Clinical and Experimental Pediatrics临床与实验儿科
Clinical and Experimental Pediatrics(英文缩写 CLIN EXP PEDIATR),ISSN 2713-4148,eISSN 2713-4148,中文译名:临床与实验儿科 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
Clinical and Experimental Pediatrics 最新收录文献
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1. Hepcidin and other obesity-related factors affecting BNT162b2 response in children and adolescents over a 6-month period.
PMID:日期:2026-09-30Obesity causes chronic inflammation and metabolic dysregulation of the immune response and increases an individual's susceptibility to severe infection. This study aimed to evaluate the effect of an increased body mass index (BMI), obesity-associated biomarkers, and habitual factors on immune responses following BNT162b2 vaccination in a pediatric population over a 6-month period. In this prospective, single-center cohort study, the participants received a 2-dose regimen of the BNT16 2b2 mRNA vaccine. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) and neutralizing antibody (Ab) levels were measured before vaccination (T0), 14 days after vaccination (T1), and 6 months after the second dose (T2). Baseline anthropometric and biochemical assessments including BMI measurements were performed at T0. Lifestyle characteristics were evaluated using a standardized questionnaire administered at baseline. T2 SARS-CoV-2 neutralizing Ab levels were significantly lower in overweight or obese participants (P= 0.02). Among the other biochemical markers, hepcidin, and leptin levels were significantly correlated with BMI (P= 0.004 and P<0.001, respectively). The main biochemical parameters that were inversely correlated with T1 IgG and neutralizing titers were uric acid (P=0.007, P<0.001), fasting serum glucose-to-plasma insulin ratio (P=0.02 and P=0.02), and hepcidin (P=0.01 and P=0.01). Passive smoking was associated with lower T2 IgG titers (P=0.04). Higher uric acid levels and a lower KIDMED index were associated with reduced T2 SARS-CoV-2 neutralizingtiters (P=0.005 and P=0.02, respectively). Reactogenicity was significantly correlated with BMI and age (P=0.03 and P= 0.02, respectively), whereas higher hepcidin and uric acid levels were associated with the presence of local and systemic adverse effects, respectively (P=0.008 and P= 0.02, respectively). Our findings suggest that obesity-related environmental and behavioral factors may be associated with humoral immune responses during 6 months of follow-up.
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4. Maternal metformin protects developing auditory brainstem function after neonatal hypoxia-ischemia in a neonatal rat model.
PMID:日期:2026-09-17Neonatal hypoxia-ischemia (HI) disrupts brain development and can impair sensory circuit maturation. However, how HI vulnerability is modified within developing auditory pathways remains poorly defined. Metformin is used during pregnancy in select cases and modulates cellular energy signaling. Here, we tested whether maternal metformin administration during gestation alters functional and cellular outcomes in offspring brain after neonatal HI. Pregnant rat dams received metformin in drinking water, and offspring rat pups underwent HI during early postnatal life. Auditory pathway function was assessed in vivo using auditory brainstem responses (ABRs), and cellular pathology within the medial nucleus of the trapezoid body (MNTB) was evaluated by immunohistochemistry across postinjury developmental time points. HI significantly elevated click-evoked ABR thresholds and reduced wave II and III amplitudes, whereas maternal metformin exposure prevented the HI-induced click-threshold elevation and preserved wave II and III amplitudes without altering peripheral or central conduction times. Histologically, HI produced an age-dependent decline in MAP2-positive neuronal density in the MNTB, culminating in marked neuronal loss at later postnatal stages. Notably, maternal metformin partially rescued HI-associated reductions in MNTB neurons, with a parallel trend toward preservation of oligodendrocyte lineage cells. Together, these findings indicate that maternal metformin administration during pregnancy enhances metabolic signaling and mitigates HI-related auditory brainstem dysfunction and cellular pathology in offspring, supporting maternal metabolic modulation as a determinant of neonatal sensory brain injury outcomes.
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6. Association between surgical repair timing and mortality in neonates with congenital diaphragmatic hernia: a systematic review and meta-analysis.
PMID:日期:2026-09-17Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly whose management involves a complex interplay between medical and surgical treatments. Stabilization prior to surgery is vital. However, the optimal timing of surgical repair and its relationship with mortality remain unknown. Hence, this meta-analysis aimed to evaluate the association between repair timing and mortality in neonates with CDH. A systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines. The PubMed, NCBI, Cochrane CENTRAL, Google Scholar, CINHAL, Ovid, Scopus, Web of Science, and Epistemonikos databases were searched for articles published through April 2026. Forty studies, including 2 randomized controlled trials, 3 prospective observational studies, and 35 retrospective studies, were included in the meta-analysis. Newborns operated on within 24 hours of life had significantly higher mortality (relative risk [RR], 2.54; 95% confidence interval [CI], 1.76-3.66; P<0.001) than those operated on at or after 24 hours. This association persisted in a subgroup analysis restricted to contemporary studies published since 2000 (RR, 2.57; 95% CI, 1.00-6.62; P<0.001). Additional subgroup analyses demonstrated significantly higher mortality in neonates who underwent repair within 24 hours than in those who underwent repair at 24-48 hours (P<0.001), whereas mortality did not differ significantly between those who underwent repair at 24-48 hours and those who underwent repair after 48 hours (P=0.65). Surgical timing did not significantly alter mortality in a specific subset of newborns requiring ECMO support. In conclusion, a brief period of stabilization of at least 24 hours significantly improved survival among neonates with CDH, whereas delaying surgical repair beyond 48 hours conferred no additional survival benefits.
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7. Antibiotic pretreatment and culture yield in pediatric osteoarticular infection: a systematic review and meta-analysis.
PMID:日期:2026-09-14Whether early antibiotic administration compromises microbiological tissue culture yield in children with suspected osteoarticular infection remains a common clinical concern, yet the underlying evidence has never been pooled. We performed a systematic review and meta-analysis to quantify the association between antibiotic pretreatment and tissue culture yield in pediatric osteomyelitis and septic arthritis. MEDLINE (PubMed) and Embase (Ovid) were searched from inception to December 2025 under a protocol prospectively registered with PROSPERO (CRD420251126960); the review is reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020 statement. Eligible studies reported tissue culture yield in pediatric patients (0-18 years) with osteoarticular infection stratified by antibiotic exposure prior to culture; all included evidence was observational, and no randomized controlled trials were identified. Risk of bias was assessed using a modified Newcastle-Ottawa Scale, and a Der Simonian-Laird random-effects meta-analysis was performed for the primary outcome of tissue culture positivity from the infection site. Nine studies: 7 retrospective cohort studies and 2 case series, comprising 1,704 tissue culture specimens were included. Antibiotic pretreatment was not associated with reduced tissue culture yield (odds ratio, 1.60; 95% confidence interval, 1.23-2.08; P=0.0004; I²=8.9%), with culture positivity of 71.5% in pretreated versus 60.0% in not-pretreated specimens. Because an odds ratio greater than 1 could be misread as a benefit of antibiotics, we emphasize that this direction most plausibly reflects confounding by indication or disease severity rather than a true effect on yield. No evidence of publication bias was detected (Egger P=0.99). Pooled evidence does not support routinely withholding antibiotics solely to preserve tissue culture yield in pediatric osteoarticular infection. Because the included studies were observational and subject to confounding by indication, these findings should not be taken as a uniform recommendation on antibiotic timing; decisions should remain individualized, with appropriate specimens obtained before antibiotics whenever clinically feasible.
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8. Effect of varicella vaccine introduction on chickenpox incidence in Kingdom of Bahrain.
PMID:日期:2026-09-14Chickenpox (varicella) is a highly contagious and self-limiting disease in children. However, complications and hospitalizations may occur. In Bahrain, the varicella vaccine was introduced into the routine childhood immunization schedule in May 2015. However, published data describing the epidemiological patterns of varicella postvaccine introduction are limited. This study aimed to estimate varicella vaccine effectiveness (VE); investigate changes in varicella incidence and seasonal variation; compare age groups, healthcare utilization, and hospitalization; and identify predictors of vaccine uptake. This retrospective national study included all clinically diagnosed varicella cases reported to the Public Health Directorate in Bahrain in 2010-2024. Annual and age-specific incidence rates and seasonal variations were calculated. Demographic characteristics, healthcare settings, and hospitalizations were compared by vaccination status. Varicella VE was estimated using a screening method. Of the 34,499 varicella surveillance records, 32,177 were confirmed as chickenpox cases (15,579 in 2010- 2013, 16,598 in 2014-2024). The annual incidence peaked at 251.8 per 100,000 in 2015 and declined to 28.5 per 100,000 by 2024 postvaccination (88.7% reduction). Seasonal peaks were more evident between 2014 and 2019 but became less pronounced thereafter. Most patients were male (57.4%), Bahraini nationals (69.1%), or unvaccinated (90.1%). The most affected age groups were children aged 5-9 years (36.1%) and 0-4 years (28.4%). More than 98% of the cases were managed in primary healthcare settings. Only 12 of the unvaccinated patients (0.1%) required hospitalization. The calculated VE ranged from 97.7% to 100%. Compared to children aged 0-4 years, all older age groups had significantly lower odds of vaccination (P<0.001). Similarly, non-Bahraini patients had a lower odd than Bahraini patients (odds ratio, 0.744; 95% confidence interval, 0.633- 0.875; P<0.001). The introduction of routine childhood varicella vaccination in Bahrain resulted in a substantial decline in the incidence of varicella, particularly among vaccine-eligible children. Severe diseases requiring hospitalization are rare and occur only in unvaccinated individuals. Age and nationality were independent predictors of vaccine uptake.
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9. Atherogenic lipid profile changes and their cardiovascular consequences across degrees of obesity in children and adolescents: a structured narrative review.
PMID:日期:2026-09-14Childhood and adolescent obesity is strongly associated with an atherogenic lipid profile and silent cardiovascular injury that begins early and evolves over time. In this structured review, we synthesized PubMed-indexed evidence from the past 25 years on lipid profile changes in children and adolescents with varying degrees of obesity- overweight, obesity, and severe obesity-and their cardiovascular consequences from childhood through young adulthood, as well as interventions that improve lipid profile and cardiovascular risk. Obesity-related dyslipidemia consistently involves elevated triglyceride, reduced high-density lipoprotein cholesterol (HDL-C), and elevated non-HDL-C levels, as well as increased triglyceride/ HDL-C ratio, whereas low-density lipoprotein cholesterol levels, although clinically important, are less consistently abnormal; the burden rises with obesity severity. In childhood, this pattern manifests with subclinical endothelial dysfunction and early carotid intimal thickening; during adolescence, arterial stiffness, elevated blood pressure levels, and early left ventricular remodeling with diastolic dysfunction become detectable, particularly in severe obesity; by young adulthood, these changes progress into accelerated atherosclerosis and clinical car diovascular risk. Mechanistically, visceral adiposity increases free fatty acid flux and promotes hepatic very-lowdensity lipoprotein overproduction, while adipose tissue inflammation, low adiponectin levels, oxidative stress, and impaired nitric oxide bioavailability link the lipid profile to vascular and cardiac injury through insulin resistance. Lifestyle interventions and improving physical fitness and dietary quality remain first-line treatments. Antiobesity pharmacotherapy and metabolic-bariatric surgery can improve weight and cardiometabolic risk in selected adolescents with severe obesity, but long-term pediatric cardiovascular outcome data remain limited. Routine lipid profile screening combined with blood pressure, insulin resistance, and obesity severity assessments should be integrated with early, family-centered intervention to reduce lifelong cardiovascular risk.
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10. Electronic media exposure and neurodevelopment in children under 5 years of age: an updated evidence-based narrative review.
PMID:日期:2026-09-08The rapid integration of electronic media into daily life has transformed early childhood experiences worldwide. While digital technology offers opportunities for learning, communication, and entertainment, concerns persist regarding its impact on neurodevelopment during the critical early years of life. This narrative review synthesizes current evidence on the association between electronic media exposure and neurodevelopmental outcomes in children under 5 years of age. The literature search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library identified 21 original studies, 12 review articles (systematic reviews/meta-analyses, scoping reviews, and narrative reviews), and 4 international guidelines/recommendations, which were included in the narrative synthesis. Evidence related to cognitive, language, motor, behavioral, socioemotional development, sleep, and neuroimaging findings was critically reviewed. Overall, excessive and early screen exposure was associated with language delays, impaired attention and executive functioning, socioemotional difficulties, sleep disturbances, and reduced motor activity. Sleep disruption, including shorter sleep duration and delayed sleep onset, may represent an important pathway linking excessive media use with adverse neurodevelopmental outcomes. Neuroimaging studies also suggest reduced white matter integrity in language-related brain pathways, providing biological plausibility for these associations.Developmental outcomes were influenced by parental mediation, content quality, socioeconomic factors, and increased screen exposure during the coronavirus disease 2019 pandemic. Current guidelines from the American Academy of Pediatrics, World Health Organization, and Indian Academy of Pediatrics recommend limiting screen exposure and promoting caregiver-supervised, developmentally appropriate media use. Excessive and unsupervised electronic media use may adversely affect multiple domains of neurodevelopment, particularly when it replaces interactive play, caregiver engagement, and healthy sleep. Further longitudinal studies incorporating objective measures of media exposure, sleep assessment, and neuroimaging are needed to strengthen current evidence and guide pediatric recommendations.