Frontiers in Pediatrics最新文献

{"title":"Comparison of the diagnostic accuracy of resistin and CRP levels for sepsis in neonates and children: a systematic review and meta-analysis.","authors":"Fen Xu, Jun Luo, Wenbin Li","doi":"10.3389/fped.2025.1555671","DOIUrl":"10.3389/fped.2025.1555671","url":null,"abstract":"<p><strong>Background: </strong>Resistin (RETN) levels are potential diagnostic markers for sepsis in neonates and children. However, studies have yielded inconsistent results. This study aimed to compare the diagnostic accuracy of RETN levels with that of C-reactive protein (CRP) levels in the diagnosis of paediatric and neonatal sepsis through a comprehensive review of recent literature.</p><p><strong>Methods: </strong>A standard methodology for systematic reviews and meta-analyses was followed. The PubMed, Embase and Cochrane databases were searched from January 1996 to October 2024 (PROSPERO CRD42024621872). Eligible studies were selected and analysed using Review Manager 5.4 and STATA 17. Meta-DiSc version 1.4 was used to describe and calculate the sensitivity, specificity, summary receiver operating characteristic (SROC) curves and areas under the curves (AUCs). SROC curve analysis was used to summarize the overall performance.</p><p><strong>Results: </strong>A total of 437 neonates and children were included in six identified studies, all of which demonstrated reasonable methodological quality. The pooled sensitivity for the RETN level was 0.88 [95% confidence interval (CI), 0.83-0.92], which surpassed that of the CRP level at 0.85 (95% CI, 0.79-0.90). However, the pooled specificity for the RETN level was 0.78 (95% CI, 0.71-0.83), which was lower than that of the CRP level at 0.84 (95% CI, 0.77-0.90). Furthermore, the SROC curves for RETN and CRP in predicting sepsis in neonates and children indicated high predictive abilities, with AUC values of 0.925 and 0.945, respectively.</p><p><strong>Conclusions: </strong>The current evidence suggests that the RETN level is a valuable biomarker for detecting paediatric and neonatal sepsis.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024621872].</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1555671"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142284","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":"Caregivers' care experiences of children with developmental dislocation of the hip in Tibet, China: a convergent mixed-methods study.","authors":"Yang Lei, Jiang Yan, Shao Wenjuan, Shen Weili, Xiao Qianyi, Fan Lingyan","doi":"10.3389/fped.2025.1561246","DOIUrl":"10.3389/fped.2025.1561246","url":null,"abstract":"<p><strong>Aim: </strong>To understand, comprehensively, care experiences of caregivers for children with developmental dislocation of the hip in Tibet, China.</p><p><strong>Background: </strong>Postoperative rehabilitation for children with developmental dislocation of the hip (DDH) may last for several months to years. Even after discharge, recovery is often partial. It is important to note that despite optimal surgical treatment, lifelong residual issues may persist, such as limping, chronic pain, or early-onset osteoarthritis. Home care is critical in postoperative recovery. Family as the basic unit of home-based care for patients, many measures are inevitably carried out in the family environment and rely on family caregivers to provide. This requires caregivers to pay long-term and high attention, posing significant challenges to caregiving capacity.</p><p><strong>Design: </strong>A convergent mixed-methods.</p><p><strong>Methods: </strong>Caregivers (<i>n</i> = 76) completed the Chinese version of the Family Caregiver Care Ability Scale, the Zarit Caregiver Burden Scale and 12 participated in semi-structured interviews from September, 2023 to February 2024. Descriptive statistics and Pearson correlation analysis were used for quantitative analysis, thematic analysis for qualitative analysis. Both quantitative and qualitative data were merged and integrated for mixed-methods analysis.</p><p><strong>Results: </strong>Low caregiver capacity and moderate caregiver burden scores were reported. Four themes emerged from care experiences: different emotions at different stages (initial worry, backend trust), caregiving process overwhelmed (role conflict, lack of caregiving capacity), insufficient information (disease-specific information, actual care information), and social support.</p><p><strong>Conclusion: </strong>This study is the first to use this mixed-methods design to analyze the current state of care and burden among family caregivers of children with developmental dislocation of the hip in Chinese highland region-Tibet. The combined results showed that qualitative results converged with quantitative results in terms of emotional changes, role burden, lack of disease-specific information, and social support; qualitative results complemented quantitative results in terms of caregiving capacity deficits and lack of actual care information to explain the quantitative results. The quantitative findings also emphasized the link between social support in terms of caregiving capacity and caregiving burden. These results guide future research to promote rehabilitation and improve quality of life for affected children and families.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1561246"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142120","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":"Prognosis of different types of acute infection in the first episode of childhood acute leukemia.","authors":"Shasha Li, Shanshan Li, Yi Chen, Shuyuan Jia, Kexin Luan, Feng Cui","doi":"10.3389/fped.2025.1589770","DOIUrl":"10.3389/fped.2025.1589770","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to determine the prognosis of different types of acute infection in pediatric leukemia patients.</p><p><strong>Methods: </strong>A retrospective study was carried out on pediatric leukemia patients with acute infections admitted to the Second Affiliated Hospital of Harbin Medical University between 1 September 2004 and 31 August 2022. Clinical characteristics, diagnostic findings, and prognostic outcomes were extracted from the eligible cases and analyzed.</p><p><strong>Results: </strong>There were 36 cases of acute myeloid leukemia (AML) and 72 cases of acute lymphoblastic leukemia (ALL) that met the inclusion criteria. There were significant differences in the incidence of pneumonia (47.2% vs. 27.8%, <i>p</i> = 0.045) and sepsis (19.4% vs. 2.8%, <i>p</i> = 0.006) between the AML and ALL groups. There were 10 cases with a poor prognosis and 26 cases with a favorable prognosis in the AML group. There were no significant differences between the poor prognosis and the favorable prognosis groups except for age (14.2 ± 1.2 years vs. 9.6 ± 4.3 years, <i>p</i> = 0.003). There were 14 cases with a poor prognosis and 58 cases with a favorable prognosis in the ALL group. There were no significant differences between the poor prognosis and favorable prognosis groups except for age (13.4 ± 2.7 years vs. 9.2 ± 4.7 years, <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>There were significantly more incidence of pneumonia and sepsis in children with AML. Younger AML and ALL children with acute infections have more favorable prognoses than older children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1589770"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142311","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":"Editorial: Insights in pediatric gastroenterology, hepatology & nutrition.","authors":"Andrew S Day","doi":"10.3389/fped.2025.1601516","DOIUrl":"10.3389/fped.2025.1601516","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1601516"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142293","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":"Population-based study on hospital admissions for pediatric status asthmaticus: from before to after the COVID-19 pandemic.","authors":"Ka Ka Siu, Michael Kwan Leung Yu, Jaime S Rosa Duque, Sophelia Hoi Shan Chan, Yu Lung Lau, So Lun Lee","doi":"10.3389/fped.2025.1534770","DOIUrl":"10.3389/fped.2025.1534770","url":null,"abstract":"<p><strong>Objectives: </strong>The increase in respiratory infections post-COVID-19 pandemic, attributed to relaxed masking and social distancing, has raised concerns about a new pattern of severe asthma exacerbations in children. We compare admission rates, severity, and risk factors of status asthmaticus in children with reference to the past 3 years before, during, and after the COVID-19 pandemic.</p><p><strong>Study design: </strong>This is a population-based cross-sectional analysis. Admission records were retrieved from the Clinical Data Analysis and Reporting System of the Hospital Authority in Hong Kong. Patients aged 2 to <18 years admitted for status asthmaticus between January 2017 and March 2024 were included.</p><p><strong>Main results: </strong>The incidence rate of pediatric status asthmaticus increased after the COVID-19 period compared to before COVID-19 (5.7-7.3 per 100,000 children aged 2 to <18 years), with a higher increase in children aged 2 to <6 years (10.1-20.6 per 100,000 children aged 2 to <18 years). There was a higher percentage of status asthmaticus admissions among total pediatric asthma admissions after COVID-19 (0.83% vs. 2.87%, <i>p</i> < 0.0001). Admissions are predicted to return to before COVID-19 levels by 2025.</p><p><strong>Conclusions: </strong>Status asthmaticus increased after the COVID-19 pandemic, particularly in preschoolers. Public health measures during the pandemic may have prevented the children's immune systems from being educated with infection.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1534770"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142309","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":"<i>Novel</i> variant in <i>MYH9</i> in a child with proteinuria and thrombocytopenia: a case report and literature review.","authors":"Dan-Feng Xie, Lin Zhu, Xiao-Meng Wang, Yun Li, Ping Zhou","doi":"10.3389/fped.2025.1502727","DOIUrl":"10.3389/fped.2025.1502727","url":null,"abstract":"<p><p>There is a lack of awareness of the diagnosis and treatment of <i>MYH9</i>-related disorder (<i>MYH9</i>-RD), which is an autosomal dominant disease with heterogeneous clinical manifestations. We summarized the clinical phenotype and reported a <i>novel</i> variant in <i>MYH9</i> in a child with focal segmental glomerulosclerosis (FSGS) and reviewed the relevant literature to better understand <i>MYH9</i>-RD. Unlike previous cases, this patient exhibited IgA deposition in the mesangial region, suggesting need for further investigation into prognostic and therapeutic significance of this finding. To reduce the risk of <i>MYH9</i>-RD misdiagnosis, we recommend assessing mean platelet diameter and granulocyte inclusions in patients with unexplained proteinuria and refractory thrombocytopenia.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1502727"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142117","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":"Case Report: Pediatric respiratory viral infection failure: a case series of eight fatalities in children under 5 years old in Iran.","authors":"Mahnaz Ramzali, Saeed Samadizadeh, Mohsen Ebrahimi, Leila Barati, Britt Nakstad, Alireza Tahamtan","doi":"10.3389/fped.2025.1396142","DOIUrl":"10.3389/fped.2025.1396142","url":null,"abstract":"<p><p>Acute respiratory tract infection (ARTI) remains a major health threat to children under five, contributing to significant morbidity and mortality worldwide. According to the World Health Organization (WHO), ARTI leads to the hospitalization of over 12 million children annually, with approximately one million fatalities, one-third of which occur in low-income countries. The respiratory tract hosts diverse microorganisms, among which pathogenic viruses and bacteria are the leading causes of ARTI. Several risk factors-including age, gender, living conditions, seasonality, and underlying diseases-can influence disease severity. Documenting detailed case series that highlight the clinical characteristics and outcomes of pediatric ARTI, particularly in children with complex underlying conditions, is essential for understanding its impact and guiding clinical decision-making. This manuscript presents a case series of eight pediatric patients from Taleghani Children's Hospital in Gorgan, northern Iran, who tragically succumbed to respiratory viral infections, offering insights into the challenges of managing severe ARTI in children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1396142"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142215","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":"Pediatric unsedated transnasal endoscopy: applications, equipment, and future directions.","authors":"Paroma Bose, Ryan Pitman","doi":"10.3389/fped.2025.1585705","DOIUrl":"10.3389/fped.2025.1585705","url":null,"abstract":"<p><p>Gastrointestinal (GI) endoscopy is a valuable tool to diagnose and treat GI conditions. Traditional pediatric GI endoscopy uses sedation or general anesthesia, with associated risks of cardiopulmonary compromise and social and economic costs like school or work absence. Unsedated, transnasal endoscopy is an approach that mitigates these disadvantages but provides similar diagnostic benefit to conventional endoscopy. Ongoing advances in the field of pediatric transnasal endoscopy will be driven by an enhanced understanding of current indications, available equipment, procedural comfort strategies, and recent developments in new diagnostic and therapeutic uses.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1585705"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142306","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":"Genetic polymorphisms of antioxidant enzymes (GSTP1/CAT/HMOX1/EPHX1) and childhood asthma risk in Fuzhou.","authors":"Ziling Wu, Qiaobin Chen, CaiChun Lin, HongBiao Huang, Lang Chen","doi":"10.3389/fped.2025.1524055","DOIUrl":"10.3389/fped.2025.1524055","url":null,"abstract":"<p><strong>Objective: </strong>Discuss the correlation between single nucleotide polymorphisms (SNPs) of the Glutathione s-transferase Pi-1 (GSTP1), Catalase (CAT), Heme oxygenase-1 (HMOX1), and Homo sapiens epoxide hydrolase 1 (EPHX1) genes and the risk of childhood asthma in Fuzhou.</p><p><strong>Methods: </strong>Next generation sequencing (<i>N</i>GS) was employed to conduct whole-exome sequencing (WES) on 50 asthmatic children and 50 healthy children. Genetic models for the GSTP1 gene rs1695, rs4891, HMOX1 gene rs2071747, rs17878790, CAT gene rs7943316, rs1049982, rs769217, and EPHX1 gene rs2234922, rs41266231, rs1051740 sites were constructed. Binary logistic regression, linkage disequilibrium analysis, haplotype analysis, and interaction analysis were used to study the correlation between the 10 SNPs of GSTP1, CAT, HMOX1, and EPHX1 genes and the risk of asthma in children in the Fuzhou region.</p><p><strong>Results: </strong>The rs1695 A>G variant increased the risk of asthma in the heterozygous, dominant, and allele models. The rs4891 T>C variant increased the risk of asthma in the heterozygous, dominant, and allele models. The rs7943316 A>T variant increased the risk of asthma in the homozygous, recessive, and allele models. The rs769217 C>T variant decreased the risk of asthma in the homozygous, recessive, and allele models. Strong linkage disequilibrium between the GSTP1 gene rs1695 and rs4891, and the CAT gene rs7943316, rs1049982, and rs769217. The GC haplotype composed of GSTP1 gene rs1695 and rs4891 may pose a risk for childhood asthma [<i>P</i> = 0.025, OR = 2.12 (1.09-4.10)], while the AT haplotype may be protective [<i>P</i> = 0.025, OR = 0.47 (0.24-0.92)]. The ATT haplotype composed of CAT gene rs7943316, rs1049982, and rs769217 may be protective against childhood asthma [<i>P</i> = 0.006, OR = 0.45 (0.25-0.79)]. Potential synergistic interaction between the GSTP1 gene rs1695, CAT gene rs7943316, and EPHX1 gene rs41266231. The combination of GSTP1 gene rs1695 and CAT gene rs7943316 formed the best predictive model for assessing the risk of childhood asthma in the Fuzhou region.</p><p><strong>Conclusion: </strong>The genotype GC, composed of GSTP1 gene rs1695 and rs4891, may represent a risk genotype for childhood asthma, whereas genotype AT may represent a protective genotype for childhood asthma. The genotype ATT, composed of CAT gene rs7943316, rs1049982, and rs769217, may represent a protective genotype for childhood asthma. The combination of GSTP1 gene rs1695 and CAT gene rs7943316 constitutes the optimal model for predicting the risk of childhood asthma in the Fuzhou region.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1524055"},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157735","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":"Case Report: A rare case of renal failure secondary to in utero megalourethra.","authors":"S Ali, V Nunez, R Terkawi, C Katsoufis, C Abitbol, R Ruano, J Duara, T Fontanez-Nieves","doi":"10.3389/fped.2025.1546561","DOIUrl":"10.3389/fped.2025.1546561","url":null,"abstract":"<p><strong>Background: </strong>Megalourethra is a rare congenital condition marked by dilation and elongation of the penile urethra, resulting from hypoplasia of either the corpus spongiosum or corpus cavernosa.</p><p><strong>Case presentation: </strong>We describe a novel case of a male infant prenatally diagnosed with megalourethra who subsequently developed rapid-onset anhydramnios and advanced renal failure.</p><p><strong>Conclusion: </strong>Unlike previously described cases, this case is unique due to the patient's abrupt progression to anhydramnios at 34 weeks and 5 days, despite having normal amniotic fluid levels prior to that. With late-onset anhydramnios, the severity of renal dysfunction was unexpected. Proximal urethrostomy requires further assessment as a potential intervention to successfully bypass the megalourethra and prevent infection. Long-term management is expected to include dialysis as a bridge to transplantation. Multiple corrective urological surgeries will be required to repair the urethra and restore penile function. Timely prenatal diagnosis of megalourethra or renal anomalies is essential for predicting long-term prognosis, as these conditions can lead to significant postnatal complications.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1546561"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127277","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}