Pediatrics and Neonatology最新文献

{"title":"Acute kidney injury and long-term renal outcomes in pediatric diabetic ketoacidosis.","authors":"Nuttanicha Suraphan, Vichit Supornsilchai, Tawatchai Deekajorndech","doi":"10.1016/j.pedneo.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.009","url":null,"abstract":"<p><strong>Background: </strong>The cumulative evidence suggests that children with type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA) have increased risk of acute kidney injury (AKI). However, there is insufficient data among Thai patients, and the available information of long-term renal outcomes is limited.</p><p><strong>Objectives: </strong>To investigate the proportion and risk factors associated with AKI in children with T1DM and DKA, and to differentiate long-term renal outcomes between those experiencing AKI and those who are unaffected.</p><p><strong>Methods: </strong>Conducting a retrospective study, we enrolled children aged 1-18 years with T1DM and DKA at university hospital from January 2010 to August 2023. Participants were categorized into two groups based on the presence of AKI according to the 2012 KDIGO guidelines. The clinical parameters associated with these risk factors and long-term renal outcomes were evaluated.</p><p><strong>Results: </strong>This study included 85 children with T1DM admitted for 122 episodes of DKA, with 46 episodes (37.7 %) experiencing AKI. Identified AKI risk factors during DKA encompassed hypertension (adjusted odds ratio, aOR, 4.36; p = 0.05), serum glucose >500 mg/dL (aOR, 13.7; p < 0.001), WBC counts >15,000 cells/mm3 (aOR, 16.13; p < 0.001), and neutrophil-lymphocyte ratio >5.5 (aOR, 5.29; p = 0.04). For long-term renal outcomes, individuals with AKI during DKA demonstrated higher prevalence of hypertension, microalbuminuria, and abnormal glomerular filtration rates.</p><p><strong>Conclusion: </strong>AKI was common in children with T1DM experiencing DKA. Of note, it was linked to severe hyperglycemia, leukocytosis, and an elevated neutrophil-lymphocyte ratio, contributing to the deterioration in long-term renal prognosis.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163891","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":"SEGA as the isolated manifestation in a patient with germline non-TSC mutation: A case report and literature review.","authors":"Ya-Lan Yu, Jia-Yun Huang, Muh-Lii Liang, Che-Sheng Ho","doi":"10.1016/j.pedneo.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.005","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182835","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":"Eyelid edema induced by lipo-prostaglandin E1 in a term infant.","authors":"Yoshihiko Shitara, Mami Kobayashi, Takuya Oshima, Sayano Oishi, Yuta Mizono, Ryo Inuzuka, Naoto Takahashi","doi":"10.1016/j.pedneo.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.04.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144550","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":"Predictive risk factors for meconium-related ileus requiring surgical intervention in very low birth weight infants.","authors":"Yoshinobu Tsuno, Takeshi Kumagai, Mitsuhiko Riko, Taro Goda, Yasuyuki Mitani, Takuya Sugimoto, Mina Ueda, Manabu Kawai, Daisuke Tokuhara","doi":"10.1016/j.pedneo.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>Meconium-related ileus (MRI) is a serious morbidity in very low birth weight infants (VLBWI). MRI can lead to intestinal perforation, which has a poor prognosis. Treatment may involve medical or surgical approaches. Our aim was to identify the risk factors predicting surgery in VLBWI with MRI, which are not well studied. We also compared clinical factors between VLBWI treated medically versus surgically.</p><p><strong>Methods: </strong>We identified VLBWI with MRI who were admitted to our institution between January 2014 and December 2022. Infants were divided into those who underwent surgery and those who received conservative medical therapy. We compared various clinical factors between the groups. In each group, we calculated the ratio of maximum dilatational diameter of the intestinal tract to the maximum abdominal transverse diameter on abdominal X-rays at different time points; we called this ratio the \"MRI index\". Using receiver operating characteristic curve analysis, we determined the MRI index cutoff value to predict surgery.</p><p><strong>Results: </strong>We evaluated 34 VLBWI with MRI; 9 underwent surgery and 25 responded to conservative medical therapy. The MRI index on day 0 and the maximum MRI index in the surgical group were significantly higher than those in the medical group (p = 0.036 and p < 0.001, respectively). The MRI index cutoff value to predict surgery was 0.205 (area under the curve: 0.900, sensitivity: 0.92, specificity: 0.78). Compared with the medical group, the surgical group required significantly longer to achieve enteral feeding at 100 ml/kg/day, had a longer duration of hospital stay (p = 0.003 and p = 0.038, respectively) and a significantly higher incidence of sepsis (p = 0.042).</p><p><strong>Conclusion: </strong>VLBWI with an MRI index ≥0.205 have a significantly high risk of requiring surgery.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082124","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":"Pediatric hypertension: Current definition and knowledge gaps.","authors":"You-Lin Tain","doi":"10.1016/j.pedneo.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.004","url":null,"abstract":"<p><p>Elevated blood pressure (BP) and hypertension are common in children and adolescents, significantly increasing the risk of cardiovascular disease (CVD) in adulthood. Accurately assessing the prevalence and significance of pediatric hypertension requires a clear definition. The use of age-, sex-, and height-dependent percentiles to define pediatric hypertension began in 1977. Since then, several national and international clinical practice guidelines have refined its classification, diagnosis, and management, with notable contributions from The Fourth Report in 2004, the European Society of Hypertension (ESH) in 2016, and the American Academy of Pediatrics (AAP) in 2017. The 2017 AAP guideline redefined pediatric hypertension, increasing the number of children classified with elevated BP or hypertension. Despite these advancements, a universal diagnostic criterion for pediatric hypertension is still lacking. This review aims to summarize recent research on pediatric hypertension, focusing on evolving definitions, persistent knowledge gaps, and future directions. Addressing pediatric hypertension early with a lifespan approach is essential to reducing the global prevalence of hypertension and its associated CVD burden. The need for continued study and innovative strategies is underscored by research gaps in the prevention, detection, classification, and treatment of pediatric hypertension.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086959","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":"Vitamin D status and the adequacy of its supplementation during the first year of life in preterm infants in northern Japan.","authors":"Fumikatsu Nohara, Toshio Okamoto, Kenta Takahashi, Tatsutoshi Sugiyama, Aiko Hashimoto, Mitsumaro Nii, Yukari Yamaki, Etsushi Tsuchida, Takashi Satou, Masaru Shirai, Ken Nagaya, Satoru Takahashi","doi":"10.1016/j.pedneo.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D (VD) deficiency (VDD) is a major concern in preterm infants. The prevalence of VDD in mothers and infants varies between countries and is affected by a range of factors, such as geography and lifestyle. Thus, strategies aimed at preventing VDD must consider the status of each region. However, few reports have explored VDD in preterm infants in Japan and the safety and efficacy of VD supplementation in addressing VDD remain unclear.</p><p><strong>Methods: </strong>This study was conducted between September 2019 and October 2022. The participants were 108 preterm infants who were divided into three groups based on their gestational age: <28 weeks (Group 1), 28-33 weeks (Group 2), and 34-36 weeks (Group 3). VD status at birth was assessed, and 25-hydroxyvitamin D (25OHD) levels and biochemical markers were monitored during supplementation with 400 IU/day of VD over the first year of life.</p><p><strong>Results: </strong>Levels of 25OHD at birth were 10.0 (10.0-16.1), 10.5 (10.0-18.0), and 13.0 (10.0-19.0) nmol/L in Groups 1, 2, and 3, respectively. Infants in all three groups exhibited marked VDD. Their 25OHD levels gradually increased with VD supplementation before plateauing at 6 months. Nevertheless, VDD persisted in the majority of infants at 1 month of age. Serum intact parathyroid hormone levels peaked at 1 month of age and declined thereafter, negatively correlating with 25OHD levels. None of the infants exhibited symptoms of VD toxicity.</p><p><strong>Conclusion: </strong>Preterm infants in northern Japan exhibited substantial VDD, regardless of gestational age. In our cohort, VD supplementation at 400 IU/day safely increased 25OHD levels. However, VD levels improved gradually over the months, and several of these infants developed secondary hyperparathyroidism. Further studies are warranted to determine the optimal VD supplementation dose for preterm infants in this region.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112846","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":"Non-invasive simple predictors of biliary atresia in cholestatic infants - A preliminary report.","authors":"Yu-Hsueh Hsiao, Wei-Li Hung, Yao-Jong Yang, Fang-Ting Lu, Fang-Min Liao, Cheng-Yu Chen, Jia-Feng Wu","doi":"10.1016/j.pedneo.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Biliary atresia (BA) and other cholestatic liver diseases of early infancy share many similar clinical manifestations. We intended to investigate easy and popular non-invasive parameters to assist the differential diagnosis of BA among cholestatic infants.</p><p><strong>Methods: </strong>We enrolled 145 consecutive cholestatic infants (43.03 ± 2.00 days) who underwent cholestatic workups at our hospital as the study cohort, and another 27 cholestatic infants (47.78 ± 13.33 days) who received their initial cholestatic workups and laboratory tests at four other 4 hospitals as the validation cohort. The clinical data were surveyed retrospectively using a cross-sectional design.</p><p><strong>Results: </strong>We demonstrated that the \"GGT∗D-bil\" was significantly higher in the BA group than in the non-BA group in the study cohort (p < 0.001). The Receiver operating characteristic curve analysis of the study cohort identified the \"GGT∗D-bil\" cutoff >510 mg U/dL.L for the best prediction of BA among cholestatic infants (92 % area under the curve, p < 0.001). The sensitivity and negative predictive value (NPV) for predicting BA among cholestatic infants are 100 % in the study cohort. In the validation cohort, the \"GGT∗D-bil\" > 510 mg U/dL.L also achieved good sensitivity and NPV (92.31 % and 90.91 %, respectively) for the prediction of BA.</p><p><strong>Conclusions: </strong>We demonstrated that an easy parameter, \"GGT∗D-bil\" > 510 mg U/dL.L, may be used as part of the non-invasive cholestatic workups to assist in the diagnosis of BA among cholestatic infants in our study and validation cohorts. The application of this parameter is easy and not limited by the resources of the hospitals.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998428","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":"Automatic assessment of fine motor development in children through hand-drawn shape images.","authors":"Nai-Hsuan Hwang, Sheng-Shan Chen, Tun-Wen Pai, Mary Hsin-Ju Ko, Ya-Lan Yu, Hui-Ju Chen","doi":"10.1016/j.pedneo.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>Fine motor skills are closely related to neurological maturity among children and serve as critical indicators of developmental status. However, clinical assessments require significant human and material resources. This study proposes an automated evaluation mechanism designed to assess the development of children's fine motor skills, offering a streamlined and resource-efficient approach to developmental assessment.</p><p><strong>Methods: </strong>The designed system evaluated the fine motor skills of 82 children aged 36-72 months. The children were asked to replicate five geometric shapes designed by the system: circles, crosses, squares, triangles, and rhombuses. The system automatically assessed 23 distinct features across the geometric shapes using an artificial intelligence-based model. A tailored scoring system then assigned a score that reflected the child's level of fine motor skill maturity.</p><p><strong>Results: </strong>A total of 81 replicated drawings from the children in the test group were collected and automatically assessed using the assessment mechanism developed in this study. The results demonstrated a strong positive correlation between fine motor skill maturity and practical age. Additionally, the scores identified children with delayed fine motor development. The macro F1-score and accuracy of the automatic classification models for the five different geometric shapes in the validation dataset were 0.9236 and 0.9268, respectively. These evaluation outcomes can effectively support early intervention and treatment efforts.</p><p><strong>Conclusion: </strong>The system's structured drawing tasks for varying geometric shapes have substantial practical value for the automatic assessment of children's fine motor maturity. The scoring method developed in this study provides a clear distinction between the different developmental stages of children's fine motor skills. This system offers an effective online tool for assessing fine motor development among children, thereby providing essential preliminary reference information for physicians in subsequent clinical evaluations and significantly reducing the burden on healthcare professionals.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086957","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":"The impact of therapeutic hypothermia on developmental outcomes in lower-middle income countries: A systematic review and meta-analysis with a health equity lens.","authors":"Cheryl C Hawkins, Elizabeth Spiegel, Diane D Allen, Kathryn Nesbit","doi":"10.1016/j.pedneo.2024.09.010","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.09.010","url":null,"abstract":"<p><p>Hypoxic-ischemic encephalopathy (HIE) from birth asphyxia is particularly burdensome on lower-middle income countries (LMICs). Our systematic review examined early and late developmental outcomes related to neonatal therapeutic hypothermia (TH) without disability thresholds or cut-offs pre-determined by high-income countries. A search of PubMed, Web of Science, and Embase databases yielded 364 articles; 11 studies met eligibility criteria. According to published standards for reporting of studies, 3 of the 11 studies were good quality and 8 studies were excellent. Within-group changes in early and late developmental outcomes showed large, significant effect sizes (d = -2.07; CI = -0.77, -3.36; d = 3.17; CI = 2.14, 4.21). Between-group differences showed significant effect sizes in late but not early developmental outcomes (d = 0.85; CI = 0.62, 1.07; d = -0.16; CI = -0.58, 0.25). The evidence indicates that TH improves developmental outcomes prior to hospital discharge and after 6 months, and surpasses standard of care for 6-month and later developmental outcomes.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059497","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":"Critical appraisal on neural tube defects and their complexities.","authors":"Fouziya Shaikh, Mallica Sanadhya, Safa Kaleem, Tiya Verma, Richard L Jayaraj, Faizan Ahmad","doi":"10.1016/j.pedneo.2024.07.015","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.07.015","url":null,"abstract":"<p><p>Neural tube defects (NTDs), as a group of diseases, are congenital disabilities due to incomplete closure of the neural tube along its length, which otherwise forms the fully developed brain and spinal cord. An amalgamation of genetic, nutritional, and environmental factors plays a role in causing NTDs. They develop relatively early, within the first month of pregnancy-the time of neurulation, which could indicate that the pathogenesis of these diseases could stem from even pre-pregnancy causes like folic acid deficiency. This article provides an overview of the various etiology of NTDs and how they interact, as well as various preventive and curative measures like folic acid and inositol supplementation, stem cell transplant, and postnatal surgery. Identifying potential risk factors can help clinicians develop better management techniques beyond the limited scope of the presently used prophylactic and treatment methods.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056496","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}