Pediatric Investigation最新文献

{"title":"The possibly neglected victims: Re-examining the involvement of children in the chikungunya epidemic.","authors":"Ran Wang, Kevin C Kain, Zhengde Xie","doi":"10.1002/ped4.70022","DOIUrl":"10.1002/ped4.70022","url":null,"abstract":"","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"234-240"},"PeriodicalIF":2.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical guideline for postoperative nutrition support in neonates with enterostomy (2024).","authors":"","doi":"10.1002/ped4.70016","DOIUrl":"10.1002/ped4.70016","url":null,"abstract":"<p><p>This is an evidence-based guideline for postoperative nutritional management of neonates with enterostomy. There were 10 clinical questions in enteral nutrition management, parenteral nutrition management, and post-discharge follow-up (including the closure of fistula). The Grading of Recommendations Assessment, Development and Evaluation method was used for constructing the recommendations. Domestic and international literature were systematically searched and reviewed. There were 22 recommendations in this guideline.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"221-233"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose versus high-dose methylprednisolone for children with severe <i>Mycoplasma pneumoniae</i> pneumonia (MCMP): A randomized controlled trial.","authors":"Baoping Xu, Ling Cao, Yunxiao Shang, Liping Liu, Liwei Gao, Ju Yin, Jun Liu, Ruohua Yan, Bo Peng, Yong Feng, Zhiying Han, Yao Yao, Wenhui Guo, Nan Yang, Jie Chang, Yiqin Song, Hao Wang, Xirong Wu, Xinyu Wang, Ning Chen, Xiaojuan Zhang, He Zhang, Anxia Jiao, Adong Shen, Keqing Zhang, Yan Yang, John S Ji, Xiaoxia Peng, Kunling Shen","doi":"10.1002/ped4.70014","DOIUrl":"10.1002/ped4.70014","url":null,"abstract":"<p><strong>Importance: </strong>Although macrolides combined with glucocorticoid therapy have demonstrated efficacy in preventing long-term pulmonary lesions of severe <i>Mycoplasma pneumoniae</i> pneumonia (MPP), evidence regarding glucocorticoid dose is lacking.</p><p><strong>Objective: </strong>To evaluate the effects of low- and high-dose methylprednisolone on the risk of long-term pulmonary lesions for children with severe MPP when combined with azithromycin.</p><p><strong>Methods: </strong>This randomized, parallel-controlled, multicenter clinical trial was conducted in mainland China and enrolled pediatric patients hospitalized with severe MPP. A total of 424 enrolled patients were randomized (allocation ratio of 1:1) to azithromycin combined with either a low-dose [2 mg/(kg·d)] or a high-dose [10 mg/(kg·d)] methylprednisolone treatment for 3 d followed by tapering over 12 d. The primary outcome was the incidence of composite adverse outcomes, including atelectasis, bronchiectasis, or bronchiolitis obliterans 6 months after treatment.</p><p><strong>Results: </strong>A total of 118 (27.8%) developed adverse pulmonary lesions at 6 months after treatment; 66 of 211 (31.3%) in the high-dose methylprednisolone group and 52 of 213 (24.4%) in the low-dose group, respectively. The risk ratio of long-term pulmonary lesions in a high-dose group to those in a low-dose group was 1.28 (95% confidence interval [95% CI]: 0.94-1.75). In addition, the risk of hypertension in the high-dose group (8.1%, 17 of 211) was higher than that in the low-dose group (1.4%, three of 213), with a risk ratio of 5.72 (95% CI: 1.70-19.23).</p><p><strong>Interpretation: </strong>Azithromycin combined with low-dose methylprednisolone demonstrates non-inferior efficacy in reducing pulmonary lesions at 6-month follow-up compared to combined with high-dose methylprednisolone while exhibiting a more favorable safety profile.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"251-261"},"PeriodicalIF":2.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of new European Respiratory Society/American Thoracic Society bronchodilator reversibility interpretation on asthma diagnosis in children.","authors":"Natalie Blyth, Joe Madge, Erol A Gaillard, David K H Lo","doi":"10.1002/ped4.70017","DOIUrl":"10.1002/ped4.70017","url":null,"abstract":"","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"300-303"},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and genetic characteristics of Cornelia de Lange syndrome in pediatric patients.","authors":"Xiaoqiao Li, Ming Cheng, Min Liu, Wenjing Li, Yuchuan Li, Bingyan Cao, Liya Wei, Yuan Ding, Xi Meng, Lele Li, Chunxiu Gong","doi":"10.1002/ped4.70013","DOIUrl":"10.1002/ped4.70013","url":null,"abstract":"<p><strong>Importance: </strong>Cornelia de Lange syndrome (CdLS) is a rare genetic disorder characterized by a spectrum of developmental and physical anomalies. Understanding the clinical and genetic landscape of CdLS in pediatric patients is crucial for improving diagnosis and management.</p><p><strong>Objective: </strong>To investigate the clinical and genetic characteristics of 19 pediatric patients with CdLS in China, with a focus on identifying the association between genetic variants and clinical severity.</p><p><strong>Methods: </strong>We performed whole exome sequencing on 19 patients with CdLS and compared their clinical characteristics based on the presence of null variants.</p><p><strong>Results: </strong>Among the 19 patients, 16 (84.2%) showed global developmental delays and 14 (73.7%) experienced prenatal growth retardation and short stature. Craniofacial anomalies-short noses and anteverted nares were observed in 94.7% (18/19) of patients. Small hands and/or feet were present in 16 patients, skin manifestations (hirsutism or mottled skin) in six, and hearing loss in four. Genetic testing identified 19 variants in <i>NIPBL</i> (78.9%, 15/19), <i>SMC1A</i> (10.5%, 2/19), and <i>RAD21</i> (10.5%, 2/19), including 13 novel variants. <i>NIPBL</i> null variants correlated significantly with more severe growth impairments (<i>P</i> = 0.016) and microcephaly (<i>P</i> = 0.004). Although complete protein function loss often correlated with more severe clinical presentations, no significant difference in clinical scoring was observed (<i>P</i> = 0.600). Three patients treated with recombinant human growth hormone showed heterogeneous responses.</p><p><strong>Interpretation: </strong>This study highlights the clinical heterogeneity of CdLS and suggests a potential link between specific genetic variants and disease severity. These findings warrant further research to optimize treatments and better understand the functional impact of these genetic variants.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"293-299"},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic identification of existing core outcomes related to preterm birth and the development of a core outcome set for preterm birth in Aotearoa New Zealand.","authors":"Briar Hunter, Lisa Dawes, Lynn Sadler, Jordon Wimsett, Sue Tutty, Matthew Moore, Malcolm R Battin, Katie M Groom","doi":"10.1002/ped4.70012","DOIUrl":"10.1002/ped4.70012","url":null,"abstract":"<p><strong>Importance: </strong>Preterm birth is a leading cause of perinatal morbidity and mortality and a priority area for care improvement globally, including in Aotearoa New Zealand. To improve the efficiency and impact of preterm birth research and clinical care advancement, it is important to use standardized outcomes across studies and clinical sites.</p><p><strong>Objective: </strong>To identify existing core outcome sets related to preterm birth and use consensus methodology to develop a national core outcome set applicable for use in Aotearoa New Zealand.</p><p><strong>Methods: </strong>A systematic search identified established core outcome sets relevant to preterm birth. The core outcomes were reviewed, similar terms were merged, and outcomes irrelevant to preterm birth were excluded. The resultant outcomes were included in a three-round online Delphi survey involving people with lived experience, healthcare professionals, and researchers, with focussed recruitment of Māori, Pacific, and Indian participants. Outcomes were included if >70% of participants in each stakeholder group scored the outcome as critically important.</p><p><strong>Results: </strong>Eighteen established core outcome sets, containing 348 outcomes, were identified. Seventy-three distinct relevant outcomes were included for prioritization. Fifty-two participants, including 25 with lived experience, completed all rounds of the Delphi survey, with 15 outcomes included in a resultant preterm birth core outcome set.</p><p><strong>Interpretation: </strong>Core outcomes relevant to preterm birth were systematically identified. A national preterm birth core outcome set, informed by people with lived experience and perinatal healthcare professionals and researchers, was developed and will allow meaningful comparisons over time and across groups.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"241-250"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline for the diagnosis, treatment, and prevention of respiratory syncytial virus infection in children in China.","authors":"","doi":"10.1002/ped4.70010","DOIUrl":"10.1002/ped4.70010","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is one of the most common respiratory pathogens in children under 5 years of age worldwide and it seriously threatens children's health. In recent years, great progress has been made in the field of RSV-related diseases. To better guide and standardize the clinical diagnosis and treatment of RSV infection and to improve the prevention and control of RSV infection in children in China, a guideline development group was established by experts in children's respiratory infections and neonatal health care, clinical epidemiology, health statistics, virology, evidence-based medicine, health economics, and other related fields. Following the standard methodology for developing clinical practice guidelines, 12 clinical questions concerning the detection, diagnosis, treatment, and prevention of RSV infection were proposed from the perspective of clinical practice. Finally, the \"Guideline for the diagnosis, treatment, and prevention of RSV infection in children in China\" was formulated to improve the clinical diagnosis, treatment, prevention, and control of RSV infection-related diseases in children in China.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"205-220"},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal characteristics in children with Marfan syndrome with or without ectopia lentis.","authors":"Marisa O'Brien, Lawrence Tychsen","doi":"10.1002/ped4.70011","DOIUrl":"10.1002/ped4.70011","url":null,"abstract":"<p><strong>Importance: </strong>Myopia of Marfan syndrome (MFS) may be ascribed to crystalline lens subluxation, abnormal corneal curvature, and increased globe axial length. Few studies have reported these measures in MFS children who did or did not have ectopia lentis (EL).</p><p><strong>Objective: </strong>To measure eye findings longitudinally in MFS children with and without EL.</p><p><strong>Methods: </strong>A prospective, comparative case study was conducted on 24 MFS children (48 eyes). EL necessitated lensectomy and intraocular lens implantation surgery in 16/24 children (mean age 5.6 ± 2.8 years). The remaining 8/24 MFS children (mean age 11.2 ± 4.2 years) had no EL and were phakic. Follow-up was a mean of 3.1 ± 0.5 years. At follow-up visits, visual acuity, tonometry, refractive error, central corneal thickness (CCT), biomicroscopic examination, axial length, anterior chamber depth, endothelial cell density (ECD), and corneal curvature were monitored.</p><p><strong>Results: </strong>At the initial visit, before EL surgery, MFS children with EL had greater myopia (<i>P</i> < 0.01), corneal cylinder (<i>P</i> = 0.04), and CCT (<i>P</i> = 0.01) compared to children with no EL. Over the follow-up interval, EL children had a progressive increase in CCT (<i>P</i> = 0.02) and a reduction in ECD (<i>P</i> = 0.02). EL children also showed: progressive flattening of corneal curvature (<i>P</i> = 0.01); reduction of corneal cylinder (<i>P</i> = 0.02); and increase in axial length (<i>P</i> < 0.01). MFS children with no EL exhibited a smaller increase in CCT (<i>P</i> < 0.01) and a milder flattening of corneal curvature (<i>P</i> < 0.01). The no EL children showed no change in ECD (<i>P</i> = 0.09), corneal cylinder (<i>P</i> = 0.80), or axial length (<i>P</i> = 0.27).</p><p><strong>Interpretation: </strong>MFS children who have EL exhibit differences in corneal structure and axial length when compared to MFS children with no EL. Children with EL have thicker CCT, more corneal cylinder, lower ECD, and longer axial lengths compared to children with no EL. The differences imply that the fibrillin defect of MFS is more severe in children with EL. The ocular defect is manifested chiefly as zonular hyperextension but has effects also on corneal and scleral integrity.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 2","pages":"160-166"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of anti-neurofascin 155 antibody-positive autoimmune nodopathy in children.","authors":"Liya Cui, Shuai Gong, Yongxiang Zhao, Siwei Wang, Xinying Yang, Shen Zhang, Weihua Zhang, Jiuwei Li, Bingbing Jia, Xiaona Fu, Lin Ge, Junlan Lv, Yun Peng, Hui Xiong","doi":"10.1002/ped4.70008","DOIUrl":"10.1002/ped4.70008","url":null,"abstract":"<p><strong>Importance: </strong>Anti-neurofascin (anti-NF) 155 antibody-positive autoimmune nodopathy is a distinct subset of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Given the increase in pediatric cases, understanding this condition is crucial.</p><p><strong>Objective: </strong>This study aimed to delineate the clinical features of children with anti-NF155 antibody-positive autoimmune nodopathy to enhance disease management strategies.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 34 CIDP patients admitted to Beijing Children's Hospital from January 2015 to December 2024, including six with confirmed anti-NF155-antibody positivity. Their clinical symptoms, laboratory results, neuroimaging findings, and therapeutic responses were retrospectively analyzed.</p><p><strong>Results: </strong>Of the 34 patients, six (17.6%) were tested positive for anti-NF155 antibodies. The cohort was male-dominated (male-to-female ratio of 4:2) with symptoms starting primarily in school-aged children. The symptoms included progressive limb weakness, sensory ataxia, and tremors. Notably, cerebrospinal fluid (CSF) protein levels were significantly elevated in seropositive patients. Electrophysiological studies indicated sensorimotor polyneuropathy, and neuroimaging revealed nerve root thickening. While intravenous immunoglobulin (IVIG) therapy was not effective, a combination of glucocorticoids, rituximab, and plasma exchange showed promise. At the final follow-up, all patients experienced symptom relief and could perform daily activities without relapse.</p><p><strong>Interpretation: </strong>Pediatric anti-NF155 antibody autoimmune nodopathy was uncommon, featuring male dominance, and distal weakness with sensory symptoms. Additionally, the CSF protein levels were significantly elevated in seropositive patients. As IVIG treatment was ineffective, early immunosuppressive therapy was recommended. Early diagnosis and treatment are critical in reducing myelin and axonal damage.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"275-281"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing dengue vaccine development: Challenges, innovations, and the path toward global protection.","authors":"Ran Wang, Bridget Kim, Hridesh Mishra, Kevin C Kain","doi":"10.1002/ped4.70005","DOIUrl":"10.1002/ped4.70005","url":null,"abstract":"<p><p>Dengue fever remains a significant global health threat, placing nearly half of the world's population at risk. Despite decades of research, developing an effective dengue vaccine continues to face multiple challenges, including antibody-dependent enhancement (ADE), serotype-specific efficacy, and logistical barriers to vaccine delivery. This review provides a comprehensive analysis of the historical and current landscape of dengue vaccine development, focusing on CYD-TDV, TAK-003, and Butantan-DV. It examines their efficacy, safety profiles, and limitations, particularly in achieving balanced quadrivalent protection. Additionally, this review highlights key areas for future research, including the impact of ADE, advancements in vaccine platforms, the need for region-specific vaccine formulations, and the integration of vaccination into broader dengue prevention strategies. Ultimately, sustained investment and global collaboration are crucial for achieving the goal of a dengue-free world.</p>","PeriodicalId":19992,"journal":{"name":"Pediatric Investigation","volume":"9 3","pages":"304-310"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}