, Yue Wu, Thomas L Snelling","doi":"10.1111/jpc.70041","DOIUrl":"https://doi.org/10.1111/jpc.70041","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence-based recommendations exist for early discharge (before 48 h) of young infants with fever without source (FWS) at low risk of serious bacterial infections (SBIs). However, concerns regarding the applicability of international data to local contexts may hinder implementation. We aimed to describe the local epidemiology of FWS and evaluate a newly implemented risk-stratification guideline to support practice change.</p><p><strong>Methods: </strong>Prospective observational study of infants aged < 3 months admitted for investigation and management of FWS to two hospitals in Perth, Western Australia following implementation of an FWS risk-stratification guideline (August 2019-December 2021). We assessed the risk-stratification rule performance and determined the positive/negative likelihood ratios of individual patient characteristics for predicting SBI diagnosis.</p><p><strong>Results: </strong>Five hundred infants were enrolled in the study cohort (median age 34 days, 36% female). SBI was diagnosed in 159 infants (32%), including urinary tract infection (n = 140), bacteraemia (n = 18) and bacterial meningitis (n = 9). Viruses were detected in 174 out of 406 tested infants (43%). Seventy-one infants met low-risk criteria (14%); only 69 out of 360 infants without SBI were classified as low risk (19%). The risk-stratification criteria demonstrated 99% sensitivity and 97% negative predictive value for SBI diagnosis, but only 21% specificity. Patient characteristics associated with a reduced likelihood of SBI diagnosis included female sex, sick contact exposure and virus detection.</p><p><strong>Conclusions: </strong>Meeting the low-risk criteria successfully excluded most infants with SBI; however, only a small proportion of infants without SBI fulfilled these criteria. Integrating additional patient characteristics into updated risk-stratification algorithms may improve the predictive value of future prediction tools.</p><p><strong>Trial registration: </strong>Australia and New Zealand Clinical Trials Register (ACTRN12619001010189).</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730366","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":"Treatment of Lamellar Ichthyosis in a 10-Year-Old Child With Secukinumab","authors":"Roberto Mazzetto, Francesca Caroppo, Elisa Milan, Fortunato Cassalia, Anna Belloni Fortina","doi":"10.1111/jpc.70044","DOIUrl":"10.1111/jpc.70044","url":null,"abstract":"<p>We report a case of a 10-year-old male patient who was born with severe large scaling and erythema, exhibiting a collodion baby presentation, while otherwise being in good general condition. A TGM1 (transglutaminase type 1) heterozygous mutation (c.788G>A and c.1559A>G) was identified. During the medical examination, no signs of erythroderma were noticeable, whereas the presence of large, brownish scales and palmoplantar keratoderma clinically supported the diagnosis of lamellar ichthyosis (LI). Despite the absence of an evident inflammatory component, the patient reported severe itching.</p><p>Figure 1 illustrates the congenital phenotype at birth and the clinical presentation at the baseline medical examination.</p><p>Ichthyoses are a clinically heterogeneous group of rare genetic skin diseases characterised by an alteration of keratinisation. This condition can manifest in several forms, ranging from dry and scaly skin to thicker plaques and scales [<span>1</span>].</p><p>The patient had previously been treated with various topical agents, including emollients with urea and/or salicylic acid, as well as systemic acitretin. These failed to adequately manage symptoms, as well as leading to abdominal pain as a side effect. The initial Children's Dermatology Life Quality Index (CDLQI) score was 20, the Numerical Rating Scale (NRS) of pruritus was 8 and NRS of pain was 6, indicating a significant impact on the patient's quality of life.</p><p>Recent studies have highlighted an increase in Th1, Th2 and Th17 cytokines in patients with certain genodermatoses [<span>2</span>]. Specifically, elevated expression of Th17-related cytokines has been observed in the keratinocytes and fibroblasts of patients with ichthyosis vulgaris and Netherton syndrome, supporting their pathogenetic role in pruritus [<span>3</span>].</p><p>Given the poor response to conventional therapies and considering the new scientific discoveries on the pathology of this disease [<span>2</span>], treatment with secukinumab was initiated. The dosing regimen followed the protocol for psoriasis: an initial subcutaneous dose of 75 mg at weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing.</p><p>The CDLQI improved from 20 to 8 (a 60% reduction) after 3 months, maintaining this improvement for 12 months. NRS of itching reduced from 8 to 4 (a 50% reduction) within 3 months and NRS of pain decreased from 6 to 2 (a 66.7% reduction). However, despite the improvement of symptoms, scaling remained unchanged (Figure 1).</p><p>During the treatment, the patient experienced an otitis media that resolved in 10 days with antibiotic therapy and without sequelae.</p><p>De Greef [<span>4</span>], recently published a case of lamellar ichthyosis treated with acitretin and tralokinumab in a man in his 30s, while Taoming et al. reported a pilot study on combination therapy with secukinumab and dupilumab in Netherton syndrome [<span>5</span>]. These findings suggest a potential role for ot","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"828-830"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PSANZ 2025 Oral","authors":"","doi":"10.1111/jpc.70008","DOIUrl":"https://doi.org/10.1111/jpc.70008","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 S1","pages":"6-40"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707384","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":"PSANZ 2025 Poster","authors":"","doi":"10.1111/jpc.70011","DOIUrl":"https://doi.org/10.1111/jpc.70011","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 S1","pages":"60-179"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707564","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":"Late-Breaking Posters","authors":"","doi":"10.1111/jpc.70029","DOIUrl":"https://doi.org/10.1111/jpc.70029","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 S1","pages":"182-185"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707566","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":"Late-Breaking Oral Presentations","authors":"","doi":"10.1111/jpc.70028","DOIUrl":"https://doi.org/10.1111/jpc.70028","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 S1","pages":"180-181"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707565","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":"PSANZ 2025 Best of the Best","authors":"","doi":"10.1111/jpc.70010","DOIUrl":"https://doi.org/10.1111/jpc.70010","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 S1","pages":"4-5"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707383","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}
Anjali S Raj, Vishwas Rao, R Deepa, Hindumathy Babu, Sandra Shaju, Suman V Rao
{"title":"Transfer to Home of Low-Birth-Weight Infants in Kangaroo Mother Care (KMC)-A Point of Care Quality Improvement (POCQI) Approach.","authors":"Anjali S Raj, Vishwas Rao, R Deepa, Hindumathy Babu, Sandra Shaju, Suman V Rao","doi":"10.1111/jpc.70040","DOIUrl":"https://doi.org/10.1111/jpc.70040","url":null,"abstract":"<p><strong>Background: </strong>Kangaroo mother care (KMC) is the standard of care for low birth weight (LBW) infants. Transport of a stable LBW infant from the hospital to home at discharge poses a significant risk of hypothermia. Though this risk can be mitigated by KMC, LBW infants are not routinely transferred back to KMC at the time of discharge.</p><p><strong>Objective: </strong>Aim: To improve transfer to the home of LBW infants in KMC at the time of discharge from the baseline of < 1% to 50% in 6 weeks with the point of care quality improvement (POCQI) approach.</p><p><strong>Methods: </strong>LBW infants discharged home during the study period were enrolled. The quality team (QI) team explored barriers to back transfer in KMC through fishbone analysis. Four plan-do-study-act (PDSA) cycles were implemented (Policy of transport KMC, ambulation in KMC during hospital stay, root cause analysis of missed babies, and Reinforcement of practice using posters). Acceptability was defined as reaching the destination in KMC and efficacy as euthermia at the destination.</p><p><strong>Results: </strong>Of 59 LBW infants discharged home during the study period, 89% were discharged in transport KMC. The acceptability was 98%; 6% had interruptions during the journey. Efficacy was 88% with a mean temperature of 36.9°C. All parents felt it was a safe method of transport. Mean hours of KMC increased from 4 h prior to the study to 8 h after. The practice was sustained at 74% following the study.</p><p><strong>Conclusion: </strong>A QI approach improves transfer to the home of LBW infants in KMC. It is a safe, effective, and acceptable mode of transport for LBW infants and aids in maintaining euthermia. However, continuous efforts are needed to sustain this practice.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700676","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":"A Mixed-Methods Evaluation of a Maternal Child Health Nurse Education Programme Using Moore's Outcomes Framework for Continuing Medical Education.","authors":"Emma King, Lichin Lim, Amy Gray","doi":"10.1111/jpc.70037","DOIUrl":"https://doi.org/10.1111/jpc.70037","url":null,"abstract":"<p><strong>Aim: </strong>Maternal Child Health Nurses (MCHN) play an integral role in child health in the community yet lack professional development opportunities. A tertiary hospital sought to fill this gap and developed an online MCHN education programme. This study aimed to assess the impact of the programme on MCHN confidence, knowledge and practice and to understand the factors influencing its impact.</p><p><strong>Methods: </strong>MCHN enrolled in the programme were invited to participate in a mixed method study based on Moore's Outcomes Framework for continuing medical education. Quantitative data from surveys collected pre and post live webinars and at 6 months post programme implementation assessed participant knowledge and confidence, and the quality of the programme. Qualitative data from individual semi-structured interviews was analysed inductively to understand impact.</p><p><strong>Results: </strong>Reported knowledge and confidence improved after each webinar (for knowledge from 2.60 out of 4 (95% CI 2.54-2.66) to 3.45 out of 4 (95% CI 3.40-3.59) post-webinar (p < 0.001) and for confidence from 2.58 out of 4 (95% CI 2.52-2.64) to 3.42 out of 4 (95% CI 3.38-3.47) post-webinar (p < 0.001)). Four themes emerged which facilitated the programme impact: filling a continuing education void, supporting diverse learning styles and needs, enhancing practice and advocacy through empowerment and fostering connections and respect.</p><p><strong>Conclusion: </strong>We demonstrated that a well-designed online education programme led to increased knowledge, confidence and changes in practice. It facilitated connection and respect and reinforced MCHN value and contribution. It highlighted and addressed an educational gap within the MCHN continuing education landscape and has proven to be sustainable and impactful.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692626","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}
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