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Risk factors for long COVID in children and adolescents:a systematic review and meta-analysis

World Journal of pediatrics 2024年第2期20卷 133-142页

作者： Daniel G.Rayner Elaine Wang Cloris Su Om D.Patel Stephanie Aleluya Alessandra Giglia Evelyn Zhu Maha Siddique Department of Health Research Methods Evidenceand ImpactFaculty of Health SciencesMcMaster University1280 Main St WHamiltonONL8S 4K1Canada Faculty of Health Sciences McMaster University1280 Main St WHamiltonON L8S 4K1Canada Faculty of Science McMaster University1280 Main St WHamiltonONL8S 4K1Canada

Background The long-term sequelae of COVID-19 in children and adolescents remain poorly understood and characterized.This systematic review and meta-analysis sought to summarize the risk factors for long COVID in the pediatric population.Methods We searched six databases from January 2020 to May 2023 for observational studies reporting on risk factors for long COVID or persistent symptoms those were present 12 or more weeks post-infection using multivariable regression analyses.Trial registries,reference lists of included studies,and preprint servers were hand-searched for relevant studies.Random-effects meta-analyses were conducted to pool odds ratios for each risk factor.Individual study risk of bias was rated using QUIPS,and the GRADE framework was used to assess the certainty of evidence for each unique factor.Results Sixteen observational studies(N=46,262)were included,and 19 risk factors were amenable to meta-analysis.With moderate certainty in the evidence,age(per 2-year increase),allergic rhinitis,obesity,previous respiratory diseases,hospitalization,severe acute COVID-19,and symptomatic acute COVID-19 are probably associated with an increased risk of long COVID.Female sex,asthma,comorbidity,and heart diseases may be associated with an increased risk of long COVID,and Asian and Black races may be associated with a decreased risk of long COVID.We did not observe any credible subgroup effects for any risk factor.Conclusions The current body of literature presents several compelling risk factors for the development of long COVID in the pediatric population.Further research is necessary to elucidate the pathophysiology of long COVID.

关键词： COVID-19 Long COVID Post-acute COVID-19 syndrome pediatrics Risk factors

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Use of donepezil for neurocognitive recovery after brain injury in adult and pediatric populations:a scoping review

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Neural Regeneration Research 2024年第8期19卷 1686-1695页

作者： Avery L.Miller Nathan K.Evanson J.Michael Taylor University of Cincinnati College of Medicine CincinnatiOHUSA Department of pediatrics University of CincinnatiCincinnatiOHUSA Department of Neurology and Rehabilitation Medicine University of CincinnatiCincinnatiOHUSA Division of Pediatric Rehabilitation Medicine Cincinnati Children’s Hospital Medical CenterCincinnatiOHUSA Division of Neurology Cincinnati Children’s Hospital Medical CenterCincinnatiOHUSA

There are few pharmacologic options for the treatment of cognitive deficits associated with traumatic brain injury in pediatric patients.Acetylcholinesterase inhibitors such as donepezil have been evaluated in adult patients after traumatic brain injury,but relatively less is known about the effect in pediatric populations.The goal of this review is to identify knowledge gaps in the efficacy and safety of acetylcholinesterase inhibito rs as a potential a djuvant treatment fo r neurocognitive decline in pediatric patients with traumatic brain injury.Investigators queried PubMed to identify literature published from database inception thro ugh June 2023 desc ribing the use of donepezil in young adult traumatic brain injury and pediatric patients with predefined conditions.Based on preselected search criteria,340 unique papers we re selected for title and abstra ct screening.Thirty-two reco rds were reviewed in full after eliminating preclinical studies and pape rs outside the scope of the project.In adult traumatic brain injury,we review results from 14 papers detailing 227 subjects where evidence suggests donepezil is well tole rated and shows both objective and patient-reported efficacy for reducing cognitive impairment.In children,3 pape rs report on 5 children recovering from traumatic brain injury,showing limited efficacy.An additional 15 pediatric studies conducted in populations at risk for cognitive dysfunction provide a broader look at safety and efficacy in 210 patients in the pediatric age group.Given its promise for efficacy in adults with traumatic brain injury and tole rability in pediatric patients,we believe further study of donepezil for children and adolescents with traumatic brain injury is warranted.

关键词： acetylcholinesterase inhibitor adult cognition donepezil pediatrics traumatic brain injury

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Childhood sleep:assessments,risk factors,and potential mechanisms

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World Journal of pediatrics 2024年第2期20卷 105-121页

作者： Jianghong Liu Xiaopeng Ji Elizabeth Rovit Susannah Pitt Terri Lipman School of Nursing University of Pennsylvania418 Curie Blvd.Room 426Claire M.Fagin HallPhiladelphiaPA 19104USA School of Nursing College of Health SciencesUniversity of DelawareNewarkDE 19716USA Geisinger Commonwealth School of Medicine ScrantonPA 18510USA

Background Sleep problem is a highly prevalent health issue among pediatric populations across the world.In this review,we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children.Potential biological,psychosocial,and environmental mechanisms as well as research gaps in the literature are also discussed.Data sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info.Both relevant data based and systematic reviews are included.Results This paper summarizes many risk factors for childhood sleep problems,including biological(e.g.,genetics,gender,age and puberty,prenatal factors,postnatal factors);nutritional(e.g.,macronutrients,micronutrients,omega-3 fatty acids,obesity);environmental(e.g.,heavy metals,noise,light,air pollution);interpersonal(e.g.,family,exposure to violence,screen media use,physical injury);and community/socioeconomic variables(e.g.,racial/ethnicity and cultural factors,neighborhood conditions and socioeconomic status,school factors,public health disasters/emergencies),to better understand the development of sleep problems in children.Conclusions Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological,environmental,and psychosocial risk factors and contributors.A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.

关键词： Child sleep pediatrics Risk factor Mechanisms

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Spotlight on eltrombopag concentration in pediatric immune thrombocytopenia: A single-center observational study in China

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儿科学研究(英文) 2024年第1期8卷 44-52页

作者： Dong Shuyue Wang Zhifa Wang Nan Ma Jingyao Meng Jinxi Sun Yixin Cheng Xiaoling Wu Runhui Hematology Oncology Center Beijing Children’s Hospital Capital Medical University National Center for Children’s Health Beijing China Department of Pharmacy Beijing Children’s Hospital Capital Medical University National Center for Children’s Health Beijing China

Importance: Eltrombopag has been recommended for pediatric immune thrombocytopenia (ITP). Response and adverse drug reactions (ADRs) varied widely between individuals, even at the same dose of eltrombopag. The appropriate eltrombopag concentration in ITP has not been reported.Objective: This study aims to explore the appropriate eltrombopag concentration in pediatric ITP.Methods: This was a single-center, prospective cohort study. Children diagnosed with refractory persistent/chronic ITP and platelet count < 30×109/L were treated with eltrombopag and followed up for at least 2 months. Concentration was detected by high-performance liquid chromatography-mass spectrometry at least 2 weeks after eltrombopag. The clinical characteristics-concentration, concentration-response, and concentration-ADRs were analyzed.Results: A total of 30 patients were enrolled, comprising 13 males and 17 females, with a median age of 72 (45-94) months. The median dose and concentration were 1.39 (1.09-1.56) mg/kg and 2.70 (2.25-4.13) mg/L, respectively. Of the enrolled patients, 14 responded to treatment, whereas 16 did not. Additionally, five experienced adverse drug reactions. No linear correlation was observed between eltrombopag concentration and clinical characteristics. The concentration was lower in the response group than in the nonresponse group, but there was no significant difference (t = 0.755,P = 0.457). Patients who experienced ADRs had a higher concentration than those without ADRs (t = 2.538,P = 0.017). The area under the receiver operating characteristic curve of ADRs was 0.78 (95% confidence interval: 0.56-1.00). Youden’s index identified the cutoff point as 4.33 mg/L, with a sensitivity of 88% and a specificity of 60%. Logistic regression analysis demonstrated that a higher platelet count before eltrombopag predicted a favorable response.Interpretation: Eltrombopag proves efficacious and well-tolerated for treating pediatric ITP. However, prolonged and high-dose administration may increase the likelihood of ADRs. Thus

关键词： Concentration Efficacy Eltrombopag Immune thrombocytopenia pediatrics Safety

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A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region

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儿科学研究(英文) 2024年第1期8卷 53-60页

作者： Lee Tiffany A. Bishop Jessica Drover Anne Midodzi William K. Twells Laurie K. School of Pharmacy Memorial University of Newfoundland (MUN) St. John’s Canada Faculty of Medicine Memorial University of Newfoundland (MUN) St. John’s Canada

Importance: Tongue tie (TT) is a condition that can cause infant feeding difficulties due to restricted tongue movement. When TT presents as a significant barrier to breastfeeding, a frenotomy may be recommended. Universally accepted diagnostic criteria for TT are lacking and wide prevalence estimates are reported. New referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and frenotomy.Objective: To determine the proportion of babies with TT as well as the frequency of frenotomy.Methods: This cross-sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14-month period. Data were collected retrospectively by chart review and analyzed using SPSS. Factors associated with frenotomy were examined using logistic regression.Results: Two hundred and forty-one babies were referred. Ninety-two percent (n = 222) were diagnosed with TT and 66.0% (n = 159) underwent frenotomy. In the multivariate model, nipple pain/trauma, inability to latch, inability to elevate tongue, and dimpling of tongue on extension were associated with frenotomy (P < 0.05). Most referrals in our region resulted in a diagnosis of TT; however, the number of referrals was lower than expected, and of these two-thirds underwent frenotomy.Interpretation: TT is a relatively common finding among breastfed infants. Future research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.

关键词： Breastfeeding Nutrition Community health services pediatrics

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Pediatric stricturing Crohn's disease

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World Journal of Gastroenterology 2024年第12期30卷 1651-1654页

作者： Alessandro Boscarelli Matteo Bramuzzo Department of Pediatric Surgery and Urology Institute for Maternal and Child Health-IRCCS“Burlo Garofolo”Trieste 34137Italy Department of Gastrointestinal Endoscopy and Nutrition Institute for Maternal and Child Health-IRCCS"Burlo Garofolo"Trieste 34137Italy

Crohn’s disease(CD)is a chronic inflammatory disease of the digestive tract.The incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 world-wide.Notably,approximately 25%of children with CD develop stricturing CD(SCD)that requires intervention.Symptomatic stricturing diseases refractory to pharmacological management frequently require non-pharmacological interventions.Non-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured seg-ment.However,strictures tend to recur postoperatively regardless of treatment modality.The lifetime risk of surgery in patients with childhood SCD remains at 50%-90%.Thus,new and emerging strategies,advanced diagnostic tools,and minimally invasive approaches are under investigation to improve the outcomes and overall quality of life of pediatric patients with SCD.

关键词： Stricturing Crohn’s disease pediatrics Insights Future perspectives

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Clinical characteristics of testicular torsion and factors influencing testicular salvage in children:A 12-year study in tertiary center

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World Journal of Clinical Cases 2024年第7期12卷 1251-1259页

作者： Xiang-Hui Gang Yuan-Yuan Duan Bin Zhang Zheng-Gan Jiang Rong Zhang Jun Chen Xiang-Yu Teng Duo-Bing Zhang Department of Urology Suzhou Hospital Affiliated to Anhui Medical UniversitySuzhou 234000Anhui ProvinceChina Department of Ultrasound Diagnosis Suzhou Hospital Affiliated to Anhui Medical UniversitySuzhou 234000Anhui ProvinceChina Department of Urology The Second Affiliated Hospital of Anhui Medical UniversityHefei 230000Anhui ProvinceChina

BACKGROUND Testicular torsion is the most common acute scrotum worldwide and mainly occurs in children and adolescents.Studies have demonstrated that the duration of symptoms and torsion grade lead to different outcomes in children diagnosed with testicular torsion.AIM To predict the possibility of testicular salvage(TS)in patients with testicular torsion in a tertiary center.METHODS We reviewed the charts of 75 pediatric patients with acute testicular torsion during a 12-year period from November 2011 to July 2023 at the Suzhou Hospital of Anhui Medical University.Univariate and multivariate logistic regression analyses were used to determine independent predictors of testicular torsion.The data included clinical findings,physical examinations,laboratory data,color Doppler ultrasound findings,operating results,age,presenting institution status,and follow-up results.RESULTS Our study included 75 patients.TS was possible in 57.3%of all patients;testicular torsion occurred mostly in winter,and teenagers aged 11-15 years old accounted for 60%.Univariate logistic regression analyses revealed that younger age(P=0.09),body mass index(P=0.004),torsion angle(P=0.013),red blood cell count(P=0.03),neutrophil-to-lymphocyte ratio(P=0.009),and initial presenting institution(P<0.001)were associated with orchiectomy.In multivariate analysis,only the initial presenting institution predicted TS(P<0.05).CONCLUSION The initial presenting institution has a predictive value for predicting TS in patients with testicular torsion.Children with scrotal pain should be admitted to a tertiary hospital as soon as possible.

关键词： Testicular torsion Testicular salvage pediatrics Predictors Case report

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Panhypopituitarism caused by a suprasellar germinoma: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1844-1850页

作者： Jelena Roganovic Lea Saric Silvije Segulja Ana Dordevic Mia Radosevic Department of pediatrics Clinical Hospital Centre RijekaRijeka 51000Croatia Faculty of Medicine University of RijekaRijeka 51000Croatia Faculty of Health Sciences University of RijekaRijeka 51000Croatia Department of Business Development Jadran Galenski LaboratorijRijeka 51000Croatia

BACKGROUND Suprasellar germinomas are rare intracranial tumors frequently associated with permanent endocrine disorders.We present the clinical picture,treatment,and complications of suprasellar germinoma at pediatric age which,besides being lifethreatening,has lifelong endocrinological consequences.CASE SUMMARY A 12-year-old female patient was presented having had intensive headaches for three weeks and visual disturbances for six months.An ophthalmological examination revealed bilateral papilledema and a marked loss of vision.Emergency brain magnetic resonance imaging(MRI)showed a suprasellar tumor,involving the infundibulum and the optic chiasm,extending to the third ventricle.Laboratory tests confirmed decreased levels of thyroxine,cortisol,gonadotropins,and insulin-like growth factor 1.Maximal tumor reduction was performed,and immunohistopathology established the diagnosis of suprasellar germinoma.MRI of the spine and cerebrospinal fluid cytology confirmed the localized disease.Adjuvant chemotherapy and radiotherapy were performed according to the SIOP CNS GCT II protocol.A post-treatment MRI showed no residual tumor,but pituitary function had not recovered.Three and a half years after the end of the treatment,the patient is in a complete remission,requiring hormonal replacement therapy,continuous education,and psychological support.CONCLUSION This complex case highlights the importance of timely diagnosis,a multidisciplinary approach,and close follow-up in children with suprasellar germinomas.

关键词： Germinoma Germ cell tumor Suprasellar tumor Hypopituitarism Management pediatrics Case report

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Atherosclerosis originating from childhood:Specific features

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Journal of Biomedical Research 2024年第3期38卷 233-240页

作者： Anastasia V.Poznyak Alexey A.Yakovlev MikhailА.Popov Elena B.Zhigmitova Vasily N.Sukhorukov Alexander N.Orekhov Institute for Atherosclerosis Research Moscow 121609Russia Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology Moscow 109240Russia Department of Cardiac Surgery Moscow Regional Research and Clinical InstituteMoscow 129110Russia Laboratory of Angiopathology Institute of General Pathology and PathophysiologyMoscow 125315Russia

Atherosclerosis is extremely widespread.Traditionally,it is considered a disease of older people,who most often experience problems with the heart and blood vessels.While much attention from the scientific community has been paid to studying the association between aging and atherosclerosis,as well as its consequences,there is evidence that atherosclerosis occurs at an early age.Atherosclerosis may form both during intrauterine development and in childhood.Nutrition plays an important role in childhood atherosclerosis,along with previous infectious diseases and excess weight of both the child and the mother.In the present review,we examined the development of atherosclerosis and the prerequisites in childhood.

关键词： atherosclerosis childhood pediatrics cardiovascular disease

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Omicron targets upper airways in pediatrics,elderly and unvaccinated population

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World Journal of Clinical Cases 2022年第32期10卷 12062-12065页

作者： Wassan Nori Muna Abdul Ghani Zghair Department of Obstetrics and Gynecology Mustansiriyah UniversityBaghdad 10052Al SaydyiaIraq Department of Radiology Mustansiriyah UniversityBaghdad 10052Hay Al jammeaIraq

Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replication,and high reinfection rates reported from all ages.Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness,epiglottitis.Not to mention the long coronavirus disease 2019,which rises exponentially in the Omicrons era.Apparently,the disease has a less aggressive course than earlier variants with lower death rates;however,the infection is not trivial.Severe infection was raised among pediatrics,unvaccinated,and the elderly.Complete vaccine protection is urgently needed to protect the most vulnerable community members.Additionally,self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.

关键词： Omicron SARS-CoV-2 Upper respiratory tract Epiglottitis pediatrics Unvaccinated

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