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世界儿科杂志（英文版）
世界儿科杂志（英文版）

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世界儿科杂志（英文版）/Journal World Journal of PediatricsCSCDCSTPCD北大核心SCI
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    Urgent need to address macrolide-resistant Mycoplasma pneumoniae in pediatric populations:insights from an expert consensus

    Xiwei WangWenwei Tu
    981-982页
      原文链接:
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    Guidelines for the diagnosis and treatment of neurally mediated syncope in children and adolescents(revised 2024)

    Cheng WangYing LiaoShuo WangHong Tian...
    983-1002页
    查看更多>>摘要：Background Significant progress has been made in the diagnosis and treatment of pediatric syncope since the publication of the"2018 Chinese Pediatric Cardiology Society(CPCS)guideline for diagnosis and treatment of syncope in children and adolescents"("2018 Edition Guidelines").Therefore,we have revised and updated it to assist pediatricians in effectively managing children with syncope.Data sources According to the"2018 Edition Guidelines",the expert groups collected clinical evidence,evaluated pre-liminary recommendations,and then organized open-ended discussions to form the recommendations.This guideline was developed by reviewing the literature and studies in databases including PubMed,Cochrane,EMBASE,China Biomedical Database,and Chinese Journal Full-text Database up to April 2024.Search terms included"syncope","children","adoles-cents","diagnosis",and"treatment."Results The guidelines were based on the latest global research progress and were evidence-based.The classification of syncope etiology,diagnostic procedures,postural tests,such as the active standing test,head-up tilt test,and active sitting test,clinical diagnosis,and individualized treatment for neurally mediated syncope in pediatric population were included.Conclusions The guidelines were updated based on the latest literature.The concepts of sitting tachycardia syndrome and sitting hypertension were introduced and the comorbidities of neurally mediated syncope were emphasized.Some biomarkers used for individualized treatment were underlined.Specific suggestions were put forward for non-pharmacological therapies as well as the follow-up process.The new guidelines will provide comprehensive guidance and reference for the diagnosis and treatment of neurally mediated syncope in children and adolescents.
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    • 维普

    Psychosocial alterations during the COVID-19 pandemic and the global burden of anxiety and major depressive disorders in adolescents,1990-2021:challenges in mental health amid socioeconomic disparities

    Soeun KimJiyoung HwangJun Hyuk LeeJaeyu Park...
    1003-1016页
    查看更多>>摘要：Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced by the psychosocial and socio-cultural context.Hence,it is imperative to thoroughly understand the psychosocial changes adolescents experienced during the pandemic and implement effective management initiatives.Data sources We examined the incidence rates of depressive and anxiety disorders among adolescents aged 10-19 years globally and regionally.We utilized data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 to compare pre-pandemic(2018-2019)and pandemic(2020-2021)periods.Our investigation covered 204 countries and territories across the six World Health Organization regions.We conducted a comprehensive literature search using databases including PubMed/MEDLINE,Scopus,and Google Scholar,employing search terms such as"psychosocial","adolescent","youth","risk factors","COVID-19 pandemic","prevention",and"intervention".Results During the pandemic,the mental health outcomes of adolescents deteriorated,particularly in terms of depressive and anxiety disorders.According to GBD 2021,the incidence rate of anxiety disorders increased from 720.26[95％uncer-tainty intervals(UI)=548.90-929.19]before the COVID-19 pandemic(2018-2019)to 880.87 per 100,000 people(95％UI=670.43-1132.58)during the COVID-19 pandemic(2020-2021).Similarly,the incidence rate of major depressive dis-order increased from 2333.91(95％UI=1626.92-3138.55)before the COVID-19 pandemic to 3030.49 per 100,000 people(95％UI=2096.73-4077.73)during the COVID-19 pandemic.This worsening was notably pronounced in high-income countries(HICs).Rapid environmental changes,including heightened social anxiety,school closures,economic crises,and exacerbated racism,have been shown to adversely affect the mental well-being of adolescents.Conclusions The abrupt shift to remote learning and the absence of in-person social interactions heightened feelings of loneliness,anxiety,sadness,and stress among adolescents.This change magnified existing socioeconomic disparities,posing additional challenges.These complexities profoundly impact adolescents'well-being,especially vulnerable groups like those from HICs,females,and minorities.Acknowledging the underreporting bias in low-to middle-income countries highlights the importance of addressing these mental health alterations in assessments and interventions within these regions as well.Urgent interventions are crucial as the pandemic-induced mental stress may have lasting effects on adolescents'mental health.
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    • 万方数据
    • 维普

    Complications of button battery ingestion or insertion in children:a systematic review and pooled analysis of individual patient-level data

    Christopher TranCarlos NunezGuy D.EslickRuth Barker...
    1017-1028页
    查看更多>>摘要：Background Button battery(BB)exposures are common in children and can have devastating consequences.We reviewed current evidence on the complications associated with BB exposure and identified predictors of outcomes using individual patient-level data.Data sources We carried out a systematic review and pooled analysis by searching MEDLINE,Embase,and Scopus up to May 19,2023.Included studies describe complications following BB exposures in children(aged＜18 years).Odds ratios(ORs)were calculated using binary logistic regression to measure associations between predictive factors and different outcomes.Results Two-hundred seventeen studies(439 children)were included.The median age at presentation was 1.75[interquartile range(IQR)1.00-3.00]years and 399(90.9％)exposures were ingestions.Of the 380 cases reporting sex,162(42.6％)were female.Feeding(192,48.1％)and respiratory difficulties(138,34.6％)were common presenting features for ingestions,while symptomatology was site-specific for insertions.Common complications included oesophageal mucosal damage alone(105,26.3％)and tracheooesophageal fistula(93,23.3％)for ingestions,and nasal septal perforation(22,55.0％)and mucosal damage alone(13,32.5％)for insertions.Intestinal perforation occurred in 2.5％of ingestion cases,including perforation of Meckel's diverticulum,peritonitis,and jejunocolic fistula.Vascular complications were common among children who died.Age(≤ 2 years),battery exposure duration(＞6 hours),and battery diameter(≥ 20 mm)were associated with common and severe complications of ingestions.Conclusion BB injuries are time-critical,with severe sequelae predominantly affecting young children.Diagnosis is chal-lenging.Preventative work through regulation and safer battery design are required to eliminate this problem.
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    • 万方数据
    • 维普

    Association of fluoride exposure with disease burden and neurodevelopment outcomes in children in South Korea

    Won Seok LeeJu Hee KimBoeun HanGi Chun Lee...
    1029-1042页
    查看更多>>摘要：Background Community water fluoridation is an effective public health strategy for preventing dental caries,yet.Concerns exist about potential health problems.This study explores associations between tap water fluoride levels and pediatric disease burden,as well as neurodevelopmental outcomes at 6 years of age.Methods This nationwide population-based cohort study included children born in Korean cities with and without tap water fluoridation projects,between 2006 and 2012,aiming for a fluoride concentration of 0.8±0.2 mg/L in treated tap water.Data from the National Health Insurance Service were used,spanning from birth to 2018.The relationship between exposure to fluoridated tap water and incidence of 16 childhood diseases that were previously identified as potentially linked to fluoride exposure were examined.Additionally,we evaluated the neurodevelopmental outcomes across various domains,including gross motor,fine motor,cognition,language,social skills,and self-help functions.These assessments were performed using data from a comprehensive national health screening program for children aged six years.Results A fluoride-unexposed group included 22,881 children,whereas a fluoride-exposed group comprised 29,991 children(52％males).Children in the fluoride-exposed group had a decreased risk of dental caries and bone fractures[hazard ratio(95％confidence interval,CI),0.76(0.63-0.93)and 0.89(0.82-0.93),respectively]and increased risk of hepatic failures[1.85,(1.14-2.98)]compared to those in the unexposed group.Additionally,the risk ratio of abnormal neurodevelopmental screening outcomes increased by 9％,but this was statistically uncertain(95％CI,0.95-1.26).Conclusions Fluoridated tap water was associated with an increased risk of hepatic failure but a decreased risk of bone fractures in children.The association between fluoridated tap water and neurodevelopmental screening outcomes at 6 years remains unclear,highlighting the need for further studies to clarify this association.
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    • 万方数据
    • 维普

    Association of the retinol to all-trans retinoic acid pathway with autism spectrum disorder

    Yu-Ru FengQian ZhangJing-Kun MiaoTing Yang...
    1043-1058页
    查看更多>>摘要：Background Autism spectrum disorder(ASD)is a complex group of neurodevelopmental disorders.Research has highlighted a close association between the retinoic acid(RA)signaling pathway and ASD.This study investigates alterations in the vitamin A(VA,retinol)to RA metabolic pathway in children with ASD and speculates on the underlying reasons for these changes.We propose a subtype characterized by downregulated RA signaling in ASD,laying the groundwork for precise diagnosis and treatment research.Methods We included 489 children with ASD and 280 typically developing(TD)children.Those with ASD underwent evaluations of core symptoms and neuro-developmental levels,which were conducted by professional developmental behavior physicians using assessment scales.Serum VA and all-trans RA(atRA)levels were determined by high-performance liquid chromatography and ultra-high-performance liquid chromatography-tandem mass spectrometry.The expression levels and concentrations of enzyme molecules such as retinol dehydrogenase 10 were assessed using quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.Results Children with ASD exhibited reduced serum atRA,accompanied by a downregulation of atRA synthesis enzymes.The reduction in serum atRA levels was linked not only to VA levels but also to the aberrant expression of metabolic enzymes responsible for atRA.Furthermore,the serum atRA levels in children with ASD were more strongly correlated with core symptoms and neurodevelopmental levels than VA levels.Conclusion Children with ASD exhibited a dual regulation of reduced serum atRA levels,influenced by both VA levels and abnormal expression of atRA metabolic enzymes.
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    • 万方数据
    • 维普

    Biomarkers of preschool children with autism spectrum disorder:quantitative analysis of whole-brain tissue component volumes,intelligence scores,ADOS-CSS,and ages of first-word production and walking onset

    Xiang ZhouWu-Sheng LinFeng-Yun ZouShuang-Shuang Zhong...
    1059-1069页
    查看更多>>摘要：Background Preschooling is a critical time for intervention in children with autism spectrum disorder(ASD);thus,we analyzed brain tissue component volumes(BTCVs)and clinical indicators in preschool children with ASD to identify new biomarkers for early screening.Methods Eighty preschool children(3-6 years)with ASD were retrospectively included.The whole-brain myelin content(MyC),white matter(WM),gray matter(GM),cerebrospinal fluid(CSF),and non-WM/GM/MyC/CSF brain component volumes were obtained using synthetic magnetic resonance imaging(SyMRI).Clinical data,such as intelligence scores,autism diagnostic observation schedule-calibrated severity scores,age at first production of single words(AFSW),age at first production of phrases(AFP),and age at walking onset(AWO),were also collected.The correlation between the BTCV and clinical data was evaluated,and the effect of BTCVs on clinical data was assessed by a regression model.Results WM and GM volumes were positively correlated with intelligence scores(both P＜0.001),but WM and GM did not affect intelligence scores(P=0.116,P=0.290).AWO was positively correlated with AFSW and AFP(both P＜0.001).The multivariate linear regression analysis revealed that MyC,AFSW,AFP,and AWO were significantly different(P=0.005,P＜0.001,P＜0.001).Conclusions This study revealed positive correlations between WM and GM volumes and intelligence scores.Whole-brain MyC affected AFSW,AFP,and AWO in preschool children with ASD.Noninvasive quantification of BTCVs via SyMRI revealed a new visualizable and quantifiable biomarker(abnormal MyC)for early ASD screening in preschool children.
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    • 万方数据
    • 维普

    Attention deficit hyperactivity disorder in children with epilepsy:a multicenter cross-sectional analysis in China

    Gang PanYing HanTian-Cheng WangZi-Yi Chen...
    1070-1078页
    查看更多>>摘要：Background The diagnosis and treatment of attention deficit hyperactivity disorder(ADHD)comorbid with epilepsy have been insufficiently addressed in China.We conducted a study in China to investigate the current status,diagnosis,and treat-ment of ADHD in children to further our understanding of ADHD comorbid with epilepsy,strengthen its management,and improve patients'quality of life.Methods We carried out a multicenter cross-sectional survey of children with epilepsy across China between March 2022 and August 2022.We screened all patients for ADHD and compared various demographic and clinical factors between children with and without ADHD,including gender,age,age at epilepsy onset,duration of epilepsy,seizure types,seizure frequency,presence of epileptiform discharges,and treatment status.Our objective was to explore any possible associations between these characteristics and the prevalence of ADHD.Results Overall,395 epilepsy patients aged 6-18 years were enrolled.The age at seizure onset and duration of epilepsy ranged from 0.1-18 to 0.5-15 years,respectively.Focal onset seizures were observed in 212(53.6％)patients,while 293(76.3％)patients had epileptiform interictal electroencephalogram(EEG)abnormalities.Among the 370 patients treated with anti-seizure medications,200(54.1％)had monotherapy.Although 189(47.8％)patients had ADHD,only 31 received treatment for it,with the inattentive subtype being the most common.ADHD was more common in children undergoing polytherapy compared to those on monotherapy.Additionally,poor seizure control and the presence of epileptiform interictal EEG abnormalities may be associated with a higher prevalence of ADHD.Conclusions While the prevalence of ADHD was higher in children with epilepsy than in normal children,the treatment rate was notably low.This highlights the need to give more importance to the diagnosis and treatment of ADHD in children with epilepsy.
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    • 万方数据
    • 维普

    Specific convulsions and brain damage in children hospitalized for Omicron BA.5 infection:an observational study using two cohorts

    Yuan-Yuan PeiHong-Li WangGen-Quan YinYi Xu...
    1079-1089页
    查看更多>>摘要：Background SARS-CoV-2 continues to mutate over time,and reports on children infected with Omicron BA.5 are limited.We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care.Methods We selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30,2022.Specific convulsions and body tempera-tures were compared between the two cohorts.We analyzed potential associations between convulsions and vaccination,and additionally evaluated the brain damage among severe Omicron-infected children.Results Convulsion rates(97.5％vs.4.3％,P＜0.001)and frequencies(median:2.0 vs.1.6,P＜0.001)significantly differed between Omicron-infected and non-Omicron-infected febrile children.The body temperatures of Omicron-infected chil-dren were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions(median:39.5 vs.38.2 and 38.6 ℃,both P＜0.001).In the three Omicron-subgroups,the temperature during convulsions was proportional to the percentage of patients and significantly differed(P＜0.001),while not in the three non-Omicron-subgroups(P=0.244).The convulsion frequency was lower in the 55 vaccinated chil-dren compared to the 260 non-vaccinated children(average:1.8 vs.2.1,P＜0.001).The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated(P＜0.001).Fifteen of the 112 severe Omicron cases had brain damage.Conclusions Omicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children.We additionally found evidence of brain damage caused by infection with omicron BA.5.Vaccination and prompt fever reduction may relieve symptoms.
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    Improving the second-tier classification of methylmalonic acidemia patients using a machine learning ensemble method

    Zhi-Xing ZhuGeorgi Z.GenchevYan-Min WangWei Ji...
    1090-1101页
    查看更多>>摘要：Introduction Methylmalonic acidemia(MMA)is a disorder of autosomal recessive inheritance,with an estimated prevalence of 1∶50,000.First-tier clinical diagnostic tests often return many false positives[five false positive(FP):one true positive(TP)].In this work,our goal was to refine a classification model that can minimize the number of false positives,currently an unmet need in the upstream diagnostics of MMA.Methods We developed machine learning multivariable screening models for MMA with utility as a secondary-tier tool for false positives reduction.We utilized mass spectrometry-based features consisting of 11 amino acids and 31 carnitines derived from dried blood samples of neonatal patients,followed by additional ratio feature construction.Feature selection strategies(selection by filter,recursive feature elimination,and learned vector quantization)were used to determine the input set for evaluating the performance of 14 classification models to identify a candidate model set for an ensemble model development.Results Our work identified computational models that explore metabolic analytes to reduce the number of false positives without compromising sensitivity.The best results[area under the receiver operating characteristic curve(AUROC)of 97％,sensitivity of 92％,and specificity of 95％]were obtained utilizing an ensemble of the algorithms random forest,C5.0,sparse linear discriminant analysis,and autoencoder deep neural network stacked with the algorithm stochastic gradient boosting as the supervisor.The model achieved a good performance trade-off for a screening application with 6％false-positive rate(FPR)at 95％sensitivity,35％FPR at 99％sensitivity,and 39％FPR at 100％sensitivity.Conclusions The classification results and approach of this research can be utilized by clinicians globally,to improve the overall discovery of MMA in pediatric patients.The improved method,when adjusted to 100％precision,can be used to further inform the diagnostic process journey of MMA and help reduce the burden for patients and their families.
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    • 万方数据
    • 维普