Pediatric Research最新文献

{"title":"Hypoxic burden as a cause of cardiovascular morbidity in childhood obstructive sleep apnea.","authors":"Plamen Bokov, Benjamin Dudoignon, Christophe Delclaux","doi":"10.1038/s41390-025-04153-3","DOIUrl":"https://doi.org/10.1038/s41390-025-04153-3","url":null,"abstract":"<p><strong>Background: </strong>To assess whether hypoxic burden (HB) is associated with cardiac autonomic nervous system dysfunction and increased blood pressure (BP) in otherwise healthy children with moderate to severe obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>Among 103 children with moderate-to-severe OSA, twenty pairs, matched for age, sex and obstructive apnea-hypopnea index (OAHI) were selected, with low (first quartile) or high (fourth quartile) HB in each pair: median [25th-75th percentiles]; age: 10.8 years [7.3; 13.2] vs. 11.4 [8.6; 13.5]; sex: 7 and 10 girls; z-score of body mass index: 1.50 [0.11; 2.43] vs. 2.40 [1.92; 2.70] (p = 0.012); OAHI: 8.6/hr [6.4; 13.3] vs. 11.1 [6.6; 17.2] and HB: 0.8%.min/h [0.3; 1.5] vs. 13.8 [10.1; 22.3], respectively.</p><p><strong>Results: </strong>Non-linear heart rate variability (HRV) indices obtained from polysomnography showed sympathetic overflow (Poincaré plot: decreased SD2) and weaker parasympathetic modulation (decreased SD1) in children with high versus low HB. The high versus low HB group had higher percentiles of office BP: systolic, 75th [61; 81] vs. 57th [47; 69], p = 0.049 and diastolic, 70th [60; 78] vs. 55th [46; 65], p = 0.007, adjusted for obesity and arousal index.</p><p><strong>Conclusions: </strong>Despite similar levels of OAHI, children with higher HB demonstrate parasympathetic withdrawal and increased daytime blood pressure.</p><p><strong>Impact: </strong>The hypoxic burden predicts cardiovascular morbidity/mortality in adult obstructive sleep apnea syndrome. Our study shows that in children with moderate to severe obstructive sleep apnea, despite similar levels of obstructive apnea-hypopnea index, those with higher hypoxic burden show cardiac autonomic nervous system dysfunction and increased daytime blood pressure. This study is the first one suggesting that the hypoxic burden is a valuable marker of cardiovascular morbidity in childhood obstructive sleep apnea.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132719","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":"Neurodevelopment of children born with gastroschisis: a scoping review.","authors":"Bianca de Moraes Rego Martins, Nathalia Cristina Oliveira de Souza, Maria Dalva Barbosa Baker Méio, Fernanda Rebelo, Carla Trevisan Martins Ribeiro","doi":"10.1038/s41390-025-04139-1","DOIUrl":"https://doi.org/10.1038/s41390-025-04139-1","url":null,"abstract":"<p><p>The neurodevelopment of children with gastroschisis may be affected by intrinsic (exposure of the abdominal viscera to the amniotic fluid, causing an inflammatory reaction) and extrinsic (pain, mobility restriction, hospitalization) factors. Thus, the objective of this study was to analyze the information available in the literature on the neurodevelopment of children born with this pathology. A scoping review was done, considering as outcomes the neurodevelopment in the motor, cognitive and language domains. A search was performed in the main databases using the term \"gastroschisis\", associated with: \"neurodevelopment\", \"impairment\", \"motor delay\" and \"language delay\". Articles in English, published in the last 10 years, were included; but those that addressed other pathologies were excluded. Eleven studies were included, mostly case series (n = 7), with samples ranging from 14 to 88 participants and ages ranging from 12 months to 10 years. The results were controversial, some reporting normal development, and others reporting deficiencies in all domains. Complex gastroschisis can be an additional risk for neurodevelopment delays. Gastroschisis is a relatively rare malformation, but the increased survival of these children stresses the relevance of investigating short- and long-term outcomes in relation to neurodevelopment to improve the care of this population. IMPACT: This review provides a comprehensive update on neurodevelopment of children born with gastroschisis. There is insufficient evidence to support or reject the idea that gastroschisis interferes negatively with neurodevelopment, but complex gastroschisis can be an additional risk for neurodevelopment delays in this population. Prematurity and being born small-for-gestation-age are confounders factors on evaluation of neurodevelopment on children born with gastroschisis. Additional studies to obtain sufficient information size, focusing on lowering bias risk, and with longer duration of analysis, are required.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128255","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":"Faster, affordable, and reliable diagnosis of cobalamin C disease by targeted sequencing.","authors":"Jamie Gilley, Binoy Shivanna","doi":"10.1038/s41390-025-04130-w","DOIUrl":"https://doi.org/10.1038/s41390-025-04130-w","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120298","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":"Growth patterns in children with prenatal methadone or buprenorphine exposure.","authors":"Ludmila N Bakhireva","doi":"10.1038/s41390-025-04137-3","DOIUrl":"https://doi.org/10.1038/s41390-025-04137-3","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120299","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":"Hyponatremia after pediatric surgery: Randomized trial of fluid composition on antidiuretic hormone response.","authors":"Kazuki Yokota, Hiroo Uchida, Katsunori Manaka, Masaomi Nangaku, Yachiyo Kuwatsuka, Masahiko Ando, Kimitoshi Nishiwaki, Takahiro Hirai, Takahisa Tainaka, Chiyoe Shirota, Wataru Sumida, Satoshi Makita, Hizuru Amano, Akinari Hinoki","doi":"10.1038/s41390-025-04124-8","DOIUrl":"https://doi.org/10.1038/s41390-025-04124-8","url":null,"abstract":"<p><strong>Background: </strong>We examined the underlying mechanisms of whether hyponatremia could be induced by hypotonic solution administration after the postoperative invasive phase (POIP).</p><p><strong>Methods: </strong>We included patients who had undergone surgery with expected oral feeding resumption after postoperative day (POD) 3. In this open-label, randomized controlled trial, 100 patients were assigned to three groups by sodium concentrations ([Na]) used for maintenance infusions: 136 mEq/L (ISO) (n = 34), 68 mEq/L (HYPO) (n = 33), and 34 mEq/L (exHYPO) (n = 33). Potassium (20 mEq/L) and glucose (60 g/L) were added to each infusion. Ringer's solution was used in all groups for the first 12 h postoperatively, then switched to a maintenance solution. Blood samples were drawn and evaluated on POD 3.</p><p><strong>Results: </strong>Hyponatremia frequencies on POD 3 were 3.6, 18, and 39% in the ISO, HYPO, and exHYPO groups, respectively, with a significant difference between the ISO and exHYPO groups. Additionally, 90% of the patients still had excessive antidiuretic hormone (ADH) secretion on POD 3. There were no remarkable adverse events.</p><p><strong>Conclusion: </strong>The persistence of surgical stress-induced ADH secretion until POD 3 suggested that hyponatremia was induced by exHYPO administration. However, using Ringer's solution during the POIP might prevent hyponatremia in HYPO patients.</p><p><strong>Registration number: </strong>UMIN000029057 ( https://www.umin.ac.jp/ctr/index.htm ).</p><p><strong>Date of first registration: </strong>01/11/2017 IMPACT: After the postoperative invasive phase, non-osmotic antidiuretic hormone (ADH) secretion due to surgical stress persisted, resulting in an excess ADH state for at least 3 postoperative days (PODs). Administration of extremely hypotonic electrolyte infusions under such circumstances might induce hyponatremia. Adequate extracellular fluid administration during the invasive phase after major pediatric laparoscopic surgery did not cause further increases in ADH secretion or hyponatremia, even for HYPO maintenance fluid.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120302","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":"What are the implications of sex differences in cell death for treatment after neonatal hypoxia-ischemia, if any?","authors":"Alice McDouall, Thomas R Wood, Benjamin A Lear, Joanne O Davidson, Laura Bennet, Alistair J Gunn, Justin M Dean","doi":"10.1038/s41390-025-04134-6","DOIUrl":"https://doi.org/10.1038/s41390-025-04134-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111008","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":"How to assess an amikacin population pharmacokinetics model on its applicability in your unit.","authors":"Karel Allegaert","doi":"10.1038/s41390-025-04138-2","DOIUrl":"https://doi.org/10.1038/s41390-025-04138-2","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111006","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":"Executive function of preschoolers: the role of physical fitness and movement behaviours.","authors":"Sophie M Phillips, Patricia Tucker","doi":"10.1038/s41390-025-04132-8","DOIUrl":"https://doi.org/10.1038/s41390-025-04132-8","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110910","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":"Plasma amino acids after human milk fortification and associations with growth in preterm infants.","authors":"Martin Bo Rasmussen, Kristine Holgersen, Tik Muk, Azra Leto, Allan Stensballe, Gerrit van Hall, Lise Aunsholt, Susanne Soendergaard Kappel, Gitte Zachariassen, Per Torp Sangild","doi":"10.1038/s41390-025-04126-6","DOIUrl":"https://doi.org/10.1038/s41390-025-04126-6","url":null,"abstract":"<p><strong>Background: </strong>It is unknown how plasma amino acid (AA) concentrations vary with fortification type, growth and insulin-like growth factor 1 (IGF-1) concentrations in the first weeks of life in very preterm infants (VPIs).</p><p><strong>Methods: </strong>Human milk for VPIs (n = 225) was fortified with bovine colostrum (BC, intact proteins, high bioactivity) or conventional fortifier (CF, hydrolysed bovine whey proteins). Plasma was sampled at fortification start (T0, ~1 week of age) and after one (T1) and two (T2) weeks. Changes in Z-scores for weight, length and head circumference (HC) were calculated from T0 to 35 weeks postmenstrual age.</p><p><strong>Results: </strong>Compared with CF, BC fortification increased 12 AAs (~10-40%, p < 0.05) and reduced Lys concentrations (10-16%, p < 0.05). Analysed across groups, T0-T2 AA increments associated positively with HC growth (12 AAs) and IGF-1 concentrations (5 AAs), and inversely with gestational age (13 AAs) and weight (8 AAs) at birth. The plasma protein profile (proteome) was unaffected by fortification.</p><p><strong>Conclusions: </strong>BC fortification increased the plasma concentrations of many AAs. Fortification-induced AA increments associated positively with HC growth and IGF-1 concentrations, and were affected by immaturity and birth weight. Still, plasma AA variability within physiological levels appears to have limited implications for clinical outcomes during the early life of VPIs.</p><p><strong>Impact: </strong>It is unknown how human milk fortification affects plasma amino acid concentrations, in turn influencing growth patterns in very preterm infants. We show that a fortifier based on bovine colostrum induces higher amino acid concentrations than a conventional fortifier. Fortification-induced increments in amino acid concentrations associated with gestational age, birth weight and head growth, but with small effect sizes and limited relation to body weight or length growth. Plasma amino acid concentrations are influenced by fortification of human milk in early life, but have limited practical application as predictors of body growth and health in individual very preterm infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094355","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":"Scar-associated macrophages and biliary epithelial cells interaction exacerbates hepatic fibrosis in biliary atresia.","authors":"Xin Li, Tengfei Li, Shaowen Liu, Yilin Zhao, Yuqiang Chen, Alimujiang Abudureyimu, Shujian Zhang, Liang Ge, Qianhui Yang, Yu Meng, Jiaying Liu, Jiayinaxi Musha, Jianghua Zhan","doi":"10.1038/s41390-025-04100-2","DOIUrl":"https://doi.org/10.1038/s41390-025-04100-2","url":null,"abstract":"<p><strong>Background: </strong>Biliary atresia (BA) is a severe pediatric biliary disorder characterized by the progressive obstruction of liver bile ducts. In the absence of treatment, fibrosis advances rapidly in most affected children. Despite the identification of various factors contributing to fibrosis progression, comprehensive investigations into the microenvironmental alterations within the liver are still scarce.</p><p><strong>Methods: </strong>Single-cell RNA sequencing (scRNA-seq) was conducted on two normal tissues adjacent to liver tumors, two choledochal cyst liver tissues, and four BA liver tissues. This analysis, combined with spatial localization data, elucidated the heterogeneity of the livers affected by BA. Ultimately, a diagnostic model for BA was developed, leveraging high-resolution fibrosis-related gene signatures.</p><p><strong>Results: </strong>We identified scar-associated macrophages (SAMs) originating from monocytes, which played a pivotal role in fibrosis progression and may be implicated in the epithelial-mesenchymal transition (EMT) of biliary epithelial cells (BECs). Furthermore, the hub genes CD96, EVL, S100A6, and S100A11 were found to be upregulated in SAMs and regulatory T cells (Tregs), aiding in the diagnosis of BA.</p><p><strong>Conclusion: </strong>SAMs and BECs not only exhibited a pro-fibrotic phenotype but also co-localized within fibrotic regions. Their interaction may facilitate the activation of EMT, highlighting a potential therapeutic target for BA treatment.</p><p><strong>Impact: </strong>Analysis of the immune landscape: Through single-cell and spatial transcriptomic techniques, the paper reveals the complex immune landscape associated with BA fibrosis. Exploration of new therapeutic targets: This paper reveals that SAMs can promote the progression of liver fibrosis by regulating the EMT conversion of BECs, opening up a new therapeutic approach. Application of diagnostic markers: The paper identifies biomarkers that may improve early diagnostic accuracy and postoperative prognosis and recommends their incorporation into clinical practice.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094265","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}