Pediatrics International最新文献

Background: Understanding infectious disease seasonality is crucial to inform immunization timing and risk communications. This study aimed to describe trends in respiratory syncytial virus (RSV) seasonality in Japan by determining thresholds across 47 prefectures using public health surveillance data.

Methods: Weekly RSV cases per sentinel (CPS) is the main indicator used in Japan. Data from approximately 3000 pediatric sentinel sites were extracted for 2012-2024. Seasonal, advisory, and alert thresholds were established via two globally utilized methods (moving epidemic methods [MEM] and fixed threshold method). Based on the established seasonal threshold, onset/duration was examined for each season during the study period.

Results: The fixed threshold method was finally chosen to establish the seasonal threshold, while medium and high-intensity thresholds under the MEM methods were chosen as advisory and alert thresholds. The threshold values were 0.23-0.80CPS for seasonal, 0.75-2.82CPS for advisory, and 1.11-4.20CPS for alert. The epidemic periods usually lasted less than 6 months, with distinct epidemic peaks in almost all prefectures over the 13-year observation. However, unlike other temperate countries/regions such as the United States and Europe, season onset shifted drastically from September-October in 2012/2013 to around March-April in 2024 with geographic variabilities. Calling season onset after 2 consecutive weeks above the threshold resulted in no false alarms in over half the prefectures.

Conclusions: In countries such as Japan and the tropics/subtropics where the RSV seasons are less predictable, a flexible prevention strategy, tailored for each region/prefecture, using thresholds as guides, would ensure optimal protection against RSV and maximize public health benefits regardless of seasonal variability.

Background: Pulmonary exacerbations (PEs) are associated with a subsequent decline in lung function. We aim to evaluate lung function in cystic fibrosis (CF) patients with frequent PEs in their first 2 years of age using spirometry at age 6.

Methods: This retrospective cohort study included CF patients who were 6 years old from the CF registry of Turkey in 2019. According to the number of PEs, patients were classified: those who had two or fewer PEs in the first 2 years of age were defined as Group 1 and those who had more than two PEs were defined as Group 2. The patients' demographics and clinical characteristics were compared between Group 1 and Group 2.

Results: The study included 88 patients who had data on PE from their first 2 years and completed their sixth year by 2019. Fifty-nine patients were included in Group 1 and 29 in Group 2. The mean percent-predictive FEV1 (ppFEV1), percent-predictive FVC (ppFVC) values, and the mean age at first PE were lower in Group 2 than in Group 1 (p = 0.019, p = 0.017, p < 0.001). The patients with chronic Pseudomonas aeruginosa (PA) colonization had lower mean ppFEV1 and ppFVC values than those without (p = 0.001, p = 0.001). Patients with PA in respiratory-sample culture during their first PE had lower ppFEV1 and ppFVC values than those with SA (p = 0.046; 0.018).

Conclusions: This study showed that more frequent PEs in the first 2 years of age and chronic PA colonization were associated with poorer FEV1, FVC, and BMI values in CF patients.

Background: Iron deficiency anemia (IDA) in children poses significant health risks, necessitating effective treatment strategies. While daily oral iron therapy is standard, alternate-day therapy has emerged as a potential alternative to improve compliance and minimize side effects. This study aimed to compare the efficacy of daily and alternate-day iron supplementation in children with IDA.

Methods: This retrospective cohort study included 82 children with nutritional IDA receiving either daily (42 patients) or alternate-day (40 patients) oral ferrous sulfate therapy. Hematologic and iron parameters, including hemoglobin (Hb), ferritin, and total iron-binding capacity (TIBC), were evaluated at baseline, day 10, 1, and 3 months. Statistical analyses were performed using SPSS, with p ≤ 0.05 considered significant.

Results: No significant differences in Hb changes were observed based on the treatment regimens. When comparing Hb changes from diagnosis to the first month and from the first month to the third month, a significant increase was noted in the daily therapy group during the first month. At the beginning of the study, the mean corpuscular volume (MCV) values were higher in the alternate-day group, while the red cell distribution width (RDW) values at diagnosis were greater in the daily group. Throughout the first and third months, MCV and RDW values were similar between the two groups. Additionally, ferritin and TIBC levels showed no significant differences over the study period.

Conclusions: Alternate-day oral iron therapy is as effective as daily therapy in managing pediatric IDA, offering a viable alternative with similar hematologic and iron parameter improvements.

Background: Perioperative antimicrobial therapy is important to prevent central nervous system (CNS) infections following cerebrospinal fluid (CSF) shunt insertion, but the optimal duration remains unclear. This study aimed to evaluate the incidence of ventriculoperitoneal (VP) shunt-associated CNS infection before and after the revision of the institutional protocol for discontinuing antimicrobial therapy within 48 h after surgery.

Methods: Patients aged 15 years or less who underwent VP shunt insertion at Tokyo Metropolitan Children's Medical Center between April 2014 and November 2021 were enrolled retrospectively. The primary outcome was the incidence of VP shunt-associated CNS infection at postoperative months 1 and 6 in pre- and post-intervention patient groups.

Results: Of the 117 patients screened, 27 were excluded. Of the eligible patients, 39 were in the pre-intervention group, and 51 were in the post-intervention group. The incidence of VP shunt-associated CNS infection at month 1 was 7.7% (3/39) in the pre-intervention group and 7.8% (4/51) in the post-intervention group (p = 0.98), with no significant difference. At month 6, the incidence was 7.7% (3/39) in the pre-intervention group and 13.7% (7/51) in the post-intervention group (p = 0.37), also not significantly different.

Conclusions: Reducing the duration of antibiotic prophylaxis for VP shunt insertion to within 48 h did not increase the incidence of VP shunt-associated CNS infection.