Journal of paediatrics and child health最新文献

英文中文

A Boy With Pulsation at the Hair Whorl 一个在头发上有脉动的男孩。

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-10 DOI: 10.1111/jpc.70263

Kazuki Iio, Mikako Enokizono

引用次数: 0

MDA5 Antibody Associated Juvenile Dermatomyositis Presenting as Rapidly Progressive Pulmonary Fibrosis—Case Report MDA5抗体相关的青少年皮肌炎表现为快速进展性肺纤维化病例报告

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-10 DOI: 10.1111/jpc.70256

Emily Le Fevre, Andrea Christoff, Davinder Singh-Grewal, Geshani Jayasuriya

引用次数: 0

Fordyce Angiokeratoma: An Unusual Localised Form in Childhood 福代斯血管角化瘤：儿童罕见的局部形式。

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-09 DOI: 10.1111/jpc.70261

Mariana Freitas Reis, Joana Lage, Catarina Ferreira, Beatriz Henriques, Cristina Amaro

引用次数: 0

Cutaneous Botryomycosis due to Burkholderia pyrrocinia in a Child With X-Linked Agammaglobulinemia: A Case Report x连锁无球蛋白血症儿童皮肤结核杆菌病的伯克霍尔德氏菌：1例报告。

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-09 DOI: 10.1111/jpc.70262

Ming-Xuan Ma, Shu-Li Gu, Jia-Ao Fang, Guang-Wen Yin

引用次数: 0

The Effect of Allogeneic Mesenchymal Stromal Cell Transplantation on an Infant With Skin Necrosis by Calcium Gluconate Extravasation: Case Report 异基因间充质细胞移植治疗婴儿葡萄糖酸钙外溢皮肤坏死1例。

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-06 DOI: 10.1111/jpc.70254

Olga Wittig, Magaly Gutierrez, Dylana Diaz-Solano, Soraima Fuentes, Eloisa Lara, Kharelys Duque, Fredy Leal, Jose E. Cardier

引用次数: 0

Impact of Evidence-Based Bundled Nutritional Care on Growth, Development and Nutritional Status in Low Birth Weight Preterm Infants 循证捆绑营养护理对低出生体重早产儿生长发育和营养状况的影响

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-06 DOI: 10.1111/jpc.70246

Yu'e Shen, Hongyan Dai, Dandan Zhao, Yiting Cai, Lin Li

Objective

This study aimed to evaluate the effectiveness of evidence-based bundled nutritional care in low birth weight (LBW) preterm infants.

Methods

The LBW preterm infants in the control group received routine nursing, while those in the observation group received evidence-based bundled nutritional interventions, including breast milk management, feeding management, nutritional monitoring, sucking function stimulation, nest-like intervention, touch intervention and discharge instructions based on routine nursing. All preterm infants were followed up for 6 months. Growth and development indices, nutritional and immune parameters, complication rates and parental satisfaction were compared between groups.

Results

A total of 140 preterm infants were enrolled in the study, with 70 assigned to the observation group and 70 to the control group. At 6 months, the observation group showed greater gains in weight (0.62 ± 0.17 vs. 0.45 ± 0.13 g/kg d), length (9.28 ± 1.44 vs. 8.31 ± 1.17 cm/week), and head circumference (7.46 ± 0.97 vs. 6.19 ± 0.70 cm/week) compared with the control group (p < 0.05). After the intervention, levels of haemoglobin, prealbumin, albumin and total protein were significantly higher in the observation group compared with the control group (p < 0.05). Immunoglobulin A, M and G concentrations also increased more markedly in this group (p < 0.05). The incidence of complications was lower in the observation group (7.14% vs. 18.57%, p < 0.05), while parental satisfaction was higher (95.71% vs. 84.29%, p < 0.05) compared with the control group.

Conclusion

Evidence-based bundled nutritional care yields favourable outcomes in LBW preterm infants by promoting physical growth, enhancing nutritional and immune status, reducing complications and improving family satisfaction.

目的：本研究旨在评价低出生体重（LBW）早产儿循证捆绑营养护理的有效性。方法：对照组对LBW早产儿进行常规护理，观察组在常规护理的基础上进行循证捆绑营养干预，包括母乳管理、喂养管理、营养监测、吮吸功能刺激、巢样干预、触摸干预和出院指导。所有早产儿随访6个月。比较两组患儿的生长发育指标、营养及免疫指标、并发症发生率及父母满意度。结果：共纳入140例早产儿，其中观察组70例，对照组70例。6个月时，观察组体重（0.62±0.17对0.45±0.13 g/kg d）、体长（9.28±1.44对8.31±1.17 cm/周）、头围（7.46±0.97对6.19±0.70 cm/周）均较对照组增加(p结论：循证捆绑营养护理在促进LBW早产儿身体发育、改善营养和免疫状况、减少并发症和提高家庭满意度方面效果良好。

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引用次数: 0

Impact of Elexacaftor/Tezacaftor/Ivacaftor (ETI) Treatment on Clinical Outcomes in a Single Centre Cohort of Paediatric Patients With Cystic Fibrosis elexaftor /Tezacaftor/Ivacaftor （ETI）治疗对囊性纤维化患儿单中心队列临床结果的影响

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-04 DOI: 10.1111/jpc.70249

Chloe Crainie, K. Frayman, J. Harrison

<p>Cystic Fibrosis (CF) affects approximately 3800 Australians, including 42% aged under 18 years [<span>1</span>]. CF is associated with significant morbidity, with many people spending at least 60 min per day on treatment. Life expectancy has progressively improved due to the development of new therapies: median survival is now 60.6 years, increased from 47 years in 2008 [<span>1</span>]. Elexacaftor, Tezacaftor and Ivacaftor (ETI) (Trikafta), the first triple-therapy CF transmembrane conductance regulator modulator, became available in Australia on the Pharmaceutical Benefits Scheme in 2022. This study aimed to measure changes in the clinical status of adolescents with CF who have completed 12-months of treatment with ETI in a real-world setting.</p><p>Adolescents with CF aged ≥ 12 years managed at the Royal Children's Hospital (RCH), Melbourne who had completed 12 months of ETI treatment by August 2023 were included. Demographic data and clinical outcomes, including lung function, weight, nutritional status, hospitalisations and microbiology were extracted from the electronic medical record and the Australian Cystic Fibrosis Data Registry (ACFDR). ‘Best’ and ‘mean’ values in the 12-month period pre- and post-ETI initiation were compared. Data analysis was performed in PRISM GraphPad V10.0.3. Rate of change of forced expiratory volume in 1-s (FEV<sub>1</sub>) per annum was calculated using linear regression; for each individual, a regression line was fitted across all FEV<sub>1</sub> measurements within each 12-month period. Paired <i>t</i>-tests and Wilcoxon signed rank tests were used to compare normally and non-normally distributed data, respectively. The study was approved by RCH Human Research Ethics Committee (#101289).</p><p>Sixty-eight adolescents were included in this study (54% male, 51% F508del homozygous, mean age 15.29 ± 1.96 years) (an additional nine patients had commenced ETI prior to 12 years (i.e., via clinical trials), and four had completed < 12 months treatment at the time of analysis). Forty study participants (59%) had prior modulator exposure (Lumacaftor-Ivacaftor 55%; Tezacaftor-Ivacaftor 37.5%; Ivacaftor 7.5%).</p><p>ETI was associated with significant changes in several clinical outcomes (Table 1). Fewer lung function tests were performed following the introduction of ETI (median six and four per patient pre- and post-ETI respectively (<i>p</i> < 0.00001)). Most patients achieved an increase in FEV<sub>1</sub>%-predicted of 1%–10% (Figure 1a), and the rate of change in FEV<sub>1</sub> increased after ETI commencement (<i>p</i> = 0.06). Although there was no significant change in weight or BMI post-ETI initiation, four patients (5.9%) moved from an ‘optimal’ BMI category (50th–85th percentile) to a ‘high’ BMI category (> 85th percentile). There were significant reductions in hospitalisation frequency and duration post-ETI initiation. The total number of hospital admissions decreased from 84 to 34; all patient

由于静息能量消耗减少、食欲增加和脂肪吸收不良减少等多种因素，ETI可导致BMI和体重增加。因此，ETI治疗可能导致肥胖率增加。在我们的研究中，超重和肥胖青少年比例的增加（总计19.2%）带来了新的临床挑战，包括修改饮食建议和监测肥胖的长期并发症。继续积极主动地接受饮食建议是至关重要的。可能样本量小，随访时间相对较短，纳入了相对健康的基线人群，影响了我们研究结果的幅度和统计意义，例如，FEV1的变化率。较大的IQR/SD可能反映了我们的队列中潜在的CFTR基因型/残留蛋白功能和基线疾病严重程度直接影响CFTR调节剂的反应，在现实世界的研究中，依从性、耐受性和潜在的剂量也会影响CFTR调节剂的反应[2,3,5]。但重要的是，我们的研究队列是澳大利亚CF青少年的代表，与2023年12-17岁CF患者的ACFDR数据相比，FEV1或体重没有显著差异。总的来说，我们证明了ETI对患有CF的澳大利亚青少年的显著影响，并预期对CF护理的前景产生重大影响。肺功能的改善，在前12个月，可能与护理负担的大幅减少和预期寿命的增加有关。护理建议需要更新，包括提高对肥胖风险的认识，关注长期健康，预期能活到成年后期。这项研究证明了澳大利亚儿童获得调节剂的广泛临床和医疗保健益处，为争取更快的资金批准和更公平地获得未来的新疗法提供了证据。几个关键的研究重点仍然是优化长期结果。需要进行纵向研究来评估ETI益处的持久性，以及在儿童早期开始时出现的不良影响。早期治疗是否能够预防或完全逆转结构性肺损伤，以及减少慢性阻塞性肺疾病相关糖尿病等长期并发症，这些问题仍然存在。未来的工作可能会探索治疗后儿童身体组成、脂肪代谢的变化，以及葡萄糖稳态改变的潜在风险——开发反映这些代谢变化的新的营养监测框架将是必不可少的。未来的研究应该旨在为个性化治疗和监测方法提供信息，确保ETI的早期益处转化为患者持续的健康收益。对于不符合条件或不能耐受ETI的患者，迫切需要开发新的治疗方法。作者声明无利益冲突。支持本研究结果的数据可根据通讯作者的合理要求提供。

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引用次数: 0

A Post-Extubation Early Feeding Protocol (PEEF) in a Tertiary Paediatric Intensive Care Unit: A Quality Improvement Initiative 第三儿科重症监护病房拔管后早期喂养方案（PEEF）：质量改进倡议。

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-02 DOI: 10.1111/jpc.70251

Sora Jung, Sainath Raman, Ian Hughes, Rahul Joshi

Aim

Recommencing enteral feeding post-extubation in children is often delayed. This study evaluated a Post-Extubation Early Feeding (PEEF) protocol on early recommencement of enteral nutrition post-extubation in a tertiary paediatric intensive care unit (PICU).

Methods

The PEEF protocol involved direction to re-commence enteral nutrition at 50% of the pre-fasting rate within 1 h of extubation and upgrade to the pre-extubation feeding rate within 2 h. The PEEF protocol was a quality improvement project implemented at a tertiary PICU and was evaluated through a retrospective analysis. The study included children aged 0–18 years who were admitted to PICU, intubated and subsequently underwent planned extubation pre-PEEF (November 2019–October 2020) and post-PEEF (November 2021–October 2022).

Results

A total of 795 patients were included in the study, 372 pre-PEEF and 423 post-PEEF. Demographic variables and severity of illness variables were similar in the two groups. Post implementation of the PEEF protocol, the median (interquartile range) time to re-commence enteral nutrition after extubation was 3.2 h (1.9, 4.7) compared to pre-PEEF, 4.2 h (3.2, 5.5; p = 2.4 × 10⁻¹³). Post-PEEF the median time to reach the pre-fasting feeding rate was 5 h (2.6, 10.6), compared to 7.3 h (4.1, 13) pre-PEEF (p = 0.0005).

Conclusions

Implementation of the PEEF protocol reduced the time to resume enteral nutrition and the time to reach pre-extubation feeding rates although improvement was not consistent with the goals of PEEF. Continuing assessment and education are required to drive outcomes further towards target goals.

目的：儿童拔管后肠内喂养的重新开始经常延迟。本研究评估了拔管后早期喂养（PEEF）方案在三级儿科重症监护病房（PICU）拔管后早期重新开始肠内营养。方法：PEEF方案包括在拔管后1 h内以50%的禁食前速率重新开始肠内营养，并在2 h内升级到拔管前喂养速率。PEEF方案是在三级PICU实施的质量改进项目，并通过回顾性分析进行评估。该研究包括0-18岁的儿童，他们在peef前（2019年11月- 2020年10月）和peef后（2021年11月- 2022年10月）入住PICU，插管并随后计划拔管。结果：共有795例患者纳入研究，peef前372例，peef后423例。两组的人口学变量和疾病严重程度变量相似。实施PEEF方案后，拔管后重新开始肠内营养的中位数（四分位数范围）时间为3.2 h(1.9, 4.7)，而PEEF前为4.2 h （3.2, 5.5; p = 2.4 × 10-13）。peef后达到禁食前摄食速率的中位时间为5 h(2.6, 10.6)，而peef前为7.3 h (4.1, 13) （p = 0.0005）。结论：PEEF方案的实施减少了恢复肠内营养的时间和达到拔管前喂养率的时间，尽管这种改善与PEEF的目标不一致。需要继续进行评估和教育，以推动成果进一步实现具体目标。

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引用次数: 0

A Neonatal Case of Cyanide Toxicity Caused by Sodium Nitroprusside During Veno-Arterial Extracorporeal Membrane Oxygenation Management 静脉-动脉体外膜氧合处理中硝普钠致新生儿氰化物中毒1例。

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-12-02 DOI: 10.1111/jpc.70250

Tsubasa Nishinosono, Ken Yakame, Ayaka Sakai, Saori Aiga, Sanae Sato, Mitsunori Sato, Tatsuya Kawasaki

引用次数: 0

Trends in Community Antibiotic Dispensing for Children and Young People in Aotearoa New Zealand, 2010–2019: Implications for Antimicrobial Stewardship 2010-2019年新西兰奥特罗阿儿童和青少年社区抗生素分配趋势：对抗菌药物管理的影响

IF 1.4 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health

Pub Date : 2025-11-29 DOI: 10.1111/jpc.70236

Anya Stephenson, Ibrahim S. Al-Busaidi, Jonathan Williman, Kirsten Fanning, Phil Hider, Lesley Voss

Aim

To analyse trends in community systemic antibiotic dispensing to children and young people (0–14 years) in New Zealand between 2010 and 2019.

Methods

Dispensing data were retrieved from the National Pharmaceuticals Collection and population data from the Te Whatu Ora Populations Web Tool. Dispensing rates were described using the number of defined daily doses/1000 inhabitants per day (DID) and courses dispensed/1000 inhabitants/year.

Results

Total antibiotic dispensing declined over the study period, both in terms of courses dispensed (annual percentage change [APC] −3.4% per year) and DIDs (APC −0.67% per year). Amoxicillin/clavulanic acid showed the greatest decline in dispensing (APC −9.5% per year), while cefalexin had the most significant increase (APC +53.7% per year). The highest dispensing rates were observed among children aged 0–4 years, Pacific patients and those in the lowest socioeconomic quintile. Counties Manukau had the highest regional dispensing rates. Antibiotic stewardship, as per the WHO AWaRe guidelines, improved: Access antibiotics increased from 83% to 91%, while Watch antibiotics decreased from 17% to 9% of total dispensing.

Conclusions

These findings suggest an overall improvement in prescribing practices, likely due to the adoption of antimicrobial stewardship programmes. Further study is under way to understand the reasons for and any risks associated with, high community rates of cefalexin dispensing.

目的：分析2010年至2019年新西兰儿童和青少年（0-14岁）社区系统抗生素分配的趋势。方法：调剂数据来自国家药品数据库，人口数据来自the Whatu Ora人口网络工具。分配率用每日确定剂量/1000居民/天（DID）和分配疗程/1000居民/年来描述。结果：在研究期间，抗生素总配药量下降，无论是配药疗程（年百分比变化[APC] -3.4% /年）还是DIDs （APC -0.67% /年）。阿莫西林/克拉维酸的分配下降幅度最大（APC -9.5% /年），而头孢氨苄的增加幅度最大（APC +53.7% /年）。在0-4岁儿童、太平洋患者和社会经济最低五分位数的儿童中，分配率最高。马努考县的区域配药率最高。根据世卫组织AWaRe指南，抗生素管理得到改善：可获得抗生素从83%增加到91%，而观察抗生素从总分配的17%下降到9%。结论：这些发现表明处方实践的全面改进，可能是由于采用了抗微生物药物管理规划。目前正在进行进一步的研究，以了解社区高头孢氨苄配药率的原因和相关风险。

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