Paediatrics and Child Health (United Kingdom)最新文献_第3页

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

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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

Revolutionizing paediatric neurorehabilitation: integrating innovation and contemporary practice 革命性的儿科神经康复：整合创新和当代实践

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.002

Vijay Palanivel, Tim Grove, Melanie Burrough

{"title":"Revolutionizing paediatric neurorehabilitation: integrating innovation and contemporary practice","authors":"Vijay Palanivel, Tim Grove, Melanie Burrough","doi":"10.1016/j.paed.2025.02.002","DOIUrl":"10.1016/j.paed.2025.02.002","url":null,"abstract":"<div><div>The field of paediatric neurorehabilitation is undergoing significant transformation, driven by evolving care pathways, innovative technologies, and a growing emphasis on addressing health disparities. Children and young people (CYP) with acquired brain injuries (ABI) benefit from rehabilitation that optimizes their participation in daily life across home, school, and community settings. This paper explores the changing landscape of paediatric neurorehabilitation and changing patterns of causes of brain injury in children. The discussion extends to health inequalities that affect access to care, underscoring the need for system-wide reforms to bridge disparities linked to socioeconomic, geographic, and cultural factors. The development of seamless, end-to-end service pathways, from acute care to specialist tertiary neurorehabilitation and onward community services, demonstrates the potential for integrated care to improve outcomes for CYP transitioning from hospital to home. Central to effective rehabilitation is personalized goal setting and high-intensity treatments, which enhance physical, cognitive, and social outcomes. Technological advancements, including virtual reality, robotics, and electrical muscle stimulation, are reshaping therapeutic approaches, increasing engagement, and fostering neuroplasticity. Findings advocate for ongoing research, investment in community services, and equitable application of emerging technologies. By prioritizing personalized care and addressing systemic barriers, the future of paediatric neurorehabilitation holds promise for improved long-term functional outcomes for children with ABI.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 5","pages":"Pages 134-139"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932185","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

Acute neurological deficit: is it demyelination? Review of demyelinating disorders of the central nervous system 急性神经缺损：是脱髓鞘吗？中枢神经系统脱髓鞘疾病综述

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.004

Yoshua C. Collins-Sawaragi, Evangeline Wassmer

引用次数: 0

Developmental and epileptic encephalopathies: the clinical approach to investigation and management 发展性和癫痫性脑病：临床方法的调查和管理

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.007

Ogechukwu Okpala, Manali Chitre

{"title":"Developmental and epileptic encephalopathies: the clinical approach to investigation and management","authors":"Ogechukwu Okpala, Manali Chitre","doi":"10.1016/j.paed.2025.02.007","DOIUrl":"10.1016/j.paed.2025.02.007","url":null,"abstract":"<div><div>Epileptic encephalopathies (EE) and developmental and epileptic encephalopathies (DEE) are a group of severe brain disorders in which epileptic electrical discharge contributes to progressive psychomotor dysfunction. These include rare but important conditions such as neonatal epileptic encephalopathy, West, Dravet, Lennox Gastaut and Landau Kleffner syndromes. These conditions result in a characteristic cluster of clinical, EEG and aetiological features which together, help us understand the condition, use more targeted therapies and prognosticate with regards to progression with age. Electroencephalography (EEG) is crucial in determining the causative epilepsy syndrome. Since the availability of next generation sequencing, genetic testing has assumed increasing importance in the diagnosis of specific syndromes. Multidisciplinary support from medical, nursing and therapy teams is essential in helping these children reach the best of their abilities, skills and to optimize their long-term outcomes. In this article we describe some of the more commonly seen EE/DEE and discuss management and prognosis of these.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 5","pages":"Pages 163-170"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932190","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

Inherited white matter disorders in children 儿童遗传性白质紊乱

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.008

Nee Na Kim, Asthik Biswas, Cheryl Hemingway

{"title":"Inherited white matter disorders in children","authors":"Nee Na Kim, Asthik Biswas, Cheryl Hemingway","doi":"10.1016/j.paed.2025.02.008","DOIUrl":"10.1016/j.paed.2025.02.008","url":null,"abstract":"<div><div>Inherited white matter disorders (IWMDs), otherwise known as leukodystrophies, represent a group of rare and heterogenous neurological conditions affecting the white matter of the central nervous system (CNS). With a wide range of differential diagnoses and associated medical complexities, they often pose a diagnostic challenge to clinicians. Rapid technological advancement including the availability of genetic investigations such as whole genome sequencing (WGS) is leading to an increasing number of patients with a confirmed genetic diagnosis. For the majority of IWMDs there is no specific treatment, and the focus of clinical management remains symptomatic and involves a multidisciplinary team and holistic approaches. Up until recently, only natural history trials were available, but now the focus is shifting to novel targeted therapies. Early diagnosis and prompt referral to specialized IWMD centers is crucial for optimum management of affected children or asymptomatic affected siblings. Collaborative efforts are needed to achieve two important goals 1) to establish international patient registries for long term natural history and recruitment to new treatment trials and 2) to encourage wider newborn screening programmes for early detection of these rare diseases at the asymptomatic stage. In this review, we aim to summarise the common clinical presentations, diagnostic investigations, management and prognosis of the more commonly encountered inherited white matter disorders in children.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 5","pages":"Pages 171-179"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932191","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

Neurocutaneous syndromes: a multidisciplinary team approach 神经皮肤综合征：多学科团队方法

Paediatrics and Child Health (United Kingdom) Pub Date : 2025-05-01 DOI: 10.1016/j.paed.2025.02.006

Hanna Richardson, Rachel Gwynn, Parisha Chadha, Penny Andreou, Karen Ray, Clare Rapier, Catherine Swales, Sarah Aylett

引用次数: 0