BMC Pediatrics[JOURNAL]
Sun
200 papers
A pediatric case of varicella-associated cerebral venous sinus thrombosis with anti-GAD65 autoimmune encephalitis and multisystem complications - a case report.
Zolfaghari M, Razzaghi E, Bahrami-Samani F … +1 more , Kazemi D
BMC Pediatr · 2026 Jul · PMID 42402564 · Full text
BACKGROUND: Varicella-zoster virus infection is typically self-limited in children but can rarely lead to severe neurological and thrombotic complications. Post-infectious immune dysregulation may contribute to condition...
BACKGROUND: Varicella-zoster virus infection is typically self-limited in children but can rarely lead to severe neurological and thrombotic complications. Post-infectious immune dysregulation may contribute to conditions such as cerebral venous sinus thrombosis (CVST) and autoimmune encephalitis. Reports describing the coexistence of these complications, particularly with anti-GAD65 antibodies, are exceedingly rare. CASE PRESENTATION: An 8-year-old boy developed seizures, headache, and right-sided hemiplegia twelve days after varicella infection. Neuroimaging revealed CVST with intracranial hemorrhage and cerebral edema, necessitating anticoagulation and decompressive craniectomy. Laboratory findings showed acquired protein S deficiency, suggesting a transient prothrombotic state. His course was complicated by deep vein thrombosis, cytopenias, and epidural abscess requiring antibiotics and surgical intervention. Despite initial stabilization, he developed progressive decline in consciousness and recurrent seizures. Brain MRI demonstrated multifocal T2 hyperintensities, and cerebrospinal fluid analysis showed lymphocytic pleocytosis. Markedly elevated anti-GAD65 antibodies were detected in both serum and CSF, confirming autoimmune encephalitis after exclusion of alternative etiologies. Treatment with high-dose corticosteroids followed by intravenous immunoglobulin resulted in rapid neurological improvement. The patient was discharged with mild residual deficits and showed near-complete recovery on follow-up. CONCLUSIONS: This case highlights a rare overlap of CVST and anti-GAD65 autoimmune encephalitis following varicella infection, emphasizing the role of infection-triggered immune and coagulation disturbances. Early recognition of evolving neurological symptoms and comprehensive evaluation for autoimmune mechanisms are critical. Prompt immunomodulatory therapy, alongside multidisciplinary management, can significantly improve outcomes in complex post-infectious neurological syndromes.
Ureaplasma positivity and respiratory outcomes in very low birth weight infants: a cohort study with a nested double-blind randomized pilot trial of azithromycin.
Jung E, Park GM, Kim CY … +7 more , Lee JM, Lee HN, Jeong J, Kim SH, Lee BS, Kim EA, Kim KS
BMC Pediatr · 2026 Jul · PMID 42399852 · Full text
BACKGROUND: Ureaplasma spp. colonization/infection has been implicated in the inflammatory pathogenesis of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants, but the benefit of targeted macrolide t...
BACKGROUND: Ureaplasma spp. colonization/infection has been implicated in the inflammatory pathogenesis of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants, but the benefit of targeted macrolide therapy remains uncertain. We evaluated respiratory outcomes associated with early Ureaplasma positivity in VLBW infants and assessed feasibility and preliminary efficacy of a standardized intravenous azithromycin regimen in a nested pilot randomized trial. METHODS: This single-center study comprised (1) a retrospective cohort of inborn VLBW infants (< 1,500 g) born between July 2017 and December 2021 who underwent Ureaplasma screening within 24 h after birth, and (2) a prospective, double-blind, randomized, placebo-controlled pilot trial nested among Ureaplasma-positive infants requiring significant respiratory support. In the cohort, outcomes included moderate-to-severe and severe BPD at 36 weeks' postmenstrual age and home oxygen therapy. Multivariable logistic regression adjusted for gestational age, sex, preterm premature rupture of membranes, histologic chorioamnionitis, antenatal steroid exposure, patent ductus arteriosus treatment, and sepsis. In the trial, infants were randomized 1:1 to intravenous azithromycin for 14 days (10 mg/kg/day for 7 days, then 5 mg/kg/day for 7 days) or placebo. Microbiologic response at 2 weeks and safety, including QTc, were assessed. RESULTS: Among 536 VLBW infants, 34 (6.3%) were Ureaplasma positive. Ureaplasma-positive infants had higher rates of moderate-to-severe BPD (76.5% vs. 41.0%), severe BPD (67.6% vs. 36.0%), and home oxygen therapy (46.2% vs. 19.1%). After adjustment, Ureaplasma positivity remained associated with moderate-to-severe BPD (adjusted odds ratio [aOR] 3.86, 95% confidence interval [CI] 1.44-10.35) and severe BPD (aOR 2.93, CI 1.21-7.10). In the pilot trial (n = 26; 13 per group), moderate-to-severe BPD occurred in 61.5% (8/13) with azithromycin versus 84.6% (11/13) with placebo, and severe BPD in 46.2% (6/13) versus 76.9% (10/13). Loss of detectable Ureaplasma by culture at 2 weeks occurred in 13/13 azithromycin-treated infants, while 5/13 placebo infants remained positive. No QTc prolongation or clinically significant safety concerns attributable to azithromycin were observed. CONCLUSION: Early Ureaplasma positivity in VLBW infants was associated with substantially worse respiratory outcomes. A two-week intravenous azithromycin regimen was feasible, microbiologically active, and showed directionally favorable estimates for BPD without an observed safety signal. Larger microbiology-guided trials are warranted. TRIAL REGISTRATION: KCT0002373 (registered 7 July 2017).
Navigating the divide - demographic and individual predictors of low HPV vaccine uptake in rural Uganda.
Evarist MR, Kibonire RA
BMC Pediatr · 2026 Jul · PMID 42399849 · Full text
BACKGROUND: Cervical cancer remains a leading cause of cancer-related mortality among women in low- and middle-income countries, with sub-Saharan Africa bearing a disproportionate burden. Although Human papillomavirus (H...
BACKGROUND: Cervical cancer remains a leading cause of cancer-related mortality among women in low- and middle-income countries, with sub-Saharan Africa bearing a disproportionate burden. Although Human papillomavirus (HPV) vaccination is an effective preventive strategy, completion of the recommended two-dose schedule remains suboptimal in many rural settings in Uganda. This study assessed demographic and individual-level predictors of low HPV vaccine uptake among adolescent girls in Rukiga District. METHODS: A cross-sectional mixed-methods study was conducted between September and November 2022 among 292 caregivers of adolescent girls aged 9-14 years in Rukiga District. Quantitative data were analyzed using multivariable logistic regression to identify factors associated with completion of the HPV vaccination series. Qualitative data were collected through in-depth interviews with 11 health workers and 10 Village Health Team members and analyzed thematically to explore contextual barriers to vaccine uptake. RESULTS: Completion of the two-dose HPV vaccination series was low (23.49%). Maternal caregiving was positively associated with vaccine completion (AOR = 1.70, 95% CI: 1.05-2.75, p = 0.030). In contrast, lack of formal education (AOR = 0.19, p = 0.033), primary education (AOR = 0.50, p = 0.007), and peasant occupation (AOR = 0.49, p = 0.013) among caregivers were associated with lower uptake. Individual factors such as residential mobility (AOR = 0.50, p = 0.001) and school absenteeism or dropout (AOR = 0.73, p = 0.037) significantly reduced the likelihood of completing vaccination. Qualitative findings revealed key barriers including misconceptions about vaccine safety, school-based delivery limitations, frequent mobility, health system constraints (e.g., stockouts, understaffing), and community mistrust. CONCLUSION: HPV vaccine uptake in Rukiga District remains low and is influenced by caregiver education, maternal involvement, socioeconomic status, and adolescent mobility and school attendance. Addressing these barriers requires targeted community health education, strengthening school and outreach vaccination strategies, and improving health system capacity. Tailored interventions focusing on less-educated caregivers and hard-to-reach adolescents are critical to improving vaccine completion and reducing the burden of cervical cancer.
Extensive cervicofacial-to-scrotal subcutaneous emphysema without pneumothorax following pediatric blunt thoracic trauma: a case report.
Alemayehu EM, Woldemichael MA, Asmare BZ
BMC Pediatr · 2026 Jul · PMID 42399846 · Full text
BACKGROUND: Pneumomediastinum with subcutaneous emphysema is an uncommon consequence of pediatric blunt thoracic trauma. Inferior extension of air into the scrotum (pneumoscrotum) is particularly rare, especially in the...
BACKGROUND: Pneumomediastinum with subcutaneous emphysema is an uncommon consequence of pediatric blunt thoracic trauma. Inferior extension of air into the scrotum (pneumoscrotum) is particularly rare, especially in the absence of pneumothorax. CASE PRESENTATION: A previously healthy 7-year-old boy presented 8 hours after sustaining blunt thoracic trauma from an ox kick directed to the left lower anterior chest. Swelling began within one hour and progressively extended from the face and neck to the chest, abdomen, and scrotum. Despite extensive cervicofacial, thoracoabdominal, and scrotal subcutaneous emphysema with diffuse crepitus, he remained hemodynamically stable without significant respiratory compromise. Hamman's sign was present. Chest radiography demonstrated pneumomediastinum with the continuous diaphragm sign and extensive subcutaneous emphysema, without pneumothorax. Computed tomography confirmed pneumomediastinum with air tracking along bronchovascular sheaths consistent with the Macklin effect, retroperitoneal extension, and a focal pulmonary contusion. No tracheobronchial or esophageal injury was identified. The patient was managed conservatively with observation, analgesia, activity restriction, and supplemental oxygen. Complete resolution occurred within 7 days. CONCLUSIONS: Extensive subcutaneous emphysema with pneumoscrotum can occur following pediatric blunt thoracic trauma via the Macklin effect without pneumothorax. Recognition of this pattern and correlation with clinical stability allows safe conservative management and avoidance of unnecessary invasive interventions.
Listening to children with obesity: lived experiences of hunger, cravings, and satiety.
Nowicka P, Neuman N, Nordin K … +5 more , Broholm H, Schollin C, Le Priol YT, Ek A, Eli K
BMC Pediatr · 2026 Jul · PMID 42399834 · Full text
BACKGROUND: Appetite regulation is central to childhood obesity, yet little is known about how children themselves experience and interpret sensations of hunger, cravings, and satiety. This study aimed to explore how chi...
BACKGROUND: Appetite regulation is central to childhood obesity, yet little is known about how children themselves experience and interpret sensations of hunger, cravings, and satiety. This study aimed to explore how children living with overweight or obesity describe these sensations and how they respond to them in everyday life. METHODS: This qualitative study included 32 children (17 girls, 15 boys) aged 8-10 years who were interviewed four years after enrolling in a randomized controlled obesity treatment trial in Stockholm, Sweden. At follow-up (mean age 9.4 years, SD 0.8), the majority had overweight or obesity (mean BMI z-score 2.4, SD 0.6). Individual semi-structured interviews were conducted and analyzed using thematic analysis. RESULTS: Two overarching themes were identified. The first, Experiences of hunger, cravings, and satiety, comprised three subthemes: Hunger - powerful bodily sensations, multiform and situational; Cravings - a sensory and emotional drive for something specific; and Satiety - recognizable bodily signals along a spectrum. The second theme, Responses and strategies for managing appetite, also included three subthemes: Self-regulation; External rules and structures; and Impulsive or emotionally driven eating. Children described hunger as embodied and sometimes overwhelming, cravings as distinct from hunger and often cue-triggered, and satiety as ranging from comfortable to distressing fullness. Responses varied across contexts and included distraction, portion control shaped by adults, and socially motivated eating. Appetite-related experiences were typically described without moral judgment or self-blame. CONCLUSIONS: These findings position appetite regulation in middle childhood as dynamic, embodied, and context-dependent. Attending to children's own language may inform developmentally sensitive, child-centered obesity treatment and support integration of behavioral and emerging pharmacological approaches.
Understanding heterogeneity in paediatric long COVID research: an overview of reviews and recommendations for future pandemics.
Appel S, Coughtrey AE, Kyrdalen A … +5 more , Takeda A, Newlands F, Stephenson T, Shafran R, Pereira SMP
BMC Pediatr · 2026 Jul · PMID 42399828 · Full text
BACKGROUND: Studies of Long COVID or Post-COVID-19 condition in children and young people have varied considerably in their reported prevalences. We aimed to examine the methodological heterogeneity underlying this varia...
BACKGROUND: Studies of Long COVID or Post-COVID-19 condition in children and young people have varied considerably in their reported prevalences. We aimed to examine the methodological heterogeneity underlying this variability and explore whether methodological characteristics were correlated with reported Long COVID outcome prevalence, in order to inform recommendations to improve reporting in future pandemic-related epidemiological research. METHODS: We conducted an overview of reviews with a narrative synthesis, identifying systematic reviews and meta-analyses and extracting their included primary studies. We identified reviews of Long COVID in children & young people in PubMed and Embase using a systematic search strategy. We extracted key methodological details including study design, sample size, sample and control group characteristics, data collection and reporting methods, as well as time-point(s) of surveying and frequency of follow-up. We explored correlations between these factors and prevalence of Long COVID via Spearman's rank correlation coefficients or the Kruskal-Wallis test. RESULTS: 69 studies, from identified reviews, met the inclusion criteria with outcome symptom prevalence varying between 0 and 90% at > 3-months post-COVID-19 infection. Only 19% of studies used an established Long COVID definition to guide analyses. There was substantial heterogeneity in the design and outcome reporting of Long COVID studies. We did not find Long COVID prevalence varied by examined methodological factors (p ≥ 0.08 for all correlations). CONCLUSION: While substantial methodological heterogeneity was observed across studies of paediatric Long COVID, no statistically significant correlations were identified between examined methodological factors and reported prevalence. Such variability limits comparability across studies and highlights the need for more standardised definitions, outcome measures, and reporting approaches in future pandemic-related epidemiological research: we discuss reporting guidelines and recommendations for future paediatric epidemiological research during a pandemic.
Narrative skills in Turkish-speaking children with hearing loss: a comparative analysis with normal-hearing peers.
Akti B, Tuz D, Piştav Akmeşe P
BMC Pediatr · 2026 Jul · PMID 42399826 · Full text
BACKGROUND: The assessment of narrative skills, which reflect higher-order language abilities, provides clear evidence of children's developmental progress and may predict later academic achievement and language developm...
BACKGROUND: The assessment of narrative skills, which reflect higher-order language abilities, provides clear evidence of children's developmental progress and may predict later academic achievement and language development. AIMS: This study aimed to compare the narrative skills of children with hearing loss (HL) and those with normal hearing (NH). METHODS: The study group included of 27 children with HL and 27 children with NH aged 4-8 year. The Turkish Early Language Development Test (TEDIL) was used to evaluate children's early verbal language development, and the Edmonton Narrative Norms Instrument was used to assess narrative skills. RESULTS: According to the results, TEDIL scores (p = 0.000, p = 0.001, and p = 0.000), mean length of utterance in words (MLUw; p = 0.014), and morphemes (MLUm; p = 0.004) in the A1 story were significantly lower in children with HL than in those with NH. Significant differences were also found between the two groups in A1 (p = 0.002) and A3 (p = 0.029) story structure scores, in favour of children with NH. Additionally, significant differences were observed in NDW (p = 0.039) and TNW (p = 0.004) in the A1 story for children with HL, and in MLUw (p = 0.046), TNW (p = 0.007), NDW (p = 0.002), and story structure (p = 0.006) in the A3 story for children with NH. CONCLUSION: The findings indicate that children with HL perform more poorly in language and narrative skills than children with NH. In addition, it was found that children with HL showed greater difficulty in making inferences from the story and establishing cause and effect relationships within stories. These results suggest that educational programmes should be developed to assess and support the narrative skills of children with HL, enabling them to catch up with their NH peers.
Nomogram for predicting 6-month BMIZ changes in children with Crohn's disease: a single-center retrospective study.
Zhang Y, Wu P, Peng X … +4 more , Ma B, Lin Y, Zheng X, Chen S
BMC Pediatr · 2026 Jul · PMID 42399820 · Full text
BACKGROUND: Perianal disease (PD) is an aggressive phenotype in children with Crohn's disease (CD), but its measurable impact on short-term nutritional recovery remains understudied. This study aimed to evaluate the inde...
BACKGROUND: Perianal disease (PD) is an aggressive phenotype in children with Crohn's disease (CD), but its measurable impact on short-term nutritional recovery remains understudied. This study aimed to evaluate the independent effect of PD on the 6-month Body Mass Index Z-score (BMIZ) trajectory and to develop a practical nomogram for early risk stratification in pediatric CD. METHODS: A single-center retrospective cohort of 51 pediatric CD patients (29 with PD and 22 without PD) with at least 6 months of follow-up was enrolled from a tertiary hospital in Fujian, southern China, between July 2017 and March 2025. BMIZ trajectories over time were estimated using linear mixed models (LMM). Predictors of 6-month ΔBMIZ were screened using univariate regression (P < 0.20), followed by LASSO regression (tenfold cross-validation) to construct a nomogram. Model performance was internally validated using 1000 bootstrap resamples (R, MAE, RMSE) and calibration plots. Decision curve analysis (DCA) was performed to evaluate clinical utility for predicting inadequate nutritional recovery (ΔBMIZ ≤ 0.40). RESULTS: LMM analysis showed that PD status significantly reduced the slope of BMIZ recovery after adjusting for age, sex, and biologic therapy (β = -0.085, 95% CI -0.147 to -0.023, P = 0.010). LASSO regression identified six core predictors: perianal disease, positive fecal occult blood test (FOBT), biologic therapy, erythrocyte sedimentation rate (ESR), hemoglobin (Hb), and 25-hydroxyvitamin D3 (25(OH)D3). The nomogram demonstrated satisfactory predictive performance (R = 0.51, MAE = 0.40, RMSE = 0.49), with calibration plots showing good agreement between predicted and observed ΔBMIZ. DCA confirmed a positive net benefit for predicting inadequate nutritional recovery (ΔBMIZ ≤ 0.40) across a threshold probability range of 5% to 85%. CONCLUSION: Perianal disease was independently associated with suboptimal short-term nutritional recovery in children with CD. The proposed nomogram, integrating phenotypic, inflammatory, and nutritional markers, may help identify high-risk patients at diagnosis or early after diagnosis and support individualized nutritional monitoring and therapeutic planning in southern Chinese pediatric CD patients.
Demand analysis of knowledge regarding cardiac rehabilitation among parents of children with congenital heart disease after surgery based on the Kano model.
Yan S, Chen L, Li X … +2 more , Cai X, Luo W
BMC Pediatr · 2026 Jul · PMID 42399807 · Full text
OBJECTIVE: Children with congenital heart disease (CHD) require long-term cardiac rehabilitation (CR) after surgery to improve cardiopulmonary function.This study aimed to use the Kano model to identify parent-perceived...
OBJECTIVE: Children with congenital heart disease (CHD) require long-term cardiac rehabilitation (CR) after surgery to improve cardiopulmonary function.This study aimed to use the Kano model to identify parent-perceived knowledge needs during children's cardiac rehabilitation after CHD surgery, with the goal of informing the design of more targeted home-centered CR education programs. METHODS: Using convenience sampling, 445 parents of post-operative CHD children who visited the Cardiac Rehabilitation Clinic at Shanghai Children's Medical Center from July 2023 to September 2024 were recruited. The knowledge needs of parents were assessed using the Knowledge section of the Children's Heart Disease Parents' CR Knowledge-Attitude-Practice Scale. The Kano model was applied to classify the attributes of knowledge needs. RESULTS: The overall score of parents' CR knowledge was 69.14 ± 1.32. The highest scores were observed in the basic knowledge dimension, while the lowest scores were in the medication management dimension. Kano classification showed that three items in the infection prevention and basic knowledge dimensions were categorized as "one-dimensional" attributes. Eleven items in the exercise management, medication management, and psychological support dimensions were "must-be" attributes. Four items in the growth and development dimension were "indifferent" attributes. CONCLUSION: The CR knowledge level of parents of post-operative CHD children is moderate. Knowledge needs vary across dimensions. Healthcare providers should adjust education strategies based on attribute classification. Priority should be given to managing must-be needs, such as exercise, medication, and psychological support, while also enhancing education on one-dimensional needs like infection prevention.
Determinants of early initiation of breastfeeding in Ethiopia: a systematic review and meta-analysis.
Abdilahi SA, Osman MO, Abate KH … +1 more , Ali JH
BMC Pediatr · 2026 Jul · PMID 42393614 · Full text
BACKGROUND: Timely initiation of breastfeeding is among the major public health problems that contribute to childhood undernutrition, morbidity, mortality, impaired intellectual development, suboptimal adult work capacit...
BACKGROUND: Timely initiation of breastfeeding is among the major public health problems that contribute to childhood undernutrition, morbidity, mortality, impaired intellectual development, suboptimal adult work capacity, and increased risk of non-communicable chronic diseases worldwide, including in Ethiopia Nevertheless, the country-specific determinants of early initiation of breastfeeding in Ethiopia show inconsistent results, and therefore we aimed at synthesizing the existing literature on early initiation of breastfeeding in Ethiopia. While previous national systematic reviews have aggregated broad institutional data, local findings remain highly divergent, and an updated synthesis filtering for rigorous adjustment of confounding factors is lacking. This study aims to bridge this evidence gap by pooling contemporary data to provide clearer policy relevance for maternal and child health interventions. METHODS: Biomedical electronic databases, including PubMed/Medline, HINARI, Science Direct, African Journal Online (AJOL), and Google Scholar, based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), were used, and the protocol was registered in PROSPERO (CRD420261307602). The available literature was critically reviewed, and STATA software version 13 was used to analyses the extracted data. Heterogeneity among studies was assessed using I2 and meta-bias statistics for publication bias. A random-effects model with a 95% confidence interval was used for pooled estimations. RESULTS: Of the 146 articles screened, 19 of them revealed that mothers residing in urban areas OR = OR = 2.02 (95% CI: 1.31-3.10), counselled during antenatal care OR = OR = 2.97 (95% CI: 2.00-4.41), advised during postnatal care OR = 6.27 (95% CI: 2.09-18.74), had normal delivery (spontaneous vertex delivery) OR = 2.99 (95% CI: 1.27-7.06), delivered at health institutions OR = 5.24 (95% CI: 2.16-12.74), and did not practice pre-lacteal feeding to their newborns OR = 7.95 (95% CI: 3.62-17.47) were the significant factors associated with early initiation of breastfeeding in Ethiopia. CONCLUSION: This review provides consolidated evidence regarding the key structural, institutional, and behavioral predictors of EIBF in Ethiopia. Because the primary data are derived from observational designs, these associations reflect strong prognostic indicators rather than definitive causal links. To increase the practice of early breastfeeding initiation, a combination of actions like behavioral change communication and the need for expanded maternal healthcare access, addressing home birth barriers, as well as implementing health service protocols are recommended.
Etiological spectrum, risk factors, and outcomes of pediatric acute encephalitis: a 17-year pediatric intensive care unit retrospective cohort study.
Elleuch A, Borni M, Ghorbel A … +3 more , Kolsi F, Belmabrouk H, Safi F
BMC Pediatr · 2026 Jul · PMID 42393601 · Full text
BACKGROUND: Acute encephalitis is a serious neurological emergency in children, characterized by altered consciousness and brain dysfunction. Prompt recognition and management are essential to reduce morbidity and mortal...
BACKGROUND: Acute encephalitis is a serious neurological emergency in children, characterized by altered consciousness and brain dysfunction. Prompt recognition and management are essential to reduce morbidity and mortality. AIMS: This study aimed to determine the prevalence and identify clinical and paraclinical factors associated with mortality and neurological sequelae among children with acute encephalitis admitted to a pediatric intensive care unit (PICU). METHODS: A retrospective cohort study was conducted over 17 years (2008-2024) in the PICU of Hédi Chaker University Hospital, Sfax, Tunisia. Cases were defined according to International Encephalitis Consortium criteria. RESULTS: Of 2,240 PICU admissions, 58 children (2.6%) met inclusion criteria, representing a mean of 3.4 cases per year over the 17-year study period in this tertiary care PICU. Median age was 5 years; 55.2% were male. Common presentations included seizures (82.8%), altered consciousness (69.0%), and fever (82.8%). Among the 46 patients who underwent MRI, neuroimaging abnormalities were detected in 35 (76.1%). Etiology was identified in 81.0% of cases (47/58). Mortality was 20.7% (12/58), and among the 46 survivors, 9 (19.6%) developed neurological sequelae. On univariate analysis, abnormal movements (p = 0.010) and need for supplemental oxygen (p = 0.027) were significantly associated with sequelae, while age under 1 year, seizures at admission, abnormal CT findings, and requirement for advanced resuscitation measures were associated with mortality. CONCLUSION: Pediatric acute encephalitis carries substantial mortality and morbidity. Early diagnosis, comprehensive etiological investigation, and timely intensive supportive care are essential to improve outcomes. Prevention through immunization and enhanced surveillance should be prioritized.
Pediatric precision sleep network: a study protocol for identifying sleep signatures of mental health risk in peri-adolescents.
Baker AE, Cooper RE, Buysse DJ … +31 more , Chien AT, Gonzalez R, Levenson JC, Miller T, Rivero-Conil S, Seo D, Visweswaran S, Wang Y, Caswell A, Chan S, Chiu K, Corcoran M, Churchill S, Currie R, Duque M, Elder I, Freitag J, Jadhav S, Locke R, Martin C, Milla M, Sahasrabudhe R, Sathe S, Shellhause K, Sritharan A, Robles J, Werner A, Wallace MJ, Jalbrzikowski M, McMakin DL, Soehner AM
BMC Pediatr · 2026 Jul · PMID 42393597 · Full text
BACKGROUND: Peri-adolescence (ages 10-13) is a sensitive-and clinically critical-developmental window for the emergence of psychiatric symptoms, yet scalable strategies for early risk detection in pediatric primary care...
BACKGROUND: Peri-adolescence (ages 10-13) is a sensitive-and clinically critical-developmental window for the emergence of psychiatric symptoms, yet scalable strategies for early risk detection in pediatric primary care (PPC) remain limited. Sleep disturbances are among the most prevalent, predictive, and modifiable indicators of youth mental health, but current pediatric assessments rely heavily on subjective, single-source reports that fail to capture the multidimensional nature of sleep health. The Pediatric Precision Sleep Network (PPSN) is a longitudinal, multi-site study designed to integrate multimodal sleep data with longitudinal clinical outcomes to improve early identification of psychiatric risk during peri-adolescence-a period marked by rapid changes in sleep-circadian biology and vulnerability to psychopathology. METHODS: PPSN will enroll 1,200 youth ages 10-13 across three metropolitan areas (Pittsburgh, Boston, Miami). Over three years, participants will complete multimodal sleep assessments-including self-report, daily sleep logs, actigraphy, ambulatory electroencephalography (EEG), and passive smartphone-based monitoring-administered primarily at home to maximize ecological validity and reduce burden. Psychiatric symptoms and functioning will be assessed biannually via online surveys and electronic health records (EHRs), including structured fields and unstructured notes processed with natural language processing to extract sleep-related information. Scalable, open-source pipelines will automatically derive sleep features. Analyses will: (1) identify multivariable "sleep signatures"-defined as empirically derived patterns of sleep features across modalities-using factor and cluster methods; (2) evaluate their predictive utility for transdiagnostic mental health outcomes using stepwise machine learning approaches; and (3) examine developmental and contextual moderators (e.g., puberty and sociocultural factors). PPSN will also partner with the NIMH Individually Measured Phenotypes to Advance Computational Translation in Mental Health (IMPACT-MH) Data Coordinating Center to standardize procedures, ensure rigorous quality control, and disseminate open-source analytic tools for the broader research community. DISCUSSION: By integrating ecologically valid, longitudinal sleep monitoring with EHR-based and survey outcomes, PPSN aims to identify developmentally sensitive sleep signatures that could be translated into scalable screening tools for PPC. Embedding sleep-informed algorithms into primary care could improve precision and equity of early risk detection and inform future efforts aimed at earlier identification and monitoring of mental health risk in peri-adolescence.
Mitochondrial dysfunction in hyperkalemic periodic paralysis: A case report and literature review.
Mikhael FG, Yatim AS, El-Khoury R … +1 more , Karam PE
BMC Pediatr · 2026 Jul · PMID 42393588 · Full text
BACKGROUND: Hyperkalemic periodic paralysis is a rare autosomal dominant disorder of sodium channels in skeletal muscles caused by pathogenic variants in the SCN4A gene. Emerging evidence suggests an association between...
BACKGROUND: Hyperkalemic periodic paralysis is a rare autosomal dominant disorder of sodium channels in skeletal muscles caused by pathogenic variants in the SCN4A gene. Emerging evidence suggests an association between this disorder and mitochondrial dysfunction, observed in mice. To our knowledge, there are still no reported cases demonstrating this link in humans. CASE PRESENTATION: We presented a case of hyperkalemic periodic paralysis caused by a heterozygous, de novo, and rare variant, NM_000334.4: c.2078T > C (p.Ile693Thr) in the SCN4A gene, reported for the first time in the Arab region. Our patient experienced intermittent episodes of weakness most frequently in the morning, with sudden onset of limb paralysis and inability to walk. She also exhibited facial myotonia with difficulty opening her mouth and eyelids. She was treated with preventive recommendations to avoid triggers and is now clinically stable. Additionally, the patient presented with mitochondrial dysfunction reported for the first time with hyperkalemic periodic paralysis. CONCLUSION: This study is the first clinical report of mitochondrial respiratory chain enzymes dysfunction in a patient with hyperkalemic periodic paralysis caused by a rare variant, c.2078T > C (p.Ile693Thr), in the SCN4A gene.
Spatiotemporal distribution of pregnancies among girls aged 14 years or younger in Bahia, Brazil, 2014-2023: an ecological study under the Brazilian legal framework of statutory rape.
Ramos RR, Carvalho-Sauer R, Paixao ES … +1 more , Bessa TCB
BMC Pediatr · 2026 Jul · PMID 42393586 · Full text
BACKGROUND: Sexual violence against children is a severe violation of human rights and a persistent public health problem, with early pregnancy representing one of its most serious consequences. Although national studies...
BACKGROUND: Sexual violence against children is a severe violation of human rights and a persistent public health problem, with early pregnancy representing one of its most serious consequences. Although national studies in Brazil have identified geographic disparities in pregnancies resulting from statutory rape, intrastate heterogeneity remains insufficiently explored. This study aimed to describe the epidemiological profile of pregnancies among girls aged 14 years or younger interpreted under the Brazilian legal framework of statutory rape in the state of Bahia and to analyze their spatiotemporal distribution between 2014 and 2023. METHODS: A spatiotemporal ecological study was conducted using secondary, aggregated data from the Live Birth Information System (SINASC) and the Mortality Information System (SIM), including live births and fetal deaths (≥ 22 weeks of gestation) among mothers aged ≤ 14 years residing in Bahia. Annual pregnancy rates per 1,000 female inhabitants aged 10-14 years were calculated by health region. Sociodemographic and clinical characteristics were described using absolute and relative frequencies. Spatiotemporal clusters with elevated risk were identified using Kulldorff's scan statistic with a discrete Poisson model, retrospective analysis, 999 Monte Carlo replications, and a 5% significance level. RESULTS: Between 2014 and 2023, 19,235 pregnancies were identified, including 18,914 live births and 321 fetal deaths. Most mothers self-identified as Brown, had low educational attainment, and were single. Preterm birth occurred in 17.5% and low birth weight in 14.0% of live-born infants. The statewide pregnancy rate declined from 3.5 to 2.5 per 1,000 girls aged 10 to 14 years (- 28.6%); however, marked regional disparities persisted. Four statistically significant spatiotemporal clusters were detected (p < 0.05), with relative risks ranging from 1.36 to 1.59, primarily concentrated in the South, Far South, North, and North-Central regions. Recurrent clusters across different periods indicated persistent territorial vulnerability. CONCLUSIONS: Despite an overall decline in rates, pregnancies among girls aged ≤ 14 years in Bahia, interpreted under the Brazilian legal framework of statutory rape, remain territorially concentrated, with persistent high-risk clusters. The persistence of high-risk clusters underscores the need for targeted, territorially tailored interventions integrating health care, surveillance, education, social assistance, and justice systems to prevent sexual violence and mitigate its reproductive consequences.
Co-occurrence of low-grade fibromyxoid sarcoma and familial Tatton-Brown-Rahman syndrome with germline DNMT3A c.1904G > A (p.Arg635Gln): a case report.
Diniz Guerra Braz L, Gomes R, Carvalho de Macedo F … +5 more , Lanes Cypriano G, Mendonça V, da Costa Reis Monte-Mór B, Ferman S, Evangelista Dos Santos AC
BMC Pediatr · 2026 Jul · PMID 42393583 · Full text
BACKGROUND: Tatton‑Brown‑Rahman syndrome (TBRS) is an ultra-rare overgrowth and neurodevelopmental disorder caused by germline DNMT3A variants. Neoplastic manifestations are rarely reported; consequently, data regarding...
BACKGROUND: Tatton‑Brown‑Rahman syndrome (TBRS) is an ultra-rare overgrowth and neurodevelopmental disorder caused by germline DNMT3A variants. Neoplastic manifestations are rarely reported; consequently, data regarding tumor susceptibility in this condition remain limited. Low-grade fibromyxoid sarcoma (LGFMS) has not been previously reported in individuals with TBRS. CASE PRESENTATION: We report a 20‑year‑old male with clinical features of TBRS and a heterozygous germline DNMT3A NM_022552.5:c.1904G > A (p.Arg635Gln) variant, inherited from his father. The patient developed LGFMS at the age of 17 years. Histopathological and immunohistochemical findings supported the diagnosis. Molecular analysis confirmed the DNMT3A variant in blood and tumor tissue without loss of heterozygosity (LOH) by Sanger-based allelic comparison. Segregation analysis identified the variant in the affected father and sister, supporting pathogenicity and confirming familial transmission. CONCLUSIONS: This case documents the first familial transmission of the DNMT3A c.1904G > A (p.Arg635Gln) variant in a Brazilian family, and describes the first reported co-occurrence of TBRS and LGFMS. While causality remains unproven, this finding suggests that germline disruption of epigenetic regulators may influence tumor susceptibility.
Transcatheter embolization of systemic artery-to-pulmonary artery shunts with n-butyl-2-cyanoacrylate for pediatric hemoptysis: a single-center retrospective study.
Shen Z, Lan X
BMC Pediatr · 2026 Jul · PMID 42393568 · Full text
BACKGROUND: Systemic artery-to-pulmonary artery (SA-PA) shunt represents a critical pathological mechanism underlying hemoptysis in pediatric patients, yet focused interventional research targeting this specific conditio...
BACKGROUND: Systemic artery-to-pulmonary artery (SA-PA) shunt represents a critical pathological mechanism underlying hemoptysis in pediatric patients, yet focused interventional research targeting this specific condition remains limited. Traditional embolic materials are frequently associated with elevated recurrence rates in SA-PA shunt cases. This study assesses the effectiveness and safety profile of n-butyl-2-cyanoacrylate (NBCA) embolization for hemoptysis secondary to pediatric SA-PA shunts, while examining the clinical significance of individualized NBCA dilution protocols. METHODS: This study retrospectively reviewed pediatric hemoptysis cases treated with NBCA embolization for SA-PA shunts at a single center from May 2021 to March 2025. Baseline characteristics, culprit feeding artery features, and NBCA-Lipiodol mixing ratios were collected. The primary study endpoints were technical success rate, 24-hour clinical success rate, incidence of severe complications, and hemoptysis recurrence rate. The Kaplan-Meier analysis was applied to generate the hemoptysis-free survival curve. RESULTS: The study cohort comprised 26 pediatric patients (mean age, 9.12 ± 3.44 years; 12 males and 14 females). Fifty-one abnormal systemic feeding arteries were embolized: 16 (31.4%) orthotopic bronchial arteries, 9 (17.6%) ectopic bronchial arteries, and 26 (51.0%) non-bronchial systemic arteries. The mixing ratio of NBCA-Lipiodol varied between 1:2 and 1:4. The rates of technical success and 24-hour clinical success both reached 100.0%. The early (≤ 1 year) hemoptysis recurrence rate was 7.7%, with no late hemoptysis recurrence over a median 25-month follow-up. Kaplan-Meier analysis showed that median hemoptysis-free survival was not reached. CONCLUSIONS: NBCA embolization achieved favorable safety and efficacy profiles in managing SA-PA shunt-related hemoptysis among pediatric patients, demonstrating sustained clinical benefit with limited disease recurrence. It is a valuable interventional treatment option worthy of clinical promotion.
Clinical features and risk factors for severe pediatric scrub typhus in Liangshan Prefecture, China: A retrospective cohort study.
Hua Y, Zhang Y, Zhou J … +2 more , Shi Y, Xu F
BMC Pediatr · 2026 Jul · PMID 42393559 · Full text
OBJECTIVE: This study aimed to analyze the clinical characteristics and identify risk factors for severe disease in pediatric scrub typhus in Liangshan Prefecture, a resource-limited region, to facilitate early diagnosis...
OBJECTIVE: This study aimed to analyze the clinical characteristics and identify risk factors for severe disease in pediatric scrub typhus in Liangshan Prefecture, a resource-limited region, to facilitate early diagnosis and intervention, thereby improving outcomes and reducing mortality. METHODS: We conducted a retrospective study of 103 children with confirmed scrub typhus admitted to a major hospital in Liangshan between July 2023 and December 2024. Patients were classified into severe and non-severe groups. Demographics, clinical features, and laboratory parameters were compared. Univariate logistic regression was performed to identify laboratory parameters associated with disease severity. Due to the limited number of severe cases (n = 12), multivariable analysis was not performed. RESULTS: A total of 103 children were enrolled, comprising 92 mild and 11 severe cases. The majority of children (53.4%) were aged 5-11 years. A distinct seasonal peak was observed from August to September (84.5%). Universal clinical manifestations included fever (100%) and eschar/ulcer (100%). Compared to the mild group, severe cases demonstrated significantly higher levels of CRP, AST, and LDH, and more pronounced reductions in hemoglobin (Hb), platelet count(PLT), fibrinogen, and albumin (all P < 0.05). Univariate analysis using categorized laboratory parameters identified decreased albumin (OR: 20.54, 95% CI: 4.07-376.76, P < 0.001), decreased hemoglobin (OR: 4.53, 95% CI: 1.38-15.87, P = 0.011), and decreased platelet count (OR: 3.20, 95% CI: 1.03-12.22, P = 0.037) as significant risk factors for severe disease. CONCLUSION: In resource-limited settings during scrub typhus season, the constellation of fever, eschar/ulcer, hepatomegaly, lymphadenopathy, and characteristic laboratory derangements supports the diagnosis. Among these, elevated CRP and LDH, coupled with reductions in PLT, fibrinogen, Hb, and particularly albumin, should alert clinicians to severe disease, enabling early intervention and improved prognosis.
Child and mother study satisfaction in a longitudinal study of children at-risk for type 1 diabetes.
Melin J, Tamura R, O'Donnell H … +2 more , Johnson SB, TEDDY study group
BMC Pediatr · 2026 Jul · PMID 42393557 · Full text
BACKGROUND: Child study satisfaction has rarely been assessed in longitudinal pediatric research. This study examined child and maternal study satisfaction among 10-15-year-old participants in The Environmental Determina...
BACKGROUND: Child study satisfaction has rarely been assessed in longitudinal pediatric research. This study examined child and maternal study satisfaction among 10-15-year-old participants in The Environmental Determinants of Diabetes in the Young (TEDDY) study, an observational multinational (US, Finland, Germany, and Sweden) study of children at increased genetic risk for type 1 diabetes enrolled at birth. METHODS: Child and maternal study satisfaction was measured by a 3-item annual questionnaire from child-age 10 years until the last visit at child-age 15. Generalized estimating equations identified sociodemographic and study-related variables associated with study satisfaction. RESULTS: Children and mothers exhibited high study satisfaction across all ages although their study satisfaction scores were weakly correlated (r ≥ 0.20, p < 0.001). Factors associated with higher study satisfaction were similar for children and mothers: living in the US compared to Finland (Finnish children: -0.78 95%CI -0.86, -0.69; Finnish mothers: -1.48 95%CI -1.61, -1.35; p < 0.001), older child age (15-year-old vs 10-year-old child: 0.09 95%CI 0.03,0.14; mother: 0.42 95%CI 0.37, 0.47; p < 0.001), and accurate perception about the child's type 1 diabetes risk (child: 0.20 95%CI 0.15,0.25; mothers: 0.20 95%CI 0.13, 0.22; p < 0.001). Additional factors associated with greater child study satisfaction included female sex (-0.29 95%CI -0.35, -0.24; p < 0.001), being multiple islet autoantibody positive (0.21 95%CI 0.11, 0.32; p < 0.001), lower child anxiety about type 1 diabetes risk (-0.01 95%CI -0.02, -0.01; p < 0.001), having a mother with higher study satisfaction (0.13 95%CI 0.12, 0.15; p < 0.001), and having read an age-appropriate book about the study, its purpose, and type 1 diabetes (0.19 95%CI 0.12, 0.25; p < 0.001). CONCLUSIONS: Study satisfaction was high among 10-15-year-old children at increased genetic risk for type 1 diabetes, and their mothers, who had participated in a longitudinal observational study since the child's birth. Factors associated with satisfaction were similar for children and their mothers. Potentially modifiable factors that could be targeted to improve study satisfaction include mother and child accuracy about the child's type 1 diabetes risk and for child study satisfaction in particular - the child's own anxiety about type 1 diabetes, the child's mother's satisfaction and having the child read high quality age-appropriate materials about the study. TRIAL REGISTRATION: NCT00279318, 06/09/2004.
Parent understanding and satisfaction with NICU discharge for infants with medical complexity: a scoping review of discharge instruction tools.
Alam L, France DJ
BMC Pediatr · 2026 Jul · PMID 42387475 · Full text
BACKGROUND: Infants with medical complexity discharged from the neonatal intensive care unit (NICU) often require technology-supported care and frequent follow-up. In this setting, discharge safety depends on parent care...
BACKGROUND: Infants with medical complexity discharged from the neonatal intensive care unit (NICU) often require technology-supported care and frequent follow-up. In this setting, discharge safety depends on parent caregivers' understanding of instructions, confidence performing specialized tasks, and the reliability of post-discharge coordination. Structured discharge instruction approaches and digital tools are increasingly used to standardize education and reinforce learning. OBJECTIVE: To map and synthesize evidence on parent caregiver-perceived understanding and satisfaction with NICU discharge instructions when structured or digital discharge instruction tools are used, with attention to evidence comparing infants with medical complexity with infants without medical complexity at discharge. METHODS: A scoping review was conducted across PubMed, Embase, CINAHL, Scopus, and the Cochrane Library. English-language studies addressing NICU discharge instruction processes/tools and parent-reported understanding and/or satisfaction were included. After duplicate removal, 281 records were screened; 63 full texts were assessed, yielding 35 sources (32 peer-reviewed papers and 3 clinical trial registry records). Findings were synthesized thematically. RESULTS: Evidence consistently framed NICU discharge as a longitudinal transition rather than a single event. Six themes emerged: (1) Caregiver readiness and skill-building; (2) Psychosocial adaptation; (3) Care coordination and continuity across systems; (4) Home care management; (5) Post-discharge surveillance and follow-up engagement; (6) Late preterm safety standards. Interventions and tools (e.g., structured education plans, written materials, family-centered models, telehealth-enabled discharge planning) were generally associated with improved caregiver preparedness and perceived readiness, but benefits varied by family needs and context. CONCLUSIONS: Structured and digital discharge tools may improve parent understanding and satisfaction, but they work best as part of a coordinated, needs-based transition. Across studies, readiness extended beyond clinical stability to include caregiver confidence and judgment, reliable handoffs, and plans that fit family capacity. Breakdowns clustered at outpatient transitions when guidance and follow-up were unclear. Priorities include stronger cross-setting coordination, post-discharge safety nets, and future research focusing on standardized measures and implementation-focused designs for NICU discharge planning for medically complex infants.
Efficacy and safety of high-flow nasal cannula versus continuous positive airway pressure and conventional oxygen therapies in pediatric acute respiratory failure: a systematic review and meta-analysis.
Memar EHE, Shirzadi R, Rahsepar NS … +1 more , Ashtari S
BMC Pediatr · 2026 Jul · PMID 42387462 · Full text
BACKGROUND: Pediatric acute respiratory failure (ARF) is a significant clinical challenge, often requiring respiratory support. While Continuous Positive Airway Pressure (CPAP) and conventional oxygen therapy (COT) are s...
BACKGROUND: Pediatric acute respiratory failure (ARF) is a significant clinical challenge, often requiring respiratory support. While Continuous Positive Airway Pressure (CPAP) and conventional oxygen therapy (COT) are standard treatments, High-Flow Nasal Cannula (HFNC) has emerged as a promising non-invasive alternative, though its benefits remain unclear. This study aimed to compare the efficacy and safety of HFNC versus CPAP and COT in treating pediatric ARF. METHODS: A literature search was conducted in Embase, PubMed, Cochrane Library, Scopus, and Web of Science until June 15, 2026. Randomized controlled trials (RCTs) comparing HFNC with CPAP and COT in children with ARF secondary to acute severe asthma, bronchiolitis, or pneumonia were included. Primary outcomes were treatment failure and intubation rates; secondary outcomes included oxygen therapy duration, pediatric intensive care unit (PICU) length of stay (LOS), hospital LOS, and mortality. Quality assessment used the Cochrane Risk of Bias Tool, and a random-effects meta-analysis was performed to calculate pooled odds ratios (ORs) and mean differences (MDs). RESULTS: A total of 22 RCTs involving 6,641 children were included in this analysis. Compared to COT, HFNC was associated with a significantly lower risk of treatment failure (OR: 0.509, 95% CI: 0.42-0.61). However, there were no significant differences in intubation rates (OR: 0.796, 95% CI: 0.39-1.63) or hospital mortality (OR: 0.654, 95% CI: 0.4-1.06) between the HFNC and COT groups. Compared to CPAP, HFNC showed increased risks for treatment failure (OR: 1.343, 95% CI: 0.75-2.4), intubation rates (OR: 1.044, 95% CI: 0.58-1.89), and hospital mortality (OR: 3.11, 95% CI: 0.96-10.1), although these increases did not reach statistical significance (P > 0.05). Additionally, there were no significant differences in the duration of oxygen therapy, pediatric PICU LOS, or hospital LOS between HFNC and either CPAP or COT. CONCLUSIONS: HFNC significantly reduces the risk of treatment failure compared to conventional oxygen therapy in children with ARF, though it does not differ significantly from CPAP regarding intubation rates or hospital mortality. Further research is necessary to clarify its relative efficacy and safety in comparison to CPAP. CLINICAL TRIAL REGISTRATION: CRD420250652913.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe