{"title":"Increased maternal urinary bisphenol F levels associated with reduced anogenital distance in male newborns.","authors":"Pongpol Jameekornkul, Nattakarn Numsriskulrat, Suparb Aroonyaparkmongkol, Kulthida Soongswang, Vichit Supornsilchai","doi":"10.1111/ped.70054","DOIUrl":"https://doi.org/10.1111/ped.70054","url":null,"abstract":"<p><strong>Background: </strong>Bisphenol exposure during pregnancy has been linked to a range of adverse reproductive outcomes. However, the full extent of the effects of bisphenol analogs, particularly bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF), on fetal development, especially anogenital distance (AGD), a sensitive marker of reproductive development, remains unclear. We conducted this research to investigate association among maternal and neonatal urinary bisphenol analogs (BPA, BPS, BPF) and AGD.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 85 mother-newborn pairs in Bangkok, Thailand, from April 2023 to January 2024. Maternal and neonatal urine samples were collected and analyzed for BPA, BPF, and BPS concentrations by liquid chromatography-tandem mass spectrometry. Neonatal AGD measurements were obtained within 72 h of birth. Correlation was analyzed by Pearson's correlation test and linear regression analysis.</p><p><strong>Results: </strong>High maternal urinary BPF concentrations were negatively associated with ano-penile distance, ano-scrotal distance, and penile length in male newborns (r -0.963, -0.844 and - 0.900, respectively, p < 0.05). No significant associations were found for BPA or BPS. Frequent maternal consumption of carton drinks was associated with higher neonatal BPS levels, while maternal obesity was positively correlated with maternal BPA concentration. No significant correlation was observed between maternal and neonatal bisphenol concentrations, nor between neonatal bisphenol levels and AGD.</p><p><strong>Conclusions: </strong>This study is the first to report a negative association between maternal BPF exposure and AGD in male newborns. These findings highlight the potential endocrine-disrupting effects of BPF on fetal development and emphasize the need for further research.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70054"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038219","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":"Characteristics of pediatric hand and foot tendon injuries in a Japanese pediatric emergency department.","authors":"Takaaki Mori, Osamu Nomura, Shun Kishibe","doi":"10.1111/ped.15862","DOIUrl":"10.1111/ped.15862","url":null,"abstract":"<p><strong>Background: </strong>Pediatric tendon injuries are rare but are associated with serious complications, such as permanent limb dysfunction, if not diagnosed and treated properly. However, there is a lack of data on their epidemiology and management in the emergency department (ED). The present study describes the characteristics and management of pediatric hand- and foot-tendon injuries in a Japanese pediatric ED.</p><p><strong>Methods: </strong>The present, retrospective, observational study, conducted from March, 2010 to March, 2023, enrolled children younger than 16 years who received a diagnosis of a tendon injury to the hands or feet at a pediatric ED in Tokyo Metropolitan Children's Medical Center. Visits to the ED for follow-up examinations were excluded. The patients' sex, age, arrival time, mechanism of injury, signs and symptoms, examinations, diagnoses, outcomes, and complications were extracted from their medical records.</p><p><strong>Results: </strong>Forty-two tendon injuries in 26 patients were included. Fifteen patients (58%) were male, and the median age was 9.5 years. Injuries occurred most frequently at home (58%) and most often involved a sharp object (42%). The median wound size was 2 cm. Tendon exposure occurred in 38% of patients and limited range of motion occurred in 83%. Tests performed in the ED included plain radiograph (100%) and ultrasonography (12%). Fracture complications occurred in three patients and nerve injury occurred in five. Orthopedic complications occurred in 15 patients (58%).</p><p><strong>Conclusions: </strong>Pediatric hand and foot-tendon injuries had a high risk of orthopedic complications and characteristic features included large wound size, tendon exposure, and limited range of motion.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15862"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449269","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":"Clinical features, diagnostic approach, and outcome of imperforate hymen: A single institution case series.","authors":"Masashi Kadohisa, Masaki Horiike, Hisanori Fujino, Takafumi Nonogaki, Narito Takada","doi":"10.1111/ped.70011","DOIUrl":"10.1111/ped.70011","url":null,"abstract":"<p><strong>Background: </strong>Imperforate hymen is uncommon but it is one of the most common obstructive lesions of the female genital tract. Hydro/hematometrocolpos, derived from retained uterine and vaginal secretions and menstrual blood, causes various nonspecific symptoms. This study aimed to examine the clinical features, diagnostic approach, and outcomes of imperforate hymen at a single institution in Japan.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients with imperforate hymen at Osaka Red Cross Hospital between January 2012 and November 2023.</p><p><strong>Results: </strong>Six patients were identified. Five patients were diagnosed at puberty (range: 10-13 years) and one was diagnosed in the neonatal period. A neonatal case was diagnosed incidentally during the follow-up of labial fusion. In the adolescent cases, various initial symptoms (e.g., lower abdominal pain, lower back pain, urinary retention, constipation, and abdominal distension) caused the first visit to various clinical departments, such as Internal Medicine, Emergency, Pediatrics, Obstetrics and Gynecology, Orthopedics, and Surgery. In all cases, a large cystic lesion in the lower abdomen, suggestive of hematometrocolpos, was easily detected by abdominal ultrasonography, which resulted in consultation with the appropriate clinical department or performance of additional imaging tests, such as magnetic resonance imaging, in some cases. All patients were treated with a hymenectomy or hymenotomy and circumferential suture at the vaginal introitus. Postoperative stenosis or reclosure during follow-up was not observed.</p><p><strong>Conclusions: </strong>Physicians should consider imperforate hymen as a possible diagnosis when examining adolescent girls who have not yet had menarche and present with refractory lower abdomen-related symptoms, and abdominal ultrasonography should be performed.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70011"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710792","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":"Avoidant/restrictive food intake disorder prognosis and its relation with autism spectrum disorder in Japanese children.","authors":"Chie Tanaka, Ayumi Okada, Mana Hanzawa, Chikako Fujii, Yoshie Shigeyasu, Akiko Sugihara, Makiko Horiuchi, Takashi Yorifuji, Hirokazu Tsukahara","doi":"10.1111/ped.70040","DOIUrl":"10.1111/ped.70040","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of reported clinical factors associated with the outcomes of children and adolescents with avoidant/restrictive food intake disorder (ARFID) in Japan. This study aimed to identify these clinical factors and explore the relationship between ARFID and autism spectrum disorder (ASD).</p><p><strong>Methods: </strong>This retrospective study analyzed data from 48 Japanese children and adolescents with ARFID who visited Okayama University Hospital between January 2011 and March 2022. Clinical characteristics were assessed using medical records and natural history questionnaires. The study compared patients with good and poor prognosis groups and used multiple logistic regression analysis to determine factors influencing prognosis.</p><p><strong>Results: </strong>The study included 33 patients with good prognoses and 15 with poor prognoses. Comorbid ASD was more prevalent in the poor prognosis group (60%) compared to the good prognosis group (21%). Additionally, more than half of the ARFID patients with comorbid ASD were initially undiagnosed. Multivariate analysis revealed that older age at first visit (p = 0.022) and comorbid ASD (p = 0.022) were statistically significant factors associated with poor prognosis in ARFID patients. There were no significant differences in body mass index standard deviation score and maximal weight loss between the two groups.</p><p><strong>Conclusions: </strong>The poor prognosis group had a higher prevalence of comorbid ASD diagnoses. Therefore, it is crucial to evaluate patient's developmental characteristics early in treatment and consider these characteristics throughout the course of care.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70040"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974958","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":"Lich-Gregoir vs. Cohen ureteral re-implantation surgery for bilateral vesicoureteral reflux: A propensity score analysis.","authors":"Takayuki Fujii, Hiroyuki Satoh, Atsuko Sato, Yoshiaki Ishizuka, Mizuki Izawa, Yuki Morimoto, Ryuichi Shimono","doi":"10.1111/ped.70010","DOIUrl":"10.1111/ped.70010","url":null,"abstract":"<p><strong>Background: </strong>The Lich-Gregoir procedure for bilateral vesicoureteral reflux (VUR) is limited by the risk of urinary retention. Here, we investigated the efficacy of the Lich-Gregoir procedure compared to that of the Cohen procedure for bilateral VUR in children.</p><p><strong>Methods: </strong>We retrospectively evaluated children who underwent open ureteral re-implantation for bilateral VUR between 2010 and 2022. The patients' clinical characteristics and perioperative outcomes were compared after 1:1 propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 137 patients were enrolled in this study, with 122 undergoing the Cohen procedure and 15 undergoing the Lich-Gregoir procedure. After PSM, there were 14 patients in each group. The operative time was shorter in the Lich-Gregoir group (121.0 vs. 157.0 min; p = 0.018), while the urethral Foley stay was longer in the Cohen group (6.0 vs. 4.0 days; p < 0.001). Only the Cohen group required ureteral catheter insertion (4.5 days) and had a higher rate of bladder spasms (85.7% vs. 0%; p < 0.001). The Cohen group experienced two postoperative complications, while the Lich-Gregoir group had one patient with temporary urinary retention. The hospitalization period was longer in the Cohen group (8.0 vs. 7.0 days; p < 0.001). There were no significant differences in postoperative hydronephrosis, postoperative urinary tract infection, and persistent VUR between the two groups.</p><p><strong>Conclusions: </strong>The Lich-Gregoir procedure for bilateral VUR was safely and effectively performed in patients who met several criteria (e.g., toilet-trained patients, mild-to-moderate reflux, and normal bladder volume and function).</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70010"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764618","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}
Hyo Ju Yang, Seul Gi Park, Soo Yeon Lim, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
{"title":"Preoperative predictors of worsened respiratory status after patent ductus arteriosus ligation in preterm infants.","authors":"Hyo Ju Yang, Seul Gi Park, Soo Yeon Lim, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim","doi":"10.1111/ped.70030","DOIUrl":"10.1111/ped.70030","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants with hemodynamically significant patent ductus arteriosus (PDA) may require surgical ligation. Following the surgery, some infants may encounter a deterioration in respiratory status. This study aimed to evaluate the risk factors that can predict worsened respiratory outcomes after PDA surgical ligation.</p><p><strong>Methods: </strong>A retrospective cohort study was performed on 57 preterm infants born at less than 32 weeks of gestational age and in whom the PDA was surgically ligated between January 2014 and December 2018 at Seoul National University Children's Hospital. Participants were divided into two groups: infants with worsened respiratory outcomes 14 days after ligation and control. Worsened respiratory outcome was defined as an increase in respiratory severity score (RSS) by 30% or more at 14 days after ligation compared to RSS before ligation, or death at 14 days after ligation.</p><p><strong>Results: </strong>Among the 57 PDA-ligated infants, 12 had worsened respiratory outcomes and 45 did not. The worsened respiratory outcomes were associated with oligohydramnios (adjusted OR 1.38, 95% CI 1.1-1.73, p < 0.01) and lower weight at surgery (adjusted OR 0.99, 95% CI 0.99-0.99, p = 0.02), compared to the control.</p><p><strong>Conclusion: </strong>Worsened respiratory outcomes after PDA ligation appeared to be associated with oligohydramnios, and lower weight on the day of surgery.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70030"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764622","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":"Hyponatremia is not induced by postoperative hypotonic fluids in infants with biliary atresia after sufficient diuresis.","authors":"Kazuki Yokota, Hiroo Uchida, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Hizuru Amano, Yoichi Nakagawa, Takuya Maeda, Yousuke Gohda, Daiki Kato, Akinari Hinoki","doi":"10.1111/ped.70016","DOIUrl":"10.1111/ped.70016","url":null,"abstract":"<p><strong>Background: </strong>In Japan, the administration of extra-hypotonic fluids (approximately 35 mmol/L of sodium) as maintenance fluid is still the mainstream practice, and there have been relatively few reports on maintenance intravenous fluid therapy. Since 2014, our institution has administered maintenance fluids containing 83 mmol/L of Na (HALF) after diuresis is achieved post-Kasai portoenterostomy for biliary atresia (BA). We investigated whether hyponatremia is induced by the administration of half saline during postoperative maintenance of infants with BA.</p><p><strong>Methods: </strong>Patients who underwent surgery for BA at our institution were included. The serum sodium concentration ([Na]) before and after surgery and the incidence of hyponatremia were compared between patients administered fluids with [Na] of 35 mmol/L (exHYPO group, 59 patients) and those with [Na] of 83 mmol/L (HALF group, 20 patients).</p><p><strong>Results: </strong>The median age of patients was 59 days. There were no significant differences in the background or preoperative [Na] between groups. There was a significant decrease in [Na] on postoperative day 3 (POD3) in the exHYPO group compared with the preoperative [Na] value in the exHYPO group and the [Na] value on POD3 in the HALF group. There were no significant differences in [Na] before and after surgery in the HALF group. The odds ratio was 21.0, and the 95% confidence interval was 3.31-130, indicating that the exHYPO group had an increased risk of hyponatremia.</p><p><strong>Conclusion: </strong>Administration of half saline as maintenance fluid can maintain [Na] levels during postoperative care of infants with BA.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70016"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024909","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":"An infant with achondroplasia worsening of the foramen magnum stenosis during early vosoritide treatment.","authors":"Yuki Gunji, Ryoji Aoki, Nobuhiko Nagano, Masako Aoki, Aya Okahashi, Koichiro Sumi, Ichiro Morioka","doi":"10.1111/ped.70089","DOIUrl":"https://doi.org/10.1111/ped.70089","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70089"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136179","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}