Frontiers in Pediatrics最新文献

{"title":"The early diagnostic value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in neonatal late-onset sepsis.","authors":"Qigai Yin, Jing Yin, Lu Shen, Qin Zhou, WeiDong Xu","doi":"10.3389/fped.2025.1483522","DOIUrl":"10.3389/fped.2025.1483522","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to investigate the early diagnostic value of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) in neonatal late-onset sepsis (LOS), as well as to evaluate the combined diagnostic utility of these markers for the early detection of neonatal LOS.</p><p><strong>Methods: </strong>The late-onset sepsis of newborns admitted to the neonatal intensive care unit of our hospital were retrospectively collected. 142 children with Late-Onset Sepsis (LOS) were selected as the LOS group, 50 neonates with systemic infection were selected as the systemic infection group, 50 neonates who underwent physical examination were selected as the non-systemic infection group. The differences of NLR, PLR, platelet-to-neutrophil ratio (PNR), and C-reactive protein (CRP), Procalcitonin among the three groups were compared.</p><p><strong>Results: </strong>The levels of NLR and PLR in LOS group were significantly higher than those in systemic infection group and non-systemic infection group. The Receiver Operating Characteristic (ROC) curve result revealed that the area under ROC (AUC, Area Under Curve) of NLR for the diagnosis of LOS was 0.903. When the optimal cut-off value was 1.30, the sensitivity and specificity were 89.4% and 81.0%. The AUC of PLR for the diagnosis of LOS was 0.833. When the optimal truncation value was 57.86, the sensitivity and specificity were 92.3% and 68.0%. The AUC of CRP for the diagnosis of LOS was 0.876, and the sensitivity and specificity were 76.8% and 87.0% when the optimal cut-off value was 10.21 mg/dl. When NLR, PLR, and CRP were combined to diagnosis LOS, The AUC was 0.942, the sensitivity and specificity were 90.8% and 86.0%.</p><p><strong>Conclusions: </strong>The levels of NLR and PLR in the LOS were higher, which have certain value in the early diagnosis of LOS, and combined with CRP can improve the diagnostic efficiency.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1483522"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691887","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":"Risk factors for peripherally inserted central catheter malposition in preterm infants: a multicenter retrospective study.","authors":"Chunyan Liang, Jinming Liu, Yingzi Tang, Wenpiao Zhao, Ruining Xin, Xiaoqun Gu, Fang Huang, Yu'e Lai, Wangjin Huang, Yanhong Liu, Mei Lin, Lili Pan, Guirong Cao, Sudan Tan, Chunliu Wei, Fangyuan Lin","doi":"10.3389/fped.2025.1534799","DOIUrl":"10.3389/fped.2025.1534799","url":null,"abstract":"<p><strong>Objective: </strong>To explore the risk factors affecting peripherally inserted central catheter (PICC) tip malposition in preterm infants.</p><p><strong>Methods: </strong>A retrospective collection of clinical data from preterm infants who underwent PICC placement in the neonatal departments of Guangxi Maternal and Child Health Hospital and eight other hospitals from January 2021 to April 2024 was conducted. The incidence of catheter tip malposition was analyzed. The infants were divided into two groups based on the occurrence of catheter tip malposition: the malposition group and the non-malposition group. Multifactorial logistic regression and multimodel logistic regression analyses were employed to explore the influencing factors of PICC tip malposition in preterm infants.</p><p><strong>Results: </strong>A total of 1,449 infants were ultimately included in the study, with an incidence of catheter tip displacement of 12.56% (182 out of 1,449). Adjusted results from multimodel regression analysis of covariates indicated that Sample selection location in Guilin (OR = 2.30, 95% CI:1.24∼4.25), Yulin (OR = 4.35, 95% CI: 2.27∼8.34) and Qinzhou (OR = 2.63, 95% CI:1.37∼5.08), duration of catheter insertion procedure (OR = 1.01, 95% CI: 1.01∼1.02), duration of catheter dwell (OR = 1.04, 95% CI: 1.02∼1.07), weight percentile at the time of catheter malpositioning (OR = 11.39, 95% CI:4.81∼26.95), extremely preterm group (<28 weeks gestation) (OR = 4.42, 95% CI: 1.29∼15.16) were risk factors for catheter tip displacement. Additionally, site of PICC catheterization in neck as a risk factor (OR = 3.48, 95% CI: 1.89∼6.40).</p><p><strong>Conclusion: </strong>Sample selection location in Guilin, Yulin and Qinzhou, duration of catheter insertion procedure, duration of catheter dwell, weight percentile at catheter removal, extremely preterm group (<28 weeks gestation) and site of PICC catheterization in neck may increase the risk of PICC catheter tip malposition.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1534799"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691869","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: Prolonged survival in Schinzel-Giedion syndrome featuring megaureter and <i>de novo SETBP1</i> mutation.","authors":"Glenda M Beaman, Benjamin W Jarvis, Anju Goyal, David J B Keene, Max Cervellione, Filipa M Lopes, Kay A Metcalfe, Adrian S Woolf, William G Newman","doi":"10.3389/fped.2025.1534192","DOIUrl":"10.3389/fped.2025.1534192","url":null,"abstract":"<p><strong>Background: </strong>Rare early-onset lower urinary tract (REOLUT) disorders affect the ureter, urinary bladder, or urethra and manifest before birth or in childhood. Monogenic causes have been reported in a subset of such individuals.</p><p><strong>Objectives: </strong>A possible genetic cause was considered in a child with a megaureter who had syndromic features.</p><p><strong>Subjects and methods: </strong>Whole-exome sequencing was undertaken in individuals with megaureter. Immunohistochemistry was performed in urinary tract tissues of unaffected human fetuses.</p><p><strong>Results: </strong>The index case presented at 6 months with urosepsis and was found to have a unilateral primary non-refluxing megaureter which required stenting of its distal portion. This, together with dysmorphic features and developmental delay, led to a clinical diagnosis of Schinzel-Giedion syndrome (SGS). She was found to carry a <i>de novo</i> missense variant in <i>SET binding protein 1</i> (<i>SETBP1</i>), c.2613T>G (GenBank: NM_015559.3) (p.Ile871Met), a gene previously implicated in SGS. She was in good general health at 11 years of age, an unusual outcome given that most individuals with SGS die in the first 2 years of life. SETBP1 was detected in the fetal urinary tract, both in the urothelium and in nerve trunks in the kidney hilum and around the ureter. No <i>SETBP1</i> gene variants were detected in eight further cases of megaureter.</p><p><strong>Conclusions: </strong>This case indicates the value of genetic testing when a REOLUT disorder is accompanied by syndromic signs outside the urinary tract. SETBP1 may drive the functional differentiation of the human fetal ureter.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1534192"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691818","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":"Mean nutrient adequacy ratio and associated factors of complementary foods among children aged 6-23 months in Northeast Ethiopia.","authors":"Abdulkerim Kassaw, Tefera Chane Mekonnen, Erkihun Tadesse Amsalu, Eyob Tilahun ABeje, Chala Daba, Yawkal Tsega, Abel Endawkie","doi":"10.3389/fped.2025.1446431","DOIUrl":"10.3389/fped.2025.1446431","url":null,"abstract":"<p><strong>Background: </strong>Inadequate intake of macro- and micronutrients is a significant public health challenge in Ethiopia. Ethiopia carries a substantial burden of both macro- and micronutrient deficiencies, with far-reaching consequences. However, there is limited evidence on the determinants and mean nutrient adequacy of complementary foods among children aged 6-23 months. Therefore, this study aims to determine the mean nutrient adequacy ratio and associated factors of complementary feeding among children aged 6-23 months in Northeast Ethiopia.</p><p><strong>Methods: </strong>A study was conducted in Northeast Ethiopia between 1 March and 30 April 2023, among 255 children aged 6-23 months. The study employed a systematic sampling technique to select 255 children. The data were collected using a 24-h dietary recall method. Linear regression analysis was conducted to identify factors associated with the nutrient adequacy of complementary foods. In the multivariable analysis, variables with <i>p</i>-values <0.05 were considered statistically significant.</p><p><strong>Results: </strong>The study found that the mean nutrient adequacy ratio of complementary foods among children aged 6-23 months in Northeast Ethiopia was 63% (95% CI 60.8-65.14). The adequacy of nutrients in complementary foods varied: energy (90%), fat (93%), carbohydrate (70%), protein (88%), calcium (57%), zinc (52%), vitamin B1 (50%), vitamin A (52%), and vitamin C (60%). The age of the child, mother's education, wealth index, feeding frequency, dietary diversity, minimum acceptable diet, source of information during antenatal care, postnatal care, food insecurity, and the number of children aged under 5 were associated with mean nutrient adequacy of complementary feeding.</p><p><strong>Conclusions: </strong>The study concludes that the mean nutrient adequacy ratio of complementary foods among children aged 6-23 months in Northeast Ethiopia is alarmingly low, indicating a significant gap in meeting the nutritional recommendations set by the World Health Organization. Various factors, including the child's age, maternal education, household wealth index, food insecurity, and dietary diversity, were identified as critical determinants of nutrient adequacy. These findings underscore the urgent need for comprehensive interventions at multiple levels, including education, food security, and health services, to enhance the consumption of adequate and diverse complementary foods. By addressing these factors, stakeholders can improve the nutritional status of young children, ultimately contributing to better health outcomes and development in the region.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1446431"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691825","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":"Bibliometric analysis of Crohn's disease in children, 2014-2024.","authors":"Yanjing Zhu, Yunhong Ma, Zhengjiu Cui, Yueli Pan, Juanjuan Diao","doi":"10.3389/fped.2025.1515251","DOIUrl":"10.3389/fped.2025.1515251","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the incidence of Crohn's disease has risen significantly in the pediatric population, and its prolongation has had a major impact on children's physical and mental health as well as on the quality of life of their families, and has therefore received extensive attention from scholars around the world. A large number of articles have been published on Crohn's disease in children; however, there is still a lack of studies that use visualization methods for bibliometric analysis of relevant literature. The purpose of this paper is to statistically analyze the published literature in the field of Crohn's disease in children in order to help in the future diagnosis and treatment of Crohn's disease in children.</p><p><strong>Methods: </strong>Literature meeting the inclusion criteria was screened from the Web of Science Core Collection database. Literature was visualized and analyzed by author, country, institution, journal, reference, and keyword using Citespace (6.2.R4) and VOSviewer (1.6.18).</p><p><strong>Results: </strong>A total of 3,177 eligible publications were included. There is an overall increasing trend in the number of annual publications.Turner, Dan published the most number of articles with 78 and has a high impact in the field of CD. The most cited author was Levine, A. Among countries and institutions, the United States and Tel Aviv University had the highest number of publications. The journal with the most publications is Journal Of Pediatric Gastroenterology And Nutrition. The most co-cited journal was Inflammatory Bowel Diseases. The most cited document was ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents, and the most cited document with the highest outbreak intensity was The Medical Management of Paediatric Crohn's Disease: an ECCO-ESPGHAN Guideline Update.The most frequent keyword was \"inflammatory bowel disease\".</p><p><strong>Conclusion: </strong>This study provides a visual summary of information for the field of pediatric Crohn's disease and contributes to international collaboration to promote research in the field of pediatric Crohn's disease.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1515251"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669244","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":"Hypoxemia detection and oxygen therapy practices in neonatal and pediatric wards across seven district and referral hospitals in Rwanda.","authors":"Hyacinthe Mushumbamwiza, Harriet H Webster, Christine Kayitesi, Jasmine Miller, Nang'andu Chizyuka, Felix Musabirema, Alida Ngwije, Brenda Kateera, Sanctus Musafiri, Lisine Tuyisenge, Hamish R Graham, Felix Lam, Corneille Ntihabose","doi":"10.3389/fped.2025.1526779","DOIUrl":"10.3389/fped.2025.1526779","url":null,"abstract":"<p><strong>Background: </strong>Hypoxemia, characterized by low levels of oxygen in the blood, is a potentially fatal condition that is commonly found in pediatric and neonatal conditions that drive childhood mortality globally. The only treatment is the provision of medical oxygen, yet children in low-income countries frequently are not diagnosed or treated. In Rwanda, it is important to understand the extent to which pediatric and neonatal inpatients are monitored and treated for hypoxemia, in order to guide policy and clinical decision-making.</p><p><strong>Methods: </strong>This retrospective cohort was undertaken through review of patient clinical case notes in seven hospitals in Rwanda. All patients, up to 14 years of age, admitted to neonatal or pediatric wards in these hospitals within a 3-month period were included in the study. In each facility, trained clinical data collectors used digital survey tools to capture demographic, clinical and outcome data, including pulse oximetry and oxygen use. Neonates were categorized as less than 1 month of age and under-5 s defined between 1 month and 59 months of age, and older children as 5-14 years of age. Our primary outcomes were proportion of admitted children screened with pulse oximetry, and proportion prescribed oxygen when found to be severely hypoxemic, on admission. Our secondary outcomes included hypoxemia prevalence, and other vital signs recorded on admission, oxygen prescription practices, and pulse oximetry screening practices on the day after admission and the day before discharge.</p><p><strong>Results: </strong>A total of 3,085 neonatal and pediatric patient case notes were included in the analysis. Of these inpatients 86.3% (CI: 95% 85.0-87.4) were screened with pulse oximetry on admission. Of those screened, 18.6% (CI: 95% 17.2-20.1) were documented to have severe hypoxemia (SpO₂ < 90%). Of 495 patients with documented severe hypoxemia on admission, 48.3% (CI: 95% 44.0-52.6) had an oxygen prescription recorded on admission, reaching 76.0% treated with oxygen across the course of their admission (CI: 95% 72.0-79.5).</p><p><strong>Conclusions: </strong>Improvements are required in management of hypoxemia in neonates and pediatric inpatients in Rwanda to ensure all patients are screened and those found to be hypoxemic are treated with medical oxygen.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1526779"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669495","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":"Clinical characteristics of patients with atypical teratoid/rhabdoid tumors: a monocentric retrospective analysis.","authors":"Zhiliang Wang, Jingchen Yang, Xing Liu, Wei Liu","doi":"10.3389/fped.2025.1463510","DOIUrl":"10.3389/fped.2025.1463510","url":null,"abstract":"<p><strong>Purpose: </strong>Atypical teratoid/rhabdoid tumors (ATRTs) are very rare, highly malignant embryonal neoplasms in central nervous system. The aim of this study was to conduct a retrospective analysis of ATRT patient survival and investigate the prognostic factors associated with ATRT.</p><p><strong>Methods: </strong>A retrospective study was conducted using information of patients who received treatment between 2016 and 2021 in Beijing Tiantan Hospital. Kaplan-Meier curves were used for overall survival (OS) analysis. Univariate and multivariate COX analyses were applied for OS predicting.</p><p><strong>Results: </strong>20 histologically confirmed ATRT patients were included. The majority were male (75%) and aged over 3 years (65%). 71.4% of patients under 3 years and 46.2% of above 3 years had supratentorial tumors. All patients underwent surgery, with 60% having total resections, primarily in the supratentorial region. Subsequent treatment involved varying chemotherapy and radiation combinations, with 40% of patients receiving it, and 87.5% of those were older than 3 years, The median overall survival for ATRT patients was 180 days. Survival differed significantly between patients under and above 3 years. Radiotherapy increased overall survival for all patients. Univariate and multivariate analysis showed better survival for those diagnosed above age 3 and with adjuvant radiation.</p><p><strong>Conclusions: </strong>Patients older than 3 years old had better prognosis and radiotherapy had a significant effect on improving patient prognosis.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1463510"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669258","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":"Twists and turns: spontaneous torsion of accessory liver lobe and gallbladder-diagnostic challenges and surgical interventions-a case report.","authors":"Soumaya Charaa, Julien Frandon, Ghizlane Touimi Benjelloun, Benoit Tessier","doi":"10.3389/fped.2025.1530918","DOIUrl":"10.3389/fped.2025.1530918","url":null,"abstract":"<p><p>An accessory liver lobe (ALL) represents a rare congenital variation of liver tissue, typically resulting from focal excessive development of liver tissue. Torsion of such lobes, though rare, can precipitate a severe surgical crisis due to hepatic ischemia and failure. We report a case involving a 9-year-old patient who was admitted with acute epigastric pain. Doppler ultrasound and contrast-enhanced CT scans revealed a heterogeneous, avascular mass with displacement of the gallbladder, which had a thickened wall. During laparotomy, a twisted, congested ALL along with the gallbladder was surgically removed. Diagnostic imaging, particularly computed tomography (CT), plays a crucial role in the rapid identification of causes behind acute abdominal pain, necessitating meticulous analysis of CT scans. We share the findings from imaging and surgery to enhance awareness of this rare condition.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1530918"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669499","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":"Utilization of ECMO with fiberoptic bronchoscopy for pediatric patients with lethal pulmonary hemorrhage unresponsive to conventional mechanical ventilation.","authors":"Siwei Lu, Yuelin Sun, Yingfu Chen, Yueqiang Fu, Jing Li, Chengjun Liu","doi":"10.3389/fped.2025.1547579","DOIUrl":"10.3389/fped.2025.1547579","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the safety and efficacy of extracorporeal membrane oxygenation (ECMO) combined with fiberoptic bronchoscopy in children with life-threatening pulmonary hemorrhage that does not respond to conventional mechanical ventilation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From October 2019 to June 2022, four pediatric patients with life-threatening pulmonary hemorrhage requiring ECMO support were admitted to our hospital. Based on their weight and vascular conditions, either venoarterial (VA)-ECMO or venovenous (VV)-ECMO was selected. The anticoagulation strategy was tailored, and fiberoptic bronchoscopy was performed to assess airway bleeding and remove blood clots.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study involved four patients. Case 1 sustained injuries from a traffic accident, Case 2 experienced combined injuries from a high fall, Case 3 had pulmonary vascular malformation, and Case 4 presented with anti-neutrophil cytoplasmic antibody-associated vasculitis. Case 1 underwent VA-ECMO with carotid artery and vein cannulation, whereas the other patients received VV-ECMO with jugular-femoral vein cannulation. During cannulation, heparin was administered at 0.5 mg/kg. Protamine was subsequently used to neutralize heparin based on the bleeding situation. Anticoagulation was initiated 24 h after ECMO commencement in Cases 1, 2, and 4, maintaining an activated clotting time (ACT) of 160-180 s. In Case 3, active bleeding was observed in the tracheal tube post-ECMO initiation. Protamine was administered to reverse the effects of heparin, and anticoagulation was withheld for the first 72 h. After a second interventional embolization of the vascular malformations, the active bleeding ceased. Two fiberoptic bronchoscopies revealed no further bleeding, and anticoagulation was initiated at 5 U/kg/h to maintain an ACT of 160 s. Coagulation parameters, including ACT, blood analysis, and thromboelastography, were closely monitored, and heparin dosages were adjusted accordingly. Heparin was paused 1 h before each fiberoptic bronchoscopy and resumed afterward. During ECMO, all patients successfully underwent fiberoptic bronchoscopy. Cases 2 and 3 required three and six procedures, respectively. Substantial thrombi were removed from the airways of Cases 2 and 3. All patients survived, and they were discharged without complications related to ECMO or fiberoptic bronchoscopy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For children with life-threatening pulmonary hemorrhage that did not respond to conventional mechanical ventilation, the combination of ECMO and fiberoptic bronchoscopy represents a promising therapeutic option. ECMO rapidly corrects hypoxemia and provides respiratory support, whereas fiberoptic bronchoscopy effectively clears blood clots and facilitates lung re-expansion. Under an individualized anticoagulation strategy, this combined approach is both safe and effective, significantly improving clinical outcomes in pediatric patie","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1547579"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669502","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":"Clinical value of Beery visual-motor integration and Beery VMI supplemental tests in Chinese preschoolers: a modified replication cross-sectional study.","authors":"Xin Tang, Xuan Xu, Cong Wang, Lijuan Ao","doi":"10.3389/fped.2025.1531192","DOIUrl":"10.3389/fped.2025.1531192","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have indicated that visual-motor performance is affected by cultural variations. This study aimed to examine differences between the proportion of children with poor visual-motor integration (VMI) performance in published population norms with that in the sample population of this study and to assess the predictive value of the visual perception(VP) and motor coordination(MC) scores in explaining VMI variance in Chinese preschoolers.</p><p><strong>Methods: </strong>A random sample of 421 children ageds 3.0-6.11 years (mean age, 4.51 ± 0.93) participated in this study. The Beery VMI, VP, and MC were administered in sequence by qualified raters.</p><p><strong>Results: </strong>The standard scores of VMI in all age groups of this study were significantly better than those in U.S. norms. Overall, 61 (14.5% of the total sample) and 6 (1.4% of the total sample) children did poorly in the VMI test using study population norms and published population norms, respectively. The proportion of children with poor VMI performance using published norms was significantly lower compared with that using study sample population norms (<i>p</i> < 0.001). Multiple regression analysis showed that VP and MC were significantly related to the VMI (VP: <i>β</i> = 0.185, <i>p</i> < 0.001; MC: <i>β</i> = 0.400, <i>p</i> < 0.001) and 25.0% (<i>F</i> = 69.571, <i>dF</i> = 2, <i>p</i> < 0.001) variance of VMI could be explained by VP and MC.</p><p><strong>Conclusion: </strong>Our findings support that the effects of culture should be considered when interpreting the results of Beery VMI using published norms, especially in poor performance diagnosis. Our findings further support that three tests should be assessed individually during the visual perception examination regardless of cultural context. Chinese preschooler-based norms need to be established in future investigations to determine the diagnostic value of the Beery VMI.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1531192"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669201","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}