Pediatric Research最新文献

{"title":"Management of intra-arterial catheters: neonatal european vascular access team-ESPR recommendation 6.","authors":"Robin van der Lee, Nadya Yousef, Bernhard Schwaberger, Barbara De Bisschop, Fiammetta Piersigilli, Tom Ouwehand, Suzy Van Eenoo, Kevin Hugill, Matheus van Rens","doi":"10.1038/s41390-026-05470-x","DOIUrl":"https://doi.org/10.1038/s41390-026-05470-x","url":null,"abstract":"<p><strong>Impact: </strong>Vascular access is a pervasive facet of contemporary neonatal practice, yet it lacks standardization, and some practices lack supporting evidence. This recommendation provides neonatal healthcare providers with evidence-based guidance for the safe insertion, securement, and management of intra-arterial catheters (IACs) in neonates. Taken together these steps aim to enhance the safety and efficacy of IAC insertion in neonatal population.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular development of critically ill neonates on mother's milk.","authors":"Sergio Verd, Alcia Serra, Juan Antonio Costa-Orvay","doi":"10.1038/s41390-026-05510-6","DOIUrl":"https://doi.org/10.1038/s41390-026-05510-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic research on childhood obesity and asthma: exploring genetic risk factors and biological mechanisms.","authors":"Xiaojuan Liu, Yonghong Sun, Mingdong Gao","doi":"10.1038/s41390-026-05513-3","DOIUrl":"https://doi.org/10.1038/s41390-026-05513-3","url":null,"abstract":"<p><p>Childhood obesity-related asthma is a heterogeneous type of asthma with a complex pathogenesis and ineffective conventional anti-asthma treatment. This review discusses the latest research advancements in the genetic associations between childhood obesity and asthma. It analyzes gene variations and hereditary risk factors, exploring their impact on children's health and potential biological mechanisms linking obesity and asthma. The article also addresses the limitations of current studies and outlines future research directions, aiming to provide a scientific basis for the prevention and treatment of obesity-related asthma in children. IMPACT: This review summarizes genetic research on childhood obesity-related asthma, highlighting its complex genetic links and mechanisms. It notes the condition's heterogeneity, poor treatment response, and genetic factors. The article also stresses the value of new technologies like gene-environment interactions and single cell sequencing in understanding the disease, proposing precise genetic risk models for early intervention. Future work should focus on longitudinal studies and precision medicine to enhance personalized care and health outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based telerehabilitation on motor function in youth with cerebral palsy: systematic review and meta-analysis.","authors":"Patricia Domínguez-López, Cristina Lirio-Romero, María Coello-Villalón, Purificación López-Muñoz, María Martínez-Olagüe Jácome, Rocío Palomo-Carrión","doi":"10.1038/s41390-026-05382-w","DOIUrl":"https://doi.org/10.1038/s41390-026-05382-w","url":null,"abstract":"<p><strong>Aim: </strong>Neurodevelopmental disorders (NDDs) affect motor, cognitive and social functioning in children and adolescents, limiting autonomy and quality of life. Limited access to specialized services may hinder rehabilitation, making home-based telerehabilitation an alternative. This study evaluated its effectiveness on motor function in individuals aged 3-18 years with NDDs compared with usual care, conventional rehabilitation, or non-telehealth interventions.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) published from database inception (earliest eligible trial, 2014) to January 2026 were identified in PubMed, Cochrane Library, PEDro, CINAHL, and Scopus. Risk of bias and evidence certainty were assessed using RoB 2.0 and GRADE. Standardized mean differences (SMDs) were pooled using a random-effects model.</p><p><strong>Results: </strong>Eight RCTs (n = 419) were included; all involved children with cerebral palsy (CP), although the review targeted NDDs. Meta-analyses suggested possible improvements in gross motor function (SMD 1.29, 95% CI 0.11 to 2.47; I² = 96%), although estimates were influenced by heterogeneity and outlier studies. Effects on fine motor function were smaller and non-significant (SMD 0.62, 95% CI -0.25 to 1.49; I² = 90%).</p><p><strong>Conclusions: </strong>Although this review targeted NDDs, all studies involved youth with CP. Home-based telerehabilitation may support gross motor rehabilitation, but low-certainty evidence and heterogeneity limit confidence and generalizability.</p><p><strong>Impact: </strong>This systematic review and meta-analysis suggests that home-based telerehabilitation may improve gross motor function in children and adolescents with cerebral palsy, although effect estimates were influenced by substantial heterogeneity and outlier studies. By synthesizing evidence from randomized controlled trials, this review highlights the potential role of home-based telerehabilitation as a complementary rehabilitation approach, while emphasizing important methodological variability across studies. The findings suggest that home-based telerehabilitation may represent a complementary rehabilitation approach for children and adolescents with cerebral palsy. However, further high-quality studies are needed to confirm effectiveness, determine clinical relevance, and better understand implementation-related factors such as adherence and intervention delivery.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daniella Levy Erez: ECI Bio commentary.","authors":"Daniella Levy Erez","doi":"10.1038/s41390-026-05299-4","DOIUrl":"https://doi.org/10.1038/s41390-026-05299-4","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel genetic variants and atypical phenotypes in pediatric progressive familial intrahepatic cholestasis.","authors":"Manal Abdel Gawad, Aml Mahfouz, Mona Abdel-Hadi, Heba Mastor, Basant Elbanna","doi":"10.1038/s41390-026-05422-5","DOIUrl":"https://doi.org/10.1038/s41390-026-05422-5","url":null,"abstract":"<p><strong>Background: </strong>Progressive familial intrahepatic cholestasis (PFIC) is a group of autosomal recessive disorders characterized by impaired bile formation and secretion, frequently progressing to cirrhosis and end-stage liver disease. This study characterized the genotypic and phenotypic spectrum of PFIC in a pediatric cohort.</p><p><strong>Methods: </strong>A retrospective cohort study with prospective enrollment of additional cases and longitudinal follow-up included 17 children with molecularly confirmed PFIC managed at Alexandria University Children's Hospital between 2017 and 2026. Clinical, biochemical, histopathological, genetic, therapeutic, and outcome data were reviewed.</p><p><strong>Results: </strong>Three, ten, two, and two patients had PFIC types 1, 2, 3, and 8, respectively, with pathogenic variants in ATP8B1, ABCB11, ABCB4, and KIF12, including four novel variants. PFIC types 1 and 2 presented with early-onset low gamma-glutamyl transferase (GGT) cholestasis and severe pruritus; five patients underwent biliary diversion. PFIC type 2 showed more severe liver disease than PFIC type 1. PFIC types 3 and 8 presented later with atypical non-icteric presentations with hepatosplenomegaly and elevated GGT without classical histopathological cholestasis in three cases. Three patients underwent successful liver transplantation.</p><p><strong>Conclusion: </strong>PFIC exhibits marked phenotypic heterogeneity. Recognition of atypical and non-icteric presentations broadens its clinical spectrum and highlights the importance of comprehensive genetic testing for accurate diagnosis.</p><p><strong>Impact statement: </strong>The study identifies and characterizes novel variants in the ABCB11, ABCB4, and KIF12 genes within an Egyptian pediatric cohort, expanding the known mutational spectrum of the disease. The study reported unusual presentation for PFIC type 3 and 8 with rapid fibrotic progression even in the absence of clinical jaundice or histological evidence of bile plugs challenging the diagnostic reliance on overt cholestasis as the primary clinical marker for PFIC.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to the special article series to guide neonatal vascular access.","authors":"Fiammetta Piersigilli, Kevin Hugill, Robin van der Lee, Matheus F P T van Rens, Giovanni Barone, Tobias Werther, Bernhard Schwaberger, Suzy Van Eenoo","doi":"10.1038/s41390-026-05468-5","DOIUrl":"https://doi.org/10.1038/s41390-026-05468-5","url":null,"abstract":"<p><strong>Impact: </strong>Vascular access is a pervasive facet of contemporary neonatal practice, yet it lacks standardization, and some practices lack supporting evidence. This special series consolidates existing knowledge and consensus around ten key areas of neonatal vascular access to bridge practice gaps, support evidence-based standardization, and highlight priorities for further research to address gaps in knowledge. Together, the ten recommendations advocate objective standardization of neonatal vascular access practice to improve neonatal vascular access management, patient safety and outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and long-term effectiveness of teduglutide in children with intestinal failure due to short bowel syndrome: a multicenter, post-marketing cohort study.","authors":"Lissette Jimenez, Aliza Ray, David Mercer, Samuel Kocoshis, Sivan Kinberg, Mercedes Martinez, Lindsey Gumer, Russell Merritt, Mark R Corkins, Charles Vanderpool, Valeria Cohran, Danielle Wendel, John Thompson, Debra Sudan, Kristin Whitfield Van Buren, Stuart Kaufman, Alexandra N Carey, Sasan Sabrdaran, Paul Mitchell, Suzanne E Dahlberg, Edie Weller, Christopher P Duggan","doi":"10.1038/s41390-026-05489-0","DOIUrl":"https://doi.org/10.1038/s41390-026-05489-0","url":null,"abstract":"<p><strong>Background: </strong>Teduglutide, a glucagon-like peptide-2 (GLP-2) analog, was approved in the US for use in children with intestinal failure dependent on parenteral support (PS, including intravenous fluids and/or parenteral nutrition (PN)) in 2019.</p><p><strong>Methods: </strong>Between May 2021 and December 2022, we enrolled 140 children with intestinal failure in a multi-center registry across 14 centers to evaluate the long-term (up to 3 years) safety and effectiveness of teduglutide.</p><p><strong>Results: </strong>Among 120 participants in whom effectiveness was measured, the mean percent reduction in parenteral calories was 8.3% by 6 months, 16.5% by 12 months, 33.0% by 2 years and 49.5% by 3 years, estimated by linear mixed models. Cumulative incidence estimates for weaning from parenteral support (full enteral autonomy) were 7.5% by 6 months, 15.2% by 1 year, 26.4% by 2 years, and 32.7% by 3 years from baseline. Five patients had inflammatory/foveolar polyps. The modeled proportion of children with low weight-for-age Z score increased from 2.3% at baseline to 12.7% at 3 years (p < 0.01) and mean BMI Z-scores declined over follow-up as well.</p><p><strong>Conclusions: </strong>In children treated with teduglutide, we found a progressive and sustained reduction in parenteral support up to 3 years and recommend careful attention to the nutritional status of such patients.</p><p><strong>Impact: </strong>The GLP-2 analog medication teduglutide was approved by the FDA in 2019 for children receiving parenteral support for intestinal failure. We enrolled 140 such children to evaluate its safety and effectiveness profile in a post-marketing study. Substantial reductions in parenteral calories and volume were noted with a reasonable safety profile. Some reductions in nutritional status (weight and BMI but not height) were also noted. Careful monitoring of nutritional status while on this new medication is warranted.</p><p><strong>Clinical trial registry site: </strong>NCT04832087.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung volume determines airway stability during total liquid ventilation: evidence from neonatal piglets.","authors":"Kevin Le Duc, Clément Bouchard, Nathalie Samson, Sarah-Gabrielle Taillandier-Pensarini, Gabriel Richard, Éric Lavallée, Etienne Croteau, Oscar-Esteban Espinosa-Bentacourt, Sébastien Poncet, Jean-Paul Praud, Philippe Micheau, Étienne Fortin-Pellerin","doi":"10.1038/s41390-026-05423-4","DOIUrl":"https://doi.org/10.1038/s41390-026-05423-4","url":null,"abstract":"<p><strong>Objectives: </strong>Total liquid ventilation (TLV) has been proposed as an alternative to gas ventilation in extreme preterm babies. Airway collapse has been described during expiration in TLV. We investigated the impact of varying lung volume on airway deformation and its effects on hemodynamic stability and gas exchange.</p><p><strong>Methods: </strong>Nine piglets (5-7 days old, 2 kg, 5 females) were ventilated with TLV. Perfluorooctyl bromide was added when tracheobronchial collapse was observed, restoring normal expiratory pressure considered as baseline ventilation level (V0). Perfluorooctyl bromide was administered at increments of +1 mL/kg (V1), +3 mL/kg (V3), and +5 mL/kg (V5) in randomized order. Static CT scans were used to measure end-expiratory lung volume (EELV), and dynamic CT scans to assess tracheal cross-sectional area during expiration.</p><p><strong>Results: </strong>At V0 (EELV of 37 [32;40] mL/kg, median [Q1;Q3]), tracheal area varied by 35% [31;63] from the beginning to the end of expiration. At V3 (EELV 42 [39:51] mL/kg), tracheal deformation decreased to 18% [9;22] (p < 0.005). Mean arterial pressure (MAP) decreased between V0 and V5 (p = 0.02). Blood gases remained unchanged.</p><p><strong>Conclusion: </strong>There is a narrow therapeutic window for end-expiratory lung volume during TLV in the neonatal-subject in order to stabilize the airway while avoiding hemodynamic impacts.</p><p><strong>Impact: </strong>During total liquid ventilation, severe expiratory tracheobronchial deformation can occur without any detectable drop in airway opening pressure, challenging current safety markers. This is the first in vivo study using dynamic CT imaging to quantify occult airway deformation during TLV in a neonatal model and to link it directly to end-expiratory lung volume. The findings redefine ventilatory safety during TLV, identify a narrow therapeutic window for lung volume optimization, and provide essential mechanistic data to guide safer translational development toward human neonatal application.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of blood and urinary heavy metals with obesity risk among children: NHANES 2015-2020.","authors":"Maoling Fu, Yechen Xiang, Xinyu Li, Ruoyu Wang","doi":"10.1038/s41390-026-05488-1","DOIUrl":"https://doi.org/10.1038/s41390-026-05488-1","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is a growing global public health concern that significantly increases the risk of metabolic diseases in both childhood and adulthood. However, research on the impact of heavy metal exposure on childhood obesity remains limited.</p><p><strong>Methods: </strong>In this cross-sectional study, data from the 2015-2020 National Health and Nutrition Examination Survey were analyzed using logistic regression, weighted quantile sum (WQS) regression, quantile-based g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) to assess the independent and combined associations of five blood metals and eleven urinary metals with childhood obesity risk, with stratification by sex and age.</p><p><strong>Results: </strong>Among 2016 children, 422 (20.9%) were diagnosed with obesity. In single-exposure models, blood cadmium (Cd), lead (Pb), manganese (Mn), and urinary Cd, Pb, cobalt (Co), cesium, antimony, and tungsten were significantly associated with obesity risk. WQS regression, qgcomp, and BKMR analyses consistently demonstrated a significant positive association between blood metal mixture exposure and obesity risk, with Mn showing the strongest association. Conversely, urinary metal mixture exposure was significantly negatively associated with obesity risk, with Cd, Pb, and Co showing the strongest negative associations. These associations were particularly pronounced among male children.</p><p><strong>Conclusions: </strong>Exposure to metal mixtures is significantly associated with obesity in U.S. children. Further research is needed to confirm these findings.</p><p><strong>Impact: </strong>First use of multiple statistical models to confirm the combined effects of metal mixtures on childhood obesity. Blood metal mixture exposure is positively associated with childhood obesity risk, with manganese showing the strongest association. Urinary metal mixture exposure, dominated by cadmium, lead, and cobalt, is significantly negatively associated with childhood obesity risk. Associations between metal exposure and childhood obesity risk are more pronounced in male children.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}