Current opinion in pediatrics最新文献

{"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":2.8,"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":2.8,"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":2.8,"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}

{"title":"Patent ductus arteriosus: emerging trial evidence firmly supports conservative management in preterm infants.","authors":"Nehal A Parikh, Sanjana Velu","doi":"10.1097/MOP.0000000000001543","DOIUrl":"10.1097/MOP.0000000000001543","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize recent evidence from randomized clinical trials (RCT) and meta-analysis of patent ductus arteriosus (PDA) closure therapies versus conservative/expectant management on key outcomes such as bronchopulmonary dysplasia (BPD) or death in very preterm (<32 weeks' gestation) infants.</p><p><strong>Recent findings: </strong>Of 10 completed RCTs in the past decade of medical therapies before 2 weeks of age to close a PDA, none demonstrated benefit in reducing moderate-severe BPD/death by 36 weeks postmenstrual age as compared to placebo treatment. When combined, the meta-analysis of the 10 RCTs showed an elevated risk of BPD/death [relative risk (RR): 1.10, 95% confidence interval (CI), 1.01-1.19) and higher risk of death by 36 weeks postmenstrual age or discharge (RR: 1.25; 95% CI, 1.01-1.56). A 2025 Cochrane meta-analysis also found a similar concerning trend of increased mortality following early medical treatment for PDA. Despite their recent popularity, there are no published trials demonstrating safety or efficacy of transcatheter PDA closure.</p><p><strong>Summary: </strong>We now have ample evidence for all clinicians to finally acknowledge that conservative PDA management is the correct path forward. Clinical experimentation is no longer acceptable, and expectant PDA management must be adopted as the current standard if we are to adhere to our foundational principle, 'first, do no harm'.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"200-206"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017627","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 use of artificial intelligence in decreasing vaccine skepticism and hesitancy.","authors":"Nathaniel Wolf, Nhan Nguyen, Rojelio Mejia","doi":"10.1097/MOP.0000000000001546","DOIUrl":"10.1097/MOP.0000000000001546","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent advances in artificial intelligence (AI) coincide with decreases in confidence in vaccines. This review examines studies that analyze and mitigate vaccine skepticism by implementing artificial intelligence strategies in various ways.</p><p><strong>Recent findings: </strong>Studies have explored public attitudes towards vaccines using AI to analyze language in social media postings and interactions, scrutinize AI responses to vaccine-related queries, and attempt to use AI to directly influence vaccine hesitancy. Findings show that AI can be effective in addressing vaccine hesitancy in various ways, including, but not limited to, directly interacting with vaccine-hesitant groups, identifying reasons for vaccine hesitancy, and predicting vaccine hesitancy among specific populations.</p><p><strong>Summary: </strong>AI will undoubtedly continue to evolve and improve over the coming years. Continued advances and new applications can help mitigate unwarranted vaccine hesitancy in a variety of ways, such as educating people with messaging tailored to end users or using AI to identify the specific concerns of vaccine-hesitant individuals and groups. It will require an integrative approach to a complex issue - vaccine hesitancy is not a monolith; there is a range of degrees of vaccine hesitancy, and various factors go into a person's vaccine knowledge and beliefs.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"136-141"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017662","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":"Evidence-based early-post natal approaches to limiting pulmonary disease in extremely low birth weight infants.","authors":"Dinushan C Kaluarachchi, Colm P Travers, Erik A Jensen","doi":"10.1097/MOP.0000000000001539","DOIUrl":"10.1097/MOP.0000000000001539","url":null,"abstract":"<p><strong>Purpose of review: </strong>Bronchopulmonary dysplasia (BPD) is a common complication among extremely low birth weight Infants. Evidence suggest that the incidence of BPD is increasing. This review examines current evidence-based strategies initiated early in life for prevention of BPD.</p><p><strong>Recent findings: </strong>In this review of early life approaches for prevention of BPD, perinatal interventions, respiratory support strategies, surfactant therapy, pharmacological therapies, fluid management, patent ductus arteriosus management, nutrition, and dietary supplements are discussed.</p><p><strong>Summary: </strong>There is no single effective strategy to prevent BPD in all at risk infants. Therefore, clinicians must use multifaceted evidence-based strategies, beginning during the perinatal period, to reduce the risk of developing BPD in preterm infants.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"184-191"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965322","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":"Treatment advances for Duchenne muscular dystrophy.","authors":"Alexander Zygmunt, Cuixia Tian","doi":"10.1097/MOP.0000000000001558","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001558","url":null,"abstract":"<p><strong>Purpose of review: </strong>Duchenne muscular dystrophy (DMD) is a severe X-linked muscle wasting disease with childhood onset that leads to loss of ambulation in the teenage years and mortality in the second or third decade of life. Prior to 10 years ago, disease-modifying pharmacologic intervention was limited to glucocorticoid steroids. However, in the past decade, several new medications have been approved for use in DMD. These medications work by different mechanisms along the disease pathway that lead to progressive muscle damage in DMD.</p><p><strong>Recent findings: </strong>Seven new medications for DMD have been approved for use by the United States Food and Drug Administration since 2016. These include vamorolone (AGAMREE), which is a novel dissociative glucocorticoid; eteplirsen (EXONDYS 51), golodirsen (VYONDYS 53), vitolarsen (VILTEPSO) and casimersen (AMONDYS-45), which are the so-called 'exon skipping' phosphorodiamidate morpholino oligomers or antisense oligonucleotides; delandistrogene moxeparvovec (ELEVIDYS), which is a microdystrophin gene transfer therapy; and givinostat (DUVYZAT), which is a histone deacetylase inhibitor.</p><p><strong>Summary: </strong>This review summarizes the mechanism of action, key safety considerations and available evidence on motor function impact that these novel medications have demonstrated in DMD.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590663","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":"Nonaccidental trauma in children: the pediatrician's role in recognition, reporting, and prevention.","authors":"Ethan M Scher, Samuel A Beber, Abigail K Allen","doi":"10.1097/MOP.0000000000001522","DOIUrl":"10.1097/MOP.0000000000001522","url":null,"abstract":"<p><strong>Purpose of review: </strong>Nonaccidental trauma remains a significant and underrecognized contributor to pediatric injury and mortality, reflecting both clinical and societal challenges in prevention and early identification. This review aims to synthesize the most recent literature on pediatric nonaccidental trauma (NAT) to better equip members of the healthcare team, particularly those in direct patient care, such as physicians, with the insight, contextual awareness, and ethical vigilance needed to identify, manage, and intervene in cases of child maltreatment. In doing so, it highlights the critical role of the healthcare team in not only treating injury but also protecting vulnerable children and addressing the broader implications of abuse.</p><p><strong>Recent findings: </strong>Recent literature highlights specific types of cutaneous injury, including patterned bruising and scald burns as well as high-energy osseous fractures such as those involving the femur, skull, face, ribs, or sternum, particularly when accompanied by an incongruent history, as the strongest indicators of NAT.</p><p><strong>Summary: </strong>Nonaccidental trauma is often difficult to identify on both historical and clinical levels. Guardians, typically the abusers, may be evasive and may offer accounts that are inconsistent or incompatible with the presenting injury. Identifying nonaccidental trauma calls for heightened vigilance and a high index of suspicion in providers, as their proximal position affords them the responsibility to be a crucial lifeline.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"81-86"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353985","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":"Building health from the foundation: centering housing in place-based child health initiatives.","authors":"Daria Murosko, Noelia Lugo, Kathryn M Leifheit","doi":"10.1097/MOP.0000000000001530","DOIUrl":"10.1097/MOP.0000000000001530","url":null,"abstract":"<p><strong>Purpose of review: </strong>To examine the landscape of place-based initiatives seeking to improve child health and address health inequities within a defined geography, and to evaluate recent literature to develop strategies to center housing-focused interventions at the center of such initiatives.</p><p><strong>Recent findings: </strong>The evidence showed that place-based efforts vary by primary focus, geographic scale, target populations, and types of interventions. Multipronged, multisector collaborative efforts aimed at improving population health outcomes have the most potential to advance pediatric health across neighborhoods and reduce disparities. Yet, few place-based models integrate housing as a central intervention, though there are some notable exceptions. Evidence suggests that place-based initiatives must expand housing interventions across four domains: ensuring affordability, preventing instability, prioritizing quality, and investing in neighborhoods. Intentional efforts to minimize risk of displacement and prevent widening disparities are critical. Ensuring the success of this work will require innovating in leadership structure, sustainable funding models, rigorous evaluation, and enhanced dissemination of results.</p><p><strong>Summary: </strong>To realize the full potential of place-based interventions, housing must be the cornerstone. Integrating affordable, stable, quality housing into these initiatives can drive population-level improvements and reduce racial disparities in health outcomes.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"15-24"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707512","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":"Bridging special education and pediatrics to promote health equity: model for engagement and access to special education (EASE) clinic.","authors":"Brianna Labonte, Conor Ross, Soukaina Adolphe","doi":"10.1097/MOP.0000000000001534","DOIUrl":"10.1097/MOP.0000000000001534","url":null,"abstract":"<p><strong>Purpose of review: </strong>Children with disabilities face inequities in accessing timely special education services, often reinforced by fragmented healthcare and educational systems. Pediatric practices play a critical role in addressing social determinants of health (SDOH) by integrating educational navigation into routine care.</p><p><strong>Recent findings: </strong>Education is consistently identified as a major social determinant of health, shaping long-term outcomes in literacy, employment, and health equity. Recent studies highlight that gaps in provider training and fragmented systems delay evaluations and interventions. Programs such as the EASE Clinic demonstrate that embedding advocacy within pediatric settings improves coordination, strengthens family engagement, and reduces inequities for marginalized communities.</p><p><strong>Summary: </strong>Integrating special education advocacy into clinical care transforms pediatrics into a platform for upstream intervention. The EASE Clinic model supports provider training, aligns healthcare with federal educational protections, and reduces disparities in access. Replication across pediatric systems can improve developmental outcomes and establish educational equity as a foundation of child health, offering a scalable public health model that aligns medical care with educational justice.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"38 1","pages":"40-44"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833306","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}