Current Pediatric Reviews最新文献

{"title":"NTRK Gene Fusions in Pediatric Soft-Tissue Tumors: Diagnostic Significance and Clinical Decision-making.","authors":"Gunvanti Rathod, Pragnesh Parmar","doi":"10.2174/0115733963458167260414053701","DOIUrl":"https://doi.org/10.2174/0115733963458167260414053701","url":null,"abstract":"<p><strong>Introduction/objective: </strong>Neurotrophic Tyrosine Receptor Kinase (NTRK) gene fusion is a newly identified and targetable oncogenic driver in various pediatric soft tissue tumors. This perspective aims to emphasize the diagnostic role and evolving practice of NTRK gene fusion in clinical practice, especially in the context of tumor-agnostic targeted therapy.</p><p><strong>Methods: </strong>This is a perspective review article based on the published literature on pediatric oncology and pathology, specifically the epidemiology, clinicopathologic features, diagnosis, and therapeutic outcomes of NTRK fusion-positive tumors. Special emphasis is placed on practical diagnostic algorithms and clinical trials of TRK inhibitors.</p><p><strong>Results: </strong>NTRK gene fusion is highly prevalent in certain pediatric tumors, such as infantile fibrosarcoma, congenital mesoblastic nephroma, and secretory carcinomas, and may be used as a defining marker for these tumors. Pan-TRK immunohistochemistry is effective as a screening test for NTRK fusion-positive tumors, while RNA-based next-generation sequencing is used as a confirmatory test. TRK inhibitors such as larotrectinib and entrectinib have shown promising efficacy in pediatric tumors, with response rates of 70-80%.</p><p><strong>Discussion: </strong>Despite advances in the management of pediatric tumors, certain issues remain regarding testing algorithms for NTRK fusion-positive tumors and the management of acquired resistance to TRK inhibitors. The long-term safety of TRK inhibitors in pediatric populations, especially infants, needs to be addressed to enable effective management of NTRK fusion-positive tumors.</p><p><strong>Conclusion: </strong>NTRK gene fusions are a critical marker for pediatric soft tissue tumors and are used for precision medicine in these tumors. NTRK gene fusions are used as diagnostic markers for infantile fibrosarcoma, congenital mesoblastic nephroma, and secretory carcinomas, and they play a critical role in the management of these tumors.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events Associated with Over-the-counter Antidiarrheals in Children: An Observational Real-world FAERS-based Disproportionality Analysis Study.","authors":"Kannan Sridharan, Gowri Sivaramakrishnan","doi":"10.2174/0115733963435966260123055002","DOIUrl":"https://doi.org/10.2174/0115733963435966260123055002","url":null,"abstract":"<p><strong>Background: </strong>Over-the-counter (OTC) antidiarrheal medications are commonly used despite potential risks for diarrheal management in children. We aimed to assess the reported suspected adverse events associated with OTC antidiarrheals from the FDA Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>We conducted a disproportionality analysis of suspected adverse event reports pertaining to commonly used antidiarrheals in the pediatric age group (aged < 16 years) as follows: bismuth subsalicylate, diphenoxylate, atropine/diphenoxylate, kaolin, pectin, and loperamide. Spontaneous reports from the FAERS database between March 2004 and June 2024 were obtained and analyzed using frequentist and Bayesian signal detection criteria to identify potential safety signals.</p><p><strong>Results and discussion: </strong>Loperamide accounted for the highest number of reports (n=256) of the total 311. Cardiac conduction abnormalities, lethargy, paralytic ileus, and fatalities with loperamide, and central nervous system adverse events with diphenoxylate and atropine/diphenoxylate were the key safety signals identified. Significantly higher mortality rates were observed with diphenoxylate and atropine/diphenoxylate compared to loperamide and bismuth subsalicylate (p = 0.00001). These findings are broadly consistent with existing clinical and regulatory literature and support existing recommendations cautioning against the routine use of certain antidiarrheal agents in young children.</p><p><strong>Conclusion: </strong>We identified significant risks associated with OTC antidiarrheal use in children. This emphasizes the need for caution among healthcare providers and caregivers. Judicious use is recommended in the pediatric age group, considering the potential severity of these adverse events. Continued pharmacovigilance is essential to ensure the safety of pediatric patients.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The EAT Algorithm: A Visual Tool to De-escalate Food Avoidance Anxiety in Parents.","authors":"Kam Lun Hon, Alexander K C Leung, Gilbert Chua, Ting Fan Leung","doi":"10.2174/0115733963423293251226104705","DOIUrl":"https://doi.org/10.2174/0115733963423293251226104705","url":null,"abstract":"<p><p>Managing parental food avoidance anxiety and concerns about their children, especially those with atopic disease, can be challenging and, at times, frustrating. The purpose of this article is to describe the usage of a simple schematic algorithm to counsel food-phobic parents. Anonymized brief cases are described to illustrate the utility of the EAT graphic algorithm, which is designed to counsel parents in managing concerns about food-avoidance anxiety. The application of the EAT algorithm in five diverse cases successfully guided dietary decisions, reduced unnecessary food avoidance, and aligned parental management with clinical evidence. The EAT algorithm provides an easy-to-understand visual schematic that can empower clinicians to counsel parents effectively, potentially reducing unnecessary testing and promoting a more normalized diet.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programs of Postural Education with Physical Activity in School Settings: A Systematic Review.","authors":"Gabriella Lavarda do Nascimento, Alexia Nadine Puel, Priscilla Moretto, Antonio Almir Junior Lima, Adriana Coutinho de Azevedo Guimarães, Anelise Sonza","doi":"10.2174/0115733963432290260121104400","DOIUrl":"https://doi.org/10.2174/0115733963432290260121104400","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to investigate scientific evidence related to the protocols and effects of PEPs using theoretical and practical approaches and physical activity in school environments.</p><p><strong>Methods: </strong>This systematic review was conducted according to the PRISMA guidelines and registered on the PROSPERO platform. The search was conducted in five electronic databases until December 2024. Randomized controlled clinical trials, non-randomized clinical trials, and quasi-experimental, interventional, and longitudinal studies published over the last 10 years were included. The studies involved children and adolescents with typical development, participating in postural education interventions in school environments that involved physical activity. Methodological quality was assessed using the PEDro Scale, and the risk of bias was evaluated using ROB 2_cluster and ROBINSI.</p><p><strong>Results: </strong>From 1,147 identified records, 11 studies met the eligibility criteria, involving 35-4,695 participants aged 5-16 years. While most studies reported improvements in postural knowledge and health education, findings on postural habits, pain reduction, and muscular endurance were inconsistent. Randomized clinical trials and most other studies exhibited good and reasonable methodological qualities, respectively. High and moderate risks of bias were prevalent.</p><p><strong>Discussion: </strong>Variability in assessment methods, interventions, and physical activity components limits standardization, yet studies aim to prevent postural changes and promote postural care to improve health in children and adolescents.</p><p><strong>Conclusion: </strong>PEPs incorporating physical activity show promise in improving postural knowledge, though evidence on long-term benefits for low back pain and postural behaviors remains inconclusive. Future research should standardize protocols and assess sustained outcomes.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Apolipoprotein A and Apolipoprotein B as Diagnostic Biomarkers of Neonatal Sepsis in Egyptian Full-term and Premature Neonates.","authors":"Mohamed Salah Eldin Mohamed Abdel Kader, Dina Hesham Ahmed, Mohamed Abdelmonaem Yousef Sharaf, Marwa Salah Eldin Mahmoud ElSherif, El Sayed H F Abouzied","doi":"10.2174/0115733963445029251222060121","DOIUrl":"https://doi.org/10.2174/0115733963445029251222060121","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal sepsis (NS) is a leading cause of morbidity and mortality in newborns, particularly in developing countries, where early and accurate diagnosis remains challenging. Conventional sepsis markers, such as C-reactive protein (CRP) and hematological indices, lack sensitivity and specificity. This study aimed to evaluate serum apolipoproteinA (Apo A) and apolipoprotein B (Apo B) as potential diagnostic biomarkers in neonatal sepsis.</p><p><strong>Methods: </strong>This case-control study included 160 neonates with sepsis (confirmed by clinical assessment, sepsis screening, and blood culture) and 80 healthy neonates as controls. Patients were classified by sepsis severity (sepsis vs. severe sepsis) and onset (early vs. late). Serum Apo A and Apo B titres were measured using an enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Serum Apo A was significantly lower in septic neonates than in controls (p < 0.001), with the lowest titres observed in severe sepsis. Apo B was significantly elevated in septic neonates, particularly in severe cases (p < 0.001). Apo A, at a cut-off of ≤57.6 mg/dL, yielded 80% sensitivity, 90% specificity, and an area under the curve (AUC) of 0.939, whereas Apo B, at a cut-off of >7.98 mg/dL, yielded 99.4% sensitivity, 75% specificity, and an AUC of 0.998. Apo A negatively correlated with hematocrit, WBC count, and neutrophil shift, while Apo B showed a negative correlation with hematocrit (p < 0.05).</p><p><strong>Discussion: </strong>Data suggest that the relationship between apolipoprotein levels and sepsis can also provide insights into inflammatory pathways associated with neonatal infections. Increased understanding of these pathways can inform the therapeutic approaches, in which the modulation of lipid metabolism becomes fundamental to managing sepsis results. Therefore, the incorporation of monitoring Apo A and Apo B levels can serve as pragmatic biomarkers to evaluate not only the presence of sepsis but also the potential response to treatment protocols, thus advancing the path toward Personalized Medicine in the Neonatal Intensive Care Unit.</p><p><strong>Conclusion: </strong>Serum Apo A and Apo B titres are valuable adjunct diagnostic markers for NS. Apo A reduction reflects the acute-phase response, while Apo B elevation may indicate altered lipid metabolism in severe infection.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Promotion for the Sub-Optimal Health State of Asian Youths with Chronic Eczema: An Integrative Medicine Perspective.","authors":"Kam Lun Hon, Zhi Xiu Lin, Wai Ling Lin, Ping Chung Leung","doi":"10.2174/0115733963360110251022064913","DOIUrl":"https://doi.org/10.2174/0115733963360110251022064913","url":null,"abstract":"","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Intestine: Development, Functions, and Its Impact on Disease Risk across the Lifespan.","authors":"Poliana Guiomar de Almeida Brasiel, Sheila Cristina Potente Dutra Luquetti","doi":"10.2174/0115733963400365251201134405","DOIUrl":"https://doi.org/10.2174/0115733963400365251201134405","url":null,"abstract":"<p><p>The intestine plays a central role in the immune system, continuously interacting with antigens, dietary components, and the microbiota. Intestinal immune processes are increasingly recognized for their influence on the development of both local and systemic diseases, with long-term effects on health and disease progression. This review provides an overview of intestinal development, encompassing its maturation from conception, temporal changes, regenerative capacity, interactions with the microbiota, and involvement in disease. Early life, particularly critical periods such as pregnancy and lactation, may represent a \"window of opportunity,\" establishing lasting conditions that either increase disease risk or confer protection in adulthood. Understanding the regulatory factors, regional and temporal variations, and existing knowledge gaps is essential for guiding clinical practice, as well as for the prevention and treatment of diseases.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pierson Syndrome: An Update.","authors":"Ana Flávia Conegundes, Nayara de Lima Silva, Felipe Rodrigues Lima Resende Silva, Maria Luíza Dias de Paiva Santos, Henrique Faustino Vieira da Silva, Wesley Cardoso Dos Santos, Ana Cristina Simões E Silva, Rafael Dos Santos Borges","doi":"10.2174/0115733963414485251204060248","DOIUrl":"https://doi.org/10.2174/0115733963414485251204060248","url":null,"abstract":"<p><p>Pierson syndrome (PS) is a rare autosomal recessive disorder, primarily characterized by (1) congenital nephrotic syndrome, (2) ocular abnormalities, and (3) neurodevelopmental deficits. It is caused by mutations in the LAMB2 gene, which encodes the laminin β2 chain-a protein subunit that is part of a specific group of proteins known as laminins. These proteins are present in the glomerular basement membrane, neuromuscular junctions, and ocular structures. Although PS exhibits a wide spectrum of phenotypic presentations, the prognosis remains poor, with most patients not surviving beyond early childhood. Despite its rarity, PS is clinically significant due to its potential to cause end-stage kidney disease early in life. This review consolidates the latest insights into the etiopathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of PS.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Dosing Strategies of Total Parenteral Nutrition in Very Low Birth Weight Infants: A Network Meta-Analysis of Randomized Controlled Trials.","authors":"Visuddho Visuddho, Fan Maitri Aldian, Mahendra Tri Arif Sampurna, Martono Tri Utomo, Risa Etika, Dina Angelika, Kartika Darma Handayani, Wurry Ayuningtyas, Abyan Irzaldy, Putri Maharani Tristanita Marsubrin, Rinawati Rohsiswatmo","doi":"10.2174/0115733963397547251206072036","DOIUrl":"https://doi.org/10.2174/0115733963397547251206072036","url":null,"abstract":"<p><strong>Introduction: </strong>Total parenteral nutrition (TPN) is essential for growth in very-low-birthweight (VLBW) infants. The worldwide variation in TPN dosing strategies warrants investigation. This study compared clinical outcomes of aggressive, rapid-increase, and standard TPN dosing strategies in VLBW infants.</p><p><strong>Methods: </strong>A systematic review and network meta-analysis were conducted following the PRISMA NMA guideline. Searches were performed in PubMed, Scopus, Web of Science, CINAHL, CENTRAL, and ProQuest. Dosing strategies were classified as aggressive (higher starting dose), rapid-increase (standard start with rapid escalation), and standard (NICE-based). Outcomes were analyzed using a Frequentist model in RStudio v4.4.1.</p><p><strong>Results: </strong>Nine randomized controlled trials were included. Compared with aggressive and standard strategies, the rapid-increase strategy was associated with a shorter time to regain birth weight (MD = -1.43 days; 95% CI -2.82 to -0.05; P-score = 0.80). The rapid-increase strategy was also associated with a shorter length of hospitalization (MD = -0.38 days; 95% CI -6.56 to 5.80; P-score = 0.54). Regarding safety outcomes, the rapid-increase strategy had the lowest proportions of mortality (Prop = 0.043), retinopathy (Prop = 0.124), and sepsis (Prop = 0.141), but a higher proportion of patent ductus arteriosus (PDA) (Prop = 0.508).</p><p><strong>Discussion: </strong>The rapid-increase approach demonstrated the most favorable balance between efficacy and safety outcomes among the included trials, although the small number of studies is a limitation.</p><p><strong>Conclusion: </strong>Rapid-increase TPN, using the recommended starting dose but achieving maintenance more quickly, may offer clinical advantages for VLBW infants. Further long-term studies are needed to confirm developmental and metabolic impacts.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Captopril-induced Cough: Does it Matter in Children? A Retrospective Cohort Study.","authors":"Michael Coffey, Brian McCrossan, Rachel Moore, Michael Shields","doi":"10.2174/0115733963356686251201052241","DOIUrl":"https://doi.org/10.2174/0115733963356686251201052241","url":null,"abstract":"<p><strong>Introduction: </strong>ACE inhibitors are commonly prescribed in children. Anecdotally, captopril- induced cough is not thought to occur in children as frequently as in adults.</p><p><strong>Methods: </strong>We performed a retrospective cohort study in 100 paediatric cardiology patients taking regular ACE inhibitors (ACE-I). Telephone interviews and questionnaires were used to ask patients and their families about their experience of ACE-I-related cough symptoms.</p><p><strong>Results: </strong>Of the 100 patients, 15% reported symptoms of captopril-related cough. Only 1% required a change in medication due to their cough.</p><p><strong>Discussion: </strong>Captopril-related cough appears to be less significant in children than in adult populations. The reason for this is unclear, but it may be related to differences in ACE expression between adult and paediatric lungs.</p><p><strong>Conclusion: </strong>The results suggest that cough associated with ACE-I use may be more prevalent in children than previously thought; however, it is generally well tolerated and rarely necessitates a change in management.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}