BMJ Paediatrics Open最新文献

{"title":"Effectiveness and feasibility of continuous renal replacement therapy for acute kidney injury in neonates weighing 3 kg or less: a two-centre, retrospective study.","authors":"Yifan Sun, Jinglin Xu, Xiaoyun Chu, Weifeng Zhang, Xiaohui Gong, Dongmei Chen, Cheng Cai","doi":"10.1136/bmjpo-2023-002241","DOIUrl":"10.1136/bmjpo-2023-002241","url":null,"abstract":"<p><strong>Background: </strong>Continuous renal replacement therapy (CRRT) is commonly used for the treatment of acute kidney injury (AKI) in critically ill neonates. This study investigated the effectiveness and feasibility of CRRT for AKI in neonates who weigh ≤3 kg.</p><p><strong>Methods: </strong>Data from 19 neonates with a weight ≤3 kg and AKI who underwent CRRT at two centres between January 2015 and October 2021 were collected retrospectively. Kidney function, circulatory function, complications and clinical outcomes were recorded. Repeated-measures analyses of variance, t-tests and non-parametric tests were conducted.</p><p><strong>Results: </strong>The median patient age at CRRT initiation was 3 days (IQR: 1-7 days). The median patient weight at CRRT initiation was 2.67 kg (IQR: 2.20-2.85 kg). The median CCRT duration was 46 hours (IQR: 32-72 hours). The serum creatinine and blood urea nitrogen levels decreased significantly, and the mean arterial pressure increased significantly after 12 hours of CRRT and at the end of CRRT. The urinary output was significantly increased at the end of CRRT. 11 patients had thrombocytopaenia, 6 had electrolyte disorders and 3 had blocked tubes. Five patients were discharged, six died after their parents chose to discontinue treatment and eight died after active treatment. Weight at CRRT initiation and urinary output at the end of CRRT were significantly lower among patients who died than among patients who survived.</p><p><strong>Conclusions: </strong>CRRT is feasible and effective for AKI in neonates who weigh ≤3 kg when accompanied by elaborate supportive care. Lower body weight and persistent oliguria may be correlated with an increased risk of poor clinical outcomes.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Power to change: a 21st-century paediatrician and their patient in conversation.","authors":"Guddi Singh, Rhea Burman","doi":"10.1136/bmjpo-2024-002972","DOIUrl":"10.1136/bmjpo-2024-002972","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a hospital-based food security programme for children with complex diseases in an upper-middle-income country: a before-and-after study.","authors":"Ángela María Gómez-Casas, Andrés Gempeler, Diana Montoya, Luisa Fernanda González, Sergio I Prada, Luis Alberto Escobar, Jorge Mario Madriñán, Marcela Granados","doi":"10.1136/bmjpo-2024-002690","DOIUrl":"10.1136/bmjpo-2024-002690","url":null,"abstract":"<p><strong>Background: </strong>To reduce health inequities in paediatric patients with complex diseases, our hospital developed a food security programme in 2022. The programme aims to mitigate food insecurity (FI) in paediatric patients with oncological, transplantation and congenital cardiovascular diagnoses, by providing a monthly nutritious food supply that covers up to 50% of the patient's family food intake, accompanied by social and nutritional follow-up. In this study, we aimed to assess the effect of the programme on FI and nutritional status and describe its implementation.</p><p><strong>Method: </strong>We conducted a before-and-after study of patients who entered the programme in a 14-month period. We used the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale score, FI level and nutritional status measures to assess the effect of the programme. We used the Wilcoxon and McNemar tests to assess changes in scores and proportions of patients with moderate and severe FI, respectively, 31.5%-14.4% (p=0.0008) and of moderate FI from 68.5% to 36.9%.</p><p><strong>Results: </strong>111 patients were included. They had a baseline median (IQR) ELCSA score=8 (7-11) that changed to 6 (4-9) (p<0.0001). Severe FI according to ELCSA changed from 31.5% to 14.4% (p<0.001) and moderate from 68.5% to 36.9% (p<0.001). We found no differences in nutritional status regarding height for age (49.5% vs 51.3%, p=0.76), weight for height (42.5% vs 59.1%, p=0.75) or body mass index for age (38% vs 46%, p=0.42) CONCLUSION: The programme reduced FI in families by improving its level to mild or moderate. Children who entered the programme maintained an appropriate nutritional status despite the considerable risk of malnutrition described for oncological paediatric patients and paediatric solid organ transplantation receptors.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma proteomic signature of neonates in the context of placental histological chorioamnionitis.","authors":"Jing Liu, Die Liu, Qi Sun, Yunchao Su, Lijuan Tang, Haixiao Liang, Fang Ye, Yuanmei Chen, Qi Zhang","doi":"10.1136/bmjpo-2024-002708","DOIUrl":"10.1136/bmjpo-2024-002708","url":null,"abstract":"<p><strong>Background: </strong>Placental histological chorioamnionitis (HCA) is recognised as a significant risk factor for various adverse neonatal outcomes. This study aims to explore if the inflammatory protein levels in neonates were associated with HCA.</p><p><strong>Methods: </strong>All women with singleton births from February 2020 to November 2022 were selected and divided into three groups based on maternal placental pathology results: the HCA-stage 1 group (n=24), the HCA-stage 2 group (n=16) and the control group (n=17). Olink Target 96 Inflammation Panel was used to detect the levels of 92 inflammation-related proteins in the plasma of newborns from all three groups within 24 hours after birth. We compared the protein profiles through differential protein expression analysis.</p><p><strong>Results: </strong>A total of six inflammation-related proteins exhibited significant differences between the HCA-stage 1 and the control group. Specifically, TRANCE and CST5 were significantly upregulated (p=0.006, p=0.025, respectively), whereas the expression of IFN-gamma, CXCL9, CXCL10 and CCL19 was significantly downregulated (p=0.040, p=0.046, p=0.007, p=0.006, respectively). HCA-stage 2 newborns had significantly elevated levels of CD5 and CD6 and decreased IFN-gamma, CXCL10 and CCL19 in comparison to controls. These differential proteins were significantly enriched in positive regulation of cytokine activity, leucocyte chemotaxis and positive regulation of T-cell activation pathway-related Gene Ontology terms. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that viral protein interaction with cytokine and cytokine receptor, interleukin-17/NF-kappa B/toll-like receptor/chemokine signalling pathway, and cytokine-cytokine receptor interaction exhibited significant differences. Spearman analysis demonstrated a significant positive connection between the levels of CD6 and CD5 proteins, not only in neonatal leucocytes but also in maternal leucocytes. Additionally, CD6 was found to be associated with neonatal birth weight.</p><p><strong>Conclusions: </strong>In conclusion, placental histological changes associated with chorioamnionitis appear to influence the expression of inflammatory proteins in offspring. Notably, CD6 and CD5 proteins may potentially contribute to the pathogenesis of HCA-related neonatal diseases.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department.","authors":"Giorgio Cozzi, Sara Chiappa, Giovanna La Fauci, Matteo Calvi, Emanuele Castagno, Eleonora Tappi, Giovanna Villa, Paola Tommasi, Gregorio Paolo Milani, Marta Cellai Rustici, Maria Luisa Casciana, Nicola Tovaglieri, Stefano Masi, Cesare Vezzoli, Sofia Zeuditù Tilatti, Manuela Giangreco, Egidio Barbi, Franca Benini","doi":"10.1136/bmjpo-2024-002719","DOIUrl":"10.1136/bmjpo-2024-002719","url":null,"abstract":"<p><strong>Background: </strong>Despite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes.</p><p><strong>Methods: </strong>A multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group. It included a survey and a retrospective data collection in which the medical records of all patients who received analgesia from 1 April 2022 to 31 May 2022 were collected.</p><p><strong>Results: </strong>48 centres (91%) answered the survey. The intranasal and sublingual routes were used in 25 centres (52%). 13 centres (27%) used both routes, 9 centres (19%) used only the sublingual and 3 centres (6%) used only the intranasal route.12 centres (48%) participated in the retrospective study. Data about 3409 patients, median age 9 years (IQR 5-12), were collected. Among them, 337 patients (9.6%) received sublingual analgesia, and 87 patients (2.5%) received intranasal analgesia. The intranasal route was employed for injuries in 79 (90.8%) cases, and fentanyl was the drug delivered in 85 (97.7%) cases. The sublingual route was used mainly for injuries (57.3%), but also for abdominal pain (15.4%), musculoskeletal pain (14.5%) and headache (10.7%). Paracetamol, ketorolac and tramadol were administered through this route.</p><p><strong>Conclusions: </strong>The use of the intranasal and sublingual routes for analgesia in the paediatric ED is still limited.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tanner's target height formula underestimates final adult height in Korean adolescents and young adults: reassessment of target height based on the Korean National Health and Nutrition Examination Survey 2010-2019.","authors":"Sejin Kim, Jae Ho Yoo, Hee Won Chueh","doi":"10.1136/bmjpo-2024-002653","DOIUrl":"10.1136/bmjpo-2024-002653","url":null,"abstract":"<p><strong>Objective: </strong>Estimating children's target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner's formula to predict children's final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner's formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children.</p><p><strong>Design/setting: </strong>Data were derived from the Korean National Health and Nutrition Examination Survey 2010-2019.</p><p><strong>Patients: </strong>A total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner's formula could not be calculated because of missing parental height data.</p><p><strong>Main outcome measures: </strong>Tanner-based TH was compared with the FAH.</p><p><strong>Results: </strong>The difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons' and daughters' heights, respectively.</p><p><strong>Conclusions: </strong>Tanner's formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between methylphenidate use and long-term cardiovascular risk in paediatric patients with attention deficit and hyperactivity disorder.","authors":"Heng-Ching Liao, Chien-Ning Hsu, Fang-Ju Lin, Susan Shur-Fen Gau, Chi-Chuan Wang","doi":"10.1136/bmjpo-2024-002753","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002753","url":null,"abstract":"<p><strong>Background: </strong>There have been concerns about the potential cardiovascular (CV) adverse effects associated with methylphenidate (MTH) use. However, only limited evidence exists on the long-term safety of MTH.</p><p><strong>Objective: </strong>To evaluate whether MTH use is associated with long-term CV risk.</p><p><strong>Methods: </strong>This was a retrospective cohort study using 2003-2017 data from the Health and Welfare Database in Taiwan. Patients newly diagnosed with attention deficit and hyperactivity disorder (ADHD) and between 3 and 18 years of age were included. Two treatment statuses were assessed: initial treatment ≥7 days and ≥180 days. Patients treated with MTH were compared with those receiving non-medication therapy. One-to-one propensity score matching was used to balance between-group differences. Study outcomes included major CV events, chronic CV disease, cardiogenic shock and all-cause mortality. Cox proportional hazard models were used to estimate HRs between the two groups.</p><p><strong>Results: </strong>We began with 307 459 patients with ADHD. After exclusion, 224 732 patients were included in the final cohort. The results showed that compared with non-ADHD medication users, patients who were treated with MTH for more than 7 days had a similar risk of major CV events (HR 0.85, 95% CI 0.72 to 0.99; p=0.040). Identical trends were found in groups who were treated for more than 180 days (HR 0.83, 95% CI 0.69 to 1.00; p=0.050). The results of the sensitivity analyses were consistent with the main analyses across all groups and individual outcomes.</p><p><strong>Conclusion: </strong>Short-term MTH use did not increase CV risk among patients with ADHD. More evidence on long-term MTH use and risk of cardiogenic shock and death is warranted.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131784","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}

{"title":"Surgery for intestinal injuries in very preterm infants: a Norwegian population-based study with a new approach to disease classification","authors":"Nina Clare Hapnes, Hans Jørgen Stensvold, Kristin Bjørnland, Thorstein Sæter, Hans Jørgen Timm Guthe, Ragnhild Støen, Sissel Jennifer Moltu, Arild Rønnestad, Claus Klingenberg","doi":"10.1136/bmjpo-2024-002722","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002722","url":null,"abstract":"Objective To evaluate population-based data on very preterm infants (<32 weeks gestation) operated for intestinal injuries, focusing on necrotising enterocolitis (NEC) and focal intestinal perforation (FIP). Design Nationwide, population-based registry cohort study. Setting All 21 neonatal units in Norway. Participants All very preterm infants born from 2014 through 2021 and admitted to a neonatal unit. Main outcome measures Incidence of surgery for subgroups of intestinal injuries, medical record data on laboratory-radiology results, anatomical location of affected bowel, length of resections, number of re-operations, morbidities of prematurity and/or death before discharge. Results Abdominal surgery was performed in 124/4009 (3.1%) very preterm infants and in 97/1300 (7.5%) extremely preterm infants <28 weeks. The main intestinal injuries operated were NEC (85/124; 69%), FIP (26/124; 21%) and ‘other abdominal pathologies’ (13/124; 10%). NEC cases were divided in (i) acute NEC, extensive disease (n=18), (ii) non-extensive disease (n=53) and (iii) NEC with surgery >3 days after disease onset (n=14). High lactate values immediately prior to surgery was predominantly seen in acute NEC-extensive disease and associated with high mortality. Other laboratory values could not discriminate between acute NEC and FIP. Timing of surgery for acute NEC and FIP overlapped. Radiological absence of portal venous gas was typical in FIP. Most infants (62.5%) underwent a stoma formation at initial surgery. The overall survival rate was 67% for NEC and 77% for FIP. Conclusion NEC cases have different presentation and prognosis depending on the extent of bowel affected. Revised classifications for intestinal injuries in preterm infants may improve prognostication and better guide therapy. Data are available on reasonable request. The raw data supporting the conclusion of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher.","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255452","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}

{"title":"Street-working children in Latin America: a critical perspective","authors":"María Camila Pinzón-Segura","doi":"10.1136/bmjpo-2024-002916","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002916","url":null,"abstract":"This article critically explores the complex realities faced by street-working children (SWC) in Latin America, highlighting historical and structural inequalities—such as coloniality, heteropatriarchy, and neoliberal capitalism—that perpetuate their marginalisation. Hegemonic public policies tend to focus narrowly on control, normalisation, and short-term relief, often neglecting the deeper systemic issues that sustain these vulnerabilities. This study calls for a shift towards alternative frameworks of public policy analysis that permit addressing the socio-political and cultural specificities of Latin America from a decolonial perspective. By incorporating affective, semiotic, and material dimensions, the Affective Interstice Theory provides analytical tools to understand how policy discourses not only shape the emotional and material experiences of those involved but also reinforce existing power structures. These insights reveal critical opportunities for resistance and transformative change, urging the development of policies that do more than address immediate needs—policies that actively dismantle the structural dynamics underpinning the marginalisation of SWC. The article underscores the need for contextualised approaches that engage with the complexity of local realities, offering a path towards more equitable and just policy outcomes across the region.","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225855","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}

{"title":"Risk of neuropsychiatric adverse events associated with montelukast use in children and adolescents: a population-based case-crossover study","authors":"Jae Won Kim, Mideum Kim, Min Sook Seo, Ju-Young Shin","doi":"10.1136/bmjpo-2023-002483","DOIUrl":"https://doi.org/10.1136/bmjpo-2023-002483","url":null,"abstract":"Purpose Montelukast is used extensively in children and adolescents for allergic rhinitis and asthma. However, concerns have been raised regarding the increased risk of neuropsychiatric adverse events (NPAEs) associated with montelukast use. Therefore, our case-crossover study was conducted to observe whether there is an increased risk of NPAEs associated with montelukast use in children and adolescents. Materials and methods A population-based case-crossover study using the customised Health Insurance Review and Assessment (HIRA) dataset was conducted. Paediatric patients aged between 0 and 19 years diagnosed with allergic rhinitis and/or asthma with a history of at least one montelukast prescription between 1 January 2018 and 31 December 2021 were included. Exposure to montelukast was assessed during 3-, 7-, 14-, 28- and 56-day hazard periods prior to each patient’s NPAE. Stratified analyses according to age group, gender and season for the risk of NPAEs associated with montelukast use in the previous 7 days and 14 days were performed, respectively. Conditional logistic regression analysis was used to calculate adjusted ORs (aORs) with their corresponding 95% CIs, adjusting for concomitant medications. Results A total of 161 386 paediatric patients was identified. An increased risk of NPAEs associated with montelukast was found in all time window periods, including 3-day (aOR 1.28, 95% CI 1.24 to 1.32), 7-day (aOR 1.29, 95% CI 1.26 to 1.33), 14-day (aOR 1.34, 95% CI 1.31 to 1.37), 28-day (aOR 1.38, 95% CI 1.36 to 1.41) and 56-day (aOR 1.21, 95% CI 1.19 to 1.22) preceding hazard periods compared with use in the four control periods. Conclusion Children and adolescents with allergic rhinitis and/or asthma should be prescribed montelukast with caution considering clinical benefits. Data are available upon reasonable request.","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201759","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}