{"title":"Acute hemorrhagic rectal ulcer in a child with severe motor and intellectual disabilities.","authors":"Kazuo Imagawa, Takuma Deguchi, Hiroki Nemoto, Atsushi Morita, Takashi Enokizono, Hidetoshi Takada","doi":"10.1111/ped.70331","DOIUrl":"10.1111/ped.70331","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70331"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12874503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125753","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":"COVID-19 requires consideration of the risk of acute kidney injury due to rhabdomyolysis, even in pediatric patients.","authors":"Kyohei Shimizu, Sho Kimura, Haruka Matohara, Takuya Matsui, Takafumi Honda, Kumi Yasukawa, Jun-Ichi Takanashi","doi":"10.1111/ped.70351","DOIUrl":"https://doi.org/10.1111/ped.70351","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70351"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220758","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}
Shinji Hagimoto, Sota Iwatani, Toshihiko Ikuta, Seiji Yoshimoto
{"title":"Impact of elevated direct bilirubin levels on the measurement of unbound bilirubin.","authors":"Shinji Hagimoto, Sota Iwatani, Toshihiko Ikuta, Seiji Yoshimoto","doi":"10.1111/ped.70325","DOIUrl":"https://doi.org/10.1111/ped.70325","url":null,"abstract":"<p><strong>Background: </strong>In high-risk neonates, such as very low birth weight infants or those undergoing abdominal surgery, elevated direct bilirubin (DB) levels are frequently observed. Under such conditions, unbound bilirubin (UB) measured using peroxidase-based analyzers may appear spuriously elevated, complicating clinical interpretation.</p><p><strong>Methods: </strong>Retrospective analysis was performed on laboratory datasets with complete measurements of total bilirubin (TB), DB, UB, and albumin from January 2021 to December 2023. DB was measured enzymatically using the Nescauto VL D-bil bilirubin oxidase method. Indirect bilirubin (iDB) was calculated as TB minus DB, and its molar ratio to albumin (iDB/albumin) was evaluated for correlation with UB across varying DB levels and DB/TB ratios. Outlier-high UB values were defined as those exceeding the 95% confidence interval of the iDB/albumin ratio within the physiological range (DB < 1 mg/dL and DB/TB < 10%).</p><p><strong>Results: </strong>A total of 5970 datasets from 1386 neonates were analyzed. As DB levels and DB/TB ratios increased, the correlation between the iDB/albumin ratio and UB weakened, and the regression slope became steeper. The proportion of outlier-high UB values rose significantly: 4.9%, 10.8%, 32.5%, and 92.2% for DB <1, 1-2, 2-3, and ≥3 mg/dL, respectively; and 4.2%, 10.3%, 17.2%, and 51.7% for DB/TB <10%, 10%-20%, 20%-30%, and ≥30%.</p><p><strong>Conclusion: </strong>UB values tend to rise spuriously as DB increases, particularly when DB ≥2 mg/dL or DB/TB ≥20%. In such situations, estimating UB from the iDB/albumin ratio may provide a more reliable basis for risk assessment.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70325"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019236","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":"Identification of new human monogenic disorders and implementation of genomic medicine in sick newborn infants.","authors":"Toshiki Takenouchi","doi":"10.1111/ped.70327","DOIUrl":"https://doi.org/10.1111/ped.70327","url":null,"abstract":"<p><p>Over the past few decades, advances in genomic analysis techniques and bioinformatics have enabled the identification of many new human monogenic diseases. In 2015, the Japan Agency for Medical Research and Development launched a national project for undiagnosed diseases called the Initiative on Rare and Undiagnosed Diseases (IRUD). Through this project, we identified Takenouchi-Kosaki syndrome (OMIM#616737), which is caused by specific pathogenic variants in CDC42, a critical regulator of diverse cellular functions, and is clinically characterized by intellectual disability and macrothrombocytopenia. In addition to the identification of disease-causing genes and new human monogenic disorders, significant progress has also been made in the clinical implementation of genomic medicine. In 2019, we launched a national project called Precise and Rapid Genetic Diagnosis and Treatability for Infants (Priority-i) to provide rapid genetic diagnosis for sick newborns in neonatal intensive care units. It is our mission to apply the benefits of the latest advances in genomic medicine to the clinical care of newborns and children.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70327"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019273","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 spontaneous resolution and surgery in non-obstructive non-refluxing megaureters.","authors":"Gizem Yildiz, Meral Torun Bayram, Husne Didem Turker, Salih Kavukcu, Alper Soylu","doi":"10.1111/ped.70323","DOIUrl":"https://doi.org/10.1111/ped.70323","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical and radiological criteria for predicting surgical approach or spontaneous resolution have been evaluated mainly in primary non-refluxing megaureters detected prenatally. We aimed to analyze these criteria in a retrospectively collected cohort of children with either prenatal or postnatal diagnosis of non-obstructive non-refluxing (NONR) megaureter.</p><p><strong>Methods: </strong>Hospital files of the children with NONR megaureter were evaluated retrospectively for age at diagnosis, presenting complaint, follow-up period, accompanying urologic abnormalities, complications (renal scar and urinary tract infection), and final status.</p><p><strong>Results: </strong>There were 27 NONR megaureters in 25 patients (male/female: 19/6; prenatal/postnatal: 18/7). Two prenatal cases had bilateral involvement. Spontaneous resolution rate in renal units was lower in postnatal cases than in prenatal cases (2 out of 7 vs. 15 out of 20, OR 7.5). Spontaneous resolution rate was also higher when ureteral diameter was <11 versus ≥11 mm (OR 10.9) and renal pelvis anteroposterior diameter ≤10 mm versus >10 mm (OR 19.2). Surgical intervention rate was higher in the presence of ureteral diameter ≥14 versus <14 mm (OR 22.0). Renal units that underwent surgical treatment showed higher rates of febrile urinary tract infections, renal scarring, and reduced renal function on <sup>99m</sup>Tc-MAG3 scintigraphy compared to those without surgical intervention.</p><p><strong>Conclusions: </strong>Initial management of asymptomatic non-refluxing megaureters should be observational monitoring. Majority of them resolve spontaneously if ureteral diameter is <11 mm with renal pelvis anteroposterior diameter ≤10 mm. However, children with ureteral diameter ≥14 mm are prone to develop febrile urinary tract infection, renal scar, and decreased renal function requiring surgical intervention.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70323"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143107","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}
Patrycia Maria Gomes da Fonte Rosa, Juliana Dantas de Araújo Santos Camargo, Sávio Ferreira Camargo, Amaxsell Thiago Barros de Souza, Camiliane Azevedo Ferreira, Amanda Karoline da Costa Bezerra, Raionara Cristina de Araújo Santos, Cijara Leonice de Freitas, Ricardo Ney Cobucci, Fabiana Ariston Filgueira, Anna Christina do Nascimento Granjeiro Barreto
{"title":"Quality Improvement Intervention Lowers Hypothermia Rates in Preterm Infants in a Resource-Limited Setting.","authors":"Patrycia Maria Gomes da Fonte Rosa, Juliana Dantas de Araújo Santos Camargo, Sávio Ferreira Camargo, Amaxsell Thiago Barros de Souza, Camiliane Azevedo Ferreira, Amanda Karoline da Costa Bezerra, Raionara Cristina de Araújo Santos, Cijara Leonice de Freitas, Ricardo Ney Cobucci, Fabiana Ariston Filgueira, Anna Christina do Nascimento Granjeiro Barreto","doi":"10.1111/ped.70397","DOIUrl":"10.1111/ped.70397","url":null,"abstract":"<p><strong>Background: </strong>Admission hypothermia significantly threatens preterm neonates, especially in resource-limited settings.</p><p><strong>Methods: </strong>A quality improvement (QI) initiative focusing on thermoregulation was implemented in a Brazilian NICU. We conducted a quasi-experimental pre-post study comparing preterm infants (< 1500 g or < 33 weeks gestation) admitted before (n = 63) and after (n = 88) the intervention. Primary outcome was hypothermia prevalence (< 36.5°C) within the first hour of life.</p><p><strong>Results: </strong>The QI intervention reduced hypothermia prevalence from 82.5% to 68.2% (crude PR = 0.83; 95% CI: 0.69-0.99; p = 0.047) and increased median admission temperature from 35.3°C to 35.8°C (p = 0.013). Post-intervention hypothermia was associated with increased mortality (PR = 3.27; 95% CI: 1.06-10.05; p = 0.017).</p><p><strong>Discussion: </strong>Implementing targeted QI measures improved thermal outcomes among preterm neonates in a resource-constrained NICU. Despite reductions, persistent hypothermia highlights the need for ongoing efforts to enhance neonatal care and survival.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70397"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691459","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":"Bioelectrical Impedance Analysis to Identify the Affected Body Component in Girls With Celiac Disease.","authors":"Arzu Gülseren, Esra Eren, Serkan Bilge Koca","doi":"10.1111/ped.70400","DOIUrl":"https://doi.org/10.1111/ped.70400","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical applicability of comparing bioelectrical impedance analysis (BIA) measurements between female patients with celiac disease (CD) and healthy control subjects with Tanner stage 2-5 to identify the affected body component in CD patients.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with 36 female patients aged between 8 and 17 years who were followed up with a diagnosis of celiac disease and 72 female controls. The research was carried out between January 2024 and June 2025. In both groups, girls with Tanner stage 2-5 were included in the study.</p><p><strong>Results: </strong>Thirty-six cases were diagnosed with CD and 72 were controls. The mean age of the case group was 12.7 ± 3.1 and the mean age of the control group was 12.0 ± 2.9 (p = 0.228). The ratio of fat free mass to whole body was 78.0% ± 3.4% in the case group and 80.0% ± 4.2% in the control group (p = 0.016). Muscle mass ratio was detected lower in the case group compared to the control group (73.9 ± 3.3 vs. 75.9 ± 4.0; p = 0.014). Fat ratio was analyzed higher in the case group (21.6 ± 3.6 vs. 19.6 ± 4.3; p = 0.023). In CD, patients with high tissue transglutaminase IgA (tTGIgA) and anti-endomysial antibody (EMA) values were found to have higher fat ratio and lower muscle ratio, but the results were not significant.</p><p><strong>Conclusion: </strong>Total body fat ratio is higher and muscle mass ratio is lower in CD patients despite gluten-free diet.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70400"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691303","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":"Japanese clinical practice guidelines for vascular tumors, vascular malformations, lymphatic malformations, and Lymphangiomatosis 2022.","authors":"Yoshiaki Kinoshita, Kosuke Ishikawa, Sadanori Akita, Katsuyoshi Koh, Satoru Sasaki, Masatoshi Jinnin, Hidefumi Mimura, Keigo Osuga, Michio Ozeki, Michiko Nagahama, Akihiro Fujino, Yoko Aoki, Akiko Asai, Noriko Aramaki-Hattori, Ryohei Ishiura, Masanori Inoue, Yuki Iwashina, Takafumi Ohshiro, Keiko Ogawa, Mine Ozaki, Junko Ochi, Shiro Onozawa, Motoi Kato, Takahide Kaneko, Tamihiro Kawakami, Akira Kitagawa, Masakazu Kurita, Yoshihiro Kuwano, Taro Kono, Shien Seike, Shinsuke Takagi, Nobuyuki Takakura, Takao Tachibana, Shuichi Tanoue, Kumiko Chuman, Hiroki Nakaoka, Yasuhiro Nakamura, Fumio Nagai, Yasunari Niimi, Shunsuke Nosaka, Taiki Nozaki, Tadashi Nomura, Kazuki Hashimoto, Ayato Hayashi, Satoshi Hirakawa, Takeshi Hirabayashi, Taizo Furukawa, Hiroshi Furukawa, Yumiko Hori, Takanobu Maekawa, Kentaro Matsuoka, Hideki Mori, Eiichi Morii, Akira Morimoto, Yuta Moriwaki, Shunsuke Yuzuriha, Naoaki Rikihisa, Munezumi Fujita, Yasuyuki Yamahana, Kyoichi Deie, Asami Tozawa, Daisuke Hasegawa, Akira Higashiyama, Daisuke Maeda, Sachiko Asayama, Yuhki Arai, Yohei Iwata, Mayu Uka, Hidehito Usui, Mizuki Uchiyama, Saori Endo, Hideki Endo, Rintaro Ono, Naoya Oshima, Toshihiro Otsuka, Kuniaki Ohara, Shinji Kagami, Tomo Kakihara, Mototoshi Kato, Hiroki Kanamori, Masafumi Kamata, Ami Kawaguchi, Akiko Kishi, Hiroshi Kitagawa, Kiyokazu Kim, Tamotsu Kobayashi, Takeshi Saito, Yusuke Shikano, Shuichi Shimada, Keisuke Suzuki, Masataka Takahashi, Shohei Takami, Reiko Takeda, Aya Tanaka, Kaishu Tanaka, Satoru Tamura, Masashi Tamura, Kanako Danno, Kenji Tsuboi, Yuta Nakajima, Ryo Nakatani, Miho Noguchi, Akifumi Nozawa, Naoki Hashizume, Masashi Hayakawa, Daichi Hayashi, Takaya Fukumoto, Mamoru Honda, Norifumi Matsuda, Hayato Maruguchi, Naoki Murakami, Kiichiro Yaguchi, Shiho Yasue, Hiroki Yoshihara, Rika Yoshimatsu, Kiyohito Yamamoto, Shinji Wada","doi":"10.1111/ped.70333","DOIUrl":"10.1111/ped.70333","url":null,"abstract":"<p><p>The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of December 2020 was searched in PubMed and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution Service (Minds) technique. A total of 38 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, pathological diagnosis deciding the diagnosis, and causal genes of vascular anomalies. Thus, the Japanese Clinical Practice Guidelines for Vascular Tumors, Vascular Malformations, Lymphatic Malformations, and Lymphangiomatosis 2022 have been prepared as the evidence-based guidelines for the management of vascular anomalies.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"68 1","pages":"e70333"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514148","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}
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