BMC Pediatrics[JOURNAL]
Sun
200 papers
Evaluability and feasibility of an intervention combining gaming and social activities to improve mental wellbeing and health behaviour in adolescents facing social challenges.
Grew JC, Gøtzsche N, Broberg L … +1 more , Schiøtz ML
BMC Pediatr · 2026 Jun · PMID 42323577 · Full text
BACKGROUND: Adolescents in Denmark increasingly report poor mental wellbeing and health behaviour. Additionally, they spend less time being physically active and being with friends and more time on gaming and social medi...
BACKGROUND: Adolescents in Denmark increasingly report poor mental wellbeing and health behaviour. Additionally, they spend less time being physically active and being with friends and more time on gaming and social media. The eHOOD intervention was developed to address physical and mental wellbeing of adolescents in vulnerable positions using their motivation for gaming to engage them in a community entailing physical and social activity, and education with peers. This study aimed to assess the evaluability of the eHOOD intervention, to develop an evaluation design, and to test the feasibility and acceptability of the evaluation design and the intervention. METHODS: Evaluability assessment was performed by a working group in a series of workshop-style meetings involving a literature review, creation of a theory of change, and preparation of an evaluation plan including outcome measures, instruments, and data collection procedures. Subsequently the evaluation design and the intervention were tested in a single arm feasibility study. Participants were 13 adolescents aged 13-16 years. The participants met with a coach and a local pedagogue in an after-school club four hours a week for 25 weeks practicing gaming, engaging in physical and social activities, and learning about healthy lifestyle habits through education and communal cooking and dining. Feasibility and acceptability of outcome measures, instruments, and data collection procedures were assessed, and initial changes in outcome measures were measured. Recruitment and retainment of participants were monitored, and participants' motivation for and benefits of participating were explored. Data were collected with qualitative and quantitative methods. RESULTS: An evaluation plan was developed and found to be suitable for use in the subsequent feasibility study. The evaluation design was overall feasible and acceptable, although several important adjustments to measurements and data collection procedures were identified. Initial changes in wellbeing were observed and the World Health Organization-Five Well-Being Index (WHO-5) was deemed relevant as a primary outcome in future evaluation. The intervention was found feasible and acceptable among participants in the present format. CONCLUSIONS: This combined evaluability assessment and feasibility study suggests that the eHOOD intervention is ready for larger-scale evaluation, although refinements to outcome measures and data collection procedures are warranted before effectiveness can be evaluated. TRIAL REGISTRATION: ClinicalTrials.gov, March 23, 2026. Identifier NCT07489365. Retrospectively registered.
Severe gastrointestinal involvement is associated with renal manifestations in pediatric IgA vasculitis: a retrospective cohort study.
Mai TT, Le TH
BMC Pediatr · 2026 Jun · PMID 42323572 · Full text
BACKGROUND: Gastrointestinal manifestations are common in pediatric IgA vasculitis (IgAV), but their relationship with renal involvement remains incompletely understood. Early identification of children at risk for renal...
BACKGROUND: Gastrointestinal manifestations are common in pediatric IgA vasculitis (IgAV), but their relationship with renal involvement remains incompletely understood. Early identification of children at risk for renal complications is clinically important. METHODS: We conducted a retrospective single-center cohort study including children diagnosed with IgA vasculitis between August 2023 and June 2024. Clinical characteristics, gastrointestinal manifestations, and renal outcomes were analyzed. Renal involvement was defined as hematuria and/or proteinuria by the end of follow-up, including both baseline and incident cases. Multivariable logistic regression was performed to identify factors associated with renal involvement. Sensitivity and subgroup analyses were conducted to assess the robustness of the findings. RESULTS: Sixty-eight children with IgA vasculitis were included, of whom 44 had available follow-up data. Gastrointestinal manifestations were observed in 82.4% of patients, and among these, 55.4% had severe involvement. Among patients with follow-up data, 19/44 (43.2%) had renal involvement by the end of follow-up, including 14 cases present at baseline and 5 new-onset cases. Severe gastrointestinal involvement was associated with renal involvement in multivariable analysis (adjusted OR 4.34, 95% CI 1.48-12.65, p = 0.007). In sensitivity and subgroup analyses, the direction of association was consistent, although statistical significance was not maintained. CONCLUSIONS: Severe gastrointestinal involvement may be associated with an increased likelihood of early renal manifestations in pediatric IgA vasculitis. These findings suggest that closer renal monitoring may be warranted in patients presenting with severe gastrointestinal symptoms. Larger multicenter studies with longer follow-up are needed to confirm these observations.
Oral manifestations of endocrine disorders among patients attending the paediatric endocrinology clinic in the lagos university teaching hospital: a cross-sectional study.
Adeloye AY, Oyenusi EE, Falokun IB … +3 more , Utomi IL, Ibenye VN, Alayo MO
BMC Pediatr · 2026 Jun · PMID 42323555 · Full text
BACKGROUND: Paediatric endocrine disorders represent a spectrum of conditions that affect hormone synthesis, regulation and function in childhood and adolescence. They present with intraoral features that may compromise...
BACKGROUND: Paediatric endocrine disorders represent a spectrum of conditions that affect hormone synthesis, regulation and function in childhood and adolescence. They present with intraoral features that may compromise the long-term well-being and oral health of affected individuals, potentially persisting into their adult years when appropriate diagnosis and therapeutic intervention are delayed or inadequate. This study aims to determine the prevalent oral manifestations of endocrine disorders among children attending the Paediatric Endocrinology Clinic of the Lagos University Teaching Hospital (LUTH). METHODS: A cross-sectional study was done among 50 paediatric patients aged (6-18 years) with endocrine disorders, recruited via consecutive sampling. Data collection employed interviewer-administered questionnaires covering medical and dental histories, followed by standardized intraoral examinations of soft and hard tissues. Ethical approval, informed consent, and participant assent were obtained. Data was analysed using SPSS version 25. Descriptive statistics included frequencies and percentages. Inferential analysis was performed using Chi-square test to evaluate associations between categorical variables. Statistical significance was set at p < 0.05. RESULTS: Type 1 diabetes mellitus was the predominant condition among the participants (n = 27, 54.0%), followed by hypothyroidism (n = 7, 14.0%). Other endocrine disorders, including congenital adrenal hyperplasia (n = 6, 12.0%), Turner syndrome, Cushing syndrome, adrenal insufficiency, and metabolic syndrome, were each represented by single cases (2.0% each). Oral dryness emerged as the leading soft tissue manifestation (n = 27, 54.0%), accompanied by oral pigmentation (n = 20, 40.0%), gingivitis (n = 7, 14.0%), and oral ulceration (n = 6, 12.0%). Enamel defects, crossbite, dental crowding, open bite, and dental caries were the primary hard tissue findings, each occurring in eight participants (n = 8, 19.0%). CONCLUSIONS: There is a significant prevalence of oral pathologies among paediatric patients with endocrine disorders. Findings support incorporating dental evaluations into endocrinological care protocols and highlight the need for coordinated inter-professional management involving endocrinologists, paediatric dentists, and orthodontists.
Birth and neonatal risk factors associated with neonatal conjunctivitis: a retrospective case-control study.
Atar MB, Hançerlioğulları N, Özdemir Ö … +1 more , Tokmak A
BMC Pediatr · 2026 Jun · PMID 42323553 · Full text
BACKGROUND: Neonatal conjunctivitis (NC) is a common ocular condition during the neonatal period and may lead to serious complications if not properly managed. Although maternal conditions contribute to its development,...
BACKGROUND: Neonatal conjunctivitis (NC) is a common ocular condition during the neonatal period and may lead to serious complications if not properly managed. Although maternal conditions contribute to its development, birth-related and neonatal factors also play an important role. OBJECTIVE: To evaluate birth-related and neonatal factors, along with maternal characteristics, associated with the development of NC. METHODS: This retrospective case-control study was conducted at a tertiary referral center and included neonates born between 34 and 42 weeks of gestation between January 2022 and December 2024. A total of 203 neonates diagnosed with conjunctivitis within the first 28 days of life were compared with 355 randomly selected controls without conjunctivitis from the same source population and study period. Maternal, obstetric, neonatal, and laboratory characteristics were extracted from electronic medical records. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of NC. RESULTS: A total of 558 neonates were included, comprising 203 cases of NC and 355 controls. Neonates with conjunctivitis were more frequently male and had lower gestational age, higher rates of prematurity, and lower Apgar scores than controls. Maternal age, maternal diabetes, and maternal CRP levels were significantly higher among cases. After adjustment for potential confounders, maternal age (OR 1.08, 95% CI 1.03-1.13), maternal diabetes (OR 2.64, 95% CI 1.17-5.94), male sex (OR 1.84, 95% CI 1.24-2.75), and maternal CRP level (OR 1.11, 95% CI 1.07-1.16) were independently associated with neonatal conjunctivitis (all p < 0.05). CONCLUSION: In this case-control study, advanced maternal age, maternal diabetes, elevated maternal CRP levels, and male sex were independently associated with NC. Recognition of these maternal and neonatal factors may facilitate earlier identification of at-risk infants and improve postnatal monitoring strategies.
National registry on characteristics and outcomes of pediatric liver transplantation in a middle-income country.
Getsuwan S, Tovikkai C, Tubjareon C … +11 more , Gesprasert G, Tantemsapya N, Eiamkulbutr S, Chongsrisawat V, Nonthasoot B, Thirapattaraphan C, Junrungsee S, Lertudomphonwanit C, Pugkhem A, Lumpaopong A, Treepongkaruna S
BMC Pediatr · 2026 Jun · PMID 42321707 · Full text
BACKGROUND: Due to the limited data available among middle-income countries, we aimed to determine the characteristics, outcomes and associated factors with death or graft failure in pediatric liver transplantation (LT)....
BACKGROUND: Due to the limited data available among middle-income countries, we aimed to determine the characteristics, outcomes and associated factors with death or graft failure in pediatric liver transplantation (LT). METHODS: Based on the Thai National Liver Transplantation Registry, we analyzed the data of patients under 18 years who underwent LT in Thailand from 2016 to 2024. RESULTS: The study included 324 liver transplants (five re-LT), mainly from living donors (246 donors, 75.9%). Among 319 recipients, the most prevalent underlying condition was cirrhosis (274 patients, 85.9%; mostly biliary atresia), followed by acute liver failure (30 patients, 9.4%). In comparison with deceased donor LT, patients who underwent living donor LT (LDLT) reported less waiting time (485 days vs. 146 days, P < 0.001) and a lower pediatric end-stage liver disease (PELD)/model for end-stage liver disease (MELD) score (20.9 vs. 18.1, P = 0.02). The registry revealed 1- and 5-year patient survival rates of 91.7% and 89.6%, respectively. Mortality was noted in 34 patients, with infection as the leading cause of death (19 patients, 55.9%). PELD/MELD score ≥ 20 was associated with death (HR: 2.95; 95% CI: 1.29-6.27) or graft failure (HR: 3.10; 95% CI: 1.37-7.06) in patients who underwent LT due to cirrhosis. CONCLUSIONS: Pediatric LT in Thailand, mainly LDLT, has a satisfactory outcome. Patients with severe ESLD or high PELD/MELD scores are at risk for death and graft failure after LT. Infection is the most common cause of death. Therefore, timely LT and early effective treatment of infection are crucial.
Assessing antenatal care utilization, socioeconomic inequalities and low birth weight outcomes: a population-based analysis using the 2022 Ghana demographic and health survey data.
Ofori MA, Agyei DMA, Asemanyi AA … +3 more , Sedegah S, Asamoah T, Mensah DK
BMC Pediatr · 2026 Jun · PMID 42321689 · Full text
BACKGROUND: Sub-Saharan Africa continues to face significant challenges with low birth weight (LBW). Factors such as antenatal care (ANC) utilization and socioeconomic status play critical roles in birth outcomes. It is...
BACKGROUND: Sub-Saharan Africa continues to face significant challenges with low birth weight (LBW). Factors such as antenatal care (ANC) utilization and socioeconomic status play critical roles in birth outcomes. It is therefore imperative to understand these relationships, which are crucial to developing tailored, workable interventions to improve maternal and child health outcomes in Ghana. OBJECTIVE: This study aimed to examine the association between ANC utilization patterns, socioeconomic disparities, and low birth weight outcomes among women in Ghana. METHODS: The study included 6,965 observations, with 4,056 complete cases. Due to substantial missingness in key variables (LBW, adequate ANC), a monotone missing data pattern consistent with Missing at Random (MAR) was observed. Multiple Imputation by Chained Equations (MICE) was employed using Fully Conditional Specification across 20 imputed datasets. Survey-weighted logistic regression was performed on each imputed dataset, with estimates pooled via Rubin's Rules. Model fit was assessed using the Hosmer-Lemeshow goodness-of-fit test. The slope index of inequality was calculated to examine socioeconomic disparities. RESULTS: The prevalence of LBW was 10.0% in complete cases and 19.2% in imputed data. Socioeconomic inequality analyses revealed significant pro-rich gradients in ANC utilization. The disparities were more pronounced for optimal ANC (8 + visits; SII: 0.431; RII: 1.538) than adequate ANC (4 + visits; SII: 0.203; RII: 1.224). LBW was disproportionately concentrated among women of lower socioeconomic status (SII: -0.159; RII: 1.172). The adjusted multivariable model showed inadequate ANC (aOR: 1.97; 95% CI: 1.34-2.90), suboptimal ANC (aOR: 1.73; 95% CI: 1.27-2.36), and poor wealth status (aOR: 1.79; 95% CI: 1.18-2.72) were independently associated with higher odds of LBW. CONCLUSION: ANC visit frequency and household wealth are independently associated with LBW among Ghanaian women. These findings underscore the need for targeted interventions to improve ANC attendance and address socioeconomic disparities to reduce the burden of LBW in Ghana.
Argon plasma coagulation for endoscopic treatment for congenital pyriform sinus fistula in children.
Wang Y, Chen Y, Wu H … +1 more , Ye H
BMC Pediatr · 2026 Jun · PMID 42321666 · Full text
OBJECTIVE: This study aimed to evaluate the efficacy of a novel endoscopic approach using argon plasma coagulation (APC) for the treatment of congenital pyriform sinus fistulas (CPSF) in children. METHODS: A retrospectiv...
OBJECTIVE: This study aimed to evaluate the efficacy of a novel endoscopic approach using argon plasma coagulation (APC) for the treatment of congenital pyriform sinus fistulas (CPSF) in children. METHODS: A retrospective analysis was conducted on 30 pediatric patients with PSF who were treated at Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center) between 2021 and 2025. All patients underwent neck color Doppler ultrasound and electronic laryngoscopy, with systematically analyzed of the results. Postoperative follow-up was performed at multiple time points. RESULTS: All 30 procedures were successfully completed, with no cases of pharyngeal fistula, dysphagia, or infection around or beyond the fistula tract. During the follow-up period, ranging from 2 weeks to 3 years, no recurrence was observed. CONCLUSION: Endoscopy-assisted argon plasma coagulation is a promising treatment for CPSF in children, offering advantages including minimal trauma, reduced bleeding, and clear visualization. This method appears safe and effective for infants and children with CPSF and warrants wider clinical adoption.
Efficacy of belimumab in children with systemic lupus erythematosus.
Yang Y, Gao T, Xu S … +1 more , Xu B
BMC Pediatr · 2026 Jun · PMID 42316362 · Full text
OBJECTIVE: To evaluate the efficacy and safety of belimumab combined with standard therapy in children with systemic lupus erythematosus (SLE) in a single-center retrospective observational cohort. METHODS: A total of 60...
OBJECTIVE: To evaluate the efficacy and safety of belimumab combined with standard therapy in children with systemic lupus erythematosus (SLE) in a single-center retrospective observational cohort. METHODS: A total of 60 children with active SLE were screened, and 40 eligible patients were included. Patients were classified into a belimumab plus standard therapy group (n = 20) and a standard therapy alone group (n = 20). Belimumab was administered intravenously at 10 mg/kg every 2 weeks for the first three doses and every 4 weeks thereafter. Clinical manifestations, laboratory parameters, SLEDAI-2000 scores, glucocorticoid doses, and adverse events were compared between groups. The 6-month assessment was considered the primary observation time point, while 12-month outcomes were exploratory. RESULTS: At 6 months, renal and mucocutaneous remission rates were 83% (15/18) and 94% (15/16) in the belimumab group, compared with 78% (7/9) and 85% (11/13) in the control group. At 12 months, the corresponding rates were 94% (15/16) and 94% (15/16) in the belimumab group, and 89% (8/9) and 85% (11/13) in the control group. C3, C4, and SLEDAI-2000 scores improved significantly in both groups. Most clinical and serological outcomes did not differ significantly between groups. Oral glucocorticoid doses decreased more markedly in the belimumab group than in the control group (53.55 ± 8.43 to 6.72 ± 3.50 mg/day vs. 55.50 ± 6.05 to 14.81 ± 5.54 mg/day; P < 0.05). One patient experienced reversible reductions in IgG levels and B-cell counts, with no severe infections or infusion reactions. CONCLUSIONS: Belimumab plus standard therapy showed a potential glucocorticoid-sparing effect in pediatric SLE, but larger prospective studies are needed to confirm its efficacy and safety.
Evaluation of serum and cerebrospinal fluid copeptin as biomarkers in children with febrile seizures, febrile illness without seizures, and meningitis: an exploratory study.
Hatipoğlu HU, Kızılırmak C, Elevli M
BMC Pediatr · 2026 Jun · PMID 42316150 · Full text
BACKGROUND: This study aimed to compare serum and cerebrospinal fluid (CSF) copeptin levels among children with febrile seizures, febrile illness without seizures, and meningitis; to investigate the relationship between...
BACKGROUND: This study aimed to compare serum and cerebrospinal fluid (CSF) copeptin levels among children with febrile seizures, febrile illness without seizures, and meningitis; to investigate the relationship between serum and CSF copeptin levels; and to assess the potential diagnostic utility of these biomarkers. METHODS: This study included children aged 1 month to 18 years who presented to the pediatric emergency department with fever or seizures and underwent lumbar puncture because of signs of meningeal irritation or the absence of an identifiable source of fever. The patients were classified into three groups: the Meningitis Group, the Febrile Illness Without Seizures Group, and the Febrile Seizure Group. In addition, a control group consisting of healthy children was included. Serum and CSF copeptin levels were measured in the patient groups, whereas only serum copeptin levels were measured in the control group. RESULTS: Serum copeptin levels were significantly higher in the Febrile Seizure Group than in both the Febrile Illness Without Seizures Group and the Control Group. Univariate linear regression analysis demonstrated a weak but statistically significant positive association between serum and CSF copeptin levels (p = 0.040), indicating that CSF copeptin levels could be estimated from serum copeptin levels using the following formula: CSF copeptin level = 2.02 + 0.05 × serum copeptin level. In multivariable linear regression analysis, C-reactive protein (CRP) and CSF glucose levels were identified as independent predictors of CSF copeptin levels, irrespective of age and sex (p = 0.009 and p = 0.004, respectively). CSF copeptin measurement was not superior to serum copeptin measurement for distinguishing children with febrile seizures, or children with febrile seizures and/or meningitis, from those with febrile illness without seizures. CONCLUSION: Serum copeptin levels were higher in children with febrile seizures than in those with febrile illness without seizures and in healthy controls. However, because of the very small meningitis sample size, the meningitis-related findings should be considered exploratory and interpreted with caution. Larger prospective studies are required to determine whether copeptin has clinically meaningful utility in distinguishing febrile seizures from meningitis.
Treatment outcome and associated factors of pyogenic meningitis among children at Hawassa University comprehensive specialized hospital: a retrospective cross-sectional study.
Teklemariam AD, Hailu BD, Tesfaye AM … +4 more , Woldegebriel TE, Mamo YA, Tegene BA, Bitewa DA
BMC Pediatr · 2026 Jun · PMID 42316125 · Full text
BACKGROUND: In Ethiopia, little is known about short-term treatment outcomes of bacterial meningitis and its associated factors among hospitalized children. This study aimed to assess the magnitude and predictors of unfa...
BACKGROUND: In Ethiopia, little is known about short-term treatment outcomes of bacterial meningitis and its associated factors among hospitalized children. This study aimed to assess the magnitude and predictors of unfavourable treatment outcome among these group. METHODS: A five-year retrospective study was conducted from September 2020 to August 2024 at Hawassa University Comprehensive Specialized Hospital. All children aged 1 month-14 years diagnosed with pyogenic meningitis and admitted to the pediatric ward or emergency department were included. Data were collected from medical charts using a structured tool. Statistical analyses were performed using SPSS v26, with binary logistic regression to identify factors associated with treatment outcomes. Statistical significance was declared at p < 0.05. RESULT: Among 203 patients, 67 (33%; 95% CI 26%, 40%) had unfavourable outcomes: 29 (14.3%) died, 16 (7.9%) developed acute neurologic complications, and 22 (10.8%) were discharged against medical advice. Being male [AOR: 2.87; 95% CI: 1.14, 7.17], malnourished [AOR: 5.4; 95% CI: 2.28, 12.8], incomplete vaccination [AOR: 4.64; 95%CI: 1.71, 12.5], developing aspiration pneumonia [AOR: 4.5; 95% CI: 1.1, 17.5], comatose upon presentation [AOR: 4.6; 95% CI: 1.42, 14.9] were significantly associated with unfavourable treatment outcomes. CONCLUSION: One-third of children hospitalized with pyogenic meningitis experienced unfavourable outcomes. Malnutrition, incomplete immunization, coma on presentation, and aspiration pneumonia were key predictors. Strengthening nutrition programs and immunization coverage may reduce morbidity and mortality.
Pure posteromedial tibiotalar dislocation in an adolescent student: a case report and literature review.
Liu S, Li X, Wei J … +2 more , Liao H, Wang Y
BMC Pediatr · 2026 Jun · PMID 42316092 · Full text
BACKGROUND: Pure Posteromedial tibiotalar dislocation unaccompanied by fractures represents an exceptionally rare orthopedic injury, accounting for approximately 0.065% of ankle injuries and 0.46% of ankle dislocations....
BACKGROUND: Pure Posteromedial tibiotalar dislocation unaccompanied by fractures represents an exceptionally rare orthopedic injury, accounting for approximately 0.065% of ankle injuries and 0.46% of ankle dislocations. Such injuries typically result from high-energy trauma, with limited reports involving low-energy mechanisms in athletic activities. This case illustrates the successful management of a closed posterior ankle dislocation in a young student, emphasizing the importance of prompt intervention and structured rehabilitation. CASE PRESENTATION: A 17-year-old male student sustained a pure posterior tibiotalar dislocation during a recreational basketball game, following a forced inversion and plantarflexion mechanism. Immediate closed reduction was performed under local anesthesia combined with intravenous analgesia, followed by immobilization in a splint and subsequent transition to a controlled ankle motion (CAM) boot. Post-reduction CT confirmed anatomical reduction and excluded occult fracture, while CTA showed no evidence of vascular injury; serial clinical examinations revealed no sensory or motor deficit. At one-year follow-up, the patient achieved a full functional recovery and unrestricted return to academic and physical activities. CONCLUSION: This case underscores that early closed reduction and phased rehabilitation can yield excellent outcomes in pure posteromedial tibiotalar dislocation, even in adolescent populations. The report highlights the viability of non-operative management for such injuries and contributes to the sparse literature on low-energy mechanisms in young, non-professional athletes.
Development and internal validation of an early postnatal nomogram for bronchopulmonary dysplasia in very preterm infants with positive respiratory tract Ureaplasma urealyticum results.
Sun K, Sun X, Li L … +3 more , Ren J, Jing R, Li Y
BMC Pediatr · 2026 Jun · PMID 42316085 · Full text
BACKGROUND: Evidence suggests that Ureaplasma urealyticum (UU) colonization is associated with the onset and progression of bronchopulmonary dysplasia (BPD) in very preterm infants. However, clinically practical tools fo...
BACKGROUND: Evidence suggests that Ureaplasma urealyticum (UU) colonization is associated with the onset and progression of bronchopulmonary dysplasia (BPD) in very preterm infants. However, clinically practical tools for early postnatal risk stratification in very preterm infants with positive respiratory tract UU results remain lacking. This study aimed to develop a 72-h early postnatal prediction model for BPD in very preterm infants with positive respiratory tract UU results using variables available by the end of the first 72 h after birth. METHODS: This retrospective study included very preterm infants (gestational age < 32 + 0 weeks) with a positive UU result from respiratory tract sampling within 48 h after admission at Qilu Hospital, Shandong University, between January 2020 and December 2024. Candidate predictors were restricted to perinatal and early postnatal variables available by the end of the first 72 h after birth; therefore, the model was intended for early postnatal risk stratification rather than delivery-room or immediate-at-birth prediction. LASSO regression with tenfold cross-validation was used for variable selection. Variables with non-zero coefficients at λ1se were entered into a full multivariable logistic regression model, and a parsimonious four-variable logistic regression model was refitted for nomogram construction. Internal validation of the final four-variable model was performed using bootstrap resampling (B = 500). RESULTS: Of 270 infants assessed for eligibility, 260 were included in the final analysis, including 90 infants with BPD and 170 without BPD. Gestational age, endotracheal intubation, neutrophil count, and lymphocyte count were retained in the final model and incorporated into a nomogram. The model showed high apparent discrimination in the derivation cohort, with an apparent C-index of 0.950 (95% CI, 0.925-0.975) and an apparent Brier score of 0.084. Bootstrap internal validation yielded an optimism-corrected C-index of 0.945, an optimism-corrected calibration intercept of 0.010, and an optimism-corrected calibration slope of 0.875. These findings indicate good internal performance but should be interpreted cautiously because the model was developed in a single-center cohort and lacks external validation. CONCLUSIONS: We developed a 72-h early postnatal prediction model for BPD risk stratification in very preterm infants with positive respiratory tract UU results. The model should be interpreted as a 72-h early postnatal risk-stratification tool rather than a delivery-room prediction model. The model showed promising internal performance in this single-center cohort, but external validation is required before clinical implementation.
Multifocal osteomyelitis and abscess due to Bacteroides caccae in a child with sickle cell disease.
Neaimeh Y, Shah M, Munir F … +3 more , Frost M, Srivaths L, Wootton SH
BMC Pediatr · 2026 Jun · PMID 42310626 · Full text
BACKGROUND: Diagnosing osteomyelitis in pediatric patients with sickle cell disease (SCD) is challenging as bone pain is often attributed to vaso-occlusive episodes ("pain crisis"). Such episodes can result in bone infar...
BACKGROUND: Diagnosing osteomyelitis in pediatric patients with sickle cell disease (SCD) is challenging as bone pain is often attributed to vaso-occlusive episodes ("pain crisis"). Such episodes can result in bone infarcts which can subsequently become sites of infection. Among non-SCD patients, Staphylococcus species are the most common cause of osteomyelitis whereas Salmonella spp. are more frequently the causative organisms in SCD patients [1]. We report the first case of Bacteroides caccae osteomyelitis in a SCD pediatric patient. CASE PRESENTATION: Our patient is a 6-year-old non-verbal male with autism and SCD who presented with fever, headache and irritability and developed new onset back and neck pain during admission. He was subsequently diagnosed with Bacteroides caccae bacteremia complicated by multifocal osteomyelitis and L5/S1 spinal epidural abscess. He underwent left femur subperiosteal abscess irrigation and drainage and L5 bone biopsy. Pathology was consistent with acute osteomyelitis. He received long term Metronidazole with improvement in his condition. CONCLUSIONS: We report the first case of a child with autism and SCD who developed multifocal osteomyelitis and L5-S1 spinal epidural abscess due to Bacteroides caccae with an improvement after prolonged Metronidazole therapy.
The impact of the Indiana Complex Care Coordination Collaborative (IC4) on caregivers of children with complex medical conditions.
Munn EE, Griffin JW, R Ciccarelli M … +1 more , Pangelinan MM
BMC Pediatr · 2026 Jun · PMID 42310601 · Full text
BACKGROUND: The Indiana Complex Care Coordination Collaborative (IC4) is a statewide model of care coordination design to enhance the quality of medical care for children with medical complexity (CMC) by training and emb...
BACKGROUND: The Indiana Complex Care Coordination Collaborative (IC4) is a statewide model of care coordination design to enhance the quality of medical care for children with medical complexity (CMC) by training and embedding nurse care coordinators in primary care practices. This study examines the impact of IC4 care coordinators on caregivers' and patients' quality of medical care, access to medical and community resources, care workload, and the quality of life of caregivers and CMC. METHODS: Caregivers of CMC (n = 13) completed one-hour semi-structured interviews focused on met/unmet needs, quality of medical care, co-developed shared plan of care, caregiver/patient quality of life, caregiver workload, and medical home experience. Using NVIVO, researchers used a codebook to conduct an inductive thematic analysis of the interview transcripts. RESULTS: The thematic analysis was revealed five overarching themes: (1) central role of the care coordinator, (2) proactive and personalized support, (3) care across the lifespan, (4) emotional support, and (5) navigating healthcare systems. Caregivers reported that they considered their care coordinator a trusted health professional who can advocate for them with other health professionals. Families appreciated that the shared plan of care created with the care coordinator can be easily disseminated to other healthcare and service professionals, as well as other family members, and helps the patients and families be seen as individuals, not just as a medical record. CONCLUSION: Care coordination can address unmet needs and greatly improve the quality of and access to care received by CMCs and their families. Unanimously, caregivers report the substantial instrumental, informational, and emotional support care coordinators (CCs) provide to access medical systems, resources, planning, and reduce patient care workload. Additionally, several caregivers reported substantial social support from the CC. However, several caregivers still reported feelings of loneliness and difficulties engaging with families without CMC.
A novel non-invasive technique for pediatric phimosis treatment: assessing efficacy and post-treatment family care - a retrospective cohort study.
Zhao X, Zhang L, Jin N
BMC Pediatr · 2026 Jun · PMID 42310587 · Full text
BACKGROUND: The European Association of Urology 2024-2025 guidelines recommend conservative management as first-line therapy for pediatric phimosis before considering surgical intervention. Balloon catheter dilation trea...
BACKGROUND: The European Association of Urology 2024-2025 guidelines recommend conservative management as first-line therapy for pediatric phimosis before considering surgical intervention. Balloon catheter dilation treatment (BCDT) has emerged as a promising foreskin-preserving approach, yet high-quality comparative evidence against conventional circumcision (CC) remains limited. This study aimed to compare the clinical efficacy, safety outcomes, and family-centered measures between BCDT and CC in a pediatric cohort. METHODS: This retrospective cohort study enrolled 200 boys (aged 2-12 years) with Kikiros grade ≥ 2 phimosis treated between January and December 2024 at a tertiary pediatric surgery center. Patients were allocated to BCDT (n = 100) or CC (n = 100) groups based on treatment received. Primary outcomes included cure rates (Kikiros grade 0-1) at 6 months. Secondary outcomes encompassed procedure-related parameters, complication rates, pain assessment using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, healing time, parent-reported satisfaction, and health literacy-associated compliance measures. Propensity score analysis confirmed baseline comparability. Number needed to treat (NNT) and effect sizes (Cohen's d) were calculated to quantify clinical significance. RESULTS: Both treatments achieved high 6-month cure rates (BCDT: 98.0% vs. CC: 100.0%; P = 0.497; absolute risk difference: 2.0%, 95% CI: -0.7% to 4.7%). BCDT demonstrated substantial advantages in procedure efficiency (mean operative time: 5.03 ± 0.62 vs. 29.38 ± 6.69 min; P < 0.001; Cohen's d=-5.13) and recovery parameters (healing time: 6.74 ± 2.13 vs. 15.90 ± 3.06 days; P < 0.001; Cohen's d=-3.47). Pain-related outcomes significantly favored BCDT: lower incidence (65.0% vs. 99.0%; P < 0.001; NNT = 3), shorter duration (21.2 ± 14.0 vs. 93.2 ± 55.6 h; P < 0.001), and reduced FLACC scores at 24 h (2.59 ± 1.44 vs. 5.22 ± 2.07; P < 0.001; Cohen's d=-1.48). Edema occurrence was substantially lower in the BCDT group (60.0% vs. 100.0%; P < 0.001; NNT = 2.5). Parent satisfaction rates (score 5, very satisfied) were 96.0% and 88.0% for BCDT and CC, respectively (P = 0.068). Parent health literacy (Newest Vital Sign score) positively correlated with home care compliance (r = 0.42; P < 0.001), with adequate literacy (NVS ≥ 4) associated with significantly better adherence (3.21 ± 0.58 vs. 2.74 ± 0.71; P < 0.001). CONCLUSIONS: In this retrospective cohort, BCDT achieved short-term (6-month) cure rates non-inferior to CC while offering clinically meaningful advantages in procedural simplicity (6-fold reduction in operative time), pain mitigation (34% absolute reduction in incidence), accelerated healing (2.4-fold faster), and enhanced parent satisfaction. As a foreskin-preserving, minimally invasive option requiring only topical anaesthesia, BCDT may be considered for carefully selected symptomatic children with pathological phimosis, within a stepwise conservative management strategy that includes watchful waiting and topical corticosteroids as first-line therapy. Routine intervention for asymptomatic physiological phimosis is not supported by these data, and durable cure, long-term recurrence prevention, and broad first-line adoption require confirmation in prospectively designed studies with follow-up extending beyond puberty. Outcomes are optimised when supported by adequate parent health literacy for post-procedure home-care adherence.
Association of postoperative infection with early bilirubin clearance and native liver survival: a single - center retrospective cohort study.
Meng X, Liang S, Li R … +4 more , Huang L, Tang Q, Yun X, Chen X
BMC Pediatr · 2026 Jun · PMID 42310576 · Full text
BACKGROUND: Apart from cholangitis, studies focusing on other postoperative infections after the Kasai procedure (KP) in children with biliary atresia (BA) remain limited.This study aimed to investigate the association b...
BACKGROUND: Apart from cholangitis, studies focusing on other postoperative infections after the Kasai procedure (KP) in children with biliary atresia (BA) remain limited.This study aimed to investigate the association between post-KP infection and prognosis. METHODS: This retrospective study included children with BA who underwent KP. Postoperative infection was the primary exposure variable of interest in this cohort. The primary outcome measure was post-operative native liver survival, while the secondary outcome measure was mortality attributed to infection. A time-dependent Cox regression model was used to account for the timing of postoperative infection as a time-varying covariate. RESULTS: One. A total of 404 cases included in the study. There were no significant differences in gender, age at operation, or gestational age between the two groups (P > 0.05). Two. Early-onset infection is primarily associated with delayed bilirubin clearance (P < 0.01).Time-dependent Cox regression showed that later onset of infection was associated with better native liver survival (HR = 0.777, 95% CI: 0.719-0.839, P < 0.001). After accounting for measured confounders, each one-month later infection onset corresponded to a 22.3% lower hazard of death or liver transplantation. These findings should be interpreted as associations, not causal effects. CONCLUSION: Postoperative infection in biliary atresia is associated with delayed bilirubin clearance and poorer native liver survival. The timing of infection onset is an important factor associated with native liver survival outcomes. Given the observational design, causality cannot be inferred.
Procalcitonin levels as a predictor of antibiotic treatment in pediatric diabetic ketoacidosis.
Dolak KD, Davila S, White PC
BMC Pediatr · 2026 Jun · PMID 42304342 · Full text
BACKGROUND: Procalcitonin is a useful screen for bacterial infection, but its utility in pediatric diabetic ketoacidosis (DKA) is unknown. METHODS: We conducted a retrospective study of DKA patients admitted to two pedia...
BACKGROUND: Procalcitonin is a useful screen for bacterial infection, but its utility in pediatric diabetic ketoacidosis (DKA) is unknown. METHODS: We conducted a retrospective study of DKA patients admitted to two pediatric hospitals in 2019-2023. RESULTS: 116 admissions had available procalcitonin levels, of which in 32, patients were prescribed a complete antibiotics course and thus presumed to have a bacterial infection. More of the treated group were female (69% vs. 45%, p = 0.036), febrile (47% vs. 22%, p = 0.013), and/or had pneumonia on chest x-ray (30.8% vs. 4.76%, p = 0.023). Area under (AUC) a receiver operating characteristic (ROC) curve for procalcitonin to predict clinically suspected infection was 0.51 (no predictive value), whereas a ROC curve using fever and C-reactive protein (CRP) as predictors had an AUC of 0.79. Including procalcitonin in this model did not improve AUC. CONCLUSIONS: CRP and fever are useful predictors for clinically suspected infection in DKA patients, but procalcitonin is not.
Factors associated with failure of hydrostatic reduction in children with ileocolic intussusception.
Xiong J, Yang H, Li T … +6 more , Hu G, Wang J, Yang H, Zhou P, Tan Q, Wang X
BMC Pediatr · 2026 Jun · PMID 42304311 · Full text
BACKGROUND/OBJECTIVES: There remains controversy regarding the risk factors for failed hydrostatic enema reduction; therefore, we aimed to identify additional factors associated with unsuccessful hydrostatic enema reduct...
BACKGROUND/OBJECTIVES: There remains controversy regarding the risk factors for failed hydrostatic enema reduction; therefore, we aimed to identify additional factors associated with unsuccessful hydrostatic enema reduction in children with ileocolic intussusception. METHODS: This study was conducted retrospectively in two tertiary centers. Data were collected from patient charts or electronic medical records and consisted of pediatric intussusception cases treated with hydrostatic reduction during January 2021 and January 2025. Univariate and multivariate analyses, incorporating stepwise logistic regression, were conducted. RESULTS: Two hundred thirty-one patients with ileocolic-type intussusception were included and treated by ultrasound-guided hydrostatic reduction at two different institutions. Hydrostatic reduction was successful in 199 patients (86.2%), failed in 32 (13.8%). All patients were successfully discharged with uneventful recoveries. On multivariate analysis, under 12-month-old(OR = 58.106,P < 0.001 95%CI,14.166-238.338),an Onset of symptoms>48 h (OR = 7.070,P = 0.014 95%CI,1.491-33.517), previous history of intussusception (OR = 42.721, P < 0.001 95%CI,5.729-318.572), constipation (OR = 31.488, P < 0.001 95%CI,5.597-177.137), and bowel Wall Thickening on US(OR = 8.177, P = 0.015 95%CI,1.513-43.553) were significantly associated with failed hydrostatic enema reduction. CONCLUSIONS: An age of under 1 year, previous history of intussusception, onset of symptoms, constipation, and bowel wall thickening on US were risk factors for failed hydrostatic reduction of ileocolic intussusception. Older children with long-term recurrent intussusception are at high risk of pathological leading points(PLPs) and hydrostatic reduction failure, requiring close pediatric surgical attention. Patients with these findings warrant early surgical consultation or transfer to a facility with pediatric surgical capabilities.
Association of vitamin D status with novel hemogram-derived inflammatory indices in preterm infants.
Kurnaz D, Özsoy AI, Okay ZÜ … +4 more , Okay B, Cebeci B, Md HÇ, Md DB
BMC Pediatr · 2026 Jun · PMID 42304308 · Full text
BACKGROUND: Vitamin D plays an important role in immune regulation and inflammatory responses. Hemogram-derived inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), syste...
BACKGROUND: Vitamin D plays an important role in immune regulation and inflammatory responses. Hemogram-derived inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) have recently emerged as practical markers of systemic inflammation. However, data regarding the relationship between vitamin D status and these inflammatory indices in preterm infants are limited. OBJECTIVE: To evaluate the association between vitamin D levels and hemogram-derived inflammatory indices in preterm infants hospitalized in the neonatal intensive care unit. METHODS: This retrospective study included 212 preterm infants born at or below 34 weeks of gestation. Serum 25-hydroxyvitamin D [25(OH)D] levels obtained during the first postnatal week and complete blood count (CBC) parameters measured on the first day of life were analyzed. Infants were classified as vitamin D deficient (< 12 ng/mL), insufficient (12-20 ng/mL), or sufficient (≥ 20 ng/mL). Hemogram-derived inflammatory indices including NLR, PLR, monocyte-to-lymphocyte ratio (MLR), SII, SIRI, and AISI were calculated and compared between groups. RESULTS: The mean vitamin D level was 15.4 ± 10.3 ng/mL. Vitamin D deficiency, insufficiency, and sufficiency were detected in 44.3%, 27.8%, and 27.8% of infants, respectively. No significant differences were observed among vitamin D groups regarding WBC (White Blood Cell), C-reactive protein (CRP), NLR, PLR, MLR, SII, SIRI, or AISI values (all p > 0.05). Similarly, no significant correlations were found between vitamin D levels and inflammatory indices. Infants born before 32 weeks' gestation had significantly higher NLR, SII, SIRI, and AISI values compared with infants ≥ 32 weeks (all p < 0.01). CONCLUSION: Vitamin D status was not associated with hemogram-derived inflammatory indices in preterm infants, even after adjustment for relevant perinatal confounders. Further prospective studies are needed to clarify the relationship between vitamin D status and inflammatory profiles in this population.
Clinical significance of LINC01093 in children with severe pneumonia and its regulation of miR‑326/MAPK1 axis.
Tong P, Wang N
BMC Pediatr · 2026 Jun · PMID 42304299 · Full text
OBJECTIVE: Severe pneumonia (SP) poses a significant threat to the life safety of children. This study aims to investigate the diagnostic and prognostic significance as well as the molecular mechanism of LINC01093 in chi...
OBJECTIVE: Severe pneumonia (SP) poses a significant threat to the life safety of children. This study aims to investigate the diagnostic and prognostic significance as well as the molecular mechanism of LINC01093 in children with SP. METHODS: Ninety-eight children with SP and ninety-two healthy children were included in the study. The diagnostic potential of LINC01093 was evaluated using the receiver operating characteristic (ROC) curve. The prognosis and the factors influencing the prognosis were analyzed through the Kaplan-Meier survival curve and the multivariate Cox regression model. An in vitro SP model was constructed by inducing MRC-5 cells with lipopolysaccharide (LPS). The relative expression of genes was measured by quantitative real-time polymerase chain reaction (qRT-PCR). Cell viability, apoptosis and levels of inflammatory factors were detected by cell counting kit-8 (CCK-8), flow cytometry and Enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared with healthy children, LINC01093 and MAPK1 were elevated in the serum of children with SP, while miR-326 was reduced. LINC01093 had a good diagnostic potential between children with SP and healthy children. High LINC01093 expression correlated with poor prognosis. Silencing LINC01093 upregulated the viability of MRC-5 cells induced by LPS, inhibited apoptosis and the levels of inflammatory factors (interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α)). Inhibiting miR-326 or overexpressing MAPK1 partially reversed the protective effect of LINC01093 silencing on LPS-induced cell damage. CONCLUSION: Silencing LINC01093 exerts a protective effect against LPS-induced damage by regulating the miR-326/MAPK1 axis. This study provides new experimental evidence for understanding the pathogenesis of SP.
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