Question: What is the natural course of viral load in children with coronavirus disease 2019 (COVID-19)? Finding: A significant number of patients still had a relatively high viral load once clinically asymptomatic. Nearly half of the patients experienced viral rebound, which contributed to prolonged viral detection in their respiratory specimens. Meaning: Further studies are needed to determine the clinical significance of viral rebound in asymptomatic or mild pediatric cases of COVID-19. |
Question: Do probiotics reduce colic symptoms? Finding: Probiotics reduced colic symptoms in colicky infants probably due to the anti-inflammatory properties. Meaning: Probiotics may be an effective and less noxious way to manage infantile colic. |
Question: We assessed the spatial modeling of mortality from acute lower respiratory infections in children under 5 years old during 2000–2017 using a global data. Finding: The total number of child deaths during the study period decreased, while the number of hot spots increased among countries. Meaning: Hot spots were concentrated in Asia in 2000 but shifted toward African countries by 2017. A cold spot formed in Europe over the study period. |
Question: Is the incidence of childhood pneumonia influenced by breastfeeding and basic immunization status? Finding: Exclusive breastfeeding and complete basic immunization status have an effect in limiting the incidence of childhood pneumonia. Meaning: While exclusive breastfeeding and complete basic immunization the Expanded Program on Immunization status are important factors for reducing the incidence of childhood pneumonia, indoor air pollution was also a significant risk factor. |
Question: Does a subtle deterioration in cardiac function affect the severity of syncope in patients without underlying disease? Finding: For syncope patients with reasonable cardiac function but without underlying disease, tissue Doppler imaging (TDI) measurements helped reveal subtle differences in cardiac function with syncope and predicted the severity of syncope or a potential recurrent event. Meaning: TDI measurements might be a useful indicator for predicting the severity of syncope. |
Is the global prevalence of toxocariasis high among children? The prevalence of toxocariasis is high in pediatric patients. Asian children are more susceptible to the disease than other children. Its virulence varies among different socioeconomic classes in various countries. Hand washing after soil contact, routine pet deworming, and appropriate disposal of pet feces in households with Asian pediatrics are needed to prevent toxocariasis. |
• The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) and remains conflicting. • We showed based on odds ratio reports in epidemiological studies that SGA can increase the risk of ASD and SGA is a risk factor for ASD. • The association between SGA and the risk of ASD has further momentum to the current public health emphasis on appropriate prepregnancy weight and weight gain during pregnancy |
Question: What are the clinical spectrum, course, and short-term outcomes of multisystem inflammatory syndrome in children (MIS-C)? Finding: MIS-C can have variable clinical manifestations. Fever is most common, followed by gastrointestinal and cardiovascular symptoms. Early identification and appropriate management lead to favorable outcomes. Meaning: MIS-C can present in a myriad of ways and severities. High suspicion is necessary to ensure its early identification and appropriate management and favorable patient outcomes. |
Question: Is there a quantitative relationship between air pollutant emissions and the incidence of type 1 diabetes (T1D)? Finding: The incidence of T1D in each region of the Russian Federation correlated with the total air pollutants emitted each year. Meaning: These findings suggest that air pollution contributes to the development of T1D. |
· This meta-analysis pooled all observational (case-control and cohort) studies to obtain the association between labor induction and the risk of attention-deficit/hyperactivity disorder (ADHD) among children. · The findings showed that labor induction is not associated with increased risk of ADHD among children. |
This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data. |
Question: Is malnutrition a risk factor for postoperative complications in pediatric surgical patients? Finding: There is a high incidence of malnutrition in pediatric surgical patients. Stunting increases the risks of postoperative complications and extended hospital stays, while underweight status contributes to extended hospital stays. Meaning: Preoperative nutritional assessments are crucial to improving postoperative outcomes. Anemia increases the risk of postoperative complications and should be corrected preoperatively. |
Question: How can we further improve the neuroprotective effects of hypothermia in newborns with hypoxic-ischemic (HI) brain injury? Finding: Combination carnosine and hypothermia therapy effectively reduced brain damage in neonatal rats. The in situ zymography, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunofluorescence study results showed that neuroprotective effects were achieved with combination therapy only. Meaning: Carnosine and hypothermia have synergistic neuroprotective effects against brain damage following HI injury |
The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran. |
Question: Is age at the time of complementary food introduction associated with asthma and atopic dermatitis (AD) in early childhood? Finding: We found no significant association between age at the time of complementary food introduction and the incidence of AD and asthma in Koreans aged 1–3 years. Meaning: Our findings suggest that the influence of individual allergenic foods on the development of AD and asthma should be clarified. |
Question: What are the differences between coronavirus disease 2019 (COVID-19) and influenza infections in children? Finding: Pediatric COVID-19 patients predominantly exhibited respiratory and/or gastrointestinal symptoms, neurological manifestations, olfactory/gustatory dysfunction, elevated monocytes, mildly elevated C-reactive protein, and unilateral or diffuse abnormalities on chest x-ray. Patients with underlying medical conditions had higher intensive care unit admission rates and should be followed closely. Meaning: The clinical presentations of pediatric COVID-19 patients varied from asymptomatic/mild to severe. |
Question: Is it possible to classify nephrotic syndrome (NS) through gene expression profiling of podocytes exposed to NS plasma? Finding: Our data showed different expression profiles in podocytes exposed to nephrotic plasma from different clinical groups, suggesting the molecular stratification of patients into intrinsic subtypes. Meaning: Transcriptome profiling of podocytes treated with NS plasma can stratify patients into intrinsic subtypes and provide insight into the molecular mechanisms of podocyte injury. |
Question: Reliably diagnosing urinary tract infection (UTI) in febrile children is often difficult. Can urinary neutrophil gelatinase-associated lipocalin (uNGAL) better predict UTI and acute pyelonephritis (APN) than serum C-reactive protein (CRP) and white blood cell (WBC) count? Finding: uNGAL better facilitated the prediction of UTI and APN, than serum CRP and WBC counts in febrile children. Meaning: uNGAL is a suitable biomarker for UTI and APN in febrile children. |
• Meconium exposure is weakly associated with an increased risk of autism spectrum disorder (ASD) development in children. • More evidence based on large prospective cohort studies is required to conclude whether meconium exposure is associated with an increased risk of ASD. |
Question: What are the prevalence and clinical characteristics of celiac disease (CD) in children in Bahrain? Finding: We found a significant increase in CD prevalence over the last decade (P=0.0001). A male predominance was noted. Atypical presentations were common. Most patients had poor adherence to a gluten-free diet. Meaning: CD is an underdiagnosed condition. Atypical symptoms should be considered to prevent missing patients with CD. |
Question: How has the antibiotic susceptibility of urinary pathogens changed and what does it imply? Finding: A yearly increase in multidrug-resistant and extended-spectrum β-lactamase (ESBL)–producing pathogens was observed. A higher recurrence rate was observed in cases of febrile urinary tract infection caused by ESBL producers in patients with underlying vesicoureteral reflux (VUR). Meaning: The initial empirical antibiotic should reflect the changing susceptibility patterns and underlying VUR status. |
· This meta-analysis analyzed the association between pesticide and polychlorinated biphenyl (PCB) exposure during pregnancy and autism spectrum disorders (ASD) risk among children. · A significant association was noted between PCB and pesticide exposure during pregnancy and ASD risk among children (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.26–2.34 and OR, 1.20; 95% CI, 1.02–1.39), respectively. · Pesticide and PCB exposure during pregnancy may affect ASD risk among children. |
Question: Is there any risk of vertical transmission of coronavirus disease 2019 (COVID-19), and what is its neonatal profile? Finding: Biological samples for vertical transmission were negative in all deliveries; however, 2 neonates tested positive for nasopharyngeal COVID-19 reverse transcription-polymerase chain reaction. No significant neonatal morbidity was observed. Meaning: COVID-19 does not increase adverse neonatal outcomes and shows a negligible risk of vertical transmission; however, horizontal transmission cannot be underestimated. |
Question: What factors are associated with bronchial hyperresponsiveness (BHR) in adolescents with childhood asthma? Finding: Age, mold sensitization, and increased eosinophil count were associated with BHR in boys versus a reduced forced expiratory volume in 1 second/forced vital capacity ratio in girls. Early mold sensitization was a risk factor for persistent BHR in boys only. Meaning: Sex-specific differences were observed in the factors associated with BHR in adolescents. |
Question: What is the most important factor that increases mortality in infants with hypoxic-ischemic encephalopathy (HIE) who receive selective head cooling? Finding: All cases of neonatal mortality were severe HIE (stage 3), and a severely abnormal amplitude-integrated electroencephalography and mortality were increased with the need for advanced neonatal resuscitation upon delivery. Meaning: Advanced neonatal resuscitation affects HIE outcomes, and medical personnel should be prepared to provide the best intervention. |
· Mortality is decreased significantly in meta-analysis of studies in different regimen of fluconazole prophylaxis. · Significant decrease was seen in incidence of invasive candidiasis-associated mortality in extremely low birth weight infants in same schedules of prophylaxis. · More studies required to relief the concerns. |
Question: Does a tethered maxillary frenulum in the newborn result in breastfeeding difficulty or other oral symptomatology? Finding: The analysis of subjects with a tethered maxillary frenulum surveyed beyond a mean 5-year follow-up did not reveal an increase in oral issues versus those of a random agematched control group. Meaning: These data demonstrate no need to intervene upon the diagnosis of a tethered maxillary frenulum. |
Question: Can central line bundles and feedback reduce central line-associated complications in pediatric patients? Finding: The central line-related bloodstream infection rate decreased from 10.0 catheter-days to 1.4/1,000 catheter-days at 6-month postintervention. The central line occlusion rate was also decreased. Meaning: Reinforcing central line care bundles with direct feedback can significantly decrease central line-associated complications in pediatric patients. |
Question: Over the past 21 years, has the prevalence of anemia decreased among Korean adolescents? Finding: The prevalence of anemia in boys aged 10–18 years decreased from 3.0% to 0.5% over the study period, whereas that in girls did not change significantly over time (increased from 7.9% to 8.5%). Meaning: The prevalence of anemia in female adolescents remains high, requiring attention and efforts to improve it. |
Question: What is the value of the diagnostic code in identifying cases of biliary atresia in a large administrative database? Finding: The diagnostic code’s accuracy and sensitivity are acceptable for identifying algorithm-defined cases. A history of pale stool and a presumed diagnosis of biliary atresia prior to referral added value. Meaning: The addition of clinical data to the diagnostic code significantly increased the diagnostic yield. |