Clinical and Experimental Pediatrics最新文献

{"title":"Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia.","authors":"Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Kamonnut Singkhamanan, Komwit Surachat","doi":"10.3345/cep.2024.01718","DOIUrl":"10.3345/cep.2024.01718","url":null,"abstract":"<p><strong>Background: </strong>Gut-lung crosstalk is a pathway involving interactions between the gastrointestinal, respiratory, and immune systems. The immune responses of the gut and lungs are intricately linked, and previous studies demonstrated that the gut microbiota can influence systemic immune responses in the respiratory system as well as bronchopulmonary dysplasia (BPD).</p><p><strong>Purpose: </strong>To analyze the composition of the gut microbiota in very low birth weight infants with versus without BPD.</p><p><strong>Methods: </strong>Secondary data from a previous randomized controlled trial were analyzed. Microbiomes were analyzed using QIIME 2 software. Gut microbiota diversity and abundance were compared between groups.</p><p><strong>Results: </strong>Fifty-one neonates were classified into the BPD (n=24) and non-BPD (n=27) groups, between which no differences were noted in the alpha and beta diversities of the gut microbiota. In both groups, Proteobacteria, Gammaproteobacteria, and Klebsiella were the predominant phylum, class, and genus in gut microbiota, respectively. Enterococcus, Acinetobacter, Elizabethkingia, Clostridium sensu stricto 1, Bacteroides, Streptococcus, and Serratia were more abundant, whereas Klebsiella, Faecalibacterium, Escherichia-Shigella, Enterobacter, Bifidobacterium, Veillonella, Staphylococcus, and Enterobacteriaceae were less abundant in the BPD versus non-BPD group. Faecalibacterium, Roseburia, Clostridium, Eubacterium, and Coprococcus were significantly more abundant in the non-BPD versus BPD group.</p><p><strong>Conclusion: </strong>The alpha and beta diversities of the gut microbiota did not differ significantly between the BPD and non-BPD groups. However, in terms of relative abundance, the presence of common respiratory pathogens was notable in the BPD group. Conversely, the non-BPD group had a significantly higher prevalence of anaerobic taxa known for their capacity to produce butyrate, a key component of postbiotics.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"503-511"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524752","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":"Debate around and impact of digital screen time and media parenting on children's development.","authors":"Gowda Parameshwara Prashanth","doi":"10.3345/cep.2025.00073","DOIUrl":"10.3345/cep.2025.00073","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"551-553"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626367","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":"Metabolic dysfunction-associated steatotic liver disease in children: a practical update based on Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN) 2024 guidelines.","authors":"Ankit Agrawal, Arghya Samanta","doi":"10.3345/cep.2025.00157","DOIUrl":"10.3345/cep.2025.00157","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"546-550"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081115","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":"Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia.","authors":"Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat","doi":"10.3345/cep.2025.00122","DOIUrl":"10.3345/cep.2025.00122","url":null,"abstract":"<p><strong>Background: </strong>Postinfectious bronchiolitis obliterans (PIBO) is a rare chronic obstructive pulmonary disease that occurs after a respiratory infection. Its diagnosis is generally based on clinical history, respiratory symptoms, and computed tomography (CT) findings.</p><p><strong>Purpose: </strong>Here we evaluated the frequency of exacerbations, clinical progress, and inhaled corticosteroid (ICS) usage in children diagnosed with PIBO with or without comorbid bronchopulmonary dysplasia (BPD).</p><p><strong>Methods: </strong>This retrospective observational study was conducted in Rouen, France. The inclusion criteria were as follows: child diagnosed with PIBO (history of respiratory infection, airway obstruction with no or poor response to bronchodilation treatment, and/or mosaic pattern or trapping on chest high-resolution CT) in 2009-2024 treated with intravenous corticosteroid pulses.</p><p><strong>Results: </strong>Fifty-seven patients were included: 13 (23%) with BPD and 44 (77%) without BPD. The mean age at diagnosis was 7.0±3.6 months, with no significant intergroup difference. We observed a significant reduction in exacerbations following corticosteroid pulse treatment as soon as 6 months (P<0.001), with persistent effects observed up to 24 months (P=0.02). We also noted a reduced daily ICS dose starting at 12 months (P=0.03). Respiratory syncytial virus is the most commonly identified causative virus, followed by rhinoviruses and adenoviruses. The viral codetection rates were 18% and 61% in the BPD and non-BPD groups, respectively.</p><p><strong>Conclusion: </strong>In our cohort, intravenous corticosteroid pulse treatment effectively treated PIBO, with a rapid and long-lasting reduction in exacerbations and ICS requirements. BPD was a significant comorbidity of PIBO.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"497-502"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014029","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 neutrophil elastase in predicting infection among children with chemotherapy-induced febrile neutropenia.","authors":"Mahmoud A El-Hawy, Doaa M Elian, Mai El-Sayad Abd El-Hamid, Esraa T Allam, Mariam S Kandeel, Asmaa A Mahmoud","doi":"10.3345/cep.2025.00318","DOIUrl":"https://doi.org/10.3345/cep.2025.00318","url":null,"abstract":"<p><strong>Background: </strong>Infection is a significant cause of death following chemotherapy-induced febrile neutropenia (FN). Neutropenia and compromised neutrophil function are the primary reasons for the decreased defense against infections.</p><p><strong>Purpose: </strong>This study aimed to evaluate the significance of neutrophil elastase (NE) in predicting the outcomes of childhood hematological malignancies with FN.</p><p><strong>Methods: </strong>The study included 64 patients with FN and 64 healthy children matched for age and sex as controls. The patients were selected from the Hematology and Oncology Unit, Menoufia University, Pediatric Department, and Tanta Oncology Institute. Complete blood counts, C-reactive protein (CRP) levels, NE levels, and blood cultures for bacteria and fungi were performed.</p><p><strong>Results: </strong>The levels of CRP and NE were increased among children with FN; of them, 21.9% had Gram-negative bacteremia, 17.2% had Gram-positive bacteremia, and 3.1% had Candidemia. NE level was increased in patients with bacterial infections, with a significant positive correlation with duration of FN. NE level had a cutoff of 6.5, with an area under the curve of 0.899, sensitivity of 83.33%, and specificity of 87.50% signifying a higher risk of mortality compared to other variables.</p><p><strong>Conclusion: </strong>NE levels were elevated in children with FN, suggesting its usefulness for the early detection of infection that could decrease infection-related morbidity and mortality.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286660","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 targeting pediatric inflammatory bowel disease-associated anemia: experience from a single tertiary center.","authors":"Ana Sc Fernandes, Sara Azevedo, Ana Rita Martins, Ana Isabel Lopes","doi":"10.3345/cep.2025.00640","DOIUrl":"https://doi.org/10.3345/cep.2025.00640","url":null,"abstract":"<p><strong>Background: </strong>Iron deficiency (ID) and iron deficiency anemia (IDA) are common complications of pediatric inflammatory bowel disease (IBD). Owing to questions regarding optimal iron formulation, dosage, route of administration, and safety, these complications are frequently overlooked and undertreated, negatively impacting patient development and quality of life.</p><p><strong>Purpose: </strong>To assess the safety and efficacy of iron sucrose (IS) and ferric carboxymaltose (FCM) in the treatment of ID and IDA in pediatric IBD.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of pediatric patients with IBD treated for 10 years with IS (age < 14 years) or FCM (age ≥ 14 years) in a single regional referral center. The Ganzoni formula was used to calculate the iron dose administered. Adverse reactions were monitored during treatment and after discharge. Efficacy was defined as a ≥2 g/dL rise in Hb or anemia resolution within 12 weeks after treatment in cases of IDA and transferrin saturation or ferritin normalization in cases of ID.</p><p><strong>Results: </strong>Sixty-three patients were treated with IV iron (41 with Crohn disease, 15 with ulcerative colitis, 7 with IBD-unclassified; median age, 14.6 years; 104 treatment courses [63 FCM, 41 IS during the 10-year study period]). Retreatment was necessary after a median 1.4 years in 26 patients (41.3 %). The median activity scores of patients with recurrent ID indicated inactive disease. The treatment efficacy was 66.7% (FCM) and 67.6% (IS) in patients with IDA and 77.8% in patients with ID but without anemia. One adverse reaction (hypotension and rash) was associated with IS treatment.</p><p><strong>Conclusion: </strong>In one of the largest and longest follow-up cohorts, FCM and IS were safe and effective for correcting ID in pediatric patients with IBD. As ID recurs frequently, proactive screening and treatment are important.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286661","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 M Blunt, Monirah Albathi, Miriam Conces, Tendy Chiang","doi":"10.3345/cep.2024.01375","DOIUrl":"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 with globus sensation for 5 months with increasing discomfort. Flexible nasolaryngoscopy revealed a pedunculated lesion attached to the posterior surface of the soft palate. 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":"428-433"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984931","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":"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":"10.3345/cep.2024.01536","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"434-436"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984949","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":"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":"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":"398-405"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123799","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":"Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis.","authors":"Emilly Henrique Dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay","doi":"10.3345/cep.2024.01543","DOIUrl":"10.3345/cep.2024.01543","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing and predicting neonatal sepsis is challenging because of its nonspecific symptoms, lack of diagnostic criteria consensus, and absence of early, sensitive, and specific diagnostic laboratory tests.</p><p><strong>Purpose: </strong>To evaluate the diagnostic and prognostic potential of adrenomedullin (ADM), interleukin-6 (IL-6), and C-reactive protein (CRP) in late-onset neonatal sepsis (LOS).</p><p><strong>Methods: </strong>We studied 53 neonates with culture-proven LOS by sampling at admission and on antibiotic treatment days 3 and 7. These data were compared with those of 22 healthy full-term controls sampled on day 3 before hospital discharge. Survivors and nonsurvivors in the sepsis group were analyzed separately.</p><p><strong>Results: </strong>Coagulase-negative Staphylococcus was the most commonly detected pathogen. ADM (cutoff, 0.5 ng/mL) and CRP (cutoff, <5 mg/L) values aligned with manufacturer recommendations, while IL-6 levels (cutoff, 10 pg/mL) were higher than expected, likely due to labor stress. The median biomarker levels significantly distinguished neonates with sepsis from controls (P<0.0001) at all time points with ADM and IL-6 levels elevated at admission, indicating their potential as early diagnostic markers. CRP level was diagnostically useful starting on day 3. Prognostically, IL-6 (P<0.001) and ADM (P<0.05) differentiated survivors from nonsurvivors; however, only IL-6 consistently predicted mortality at all time points (area under the curve [AUC] >0.90). ADM and CRP levels showed poor prognostic value (AUC<0.70). ADM and IL-6 demonstrated strong diagnostic utility in early LOS, whereas CRP became relevant later. IL-6 was the only reliable biomarker for predicting mortality, supporting its integration into clinical protocols. Combining IL-6 with CRP may enhance early detection and management, potentially improving neonatal outcomes.</p><p><strong>Conclusion: </strong>IL-6 is a robust biomarker for the early diagnosis and prognosis of LOS. Incorporating IL-6 into clinical practice with CRP could improve early neonatal LOS diagnosis and patient outcomes.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"463-471"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899035","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}