Pediatrics and Neonatology最新文献

{"title":"Efficacy of probiotics in vancomycin-resistant enterococci decolonization: A meta-analysis of randomized clinical trials.","authors":"Fei-Hsia Fan, Yi-Jyuan Lin, Jin-Hua Chen, Shiuh-Bin Fang","doi":"10.1016/j.pedneo.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.03.002","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis investigated whether probiotics can decolonize vancomycin-resistant enterococci (VRE) and examined the effects of probiotics through subgroup analyses stratified by treatment duration, probiotic strain, and patient age.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and MEDLINE for human trials evaluating probiotics for VRE decolonization. The primary outcome was overall probiotic effectiveness in decolonizing VRE; subgroup analyses stratified by treatment duration (<12 vs. ≥12 weeks), probiotic strain (Lactobacillus rhamnosus GG [LGG] vs. non-LGG), and age group (<18 vs. ≥18 years) were also conducted. Odds ratios (ORs) with 95% confidence intervals (CIs) and p values were derived from a random-effects model using the Z test in Review Manager version 5.4.1.</p><p><strong>Results: </strong>Five trials involving 189 patients (95 probiotic, 94 control) were included. Probiotics statistically decreased VRE colonization compared with control treatments with small sample sizes, wide CIs, and heterogeneity across studies (OR: 5.70, 95% CI: 1.29-25.07, I² = 68%, p = 0.02). Neither short-duration (OR: 4.26, 95% CI: 0.81-22.43, I² = 70%, p = 0.09) nor long-duration (OR: 4.89, 95% CI: 0.27-89.78, I² = 65%, p = 0.28) treatments were significantly effective. LGG statistically decreased colonized VRE (OR: 7.22, 95% CI: 1.34-39.02, I² = 76%, p = 0.02) more than Lactobacillus rhamnosus Lcr35 (OR: 1.50, 95% CI: 0.06-40.63, I² not applicable, p = 0.81). Probiotics statistically decreased colonized VRE in pediatric patients (OR: 7.17, 95% CI: 2.37-21.71, I² = 11%, p = 0.0005) but not in adults (OR: 5.07, 95% CI: 0.24-105.69, I² = 76%, p = 0.29).</p><p><strong>Conclusions: </strong>Probiotics, particularly LGG, may facilitate decolonizing VRE from the human gut, especially in pediatric patients. Inconsistent effect was observed in adults or with Lactobacillus rhamnosus Lcr35.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric lavage for neonates with coffee-ground hematemesis: Toward a selective, evidence-based approach.","authors":"Ching-Chung Tsai","doi":"10.1016/j.pedneo.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.04.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of the coronavirus disease 2019 pandemic on the care of premature infants.","authors":"Shih-Ming Chu","doi":"10.1016/j.pedneo.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.04.001","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of a predictive model for the response to intravenous immunoglobulin in children with Kawasaki disease.","authors":"Tao Liu, Xia Zhang, Bin Liu","doi":"10.1016/j.pedneo.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.03.001","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease (KD) is an acute and self-limited vasculitis that predominantly affects children. Intravenous immunoglobulin (IVIG) remains the standard treatment. However, a subset of patients shows resistance to IVIG, which increases the risk of coronary artery complications. This study aims to identify reliable clinical biomarkers for predicting IVIG response in pediatric patients with KD.</p><p><strong>Methods: </strong>This retrospective study included 136 pediatric patients diagnosed with KD who received IVIG treatment between January 2021 and December 2023. Patients were categorized into IVIG responders or non-responders. Baseline clinical characteristics and laboratory parameters were compared between groups. Multivariate logistic regression analysis was used to identify independent predictors of IVIG response (responders = 1, non-responders = 0). Receiver operating characteristic (ROC) analysis was applied to evaluate the predictive performance of significant variables.</p><p><strong>Results: </strong>IVIG responders exhibited significantly higher hemoglobin and sodium levels, and significantly lower neutrophil percentage, platelet count, aspartate transaminase (AST), total bilirubin (TBIL), and C-reactive protein (CRP) levels (P < 0.05). Serum sodium concentration, platelet count, AST, and TBIL were independent predictors of IVIG response. Higher sodium levels were associated with increased IVIG response. Elevated platelet count, AST, and TBIL levels were associated with reduced response probability. AST and sodium had the highest AUC values and specificity, indicating strong diagnostic value. Platelet count provided supportive predictive value.</p><p><strong>Conclusions: </strong>Higher serum sodium levels were associated with an increased likelihood of IVIG response, whereas elevated platelet count, AST, and TBIL were associated with IVIG non-responsiveness in pediatric KD.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic diagnosis of pulmonary thromboembolism in a preterm infant presenting with congenital chylothorax.","authors":"Takao Kobayashi, Sota Iwatani, Seiji Yoshimoto","doi":"10.1016/j.pedneo.2026.01.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.01.005","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with life-threatening outcome in drug poison reports in Taiwan children (1991-2020).","authors":"Szu-Yin Tseng, Wei-Yu Chen, Nai-Yu Chen, Chih-Wei Lin, Hsing-Yuan Li, Chen-Chang Yang, Mei-Jy Jeng","doi":"10.1016/j.pedneo.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.04.010","url":null,"abstract":"<p><strong>Background: </strong>Pediatric drug poisoning poses significant risks, with some cases resulting in life-threatening outcomes. This study analyzes drug poisoning of children under 18 years of age in Taiwan, utilizing a comprehensive 30-year database to identify factors associated with severe to fatal outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of cases from the Taiwan Poison Control Center (PCC-Taiwan) database (1991-2020), focusing on various drugs, including pharmaceuticals, pesticides, environmental agents, and herbal medicines. Demographic data, poisoning characteristics, involved substances, and clinical outcomes were extracted. Cases were classified by severity: asymptomatic to moderate versus severe to fatal (life-threatening). Statistical analyses were performed to compare demographic data and identify factors associated with severe to fatal outcomes.</p><p><strong>Results: </strong>Of 17,274 cases, 99.0% were asymptomatic to moderate, while 1.0% (175 cases) were severe to fatal, resulting in an overall mortality rate of 0.26% (n = 45). Significant differences in demographics and specific management were observed between severity groups (p < 0.001). Among severe to fatal cases, peak incidence occurred in early childhood (0-5 years: 49.7%) and late adolescence (12-17 years: 42.3%).The most common toxic substances identified were organophosphates, anticonvulsants, and amphetamines. Intentional exposures accounted for 38.9% of severe to fatal cases, of which 55.9% were suicide attempts and 25.0% involved drug abuse. Significant factors associated with severe to fatal outcomes included prolonged exposure, intentionality, injection route, pesticide/herbal medicine use, and the requirement for specific management (p < 0.001). Pesticide use and requirement for specific management are risk factors for death in life-threatening cases (p < 0.01).</p><p><strong>Conclusion: </strong>Between 1991 and 2020, life-threatening outcomes occurred in 1.0% of pediatric drug poisoning cases, primarily affecting young children and adolescents. Intentional exposures, especially suicide attempts and drug abuse, were significant contributors to these cases, while pesticides use was associated with higher mortality rates. Further studies on targeted prevention strategies and effective interventions are essential to improving outcomes for this vulnerable population.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset sepsis in preterm-very-low-birth-weight neonates in Taiwan: A nationwide cohort study of incidence, outcomes, and risk factors.","authors":"Hsiao-Han Yang, Yu-Chia Chang, Shang-Po Shen, Hao-Wen Cheng, Ming-Luen Tsai, Hsiang-Yu Lin, Hsiao-Yu Chiu, Hung-Chih Lin, Yin-Ting Chen","doi":"10.1016/j.pedneo.2026.02.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.02.006","url":null,"abstract":"<p><strong>Background: </strong>This cohort study aimed to investigate the impact of early onset sepsis (EOS) on preterm-very-low-birth-weight neonates (PVLBW) before discharge.</p><p><strong>Methods: </strong>This study utilized data from the Taiwan Neonatal Network (TNN) and focused on neonates weighing less than 1500 g at a gestational age between 22 and 32 + 6 weeks, from 2016 to 2021. EOS was defined as a culture-confirmed bacterial infection of the blood or cerebrospinal fluid within three days of birth. Multivariate logistic regression analysis was performed to calculate the adjusted odds ratio (AOR) to identify independent risk factors for EOS while controlling for factors present at birth.</p><p><strong>Results: </strong>Out of the 7349 eligible PVLBW neonates, 208 (2.83%) experienced EOS, with a mortality rate of 29.3% (61/208). The independent risk factors for EOS included maternal chorioamnionitis (AOR: 4.10), male sex (AOR: 1.38), and a lower 1-min Apgar score (AOR: 0.83). Neonates with EOS exhibited significantly higher rates of severe outcomes, including severe intraventricular hemorrhage (25.26% vs. 8.05%), periventricular leukomalacia (8.25% vs. 3.42%), chronic lung disease (48.94% vs. 31.43%), severe retinopathy of prematurity (23.13% vs. 12.81%), necrotizing enterocolitis (8.33% vs. 4.69%), and late-onset sepsis (31.58% vs. 8.96%) compared to the non-EOS group.</p><p><strong>Conclusion: </strong>This study provides the first nationwide epidemiological data on early onset sepsis in neonates with PVLBW. Our findings indicate that EOS in neonates with PVLBW significantly increases the risk of mortality and severe adverse outcomes. Further investigations of the pathogens involved are warranted to develop strategies and predictive tools to improve patient outcomes.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal pain impairs spatial memory: Enrichment as a neuroprotective approach.","authors":"Khawla Nuseir, Amal Alachkar, Sally Ababneh, Ahmad Altarifi, Karem Alzoubi, Omar Khabour","doi":"10.1016/j.pedneo.2025.11.014","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.11.014","url":null,"abstract":"<p><p>Prematurity is on the rise worldwide and the need for procedures done to premature and mature infants to enhance their survival is also rising. These procedures, despite being lifesaving, result in short- and long-term detrimental impacts. The need for non-pharmacological alleviation of these negative consequences is clinically and ethically necessary. Enriched environment (EE) is such a modality that had been explored but needs further study. This research was undertaken to explore the possibility for EE to mitigate some or all the harmful effects of neonatal pain. In this work, EE was shown to mitigate the effects of painful neonatal procedures on learning and memory later in life in Wistar rats. The effects of EE on pain sensitivity were mixed; at 4 weeks of age, EE reversed the heightened pain sensitivity, but at 8 weeks it had no effect. In conclusion, EE is an easy and inexpensive method that has a major effect on early-life distressful events.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laryngeal atresia with esophageal atresia and dual tracheoesophageal fistulas: A case report.","authors":"Ching-Wen Huang, Ya-Ling Chou, Chien-Ming Lin, Kao-Hsian Hsieh","doi":"10.1016/j.pedneo.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2026.02.005","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dichotomy in biventricular function, progress and recovery among extreme preterm infants with persistent ductus arteriosus.","authors":"Krishna Revanna Gopagondanahalli, Joyce Khoo May Lyn, Abdul Alim Abdul Haium, Boon Siew Ooi, Kee Thai Yeo, Wai Lin Ang, Nur Qaiyimah Binte Mohamad Taib, Tze Liang Jonathan Choo, Victor Samuel Rajadurai, Sreekanthan Sundararaghavan","doi":"10.1016/j.pedneo.2025.11.012","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.11.012","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the biventricular functional changes in persistent patent ductus arteriosus (PDA) in extreme premature population.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>Single-center, tertiary-level neonatal intensive care unit.</p><p><strong>Patients: </strong>Infants born <28 weeks gestation.</p><p><strong>Main outcome measures: </strong>Serial cardiac function was evaluated using tissue Doppler echocardiography in 80 preterm infants born <28 weeks of gestation. Recruited infants had 4 weekly scans till 36 weeks. The serial cardiac function was compared between infants with persistent PDA beyond the first week of life and those with closed PDA.</p><p><strong>Results: </strong>Eighty infants were recruited. The incidence of moderate to severe BPD (51vs. 7, p = 0.01, OR 4.2, 95% CI 1.2-14.4), BPD-PH (28 vs. 3, p = 0.01, OR 5.07 95% CI 1.7-14.5) was higher among persistent PDA groups. The tissue Doppler imaging among persistent PDA cohort showed prolonged right ventricular (RV) isovolumetric relaxation time (IVRT) (38.9 ± 8.6 vs. 36.2 ± 7.8, p = 0.02) and RV myocardial performance index (MPI) (0.37 ± 0.06 vs. 0.35 ± 0.05, p = 0.04). The persistent PDA group had a higher left ventricular (LV) E/E' ratio (12.2 ± 4.7 vs. 8.9 ± 2, p = 0.01). The serial scans showed an abnormal left ventricular eccentricity index (1.07 ± 0.1 vs. 0.96 ± 0.2, p = 0.03), prolonged RV IVRT (39.8 ± 11 vs. 32.7 ± 6.5, p < 0.001), and RV MPI (0.36 ± 0.1 vs. 0.31 ± 0.04, p < 0.05) up to 36 weeks. The LV E/E' and LV E'/A' were abnormal for up to 33 weeks and normalized by 36 weeks of gestation.</p><p><strong>Conclusion: </strong>A significant dichotomy exists between biventricular function, progression, and recovery in PDA-exposed extreme premature neonates. The RV dysfunction was consistent and persisted longer than LV changes.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}