BMC Pediatrics最新文献

{"title":"Epidemiology and management of massive, sub-massive, and non-massive pediatric pulmonary embolism: a systematic reviews.","authors":"Mohammed Alsabri, Dina Essam Abo-Elnour, Mohammed Ayyad, Mahmoud Shaaban Abdelgalil, Basel F Alqeeq, Muhammad Azan Shahid","doi":"10.1186/s12887-025-05472-4","DOIUrl":"https://doi.org/10.1186/s12887-025-05472-4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the current evidence on the diagnosis, management, and outcomes of pediatric pulmonary embolism (PE) across varying severity classifications, including massive, submassive, and non-massive presentations.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane databases up to February 17, 2024. Eligible studies included pediatric and adolescent patients (≤ 21 years) with confirmed PE diagnoses. Risk of bias was assessed using the NIH tool.</p><p><strong>Results: </strong>Six studies involving 258 pediatric patients with massive, submassive, or non-massive PE were included. Most patients were adolescents, with a mean age of 14.1 years and a predominance of females (62-66%). Risk factors included obesity, oral contraceptive use, thrombophilia, and autoimmune conditions. Computed tomography pulmonary angiography (CTPA) was the most frequently used diagnostic modality, showing varied lobar, segmental, and subsegmental involvement. Management strategies ranged from anticoagulation to catheter-directed thrombolysis and surgical thrombectomy. Outcomes varied by severity, with massive PE cases showing higher mortality and complications compared to submassive and non-massive cases.</p><p><strong>Conclusion: </strong>Pediatric PE requires tailored risk stratification and management strategies to optimize outcomes. Delays in diagnosis and severe disease presentations contribute to higher morbidity and mortality. Future research should focus on standardized severity classifications, novel diagnostic modalities, and comparative assessments of therapeutic interventions to enhance outcomes in this population.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"330"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972094","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":"Metabolism-related hepatokines change in biliary atresia: ANGPTL6 as a potential biomarker.","authors":"Daiqiong Fang, Shuqi Hu, Jinfa Tou, Fengqin Dong, Shiqiao Peng","doi":"10.1186/s12887-025-05675-9","DOIUrl":"https://doi.org/10.1186/s12887-025-05675-9","url":null,"abstract":"<p><strong>Objectives: </strong>Biliary atresia (BA) is a severe obstructive cholangiopathy of early infancy that progresses to end-stage liver disease without any intervention. The aim of this study was to investigate the impact of drainage obstruction of bile on metabolism-related hepatokines and identify clinical biomarkers of BA.</p><p><strong>Methods: </strong>A total of 38 patients with BA and 12 age-matched controls were recruited. Blood samples were obtained for measuring liver function and hepatokine levels. Linear correlations between these changes in hepatokines and bilirubin/bile acid were subsequently examined to explore the hepatokines that may reflect the illness severity. Afterwards, ROC curve analysis was conducted to assess the diagnostic value of the hepatokines. Finally, prognostic analysis of the hepatokines was performed based on early cholangitis, the clearance of jaundice, native liver survival and liver transplantation.</p><p><strong>Results: </strong>The serum concentrations of TB, DB, ALT, AST, GGT, ALP and TBA in patients with BA were all increased compared with those in controls (P < 0.05). The plasma levels of ANGPTL4, HGF, FABP1, FGF21 and FGF23 were elevated in BA patients (P < 0.05), whereas the plasma ANGPTL6 level was decreased in BA patients (P < 0.05). The results of the correlation analysis revealed that ANGPTL6 was negatively linearly correlated with TB and DB and that FGF23 was positively linearly correlated with TBA. ROC curve analysis revealed that the AUC of ANGPTL6 for diagnosing BA was 0.9693, with a sensitivity of 0.8684 and a specificity of 1.0 at an optimal cut-off value of 1140.76 ng/ml. Prognostic analysis revealed that a lower plasma level of ANGPTL6 at KPE was associated with the occurrence of early cholangitis after KPE (P < 0.05).</p><p><strong>Conclusions: </strong>Among all of the hepatokines that were measured in this study, ANGPTL6 may be a potential diagnostic biomarker of BA and may be able to predict the occurrence of early cholangitis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"327"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973809","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":"Prediction of significant congenital heart disease in infants and children using continuous wavelet transform and deep convolutional neural network with 12-lead electrocardiogram.","authors":"Yu-Shin Lee, Hung-Tao Chung, Jainn-Jim Lin, Mao-Sheng Hwang, Hao-Chuan Liu, Hsin-Mao Hsu, Ya-Ting Chang, Syu-Jyun Peng","doi":"10.1186/s12887-025-05628-2","DOIUrl":"https://doi.org/10.1186/s12887-025-05628-2","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease (CHD) affects approximately 1% of newborns and is a leading cause of mortality in early childhood. Despite the importance of early detection, current screening methods, such as pulse oximetry and auscultation, have notable limitations, particularly in identifying non-cyanotic CHD. (AI)-assisted electrocardiography (ECG) analysis offers a cost-effective alternative to conventional CHD detection. However, most existing models have been trained on older children, limiting their generalizability to infants and young children. This study developed an AI model trained on real-world ECG data for the detection of hemodynamically significant CHD in children under five years of age.</p><p><strong>Methods: </strong>ECG data was retrospectively collected from 1,035 patients under five years old at Chang Gung Memorial Hospital, Taoyuan, Taiwan (2013-2020). Based on ECG findings, patients were categorized into the following groups: normal heart structure (NOR), non-significant right heart disease (RHA), significant right heart disease (RHB), non-significant left heart disease (LHA), and significant left heart disease (LHB). ECG signals underwent preprocessing using continuous wavelet transformation and segmentation into 2-s intervals for data augmentation. Transfer learning was applied using three pre-trained deep learning models: ResNet- 18, InceptionResNet-V2, and NasNetMobile. Model performance was evaluated in terms of accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among the tested models, the model based on ResNet-18 demonstrated the best overall performance in predicting clinically significant CHD, achieving accuracy of 73.9%, an F1 score of 75.8%, and an AUC of 81.0% in differentiating significant from non-significant CHD. InceptionResNet-V2 performed well in detecting left heart disease but was computationally intensive. The proposed AI model significantly outperformed conventional ECG interpretation by pediatric cardiologists (accuracy 67.1%, sensitivity 71.6%).</p><p><strong>Conclusions: </strong>This study highlights the potential of AI-assisted ECG analysis for CHD screening in young children. The ResNet-18-based model outperformed conventional ECG evaluation, suggesting its feasibility as a supplementary tool for early CHD detection. Future studies should focus on multi-center validation, inclusion of more CHD subtypes, and integration with other screening modalities to improve diagnostic accuracy and clinical applicability.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"324"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964368","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":"Global prevalence of myopia in children using digital devices: a systematic review and meta-analysis.","authors":"Nader Salari, Saba Molaeefar, Amir Abdolmaleki, Mahan Beiromvand, Masoud Bagheri, Shabnam Rasoulpoor, Masoud Mohammadi","doi":"10.1186/s12887-025-05684-8","DOIUrl":"https://doi.org/10.1186/s12887-025-05684-8","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of myopia among children has considerably increased over the past few decades, affecting the children's eye health and quality of life. According to the inconsistent reports of myopia among children, the purpose of this systematic review and meta-analysis study was to determine the global prevalence of myopia in children using digital devices.</p><p><strong>Methods: </strong>Various databases (PubMed, ScienceDirect, Embase, Web of Science, Scopus, and Google Scholar) were searched systematically (No time limit until September 2023, last updated in May 2024) using keywords of \"Myopia Prevalence\", \"Children\", \"TV\", \"Computer\", \"Video games\", and \"Smartphone\". PRISMA guideline was also used for paper collection based on the Inclusion/Exclusion criteria. The quality of articles was determined based on the STROBE checklist. Data analysis, heterogeneity assessment, publication bias, and all factors influencing heterogeneity were executed using the CMA software (v.2).</p><p><strong>Results: </strong>Initially, 828 articles were identified through database assessment. 563 and 133 papers were evaluated using primary and secondary assessments, respectively. Ultimately, 17 eligible articles were selected for meta-analysis following paper exclusion. In this era, the global prevalence of myopia among children using computer and video games was reported 28.8% (95%CI:21.1-38), using TV (TV watching) was 35.4% (95%CI:20.6-53.7), and smartphone usage was 31.4% (95%CI:13.5-57.3).</p><p><strong>Conclusion: </strong>Myopia is now recognized as a critical global issue with a daily increasing rate. Technology, along with various digital devices, causes several issues in this era. It is suggested that the application of all digital screens and smart devices can potentially increase the risk of myopia among children. Thus, the reduction of these smart device applications in children can alleviate the potential risk of myopia. The results of this study can be a guide for health policymakers and a useful advertisement for society and families in paying attention to this problem in children, as well as increasing health interventions such as early screening and timely diagnosis for treatment. In this regard, it can be effective in both prevention and increasing the quality of life of children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"325"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976500","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":"Sociodemographic and clinical indicators associated with quality of life among parents of autistic children.","authors":"James Rufus John, Christa Lam-Cassettari, Cheryl Dissanayake, Valsamma Eapen","doi":"10.1186/s12887-025-05682-w","DOIUrl":"https://doi.org/10.1186/s12887-025-05682-w","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that parents/carers of autistic children have lower subjective physical and mental health which in turn can affect their overall quality of life (QoL). The aim of this study was to determine the relationship between the behavioural and emotional profile of autistic preschool children, parental stress, and an Autism (ASD) specific measure of the parental QoL using a sociodemographic lens.</p><p><strong>Methods: </strong>A secondary analysis of the data collected from parents of autistic children from six Autism Specific Early Learning and Care Centres (ASELCCs) across six states in Australia. The standardised Quality of Life in Autism scale (QoLA) scale was used as the primary outcome to ascertain the QoL of parents/carers. Primary exposure included child's autistic traits as well as cognitive, adaptive, and behavioural profile; parental stress; and key sociodemographic factors. Multivariable linear regression analyses were used to determine whether the sociodemographic factors and child's autistic traits were significantly associated with parental QoL whilst adjusting for key sociodemographic factors (for the latter).</p><p><strong>Results: </strong>Among a sample of 518 participants, findings of the regression analyses showed that sibling's ASD diagnosis and carer's disability status were negatively associated with parental QoL (Part A) whereas only sibling's ASD diagnosis was negatively associated with parental QoL (Part B). Additionally, higher parental stress levels, child's internalising, externalising, repetitive behaviours, and communication difficulties were negatively associated with both parental QoL subscales whereas greater adaptive functioning among autistic children was positively linked to better parental QoL.</p><p><strong>Conclusion: </strong>Findings indicate that a child's autism specific traits as reported by parents have significant impacts on their QoL. Hence, targeted supports in these areas for families could be expected to have benefits not only for the child's outcomes but also for parental QoL.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"326"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964311","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":"Evaluating high dose laxatives via nasogastric tube versus enemas in children with severe constipation: a prospective cohort study.","authors":"Marion A Meester-Soonius, Brigitha W Nuijens, Roy S Koendering, Inge Ertugrul-van der Graaf, Elvira K George","doi":"10.1186/s12887-025-05667-9","DOIUrl":"https://doi.org/10.1186/s12887-025-05667-9","url":null,"abstract":"<p><strong>Objectives: </strong>Children with severe constipation often require disimpaction when standard treatments fail, typically involving high doses of oral laxatives or rectal enemas. Practice guidelines for nurses lack clear directives. This study compared the effectiveness of nasogastric laxatives versus rectal enemas in children aged 0-18 years and aimed to assess the pain and burden experienced by children and parents.</p><p><strong>Methods: </strong>A prospective cohort study was conducted between December 2018 and June 2022 at a Dutch pediatric outpatient clinic. Of 111 children with severe constipation, 70 participated: 51 (73%) received rectal enemas and 19 (27%) received nasogastric laxatives. Treatment choice was made by the pediatrician in consultation with the parents and, when possible, the child.</p><p><strong>Results: </strong>After eight weeks, 98% (50/51) of enema-treated children and 89% (17/19) of those receiving nasogastric laxatives achieved effective stool consistency (Bristol Stool Scale 3-5), with no significant difference in overall effectiveness (p = 0.177). Pain scores were higher for children treated with nasogastric laxatives, but not statistically significant. No significant differences were found in the reported burden for children or parents. Fecal incontinence was lower in the enema group (33% vs. 47%) but not statistically different.</p><p><strong>Conclusions: </strong>Both nasogastric laxatives and rectal enemas were effective for disimpaction in children with severe constipation, with no significant difference in efficacy. Although enemas appeared to cause less pain and burden in children under twelve, this was not statistically significant. Further research is needed to address the effect of interprofessional approach and education on compliance and admission of this specific population.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"322"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982913","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 clinical and urinary factors in treatment-resistant vs. treatment-responsive childhood enuresis: a comparative study.","authors":"Parsa Lorestani, Alireza Khodadadiyan, Mohammad Amin Kaviari, Alireza Montazeri, Hadi Golmoradi, Amir Mohammad Lorestani, Mohamad Reza Tohidi","doi":"10.1186/s12887-025-05669-7","DOIUrl":"https://doi.org/10.1186/s12887-025-05669-7","url":null,"abstract":"<p><strong>Background: </strong>Nocturnal enuresis represents a persistent pediatric health challenge characterized by variable treatment responses. Despite established therapeutic interventions, a substantial proportion of children fail to achieve successful management, highlighting the critical need for a deeper understanding of treatment resistance mechanisms. This study sought to systematically examine the multifaceted factors underlying differential treatment outcomes in childhood enuresis.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted in 2017 at Mohammad Kermanshahi Hospital, Iran. The study included 144 children aged 5-8 years with nocturnal enuresis, divided into treatment-controlled (n = 85) and treatment-resistant (n = 59) groups. Participants received Desmopressin nasal spray (DDAVP) at 10 mcg/spray nightly. Demographics, clinical characteristics, sleep patterns, urination habits, and ultrasound findings were analyzed.</p><p><strong>Results: </strong>The prevalence of controlled nocturnal enuresis was higher than treatment-resistant cases. Factors, including abnormal residual urine volume (P-value = 0.04), one episode of bedwetting per night (P-value = 0.03) and more than one episode of bedwetting per night (P-value = 0.02) were found to be statistically significant in our findings. Factors more common in the treatment-responsive group included deep sleep (85.9%), daytime urinary control (77.6%). Conversely, treatment-resistant children exhibited higher rates of poor medication adherence (94.9%), high urine volume per episode (86.4%), although these parameters were identified as non-statistically significant in our study.</p><p><strong>Conclusion: </strong>This study highlights critical factors differentiating treatment-resistant from treatment-responsive nocturnal enuresis in children. Key factors such as deep sleep, daytime urinary control, and effective fluid management were associated with controlled enuresis, while treatment-resistant cases were marked by poor adherence to medication, high urine volume per episode, and frequent enuresis. Future research should explore long-term efficacy and innovative approaches to enhance the management of nocturnal enuresis.</p><p><strong>Clinical trial number: </strong>Not applicable (This was a cross-sectional analytical study and did not involve a clinical trial).</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"321"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972573","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":"A new mortality score in preterm infants: the vasoactive inotropic score.","authors":"Elif Özalkaya, İlter Arifoğlu, Emre Yarış, Sevilay Topcuoğlu, Selim Sancak, Emre Dinçer, Özge Yatır Alkan, Güner Karatekin","doi":"10.1186/s12887-025-05638-0","DOIUrl":"https://doi.org/10.1186/s12887-025-05638-0","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to evaluate the predictive value of the vasoactive inotropic score (VIS) for mortality in extremely low birth weight (ELBW) preterm infants and to compare this value with the well-known Clinical Risk Index for Babies-II (CRIB-II) score.</p><p><strong>Methods: </strong>This study was designed as a retrospective study. A total of 280 preterm infants weighing under 1000 g who were admitted to the neonatal intensive care unit over a five-year period were included in the study. For each patient, a CRIB-II score and VIS were calculated, and their ability to predict mortality was compared. To predict and compare the accuracy of the scoring systems, Receiver Operating Characteristic (ROC) analysis was used, and the area under the curve (AUC) was calculated.</p><p><strong>Results: </strong>In infants who died within the first 28 days after birth, the CRIB-II score (p < 0.001) and VISmax (p < 0.001) were higher compared with those who survived. The AUCs for the CRIB-II score and VIS in predicting mortality were 0.86/0.81, with cut-offs of > 12/ > 5, sensitivities of 79/70, specificities of 82/87, positive predictive values (PPVs) of 81/85, and negative predictive values (NPVs) of 80/75. There were no statistically significant differences between the AUC values of the CRIB-II score and VIS variables (p = 0.160).</p><p><strong>Conclusion: </strong>The VIS can predict mortality in ELBW preterm infants as accurately as the CRIB-II score can.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"317"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953763","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":"Safety of MMR vaccination evaluated in children with food and gelatin allergy in Iran.","authors":"Mehdi Shokri, Masoud Movahedi, Nima Parvaneh, Mohammad Gharagozlou, Mohadese Sadat Mousavi Khorshidi, Muhadese Mahdavi, Fatemh Alizadeh","doi":"10.1186/s12887-025-05666-w","DOIUrl":"https://doi.org/10.1186/s12887-025-05666-w","url":null,"abstract":"<p><strong>Background: </strong>Vaccination is essential for building immunity across various populations, and governments consider it a cornerstone of public health. This study aims to investigate the prevalence of gelatin allergy among infants with food allergies who have received previous vaccinations and were referred to this center for Measles-Mumps-Rubella (M.M.R.) vaccine administration.</p><p><strong>Methods: </strong>This study, conducted at the Immunology Children's Medical Center (CMC) Hospital in Tehran, Iran, aimed to explore the prevalence of gelatin allergy in infants with food allergies undergoing M.M.R vaccine injections. The cross-sectional study included children diagnosed with food allergies, confirmed by allergy specialists, and who provided consent. The methodology involved different tests based on the severity of food allergies. For children with mild food allergies, a gelatin prick test preceded MMR vaccination. Those with severe food allergies or a history of vaccine reactions underwent skin prick tests with various gelatins and the MMR vaccine. Positive results led to graded dose vaccinations. Data, including clinical questions, were recorded using a standard vaccination questionnaire.</p><p><strong>Results: </strong>Results from 163 evaluated children (average age: 16.85 months) revealed that 8% were allergic to gelatin. Notably, all gelatin-allergic patients had a positive family history of atopia. A significant association existed between gelatin allergy and a positive intradermal vaccine test. No significant relationships were found with gender, age, food allergens, infant milk type, antihistamine use, blood history, or product use.</p><p><strong>Conclusion: </strong>The study concludes that a gelatin-free vaccine is preferable for allergic patients. In cases where such a vaccine isn't available, a skin test with the vaccine is recommended before full-dose administration. The findings emphasize the importance of considering family history and intradermal vaccine tests in managing gelatin allergies during vaccinations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"318"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962498","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":"Growth characteristics of children with 21-hydroxylase deficiency and the value of steroid hormones in height assessment.","authors":"Hemeng Chong, Yalei Pi, Yanan Zhang, Yuqian Li, Yutong Xing, Huifeng Zhang","doi":"10.1186/s12887-025-05643-3","DOIUrl":"https://doi.org/10.1186/s12887-025-05643-3","url":null,"abstract":"<p><strong>Background: </strong>Impaired height is a common complication of 21-hydroxylase deficiency (21OHD), yet sensitive monitoring indicators remain limited. This study aims to elucidate growth characteristics and identify effective monitoring parameters for 21OHD children.</p><p><strong>Methods: </strong>Cross-sectional data from 111 patients were categorized into four groups based on age and developmental stage: 0 - 2 years, 2 years old to pre-pubertal initiation, puberty initiation to pre-epiphyseal closure, and post-epiphyseal closure, named groups A to D, respectively. Each group was further stratified by phenotype and sex. Height standard deviation scores (HSDS), corrected for bone age (BA) and target height (HSDS - THSDS, H_BASDS - THSDS), were calculated. Steroid hormone levels and hydrocortisone (HC) doses were analyzed using statistical models to identify factors influencing height.</p><p><strong>Results: </strong>The medians of HSDS - THSDS were > 0 in all subgroups of Group A. The medians of H_BASDS - THSDS were < 0 in all subgroups of Group B, and 17-hydroxyprogesterone (17OHP) and HC dose significantly positively influenced BA advancement. BA of patients in Group C was older than the calendar age(CA), while the medians of H_BASDS - THSDS in all subgroups except the non-classic females were all < 0, and 17OHP, 21-deoxycortisol(21DOF), and 11-oxy-androgen were significant influencing factors. The medians of final height (FHSDS - THSDS) of all subgroups in Group D were < 0, males with classic 21OHD significantly lower than females.</p><p><strong>Conclusions: </strong>21OHD children exhibit accelerated bone maturation as early as childhood, worsening during adolescence, leading to severely impaired growth potential and final height. 17OHP, 21DOF, and 11-oxy-androgens are promising biomarkers for evaluating growth and bone maturity.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"323"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960852","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}