Clinical and Experimental Pediatrics最新文献

{"title":"The role of serum zinc and selenium levels in etiology of febrile seizures.","authors":"Yavuz Ataş, Hatice Gamze Poyrazoğlu","doi":"10.3345/cep.2024.01410","DOIUrl":"10.3345/cep.2024.01410","url":null,"abstract":"<p><strong>Background: </strong>Febrile seizures (FSs) are the most common form of childhood seizures. Determining the role of trace elements in the pathophysiology of FSs will contribute to the management of FSs by pediatricians.</p><p><strong>Purpose: </strong>This study aimed to investigate the effects of zinc and selenium on the nervous system and how they may influence the risk of FSs.</p><p><strong>Methods: </strong>In this case-control study, there were 60 children in the simple FS group and 40 children in the complex FS group. The control groups comprised 50 children with fever but without seizures and 50 healthy children. Blood samples were collected within the first hour after FS.</p><p><strong>Results: </strong>Zinc and selenium levels were significantly lower in children with fever but without seizures versus healthy children (P<0.001). Serum zinc levels were lower in children with FSs (simple and complex FSs) than in healthy children (P<0.001) but higher than in children with fever but without seizures (P<0.001). Serum selenium levels in children with FSs (simple and complex) were lower than in healthy children but higher than in the children with fever but without seizures. However, these differences were not statistically significant (P>0.05).</p><p><strong>Conclusion: </strong>Serum zinc levels are significantly decreased during infection, whereas they show a statistically significant increase within the first hour after FS activity. This indicates that the body secretes zinc during FSs to restore homeostasis, reduce oxidative stress, and increase the seizure threshold. Therefore, zinc supplementation during febrile periods may effectively prevent FSs in high-risk children.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"388-394"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984980","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":"Further research on impact of microplastics on children's health is essential to protecting future generations.","authors":"Jongin Lee, Dong-Wook Lee","doi":"10.3345/cep.2024.01459","DOIUrl":"10.3345/cep.2024.01459","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"359-361"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629615","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":"https://doi.org/10.3345/cep.2025.00549","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001391","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":"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":"https://doi.org/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 six with neonatal alloimmune hemolytic anemia, two who were treated at other centers, and two with transient bone marrow suppression due to a viral infection. Thus, this study retrospectively analyzed the treatment responses of eight patients with AIHA.</p><p><strong>Results: </strong>: The median age at diagnosis was 5.2 (range, 2.3-11.8) years; 62.5% (5/8) were male. Median hemoglobin (Hb) at diagnosis was 6.3 (range, 3.4-9.5) g/dL, median reticulocyte index was 6.53% (range, 1.64-22.07%), median total bilirubin was 2.75 (range, 0.98-7.23) mg/dL, and median lactate dehydrogenase was 1662.0 (range, 790-2921) U/L. All haptoglobin levels were <10 mg/dL. Treatments included steroids (8/8), red blood cell transfusions (5/8), and intravenous immunoglobulins (2/8). 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 (range, 9-22) days. Steroids were administered for a median 37.5 (range, 14-119) days. Excluding one patient later diagnosed with systemic lupus erythematosus, no relapses occurred during the 3-19-month follow-up period.</p><p><strong>Conclusion: </strong>: Patients with pediatric AIHA showed relapse-free 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":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030953","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: a comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.3345/cep.2025.00304","DOIUrl":"https://doi.org/10.3345/cep.2025.00304","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047560","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":"Factors associated with thiamin deficiency in pediatric patients with heart disease and receiving diuretics: a single-center study.","authors":"Phakwan Laohathai, Rathaporn Sumboonnanonda, Puthita Saengpanit, Chodchanok Vijarnsorn, Chatchawan Srisawat, Kwanjai Chotipanang, Sarawut Junnu, Supawan Kunnangja, Hathaichanok Rukprayoon, Phakkanan Phuangphan, Sompong Liammongkolkul, Arthima Phaokong, Narumon Densupsoontorn","doi":"10.3345/cep.2024.01893","DOIUrl":"https://doi.org/10.3345/cep.2024.01893","url":null,"abstract":"<p><strong>Background: </strong>: Thiamin deficiency (TD) manifesting clinically as wet beriberi can significantly impair a patient's cardiac function. Children with heart disease who are receiving diuretic treatment may be at increased risk for severe clinical manifestations of TD.</p><p><strong>Purpose: </strong>: This study aimed to determine the prevalence of TD and evaluate the association between various factors with thiamin status in pediatric patients with heart disease undergoing diuretic treatment.</p><p><strong>Methods: </strong>: Children with heart disease aged 1 month to 15 years who exhibited increased pulmonary blood flow or congestive heart failure and had been taking diuretics for at least 1 month were recruited. Data regarding their heart condition, treatment, dietary intake, anthropometry, and symptoms and signs of TD were collected. An erythrocyte transketolase activity assay after the addition of exogenous thiamin pyrophosphate was used to assess thiamin status. Left ventricular ejection fraction and N-terminal pro-brain natriuretic peptide levels were indicators of cardiac function and laboratory evidence of congestive heart failure (CHF), respectively.</p><p><strong>Results: </strong>: A total of 68 participants were recruited, of whom 10 (15%) had TD. TD was not associated with a CHF exacerbation. An adequate dietary thiamin intake was associated with a better thiamin status (β: -0.37, P=0.003), while increasing age was linked to a poorer thiamin status (β: +0.40, P=0.001).</p><p><strong>Conclusion: </strong>: Thiamin deficiency was present in 15% of pediatric patients with heart disease who were receiving diuretic treatment. An adequate dietary thiamin intake appeared to have a protective effect against thiamin deficiency, while increasing age was associated with a poorer thiamin status.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050944","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":"Cost-effectiveness of newborn screening for severe combined immunodeficiency: a systematic review.","authors":"Rezwanul Rana, Syed Afroz Keramat, Moin Ahmed","doi":"10.3345/cep.2025.00052","DOIUrl":"https://doi.org/10.3345/cep.2025.00052","url":null,"abstract":"<p><p>Severe combined immunodeficiency (SCID) is a rare genetic disorder that causes severe infections and death in early childhood. Newborn bloodspot screening (NBS) for SCID using the T-cell receptor excision circle assay can revolutionize the early detection and treatment of infants with SCID, leading to improved quality of life and life expectancy. This systematic review aimed to examine the cost-effectiveness of universal NBS for SCID. The MEDLINE, Embase, NHS Economic Evaluation Database, Health Technology Assessment, Scopus, and EconLit databases were searched for studies of the NBS for SCID published between January 2008 and March 2024. A standardized data extraction form was used to gather pertinent data such as characteristics, design, perspective, screening strategies and costs, health outcomes, incremental cost-effectiveness ratios, and sources of uncertainty. Eight studies met our inclusion criteria: six cost-utility analyses and two cost-effectiveness analyses. All studies were model-based economic evaluations. These studies indicated that universal NBS for SCID is highly likely to demonstrate health system and societal cost-effectiveness. The incremental cost-effectiveness ratio per quality-adjusted life-year gained ranged from $30,214-54,282 (USD 2022 value). Evidence suggests that early treatment of SCID is beneficial and that population-based NBS provides good value for the money. However, policymakers require better information about optimal treatment and treatment and screening costs to make informed decisions regarding competing healthcare priorities.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031654","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":"Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: A randomized controlled trial.","authors":"Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh","doi":"10.3345/cep.2024.01970","DOIUrl":"https://doi.org/10.3345/cep.2024.01970","url":null,"abstract":"<p><strong>Background: </strong>The role of vitamin C in children with community-acquired pneumonia (CAP) in children is controversial; moreover, a standard dose is lacking.</p><p><strong>Purpose: </strong>This study aimed to evaluate the ability of vitamin C to reduce symptom severity and length of hospital stay among children with CAP as well as determine its optimal dose.</p><p><strong>Methods: </strong>This randomized controlled clinical trial was conducted between July 2020 and October 2023. The participating patients were aged 6 months to 15 years, had CAP, and required hospitalization at Naresuan University Hospital. The patients were randomly assigned to placebo, low-dose vitamin C (15 mg/kg/dose every 6 h), and high-dose vitamin C (30 mg/kg/dose every 6 h) groups. Treatment was provided until discharge and doses maximized after 3 days. The patients' clinical symptoms and side effects were recorded every 12 h.</p><p><strong>Results: </strong>This study included 143 patients (median age, 3 years). The clinical severity score improved significantly in the low- and high-dose vitamin C versus placebo groups at 48-72 h. Vitamin C supplementation did not reduce the length of hospital stay in any group.</p><p><strong>Conclusion: </strong>Vitamin C supplementation did not reduce the length of hospital stay among patients with CAP who required hospitalization. However, it improved the mean clinical severity score, with the greatest reduction observed at 48 h post-treatment. A dose of 15 mg/kg was demonstrated effective with minimal side effects.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056850","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":"Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants.","authors":"Eduardo Cuestas, Alina Rizzotti","doi":"10.3345/cep.2024.01354","DOIUrl":"10.3345/cep.2024.01354","url":null,"abstract":"<p><p>Very preterm infants (VPIs) often experience extrauterine growth failure. Therefore, aggressive nutritional management of VPIs is recommended with the goal of achieving the postnatal growth of an equivalent fetus. However, VPIs frequently present postnatal length growth restriction at term-corrected age that remains lower than the standard weight and have greater fat mass and lower lean and bone mass than term-born infants. This condition differs from the classic pattern of infant undernutrition defined as a significantly lower weight for a given length. Moreover, it suggests that nonnutritional factors play a key role in length growth restriction. While weight faltering has been extensively studied, the significance of length growth failure in VPIs has only recently emerged. The nonnutritional factors underlying poor length growth in VPIs are currently not fully understood. In this review, we address recent advances in our understanding of the pathophysiology of length growth restriction, which has been identified as a major predictor of adverse neurodevelopmental and cognitive outcomes in VPIs. First, we review the shortand long-term consequences of poor length growth in VPIs; next, we highlight the effects of nonnutritional factors on postnatal length growth with focus on sustained neonatal inflammation; and finally, we discuss hypothesis and future lines of research attempting to understand the complex inflammatory-endocrine interactions and pathophysiological changes during early postnatal life, appropriately guide and apply clinical strategies aimed at optimizing length growth of VPIs, and identify evidence of the associations between sustained neonatal inflammation, stunting, and long-term health risks and the potential implications thereof.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"287-297"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898956","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":"Global breastfeeding efforts: a long way to go.","authors":"Hye-Jung Shin","doi":"10.3345/cep.2024.01361","DOIUrl":"10.3345/cep.2024.01361","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"300-302"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629626","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}