Paediatrics and Child Health (United Kingdom)最新文献

英文中文

Febrile seizures: an overview of presentation, management and parental guidance 热性惊厥：介绍，管理和家长指导的概述

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1016/j.paed.2025.08.002

Laura Duthie, Roisin Begley

Febrile seizures are the commonest form of seizure under the age of 2, occurring in 2–4% of children in the UK. Most occur between 12 and 18 months and are more common in those with a family history. The aetiology is multi-factorial, although most episodes occur in children with viral infections. In the majority of children the seizure will have resolved prior to coming to hospital and the child may be back to normal. These may require no further investigation or treatment. However, for parents who have witnessed the episode, it will have been extremely distressing and frightening. In addition, there are many myths and misconceptions held by parents particularly in relation to the association with fever and further episodes, as well as the concerns surrounding longer term outcomes. Reassurance and clear advice given by clinicians is therefore one of the most important aspects to management. This review gives a practical approach to management for clinicians and enables them to give informed and up to date guidance to parents, thus allowing them to feel confident about how to manage their child at home if they were to have further episodes, as well as providing reassurance about the harmless nature of febrile seizures.

热性惊厥是2岁以下最常见的惊厥形式，在英国发生在2 - 4%的儿童中。大多数发生在12到18个月之间，在有家族史的人中更常见。病因是多因素的，尽管大多数发作发生在病毒感染的儿童中。在大多数儿童癫痫发作将在来医院之前解决，孩子可能会恢复正常。这些可能不需要进一步的调查或治疗。然而，对于目睹了这一事件的父母来说，这将是非常痛苦和可怕的。此外，家长们持有许多误解和误解，特别是与发烧和进一步发作的关系，以及对长期结果的担忧。因此，临床医生给出的保证和明确的建议是管理最重要的方面之一。本综述为临床医生提供了一种实用的管理方法，使他们能够向父母提供知情和最新的指导，从而使他们对如何在家中管理孩子有信心，如果他们再次发作，以及提供关于热性癫痫发作无害性质的保证。

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引用次数: 0

Which child needs a gastrointestinal endoscopy? 哪个孩子需要胃肠内窥镜检查？

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-11-01 Epub Date: 2025-08-29 DOI: 10.1016/j.paed.2025.08.003

Bharanikumar Ravikumar, Sehrish Cheema, Lisa Whyte

Gastrointestinal (GI) endoscopy plays a pivotal role in both the diagnosis and treatment of paediatric gastrointestinal disorders. As indications expand and procedures become increasingly available across the UK, healthcare professionals must have an overview on when to refer a child for endoscopy. This article provides a practical approach, elaborating diagnostic and therapeutic uses, upper versus lower GI indications, and red flags that warrant endoscopic assessment. It covers common presentations such as persistent vomiting, chronic diarrhoea, gastrointestinal bleeding, and suspected coeliac disease and explains when endoscopy is not indicated. We also discuss the structure of paediatric endoscopy services across the UK and the need for appropriate preparation, support, and aftercare. We aim to support healthcare professionals in making informed referrals and minimizing unnecessary procedures while ensuring timely diagnosis and intervention for those who need it.

胃肠内镜在小儿胃肠疾病的诊断和治疗中起着举足轻重的作用。随着适应症的扩大和程序在英国变得越来越可用，医疗保健专业人员必须有一个概述，何时转介儿童进行内窥镜检查。本文提供了一种实用的方法，详细阐述了诊断和治疗的用途，上消化道与下消化道的适应症，以及需要内镜评估的危险信号。它涵盖了常见的症状，如持续呕吐、慢性腹泻、胃肠道出血和疑似乳糜泻，并解释了何时不需要内窥镜检查。我们还讨论了整个英国儿科内窥镜检查服务的结构和需要适当的准备，支持和善后护理。我们的目标是协助医护专业人员作出明智的转介，尽量减少不必要的程序，同时确保有需要的人士得到及时的诊断和干预。

引用次数: 0

Vaping in children and young people, and why it is a bad idea 儿童和年轻人吸电子烟，以及为什么这是一个坏主意

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1016/j.paed.2025.08.001

Rachel Isba, Liz Brewster

It is illegal for under-18s to buy vapes (e-cigarettes) in the UK, but evidence suggests that vaping amongst children and young people is a growing issue. Although recommended as a cessation aid for tobacco smoking in adults, the rationale for introduction of the Tobacco and Vapes Bill to “create a smokefree generation and tackle youth vaping” recognises the potential for harm caused by children and young people using vapes. Many vapes contain nicotine, and while the effects of nicotine from tobacco are well-established, much is unknown about the impacts of vaping-associated nicotine dependence. It is unlikely that vaping is entirely risk-free to health, particularly as nicotine is highly addictive. The wider context of how children and young people access vapes and why they use them also needs to be accounted for in identifying additional impact. Paediatricians need an awareness of prevention and cessation interventions, including how to start a supportive conversation around vaping and vaping cessation. The production and disposal of vapes also raises significant environmental concerns, so reducing vaping levels is also important for sustainability. Supporting children and young people to be nicotine free should be a public health priority.

在英国，18岁以下的未成年人购买电子烟是违法的，但有证据表明，儿童和年轻人吸电子烟的问题日益严重。尽管《烟草和电子烟法案》被推荐为成年人戒烟的辅助手段，但其“创造无烟一代，解决青少年吸电子烟问题”的基本原理是认识到儿童和青少年使用电子烟可能造成的危害。许多电子烟都含有尼古丁，虽然烟草中尼古丁的影响是公认的，但与电子烟相关的尼古丁依赖的影响尚不清楚。电子烟对健康不太可能完全没有风险，尤其是尼古丁极易上瘾。在确定额外影响时，还需要考虑儿童和年轻人如何接触电子烟以及他们为什么使用电子烟的更广泛背景。儿科医生需要了解预防和戒烟干预措施，包括如何就吸电子烟和戒烟展开支持性对话。电子烟的生产和处理也引起了严重的环境问题，因此减少电子烟的使用水平对可持续发展也很重要。支持儿童和青少年远离尼古丁应该是公共卫生的优先事项。

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引用次数: 0

Approach to a child with swollen optic disc(s) 视盘肿大儿童的手术入路

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-11-01 Epub Date: 2025-08-30 DOI: 10.1016/j.paed.2025.08.004

Nermin Alashal, Niha Mariam Hussain, Nahin Hussain

Swollen appearance of the optic disc is a common ocular finding in children. Several underlying conditions can contribute to this appearance. It is essential to accurately identify and promptly address causes that may threaten vision or life. Additionally, awareness of certain congenital variations that may present with a swollen optic disc is important. This article provides an overview of the issue and a practical approach to the diagnosis and management of optic disc(s) swelling in children.

视盘肿胀是儿童常见的眼部现象。几个潜在的条件可能导致这种现象。准确识别和迅速解决可能威胁视力或生命的原因至关重要。此外，意识到某些先天性变异可能出现视盘肿胀是很重要的。这篇文章提供了一个问题的概述和一个实用的方法来诊断和管理视盘(s)肿胀的儿童。

引用次数: 0

Developing a video-based educational resource for young people with asthma 为患有哮喘的年轻人开发基于视频的教育资源

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-10-01 Epub Date: 2025-08-21 DOI: 10.1016/j.paed.2025.07.004

Moira Gibbons, Nicki Barker, Nichola Butler, Heather Elphick

Asthma deaths amongst young people in the United Kingdom are amongst the highest in the world. However, it is widely acknowledged that effective self-management can improve asthma control and ultimately outcomes. Good quality patient education is key to this effective self-management, and this is especially true when young people are preparing for transition to adult services. The Respiratory Research Team at Sheffield Children's NHS Foundation Trust has developed an educational resource to support healthcare professionals with the delivery of this education. This article considers the framework adopted, content creation, the hosting of videos, the review process for draft materials, promoting the resource and finally, assessing its impact. In conclusion the challenges, relating to the adoption of the materials in clinical practice and to patient education as a tool for the empowerment of patients and improvement of asthma outcome, are addressed.

英国年轻人的哮喘死亡率是世界上最高的。然而，人们普遍认为，有效的自我管理可以改善哮喘控制和最终结果。高质量的患者教育是这种有效自我管理的关键，在年轻人准备过渡到成人服务时尤其如此。谢菲尔德儿童NHS基金会信托的呼吸研究小组开发了一种教育资源，以支持医疗保健专业人员提供这种教育。本文考虑了采用的框架，内容创建，视频的托管，草稿材料的审查过程，推广资源，最后评估其影响。总之，在临床实践中采用这些材料，并将患者教育作为赋予患者权力和改善哮喘结果的工具，这些挑战都得到了解决。

引用次数: 0

My child won't sleep! Recognising and managing sleep disorders in children and young people 我的孩子睡不着！认识和管理儿童和青少年的睡眠障碍

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-10-01 Epub Date: 2025-09-04 DOI: 10.1016/j.paed.2025.07.003

Lauren Williams, Thomas Maycock, Vanessa Hewertson, Jahnaky Suththanantha, Jasmine Krieg, Sarusan Kugarajah, Desaline Joseph

Anecdotally sleep takes up a third of a person's life, however, for many Children and Young People (CYP), it can feel like a good night's sleep is elusive. The refrain “my child won't sleep” is common in both general practitioner and paediatric clinics and it can feel overwhelming for both parents, carers, and professionals. With over 70 sleep disorders, differentiation and treatment options can feel confusing. This article focuses on circadian rhythm disorders, insomnia, parasomnia, and sleep related movement disorders providing an outline of these conditions and giving treatment advice. We will discuss the importance of utilizing behavioural interventions as a first line treatment, with pharmacological interventions used to support behavioural interventions, or in cases where behavioural intervention alone has not been effective. In all cases of children who struggle to sleep, it is important that treatment decisions are made on a case by case basis, allowing for individual needs, and neurodiversity. With appropriate, individualized support nearly all CYP can sleep well.

有趣的是，睡眠占据了一个人生命的三分之一，然而，对于许多儿童和年轻人（CYP）来说，晚上睡个好觉似乎是难以捉摸的。“我的孩子睡不着”这句话在全科医生和儿科诊所都很常见，这对父母、护理人员和专业人士来说都是难以承受的。有超过70种睡眠障碍，区分和治疗选择可能会让人感到困惑。这篇文章的重点是昼夜节律紊乱，失眠，睡眠异常，和睡眠相关的运动障碍提供这些条件的概述和治疗建议。我们将讨论利用行为干预作为一线治疗的重要性，使用药物干预来支持行为干预，或者在单独的行为干预无效的情况下。对于所有难以入睡的儿童，重要的是要根据具体情况做出治疗决定，考虑到个人需求和神经多样性。在适当的个体化支持下，几乎所有的CYP都能睡得很好。

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引用次数: 0

Respiratory syncytial virus (RSV): recent advances in preventative strategies and visions for the future 呼吸道合胞病毒（RSV）：预防策略的最新进展和对未来的展望

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-10-01 Epub Date: 2025-08-26 DOI: 10.1016/j.paed.2025.07.005

Geraldine Campbell, Peter Mallett, Shaun O'Hagan

Respiratory syncytial virus (RSV) has a significant global impact, especially amongst vulnerable infants with immature immune systems. Elevated hospitalization and mortality rates within this group underscore this substantial risk. Until 2022, the only available preventive was the costly monoclonal antibody, palivizumab, which requires monthly winter injections, limiting its use to high-risk infants. Significant progress has led to the recent ground-breaking approval of two further RSV preventatives for infants: an extended half-life monoclonal antibody, nirsevimab (Beyfortus®) and a protein-based maternal vaccine, RSVpreF (Abrysvo®). Following authorization, several European countries, including Spain, France and Italy introduced nirsevimab during the 2023/24 RSV season. In contrast, the maternal RSV vaccine was integrated into antenatal immunization programmes within the United Kingdom and Argentina. Given the swiftly changing landscape of RSV prevention, this review offers timely insights into significant clinical trials and emerging real-world evidence; emphasizing the considerable effectiveness of current preventatives, as well as considering those under development. We also consider the potential impact on the National Health Service (NHS), including a changing disease burden, and the role of the paediatrician and broader multidisciplinary team in enhancing public health policy, supporting immunization campaigns and contributing to future research.

呼吸道合胞病毒（RSV）具有重大的全球影响，特别是在免疫系统不成熟的易感婴儿中。这一群体中住院率和死亡率的升高凸显了这一重大风险。直到2022年，唯一可用的预防药物是昂贵的单克隆抗体帕利珠单抗（palivizumab），需要在冬季每月注射，限制了高风险婴儿的使用。最近，两种用于婴儿的RSV预防药物获得了突破性的批准：延长半衰期的单克隆抗体nirsevimab （Beyfortus®）和基于蛋白质的母源疫苗RSVpreF （Abrysvo®）。在获得授权后，包括西班牙、法国和意大利在内的几个欧洲国家在2023/24 RSV季节引入了nirsevimab。相比之下，在英国和阿根廷，母体呼吸道合胞病毒疫苗被纳入产前免疫规划。鉴于RSV预防形势的迅速变化，本综述为重要的临床试验和新出现的真实世界证据提供了及时的见解；强调目前的预防措施相当有效，并考虑正在发展的预防措施。我们还考虑了对国民健康服务（NHS）的潜在影响，包括疾病负担的变化，以及儿科医生和更广泛的多学科团队在加强公共卫生政策、支持免疫运动和促进未来研究方面的作用。

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引用次数: 0

What's new in paediatric asthma? 儿童哮喘有什么新进展？

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-10-01 Epub Date: 2025-08-09 DOI: 10.1016/j.paed.2025.07.001

Muhammad F Zulkifli, Michael P Yanney, Jayesh Mahendra Bhatt

It is well documented that asthma outcomes for children and young people in the UK are amongst the worst in Europe and in high-income countries worldwide. Several reports in the last 10 years have evaluated the reasons for the poor outcomes, with a high degree of concordance between the report findings. In this review, we summarise the key findings of these reports and how they are being addressed by new treatment strategies in updated guidance published annually by the Global Initiative for Asthma (GINA) and the latest update of the joint British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) Asthma guideline. We discuss the importance of an early and accurate asthma diagnosis; the problem of poor recognition of asthma severity and the dangers of short acting beta agonists (SABA) overuse and inhaled corticosteroid (ICS) underuse. We summarise the evidence for anti-inflammatory reliever (AIR) strategy and maintenance and reliever therapy (MART) which are now advocated in all new asthma guidance due to compelling evidence showing their positive impact on most treatment outcome measures. Finally, we highlight changes to Salbutamol weaning guidance in children discharged from hospital following an acute asthma exacerbation.

有充分的证据表明，英国儿童和年轻人的哮喘结果在欧洲和世界高收入国家中是最糟糕的。过去10年的几份报告对不良结果的原因进行了评估，报告结果之间高度一致。在这篇综述中，我们总结了这些报告的主要发现，以及全球哮喘倡议（GINA）和英国胸科学会（BTS）、国家健康与护理卓越研究所（NICE）和苏格兰校际指南网络（SIGN）哮喘指南最新更新的指南中如何采用新的治疗策略来解决这些问题。我们讨论早期和准确的哮喘诊断的重要性；对哮喘严重程度认识不足的问题以及短效β受体激动剂（SABA）过度使用和吸入皮质类固醇（ICS）使用不足的危险。我们总结了抗炎缓解（AIR）策略和维持和缓解治疗（MART）的证据，由于令人信服的证据显示它们对大多数治疗结果的积极影响，它们现在在所有新的哮喘指南中被提倡。最后，我们强调急性哮喘发作后出院儿童沙丁胺醇断奶指导的变化。

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引用次数: 0

Respiratory complications of neurodisability in children and young people 儿童和青少年神经残疾的呼吸并发症

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-10-01 Epub Date: 2025-09-10 DOI: 10.1016/j.paed.2025.07.002

Matthew Hurley

Respiratory problems are common in children with a neurodisability. These respiratory issues are a common cause of morbidity and death. Children with neurodisability are at particular risk of respiratory infection due to impaired respiratory drive, poor cough strength an increased cough threshold and aspiration. This leads to recurrent infections and eventually to chronic bacterial infection in many cases. Gastro-oesophageal reflux, muscle weakness and development of kyphoscoliosis may also contribute to chronic ongoing morbidity. Common paediatric respiratory conditions such as asthma and chronic lung disease of prematurity may co-exist, complicating the presentation. The adverse effects of polypharmacy needs to be considered carefully. To optimize care of children with medical complexity, a multidisciplinary team should include a respiratory physician and physiotherapist. This short article provides an overview of the evidence for optimal respiratory care for children with neurodisability and, in the absence of such, offers some practical advice based upon the experience of the author.

呼吸系统疾病在患有神经功能障碍的儿童中很常见。这些呼吸问题是发病和死亡的常见原因。由于呼吸动力受损、咳嗽强度差、咳嗽阈值升高和误吸，神经残疾儿童特别容易发生呼吸道感染。这导致反复感染，并最终在许多情况下慢性细菌感染。胃食管反流、肌肉无力和脊柱后凸的发展也可能导致慢性持续发病率。常见的儿科呼吸系统疾病，如哮喘和早产儿慢性肺病可能共存，使表现复杂化。复方药的不良反应需要仔细考虑。为了优化医疗复杂性儿童的护理，一个多学科团队应该包括一名呼吸内科医生和物理治疗师。这篇短文概述了神经功能障碍儿童最佳呼吸护理的证据，在缺乏这些证据的情况下，根据作者的经验提供了一些实用的建议。

引用次数: 0

The changing landscape of eating disorders in children: a guide to understanding, diagnosis and management 儿童饮食失调的变化：理解、诊断和管理指南

Q3 Medicine

Paediatrics and Child Health (United Kingdom)

Pub Date : 2025-09-01 Epub Date: 2025-07-03 DOI: 10.1016/j.paed.2025.06.003

Laura Duthie

Eating disorders are common and the incidence has risen significantly over recent years, particularly in children and young people. However, there is less familiarity with and understanding of their management than other common long-term illnesses. The consequences of having an eating disorder can be devastating and can affect all aspects of a young person's life as well as those around them. However, as mental health services are struggling to cope with the increased demand, there is a higher threshold to access specialist services and long waiting lists. It is therefore more likely that children and young people will present to primary care or paediatricians with disordered eating or the medical complications. This article provides guidance on how to assess a young person who presents acutely with an eating disorder or the features suggestive of one, focusing on how to assess risk and the potential for medical complication.

饮食失调很常见，近年来发病率显著上升，特别是在儿童和年轻人中。然而，与其他常见的长期疾病相比，人们对其管理的熟悉和理解较少。饮食失调的后果可能是毁灭性的，会影响年轻人生活的方方面面，也会影响他们周围的人。然而，由于心理健康服务正在努力应对日益增长的需求，获得专家服务的门槛更高，等候名单也很长。因此，儿童和年轻人更有可能向初级保健或儿科医生提出饮食失调或医学并发症。本文提供了如何评估急性饮食失调或暗示饮食失调特征的年轻人的指导，重点是如何评估风险和潜在的医疗并发症。

引用次数: 0

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