European Journal of Pediatrics最新文献

{"title":"Application of the TIDieR checklist to improve the HFNC use in bronchiolitis management.","authors":"Manti Sara, Gambadauro Antonella, Ruggeri Paolo, Baraldi Eugenio","doi":"10.1007/s00431-024-05880-1","DOIUrl":"https://doi.org/10.1007/s00431-024-05880-1","url":null,"abstract":"<p><p>The use of High-Flow Nasal Cannula (HFNC) in children with bronchiolitis is globally increased in the last decade, despite the lack of evidence-based and universal guidelines to standardize their application in the clinical practice. In this systematic review, we aimed to analyse the completeness of previous studies on HFNC interventions in children with bronchiolitis using an adapted Template for Intervention Description and Replication (TIDieR) checklist. Randomized clinical trials (RCTs) and cohort studies on children younger than 2 years old with a diagnosis of bronchiolitis were included. We analysed manuscripts published between January 2010 and October 2023. An adapted TIDieR checklist based on 14 items about HFNC interventions was used to assess the completeness of the studies. A total sample of 67,324 patients was analysed in the 78 included manuscripts (21 RCTs and 57 cohort studies). Completeness of TIDieR checklist items ranged from 1% to 100%. The most reported items were related to the study rationale and the selection strategy (inclusion/exclusion criteria), identifying high quality of patients' selection in the included manuscripts. However, most of the studies did not provide separate indications for children with comorbidities. Only 23% of studies reported a complete definition and rates of treatment failure suggesting that this item needs more clarification in future studies. A minority of articles (40%) described the HFNC weaning procedures. Interestingly, most of the interventions took place in ICUs (61%), showing how, in the last decade, this location was the most cited for the use of HFNC in children with bronchiolitis.</p><p><strong>Conclusions: </strong> Our results suggest complete reporting of our TIDieR checklist in future studies may improve the quality of the research on HFNC use in children with bronchiolitis. Our findings encourage researchers to clarify the personalization of treatment administration and to better define the criteria for treatment failure. The adoption of universal definitions in this field is needed to increase the results' comparability and create standardized protocols. Researchers may use the proposed TIDieR checklist to develop, conduct and report clinical research into HFNC and bronchiolitis as this may help to create a consensus for establishing an evidence-based protocol for HFNC.</p><p><strong>What is known: </strong>• High-flow nasal cannula (HFNC) is a common device used in children with bronchiolitis in the presence of respiratory distress, after the failure of standard oxygen therapy. However, no evidence-based and standardized protocol for the use of this device is globally available.</p><p><strong>What is new: </strong>• By using an adapted Template for Intervention Description and Replication (TIDieR) checklist to review previous studies on HFNC in bronchiolitis, we found a global heterogeneity in the description of interventions with some items of the checklist poorly report","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"87"},"PeriodicalIF":3.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846141","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":"The impact of multiplex nested gastrointestinal PCR panel in children with gastroenteridis requiring pediatric infectious disease consultation.","authors":"Deniz Ergün, Pelin Kaçar, Hıncal Özbakır, Mustafa Gülderen, Miray Yılmaz Çelebi, Ege Gürbüz, Gizem Güner Özenen, Arife Özer, Aybüke Akaslan Kara, Fahri Yüce Ayhan, Çigdem Ömür Ecevit, Özlem Bekem, Süleyman Nuri Bayram, İlker Devrim","doi":"10.1007/s00431-024-05918-4","DOIUrl":"10.1007/s00431-024-05918-4","url":null,"abstract":"<p><p>Infectious gastroenteritis is an important cause of morbidity and mortality, especially in nations with middle and low incomes. In a pediatric gastroenteritis patient, the aim was to determine the therapeutic impact of using the Gastrointestinal Panel in our clinical practice. A single-center retrospective study was designed to evaluate children who were admitted to the hospital for gastroenteritis and had a gastrointestinal panel between August 2021 and January 2024. 103 patients who had gastrointestinal (GI) panel results were included in the study. The GI Panel positivity rate among 103 patients was 55.3% (n = 57). Bacterial agents were positive in 25 patients (43.8%), viral agents were found in 11 patients (19.2%), and polymicrobial agents were found positive in 21 patients (36.8%). Escherichia coli (9.1%) was the most common bacterial pathogen, and viral pathogens most frequently included Rotavirus (11.6%) and Norovirus (11.6%). When the effect of the GI Panel test on treatment was determined, the treatment of 51 (49.5%) patients was changed according to GI Panel.</p><p><strong>Conclusions: </strong>In our study, the treatment regimen of many patients was adjusted based on the GI panel results in patients presenting with gastroenteritis. GI panel had an important impact on the patients care and optimization according to the principles of antimicrobial treatment. GI panel tests had several advantages such as speed and diagnostic accuracy as good as stool culture.</p><p><strong>What is known: </strong>• Infectious gastroenteritis is a major cause of morbidity and mortality, especially in middle- and low-income countries. • BioFire® FilmArray, Gastrointestinal Panel (BioFire- Biomerieux, France) is a rapid and simple technique that uses nested multiplex PCR to detect gastrointestinal pathogens rapidly.</p><p><strong>What is new: </strong>  • In this study, the GI Panel test was found to have a cumulative impact on 49.5% (n=51) of the clinician's treatment modalities. • With its speed and diagnostic sensitivity, the GI Panel may provide clinicians with an important tool in the fight against antibiotic resistance by decreasing antimicrobial drug treatment at the children with gastroenteritis.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"85"},"PeriodicalIF":3.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827930","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":"Prevalence of Duchenne muscular dystrophy in Italy: a nationwide survey.","authors":"Anna Capasso, Gianpaolo Cicala, Martina Ricci, Marika Pane, Adele D'Amico, Claudio Bruno, Valeria Ada Sansone, Sonia Messina, Luca Bello, Elena Pegoraro, Maria Grazia D'Angelo, Riccardo Masson, Angela Berardinelli, Antonella Pini, Federica Ricci, Tiziana Enrica Mongini, Michela Coccia, Vincenzo Nigro, Antonio Trabacca, Massimiliano Filosto, Giacomo Comi, Francesca Magri, Andrea Barp, Roberta Battini, Stefano Carlo Previtali, Maria Lucia Valentino, Eleonora Diella, Claudia Dosi, Lucia Ruggiero, Gabriele Siciliano, Giulia Ricci, Michela Catteruccia, Chiara Arpaia, Giorgia Coratti, Giulia Norcia, Silvia Bonanno, Lorenzo Verriello, Caterina Agosto, Antonio Varone, Alessandra Ferlini, Maria Antonietta Maioli, Claudia Brogna, Sabrina Siliquini, Irene Bruno, Chiara Panicucci, Cosimo Allegra, Emilio Albamonte, Eugenio Mercuri","doi":"10.1007/s00431-024-05903-x","DOIUrl":"10.1007/s00431-024-05903-x","url":null,"abstract":"<p><strong>Purpose: </strong>The availability of care recommendations has improved survival and delayed the progression of clinical signs in Duchenne muscular dystrophy. The aim of the study was to perform a nationwide survey investigating the prevalence, age distribution, and functional status of Duchenne muscular dystrophyin Italy.</p><p><strong>Methods: </strong>The survey was performed by collecting data from all 31 reference centers for Duchenne muscular dystrophy in Italy using a structured form. We assessed age distribution, motor function, and the need for respiratory and nutritional support to evaluate their prevalence in different age and functional subgroups.</p><p><strong>Results: </strong>The estimated prevalence was 1.65/100,000 (3.4/100,000 males). There were 972 boys and adults with a confirmed diagnosis of Duchenne, of age ranging between 6 months and 48 years (mean = 16.5). Over 59% were below the age of 18 years and the remaining 41% were adults. Over 43% were ambulant and 57% non-ambulant; 14.7% were steroids naive (mean 20.6 years), 75% are currently on steroids (mean 14.6 years) with 604 on the daily regime, 126 intermittent. Nearly 73% did not require any ventilatory support, 16% had NIV ≤ 12 h, 9% > 12 h, and 1.4% had a tracheostomy. More than 82% did not require any nutritional support, 13% required food modification/semisolid and 4.4% had a G-tube.</p><p><strong>Conclusions: </strong>Our findings provide information to be used not only for epidemiological purposes but also for possible trial design to include older non-ambulant patients who until recently have been excluded and for whom clinical information is limited. What is Known • Duchenne muscular dystrophy is a progressive disorder associated with reduced survival. • As part of the disorder there is also a progressive loss of important milestones, including loss of ambulation, and increased need for respiratory and nutritional support. What is New • Our nationwide survey provides prevalence, age distribution, and functional status for Duchenne muscular dystrophyin Italy including both boys and adults. • Our findings can be used for epidemiological purposes and for possible trial design.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"86"},"PeriodicalIF":3.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827925","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":"Safety of erythrocyte transfusion over a short period in pediatric patients assessed using cardiac deformation imaging.","authors":"Ali Algiraigri, Naif Alkhushi, Mohamed Elnakeeb, Mohamed Abdelsalam, Maha Badawi, Gaser Abdelmohsen","doi":"10.1007/s00431-024-05912-w","DOIUrl":"https://doi.org/10.1007/s00431-024-05912-w","url":null,"abstract":"<p><p>Erythrocyte transfusion is a time-consuming process for both health care personnel and patients. This research is aimed at assessing the safety of erythrocyte transfusion over a short period of time in pediatric patients using innovative echocardiographic parameters, such as tissue Doppler imaging and 2D speckle-tracking echocardiography. Twenty pediatric patients with chronic hemolytic anemia were included in the study. Patients with underlying cardiac, renal, or respiratory dysfunction and severe anemia (hemoglobin < 60 g/L) were excluded. The patients were grouped into small cohorts, and erythrocyte transfusion was initiated at 6 ml/kg/h. If tolerated, the rate was progressively increased by 1 ml/kg/h per cohort until reaching 12 ml/kg/h. Symptoms and signs of clinical intolerance and vital signs were evaluated during and following transfusions. Conventional echocardiography, tissue Doppler imaging, and 2D speckle-tracking echocardiography were performed before and after transfusion. No symptoms or signs of clinical intolerance were reported during or after transfusion. Following transfusion, the heart rate decreased significantly (P = 0.018). No significant changes in the systolic or diastolic functions of the right or left ventricles were observed after transfusion. Following transfusion, significant improvements in the ejection times of the left and right ventricles (P = 0.001 and P = 0.007, respectively) were noted. Similarly, the myocardial performance index significantly improved (P = 0.038 and P = 0.046, respectively). Conclusion: This exploratory study addresses the issue of whether erythrocyte transfusion may be administered at up to 12 ml/kg/h in selected stable pediatric patients with chronic anemia without the risk of developing transfusion-associated circulatory overload or affecting cardiac function. In addition to reducing tachycardia, erythrocyte transfusion improves biventricular ejection time and myocardial performance index (Tei-index).</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"84"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821620","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":"Antibiotic treatment of bacterial lung infections in cystic fibrosis.","authors":"Giovanni Taccetti, Vito Terlizzi, Silvia Campana, Daniela Dolce, Novella Ravenni, Cristina Fevola, Michela Francalanci, Valeria Galici, Anna Silvia Neri","doi":"10.1007/s00431-024-05905-9","DOIUrl":"10.1007/s00431-024-05905-9","url":null,"abstract":"<p><p>Bacterial infections of the lower airways are the main cause of mortality and morbidity in cystic fibrosis. The most frequently isolated pathogens are S. aureus and P. aeruginosa; bacterial co-infections are frequently observed. The aim of this review is to provide, in the current context, the indications regarding the best antibiotic strategy to adopt in subjects affected by CF infected with the most common pathogens. We selected relevant publications (guidelines, systematic reviews and clinical studies published so far on these topics) and we analysed the sampling methods used and antibiotic strategies adopted. Oropharyngeal sampling methods are considered less sensitive for pathogen detection than sputum. In non-expectorating people, induced sputum is considered equivalent to two-lobe bronchoalveolar lavage, which is considered invasive. Antibiotic treatment against the main pathogens can consist in eradication treatment in the early stages of infection, chronic suppressive therapy and treatment of the pulmonary exacerbations. This scheme is valid for P. aeruginosa but remains to be demonstrated for the other pathogens. For S. aureus, no evidence-based therapeutic strategies on how to treat the different stages of bacterial infection have been established with certainty. With regard to the treatment of the other classic pathogens (B. cepacia complex, A. xylosoxidans and S. maltophilia), no evidence-based indications exist and decision is left to the clinician. The recent introduction of highly effective modulators on the CFTR protein, in addition to the favourable effects described in regulatory trials, has led to a reduction in bacterial isolations; the real effect of which in clinical practice has still to be assessed on the basis of scientific data. CONCLUSIONS: The reliability of culture examination depends on sampling methods, and expectorated sputum continues to be the best method as it is simple and non-invasive. P. aeruginosa is the pathogen for which antibiotic strategies for the various stages of infection appear best established, and the efficacy of early eradication treatment and chronic suppressive therapy have been underlined in clinical trials and systematic reviews. The recent introduction of modulators into clinical practice, despite their widely described efficacy, has not yet led to suggestions for changes in antibiotic strategies against the pathogens most frequently isolated.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"82"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822013","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":"Artificial intelligence in the care of children and adolescents with chronic diseases: a systematic review.","authors":"Janna-Lina Kerth, Maurus Hagemeister, Anne C Bischops, Lisa Reinhart, Juergen Dukart, Bert Heinrichs, Simon B Eickhoff, Thomas Meissner","doi":"10.1007/s00431-024-05846-3","DOIUrl":"10.1007/s00431-024-05846-3","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) and machine learning (ML) has shown potential for various applications in the medical field, particularly for diagnosing and managing chronic diseases among children and adolescents. This systematic review aims to comprehensively analyze and synthesize research on the use of AI for monitoring, guiding, and assisting pediatric patients with chronic diseases. Five major electronic databases were searched (Medline, Scopus, PsycINFO, ACM, Web of Science), along with manual searches of gray literature, personal archives, and reference lists of relevant papers. All original studies as well as conference abstracts and proceedings, focusing on AI applications for pediatric chronic disease care were included. Thirty-one studies met the inclusion criteria. We extracted AI method used, study design, population, intervention, and main results. Two researchers independently extracted data and resolved discrepancies through discussion. AI applications are diverse, encompassing, e.g., disease classification, outcome prediction, or decision support. AI generally performed well, though most models were tested on retrospective data. AI-based tools have shown promise in mental health analysis, e.g., by using speech sampling or social media data to predict therapy outcomes for various chronic conditions.</p><p><strong>Conclusions: </strong>While AI holds potential in pediatric chronic disease care, most reviewed studies are small-scale research projects. Prospective clinical implementations are needed to validate its effectiveness in real-world scenarios. Ethical considerations, cultural influences, and stakeholder attitudes should be integrated into future research.</p><p><strong>What is known: </strong>• Artificial Intelligence (AI) will play a more dominant role in medicine and healthcare in the future and many applications are already being developed.</p><p><strong>What is new: </strong>• Our review provides an overview on how AI-driven systems might be able to support children and adolescents with chronic illnesses. • While many applications are being researched, few have been tested on real-world, prospective, clinical data.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"83"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822014","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":"Zinc sulfate on neonatal hyperbilirubinemia: an updated systematic review and meta-analysis.","authors":"Helen Michaela de Oliveira, Mariano Gallo Ruelas, Lucas Mendes Barbosa, Camilo André Viana Diaz, Gustavo Roberto Minetto Wegner, Bruno Francisco Minetto Wegner, André Vieira da Cruz","doi":"10.1007/s00431-024-05917-5","DOIUrl":"https://doi.org/10.1007/s00431-024-05917-5","url":null,"abstract":"<p><p>Neonatal hyperbilirubinemia is a prevalent condition, with a risk of serious complications. Phototherapy is the standard treatment for significant cases, but its limitations highlight the need for additional options. Zinc sulfate has emerged as a potential adjunctive treatment. Our objective is to evaluate the efficacy of zinc sulfate as an adjunct to phototherapy in neonates with hyperbilirubinemia. PubMed, Embase, and CENTRAL were searched for studies published up to September 2024. Eligible studies were randomized clinical trials (RCTs) enrolling neonates with hyperbilirubinemia that evaluated the combined use of phototherapy and zinc sulfate. This study followed PRISMA guidelines, with independent extraction of data by two reviewers. Risk of bias was assessed using the RoB2 tool, and the quality of evidence was evaluated using the GRADE approach. Eleven RCTs comprising 1,349 neonates were included. A total of 690 (51.1%) neonates received zinc sulfate. Zinc sulfate significantly reduced bilirubin levels at 24 h (MD = -0.76 mg/dL; 95% CI = -1.30 to -0.22; P < .01; I² = 82%), 48 h (MD = -0.88 mg/dL; 95% CI = -1.60 to -0.17; P = 0.02; I² = 76%) and at 72 h (MD = -1.19 mg/dL; 95% CI = -2.29 to -0.09; P = .003; I² = 94%). Subgroup analysis indicated that term neonates with normal birth weight benefited most from the intervention, while preterm and low-birth-weight infants showed no significant difference.Conclusion: Zinc sulfate effectively reduces serum bilirubin levels in neonates with hyperbilirubinemia when used alongside phototherapy, especially in term neonates.Trial registration number and date of registration: PROSPERO, CRD42024586259, 09/13/2024. The Impact of Zinc Sulfate on the Treatment of Neonatal Hyperbilirubinemia: An Updated Systematic Review and Meta-Analysis\"; CRD42024586259; Link: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=586259.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"79"},"PeriodicalIF":3.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817476","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":"Development and validation of the Post-COVID Symptom Scale for Children/Youth (PCSS-C/Y).","authors":"Winnie Wan Yee Tso, Yuliang Wang, Daniel Yee Tak Fong, Mike Yat Wah Kwan, Patrick Ip, Jasper Fuk Woo Chan, Lok Kan Leung, Jason Ying Kuen Chan, Sabrina Siu Ling Tsao, Christy Shuk Kuen Chau, Ka Man Yip, Ka Yi Hui, Jaime Sou Rosa Duque, Yu Lung Lau, Tatia Mei Chun Lee","doi":"10.1007/s00431-024-05913-9","DOIUrl":"10.1007/s00431-024-05913-9","url":null,"abstract":"<p><p>This study aims to develop and validate the Post-COVID Symptom Scale for Children/Youth (PCSS-C/Y), which is a comprehensive tool for measuring the symptom burden of post-COVID-19 conditions-persistent symptoms after SARS-CoV-2 infection, commonly known as Long COVID-and its impact on health-related quality of life among children and adolescents. Parents of children and adolescents, adolescents, and young adults with and without a history of COVID-19 were invited to fill in a questionnaire from October 2022 to June 2023. There were 386 valid parent proxy-reported responses, 433 valid adolescent self-reported responses, and 324 valid young adult self-reported responses included in the final analysis. The PCSS-C/Y demonstrated stable factor structure and good internal consistency in different sampling groups. The scale score was negatively associated with Paediatric Quality of Life Inventory (PedsQL) scores (young adult self-report, adjusted R² = 0.394; adolescent self-report, adjusted R² = 0.219; parent-report, adjusted R² = 0.292), while it was positively associated with Strengths and Difficulties Questionnaire (SDQ) scores (young adult self-report, adjusted R² = 0.195; adolescent self-report, adjusted R² = 0.154; parent-report, adjusted R² = 0.239). The scale can also discriminate the post-infected cases and control cases, Cohen's d = 0.41, 0.50, and 0.38 for adult self-report, adolescent self-report, and parent-report, respectively. Conclusions: The PCSS-C/Y is a valid and reliable tool for quantifying the diverse symptomatology of post-COVID-19 conditions in children and adolescents. It provides quantifiable measurements that enable clinicians to monitor post-COVID-19 symptoms in children and young people and facilitates the development of interventions for post-COVID-19 conditions.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"81"},"PeriodicalIF":3.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822015","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":"Comparison of the effectiveness of three different skin substitutes for the treatment of pediatric burns.","authors":"Carlos Delgado-Miguel, Ada García Morán, Lara Fuentes Gómez, Mercedes Díaz, Miriam Miguel-Ferrero, Juan Carlos López-Gutiérrez","doi":"10.1007/s00431-024-05916-6","DOIUrl":"https://doi.org/10.1007/s00431-024-05916-6","url":null,"abstract":"<p><p>Early debridement of partial-thickness burns and coverage with skin substitutes is currently the standard of care in children, although there is currently no \"gold standard\" skin substitute. Our aim is to compare the effectiveness of three different skin substitutes, analyzing the medium- and long-term outcomes.</p><p><strong>Methods: </strong>A retrospective study was conducted on burn patients under 18 years admitted to our Burn Unit between 2015 and 2021, who were divided into 3 groups according to the type of skin substitute used (EZ-derm®, Biobrane®, and Suprathel®). Demographic and clinical data and short- and long-term outcomes were analyzed. Effectiveness was analyzed by escharectomy and grafting rate during acute management and long-term follow-up reintervention rate. A total of 378 patients were included (179 EZ-derm® group, 107 Biobrane® group, and 92 Suprathel® group). No differences in demographics or burn characteristics were observed between the groups. Patients treated with Suprathel® had a significantly shorter hospital stay (median 4 days (IQR 2-9)), a lower rate of escharectomy and grafting during acute management (21.1%), and a lower long-term follow-up reintervention rate (18.5%) when compared to the EZ-derm® group (median stay 9 days (IQR 6-13); escharectomy and graft 24.6% and reintervention 26.8%) and to the Biobrane® group (median stay 9 days (IQR 7-14); escharectomy and graft 32.1% and reintervention 26.2%).</p><p><strong>Conclusion: </strong>Treatment of partial-thickness burns with Suprathel® is associated with a shorter hospital stay, lower need for escharectomy and grafting, and lower need for long-term reintervention. Therefore, it should be considered the treatment of choice for pediatric partial-thickness burns.</p><p><strong>What is known: </strong>• Different types of skin substitutes are available for the treatment of skin burns in paediatric patients.</p><p><strong>What is new: </strong>• Suprathel® is linked to a reduction in hospital stays, a lower need for escharectomy and grafting, and a lower likelihood of requiring long-term re-interventions.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"80"},"PeriodicalIF":3.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817474","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 adolescents' binge drinking on blood chemistry.","authors":"Enrico Pistritto, Federica M F Schera, Emilia Vassilopoulou, Antonio Corsello, Ilaria Alberti, Sebastiano A G Lava, Céline Betti, Mario G Bianchetti, Carlo Agostoni, Pietro Camozzi, Gregorio P Milani","doi":"10.1007/s00431-024-05862-3","DOIUrl":"10.1007/s00431-024-05862-3","url":null,"abstract":"<p><p>Adolescent binge drinking is increasingly common. This study investigates the anomalies in glucose, sodium, calcium, potassium, and acid-base homeostasis induced by binge drinking in adolescents. The records of teenagers who sought medical attention for binge drinking (ethanol level ≥ 0.80 g/L) at the Pediatric Emergency Department, Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy), spanning the years 2013 to 2023 were retrospectively analyzed. For this analysis, cases were selected if documented blood chemistry encompassed sodium, potassium, total calcium, glucose, acid-base balance, and lactic acid (only for those with metabolic acidosis). Included were 173 adolescents (female-to-male ratio 0.94), 13.2 to 18.4, median 16.4 years of age. Hypoglycemia (≤ 3.3 mmol/L; N = 1, 0.6%), hyponatremia (≤ 134 mmol/L; N = 7, 4.0%), hypernatremia (≥ 146 mmol/L; N = 3, 1.7%), hypocalcemia (≤ 2.19 mmol/L; N = 0) hypercalcemia (≥ 2.61 mmol/L; N = 0), and hyperkalemia (≥ 5.1 mmol/L; N = 0) were infrequent. Acute respiratory acidosis (pCO₂ ≥ 46 mm Hg; pH < 7.40; N = 101, 58%) was the most common acid-base imbalance, followed by respiratory alkalosis (pCO₂ ≤ 34 mm Hg; pH > 7.40; N = 10, 5.6%), and metabolic acidosis (HCO₃^- ≤ 19 mmol/L, pH < 7.40; N = 9, 5.2%). The lactic acid level was increased (≥ 2.1 mmol/L) in all cases with metabolic acidosis. Metabolic alkalosis (HCO₃^- ≥ 28 mmol/L, pH > 7.40) never occurred. Hypokalemia (≤ 3.4 mmol/L; N = 56, 32%) was prevalent, particularly in adolescents with normal acid-base equilibrium or metabolic acidosis, rather than respiratory acidosis or alkalosis.Conclusion: Adolescents who engage in binge drinking often experience a disrupted acid-base balance and hypokalemia, while glucose, sodium and calcium levels are rarely affected. What is known? • Binge drinking is becoming increasingly common among adolescents. • Conflicting data regarding the type and prevalence of biochemical disorders induced by binge drinking are available in this age group. What is new? • Acute respiratory acidosis is prevalent in adolescents with binge drinking, whereas respiratory alkalosis, metabolic acidosis, and hypoglycemia are uncommon. • Hypokalemia develops frequently.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 1","pages":"77"},"PeriodicalIF":3.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812450","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}