Jornal de pediatria最新文献

{"title":"Eosinophilic esophagitis in pediatrics: advances in diagnosis, treatment, and follow-up.","authors":"Cristina Targa Ferreira, Elisa de Carvalho, Carlos M Timossi, Luciana Rodrigues Silva, Marise Helena Cardoso Tofoli, Maria do Carmo Barros de Melo, Jackeline de Motta Franco, Lucila Camargo Lopes de Oliveira, Renata Rodrigues Cocco, Herberto José Chong-Neto, Dirceu Solé","doi":"10.1016/j.jped.2026.101635","DOIUrl":"https://doi.org/10.1016/j.jped.2026.101635","url":null,"abstract":"<p><strong>Objective: </strong>To identify the evidence and recommendations regarding pediatric eosinophilic esophagitis (EoE), including its diagnosis, treatment, and follow-up.</p><p><strong>Sources: </strong>Narrative review based on a comprehensive and structured search of the MEDLINE (PubMed), EMBASE (Ovid), LILACS, and SciELO databases using the terms \"diagnosis\" OR \"clinical manifestations\" OR \"treatment\" OR \"follow-up\" AND \"eosinophilic esophagitis\" AND \"children\" through March 2026. Data obtained from the Brazilian Consensus (Brazilian Society of Pediatrics/Brazilian Association of Allergy and Immunology) were incorporated.</p><p><strong>Summary of the findings: </strong>EoE is a chronic and emerging disease, and a significant cause of esophageal dysfunction. Early and accurate diagnosis is fundamental to avoid complications, such as fibrostenotic sequelae. Treatment can be performed with proton pump inhibitors, topical corticosteroids, and empirical diets, chosen according to clinical profile, adherence, and socioeconomic context. In refractory cases, dupilumab is an effective option. Allergy tests should not guide elimination diets. Endoscopic follow-up with biopsies is essential for evaluating response and maintenance, as the relapse rate is high, even in asymptomatic patients. Reassessment intervals should be individualized, but post-induction control between 8 and 12 weeks and periodic reviews during maintenance are recommended.</p><p><strong>Conclusions: </strong>The dissociation between symptoms and histological inflammation represents one of the greatest clinical challenges, in addition to the heterogeneity of therapeutic response and limitations of long-term studies. Changes in follow-up and treatment algorithms are expected, especially with the inclusion of dupilumab. The Brazilian consensus represents an attempt to standardize diagnostic criteria, approach, and treatment.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101635"},"PeriodicalIF":3.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy trauma and risks of hypoxia, convulsions, cerebral palsy and respiratory complications in offspring.","authors":"Yao-Chi Hsieh, Ching-Heng Lin, Ming-Chih Lin","doi":"10.1016/j.jped.2026.101632","DOIUrl":"https://doi.org/10.1016/j.jped.2026.101632","url":null,"abstract":"<p><strong>Objectives: </strong>Pregnancy trauma affects 5% to 8% of pregnancies, yet evidence regarding neurological and respiratory consequences for offspring remains limited. The authors investigated the association between pregnancy trauma and adverse neurological and respiratory outcomes in children.</p><p><strong>Method: </strong>This population-based cohort study used linked data from the Taiwan National Health Insurance Research Database and Maternal and Child Health Database. The study included 2,018,401 mother-infant pairs between 2004 and 2020. Mothers with pregnancy trauma (n = 55,500) were matched 1:4 with mothers without pregnancy trauma (n = 222,000) based on maternal age, neonatal sex, and birth month. Participants were followed up through December 31, 2023. Adjusted hazard ratios (aHRs) were estimated using multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>Compared with controls, children of exposed pregnancy trauma had significantly increased risks of intrauterine hypoxia and birth asphyxia (aHR, 1.57; 95% CI, 1.13-2.18), composite neonatal respiratory morbidity (aHR, 1.12; 95% CI, 1.03-1.22), convulsions in newborn (aHR, 1.45; 95% CI, 1.04-2.03) and cerebral palsy, unspecified (aHR, 1.26; 95% CI, 1.06-1.51). Risks were markedly higher when pregnancy trauma required hospitalization (aHR for intrauterine hypoxia and birth asphyxia, 3.29; 95% CI, 1.67-6.50; composite neonatal respiratory morbidity, 1.43; 95% CI, 1.14-1.79) or occurred during the second trimester (hypoxia and asphyxia, 1.91; 95% CI, 1.22-2.98).</p><p><strong>Conclusion: </strong>Pregnancy trauma is associated with increased risks of adverse neurological and respiratory outcomes in offspring, particularly following severe or second-trimester trauma. These findings highlight the need for pregnancy trauma prevention and underscore the importance of appropriate postnatal care and neurological surveillance for offspring exposed to pregnancy trauma.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101632"},"PeriodicalIF":3.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond reassurance: a validated video to support pediatric perioperative communication.","authors":"Johan Berghmans","doi":"10.1016/j.jped.2026.101634","DOIUrl":"https://doi.org/10.1016/j.jped.2026.101634","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101634"},"PeriodicalIF":3.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid use and naloxone-identified suspected opioid-related adverse events in a tertiary pediatric hospital: a retrospective study.","authors":"Luíza Siqueira de Lima, Meire Ellen Pereira, Júlia Vicentin de Souza, Diancarlos Pereira de Andrade, Cristian Rodolfo Voigt, Julliana Bianco Giuriatti Bassani, Carolina Cardoso de Mello Prando, Cristiano Matos, João José Joaquim, Cláudia Sirlene Oliveira","doi":"10.1016/j.jped.2026.101628","DOIUrl":"https://doi.org/10.1016/j.jped.2026.101628","url":null,"abstract":"<p><strong>Objective: </strong>Opioids are essential for analgesia and sedation in pediatric inpatient care, particularly in perioperative and intensive care settings. However, their use requires careful monitoring because children, especially infants and critically ill patients, may be vulnerable to respiratory, cardiovascular, and neurological adverse effects.</p><p><strong>Methods: </strong>This retrospective observational study evaluated opioid administration records and naloxone-identified suspected opioid-related adverse-event episodes at a tertiary pediatric hospital in Brazil from January 2019 to September 2024. Opioid administration records were identified from hospital pharmacy dispensing data. Medical records of patients with naloxone administration records were reviewed to classify naloxone indication, opioid involvement, clinical manifestations, hospital setting, underlying conditions, and short-term outcomes.</p><p><strong>Results: </strong>During the study period, 154,867 opioid administration records were identified. A total of 284 naloxone administration records were screened. After medical record review, 171 naloxone administrations did not meet criteria for suspected opioid-related adverse-event episodes and were excluded from the main adverse-event analysis. The final naloxone-identified sample included 112 episodes. Events occurred predominantly in intensive care settings, especially the cardiac intensive care unit. The most frequently documented manifestations were bradycardia, oxygen desaturation, apnea, chest wall rigidity, drowsiness/somnolence, and worsened respiratory pattern. Most episodes improved after naloxone administration.</p><p><strong>Conclusion: </strong>Naloxone-identified suspected opioid-related adverse-event episodes were uncommon relative to the total volume of opioid administration records and were concentrated in clinically complex pediatric inpatients. These findings support risk-stratified monitoring, standardized documentation of naloxone indications, and continued opioid stewardship in tertiary pediatric care.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101628"},"PeriodicalIF":3.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between dietary live microbial consumption and hypertension risk in children and adolescents: results from the NHANES 2009-2023.","authors":"Xiaowei Li, Xiaoli Li, Yong Han, Xianmei Huang","doi":"10.1016/j.jped.2026.101630","DOIUrl":"https://doi.org/10.1016/j.jped.2026.101630","url":null,"abstract":"<p><strong>Objective: </strong>This analysis aimed to evaluate the association between dietary live microbial consumption and hypertension risk in children and adolescents.</p><p><strong>Methods: </strong>This cross-sectional analysis comprised data on children and adolescents (aged 8-17 years) from the NHANES database 2009-2023. The association between dietary live microbial consumption and hypertension risk was analyzed using logistic regression analyses. The combined effect of dietary live microbial consumption and overweight/obesity on hypertension risk was examined using interaction analysis.</p><p><strong>Results: </strong>Of these 9342 enrolled children and adolescents, 433 had hypertension, and 8909 did not. Individuals in the high-MedHi (foods containing medium and high live microbes) consumption group (vs. low-MedHi) [OR = 0.70 (0.50-0.98), P = 0.039] were associated with lower odds of hypertension, and this association persisted after further adjustment for overweight/obesity [OR = 0.71 (0.51-0.99), P = 0.046]. In the joint effect analysis of live microbial consumption (low, high) and overweight/obesity (no, yes), individuals in the high-MedHi and overweight/obesity group [OR = 0.60 (0.39-0.92)], the low-MedHi and non-overweight/obesity group [OR = 0.29 (0.20-0.42)], and the high-MedHi and non-overweight/obesity group [OR = 0.28 (0.16-0.49)] were linked to lower odds of hypertension versus the low-MedHi and overweight/obesity group, and there was a significant trend in these joint effect terms (P_trend = 0.019).</p><p><strong>Conclusion: </strong>High live microbial consumption was associated with reduced odds of hypertension among children and adolescents, and live microbial intake and overweight/obesity exerted a joint effect on the odds of hypertension.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101630"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choosing a growth chart for preterm infants: does it matter?","authors":"Stephanie Merlino Barr","doi":"10.1016/j.jped.2026.101614","DOIUrl":"10.1016/j.jped.2026.101614","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 5","pages":"Article 101614"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early sexual initiation, sexual activity below legal age of consent, and sexual coercion: distinguishing overlapping public health challenges","authors":"Venkatraman Chandra-Mouli","doi":"10.1016/j.jped.2026.101607","DOIUrl":"10.1016/j.jped.2026.101607","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 5","pages":"Article 101607"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental management of childhood fever and associated factors: progress and promise","authors":"Edward Purssell","doi":"10.1016/j.jped.2026.101605","DOIUrl":"10.1016/j.jped.2026.101605","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 5","pages":"Article 101605"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of portal vein thrombosis prevalence and risk factors in neonates following umbilical venous catheterization: a systematic review and meta-analysis","authors":"Roberta Martinez Novaes,&nbsp;Roberta Vacari de Alcântara,&nbsp;Gabriel Hessel","doi":"10.1016/j.jped.2026.101559","DOIUrl":"10.1016/j.jped.2026.101559","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the prevalence of portal vein thrombosis (PVT) in neonates following umbilical venous catheterization (UVC), and to identify risk factors associated with PVT development in this population.</div></div><div><h3>Methods</h3><div>Systematic review conducted in accordance with PRISMA guidelines. Prospective cohort studies assessing PVT in catheterized patients were included. Meta-analyses were performed using random-effects models for prevalence estimates and odds ratios (OR), heterogeneity assessment with Cochran's Q test and Higgins' I², and publication bias with funnel plot and Egger’s test.</div></div><div><h3>Results</h3><div>The search identified 344 studies, of which 11 met the inclusion criteria. The sample included 1086 neonates (1052 catheterized). Abdominal ultrasound confirmed 200 cases of PVT, yielding a prevalence of 19% (range: 0% to 49%), with six studies reporting prevalence rates above 5%. Meta-analysis showed an association between PVT and blood transfusion or exchange transfusion through the umbilical catheter (<em>p</em> = 0.0024). There was a trend toward increased risk of PVT in neonates with sepsis (<em>p</em> = 0.0705), whereas catheter tip location was not associated with increased PVT prevalence, although there is a risk of bias (<em>p</em> = 0.4636).</div></div><div><h3>Conclusion</h3><div>A wide variation in PVT prevalence was observed across the included studies. Blood transfusion through the umbilical catheter was confirmed as a risk factor, while neonatal sepsis was associated with a trend toward this outcome. These findings support the implementation of systematic abdominal ultrasound screening protocols for PVT in all neonates undergoing UVC.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 4","pages":"Article 101559"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening nurturing care by supporting caregiver engagement in early childhood stimulation activities","authors":"Gabriela Buccini","doi":"10.1016/j.jped.2026.101584","DOIUrl":"10.1016/j.jped.2026.101584","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 4","pages":"Article 101584"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}