Paediatrics and Child Health (United Kingdom)最新文献

Preparing young people with neurodisability for transition to adult health services 为神经残疾青年过渡到成人保健服务做好准备

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-07-01 DOI: 10.1016/j.paed.2025.05.009

Elizabeth Homer, Sarah Hughes

引用次数: 0

Difficult-to-treat asthma: revisiting essential management principles 难治性哮喘：重新审视基本管理原则

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-06-19 DOI: 10.1016/j.paed.2025.05.011

Emine Nebati, Sejal Saglani

{"title":"Difficult-to-treat asthma: revisiting essential management principles","authors":"Emine Nebati, Sejal Saglani","doi":"10.1016/j.paed.2025.05.011","DOIUrl":"10.1016/j.paed.2025.05.011","url":null,"abstract":"<div><div>Difficult-to-treat asthma in children remains a significant clinical challenge, often resulting in high healthcare costs and poor outcomes. Despite many referrals to specialist centres, basic management principles are frequently overlooked, with premature escalation to high-dose corticosteroids. This review highlights the importance of a systematic approach to paediatric asthma, beginning with accurate diagnosis using objective tests such as spirometry and fractional exhaled nitric oxide (FeNO) and careful exclusion of alternative or co-existing diagnoses. Optimizing adherence, inhaler technique and environmental control—alongside identifying comorbidities such as allergic rhinitis, obesity and dysfunctional breathing—can dramatically improve outcomes in most cases without requiring advanced therapies. A multidisciplinary team approach, incorporating education, psychological support, and personalized asthma action plans, is essential. For children with truly severe therapy-resistant asthma (STRA), biologics offer promising control when traditional therapies fail, especially where modifiable factors are non-correctable. However, their use should follow thorough evaluation and shared decision-making. Ultimately, reinforcing fundamental asthma care in primary and secondary settings can prevent progression to specialist referral and reduce both direct and indirect healthcare burdens. Addressing modifiable factors enables over 70% of children with difficult asthma to achieve good control, emphasizing the need to revisit and reinforce core management strategies.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 8","pages":"Pages 282-288"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723373","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

Using a rights-based approach in the care of children and young people with disability: an introduction for paediatric practice 在照顾残疾儿童和青年方面采用基于权利的方法：儿科实践介绍

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-06-17 DOI: 10.1016/j.paed.2025.05.008

Alison McLuckie

{"title":"Using a rights-based approach in the care of children and young people with disability: an introduction for paediatric practice","authors":"Alison McLuckie","doi":"10.1016/j.paed.2025.05.008","DOIUrl":"10.1016/j.paed.2025.05.008","url":null,"abstract":"<div><div>Children with disabilities account for around 11% of the United Kingdom paediatric population and some attend frequently to healthcare services, both in the community and to secondary care. They are not a homogenous group and each child will have their own identity, needs and beliefs. As a group, however, they are particularly vulnerable to discrimination and may be more at risk of abuse and neglect. They may face additional barriers to having their voice heard and their rights fulfilled. The United Nations Convention on the Rights of the Child (UNCRC) makes specific provision for children with disabilities and exists alongside several other legal frameworks which aim to ensure that people with disability live as full and dignified a life as their peers. This article will examine which human rights provisions exist for children and young people with disability and which tools might be helpful for paediatricians and healthcare professionals to have awareness of to ensure that children and young people with disability have their rights considered when decisions are taken which affect them.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 8","pages":"Pages 263-266"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723371","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

Eyes on vision – functional visual assessment in the child with a disability: a practical assessment approach for paediatricians 视力上的眼睛-残疾儿童的功能视力评估：儿科医生的实用评估方法

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-06-13 DOI: 10.1016/j.paed.2025.05.007

Jenefer Sargent, Eleanor Yule

{"title":"Eyes on vision – functional visual assessment in the child with a disability: a practical assessment approach for paediatricians","authors":"Jenefer Sargent, Eleanor Yule","doi":"10.1016/j.paed.2025.05.007","DOIUrl":"10.1016/j.paed.2025.05.007","url":null,"abstract":"<div><div>Vision plays a critical role in early developmental processes and current functioning. Descriptions of current developmental skills are often confidently made by paediatricians without making explicit the ways in which visual materials are used by the child in everyday activities. When we describe how the child functions in the performance of tasks that involve vision and which are meaningful to everyday activity and participation, it is the child's functional vision that is being described. Although responsibility for vision assessment is often assumed to lie with the eye clinic, multiple aspects of functional vision assessment fall strongly within the scope of paediatric practice and of other members of the multidisciplinary team. Paediatricians can develop their ability to help parents of disabled children understand what their child can visually detect and interpret and use existing developmental knowledge to contribute to advice on the most appropriate format and style of visual materials to support play and learning. Confidence in assessment of functional visual skills will support such advice giving. A practical approach to such assessment is set out here.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 8","pages":"Pages 257-262"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723370","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

Diagnosis of intellectual disability: updates on multi-agency screening, assessment, reporting and interventions for children and young people 智力残疾诊断：儿童和青少年多机构筛查、评估、报告和干预措施的最新情况

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-06-11 DOI: 10.1016/j.paed.2025.05.010

Miranda Eodanable, Hannah MacLean

{"title":"Diagnosis of intellectual disability: updates on multi-agency screening, assessment, reporting and interventions for children and young people","authors":"Miranda Eodanable, Hannah MacLean","doi":"10.1016/j.paed.2025.05.010","DOIUrl":"10.1016/j.paed.2025.05.010","url":null,"abstract":"<div><div>Diagnosis of intellectual disability (ID) can be a protective factor for individuals across their life course. ID is a neurodevelopmental disorder, lifelong disability, and disability identity. Early screening and assessment in children and young people can reduce duplication of assessment processes, waiting lists and is an essential component for intervention. Barriers to assessment and diagnosis have included limited availability of assessment pathways, professional confidence in assessment practice, and limited shared developmental understanding of a child across health and education settings. Early diagnosis and intervention can improve individuals’ physical and mental health, support networks, educational outcomes, and transition into adulthood. This article seeks to outline key issues in the processes of screening, assessment, and reporting of ID and provide clarity for clinicians regarding assessment tools and areas for relevant intervention. Multi-agency processes have been developed in one local authority between health and education services to improve identification and support for children and young people before they enter adulthood. Wider multidisciplinary and multi-agency awareness and assessment of ID can be transformative for a broader formulation of individual and family needs and supports, and service delivery.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 8","pages":"Pages 275-281"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723374","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

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