European Journal of Pediatrics最新文献

{"title":"Prevalence of non-communicable diseases and duration of breastfeeding in children under 14 years of age: a nationwide community-based cross-sectional study.","authors":"Mehmet Emin Arayici, Ali Kose, Hatice Simsek","doi":"10.1007/s00431-025-06346-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06346-8","url":null,"abstract":"<p><p>It's a well-established fact that non-communicable diseases (NCDs) originating in childhood contribute significantly to long-term morbidity. While breastfeeding is a known protective factor for various health outcomes, limited national-level data exist linking breastfeeding duration to chronic pediatric conditions. The study aims to assess the prevalence of key pediatric NCDs and examine the association between breastfeeding duration and the risk of heart disease, diabetes mellitus (DM), musculoskeletal disorders, cancer, and mental health problems in a weighted sample of children aged 0-14 years in Türkiye. This community-based cross-sectional study analyzed data from the 2022 Türkiye Health Survey microdata, including 4229 children and representing a weighted national pediatric population of 15,725,436. Breastfeeding duration was categorized as 0-5, 6-12, 13-23, and ≥ 24 months. Weighted prevalence estimates were calculated for each NCD, and multivariable logistic regression models-adjusted for age, sex, maternal education, household income, and kindergarten attendance-were used to estimate adjusted odds ratios (aORs) and corresponding 95% confidence intervals (CIs) for the breastfeeding categories and NCD outcomes. The weighted prevalence of musculoskeletal disorders, mental health conditions, heart disease, DM, and cancer was 1.39% (1.02-1.76), 1.21% (0.86-1.56), 1.19% (0.85-1.53), 0.26% (0.10-0.42), and 0.05% (0.01-0.12), respectively. Cancer prevalence was higher in boys than girls (93.9% vs. 6.1%, p = 0.004), and musculoskeletal and mental health conditions increased with age (p = 0.031 and p = 0.017). In adjusted analyses, breastfeeding for 6-12 months (aOR = 0.347, 95% CI 0.137-0.876, p = 0.025) and 13-23 months (aOR = 0.335, 95% CI 0.143-0.786, p = 0.012) was associated with lower odds of musculoskeletal disorders compared with 0-5 months. No significant associations were observed for heart disease, DM, and mental health disorders.</p><p><strong>Conclusions: </strong>The findings of this large-scale population-based study indicate that moderate breastfeeding duration (6-23 months) was associated with lower odds of pediatric musculoskeletal disorders but showed no association with other NCDs. Policy interventions should prioritize breastfeeding support and education to mitigate the future burden of chronic diseases beginning in childhood.</p><p><strong>What is known: </strong>• Breastfeeding supports early childhood development and protects against infections. • Its long-term effects on chronic diseases in children are less well understood.</p><p><strong>What is new: </strong>• Breastfeeding for 6-23 months was significantly associated with lower odds of musculoskeletal disorders in children, while no associations were observed for heart disease, DM, or mental health disorders. • The findings highlight a selective protective association between moderate breastfeeding duration and specific pediatric health outcomes, warranting furth","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"496"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689665","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":"Serious bacterial infections in infants younger than 90 days of age with acute bronchiolitis.","authors":"Minsung Kim, Jin Lee, Seung Beom Han, Soo Young Lee","doi":"10.1007/s00431-025-06340-0","DOIUrl":"https://doi.org/10.1007/s00431-025-06340-0","url":null,"abstract":"<p><p>Although acute bronchiolitis is primarily caused by viral infections, antibiotics are often administered to children with acute bronchiolitis. Due to concerns about serious bacterial infections (SBI), neonates and young infants are particularly prone to antibiotic overuse. This study aimed to identify the clinical characteristics and prevalence of SBI in neonates and infants aged < 90 days with acute bronchiolitis. We retrospectively reviewed the medical records of 651 neonates and infants aged < 90 days hospitalized with acute bronchiolitis between September 2015 and August 2024. Demographic and clinical data were analyzed to assess their clinical characteristics and the prevalence of SBI. Of the 651 infants, 230 (35.3%) had fever, and 485 (74.5%) received antibiotics. Blood cultures were performed in 646 (99.2%) infants; 52 (8.0%) yielded bacterial growth, but 50 were skin contaminants and one (Enterococcus faecium from an afebrile infant) was considered clinically insignificant. Only one (0.2%) infant had a probable true bacteremia caused by methicillin-susceptible Staphylococcus aureus. Among 621 (95.4%) infants who underwent urine cultures, seven (1.1%) had both bacteriuria and pyuria. Among them, only one (0.2%) infant had fever, which was deemed to have clinically significant urinary tract infection. Cerebrospinal fluid cultures in 31 infants were all negative.</p><p><strong>Conclusion: </strong>SBI were rare in neonates and infants aged < 90 days hospitalized for acute bronchiolitis. This suggests that routine sepsis workups and empirical antibiotic therapy are not necessary for most of these patients. A selective approach to bacterial testing and antibiotic therapy is strongly justified.</p><p><strong>What is known: </strong>•Empirical antibiotics are commonly used in infants aged ‹90 days with acute bronchiolitis due to concerns about concurrent serious bacterial infections.</p><p><strong>What is new: </strong>•Serious bacterial infections are extremely rare in infants aged ‹90 days hospitalized with acute bronchiolitis, regardless of fever.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"494"},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682180","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":"Does extended follow-up period after birth improve precision of diagnosis of congenital anomalies? An observational study based on the Berlin Embryotox project.","authors":"Corinna Weber-Schoendorfer, Nadia Maaß, Lukas Lohse, Evelin Beck, Christof Schaefer, Katarina Dathe","doi":"10.1007/s00431-025-06333-z","DOIUrl":"https://doi.org/10.1007/s00431-025-06333-z","url":null,"abstract":"<p><p>The aetiology of congenital anomalies is often difficult to assess. Genetic abnormalities can play a role or exogenous factors such as maternal medication during pregnancy. Observational studies require reliable data on both gestational time and dosage of drug exposure during pregnancy and, if applicable, on precise description of congenital anomalies in the infant. The Berlin Embryotox Centre carried out a questionnaire-based project to investigate whether longer follow-up periods after birth lead to more accurate diagnoses of congenital anomalies. The Berlin Embryotox Centre offers risk assessment on medication during pregnancy to health care providers and pregnant women. Follow-up questionnaires asking for course and outcome of pregnancy are routinely sent out 8 weeks after the estimated date of birth. In this project, three additional questionnaires were sent to women with a singleton live-born infant, asking for paediatric findings documented along routine examinations offered to all children in Germany at the age of approximately 6 months (U5), 1 year (U6) and 2 years (U7). In addition, parents were asked to report their observations on the child's development. Data were collected between March 2019 and May 2024. A total of 3719 parents completed at least one of the three additional follow-up questionnaires. Results of the standard questionnaire 8 weeks after birth showed 138 infants with a major defect and 13 with a genetic disorder. At the end of the extended follow-up period, 180 children were reported to have a major birth defect and 39 a genetic disorder. The rate of major birth defects increased from 3.7% to 4.8%. Gain of information was largest between the examinations at 8 weeks and 6 months.</p><p><strong>Conclusion: </strong>Extending the observation period beyond the neonatal period substantially improves diagnostic accuracy in terms of completeness and specification of congenital anomalies including genetic disorders. Studies on the risk and safety of drugs in pregnancy would benefit considerably from routine follow-up for at least 6 months after birth.</p><p><strong>What is known: </strong>• Diagnosis of congenital anomalies is often incomplete during the neonatal period. • A longer follow-up period increases the completeness of recorded congenital anomalies.</p><p><strong>What is new: </strong>• Regarding major birth defects, gain of information after the neonatal period is largest up to the age of 6 months. • Only one-third of genetic diseases were diagnosed during the neonatal period, a further third up to the age of 6 months.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"495"},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689664","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":"C-reactive protein-to-lymphocyte ratio and hemoglobin-to-red cell distribution width ratio as effective prognostic predictors in pediatric patients with neuroblastoma.","authors":"Qi Wu, Chencheng Xu, Zhiyao Cao, Jingchun Lv, Yali Han, Gebu Teng, Zhou Wu, Feng Tian, Dapeng Jiang","doi":"10.1007/s00431-025-06334-y","DOIUrl":"https://doi.org/10.1007/s00431-025-06334-y","url":null,"abstract":"<p><p>Inflammatory responses critically influence tumor progression, yet traditional inflammatory biomarkers in neuroblastoma (NB) research lack optimal sensitivity and specificity. This study aimed to evaluate the prognostic value of two pretreatment inflammatory biomarkers: the C-reactive protein-to-lymphocyte ratio (CLR) and hemoglobin-to-red cell distribution width ratio (HRR) in NB patients. A retrospective analysis was conducted on NB patients diagnosed and treated at Shanghai Children's Medical Center (2016-2022). Pretreatment blood parameters (within 1 week before therapy) were utilized to calculate CLR, HRR, and conventional biomarkers. Optimal cutoff values for each inflammatory biomarker were defined separately. Multivariate Cox regression models identified independent prognostic factors, while Kaplan-Meier curves with log-rank tests assessed survival differences. The cohort included 201 NB children (95 males, 106 females; median age, 37 months). CLR and HRR demonstrated clinically significant predictive accuracy (AUC > 0.7) over traditional biomarkers for both progression-free and overall survival. Elevated ferritin (hazard ratio = 0.35; 95% confidence interval, 0.14-0.90; P = 0.030) independently predicted poor short-term outcomes. For long-term survival, high CLR (hazard ratio = 0.20; 95% confidence interval, 0.05-0.86; P = 0.031) and low HRR (hazard ratio = 2.91; 95% confidence interval, 1.19-7.13; P = 0.019) were significant independent predictors. Kaplan-Meier survival curves demonstrated that high CLR and low HRR were associated with poor long-term outcomes in NB patients (P < 0.05). Intergroup comparisons indicated that the high-CLR and low-HRR groups were predominantly composed of high-risk M-stage patients (P < 0.05).</p><p><strong>Conclusion: </strong>CLR and HRR outperform conventional inflammatory biomarkers as pretreatment prognostic indicators in NB. Elevated CLR and reduced HRR were strongly linked with advanced-stage grouping and adverse long-term outcomes and may serve as effective practical tools for enhancing clinical risk stratification in pediatric NB.</p><p><strong>What is known: </strong>•Neuroblastoma is the most common extracranial solid malignancy in children, and inflammatory biomarkers can effectively predict its prognosis.</p><p><strong>What is new: </strong>•CLR and HRR are cost-effective biomarkers that enhance risk stratification and correlate strongly with adverse long-term prognosis in NB.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"493"},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674220","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":"Expert review of CLABSI prevention in the NICU: supporting the transition of investigational drugs into clinical practice.","authors":"Paolo Manzoni, David A Kaufman, Victoria Niklas, Mario Giuffrè, Anne-Sylvie Ramelet, Daniele De Luca","doi":"10.1007/s00431-025-06329-9","DOIUrl":"10.1007/s00431-025-06329-9","url":null,"abstract":"<p><p>Central venous catheters (CVCs) are essential for administering life-saving medications, parenteral nutrition, and fluids in extremely premature (EP; i.e., 28 weeks' gestational age) infants. Indeed, CVCs have enabled increased survival and improved outcomes in EP infants over the last several decades. However, CVCs remain a major risk factor for central line-associated bloodstream infection (CLABSI), which can lead to serious complications in this vulnerable population. While many neonatal intensive care units (NICUs) have adopted CVC bundles to reduce CLABSI risk, implementation remains inconsistent, contributing to significant variability across centers. A minimized and reproducible baseline rate of CLABSI is important not only to physicians caring for EP infants and their families but also to clinical investigators and regulatory authorities in the evaluation of experimental therapies aimed at combating the complications of prematurity, such as bronchopulmonary dysplasia, retinopathy of prematurity, and impaired neurological development. CLABSIs may confound clinical outcomes and thus impact the interpretation of trial results. We propose a standardized central line bundle, informed by current clinical practice and a critical appraisal of the literature, for mandatory use in clinical trials.</p><p><strong>Conclusion: </strong>Consistent application of a standardized central line bundle would reduce variability in baseline CLABSI rates across study sites, enabling more accurate benefit-risk assessments of experimental therapies, particularly those requiring central venous access, in this population of infants with a high unmet medical need.</p><p><strong>What is known: </strong>• Central venous catheters (CVCs) are essential for administering life-saving treatments in extremely premature infants, significantly improving their survival and outcomes. CVCs, however, are known to increase the risk of central line-associated bloodstream infection (CLABSI). • Central line bundles are routinely implemented in clinical practice with demonstrable benefit in reducing CLABSI. Still, their impact often wanes as the focus and stringency on bundle components and audit programs decrease.</p><p><strong>What is new: </strong>• We propose a standardized central line bundle for mandatory use in clinical trials. This will help reduce variability in baseline CLABSI rates across study centers, enabling a more accurate evaluation of the benefit-risk profile of experimental therapies-especially those requiring administration via central venous catheters.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"492"},"PeriodicalIF":3.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667450","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":"Rib-indexed quantitative lung ultrasound versus chest X-ray for lung recruitment assessment in neonates with moderate-severe ARDS on surfactant therapy combined with prone position: a prospective observational study.","authors":"Xia Ouyang, Li Fang, Huichen Yang, Qiongxia Ou, Haihong Zhang, Shaoru Huang, Fa Chen, Yanfang Fan, Wen Ling, Yunfeng Lin","doi":"10.1007/s00431-025-06313-3","DOIUrl":"10.1007/s00431-025-06313-3","url":null,"abstract":"<p><p>Serial lung recruitment assessment in neonates with moderate-to-severe neonatal acute respiratory distress syndrome (NARDS) is crucial. However, current methods involve ionizing radiation or invasiveness, which limits their serial use in neonates. This study evaluated the feasibility of rib-indexed quantitative lung ultrasound (LUS) as a radiation-free alternative for monitoring lung aeration in neonates with moderate-to-severe NARDS on surfactant therapy combined with prone position. A prospective observational study enrolled 35 term neonates with moderate-to-severe NARDS. Lung recruitment was assessed via anterior-posterior approach rib-indexed quantitative LUS and posteroanterior chest X-ray (CXR) before and 6 h after combined surfactant therapy and prone position. Following the intervention, it demonstrated a significant reduction in the LUS aeration score, from a pre-intervention median of 18 points (IQR 16, 22) to a post-intervention median of 15 points (IQR 12, 20) (P < 0.001). In contrast, the decrease in the CXR score (pre-intervention median 3 (IQR 3, 4) vs. post-intervention median 2 (IQR 2, 3)) did not reach statistical significance (P = 0.059). Posterior approach rib-indexed quantitative LUS showed high concordance with posteroanterior CXR in determining the rib level of the pulmonary-diaphragmatic interface (ICC > 0.95, kappa > 0.94, P < 0.001). No adverse events occurred during the LUS assessments.Conclusion: Posterior approach rib-indexed quantitative LUS is a reliable and non-invasive modality for real-time lung recruitment assessment in neonates with NARDS. It significantly detected improved lung aeration following surfactant therapy combined with prone position, whereas CXR failed to demonstrate a statistically significant improvement. Posterior approach rib-indexed quantitative LUS can also determine the rib level of the pulmonary-diaphragmatic interface, similarly to posteroanterior CXR. The superior sensitivity and safety of rib-indexed quantitative LUS offer a clinically valuable and innovative alternative for dynamic monitoring of lung recruitment in neonatal critical care. Future multi-centre studies should integrate CT validation to confirm broader applicability.Trial registration: The trial was prospectively registered with the Chinese Clinical Trial Registry (ChiCTR2300074652) on August 11, 2023.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"489"},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658774","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":"Comparative evaluation of ChatGPT and LLaMA for reliability, quality, and accuracy in familial Mediterranean fever.","authors":"Aslıhan Uzun Bektaş, Balahan Bora, Erbil Ünsal","doi":"10.1007/s00431-025-06318-y","DOIUrl":"10.1007/s00431-025-06318-y","url":null,"abstract":"<p><p>Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease. Large language models (LLMs) offer rapid access to medical information. This study evaluated and compared the reliability, quality, and accuracy of ChatGPT-4o and LLaMA-3.1 for FMF. Single Hub and Access Point for Paediatric Rheumatology in Europe (SHARE) and European League Against Rheumatism (EULAR) guidelines were used for question generation and also for answer validation. Thirty-one questions were developed from a clinician's perspective based on the related guidelines. Two pediatric rheumatologists with over 20 years of FMF experience independently and blindly evaluated the responses. Reliability, quality, and accuracy were assessed using the modified DISCERN Scale, Global Quality Score, and the guidelines, respectively. Readability was assessed using multiple established indices. Statistical analyses included the Shapiro-Wilk test to assess normality, followed by paired t-tests for normally distributed scores, and Wilcoxon signed-rank tests for non-normally distributed scores. Both models demonstrated moderate reliability and high response quality. In terms of alignment with the guidelines, LLaMA provided fully aligned, complete, and accurate responses to 51.6% (16/31) of the questions, whereas ChatGPT provided such responses to 80.6% (25/31). While 9.7% (4/31) of LLaMA's responses were entirely contradictory to the guidelines, ChatGPT did not produce any such responses. ChatGPT outperformed LLaMA in terms of accuracy, quality, and reliability, with statistical significance. Readability assessments showed that both LLMs required college-level understanding.</p><p><strong>Conclusion: </strong>While LLMs show great promise, current limitations in accuracy and guideline adherence mean they should supplement, not replace, clinical expertise.</p><p><strong>Clinical trial registration: </strong>This study does not involve clinical trials; therefore, no clinical trial registration is required.</p><p><strong>What is known: </strong>•FMF is the most common hereditary autoinflammatory disease. LLMs are increasingly used to provide clinical information.</p><p><strong>What is new: </strong>•This is the first study to assess two different LLMs in the context of FMF, evaluating their reliability, quality, and alignment with clinical guidelines. ChatGPT-4o outperformed LLaMA-3.1 in reliability,quality, and guideline alignment for FMF. However, both models showed informational gaps that may limit their clinical use.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"491"},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658772","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":"An AI-assisted tool for automated growth monitoring in pediatric achondroplasia.","authors":"Eyal Cohen-Sela, Yael Lebenthal, Avivit Brener, Ravit Regev, Lars Hagenäs","doi":"10.1007/s00431-025-06321-3","DOIUrl":"10.1007/s00431-025-06321-3","url":null,"abstract":"<p><p>Growth assessment in achondroplasia requires disorder-specific growth charts incorporating sex- and age-specific values. Manual calculations are tedious and subject to error. We present an artificial intelligence (AI)-assisted tool that automates z-score calculations for pediatric patients with achondroplasia. The tool integrates European Lambda-Mu-Sigma (LMS) growth reference data for 9 anthropometric parameters: height, weight, body mass index, head circumference, sitting height, leg length, arm span, relative sitting height, and foot length. It inputs anthropometric measurements and transforms them into sex- and age-specific z-scores and percentiles in real time. Ten pediatric endocrinologists independently calculated anthropometric z-scores for 3 patients with achondroplasia using both the manual growth charts and the automated tool. Time-to-completion and accuracy were recorded and compared. The mean time required by the AI-assisted tool to calculate z-scores for all 9 parameters was significantly shorter than that required by manual calculation (23.4 ± 5.8 vs. 10.1 ± 2.8 min, p < 0.001). The tool demonstrated 100% agreement with manual LMS-based calculations and eliminated human errors to which manual calculations are subject, with significantly higher median absolute z-score deviation compared to the smart tool (0.17 [0.07-0.30] vs. 0 [0-0.01], p < 0.001).</p><p><strong>Conclusion: </strong>This AI-assisted tool provides a user-friendly, accessible, and highly accurate method for automated growth assessment in pediatric achondroplasia. It facilitates efficient clinical and research applications, with potential for future integration into electronic health records and web-based platforms.</p><p><strong>What is known: </strong>•Growth monitoring in achondroplasia requires syndrome-specific Lambda-Mu-Sigma based charts. •Manual z-score calculations are time-consuming and subject to error.</p><p><strong>What is new: </strong>•We present an AI-assisted Excel tool that automates z-scores and percentile calculations for 9 anthropometric parameters. •Performance and inter-user reliability testing by 10 pediatric endocrinologists showed significantly improved speed and accuracy over manual methods.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"490"},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658771","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":"Evaluation of drug provocation tests without prior skin testing in children with suspected penicillin allergy and correlation with PEN-FAST: A single-center study.","authors":"Halime Yağmur, Özge Atay, Damla Baysal Bakır, Gizem Kabadayı, Özge Kangallı Boyacıoğlu, Suna Asi̇lsoy, Nevin Uzuner","doi":"10.1007/s00431-025-06301-7","DOIUrl":"10.1007/s00431-025-06301-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate patients with suspected penicillin allergy in whom skin testing was omitted during immediate and delayed reactions before drug provocation test (DPT).</p><p><strong>Methods: </strong>This retrospective study analyzed patients aged 0-18 years with suspected penicillin allergy between 2020 and 2023. Data on hypersensitivity reaction history, laboratory tests, PEN-FAST scores, and DPT records were collected.</p><p><strong>Results: </strong>We evaluated 75 patients (male: 61.3%; median age at index reaction: 4 [range: 1-15] years) with suspected penicillin allergy. Nearly all reactions occurred at home (98.7%) following oral administration, with antihistamines being the most common treatment (56%). Urticaria was the most frequent manifestation in immediate reactions (30.7%), whereas maculopapular exanthema was predominant in delayed reactions (33.7%). Amoxicillin-clavulanic acid was the most frequently implicated drug (85.3%). The median PEN-FAST score was 3 (range: 0-5). Immediate reactions were significantly more common in females (p < 0.05). In total, 78 DPTs were performed, and four patients tested positive, all experiencing mild cutaneous reactions. No life-threatening reactions were observed. At the 3-month follow-up, 90.7% of patients tolerated beta-lactam antibiotics, though 4% chose to avoid them despite negative DPT results.</p><p><strong>Conclusion: </strong>In our study, we successfully performed DPT without major complications by omitting skin testing in both immediate and delayed reactions. Our findings suggest that in delayed reactions, direct DPT can safely replace skin testing. Notably, we also propose that after in vitro tests, DPT may be safely used in immediate reactions without additional in vivo testing. Also, this is the first study to evaluate PEN-FAST in children with suspected penicillin allergy in our country, offering practical value for clinicians and patients.</p><p><strong>What is known: </strong>• The label of drug allergy in children is assigned far more frequently than the actual diagnosis of true allergic reactions. • Due to unverified drug allergy diagnoses, patients face challenges such as inadequate treatment and the development of antibiotic resistance.</p><p><strong>What is new: </strong>• In cases with immediate reactions, including anaphylaxis, direct drug provocation test (DPT) performed without prior skin testing can be conducted without severe reactions. • The PEN-FAST score has been observed to be highly effective in ruling out beta-lactam allergy in pediatric patients with low scores.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"488"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658773","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":"Mental health risks in children with food allergies: a population-based comparison of food allergies with other chronic conditions.","authors":"Natalie Flaks-Manov, Inbal Goldshtein, Chen Yanover, Idit Lachover-Roth","doi":"10.1007/s00431-025-06316-0","DOIUrl":"https://doi.org/10.1007/s00431-025-06316-0","url":null,"abstract":"<p><p>Children with chronic diseases face a higher risk of mental health disorders. However, the cognitive consequences of food allergies (FA), which are not classified as a chronic disease, remain insufficiently researched. The objective of this study is to examine the association between FA and mental health in children and adolescents, compared to children and adolescents without FA (controls) and those with other chronic conditions but no history of FA. This is a retrospective cohort study using IQVIA Medical Research Data from UK primary care practices. Five cohorts of children aged 0-18 between 2000 and 2021 were defined: FA, control, asthma, atopic dermatitis (AD), and type 1 diabetes (T1D). The study included 1,130,721 children without FA (control), 23,263 with FA, 136,453 with asthma, 207,575 with AD, and 4835 with T1D. Compared to control, FA patients had higher risks of eating disorders (hazard ratio (HR) 1.85, 95% CI 1.42-2.41), anxiety (HR 1.35, 95% CI 1.25-1.45), and depression (HR 1.24, 95% CI 1.11-1.39). FA patients had lower depression risk than asthma and T1D patients (HR 0.77, 95% CI 0.68-0.87, 0.64, 95% CI 0.54-0.76, respectively) and lower anxiety risk than asthma patients (HR 0.86, 95% CI 0.79-0.91). FA patients' risk of eating disorders was not significantly different from asthma and T1D patients (HR 1.17, 95% CI 0.88-1.55, 1.58, 95% CI 0.81-3.10, respectively) but was significantly higher than in the AD group (HR 1.43, 95% CI 1.07-1.90).</p><p><strong>Conclusion: </strong>This study indicates that children with FA face elevated risks of anxiety, depression, and eating disorders compared to children without FA, and that these risks vary when compared to children with other chronic conditions. These findings highlight the need for integrated mental health support in FA management and greater awareness of FA's psychological impact among healthcare providers.</p><p><strong>What is known: </strong>• Children with chronic illnesses such as asthma and diabetes are known to have an elevated risk of mental health disorders. However, research on the mental health impact of food allergies remains limited.</p><p><strong>What is new: </strong>• This study reveals that children with FA have significantly increased risks of anxiety, depression, and eating disorders compared to children without FA and provides comparative insights into the mental health risks of FA relative to other chronic conditions like asthma, atopic dermatitis, type 1 diabetes, and healthy controls.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 8","pages":"483"},"PeriodicalIF":3.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642062","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}