European Journal of Pediatrics最新文献

{"title":"The effectiveness and sustained effects of exercise therapy to improve executive function in children and adolescents with autism: a systematic review and meta-analysis.","authors":"Hao Wang, Gong Cheng, Meng-Meng Li","doi":"10.1007/s00431-025-06115-7","DOIUrl":"https://doi.org/10.1007/s00431-025-06115-7","url":null,"abstract":"<p><p>This study rigorously examines the efficacy and sustained impact of exercise therapy on enhancing executive function among children and adolescents diagnosed with autism spectrum disorder (ASD). Furthermore, it conducts a comprehensive analysis of five distinct subgroups, categorized by variations in school age, exercise cycles, exercise characteristics, dimensions of executive function, and the administration of medication. A systematic search was conducted across the PubMed, EmBase, Cochrane Library, Web of Science, and SPORTDiscus databases to identify randomized controlled trials published from the inception of the library until October 20, 2024, focusing on the effects of exercise therapy on the enhancement of executive function in children and adolescents with ASD. Sixteen studies were systematically evaluated and included in the meta-analysis, revealing that exercise therapy led to a significant improvement in executive function among children and adolescents with ASD (SMD = 0.41, 95% CI [0.30, 0.52], P = 0.00), along with some evidence of sustained improvement (SMD = 0.74, 95% CI [0.29, 1.20], P = 0.00). Subgroup analyses indicated that exercise did not significantly enhance executive functioning in preschool-aged patients with ASD, and working memory did not exhibit a significant improvement across various dimensions of executive functioning. Furthermore, no differences were observed in analyses of different exercise cycles, exercise characteristics, or the use of medication among subjects.</p><p><strong>Conclusion: </strong>Exercise interventions improve executive function in children and adolescents with ASD, with sustained post-intervention effects. Limited impact on working memory and observed heterogeneity highlights the need for more precise intervention designs and rigorous research.</p><p><strong>What is known: </strong>• Exercise therapy is widely considered a promising non-pharmacological intervention for improving cognitive functions in children and adolescents with autism spectrum disorder (ASD). • Prior studies suggest exercise benefits executive function in ASD, but evidence on sustained effects and subgroup differences remains limited.</p><p><strong>What is new: </strong>• This meta-analysis confirms that exercise therapy significantly and sustainably improves executive function in children and adolescents with ASD, with greater benefits observed in school-aged participants. • For the first time, subgroup analyses reveal age-dependent effects and confirm that working memory shows limited responsiveness to exercise, regardless of medication use or exercise characteristics.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"286"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810844","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 tele-nursing on maternal self-efficacy and anxiety in post-discharge epilepsy care: an quasi-experimental study.","authors":"Marzieh Seif, Mohammad Reza Khodahakhshi, Reyhaneh Roozbahani, Maryam Dehghani, Hamideh Hakimi, Hadi Ranjbar, Afshin Fayyazi","doi":"10.1007/s00431-025-06111-x","DOIUrl":"https://doi.org/10.1007/s00431-025-06111-x","url":null,"abstract":"<p><p>Epilepsy is one of the most common neurological disorders and one of the chronic childhood diseases that affects many children every year. Therefore, the present study was conducted with the aim of determining the effect of tele-nursing after discharge on the self-efficacy and anxiety of mothers with children with epilepsy. In this quasi-experimental study, 90 mothers of children with epilepsy were selected by available sampling method and then randomly divided into two control and intervention groups. Demographic information questionnaire, Spielberger anxiety questionnaire and caregiver self-efficacy questionnaire were used to collect data. The intervention group was trained by telephone in the form of 10 telephone calls at regular intervals during two months. Data collected was analyzed using SPSS version 16 using descriptive and inferential statistics (independent t-test and paired t-test). The results showed that the two control and intervention groups were similar in terms of mother's age, gender, mother's occupation, and parents' education. In addition, the anxiety scores of the two groups were similar before the intervention, and after the intervention the two groups had a statistically significant difference (P < 0.001). In terms of the self-efficacy score, the two groups had a statistically significant difference after the intervention (P < 0.001), so in the intervention group, a decrease in anxiety and an increase in mothers' self-efficacy were observed.</p><p><strong>Conclusion: </strong>Tele-nursing after discharge caused a significant decrease in anxiety and increased self-efficacy of mothers in taking care of their children; therefore, it is recommended to use a comprehensive program in the form of tele-nursing according to parents' educational needs and wishes.</p><p><strong>What is known: </strong>• Tele-nursing and follow-up by nurses via telephone can reduce anxiety in mothers facing their child's epilepsy diagnosis. • Tele-nursing, focusing on both internal and external capacities, can enhance mothers' self-efficacy in caring for a child with epilepsy.</p><p><strong>What is new: </strong>• Mobile tele-nursing is an innovative and effective method for increasing community awareness and educating patients, which should be considered by health policymakers. • By addressing parents' questions and educational needs through tele-nursing, we can take steps to control anxiety and increase parents' self-efficacy.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"285"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810793","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":"Significance of ectopic intrathyroidal thymic tissue detected on ultrasound in different paediatric age groups: a proposed classification to guide investigation and management.","authors":"Hannah Jeffery, Karen D Bosch, Caroline Brain, Tom Kurzawinski, Tim Beale, Xin-Ying Kowa, Tarek Abdel Aziz","doi":"10.1007/s00431-025-06121-9","DOIUrl":"https://doi.org/10.1007/s00431-025-06121-9","url":null,"abstract":"<p><p>Ectopic aberrant thymic tissue is most commonly found in the thyroid gland and is increasingly found incidentally due to the widespread use of ultrasound. Correct identification of this benign pathology on ultrasound can avoid the morbidity associated with fine needle aspiration (FNA) and anxiety associated with a possible cancer diagnosis. A case series of 21 children found to have likely intrathyroidal thymic tissue on ultrasound scan of the neck between 2013 and 2024 at the University College London Hospital. Twenty-one children aged between six months and ten years old, 52% male and 48% female. The scans were performed following referral for a neck lump or cervical lymphadenopathy (N = 15), sore throat/cough (N = 4), pre-thyroidectomy scan for a Multiple Endocrine Neoplasia 2 patient (N = 1), and post cystic hygroma excision routine scan (N = 1). These well-defined hypoechoic foci ranged in size from 3 to 14 mm and direct comparison to normal thymic tissue was possible in 19/21 (90%). Three patients (14%) went on to have FNA to rule out papillary thyroid cancer (PTC); other cases had interval scans at median six months to confirm stable appearances.</p><p><strong>Conclusion: </strong>All patients in our study with intrathyroidal ectopic thymic tissue were younger than 10 years. We suggest a tailored management approach based on the age at presentation, presence of clear thymic tissue for comparison and past/family history. Given that it is unlikely for such tissue to be present in older children, an FNA would be recommended to exclude underlying thyroid cancer in children over 14 years.</p><p><strong>What is known: </strong>• Intrathyroidal thymic tissue is a common variant that will be increasingly incidentally picked up on ultrasound scans in chlidren.</p><p><strong>What is new: </strong>• We suggest separation of children with ectopic intrathyroidal thymic tissue into three groups based on age and the ability to compare directly with normal thymic tissue.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"284"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810795","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":"Family perspectives and experiences on implementing telehealth in pediatric palliative care: a qualitative approach.","authors":"Lucia Peñarrubia-San-Florencio, Carlos Godoy Junior, Silvia Ricart, Sergi Navarro Vilarrubí, Cristina Ruiz-Herguido, Arnau Valls Esteve, Julia Meca-Santamaria, Joan Blanco-Blanco, Laura Lahuerta Valls","doi":"10.1007/s00431-025-06124-6","DOIUrl":"https://doi.org/10.1007/s00431-025-06124-6","url":null,"abstract":"<p><p>Telehealth is seen as a promising avenue to improve accessibility and quality of pediatric palliative care (PPC) yet engaging users with digital tools (DT) over the long term poses a challenge. Aligning telehealth initiatives with the actual needs and expectations of families is crucial for sustainable care models. To explore family perspectives and experiences with telehealth in PPC, focusing on their needs, perspectives, concerns, and hopes to refine digital care models. This research employed a qualitative methodology, gathering data through a combination of semi-structured interviews and focus group discussions with primary caregivers (PCGs) of PPC patients. PCGs of children utilizing telehealth services in PPC contexts. Interviews with seven individuals and a focus group of eight revealed three main themes: the experience of engaging with a PPC service that utilizes telehealth, the transformative potential of telehealth within PPC, and the barriers and facilitators influencing its adoption. A key finding was the collective desire among PCGs for telehealth solutions that support a patient and family-centered, holistic care model that integrates various health services without compromising the humanized essence of care.</p><p><strong>Conclusions: </strong>Families are generally positive about integration of telehealth into PPC, emphasizing the need for telehealth models that maintain the core values of humanized care. Success depends on engaging end-users throughout development, implementing user-friendly technology that fits into family life, and focusing on customization for patients.</p><p><strong>What is known: </strong>• Telehealth has emerged as an innovative response to meet the increasing demand for highly specialized care in PPC. • Digital health solutions often face increasing abandonment rates over time.</p><p><strong>What is new: </strong>• Families caring for children with palliative needs are receptive to telehealth, identifying essential features for its long-term success. • They value the preservation of personal attention in care, emphasizing the importance of maintaining human connection alongside digital innovations.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"287"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810791","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":"Prediction of moderate to severe bleeding risk in pediatric immune thrombocytopenia using machine learning.","authors":"Xuelan Shen, Xiaoli Guo, Yang Liu, Xiaorong Pan, Haisu Li, Jianwen Xiao, Liping Wu","doi":"10.1007/s00431-025-06123-7","DOIUrl":"https://doi.org/10.1007/s00431-025-06123-7","url":null,"abstract":"<p><p>This study aimed to develop and validate a risk prediction model for moderate to severe bleeding in children with immune thrombocytopenia (ITP). Data from 286 ITP patients were prospectively collected and randomly split into training (80%) and test (20%) sets. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for feature selection. Among seven machine learning algorithms, the eXtreme Gradient Boosting (XGBoost) model demonstrated the best performance (AUC = 0.886, 95% CI: 0.790-0.982) and was selected as the optimal model. Shapley Additive Explanations (SHAP) were used for model interpretation, identifying child age, age at diagnosis, and initial platelet count as key predictors of moderate to severe bleeding risk.</p><p><strong>Conclusion: </strong>The XGBoost-based prediction model shows strong predictive performance and could assist healthcare providers in identifying high-risk ITP patients, supporting appropriate clinical decision-making.</p><p><strong>Trial registration number: </strong>ChiCTR2100054216, December 11, 2021 What is Known: • Current clinical practice relies solely on platelet counts to guide hospitalization and treatment in ITP children, often overlooking bleeding manifestations, leading to delayed or inappropriate treatment. Existing severe bleeding risk prediction models are primarily designed for adults and lack applicability to children.</p><p><strong>What is new: </strong> • This study prospectively collected data, enhancing accuracy. A novel machine learning-based prediction model was developed to assess moderate to severe bleeding risk in pediatric ITP patients.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"283"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802880","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":"How familial Mediterranean fever affects the characteristics of immunoglobulin a vasculitis in pediatric patients at the time of diagnosis?","authors":"Mehveş Işıklar Ekici, Elif Çelikel, Zahide Ekici Tekin, Vildan Güngörer, Cüneyt Karagöl, Melike Mehveş Kaplan, Nimet Öner, Merve Cansu Polat, Didem Öztürk, Emine Özçelik, Yasemin Uğur Es, Sultan Nilay Yoğun, Banu Çelikel Acar","doi":"10.1007/s00431-025-06091-y","DOIUrl":"10.1007/s00431-025-06091-y","url":null,"abstract":"<p><p>Familial Mediterranean fever (FMF) is the most common autoinflammatory disease of childhood and is frequently associated with systemic inflammatory diseases such as vasculitis. The aim of this study is to evaluate the impact of FMF on clinical and laboratory findings and disease activity of immunoglobulin A vasculitis (IgAV) at presentation. Patients with IgAV who were followed up for more than 3 months were included in the study. Patients were divided into two subgroups regarding presence of FMF. Demographic characteristics, clinical findings in the first 3 months, laboratory findings at the time of diagnosis, vasculitis activity scores (PVAS), and treatments administered were recorded. A total of 662 patients with IgAV were included in the study. FMF was diagnosed in 49 (7.4%) patients with IgAV. Patients with FMF had more gastrointestinal tract and renal involvement, higher PVAS score, higher C-reactive protein levels, and higher need for steroids, cyclophosphamide, and intravenous immunoglobulin (p = 0.01, p = 0.03, p < 0.001, p < 0.001, p = 0.04, p < 0.001, p = 0.01, respectively). When patients were analyzed according to MEFV mutations, the effect of FMF on vasculitis was more prominent especially in patients carrying homozygous and compound heterozygous mutations in exon 10.</p><p><strong>Conclusion: </strong> FMF may lead to more severe clinical and laboratory findings and disease activity at the time of IgAV diagnosis. The clinician should be aware that the course of IgAV may be affected by the presence of FMF.</p><p><strong>Trial registration: </strong>E2-24-6125, 21.01.2024, retrospectively registered.</p><p><strong>What is known: </strong>• In patients with familial Mediterranean fever (FMF), some vasculitides are more common and may affect the course of vasculitis.</p><p><strong>What is new: </strong>• At the time of immunoglobulin A vasculitis diagnosis, patients with FMF may have more system involvement, higher vasculitis activation scores, and acute phase reactants and require more intensive treatment than those without FMF.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"282"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802877","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":"Challenges in the clinical management of rare diseases and center-based multidisciplinary approach to creating solutions.","authors":"D Gunes, M Karaca, A Durmus, B Ak, N Aktay Ayaz, Z U Altınel, A D Aslanger, F Atalar, M C Balci, L Bilgin, F Darendeliler, D Demirkol, O Durmaz, A Gedikbasi, E Inan Balci, E Z Ince, S G Karadag, G Keskindemirci, K Nisli, M Ozcetin, A Somer, A Unuvar, M Uysalol, E Yildiz, Z N Yuruk Yildirim, M Demirkol, G F Gokcay","doi":"10.1007/s00431-025-06101-z","DOIUrl":"10.1007/s00431-025-06101-z","url":null,"abstract":"<p><p>The diagnosis and treatment of rare diseases present significant global challenges. This study aimed to identify the difficulties faced by specialists in the diagnosis and management of rare diseases, as well as to gather their recommendations for potential solutions. An expert committee specializing in inborn metabolic disease and genetics developed a comprehensive survey, which was then distributed online to professionals working with rare diseases. A total of 21 specialists actively engaged in the management of rare diseases participated in the survey. All participants acknowledged the substanstial significant diagnostic challenges associated with rare diseases, with 86% indicating that these diagnostic challenges negatively affect their clinical practice. The primary obstacles encountered in the diagnosis and follow-up of rare diseases were low awareness, a lack of a multidisciplinary approach, insufficient numbers of specialists and inadequate infrastructure, limited newborn screening programs, challenges in accessing treatment, and insufficient psychosocial support. All participants emphasized the need for a multidisciplinary approach in the management of rare diseases. Proposed solutions included enhanced training for healthcare professionals, the establishment of multidisciplinary teams and diagnostic algorithms, the regular convening of councils and meetings, and the establishment of robust registries. While all participants rated their own clinical experience as proficient in diagnosing and treating rare diseases, the establishment of multidisciplinary teams was the most frequently suggested area for improvement.</p><p><strong>Conclusion: </strong>Addressing the challenges in the diagnosis, treatment, and monitoring of rare diseases requires a multifaceted approach, including raising awareness, enhancing patient services, developing robust research and improving the infrastructure, establishing multidisciplinary care frameworks, and implementing preventive medicine and social policies.</p><p><strong>What is known: </strong>• It is estimated that over 300 million people globally are living with one or more rare diseases. The process of diagnosis, treatment, and follow-up of rare diseases involves significant global challenges.</p><p><strong>What is new: </strong>• In our study, the difficulties encountered by specialists in the diagnosis and treatment of rare diseases in Türkiye and solution suggestions are presented. This is the first study on this subject in Türkiye.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"281"},"PeriodicalIF":3.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788150","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":"Campylobacter and Salmonella infections in children hospitalized with gastroenteritis in Northeastern Poland, 2020-2023.","authors":"Teresa Fernandez Moreno, Aleksandra Kołcz, Maria Qaheri, Dawid Lewandowski, Artur Sulik, Kacper Toczyłowski","doi":"10.1007/s00431-025-06122-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06122-8","url":null,"abstract":"<p><p>This study aimed to investigate the epidemiology, seasonal trends, and clinical characteristics of Campylobacter and Salmonella infections in children hospitalized with acute gastroenteritis (AGE) in Northeastern Poland from 2020 to 2023. The research sought to address the scarcity of localized data on these bacterial pathogens and identify key clinical and demographic markers to improve diagnostic and therapeutic strategies. A retrospective analysis was conducted on medical records of children aged 0-17 years hospitalized at the Bialystok Children's Clinical Hospital. Stool samples were systematically collected and tested for bacterial pathogens following World Health Organization guidelines. Confirmed cases of Campylobacter and Salmonella infections were analyzed for demographic, clinical, and laboratory characteristics. Among 3,392 hospitalized children with acute gastroenteritis, bacterial pathogens were identified in 560 cases, with Campylobacter (33%) and Salmonella (32%) being the most common. A slight male predominance was noted across both pathogens. Salmonella infections were associated with significantly greater clinical severity, characterized by longer duration of diarrhea, higher frequency of vomiting, more persistent fever, greater dehydration, notably elevated inflammatory markers and longer hospital stays compared to Campylobacter. Campylobacter was notably more prevalent among children younger than 2 years. Seasonal peaks for both pathogens consistently occurred during the summer months.</p><p><strong>Conclusion: </strong>Campylobacter and Salmonella are significant contributors to bacterial AGE in children, with distinct clinical and demographic profiles. Public health measures and enhanced diagnostics are critical to reducing the burden of these infections, particularly among younger and vulnerable children.</p><p><strong>What is known: </strong>• Campylobacter and Salmonella are leading causes of pediatric gastroenteritis globally, with seasonal variation and clinical severity differences.</p><p><strong>What is new: </strong>• In Northeastern Poland, Campylobacter and Salmonella cause similar numbers of pediatric AGE hospitalizations, despite official reports suggesting low Campylobacter incidence. • Salmonella infections are significantly more severe clinically, yet Campylobacter infections commonly affect children of all ages, including infants as young as 2 months.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"280"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779309","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":"Early discontinuation of steroid treatment in children with abdominal pain due to IgA vasculitis.","authors":"Sumika Kambara, Nobuhiro Nishio, Yuichiro Sugiyama, Yosuke Nishio, Yukina Takamoto, Fumie Kitai, Yuma Takahashi, Nozomi Hayashi, Kazunori Haruta, Maki Kondo, Naoko Oike, Takeshi Miwa, Nobuhiro Watanabe, Marei Omori, Fumie Kinoshita, Taiki Furukawa, Jun-Ichi Kawada, Hiroyuki Kidokoro, Yoshiaki Sato, Yoshiyuki Takahashi","doi":"10.1007/s00431-025-06107-7","DOIUrl":"10.1007/s00431-025-06107-7","url":null,"abstract":"<p><p>This study aims to evaluate the impact of early steroid discontinuation on total dosage and outcomes in pediatric immunoglobulin A (IgA) vasculitis patients with uncontrolled abdominal pain. This retrospective cohort study included children younger than 16 years with newly diagnosed IgA vasculitis hospitalized for abdominal pain who received their first dose of steroids between April 1, 2013, and March 31, 2019, at 14 hospitals. Patients were divided into two groups: the standard (STD) group, which received steroid therapy for at least 8 consecutive days, and the early discontinuation attempt (EDA) group, which attempted discontinuation within 7 days. EDA was further divided into two subgroups: the early discontinuation (ED) group, which completed steroid treatment within a week, and the readministration (RA) group, which required readministration. Total steroid dosage, duration of therapy, hospital stay, and complications were compared. A total of 272 patients were analyzed: STD (n = 190) and EDA (n = 82). There were no significant differences in baseline characteristics. EDA had a shorter hospital stay (8.5 vs. 15.0 days, p < 0.01), fewer total steroid days (6 vs. 17.5 days, p < 0.01), and lower total steroid dosage (5.4 mg/kg vs. 15.4 mg/kg, p < 0.01) compared to STD, with no significant differences in complications. Among EDA patients, 22 (27%) required steroid readministration due to symptom recurrence; however, symptoms resolved in all RA patients, with lower total steroid dosage and duration compared to STD, without prolonging hospital stay. Conclusion: Discontinuing steroids within 7 days for abdominal pain in children with IgA vasculitis reduces total steroid dosage without increasing complications, even with occasional readministration. Clinical trial registration: Approval no. 2019-0394.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"279"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779310","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":"High prevalence of epilepsy in pediatric patients with obstructive sleep apnea-a large-scale cross-sectional study.","authors":"Dekel Avital, Iris Noyman, Jacob Bistritzer, Aviv Goldbart, Guy Hazan, Yasmine Langman, Oren Ziv, Itai Hazan, Inbal Golan-Tripto","doi":"10.1007/s00431-025-06105-9","DOIUrl":"10.1007/s00431-025-06105-9","url":null,"abstract":"<p><p>The purpose of the study is to evaluate the prevalence of epilepsy in children with surgically treated obstructive sleep apnea (OSA) and examine the associated healthcare utilization. This cross-sectional study included children aged 1-18 years diagnosed with moderate to severe OSA who were treated with adenoidectomy or adenotonsillectomy. A matched control group (1:3 ratio) without OSA was used for comparison. Data were obtained from Clalit Health Services, Israel's largest healthcare provider. The study analyzed the prevalence of epilepsy, hospital admissions for seizures, use of anti-seizure medications (ASMs), and outpatient visits to pediatric neurologists. Among 55,164 children (13,791 in the OSA group and 41,373 in the control group), the prevalence of epilepsy was higher in the OSA group (0.9% vs. 0.4%; odds ratio (OR) = 2.22, p < 0.001). The OSA group also exhibited higher rates of ASM use (1.1% vs. 0.5%; OR = 2.24, p < 0.001), emergency department visits (OR = 15.66, p < 0.001), hospital admissions (OR = 3.18, p < 0.001), and visits to pediatric neurologists (14% vs. 8.1%; OR = 1.85, p < 0.001). The usage of ASMs was significantly higher in the OSA group, particularly for levetiracetam (OR = 3.73, p < 0.001).</p><p><strong>Conclusion: </strong>Children with surgically treated OSA had higher rates of epilepsy and greater healthcare utilization compared to their peers. These findings underscore the necessity for integrated care, including neurological assessments, for children with OSA. Further research is needed to examine the impact of OSA treatment on epilepsy outcomes.</p><p><strong>What is known: </strong>• Obstructive sleep apnea (OSA) and epilepsy are prevalent neurological conditions in children, with evidence suggesting a bidirectional relationship between sleep disorders and epilepsy in adults. • OSA prevalence is notably higher in children with refractory epilepsy or those prescribed multiple anti-seizure medications (ASMs).</p><p><strong>What is new: </strong>• This study demonstrates a twofold increase in epilepsy prevalence among children with surgically treated moderate-to-severe OSA compared to matched controls. • Pediatric patients with OSA exhibit significantly higher rates of epilepsy-related healthcare utilization, including hospital admissions, emergency visits, and consultations with pediatric neurologists.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 5","pages":"278"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771677","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}