Translational pediatrics最新文献

{"title":"Treatment of idiopathic segmental infarction of the greater omentum in children via transumbilical single-port laparoscopy.","authors":"Yinan Hong, Weiming Chen, Huazhe Wu, Hongbiao Zeng, Yongjuan Wei","doi":"10.21037/tp-2026-0430","DOIUrl":"https://doi.org/10.21037/tp-2026-0430","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic segmental infarction of the omentum represents a rare etiology of acute abdominal pain in pediatric patients. The atypical clinical presentation often leads to misdiagnosis and delayed intervention. This study aimed to summarize the treatment procedure of idiopathic segmental infarction of the omentum in children via transumbilical single-port laparoscopy and to offer a reference for clinical diagnosis and management of this condition.</p><p><strong>Methods: </strong>Clinical information, including blood tests, imaging examinations, intraoperative findings, postoperative pathological results, and follow-up outcomes, was collected from children with idiopathic segmental infarction of the omentum at our institution from September 2023 to September 2025, and a retrospective analysis was conducted.</p><p><strong>Results: </strong>There were 1 girl and 7 boys, whose ages ranged from 7 to 11 years, with an average of 9.1±1.2 years, and whose body mass index (BMI) ranged from 18.35 to 24.00 kg/m^2, with an average of 21.95±2.11 kg/m² among the 8 pediatric patients. The initial symptom was abdominal pain without any other accompanying symptoms. Ultrasound examinations revealed a hyperechoic abdominal mass in each patient without obvious blood flow signals, and computed tomography (CT) examinations revealed a mixed-density shadow mass in the abdomen without significant enhancement. Postoperative pathology confirmed infarction of the greater omentum, consistent with the preoperative diagnosis. All patients underwent transumbilical single-port laparoscopic surgery, with a hospital stay of 3-7 days and an average duration of 4.88±1.55 days. No complications, such as intestinal obstruction or incisional hernia, were observed during an average follow-up period of 21 months.</p><p><strong>Conclusions: </strong>Transumbilical single-port laparoscopic surgery is safe, effective, and feasible for treating idiopathic segmental infarction of the omentum in children, and could serve as an alternative surgical approach for this condition.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"368"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184584","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":"Native amniotic fluid promotes barrier-associated maturation of the neonatal intestine under physiological conditions.","authors":"Fredy John Makele, Chenang Sheng, Jiayi Wu, Yixin Zhang, Tianci Weng, Yuchen Zhang, Yi Yang, Wenqiang Zhang, Libin Zhu","doi":"10.21037/tp-2026-0598","DOIUrl":"https://doi.org/10.21037/tp-2026-0598","url":null,"abstract":"<p><strong>Background: </strong>The neonatal intestine undergoes dynamic maturation after birth, during which an effective epithelial barrier is essential for intestinal adaptation and function. Amniotic fluid (AF) contains diverse bioactive components that may contribute to intestinal development. This study aimed to investigate whether native AF supports barrier-associated maturation of the neonatal intestine under physiological, non-injury conditions.</p><p><strong>Methods: </strong><i>In vitro</i> models using Caco-2 and IEC-6 cells and an <i>in vivo</i> neonatal rat model were used to assess the effects of 25% and 50% native AF. Tight junction protein expression, including Claudin-1, Claudin-8, and Occludin, was measured by Western blotting. Barrier-related properties were evaluated using transepithelial electrical resistance (TEER) and fluorescein isothiocyanate-conjugated inulin permeability assays.</p><p><strong>Results: </strong>Native AF at 25% and 50% increased tight junction protein expression, with the strongest response observed in the 50% AF group (P<0.01). TEER values increased in Caco-2 and IEC-6 monolayers (P<0.001 for 50% AF) and in neonatal rat intestinal tissues, particularly on day 14 (P<0.01 for 50% AF). Permeability to fluorescein isothiocyanate-conjugated inulin decreased significantly in both AF-treated monolayer groups (P<0.001). Intestinal morphology remained unchanged across treatment groups.</p><p><strong>Conclusions: </strong>Native AF increased tight junction protein expression, improved barrier-related properties in epithelial monolayers, and produced early <i>ex vivo</i> TEER changes in neonatal rat intestinal tissues without altering intestinal morphology. These findings suggest that AF may support physiological postnatal barrier-associated maturation, although direct <i>in vivo</i> permeability effects require further investigation.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"364"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184695","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":"Development and internal validation of a nomogram for predicting flexible bronchoscopy utilization in children with lobar pneumonia caused by <i>Mycoplasma pneumoniae</i>: a single-center retrospective cohort study.","authors":"Lilin Huang, Jing Li, Cuilan Liu, Xiaole Yang, Hainan Xu","doi":"10.21037/tp-2026-0453","DOIUrl":"10.21037/tp-2026-0453","url":null,"abstract":"<p><strong>Background: </strong>The recent resurgence of <i>Mycoplasma pneumoniae</i> (MP) pneumonia has increased the number of children with lobar pneumonia who may receive flexible bronchoscopy (FB), yet the decision to perform FB remains subjective, and no quantitative tool exists for this specific high-risk subgroup. This study aimed to develop and internally validate a nomogram to predict FB utilization in children with MP-related lobar pneumonia using routine admission indicators to support real-time bedside decision-making.</p><p><strong>Methods: </strong>This single-center retrospective study included 345 children (aged 1 month-18 years) with serology-confirmed MP-related lobar pneumonia (January 2022-March 2025); those with congenital heart disease, immunodeficiency, or plastic bronchitis were excluded. Patients were divided into FB (n=171) and non-FB (n=174) groups based on whether FB was performed. Laboratory predictors were restricted to values obtained within 72 hours of admission and before the FB decision. FB was recommended if symptoms or signs persisted after ≥72 hours of standard therapy. Multivariate logistic regression was used to identify predictors, and a nomogram was constructed and internally validated by 10-fold cross-validation. Model performance was assessed by area under the curve (AUC), calibration, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Viral coinfection [odds ratio (OR) =23.271, 95% confidence interval (CI): 9.299-64.900, P<0.001] was the strongest independent risk factor for FB utilization, while bacterial coinfection (OR =0.215, 95% CI: 0.088-0.507, P<0.001) and male sex (OR =0.146, 95% CI: 0.061-0.313, P<0.001) were independent protective factors. The nomogram incorporating these six variables demonstrated moderate discrimination (apparent AUC =0.741, 95% CI: 0.689-0.792; cross-validated AUC =0.705) and good calibration (Hosmer-Lemeshow P=0.56). At the optimal cutoff value of 0.56, the model had a sensitivity of 51.5% and a specificity of 85.1%. DCA demonstrated net clinical benefit over a \"treat-all\" strategy within a threshold probability range of 0.1-0.3.</p><p><strong>Conclusions: </strong>The nomogram showed modest ability to predict FB use in this single-center cohort, but its clinical utility for identifying children with lobar pneumonia caused by MP who truly require FB remains uncertain.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"372"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167159","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":"Reassessing bronchopulmonary dysplasia definitions: association between severity grading and brain injury on term-equivalent age MRI.","authors":"Su-Hua Xu, Ting-Ting Li, Chong-Bing Yan, Huan-Huan Zhang, Xiao-Hui Gong, Cheng Cai","doi":"10.21037/tp-2026-0651","DOIUrl":"https://doi.org/10.21037/tp-2026-0651","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the associations between severity classified by three bronchopulmonary dysplasia (BPD) diagnostic criteria [2001 National Institute of Child Health and Human Development (NICHD), 2018 NICHD, and 2019 Jensen] and cerebral injury identified on term-equivalent age (TEA) magnetic resonance imaging (MRI) in infants born at <32 weeks' gestation.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 222 preterm infants (mean gestational age 29.3±1.6 weeks) admitted to Shanghai Children's Hospital [2018-2022]. Brain injury was scored on TEA MRI using the Kidokoro system, yielding white matter (WM), cortical gray matter (GM), deep GM, and cerebellar scores; a global brain abnormality (GBA) score ≥6 defined moderate-to-severe global brain injury (msGBI). We compared brain injury across BPD severity groups for each criterion and analyzed associations between BPD severity and msGBI using Firth's penalized-likelihood regression, adjusting for gestational age and birth weight.</p><p><strong>Results: </strong>WM abnormalities were the most frequent injury (70.3%); msGBI was present in 12.6% of infants. Applying the 2019 Jensen criteria revealed a severity-dependent increase in brain injury scores, with significant differences in GBA, WM, and cortical GM scores across severity groups (all P<0.05). Only grade 3 BPD by the 2019 Jensen criteria was independently associated with msGBI (adjusted odds ratio =8.54, 95% confidence interval: 2.04-37.72, P=0.004). No significant associations were found for the other criteria.</p><p><strong>Conclusions: </strong>The 2019 Jensen criteria uniquely identify a high-risk subgroup (grade 3 BPD) with significantly increased odds of msGBI on TEA MRI, supporting its utility in neurological risk stratification.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"360"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184226","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":"Associated factors for unfavorable prognosis in neonates with septic shock.","authors":"Yaocong Zhong, Xi Kang, Huaxi Luo, Yuan Wang, Jingjie Zeng, Zhiting Qiu, Yuxin Gong, Shuqiang Gao","doi":"10.21037/tp-2026-0665","DOIUrl":"https://doi.org/10.21037/tp-2026-0665","url":null,"abstract":"<p><strong>Background: </strong>Neonatal septic shock represents a life-threatening complication of neonatal sepsis associated with substantial in-hospital mortality. Conventional diagnostic criteria only detect shock at the decompensated stage, which inevitably delays optimal treatment. This study aimed to identify independent predictors associated with adverse outcomes in neonates with septic shock and evaluate the predictive performance of combined early laboratory biomarkers and point-of-care cardiac ultrasound parameters.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was performed on 98 neonates diagnosed with septic shock admitted to the Neonatal Intensive Care Unit of Chengdu Women's and Children's Central Hospital from January 2024 to December 2025. Patients were stratified into a favorable prognosis group (n=67) and an unfavorable prognosis group (n=31) based on discharge outcomes. Perinatal baseline data, initial laboratory tests and bedside critical cardiac ultrasound measurements were compared between groups. Univariate analyses followed by backward stepwise binary logistic regression were used to screen independent prognostic predictors, and receiver operating characteristic (ROC) curves were constructed to quantify predictive efficacy.</p><p><strong>Results: </strong>Compared with patients with favorable outcomes, neonates with poor prognosis exhibited lower gestational age, birth weight and Apgar scores, elevated serum interleukin-6 (IL-6), myoglobin (MYO) and high-sensitivity cardiac troponin I; reduced serum albumin and calcium, as well as increased serum potassium. Cardiac ultrasound revealed significantly decreased velocity-time integral (VTI), cardiac output (CO) and tricuspid annular plane systolic excursion (TAPSE) in the unfavorable prognosis group (all P<0.05). Multivariate logistic regression identified gestational age, VTI and TAPSE as independent protective factors, while elevated IL-6 served as an independent predictor for adverse prognosis (P<0.05). ROC analysis demonstrated that TAPSE yielded the highest area under the curve (AUC =0.857), followed by VTI (AUC =0.785), gestational age (AUC =0.739) and IL-6 (AUC =0.716). The combined four-marker model achieved an AUC of 0.905, which outperformed all individual indicators.</p><p><strong>Conclusions: </strong>Lower gestational age, elevated IL-6, and reduced VTI and TAPSE independently associated with poor prognosis in neonates with septic shock. Integrated assessment combining perinatal characteristics, admission inflammatory biomarkers and bedside cardiac ultrasound enables identification of high-risk infants, and may facilitate risk stratification for neonatal septic shock.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"373"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184521","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":"Bovine milk-derived osteopontin attenuates hyperoxia-induced lung injury associated with NLRP3 inflammasome regulation in neonatal mice with bronchopulmonary dysplasia.","authors":"Chongchong Liu, Yi Zhang, Jingjing Li, Qianqian Zhou, Yanrong Ji, Shiwen Xia","doi":"10.21037/tp-2026-0632","DOIUrl":"https://doi.org/10.21037/tp-2026-0632","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD) is a major complication of prematurity, and effective preventive strategies remain limited. This study aimed to investigate the protective effect of osteopontin (OPN) supplementation on hyperoxia (Hyp)-induced BPD and its underlying mechanisms.</p><p><strong>Methods: </strong>Newborn mice were randomly assigned to Control, Hyp, and Hyp + OPN groups. From postnatal day 0 (P0) to P14, mice were exposed to 21% or 75% O₂. The Hyp + OPN group received OPN (300 mg/kg) daily by gavage. Lung structure was assessed by hematoxylin and eosin (H&E) staining, mean linear intercept (MLI), and radial alveolar count (RAC). Cell proliferation and angiogenesis were evaluated by detecting Ki67 and CD31, respectively. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and Western blotting were used to analyze markers of inflammation, oxidative stress, and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome-related molecules. The number of TUNEL-positive cells was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL).</p><p><strong>Results: </strong>Hyp exposure significantly inhibited body weight gain in newborn mice, leading to simplified alveolar structure, thickened alveolar septa, and impaired pulmonary vascular development. These changes were reflected by increased MLI, decreased RAC, reduced Ki67-positive cells, and fewer CD31-positive vessels. Hyp also induced a heightened inflammatory response, elevated oxidative stress levels, and increased expression of NLRP3 inflammasome-related molecules, accompanied by an increased number of TUNEL-positive cells. OPN intervention partially restored body weight, alleviated hyperoxia-induced lung pathological changes, improved morphometric parameters (decreased MLI and increased RAC), enhanced cell proliferation and vascular-associated changes, and reduced inflammation, oxidative stress, NLRP3 inflammasome activation, and the number of TUNEL-positive cells.</p><p><strong>Conclusions: </strong>Exogenous bovine milk-derived OPN supplementation alleviates hyperoxia-induced lung injury, partially improves alveolar and vascular-associated changes, reduces inflammatory responses and oxidative stress levels, and is associated with reduced expression of NLRP3 inflammasome-related molecules in a neonatal mouse model of hyperoxia-induced BPD. These findings support the potential of OPN supplementation as a candidate intervention strategy for BPD prevention and management.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"374"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184534","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":"Beyond biochemical recovery: rethinking liver dysfunction in Kawasaki disease.","authors":"Yoshitaka Watanabe, Hirokazu Ikeda","doi":"10.21037/tp-2026-0851","DOIUrl":"https://doi.org/10.21037/tp-2026-0851","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"359"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184570","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":"Phenotypic heterogeneity in pediatric pituitary stalk interruption syndrome: greater disease burden in the metabolic-onset phenotype.","authors":"Fang Xu, Yanfang Su, Canmiao Zhao, Liping Ge, Qi Huang, Yang Yang, Lijun Xu, Meiyuan Sun, Na Tao","doi":"10.21037/tp-2026-0681","DOIUrl":"https://doi.org/10.21037/tp-2026-0681","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pituitary stalk interruption syndrome (PSIS) is a rare congenital hypothalamic-pituitary disorder with marked clinical heterogeneity. Whether different presenting phenotypes reflect variations in disease burden and neurodevelopmental outcomes remains unclear. This study aimed to characterize distinct presenting phenotypes of children with PSIS and compare their diagnostic trajectories, endocrine and structural disease burden, and neurodevelopmental outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this single-center retrospective study, 31 magnetic resonance imaging (MRI)-confirmed children with PSIS were classified into a systemic-onset phenotype (n=10; hypoglycemia, cholestasis, micropenis, or adrenal crisis) and a growth-predominant phenotype (n=21; short stature or growth deceleration). Clinical characteristics, pituitary hormone deficiency profiles at diagnosis and during follow-up, MRI findings, and neurodevelopmental outcomes were compared. Exploratory Spearman analyses examined potential associations between baseline clinical and endocrine characteristics and general quotient (GQ).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The systemic-onset phenotype showed earlier symptom onset (0.07±0.04 &lt;i&gt;vs.&lt;/i&gt; 2.68±0.73 years, P&lt;0.001) but longer diagnostic lag (4.75±1.26 &lt;i&gt;vs.&lt;/i&gt; 2.93±1.02 years, P=0.001). At diagnosis, the systemic-onset phenotype showed higher proportions of adrenocorticotropic hormone (ACTH) deficiency (80.0% &lt;i&gt;vs.&lt;/i&gt; 33.3%, P=0.02) and luteinizing hormone/follicle-stimulating hormone (LH/FSH) deficiency (60.0% &lt;i&gt;vs.&lt;/i&gt; 9.5%, P=0.006), a greater number of deficient pituitary axes, and lower anterior pituitary height after adjustment for age at MRI evaluation. Isolated growth hormone deficiency was present in 8 of 21 (38.1%) children with the growth-predominant phenotype but in none of those with the systemic-onset phenotype. During follow-up, at least one additional pituitary hormone deficiency was newly identified in 30.0% and 38.1% of the systemic-onset and growth-predominant groups, respectively (P&gt;0.99), while the systemic-onset phenotype retained a greater number of deficient pituitary axes at the latest assessment (P=0.001). Neurodevelopmental outcomes were poorer, with lower GQ (P=0.007) and higher prevalence of intellectual disability (30.0% &lt;i&gt;vs.&lt;/i&gt; 0%, P=0.03). Exploratory analyses suggested potential relationships between lower GQ and longer diagnostic lag, lower free thyroxine (FT4), lower basal cortisol, lower minimum blood glucose, and a greater number of deficient pituitary axes; these associations were exploratory and should not be interpreted causally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The systemic-onset phenotype was associated with greater pituitary hormone deficiency burden at diagnosis, longer diagnostic lag, and poorer neurodevelopmental outcomes during follow-up. Initial clinical phenotype may provide a useful framework for early recognition and risk assessment, while the ident","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"363"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184739","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":"Complications and management of thyroglossal duct cyst following Sistrunk procedure in children: a single-center retrospective study in Shanghai, China.","authors":"Jiarui Chen, Ying Wang, Chenling Shen, Penghui Chen, Zhibo Xie, Xiaojun Liu, Xiaoyan Li","doi":"10.21037/tp-2026-0675","DOIUrl":"10.21037/tp-2026-0675","url":null,"abstract":"<p><strong>Background: </strong>Thyroglossal duct cysts (TGDCs) are the most common congenital neck masses in children, and the Sistrunk procedure is the established standard surgical treatment; however, large pediatric-specific studies that systematically characterize the full spectrum of postoperative complications using standardized grading systems remain scarce. This study aimed to investigate the incidence, spectrum, and risk factors of complications following the Sistrunk procedure for TGDC excision in a pediatric population, and to summarize effective perioperative management strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on all pediatric patients with TGDC who underwent Sistrunk surgery at Shanghai Children's Hospital (Shanghai, China), a tertiary academic pediatric referral center affiliated with Shanghai Jiao Tong University School of Medicine, between January 2019 and December 2023. Surgical complications were graded according to the Clavien-Dindo classification. Risk factors for postoperative recurrence were analyzed using Chi-squared or Fisher's exact tests as appropriate. Variables included age, sex, prior recurrence status, preoperative infection history, and perioperative antibiotic use. Statistical analyses were performed using SPSS version 22.0, with significance set at P<0.05.</p><p><strong>Results: </strong>A total of 170 children (89 males, 81 females; mean age 4.72 years; mean follow-up 3.1 years) were included. Twenty-seven patients (15.9%) had undergone prior surgery at other institutions. Overall, 56 patients (32.9%) experienced at least one postoperative complication. By Clavien-Dindo grade, the distribution was as follows: Grade I, 19 patients (11.2%); Grade II, 10 patients (5.9%); Grade III, 11 patients (6.5%). Specific complications included fever (8.8%), salivary amylase-rich seroma (7.1%), wound infection (4.7%), TGDC recurrence (4.7%), pharyngeal leakage (1.2%), and postoperative bleeding requiring reoperation (1.2%). Notably, 12 patients (7.1%) developed seroma with salivary amylase-rich fluid, a previously under-recognized complication. Preoperative TGDC infection was the only significant predictor of recurrence on univariate analysis (13.7% <i>vs.</i> 0.8%, P<0.001). Age, sex, prior recurrence, and perioperative antibiotic use showed no significant association with recurrence.</p><p><strong>Conclusions: </strong>The Sistrunk procedure is the standard surgical approach for pediatric TGDC; approximately one-third of patients experienced complications, most of which were minor. Preoperative TGDC infection is a strong predictor of recurrence. Recognition of salivary amylase-rich seroma as a distinct complication and implementation of targeted perioperative care-including dietary modification, wound compression, and vigilant monitoring for airway compromise-are essential for optimizing outcomes.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"386"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169963","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":"Rapid whole-genome sequencing in the pediatric intensive care unit: from etiologic diagnosis to precision management-a narrative review.","authors":"Xin Yang, Di Liu","doi":"10.21037/tp-2026-0625","DOIUrl":"https://doi.org/10.21037/tp-2026-0625","url":null,"abstract":"<p><strong>Background and objective: </strong>Children admitted to the pediatric intensive care unit (PICU) with critical illness may have underlying genetic diseases that are difficult to distinguish from sepsis, hypoxia, shock, postoperative complications, medication effects, or secondary organ injury. Rapid whole-genome sequencing (rWGS) provides a broad genomic framework within clinically actionable timeframes. This narrative review aims to summarize the diagnostic scope, implementation workflow, and clinical utility of rWGS in critically ill children.</p><p><strong>Methods: </strong>A focused literature search was conducted in PubMed using terms related to rWGS, rapid genome sequencing, rapid exome sequencing (rES), PICU, critical illness, and critically ill children. Original studies, multicenter studies, and relevant consensus documents were considered, and the primary literature search was conducted on June 25, 2026, and the final update was performed on August 20, 2026.</p><p><strong>Key content and findings: </strong>Evidence from critical care cohorts indicates that rapid genomic sequencing can increase etiologic diagnosis and influence clinical management through disease-specific therapy, metabolic crisis management, adjustment of antimicrobial or immunomodulatory treatment, avoidance of contraindicated interventions, reduction of low-yield procedures, prognostication, and family risk counseling. Clinical utility depends on appropriate patient selection, rapid turnaround time, trio analysis when feasible, standardized phenotyping, and multidisciplinary interpretation.</p><p><strong>Conclusions: </strong>rWGS can support precision management in critically ill children when integrated into a structured PICU genomic pathway. Nondiagnostic results and variants of uncertain significance require continued reassessment and complementary testing.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"15 9","pages":"393"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183951","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}