Pranav R Jani, Traci-Anne Goyen, Kiran Kumar Balegar Virupakshappa, Rajesh Maheshwari, Dharmesh Shah, Maria Saito-Benz, Tim Schindler, James Moore, James Elhindi, Himanshu Popat
{"title":"Targeted Cerebral Oxygenation Using Dedicated Treatment Versus Usual Care in Extremely Preterm Infants: Protocol for a Multicentre International Phase II Randomised Controlled Trial.","authors":"Pranav R Jani, Traci-Anne Goyen, Kiran Kumar Balegar Virupakshappa, Rajesh Maheshwari, Dharmesh Shah, Maria Saito-Benz, Tim Schindler, James Moore, James Elhindi, Himanshu Popat","doi":"10.1111/jpc.70066","DOIUrl":"https://doi.org/10.1111/jpc.70066","url":null,"abstract":"<p><strong>Background: </strong>Near infrared spectroscopy (NIRS) allows continuous monitoring of cerebral oxygenation and therefore has the potential to be neuroprotective. Recurrent episodes of cerebral hypo-and/or hyperoxia may result in brain injury. The Safe-BoosC-II study reported stable cerebral oxygenation in extremely preterm infants by combining a dedicated treatment guideline with NIRS monitoring using several devices and adult sensors. The ability to maintain stable cerebral oxygenation with a dedicated treatment algorithm using one type of NIRS device with neonatal sensors has not been previously investigated.</p><p><strong>Methods: </strong>In this multicentre, 2-arm, parallel, single-blinded, phase II RCT, stratified by gestation and hospital site, 100 participants born < 29 weeks' gestation (inborn and outborns, singleton and twins) will be randomised to targeted cerebral oxygenation using dedicated treatment or usual care with blinded cerebral NIRS monitoring for the first 5 days of life. We will exclude infants > 6 h of age, those with congenital anomaly requiring major surgery or a genetic disorder, and triples or higher multiple births. The primary outcome is the burden of cerebral hypoxia and hyperoxia for the first 5 days after birth expressed as percent hours.</p><p><strong>Discussion: </strong>The findings of this trial will provide essential information on (i) validating results from the Safe-BoosC-II study, considering the differences in the study methodology between the two trials (ii) strengthening support for routine use of cerebral NIRS monitoring in this population and (iii) informing the design of future RCTs on the effects of targeted cerebral oxygenation on neurodevelopment in early childhood as the primary outcome.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry registration number ACTRN12621000778886.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025613","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}
Ufuk Ateş, Gülnur Göllü, Ergun Ergün, Fırat Serttürk, Anar Jafarov, Merve Bülbül, Ege Evin, Sümeyye Sözduyar, Meltem Bingöl Koloğlu, Ahmet Murat Çakmak
{"title":"Corrosive Substance Ingestion: When to Perform Endoscopy?","authors":"Ufuk Ateş, Gülnur Göllü, Ergun Ergün, Fırat Serttürk, Anar Jafarov, Merve Bülbül, Ege Evin, Sümeyye Sözduyar, Meltem Bingöl Koloğlu, Ahmet Murat Çakmak","doi":"10.1111/jpc.70064","DOIUrl":"10.1111/jpc.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Ingestion of corrosive substances is a difficult and important medical problem to manage. The aim of this study is to present an algorithm that will regulate the treatment and follow-up of paediatric patients with corrosive ingestion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children who were admitted to the paediatric emergency department with corrosive substance ingestions between July 2015 and December 2021 were included. Between July 2015 and January 2020, endoscopy was performed on all patients. After January 2020, endoscopy was performed only for patients presenting with hypersalivation and dysphagia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>172 patients were followed up and treated in our clinic due to corrosive substance ingestion. Endoscopic evaluation of 19 patients with hypersalivation revealed oesophageal corrosion stages as follows: grade I in 5 patients, grade II-A in 1 patient, grade II-B in 3 patients, and normal findings in the remaining patients. Of the 14 patients with dysphagia, 1 had grade I, 2 had grade II-A, and 4 had grade II-B corrosion, and the remaining patients had normal endoscopic findings. In the long-term follow-up of the patients without hypersalivation and dysphagia, no complications developed and no additional treatment was required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients presenting with suspicion of ingestion of high risk corrosive substances, there is no need for endoscopy unless hypersalivation and dysphagia are present simultaneously.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"967-973"},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970557","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":"Multiple Fractures and Hypercalcaemia Secondary to Parathyroid Hormone-Related Peptide (PTHrP): An Uncommon Presentation of Hepatoblastoma.","authors":"J Hawkins, M Lambeth, M Sullivan, J A Heath","doi":"10.1111/jpc.70050","DOIUrl":"https://doi.org/10.1111/jpc.70050","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004810","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":"Paediatric Endocrinology: Before and Beyond ‘Ringing the Bell’","authors":"Louise S. Conwell","doi":"10.1111/jpc.70055","DOIUrl":"10.1111/jpc.70055","url":null,"abstract":"<p>\u0000 <i>Ringing the bell…</i>\u0000 </p><p>Many cancer centres have adopted a naval tradition of bell ringing to signify ‘when the job is done’ at the completion of treatment. Despite global disparities [<span>1, 2</span>], the childhood cancer cure rates have improved, and the population of ageing survivors is increasing [<span>3</span>]. However, the majority experience cancer- and treatment-related effects requiring life-long care [<span>3</span>]. The most prevalent severe chronic health conditions include endocrine disorders, subsequent neoplasms, and cardiovascular disease [<span>4</span>].</p><p>In 2006, an expert panel met in Italy to produce the Erice Statement, updated a decade later: ‘the long-term goal of the cure and care of a child with cancer is that they become a resilient and autonomous adult with optimal health-related quality of life, accepted in society at the same level as their age peers’ [<span>5, 6</span>].</p><p>I had the opportunity to reflect on two decades of Australian and Canadian ‘Paediatric Endocrine Oncology’ experience with an enthusiastic group of Australian and New Zealand paediatric endocrinology trainees. The themes were (i) acute endocrinology (ii) chronic endocrinology (‘within care’ and ‘after care’), (iii) late effects surveillance, more aptly and positively described as ‘Aftercare’ or ‘Survivorship’ and (iv) endocrinology within childhood cancer genetic predisposition syndromes. I shared reflections relevant to before and beyond ‘ringing the bell’, with a selection included below.</p><p>\u0000 <i>Know their story…</i>\u0000 </p><p>A child approaching pubertal age with a history of acute lymphoblastic leukaemia (ALL) is referred. The child's story: an early infantile diagnosis, a poor short-term prognosis and an uncertain journey ahead. The parents' stories convey their differing approaches: a 10-year division of cognitive load, one cure and one care.</p><p>\u0000 <i>Know their story before…</i>\u0000 </p><p>An adolescent girl with a craniopharyngioma is experiencing the challenging sequelae of hypothalamic obesity and learning difficulties [<span>7, 8</span>]. A short duration before: high levels of academic and sporting achievement. Familial expectations of these outcomes persist.</p><p>\u0000 <i>Sticky notes…</i>\u0000 </p><p>These colourful, small pieces of paper with a re-adherable strip of glue are found peppered across workplaces and homes. Covering text- and notebooks, they were the clue to another adolescent's short-term memory struggles.</p><p>My first ‘aftercare’ experience in the early 1990s was a preschool-age boy with microcephaly and cognitive impairment after treatment for high-risk ALL [<span>9</span>]. Modern treatments differ, but deficits in neurocognitive functioning persist [<span>10</span>].</p><p>\u0000 <i>Shifting goals…</i>\u0000 </p><p>The safety of growth hormone is continually monitored [<span>11</span>]. The par","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"993-995"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003124","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":"A Paediatric Case of Granulomatosis With Polyangiitis Presenting With Kawasaki Disease-Like Symptoms","authors":"Shinnosuke Haruta, Yukari Aida, Kazuya Yatani, Kengo Nakashima, Hiroko Sano, Yusuke Ishida, Shogo Minamikawa, Mao Mizuta, Yosuke Inaguma, Hiroshi Kaito, Yasuo Nakagishi","doi":"10.1111/jpc.70061","DOIUrl":"10.1111/jpc.70061","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"985-988"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987931","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":"An Alarming Widespread Vesicular Rash in a Neonate","authors":"Geethanjali Sahadevan, Malathi Munisamy","doi":"10.1111/jpc.70062","DOIUrl":"https://doi.org/10.1111/jpc.70062","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"822-824"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908904","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":"Global, Regional, and National Incidence and Prevalence of Children With Peptic Ulcer Disease: A Temporal Trend and Bayesian Age-Period-Cohort Analysis Based on the 2021 Global Burden of Disease Study","authors":"Haosen Cui, Congfeng Xu, Yue Fan, Zhanyu Wang","doi":"10.1111/jpc.70058","DOIUrl":"10.1111/jpc.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Identifying temporal trends in children with peptic ulcer disease (PUD) could enhance public awareness and inform future policy development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilising data from GBD 2021, we analysed the incidence, prevalence and age-specific rates (ASR) of children with PUD from 1990 to 2021, conducting stratified analyses based on regional temporal variations. A Bayesian age-period-cohort (BAPC) model was employed to project the global burden of children with PUD over the next 15 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Globally, both the incidence and prevalence of children with PUD exhibited a marked decline, with incidence and prevalence cases decreasing by 0.93% and 3.67%, respectively. Regions with lower sociodemographic index (SDI) bore a heavier burden, with the highest incidence and prevalence observed in Oceania, Western sub-Saharan Africa and the Caribbean in 2021. By 2035, the global incidence and prevalence of children with PUD are projected to further decline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While the global burden of children with PUD had significantly decreased, regional disparities persist. Low-SDI countries continue to face disproportionately high incidence and prevalence rates, warranting sustained attention and intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"957-966"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040890","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":"Historic First Global Status Report on Drowning Prevention Highlights Challenges and Opportunities for Preventing Drowning Among Children and Adolescents","authors":"Sanghamitra Pati, Arohi Chauhan, Puspa Raj Pant, Bhagabati Sedain, Amy E. Peden","doi":"10.1111/jpc.70057","DOIUrl":"https://doi.org/10.1111/jpc.70057","url":null,"abstract":"<p>Drowning disproportionately impacts children and young people around the world. The historic inaugural Global Status Report on Drowning Prevention (GSRDP) sheds further light on this preventable cause of injury-related mortality and morbidity [<span>1</span>].</p><p>Children under 15 years of age account for 43% of the global drowning burden, with 130 000 deaths in 2021. Globally, drowning is the fourth leading killer of 1–4 year-olds and the third leading killer of 5–14 year-olds (Table 1) [<span>1</span>]. In the World Health Organisation (WHO) South-East Asian region, drowning is the third leading cause of death of children aged 5–14 years, and the 0–4 year age group records the third highest drowning rate in the world) [<span>1</span>]. Many countries, including India and Nepal, are facing growing drowning risks due to changing interaction with water and the increasing impacts of disasters. Even in high-income countries, such as Australia and the United States, drowning fatalities are on the rise in recent years [<span>2, 3</span>].</p><p>While effective drowning prevention interventions exist for all ages, there are several specific to children [<span>4</span>]. These include awareness raising campaigns and community-level interventions such as daycare services for pre-school children, swimming and water safety training for school aged children and the installation of barriers near water.</p><p>However, global implementation remains limited. The Status Report indicates only 28% of the 139 member states who participated reported having day-care services for pre-school children [<span>1</span>]. This is despite the well-documented dual benefits of day-care-reducing drowning risk through active supervision, while simultaneously supporting early childhood development [<span>5</span>]. For some countries, there remain challenges to implementation due to resource constraints, administrative hurdles, and cultural factors hindering implementation, in particular in rural areas where drowning risk is higher, yet community-based efforts show promise [<span>6</span>].</p><p>The GSRDP indicates implementation is slightly higher for swimming and water safety training for school-aged children, at 28% of member states [<span>1</span>]. Despite the provision of technical guidance from the WHO, the unique challenges to implementation in low-resource settings, where the drowning burden is greatest, remain [<span>4, 7</span>]. India reports limited subnational coverage of swimming and water safety education in the school curriculum, with a lack of awareness, standardised protocols, and policy prioritisation acting as key barriers to wider implementation, as well as a need for swimming skills training and safe places within which to conduct lessons [<span>8</span>]. In Nepal, efforts are underway to address the near total absence of water safety education in schools at the municipal level through sub-national and localised drowning prevention strategies, supp","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"817-819"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909235","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":"C-Reactive Protein Diagnostic Value for Bacterial Infections","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1111/jpc.70059","DOIUrl":"10.1111/jpc.70059","url":null,"abstract":"<p>Dear Editor,</p><p>we hereby comment on the publication on “C-reactive protein diagnostic value for bacterial infections in the paediatric emergency department setting” [<span>1</span>] This study sheds light on the association between CRP levels and bacterial infections in a paediatric emergency room (PER). A retrospective cohort method is excellent for analysing big data sets and identifying patterns in CRP levels across clinical outcomes. However, greater information about the many types of bacterial infections implicated would have been beneficial to this study. Because CRP responses vary widely depending on the causal infection, data disaggregation by bacterial species may improve the findings' interpretability. Furthermore, the lack of microbiological confirmation of bacterial illnesses, along with the reliance on clinical diagnosis rather than laboratory-confirmation, limits the accuracy of findings regarding CRP's diagnostic value. Although the link between CRP and clinical symptoms like fever and leukocytosis is useful, the study should assess other potential factors that could influence CRP levels, such as underlying disease, antibiotic use history, and vaccine history. The omission of these factors is a notable limitation, as their inclusion could have improved the ability of CRP to distinguish severe illness and provided more comprehensive insights into its diagnostic value.</p><p>The sensitivity and specificity data offered highlighted critical difficulties. CRP has moderate specificity (about 60%) for bacterial infections at thresholds of 2 mg/dL and above, but low sensitivity, particularly at high thresholds (e.g., < 50%at CRP ≥ 5 mg/dL). This shows that CRP alone may not be a valid independent biomarker for identifying bacterial infections in children, emphasising the importance of additional diagnostic techniques. Although this study successfully shows a link between CRP levels and demographic characteristics such as age, it fails to investigate the role of these variables in more depth. For example, younger children frequently have different reactions to CRP than older children and adults, and this age-related variance must be better understood. Stratifying patients based on age and other pertinent characteristics may improve CRP's diagnostic usefulness.</p><p>Looking to this work raises several key questions that could inform future research. First, how can CRP be incorporated into diagnostic algorithms for bacterial infections in paediatric crises, particularly when paired with other biomarkers such as procalcitonin (PCT) and clinical observations [<span>2</span>], and what function does CRP play in early detection of infection? According to the literature [<span>2</span>], multi-panel diagnostic markers, which include PCT, is proposed to provide improved diagnostic properties. According to systematic review, both indicators are beneficial in directing antibiotic therapy, with PCT demonstrating a more dynamic response to","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"998-999"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998451","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}
Samantha Ting, Kelvin Truong, Gloria Fong, Melanie Wong, Andrew Ming
{"title":"Ruxolitinib for STING-Associated Vasculopathy With Onset in Infancy: A Case Report","authors":"Samantha Ting, Kelvin Truong, Gloria Fong, Melanie Wong, Andrew Ming","doi":"10.1111/jpc.70060","DOIUrl":"10.1111/jpc.70060","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"981-984"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005927","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}