European Journal of Pediatrics最新文献

{"title":"Post-coronavirus disease 2019-associated symptoms among children and adolescents in the SARS-CoV-2 Omicron era.","authors":"Anne Schlegtendal, Christoph Maier, Julien Stein, Jakob Höpner, Astrid Petersmann, Denisa Drinka, Reinhard Berner, Thomas Lücke, Nicole Toepfner, Folke Brinkmann","doi":"10.1007/s00431-024-05919-3","DOIUrl":"10.1007/s00431-024-05919-3","url":null,"abstract":"<p><strong>Purpose: </strong>Lack of a control group(s) and selection bias were the main criticisms of previous studies investigating the prevalence of post-coronavirus disease 2019 (COVID-19) syndrome (PCS). There are insufficient data regarding paediatric PCS, particularly in the SARS-CoV-2 Omicron era. As such, our study investigated PCS-associated symptoms in a representative control-matched cohort.</p><p><strong>Methods: </strong>This multicentre, cross-sectional, cohort study within the \"Immunebridge\" project of the German Network University Medicine (NUM) recruited children and adolescents (five to 17 years old) between July and October 2022. Children with polymerase chain reaction-confirmed SARS-CoV-2 infection in 2022 (COVID-19 group) were compared with those without history of SARS-CoV-2 infection and negative for SARS-CoV-2 antibodies. Queries included vaccinations, quality of life (QoL), and mental and physical symptoms potentially associated with PCS in the previous three months. An additional composite item, \"physical performance\", was created from the responses.</p><p><strong>Results: </strong>The number of children with ≥ 1 PCS symptom(s) was comparable between the COVID-19 (n = 114 [62.1%]) and control (n = 66 [64.9%]) groups. Concentration disorders were reported more frequently in the COVID-19 group (12.3% versus 1.5%; p = 0.012) and \"physical performance\" was significantly impaired (p = 0.016) regardless of age, sex, and SARS-CoV-2 vaccination. The frequencies of other symptoms were similar in both groups. The COVID-19 group rated their fitness as worse, with otherwise equal QoL ratings regarding general and mental health. Conclusion Children with and without previous infections did not differ in most PCS-associated symptoms. Exceptions included physical performance and cognitive problems, which appeared to be more impaired after Omicron infection than in controls.</p><p><strong>What is known: </strong>• Mainly due to too few controlled studies, knowledge about the prevalence of individual symptoms in paediatric post-COVID-19 syndrome (PCS) for the Omicron era is poor.</p><p><strong>What is new: </strong>• In a representative control-matched cohort most parent-reported PCS-associated symptoms and quality of life scores in children and adolescents with PCR-confirmed SARS-CoV-2 infection did not differ from those without infection. • Exceptions were physical performance and cognitive problems, which were apparently more severely impaired after SARS-CoV-2-Omicron infection than in the control subjects.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"96"},"PeriodicalIF":3.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871734","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":"Association between FTO gene polymorphism and obesity in down syndrome children.","authors":"Shereen A Mourad, Reham M El-Farahaty, Mohamed A Atwa, Sohier Yahia, Abdel-Hady El-Gilany, Ahmed A Elzeiny, Eman S Elhennawy","doi":"10.1007/s00431-024-05909-5","DOIUrl":"10.1007/s00431-024-05909-5","url":null,"abstract":"<p><p>Children with Down syndrome (DS) have a higher incidence of overweight and obesity compared to typically developing peers. The fat mass and obesity-associated gene (FTO) is one of the early identified genes linked to obesity in various populations. To date, the FTO rs17817449 gene polymorphism has not been investigated in overweight/obese-DS (ODS) individuals. The current study aimed to explore the potential association between the FTO rs17817449 gene polymorphism and obesity-related markers, and to evaluate the ability of this polymorphism in the prediction of overweight/obesity in DS children and adolescents. This case-control study included 100 DS children under the age of 18, classified into three groups according to BMI-percentile; 50 non-obese DS (NODS), 24 overweight DS, and 26 ODS. Genotyping of FTO gene rs17817449 polymorphism was performed using the restriction fragment length polymorphism (RFLP-PCR) method. Serum lipid and thyroid profiles were also assessed. The results revealed significant increase in the frequency of the FTO rs17817449 T allele among overweight /ODS children compared to NODS children (p=0.0099). Overweight/ODS children exhibited significantly higher frequencies of the FTO rs17817449 GT and TT genotypes compared to NODS children.</p><p><strong>Conclusion: </strong>There is an association between FTO rs17817449 genetic variant and overweight/obesity among the studied DS groups. The FTO rs17817449 GT and TT genotypes, as well as TGs level, were identified as independent risk factors for predicting overweight and obesity in DS children.</p><p><strong>What is known: </strong>• Overweight and obese-DS (ODS) children displayed higher BMI and atherogenic lipid profile than non-obese DS children (NODS). FTO gene polymorphism rs17817449 contributes to obesity development in general population, but there is conflicting information about the risk allele.</p><p><strong>What is new: </strong>• FTO rs17817449 TT genotype and T allele were considered as independent risk factors for overweight and obesity development in DS children, so they could be used for obesity prediction in DS children.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"95"},"PeriodicalIF":3.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871659","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":"Early hypoglycemia is not an independent risk factor for 2-year cognitive impairment in small for gestational age preterm infants of less than 32 weeks.","authors":"Martina Palazzo, Alessio Correani, Margherita Bonanni, Enrica Ferretti, Rita D'Ascenzo, Chiara Biagetti, Ilaria Burattini, Paola Cogo, Virgilio Carnielli","doi":"10.1007/s00431-024-05936-2","DOIUrl":"https://doi.org/10.1007/s00431-024-05936-2","url":null,"abstract":"<p><p>The objective of this study is to evaluate whether early hypoglycemia is an independent risk factor for 2-year cognitive (COG) impairment in small for gestational age (SGA) preterm infants with gestational age (GA) < 32 weeks. We retrospectively reviewed data of 1364 preterm infants with a GA 24^+0/7-31^+6/7 weeks. Infants were classified based on blood glucose concentrations within the first 6 h of life (HOL) as < or ≥ 40 mg/dL (Glyc < 40^[Birth-6HOL] and Glyc ≥ 40^[Birth-6HOL], respectively) and subsequently by birth weight z-score as SGA or appropriate for gestational age (AGA). Propensity score matching analyses were conducted for each comparison. Multiple logistic regression was used to evaluate the association of Glyc < 40^[Birth-6HOL] with 2-year COG impairment, defined as a Bayley-III score < 85, in SGA infants. Out of the 747 preterm infants who met the inclusion criteria, 173 (23.2%) were classified as Glyc < 40^[Birth-6HOL], and 574 (76.8%) as Glyc ≥ 40^[Birth-6HOL]. The proportion of SGA infants was significantly higher in Glyc < 40^[Birth-6HOL] than in Glyc ≥ 40^[Birth-6HOL] (25.4 vs 18.3%, p = 0.039). The incidence of 2-year COG impairment was significantly higher in SGA infants compared to matched AGA counterparts both in Glyc < 40^[Birth-6HOL] (+ 20%, p = 0.040) and Glyc ≥ 40^[Birth-6HOL] (+ 17%, p = 0.029). Neither in the entire cohort nor in the SGA infants, Glyc < 40^[Birth-6HOL] was significantly associated with 2-year COG impairment (aOR: 1.077, p = 0.768; 0.993, p = 0.935; respectively) after the adjustment for GA, sex, Apgar score at 5 min < 7, SGA status, complications of prematurity, duration of mechanical ventilator support > 7 days, cumulative energy intakes from birth to 36 weeks, and maternal university level.</p><p><strong>Conclusion: </strong> Among SGA preterm infants with GA between 24^+0/7 and 31^+6/7 weeks/days, hypoglycemia within the first 6 HOL was not an independent risk factor for 2-year COG impairment.</p><p><strong>What is known: </strong>• Hypoglycemia is associated with poor neurodevelopmental outcomes in preterm infants. • Small for gestational age (SGA) preterm infants are more prone to cognitive (COG) impairment compared to AGA counterparts.</p><p><strong>What is new: </strong>• In a large cohort of preterm infants < 32 weeks, the incidence of hypoglycemia within the first 6 hours of life (HOL) was higher in SGA compared to AGA. • Hypoglycemia within the first 6 HOL was not an independent risk factor for 2-year COG impairment in SGA preterm infants.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"97"},"PeriodicalIF":3.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871729","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":"Study on the impact of children's myopia on parental anxiety levels and its related factors.","authors":"Hui-Hui Chu, Ru Zhang, Ling-Ling Han, Ji-Feng Yu","doi":"10.1007/s00431-024-05938-0","DOIUrl":"10.1007/s00431-024-05938-0","url":null,"abstract":"<p><strong>Objective: </strong>To assess how children's myopia affects the psychological state of their parents, especially their anxiety levels, and its related factors.</p><p><strong>Methods: </strong>Using a cross-sectional case series design, this study employed the Beck Anxiety Inventory (BAI) to assess the anxiety status of parents of myopic children who visited Beijing Children's Hospital from May to August 2024. Data were statistically analyzed using Chi-square test, t-test, and analysis of variance, and Spearman correlation analysis was used to explore the relationship between myopia and anxiety.</p><p><strong>Results: </strong>Among the 242 parents surveyed, 64.46% (156) showed no anxiety symptoms, 17.36% (42) exhibited mild anxiety, 9.5% (23) had moderate anxiety, and 8.68% (21) had severe anxiety. There was a significant gender difference in anxiety levels, with mothers generally experiencing more anxiety. Specifically, the average anxiety score for mothers was 8.58 ± 12.01, while that for fathers was 7.19 ± 9.16. Univariate analysis revealed that mothers of girls aged under40 with the myopia degree ranging from -0.25D to -6.00D exhibited more pronounced myopic anxiety. In addition, difference analysis indicated that the higher the degree of myopia in the child, the higher the anxiety score of the parents (P < 0.05). Younger children were typically associated with a higher anxiety level of parents. Spearman correlation analysis showed a positive correlation between the degree of myopia in the child and the anxiety level in the parents, while there was a negative correlation between the age of the child and anxiety scores (P < 0.05).</p><p><strong>Conclusion: </strong>Children's myopia has a significant impact on the mental health of parents, especially mothers. The anxiety level is closely related to the gender of the child and the severity of myopia. Therefore, it is particularly important to provide positive psychological support for promoting children's vision health and enhancing family psychological harmony.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"94"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871736","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":"Detection of circulating tumor cells using a microfluidic chip for diagnostics and therapeutic prediction in mediastinal neuroblastoma.","authors":"Yuanxiang Wang, Nianhua Cao, Xiufang Cui, Zongbin Liu, Xiuli Yuan, Senmin Chen, Huanli Xu, Meng Yi, Yunxing Ti, Fengnan Zheng, Kaican Cai","doi":"10.1007/s00431-024-05896-7","DOIUrl":"https://doi.org/10.1007/s00431-024-05896-7","url":null,"abstract":"<p><p>Circulating tumor cells (CTCs) have served as noninvasive tumor biomarkers in many types of cancer. Here, we detected CTCs in mediastinal neuroblastoma (mNB) patients for use as diagnostic and treatment response predictive biomarkers. We employed a cascaded filter deterministic lateral displacement microfluidic chip (CFD-Chip) to enrich CTCs in peripheral blood from 32 mNB patients and 7 healthy children. CTCs were identified by immunofluorescence staining and integrated neoplastic cell morphology. In total, 66.67% of newly diagnosed mNB patients were positive for CTCs while no CTCs were detected in healthy children. Moreover, CTC count differed significantly across different International Neuroblastoma Staging System, International Neuroblastoma Risk Group staging system, and risk stratifications. CTC count was also significantly higher in children with metastasis than those without metastasis. Additionally, CTC demonstrated a significant difference among patients with different clinical responses to therapy. CTC count decreased or fluctuated at low levels in patients with complete and partial response, compared to considerably increased in patients with stable and progressive diseases.Conclusion: CTCs may serve as non-invasive indicators for mNB diagnosis, staging, and metastasis prediction, and demonstrate promising potential as a liquid biopsy biomarker for the dynamic monitoring of therapeutic efficacy.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"93"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863749","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 and genetic characteristics of patients with monocarboxylate transporter-8 deficiency: a multicentre retrospective study.","authors":"Nurullah Çelik, Korcan Demir, Saime Ergen Dibeklioğlu, Bumin Nuri Dündar, Nihal Hatipoğlu, Gül Yeşiltepe Mutlu, Emrullah Arslan, Didem Yıldırımçakar, Atilla Çayır, Bülent Hacıhamdioğlu, Zümrüt Kocabey Sütçü, Yağmur Ünsal, Gülay Karagüzel","doi":"10.1007/s00431-024-05931-7","DOIUrl":"10.1007/s00431-024-05931-7","url":null,"abstract":"<p><p>Allan-Herndon-Dudley syndrome is a neurodevelopmental disorder characterized by motor and intellectual disabilities. Despite its rarity, there has been a rise in interest due to ongoing research and emerging therapy suggestions. In this multicenter, retrospective, cross-sectional study, the genetic characteristics and clinical data of twenty-one cases of genetically confirmed MCT8 deficiency were evaluated. The median age at the diagnosis was 2.4 (1.29; 5.9) years, which ranged from 0.5 to 14.0 years. The median follow-up period was 2.34 years, ranging from four months to 7.9 years. In 21 patients, 17 different variants were detected in the SLC16A2 gene. Eleven of these variants (c.1456delC, c.439G > T, c.949C > A, c.1392dupC, c.1612C > T, c.407dup, c.781del, c.589C > A, c.712G > A, c.311 T > A, c.1461del) have not been previously reported. In this study, with the exception of three cases with fT3/fT4 ratios of 4.95, 3.58, and 4.52, all cases exhibited fT3/fT4 ratios higher than five (9.9 (7.9; 12.0)).</p><p><strong>Conclusion: </strong>MCT8 deficiency is a rare and devastating disorder characterized by central hypothyroidism and peripheral thyrotoxicosis. The fT3/fT4 ratio can be used as a useful diagnostic indicator of MCT8 deficiency in males with mental and motor retardation. There is a need to raise clinicians' awareness of this potentially treatable condition with the emergence of new and promising treatments.</p><p><strong>What is known: </strong>• Allan-Herndon-Dudley syndrome, also known as MCT8 deficiency is a rare and devastating disorder characterized by central hypothyroidism and peripheral thyrotoxicosis.</p><p><strong>What is new: </strong>• In this study, seventeen different variants were detected in the SLC16A2 gene, eleven of which (c.1456delC; c.439G>T; c.949C>A; c.1392dupC; c.1612C>T; c.407dup; c.781del; c.589C>A; c.712G>A; c.311T>A; c.1461del) have not been reported before. • The fT3/fT4 ratio can be used as a useful diagnostic indicator of MCT8 deficiency in males with mental and motor retardation.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"92"},"PeriodicalIF":3.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853182","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":"Exploring the \"shared\" in shared decision-making in the care for children with chronic diseases or disabilities: what are the roles of parents and professionals?","authors":"M W Alsem, A Bakkum, M Ketelaar, A M Willemen","doi":"10.1007/s00431-024-05930-8","DOIUrl":"10.1007/s00431-024-05930-8","url":null,"abstract":"<p><p>There is a growing body of literature that recognizes the importance of shared decision-making (SDM) in the care for children with chronic conditions and/or disabilities. Although participation in SDM can be more or less active, the tuning between parents and professionals about the way they want to participate in SDM is often an implicit process, limiting parents' optimal involvement. Role definitions may support both partners in the process of SDM. We conducted a scoping review to investigate the available knowledge on the interpretation and variability of different roles of parents and professionals in SDM. In total, 43 articles were included and were subjected to data extraction and thematic coding. The findings show that roles are described in the literature by three themes: (1) active and passive involvement, (2) leadership in decision-making, and (3) six specific roles: informing, advocating, supporting, facilitating, coordinating, and interacting. Some, but not all, of these roles are described for parents as well as professionals.Conclusion: The literature provides a first definition of the various roles parents and professionals may take during SDM. However, the results do not inform how the described roles can be performed in clinical practice. Follow-up research is needed to develop and evaluate practical initiatives to achieve suitable roles for both parents and professionals. What is Known: • Parents often play a role in shared decision-making What is New: • Parents and professionals can play different and various roles in decision-making • Most described roles can be played by both parents and professionals.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"91"},"PeriodicalIF":3.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853215","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":"Serial sonographic assessment of diaphragmatic atrophy and lung injury patterns in mechanically ventilated preterm infants to predict extubation failure: a prospective observational study.","authors":"Shohood Ibraheem, Mazhar Bustami, Marwa Jaffer Ahmed, Mohamed Abdou Alzanqaly, Ismail Ali, Ali Salah Alsaadi, Islam Nour, Adel Mohamed, Nehad Nasef","doi":"10.1007/s00431-024-05927-3","DOIUrl":"10.1007/s00431-024-05927-3","url":null,"abstract":"<p><p>Diaphragmatic atrophy (DA) and lung injury (LI) have been associated with mechanical ventilation (MV). We aimed to assess the ultrasonographic changes in diaphragmatic thickness and LI during MV and their prediction for extubation failure in preterm infants. In this prospective observational study, mechanically ventilated preterm infants, < 30 weeks gestation, within the first 24 h of life underwent a baseline, within 24 h of MV, and serial diaphragmatic and lung ultrasounds scans until their first extubation attempt. DA was defined as a decline in pre-extubation expiratory diaphragmatic thickness (DT_exp) by ≥ 10% compared to baseline. A total of 251 ultrasound scans were performed on 38 preterm infants with a mean gestational age of 26.6 ± 1.7 weeks. Of these, 18 infants (47%) had DA. Among infants with DA, a pattern of progressive decline in DT_exp was associated with a concomitant pattern of increase in the lung ultrasound score (LUS). Infants in the DA group experienced a significantly higher percentage of extubation failure [13 (72%) versus 5 (25%), p = 0.004] compared to the no-DA group. Pre-extubation LUS was significantly higher in the DA compared to the no-DA group (14.2 ± 6.0 versus 10.3 ± 5.2, p = 0.04). Logistic regression analysis controlling for gestational age, pre-extubation weight, and mean airway pressure at extubation showed that LUS [OR 1.27, 95% CI (1.04-1.56), p = 0.02] was an independent predictor of for extubation failure.</p><p><strong>Conclusion: </strong>In this cohort of preterm infants, lung ultrasound score has proved to be a stronger predictor of successful extubation compared to diaphragmatic thickness.</p><p><strong>What is known: </strong>• Ultrasonographic assessment of the diaphragm and lungs is a sensitive tool in diagnosis of ventilator induced diaphragmatic atrophy and lung injury in preterm infants. Accuracy of lung and diaphragmatic ultrasound in predicting extubation outcome in preterm infants is questionable.</p><p><strong>What is new: </strong>• A pattern of progressive decline in diaphragmatic thickness was associated with a concomitant pattern of increase in the lung ultrasound score in mechanically ventilated preterm infants. Lung ultrasound score has proved to be a stronger predictor of successful extubation compared to diaphragmatic thickness.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"90"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846157","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":"Burden of viral respiratory infections in the pediatric intensive care unit: age, virus distribution, and the impact of the COVID-19 pandemic.","authors":"Sapir Cohen, Halima Dabaja-Younis, Liat Etshtein, Itamar Gnatt, Moran Szwarcwort-Cohen, Amir Hadash, Imad Kassis, Michael Halberthal, Yael Shachor-Meyouhas","doi":"10.1007/s00431-024-05914-8","DOIUrl":"https://doi.org/10.1007/s00431-024-05914-8","url":null,"abstract":"<p><p>Though usually self-limiting, viral respiratory infections can escalate to severe cases requiring admission to a pediatric intensive care unit (PICU). This study aims to examine the proportional incidence, affected age ranges, viral pathogens involved, associated severity measures, and the impact of the COVID-19 pandemic on their incidence and virus distribution. This retrospective cohort study conducted in a tertiary care center (2011-2021) reviewed all pediatric patients admitted to PICU with laboratory-confirmed viral respiratory infection. The study included 312 patients, comprising 5.5% of all PICU admissions; 45% were males; 52% had underlying conditions. The median age was 1.1 (IQR 0.3-2.8) years; 18% were born prematurely. The most common viruses were respiratory syncytial virus (35%), adenovirus (26%), influenza (10%), parainfluenza (11%), and human metapneumovirus (11%). All viruses displayed a seasonal pattern, except year-round occurrence in adenovirus. The seasonality pattern was disrupted by COVID-19 pandemic-related restrictions. Mechanical ventilation was required for 46% of patients; 27% required other non-invasive respiratory support. Thirty-day mortality was documented in 18 (5.8%) patients. Underlying conditions, particularly immunosuppression, neuromuscular diseases, and genetic/metabolic syndromes, were associated with increased mortality (p = 0.001, 0.006, and 0.001, respectively). Adenovirus was also linked to higher mortality (p = 0.04), hMPV to prolonged ventilation (p = 0.004) and prolonged PICU stay (p = 0.009), and SARS-CoV-2 to extended ventilation (p = 0.04). During COVID-19, patients were older (p = 0.001), RSV cases decreased (p = 0.006), ventilation duration increased (p = 0.03), and cardiologic complications rose (p = 0.02). No influenza A or B cases appeared post-pandemic.</p><p><strong>Conclusion: </strong>Viral respiratory infections can lead to severe complications. Their high prevalence in infants and young children highlights the need to extend vaccination age ranges for vaccine-preventable viral infections, monitor uptake in at-risk children, and implement public health interventions in daycare settings.</p><p><strong>What is known: </strong>• Viral respiratory infections in children are a significant cause of illness and mortality.</p><p><strong>What is new: </strong>• Severe infections in children beyond current vaccine eligibility suggest the need to expand vaccination to broader age groups. • SARS-CoV-2 dominance during the COVID-19 pandemic altered disease characteristics of respiratory infections.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"88"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846150","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":"Efficacy of piracetam in children with breath-holding spells: a systematic review and meta-analysis.","authors":"Indar Kumar Sharawat, Lesa Dawman, Pragnya Panda, Prateek Kumar Panda","doi":"10.1007/s00431-024-05926-4","DOIUrl":"10.1007/s00431-024-05926-4","url":null,"abstract":"<p><p>A number of randomized-controlled trials (RCTs) have been conducted comparing the efficacy of piracetam with placebo and other medications in children with breath-holding spells (BHS). However, no systematic review has yet collated all this evidence. All RCTs comparing the efficacy and/or safety of piracetam with placebo or other medications in children with BHS were included. The pooled estimates were compared for the number of participants with a favorable response, the change in monthly frequency of BHS, compliance, and adverse effects in both groups. The ROB 2.0 tool was used to assess the risk of bias, and the GRADE system was used to determine the certainty of the collated evidence. We included 5 RCTs (437 participants) in the review. Piracetam group had significantly more participants with favorable responses at 1, 2 and 3 months after randomization, as compared to placebo group (RR: 6.5 (95% CI-1.8-23.2), I2 = 75%, p = 0.004, RR: 4.7 (95% CI-3.3-6.7), I2 = 49%, p < 0.0001, RR: 5.4 (95% CI-3.4-8.5), I2 = 0%, p < 0.0001 respectively). Number of participants with complete response or total cessation of attacks was more in the piracetam group compared to placebo (RR: 5.7 (95% CI-1.4-23.2), I2 = 88%, p = 0.01). Change in the average number of BHS was significantly more in the piracetam group, as compared to the placebo group (mean difference-4.9 (95% CI-0.7-9.0), I2 = 99%, p = 0.02). Number of participants with treatment-emergent adverse effects were comparable in both piracetam and placebo groups (RR: 1.9 (95% CI-0.5-7.6), I² = 0%, p = 0.33). Conclusion: Oral piracetam is efficacious and safe in children with BHS, and its efficacy may further increase by co-administration of oral docosahexaenoic acid. What is known? • Breath-holding spells (BHS) are a common pediatric condition, affecting 0.1% to 4.6% of otherwise healthy children. • Several studies have investigated the efficacy of piracetam in reducing the frequency and severity of BHS, with mixed results. What is new? • Oral piracetam is efficacious and safe in children with BHS. • Its efficacy is further increased by co-administration of oral docosahexaenoic acid.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"89"},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846151","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}