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Vol 18, No 9
Vol 18, No 9 September 2022 ISSN 1708-8569
Review article
Original articles
Research letters
Pediatric patients in the new wave of SARS-CoV-2 infection in Shanghai, China
  Jian-Guo Zhou, Yan-Ming Lu, Li-Bo Wang, Hui Yu, Ting Zhang, Yi-Wei Chen, Wen-Hao Zhou
  [Abstract] [Full Text] [PDF]  
Review article:
Gastrointestinal viral shedding in children with SARS-CoV-2: a systematic review and meta-analysis
  Sepideh Benvari, Shima Mahmoudi, Mohsen Mohammadi
Background: Coronavirus disease 2019 (COVID-19) has different manifestations in pediatric cases. It is assumed that they might present more gastrointestinal symptoms with a different viral shedding pattern in gastrointestinal samples. In this systematic review and meta-analysis, we aimed to evaluate the viral shedding pattern in gastrointestinal specimens of children with COVID-19.
Methods: We searched all published studies in English language in PubMed, Web of Science, and Scopus, up to date as of October 2021. Our search included the term "severe acute respiratory syndrome coronavirus 2, COVID-19, SARS-CoV-2, novel coronavirus, or coronavirus; and shed, excrete, secret, or carriage; and stool or rectal; and children or pediatrics". We included studies evaluating SARS-CoV-2 shedding in gastrointestinal specimens, including rectal swabs and stool samples of children with COVID-19 infection. We excluded duplicated data, case reports, and studies without original data.
Results: Twelve studies met the eligibility criteria for the qualitative synthesis, 10 of which were included in the meta-analysis. The pooled prevalence of gastrointestinal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in children with COVID-19 was 86% (95% confidence interval 73%每96%, I 2 = 62.28%). After respiratory specimen had become negative, 72% (43/60) had persistent shedding in gastrointestinal specimens. The gastrointestinal RNA had a positive test result for more than 70 days after symptoms onset.
Conclusions: Gastrointestinal shedding of SARS-CoV-2 might occur in a substantial portion of children and might persist long after negative respiratory testing. Further research is recommended to find the role of SARS-CoV-2 gastrointestinal shedding in transmission in children.
  [Abstract] [Full Text] [PDF]  
Ursodeoxycholic acid as adjuvant treatment to phototherapy for neonatal hyperbilirubinemia: a systematic review and meta-analysis
  Ilari Kuitunen, Panu Kiviranta, Ulla Sankilampi, Marjo Renko
Background: Neonatal hyperbilirubinemia is observed in most newborns, and 5每15% of neonates require phototherapy. Phototherapy is effective but often prolongs hospitalization and has both short-term and potential long-term harms. The aim of this systematic review and meta-analysis was to evaluate the role of ursodeoxycholic acid (UDCA) combined with phototherapy in neonatal hyperbilirubinemia.
Methods: A literature search was conducted on September 1, 2021; 590 studies were screened, and 17 full texts were assessed by two authors. We included randomized controlled trials with or without placebo intervention. Primary outcomes were changes in total bilirubin levels at 24 hours and phototherapy duration. We calculated mean differences with 95% confidence intervals (CI).
Results: Six studies with 880 neonates were included. Of these studies, only two used a placebo-controlled double-blinded design. The overall risk of bias was high in one and moderate in four of the included studies. The mean decrease in the total bilirubin level during the first 24 hours was 2.06 mg/dL (95% CI 0.82每3.30; six studies) greater in the UDCA treatment group. The phototherapy duration was 19.7 hours (95% CI 10.4每29.1; five studies) shorter in the UDCA treatment group.
Conclusions: We found low-quality evidence that UDCA as an adjuvant to phototherapy seems to decrease total bilirubin faster and shorten phototherapy duration compared to standard treatment. Further studies are needed to confirm the efficacy, acute and long-term outcomes, and safety before implementing UDCA as an adjuvant to phototherapy in neonatal hyperbilirubinemia.
  [Abstract] [Full Text] [PDF]  
Original articles:
Asthma mortality among children and adolescents in China,
  Ting-Ting Liu, Jin-Lei Qi, Ju Yin, Qi Gao, Wei Xu, Jing-Jing Qiao, Peng Yin, Mai-Geng Zhou, Kun-Ling Shen
Background: Asthma mortality among children and adolescents at the national level in China was unreported. The aim of this study was to analyze the mortality of asthma among children and adolescents in China using a nationally representative database.
Methods: This was a descriptive study using data from the Disease Surveillance Points (DSPs) system. All asthma-related deaths among children and adolescents aged 0每19 years occurring in DSPs across China from 2008 to 2018 were included. Multilevel Poisson regression models were used to compute the total, age-, gender-, region- and residence-specific asthma mortality rates and to investigate the significance of trends and factors associated with asthma mortality. Data from the National Bureau of Statistics were used to estimate the national asthma deaths.
Results: Total asthma mortality rate among Chinese children and adolescents fluctuated between 0.020 (0.009, 0.045) and 0.059 (0.025, 0.137) per 100,000 and showed an overall downward trend (RR, 0.909; 95% CI 0.854每0.968) during the study period (2008每2018). Asthma mortality rate was higher in the western China (RR 2.356, 95% CI 1.513, 3.669) and varied over a ninefold range among DSPs in China. The estimated number of deaths decreased by 51.38% from 2008 (n = 148; 95% CI 58,379) to 2018 (n = 71; 95% CI 34, 109).
Conclusions: Asthma mortality rate among children and adolescents in China was at a low level compared to rates worldwide and decreased significantly from 2008 to 2018. Compared with most countries in the world, the number of asthma deaths was higher in China.
  [Abstract] [Full Text] [PDF]  
Evaluation of proximal tubule functions in children with COVID-19: a prospective analytical study
  Fatma Devrim, Elif Bönc邦oğlu, Elif Kıymet, Şahika Şahinkaya, Ela Cem, Mine D邦zgöl, Ayb邦ke Akaslan Kara, Kamile Ötiken Arıkan, Aslı Kantar, Ebru Yılmaz, Nida Dinçel, Nuri Bayram, İlker Devrim
Background: There are limited numbers of studies focusing on renal effects of coronavirus disease 2019 (COVID-19) infection and proximal tubular dysfunction in children with COVID-19 infections. The purpose of this study was to evaluate the functions of the proximal tubule in hospitalized children with confirmed acute COVID-19.
Methods: The children who were hospitalized for confirmed COVID-19 were included in this prospective descriptive analysis. The presence of at least two of the following four abnormalities was used to diagnose proximal tubule injury: abnormal tubular reabsorption of phosphate, normoglycemic glycosuria, hyperuricosuria, and proteinuria.
Results: A total of 115 patients were included in the study. About a third of the individuals had elevated blood creatinine levels or proteinuria. In addition, abnormal renal tubular phosphate loss measured by renal tubular phosphate loss was found in 10 (8.7%) patients, as was hyperuricosuria in 28.6%. As a result, total proximal tubular dysfunction was found in 24 (20.9%) patients.
Conclusions: One in every five children with acute COVID-19 infections had proximal tubular dysfunction, according to our data. Although, the rate of proximal tubular dysfunction was lower than in adults, it should be noted. The recovery of proximal tubular function in children with COVID-19 should be followed.
  [Abstract] [Full Text] [PDF]  
Effect of early feeding practices and eating behaviors on body composition in primary school children
  Omneya Magdy Omar, Mohamed Naguib Massoud, Afaf Gaber Ibrahim, Nada Atef Khalaf
Background: Understanding children*s feeding practices and eating behaviors is important to determine etiology of childhood obesity. This study aimed to explore the relationship between early feeding practices, eating behavior and body composition among primary school children.
Methods: The data were collected from 403 primary school children. They were administered structured questionnaire, including sociodemographic characteristics, early feeding practices and Child*s Eating Behavior Questionnaire. Anthropometric and blood pressure (BP) measurements were performed.
Results: Children with obesity and overweight showed higher food approach subscales and lower food avoidance subscales compared to a healthy and underweight child. Children who were exclusively or predominantly breast fed during the first 6 months had the lowest scores for the food approach subscales, food responsiveness (FR) and emotional overeating (EOE) and had the highest scores for the food avoidance subscales, satiety responsiveness (SR) and emotional under eating (EUE). Children who were introduced solid food after 6 months showed lower scores for FR, enjoyment of food and EOE but scored highest for SR, slowness in eating (SE) and EUE. All anthropometric measurements were positively correlated with all food approach subscales and negatively with SE, SR and food fussiness. All food approach subscales were positively correlated with BP percentiles. All food avoidance subscales were negatively correlated with both BP percentiles, except for EUE, which was negatively correlated with diastolic BP percentile only. Age, SR, SE and FR were predictors for child body mass index.
Conclusion: Early feeding practices and eating behavior are considered as prevention approaches for obesity.
  [Abstract] [Full Text] [PDF]  
Research letters:
Impact of comorbidities on the prognosis of pediatric vasovagal syncope
  Ya-Ru Wang, Xue-Ying Li, Jun-Bao Du, Yan Sun, Wen-Rui Xu, Yu-Li Wang, Ying Liao, Hong-Fang Jin
  [Abstract] [Full Text] [PDF]  
Using echocardiography in newborn screening for congenital heart disease may reduce missed diagnoses
  Yun-Xiang Qiu, Wei Jiang, Jia-Yu Zhang, Die Li, Kai Yu, Cang-Cang Fu, Xiao-Min Tang, Wei-Ze Xu
  [Abstract] [Full Text] [PDF]  
Association between genetic polymorphisms of base excision repair pathway and glioma susceptibility in Chinese children
  Yong-Ping Chen, Yu-Xiang Liao, Zhen-Jian Zhuo, Li Yuan, Hui-Ran Lin, Lei Miao, Xia Li, Xiao-Kai Huang, Jing-Ying Zhou, Jun Bian, Jing He
  [Abstract] [Full Text] [PDF]  
Genotypic and phenotypic spectra of NBEA 每related neurodevelopmental disorder with epilepsy: a case series and literature review
  Zou Pan, Chen Chen, Fei Yin, Jing Peng
  [Abstract] [Full Text] [PDF]  
World Journal of Pediatric Surgery
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