Current Pediatric Reviews最新文献

{"title":"Maternal and Placental Risk Factors for Small Gestational Age and Fetal Malnutrition.","authors":"Vivekanand N,&nbsp;Poonam Singh,&nbsp;Vigneshwar Nkv,&nbsp;Michael Leonard Anthony,&nbsp;Shalinee Rao,&nbsp;Swathi Chacham,&nbsp;Jaya Chaturvedi,&nbsp;Sriparna Basu","doi":"10.2174/1573396318666220705154424","DOIUrl":"https://doi.org/10.2174/1573396318666220705154424","url":null,"abstract":"<p><strong>Aims: </strong>This case-control study was conducted to identify maternal and placental risk factors of small-for-gestational-age (SGA) and fetal malnutrition.</p><p><strong>Methods: </strong>Cases comprised 104 consecutively delivered SGA neonates (determined as per INTERGROWTH- 21st standard). An equal number of next-born gestation and gender-matched appropriatefor- gestational age (AGA) neonates served as controls. Maternal risk factors were enquired, and placentae were evaluated by clinical and histopathological examination. Nutrition of the neonates was assessed by the clinical assessment of nutrition (CAN) score. Univariate and multivariate logistic regression analysis was done to identify the maternal and placental risk factors.</p><p><strong>Results: </strong>The prevalence of SGA in the present study was 23.9%. Maternal fever [adjusted Odds Ratio (aOR), 95% confidence interval (CI), 16.3 (3.5-124.1); p = 0.001], presence of placental syncytial knots [aOR (95% CI), 2.9 (1.1-9.1); p = 0.04] and placental calcifications [aOR (95% CI), 3(1.1- 8.7); p = 0.03], were identified as independent predictors of SGA using multivariate logistic regression analysis. Malnutrition (SCORE <25) affected 64% of SGA and 16.3% of AGA neonates. The only risk factor significantly associated with malnourished SGA was prematurity, whereas malnourished AGA was significantly associated with prematurity and fetal distress. In-hospital morbidities significantly higher in SGA were perinatal asphyxia, respiratory distress, need for respiratory support, polycythemia, hypoglycemia, and feeding intolerance. Mortality before discharge was 4.8% and 3.8% in SGA and AGA population, respectively (p > 0.05). Neonatal outcomes were comparable among well-nourished, malnourished SGA and AGA groups.</p><p><strong>Conclusion: </strong>Maternal fever, placental syncytial knots, and calcifications were independent risk factors of SGA, whereas prematurity and fetal distress were responsible for malnutrition.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 2","pages":"187-196"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10662924","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":"Neutropenia in Preterm Infants.","authors":"Gaetano Chirico","doi":"10.2174/1573396319666221216121530","DOIUrl":"https://doi.org/10.2174/1573396319666221216121530","url":null,"abstract":"<p><strong>Background: </strong>The non-specific and antigen-specific components of host defense mechanisms are subject to the adaptation process in the neonate; however, the neutrophil quantitative and qualitative deficiency is one of the most significant causative factors of neonatal-increased vulnerability to infection.</p><p><strong>Objective: </strong>To review the incidence and outcome of neutropenia of unknown cause in preterm infants.</p><p><strong>Results: </strong>The incidence of early and late-onset idiopathic neutropenia of prematurity is significant.</p><p><strong>Conclusion: </strong>The low neutrophil counts respond quickly to G-CSF treatment; however, due to the low probability of septic complications, particularly in the late-onset neutropenia, a deep diagnostic approach and the potential hematopoietic growth factor treatment should be limited to the severe cases, such as a neutrophil count <500/μL, lasting for more than 2 days.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 4","pages":"352-356"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664643","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":"Procalcitonin Biomarker for Sepsis in Postoperative Pediatric Trauma Patients: Three Years of Experience from a Tertiary University Hospital.","authors":"Waleed H Albuali","doi":"10.2174/1573396318666220912093557","DOIUrl":"https://doi.org/10.2174/1573396318666220912093557","url":null,"abstract":"<p><strong>Background: </strong>The biomarker procalcitonin (PCT) is good in detecting sepsis in postoperative pediatric trauma patients, especially those with a high suspicion of sepsis, and formulating a quick treatment. Its use is still limited to pediatric surgical patients, particularly those in intensive care units (ICUs), who are more susceptible to sepsis. The purpose of this study was to see if procalcitonin could be used as a reliable and quick biomarker for sepsis in postoperative pediatric trauma patients and were brought to the PICU.</p><p><strong>Methods: </strong>This retrospective longitudinal study was conducted from January 2017 to December 2019. Postoperative pediatric trauma patients aged > 2 weeks old who were hospitalized at the PICU of King Fahd Hospital of the University due to serious trauma or post-acute surgical events were included. Within 24 hours of admission, PCT levels were measured, and again 48-72 hours later.</p><p><strong>Results: </strong>In our study, 31% of severely ill children developed post-surgical sepsis. When compared to the PRISM III score and 24-hour PCT level, PCT levels at 48-72 hours exhibited the largest area under the curve (AUC). With a sensitivity of 71% and a specificity of 65%, the predictive AUC value was estimated to be 0.71. The AUC of PCT levels at 48-72 hours was 0.72 (95% confidence interval (CI): 0.65-0.79; p < 0.001), indicating high predictive validity using a cutoff point > 0.10, with sensitivity, specificity, and positive and negative predictive values of 68.4%, 63.6%, 45.8%, and 81.8%, respectively.</p><p><strong>Conclusion: </strong>PCT is a sensitive biomarker for detecting sepsis in postoperative pediatric trauma patients, especially those with a high pre-test suspicion for sepsis. In addition, PCT can be used alone or in combination with other clinical findings to help formulate a rapid primary diagnosis of sepsis in this subset of patients.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 3","pages":"296-303"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666229","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":"A Review of the Diagnosis and Treatment of Necrotizing Enterocolitis.","authors":"Xue Cai,&nbsp;Heather Liebe,&nbsp;Alena Golubkova,&nbsp;Tyler Leiva,&nbsp;Catherine J Hunter","doi":"10.2174/1573396318666220805110947","DOIUrl":"https://doi.org/10.2174/1573396318666220805110947","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is a devastating disease that primarily affects the gastrointestinal tract of premature neonates. The diagnosis and treatment of NEC remain challenging. New biomarkers and potential treatments for NEC have emerged in recent years, leading to the potential of earlier therapeutic intervention and improved outcomes. This paper aims to provide a review of the most recent diagnostic indicators and therapeutics of NEC along with a brief overview of future directions of research into this disease.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 3","pages":"285-295"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10721394","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":"Biology and Natural History of Type 1 Diabetes Mellitus.","authors":"Jenner Chrystian Veríssimo de Azevedo,&nbsp;Thales Allyrio Araújo de Medeiros Fernandes,&nbsp;Gilson Aquino Cavalcante,&nbsp;Iluska Almeida Carneiro Martins de Medeiros,&nbsp;Daniel Carlos Ferreira Lanza,&nbsp;Joselio Maria Galvão de Araújo,&nbsp;Fabiana Lima Bezerra,&nbsp;José Veríssimo Fernandes","doi":"10.2174/1573396318666220409001955","DOIUrl":"https://doi.org/10.2174/1573396318666220409001955","url":null,"abstract":"<p><p>Type 1 diabetes mellitus is a clinical condition characterized by insufficient insulin production due to progressive loss of pancreatic islet β-cells mediated by an autoimmune response. This deregulation of the immune system is caused by the action of genetic, epigenetic, and environmental factors in varying combinations for each individual. Although the inflammation of the islets with immune cell infiltration, known as insulitis, is an important element in pathogenesis, other factors are necessary for disease initiation. Associations with variants of HLA and other genes related to immune system function, mainly haplotypes HLA-DR3-DQ2 and HLA-DR4-DQ8, are more evident. The influence of polymorphisms and epigenetic modifications, as well as the microbiome, is convincing proof of the existence of a complex interaction between genetic, immune, and environmental factors in the etiology and pathogenesis of this metabolic disorder. Loss of selftolerance to autoimmunity is a critical point in the development of the disease, and regulatory T cells play a key role in this process. Thus, any failure of these cells, either due to an insufficient number or altered expression of cytokines and transcription factors, may be the trigger for the onset of the disease. The protective action of regulatory T cells is controlled by gene expression that is modulated by epigenetic modifications, including the dysregulation of noncoding RNAs. This review takes an updated approach to the natural history of type 1 diabetes, focusing on the factors involved in the etiology and pathogenesis.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 3","pages":"253-275"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756988","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":"Cord Blood Sampling - A Review of Umbilical Cord Blood Use for Admission Laboratory Tests in the Immediate Newborn Period.","authors":"Patrick D Carroll","doi":"10.2174/1573396319666221125140556","DOIUrl":"https://doi.org/10.2174/1573396319666221125140556","url":null,"abstract":"<p><p>Historically blood for admission laboratory studies in neonates was obtained through direct neonatal phlebotomy. Over the past decade, there has been a significant increase in studies evaluating the validity and clinical impact of using a cord blood sample for many admission laboratory studies. This article reviews various studies that together suggest that using cord blood samples for admission testing in neonates is both acceptable and beneficial.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 4","pages":"371-375"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657611","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":"Association between Sleep Duration and Early Pubertal Timing in Children and Adolescents: A Systematic Review and Meta-analysis.","authors":"Nafiseh Mozafarian,&nbsp;Maryam Yazdi,&nbsp;Mahin Hashemipour,&nbsp;Silva Hovsepian,&nbsp;Mohammad Reza Maracy","doi":"10.2174/1573396318666220819145346","DOIUrl":"https://doi.org/10.2174/1573396318666220819145346","url":null,"abstract":"<p><strong>Background: </strong>Early puberty increases the risk of diverse health outcomes during adolescence and beyond. Several studies have explored the links between short sleep duration and early puberty worldwide.</p><p><strong>Objective: </strong>The current systematic review and meta-analysis aimed to evaluate the association between sleep duration and early pubertal timing based on published evidence systematically.</p><p><strong>Methods: </strong>We searched important electronic databases for articles that reported the association between childhood sleep duration and puberty timing up to October 2020. A total of 848 papers were identified from the databases and manual search. Finally, 10 studies including 23752 participants were included in the meta-analysis. We calculated the pooled effect sizes using a random or fixed effects model as appropriate.</p><p><strong>Results: </strong>There was a significant inverse association between sleep duration and the risk of early puberty, longer duration of sleep was associated with 0.34% decreased odds of early puberty (OR = 0.66, 95% CI = 0.58-0.77, I² = 96.6%). In a subgroup analysis, when pubertal status was assessed by physical examination compared with Pubertal Development Scale (PDS) or Sexual Maturation Scale (SMS), the associations between sleep duration and age of puberty were attenuated. The pooled OR (95% CI) of studies measuring pubertal timing by PDS/SMS and Tanner stage were 0.50(0.37-0.69) and 0.91(0.77-1.09), respectively. When pooling effect sizes was limited to studies that had BMI level adjustment, the association of sleep duration and early puberty was not statistically significant anymore (OR = 0.95, 95% CI = 0.89-1.01).</p><p><strong>Conclusion: </strong>Longer sleep duration is associated with a lower risk of early puberty in children. The association between sleep duration and risk of early puberty may be modified by other factors such as BMI. To clarify the effect of sleep duration on the risk of early puberty in children, further prospective studies are needed.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 3","pages":"318-328"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10665217","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":"Elimination, Containment, and Mitigation of COVID-19: A Personal Story about International Travels.","authors":"K L Hon,&nbsp;Karen K Y Leung","doi":"10.2174/1573396318666220823152942","DOIUrl":"https://doi.org/10.2174/1573396318666220823152942","url":null,"abstract":"<p><strong>Background: </strong>The author and his wife report their unique experience of international travels during the COVID-19 pandemic, and discuss issues encountered in various countries.</p><p><strong>Methods: </strong>Narrated discussion of issues encountered during the COVID-19 pandemic.</p><p><strong>Discussion: </strong>\"Zero-COVID\" versus \"Living with COVID-19\" strategies are compared. Children have unique issues with COVID-19 pandemic. Evaluation of efficacy of the approaches in pandemic with time should consider the main types of interventions (e.g., border management/quarantine; physical distancing; mask use; case isolation, testing and contact tracing; vaccination). The key metrics that can be used to compare the impacts of different strategies between the cities (e.g., cumulative case rate, cumulative mortality rate, case fatality risk, stringency index, economic performance) should be identified. Research in these approaches can help manage future pandemics in coronaviruses and emerging infections. The UK started with very loose mitigation ('herd immunity') and then switched to a suppression approach in 2021, followed by \"living with the virus\" approach. Whereas HK has been targeting towards elimination throughout. In between, countries like Singapore, Australia and New Zealand have shifted from zero-COVID strategy to living with the virus. It is easier to have effective social control measures in Hong Kong because it has clear borders and an authoritarian government, but it did not have a clear exit policy when Omicron spread.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 3","pages":"218-222"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9234232","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":"Neonatal Anemia.","authors":"Kendell R German,&nbsp;Sandra E Juul","doi":"10.2174/1573396319666221121140627","DOIUrl":"https://doi.org/10.2174/1573396319666221121140627","url":null,"abstract":"<p><p>All neonates experience a downtrend in their hematocrit values immediately following the birth through normal falls in erythropoietin (Epo) production, transition to adult hemoglobin, and hemodilution with somatic growth. However, this drop is more pronounced in critically ill and preterm neonates and can lead to potentially pathologic anemia that impairs tissue oxygen delivery. In this review, we highlight the mechanisms underlying physiologic anemia and anemia of prematurity and briefly review the evidence for the treatment of anemia in the neonatal population, including the use of red blood cell transfusions, erythropoietic stimulating agents, and iron supplementation.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 4","pages":"388-394"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657607","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":"Familial Hypercholesterolaemia in Children and Adolescents: Current and Future Perspectives.","authors":"Francesco Martino,&nbsp;Francesco Barilla',&nbsp;Eliana Martino,&nbsp;Giuseppe Calcaterra,&nbsp;Vassilios Fanos,&nbsp;Pier Paolo Bassareo","doi":"10.2174/1573396318666220921155314","DOIUrl":"https://doi.org/10.2174/1573396318666220921155314","url":null,"abstract":"<p><p>Familial hypercholesterolemia (FH) is a genetic disease, the underlying cause of which is represented by mutations capable of influencing the metabolism of low-density lipoproteins (LDL). The distinguishing characteristic of FH has increased LDL cholesterol blood levels since birth, triggering early development of atherosclerosis-related diseases. Diagnosis of FH is frequently either missed or made with a considerable delay. Prompt identification of the disease is pivotal in implementing early prevention measures. Safe and effective drugs have been approved for use in children and adolescents, with statins, with or without ezetimibe, representing first-line therapy. At times, however, these medications may not be sufficient to achieve the therapeutic target, particularly in homozygous FH patients. Lipoprotein apheresis, which has proved safe and efficient, is strongly suggested in such cases. New drugs still at the investigational stage may represent a promising and personalised therapy. Lowering cholesterol levels in childhood hampers the formation of arterial atherosclerotic plaques, thus reducing cardiovascular events later in life. Accordingly, early detection, diagnosis, and therapy in FH subjects are priority aims.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":"19 3","pages":"234-241"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10665644","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}