Clinical and Experimental Pediatrics最新文献

{"title":"Advancements and challenges in neonatal resuscitation: embracing laryngeal mask airways for improved outcomes.","authors":"Jang Hoon Lee","doi":"10.3345/cep.2024.01088","DOIUrl":"https://doi.org/10.3345/cep.2024.01088","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751888","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":"Cerebral organoid research for pediatric patients with neurological disorders.","authors":"Jin Eun, Jung-Eun Lee, Seung-Ho Yang","doi":"10.3345/cep.2024.01235","DOIUrl":"https://doi.org/10.3345/cep.2024.01235","url":null,"abstract":"<p><p>Cerebral organoids derived from human induced pluripotent stem cells offer a groundbreaking foundation for the analysis of pediatric neurological diseases. Unlike organoids from other somatic systems, cerebral organoids present unique challenges, such as the high sensitivity of neuronal cells to environmental conditions and the complexity of replicating brain-specific architectures. Cerebral organoids replicate the human brain development and pathology, enabling research on conditions such as microcephaly, Rett syndrome, autism spectrum disorders, and brain tumors. This review explores the utility of cerebral organoids for modeling diseases and testing therapeutic interventions. Despite current limitations such as variability and lack of vascularization, recent technological advancements have improved the reliability and application of such interventions. Cerebral organoids provide valuable insight into the mechanisms underlying complex neural disorders and hold promise as novel treatment strategies for pediatric neurological diseases.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751894","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":"C3 glomerulopathy in children: experience at a resource-limited center.","authors":"Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan","doi":"10.3345/cep.2024.01256","DOIUrl":"https://doi.org/10.3345/cep.2024.01256","url":null,"abstract":"<p><strong>Background: </strong>In children, C3 glomerulopathy (C3G) is a heterogeneous disease characterized by diverse clinicopathological profiles and kidney outcomes. However, diagnostic work-up in resource-limited settings is challenging because of the unavailability of complement assays and limited access to electron microscopy or genetic testing.</p><p><strong>Purpose: </strong>This study aimed to describe the clinicopathological features and response to immunosuppression and evaluate renal outcomes among children with C3G in a resource-limited setting.</p><p><strong>Methods: </strong>This retrospective cohort study involved a review of the hospital records of 46 children (2013-2021) diagnosed with C3G on kidney biopsy. Their clinical, laboratory, treatment, and outcome details at onset and follow-up were noted.</p><p><strong>Results: </strong>The mean (SD) age was 9 (4) years. The common presentation was acute nephritis (27 [58.6%]), while one in five (19.5%) presented with rapidly progressive glomerulonephritis. Focal-crescentic glomerulonephritis (14 [30.4%]) was the common histological pattern. Electron microscopy was performed in 22 (47.8%), of which 17 were C3 glomerulonephritis (C3GN) and four were dense deposit disease (DDD). None of the patients underwent complement assay or genetic testing. Almost two-thirds (63%) received empirical immunosuppressive therapy, most commonly steroids. Of the 31/46 who completed follow-up (median [IQR] duration, 11.5 [6-24] months), six (19.4%) demonstrated complete kidney recovery, while the other 25 (80.7%) had kidney sequelae; of them, five (16.1%) progressed to end-stage kidney disease and two (4.3%) died by the last follow-up.</p><p><strong>Conclusion: </strong>Pediatric C3G has a variable clinicopathological spectrum, while DDD is less common. Most patients present with glomerulonephritis and significant morbidities. The lack of genetic and C3Nephritic factor testing is a barrier to the comprehensive phenotyping and management of C3G in resource-limited settings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751893","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":"Lifelong impact of elevated blood pressure from childhood to adulthood.","authors":"Junhyun Kwon, Eunji Kim","doi":"10.3345/cep.2024.01445","DOIUrl":"https://doi.org/10.3345/cep.2024.01445","url":null,"abstract":"<p><p>Elevated blood pressure (BP) during childhood and adolescence is increasingly being recognized as a precursor to adult hypertension and cardiovascular disease (CVD). This review examines the existing evidence of the relationship between early BP elevations and long-term cardiovascular (CV) outcomes. Previous studies demonstrated a moderate association between childhood BP and adult hypertension, with early BP elevations contributing to subclinical CV changes such as left ventricular hypertrophy and increased carotid intima-media thickness as well as major premature CVD events in adulthood. However, evidence also indicates that BP normalization before adulthood may mitigate these risks, suggesting a critical interventional window before irreversible CV changes occur. Multiple modifiable and nonmodifiable factors contribute to early-life BP elevations, including genetic predisposition, a high sodium intake, obesity, sedentary behavior, and sleep disturbances. Although establishing a direct causal association between childhood BP and adult hypertension or CVD remains challenging owing to the need for long-term follow-up and large sample sizes, further research is essential to addressing the existing knowledge gaps in pediatric hypertension prevention, detection, impact, and treatment. This review highlights the importance of preventing BP elevations early in life to reduce the long-term burden of hypertension and CVD. Promoting healthy behaviors, such as maintaining a healthy weight, reducing one's sodium intake, engaging in physical activity, and ensuring adequate sleep, is essential for managing BP at an early age. These efforts reduce individual CV risk and help alleviate the broader future public health burden of hypertension and CVD.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751896","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":"Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis.","authors":"Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee","doi":"10.3345/cep.2024.01102","DOIUrl":"https://doi.org/10.3345/cep.2024.01102","url":null,"abstract":"<p><strong>Background: </strong>Citrin deficiency is a rare metabolic disorder prevalent in East and Southeast Asia that affects liver or neurological function throughout various life stages. While early diagnosis and dietary management can improve prognosis for infant onset disease, data on long-term neurocognitive outcomes is scarce.</p><p><strong>Purpose: </strong>This study aimed to clarify whether transient metabolic disturbances during early childhood have a lasting effect on the neurocognitive function of individuals with citrin deficiency.</p><p><strong>Methods: </strong>Thirty patients diagnosed with citrin deficiency prior to 1 year of age underwent neuropsychological assessments including attention-deficit/hyperactivity disorder (ADHD) and intelligence quotient (IQ). We compared the peak laboratory values during infancy between children who were versus were not later diagnosed with ADHD.</p><p><strong>Results: </strong>Neurocognitive assessments of 30 individuals with citrin deficiency aged 3-25 years revealed that full-scale IQ scores were normally distributed. Of this cohort, 47% (14 of 30) were diagnosed with ADHD: six, six, and two with the combined, inattentive, and hyperactive-impulsive types, respectively. This prevalence was higher than that in the general population (1.7-16%). Moreover, a one-unit increase in ammonia levels before 1 year of age was associated with a 1.023-fold increase in the likelihood of future hyperactivity-impulsivity symptoms (p = 0.038; 95% confidence interval, 1.001-1.046). Despite these findings, this long-term follow-up of individuals with citrin deficiency indicated that it had minimal impact on neurocognitive function, allowing for a generally normal life.</p><p><strong>Conclusion: </strong>Patients with a history of cholestasis caused by citrin deficiency during infancy have a greater incidence of ADHD than the general population, suggesting that metabolic disturbances during early childhood in individuals with citrin deficiency may have a long-term negative impact on their neurocognitive function.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751897","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":"Hidden link between endocrine-disrupting chemicals and pediatric obesity.","authors":"Min Won Shin, Shin-Hye Kim","doi":"10.3345/cep.2024.00556","DOIUrl":"https://doi.org/10.3345/cep.2024.00556","url":null,"abstract":"<p><p>The increasing prevalence of pediatric obesity has emerged as a significant public health concern. Among various contributing factors, exposure to endocrine-disrupting chemicals (EDCs) has gained recognition for its potential role. EDCs, including bisphenols, phthalates, per- and polyfluoroalkyl substances, polycyclic aromatic hydrocarbons, and organochlorines, disrupt hormonal regulation and metabolic processes, contributing to alterations in fat storage, appetite regulation, and insulin sensitivity. This study offers a comprehensive review of the current research linking EDC exposure to pediatric obesity by integrating the findings from experimental and epidemiological studies. It also addresses the complexities of interpreting this evidence in the context of public health, highlighting the urgent need for further research.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751895","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":"Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia.","authors":"Abdul Wahab, Ida Safitri Laksanawati, Retna Siwi Padmawati, Asal Wahyuni Erlin Mulyadi, Wahyu Triadmajani, Jarir At Thobari","doi":"10.3345/cep.2024.00962","DOIUrl":"https://doi.org/10.3345/cep.2024.00962","url":null,"abstract":"<p><strong>Background: </strong>Despite recent behavioral interventions aimed at reducing the burden of dengue, persistent unfavorable related behaviors in the Indonesian community suggest that vaccination could be effective. However, before this is implemented nationally, public perception and acceptance of the vaccine should be assessed in addition to health providers' points of view.</p><p><strong>Purpose: </strong>This study aimed to assess the knowledge, attitudes, and practices (KAP) of community members and health providers in Indonesia.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in six districts of three Indonesian provinces. Respondents included both community members and health providers living within the territory of the selected primary health care centers. Pretested questionnaires were used to gather information on the sociodemographic characteristics and KAPs regarding dengue vaccines. An independent t-test was performed to compare the mean KAP scores between community members and health providers, while a logistic regression analysis was used to identify the predictors in each domain.</p><p><strong>Results: </strong>Only 18.5% of health providers possessed high knowledge of the dengue vaccine versus only 12.5% of community members. Approximately one-third of the health providers versus one-fourth of community members displayed a high to moderate score for attitudes about dengue vaccines. Dengue vaccination practices demonstrated a more favorable score for both health providers and community members at 59.1% and 41.1%, respectively. No individual sociodemographic characteristics were associated with KAPs; rather, only education was correlated with better dengue vaccination practices. We also found that good knowledge of dengue was the only factor associated with all domains.</p><p><strong>Conclusions: </strong>Our findings highlight the urgent need to deliver educational interventions to health providers and community members in Indonesia to improve their awareness of dengue vaccines.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629688","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":"Global breastfeeding efforts: a long way to go.","authors":"Hye-Jung Shin","doi":"10.3345/cep.2024.01361","DOIUrl":"https://doi.org/10.3345/cep.2024.01361","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629626","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":"Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study.","authors":"Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius","doi":"10.3345/cep.2024.01214","DOIUrl":"https://doi.org/10.3345/cep.2024.01214","url":null,"abstract":"<p><strong>Background: </strong>Most studies that estimate the occurrence of childhood stroke use heterogeneous methods and rely on International Classification of Diseases codes, a strategy that may be unreliable.</p><p><strong>Purpose: </strong>This study aimed to estimate the occurrence of childhood stroke in Indonesia using imaging and clinical data from a private hospital network.</p><p><strong>Methods: </strong>This cross-sectional study used consecutive retrospective multi-center data samples collected in 2019-2023. The study cohort included children aged >28 days to young adults aged 24 years with confirmed ischemic or hemorrhagic stroke on computed tomography (CT) or magnetic resonance imaging (MRI). The 1-year occurrence was calculated, and the data analysis was performed using SPSS version 26.</p><p><strong>Results: </strong>Over 5 years, the performance of 8,987 CT and 6,133 MRI scans resulted in the identification of 1,074 stroke cases. The average patient age was 14.8 ± 7 years. Stroke occurrence was highest in 2021 (9.08%) and lowest in 2022 (5.91%). Male patients accounted for 67.9% of cases, with hemorrhagic strokes accounting for 83.4% of the total, primarily resulting from accidents (73.2%) and predominantly occurring in the frontal region (37.1%). A significant majority of cases (66.7%) were reported in Java. Males had a relative risk of 1.93 (95% confidence interval, 1.48-2.52; p < 0.0001) for hemorrhagic stroke versus females.</p><p><strong>Conclusion: </strong>The incidence of childhood stroke revealed critical epidemiological trends and disparities, emphasizing the need for targeted public health interventions and enhanced stroke prevention strategies in Indonesia.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study.","authors":"Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran","doi":"10.3345/cep.2024.01053","DOIUrl":"https://doi.org/10.3345/cep.2024.01053","url":null,"abstract":"<p><strong>Background: </strong>The increasing global prevalence of obesity poses significant public health problems, as obesity exerts adverse effects on many systems and lung function. However, research on the lung function of preschool children with obesity is limited and inconclusive. In addition, studies specific to obesity indices that influence lung function in young children with obesity are limited.</p><p><strong>Purpose: </strong>This study aimed to evaluate lung function of obese versus normal-weight preschool children using impulse oscillometry (IOS) and identify obesity indices predictive of altered lung function.</p><p><strong>Methods: </strong>We enrolled obese children aged 3-7 years as well as age- and sex-matched normal-weight controls. The participants underwent IOS assessments that measured the resistance at 5 Hz (R5) and 20 Hz (R20), the difference in resistance between these frequencies (R5-R20), reactance at 5 Hz (X5), resonance frequency, and reactance area (AX). We compared these parameters between groups and analyzed the correlations between obesity indices and IOS measures within the obese group using multiple linear regression.</p><p><strong>Results: </strong>The study included 68 participants (n=34 each group). In the obese group, significantly higher values were observed for R5 (adjusted for height, p = 0.02; % predicted, p = 0.01; z-score, p < 0.001), R5-R20 (absolute value, p = 0.002; adjusted for height, p = 0.001), and AX (z-score, p = 0.01). AX adjusted for height showed a greater trend (p = 0.07). The waist-to-height ratio was the most robust independent predictor of total and peripheral airway resistance, with increases in R5 (b = 1.65, p = 0.02) and R5-R20 (b = 1.39, p = 0.03) and a near-significant correlation with AX (b = 12.12, p = 0.06).</p><p><strong>Conclusion: </strong>Preschool children with obesity exhibit impaired lung function, characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of these changes.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629710","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}