BMC Pediatrics最新文献

Background: During the preschool years, children experience rapid development of inhibitory control (IC). This period is also crucial to foster the establishment of the foundations of physical fitness (PF) and motor competence (MC), which are essential for long-term health outcomes. This study aimed to investigate the predictive roles of PF and MC in IC in preschool children.

Method: A total of 139 children (78 boys and 61 girls) participated in the study, with a mean age of 5.76 ± 0.30 years and a body mass index (BMI) of 16.15 ± 1.94 kg/m². Children performed the Go/No-Go test, Körperkoordinationstest für Kinder (KTK3+) test, static and dynamic balance tests, a pro-agility and countermovement jumping (CMJ) test.

Results: The findings showed that there was a positive association between MCT and accuracy number (AC) (go) (β = 0.079, 95%CI: 0.051-0.107), AC (no go) (β = 0.022, 95%CI: 0.003-0.041). However, between MCT and reaction time (RT), there was a negative relationship (β = [Formula: see text]0.497, 95%CI: [Formula: see text]0.988 - [Formula: see text]0.006). MCT scores showed a significant positive relationship with AC (go), with a beta coefficient of 0.309 (95% CI: 0.181, 0.436). This finding further underscores the robustness of this relationship. The PF indicator agility showed a negative relationship with AC (go) (β = -3.638 [-5.590, -1.687]) and static balance was negatively related to RT (β = -34.767, 95% CI [0.018, 0.165]).

Conclusions: Overall, this study indicates that MC, rather than general PF, is strongly associated with the concurrent level of IC during the preschool period. These findings highlight the potential importance of promoting MC through targeted interventions that may support cognitive function in young children. Further longitudinal research is recommended to explore the causal relationships and long-term effects of these interventions.

Study registration: Research protocol number: 2022.214.11.15.

Background: Cardiac tumors in children are rare and usually have no obvious clinical symptoms. However, a small number of children may experience serious conditions such as arrhythmia, heart obstruction, and even death. When severe arrhythmia cannot be controlled by conservative treatment, surgical intervention is needed.

Case presentation: A 20-day-old male neonate, born full-term via cesarean section, was admitted to the emergency department with complaints of jaundice for 16 days and a rapid heart rate detected for one day. The heart rate was recorded at 280 beats per minute. An electrocardiogram (ECG) initially suggested supraventricular tachycardia, later progressing to ventricular tachycardia. A bedside echocardiogram indicated an intracardiac mass. Conservative treatment failed to restore normal heart rhythm, then the patient underwent emergency surgery with tumor resection under general anesthesia and cardiopulmonary bypass. Post-surgery, ventilator-assisted breathing was administered, along with inotropic support, diuretics, anti-infective therapy, and fluid management. the heart rate and rhythm returned to normal. Postoperative pathology revealed the presence of a cardiac rhabdomyoma, and follow-up was arranged post-discharge.

Conclusion: Cardiac tumors in children are relatively rare, mostly benign, and have a good prognosis. But for some emergency situations or heart tumors that cause adverse effects, timely and effective intervention is needed to avoid adverse consequences.

Background: Neonatal sepsis is a significant cause of morbidity and mortality in low- income countries. Neonatal sepsis is classified as early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS). Etiologies responsible for EONS are mostly acquired vertically from the mother during or before birth with the possibility of prevention. The burden and etiology of neonatal sepsis is not uniform across the globe with huge disparities based on the income level of the countries. This study aimed to determine neonatal sepsis trends, prevalence, and etiologies at Hawassa University Comprehensive Specialised Hospital (HUCSH).

Methods: A hospital-based retrospective cross-sectional study was conducted among newborns aged 0 to 90 days who were admitted to the HUCSH from January 2019 to July 2023. Patient-related information and the culture results were obtained from HUCSH microbiology laboratory registration book. Data analysis was performed using SPSS version 25 software.

Results: Out of 2364 newborns suspected of having sepsis, 56% (95% CI: 54-58%) had culture-confirmed sepsis. When excluding Coagulase Negative Staphylococcus (CONS), the prevalence of culture-confirmed neonatal sepsis was 36.9%. The highest numbers of culture-confirmed cases was observed in 2021. The predominant bacteria identified were Coagulase Negative Staphylococcus (CONS) (34.1%), Klebsiella pneumoniae (12.9%), and Enterococcus (10.6%). Among culture-confirmed neonatal sepsis, 59.9% and 40.1% of cases were EONS and LONS, respectively. Coagulase Negative Staphylococcus and Enterococcus were the major bacteria found in both EONS and LONS while. Klebsiella pneumoniae was the second most common bacteria among newborns with EONS following CONS.

Conclusions: The prevalence of culture-confirmed neonatal sepsis was relatively high in the study area. Early-onset neonatal sepsis was consistently more prevalent than LONS. The predominant etiologies of neonatal sepsis excluding CONS were K. pneumoniae, Enterococcus, Enterobacter agglomerans, Acinetobacter species, and Staphylococcus aureus. Among newborns with EONS, the predominant bacteria were K. pneumoniae, Enterococcus, Enterobacter agglomerans, and Acinetobacter species.

Here we describe the case of an infant incidentally diagnosed with congenital KMT2A-rearranged (KMT2A-r) B-cell ALL on Day of Life 4. He received the first dose of intrathecal methotrexate on DOL 5, and induction systemic therapy on DOL 6. He demonstrated morphologic remission at the end of induction but had positive bone marrow. Minimal residual disease (MRD) was 1.4%. He experienced isolated CNS disease after consolidation and immunotherapy. At 8 months of age he underwent hematopoietic stem cell transplantation (HSCT). At 14 months of age he had medullary and CNS relapse, and at 16 months of age underwent CD19 CAR-T therapy. At 6 years of age he remains in remission with tolerable developmental delays and a good quality of life.

Background: Premature ventricular complexes (PVCs) are generally benign in healthy children, but in some cases, a persistent high PVC burden may be observed, potentially related to ventricular tachycardia or left ventricular dysfunction. This study explores the natural history of PVCs in children with structurally normal hearts and identifies factors associated with unresolved PVCs.

Methods: We retrospectively analyzed demographic and clinical data from children < 18 years of age with confirmed PVCs, including 12-lead electrocardiogram (ECG) and 24-h Holter monitoring data.

Results: A total of 113 children (mean age 8.35 ± 5.28 years, 71 males [62.8%]) were included. The mean follow-up duration was 44.9 ± 44.8 months. PVC burden at initial diagnosis was 13.54 ± 12.53%. During follow-up, 44.2% of patients showed complete PVC improvement, 13.3% partial improvement, and 42.5% persistent. Older age at the initial onset and female sex were associated with unresolved PVCs (per 1-year increase: OR 1.09, 95% CI: 1.01-1.18, P = 0.027; females: OR 2.25, 95% CI: 1.00-5.06, P = 0.050).

Conclusion: Older age at onset and female sex were predictors of unresolved PVCs in healthy children, highlighting the need for tailored monitoring for these subgroups, despite the generally favorable prognosis of PVCs.

This meta-analysis investigates the efficacy of infliximab in reducing vascular damage, suppressing inflammation, and promoting mucosal healing in patients with immunoglobulin-resistant Kawasaki Disease (KD). A systematic literature search was conducted in line with PRISMA guidelines across databases (e.g., PubMed, Google Scholar) for studies published between, 2003-2023. While high-dose intravenous immunoglobulin remains the standard treatment for KD, a subset of patients exhibit resistance, necessitating alternative therapeutic strategies. Infliximab, a monoclonal antibody that targets tumor necrosis factor-alpha, presents a promising option for these challenging cases. By modulating the immune response and suppressing inflammation, Infliximab has the potential to alleviate vascular damage and enhance mucosal healing in patients unresponsive to conventional treatments. This study specifically focuses on the impact of Infliximab on healing of vascular damage, as indicated by clinical remission, mucosal healing, and changes in absolute neutrophil counts-a key marker of inflammation. Employing a proportional meta-analysis via the 'metafor' function in R, we analyzed data from 857 patients, including 403 events related to mucosal and vascular healing outcomes. Our findings reveal a significant improvement in these healing processes among KD patients treated with Infliximab (Proportion: 0.45, 95% CI: [0.42; 0.48], I² = 87%, p < 0.01), accompanied by a notable reduction in inflammation as evidenced by decreased absolute neutrophil counts (mean difference: 7.67). These results underscore the potential of Infliximab and similar biologic therapies to effectively address the unmet needs of patients with immunoglobulin-resistant KD, offering a viable pathway to mitigate inflammation and enhance mucosal and vascular healing outcomes.

Background: Perinatal asphyxia is one of the leading causes of neonatal morbidity and mortality in the world. While there is much published data on the epidemiology of perinatal asphyxia in African countries, there is a lack of data on this topic in Sudan, which is the third-largest country in Africa. This study aimed to determine the prevalence of perinatal asphyxia and its associated factors among neonates delivered at Saad Abuelela Maternity Hospital, Sudan.

Methods: A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Questionnaires were used to collect maternal sociodemographic, obstetric, and clinical data. The neonates' clinical data (birth weight, sex of newborn, and Apgar score) were also collected and recorded. Multivariate binary analysis was performed.

Results: Six hundred and nineteen mother-neonate pairs were included in the study. The mothers' median (IQR) age and parity was 27.0 (23.0-32.0) years and 3(1-5), respectively. Seventy (11.3%) neonates had perinatal asphyxia. In univariate analysis, the odds of perinatal asphyxia were increased in employed mothers, rural residents, cesarean delivery, preterm infants, and low birth weight neonates. There was no association between age, parity, mother education, mother anemia, sex of the neonates, and perinatal asphyxia. In multivariate analysis, the odds (adjusted) of perinatal asphyxia were increased in cesarean delivery (adjusted odds ratio [aOR] = 2.31, 95.0% CI [confidence interval] = 1.33‒4.02), preterm delivery (AOR = 6.37, 95.0% CI = 2.34‒7.95) and low birth weight (aOR = 2.29, 95.0% CI = 1.26‒4.18).

Conclusion: There was a high prevalence of perinatal asphyxia among newborns delivered at Saad Abuelela Maternity Hospital, Sudan. The factors associated with perinatal asphyxia among neonates were cesarean delivery, low birth weight, and preterm birth.

Background: Poor growth is one of the major obstacles to human development, affecting millions of children under the age of 5 years, particularly those living in low- and middle-income countries (LMICs). The objective of this review was to evaluate the efficacy of administering pre-, pro- or synbiotics on the growth of children aged 0-59 months living in LMICs.

Methods: Google scholar, Pubmed, clinical trial.org and Science Direct databases were searched in April 2023 for randomised controlled trials of pre-, pro- or synbiotics that evaluated growth in under fives in LMICs. The primary outcome were weight and height gain. Secondary outcomes were head circumference, body mass index gain and Z score. Random-effects meta-analysis was used to calculate mean differences for continuous outcomes. Grading of Recommendations Assessment, Development and Evaluation criteria was used to assess certainty of the evidence.

Results: Eight trials involving 1375 children under 5 years of age were identified. Meta-analysis of 6 RCTs (n = 991 children) revealed a significant difference in favor of the experimental group (n = 579) compared the control group (n = 412) for weight gain: (MD = 0.33 kg, 95% CI 0.11 to 0.55); low-certainty evidence. Sub-group analysis revealed that pre-, pro, or synbiotics may be more effective in malnourished that healthy children (p = 0.003). Meta-analysis of height gain for 4 RCTs (n = 845) found that there was no significant difference between the experimental group (n = 496) and the control group (n = 349) (MD = 0.31 cm; 95% CI -0.36 to 0.98); low-certainty evidence. In sub-group analysis, prebiotics had a greater impact on height gain than synbiotics (p = 0.03). In the only study reporting an increase in head circumference (n = 32 children), this was not improved by the administration of synbiotics. However, administration of synbiotics to undernourished children significantly improved BMI gain.

Conclusion: The evidence for the administration of pre-, pro- or synbiotics on the growth of children in LMICs is weak. Administration of pre-, pro- or synbiotics may improve weight gain in both healthy and malnourished children. Prebiotics and synbiotics had a significant effect on weight gain. Further research is needed due to the small number of studies, short duration of administration and small sample size.

Background: Obesity among the young is an emerging health problem with many metabolic changes including liver damage. Our objective was to investigate the association of fatty liver with serum uric acid (UA) and gamma-glutamyltransferase (GGT) in a cohort of obese children in Sri Lanka.

Methods: A cross-sectional analytical study was conducted among 5-15-year-old obese children (based on WHO 2007 standards). After a 12-hour overnight fast, blood was drawn for glucose, lipid profile, alanine aminotransferase (ALT), aspartate aminotransferase (AST), insulin, UA and GGT. Height, weight, waist circumference, blood pressure and fat mass were measured. Ultrasound scan of abdomen was performed to determine fatty liver.

Results: We studied 146 obese children with a mean age (SD) 9.86 (2.1) years. The fatty liver group showed significantly elevated levels (p < 0.05) of UA, oral glucose tolerance test (OGTT), triglycerides (TG), AST, ALT, GGT, insulin resistance (HOMA-IR) and a reduced AST/ALT ratio, compared to the non-fatty liver group. Chi square test showed statistically significant associations between fatty liver and AST, ALT, AST/ALT ratio, HOMA-IR, UA and GGT. With existing cut offs, GGT (> 30 U/L) and UA (> 330 µmol/L) the sensitivity and specificity of GGT in predicting fatty liver was 26.9% and 94.1% respectively while for UA it was 38.5% and 83.8% respectively. A cut-off value of 18.5 U/L (sensitivity 76.9% and specificity 52.9%) for GGT, 277µmol/L (sensitivity 70.5% and specificity 57.4%) for UA, 27.5 U/L (sensitivity 70.5%, specificity 51.5%) for AST, 21.5 U/L (sensitivity 80.8% and specificity 61.8%) for ALT, a ratio of 0.99 (sensitivity 77.9% and specificity 55.1%) for AST/ALT and 2.02 (sensitivity 73.2%, specificity 58.5%) for HOMA-IR predicted fatty liver.

Conclusion: GGT and UA are associated with fatty liver and these biomarkers can be used to predict fatty liver disease.