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Question: How is arterial blood pressure related to cerebral oxygenation during the immediate postnatal transition in neonates? Finding: Among preterm infants requiring respiratory support, cerebral oxygenation was associated with diastolic and mean arterial pressures, indicating passive pressure perfusion. Meaning: Compromised preterm infants are vulnerable to impaired autoregulation with cerebral oxygenation fluctuations, highlighting the need for hemodynamic and cerebral monitoring plus routine monitoring of arterial oxygen saturation and heart rate. |
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Question: Does atrial septal defect (ASD) physiology affect postrepair mitral valve growth in patients with coarctation of the aorta or an interrupted aortic arch? Finding: Mitral valve growth occurred after biventricular repair but not single-ventricle palliation, particularly in patients with small valves and low ASD pressure gradients. Meaning: The ASD pressure gradient determines mitral valve growth and should guide surgical strategies in patients with borderline hypoplastic left heart syndrome. |
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Question: Does granulocyte transfusion improve survival and clinical recovery in pediatric febrile neutropenia? Finding: In this 15-year real-world cohort, granulocyte transfusion significantly increased 30-day survival (92.3 % vs. 65.4%; adjusted odds ratio, 0.105; P=0.020) and accelerated fever and neutrophil recovery without serious adverse events. Meaning: Granulocyte transfusion may be an effective adjunctive therapy for severe neutropenic infections in children, particularly in low- and middle-income settings. |
| Compared to PCV13, PCV15 includes 2 (22F and 33F), and PCV20 includes 7 (8, 10A, 11A, 12F, 15B, 22F, and 33F) additional serotypes. The vaccination schedule remains the same: primary doses at 2, 4, and 6 months, and a booster at 12–15 months. If PCV13 was administered in the primary series, PCV15 and PCV20 may be used to complete it or as a booster. |
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Question: What perinatal factors influence patent ductus arteriosus (PDA) in and improve outcomes of preterm infants? Finding: Lower birth weight, frequent surfactant treatment, and maternal hypertension increased hemodynamically significant PDA risk in very low birth weight infants, whereas chorioamnionitis and premature rupture of membranes protected against it. A lower birth weight and incomplete antenatal steroid use increased the risk of surgical ligation, whereas small for gestational age reduced it. Meaning: Recognizing these factors may enable early, targeted intervention and reduce the need for surgical management. |
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Question: Is prolonged monitoring of regional cerebral oxygen saturation (rcSO2) and hemodynamic parameters a feasible approach? Can these measures predict the neurological outcomes in extremely preterm infants? Finding: We used a neurocritical care bundle from birth to discharge or term-equivalent age. Infants with poor outcomes had significantly lower rcSO2 values. Meaning: Understanding rcSO2 and hemodynamic parameters may help manage cerebral hypoxia and reduce neurological complications in extremely preterm infants. |
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Question: What are the characteristics and clinical implications of thrombocytopenia in preterm neonates born to mothers with systemic lupus erythematosus? Finding: Nearly one-third of preterm infants developed thrombocytopenia. Key modulators of this risk included gestational age, maternal hypertensive disorders of pregnancy, and hydroxychloroquine use. Thrombocytopenia may be associated with neonatal morbidity. Meaning: Platelet count should be monitored during the first week of life, and infants should be assessed for potential complications. |
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Question: How does obesity severity affect baseline fitness and improvements in key obesity-related measures following participation in a structured lifestyle modification program? Finding: Severely obese youth showed poorer baseline physical fitness but greater improvements in key obesity-related measures following lifestyle interventions. Meaning: Early targeted intervention may help prevent progression to more severe obesity and declines in physical fitness in patients with obesity. |
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Sleep disorders affect more than half of pregnancies worldwide and can harm maternal health and offspring outcomes. Prioritizing maternal sleep as a public health strategy may help prevent prenatal and pediatric allergic diseases and reduce their burden. Other maternal health strategies may also reduce the burden of offspring allergic diseases, while adequate maternal sleep is associated with other offspring outcomes, underscoring its importance as a key public health strategy. |
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The pubertal induction process in males still poses a challenge for pediatric endocrinologists. The existing literature is limited, and it is not yet possible to make definitive recommendations. We described the various treatment for this condition and tried to analyze the unresolved questions to address the question posed in the title of our manuscript. |
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Question: Do gut microbiota differ between patients with Hirschsprung disease (HSCR) and healthy children, and can specific bacterial taxa predict postoperative HSCRassociated enterocolitis (HAEC)? Finding: Patients with HSCR showed gut dysbiosis with reduced diversity. Postoperative microbial changes included increased alpha diversity. Certain taxa, such as Eubacterium and Collinsella, were associated with recovery or HAEC. Meaning: Distinct microbial signatures may help identify HAEC risk and guide microbiota-based strategies to improve outcomes. |
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Foreign body and caustic substance ingestion in children aged 1–5 years can feature to severe and, sometimes life-threatening complications. High-risk items include batteries, magnets, and corrosive chemicals. Severity depends on object type, location, and ingestion timing. Prompt diagnosis and early endoscopic intervention are crucial. Individualized management, high clinical suspicion, and parental education are essential to improving outcomes and preventing immediate and long-term complications affecting a child’s quality of life. |
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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. |
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Question: Does completing a third-generation cephalosporin course, despite in vitro resistance, increase the early urinary tract infection recurrence rate in children? Finding: Among 989 Korean children, discordant therapy increased the 2-month recurrence risk by 40% compared with concordant or susceptible therapy. Meaning: Checking isolate susceptibility and switching to an active oral drug may curb recurrence and limit the use of broad-spectrum antibiotics. |
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· 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. |
| Pediatric for invasive group A Streptococcus has resurged globally with increasing severity and toxin-mediated presentations. Beta-lactams remain the first-line treatment, but linezolid has emerged as a safe alternative in cases refractory to β-lactams. Early intravenous immunoglobulin use may improve outcomes in severe streptococcal toxic shock syndrome cases, while C-reactive protein and procalcitonin aid early risk stratification. Integrating global surveillance and individualized therapy is crucial in the postpandemic era. |
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Early lipid screening, including lipoprotein(a) (Lp(a)), in children/adolescents is key to identifying and managing dyslipidemia and reducing the risk of early-onset cardiovascular disease. This study shows that prevalence of elevated Lp(a) in high-risk Portuguese children is alarming, with over 30% at intermediate/high risk and nearly 1% at very high-risk (>430 nmol/L). Since Lp(a) is mostly genetically determined, one-time early screening in atrisk children is crucial for timely monitoring and prevention. |
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Antiangiogenic therapy resistance in pediatric cancers involves alternative angiogenic pathways, microenvironmental support, hypoxia-driven signaling, metabolic reprogramming, and structural adaptations such as vascular co-option. Metabolic adaptation highlights tumor plasticity. Effective treatments combine immunotherapy with biomarkers. To address vascular endothelial growth factor limitations, emerging targets include hypoxia-inducible factor-2α, endoglin, CXCR4, angiopoietin/Tie2, and bispecific antibodies. In resource-constrained settings, the guidelines recommend low-dose chemotherapy plus oral multiantiangiogenic agents to ensure improved accessibility and treatment outcomes. |
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Background: Intravenous cannulation (IVC) is a routine yet distressing procedure in pediatric patients, often provoking significant anxiety and procedural pain. Although eutectic mixtures such as eutectic mixture of local anesthetic cream are widely used, their delayed onset limits their applicability in time-sensitive settings. Ethyl chloride vapocoolant spray and 10% lignocaine spray have been proposed as rapid-onset alternatives, yet direct comparative... |
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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. |
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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. |
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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. |
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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. |
| Rickets should be recognized as a significant public health concern during infancy and childhood. Recent studies from Taiwan have demonstrated a steady increase in the prevalence of nutritional rickets, and a similar trend is likely to emerge in Korea. Therefore, comprehensive clinical evaluation and appropriate biochemical assessment are essential to prevent long-term skeletal and systemic complications. Prompt diagnosis and timely initiation of appropriate treatment are crucial. |
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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. |
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Question: Which immunomodulatory strategies can reduce mortality in children with acute necrotizing encephalopathy (ANE)? Finding: High-dose methylprednisolone (30 mg/kg/day) significantly improved the survival of high-risk patients, particularly when combined with tocilizumab. Meaning: These findings support the use of a severity-based immunotherapy approach to optimize the outcomes of pediatric ANE. |
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Question: What can predict immunoglobulin A vasculitis (IgAV) recurrence, and when does it occur? How do childhood- and adolescent-onset IgAV compare? Finding: The IgAV recurrence rate was 35.6%. It usually occurred within 12 months and was associated with corticosteroids treatment. Meaning: Childhood-onset IgAV more commonly featured gastrointestinal and musculoskeletal manifestations and required hospitalization. Adolescent-onset IgAV more commonly featured renal involvement. Vigilant monitoring for recurrence is necessary, particularly with corticosteroids treatment. |
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Question: Associations have been made between maternal sleep disorders during pregnancy and allergic diseases including bronchial asthma, atopic dermatitis, food allergy, and allergic conjunctivitis/rhinitis/hay fever in their children. Finding: In the crude model, sleep disorders during pregnancy were associated with all examined allergic diseases in children. After adjustment, significant associations remained for atopic dermatitis and allergic conjunctivitis/rhinitis/hay fever. Meaning: The study highlights associations between maternal sleep and child allergic diseases. |
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