Pediatrics and Neonatology最新文献

{"title":"A comprehensive analysis of clinical variables for severe bronchopulmonary dysplasia in extremely preterm infants.","authors":"Yi-Ling Tung, Shih-Ming Chu, Reyin Lien, Ren-Huei Fu, Kai-Hsiang Hsu, Ming-Chou Chiang, Chih-Yung Chiu","doi":"10.1016/j.pedneo.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2025.01.006","url":null,"abstract":"<p><strong>Background: </strong>Identifying clinical risk factors that may forecast the development of severe bronchopulmonary dysplasia (BPD) in very and extremely premature infants can assist clinicians in implementing early interventions to reduce long-term morbidity and mortality rates.</p><p><strong>Methods: </strong>A cohort study of enrolled preterm neonates born before the gestational age (GA) of 32 weeks was performed between May 2018 and January 2022. Clinical parameters and comorbidities were gathered retrospectively from medical records and compared among different BPD severity levels based on the diagnostic definition of the 2019 National Institute of Child Health and Human Development criteria. Random forest models were used to rank the importance of clinical variables independently for severe BPD development.</p><p><strong>Results: </strong>A total of 134 preterm infants were enrolled and then divided into three groups based on their BPD severity. Unlike infants with no or mild BPD, the GA, birth weight, and Apgar score at 5 min were considerably lower in preterm infants with severe BPD (P < 0.001). Subgroup analysis of preterm infants born before GA 28 weeks revealed that only birth weight was significantly lower in those with severe BPD (P = 0.001). Furthermore, sepsis rates were significantly higher in extremely preterm infants with severe BPD (P < 0.001). Using random forest analysis, sepsis, birth weight, and patent ductus arteriosus (PDA) appeared to have the highest importance for severe BPD in extremely premature infants.</p><p><strong>Conclusion: </strong>Lower birth weight, sepsis, and the presence of PDA all play important roles in the development of severe BPD in extremely preterm infants.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588395","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":"Association of LEP rs7799039 and LEPR rs1137101 polymorphisms with obesity in Vietnamese preschool children.","authors":"Thi Tuyet Le, Bui Quang Minh Pham, Thi Trung Thu Nguyen, Thi Hong Hanh Nguyen, Thi Thuy Dung Le","doi":"10.1016/j.pedneo.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.09.007","url":null,"abstract":"<p><strong>Background: </strong>Single nucleotide polymorphisms (SNPs) in genes that regulate body weight and energy homeostasis, such as LEP and LEPR, may influence susceptibility to obesity. The present study aims to evaluate the association of LEP rs7799039 and LEPR rs1137101 polymorphisms with obesity in Vietnamese preschool children.</p><p><strong>Methods: </strong>A case-control study was conducted on 1146 preschool children aged 3-6 years (360 obese children and 786 normal-weight children). Genotypes at rs7799039 and rs1137101 loci were identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.</p><p><strong>Results: </strong>After adjusting for age and sex, single SNP analysis indicated an association of LEP rs7799039 with obesity (OR∗ = 1.41, P∗ = 0.01 in the recessive model), but no association between LEPR rs1137101 and obesity was found. In SNP-SNP interaction analysis, the combination of LEP rs7799039 AA and LEPR rs1137101 GG genotypes conferred a greater risk of obesity (OR∗ = 1.48, P∗ = 0.015).</p><p><strong>Conclusions: </strong>This study implies a synergistic effect of LEP rs7799039 and LEPR rs1137101 on obesity susceptibility. Therefore, these two polymorphisms are potential genetic markers to predict childhood obesity in the Vietnamese population.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568875","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":"Lung ultrasonography in the management of preterm (≤34 weeks) neonates with respiratory distress syndrome.","authors":"Shivendra Rai, Shalini Tripathi, Mala Kumar, S N Singh, Sukriti Kumar","doi":"10.1016/j.pedneo.2024.07.014","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.07.014","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of respiratory distress syndrome (RDS) is largely clinical with the support of a chest X-ray. Lung ultrasound (LUS) is emerging as a reliable bedside technique to evaluate RDS.</p><p><strong>Aims and objectives: </strong>To determine the LUS for preterm neonates ≤34 weeks of gestation admitted within 12 h of birth with clinical suspicion of RDS and to compare the lung USG score with the chest X-ray score to predict the need for surfactant administration.</p><p><strong>Methods: </strong>This prospective observational study was conducted among 67 preterm neonates with clinical suspicion of RDS admitted to our NICU. Neonates underwent a clinical examination, followed promptly by a chest X-ray and LUS. The decision to administer surfactant was made on the basis of the clinical picture and chest X-ray. The NICU team was blinded to the findings of LUS, and the radiologist was blinded to the X-ray chest report.</p><p><strong>Results: </strong>More than two-thirds (67.2%) of the enrolled neonates with clinical suspicion of RDS required surfactant administration. The median LUS score was 12 among those who needed surfactant, while it was 8 for those who did not need surfactant. A receiver operator curve was constructed for the LUS and chest X-ray scores to determine the need for surfactant administration. The area under the curve (AUC) for the LUS score was higher than that of the chest X-ray score (0.962 vs. 0.811; p < 0.001) for predicting the need for surfactant administration. The sensitivity and specificity for the LUS and chest X-ray scores were 95.6% versus 93.3% and 91% versus 50%, respectively.</p><p><strong>Conclusion: </strong>The LUS score is more useful than the chest X-ray score for determining the need for surfactant in preterm neonates with RDS suspicion.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588397","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":"Development of necrotizing enterocolitis in term newborns with critical congenital heart disease and affecting factors.","authors":"Berra Zumrut Tan Recep, Erkut Öztürk","doi":"10.1016/j.pedneo.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.09.006","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the frequency of necrotizing enterocolitis (NEC) and its influencing factors in term newborns diagnosed with critical congenital heart disease.</p><p><strong>Methods: </strong>The study was conducted retrospectively on term neonates diagnosed with critical congenital heart disease who were admitted to the pediatric cardiac intensive care unit between January 1, 2022, and January 1, 2024. The frequency of NEC and the risk factors contributing to its development were evaluated in the cases. The results were analyzed statistically.</p><p><strong>Results: </strong>There were 400 cases during the study period, with 52% being male. The median weight was 2900 g (IQR 2800-3000 g). NEC development was observed in 12 cases (3%). Ten cases were ductus-dependent (10/320), and two cases were diagnosed with other critical congenital heart diseases (2/80). The median age at diagnosis was 7 days (IQR 5-10 days). According to the modified Bell criteria, six patients had NEC stage IIA, four had stage IIB, one had stage IIIA, and one had stage IIIB. Surgical treatment was administered to three cases (25%). Independent risk factors for NEC included gestational age <38 weeks (OR 5.9, p = 0.004), birth weight <2500 g (OR 3.2, p = 0.02), mechanical ventilation dependency (OR 6.4, p = 0.01), >6 packed red blood cells (OR 6.4, p = 0.01), parenteral nutrition (OR 9, p < 0.001), and presence of functional single ventricle (OR 6.8, p = 0.008). The mortality rate was higher in cases with NEC compared to those without (50% vs. 7.7%, p < 0.001).</p><p><strong>Conclusion: </strong>NEC is a common complication in term neonates diagnosed with critical congenital heart disease. Low birth weight and gestational age, single ventricle physiology, mechanical ventilation dependency, excessive blood product usage, and parenteral nutrition increase the risk of NEC development in these cases.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558865","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":"Alport syndrome: Expanding diagnosis and treatment","authors":"Hou-Xuan Huang ,&nbsp;I-Jung Tsai ,&nbsp;Larry A. Greenbaum","doi":"10.1016/j.pedneo.2024.10.005","DOIUrl":"10.1016/j.pedneo.2024.10.005","url":null,"abstract":"<div><div>Alport syndrome (AS) is the second common monogenic cause of end-stage kidney disease (ESKD) worldwide and is caused by defective type 4 collagen due to pathogenic variants of <em>COL4A3, COL4A4,</em> or <em>COL4A5</em>. Type 4 collagen also exists in the eyes and ears, and thus ocular defects and hearing loss occur in AS. The understanding of AS has expanded over the past two decades due to greater availability of genetic testing and research on genotype-phenotype correlation. Patients previously diagnosed with idiopathic steroid resistant nephrotic syndrome or ESKD of unknown etiology may now be diagnosed as AS if pathogenic <em>COL4A3-5</em> variants are identified. Some carriers of heterozygous <em>COL4A3-5</em> variants may now be classified into females with X-linked AS or autosomal dominant AS, if there are typical pathologic changes in the glomerular basement membrane or if there is proteinuria and progression of kidney disease. Lastly, it has been recommended that renin-angiotensin-aldosterone system inhibition be started as soon as possible for selected AS patients for its long-term protective effect against kidney function deterioration. The purpose of this review is to introduce these important concepts to general pediatricians and pediatric nephrologists.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 ","pages":"Pages S13-S17"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633323","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":"Therapeutic plasma exchange in Pediatrics: An overview from the Pediatric nephrologists’ perspective","authors":"Gwo-Tsann Chuang ,&nbsp;Hou-Xuan Huang ,&nbsp;Min-Hwa Tseng ,&nbsp;I-Jung Tsai ,&nbsp;Yong-Kwei Tsau","doi":"10.1016/j.pedneo.2025.01.002","DOIUrl":"10.1016/j.pedneo.2025.01.002","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 ","pages":"Pages S23-S27"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016965","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":"Advocacy for DOHaD research optimizing child kidney health","authors":"You-Lin Tain","doi":"10.1016/j.pedneo.2024.10.006","DOIUrl":"10.1016/j.pedneo.2024.10.006","url":null,"abstract":"<div><div>Emerging antenatal risk factors have been associated with an increased risk of kidney disease throughout the offspring's life course. However, the intricate kidney programming mechanisms underlying these risks remain complex and are incompletely understood, but they are rooted in structural and functional alterations within the kidneys. The Developmental Origins of Health and Disease (DOHaD) theory underscores the significance of elucidating core mechanisms initiated through the maternal-fetal interface, which trigger kidney programming. Furthermore, it offers a promising avenue for preventing kidney disease at its earliest stages through a process known as reprogramming. This concise review aims to synthesize existing knowledge regarding the impact of kidney programming on offspring kidney disease and to provide an overview of documented reprogramming strategies as observed in animal models of kidney programming. By consolidating this information, we aim to expedite the translation of research breakthroughs into practical clinical solutions, ultimately resulting in enhanced outcomes for children facing kidney-related issues.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 ","pages":"Pages S18-S22"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585255","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":"Acid-base homeostasis in the neonate","authors":"Michael G. Michalopulos,&nbsp;Raymond Quigley","doi":"10.1016/j.pedneo.2024.10.004","DOIUrl":"10.1016/j.pedneo.2024.10.004","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"66 ","pages":"Pages S8-S12"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633309","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":"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}