Clinical and Experimental Pediatrics最新文献

{"title":"Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the USA: a cross-sectional study.","authors":"Chuhan Cheng, Liyan Zhang","doi":"10.3345/cep.2024.01844","DOIUrl":"https://doi.org/10.3345/cep.2024.01844","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with various diseases including respiratory conditions. However, the relationship between NLR and asthma in the pediatric population remains underexplored.</p><p><strong>Purpose: </strong>This study aimed to explore the association between NLR and asthma in children and adolescents and assess its potential role as a predictive biomarker for pediatric asthma.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of 12,974 children and adolescents from the National Health and Nutrition Examination Survey in 2011-2020. NLR was defined as the ratio of neutrophil to lymphocyte counts. Asthma was diagnosed using a structured questionnaire. Multivariate logistic regression models were used to evaluate the association between NLR and asthma. A restricted cubic spline was used to explore non-linear relationships, and a threshold analysis was conducted to identify potential cutoff values for the NLR.</p><p><strong>Results: </strong>A total of 12,974 children and adolescents were included (male: 6,686 [51.5%]; mean age: 10 years [IQR, 5.0-14.0]). After the adjustment for confounders, participants with the highest versus lowest NLR exhibited a significantly elevated risk of asthma (odds ratio [OR]=1.39; 95% confidence interval [CI], 1.13-1.71). Additionally, a multivariate restricted cubic spline analysis revealed a non-linear relationship between NLR and asthma (p=0.023). A threshold analysis revealed that an NLR<2.23 was significantly associated with an increased risk of asthma (OR=1.23; 95% CI, 1.05-1.45), while an NLR≥2.23 showed no significant association. A subgroup analysis revealed no interactive role of NLR and asthma.</p><p><strong>Conclusion: </strong>Our findings indicate a non-linear saturation-effect relationship between NLR and asthma in children and adolescents.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626405","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":"Somatic symptom severity during acute illnesses among children with functional gastrointestinal disorders.","authors":"Rattanachart Sirinil, Anundorn Wongteerasut","doi":"10.3345/cep.2024.01795","DOIUrl":"https://doi.org/10.3345/cep.2024.01795","url":null,"abstract":"<p><strong>Background: </strong>Functional gastrointestinal disorders (FGIDs) are associated with various gastrointestinal (GI) and non-GI symptoms, risk factors for which commonly include psychosocial and physical stresses.</p><p><strong>Purpose: </strong>This study aimed to compare somatic symptom severity between children with FGIDs and healthy controls during acute illnesses.</p><p><strong>Methods: </strong>This was a prospective descriptive cross-sectional study whose inclusion criterion was age 4-18 years. Children were classified into FGID and control groups using the Rome IV diagnostic criteria. Somatic symptom severity was estimated using a visual analog scale (VAS) and the Children's Somatic Symptoms Inventory-24 (CSSI-24) questionnaire and compared between groups.</p><p><strong>Results: </strong>Ninety-three children, including 40 with FGIDs (43%), were enrolled. The FGID group had statistically significantly higher VAS scores for abdominal pain than controls (2.93 ± 3.68 vs. 0.72 ± 2.08, p<0.001). However, no significant intergroup differences were noted in VAS scores for nausea (p=0.493) or headache (p=0.311). For somatization symptoms, the CSSI-24 total (20.58 ± 18.32 vs. 7.06 ± 10.49, p<0.001), GI symptom (9.60 ± 7.48 vs. 2.43 ± 3.39, p≤0.001) and non-GI symptom (10.98 ± 11.67 vs. 4.62 ± 7.88, p<0.001) scores were significantly higher for the FGID versus control groups, respectively.</p><p><strong>Conclusion: </strong>Children with FGIDs exhibited more significant somatic symptoms than controls during acute illnesses. GI and non-GI manifestations were significantly more common in children with FGIDs.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626407","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":"Debate around and impact of digital screen time and media parenting on children's development.","authors":"Gowda Prashanth","doi":"10.3345/cep.2025.00073","DOIUrl":"https://doi.org/10.3345/cep.2025.00073","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626367","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":"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 6 districts of 3 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>Conclusion: </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":"228-237"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629688","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":"Zinc as a treatment modality for acute infectious diarrhea in children.","authors":"Ji Sook Park","doi":"10.3345/cep.2024.00381","DOIUrl":"10.3345/cep.2024.00381","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"223-224"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559029","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":"Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation.","authors":"Upasana Ghosh, Ujjal Poddar, Srinivas Srinidhi Vadlapudi, Moinak Sen Sarma, Anshu Srivastava","doi":"10.3345/cep.2024.01242","DOIUrl":"10.3345/cep.2024.01242","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"266-268"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984906","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":"The predetermined future: tackling South Korea's total fertility rate crisis.","authors":"Jin Kyu Kim","doi":"10.3345/cep.2024.00871","DOIUrl":"10.3345/cep.2024.00871","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"225-227"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629771","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":"Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency.","authors":"Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul","doi":"10.3345/cep.2024.01060","DOIUrl":"10.3345/cep.2024.01060","url":null,"abstract":"<p><strong>Background: </strong>Individuals with 21-hydroxylase deficiency (21OHD) require lifelong glucocorticoid (GC) therapy, which increases their risk of fragility fractures. However, fractures in GC-treated individuals can occur at normal bone mineral density (BMD) levels, suggesting an alteration in the bone microarchitecture.</p><p><strong>Purpose: </strong>To evaluate trabecular bone microarchitecture and its changes in adolescents with 21OHD.</p><p><strong>Methods: </strong>We enrolled 38 adolescents with 21OHD for whom complete clinical data and baseline and follow-up lumbar spine BMD (LSBMD) measurements were available. The mean duration was 1.5±0.6 years. Trabecular bone score (TBS), an indirect measurement of bone microarchitecture, was analyzed using iNsight software version 3.0. Impaired BMD and TBS were defined as z scores ≤ -1.5.</p><p><strong>Results: </strong>At baseline, participants (55% female; 68% salt- wasting type; mean age, 15.2±3.8 years; bone age, 17.5± 2.8 years; mean GC dose, 18.5±6.5 mg/m2/day) had the prevalence of impaired BMD and TBS of 5% and 18%, respectively. During follow-up, adolescents with 21OHD receiving prednisolone showed a lower annual percentage change in TBS than those who received hydrocortisone (P=0.028). A stepwise regression analysis showed that body mass index percentile (P<0.001) and testosterone concentration (P=0.002) were independent positive predictors of the baseline TBS z score, whereas prednisolone use was the only negative predictor of the annual percentage change in TBS (P=0.002).</p><p><strong>Conclusion: </strong>Adolescents with 21OHD have a high prevalence of impaired bone microarchitecture. Furthermore, prednisolone therapy is associated with impaired bone microarchitecture development, suggesting that hydrocortisone may better preserve bone microarchitecture and should be considered the first-line treatment for this population.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"238-246"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629765","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":"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":"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 disorders (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: 6, 6, and 2 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":"257-265"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751897","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":"Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children.","authors":"Byung-Ho Choe","doi":"10.3345/cep.2024.01165","DOIUrl":"10.3345/cep.2024.01165","url":null,"abstract":"<p><p>Eosinophilic gastrointestinal disorders (EGIDs) are emerging as significant concerns in the Korean pediatric population and transitioning from rare to more commonly diagnosed conditions. This review discusses the increasing prevalence of EGID among children and adolescents and highlights the complexities involved in its diagnosis and management. This review begins with a thorough examination of the diverse clinical presentations of EGIDs in Korean children, with a special focus on common gastrointestinal symptoms such as abdominal pain, diarrhea, and bloody stool. Additionally, we explored extraintestinal manifestations, including growth failure, malnutrition, and associated allergic comorbidities, highlighting their importance in the clinical landscape of EGIDs. Because of its subtle and overlapping symptoms with those of other gastrointestinal disorders, EGID is frequently underdiagnosed. Addressing this challenge requires maintaining a high index of suspicion and employing a comprehensive diagnostic approach to differentiating EGID from functional gastrointestinal disorders and other inflammatory or systemic diseases such as inflammatory bowel disease. The optimal management of EGID requires a collaborative multidisciplinary strategy that includes dietary management, regular monitoring, and tailored medical interventions. This review emphasizes the importance of proactive patient and caregiver education and regular follow-ups to improve long-term outcomes in affected children. Enhanced awareness among healthcare providers and better educational resources for families are critical for the early identification and effective management of EGID among pediatric patients.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"185-198"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629763","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}