Clinical and Experimental Pediatrics最新文献

{"title":"Eosinophil-derived neurotoxin levels can predict allergic disease development and atopic march in children.","authors":"Zak Callaway, Chang-Keun Kim","doi":"10.3345/cep.2024.01382","DOIUrl":"https://doi.org/10.3345/cep.2024.01382","url":null,"abstract":"<p><p>In some children, atopic manifestations begin with atopic dermatitis and progress to allergic asthma and allergic rhinitis; of them, a small subset experience food allergies as well. This progression shares genetic and environmental predisposing factors and immunological features, such as allergen-specific T helper type 2 responses, that manifest as specific immunoglobulin E production and eosinophil activation. Eosinophil-derived neurotoxin (EDN), which is released by eosinophils during this activation, shows promise as a reliable and accurate biomarker. EDN levels are elevated in a subset of patients with atopic march-associated conditions. Elevated EDN levels predict allergic disease development, demonstrating that EDN is a good biomarker for the prognosis, diagnosis, treatment, and monitoring of allergic diseases comprising atopic march. The early measurement of EDN would help identify those who are more likely to develop allergic diseases later in life. Thus, the early detection and treatment of elevated EDN could lead to better outcomes, including halting atopic march.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential effects of dietary and physical activity interventions on adiposity of children with obesity.","authors":"Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho","doi":"10.3345/cep.2024.01347","DOIUrl":"https://doi.org/10.3345/cep.2024.01347","url":null,"abstract":"<p><strong>Background: </strong>Managing obesity in children remains challenging. In addition to body mass index (BMI), incorporating body composition into evaluations of post-obesity interventions would help assess changes in adiposity.</p><p><strong>Purpose: </strong>This study aimed to identify the relationship between dietary intake, physical activity, and changes in BMI z-scores and adiposity among children with obesity.</p><p><strong>Methods: </strong>Children aged 7-15 years with obesity received monthly dietary and physical activity instructions for 6 months. Three-day dietary records and physical activity questionnaires were collected at 0, 3, and 6 months. Body composition was measured using bioelectrical impedance analysis. These relationships were analyzed using uni- and multivariate linear regression analyses.</p><p><strong>Results: </strong>A total of 155 children with obesity completed the 6-month study. A higher total protein intake per ideal weight for height was significantly correlated with a decrease in BMI z-score and trunk fat mass index (trunk fat mass [FM] in kg/height in m2). Mean dietary fiber intake was negatively correlated with BMI z-score, FM, FM index (FMI, FM in kg/height in m2), and visceral fat area (VFA) at 6 months. Each 1 g/kg/day increase in protein intake and additional 1 g/day of dietary fiber intake led to a 0.191 kg/m2 (95% confidence interval [CI], -0.309 to -0.072) and 0.028 kg/m2 (-0.05 to -0.005) reduction in BMI z-score. Each 1 g/day increase in protein intake led to a reduction of 0.009 kg/m² in trunk FMI (-0.016 to -0.002) and 0.21 cm² in VFA (-0.418 to -0.002). The outcomes observed at 6 months were consistent with the overall 6-month findings, reinforcing the efficacy of the intervention.</p><p><strong>Conclusion: </strong>Our study showed beneficial effects of high dietary protein and fiber intakes on BMI z-scores and adiposity of children with obesity. Fine-tuning dietary interventions that emphasize appropriate protein and fiber intakes may be more practical for managing childhood obesity.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus.","authors":"Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn","doi":"10.3345/cep.2024.01340","DOIUrl":"https://doi.org/10.3345/cep.2024.01340","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) vaccination remains an essential strategy for reducing disease burden. Specific guidelines for vaccinating children with systemic lupus erythematosus (SLE) are currently unavailable, highlighting the gap in tailored recommendations for this population.</p><p><strong>Purpose: </strong>This study aimed to estimate parental intention to vaccinate children with SLE against COVID-19 and identify factors associated with this intention. It also explored parents' attitudes toward the vaccine.</p><p><strong>Methods: </strong>Seventy-four parents of patients aged 5-21 years who were diagnosed with SLE before 18 years of age were surveyed regarding their willingness to further vaccinate their children with SLE against COVID-19. The parents were categorized into vaccine acceptance (VA) and vaccine hesitancy (VH) groups and completed a validated six-item questionnaire designed to gauge their attitudes toward the vaccine. Vaccine Hesitancy Scale (VHS) scores were calculated with higher scores indicating increased VH. The adjusted odds ratios (aOR [95% confidence interval]) for VA-associated factors were determined using multivariate analysis.</p><p><strong>Results: </strong>Twenty-five parents (33.8%) were diagnosed with VH. Compared with the VH group, the VA group showed a higher frequency of previous COVID-19 vaccine uptake, completed immunization in children, and parental willingness to be vaccinated themselves. Children were older in the VA versus VH group. The mean total VHS score was significantly higher in the VH versus VA group. In a multivariate model of factors differing significantly between the VA and VH groups, parental willingness to vaccinate themselves (aOR, 5.0 [1.2-20.4]), patient age (aOR, 1.4 [1.1-1.9]), and VHS score on vaccine efficacy belief (aOR, 0.1 [0.0-0.5]) were significantly associated with VA.</p><p><strong>Conclusion: </strong>A significant proportion of parents were hesitant to vaccinate their children with SLE against COVID-19. These insights underscore the importance of developing targeted educational interventions to address specific parental concerns and improve vaccine uptake in children with SLE.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine in pediatrics: things to consider.","authors":"Sandhya J Kadam, Archana Reddy Bongurala","doi":"10.3345/cep.2024.01788","DOIUrl":"https://doi.org/10.3345/cep.2024.01788","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Xmn1 polymorphism on hydroxyurea therapy in children with HbE-βnon-transfusion dependent thalassemia: a cohort study.","authors":"Saheli Roy, Paramita Bhattacharya, Atanu Kumar Dutta, Mrinal Kanti Das","doi":"10.3345/cep.2024.01284","DOIUrl":"10.3345/cep.2024.01284","url":null,"abstract":"<p><strong>Background: </strong>Fetal hemoglobin (HbF) inducers, among which hydroxyurea is the most extensively used, have shifted the paradigm toward the treatment of non-transfusion-dependent thalassemia (NTDT). Xmn1 polymorphism (rs7482144) is characterized by substitution (C>T) at -158 position of the γ-globin gene, which leads to CC, CT, or TT genotype. Recently, the role of the Xmn1 polymorphism as a modifier of hydroxyurea therapy has attracted immense research interest.</p><p><strong>Purpose: </strong>This study aimed to estimate the prevalence of the Xmn1 polymorphism and determine its impact on the efficacy of hydroxyurea therapy in children with NTDT in Eastern India.</p><p><strong>Methods: </strong>This observational ambispective cohort study involved the assessment of 50 patients with NTDT, of whom 28 qualified, who had been receiving hydroxyurea for less than a month. Relevant molecular analyses were performed, and data on the annual transfusion requirement (ATR), height, and HbF level before starting hydroxyurea treatment were derived from medical records. The same parameters were reassessed after six months of hydroxyurea therapy. Furthermore, patients were monitored for drug toxicity.</p><p><strong>Results: </strong>All patients included in this study exhibited HbE-β-thalassemia, thus implying it to be one of the commonest NTDT genotypes in Eastern India. The prevalence rates of CC and CT were 43% and 57%, respectively, and none of the patients harbored the TT genotype. Toxicity developed in 22% of patients; however, it was not significantly associated with the Xmn1 polymorphism. Significant decrease in ATR and increase in height were observed following hydroxyurea therapy in both groups. Nevertheless, the change was more marked in CT genotype (median ATR drop: 33%, increase in median height: 3.7%, pCT = 0.001) than in CC genotype (median ATR drop: 28%, increase in median height: 2.8%, pCC = 0.003).</p><p><strong>Conclusion: </strong>The T allele of the Xmn1 polymorphism had a favorable effect on the efficacy of hydroxyurea in patients with HbE-β-NTDT.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screen time and neurodevelopment in preschoolers: addressing a growing concern in pediatric practice.","authors":"Soongang Park, Hyewon Woo","doi":"10.3345/cep.2024.01536","DOIUrl":"https://doi.org/10.3345/cep.2024.01536","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral nerve sheath tumors in the head and neck in patients with APC gene deletion mutations: a case report and scoping review of the literature.","authors":"Koral Blunt, Monirah Albathi, Miriam Conces, Tendy Chiang","doi":"10.3345/cep.2024.01375","DOIUrl":"https://doi.org/10.3345/cep.2024.01375","url":null,"abstract":"<p><p>Adenomatous Polyposis Coli (APC) is a tumor suppressor gene expressed throughout the body. APC mutations increase the risk of malignancy and are often characterized by syndromes that encompass a spectrum of neoplastic manifestations, such as familial adenomatous polyposis (FAP). We present a rare case of palatal peripheral nerve sheath tumor in the context of APC gene mutation. A 17-year-old male with a significant history of FAP presented to our clinic for with globus sensation for 5 months with increasing discomfort. Flexible nasolaryngoscopy revealed a pedunculated lesion attached to the posterior surface of the soft. Imaging was obtained and confirmed a soft tissue homogenous mass contiguous with the soft palate. Endoscopic-assisted transoral resection was performed and pathologic features were consistent with schwannoma. We also discuss the spectrum of benign neoplastic lesions. Current literature fails to describe pharyngeal masses in the setting of APC gene mutations. The purpose of this case report is to describe a patient presentation of a symptomatic pharyngeal tumor with a known APC gene mutation and explore the differential diagnoses that must be considered.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety disorders presenting as gastrointestinal symptoms in children - a scoping review.","authors":"Anjali Kumar, Pramodh Vallabhaneni","doi":"10.3345/cep.2024.01732","DOIUrl":"https://doi.org/10.3345/cep.2024.01732","url":null,"abstract":"<p><p>Functional gastrointestinal disorders (FGID) and their association with anxiety disorders in children significantly impact a child's functioning and treatment response. This study aimed to scope the evidence of anxiety disorders manifesting as FGID in children up to 16 years old. A comprehensive search strategy was conducted on Embase (1974-2024), Medline (via EBSCOHost 1946-2024), and APA PsycINFO (via EBSCOHost 1967-2024). Articles were retrieved, screened, and assessed for bias using the GRADE system. Our initial search yielded 1984 articles. After screening titles and abstracts, 53 articles remained. Full-text screening further narrowed this to four eligible studies. The first study found that anxiety indirectly influenced abdominal pain severity in children with irritable bowel syndrome (IBS). The second study reported an association between anxiety and abdominal pain but found that anxiety might not predict abdominal pain in later childhood. The third study suggested FGID could be a risk factor for anxiety, with higher anxiety rates in children with FGID compared to those without. The fourth study found no significant difference in pain intensity between children with functional abdominal pain disorders (FAPD) alone and those with FAPD and anxiety. The reviewed studies indicate a relationship between anxiety and FGID but lack clarity on directionality or causation. The limited number of studies calls for more research, including case-control studies with large sample sizes and longitudinal cohort studies to investigate the incidence and causation.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of midregional proadrenomedullin in predicting infection in pediatric cancer with febrile neutropenia.","authors":"Seham Ragab, Sara El-Deeb, Ahmed Saeed, Asmaa Mahmoud","doi":"10.3345/cep.2024.01620","DOIUrl":"https://doi.org/10.3345/cep.2024.01620","url":null,"abstract":"<p><strong>Background: </strong>Febrile neutropenia (FN) remains an important complication of cytotoxic chemotherapy for which an urgent and appropriate evaluation is imperative.</p><p><strong>Purpose: </strong>To assess the diagnostic and prognostic roles of mid-regional pro-adrenomedullin (MR-ProADM) levels in predicting infection in patients with FN.</p><p><strong>Methods: </strong>This comparative cross-sectional study included 137 patients with chemotherapy-induced FN. Complete blood count, C-reactive protein (CRP), procalcitonin, and MR-ProADM were evaluated on the 1st day of FN. Chest computed tomography (CT) was performed on the 5th day.</p><p><strong>Results: </strong>MR-ProADM levels were significantly higher in patients with FN than in controls. CRP and MR-ProADM levels were significantly higher and ANC was significantly lower in patients with versus without bacterial infections. CRP, procalcitonin, and MR-ProADM levels were significantly negatively correlated with absolute neutrophil count (ANC). CRP, procalcitonin, and MR-ProADM levels were significantly and positively correlated with FN degree, FN duration, and hospital stay length. A multivariate regression analysis showed that a longer FN duration and hospital stay length, along with elevated CRP, procalcitonin, and MR-ProADM levels, were significant risk factors for mortality.</p><p><strong>Conclusion: </strong>MR-ProADM is a reliable prognostic and diagnostic tool for predicting infection in patients with FN.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation.","authors":"Upasana Ghosh, Ujjal Poddar, Srinivas Srinidhi Vadlapudi, Moinak Sen Sarma, Anshu Srivastava","doi":"10.3345/cep.2024.01242","DOIUrl":"https://doi.org/10.3345/cep.2024.01242","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}