Pediatrics and Neonatology最新文献

{"title":"Iatrogenic pharyngoesophageal perforation in very low birth weight infants","authors":"Chung-Ming Chen","doi":"10.1016/j.pedneo.2024.10.002","DOIUrl":"10.1016/j.pedneo.2024.10.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 1","pages":"Page 1"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633353","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":"Efficacy and safety of nasal high-frequency oscillation in preventing intubation in very-low-birth-weight infants with respiratory distress syndrome.","authors":"Buu Quoc Dang, Tam Thi Thanh Pham, Duc Ninh Nguyen, Nguyen Phuoc Long, Thu-Tinh Nguyen","doi":"10.1016/j.pedneo.2024.06.015","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.015","url":null,"abstract":"<p><strong>Background: </strong>Invasive mechanical ventilation in very-low-birth-weight infants (VLBWI) was associated with immediate and long-term complications. Nasal high-frequency oscillation (nHFO) has recently become a new non-invasive ventilation (NIV) mode for treating respiratory failure in VLBWI. This study aimed to investigate the safety and efficacy of nHFO as an alternative respiratory support to prevent intubation in VLBWI.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the clinical data of 42 VLBWIs with respiratory distress syndrome (RDS) who were treated in our department from August 2018 to August 2020 and met the selection criteria.</p><p><strong>Results: </strong>nHFO was used as a rescue strategy in 32 infants and a prophylactic strategy in 10 infants. It was observed that out of 42 cases, 30 cases (71.4%) were able to avoid intubation within 72 h, while 23 cases (54.8%) were successfully switched to another NIV mode from nHFO. There was a significant decrease in pCO₂ and an increase in pH 1 h after using nHFO in the success group. Two cases (4.8%) of feeding intolerance associated with nHFO were noted.</p><p><strong>Conclusion: </strong>This study showed that nHFO as alternative respiratory support for preterm infants with RDS might be safe and effective in reducing the need for intubation.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967472","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":"Oxidative stress in infants of diabetic mothers: Role of ischemia modified albumin in relation to lipid peroxidation, antioxidant status and essential trace elements.","authors":"Rania Ali El-Farrash, Eman Abdel Ismail, Ahmed Shafik Nada, Khaled Yousry Elesnawy","doi":"10.1016/j.pedneo.2024.06.016","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.016","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress plays an important role in the pathogenesis of maternal and fetal complications of diabetic pregnancies.</p><p><strong>Aim: </strong>To assess oxidative stress status in infants of diabetic mothers (IDMs) through measurement of ischemia modified albumin (IMA) and to examine its relation to lipid peroxidation, antioxidant status, essential trace elements, and maternal glycemic control.</p><p><strong>Methods: </strong>This study was conducted on 100 full-term infants; 50 infants were born to diabetic mothers and another 50 age- and sex-matched healthy infants were enrolled as controls. Maternal laboratory investigations included random blood glucose (RBG) and HbA1c. Cord blood RBG, total antioxidant capacity (TAC), malondialdehyde (MDA), IMA, and trace elements (copper [Cu] and zinc [Zn]) were measured.</p><p><strong>Results: </strong>Cord blood TAC, Cu, and Zn were significantly lower (p < 0.05 for all) while MDA and IMA levels were higher among IDMs compared with the control group (p < 0.001 for both). Maternal HbA1c was negatively correlated to TAC (r = -0.351, p = 0.013) while positively correlated to MDA (r = 0.305, p = 0.031) and IMA (r = 0.755, p < 0.001). IMA was also positively related to maternal RBG (r = 0.493, p < 0.001) while there were negative correlations between IMA and each of TAC (r = -0.491, p < 0.001) and Cu (r = -0.480, p = 0.001).</p><p><strong>Conclusions: </strong>Oxidative stress is enhanced in IDMs as indicated by increased lipid peroxidation and IMA levels. This is accompanied by decreased antioxidant defense, reflected by decreased TAC, Cu, and Zn levels. Oxidant-antioxidant balance is related to maternal glycemic control. Proper glycemic control among diabetic mothers is mandatory to avoid oxidative stress and its potentially harmful effects on their infants.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924150","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":"Iselin's disease.","authors":"Lalit Parida, Adya Kinkar Panda, Bibhudutta Sahoo","doi":"10.1016/j.pedneo.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.005","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924147","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":"Clinical features of atypical solid-type congenital pulmonary airway malformation (CPAM) type 1.","authors":"Mizuho Igarashi, Hidehiko Maruyama, Osamu Miyazaki, Takako Yoshioka, Yutaka Kanamori, Tetsuya Isayama, Yushi Ito, Haruhiko Sago","doi":"10.1016/j.pedneo.2024.07.012","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.07.012","url":null,"abstract":"<p><strong>Introduction: </strong>Type 1 congenital pulmonary airway malformation (CPAM) is characterized by large, dilated cysts that rapidly expand due to aeration immediately after birth, often necessitating surgical resection. In atypical cases of CPAM type 1, fetal T2-weighted magnetic resonance imaging (MRI) reveals a low-intensity solid lung mass containing multiple irregular T2 high-intensity areas.</p><p><strong>Methods: </strong>Data were retrospectively collected for infants with atypical CPAM type 1 born at our hospital between March 2002 and December 2022.</p><p><strong>Results: </strong>Four infants were identified, all presenting with a low-intensity solid lung mass on T2-weighted fetal MRI and requiring respiratory support after birth. Chest X-rays showed reduced aeration within the mass. Three infants with CPAM volume ratios (CVRs) ≥1.6 underwent emergency surgery on day 1 or 2 due to respiratory failure, while the fourth infant had elective surgery on day 9. Histological examination revealed small CPAM type 1 cysts (inner diameter [I.D.] 1-10 mm), lined by ciliated columnar epithelium and surrounded by a solid component composed of proliferative mucous cells and smaller cysts (I.D. 0.1-0.6 mm), lined by ciliated low-columnar or cuboidal epithelium resembling CPAM type 2 cysts.</p><p><strong>Conclusion: </strong>We managed four cases of solid-type CPAM type 1 with consistent findings on fetal MRI, chest X-ray, and histology. Larger CVRs were associated with the need for early neonatal surgery. Given the volumetric effect on surrounding lung tissue, early surgical resection may be required for large lesions.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877988","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":"Maternal Lactobacillus johnsonii supplementation attenuates hyperoxia-induced lung injury in neonatal mice through microbiota regulation.","authors":"Yu-Chen S H Yang, Hsiu-Chu Chou, Chung-Ming Chen","doi":"10.1016/j.pedneo.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.09.005","url":null,"abstract":"<p><strong>Background: </strong>Supplemental oxygen impairs lung development in premature infants with respiratory distress. This study investigated the effects of maternal Lactobacillus johnsonii supplementation on hyperoxia-induced lung injury in neonatal mice.</p><p><strong>Methods: </strong>Pregnant C57BL/6 mice received L. johnsonii in normal saline (NS) from gestational days 16-21. Control pregnant mice received an equal volume of NS. After birth, the pups were exposed to hyperoxia (O₂) or room air (RA) for 1 week. Four groups were studied: NS + RA, probiotic + RA, NS + O₂, and probiotic + O₂. On postnatal day 7, the lung and intestinal microbiota were sampled, and the right lung was analyzed.</p><p><strong>Results: </strong>Compared to the NS + RA, probiotic + RA, and probiotic + O₂ groups, the NS + O₂ group exhibited significantly lower body weight, lung vascular density, and more significant mean linear intercept, IL-6, and 8-OHdG. In the genus level of gut microbiota, the NS + O₂ group showed considerably more Staphylococcus and less Lactobacillus than the other three groups. The outcomes showed that in neonatal mice exposed to hyperoxia, maternal L. johnsonii supplementation improved lung development, decreased IL-6 and 8-OHdG levels, and restored gut microbiota.</p><p><strong>Conclusions: </strong>Maternal L. johnsonii supplementation reduced lung inflammation and improved lung development in hyperoxia-exposed neonatal mice. The mechanism may be related to the gut microbiota, as L. johnsonii improved gut microbiota communities and regulated dysregulated metabolic pathways.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900590","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":"Clinical course and management of pediatric gastroduodenal perforation beyond neonatal period.","authors":"Naohiro Takamoto, Takaaki Konishi, Michimasa Fujiogi, Mai Kutsukake, Kaori Morita, Yohei Hashimoto, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Jun Fujishiro","doi":"10.1016/j.pedneo.2024.06.014","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.014","url":null,"abstract":"<p><strong>Background: </strong>The treatments and outcomes of pediatric gastroduodenal perforations have rarely been described.</p><p><strong>Methods: </strong>We retrospectively identified 515 patients aged 28 days to 17 years who were hospitalized for gastroduodenal perforation between July 2010 and March 2021 using a nationwide inpatient database. We compared characteristics, treatments, and outcomes for pediatric gastroduodenal perforation between children aged <7 years (n = 38) and ≥7 years (n = 477).</p><p><strong>Results: </strong>Children aged <7 years had a higher prevalence of females, comorbidities, and gastric perforation than those aged ≥7 years. Compared to children aged ≥7 years, children aged <7 years were more likely to receive surgical treatment (79% vs. 55%), open surgery (58% vs. 19%), and supportive treatment such as mechanical ventilation (39% vs. 2.5%), treatment for disseminated intravascular coagulation (13% vs. 1.3%), catecholamines (32% vs. 2.7%), blood transfusion (37% vs. 2.1%), and intensive care unit admission (47% vs. 7.1%). Children aged <7 years had higher in-hospital mortality (5.3% vs. 0.4%) and morbidity (18% vs. 4.8%) than those aged ≥7 years.</p><p><strong>Conclusions: </strong>In pediatric gastroduodenal perforation, children aged <7 years were more likely to have comorbidities, undergo surgical and supportive treatments, and demonstrate poor outcomes than those aged ≥7 years.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873586","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 retrospective analysis of tacrolimus pharmacokinetic in Saudi paediatric patients in early post-liver transplantation period.","authors":"Ashjan Alghanem, Hala Joharji, Noureldeen Garaween, Huda Alenazi, Nada A Alsaleh, Dieter Broering, Mohammed Alshagrani, Fatimah Alhassan, Ahmed A Albassam, Abdullah Alsultan, Abeer Alsmari","doi":"10.1016/j.pedneo.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus is an essential immunosuppressive medication in paediatric patients' post-liver transplantation. Achieving tacrolimus target concentration in early post-transplantation is crucial to minimise the risk of acute rejection; however, this is challenging due to inter- and intra-patient variability in tacrolimus metabolism and clearance. Therefore, our study aims to describe tacrolimus trough concentration variability and pharmacokinetics in paediatric post-liver transplantation during the first two weeks post-transplantation.</p><p><strong>Method: </strong>This retrospective multicentre observational study included paediatric patients post-liver transplantation. Post-operative data was collected within the initial 14 days using electronic health records, including daily tacrolimus doses, measured trough concentrations, graft data, surgical data, and documented acute rejection. Pharmacokinetic analysis was completed using the Monolix software. We used the empirical Bayesian estimates of clearance and volume of distribution for covariate testing to assess possible correlations. We performed a stepwise regression analysis (alpha = 0.05).</p><p><strong>Results: </strong>Ninety-one paediatric patients were included in the study, with a mean age of 4.1 years (SD = 4.6). The mean graft-to-recipient weight ratio (GRWR) was 3% (SD = 6). The vast majority of the patients received the liver from living donors (n = 84, 92.3%). The average time needed to reach therapeutic concentration was 4.6 (SD = 2.8) days. The initial clearance (Clini) was very low at baseline (0.012 L/h), then increased dramatically to 9.84 L/h at 14 days post-transplantation. The clearance appeared to be time-dependent, and the time needed to reach 50% of maximum clearance was five days post-transplantation. The covariates that significantly affected clearance included bodyweight and aspartate transaminase, while the only significant covariate for volume of distribution was bodyweight.</p><p><strong>Conclusion: </strong>Tacrolimus is a drug with high intra- and interindividual variability, making dosing challenging in the paediatric liver transplantation population. Prospective studies with more intensive sampling are needed to address the time-dependent changes in clearance, which will aid in establishing the optimal dosing regimens in this population.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793129","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":"Chorioamnionitis and earlier gestational age are associated with neonatal hypercalcemia after maternal magnesium sulfate therapy: A case-control study.","authors":"Takahiro Tominaga, Yoshiko Seki, Sayu Omori-Shimano, Kazushige Ikeda, Yuki Shiko, Hiromichi Hamada, Midori Awazu","doi":"10.1016/j.pedneo.2024.06.013","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.013","url":null,"abstract":"<p><strong>Background: </strong>Magnesium sulfate (MgSO₄) is a tocolytic agent used to treat gestational hypertension and to prevent preterm labor. Neonatal hypocalcemia is a well-known side effect of maternal MgSO₄ use. Cases of neonatal hypercalcemia after maternal MgSO₄ have been reported. Little is known about neonatal hypercalcemia following maternal MgSO₄ therapy. We investigated the frequency and risk factors of neonatal hypercalcemia in this setting.</p><p><strong>Methods: </strong>This case-control study investigated serum calcium in neonates born within 24 h after maternal MgSO₄ administration. We reviewed the electronic medical records of Saitama City Hospital for pregnant women who were treated with MgSO₄ between January 2016 and December 2021. There were 504 pregnant women that were treated with MgSO₄. We enrolled 257 neonates. Hypercalcemia was defined as serum albumin-corrected calcium greater than 2.74 mmol/L (11 mg/dL). We collected the perinatal information from the mothers and neonates.</p><p><strong>Results: </strong>Twenty-one neonates (8%) had hypercalcemia at birth (H group). Umbilical arterial ionized calcium, neonatal plasma ionized calcium, and total serum calcium were significantly higher in H group than in N group. Neonatal serum albumin, on the other hand, was lower in H group than in N group. Neonates in H group were born earlier (28.4 ± 3.1 vs. 32.4 ± 3.1 wk, p < 0.001) and more likely to be born to mothers with pathological chorioamnionitis (91.0% vs. 12.7%, p < 0.001) than neonates who were normocalcemic (N group). Serum alkaline phosphatase was lower in H group (661 ± 276 vs. 816 ± 265 U/L, p = 0.01). Multivariate analysis showed that earlier gestational age and chorioamnionitis were significant risk factors.</p><p><strong>Conclusion: </strong>Hypercalcemia after maternal MgSO₄ was seen in 8% of neonates. Maternal chorioamnionitis and earlier gestational age were associated with this condition.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815106","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":"Perinatal risk factors and outcomes of pulmonary air leak in very-low-birth-weight preterm infants: A multicenter registry study in Taiwan.","authors":"Sung-Hua Wang, Yi-Li Hung, Chung-Min Shen, Wu-Shiun Hsieh","doi":"10.1016/j.pedneo.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.05.006","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary air leak may cause serious complications and mortality in neonates, especially preterm infants. Its incidence and perinatal risk factors in preterm infants might differ from those in term infants. We investigated the incidence, perinatal risk factors and morbidities associated with pulmonary air leak in very-low-birth-weight (VLBW) preterm infants in Taiwan.</p><p><strong>Methods: </strong>Data from 2011 to 2015 from the nationwide multihospital registry of the Taiwan Premature Infant Follow-up Network were analyzed. Preterm infants with pulmonary air leak, including pneumothorax and pneumomediastinum, were enrolled. Data on perinatal characteristics, the course of resuscitation in the delivery room, the management of respiratory distress syndrome (RDS), and the clinical outcomes of pulmonary air leak were collected and compared between VLBW preterm infants with and without pulmonary air leak.</p><p><strong>Results: </strong>We included 5906 VLBW preterm infants with a mean gestational age of 28.6 ± 3 weeks and mean birth weight of 1078 ± 284 g. Of them, 379 neonates (6.4%) had pulmonary air leak, with 5.4% and 1% having isolated pneumothorax and isolated pneumomediastinum, respectively. Independent risk factors for pulmonary air leak in VLBW preterm infants were male sex, a 5-min Apgar score <7, and RDS treated with surfactant. VLBW preterm infants who had higher gestational age or received nasal continuous positive airway pressure (NCPAP) had a lower risk of pulmonary air leak. However, pulmonary air leak was associated with higher rates of severe retinopathy of prematurity, severe intraventricular hemorrhage, chronic lung disease, and mortality.</p><p><strong>Conclusions: </strong>NCPAP appeared to protect against pulmonary air leak in VLBW preterm infants. Clinicians should be aware of the risk factors for pulmonary air leak in such infants and promptly initiate meticulous ventilation strategies as needed.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787719","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}