Frontiers in Pediatrics最新文献

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Editorial: Management of congenital heart disease: challenges, implications, innovations and pitfalls. 社论:先天性心脏病的管理:挑战、影响、创新和缺陷。
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-07-01 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1599311
Stefano Carmelo Di Bernardo
{"title":"Editorial: Management of congenital heart disease: challenges, implications, innovations and pitfalls.","authors":"Stefano Carmelo Di Bernardo","doi":"10.3389/fped.2025.1599311","DOIUrl":"https://doi.org/10.3389/fped.2025.1599311","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1599311"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642444","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}
引用次数: 0
A population-based study of neonatal air transport in the Arctic region of Norway from 1994 to 2023. 1994年至2023年挪威北极地区新生儿航空运输人口基础研究
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-07-01 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1594729
Lene Nymo Trulsen, Lisa Gullhav Hansen, Nils Thomas Songstad, Astri Lang, Claus Klingenberg
{"title":"A population-based study of neonatal air transport in the Arctic region of Norway from 1994 to 2023.","authors":"Lene Nymo Trulsen, Lisa Gullhav Hansen, Nils Thomas Songstad, Astri Lang, Claus Klingenberg","doi":"10.3389/fped.2025.1594729","DOIUrl":"10.3389/fped.2025.1594729","url":null,"abstract":"<p><strong>Background and aims: </strong>Regionalized centralization of moderate and high-risk pregnancies is essential, but a well-organized postnatal transport service is equally important. This study evaluates the overall activity and clinical outcomes of the neonatal air transport team (NATT) at the University Hospital of North Norway (UNN) in Tromsø, covering a large catchment area in the Arctic region of Norway.</p><p><strong>Methods: </strong>Medical data from all neonatal air transports between the years 1994-2023 were recorded prospectively. Body temperature, blood glucose and blood gas within 3-6 h after arrival at UNN were assessed from medical files retrospectively. To assess temporal changes, we compared data between 1994 and 2008 (Period 1) and 2009-2023 (Period 2).</p><p><strong>Results: </strong>A total of 882 acute transports were included. Of these, 655 (74.3%) were referrals to the tertiary neonatal unit at UNN and 227 (25.7%) transfers to national surgical centers. Most transports (61.5%) were by fixed wing aircrafts. The proportion of infants transported due to congenital heart defects (CHD), prematurity and asphyxia was lower in Period 2. When comparing Period 1 and 2, upon arrival we found similar rates of hypothermia (9.8% vs. 6.7%, <i>p</i> = 0.17) and hypercapnia (17.3% vs. 15.3%, <i>p</i> = 0.55), but decreasing rates of hypocapnia (6.7% vs. 2.5%, <i>p</i> = 0.014) and hypoglycemia (10.8% vs. 2.3%, <i>p</i> = 0.001). There were low rates of outborn very low birth weight (VLBW) infants (<1,500 g) in both periods; 4.3% and 3.1%. However, severe IVH was observed in 6/29 (20.7%) outborn VLBW-infants vs. only 21/356 (5.9%) inborn VLBW-infants in the last 15-year period.</p><p><strong>Conclusion: </strong>Decreasing rates of transport due to prematurity and CHDs is probably secondary to improved perinatal care. Rates of hypoglycemia and hypocapnia improved in the second 15-year period, but further focus on improvements in both temperature and CO<sub>2</sub> control is warranted. Acute transport of VLBW-infants is associated with a markedly increased risk of severe IVH. In-utero transfer of women with threatened preterm birth to a tertiary perinatal center is therefore paramount.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1594729"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642441","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}
引用次数: 0
Editorial: Disorders of sex development in children: advancing multidisciplinary approaches for complex diagnosis and management. 社论:儿童性发育障碍:推进复杂诊断和管理的多学科方法。
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-07-01 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1646197
Saida Hidouri, Evangelia Kalaitzoglou, Christopher J Romero
{"title":"Editorial: Disorders of sex development in children: advancing multidisciplinary approaches for complex diagnosis and management.","authors":"Saida Hidouri, Evangelia Kalaitzoglou, Christopher J Romero","doi":"10.3389/fped.2025.1646197","DOIUrl":"10.3389/fped.2025.1646197","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1646197"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642443","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}
引用次数: 0
Therapeutic effect of adalimumab in the treatment of intestinal Behçet's disease in children. 阿达木单抗治疗儿童肠道behaperet病的疗效观察。
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-30 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1619065
Tianjiao Gao, Xiaoxia Ren, Yanan Han, Fengfan Wang, Bianhua Liu, Ying Fang
{"title":"Therapeutic effect of adalimumab in the treatment of intestinal Behçet's disease in children.","authors":"Tianjiao Gao, Xiaoxia Ren, Yanan Han, Fengfan Wang, Bianhua Liu, Ying Fang","doi":"10.3389/fped.2025.1619065","DOIUrl":"10.3389/fped.2025.1619065","url":null,"abstract":"<p><strong>Objective: </strong>Intestinal Behçet's disease is a rare but severe manifestation of Behçet's disease, particularly in pediatric populations. Currently, there is no cure for intestinal Behçet's disease, and the goal of treatment is to control acute episodes and reduce inflammation. Adalimumab, a tumor necrosis factor-alpha (TNF-α) inhibitor, has shown promise in adult patients, but data on its efficacy and safety in children are limited. The aim of this study was to evaluate the efficacy and safety of adalimumab in the treatment of intestinal Behçet's disease in children.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 8 children with intestinal Behçet's disease treated with adalimumab at Xi'an Children's Hospital from January 2021 to December 2024. Clinical symptoms, endoscopic findings, and inflammatory markers were assessed before and after treatment. Efficacy was evaluated on the basis of symptom resolution, ulcer healing, and changes in inflammatory markers.</p><p><strong>Results: </strong>The cohort included 4 males and 4 females, with an average age of 11.9 ± 1.4 years and a disease course of 10.5 (6.75, 22.5) months. All patients presented with gastrointestinal symptoms, including abdominal pain (<i>n</i> = 7), vomiting (<i>n</i> = 1), and complications such as intestinal obstruction (<i>n</i> = 3) and perforation (<i>n</i> = 1). Colonoscopy revealed ileocecal ulcers in 7 patients and only terminal ileal ulcers in 1 patient. After treatment with adalimumab, complete resolution of clinical symptoms was observed in all patients. Gastrointestinal endoscopy revealed that 6 patients had completely healed ulcers, while the remaining 2 patients had ulcers that were reduced to 50% of their original size. The levels of inflammatory markers significantly decreased, with the erythrocyte sedimentation rate (ESR) decreasing from 44.63 ± 43.48 mm/h to 10.50 ± 7.65 mm/h (<i>p</i> = 0.046) and the high sensitivity C-reactive protein (hs-CRP) level decreasing from 43.87 ± 39.10 mg/L to 0.96 ± 0.67 mg/L (<i>p</i> = 0.017). On the basis of clinical symptoms and endoscopic findings, 6 patients (75%) achieved complete remission, and 2 patients (25%) showed improvement. Adalimumab was well tolerated, with only one case of mild eczema reported.</p><p><strong>Conclusion: </strong>Adalimumab is safe and effective in the treatment of intestinal Behçet's disease in children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1619065"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636827","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}
引用次数: 0
Cytokine dysregulation in children with severe neurological impairment correlates with significant clinical outcomes. 严重神经损伤儿童的细胞因子失调与显著的临床结果相关。
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-30 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1567221
John Allen, Johana Isaza-Correa, Lynne Kelly, Ashanty Melo, Conor Power, Aoife Mahony, Denise McDonald, Eleanor J Molloy
{"title":"Cytokine dysregulation in children with severe neurological impairment correlates with significant clinical outcomes.","authors":"John Allen, Johana Isaza-Correa, Lynne Kelly, Ashanty Melo, Conor Power, Aoife Mahony, Denise McDonald, Eleanor J Molloy","doi":"10.3389/fped.2025.1567221","DOIUrl":"10.3389/fped.2025.1567221","url":null,"abstract":"<p><strong>Background: </strong>Children with neurological disorders have altered inflammatory responses. We aimed to describe pro-inflammatory, anti-inflammatory and hypoxia-induced cytokines in serum, at baseline, and in response to stimulation of whole blood with lipopolysaccharide, in children with Severe Neurological Impairment (SNI) compared to controls.</p><p><strong>Methods: </strong>Whole blood samples from children with SNI and healthy controls were incubated in the presence or absence of lipopolysaccharide (LPS). Serum was isolated and 12 cytokines were analysed by ELISA. Select clinical data was collected from healthcare records and correlated with cytokine results.</p><p><strong>Results: </strong>Twenty-nine children with SNI (<i>n</i> = 14) and age-matched controls (<i>n</i> = 15) were recruited. Cytokine responses to lipopolysaccharide were similar between the groups for Interferon (INF)-γ, Interleukin(IL)-18, Tumour Necrosis Factor(TNF)-β, IL-10, IL-1ra, IL-1β, IL-8, TNF-α and Vascular Endothelial Growth Factor (VEGF). Granulocyte Monocyte Colony Stimulating Factor (GM-CSF) increased in response to LPS in the control group (<i>p</i> = 0.04) but not in those with SNI (<i>p</i> = 0.07). The SNI cohort had a significantly greater increase in EPO in response to LPS than controls (<i>p</i> = 0.006). IL-6 in the SNI cohort was relatively hyporesponsive to LPS (<i>p</i> = 0.01). Correlations were found in LPS responses as follows: number of antiseizure medications and IL-1ra (<i>p</i> = 0.01) and TNF-α (<i>p</i> = 0.04); number of infections within the last year and IL-18 (<i>p</i> = 0.02); requirement for enteral feeding and IL-10 (<i>p</i> = 0.03) and EPO (<i>p</i> = 0.001); use of prophylactic antibiotics and IL-10 (<i>p</i> = 0.001); requirement for respiratory support and VEGF (<i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Children with SNI have persistent altered inflammatory responses. These alterations may contribute to tertiary neurological injury and impaired ability to respond to infection and may provide a target for immunomodulation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1567221"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636816","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}
引用次数: 0
Artificial intelligence in pediatrics: promise, peril, and the path ahead. 儿科学中的人工智能:希望、危险和未来的道路。
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-30 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1631521
Stefan Kurath-Koller
{"title":"Artificial intelligence in pediatrics: promise, peril, and the path ahead.","authors":"Stefan Kurath-Koller","doi":"10.3389/fped.2025.1631521","DOIUrl":"10.3389/fped.2025.1631521","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1631521"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636813","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}
引用次数: 0
Burden of pulmonary arterial hypertension in children globally, regionally, and nationally (1990-2021): results from the global burden of disease study. 全球、区域和国家儿童肺动脉高压负担(1990-2021):来自全球疾病负担研究的结果
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-30 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1527281
Lili Deng, Jingxuan Xiong, Jiaoli Xu, Qinhong Li, Zugen Cheng
{"title":"Burden of pulmonary arterial hypertension in children globally, regionally, and nationally (1990-2021): results from the global burden of disease study.","authors":"Lili Deng, Jingxuan Xiong, Jiaoli Xu, Qinhong Li, Zugen Cheng","doi":"10.3389/fped.2025.1527281","DOIUrl":"10.3389/fped.2025.1527281","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric pulmonary arterial hypertension (PAH) is a rare and severe disorder characterized by obstructive vascular changes that can lead to right heart failure. The clinical presentation and underlying causes of pediatric PAH differ significantly from those in adults, often involving congenital heart disease and developmental lung disorders, such as bronchopulmonary dysplasia (BPD). Despite advances in treatment, pediatric PAH remains underrecognized globally.</p><p><strong>Methods: </strong>This study analyzed global, regional, and national trends in pediatric PAH from 1990 to 2021 using data from the Global Burden of Disease (GBD) database.</p><p><strong>Results: </strong>The findings indicate a stable prevalence rate globally, with a slight increase in the absolute number of cases. Significantly, reductions were observed in both mortality and disability-adjusted life years (DALYs) associated with pediatric PAH, with mortality decreasing by 57.66% and DALYs by 63.59% over the study period, indicating progress in mitigating the disease burden. Substantial regional disparities were identified, with low-income regions, particularly Low Socio-Demographic Index (SDI) areas, experiencing the highest mortality and DALY rates. In contrast, high-middle SDI regions showed the greatest reductions in disease burden. The highest prevalence and burden were observed in South Asia, the Caribbean, and parts of Sub-Saharan Africa, with China, India, and Haiti bearing the greatest national burdens.</p><p><strong>Discussion: </strong>These findings highlight the necessity for targeted health interventions, especially in low-resource settings, to improve early diagnosis, intervention, and treatment.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1527281"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636814","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}
引用次数: 0
Combined effects of maternal supplementation of iron, calcium, folic acid, and multivitamin during pregnancy on obesity in Chinese preschoolers born macrosomia. 妊娠期间母亲补充铁、钙、叶酸和多种维生素对中国巨大儿学龄前儿童肥胖的联合影响
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-27 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1608521
Ming-Fei Yan, Esben Strodl, Wei-Kang Yang, Xiao-Na Yin, Guo-Min Wen, Deng-Li Sun, Dan-Xia Xian, Ya-Fen Zhao, Wei-Qing Chen
{"title":"Combined effects of maternal supplementation of iron, calcium, folic acid, and multivitamin during pregnancy on obesity in Chinese preschoolers born macrosomia.","authors":"Ming-Fei Yan, Esben Strodl, Wei-Kang Yang, Xiao-Na Yin, Guo-Min Wen, Deng-Li Sun, Dan-Xia Xian, Ya-Fen Zhao, Wei-Qing Chen","doi":"10.3389/fped.2025.1608521","DOIUrl":"10.3389/fped.2025.1608521","url":null,"abstract":"<p><strong>Objective: </strong>Childhood obesity has become a global public health crisis. Previous studies have shown that nutritional supplementation during pregnancy may be protective against offspring obesity. However, the research in this area is still emerging and the impact of moderators, such as birth weight, upon outcomes has not been fully explored. This study aimed to examine the combined effect of maternal supplementation with iron, calcium, folic acid, and multivitamin during pregnancy on the risk of obesity in Chinese preschoolers born macrosomia.</p><p><strong>Methods: </strong>A total of 6,031 singleton children, born macrosomia, aged 3-6.5 years old were recruited from Longhua District in Shenzhen of China in 2021. Their mothers were asked to complete a structured questionnaire for collecting the sociodemographic characteristics of the child and parents, the child's birth-related characteristics, and maternal supplementation with iron, calcium, folic acid, and multivitamins during pregnancy. The children's weight and height were measured using a standardized method by well-trained medical staff from the Women's and Children's Hospital of Longhua District of Shenzhen.</p><p><strong>Results: </strong>After controlling for confounding variables, including other nutrients, the results of a series of logistic regressions showed that only iron supplementation (AOR = 0.75, 95% CI = 0.60-0.92) during pregnancy was negatively associated with the presence of obesity in preschoolers born macrosomia in boys. In contrast, there was no independent associations between maternal prenatal ingestion of iron, calcium, folic acid, or multivitamin supplements and obesity in preschool girls born macrosomia. Examination of interaction effects through crossover analyses showed that maternal supplementation with both iron and calcium (AOR = 0.68, 95% CI = 0.49-0.94), and both iron and multivitamins (AOR = 0.64, 95% CI = 0.48-0.86) during pregnancy significantly reduced the risk of obesity in male preschoolers born macrosomia. Furthermore, interaction analysis found a multiplicative interaction between maternal iron and multivitamin supplementation during pregnancy on the risk of obesity in male preschoolers born macrosomia (IOR = 0.52, 95% CI = 0.35-0.79).</p><p><strong>Conclusion: </strong>Our findings suggest that iron supplementation during pregnancy may reduce the risk of obesity in preschoolers born macrosomia in boys, with this effect enhanced with the combined ingestion of calcium and multivitamin supplementation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1608521"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626022","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}
引用次数: 0
Woodward procedure with intraoperative neuromonitoring for Sprengel deformity: a retrospective study with a mean 5-year follow-up. Woodward手术术中神经监测治疗Sprengel畸形:一项平均5年随访的回顾性研究。
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-27 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1541132
Li Zhang, Haoqi Cai, Yangbo Huang, Mengting Yang, Shi Huang, Mingyuan Miao, Haiqing Cai, Zhigang Wang
{"title":"Woodward procedure with intraoperative neuromonitoring for Sprengel deformity: a retrospective study with a mean 5-year follow-up.","authors":"Li Zhang, Haoqi Cai, Yangbo Huang, Mengting Yang, Shi Huang, Mingyuan Miao, Haiqing Cai, Zhigang Wang","doi":"10.3389/fped.2025.1541132","DOIUrl":"10.3389/fped.2025.1541132","url":null,"abstract":"<p><strong>Background: </strong>The Woodward procedure was designed to correct Sprengel deformity (SD) while brachial plexus injury remains a critical complication. This study aimed to assess the effectiveness of the Woodward procedure with clavicle osteotomy and intraoperative neuromonitoring (IONM) in enhancing postoperative functional outcomes, cosmetic appearance, and nerve injury prevention.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of patients who underwent the Woodward procedure with clavicle osteotomy and IONM for Sprengel deformity at our institution between January 2013 and May 2023. Patient demographics, clinical and cosmetic outcomes before and after surgery, and complications were analyzed.</p><p><strong>Results: </strong>A total of 36 patients (female: male = 16:20) with a mean age of 4.1 ± 1.5 years were included, with a mean follow-up of 5.6 years. Intraoperatively, no IONM alerts occurred. At the latest follow-up, shoulder abduction improved by an average of 74°, and Cavendish grade improved from grade 3 or 4 preoperatively to grade 1 or 2. Radiographic analysis showed Rigault grade improvement from grade 3 to grade 1 or 2. Aside from a single instance of delayed wound healing and one case of hypertrophic scarring, no brachial plexus injuries or long-term complications were observed.</p><p><strong>Conclusions: </strong>Woodward procedure combined with clavicle osteotomy and IONM for SD patients is associated with significant improvement in postoperative functional outcome, cosmetic appearance, low risk of complications and high levels of satisfaction.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1541132"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626057","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}
引用次数: 0
Delayed extubation and hypertrophic pyloric stenosis: what are the predictive factors? 延迟拔管和肥厚性幽门狭窄:什么是预测因素?
IF 2.1 3区 医学
Frontiers in Pediatrics Pub Date : 2025-06-27 eCollection Date: 2025-01-01 DOI: 10.3389/fped.2025.1540435
Sabrine Ben Youssef, Syrine Laribi, Sawsen Chakroun, Maha Ben Mansour, Mariem Ben Fredj, Afef Toumi, Radhouen Ben Salah, Amine Ksia, Mongi Mekki, Mohsen Belghith, Samia Belhassen, Lassaad Sahnoun
{"title":"Delayed extubation and hypertrophic pyloric stenosis: what are the predictive factors?","authors":"Sabrine Ben Youssef, Syrine Laribi, Sawsen Chakroun, Maha Ben Mansour, Mariem Ben Fredj, Afef Toumi, Radhouen Ben Salah, Amine Ksia, Mongi Mekki, Mohsen Belghith, Samia Belhassen, Lassaad Sahnoun","doi":"10.3389/fped.2025.1540435","DOIUrl":"10.3389/fped.2025.1540435","url":null,"abstract":"<p><strong>Introduction: </strong>Prolonged time to extubation after general anesthesia has been defined as a delay of more than 15 min from the end of surgery to tracheal extubation. This incident is frequently seen in infants operated on for hypertrophic pyloric stenosis (HPS), which can lead to inefficient use of operating rooms and delayed care for other patients.</p><p><strong>Aim: </strong>To evaluate the frequency of \"delayed extubations\" in infants who have received an extramucosal pyloromyotomy under general anesthesia and to identify the predictive factors of this incident.</p><p><strong>Methods: </strong>We report a retrospective and comparative study of patients operated for HPS at the pediatric surgery department of Monastir, between January 2020 and December 2023.</p><p><strong>Results: </strong>Thirty-four cases were collected. Delayed extubation occurred in 19 cases with very prolonged extubation (>60 min) in 3 cases. The mean age at diagnosis was 38.07 days for group 1 and 34.42 days for group 2. The average of operating time was 56 min for both groups. On the <i>χ</i> <sup>2</sup> test, the difference between the groups was significant for metabolic alkalosis. However, the results were not significant for the other criteria (prematurity, hypotrophy, dehydration, hyponatremia, hypochloremia, hypokalemia, functional renal failure, pre-operative resuscitation time).</p><p><strong>Conclusions: </strong>These data suggest that metabolic alkalosis is predictive of delayed extubation in infants operated on for HPS under general anesthesia. The use of spinal anesthesia may be an alternative to general anesthesia but it remains a controversial issue, as there are few comparative data.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1540435"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626034","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}
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