Jornal de pediatria最新文献_第4页

The effects of submission and exposure to real-world and virtual violence during childhood and adolescence 儿童和青少年时期屈服和暴露于现实世界和虚拟暴力的影响。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.jped.2025.101494

Luci Pfeiffer

Objective

This text proposes a discussion and analysis of the effects of exposure to real-world and virtual violence in childhood and adolescence, and its repercussions on development.

Data sources

literature review on the topic of children's and adolescents' exposure to real-world and virtual violence, and observations from case studies of children and adolescents who were victims of serious and very serious violence, assisted by the DEDICA Program – Defense of the Rights of Children and Adolescents in Curitiba in the first semester of 2025.

Summary of findings

It is observed that a significant number of children and adolescents, regardless of their origins, ethnicities, beliefs, cultures, and the sociocultural condition of their guardians, are being exposed to various forms of violence, whether intrafamilial, domestic, institutional, or from their surroundings, through what they observe, witness, and experience in the real or virtual world.

Conclusions

It is concluded that exposure to situations of violence through direct aggression, witnessing, cohabitation, and/or participation can promote desensitization and the normalization of causing harm to others. Without protection or contestation of violent acts, whatever their source, those who are learning their own value and the value of others, and how to fight for life, come to accept them as an inevitable part of life, either suffering them or perpetrating them. The need for pediatric consultations to include guidance for caregivers and patients on preventing exposure to any form of violence, as well as the adoption of protective measures, including legal ones, against the harm to which they may be subjected, is evident.

目的：本文提出了儿童和青少年接触现实世界和虚拟暴力的影响及其对发展的影响的讨论和分析。数据来源：关于儿童和青少年暴露于现实世界和虚拟暴力的文献综述，以及对遭受严重和非常严重暴力的儿童和青少年的案例研究的观察，由2025年第一学期的“捍卫库里提巴儿童和青少年权利”项目协助。调查结果总结：据观察，相当数量的儿童和青少年，无论其出身、种族、信仰、文化和监护人的社会文化状况如何，都面临着各种形式的暴力，无论是家庭内部的、家庭的、机构的，还是来自他们周围的，通过他们在现实或虚拟世界中的观察、见证和经历。结论：通过直接攻击、目睹、同居和/或参与等方式暴露于暴力情境可以促进对他人造成伤害的脱敏和正常化。对于暴力行为，无论其来源如何，没有保护或争论，那些正在学习自己的价值和他人的价值，以及如何为生命而战的人，开始接受它们作为生活中不可避免的一部分，要么遭受它们，要么实施它们。显然，儿科咨询需要包括指导护理人员和患者如何防止遭受任何形式的暴力，以及采取保护措施，包括法律措施，以防止他们可能受到的伤害。

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引用次数: 0

Sleep disorder assessment in children and adolescents with neurodevelopmental disorders 患有神经发育障碍的儿童和青少年的睡眠障碍评估。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2025-09-26 DOI: 10.1016/j.jped.2025.101441

Camila dos Santos El Halal , Magda Lahorgue Nunes

Objective

To review the associations between various neurodevelopmental disorders and the most prevalent sleep disorders in children and adolescents, focusing on clinical characteristics and diagnostic approaches.

Data sources

A literature review was conducted using the PubMed database, employing the search terms “neurodevelopmental disorders” and “sleep disorders,” including “insomnia,” “sleep-related breathing disorders,” “circadian rhythm sleep-wake disorders,” “sleep-related movement disorders,” “parasomnias,” and “central disorders of hypersomnolence.” Specific diagnostic terms related to neurodevelopmental and sleep disorders were also utilized. Additionally, the reference lists of selected manuscripts were manually reviewed to identify further relevant publications.

Data synthesis

Sleep disorders are frequently associated with neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and intellectual disability, as well as genetic syndromes known to predispose individuals to sleep disturbances, including Down syndrome, Smith-Magenis syndrome, Prader-Willi syndrome, and mucopolysaccharidosis type II. These associations are mediated by anatomical, biological, and behavioral mechanisms. Diagnostic evaluation should be guided by clinical suspicion and typically involves a comprehensive clinical history, sleep diaries, standardized questionnaires, and, when indicated, additional diagnostic procedures.

Conclusions

Sleep disorders are more prevalent in children and adolescents with neurodevelopmental disorders. A thorough understanding of the most commonly associated sleep disturbances and the implementation of targeted diagnostic strategies are essential for appropriate clinical management and for improving long-term outcomes in this population.

目的：回顾各种神经发育障碍与儿童和青少年中最常见的睡眠障碍之间的关系，重点介绍临床特征和诊断方法。数据来源：使用PubMed数据库进行文献综述，使用搜索词“神经发育障碍”和“睡眠障碍”，包括“失眠”、“睡眠相关呼吸障碍”、“昼夜节律睡眠-觉醒障碍”、“睡眠相关运动障碍”、“睡眠异常”和“嗜睡中枢性障碍”。还使用了与神经发育和睡眠障碍有关的特定诊断术语。此外，还对选定手稿的参考书目进行了人工审查，以确定进一步的相关出版物。数据综合：睡眠障碍通常与神经发育障碍有关，如自闭症谱系障碍、注意力缺陷/多动障碍和智力残疾，以及已知易使个体发生睡眠障碍的遗传综合征，包括唐氏综合征、史密斯-马格尼斯综合征、普雷德-威利综合征和II型粘多糖病。这些关联是由解剖学、生物学和行为学机制介导的。诊断评估应以临床怀疑为指导，通常包括全面的临床病史、睡眠日记、标准化问卷，并在必要时进行额外的诊断程序。结论：睡眠障碍在患有神经发育障碍的儿童和青少年中更为普遍。彻底了解最常见的相关睡眠障碍和实施有针对性的诊断策略对于适当的临床管理和改善这一人群的长期预后至关重要。

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引用次数: 0

The role of neuropsychological assessment in the investigation of neurodevelopmental disorders 神经心理学评估在神经发育障碍研究中的作用。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2025-11-26 DOI: 10.1016/j.jped.2025.101470

Danielle Irigoyen da Costa , Rosana Vieira de Souza , Thaís Cecília Fiamoncini

Objective

The present study aims to present and discuss the role of neuropsychological assessment (NA) in the investigation of neurodevelopmental disorders (NDDs), with an emphasis on early diagnosis, on the steps that make up the evaluation process, and on the resources that complement clinical evaluation. Furthermore, the discussion is expanded to specific conditions, such as Attention Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Specific Learning Disorders (SLD), considering that they represent frequent assessment demands.

Data sources

A critical review of the national and international literature on neuropsychological assessment in NDDs was carried out, highlighting standardized instruments for the Brazilian context, complementary clinical tasks, and main cognitive and behavioral domains. References to essential books and manuals were included, with analysis enriched by the authors' clinical and teaching experience.

Data synthesis

NA constitutes a central tool for the early identification of alterations in neurodevelopment, with contributions to diagnosis and to the definition of intervention strategies. The process involves systematic steps, such as detailed anamnesis, application of standardized tests, and behavior analysis, covering different domains. The feedback, the final stage of the process, is essential for the understanding of the results and for adhering to the suggested procedures, and it should guide parents on practical implications, therapeutic and educational recommendations, and necessary referrals.

Conclusions

NA represents an essential resource in pediatric practice, both for diagnostic support and for directing interventions and monitoring the progress of children with NDDs. Its early use can modify the prognosis and promote better functional, academic, and socioemotional outcomes.

目的：本研究旨在介绍和讨论神经心理学评估（NA）在神经发育障碍（ndd）调查中的作用，重点是早期诊断，构成评估过程的步骤，以及补充临床评估的资源。此外，讨论扩展到特定条件，如注意缺陷/多动障碍（ADHD），自闭症谱系障碍（ASD）和特殊学习障碍（SLD），考虑到它们代表了频繁的评估需求。数据来源：对ndd神经心理评估的国内和国际文献进行了批判性回顾，强调了巴西背景下的标准化工具，补充临床任务，以及主要的认知和行为领域。参考必要的书籍和手册包括，分析丰富了作者的临床和教学经验。数据综合：NA构成了早期识别神经发育改变的核心工具，有助于诊断和干预策略的定义。这个过程包括系统的步骤，如详细的记忆、标准化测试的应用和行为分析，涵盖了不同的领域。反馈是这个过程的最后一个阶段，对于理解结果和遵守建议的程序是至关重要的，它应该指导家长对实际影响、治疗和教育建议以及必要的转诊。结论：NA代表了儿科实践中的重要资源，无论是诊断支持还是指导干预和监测ndd患儿的进展。早期使用它可以改善预后，促进更好的功能、学业和社会情感结果。

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引用次数: 0

Transdiagnostic irritability in youth: a clinical review 青少年易激惹症的临床回顾。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2025-10-28 DOI: 10.1016/j.jped.2025.101457

Luiza Magalhaes de Oliveira, Guilherme V. Polanczyk, Luisa Shiguemi Sugaya

Objective

Irritability is one of the most frequent concerns in pediatric mental health and a predictor of long-term psychopathology and burden. This article aims to provide a comprehensive review of non-episodic irritability along with evidence-based clinical recommendations for pediatric care professionals.

Sources

A narrative review was conducted based on the literature from the last 10 years and additional key studies. Observational studies, randomized controlled trials, systematic reviews, and meta-analyses were considered.

Summary of the findings

Non-episodic irritability is a transdiagnostic construct associated with several mental disorders. Research on etiological pathways suggests that irritability may involve distinct mechanisms, moderate heritability, and genetic associations with attention-deficit/hyperactivity disorder (ADHD), and depression. Clinical manifestations vary across different developmental stages, and distinguishing pathological from normative irritability may be challenging. Although there is no gold-standard measure, validated instruments are available. Despite recent advances, evidence-based treatment remains limited. Evidence supports psychosocial interventions that integrate parent- and child-focused components, as well as the use of stimulants for patients with comorbid ADHD. Antipsychotics are effective in reducing irritability in children with autism spectrum disorder. However, its use requires caution in non-autistic youth with irritability without a diagnosable disorder or with oppositional defiant disorder due to inconclusive efficacy and potential adverse effects.

Conclusions

Although publications on non-episodic irritability have increased, the evidence remains relatively nascent. Further research is needed to advance the knowledge on underlying mechanisms, enhance clinical recognition, identify effective interventions, and support the development of new treatments, ensuring that irritability is adequately addressed in clinical practice.

目的：易怒是儿童心理健康中最常见的问题之一，也是长期精神病理和负担的预测因子。本文旨在为儿科护理专业人员提供非发作性易怒的综合综述以及循证临床建议。资料来源：根据近10年的文献和其他重要研究进行了叙述性回顾。我们考虑了观察性研究、随机对照试验、系统评价和荟萃分析。研究结果总结：非发作性易怒是一种与多种精神障碍相关的跨诊断结构。对病因途径的研究表明，易怒可能涉及不同的机制，适度的遗传性，以及与注意缺陷多动障碍（ADHD）和抑郁症的遗传关联。不同发育阶段的临床表现各不相同，区分病理性和规范性易怒可能具有挑战性。虽然没有金标准的测量方法，但是可以使用经过验证的仪器。尽管最近取得了进展，但循证治疗仍然有限。证据支持将以父母和儿童为重点的成分结合起来的社会心理干预措施，以及对患有共病性多动症的患者使用兴奋剂。抗精神病药物在减少自闭症谱系障碍儿童的易怒方面是有效的。然而，由于不确定的疗效和潜在的不良反应，在没有诊断障碍的非自闭症青少年中使用它需要谨慎。结论：尽管关于非发作性易怒的出版物有所增加，但证据仍然相对较少。需要进一步的研究来推进对潜在机制的了解，增强临床认识，确定有效的干预措施，并支持新治疗方法的发展，确保在临床实践中充分解决烦躁不安问题。

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引用次数: 0

The pediatrician’s role in the follow-up of children/adolescents with mental and/or neurodevelopmental disorders 儿科医生在患有精神和/或神经发育障碍的儿童/青少年随访中的作用。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2025-12-19 DOI: 10.1016/j.jped.2025.101492

Magda Lahorgue Nunes

引用次数: 0

Community-based pediatric palliative care: a systematic review of structures, processes, and outcomes 以社区为基础的儿科姑息治疗：对结构、过程和结果的系统回顾。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.jped.2026.101510

Sergio Andres Acuña-Caicedo , Aura Gisela González-Brossard , Laury Ellen Pérez-González , María Eugenia Arcia-Gálvez , Miguel Antonio Sánchez-Cárdenas

Objective

To analyze the structure, processes, and outcomes of different models of community-based palliative care of children, adolescents, and their families reported in the literature.

Methods

The authors conducted a systematic review of original, full-text studies in MEDLINE and Embase (January 2014–May 2024), following PRISMA. Two reviewers screened/extracted data; a third resolved disagreements. Study quality and reporting were appraised with the Newcastle–Ottawa Scale and, as applicable, STROBE, COREQ, and CARE. Narrative synthesis was organized with Donabedian’s framework. PROSPERO: CRD42018747214.

Results

Twenty-six high-quality studies (5 qualitative, 18 quantitative, 3 mixed-methods) described community PPC across home-based services, outpatient programs, community health and social support centers. Common structures included multidisciplinary teams with 24/7 availability, assistive devices/equipment, telemedicine, and screening/assessment tools (e.g., PedsQL, PedsQL-FIM, PIP, PaPaS). Core processes were home visits, caregiver education, symptom monitoring (including digital tools), advance care planning, interprofessional teamwork, and coordination with schools and social services. Reported outcomes most frequently included reduced hospital admissions and emergency use, improved symptom control and health-related quality of life, higher caregiver satisfaction, and lower parenting stress; however, measures and follow-up were heterogeneous.

Conclusions

Community-based PPC can improve children’s and families’ quality of life when medical, psychosocial, and social resources are integrated beyond the hospital. To advance the field, validated outcome measures, sustainable financing, workforce training, and stronger policy frameworks are urgently needed.

目的：分析文献报道的不同社区儿童、青少年及其家庭姑息治疗模式的结构、过程和结果。方法：在PRISMA之后，作者对MEDLINE和Embase（2014年1月- 2024年5月）的原始全文研究进行了系统回顾。两名审稿人筛选/提取数据；第三个解决了分歧。研究质量和报告采用纽卡斯尔-渥太华量表和适用的STROBE、COREQ和CARE进行评估。叙事综合是在Donabedian的框架下组织起来的。普洛斯彼罗:CRD42018747214。结果：26项高质量研究（5项定性研究，18项定量研究，3项混合方法研究）描述了家庭服务、门诊项目、社区卫生和社会支持中心的社区PPC。常见的结构包括全天候可用的多学科团队、辅助设备/设备、远程医疗和筛选/评估工具（例如，PedsQL、PedsQL- fim、PIP、PaPaS）。核心流程包括家访、护理人员教育、症状监测（包括数字工具）、提前护理计划、跨专业团队合作以及与学校和社会服务机构的协调。报告的结果最常见的包括减少住院和急诊使用，改善症状控制和与健康相关的生活质量，提高照顾者满意度和降低养育压力；然而，测量和随访是异质的。结论：当医院以外的医疗、心理社会和社会资源得到整合时，社区PPC可以改善儿童和家庭的生活质量。为了推动这一领域的发展，迫切需要有效的成果措施、可持续融资、劳动力培训和更强有力的政策框架。

{"title":"Community-based pediatric palliative care: a systematic review of structures, processes, and outcomes","authors":"Sergio Andres Acuña-Caicedo , Aura Gisela González-Brossard , Laury Ellen Pérez-González , María Eugenia Arcia-Gálvez , Miguel Antonio Sánchez-Cárdenas","doi":"10.1016/j.jped.2026.101510","DOIUrl":"10.1016/j.jped.2026.101510","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the structure, processes, and outcomes of different models of community-based palliative care of children, adolescents, and their families reported in the literature.</div></div><div><h3>Methods</h3><div>The authors conducted a systematic review of original, full-text studies in MEDLINE and Embase (January 2014–May 2024), following PRISMA. Two reviewers screened/extracted data; a third resolved disagreements. Study quality and reporting were appraised with the Newcastle–Ottawa Scale and, as applicable, STROBE, COREQ, and CARE. Narrative synthesis was organized with Donabedian’s framework. PROSPERO: CRD42018747214.</div></div><div><h3>Results</h3><div>Twenty-six high-quality studies (5 qualitative, 18 quantitative, 3 mixed-methods) described community PPC across home-based services, outpatient programs, community health and social support centers. Common structures included multidisciplinary teams with 24/7 availability, assistive devices/equipment, telemedicine, and screening/assessment tools (e.g., PedsQL, PedsQL-FIM, PIP, PaPaS). Core processes were home visits, caregiver education, symptom monitoring (including digital tools), advance care planning, interprofessional teamwork, and coordination with schools and social services. Reported outcomes most frequently included reduced hospital admissions and emergency use, improved symptom control and health-related quality of life, higher caregiver satisfaction, and lower parenting stress; however, measures and follow-up were heterogeneous.</div></div><div><h3>Conclusions</h3><div>Community-based PPC can improve children’s and families’ quality of life when medical, psychosocial, and social resources are integrated beyond the hospital. To advance the field, validated outcome measures, sustainable financing, workforce training, and stronger policy frameworks are urgently needed.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101510"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lumbopelvic stabilization-based physiotherapy and rehabilitation and urotherapy for lower urinary tract dysfunction in Duchenne Muscular Dystrophy: a randomized controlled trial 杜氏肌营养不良患者下尿路功能障碍的基于腰盆腔稳定的物理治疗、康复和泌尿治疗：一项随机对照试验。

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2026-02-13 DOI: 10.1016/j.jped.2026.101511

Demet Öztürk , Aynur Ayşe Karaduman , Türkan Akbayrak

Objective

This randomized controlled trial investigated the effectiveness of supervised lumbopelvic stabilization and urotherapy on factors associated with lower urinary tract symptoms in children with Duchenne Muscular Dystrophy and lower urinary tract dysfunction (LUTD).

Method

The study included 32 children aged 5–12 years, who were ambulatory and had a Dysfunctional Voiding and Incontinence Symptom Scale (DVISS) of 8.5 or higher. Lower urinary tract symptoms were assessed using the DVISS, a three-day bladder diary, and a nocturnal enuresis diary. Bowel symptoms were assessed with a seven-day bowel diary. Moreover, physical performance tests, the strength of pelvis-related muscle groups, and participation in activities of daily living were evaluated using validated measurement tools. Participants were randomized into two groups: the active control group (n:16, weight:25.81±9.53 kg, height:121.25±18.22 cm) received only urotherapy, while the treatment group (n:16, weight:25.88±9.67 kg, height: 122.69±16.63 cm) additionally performed lumbopelvic stabilization-based exercises for eight weeks under the supervision of a physiotherapist.

Results

Urotherapy significantly reduced LUTD severity (p < 0.001), enuresis frequency (p = 0.014), and the number of symptoms associated with LUTD (p = 0.001). However, adding lumbopelvic stabilization exercises conferred no superiority over urotherapy alone (p > 0.05). Supervised lumbopelvic stabilization improved functional mobility (p < 0.003), muscle strength (p < 0.05), and participation in activities of daily living (p < 0.049). However, neither urotherapy nor lumbopelvic stabilization training had a significant effect on Gower’s time or daytime voiding frequency (p > 0.05).

Conclusion

Both interventions were effective in improving bladder and bowel outcomes in children with Duchenne Muscular Dystrophy and LUTD, with no superiority observed on lower urinary tract symptoms.

目的：本随机对照试验探讨了监督腰盆腔稳定和泌尿治疗对杜氏肌营养不良和下尿路功能障碍（LUTD）儿童下尿路症状相关因素的有效性。方法：研究对象为32名5-12岁、可走动、排尿功能障碍及尿失禁症状量表（DVISS） 8.5及以上的儿童。下尿路症状采用DVISS、三天膀胱日记和夜间遗尿日记进行评估。用7天肠道日记评估肠道症状。此外，使用经过验证的测量工具对身体性能测试、骨盆相关肌肉群的力量和日常生活活动的参与进行了评估。参与者被随机分为两组：积极对照组（n:16，体重：25.81±9.53 kg，身高：121.25±18.22 cm）只接受泌尿治疗，而治疗组（n:16，体重：25.88±9.67 kg，身高：122.69±16.63 cm）在物理治疗师的监督下进行为期8周的腰椎骨盆稳定训练。结果：尿路治疗显著降低了LUTD严重程度（p  0.05）。有监督的腰盆腔稳定改善了功能活动（p  0.05）。结论：两种干预措施均可有效改善杜氏肌营养不良症和LUTD患儿的膀胱和肠道结局，对下尿路症状无明显优势。

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引用次数: 0

Dietary protein intake and asthma in US children and adolescents: a cross-sectional analysis of NHANES data 膳食蛋白质摄入与美国儿童和青少年哮喘：NHANES数据的横断面分析

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1016/j.jped.2025.101495

Lingyu Li, Peipei Tian, Yanmei Teng, Rui Wang, Mingxiao Zhang, Qiuyu Ma

Objective

Evidence regarding total dietary protein intake remains inconsistent and limited for the US pediatric population. This study utilizes nationally representative data to examine the association between total dietary protein intake and asthma prevalence, thereby addressing this research gap.

Method

A cross-sectional study that involved 4825 people used data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. The relationship between total protein intake and asthma was investigated using multiple linear regression models. The linear relationship between the two was tested using a restricted cubic spline. Stratified analysis further confirms the stability of the findings.

Results

All eligible participants (N = 4,825; mean age 10.6 ± 2.9 years; 49.7% male) were analyzed. The fully-adjusted model revealed a positive association between total protein consumption and asthma after controlling for confounders. Compared to the lowest intake quartile Q1 (≤ 3.966 mg/day), adjusted odds ratios for asthma in Q2 (3.967-6.364 mg/day) and Q3 (≥ 6.365 mg/day) were 0.097 (95%CI:0.97-1.44, p = 0.097) and 0.036 (95%CI:1.01-1.55, p = 0.036), respectively. A dose-response relationship (p = 0.037) emerged between total protein consumption and asthma risk.

Conclusion

Total dietary protein intake demonstrated a positive association with asthma among US children and adolescents. These findings are statistically significant.

目的：关于美国儿科人群总膳食蛋白质摄入量的证据仍然不一致且有限。本研究利用具有全国代表性的数据来检验总膳食蛋白质摄入量与哮喘患病率之间的关系，从而解决了这一研究空白。方法：采用2011年至2020年国家健康与营养检查调查（NHANES）的数据，对4825人进行横断面研究。采用多元线性回归模型研究总蛋白摄入量与哮喘的关系。用限制三次样条检验了两者之间的线性关系。分层分析进一步证实了研究结果的稳定性。结果：所有符合条件的参与者（N = 4,825人，平均年龄10.6±2.9岁，男性49.7%）均被纳入分析。完全调整的模型显示，在控制混杂因素后，总蛋白质摄入量与哮喘呈正相关。与最低摄入四分位数Q1（≤3.966 mg/天）相比，Q2（3.967-6.364 mg/天）和Q3（≥6.365 mg/天）哮喘的调整优势比分别为0.097 （95%CI:0.97-1.44, p = 0.097）和0.036 （95%CI:1.01-1.55, p = 0.036）。总蛋白质摄入量与哮喘风险之间存在剂量-反应关系（p = 0.037）。结论：在美国儿童和青少年中，总膳食蛋白质摄入量与哮喘呈正相关。这些发现具有统计学意义。

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引用次数: 0

Navigating the Precipice: continuous renal replacement therapy in critically Ill children with oncologic diseases 在悬崖边航行：肿瘤疾病危重儿童的持续肾脏替代治疗

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.1016/j.jped.2026.101505

Shina Menon

引用次数: 0

Epidemiological and clinical characteristics associated with enterovirus D68 respiratory diseases in Asian children: a systematic review and meta-analysis 亚洲儿童肠道病毒D68呼吸道疾病相关的流行病学和临床特征：一项系统综述和荟萃分析

IF 2.5 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2026-01-01 Epub Date: 2025-11-14 DOI: 10.1016/j.jped.2025.101475

Xiaojing Lu , Bingbing Li , Shufang Li , Lihong Wang , Guangen Guo , Yanli Zhang , Jiajia Duan , Changlian Zhu

Objective

This study aimed to determine the epidemiology and clinical characteristics of EV-D68-associated respiratory diseases among Asian children.

Sources

The PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), VIP, WanFang, and SinoMed electronic databases were searched from inception to February 28, 2025, to identify relevant articles. Studies reporting the detection rate of enterovirus D68 (EV-D68) in pediatric patients with respiratory tract infections were included. The methodological quality regarding the risk of bias was assessed according to the approach proposed by the Joanna Briggs Institute.

Summary of the findings

Twenty studies involving 47,451 participants were included; additionally, 450 participants were positive for EV-D68 infection. The detection rate of EV-D68 ranged from 0.23 % to 10.56 %, with a pooled prevalence of 1.29 % (95 % CI 0.88–1.78 %), but significant heterogeneity (I² = 94.20 %, p < 0.001) indicated that this estimate was context-dependent. Subgroup analyses revealed that detection rates varied substantially by country, study period, and income level. Pneumonia is the most common respiratory disease presentation. EV-D68 is most prevalent during the summer and autumn.

Conclusion

This is the first review to focus specifically on Asian children, which suggests that EV-D68 detection rates vary significantly across Asian populations and are especially influenced by geographic location and surveillance timing. EV-D68 infection in children is most frequently associated with pneumonia. These findings support targeted regional surveillance networks during the summer-autumn seasons to improve clinical diagnostics and public health responses.

Trial Registration

PROSPERO Identifier: CRD42023449889.

目的：本研究旨在了解亚洲儿童ev - d68相关呼吸道疾病的流行病学和临床特征。资料来源：检索PubMed、Embase、Web of Science、Scopus、CNKI、VIP、万方、SinoMed等电子数据库，检索时间为创刊至2025年2月28日。研究报告了肠道病毒D68 （EV-D68）在儿科呼吸道感染患者中的检出率。根据乔安娜布里格斯研究所提出的方法评估偏倚风险的方法学质量。研究结果总结：纳入了20项研究，涉及47,451名参与者；此外，450名参与者的EV-D68感染呈阳性。的检出率EV-D68范围从0.23 % 10.56 %,汇集患病率为1.29 %(95 %可信区间0.88 - -1.78 %),但是显著的异质性(我²  % = 94.20,p 结论:这是第一个评论特别关注亚洲的孩子,这表明EV-D68亚洲人群检出率显著不同,尤其受地理位置的影响和监测时机。儿童感染EV-D68最常与肺炎相关。这些发现支持在夏秋季节建立有针对性的区域监测网络，以改进临床诊断和公共卫生反应。试验注册：PROSPERO标识符：CRD42023449889。

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引用次数: 0