Evin Ilter Bahadur, Pınar Zengin Akkus, Mehmet Yan, Miray Yılmaz Celebi, Mine İnal Akkaya, Gökçenur Ozdemir, Remziye Baran, Nuran Celik, Asena Ayca Ozdemir, Ali Kanık, Elif Nursel Ozmert
{"title":"The risk factors for preschoolers' behavioral problems in a low/middle-income country.","authors":"Evin Ilter Bahadur, Pınar Zengin Akkus, Mehmet Yan, Miray Yılmaz Celebi, Mine İnal Akkaya, Gökçenur Ozdemir, Remziye Baran, Nuran Celik, Asena Ayca Ozdemir, Ali Kanık, Elif Nursel Ozmert","doi":"10.1111/ped.15829","DOIUrl":"https://doi.org/10.1111/ped.15829","url":null,"abstract":"<p><strong>Background: </strong>Children have a greater risk of mental health problems in low/middle-income countries. Determining the risk factors and earlier identification of young children at high risk for behavioral problems are central to cost-effective intervention with positive long-term outcomes. The aim of this study was to examine the prevalence and risk factors of behavioral problems of preschoolers in three different cities located in eastern, western, and central Türkiye, a low/middle-income country.</p><p><strong>Methods: </strong>In total, 300 children (4-6 years old) without any chronic diseases participated the study. The parents completed the Children's Behavior Checklist/4-18 (CBCL/4-18), the Children's Sleep Habits Questionnaire, the Pittsburgh Sleep Quality Index, and the Beck Depression Inventory. Daily activities were evaluated using questionnaires that were specifically developed for the present study.</p><p><strong>Results: </strong>Based on the CBCL4-18, 12.3% of children were at high risk for behavioral problems. Paternal unemployment, screen time, maternal depressive symptoms, and maternal and child sleep problems were associated with internalizing behavioral problems; maternal depressive symptoms and watching videos on touch-screen devices were associated with externalizing behavioral problems. Total behavioral problems were associated with maternal unemployment, maternal depressive symptoms, being the eldest child, and child sleep problems.</p><p><strong>Conclusion: </strong>Preventable risk factors such as daily activities and maternal mental health should be evaluated as well as sociodemographic factors among preschoolers who may be at high risk of behavioral problems. The results of this study contribute toward drawing attention to preventable risk factors in a low/middle-income country.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15829"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449646","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":"Immaturity of gut functions and induction of tolerance during early infancy.","authors":"Yoshikazu Ohtsuka, Toshiaki Shimizu","doi":"10.1111/ped.15855","DOIUrl":"10.1111/ped.15855","url":null,"abstract":"<p><p>Tolerance to foreign molecules is primarily induced through three pathways: anergy, active suppression, and clonal deletion. The immaturity of gut functions, including digestion and barrier protection against foreign molecules during early infancy, is closely linked to the induction of tolerance. A significant number of undigested peptides can pass through leaky gut walls during this period, making it an opportune time to introduce active suppression and clonal deletion in the intestine. Increased production and expression of TGF-β and CXCL13 with lymphoid hyperplasia in early infancy can be a convenient way to introduce tolerance and immunoglobulin A (IgA) synthesis against food and other antigens to protect hosts from allergic diseases. In this article we will discuss the immaturity of gut functions and mucosal immunity in infancy and its relationship to the introduction of tolerance.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15855"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910133","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}
Hikaru Nishida, Eri Imagawa, Toshiki Tsunogai, Naoya Saijo, Jin Ogata, Ken Sakurai, Kimihiko Oishi
{"title":"A case of Wiedemann-Steiner syndrome caused by a novel KMT2A c.8862del variant.","authors":"Hikaru Nishida, Eri Imagawa, Toshiki Tsunogai, Naoya Saijo, Jin Ogata, Ken Sakurai, Kimihiko Oishi","doi":"10.1111/ped.15873","DOIUrl":"https://doi.org/10.1111/ped.15873","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15873"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009910","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":"Retrospective evaluation of mild encephalitis/encephalopathy with a reversible splenial lesion in children.","authors":"Xin Li, Suzhen Sun, Huifeng Zhang","doi":"10.1111/ped.15869","DOIUrl":"https://doi.org/10.1111/ped.15869","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive documentation on consecutive years of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children is lacking. This study aims to provide an in-depth analysis of the clinical profiles of MERS in children across different age groups, focusing on pathogens and recovery time.</p><p><strong>Methods: </strong>In this retrospective study, 43 patients diagnosed with MERS were enrolled between December 2017 and November 2021. Due to different clinical manifestations at different ages, we categorized them into two age groups: the 6-year-old or younger group and the over 6-year-old group. Clinical data were described and compared for these age cohorts.</p><p><strong>Results: </strong>Sixty percent of the cases occurred during winter, with two distinct peaks in onset age, at 1-3 years of age and 7-8 years of age. Intestinal infections were prevalent among children aged below 6 years, mainly caused by rotavirus; convulsion was the most common symptom (92.6% vs. 50%, p = 0.005). Conversely, respiratory tract infections were often observed in children older than 6 years of age, which were mainly attributed to mycoplasma pneumonia; headache and dizziness were characteristic symptoms (62.5% vs. 18.5%, p = 0.003). No significant differences were found in treatment outcomes between the two age groups. Nonetheless, MERS type II exhibited a notably longer clinical recovery time than type I (4.8 ± 1.7 vs. 8.2 ± 5.5).</p><p><strong>Conclusion: </strong>Mild encephalitis/encephalopathy with a reversible splenial lesion exhibits a distinct seasonal pattern with varied clinical manifestations across different age groups. Although the prognosis was favorable, discernible differences in clinical symptoms and pathogens were observed between the two age cohorts. It was noted that the clinical recovery time for MERS type II was comparatively protracted in comparison with type I.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15869"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606093","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":"Liver function trends in children with suspected drug-induced hepatocellular injury: A survey using an electronic medical records database.","authors":"Masayoshi Nakakuni, Kosuke Nakano, Ayano Inui, Shinji Kobayashi, Naoko Deguchi, Seiji Mitsui, Takeshi Kuriyama, Seiko Miyazaki","doi":"10.1111/ped.15847","DOIUrl":"https://doi.org/10.1111/ped.15847","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced liver injury (DILI) is a common adverse drug event with limited pediatric data in the literature. This study aimed to use pediatric electronic medical records to assess hepatocellular DILI in pediatric patients who were prescribed liver-injury-inducing drugs.</p><p><strong>Methods: </strong>The Pediatric Medical Information Collection System (P-MICS) is a centralized database integrating electronic medical records from over 40 medical pediatric centers. Pediatric patients in the P-MICS with serum alanine aminotransferase (ALT) levels five or more times the upper limit of normal and who were below 15 years of age were selected. Those with liver diseases unrelated to drug-induced causes were excluded. We identified drugs prescribed 2 to 90 days before the first elevated ALT reading. High-risk liver-injury-causing drugs were determined based on the LiverTox score. We analyzed post-event ALT and total bilirubin levels (TB) and DILI management.</p><p><strong>Results: </strong>Of the 817 patients with suspected DILI, 251 were prescribed four drugs identified as high-risk drugs for hepatocellular DILI: methotrexate (n = 129), aspirin (n = 82), vancomycin (n = 58), and cyclophosphamide (n = 51). The median ALT level at the first event was 245 U/L. Approximately 35% of methotrexate users and cyclophosphamide users experienced recurrent ALT elevation. Some methotrexate users also showed TB elevation. Discontinuation of high-risk drugs resulted in fewer relapses and TB elevations than pharmacotherapy.</p><p><strong>Conclusions: </strong>The P-MICS effectively identifies pediatric patients with potential liver injury and tracks liver function in those prescribed liver-injury-causing drugs. This study underscores liver injury risks in pediatric anticancer drug users, highlighting the utility of the P-MICS in monitoring off-label drug safety in children.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15847"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449615","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":"A novel in-frame deletion flanking exon 54 of the FBN1 gene in a Japanese girl with Marfan syndrome.","authors":"Toshihiko Mori, Shigeto Fuse, Kazuna Hirai, Maki Katai, Hiroko Morisaki","doi":"10.1111/ped.15857","DOIUrl":"https://doi.org/10.1111/ped.15857","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15857"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984474","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}