Jornal de pediatria最新文献_第10页

Comparative randomized clinical trial on postoperative pain in circumcision with ultrasound-guided versus conventional anesthetic block 超声引导与常规麻醉阻滞对包皮环切术后疼痛的比较随机临床试验。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-06-19 DOI: 10.1016/j.jped.2025.05.004

Isabela P. Moraes , Flavia P. Payan , Camila G. Fachin , Rogério de Fraga

{"title":"Comparative randomized clinical trial on postoperative pain in circumcision with ultrasound-guided versus conventional anesthetic block","authors":"Isabela P. Moraes , Flavia P. Payan , Camila G. Fachin , Rogério de Fraga","doi":"10.1016/j.jped.2025.05.004","DOIUrl":"10.1016/j.jped.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Circumcision is a common surgical procedure worldwide, with indications ranging from medical to cultural-religious contexts. Effective pain control is crucial to reduce analgesic use and improve patient safety. Recent advances include the use of the Plastibell® device and ultrasound-guided dorsal penile nerve block, aimed at minimizing surgical time and complications. This study compares postoperative pain in patients undergoing circumcision with either the landmark dorsal penile nerve block (blind block) or ultrasound-guided block.</div></div><div><h3>Methods</h3><div>In this prospective, randomized study, patients aged 3–14 years undergoing elective circumcision were assigned to receive either anesthetic technique. Pain was assessed using physiological parameters (heart rate variation, movement during surgery) and subjective measures (Wong-Baker scale) at multiple time points, along with analgesic consumption. The sample was subdivided into patients aged ≤5 years and >5 years.</div></div><div><h3>Results</h3><div>Pain scores before hospital discharge were higher in patients under 5 years. The blind block was faster to perform but had a higher incidence of hematomas and a trend toward greater block failure, indicated by increased heart rate, patient movement, and opioid use, although differences were not statistically significant. Ultrasound-guided blocks showed fewer complications and a tendency for better pain control.</div></div><div><h3>Conclusion</h3><div>Both anesthetic techniques provide comparable pain control in circumcision; however, ultrasound guidance may reduce complications and improve block success, supporting its use as a safe and effective alternative to the conventional method.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101416"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247975","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}

引用次数: 0

Strengthening RSV prevention in early life through new generation strategies* 通过新一代策略加强早期呼吸道合胞病毒预防*

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-09-19 DOI: 10.1016/j.jped.2025.101445

Asuncion Mejias, Octavio Ramilo

引用次数: 0

Thyroidectomy in children and adolescents: distinguishing benign from malignant thyroid nodules 儿童和青少年甲状腺切除术：区分良性和恶性甲状腺结节。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.jped.2025.101426

Mário Sérgio Rocha Macedo , Jônatas Catunda de Freitas , Débora Cabral Coutinho , Carina Marques Barroso , Sandra Regina Geroldo , Rhuce Pedrosa Carvalho , Letícia Siqueira Monte Alverne , Tamyres Ferreira Campos , Lívia Rolim Fernades Macedo , José Huygens Parente Garcia , Wellington Alves Filho

{"title":"Thyroidectomy in children and adolescents: distinguishing benign from malignant thyroid nodules","authors":"Mário Sérgio Rocha Macedo , Jônatas Catunda de Freitas , Débora Cabral Coutinho , Carina Marques Barroso , Sandra Regina Geroldo , Rhuce Pedrosa Carvalho , Letícia Siqueira Monte Alverne , Tamyres Ferreira Campos , Lívia Rolim Fernades Macedo , José Huygens Parente Garcia , Wellington Alves Filho","doi":"10.1016/j.jped.2025.101426","DOIUrl":"10.1016/j.jped.2025.101426","url":null,"abstract":"<div><h3>Objectives</h3><div>The research aimed to analyze the clinical, epidemiological, laboratory, imaging, and pathological characteristics of pediatric patients who underwent surgery for thyroid nodules, distinguishing and comparing malignant and benign conditions.</div></div><div><h3>Methodology</h3><div>A retrospective and descriptive analysis was conducted on patients aged 0–18 years who underwent thyroidectomy. The following variables were evaluated: gender, previous and current pathological history, laboratory thyroid hormone levels, ultrasonography, cytology, and histopathological findings.</div></div><div><h3>Results</h3><div>A total of 91 children underwent thyroidectomy from January 2013 to May 2023. The average age was 13 years, and 68 patients were female. Ultrasonography evaluation revealed that 62 children had unimodular disease. Histopathology reports showed benign tumors in 54 patients and malignant tumors in 37. The factors associated with a higher incidence of cancer in univariate analysis were age < 10 years (<em>p</em> = 0.025), the presence of nodules on ultrasound with microcalcification (<em>p</em> < 0.001), and hypoechogenic nodules (<em>p</em> = 0.007). On multivariate analysis, only age under 10 years (OR = 5.69; <em>p</em> = 0.028) and the presence of microcalcifications (OR = 28.44 and <em>p</em> = 0.002) were significantly associated with malignancy.</div></div><div><h3>Conclusion</h3><div>The medical community is becoming increasingly aware of the differences in the clinical, epidemiological, pathological, and molecular presentations of benign and malignant thyroid diseases, highlighting the need for further training in this area.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101426"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812020","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}

引用次数: 0

Challenges in the prophylaxis of severe respiratory syncytial virus infections 预防严重呼吸道合胞病毒感染的挑战。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-05-22 DOI: 10.1016/j.jped.2025.04.003

Dana C. Feitosa , Sandra E. Vieira

{"title":"Challenges in the prophylaxis of severe respiratory syncytial virus infections","authors":"Dana C. Feitosa , Sandra E. Vieira","doi":"10.1016/j.jped.2025.04.003","DOIUrl":"10.1016/j.jped.2025.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze palivizumab prophylaxis adherence among newborns and infants, as well as identify its challenges and facilitators.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed medical records of individuals who received palivizumab between 2008 and 2019 at a referral center in a metropolitan city in Brazil. Three adherence criteria were evaluated: an adequate number of doses received, interval between doses ≤ 35 days, and complete adherence (meeting both prior criteria). Associations between these criteria and sociodemographic/clinical variables, as well as post-prophylaxis bronchiolitis-related hospitalizations, were examined.</div></div><div><h3>Results</h3><div>A total of 908 participants (mean age 6.7 months,50.8 % male,57.8 % residing in the city) were analyzed. During the three-season study period, a total of 1,158 doses were prescribed, and complete adherence was observed in 44.5 % of cases. Based on both the adequate number of doses and complete adherence criteria, lower adherence was noted among those living outside the city (52.8 % vs.60.9 %, <em>p</em> = 0.01; and 41.5 %vs.48.5 %, <em>p</em> = 0.03, respectively) and infants born to mothers younger than 20 years (39.7 % vs.60.3 %,<em>p</em> < 0.01; and 31.5 %vs.68.5 %, <em>p</em> = 0.02, respectively). Infants with gestational age < 28 weeks (65.8 % vs.34.2 %, <em>p</em> = 0.03) and birth weight < 1000 g (67.8 % vs.32.2 %, <em>p</em> = 0.03) had higher adherence under the adequate number of doses criterion. No association emerged between adherence and bronchiolitis-related hospitalizations, which were predominantly linked to maternal smoking during pregnancy and chronic lung disease.</div></div><div><h3>Conclusion</h3><div>Adherence to palivizumab prophylaxis was low, highlighting the need to address geographic barriers and maternal age factors. Extreme prematurity and very low birth weight facilitated adherence, indicating that more targeted strategies or decentralized administration may improve outcomes in high-risk populations.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101405"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078038","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}

引用次数: 0

Biparametric score as a new tool for early indication of surfactant in preterm infants 双参数评分作为早产儿表面活性剂早期指征的新工具。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-08-18 DOI: 10.1016/j.jped.2025.101425

Ana Román Fernández, Jessica Gómez Ávila

{"title":"Biparametric score as a new tool for early indication of surfactant in preterm infants","authors":"Ana Román Fernández, Jessica Gómez Ávila","doi":"10.1016/j.jped.2025.101425","DOIUrl":"10.1016/j.jped.2025.101425","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether the use of a biparametric score, based on lung ultrasound (LUS) and oxygen saturation/fraction of inspired oxygen ratio (SF ratio), in preterm infants with respiratory distress syndrome (RDS) allows earlier surfactant therapy (first 3 hours of life) compared to classic FiO<sub>2</sub> criteria.</div></div><div><h3>Material and methods</h3><div>Before-after design study, performed in a tertiary neonatal intensive care unit. Inclusion criteria were newborns with gestational age < 34 weeks with clinical RDS and respiratory support with noninvasive ventilation. The patients were divided into two groups, the control group, with surfactant indication according to classic criteria, collected retrospectively, and the new protocol group, with surfactant criteria according to biparametric score.</div></div><div><h3>Results</h3><div>61 patients were included. The new protocol group received surfactant earlier (all patients in the first 3 hours, p 0.013). Likewise, after surfactant treatment, newborns in this group required lower FiO<sub>2</sub> (p 0.001) and a better pulmonary ultrasound evolution according to LUS (p 0.008).</div></div><div><h3>Conclusions</h3><div>Biparametric scoring allowed earlier surfactant therapy and reduced post-treatment oxygen requirement. This protocol offers a more personalized approach tailored to the patient's needs, which helps us in decision-making.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101425"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799121","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}

引用次数: 0

Psychometric characteristics of the Mini-TEA scale: a screening instrument for autism spectrum disorder in children 迷你tea量表的心理测量特征：儿童自闭症谱系障碍的筛查工具。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-06-26 DOI: 10.1016/j.jped.2025.05.006

Cassiano Mateus Forcelini , Regina Ampese , Helena Younes de Melo , Camila Pereira Neubauer Pasin , José Renato Donadussi Pádua , Itamara Danelli de Moura , Camila Boschetti Spanholo , Francine Ehrhardt Hoffmann , Júlia Breitenbach Diniz , Laís Cristine Zanella Capponi , Luiza Souza , Maxciel Zortea

{"title":"Psychometric characteristics of the Mini-TEA scale: a screening instrument for autism spectrum disorder in children","authors":"Cassiano Mateus Forcelini , Regina Ampese , Helena Younes de Melo , Camila Pereira Neubauer Pasin , José Renato Donadussi Pádua , Itamara Danelli de Moura , Camila Boschetti Spanholo , Francine Ehrhardt Hoffmann , Júlia Breitenbach Diniz , Laís Cristine Zanella Capponi , Luiza Souza , Maxciel Zortea","doi":"10.1016/j.jped.2025.05.006","DOIUrl":"10.1016/j.jped.2025.05.006","url":null,"abstract":"<div><h3>Objective</h3><div>Early diagnosis of autism spectrum disorder (ASD) is advisable to promote better prognosis. The Mini-TEA scale was conceived as a sensitive screening for ASD among children. The authors aimed to confirm the diagnostic accuracy of the scale in a wider population.</div></div><div><h3>Method</h3><div>279 children from 2.5 to 12 yo were recruited, most of them under evaluation for possible ASD in the APAE of Passo Fundo/RS, as well as children with other diagnoses and normal children. Their parents/relatives answered the 48 binary questions (yes/no) of the Mini-TEA scale, divided into 15 items, which resulted in a score from 0 to 15. After that, the children were evaluated regarding the diagnostic criteria of ASD by experienced raters (gold standard) who had previously submitted to a concordance test and remained unaware of the children’s scores. Sensitivity and specificity Figs. were obtained. Factor analysis and Item Response Theory approaches were used for validity evidence.</div></div><div><h3>Results</h3><div>115 children were diagnosed with ASD. Scores ≥9 had 98.3 % of sensitivity and 62.2 % of specificity for the diagnosis. Two cases with the typical presentation of Asperger’s syndrome scored lower than 9. The mean time for screening was about 8.5 min. The validation model presented excellent coefficients of factorability. The analysis showed that the total variance of the scores of the scale through the 15 items was explained only by the set of ASD symptoms (unidimensionality).</div></div><div><h3>Conclusion</h3><div>The Mini-TEA scale is a very sensitive tool to screen for ASD and has high internal consistency for assessing typical autistic symptoms.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101419"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316979","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}

引用次数: 0

A comparative study of serum and fecal calprotectin levels in necrotizing enterocolitis 坏死性小肠结肠炎患者血清和粪便钙保护蛋白水平的比较研究。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-08-21 DOI: 10.1016/j.jped.2025.101428

Sara Erol , Cuneyt Tayman , Sabriye Korkut , Ufuk Çakir , Abdullah Kurt , Ismail Koyuncu

{"title":"A comparative study of serum and fecal calprotectin levels in necrotizing enterocolitis","authors":"Sara Erol , Cuneyt Tayman , Sabriye Korkut , Ufuk Çakir , Abdullah Kurt , Ismail Koyuncu","doi":"10.1016/j.jped.2025.101428","DOIUrl":"10.1016/j.jped.2025.101428","url":null,"abstract":"<div><h3>Objectives</h3><div>Necrotizing enterocolitis is a significant cause of morbidity and mortality in premature infants. Various fecal, urinary, and serum biomarkers have all been investigated for their potential in the prediction and early detection of necrotizing enterocolitis. This pilot study aimed to explore the feasibility and clinical utility of measuring serum and fecal calprotectin levels in preterm infants with necrotizing enterocolitis.</div></div><div><h3>Methods</h3><div>This prospective pilot study included preterm infants born at < 32 weeks’ gestation with a birth weight of ≤ 1500 g, consisting of patients diagnosed with necrotizing enterocolitis stage II or III and a randomly selected control group without necrotizing enterocolitis. The relationship between serum and fecal calprotectin concentrations and necrotizing enterocolitis severity, need for surgical intervention, and mortality was systematically analyzed.</div></div><div><h3>Results</h3><div>A total of 39 necrotizing enterocolitis patients (25 with stage II, 14 with stage III) and 20 randomly selected preterm infants were included as the control group. Serum and fecal calprotectin levels were significantly higher in necrotizing enterocolitis stage III and in infants who required surgery or died (<em>p</em> < 0.05), indicating their potential to predict disease severity and poor outcomes.</div></div><div><h3>Conclusions</h3><div>This pilot study suggests that dual assessment of serum and fecal calprotectin may provide insight into necrotizing enterocolitis severity and outcomes. Larger studies are needed to validate these findings and determine clinical applicability.</div></div><div><h3>Trial Registration</h3><div>This study was registered with the ClinicalTrials.gov database under the registration number NCT06693154 on November 15, 2024.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101428"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816704","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}

引用次数: 0

Serum hsa-miR-21 expression and its clinical value in pediatric patients with fulminant myocarditis 小儿暴发性心肌炎患者血清hsa-miR-21表达及其临床价值

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-05-28 DOI: 10.1016/j.jped.2025.04.007

Wenwen Wang, Jingmin Sun, Jing Li

{"title":"Serum hsa-miR-21 expression and its clinical value in pediatric patients with fulminant myocarditis","authors":"Wenwen Wang, Jingmin Sun, Jing Li","doi":"10.1016/j.jped.2025.04.007","DOIUrl":"10.1016/j.jped.2025.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>Fulminant myocarditis (FM) is a distinct and rare form of myocarditis. This study probed hsa-miR-21 expression in FM pediatric patients and its clinical value.</div></div><div><h3>Methods</h3><div>This study enrolled 88 FM pediatric patients and 90 healthy children (normal controls), with serum sample hsa-miR-21 levels measured by RT-qPCR. FM children were categorized into the good and poor prognosis groups. Correlations of hsa-miR-21 expression with myocardial injury markers [cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB)], and independent risk factors and predictive value of hsa-miR-21 expression for FM patients’ poor prognoses were analyzed by Pearson’s, logistic regression, and receiver operating characteristic (ROC) curve analyses.</div></div><div><h3>Results</h3><div>Serum hsa-miR-21 levels were elevated in FM children relative to the healthy controls and linked with poor prognoses. hsa-miR-21 levels positively correlated with myoglobin (MYO), B-type natriuretic peptide (BNP), cTnI, and CK-MB levels. Elevated hsa-miR-21, CK-MB, left ventricular ejection fraction, C-reactive protein, lactate dehydrogenase, and lactate were independent risk factors for FM children’s poor prognoses. Serum hsa-miR-21 levels yielded an area under the ROC curve of 0.790 in predicting FM pediatric patients’ poor prognoses (58.1 % sensitivity, 87.7 % specificity), with positive and negative predictive values of 74.07 % and 81.97 %, respectively, demonstrating that hsa-miR-21 aided in predicting FM pediatric patients’ poor prognoses to some extent.</div></div><div><h3>Conclusion</h3><div>Serum hsa-miR-21 was up-regulated in FM pediatric patients, and positively correlated with MYO, BNP, cTnI, and CK-MB. hsa-miR-21 expression was an independent risk factor for FM pediatric patients' poor prognosis, and predicted prognoses to some extent; however, the diagnostic accuracy was limited.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101409"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127390","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}

引用次数: 0

Sleep and breathing in children with cerebral palsy: it’s complicated….!* 脑瘫儿童的睡眠和呼吸：这很复杂....！

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-08-11 DOI: 10.1016/j.jped.2025.101434

David Gozal

引用次数: 0

Use of simulation in the evaluation of airway clearance devices 在气道间隙装置评估中的模拟应用。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2025-09-01 Epub Date: 2025-08-11 DOI: 10.1016/j.jped.2025.101435

Maria Lucia S. Hristonof , Marina C. Amantéa , Fernando J. Lazzaretti , Marina M. Bernardes , Luiza F. Xavier , Sergio Luis Amantéa

引用次数: 0