Jornal de pediatria最新文献

{"title":"From the Sound of Silence to Ultrasound of Life?","authors":"Samuel Kunz , Luregn Jan Schlapbach , Fábio Joly Campos","doi":"10.1016/j.jped.2025.101483","DOIUrl":"10.1016/j.jped.2025.101483","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101483"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680986","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":"Alternative antibiotics for the treatment of bacterial meningitis in children: a systematic review of efficacy and safety","authors":"Ana Clara Valente de Alencar ,&nbsp;Athus Graziani Apollaro Rego ,&nbsp;Carolina Soares Chady ,&nbsp;Alisson Gabriel Maués Miranda ,&nbsp;Lara Fernanda Alves de Souza ,&nbsp;João Vitor Martins Pinto ,&nbsp;Bárbara de Souza Maia do Nascimento ,&nbsp;Camili Giseli Oliveira de Menezes ,&nbsp;Isa Mendes Moreira ,&nbsp;José Carlos Favacho Furlan ,&nbsp;Ester Carolina Vieira Maia ,&nbsp;Maria Fernanda Nakayama Martins ,&nbsp;Nayara Cristina Cardoso da Silva ,&nbsp;Paula do Socorro de Oliveira da Costa Laurindo ,&nbsp;Luis Edilson de Azevedo Ferreira ,&nbsp;Antônio Rafael Quadros Gomes ,&nbsp;Heliton Patrick Cordovil Brígido","doi":"10.1016/j.jped.2025.05.002","DOIUrl":"10.1016/j.jped.2025.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aimed to evaluate the efficacy and safety of alternative antibiotics and different standard treatment regimens for bacterial meningitis in children, considering the increasing antimicrobial resistance and the need for adapted therapeutic options. To justify the use of alternative antibiotics, the authors analyzed the specific efficacy of ampicillin, chloramphenicol, cefuroxime and meropenem, which showed potential to overcome cases of antimicrobial resistance.</div></div><div><h3>Data sources</h3><div>A search was performed in databases such as PubMed, Scopus, Web of Science and Cochrane Library, without data restrictions, including planned clinical trials that compared alternative antibiotics and different standard treatment regimens, such as ceftriaxone, in children with bacterial meningitis. Inclusion criteria include studies reporting cure rates, complications and safety of treatments.</div></div><div><h3>Summary of results</h3><div>An analysis of 14 studies, totaling 2,014 children, indicated that antibiotics such as ampicillin, chloramphenicol, cefuroxime and meropenem had comparable efficacy and safety to standard treatment regimens. The review showed that, in many cases, alternative regimens and shorter treatment durations could be effective, without significantly increasing complications or mortality.</div></div><div><h3>Conclusion</h3><div>The results suggest that alternatives to standard treatment, such as ampicillin, chloramphenicol, cefuroxime and meropenem, are viable and safe options for the treatment of bacterial meningitis in children. These results help to adapt clinical practices, especially in settings with high antimicrobial resistance and resource limitations, by providing evidence for shorter and equally effective treatment regimens.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101414"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208609","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 and validation of entrustable professional activities in pediatric surgery for pediatricians","authors":"Rodrigo Pinheiro de Abreu Miranda ,&nbsp;Edna Regina Silva Pereira ,&nbsp;Leopoldo Luiz dos Santos-Neto","doi":"10.1016/j.jped.2025.101444","DOIUrl":"10.1016/j.jped.2025.101444","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate entrustable professional activities (EPAs) for the training of pediatric residents on topics that interface with pediatric surgical areas in the Brazilian context.</div></div><div><h3>Methods</h3><div>The study was conducted in two phases. In the first phase, experts were oriented and contextualized, and they were responsible for developing the initial list of EPAs. In the second phase, the Delphi technique was applied in three rounds: the first for consensus, the second for selection according to relevance and agreement, and the third for validation and detailing of the EPAs.</div></div><div><h3>Results</h3><div>In the first phase of the study, 9 experts listed 88 EPAs, which were applied in the Delphi method. In the first round of Delphi, the consensus of these experts defined 31 EPAs, with CVI ≥ 0.80, and ICC of 0.893 (95 % CI 0.823–0.945). In the second round, 25 coordinators of Medical Residency Programs selected 17 EPAs by agreement and relevance (CVI ≥ 0.80, and ICC of 0.851–95 % CI 0.753 to 0.924). In the third round, 50 preceptors from all over Brazil validated 14 EPAs with CVI ≥ 0.965 and ICC 0.866 (95 % CI 0.804–0.915), which were organized and detailed into 7 final EPAs.</div></div><div><h3>Conclusion</h3><div>Seven pediatric surgery EPAs were developed, consensualized, selected, and validated by experts for the work of pediatricians in Brazil through the Delphi method. The great participation and interest of medical residency preceptors with a wide geographical coverage in Brazil were strong points of this study, and these EPAs can be applied, reviewed, and updated.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101444"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086305","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":"Diagnostic yield of array-CGH in children with suspected rare disease","authors":"M. Carla Criado-Muriel ,&nbsp;Ramón Arroyo-Ruiz ,&nbsp;Elena Marcos-Vadillo ,&nbsp;María Justel-Rodriguez ,&nbsp;Lydia Alcubilla-García ,&nbsp;María Isidoro-García ,&nbsp;Pablo Prieto-Matos","doi":"10.1016/j.jped.2025.101450","DOIUrl":"10.1016/j.jped.2025.101450","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to analyze the diagnostic yield of aCGH in pediatric patients with suspected rare diseases, focusing on its diagnostic value and effectiveness depending on different clinical symptoms.</div></div><div><h3>Methods</h3><div>This observational study analyzed 600 aCGH tests performed in a pediatric unit (2018–2022) for patients with suspected rare diseases. DNA was extracted from peripheral blood; aCGH resolution was adjusted to clinical features. CNVs were classified per international guidelines. Forty sociodemographic, clinical, and genetic variables were analyzed using IBM SPSS v.26.</div></div><div><h3>Results</h3><div>Of the 600 patients analyzed, 543 were included in the final study. The median age was 4.7 years (IQR: 6.36 years), and 66.3% were male. Most referrals came from pediatric neurology (84.3%), and the most common clinical manifestations were altered phenotype (38.6%), autism spectrum disorder (ASD) (38.6%), dysmorphia (28.2%), global developmental delay (GDD) (27.1%), and intellectual disability (21.0%). Among 543 patients, 30.4% presented CNVs, with 12.4% identified as pathogenic and 18.1% as variants of uncertain significance. Diagnostic yield was 12.2%, with 66 conclusive results — 90.9% of which were pathogenic. CNVs were most frequently detected on chromosomes 15 and 16. The highest yield was observed in clinical features such as coordination problems (35.7%), learning disorders (28.6%), and microcephaly (22.6%).</div></div><div><h3>Conclusion</h3><div>The diagnostic yield of aCGH in this study was 12.2%. The test demonstrated higher diagnostic value in patients with multiple clinical manifestations, highlighting the importance of aCGH as a first-line diagnostic tool for rare diseases. This technique enables earlier diagnosis, improves clinical management, and provides better counseling for affected families.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101450"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149065","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":"Fluid tolerance assessed by lung ultrasound and effect of crystalloid expansion on extravascular lung water in critically ill children with cancer","authors":"Bruno S. Camargo,&nbsp;Orlei R. de Araujo,&nbsp;Dafne Cardoso B. da Silva","doi":"10.1016/j.jped.2025.101456","DOIUrl":"10.1016/j.jped.2025.101456","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the effect of a bolus of saline on extravascular lung water (EVLW), and to analyze correlations of EVLW with outcome.</div></div><div><h3>Methods</h3><div>Prospective cohort. Patients received 10 mL/kg of saline (bolus). Central venous blood gas analysis and echocardiography measurements were performed before and after. Lung ultrasound was performed with 12 measurements, repeated after expansion. Statistics included paired <em>t</em>-test and logistic regression models. The magnitude of the effect was assessed using Cohen's test.</div></div><div><h3>Results</h3><div>88 measurements were made on 83 patients. There was a response to volume in 48 measurements (54.5 %). 28 patients (33.7 %) had signs of shock, and 60 were on mechanical ventilation (MV, 72.2 %). In 68 paired measurements, there was an increase in B-lines after expansion (77.2 %). The mean number of B-lines pre- was 1.42 (SD 1.12) per intercostal space, increasing to 1.71 (SD 1.17) post-expansion (<em>p</em> &lt; 0.001, Cohen's d 0.97). The mean pre-expansion cardiac index was 3.43 L/min/m2 (SD 1.05), increasing to 3.87 (SD 1.21, <em>p</em> &lt; 0.001, Cohen's <em>d</em> = 0.8). In a multivariate model, lactate and mean pre-expansion B-lines were independent predictors of death in ICU: pre-B-lines, Odds ratio 1.87, <em>p</em> = 0.012; pre-lactate OR 1.59, <em>p</em> = 0.012. The same was observed with post-volume B-lines, in a model which also included MV: post-volume B-lines, OR 1.87, <em>p</em> = 0.01; post-volume lactate, OR 1.51, <em>p</em> = 0.03; MV, OR 4.32, <em>p</em> = 0.041.</div></div><div><h3>Conclusions</h3><div>Most patients showed signs of fluid intolerance, with increased EVLW. EVLW assessed by ultrasound is a predictor of mortality.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101456"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212308","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":"Associations between adverse childhood experiences and perinatal outcomes","authors":"Nina de Siqueira Kuperman ,&nbsp;Maria Clara Magalhães-Barbosa ,&nbsp;Fernanda de Carvalho Lima ,&nbsp;Mariana Barros Genuino de Oliveira ,&nbsp;Jaqueline Rodrigues Robaina ,&nbsp;Margarida dos Santos Salú ,&nbsp;Arnaldo Prata-Barbosa ,&nbsp;Antônio José Ledo Alves da Cunha","doi":"10.1016/j.jped.2025.101433","DOIUrl":"10.1016/j.jped.2025.101433","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the frequency of adverse childhood experiences (ACE) among a cohort of pregnant women (primary outcome) and explore their association with prematurity, pre-eclampsia, and fetal growth restriction (secondary outcomes).</div></div><div><h3>Methods</h3><div>The Adverse Childhood Experiences International Questionnaire - ACE-IQ was applied to patients during prenatal visits. Information on perinatal outcomes was collected from medical records. The proportion of total ACE and its different domains was estimated. Multiple logistic regressions were performed to assess the association between ACE and outcomes, after adjusting for possible confounding factors.</div></div><div><h3>Results</h3><div>A cohort of 307 pregnant women completed the ACE-IQ. The results in the binary and frequency versions were, respectively: mean (SD) scores of 5.84 (2.87) and 3.55 (2.73); the proportion of ACE 4 of 75% and 44%; the most prevalent ACE domains were home dysfunction (89.6 and 86.6%) and exposure to community violence (76.5 and 50%). For fetal growth restriction, pregnant women with ACE ≥ 4 had 2.32 times (95% CI: 1.04–5.37; p = 0.042) higher chance of this outcome. For preterm birth, the odds ratio was 1.1 (95% CI: 0.5–2.6; p = 0.886), indicating no statistically significant association. There was no significant association between the total ACE score, or its domains, and the other perinatal outcomes studied.</div></div><div><h3>Conclusions</h3><div>The frequency of ACE was high in this cohort of pregnant women, and exposure to community violence was associated with fetal growth restriction. The investigation of the association with other perinatal outcomes should be extended to a general population of pregnant women.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101433"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821490","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":"Evaluation of stretched penile length (SPL), postnatal penile growth evolution, and micropenis in Brazilian preterm newborns","authors":"Bárbara Reis Krämmer ,&nbsp;Rita C. Silveira ,&nbsp;Eduardo Correa Costa ,&nbsp;Matheus Lourenço Mendes ,&nbsp;Renato S. Procianoy ,&nbsp;Guilherme Guaragna Filho","doi":"10.1016/j.jped.2025.101437","DOIUrl":"10.1016/j.jped.2025.101437","url":null,"abstract":"<div><h3>Objective</h3><div>to develop a reference curve for SPL in Brazilian preterm newborns, assessing their postnatal growth adjusted for corrected gestational age (cGA).</div></div><div><h3>Materials and Methods</h3><div>This is a prospective cohort study conducted in southern Brazil. Newborns who were born below 37 weeks of gestational age were selected at tertiary care hospital during the first 3 days of life were selected over a one-year period. SPL was measured weekly until the participants reached 37 weeks of cGA or were discharged from the hospital. Statistical analysis included the Lambda Mu Sigma (LMS) method for growth curve construction and the Bland-Altman test to assess measurement agreement.</div></div><div><h3>Results</h3><div>A total of 290 SPL measurements were collected from 140 participants. Reference curves were developed for cGA between 26 and 37 weeks. Bland-Altman analysis suggested agreement between measurements taken immediately after birth and those taken during follow-up, inferring that preterm newborns may exhibit penile growth patterns similar to those exhibited during the intrauterine period.</div></div><div><h3>Conclusion</h3><div>hypothalamic-pituitary-gonadal axis integrity appears to be the primary determinant of post-natal penile growth. The proposed reference curves aid in the early diagnosis of hormonal and genetic alterations, allowing for timely medical interventions.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101437"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873288","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":"Factors associated with weight Z-score in very low birth weight and extremely low birth weight preterm infants during hospitalization","authors":"Eduarda Couto Plácido Nunes ,&nbsp;Eduarda Silva ,&nbsp;Eduarda Dallmann Lopes Pereira ,&nbsp;Karla Pereira Machado ,&nbsp;Sandra Costa Valle","doi":"10.1016/j.jped.2025.101443","DOIUrl":"10.1016/j.jped.2025.101443","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the behavior of weight-for-age z-score (WAZ) and associated factors in preterm newborns (PTNB) with very low birth weight (VLBW) and extremely low birth weight (ELBW), comparing them to low birth weight (LBW) during four weeks (wk.) of hospitalization in a neonatal intensive care unit (NICU).</div></div><div><h3>Methods</h3><div>Longitudinal study conducted using data from PTNB records in the southern Brazil NICU, between January 2017 and December 2020. Non-twin PTNB with gestational age of ≥ 24 and &lt; 37 wk. and a birth weight (BW) ≥ 500 g were included. The outcome was WAZ, and the exposure was the PTNB’s BW, categorized as VLBW/ELBW (&lt; 1500 g) and LBW (≥ 1500 g up to 2500 g). Energy (kcal/kg/day) and protein (g/kg/day) intakes were also evaluated. Two-way ANOVA and multiple linear regression were used to assess the association between demographic, clinical, and nutritional factors and the WAZ.</div></div><div><h3>Results</h3><div>The majority of PTNB were male (60 %) and had a birth weight ≥1500 g (65 %). A significant interaction was between the BW category and the length of hospitalization on WAZ (<em>F</em> = 4.0; <em>p</em> = 0.003). In the VLBW and ELBW, the WAZ was significantly lower in the first wk. compared to the LBW [−1.05 (−1.34;−0.75) vs −0.34 (−0.49;−0.18)]. Factors such as male sex, sepsis, initiation of enteral nutrition (EN), and protein intake were associated with WAZ behavior.</div></div><div><h3>Conclusion</h3><div>The downward trend of the WAZ curve was associated with the interaction between birth weight and length of hospitalization, especially in PTNB with VLBW and ELBW. The study concluded that male sex and sepsis contributed to the observed decline.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101443"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040176","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":"Quality improvement initiative to reduce late-onset sepsis in very low birth weight preterm infants: a multicenter study from the Brazilian network on neonatal research","authors":"Ligia Maria Suppo de Souza Rugolo ,&nbsp;Maria Regina Bentlin ,&nbsp;Fernanda Pegoraro de Godoi Melo ,&nbsp;Maria Eduarda Gurgel ,&nbsp;Gabriella Miranda Martins ,&nbsp;Suely Dornellas do Nascimento ,&nbsp;Edna Maria de Albuquerque Diniz ,&nbsp;Renata Yoshida ,&nbsp;Jamil Pedro de Siqueira Caldas ,&nbsp;Silvia Cwajg ,&nbsp;Marcia Pereira Alves de Souza ,&nbsp;Clarissa Gutierrez Carvalho ,&nbsp;Daniela Marques de Lima Mota Ferreira","doi":"10.1016/j.jped.2025.101459","DOIUrl":"10.1016/j.jped.2025.101459","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of a quality improvement project (QI) on reducing proven late-onset sepsis (LOS) in centers of the Brazilian Network Neonatal Research (BNNR).</div></div><div><h3>Method</h3><div>An interventional study conducted in 12 BNNR centers from 2021 to 2023. Included preterm infants (PT) born at 22–36 weeks' gestational age, weighing 400–1499 grams, without malformations, and admitted to the NICU for &gt; 72 h. QI tools were used and four process indicators were defined: central catheter complication (≤ 20 %); antibiotic discontinuation ≤48 h in non-infected infants (≥ 80 %); breast milk expression within the first 48 h and enteral feeding within the first 24 h of life (≥ 80 %); full enteral feeding without parenteral nutrition by day 11 (≥ 70 %). The outcome was the proportional reduction of LOS according to each center’s baseline (2020). Indicators were analyzed descriptively across three periods.</div></div><div><h3>Results</h3><div>A total of 1993 PT &lt; 1500 grams were included. Half of the centers achieved the target for umbilical catheter complications, and 92 % for percutaneous catheters. Antibiotics were discontinued within 48 h in 67 % of non-infected infants. Early breast milk expression and enteral feeding were achieved in 44 % and 75 % of cases, respectively. 58 % achieved full enteral nutrition without parenteral support by day 11. LOS incidence declined in 67 % of centers, and half met their targets, with an overall 18.5 % reduction.</div></div><div><h3>Conclusions</h3><div>The project reduced LOS in most centers, although some clinical practices still need improvement. It demonstrates a reproducible, low-cost strategy with the potential to guide other neonatal units facing high sepsis incidence.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101459"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286268","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":"Reply to the letter ‘Beyond overdiagnosis: reframing autism prevalence’","authors":"Kamila Castro ,&nbsp;Rudimar Riesgo ,&nbsp;Carlos Gadia","doi":"10.1016/j.jped.2025.101469","DOIUrl":"10.1016/j.jped.2025.101469","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101469"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421902","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}