Global pediatrics最新文献

英文中文

Abdominal ultrasound screening for abdominal manifestations of neurofibromatosis type 1 in the pediatric population: A case series 小儿1型神经纤维瘤病腹部表现的腹部超声筛查：一个病例系列

Global pediatrics

Pub Date : 2025-12-13 DOI: 10.1016/j.gpeds.2025.100311

Tuzger N , Milani D , Grilli F , Pavesi MA , Vespro V , Carnevali A , Chiaraviglio MF , Natacci F , Fabiano V

引用次数: 0

Clinical spectrum and outcomes of tracheobronchial foreign body aspiration in children: A retrospective cohort study 儿童气管支气管异物吸入的临床谱和结果：一项回顾性队列研究

Global pediatrics

Pub Date : 2025-12-10 DOI: 10.1016/j.gpeds.2025.100310

Nadim Nafie Haddad

Background

Foreign body aspiration (FBA) is one of the principal causes of respiratory emergencies in children that can be prevented. This research paper was an attempt to describe the clinical manifestation, radiographic appearance, and prognosis of tracheobronchial FBA in children and to determine which factors predict abnormal postoperative recovery.

Methods

A retrospective cohort study was conducted at Azadi Teaching Hospital, the main tertiary referral center in Kirkuk, Iraq, from January 2015 to December 2024. Medical records of 245 children (<15 years) with bronchoscopically confirmed tracheobronchial foreign bodies were reviewed. Demographic, clinical, radiological, and operative data were collected. Logistic regression was used to identify independent predictors of abnormal postoperative outcomes.

Results

The mean was 3.93 ± 3.10 years; half of them were female. The percentage of organic foreign bodies was 73.9 percent with the right main bronchus being the most common location (41.6%). There were abnormal radiology in 49.4 percent. The postoperative outcomes were full recovery (42.9%), mild cough (45.7%), respiratory distress that needed RCU observation (11.0%), and one death (0.4). Independent predictors of abnormal postoperative outcomes were abnormal radiographs (AOR = 15.22; 95% CI: 7.16–32.37; p = 0.001) and younger age. There was good model performance (AUC = 0.81).

Conclusion

The most common example of the foreign body aspiration of the tracheobronchial is in toddlers and is mostly due to organic matter. Age and abnormal chest radiographic results are the major predictors of postoperative complications in younger ages. Early identification, prompt bronchoscopy and vigorous postoperative care are pivotal to the decrease of morbidity and in particular among high-risk children. Radiographic findings during the presentation could assist in sorting out children at risk to be closely observed during the postoperative period. Raising awareness of the risks of small organic objects is crucial with the prevention in the areas of the seed ingestion.

背景：异物吸入（FBA）是可预防的儿童呼吸紧急情况的主要原因之一。本研究试图描述儿童气管支气管FBA的临床表现、影像学表现和预后，并确定哪些因素可预测术后异常恢复。方法2015年1月至2024年12月在伊拉克基尔库克主要三级转诊中心Azadi教学医院进行回顾性队列研究。本文回顾了245例经支气管镜确认的气管支气管异物患儿（15岁）的病历。收集了人口学、临床、放射学和手术资料。采用Logistic回归确定异常术后预后的独立预测因素。结果平均3.93±3.10年；其中一半是女性。有机异物占73.9%，其中以右主支气管为最常见部位（41.6%）。49.4%有影像学异常。术后完全恢复（42.9%），轻度咳嗽（45.7%），呼吸窘迫需RCU观察（11.0%），1例死亡（0.4%）。术后异常预后的独立预测因素是异常x线片（AOR = 15.22; 95% CI: 7.16-32.37; p = 0.001）和年龄较小。模型性能良好（AUC = 0.81）。结论幼童气管支气管异物吸入最常见，多为有机物吸入。年龄和异常胸片结果是年轻患者术后并发症的主要预测因素。早期识别，及时的支气管镜检查和有力的术后护理是降低发病率的关键，特别是在高危儿童中。表现时的x线表现可以帮助筛选有风险的儿童，以便在术后密切观察。提高对小型有机物体的风险的认识对于预防种子摄入区域至关重要。

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引用次数: 0

Integrating climate change into pediatric education: A call to protect children's respiratory health 将气候变化纳入儿科教育：呼吁保护儿童呼吸系统健康

Global pediatrics

Pub Date : 2025-12-10 DOI: 10.1016/j.gpeds.2025.100309

Michele Ghezzi , Nicolò Garancini , Nada El Gallad , Giulia Grillo , Enza D’Auria , Gianvincenzo Zuccotti

Climate change (CC) represents a serious threat for human health, through air pollution, global warming and extreme weather events. Its consequences are particularly relevant for children and their respiratory system, because of a developing immune system, higher respiratory rate and exposure to toxins and pollutants, but our understanding on this phenomenon is still lacunose. Pediatricians are crucial as clinicians, diagnosing and managing conditions CC-related, and as advocates of education and public health strategies for environmental sustainability and addressing social health disparities. In order to mitigate the effects of CC on children, several policies, public health initiative and general guidelines have been developed but rigorous application and implementation are still needed. Although concern around this topic is growing, there is still a lack in health workers educational program on the impact and mechanisms of CC-related diseases.

气候变化（CC）通过空气污染、全球变暖和极端天气事件对人类健康构成严重威胁。由于免疫系统发育、呼吸频率较高以及接触毒素和污染物，其后果对儿童及其呼吸系统尤为重要，但我们对这一现象的理解仍然很有限。儿科医生作为临床医生，诊断和管理与cc相关的疾病，以及作为环境可持续性和解决社会健康差距的教育和公共卫生战略的倡导者，至关重要。为了减轻CC对儿童的影响，已经制定了若干政策、公共卫生倡议和一般准则，但仍然需要严格的应用和执行。尽管对这一主题的关注日益增加，但卫生工作者仍然缺乏关于cc相关疾病的影响和机制的教育计划。

引用次数: 0

Efficacy of antenatal glucocorticoids in preterm births and neonatal outcome from a population-based, retrospective, cohort study 基于人群的回顾性队列研究：产前糖皮质激素对早产和新生儿结局的影响

Global pediatrics

Pub Date : 2025-12-10 DOI: 10.1016/j.gpeds.2025.100308

Tingting Qi , Xiaojing Guo , Yaling Xu , Siwei Luo , Zhaojun Pan , Xiaoqin Zhu , Hui Wang , Hongni Yue , Xiaoqiong Li , Bo Sun

Background

The efficacy of antenatal glucocorticoids (ANG) may differ in developing regions, where perinatal care standards are often suboptimal with variable limitations, compared to well-advanced perinatal system.

Objective

This study aimed to evaluate the efficacy of ANG on outcome of all preterm births using a prospective database from a regional birth datafile covering 5.6 million residents, representative of regions with intermediate level of perinatal-neonatal healthcare in China.

Methods

From 59,245 birth registries in Huai’an, Jiangsu Province in 2015, 9,405 birth records and 1,856 in-hospital cases were integrated into a maternal-infant cohort at Huai’an Women and Children’s Hospital (HWCH), a leading regional perinatal referral center. Benefits and risks of ANG towards major outcome of preterm birth population were estimated in different gestational age (GA) ranges for courses, timing, birth status, and impact of maternal infection.

Results

ANG was administered to 41.8 % (1,109/2,651) of preterm births in the whole region, and 45.1 % (513/1,138) in HWCH. ANG was associated with significantly higher maternal morbidities. Perinatal and neonatal mortality risks were significantly reduced in infants under < 34 weeks after adjustment of GA and maternal co-morbidities with multivariable logistic regression models. Stillbirths decreased among extremely preterm infants, contributing to the overall outcome improvement. A similar trend of mortality reduction in non-HWCH preterm births was observed. The ANG efficacy was more pronounced in singletons than multiples. For those with maternal infection, ANG was associated with reduced occurrence of necrotizing enterocolitis only but not death risks. Notably, ANG was associated with increased neonatal hypoglycemia in multiple births and neurologic impairment in infants without maternal infection.

Conclusions

ANG reduced perinatal-neonatal mortality in the HWCH preterm cohort as a baseline within an evolving regional perinatal care system. The findings highlight the need for balance of short-term benefits versus potential risks in resource and paradigm transition.

背景：在发展中地区，产前糖皮质激素（ANG）的疗效可能有所不同，与先进的围产期系统相比，这些地区的围产期护理标准往往不够理想，存在各种限制。目的：本研究旨在评估ANG对所有早产儿结局的疗效，使用一个前瞻性数据库，该数据库来自中国560万居民的地区出生数据，这些地区代表了中国围产期-新生儿保健水平中等的地区。方法选取江苏省淮安市2015年59,245份出生登记，将9,405份出生记录和1,856例住院病例纳入淮安市妇幼医院的母婴队列。在不同胎龄（GA）范围内，对ANG对早产人群主要结局的益处和风险进行了评估，包括病程、时间、出生状况和母体感染的影响。结果全区41.8%（1,109/2,651）的早产儿接受了母乳喂养，HWCH为45.1%（513/1,138）。ANG与较高的孕产妇发病率显著相关。使用多变量logistic回归模型调整GA和产妇合并症后，34周以下婴儿的围产期和新生儿死亡风险显著降低。极早产儿的死产减少，有助于整体结果的改善。在非妊娠期早产中也观察到类似的死亡率下降趋势。ANG的疗效在单例中比多例更明显。对于母体感染的患者，ANG仅与坏死性小肠结肠炎发生率降低有关，但与死亡风险无关。值得注意的是，ANG与多胎新生儿低血糖增加和未受母体感染的婴儿神经功能损害有关。结论：在不断发展的区域围产期护理系统中，sang降低了HWCH早产儿队列的围产期新生儿死亡率。研究结果强调了在资源和范式转换中需要平衡短期利益与潜在风险。

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引用次数: 0

Peer support and psychosocial gains among adolescents living with HIV: Mixed methods evaluation of an overnight camp in Uganda 感染艾滋病毒的青少年的同伴支持和心理社会收益：乌干达过夜营地的混合方法评估

Global pediatrics

Pub Date : 2025-12-04 DOI: 10.1016/j.gpeds.2025.100307

Ann Gillard , Rebecca Egan , Joseph Rujumba , Peter Boedeker , Gilbert Amutuhe , Cissy Nassozi Ssemambo , Fairuzi Naiga , Resty Babirye Okello , Patricia Nahirya Ntege , Jose Euberto Mendez Reyes , Richard Sebastian Wanless , Diane Nguyen

This mixed methods study evaluated the effects of Sanyuka Camp, an overnight camp program in Uganda, on HIV viral loads and ART adherence behaviors among adolescents living with HIV (ALHIV). The quantitative component compared viral loads of camp participants (n = 41–49 annually) with a control group (n = 48–64 annually) over five years (2016–2020), examining measurements before, three months after, and twelve months after camp. The qualitative component, conducted in 2023, gathered data through focus groups with 33 ALHIV (ages 14–18) and interviews with five camp leaders. Although no statistically significant differences in viral loads emerged among camp attendees and non-attendees, qualitative findings revealed positive camp experiences including peer connections with shared identity, supportive relationships with healthcare workers, enhanced understanding of ART adherence, and specific camp activities that promoted medication adherence behaviors. Participants particularly valued taking medications as a group, supervised medicine administration, and interactive educational activities. Challenges included pre-camp apprehension, concerns about HIV disclosure through branded items, and disappointment when returning to less supportive home environments. Although the camp intervention did not directly influence suppression of viral loads, it provided meaningful psychosocial benefits and educational opportunities that could support long-term health behaviors among ALHIV beyond clinical measures of viral suppression.

这项混合方法研究评估了乌干达夜间营地项目Sanyuka Camp对感染艾滋病毒的青少年（ALHIV）的艾滋病毒载量和抗逆转录病毒治疗依从性行为的影响。定量部分比较了五年（2016-2020）期间营地参与者（n = 41-49）与对照组（n = 48-64）的病毒载量，检查了营地前、三个月后和12个月后的测量结果。定性部分于2023年进行，通过对33名艾滋病毒携带者（14-18岁）的焦点小组和对5名营地领导人的访谈收集数据。虽然在训练营参与者和非参与者中，病毒载量没有统计学上的显著差异，但定性研究结果揭示了积极的训练营经历，包括具有共同身份的同伴联系，与卫生保健工作者的支持关系，对抗逆转录病毒治疗依从性的增强理解，以及促进药物依从性行为的特定营地活动。参与者特别重视集体服药、监督用药和互动教育活动。挑战包括营地前的担忧，担心通过品牌物品泄露艾滋病毒，以及回到不那么支持的家庭环境时的失望。虽然营地干预没有直接影响病毒载量的抑制，但它提供了有意义的心理社会效益和教育机会，可以支持ALHIV患者的长期健康行为，而不是临床病毒抑制措施。

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引用次数: 0

Esophageal Atresia: From worry to wisdom–Parental information needs and considerations on etiology, care, and parental support 食道闭锁：从忧虑到智慧——父母对病因、护理和父母支持的信息需求和考虑

Global pediatrics

Pub Date : 2025-12-01 DOI: 10.1016/j.gpeds.2025.100299

Katherine Merritt Doucet , Juliana Coronado , Rebecca Leslie , Emily Whitesel , Benjamin Zendejas , Dusica Bajic

Esophageal atresia (EA) is one of the most common congenital gastrointestinal anomalies, posing complex challenges across diagnosis, treatment, and long-term care. This narrative review addresses four key domains: etiology and diagnosis; surgical repair techniques; feeding challenges; and parental stress and support. It outlines current evidence and clinical considerations relevant to families, clinical staff, and researchers. By highlighting informational gaps and long-term concerns, the review supports improved communication, care planning, and research direction for optimizing outcomes in children with EA.

食管闭锁（EA）是最常见的先天性胃肠道异常之一，在诊断、治疗和长期护理方面提出了复杂的挑战。这篇叙述性综述涉及四个关键领域：病因和诊断；外科修复技术；喂养挑战;父母的压力和支持。它概述了与家庭、临床工作人员和研究人员相关的当前证据和临床考虑。通过强调信息差距和长期关注，该综述支持改善沟通、护理计划和研究方向，以优化EA儿童的预后。

引用次数: 0

Erratum to “Neonatal umbilical hernia: A simple noninvasive technique” [Global Pediatrics 13C (2025) 100280] 《新生儿脐疝：一种简单的无创技术》勘误[全球儿科学13C (2025) 100280]

Global pediatrics

Pub Date : 2025-12-01 DOI: 10.1016/j.gpeds.2025.100289

Jayalaxmi Shripati Aihole

引用次数: 0

How maternal diet, probiotics, prebiotics, and postbiotics during pregnancy influence neurodevelopment in newborns 孕期孕妇饮食、益生菌、益生元和后益生菌如何影响新生儿神经发育

Global pediatrics

Pub Date : 2025-12-01 DOI: 10.1016/j.gpeds.2025.100301

Valentina Biagioli , Mariarosaria Matera , Pasquale Striano

The maternal microbiota plays a pivotal role in shaping fetal and neonatal neurodevelopment through the gut–brain axis. Modern lifestyles, cesarean delivery, formula feeding, and Westernized diets contribute to maternal and neonatal dysbiosis, increasing the risk of neurodevelopmental, metabolic, and immune disorders in offspring. This review explores how maternal diet, microbiota composition, probiotics, prebiotics, and postbiotics during pregnancy and lactation influence the microbial and neurodevelopmental trajectory of newborns. Evidence suggests that prenatal microbial transfer begins in utero, while birth mode and breastfeeding strongly shape early microbial colonization. Dysbiosis, maternal immune activation, and pro-inflammatory conditions such as obesity or gestational diabetes disrupt microglial maturation and increase the risk of neurodevelopmental disorders, including autism spectrum disorder, ADHD, and mood disorders. Conversely, maternal adherence to a Mediterranean diet, combined with selected probiotic, prebiotic, and postbiotic supplementation, supports microbial diversity, enhances barrier function, and promotes neuroprotective metabolite production.

In conclusion, early maternal interventions targeting microbiota composition—through diet and microbial therapies—represent a promising strategy to optimize neonatal neurodevelopment and long-term health. Future personalized approaches, guided by maternal microbiota profiling, could strengthen preventive pediatric care.

母体微生物群通过肠-脑轴在塑造胎儿和新生儿神经发育中起关键作用。现代生活方式、剖宫产、配方喂养和西方化饮食导致产妇和新生儿生态失调，增加后代神经发育、代谢和免疫紊乱的风险。本文综述了孕期和哺乳期母亲的饮食、微生物群组成、益生菌、益生元和后益生菌对新生儿微生物和神经发育轨迹的影响。有证据表明，产前微生物转移始于子宫，而出生方式和母乳喂养强烈塑造早期微生物定植。生态失调、母体免疫激活和促炎条件，如肥胖或妊娠糖尿病，会破坏小胶质细胞的成熟，增加神经发育障碍的风险，包括自闭症谱系障碍、多动症和情绪障碍。相反，母亲坚持地中海饮食，结合选定的益生菌、益生元和益生后补充，支持微生物多样性，增强屏障功能，促进神经保护代谢物的产生。总之，通过饮食和微生物治疗，针对微生物群组成的早期产妇干预是优化新生儿神经发育和长期健康的有希望的策略。未来的个性化方法，以母体微生物群分析为指导，可以加强预防性儿科护理。

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引用次数: 0

What is the place for digital health and AI in pediatric primary care? A call to action from the European Confederation of Primary Care Paediatricians (ECPCP) 数字健康和人工智能在儿科初级保健中的地位是什么？欧洲初级保健儿科医师联合会（ECPCP）的行动呼吁

Global pediatrics

Pub Date : 2025-12-01 DOI: 10.1016/j.gpeds.2025.100290

Laura Reali, Annamaria Sapuppo, Doron Dushnitzky

Digitalization and technological breakthroughs have transformed pediatric medical services via integrated digital health systems, encompassing telemedicine, teleconsultation, and artificial intelligence applications. This article examines the potential and current status of digital health (DH) and artificial intelligence (AI) in pediatric primary care (PPC), as well as their impact on clinical practice, patient outcomes, and healthcare delivery. In pediatric populations, digital health technologies—including wearable devices, electronic health records (EHRs), and mobile health applications—have significantly improved care coordination, health education, and remote monitoring. Telemedicine facilitates mental health assessments and the management of chronic illnesses, increasing accessibility and convenience. AI applications demonstrate potential in individualized treatment planning, email management, therapeutic decision assistance, and diagnostic imaging. The COVID-19 pandemic accelerated the implementation of these technologies, which are particularly beneficial in emergencies and remote care scenarios. Nonetheless, impediments to adoption exist, including the necessity for human oversight, interoperability challenges, socioeconomic limitations, and data privacy concerns. Artificial intelligence and digital health technologies possess substantial potential to enhance patient-centered care by augmenting efficiency, quality, and accessibility. Successful implementation necessitates meticulous consideration of safety, efficacy, ethical oversight, and appropriate resource allocation. Future research should focus on addressing the individual needs of patients and healthcare professionals, with regulatory compliance, personalized care, and precise diagnosis.

数字化和技术突破通过集成数字卫生系统改变了儿科医疗服务，包括远程医疗、远程会诊和人工智能应用。本文探讨了数字健康（DH）和人工智能（AI）在儿科初级保健（PPC）中的潜力和现状，以及它们对临床实践、患者结果和医疗保健服务的影响。在儿科人群中，数字健康技术——包括可穿戴设备、电子健康记录（EHRs）和移动健康应用程序——显著改善了护理协调、健康教育和远程监测。远程医疗促进了心理健康评估和慢性疾病的管理，增加了可及性和便利性。人工智能应用在个性化治疗计划、电子邮件管理、治疗决策辅助和诊断成像方面显示出潜力。2019冠状病毒病大流行加速了这些技术的实施，这些技术在紧急情况和远程护理情况下尤其有益。尽管如此，采用的障碍仍然存在，包括人类监督的必要性、互操作性挑战、社会经济限制和数据隐私问题。人工智能和数字医疗技术具有通过提高效率、质量和可及性来增强以患者为中心的护理的巨大潜力。成功的实施需要对安全性、有效性、伦理监督和适当的资源分配进行细致的考虑。未来的研究应侧重于解决患者和医疗保健专业人员的个性化需求，包括遵守法规、个性化护理和精确诊断。

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引用次数: 0

Erratum to “Neonatal umbilical hernia: A simple noninvasive technique” “新生儿脐疝：一种简单的无创技术”的勘误

Global pediatrics

Pub Date : 2025-12-01 DOI: 10.1016/j.gpeds.2025.100297

Jayalaxmi Shripati Aihole

Umbilical hernias are a common congenital anomaly in infants, characterized by the protrusion of abdominal contents through an incompletely closed umbilical fascial ring. While the majority of these hernias resolve spontaneously within the first few years of life, a small but significant proportion can lead to complications such as incarceration, strangulation, or evisceration, necessitating urgent surgical intervention. Current clinical guidelines predominantly advocate for watchful waiting in asymptomatic cases. However, this expectant approach can cause considerable parental anxiety and does not actively support the natural closure process. This clinical report describes the Jayalaxmi Shripati Aihole-JSA's Maneuver, a practical, parent-administered manual compression technique designed to potentially accelerate the spontaneous closure of umbilical hernias and mitigate the risk of complications during the watchful waiting period. Preliminary observations from 55 neonates and infants suggest that this simple, no-cost intervention may hasten the resolution of the hernia, improve infant comfort, and enhance parent-child bonding. Further rigorous research is warranted to validate the efficacy and safety of this technique.

脐疝是一种常见的婴儿先天性异常，其特征是腹部内容物通过不完全闭合的脐筋膜环突出。虽然大多数疝气在生命的最初几年内自然消退，但一小部分但重要的比例可能导致并发症，如嵌顿，绞窄或内脏取出，需要紧急手术干预。目前的临床指南主要提倡对无症状病例进行观察等待。然而，这种期待的方法会引起相当大的父母焦虑，并没有积极支持自然关闭过程。这篇临床报告描述了Jayalaxmi Shripati Aihole-JSA的手法，这是一种实用的、由父母管理的手动按压技术，旨在潜在地加速脐疝的自发闭合，并在观察等待期间减轻并发症的风险。对55名新生儿和婴儿的初步观察表明，这种简单、无成本的干预可能会加速疝气的消退，提高婴儿的舒适度，并增强亲子关系。需要进一步严格的研究来验证该技术的有效性和安全性。

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