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Editorial
Rickets prevalence and treatment outcome: real-world data from Taiwan
Young Suk Shim
Original Article
Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices
Nuanpan Penboon, Pornpimol Rianthavorn
Background: Childhood-onset lupus nephritis (cLN) is an aggressive disease. Although histological class has historically guided its treatment, its prognostic value remains limited. Although the National Institutes of Health (NIH)-modified activity index (AI) and chronicity index (CI) incorporate glomerular and tubulointerstitial changes and may provide better prognostic insight, their utility in cLN is not well established.
Purpose: Here we aimed to assess the utility of the NIH-modified-modified AI and CI...
Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units
Aristóteles Almeida Pires, Luciano Remião Guerra, Luciane Gomes da Cunha, João Ronaldo Mafalda Krauzer, Mariana Motta Dias da Silva, Vanessa Cristina Jacovas, Hilda Maria Rodrigues Moleda, Tais de Campos Moreira, Paulo Márcio Pitrez, Felipe Cezar Cabral
Background: Pediatric intensive care units (PICUs) have undergone significant evolution, resulting in a reduction in patient morbidity and mortality rates. Telemedicine has emerged as a valuable resource for services that optimize the care processes in PICUs. Despite growing interest in telemedicine for pediatric critical care, its impact on mechanically ventilated (MV) children in public health settings in Brazil remains underexplored.
Purpose: This study aimed to evaluate the effect...
Associations of routine breakfast and napping habits with early adiposity rebound by age 3 years: a populationbased cohort study in Japan
Toshifumi Yodoshi
Background: Early adiposity rebound (AR) is a key predictor of later obesity and metabolic risk, yet modifiable factors related to early AR remain understudied in large populations.
Purpose: To quantify the prevalence of early AR at age 3 years and identify modifiable correlates in a population‑based cohort of Japanese preschool children. Methods: We retrospectively analyzed health-check records for 74,466 children who attended both 1.5- and 3-year examinations (2014–2019). Body mass...
High-dose methylprednisolone and tocilizumab improve survival of patients with high-risk pediatric acute necrotizing encephalopathy
Chaonan Fan, Fei Li, Kechun Li, Zheng Li, Yiyang Mao, Lijuan Wang, Gang Liu, Yingchao Liu, Quan Wang, Suyun Qian
Background: Acute necrotizing encephalopathy (ANE) is a rare but devastating neurological disorder in children that is typically triggered by viral infections such as influenza, sudden acute respiratory syndrome coronavirus 2, and human herpesvirus-6. ANE is characterized by cytokine storm and associated with high mortality; however, optimal immunomodulatory strategies remain undefined.
Purpose: To evaluate the effectiveness of multiple immunomodulatory strategies, including high-dose methylprednisolone (MP), plasma exchange (PLEX), and tocilizumab, at reducing short-term...
Clinical note
Successful rescue after catastrophic bleeding of carotid artery pseudoaneurysm following button battery ingestion in a toddler
Manjit Kaur, Ujjal Poddar, Basant Kumar, Abdul Muzil Munshi, Rajanikant Yadav, Moinak Sen Sarma, Anshu Srivastava
Original Article
Maternal sleep disorders during pregnancy and subsequent risk of allergic diseases in Japanese children: the TMM BirThree Cohort Study
Ami Uematsu, Masatsugu Orui, Mami Ishikuro, Keiko Murakami, Aoi Noda, Genki Shinoda, Taku Obara, Shinichi Kuriyama
Background: Associations have been suggested between prenatal exposure and allergic diseases in children as well as between respiratory allergies and maternal sleep disorders during pregnancy.
Purpose: This study aimed to examine the association between maternal sleep disorders during pregnancy and allergic diseases, including respiratory, skin, and ocular allergies, in their children. Methods: This study was based on the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Sleep disorders during...
Recurrent immunoglobulin A vasculitis in children and adolescents: prevalence and associated risk factors
Nootsara Atchariyaphuk, Maynart Sukharomana, Thanaporn Chaiyapak, Sirirat Charuvanij
Background: Immunoglobulin A vasculitis (IgAV) is a systemic vasculitis characterized by potential recurrence.
Purpose: This study aimed to explore the prevalence of and factors associated with IgAV recurrence. The clinical phenotypes of childhood- and adolescent-onset IgAV were described and compared. Methods: This retrospective cohort analysis included patients aged ≤18 years and diagnosed with IgAV treated in a tertiary academic center between January 2010 and December 2022. Recurrence was classified...
Gut microbiota and metabolomic alterations in newborns of mothers with gestational diabetes mellitus
Wan-Hsin Su, Yi-Wei Wang, Chien-Chang Chen, Ming-Wei Lai, Hsun-Chin Chao, Ming-Chou Chiang, Ren-Huei Fu, Pai-Jui Yeh
Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with various perinatal risks in mothers and heightened risks of long-term obesity and metabolic syndrome in their children. Understanding the effect of GDM on infant health is crucial. Infant gut colonization has generated significant interest owing to its profound impact on health and potential role in later disease development.
Purpose: Here we conducted a thorough analysis...
Review Article
Exploring nutritional screening tools for hospitalized children: a narrative review
Pankaj Soni, Amit Agrawal, Gaurav Jadon
Malnutrition is common among hospitalized children, especially those who are critically ill. Routine measures, such as anthropometric measurements, body composition, and nutritional assessment, comprise the basics of monitoring. This review discusses the adequacy of nutritional screening tools (NSTs) such as the SGNA (Subjective Global Nutritional Assessment), PYMS (Pediatric Yorkhill Malnutrition Score), STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics), and STRONGkids (Screening Tool for Risk of Nutritional Status...
Original Article
Association between vitamin D polymorphisms and binding protein and COVID-19 risk and severity in children
Victoria Giatraki, Helen Dimitriou, Georgia Martimianaki, Christos Tsatsanis, Emmanouil Galanakis, Chrysoula Perdikogianni
Background: The effects of genetic background on the biological effects of vitamin D on coronavirus disease 2019 (COVID-19) in children remain unclear.
Purpose: This study aimed to explore the association between vitamin D-related genetic background and 25- hydroxyvitamin D status and COVID-19 occurrence and severity in children. Here we explored key genetic variants within the vitamin D pathway in pediatric COVID-19 patients in relation to circulating vitamin D...
Review Article
Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications
Hwa Young Kim, Jaehyun Kim
Continuous glucose monitoring (CGM) has become a key component in the management of pediatric type 1 diabetes mellitus (T1DM) since it offers real-time glucose data that facilitate tighter glycemic control and reduce acute complications. Accumulating evidence and international guidelines highlight the clinical efficacy, safety, and feasibility of CGM use in children, particularly those with high adherence. Regular CGM use is associated with significant reductions in glycated hemoglobin, fewer hypo-...
Original Article
Ciclesonide shows a lung-protective effect in neonatal hyperoxia-exposed rats
Victoria Mielgo, Miguel A Gomez-Solaetxe, Lara Olazar, Begoña Loureiro, Carmen Rey-Santano
Background: Bronchopulmonary dysplasia (BPD), a chronic lung disease primarily observed in premature infants, is attributed to a lung injury–repair imbalance. Studies of postnatal corticosteroids have failed to identify clear candidates to help alleviate high BPD rates without risks or adverse effects.
Purpose: This study aimed to assess whether the systemic postnatal administration of an alternative glucocorticoid, ciclesonide, could attenuate alterations in lung structure and right ventricular hypertrophy in a...
Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants
Bjoern Vogt, Ariane Deutschle, Gerog Gosheger, Adrien Frommer, Andrea Laufer, Henning Tretow, Robert Roedl, Gregor Toporowski
Background: Positional plagiocephaly (PP) is a common cranial asymmetry of infancy. Its treatment options include conservative management and helmet therapy. However, the efficacy of each, particularly at achieving a normal cranial shape, remains uncertain.
Purpose: This study aimed to compare the efficacy of conservative management and helmet therapy for PP. Methods: We retrospectively analyzed 199 infants with PP treated in 2015–2024. A total of 72 patients with a...
HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol
Parisa Maneechai, Cholada Ratanatharathron, Jassada Buaboonnam, Kleebsabai Sanpakit
Background: Allopurinol is widely used to prevent hyperuricemia in patients with tumor lysis syndrome. However, its use can trigger severe cutaneous adverse reactions (SCARs) with a mortality rate of approximately 11.39%. The human leukocyte antigen (HLA)–B*58:01 genotype is a major risk factor for SCARs. Although most studies to date have examined HLA–B*58:01 in Thai adults, data on pediatric patients are limited.
Purpose: Here we aimed to evaluate the...
Review Article
Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review
Sandhya J Kadam, Malika Goel
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulty with communication and social interactions as well as restricted or repetitive behaviors. Over the last few decades, the prevalence of ASD has increased globally, with major differences in reporting, diagnosis, and interventions between developed and developing countries. The United States (U.S.) has seen a sharp rise in diagnosed ASD cases, with a current prevalence of approximately 1...
Neonatal ichthyosis-sclerosing cholangitis syndrome caused by a novel CLDN1 mutation: a case report and literature review
Upasana Ghosh, Ankit Agrawal, Varunvenkat M Srinivasan, Rani Manisha, Umesh Shukla, Vikas Jain, Mayank Nilay, Harish Kumar
Neonatal ichthyosis-sclerosing cholangitis syndrome (NISCH) is an autosomal recessive disorder characterized by cholestasis, generalized ichthyosis, alopecia, and dental anomalies. As this is a rare syndrome, here we present a case caused by a novel mutation followed by a literature review of all published cases. This retrospective review includes all original articles on the clinical profiles of all 37 cases published through December 2024 using a PubMed search. The...
Original Article
Clinical outcomes and healthcare utilization of hospitalized children with influenza versus COVID-19
David Chun-Ern Ng, Chuin-Hen Liew, Kah Kee Tan, Joanne Pereira, Muhammad Ihsan Roslan, Xiang Lin Cheng, Hui Yi Lim, Farah Nuruliayana A.Nazri, Asuwani Maran, Wan Fei Wong, Yasothai Chandran, Syaniza Shaharudin, Pon Ling Lau, Naveen Nair Gangadaran, Marlindawati Mohd Ali
Background: Influenza and coronavirus disease 2019 (COVID-19) are major causes of pediatric respiratory illness with overlapping clinical features but potentially differing impacts on healthcare utilization and outcomes.
Purpose: To compare the clinical presentations, healthcare resource utilization, and outcomes of children hospitalized with influenza and COVID-19 and address the gaps in pediatric data from Southeast Asia. Methods: This retrospective observational study included children aged ≤12 years hospitalized with laboratoryconfirmed influenza or...
Less invasive surfactant administration versus intubation-surfactant-extubation: a single-center retrospective study
Jithin CS, Nalina A, shashidhar A, Suman Rao PN
Background: In recent years, minimally invasive methods have been increasingly utilized for surfactant administration in spontaneously breathing preterm infants with respiratory distress syndrome (RDS) managed with nasal continuous positive airway pressure owing to their feasibility and association with improved respiratory outcomes. However, data are limited from developing countries on the use and effectiveness of these techniques.
Purpose: The primary objective of...
Cytokine profile of Post–cardiopulmonary bypass in children
Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surassombatpattana, Pharsai prasertsan
Background: Open cardiac surgery involving cardiopulmonary bypass (CPB) triggers a systemic inflammatory response that significantly affects clinical outcomes. However, the dynamics and specific roles of cytokine release after CPB in the pediatric population remain unclear.
Purpose: To evaluate the dynamics of cytokine levels and their association with low cardiac output syndrome (LCOS)-related outcomes. Methods: A prospective observational cohort study was conducted of 32 children who underwent elective open cardiac surgery...
Assessment of natural killer cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major
Fathia Elbassal, Mohamed Soliman, Nourhan Mohamed, Mai El-Hamid, Hanan El-Sheity
Background: Iron overload is a hallmark complication in patients with transfusion-dependent β-thalassemia major, primarily resulting from ineffective erythropoiesis, repeated blood transfusions, and increased gastrointestinal iron absorption. This iron accumulation, reflected in elevated serum ferritin levels, has been implicated in immune dysregulation. Natural killer (NK) cells are a pivotal component of the innate immune system, known for their cytotoxic activity and...
Effectiveness of Kinder Lebensqualität Fragebogen (KINDL) and Children’s Somatic Symptom Inventory-24 (CSSI-24) for measuring postacute sequelae of COVID-19 in children: a diagnostic validation study
Lawrence Shih-Hsin Wu, Pei-Chi Chen, Xiao-Ling Liu, Shu-Tsen Liu, Chi-Hung Wei, Yu-Lung Hsu, Kai-Sheng Hsieh, Huan-Cheng Lai, Chien-Heng Lin, Chieh-Ho Chen, An-Chyi Chen, I-Ching Chou, Wen-Jue Soong, Hui-Ju Tsai, Chung-Ying Lin, Jiu-Yao Wang
Background: The postacute sequelae of coronavirus disease 2019 (PASC), also known as pediatric long coronavirus disease (COVID), can significantly affect the quality of life (QoL) of affected children. Currently, there are no standardized screening tools to identify high-risk children. The Kinder Lebensqualität fragebogen (KINDL) is a psychometric method for measuring QoL in children.
Purpose: This study used the KINDL questionnaire and...
Long-term epidemiological insights into rickets: a nationwide population-based retrospective study
Chun-Hao Chu, Ying-Chuan Chen, Pei-Yao Liu, Chun-Chieh Hu, Yu-Lung Lin, Feng-Chih Kuo, Chieh-Hua Lu, Tzu-Ju Hsu, Yu-Tung Hung, Fuu-Jen Tsai, Chien-Ming Lin
Background: Rickets is a growth disorder that imposes a global health burden and causes disability in affected children. However, issues related to the clinical epidemiology and mortality risk of nutritional versus hereditary rickets have not been fully investigated in large population studies, particularly in Asia.
Purpose: This study aimed to investigate the nationwide incidence, demographic characteristics, and mortality-related risk factors of...
Fecal microbiome profiles in infants with biliary atresia versus nonbiliary atresia cholestasis: a pilot study
Nur Azizah, Fadilah Fadilah, Silvia Werdhy Lestari, Muzal Kadim, Fithriyah Sjatha, Hanifah Oswari
Background: Cholestasis is characterized by disrupted bile flow and can lead to severe liver disease in newborns, of which biliary atresia (BA) is a common cause. The gut microbiome plays a crucial role in aggravating liver injury in BA and non-BA cholestasis. However, information is lacking regarding the differences in gut microbiome composition between patients with BA and non-BA cholestasis.
Purpose:...
Evolving treatment strategies for invasive Streptococcus pyogenes in children in the postpandemic era
Laura Buricchi, Giuseppe Indolfi, Marco Renni, Elisabetta Venturini, Luisa Galli, Elena Chiappini
Background: Streptococcus pyogenes (group A Streptococcus [GAS]) is a common cause of bacterial pharyngitis and skin infections in children that can lead to severe and invasive GAS (iGAS) infections. The sudden acute respiratory syndrome coronavirus 2 pandemic coincided with an increase in iGAS cases, with emerging serotypes and risk factors like age, reduced postpandemic immunity, and viral coinfections. The treatment...
Serum copper and ceruloplasmin levels as biomarkers reflecting liver fibrosis in children with autoimmune hepatitis
Salma Abdel Megeed Nagi, Mai Ibrahim Elashmawy, Amany E. Elashkar, Mohamed Zaeim Hafez, Ashraf A.E. Emara, Osama Mohammad Abdelhay, Albayoumi A.B. Fouda, Mohamed AbdelAziz Doma, Ahmad Mohamed Awad, Ahmed Mohammed Saba, Hesham Abdelrahman Ahmed, Ahmed Mohamed Gad Allah, Fatma Mahmoud Abdelraheem, Mohamed A. Gad, Mohamad A. Soliman, Tamer I. Abdalrhman, Khaled Hassaan Awad, Ismael A.K.M. El-lebedy, Mostafa M. Abdelnaser, Mohammed Z. Abdel Kareem, Marwa Fekry Hassan, Shymaa Sobhy Menshawy Khalifa
Background: Clinical, biochemical, histological, and immunological indicators are frequently used to diagnose autoimmune hepatitis (AIH), a chronic inflammatory liver disease affecting children. Wilson disease, which resembles AIH, is mainly evaluated using serum ceruloplasmin and copper levels. However, changes in these biomarkers have also been observed in AIH, raising the question of whether they could be useful for evaluating children with...
Evaluation of Bak and Bcl-Xl gene expression among pediatric patients with acute primary immune thrombocytopenia
Amira Zaki Badawy, Samia Hassan Kandel, Iman Aly Ahmedy, Mahmoud Ahmed Elhawy, Sally Mohamed El-Hefnawy, Dina Fouad Sief El-Nasr Zidan, Hanan Hassan El-sheity
Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a low platelet counts and an increased risk of bleeding. Moreover, the apoptotic mechanisms of platelets may influence their production and lifespan.
Purpose: To assess the involvement of apoptotic markers—specifically the B-cell lymphoma protein 2 family proteins Bak and Bcl-Xl in the pathogenesis of acute primary ITP in pediatric patients, and...
Success rates of conservative treatment and optimal surgical timing for pediatric chylothorax
Pakwan Kaewchusen, Narumon Densupsoontorn, Supaluck Kanjanauthai, Puthita Saengpanit
Background: Pediatric chylothorax poses management challenges, with conservative treatment as the first-line approach and surgery reserved for persistent cases. However, data remain limited on factors related to conservative treatment success and optimal surgical timing.
Purpose: This study aimed to evaluate the success rate of conservative treatment, identify the associated factors, and determine the optimal timing for surgical intervention. Methods: We retrospectively reviewed...
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