Journal of paediatrics and child health最新文献

{"title":"Optimising Symptom-Based Endoscopy Decision Making in Paediatric Corrosive Ingestion","authors":"Shaher Yar, Muhammad Taimur Hasan, Zainab Afzal, Zahin Shahriar","doi":"10.1111/jpc.70169","DOIUrl":"10.1111/jpc.70169","url":null,"abstract":"<p>We were very interested in the study by Ateş et al. [<span>1</span>] called ‘Corrosive substance ingestion: When to perform endoscopy?’ that was published in your journal. The authors present a useful symptom-based algorithm for deciding whether a child who has ingested corrosive substances needs an endoscopic evaluation. This is a big step forward for evidence-based emergency paediatric care.</p><p>It is especially interesting that the proposed algorithm focuses on hypersalivation and dysphagia as the main signs for endoscopy. This approach is in line with current research that shows that clinical symptoms are good indicators of serious oesophageal injury [<span>2</span>]. The fact that 27.9% of patients had no symptoms and no complications strongly supports the safety of conservative management in carefully chosen cases.</p><p>Recent studies have shown that symptom-based approaches are even more useful. For example, the DROOL score (Drooling, Reluctance, Oropharynx, Others, Leukocytosis) has been shown to be very good at predicting oesophageal injuries, with a sensitivity of 94.4% and a specificity of 76.9% [<span>3</span>]. This scoring system works well with the algorithm suggested by Ateş et al. and gives doctors more objective criteria to use when making decisions.</p><p>This study has real-world effects that go beyond just caring for one patient. In places where resources are limited and endoscopic capabilities may be limited, the ability to safely avoid unnecessary procedures while still providing high-quality care is especially useful. The authors' algorithm could cut down on unnecessary endoscopies by 63%, which would be a big improvement in resource use without putting patients at risk [<span>4</span>].</p><p>We do, however, think that some areas need more thought. First, we should pay special attention to how well the algorithm works in very young children (under 2 years) who may not be able to clearly show symptoms. Second, it would be helpful to go into more detail about the role of chest x-rays and how they fit into the decision-making process, especially when the clinical presentation is unclear.</p><p>Long-term outcomes and the growth of oesophageal strictures are also very important things to think about. The study is mostly about acute management; however, follow-up protocols for patients who were treated conservatively could make this algorithm more useful in real life [<span>5</span>].</p><p>In conclusion, Ateş et al. have given us a useful, evidence-based way to deal with a difficult clinical situation. Their symptom-based algorithm is a big step forward in how to handle corrosive ingestion in children. It could help make better use of resources while keeping safety standards high. We suggest that this algorithm be tested in larger, multicentre groups to further prove its usefulness in the clinic.</p><p>The authors have nothing to report.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of ","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1705-1706"},"PeriodicalIF":1.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775601","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":"Massively Parallel Sequencing: Successes, Limitations and the Future for Inborn Errors of Metabolism","authors":"Sophie Manoy, Pauline McGrath, Sally Smith, Lauren Swan, Janette Spicer, Catherine Atthow, Jesse Somerville, Aoife Elliott, Sara O'Neill, Rhiannon Roberts, Laura Allen, Camron Ebzery, Melanie Boon, Carolyn Bursle, Michelle Lipke, Matthew Lynch, Anita Inwood, David Coman","doi":"10.1111/jpc.70164","DOIUrl":"10.1111/jpc.70164","url":null,"abstract":"<p>Inborn errors of metabolism (IEM) are a diverse group of inherited diseases from a presentation, natural history and diagnostic perspective [<span>1</span>]. They remain one of the few groups of primary genetic diseases where treatment options are available and established. The management of IEM varies based on the associated dysfunctional metabolic pathway, and central to the management of IEM is multi-disciplinary team care. Amongst others, this includes medical, nursing, dietetics, social work and genetic counselling [<span>2</span>].</p><p>Common presentations of IEM include acute small molecule intoxication, multi-system malformation disorders [<span>3</span>], global developmental delay and developmental regression [<span>2</span>]. Given the broad nature of these disorders, the expansion of genomics with massively parallel sequencing (MPS) has revolutionised some aspects of IEM investigation and management [<span>4</span>] with the highest yield applying to multi-system malformation or complex molecule disorders. The most notable of these is the investigation of mitochondrial respiratory chain (MRC) defects. For these disorders, MPS has become the first-line clinical and health economic approach and has almost made the use of invasive tissue biopsies redundant [<span>5, 6</span>]. The clinical presentations of MRC defects are heterogeneous but commonly include global developmental delay, developmental regression, cardiomyopathy, lactic acidosis, liver failure or facial dysmorphism [<span>7</span>], many of which may be first referred for general paediatric review.</p><p>Genomics with MPS includes exome sequencing (ES) and whole genome sequencing (WGS). ES is limited to exonic (protein-coding) information but is cheaper and faster to perform. WGS is more sensitive with full genome coverage, including coding and non-coding information, but is more costly, slower and can result in more challenging data interpretation with respect to relevant findings [<span>7</span>]. In Australia, ES is currently more accessible than WGS, but WGS is increasingly utilised overseas [<span>6</span>].</p><p>Through a series of cases, we aim to describe how MPS is influencing the diagnosis and management of IEM, including successes, limitations and looking to the future.</p><p>MPS has revolutionised the diagnostic yield in some areas of paediatric care and reduced the diagnostic odyssey for many families, particularly those presenting with multi-system disorders [<span>7</span>]. Should families wish to pursue this, a genetic diagnosis can provide clarity, optimise management through established evidence, allow families to connect with support/family groups and provide timely reproductive planning information [<span>8</span>]. Dignity in a diagnosis is an important factor for families, as is reproductive confidence. The turnaround time for MPS has considerably improved, and options such as rapid and ultra-rapid ES have become more accessible in Australia. This","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 9","pages":"1523-1528"},"PeriodicalIF":1.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775602","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":"Establishing Research Priorities for Children Living With Chronic Health Conditions: A Value-Weighting Study by Australian Caregivers","authors":"Louise Fisher,&nbsp;Macken Stirling,&nbsp;Renee Jones,&nbsp;Kris Pierce,&nbsp;Raghu Lingam,&nbsp;Glenn M. Marshall,&nbsp;Harriet Hiscock,&nbsp;Kim Dalziel","doi":"10.1111/jpc.70128","DOIUrl":"10.1111/jpc.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Improving the wellbeing of children with chronic health conditions and their caregivers can be maximised through research that addresses the priorities of this population. This study aimed to investigate the research topics and areas of care deemed most important to caregivers of children living with chronic health conditions in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A list of 25 research topics were presented in two rounds of a classic Delphi consensus survey to caregivers of children with chronic health conditions. Caregivers ranked these topics according to their perceived importance. High ranking topics were taken forward into a value-weighting exercise which was presented to a national sample of caregivers. In this exercise caregivers were asked to allocate hypothetical research funding units (FU) across research topics as well to different areas of care (Prevention, Screening and Early Detection; Newly Diagnosed; Receiving treatment; Finished treatment; Relapsed, receiving Palliative care; Significant Others [e.g., family members, friends, caregivers]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy five caregivers completed Delphi Survey 1, 45 completed Delphi Survey 2 and 252 completed the value-weighting exercise. In the value-weighting exercise, the research topic ‘Improve Access to Healthcare’ received the highest mean allocation of 23.42/100 FU (SD = 19.48), followed by ‘Improving Day to Day Functioning’ (mean allocation 17.37 FU [SD = 16.2]). The ‘Prevention, Screening and Early Detection’ area of care received the highest mean allocation of 27.47 FU (SD = 19.48).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the research priorities of caregivers of children living with chronic health conditions. This information can be used to guide future research and funding decisions in paediatric chronic health conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1646-1654"},"PeriodicalIF":1.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784529","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":"Using Digital Dashboards to Characterise Demographics and Service Utilisation of Multi-Tiered Outpatient Paediatric Feeding Clinics: Differentiated Care for Subtypes of Paediatric Feeding Disorder","authors":"Maryanne Syrmis,&nbsp;Olivia Taylor,&nbsp;Danielle McCoy,&nbsp;Nadine T. Frederiksen,&nbsp;Annabelle Lang","doi":"10.1111/jpc.70163","DOIUrl":"10.1111/jpc.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Digital dashboards are interactive, visual displays that provide real-time identification of clinical and service performance trends. Few studies have reported their use in characterising feeding clinic care for children with paediatric feeding disorder (PFD). This study used data from a digital dashboard at a children's hospital to compare populations and service utilisation across four outpatient feeding clinics: speech pathology-only (SP-only), dietetics and speech pathology (DT-SP), occupational therapy and speech pathology (OT-SP), and dietetics, occupational therapy, and speech pathology (DT-OT-SP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-centre, retrospective study used 2023 digital dashboard data to compare the demographics (i.e., cultural background) and service utilisation (e.g., appointment scheduling) of the four clinics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data relating to 551 children were analysed. Significant differences were found between clinics for demographics, wait times, scheduling, delivery methods, attendance, and outcomes. Children referred for suspected oropharyngeal dysphagia and infants were prioritised for earlier management, whereas those requiring OT-SP intervention waited longest. Infants received the most intensive hospital-based management, whereas children with oropharyngeal dysphagia did not require long-term hospital-based follow-up. Children in DT-OT-SP were more likely to receive telehealth appointments, whilst those in OT-SP had the lowest telehealth utilisation. Children from culturally and linguistically diverse communities were more likely to attend OT-SP or DT-OT-SP. OT-SP had a higher likelihood of missed appointments and was less likely to need a review waiting list.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings support multi-tiered multidisciplinary feeding clinics in addressing the clinical and service needs associated with different types of PFD. Results inform future development needs of digital dashboards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1637-1645"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760378","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 Unusual Case of Haemoptysis Secondary to Congenital Bronchial-Pulmonary Artery Shunt","authors":"Daryl Yuan Chong Yeo,&nbsp;Mahesh Babu Ramamurthy,&nbsp;Daniel Yam Thiam Goh,&nbsp;Michael Teik Chung Lim,&nbsp;Chee Wen Terence Lim,&nbsp;Stanley Eu Kuang Loh","doi":"10.1111/jpc.70161","DOIUrl":"10.1111/jpc.70161","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1676-1680"},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731877","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":"Neutrophils and Lymphocytes With Characteristic Alder-Reilly Anomaly: Clues to the Diagnosis of Maroteaux-Lamy Syndrome","authors":"Lingrong He,&nbsp;Fang Long,&nbsp;Xiepeng Lu,&nbsp;Hongjuan Yu,&nbsp;Junge Zhang,&nbsp;Ting Li","doi":"10.1111/jpc.70162","DOIUrl":"10.1111/jpc.70162","url":null,"abstract":"&lt;p&gt;Mucopolysaccharidosis type VI (MPS VI), also known as Maroteaux-Lamy syndrome, is a rare lysosomal storage disorder, characterised by a wide syndromic manifestation involving skeletal abnormalities, including short and wide thorax, macrocephaly, characteristic facial features and short limbs, hepatosplenomegaly, facial dysmorphism, and neurodevelopmental delay [&lt;span&gt;1, 2&lt;/span&gt;]. As is well known, one of the morphological features of mucopolysaccharidoses is the occurrence of numerous, large discrete metachromatic granules in leukocytes and often with a clear zone around them, also known as Alder-Reilly anomaly [&lt;span&gt;3&lt;/span&gt;]. Here, we describe a 7-year-old boy diagnosed as Maroteaux-Lamy syndrome, showing typical skeletal abnormalities and facial dysmorphism, as well as the presence of characteristic Alder-Reilly anomaly in the peripheral blood smears.&lt;/p&gt;&lt;p&gt;A 7-year-old boy was admitted because of recurrent cough for 30 days. A complete blood count revealed white blood cells 6.73 × 10&lt;sup&gt;9&lt;/sup&gt;/L with 51.7% lymphocytes, haemoglobin 139 g/L, and platelets 404 × 10&lt;sup&gt;9&lt;/sup&gt;/L. Physical examination revealed short-trunk short stature, macrocephaly, coarse facies, depressed nasal bridge, and bulging forehead. Peripheral blood smear showed 36% neutrophils, 52% lymphocytes, 8% monocytes and 4% eosinophils. Of note, many lymphocytes (Figure 1A–C) and neutrophils (Figure 1D–F) showed numerous intense azurophilic granules surrounded by clear halos, consistent with Alder-Reilly anomaly. The presence of these unique granules in the leukocytes raised a suspicion of Alder-Reilly anomaly and underlying MPS. Then, genetic sequencing was performed immediately by peripheral blood samples from this patient and his parent. ARSB [c.1197C&lt;G (p.F399L)] mutation was detected from the child and his father by whole exon sequencing. Haploidy deletion in the exon 2–3 region of the gene was present in the boy and his mother. All these findings confirmed the diagnosis of Maroteaux-Lamy syndrome.&lt;/p&gt;&lt;p&gt;Maroteaux-Lamy syndrome is an autosomal recessive lysosomal disorder caused by the deficiency of the enzyme arylsulfatase B, leading to the accumulation of dermatan sulfate in tissues. Morphologically, one of the most characteristic features of this rare disease is the presence of abundant dark lilac granules within neutrophils, lymphocytes and monocytes, with clear halos surrounding the granules. The granules in Alder-Reilly anomaly should be differentiated from toxic granulations, granulocyte colony-stimulating factor effect and Chediak-Higashi granules [&lt;span&gt;3&lt;/span&gt;]. The toxic granules are often found in patients with sepsis, toxic conditions, or growth factor therapy, showing larger granules that are increased in number but lacking surrounding halos. They can also be distinguished from Alder-Reilly anomaly by the presence of accompanying immature myeloid cells and the absence of granules in lymphocytes. Compared to Alder-Reilly anomaly, Chediak-Higashi, as","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1702-1704"},"PeriodicalIF":1.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731879","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":"Hard Lumps in Disguise: What's Beneath the Surface?","authors":"Jessica Win See Wong,&nbsp;Eloise Molan,&nbsp;Helen Puusepp-Benazzouz","doi":"10.1111/jpc.70159","DOIUrl":"10.1111/jpc.70159","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 8","pages":"1351-1353"},"PeriodicalIF":1.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731878","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":"Vitamin C Deficiency in Children: Clinical Characteristics, Testing Patterns and Management Outcomes at a Tertiary Paediatric Hospital","authors":"Thomas McFinnegan,&nbsp;Jennifer Anderson,&nbsp;Jacqueline Dalby-Payne,&nbsp;Jason Chung","doi":"10.1111/jpc.70158","DOIUrl":"10.1111/jpc.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the clinical characteristics and management outcomes of vitamin C deficiency in a paediatric tertiary hospital cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective review of all serum vitamin C tests from August 2020 to January 2023 at a tertiary paediatric centre. Vitamin C deficiency was defined as &lt; 40 μmol/L, with ≤ 10 μmol/L as critically deficient. Demographics, clinical indications, interventions and follow-up results were analysed using descriptive statistics, chi-square tests, Mann–Whitney U tests and logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1923 tests in 1350 patients (median age 8.4 years, 58.5% male), 25.2% were deficient (&lt; 40 μmol/L) and 5.4% critically low (≤ 10 μmol/L). Inpatients and older children had higher deficiency rates (<i>p</i> &lt; 0.001). Oncology and renal specialties demonstrated the highest deficiency yields. Age, inpatient status and oncology referrals independently predicted deficiency. Clinical indications included suspected scurvy symptoms (29%, deficiency yield 25.8%), routine screening (21%; yield 31.5%) and unclear reasons (49%; 22.2% yield). For patients with critical vitamin C deficiency (<i>n</i> = 86), oral vitamin C supplementation was most common (69%) and follow-up levels (available in 47%) showed improvement in 90%, with normalisation in 62.5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vitamin C deficiency was common in this paediatric cohort. Improved clinical vigilance, clearer documentation of test rationale and consistent follow-up practices could optimise outcomes for affected children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1630-1636"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707777","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 COVID-19 Lockdowns on Admissions to Paediatric and Adolescent Eating Disorder Units in Melbourne, Australia: A Multi-Centre Retrospective Observational Study","authors":"Christine Kwa,&nbsp;Shyharini Abeysinghe,&nbsp;Jacinta Coleman,&nbsp;Suba Rudolph,&nbsp;Michele Yeo,&nbsp;Rachel Schembri,&nbsp;Christopher Harding,&nbsp;Rhys Rumley,&nbsp;Raimah Ahmed,&nbsp;Hannah C. Cooney,&nbsp;Jessica Costa-Pinto","doi":"10.1111/jpc.70157","DOIUrl":"10.1111/jpc.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The COVID-19 pandemic saw an increase in paediatric eating disorder admissions worldwide. This multi-centre study aimed to determine the impact of COVID-19 lockdown measures on paediatric eating disorder admissions across Melbourne, Australia, where restrictions were among the harshest in the world, despite relatively low infection rates. We explored changes in markers of severity and factors contributing to increased admissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was completed of patients admitted under the four paediatric eating disorder units in Melbourne between April–September 2019 (“pre-COVID-19”) and 2020 (COVID-19). Overall monthly admission numbers were also compared from 2018 to 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Admissions increased by 55% from 2019 to 2020. In post-pandemic years (2022–2023), admissions decreased, but not to pre-pandemic levels. Length of stay decreased from a median of 12 days (IQR 7–18) in 2019 to 10 days (IQR 5–14) in 2020 (<i>p</i> = 0.045). In 2020, compared to 2019, there was an increase in patients with hypoglycaemia (OR 1.51; 95% CI 1.02, 2.23) and hypothermia (OR 1.84; 95% CI 1.26, 2.70). The perceived impact of COVID-19 was documented in 50.9% of 2020 admission records and identified as contributors to deterioration in 70.6% of these. Restrictions on schooling and activities, increased time to focus on disordered eating behaviours, and worsening mental health were the commonest lockdown-related factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>During the first year of the pandemic in Melbourne, there was a significant increase in eating disorder admissions and some markers of severity. Factors potentially contributing to deterioration and admissions should be considered in inpatient and outpatient management of children with eating disorders, and in future planning of social restrictions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 10","pages":"1621-1629"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707776","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":"Australasian Bronchiolitis PREDICT Guideline 2025: Evidence-Based Recommendations for Equity and Care Across Diverse Settings","authors":"Habib Bhurawala,&nbsp;Adam Jaffe","doi":"10.1111/jpc.70142","DOIUrl":"10.1111/jpc.70142","url":null,"abstract":"&lt;p&gt;Bronchiolitis remains the most common reason for hospitalisation in infants across Australia and Aotearoa New Zealand (AoNZ), particularly during colder months. To address long-standing variation in care and respond to new clinical data, the 2025 Australasian Bronchiolitis Guideline—produced by the Paediatric Research in Emergency Departments International Collaborative (PREDICT) offers timely, evidence-informed recommendations for the management of infants under 12 months of age [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Since the original 2016 guideline [&lt;span&gt;2&lt;/span&gt;], which aimed to establish consistency across emergency and inpatient settings, research has continued to evolve. The updated 2025 edition is a welcome expansion on the scope to include high-dependency and intensive care management (excluding mechanical ventilation), preventive strategies such as RSV immunoprophylaxis and vaccination, and specific considerations for SARS-CoV-2 co-infection.&lt;/p&gt;&lt;p&gt;The guideline recognises that bronchiolitis care often takes place outside major paediatric centres. As such, it advises clinicians to base decisions on available skills and local resources, not just the physical setting.&lt;/p&gt;&lt;p&gt;Importantly, it also addresses inequities in outcomes. While Indigeneity is not a clinical risk factor, Aboriginal, Torres Strait Islander Peoples, and Māori infants face systemic disadvantages that affect access and outcomes. The guideline emphasises the need for equitable implementation and culturally respectful care.&lt;/p&gt;&lt;p&gt;These recommendations were developed using the GRADE approach (Grading of Recommendations, Assessment, Development, and Evaluation) [&lt;span&gt;3&lt;/span&gt;], ensuring a transparent and structured review of the evidence.&lt;/p&gt;&lt;p&gt;This Australasian guideline aligns well with contemporary international guidance. For example, the UK NICE guideline uses similar oxygen thresholds, while the American Academy of Paediatrics (AAP) continues to advocate for the de-implementation of unnecessary treatments [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Australasian trials have had direct influence here, particularly in shaping the revised approach to HFNC. Local ICU studies also support the cautious endorsement of corticosteroid–adrenaline therapy in select cases of severe illness.&lt;/p&gt;&lt;p&gt;Further research will determine whether these findings apply across more varied clinical settings.&lt;/p&gt;&lt;p&gt;While the 2025 guideline is comprehensive in its hospital-based scope, it does not address the follow-up of infants once discharged, an area that is explored more directly in other respiratory guidelines, such as those for asthma. The exclusion of post-discharge strategies, including virtual care or remote monitoring, may limit opportunities to support families in the community and potentially reduce avoidable readmissions. These elements may have been outside the scope of the current document, but they represent important directions for future updates as healthcare delivery models evolve.&lt;/p&gt;&lt;p&gt;Some areas of the ","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 8","pages":"1347-1348"},"PeriodicalIF":1.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698875","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}