Journal of paediatrics and child health最新文献

英文中文

Paediatric idiopathic intracranial hypertension: Epidemiology, clinical features and treatment outcomes in a tertiary care centre in Western Australia. 小儿特发性颅内高压：西澳大利亚州一家三级医疗中心的流行病学、临床特征和治疗效果。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-16 DOI: 10.1111/jpc.16622

Snehal Shah, Aleksandra Khan, Mohd Khan, Rahul Lakshmanan

Aim: This retrospective study aims to analyse the epidemiology, clinical and neuroimaging features, treatment modalities, and outcomes of paediatric idiopathic intracranial hypertension (IIH) in a tertiary care centre in Australia.

Methods: Using the International Classification of Diseases Diagnostic Criteria for IIH, we identified and analysed a cohort of children diagnosed with IIH over a 5-year period (2017-2022). Data on patient demographics, symptomatology, examination findings, investigative results, treatments and outcomes were collected from medical records and electronic health records.

Results: A total of 45 cases were analysed. The pre-pubertal group saw a male predominance and the post-pubertal a female one. Increased body mass index was an associated comorbidity in majority of patients. Headaches (89%) and visual symptoms (56%) were the most common symptoms, with tinnitus also seen in 20% of patients. Papilledema was detected in 91% of the cases examined. The commonest neuroimaging features were optic nerve sheath distention (78%) and empty sella (49%). Acetazolamide was the primary treatment, with most patients responding well. Only a minority required surgical intervention. Long-term resolution of headaches was achieved in 89% of patients.

Conclusions: The incidence of paediatric IIH in the West Australian population appears relatively high. It presents with subtle symptoms, emphasising the need for increased awareness among health-care providers. Younger children may represent a distinct subgroup with unique clinical features. Timely diagnosis and aggressive medical management lead to favourable outcomes. However, weight loss interventions showed limited effectiveness. This study underscores the importance of early recognition and management of paediatric IIH to optimise patient outcomes.

目的：这项回顾性研究旨在分析澳大利亚一家三级医疗中心的小儿特发性颅内高压（IIH）的流行病学、临床和神经影像学特征、治疗方式和结果：我们采用国际疾病分类 IIH 诊断标准，对 5 年内（2017-2022 年）诊断为 IIH 的儿童进行了鉴定和分析。我们从医疗记录和电子健康记录中收集了有关患者人口统计学、症状学、检查结果、检查结果、治疗和结果的数据：共分析了 45 个病例。结果：共分析了 45 个病例，青春期前的病例以男性为主，青春期后的病例以女性为主。体重指数升高是大多数患者的并发症。头痛（89%）和视觉症状（56%）是最常见的症状，20%的患者还伴有耳鸣。91%的受检病例出现乳头水肿。最常见的神经影像学特征是视神经鞘膨胀（78%）和空蝶鞍（49%）。乙酰唑胺是主要的治疗方法，大多数患者反应良好。只有少数患者需要手术治疗。89%的患者可长期缓解头痛：西澳大利亚州儿童 IIH 的发病率似乎相对较高。结论：小儿 IIH 在西澳大利亚人群中的发病率相对较高，且症状不明显，因此需要提高医疗服务提供者的认识。年龄较小的儿童可能是一个具有独特临床特征的亚群体。及时诊断和积极的医疗管理可带来良好的治疗效果。然而，减肥干预的效果有限。这项研究强调了早期识别和治疗小儿IIH以优化患者预后的重要性。

{"title":"Paediatric idiopathic intracranial hypertension: Epidemiology, clinical features and treatment outcomes in a tertiary care centre in Western Australia.","authors":"Snehal Shah, Aleksandra Khan, Mohd Khan, Rahul Lakshmanan","doi":"10.1111/jpc.16622","DOIUrl":"https://doi.org/10.1111/jpc.16622","url":null,"abstract":"<p><strong>Aim: </strong>This retrospective study aims to analyse the epidemiology, clinical and neuroimaging features, treatment modalities, and outcomes of paediatric idiopathic intracranial hypertension (IIH) in a tertiary care centre in Australia.</p><p><strong>Methods: </strong>Using the International Classification of Diseases Diagnostic Criteria for IIH, we identified and analysed a cohort of children diagnosed with IIH over a 5-year period (2017-2022). Data on patient demographics, symptomatology, examination findings, investigative results, treatments and outcomes were collected from medical records and electronic health records.</p><p><strong>Results: </strong>A total of 45 cases were analysed. The pre-pubertal group saw a male predominance and the post-pubertal a female one. Increased body mass index was an associated comorbidity in majority of patients. Headaches (89%) and visual symptoms (56%) were the most common symptoms, with tinnitus also seen in 20% of patients. Papilledema was detected in 91% of the cases examined. The commonest neuroimaging features were optic nerve sheath distention (78%) and empty sella (49%). Acetazolamide was the primary treatment, with most patients responding well. Only a minority required surgical intervention. Long-term resolution of headaches was achieved in 89% of patients.</p><p><strong>Conclusions: </strong>The incidence of paediatric IIH in the West Australian population appears relatively high. It presents with subtle symptoms, emphasising the need for increased awareness among health-care providers. Younger children may represent a distinct subgroup with unique clinical features. Timely diagnosis and aggressive medical management lead to favourable outcomes. However, weight loss interventions showed limited effectiveness. This study underscores the importance of early recognition and management of paediatric IIH to optimise patient outcomes.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626971","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

Informing knowledge translation for selective dorsal rhizotomy: A survey of Australian clinicians and people with lived experience of cerebral palsy 为选择性背根切断术的知识转化提供信息：对澳大利亚临床医生和脑瘫患者的调查。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-08 DOI: 10.1111/jpc.16605

Jennifer A Lewis, Simon P Paget, Neil Wimalasundera, Meredith Wynter, Lani Campbell, Olivia S Lee, Kirsty Stewart, R Shah, Marnee J McKay, the Selective Dorsal Rhizotomy Knowledge Translation Advisory Team

Aim

Selective dorsal rhizotomy (SDR) is a neurosurgical intervention used to reduce spasticity in children with cerebral palsy (CP). There is minimal relevant, evidence-based information available for Australian families and clinicians. This study aims to investigate the knowledge of people with lived experience and clinicians regarding SDR, including how they currently access information and what information they seek.

Methods

Adults with CP, carers of children with CP and clinicians treating children with CP were invited to complete an online survey. Data regarding participant demographics, current knowledge and confidence in knowledge about CP and SDR, information source/s used and participants level of trust in these sources are presented as counts and percentages. Comparisons in knowledge between groups were analysed.

Results

A total of 114 surveys were completed: 63 clinicians, 48 carers, and 3 adults with CP. Eighty percent of clinicians were allied health professionals. People with lived experience were less confident in their knowledge about SDR compared to knowledge of CP (P < 0.001). Clinicians rated scientific research literature and the hospital team as the most useful and trustworthy information source. People with lived experience used a wider range of information sources including the internet, rating their community therapy team and other people with lived experience as the most useful.

Conclusion

This study identified a lack of confidence in knowledge of SDR for people with lived experience, likely due to a gap in accessible and readable evidence-based information. While both groups differed in how they access information, there was agreement that greater information about SDR is needed.

目的：选择性背根切断术（SDR）是一种用于减轻脑性瘫痪（CP）儿童痉挛的神经外科干预措施。澳大利亚家庭和临床医生可获得的相关循证信息极少。本研究旨在调查有生活经验者和临床医生对 SDR 的了解，包括他们目前如何获取信息以及他们寻求哪些信息：方法：邀请患有脊髓灰质炎的成年人、脊髓灰质炎患儿的照顾者以及治疗脊髓灰质炎患儿的临床医生完成一项在线调查。有关参与者的人口统计学特征、目前对 CP 和 SDR 知识的了解和信心、所使用的信息来源以及参与者对这些信息来源的信任程度等数据均以计数和百分比的形式呈现。对各组之间的知识比较进行了分析：共完成了 114 份调查问卷：结果：共完成了 114 份调查问卷，其中包括 63 名临床医生、48 名照护者和 3 名成年脊髓灰质炎患者。80%的临床医生为专职医疗人员。与对脊髓灰质炎的了解相比，有生活经验的人对 SDR 的了解更缺乏信心（P 结论：本研究发现了对 SDR 缺乏信心的原因：本研究发现，有生活经验的人对 SDR 的知识缺乏信心，这可能是由于缺乏可获取、可阅读的循证信息。虽然两个群体在获取信息的方式上存在差异，但他们一致认为需要获得更多有关 SDR 的信息。

{"title":"Informing knowledge translation for selective dorsal rhizotomy: A survey of Australian clinicians and people with lived experience of cerebral palsy","authors":"Jennifer A Lewis, Simon P Paget, Neil Wimalasundera, Meredith Wynter, Lani Campbell, Olivia S Lee, Kirsty Stewart, R Shah, Marnee J McKay, the Selective Dorsal Rhizotomy Knowledge Translation Advisory Team","doi":"10.1111/jpc.16605","DOIUrl":"10.1111/jpc.16605","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Selective dorsal rhizotomy (SDR) is a neurosurgical intervention used to reduce spasticity in children with cerebral palsy (CP). There is minimal relevant, evidence-based information available for Australian families and clinicians. This study aims to investigate the knowledge of people with lived experience and clinicians regarding SDR, including how they currently access information and what information they seek.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults with CP, carers of children with CP and clinicians treating children with CP were invited to complete an online survey. Data regarding participant demographics, current knowledge and confidence in knowledge about CP and SDR, information source/s used and participants level of trust in these sources are presented as counts and percentages. Comparisons in knowledge between groups were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 114 surveys were completed: 63 clinicians, 48 carers, and 3 adults with CP. Eighty percent of clinicians were allied health professionals. People with lived experience were less confident in their knowledge about SDR compared to knowledge of CP (<i>P <</i> 0.001). Clinicians rated scientific research literature and the hospital team as the most useful and trustworthy information source. People with lived experience used a wider range of information sources including the internet, rating their community therapy team and other people with lived experience as the most useful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified a lack of confidence in knowledge of SDR for people with lived experience, likely due to a gap in accessible and readable evidence-based information. While both groups differed in how they access information, there was agreement that greater information about SDR is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554976","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

A 10-year-old child with acute torticollis and walking difficulty 一名 10 岁儿童，患有急性肢体扭转和行走困难。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-05 DOI: 10.1111/jpc.1_16452

Meltem Akcaboy, Yasemin Tasci Yildiz, Betül Emine Derinkuyu, Saliha Senel

引用次数: 0

An unusual rash 不寻常的皮疹

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-05 DOI: 10.1111/jpc.1_16483

Ellie Gribbin, Mark Westphalen

引用次数: 0

Nail sign: Harbinger to systemic disease 指甲征全身性疾病的先兆。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-05 DOI: 10.1111/jpc.1_16499

Dr Shruti Sharma, Dr Yash P Sharma

引用次数: 0

Eye care following pre-school vision screening: Data from the Growing Up in New Zealand study 学前视力筛查后的眼保健：来自新西兰成长研究的数据。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-04 DOI: 10.1111/jpc.16613

Rebecca W Findlay, Nicola S Anstice, Joanna M Black, Cameron C Grant, Carol Chelimo

Aim

This study aimed to determine adherence with follow-up from the New Zealand pre-school vision screening programme. The study also examined associations between pre-school vision screening outcomes and cognitive measures assessed at the 54-month follow-up in the Growing Up in New Zealand study cohort.

Methods

A cross-sectional retrospective record review of pre-school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data.

Results

Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow-up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow-up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05).

Conclusions

Non-attendance at referral and follow-up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity-based improvements are required to ensure that all children referred from vision screening receive appropriate follow-up eye care.

目的：本研究旨在确定新西兰学前视力筛查计划的随访情况。该研究还考察了学前视力筛查结果与 "新西兰成长 "研究队列 54 个月随访评估的认知指标之间的关联：方法：对学前视力筛查结果和医院眼科记录进行横断面回顾性记录审查，并与新西兰成长队列研究数据建立联系：在 176 名通过视力筛查转诊的儿童中，21.6% 的儿童没有参加转诊预约。在 138 名参加了转诊预约的儿童中，21.0% 的儿童没有参加一次或多次后续预约。在参加转介预约（参加的毛利人占13%，太平洋岛民占22.5%，欧裔/其他族裔占64.5%；未参加的毛利人占26.3%，太平洋岛民占28.9%，欧裔/其他族裔占44.7%；P = 0.04）和复诊预约（参加的毛利人占11.9%，太平洋岛民占15.6%，欧裔/其他族裔占72.5%；未参加的毛利人占17.2%，太平洋岛民占48.3%，欧裔/其他族裔占34.5%；P = 0.001）方面观察到了种族差异。视力筛查结果与字母命名流利度得分（P = 0.01）明显相关，但与姓名和数字得分（P = 0.05）无关：结论：不参加转诊和复诊限制了视力筛查的效果，尤其是对毛利族和太平洋岛屿族裔儿童而言。通过视力筛查转诊的儿童在字母命名流利度方面得分较低，而字母命名流利度是预测儿童日后阅读能力的关键因素。需要在公平的基础上进行改进，以确保所有通过视力筛查转诊的儿童都能得到适当的后续眼科护理。

{"title":"Eye care following pre-school vision screening: Data from the Growing Up in New Zealand study","authors":"Rebecca W Findlay, Nicola S Anstice, Joanna M Black, Cameron C Grant, Carol Chelimo","doi":"10.1111/jpc.16613","DOIUrl":"10.1111/jpc.16613","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to determine adherence with follow-up from the New Zealand pre-school vision screening programme. The study also examined associations between pre-school vision screening outcomes and cognitive measures assessed at the 54-month follow-up in the <i>Growing Up in New Zealand</i> study cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional retrospective record review of pre-school vision screening outcomes and hospital ophthalmology records with linkage to <i>Growing Up in New Zealand</i> cohort study data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow-up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; <i>P</i> = 0.04) and follow-up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; <i>P</i> = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (<i>P</i> = 0.01) but not name and numbers scores (<i>P</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Non-attendance at referral and follow-up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity-based improvements are required to ensure that all children referred from vision screening receive appropriate follow-up eye care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534621","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}

引用次数: 0

Facial birthmark, epilepsy and glaucoma in the infant 婴儿面部胎记、癫痫和青光眼。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-03 DOI: 10.1111/jpc.16606

Grace X Li, Esther Tantsis, Deshan F Sebaratnam

A 4-week-old infant was initially referred to the dermatology department for review of a birthmark. The lesion was present congenitally and characterised by well-demarcated erythema affecting the bilateral forehead a cheek extending to the philtrum (Fig. 1). Following several episodes of desaturation and poor responsiveness during sleep, he was diagnosed with epilepsy at 5 months of age based on video encephalography. At 6 months of age, glaucoma in his left eye was noted, and a baseline feed and wrap MRI demonstrated changes compatible with leptomeningeal angiomatosis. What is the most likely diagnosis? (Answer on page 389)

一名 4 周大的婴儿因胎记被转到皮肤科就诊。该胎记是先天性的，其特征是双侧前额和脸颊出现界限清晰的红斑，并延伸至咽部（图 1）。在睡眠期间，他曾多次出现睡眠不饱和和反应迟钝的情况，5 个月大时，根据视频脑电图被诊断为癫痫。6 个月大时，他的左眼出现青光眼，基线喂养和包膜核磁共振成像显示其变化与脑膜血管瘤病症相符。最有可能的诊断是什么？(答案在第 389 页）

引用次数: 0

Provision of bubble continuous positive airway pressure for the stabilisation of extremely and very preterm infants after birth: A single-centre experience 在极早产儿和超早产儿出生后提供气泡持续正压呼吸以稳定病情：单中心经验。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-03 DOI: 10.1111/jpc.16608

Nele Legge, Dominic Fitzgerald, Himanshu Popat

Aim

To describe the effect of resuscitation with bubble CPAP (bCPAP) versus T-piece device at birth on early clinical parameters and hospital outcomes in infants born <32 weeks gestation.

Methods

This is a single-centre pre- and post-implementation study comparing outcomes in two epochs. In epoch 1 (1 July 2013–31 December 2014), infants were managed with non-humidified gas using Neopuff® T-piece devices to support breathing after birth. In epoch 2 (1 March 2020–31 December 2021), routine application of bCPAP with humidified gas was introduced at birth.

Results

Three hundred fifty-seven patients were included (176 epoch 1, 181 epoch 2). The mean gestational age was 28 ± 2 weeks. The demographics of the two epochs were comparable. There were significant improvements in outcomes of infants in epoch 2 with less infants intubated at delivery (16% vs. 4%, P ≤ 0.001), improved 5 min Apgar (7 vs. 8, P ≤ 0.001), reduced need for ventilation (21% vs. 8.8%, P ≤ 0.001), duration of ventilation in the first 72 h (9.6 vs. 4.6 h) and mortality (10.8% vs. 1.7%, P ≤ 0.001). There was, increased incidence of chronic lung disease (30% vs. 55%, P = 0.02) but no increase in infants discharged on oxygen (3.8% vs. 5%, P = 0.25). Similar findings were observed in a subgroup of infants born <25 weeks' gestation with no increase in the incidence of CLD.

Conclusion

Introducing application of bCPAP from the first breaths in infants <32 weeks' gestation was associated with better short-term outcomes and mortality, albeit with increased incidence of CLD. The subgroup of infants born <25 weeks' gestation showed similar change in outcomes, with no increase in CLD.

目的：描述在婴儿出生时使用气泡式 CPAP（bCPAP）和 T 片式设备进行复苏对婴儿早期临床参数和住院治疗效果的影响方法：这是一项实施前和实施后的单中心研究，比较两个时期的治疗效果：这是一项单中心研究，比较两个阶段实施前和实施后的结果。在第一阶段（2013 年 7 月 1 日至 2014 年 12 月 31 日）中，婴儿出生后使用 Neopuff® T 片式装置以非湿化气体支持呼吸。在第二阶段（2020 年 3 月 1 日至 2021 年 12 月 31 日），婴儿出生后常规使用带加湿气体的 bCPAP：结果：共纳入 357 例患者（176 例病程 1，181 例病程 2）。平均胎龄为 28±2 周。两个阶段的人口统计学特征相当。第 2 阶段的婴儿预后明显改善，分娩时插管的婴儿减少（16% 对 4%，P≤0.001），5 分钟 Apgar 有所改善（7 对 8，P≤0.001），通气需求减少（21% 对 8.8%，P≤0.001），前 72 小时的通气持续时间（9.6 对 4.6 小时）和死亡率（10.8% 对 1.7%，P≤0.001）。慢性肺病的发病率有所增加（30% 对 55%，P = 0.02），但吸氧出院的婴儿人数没有增加（3.8% 对 5%，P = 0.25）。在一组出生婴儿中也观察到了类似的结果：从婴儿的第一次呼吸开始使用 bCPAP

{"title":"Provision of bubble continuous positive airway pressure for the stabilisation of extremely and very preterm infants after birth: A single-centre experience","authors":"Nele Legge, Dominic Fitzgerald, Himanshu Popat","doi":"10.1111/jpc.16608","DOIUrl":"10.1111/jpc.16608","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the effect of resuscitation with bubble CPAP (bCPAP) versus T-piece device at birth on early clinical parameters and hospital outcomes in infants born <32 weeks gestation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single-centre pre- and post-implementation study comparing outcomes in two epochs. In epoch 1 (1 July 2013–31 December 2014), infants were managed with non-humidified gas using Neopuff® T-piece devices to support breathing after birth. In epoch 2 (1 March 2020–31 December 2021), routine application of bCPAP with humidified gas was introduced at birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred fifty-seven patients were included (176 epoch 1, 181 epoch 2). The mean gestational age was 28 ± 2 weeks. The demographics of the two epochs were comparable. There were significant improvements in outcomes of infants in epoch 2 with less infants intubated at delivery (16% vs. 4%, <i>P</i> ≤ 0.001), improved 5 min Apgar (7 vs. 8, <i>P</i> ≤ 0.001), reduced need for ventilation (21% vs. 8.8%, <i>P</i> ≤ 0.001), duration of ventilation in the first 72 h (9.6 vs. 4.6 h) and mortality (10.8% vs. 1.7%, <i>P</i> ≤ 0.001). There was, increased incidence of chronic lung disease (30% vs. 55%, <i>P</i> = 0.02) but no increase in infants discharged on oxygen (3.8% vs. 5%, <i>P</i> = 0.25). Similar findings were observed in a subgroup of infants born <25 weeks' gestation with no increase in the incidence of CLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Introducing application of bCPAP from the first breaths in infants <32 weeks' gestation was associated with better short-term outcomes and mortality, albeit with increased incidence of CLD. The subgroup of infants born <25 weeks' gestation showed similar change in outcomes, with no increase in CLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492383","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}

引用次数: 0

Black tongue in an infant 婴儿的黑舌头

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-03 DOI: 10.1111/jpc.16610

Ivânia Soares, Hugo Leme, Inês Pereira Amaral, Madalena Pupo Correia, Paulo Filipe

引用次数: 0

Prevention of vertical transmission of hepatitis B: A retrospective review of a 5-year maternal–infant cohort in London 预防乙型肝炎的垂直传播：对伦敦 5 年母婴队列的回顾性研究。

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2024-07-02 DOI: 10.1111/jpc.16609

Elizabeth O'Mahony, Sophie Raghunanan, Ashley Brown, Caroline Foster

Aims

The World Health Organization (WHO) estimates that 3.5% of the population live with hepatitis B virus (HBV); migrants to Europe are disproportionately affected. UK birth dose HBV vaccination is limited to infants born to those living with HBV (LWHBV). High-risk infants (high maternal infectivity, low birthweight) also receive HBV immunoglobulin (HBIG). The Family Hepatitis Clinic follows infants and those LWHBV working towards WHO goals of combating viral hepatitis by 2030.

Methods

A trust-wide electronic note review of outcomes for infants born to those LWHBV (2016–2020).

Results

Two hundred and eighty-three infants, 134 (47%) females, born to those LWHBV were referred. Two hundred and thirty-one (82%) attended follow-up with a vertical transmission rate of 0%. Twenty (7%) individuals LWHBV received tenofovir disoproxil fumerate in pregnancy; median viral load (VL) at initiation 125 416 376 DNA IU/mL, one having birth VL. Twenty-eight (10%) infants were stratified as high risk and all received HBIG and birth dose vaccination with 9 (32%) subsequently lost to follow-up, compared to 48 (19%) low-risk infants. 267/283 (94%) had birth dose vaccination documented and 206/283 (73%) received at least four vaccine doses. 215/283 (76%) infants had serology by 24 months; 17 (6%) with suboptimal vaccine responses: hepatitis B surface antibody <100 IU/mL. Serology before 18 months resulted in higher rates of maternal hepatitis B core antibody detection (15% vs. 3%).

Conclusion

Prevention of vertical transmission of HBV was universal in those attending, although high-risk infants were more likely lost to follow up. HBV post-vaccine serological protection was comparable with national data from 2021 (77% >4 doses, 77% HBsAb >100).

目的：据世界卫生组织（WHO）估计，3.5% 的人口携带乙型肝炎病毒 (HBV)；欧洲移民受到的影响尤为严重。英国的出生剂量乙型肝炎病毒疫苗接种仅限于乙型肝炎病毒感染者（LWHBV）所生的婴儿。高风险婴儿（母体感染率高、出生体重低）也会接种 HBV 免疫球蛋白 (HBIG)。家庭肝炎诊所对婴儿和 LWHBV 患者进行跟踪，努力实现世界卫生组织到 2030 年消除病毒性肝炎的目标：方法：在整个信托基金范围内对 LWHBV 患者所生婴儿的治疗结果进行电子记录审查（2016-2020 年）：转诊了283名LWHBV感染者所生的婴儿，其中134名（47%）为女性。231人（82%）接受了随访，垂直传播率为0%。20名（7%）LWHBV患者在怀孕期间接受了替诺福韦酯富马酸盐治疗；开始治疗时的病毒载量（VL）中位数为125 416 376 DNA IU/mL，其中一名患者出生时病毒载量为VL。28名婴儿（10%）被分层为高风险婴儿，所有婴儿都接受了 HBIG 和出生剂量疫苗接种，其中 9 名婴儿（32%）后来失去了随访机会，而低风险婴儿有 48 名（19%）。267/283（94%）名婴儿有出生剂量疫苗接种记录，206/283（73%）名婴儿至少接种了四剂疫苗。215/283（76%）名婴儿在 24 个月前进行了血清学检测；17（6%）名婴儿的疫苗反应不理想：乙肝表面抗体：虽然高风险婴儿更有可能失去随访，但参加疫苗接种的婴儿都能预防 HBV 垂直传播。接种乙肝疫苗后的血清学保护率与 2021 年的全国数据相当（77% >4 剂，77% HBsAb >100）。

{"title":"Prevention of vertical transmission of hepatitis B: A retrospective review of a 5-year maternal–infant cohort in London","authors":"Elizabeth O'Mahony, Sophie Raghunanan, Ashley Brown, Caroline Foster","doi":"10.1111/jpc.16609","DOIUrl":"10.1111/jpc.16609","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The World Health Organization (WHO) estimates that 3.5% of the population live with hepatitis B virus (HBV); migrants to Europe are disproportionately affected. UK birth dose HBV vaccination is limited to infants born to those living with HBV (LWHBV). High-risk infants (high maternal infectivity, low birthweight) also receive HBV immunoglobulin (HBIG). The Family Hepatitis Clinic follows infants and those LWHBV working towards WHO goals of combating viral hepatitis by 2030.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A trust-wide electronic note review of outcomes for infants born to those LWHBV (2016–2020).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and eighty-three infants, 134 (47%) females, born to those LWHBV were referred. Two hundred and thirty-one (82%) attended follow-up with a vertical transmission rate of 0%. Twenty (7%) individuals LWHBV received tenofovir disoproxil fumerate in pregnancy; median viral load (VL) at initiation 125 416 376 DNA IU/mL, one having birth VL. Twenty-eight (10%) infants were stratified as high risk and all received HBIG and birth dose vaccination with 9 (32%) subsequently lost to follow-up, compared to 48 (19%) low-risk infants. 267/283 (94%) had birth dose vaccination documented and 206/283 (73%) received at least four vaccine doses. 215/283 (76%) infants had serology by 24 months; 17 (6%) with suboptimal vaccine responses: hepatitis B surface antibody <100 IU/mL. Serology before 18 months resulted in higher rates of maternal hepatitis B core antibody detection (15% vs. 3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Prevention of vertical transmission of HBV was universal in those attending, although high-risk infants were more likely lost to follow up. HBV post-vaccine serological protection was comparable with national data from 2021 (77% >4 doses, 77% HBsAb >100).</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476829","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of paediatrics and child health

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀