Child participation during outpatient consultations: a mixed methods study
Conclusion: Despite increased turn taking, children ’s verbal participation remains low in pediatric consultations. If pediatricians and parents maintain a triadic conversation style throughout every stage of the medical encounter, child participation may increase.What is Known:• Verbal child participation varies between 4 and 17%, measured in turns, words, speech time, or utterances.• Child participation is limited to social talk, laughter, and providing medical information.What is New:• Child speech turns equal parental speech turns (28%), but average relative word count remains low (11%).• Three percent of the...
Source: European Journal of Pediatrics - April 19, 2024 Category: Pediatrics Source Type: research
Early neurological signs in infants identified through neonatal screening for SMA: do they predict outcome?
Conclusion: Our findings suggest that early clinical signs may contribute to predict motor milestones development.What is Known:• There is increasing evidence of heterogeneity among the SMA newborns identified via NBS.• The proposed nosology describes a clinically silent disease, an intermediate category (‘paucisymptomatic’) and ‘symptomatic SMA’.What is New:• The presence of minimal clinical signs at birth does not prevent the possibility to achieve independent walking but this may occur with some delay.• The combination of genotype at SMN locus and clinical evaluation may better predict the possibility to...
Source: European Journal of Pediatrics - April 18, 2024 Category: Pediatrics Source Type: research
Predicting community acquired bloodstream infection in infants using full blood count parameters and C-reactive protein; a machine learning study
Conclusion: We identified several models that can predict positive blood cultures in infants with suspected BSI aged 7 to 60 days. Application of these models could prevent administration of antimicrobial treatment and burdensome diagnostics in infants who do not need them.What is Known:• Bloodstream infection (BSI) in infants cause non-specific symptoms and may be difficult to diagnose.• Results of blood cultures can take up to 48 hours.What is New:• Machine learning models can contribute to clinical decision making on BSI in infants while blood culture results are not yet known. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - April 18, 2024 Category: Pediatrics Source Type: research
Challenges in the treatment of pediatric Mycoplasma pneumoniae pneumonia
Conclusion: This report summarizes the clinical significance of macrolide-resistant and refractory MP pneumonia and discusses the efficacy and safety of alternative drugs, with a stepwise approach to the management of MP pneumonia recommended from the viewpoint of clinical practice.What is Known:•Although MP pneumonia is usually a benign self-limited infection with response macrolides as first line therapy,severe life-threatening cases may develop if additional treatment strategies are not effectively implemented.•Macrolide-resistant and refractory MP pneumonia are two conditions that may complicate the clinical cour...
Source: European Journal of Pediatrics - April 18, 2024 Category: Pediatrics Source Type: research
Association between viral infection and bronchopulmonary dysplasia in preterm infants: a systematic review and meta-analysis
Conclusion: Viral infections, especially CMV, are associated with an increased risk of BPD in preterm infants. Methodologically reliable prospective studies with large samples are needed to validate our conclusions, and high-quality randomized controlled studies are needed to explore the effect of prevention or treatment of viral infections on the incidence of BPD.What is Known:• Studies have attempted to identify viral infections and bronchopulmonary dysplasia in preterm infants; however, results have been inconsistent.What is New:• Systematic demonstration that viral infections, particularly cytomegalovirus, are posi...
Source: European Journal of Pediatrics - April 18, 2024 Category: Pediatrics Source Type: research
Impact of macronutrients intake on glycemic homeostasis of preterm infants: evidence from continuous glucose monitoring
Conclusions: Macronutrient intakes influence neonatal glucose profile as described by continuous glucose monitoring. CGM might contribute to adjust nutritional intakes in preterm infants.What is Known:• Parenteral nutrition may affect glucose profile during the first days of life of preterm infants.What is New:• Continuous glucose monitoring describes the relationship between daily parenteral nutrient intakes and time spent in hypo and hyperglycemic ranges. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - April 18, 2024 Category: Pediatrics Source Type: research
Nationwide hospitalizations of patients with down syndrome and congenital heart disease over a 15-year period
Conclusions: A younger age at first admission is a predictor for mortality in patients with Down syndrome and congenital heart disease. If patients undergo more than one admission, the risk of further readmissions increases. There is a pivotal role for heart disease in influencing the hospitalization rate and subsequent mortality.What is Known:•Down syndrome individuals often face an increased risk of congenital heart diseases.•Congenital heart diseases contribute significantly to morbidity and mortality in Down syndrome patients.What is New:•This study analyzes nationwide data covering a 15-year period of pediatric ...
Source: European Journal of Pediatrics - April 16, 2024 Category: Pediatrics Source Type: research
European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children
Conclusion: Low-dose melatonin is a useful strategy for managing sleep onset insomnia in healthy children who have not improved or have responded insufficiently to sleep hygiene and behavioral interventions.What is Known:• Pediatric insomnia is a common disorder and impacts children's emotional, behavioral, and cognitive functioning, as well as parents' sleep and daytime functioning.• There is no consensus in Europe on the management of sleep onset insomnia and the use of melatonin in typically developing children.What is New:• A group of European experts has compiled a set of recommendations for the management of ...
Source: European Journal of Pediatrics - April 16, 2024 Category: Pediatrics Source Type: research
Prospective multicenter evaluation of adherence to the Dutch guideline for children aged 0 –16 years with fever without a source—febrile illness in children (FINCH) study
Conclusions: We found a high non-adherence rate of 48%, which did not lead to unfavorable clinical outcomes. This substantiates the need for a critical reevaluation of the FWS guideline and its indications for bacterial cultures, viral testing, and antibiotic treatment.What is Known:• Despite the development of national guidelines, variation in practice is still substantial in the assessment of febrile children to distinguish severe infection from mild self-limiting disease.• Previous retrospective research suggests low adherence to national guidelines for febrile children in practice.What is New:• In case of non-adh...
Source: European Journal of Pediatrics - April 15, 2024 Category: Pediatrics Source Type: research
Influenza vaccine uptake in juvenile idiopathic arthritis: a multi-centre cross-sectional study
Conclusion: Despite variations among countries, the uptake of influenza vaccines remains low in children with JIA. Improving awareness among families about the importance of influenza vaccination may increase vaccination rates in children with rheumatic diseases.What is Known:• Rheumatic children are at increased risk for influenza infection due to immunosuppressive therapy and immune dysregulation.• Influenza vaccine is formally recommended to children with rheumatic diseases.What is New:• This multicentre study showed that influenza vaccine uptake rates remain suboptimal among children with Juvenile Idiopathic Ar...
Source: European Journal of Pediatrics - April 15, 2024 Category: Pediatrics Source Type: research
I will prevent disease whenever I can, for prevention is preferable to cure: doctors ’ role in the vaping epidemic
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - April 13, 2024 Category: Pediatrics Source Type: research
Pediatric thermal epiglottitis: insights from a tertiary center experience
Conclusion: Thermal epiglottitis stands as a potential contributor to acute upper airway obstruction. Although it ’s rarity, it should be discussed in any child with acute upper airway obstruction. It is essential to inquire directly about the accidental intake of hot beverages, particularly in cases lacking fever or elevated inflammatory markers.What is Known:•Thermal epiglottitis is a rare, non-infectious condition sharing clinical features with infectious epiglottitis.•Common presentations include stridor, respiratory distress, and drooling.What is New:•Thermal epiglottitis is a potential contributor to acute up...
Source: European Journal of Pediatrics - April 13, 2024 Category: Pediatrics Source Type: research
A silent scream in the pediatric emergency department: child abuse and neglect
Conclusion: Pediatric emergency departments are one of the important units visited by child maltreatment patients. Victimized children may reflect their silent screams with various clinical presentations. Infants are at the greatest risk of suffering serious or fatal injuries. Health professionals working in the emergency department have an important role in detecting, treating, and preventing recurrence of child neglect and abuse.What is Known:• The pediatric emergency department is an important entry point in the health care system for children who experience maltreatment.• It has a wide spectrum of physical, sexual,...
Source: European Journal of Pediatrics - April 13, 2024 Category: Pediatrics Source Type: research
The confidence and competence of primary school staff to administer an adrenaline auto-injector
Conclusion: Improvements in readiness to administer AAIs can be achieved through the application of more effective approaches to teaching clinical skills, changes to school policies and practices, and consideration of the design of AAIs in order to make their operation safer and simpler. It is important that teachers have the confidence and competence to safely administer an AAI.What is Known:• Poor ability in adrenaline auto-injector use seen across population groups—healthcare professionals, patients, carers, and school staff• Training in the use of adrenaline auto-injectors has positive impact on competencyWhat ...
Source: European Journal of Pediatrics - April 12, 2024 Category: Pediatrics Source Type: research
Symptomatic corpus luteum hemorrhage in adolescent females with ITP
Conclusion: CLH could potentially pose a significant complication in the context of adolescent females with ITP, requiring a strong index of suspicion to direct expedient therapy.What is Known:• Immune thrombocytopenia is typically associated with minor bleeding tendency.• Corpus luteum hemorrhage is generally asymptomatic; however, in women with bleeding disorders, it has the potential to result in substantial intra-abdominal bleeding.What is New:• Corpus luteum hemorrhage leading to intra-abdominal bleeding is a potential severe complication of immune thrombocytopenia in adolescent females. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - April 11, 2024 Category: Pediatrics Source Type: research
