Current Pediatric Reviews最新文献

{"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}

{"title":"The Impact of GATA2 Expression and Methylation on Patients with Hirschsprung's Disease.","authors":"Gunadi, Pramana Adhityo, Alvin Santoso Kalim, Ali Zainal Abidin, Kurnia Corie Tonda, Siti Maisaroh, Aulia Ichlasul Rezza, Petrus Gandi Purwosatrio, Brahmastra Megasakti, Dwi Aris Agung Nugrahaningsih","doi":"10.2174/0115733963385500251030072437","DOIUrl":"https://doi.org/10.2174/0115733963385500251030072437","url":null,"abstract":"<p><strong>Introduction: </strong>Hirschsprung's (HIRSH-sproongz) disease is a multifactorial disorder characterized by the failure of enteric nervous system (ENS) development and is associated with loss-of-function variants, primarily in the RET gene. Rearranged during transfection (RET) expression is tightly regulated within a complex gene regulatory network (GRN) involving many transcription factors, such as GATA2. Aberrant DNA methylation in GATA2 may indicate a reduced enhancer activity, resulting in the silencing of RET and contributing to the failure of ENS development in HIRSH. However, the epigenetic mechanisms underlying these processes have yet to be established.</p><p><strong>Method: </strong>We analyzed the GATA2 mRNA expression and DNA methylation levels in colonic tissues from the HIRSH patients and controls using quantitative polymerase chain reaction (qPCR) and methylation-specific quantitative PCR (MSP-qPCR). HIRSH tissues, including aganglionic and ganglionic segments, were obtained during pull-through surgery. In addition, control tissues were collected from patients with anorectal malformation (ARM) undergoing definitive surgery, and no clinical evidence of ENS issues was found.</p><p><strong>Results: </strong>Our study contained 27 unrelated HIRSH patients (20 males and seven females) and 20 controls (12 males and eight females). GATA2 expression was significantly increased in HIRSH than in control colon (ganglionic: 11.78 ± 0.97 vs. 12.59 ± 0.46; p=0.049; aganglionic: 11.94 ± 0.63 vs. 12.59 ± 0.46; p=0.030). In addition, the percentage of methylation was higher in the HIRSH patients than in the control (60.71 ± 2.94% [ganglionic] vs. 79.55 ± 1.79% [aganglionic] vs. 40.43 ± 3.67% [control]).</p><p><strong>Discussion: </strong>Overexpression of GATA2 in our subjects may indicate a compensatory mechanism for the loss of other TFs within RET-EDNRB or other HIRSH-associated GRN, as an in vitro study has shown that loss of GATA1 in mouse embryonic stem cells results in a marked increase of GATA2 expression, implying potential interchangeability or compensatory mechanism of GATA TFs in RET GRN. Several mechanisms on how specific DNA hypermethylation pathways can lead to upregulated gene expression have been proposed, including facilitating transcription in gene bodies by suppressing cryptic promoters and protecting the borders of promoters or enhancers against unwanted expansion or contraction.</p><p><strong>Conclusions: </strong>We demonstrated aberrant expression and methylation of GATA2 in the HIRSH patients. The findings of this study also indicate that GATA2 hypermethylation is associated with increased GATA2 expression, contradicting the established inverse association between DNA methylation and transcriptional activity. This may indicate a distinctive interplay between the epigenetics of GATA2 and RET GRN in the context of HIRSH.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932736","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":"Mapping Systematic Reviews on the Management of Dental Caries in Primary Teeth: A Meta-research.","authors":"Aline MaquinE Pascareli-Carlos, Thais Marchezini Reis, Tatiane Fernandes de Novaes, Anelise Fernandes Montagner, Francoise Helene van de Sande, Thais Gimenez, Daniela Procida Raggio, Tamara Kerber Tedesco","doi":"10.2174/0115733963290288240813050512","DOIUrl":"10.2174/0115733963290288240813050512","url":null,"abstract":"<p><strong>Background: </strong>Systematic reviews (SRs) represent the most robust source of evidence for informing decision-making. While there are rigorous protocols for properly conducting SRs, sometimes the methodological biases in the primary studies are accounted for in the conclusions of the SRs.</p><p><strong>Objectives: </strong>This study aimed to map the evidence regarding the management of caries lesions in primary teeth.</p><p><strong>Methods: </strong>Two reviewers conducted a systematic search up to March 2024 in electronic databases. Any SR concerning the management of caries lesions in primary teeth was considered eligible.</p><p><strong>Results: </strong>About 162 SRs were included. Among these, 80 focused on restorative treatments, 64 on endodontic treatments, and 18 on non-invasive treatments. Only 42.6% presented a study registration protocol. The majority (67.9%) performed a meta-analysis, while a minority exclusively carried out qualitative data analysis. Despite 92.6% of the SRs evaluating the methodological quality or risk of bias of the primary studies using some tool, only 24% assessed the certainty of evidence using the GRADE approach, resulting in classifications ranging from very low to moderate.</p><p><strong>Conclusion: </strong>There is a limited adherence to study registration protocols, indicating a need for improvements in this practice. Additionally, among the few SRs that used the GRADE approach, the majority demonstrated levels of very low to moderate certainty.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"25-60"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281843","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":"Effects of Breast Milk or Supplemented Formula Milk on Fecal Metabolomic Profile.","authors":"Giuseppe De Bernardo, Fabio Centanni, Marta Improta, Valeria Crisci, Maurizio Giordano, Giuseppe Buonocore, Serafina Perrone","doi":"10.2174/0115733963341570250422095946","DOIUrl":"10.2174/0115733963341570250422095946","url":null,"abstract":"<p><p>Breast milk (BM) is the best option for the nutritional needs of an infant. In situations where breastfeeding is contraindicated, donor human milk and formula milk (FM) are suggested as alternatives. This study highlights findings from two studies that evaluated how different dietary patterns (standard formula, post-biotic fermented formula, and breast milk) affected the intestinal microbiota and metabolome of late preterm and full-term infants. The metabolome of late preterm newborns showed a higher presence of metabolites-such as azelaic acid, N-acetylglucosamine- 6- sulfate, and 13(S)-hydroperoxylinolenic acid-in those fed postbiotic-fermented formula, similar to breastfed full-term newborns. The fecal metabolites of breast milk and substitute feeding systems are comparable in these preliminary studies, confirming the effectiveness of formula preparations as breast milk substitutes. Furthermore, newborns fed with postbiotic-supplemented formula or breast milk had several similarities in fecal metabolites. The addition of postbiotics to formula milk appears to be more efficient than standard formula milk and is considered a better alternative to breast milk.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"20-24"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988926","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 Quantitative Review of Un-licensed and Off-label Medicines Use in Children Aged 0-2 Years in the Private Sector in South Africa: Extent, Challenges, and Implications.","authors":"Hlayiseka Mathevula, Moliehi Matlala, Natalie Schellack, Samuel Orubu","doi":"10.2174/0115733963303583240820043749","DOIUrl":"10.2174/0115733963303583240820043749","url":null,"abstract":"<p><strong>Background: </strong>The global lack of suitable formulations for children leads to off-label and unlicensed medicine use, posing significant risks of adverse effects. Understanding this usage on a national level can help guide interventions for better formulations. This study aimed to measure the prevalence of off-label and unlicensed medicines among children in South Africa's private sector.</p><p><strong>Methods: </strong>The study used a point prevalence methodology to review medicine use in children aged 0-2 years enrolled in a selected pharmaceutical benefit management company in South Africa from January to June 2022. A sample size of 1055 prescriptions was calculated using a 90% confidence interval, 50% prevalence rate, and 5% error margin. A systematic random sampling approach selected every 7th entry from 91,973 total entries, resulting in a final sample size of 13,139. Data included patient age, number and characteristics of medicines, quantity, and indications. Descriptive statistics analysed and reported the prevalence of unlicensed and off-label medicine use.</p><p><strong>Results: </strong>Among the 13,139 prescribed medicines, 40% (5,246) were off-label or unlicensed, and 60% (7,893) were on-label. Of the off-label/unlicensed medicines, 16.85% (2,214) were unlicensed, and 23.08% (3,032) were off-label. Methylprednisolone was the top off-label medicine, probiotics were the top unlicensed, and the ICD10 code Z76.9 was the top diagnosis.</p><p><strong>Conclusion: </strong>The study found that 40% of children aged 0-2 years were prescribed unlicensed or off-label medicines in South Africa's private healthcare sector between January and June 2022. This suggests a widespread practice of off-label or unlicensed prescriptions in paediatric treatment in the South African private sector.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"61-70"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125125","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}