Acta Paediatrica最新文献_第10页

Development and Evaluation of a New Gastroenteritis Clinical Severity Score for Children Aged Under 5.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-23 DOI: 10.1111/apa.17592

Lydie Masson, Fleur Lorton, Jacques Lependu, Berthe Marie Imbert, Bénédicte Vrignaud, Christèle Gras-Le Guen, Pauline Scherdel

{"title":"Development and Evaluation of a New Gastroenteritis Clinical Severity Score for Children Aged Under 5.","authors":"Lydie Masson, Fleur Lorton, Jacques Lependu, Berthe Marie Imbert, Bénédicte Vrignaud, Christèle Gras-Le Guen, Pauline Scherdel","doi":"10.1111/apa.17592","DOIUrl":"https://doi.org/10.1111/apa.17592","url":null,"abstract":"Aim: To develop and internally validate a new severity score to more accurately assess the clinical severity forms of acute gastroenteritis (AGE) in children from birth to age 5 years.Methods: We included children consulting for AGE in the emergency department of the University Hospital of Nantes (March 2017-June 2019). We developed and evaluated a new predictive score (GASTROVIM score) using the classification and regression trees. We compared its diagnostic performance with the two existing scores: the Vesikari score and clinical dehydration scale (CDS). A clinical expert a posteriori evaluated children's medical records to determine the severity form of AGE as the gold standard.Results: Of the 200 children included, 129 (64.5%) had severe forms of AGE according to the GASTROVIM score (maximal number of liquid stools and vomiting per day, weight loss and CDS), with sensitivity 90.0% (95% CI: 83.5-94.6) and specificity 82.9% (72.0-90.8). The Vesikari score had similar sensitivity (97.3%) but lower specificity (17.0%) and the CDS had lower sensitivity (28.3%) and higher specificity (100%) than the GASTROVIM score.Conclusion: The GASTROVIM score could discriminate severe forms of AGE with good diagnostic performance. Nevertheless, external validation in other populations and/or other countries is needed.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025634","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}

引用次数: 0

Children With Sydenham Chorea and Psychiatric Disorders Had Variable Long-Term Outcomes and Required Multidisciplinary Management. 患有西德纳姆舞蹈病和精神疾病的儿童有不同的长期预后，需要多学科管理。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-22 DOI: 10.1111/apa.17590

Nadine Mushet, Michael Morton, Helen Minnis, Christopher Gillberg

{"title":"Children With Sydenham Chorea and Psychiatric Disorders Had Variable Long-Term Outcomes and Required Multidisciplinary Management.","authors":"Nadine Mushet, Michael Morton, Helen Minnis, Christopher Gillberg","doi":"10.1111/apa.17590","DOIUrl":"https://doi.org/10.1111/apa.17590","url":null,"abstract":"Aim: Sydenham chorea (SC) is a globally significant, post-streptococcal, childhood neuropsychiatric condition that is rare in western Europe. This retrospective single-centre study focused on children with neuropsychiatric features of SC.Methods: Participants were recruited from neuropsychiatry referrals to a regional paediatric neurology department in Glasgow, Scotland, from 2009 to 2012. Interviews established the course of SC and the children's medical and family histories. Semi-structured psychiatric interviews explored current and past episodes of psychopathology.Results: We studied 12 children (seven girls) with a mean age of 13 (range 10-15) years, and an average of six (range 4-10) years after their SC symptoms began. Before they displayed symptoms, seven children had been suspected or diagnosed neurodevelopmental problems and four had separation anxiety. Their physical symptoms were often debilitating. Psychopathology was most severe during their first episode and SC diagnoses were sometimes delayed. Educational problems were frequent. Multiple psychiatric conditions were diagnosed in 11 children and anxiety and attention deficit hyperactivity disorder were the most common. Relapses occurred in nine cases. Additional services that were accessed included cardiology, rheumatology, physiotherapy, occupational therapy and speech therapy. Medication included prophylactic penicillin and symptomatic treatment.Conclusion: Children with SC and psychiatric disorders had variable long-term outcomes and required multidisciplinary management.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016291","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}

引用次数: 0

Pharmacological Strategies for High-Output Ileostomies in Children: A Narrative Review. 儿童高输出回肠造口的药理学策略：叙述性回顾。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-22 DOI: 10.1111/apa.17587

Marijke Awouters, Tim Vanuytsel, Pauline De Bruyne, Karen van Hoeve, Ilse Hoffman

{"title":"Pharmacological Strategies for High-Output Ileostomies in Children: A Narrative Review.","authors":"Marijke Awouters, Tim Vanuytsel, Pauline De Bruyne, Karen van Hoeve, Ilse Hoffman","doi":"10.1111/apa.17587","DOIUrl":"https://doi.org/10.1111/apa.17587","url":null,"abstract":"Aim: Nutritional measures often suffice for managing high-output ileostomy (HOI) in paediatric patients, but pharmacological treatment may be required to control ostomy output. This paper reviews the literature on the pharmacological management of paediatric HOI and provides recommendations.Methods: PubMed and Embase were searched for relevant articles up to 22 May 2024. Relevant articles were reviewed and recommendations were formulated.Results: No pharmacological studies involving paediatric ileostomy patients were identified, apart from two case reports on octreotide. The formulated recommendations are therefore based on data from adults or other intestinal failure conditions. The primary treatment suggestions are proton pump inhibitors and loperamide. Subcutaneous octreotide can be administered when complications persist. Codeine may be used in rare cases in children over 12 years old, but addiction risk and side effects limit its use. There is no or insufficient evidence for smectite, racecadotril, probiotics or prophylactic cycled antibiotics or clonidine. Bile acid sequestrants are not indicated in patients without a colon in continuity.Conclusion: Pharmacological options for the treatment of HOI in children are limited and evidence for their use is lacking. Research in paediatric HOI patients is needed to validate the use of pharmacotherapy in this patient group.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016655","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}

引用次数: 0

Implications of Tongue and Lingual Frenulum Anatomy for Tongue-Tie Evaluation and Management. 舌和舌系带解剖学对舌系带评估和管理的意义。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-22 DOI: 10.1111/apa.17600

Márta Guóth-Gumberger, Daniela Karall

引用次数: 0

Assessment of Fasting Metabolism With Microdialysis Indicates Earlier Lipolysis in Children With VLCADD Than MCADD. 微透析空腹代谢评估表明VLCADD儿童比MCADD更早发生脂肪溶解。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-21 DOI: 10.1111/apa.17591

David Olsson, Charlotte Bieneck Haglind, Maria Halldin, Svetlana Lajic, Anna Nordenström

{"title":"Assessment of Fasting Metabolism With Microdialysis Indicates Earlier Lipolysis in Children With VLCADD Than MCADD.","authors":"David Olsson, Charlotte Bieneck Haglind, Maria Halldin, Svetlana Lajic, Anna Nordenström","doi":"10.1111/apa.17591","DOIUrl":"https://doi.org/10.1111/apa.17591","url":null,"abstract":"Aim: To investigate fasting metabolism in children with very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) and medium-chain acyl-CoA dehydrogenase deficiency (MCADD) using microdialysis technique.Methods: Twelve patients (7 with VLCADD, 5 with MCADD, mean age 4.9 years, 10/12 diagnosed via newborn screening) were recruited for investigation in connection to clinical fasting examinations at the Karolinska University Hospital (between 2015 and 2024). Patients were subjected to a 9-h night fast after a standard late evening meal. Analysis of glucose, glycerol, lactate, and pyruvate was conducted by continuous microdialysis. Fasting hormones and acylcarnitines were analysed in blood samples at 1-h intervals in patients with VLCADD.Results: Children with VLCADD showed signs of lipolysis after a median fasting time of 4.5 h, whereas patients with MCADD showed no significant increase in lipolysis during the fast. A shorter time to initiation of lipolysis tended to correlate with a lower residual enzyme activity in patients with VLCADD. All patients maintained euglycemia during fasting.Conclusion: Children with VLCADD had a shorter time to initiation of lipolysis during fasting than children with MCADD. Clinical evaluation of fasting metabolism in beta-oxidation disorders should include assessment of lipolysis as an early and important determinant.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016164","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}

引用次数: 0

The Emerging Role of Magnetic Resonance Imaging as a Primary Diagnostic Tool for Paediatric Tracheomalacia. 磁共振成像作为儿科气管软化症的主要诊断工具的新兴作用。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-21 DOI: 10.1111/apa.17593

Nikolaos-Achilleas Arkoudis

引用次数: 0

Respiratory Syncytial Virus Vaccination Is Associated With Increased Odds of Preterm Birth. 呼吸道合胞病毒疫苗接种与早产几率增加有关

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-20 DOI: 10.1111/apa.17595

Ilari Kuitunen, Marjut Haapanen

{"title":"Respiratory Syncytial Virus Vaccination Is Associated With Increased Odds of Preterm Birth.","authors":"Ilari Kuitunen, Marjut Haapanen","doi":"10.1111/apa.17595","DOIUrl":"https://doi.org/10.1111/apa.17595","url":null,"abstract":"Aim: To analyse whether respiratory syncytial virus (RSV) vaccination during pregnancy increases the odds of preterm birth.Methods: A rapid review and meta-analysis was performed. The main outcome was the risk of preterm (gestational week less than 37) birth. A fixed-effects model was used to analyse pooled odds ratios (OR) with 95% confidence intervals (CI). Evidence certainty was assessed according to GRADE.Results: We included six randomised controlled trials with 17 656 births and two observational studies with 3446 births. The odds for preterm birth were increased in the randomised studies (OR 1.17, CI 1.02-1.34). No evidence of a difference was seen in the observational studies (OR 0.93, CI 0.69-1.25). Combined, these showed increased odds for preterm birth (OR 1.13, CI 1.00-1.27). Evidence certainty was rated to be moderate. When restricted to market-approved vaccine, the odds seemed to be increased in RCTs (OR 1.21, CI 0.98-1.49).Conclusion: Based on the available evidence, RSV vaccination seems to be associated with increased odds for preterm birth. RSV vaccination needs continuous population-level observational safety data monitoring on the perinatal outcomes during the early phases of vaccine rollouts to detect possible safety signals and further confirm the magnitude of the effect on preterm birth.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016662","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}

引用次数: 0

More Complex Investigations Improved Diagnoses of Community-Acquired Pneumonia in Children With Different Vaccination Histories. 更复杂的调查改善了不同疫苗接种史儿童社区获得性肺炎的诊断。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-20 DOI: 10.1111/apa.17586

Bibigul Tukbekova, Aliya Zhanpeissova, Akbota Kysabekova, Gulmira Sarmankulova, Saule Turlybekova

{"title":"More Complex Investigations Improved Diagnoses of Community-Acquired Pneumonia in Children With Different Vaccination Histories.","authors":"Bibigul Tukbekova, Aliya Zhanpeissova, Akbota Kysabekova, Gulmira Sarmankulova, Saule Turlybekova","doi":"10.1111/apa.17586","DOIUrl":"https://doi.org/10.1111/apa.17586","url":null,"abstract":"Aim: Community-acquired pneumonia (CAP) significantly contributes to high infant mortality in Kazakhstan and developing effective treatment methods is critical. The aim of this study was to explore the microbiological and immunological characteristics of CAP in vaccinated and unvaccinated paediatric patients.Methods: The study was carried out in the Regional Children's Clinical Hospital and the research centre of Karaganda Medical University, Republic of Kazakhstan. It comprised 85 children aged 2 months to 3 years who had been diagnosed with CAP and had received inpatient treatment from 2017 to 2019. Of these, 45 had complete pneumococcal vaccinations and 40 had not. Their CAP diagnoses were confirmed by microscopic, bacteriological and radiological methods and vaccination status. General clinical examinations were conducted.Results: The study showed the diagnostic and prognostic value of the level of cytokines, depending on the severity of the children's CAP. The level of monocytic chemoattractant protein-1 was 2.1 pg/mL in the vaccinated children with mild CAP and 3.4 pg/mL in those with impaired immunisation. Pneumococcal vaccination affected the aetiological structure of CAP in early childhood.Conclusion: More complex clinical and immunological diagnostic methods increased the efficiency of diagnosing CAP in children with different vaccination histories.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016654","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}

引用次数: 0

RE: EBNEO Commentary: Surfactant Administration via Laryngeal Mask Airway Versus Brief Tracheal Intubation in Preterm Infants. RE: EBNEO评论：表面活性剂通过喉罩气道给药与短暂气管插管在早产儿。

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-20 DOI: 10.1111/apa.17596

Manjari Pophale, Scott O Guthrie, Kari D Roberts

引用次数: 0

Post-secondary education in young patients with inflammatory bowel disease: A population-based cohort study. 炎症性肠病患者的中学后教育：一项基于人群的队列研究

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-19 DOI: 10.1111/apa.17571

Julie Rasmussen, Bente Mertz Nørgård, Rasmus Gaardskær Nielsen, Niels Qvist, Henrik Bøggild, Kirsten Fonager

{"title":"Post-secondary education in young patients with inflammatory bowel disease: A population-based cohort study.","authors":"Julie Rasmussen, Bente Mertz Nørgård, Rasmus Gaardskær Nielsen, Niels Qvist, Henrik Bøggild, Kirsten Fonager","doi":"10.1111/apa.17571","DOIUrl":"https://doi.org/10.1111/apa.17571","url":null,"abstract":"Aim: Inflammatory bowel disease (IBD) diagnosed in adolescence may have adverse effects on educational attainment. The study aims to examine post-secondary educational attainment in patients with IBD and how it is affected by disease severity and comorbid mental health disorders.Methods: This cohort study used nationwide Danish registries. In a cohort of patients with IBD and matched references, the time to attainment of post-secondary education was examined using Cox regression. In the analysis for disease severity and mental health disorders, the relative risk of attainment of post-secondary education was evaluated using binomial regression.Results: We identified 1136 patients with IBD and 8791 references. Overall, patients with Crohn's disease (CD) or ulcerative colitis (UC) attained a post-secondary education as often as references (CD: hazard ratio (HR) 1.10 (95% confidence interval (CI) 0.99-1.22); UC: HR 0.97 (95% CI 0.88-1.06)). Patients with both severe IBD and mental health disorders had a significantly lower chance of attaining a post-secondary education compared to patients with severe IBD without mental health disorders.Conclusions: Patients with IBD attained a post-secondary education at the same rate as references. Having both severe IBD and mental health disorder negatively affected post-secondary educational attainment.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016656","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}

引用次数: 0