Jornal de pediatria最新文献

{"title":"Serological biomarker models composed of luteinizing hormone, kisspeptin, vitamin D and estradiol, and their clinical test value in girls","authors":"Mingyu Shao ,&nbsp;Zhiyi Jia ,&nbsp;Tongtong Liu ,&nbsp;Xiaopeng Zhang","doi":"10.1016/j.jped.2025.101477","DOIUrl":"10.1016/j.jped.2025.101477","url":null,"abstract":"<div><h3>Objective</h3><div>Central precocious puberty (CPP) may lead to premature pubertal onset. While the GnRH stimulation test remains the gold standard, its invasive nature and prolonged procedure limit clinical utility, particularly in pediatric populations. Emerging biomarkers, including luteinizing hormone, estradiol, kisspeptin, and vitamin D, have shown promise in distinguishing CPP from normal puberty. This study systematically evaluated the diagnostic utility of these biomarkers both individually and in novel combinatorial models, with the aim of establishing a non-invasive and more accessible diagnostic alternative for CPP.</div></div><div><h3>Methods</h3><div>This retrospective study included 129 girls with CPP and 116 age-matched controls. Clinical characteristics, including height, weight, body mass index, and bone age, were recorded. Serum levels of luteinizing hormone, estradiol, kisspeptin, vitamin D, progesterone, and prolactin were measured. The diagnostic performance of individual biomarkers and three combined biomarker models was assessed using receiver operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>Model 1 included luteinizing hormone and kisspeptin, Model 2 incorporated vitamin D, and Model 3 added estradiol. CPP patients exhibited significantly higher levels of luteinizing hormone (2.51 vs. 0.23 mIU/mL), kisspeptin (1.59 vs. 0.96 μg/L), and estradiol (25.86 vs. 13.41 pg/mL) and lower vitamin D levels (20.13 vs. 25.90 ng/mL) compared to controls (all <em>p</em> &lt; 0.001). Model 3 demonstrated the highest diagnostic accuracy with an AUC of 0.939 (95 % CI: 0.910–0.968), sensitivity of 89.06 %, and specificity of 87.93 %, outperforming individual biomarkers and other models.</div></div><div><h3>Conclusion</h3><div>This study highlights the potential of combining luteinizing hormone, kisspeptin, vitamin D, and estradiol into a single diagnostic model for CPP.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101477"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549169","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":"Unraveling the relationship between childhood dry eye symptoms and sleep patterns","authors":"Qing He ,&nbsp;Ziwen Sun ,&nbsp;Ruixin Li ,&nbsp;Yanling Wang ,&nbsp;Haoru Li ,&nbsp;Desheng Song ,&nbsp;Bei Du ,&nbsp;Lin Liu ,&nbsp;Ruihua Wei","doi":"10.1016/j.jped.2025.101471","DOIUrl":"10.1016/j.jped.2025.101471","url":null,"abstract":"<div><h3>Objective</h3><div>Given the increasing incidence of dry eye in children and the established role of sleep as a key health determinant, this study aimed to examine the prevalence of dry eye in children and its association with sleep, adjusting for confounders.</div></div><div><h3>Method</h3><div>This study included 169,080 children aged 6–12 years. Dry eye syndromes (DEs) were assessed using the 5-Item Dry Eye Questionnaire, whereas sleep quality was evaluated using the Children's Sleep Habits Questionnaire. Logistic and linear regression analyses were performed.</div></div><div><h3>Results</h3><div>Overall, 13.12% of the children exhibited DEs, and 66.25% experienced poor sleep. Children with poor sleep quality had a significantly higher prevalence of DEs (15.97%, 17,889/112,018) than those with normal sleep quality (7.53%, 4296/57,062) (<em>P</em> &lt; 0.001). The prevalence of poor sleep was 80.64% (17,889/22,185) in children with DEs, compared to 64.08% (94,129/146,895) in those without DEs (<em>P</em> &lt; 0.001). After adjusting for age, sex, body mass index, and other risk factors, poor sleepers had a higher risk of developing DEs than good sleepers (odds ratio [OR] = 2.005; 95% confidence interval [CI]: 1.933–2.080). Children who slept for &lt; 10 h were more likely to have DEs (OR = 1.236l; 95% CI: 1.167–1.310). In logistic regression analyses stratified by age and sex, poor sleepers showed a high risk of DEs. Moreover, the three dry eye symptoms and sleep were related (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This large-scale study revealed that all domains of sleep were significantly poorer in participants with DEs in children, and these associations remained significant after adjusting for comorbidities.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101471"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470961","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":"Respiratory mechanic instability in evaluating the effectiveness of adenotonsillectomy for pediatric obstructive sleep apnea","authors":"Ji Ho Choi ,&nbsp;Yeji Lee ,&nbsp;Sungkyoung Shin ,&nbsp;Tae Kyoung Ha ,&nbsp;Se A. Lee","doi":"10.1016/j.jped.2025.101479","DOIUrl":"10.1016/j.jped.2025.101479","url":null,"abstract":"<div><h3>Objectives</h3><div>Respiratory mechanic instability (RMI) is characterized by irregular chest and abdominal movements due to upper airway collapse or obstruction, frequently observed during obstructive apnea or hypopnea events. This study aims to explore the potential of RMI as a determinant of adenotonsillectomy's success in treating pediatric obstructive sleep apnea (OSA).</div></div><div><h3>Methods</h3><div>Medical records of pediatric patients diagnosed with OSA via standard polysomnography who underwent adenotonsillectomy with subsequent follow-up evaluations were retrospectively analyzed. RMI parameters were automatically discerned during polysomnography, and comparisons of sleep scoring data, respiratory events, and RMI metrics (events, index, duration, and % of stage duration) were made pre- and post-surgery.</div></div><div><h3>Results</h3><div>A total of 42 consecutive pediatric patients with OSA (26 boys, 16 girls) were included in the study. Post-adenotonsillectomy, marked improvements were noted in RMI parameters (events [95.6 ± 43.7 vs 58.9 ± 34.7; <em>p</em> &lt; 0.001], index [14.5 ± 7.0 vs 8.5 ± 4.5; <em>p</em> &lt; 0.001], duration [81.2 ± 56.3 vs 42.1 ± 52.0; <em>p</em> = 0.003], and % of stage duration [20.5 ± 13.9 vs 7.6 ± 6.8; <em>p</em> &lt; 0.001]), along with significant improvements in polysomnographic parameters such as arousal index, AHI, RDI, ODI3, mean oxygen saturation, and snoring duration. Significant correlations were observed between respiratory events (AHI, RDI, ODI3) and RMI metrics such as event counts and index, both before and after the procedure.</div></div><div><h3>Conclusion</h3><div>This study highlights the effectiveness of adenotonsillectomy in improving sleep quality and respiratory stability in pediatric patients with OSA, underscoring the utility of RMI as a promising additional marker in conjunction with conventional polysomnographic measures.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101479"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648630","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":"Association of blood transfusion-related DEHP exposure with gut microbiota alterations in preterm infants","authors":"Yung-Ning Yang ,&nbsp;Yu-Chen S.H. Yang ,&nbsp;San-Nan Yang ,&nbsp;Ying-Yu Chen ,&nbsp;Hung-Yun Lin ,&nbsp;Jau-Ling Suen","doi":"10.1016/j.jped.2025.101476","DOIUrl":"10.1016/j.jped.2025.101476","url":null,"abstract":"<div><h3>Objective</h3><div>Avoiding early-life exposure to environmental endocrine disruptors (EDCs) is critical for neonatal growth and long-term health. However, exposure to Di-(2-ethylhexyl) phthalate (DEHP), a typical EDC and plasticizer, is unavoidable in neonatal intensive care units due to contact with polyvinyl chloride medical devices.</div></div><div><h3>Methods</h3><div>This study examined the impact of DEHP exposure through blood transfusion on gut microbiota development in preterm infants. To address this aim, the authors conducted a prospective cohort study, enrolling preterm infants between May 1, 2016, and March 30, 2021, who had not received blood transfusions or antibiotic treatment for at least seven consecutive days prior to enrollment. Fecal samples collected before and after transfusion underwent 16S ribosomal RNA gene-based next-generation sequencing analysis, while DEHP levels were measured in post-transfusion blood products. The average DEHP level in these products was 0.072 ± 0.03 mg/mL.</div></div><div><h3>Results</h3><div>Initial analysis of 23 preterm infants (including five recruited twice) indicated that blood transfusion did not significantly alter bacterial composition and diversity. However, when examining recruitment events by postmenstrual age (PMA) or days of life (DOL), a significant increase in <em>Enterococcus</em> abundance was observed in both the lower PMA and younger DOL groups.</div></div><div><h3>Conclusions</h3><div>These findings suggest a possible association between early-life DEHP exposure via blood transfusion and altered gut microbiota. Further studies are needed to clarify causality and long-term health implications.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101476"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540771","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":"Caregiver adherence to outpatient follow-up of children infected with or exposed to syphilis during pregnancy","authors":"Márcia Galdino Sampaio ,&nbsp;Cristina Barroso Hofer","doi":"10.1016/j.jped.2025.101493","DOIUrl":"10.1016/j.jped.2025.101493","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the caregiver adherence to the various interventions proposed by the Ministry of Health in the follow-up of children infected with or exposed to <em>Treponema pallidum</em> during pregnancy.</div></div><div><h3>Method</h3><div>This is a prospective cohort study that included 256 children treated for congenital syphilis during the neonatal period. The children were referred from maternity to a reference outpatient clinic in the state of Rio de Janeiro between 2016 and 2021. Adherence was used as the outcome variable. It was assessed in two components: clinical-laboratory adherence (basic adherence) and adherence to specialist consultations (final adherence). Factors associated with adherence were investigated using logistic regression.</div></div><div><h3>Results</h3><div>It was observed that 41 % of the children were followed for at least 18 months, and 68 % had two consecutive non-reactive VDRL tests. Basic adherence was 32 %, while final adherence (including specialist consultations and clinical-laboratory follow-up) was only 16 %. Additionally, 36 children presented permanent sequelae during follow-up. Factors such as higher maternal age (OR = 1.10; 95 % CI:1.03–1.20) and the presence of permanent sequelae in the children (OR = 4.87; 95 % CI: 2.29–10.35) were predictors of adherence. Loss to follow-up occurred in 68 % (173/256) of the cases.</div></div><div><h3>Conclusion</h3><div>This study highlights a very low level of caregiver adherence to the congenital syphilis management protocol recommended by the Brazilian Ministry of Health. The presence of sequelae in children and higher maternal age were associated with improved adherence.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101493"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781335","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":"Development of a machine learning-based predictive model for long-term adverse outcomes in neonatal bacterial meningitis","authors":"Ying Chen ,&nbsp;Shengpei Wang ,&nbsp;Jing Wu ,&nbsp;Chi Wang ,&nbsp;Ying Li ,&nbsp;Peicen Zou ,&nbsp;Ruiqi Xiao ,&nbsp;Na Zhang ,&nbsp;Huiguang He ,&nbsp;Yajuan Wang","doi":"10.1016/j.jped.2025.101472","DOIUrl":"10.1016/j.jped.2025.101472","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the application of machine learning methods for screening risk factors for long-term adverse prognosis in neonatal bacterial meningitis, determine the final prediction model, and evaluate its predictive value.</div></div><div><h3>Methods</h3><div>This study included 139 full-term neonates diagnosed with neonatal bacterial meningitis in the capital institute of pediatrics between January 2019 and December 2023. Based on follow-up outcomes, they were divided into a poor prognosis group (<em>n</em> = 45) and a good prognosis group (<em>n</em> = 94). Thirty-three clinical variables were collected. Feature selection was performed using the Least Absolute Shrinkage and Selection Operator, Boruta, and Recursive Feature Elimination. Seven machine learning models were constructed. Model performance was evaluated using metrics including the area under the receiver operating characteristic curve, accuracy, and sensitivity. The Shapley Additive explanation method was used to interpret the models.</div></div><div><h3>Results</h3><div>Among the seven models, The Random Forest model demonstrates the best overall predictive performance, although Logistic Regression achieved the highest discriminative ability (AUC: 0.903), Random Forest was more suitable for clinical application due to its superior accuracy (0.881), better calibration (Brier score: 0.123), and balanced sensitivity (0.887) and specificity (0.878). Shapley Additive explanation interpretability analysis further revealed that the top three important features were cerebrospinal fluid white blood cell count, cerebrospinal fluid protein levels, and seizures.</div></div><div><h3>Conclusion</h3><div>Machine learning models, particularly the superior-performing Random Forest, are proven to reliably predict long-term adverse outcomes in NBM patients, aiding in the identification of high-risk individuals. Further validation in broader cohorts is warranted to enhance generalizability and clinical applicability.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101472"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145487834","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":"Clinical characteristics and gaps in palliative care among tracheostomized children: a retrospective observational study","authors":"Luziane Lais Sabino Silva Luna,&nbsp;Sheyla Suelle dos Santos Levy,&nbsp;Luciana Santana Lima,&nbsp;Maria do Carmo Menezes Bezerra Duarte","doi":"10.1016/j.jped.2025.101480","DOIUrl":"10.1016/j.jped.2025.101480","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical characteristics of tracheostomized children in Northeastern Brazil and to identify existing gaps in the indication and implementation of palliative care.</div></div><div><h3>Methods</h3><div>This retrospective descriptive study reviewed medical records of children under 15 years who underwent tracheostomy between 2008 and 2019 at a quaternary referral center.</div></div><div><h3>Results</h3><div>Sixty-five tracheostomized patients with indications for palliative care were analyzed. The main reasons for palliative classification were acute life-threatening conditions (50.7 %) and chronic life-threatening conditions (20 %). The most frequent tracheostomy indications were prolonged invasive mechanical ventilation (46.1 %) and severe upper airway obstruction (23 %). The mortality rate was 30.7 %, higher among infants, severely malnourished children, those with Lansky scores below 40 % before tracheostomy, congenital heart disease, bronchopulmonary dysplasia, and multiple comorbidities. Only 10.8 % received palliative care consultations during hospitalization, all in the end-of-life care phase.</div></div><div><h3>Conclusions</h3><div>The results highlight a critical gap in the provision of palliative care to tracheostomized children. Early involvement of a multidisciplinary palliative care team is crucial to support clinical decision-making, family-centered care, and ensure quality of life. The proposed framework may facilitate timely referral and airway planning in the Intensive therapy, although further validation and qualitative research in various healthcare settings are needed.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101480"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648649","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":"Applicability of anthropometric indicators to assess physical fitness: proposal of percentiles for schoolchildren living at high altitude in Peru","authors":"Jose Fuentes-Lopez ,&nbsp;Ruben Vidal-Espinoza ,&nbsp;Danilo Rodrigues Pereira da Silva ,&nbsp;Dony Mamani-Velásquez ,&nbsp;Eliseny Vargas-Ramos ,&nbsp;Estanislao Pacompia-Cari ,&nbsp;Wilbert Cossio-Bolaños ,&nbsp;Marco Cossio-Bolaños ,&nbsp;Rossana Gomez-Campos","doi":"10.1016/j.jped.2025.101497","DOIUrl":"10.1016/j.jped.2025.101497","url":null,"abstract":"<div><h3>Objective</h3><div>a) To verify the applicability of anthropometric indicators to evaluate physical fitness in school children and b) Propose physical fitness reference values for Peruvian children living at high altitudes in Peru.</div></div><div><h3>Methods</h3><div>A cross-sectional study was carried out in children aged 6 to 12 years living at high altitude in Peru. A total of 1372 primary school children (785 males and 587 females) were evaluated. Weight, height and four physical tests [Hand grip strength (right and left HGS)], Horizontal jump (HJ), Round trip (5 × 10 repetitions), and the 6-minute walk test (6MWT)] were evaluated. Body Surface Area (BSA), Body Mass Index (BMI), and Triponderal Index (TPI) were calculated.</div></div><div><h3>Results</h3><div>The BSA presented a better comparative structure in relation to BMI and TPI with all physical tests. In males, HGS was related between <em>r</em> = 0.64 and 0.66; HJ (<em>r</em> = 0.26), agility (<em>r</em> = -0.31) and 6MWT (<em>r</em> = 0.30). In females, HGS was related between <em>r</em> = 0.63 and 0.64; HJ (<em>r</em> = 0.36), agility (<em>r</em> = -0.36), and 6MWT (<em>r</em> = 0.21). The predictive power in the four physical tests ranged from R² = 9% to 43% in males, and from 5% to 41% in females. Percentiles by age and sex were proposed for BSA, HGS (right and left), HJ, agility, and 6MWT.</div></div><div><h3>Conclusion</h3><div>BSA is the best predictor of physical fitness in schoolchildren from high altitude areas in Peru, surpassing BMI and TPI. In addition, reference values were proposed to evaluate physical fitness in these children.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 1","pages":"Article 101497"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850104","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":"Cardiac manifestations in children and adolescents diagnosed with pediatric multisystem inflammatory syndrome related to COVID-19","authors":"Thiago T. Panizzi ,&nbsp;Katharine A. de Souza ,&nbsp;Gabriela B. Stutz ,&nbsp;Fernanda M.C.F. Lemos ,&nbsp;Marta C.F. Rodrigues ,&nbsp;Rozana G. de Almeida ,&nbsp;Luciane A. da Rocha ,&nbsp;Flavio R. Sztajnbok ,&nbsp;Adriana R. Fonseca ,&nbsp;Nathalie J.M. Bravo-Valenzuela","doi":"10.1016/j.jped.2025.101461","DOIUrl":"10.1016/j.jped.2025.101461","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe clinical and cardiologic findings in patients with multisystem inflammatory syndrome in children (MIS-C) in a follow-up of up to 3 years.</div></div><div><h3>Materials and methods</h3><div>A retrospective-prospective, observational, longitudinal study was conducted, including children and adolescents up to 18 years diagnosed with MIS-C (WHO criteria), at a university center between March 2020 and December 2024. Demographic, clinical, and laboratory data, electrocardiograms, and transthoracic echocardiograms were analyzed at admission and at 12 months and left ventricular global longitudinal strain (LV-GLS) three years after diagnosis. Statistical analysis used frequencies for categorical variables, and means with standard deviations or medians with interquartile ranges for continuous variables. Differences in proportions between patients with and without cardiovascular abnormalities were assessed using Fisher's exact test, Chi-squared, or Wilcoxon rank-sum test (significant p-value &lt; 0.05). T-test was used to compare left ventricular ejection fraction (LVEF) and coronary artery Z scores.</div></div><div><h3>Results</h3><div>Thirty-six patients were included (males 69.4%), with a median age at diagnosis of 2.15 years (IQR 3.3). At admission, 41.7% presented with clinical or echocardiographic abnormalities, which were absent at 1-year follow-up. However, three years after diagnosis, among the 11 patients evaluated with LV-GLS, 10 showed changes indicating subclinical dysfunction not detected by conventional electrocardiogram or echocardiography.</div></div><div><h3>Conclusion</h3><div>Clinical and echocardiographic cardiovascular abnormalities are common in the acute phase of MIS-C. Although most patients showed clinical and echocardiographic resolution, LV-GLS proved valuable for detecting subclinical myocardial dysfunction not identified by conventional evaluation, highlighting its potential as a screening tool in short- and long-term follow-up.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101461"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367987","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 overdiagnosis: reframing autism prevalence through a neurodivergent phenotype lens","authors":"Simone Hauck ,&nbsp;Luciana Terra de Oliveira","doi":"10.1016/j.jped.2025.101467","DOIUrl":"10.1016/j.jped.2025.101467","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101467"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421904","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}