Current opinion in pediatrics最新文献

{"title":"Using artificial intelligence to advance pediatric infection prevention and control.","authors":"Thomas S Murray, Morgan Quan, Michael Aniskiewicz, Theodore R Pak","doi":"10.1097/MOP.0000000000001540","DOIUrl":"10.1097/MOP.0000000000001540","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent literature describes the deployment of different artificial intelligence (AI) technologies to potentially support infection prevention and control (IP&C) in both the community and healthcare environment. However, most studies focus on adults. This review explores the data and potential for AI to enhance IP&C for pediatric populations as well as recognizing important limitations.</p><p><strong>Recent findings: </strong>In community settings, AI can educate families about infections and risk, recognize potential clusters and outbreaks of infectious pathogens, and prescreen individually infected patients prior to entering a healthcare facility. For admitted patients, AI has been used to identify patients at risk for healthcare-associated infections (HAIs) such as central line associated blood stream infections, and may assist infection preventionists in abstracting chart data for HAI surveillance. Limitations include potential biases in training data and the lack of prospective studies validating the use of AI for IP&C purposes, especially in heterogeneous pediatric populations.</p><p><strong>Summary: </strong>AI can be a valuable tool in recognizing and controlling infections in both the community and healthcare settings. However, more studies in pediatric populations are needed, including prospective studies that validate tools created and trained on retrospective cohorts.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"142-148"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical concerns and considerations for leucovorin use in autism spectrum disorder.","authors":"Caroline Howard, Joseph Mekhail, Lillian Maidman Ravikoff, Ruth Milanaik","doi":"10.1097/MOP.0000000000001547","DOIUrl":"10.1097/MOP.0000000000001547","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide pediatric clinicians with an overview of current research on leucovorin use in children with autism spectrum disorder (ASD) and a guide to patient evaluation and treatment.</p><p><strong>Recent findings: </strong>An association between cerebral folate deficiency (CFD) and ASD has been suggested in some studies. Autoantibodies that block folate entry into the brain are a cause of CFD and have been detected in 71% of patients with ASD. Leucovorin is a synthetic drug that increases folate concentrations in the brain despite the presence of autoantibodies. Certain studies have indicated reductions in communication deficits in nonverbal children with ASD, particularly those with these autoantibodies, following consistent leucovorin use. However, other studies have found no change in symptoms despite leucovorin intake. The American Academy of Pediatrics (AAP) currently does not recommend use of leucovorin in children with ASD.</p><p><strong>Summary: </strong>Due to recent popularity among policymakers and on social media, many pediatricians have reported increased requests by families for leucovorin prescriptions to treat ASD in pediatric patients. This review provides clinicians with an overview of the biological rationale, clinical evidence, and potential benefits and limitations of leucovorin use in children with ASD.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"207-211"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the single cell revolution on neonatology research.","authors":"Kerri St Denis, Tyler A Rice, Oluwabunmi Olaloye, Liza Konnikova","doi":"10.1097/MOP.0000000000001556","DOIUrl":"10.1097/MOP.0000000000001556","url":null,"abstract":"<p><strong>Purpose of review: </strong>Single cell technologies are quickly becoming more affordable and widespread throughout academic research. We review the application of single cell and multi-omic technologies to study neonatal health and disease, as well as their potential to further impact translational discoveries in the future.</p><p><strong>Recent findings: </strong>Pediatric and neonatal development and disease have been largely understudied compared to their adult counterparts. This difference can be partially attributed to limited sample access and small sample volumes. Single cell and multi-omic approaches have drastically altered the landscape of neonatal research, as they allow for the acquisition of large volumes of data from small and limited samples. When profiled individually, even a few hundred cells contain a wealth of information that was previously inaccessible with prior techniques. Single cell technologies have revealed profound cellular heterogeneity, dynamic regulation over time and across tissues, disease activity, and many other factors.</p><p><strong>Summary: </strong>The use of single-cell technologies has rapidly advanced our understanding of baseline immune development and pathologies of early-life, however, there is a pressing need for development and benchmarking of multi-modal platforms that measure parameters beyond mRNA transcripts, and the analytical tools required to integrate these complex datasets.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"177-183"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric trigger thumb: clinical management update.","authors":"Dan Gordon, Pamela J Sherman","doi":"10.1097/MOP.0000000000001541","DOIUrl":"10.1097/MOP.0000000000001541","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pediatric trigger thumb is a common problem in children accounting for 1 in 2000 visits to the pediatric hand clinic. Misdiagnosis as a fracture or dislocation is common, so proper identification is key. The ideal treatment strategy remains a subject of debate, and there are studies documenting successful outcomes with both nonoperative and surgical treatment.</p><p><strong>Recent findings: </strong>Recent literature highlights that observation is reasonable, as spontaneous resolution can occur in 30-50% of cases over a several-year period, with those having an interphalangeal angle of less than 30° being more likely to resolve. Surgical release of the A1 pulley remains the definitive treatment, with consistently excellent outcomes and minimal complications, particularly for children older than 2 years or those with more severe contractures or failed conservative management. Recent studies have identified certain congenital malformations that occur at a higher rate in children with trigger thumbs.</p><p><strong>Summary: </strong>This developmental condition is common with spontaneous resolution being frequent. Proper diagnosis includes findings on examination of the volar nodule and flexion at the interphalangeal joint of the thumb. Minimizing misdiagnosis and appropriate observation in mild cases for a certain time frame is acceptable. Awareness of the potential need for surgical intervention, which is highly effective for persistent or severe trigger thumb in children, is important. The choice of management should be individualized based on age, severity, and parental preference, with recent studies supporting both approaches depending on clinical context.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"212-218"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine daily chest radiographs in pediatric critical care: necessary standard or unwarranted practice?","authors":"Duane C Williams, Conrad Krawiec, Gregory Vorona","doi":"10.1097/MOP.0000000000001565","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001565","url":null,"abstract":"<p><strong>Purpose of review: </strong>The routine use of daily chest radiographs in pediatric critical care remains common in the management of critically ill children. However, this practice has come under question. This review evaluates whether daily chest radiography is necessary.</p><p><strong>Recent findings: </strong>The evidence indicates that the practice of daily chest radiography does not significantly improve clinical outcomes in children. It also does not replace careful clinical assessment, exposes children to unnecessary radiation with potential long-term risk, and may reflect defensive medical practice rather than patient-centered decision-making.</p><p><strong>Summary: </strong>Providers should base imaging decisions on clinical findings and changes in patient condition rather than on a routine schedule of obtaining studies.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and diagnosis and management of tuberculosis disease in children.","authors":"Declan Ikechukwu Emegano, Ilker Ozsahin, Emeje Paul Isaac, Dilber Uzun Ozsahin, Oyibo Saidu Silas, Chinonye Lynda Emegano, Berna Uzun","doi":"10.1097/MOP.0000000000001551","DOIUrl":"10.1097/MOP.0000000000001551","url":null,"abstract":"<p><strong>Purpose of review: </strong>The literature review is pertinent because diagnosing pediatric tuberculosis (PdTB) remains quite challenging, especially in areas with limited resources, due to complications caused by variable generalized symptoms, paucibacillary characteristics, vague clinical manifestations, and challenges associated with pediatric sputum sample production. Recent developments in artificial intelligence have the potential to enhance the accuracy of diagnoses and the effectiveness of treatments.</p><p><strong>Recent findings: </strong>Nineteen published studies between January 2024 and July 2025 were examined, which focused on artificial intelligence driven chest X-ray (CXR) examination and medical prediction. The reviewed studies utilized convolutional neural networks (CNN), transfer learning, and stacked ensemble machine learning (SEML) to achieve sensitivity values ranging from 76.0 to 98.2%, specificity of 70.0 to 98.0%, and area under the curve (AUC) values of as high as 0.98 in AI-CXR diagnosis for the detection of PdTB. Through continuous experiments and use of the AI-CXR triage in Ethiopia (2025), successfully identifying over 30% of patients, while prediction models indicate 82% hepatotoxicity concerns in Nigerian cohorts. Plasma proteomics and exhaled breath analysis are emerging methodologies that exhibit potential; however, pediatric datasets are limited, necessitating multicenter validation.</p><p><strong>Summary: </strong>Artificial intelligence enhances the diagnosis and treatment prediction of PdTB in resource-constrained settings. The integration of artificial intelligence with existing diagnostic tools like GeneXpert and telemedicine strategies can significantly improve the efficiency of screening processes. Future research efforts should prioritize the expansion of pediatric datasets and the evaluation of multimodal AI-PdTB approaches.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"155-161"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates in atypical hemolytic syndrome.","authors":"Keri Drake, Jyothsna Gattineni","doi":"10.1097/MOP.0000000000001435","DOIUrl":"10.1097/MOP.0000000000001435","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to summarize how scientific advances in complement biology have not only improved the diagnosis and management of aHUS but also continue to offer insights into the pathophysiology of complement-mediated disease that may be leveraged for future therapeutic developments.</p><p><strong>Recent findings: </strong>Updated information on the clinical and epidemiological features, pathophysiology, diagnosis, management, and potential for future therapeutic advancements in the treatment of aHUS are reviewed.</p><p><strong>Summary: </strong>aHUS is a rare but potentially life-threatening disease that requires prompt diagnosis and treatment as well as long-term management via a multidisciplinary team providing coordination of primary and specialty care as well as outreach and education for children and families affected by this life-long disease.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"219-225"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in the diagnosis and prognosis of pediatric bacterial pneumonia: current advances and challenges.","authors":"Yingying Ye, Weifang Zhou","doi":"10.1097/MOP.0000000000001545","DOIUrl":"10.1097/MOP.0000000000001545","url":null,"abstract":"<p><strong>Purpose of review: </strong>The clinical presentation of pediatric bacterial pneumonia often overlaps with that of other respiratory conditions, posing considerable diagnostic challenges. This review evaluates the potential of artificial intelligence to improve diagnostic accuracy and prognostic evaluation for this disease.</p><p><strong>Recent findings: </strong>Artificial intelligence driven diagnostic tools for pediatric bacterial pneumonia have now been validated in several studies. Clinically, these systems can rapidly process chest imaging, synthesize heterogeneous patient data, and alert physicians to early signs of severe pneumonia. Beyond immediate diagnostics, they also show emerging utility in uncovering biomarkers relevant to disease prognosis and management.</p><p><strong>Summary: </strong>In clinical practice, artificial intelligence driven decision support is emerging as a valuable tool for the early diagnosis of pediatric bacterial pneumonia. As high-quality, multicenter datasets continue to grow and model interpretability improves, artificial intelligence is expected to become increasingly important in managing pediatric bacterial pneumonia.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"149-154"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the findings from the Assessment of Worldwide Acute Kidney Epidemiology in Neonates cohort.","authors":"Tara Beck, David Askenazi, Ronnie Guillet","doi":"10.1097/MOP.0000000000001512","DOIUrl":"10.1097/MOP.0000000000001512","url":null,"abstract":"<p><strong>Purpose of review: </strong>Acute kidney injury (AKI) is a major contributor to morbidity and mortality in critically ill neonates. Before 2014, data were limited to small retrospective studies. In response, the 2013 NIH-sponsored workshop highlighted the need for collaborative, multidisciplinary research. The Assessment of Worldwide Acute Kidney Epidemiology in Neonates (AWAKEN) study was launched to fill this gap by defining AKI prevalence, risk factors, and outcomes, while also establishing infrastructure for future studies.</p><p><strong>Recent findings: </strong>AWAKEN screened 4273 neonates admitted to 24 NICUs over a 3-month period in 2014. Strict criteria, including the requirement for ≥48 h of intravenous fluids, resulted in 2022 enrolled neonates. AKI was defined using a neonatal-modified KDIGO system.</p><p><strong>Summary: </strong>AWAKEN confirmed AKI as an independent risk factor for mortality and prolonged hospitalization across all gestational ages. The creation of this high-quality, multicenter database has produced 21 peer-reviewed publications and significantly advanced the field of neonatal nephrology.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"162-168"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal corticosteroids and bronchopulmonary dysplasia: balancing pulmonary and neurologic effects to enable individualized decision-making.","authors":"Nehal A Parikh, Shipra Jain","doi":"10.1097/MOP.0000000000001544","DOIUrl":"10.1097/MOP.0000000000001544","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize existing evidence about the long-term effects of bronchopulmonary dysplasia (BPD) and postnatal corticosteroid (PNC) treatment to enable evidence-based risk-stratification and individualized decision-making in very preterm (<32 weeks' gestation) infants.</p><p><strong>Recent findings: </strong>BPD remains a top risk factor for neurodevelopmental impairments (NDI) or death and BPD rates are rising in Western nations. Conversely, clinical trials and meta-regression data suggest medium (2-4 mg/kg cumulative dose) or high dose (4-8 mg/kg) dexamethasone use after a week of age reduces BPD/death and may improve or at worst have no effect on survival without NDI, as compared to placebo. Data from a validated meta-regression of all dexamethasone RCTs suggest dexamethasone effects are modified by the baseline risk of BPD: in infants with >50-70% risk of BPD, dexamethasone improved survival free of cerebral palsy, but had an opposite effect when BPD risk was <30%. A recent network meta-analysis of all PNC RCTs identified: moderately early-initiated (days 8-14), medium dose dexamethasone provided the largest reduction in BPD/death; high dose courses between 8 and 27 days were also highly effective; low dose dexamethasone, hydrocortisone, and inhaled or intratracheal steroids are ineffective or exhibit low potency in reducing BPD/death.</p><p><strong>Summary: </strong>Current evidence supports the use of medium dose systemic dexamethasone - preferably between days 8 and 14 in ventilator-dependent infants at >50-70% risk of developing BPD. While more NDI follow-up data are needed, this regimen is proven to reduce BPD risk and may also reduce NDI risk, considering PNC effects on BPD reduction appear stronger than any direct NDI toxicity. Practical suggestions are provided to enable transition from the current prevalent use of late initiated (>3-4 weeks of age), low dose dexamethasone to moderately early, medium dose dexamethasone to reduce the ongoing high rates of BPD in very preterm infants.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"192-199"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}