首页 > 最新文献

Clinical and Experimental Pediatrics最新文献

英文 中文
Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants. 非常早产儿非营养性发育迟缓病理生理学的最新进展。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-12-23 DOI: 10.3345/cep.2024.01354
Eduardo Cuestas, Alina Rizzotti

Very preterm infants (VPIs) often experience extrauterine growth failure. Therefore, aggressive nutritional management of VPIs is recommended with the goal of achieving the postnatal growth of an equivalent fetus. However, VPIs frequently present postnatal length growth restriction at term-corrected age that remains lower than the standard weight and have greater fat mass and lower lean and bone mass than term-born infants. This condition differs from the classic pattern of infant undernutrition defined as a significantly lower weight for a given length. Moreover, it suggests that nonnutritional factors play a key role in length growth restriction. While weight faltering has been extensively studied, the significance of length growth failure in VPIs has only recently emerged. The nonnutritional factors underlying poor length growth in VPIs are currently not fully understood. In this review, we address recent advances in our understanding of the pathophysiology of length growth restriction, which has been identified as a major predictor of adverse neurodevelopmental and cognitive outcomes in VPIs. First, we review the shortand long-term consequences of poor length growth in VPIs; next, we highlight the effects of nonnutritional factors on postnatal length growth with focus on sustained neonatal inflammation; and finally, we discuss hypothesis and future lines of research attempting to understand the complex inflammatory-endocrine interactions and pathophysiological changes during early postnatal life, appropriately guide and apply clinical strategies aimed at optimizing length growth of VPIs, and identify evidence of the associations between sustained neonatal inflammation, stunting, and long-term health risks and the potential implications thereof.

极早产儿(vpi)经常经历子宫外生长衰竭。因此,建议对vpi进行积极的营养管理,以实现同等胎儿的出生后生长。然而,在足月矫正年龄时,VPIs经常出现出生后身高生长受限,仍然低于标准体重,并且比足月出生的婴儿有更多的脂肪量和更低的瘦骨量。这种情况不同于婴儿营养不良的典型模式,即在给定的长度下体重明显较低。此外,非营养因素在长度生长限制中起关键作用。虽然体重下降已被广泛研究,但长度增长失败在vpi中的重要性直到最近才出现。目前还不完全了解导致vpi长度生长不良的非营养因素。在这篇综述中,我们讨论了我们对长度生长限制的病理生理理解的最新进展,长度生长限制已被确定为vpi不良神经发育和认知结果的主要预测因素。首先,我们回顾了vpi长度生长不良的短期和长期后果;接下来,我们强调非营养因素对产后长度增长的影响,重点是持续的新生儿炎症;最后,我们讨论了假设和未来的研究方向,试图了解复杂的炎症-内分泌相互作用和产后早期生命的病理生理变化,适当地指导和应用旨在优化vpi长度增长的临床策略,并确定持续新生儿炎症、发育迟缓和长期健康风险之间的关联证据及其潜在影响。
{"title":"Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants.","authors":"Eduardo Cuestas, Alina Rizzotti","doi":"10.3345/cep.2024.01354","DOIUrl":"10.3345/cep.2024.01354","url":null,"abstract":"<p><p>Very preterm infants (VPIs) often experience extrauterine growth failure. Therefore, aggressive nutritional management of VPIs is recommended with the goal of achieving the postnatal growth of an equivalent fetus. However, VPIs frequently present postnatal length growth restriction at term-corrected age that remains lower than the standard weight and have greater fat mass and lower lean and bone mass than term-born infants. This condition differs from the classic pattern of infant undernutrition defined as a significantly lower weight for a given length. Moreover, it suggests that nonnutritional factors play a key role in length growth restriction. While weight faltering has been extensively studied, the significance of length growth failure in VPIs has only recently emerged. The nonnutritional factors underlying poor length growth in VPIs are currently not fully understood. In this review, we address recent advances in our understanding of the pathophysiology of length growth restriction, which has been identified as a major predictor of adverse neurodevelopmental and cognitive outcomes in VPIs. First, we review the shortand long-term consequences of poor length growth in VPIs; next, we highlight the effects of nonnutritional factors on postnatal length growth with focus on sustained neonatal inflammation; and finally, we discuss hypothesis and future lines of research attempting to understand the complex inflammatory-endocrine interactions and pathophysiological changes during early postnatal life, appropriately guide and apply clinical strategies aimed at optimizing length growth of VPIs, and identify evidence of the associations between sustained neonatal inflammation, stunting, and long-term health risks and the potential implications thereof.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"287-297"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global breastfeeding efforts: a long way to go. 全球母乳喂养工作:任重道远。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-13 DOI: 10.3345/cep.2024.01361
Hye-Jung Shin
{"title":"Global breastfeeding efforts: a long way to go.","authors":"Hye-Jung Shin","doi":"10.3345/cep.2024.01361","DOIUrl":"10.3345/cep.2024.01361","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"300-302"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study. 肥胖对学龄前儿童肺功能的影响:脉冲振荡仪研究。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-13 DOI: 10.3345/cep.2024.01053
Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran

Background: The increasing global prevalence of obesity poses significant public health problems, as obesity exerts adverse effects on many systems and lung function. However, research on the lung function of preschool children with obesity is limited and inconclusive. In addition, studies specific to obesity indices that influence lung function in young children with obesity are limited.

Purpose: This study aimed to evaluate lung function of obese versus normal-weight preschool children using impulse oscillometry (IOS) and identify obesity indices predictive of altered lung function.

Methods: We enrolled obese children aged 3-7 years as well as age- and sex-matched normal-weight controls. The participants underwent IOS assessments that measured the resistance at 5 Hz (R5) and 20 Hz (R20), the difference in resistance between these frequencies (R5-R20), reactance at 5 Hz (X5), resonance frequency, and reactance area (AX). We compared these parameters between groups and analyzed the correlations between obesity indices and IOS measures within the obese group using multiple linear regression.

Results: The study included 68 participants (n=34 each group). In the obese group, significantly higher values were observed for R5 (adjusted for height, P=0.02; % predicted, P=0.01; z score, P<0.001), R5-R20 (absolute value, P=0.002; adjusted for height, P=0.001), and AX (z score, P=0.01). AX adjusted for height showed a greater trend (P=0.07). The waist-to-height ratio was the most robust independent predictor of total and peripheral airway resistance, with increases in R5 (b=1.65, P=0.02) and R5-R20 (b=1.39, P=0.03) and a near-significant correlation with AX (b=12.12, P=0.06).

Conclusion: Preschool children with obesity exhibit impaired lung function, characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of these changes.

背景:全球肥胖症发病率的不断上升带来了严重的公共卫生问题,因为肥胖会对许多系统和肺功能造成不良影响。然而,有关学龄前肥胖儿童肺功能的研究却十分有限,且尚无定论。此外,针对影响肥胖幼儿肺功能的肥胖指数的研究也很有限。目的:本研究旨在使用脉冲振荡仪(IOS)评估肥胖与正常体重学龄前儿童的肺功能,并确定可预测肺功能改变的肥胖指数:我们招募了 3-7 岁的肥胖儿童以及年龄和性别匹配的正常体重对照组儿童。参与者接受了 IOS 评估,测量了 5 赫兹(R5)和 20 赫兹(R20)的阻力、这两个频率之间的阻力差(R5-R20)、5 赫兹(X5)的电抗、共振频率和电抗面积(AX)。我们比较了各组之间的这些参数,并使用多元线性回归分析了肥胖组中肥胖指数和 IOS 测量值之间的相关性:研究包括 68 名参与者(每组 34 人)。在肥胖组中,R5(根据身高调整,p = 0.02;预测百分比,p = 0.01;z-score,p < 0.001)、R5-R20(绝对值,p = 0.002;根据身高调整,p = 0.001)和 AX(z-score,p = 0.01)的数值明显更高。根据身高调整后的 AX 显示出更大的趋势(p = 0.07)。腰围-身高比是总气道阻力和外周气道阻力最可靠的独立预测指标,R5(b = 1.65,p = 0.02)和R5-R20(b = 1.39,p = 0.03)均有所增加,且与AX(b = 12.12,p = 0.06)有近乎显著的相关性:结论:学龄前肥胖儿童的肺功能受损,表现为总气道阻力和外周气道阻力升高。结论:学龄前肥胖儿童的肺功能受损,表现为总气道阻力和外周气道阻力升高,而腰高比是预测这些变化的最有力指标。
{"title":"Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study.","authors":"Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran","doi":"10.3345/cep.2024.01053","DOIUrl":"10.3345/cep.2024.01053","url":null,"abstract":"<p><strong>Background: </strong>The increasing global prevalence of obesity poses significant public health problems, as obesity exerts adverse effects on many systems and lung function. However, research on the lung function of preschool children with obesity is limited and inconclusive. In addition, studies specific to obesity indices that influence lung function in young children with obesity are limited.</p><p><strong>Purpose: </strong>This study aimed to evaluate lung function of obese versus normal-weight preschool children using impulse oscillometry (IOS) and identify obesity indices predictive of altered lung function.</p><p><strong>Methods: </strong>We enrolled obese children aged 3-7 years as well as age- and sex-matched normal-weight controls. The participants underwent IOS assessments that measured the resistance at 5 Hz (R5) and 20 Hz (R20), the difference in resistance between these frequencies (R5-R20), reactance at 5 Hz (X5), resonance frequency, and reactance area (AX). We compared these parameters between groups and analyzed the correlations between obesity indices and IOS measures within the obese group using multiple linear regression.</p><p><strong>Results: </strong>The study included 68 participants (n=34 each group). In the obese group, significantly higher values were observed for R5 (adjusted for height, P=0.02; % predicted, P=0.01; z score, P<0.001), R5-R20 (absolute value, P=0.002; adjusted for height, P=0.001), and AX (z score, P=0.01). AX adjusted for height showed a greater trend (P=0.07). The waist-to-height ratio was the most robust independent predictor of total and peripheral airway resistance, with increases in R5 (b=1.65, P=0.02) and R5-R20 (b=1.39, P=0.03) and a near-significant correlation with AX (b=12.12, P=0.06).</p><p><strong>Conclusion: </strong>Preschool children with obesity exhibit impaired lung function, characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of these changes.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"319-325"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study. 印度尼西亚儿童和年轻人的中风发生率:一项多中心私立医院研究。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-13 DOI: 10.3345/cep.2024.01214
Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius

Background: Most studies that estimate the occurrence of childhood stroke use heterogeneous methods and rely on International Classification of Diseases codes, a strategy that may be unreliable.

Purpose: This study aimed to estimate the occurrence of childhood stroke in Indonesia using imaging and clinical data from a private hospital network.

Methods: This cross-sectional study used consecutive retrospective multicenter data samples collected in 2019- 2023. The study cohort included children aged >28 days to young adults aged 24 years with confirmed ischemic or hemorrhagic stroke on computed tomography (CT) or magnetic resonance imaging (MRI). The 1-year occurrence was calculated, and the data analysis was performed using IBM SPSS Statistics ver. 26.0.

Results: Over 5 years, the performance of 8,987 CT and 6,133 MRI scans resulted in the identification of 1,074 stroke cases. The average patient age was 14.8±7.0 years. Stroke occurrence was highest in 2021 (9.08%) and lowest in 2022 (5.91%). Male patients accounted for 67.9% of cases, with hemorrhagic strokes accounting for 83.4% of the total, primarily resulting from accidents (73.2%) and predominantly occurring in the frontal region (37.1%). A significant majority of cases (66.7%) were reported in Java. Males had a relative risk of 1.93 (95% confidence interval, 1.48-2.52; P<0.001) for hemorrhagic stroke versus females.

Conclusion: The incidence of childhood stroke revealed critical epidemiological trends and disparities, emphasizing the need for targeted public health interventions and enhanced stroke prevention strategies in Indonesia.

背景:目的:本研究旨在利用一家私立医院网络的影像和临床数据,估计印度尼西亚儿童中风的发生率:这项横断面研究使用了 2019-2023 年收集的连续回顾性多中心数据样本。研究队列包括经计算机断层扫描(CT)或磁共振成像(MRI)确诊为缺血性或出血性中风的年龄大于 28 天的儿童到 24 岁的年轻人。计算1年的发生率,并使用SPSS 26版进行数据分析:结果:5 年内共进行了 8,987 次 CT 扫描和 6,133 次 MRI 扫描,共发现 1,074 例中风病例。患者平均年龄为 14.8 ± 7 岁。中风发生率在 2021 年最高(9.08%),2022 年最低(5.91%)。男性患者占 67.9%,出血性中风占总数的 83.4%,主要由意外事故引起(73.2%),且主要发生在额部(37.1%)。绝大多数病例(66.7%)发生在爪哇岛。男性与女性相比,出血性中风的相对风险为 1.93(95% 置信区间,1.48-2.52;p < 0.0001):儿童中风发病率揭示了重要的流行病学趋势和差异,强调了在印度尼西亚采取有针对性的公共卫生干预措施和加强中风预防策略的必要性。
{"title":"Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study.","authors":"Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius","doi":"10.3345/cep.2024.01214","DOIUrl":"10.3345/cep.2024.01214","url":null,"abstract":"<p><strong>Background: </strong>Most studies that estimate the occurrence of childhood stroke use heterogeneous methods and rely on International Classification of Diseases codes, a strategy that may be unreliable.</p><p><strong>Purpose: </strong>This study aimed to estimate the occurrence of childhood stroke in Indonesia using imaging and clinical data from a private hospital network.</p><p><strong>Methods: </strong>This cross-sectional study used consecutive retrospective multicenter data samples collected in 2019- 2023. The study cohort included children aged >28 days to young adults aged 24 years with confirmed ischemic or hemorrhagic stroke on computed tomography (CT) or magnetic resonance imaging (MRI). The 1-year occurrence was calculated, and the data analysis was performed using IBM SPSS Statistics ver. 26.0.</p><p><strong>Results: </strong>Over 5 years, the performance of 8,987 CT and 6,133 MRI scans resulted in the identification of 1,074 stroke cases. The average patient age was 14.8±7.0 years. Stroke occurrence was highest in 2021 (9.08%) and lowest in 2022 (5.91%). Male patients accounted for 67.9% of cases, with hemorrhagic strokes accounting for 83.4% of the total, primarily resulting from accidents (73.2%) and predominantly occurring in the frontal region (37.1%). A significant majority of cases (66.7%) were reported in Java. Males had a relative risk of 1.93 (95% confidence interval, 1.48-2.52; P<0.001) for hemorrhagic stroke versus females.</p><p><strong>Conclusion: </strong>The incidence of childhood stroke revealed critical epidemiological trends and disparities, emphasizing the need for targeted public health interventions and enhanced stroke prevention strategies in Indonesia.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"303-310"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cerebral organoid research for pediatric patients with neurological disorders. 小儿神经系统疾病患者脑类器官的研究。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-28 DOI: 10.3345/cep.2024.01235
Jin Eun, Jung Eun Lee, Seung Ho Yang

Cerebral organoids derived from human induced pluripotent stem cells offer a groundbreaking foundation for the analysis of pediatric neurological diseases. Unlike organoids from other somatic systems, cerebral organoids present unique challenges, such as the high sensitivity of neuronal cells to environmental conditions and the complexity of replicating brain-specific architectures. Cerebral organoids replicate the human brain development and pathology, enabling research on conditions such as microcephaly, Rett syndrome, autism spectrum disorders, and brain tumors. This review explores the utility of cerebral organoids for modeling diseases and testing therapeutic interventions. Despite current limitations such as variability and lack of vascularization, recent technological advancements have improved the reliability and application of such interventions. Cerebral organoids provide valuable insight into the mechanisms underlying complex neural disorders and hold promise as novel treatment strategies for pediatric neurological diseases.

来自人类诱导多能干细胞的脑类器官为儿科神经系统疾病的分析提供了开创性的基础。与来自其他躯体系统的类器官不同,脑类器官面临着独特的挑战,例如神经元细胞对环境条件的高度敏感性以及复制大脑特异性结构的复杂性。脑类器官复制了人类大脑的发育和病理,使小头畸形、Rett综合征、自闭症谱系障碍和脑肿瘤等疾病的研究成为可能。这篇综述探讨了脑类器官在疾病建模和治疗干预测试中的应用。尽管目前存在变异性和缺乏血管化等限制,但最近的技术进步提高了此类干预措施的可靠性和应用。脑类器官为复杂神经疾病的潜在机制提供了有价值的见解,并有望成为儿科神经疾病的新治疗策略。
{"title":"Cerebral organoid research for pediatric patients with neurological disorders.","authors":"Jin Eun, Jung Eun Lee, Seung Ho Yang","doi":"10.3345/cep.2024.01235","DOIUrl":"10.3345/cep.2024.01235","url":null,"abstract":"<p><p>Cerebral organoids derived from human induced pluripotent stem cells offer a groundbreaking foundation for the analysis of pediatric neurological diseases. Unlike organoids from other somatic systems, cerebral organoids present unique challenges, such as the high sensitivity of neuronal cells to environmental conditions and the complexity of replicating brain-specific architectures. Cerebral organoids replicate the human brain development and pathology, enabling research on conditions such as microcephaly, Rett syndrome, autism spectrum disorders, and brain tumors. This review explores the utility of cerebral organoids for modeling diseases and testing therapeutic interventions. Despite current limitations such as variability and lack of vascularization, recent technological advancements have improved the reliability and application of such interventions. Cerebral organoids provide valuable insight into the mechanisms underlying complex neural disorders and hold promise as novel treatment strategies for pediatric neurological diseases.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"269-277"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancements and challenges in neonatal resuscitation: embracing laryngeal mask airways for improved outcomes. 新生儿复苏的进展和挑战:采用喉罩气道改善预后。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-28 DOI: 10.3345/cep.2024.01088
Jang Hoon Lee
{"title":"Advancements and challenges in neonatal resuscitation: embracing laryngeal mask airways for improved outcomes.","authors":"Jang Hoon Lee","doi":"10.3345/cep.2024.01088","DOIUrl":"10.3345/cep.2024.01088","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"298-299"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
C3 glomerulopathy in children: experience at a resource-limited center. 儿童C3肾小球病变:资源有限中心的经验。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-28 DOI: 10.3345/cep.2024.01256
Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan

Background: In children, C3 glomerulopathy (C3G) is a heterogeneous disease characterized by diverse clinicopathological profiles and kidney outcomes. However, diagnostic work-up in resource-limited settings is challenging because of the unavailability of complement assays and limited access to electron microscopy or genetic testing.

Purpose: This study aimed to describe the clinicopathological features and response to immunosuppression and evaluate renal outcomes among children with C3G in a resource-limited setting.

Methods: This retrospective cohort study involved a review of the hospital records of 46 children (2013-2021) diagnosed with C3G on kidney biopsy. Their clinical, laboratory, treatment, and outcome details at onset and follow-up were noted.

Results: The mean (standard deviation) age was 9 (4) years. The common presentation was acute nephritis (27 [58.6%]), while 1 in 5 (19.5%) presented with rapidly progressive glomerulonephritis. Focal crescentic glomerulonephritis (14 [30.4%]) was the common histological pattern. Electron microscopy was performed in 22 (47.8%), of which 17 were C3 glomerulonephritis and 4 were dense deposit disease (DDD). None of the patients underwent complement assay or genetic testing. Almost two-thirds (63%) received empirical immunosuppressive therapy, most commonly steroids. Of the 31/46 who completed follow-up (median [interquartile range] duration, 11.5 [6-24] months), 6 (19.4%) demonstrated complete kidney recovery, while the other 25 (80.7%) had kidney sequelae; of them, 5 (16.1%) progressed to end-stage kidney disease and 2 (4.3%) died by the last follow-up.

Conclusion: Pediatric C3G has a variable clinicopathological spectrum, while DDD is less common. Most patients present with glomerulonephritis and significant morbidities. The lack of genetic and C3Nephritic factor testing is a barrier to the comprehensive phenotyping and management of C3G in resource-limited settings.

背景:在儿童中,C3肾小球病变(C3G)是一种异质性疾病,具有不同的临床病理特征和肾脏结局。然而,在资源有限的情况下,诊断工作是具有挑战性的,因为无法获得补体测定和有限的电子显微镜或基因检测。目的:本研究旨在描述资源有限的C3G儿童的临床病理特征和免疫抑制反应,并评估肾脏结局。方法:本回顾性队列研究回顾了46例肾活检诊断为C3G的儿童(2013-2021)的医院记录。记录了他们的临床、实验室、治疗以及发病和随访时的结果细节。结果:平均(SD)年龄为9(4)岁。常见的表现为急性肾炎(27例[58.6%]),而五分之一(19.5%)的患者表现为快速进展的肾小球肾炎。局灶新月形肾小球肾炎(14例[30.4%])是常见的组织学类型。22例(47.8%)行电镜检查,其中C3型肾小球肾炎(C3GN) 17例,致密沉积病(DDD) 4例。所有患者均未进行补体测定或基因检测。近三分之二(63%)接受经验性免疫抑制治疗,最常见的是类固醇。在完成随访的31/46人中(中位[IQR]持续时间为11.5[6-24]个月),6人(19.4%)表现出肾脏完全恢复,而另外25人(80.7%)有肾脏后遗症;其中5例(16.1%)进展为终末期肾病,2例(4.3%)在最后一次随访时死亡。结论:小儿C3G临床病理谱多变,而DDD较少见。大多数患者表现为肾小球肾炎和显著的发病率。在资源有限的环境中,缺乏遗传和C3G肾病因子检测是C3G综合表型和管理的障碍。
{"title":"C3 glomerulopathy in children: experience at a resource-limited center.","authors":"Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan","doi":"10.3345/cep.2024.01256","DOIUrl":"10.3345/cep.2024.01256","url":null,"abstract":"<p><strong>Background: </strong>In children, C3 glomerulopathy (C3G) is a heterogeneous disease characterized by diverse clinicopathological profiles and kidney outcomes. However, diagnostic work-up in resource-limited settings is challenging because of the unavailability of complement assays and limited access to electron microscopy or genetic testing.</p><p><strong>Purpose: </strong>This study aimed to describe the clinicopathological features and response to immunosuppression and evaluate renal outcomes among children with C3G in a resource-limited setting.</p><p><strong>Methods: </strong>This retrospective cohort study involved a review of the hospital records of 46 children (2013-2021) diagnosed with C3G on kidney biopsy. Their clinical, laboratory, treatment, and outcome details at onset and follow-up were noted.</p><p><strong>Results: </strong>The mean (standard deviation) age was 9 (4) years. The common presentation was acute nephritis (27 [58.6%]), while 1 in 5 (19.5%) presented with rapidly progressive glomerulonephritis. Focal crescentic glomerulonephritis (14 [30.4%]) was the common histological pattern. Electron microscopy was performed in 22 (47.8%), of which 17 were C3 glomerulonephritis and 4 were dense deposit disease (DDD). None of the patients underwent complement assay or genetic testing. Almost two-thirds (63%) received empirical immunosuppressive therapy, most commonly steroids. Of the 31/46 who completed follow-up (median [interquartile range] duration, 11.5 [6-24] months), 6 (19.4%) demonstrated complete kidney recovery, while the other 25 (80.7%) had kidney sequelae; of them, 5 (16.1%) progressed to end-stage kidney disease and 2 (4.3%) died by the last follow-up.</p><p><strong>Conclusion: </strong>Pediatric C3G has a variable clinicopathological spectrum, while DDD is less common. Most patients present with glomerulonephritis and significant morbidities. The lack of genetic and C3Nephritic factor testing is a barrier to the comprehensive phenotyping and management of C3G in resource-limited settings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"311-318"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lifelong impact of elevated blood pressure from childhood to adulthood. 从童年到成年血压升高的终生影响。
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2024-11-28 DOI: 10.3345/cep.2024.01445
Junhyun Kwon, Eunji Kim

Elevated blood pressure (BP) during childhood and adolescence is increasingly being recognized as a precursor to adult hypertension and cardiovascular disease (CVD). This review examines the existing evidence of the relationship between early BP elevations and long-term cardiovascular (CV) outcomes. Previous studies demonstrated a moderate association between childhood BP and adult hypertension, with early BP elevations contributing to subclinical CV changes such as left ventricular hypertrophy and increased carotid intima-media thickness as well as major premature CVD events in adulthood. However, evidence also indicates that BP normalization before adulthood may mitigate these risks, suggesting a critical interventional window before irreversible CV changes occur. Multiple modifiable and nonmodifiable factors contribute to early-life BP elevations, including genetic predisposition, a high sodium intake, obesity, sedentary behavior, and sleep disturbances. Although establishing a direct causal association between childhood BP and adult hypertension or CVD remains challenging owing to the need for longterm follow-up and large sample sizes, further research is essential to addressing the existing knowledge gaps in pediatric hypertension prevention, detection, impact, and treatment. This review highlights the importance of preventing BP elevations early in life to reduce the longterm burden of hypertension and CVD. Promoting healthy behaviors, such as maintaining a healthy weight, reducing one's sodium intake, engaging in physical activity, and ensuring adequate sleep, is essential for managing BP at an early age. These efforts reduce individual CV risk and help alleviate the broader future public health burden of hypertension and CVD.

儿童期和青春期血压升高越来越被认为是成人高血压和心血管疾病(CVD)的前兆。本文综述了早期血压升高与长期心血管(CV)结局之间关系的现有证据。先前的研究表明,儿童血压与成人高血压之间存在中度关联,早期血压升高会导致亚临床CV改变,如左心室肥厚、颈动脉内膜-中膜厚度增加,以及成年期主要的过早CVD事件。然而,也有证据表明,成年前血压正常化可能会减轻这些风险,这表明在不可逆的CV变化发生之前有一个关键的介入窗口。多种可改变和不可改变的因素导致生命早期血压升高,包括遗传易感、高钠摄入、肥胖、久坐行为和睡眠障碍。尽管由于需要长期随访和大样本量,建立儿童血压与成人高血压或心血管疾病之间的直接因果关系仍然具有挑战性,但进一步的研究对于解决儿童高血压预防、检测、影响和治疗方面的现有知识空白至关重要。这篇综述强调了在生命早期预防血压升高对于减少高血压和心血管疾病的长期负担的重要性。促进健康的行为,如保持健康的体重,减少钠摄入量,参加体育活动,保证充足的睡眠,对于早期控制血压至关重要。这些努力降低了个体心血管疾病的风险,并有助于减轻高血压和心血管疾病未来更广泛的公共卫生负担。
{"title":"Lifelong impact of elevated blood pressure from childhood to adulthood.","authors":"Junhyun Kwon, Eunji Kim","doi":"10.3345/cep.2024.01445","DOIUrl":"10.3345/cep.2024.01445","url":null,"abstract":"<p><p>Elevated blood pressure (BP) during childhood and adolescence is increasingly being recognized as a precursor to adult hypertension and cardiovascular disease (CVD). This review examines the existing evidence of the relationship between early BP elevations and long-term cardiovascular (CV) outcomes. Previous studies demonstrated a moderate association between childhood BP and adult hypertension, with early BP elevations contributing to subclinical CV changes such as left ventricular hypertrophy and increased carotid intima-media thickness as well as major premature CVD events in adulthood. However, evidence also indicates that BP normalization before adulthood may mitigate these risks, suggesting a critical interventional window before irreversible CV changes occur. Multiple modifiable and nonmodifiable factors contribute to early-life BP elevations, including genetic predisposition, a high sodium intake, obesity, sedentary behavior, and sleep disturbances. Although establishing a direct causal association between childhood BP and adult hypertension or CVD remains challenging owing to the need for longterm follow-up and large sample sizes, further research is essential to addressing the existing knowledge gaps in pediatric hypertension prevention, detection, impact, and treatment. This review highlights the importance of preventing BP elevations early in life to reduce the longterm burden of hypertension and CVD. Promoting healthy behaviors, such as maintaining a healthy weight, reducing one's sodium intake, engaging in physical activity, and ensuring adequate sleep, is essential for managing BP at an early age. These efforts reduce individual CV risk and help alleviate the broader future public health burden of hypertension and CVD.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"278-286"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telemedicine in pediatrics: things to consider.
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-04-01 Epub Date: 2025-02-03 DOI: 10.3345/cep.2024.01788
Sandhya J Kadam, Archana Reddy Bongurala
{"title":"Telemedicine in pediatrics: things to consider.","authors":"Sandhya J Kadam, Archana Reddy Bongurala","doi":"10.3345/cep.2024.01788","DOIUrl":"10.3345/cep.2024.01788","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"326-328"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abdominal pain in a young girl: a twist in the tale.
IF 3.2 Q1 PEDIATRICS Pub Date : 2025-03-11 DOI: 10.3345/cep.2024.01949
Upasana Ghosh, Ankit Agrawal, Umesh Shukla, Vikas Jain, Deeksha Bhalla
{"title":"Abdominal pain in a young girl: a twist in the tale.","authors":"Upasana Ghosh, Ankit Agrawal, Umesh Shukla, Vikas Jain, Deeksha Bhalla","doi":"10.3345/cep.2024.01949","DOIUrl":"https://doi.org/10.3345/cep.2024.01949","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical and Experimental Pediatrics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1