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Articles in E-pub version are posted online ahead of regular printed publication.

Editorial
Tocilizumab as a key therapeutic option in high-risk pediatric acute necrotizing encephalopathy
Jon Soo Kim
· Acute necrotizing encephalopathy (ANE) is a severe, infection- triggered encephalitis driven primarily by cytokine- mediated immune dysregulation rather than direct viral cytotoxicity.
· Tocilizumab, through targeted inhibition of interleukin-6 signaling, is an important therapeutic option for ANE that may improve survival and neurological outcomes of high-risk pediatric patients.
DOI: https://doi.org/10.3345/cep.2026.00073    [Epub ahead of print]
Review Article
Systematic review of influence of ethnicity on efficacy and safety of pharmacotherapy for childhood and adolescent obesity
Surendra Gupta, Purushottam Lal, Abhishek Gupta, Brajesh Raj Chaudhary
Ethnic variations may influence the response of children and adolescents to obesity pharmacotherapy. Current evidence does not show consistent differences in efficacy or safety among ethnic groups; however, available data are limited. Larger, ethnically diverse trials are needed to develop personalized obesity treatment strategies.
DOI: https://doi.org/10.3345/cep.2025.02838    [Epub ahead of print]
Clinical note
Happle-Tinschert syndrome in an infant: clinical, radiologic and genetic correlation
Belén Rodríguez-Sanchez, Francisco Javier Narbona-Cárceles, Jorge Martín-Nieto-González, Marina de la Puente-Alonso, Luis Zamarro-Díaz, Luis iménez-Briones, Julia Suárez-González, Francisco Arias-Lotto, Minia Campos-Domínguez
DOI: https://doi.org/10.3345/cep.2025.02614    [Epub ahead of print]
Original Article
Progression from acute to chronic pancreatitis in children: a systematic review and meta-analysis
Endre Botond Gagyi, Mahmoud Obeidat, Edina Tari, Szilárd Váncsa, Dániel Sándor Veres, Peter Banovcin, Péter Jenő Hegyi, Péter Hegyi, Bálint Erőss
Approximately 1 in 5 children with acute pancreatitis develops recurrent attacks, and over one-third of such cases progress to chronic pancreatitis. Progression is closely linked to genetic mutations, particularly PRSS1, and anatomical abnormalities, whereas demographic and routine clinical factors lack predictive value. These results support early genetic and anatomical assessments, enabling targeted follow-ups and timely interventions in highrisk pediatric patients.
DOI: https://doi.org/10.3345/cep.2025.01879    [Epub ahead of print]
Review Article
Sacral dimple: clinical perspectives of lesions hidden beneath the skin
Jin Eun, Kwan Sung Lee, Seung Ho Yang
· Most sacral dimples are benign, but atypical features may indicate occult spinal dysraphism.
· Simple dimples meeting strict criteria require no imaging, whereas atypical dimples require targeted ultrasonography or magnetic resonance imaging.
· The early diagnosis and surgical management of highrisk cases prevents irreversible neurological, orthopedic, and urological deficits.
DOI: https://doi.org/10.3345/cep.2025.01802    [Epub ahead of print]
Original Article
Global and regional burden of neonatal disorders (preterm birth, encephalopathy, jaundice, and sepsis), 1990–2021 and projections to 2050
Yuseon Kang, Jeongseon Oh, Dongjin Yeo, Jaeyu Park, Sooji Lee, Na Yun Kim, Jungmin Park, Seung Ha Hwang, Tae Hyeong Kim, Dong Keon Yon
This study provides the first comprehensive estimated global burden of neonatal disorders attributable to risk factors in 1990–2021 stratified by sex, cause, sociodemographic index (SDI), and region. We identified persistent disparities across SDI levels, with low birthweight and short gestation contributing most to the age-standardized disability-adjusted life year rate of neonatal disorders. These findings highlight the urgent need for targeted context-specific interventions to reduce infant mortality and improve neonatal health equity.
DOI: https://doi.org/10.3345/cep.2025.01480    [Epub ahead of print]
Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial
Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium
Question: Can probiotic BLa80 bring long-term benefits to the health of young children?
Finding: This trial demonstrated that the daily administration of s BLa80 at 5×109 colony-forming units for 3 months in children can reduce the risk of eczema, upper respiratory tract infections, and acute tracheitis/bronchitis as well as beneficially improve the gut microbiome without any adverse effect.
Meaning: Bla80 can bring definite health benefits to young children.
DOI: https://doi.org/10.3345/cep.2025.01256    [Epub ahead of print]
Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices
Nuanpan Penboon, Pornpimol Rianthavorn
Question: In children with proliferative lupus nephritis, do National Institutes of Health-modified indices and treatment choices predict long-term kidney function?
Finding: Higher chronicity index scores, especially tubular atrophy and interstitial fibrosis, predicted kidney impairment. Additionally, the use of mycophenolate mofetil (MMF) for maintenance therapy was associated with a lower risk of kidney function decline.
Meaning: The early recognition of chronic lesions and MMF-based maintenance therapy may improve kidney outcomes in childhood-onset lupus nephritis.
DOI: https://doi.org/10.3345/cep.2025.01277    [Epub ahead of print]
Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units
Aristóteles de Almeida Pires, Luciano Remião Guerra, João Ronaldo Mafalda Krauzer, Luciane Gomes da Cunha, Mariana Motta Dias da Silva, Vanessa Cristina Jacovas, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Paulo Márcio Pitrez, Felipe Cezar Cabral
Question: Telemedicine interventions in Brazilian public pediatric intensive care units effectively address the challenges related to specialized care provision in resource-limited settings.
Finding: The implementation of telemedicine significantly reduced overall mortality rates among mechanically ventilated children (from 20.7% to 10.4%) and increased ventilator-free days from 3 (interquartile range, 0–7) to 4 (interquartile range, 2–8) days.
Meaning: These findings support telemedicine as a viable strategy for enhancing pediatric critical care in public health systems, particularly by improving patient outcomes.
DOI: https://doi.org/10.3345/cep.2025.01270    [Epub ahead of print]
Associations of routine breakfast and napping habits with early adiposity rebound by age 3 years: a population-based cohort study in Japan
Toshifumi Yodoshi
In a population‑based cohort of 74,466 children, 25% experienced early adiposity rebound (AR) by age 3. Daily breakfast and routine napping at 1.5 years were independently associated with lower odds of AR, while obesity at 1.5 years was a strong predictor. These modifiable routines could help delay AR and enable early identification during routine child health checks.
DOI: https://doi.org/10.3345/cep.2025.01998    [Epub ahead of print]


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