Current Pediatric Reviews最新文献

Breast milk (BM) is the best option for the nutritional needs of an infant. In situations where breastfeeding is contraindicated, donor human milk and formula milk (FM) are suggested as alternatives. This study highlights findings from two studies that evaluated how different dietary patterns (standard formula, post-biotic fermented formula, and breast milk) affected the intestinal microbiota and metabolome of late preterm and full-term infants. The metabolome of late preterm newborns showed a higher presence of metabolites-such as azelaic acid, N-acetylglucosamine- 6- sulfate, and 13(S)-hydroperoxylinolenic acid-in those fed postbiotic-fermented formula, similar to breastfed full-term newborns. The fecal metabolites of breast milk and substitute feeding systems are comparable in these preliminary studies, confirming the effectiveness of formula preparations as breast milk substitutes. Furthermore, newborns fed with postbiotic-supplemented formula or breast milk had several similarities in fecal metabolites. The addition of postbiotics to formula milk appears to be more efficient than standard formula milk and is considered a better alternative to breast milk.

Background: The global lack of suitable formulations for children leads to off-label and unlicensed medicine use, posing significant risks of adverse effects. Understanding this usage on a national level can help guide interventions for better formulations. This study aimed to measure the prevalence of off-label and unlicensed medicines among children in South Africa's private sector.

Methods: The study used a point prevalence methodology to review medicine use in children aged 0-2 years enrolled in a selected pharmaceutical benefit management company in South Africa from January to June 2022. A sample size of 1055 prescriptions was calculated using a 90% confidence interval, 50% prevalence rate, and 5% error margin. A systematic random sampling approach selected every 7th entry from 91,973 total entries, resulting in a final sample size of 13,139. Data included patient age, number and characteristics of medicines, quantity, and indications. Descriptive statistics analysed and reported the prevalence of unlicensed and off-label medicine use.

Results: Among the 13,139 prescribed medicines, 40% (5,246) were off-label or unlicensed, and 60% (7,893) were on-label. Of the off-label/unlicensed medicines, 16.85% (2,214) were unlicensed, and 23.08% (3,032) were off-label. Methylprednisolone was the top off-label medicine, probiotics were the top unlicensed, and the ICD10 code Z76.9 was the top diagnosis.

Conclusion: The study found that 40% of children aged 0-2 years were prescribed unlicensed or off-label medicines in South Africa's private healthcare sector between January and June 2022. This suggests a widespread practice of off-label or unlicensed prescriptions in paediatric treatment in the South African private sector.

We read a review of case reports published on Current Pediatric Reviews 2024 about the use of I-gel® in neonatal complicated intubation, and we decided to write a commentary on the benefits and limitations of using supraglottic airways in neonatal age, with a specific focus on Igel. The use of supraglottic airway devices in neonatal ages is limited to particular conditions, but further research is showing the utility of these devices as the first choice in neonatal resuscitation or airway stabilization. Our commentary highlights the broader practical applications of I-gel and reinforces its role as a valuable tool in neonatal resuscitation.

The novel Coronavirus Disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, created a need for evidence-based guidelines for the evaluation, management, and follow-up after infection. Data have become rapidly available, creating a challenge for medical providers to stay abreast of the ever-evolving recommendations. This article, written collaboratively by pediatric cardiovascular experts, pediatricians, and sports medicine specialists, is focused on SARS-CoV- 2-related pediatric cardiac manifestations. It aims to provide a systematic review of high-yield literature related to all cardiovascular entities as a tool for primary pediatric clinicians to utilize as they consider the cardiac consequences of acute SARS-CoV-2 infection, MIS-C, vaccine-related myocarditis, return-to-play, and long COVID-19 syndrome.

Background: Studies on prenatal antibiotic use and Autism Spectrum Disorder (ASD) risk have yielded inconsistent results.

Aim: This study aimed to resolve these discrepancies by conducting a meta-analysis on the relationship between prenatal antibiotic use and ASD in children.

Methods: A comprehensive search was conducted in four main databases: Medline (OVID) PubMed, Scopus, and Web of Science, up to August 1, 2024. The analysis employed random-effect models to estimate effect sizes, including hazard ratios (HR) and odds ratios (OR). Publication bias was assessed using Begg's test and Egger's regression test. Subgroup analyses explored variations in the association based on the trimester of pregnancy. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Results: In this meta-analysis, which included twelve studies with a total population of 6,264,831, prenatal antibiotic use was associated with an increased risk of Autism Spectrum Disorder (ASD). The estimated HR for this risk was 1.08 (95% CI: 1.05, 1.12), and the OR was 1.16 (95% CI: 1.09, 1.23), with no detected heterogeneity among studies. The analysis found no publication bias. Significant associations were observed for each trimester: first trimester (HR: 1.11; 95% CI: 1.04, 1.18), second trimester (HR: 1.10; 95% CI: 1.06, 1.14), and third trimester (HR: 1.09; 95% CI: 1.01, 1.18).

Conclusion: The analysis showed that prenatal antibiotic use is a risk factor for ASD. Prenatal antibiotic use was associated with an increase in the risk of ASD across all trimesters of pregnancy. Future research should focus on elucidating the mechanisms underlying this association by examining the effects of specific antibiotic classes, dosages, and timing during critical developmental periods. Longitudinal studies with comprehensive control for confounding factors are essential for strengthening causal inferences and guiding clinical recommendations regarding antibiotic use during pregnancy.

Atypical Pneumonia (AP) is any type of pneumonia not caused by one of the common microorganisms, such as Streptococcus pneumoniae. The most common etiologic microorganisms are intracellular bacteria and viruses, including Chlamydia pneumoniae and Mycoplasma pneumoniae. These microorganisms have been difficult to culture. The pandemic of COVID-19 has changed the management of these APs as a result of the widespread usage of multiplexed PCR tests. We have audited 7 anonymized cases of AP to illustrate the utility of these multiplexed PCR-based tests, which can aid the diagnosis and prompt treatment of several AP cases. In conclusion, AP can be readily diagnosed with a multiplexed PCR test, so that efficacious treatment can be initiated without delay. Chlamydia and Bordetella diseases are readily diagnosed even with NPS specimens. Macrolides and doxycycline are readily available oral medications for treating AP in children. Doxycycline is efficacious for macrolide-resistant mycoplasma disease and does not have the side effects of tetracycline in the young pediatric population.

Introduction: To study internet health information-seeking behavior and its determinants among caregivers in a tertiary Pediatric Outpatient Department (OPD) in Eastern India.

Methods: A cross-sectional study was conducted between September and December 2022 at the Pediatric Outpatient Department of the All India Institute of Medical Sciences (AIIMS), Deoghar, India. A 13-item validated questionnaire was administered through face-to-face interviews, capturing demographic information and internet health information-seeking behavior. Statistical analyses, including multivariable logistic regression, identified significant determinants.

Results: Outpatient visits were primarily for acute diseases (39.3%), followed by chronic disease monitoring (19.5%) and acute follow-ups (19.3%). Approximately 34.4% of caregivers sought health information online. Internet health information-seeking behavior was significantly associated with higher educational attainment and visit reasons. Caregivers with higher secondary education or graduate degrees were 7.5 and 7.6 times more likely, respectively, to seek health information online. Those attending for acute or acute follow-up visits had 2.2- and 3.5-times higher odds, respectively. The multivariable model explained 32.4% variability and had a predictive accuracy of 74.1%.

Discussion: The relatively low prevalence of online health information-seeking highlights regional gaps in digital health literacy. Education level and visit type were key predictors, underscoring the need for targeted guidance. Findings are limited by self-reporting and single-center design but offer direction for integrating digital support into pediatric care.

Conclusion: One-third of caregivers utilized the internet for children's health information, with higher education and acute visit reasons as key determinants.

The birth of a baby is a significant milestone for both parents, marking a major life transition into parenthood. In high-risk situations, such as preterm delivery, this event disrupts functional adaptation and greatly impacts parents' ability to recognize and effectively respond to their newborn's physiological and developmental needs. Positive interactions and sensitive responses to an infant's needs enable parents to foster development, supporting regulatory processes and establishing healthy social interaction patterns. The Newborn Behavioral Observation (NBO) Early Intervention is a prevention-focused follow-up program initiated shortly after birth during a developmental window when the infant's brain is highly receptive to environmental influences, maximizing its impact on infant development. Recent applications of the NBO intervention in at-risk contexts have shown promising effects on both infant development and the parent-infant relationship. This educational mini-review aims to summarize the main findings and future prospects of using the NBO to support the transition to parenthood from birth through the first months of life, particularly in high-risk environments such as intensive care units.