Journal of paediatrics and child health最新文献

{"title":"Idiopathic Acute Pancreatitis in Paediatric Inflammatory Bowel Disease: Clinical Features and Outcomes in a Retrospective Single-Centre Study","authors":"Giovanna Fernanda Vazzana,&nbsp;Alessia Romano,&nbsp;Claudio Romano","doi":"10.1111/jpc.70553","DOIUrl":"10.1111/jpc.70553","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the clinical characteristics, timing, and long-term outcomes of idiopathic acute pancreatitis (AP) in paediatric inflammatory bowel disease (IBD) after systematic exclusion of secondary causes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre cohort study of paediatric IBD patients followed between January 2018 and December 2024. AP diagnosis and severity were classified according to the <i>North American Society for Paediatric Gastroenterology, Hepatology and Nutrition</i> (<i>NASPGHAN</i>) criteria. Patients with drug-induced, metabolic, infectious, genetic, or structural causes were excluded. Clinical, laboratory, imaging, and outcome data were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 395 paediatric IBD patients, 16 (4.1%) developed AP. After excluding four azathioprine-related cases, 12 patients (3%) were included (50% male; median age 10.6 years). Ulcerative colitis (UC) predominated (67%), with colonic involvement in all cases. Idiopathic AP occurred during active disease in 75% and after IBD-related surgery in 25%. All episodes were mild and resolved with supportive management without complications. Ultrasound showed focal pancreatic inflammatory changes in 58% of patients, predominantly involving the body and tail, while diffuse pancreatic enlargement was reported in 5 patients (42%). Over a median follow-up of 3.7 years, 8/12 patients (67%) developed acute recurrent pancreatitis (ARP), with a median time to recurrence of 9 months. No patients developed pancreatic insufficiency or diabetes. Serum IgG4 levels were negative in all patients. Among those who developed ARP, genetic testing revealed no pathogenic variants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Idiopathic AP in children with IBD appeared to be a mild but potentially relapsing condition associated with active intestinal inflammation and colonic disease. Pancreatic function remained preserved despite recurrence, which may be consistent with an immune-mediated gut–pancreas axis. Given the limited sample size, these findings should be considered hypothesis-generating, and prospective multicentre studies are required to confirm these observations and better characterise the underlying pathogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1987-1994"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794515","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":"Ganciclovir Improves Transplant-Free Liver Survival in Children With Biliary Atresia and Concurrent Cytomegaloviral Infection: A Pilot Study","authors":"Huang Teng,&nbsp;Li Qian,&nbsp;Wan Hao,&nbsp;Huang Jinshi","doi":"10.1111/jpc.70496","DOIUrl":"10.1111/jpc.70496","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate the effect of post-operative ganciclovir therapy on transplant-free liver survival in children with biliary atresia (BA) complicated by cytomegalovirus (CMV) infection, and to propose an intervention mechanism hypothesis based on the ‘CMV–hepatic stellate cell–fibrosis–long-term prognosis’ pathogenic axis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This retrospective study included children diagnosed with BA complicated by CMV infection at a tertiary children's hospital between January 2017 and October 2023. Patients were divided into a treatment group and a non-treatment group based on whether ganciclovir was administered for ≥ 1 week within 3 months after Kasai portoenterostomy (KPE). All patients had follow-up of at least 2 years by 1 October 2025. Baseline characteristics and clinical outcomes (transplant-free liver survival time and 3-month post-operative jaundice clearance rate) were compared between groups. Kaplan–Meier analysis was used to generate survival curves, and differences were assessed using the Log-Rank test. Evidence from basic and clinical research was integrated to construct a mechanistic hypothesis diagram for CMV-driven hepatic fibrosis and antiviral intervention.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 17 children with BA were included, with 6 in the treatment group and 11 in the non-treatment group. Baseline characteristics indicated no significant differences between the two groups in terms of sex, hepatic fibrosis stage, age at surgery, preoperative DBIL and other clinical indicators, demonstrating balanced comparability (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Comparison of clinical outcomes and Kaplan–Meier survival curves showed that transplant-free liver survival time was significantly longer in the treatment group than in the non-treatment group: 1518 (217, 2825) versus 190 (83, 265) days, &lt;i&gt;p&lt;/i&gt; = 0.035; the survival curve showed an improving trend (Log-Rank &lt;i&gt;p&lt;/i&gt; = 0.087). The 3-month post-operative jaundice clearance rate did not differ significantly between groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). The mechanistic hypothesis diagram suggested that CMV may activate hepatic stellate cells via multiple pathways, including CCL19/CCR7 and TGF-β, accelerating fibrosis progression, while ganciclovir may block this process.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ganciclovir antiviral therapy may be associated with improved transplant-free liver survival in CMV-positive children with BA, exerting a specific effect on long-term fibrosis progression rather than short-term bile drainage. This clinical observation aligns with the ‘CMV–fibrosis–long-ter","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1907-1912"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684992","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":"Managing Neonatal Pulmonary Hypertension in Low-Resource Settings","authors":"R. Kishore Kumar,&nbsp;Ju-Lee Oei,&nbsp;Rajeshwari Madappa,&nbsp;Satyan Lakshminrusimha","doi":"10.1111/jpc.70550","DOIUrl":"10.1111/jpc.70550","url":null,"abstract":"<div>\u0000 \u0000 <p>Persistent pulmonary hypertension of the newborn (PPHN) is a critical condition marked by elevated pulmonary vascular resistance (PVR) and persistent hypoxemia, due to the failure of transition from foetal to neonatal circulation. Management focuses on reducing PVR, enhancing pulmonary vasodilation, and ensuring adequate oxygen delivery. Inhaled nitric oxide (iNO), an FDA-approved therapy, effectively lowers PVR and improves oxygenation in term neonates. However, in resource-limited settings, its use is constrained by high costs, the need for specialized equipment, and limited availability of medical-grade iNO, with industrial-grade NO sometimes used despite potential impurities. These limitations have led to increased use of accessible alternatives such as sildenafil, milrinone and other vasodilators, which offer vital options where iNO is not feasible. This review highlights regional variability in management, the impact of resource constraints, and the need for equitable care. Using India as an example, a 10-step approach for managing PPHN in low-resource settings is proposed, alongside a call for standardized protocols and further research into both established and emerging therapies.</p>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1859-1872"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813195","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":"HOMEFREE: Scaling-Up Evidence-Based Guidelines for IV-to-Oral Antibiotic Switch in Hospitalised Children, an Implementation Study Protocol","authors":"Jessica Suna,&nbsp;Daniel Tanti,&nbsp;Adam Bartlett,&nbsp;Christopher Blyth,&nbsp;Karin Thursky,&nbsp;Evette Buono,&nbsp;Lolita Java,&nbsp;Gabrielle Haeusler,&nbsp;Penelope Bryant,&nbsp;Lisa Hall,&nbsp;Gregory Merlo,&nbsp;Brendan McMullan","doi":"10.1111/jpc.70528","DOIUrl":"10.1111/jpc.70528","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Around half of children admitted to hospital receive intravenous (IV) antibiotics, contributing to higher costs, vascular access complications and longer hospital stays. A single-site pilot in a tertiary Australian paediatric hospital implemented nationally endorsed Australasian Stewardship of Antimicrobials in Paediatrics (ANZPID-ASAP) IV-to-oral antibiotic switch guidelines, improving timely switch rates from 64% to 82%. Following this success, a broader study is planned to assess the feasibility of scaling this approach across hospitals of varying types and sizes within NSW, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The HOMEFREE study hypothesises that implementation of an IV-to-oral antibiotic switch programme based on endorsed guidelines and supported by audit and feedback will increase the proportion of hospitalised children transitioned to oral therapy or antibiotic cessation within 24 h of meeting eligibility criteria. The study will evaluate both effectiveness and implementation feasibility across tertiary paediatric and general hospitals in metropolitan and rural/regional settings. This paper presents the study protocol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participating sites will select context-appropriate interventions to support guideline-concordant prescribing, informed by shared learning during the prospective phase. Effectiveness will be assessed using prospective audits, with key outcomes including timely guideline-concordant IV-to-oral switch and hospital length of stay. Implementation feasibility will be evaluated using the Consolidated Framework for Implementation Research through surveys of local project committee members conducted before and after 12 months of audit and feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study will assess the effectiveness and feasibility of translating and scaling best-practice IV-to-oral antibiotic switch guidelines for children in real-world hospital settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1901-1906"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70528","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679109","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":"Diagnostic Pitfalls in Meconium-Related Ileus: Red Flags for Surgical Pathologies in Extremely Low Birth Weight Infants","authors":"Kenji Santo,&nbsp;Yuichi Takama,&nbsp;Marie Todo,&nbsp;Yuko Tanaka,&nbsp;Hiroyuki Ichiba,&nbsp;Masafumi Kamiyama,&nbsp;Takashi Sasaki","doi":"10.1111/jpc.70549","DOIUrl":"10.1111/jpc.70549","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Meconium-related ileus (MRI) often mimics other surgical pathologies in extremely low birth weight infants (ELBWIs), leading to diagnostic difficulties. This study aimed to clarify the clinical presentation and management outcomes of enema therapy in ELBWIs with a specific focus on the clinical indicators of underlying non-MRI surgical pathologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted of 31 ELBWIs (birth weight &lt; 1000 g) who received enema therapy for suspected MRI at a single tertiary center between 2008 and 2024. Infants were categorized into Success (<i>n</i> = 20) and Failure (<i>n</i> = 11) groups. The clinical characteristics, timing of intervention, and underlying pathologies were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Underlying non-MRI surgical pathologies were identified only in the Failure group (36% [4/11] vs. 0% [0/20] in the Success group, <i>p</i> = 0.010), including Hirschsprung disease, necrotizing enterocolitis, meconium peritonitis, and ileal stenosis. The overall survival was significantly lower in the Failure group than in the Success group (55% vs. 95%, <i>p</i> = 0.013). A descriptive review of these non-MRI patients highlighted that an atypically late initial enema therapy or a high frequency of repetitive procedures was critical clinical features that masked the underlying pathologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In ELBWIs with suspected MRI, the failure of enema therapy was significantly associated with underlying non-MRI surgical pathologies. Although these findings require validation in larger cohorts, delayed initiation of therapeutic enema or repeated procedures without sustained improvement should prompt reassessment for non-MRI surgical pathology and early surgical consultation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1981-1986"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794476","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":"Early Mortality Risk Assessment in Preterm Neonates Using the Prognostic Nutritional Index","authors":"Seyma Butun Turk,&nbsp;Mustafa Senol Akin,&nbsp;Fatma Nur Sari,&nbsp;Evrim Alyamac Dizdar","doi":"10.1111/jpc.70554","DOIUrl":"10.1111/jpc.70554","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preterm neonates are at high risk of morbidity and mortality due to physiological immaturity and susceptibility to complications. The prognostic nutritional index (PNI), calculated from serum albumin and lymphocyte counts, is an inflammation-based biomarker widely used to predict prognosis in adult diseases. However, its role in neonatology remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association between PNI and early mortality in preterm infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Preterm infants born at &lt; 32 weeks of gestation and admitted to the neonatal intensive care unit were retrospectively analysed. Demographic, clinical and laboratory data were obtained from medical records. Infants who died within the first 7 days of life were defined as the mortality group and compared with survivors. PNI was calculated using lymphocyte and albumin levels measured within the first 24 h of life. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive performance of PNI for early mortality, and multi-variable logistic regression analysis was performed to identify independent predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 142 infants were included, of whom 17 (12%) died within the first 7 days. Gestational age, birth weight and Apgar scores were significantly lower in the mortality group, whereas maternal smoking was more frequent. PNI values were significantly lower in infants who died (<i>p</i> &lt; 0.05). ROC analysis demonstrated an AUC of 0.703 for PNI in predicting early mortality with a cut-off value of 40 (sensitivity 77%, specificity 64%). Multi-variable logistic regression analysis identified low PNI (&lt; 40) and gestational age as independent predictors of early mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PNI may serve as an adjunctive biomarker to complement established clinical predictors of early neonatal mortality in preterm infants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1995-2002"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808556","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 Socioeconomic Status and Rurality on the Rate of Prenatal Detection of Major and Critical Congenital Heart Disease in Western Australia.","authors":"Steven B Hurwitz, Elaine O'Connell, Bradley MacDonald, Darshan Kothari, Jan E Dickinson, Deane Yim","doi":"10.1111/jpc.70613","DOIUrl":"https://doi.org/10.1111/jpc.70613","url":null,"abstract":"<p><strong>Aim: </strong>Prenatal diagnosis of congenital heart disease (CHD) is associated with reduced infant morbidity and mortality. Location and subsequent socioeconomic status influence rates and timing of prenatal diagnoses of CHD. We investigated the impact of socioeconomic status and rurality on the rate of prenatal diagnosis of critical and major CHD in Western Australia (WA).</p><p><strong>Methods: </strong>This retrospective cross-sectional study reviewed all critical (surgical intervention ≤ 30 days of life) and major (surgical intervention ≤ 1 year of life) CHD in WA between 2017 and 2021. Patients were identified from the WA Fetal Cardiology and Perth Children's Hospital Cardiology Databases. Clinical records were used to identify diagnoses, outcomes, postcode, rurality (via the Modified Monash Model [MMM]) and socioeconomic status (Socio-Economic Indexes for Areas [SEIFA] Index of Relative Socio-economic Disadvantage). Postcode was used to estimate SEIFA index and MMM rurality.</p><p><strong>Results: </strong>There were 478 cases with major CHD; 282 (59%) were prenatally diagnosed, of which 268 cases were critical CHD, with a 77% detection rate. Seventy-four percent of patients were from metropolitan areas. The distribution of SEIFA decile (p = 0.15) and MMM (p = 0.09) were not significantly different between pre- and postnatal groups. The diagnosis rate of univentricular CHD was 94% (n = 102) and 49% (n = 180) for CHD undergoing biventricular repair.</p><p><strong>Conclusion: </strong>Critical CHD increases the likelihood of prenatal diagnosis in WA; however, rurality and socioeconomic status were not found to influence diagnosis rates. Further studies are needed to review the availability of obstetric services in rural communities to ensure equitable healthcare.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182588","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":"Early-Onset Thyroid Hormone Resistance Beta: A Neonatal Case With THRB (c.949G>A; p.Ala317Thr) Pathogenic Variant.","authors":"Cristina Di Geronimo, Martino Landi, Francesca Mugnai, Marco Masutti, Margherita Baldassarri, Chiara Fallerini, Giovanna Municchi, Alessandra Renieri, Stefano Stagi, Barbara Tomasini","doi":"10.1111/jpc.70624","DOIUrl":"https://doi.org/10.1111/jpc.70624","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168838","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":"Systemic Immune-Inflammation Index as a Predictor of Ovarian Necrosis in Children With Incarcerated Ovary Hernia: A Single-Centre Retrospective Study.","authors":"Gang Zhao, Chenghui Ke, Hong Zhang, Longhua Yang, Ming Zhao, Peiji Zhao, Yunpeng Yang","doi":"10.1111/jpc.70618","DOIUrl":"https://doi.org/10.1111/jpc.70618","url":null,"abstract":"<p><strong>Aim: </strong>Ovarian necrosis is a severe complication of incarcerated ovary hernia in female children, yet reliable preoperative predictors are lacking. We aimed to evaluate the systemic immune-inflammation index (SII) as a predictor of ovarian necrosis and to compare its diagnostic performance with the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP).</p><p><strong>Methods: </strong>We retrospectively reviewed female children who underwent emergency surgery for incarcerated ovary or fallopian-tube hernia between October 2018 and April 2026. SII was calculated as platelet count × neutrophil count/lymphocyte count and NLR as neutrophil count/lymphocyte count. Univariable Firth-penalised logistic regression and receiver-operating-characteristic (ROC) analyses were performed. AUCs were estimated with DeLong 95% confidence intervals, optimal cut-offs by the Youden index, and AUCs were compared using the DeLong test.</p><p><strong>Results: </strong>Among 45 patients, 10 (22.2%) had intraoperatively confirmed ovarian necrosis. SII and CRP were significantly associated with necrosis in univariable Firth analyses. SII showed an AUC of 0.894 (95% CI 0.790-0.999), sensitivity 90.0%, and specificity 85.7%. NLR showed an AUC of 0.917 (95% CI 0.836-0.998), sensitivity 100.0%, and specificity 80.0%. The AUCs of SII and NLR did not differ significantly (DeLong p = 0.542). CRP had an AUC of 0.867 (95% CI 0.681-1.000), sensitivity 80.0%, and specificity 94.3%.</p><p><strong>Conclusions: </strong>SII showed good discrimination for ovarian necrosis in paediatric incarcerated ovary hernia, but did not outperform the simpler NLR in this small cohort. Both CBC-derived indices may assist preoperative risk stratification; however, the proposed thresholds are exploratory and require prospective multicentre external validation before clinical implementation.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136847","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":"Profuse Neonatal Haematochezia and the Limits of First Impressions.","authors":"Akihisa Nitta, Shinichiro Tanaka, Chiharu Miyayama, Yuji Oto, Satomi Koyama, Tomozumi Takatani","doi":"10.1111/jpc.70621","DOIUrl":"https://doi.org/10.1111/jpc.70621","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136731","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}