Acta Paediatrica最新文献_第7页

Learning About Their Condition: The Gradual Path of Young People With Childhood-Onset Motor Disabilities.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-29 DOI: 10.1111/apa.17609

Charlotte Martin, Christina Akre, Christopher J Newman

{"title":"Learning About Their Condition: The Gradual Path of Young People With Childhood-Onset Motor Disabilities.","authors":"Charlotte Martin, Christina Akre, Christopher J Newman","doi":"10.1111/apa.17609","DOIUrl":"https://doi.org/10.1111/apa.17609","url":null,"abstract":"Aim: Young people with childhood-onset motor disabilities face unique challenges in understanding and managing their condition. This study explored how they learnt about their condition.Method: A descriptive qualitative study was conducted in 2023-2024 at a Swiss paediatric neurorehabilitation unit. Ten participants aged 15-24 years were recruited through purposive sampling, representing diverse conditions and socio-educational backgrounds. Inductive thematic analysis was conducted on interview transcripts.Results: Four themes emerged. First, learning paths revealed that participants gradually acquired knowledge about their condition. Early explanations often involved parents and visual aids, with moments of awareness and evolving information needs shaping their learning over time. Second, building blocks of understanding showed that knowledge was constructed through interactions with physicians, therapists, parents, peers and the Internet. Third, interacting with healthcare professionals highlighted the importance of trust and continuity in relationships with healthcare professionals to support learning. Last, improving the learning process suggested strategies such as dedicated consultations for recapping information during adolescence and increasing disability awareness in schools.Conclusion: Young people with motor disabilities require information and support tailored to their individual learning needs. Adapting these resources could enhance their understanding of their condition, supporting the development of their autonomy and self-advocacy within healthcare.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061695","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

Misses and Near Misses in Paediatric Appendicitis: An Eight-Year, Single-Centre Retrospective Review.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-29 DOI: 10.1111/apa.17599

Eric Scheier, Walid Abu Zvis, Sarah Borsekofsky

{"title":"Misses and Near Misses in Paediatric Appendicitis: An Eight-Year, Single-Centre Retrospective Review.","authors":"Eric Scheier, Walid Abu Zvis, Sarah Borsekofsky","doi":"10.1111/apa.17599","DOIUrl":"https://doi.org/10.1111/apa.17599","url":null,"abstract":"Aim: Diagnostic error can result in the appendectomy of a normal appendix, commonly known as negative appendectomy (NA). Missed appendicitis (MA) is related to a poor outcome. The aim of this study was to determine whether there are factors in presentation associated with NA or MA.Methods: This is a single-centre, retrospective chart review of histology-confirmed appendicitis over an eight-year period. We defined MA as appendicitis diagnosed within the week of a paediatric emergency department discharge for a similar presentation. Negative appendectomy was defined as a histologic examination of the appendix that lacked signs of inflammation.Results: A total of 845 children had appendicitis on pathologic examination. NA included 69 children, and MA 29 children. Inflammatory markers were lower for children with NA than for children with appendicitis, and children with NA were less likely to undergo CT. Almost half of the children with MA were discharged without laboratory evaluation, and almost three quarters were discharged without imaging evaluation. Half of the children with MA returned with complicated appendicitis.Conclusion: Increased rates of laboratory and/or imaging evaluations in patients with abdominal pain or non-classic gastroenteritis, along with observation or early follow-up, may decrease MA. More frequent use of ultrasound and MRI may keep the NA rate to a minimum.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061696","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

Predictors for Development of Asphyxiated Neonates Treated With Therapeutic Hypothermia.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-29 DOI: 10.1111/apa.17598

Fabienne Kühne, Nina Wald de Chamorro, Laura Glasmeyer, Maria Grigoryev, Yee Lee Shing, Claudia Buss, Christoph Bührer, Angela M Kaindl

{"title":"Predictors for Development of Asphyxiated Neonates Treated With Therapeutic Hypothermia.","authors":"Fabienne Kühne, Nina Wald de Chamorro, Laura Glasmeyer, Maria Grigoryev, Yee Lee Shing, Claudia Buss, Christoph Bührer, Angela M Kaindl","doi":"10.1111/apa.17598","DOIUrl":"https://doi.org/10.1111/apa.17598","url":null,"abstract":"Aim: To describe the long-term neurodevelopmental outcomes of asphyxiated neonates treated with hypothermia in association with neonatal magnetic resonance imaging (MRI) findings.Methods: We evaluated, retrospectively, clinical and radiological single-centre data at 0, 2, and 5 years of age of 53 asphyxiated neonates born between 2005 and 2015. Neonatal cranial MRI was re-evaluated using the Weeke score ranging from 0 (normal finding) to 55 (cerebral devastation) by a single neuroradiologist blinded to patient outcomes. Neurodevelopmental outcomes were evaluated using the Bayley Scales of Infant Development (BSID) at 2 years, and tests assessing intellectual performance at 5 years of age.Results: Of the 191 asphyxiated neonates treated with hypothermia, 53 returned for their 5-year follow-up. There were 10 children with MRI scores ≥ 10, all of whom had epilepsy, 9 had severe cognitive impairment, and 9 had cerebral palsy. In contrast, MRI scores < 10 were poorly predictive of later development. BSID at 2 years of age showed good correlation with IQ scores at 5 years of age (Rs = 0.58, p < 0.001).Conclusion: The Weeke score can be used to identify severely impaired children in the neonatal period. In contrast, the neurocognitive test results at 2 years of age were indicative of mild or moderate impairment at 5 years of age.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061697","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

Incorporating an Elevated Perfusion Index in the Right Hand Enhanced Screening Sensitivity for Critical Aortic Arch Obstruction in Newborn Infants.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-29 DOI: 10.1111/apa.17601

Katarina Lannering, Ingegerd Östman-Smith, Mats Mellander

{"title":"Incorporating an Elevated Perfusion Index in the Right Hand Enhanced Screening Sensitivity for Critical Aortic Arch Obstruction in Newborn Infants.","authors":"Katarina Lannering, Ingegerd Östman-Smith, Mats Mellander","doi":"10.1111/apa.17601","DOIUrl":"https://doi.org/10.1111/apa.17601","url":null,"abstract":"Aim: Newborn infants with critical aortic arch obstruction are often undiagnosed at discharge, despite screening. This study investigated if adding the perfusion index improved early detection.Methods: We retrospectively studied 38 newborn infants with critical aortic arch obstruction, who were routinely screened in 2014-2019 by 13 Swedish hospitals using pulse oximetry and the perfusion index. They were identified through surgery records and national mortality databases. The controls were 512 healthy newborn infants from one hospital. Optimal perfusion index cut-offs were determined using frequency distribution analysis.Results: The groups had similar median gestational ages and birth weight. No infants with critical aortic arch obstruction were diagnosed just because of a positive perfusion index result. However, the right-hand perfusion index was significantly higher in the cases than in controls (p < 0.001). A perfusion index of > 3%, or positive pulse oximetry or positive physical examination, yielded 76% sensitivity and 85% specificity, with an area under the receiver operating characteristic curve of 0.81 (range 0.73-0.89, p < 0.0001). Pulse oximetry and just neonatal physical examinations had a lower sensitivity (45%, p = 0.009).Conclusion: A high perfusion index in the right hand enhanced critical aortic arch obstruction screening and repeated measurements should be explored to minimise false positives.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061694","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

Evaluating C-Reactive Protein and Procalcitonin Discordance Among Febrile Infants at Risk of Serious Bacterial Infections.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-28 DOI: 10.1111/apa.17602

Shu-Ling Chong, Stella Jinran Zhan, Zi Xean Khoo, Rupini Piragasam, Lena Wong, Seyed Ehsan Saffari, Jan Hau Lee, Sashikumar Ganapathy, Gene Yong-Kwang Ong

{"title":"Evaluating C-Reactive Protein and Procalcitonin Discordance Among Febrile Infants at Risk of Serious Bacterial Infections.","authors":"Shu-Ling Chong, Stella Jinran Zhan, Zi Xean Khoo, Rupini Piragasam, Lena Wong, Seyed Ehsan Saffari, Jan Hau Lee, Sashikumar Ganapathy, Gene Yong-Kwang Ong","doi":"10.1111/apa.17602","DOIUrl":"https://doi.org/10.1111/apa.17602","url":null,"abstract":"Aim: We aimed to investigate the prevalence and factors associated with C-reactive protein (CRP) and procalcitonin (PCT) discordance in febrile infants with serious bacterial infections (SBIs).Methods: We performed a retrospective review of febrile infants ≤ 90 days old presenting to the emergency department between December 2018 and June 2023. We compared conservative and pragmatic thresholds for PCT (< 0.5 ng/mL and < 1.7 ng/mL) and CRP (< 10 mg/L and < 20 mg/L). Discordance was defined as normal CRP with abnormal PCT and vice versa. Performance was presented using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results: Among 3459 infants, 426 infants (12.3%) had SBIs, among whom 355 (83.3%) had both CRP and PCT performed. Overall, a conservative CRP threshold had the highest sensitivity (74.1%, 95% CI 69.2%-78.6%) and NPV (95.6%, 95% CI 94.6%-96.4%). Among those with SBIs, 148/355 (41.7%) had a normal PCT (< 1.7 ng/mL) and an abnormal CRP (≥ 20 mg/L), while 16/355 (4.5%) had a normal CRP (< 20 mg/L) and an abnormal PCT (≥ 1.7 ng/mL). An increased discordance, specifically abnormal CRP with normal PCT, was found in males, infants 29-90 days old, and those with urinary tract infections.Conclusion: SBI clinical decision rules should consider CRP-PCT discordance in specific patient populations.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054348","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

Authors and Readers Need to Be Wary of Predatory Medical Titles and Focus on High-Quality Peer-Review Journals.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-28 DOI: 10.1111/apa.17605

Annika Janson, Göran Wennergren, Hugo Lagercrantz

引用次数: 0

Quality of Care for Young Febrile Infants Varied Widely Among Spanish Paediatric Emergency Departments.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-27 DOI: 10.1111/apa.17597

Ainara Lejarzegi, Roberto Velasco, David Andina, Borja Gómez, Santiago Mintegi

引用次数: 0

Defining Excellence: The First Core Set of Quality Indicators for the European Paediatric Surgical Audit on Hirschsprung's Disease Care.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-25 DOI: 10.1111/apa.17594

Daniel Rossi, Anna Löf Granström, Mikko Pakarinen, Kristin Bjørnland, Ivo de Blaauw, Mark Ellebæk, Francesco Fascetti Leon, Dirk-Jan Gloudemans, Alessio Pini Prato, Udo Rolle, Nicole Schwarzer, Merit Tabbers, Alejandra Vilanova, Rene Wijnen, Cornelius E J Sloots, Tomas Wester

{"title":"Defining Excellence: The First Core Set of Quality Indicators for the European Paediatric Surgical Audit on Hirschsprung's Disease Care.","authors":"Daniel Rossi, Anna Löf Granström, Mikko Pakarinen, Kristin Bjørnland, Ivo de Blaauw, Mark Ellebæk, Francesco Fascetti Leon, Dirk-Jan Gloudemans, Alessio Pini Prato, Udo Rolle, Nicole Schwarzer, Merit Tabbers, Alejandra Vilanova, Rene Wijnen, Cornelius E J Sloots, Tomas Wester","doi":"10.1111/apa.17594","DOIUrl":"https://doi.org/10.1111/apa.17594","url":null,"abstract":"Aim: This study aimed to develop a universally applicable core set of quality indicators for Hirschsprung's disease care through a consensus-driven process, to standardise and improve care quality across Europe.Methods: A modified Delphi method was used to achieve consensus among healthcare professionals (HPs) and patient representatives (PRs) across Europe. Participants completed three rounds of anonymous surveys, rating quality indicators for Hirschsprung's disease care. A systematic literature review informed the initial item list. Results were analysed using predefined criteria, and a final consensus meeting established the core set of indicators.Results: An international panel of 8 PRs and 96 multidisciplinary health care professionals representing 59 European hospitals completed all questionnaires, eventually including 12 baseline characteristics and 39 indicators. Six of the top 10 indicators were commonly prioritised by both groups. The remaining items were refined through debate and finalised during a consensus meeting.Conclusion: This study established a core set of 12 baseline characteristics and 14 quality indicators for evaluating Hirschsprung's disease care. These indicators will support benchmarking and continuous quality improvement within the European Paediatric Surgical Audit framework, ultimately enhancing outcomes and care for children with Hirschsprung's disease.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048924","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

Randomised In Vitro Study Investigating PEEP-Stability During Application of CPAP With Binasal Prongs and Face Masks.

IF 2.4 4区医学

Acta Paediatrica Pub Date : 2025-01-24 DOI: 10.1111/apa.17589

Hanna Sterzik, Kriszta Molnar, Anette Stauch, Martin Wald, Christian F Poets, Bianca Haase

{"title":"Randomised In Vitro Study Investigating PEEP-Stability During Application of CPAP With Binasal Prongs and Face Masks.","authors":"Hanna Sterzik, Kriszta Molnar, Anette Stauch, Martin Wald, Christian F Poets, Bianca Haase","doi":"10.1111/apa.17589","DOIUrl":"https://doi.org/10.1111/apa.17589","url":null,"abstract":"Aim: Face masks and binasal prongs are commonly used interfaces for applying continuous positive airway pressure (CPAP) in neonatology. We aimed to assess CPAP stability in a randomised controlled in vitro study.Methods: In a simulated resuscitation scenario of a 1000-g preterm infant with respiratory distress, 20 operators (10 with/without neonatology experience) aimed to maintain a CPAP of 5 cmH2O as precisely as possible using face masks or binasal prongs in random order. The primary outcome was the minimum-achieved CPAP at the Y-piece (PYmin). Secondary outcomes included time to target CPAP, CPAP stability and the impact of operator experience.Results: Binasal prongs enabled more consistent maintenance of the target CPAP of 5 cmH2O than face masks (median [IQR]: PYmin: binasal prongs, 3.74 cmH2O [3.54-3.88]) vs. 3.20 cmH2O (2.72-3.73), with no significant deviation from the target CPAP. Target CPAP was achieved significantly faster with face masks (2.89 s [1.67-5.64] vs. 6.49 s [4.76-13.62] [p < 0.05]). No significant differences were observed on the basis of operator experience (p > 0.05).Conclusion: Binasal prongs allow more accurate CPAP maintenance than face masks regardless of the operator's experience, although current clinical studies offer limited evidence on the superiority of nasal interfaces compared with that of face masks.","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034786","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

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