Question: How do structural and staffing characteristics of neonatal intensive care units (NICUs) influence the mortality rates of very low birth weight infants (VLBWIs)? Findings: NICUs with higher staffing levels, particularly with more neonatologists, and those offering advanced care levels were associated with lower mortality rates. Additionally, regional disparities were observed, with some areas demon-strating significantly higher survival rates. Meaning: Adequate staffing and equitable regional distribution of medical resources are crucial for improving survival outcomes in VLBWIs. Efforts to enhance NICU staffing and address regional healthcare disparities are essential for optimizing care quality and reducing mortality in this vulnerable population. |
· This study analyzed 45 randomized controlled trials (5,061 participants, 13 interventions) of the comparative efficacies of treatments for acute bronchiolitis in infants. · Inhalation therapy with epinephrine and hypertonic saline significantly reduced the length of hospital stay compared with normal saline. · Hypertonic saline had the greatest ability to improve the clinical severity score of bronchiolitis in infants younger than 2 years of age. |
· Although there is broad consensus on many aspects regarding the symptoms, diagnosis, and treatment of cow's milk allergy, the impact of geographical, cultural, and socioeconomic factors remains unestablished. · Availability and cost of formula for the management of cow's milk allergy have a major impact on the therapeutic choice. · Region-specific guidelines for the treatment of cow's milk allergy are required. |
Liver transplantation (LT) is crucial for children with end-stage liver diseases, yet bloodstream infections (BSI) pose significant risks, despite medical advancements. Immunosuppressants, essential for preventing organ rejection, heighten infection susceptibility. Understanding BSI organisms is vital due to antimicrobial resistance. Pediatric LT recipients have unique risk factors, demanding tailored preventive measures. This systematic review on bacterial BSI emphasizes the urgency of effective prevention strategies, considering the high incidence and distinct organism profile. Further research is vital for optimizing antibiotic management and improving outcomes for this vulnerable population. |
· Exposure to air pollutants cause allergic and respiratory diseases as well as chronic kidney disease. · Adequate physical activity and proper nutrition are essential for children to maintain good health. · We must educate people about the harmful effects of noise, blue light, heavy metals and smoke. · Government and society must actively decrease environ-mental hazards. |
Atopic dermatitis (AD) is a complex disease with multifactorial pathogenesis and variable clinical presentation. Up to one-fifth of patients with AD develop moderate to severe disease that is often refractory to classical therapies and can compromise quality of life. This review summarizes recent clinical evidence on biological agents and small-molecule immunotherapies for the treatment of AD. |
The long-term effects of concussion for pediatric patient remains unclear. Children and teenagers do not experience or recover from concussion in the same manner as adults do. Concussions can cause a variety of anatomical and functional alterations. Nonpharmacological approach in pediatric concussion management is an understudied field of research with significant ability to affect prognosis and quality of life. Active rehabilitation and occupational therapy were especially promising. |
· This summary emphasizes the importance of the early diagnosis of Turner syndrome (TS) and presents a multidisciplinary approach to its prevention and management, high-lighting the need for customized care. · Advancements in immunogenetic research may improve our understanding of TS and improve its outcomes. · TS encompasses a wide array of medical challenges, including cardiovascular, endocrine, autoimmune, and mental health issues, as well as a heightened cancer risk. |
Height gains result from longitudinal bone growth. Upon adequate growth, growth plate closure limits longitudinal bone growth. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure and increase human height. The development of more effective therapeutic modalities for short stature, precocious puberty, and skeletal dysplasia is anticipated. |
Lung injury is generated from the early stage of hyperoxia through the biologic effects of cell death and inflammatory response, which eventually leads to evolution of bronchopul-monary dysplasia. Therefore, a protective measure against hyperoxia-induced lung injury is needed. The present study observed that anti-inflammatory cytokine, interleukin-10 had protective effects on newborn rat lungs from injury induced at the early stage of hyperoxia, by preventing cell death and down-regulating inflammatory response. |
Question: How prevalent is energy drink consumption among Korean adolescents and what are the associated factors? Findings: The prevalence of energy drink consumption among Korean adolescents increased from 3.2% in 2014 to 12.2% in 2019. Energy drink consumption varies according to sociode-mographic and individual factors. Meaning: Policies and educational strategies are needed to reduce energy drink consumption in adolescents. |
Question: Do interventions based on Meleis' transition theory affect mothers' readiness for baby care and breastfeeding? Findings: We found a statistically significant difference between the intervention and control groups in mothers' readiness for newborn care and breastfeeding (P<0.001). Meaning: This intervention increased breastfeeding rates while ensuring that mothers were ready to care for their babies and prepared for the role of motherhood. |
· Pediatric chronic cough often involves eosinophilic inflammation; however, objective measurements are not routinely used in treatment decisions. · Accurate biomarkers of eosinophil activity, such as eosinophil-derived neurotoxin (EDN) and cationic proteins (ECP), should be used. EDN, which overcomes the shortcomings of ECP, recently received approval for use in Korean healthcare settings. · EDN and ECP can play a role in treatment period and drug selection decisions. |
This review aimed to determine whether pesticide exposure is associated with stunting in children. The 13 included studies agree that pesticide exposure is not correlated with stunting incidence regardless of substance type (organophosphate and pyrethroid). Heterogeneity appeared with age covariate as potential confounding. The evidence of this study is challeng-ing, as the adverse effects of pesticides grossly occurred. The protection of children is warranted for preventing future neurodevelopment issues. |
· Since 1960, South Korea's TFR decreased from 6.33 to 0.78 in 2022, below the 2.1 replacement level since 1983, with women's average age at first marriage rising to 31.3 in 2022. · Policies needed: financial incentives, longer parental leave, better childcare. · The U.S. (15.3% immigrants) and Germany (18.8%) use immigration to maintain demographic stability, a strategy South Korea is considering. |
· The safety and efficacy of the two-bag versus one-bag system for treating patients with diabetic ketoacidosis (DKA) < 21 years remains unestablished. · Our meta-analysis demonstrated similar safety outcomes but sooner DKA resolution and shorter mean response time for intravenous fluid changes for the two-bag system. · This preliminary evidence suggests that the two-bag system has some advantages in efficacy, but further studies are needed to evaluate their extent. |
To prevent food allergy in infants, based on the dual allergen exposure hypothesis, we recommend a personalized approach consisting of both skin intervention (eczema treatment to achieve early remission and well-controlled skin without eczema to prevent percutaneous immunoglobulin E sensitization) and oral intervention (early allergenic food introduction). |
· Polymorphisms in interleukin (IL)-1B and IL-1 receptor (IL-1R) antagonists may significantly affect the pathogenesis of immune thrombocytopenia (ITP). · IL-1B and IL-1R antagonist gene polymorphisms are correlated with severity and susceptibility to primary ITP in children. |
Question: What are the neonatal risk factors for autism spectrum disorder (ASD)? Findings: Significant effect sizes were observed for congenital heart disease (odds ratio [OR], 1.35), macrosomia (OR, 1.11), low birth weight (OR, 1.63), very low birth weight (OR, 2.25), small for gestational age (OR, 1.17), jaundice (OR, 1.74), male sex (OR, 1.47), and Apgar score (OR, 1.40). Meaning: These factors were identified as risk factors for ASD. |
· The frequency of benign convulsions with mild gastroenteritis (CwG) was not significantly influenced by the pandemic. · The coronavirus disease 2019 pandemic has further diversified the etiologic enteric viral pathogens of CwG. |
Asthma is the most common chronic disease among children. Although asthma in children may spontaneously improve, it continues into adulthood in many cases. Therefore, appropriate disease management and medication are essential. Consistent and objective guidelines are needed to manage pediatric asthma and related adverse reactions. |
· A detailed history and comprehensive physical examination remain the cornerstones for establishing a diagnosis of global developmental delay/intellectual disability (GDD/ID). · Comprehensive surveillance and screening programs play a significant role in the early detection of GDD. · Whole-exome sequencing is highly recommended as first- or second-line testing for individuals with idiopathic GDD/ID. · Early intervention by a well-versed multidisciplinary team can significantly improve the outcomes and prognosis of GDD/ID. |
The overall incidence of bloodstream infections was 23.5%. Gram-negative organisms occur at a much higher rate in pediatric liver transplant recipients then that the general pediatric population. However, when comparing pediatric and adult liver transplant recipients Gram-positive organisms occur with a much higher rate in the pediatric population highlighting the importance of early and broad spectrum antimicrobial coverage when bloodstream infections are suspected. |
· We suggest offering long-term macrolides to children with noncystic fibrosis bronchiectasis with frequent exacerbations (conditional recommendation, moderate quality of evidence). · We do not recommend the routine use of mucolytic agents, inhaled corticosteroids, or nonsteroidal anti-inflammatory drugs to prevent exacerbation of bronchiectasis in children (inconclusive, very low quality of evidence). · We recommend the use of nebulized hypertonic saline to prevent exacerbations and improve the lung function of children with noncystic fibrosis bronchiectasis (weak recommendation, moderate quality of evidence). |
Question: Is there a reliable model to predict intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD)? Finding: We constructed 5 machine learning models to predict IVIG-resistant KD. Extreme gradient boosting (XGBoost) model was superior to logistic, support vector machine, light gradient boosting machine and multiple layers perception models. The SHAP (SHapley Additive exPlanations) value interpreted the contribution of each feature in XGBoost model. Meaning: XGBoost model showed the excellent performance to predict IVIG-resistant KD with explainable and visualizable machine learning algorithm. |
· Patients with neurological diseases often require external mechanical support to maintain mechanical ventilation or supply. · Little has been done to help the families of affected children make difficult decisions that carry significant physical and psychological consequences. · The establishment of a department that provides pediatric palliative care for neurological patients should be considered. |