Current opinion in pediatrics最新文献

{"title":"Transgression of planetary boundaries and the effects on child health through an infectious diseases lens.","authors":"Mikaela Coleman, Palwasha Y Khan, Lauren Linde, Phoebe C M Williams, Ben J Marais","doi":"10.1097/MOP.0000000000001442","DOIUrl":"10.1097/MOP.0000000000001442","url":null,"abstract":"<p><strong>Purpose of review: </strong>Life on earth, as we know it, is changing. The likelihood of more frequent pandemics and disease outbreaks is something that current global healthcare infrastructure is ill equipped to navigate. Human activity is forcing our planet into a new geologic epoch, the Anthropocene, which is typified by increased uncertainty resulting from human disruption of earth's life-giving ecosystems. Plagues and pandemics have always been unfortunate partners to periods of disruption, as they will be again if the frequency and severity of climate and conflict-mediated disasters increase in coming years. If we continue to exceed and degrade the planetary boundaries that protect human health, our children and their children will reap the consequences.</p><p><strong>Recent findings: </strong>Scientists have defined nine 'safe operating' planetary boundaries for life in all its glorious diversity to thrive on planet earth. Recent evidence suggests that six of these nine boundaries have already been transgressed, but the potential implications for these transgressions upon child health is not well articulated. We highlight how contravention of these boundaries will impact infectious disease risk and humans' ability to survive and thrive. We reflect specifically on how paediatricians are called upon to speak up for the most vulnerable members of our species, young children and as yet unborn future generations.</p><p><strong>Summary: </strong>Post COVID-19 initiatives to improve pandemic preparedness and response are certainly warranted, but pandemic prevention should include committed efforts not to exceed safe planetary boundaries. Willingly exceeding these boundaries has deep moral consequences that are poorly articulated by current ethical frameworks. Paediatricians are best placed to develop and champion the neglected 'third dimension' of medical ethics, recognizing the moral imperative to protect the long-term best interests of children and future generations.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"124-136"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064373","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":"Overview of mucosal immunity and respiratory infections in children: a focus on Africa.","authors":"Richard K Mwape, Mish-Al Barday, Marieke M van der Zalm, Lilly M Verhagen","doi":"10.1097/MOP.0000000000001438","DOIUrl":"10.1097/MOP.0000000000001438","url":null,"abstract":"<p><strong>Purpose of review: </strong>Given the substantial burden of respiratory tract infections (RTIs) on global paediatric health, enhancing our understanding of mucosal immunity can help us advance mucosal biomarkers for diagnosis, prognosis and possible interventions in order to improve health outcomes. This review highlights the critical role of mucosal immunity in paediatric RTIs and recent advances in mucosal interventions, which offer promising strategies to improve outcomes.</p><p><strong>Recent findings: </strong>The significant burden of paediatric RTIs and growing interest in mucosal immunity advanced our understanding of the role of the respiratory mucosal immune system in protective immunity against RTIs. Studies show that sub-Saharan Africa is disproportionately affected by paediatric RTIs with poverty-associated factors such as human immunodeficiency virus (HIV) and malnutrition as risk factors. Emerging evidence highlights the important role of the respiratory microbiome and mucosal innate and adaptive immune responses in protective immunity against RTIs.</p><p><strong>Summary: </strong>The growing interest in mucosal immunity in RTIs has not only advanced our understanding of the overall immune responses in RTIs but also created opportunities to improve RTI care through translation of knowledge from these studies into diagnostics, therapeutics, and vaccines.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"137-144"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188609","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":"Impact of antimicrobial resistance on infections in children in Africa.","authors":"Joycelyn Assimeng Dame, Yemah Mariama Bockarie, Anthony Kwame Enimil","doi":"10.1097/MOP.0000000000001440","DOIUrl":"10.1097/MOP.0000000000001440","url":null,"abstract":"<p><strong>Purpose of review: </strong>Antimicrobial resistance is an escalating public health threat in Africa, and an awareness of the devastating impact on children is growing. This review highlights the prevalence and patterns of antimicrobial resistance among children in Africa, focusing on pathogens responsible for bloodstream infections, community-acquired pneumonia, bacterial meningitis, neonatal infections, diarrhea and malaria. Current strategies to tackle antimicrobial resistance in pediatric populations are discussed.</p><p><strong>Recent findings: </strong>Bloodstream infections significantly contribute to child mortality, with high resistance observed in pathogens like Salmonella spp., Klebsiella spp., Escherichia coli , and Staphylococcus aureus . Additionally, rising resistance in pathogens causing community-acquired pneumonia, meningitis and bacterial diarrhea challenges the effectiveness of WHO-recommended therapies. Antibiotics used to treat neonatal infections, such as ampicillin, gentamicin and cefotaxime, are threatened by high resistance in Escherichia coli and Klebsiella spp , contributing to adverse neonatal outcomes. PfKelch 13 mutations linked to artemisinin resistance in parts of Africa raise public health concerns, as malaria remains a major cause of illness and death.</p><p><strong>Summary: </strong>Stronger collaborative efforts are needed to enhance surveillance, improve diagnostic capabilities and update treatment protocols based on local pathogen sensitivities. More research is required on pediatric antimicrobial resistance in Africa.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"145-152"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064339","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":"The promise of cerebral organoids for neonatology.","authors":"Clare E Howard, Manju Cheenath, Elizabeth E Crouch","doi":"10.1097/MOP.0000000000001446","DOIUrl":"10.1097/MOP.0000000000001446","url":null,"abstract":"<p><strong>Purpose of review: </strong>Applying discoveries from basic research to patients in the neonatal intensive care unit (NICU) is challenging given the difficulty of modeling this population in animal models, lack of translational relevance from animal models to humans, and scarcity of primary human tissue. Human cell-derived cerebral organoid models are an appealing way to address some of these gaps. In this review, we will touch on previous work to model neonatal conditions in cerebral organoids, some limitations of this approach, and recent strategies that have attempted to address these limitations.</p><p><strong>Recent findings: </strong>While modeling of neurodevelopmental disorders has been an application of cerebral organoids since their initial description, recent studies have dramatically expanded the types of brain regions and disease models available. Additionally, work to increase the complexity of organoid models by including immune and vascular cells, as well as modeling human heterogeneity with mixed donor organoids will provide new opportunities to model neonatal pathologies.</p><p><strong>Summary: </strong>Organoids are an attractive model to study human neurodevelopmental pathologies relevant to patients in the neonatal ICU. New technologies will broaden the applicability of these models to neonatal research and their usefulness as a drug screening platform.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"182-190"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514990","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":"The impact of environmental changes on infectious diseases among children in North America.","authors":"Kristen A Bastug, Elizabeth L Schwartz, Nadia A Sam-Agudu","doi":"10.1097/MOP.0000000000001436","DOIUrl":"10.1097/MOP.0000000000001436","url":null,"abstract":"<p><strong>Purpose of review: </strong>Climate change is no longer a distant threat but a present and accelerating force reshaping the epidemiology of infectious diseases in North America and elsewhere. Rising temperatures, shifting precipitation patterns, and extreme weather events are impacting the geographic distribution of pathogens and their vectors. Understanding these environmental influences on infectious diseases in children is essential for equipping healthcare providers to deliver competent care in the era of climate change.</p><p><strong>Recent findings: </strong>The northward spread of vector-borne diseases, warming waters and soils, and disease outbreaks following extreme weather events highlight the complex and multifactorial ways through which the environment influences the spread of infectious diseases.</p><p><strong>Summary: </strong>Continuing medical education and training on the evolving epidemiology of climate-sensitive diseases is critical for clinicians to address emerging health threats effectively. We advocate for more equitable funding and resource allocation to support innovative pediatric research on climate change and infectious diseases in the United States and other countries in North America.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"153-164"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364001","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":"Behavioral interventions for adolescents and young adults with type 2 diabetes or prediabetes.","authors":"Ashley S Ko, Ashley A Michel, Lauren E Wisk","doi":"10.1097/MOP.0000000000001461","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001461","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent trends show an increase in the prevalence and incidence of type 2 diabetes and prediabetes among youth, adolescents, and young adults (AYA) in the United States, especially among minoritized groups, including American Indians and African Americans. Despite the growing urgency of addressing rising incidence, there is a notable lack of comprehensive intervention programs tailored to address the unique needs of AYA living with or at risk of diabetes, with current efforts largely focused on adult/older populations.</p><p><strong>Recent findings: </strong>This review highlights the large gap in research regarding the implementation and efficacy of behavioral and lifestyle interventions targeting AYA with type 2 diabetes or prediabetes. Although we identified some studies that were relevant to this largely under-researched area, these studies are often limited by lack of long-term follow-up and highly selected samples lacking diversity.</p><p><strong>Summary: </strong>The findings of this review underscore the need for more extensive studies on AYA-focused behavioral interventions to address diabetes prevention and management.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763314","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":"Recent updates on the screening, diagnosis, and management of lipids disorders in children and adolescents.","authors":"Meghan Sara Drastal, Sarah de Ferranti, Holly Gooding","doi":"10.1097/MOP.0000000000001460","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001460","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to provide an update on screening, diagnosis, and treatment of lipid disorders in the pediatric patient.</p><p><strong>Recent findings: </strong>Apart from the United States Preventive Services Task Force (USPSTF), the majority of medical societies recommend universal screening for lipid disorders in children and adolescents 21 years or younger. Recent population studies confirm lipid abnormalities are prevalent in children, affecting at least one in five children aged 6-19 years. A systematic review and network meta-analysis of lipid-lowering therapies in children and adolescents with familial hypercholesterolemia found that statins reduced LDL-C by 33.61% and adding ezetimibe reduced LDL-C by an additional 15.85%.</p><p><strong>Summary: </strong>Nearly all major medical societies recommend universal lipid screening in children aged 9-11 and 17-21. Lipid abnormalities are common, and diagnosis is generally made by confirming abnormal lipid results with fasting lipid studies. Lifestyle modifications and statins are the mainstay for treatment of dyslipidemia. However, most research on lipid-lowering therapies is in familial hypercholesterolemia.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763258","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":"Who may compete in the female category in sport? Chromosomes, genes, hormones, and psychosocial/cultural aspects.","authors":"Natalie J Nokoff, Alan D Rogol","doi":"10.1097/MOP.0000000000001456","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001456","url":null,"abstract":"<p><strong>Purpose of review: </strong>Throughout history, competitive sport has been categorized by sex. Since the 1930s, sporting organizations have implemented various methods of confirming sex for competition in the female category. These policies primarily impact individuals with differences of sex development (DSD), whose biology falls outside the binary of male/female, and individuals who identify as transgender, whose identity differs from their sex at birth. This review will cover the dimensions of biologic sex, the history of sex verification in sport, the role of testosterone, and review data for athletes who have a DSD or are transgender.</p><p><strong>Recent findings: </strong>Several recent studies, reviews, and policy statements demonstrate that testosterone and its rise during masculinizing puberty are key determinants of differences in athletic performance between men and women. Recent studies in adult transgender women who went through a masculinizing puberty show that after 2 years of estradiol and antiandrogen therapy, run times are similar to cisgender women, but they still retrain strength advantages. Data are sparse for individuals who had masculinizing puberty blocked and also for individuals who have a DSD.</p><p><strong>Summary: </strong>Sex is complex and multidimensional, and there are shortcomings with any method of sex verification in sport. Testosterone remains a key determinant of differences in athletic performance by sex.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763410","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":"IUDs and pain control for adolescents and young adults.","authors":"Sydney M Hartman-Munick, Grace Jhe, Anne Powell","doi":"10.1097/MOP.0000000000001457","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001457","url":null,"abstract":"<p><strong>Purpose of review: </strong>Intrauterine devices (IUDs) are safe and effective for most adolescents and young adults (AYA) for both contraception and menstrual management. However, multiple barriers exist to placement, including procedure-associated pain. There has been a recent call to action for healthcare providers to optimize pain management strategies for IUD insertion.</p><p><strong>Recent findings: </strong>Approach to pain management for IUD insertion varies significantly among providers, and there is no standardized approach to comfort optimization. Several methods of pain control for IUD insertion, both pharmacologic and nonpharmacologic, have been studied, though many have variable results.</p><p><strong>Summary: </strong>Approaching IUD insertion counseling through a lens of patient autonomy and reproductive justice will likely improve the patient experience and help providers to work toward enhancing comfort during the procedure. Further research is needed to determine optimal pain control strategies for IUD insertion.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656448","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":"Environmental factors trigger pubertal development.","authors":"Sofia Malave-Ortiz, Cameron Grant, Natalie D Shaw","doi":"10.1097/MOP.0000000000001451","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001451","url":null,"abstract":"<p><strong>Purpose of review: </strong>We provide an overview of the secular trend of earlier pubertal development, why there is a growing concern that environmental factors may be to blame, and how these factors may influence the developing reproductive axis.</p><p><strong>Recent findings: </strong>We highlight recent work suggesting that, in addition to activating sex steroid receptors, environmental compounds may influence neuropeptide receptors and/or epigenetic regulators. We describe recent studies linking air pollution, metals, endocrine disrupting compounds (EDCs), short sleep duration, early life adversity, and stress to pubertal timing.</p><p><strong>Summary: </strong>Pubertal timing is tightly controlled by genetic, epigenetic, and environmental factors. While animal and epidemiological studies have pointed to several potential environmental factors, additional work is necessary to identify the critical levels and developmental windows of exposure as well as the mechanistic underpinnings.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514989","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}