Journal of pediatrics, perinatology and child health最新文献

{"title":"Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Autoimmune Mechanisms, Diagnostic Controversies, and Therapeutic Implications.","authors":"Victoria Lynne, Devendra K Agrawal","doi":"10.26502/jppch.74050244","DOIUrl":"10.26502/jppch.74050244","url":null,"abstract":"<p><p>Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a proposed postinfectious neuroimmune syndrome characterized by the abrupt onset of obsessive-compulsive disorder, tic disorders, and associated neuropsychiatric symptoms temporally associated with Group A beta-hemolytic Streptococcus infection. Since its initial description by Swedo and colleagues in 1998, PANDAS has generated notable scientific interest and controversy. Increasing evidence from immunology, neuroimaging, epidemiology, and translational neuroscience suggests that infection-triggered autoimmune processes may contribute to neuropsychiatric symptom development in a subset of pediatric patients. However, significant uncertainty remains regarding diagnostic validity, biomarker reproducibility, pathophysiologic mechanisms, and optimal treatment strategies. This review carefully evaluates current evidence regarding the epidemiology, immunopathogenesis, clinical manifestations, diagnosis, treatment, prognosis, and controversies surrounding PANDAS and related Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Relevant literature published from 1998 through May 2026 was critically reviewed. Recent publications from 2021-2026 were incorporated to update evidence on clinical guidance, neuroimaging, immune biomarkers, autoimmune comorbidity, and IVIG outcomes. Evidence supporting the PANDAS construct includes epidemiologic associations with streptococcal infection, parallels with Sydenham chorea, identification of antineuronal antibodies, neuroimaging abnormalities involving basal ganglia structures, translational animal models, and selective responsiveness to immunomodulatory therapies. Conversely, substantial concerns remain regarding inconsistent biomarker replication, methodological heterogeneity, diagnostic overlap with primary psychiatric disorders, and the absence of universally accepted diagnostic tests. Current evidence supports the biologic plausibility of infection-triggered neuroimmune neuropsychiatric syndromes in a subset of pediatric patients. However, the specificity of the PANDAS construct, the boundaries between PANDAS and Pediatric Acute-Onset Neuropsychiatric Syndrome, and the identification of immune-responsive subgroups remain incompletely defined. Future multicenter prospective studies incorporating standardized diagnostic criteria, advanced immunophenotyping, neuroimaging, genomics, and longitudinal outcome measures are required to clarify disease mechanisms and optimize patient management.</p>","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"10 3","pages":"138-158"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the Gap Between Recommendation and Uptake: Provider Communication About Low-Dose Aspirin for Preeclampsia Prevention.","authors":"Sharla M Smith, Shea Kempsen, Claire Metcalf, Oluoma Obi, Elizabeth Madrigal, Kionna L Henderson, Megha Ramaswamy","doi":"10.26502/jppch.74050232","DOIUrl":"10.26502/jppch.74050232","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertensive disorders of pregnancy (HDPs), including preeclampsia, disproportionately contribute to preventable maternal morbidity and mortality. This study examined variations in clinician counseling and management of HDPs, provider communication about low-dose aspirin (LDA) prophylaxis, and barriers and facilitators to patient activation.</p><p><strong>Methods: </strong>A cross-sectional, mixed-methods study was conducted with perinatal care providers at two Midwest academic medical centers (2021-2022). An online survey was completed by 74 providers, followed by semi-structured interviews with a purposive sample of 13 providers. Survey data were analyzed descriptively using SAS 9.4; interview transcripts were analyzed using deductive thematic analysis with intercoder reliability.</p><p><strong>Results: </strong>All interviewed providers recommended LDA initiation between 12- and 16-weeks' gestation. Primary barriers included limited medication adherence (43%) and appointment non-attendance (16.5%). Facilitators included LDA's low cost, over-the-counter availability, and established safety profile. Themes include initiating conversations about LDA with all patients regardless of risk, emphasizing universal LDA uptake, and recognizing continued preeclampsia risk postpartum.</p><p><strong>Conclusions: </strong>Providers demonstrated familiarity with HDP guidelines but exhibited inconsistencies in counseling. Reframing \"patient compliance\" as \"patient activation\" supports equity-centered shared decision-making. Recommended strategies include establishing universal LDA recommendation protocols, expanding Medicaid coverage to reduce insurance barriers, and implementing community-focused public health education initiatives.</p>","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"10 1","pages":"40-50"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Maternal Ultra-Processed Food Consumption and Preterm Birth on the Development of Metabolic Disorders in Offspring.","authors":"Gauri Gurumurthy, Devendra K Agrawal","doi":"10.26502/jppch.74050214","DOIUrl":"10.26502/jppch.74050214","url":null,"abstract":"<p><p>This review examines the growing concern regarding the relationship between maternal ultra-processed food (UPF) consumption, preterm birth, and the subsequent development of metabolic disorders in offspring. Ultra-processed foods have become increasingly prevalent in global diets, coinciding with rising rates of metabolic diseases. Concurrently, preterm birth remains a significant public health concern affecting 5-18% of births worldwide. Here, we critically reviewed the current evidence regarding how maternal UPF consumption affects fetal development and how preterm birth disrupts metabolic programming. Furthermore, the information is presented on the potential synergistic effects when both factors are present. The mechanisms underlying these associations, including fetal malnutrition, inflammation, and hormonal dysregulation, are analyzed. Research suggests that maternal UPF consumption and preterm birth independently contribute to altered metabolic health in offspring, with potential compounding effects when both factors are present. This review highlights the public health implications of these findings and identifies areas requiring further research to better understand the complex interplay between maternal diet, preterm birth, and long-term metabolic health outcomes in offspring.</p>","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"9 2","pages":"68-84"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodevelopmental Risk in HIV-Exposed Uninfected Children: Call for Developmental Surveillance.","authors":"Aliyah Williams, Devendra K Agrawal","doi":"10.26502/jppch.74050227","DOIUrl":"10.26502/jppch.74050227","url":null,"abstract":"<p><p>As global efforts to prevent mother-to-child transmission of HIV have expanded, the population of children born HIV-exposed, uninfected (HEU) has grown substantially. HEU children face distinctive biological and environmental exposures that may place them at risk for neurodevelopmental challenges. This narrative review synthesizes evidence from the past decade on the neurodevelopmental outcomes of HEU children, including cognitive, motor, and behavioral differences observed across multiple international cohorts. It explores contributing factors such as maternal immune alterations, residual viremia during pregnancy, antiretroviral drug exposure, and postnatal growth impairments. These exposures have been linked to measurable developmental delays in infancy and early childhood, with some effects persisting into school age. Despite these risks, developmental monitoring is not routinely included in the care of HEU children. This review underscores the need to integrate neurodevelopmental surveillance into pediatric HIV-exposed care, optimize anti-retroviral therapy regimens with consideration of fetal outcomes, and support caregiver- and community-based interventions that promote healthy development. Addressing the developmental needs of HEU children is critical to improving long-term outcomes and ensuring this growing population is not left behind.</p>","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"9 4","pages":"184-189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De Novo Crohn's Disease Diagnosed in the Setting of Acute SARS-Cov-2 Infection Requiring Escalation of Infliximab Therapy Guided by Personalized Pharmacokinetics.","authors":"Martin Varea Romo, Kishor Acharya, Nathan R Shelman, Phillip Minar, Lee A Denson, Samir Softic","doi":"10.26502/jppch.74050172","DOIUrl":"https://doi.org/10.26502/jppch.74050172","url":null,"abstract":"<p><p>Here, we describe a 7-year-old girl who was diagnosed with an early-onset Crohn's disease in the setting of COVID-19 illness. Her disease process responded poorly to standard infliximab dosing, necessitating repeat hospitalizations and red blood cell transfusions. Remission was subsequently induced using a personalized infliximab pharmacokinetic profile based on therapeutic drug monitoring. While the initial data does not support a link, several case reports suggest an association between COVID-19 illness and de-novo development of IBD, especially in young female patients. We report, to our knowledge, the youngest patient who developed early-onset Crohn's disease in the setting of concomitant SARS-CoV-2 infection.</p>","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"8 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11042678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational dermatoses in health care personnel using PPE during the COVID pandemic.","authors":"Dinesh P Asati, K. Baheti, Maninder Kaur, S. Patra, Kritika Singhal Singhal","doi":"10.1101/2023.07.13.23292421","DOIUrl":"https://doi.org/10.1101/2023.07.13.23292421","url":null,"abstract":"Background: A sudden surge of occupation-associated dermatoses among the healthcare workers (HCWs) serving COVID-19 patients have been witnessed recently due to increased usage of PPE (PPE) kits and increased frequency of hygiene practices, with a significant impact on their quality of life and compromised efficacy at work. Hence, this study was conducted to measure the prevalence of occupational dermatoses among HCWs serving Covid-19 patients using PPE kits and hygiene practices and their impact on quality of life. Methods: HCWs of all cadres were screened for occupation-associated dermatoses. Cases with occupational dermatosis were evaluated further regarding the use of a PPE kit, and DLQI was calculated. Results: 19% of HCWs had dermatoses associated with PPE and hygiene practices. Hands were most affected, followed by the face, nasal bridge, and facial skin in contact with goggles. 48% had Mathias score >/= 4. Most cases had reported some impact on their quality of life. A significant association could be established between frequency of hand washing >/= 10 times/day with hand dermatitis (p=0.000). Conclusion: The use of PPE has significantly raised cases of occupational dermatosis among HCWs. Repeated hand washing and hand sanitizer use has increased the incidence of hand dermatitis.","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42365215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Digital Dashboard for Visual Representation of Child Health Information: Results of A Mixed Methods Study on Usability and Feasibility of A New CHILD-Profile","authors":"Miriam Weijers, Jonne Van der Zwet, N. Boumans, F. Feron, Caroline H.G. Bastiaenen","doi":"10.26502/jppch.74050142","DOIUrl":"https://doi.org/10.26502/jppch.74050142","url":null,"abstract":"Feasibility","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69350508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Malignant Pleural Effusion as an Initial Manifestation of Acute Lymphoblastic Leukemia: A Rare Case Report","authors":"Gajjar Jay Daxay, Vyakhya ., Ajeta Vijaykumar Gupta, Bhagwan Sahai Sharma, Susheel kumar saini, Madhur Sarthalia, Ajay kumar saini","doi":"10.26502/jppch.74050148","DOIUrl":"https://doi.org/10.26502/jppch.74050148","url":null,"abstract":"Exudative pleural effusion in children is mainly caused by bacterial infections. Leukemia rarely presents as pleural effusion as the first manifestation of the disease process. Bilateral malignant pleural effusion as an initial manifestation that leads to the diagnosis of an underlying acute lymphoblastic leukemia is a rare event. Most commonly pleural effusion is seen as complication in solid tumors such as the lung, lymphomas, carcinomas of the breast and gastrointestinal tract.","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69350612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive End-Expiratory Pressure During Helmet Ventilation in Critically Ill Bronchiolitis: A Multicenter Randomized Clinical Trial","authors":"Emanuele Rossetti MD, PhD, Zaccaria Ricci, MD, Daniele Bonacina, MD, Cristina Giugni MD, Ezio Bonanomi MD","doi":"10.26502/jppch.74050153","DOIUrl":"https://doi.org/10.26502/jppch.74050153","url":null,"abstract":"Emanuele Rossetti MD, PhD1*, Zaccaria Ricci, MD2, Daniele Bonacina, MD3, Cristina Giugni MD2 , Ezio Bonanomi MD3, Marina Franci MN1, Marta Ciofi degli Atti MD4, Manuela L’Erario MD2, Daniela Perrotta MD1, Corrado Cecchetti MD, PhD1, Linda Appierto MD1, Luigi Dei Giudici MD1, Alessandro Germani MD1, Francesco Polisca MD1, Francesca Tortora MD1, Ivano Farinelli MD1, Fabrizio Chiusolo MD1, Paola Serio MD2, Roberto Bianchi MD1, Sergio G. Picardo MD1 on behalf of the SARNePI (Italian Society for Pediatric and Neonatal Anaesthesia and Intensive Care).","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69350663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between Serum Testosterone Level and Erythrocytosis in Adolescent Males- A Cross-Sectional Study","authors":"Ariel Ben, Abu Arisha Rana, Bechor Ariel Tal, Yana Moshe, Leibzon Maor, Ben-Acon Michael, Sharon Nechama","doi":"10.26502/jppch.74050137","DOIUrl":"https://doi.org/10.26502/jppch.74050137","url":null,"abstract":"Background: Androgens and testosterone can induce erythrocytosis in several mechanisms. Adolescent males often present to primary clinics with an elevated Red Blood Cell values without Hemoglobin abnormalities. We investigated the correlation between serum testosterone levels and red blood cell values. Methods: 91 adolescents who were referred to the Emergency department were included in the trial, for which a complete blood count and serum testosterone were obtained, along with assessing Tanner score. Patients were divided into two groups with high and low red blood cell count. Mann -Whitney U test was performed to compare Serum testosterone level and Tanner score between the groups. Pearson’s correlation coefficient was calculated to determine the correlation between red blood cell count and Testosterone levels. Results: Testosterone levels was higher in the erythrocytosis group 14.05 (SD 5.53) vs non erythrocytosis group 11.94 (SD 7.38) although it did not meet statistical significance (p-value = 0.168). There is a weak positive correlation (Pearson’s R = 0.146) between testosterone and erythrocyte levels. Conclusion: In healthy adolescent males, whose serum testosterone levels are within normal range we observed erythrocytosis in 22% of patients. Testosterone levels was positively correlated with","PeriodicalId":73894,"journal":{"name":"Journal of pediatrics, perinatology and child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69350451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}