Jornal de pediatria最新文献

{"title":"Comparison between the safety of the HPV vaccine versus placebo: a systematic review and meta-analysis of randomized clinical trials","authors":"Swelen Aparecida dos Santos ,&nbsp;Mariane Yoshie Sato ,&nbsp;Pedro Henrique Gunha Basilio ,&nbsp;Meire Ellen Pereira ,&nbsp;Rafaela Climaco Julião ,&nbsp;Nielson da Cunha Arruda ,&nbsp;Davi Paula da Silva ,&nbsp;Cláudia Sirlene Oliveira ,&nbsp;Victor Horacio de Souza Costa-Junior ,&nbsp;Izonete Cristina Guiloski","doi":"10.1016/j.jped.2025.04.009","DOIUrl":"10.1016/j.jped.2025.04.009","url":null,"abstract":"<div><h3>Objective</h3><div>Human Papillomavirus (HPV) is a virus that targets epithelial tissues. Virtually all cases of cervical cancer are related to HPV, emphasizing the importance of vaccines in prevention. Although &gt;200 million doses have been administered worldwide, concerns persist about adverse reactions. This study evaluated the safety of the HPV vaccine and the main adverse effects.</div></div><div><h3>Data sources</h3><div>The study was registered in the PROSPERO database (CRD42023365692). The systematic searches were conducted in the PubMed, Scopus, Embase, Cochrane, Science Direct, and Web of Science databases using the search strategy \"HPV\" AND \"vaccine\" AND \"safety\" NOT \"COVID\" from 01/01/2007 to 31/12/2022. Inclusion criteria were based on the PICOT strategy, focusing on studies with humans, vaccinated populations comprising children, adolescents, and adults, and Phase II/III randomized clinical trials. The PEDro scale was used to assess the quality of the studies.</div></div><div><h3>Summary of findings</h3><div>Eleven articles were qualified for qualitative synthesis and meta-analysis. The results indicated that HPV vaccination was associated with increased local reactions, fatigue, and myalgia compared to the placebo. However, there were no significant differences in serious adverse events, gastrointestinal reactions, cutaneous effects, headache, or fever between the vaccine and placebo groups.</div></div><div><h3>Conclusion</h3><div>Local reactions, fatigue, and myalgia were more prevalent in the HPV vaccine group; the overall safety profile of the vaccine was favorable. The HPV vaccine was deemed safe, mirroring the profile of adverse reactions seen with other vaccines. With its potential to prevent cancer, the benefits of HPV vaccination far outweigh the minimal risks.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101411"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159110","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}

{"title":"Impact of the COVID-19 pandemic on the incidence of acute mastoiditis in a tertiary reference children’s hospital in Brazil","authors":"Hemily Izabel Alves Neves MD ,&nbsp;Joel Lavinsky MD, PhD ,&nbsp;Luana Vieira Margheti MD ,&nbsp;Mauricio Schneider Miura MD, PhD ,&nbsp;Patrícia Barcelos Ogando MD, MsC ,&nbsp;Marcelo Assis Moro da Rocha Filho MD ,&nbsp;Jose Faibes Lubianca Neto MD, PhD","doi":"10.1016/j.jped.2025.05.003","DOIUrl":"10.1016/j.jped.2025.05.003","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the incidence of AM hospitalizations and complications across three periods: pre-pandemic, pandemic, and post-pandemic. Additionally, the study aims to evaluate associations with patient age, need for surgical intervention, antibiotic therapy, and isolated etiological agents.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed pediatric charts from three 22-month periods: pre-pandemic (P1), pandemic (P2), and post-pandemic (P3). These periods were compared in terms of case numbers, presence and severity of AM complications, patient demographics (age and sex), and treatment approaches.</div></div><div><h3>Results</h3><div>A total of 9 AM cases were recorded in (P1), 5 in the (P2), and 25 in (P3). This represents a 25.5 % reduction in AM incidence during the pandemic compared to the pre-pandemic period, though this was not statistically significant (<em>p</em> = 0.8027). However, a significant 103.3 % increase in AM incidence was noted between the pre- and post-pandemic periods (<em>p</em> = 0.0322). No significant differences were found among periods regarding age, sex, complications, case severity, surgical intervention, antibiotic duration, or length of hospitalization.</div></div><div><h3>Conclusion</h3><div>Although AM incidence slightly declined during the pandemic, the post-pandemic period showed a significant rise in the incidence of cases compared to pre-pandemic values.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101415"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215904","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}

{"title":"Efficacy and safety of using Elexacaftor/Tezacaftor/Ivacaftor in the treatment of children with cystic fibrosis: real-world evidence from Brazil","authors":"Guilherme da Silva Martins ,&nbsp;Carolina Rambo ,&nbsp;Gabriela Spessatto ,&nbsp;Maitê Milagres Saab ,&nbsp;Bruno Hernandes David João ,&nbsp;Aline Didoni Fajardo ,&nbsp;Juliana Gonçalves Primon ,&nbsp;Thalita Gonçalves Picciani ,&nbsp;Roberta Corrêa da Cunha ,&nbsp;Herberto José Chong-Neto ,&nbsp;Carlos Roberto Lebarbenchon Massignan ,&nbsp;Luiz Vicente Ribeiro Ferreira da Silva-Filho ,&nbsp;Carlos Antônio Riedi ,&nbsp;Nelson Augusto Rosário Filho ,&nbsp;Débora Carla Chong-Silva","doi":"10.1016/j.jped.2025.05.007","DOIUrl":"10.1016/j.jped.2025.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>Cystic fibrosis (CF) treatment has evolved significantly with the development of CFTR modulators, particularly elexacaftor/tezacaftor/ivacaftor (ETI). This study aimed to evaluate in a real-life context, the efficacy, safety and tolerability of ETI in children and adolescents with CF at a national reference center in Brazil.</div></div><div><h3>Methods</h3><div>A cohort of 39 patients (mean age: 11.7 years) who had been using ETI for at least three months were evaluated. Anthropometric data, pulmonary function, sweat chloride concentration, pulmonary exacerbations, antibiotic use, and liver function were assessed over a follow-up period of up to 17 months.</div></div><div><h3>Results</h3><div>Significant improvements were observed in weight Z-score at three months (<em>p</em> = 0.046) and six months (<em>p</em> = 0.018), as well as absolute weight gain (<em>p</em> &lt; 0.001). Height showed absolute growth, but no significant changes in Z-scores. Sweat chloride concentration decreased by 52.8 mmol/L (<em>p</em> &lt; 0.001). Pulmonary exacerbations and antibiotic use significantly declined (<em>p</em> &lt; 0.001 for both). Despite limitations in spirometry data collection, FEV1 values showed a median increase of 6 percentage points. Oropharyngeal swab cultures for <em>Pseudomonas aeruginosa</em> positivity dropped from 43.6 % to 5.1 %. Safety assessments showed a transient rise in alkaline phosphatase (<em>p</em> = 0.011), but no significant hepatotoxicity. The most common adverse events were increased respiratory secretions (25.6 %) and abdominal pain (15.4 %). One temporary treatment suspension and one dose reduction occurred, but no patient required permanent discontinuation.</div></div><div><h3>Conclusions</h3><div>ETI demonstrated effectiveness in improving weight gain, reducing pulmonary exacerbations, and significantly lowering sweat chloride concentration. The treatment was well-tolerated, with a favorable safety profile. These findings align with existing literature, supporting ETI's role as a transformative therapy in pediatric CF management.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101420"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484465","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}

{"title":"A response to \"Comparative efficacy of LifeVac® and Heimlich Maneuver in simulated airway obstruction\".","authors":"Simon Gould","doi":"10.1016/j.jped.2025.101427","DOIUrl":"10.1016/j.jped.2025.101427","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101427"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The full blood count as a tool of differentiation between benign and malignant lymphadenopathy in pediatric and adolescent populations","authors":"Mariana Moreira Magnabosco da Silva ,&nbsp;Leniza Costa Lima Lichtvan ,&nbsp;Thaís Cugler Meneghetti","doi":"10.1016/j.jped.2025.05.001","DOIUrl":"10.1016/j.jped.2025.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>Studies have shown the benefit of ratios between cell types in full blood count for the diagnosis and prognosis of various pathologies, but its use in the investigation of lymphadenopathy is still controversial. The aim of this study is to assess whether there is a difference between the full blood count ratios of children and adolescents with lymphadenopathy who had benign or malignant causes identified in excisional biopsies during the investigation of lymphadenopathy.</div></div><div><h3>Method</h3><div>This is a cross-sectional observational study. A total of 72 participants between 0 and 17 years old who underwent an excisional lymph node biopsy and had their full blood count collected up to 15 days before the procedure were included. The participants were divided into two groups, malignant and benign, according to the biopsy result. Neutrophils/lymphocytes (N/L), monocytes/lymphocytes (M/L), and platelets/lymphocytes (P/L) ratios were then calculated and compared between the groups.</div></div><div><h3>Results</h3><div>The mean full blood count ratios for the benign and malignant groups, respectively, were: N/L 2.36 × 3.28 <em>(p</em> <em>=</em> <em>0.09)</em>, M/L 0.30 × 0.32 <em>(p</em> <em>=</em> 0.722<em>)</em>, P/L 180.53 × 191.30 <em>(p</em> <em>=</em> <em>0.249)</em>.</div></div><div><h3>Conclusion</h3><div>The use of full blood count ratios as predictors of malignant or benign results has no proven statistical significance. Higher ratio values tend towards malignant results but should be interpreted with caution, as this is only one of the factors to be considered during the investigation.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101413"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187029","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}

{"title":"Empower your child's health: tailored strategies to prevent rhinosinusitis","authors":"Francesca De Bernardi ,&nbsp;Chiara Zeroli ,&nbsp;Sandra Coecke ,&nbsp;Massimo Landi ,&nbsp;Stefania Gallo ,&nbsp;Paolo Castelnuovo ,&nbsp;Luana Nosetti","doi":"10.1016/j.jped.2024.02.005","DOIUrl":"10.1016/j.jped.2024.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>This review explores preventive strategies for pediatric rhinosinusitis and examines their potential impact on children's mental well-being, advocating for a comprehensive holistic approach that includes medical disciplines and government policies to support EU and global prevention strategies.</div></div><div><h3>Sources</h3><div>A comprehensive search encompassed Medline, Embase, PubMed, and the Cochrane Library for English-language articles from January 2010 to December 2023. Inclusion criteria involved papers on pediatric rhinosinusitis prevention in the pediatric population, published in peer-reviewed journals. Following the removal of duplicates and exclusion of irrelevant studies, 20 unique titles were included in the review.</div></div><div><h3>Summary of the findings</h3><div>The review underscores the challenges posed by the similarity of symptoms between pediatric rhinosinusitis and other common childhood illnesses. It emphasizes the interconnected nature of upper and lower airways, illustrating the potential impact on both physical and mental well-being in children. The findings highlight the necessity for a multifaceted prevention approach, supported by individualized prevention plans, medical professional involvement, and government policies.</div></div><div><h3>Conclusions</h3><div>The holistic research and clinical approach proposed in this review contribute valuable insights into the global efforts aimed at reducing the incidence of pediatric rhinosinusitis while promoting the mental well-being of children. The article serves as an informative resource for readers seeking a deeper understanding of pediatric rhinosinusitis prevention strategies.</div><div>The review emphasizes the necessity of a multidisciplinary approach, involving pediatricians, otolaryngologists, pneumologists, and allergologists, in PRS prevention. Government prioritization of preventive measures is essential. Precision medicine and integrative approaches are recommended for tailored treatment plans.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101417"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258098","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}

{"title":"Comparative randomized clinical trial on postoperative pain in circumcision with ultrasound-guided versus conventional anesthetic block","authors":"Isabela P. Moraes ,&nbsp;Flavia P. Payan ,&nbsp;Camila G. Fachin ,&nbsp;Rogério de Fraga","doi":"10.1016/j.jped.2025.05.004","DOIUrl":"10.1016/j.jped.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Circumcision is a common surgical procedure worldwide, with indications ranging from medical to cultural-religious contexts. Effective pain control is crucial to reduce analgesic use and improve patient safety. Recent advances include the use of the Plastibell® device and ultrasound-guided dorsal penile nerve block, aimed at minimizing surgical time and complications. This study compares postoperative pain in patients undergoing circumcision with either the landmark dorsal penile nerve block (blind block) or ultrasound-guided block.</div></div><div><h3>Methods</h3><div>In this prospective, randomized study, patients aged 3–14 years undergoing elective circumcision were assigned to receive either anesthetic technique. Pain was assessed using physiological parameters (heart rate variation, movement during surgery) and subjective measures (Wong-Baker scale) at multiple time points, along with analgesic consumption. The sample was subdivided into patients aged ≤5 years and &gt;5 years.</div></div><div><h3>Results</h3><div>Pain scores before hospital discharge were higher in patients under 5 years. The blind block was faster to perform but had a higher incidence of hematomas and a trend toward greater block failure, indicated by increased heart rate, patient movement, and opioid use, although differences were not statistically significant. Ultrasound-guided blocks showed fewer complications and a tendency for better pain control.</div></div><div><h3>Conclusion</h3><div>Both anesthetic techniques provide comparable pain control in circumcision; however, ultrasound guidance may reduce complications and improve block success, supporting its use as a safe and effective alternative to the conventional method.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101416"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247975","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}

{"title":"Parents' perception of their children's neurodevelopment during the COVID-19 pandemic and associated factors","authors":"Sabrina Ribeiro Ibiapina ,&nbsp;Taís Michele Werle ,&nbsp;Milena Monticelli Giongo ,&nbsp;Magda Lahorgue Nunes","doi":"10.1016/j.jped.2025.06.002","DOIUrl":"10.1016/j.jped.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>To verify parents’/caregivers’ perceptions of changes in their children’s development during the COVID-19 pandemic and factors associated with such perceptions.</div></div><div><h3>Methods</h3><div>Cross-sectional study using an online survey made available to parents/caregivers of children between 0-7 years old, from September 2021 to March 2023 in two Brazilian states. Respondents answered questions about their perceptions regarding their children's neurodevelopment, and worsening of neurodevelopment during the COVID-19 pandemic. Validated questionnaires such as M-CHAT, “Swanson, Nolan and Pellham,” and “Strengths and Difficulties “were applied according to age. Comparisons were made using the chi-square test or Fisher's exact test, and Poisson regression was used in the univariate analysis and in the multivariate analysis.</div></div><div><h3>Results</h3><div>Data from 589 children were obtained, 49.7% aged 0-3 years and 50.3% 4-7 years. Of the 0-3 age group, 50 (17.1%) were perceived as having abnormal neurodevelopment, and 79 (27.0%) as having worsened neurodevelopment during the pandemic. Of the 4-7 year group, 76 (25.7%) were perceived as having abnormal neurodevelopment, and 104 (35.1%) as having worsened their neurodevelopment. Significant risk factors associated with the perception of abnormal neurodevelopment were maternal schooling, the child's sex and age; for the perception of worsening neurodevelopment were the child's sex and age, low socioeconomic status, degree of social isolation, and death in the family due to COVID-19.</div></div><div><h3>Conclusion</h3><div>Data from the present study showed that parents/ caregivers' perception of normal neurodevelopment was significantly higher than their recognition of abnormalities. In addition, a significant percentage perceived a worsening during the COVID-19 pandemic.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101422"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637071","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}

{"title":"Strengthening RSV prevention in early life through new generation strategies*","authors":"Asuncion Mejias,&nbsp;Octavio Ramilo","doi":"10.1016/j.jped.2025.101445","DOIUrl":"10.1016/j.jped.2025.101445","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101445"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094816","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}

{"title":"Challenges in the prophylaxis of severe respiratory syncytial virus infections","authors":"Dana C. Feitosa ,&nbsp;Sandra E. Vieira","doi":"10.1016/j.jped.2025.04.003","DOIUrl":"10.1016/j.jped.2025.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze palivizumab prophylaxis adherence among newborns and infants, as well as identify its challenges and facilitators.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed medical records of individuals who received palivizumab between 2008 and 2019 at a referral center in a metropolitan city in Brazil. Three adherence criteria were evaluated: an adequate number of doses received, interval between doses ≤ 35 days, and complete adherence (meeting both prior criteria). Associations between these criteria and sociodemographic/clinical variables, as well as post-prophylaxis bronchiolitis-related hospitalizations, were examined.</div></div><div><h3>Results</h3><div>A total of 908 participants (mean age 6.7 months,50.8 % male,57.8 % residing in the city) were analyzed. During the three-season study period, a total of 1,158 doses were prescribed, and complete adherence was observed in 44.5 % of cases. Based on both the adequate number of doses and complete adherence criteria, lower adherence was noted among those living outside the city (52.8 % vs.60.9 %, <em>p</em> = 0.01; and 41.5 %vs.48.5 %, <em>p</em> = 0.03, respectively) and infants born to mothers younger than 20 years (39.7 % vs.60.3 %,<em>p</em> &lt; 0.01; and 31.5 %vs.68.5 %, <em>p</em> = 0.02, respectively). Infants with gestational age &lt; 28 weeks (65.8 % vs.34.2 %, <em>p</em> = 0.03) and birth weight &lt; 1000 g (67.8 % vs.32.2 %, <em>p</em> = 0.03) had higher adherence under the adequate number of doses criterion. No association emerged between adherence and bronchiolitis-related hospitalizations, which were predominantly linked to maternal smoking during pregnancy and chronic lung disease.</div></div><div><h3>Conclusion</h3><div>Adherence to palivizumab prophylaxis was low, highlighting the need to address geographic barriers and maternal age factors. Extreme prematurity and very low birth weight facilitated adherence, indicating that more targeted strategies or decentralized administration may improve outcomes in high-risk populations.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101405"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078038","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}