Lefeng Wang, Shanneng Pan, Ruimin Zhao, Long Cui, Yinghui Ye
{"title":"Impact of maternal serum 25(OH)D concentration in the third trimester on birth outcomes and cord blood FGF23 levels.","authors":"Lefeng Wang, Shanneng Pan, Ruimin Zhao, Long Cui, Yinghui Ye","doi":"10.1111/ped.70145","DOIUrl":"10.1111/ped.70145","url":null,"abstract":"<p><strong>Background: </strong>Maternal vitamin D concentration has been linked to various health outcomes, but its associations with obstetric outcomes, infant growth, and cord blood cytokines remain inconclusive.</p><p><strong>Methods: </strong>We conducted an observational study including 132 pregnant women whose serum 25-hydroxyvitamin D [25(OH)D] levels were measured in the third trimester. After delivery, cord blood cytokines related to fetal growth were measured. Participants were divided into quartiles based on 25(OH)D concentration. Infant anthropometric indicators were analyzed using WHO-standardized Z-scores for length, weight, and head circumference at birth, 3 months, and 6 months. Analysis of variance or the Kruskal-Wallis method was used to compare obstetric complications, neonatal outcomes, and infant growth among the groups.</p><p><strong>Results: </strong>Maternal serum 25(OH)D concentration in the third trimester exhibited a significant association with infant length, weight, and head circumference up to 6 months, with greatest differences at 6 months. However, the prevalence of obstetric complications did not differ significantly across quartiles. Cord blood fibroblast growth factor 23 (FGF23) levels were positively correlated with maternal serum 25(OH)D concentration and may contribute to fetal growth regulation.</p><p><strong>Conclusions: </strong>This study demonstrated a positive association between maternal serum 25(OH)D concentration and early infant growth outcomes. Cord blood FGF23 levels were associated with maternal vitamin D levels and neonatal growth, suggesting a potential role of FGF23 in the underlying mechanism of fetal growth restriction associated with vitamin D deficiency. These findings highlight the relevance of adequate maternal vitamin D status during pregnancy for promoting healthy perinatal growth.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70145"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795083","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 case of rapid blood glucose fluctuation in the neonatal period attributed to maternal anti-insulin antibodies.","authors":"Yasuhiro Nakao, Makoto Arioka, Shinji Nakamura, Kota Inoue, Hirosuke Morita, Kosuke Koyano, Takashi Kusaka","doi":"10.1111/ped.70004","DOIUrl":"https://doi.org/10.1111/ped.70004","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70004"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964740","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":"Usefulness of the starry sky liver sign for diagnosing ketotic hypoglycemia in children.","authors":"Tomoki Sato, Ayako Sakuma, Rika Okano","doi":"10.1111/ped.70109","DOIUrl":"https://doi.org/10.1111/ped.70109","url":null,"abstract":"<p><strong>Background: </strong>The starry sky liver (SSL) sign, which is characterized by increased visualization of the peripheral intrahepatic vasculature during ultrasound examinations, has been associated with conditions such as acute hepatitis, Burkitt's lymphoma, and prolonged starvation. This study evaluated the utility of the SSL sign for diagnosing ketotic hypoglycemia, which is a condition that presents with vomiting and is characterized by increased ketone levels and hypoglycemia.</p><p><strong>Methods: </strong>Eighty-two patients who experienced vomiting underwent an ultrasound examination of the liver, and the SSL sign was observed and scored by two pediatricians. Patients were grouped based on blood ketone (≥2.0 mmol/L or <2.0 mmol/L) and glucose (>70 mg/dL or ≤ 70 mg/dL) levels. Ultrasound images were quantitatively analyzed using the SSL index.</p><p><strong>Results: </strong>A significant association between higher SSL signs, increased ketone levels, and lower glucose levels was observed (p < 0.05). The SSL sign was more frequently observed in patients with high ketone levels or hypoglycemia. A quantitative analysis showed an inverse correlation between the SSL index and ketone levels (R = -0.361) and a positive correlation with glucose levels (R = 0.363). The SSL index indicated good diagnostic accuracy, with areas under the receiver-operating characteristic curves of 0.76 for ketone levels and 0.73 for hypoglycemia.</p><p><strong>Conclusion: </strong>The SSL sign observed with ultrasound is a useful and noninvasive indicator that can be used to diagnose ketotic hypoglycemia in pediatric patients.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70109"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234794","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}
Ai Yuda, Tomo Nozawa, Seira Hattori, Ayako Murase, Kenichi Nishimura, Ryoki Hara, Shuichi Ito
{"title":"Intolerance of oral methotrexate in juvenile idiopathic arthritis.","authors":"Ai Yuda, Tomo Nozawa, Seira Hattori, Ayako Murase, Kenichi Nishimura, Ryoki Hara, Shuichi Ito","doi":"10.1111/ped.70112","DOIUrl":"10.1111/ped.70112","url":null,"abstract":"<p><strong>Background: </strong>Oral methotrexate (MTX) is a cornerstone treatment for juvenile idiopathic arthritis (JIA), although adverse events (AEs) such as nausea and vomiting often impact adherence. This study examined the intolerability of MTX in patients with JIA.</p><p><strong>Methods: </strong>We retrospectively investigated MTX intolerability in 52 patients treated at our institute between April 2011 and October 2022. The target MTX dose was 10 mg/m<sup>2</sup>/week (maximum 16 mg/week) according to the Japanese clinical guidelines for JIA.</p><p><strong>Results: </strong>The median age at MTX initiation was 8.3 years, with a median maximum dose of 8.9 mg/m<sup>2</sup>/week. Of the 52 patients, 16 (31%) were started on biologics before or at the initiation of MTX, while 36 (69%) began MTX monotherapy. Fifteen (29%) patients could not reach the target MTX dose because of AEs. Thirty-six (68%) patients experienced one or more AEs, with nausea and vomiting being the most common (n = 24). Eleven patients (21%) failed to achieve or maintain remission because of intractable nausea/vomiting, and nine (17%) eventually required biologics. Among the 24 patients who experienced nausea/vomiting, 42% developed symptoms within 6 months and 67% within 12 months of MTX initiation. AEs occurred regardless of MTX dose.</p><p><strong>Conclusions: </strong>Two-thirds of patients experienced AEs with oral MTX, leading some to fail remission and require biologics. Intolerability of oral MTX was common and significantly influenced patient outcomes.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70112"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333725","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}
Aya Tanaka, Sella Takei, Takayuki Fujii, Hiroto Katami, Ryuichi Shimono
{"title":"A case of intestinal obstructioncaused by potato bezoar in an infant.","authors":"Aya Tanaka, Sella Takei, Takayuki Fujii, Hiroto Katami, Ryuichi Shimono","doi":"10.1111/ped.70136","DOIUrl":"https://doi.org/10.1111/ped.70136","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70136"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541849","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}
Seongjin Choi, Seo-Hee Kim, Seong Pyo Kim, Yujin Park, Su Hwan Kim, Yeong Eun Kim, Ho Jung Choi, In Sook Jeong, Seak Hee Oh, Hyung-Jin Yoon, Kyung Mo Kim
{"title":"Long-term trend of cumulative incidence of venous thromboembolism in Korean pediatric inflammatory bowel disease.","authors":"Seongjin Choi, Seo-Hee Kim, Seong Pyo Kim, Yujin Park, Su Hwan Kim, Yeong Eun Kim, Ho Jung Choi, In Sook Jeong, Seak Hee Oh, Hyung-Jin Yoon, Kyung Mo Kim","doi":"10.1111/ped.70158","DOIUrl":"https://doi.org/10.1111/ped.70158","url":null,"abstract":"<p><strong>Background: </strong>Research on venous thromboembolism (VTE) in pediatric inflammatory bowel disease (PIBD) is rare in Asia. This study aimed to investigate the epidemiological characteristics of VTE within the Korean PIBD population.</p><p><strong>Methods: </strong>A cohort study was conducted on pediatric patients (<17 years) using South Korea's health claims data from 2005 to 2015. IBD and VTE were identified using ICD-10 codes. We analyzed incidence rate, cumulative incidence, and risk factors, including very early-onset (VEO, <6 years) IBD.</p><p><strong>Results: </strong>Among 2456 newly diagnosed PIBD patients (2005-2015), 15 (0.6%) developed VTE. The overall VTE incidence was 11.08 per 10,000 patient-years, with rates of 76.72 for VEO-IBD and 9.79 for late-onset (LO, 6-16 years) PIBD. Cumulative VTE rates at 0, 1, 5, and 10 years were 0.04%, 0.08%, 0.56%, and 1.26%, respectively. Age at onset increased VTE risk, while gender and disease type did not show significant differences.</p><p><strong>Conclusions: </strong>The incidence of VTE in PIBD steadily increased over the 10-year period, with a higher occurrence in those with VEO-IBD. This study emphasizes the importance of continuous follow-up for VTE from the early stages of the disease in pediatric IBD patients, particularly focusing on younger age groups.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70158"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795084","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":"Significant head and facial injuries in pediatric balance bike riders: A case series from the emergency department.","authors":"Tsuyoshi Aihara, Shunsuke Amagasa, Shima Ohnishi, Yoshiko Uchida, Satoko Uematsu","doi":"10.1111/ped.70105","DOIUrl":"https://doi.org/10.1111/ped.70105","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70105"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234793","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":"Nationwide questionnaire survey on diagnostic errors in pediatric outpatient acute care.","authors":"Kenichi Tetsuhara, Hiromichi Hamada, Genya Taketazu, Mitsuru Kashiwagi, Yasushi Saito, Ryugo Hiramoto, Takashi Hamazaki, Yasuhiro Takeshima","doi":"10.1111/ped.70183","DOIUrl":"https://doi.org/10.1111/ped.70183","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic errors are harmful and occur at unacceptably high rates. However, data regarding diagnostic errors in pediatric populations, particularly in acute outpatient care settings, remain insufficient. This study aimed to investigate the frequency of diagnostic errors, contributing factors, common symptoms, initial diagnoses, and final diagnoses in pediatric outpatient acute care in Japan and clarify the challenges that should be prioritized for preventing such errors.</p><p><strong>Methods: </strong>A secondary analysis of the Nationwide Survey on Diagnostic Errors in Pediatric Outpatient Acute Care questionnaire data was performed.</p><p><strong>Results: </strong>In total, 1511 responses were received from the members of the Japan Pediatric Society. Cognitive factors, particularly insufficient information gathering, were identified as the primary contributors to diagnostic errors. Situational factors such as high workload and limited time were prominent factors, particularly in clinics. Among the most memorable cases of diagnostic errors, the chief complaints at the initial visit were frequently fever, abdominal pain, and vomiting. The common initial diagnoses included gastroenteritis, upper respiratory infection, and lower respiratory infection, whereas the final diagnoses were appendicitis, encephalitis/encephalopathy, and intussusception. Diagnostic errors with poor outcomes frequently involved final diagnoses of encephalitis/encephalopathy, myocarditis, and testicular torsion.</p><p><strong>Conclusions: </strong>Caution should be exercised to avoid diagnostic errors when addressing the chief complaints and initial diagnoses frequently identified in this study. Diseases listed as final diagnoses should be prioritized in the differential diagnoses. Addressing the factors contributing to diagnostic errors, along with increased awareness and targeted strategies for differential diagnosis, may reduce diagnostic errors and improve healthcare quality.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70183"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993192","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}