Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns.To address this public health concern,we conducted a comprehensive study to examine the association between c...Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns.To address this public health concern,we conducted a comprehensive study to examine the association between coarse cereals consumption and body fat percentage(BFP)in Chinese children and adolescents.Methods The study included 48,305 children aged 6–17 years from 28 districts/counties in 14 provinces across seven regions of China(24,152 girls and 24,153 boys).BFP was examined using bioelectrical impedance analysis in the early morning.Coarse cereals consumption was assessed using a Food Frequency Questionnaire and categorized into three groups:0 g/1,000 kcal per day,0–10 g/1,000kcal per day,and>10 g/1,000 kcal per day(daily consumption of coarse cereals×1,000/total energy consumption).Quantile regression model was used to analyze the association between coarse cereals and BFP,adjusting for potential confounders such as age,pubertal development stage,urban/rural and regional factors,total daily dietary energy consumption,sedentary time,moderate-to-high physical activity,household income,parental education,and consumption of other foods.Results Boys aged 6–10,11–14,and 15–17 years had median daily coarse cereals consumptions of6.6 g,7.1 g,and 5.7 g,with BFP of 19.6%,19.5%,and 17.5%(all P<0.05).Girls in the same age groups showed consumption of 7.1 g,8.4 g,and 6.7 g,with BFP of 20.3%,26.4%,and 31.0%(all P<0.05).The quantile regression results for boys showed that daily consumption of coarse cereals was significantly correlated with their BFP in the 0.15,0.25,and 0.50 quartiles,with regression coefficients of-0.257,-0.221,and-0.330,respectively,after adjusting for potential confounders(P<0.05).For girls,there was a significant correlation with PBF at the 0.05,0.15,0.25,0.50,0.75,and 0.85 quartiles,with regression coefficients of-0.258,-0.366,-0.372,-0.431,-0.472,and-0.503(P<0.05 for all).Conclusions Coarse cereals consumption among Chinese children and adolescents remains relatively low.Higher consumption was inversely associated with BFP in children aged 6–17 years.Future interventional studies should assess how increased coarse cereals consumption prevents childhood obesity.展开更多
BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental...BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.展开更多
This paper systematically reviews epidemiological empirical studies on the association between children’s sleep problems (such as insufficient sleep, sleep-disordered breathing, and circadian rhythm disorders) and co...This paper systematically reviews epidemiological empirical studies on the association between children’s sleep problems (such as insufficient sleep, sleep-disordered breathing, and circadian rhythm disorders) and common oral diseases (dental caries, malocclusion, periodontal diseases, etc.). Starting from potential biological mechanisms, it deeply analyzes the correlation from dimensions including salivary secretion rhythm disturbance, oral microbiota imbalance, abnormal inflammatory response, and abnormal circadian rhythm gene regulation. The limitations of existing research and future development directions are discussed, providing references for clinical interventions and subsequent studies on children’s sleep and oral health.展开更多
Background:This study aims to analyze the genotypes and antibiotic resistance characteristics of Clostridioides difficile(C.difficile)isolated from children under 5 years old with diarrhea in Yunnan Province.Methods:F...Background:This study aims to analyze the genotypes and antibiotic resistance characteristics of Clostridioides difficile(C.difficile)isolated from children under 5 years old with diarrhea in Yunnan Province.Methods:Fecal samples from children under 5 years of age with diarrhea in Kunming city from 2013-2019 were collected for anaerobic culture,isolation,and identification of C.difficile.The antibiotic susceptibility tests and molecular typing of isolated strains were also performed.Results:44 strains of C.difficile were isolated from 896 fecal samples.Of these,40 strains(90.9%)were positive for both tcdA and tcdB,while 4 strains(9.1%)were negative for both.All isolates were negative for cdtA and cdtB.The isolates were classified into 13 STs,the predominant types were ST3(13 strains,29.5%),ST35(8 strains,18.2%),and ST54(5 strains,11.4%).All the strains were susceptible to metronidazole,amoxicillin/clavulanic acid,vancomycin,and amoxicillin.The highest resistance rate was observed against gentamicin(86.36%),followed by polymyxin E(84.09%),quinupristin-dalfopristin(61.36%),and ceftazidime(36.36%).Some patients with diarrhea had C.difficile co-infections with other pathogens,including norovirus,adenovirus,rotavirus or Salmonella or Escherichia coli.Conclusion:C.difficile strains isolated from children under 5 years of age are mostly toxigenic,and the MLST results are highly diverse.Monitoring and prevention of C.difficile should be strengthened.展开更多
AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED...AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED or at risk of DED were randomly assigned in a 1∶1 ratio to receive either 3%diquafosol sodium eye drops 6 times daily or a blank control at Chongqing Aier Children’s Eye Hospital from November 2023 to November 2024.The primary endpoint was the change in the Dry Eye Questionnaire-5(DEQ-5)score from baseline at 12 wk.Secondary assessments included non-invasive breakup time(NIBUT),tear meniscus height,Schirmer’s test,corneal fluorescein staining score,and axial length.RESULTS:A total of 80 participants(80 eyes)were enrolled(40 in each group),the average age of the participants was 11.11±1.88 years,with 43 females(54%)and 37 males(46%),and all completed the trial.After 12 wk,the DEQ-5 scores for the diquafosol sodium group and the blank control group were 1.88±2.02 and 2.88±2.79,respectively(P=0.079).The diquafosol sodium group demonstrated a significant improvement in DEQ-5 dryness symptom scores(-0.33±0.66 vs.0.05±0.81,P=0.023)and NIBUT(6.18±3.73 vs.-1.09±4.40 s,P<0.001)at 12 wk.Additionally,the diquafosol sodium group showed no axial length elongation,in contrast to the blank control group,which exhibited elongation(0.00±0.08 vs.0.05±0.10 mm,P=0.013).No other significant differences were found in the secondary endpoints.No adverse events occurred during the trial.CONCLUSION:Although no statistically significant improvements were noted in the overall DEQ-5 scores,the 3%diquafosol sodium eye drops significantly improved dryness symptoms and NIBUT when compared to the blank control group.展开更多
This study evaluated the physical development levels of preschool children across different districts of Chongqing,considering variations in age and gender,with the aim of proposing a differentiated physical education...This study evaluated the physical development levels of preschool children across different districts of Chongqing,considering variations in age and gender,with the aim of proposing a differentiated physical education curriculum implementation plan tailored to the differences in age,gender,and physical fitness levels among this population.A total of 1209 preschool children(46.89%girls)aged 3-6 years were tested on eight items:height,weight,standing long jump,10 m toss,seated forward bend,tennis ball toss,continuous jump on both feet and walking the balance beam.One-way variance,multiple comparisons and t-tests were used to calculate and express differences in their results.Overall,preschoolers(City)performed better than preschoolers(Country)in height and standing long jump,and preschoolers(Country)performed better than preschoolers(City)in continuous jumping on both feet.With the exception of the seated forward bend test,there were significant differences in the fitness levels of preschoolers by grade,with preschoolers of different genders(Boys)performing better than preschoolers(Girls)in height,weight,standing long jump and tennis throw.Preschoolers(Girls)performed better than preschoolers(Boys)in the 10 m toss and bend in a sitting position,and the gender differences were more pronounced with increasing age.展开更多
Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood...Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood.The present study investigated the association between prenatal depression and children's growth trajectories,as well as the odds of overweight and obesity from 1 to 36 months,while also accounting for maternal anxiety and stress.We analyzed data from 4710 mother-child dyads in the Jiangsu Birth Cohort,assessing maternal psychological distress across trimesters and categorizing participants into groups with mild,moderate,and severe depressive symptomatology.Children's weight-for-length z-scores(WLZ)were used to assess overweight/obesity prevalence,and growth patterns were identified through trajectory models.The results from the generalized estimating equations analysis showed that greater depressive symptomatology during pregnancy was associated with a 28%to 41%increase in the odds of childhood overweight/obesity across all three trimesters,compared with mild depressive symptomatology.We identified five distinct WLZ growth trajectory patterns,and found that mothers with greater depressive symptomatology were 39%–47%more likely to have children who followed a very-high-stable growth trajectory,compared with mothers with mild depressive symptomatology.These findings highlight the significant impact of prenatal depression on adverse growth patterns and childhood overweight/obesity,underscoring the need for early intervention.展开更多
Objective This study aimed to describe 24-hour movement behaviors,including physical activity,sedentary behavior,and sleep period,among Chinese preschoolers using nationally representative data,and examine disparities...Objective This study aimed to describe 24-hour movement behaviors,including physical activity,sedentary behavior,and sleep period,among Chinese preschoolers using nationally representative data,and examine disparities by age,gender,and residence.Methods A cross-sectional analysis was conducted using data from the China National Nutrition and Health Systematic Survey for Children(2019–2021),including 10,935 children aged 3–5 years.Daily total time of physical activity(TPA),total time of sedentary behaviors(TSB),and total sleep period(TSP)was collected via validated structured questionnaires.Physical inactivity was defined as<180 minutes of TPA per day.Results Median TPA was 121.4(IQR:71.4−209.6)minutes/day,and TSB was 231.4(IQR:175.0−304.3)minutes/day,with 11.46±1.00 hours/day average TSP.Overall,68.8%were physically inactive,with higher prevalence in rural(73.3%)versus urban areas(64.8%,P<0.001).TPA and TSB increased with age,while TSP decreased(all P<0.001).No significant gender differences were observed.Conclusion Most Chinese preschoolers exhibit insufficient physical activity and excessive sedentary behaviors,with notable urban–rural disparities and an escalating trend of ageing.Continuous monitoring and targeted interventions,especially in rural areas,are urgently needed.展开更多
Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general ...Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.展开更多
AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional...AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.展开更多
1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconn...1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.展开更多
Background:Childhood leukemia,a malignant proliferative disorder of the hematopoietic system and the most common childhood cancer,poses a significant threat to the lives and health of affected children.For parents,a l...Background:Childhood leukemia,a malignant proliferative disorder of the hematopoietic system and the most common childhood cancer,poses a significant threat to the lives and health of affected children.For parents,a leukemia diagnosis in their child is a profoundly traumatic event.As primary caregivers,they endure immense psychological distress and caregiving stress throughout the prolonged and demanding treatment process,which can adversely affect their own well-being and caregiving capacity.However,the psychological mechanisms,such as the role of mindfulness,linking caregiver stress to parental coping strategies remain underexplored,and evidence-based interventions to support these parents are needed.Methods:In Study 1,we administered a cross-sectional survey to 242 parents of children with leukemia who were hospitalized at the Affiliated Hospital of Qingdao University between January and August 2024.Participants completed measures assessing caregiver burden,mindful attention awareness,and parental coping style.In Study 2,we further evaluated the effects of a Mindfulness-Based Stress Reduction(MBSR)intervention.Results:The results of Study 1 revealed:(1)The caregiving stress significantly and negatively predicted coping style(β=−1.18,95%CI[−2.18,−0.18],p<0.01).(2)Caregiving stress also significantly and negatively predicted mindfulness(β=−1.90,95%CI[−2.43,−1.38],p<0.01).(3)Conversely,mindfulness significantly and positively predicted coping style(β=0.85,95%CI[0.62,1.07],p<0.01).These findings suggest that mindfulness mediates the relationship between caregiver burden and coping style.In Study 2,the experimental group showed a significant decrease in caregiver stress post-intervention(t=2.24,p<0.05),a significant increase in mindfulness(t=−4.61,p<0.001),and a significant improvement in coping style(t=−2.36,p<0.01).No significant changes were observed in the control group.Conclusion:MBSR can effectively enhance mindfulness and promote adaptive coping strategies,while reducing caregiver burden among parents of children with leukemia.展开更多
At present,the caries rate of deciduous teeth in Chinese children remains high,and there is a huge gap with the actual consultation rate,indicating that children’s oral health management has a long way to go.Against ...At present,the caries rate of deciduous teeth in Chinese children remains high,and there is a huge gap with the actual consultation rate,indicating that children’s oral health management has a long way to go.Against this background,doctors should comply with the development of the“digital intelligence”era and actively explore the innovative application of digital intelligence technology in children’s oral health management to solve the practical dilemmas of children’s oral health.Based on this,this paper will briefly analyze the importance of children’s oral health management in the era of“digital intelligence”and the current status of children’s oral health management,and discuss the improvement strategies of children’s oral health management in the era of“digital intelligence”.展开更多
BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current statu...BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.展开更多
Mycotoxins are the toxic metabolites produced by the fungi that grow in food crops;however,the modified mycotoxins are the undetectable metabolites during testing for the parent mycotoxin.Although more than 300 mycoto...Mycotoxins are the toxic metabolites produced by the fungi that grow in food crops;however,the modified mycotoxins are the undetectable metabolites during testing for the parent mycotoxin.Although more than 300 mycotoxins were discovered and identified,little is known about the effects of most of them or their modified forms on child health.Aflatoxins are well known to induce liver cancer and play a significant role in the impairment of child growth.Fumonisin also are known to induce esophageal cancer and neural tube defects.However,deoxynivalenol and the other trichothecenes are well known as immunotoxic and induce gastroenteritis.In this review,the adverse health hazards in children associated with the major mycotoxins as well as the modified forms of fusarium mycotoxins were described.Additionally,the global burden of the health ghazards resulted from the exposure of children to dietary mycotoxin.The risk assessment,risk characterization and the challenges in risk characterization of multiple mycotoxins in children food were discussed.展开更多
Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CIN...Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CINAHL,and Web of Science were systematically searched for this network meta-analysis.Randomized controlled studies(RCTs)that included children aged 4-12 years with no physical or mental conditions;performed at least 1 type of lifestyle intervention;reported change in body mass index(BMI),BMI z-score,or body fat percentage(BFP);and were published between January2010 and August 2023 were included.Results:The final analysis included 91 RCTs with aggregate data for 58,649 children.All interventions were categorized into single-arm approaches(physical activity,diet,and behavioral and informational support)and combined arms approaches(bicomponent and multicomponent treatment).Multicomponent treatment showed significant effectiveness on the reduction of BMI(mean deviation(MD)-0.49,95%confidence interval(95%CI):-0.88 to-0.12),BMI z-score(MD=-0.11,95%CI:-0.18 to-0.04),and BFP(MD=-1.69,95%CI:-2.97 to-0.42)compared to the usual care condition.Bicomponent treatment also significantly reduced BMI(MD=-0.28,95%CI:-0.54 to-0.04)and BMI z-score(MD=-0.07,95%CI:-0.12 to-0.02)compared to usual care.Conclusion:Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP.Among single-component approaches,physical activity engagement emerged as the most effective.These findings should guide practitioners in recommending comprehensive lifestyle modifications for children.Moreover,children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.展开更多
Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractor...Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.展开更多
Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention a...Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.展开更多
BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,pa...BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,particularly in children.This report describes a DPB case resolved with long-term azithromycin therapy,em-phasizing the need for a timely and accurate diagnosis.CASE SUMMARY A 12-year-old girl,diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists,developed a history of chronic productive cough and chronic sinusitis for a year.On examination,she exhibited wheezing and coarse crackles.Despite receiving treatment for an asthma exacer-bation,her symptoms did not improve.A chest X-ray revealed reticulonodular infiltration in both lower lungs,prompting further evaluation with high-resolu-tion computed tomography(HRCT).The HRCT confirmed centrilobular nodule opacities,a'tree-in-bud'pattern,and non-tapering bronchi,suggesting DPB.Elevated cold hemagglutinin titers at 128 further supported the diagnosis.Her cough and sinusitis resolved within a month after starting azithromycin therapy,chosen for its anti-inflammatory and immunomodulatory effects.Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.CONCLUSION This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.展开更多
基金supported by the Special Project of National Science and Technology Basic Resources Survey(Grant No.2017FY101100)。
文摘Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns.To address this public health concern,we conducted a comprehensive study to examine the association between coarse cereals consumption and body fat percentage(BFP)in Chinese children and adolescents.Methods The study included 48,305 children aged 6–17 years from 28 districts/counties in 14 provinces across seven regions of China(24,152 girls and 24,153 boys).BFP was examined using bioelectrical impedance analysis in the early morning.Coarse cereals consumption was assessed using a Food Frequency Questionnaire and categorized into three groups:0 g/1,000 kcal per day,0–10 g/1,000kcal per day,and>10 g/1,000 kcal per day(daily consumption of coarse cereals×1,000/total energy consumption).Quantile regression model was used to analyze the association between coarse cereals and BFP,adjusting for potential confounders such as age,pubertal development stage,urban/rural and regional factors,total daily dietary energy consumption,sedentary time,moderate-to-high physical activity,household income,parental education,and consumption of other foods.Results Boys aged 6–10,11–14,and 15–17 years had median daily coarse cereals consumptions of6.6 g,7.1 g,and 5.7 g,with BFP of 19.6%,19.5%,and 17.5%(all P<0.05).Girls in the same age groups showed consumption of 7.1 g,8.4 g,and 6.7 g,with BFP of 20.3%,26.4%,and 31.0%(all P<0.05).The quantile regression results for boys showed that daily consumption of coarse cereals was significantly correlated with their BFP in the 0.15,0.25,and 0.50 quartiles,with regression coefficients of-0.257,-0.221,and-0.330,respectively,after adjusting for potential confounders(P<0.05).For girls,there was a significant correlation with PBF at the 0.05,0.15,0.25,0.50,0.75,and 0.85 quartiles,with regression coefficients of-0.258,-0.366,-0.372,-0.431,-0.472,and-0.503(P<0.05 for all).Conclusions Coarse cereals consumption among Chinese children and adolescents remains relatively low.Higher consumption was inversely associated with BFP in children aged 6–17 years.Future interventional studies should assess how increased coarse cereals consumption prevents childhood obesity.
文摘BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.
文摘This paper systematically reviews epidemiological empirical studies on the association between children’s sleep problems (such as insufficient sleep, sleep-disordered breathing, and circadian rhythm disorders) and common oral diseases (dental caries, malocclusion, periodontal diseases, etc.). Starting from potential biological mechanisms, it deeply analyzes the correlation from dimensions including salivary secretion rhythm disturbance, oral microbiota imbalance, abnormal inflammatory response, and abnormal circadian rhythm gene regulation. The limitations of existing research and future development directions are discussed, providing references for clinical interventions and subsequent studies on children’s sleep and oral health.
基金supported by Yunnan Provincial Key Research and Development Program(grant No.202503AP140034)Infectious Disease Spectrum and Epidemiology Project of YNCDC(grant No.YNAPM2025-003).
文摘Background:This study aims to analyze the genotypes and antibiotic resistance characteristics of Clostridioides difficile(C.difficile)isolated from children under 5 years old with diarrhea in Yunnan Province.Methods:Fecal samples from children under 5 years of age with diarrhea in Kunming city from 2013-2019 were collected for anaerobic culture,isolation,and identification of C.difficile.The antibiotic susceptibility tests and molecular typing of isolated strains were also performed.Results:44 strains of C.difficile were isolated from 896 fecal samples.Of these,40 strains(90.9%)were positive for both tcdA and tcdB,while 4 strains(9.1%)were negative for both.All isolates were negative for cdtA and cdtB.The isolates were classified into 13 STs,the predominant types were ST3(13 strains,29.5%),ST35(8 strains,18.2%),and ST54(5 strains,11.4%).All the strains were susceptible to metronidazole,amoxicillin/clavulanic acid,vancomycin,and amoxicillin.The highest resistance rate was observed against gentamicin(86.36%),followed by polymyxin E(84.09%),quinupristin-dalfopristin(61.36%),and ceftazidime(36.36%).Some patients with diarrhea had C.difficile co-infections with other pathogens,including norovirus,adenovirus,rotavirus or Salmonella or Escherichia coli.Conclusion:C.difficile strains isolated from children under 5 years of age are mostly toxigenic,and the MLST results are highly diverse.Monitoring and prevention of C.difficile should be strengthened.
文摘AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED or at risk of DED were randomly assigned in a 1∶1 ratio to receive either 3%diquafosol sodium eye drops 6 times daily or a blank control at Chongqing Aier Children’s Eye Hospital from November 2023 to November 2024.The primary endpoint was the change in the Dry Eye Questionnaire-5(DEQ-5)score from baseline at 12 wk.Secondary assessments included non-invasive breakup time(NIBUT),tear meniscus height,Schirmer’s test,corneal fluorescein staining score,and axial length.RESULTS:A total of 80 participants(80 eyes)were enrolled(40 in each group),the average age of the participants was 11.11±1.88 years,with 43 females(54%)and 37 males(46%),and all completed the trial.After 12 wk,the DEQ-5 scores for the diquafosol sodium group and the blank control group were 1.88±2.02 and 2.88±2.79,respectively(P=0.079).The diquafosol sodium group demonstrated a significant improvement in DEQ-5 dryness symptom scores(-0.33±0.66 vs.0.05±0.81,P=0.023)and NIBUT(6.18±3.73 vs.-1.09±4.40 s,P<0.001)at 12 wk.Additionally,the diquafosol sodium group showed no axial length elongation,in contrast to the blank control group,which exhibited elongation(0.00±0.08 vs.0.05±0.10 mm,P=0.013).No other significant differences were found in the secondary endpoints.No adverse events occurred during the trial.CONCLUSION:Although no statistically significant improvements were noted in the overall DEQ-5 scores,the 3%diquafosol sodium eye drops significantly improved dryness symptoms and NIBUT when compared to the blank control group.
基金2024 Chongqing Vocational Education Teaching Reform Research Project(Project No.:Z2241594)2025 Project of The Science and Technology Research Program of the Chongqing Education Commission in China(Project No.:KJZD-K202502902)。
文摘This study evaluated the physical development levels of preschool children across different districts of Chongqing,considering variations in age and gender,with the aim of proposing a differentiated physical education curriculum implementation plan tailored to the differences in age,gender,and physical fitness levels among this population.A total of 1209 preschool children(46.89%girls)aged 3-6 years were tested on eight items:height,weight,standing long jump,10 m toss,seated forward bend,tennis ball toss,continuous jump on both feet and walking the balance beam.One-way variance,multiple comparisons and t-tests were used to calculate and express differences in their results.Overall,preschoolers(City)performed better than preschoolers(Country)in height and standing long jump,and preschoolers(Country)performed better than preschoolers(City)in continuous jumping on both feet.With the exception of the seated forward bend test,there were significant differences in the fitness levels of preschoolers by grade,with preschoolers of different genders(Boys)performing better than preschoolers(Girls)in height,weight,standing long jump and tennis throw.Preschoolers(Girls)performed better than preschoolers(Boys)in the 10 m toss and bend in a sitting position,and the gender differences were more pronounced with increasing age.
基金supported by the National Natural Science Foundation of China(Grant No.82373581 to Yuan Lin).
文摘Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood.The present study investigated the association between prenatal depression and children's growth trajectories,as well as the odds of overweight and obesity from 1 to 36 months,while also accounting for maternal anxiety and stress.We analyzed data from 4710 mother-child dyads in the Jiangsu Birth Cohort,assessing maternal psychological distress across trimesters and categorizing participants into groups with mild,moderate,and severe depressive symptomatology.Children's weight-for-length z-scores(WLZ)were used to assess overweight/obesity prevalence,and growth patterns were identified through trajectory models.The results from the generalized estimating equations analysis showed that greater depressive symptomatology during pregnancy was associated with a 28%to 41%increase in the odds of childhood overweight/obesity across all three trimesters,compared with mild depressive symptomatology.We identified five distinct WLZ growth trajectory patterns,and found that mothers with greater depressive symptomatology were 39%–47%more likely to have children who followed a very-high-stable growth trajectory,compared with mothers with mild depressive symptomatology.These findings highlight the significant impact of prenatal depression on adverse growth patterns and childhood overweight/obesity,underscoring the need for early intervention.
基金supported by National Special Program for Science&Technology Basic Resources Investigation of China(Grant No.2017GFY101100).
文摘Objective This study aimed to describe 24-hour movement behaviors,including physical activity,sedentary behavior,and sleep period,among Chinese preschoolers using nationally representative data,and examine disparities by age,gender,and residence.Methods A cross-sectional analysis was conducted using data from the China National Nutrition and Health Systematic Survey for Children(2019–2021),including 10,935 children aged 3–5 years.Daily total time of physical activity(TPA),total time of sedentary behaviors(TSB),and total sleep period(TSP)was collected via validated structured questionnaires.Physical inactivity was defined as<180 minutes of TPA per day.Results Median TPA was 121.4(IQR:71.4−209.6)minutes/day,and TSB was 231.4(IQR:175.0−304.3)minutes/day,with 11.46±1.00 hours/day average TSP.Overall,68.8%were physically inactive,with higher prevalence in rural(73.3%)versus urban areas(64.8%,P<0.001).TPA and TSB increased with age,while TSP decreased(all P<0.001).No significant gender differences were observed.Conclusion Most Chinese preschoolers exhibit insufficient physical activity and excessive sedentary behaviors,with notable urban–rural disparities and an escalating trend of ageing.Continuous monitoring and targeted interventions,especially in rural areas,are urgently needed.
文摘Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.
基金Supported by Vision International Eye Missions-USA,“One Drop for All”,Italy,and Private Donors in the Netherlands.
文摘AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.
文摘1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.
基金approved by the Ethics Review Committee of Northwest Normal University(Approval No.:[2023028]).All participants signed the informed consent in this study.
文摘Background:Childhood leukemia,a malignant proliferative disorder of the hematopoietic system and the most common childhood cancer,poses a significant threat to the lives and health of affected children.For parents,a leukemia diagnosis in their child is a profoundly traumatic event.As primary caregivers,they endure immense psychological distress and caregiving stress throughout the prolonged and demanding treatment process,which can adversely affect their own well-being and caregiving capacity.However,the psychological mechanisms,such as the role of mindfulness,linking caregiver stress to parental coping strategies remain underexplored,and evidence-based interventions to support these parents are needed.Methods:In Study 1,we administered a cross-sectional survey to 242 parents of children with leukemia who were hospitalized at the Affiliated Hospital of Qingdao University between January and August 2024.Participants completed measures assessing caregiver burden,mindful attention awareness,and parental coping style.In Study 2,we further evaluated the effects of a Mindfulness-Based Stress Reduction(MBSR)intervention.Results:The results of Study 1 revealed:(1)The caregiving stress significantly and negatively predicted coping style(β=−1.18,95%CI[−2.18,−0.18],p<0.01).(2)Caregiving stress also significantly and negatively predicted mindfulness(β=−1.90,95%CI[−2.43,−1.38],p<0.01).(3)Conversely,mindfulness significantly and positively predicted coping style(β=0.85,95%CI[0.62,1.07],p<0.01).These findings suggest that mindfulness mediates the relationship between caregiver burden and coping style.In Study 2,the experimental group showed a significant decrease in caregiver stress post-intervention(t=2.24,p<0.05),a significant increase in mindfulness(t=−4.61,p<0.001),and a significant improvement in coping style(t=−2.36,p<0.01).No significant changes were observed in the control group.Conclusion:MBSR can effectively enhance mindfulness and promote adaptive coping strategies,while reducing caregiver burden among parents of children with leukemia.
文摘At present,the caries rate of deciduous teeth in Chinese children remains high,and there is a huge gap with the actual consultation rate,indicating that children’s oral health management has a long way to go.Against this background,doctors should comply with the development of the“digital intelligence”era and actively explore the innovative application of digital intelligence technology in children’s oral health management to solve the practical dilemmas of children’s oral health.Based on this,this paper will briefly analyze the importance of children’s oral health management in the era of“digital intelligence”and the current status of children’s oral health management,and discuss the improvement strategies of children’s oral health management in the era of“digital intelligence”.
基金Supported by the Shijiazhuang Science and Technology Research and Development Program,No.221460383.
文摘BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.
文摘Mycotoxins are the toxic metabolites produced by the fungi that grow in food crops;however,the modified mycotoxins are the undetectable metabolites during testing for the parent mycotoxin.Although more than 300 mycotoxins were discovered and identified,little is known about the effects of most of them or their modified forms on child health.Aflatoxins are well known to induce liver cancer and play a significant role in the impairment of child growth.Fumonisin also are known to induce esophageal cancer and neural tube defects.However,deoxynivalenol and the other trichothecenes are well known as immunotoxic and induce gastroenteritis.In this review,the adverse health hazards in children associated with the major mycotoxins as well as the modified forms of fusarium mycotoxins were described.Additionally,the global burden of the health ghazards resulted from the exposure of children to dietary mycotoxin.The risk assessment,risk characterization and the challenges in risk characterization of multiple mycotoxins in children food were discussed.
文摘Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CINAHL,and Web of Science were systematically searched for this network meta-analysis.Randomized controlled studies(RCTs)that included children aged 4-12 years with no physical or mental conditions;performed at least 1 type of lifestyle intervention;reported change in body mass index(BMI),BMI z-score,or body fat percentage(BFP);and were published between January2010 and August 2023 were included.Results:The final analysis included 91 RCTs with aggregate data for 58,649 children.All interventions were categorized into single-arm approaches(physical activity,diet,and behavioral and informational support)and combined arms approaches(bicomponent and multicomponent treatment).Multicomponent treatment showed significant effectiveness on the reduction of BMI(mean deviation(MD)-0.49,95%confidence interval(95%CI):-0.88 to-0.12),BMI z-score(MD=-0.11,95%CI:-0.18 to-0.04),and BFP(MD=-1.69,95%CI:-2.97 to-0.42)compared to the usual care condition.Bicomponent treatment also significantly reduced BMI(MD=-0.28,95%CI:-0.54 to-0.04)and BMI z-score(MD=-0.07,95%CI:-0.12 to-0.02)compared to usual care.Conclusion:Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP.Among single-component approaches,physical activity engagement emerged as the most effective.These findings should guide practitioners in recommending comprehensive lifestyle modifications for children.Moreover,children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.
文摘Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.
文摘Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.
文摘BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,particularly in children.This report describes a DPB case resolved with long-term azithromycin therapy,em-phasizing the need for a timely and accurate diagnosis.CASE SUMMARY A 12-year-old girl,diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists,developed a history of chronic productive cough and chronic sinusitis for a year.On examination,she exhibited wheezing and coarse crackles.Despite receiving treatment for an asthma exacer-bation,her symptoms did not improve.A chest X-ray revealed reticulonodular infiltration in both lower lungs,prompting further evaluation with high-resolu-tion computed tomography(HRCT).The HRCT confirmed centrilobular nodule opacities,a'tree-in-bud'pattern,and non-tapering bronchi,suggesting DPB.Elevated cold hemagglutinin titers at 128 further supported the diagnosis.Her cough and sinusitis resolved within a month after starting azithromycin therapy,chosen for its anti-inflammatory and immunomodulatory effects.Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.CONCLUSION This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.
