BMC Pediatrics最新文献

{"title":"Frequency and types of antibiotic usage in a referral neonatal intensive care unit, based on the world health organization classification (AwaRe).","authors":"Farzaneh Hematian, Seyyed Mohammad Hassan Aletayeb, Masoud Dehdashtian, Mohammad Reza Aramesh, Arash Malakian, Mahboobeh Sadat Aletayeb","doi":"10.1186/s12887-025-05407-z","DOIUrl":"10.1186/s12887-025-05407-z","url":null,"abstract":"<p><strong>Background: </strong>Excessive prescription of antibiotics in infants increases the risk of short-term and lifelong morbidity and mortality. Nonetheless, the use of antibiotics in neonatal intensive care units (NICUs) is significantly high. This is primarily because neonatologists are concerned about the fragile immune systems of newborns, their vulnerability to serious infectious diseases, and the challenge of accurately distinguishing between infectious and non-infectious conditions.</p><p><strong>Method: </strong>A five-month cross-sectional prospective study was conducted in southwestern Iran's largest neonatal intensive care unit. This study aimed to evaluate the dose and duration of antibiotic therapy and identify the prescribing pattern of antibiotics based on the Access, Watch, and Reserve (AWaRe) classification recommended by the World Health Organization (WHO).</p><p><strong>Results: </strong>Out of 502 examined patient files, antibiotics were prescribed for 483 neonates. The most common drug combinations were ampicillin and amikacin. The mean number and duration of antibiotic administration were 2.14 drugs and 7.78 days, respectively. 84.3% of infants received antibiotics for ten days or less. The mean course of antibiotic prescription for newborns was 1.1, and 83.1% of prescribed antibiotics were from the Access Group.</p><p><strong>Conclusion: </strong>The antibiotic prescription rate was high in our study's department. Most neonates received two antibiotics in one course from the Access group.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"60"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric pancreatic acinar cell carcinoma with a non-canonical BRAF-KMT2C fusion and a classic SND1-BRAF fusion: a case report and literature review.","authors":"Yaqin Wang, Jiasi Zhang, Dimin Nie, Ai Zhang, Qun Hu, Aiguo Liu","doi":"10.1186/s12887-024-05378-7","DOIUrl":"10.1186/s12887-024-05378-7","url":null,"abstract":"<p><strong>Background: </strong>Pediatric pancreatic acinar cell carcinoma (PACC) is an exceptionally rare and poorly understood malignancy with a challenging prognosis. Its clinical presentation is often atypical, and standardized treatment guidelines are currently unavailable. While genetic alterations in adult PACC have been studied to some extent, knowledge of genetic abnormalities in pediatric cases remains limited.</p><p><strong>Case presentation: </strong>We report a case of pediatric PACC in a 7-year-old male presenting with a large, non-tender abdominal mass (11 cm x 11 cm) on the right side. Pathological and imaging evidence confirmed the diagnosis of PACC, with no lymph node infiltration or distant metastasis. Comprehensive genomic profiling by next-generation sequencing identified a non-canonical BRAF fusion with KMT2C at the DNA level and a classic SND1-BRAF fusion at the RNA level. The patient underwent surgical resection through a Whipple operation followed by six cycles of mFOLIRINOX chemotherapy and radiation therapy, achieving a favorable outcome up to now.</p><p><strong>Conclusions: </strong>Next-generation sequencing has demonstrated significant value in identifying genetic fusions in pediatric PACC. In our case report, we identified both the classical SND1-BRAF fusion, commonly associated with PACC, and a previously unreported nonclassical BRAF-KMT2C fusion. These findings underscore the critical role of BRAF alterations as key drivers of oncogenesis in PACC. A multidisciplinary treatment strategy integrating surgery, chemotherapy, and radiation therapy offers a promising precedent for improving therapeutic outcomes and prolonging survival in pediatric PACC cases.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"57"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of macrosomia with sociodemographic, anthropometric, lifestyle factors and perinatal outcomes in Southwest Nigeria.","authors":"Ikeola A Adeoye, Joshua I Fakorede, Mobolaji M Salawu, Kofoworola I Adediran","doi":"10.1186/s12887-025-05397-y","DOIUrl":"10.1186/s12887-025-05397-y","url":null,"abstract":"<p><strong>Background: </strong>Currently, macrosomia contributes to maternal and neonatal morbidity and mortality in low-and middle-income countries because of changes in maternal lifestyle. Reliable data are needed for its prevention, early detection, and management. This study assessed the associations between sociodemographic, anthropometric, maternal lifestyle, perinatal outcomes, and macrosomia in Southwest Nigeria.</p><p><strong>Methods: </strong>We used the Ibadan Pregnancy Cohort Study (IbPCS) data, which investigated maternal obesity, lifestyle factors and the associated pregnancy outcomes among 1745 antenatal care attendees in Southwest Nigeria. This study examined the 1200 women who were not lost to follow-up, had health facility deliveries and the infants' birthweight records. Outcome variables were macrosomia (birthweight ≥ 4 kg) and perinatal outcomes. Explanatory variables were sociodemographic, anthropometric, and maternal lifestyle factors. Maternal blood glucose and lipids were assessed between 24 and 28 weeks' gestation. Bivariate and multiple logistic and Poisson regression analyses examined the associations at a 5% level of statistical significance.</p><p><strong>Results: </strong>The prevalence of macrosomia was 72 (6%) [95% CI: 4.66-7.35]. On bivariate analysis parity (p = 0.009), maternal age (p = 0.012), history of macrosomia (0.021), consumption of protein-rich diets with non-alcoholic beverages (p = 0.021), sex of infants (p = 0.018), and engagement in physical activity (p = 0.036) were significantly associated with macrosomia. The mean maternal glucose levels were significantly higher among mothers with macrosomic babies compared with those without macrosomia: FPG: 4.72 ± 2.32 vs. 4.32 ± 0.9 mmol/l (p = 0.035), 1-hour plasma glucose: 8.80 ± 3.77 vs. 6.97 ± 1.93 mmol/l (p < 0.001), 2-hour plasma glucose: 7.16 ± 3.20 vs. 6.25 ± 1.73 mmol/l (p = 0.008). The predictors of macrosomia include a history of macrosomia [AOR = 2.057, 95% CI: 1.009-4.191), maternal obesity [AOR = 1.883, 95% CI: 1.027-3.451], and male infants [AOR = 1.847, 95% CI: 1.016-3.357) were more likely to have macrosomia compared to female infants. Furthermore, Emergency Cesarean section was a significant outcome of macrosomia [RR = 1.675, 95% CI: 1.068-2.627].</p><p><strong>Conclusions: </strong>Macrosomia was common among our study population. This study identified common modifiable risk factors for foetal macrosomia, its mechanistic pathways and suggested prevention and control strategies for macrosomia among pregnant women.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"61"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cyclooxygenase-2 (COX-2) and inflammatory markers in the progress of Alport syndrome in Egyptian children.","authors":"Moushira Zaki, Hisham A Orban, Mohamed A Shahba, Rehab S I Moustafa, Ahmed Adel, Fatina I Fadel, Abeer Selim, Hala T El-Bassyouni, Eman R Youness","doi":"10.1186/s12887-025-05412-2","DOIUrl":"10.1186/s12887-025-05412-2","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammation and its control are crucial to the responses of glomerular and renal tubular cells. This contributes to the pathogenic mechanisms and advancement of the disease in Alport syndrome. The study aimed to elucidate the role of cyclooxygenase-2, Interleukin 4, Plasminogen activating inhibitor 1, and Prostaglandin E2 in the development and course of Alport syndrome.</p><p><strong>Methods: </strong>In our study inflammatory markers were evaluated in 26 Alport syndrome patients, 15 males and 11 females and 24 controls.</p><p><strong>Results: </strong>Their age ranged from 4 to 16 years (mean ± SD was 8.50 ± 2.877) and 24 were normal controls matching age and sex. The serum levels of cyclooxygenase-2, Prostaglandin E2, Interleukin 4, and Plasminogen activating inhibitor 1 were evaluated in all patients. The serum level of cyclooxygenase-2, Prostaglandin E2, Interleukin 4, and Plasminogen activating inhibitor 1 were all increased significantly in the Alport syndrome patients compared to control (588.68 ± 73.08, 42.57 ± 4.18, 42.32 ± 3.49, and 846.47 ± 45.433, respectively versus controls (369.12 ± 50.28, 25.52 ± 4.98, 28.89 ± 3.19, and 312.79 ± 40.53 respectively).</p><p><strong>Conclusion: </strong>The role of inflammatory markers cyclooxygenase-2, Prostaglandin E2, Interleukin 4, and Plasminogen activating inhibitor 1 in Alport syndrome that are causally connected and have a role in the development and course of Alport disease was delineated. This may highlight and speculate an innovative strategy for targeting the creation of safe and efficient anti-inflammatory treatments to inhibit disease progression in Alport syndrome.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"56"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study.","authors":"Yueju Cai, Yongjiang Jiang, Ping Wang, Xiaopeng Zhao, Yanyan Song, Xiaolan Li","doi":"10.1186/s12887-025-05390-5","DOIUrl":"10.1186/s12887-025-05390-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the risk factors for early intraventricular hemorrhage (IVH) in extremely low birth weight infants (ELBWIs) to provide guidance for early intervention, thereby improving survival rates and quality of life for these vulnerable infants.</p><p><strong>Methods: </strong>A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. Standard head ultrasound screening (HUS) was used to assess the presence and severity of IVH on days 1-3 and 5-7 post-birth. Infants were categorized into either the IVH or non-IVH group based on HUS findings. Univariate analysis and logistic regression were employed to identify risk factors for IVH, and the efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Among the 205 ELBWIs (97 males, 108 females), 82 (40%) developed IVH, with 26 (12.7%) classified as severe IVH and 56 (27.3%) as mild IVH. IVH within the first three days occurred in 51 of the 82 cases. Severe IVH was more prevalent in the lower gestational age groups: 40.0% in infants at 23 + 1 to 26 weeks, 10.7% in infants at 26 + 1 to 28 weeks, and 1.4% in infants at 28 + 1 to 32 weeks (p < 0.001).Logistic regression analysis revealed two independent risk factors: failure to withdraw invasive ventilation within the first week (OR = 3.276, 95% CI = 1.465-7.324, p = 0.004) and the use of vasoactive drugs within the first week (OR = 2.112, 95% CI = 1.002-4.451, p = 0.049). The ROC curve showed a sensitivity of 68.3%, specificity of 81.3%, and an area under the curve (AUC) of 0.792.</p><p><strong>Conclusion: </strong>The incidence of IVH in ELBWIs is high, particularly within the first three days after birth. The use of vasoactive drugs and prolonged invasive ventilation are associated with increased risk, highlighting the need for careful management of respiratory and hemodynamic support in these infants.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"58"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the clinical value of procalcitonin, c-reactive protein, white blood cell count, and neutrophil-to-lymphocyte ratio in the early diagnosis of bloodstream infections in children.","authors":"Yadong Li, Mingjie Li, Chenye Lin, Wentao Tang, Qiuyu Tang, Feng Cheng","doi":"10.1186/s12887-025-05402-4","DOIUrl":"10.1186/s12887-025-05402-4","url":null,"abstract":"<p><strong>Backgroud: </strong>In the diagnosis of bloodstream infections (BSI) in children, compared to the gold standard of blood culture, markers in the blood offer advantages such as rapid results and cost-effectiveness. Therefore, we investigated the clinical value of procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in the early diagnosis of BSI in children.</p><p><strong>Methods: </strong>This study included a retrospective analysis of 309 suspected BSI cases and patients were categorized into 2 groups based on blood culture results: blood culture-positive group, and blood culture-negative group. The blood culture-positive group was further partitioned into 3 sub-groups based on the type of pathogen: Gram-positive (G +) bacteria, Gram-negative (G-) bacteria, and fungi. Changes in PCT, CRP, WBC, and NLR were evaluated, and pathogen infections among these aforementioned groups were further determined. Moreover, the study employed the receiver operating characteristic (ROC) curve to evaluate the diagnostic value of these indicators in identifying BSI in pediatric patients at an early stage.</p><p><strong>Results: </strong>Among the 98 strains of pathogens detected in blood culture, 58 (58.2%) strains were G- bacteria, 33 (33.7%) strains were G + bacteria, and 7 (7.1%) strains were fungi. The levels of PCT, CRP, WBC, and NLR were found to be significantly higher in the blood culture-positive group than the blood culture-negative group (p < 0.01). Upon comparing the levels of PCT and CRP in the three pathogen infections, it was found that the fungi group exhibited higher levels than the G- and G + bacteria groups (p < 0.01). The G- bacteria group exhibited higher levels of PCT, CRP, and WBC than the blood culture-negative group (p < 0.05). Similarly, the G + bacteria group exhibited higher levels of PCT, WBC, and NLR than the blood culture-negative group (p < 0.01). Besides, PCT presented the highest diagnostic efficiency among the single-item detections, with an AUC of 0.862 (95% CI: 0.819-0.906). The simultaneous detection of multiple parameters does not necessarily improve diagnostic performance but can enhance detection sensitivity.</p><p><strong>Conclusions: </strong>PCT and CRP can provide important complementary information for the etiological diagnosis of BSI in children. Elevated levels of PCT and CRP were often associated with fungal or G- bacterial infections, with PCT showing particularly significant effects. Combined use of serum PCT, CRP, WBC, and NLR testing can improve the diagnostic sensitivity of pediatric BSI, reducing the risk of missed diagnoses, thereby enhancing the early diagnostic value of pediatric BSI.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"62"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 rhGH treatment combined with letrozole/GnRHa in adolescent boys.","authors":"Ying Zhang, Xin Yuan, Kenneth McCormick, Xiao-Hong Yang, Shi-Jun Chen, Rui-Min Chen","doi":"10.1186/s12887-025-05408-y","DOIUrl":"10.1186/s12887-025-05408-y","url":null,"abstract":"<p><strong>Objective: </strong>In boys during puberty who were undergoing recombinant human growth hormone (rhGH) treatment, we compared the therapeutic efficacy on growth, and any adverse reactions, of co-therapy with either letrozole or gonadotropin-releasing hormone analog (GnRHa).</p><p><strong>Methods: </strong>Fifty-six pubertal growth hormone deficiency (GHD) boys were studied, they were treated with the combination of letrozole and rhGH (letrozole group, n = 28) or the combination of GnRHa and rhGH (GnRHa group, n = 28) for at least one year. Eighteen patients in the letrozole group and seventeen patients in the GnRHa group attained final adult height (FAH).</p><p><strong>Results: </strong>The increase in height of the letrozole group was significantly more than the GnRHa group both in the first year [(10.37 ± 2.19) vs. (7.78 ± 1.55) cm] and at two years [(18.82 ± 2.49) vs. (13.84 ± 2.17) cm] (p < 0.05), however, there was no significant group difference in the advancement of bone age (BA) of in the first year or at two years (p > 0.05). The mean FAH in two groups were similar, but the treatment duration of the letrozole group was significantly less than GnRHa group. There was a significant body mass index (BMI) SDS increase in the letrozole vs. GnRHa groups. Of concern, bone mineral density (BMD) decreased in both groups after treatment, but more so in the letrozole cohort.</p><p><strong>Conclusion: </strong>The combination of letrozole/rhGH in pubertal GHD boys was similar to GnRHa/rhGH in terms of the progression of BA and FAH, but the former co-therapy was superior in the gain of height. Disconcertingly, however, this combination may adversely affect BMI and BMD.</p><p><strong>Clinical trial registration number: </strong>ChiCTR2300068405.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"59"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal indicator data in Tanzania District Health Information System: evaluation of availability and quality of selected newborn indicators, 2015-2022.","authors":"Josephine Shabani, Nahya Salim, Christine Bohne, Louise Tina Day, Claud Kumalija, Ahmad Mohamed Makuwani, Felix Bundala, Habib Ismail, Joy E Lawn, Eric O Ohuma","doi":"10.1186/s12887-025-05417-x","DOIUrl":"10.1186/s12887-025-05417-x","url":null,"abstract":"<p><strong>Background: </strong>The Every Newborn Action Plan (ENAP) indicators are essential in monitoring neonatal healthcare coverage and quality. The District Health Information System (DHIS2), an open-source platform in over 80 countries, supports health data collection and analysis, enabling progress tracking at national and subnational levels. This study evaluates the availability and quality of maternal and newborn health indicators, explicitly focusing on ENAP indicators within Tanzania's DHIS2.</p><p><strong>Methods: </strong>Using the EN-MINI tool, we assessed data availability for 20 ENAP indicators by analysing their numerators and denominators in Tanzania's DHIS2 (2015-2022) across all healthcare levels. World Health Organization's (WHO) data quality framework was adapted to examine four dimensions: (a) availability of indicators, (b) completeness of indicator reporting, (c) internal consistency of related indicators, and (d) indicator plausibility by comparing DHIS2 data with population-based Demographic and Health Survey (DHS) data.</p><p><strong>Results: </strong>Of the 20 ENAP indicators, 14 were available in Tanzania's DHIS2, with definitions, numerators and denominators aligned with WHO standards. Between 2015 and 2022, the number of facilities reporting at least one delivery annually increased by 19% from 5,898 to 7,016. During this period, 75% to 97% of facilities consistently reported data on skilled attendance at birth and early breastfeeding initiation. In contrast, 4% to 54% of facilities reported on maternal and newborn outcomes, including complications such as stillbirths and maternal mortality. Internal consistency was high (> 94%). However, neonatal mortality rates reported in DHIS2 were lower than those reported in Tanzania DHS for similar periods, even after a 20% adjustment to account for home births.</p><p><strong>Conclusion: </strong>Tanzania's DHIS2 captures many ENAP indicators; however, notable variability in data quality persists, with substantial data gaps related to maternal and newborn outcomes and complications. To address these challenges, it is crucial to strengthen routine data review, implement robust quality checks, enhance validation processes, provide targeted training, deliver constructive feedback, and conduct supportive supervision. Placing greater emphasis on using DHIS2 data to monitor progress will help identify gaps and drive improvements in data quality, ultimately supporting better maternal and newborn health outcomes.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"23 Suppl 2","pages":"658"},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of azithromycin treatment on respiratory morbidity in children with down syndrome.","authors":"Inbal Golan-Tripto, Omer Dor, Noga Arwas, Itai Hazan, Guy Hazan, Aviv Goldbart","doi":"10.1186/s12887-025-05421-1","DOIUrl":"10.1186/s12887-025-05421-1","url":null,"abstract":"<p><strong>Background: </strong>Children with Down syndrome (DS) often experience recurrent and prolonged hospitalizations from respiratory infections. While Azithromycin has been increasingly used for lower-respiratory tract infections (LRTIs) in children, its potential benefits for DS patients are unexplored. This study evaluates the effect of chronic azithromycin treatment on respiratory morbidity in children with DS.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed data from children with DS aged 0-6 years treated with Azithromycin for at least 6 weeks (10 mg/kg, thrice weekly). Respiratory morbidity indicators, such as primary care visits, medication consumption, emergency department visits, hospitalizations, and hospital length of stay (LOS), were assessed and compared six months before and after the Azithromycin treatment.</p><p><strong>Results: </strong>Twenty-three episodes of Azithromycin treatment (≥ 6 weeks) in eighteen children with DS (mean age of 2.3 years, 78% males) during 2016-2023 were included. A significant reduction in mean respiratory LOS was observed (13.6 vs. 4.7 days, p = 0.05) when comparing pre to post-Azithromycin treatment. Other secondary respiratory outcomes showed no significant differences.</p><p><strong>Conclusion: </strong>The significant reduction in respiratory LOS suggests the potential benefits of Azithromycin in children with DS, and emphasizes the need for larger clinical trials to determine optimal use and long-term effects in this vulnerable population.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"53"},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between platelet distribution width and non-dipping pattern in children with essential hypertension.","authors":"Ling Sun, Bo Wang, Daoping Yang, Wanping Zhou, Yunjia Tang, Xuan Li, Haitao Lv, Miao Hou","doi":"10.1186/s12887-025-05420-2","DOIUrl":"10.1186/s12887-025-05420-2","url":null,"abstract":"<p><strong>Background: </strong>Hypertension has shown a trend of prevalence at younger ages, and the non-dipping pattern is associated with target organ damage in hypertension. However, few studies have yet investigated the clinical characteristics and risk factors of non-dipper status in essential hypertension children. This study aimed to explore the clinical characteristics and possible indicators associated with non-dipper status in children with essential hypertension.</p><p><strong>Methods: </strong>A total of 125 children (99 boys, 26 girls) with untreated essential hypertension were retrospectively included in this study. Non-dipping was defined as a nocturnal drop in systolic or diastolic BP (SBP, DBP) < 10%. Clinical data, ambulatory blood pressure monitoring (ABPM), laboratory and echocardiography parameters were recorded from the hospital database.</p><p><strong>Results: </strong>Non-dipping pattern was found in 74 (59.2%) children and the dipping pattern in 51(40.8%) children, and the nocturnal SBP drop was 8.43 ± 0.71 (%), and the DBP drop was 14.44 ± 0.86 (%). The proportion of children with left ventricular hypertrophy was higher in the non-dipping group than in the dipping group. The platelet distribution width, high-sensitivity C-reactive protein (hs-CRP) and triglycerides (TG) levels were higher in the non-dipping group compared with the dipping group. In multivariate logistic regression analysis, PDW, TG and hs-CRP were found to be associated with the non-dipping pattern.</p><p><strong>Conclusion: </strong>Non-dipping pattern in children hypertension is common, and the proportion of left ventricular hypertrophy is higher in non-dipping hypertension children. Moreover, higher PDW, hs-CRP and TG levels are the risk factors for non-dipping status in essential hypertension children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"54"},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}