Search

Human parechovirus (HPeV) infections in neonates and infants have been linked to outbreaks in regions including Australia, Northern Europe, and the US, resulting in long-term neurological complications. HPeV symptoms range from mild gastroenteritis and respiratory issues to severe systemic illness, including seizures and neurological damage. Human parechovirus type 3 (HPeV3) has emerged as a significant cause of sepsis-like illness in infants aged less than 3 months. We describe the case of a neonate aged 11 days with an acute abdomen and meningitis, treated at a rural hospital in Queensland, Australia. Early diagnosis of HPeV3 in this case facilitated supportive management of the neonate, and avoided unnecessary transfer to a tertiary centre.

Aim: To determine the incidence and presenting features of type 1 diabetes mellitus and diabetic ketoacidosis in a paediatric population serviced by a regional health service in Queensland, Australia., Methods: All patients less than 16 years old diagnosed with type 1 diabetes mellitus between 01 January 2015 and 31 December 2021 were included in this retrospective, observational study. The electronic medical records of each patient were reviewed to collect data on demographics, presentation and ongoing diabetes care., Results: Sixty-four paediatric patients were diagnosed with type 1 diabetes mellitus during the study period, giving an incidence of 25 cases per 100 000 person years. Half the patients presented with diabetic ketoacidosis, with 14 (22% of the total cohort) presenting in severe diabetic ketoacidosis. There was no significant increase in the incidence of type 1 diabetes mellitus or proportion of patients with diabetic ketoacidosis across the years of the study. Patients that had a delayed diagnosis had an increased likelihood of presenting with severe diabetic ketoacidosis., Conclusion: Incidence of type 1 diabetes mellitus in the paediatric population in this regional centre in Queensland, Australia, is similar to national data. High proportions of patients presenting with diabetic ketoacidosis and severe diabetic ketoacidosis were identified in the study population, with delayed diagnosis, a risk factor for severe diabetic ketoacidosis., (© 2024 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Aim: High-risk neonates are retrieved from regional centres to tertiary neonatal units when the required care of the baby exceeds the clinical capabilities of the birthing facility. However, there is limited research on the outcomes of neonatal retrievals from regional special care centres and the barriers to back transfer of neonates from a tertiary centre are not well established. This study aimed to review the outcome of neonatal retrievals >32 weeks gestation from a regional referral centre. The study also aimed to determine missed opportunities for providing care at the regional centre and evaluate patient back transfer delays., Methods: All neonates transferred to a tertiary neonatal intensive care unit in North Queensland over the 5-year period January 2016 to December 2020 from a regional neonatal centre were retrospectively reviewed from the electronic medical records., Results: Fifty neonates transferred to a tertiary neonatal intensive care unit over the study period were identified. Between 2016 and 2020, the number of neonatal retrievals increased (P = 0.021). Out of the 50 neonatal retrievals, 86% were for medical reasons. Overall, eight neonates were identified as missed opportunities whose care could have been maintained at the regional centre with support from the tertiary neonatal intensive care unit. In total, 16 neonates were affected by a delay in back transfer., Conclusions: This study shows a significant increase in retrievals to tertiary neonatal intensive care unit over the study period. Increasing bed capacity, utilising telehealth and recruiting regional special care nursery staff could improve outcomes and reduce strain on tertiary neonatal resources., (© 2023 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)