Pediatrics and Neonatology最新文献

{"title":"The influencing factors of neonatal extubation failure: A systematic review and meta-analysis.","authors":"Hengyang Wang, Donghui Jia, Qian Wang, Wenrui Li, Xuhong Lan, Hongfang Zhou, Zhigang Zhang, Lihong Pang","doi":"10.1016/j.pedneo.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.05.006","url":null,"abstract":"<p><strong>Objective: </strong>To assess risk factors for extubation failure in mechanically ventilated neonatal patients in the neonatal intensive care unit.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of the literature. Data are reported as pooled odds ratios for categorical variables and mean differences for continuous variables. Data were sourced from common databases.</p><p><strong>Results: </strong>A total of 3152 studies were retrieved, 22 of which were included in this meta-analysis involving 4096 children. The risk factors identified were: male sex, low gestational age, low body weight, low 1-min Apgar score and 5-min Apgar score, airway abnormality, necrotizing enterocolitis, diaphragmatic paralysis, sternal closure delay, patent ductus arteriosus, low pH, highPaCO₂, low PaO₂, low PaO₂/FiO₂, low white blood cell count, high heart rate, prolonged length of MV, inhaled nitric oxide and prolonged length of stay in the NICU. Subgroup analysis showed distinct risk factors for extubation failure among preterm, term, surgical, and non-surgical neonates. Within 48 or 72 h of extubation, risk factors mostly overlapped, highlighting the need for tailored extubation strategies.</p><p><strong>Conclusions: </strong>We identified 20 factors associated with an increased risk of extubation failure, which can help medical staff in the early identification of children with high risk of extubation failure and thereby take measures. Future studies could develop more accurate predictive models based on these factors to predict extubation outcomes in neonatal.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621264","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":"Increased incidence of attention-deficit/hyperactivity disorder is associated with early and prolonged exposure to antibiotics: A population-based retrospective cohort study.","authors":"Chia-Yu Li Lin, Yu-Jui Huang, Hsiu-Chen Lin, Min-Lan Tsai, Jung-Tzu Ku, Feng-Chin Lee, Hsi Chang","doi":"10.1016/j.pedneo.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>Medication exposure has been shown to alter the composition of healthy gut microbiome, thereby disrupting the microbiota-gut-brain axis. Gut dysbiosis has been linked to increasing cases of neurodevelopmental disorders. To identify any correlation between antibiotics use and one of the most prevalent childhood disorders - ADHD - we conducted a nationwide study spanning over a decade in Taiwan.</p><p><strong>Methods: </strong>Two million individuals were randomly sampled between the years 2005 and 2018 ranging from the time of birth to the age of 8. They were categorized into three groups based on age of initial exposure to antibiotics and further stratified by exposure duration. The hazard ratios and 95 % confidence interval for ADHD were compared using a Cox proportional hazard model. Cumulative incidence curves were generated using the Kaplan-Meier method and analyzed using a log-rank test.</p><p><strong>Results: </strong>ADHD risk was highest in individuals exposed to antibiotics before the age of 2 years, regardless of the duration of exposure. In children aged >2 years, increased ADHD risk was observed alongside prolonged antibiotic exposure.</p><p><strong>Conclusions: </strong>In clinical practice, we may consider the potential adverse impact of prescribing antibiotics in young children, particularly in children aged <2 years. If antibiotic use is necessary, duration of administration should be shortened whenever practicable.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318788","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":"Seasonal influence and screening strategy for developmental dysplasia of the hip: A timely reappraisal","authors":"Chien-Chung Kuo ,&nbsp;Yin-Ting Chen","doi":"10.1016/j.pedneo.2025.05.002","DOIUrl":"10.1016/j.pedneo.2025.05.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 4","pages":"Pages 295-296"},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287207","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 improvement following speech and language therapy in children with mixed receptive-expressive language disorder across different age groups: A retrospective study.","authors":"Kuo-Cheng Liu, Jian-Jia Huang, Yu-Cheng Pei, Shu-Chun Huang, Chia-Ying Chung","doi":"10.1016/j.pedneo.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.007","url":null,"abstract":"<p><strong>Background: </strong>Mixed receptive-expressive language disorder (MLD) may have long-term impacts on development, sociobehavioral problems, and mental health issues in children. Speech and language therapy (SLT) has been proven to improve developmental language disorder (DLD) in childhood, and post-SLT improvements in language development are more prominent in younger children with DLD than in older children. However, there is still limited evidence on MLD. Therefore, this study aimed to investigate whether post-SLT improvements occur in children with MLD and whether there are age-related differences in improvements.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted to achieve this aim. We examined medical records from September 2020 to May 2023 and collected information on children who received SLT for DLD. Children who were diagnosed with MLD by the Comprehensive Development Inventory for Infants and Toddlers (CDIIT) and underwent post-SLT reassessment by the CDIIT were included for analysis. All subjects were furthermore categorized into 2 groups based on their age at initial assessment: ≤3 years and >3 years. The pre- and post-intervention CDIIT scores were compared.</p><p><strong>Results: </strong>A total of 41 children with MLD were included. The main effect of assessment time showed significant improvements in all language domain after SLT (all p < 0.01, η² > 0.14). While the main effect of age group revealed that post-SLT improvement was not influenced by age group classification, indicating comparable post-SLT improvements between the two age groups (all p > 0.05). Furthermore, the comparison of pre- and post-intervention differences between the two age groups did not yield significant differences, indicating that 12-week SLT was beneficial for children with MLD in both age groups.</p><p><strong>Conclusion: </strong>The present study indicated that post-SLT improvement occurred in all language domains among children with MLD. Furthermore, comparable improvement was observed between the two age groups, indicating that SLT is beneficial for children with MLD across different age ranges.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303622","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":"Effectiveness of early intervention and prediction of outcomes in taiwanese children with developmental delay.","authors":"Chao-Yang Kuo, Hsi Chang, Emily Chia-Yu Su, Yu-Jui Huang, Min-Lan Tsai, Sung-Hui Tseng","doi":"10.1016/j.pedneo.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.01.015","url":null,"abstract":"<p><strong>Background/purpose: </strong>In the 1990s, the Taiwanese government introduced a nationwide program for enhancing the development of children with developmental delay (DD) at the earliest point. As a part of this program, children with suspected DD or those at a risk of DD are referred to child assessment centers, where they undergo comprehensive multidisciplinary assessments (MDAs) using standardized screening tools to determine their developmental status. This study investigated the correlation between developmental outcomes and child-level factors by using serial MDA data, and we also aimed to develop an MDA result-based predictive model for identifying factors facilitating functional improvement in children with DD.</p><p><strong>Methods: </strong>This study included children who underwent at least two MDAs at Taipei Medical University Hospital between 2011 and 2020. DD and borderline DD were defined as scores more than1.5 and 1.0-1.5 standard deviations (SD), respectively, below the mean score in age-appropriate standardized norm-referenced tests. MDA results across various developmental domains were converted into a total developmental score. A machine-learning-based predictive model was constructed to differentiate between children with functional improvement and those without it.</p><p><strong>Results: </strong>The final analysis included 684 children (1368 MDAs). Of them, 58.9 % exhibited improved total developmental scores. Children who initially exhibited normal development in socioemotional skills, fine motor abilities, or language skills during the initial assessment were likely to exhibit improved outcomes.</p><p><strong>Conclusion: </strong>This study underscores the effectiveness of early intervention services in Taiwan. Consistent reassessments may facilitate subsequent educational interventions. Future studies should explore effective and efficient early intervention models for addressing DD.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546308","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 food bolus impaction triggered by bubble tea: A rare case of pediatric gastroparesis","authors":"Emi Nonaka ,&nbsp;Ryo Matsuoka ,&nbsp;Naoe Akiyama","doi":"10.1016/j.pedneo.2025.05.003","DOIUrl":"10.1016/j.pedneo.2025.05.003","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 4","pages":"Pages 406-407"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251040","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":"Successful transcatheter closure of a large inferior sinus venosus atrial septal defect","authors":"Chieh-Wen Kuo ,&nbsp;Hsi-Chuan Hung ,&nbsp;Hīng-Ka Lîm","doi":"10.1016/j.pedneo.2025.05.004","DOIUrl":"10.1016/j.pedneo.2025.05.004","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 5","pages":"Pages 500-501"},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267961","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":"Tract integrity predicts neurological outcomes in neonatal hypoxic-ischemic encephalopathy.","authors":"Pei-Ling Tsai, Yu-Chun Lo, Yi-Shan Tsai, Yea-Shwu Hwang, Ting-Chun Lin, Yao-Wen Liang, Chen-En Huang, Fu-Chun Hsu, Yi-Fang Tu, You-Yin Chen","doi":"10.1016/j.pedneo.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.01.014","url":null,"abstract":"<p><strong>Objective: </strong>Early prognostication in infants with neonatal hypoxic-ischemic encephalopathy (HIE) is crucial for follow-up management. Alternations of microstructural integrity of neural fiber tracts in large-scale neural networks might predict neurological outcomes.</p><p><strong>Methods: </strong>All consecutively-admitted patients with neonatal HIE from 2016 to 2020 were enrolled. Diffusion tensor imaging (DTI) tractography was performed at 4-7 days of age. Neurodevelopmental outcomes at 24 months of age were assessed with Bayley Scales of Infant Development, 3rd edition.</p><p><strong>Results: </strong>A total of 62 HIE infants were enrolled, and 53 of these underwent DTI. Fractional anisotropy (FA) and mean diffusivity (MD) were measured to indicate the microstructural integrity of tracts, including the arcuate fasciculus, uncinate fasciculus, inferior fronto-occipital fasciculus, corticospinal tract (CST), and optic radiations (OR). Lower FA values of target tracts were associated with lower developmental scores at 24 months of age, particularly in the CST and OR (all P ≤ 0.003). The prognostic accuracy of FA values in CST surpassed that in the region of thalamus/basal ganglia (area under curves 0.839, 95 % CI: 0.728-0.950 vs. 0.755, 95 % CI: 0.583-0.928). Furthermore, the correlation between FA values in target tracts and developmental scores was most significant in infants with HIE stage III and this was not affected by therapeutic hypothermia.</p><p><strong>Conclusion: </strong>Tract integrity in the CST and OR detected by DTI provides valuable insights for early prognostication in infants with HIE, regardless of therapeutic hypothermia.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295464","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":"Trends in antibiotic resistance of urinary tract infections in young children, 2010-2023.","authors":"Peong Gang Park, Seon Hee Lim, Ji Yeon Song, Yo Han Ahn, Seong Heon Kim, Hee Gyung Kang","doi":"10.1016/j.pedneo.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTI) are the leading cause of severe bacterial infection in children under 24 months. Increasing antimicrobial resistance, particularly to third-generation cephalosporins, is a growing concern. This study examines recent resistance trends in young children with UTI in Korea.</p><p><strong>Methods: </strong>A retrospective study was conducted on children under 24 months who presented with UTI to three university hospitals in Korea between 2010 and 2023. Children diagnosed with UTI and/or acute pyelonephritis with gram-negative bacteria identified in urine cultures were included. Antibiotic susceptibility data of antibiotics commonly used to treat pediatric UTI were collected, focusing on third-generation cephalosporins. Trends in resistance were analyzed according to age group, causative organism, and the presence of congenital anomalies of the kidney and urinary tract.</p><p><strong>Results: </strong>A total of 10,029 children were included, with a mean age of 4.0 months (IQR, 2.3-6.6 months); 67.9 % were male, and Escherichia coli accounted for 84 % of isolates. Resistance to cefotaxime increased significantly from around 10 % in the early 2010s to over 30 % after 2020. This increasing trend was consistent regardless of age group, causative organism, or presence of congenital anomalies of the kidney and urinary tract, although it showed a decreasing trend after 2021.</p><p><strong>Conclusions: </strong>There has been a significant rise in resistance to third-generation cephalosporins among young children with UTI in Korea over the past decade. These findings suggest a need to reconsider the empirical use of these antibiotics and consider alternative treatments to effectively manage UTI and prevent kidney scarring in Korean children.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251041","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":"Atypical presentations and neurosurgical Synergy in the treatment of paravertebral tumors in children: Lessons from a single institution.","authors":"Wei-Hsiang Su, Yu-Cheng Chou, Chia-Man Chou, Sheng-Yang Huang, Hou-Chuan Chen","doi":"10.1016/j.pedneo.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the surgical management and outcomes of pediatric paravertebral tumors, particularly focusing on dumbbell tumors, within a single medical center.</p><p><strong>Methods: </strong>Employing a retrospective analysis at Taichung Veterans General Hospital from January 2016 to February 2022, we included pediatric patients diagnosed with paravertebral tumors confirmed via MRI and histopathology, who underwent surgical treatment. We aimed to assess the extent of tumor resection as the primary outcome, with postoperative complications, recurrence rates, and neurological function as secondary outcomes, utilizing descriptive statistics.</p><p><strong>Results: </strong>In the given period, four pediatric patients, two males and two females aged 53-204 months, were treated at our institute for paravertebral tumors using CT and MRI for diagnosis. The tumors were located in the posterior mediastinum (3 patients) and retroperitoneum (1 patient), with varied MRI findings. Diagnoses included Ganglioneuroma, Schwannoma, Plexiform neurofibroma, and Spindle cell sarcoma. Treatments involved minimally invasive surgeries, with three cases using intraoperative neurological monitoring. Despite a mean operative time of 376 min and a 13-day average hospital stay, one patient experienced recurrence requiring chemotherapy, another had distant metastasis, and one died at a two-year median follow-up.</p><p><strong>Conclusions: </strong>Our study concludes that CT and MRI are crucial for diagnosing paravertebral tumors and planning surgery, and a multidisciplinary approach is essential for optimal functional preservation in pediatric patients. These findings emphasize the necessity for ongoing research to refine treatment strategies and improve patient outcomes in this complex clinical area.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295450","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}