Pediatrics and Neonatology最新文献

{"title":"Emerging trends in pediatric nephrology: A new frontier in care and research","authors":"You-Lin Tain","doi":"10.1016/j.pedneo.2025.01.001","DOIUrl":"10.1016/j.pedneo.2025.01.001","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 ","pages":"Page S1"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut dysbiosis as a susceptibility factor in childhood idiopathic nephrotic syndrome","authors":"Kazunari Kaneko","doi":"10.1016/j.pedneo.2024.10.003","DOIUrl":"10.1016/j.pedneo.2024.10.003","url":null,"abstract":"<div><div>Idiopathic nephrotic syndrome (INS) is a relatively common renal disorder of childhood characterized by severe proteinuria and associated hypoproteinemia and edema. Although the pathogenesis of INS remains unknown, the prevailing theory of its pathogenesis is as follows. Antigenic stimulation, such as viral infections or vaccines, in children with susceptibility factors for INS triggers abnormal immune responses, resulting in production of pathogenic substances that injure podocytes (renal glomerular epithelial cells). The injured podocytes then change their function and morphology, resulting in increased permeability of plasma proteins. Consequently, plasma proteins, especially albumin, are leaked into urine and massive proteinuria ensues. Research on susceptibility factors for INS has focused on polymorphisms in several genes including human leukocyte antigen class II genes. However, we propose that dysbiosis of the intestinal microbiota could be a susceptibility factor for relapse. This proposal is based on our research group finding that children with INS and frequent relapses have gut dysbiosis characterized by a decreased proportion of beneficial bacteria such as short-chain fatty acid-producing bacteria. Dysbiosis from the neonatal period to infancy may result from environmental factors, such as cesarean section delivery and antibiotic administration, which prevent the establishment of a normal intestinal microbiota. Dysbiosis leads to aberrant gut immunity and is characterized by a decreased ratio of T helper 1 cells/T helper 2 cells and an increased ratio of T helper 17 cells/regulatory T-cells. Therefore, relapse occurs when immunologically pathogenic factors that injure podocytes are produced in response to trigger events in children with INS and gut dysbiosis. Our recent clinical trial suggested that long-term oral administration of butyric acid-producing bacterium as a probiotic is promising for suppressing relapse. Therefore, studying the causal relationship between dysbiosis and relapses in patients with INS in a larger number of patients is necessary.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 ","pages":"Pages S2-S7"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of diagnostic renal arteriography in children with suspected secondary hypertension.","authors":"Hou-Xuan Huang, Chun-Ann Chen, Gwo-Tsann Chuang, I-Jung Tsai","doi":"10.1016/j.pedneo.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.12.001","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257397","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":"Cutoff levels of serum 25-OH-D for defining vitamin D deficiency in early infancy.","authors":"Bharti Yadav, Neeraj Gupta, Pragya Kumar, Rohit Sasidharan, Purvi Purohit, Kuldeep Singh, Praveen Sharma, Arun Singh","doi":"10.1016/j.pedneo.2024.06.017","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.017","url":null,"abstract":"<p><strong>Background: </strong>Various organizations use different thresholds to define vitamin D deficiency (VDD), which complicates its diagnosis, particularly in infants, as these thresholds are often extrapolated from adult data. Routine vitamin D3 supplementation in infants based on these criteria may impose unnecessary economic costs without clear benefits. Recent evidence suggests that the Institute of Medicine's (IOM) current threshold of <12 ng/ml might overestimate VDD in infants.</p><p><strong>Method: </strong>This study is a secondary analysis of data derived from a randomized controlled trial that compared the effects of 800 IU/day versus 400 IU/day of oral vitamin D3 supplementation in healthy, term, breastfed infants from 48 hours after birth to 14 weeks of age. The primary goal was to determine the serum 25-hydroxyvitamin D (25-OH-D) inflection point at which parathyroid hormone (PTH) levels begin to rise, in order to establish a more accurate cutoff for VDD in early infancy.</p><p><strong>Result: </strong>Among the 99 infants analyzed, 16 (16.2%) exhibited both elevated PTH levels and VDD at 14 weeks. The optimal inflection point for serum 25-OH-D was identified as 6.83 ng/ml (95% CI, 5.02-8.64), with an adjusted R² of 39.4% (p < 0.001). Using a revised cutoff of 8.64 ng/ml based on the 95% CI, only 10 (10.1%) infants would be classified as VDD, compared to 16 (16.2%) (p = 0.18) under the current threshold.</p><p><strong>Conclusion: </strong>The lower inflection point of 6.83 ng/ml and a revised cutoff of 8.64 ng/ml, supported by limited existing literature, suggest the need to reassess the IOM's current threshold for defining VDD in infants.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392418","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":"A case of mesenteroaxial gastric volvulus with wandering spleen in a 2-year-old boy.","authors":"Yu-Hsuan Chen, Yu-Tang Chang","doi":"10.1016/j.pedneo.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.12.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257395","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 recovery time and its predictors among under five years old children admitted with severe acute malnutrition at public hospitals in Addis Ababa, Ethiopia.","authors":"Samuel Dessu Sifer, Milkiyas Solomon Getachew, Rediet Awoke Assefa","doi":"10.1016/j.pedneo.2024.07.013","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.07.013","url":null,"abstract":"<p><strong>Background: </strong>The protocol advised by the World Health Organization suggests that therapeutic treatments center for Severe Acute Malnutrition should span two to three weeks but not surpass four weeks. Despite the existence of outpatient therapeutic feeding and other nutritional initiatives in the country, the Ethiopian demographic health surveillance and various studies indicate that nutritional issues continue to be a significant concern in Ethiopia. The average recovery time from SAM is prolonged in Ethiopia due to the demographic-, economic-, and facility-related factors. Therefore, the aim of this study was to determine the recovery time and its predictors among children under five admitted with severe acute malnutrition at public hospitals in Addis Ababa Ethiopia.</p><p><strong>Methods: </strong>A prospective cohort study was conducted with 240 children admitted with Severe Acute Malnutrition at Zewditu Memorial Hospital, Tirunesh Beijing Hospital, and Yekatit 12 Hospital from June 1 to September 28, 2023. Information was gathered from parents by data collectors. The determination of recovery time involved Kaplan-Meier survival curve analysis along with a log-rank test. Variables with a p-value below 0.05 in the multivariable Cox proportional hazard model were considered statistically significant.</p><p><strong>Result: </strong>The median recovery time was 16 days (95% CI: 14.66, 17.34), and the median hospital stay duration was 14 days (IQR: 9, 21). Absence of dehydration (AHR: 2.45; 95%CI; 1.25, 4.79), no malaria (AHR: 2.14; 95% CI: 1.10, 4.58), no hypoglycemia (AHR: 2.95; 95% CI: 1.05, 8.33), and MUAC greater than 11.5 cm (AHR: 1.54; 95% CI: 1.01, 2.35) were identified as statistically significant predictors influencing the time taken for recovery from Severe Acute Malnutrition.</p><p><strong>Conclusion: </strong>The majority of children exhibited recovery during the initial follow-up phases. Furthermore, factors such as dehydration, malaria, hypoglycemia, and Mid-Upper Arm Circumference independently influenced the time required for recovery from severe acute malnutrition.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257400","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":"Biologics promote catch-up growth in young Juvenile idiopathic arthritis patients with lower body height.","authors":"Jr-Lin Hsu, Ching-Chih Huang, Bo-Han Huang, Hsin-Yi Huang, Jing-Long Huang, Chao-Yi Wu","doi":"10.1016/j.pedneo.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.08.005","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is accompanied by growth retardation especially in severe cases. While the use of biologics has shown efficacy in restoring growth impairment, data from Asia are limited. We aim to investigate the growth of JIA patients and identify those who can benefit from the use of biologics in Taiwan.</p><p><strong>Methods: </strong>JIA patients who received regular follow-up and treatment at a tertiary medical center in Taiwan between January 2011 and June 2023 were retrospectively reviewed. General demographics and growth parameters, including body height, body weight, and body mass index (BMI), were collected at the time of biologics initiation, then at 6 and 12 months into treatment and they were transformed into z-scores for further analysis.</p><p><strong>Results: </strong>A total of 104 JIA patients, including 52 biologics-free controls, were enrolled. Enthesitis-related arthritis (ERA) accounted for 51% all cases. The initial z-scores for body height, body weight and BMI were -0.33, -0.35, -0.45, respectively. A significantly higher proportion of biologics-treated patients achieved catch-up growth, defined as a continuous increase in height z-scores 1 year following biologics treatment, compared to the biologics-free controls (38% vs. 12%; p = 0.002) 12 months into treatment. In subgroup analysis, JIA patients with lower initial z-scores for height (p = 0.021), a shorter period between symptom onset and diagnosis (p = 0.026), younger ages at the time of biologics initiation (p < 0.001) and higher accumulative dose of steroid before biologics (p = 0.048) are more likely to achieve catch-up growth. Combining the age at the time of biologics initiation and patients' initial z-score for height may be sufficient to predict catch-up growth following treatment with biologics (AUC = 0.804; p < 0.0001).</p><p><strong>Conclusions: </strong>Growth retardation appears limited among JIA patients in Taiwan. Initiation of biologics at a younger age may improve linear growth, especially for patients initially shorter for their age.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374997","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":"Determinants of acute phase reactant scores in well-appearing neonates with maternal risk factors for neonatal infection.","authors":"Aiko Kato, Kyoko Yokoi, Sachiko Iwata, Yoshiki Mizuno, Masami Asai, Haruo Goto, Shinji Saitoh, Osuke Iwata","doi":"10.1016/j.pedneo.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.08.007","url":null,"abstract":"<p><strong>Aim: </strong>Approximately 99% of neonatal deaths from sepsis occur in low-to middle-income countries, highlighting the need for efficient screening tools. The Acute Phase Reactant (APR) score comprises C-reactive protein, α1-acid glycoprotein, and haptoglobin, and can be assessed using a latex agglutination kit without modern equipment and expertise. This study assessed APR-score inter-rater reliability and identified non-infectious independent variables associated with positive APR scores in well-appearing term neonates with maternal risk factors for neonatal infection.</p><p><strong>Methods: </strong>APR scores were assessed within 24 h of birth in 309 term neonates with maternal premature rupture of membranes, meconium-stained amniotic fluid, or maternal colonization of group B Streptococcus.</p><p><strong>Results: </strong>Positive APR scores were identified in 29.9%, and the kappa value between the two examiners was 0.94. Positive APR scores were associated with higher gestational age (p = 0.010), female sex (p = 0.001), and meconium-stained amniotic fluid (p = 0.041).</p><p><strong>Conclusion: </strong>In neonates with maternal risk factors for neonatal infection, a convincingly high interrater agreement was demonstrated in the assessment of the APR score using a latex agglutination kit. Gestational age, sex, and meconium-stained amniotic fluid were identified as non-infectious independent variables associated with positive APR scores. By adjusting for these variables, an APR-based screening algorithm for neonates with sepsis may be established for use in low-resource settings.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400875","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":"Impact of late-onset circulatory collapse and bronchopulmonary dysplasia on short-term outcomes in preterm infants: A Japanese retrospective cohort study.","authors":"Shuji Ishida, Hidehiko Nakanishi, Rika Sekiya, Kohei Kawada, Yukako Kosaka, Ayano Yamaguchi, Mari Ooka","doi":"10.1016/j.pedneo.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.08.006","url":null,"abstract":"<p><strong>Background: </strong>Late-onset circulatory collapse (LCC) and bronchopulmonary dysplasia (BPD) are significant complications in extremely preterm infants, leading to adverse short-term outcomes. While adverse short-term outcomes associated with each condition have been reported individually, the impact of the interaction between BPD and LCC on adverse short-term outcomes remains unclear.</p><p><strong>Methods: </strong>This was a retrospective multicenter cohort study based on the Neonatal Research Network of Japan (NRNJ) including extremely preterm infants weighing <1500 g who were admitted to the neonatal intensive care unit and registered with NRNJ between 2010 and 2022. Demographic characteristics, morbidity, and mortality were compared among the BPD-LCC-, BPD-LCC+, BPD + LCC-, and BPD + LCC + groups.</p><p><strong>Results: </strong>A total of 14,644 infants were included. LCC was an independent risk factor for BPD (adjusted odds ratio (aOR) 1.30, 95% confidence interval (CI): 1.17-1.46) and significantly increased the risk of more severe BPD forms (aOR 1.34, 95%CI 1.22-1.46). Concomitant LCC in infants with BPD did not affect the incidence of home oxygen therapy and tracheostomy. Furthermore, LCC was found to increase the incidence of periventricular leukomalacia (PVL) (aOR 2.33, 95%CI 1.70-3.18). However, PVL was not associated with BPD. BPD was associated with an increased risk of severe retinopathy of prematurity (ROP) (aOR 1.14, 95% CI 1.02-1.26), which was further increased with concomitant LCC (aOR 1.97, 95% CI 1.71-2.26).</p><p><strong>Conclusions: </strong>LCC was a risk factor for the development of BPD. Concurrent LCC in infants with BPD increased the risk of severe ROP. Furthermore, LCC increased the incidence of PVL. However, PVL was not associated with BPD. The possible interaction between LCC and BPD was rooted in steroid deficiency. These findings suggest a potential avenue for future preventive interventions.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392424","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":"Prenatal cannabis use and adverse health outcomes in neonates and early childhood.","authors":"Panagiota Kitsantas, Katerina Benson, Alexandra Rubenstein, Maria Carmenza Mejia, Robert S Levine, Charles H Hennekens, Sarah K Wood","doi":"10.1016/j.pedneo.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.004","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016960","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}