European Journal of Pediatrics最新文献

{"title":"Evaluation of tolerance towards ureteral double-J-stents in children: an unmet need.","authors":"Dafni Planta, Raphael N Vuille-Dit-Bille, Stefan Holland-Cunz, Martina Frech-Doerfler","doi":"10.1007/s00431-025-06165-x","DOIUrl":"https://doi.org/10.1007/s00431-025-06165-x","url":null,"abstract":"<p><p>Ureteric double-J-stents (DJS) are commonly applied devices in urology that often cause irritative symptoms in adults, leading to decreased quality of life. Little is known about how they are tolerated by children. Furthermore, standardized patient-centered care for children has not yet been established. The objective of this observational study is to assess the tolerance of children towards DJS in relation to their age by evaluating their irritative symptom rate and to raise awareness of the need for a standardized evaluation method. A prospective observational single-center study was conducted over a period of 14 months on children with indwelling DJS. A questionnaire addressing 5 categories (voiding symptoms, general symptoms, social activities and/or sexual health, catheter removal, and medication) was developed for different age groups and employed after stent removal. Twenty patients with a mean age of 5.8 years (range 3 months to 15 years) were enrolled in the study. During the indwelling time (mean 6 weeks), 13 patients suffered from irritative symptoms (intermittent pain and/or voiding problems). There was a positive association between age and the reported pain score (Spearman's ρ = 0.54, p = 0.04). Overall, the quality of life (QoL) was less impaired than in adult patients and the complications were less severe, but the symptom occurrence rate was similarly high.</p><p><strong>Conclusion: </strong> The current study lays the groundwork for a standardized re-evaluation of ureteral stents in pediatric applications. Through the development of a specialized questionnaire, we provide a quantitative tool for assessing the QoL of children with indwelling ureteral stents. The next step in standardizing the use of DJS in the pediatric population involves the validation of our questionnaire through a large-scale multi-center study.</p><p><strong>What is known: </strong>• Ureteric double-J stents are commonly used devices in pediatric urology. • Double-J stents are often not well tolerated by adults due to severe irritating symptoms, which decreases their quality of life.</p><p><strong>What is new: </strong>• In children, little is known about tolerance of double-J stents. • There is no standardized method to assess tolerance in children, especially with regard to age.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"364"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149879","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":"Letter to the editor: heterogeneity in effects of PDA treatment.","authors":"William E Benitz","doi":"10.1007/s00431-025-06192-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06192-8","url":null,"abstract":"<p><p>The recent meta-analysis by Matsushita et al on \"Heterogeneity in treatment response for patent ductus arteriosus\" confirms prior results showing that medical treatment of PDA does not reduce but increases mortality. The discussion implies that there is heterogeneity in effects of treatment on mortality, but this is not consistent with the data. The implication of their analysis is that early medical treatment of PDA in preterm infants should be abandoned, as recommended in the recent Clinical Report from the American Academy of Pediatrics.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"363"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149881","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":"Consumption of energy drinks among youth in Spain: trends and characteristics.","authors":"Ana Teijeiro, Mónica Pérez-Ríos, Guadalupe García, Lucia Martin-Gisbert, Cristina Candal-Pedreira, Julia Rey-Brandariz, Carla Guerra-Tort, Leonor Varela-Lema, Nerea Mourino","doi":"10.1007/s00431-025-06177-7","DOIUrl":"https://doi.org/10.1007/s00431-025-06177-7","url":null,"abstract":"<p><p>The aims of this study were to describe the trend across 2014-2023 in the prevalence of the consumption of energy drinks among students aged 14 to 18 years in Spain and the shifting characteristics of consumers. Data source was the microdata of the Survey of Drug Use in Secondary Education in Spain (2014-2023). Prevalence of energy drink consumption was calculated overall, by sex and age, and in the 18 Autonomous Regions. To identify the factors linked to consumption, multivariate models were fitted. Prevalence and adjusted odds ratios are shown with their 95% confidence intervals; the geographic distribution of energy drink consumption was plotted on maps. The prevalence of consumption of energy drinks in the last 30 days ranged from 40.4% (2014) to 47.7% (2023). For any given year, prevalence was higher in boys and varied among regions. Being male, non-Spanish, a repeat student of 1 or more academic years, having no parent with higher education, or consuming tobacco, cannabis, or alcohol increased the likelihood of energy drink consumption.</p><p><strong>Conclusions: </strong>The prevalence of energy drink consumption among Spanish students aged 14-18 years has shown an upward trend among both sexes, especially among girls. The characteristics of consumers have been stable since 2014. Understanding these trends, factors associated with consumption, and the differences among regions is critical to directing efforts to educate young people about the risks involved and to prevent the initiation of energy drink consumption.</p><p><strong>What is known: </strong>• The energy drink market has grown since 2000. • Energy drink consumption is higher in adolescents. • Some European countries have taken regulatory measures, such as banning energy drink sales to minors.</p><p><strong>What is new: </strong>• The prevalence of energy drink consumption among Spanish adolescents has shown an upward trend in 2014-2023. • Prevalence was higher in boys and varied among regions. • The characteristics of consumers were stable during this period.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"365"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157607","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":"Pediatric migraine care: bridging gaps, overcoming barriers, and advancing solutions.","authors":"Aynur Özge, Mario Fernando Prieto Peres, Rami Burstein","doi":"10.1007/s00431-025-06199-1","DOIUrl":"https://doi.org/10.1007/s00431-025-06199-1","url":null,"abstract":"<p><p>Pediatric migraine is an increasingly recognized public health concern, with a rising prevalence among children and adolescents. Despite advances in our understanding of migraine mechanisms and treatment, major gaps and barriers persist in diagnosis, management, and awareness. This review highlights the current gaps in pediatric migraine care, including underdiagnosis, comorbidities, disparities in access to treatment, and proposes actionable strategies to improve outcomes. A structured narrative review focused on pediatric migraine prevalence, diagnosis, treatment, and comorbidities. Emphasis was placed on interdisciplinary collaboration, emerging mechanism-based therapies, and holistic approaches to managing pediatric migraine. Pediatric migraine are frequently underdiagnosed and undertreated, partly due to a lack of physician awareness, inadequate training, and outdated guidelines. Emerging mechanism-based therapies, such as CGRP-targeted treatments, hold promise but are not yet widely adopted in pediatric care and are unlikely to be accessible to all but a few patients. Holistic approaches, including lifestyle modifications and behavioral therapy, can complement traditional treatments but remain underutilized.</p><p><strong>Conclusion: </strong>Addressing the current gaps and barriers in pediatric migraine care requires updated clinical guidelines, increased healthcare provider training, increased awareness of comorbidities, affordability of approved medications, and encouragement of holistic treatment options. By fostering interdisciplinary collaboration and expanding access to care, better outcomes can be achieved for children suffering from migraine.</p><p><strong>What is known: </strong>• Pediatric migraine is a prevalent but often underdiagnosed condition, with significant impact on quality of life. • Traditional treatment approaches are frequently inadequate, and physician awareness and training remain suboptimal.</p><p><strong>What is new: </strong>• This review identifies critical gaps in pediatric migraine care, including limited access to emerging therapies and insufficient integration of holistic approaches. • It proposes actionable strategies such as interdisciplinary collaboration, updated guidelines, and enhanced provider education to improve care outcomes.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"362"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136039","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":"Evaluation of testicular function in 1-2-year-old cryptorchid children with alterations of anti-mullerian hormone after various orchidopexy.","authors":"Chenjie Zhang, Chunsheng Hao, Zhishang Niu, Jinqiu Song, Ying Qiu, Yalin Wang, Dongsheng Bai","doi":"10.1007/s00431-025-06190-w","DOIUrl":"https://doi.org/10.1007/s00431-025-06190-w","url":null,"abstract":"<p><p>This study assessed testicular function in children with cryptorchidism following different orchidopexy procedures by measuring serum anti-Müllerian hormone (AMH). The aim was to identify clinical factors associated with testicular function recovery by comparing pre- and post-operative levels of AMH, luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and testicular volume at various time points. This prospective observational cohort study included children aged 1 to 1.5 years diagnosed with cryptorchidism via physical examination and ultrasound. The study evaluated testicular function parameters before and after two different orchidopexy techniques, measured at five intervals. Serum AMH was the primary outcome, with FSH, LH, testosterone, and testicular volume as secondary measures. A control group of 57 healthy male infants aged 1 to 2 years was included for comparative analysis. A total of 138 patients were enrolled, with testicular function evaluated preoperatively and at 10 days, 1 month, 3 months, and 6 months post-surgery. Preoperative AMH levels were significantly higher in unilateral compared to bilateral cryptorchidism (P < 0.05). Postoperatively, AMH levels increased by 3 months in children with palpable testicles and by 6 months in those with non-palpable testicles (P < 0.05), with no significant difference between groups at 6 months. Cases with intraperitoneal release procedures also showed significant AMH increases at 3 and 6 months (P < 0.05), and testicular function improved similarly across surgical techniques.</p><p><strong>Conclusion: </strong>Orchidopexy can pose a risk of injury, emphasizing the need for careful treatment planning. While surgical technique did not significantly affect outcomes in children aged 1 to 1.5 years, serum AMH is a valuable tool for preoperative evaluation and prognosis in cryptorchidism.</p><p><strong>What is known: </strong>•Cryptorchidism impairs testicular function.•Orchidopexy improves function but varies by technique and testicular position.</p><p><strong>What is new: </strong>•AMH is a sensitive postoperative marker for testicular recovery.•Function improvement is consistent across surgical techniques, with intraperitoneal release showing significant AMH gains by 3-6 months.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"361"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135977","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":"Salbutamol in 5q spinal muscular atrophy: a systematic review and meta-analysis of efficacy and safety.","authors":"Xiaodong Xing, Shuyan Zhao, Ruoyu Jiang, Wengao Jiang","doi":"10.1007/s00431-025-06184-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06184-8","url":null,"abstract":"<p><p>Salbutamol, an agonist of the β2-adrenergic receptor, has demonstrated positive outcomes in spinal muscular atrophy (SMA). This systematic review and meta-analysis aimed to investigate its efficacy and safety in patients with SMA. Four biomedical databases (PubMed, Embase, Web of Science, Cochrane Library) and three conference abstract repositories were systematically searched on 1 February 2025 for related clinical studies. Primary outcomes were the motor function, respiratory function, and the peripheral survival motor neuron (SMN) transcript levels of SMA patients pre- and post-salbutamol. Secondary outcomes included musculoskeletal function metrics, patient-reported symptoms, and adverse events. A total of eight studies involving 154 subjects were included in the final analysis. Qualitative analysis revealed that a significant number of patients reported subjective improvements. Additionally, salbutamol has been shown to improve respiratory function and contribute to weight gain in certain younger individuals. Meta-analysis demonstrated that, in two selected studies, patients under 6 years old showed a substantial improvement in the Revised Upper Limb Module (RULM) scores (mean difference (MD) = 3.89, 95% confidence interval (CI) 0.35-7.43, P = 0.03) with no significant heterogeneity. Salbutamol also elevated the levels of peripheral SMN2 full-length transcripts, with statistical significance observed at 6 months (MD = 25.13, 95% CI 16.12-34.13, P < 0.00001) and sustained through to 12 months.</p><p><strong>Conclusion: </strong> Salbutamol represents a safe therapeutic option that holds considerable promise in the management of SMA, particularly among clinical responders and younger subgroups. Double-blind, randomized, controlled trials are required to confirm these findings.</p><p><strong>What is known: </strong>• Clinical trials in neuromuscular junction disorders report motor function gains associated with β2-agonists therapy, attributed to both muscle trophic effects and NMJ synaptic modulation. • Salbutamol, a β2-adrenergic receptor agonist, has been shown to increase full-length SMN2 mRNA and functional SMN protein levels in SMA patient-derived fibroblasts.</p><p><strong>What is new: </strong>• Salbutamol possesses the potential to improve motor function in patients with SMA and represents a safe therapeutic option that holds considerable promise in the management of SMA. • The potential mechanism of salbutamol in treating SMA patients may involve enhancing SMN2 transcript expression via cAMP regulation and increasing SMN protein levels by inhibiting ubiquitin-mediated SMN degradation through the β2 adrenergic receptor-PKA pathway. • Salbutamol emerges as a cost-effective and viable option for SMA patients in underdeveloped regions who lack access to or cannot afford disease-modifying treatments.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"358"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131932","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":"Impact of COVID-19 on the epidemiology of severe sinogenic and otogenic infections and their intracranial complications.","authors":"Dimitra Dimopoulou, Maria M Berikopoulou, Ioannis Tsoliakos, Athanasios Michos","doi":"10.1007/s00431-025-06188-4","DOIUrl":"10.1007/s00431-025-06188-4","url":null,"abstract":"<p><p>This study aims to evaluate the impact of COVID-19 pandemic on the incidence, microbiological characteristics, management, and outcomes of mastoiditis and orbital cellulitis and their intracranial complications in pediatric patients. A retrospective observational study was conducted at the major pediatric hospital of Athens from 1/2018 to 12/2023. Pediatric patients (0-16 years) diagnosed with mastoiditis, orbital cellulitis, and related complications were included. Data were collected across three periods: pre-pandemic (1/2018-3/2020), during the pandemic (4/2020-6/2021), and post-pandemic (7/2021-12/2023). Statistical analyses compared demographic, clinical, and microbiological characteristics between the periods. A total of 176 cases were included (76 mastoiditis and 100 orbital cellulitis cases). The in-hospital incidence of both infections increased significantly post-pandemic compared to the period before the pandemic (mastoiditis: 5.5 vs.13.6 per 1000 admissions; orbital cellulitis: 4.8 vs. 21.8 per 1000 admissions, P < 0.001). Streptococcus and Staphylococcus species predominated across the three periods. Median (IQR) age was not significantly different between the two periods among patients with mastoiditis (pre-pandemic: 5.6 (3.5) years vs. post-pandemic: 3.3 (3.4) years, P = 0.12) and among patients with orbital cellulitis (pre-pandemic: 9.2 (6.6) years vs. post-pandemic: 8 (9.2) years, P = 0.50). Regarding the complications, the rate of intracranial empyema/abscess development among patients with orbital cellulitis, but not mastoiditis, was lower post-pandemic compared to pre-pandemic (30% vs. 10.1%, P = 0.03).</p><p><strong>Conclusion: </strong>The study findings demonstrate a significant rise in the post-COVID-19 in-hospital incidence of mastoiditis and orbital cellulitis in children. Future epidemiological surveillance of these complications and pathogen-specific dynamics, are important to develop prevention strategies for these severe pediatric infections.</p><p><strong>What is known: </strong>• The COVID-19 pandemic shifted the epidemiology of severe upper respiratory tract infections. • Data on the epidemiology of severe sinogenic and otogenic infections and their intracranial complications during and after the acute phase of the COVID-19 pandemic are limited in Europe.</p><p><strong>What is new: </strong>• This study highlights a notable increase in the in-hospital incidence of mastoiditis and orbital cellulitis during the post-COVID-19 pandemic era, likely associated with immunity debt and alterations in respiratory microbiota. • Despite the increase in pediatric mastoiditis and orbital cellulitis cases, the rates of complications and surgical management remained stable throughout the study period.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"359"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131893","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":"Physical activity and weight status of children in Germany: cross-sectional results from the MoMo Wave 3 (2018-2020).","authors":"Elena Brehm, Lara Tschuschke, Leon Klos, Alexander Burchartz, Carmen Volk, Anke Hanssen-Doose, Darko Jekauc, Claudia Niessner, Alexander Woll","doi":"10.1007/s00431-025-06183-9","DOIUrl":"10.1007/s00431-025-06183-9","url":null,"abstract":"<p><p>Childhood physical activity (PA) plays a critical role in preventing obesity and supporting overall health. This study investigates the prevalence of weight status categories and their association with organized and unorganized PA among 6- to 17-year-old children in Germany using MoMo Wave 3 (2018-2020). Cross-sectional data from MoMo Wave 3 (2018-2020) were analyzed to examine associations between weight status and PA. A total of 1983 participants (age: 11.6 ± 3.4 years, 52.3% male) completed a questionnaire and had anthropometric measurements taken, including height and weight. Statistical comparisons between normal-weight children and those classified as underweight or overweight based on their body mass index focused on their participation in organized and unorganized PA. Linear and logistic regressions were used for statistical analysis. Among the participants, 3.0% were severely underweight, 5.8% were underweight, 7.2% were overweight, and 4.6% were obese. Participants classified as underweight (ꞵ = - .084; p < .001) and overweight (ꞵ = - .045; p = .042) spent less time in organized PA compared to normal weights. Overweight participants were less likely to participate in unorganized PA (OR = .64, p = .003). No significant differences were observed in the duration of unorganized PA among those who participated, regardless of weight status.</p><p><strong>Conclusion: </strong>The prevalence of overweight and obesity has remained consistently high in recent years. Tailored interventions should address the specific barriers faced by both underweight and overweight children to enhance their participation in PA and improve health outcomes across diverse groups.</p><p><strong>What is known: </strong>• Children with overweight or obesity are less physically active than their normal-weight peers, underweight children are often as physically active as those with normal weight.</p><p><strong>What is new: </strong>• Children with overweight and underweight show less organized physical activities compared to their normal-weight peers. • Although overweight children engaged less frequently in unorganized physical activities, those who did participated for a similar duration as normal-weight children.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"360"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136040","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":"Serial lung ultrasound in predicting the need for surfactant and respiratory course in preterm infants-multicentre observational study (SLURP).","authors":"P K Loganathan, V Meau-Petit, B Bhojnagarwala, V Nair, J Holmes, A Occhipinti, M Montasser","doi":"10.1007/s00431-025-06185-7","DOIUrl":"10.1007/s00431-025-06185-7","url":null,"abstract":"<p><p>Lung ultrasound (LUS) scores may predict surfactant need early and the progression of the respiratory course in preterm infants. The objective of this study is to report the diagnostic value of LUS scores performed by operators of varying levels of experience to predict the need for surfactant in preterm infants. A prospective observational study was conducted across 3 UK-based neonatal intensive care units. Preterm infants ≤ 34 weeks on non-invasive respiratory support within 3 h of birth were included. Ten lung zones were scored serially, first within the first 3 h of life, then at 12-24-h intervals (a total of four scans). All scans were performed by the local team members with formal training on LUS and varying levels of expertise. All the LUS videos were scored by an expert investigator who was blinded to clinical details. Written retrospective parental consents were obtained. We recruited 83 preterm infants ≤ 34 weeks (May 2023 to June 2024). A total of 325 LUS scans were performed by 27 clinical staff. The median birth gestational age and birth weight were 31 weeks and 1515 g, respectively. Twenty-eight (34%) babies received surfactants. The first LUS using a 6-zone method within 3 h of life predicted surfactant need and bronchopulmonary dysplasia with an AUC of 0.80 for both outcomes, offering sensitivity (79% and 73%) and specificity (75% and 76%), respectively.</p><p><strong>Conclusions: </strong> LUS performed by operators of varying levels of experience within the first 3 h of life is a reliable tool for predicting surfactant need in preterm infants ≤ 34 weeks.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ( https://clinicaltrials.gov/ ): NCT05782569.</p><p><strong>What is known: </strong>• There are considerable variations in the selection criteria of preterm infants for surfactant administration. • Lung ultrasound score has been shown to predict the need for surfactant early and the progression of respiratory course in preterm infants.</p><p><strong>What is new: </strong>• LUS performed within 3 h of life by operators of varying levels of experience and interpreted by expert predicted the need for surfactant deficiency in preterm infants. • Our research with a structured training programme enabled novice operators to perform LUS and achieve reasonable competency.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"356"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126799","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":"Extended vs. concise lung ultrasound scores to predict the need for respiratory support in bronchiolitis: a prospective observational study.","authors":"Seyfeddine Zayani, Farah Thabet, Abir Daya, Olfa Betbout, Bennasrallah Cyrine, Chokri Chouchane, Slaheddine Chouchane","doi":"10.1007/s00431-025-06189-3","DOIUrl":"10.1007/s00431-025-06189-3","url":null,"abstract":"<p><p>Lung ultrasound (LUS) has emerged as a valuable tool for assessing bronchiolitis severity, yet the optimal scoring system remains uncertain. This study aimed to compare the predictive performance of two LUS scoring methods-concise vs. extended-for determining the need for respiratory support in infants hospitalized with bronchiolitis. We conducted a prospective observational study including infants < 12 months hospitalized for bronchiolitis. All patients underwent LUS within 12 h of admission, performed by trained pediatricians blinded to clinical outcomes. The concise score assessed three lung regions per hemithorax, whereas the extended score included six regions per hemithorax. The primary outcome was the need for respiratory support (high-flow nasal cannula, noninvasive ventilation, or invasive mechanical ventilation). Interobserver agreement was assessed via the intraclass correlation coefficient (ICC). A total of 160 infants were included, with 87 (54.4%) requiring respiratory support. The extended LUS score demonstrated superior predictive performance (AUC = 0.879, 95% CI 0.824-0.934) compared to the concise score (AUC = 0.761, 95% CI 0.686-0.837, p < 0.001). The optimal cutoffs were 14 for the extended score (89.7% sensitivity, 78.1% specificity) and 7 for the concise score (79.3% sensitivity, 67.1% specificity). Interobserver reliability was good for both scores (ICC = 0.86 and 0.79).</p><p><strong>Conclusion: </strong>The extended LUS score exhibited higher predictive accuracy but at the expense of increased complexity. While both scores demonstrated clinical utility, further studies should explore the balance between feasibility and precision in bronchiolitis management.</p><p><strong>What is known: </strong>• Lung ultrasound (LUS) is increasingly used to assess the severity of bronchiolitis in infants. • Several LUS scoring systems exist, but there is no consensus on which score best predicts the need for respiratory support.</p><p><strong>What is new: </strong>• This study prospectively compares a concise and an extended LUS score to predict the need for advanced respiratory support in hospitalized infants. • The extended score had significantly higher diagnostic accuracy and clinically oriented cut-offs to guide triage decisions.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"357"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131956","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}