Pediatrics and Neonatology最新文献

{"title":"Early postnatal immature-to-total neutrophil ratio in the histological chorioamnionitis among neonatal intensive care unit infants","authors":"Takashi Imamura, Shuhei Yamaguchi, Yuji Kanai, Yoshiyuki Namai","doi":"10.1016/j.pedneo.2024.04.013","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.04.013","url":null,"abstract":"Histological chorioamnionitis (hCAM) is a major risk factor for early-onset sepsis. Predictive methods for hCAM are needed in clinical practice during the early postnatal period. To examine the relationship between hCAM and perinatal variables including early postnatal immature-to-total neutrophil ratio (ITR).","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"23 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263318","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":"Molecular biology of glucose-6-phosphate dehydrogenase and UDP-glucuronosyltransferase 1A1 in the development of neonatal unconjugated hyperbilirubinemia","authors":"","doi":"10.1016/j.pedneo.2024.02.003","DOIUrl":"10.1016/j.pedneo.2024.02.003","url":null,"abstract":"<div><p>Glucose-6-phosphate dehydrogenase (G6PD) deficiency and variants of the <em>UDP-glucuronosyltransferase 1A1</em> (<em>UGT1A1</em>) gene are the most common genetic causes of neonatal unconjugated hyperbilirubinemia (NUH). In this review, we searched PubMed for articles on the genetic causes of NUH published before December 31, 2022, and analyzed the data. On the basis of the results, we reached eight conclusions: (1) 37 mutations of the <em>G6PD</em> gene are associated with NUH; (2) the clinical manifestation of G6PD deficiency depends not only on ethnicity but also on the molecular mechanisms underlying the deficiency (and thus its severity); (3) of mutations in the <em>UGT1A1</em> gene, homozygous c.−53A(TA)₆TAA &gt; A(TA)₇TAA is the main cause of NUH in Caucasians and Africans, whereas homozygous c.211G &gt; A is the main genetic cause of NUH in East Asians; (4) in Indonesian neonates, homozygous c.−3279T &gt; G is the most common cause of NUH development, and neither c.−53 A(TA)₆TAA &gt; A(TA)₇TAA nor c.211G &gt; A causes it; (5) in breast-fed East Asian neonates, the TA7 repeat variant of the <em>UGT1A1</em> gene protects against the development of NUH; (6) G6PD deficiency combined with homozygous c.211G &gt; A variation of the <em>UGT1A1</em> gene increases the risk of severe NUH; (7) in Pakistani and Caucasian patients with Crigler–Najjar syndrome type 2 (CN-2), point mutations of the <em>UGT1A1</em> gene are widely distributed and frequently occur with variation at nucleotide −53, whereas in Asian patients with CN-2, compound homozygous variations in the coding region are frequently observed; and (8) records of G6PD deficiency and <em>UGT1A1</em> variation status for a neonate offer useful pharmacogenomic information that can aid long-term care. These results indicate that timely diagnosis of NUH through molecular tests is crucial and that early initiation of treatment for the neonates and educational programs for their parents improves outcomes.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 419-426"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000202/pdfft?md5=b9f2102db26a7953789db902b39a4009&pid=1-s2.0-S1875957224000202-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140044458","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":"The efficacy and safety of intravenous immunoglobulin infusion in 12 h for the initial treatment of Kawasaki disease","authors":"","doi":"10.1016/j.pedneo.2023.09.012","DOIUrl":"10.1016/j.pedneo.2023.09.012","url":null,"abstract":"<div><h3>Background</h3><p>Approximately 10–20 % of individuals develop a recrudescent or persistent fever after intravenous immunoglobulin (IVIG) infusion for the initial treatment of Kawasaki disease. The aim of this study was to evaluate the efficacy and safety of the initial IVIG treatment of Kawasaki disease based on duration of infusion.</p></div><div><h3>Methods</h3><p>This retrospective, single-center study included 53 patients with Kawasaki disease who were initially treated with 2 g/kg of IVIG by means of a single infusion from June 2018 to August 2019. We classified patients into two groups based on the duration of the infusion: the 12-h group and the 24-h group. We compared the treatment response of the primary IVIG and its adverse events using the Mann-Whitney <em>U</em> test and Fisher's exact or Chi-square tests.</p></div><div><h3>Results</h3><p>There were no significant differences in the response to initial IVIG treatment between the two groups. The duration from treatment onset to defervescence was shorter in the 12-h group than the 24-h group (7 h vs. 12 h, respectively, p = 0.07); however, this was not significant. There were no significant between-group differences regarding adverse events.</p></div><div><h3>Conclusion</h3><p>We concluded that the initial 12-h IVIG treatment was comparable to the 24-h treatment in terms of efficacy and safety. This will enable physicians to feel confident about pursuing a shorter course of treatment with similar results as conventional treatment and decide on administering additional therapy to their patients.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 441-444"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000032/pdfft?md5=2936a1bad2254adcf9648840c5c42846&pid=1-s2.0-S1875957224000032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572088","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":"Corticosteroid use in neonatal hypotension: A survey of Canadian neonatologists","authors":"","doi":"10.1016/j.pedneo.2023.09.013","DOIUrl":"10.1016/j.pedneo.2023.09.013","url":null,"abstract":"<div><h3>Objective</h3><p>To assess prescribing practices and perspectives regarding the use of corticosteroids in the management of neonatal hypotension.</p></div><div><h3>Methods</h3><p>Cross-sectional questionnaire-based electronic survey of neonatologists (n = 206) practicing at tertiary neonatal intensive care units across 30 academic centres in Canada.</p></div><div><h3>Results</h3><p>The overall response rate was 33% (72/206), with a completion rate was 94%. Most (48/72, 64%) worked in a unit that covered both inborn and outborn infants, and 53% (37/70) worked in units with &gt;100 very low birth weight infants admitted annually. Among the 72 respondents, 39% use a loading dose, of whom most (57%) use 2 mg/kg. Dosing ranges were variable, most using either 0.5 mg/kg or 1 mg/kg, q6h. Among the 56% (40/72) of neonatologists who reported measuring cortisol before initiation of hydrocortisone, cut-offs for initiation of hydrocortisone varied from &lt;100 to &lt;500 nmol/L, most of whom (48%) used &lt;100 nmol/L. Of 71 respondents, 92% (65) indicated that a randomized control trial examining the use of corticosteroids in neonatal hypotension is needed, of whom 52% (37) indicated that the intervention group should receiving hydrocortisone after one vasopressor/inotrope.</p></div><div><h3>Conclusions</h3><p>This survey provides insight into the prescribing practices of tertiary neonatologists with regards to the use of corticosteroids in neonatal hypotension. While corticosteroids are frequently prescribed, there is variability in the indication, dosing, and duration of corticosteroid use. The findings from this survey can be used to inform further research, including a clinical trial, regarding the practice in the management of neonatal hypotension.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 451-456"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000056/pdfft?md5=a2e2a9af90852b686b997d40972fa26c&pid=1-s2.0-S1875957224000056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139926464","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":"Predictors of high maintenance prostaglandin E1 doses in neonates with critical congenital heart disease-ductal-dependent pulmonary circulation during preoperative care","authors":"","doi":"10.1016/j.pedneo.2024.01.002","DOIUrl":"10.1016/j.pedneo.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Neonates with critical congenital heart disease of the ductal-dependent pulmonary circulation type (CCHD-DDPC) require prostaglandin E1 (PGE1) to maintain oxygen saturation until surgery. However, the factors contributing to the maintenance doses of PGE1 remain unclear. This study aimed to determine the predictors of high maintenance PGE1 doses in these neonates.</p></div><div><h3>Methods</h3><p>This retrospective cohort study included neonates with CCHD-DDPC at Songklanagarind Hospital between January 1, 2006, and December 31, 2021. Factors associated with high maintenance PGE1 doses (&gt; 0.01 mcg/kg/min) were analyzed to identify predictors. Odds ratios were calculated using tabulation and logistic regression analysis. A prediction score was developed for high maintenance PGE1 doses.</p></div><div><h3>Results</h3><p>Among 96 neonates with CCHD-DDPC, 55 % required high maintenance doses of PGE1. Three factors significantly associated with high maintenance PGE1 doses were patent ductus arteriosus (PDA) size-to-birthweight ratio ≤1.3 mm/kg, initial PGE1 dose &gt;0.03 mcg/kg/min, and preoperative invasive mechanical ventilation. The area under the receiver operating characteristic curve for these three predictors was 0.7409. A predictive score of 0–3 was created based on these factors. The probabilities of receiving a high maintenance dose of PGE1 for patients with overall scores of 0, 1, 2, and 3 were 0.19 (95 % CI: 0.04–0.33), 0.42 (95 % CI: 0.30–0.54), 0.69 (95 % CI: 0.57–0.81), and 0.87 (95 % CI: 0.76–0.99), respectively.</p></div><div><h3>Conclusions</h3><p>In neonates with CCHD-DDPC, a PDA size-to-birth weight ratio ≤1.3 mm/kg, an initial dose of PGE1 &gt; 0.03 mcg/kg/min, and preoperative invasive mechanical ventilation were predictors of high maintenance PGE1 doses during the preoperative period.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 464-468"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000111/pdfft?md5=d5d60a2709c7dbd50c894bb676da744c&pid=1-s2.0-S1875957224000111-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139677560","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":"Using a survey, analyzing the current situation of allergic March in elementary and junior high school students of oyama and tochigi cities, Japan","authors":"","doi":"10.1016/j.pedneo.2023.10.008","DOIUrl":"10.1016/j.pedneo.2023.10.008","url":null,"abstract":"<div><h3>Background</h3><p>Over the past few decades, allergic diseases have become more prevalent and impact around 20% of the global population. There is clinical significance of allergic march as it places a burden on the quality of life of children and their families.</p></div><div><h3>Objectives</h3><p>To assess the current situation of allergy conditions experienced by children attending elementary and junior high schools in Oyama and Tochigi cities, Japan.</p></div><div><h3>Methods</h3><p>A letter was sent to parents informing them about an opt-in online survey concerning children's allergies along with a weblink and a QR code. A video explained the survey process and informed parents that their replies could not be retracted. Parents who had watched the explanation video and answered yes to participating were considered to have provided consent for the survey.</p></div><div><h3>Results</h3><p>A total of 2038 valid replies were gathered. Allergic Rhinitis was the most commonly diagnosed allergy, followed by Asthma, Food Allergy, and Atopic Dermatitis. Around 70% of the children were affected by the allergies, of whom half had been affected by multiple allergies. Most children affected by Atopic Dermatitis, Food Allergy or Asthma were affected by other allergies. Atopic Dermatitis and Food Allergy were mostly diagnosed before Asthma and Allergic Rhinitis.</p></div><div><h3>Conclusions</h3><p>Children who are diagnosed with either Atopic Dermatitis or a Food Allergy will likely be affected by other allergies later in life. Allergic march perpetuated an earlier peak diagnosis incident rate for allergic rhinitis. Allergic Rhinitis can occur independently from other allergies compared to Atopic Dermatitis, Food Allergy and Asthma.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 500-505"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187595722400038X/pdfft?md5=6a63625565b6c5a891971ea143ad5e42&pid=1-s2.0-S187595722400038X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190460","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":"Protective effect of breastfeeding on Kawasaki disease: A systemic review and meta-analysis","authors":"","doi":"10.1016/j.pedneo.2024.03.001","DOIUrl":"10.1016/j.pedneo.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Previous research has indicated a negative correlation between exclusive breastfeeding and the incidence of Kawasaki disease (KD). However, the validation of this discovery through meta-analytical studies has been lacking. Furthermore, uncertainties persist regarding whether breastfeeding reduces the risk of coronary artery lesions (CAL) or resistance to intravenous immunoglobulin (IVIG).</p></div><div><h3>Methods</h3><p><u>A systematic exploration of</u> the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> databases was conducted to identify longitudinal or randomized controlled trials investigating the efficacy of breastfeeding in preventing KD. The primary focus was on the incidence of KD, with secondary emphasis placed on the incidence of CAL and IVIG resistance. Data were pooled using a frequentist-restricted maximum-likelihood random-effects model.</p></div><div><h3>Results</h3><p>Of the 179 potentially eligible studies identified, five (n = 1,982,634) were included. The analysis revealed a significantly lower risk of KD (expressed as odds ratio, with 95% confidence intervals and p-values) in comparisons between exclusive breastfeeding and formula feeding (0.62, 0.43−0.91, <em>p</em> = 0.014), exclusive breastfeeding/partial breastfeeding and formula feeding (0.66, 0.46− 0.96, <em>p</em> = 0.03), and exclusive breastfeeding and partial breastfeeding/formula feeding (0.81, 0.74− 0.90, <em>p</em> &lt; 0.01). However, no significant difference was observed in the risk of developing KD when comparing partial breastfeeding to formula feeding exclusively. Regarding secondary outcomes, no statistically significant difference was found in the risk of CAL or IVIG resistance across any comparison formats.</p></div><div><h3>Conclusions</h3><p>Our study suggests that breastfeeding correlated with a reduced risk of KD but not with a reduced risk of CAL or IVIG resistance. These findings advocate for the implementation of breastfeeding policies in clinical practice.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 427-434"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000445/pdfft?md5=09b21872c98e81b76ed4e98931d73e71&pid=1-s2.0-S1875957224000445-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788655","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":"Development and validation of a nomogram to predict intracranial haemorrhage in neonates","authors":"","doi":"10.1016/j.pedneo.2024.02.005","DOIUrl":"10.1016/j.pedneo.2024.02.005","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to establish and validate a Susceptibility-weighted imaging (SWI)-based predictive model for neonatal <em>intracranial haemorrhage</em> (ICH).</p></div><div><h3>Methods</h3><p>A total of 1190 neonates suspected of ICH after cranial ultrasound screening in a tertiary hospital were retrospectively enrolled. The neonates were randomly divided into a training cohort and a internal validation cohort by a ratio of 7:3. Univariate analysis was used to analyze the correlation between risk factors and ICH, and the prediction model of neonatal ICH was established by multivariate logistic regression based on minimum Akaike information criterion (AIC). The nomogram was externally validated in another tertiary hospital of 91 neonates. The performance of the nomogram was evaluated in terms of discrimination by the area under the curve (AUC), calibration by the calibration curve and clinical net benefit by the decision curve analysis (DCA).</p></div><div><h3>Results</h3><p>Univariate analysis and min AIC-based multivariate logistic regression screened the following variables to establish a predictive model for neonatal ICH: Platelet count (PLT), gestational diabetes, mode of delivery, amniotic fluid contamination, 1-min Apgar score. The AUC was 0.715, 0.711, and 0.700 for the training cohort, internal validation cohort, and external validation cohort, respectively. The calibration curve showed a good correlation between the nomogram prediction and actual observation for ICH. DCA showed the nomogram was clinically useful.</p></div><div><h3>Conclusion</h3><p>We developed and validated an easy-to-use nomogram to predict ICH for neonates. This model could support individualized risk assessment and healthcare.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 493-499"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000378/pdfft?md5=5ef33d212f669928854d627faab1979e&pid=1-s2.0-S1875957224000378-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873502","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":"Hemoperitoneum presenting as hypovolemic shock in an extremely premature infant – Case report and review of literature","authors":"","doi":"10.1016/j.pedneo.2024.03.002","DOIUrl":"10.1016/j.pedneo.2024.03.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 509-510"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000676/pdfft?md5=77a1d66e36564a501b6d8edceb476a30&pid=1-s2.0-S1875957224000676-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035678","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":"Lessons from two patients with Prader–Willi syndrome attributed to heterodisomy and isodisomy","authors":"","doi":"10.1016/j.pedneo.2024.06.002","DOIUrl":"10.1016/j.pedneo.2024.06.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 519-520"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000895/pdfft?md5=ef453fe496ad4380fbe80bc4c174bd86&pid=1-s2.0-S1875957224000895-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412677","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}