European Journal of Pediatrics最新文献

{"title":"The effect of obesity on the GnRH stimulation test in girls with idiopathic central precocious puberty.","authors":"Ulku Gul Siraz, Ayse Karadag, Nazlı Sultan Ozsoy, Emine Kaygi Tartici, Aynura Aliyeva, Selim Kurtoglu, Nihal Hatipoglu","doi":"10.1007/s00431-025-06077-w","DOIUrl":"https://doi.org/10.1007/s00431-025-06077-w","url":null,"abstract":"<p><p>The gonadotropin-releasing hormone (GnRH) stimulation test is essential for diagnosing idiopathic central precocious puberty (ICPP). Research provided that luteinizing hormone (LH) levels during the test are lower in overweight and obese girls. This study aims to establish diagnostic cut-off values in the GnRH stimulation test specifically for overweight and obese girls with ICPP. Retrospective data from 925 girls diagnosed with ICPP or premature thelarche (PT) who underwent GnRH testing were analyzed. Patients were categorized into normal weight (NW) and overweight/obese (OW) groups based on Body Mass Index Standard Deviation Score (BMI-SDS), with BMI-SDS ≥ 1 indicating OW. Only patients with Tanner stage 2 or 3 breast development were included. The mean age at diagnosis was 7.9 ± 1.1 years in ICPP and 6.4 ± 1.4 years in PT. Among the patients, 455 (49.2%) were OW. In the OW-ICPP group, the peak LH cut-off was 3.56 IU/L (AUC:0.733; sensitivity:69.2%, specificity:64%), and the peak LH/FSH ratio was 0.29 (AUC:0.828; sensitivity:77.1%, specificity:76.3%). For NW patients, the peak LH cut-off was 4.75 IU/L (AUC:0.809; sensitivity:77.1%, specificity:70.7%), and the peak LH/FSH ratio was 0.3 (AUC:0.926; sensitivity: 86.3%, specificity: 86%). In the peak LH cut-off model, the multivariate analysis identified BMI-SDS as a significant negative predictor (OR:0.585, 95%CI: 0.477-0.717, p < 0.001), showing a strong inverse relationship. Similarly, in the peak LH/FSH ratio model, BMI-SDS remained a significant negative predictor (OR: 0.744, 95% CI: 0.614-0.902, p < 0.001).</p><p><strong>Conclusion: </strong>In this study, gonadotropin responses during the GnRH stimulation test were lower in overweight and obese girls with Tanner stage 2 and 3 ICPP compared to standard thresholds. It is important to utilize the GnRH test alongside clinical findings when diagnosing these patients, as responses below standard values do not rule out precocious puberty. This highlights the need for tailored diagnostic criteria to ensure timely and accurate diagnosis in this population.</p><p><strong>What is known: </strong>• Obesity is a risk factor for early puberty.</p><p><strong>What is new: </strong>• In girls with idiopathic central precocious puberty, obesity leads to lower values in the GnRH stimulation test compared to normal ranges. This may result in missed diagnoses, emphasizing the need to evaluate cases thoroughly with clinical data.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"254"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647759","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":"Global, regional, and national burden of congenital heart disease, 1990-2021: a systematic analysis for the global burden of disease study 2021.","authors":"Xiaoling Zhang, Yuxuan Feng, Jiajia Ren, Xuting Jin, Jiamei Li, Yanli Hou, Ruohan Li, Lingzhi Qin, Wanyuan Liu, Yawen Yang, Qingmiao Ma, Gang Wang","doi":"10.1007/s00431-025-06085-w","DOIUrl":"https://doi.org/10.1007/s00431-025-06085-w","url":null,"abstract":"<p><p>Congenital heart disease (CHD) is a major birth defect characterized by structural and functional heart abnormalities. This study provides updated estimates of CHD prevalence, mortality, and disability using the Global Burden of Disease (GBD) 2021 database. We examined the age-standardized rates of CHD prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021, stratified by gender, age group, and region. Temporal trends were evaluated using the estimated annual percentage change (EAPC), and associations with the Socio-Demographic Index (SDI) were examined to evaluate the influence of socioeconomic development. From 1990 to 2021, the global age-standardized prevalence rate (ASPR) of CHD remained stable (EAPC: 0.04%, 95% CI: 0.03%-0.05%), while the age-standardized mortality rate (ASMR) (EAPC: -2.38%, 95% CI: -2.44% to -2.32%) and DALYs rate (EAPC: -2.34%, 95% CI: -2.40% to -2.28%) showed significant declines. Among the SDI quintiles, low-SDI regions had the highest ASMR and age-standardized DALYs rates, whereas high-SDI regions demonstrated the highest ASPR. Males experienced higher ASMR and age-standardized DALYs rates than females. Meanwhile, infants under 28 days exhibited the highest prevalence rate (1,539.77 per 100,000 population, 95% UI: 1,309.62 to 1,805.88), mortality rate (760.25 per 100,000 population, 95% UI: 609.51 to 944.66), and DALYs rate (68,489.79 per 100,000 population, 95% UI: 54,902.56 to 85,088.24) in 2021.</p><p><strong>Conclusion: </strong>Despite the global decline in CHD-related mortality and DALYs, targeted strategies are crucial for low-SDI regions, males, and infants under 28 days. Improving prenatal screening, maternal nutrition, and pediatric cardiology services can address persistent disparities in CHD outcomes.</p><p><strong>What is known: </strong>• Congenital heart disease (CHD), characterized by structural and functional heart abnormalities during embryonic development, is one of the most common type of congenital defects. • While the global age-standardized mortality rate (ASMR) related to CHD declined significantly from 1990 to 2017, it remained notably high in low-SDI and lower-middle-SDI regions in 2017.</p><p><strong>What is new: </strong>• Infants under 28 days of age had the highest prevalence, mortality, and Disability-Adjusted Life Years (DALYs) rates related to CHD. • Males had higher ASMR and age-standardized DALYs rates compared to females.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"253"},"PeriodicalIF":3.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633898","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":"Clinical characteristics of children with anti-N-methyl-D-aspartate receptor encephalitis with and without anti-myelin oligodendrocyte glycoprotein antibody.","authors":"Yuan Xue, Yuhang Li, Hanyu Luo, Jiannan Ma, Xiujuan Li, Siqi Hong, Wei Han, Li Jiang","doi":"10.1007/s00431-025-06078-9","DOIUrl":"https://doi.org/10.1007/s00431-025-06078-9","url":null,"abstract":"<p><p>To analyze the clinical characteristics of an overlapping syndrome, MNOS, of anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab) coexisting with anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) in children. We included patients with NMDARE at Children's Hospital of Chongqing Medical University between 2018 and 2022 and conducted a comparison between NMDARE with and without MOG-Ab. Among 163 patients with NMDARE, 15 individuals tested positive for MOG-Ab. The median age of MNOS was 11 years (IQR 8-13). Furthermore, 10 out of 15 were female. More than half of MNOS experienced a prior history of encephalitis or demyelinating disorders. Among ten patients with low MOG-Ab titers, two met the diagnostic criteria for MOGAD. All five patients with high MOG-Ab titers satisfied the criteria for MOGAD. A total of seven patients diagnosed with MOGAD presented with acute disseminated encephalomyelitis. The proportion of prodromal symptoms and brain lesions, the neutrophil counts, and the frequency of mycophenolate mofetil administration were significantly higher in MNOS compared to NMDARE patients without MOG-Ab (p < 0.05). The outcomes of MNOS were favorable and comparable to those observed in NMDARE. Nevertheless, MNOS demonstrated a higher tendency to relapse, with rates of 60.0% compared to 3.1% (p < 0.001).</p><p><strong>Conclusion: </strong>Pediatric MNOS exhibited a high prevalence among females, particularly those with a prior history of MOGAD or encephalitis. MNOS had a favorable prognosis but with a high relapse rate. Coexisting MOG-Ab in pediatric MNOS may be pathogenic or a bystander, potentially correlating with antibody titers.</p><p><strong>What is known: </strong>• Pediatric anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) coexisting with anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab) generally has a favorable prognosis, albeit with a tendency to relapse. • Pediatric NMDARE coexisting with MOG-Ab may exhibit imaging features indicative of demyelination.</p><p><strong>What is new: </strong>• Pediatric patients of MOG-Ab coexisting with NMDARE overlapping syndrome (MNOS) were predominantly observed in females, particularly those with a history of MOG-Ab-associated disorder (MOGAD) or encephalitis. • Compared with NMDARE patients, pediatric MNOS patients had higher neutrophil counts and more frequently exhibited abnormal MRI findings in the basal ganglia, insular lobe, temporal lobe, thalamus, and cerebellum.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"249"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624080","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":"A web-based questionnaire to evaluate risk factors to develop cow milk allergy.","authors":"Meltem Dinleyici, Koray Harmanci, Didem Arslantas, Yvan Vandenplas, Ener Cagri Dinleyici","doi":"10.1007/s00431-025-06070-3","DOIUrl":"10.1007/s00431-025-06070-3","url":null,"abstract":"<p><p>Many environmental, genetic, and epigenetic variables are considered to influence the evolution of cow's milk allergy (CMA). The gastro-intestinal microbiota may play a direct role in or inhibit tolerance development. In this study, we planned to evaluate the presence of previously identified risk factors for microbiota composition. This study used a cross-sectional electronic survey in Turkiye, utilizing a national convenience sample of 270 children with CMA, as reported by their caregivers, and 2154 healthy controls. We developed a web-based questionnaire to gather information on pregnancy and maternal-related factors, delivery mode, feeding patterns, antibiotic use, and the presence of pets in the home. The risk factors affecting CMA were maternal age (OR 0.897; 0.862-0.934, p < 0.01), presence of maternal allergic disorders (OR 3.070; 1.891-4.983, p < 0.001) and in both parents (OR 3.831; 1.202-12.210, p < 0.001), maternal weight at conception (OR 1.016; 1.003-1.030, p < 0.05), maternal weight gain during pregnancy (OR 1.033; 1.012-1.056, p < 0.01), (absence of a) pet at home (OR 1.394; 1.003-1.938, p < 0.05), intrapartum antibiotic use (OR 1.469; 1.092-1.975, p < 0.05), antibiotic use during the first 6 months of life (OR 1.933; 1.306-2.863, p < 0.001), and number of householders (OR 0.794; 0.650-0.969, p < 0.05).</p><p><strong>Conclusion: </strong>In addition to allergic disorders in parents, maternal weight and weight gain during pregnancy, intrapartum and first 6 months of life antibiotic use, and the presence of pets at home were found to be microbiota-related risk factors in children with CMA. Potential strategies related to microbiota composition may contribute positively to the disease's development and progression.</p><p><strong>What is known: </strong>• The gut microbiome contributes to the development of cow milk allergy, and disrupted microbiota maturation during the first year of life appears to be common in pediatric food allergies. • Factors that influence an infant's microbiota within the first 1000 days and the relationship between these factors and microbiota may enhance allergy diagnosis, prevention, and treatment.</p><p><strong>What is new: </strong>• Besides parental allergy disorders, maternal weight and weight gain during pregnancy, antibiotic use during intrapartum and first six months of life, and the presence of pets at home were identified as microbiota-related risk factors in children with CMA.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"250"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630267","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":"The impact of COVID-19 pandemic on sarcopenic obesity among children between 6 and 10 years of age: a prospective study.","authors":"Bahar Öztelcan Gündüz, Aysu Duyan Çamurdan, Mücahit Yıldız, Fatma Nur Baran Aksakal, Emine Nükhet Ünsal","doi":"10.1007/s00431-025-06067-y","DOIUrl":"10.1007/s00431-025-06067-y","url":null,"abstract":"<p><p>This study aims to examine the effects of physical activity, eating habits, sleep patterns, and media use on children's body composition during the COVID-19 pandemic, as well as the relationship of these factors with sarcopenic obesity (SO). This prospective cross-sectional study has involved 431 healthy male and female child participants aged between 6 and 10 years during the COVID-19 pandemic lockdown period. The daily routines of participants, including their dietary habits, levels of physical activity, and media usage patterns, have been assessed. The anthropometric measurements taken included body weight, height, body mass index (BMI), and skinfold thickness assessments. Body composition analyses have been conducted using the bioelectrical impedance (BIA) method to determine the total body fat and muscle mass as well as the fat percentage. It has identified obesity in 25.2% and SO in 9.5%. Children with SO have had mean BMI SDS of 2.67 ± 0.4 and mean waist circumference of 78.5 ± 9 cm. Fruit consumption OR = 2.68, 95% CI (1.13-6.31), the number of household members OR = 0.54, 95% CI (0.35-0.84), the duration of sitting time OR = 1.17, 95% CI (1.02-1.36)], and junk food consumption OR = 1.27, 95% CI (1.03-1.57)] have been found to be effective in the development of SO.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic has had a significant impact on the body composition of children, resulting in an increased prevalence of obesity and sarcopenic obesity. This research highlights the critical importance of engaging in regular physical activity, consuming a balanced diet, and obtaining sufficient sleep, particularly during times of crisis.</p><p><strong>What is known: </strong>• Sarcopenic obesity is a complex metabolic condition characterized by reduced muscle mass and increased adipose tissue. • COVID-19 pandemic-related physical inactivity potentially has led to adverse effects on muscle mass composition.</p><p><strong>What is new: </strong>• First comprehensive assessment of sarcopenic obesity development in children during the COVID-19 pandemic, utilizing advanced bioelectrical impedance analysis (BIA) to evaluate changes in muscle mass and adipose tissue. • Systematic evaluation of the impact of sedentary lifestyle and dietary habits on sarcopenic obesity during the unprecedented lockdown period.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"251"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630274","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":"Parental knowledge of developmental milestones in Peshawar, Pakistan: a cross-sectional study.","authors":"Bareera Asad, Musawaira Noor, Eeman Sohail, Inam Ullah, Bashir Ahmad","doi":"10.1007/s00431-025-06088-7","DOIUrl":"https://doi.org/10.1007/s00431-025-06088-7","url":null,"abstract":"<p><p>Developmental milestones are significant achievements in a child's growth and development across various domains including physical, cognitive, language, social, emotional, and adoptive development. These milestones mark important transitions from simple reflexes to complex skills and behaviors in a child's life. A cross-sectional analytical study was conducted involving 225 parents using convenience sampling at the pediatrics OPD of Northwest General Hospital, Peshawar. The study was conducted in June 2024. A structured questionnaire was employed to assess parental knowledge of developmental milestones and their sources of information. The data was analyzed using SPSS v27. This study aimed to assess parental knowledge regarding developmental milestones in children. It also explores various sources used by the parents for information regarding their children's health and development. Two hundred twenty-five parents including 89 (39.6%) males and 136 (60.4%) females averaging 35.5 years of age participated in the study. Two hundred twenty-two (98.7%) were married and more than half were working jobs or owning businesses. Parents showed poor levels of knowledge in all four domains, i.e., physical, cognitive, social, and emotional development. They scored 9.2% in physical, 20.6% in cognitive, 14.5% in social, and 10.07% in emotional developmental milestones. Most parents (161 (75%)) relied on advice from friends and family. Parenting seminars and courses were unpopular sources of information as more than 193 (85%) \"never\" attended any. No significant difference (p > 0.05) in knowledge was observed across different genders of the parents and child, socioeconomic status, and education level. The knowledge of \"emotional developmental milestones\" showed a slightly positive statistically significant correlation (Pearson correlation coefficient, 0.149; p-value = 0.026) with \"the number of children under 14.\"</p><p><strong>Conclusion: </strong>Parents are poorly informed about developmental milestones. Most parents rely on relatives and friends instead of parenting workshops, courses, or consulting their caregivers and doctors.</p><p><strong>What is known: </strong>• Parents in the Northwestern regions of Pakistan have one of the lowest literacy rates in the world. • No studies have been done to investigate parental knowledge regarding the development of children in Peshawar, Pakistan.</p><p><strong>What is new: </strong>• Parents in Peshawar, Pakistan have subpar knowledge of developmental milestones of children. • Most parents rely on advices from their friends and family instead of attending parenting seminars, reading books or other r helpful material.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"248"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624084","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":"Osmolality of compounded oral liquids for pediatrics.","authors":"Marine Cavelier, Charles Hervouët, Rémi Varin, Henri Gondé","doi":"10.1007/s00431-025-06080-1","DOIUrl":"https://doi.org/10.1007/s00431-025-06080-1","url":null,"abstract":"<p><p>Compounding oral liquids is a common practice in pediatrics given the scarcity of medications suitable for children. However, compounded products are unlicensed. Their safety, effectiveness and quality are not assessed by regulatory agencies. Then, the assessment of critical characteristics of compounded medications relies on compounding pharmacies. Since the osmolality of oral liquids may contribute to gastrointestinal complications, this study aimed to evaluate the osmolality of compounded oral liquid medications. The osmolality of compounded liquid medications listed in the formulary of our institution was measured. The source of the active pharmaceutical ingredient and the vehicle of each compounded medication were collected. Results showed that 61% of the 28 compounded medications exceeded the recommended threshold of 450 mOsm/kg. The primary determinant of osmolality was found to be the vehicle used in compounding, with commercial vehicles being associated with higher osmolality values. The active pharmaceutical ingredient had minimal influence on the osmolality.</p><p><strong>Conclusion: </strong>These findings underscore the importance of the vehicle in the osmolality of compounded oral liquids. Careful selection of compounding vehicles is required to minimize the risks associated with high-osmolality medications, especially for vulnerable populations such as enterally fed neonates. The systematic assessment of osmolality of compound medication would support the implementation of strategies to mitigate the risks associated with high osmolality and improve the safety of compounded pediatric medications.</p><p><strong>What is known: </strong>• Compounded oral liquid medications are widely used in pediatrics due to the limited availability of commercial pediatric formulations. • High osmolality in liquid oral medications may contribute to adverse effects.</p><p><strong>What is new: </strong>• This study highlighted the significant impact of the compounding vehicle on the osmolality of compounded oral liquid medications. • Careful selection of compounding vehicles is important, especially for vulnerable children.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"252"},"PeriodicalIF":3.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630185","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":"Recurrent dizziness among adolescents in Denmark: Trends 1991-2022 and associations with sociodemographic factors, health, and health behaviours.","authors":"Bjørn E Holstein, Mogens Trab Damsgaard, Trine Pagh Pedersen, Mette Rasmussen, Mette Toftager, Katrine Rich Madsen","doi":"10.1007/s00431-025-06076-x","DOIUrl":"10.1007/s00431-025-06076-x","url":null,"abstract":"<p><p>1) to study time trends in the prevalence of recurrent dizziness among adolescents in Denmark 1991-2022, and 2) to examine how dizziness was associated with sociodemographic factors, mental health related factors, health status, and health behaviours in 2022. The study focused on recurrent dizziness, i.e. episodes of dizziness several times a week during the last six months. Data stem from the Danish arm of the international Health Behaviour in School-aged Children (HBSC) study which included 11-, 13- and 15-year-olds from random samples of schools in nine comparable surveys from 1991 to 2022, n = 40,102. We applied multivariate logistic regression analyses in the 2022 dataset (n = 5,737) to examine how dizziness was associated with other factors. In 2022, the prevalence of recurrent dizziness was 14.3% (boys 8.8%, girls 19.7%), significantly higher than the 7.1% in the surveys 1991-2018. The prevalence in 2022 was significantly higher among girls, older students, and students not living with both parents. Dizziness was significantly elevated among students with short sleep duration, who skipped breakfast, used alcohol and tobacco, felt lonely, had low life satisfaction, low self-esteem, were exposed to bullying at school, felt high schoolwork pressure, low school satisfaction, who were underweight, overweight, had poor self-rated health, chronic illness, injuries in the last year, headache, stomachache, backpain, feeling low, irritability/bad temper, nervousness, difficulties falling asleep, and poor/restless sleep.</p><p><strong>Conclusion: </strong>The study suggested that dizziness is a general indicator of not feeling well, run down, or suffering rather than a sign of specific somatic health problems.</p><p><strong>What is known: </strong>• Recurrent dizziness is common among adolescents and may limit daily activities and harm quality of life. • Recurrent dizziness in adolescence may reflect somatic and mental health problems and is strongly associated with headache.</p><p><strong>What is new: </strong>• The prevalence of recurrent dizziness among adolescents in Denmark was stable 1991-2018 and increased steeply from 2018 to 2022. • Recurrent dizziness was strongly associated with poor health behaviours, a broad range of somatic and mental health problems, and exposure to stressors.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"247"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624086","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":"Distinct seasonality and increased respiratory failure in RSV patients < 2 years of age after emergence of SARS-CoV-2: data from the multicentric, prospective PAPI study.","authors":"Jessica Bähre, Matthias Lange, Patrick Salaschek, David Twardella, Stefan Arens, Frank Eberhard, Grit Barten-Neiner, Marcus Panning, Holger Köster, Cordula Körner-Rettberg, Martin Wetzke, Christine Happle","doi":"10.1007/s00431-025-06057-0","DOIUrl":"10.1007/s00431-025-06057-0","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is a leading cause for global infant morbidity and mortality. The COVID-19 pandemic caused significant shifts in seasonality of RSV, and changes in disease severity have been matter of intense discussion. Between September 2020 and February 2023, the multicentric, prospective PAPI study analyzed rates and phenotypes of hospitalized RSV patients aged ≤ 24 months across three German hospitals. Pseudonymized patient data were analyzed employing Mann-Whitney U and chi-square testing, or one-way ANOVA or Kruskal-Wallis testing when more than two groups were compared. Additionally, RSV cases from seasons 2017/2018-2020/2021 were retrospectively analyzed. After its absence in 2020/2021, RSV returned approximately 2 months earlier than usual in late 2021. Overall duration of the season and patient numbers were comparable to previous seasons, and no significant shifts in age and gender distributions occurred in our cohort. While duration of hospitalization did not differ between the periods before vs. after the emergence of SARS-CoV-2, a significantly higher rate of patients with hypoxemia and respiratory failure occurred after the onset of the pandemic (oxygen supplementation post vs. pre: 59.4% vs. 54.8%, p < 0.001, non-invasive ventilation post vs. pre: 12.4% vs. 7.2%; p < 0.001). No deaths occurred during the entire observational period.</p><p><strong>Conclusion: </strong>We present comprehensive data on distinct seasonality and increased disease severity in children hospitalized with RSV bronchiolitis before and after the onset of the SARS-CoV-2 pandemic. Our data aids in understanding the impact of the pandemic on RSV disease in infants and provides valuable information on the impact of RSV on pediatric healthcare prior to broad introduction of novel prevention measures such as nirsevimab.</p><p><strong>What is known: </strong>• Respiratory syncytial virus (RSV) is a leading cause of infant morbidity and mortality globally. • COVID-19 has led to significant shifts in RSV seasonality, and concerns about shifts in RSV severity.</p><p><strong>What is new: </strong>• This study shows distinct seasonality and significant shifts in diseases severity amongst children with RSV associated hospitalization under the age of 2 yrs in the last years in Germany. • It reports significantly higher rates of RSV associated respiratory failures in children < 2 yrs. of age after emergence of the pandemic.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"246"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624082","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":"A global cross-sectional survey on neonatal analgosedation: unveiling global trends and challenges through latent class analysis.","authors":"Cristina Arribas, Giacomo Cavallaro, Nunzia Decembrino, Juan Luis González, Carolina Lagares, Genny Raffaeli, Anne Smits, Sinno P H Simons, Eduardo Villamor, Karel Allegaert, Felipe Garrido","doi":"10.1007/s00431-025-06074-z","DOIUrl":"10.1007/s00431-025-06074-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to analyze global prescribing patterns for analgosedation in neonates during four critical care scenarios. The research explores existing patterns, their association with geographic and sociodemographic index (SDI), and adherence to evidence-based practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from a 2024 global survey of 924 responses to 28 questions were analyzed, focusing on four items for their high variability: premedication in intubation (Q17), sedation in preterm (Q19) and full-term newborns (Q23), and perinatal asphyxia (Q26). Latent class analysis (LCA) classified neonatal intensive care unit (NICU) prescriptions into patterns, assigning participants to the most likely class. Demographic variables, including geographic region and SDI, were compared using chi-square tests to assess associations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three distinct prescribing patterns emerged for each scenario. In premedication during intubation, Europe and North America predominantly used Class 1, adhering to guidelines with fentanyl, atropine, and muscle relaxants. In contrast, Class 2, standard in Asia and Latin America-Caribbean, primarily utilized fentanyl and midazolam, with rare use of atropine and muscle relaxants. For analgosedation in newborns, higher-SDI NICUs favored fentanyl, while lower-SDI NICUs preferred midazolam or morphine combinations. In perinatal asphyxia cases, fentanyl was the leading choice in Class 3, especially in Europe. Dexmedetomidine use was limited, primarily appearing in Class 1 NICUs.  CONCLUSION: The study highlights substantial regional variability in neonatal analgosedation, influenced by SDI and geography. Despite established guidelines, gaps in evidence-based implementation persist. These findings underscore the need for global standardization of neonatal care protocols and further research on the long-term safety of midazolam and dexmedetomidine.  What is Known: • Previous research has demonstrated significant disparities in prescribing patterns for neonatal analgosedation across geographic areas influenced by demographic and socioeconomic factors. • Midazolam remains a commonly utilized agent in neonatal analgosedation despite evidence suggesting potential neurodevelopmental risks, particularly in premature infants. • Current guidelines regarding neonatal analgesia and sedation, including premedication for endotracheal intubation, are not consistently implemented, particularly in regions characterized by lower sociodemographic indices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is new: &lt;/strong&gt;• This study employs Latent Class Analysis (LCA) to categorize global neonatal prescribing practices into three distinct patterns, elucidating regional differences and compliance with evidence-based guidelines. • Care providers working in countries with higher Sociodemographic Index (SDI) are more likely to adhere to evidence-based practices, such as intubation premedication, than regions with medium or mediu","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 4","pages":"241"},"PeriodicalIF":3.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614044","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}