Pediatrics and Neonatology最新文献

{"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}

{"title":"Assessing the rarity of noma in Ethiopia: Estimating cumulative point prevalence of the devastating childhood disease.","authors":"Heron Gezahegn Gebretsadik","doi":"10.1016/j.pedneo.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.12.005","url":null,"abstract":"<p><strong>Background: </strong>Noma, a severe and often fatal disease, is poorly understood due to limited data. Recently classified as a neglected tropical disease by WHO, its status in Ethiopia remains unclear. This study estimates Ethiopia's cumulative point prevalence of noma.</p><p><strong>Methods: </strong>In a retrospective cross-sectional study, the disease incidence in Ethiopia was determined using data from the review of medical records of noma cases. The medical records were obtained from the three main centers for treating noma in Ethiopia. Disease duration, which is critical for estimating point prevalence, was determined based on existing literature. Mean annual incidence data and disease duration were used to calculate the point prevalence of noma in 2019. This was translated into a ratio per 10,000 total population in Ethiopia to assess the disease status. The UN World Population Dashboard dataset was used to determine the population size of Ethiopia in 2019.</p><p><strong>Results: </strong>The study reviewed 325 medical records from three noma treatment centers in Ethiopia between 2007 and 2019. Noma cases spanned all Ethiopian regions, with Oromia and Amhara accounting for the most cases. An estimated 26,000 cases occurred nationwide during this period, translating to an annual incidence of 2167. The 2019 point prevalence was 0.77 per 10,000 people, confirming noma as a rare disease in Ethiopia.</p><p><strong>Conclusion: </strong>This study reveals the rarity of noma in Ethiopia and provides new insights critical to global understanding. Recognition of its rarity underscores the need to redirect resources to mitigate its impact in resource-poor settings such as Ethiopia, where the disease is more prevalent. The findings underscore the need for continued surveillance, data collection, and collaboration to better understand and effectively address noma. Thus, the results of the current study may serve as a landmark baseline data set to re-evaluate traditional perspectives on this devastating disease.</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":"144546307","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":"Evaluating the diagnostic value of the early postnatal immature-to-total neutrophil ratio in histological chorioamnionitis","authors":"Chih-Cheng Chen M.D.","doi":"10.1016/j.pedneo.2025.05.001","DOIUrl":"10.1016/j.pedneo.2025.05.001","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 4","pages":"Pages 293-294"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251039","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":"Hepatopathy-thrombocytopenia syndrome and disease relapse in pediatric wilms tumor: A 20-year retrospective analysis in a single center.","authors":"Chi-Yen Chen, Jui-Ju Tseng, Ke-Xin Chang, Chiung-Wen Liang, Li-Min Chen, Te-Kau Chang, Fang-Liang Huang","doi":"10.1016/j.pedneo.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.010","url":null,"abstract":"<p><strong>Background: </strong>Wilms tumor (WT) is the most common renal malignancy in children. With current treatments, the 5-year overall survival (OS) rate for children with WT is approximately 90 %. However, nearly 15 % of patients experience disease recurrence. A rare but severe treatment-related complication is hepatopathy-thrombocytopenia syndrome (HTS). In this study, we evaluated the characteristics, treatment outcomes, and complications of patients with WT, particularly focusing on HTS and relapse cases.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of WT cases from 2001 to 2021 at a tertiary care hospital in central Taiwan. Patient records were examined to collect information on age at diagnosis, sex, disease stage, treatment, tumor characteristics, treatment complications, and outcomes.</p><p><strong>Results: </strong>We included 23 pediatric patients with untreated WT. Their median follow-up duration was 102 months. Their median age was 3.4 (0.8-10.8) years. The most common tumor stage was Stage II (9/23, 39.1 %), followed by Stage I (7/23, 30.4 %), III (5/23, 21.7 %), IV (1/23, 4.3 %), and V (1/23, 4.3 %). One patient with Stage IV disease had distant metastasis of the right atrium. Two patients with Stage III disease developed HTS during treatment. Relapse occurred in 3 (13 %) of 23 patients, and the average time to relapse from the initial diagnosis was 25 (range, 9-44) months. All patients survived during the follow-up period, but one continued to experience refractory lung recurrence. Two patients underwent hematopoietic stem cell transplantation for relapse/refractory disease. No disease-related mortality was noted. The 5-year event-free survival and OS rates were 86.2 % and 100 %, respectively.</p><p><strong>Conclusion: </strong>Although WT generally has a favorable prognosis, physicians should remain mindful of potential treatment-associated complications and the risk of relapse when managing WT in children.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200939","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":"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 ,&nbsp;Jia-Yun Huang ,&nbsp;Muh-Lii Liang ,&nbsp;Che-Sheng Ho","doi":"10.1016/j.pedneo.2025.03.005","DOIUrl":"10.1016/j.pedneo.2025.03.005","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 4","pages":"Pages 402-403"},"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,&nbsp;Mami Kobayashi,&nbsp;Takuya Oshima,&nbsp;Sayano Oishi,&nbsp;Yuta Mizono,&nbsp;Ryo Inuzuka,&nbsp;Naoto Takahashi","doi":"10.1016/j.pedneo.2025.04.002","DOIUrl":"10.1016/j.pedneo.2025.04.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 4","pages":"Pages 404-405"},"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":"Perception of obesity and weight-loss attitudes among adolescents living with obesity, caregivers, and healthcare professionals in Taiwan: Data from the ACTION Teens survey study.","authors":"Chieh-Chung Lin, Hui-Chun Lo, Yu-Chen Yang, Chet Joe Sim, Bill Chen, Walter Chen","doi":"10.1016/j.pedneo.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>The ACTION Teens study (NCT05013359) surveyed adolescents living with obesity (ALwO), caregivers (CGs) of ALwO, and healthcare professionals (HCPs) of ALwO, to identify behaviors, perceptions, attitudes, and barriers to effective obesity care. The goal was to generate insights to help improve obesity management for ALwO, both globally and locally. Here, we discuss insufficient management of adolescent obesity in Taiwan.</p><p><strong>Methods: </strong>ACTION Teens was a cross-sectional, online survey study conducted in 2021. Three participant cohorts were recruited: ALwO (aged 12-<18 years with a body mass index ≥95th percentile for age and sex), CGs, and HCPs.</p><p><strong>Results: </strong>Most ALwO (77 %) and CGs (86 %) were at least somewhat worried about their/their child's weight, but only 57 % of ALwO and 54 % of CGs recognized that they/their child had obesity. Many respondents believed obesity had at least as much impact on overall health/wellbeing as cancer (ALwO: 65 %; CGs: 54 %; HCPs: 36 %). Both ALwO (53 %) and CGs (40 %) indicated that they themselves are responsible for initiating weight discussions with HCPs; among HCPs, this was 17 %. ALwO and CGs were more likely to use social media (ALwO: 28 %; CGs: 62 %) or search engines (ALwO: 27 %; CGs: 72 %) for information about weight management than a doctor (ALwO: 19 %; CGs: 26 %). Barriers to weight loss among ALwO and CGs included inability to control hunger (ALwO: 25 %; CGs: 24 %) and dislike of exercise (ALwO: 22 %; CGs: 24 %). Key motivators for weight loss differed between ALwO (\"I want to be healthier\" [27 %]), CGs, (\"My child wants to fit into smaller clothing\" [32 %]), and HCPs (\"Improved social life, social interactions, popularity\" [84 %]).</p><p><strong>Conclusion: </strong>This survey identified misalignment regarding obesity and weight management among ALwO, CGs, and HCPs in Taiwan. The results suggest HCPs should proactively initiate weight-loss communication. HCP-patient relationships based on communication and trust are key for weight-loss success.</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":"144227760","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}