Lancet Child & Adolescent Health最新文献

{"title":"The neonatal intensive care unit: a father's perspective","authors":"Jules Morgan","doi":"10.1016/S2352-4642(24)00262-1","DOIUrl":"10.1016/S2352-4642(24)00262-1","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Pages 783-784"},"PeriodicalIF":19.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EDCs: a threat to child health","authors":"The Lancet Child & Adolescent Health","doi":"10.1016/S2352-4642(24)00263-3","DOIUrl":"10.1016/S2352-4642(24)00263-3","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Page 773"},"PeriodicalIF":19.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The expanding field of genetic developmental and epileptic encephalopathies: current understanding and future perspectives","authors":"Nicola Specchio MD ,&nbsp;Marina Trivisano MD ,&nbsp;Prof Eleonora Aronica MD ,&nbsp;Simona Balestrini MD ,&nbsp;Prof Alexis Arzimanoglou MD ,&nbsp;Gaia Colasante PhD ,&nbsp;Prof J Helen Cross MD ,&nbsp;Sergiusz Jozwiak MD ,&nbsp;Prof Jo M Wilmshurst MD ,&nbsp;Federico Vigevano MD ,&nbsp;Prof Stéphane Auvin MD ,&nbsp;Prof Rima Nabbout MD ,&nbsp;Prof Paolo Curatolo MD","doi":"10.1016/S2352-4642(24)00196-2","DOIUrl":"10.1016/S2352-4642(24)00196-2","url":null,"abstract":"<div><div>Recent advances in genetic testing technologies have revolutionised the identification of genetic abnormalities in early onset developmental and epileptic encephalopathies (DEEs). In this Review, we provide an update on the expanding landscape of genetic factors contributing to DEEs, encompassing over 800 reported genes. We focus on the cellular and molecular mechanisms driving epileptogenesis, with an emphasis on emerging therapeutic strategies and effective treatment options. We explore noteworthy, novel genes linked to DEE phenotypes, such as <em>gBRAT-1</em> and <em>GNAO1</em>, and gene families such as <em>GRIN</em> and <em>HCN</em>. Understanding the network-level effects of gene variants will pave the way for potential gene therapy applications. Given the diverse comorbidities associated with DEEs, a multidisciplinary team approach is essential. Despite ongoing efforts and improved genetic testing, DEEs lack a cure, and treatment complexities persist. This Review underscores the necessity for larger international prospective studies focusing on both seizure outcomes and developmental trajectories.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Pages 821-834"},"PeriodicalIF":19.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home phototherapy: an essential component of managing hyperbilirubinaemia","authors":"Wanlin Cui","doi":"10.1016/S2352-4642(24)00234-7","DOIUrl":"10.1016/S2352-4642(24)00234-7","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Page e16"},"PeriodicalIF":19.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular thrombectomy for childhood stroke (Save ChildS Pro): an international, multicentre, prospective registry study","authors":"Peter B Sporns MD MHBA ,&nbsp;Kartik Bhatia MD ,&nbsp;Prof Todd Abruzzo MD ,&nbsp;Lisa Pabst MD ,&nbsp;Stuart Fraser MD ,&nbsp;Melissa G Chung MD ,&nbsp;Prof Warren Lo MD ,&nbsp;Prof Ahmed Othman MD ,&nbsp;Sebastian Steinmetz MD ,&nbsp;Ulf Jensen-Kondering MD ,&nbsp;Stefan Schob MD ,&nbsp;Daniel P O Kaiser MD ,&nbsp;Wolfgang Marik MD ,&nbsp;Prof Christina Wendl MD ,&nbsp;Ilka Kleffner MD ,&nbsp;Prof Hans Henkes MD ,&nbsp;Hermann Kraehling MD ,&nbsp;Thi Dan Linh Nguyen-Kim MD ,&nbsp;Prof René Chapot MD ,&nbsp;Umut Yilmaz MD ,&nbsp;Prof Moritz Wildgruber MD PhD","doi":"10.1016/S2352-4642(24)00233-5","DOIUrl":"10.1016/S2352-4642(24)00233-5","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular thrombectomy plus best medical practice or best medical treatment alone. Intravenous thrombolysis was considered part of best medical treatment and therefore permitted in both groups. The primary outcome was the difference in median modified Rankin Scale (mRS) score between baseline (pre-stroke) and 90 days (±10 days) post-stroke, assessed by the Wilcoxon rank test (α=0·05). Efficacy outcomes in the endovascular thrombectomy and best medical treatment groups were compared in sensitivity analyses using propensity score matching. The Save ChildS Pro study is registered at the German Clinical Trials Registry, DRKS00018960.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between Jan 1, 2020, and Aug 31, 2023, of the 241 patients in the Save ChildS Pro registry, 208 were included in the analysis (115 [55%] boys and 93 [45%] girls). 117 patients underwent endovascular thrombectomy (median age 11 years [IQR 6–14]), and 91 patients received best medical treatment (6 years [3–12]; p&lt;0·0001). The median Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score on admission was 14 (IQR 10–19) in the endovascular thrombectomy group and 9 (5–13) in the best medical treatment group (p&lt;0·0001). Both treatment groups had a median pre-stroke mRS score of 0 (IQR 0–0) at baseline. The change in median mRS score between baseline and 90 days was 1 (IQR 0–2) in the endovascular thrombectomy group and 2 (1–3) in the best medical treatment group (p=0·020). One (1%) patient developed a symptomatic intracranial haemorrhage (this patient was in the endovascular thrombectomy group). Six (5%) patients in the endovascular thrombectomy group and four (5%) patients in the best medical treatment group had died by day 90 (p=0·89). After propensity score matching for age, sex, and PedNIHSS score at hospital admission (n=79 from each group), the change in median mRS score between baseline and 90 days was 1 (IQR 0–2) in the endovascular thrombectomy group and 2 (1–3) in the best medical treatment group (p=0·029). Regarding the primary outcome for patients with suspected focal cerebral arteriopathy, endovascular thrombectomy (n=18) and best medical treatment (n=33) showed no difference in 90-day media","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 882-890"},"PeriodicalIF":19.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric endovascular thrombectomy: balancing strength of numbers and accuracy of precision medicine","authors":"Manoëlle Kossorotoff","doi":"10.1016/S2352-4642(24)00257-8","DOIUrl":"10.1016/S2352-4642(24)00257-8","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 844-845"},"PeriodicalIF":19.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authentic First Nations health research","authors":"Allison J Hempenstall ,&nbsp;Francis Nona","doi":"10.1016/S2352-4642(24)00258-X","DOIUrl":"10.1016/S2352-4642(24)00258-X","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Pages 777-778"},"PeriodicalIF":19.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trimodal skin health programme for childhood impetigo control in remote Western Australia (SToP): a cluster randomised, stepped-wedge trial","authors":"Hannah M M Thomas PhD ,&nbsp;Stephanie L Enkel MPH ,&nbsp;Marianne Mullane BSc ,&nbsp;Tracy McRae PhD ,&nbsp;Timothy C Barnett PhD ,&nbsp;Prof Jonathan R Carapetis PhD ,&nbsp;Raymond Christophers ,&nbsp;Prof Julianne Coffin PhD ,&nbsp;Rebecca Famlonga MAH ,&nbsp;John Jacky ,&nbsp;Mark Jones MBiostat ,&nbsp;Julie Marsh PhD ,&nbsp;Kelli McIntosh ,&nbsp;Vicki O'Donnell ,&nbsp;Edward Pan BA ,&nbsp;Glenn Pearson BA ,&nbsp;Slade Sibosado ,&nbsp;Bec Smith MC-HHS ,&nbsp;Prof Thomas Snelling PhD ,&nbsp;Prof Andrew Steer PhD ,&nbsp;Edie Wright","doi":"10.1016/S2352-4642(24)00229-3","DOIUrl":"10.1016/S2352-4642(24)00229-3","url":null,"abstract":"<div><h3>Background</h3><div>Skin infections affect physical health and, through stigma, social-emotional health. When untreated, they can cause life-threatening conditions. We aimed to assess the effect of a holistic, co-designed, region-wide skin control programme on the prevalence of impetigo.</div></div><div><h3>Methods</h3><div>The SToP (See, Treat, and Prevent Skin Sores and Scabies) trial is a pragmatic, open-cohort, stepped-wedge cluster randomised trial involving participants aged 0–18 years in nine remote communities of the Kimberley, Western Australia. The trial involves programmatic interventions in three domains: See (skin checks and skin infection recognition training), Treat (skin infection treatment training, sulfamethoxazole–trimethoprim for impetigo, and ivermectin for scabies), and Prevent (co-designed health promotion and environmental health). Four clusters, defined as pragmatic aggregations of communities, were randomised in two steps to progressively receive the activities during ten visits. The primary outcome was the proportion of school-aged children (aged 5–9 years) with impetigo. We adopted an intention-to-treat analysis and compared the intervention with the control (usual care before the start of intervention) states to derive a time and cluster averaged effect using Bayesian modelling. This study is registered with Australian New Zealand Clinical Trials Registry, ACTRN12618000520235.</div></div><div><h3>Findings</h3><div>Between Sept 19, 2018, and Nov 22, 2022, 915 children were consented and 777 (85%) had skin checks performed on at least one of ten possible visits between May 5, 2019, and Nov 22, 2022. Of the participants, 448 (58%) of 777 were aged 5–9 years at one or more of the visit timepoints and were eligible for primary outcome assessment. A decline in impetigo occurred across all clusters, with the greatest decline during the observational period of baseline skin checks before commencement of the interventional trial activities activities. The mean (95% credible interval) for the conditional posterior odds ratio for observing impetigo in the intervention compared with the control period was 1·13 (0·71–1·70). The probability that the intervention reduced the odds of observing impetigo was 0·33.</div></div><div><h3>Interpretation</h3><div>A decreased prevalence of impetigo during the observational period before the commencement of trial activities was sustained across the trial, attributable to the trimodal skin health initiative. Although the prevalence of impetigo reduced, there is no direct evidence to attribute this to the individual effects of the trial activities. The wholistic approach inclusive of skin checks collectively contributed to the sustained reduction in impetigo.</div></div><div><h3>Funding</h3><div>Western Australia Department of Health, Australian National Health and Medical Research Council, and Healthway.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Pages 809-820"},"PeriodicalIF":19.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primaquine for children, once and for all","authors":"Tsige Ketema ,&nbsp;Quique Bassat","doi":"10.1016/S2352-4642(24)00231-1","DOIUrl":"10.1016/S2352-4642(24)00231-1","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Pages 775-777"},"PeriodicalIF":19.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primaquine for uncomplicated Plasmodium vivax malaria in children younger than 15 years: a systematic review and individual patient data meta-analysis","authors":"Robert J Commons FRACP ,&nbsp;Megha Rajasekhar PhD ,&nbsp;Elizabeth N Allen PhD ,&nbsp;Prof Daniel Yilma MD ,&nbsp;Palang Chotsiri PhD ,&nbsp;Tesfay Abreha MPH ,&nbsp;Prof Ishag Adam PhD ,&nbsp;Ghulam Rahim Awab PhD ,&nbsp;Bridget E Barber PhD ,&nbsp;Larissa W Brasil PhD ,&nbsp;Cindy S Chu MD ,&nbsp;Prof Liwang Cui PhD ,&nbsp;Peta Edler MBiostat ,&nbsp;Margarete do Socorro M Gomes PhD ,&nbsp;Lilia Gonzalez‑Ceron PhD ,&nbsp;Matthew J Grigg PhD ,&nbsp;Muzamil Mahdi Abdel Hamid PhD ,&nbsp;Jimee Hwang MD ,&nbsp;Harin Karunajeewa PhD ,&nbsp;Prof Marcus V G Lacerda PhD ,&nbsp;Adugna Woyessa","doi":"10.1016/S2352-4642(24)00210-4","DOIUrl":"10.1016/S2352-4642(24)00210-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Primaquine, the only widely available treatment to prevent relapsing &lt;em&gt;Plasmodium vivax&lt;/em&gt; malaria, is produced as 15 mg tablets, and new paediatric formulations are being developed. To inform the optimal primaquine dosing regimen for children, we aimed to determine the efficacy and safety of different primaquine dose strategies in children younger than 15 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We undertook a systematic review (Jan 1, 2000–July 26, 2024) for &lt;em&gt;P vivax&lt;/em&gt; efficacy studies with at least one treatment group that was administered primaquine over multiple days, that enrolled children younger than 15 years, that followed up patients for at least 28 days, and that had data available for inclusion by June 30, 2022. Patients were excluded if they were aged 15 years or older, presented with severe malaria, received adjunctive antimalarials within 14 days of diagnosis, commenced primaquine more than 7 days after starting schizontocidal treatment, had a protocol violation in the original study, or were missing data on age, sex, or primaquine dose. Available individual patient data were collated and standardised. To evaluate efficacy, the risk of recurrent &lt;em&gt;P vivax&lt;/em&gt; parasitaemia between days 7 and 180 was assessed by time-to-event analysis for different total mg/kg primaquine doses (low total dose of ∼3·5 mg/kg and high total dose of ∼7 mg/kg). To evaluate tolerability and safety, the following were assessed by daily mg/kg primaquine dose (low daily dose of ∼0·25 mg/kg, intermediate daily dose of ∼0·5 mg/kg, and high daily dose of ∼1 mg/kg): gastrointestinal symptoms (vomiting, anorexia, or diarrhoea) on days 5–7, haemoglobin decrease of at least 25% to less than 7g/dL (severe haemolysis), absolute change in haemoglobin from day 0 to days 2–3 or days 5–7, and any serious adverse events within 28 days. This study is registered with PROSPERO, CRD42021278085.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;In total, 3514 children from 27 studies and 15 countries were included. The cumulative incidence of recurrence by day 180 was 51·4% (95% CI 47·0–55·9) following treatment without primaquine, 16·0% (12·4–20·3) following a low total dose of primaquine, and 10·2% (8·4–12·3) following a high total dose of primaquine. The hazard of recurrent &lt;em&gt;P vivax&lt;/em&gt; parasitaemia in children younger than 15 years was reduced following primaquine at low total doses (adjusted hazard ratio [HR] 0·17, 95% CI 0·11–0·25) and high total doses (0·09, 0·07–0·12), compared with no primaquine. In 525 children younger than 5 years, the relative rates of recurrence were also reduced, with an adjusted HR of 0·33 (95% CI 0·18–0·59) for a low total dose and 0·13 (0·08–0·21) for a high total dose of primaquine compared with no primaquine. The rate of recurrence following a high total dose was reduced compared with a low dose in children younger than 15 years (adjusted HR 0·54, 95% CI 0·35–0·85) and children younger than 5 years (0·41, ","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 11","pages":"Pages 798-808"},"PeriodicalIF":19.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}