Clinical and Experimental Pediatrics最新文献

{"title":"Liposomal SunActive versus conventional iron for treatment of iron-deficiency anemia in children aged 2-12 years: a prospective randomized controlled trial.","authors":"Wael A Bahbah, Yasmin A H S Younis, Hanan Salama Elbelouny, Asmaa A Mahmoud","doi":"10.3345/cep.2025.00262","DOIUrl":"https://doi.org/10.3345/cep.2025.00262","url":null,"abstract":"<p><strong>Background: </strong>Liposomal iron, a novel oral formulation of ferric pyrophosphate that demonstrates improved gastrointestinal absorption and bioavailability with fewer side effects than conventional iron, represents a significant advancement in the treatment of iron-deficiency anemia (IDA).</p><p><strong>Purpose: </strong>To conduct an in-depth comparative study of liposomal SunActive and conventional iron supplements (iron polymaltose complex) for treating IDA in children aged 2-12 years.</p><p><strong>Methods: </strong>This prospective randomized controlled trial included 192 children who visited the outpatient clinic of the Pediatric Department at Menoufia University Hospital and were diagnosed with IDA. The patients were divided into group 1, 96 pediatric patients receiving oral liposomal SunActive iron; and group 2, 96 pediatric patients treated with conventional oral iron (iron polymaltose complex).</p><p><strong>Results: </strong>After 1 month of oral iron therapy, group 1 exhibited higher hemoglobin, hematocrit, serum ferritin, and serum iron levels and greater transferrin saturation than group 2. After 6 months of oral iron therapy, hemoglobin level (P<0.001), iron profile (P<0.001), and growth-related anthropometric measurements were higher in group 1 versus group 2 (P<0.001for z score for weight).</p><p><strong>Conclusion: </strong>Iron supplements effectively improve anthropometric measurements, complete blood count parameters, and iron profiles. However, orally administered liposomal SunActive iron exhibits better effects, reduced drug refusal rates, and improved compliance rates, thereby benefiting children's growth.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676033","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":"Beyond the eye: a multidisciplinary perspective on managing pediatric myopia.","authors":"Eoi Jong Seo","doi":"10.3345/cep.2025.00955","DOIUrl":"https://doi.org/10.3345/cep.2025.00955","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676032","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":"Authors' reply: a commentary on \"COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus\".","authors":"Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn","doi":"10.3345/cep.2025.01200","DOIUrl":"https://doi.org/10.3345/cep.2025.01200","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676031","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":"Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study.","authors":"Ajay Kumar, Nidhi Jain","doi":"10.3345/cep.2024.01249","DOIUrl":"10.3345/cep.2024.01249","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the outcomes of jaundiced neonates using 2 different total serum bilirubin (TSB) thresholds for discontinuing phototherapy.</p><p><strong>Purpose: </strong>The study aims to evaluate the outcomes of jaundiced neonates by comparing 2 different TSB thresholds for discontinuing phototherapy.</p><p><strong>Methods: </strong>All consecutive jaundiced neonates in a tertiary care hospital with a gestational age of ≥35 weeks and ≥3 days postnatal age were randomly assigned to 2 groups.</p><p><strong>Results: </strong>Eighty neonates were included. The mean±standard deviation TSB at the time of phototherapy discontinuation was 13.1±2.2 mg/dL in the recommended threshold group and 10.5±2.5 mg/dL in the low threshold group. After discontinuing phototherapy, 17 infants in the recommended threshold group and 21 in the low threshold group experienced an increased TSB, with 3 and 9 crossing the treatment threshold, respectively. Following the National Institute for Health and Clinical Excellence (NICE) guidelines, there was a 14.3% increase in the reinstitution of treatment, averaging 28.11 hours with no reported adverse outcomes.</p><p><strong>Conclusion: </strong>Discontinuation of phototherapy in neonates led to increased TSB levels, with a reinstitution rate of 14.3%. While adherence to the NICE guidelines is important, careful posttreatment monitoring is essential. Incorporating the 2022 American Academy of Pediatrics guidelines into future research could provide a more comprehensive understanding of safe practices in this area.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"539-545"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent sigh breaths during high-frequency oscillatory ventilation among newborn infants.","authors":"Ga Won Jeon","doi":"10.3345/cep.2025.00549","DOIUrl":"10.3345/cep.2025.00549","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"486-488"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea.","authors":"Young Dai Kwon, Eun Sun Jung, Yeon Jung Lim","doi":"10.3345/cep.2024.02026","DOIUrl":"10.3345/cep.2024.02026","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune hemolytic anemia (AIHA) is rare and characterized by hemolytic anemia with a positive direct antiglobulin test result after the exclusion of other causes. While adults often relapse within 1 year of first-line steroid therapy, children generally respond well. However, current treatment approaches lack substantial evidence and are primarily expert opinion-based.</p><p><strong>Purpose: </strong>This study aimed to contribute our single-center experience to pediatric AIHA treatment guidelines.</p><p><strong>Methods: </strong>Between January 2012 and June 2024, 475 children were diagnosed with anemia; of them, 18 had immune hemolytic anemia, including 6 with neonatal alloimmune hemolytic anemia, 2 who were treated at other centers, and 2 with transient bone marrow suppression due to a viral infection. Thus, this study retrospectively analyzed the treatment responses of 8 patients with AIHA.</p><p><strong>Results: </strong>The median age at diagnosis was 5.2 years (range, 2.3-11.8 years); 62.5% (5 of 8) were male. Median hemoglobin (Hb) at diagnosis was 6.3 g/dL (range, 3.4-9.5 g/dL), median reticulocyte index was 6.53% (range, 1.64%-22.07%), median total bilirubin was 2.75 mg/dL (range, 0.98-7.23 mg/dL), and median lactate dehydrogenase was 1,662 U/L (range, 790-2,921 U/L). All haptoglobin levels were <10 mg/dL. Treatments included steroids (8 of 8), red blood cell transfusions (5 of 8), and intravenous immunoglobulins (2 of 8). Half of the steroid-treated patients received intravenous methylprednisolone for 1-5 days, while half received oral prednisolone (median, 1.78 [range, 0.79-3.39] mg/kg/day). The median time to age-adjusted normal Hb levels was 16.5 days (range, 9.0-22.0 days). Steroids were administered for a median 37.5 days (range, 14.0-119.0 days). Excluding one patient later diagnosed with systemic lupus erythematosus, no relapses occurred during the 3- to 19-month follow-up period.</p><p><strong>Conclusion: </strong>Patients with pediatric AIHA showed relapsefree rapid hematological improvement and sustained steroid responses within 2 months, suggesting that systematic steroid treatment is feasible and highlighting the need for multicenter trials to establish standardized guidelines.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"522-529"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of neural tube defects in tertiary care university hospital in Bangladesh.","authors":"Ismat Jahan, Arif Hossain, Shah Nizam Uddin Shaon, Sadeka Choudhury Moni, Mohammad Kamrul Hassan Shabuj, Sanjoy Kumer Dey, Mohammad Abdul Mannan, Mohammod Shahidullah","doi":"10.3345/cep.2024.01578","DOIUrl":"10.3345/cep.2024.01578","url":null,"abstract":"<p><strong>Background: </strong>Although national population-based birth defect prevalence estimates are unavailable for Bangladesh specifically, data extrapolated from the March Dimes Global Birth Defects Report indicate a prevalence of neural tube defects (NTDs) of 4.7 per 1,000 live births.</p><p><strong>Purpose: </strong>This study aimed to determine the prevalence of NTD among infants born at a tertiary care multidisciplinary referral hospital in Bangladesh.</p><p><strong>Methods: </strong>Live born infants with NTD were prospectively enrolled in 2015-2021. Each enrolled NTD case was examined for type, location, and associated anomalies. The overall and annual prevalence rates were then calculated.</p><p><strong>Results: </strong>A total of 10,372 newborns were enrolled; of them, 68 had NTD (incidence, 6.4 [range, 4.59-11.2] per 1,000 live births). The mean maternal age was 27.49± 4.72 years. Three-quarters of the NTD cases were detected at birth, and 94% of the mothers reported not taking periconceptional folic acid supplements. The meningomyelocele complex was the most frequent location. Two peaks in incidence were noted in 2017 and 2021 (10.28 and 11.2 per 1,000 live births, respectively). The distribution of different NTD types included meningomyelocele at 53%, encephalocele at 26.6%, meningocele at 16%, and anencephaly at 4.4%. A male predominance was noted overall except for anencephaly. The most common location was the lumbosacrum (47%). The NTD was isolated in 20.59% (14 of 68) of cases and associated with other malformations in 80% (54 of 68) of cases.</p><p><strong>Conclusion: </strong>The incidence of NTD was 6.4 per 1,000 live births at a leading tertiary care multidisciplinary referral center in Bangladesh. However, this figure might not reflect the incidence of NTD in the wider population.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"530-538"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the United States: a cross-sectional study.","authors":"Chuhan Cheng, Liyan Zhang","doi":"10.3345/cep.2024.01844","DOIUrl":"10.3345/cep.2024.01844","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with various diseases including respiratory conditions. However, the relationship between NLR and asthma in the pediatric population remains underexplored.</p><p><strong>Purpose: </strong>This study aimed to explore the association between NLR and asthma in children and adolescents and assess its potential role as a predictive biomarker for pediatric asthma.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of 12,974 children and adolescents from the National Health and Nutrition Examination Survey in 2011-2020. NLR was defined as the ratio of NLR counts. Asthma was diagnosed using a structured questionnaire. Multivariate logistic regression models were used to evaluate the association between NLR and asthma. A restricted cubic spline was used to explore nonlinear relationships, and a threshold analysis was conducted to identify potential cutoff values for the NLR.</p><p><strong>Results: </strong>A total of 12,974 children and adolescents were included (male: 6,686 [51.5%]; mean [interquartile range] age, 10 [5.0-14.0 years]). After the adjustment for confounders, participants with the highest versus lowest NLR exhibited a significantly elevated risk of asthma (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.13-1.71). Additionally, a multivariate restricted cubic spline analysis revealed a nonlinear relationship between NLR and asthma (P=0.023). A threshold analysis revealed that an NLR<2.23 was significantly associated with an increased risk of asthma (OR, 1.23; 95% CI, 1.05-1.45), while an NLR≥2.23 showed no significant association. A subgroup analysis revealed no interactive role of NLR and asthma.</p><p><strong>Conclusion: </strong>Our findings indicate a nonlinear saturation-effect relationship between NLR and asthma in children and adolescents.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"489-496"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NLRP3 inflammasome: a key player in neonatal brain injury.","authors":"Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc","doi":"10.3345/cep.2024.01935","DOIUrl":"10.3345/cep.2024.01935","url":null,"abstract":"<p><p>Among neonates, hypoxic-ischemic encephalopathy is the most significant cause of mortality and hypoxia-ischemia is among the leading causes of brain damage. The microglia are primary mediators of neuroinflammation. NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activation is the first line of defense in the central nervous system. Numerous studies have shown that the NLRP3 inflammasome is activated and proinflammatory cytokines are upregulated upon hypoxia-ischemia-induced brain damage. However, aberrant activation of the NLRP3 inflammasome results in cell death and brain tissue damage. Given that neonates are particularly vulnerable to neuroinflammation, which may cause lifelong disabilities, it is important to target the pathways involved in its complex nature to improve their prognosis. The potential use of compounds or drugs that target inflammasome activation to relieve hypoxia-induced brain damage has become significant. This review describes the NLRP3 inflammasome in neonates to contribute to the development of therapeutic approaches.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"475-485"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of microRNA-498 and microRNA-410 in neonatal hypoxic-ischemic encephalopathy.","authors":"Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Sabri Abouzouna","doi":"10.3345/cep.2024.01669","DOIUrl":"10.3345/cep.2024.01669","url":null,"abstract":"<p><strong>Background: </strong>Neonatal asphyxia is the primary cause of hypoxic-ischemic encephalopathy (HIE), a condition characterized by hypoxic and ischemic brain damage. A class of short noncoding RNAs known as microRNAs (miRNAs) have significant regulatory functions, can function as diagnostic and developmental indicators of diseases, and are involved in disease pathophysiology.</p><p><strong>Purpose: </strong>To study the role of microRNA-410 and micro RNA-498 in neonatal HIE as well as control and prevention of neonatal encephalopathy.</p><p><strong>Methods: </strong>A case-control study was performed of on 30 full-term neonates with proven HIE, and 30 clinically healthy full-term neonates with no evidence of HIE matched for age and sex serving as controls. The expression of microRNA-498 and microRNA-410 were measured using quantitative real-time polymerase chain reaction.</p><p><strong>Results: </strong>Levels of miRNA-410 and miRNA-498 were higher in cases versus controls (1.56±6.43 copies/mL vs 0.58±0.60 copies/mL) and (55.63±118.24 copies/mL vs 3.74± 7.09 copies/mL), respectively. Of the cases, 66.7% were discharged cases and 33.3% died. Overall miRNA-410 had a sensitivity of 70%, specificity of 60%, and cutoff point of ≤0.242, whereas miRNA-498 had a sensitivity of 70%, specificity of 66.7%, and cutoff point >1.854.</p><p><strong>Conclusion: </strong>These findings suggest that miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"512-521"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}