Journal of paediatrics and child health最新文献

{"title":"The Association of Cyberspace and Attention-Deficit Hyperactivity Disorder Symptoms in Children During the COVID-19 Pandemic: A Systematic Review","authors":"Maryam Abdoli,&nbsp;Majid Rahimi,&nbsp;Ali Dianati,&nbsp;Seyede Shahrbanoo Daniali,&nbsp;Roya Kelishadi","doi":"10.1111/jpc.70003","DOIUrl":"10.1111/jpc.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The negative impact of the COVID-19 pandemic on the mental health of children has been considered. Children with attention-deficit and hyperactivity disorder (ADHD) are likely to be more vulnerable too. This study aimed to provide a systematic review of evidence regarding the association between screen usage and symptoms of ADHD during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review adhered to PRISMA guidelines. Systematic searches were conducted in PubMed, Scopus, Web of Sciences and Cochrane Library.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 130 identified reports, 8 papers covering 1587 subjects were included. The spent time on different types of screen time from TV to video games among children and adolescents with ADHD increased. The majority of studies showed that a surge in screen time was associated with the worsening of ADHD symptoms such as irritation, inattention, hyperactivity and oppositional defiant disorders (ODDs). The finding confirmed the severity of ADHD symptoms in individuals with a history of addictive or problematic usage of media was higher in comparison with others. One study found that educational screen time was not associated with disturbances in ADHD symptoms. In addition, ADHD symptoms during the COVID-19 pandemic were influenced by prior mental health situations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current findings suggest considering the negative association of excess screen time with ADHD symptoms, monitoring of screen time particularly for recreational purposes should be monitored to prevent negative consequences in children and adolescents with ADHD. On the other hand, designing educational and treatment interventions based on digital technology could not be ignored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"549-558"},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433482","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":"Effect of Pro-, Pre- and Synbiotic Supplementation on the Growth of Infants and Children: An Umbrella Systematic Review and Meta-Analysis","authors":"Shengnan An,&nbsp;Jinfeng Kong,&nbsp;Asghar Ghorbani,&nbsp;Azadeh Dehghani,&nbsp;Shahab Alizadeh","doi":"10.1111/jpc.16789","DOIUrl":"10.1111/jpc.16789","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In recent years, pro-, pre- and synbiotics have been suggested to positively influence the growth outcomes of infants and children. However, the findings have been inconsistent. This umbrella meta-analysis was conducted to evaluate this effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed, Web of Science and Scopus databases were systematically searched until June 2024 to identify relevant studies. Weight gain, length gain, head circumstance (HC) gain, body mass index (BMI) as well as weight-for-height (WHZ), height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BMIAZ) <i>Z</i>-scores were considered as the outcomes. Standardised mean differences (SMD) along with the 95% confidence interval (CI) were utilised to estimate the overall effect size. Subgroup analyses were conducted to identify the sources of heterogeneity among the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 26 meta-analyses, which encompassed a total of 72 285 participants. The pooled umbrella analysis revealed positive effects of pro-, pre- and synbiotics on weight gain (SMD = 0.17, 95% CI: 0.09–0.25) and height gain (SMD = 0.10, 95% CI: 0.01–0.19) in both healthy individuals and preterm infants, although significant heterogeneity was observed across the studies (<i>p</i> &lt; 0.001). Furthermore, the subgroup analyses indicated very weak evidence for an increase in BMI and WAZ following microbiome-based interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Supplementation with pro-, pre- and synbiotics has the potential to enhance weight and height gain in infants and children. Additional large-scale studies are needed to confirm their clinical applications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 3","pages":"354-368"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414590","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":"Accidental Trisodium Phosphate [Na3PO4] (TSP) Ingestion in a Child","authors":"William Hoffmann,&nbsp;Christopher Cooke,&nbsp;Ryan F. Bloomquist","doi":"10.1111/jpc.70012","DOIUrl":"10.1111/jpc.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is not uncommon for a child to present to the hospital due to accidental ingestions, and oftentimes they are the result of a child accessing household cleaning or home improvement products. Typically, the upper gastrointestinal tract is the site of initial tissue insult and prognosis of these cases depends on a variety of factors, including the ingested substance, injury extent, and assessments and treatments rendered. Possible post-ingestion complications that make management difficult may include mediastinitis, hemodynamic instability, gastrointestinal perforation, erosion and scarring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>In this case, a 13-month-old boy accidently swallowed Trisodium phosphate [Na₃PO₄] (TSP), a common household all-purpose heavy-duty cleaner. After ingestion, the patient presented to the emergency department where a multi-disciplinary team-initiated care. Work-up included regular vital checks, electrolyte profiles, blood profiles and an esophagogastroduodenoscopy. He was eventually discharged and scheduled to return for follow-up with esophagram, without long term consequences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the ingestion of TSP has occurred before, the literature regarding consumption of this specific detergent is negligible. This case provides evidence regarding the treatment and outcome of a paediatric patient who accidentally swallowed TSP and offers guidance in the management of their care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"643-646"},"PeriodicalIF":1.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408479","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":"Topical Steroid Withdrawal: An Emerging Challenge in the Treatment of Atopic Dermatitis","authors":"Conor Larney,&nbsp;Ashling Courtney,&nbsp;Anousha Yazdabadi,&nbsp;John C. Su","doi":"10.1111/jpc.70018","DOIUrl":"10.1111/jpc.70018","url":null,"abstract":"<div>\u0000 \u0000 <p>Topical corticosteroids (TCS) have been a cornerstone in managing atopic dermatitis (AD) since their introduction in 1952. Though there are well-documented adverse effects attributed to their use, the existence of some complications of TCS use, including topical steroid withdrawal (TSW) syndrome, characterised by TCS dependence and skin disease worsening after TCS discontinuation, are more controversial within the dermatology community. There is no consensus on diagnostic criteria for TSW or clarity on its prevalence, natural history and management. Media reports are common and TSW overdiagnosis may lead to steroid phobia, poor adherence to TCS therapy, and unnecessary, increased, and protracted AD flares. This paper reviews the historical context, clinical presentations, challenges in diagnosis and the ongoing debate regarding TSW, with a focus on the implications for patient management and the potential consequences of steroid phobia on treatment adherence.</p>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"545-548"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399329","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 Study of Body Composition in Children Suffering From Infantile Vitamin B12 Deficiency.","authors":"Viresh Vohra, Harvinder Kaur, Savita Verma Attri, Bhavneet Bharati, Pawan Kumar, Shivan Kesavan, Naveen Sankhyan","doi":"10.1111/jpc.70000","DOIUrl":"https://doi.org/10.1111/jpc.70000","url":null,"abstract":"<p><strong>Background: </strong>Infantile tremor syndrome (ITS), or neurocutaneous infantile vitamin B12 deficiency syndrome (NIBS), is characterised by tremors, developmental delay, anaemia and skin hyperpigmentation. This study aimed to assess the body composition and serum lipids in children with ITS.</p><p><strong>Methods: </strong>Children under 2 years of age with a clinical diagnosis of ITS were enrolled. Dietary history, developmental milestones and anthropometric data were recorded, along with blood tests for B12, homocysteine, lipid profile and blood counts.</p><p><strong>Results: </strong>Of 50 children screened, 31 with a median age of 13 months were included. Most (80.6%) were from lower socio-economic backgrounds. Limb tremors were observed in 51.6%, and all but one child had a developmental quotient (DQ) below 70, indicating significant developmental delays. Microcephaly was present in 35.4%, and moderate to severe anaemia was nearly universal. Growth parameters, including fat mass and fat-free mass, were significantly lower in children with ITS compared to controls. Lipid profiles revealed consistently high triglycerides, low HDL and elevated LDL in most age groups, suggesting a pro-atherogenic metabolic state.</p><p><strong>Conclusion: </strong>Severe Infantile vitamin B12 deficiency significantly impairs head growth, overall development and body composition, with potential long-term cardiovascular risks due to abnormal lipid profiles.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399208","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":"The Clinical Burden of SARS-CoV-2 Compared to Influenza A in the Same Cohort of Paediatric Outpatients; Increased Influenza Severity and Potential Insights.","authors":"Papadopoulou Athina, Lampidi Stavroula, Mermiri T Despoina Zoe, Kostaridou Stavroula, Kanariou G Maria","doi":"10.1111/jpc.70014","DOIUrl":"https://doi.org/10.1111/jpc.70014","url":null,"abstract":"<p><strong>Introduction: </strong>The variation in the clinical severity of viral infections remains a matter of scientific debate. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Influenza A virus (IAV) are both RNA viruses, exhibiting a range of clinical presentations, ranging from asymptomatic cases to fatalities, influenced by both viral and host factors. A descriptive real-life study was conducted, aiming to compare the clinical manifestations of recent COVID-19 with those of IAV infection in the same group of non-hospitalised, unvaccinated children.</p><p><strong>Materials and method: </strong>Between September 2021 and February 2023, we evaluated 115 individuals (male 48.7%, mean age 101.8 ± 50.8 months) who had not received vaccination for both SARS-CoV-2 and the quadrivalent influenza vaccine and were documented to be infected with both viruses within a 12-month time interval. The visual analogue scale (VAS-5) was used to assess parents'/patients' evaluation comparing the two infections.</p><p><strong>Results: </strong>In cases of IAV infection, a significantly higher prevalence of prolonged high fever, upper and lower respiratory symptoms, and secondary infections was observed. The majority (74.8%) of patients and/or parents assessed IAV as a more severe clinical syndrome compared with SARS-CoV-2.</p><p><strong>Conclusions: </strong>The clinical burden of IAV was found to be greater than that of SARS-CoV-2 infection in the same unvaccinated children. This variation in clinical severity may provide a reference for effective vaccination policies; however, underlying mechanisms that could explain this difference require further evaluation.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399326","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":"Recent Advances in Diagnostics and Therapeutics for Paediatric Thyroid Cancer.","authors":"Joel A Vanderniet, Noemi A Fuentes-Bolanos, Yoon Hi Cho, David K V Chung, Gideon Sandler, Ali Moghimi, Bhavna Padhye, Kathy Tucker, Antoinette Anazodo, Paul Z Benitez-Aguirre","doi":"10.1111/jpc.70013","DOIUrl":"https://doi.org/10.1111/jpc.70013","url":null,"abstract":"<p><strong>Purpose of review: </strong>Paediatric thyroid cancer management traditionally relied on extrapolation from adult data and, despite good survival outcomes, often involved extensive surgical approaches and radioactive iodine (RAI) therapy with potentially life-long complications. Increasing understanding of paediatric diagnostic techniques, molecular tumour drivers and targeted therapies will allow a more nuanced, disease-specific comprehensive model of care. This review summarises recent developments in paediatric thyroid cancer biology, diagnosis and models of care.</p><p><strong>Methods: </strong>Review of relevant literature from the last 5 years to inform a narrative summary by a multidisciplinary team of clinician experts in paediatric thyroid cancer management.</p><p><strong>Findings: </strong>Standardised risk scoring systems will likely improve the objectivity and accuracy of paediatric thyroid nodule risk stratification on ultrasound, but further studies are needed to validate these. Identification of somatic and germline gene variants is playing a rapidly increasing role in paediatric thyroid cancer diagnosis and planning of surgical approaches and neoadjuvant and adjuvant therapies. There is growing recognition that lobectomy may achieve comparable outcomes, with reduced risk of complications, to total thyroidectomy in patients with low-risk disease. Molecularly targeted therapies are now available for the management of advanced disease as an adjuvant, and likely neo-adjuvant, therapy for medical debulking of large tumours and resensitisation of RAI-resistant disease.</p><p><strong>Conclusions: </strong>The management pathways for paediatric thyroid cancer are rapidly evolving due to the increasing availability of paediatric-specific data. As management options become more complex, interdisciplinary collaboration and shared decision-making are ever more important.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399222","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":"Emergency Department Mental Health Presentations in Young Children Letter to the Editor “Addressing the Unique Challenges of Paediatric Mental Health Emergency Care” Response","authors":"Elyssia M. Bourke,&nbsp;Daniela F. Say,&nbsp;Anna Carison,&nbsp;Sinead M. O'Donnell,&nbsp;Franz E. Babl,&nbsp;the Paediatric Research in Emergency Departments International Collaborative (PREDICT) research network","doi":"10.1111/jpc.70005","DOIUrl":"10.1111/jpc.70005","url":null,"abstract":"&lt;p&gt;In reply:&lt;/p&gt;&lt;p&gt;We thank the authors for their thoughtful response to our article &lt;i&gt;Emergency department mental health presentations in young children: a retrospective chart review&lt;/i&gt; [&lt;span&gt;1&lt;/span&gt;]. Their efforts to highlight potential interventions for young children with autism spectrum disorder (ASD) who present to the Emergency Department (ED) with acute behavioural disturbance are commendable.&lt;/p&gt;&lt;p&gt;We agree that utilising strategies to reduce or eliminate the use of restrictive interventions including mechanical and physical restraint is a high priority when caring for young people presenting to the ED with behavioural disturbance. This is true regardless of whether the young person is neurotypical or neurodiverse. There is limited literature assessing the experience of young people when restrictive interventions are used in the context of behavioural disturbance management. Adults who were physically restrained during an episode of behavioural disturbance have reported feelings of dehumanisation as well as anxiety relating to seeking healthcare in the future [&lt;span&gt;2&lt;/span&gt;]. Due to the negative effects of restrictive interventions, alternate strategies to manage acute behavioural disturbance are vital.&lt;/p&gt;&lt;p&gt;The suggestion from Chen et al. regarding the use of non-pharmacological strategies to de-escalate the young person's behaviour is logical. It is worth noting though that currently there have been no studies which have objectively assessed the effectiveness of these strategies for young people experiencing acute behavioural disturbance in the ED setting. A concerted focus on establishing an evidence base for which non-pharmacological strategies are most effective is therefore a high research priority.&lt;/p&gt;&lt;p&gt;We support the suggestion from the authors to consider the involvement of caregivers in guiding the most effective non-pharmacological strategies for these young people. However, an episode of acute behavioural disturbance—and in particular one that has necessitated an ED presentation—can be a unique situation. Evidence suggests that in this particular circumstance the caregivers of these young people are often overwhelmed, exhausted and have tried every strategy that would normally assist in calming their child down prior to presenting to ED [&lt;span&gt;2&lt;/span&gt;]. These parents may therefore need to take a step back from guiding their child's management to provide them with a physical and emotional break.&lt;/p&gt;&lt;p&gt;It is also worth highlighting that although using least restrictive strategies is a priority in these presentations, this needs to be balanced against the risk of physical and psychological harm that these young people pose to themselves, their caregivers and to healthcare staff [&lt;span&gt;3, 4&lt;/span&gt;]. Emergency care workers report the highest rates of occupational violence and aggression across the health system, and acute behavioural disturbance presentations account for a large proportion of these incidents [&lt;span&gt;5&lt;/spa","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"655-656"},"PeriodicalIF":1.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390471","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":"Addressing the Unique Challenges of Paediatric Mental Health Emergency Care: Response to Bourke et al.'s Study on Young Children's Emergency Department Presentations","authors":"Li-Hua Chen,&nbsp;Lien-Chung Wei","doi":"10.1111/jpc.70004","DOIUrl":"10.1111/jpc.70004","url":null,"abstract":"<p>I appreciate the timely study by Bourke et al. [<span>1</span>], which investigates mental health (MH) presentations among young children in emergency department (ED) settings. The focus on children aged 12 or younger is particularly relevant, as it sheds light on the growing challenges faced by healthcare providers globally, including in Taiwan.</p><p>Building upon their work, this correspondence aims to further address gaps in intervention strategies, especially for children with neurodevelopmental disorders like autism spectrum disorder (ASD) presenting with acute behavioural disturbances. Below, I propose evidence-supported recommendations to enhance emergency care and reduce the burden on EDs.</p><p>Bourke et al. [<span>1</span>] underscore the lack of adequate post-discharge support, which contributes to repeated ED visits. Strengthening connections between EDs and community mental health services is imperative. In Taiwan, initiatives that integrate caregivers, schools, and paediatric MH specialists have shown promise in preventing crises from escalating to the ED level. Evidence indicates that proactive follow-up systems significantly lower readmission rates and improve long-term outcomes [<span>6</span>].</p><p>While Bourke et al. provide valuable insights, this correspondence emphasises the need for actionable solutions to improve outcomes for young children experiencing mental health crises. By adopting non-pharmacological de-escalation techniques, engaging caregivers, integrating multidisciplinary teams, and ensuring robust follow-up systems, healthcare providers can enhance the quality of care and alleviate the burden on EDs. Collaborative efforts between EDs and community MH services remain essential to addressing the unique challenges faced by this vulnerable population.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"653-654"},"PeriodicalIF":1.6,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382518","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":"Red Flags in the Evaluation of the Tiptoeing Child","authors":"Francesco Baldo,&nbsp;Arianna Traunero,&nbsp;Andrea Ballaben,&nbsp;Alessandro Zago,&nbsp;Egidio Barbi","doi":"10.1111/jpc.16793","DOIUrl":"10.1111/jpc.16793","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tiptoeing is a common phenomenon in gate development. However, in some cases, it can be the first clinical sign of a medical condition, more often a neurological or muscle disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To provide a practical guide for paediatricians on how to approach tiptoeing and its possible causes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Input from the literature were used to construct this guide. We evaluated articles both on the general topic and the various conditions associated with tiptoeing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Red flags in tiptoeing are its persistence for more than 6 months after the establishment of independent walking, its persistence after 2 years of age and its appearance afterwards. Historical and physical examination clues, together with few blood tests and radiological investigations, are key elements to direct the clinician's diagnosis in the right direction, especially nowadays, considering that many of these conditions have a specific treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In presence of red flags, tiptoeing should never be underestimated and must be considered a sign of a pathological condition until proven otherwise.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"540-544"},"PeriodicalIF":1.6,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382523","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}