Pediatrics and Neonatology最新文献

英文中文

Perinatal risk factors and lung function at 8 years of age in extremely preterm infants: Insights from a new Japanese bronchopulmonary dysplasia classification 围产期危险因素和8岁极早产儿肺功能：来自日本支气管肺发育不良新分类的见解

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2026-01-01 DOI: 10.1016/j.pedneo.2025.05.005

Katsuya Hirata , Hidehiko Nakanishi , Fumihiko Namba , Narutaka Mochizuki , Shinya Hirano , Kazuko Wada , Masanori Fujimura

Background

Advances in neonatal care have considerably improved the survival rates of extremely preterm infants. However, long-term pulmonary sequelae remain a major concern. A revised classification of bronchopulmonary dysplasia (BPD) in Japan highlights histological chorioamnionitis, small for gestational age (SGA), and a bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as key risk factors. This study aimed to evaluate the effect of extremely preterm birth on lung function at school age.

Methods

This retrospective study included 283 extremely preterm infants (born at <28 weeks of gestation) admitted to our institution between 1994 and 2013. Perinatal data and spirometry results obtained at 8 years of age were analyzed. Logistic regression analysis was performed to assess the association of histological chorioamnionitis, SGA, and bubbly/cystic CXR with obstructive (FEV₁ [forced expiratory volume in 1 s]/FVC [forced vital capacity] < LLN [lower limit of normal]), restrictive (FEV₁/FVC ≥ LLN and FVC < LLN), and mixed (FEV₁/FVC < LLN and FVC < LLN) patterns, with adjustments for gestational age, sex, and birth year.

Results

Extremely preterm infants exhibited lower z-scores for FEV₁/FVC, FEV₁, and FVC than the predicted values based on age, height, and sex. Bubbly/cystic CXR findings was associated with an increased risk of obstructive (adjusted odds ratio [aOR], 2.30; 95 % confidence interval [CI], 1.12–4.72) and mixed patterns (aOR, 3.51; 95 % CI, 1.19–10.4). SGA was a risk factor for a restrictive pattern (aOR, 2.81; 95 % CI, 1.37–5.74).

Conclusion

Bubbly/cystic CXR findings and SGA status, key components of the revised Japanese BPD classification, were significantly associated with long-term pulmonary function abnormalities in extremely preterm infants, characterized predominantly by obstructive/mixed and restrictive patterns, respectively. These findings highlight the importance of targeted strategies to address specific perinatal risk factors and improve long-term pulmonary outcomes in this high-risk population.

背景：新生儿护理的进步大大提高了极早产儿的存活率。然而，长期的肺部后遗症仍然是一个主要问题。日本修订的支气管肺发育不良（BPD）分类强调了组织学绒毛膜羊膜炎、胎龄小（SGA）和胸片上的泡状/囊性外观（泡状/囊性CXR）是关键的危险因素。本研究旨在评估极度早产对学龄期儿童肺功能的影响。方法：本回顾性研究纳入283例极早产儿（出生时为1 [1 s用力呼气量]/FVC[用力肺活量]1/FVC≥LLN和FVC 1/FVC）。结果：极早产儿FEV1/FVC、FEV1和FVC的z评分低于基于年龄、身高和性别的预测值。气泡/囊性CXR发现与阻塞性风险增加相关(校正优势比[aOR]， 2.30；95%置信区间[CI]， 1.12-4.72)和混合模式(aOR, 3.51；95% ci, 1.19-10.4)。SGA是限制性模式的危险因素(aOR, 2.81；95% ci, 1.37-5.74)。结论：泡泡/囊性CXR表现和SGA状态是修订的日本BPD分类的关键组成部分，与极早产儿的长期肺功能异常显著相关，分别以阻塞性/混合性和限制性模式为主要特征。这些发现强调了针对性策略的重要性，以解决特定的围产期危险因素，并改善这一高危人群的长期肺部预后。

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引用次数: 0

Increased incidence of attention-deficit/hyperactivity disorder is associated with early and prolonged exposure to antibiotics: A population-based retrospective cohort study 注意缺陷/多动障碍的发病率增加与早期和长期接触抗生素有关：一项基于人群的回顾性队列研究。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2026-01-01 DOI: 10.1016/j.pedneo.2025.03.008

Chia-Yu Li Lin , Yu-Jui Huang , Hsiu-Chen Lin , Min-Lan Tsai , Jung-Tzu Ku , Feng-Chin Lee , Hsi Chang

Background

Medication exposure has been shown to alter the composition of healthy gut microbiome, thereby disrupting the microbiota-gut-brain axis. Gut dysbiosis has been linked to increasing cases of neurodevelopmental disorders. To identify any correlation between antibiotics use and one of the most prevalent childhood disorders - ADHD - we conducted a nationwide study spanning over a decade in Taiwan.

Methods

Two million individuals were randomly sampled between the years 2005 and 2018 ranging from the time of birth to the age of 8. They were categorized into three groups based on age of initial exposure to antibiotics and further stratified by exposure duration. The hazard ratios and 95 % confidence interval for ADHD were compared using a Cox proportional hazard model. Cumulative incidence curves were generated using the Kaplan–Meier method and analyzed using a log-rank test.

Results

ADHD risk was highest in individuals exposed to antibiotics before the age of 2 years, regardless of the duration of exposure. In children aged >2 years, increased ADHD risk was observed alongside prolonged antibiotic exposure.

Conclusions

In clinical practice, we may consider the potential adverse impact of prescribing antibiotics in young children, particularly in children aged <2 years. If antibiotic use is necessary, duration of administration should be shortened whenever practicable.

背景：药物暴露已被证明会改变健康肠道微生物组的组成，从而破坏微生物-肠道-脑轴。肠道生态失调与神经发育障碍病例的增加有关。为了确定抗生素的使用与最普遍的儿童疾病之一——多动症之间的关系，我们在台湾进行了一项为期十年的全国性研究。方法：在2005年至2018年期间，随机抽取200万人，从出生到8岁。他们根据最初接触抗生素的年龄分为三组，并根据接触时间进一步分层。使用Cox比例风险模型比较ADHD的风险比和95%置信区间。使用Kaplan-Meier法生成累积发生率曲线，并使用log-rank检验进行分析。结果：在2岁之前暴露于抗生素的个体中，ADHD风险最高，与暴露时间长短无关。在1 ~ 2岁的儿童中，观察到ADHD风险随着抗生素暴露时间的延长而增加。结论：在临床实践中，我们可以考虑给幼儿，特别是老年儿童开抗生素的潜在不良影响

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引用次数: 0

Hepatic calcification following malpositioned umbilical venous catheters in neonates with congenital heart disease 先天性心脏病新生儿脐静脉置管错位后肝钙化。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2026-01-01 DOI: 10.1016/j.pedneo.2025.08.009

Kazufumi Yaginuma , Akihiro Suzuki , Naoyuki Taga , Mamoru Takeuchi

引用次数: 0

Neuroimaging of patients with headache in the pediatric emergency department: A single center retrospective study 儿科急诊科头痛患者的神经影像学：一项单中心回顾性研究

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2026-01-01 DOI: 10.1016/j.pedneo.2024.11.008

Donghyun Shin , Yoo Jung Lee , Yoon Hee Jo , Juhyun Kong , Yun-Jin Lee , Sang Ook Nam , Young Mi Kim

Background

Headache is a common neurologic complaint in children and adolescents, and the secondary causes of headache in these patients should be identified and excluded. We investigated the sensitivity and specificity of red flags in children with headache admitted to the emergency room and the associations of red flags with abnormal findings in neuroimaging, especially in serious pathologies.

Methods

A retrospective review was conducted on individuals under <18 years old with headache who visited the emergency department at Pusan National University Hospital, the Republic of Korea, from January 2017 to December 2022. In total, 267 patients were included in this study.

Results

Using the positive likelihood ratio, the association between each red flag with the positive results of neuroimaging was calculated. Red flags such as fever (P < 0.001), past history of neoplasm (P = 0.002), gradual worsening (P < 0.001), painful eye (P = 0.02), posttraumatic onset (P = 0.037), precipitated by exercise or Valsalva maneuver (P = 0.021) and lack of response to painkiller (P = 0.004) were statistically significant in patients with the positive neuroimaging results. Of 267 patients, 16 patients (6.0 %) had life-threatening headache that required urgent treatment and similar red flags were statistically significant in this group.

Conclusions

Red flags are useful reminders for physicians regarding whether to perform neuroimaging in the emergency department for patients with headache. Clinicians should perform neuroimaging depending on each circumstance and consider the red flags.

背景：头痛是儿童和青少年常见的一种神经系统疾病，这些患者头痛的继发原因应该被识别和排除。我们研究了急诊室收治的头痛儿童中危险信号的敏感性和特异性，以及危险信号与神经影像学异常发现的关联，特别是在严重的病理中。方法：对个体进行回顾性分析。结果：采用正似然比，计算各危险信号与神经影像学阳性结果的相关性。结论：对于急诊科是否对头痛患者进行神经影像学检查，危险信号是一个有用的提醒。临床医生应该根据每种情况进行神经成像，并考虑危险信号。

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引用次数: 0

Assessing the rarity of noma in Ethiopia: Estimating cumulative point prevalence of the devastating childhood disease 评估埃塞俄比亚坏疽性口炎的罕见性：估计这一毁灭性儿童疾病的累积流行点。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2026-01-01 DOI: 10.1016/j.pedneo.2024.12.005

Heron Gezahegn Gebretsadik

Background

Noma, a severe and often fatal disease, is poorly understood due to limited data. Recently classified as a neglected tropical disease by WHO, its status in Ethiopia remains unclear. This study estimates Ethiopia's cumulative point prevalence of noma.

Methods

In a retrospective cross-sectional study, the disease incidence in Ethiopia was determined using data from the review of medical records of noma cases. The medical records were obtained from the three main centers for treating noma in Ethiopia. Disease duration, which is critical for estimating point prevalence, was determined based on existing literature. Mean annual incidence data and disease duration were used to calculate the point prevalence of noma in 2019. This was translated into a ratio per 10,000 total population in Ethiopia to assess the disease status. The UN World Population Dashboard dataset was used to determine the population size of Ethiopia in 2019.

Results

The study reviewed 325 medical records from three noma treatment centers in Ethiopia between 2007 and 2019. Noma cases spanned all Ethiopian regions, with Oromia and Amhara accounting for the most cases. An estimated 26,000 cases occurred nationwide during this period, translating to an annual incidence of 2167. The 2019 point prevalence was 0.77 per 10,000 people, confirming noma as a rare disease in Ethiopia.

Conclusion

This study reveals the rarity of noma in Ethiopia and provides new insights critical to global understanding. Recognition of its rarity underscores the need to redirect resources to mitigate its impact in resource-poor settings such as Ethiopia, where the disease is more prevalent. The findings underscore the need for continued surveillance, data collection, and collaboration to better understand and effectively address noma. Thus, the results of the current study may serve as a landmark baseline data set to re-evaluate traditional perspectives on this devastating disease.

背景：坏疽性口炎是一种严重且往往致命的疾病，由于数据有限，人们对其了解甚少。世卫组织最近将其列为被忽视的热带病，但其在埃塞俄比亚的状况仍不清楚。本研究估计了埃塞俄比亚坏疽性口炎的累积流行点。方法：在一项回顾性横断面研究中，利用对坏疽性口炎病例病历的回顾数据确定埃塞俄比亚的疾病发病率。医疗记录是从埃塞俄比亚治疗坏疽性口炎的三个主要中心获得的。疾病持续时间是估计点患病率的关键，根据现有文献确定。使用年平均发病率和病程数据计算2019年坏疽性口炎的点患病率。这被转化为埃塞俄比亚每1万人口中的比率，以评估疾病状况。联合国世界人口仪表板数据集用于确定2019年埃塞俄比亚的人口规模。结果：该研究回顾了2007年至2019年埃塞俄比亚三个坏疽性口炎治疗中心的325份医疗记录。坏疽性口炎病例遍及埃塞俄比亚所有地区，其中奥罗米亚和阿姆哈拉的病例最多。据估计，在此期间，全国发生了26,000例病例，相当于年发病率为2167例。2019年的点流行率为0.77 / 10000人，证实了坏疽性口炎在埃塞俄比亚是一种罕见疾病。结论：这项研究揭示了埃塞俄比亚坏疽性口炎的罕见性，并为全球理解提供了至关重要的新见解。认识到该病的稀缺性，强调有必要重新分配资源，以减轻该病在埃塞俄比亚等资源贫乏环境中的影响，因为该病在埃塞俄比亚更为普遍。研究结果强调需要继续进行监测、数据收集和合作，以便更好地了解和有效地应对坏疽性口炎。因此，目前的研究结果可以作为一个里程碑式的基线数据集，以重新评估对这种毁灭性疾病的传统观点。

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引用次数: 0

Clinical and methodological considerations on nasal high-frequency oscillation in very-low-birth-weight infants with RDS 极低出生体重儿RDS鼻高频振荡的临床和方法学考虑。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2026-01-01 DOI: 10.1016/j.pedneo.2025.10.002

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Time is bowel: Recognizing a strangulated closed-loop obstruction in a child. 时间就是肠道：识别儿童的绞窄性闭环阻塞。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-12-31 DOI: 10.1016/j.pedneo.2025.12.002

Chih-Hao Wang, Pei-Shan Tsai, Po-Chih Lin, Yi-Ting Yeh

引用次数: 0

Epidemiological characterization and clinical utility of the multiplex PCR FilmArray™ Gastrointestinal Panel at a tertiary university hospital in Japan, 2024. 多重PCR FilmArray™胃肠道检测面板在日本某三级大学医院的流行病学特征和临床应用，2024年。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-12-31 DOI: 10.1016/j.pedneo.2025.11.009

Yoshitaka Asagai, Hiroshi Yamaguchi, Tomohiko Yamamura, Mari Kusuki, Kenichiro Ohnuma, Tomoko Horinouchi, Ryosuke Bo, Nobuyuki Yamamoto, Yoshihiko Yano, Hiroaki Nagase, Kandai Nozu

Background: Rapid and reliable diagnostic methods are essential to ensure appropriate management of acute gastroenteritis. The BioFire FilmArray® Gastrointestinal Panel (FGP) rapidly and accurately identifies various pathogens. However, previous studies on FGP lacked detailed descriptions of its utility in clinical practice. Additionally, pediatric data from Japan are limited. Therefore, we aimed to evaluate the clinical utility of the FGP and identify the characteristics of patients with positive FGP results.

Methods: We retrospectively reviewed the records of pediatric patients (aged ≤18 years) who underwent FGP testing at Kobe University Hospital in 2024. The pathogens detected and clinical characteristics of FGP-positive and FGP-negative patients were compared. Subgroup analyses were conducted by bacterial- and viral-positive status.

Results: The median time from FGP testing to the confirmation of results was 82 min. Of the 67 patients who underwent FGP testing, 28 (42 %) were FGP-positive. The most frequently detected pathogen was norovirus (18 %), followed by Clostridioides difficile toxin A/B (12 %), Campylobacter spp. (4.5 %), Yersinia enterocolitica (4.5 %), Enteroaggregative Escherichia coli (4.5 %), Enteropathogenic Escherichia coli (3 %), astrovirus (3 %), sapovirus (1.5 %), Shiga -like toxin producing Escherichia coli (1.5 %), and Salmonella spp. (1.5 %). No significant differences in clinical findings were observed between FGP-positive and FGP-negative cases. Subgroup analysis revealed frequent vomiting, and significantly shorter fever in patients with viral-positive FGP results than in those with bacterial-positive FGP results.

Conclusion: FGP aids clinical decision-making by enabling the early detection of pathogens, such as Campylobacter spp. and Yersinia enterocolitica, which typically require several days for stool culture results.

背景：快速可靠的诊断方法对于确保急性胃肠炎的适当治疗至关重要。BioFire FilmArray®胃肠道面板（FGP）快速准确地识别各种病原体。然而，先前关于FGP的研究缺乏对其在临床实践中的应用的详细描述。此外，来自日本的儿科数据有限。因此，我们旨在评估FGP的临床应用，并确定FGP阳性患者的特征。方法：回顾性分析神户大学医院2024年接受FGP检测的儿童患者（年龄≤18岁）的记录。比较fgp阳性和fgp阴性患者的病原菌检测及临床特点。根据细菌和病毒阳性情况进行亚组分析。结果：从FGP检测到结果确认的中位时间为82 min。在67例接受FGP检测的患者中，28例（42%）为FGP阳性。检出最多的病原体为诺如病毒（18%），其次为艰难梭菌毒素A/B（12%）、弯曲杆菌（4.5%）、小肠结肠炎耶尔森菌（4.5%）、肠聚集性大肠杆菌（4.5%）、肠致病性大肠杆菌（3%）、星状病毒（3%）、萨波病毒（1.5%）、产志贺样毒素的大肠杆菌（1.5%）和沙门氏菌（1.5%）。fgp阳性和fgp阴性病例的临床表现无显著差异。亚组分析显示，与FGP结果为细菌阳性的患者相比，FGP结果为病毒阳性的患者频繁呕吐，发热时间明显缩短。结论：FGP通过早期发现病原体（如弯曲杆菌和小肠结肠炎耶尔森菌）来帮助临床决策，这些病原体通常需要几天的粪便培养结果。

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引用次数: 0

A case of PCV13-Serotype breakthrough pneumococcal endocarditis associated with chronic aortic regurgitation. pcv13血清型突破性肺炎球菌心内膜炎合并慢性主动脉瓣反流1例。

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-12-31 DOI: 10.1016/j.pedneo.2025.11.006

Ni-Chun Kuo, Chung-Chi Wang, Ming-Chih Lin

引用次数: 0

Comment on "Quantification of post-COVID-19 symptoms and pulmonary functional capacity in children with COVID-19". 对“COVID-19儿童COVID-19后症状和肺功能的量化”的评论

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2025-12-31 DOI: 10.1016/j.pedneo.2025.12.004

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0

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