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Background: Liposomal iron, a novel oral formulation of ferric pyrophosphate that demonstrates improved gastrointestinal absorption and bioavailability with fewer side effects than conventional iron, represents a significant advancement in the treatment of iron-deficiency anemia (IDA).
Purpose: To conduct an in-depth comparative study of liposomal SunActive and conventional iron supplements (iron polymaltose complex) for treating IDA in children aged 2–12 years Methods: This... |
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Question: Could hematopoietic stem cell transplantation (HSCT) be an alternative to enzyme replacement therapy (ERT) for type VI mucopolysaccharidosis (MPS VI)? Finding: HSCT is generally not offered due to reports of high toxicity and mortality. However, we detected fewer complications and graft-versus-host disease cases and no deaths with HSCT. Meaning: HSCT is both less expensive than ERT and permanent; thus, it should be considered an alternative treatment for MPS VI. |
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CO2 insufflation has been used instead of air insufflation to reduce postprocedure pain and discomfort in adults; however, adequately powered studies in children are scarce. This randomized controlled trial of 200 children showed that CO2 insufflation reduces postprocedure pain and discomfort during pediatric colonoscopy with no signs of CO2 retention. CO2 insufflation is safe and causes less pain in children. |
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Functional gastrointestinal disorders (FGIDs) are associated with various somatic symptoms measured using a visual analogue scale and the Children’s Somatic Symptoms Inventory-24 questionnaire. Children with FGIDs exhibited more significant somatic symptoms than controls during acute illnesses. Gastrointestinal (GI) and non-GI manifestations are significantly more common in children with FGIDs. |
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Question: Are serum amyloid A (SAA) and proadrenomedullin (proADM) levels early markers in critically ill children with sepsis? Finding: This prospective case-control study included 65 critically ill children with sepsis admitted to the pediatric intensive care unit and 31 controls. SAA and proADM levels were significantly higher in patients versus controls. Meaning: SAA and proADM are promising biomarkers for diagnosing and predicting outcomes in pediatric sepsis. |
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Question: What can be used to create a reliable supply of somatic cells for induced pluripotent stem cells (iPSCs) generation and standardize procedures for building an iPSC bank for researching pediatric neurogenetic disorders? Findings: Noninvasively acquired urine cells are a desirable cell source for iPSC reprogramming. Meaning: An iPSC bank can be created from diverse patient cell sources and offer a useful resource for translating research results into clinical therapy for pediatric neurogenetic disorders. |
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Question: What are the outcomes of jaundiced neonates when phototherapy is discontinued at 2 different total serum bilirubin (TSB) thresholds? Findings: The study involved 80 neonates, comparing a recommended TSB threshold and a lower threshold for phototherapy discontinuation. Results showed a 14.3% reinstitution rate of treatment, with no adverse outcomes. Meaning: Careful posttreatment monitoring is essential when discontinuing phototherapy, and future research should consider updated guidelines like those from the American Academy of Pediatrics. |
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Question: What is the burden of neural tube defects (NTDs) in a tertiary care neonatal intensive care unit in Bangladesh? Finding: The overall incidence of NTD was 6.4 (range, 4.59–11.2) per 1,000 live births, and the meningomyelocele complex was the most frequent location. Meaning: The high incidence of NTD found in a leading tertiary care multidisciplinary referral hospital in Bangladesh may not reflect that of the wider population. |
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Question: Can pediatric autoimmune hemolytic anemia (AIHA) be effectively managed using first-line steroids? Finding: In this single-center study, pediatric patients with AIHA achieved normal hemoglobin levels within 16.5 days (range, 9.0–22.0 days) of first-line steroid treatment and maintained effective responses for 2 months. Meaning: These outcomes highlight the efficacy of steroid treatment in pediatric versus adult AIHA and underscore the need for multicenter trials to establish standardized treatment guidelines. |
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Question: Is it role of microRNA-410 (miRNA-410) and microRNA-498 (miRNA-498) in neonatal hypoxic-ischemic encephalopathy (HIE)? Findings: miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE. Meaning: we can use miRNA-498 and miRNA-410 as markers and indicator for HIE. |
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Question: Does the gut microbiota differ between very low birth weight (VLBW) infants with versus without bronchopulmonary dysplasia (BPD)? Finding: Common respiratory pathogens were notably elevated in the BPD group, whereas anaerobic and butyrate-producing taxa, key components of postbiotics, were dominant in the non-BPD group. Meaning: In gut-lung communication, the interplay between the intestinal and respiratory systems may implicate pro- and postbiotics in VLBW infants with BPD. |
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Question: Postinfectious bronchiolitis obliterans (PIBO) is a chronic respiratory disease that typically develops in children after a severe respiratory infection. Bronchopulmonary dysplasia (BPD) is often comorbid in patients with PIBO. Finding: Corticosteroid pulse therapy effectively manages PIBO with or without comorbid BPD, significantly reducing exacerbations and decreasing the daily requirement for inhaled corticosteroids. Meaning: Therapeutic effects of corticosteroid pulses are rapid and sustained over time, in both groups. |
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Question: Is there a nonlinear relationship between neutrophil-to-lymphocyte ratio (NLR) and asthma in children and adolescents? Finding: NLR showed a nonlinear association with asthma, with an NLR threshold of 2.23 identifying individuals at higher risk. Meaning: An NLR<2.23 may serve as a potential biomarker for asthma risk assessment and management in pediatric populations, thereby offering a simple tool for the early identification of at-risk individuals. |
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Question: Can adrenomedullin (ADM) or interleukin-6 (IL-6) detect late-onset neonatal sepsis (LOS) at admission (area under the curve [AUC]>0.90) as an early diagnostic marker? Finding: Only IL-6 consistently distinguished survivors from nonsurvivors (AUC>0.90) on admission and antibiotic treatment days 3 and 7. C-reactive protein level identified infections from day 3 but failed to predict outcomes (AUC<0.70). Meaning: IL-6 level can improve LOS diagnosis and prognosis. |
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Question: What is the acceptance rate for coronavirus disease 2019 vaccination among parents of children with systemic lupus erythematosus (SLE)? Finding: One-third of parents were hesitant to vaccinate their child. Parental willingness to vaccinate themselves, older patient age, and belief in the vaccine's potency were associated with vaccine acceptance. Meaning: These findings highlight the need for targeted interventions to improve vaccine acceptance among parents of children with SLE. |
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· Infection remains a leading cause of death in febrile neutropenia (FN). · Mid-regional pro-adrenomedullin (MR-ProADM) levels are higher among patients with FN and a bacterial infection. · A longer FN duration and hospital stay length as well as elevated C-reactive protein, procalcitonin, and MR-ProADM levels are significant risk factors for mortality. |
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Question: Does the T allele of Xmn1 polymorphism favorably influence hydroxyurea efficacy in children of Eastern descent with fetal hemoglobin (HbE)-β nontransfusion dependent thalassemia (NTDT)? Finding: Decrease in transfusion requirement and increase in height following hydroxyurea therapy was noted in both groups, however, change in CT was more critical than that in CC genotype. Meaning: T allele of Xmn1 polymorphism favorably influences hydroxyurea efficacy in children with HbE-β NTDT. |
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Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes. |
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Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible? Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected. Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea. |
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Question: How do dietary intake and physical activity affect body mass index (BMI) z scores and adiposity among children with obesity? Finding: Higher dietary protein and fiber intakes were significantly associated with a decrease in BMI z scores and adiposity among children with obesity. Meaning: Optimizing dietary interventions by focusing on protein and fiber intakes could be an effective strategy for managing childhood obesity. |
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Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics? Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative. Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations. |
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Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations? Finding: 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 such changes. Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function. |
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Question: What are the clinicopathological features and outcomes of pediatric C3 glomerulopathy (C3G) in resource-limited settings? Finding: Children with C3G in resource-limited settings have significant morbidities, and most experience kidney sequelae despite treatment. Electron microscopy was performed in only 50% of our patients, while none received complement assays or genetic testing. Meaning: Pediatric C3G presentation, management, and kidney outcomes vary. Its thorough evaluation and management are challenging in resource-limited settings. |
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Question: What is the occurrence of pediatric stroke in Indonesia? Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%). Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims. |
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Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function? Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk. Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal. |
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Question: Short-term (1-year) follow-up data in pediatric patients with inflammatory bowel disease (IBD), especially in Southeast Asian countries, are limited. Finding/Meaning: Abdominal pain and pallor rates remained high at 1 year after IBD diagnosis. Three independent factors of 1-year clinical remission for Crohn disease were oral prednisolone, antibiotic, and immunomodulator use at 1-year follow-up. A history of weight loss at diagnosis was the only independent risk factor of IBD flare. |
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Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population? Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change. Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development. |
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Question: Do community members and health providers show different level of knowledge, attitude, and practice towards dengue vaccine? Finding: These 2 groups only differed in practice component, while the knowledge and attitude constituents were relatively low for both. Meaning: There is an urgent need to deliver educational interventions to raise awareness of community members and health providers regarding dengue vaccination. |
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Question: Can sigh breaths (Sighs) application during high-frequency oscillatory ventilation (HFOV) decrease partial pressure of carbon dioxide (PaCO2) levels? Finding: The mean PaCO2 level after Sighs during HFOV was significantly decreased compared to that after HFOV alone (mean difference, -3.6 mmHg). Meaning: HFOV plus Sighs functionality can reduce PaCO2 levels. However, further studies are required to conclusively determine the effects of Sighs. |
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Question: What are common tantrum behaviors in preschool children, and how frequently are problematic behaviors observed? Do problematic tantrums have a different emotional impact on caregivers compared to typical tantrums? Finding: Temper tantrums are common in preschool children, and verbal tantrums are the most common type. Meaning: Problematic tantrums, defined as tantrums exhibiting aggressive physical behavior, long duration (>15 minutes), or frequent occurrence (>3 days/wk), significantly affected caregivers’ emotions. |
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