Journal of paediatrics and child health最新文献

{"title":"Characteristics of children and adolescents with recurrent mental health emergency visits and clinicians' intervention tendencies.","authors":"Oguz Bilal Karakus, Ipek Suzer Gamli, Cemre Yasoz, Irem Yildirim, Ibrahim Adak","doi":"10.1111/jpc.16688","DOIUrl":"https://doi.org/10.1111/jpc.16688","url":null,"abstract":"<p><strong>Aim: </strong>Mental disorders affect approximately 15%-20% of childhood. However, due to various factors, these individuals do not benefit sufficiently from mental health services. Therefore, psychiatry emergency services become a key system in the need of psychiatric care for these children. This study aims to reveal the factors that predict recurrent admissions in children and adolescents admitted to the emergency department of a psychiatric hospital and the tendencies of clinicians during management.</p><p><strong>Methods: </strong>In our study, the data of patients aged 0-18 years who applied to the emergency department between 1 March 2022 and 01 March 2023 were scanned retrospectively. Participants who applied once were included in the 'single applicant' group, whereas patients who applied two or more times were included in the 'repeated applicants' group.</p><p><strong>Results: </strong>A total of 1563 emergency applications were recorded by 785 different patients. A total of 62.2% of the patients visited the emergency department once, while 37.8% applied two or more times. Non-suicidal self-injury, delusion/hallucination, irritability and depression were significantly higher in recurrent applicants (P < 0.05). Psychotic disorder, bipolar disorder, major depression and borderline personality traits were significantly frequent in these patients (P < 0.05). Additionally, it was determined that the number of psychiatric diagnoses, referral time, need for chemical restraint, having a diagnosis of psychotic disorder or borderline personality traits increased the likelihood of recurrence.</p><p><strong>Conclusions: </strong>Our results indicate some special risk factors that increase the likelihood of recurrent emergency admissions in children and adolescents. Further research with larger sample sizes may elucidate the unique needs of these children in order to use of community resources beneficially.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391267","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 clinical image of cutaneous neonatal lupus erythematosus","authors":"Shalini Verma","doi":"10.1111/jpc.16692","DOIUrl":"10.1111/jpc.16692","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"60 11","pages":"770"},"PeriodicalIF":1.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391314","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":"Letter to the Editor.","authors":"Qian Zhang","doi":"10.1111/jpc.16687","DOIUrl":"https://doi.org/10.1111/jpc.16687","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391269","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":"Novel pathogenic variant in GATA6 causes neonatal diabetes mellitus due to pancreas malformation and congenital heart disease.","authors":"María Tornero-Hernández, Alba Cayuela-Hernández, Clara Chover-Martínez, Sara León-Cariñena, Juan Diego Toledo, Sergio Martín-Zamora, Álvaro Solaz-García","doi":"10.1111/jpc.16683","DOIUrl":"https://doi.org/10.1111/jpc.16683","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381109","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":"Psychosocial impact of alopecia areata in paediatric and adolescent populations: A systematic review.","authors":"Isabella J Tan, Mohammad Jafferany","doi":"10.1111/jpc.16678","DOIUrl":"https://doi.org/10.1111/jpc.16678","url":null,"abstract":"<p><p>Alopecia areata is an autoimmune disorder characterised by sudden hair loss, and can range from patchy baldness to more severe forms such as alopecia totalis and universalis. Hair loss can have a profound impact on self-esteem and body image, particularly during childhood and adolescence. Understanding the psychosocial impact of alopecia areata in paediatric and adolescent populations is crucial to address the emotional and social challenges faced by these patients. The aim is to review the existing literature for clinical studies and reports investigating the psychosocial impact of alopecia areata in paediatric and adolescent populations. A systematic review of the literature was performed using PubMed, Cochrane and Embase databases from inception to July 2023. Included articles assessed the psychosocial impact of alopecia areata in paediatric and adolescent populations. Of 79 total articles, 10 were identified as meeting the inclusion criteria. Several studies highlighted self-esteem, emotional distress and social challenges as features of psychosocial manifestations. Factors such as stress, psychiatric comorbidities and familial issues are significantly associated with alopecia areata in these populations. The heterogeneity of studies precluded data synthesis and analysis. A majority of the included studies evaluated short-term findings. Alopecia areata has significant psychosocial impacts in paediatric and adolescent populations, with studies emphasising the negative effects on self-esteem, body image and quality of life. Additional research is required to better elucidate this relationship and draw meaningful conclusions to guide clinical support and interventions.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391270","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":"Subclinical left ventricular dysfunction and laboratory predictor of activity in children with ulcerative colitis: A single-centre study.","authors":"Ahmed Said Behairy, Gehan Hussein, Ahmed Afifi, Mary Michel, Amera M Hasnoon","doi":"10.1111/jpc.16681","DOIUrl":"https://doi.org/10.1111/jpc.16681","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to detect subclinical cardiac impairment in children with ulcerative colitis (UC) and test the association between absolute monocytic count (AMC) and lymphocyte-to-monocyte ratio (LMR) with disease activity.</p><p><strong>Methods: </strong>A group of children with UC and a comparable group as healthy controls were included. All children underwent history-taking, clinical examination and blood testing for complete blood counts with white blood cell differentials, LMR and erythrocyte sedimentation rate (ESR). Disease severity was assessed using the Paediatric UC Activity Index score. We used echocardiography for tissue Doppler, M-Mode, two-dimensional and three-dimensional (3D) speckle tracking echocardiography (STE) for left ventricular function assessment.</p><p><strong>Results: </strong>Forty children were included, 20 with UC as cases, and 20 healthy controls. Disease activity was mild in 75% cases and moderate in 25% cases. Cases had significantly higher ESR than the control group (P < 0.001). Among cases, positive correlations were observed between monocytic, and platelet counts with left ventricular end-diastolic diameter (r = 0.5, P = 0.02; r = 0.5, P = 0.03). Children with UC had significantly lower ejection fraction and impaired left ventricular systolic function compared to the control group (P < 0.001) assessed by 3D STE, yet this observation was not reached by the conventional method (P = 0.3).</p><p><strong>Conclusions: </strong>In children with UC, 3D STE could detect subclinical left ventricular systolic dysfunction that conventional echocardiography could not. AMC and LMR showed no significant difference between children with UC and controls.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377977","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":"Empowering general practitioners to diagnose and treat attention-deficit/hyperactivity disorder: Insights from an Australian pilot program","authors":"Alison Poulton,&nbsp;Simone Heiler,&nbsp;Jessica Bedford,&nbsp;Lujing Liu,&nbsp;Marilyn Dyson,&nbsp;Habib Bhurawala","doi":"10.1111/jpc.16684","DOIUrl":"10.1111/jpc.16684","url":null,"abstract":"&lt;p&gt;As the number of Australians seeking treatment for attention-deficit/hyperactivity disorder (ADHD) has been steadily increasing,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; this has put increasing strain on the pathways to treatment. In 2023, the Australian Senate published a report on Assessment and support services for people with ADHD, noting the barriers to accessing assessment and treatment for ADHD.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The government has yet to respond. A particular issue was the limited capacity and high costs of specialist treatment. These findings are consistent with the 2019 Henry Review,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; which identified a serious problem with access to ADHD services for young people in New South Wales.&lt;/p&gt;&lt;p&gt;The difficulties with accessing specialist treatment for ADHD are putting increased pressure on general practitioners (GPs). A recent survey of Australian GPs found that 92% had identified ADHD in one or more of their patients within the previous year,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; but inadequate access to specialists for diagnosis and treatment was a major concern.&lt;/p&gt;&lt;p&gt;In order to address this bottleneck, we are piloting a model of integrated care with upskilled GPs. Our model differs from the pilot study of integrated GP-paediatrician care by Hiscock and colleagues in Victoria.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; In that study, the paediatricians attended the individual practices to support the GPs with paediatric consultations. Our study relates solely to ADHD in individuals aged 4–25 years, diagnosed in childhood. With this particular cohort of patients, it is more time-efficient to train GPs in a specialised ADHD clinic. The GPs work at the weekly ADHD clinic for 3 months under supervision and are delivered a four-module course on ADHD. After an assessment of competence, they are authorised to diagnose and treat children and adolescents with ADHD independently in general practice.&lt;/p&gt;&lt;p&gt;Three GPs have qualified from this program since June 2023 and are running a weekly ADHD clinic in primary care. Between them, they see up to six new patients per week and have enrolled 98 participants in the ethically approved pilot study. They now have a 4-week waiting time and are receiving referrals from Orange to Sydney. Reflections from the GPs are given in Table 1.&lt;/p&gt;&lt;p&gt;We will shortly review our first year in terms of the number treated, clinical outcomes and patient satisfaction. The clinical outcomes of interest are changes in teacher ratings using the IOWA Conners,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; growth parameters and adverse effects of medication (including medication changes made due to side effects). In the long term, we hope to increase the capacity for treating ADHD within the Nepean Blue Mountains Local Health District. This model of care could be expanded to include adults and implemented in other districts across Australia (in the first instance expanded into a multicentre study), ultimately empowering GPs to provide accessible, holistic care to t","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"60 11","pages":"768-769"},"PeriodicalIF":1.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16684","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372083","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":"Oral feeding practices in medically complex infants receiving prolonged high-flow nasal cannula support: A retrospective cohort study.","authors":"Emily Cox, Jasneek Chawla, Madison Moore, Sandra Schilling, Miriam Cameron, Sally Clarke, Chelsea Johnstone, Jeanne Marshall","doi":"10.1111/jpc.16679","DOIUrl":"https://doi.org/10.1111/jpc.16679","url":null,"abstract":"<p><strong>Aim: </strong>To characterise the feeding profile and care pathway for infants receiving prolonged high-flow nasal cannula (HFNC) respiratory support for management of a chronic condition at one facility from January to December 2021.</p><p><strong>Methods: </strong>Data regarding medical history, HFNC admission details (reason for HFNC, HFNC duration, flow rate), feeding outcomes and speech pathology care were collected from electronic records of HFNC-dependent infants (requiring HFNC ≥2-3 L/kg for ≥5 consecutive days). Infants with acute respiratory conditions (e.g. bronchiolitis) were excluded.</p><p><strong>Results: </strong>This study included 24 participants (median corrected age at admission 5.3 weeks, range -6 to 18.6). Of these, 15 (60%) had a condition/s that affected more than one body system (e.g. congenital diaphragmatic hernia), requiring the care of multiple specialities. Median length of HFNC use was 37.5 days (range 11-188). Twenty (83.3%) infants were referred for speech pathology (SLP) input while on HFNC support. For those referred, frequency of SLP input was variable (0-3 sessions/week), and HFNC support requirements were the most common barrier to SLP intervention (n = 9, 45%). Twelve (54.5%) infants demonstrated improvement in their primary feeding method by discharge; however, only two (9.1%) infants were discharged on full oral feeds.</p><p><strong>Conclusions: </strong>This study demonstrates variability in oral feeding management in infants with prolonged HFNC-dependence at our centre. Respiratory support with HFNC was identified as a barrier to progressing oral feeding. Further research is required to determine if oral feeding can be safely undertaken in this cohort. This is imperative to ensure that long-term feeding outcomes are not negatively impacted by current practice.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348574","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 Force is strong with this one","authors":"Mick O'Keeffe","doi":"10.1111/jpc.16680","DOIUrl":"10.1111/jpc.16680","url":null,"abstract":"&lt;p&gt;And now here you are. Last day of training.&lt;/p&gt;&lt;p&gt;New job as a consultant paediatrician starting soon.&lt;/p&gt;&lt;p&gt;Taking a moment to look back on your journey to this point.&lt;/p&gt;&lt;p&gt;Fleeting images strung together, a montage of your rise through the ranks.&lt;/p&gt;&lt;p&gt;You recall the early inklings of a professional affinity.&lt;/p&gt;&lt;p&gt;Perhaps your student immersion in paediatrics piqued your curiosity.&lt;/p&gt;&lt;p&gt;No other rotation came close.&lt;/p&gt;&lt;p&gt;Maybe as a junior doctor you found yourself volunteering to see the youngsters in a mixed emergency department, with colleagues only too happy for you to take on this responsibility.&lt;/p&gt;&lt;p&gt;‘A bit of a knack’ with kids? You wondered whether you might be on to something.&lt;/p&gt;&lt;p&gt;Others noticed and gave encouragement. &lt;i&gt;You should think about paediatrics……&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;Think about it you did. Felt it as well.&lt;/p&gt;&lt;p&gt;Something special in these encounters.&lt;/p&gt;&lt;p&gt;You met the unblinking gaze of wary toddlers, the boisterous fidgeting of primary schoolers, the half-smile of self-conscious teenagers, and wondered each time; ‘How can I best help you today, cherished child?’&lt;/p&gt;&lt;p&gt;A feeling that……&lt;i&gt;what could possibly be better than this?!&lt;/i&gt;&lt;/p&gt;&lt;p&gt;Your decision was made. To test the waters, to dive into paediatrics training.&lt;/p&gt;&lt;p&gt;Starry-eyed ambitions soon crashed up against the reality of the task ahead.&lt;/p&gt;&lt;p&gt;The grind.&lt;/p&gt;&lt;p&gt;The daily worksheet. Overtime. Night shifts. Weekends.&lt;/p&gt;&lt;p&gt;Study somehow shoehorned into the remainder of a week, month after month after….&lt;/p&gt;&lt;p&gt;Trying to help your loved ones understand. Thankful that they did.&lt;/p&gt;&lt;p&gt;Gratitude also for the work itself. The adrenaline charge of the life-threatening. The intricacies of each subspecialty. The challenge of weaving together the threads of complex care. The slow-burning turnaround of the developmental and behavioural.&lt;/p&gt;&lt;p&gt;The unique therapeutic triad; a child, their parents, and you.&lt;/p&gt;&lt;p&gt;Brain crammed with knowledge, skills polished bright, you took a deep breath and entered the pressure chamber of exams. Nowhere to hide in there. Under the intense gaze of peer review, you summoned your best……and unlocked your future.&lt;/p&gt;&lt;p&gt;Elation!&lt;/p&gt;&lt;p&gt;And then…. post-exam blues.&lt;/p&gt;&lt;p&gt;A strange feeling of having summited……only to realise that greater peaks, previously hidden, lay beyond. The expedition needed to resume.&lt;/p&gt;&lt;p&gt;More years of advanced apprenticeship. Yet another level reached.&lt;/p&gt;&lt;p&gt;And having now arrived at this point, how will the world react?&lt;/p&gt;&lt;p&gt;Pride from your family of course.&lt;/p&gt;&lt;p&gt;A low-key acknowledgement from friends and workmates.&lt;/p&gt;&lt;p&gt;A certificate.&lt;/p&gt;&lt;p&gt;Precious little fanfare. No coronation ceremony.&lt;/p&gt;&lt;p&gt;Bit of an anti-climax?&lt;/p&gt;&lt;p&gt;Do not be fooled. This IS a momentous day!&lt;/p&gt;&lt;p&gt;After all the long years of study, training and working……finally achieving your dream of becoming a specialist paediatrician.&lt;/p&gt;&lt;p&gt;A watershed in your professional life.&lt;/p&gt;&lt;p&gt;Those of us who have walked this same path are proud of you.&lt;/p&gt;&lt;p&gt;Excited for you","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"60 11","pages":"767"},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348575","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":"Inguinal hernias in children: Update on management guidelines","authors":"Mariana Morgado,&nbsp;Andrew JA Holland","doi":"10.1111/jpc.16677","DOIUrl":"10.1111/jpc.16677","url":null,"abstract":"<p>Inguinal hernia repair is one of the most performed procedures in children, but aspects of care remain controversial. The aim of this review was to provide a critical appraisal of recently published guidelines on the management of inguinal hernias in children, by the American Academy of Pediatrics (2023) and the European Pediatric Surgeons' Association Evidence and Guideline Committee (2022). This was achieved by delineating areas of controversy and reviewing the most relevant recent literature on these topics. Currently available moderate-to-low quality evidence recommends postponing hernia repair in premature infants until after discharge, to reduce the risk of respiratory difficulties and recurrence. Laparoscopic repair provides similar outcomes to open but may shorten operative time in bilateral cases. No clear recommendation can be made for contralateral exploration, therefore should be evaluated case by case. In preterm infants, consideration of regional anaesthesia may reduce post-operative apnoea and pain, with no difference in neurodevelopment outcomes.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"60 11","pages":"648-653"},"PeriodicalIF":1.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348573","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}