Frontiers in Pediatrics最新文献

{"title":"Family relationships and personality traits of postural tachycardia syndrome.","authors":"Meiko Matsui, Seiji Yoshida, Hidetaka Tanaka, Ginroku Yamawake, Yusuke Kurooka, Yoshitaka Ota, Atsuko Kubo, Midori Mizutani, Akira Ashida","doi":"10.3389/fped.2025.1543200","DOIUrl":"https://doi.org/10.3389/fped.2025.1543200","url":null,"abstract":"<p><strong>Introduction: </strong>Orthostatic intolerance is the name of the disease in Europe and the United States; however, in Japan, it is commonly known as orthostatic dysregulation (OD). OD is a physical disorder caused by failure of the body's compensatory regulatory mechanism to adapt to changes in circulatory dynamics during orthostasis; however, in many cases, the influence of psychosocial factors has been noted. The mother-child relationship is a major psychosocial factor in children, and it has been reported that parent-child patterns associated with OD are often excessive parental interference and child over-adaptation. This study focused on the psychological and physical factors of OD and assessed the parent-child relationship patterns among children with postural tachycardia syndrome (POTS), a subtype of OD, and examined how they relate to the child's personality traits and autonomic neuron function.</p><p><strong>Methods: </strong>A total of 36 six children diagnosed with POTS (mean age 13.5 ± 0.9 years) were compared with the results of the following questionnaires on parent-child relationships, personality traits, and the autonomic neuron function test: Family diagnostic test (a diagnostic test of parent-child relationship) for mothers and children, AN-EGOGRAM (the egograms that can be adapted to childhood and adolescence, when the ego is in the process of developing and growing), and a frequency analysis of heartrate and blood pressure variability for the children.</p><p><strong>Results: </strong>Assessments of the mother-child relationship patterns among children with POTS found significant associations between maternal \"strict discipline\" and children's negative feelings, excessive parental intervention and children's susceptibility to stress, and the degree of children's \"feeling of rejection\" and lower supine vasomotor sympathetic nerve activity. The findings also suggested that children with POTS typically exhibited lower scores in critical parent and free child personality traits, but higher scores in adapted child (AC). Notably, mothers of children with high AC scores reported less dissatisfaction with their spouses regarding childcare.</p><p><strong>Discussion: </strong>In the parent-child relationship in POTS, an association was observed between maternal \"strict discipline\" and children's negative feelings, suggesting that a less strict disciplinary approach may contribute to a more positive parent-child relationship.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1543200"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012970","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":"Longitudinal transcriptomic analysis of the hyperoxia-exposed preterm rabbit as a model of BPD.","authors":"Carlotta Boggi, Nicola Casiraghi, Xabier Murgia, Silvia Parolo, Enrica Scalera, Giorgio Aquila, Chiara Catozzi, Fabrizio Salomone, Francesca Stretti, Ilaria Minato, Francesca Ravanetti, Luisa Ragionieri, Roberta Ciccimarra, Matteo Zoboli, Gino Villetti, Barbara Montanini, Francesca Ricci, Matteo Storti","doi":"10.3389/fped.2025.1567091","DOIUrl":"https://doi.org/10.3389/fped.2025.1567091","url":null,"abstract":"<p><p>Bronchopulmonary dysplasia (BPD) is a multifactorial chronic lung disease of premature neonates. BPD development depends on prenatal and postnatal factors that induce inflammation, altering alveolar growth and pulmonary vascular development. Animal models are essential to investigate the precise molecular pathways leading to BPD. The preterm rabbit combines many advantages of small (e.g., rodents) and large BPD models (e.g., preterm lambs and baboons). Preterm rabbits display mild-to-moderate respiratory distress at delivery, which, along with continuous exposure to hyperoxia (95% O₂), leads to functional and morphological lung changes resembling a BPD-like phenotype. Nevertheless, the molecular pathways leading to the BPD-like phenotype remain poorly understood. Here, we aimed to characterize the longitudinal gene expression in the lungs of preterm rabbits exposed to 95% O₂, on postnatal days 3, 5, and 7. Histological analyses confirmed extensive lung injury and reduced lung development after 7 days of hyperoxia. Longitudinal transcriptomic analysis revealed different expression patterns for several genes and pathways. Over time, extracellular matrix organization and angiogenesis were increasingly downregulated. Apoptosis, RNA processing, and inflammation showed the opposite trend. We also investigated the expression of representative genes of these pathways, whose signatures could aid in developing pharmacological treatments in the context of BPD.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1567091"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinician-based comparative study of large language models in answering medical questions: the case of asthma.","authors":"Yong Yin, Mei Zeng, Hansong Wang, Haibo Yang, Caijing Zhou, Feng Jiang, Shufan Wu, Tingyue Huang, Shuahua Yuan, Jilei Lin, Mingyu Tang, Jiande Chen, Bin Dong, Jiajun Yuan, Dan Xie","doi":"10.3389/fped.2025.1461026","DOIUrl":"https://doi.org/10.3389/fped.2025.1461026","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate and compare the performance of four major large language models (GPT-3.5, GPT-4.0, YouChat, and Perplexity) in answering 32 common asthma-related questions.</p><p><strong>Materials and methods: </strong>Seventy-five clinicians from various tertiary hospitals participated in this study. Each clinician was tasked with evaluating the responses generated by the four large language models (LLMs) to 32 common clinical questions related to pediatric asthma. Based on predefined criteria, participants subjectively assessed the accuracy, correctness, completeness, and practicality of the LLMs' answers. The participants provided precise scores to determine the performance of each language model in answering pediatric asthma-related questions.</p><p><strong>Results: </strong>GPT-4.0 performed the best across all dimensions, while YouChat performed the worst in all dimensions. Both GPT-3.5 and GPT-4.0 outperformed the other two models, but there was no significant difference in performance between GPT-3.5 and GPT-4.0 or between YouChat and Perplexity.</p><p><strong>Conclusion: </strong>GPT and other large language models can answer medical questions with a certain degree of completeness and accuracy. However, clinical physicians should critically assess internet information, distinguishing between true and false data, and should not blindly accept the outputs of these models. With advancements in key technologies, LLMs may one day become a safe option for doctors seeking information.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1461026"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of echocardiography in the staging of preexcitation syndrome and the assessment of left ventricular wall dyskinesia in children.","authors":"Yahui Yuan, Shu Li, Jun Chen, Yu Mao, Ming Yang, Shiwei Yang, Wentao Kong, Hao Liu","doi":"10.3389/fped.2025.1567172","DOIUrl":"https://doi.org/10.3389/fped.2025.1567172","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The incidence of Wolff-Parkinson-White syndrome (WPWs) in the pediatric population is increasing recently. Conventional echocardiography lacks specificity and was limited to assessing the effects of WPWs on cardiac structure, while changes in cardiac function, ventricular wall dysfunction and different subtypes of WPWs were less commonly addressed. Whether WPWs causes cardiac decompensation and ventricular dyskinesia was controversial. Whether echocardiographic multiparameter indices can improve the diagnostic specificity and guide the classification of WPWs and assess the recovery of left ventricular (LV) synchrony and ventricular wall dyskinesia in patients after radiofrequency ablation (RFA) is a very important direction of research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To analyse the echocardiographic performance of patients with WPWs: (1) to assess the hazard of WPWs on cardiac function and LV wall dyskinesia using ultrasound multiparameters, with the aim of exploring in depth the pattern of effect of WPWs on cardiac function and motion, (2) to attempt to use echocardiography for staging WPWs, and (3) to predict patient recovery after RFA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The clinical, echocardiographic and RFA data of 75 children with RFA-confirmed WPWs from January 2019 to December 2024 were retrospectively analysed and compared with 60 healthy controls during the same period. All statistical analyses were carried out using SPSS 26.0 and &lt;i&gt;P&lt;/i&gt;-values &lt;0.05 were considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Two-dimensional echocardiography demonstrated significant LV enlargement, reduced LV systolic function, and significant ventricular wall dyskinesia in 14 of 75 patients, basal segmental septal dyskinesia in 5, and LV posterior wall dyskinesia in 4. The remaining 52 patients did not have significant ventricular wall dyskinesia. Multiparameters showed that WPWs patients compared with healthy controls: GLS (-18.16 ± 3.54% vs. -22.88 ± 0.71%), TD&lt;sub&gt;SD&lt;/sub&gt; (38.88 ± 6.77 ms vs. 24.03 ± 1.90 ms), TD&lt;sub&gt;RV-LV&lt;/sub&gt; (41.18 ± 7.21 ms vs. 24.32 ± 1.94 ms), PSD (35.26 ± 5.42 ms vs. 22.44 ± 2.23 ms), and MPTD (196.92 ± 61.41 ms vs. 100.55 ± 10.25 ms) were all statistically different from each other (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). LVEDD &lt;i&gt;Z&lt;/i&gt; score (1.07 ± 0.84 vs. 1.05 ± 0.56), LVEF (61.20 ± 9.02% vs. 66.52 ± 3.16%) was not significantly different between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). Seventy-five patients underwent RFA among them, 28 cases of type A bypass and 47 cases of type B bypass, analysed the longitudinal strain bull's-eye diagram of the LV, it was concluded that the GLS of the inferior, inferior lateral and anterior lateral walls of type A bypass was significantly reduced, and the GLS of the anterior wall, anterior septum and inferior septum of type B bypass was significantly reduced, with the most significant in the basal segment, followed by the intermediate segment, and the apical reg","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1567172"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978901","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":"Exon 1 deletion of the androgen receptor gene causing complete androgen insensitivity syndrome in a newborn: a case report.","authors":"Shengxia Wang, Ya-Ting Zhang, Fan Wang","doi":"10.3389/fped.2025.1508618","DOIUrl":"https://doi.org/10.3389/fped.2025.1508618","url":null,"abstract":"<p><strong>Objective: </strong>To genetically characterize a case of neonatal complete androgen insensitivity syndrome (CAIS) and identify the underlying molecular defect.</p><p><strong>Methods: </strong>This was a retrospective analysis of the clinical data, diagnosis, and treatment of a case of CAIS in the Second Hospital of Lanzhou University. Genetic testing of the patient and their parents was done; the pathogenic genes of the child were detected using whole exome sequencing (WES) technology.</p><p><strong>Results: </strong>The social sex of the proband was female, but the chromosomal sex was male. WES detected Exon 1 deletion mutation of AR gene in the proband and Exon 1 heterozygosity deletion in the mother. This mutation may cause disease according to the ACMG guidelines, but this variation has not been reported in CAIS caused by an AR gene.</p><p><strong>Conclusion: </strong>This study genetically characterized a neonate with CAIS, identifying a novel Exon 1 deletion in the AR gene as the underlying cause. This finding expands the spectrum of known mutations associated with CAIS and provides valuable insights into the genetic basis of this condition.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1508618"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of IL-18 and IL-33 in the bronchoalveolar lavage fluid of children with severe community-acquired pneumonia complicated with pleural effusion.","authors":"Yinxia Zhang, Zihao Liu, Yiwei Hong, Li Li, Youzhuo Liang, Liangxin Lin, Wenjian Wang, Heping Wang","doi":"10.3389/fped.2025.1560328","DOIUrl":"https://doi.org/10.3389/fped.2025.1560328","url":null,"abstract":"<p><strong>Background: </strong>To investigate the evaluative role of interleukin (IL)-1 family cytokines in bronchoalveolar lavage fluid (BALF) among children with severe community-acquired pneumonia (SCAP) and identify cytokines with clinical relevance for pediatric SCAP.</p><p><strong>Methods: </strong>Children with SCAP hospitalized at Shenzhen Children's Hospital (2019-2020) were studied. IL-1 family cytokines in the BALF were measured via CBA or ELISA. These cytokines included nine IL-1 family members (IL-1<i>α</i>, IL-1β, IL-1Ra, IL-33, IL-18, IL-37, IL-36<i>α</i>, IL-36Ra, and IL-38) and two receptors (sST2 and IL-18BP). The ratio of proinflammatory cytokines to anti-inflammatory cytokines was analyzed.</p><p><strong>Results: </strong>In the BALF of children with SCAP complicated with pleural effusion (PE), the levels of IL-18, the IL-18/IL-38 ratio, and the IL-33 level were significantly elevated (<i>P</i> < 0.05). Furthermore, the receiver operating characteristic (ROC) curve indicated that these three markers have strong predictive efficacy for diagnosing SCAP complicated with PE. The levels of members of the IL-1 family, including IL-1<i>α</i>, IL-1β, IL-1Ra, IL-18, and IL-33, and their associated ratios significantly differed across different pathogen groups (<i>P</i> < 0.05). IL-36<i>α</i> and the IL-36<i>α</i>/IL-38 ratio differed significantly between the <i>Haemophilus influenzae</i> (Hi)-positive and -negative groups (<i>P</i> < 0.0001 and 0.0048), with lower levels in the Hi-positive group.</p><p><strong>Conclusion: </strong>IL-18, IL-33, and IL-38 in BALF may serve as effective markers for predicting the development of PE in pediatric SCAP patients. Additionally, respiratory tract colonization by Hi may diminish the production of specific proinflammatory cytokines, including IL-18, IL-33, and IL-36<i>α</i>, during SCAP.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1560328"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001907","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":"En-bloc kidney transplants from very small pediatric donors: a propensity score matched analysis.","authors":"Silvia Oberparleiter, Felix J Krendl, Thomas Resch, Rupert Oberhuber, Hannah Esser, Florian Ponholzer, Annemarie Weissenbacher, Robert Breitkopf, Hannes Neuwirt, Stefan Schneeberger, Manuel Maglione, Benno Cardini","doi":"10.3389/fped.2025.1570489","DOIUrl":"https://doi.org/10.3389/fped.2025.1570489","url":null,"abstract":"<p><strong>Background: </strong>Kidneys from brain-death small pediatric donors ≤2 years are still classified as marginal organs. Herein, we analyse the outcomes following en-bloc kidney transplantation (EBKT) from pediatric donors ≤2 years into adult recipients compared to standard criteria donor kidney transplant recipients (SKTs).</p><p><strong>Methods: </strong>A retrospective single center analysis of a prospectively collected and auditable database identified six EBKTs and 75 SKTs between January 2015 and June 2017. Propensity score matching minimized selection bias.</p><p><strong>Results: </strong>After a median follow-up of 74 months, five-year patient and graft survival were 100%, each in the EBKTs group. Following SKTs, the five-year patient survival rate was 94.7%, likewise death-censored graft survival reached 94.7%. Two EBKT cases experienced unilateral arterial graft thrombosis requiring unilateral nephrectomy, with full recovery and good kidney function. At hospital discharge, recipients of EBKTs showed decreased eGFR compared to SKTs, however, from 3 months onward this reversed and following a median follow-up of 74 months the median eGFR was twice as high after EBKT compared to SKT (107 ml/min/1.73m² vs. 52 ml/min/1.73m², <i>p</i> < 0.001). These favourable results persist in the PSM analysis.</p><p><strong>Conclusion: </strong>EBKTs from very small pediatric donors show excellent long-term kidney function. The higher incidence of postoperative complications does not translate into poorer mid-term patient and graft survival.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1570489"},"PeriodicalIF":2.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The practice of a modified bubble CPAP therapy in a rural Sierra Leone SCBU-A pilot study.","authors":"Fanghua Qin, Cuilan Dong, Jun Qiu, Qingqing Song, Kumba Konomanyi, Lucinda Sia Fatmata Sesay, Aiqing Xiao","doi":"10.3389/fped.2025.1534550","DOIUrl":"https://doi.org/10.3389/fped.2025.1534550","url":null,"abstract":"<p><strong>Background: </strong>Continuous Positive Airway Pressure (CPAP) is an effective intervention for managing neonatal respiratory distress. However, its implementation encounters numerous challenges in resource-limited settings. It is imperative for healthcare professionals to devise highly practical and cost-effective modifications to CPAP systems to address these challenges.</p><p><strong>Objective: </strong>To evaluate the clinical efficacy and operational feasibility of a modified bubble CPAP therapy utilizing locally available materials in reducing respiratory distress and improving survival rates of neonates in the Special Care Baby Unit (SCBU) of the Sierra Leone-China Friendship Hospital.</p><p><strong>Materials and methods: </strong>93 neonates with respiratory distress were divided into the control group (<i>n</i> = 48) for nasal cannula oxygen therapy and the observation group (<i>n</i> = 45) for modified bubble CPAP therapy. The modified CPAP device was constructed using locally available materials, such as drinking cups and modified nasal cannulas, with oxygen delivered via concentrators. Respiratory Severity Score, blood oxygen saturation, heart rate, and respiration were monitored with data recorded at admission and 8 h after intervention.</p><p><strong>Results: </strong>After intervention, the neonates in the observation group showed significant improvements in all parameters: decreased RSS scores (7.40 ± 0.986 vs. 5.33 ± 1.447, <i>P</i> < 0.001), heart rate (153.13 ± 5.998 vs. 141.60 ± 8.830, <i>P</i> < 0.001), and respiratory rate (47.87 ± 4.103 vs. 43.47 ± 3.833, <i>P</i> < 0.01), and higher oxygen saturation (73.60% ± 10.636% vs. 91.07% ± 8.940%, <i>P</i> < 0.001) and survival rate (88% vs. 62.5%, <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>The study indicated that the implementation of modified bubble CPAP therapy enhanced respiratory outcomes and increased survival rates among neonates experiencing respiratory distress in a resource-constrained setting in rural Sierra Leone.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1534550"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011207","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":"Ultrasound-guided coracobrachialis plane musculocutaneous nerve block for perioperative analgesia in pediatric Gartland type III supracondylar humerus fracture: a prospective pilot study.","authors":"Tianyi Gao, Zhuorun Song, Shunyi Lu, Nan Song, Wentao Yu, Huilin Yang, Jun Zou, Qian Wang, Jun Ge","doi":"10.3389/fped.2025.1485277","DOIUrl":"https://doi.org/10.3389/fped.2025.1485277","url":null,"abstract":"<p><strong>Purpose: </strong>Perioperative pain management in children with Gartland Type III supracondylar humerus fractures (SHF) is crucial but often inadequately addressed, leading to significant pain experiences. This study aimed to evaluate the efficacy and safety of coracobrachialis plane musculocutaneous nerve block (Cora-MNB) compared to supraclavicular brachial plexus block (SC-BPB) for analgesia in pediatric Gartland Type III SHF patients.</p><p><strong>Methods: </strong>A prospective pilot study enrolled 105 pediatric patients with Gartland Type III SHF was performed. Primary outcome was the postoperative FLACC scale measured at 12 h postoperatively. Secondary outcomes included FLACC scale measured at 1 h, 6 h and 24 h postoperatively. They also included postoperative thumb and shoulder strength, opioid use, NSAIDs use, length of hospital stays, patient satisfaction, surgeon satisfaction, operation time and puncture channels. One hundred and five patients were randomized allocated between groups.</p><p><strong>Results: </strong>Patients receiving Cora-MNB showed superior analgesia, with median postoperative FLACC pain scores at 12 h reduced by 40% [Cora-MNB: 3.00 (2.00) vs. SC-BPB: 5.00 (2.00), ***<i>p</i> < 0.001]. Thumb extensor weakness incidence decreased significantly (Cora-MNB: 13.5% vs. SC-BPB: 84.9%, ***<i>p</i> < 0.001). Shoulder mobility preservation was achieved in 98.08% of Cora-MNB cases vs. 20.75% with SC-BPB (***<i>p</i> < 0.001). While opioid consumption showed no intergroup difference, Cora-MNB reduced NSAID rescue times [Cora-MNB: 0.00 (1.00) vs. SC-BPB: 1.00 (1.00), **<i>p</i> = 0.0014]. Procedure duration favored Cora-MNB [4.54 ± 1.21 (min) vs. 9.02 ± 1.94 (min), T = 14.32, 95% CI: 3.88-5.12, ***<i>p</i> < 0.001], with higher surgical and parental satisfaction scores. Hospital stays remained comparable [1.60 ± 0.66 (days) vs. 1.56 ± 0.67 (days), <i>p</i> = 0.98].</p><p><strong>Conclusion: </strong>Cora-MNB proves to be a safe and effective approach for anesthesia in pediatric SHF cases, offering superior analgesic outcomes, reduced NSAIDs usage, improved shoulder functionality, and high satisfaction levels without extending the hospital stay. This study supports the implementation of Cora-MNB as a valuable technique in perioperative pain management for pediatric SHF patients.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1485277"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of congenital external ear anomalies and their associated factors.","authors":"Alejandro Acosta-Rodríguez, Sandra A Reza-López, César R Aguilar-Torres, Luis C Hinojos-Gallardo, Dora V Chávez-Corral","doi":"10.3389/fped.2025.1520200","DOIUrl":"https://doi.org/10.3389/fped.2025.1520200","url":null,"abstract":"<p><strong>Objective: </strong>External ear anomalies may lead to conductive hearing loss with significant childhood disability, psychological distress, anxiety, social avoidance, and behavioral problems. The aim of this study is to compile and review published literature on the frequency of isolated and non-isolated external ear anomalies, their associated factors, and associated malformations/deformations in non-isolated cases.</p><p><strong>Methods: </strong>We conducted a systematic review in PubMed, Google Scholar, and Science Direct searching for any type of article (excluding reviews and meta-analyses) reporting isolated and non-isolated external ear anomalies in humans. Two authors extracted the information according to the main variables of interest according to PICO criteria. Details of studied population and main findings were also obtained (malformation type, unilateral or bilateral malformations and associated factors).</p><p><strong>Results: </strong>Twenty-six studies met eligibility criteria to be included in this review. Anotia/microtia was the most reported malformation, more frequently found in males, mostly unilateral; being the right ear the most affected, and more frequent in Hispanic population. Associated factors for external ear anomalies included parental age, maternal education, multiple pregnancies, high maternal body mass index and diabetes, pregnancy, and perinatal complications (low birth weight, prematurity, threatened abortion, etc.), twining, and chemical/drug exposure. The most reported malformations and syndromes associated with congenital external ear defects included: skull/face anomalies, cleft lip/palate, congenital heart defects, musculoskeletal malformations of skull, face and jaw, Treacher-Collins, OAVS (oculo-auriculo-vertebral spectrum), and trisomy 18, 13 and 21.</p><p><strong>Conclusion: </strong>Congenital external ear anomalies can occur isolated or associated with other malformations or syndromes. Environmental, socioeconomic, and cultural factors may partially explain the variation across populations for congenital external ear anomalies. Depending on their type and severity, they can lead to speech impediments and childhood disability, particularly in bilateral cases, highlighting the relevance of early detection and repair to avoid childhood disability.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1520200"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007131","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}