Clinical and Experimental Pediatrics最新文献

{"title":"Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status.","authors":"Sung-Hoon Chung, Chae Young Kim, Yong-Sung Choi, Myung Hee Lee, Jae Woo Lim, Byong Sop Lee, Ki-Soo Kim","doi":"10.3345/cep.2023.01613","DOIUrl":"10.3345/cep.2023.01613","url":null,"abstract":"<p><strong>Background: </strong>Very low birth weight infants (VLBWIs) continue to face high mortality risk influenced by the care quality of neonatal intensive care units (NICUs). Under-standing the impact of workload and regional differences on these rates is crucial for improving outcomes.</p><p><strong>Purpose: </strong>This study aimed to assess how the structural and staffing attributes of NICUs influence the mortality rates of VLBWIs, emphasizing the significance of the availability of medical personnel and the regional distribution of care facilities.</p><p><strong>Methods: </strong>Data from 69 Korean NICUs collected by the Korean Neonatal Network between January 2015 and December 2016 were retrospectively analyzed. The NICUs were classified by various parameters: capacity (small, medium, large), nurse-to-bed ratio (1-4), and regional location (A, B, C). Pediatrician staffing was also analyzed and NICUs categorized by beds per pediatrician into low (≤10), medium (11-15), and high (≥16). The NICUs were classified by mortality rates into high-performance (1st and 2nd quartiles) and low-performance (3rd and 4th quartiles). Demographic, perinatal, and neonatal outcomes were analyzed using multivariate logistic regression to explore the association between NICU characteristics and mortality rates.</p><p><strong>Results: </strong>This study included 4,745 VLBWIs (mean gestational age, 28.4 weeks; mean birth weight, 1,088 g; 55.4% male) and found significant variations in survival rates across NICUs linked to performance and staffing levels. High-performing NICUs, often with lower bed-to-staff ratios and advanced care levels, had higher survival rates. Notably, NICUs with 2 rather than 1 neonatologist were associated with reduced mortality rates. The study also underscored regional disparities, with NICUs in certain areas showing less favorable survival rates.</p><p><strong>Conclusion: </strong>Adequate NICU staffing and proper facility location are key to lowering the number of VLBWI deaths. Enhancing staffing and regional healthcare equity is crucial for improving the survival of this population.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"619-627"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297329","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 nonpharmacological concussion management in children: systematic review of randomized controlled trials.","authors":"Andre Marolop Pangihutan Siahaan, Alvin Ivander, Rr Suzy Indharty, Steven Tandean, Anastasia Grace Milenia Ginting, Masrini Ginting, Felix Khosasi, Elbert","doi":"10.3345/cep.2023.01256","DOIUrl":"10.3345/cep.2023.01256","url":null,"abstract":"<p><p>Concussion is a global public health problem that affects many children worldwide. Most patients present with postconcussion syndrome and normal brain imaging findings. Despite the high incidence of concussion in children, published research on nonpharmacological management is lacking and much more often concerns pharmacological interventions. This systematic review aimed to evaluate the role of nonpharmacological interventions in managing concussion based on randomized controlled trials. The PubMed, Scopus, Web of Science, and Cochrane databases were extensively searched for articles published between January 2013 and July 2023. A modified patient intervention, comparison, and outcome framework was used to construct the search strategy and eligibility criteria. Risk of bias was assessed using the Risk of Bias-2 tool. A total of 16 studies conducted between January 2013 and July 2023 were analyzed. Three studies were conducted in an acute care setting (<24-hour postinjury) involving rest, computer time, and doing nothing, while the other 13 studies were conducted in a chronic care setting (>24-hour postinjury) and included aerobic exercise, collaborative care intervention, cervical spine rehabilitation, education by physiotherapists, a hyperbaric oxygen therapy protocol, family intervention therapy, virtual reality, traditional occupational therapy, virtual rehabilitation, oculomotor control exercises, vestibular rehabilitation, coordination exercises, and balance exercises. This systematic review highlights the importance of nonpharmacological therapy in pediatric concussion cases. Active rehabilitation may yield promising outcomes. Another interesting approach may be useful in pediatric concussion management. However, this systematic review shows a lack of high-quality literature supporting nonpharmacological pediatric concussion treatments.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"569-579"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509573","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":"Lifelong medical challenges and immunogenetics of Turner syndrome.","authors":"Won Kyoung Cho","doi":"10.3345/cep.2024.00430","DOIUrl":"10.3345/cep.2024.00430","url":null,"abstract":"<p><p>Turner syndrome (TS) is a female phenotypic condition characterized by one or more typical clinical features and the partial or complete absence of a second X chromosome as determined by karyotype analysis. TS, among the most common chromosomal abnormalities, has an estimated prevalence of approximately 1 in 2,500 live-born females, with ethnic and racial differences. TS encompasses a wide array of medical challenges, including cardiovascular, endocrine, autoimmune, and mental health issues, as well as a heightened cancer risk. The somatic stigmata of TS are thought to arise from haploinsufficiency of the X chromosomes. This review explores the lifelong medical challenges and immunogenetics of individuals with TS and aimed to investigate strategies for preventing and managing TS while considering the implications of immunogenetics.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"560-568"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876194","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":"Impact of COVID-19 pandemic on healthcare provision in youth with systemic lupus erythematosus.","authors":"Punchita Apisrinitirath, Nuanpan Siripen, Pornpimol Rianthavorn","doi":"10.3345/cep.2024.00689","DOIUrl":"10.3345/cep.2024.00689","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"628-631"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509571","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":"https://doi.org/10.3345/cep.2024.00381","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559029","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":"Comparative analysis of rare periodic fever syndromes including the first Korean case of hyperimmunoglobulinemia D and periodic fever syndrome.","authors":"Yoonsun Yoon, Hyun Seo Kim, Jung Ok Shim, JungHwa Lee","doi":"10.3345/cep.2024.00787","DOIUrl":"10.3345/cep.2024.00787","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"550-552"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308687","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":"Demographic transition in South Korea: implications of falling birth rates.","authors":"Chae Young Kim, Sung-Hoon Chung","doi":"10.3345/cep.2023.01599","DOIUrl":"10.3345/cep.2023.01599","url":null,"abstract":"<p><p>This review examines the critical issues of declining total fertility rates (TFRs) and aging populations in East Asia with special focus on South Korea. It provides a comprehensive analysis of TFR trends, aging demographics, and the policy responses of these nations to the low-fertility crisis. This study highlights the intricate tapestry of the factors contributing to these demographic shifts, including economic, social, and cultural influences. It also examines the effectiveness of various prenatal policies implemented across these countries, offering insight into their successes and limitations. Furthermore, it explores the role of immigration as a potential solution to the structural challenges posed by low birth rates. This review underscores the importance of multifaceted strategies for addressing the complex demographic challenges faced by South Korea.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"498-509"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471281","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":"Effect of pesticide exposure on stunting incidence: a systematic review and meta-analysis.","authors":"Sani Rachman Soleman, Yaltafit Abror Jeem, Muhammad Fathi Banna Al Faruqi, Mahdea Kasyiva, Vita Widyasari, Kuswati Kuswati, Nur Aini Djunet, Muflihah Rizkawati, Ety Sari Handayani","doi":"10.3345/cep.2023.01522","DOIUrl":"10.3345/cep.2023.01522","url":null,"abstract":"<p><p>As an endocrine disruptor chemical, pesticide exposure may affect the regulation of growth hormones such as insulin-like growth factor-1 (IGF-1). A few current studies to date have noted that long-term pesticide exposure disrupted IGF-1, a potential risk of stunting in children. This study aims to evaluate studies to date of the effect of pesticide exposure on stunting incidence. This systematic review and meta-analysis adhered to the PRISMA (Pre-ferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. The PubMed and EBSCO databases were searched for relevant articles without publication restrictions. This review aimed to include reviews, randomized controlled trials (RCT), and cohort, case-control, and cross-sectional studies, which provide actual exposure types of pesticides with stunting measurement by height-age z score. A screening, extraction, and synthesis were conducted, leading to a consensus for reaching mutual agreement. The analysis was performed using Microsoft Excel 2017 for the screening and extraction, Revman version 5.4 software for the meta-analysis, and OpenMEE software for the meta-regression. Of the 13 studies subjected to the qualitative analysis, 6 were eligible for inclusion in the meta-analysis: 2 reviews, 2 RCTs, 2 cohorts, 2 case-control, and 5 cross-sectional studies. Exposure to organophosphate and pyrethroid pesticides was not associated with stunting (P=0.78; odds ratio [OR], 1.11; 95% confidence interval [CI], 0.65-1.88). Heterogeneity existed for 79% of the meta-analysis (P≤0.000; z=-5.37; 95% CI, -0.034 to -0.016), and the meta-regression identified age as the causative covariate. Pesticide exposure, regardless of type, is not associated with stunting in children.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"510-518"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308688","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":"Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis.","authors":"Maya L Nasser, Joseph Nasr, Reem B Zalloum, Nathanael Q E Yap, Natalie E Bourdakos, Shahid Miangul, Tara A Betts, Hayato Nakanishi, Christian A Than, Serge Jabbour","doi":"10.3345/cep.2023.01536","DOIUrl":"10.3345/cep.2023.01536","url":null,"abstract":"<p><p>Two rehydration protocols currently exist to treat diabetic ketoacidosis (DKA) in pediatric patients aged <21 years: the traditional \"one-bag\" system and the more recent \"two-bag\" system. This study aimed to evaluate the safety and efficacy of the newer two-bag system versus the well-established one-bag system. The CiNAHL, Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases were comprehensively searched from inception to June 2023 by 2 independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis framework. Eligible studies were those that reported participants <21 years of age who presented to the emergency room with a clinical diagnosis of DKA. This review was prospectively registered on PROSPERO (CRD42023427551). From the initial screening of 42 studies, 8 unique studies encompassing 583 patients met the eligibility criteria. The analysis yielded no significant intergroup differences in hypoglycemia (odds ratio, 0.61; 95% confidence interval [CI], 0.20-1.87; I2=3%) or mean glucose correction rate (mean difference [MD], 0.04 mg/ dL/hr; 95% CI, -13.10 to 13.17; I2=64%). The incidence of cerebral edema was as low (0.17%) across groups, with only one case reported in the one-bag group. Notably, the mean time to DKA resolution (MD, -3.24 h; 95% CI, -5.57 to -0.91; I2=0%) and mean response time for intravenous fluid changes (MD, -32.75 min; 95% CI, -43.21 to -22.29; I2=59%) was lower for the two-bag system. This meta- analysis presents preliminary evidence suggesting that the two-bag system may confer advantages over the one-bag system for selected patients. However, further studies with greater patient stratification based on DKA severity, fluid composition, and protocol are needed to draw definitive conclusions and elucidate the extent of these advantages.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"486-497"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471282","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":"Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis.","authors":"Kiwako Yamamoto-Hanada, Yukihiro Ohya","doi":"10.3345/cep.2023.00045","DOIUrl":"10.3345/cep.2023.00045","url":null,"abstract":"<p><p>Early-onset atopic dermatitis increases an individual's risk of food allergies, suggesting that transcutaneous sensitization may occur through inflamed skin. Regarding food allergy causation, the dual allergen exposure hypothesis proposes that oral allergen exposure leads to immune tolerance, whereas allergen exposure via inflamed skin causes food allergies. This hypothesis suggests that it is important to induce oral immune tolerance and prevent allergic food sensitization through the skin. This review focuses on the breakthrough evidence based on the dual allergen exposure hypothesis that involves both skin and oral interventions for food allergy prevention.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"477-485"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683749","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}