J Paediatr Child Health [JOURNAL]
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200 papers
Assessing the Reduction of Recurrent Admissions Using OM-85 for the Treatment of Preschool Wheeze (ARROW): Protocol for a Multi-Centre, Randomised, Double-Blind, Placebo-Controlled Trial.
Costa-Pinto JC, van Arragon M, Lee KJ … +6 more , Gold L, Sly PD, Grant CC, McNab S, Vuillermin P, Children's Inpatient Research Collaboration of Australia and New Zealand (CIRCAN) Investigator Group
J Paediatr Child Health · 2026 Jun · PMID 42294810 · Publisher ↗
AIMS: Acute wheezing illnesses are among the most common reasons preschool-aged children are admitted to hospital. Readmission rates are high, and novel preventive strategies are required. OM-85 is an orally administered...
AIMS: Acute wheezing illnesses are among the most common reasons preschool-aged children are admitted to hospital. Readmission rates are high, and novel preventive strategies are required. OM-85 is an orally administered bacterial lysate that stimulates anti-viral immune responses and reduces excessive airway inflammation associated with wheezing episodes. The aim of the Assessing the Reduction of Recurrent admissions using OM-85 for the treatment of preschool Wheeze (ARROW) trial is to determine the efficacy of OM-85 in preventing hospital readmissions in children admitted to hospital with preschool wheeze. The primary outcome is hospital admission due to an acute wheezing illness during the 12-month treatment period. Secondary outcomes include the frequency and duration of wheeze episodes and the cost-effectiveness of the intervention. METHODS: ARROW is a decentralised, Phase 3 randomised, double-blind, placebo-controlled trial. We aim to recruit and follow-up 870 children aged 1 to < 6 years. Participants are randomised to 3.5 mg of OM-85 or placebo daily for the first 10 days of every month, for 12 months. Health professionals from over 40 hospitals participating in the Children's Inpatient Research Collaboration of Australia and New Zealand (CIRCAN) invite families to the ARROW trial. The ARROW central team organises enrolment, randomisation, medication distribution, and follow-up, conducting these activities entirely remotely in Australia and both remotely and in-person in New Zealand. ETHICS AND DISSEMINATION: ARROW received ethics approval from The Royal Children's Hospital Human Research Ethics Committee in Australia and the Health and Disability Ethics Committee in New Zealand. Findings will be published in peer-reviewed international journals. TRIAL REGISTRATION: ANZCTR: ACTRN12620001370998 (Registered on 21 December 2020).
Artificial Intelligence in Neonatal Hip Ultrasound: A Scoping Review of Methods and Clinical Evidence.
Carnazzo SM, Balconara D, La Quatra M … +1 more , Praticò AD
J Paediatr Child Health · 2026 Jun · PMID 42290645 · Publisher ↗
BACKGROUND: Developmental dysplasia of the hip (DDH) is among the most common musculoskeletal disorders in infants. Ultrasound, especially the Graf method, is the gold standard for early diagnosis but suffers from operat...
BACKGROUND: Developmental dysplasia of the hip (DDH) is among the most common musculoskeletal disorders in infants. Ultrasound, especially the Graf method, is the gold standard for early diagnosis but suffers from operator dependence and variability. Artificial intelligence (AI) and machine learning (ML) have recently been applied to improve acquisition, measurement, and classification tasks in neonatal hip ultrasound. OBJECTIVE: To systematically map and synthesise the literature on AI/ML applications for neonatal hip ultrasound, identifying algorithmic approaches, tasks, study characteristics, performance metrics, and knowledge gaps. METHODS: A scoping review was conducted using the Arksey and O'Malley framework, refined by the Joanna Briggs Institute, and reported according to PRISMA-ScR. The protocol was registered in PROSPERO (CRD420251150044). The protocol was initially registered as a systematic review and subsequently conducted as a scoping review; this methodological adaptation is acknowledged. PubMed/MEDLINE, Embase, Scopus, and IEEE Xplore were searched for English-language studies from January 1, 2015, to September 10, 2025. Eligible studies evaluated AI/ML algorithms for neonatal hip ultrasound in infants ≤ 12 months. RESULTS: From 192 records, 41 studies met inclusion criteria. Publications increased from 2020 onward, with China and Canada contributing over half. Most were retrospective, single-centre developments using convolutional neural networks; a minority used YOLO detectors or transformer models. Tasks included landmark detection/segmentation (53.7%), automated α/β angle estimation (26.8%), classification (19.5%), and scan quality assessment (≈10%). Because some studies addressed multiple analytic tasks, these categories were not mutually exclusive and percentages therefore exceed 100%. Internal performance was high (ICC up to 0.94, Dice > 0.90, AUC ≥ 0.95), but external validation was rare (≈5%). CONCLUSION: AI/ML has been applied to neonatal hip ultrasound primarily for landmark detection, angle estimation, classification, and scan-quality assessment. Reported internal performance is often high; however, clinically relevant diagnostic accuracy studies remain limited, external validation is rare, and most evidence derives from single-centre datasets. These limitations currently constrain clinical generalizability.
Selumetinib as a Target Therapy in Progressive Paediatric Low-Grade Gliomas-Case Series (pLGG).
Trapani L, Gortani G, Magnolato A … +10 more , Murru FM, Cattaruzzi E, Diplotti L, Michieletto P, Giganti S, Zanon D, Maestro A, Kiren V, Barbi E, Bruno I
J Paediatr Child Health · 2026 Jun · PMID 42276973 · Publisher ↗
BACKGROUND: Optic pathway gliomas (OPGs) occur in 15%-20% of children with neurofibromatosis type 1 (NF1). While smaller gliomas may be only monitored, the current standard of care for symptomatic ones relies on chemothe...
BACKGROUND: Optic pathway gliomas (OPGs) occur in 15%-20% of children with neurofibromatosis type 1 (NF1). While smaller gliomas may be only monitored, the current standard of care for symptomatic ones relies on chemotherapy, most commonly carboplatin and vincristine. These drugs can achieve tumour control but are associated with significant toxicity and do not generally restore visual function. Selumetinib, a selective MEK inhibitor, has shown efficacy in reducing NF1-related plexiform neurofibromas and has emerged as a promising targeted therapy for NF1-associated low-grade gliomas. AIM: To retrospectively evaluate the efficacy and safety of selumetinib in children with NF1-associated progressive OPGs, with attention to radiological and functional visual outcomes. METHODS: We reviewed three paediatric patients with NF1 and progressive OPGs treated with selumetinib at 25 mg/m/day. In one case, selumetinib was initiated as second-line after tumour regrowth following chemotherapy; in the other two, it was administered as first-line under compassionate use. Tumour response was assessed by MRI, visual function with serial ophthalmological evaluations. RESULTS: All patients showed radiological tumour shrinkage or stabilization with clinically meaningful improvements in visual acuity. One child achieved near-complete recovery of vision. Treatment was well tolerated: adverse events were mild, predominantly dermatological. No severe systemic toxicities were observed. CONCLUSIONS: While rigorous clinical trial data is still emerging, these preliminary cases suggest selumetinib may be a safe and effective therapeutic option for NF1-related OPGs, offering significant tumour control with a favourable toxicity profile compared to chemotherapy. Beyond stabilization, its potential to restore visual function represents a major advance, supporting the potential role of MEK inhibition as a first- and second-line treatment strategy.
What Are the Systemic Therapeutic Options for Paediatric Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)?
Wargon O
J Paediatr Child Health · 2026 Jun · PMID 42272088 · Publisher ↗
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Prevalence, Comparative Risk, and Predictors of Shock in Children With Multisystem Inflammatory Syndrome Associated With COVID-19: A Systematic Review and Meta-Analysis.
Jan A, Waheed B, Hussein GA … +4 more , Pandey P, Sultana H, Kumar S, Dagnaw M
J Paediatr Child Health · 2026 Jun · PMID 42272086 · Publisher ↗
BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition associated with SARS-CoV-2 infection and is frequently complicated by cardiovascular dysfunction, particularly sho...
BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition associated with SARS-CoV-2 infection and is frequently complicated by cardiovascular dysfunction, particularly shock. Early recognition of shock in MIS-C is critical to reduce morbidity and mortality. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the prevalence, comparative risk, and predictors of shock among children with MIS-C, enhancing clinical management and informing future research. METHODS: A systematic search of PubMed, Embase and Web of Science was conducted from database inception to 15 July 2025. Observational studies reporting prevalence, comparative risk or predictors of shock in children with MIS-C were included. Random-effects meta-analysis with Freeman-Tukey double arcsine transformation was used to estimate pooled prevalence with 95% confidence intervals (CI). Relative risks (RR) were pooled for comparative analyses. Subgroup analyses, sensitivity analyses and meta-regression were performed to explore heterogeneity. Publication bias was assessed using funnel plots and Egger's regression test. RESULTS: Seventy studies involving 13 263 children with MIS-C were included. The pooled prevalence of shock was 56% (95% CI: 49%-63%), although substantial heterogeneity was observed (I = 98.4%). Sensitivity analyses excluding studies with sample sizes < 50 and < 100 participants yielded pooled prevalence estimates of 50% (95% CI: 40%-59%) and 46% (95% CI: 33%-59%), respectively. Subgroup analyses demonstrated variation according to publication year and diagnostic criteria. Children with MIS-C had a significantly increased risk of shock compared with Kawasaki disease cohorts (RR = 8.52, 95% CI: 1.24-58.41; p < 0.05) and acute/severe COVID-19 cohorts without MIS-C (RR = 4.42, 95% CI: 2.44-8.02; p < 0.001). Echocardiographic abnormalities, myocardial dysfunction, elevated inflammatory markers and acute kidney injury were consistently associated with shock. CONCLUSION: The certainty of evidence ranged from very low to low because of substantial heterogeneity, imprecision and methodological variability across studies. Despite these limitations, shock remains a frequent and serious complication of MIS-C, highlighting the importance of early cardiovascular assessment and timely recognition of high-risk children.
Long-Term Outcomes Following Bacterial Meningitis in Childhood: A Systematic Review and Meta-Analysis.
Araújo RD, Diniz LMO, Teixeira DC … +5 more , Viana ACVF, Franco LP, Carvalho SADS, Liboredo R, de Castro Romanelli RM
J Paediatr Child Health · 2026 Jun · PMID 42267426 · Publisher ↗
INTRODUCTION: This study conducted a systematic literature review to answer the question: "What is the frequency of post-discharge complications in patients who had bacterial meningitis during childhood and adolescence?"...
INTRODUCTION: This study conducted a systematic literature review to answer the question: "What is the frequency of post-discharge complications in patients who had bacterial meningitis during childhood and adolescence?" METHODS: Observational studies assessing post-discharge complications in patients aged 29 days to 18 years with bacterial meningitis were included. Studies on Mycobacterium tuberculosis meningitis or lacking clear diagnostic criteria were excluded. Searches were performed in July 2025 across seven databases (PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, LILACS, and BVS). Evidence certainty was assessed using GRADE. Data on events and total participants were synthesized quantitatively. RESULTS: Thirteen studies were included (sample size range: 51-3623 participants). Age at meningitis diagnosis ranged from 29 days to 18 years, with follow-up periods from 6 months to 35 years. The overall complication rate was 37.3% (95% CI 28.7-46.9). The most frequent sequelae were cognitive impairment (21.6%; 95% CI 13.2-32.8), emotional/behavioural problems (15.3%; 95% CI 8.1-26.8), and hearing loss (14.3%; 95% CI 7.7-25.1). DISCUSSION: Bacterial meningitis in childhood is associated with a significant and persistent impact on health and development. Despite heterogeneity across studies, a consistently high burden of auditory, motor, cognitive, and behavioural sequelae is observed, underscoring the need for long-term follow-up of affected individuals.
Neonatal Acute Kidney Injury-An Australian and New Zealand Perspective.
Desai S, Forbes T, Carter SA … +5 more , Kent AL, Prestidge C, Selewski DT, Staub E, Raaijmakers A
J Paediatr Child Health · 2026 Jun · PMID 42265899 · Publisher ↗
Acute kidney injury (AKI) is increasingly recognized as a critical and underdiagnosed condition among neonates, with significant short and long-term implications for survival, kidney function, and long-term cardiovascula...
Acute kidney injury (AKI) is increasingly recognized as a critical and underdiagnosed condition among neonates, with significant short and long-term implications for survival, kidney function, and long-term cardiovascular health. Neonatal physiology, including ongoing nephrogenesis, immature renal haemodynamics, and limited glomerular filtration, makes this population vulnerable to AKI. Advances in consensus definitions, particularly the modified neonatal Kidney Disease Improving Global Outcomes (KDIGO) criteria, have enhanced epidemiologic understanding and facilitated global research collaboration. Despite this, significant variability in AKI surveillance, diagnosis, and follow-up persists. Recent research efforts within Australia emphasize the need to incorporate AKI metrics into quality registries and improve equity of kidney care for infants. Integration of protocolized monitoring, preventative strategies such as nephrotoxin stewardship and methylxanthine therapy, and long-term follow-up for AKI survivors are essential to mitigating progression to chronic kidney disease. This narrative review synthesizes evolving evidence in neonatal renal physiology, AKI definition and biomarkers, epidemiology, management, and policy directions, emphasizing opportunities for education, protocol development, and collaborative improvement across Australia, New Zealand and beyond.
Clinician Perspectives of Oxygen Control in Children With Bronchopulmonary Dysplasia at Home: An International Survey of Clinicians From 44 Countries.
Pham TAN, Sotiropoulos JX, Rakshasbhuvankar A … +21 more , Bhandari V, Schmölzer GM, Kumar RK, Kusuda S, Zhang H, Nguyen TT, Kitsommart R, Kim HS, Ma L, Yang F, Ahmad Kamar A, Lusyati SD, Yeo KT, Kong JY, Tooke L, Fitzgerald D, Gonski K, Dekker J, Lim G, Lara-Díaz VJ, Oei JL
J Paediatr Child Health · 2026 Jun · PMID 42265765 · Publisher ↗
BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth and may lead to difficulties with oxygen control even at home. How oxygenation is managed outside the hospital and in high and...
BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth and may lead to difficulties with oxygen control even at home. How oxygenation is managed outside the hospital and in high and low resourced settings is unclear. AIMS: To determine clinician perspectives for managing oxygenation after hospital discharge in infants with BPD. METHODS: An opportunistic, anonymous, online survey was developed in English and translated into Mandarin, Vietnamese and Korean. The survey was disseminated three times to neonatal clinicians between December 2022 and August 2023. Responses were classified using the World Bank Income Classification. RESULTS: Overall, 610 clinicians from 44 countries responded, with 453 (74%, 453/610) from high- and upper-middle-income countries (HMIC) and 153 (25%, 153/610) from low- and lower-middle-income countries (LMIC). Most clinicians (84%, 510/610) would advocate discharge on home oxygen therapy (HOT), but this was less possible in LMIC (65% vs. 91%, p < 0.001). Most clinicians perceived HOT to improve growth (73%, 370/510) and neurodevelopment (72%, 366/510). HMIC respondents were more likely to use home oximetry (78% vs. LMIC 67%, p = 0.012). There were wide variations in oxygen saturation targets, pre-discharge oximetry use, and parameters for weaning. Most clinicians perceived novel technologies such as wearable oximetry with parent-led oxygen control as important (77%, 460/596) and useful (84%, 499/595) for improving oxygen management at home. CONCLUSION: Most neonatal clinicians would prescribe HOT for infants with BPD but are limited by barriers to sufficient resourcing, especially in LMIC. Evaluation of cost-effective novel monitoring techniques may improve accessibility and control of HOT.
Can Electronic Medical Records Improve Recognition of Paediatric Sepsis?
Bhurawala H
J Paediatr Child Health · 2026 Jun · PMID 42252728 · Publisher ↗
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Role of Skinfold Thickness and MUAC in Predicting Insulin Resistance: ROC And Regression Analysis.
Gürcan Kaya N, Kinali Çetin Y
J Paediatr Child Health · 2026 Jun · PMID 42252548 · Publisher ↗
INTRODUCTION: Early detection of insulin resistance (IR) in children is essential to prevent long-term metabolic complications. Simple anthropometric measures-mid-upper arm circumference (MUAC) and skinfold thickness-are...
INTRODUCTION: Early detection of insulin resistance (IR) in children is essential to prevent long-term metabolic complications. Simple anthropometric measures-mid-upper arm circumference (MUAC) and skinfold thickness-are widely used, but their predictive value, especially when age-standardized, remains unclear. This study aimed to evaluate the performance of raw, SDS, and percentile MUAC and skinfold measurements in predicting IR in patients with obesity and adolescents. METHODS: A cross-sectional study was conducted with 171 participants with obesity aged 6-18 years. Anthropometric measurements were recorded and converted to SDS and percentile values. Insulin resistance was evaluated using HOMA-IR with pubertal-stage-adjusted cutoffs. Logistic regression and ROC analyses were applied. RESULTS: Insulin resistance was present in 56.1% of participants. Both MUAC and skinfold thickness showed significant positive associations with IR; however, standardized measures (SDS and percentiles) demonstrated markedly stronger predictive value than raw measurements. Skinfold thickness SDS emerged as the strongest independent predictor of IR (OR = 12.04, p < 0.001), followed by MUAC SDS (OR = 7.28, p < 0.001). ROC analysis showed excellent discriminatory power for skinfold SDS (AUC = 0.82), with an optimal cutoff of 1.48 (76% sensitivity, 80% specificity). MUAC SDS also performed well (AUC = 0.76; cutoff = 1.10). CONCLUSION: Skinfold thickness SDS and MUAC SDS are strong, practical, and non-invasive markers for predicting insulin resistance in paediatric patients with obesity. Standardized measurements clearly outperform raw values and should be integrated into routine clinical assessment to enhance early detection of metabolic risk.
Accuracy of Referral for Undescended Testes in Paediatric Patients Referred to Specialist Paediatric Surgical Centres: A Multicentre Prospective Cohort Study.
Abdullah A, Tan WS, Sanmugam A … +5 more , Singaravel S, Zaki LI, Salihhuddin SA, Jefry NS, Nah SA
J Paediatr Child Health · 2026 Jun · PMID 42249797 · Publisher ↗
AIM: Undescended testes (UDT) are a common congenital disorder in boys, yet delays in diagnosis and referral still occur, especially in low-and middle-income countries where access to specialist care may vary. Our study...
AIM: Undescended testes (UDT) are a common congenital disorder in boys, yet delays in diagnosis and referral still occur, especially in low-and middle-income countries where access to specialist care may vary. Our study aimed to examine the accuracy and timing of referrals of UDT to paediatric surgical services across different healthcare settings and to evaluate knowledge regarding UDT among paediatric and family medicine trainees. METHOD: A prospective cohort study was conducted from January to December 2022 involving patients referred for UDT at three paediatric surgical centres representing urban and rural health-system structures. Diagnostic accuracy was confirmed by paediatric surgeons. Referral beyond 12 months of age was considered delayed. An anonymised survey assessing knowledge of diagnosis and management of UDT was distributed to paediatric and family medicine trainees. RESULTS: Two hundred and one boys were referred for UDT. Median age at referral was 8 months (1-24), and median age at review was 14 months (6-26). Most referrals were from community clinics (42%), followed by paediatricians (31%), in-hospital (18%), and private general practitioners (GP, 9%). 50% were confirmed UDT. Diagnostic accuracy was significantly related to patient age < 1 year (p = 0.001), unilaterality (p < 0.001), impalpability (p = 0.037), and UDT identified at birth (p = 0.004). Our survey showed that 22% of trainees would refer after 12 months of age and another 12% would refer after obtaining imaging. CONCLUSION: Delayed UDT referrals remain and may reflect clinician knowledge gaps and differences in referral pathways across a geographically extensive and heterogeneous healthcare system. Targeted education among referring healthcare professionals and locally tailored referral pathways may improve referral timeliness and accuracy.
Social Isolation and Excessive Weight Gain in Infants: A Nationwide Cohort Study of 1.8 Million Infants.
Ha E, Kim JH, Shin J … +5 more , Han B, Kim MS, You SH, Rhie S, Han MY
J Paediatr Child Health · 2026 Jun · PMID 42249795 · Publisher ↗
OBJECTIVE: Infant weight gain predicts childhood obesity, yet the effect of pandemic-related social isolation on first-year weight gain is unclear. We assessed its impact and implications for obesity risk. METHODS: We an...
OBJECTIVE: Infant weight gain predicts childhood obesity, yet the effect of pandemic-related social isolation on first-year weight gain is unclear. We assessed its impact and implications for obesity risk. METHODS: We analysed a nationwide birth cohort of South Korean children born 2014-2021, excluding prematurity, low birth weight or neonatal intensive care admission. Anthropometrics at 9-12 months were used. Interrupted time-series regression compared pre-pandemic (January 2015-January 2020) and pandemic (February 2020-December 2021) periods, adjusting for confounders. Relative risks (RRs) were estimated using modified Poisson regression with robust standard errors. The primary outcome was accelerated weight gain, defined as a change in weight-for-age Z-score (ΔWAZ) > 1.0. The secondary outcome was rapid weight gain, ΔWAZ > 0.67, encompassing excessive (ΔWAZ > 0.67 to ≤ 1.0) and accelerated (ΔWAZ > 1.0) gain. RESULTS: Among 1 809 054 infants (51.2% male), accelerated gain rose immediately after social isolation began (RR, 1.173; 95% confidence interval, CI, 1.154-1.193) and remained elevated (RR, 1.093; 95% CI, 1.063-1.125). Excessive gain likewise increased immediately (RR, 1.173; 95% CI, 1.154-1.192) and persisted (RR, 1.040; 95% CI, 1.025-1.055). Birth weight was stable (mean 3.24 kg, SD 0.36), while breastfeeding rates declined, socioeconomic levels rose and perinatal abnormalities increased. Infants born during the pandemic gained an additional 244 g (95% CI, 214-275) by 9-12 months. CONCLUSIONS: Infants born during pandemic-related social isolation gained more weight in the first year than pre-pandemic cohorts. Policies that sustain breastfeeding, promote healthy feeding and active play, support caregiver mental health and ensure routine early growth monitoring may help mitigate these risks.
Reframing the Digital Native Paradox: Strengthening Critical AI Literacy in Paediatric Medical Education.
Krisnanda VD
J Paediatr Child Health · 2026 Jun · PMID 42249792 · Publisher ↗
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Glucose Metrics During School Hours in Primary School-Aged Children With Type 1 Diabetes: A Population-Based Cohort Study.
Paull S, Connor A, Smith G … +6 more , Jones C, Provost K, Ellis K, Davis EA, Abraham MB, Taplin CE
J Paediatr Child Health · 2026 Jun · PMID 42249791 · Publisher ↗
AIM: School time represents a significant component of overall glycaemia for children with type 1 diabetes (T1D), and glucose levels during instructional time may be important for optimising academic progress. There is,...
AIM: School time represents a significant component of overall glycaemia for children with type 1 diabetes (T1D), and glucose levels during instructional time may be important for optimising academic progress. There is, however, limited literature regarding glycaemia during school hours. This study aimed to evaluate glucose levels during school in primary school-aged children with T1D in Western Australia (WA) and to compare these with non-school days. METHODS: A 12-week cross-sectional cohort study was performed comprising a WA school term and subsequent school holidays, utilising demographic, clinical and continuous glucose monitor data from the WA Children's Diabetes Database for primary school children with > 1 year of diagnosis of T1D. RESULTS: A total of 235 children, mean age 9.54 ± 1.67 years and duration of T1D of 4.08 ± 2.31 years met inclusion criteria. Children had higher mean ± standard deviation time in range (3.9-10.0 mmol/L) during school (58.0% ± 15.8%) than equivalent hours during school holidays (53.5% ± 18.8%, p < 0.001) and weekends (56.6% ± 17.3%, p = 0.006). Children had lower mean sensor glucose, SD sensor glucose and time above range (> 10.0 and > 13.9 mmol/L) during school compared to school holidays and weekends. Time below 3.9 mmol/L was higher during school time compared with weekdays during school holidays (p = 0.024), but lower than on school term weekends (p = 0.009), and < 4% in all periods. There was no significant difference in time below 3.0 mmol/L. CONCLUSIONS: Primary school-aged children in WA had modestly improved glycaemia during school compared with weekends, with more pronounced improvements compared with school holidays.
Management of Kaposiform Haemangioendothelioma-A Retrospective Case Series Examining the Use and Effectiveness of Vincristine.
Kirk B, Adams S, Wargon O … +2 more , Tatian A, Russell S
J Paediatr Child Health · 2026 Jun · PMID 42246503 · Publisher ↗
AIM: Kaposiform haemangioendothelioma is a rare vascular tumour. Management has evolved over the last two decades, with most cases receiving vincristine or sirolimus. We aim to describe our experience with managing this...
AIM: Kaposiform haemangioendothelioma is a rare vascular tumour. Management has evolved over the last two decades, with most cases receiving vincristine or sirolimus. We aim to describe our experience with managing this tumour, with a focus on the safety and efficacy of vincristine. METHODS: A retrospective cohort study of all cases treated at Sydney Children's Hospital over a 19-year period was conducted. Explanatory variables included age, tumour location, imaging, the presence of Kasabach-Merrit Phenomenon, and treatment modality. The primary outcome was disease recurrence and the secondary outcome, complications. RESULTS: Twenty-one cases were identified with 13 (60%) presenting as neonates. The most common site was limb; and imaging included ultrasound (7/21, 33%) and MRI (12/21, 57%). Almost all had consumptive coagulopathy (20/21, 95%) with 6/21 (29%) having severe Kasabach-Merrit Phenomenon. Six tumours were excised and 16 (76%) were treated with vincristine, with three (14%) progressing to treatment with sirolimus. There were no recurrences. Complications of vincristine therapy were common but mild in most cases, with only one proven blood stream infection and one requiring central line replacement. CONCLUSION: Vincristine remains a highly effective first-line treatment for kaposiform haemangioendothelioma with an acceptable safety profile. Further well-designed multicentre trials are needed to objectively compare its effectiveness and safety with sirolimus.
Toddler Track: Streamlining Developmental Assessments-A Retrospective Cohort Study.
Campbell-Woods N, Atkinson S, Balfour-Ogilvy J … +7 more , Benham C, Gibbons C, Harris K, Hennessy P, Ng E, Perez WP, Thomson J
J Paediatr Child Health · 2026 Jun · PMID 42244125 · Publisher ↗
AIMS: To design, implement and evaluate a novel model of care, Toddler Track Model (TTM), at a specialist outpatient developmental assessment service to determine whether the model: (1) reduced wait times to access the s...
AIMS: To design, implement and evaluate a novel model of care, Toddler Track Model (TTM), at a specialist outpatient developmental assessment service to determine whether the model: (1) reduced wait times to access the service; (2) reduced length of time to complete developmental assessment; (3) resulted in any change to the formulation of developmental profiles. METHODS: TTM utilised a Plan-Do-Study-Act (PDSA) framework to redesign service delivery. Children aged 18 months to 3 years 11 months were triaged into one of four streams based on clinical information, with tailored pathways involving allied health and paediatrician input. Outcomes were measured through a retrospective chart audit, comparing key time points and service metrics before and after implementation of TTM. RESULTS: The average time from initial clinical session (ICS) to diagnostic formulation decreased from 116 to 63 days (p < 0.001), with statistically significant reductions observed at all measured service time points. The number of children assessed in 2024 increased substantially (n = 132). Importantly, diagnostic outcomes did not differ between cohorts, indicating no change in clinical formulation. Service-wide wait times declined by 61.5%, with 68% of this reduction estimated to be associated with TTM. CONCLUSION: The findings suggested that TTM is a novel model of care for children aged 18 months to 3 years 11 months. Its implementation successfully reduced wait times and assessment duration while increasing service capacity, without altering diagnostic outcomes or clinical practice standards.
Rome IV Functional Constipation in Childhood: Early-Life Factors and Dietary Habits in a Southeast Asian Clinical Setting.
Tseng TT, Bui HM, Chen SY … +4 more , Lin SH, Shen SC, Wu CH, Nguyen NTK
J Paediatr Child Health · 2026 Jun · PMID 42241466 · Publisher ↗
AIM: Functional constipation (FC) is a prevalent paediatric condition that places a significant burden on healthcare systems and adversely impacts the quality of life of children. Despite its widespread occurrence, the u...
AIM: Functional constipation (FC) is a prevalent paediatric condition that places a significant burden on healthcare systems and adversely impacts the quality of life of children. Despite its widespread occurrence, the underlying contributors to FC in early childhood remain inconsistently documented. Thus, the study aimed to assess the early life factors and dietary habits in the associations with FC in children aged 6-48 months. METHODS: This cross-sectional study recruited children undergoing routine health examinations in the City Children's Hospital. FC was diagnosed using the Rome IV criteria. Data were collected from caregivers by interview using questionnaires. RESULTS: Among 344 children, 24.41% (n = 84) were diagnosed with FC, increasing to 31.71% in those aged 36.1-48 months. Low birth weight (< 2.0 kg) and preterm birth were independently associated with FC. Higher consumption of vegetables and fruits was significantly protective against FC, whereas increased intake of cheese (p < 0.001) and soft drinks (p < 0.001) was positively associated with FC risk. After adjustment for age, sex, and BMI z-score, frequent cheese consumption remained a risk factor (> 5 days/week: adjusted odds ratio (aOR) = 5.18, 95% CI: 1.58-16.93; 2-4 days/week: aOR = 3.10, 95% CI: 1.52-6.34), and daily fresh fruit intake was protective (aOR = 0.28, 95% CI: 0.14-0.59). CONCLUSIONS: This study emphasises the critical influences of birth weight and gestational age on FC risk. Targeted interventions, including promoting fibre-rich fresh fruit consumption and limiting excessive cheese intake, are recommended to help prevent FC in young children.
Measuring Adherence to Family-Centred Goal Setting in Paediatric Rehabilitation: A Retrospective Chart Review.
Dabbagh A, Kingsnorth S, Maxwell J … +5 more , Bosveld L, Khalaf N, Maine K, Nelson E, Colquhoun H
J Paediatr Child Health · 2026 Jun · PMID 42231665 · Publisher ↗
AIM: Family-centred goal setting (FCGS) is seen as fundamental to improving meaningful outcomes in paediatric rehabilitation. However, the degree to which FCGS is implemented in paediatric rehabilitation is unknown. This...
AIM: Family-centred goal setting (FCGS) is seen as fundamental to improving meaningful outcomes in paediatric rehabilitation. However, the degree to which FCGS is implemented in paediatric rehabilitation is unknown. This study aimed to develop and utilise a Chart Audit Tool to measure adherence to FCGS in a Canadian inpatient paediatric brain injury unit. METHODS: In this retrospective chart review, a FCGS Chart Audit Tool was developed, piloted on 17 charts, and refined. The audit tool evaluated three categories (i.e., Partnership, Identification and Agreement) and eight subcategories. Charts were included of patients discharged between January and December 2023, with a minimum 14-day stay and involvement from at least two rehabilitation professionals. After a 70% inter-rater reliability was achieved, the audit tool was applied independently by one researcher to review 50 charts. Descriptive analyses were employed to calculate the adherence rates of rehabilitation professionals to the recommended practise of FCGS. RESULTS: Overall, FCGS mean adherence expressed per chart was observed in 60% of the 50 charts reviewed across all categories (range of 33% to 80%). Individual mean adherence rates for the categories were 68% for Partnership, 70% for Identification and 66% for Agreement. Across the eight subcategories, mean adherence rates varied between 7% for the use of 'family-centred tools' to 79% for 'goals supporting family priorities.' CONCLUSIONS: Results of a chart review suggest that FCGS is being implemented most of the time but with areas for improvement. The novel creation of an audit tool to systematically quantify FCGS provides an important foundation for future research.
Intravesical Botox: An Effective Therapy for Refractory Monosymptomatic Nocturnal Enuresis.
Szwarcberg E, Kimber C, Taghavi K
J Paediatr Child Health · 2026 Jun · PMID 42226401 · Publisher ↗
AIM: Monosymptomatic nocturnal enuresis (MNE) significantly impacts many children, with substantial patient groups refractory to conventional first-line treatments. Intravesical Botox is used for various refractory funct...
AIM: Monosymptomatic nocturnal enuresis (MNE) significantly impacts many children, with substantial patient groups refractory to conventional first-line treatments. Intravesical Botox is used for various refractory functional voiding disorders in children, but its efficacy in MNE has not been widely established. This study aimed to determine the efficacy of intravesical Botox in children with refractory monosymptomatic nocturnal enuresis. METHODS: A retrospective analysis was conducted of 22 children with MNE (median age 11 years; 19 males) treated with intravesical Botox injection over a 6 year period. All participants had previously failed desmopressin, and the majority had trialled an enuresis alarm and oxybutynin. Each child received 200iU of Botox injected into the detrusor muscle. Treatment outcomes were classified as complete (100% reduction in wet nights), partial (50%-99% reduction), or no response (0%-49% reduction). RESULTS: Prior to treatment, median number of wet nights was six per week. Following the final injection, complete response was observed in 8 of 22 (36%) children, partial response in 7 of 22 (32%), and no response in 7 of 22 (32%). Median reduction in wet nights was 2.5 per week. Median duration of response for those experiencing relapse was 11 months. No intra-operative complications occurred. Post-operative complications were mild and self-resolving, limited to transient haematuria/pain and dysuria in isolated cases, with no instances of urinary tract infection or retention. CONCLUSIONS: Intravesical Botox injection is an effective, well-tolerated treatment option for children with refractory monosymptomatic nocturnal enuresis, demonstrating a sustained response in a significant proportion of patients. This intervention presents a valuable option for treating this multi-faceted condition.
Changes in Hospital Care for Children With IBD Across Australia From 2014 to 2022.
Rishanghan L, Skvarc D, Moller S … +13 more , Nataraja R, Nightingale S, Burgess C, Dutt S, Alex G, Jurgens H, Sharma A, Hammond P, Foo C, Raven L, Mikocka-Walus A, Massuger W, Giles E
J Paediatr Child Health · 2026 Jun · PMID 42223277 · Publisher ↗
BACKGROUND: Inflammatory bowel disease is a chronic, lifelong gastrointestinal disorder, with 8%-10% of patients diagnosed < 18 years old. Over the last decade, there has been a global increase in paediatric IBD (pIBD) i...
BACKGROUND: Inflammatory bowel disease is a chronic, lifelong gastrointestinal disorder, with 8%-10% of patients diagnosed < 18 years old. Over the last decade, there has been a global increase in paediatric IBD (pIBD) incidence and changes in therapeutic approaches. Our study aimed to assess the changes in hospital care for young people with IBD from 2014 to 2022. METHODS: Complete national pIBD data on admissions was collected through the Australian Institute of Health and Welfare (AIHW). Hospitals nationally were invited to participate in a clinical audit of inpatient overnight admissions for 2021. Data was compared to a previous study from 2014. RESULTS: There were 813 overnight pIBD admissions in 2021, compared to 590 in 2014. Eight public hospitals participated, with 186 admissions, capturing 23% of all 2021 pIBD admissions. UC admission rates doubled; however, surgical admissions reduced (16% in 2014 to 5% in 2021, p < 0.05). CD and surgical admissions remained stable. There was reduced corticosteroid use, and 56 patients had off-label medication use. Sixty-five percent of patients had active disease at the last clinic review. There was a trend towards shorter admissions, and re-admission rates were similar to previous global data. Despite psychological co-morbidity in 28% of cases, psychologists were not part of the team at any site. CONCLUSION: This study showed a significant increase in UC admissions in Australia over the last decade. Medication changes were in line with global trends, and multi-disciplinary care remained inadequate despite national standards. This data provides evidence for planning and resourcing pIBD care nationally and worldwide.
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