Translational pediatrics最新文献

{"title":"A rare <i>de novo</i> mutation, m.1630A>G, in the mitochondrial tRNAVal (<i>MT-TV</i>) gene in a child with epilepsy: case report and review of the literature.","authors":"Qiong Wang, Yan Chen, Jun Li, Baomin Li","doi":"10.21037/tp-24-462","DOIUrl":"10.21037/tp-24-462","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial diseases represent a diverse group of disorders caused by defects in mitochondrial DNA (mtDNA) or nuclear DNA (nDNA), leading to a wide range of clinical manifestations. These diseases can affect multiple organs, particularly the nervous system, and present with symptoms such as epilepsy, neurodevelopmental delays, and muscular disorders. Over 300 genetic mutations have been linked to these conditions, with clinical heterogeneity being a hallmark of mitochondrial diseases. Early diagnosis and management are crucial, especially in pediatric cases where the disease burden may evolve with age. The aim of this study is to explore the variability in clinical presentation and progression associated with specific genetic mutations, using the case of a rare <i>de novo</i> mutation in the <i>MT-TV</i> gene as an illustrative example, and to discuss the implications for clinical diagnosis.</p><p><strong>Case description: </strong>This paper reports on a rare <i>de novo</i> mutation, m.1630A>G, in the <i>MT-TV</i> gene of a 3-year-old boy with epilepsy. In contrast to previously reported cases of the mitochondrial neurogastrointestinal encephalopathy (MNGIE)-like disease/the mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) associated with the m.1630A>G mutation, this patient exhibited an earlier age of onset, simpler clinical manifestations, and lower heterogeneity levels in the blood.</p><p><strong>Conclusions: </strong>This case offers significant insights into the intricate nature of mitochondrial diseases, especially in pediatric populations. It highlights the critical importance of regular physical examinations and vigilant monitoring for potential multi-system involvement, which are essential for early detection and timely symptomatic intervention to mitigate further damage. Furthermore, this case underscores the necessity to investigate factors influencing clinical penetrance, such as the interplay between mitochondrial and nuclear gene mutations, heterogeneity levels, and age-related accumulation of cellular damage, to better understand disease progression and optimize therapeutic strategies.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"367-372"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671038","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":"Headache attributed to rhinosinusitis in pediatric patients: clinical insights and diagnostic implications.","authors":"Eu Gene Park, Seung Beom Han, Jin Lee, Jee Min Kim, Ji Yoon Han","doi":"10.21037/tp-24-481","DOIUrl":"10.21037/tp-24-481","url":null,"abstract":"<p><strong>Background: </strong>Headache attributed to rhinosinusitis (HRS) is relatively uncommon in pediatric patients and frequently misdiagnosed as a primary headache disorder. This study was conducted to identify the clinical characteristics of HRS [bacterial rhinosinusitis (BRS) and non-BRS] and determine the appropriate treatment of headaches.</p><p><strong>Methods: </strong>The medical records of 1,777 individuals who exhibited headache and underwent neuroimaging studies at two institutions between January 2014 and December 2023 were retrospectively reviewed.</p><p><strong>Results: </strong>Of the 1,777 patients, 203 (11.3%) were diagnosed with HRS (47 with BRS, 90 with non-BRS, and 66 unclassified). The proportion of male patients was significantly higher in the BRS group (76.6% <i>vs.</i> 57.8%, P=0.02). A comparison of clinical characteristics between the BRS and non-BRS groups revealed significantly higher frequencies of respiratory symptoms in the BRS group (P<0.001) and blurred vision in the non-BRS group (P=0.03). The BRS group demonstrated the involvement of a greater number of sinuses and more frequent use of therapies, including antibiotics and antihistamines (P<0.001 for both).</p><p><strong>Conclusions: </strong>Recognizing the clinical characteristics of BRS and non-BRS is important for the accurate diagnosis and optimal management of pain in pediatric patients with headache, as alleviating headaches significantly could affect both the quality of life and academic performance.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"161-170"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671082","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":"Pleomorphic xanthoastrocytoma and treatment of epilepsy: a case report.","authors":"Nan Wu, Jibin Ren, Guodong Li, Yongjun Wang, Xi Wu, Dong Li, Yuqin Zhang, Zhongbin Zhang","doi":"10.21037/tp-24-306","DOIUrl":"10.21037/tp-24-306","url":null,"abstract":"<p><strong>Background: </strong>Pleomorphic xanthoastrocytoma (PXA) is a rare central nervous system (CNS) tumor. Clinical manifestations often start with seizures, and the lesions are often located in the superficial parts of the cerebral hemisphere, especially in the temporal lobe. Patients with PXA can be cured via surgical treatment, but whether the seizure can be controlled by simply removing the tumor through surgery still needs to be determined.</p><p><strong>Case description: </strong>The patient was a 10-year-old boy with clinical manifestations of recurrent epileptic seizures. Preoperative standardized antiepileptic drug treatment failed to control seizures. The patient's electroencephalogram (EEG) showed was the right temporal lobe is the main slow wave and spike slow wave emitting area, and magnetic resonance imaging (MRI) showed was structural abnormalities in the right anterior temporal cortex. After multidisciplinary preoperative evaluation at the epilepsy center of Tianjin Children's Hospital, lesion enlargement resection was performed with the assistance of multimodal imaging and electrocorticography (ECoG) monitoring. There were no epileptic seizures during the 6-month follow-up after surgery.</p><p><strong>Conclusions: </strong>For this patient with PXA accompanied by epilepsy, surgical resection can be the first line of treatment. Meanwhile, a comprehensive multidisciplinary preoperative evaluation should be conducted rather than solely relying on neurosurgery to determine surgical treatment. Additionally, imaging and intraoperative ECoG are crucial for the success of surgery and appropriate enlargement and resection can effectively eliminate epileptic seizures.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"329-337"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671191","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":"Non-invasive brain stimulation for upper extremity dysfunction in children with cerebral palsy: a systematic review and meta-analysis.","authors":"Yage Zhang, Mengru Zhong, Tingting Peng, Tingting Chen, Simian Cai, Zhaofang Chen, Kaishou Xu","doi":"10.21037/tp-24-488","DOIUrl":"10.21037/tp-24-488","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are the most commonly used non-invasive brain stimulation (NIBS) techniques. However, NIBS for upper extremity dysfunction remains unclear in children with cerebral palsy (CP). Thus, we aim to determine safety and effectiveness of NIBS for upper extremity dysfunction in children with CP.</p><p><strong>Methods: </strong>Two reviewers conducted literature search on five databases including PubMed, Web of Science, ProQuest, Scopus, and Embase independently. Systematic review and meta-analyses of included studies were conducted. Studies used standardized mean difference (SMD) and 95% confidence interval (CI) to calculate pooled effect size between two groups. The statistics I² was used to assess the heterogeneity between randomized controlled trials (RCTs).</p><p><strong>Results: </strong>Fifteen studies were included, with seven of which examined rTMS and eight studied tDCS. Total 366 children with CP were included. Changes in Box and Block Test (BBT) of the affected hand changed significantly in post (SMD =0.68; 95% CI: 0.02 to 1.34; P=0.044; I²=0%) and 90-minute effect (SMD =0.69; 95% CI: 0.02 to 1.36; P=0.04; I²=0%), and Modified Ashworth Scale (MAS) (SMD =-0.51; 95% CI: -0.99 to -0.03; P=0.04; I²=0%) after using tDCS were statistically significant. There was no difference of total number of dropouts between each group. No patients experienced serious adverse events.</p><p><strong>Conclusions: </strong>NIBS is safe and well tolerated in children with CP. And current evidence suggests that when safety guidelines are followed, NIBS does not induce seizures in pediatric patients with no history of epilepsy or stable epilepsy. tDCS is effective in improving upper extremity dysfunction such as fine motor function especially hand dexterity, and reducing upper extremity spasticity in children with CP. Due to insufficient studies, the effectiveness of rTMS is uncertain.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"262-285"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671189","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":"Mitophagy and immune cell interaction: insights into pathogenesis and potential targets for necrotizing enterocolitis.","authors":"Xinyun Jin, Wenqiang Sun, Yihui Li, Xueping Zhu","doi":"10.21037/tp-24-441","DOIUrl":"10.21037/tp-24-441","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Neonatal necrotizing enterocolitis (NEC) is a fatal disease in early life characterized by an inflammatory response or even necrosis of the bowel wall. NEC is one of the leading causes of preterm infant mortality. The pathogenesis of NEC is intricate and involves mitochondrial damage to intestinal cells and infiltration of immune cells. However, the specific functions of mitophagy and its association with immune cells in NEC remain unclear. The aim of this study was to explore the pivotal roles of mitophagy and the immune microenvironment in NEC and their potential interactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Microarray data (GSE46619) associated with NEC were obtained from the Gene Expression Omnibus (GEO) at the National Center for Biotechnology Information (NCBI). Differentially expressed genes (DEGs) were screened by GEO2R. Mitophagy gene data were downloaded from the Pathway Unification database and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Consequently, mitophagy-related differentially expressed genes (MRDEGs) were obtained. To identify hub MRDEGs that are closely associated with NEC, we used CytoHubba, Molecular Complex Detection (MCODE) and Comparative Toxicogenomics Database (CTD) scores. Cytoscape and miRWalk databases were used to predict the transcription factors (TFs) and target microRNAs (miRNAs) of hub MRDEGs, respectively, and a regulatory network was established. The ImmuCellAI was used to analyze the pattern of immune infiltration, and the Spearman correlation was used to investigate the relationship between the hub MRDEGs and the abundance of infiltrating immune cells. Finally, the expression levels of the hub MRDEGs were verified by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting in NEC animal model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 14 up-regulated and 22 down-regulated MRDEGs were identified, these genes exhibited enrichment in mitophagy, and inflammation-related pathways. Furthermore, 13 hub MRDEGs closely related to NEC were identified. The increased presence of immune cells such as neutrophils, M1 macrophages, and activated mast cells were observed while adaptive immune cells including B cells and various T-cell subsets exhibited reduced infiltration. Furthermore, up-regulated MRDEGs were positively correlated with the proinflammatory immune cell infiltration, and the down-regulated MRDEGs were positively correlated with the anti-inflammatory immune cell infiltration. &lt;i&gt;In vivo&lt;/i&gt; experiments demonstrated that the expressions of four genes &lt;i&gt;Hif-1a&lt;/i&gt;, &lt;i&gt;Acsl4&lt;/i&gt;, &lt;i&gt;Pck2&lt;/i&gt;, and &lt;i&gt;Aifm1&lt;/i&gt; were consistent with the bioinformatics analysis results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The potential interplay of mitophagy and immune cells is crucial in the onset and progression of NEC. This perspective opens the door for deeper investigations into NEC pathogenesis, presenting a possibl","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"171-186"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671171","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":"Clinical, genetic characteristics and long-term follow-up of sitosterolemia in children.","authors":"Shuyue Huang, Mu Du, Xi'ou Wang, Yi Liu, Fuying Song","doi":"10.21037/tp-24-457","DOIUrl":"10.21037/tp-24-457","url":null,"abstract":"<p><strong>Background: </strong>Sitosterolemia is a rare lipid disorder characterized by elevated phytosterols and low-density lipoprotein cholesterol (LDL-C), resulting from pathogenic variants in the <i>ABCG5</i> and/or <i>ABCG8</i> genes. To enhance the understanding of this condition, we systematically summarized the clinical manifestations, laboratory findings, gene variations, and treatment effect outcomes in 12 pediatric patients diagnosed with sitosterolemia.</p><p><strong>Methods: </strong>The clinical features, laboratory profiles, and gene variations of 12 children diagnosed with sitosterolemia were analyzed. Long-term follow-up was conducted, with the longest observation period exceeding 8 years.</p><p><strong>Results: </strong>A total of 12 patients with sitosterolemia were diagnosed at our center. The age at diagnosis ranged from 4 months to 8.3 years, with a median age of 1.2 years. Seven patients presented with xanthoma. All patients underwent genetic testing, which revealed <i>ABCG5</i> variants in 10 patients and an <i>ABCG8</i> pathogenic variant in one patient; no detectable variants were identified in one patient. Serum sitosterol levels were measured in nine patients, confirming the diagnosis in all cases. Nine patients were managed with a diet low in cholesterol and phytosterols, while three patients received ezetimibe and/or cholestyramine. Long-term follow-up demonstrated reductions in total cholesterol (TC) and LDL-C levels across all patients. Notably, xanthomas resolved in three patients within 1-2 years of treatment, and significant improvement was observed in the remaining four patients.</p><p><strong>Conclusions: </strong>Xanthoma is a hallmark clinical feature in pediatric sitosterolemia, with most cases linked to variants in the <i>ABCG5</i> gene. Genetic testing and serum phytosterol profiling are essential for diagnosis. Dietary modification alone can achieve favorable outcomes in a substantial number of patients. Furthermore, ezetimibe and cholestyramine have proven effective in managing sitosterolemia in children, contributing to significant clinical improvement.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"222-230"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671145","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":"Comparative analysis of laparoscopic and transumbilical incision open pyeloplasty for treatment of infants with ureteropelvic junction obstruction: a clinical efficacy and safety study.","authors":"Han Chu, Qifei Deng, Yongsheng Cao, Xin Yu","doi":"10.21037/tp-2024-503","DOIUrl":"10.21037/tp-2024-503","url":null,"abstract":"<p><strong>Background: </strong>The treatment for the renal ureteropelvic junction obstruction (UPJO) is mainly dominated by laparoscopic minimally invasive techniques. Open surgery is used less frequently. However, in regions where endoscopic techniques are not yet well-developed or in very young infants, open pyeloplasty (OP) still plays a significant role. This study aims to investigate the clinical efficacy and safety of transumbilical incision open pyeloplasty (TUOP) in infants by comparing it with laparoscopic pyeloplasty (LP).</p><p><strong>Methods: </strong>A retrospective analysis involving 40 infants (≤6 months) who underwent pyeloplasty at Department of Urology, Anhui Provincial Children's Hospital was conducted between April 2021 and April 2024. Eighteen infants were in the TUOP group, and 22 were in the LP group. After operation, the mean follow-up period of all infants was 18 (range, 6-28) months. The two groups were compared in terms of age, weight, operation time, duration of the indwelling catheter and peritoneal drainage, postoperative incision satisfaction, hospitalization costs and degree of recovery from postoperative hydronephrosis.</p><p><strong>Results: </strong>There were no significant differences between the two groups in terms of the duration of abdominal drainage tubes used (P=0.67) or the duration of catheter retention (P=0.56). There were significant statistical differences between the two groups in terms of age (P=0.003), weight (P=0.02), operation time (P<0.001), postoperative incision satisfaction (P=0.03), and hospitalization costs (P=0.04). Compared with the preoperative results, the postoperative Society of Fetal Urology (SFU) grades were significantly improved in both groups.</p><p><strong>Conclusions: </strong>Compared with the LP approach, TUOP treatment for infants with giant hydronephrosis is safe and effective, it has the advantages of a shorter surgical time, lower hospitalization costs, and involves an aesthetic and concealed incision. It is more worthy of promotion and application in younger infants or economically disadvantaged areas where endoscopic techniques are underdeveloped.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"231-239"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671159","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":"Management of pediatric renal trauma with urinary extravasation: a retrospective study in a single clinical center.","authors":"Xiaojiang Zhu, Saisai Liu, Yunfei Guo, Yongji Deng","doi":"10.21037/tp-2024-492","DOIUrl":"10.21037/tp-2024-492","url":null,"abstract":"<p><strong>Background: </strong>The majority of adult renal trauma patients choose conservative treatment, while the proportion of pediatric renal trauma patients requiring surgical intervention is higher than that of adult patients, especially grade IV renal trauma with urinary extravasation or urinoma. There has been an ongoing discussion about the need for timely surgical intervention in such pediatric patients. This study aims to investigate the therapeutic strategies of grade IV renal trauma with urinary extravasation in children.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the diagnosis and treatment of 19 cases of pediatric grade IV renal trauma with urinary extravasation at Children's Hospital of Nanjing Medical University from December 2016 to December 2023.</p><p><strong>Results: </strong>The cohort included patients with multiple injuries (n=7) and ureteropelvic junction ruptures (n=5). Initial assessment involved plain computed tomography (CT) scans for 14 patients, while 5 cases underwent delayed CT imaging to evaluate the extent of trauma. Treatment modalities included ultrasound-guided drainage of perinephric urinoma (n=2), cystoscopic double J-tube placement (n=7), nephrostomy (n=2), pelvic repair and pyeloureteroplasty (n=6), and calyceal-ureteral anastomosis (n=2). Follow-up ranged from 2 to 61 months, with an average of 15.9 months. The interventions demonstrated favorable outcomes, with complete recovery in 9 cases of urinoma drainage and ureteral stenting as evidenced by regular ultrasound monitoring. Two nephrostomy patients required revision surgery due to tube complications. Five of six cases who underwent pyeloureteroplasty recovered well, except for one who presented with moderate hydronephrosis, yet functional evaluation showed effective urinary excretion without significant obstruction. Both patients who received calyceal-ureteral anastomosis reported satisfactory healing.</p><p><strong>Conclusions: </strong>Effective management of pediatric grade IV renal trauma with urinary extravasation necessitates comprehensive imaging, with delayed CT scanning serving as the modality of choice when permissible. Regular follow-up via ultrasound or CT is critical for conservatively managed cases. Surgical intervention should be considered for patients with ongoing urinary extravasation, expanding urinoma, post-traumatic hydronephrosis, or suspected ureteropelvic junction disruption. The therapeutic approach, including ureteral stenting, renal laceration repair, or calyceal-ureteral anastomosis, should be tailored to the individual patient's condition.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"200-207"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671164","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":"Impacts of red blood cell suspension storage on pediatric outcomes: pediatric medicine and pediatric surgery.","authors":"Mingwei Yin, Guannan Bai, Yangyang Zhong, Jihua Ma, Dandan Tian, Xuying Guo, Chao Zhou, Baohai Chen, Xuejun Chen, Zhigang Gao","doi":"10.21037/tp-24-433","DOIUrl":"10.21037/tp-24-433","url":null,"abstract":"<p><strong>Background: </strong>Impacts of red blood cell (RBC) suspension storage on outcomes in pediatric patients receiving RBC transfusions remains uncertain. Therefore, our objective is to examine the association between RBC storage duration and outcomes in pediatric patients.</p><p><strong>Methods: </strong>A retrospective study was conducted on 222 patients admitted to medical and surgical departments at our center in 2021. Primary outcomes assessed were 28-day mortality and length of hospital stays, while secondary outcomes included transfusion-related complications, total volume of RBC transfusions, number of RBC transfusions, and interval between RBC transfusions. Patients were categorized into the fresh group (≤10 days) and the old group (≥21 days) based on RBC storage time.</p><p><strong>Results: </strong>Following RBC transfusions, there was a significant improvement in post-transfusion hemoglobin, RBC counts, and hematocrit in both internal medicine and surgery departments. Among medical patients, the fresh group exhibited a shorter hospital stays compared to the old group [hazard ratio (HR) =0.677; 95% confidence interval (CI): 0.476 to 0.961; P=0.03]; however, no significant difference was observed among surgical patients. Within surgical patients, the fresh group showed longer interval between RBC transfusions (HR =2.235; 95% CI: 1.145 to 4.363; P=0.02) and required fewer number of RBC transfusions (P=0.04). No significant differences were found in hemoglobin, RBC counts, hematocrit, K⁺, Ca²⁺, lactate (Lac), and pH after RBC transfusions.</p><p><strong>Conclusions: </strong>RBC storage was not associated with 28-day mortality in medical and surgical pediatric patients. Fresh RBC transfusions were found to reduce the length of hospital stays by 32.3% in medical patients, extend the interval between RBC transfusions by 1.235 times and decrease the number of RBC transfusions in surgical patients.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 2","pages":"187-199"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671085","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":"Shorter treatments for (febrile) urinary tract infections: are we there?","authors":"Gerdien A Tramper-Stranders","doi":"10.21037/tp-24-447","DOIUrl":"10.21037/tp-24-447","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 1","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410921","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}