Current opinion in pediatrics最新文献_第7页

Use of near-infrared spectroscopy to guide care in the cardiac ICU: actionable insight or just another costly monitor without impact? The affirmative position: unlocking the black box of tissue perfusion. 使用近红外光谱来指导心脏ICU的护理：可行的见解或只是另一个没有影响的昂贵监测仪？正位：打开组织灌注黑箱。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-06-01 Epub Date: 2026-04-29 DOI: 10.1097/MOP.0000000000001569

Aziez Ahmed

{"title":"Use of near-infrared spectroscopy to guide care in the cardiac ICU: actionable insight or just another costly monitor without impact? The affirmative position: unlocking the black box of tissue perfusion.","authors":"Aziez Ahmed","doi":"10.1097/MOP.0000000000001569","DOIUrl":"10.1097/MOP.0000000000001569","url":null,"abstract":"Purpose of review: The assessment of hemodynamic stability in the pediatric cardiac intensive care unit (PCICU) has historically relied on macro-hemodynamic parameters that often fail to reflect microcirculatory distress. This review analyzes the 'affirmative' evidence from 2024 to 2025 advocating for near-infrared spectroscopy (NIRS/rSO2) not merely as a trend monitor, but as a critical decision-support tool.Recent findings: New data demonstrate that NIRS provides 'hemodynamic lead time', predicting low cardiac output syndrome (LCOS) up to 12 h before lactate elevation. In pediatric cardiac arrest, NIRS has emerged as a superior guide to resuscitation quality compared to end-tidal CO2, particularly in cyanotic physiology. Furthermore, renal NIRS has been validated as a sensitive biomarker for acute kidney injury (AKI) and a predictor of extubation failure via the 'renal steal' mechanism.Summary: NIRS bridges the gap between systemic vital signs and tissue-level oxygenation. Its integration into goal-directed protocols for LCOS prediction, high-stakes resuscitation, and mechanical support surveillance offers actionable insights that improve survival and reduce morbidity, justifying its role as a standard of care.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"38 3","pages":"240-247"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873663","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}

引用次数: 0

Ventilator management on extracorporeal membrane oxygenation: considerations for open lung strategy. 体外膜氧合的呼吸机管理：开放肺策略的考虑。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-06-01 Epub Date: 2026-03-20 DOI: 10.1097/MOP.0000000000001561

Christine Vohwinkel, Bereketeab Haileselassie, David N Cornfield

{"title":"Ventilator management on extracorporeal membrane oxygenation: considerations for open lung strategy.","authors":"Christine Vohwinkel, Bereketeab Haileselassie, David N Cornfield","doi":"10.1097/MOP.0000000000001561","DOIUrl":"10.1097/MOP.0000000000001561","url":null,"abstract":"Purpose of review: The present review addresses the underlying biology of acute respiratory distress syndrome (ARDS) while recognizing that extracorporeal membrane oxygenation (ECMO) is an increasingly employed technology in the context of severe disease. The review provides the physiologic and molecular foundation for the ventilation strategies most likely to facilitate lung repair and recovery.Recent findings: In infants and children, ARDS remains a significant cause of morbidity and mortality. Although any infant or child can develop ARDS, children who have experienced trauma, pneumonia, aspiration, or immune compromise are at increased risk. Though ECMO accomplishes oxygenation and ventilation independent of the lung, rhythmic distention of the lung, maintenance of an air-liquid interface, and strategies that prevent atelectasis are strongly recommended to minimize lung injury and promote recovery. An open-lung ventilation strategy that employs sufficient positive end-expiratory pressure to avoid atelectasis, a tidal volume limited to <5-7 cc/kg per breath, a plateau pressure of 30 cm of water, and driving pressure of <20 cm of water afford the greatest likelihood of lung repair.Summary: ECMO can be effective to treat children with severe ARDS. Even with ECMO in place, the principles of physiologically sound mechanical ventilation need to be applied. Collaborative trials and development of well curated international clinical information are needed to better understand which children with ARDS are most likely benefit from ECMO.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"302-307"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590605","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}

引用次数: 0

Growing bromance between infectious diseases and artificial intelligence: for better or for worse. 传染病和人工智能之间日益紧密的兄弟关系：是好是坏。

IF 2.5 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-03-05 DOI: 10.1097/MOP.0000000000001548

Elijah Paintsil

引用次数: 0

Neonatal trials and informed consent in the NICU: a literature review. 新生儿试验和知情同意在新生儿重症监护室：文献综述。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1097/MOP.0000000000001542

Tiffany Dial, Toby Yanowitz, Burhan Mahmood, John Ibrahim

{"title":"Neonatal trials and informed consent in the NICU: a literature review.","authors":"Tiffany Dial, Toby Yanowitz, Burhan Mahmood, John Ibrahim","doi":"10.1097/MOP.0000000000001542","DOIUrl":"10.1097/MOP.0000000000001542","url":null,"abstract":"Purpose of review: With the recent advances in neonatal care, resuscitation of periviable neonates and challenges to conducting clinical research and funding, efficient clinical trials with relevant outcomes are pivotal to direct the future of neonatology.Recent findings: Parents of neonates in the Neonatal ICU are supportive and hold positive views of clinical research. Timing and who approaches the parents plays a great role in parents' perception of a clinical trial. Parents prefer a bigger role for the clinical team at least when introducing the idea of research. The consent process has evolved, and newer technology should be incorporated to make it simple and more clear. Consenting mothers in labor remains a point of contention as timing of consent and ability to retain information matters. Different types of consent can be used based on timing of intervention of a research trial, to allow for efficient and diverse enrollment.Summary: The challenges inherent to conducting research in neonatology have not received the attention it deserves, especially when it comes to interventional trials, raising questions about equity of research in this patient cohort. Parents view research positively and are supportive provided that the timing is appropriate and language is clear.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"169-176"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060460","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}

引用次数: 0

Clinical concerns and considerations for leucovorin use in autism spectrum disorder. 亚叶酸素治疗自闭症谱系障碍的临床关注与考虑。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1097/MOP.0000000000001547

Caroline Howard, Joseph Mekhail, Lillian Maidman Ravikoff, Ruth Milanaik

{"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":"Purpose of review: 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.Recent findings: 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.Summary: 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.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"207-211"},"PeriodicalIF":2.8,"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}

引用次数: 0

Using artificial intelligence to advance pediatric infection prevention and control. 利用人工智能推进儿科感染防控。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-01-19 DOI: 10.1097/MOP.0000000000001540

Thomas S Murray, Morgan Quan, Michael Aniskiewicz, Theodore R Pak

{"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":"Purpose of review: 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.Recent findings: 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.Summary: 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.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"142-148"},"PeriodicalIF":2.8,"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}

引用次数: 0

Impact of the single cell revolution on neonatology research. 单细胞革命对新生儿研究的影响。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-02-13 DOI: 10.1097/MOP.0000000000001556

Kerri St Denis, Tyler A Rice, Oluwabunmi Olaloye, Liza Konnikova

{"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":"Purpose of review: 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.Recent findings: 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.Summary: 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.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"177-183"},"PeriodicalIF":2.8,"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}

引用次数: 0

Pediatric trigger thumb: clinical management update. 小儿触发拇指：临床管理更新。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1097/MOP.0000000000001541

Dan Gordon, Pamela J Sherman

{"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":"Purpose of review: 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.Recent findings: 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.Summary: 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.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"212-218"},"PeriodicalIF":2.8,"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}

引用次数: 0

Artificial intelligence and diagnosis and management of tuberculosis disease in children. 人工智能与儿童结核病的诊断和管理。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-02-09 DOI: 10.1097/MOP.0000000000001551

Declan Ikechukwu Emegano, Ilker Ozsahin, Emeje Paul Isaac, Dilber Uzun Ozsahin, Oyibo Saidu Silas, Chinonye Lynda Emegano, Berna Uzun

{"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":"Purpose of review: 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.Recent findings: 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.Summary: 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.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"155-161"},"PeriodicalIF":2.8,"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}

引用次数: 0

Updates in atypical hemolytic syndrome. 非典型溶血综合征的最新进展。

IF 2.8 3区医学

Current opinion in pediatrics Pub Date : 2026-04-01 Epub Date: 2026-03-05 DOI: 10.1097/MOP.0000000000001435

Keri Drake, Jyothsna Gattineni

引用次数: 0