Jornal de pediatria最新文献

{"title":"Translation and cross-cultural adaptation of the Dubowitz Neurological Examination for premature infants in a high-risk outpatient clinic in Brazil","authors":"Ana Clara D. Massarollo ,&nbsp;Guilherme W. Wendt ,&nbsp;Lirane E.D. Ferreto ,&nbsp;Ana P. Vieira ,&nbsp;Gisele Arruda ,&nbsp;Joseane R. da S. Nobre ,&nbsp;Marina D. Massarollo ,&nbsp;Débora M. Mazzo ,&nbsp;Elizamara E.P. Segala ,&nbsp;Claudicéia R. Pascotto ,&nbsp;Franciele A.C. Follador","doi":"10.1016/j.jped.2025.101460","DOIUrl":"10.1016/j.jped.2025.101460","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to translate and cross-culturally adapt the Dubowitz Neurological Examination (DNE) instrument into Brazilian Portuguese for the neurological assessment of preterm newborns (PTNBs), as well as to evaluate its psychometric properties.</div></div><div><h3>Method</h3><div>This is a methodological study of translation and cross-cultural adaptation. The methodological process consisted of two forward translations from the original to the target language, a synthesis of the translations, two back-translations, an evaluation by an expert committee, pre-testing, and the development and application of the final version in 40 PTNBs followed at a high-risk outpatient clinic.</div></div><div><h3>Results</h3><div>Concordance among experts was 98.03 %, the intraclass correlation was 0.81, the content validity index (CVI) was 0.96 and the Kappa coefficient value was 0.76, indicating substantial agreement. Furthermore, the internal consistency indices were considered acceptable (α = 0.75). The comprehension of the 34 instrument items during the pre-test phase ranged from 82 % to 100 %.</div></div><div><h3>Conclusions</h3><div>DNE was adequately translated and adapted for Brazilian culture, showing evidence of semantic, idiomatic, and conceptual equivalence. The results demonstrate satisfactory internal consistency and high inter-rater agreement.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101460"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409315","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":"Palliative extubation in pediatrics: a scoping review","authors":"Carolina de Araújo Affonseca ,&nbsp;Luís Fernando Andrade de Carvalho ,&nbsp;Lêni Márcia Anchieta","doi":"10.1016/j.jped.2025.101468","DOIUrl":"10.1016/j.jped.2025.101468","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate evidence in the literature on palliative extubation in pediatrics in the context of palliative care, in any healthcare setting, to synthesize knowledge, identify gaps, and highlight future research opportunities.</div></div><div><h3>Data sources</h3><div>The PRISMA-ScR recommendations and the JBI Collaboration method were used. Searches were conducted in: Virtual Health Library, PubMed, Scopus, Embase, Cochrane Library and Web of Science. The following strategy was used: Population - children and adolescents (0 to 18 years) undergoing invasive mechanical ventilation; Concept - practices, experiences, or approaches related to palliative extubation; Context - palliative care in a hospital, hospice or home setting. Original articles published up to April 2025 were included; those that didn’t define age or were over 18 years, opinion pieces, editorials, and conference proceedings were excluded. Two independent reviewers extracted the data; discrepancies were resolved by consensus or with a third reviewer. The quality of the studies was assessed using the critical appraisal tools recommended by the JBI.</div></div><div><h3>Data synthesis</h3><div>Twelve articles were selected: eight case reports and four cross-sectional studies, totaling 129 patients; 128 were analyzed. In 78.1% of cases, palliative extubation was performed in a hospital setting, mainly in the ICU (72.6%); 93% used an endotracheal tube; 95.3% received analgesia/sedation around the time of extubation; 90.6% died after support withdrawn.</div></div><div><h3>Conclusions</h3><div>Knowledge of practices, experiences, and challenges related to palliative extubation in pediatrics is essential to support clinical decision-making and ensure that it is performed in a timely, responsible, and technically appropriate manner, following the principles of palliative care.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101468"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431384","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":"Pediatric Stevens–Johnson syndrome and toxic epidermal necrolysis: age-stratified insights from the FAERS database","authors":"Dilara Bayram-Ozgur ,&nbsp;Onur Colak ,&nbsp;Onur Gultekin ,&nbsp;Narin Akici ,&nbsp;Zehra Esra Onal ,&nbsp;Ahmet Akici","doi":"10.1016/j.jped.2025.101455","DOIUrl":"10.1016/j.jped.2025.101455","url":null,"abstract":"<div><h3>Objective</h3><div>Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but severe cutaneous adverse drug reactions, particularly concerning in pediatric populations due to their unique etiologies, clinical outcomes, and long-term complications. This study aims to examine pediatric cases of SJS/TEN reported in the U.S. FDA’s FAERS database, focusing on age-stratified patterns and drug associations.</div></div><div><h3>Method</h3><div>A retrospective cross-sectional analysis was conducted using FAERS reports submitted until the end of 2024. Pediatric cases (0–17 years) with a diagnosis of SJS or TEN and a single suspected drug were included. Reports were analyzed by age group (0–11 and 12–17 years), gender, and drug classification using ATC codes. Statistical analyses assessed associations between demographic groups and implicated medications.</div></div><div><h3>Results</h3><div>Out of 2673 pediatric reports, 67.4 % involved SJS and 32.6 % TEN. The majority (62.3 %) were in the 0–11 age group. Nervous system agents—especially antiepileptics—were predominantly associated with older children, while systemic antiinfectives such as amoxicillin, azithromycin, and cefaclor were more frequent in younger children. Lamotrigine showed both age groups and female predominance. Conversely, paracetamol and ibuprofen were significantly associated with the TEN phenotypes in younger males.</div></div><div><h3>Conclusions</h3><div>The study reveals clear age- and drug-specific patterns in pediatric SJS/TEN. Findings emphasize the importance of age-stratified pharmacovigilance issues and cautious prescribing of high-risk drugs such as lamotrigine and antibiotics. Better awareness of potential biases, such as protopathic misattribution, is crucial for accurate signal detection in pediatric pharmacovigilance.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 6","pages":"Article 101455"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274675","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":"Prognostic nutritional index as a biomarker for identifying coronary artery lesions in Kawasaki disease","authors":"Chao Zhang ,&nbsp;Guoshun Mao ,&nbsp;Guosheng Hu","doi":"10.1016/j.jped.2025.101436","DOIUrl":"10.1016/j.jped.2025.101436","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the Prognostic Nutritional Index as a biomarker for identifying coronary artery lesions in Kawasaki disease.</div></div><div><h3>Methods</h3><div>The clinicopathological and laboratory characteristics of 241 patients with Kawasaki disease were collected from patients who were hospitalized in Fuyang People's Hospital from January 2018 to December 2024. Logistic regression analysis was conducted to evaluate the relationship between Prognostic Nutritional Index and coronary artery lesions. The critical levels of hematological parameters were determined by receiver operating characteristic analysis.</div></div><div><h3>Results</h3><div>The incidence of coronary artery lesions was 10.3 %. The optimal cut-off point for the Prognostic Nutritional Index was defined as 46.575. Prognostic Nutritional Index was negatively correlated with coronary artery diameter (<em>r</em> = −0.260, <em>p</em> &lt; 0.001). Patients with low Prognostic Nutritional Index levels (Prognostic Nutritional Index &lt; 46.575) were 4.25 times more likely to have coronary artery lesions compared to those with high Prognostic Nutritional Index levels (Prognostic Nutritional Index ≥ 46.575) (OR = 4.25, 95 % CI: 1.688 - 10.697, <em>p</em> &lt; 0.001). The area under the receiver operating characteristic curve for Prognostic Nutritional Index in predicting coronary artery lesions was 0.702 (95 % CI: 0.584 - 0.821, <em>p</em> = 0.001), indicating moderate diagnostic efficacy.</div></div><div><h3>Conclusion</h3><div>Prognostic Nutritional Index may be a biomarker for children with Kawasaki disease complicated with coronary artery lesions, and it may help identify high-risk patients of coronary artery lesions among children with Kawasaki disease.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101436"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855293","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":"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":"Predictive value of clinical indicators in children with community-acquired pneumonia complicated with Kawasaki disease","authors":"Yuanhui Duan,&nbsp;Yuexu Ou,&nbsp;Xiaoming Gan,&nbsp;Jieling Li,&nbsp;Jie Cao","doi":"10.1016/j.jped.2025.101424","DOIUrl":"10.1016/j.jped.2025.101424","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the predictive value of clinical indicators in community-acquired pneumonia (CAP) complicated with Kawasaki disease (KD).</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on the clinical data of inpatients with KD (39 cases), CAP (40 cases), and CAP complicated with KD (CAPKD, 32 cases) at the Children's Hospital of Chongqing Medical University from February 2021 to October 2022. The clinical indicators examined included serum cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, IFN-γ), White Blood Cell (WBC), Neutrophilic granulocyte percentage(NEU%), blood platelet(PLT), Red Blood Cell (RBC), Hemoglobin(Hb), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), alanine aminotransferase(ALT), alkaline phosphatase(ALP), Gamma-glutamyl transferase (γ-GT), Aspartate aminotransferase (AST), albumin(Alb), Lactate dehydrogenase (LDH), globulin(Glb), and Total Protein(TP) in patients with KD, CAP, and CAPKD were compared.</div></div><div><h3>Results</h3><div>The present findings showed that IL-6 &gt; 55.4pg/mL, IL-10 &gt; 9.15pg/mL, PCT &gt; 0.19ng/mL, and ALT &gt; 22.5 U/L were important predictors of CAPKD. Additionally, Hb &gt; 103.5 g /L, and TP &gt; 63.85 g/L have predictive values for CAP without KD. The authors also observed a positive correlation between PCT and IL-6, IL-10. However, Hb and TP were negatively correlated with IL-6 and IL-10.</div></div><div><h3>Conclusion</h3><div>From the perspective of cytokine levels, IL-6 &gt; 55.4 pg/mL and IL-10 &gt; 9.15 pg/mL have important predictive values for CAPKD.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101424"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816707","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":"X-ray is not inferior to CT in terms of F1 score in the diagnosis of foreign body aspiration: a recall, precision and F1 score performance analysis based on bronchoscopically proven cases","authors":"Fatma Sarac,&nbsp;Mehmet Yazici","doi":"10.1016/j.jped.2025.101430","DOIUrl":"10.1016/j.jped.2025.101430","url":null,"abstract":"<div><h3>Objective</h3><div>In this study, we aimed to evaluate the diagnostic accuracy of X-ray and CT by using the F1 score with its non-inferiority margin in patients who underwent bronchoscopy with suspected diagnoses of foreign body aspiration (FBA).</div></div><div><h3>Methods</h3><div>All children aged under 18 who underwent bronchoscopy with suspected diagnoses of FBA between June 2020 and December 2023 were included. The patient’s medical records were examined retrospectively.</div></div><div><h3>Results</h3><div>A total of 310 patients were included. Foreign bodies were most frequently located in the right main bronchus (47.52 %). The bronchoscopy (-) rate was 18 % in patients who had X-ray (+), 24 % in those who had CT (+), and 15 % in those who had X-ray (+) and CT (+). Chest x-rays were found to exhibit 42 % sensitivity, 74 % specificity, a positive predictive value (PPV) of 61 %, a negative predictive value (NPV) of 51 %, accuracy of 66 %, precision: 0.63, recall: 0.82, and F1 score: 0.71. Analysis showed that CT exhibited 82 % sensitivity, 37 % specificity, a PPV of 75 %, NPV of 47 %, an accuracy rate of 69 %, precision: 0.83, recall: 0.76, and F1 score: 0.79. In the present study, the diagnostic F1 score was calculated as 0.79 for CT and 0.71 for X-ray.</div></div><div><h3>Conclusion</h3><div>Despite a negative bronchoscopy rate of 34.83 % in this study, since the authors observed no severe complications or mortality, the authors recommend that it be performed on all patients with suspected foreign body aspiration. When a 10 % non-inferiority margin was applied, X-ray was found to be not inferior to CT in terms of F1 score.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 5","pages":"Article 101430"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816710","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}