BMC Pediatrics最新文献

{"title":"Integration of Mendelian Randomization to explore the genetic influences of pediatric sepsis: a focus on RGL4, ATP9A, MAP3K7CL, and DDX11L2.","authors":"Liuzhao Zhang, Quanwang Chu, Shuyue Jiang, Bo Shao","doi":"10.1186/s12887-025-05424-y","DOIUrl":"10.1186/s12887-025-05424-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the genetic characteristics of pediatric sepsis through a combined analysis of multiple methods, including Mendelian Randomization (MR), differential gene expression analysis, and immune cell infiltration assessment. It explores their potential as biomarkers for sepsis risk and their involvement in immune-related pathways.</p><p><strong>Methods: </strong>Differential expression analysis was performed using public datasets to identify genes with significant expression changes between pediatric sepsis patients and healthy controls. MR analysis utilized genome-wide significant SNPs as instrumental variables to assess causal relationships between gene expression and sepsis risk. Bi-directional MR was conducted to assess both forward and reverse causality. FDR correction was applied to adjust for multiple comparisons in MR results. Immune cell infiltration analysis was performed to investigate the genes' roles in immune responses, and findings were validated with independent datasets. ROC curves were constructed to assess predictive performance.</p><p><strong>Results: </strong>Differential expression analysis identified significant changes in RGL4,ATP9A,MAP3K7CL, and DDX11L2. MR analysis revealed causal associations between these genes and sepsis risk, with RGL4 and ATP9A upregulated (inflammatory roles), and MAP3K7CL and DDX11L2 downregulated (protective roles). Bi-directional MR found no significant reverse causality. Immune cell analysis showed associations with key immune cell types, and ROC analysis demonstrated strong predictive potential.</p><p><strong>Conclusion: </strong>RGL4,ATP9A,MAP3K7CL, and DDX11L2 play important roles in pediatric sepsis risk and immune response regulation, offering insights into genetic and immune mechanisms that may inform future sepsis research and treatment.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"66"},"PeriodicalIF":2.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051732","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":"Severe central nervous system injury in 9 children with COVID-19.","authors":"Peipei Zhang, Meiyun Xin, Yingge Bai, Xueyun Ren, Na Li","doi":"10.1186/s12887-025-05436-8","DOIUrl":"10.1186/s12887-025-05436-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical features and prognosis of severe central nervous system (CNS) injury in children caused by coronavirus disease 2019 (COVID-19).</p><p><strong>Method: </strong>We retrospectively studied confirmed pediatric cases of COVID-19 complicated with CNS injury.</p><p><strong>Results: </strong>Nine patients diagnosed with COVID-19 complicated with severe CNS injury were admitted to the pediatric intensive care unit of the Affiliated Hospital of Jining University from December 1, 2022 to January 12, 2023. Of the nine patients, seven were male (77.78%). Five children were aged ≥ 10 years, and the others were 1-2 years old. All children had fever, eight had convulsions, seven had progressed to multiple organ failure, and all suffered varying degrees of coma. Most of the children had elevated interleukin-6 (100%), lactic acid (100%), alanine transaminase (87.5%), aspartate transaminase (87.5%), creatine kinase MB (87.5%), and lactate dehydrogenase (85.7%) levels. Four children had cerebrospinal fluid proteinnacell separation. The cranial imaging results of five children were abnormal. One child had lost his vital signs when admitted to hospital, and the remaining eight received hormonal shock, human immunoglobulin transfusion, antinainfection, cranial pressure reduction, and tracheal intubation, among others, during hospitalization. Ultimately, eight children died, and the remaining child has serious neurological sequelae and is undergoing rehabilitation.</p><p><strong>Conclusions: </strong>Severe CNS injury caused by COVID-19 has an acute onset, rapid progression, high disability rate, and high fatality rate. A low cerebrospinal fluid protein level may be a protective factor for children with severe nervous system injury caused by COVID-19.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"63"},"PeriodicalIF":2.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051763","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 a comprehensive intervention on anthropometric indices, dietary intake, and physical activity of adolescent boys with overweight.","authors":"Fatemeh Sadat Hashemi Javaheri, Zahra Mousavi, Saeideh Mohammadi, Arezoo Amjadi, Khadijeh Abbasi Mobarakeh, Seyedeh Hayedeh Mousavi Shalmani, Mahdieh Torkaman, Masoomeh Alsadat Mirshafaei, Sara Khoshdooz, Zahra Saeedirad, Naser Kalantari, Parmis Mirzaei, Saeid Doaei, Nastaran Keshavarz Mohammadi, Maryam Gholamalizadeh","doi":"10.1186/s12887-025-05396-z","DOIUrl":"10.1186/s12887-025-05396-z","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases in adulthood are reported to be strongly associated with adolescent obesity. The present study aimed to assess the effect of a comprehensive lifestyle modification intervention on the anthropometric indices, dietary intake, and physical activity of adolescent boys with overweight.</p><p><strong>Methods: </strong>This pragmatic trial was conducted on 126 adolescent boys with overweight. A comprehensive school-based intervention was carried out at two levels for four months: at the school level based on the Ottawa Charter framework and at the personal level including individualized diet and physical activity.</p><p><strong>Results: </strong>The percentage of mean difference of BMI and BF loss in the intervention group were 1.20% (P < 0.05) and 6.41% (P < 0.01), respectively. The intervention group had a lower intake of calorie (2350 ± 861 vs. 2634 ± 917 kcal/d), carbohydrate (255.68 ± 41 vs. 286.97 + 47 g/d), and fat (112.67 ± 78 vs. 217.72 ± 86 g/d) after the intervention compared to the control group (All P < 0.05). The intervention resulted in a significant increase in physical activity parameters including distance (3501 ± 287 vs. 614 ± 56 m/d), duration (203 ± 35 vs. 72 ± 10 min/d), and calorie expenditure (359.24 ± 62.4 vs. 46.74 ± 7.5 kcal/d) in the intervention group compared to the control group (P < 0.01).</p><p><strong>Conclusion: </strong>A comprehensive lifestyle modification intervention which covers both school and individual levels may positively influence BMI, body fat, calorie intake, and distance and duration of physical activity in adolescents. Thus, adopting multifaceted strategies using the Ottawa Charter framework may be considered as an effective approach to managing obesity in adolescents.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"67"},"PeriodicalIF":2.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051764","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":"Incidence and risk factors for clinical omphalitis among neonates in Eastern Uganda using chlorhexidine gel for cord care: a community-cohort study.","authors":"John Wogabaga, Kathy Burgoine, Abel Kakuru, Brendah Nambozo, Martin Chebet, Josephine Tumuhamye, Benon Wanume, Faith Oguttu, Milton W Musaba, Agnes Napyo, Solomon Wani, Peter Olupot-Olupot, Andrew D Weeks, Thorkild Tylleskär, David Mukunya","doi":"10.1186/s12887-025-05428-8","DOIUrl":"10.1186/s12887-025-05428-8","url":null,"abstract":"<p><strong>Background: </strong>Omphalitis is a bacterial infection of the umbilicus and/or surrounding tissues, occurring primarily in the neonatal period. Whereas it is known to be a major route of localized and often systemic infection, studies describing incidence and risk factors remain scanty, especially in resource limited settings where the condition is thought to be common. We assessed the incidence and risk factors for omphalitis among neonates born to women who received a birth kit containing chlorhexidine for umbilical cord care after birth in Eastern Uganda.</p><p><strong>Trial registration for the parent study: </strong>The BabyGel trial was registered in the Pan African Clinical Trial Registry -(PACTR202004705649428 Registered 1 April 2020, https://pactr.samrc.ac.za/ ).</p><p><strong>Methods: </strong>We conducted a community-based cohort study between January 2021 and June 2023. This study was nested within the BabyGel trial. Our outcome of interest was clinical omphalitis, defined as purulent discharge from the umbilical cord stump within the first twenty-eight days of life as witnessed by a study midwife. Data were analyzed using Stata version 17.0. Bivariable and multivariable analyses were conducted using Cox proportional hazard regression models to estimate hazard ratios (HR) of selected exposures and time to omphalitis.</p><p><strong>Results: </strong>A total of 2052 neonates were enrolled; half of which were female (51.1%). The incidence of omphalitis was 3.0% (62/2052; 95% confidence interval (CI): 1.9%, 4.4%). The incidence rate of omphalitis was 1.6 cases per 1000 person days (95% CI: 1.1, 2.3). Neonates born at home were twice as likely to develop omphalitis as those born in a health facility (adjusted hazards ratio (AHR) 1.99; 95% CI: 1.01, 3.9).</p><p><strong>Conclusion: </strong>The incidence of omphalitis among neonates in Eastern Uganda was low. Home births carried twice the risk for omphalitis. Use of chlorhexidine coupled with close follow-up of neonates in the community by health workers and community health workers might have reduced the risk of omphalitis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"55"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036814","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":"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":"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":"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":"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}