Paediatrics and Child Health (United Kingdom)最新文献

A practical approach to high-risk foreign body ingestion in children 儿童高危异物误食的实用方法

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-28 DOI: 10.1016/j.paed.2025.05.001

Sarah Stibbards

{"title":"A practical approach to high-risk foreign body ingestion in children","authors":"Sarah Stibbards","doi":"10.1016/j.paed.2025.05.001","DOIUrl":"10.1016/j.paed.2025.05.001","url":null,"abstract":"<div><div>Children commonly present with a history of witnessed or unwitnessed ingested foreign body (FB). Most are low risk objects, with the child or young person remaining asymptomatic enabling management without imaging or intervention. However, there are a several high-risk objects and clinical scenarios where it is important to have high clinical suspicion as they can cause serious injury if they remain in the gastrointestinal tract. Such injuries include oesophageal obstruction, perforation, fistulae into surrounding structures e.g. trachea, blood vessels, and bowel obstruction or perforation and can lead to long term complications or death. Button battery ingestion is particularly dangerous as necrosis, erosion and perforation can occur within hours and even after the battery has been removed, serious complications can still develop days, weeks, or months later. Currently there is not enough research to agree a standard approach following the ingestion of all FBs. This article aims to allow clinicians to follow a standardised approach and enact safe management of ingested FBs in children, whilst avoiding unnecessary investigation or ionising radiation. It includes guidance on which patients can go home safely without investigation or follow-up, which patients require investigations and which patients require emergent or urgent intervention by specialty teams.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 7","pages":"Pages 221-226"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Point-of-care ultrasound in paediatric clinical practice: transforming tomorrow today 儿科临床实践点超声：今天改变明天

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-20 DOI: 10.1016/j.paed.2025.05.003

David J McCreary, Niall Mullen

引用次数: 0

Post COVID-19 paediatric inflammatory syndrome (PIMS-TS/MIS-C): what have we learned? COVID-19后儿童炎症综合征（PIMS-TS/MIS-C）：我们学到了什么？

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-20 DOI: 10.1016/j.paed.2025.05.005

David Reynolds, Patrick Davies

{"title":"Post COVID-19 paediatric inflammatory syndrome (PIMS-TS/MIS-C): what have we learned?","authors":"David Reynolds, Patrick Davies","doi":"10.1016/j.paed.2025.05.005","DOIUrl":"10.1016/j.paed.2025.05.005","url":null,"abstract":"<div><div>During the early phase of the COVID-19 pandemic, PIMS-TS emerged as a new hyper-inflammatory disorder affecting children. These children were often unstable requiring admission to critical care. Children with PIMS-TS displayed symptoms mimicking other inflammatory processes but it was quickly apparent this was a novel condition requiring its own treatment regime. Through international co-operative resource sharing, agreement grew over several treatment options including biological agents, IVIG and steroids leading to consensus guidance based on anecdotal and limited observed data. As our understanding of COVID-19 grew with each wave of the pandemic, so has our understanding of PIMS-TS. Several large trials, including the RECOVERY and BATS trials, are now able to provide an evidence base for the treatment of this condition, and challenge some of the management practices that were widely utilized. IV Immunoglobulin, for example, has been shown not to change outcomes and would therefore no longer be recommended for treatment, whereas methylprednisolone did show some improvements over usual supportive care. Epidemiology data shows PIMS-TS to have been a temporally limited condition, reducing in prevalence with each variant of COVID-19. Looking at overall outcome data, this was thankfully a condition with overall very low mortality and limited long term morbidity.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 7","pages":"Pages 247-252"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to interpret creatine kinase level in neuromuscular conditions 如何解释肌酸激酶在神经肌肉疾病中的水平

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-16 DOI: 10.1016/j.paed.2025.05.004

Nermin Alashal, Nahin Hussain

{"title":"How to interpret creatine kinase level in neuromuscular conditions","authors":"Nermin Alashal, Nahin Hussain","doi":"10.1016/j.paed.2025.05.004","DOIUrl":"10.1016/j.paed.2025.05.004","url":null,"abstract":"<div><div>Creatine kinase (CK) is a screening diagnostic test for suspected neuromuscular disease. It is a sensitive indicator of muscle injury and is preferred to other skeletal muscle enzymes as it is least affected by haemolysis, is readily released in cellular injury and has a relative predominance in skeletal muscle. In a healthy individual the normal range varies between 22 and 200 IU/L (varies with laboratory), although gender and race can influence this range. CK can also be elevated in non-pathological transient situations such as cramps and post-exercise. It can increase up to three times the normal value after strenuous exercise, intramuscular injections, EMG studies and viral infections. Highest level of CK is seen in inflammatory myopathies and in early stages of DMD when patients are still ambulant. Occasionally CK is elevated in asymptomatic or mildly symptomatic children and this creates unwarranted anxiety and diagnostic uncertainties. The need for extensive ancillary investigations and muscle biopsy in clinically normal individuals with elevated CK remains an unresolved issue. This review discusses the diagnostic value of creatine kinase in neuromuscular conditions in children and offers practical advice about how results should be interpreted in different clinical situations.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 7","pages":"Pages 241-246"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From inquisitive toddlers to adventurous teenagers: how to navigate paediatric minor injuries 从好奇的幼儿到冒险的青少年：如何处理儿科轻伤

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-15 DOI: 10.1016/j.paed.2025.05.002

Melissa Leadbetter, Laura Duthie

引用次数: 0

Self-assessment 自我评估

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-13 DOI: 10.1016/j.paed.2025.05.006

Leon Srikantha, Peter Heinz

引用次数: 0

Managing difficult intravenous access: obtaining and maintaining paediatric vascular access 处理困难的静脉通路：获得和维持儿科血管通路

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-08 DOI: 10.1016/j.paed.2025.04.002

Wei Yen Evelyn Chia

引用次数: 0

Renal replacement therapy in the paediatric intensive care unit 儿科重症监护病房的肾脏替代疗法

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-06 DOI: 10.1016/j.paed.2025.04.006

Rajalakshmi Iyer, Nalaayeni Kanesan, Oluwaseun Ajayi, Arun Ghose

{"title":"Renal replacement therapy in the paediatric intensive care unit","authors":"Rajalakshmi Iyer, Nalaayeni Kanesan, Oluwaseun Ajayi, Arun Ghose","doi":"10.1016/j.paed.2025.04.006","DOIUrl":"10.1016/j.paed.2025.04.006","url":null,"abstract":"<div><div>Acute kidney injury (AKI) and chronic kidney disease (CKD) are significant concerns in paediatric intensive care units (PICUs), with AKI affecting up to 50% of critically ill children. Renal replacement therapy (RRT) is essential for managing these conditions, with available modalities including intermittent haemodialysis (IHD), continuous renal replacement therapy (CRRT), and peritoneal dialysis (PD). This article defines AKI and CKD based on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines and outlines the key indications for RRT, such as severe electrolyte abnormalities, fluid overload exceeding 10%, metabolic acidosis and toxin clearance. The fundamental principles of solute clearance in RRT—including diffusion, ultrafiltration, convection, and adsorption—are explained. Additionally, the article reviews essential considerations such as vascular access, anticoagulation strategies and the unique challenges of RRT in neonates and children requiring extracorporeal life support (ECLS). CRRT allows precise and gradual solute and fluid removal, making it ideal for haemodynamically unstable patients. However, it requires an extracorporeal circuit, large-bore vascular access and anticoagulation which can pose challenges, particularly in neonates. In contrast, PD can be initiated quickly via a percutaneous catheter, avoiding the risks associated with central venous access (thrombosis and bleeding). Conversely PD solute and fluid clearance rates are less effective than CRRT, and it is unsuitable for patients with recent abdominal surgery or congenital anomalies. The choice of RRT modality depends on the child's clinical condition, available resources, and institutional expertise. This review highlights the need for individualised RRT strategies to improve outcomes and survival in critically ill children.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 6","pages":"Pages 196-202"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to assess and manage headache in children: the basics 如何评估和管理儿童头痛：基础

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.001

Elizabeth Liew, William P Whitehouse

引用次数: 0

Beyond valproate: considerations for the general paediatrician 丙戊酸以外：普通儿科医生的注意事项

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.005

Alison Skippen, Rohini Rattihalli

引用次数: 0