Pediatric Research最新文献

{"title":"Are we ready for volume targeting during high-frequency oscillatory ventilation in neonates?","authors":"David G Tingay, Sophia I Dahm, Arun Sett","doi":"10.1038/s41390-025-04015-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04015-y","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649920","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":"Ethanol metabolites increase over time in preterm infants receiving ethanol containing medications: a concern.","authors":"Arushi Mahajan, Juliann M DiFiore, Nageswara Pilli, Cansu Tokat, Maureen A Kane, Cynthia F Bearer","doi":"10.1038/s41390-025-03993-3","DOIUrl":"https://doi.org/10.1038/s41390-025-03993-3","url":null,"abstract":"<p><strong>Impact: </strong>That extremely premature infants may be exposed to ethanol to a greater degree than expected.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649923","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":"Unraveling the promise and challenges of biomarkers in pediatric sepsis: a commentary on risk estimation of organ dysfunction and immune dysregulation.","authors":"Kenneth E Remy, Niranjan Kissoon","doi":"10.1038/s41390-025-03983-5","DOIUrl":"https://doi.org/10.1038/s41390-025-03983-5","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649956","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":"Invited Commentary: \"Is physical fitness associated with leukocyte telomere length in youth with type 1 diabetes?\"","authors":"George Paltoglou","doi":"10.1038/s41390-025-03988-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03988-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649954","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":"Evaluating 3D-printed models for congenital heart disease: impact on parental anxiety and procedural understanding.","authors":"Linda Grefen, Felix Rudolf, Christopher Herz, Nikolaus A Haas, André Jakob, Christian Hagl, Paul Philipp Heinisch, Jürgen Hörer, Nikolaus Thierfelder, Maximilian Grab","doi":"10.1038/s41390-025-03999-x","DOIUrl":"https://doi.org/10.1038/s41390-025-03999-x","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of the impact of 3D-printed models on parental education and anxiety in parents of children with congenital heart disease (CHD) who are undergoing interventions or surgeries.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was conducted at LMU University Hospital and the German Heart Center Munich. Parents (n = 57) of pediatric CHD patients were randomized into two groups: a control group using standardized paper-based methods and an intervention group using additional 3D-printed models. Parental anxiety was assessed using the Visual Analog Scale (VAS) and the State-Trait Anxiety Inventory, while procedural understanding and satisfaction with the education were evaluated using custom-developed questionnaires.</p><p><strong>Results: </strong>Both educational methods significantly increased procedural understanding (control 77.5% to 92.3%; 3D model: 77% to 89.4%, p < 0.0001, respectively). Significant reduction of anxiety was observed in both groups, (VAS reduction control: -0.9, p = 0.0342; 3D model: -1.1, p = 0.0116). Parents with medical background or those informed by pediatricians had lower anxiety whereas those seeking information online exhibited higher anxiety levels.</p><p><strong>Conclusion: </strong>Both educational methods significantly reduced parental anxiety and improved procedural understanding. 3D-printed models were well-received and will be integrated into routine practice to enhance education on CHD procedures and optimize physician-parent communication.</p><p><strong>Impact statement: </strong>Using additional 3D-printed models of congenital heart defects significantly reduces parental anxiety and increases procedural understanding of complex interventions or surgeries. Physicians are in desperate need of new visualization methods for an efficient patient education. This study underscores the need for tailored educational and psychological support for parents based on their previous experiences.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649952","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":"Predicting optimal endotracheal tube depth in children based on height and middle finger length.","authors":"Yang Zhang, Jiarong Wang, Hao Cheng, Wenjun Guo","doi":"10.1038/s41390-025-03987-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03987-1","url":null,"abstract":"<p><strong>Background: </strong>Current calculation formulas cannot accurately predict intubation depth in children due to variations in growth and development patterns and unique anatomical characteristics of the pediatric airway. This study aims to develop a method for determining the appropriate ETT insertion depth in pediatric patients.</p><p><strong>Methods: </strong>This study included 205 patients aged 4-12 years who underwent elective surgery under general anesthesia with tracheal intubation. The general condition of the enrolled children was recorded, and growth parameters were measured preoperatively. Multivariate linear regression analysis was employed to develop a new formula for predicting intubation depth.</p><p><strong>Results: </strong>The novel multivariate-based formula was derived using height and middle finger length [D (cm) = 0.06 × height (cm) + 0.89 × middle finger length (cm) + 3.4] as reference variables. Bland-Altman analysis demonstrated mean differences between the optimal depth and ETT depth was -0.05 cm (95% LOA, -1.38 to 1.28 cm) for the new formula and 1.24 cm (95% LOA, -0.74 to 3.23 cm) for the traditional formula, respectively. This study demonstrated significant individual variations in tracheal intubation depth in pediatric patients.</p><p><strong>Conclusion: </strong>The height- and middle finger length-referenced formulas predicted the depth of intubation more accurate than the traditional age-based formula in pediatric patients.</p><p><strong>Impact: </strong>The prediction formula is effective in reducing the misalignment rate in children undergoing tracheal intubation under general anesthesia. The new formula, which incorporates both height and middle finger length, was found to predict the optimal endotracheal intubation depth with greater accuracy than the traditional formula. This provides an accurate and easy way for clinicians to calculate the depth of intubation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649955","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":"Maternal di(2-ethylhexyl) phthalate exposure increases the risk of congenital heart disease in mice offspring.","authors":"Haiqun Shi, Zehua Zhang, Anna Shen, Tong Ding, Rui Zhao, Yan Shi, Jianyuan Zhao, Ke Cai, Feng Wang","doi":"10.1038/s41390-025-03997-z","DOIUrl":"10.1038/s41390-025-03997-z","url":null,"abstract":"<p><strong>Abstrct: </strong>BACKGROUD: Epidemiological data suggest that maternal occupational exposure to mixed phthalates comprising di(2-ethylhexyl) phthalate (DEHP) increases the risk of congenital heart disease (CHD). In this study, we used mice as an animal model to validate impact of first-trimester DEHP exposure on the risk of CHD in offspring, to elucidate the possible mechanisms and to provide a potential feasible intervention.</p><p><strong>Methods and results: </strong>Eight-week-old C57BL/6J pregnant mice were randomly divided into standard and DEHP diet groups. The incidence of CHD in DEHP diet group offspring was up to 14.41% observed via Hematoxylin-eosin (HE) staining. Quantitative PCR analysis revealed that expression of key genes involved in cardiogenesis were suppressed at the transcriptional level, which may be due to decreased nuclear translocation of p65. The inhibition of DEHP on key genes was rescued to some extent by choline through driving p65 into nuclear. In the mice, supplementation of choline during DEHP exposure reduced the incidence of CHD in offspring from 14.41% to 4.63%.</p><p><strong>Conclusions: </strong>Our study demonstrates that mice first-trimester DEHP exposure significantly increases the risk of CHD in the offspring via inhibiting mRNA levels of key genes in cardiogenesis, and choline could protect against the pathogenesis.</p><p><strong>Impact: </strong>Our study provides key mechanistic insights into the risk of CHD by DEHP exposure during early pregnancy, and provides choline as a potentially effective intervention. DEHP suppressed the expression of key genes involved in embryonic cardiac septum development at the transcriptional level via inhibiting nuclear translocation of p65. Choline can play a role in rescuing the inhibition of DEHP on cardiogenesis genes via driving p65 translocate into the nuclear.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634337","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":"A wake-up call for India to improve the TB elimination strategies.","authors":"Abhijit Poddar, S R Rao","doi":"10.1038/s41390-025-04014-z","DOIUrl":"https://doi.org/10.1038/s41390-025-04014-z","url":null,"abstract":"<p><strong>Impact: </strong>To augment a recent study highlighting the concerning rise in the global burden of multidrug-resistant tuberculosis (MDR-TB) among children and adolescents, this article presents the realities in India, stressing the urgent need for enhanced TB elimination strategies. It explores how insufficient data, rising air pollution, and recent U.S. sanctions impede the detection and control of pediatric TB burden including MDR-TBs in India. This article serves as a wake-up call for stakeholders to take decisive actions while facilitating future research and policy development. We provide targeted recommendations to address vulnerabilities and prevent a potential public health crisis.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634335","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":"Microbes, metabolites, and inflammation: mapping the early neonatal intestinal landscape.","authors":"Muralidhar H Premkumar, Lovya George, Venkatesh Sampath","doi":"10.1038/s41390-025-04016-x","DOIUrl":"10.1038/s41390-025-04016-x","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625285","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":"Effect of different intranasal dexmedetomidine doses on pediatric postoperative delirium and agitation: network meta-analysis.","authors":"Huan Wu, Ping Wu, Liubo Xiang, Qianqian Huang, Yi Xiang, Jianshu Zhang, Zhihao Zhao, Tao Xu","doi":"10.1038/s41390-025-03851-2","DOIUrl":"https://doi.org/10.1038/s41390-025-03851-2","url":null,"abstract":"<p><strong>Objectives: </strong>Our research served to explore the influences of intranasal dexmedetomidine (DEX) at different doses on agitation, delirium, and other complications among children undergoing general anesthesia.</p><p><strong>Methods: </strong>A systematic search was executed in EMBASE, Cochrane Library, PubMed, and Web of Science, from the establishment of the database until February 12, 2024. The data analytics was implemented through R software and STATA version 16.0.</p><p><strong>Results: </strong>The final analysis incorporated 15 randomized controlled trials (RCTs) containing 1965 pediatric participants in total. The findings uncovered that relative to normal saline (NS), intranasal DEX at doses of 1 μg/kg [RR = 0.31, 95%CI = (0.17, 0.56)], 1.5 μg/kg [RR = 0.28, 95%CI = (0.09, 0.85)], and 2 μg/kg [RR = 0.18, 95%CI = (0.08, 0.36)] remarkably reduced the prevalence of post-anesthetic emergence agitation (EA) in children, with the 2 μg/kg dose demonstrating the highest effectiveness (SUCRA = 0.8997). Additionally, DEX at doses of 1 μg/kg [MD = -3.36, 95%CI = (-6.46, -0.44)] and 2 μg/kg [MD = -2.59, 95%CI = (-5.17, -0.32)] effectively reduced the Pediatric Anesthesia Emergence Delirium (PAED) score, with the 1 μg/kg dose ranking as the most efficacious according to SUCRA analysis (SUCRA = 0.8557).</p><p><strong>Conclusions: </strong>DEX prominently reduces the prevalence of emergence agitation and delirium. At doses of 2 μg/kg and 1 μg/kg, DEX effectively lowers the incidence of EA and PAED scores.</p><p><strong>Impact: </strong>Our research attempts to appraise the influence of discrepant doses of intranasal dexmedetomidine (DEX) on the incidence of postoperative agitation and delirium among children undergoing general anesthesia. The research elucidates the impact of various DEX doses on reducing postoperative agitation, PAED scores, and the need for postoperative analgesics, offering valuable guidance for selecting optimal dosing strategies in clinical practice. The research results support considering individual differences in children when choosing different doses of DEX to provide more suitable sedation and analgesia regimens, thereby improving postoperative recovery quality.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625253","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}