Clinical and Experimental Pediatrics最新文献

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Cytokine profile of Post-cardiopulmonary bypass in children. 儿童体外循环术后细胞因子分析。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-19 DOI: 10.3345/cep.2025.00836
Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surassombatpattana, Pharsai Prasertsan
{"title":"Cytokine profile of Post-cardiopulmonary bypass in children.","authors":"Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surassombatpattana, Pharsai Prasertsan","doi":"10.3345/cep.2025.00836","DOIUrl":"https://doi.org/10.3345/cep.2025.00836","url":null,"abstract":"<p><strong>Background: </strong>Open cardiac surgery involving cardiopulmonary bypass (CPB) triggers a systemic inflammatory response that significantly affects clinical outcomes. However, the dynamics and specific roles of cytokine release after CPB in the pediatric population remain unclear.</p><p><strong>Purpose: </strong>To evaluate the dynamics of cytokine levels and their association with low cardiac output syndrome (LCOS)-related outcomes.</p><p><strong>Methods: </strong>A prospective observational cohort study was conducted of 32 children who underwent elective open cardiac surgery with CPB at Songklanagarind Hospital, Thailand. Levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α were analyzed preoperatively and immediately (T0), 6, 12, and 24 hours after intensive care unit admission. LCOS-related outcomes were defined with at least two of the following criteria being met within 24 hours postoperative: clinical and laboratory parameters, vasopressor-inotropic score ≥20, ejection fraction <50% on echocardiography; and requirement for a serious postoperative intervention. Statistical analyses utilized linear mixed models and multivariate logistic regression to identify the independent predictors of LCOS.</p><p><strong>Results: </strong>The mean patient age was 34.8±34.4 months; 56.2 % were male. Roughly one-third (37.5%) had a history of previous cardiac surgery, while one-quarter (28.3%) had a Risk Adjustment for Congenital Heart Surgery score ≥3. LCOS-related outcomes occurred in 37.5% of patients. IL- 6, IL-8, and TNF-α levels differed significantly between patients with and without LCOS outcomes. An increase in IL-8 of >56 pg/mL from baseline to T0 showed the strongest association with LCOS (odds ratio, 37.34; 95% confidence interval, 4.53-836.53).</p><p><strong>Conclusion: </strong>An elevated postoperative IL-8 level is a robust predictor of LCOS-related outcomes in pediatric patients undergoing cardiac surgery. These findings emphasize the importance of monitoring cytokine dynamics to guide interventions and improve patient outcomes.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087537","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}
引用次数: 0
Effectiveness of Kinder Lebensqualität Fragebogen (KINDL) and Children's Somatic Symptom Inventory-24 (CSSI-24) for measuring postacute sequelae of COVID-19 in children: a diagnostic validation study. Kinder Lebensqualität Fragebogen (KINDL)和儿童躯体症状量表-24 (CSSI-24)测量儿童COVID-19急性后后遗症的有效性:一项诊断验证研究
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-12 DOI: 10.3345/cep.2025.00983
Lawrence Shih-Hsin Wu, Pei-Chi Chen, Xiao-Ling Liu, Shu-Tsen Liu, Chi-Hung Wei, Yu-Lung Hsu, Kai-Sheng Hsieh, Huan-Cheng Lai, Chien-Heng Lin, Chieh-Ho Chen, An-Chyi Chen, I-Ching Chou, Wen-Jue Soong, Hui-Ju Tsai, Chung-Ying Lin, Jiu-Yao Wang
{"title":"Effectiveness of Kinder Lebensqualität Fragebogen (KINDL) and Children's Somatic Symptom Inventory-24 (CSSI-24) for measuring postacute sequelae of COVID-19 in children: a diagnostic validation study.","authors":"Lawrence Shih-Hsin Wu, Pei-Chi Chen, Xiao-Ling Liu, Shu-Tsen Liu, Chi-Hung Wei, Yu-Lung Hsu, Kai-Sheng Hsieh, Huan-Cheng Lai, Chien-Heng Lin, Chieh-Ho Chen, An-Chyi Chen, I-Ching Chou, Wen-Jue Soong, Hui-Ju Tsai, Chung-Ying Lin, Jiu-Yao Wang","doi":"10.3345/cep.2025.00983","DOIUrl":"https://doi.org/10.3345/cep.2025.00983","url":null,"abstract":"<p><strong>Background: </strong>The postacute sequelae of coronavirus disease 2019 (PASC), also known as pediatric long coronavirus disease (COVID), can significantly affect the quality of life (QoL) of affected children. Currently, there are no standardized screening tools to identify high-risk children. The Kinder Lebensqualität fragebogen (KINDL) is a psychometric method for measuring QoL in children.</p><p><strong>Purpose: </strong>This study used the KINDL questionnaire and Children's Somatic Symptom Inventory-24 (CSSI-24) to evaluate symptom burden and establish a screening threshold for pediatric PASC.</p><p><strong>Methods: </strong>We performed a cross-sectional study of children diagnosed with PASC defined as the presence of at least one persistent symptom lasting more than 4 weeks after a confirmed COVID-19 infection. Symptoms were assessed using a structured checklist developed by our team. The correlation between the KINDL and CSSI-24 scores was analyzed, and receiver operating characteristic (ROC) curve analysis was used to determine the optimal KINDL cutoff for identifying high-risk cases. QoL scores were also compared with those of historical cohorts to evaluate the impact of the PASC.</p><p><strong>Results: </strong>We included 84 participants: 46 children (mean age, 8.74±1.77 years; 41.3% girls) and 38 adolescents (mean age, 14.50±1.56 years; 44.7% girls). KINDL and CSSI-24 scores showed a significant negative correlation (r=-0.44, P<0.001), suggesting that increased somatic symptoms were associated with a reduced QoL. The ROC analysis identified a KINDL cutoff score of 74.75 (area under the curve, 0.82) for detecting high-risk children. Compared to historical cohorts, children with PASC had QoL scores comparable to child-reported norms from 2010 but lower than parent-reported norms from the same year.</p><p><strong>Conclusion: </strong>KINDL and CSSI-24 are practical tools for screening for pediatric PASC in outpatient settings. A KINDL cutoff of 74.75 may help clinicians identify children with PASC who require early intervention. Further studies in larger and more diverse populations are required to validate these findings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087522","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}
引用次数: 0
Assessment of natural killer cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major. 输血依赖性β-地中海贫血儿童患者的自然杀伤细胞亚群评估
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-12 DOI: 10.3345/cep.2025.01046
Fathia Elbassal, Mohamed Soliman, Nourhan Mohamed, Mai El-Hamid, Hanan El-Sheity
{"title":"Assessment of natural killer cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major.","authors":"Fathia Elbassal, Mohamed Soliman, Nourhan Mohamed, Mai El-Hamid, Hanan El-Sheity","doi":"10.3345/cep.2025.01046","DOIUrl":"https://doi.org/10.3345/cep.2025.01046","url":null,"abstract":"<p><strong>Background: </strong>Iron overload is a hallmark complication in patients with transfusion-dependent β-thalassemia major, primarily resulting from ineffective erythropoiesis, repeated blood transfusions, and increased gastrointestinal iron absorption. This iron accumulation, reflected in elevated serum ferritin levels, has been implicated in immune dysregulation. Natural killer (NK) cells are a pivotal component of the innate immune system, known for their cytotoxic activity and cytokine secretion, particularly interferon-gamma (IFN-γ). Disruption in NK cell subsets may compromise immune surveillance and defense against infections in these patients.</p><p><strong>Purpose: </strong>To evaluate the distribution and function of NK cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major and explore their association with iron overload and immune dysfunction.</p><p><strong>Methods: </strong>Seventy-eight children were enrolled and divided into 2 groups: 43 pediatric patients with transfusion-dependent β-thalassemia major and 35 apparently healthy controls. NK cells and their subsets (CD56bright, CD56dim, CD56neg) were quantified using multicolor flow cytometry. Serum IFN-γ levels were measured to assess NK cell cytokine activity. Ferritin levels were used as a marker of iron overload.</p><p><strong>Results: </strong>Patients showed a significant reduction in CD56bright and CD56dim NK cells compared to controls (P<0.001), indicating impaired NK-mediated immunity. Conversely, the CD56neg subset, associated with dysfunctional or altered NK cell phenotypes, was significantly elevated in patients (P<0.002). A strong negative correlation was observed between serum ferritin levels and CD56dim NK cells (P=0.003), suggesting that iron overload suppresses cytotoxic NK activity. Moreover, IFN-γ levels inversely correlated with CD56bright (P<0.001) and CD56dim (P=0.019) cells, but positively correlated with CD56neg cells, implicating this altered subset as a potential compensatory source of cytokine production.</p><p><strong>Conclusion: </strong>Hyperferritinemia in pediatric β-thalassemia major is linked to a dysregulated NK cell profile, marked by suppression of functional CD56bright and CD56dim subsets and expansion of the atypical CD56neg subset. These alterations may compromise innate immunity and contribute to increased infection risk. Our findings highlight the immunomodulatory impact of iron overload and underscore the clinical importance of monitoring NK cell dynamics in thalassemia management.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087488","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}
引用次数: 0
Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea. 不可持续和过度劳累:揭露韩国儿科心脏病专家和心脏外科医生面临的挑战。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-08-06 DOI: 10.3345/cep.2025.01123
Soo In Jeong, Gi Beom Kim, Sung Hye Kim, Jae Yoon Na, Hong Ju Shin, Sin Weon Yun, Lucy Youngmin Eun, Sang Yun Lee, Chang-Ha Lee, Kwang Ho Choi, Seul Gi Cha, Mi Young Han
{"title":"Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea.","authors":"Soo In Jeong, Gi Beom Kim, Sung Hye Kim, Jae Yoon Na, Hong Ju Shin, Sin Weon Yun, Lucy Youngmin Eun, Sang Yun Lee, Chang-Ha Lee, Kwang Ho Choi, Seul Gi Cha, Mi Young Han","doi":"10.3345/cep.2025.01123","DOIUrl":"10.3345/cep.2025.01123","url":null,"abstract":"<p><strong>Background: </strong>Pediatric cardiologists (PCs) and pediatric cardiac surgeons (PedCSs) in Korea face growing workforce shortages due to declining birth rates, decreasing interest among trainees, and increasing burnout.</p><p><strong>Purpose: </strong>This study investigated the working conditions, job satisfaction, and burnout levels among Korean PCs and PedCSs.</p><p><strong>Methods: </strong>In June 2023, the Korean Pediatric Heart Society distributed a structured questionnaire via email to 149 members actively practicing pediatric cardiac care (115 PCs, 34 PedCSs). Responses from 122 members were analyzed. Descriptive statistics and regression analyses were performed to identify the factors associated with burnout (P<0.05).</p><p><strong>Results: </strong>A total of 122 physicians (96 PCs, 26 PedCSs) completed the survey (response rates: overall, 81.9%; PCs, 83.5%; PedCSs, 76.5%). Among the PCs, 79.2% worked more than 51 hr/wk, 57.3% worked night shifts, and 70.8% experienced emergency callbacks at least once per month. PedCSs reported comparably heavy burdens, with 80.8% working >51 hr/wk and 88.5% experiencing monthly emergency callbacks. Regional disparities were notable: 48.2% of PCs in the Seoul metropolitan area (SMA) performed >51 catheterizations annually versus 7.1% in other regions, while 62.5% of PedCSs in the SMA performed >30 surgeries annually versus 20% elsewhere. Litigation, reported by 66.7% of PCs versus 84.6% of PedCSs, contributed to dissatisfaction and burnout. The key drivers included limited research time, legal risks, and nonspecialized duties. Overall, 64.0% of the PCs and 61.6% of the PedCSs reported experiencing burnout. In the multivariable analysis, answering ≥6 emergency callbacks/mo (adjusted odds ratio [aOR], 7.91; 95% confidence interval [CI], 1.28-48.79), occupational dissatisfaction (aOR, 2.57; 95% CI, 1.09-6.04), and work environment dissatisfaction (aOR, 2.74; 95% CI, 1.16-7.14) independently predicted burnout, whereas the working >51 hr/wk variable did not remain significant postadjustment.</p><p><strong>Conclusion: </strong>Excessive workload, frequent emergency callbacks, regional maldistribution of case volumes, litigation pressure, and occupational dissatisfaction drive high burnout among Korean pediatric cardiac specialists. These findings highlight persistent workforce challenges in Korea's pediatric cardiac system. Regular surveys and ongoing research are essential to ensuring sustainable pediatric cardiac care.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"732-741"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800486","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}
引用次数: 0
Artificial intelligence in pediatric healthcare: bridging potential, clinical practice, and ethical considerations. 人工智能在儿科医疗保健:桥梁潜力,临床实践和伦理考虑。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-08-28 DOI: 10.3345/cep.2025.01844
Yoon Lee, Seohyun Hong, Dong Keon Yon
{"title":"Artificial intelligence in pediatric healthcare: bridging potential, clinical practice, and ethical considerations.","authors":"Yoon Lee, Seohyun Hong, Dong Keon Yon","doi":"10.3345/cep.2025.01844","DOIUrl":"10.3345/cep.2025.01844","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":"68 9","pages":"652-655"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972206","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}
引用次数: 0
Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: a randomized controlled trial. 补充维生素C治疗需要住院的儿童肺炎的效果:一项随机对照试验。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-04-01 DOI: 10.3345/cep.2025.01970
Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh
{"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.2025.01970","DOIUrl":"10.3345/cep.2025.01970","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 hours), and high-dose vitamin C (30 mg/kg/dose every 6 hours) groups. Treatment was provided until discharge and doses maximized after 3 days. The patients' clinical symptoms and side effects were recorded every 12 hours.</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 hours. 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-hour posttreatment. A dose of 15 mg/kg was demonstrated effective with minimal side effects.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"690-699"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056850","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}
引用次数: 0
Allogeneic stem-cell transplantation following chimeric antigen receptor T-cell therapy for treatment of relapsed/refractory hematologic malignancy in children and young adults: a systematic review and meta-analysis. 嵌合抗原受体t细胞治疗后的异体干细胞移植治疗儿童和年轻人复发/难治性恶性血液病:系统回顾和荟萃分析
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-07-04 DOI: 10.3345/cep.2025.00031
Ghea Mangkuliguna, Edi Setiawan Tehuteru, Reganedgary Jonlean, Nicholas Adrianto, Stella Kallista
{"title":"Allogeneic stem-cell transplantation following chimeric antigen receptor T-cell therapy for treatment of relapsed/refractory hematologic malignancy in children and young adults: a systematic review and meta-analysis.","authors":"Ghea Mangkuliguna, Edi Setiawan Tehuteru, Reganedgary Jonlean, Nicholas Adrianto, Stella Kallista","doi":"10.3345/cep.2025.00031","DOIUrl":"10.3345/cep.2025.00031","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic stem cell transplantation (allo-SCT) and chimeric antigen receptor (CAR) T-cell therapy offer potential complementary benefits.</p><p><strong>Purpose: </strong>This study aimed to ascertain whether incorporating consolidative allo-SCT after CAR T-cell therapy can augment the therapeutic outcomes of child and young adult patients with relapsed/refractory hematologic malignancy.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, ScienceDirect, Cochrane Library, EBSCOHost, ProQuest, and the grey literature repositories was performed for articles published between May 5, 2014, and May 5, 2024. We included studies reporting consolidative allo-SCT following CAR T-cell therapy for treating hematologic malignancies in subjects aged ≤25 years old. The outcomes of interest were complete remission, survival, relapse, and mortality rates. The estimates were pooled using random-effects meta-analysis. The risk of bias was evaluated using the Newcastle-Ottawa Scale, while the certainty of evidence was assessed using GRADE. This study follows the PRISMA 2020 criteria and is registered in the PROSPERO database (CRD42023433417).</p><p><strong>Results: </strong>Twelve cohort studies involving 380 patients, primarily those with B-cell acute lymphoblastic leukemia (B-ALL), were included. The CAR T-cell+SCT group showed a trend toward higher complete remission (odds ratio [OR], 2.74; 95% confidence interval [CI], 0.88-8.54; P= 0.08; I2=57%; evidence, very low); lower mortality (OR, 0.58; 95% CI, 0.27-1.27; P=0.17; I2=0%; evidence, low), and decreased relapse (OR, 0.18; 95% CI, 0.06-0.56; P=0.003; I2=41%; evidence, low) rates than those who did not proceed to SCT. In addition, both overall survival and leukemia-free survival rates showed a favorable trend toward the CAR T-cell+SCT group, respectively (hazard ratio, 0.44; 95% CI, 0.25-0.77; P=0.005; I2=0%; evidence, low; and hazard ratio, 0.29; 95% CI, 0.17-0.49; P<0.00001; I2=0%; evidence, low). Common posttransplant toxicities include mild to moderate acute and chronic graft-versus-host diseases.</p><p><strong>Conclusion: </strong>Although the current level of evidence remains low or very low, allo-SCT following CAR T-cell infusion potentially benefits patient survival. Further clinical studies are required to confirm these findings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"712-721"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800465","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}
引用次数: 0
Treatment targeting pediatric inflammatory bowel disease-associated anemia: experience from a single tertiary center. 针对儿童炎症性肠病相关贫血的治疗:来自单一三级中心的经验。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-06-10 DOI: 10.3345/cep.2025.00640
Ana S C Fernandes, Sara Azevedo, Ana Rita Martins, Ana Isabel Lopes
{"title":"Treatment targeting pediatric inflammatory bowel disease-associated anemia: experience from a single tertiary center.","authors":"Ana S C Fernandes, Sara Azevedo, Ana Rita Martins, Ana Isabel Lopes","doi":"10.3345/cep.2025.00640","DOIUrl":"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":"722-731"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286661","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}
引用次数: 0
Respiratory severity score-guided postnatal systemic corticosteroid therapy for bronchopulmonary dysplasia in extremely preterm infants. 呼吸严重程度评分指导下的产后全身皮质类固醇治疗极早产儿支气管肺发育不良。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-07-08 DOI: 10.3345/cep.2025.00514
Gyeong Eun Yeom, Ju Sun Heo, Baek Sup Shin, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
{"title":"Respiratory severity score-guided postnatal systemic corticosteroid therapy for bronchopulmonary dysplasia in extremely preterm infants.","authors":"Gyeong Eun Yeom, Ju Sun Heo, Baek Sup Shin, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim","doi":"10.3345/cep.2025.00514","DOIUrl":"10.3345/cep.2025.00514","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD) is a major complication in extremely preterm (EP) infants. Postnatal systemic corticosteroids reduce inflammation and may help prevent or treat BPD. However, their use is limited because of concerns regarding neurodevelopmental outcomes. However, the optimal timing and criteria for steroid therapy initiation remain unclear.</p><p><strong>Purpose: </strong>This study aimed to evaluate the effect of a respiratory severity score (RSS)-guided postnatal systemic corticosteroid protocol on BPD and neurodevelopmental outcomes in mechanically ventilated infants with EP.</p><p><strong>Methods: </strong>A historical comparative study was conducted to compare the preprotocol (2010-2014; phase I) and postprotocol (2016-2022; phase II) periods. Infants born at <28 weeks' gestation and ventilated on postnatal day 14 were included in the study. The protocol implemented in 2015 used the RSS to guide corticosteroid initiation. Clinical outcomes including BPD severity and severe neurodevelopmental impairment (NDI) were compared.</p><p><strong>Results: </strong>Among the 208 infants, those in phase II had higher dexamethasone use (17.6% vs. 33.0%, P=0.017) and earlier initiation (postmenstrual age, 31.1 vs. 29.0 weeks; P=0.027). In phase II, Jensen grade 0 was significantly increased (15.2% vs. 30.2%; adjusted odds ratio [aOR], 2.31; P=0.024), particularly among patients who did not receive steroids. In steroid-treated infants, Jensen grade 3 BPD was decreased (47.4% vs. 21.2%; aOR, 0.26; P=0.050), whereas grade 1 BPD was increased (5.3% vs. 33.3%; aOR, 12.22; P=0.035) in phase II. There were no significant intergroup differences in mortality or NDI.</p><p><strong>Conclusion: </strong>The RSS-guided protocol enabled more targeted and earlier steroid administration, reducing severe BPD without worsening neurodevelopmental outcomes. This approach may refine postnatal corticosteroid treatment strategies for infants with EP.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"656-665"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800482","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}
引用次数: 0
Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement. 利奈唑胺减轻小儿睾丸扭转实验模型的组织损伤:TLR-4/MAPK/NF-κB参与。
IF 3.6
Clinical and Experimental Pediatrics Pub Date : 2025-09-01 Epub Date: 2025-08-26 DOI: 10.3345/cep.2025.00080
Moein Ghasemi, Abolfazl Basiri, Houman Kazemzadeh, Mohammad Amin Manavi, Seyed Mohammad Tavangar, Ahmad Reza Dehpour, Hamed Shafaroodi
{"title":"Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement.","authors":"Moein Ghasemi, Abolfazl Basiri, Houman Kazemzadeh, Mohammad Amin Manavi, Seyed Mohammad Tavangar, Ahmad Reza Dehpour, Hamed Shafaroodi","doi":"10.3345/cep.2025.00080","DOIUrl":"10.3345/cep.2025.00080","url":null,"abstract":"<p><strong>Background: </strong>Testicular torsion is a urological emergency that requires prompt surgery to prevent orchiectomy. Pharmacological interventions may slow the progression of damage and reduce reperfusion injury after surgical correction.</p><p><strong>Purpose: </strong>This study evaluated the protective effects of linezolid against testicular torsion-detorsion (T/D) injury in rats by focusing on the mechanisms involving the Toll-like receptor 4 (TLR-4) pathway.</p><p><strong>Methods: </strong>Eighty-four male Wistar rats were allocated into 8 groups; of them, one was subjected to a sham operation and another was subjected to 4-hour ischemia via 720° of torsion followed by 24-hour reperfusion. Linezolid (3-100 mg/kg) was assessed for its effects on T/D injury using histopathological evaluation, oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD]), and inflammatory biomarker tumor necrosis factor-alpha (TNF-α). Mechanistic investigations have focused on TLR-4 the mitogen-activated protein kinase (MAPK)/nuclear factor kappa B (NF-κB) pathway. Molecular docking and in silico analyses were conducted to predict interactions with key inflammatory proteins.</p><p><strong>Results: </strong>Linezolid 25, 50, and 100 mg/kg significantly reduced the histopathological damage, with 50 mg/kg being the most effective dosage. Within the 6-50 mg/kg range, linezolid reduced MDA, increased SOD, decreased TNF-α, and suppressed TLR-4/NF-κB pathway activity, with maximal reductions in MDA, TNF-α, NF-κB, and TLR-4 of 64%, 77%, 56%, and 53%, respectively, and an enhancement in SOD of 47%. In silico docking predicted strong binding interactions with TLR-4 pathway proteins, including p38 MAPK and JNK, with affinities of -7.4 to -8.3 kcal/mol.</p><p><strong>Conclusion: </strong>Linezolid protects against testicular torsion by reducing oxidative stress and inflammation via modulating the TLR-4/NF-κB pathway, suggesting its therapeutic potential and need for further study.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":"68 9","pages":"700-711"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972213","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}
引用次数: 0
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