Journal of Pediatrics最新文献

{"title":"On What Evidence Are We Managing Infants Born <25 Weeks of Gestation in Our NICUs?","authors":"Prakesh S. Shah MD","doi":"10.1016/j.jpeds.2025.114612","DOIUrl":"10.1016/j.jpeds.2025.114612","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114612"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0022-3476(25)00146-5","DOIUrl":"10.1016/S0022-3476(25)00146-5","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114606"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary Exercise Testing in a Pediatric Fontan Cohort.","authors":"Alan P Wang, Garett J Griffith, Kendra Ward","doi":"10.1016/j.jpeds.2025.114643","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114643","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association of cardiopulmonary exercise testing (CPET) variables with transplant-free survival in children who have undergone a Fontan procedure.</p><p><strong>Study design: </strong>A retrospective review of patients ≤ 18 years of age who had a lateral tunnel or extracardiac Fontan and underwent a CPET between 2004 and 2022. Serial analysis was performed for patients with CPETs ≥ 1 year apart. Cardiovascular adverse events (CAE) were categorized as mortality or cardiac transplantation. Univariable regression analysis was performed to evaluate predictors of CAE.</p><p><strong>Results: </strong>A total of 118 patients were included. The mean age at the baseline CPET was 12.9 ± 2.7 years, age at Fontan operation was 3.2 ± 1.8 years, and 65.3% of the cohort were male. The baseline peak oxygen consumption (VO_2peak) was 32.3 ± 7.7mL/kg/min (74.6 ± 17.8% of expected). A second CPET was performed in 63 of 118 (53.3%) patients with a mean duration between CPETs of 3.1 ± 2.4 years. The percent of expected VO_2peak decreased by 1.36 ± 8.05% per year. A total of 14 (11.9%) patients had CAE over a mean follow up time of 7.8 ± 4.8 years. In univariable regression analysis using baseline CPETs, exercise duration (HR = 0.69, p = 0.05) and percent age-predicted maximal heart rate achieved (%APMHR) (HR 0.98, p = 0.02) were significantly associated with CAE.</p><p><strong>Conclusion: </strong>Exercise capacity is mildly depressed in a contemporary cohort of Fontan patients in early adolescence and gradually declines into early adulthood. Exercise duration and %APMHR achieved was significantly associated with CAE.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114643"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical Features and Clinical Factors Influencing Response to Surfactant Treatment among Infants Born Late Preterm with Respiratory Distress Syndrome.","authors":"Lucia Lanciotti, Anna Sartori, Manuela Simonato, Alessio Correani, Paola Cogo, Ilaria Burattini, Chiara Giorgetti, Roberta Centorrino, Barbara Loi, Daniele De Luca, Virgilio Carnielli","doi":"10.1016/j.jpeds.2025.114644","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114644","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate main biophysically active surfactant components and inflammatory mediators, and to identify the factors associated with good response to surfactant, in late preterm infants with respiratory distress syndrome (RDS).</p><p><strong>Study design: </strong>This was a prospective, multicenter, cohort study enrolling late (gestational age 34^+0/7-36^+6/7 weeks [late-PT_RDS]) and moderately (gestational age 32^+0/7-33^+6/7 weeks, ]moderately-PT_RDS]) preterm infants with RDS. Term infants with no lung disease (term-NLD) were enrolled as controls. The concentration of disaturated-phosphatidylcholine (DSPC), surfactant protein-B (SP-B), total proteins, IL-1β, IL-6, and TNF-α in epithelial lining fluids were measured by high-performance liquid chromatography-mass spectrometry, ELISA, Lowry, or Luminex techniques, respectively, and corrected using plasma-to-bronchoalveolar lavage fluid urea ratio. Clinical data, including inspired oxygen fraction (FiO₂) and preductal hemoglobin saturation (SpO₂), were recorded in real-time.</p><p><strong>Results: </strong>We studied 55 late-PT_RDS, 44 moderately-PT_RDS and 18 term-NLD infants. DSPC was lower in late-PT_RDS (43 [24-124] mg/dL) than in term-NLD (249 [147-688] mg/dL, p<0.001) but similar to that of moderately-PT_RDS (30 [9-80] mg/dL, p=0.083). SP-B, total proteins, IL-1β, IL-6, and TNF-α were similar between late-PT_RDS and moderately-PT_RDS. SP-B, total proteins, and IL-6 were significantly higher in late-PT_RDS than term-NLD. Each hour of delay for surfactant administration, each 5-point increase in FiO₂ threshold, and each 5-point decrease in SpO₂/FiO₂ before surfactant treatment decreased the likelihood of good response by 12% (p=0.002), 28% (p=0.019) and 15% (p=0.028), respectively.</p><p><strong>Conclusions: </strong>Late-PT_RDS had DSPC and SP-B levels similar to moderately-PT_RDS. Early administration, lower FiO₂ threshold, and better oxygenation prior to surfactant treatment were associated with a better response to surfactant therapy.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114644"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Utero Exposure to Gestational Diabetes and Child Health at Age Three to Seven: A Cohort Study.","authors":"Oluwatoyin I Oladimeji, Phyllis Ohene-Agyei, Qiliang Liu, Luling Lin, Greg Gamble, Caroline A Crowther, Jane E Harding","doi":"10.1016/j.jpeds.2025.114639","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114639","url":null,"abstract":"<p><strong>Objective: </strong>To determine if, after adjusting for potential confounders, child health outcomes differed between children exposed to maternal gestational diabetes mellitus (GDM) and their unexposed peers.</p><p><strong>Study design: </strong>Prospective cohort study. Recruitment took place between June 2022 and May 2024. The primary outcome was overweight or obesity. Secondary outcomes were other measures of size, eating behavior, behavioral and emotional problems, neurodevelopmental disorders, atopic disorders, and diabetes. Between-group differences were determined with generalized linear mixed models adjusted for gestational weight gain and socioeconomic status.</p><p><strong>Results: </strong>Of the 699 children who participated at a mean age of 5.6 years, 295 (42.2%) were exposed to GDM. There was no difference in the risk of being overweight or obese in children exposed to GDM compared with those unexposed (aRR [95% CI]: 0.69 [0.44, 1.08]). Children exposed to GDM had lower BMI z-scores (aRR [95% CI]: -0.30 [-0.53, -0.60]), enjoyment of food scores (aRR [95% CI]: -0.17 [-0.31, -.04]), and risk of abnormal hyperactivity scores (aRR [95% CI]: 0.23 [.06, 0.87])] Other outcomes were similar between exposure groups.</p><p><strong>Conclusion: </strong>After accounting for confounders, children exposed to treated GDM had comparable risk of being overweight or obese with their unexposed peers. Our findings are reassuring for parents and health practitioners caring for women who experience GDM and their children.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114639"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Infarction in Kawasaki Disease.","authors":"Sunil J Ghelani, Annette L Baker, Kevin Friedman, Audrey Dionne, Sarah de Ferranti, Kelly Fitzgerald Cohen, Jane W Newburger","doi":"10.1016/j.jpeds.2025.114638","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114638","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical features, diagnostic methods, treatment courses, and outcomes of myocardial infarction (MI) among patients with Kawasaki disease (KD).</p><p><strong>Study design: </strong>This retrospective, single-center study reviewed patients with a history of KD who experienced MI from 1984 to 2023. Data collection included demographics, clinical presentation, imaging findings, interventions, and outcomes.</p><p><strong>Results: </strong>Among 22 patients, 86% were male, with a median KD onset of 14 months (range: 3 months-15 years). MI was diagnosed at the time of the event in seven patients, through surveillance magnetic resonance imaging in eight asymptomatic cases, and by other diagnostic tests in four. Nearly half (48%) of MIs occurred within three months of acute KD, and 81% within two years. All patients had at least one large or giant coronary artery aneurysm, most commonly in the proximal left anterior descending artery. Seven patients underwent coronary artery bypass grafting, one had percutaneous coronary intervention, and one was listed for heart transplantation. Two patients died from MI-related complications in the 1980s, and 23% had left ventricular dysfunction on follow-up.</p><p><strong>Conclusions: </strong>A high prevalence of missed MI diagnoses and adverse outcomes highlight the need for improved early detection and management. Although MI occurred only in patients with giant aneurysms, additional risk factors remain unclear. Future studies exploring computational modeling and genetic predispositions may help personalize antithrombotic regimens and optimize care for high-risk patients.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114638"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Pediatrics: An opportunity to Lead, not to Follow.","authors":"Gianluca Mondillo, Alessandra Perrotta, Simone Colosimo, Vittoria Frattolillo, Mariapia Masino, Massimo Pettoello-Mantovani","doi":"10.1016/j.jpeds.2025.114641","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114641","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114641"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine-Learning Assisted Screening with FIND FH® for Familial Hypercholesterolemia Among Youth.","authors":"Kerrilynn C Hennessey, Mary P McGowan, Hanyuan Shi, Terry Sturke, Roshni S Kalkur, Adam J Prince, Shoshana H Bardach, Nichole M Rogovoy, Marc A Hofley","doi":"10.1016/j.jpeds.2025.114640","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114640","url":null,"abstract":"<p><p>Although the American Academy of Pediatrics recommends universal lipid screening among children to find cases of familial hypercholesterolemia, such screening is rarely performed. We report the first clinical use of a novel machine learning model (FIND FH®) to identify youth at increased risk of familial hypercholesterolemia and results from associated outreach.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114640"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Nonbacterial Osteomyelitis: A Noninfectious Autoinflammatory Disorder of Bone","authors":"Lillian Lim MD, MPH ,&nbsp;Ronald M. Laxer MDCM","doi":"10.1016/j.jpeds.2025.114636","DOIUrl":"10.1016/j.jpeds.2025.114636","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"283 ","pages":"Article 114636"},"PeriodicalIF":3.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Various Regimens for Autoimmune Hepatitis in Northern European Children Show Equivalent Outcomes at 1 Year: A Retrospective Study.","authors":"Marianne Hørby Jørgensen, Runar Almaas, Gandom Kharrazi, Vaidotas Urbonas, Helene Kvistgaard, Embjørg Wollen, Bente Utoft Andreassen, Thomas Casswall, Björn Fischler","doi":"10.1016/j.jpeds.2025.114635","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114635","url":null,"abstract":"<p><strong>Objective: </strong>To compare the remission rates after 1 year of treatment between two regimens: tacrolimus (with or without prednisolone) or prednisolone (with or without azathioprine) in children with autoimmune liver disease (AILD).</p><p><strong>Study design: </strong>Retrospective data from children (n=157) with biopsy-proven AILD in five tertiary northern European centers were included. Data were collected at presentation and after 3, 6, and 12 months.</p><p><strong>Results: </strong>Initially, 111 were treated with prednisolone (with or without azathioprine) and 46 received tacrolimus (with or without prednisolone) (median start dose prednisolone: 0.99 mg/kg and 0.43 mg/kg, respectively). At diagnosis, alanine transaminase (ALT) levels were similar, but the rate of advanced fibrosis was significantly higher in the tacrolimus (with or without prednisolone) group. Lower rates of ALT normalization in the tacrolimus (with or without prednisolone) group were found at 3 months (26.8 vs 58.0%, p< 0.001) and 6 months (46.2% vs 68.8, p=0.014), but not at 1 year (68.2 vs. 76.2%, p>0.05). The same pattern was seen for immunoglobulin G.</p><p><strong>Conclusion: </strong>Despite slower treatment response for patients initially started on tacrolimus (with or without prednisolone) at 3 and 6 months, biochemical and immunological responses to the two different regimens appeared equivalent at 1 year after treatment initiation.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114635"},"PeriodicalIF":3.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}