BMC Pediatrics[JOURNAL]
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200 papers
Asthma and overt stroke in children with sickle cell disease: a multicenter pediatric cohort study in French Guiana.
Bafunyembaka G, Nacher M, Maniassom C … +3 more , Makembi A, Furero P, Elenga N
BMC Pediatr · 2026 Jul · PMID 42387435 · Full text
BACKGROUND: Stroke remains one of the most severe complications of sickle cell disease (SCD) in children. Although asthma is increasingly recognized as a clinical marker of SCD severity, its association with cerebrovascu...
BACKGROUND: Stroke remains one of the most severe complications of sickle cell disease (SCD) in children. Although asthma is increasingly recognized as a clinical marker of SCD severity, its association with cerebrovascular complications remains insufficiently characterized. We aimed to evaluate the association between physician-documented asthma and overt stroke in children with SCD and to explore the associations of ferritin levels and continuity of care with overt stroke. METHODS: We conducted a multicenter observational cohort study including 175 children with confirmed SCD followed in three public hospitals in French Guiana between January 2012 and December 2022. Overt stroke was defined as a clinically documented neurological deficit lasting > 24 h and confirmed by brain MRI. Asthma status, ferritin levels, and continuity of care, defined as attendance at ≥ 75% of scheduled routine visits during a 12-month period, were assessed. Multivariable penalized logistic regression was used to estimate adjusted associations with overt stroke. RESULTS: Twenty-four children (13.7%) had a history of overt stroke. Asthma was significantly more frequent among children with stroke than among those without stroke (41.7% vs. 16.6%; unadjusted OR 3.60; 95% CI 1.44-9.02). All 175 children had complete data for the covariates included in the adjusted multivariable analysis. In multivariable analysis, asthma remained associated with higher odds of overt stroke (adjusted OR 3.05; 95% CI 1.12-8.31). Ferritin showed a non-significant trend toward higher odds of stroke (adjusted OR 1.58 per SD increase; 95% CI 0.99-2.63). Irregular continuity of care also showed a non-significant increase in the odds of stroke (adjusted OR 2.10; 95% CI 0.88-5.02). All 175 children were included in the adjusted multivariable analysis. CONCLUSIONS: Physician-documented asthma remained associated with higher odds of overt stroke after adjustment in this multicenter pediatric SCD cohort. Ferritin levels and irregular continuity of care showed non-significant exploratory trends. These findings suggest that asthma may identify a subgroup of children with SCD requiring closer clinical assessment. Prospective studies are needed to confirm this association and clarify its clinical significance.
Hyper-hypodontia, gemination, ankyloglossia and multiple high-attached frena: a case report.
Bahrololoomi Z, Irannezhad M, Javaheri-Mahd M … +1 more , Zarebidoki F
BMC Pediatr · 2026 Jul · PMID 42387432 · Full text
BACKGROUND: The concomitant occurrence of hypodontia and hyperdontia is a rare clinical phenomenon. This report describes the multidisciplinary management of a non-syndromic 8-year-old patient presenting with a complex c...
BACKGROUND: The concomitant occurrence of hypodontia and hyperdontia is a rare clinical phenomenon. This report describes the multidisciplinary management of a non-syndromic 8-year-old patient presenting with a complex combination of gemination, bilateral missing mandibular lateral incisors, supplemental maxillary canines, ankyloglossia, and multiple hyperplastic frena. CASE PRESENTATION: An 8-year-old female was referred for the management of ankyloglossia. Clinical and radiographic assessments, utilizing panoramic imaging and cone beam computed tomography (CBCT), identified bilateral supernumerary maxillary canines and agenesis of mandibular lateral incisors. Under general anesthesia, the supernumerary teeth were surgically extracted, and frenectomies were performed to restore tongue mobility and enhance periodontal health through improved plaque control. Furthermore, a geminated tooth (73) received prophylactic resin restoration to preserve arch integrity. Maxillary expansion was initiated using a Hyrax appliance for orthodontic interception. The patient remains under longitudinal observation for definitive interdisciplinary orthodontic treatment. CONCLUSION: Managing concurrent numerical and structural dental anomalies requires early detection via advanced imaging and a coordinated, multi-specialty approach. Clinical intervention should prioritize the restoration of physiological function and the prevention of secondary complications, such as periodontal instability or severe malocclusion, rather than isolated phenotypic corrections.
Low serum vitamin D levels are associated with neonatal indirect hyperbilirubinemia and prolonged phototherapy duration: a retrospective case-control study.
Demir BB, Hazer İ, Turkeli A
BMC Pediatr · 2026 Jun · PMID 42380924 · Full text
OBJECTIVE: To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels, indirect hyperbilirubinemia severity, and phototherapy duration in term neonates. METHODS: This retrospective case-control stu...
OBJECTIVE: To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels, indirect hyperbilirubinemia severity, and phototherapy duration in term neonates. METHODS: This retrospective case-control study included 79 term neonates admitted to a tertiary neonatal intensive care unit between March 2023 and March 2024. Thirty-nine neonates requiring phototherapy for indirect hyperbilirubinemia (case group) were compared with 40 healthy term neonates (control group). Clinical and biochemical parameters, including bilirubin, 25(OH)D, calcium, phosphorus, magnesium, and alkaline phosphatase levels, were evaluated. Correlation, receiver operating characteristic [ROC], and multivariable regression analyses were performed to assess the association between vitamin D status and phototherapy duration in indirect hyperbilirubinemia. RESULTS: Serum 25(OH)D levels were significantly lower in neonates requiring phototherapy, with 75% demonstrating vitamin D deficiency (< 20 ng/mL). Lower vitamin D levels were associated with prolonged phototherapy duration (r = - 0.337, p = 0.036). Although no significant linear correlation was observed between serum 25(OH)D concentration and baseline bilirubin levels, neonates with vitamin D concentrations < 20 ng/mL exhibited significantly higher bilirubin levels than those with concentrations ≥ 20 ng/mL. ROC analysis demonstrated moderate predictive performance for prolonged phototherapy duration (AUC = 0.78, 95% CI: 0.67-0.88). The optimal cutoff value was 17.2 ng/mL, yielding a sensitivity of 84% and specificity of 69%. Multivariable regression analysis identified serum vitamin D level and baseline bilirubin concentration as significant predictors of phototherapy duration. CONCLUSION: Lower serum 25(OH)D concentrations were associated with indirect hyperbilirubinemia and prolonged phototherapy duration in term neonates. Larger prospective studies are needed to confirm these findings and clarify their clinical significance.
A case of neonatal Langerhans cell histiocytosis initially presenting with haemorrhagic vesicles: a case report and literature review.
Xiang Y, Qiu YX, Chen ZG … +1 more , Zhang L
BMC Pediatr · 2026 Jun · PMID 42380923 · Full text
BACKGROUND: Neonatal Langerhans cell histiocytosis (LCH) presenting with haemorrhagic vesicles as the initial manifestation is exceedingly rare. CASE PRESENTATION: A neonate with generalized hemorrhagic vesicles and part...
BACKGROUND: Neonatal Langerhans cell histiocytosis (LCH) presenting with haemorrhagic vesicles as the initial manifestation is exceedingly rare. CASE PRESENTATION: A neonate with generalized hemorrhagic vesicles and partial erosion/crusting at birth, The initial differential diagnosis included infections such as syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus; however, specific antibody testing for these pathogens in both the mother and infant returned negative results. The diagnosis of LCH was confirmed by dermatological consultation and histopathological examination.The infant was treated with intravenous cefotaxime-sulbactam and topical fusidic acid & hirudoid cream, leading to gradual crusting of haemorrhagic vesicles. Follow-up at 3-4 weeks postpartum showed resolution of skin lesions, with no recurrence observed after 2 months. CONCLUSIONS: In this study, we documented a unique and notable manifestation of neonatal Langerhans cell histiocytosis.
Liver transplant for paediatric acute liver failure: insights from a newly established paediatric liver transplant program in a developing country.
Fernando M, Tillakaratne S, Gunathilake B … +8 more , Withanage R, Liyanage C, Weerasuriya A, Appuhamy C, Ganewatte E, Ranaweera L, Herath P, Siriwardana R
BMC Pediatr · 2026 Jun · PMID 42374355 · Full text
BACKGROUND: Liver transplantation (LT) is the cure for medically refractory acute liver failure (ALF). In resource-limited settings, establishing a paediatric LT program for paediatric ALF (PALF) encounters unique challe...
BACKGROUND: Liver transplantation (LT) is the cure for medically refractory acute liver failure (ALF). In resource-limited settings, establishing a paediatric LT program for paediatric ALF (PALF) encounters unique challenges. METHODS: This study describes the initial 5-year experience of the paediatric LT (PLT) program at the Colombo North Centre for Liver Diseases (CNCLD), Sri Lanka (March 2020 to March 2025). Data from all PALF cases (n = 35) were retrospectively analyzed. RESULTS: A total of 120 children were referred to LT and 35 (29%) were due to ALF. Median age was 8 years 9 months (range: 2 months - 13 years) and 63% were male. Common etiologies included Wilson disease (23%) and autoimmune liver disease (20%). Spontaneous recovery occurred in 43% (15) while 34% (12/35) underwent LT and 23% (8) died without LT. Of 12 transplant recipients, 8/12 received living donor liver transplants (LDLT) (5/8 related donors, 3/8 altruistic - Buddhist monks), and 4/12 received deceased donor liver transplants (DDLT). The median time from listing to transplant was 72 h. Post-transplant survival in one and three months was 75% and 66% respectively. There were three immediate post-LT deaths due to primary non-function of deceased donor grafts. CONCLUSION: PALF comprised a substantial proportion of referrals in Sri Lanka's nascent PLT program. The majority of LT for PALF were LDLT with favorable outcomes compared to DDLT. Optimum utilization of a budding LT program with timely referrals and availability of altruistic donors have played key roles in the success of the PLT program in a resource limited setting.
Tongue strength, hard palate morphology and adenotonsillar hypertrophy in schoolchildren with early mixed dentition: a cross-sectional study.
Hoang DA, Nguyen VTN, Nguyen DNT … +3 more , Hoang TA, Nguyen TM, Jagomägi T
BMC Pediatr · 2026 Jun · PMID 42374331 · Full text
BACKGROUND: Adenotonsillar hypertrophy (ATH) relates to airway obstruction and orofacial changes in children. Whether adenoid hypertrophy (AH), palatine tonsil hypertrophy (PTH), and combined ATH were associated with dis...
BACKGROUND: Adenotonsillar hypertrophy (ATH) relates to airway obstruction and orofacial changes in children. Whether adenoid hypertrophy (AH), palatine tonsil hypertrophy (PTH), and combined ATH were associated with distinct patterns of hard palate morphology and tongue function in the early mixed dentition remains unclear. METHODS: This cross-sectional study examined 420 schoolchildren aged 6-8 years in central Vietnam. AH was defined by the Fujioka adenoid-nasopharynx ratio (ANR > 0.6) and PTH by Brodsky grades 3-4; tongue strength was measured with the Iowa Oral Performance Instrument, and hard palate morphology by digital dental-cast analysis. Multivariable regression (adjusted for age, sex, BMI, lip-seal at rest, and school location) analyzed individual measures; modified Poisson regression analyzed a co-occurring phenotype (structural alteration plus low tongue strength). Univariable comparisons applied Benjamini-Hochberg false-discovery-rate (FDR) correction. RESULTS: Enlarged lymphoid tissue was present in 65.2% of children (AH only 19.3%, PTH only 32.6%, combined ATH 13.3%); tapered arch (31.0%), high-arch palate (20.0%), and low tongue strength (35.0%) were common. Nominally, AH was associated with a deeper, shorter palate, and PTH with a narrower tapered arch and lower tongue strength; but none survived FDR correction (smallest q = 0.16). In adjusted models, combined ATH was associated with a smaller anterior maxillary angle (β = -3.76°; 95% CI -6.22 to -1.29; p = 0.003) and palatal vault module (β = -0.54; -1.02 to -0.05; p = 0.032), each decreasing with adenotonsillar burden (both trends p ≤ 0.020). The co-occurring phenotype (77 children; 18.3%) became more common with burden (PTH only aPR 1.77, p = 0.040; combined ATH aPR 1.87, p = 0.048; trend aPR 1.38 per level, p = 0.020). CONCLUSIONS: Adenotonsillar hypertrophy was common in schoolchildren with mixed dentition. AH and PTH showed distinct patterns of palate and tongue alteration, although these did not survive FDR correction and remain exploratory. Combined ATH and greater adenotonsillar burden were consistently associated with maxillary arch narrowing; the co-occurrence alteration was also more frequent with higher burden. These findings support including palatal morphology and tongue function in orofacial screening during the mixed dentition, pending longitudinal confirmation.
Clinical significance and management of antenatally detected hydronephrosis due to ureteropelvic junction obstruction: a retrospective single-center study.
Görmüş S, Cömert HSY, Şalcı G … +5 more , Kızılırmak R, Osmanağaoğlu MA, Eyüboğlu İ, İmamoğlu M, Sarıhan H
BMC Pediatr · 2026 Jun · PMID 42374325 · Full text
BACKGROUND: Antenatal hydronephrosis (ANH) is a common prenatal finding with a heterogeneous postnatal course. This study aims to describe an institutional experience and protocol adherence regarding the clinical course,...
BACKGROUND: Antenatal hydronephrosis (ANH) is a common prenatal finding with a heterogeneous postnatal course. This study aims to describe an institutional experience and protocol adherence regarding the clinical course, intervention timing, and surgical outcomes of severe ANH secondary to ureteropelvic junction obstruction (UPJO) and its rare coexistence with ureterovesical junction obstruction (UVJO). METHODS: We retrospectively reviewed the records of infants referred to our tertiary center with severe prenatal urinary tract dilation (UTD A2-3 / high risk). Out of 400 initially screened patients, 80 infants who completed a standardized 1-year postnatal follow-up protocol were included, representing a highly selected completer cohort. Postnatal evaluation included serial ultrasounds (USG) and mercatoacetyltriglycine 3 (MAG-3) renography. Surgical intervention (dismembered pyeloplasty) was indicated based on standardized empirical consensus criteria: anterior-posterior renal pelvic diameter (APRPD) ≥ 19 mm, parenchymal thickness ≤ 5 mm, or split differential renal function (DRF) ≤ 40% with obstructive clearance patterns. Postoperative complications were graded using the Clavien-Dindo classification. RESULTS: The final analysis included 80 infants. Isolated UPJO was diagnosed in 12 patients (15.0%), transient/physiological hydronephrosis in 35 (43.75%), vesicoureteral reflux (VUR) in 29 (36.25%), and coexisting UPJO and UVJO in 4 patients (5.0%). Pyeloplasty was performed in all 12 isolated UPJO patients and 4 coexisting UPJO+UVJO patients (total n = 16 surgical cases) at a median age of 3 months. Postnatal USG at 12 months demonstrated a significant reduction in pelvic dilatation and marked parenchymal thickening. No deterioration in renal function was observed during follow-up, and no postoperative complications were recorded in this cohort. CONCLUSION: Adherence to a strict, conservative management protocol with standardized surgical thresholds was associated with favorable outcomes in high-risk ANH patients. Given the single-center descriptive nature and substantial loss-to-follow-up within this completer cohort, these findings represent descriptive institutional experiences rather than statistically validated threshold models.
Meningococcal serogroup W ST-11 causing meningitis, endogenous endophthalmitis, and septic arthritis in a child.
Kiral E, Kilic O, Bozan G … +6 more , Mardinoglu G, Erem T, Bostan A, Bilgec MD, Oz Y, Dinleyici EC
BMC Pediatr · 2026 Jun · PMID 42374315 · Full text
BACKGROUND: Invasive meningococcal disease (IMD) remains a major global health concern because of its epidemic potential, unpredictable presentation, and rapid progression. Although IMD classically presents as meningitis...
BACKGROUND: Invasive meningococcal disease (IMD) remains a major global health concern because of its epidemic potential, unpredictable presentation, and rapid progression. Although IMD classically presents as meningitis, meningococcemia, or both, Neisseria meningitidis can also cause extra-meningeal manifestations. Serogroup W (MenW), particularly the hyperinvasive ST-11 lineage, has increasingly been associated with atypical and invasive clinical phenotypes. We report an 11-year-old previously healthy boy with IMD due to MenW ST-11 who developed the exceptional triad of meningitis, endogenous endophthalmitis, and septic arthritis. CASE REPORT: An 11-year-old boy residing in a school dormitory presented with fever, rhinorrhea, cough, generalized erythematous rash, and conjunctival redness. Because of altered consciousness and seizures, he was transferred to the pediatric intensive care unit after receiving initial antibiotic therapy. He had not received meningococcal vaccines. On admission, he was lethargic, with anisocoria, marked right conjunctival hyperemia, neck stiffness, and a diffuse non-blanching petechial and purpuric rash. Cerebrospinal fluid (CSF) analysis was consistent with purulent meningitis; Gram stain showed rare Gram-negative diplococci, and CSF PCR identified N. meningitidis serogroup W, ST-11. Ophthalmologic examination confirmed severe endogenous endophthalmitis with hypopyon, and vitreous PCR also detected N. meningitidis. Because of clinical non-response with progressive ocular and neurologic involvement, therapy was escalated to meropenem. On hospital day 7, acute right knee swelling developed, and synovial fluid PCR confirmed MenW. At 6-week follow-up, the patient had normal vision, normal hearing, no neurologic deficits, and no joint sequelae. CONCLUSION: Meningococcal endophthalmitis is rare and usually associated with poor visual outcomes; only one adult MenW case has been reported previously. This case demonstrates that MenW ST-11 can cause aggressive multisystem IMD in children and underscores the importance of molecular diagnosis, early multidisciplinary care, and MenACWY vaccination.
Family ecological influences on early childhood development in Shanghai, China: a cross-sectional study.
Liu X, Ji Y, Zhou J … +5 more , Xiao T, Dai M, Ge Y, Guo Z, Yu W
BMC Pediatr · 2026 Jun · PMID 42374312 · Full text
BACKGROUND: Studies regarding the prevalence of early childhood development (ECD) delays and comprehensive evidence of family ecological influences in urban regions of China are scarce. We aimed to include multilevel fac...
BACKGROUND: Studies regarding the prevalence of early childhood development (ECD) delays and comprehensive evidence of family ecological influences in urban regions of China are scarce. We aimed to include multilevel factors in Bronfenbrenner's family ecosystem model and examine the effect of each factor on ECD among 1-36-month-old children. METHODS: A questionnaire was designed to collect demographic characteristics and family ecological factors from the microsystem and exosystem. The questionnaires were distributed online to caregivers in Shanghai from February 6, 2022, to March 29, 2024. RESULTS: A total of 557 questionnaires were distributed, and 534 valid responses were obtained. In total, 16.7% of children confirmed developmental delay in at least one developmental domain. Boys, children born prematurely with oxygen supplementation, those with fewer child books, parents with lower marital happiness, less frequent parent-child activities, mothers' screen use and associated neglect, and poorer family functioning were risk factors for early developmental delays, particularly affecting language, problem-solving, personal-social, and social-emotional domains. CONCLUSION: Children aged 1-36 months in Shanghai face a severe risk of ECD delays. The identified family ecological factors, as conceptualized within the family ecosystem theory and the Nurturing Care Framework, are measurable and may represent potential targets for early identification and intervention.
Factors associated with short-term response after systemic corticosteroid treatment in invasively ventilated preterm infants.
Yeom GE, Shin SH, Kim HS … +3 more , Kim EK, Heo JS, Kim SH
BMC Pediatr · 2026 Jun · PMID 42374303 · Full text
PURPOSE: This study evaluated the factors affecting the short-term efficacy of systemic corticosteroid (CS) therapy, focusing on pulmonary hypertension (PH) and other clinical conditions in preterm infants with evolving...
PURPOSE: This study evaluated the factors affecting the short-term efficacy of systemic corticosteroid (CS) therapy, focusing on pulmonary hypertension (PH) and other clinical conditions in preterm infants with evolving or established bronchopulmonary dysplasia (BPD). METHODS: A retrospective review was conducted on preterm infants (< 32 weeks of gestation and/or < 1,500 g birth weight) who received systemic CS therapy for BPD. Responders were defined as infants who were extubated within 14 days and/or achieved a ≥ 60% reduction in the respiratory severity score (RSS). RESULTS: Of the 62 infants, 32 were classified as responders and 30 as non-responders. Non-responders had a significantly higher prevalence of PH requiring treatment (70.0% vs. 21.9%, p < 0.001) and hemodynamically significant patent ductus arteriosus (hsPDA) at treatment initiation (30.0% vs. 3.1%, p = 0.005). Responders showed a greater reduction in RSS from day 1 to day 4 (33.8% vs. 11.7%, p = 0.002). In multivariate analysis, PH requiring treatment (adjusted odds ratio [aOR]: 6.66, 95% confidence interval [CI]: 1.39-31.92, p = 0.018) and hsPDA (aOR: 12.54, 95% CI: 1.16-135.05, p = 0.037) at treatment initiation were significant predictors of non-response. CONCLUSION: Identifying the vascular phenotypes of BPD, including PH and hsPDA, before initiating systemic CS therapy may improve patient selection and optimize treatment outcomes. Incorporating early changes in RSS from treatment day 1 to day 4 enhanced the predictive accuracy for treatment failure and may facilitate the timely identification of non-responders.
The rationality of drug treatment and clinical characteristics in children with SARS-CoV-2 infection: a retrospective analysis.
Su L, Chen HS, Qiu WL … +3 more , Zhong WM, Ren M, He WQ
BMC Pediatr · 2026 Jun · PMID 42374298 · Full text
BACKGROUND: With the ongoing global pandemic of coronavirus disease 2019 (COVID-19), the rational use of medications and clinical profiles in the afflicted children-a particularly susceptible group-warrant further invest...
BACKGROUND: With the ongoing global pandemic of coronavirus disease 2019 (COVID-19), the rational use of medications and clinical profiles in the afflicted children-a particularly susceptible group-warrant further investigation. This paper analyzed the rationality of medicinal treatments and clinical characteristics in children with COVID-19. METHODS: We retrospectively reviewed the clinical data of pediatric inpatients with COVID-19 admitted to the Fifth Hospital of Xiamen from January 2025 to December 2025. Clinical classifications, symptoms, outcomes, complications and the use of therapeutic drugs were statistically analyzed. The rationality of medication was assessed by indication consistency and administration routes. RESULTS: The clinical cure and improvement rate reached 99.22% in the 129 confirmed pediatric cases of COVID-19. They were categorized into a mild group (69 cases, 53.49%), a moderate group (59 cases, 45.74%), and a critical group (1 case, 0.77%). Clinical manifestations mainly included fever, cough, and runny nose. A significant difference was evident between the mild group and the moderate group in age, weight, outcomes, and clinical symptoms (e.g., coughing, runny nose, and nasal congestion) (P < 0.05 for all). Compared with the mild group, the moderate group reported a significantly higher reception of expectorants, nebulized inhalation medication, antihistamines, glucocorticoids, and antibiotics (P < 0.05 for all). In the mild and moderate groups, the irrational use of medications involved 3 types of drugs in 15 pediatric patients, including 2 cases (3.39%) of inhaled corticosteroid (ICS), 8 cases (13.11%) of antibacterial drugs, and 5 cases (5.43%) of interferon alpha 1b for injection. The irrationality of the first two types was attributed to inconsistent medication indications and that of the last type to mismatched administration routes. One rare complication, specifically multisystem inflammatory syndrome in children (MIS-C), was identified in the critical group. CONCLUSION: The clinical manifestations of COVID-19 in children are predominantly mild and moderate, with an overall favorable prognosis. The moderate group presents more pronounced respiratory symptoms (cough, runny nose, nasal congestion). The risk of complications in children with mild to moderate symptoms is similar, emphasizing the importance of early screening and prevention of complications. In clinical care for children with COVID-19, medication irrationality, such as indication inconsistency and mismatched administration routes, still exist in the administration of antiviral drugs, glucocorticoids, and antibiotics in some children with mild to moderate symptoms. The findings indicate a need for further optimizing real-world clinical practice and provide some insights for rational drug use.
Prediction of severe pediatric community-acquired pneumonia using multimodal fusion of chest radiographs and clinical data.
Hu L, Li Y, Huang M … +8 more , Kong M, Liu Y, Chen K, Zhang Y, Zhu F, Yang C, Xiong C, Lu X
BMC Pediatr · 2026 Jun · PMID 42374289 · Full text
BACKGROUND: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in children, particularly in low-income countries. Severe CAP is associated with high mortality risk, making early prediction a...
BACKGROUND: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in children, particularly in low-income countries. Severe CAP is associated with high mortality risk, making early prediction and intervention critical. Despite advancements in artificial intelligence applications for disease prediction, most models have focused on adults, with limited attention to pediatric populations and the integration of chest radiographs and laboratory tests. METHODS: To develop a predictive model for severe CAP in children by integrating multimodal data, including chest radiographs, laboratory tests, and demographic information. A retrospective cohort of 3,964 pediatric CAP patients was constructed using data from Wuhan Children's Hospital. A predictive model for severe CAP was developed by integrating chest radiographs, laboratory test results, and demographic data. Key hyperparameters, including model architecture, initialization parameters, loss function weighting, down-sampling strategies, and multimodal fusion were systematically optimized to enhance performance. These approaches were compared to determine the optimal method for predicting severe CAP in children. RESULTS: The best-performing unimodal model based solely on chest radiographs achieved a PR-AUC of 16.33 ± 1.98% and a ROC-AUC of 78.28 ± 1.48%. Through multimodal fusion, the optimal fusion model significantly improved performance, achieving a PR-AUC of 46.68 ± 4.50% and a ROC-AUC of 92.91 ± 0.64%. SHapley Additive exPlanations values were used to analyze the contributions of individual modalities to the model's predictions, revealing key predictive factors. Furthermore, the regions activated by the model showed substantial overlap with radiologist-annotated lesion areas on chest radiographs. CONCLUSION: This study highlights the potential of multimodal fusion to enhance the prediction of severe CAP in children by integrating chest radiograph and clinical data. The proposed model provides a foundation for future AI-based tools to support early diagnosis and targeted intervention, potentially reducing mortality associated with pediatric CAP.
Correlates of social participation of children with special healthcare needs: baseline of the PART-CHILD study.
Fioroni Ribeiro da Silva C, Herrler A, Wirth M … +2 more , Weyers S, De Bock F
BMC Pediatr · 2026 Jun · PMID 42366361 · Full text
BACKGROUND: Children with special healthcare needs (CSHCN) live with long-term physical, developmental, behavioural, or mental conditions that affect everyday functioning and require specialized care. According to the In...
BACKGROUND: Children with special healthcare needs (CSHCN) live with long-term physical, developmental, behavioural, or mental conditions that affect everyday functioning and require specialized care. According to the International Classification of Functioning, Disability and Health (ICF), such conditions may cause impairments in body functions and structures, limitations in activities, and restrictions in participation, shaped by environmental factors. Evidence on social participation and its correlates in CSHCN remains limited. Therefore, we aimed to identify which correlates are associated with social participation across different conditions and indications in a multi-site sample of CSHCN in Social Paediatric Centres (SPCs) in Germany. METHODS: This study analysed parent-reported data of CSHCN (3-18 years) from the baseline of the PART-CHILD cohort collected in routine care in 15 SPCs in Germany (2019-2020). Social participation (outcome) in home, community, school, and living activity domains was assessed using the German Child and Adolescent Scale of Participation (CASP). In the regression analysis, independent variables included environmental factors (parental educational attainment, German native language) and health-related factors (impairment type and complexity reported as reason for referral to the SPCs, health-related quality of life (HRQoL)), as well as age (operationalised in groups [3-6; 7-10; 11-18 years]) and sex as covariates. Linear complete case regression models were performed, and β-coefficients and 95% confidence intervals were reported. RESULTS: Five hundred fifty-one families of CSHCN (68.24% female; 44.46% aged three to six and 34.66% from seven to ten years old) were available for analysis (10.99% missing outcome). CASP total mean score was 75.99 (± 20.03; range: 25-100), the lowest in living activities subscale (68.07 ± 24.81), including household activities, shopping, transportation. In the complete case regression analysis (n = 350), older child age and higher HRQoL were associated with higher social participation score across all domains. Children with both physical and cognitive impairments had lower CASP scores in the total, home, and school models, with a trend to association in the community model. Lower parental educational attainment was significantly associated with reduced social participation in the living activities subscale. CONCLUSIONS: In this study, we confirmed previous findings on factors determining social participation in CSHCN, such as age and higher HRQoL. Impairment complexity (combined physical and cognitive impairments) decreased participation in home and school. The lower participation in daily living activities for lower educated parents confirms, that social environment significantly influences social participation. This highlights that to improve social participation, strategies are needed that address family-level and broader environmental barriers to lessen social and functional disadvantages in particularly vulnerable subgroups. TRIAL REGISTRATION: PART-CHILD cohort, German Clinical Trials Register - Deutsches Register Klinischer Studien (DRKS), DRKS00015054, registered on 16 November 2018.
Clinical, biochemical and molecular spectrum of acute neuronopathic type 2 Gaucher disease from India.
Sheth J, Nair A, Bhavsar R … +12 more , Muranjan M, Nampoothiri S, Yesodharan D, Kaur A, Shah RC, Ranganath P, Agrawal S, Baluni A, Saini N, Dalal A, Sheth F, Sheth H
BMC Pediatr · 2026 Jun · PMID 42365319 · Full text
BACKGROUND: Gaucher disease (GD) is one of the most common lysosomal storage disorders, and has three clinical subtypes (Type 1, 2 and 3). Of the three subtypes, type 2 GD (GD2), also referred to as acute infantile neuro...
BACKGROUND: Gaucher disease (GD) is one of the most common lysosomal storage disorders, and has three clinical subtypes (Type 1, 2 and 3). Of the three subtypes, type 2 GD (GD2), also referred to as acute infantile neuronopathic GD is the most severe type. It is characterized by early and profound central nervous system involvement, and patients succumb to disease before two years of age due to severe neurological deterioration and associated complications. It is the rarest of the three subtypes with a reported proportion of < 1% among all Gaucher subtypes. Furthermore, data from the Indian subcontinent on clinical profiles, molecular spectrum, and outcomes in GD2 remain scarce. The present study describes the clinical, biochemical, and molecular spectrum of GD2 cases in an Indian cohort. METHODS: This is a retrospective study comprising 19 patients referred by pediatricians from across India, who were diagnosed with GD based on β-Glucosidase enzyme activity and GBA gene study. Plasma chitotriosidase activity and β-glucosidase activity were measured in plasma sample and leukocytes respectively using fluorometric enzyme assays. Molecular confirmation was performed in all 19 patients by using one of the following tests: polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), Sanger sequencing, targeted panel or whole exome sequencing study. RESULTS: The common clinical signs observed in the study cohort were hepatosplenomegaly, thrombocytopenia, oculomotor signs, failure to thrive and feeding difficulties. Molecular study revealed causative variants distributed across exons 3, 4, 5, 6, 7, 9, 10, and 11 of the GBA1 gene, with exon 10 being the most common (n = 11/19). The variant c.1448T > C (p.Leu483Pro) was identified in a compound heterozygous state in majority cases (n = 10/19). Furthermore, we also identified a rare recurrent missense variant c.371T > G (p.Met124Arg) in exon 4 of the GBA1 gene in 4 patients with GD2 from Gujarat, suggesting the possibility of a founder effect. Computational protein modeling and in-silico analysis predicted a destabilizing effect on GBA1 protein structure and stability. CONCLUSION: Overall, the present study represents the largest case series of type 2 Gaucher disease reported from India to date and provides important insights into its clinical and molecular spectrum in the Indian population.
Nasal eosinophilia in pediatric non-allergic rhinitis: correlation with clinical severity scales.
Günizi H, Orhan Kubat G, Günizi ÖC … +3 more , Sevil E, Yıldırım E, Eren A
BMC Pediatr · 2026 Jun · PMID 42365301 · Full text
BACKGROUND: Non-allergic rhinitis syndrome (NAR) is a chronic rhinitis characterized by the significant absence of an allergy history, negative skin prick test results, and normal serum IgE levels. Nasal cytology is a va...
BACKGROUND: Non-allergic rhinitis syndrome (NAR) is a chronic rhinitis characterized by the significant absence of an allergy history, negative skin prick test results, and normal serum IgE levels. Nasal cytology is a valuable diagnostic method that enables qualitative and quantitative assessment of inflammatory cells - including eosinophils, neutrophils, mast cells, and lymphocytes - in the nasal mucosa. This study aimed to evaluate the levels of nasal eosinophilia in a pediatric NAR population and to evaluate the correlation of this local inflammatory biomarker with clinical severity scales such as ARIA and PRQLQ. METHODS: This prospective, cross-sectional study included 103 children aged 5-18 years: 53 with NAR and 50 healthy controls. Symptom duration and severity were classified according to ARIA 2019 criteria. The Paediatric Rhinitis Quality of Life Questionnaire (PRQLQ) was used for quality of life assessment. Nasal cytology specimens were collected by nasal swab from the middle meatus and the eosinophil percentage was calculated by counting a total of 100 cells in the area of highest cell density. RESULTS: A total of 103 children were enrolled: 53 NAR patients and 50 healthy controls. Median age was 10 (8-13) years in the study group and 11 (8-14) years in the control group. Family history of allergy was significantly higher in the study group (30.2%) compared to controls (12.0%) (p = 0.024). Median nasal eosinophil level was 7.0 (3.5-15.5) in the study group and 0 (0-3.0) in controls; the difference was statistically significant (p < 0.001). The nasal eosinophil cut-off value was determined as 3.5%. No significant difference was found between nasal eosinophil groups (< 3.5% and ≥ 3.5%) and any PRQLQ subscale or total score (p > 0.05). CONCLUSIONS: Nasal cytology may serve as a simple, non-invasive diagnostic tool to identify NAR subtypes and to determine clinical severity in pediatric patients.
Experience-based co-design to refine a remote parent-mediated intervention program for preterm infants after NICU discharge: a qualitative study.
Na Y, Chang SJ, Choe Y … +2 more , Kang J, Kwon JY
BMC Pediatr · 2026 Jun · PMID 42365252 · Full text
BACKGROUND: Preterm infants have elevated risks of motor, cognitive, and socioemotional difficulties, yet families often face substantial barriers to accessing rehabilitation after NICU discharge. Coaching-based parent-m...
BACKGROUND: Preterm infants have elevated risks of motor, cognitive, and socioemotional difficulties, yet families often face substantial barriers to accessing rehabilitation after NICU discharge. Coaching-based parent-mediated intervention program supported through remote guidance may improve continuity and accessibility of developmental care, but few programs are tailored to the unique needs of preterm infants or developed with stakeholder input. This study used experience-based co-design (EBCD) to refine an existing remote parent-mediated intervention program for preterm infants after NICU discharge. METHODS: A modified five-stage EBCD framework was employed. Nine participants were recruited through purposive sampling: five mothers of preterm infants who had experienced remote rehabilitation (individual in-depth interviews) and four multidisciplinary healthcare professionals-one pediatric physiatrist, one NICU nurse, and two pediatric physical therapists (focus group interview). Data from Stages 1-3 (observation, interviews) were analyzed using inductive qualitative content analysis. Findings were synthesized into a trigger film (Stage 4) and presented at a co-design workshop involving 13 stakeholders (Stage 5) to collaboratively finalize program components. RESULTS: Three themes emerged from stakeholder experiences: (1) navigating the threshold-high parental motivation and accessibility advantages offset by intensive session preparation demands; (2) engaging in the interface-professional feedback enhanced parental confidence, but remote delivery created psychological pressure and a tactile disconnect; and (3) beyond the screen-static educational materials were insufficient for independent home practice and documentation burden hindered adherence. Through co-design, stakeholders prioritized a hybrid model comprising 15-minute synchronous video sessions, pre-discharge in-person training, asynchronous video resources, video-based formative assessment, and a messaging-based Q&A system. Program scope was expanded beyond motor rehabilitation to encompass oral feeding intervention, sleep hygiene, parent-infant interaction, and psychosocial outcomes. CONCLUSION: Through EBCD, we collaboratively refined an existing remote parent-mediated intervention program addressing key stakeholder priorities including hybrid delivery, professional feedback, and psychosocial support. The intervention balances ideal and pragmatic solutions and is prepared for feasibility testing in a future randomized controlled trial.
Effects of a less invasive suction protocol on pain and physiological stability in preterm infants receiving non-ınvasive ventilation: a randomized controlled trial.
Temizsoy E, Topcuoglu S, Aliustaoglu H … +2 more , Ozkan E, Karatekin G
BMC Pediatr · 2026 Jun · PMID 42363180 · Full text
BACKGROUND: Non-invasive ventilation (NIV) is widely used in preterm infants to reduce ventilator-associated lung injury. However, nasopharyngeal suctioning during NIV is an invasive procedure that may cause pain, stress...
BACKGROUND: Non-invasive ventilation (NIV) is widely used in preterm infants to reduce ventilator-associated lung injury. However, nasopharyngeal suctioning during NIV is an invasive procedure that may cause pain, stress and physiological instability in preterm infants. This study aimed to compare the effects of less invasive suction protocol and conventional nasopharyngeal suctioning on pain and physiological stability in preterm infants receiving non-invasive ventilation. METHODS: This randomized controlled trial was conducted in a tertiary neonatal intensive care unit. Preterm infants with a gestational age of 32 to 36 weeks who required NIV were eligible. A total of 100 infants were randomly assigned to either the less invasive suction protocol group (n = 50) or the conventional suction group (n = 50). Pain was assessed using the Neonatal Pain, Agitation and Sedation Scale (N-PASS). Heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂), and skin color were recorded before suctioning, during the procedure, and 10 min after completion. Between-group comparisons were performed using appropriate parametric or non-parametric statistical tests, with p < 0.05 considered statistically significant. RESULTS: Baseline demographic and clinical characteristics were comparable between groups. During suctioning, infants in the less invasive suction protocol group had significantly lower HR and higher SpO₂ levels compared to the conventional group (p < 0.05). The proportion of infants with pink skin color was significantly higher in the less invasive suction protocol group. N-PASS pain scores during the procedure were significantly lower in the less invasive suction protocol group (p < 0.05). No significant differences were observed between groups in RR measurements at any time point. CONCLUSIONS: The less invasive suction protocol reduced procedural pain and supported physiological stability in preterm infants receiving NIV. Minimizing airway manipulation may contribute to safer and more developmentally supportive care in neonatal intensive care units. TRIAL REGISTRATION: ClinicalTrials.gov (NCT07111611), registered on 08 August 2025 (retrospectively registered).
Antenatal diagnosis and successful management of fetal mucocolpometra in a resource-limited setting: a case report from Ethiopia.
Addis NA, Yigzaw KT, Shibesh MH … +3 more , Asifaw BA, Zewudu AA, Bicha AT
BMC Pediatr · 2026 Jun · PMID 42363164 · Full text
INTRODUCTION: Imperforate hymen is the most common congenital anomaly of the female genital tract, usually diagnosed at puberty. Neonatal presentation is rare, and antenatal diagnosis is even less common but increasingly...
INTRODUCTION: Imperforate hymen is the most common congenital anomaly of the female genital tract, usually diagnosed at puberty. Neonatal presentation is rare, and antenatal diagnosis is even less common but increasingly recognized with advances in prenatal ultrasonography. Fetal mucocolpometra results from distal vaginal obstruction and may present as a cystic pelvic mass, with potential for postnatal complications such as urinary obstruction. CASE PRESENTATION: We report a 17-year-old primigravida from rural North-western Ethiopia whose fetus was found on late antenatal ultrasound to have a large cystic pelvic mass suggestive of mucocolpometra. At 37 weeks and 6 days of gestation, she underwent emergency cesarean section for obstetric indications. A live female neonate was delivered with good APGAR scores but developed marked abdominal distension and acute urinary retention shortly after birth. Examination revealed a bulging, bluish vaginal introitus. The diagnosis of mucocolpometra secondary to imperforate hymen was made. Hymenectomy was performed under sterile conditions, draining approximately 300 mL of milky fluid, with immediate clinical improvement. DISCUSSION: Antenatal detection of mucocolpometra remains uncommon, particularly in resource-limited settings. Early recognition is important to prevent complications such as urinary obstruction and abdominal distension. This case demonstrates that antenatal ultrasound alone can provide sufficient diagnostic suspicion to guide timely intervention, even where advanced imaging is unavailable. CONCLUSION: Fetal mucocolpometra should be considered in cases of antenatally detected pelvic cystic masses. Early diagnosis and prompt surgical management can result in excellent outcomes, even in resource-limited settings.
A school-year mini basketball curricular program promotes fundamental movement skills of urban Chinese preschoolers with typical development.
Zhang S, Yan J, Shao Y … +4 more , Yan J, O'Connell CS, Wu M, Zhang M
BMC Pediatr · 2026 Jun · PMID 42363149 · Full text
The aim of this study was to investigate the effects of a school-year skill-based mini basketball program on the fundamental movement skills (FMS) of urban Chinese preschoolers. A cluster randomized trial was conducted,...
The aim of this study was to investigate the effects of a school-year skill-based mini basketball program on the fundamental movement skills (FMS) of urban Chinese preschoolers. A cluster randomized trial was conducted, in which 18 intact classes were randomly assigned to either the mini basketball (MB; 9 classes) or conventional physical education (CP; 9 classes) group. Children in the MB group received the MB curricular intervention, while the CP group received regular physical education curriculum representing standard practice in urban Chinese preschools. Motor development was evaluated by the Test of Gross Motor Development 2nd Edition. The results of the 2 × 2 (time × group) multivariate analysis of variance with repeated measures showed that the MB program was associated with greater improvements in FMS compared to the CP program, suggesting an added benefit beyond typical developmental progression. Our findings also revealed that the effects of MB on object control were influenced by age, with four- and five-year-old children demonstrating greater improvements than three-year-olds. These findings suggest that MB appears to be a feasible and potentially effective intervention to promote FMS development in preschool settings.
"A lifeline to belonging": exploring caregiver's perspectives on quality participation in Easter Seals' adapted physical activity and parasport programs.
So SJ, Locke M, Ghazzawi R … +5 more , Higgins A, Bowman H, Phelan S, Bernard J, Moore SA
BMC Pediatr · 2026 Jun · PMID 42363123 · Full text
BACKGROUND: Inclusive adapted physical activity and parasport programs support physical and psychosocial well-being of children experiencing disability. Easter Seals offers opportunities for children of all abilities to...
BACKGROUND: Inclusive adapted physical activity and parasport programs support physical and psychosocial well-being of children experiencing disability. Easter Seals offers opportunities for children of all abilities to engage in physical activity through introductory parasports. PURPOSE: Our evaluation aimed to understand caregiver's perspectives on quality participation in Easter Seals programs. METHODS: We collected quantitative and qualitative data through surveys followed by semi-structured interviews to further explore survey data findings. Survey data were analyzed using descriptive statistics and interviews using reflexive thematic analysis. RESULTS: Surveys highlighted caregiver-perceived participant satisfaction and a caregiver-perceived positive impact of programs on participants' physical and psychosocial well-being. Five themes were generated: (1) caregiver support and dedication, (2) meaningful participation, (3) mastery of skills, (4) thriving alongside peers, and (5) hopes for the future. CONCLUSION: Findings illustrate the importance of thoughtfully designed programs, focused on quality participation, for children experiencing disability and their families.
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