Most-cited articles are from the articles published during the last two years (2022 ~ ).
· Diverse clinicoradiological features of central nervous system (CNS) complications in rotavirus infection can be identified with the rapid and wide use of various brain magnetic resonance imaging protocols. · An increased understanding of the various pathophysiological mechanisms of rotavirus-induced CNS manifestations will enable precise management in the future. |
· Sensitivity to endocrine-disrupting chemical (EDC) exposure increases during critical developmental periods (in embryos, fetuses, and neonates). · Pre- and postnatal exposure to EDCs is associated with fetal growth restriction, preterm birth, and low birth weight. · Exposure to EDCs during fetal and early postnatal life can have lasting and lifelong neurodevelopmental outcomes, including autism spectrum, attention deficit hyperactivity, and other cognitive and behavioral disorders. |
· The guidelines may not work in the real world. · An action-plan reflecting patient’s severity and variable of symptoms, values and preferences as well as the benefits and harms of treatment, may be a useful alternative. · The action plan and as-needed therapy must include the following elements: when, what, how, and why. · Action plan and as-needed therapy can help patients manage their symptoms more effectively. |
Questions: Can the serum levels of kisspeptin and DLK1 be potential biomarkers for monitoring the treatments for central precocious puberty (CPP)? Findings: There were no significant differences in the baseline serum kisspeptin and DLK1 levels in CPP girls compared to girls with premature thelarche (PT). After 6 months of GnRH analogue treatment in CPP girls, median serum kisspeptin levels decreased, while median serum DLK1 levels increased compared to baseline. Meanings: Serum levels of kisspeptin and DLK1 may serve as novel biomarkers for monitoring the efficacy of treatments for CPP. |
· The infant gut microbiome is highly dynamic and individualized. · Microbes are vertically transmitted from mother to infant during delivery and throughout infancy. · Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function. · In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems. · Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality. |
Question: Is bronchopulmonary dysplasia (BPD) associated with functional/structural abnormalities later in life? Finding: School-aged children with severe BPD had abnormalities on pulmonary function tests and lung computed tomography despite no subjective respiratory symptoms; however, only prenatal oligohydramnios and prolonged ventilator use were associated with abnormal lung function. Meaning: Long-term monitoring of preterm infants’ lung health is essential, especially for those with prenatal oligohydramnios or prolonged ventilator use. |
Question: Did coronavirus disease 2019 (COVID-19) affect the frequency, seasonal variation, or virus type of benign convulsions with mild gastroenteritis (CwG)? Findings: We compared 41 cases of CwG before and during the COVID-19 pandemic. After March 2020, frequency did not change significantly (18 patients vs. 23 patients), seasonal variation was lost, and number of cases of enteric adenovirus-associated CwG increased (1 cases vs. 7 cases). Meaning: The COVID-19 pandemic affected CwG. |
MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression post transcriptionally, and MiRNA expression levels vary with developmental stages. MiRNAs play an important role in several biological processes in children, including growth, neuro-development, inflammation, and tumor formation. Research on miRNAs may uncover the molecular mechanisms underlying various pediatric diseases, leading to the development of novel biomarkers that aid in the diagnosis, treatment, and prognosis of these diseases. |
· With the increase in childhood obesity, nonalcoholic fatty liver disease (NAFLD) has become a concern in recent years. · NAFLD is strongly associated with insulin resistance. · Lifestyle modifications are the mainstay treatment for NAFLD. |
· Clinical studies of coronavirus disease 2019 (COVID-19) in infants should be supported by rigorous laboratory diagnostic criteria. · Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads to infants similarly to other viral respiratory infections. · Among infants ≤1 year of age beyond the immediate postpartum period, COVID-19 is relatively mild, but even the low risk of severe disease requires prevention. · Comorbidities increase infection vulnerability and complications in infants. · Clinical and laboratory data do not sufficiently distinguish COVID-19 from other respiratory viral infections. · Coinfection with SARS-CoV-2 is uncommon among infants. · Unique infection sequelae, including multi-inflammatory syndrome in children and neonates and long COVID require further study and refinement of diagnostic criteria. · Infection control standards applied to mother-infant dyads should be tempered by standard preventive strategies, maternal input, accommodation potential, and overall safety. · Maternal vaccination prevents disease in early infancy. |
Question: What is the prevalence of insulin resistance (IR) in excess-weight Latin children, and can proinflammatory biomarkers predict it? Finding: IR prevalence was elevated and tumor necrosis factor- α, interleukin-6, monocyte chemoattractant protein- 1, soluble CD40 ligand, and high-sensitivity C-reactive protein levels were increased in excess-weight Latin children. However, none predicted IR status. Meaning: These inflammatory biomarkers were unable to predict IR status. Therefore, further investigations are necessary. |
Question: What is the ideal initiation timing of parenteral nutrition for critically ill children? Finding: This randomized clinical trial of 140 children examined the effects of an early or late start of parenteral nutrition on mechanical ventilation need (primary outcome) and length of stay and mortality (secondary outcomes). Meaning: Children who received early versus late parenteral nutrition had lower mechanical ventilation need and duration. |
Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy? Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis. Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required. |
High-resolution esophageal manometry can be safely performed in children where recurrent vomiting and persistent dysphagia is the working diagnosis after excluding nonluminal and structural obstructive pathologies using pediatric upper gastrointestinal endoscopy. Normal manometry values are available. Clinical picture, biochemical tests, radiological interpretation, and endoscopic findings with manometry completes the analysis of patients with recurrent vomiting and dysphagia. |
The number of studies on ferritin predictive ability in pediatric critical illness has grown exponentially over the past 2 decades. However, among the 66 of 1,580 studies analyzed here, summary statistics for overall and condition-specific studies were only reported in 45.4% and 71.2%, respectively. In contrast, ferritin as a categorical variable with a preset threshold was a significant predictor in 84.6% of studies. |
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking. |
· Although the basic concept of hemodialysis (HD) is similar in adults and children, specific factors must be considered in the latter, including the small dialyzer and circuit, difficult vascular access, and frequent complications. · HD-associated complications include catheter-related problems, hemodynamic instability, and neurodevelopmental and cognitive dysfunction. · Pediatric HD is challenging, and steady efforts are needed to perform it safely and reduce its complications, thereby improving clinical outcomes. |
Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children. Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I2=61.7%). Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children. |
This systematic review summarizes convincing evidence that total energy expenditure (TEE) measured using the doubly labeled water technique increased with age from 1 to 18 years, while fat-free mass (FFM) increased with growth. TEE and in normal-weight participants, while physical activity level did not differ from that of normal-weight participants. |
Question: This is the first meta-analysis to examine published evidence of the effectiveness of virtual reality at reducing pain during pediatric intravenous injections. Finding: Our results suggest that virtual reality effectively reduces pain associated with intravenous injections in pediatric patients. Meaning: These findings suggest the importance of virtual reality in decreasing the pain of intravenous injections among children. |
Question: What are the risk factors for prolonged diarrhea in children under 2 years old? Finding: History of antibiotic use, zinc deficiency, and elevated fecal alpha-1 antitrypsin levels were the main risk factors of prolonged diarrhea in children under 2 years old with acute diarrhea. Meaning: Rational antibiotic usage is necessary as well as thorough testing of serum zinc level and fecal alpha-1 antitrypsin levels. |
· Spontaneous movements can be useful to evaluate neuronal integrity in preterm infants. · In General Movements Assessment, continuous cramped synchronized movements and absent fidgety movements can indicate high-risk infants for cerebral palsy. · Recent advances in machine learning techniques have led to the automated prediction of cerebral palsy based on infantile spontaneous movements. |
Question: The inferior vena cava to aorta (IVC/Ao) ratio measured via ultrasound has been touted as a promising noninvasive technique to assess clinically significant dehydration in pediatric patients. Finding: Our meta-analysis found that IVC/Ao ratio had a positive likelihood ratio of 3.2 (95% confidence interval [CI], 2.1–5.1) and negative likelihood ratio of 0.18 (95% CI, 0.12–0.28). Meaning: Hence, IVC/Ao ratio is insufficient to exclude or confirm significant dehydration in pediatric patients. |
· Enhanced safety monitoring system of coronavirus disease 2019 (COVID-19) vaccines were implemented to detect signals rapidly as part of the national COVID-19 vaccination program. · As of June 4, 2023, reported adverse events after COVID-19 vaccination was 0.38% among 125,107,883 doses of COVID- 19 vaccines administered. · Most reported adverse reactions after COVID-19 vaccinations have shown nonserious and mild intensity. |
Several observational studies have shown that acute kidney injury affects up to 46% of children and adolescents who develop severe postinflammatory responses, such as multisystem inflammatory syndrome in childhood, due to coronavirus disease 2019 (COVID-19). Although causality has not been established, some cases of glomerulopathy or nephrotic syndrome occurring after COVID-19 infection or vaccination have been reported. Therefore, kidney complications associated with these conditions in children and adolescents warrant attention. |
· Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children · Factors other than etiology are equally important to a compre hensive understanding of CAP · Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification |
In children with primary dyslipidemia, functional myocardial abnormalities can occur at young age, including diastolic functional impairment of both ventricles and narrowing of the aortic valve and the sinus of Valsalva. Echocardiographic evaluations of high-risk children may be as important as biochemical evaluations. |