Question: Can face masks alter pulmonary pressure in children and adolescents with and without congenital heart disease? Findings: Mask removal during echocardiography (ECHO) reduced pulmonary pressure. Meaning: These findings suggest that face masks should be removed during ECHO in children and adolescents. |
Noncystic fibrosis bronchiectasis is a chronic respiratory disease that carries high socioeconomic and medical burdens and is caused by diverse respiratory illnesses. To improve clinical outcomes, early recognition, active treatment of exacerbations, and prevention of further exacerbations are essential. However, evidence for the treatment and prevention of acute exacerbation of noncystic fibrosis bronchiectasis, especially in children, is lacking. Therefore, the... |
Unexplained acute kidney injury (AKI) in children owing to diethylene glycol (DEG) contamination during drug production has gained attention in recent years. This qualitative study investigated the effects of DEG exposure on the incidence of unknown AKI in children. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines was proposed to search for studies... |
Question: What is the prevalence of insulin resistance (IR) in excess-weight Latin children, and can proinflammatory biomarkers predict it? Finding: IR prevalence was elevated and tumor necrosis factor- α, interleukin-6, monocyte chemoattractant protein- 1, soluble CD40 ligand, and high-sensitivity C-reactive protein levels were increased in excess-weight Latin children. However, none predicted IR status. Meaning: These inflammatory biomarkers were unable to predict IR status. Therefore, further investigations are necessary. |
· Clinical studies of coronavirus disease 2019 (COVID-19) in infants should be supported by rigorous laboratory diagnostic criteria. · Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads to infants similarly to other viral respiratory infections. · Among infants ≤1 year of age beyond the immediate postpartum period, COVID-19 is relatively mild, but even the low risk of severe disease requires prevention. · Comorbidities increase infection vulnerability and complications in infants. · Clinical and laboratory data do not sufficiently distinguish COVID-19 from other respiratory viral infections. · Coinfection with SARS-CoV-2 is uncommon among infants. · Unique infection sequelae, including multi-inflammatory syndrome in children and neonates and long COVID require further study and refinement of diagnostic criteria. · Infection control standards applied to mother-infant dyads should be tempered by standard preventive strategies, maternal input, accommodation potential, and overall safety. · Maternal vaccination prevents disease in early infancy. |
Question: What are the risk factors for prolonged diarrhea in children under 2 years old? Finding: History of antibiotic use, zinc deficiency, and elevated fecal alpha-1 antitrypsin levels were the main risk factors of prolonged diarrhea in children under 2 years old with acute diarrhea. Meaning: Rational antibiotic usage is necessary as well as thorough testing of serum zinc level and fecal alpha-1 antitrypsin levels. |
· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition. · SIBO is prevalent in children and adolescents with functional abdominal pain disorders. · Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria. · Breath tests are safe and noninvasive. · Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics. |
· Dietary macronutrient modifications affect the body composition of and metabolic markers in children and adolescents. · Hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children. · Future interventional studies with meta-analyses that include Korean children and adolescents are needed to provide basic information applicable to this population. |
Several observational studies have shown that acute kidney injury affects up to 46% of children and adolescents who develop severe postinflammatory responses, such as multisystem inflammatory syndrome in childhood, due to coronavirus disease 2019 (COVID-19). Although causality has not been established, some cases of glomerulopathy or nephrotic syndrome occurring after COVID-19 infection or vaccination have been reported. Therefore, kidney complications associated with these conditions in children and adolescents warrant attention. |
· Pediatric heart failure (PHF) is a clinical syndrome featuring various symptoms (shortness of breath, ankle swelling, fatigue) and signs (pulmonary crackles, peripheral edema). · Congenital heart diseases are the most common underlying etiology of PHF, whereas myocarditis and primary cardio-myopathies are common in children without structural ab-normalities. · PHF pathophysiology is complex and multifactorial and varies by etiology and age. · PHF management includes decongestive therapy, treatment of underlying causes, preventing progression, and managing pulmonary or systemic obstructions. · Drugs should be chosen based on pharmacodynamics, clinical manifestations, hemodynamic state, and renal function. |
· Most commonly confirmed causes of community-acquired pneumonia (CAP) in children are Mycoplasma pneumoniae (8%–40%) and respiratory syncytial virus (15%–20%). · Pyogenic bacteria, most commonly Streptococcus pneumoniae (40%–50%) and Streptococcus pyogenes (10%–25%), are detected in 2%–5% of children hospitalized with CAP. · CAP should be diagnosed conservatively according to clinical and radiological criteria. · The etiology should be identified via appropriate test result interpretation. |
· Atopic dermatitis (AD) is characterized by a strong T helper (Th)2 response, although the extents of Th22, Th17/ interleukin (IL)-23, and Th1 responses vary among disease subtypes. · Children with moderate to severe AD may require early systemic therapy to reduce the systemic inflammation caused by increased Th2 cytokine levels. · Dupilumab, which blocks IL-4/IL-13 receptor, has equivalent efficacy for extrinsic and intrinsic AD and a favorable safety profile in infants and children aged 6 months and older. |
Question: What is the ideal initiation timing of parenteral nutrition for critically ill children? Finding: This randomized clinical trial of 140 children examined the effects of an early or late start of parenteral nutrition on mechanical ventilation need (primary outcome) and length of stay and mortality (secondary outcomes). Meaning: Children who received early versus late parenteral nutrition had lower mechanical ventilation need and duration. |
Question: Is dyslipidemia a risk factor for asthma in children? Finding: This was a comprehensive systematic review and retrospective multicenter study of the association between dyslipidemia and asthma in children. In a multicenter cohort analysis using the Observational Medical Outcomes Partnership Common Data Model, elevated total cholesterol levels were associated with increased risk of asthma development. Meaning: These findings suggest an association between dyslipidemia and asthma in children. |
· Vitamin D may affect asthma via multiple mechanisms, including lung and optimal immune system functions. · Many clinical trials have demonstrated the beneficial effects of vitamin D on asthma onset and aggravation. However, definitive clinical trials are lacking, and reports have detailed contradictory effects of vitamin D in children with asthma. · Some exciting reports stated that obesity and vitamin D deficiency are associated with increased asthma symptoms in the pediatric population. |
Question: What causes childhood constipation, and what can predict organic constipation? Finding: Constipation represents 14.7% of gastroenterology visits. Functional constipation is more common among constipation types, while organic constipation is more common in young children and those with a low body weight, stunted growth, mucus in the stool, and associated diseases. Meaning: Younger children and those with lower growth or mucus in the stool should be assessed for underlying organic causes of constipation. |
MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression post transcriptionally, and MiRNA expression levels vary with developmental stages. MiRNAs play an important role in several biological processes in children, including growth, neuro-development, inflammation, and tumor formation. Research on miRNAs may uncover the molecular mechanisms underlying various pediatric diseases, leading to the development of novel biomarkers that aid in the diagnosis, treatment, and prognosis of these diseases. |
Question: Z score reference values for right ventricular size and systolic function in children using echocardiography are available in several countries. Despite the high burden of diseases involving the right ventricle in Nigeria, these reference values have limited applicability. Finding: The right ventricular sizes of Nigerian children differed from those published elsewhere. Meaning: These reference values will aid the treatment, monitoring, and pre- and postintervention for Nigerian children. |
· Pediatric patients have a relatively low incidence of tachyarrhythmia both in acute coronavirus disease 2019 and multisystem inflammatory syndrome in children (MIS-C), but it was associated with an increased risk of poor outcomes. · Conduction abnormalities were not uncommon, especially in those with MIS-C. Most patients recovered to normal sinus rhythm; however, some progressed to advanced atrioventricular block and rarely required permanent pacemaker implantation. |
Most immunocompromised children and adolescents are not at increased risk of developing severe coronavirus disease 2019 (COVID-19). COVID-19 outcomes for low- or medium-risk immunocompromised children are favorable, while more serious illness reportedly occurs in high-risk immunocompromised children by underlying disease, its treatments, and other factors. Therefore, the early detection and timely management of severe COVID-19 and treatment of underlying disease are important. Hospitalization and COVID-19 vaccination should be carefully considered. |
· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea. · Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD. · Insulin resistance is closely related to NAFLD. |
· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates. · Etiologies vary, and up to 80% of cases are genetic. · Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention. |
· Eosinophilic gastrointestinal disease (EGID) is uncommon, with a prevalence of 1–30/100,000 in the general population; however, it is increasing worldwide. · The diagnosis of EGID is based on histopathological findings of endoscopic mucosal biopsy in which tissue eosinophils are counted in each gastrointestinal tract segment of patients with chronic or recurrent gastrointestinal symptoms. · Individualized treatment strategies, including adequate dietary and pharmacological therapy, may help improve outcomes of children with EGID. |
· This review discusses the development and application of the Korean Developmental Screening Test for Infants and Children (K-DST) for ensuring early childhood development. · Various studies have demonstrated the integral role of the K-DST in facilitating the detection of developmental delays and delivery of timely interventions. · The tailoring of the K-DST to Korean infants and children suggests that other countries may further translate and adapt it. |
Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown. Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV. Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic. |
· Social media use can cause adverse health outcomes, including gastrointestinal disorders, in children and adolescents. · Recent findings have shown a high prevalence of social media use and decreased well-being in patients with functional gastrointestinal disorders. · The biopsychosocial nature of functional gastrointestinal disorders and the clear influence of social media on the psychosocial lives of children suggests the likely involvement of social media in their development. |
Question: What are the risk factors of newborn birth weight? Does gestational weight gain and prepregnancy body mass index affect childhood weight? Finding: Excess maternal weight gain increases the risk of overweight/obesity, newborn birth weight, and child body mass index at 4–6 years. Meaning: Maternal weight control before and during pregnancy should be well controlled. |
The gut microbiota is an emerging factor in the development of pediatric obesity, which is affected by renowned risk factors such as diet, lifestyle, and socioeconomic status. This review aimed to describe the association between the gut microbiota and childhood obesity. |
SpO2/FiO2 ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients. |
· This study compared the ability of 2 probiotics to reduce and improve functional abdominal pain (FAP) in children. · In the polymicrobial probiotic (PMP) group, 10.34% of children reported no pain; in the mono-strain probiotic (MSP) group, all patients reported low-degree pain. The mean pain score decreased significantly over time in both groups. · The use of both PMP and MSP is recommended to reduce pain in patients with FAP. |