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        <title>Frontiers in Pediatrics | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/pediatrics</link>
        <description>RSS Feed for Frontiers in Pediatrics | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-08T19:51:19.733+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1836614</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1836614</link>
        <title><![CDATA[Clinical characteristics and surgical treatment of congenital gluteal dermal sinus tract in children: a 15-year retrospective single-center clinical experience]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Debao Li</author><author>Shan Zheng</author><author>Xianmin Xiao</author><author>Yangyang Ma</author><author>Qingchi Zhang</author><author>Chenbin Dong</author><author>Weijing He</author><author>Gong Chen</author><author>Chun Shen</author><author>Song Sun</author>
        <description><![CDATA[ObjectiveTo summarize the clinical features, diagnosis, treatment, and prognosis of congenital gluteal dermal sinus tracts in children, providing insights for better clinical management.MethodsA retrospective analysis was conducted on 20 patients diagnosed with congenital gluteal dermal sinus tracts at the Children's Hospital of Fudan University over 15 years. The analysis focused on age, gender, diagnostic delay, diagnostic methods, course and opening of the sinus tract, and postoperative follow-up.ResultsThe study included 6 males and 14 females, with symptom onset ranging from birth to 12 years (median age of 9.5 months). Initial symptoms included abnormal gluteal depression with recurrent infections (n = 8), unexplained recurrent infections (n = 6), and asymptomatic gluteal depression or small holes (n = 6). The time from symptom onset to diagnosis ranged from 1 to 102 months (median: 13.5 months). MRI was positive in 87.5%, identifying the tract in 81.25%. CT scans were positive in all cases, but only 50% identified the tract. Sinus tractography successfully identified the tract in 7 of 10 patients. The sinus tracts were classified into three types based on the opening location. All sinus tracts were excised during surgery, with an average length of 4.95 cm. Two patients experienced recurrence and underwent reoperation, while the remaining 15 had no recurrence.ConclusionCongenital gluteal dermal sinus tracts are more common in females and often misdiagnosed. CT is more sensitive but less specific than MRI. Sinus tractography helps determine the tract's path. Prognosis is generally good after complete excision, with recurrence being the main postoperative complication.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1774994</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1774994</link>
        <title><![CDATA[Diagnostic performance of wearable acoustic–electrocardiographic indices for screening secundum atrial septal defect in children]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jinyong Pan</author><author>Fengling Zhang</author><author>Yan Guo</author><author>Hu Li</author><author>Yonglin Chen</author><author>Muqing Niu</author><author>Yan Zhang</author><author>Heyun Xiong</author>
        <description><![CDATA[ObjectiveTo evaluate the diagnostic performance of acoustic–electrocardiographic indices derived from a wearable phonocardiogram–electrocardiogram (ECG) sensor for screening secundum atrial septal defect (ASD) in children.MethodsIn this cross-sectional study, 50 children (4–12 years) with secundum ASD and 50 age- and sex-matched healthy controls were enrolled. A wearable patch device recorded synchronized single-lead ECG and phonocardiogram, and S2 splitting time, S1–S2, S1–S2/RR (%), EMAT and EMAT/RR (%) were derived from artifact-free sinus beats at end-expiration. Group differences were assessed using independent-samples t-tests or χ2 tests. Receiver operating characteristic analysis evaluated the ability of S2 splitting time and S1–S2/RR (%) to detect ASD, with optimal cut-offs defined by the Youden index. Multivariable logistic regression examined the independent association of these indices with ASD.ResultsBaseline demographic, anthropometric, and hemodynamic variables were well balanced between ASD and control groups. Compared with healthy controls, children with ASD had significantly prolonged S2 splitting time (39.65 ± 8.37 vs. 28.20 ± 8.91 ms; t = 6.623, P < 0.001) and an increased systolic fraction S1–S2/RR (%) (37.53 ± 2.39% vs. 34.47 ± 2.99%; t = 5.653, P < 0.001), whereas S1–S2 interval, EMAT, and EMAT/RR (%) did not differ significantly between groups. ROC analysis showed that S2 splitting time had good discriminative ability for detecting ASD, with an area under the curve (AUC) of 0.831 [95% confidence interval (CI): 0.752–0.910]. A cut-off value of ≥31.75 ms yielded a sensitivity of 0.90 and a specificity of 0.66. S1–S2/RR (%) demonstrated acceptable discrimination, with an AUC of 0.776 (95% CI 0.686–0.866) and an optimal cut-off of ≥35.25% (sensitivity 0.88, specificity 0.60). In multivariable logistic regression, both S2 splitting time [odds ratio (OR): 1.19 per 1-ms increase; 95% CI: 1.09–1.29; P < 0.001] and S1–S2/RR (%) (OR: 1.58 per 1% increase; 95% CI: 1.25–2.00; P < 0.001) remained independently associated with ASD.ConclusionsWearable acoustic–electrocardiographic monitoring enables quantitative assessment of S2 splitting and systolic time fractions in children. Prolonged S2 splitting time and increased S1–S2/RR (%) are characteristic of secundum ASD and show good diagnostic performance, supporting these simple indices from a patch-type phonocardiogram–ECG sensor as a practical non-invasive tool for pediatric ASD screening.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1814850</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1814850</link>
        <title><![CDATA[Efficacy of transumbilical single-port and two-port laparoscopy in the treatment of pediatric inguinal hernia: a systematic review and meta-analysis]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Bo Yang</author><author>Yi Zhou</author><author>Shipeng Tang</author>
        <description><![CDATA[ObjectiveTo systematically evaluate the perioperative efficacy and safety of transumbilical single-port laparoscopic surgery and two-port laparoscopic surgery in the treatment of pediatric inguinal hernia, and to provide high-quality evidence-based medical evidence for the selection of clinical surgical methods.MethodsA comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases to collect relevant controlled studies published from the establishment of the databases to December 31, 2025. After screening the literature and extracting data according to the pre-set inclusion and exclusion criteria, the ROB2 tool and ROBINS-I tool were used to evaluate the risk of bias in RCT and non-RCT studies, respectively. Meta-analysis was performed using RevMan 5.3 software and R software.ResultsA total of 13 studies were included, involving 22,846 children. Meta-analysis showed that the postoperative recurrence rate in the single-port laparoscopic group was significantly lower than that in the two-port laparoscopic group (RR = 0.60, 95% CI: 0.39–0.94, P = 0.02); there were no statistically significant differences between the two groups in terms of operation time (MD = −1.43, 95% CI: −3.42–0.57, P = 0.16), hospital stay (MD = −2.34, 95% CI: −7.73–3.06, P = 0.40), detection rate of contralateral occult hernia (RR = 1.03, 95% CI: 0.94–1.13, P = 0.55), conversion to open surgery rate (RR = 1.57, 95% CI: 0.14–17.93, P = 0.71), and the incidence of various postoperative complications (all P > 0.05). Subgroup analysis showed that in large sample size studies, the operation time in the single-port laparoscopic group was significantly shorter (MD = −4.27, 95% CI: −7.25–1.28, P < 0.001), and in small sample size studies, the recurrence rate advantage of the single-port laparoscopic group was more significant (RR = 0.43, 95% CI: 0.25–0.71, P = 0.001).ConclusionTransumbilical single-port laparoscopic surgery has a significant advantage in reducing postoperative recurrence rate in the treatment of pediatric inguinal hernia. In large sample size studies, its advantage in operation time is more evident, and its safety is comparable to that of two-port laparoscopic surgery. For medical centers with mature single-port operation techniques, single-port laparoscopy can be the preferred surgical method; for complex hernias or when technical conditions are limited, two-port laparoscopy remains a reliable choice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1826262</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1826262</link>
        <title><![CDATA[Clinical spectrum of pediatric-onset Erdheim-Chester disease: insights from a single-center case series]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ying Yang</author><author>Zi-Chao Lyu</author><author>Zheng-Zheng Liu</author><author>Zhuo Li</author><author>Jia-Ying Yang</author><author>Jia-Wen Dai</author><author>Yue-Lun Zhang</author><author>Xin-Xin Cao</author><author>Wei-Hong Zhang</author><author>Juan Xiao</author>
        <description><![CDATA[PurposePediatric-onset Erdheim-Chester disease (PECD) is considerably rarer than the adult-onset Erdheim-Chester disease (AECD). This study aimed to characterize the clinical, laboratory, imaging, and outcome features of PECD and to compare similarities and differences with adult-onset cases treated at the same center.MethodsWe performed a comparative analysis of PECD and AECD patients treated at the same center over the same period, examining differences in clinical presentation, laboratory and imaging findings, treatment responses, and outcomes.ResultsFive pediatric and sixty-seven adult patients were included. Central nervous system and hypothalamic or pituitary involvement were observed in over 50% of children. PECD patients demonstrated distinct organ involvement patterns, including lower rates of bone involvement (60.0% vs. 97.0%; P = 0.022) and cardiac or large-vessel involvement (0% vs. 65.7%; P = 0.007) compared with AECD patients. Analysis of skeletal manifestations revealed significantly less appendicular skeleton involvement in children [1/3 (33.3%) vs. 64/65 (98.5%); P = 0.004]. Osteosclerosis was the predominant radiographic pattern in both groups (66.7% in children vs. 83.9% in adults; P = 0.505), while osteolytic lesions were present in roughly one-third of patients in each cohort. Inflammatory markers were significantly lower in the pediatric group (P < 0.05). PECD patients exhibited trends toward higher progression-free survival (80.0% vs. 35.0%; P = 0.196) and overall survival (100% vs. 80.5%; P = 0.382) compared with adults; however, these findings should be interpreted cautiously due to the extremely small pediatric sample size.ConclusionsPECD and AECD differ in clinical manifestations and the intensity of systemic inflammation. Pediatric patients appear to have more favorable survival outcomes. These findings suggest potential age-related differences in disease presentation and inflammatory burden. Nevertheless, validation in larger multicenter cohorts is required, underscoring the necessity for large-scale, multicenter collaborative investigations to inform the development of pediatric-specific management strategies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1825355</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1825355</link>
        <title><![CDATA[Treatment of pediatric flatfoot: a systematic review-based consensus and guidelines by CPAM-LRC]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author> Sharula</author><author>Fei Zhao</author><author>Tianyi Wu</author><author>Qinglin Kang</author><author>Xiang Geng</author><author>Hui Qin</author><author>Yan Zhang</author><author>Jin He</author><author>Lihua Huang</author><author>Jia Xu</author><author>Shengdi Lu</author>
        <description><![CDATA[The purpose of this clinical practice guideline is to provide evidence-based recommendations for the treatment of pediatric flexible flatfoot, developed in accordance with the Appraisal of Guidelines for Research and Evaluation II framework and with evidence certainty assessed using the GRADE framework and the Oxford Centre for Evidence-Based Medicine levels of evidence system. A multidisciplinary guideline development group under the Limb Reconstruction Committee of the Orthopedics Branch of China International Exchange and Promotion Association for Medical and Health Care systematically searched and reviewed evidence from primary studies including randomized controlled trials, cohort studies, and comparative studies, supplemented by existing systematic reviews and expert society surveys, to evaluate the effectiveness of conservative and surgical interventions and to guide clinicians and families on the content of an optimal treatment pathway. The guideline targets children and teenagers with flexible flatfoot and addresses interventions available to orthopedic surgeons, podiatrists, rehabilitation physicians, and orthotists, including observation, rehabilitative exercises, foot orthoses, subtalar arthroereisis, calcaneal osteotomy, and criterion-based progression to surgery. Structured conservative management should be considered the mainstay of care for all symptomatic children, with a minimum 6-month trial before surgical referral. However, there is limited evidence on the optimal type, dose, and duration of conservative treatment, and what constitutes an adequate trial of nonoperative care remains undefined. Foot orthoses can be helpful for symptomatic relief when pain or functional limitation is present, and rehabilitative exercise programs may allow superior normalization rates compared to orthoses alone. Pain-free ambulation and return to unrestricted sport are key milestones for both conservative and surgical pathways. However, no validated progression or discharge criteria exist to guide the transition from one treatment phase to the next. While the certainty of evidence was low to very low for most components of the treatment pathway, all 15 recommendation statements were formulated through two rounds of Delphi consensus polling, with 13 achieving the predefined ≥75% agreement threshold. This guideline also highlights the need for standardized diagnostic definitions, multicenter registry data, and age-stratified surgical indications not systematically addressed in previously published literature.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1791876</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1791876</link>
        <title><![CDATA[Independent association of serum IgA levels with moderate-to-severe obstructive sleep apnea in children with adenotonsillar hypertrophy]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Fei Xia</author><author>Zhongfang Xia</author><author>Tao Huang</author><author>Dong Li</author>
        <description><![CDATA[BackgroundAdenotonsillar hypertrophy (ATH) is the leading cause of obstructive sleep apnea (OSA) in children. While the role of allergic inflammation (IgE-mediated) has been widely studied, the contribution of mucosal immunity—specifically Immunoglobulin A (IgA)—to disease severity remains unclear. This study aimed to investigate the association between serum immune markers and OSA severity and to construct a multivariate diagnostic model for moderate-to-severe disease.MethodsA total of 110 children diagnosed with ATH were enrolled in this cross-sectional study. Based on polysomnography (PSG) results and the 2020 Chinese Guidelines for Diagnosis and Treatment of Childhood OSA, participants were divided into a Mild/No OSA group (n = 65) and a Moderate-to-Severe OSA group (n = 45). Serum immunoglobulins (IgA, IgE, IgG, IgM) and complement components (C3c, C4) were analyzed. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were performed.ResultsThe Moderate-to-Severe group exhibited significantly lower lowest oxygen saturation (LSpO2) [0.85 (0.81, 0.89) vs. 0.89 (0.86, 0.91), P < 0.001], larger adenoids [A/N ratio: 0.77 (0.71, 0.80) vs. 0.65 (0.62, 0.75), P < 0.001], and a higher proportion of Grade III tonsils (28.9% vs. 12.3%, P < 0.001). Notably, serum IgA levels were significantly elevated in the Moderate-to-Severe group (2.05 ± 0.55 vs. 1.79 ± 0.75 g/L, P = 0.032), while IgE showed no significant difference. Multivariate logistic regression identified LSpO2 (OR = 0.853, P = 0.005) as a protective factor, while Tonsillar Hypertrophy (ORs 27.09–45.54) and IgA (OR = 2.520, 95% CI: 1.033–6.146, P = 0.042) were independent risk factors. A combined model incorporating these variables achieved an Area Under the Curve (AUC) of 0.852.ConclusionElevated serum IgA is an independent associated factor of moderate-to-severe OSA in children with ATH, suggesting a potential mechanism involving chronic mucosal inflammation distinct from atopy. A combined diagnostic model involving IgA, anatomical metrics, and oximetry provides high diagnostic value.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1762616</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1762616</link>
        <title><![CDATA[Case Report: Progressive limb necrosis as a portal to multifocal osteomyelitis in pediatric septic shock: a tissue-oriented management paradigm]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Cheng Yang</author><author>Wansha Zhou</author><author>Ximeng Huang</author><author>Jiawei Li</author>
        <description><![CDATA[BackgroundLimb necrosis in pediatric septic shock may serve as a persistent source of deep infection, but its role in hematogenous dissemination is underrecognized.Case presentationA 12-year-old boy with septic shock developed progressive left foot necrosis. This was followed by septic arthritis, multifocal osteomyelitis with extensive osteolytic destruction and pathological fracture of the femur, recurrent pneumothorax, and deep vein thrombosis, complicated by multidrug-resistant infections.Management strategiesSource control was achieved via ultrasound-guided drainage of septic arthritis, pathogen-directed antibiotics, and multidisciplinary conservative management prioritizing medical treatment over high-risk surgery.ResultsClinical stabilization occurred after more than 90 days of intensive care before transfer to a general ward.ConclusionThis case illustrates that limb necrosis in septic shock may precede disseminated osteomyelitis. Early bedside ultrasound and multidisciplinary source control are essential when deep infection is suspected.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1798935</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1798935</link>
        <title><![CDATA[Genetic evaluation and pregnancy outcome of fetuses with digestive system malformations: an eight-year single-center retrospective study]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jianlong Zhuang</author><author>Nan Huang</author><author>Wenli Chen</author><author>Yu'e Chen</author>
        <description><![CDATA[BackgroundLimited reports have investigated the genetic etiology of fetuses with digestive system malformations (DSMs). Our initial aim was to describe supplement data of fetal DSMs and further elucidate the genotype-phenotype correlations in fetuses with DSMs.MethodsA total of 7,497 pregnancies with various high-risk factors undergoing prenatal diagnosis were enrolled at Quanzhou Women's and Children's Hospital from 2017 to 2024. Among these, 76 fetuses diagnosed with DSMs via prenatal ultrasound were collected for further analysis. All subjects underwent amniocentesis, followed by karyotype analysis and chromosomal microarray analysis (CMA).ResultsKaryotype analysis identified 3 cases of trisomy-21, 1 case of trisomy-18, and 1 case of balanced translocation t(10;11), reaching a chromosomal aberration detection rate of 6.58% (5/76). The chromosomal aneuploies detected by karyotype were confirmed by CMA. Additionally, CMA identified 6 cases of likely pathogenic/pathogenic CNVs (pCNVs/lpCNVs) that were missed by karyotype analysis, including 17q12 microdeletion/microduplication, 16p11.2 microduplication, 22q11.21q11.22 microdeletion, 2q13 microdeletion, and 16p13.11 microduplication, yielding an incremental diagnostic rate of 7.89% (6/76) for CMA over karyotype analysis (P = 0.031).ConclusionSeveral pCNVs/lpCNVs that associate with DSMs were identified. Our findings may strengthen the association between 16p11.2 microduplication syndrome and DSMs, and the correlation between 16p13.11 microduplication syndrome and intestinal malrotation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1802778</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1802778</link>
        <title><![CDATA[Pediatric bronchial Dieulafoy's disease: a biopsy-sparing bronchoscopic approach with selective bronchial artery embolization]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Weiqing Liu</author><author>Jiasi Zhou</author><author>Jia Guo</author><author>Tuanjie Wang</author><author>Yuping Xu</author><author>Shujun Li</author>
        <description><![CDATA[BackgroundBronchial Dieulafoy's disease (BDD) is an exceedingly rare vascular malformation in children, characterized by aberrant submucosal arteries prone to life-threatening hemorrhage. The optimal diagnostic and therapeutic pathway remains undefined due to limited pediatric cases.ObjectiveTo evaluate the feasibility and outcomes of a standardized pathway featuring biopsy-sparing bronchoscopy with typical endoscopic signs as triggers for selective bronchial artery embolization (BAE) in pediatric BDD.MethodsThis single-center retrospective study analyzed consecutive children (<18 years) with hemoptysis who underwent selective angiography and BAE at the First Affiliated Hospital of Xinxiang Medical University from 2021 onwards. A predefined diagnostic pathway prioritizing airway safety, strict avoidance of biopsy at suspicious lesions, and early progression to BAE was implemented. Patients were classified as confirmed BDD (typical bronchoscopic findings without biopsy, angiographically confirmed) or highly suspected BDD (clinical phenotype consistent, angiographic abnormalities, hemostasis after BAE).ResultsThree patients were included (median age 11 years). Two cases demonstrated typical bronchoscopic findings (submucosal elevation without pulsation) with strict biopsy avoidance and were classified as confirmed BDD. One patient bypassed bronchoscopy due to airway instability, classified as highly suspected BDD. All three patients in this cohort showed unilateral bronchial artery abnormalities on selective angiography, and computed tomography angiography (CTA) failed to identify definitive responsible vascular lesions in 100% (3/3) of cases. All patients achieved immediate hemostasis after superselective embolization (microspheres 300–500 μm ± coils). No major complications occurred. During follow-up (3–36 months), no recurrence was observed. Bronchoscopic localization matched angiographic laterality in 2/2 cases where bronchoscopy was performed.ConclusionsA standardized pathway emphasizing biopsy-sparing bronchoscopy and early BAE appears feasible and safe for pediatric BDD management, achieving favorable short-term outcomes even when computed tomography angiography (CTA) is non-localizing or bronchoscopy is bypassed due to clinical instability.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1775052</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1775052</link>
        <title><![CDATA[Online registration of neonatal stroke in Shenzhen: protocol for a multicentre, prospective, observational cohort study]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Xiaoli Zhao</author><author>Hongqin Zhang</author><author>Lijuan Sheng</author><author>Zhangbin Yu</author><author>Yanping Guo</author><author>Hanni Lin</author><author>Xuelei Gong</author><author>Xueli Zhang</author><author>Miao Tang</author><author>Jiaoyu Mao</author><author>Genshen Zheng</author><author>YuanYuan Li</author><author>Yan Huang</author><author>Fangshi Zhang</author><author>Zhangcong Liang</author><author>Jing Feng</author><author>Lichun Bai</author><author>Yaping Liu</author><author>Yinsha Cai</author><author>Zhifeng Huang</author><author>Qianshen Zhang</author><author>Aiyun Zhang</author><author>Xiaoyi Fang</author><author>Jingxing Cai</author><author>Xue Tang</author><author>Xufeng Luo</author><author>Jinxing Feng</author><author>Lina Men</author><author>Di Gao</author>
        <description><![CDATA[IntroductionNeonatal stroke remains a primary cause of permanent neurological disability. While global prognostic frameworks, including magnetic resonance imaging (MRI) of the posterior limb of the internal capsule (PLIC), General Movements Assessment (GMA), and the Hammersmith Infant Neurological Examination (HINE), have been established to predict motor outcomes, these tools have not been systematically integrated into large-scale Chinese clinical registries. In regions like Shenzhen, the scarcity of prospective, multicenter data continues to hinder the characterization of stroke incidence, risk factors, and long-term outcomes. This protocol details the establishment of the first dedicated online registry in Shenzhen to address these critical evidence gaps.Methods and analysisThis multicenter, prospective, observational cohort study aims to enroll 300 neonates diagnosed with stroke, including arterial ischemic, hemorrhagic, and cerebral venous sinus thrombosis subtypes from a network of 22 hospitals in Shenzhen, China, between January 2025 and December 2030. Data collection will utilize standardized electronic case report forms (eCRFs), initially managed via a uniform digital system (<br>Supplementary File 1), with a planned transition to a secure web-based registry for broader access. Participants will undergo longitudinal follow-up until age five, with neurodevelopmental outcomes assessed using the Bayley Scales of Infant and Toddler Development (4th Ed., Chinese Version), 3T cranial MRI, and video-EEG. To explore the metabolic-inflammatory nexus of neonatal injury, placental pathology will be integrated into the clinical data, and a biobank of stool and breast milk samples will be established. The primary outcome is the registry-based incidence of neonatal stroke. In contrast, secondary outcomes include characterizing clinical subtypes, identifying prenatal/perinatal risk factors, and developing and internally validating a robust prognostic prediction model.Clinical Trial Registration:https://www.chictr.org.cn, identifier ChiCTR2500097104.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1818097</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1818097</link>
        <title><![CDATA[Efficacy of interventions in peripheral arterial and venous malformations of the limbs in children: protocol for a systematic review]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Zhaokun Guo</author><author>Zhongjing Zhang</author><author>Ying Jiang</author><author>Jun Zhou</author><author>Ke-Heng Deng</author><author>Wen-Xiang Zhu</author><author>Xiangyou Zhao</author><author>Pan Jiao</author>
        <description><![CDATA[BackgroundPeripheral arteriovenous malformations (pAVMs) of the limbs are common in children, with distinct clinical features and high intervention difficulty. Existing research on its interventions is controversial due to non-standardized criteria, small-sample uncontrolled studies and inconsistent efficacy evaluation, leaving clinicians without high-quality evidence-based guidance.Methods and analysisThis study will conduct a PROSPERO-registered systematic review, searching PubMed, Embase and other databases for relevant clinical studies. Two researchers will independently screen literature, extract data and assess evidence quality via GRADE. RevMan 5.4 will be used for qualitative and quantitative statistical analysis, with subgroup and sensitivity analyses to explore heterogeneity. Primary outcome is short-term symptom improvement rate within 3 months post-intervention; secondary outcomes include adverse event incidence and quality of life.Ethics and disseminationEthical approval is not required because this study is a secondary analysis of existing data. We will disseminate the findings through peer-reviewed publications.Clinical Trial RegistrationPROSPERO (CRD420261326988).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1828908</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1828908</link>
        <title><![CDATA[Construction of a nomogram combining CT and serum markers for predicting macrolide resistance gene mutation status in pediatric Mycoplasma pneumoniae pneumonia]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xinhui Yuan</author><author>Rui Xin</author><author>Lifang Wang</author><author>Jizu Ling</author><author>Yumei Li</author><author>Lihong Pang</author>
        <description><![CDATA[PurposeTo develop and validate a nomogram integrating chest computed tomography (CT) features and serum biomarkers for predicting the mutation status of macrolide resistance genes in pediatric Mycoplasma pneumoniae pneumonia (MPP).MethodsThis retrospective study enrolled children diagnosed with MPP, genetically stratified into macrolide-resistant (MRMP) and macrolide-sensitive (MSMP) groups based on 23S rRNA gene mutations (A2063G/A2064G). Clinical data, chest CT scans obtained within 48 h of admission, and serum biomarker levels (including C-reactive protein [CRP], procalcitonin [PCT], interleukin-6 [IL-6], D-dimer, neutrophil-to-lymphocyte ratio [NLR], and lactate dehydrogenase to albumin ratio [LAR]) measured within 24 h of admission prior to antibiotic therapy were analyzed.ResultsCompared to the MSMP group (n = 283), the MRMP group (n = 145) had longer fever duration (5.91 vs. 4.85 days) and hospital stay (8.77 vs. 7.32 days), higher rates of shortness of breath (35.86% vs. 24.38%) and oxygen requirement (25.52% vs. 13.78%), elevated serum levels of CRP (39.16 vs. 31.74 mg/L), D-dimer (1.51 vs. 1.32 mg/L FEU), NLR (6.15 vs. 5.22), PCT (0.55 vs. 0.35 ng/mL), IL-6 (28.86 vs. 21.35 pg/mL), and LAR (9.19 vs. 8.42), and more frequent CT findings of lobar consolidation (68.28% vs. 45.23%), bilateral involvement (66.21% vs. 51.59%), pleural effusion (32.41% vs. 14.49%), and higher total severity score (9.22 vs. 7.88). The nomogram based on these independent predictors showed excellent discrimination with an area under the curve of 0.869.ConclusionA nomogram combining CT imaging characteristics and serum biomarkers predicted mutation status of macrolide resistance genes in pediatric MPP, potentially aiding early clinical decision-making.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1814470</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1814470</link>
        <title><![CDATA[Nurses’ perspectives on pain management in pediatric care: systematic review and meta-synthesis]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Majd Elmobasher</author><author>Hui Tao</author><author>Jing Guo</author><author>Issam AbuQeis</author><author>Abeer Teeti</author><author>Yu Wang</author><author>Ma Fang</author>
        <description><![CDATA[BackgroundPain remains one of the most frequently misinterpreted, underdiagnosed, and inadequately managed clinical conditions in pediatric populations. An estimated 50%–70% of pediatric patients experience undertreated pain, which can have serious negative effects on their overall health and well-being. Our study aims to identify, appraise, and synthesize qualitative studies exploring nurses’ perspectives on pain management for pediatric patients to develop a conceptual understanding of facilitators and barriers from the nurses’ perspective.MethodsThis review was registered with PROSPERO (CRD420251034205). A comprehensive literature search was conducted across CINAHL, PubMed, and Nursing journals for English-language studies. The SPIDER framework was used to guide the selection of qualitative studies. Inclusion and exclusion criteria were applied following the PRISMA 2020 guidelines, resulting in the inclusion of nine studies in the final synthesis. Confidence in the synthesized findings was assessed using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach.ResultsAnalysis of nine qualitative studies identified five interconnected themes shaping nurses’ perceptions of pediatric pain management. Being Defeated by Pain reflected nurses’ emotional and professional struggles with persistent or poorly managed pain. Family Participation is a Necessity emphasized the vital role of caregivers in assessment and decision-making. Evidence-Based vs. Experience-Based Pain Assessment revealed tension between adherence to clinical guidelines and reliance on personal judgment. Pharmacological vs. Non-Pharmacological Interventions highlighted challenges in selecting appropriate treatment strategies within practical constraints. Culture-Related Pain Management illustrated how cultural beliefs influence both pain assessment and intervention. Collectively, these themes underscore the complex, multifaceted nature of pediatric pain care from the nursing perspective. The GRADE-CERQual assessment indicated high confidence in the findings for “Being Defeated by Pain” and “Pharmacological vs. Non-Pharmacological Interventions,” and moderate confidence for the remaining three themes.ConclusionsNurses face multifaceted challenges in pediatric pain management. Targeted, culturally sensitive strategies are needed to enhance nursing competence and quality of care.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1815201</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1815201</link>
        <title><![CDATA[Association between a four-locus gene model including IL13, IL4, FCER1B, and ADRB2 and asthma outcomes]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shasha Bai</author><author>Linlin Qin</author><author>Tingting Zhou</author><author>Shaomin Chen</author><author>Fen Yang</author><author>Li Hua</author><author>Yixiao Bao</author>
        <description><![CDATA[BackgroundThis study aimed to explore the association between a four-locus gene model and asthma outcomes.MethodsFour single-nucleotide polymorphisms were genotyped in 139 patients with different asthma outcomes (clinical remission, relapse, or persistence). The high-risk and low-risk genotypes for asthma were evaluated according to the different genotypes that they carried. Differences in asthma outcomes and the factors affecting asthma prognosis were analyzed.ResultsMore patients with high-risk genotypes had severe asthma attacks than those with low-risk genotypes. Compared with patients in asthma clinical remission, patients with severe asthma attacks were at risk for asthma relapse and asthma persistence. In addition, smoking was a risk factor for asthma persistence. The older the age of asthma onset, the more likely it was to be persistent. More patients in the high-risk genotype group had an age of asthma onset younger than 6 years old and an asthma course longer than 4 years than in the low-risk genotype group, regardless of the confounding factors.ConclusionsThe patients with high-risk genotypes not only had more severe asthma attacks and a younger age of asthma onset but also had a longer course, which suggested that the gene model could serve as a tool for asthma prognosis assessment with moderate utility.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1817016</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1817016</link>
        <title><![CDATA[A clustered pulmonary Tuberculosis outbreak at a technical school in Shenzhen, China]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jing Tang</author><author>Mingbin Xie</author><author>Congyang Li</author><author>Fan Huang</author><author>Liai Peng</author><author>Yali Qu</author><author>Jinzhou Mei</author><author>Zhenyang Liu</author><author>Eryong Liu</author><author>Yanfang Guo</author><author>Yunxia Wang</author>
        <description><![CDATA[BackgroundOn 11 June 2025, a clustered outbreak of pulmonary tuberculosis (TB) was detected in a vocational school class in Shenzhen.MethodsA two-phase screening investigation was conducted in accordance with Chinese tuberculosis prevention and treatment guidelines. Screening procedures included symptom assessment, Interferon-Gamma Release Assays (IGRA), and chest radiography (CXR). Confirmed, clinically diagnosed, and suspected cases were identified by specialized pulmonologists following the Diagnostic Criteria for Pulmonary Tuberculosis (WS 288–2017). To assess transmission patterns, a comparative analysis of dormitory and class distributions among individuals with a positive IGRA result was performed. Additionally, whole genome sequencing (WGS) of clinical isolates was conducted to determine genetic relatedness and infer potential transmission pathways.ResultsAfter the initial report of two cases, two rounds of screening were conducted at the school. In the first round, 453 individuals were screened. IGRA yielded valid results for 421 individuals, with a positivity rate of 9.3% (39/421); in the second round, the IGRA positivity rate was 5.1% (9/176). The abnormal CXR rates were 2.4% (11/453) and 1.1% (2/176), respectively. Across both screenings, a total of 7 cases of active tuberculosis were confirmed (including one negative for IGRA), and 42 cases of latent infection were identified. A comparative analysis of the dormitory and class distributions among individuals with a positive IGRA result showed that the IGRA positivity rate in the affected class was 62.2 % (23/37), significantly exceeding rates observed in other classes (P < 0.05). The four dormitories with the highest positivity rates were all occupied by students from Class 2302 (Room 310: 100%, Room 309: 62.5%, Room 506: 50.0%, and Room 308: 37.5%). WGS analysis revealed that five isolates belonged to the Beijing genotype and exhibited high genetic homology with minimal divergence, confirming a single clonal outbreak with slight genetic variation.ConclusionsThis outbreak stemmed from intertwined factors: close contact, poor ventilation, delayed detection, and insufficient prevention. Early syndromic surveillance, enhanced health education for students and staff, improved environmental hygiene, and timely implementation of preventive treatment for latent tuberculosis infection are vital strategies for preventing and controlling TB clusters in educational settings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1818666</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1818666</link>
        <title><![CDATA[Procedural pain in pediatric care: educational, ethical, and public health imperatives]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Opinion</category>
        <author>Christoffer Krug</author><author>Michael Knipper</author><author>Philipp Stieger</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1805856</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1805856</link>
        <title><![CDATA[Prenatal ultrasound diagnosis, intrauterine monitoring and postnatal management of a giant fetal abdominopelvic lymphangioma: a case report and scoping review]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Matteo Giudice</author><author>Milena Viggiano</author><author>Chiara Vassallo</author><author>Alice Novak</author><author>Laura Valfrè</author><author>Irma Capolupo</author><author>Andrea Dotta</author><author>Andrea Conforti</author><author>Marco Bonito</author><author>Maurizio Guida</author><author>Leonardo Caforio</author><author>Isabella Fabietti</author>
        <description><![CDATA[BackgroundFetal lymphangioma is a rare congenital malformation, generally isolated and clinically asymptomatic, except when it invades adjacent tissues, causing compression-related symptoms.ObjectivesTo present a rare case of a giant fetal abdominopelvic lymphangioma and to perform, to our knowledge, the first scoping review of the literature specifically addressing prenatal diagnosis, intrauterine monitoring and postnatal management of this condition.MethodsThe PubMed, Scopus and Embase databases were searched up to September 2025. No limitations on the country were made.ResultsWe present the case of a 38-year-old primigravida with gestational diabetes, hypothyroidism and severe obesity referred to our institute for a second opinion after prenatal detection of a large multiloculated cystic abdominal mass in the fetus, extending to the pelvis, without vascularization. Follow-up imaging, including a fetal magnetic resonance imaging (MRI), confirmed the suspicion of a giant lymphatic malformation with progressive fetal ascites and associated symptomatic polyhydramnios requiring amnioreduction. A male infant was delivered via emergency cesarean section at 34 + 3 weeks and admitted to neonatal intensive care unit (NICU) with respiratory distress. Due to progressive clinical worsening and persistent fluid accumulation, an abdominal drain was placed, followed by debulking surgery at four months, which confirmed the diagnosis of lymphangioma. Gradual clinical improvement enabled the patient's transfer to the Nutritional Rehabilitation Unit and subsequent discharge. Regarding the scoping review, 20 case reports fulfilled the inclusion criteria. Patients were analyzed concerning the prenatal ultrasound diagnosis of a fetal abdominal lymphangioma, pregnancy outcomes, intrauterine and postnatal treatment of the mass.ConclusionClinical presentation and outcomes of fetal abdominal and abdominopelvic lymphangiomas are highly heterogeneous and strongly influenced by lesion extent and intra-abdominal involvement. Our case, characterized by diffuse intestinal and mesenteric disease, highlights the limitations of curative surgical strategies and underscores the need for early recognition of patients who may require prolonged supportive management rather than a complete excision. The scoping review suggests that while focal lesions are often amenable to surgery with favorable outcomes, diffuse forms often require a multidisciplinary, staged approach, with realistic prognostic counseling and long-term follow-up.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1826300</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1826300</link>
        <title><![CDATA[Feasibility and safety of endoscopic retrograde appendiceal foreign body removal in children]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tianjiao Gao</author><author>Kuku Ge</author><author>Lina Sun</author><author>Bianhua Liu</author><author>Dan Nan</author><author>Zhao Yang</author><author>Ying Fang</author><author>Xiaoxia Ren</author>
        <description><![CDATA[ObjectiveEndoscopic retrograde appendicitis therapy (ERAT), developed for acute appendicitis, enables minimally invasive access to the appendix for diagnosis and therapy. Based on the ERAT technique, endoscopic retrograde appendiceal foreign body removal has emerged as a logical yet technically advanced extension, offering a potential minimally invasive alternative to surgical appendectomy. The aim of this study was to evaluate the efficacy and safety of endoscopic retrograde appendiceal foreign body removal in children with appendiceal foreign bodies.MethodsThis retrospective case series included six children (n = 6) who underwent endoscopic retrograde appendiceal foreign body removal at Xi'an Children's Hospital between January 2022 and May 2025. Clinical data, imaging findings, and procedural details were analyzed.ResultsSix male patients (9.2 ± 2.2 years) were included. One patient had a clear history of foreign body ingestion but was asymptomatic. Five patients denied foreign body ingestion history and presented with varying degrees of right lower quadrant or diffuse abdominal pain. All procedures were successful without perioperative complications. Mean procedure duration was 77.5 ± 41.9 min. Retrieved foreign bodies included a wooden strip, button battery, fruit peel, metal object, fruit shell, and pinworms. Average postoperative hospitalization was 3.2 ± 1.5 days. No patient experienced recurrence of symptoms, appendicitis, or complications during the 6-month follow-up.ConclusionEndoscopic retrograde appendiceal foreign body removal appeared feasible in this small series for removing non-sharp appendiceal foreign bodies with low-grade impaction in children, preserving appendiceal function and avoiding surgery.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1792500</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1792500</link>
        <title><![CDATA[Ophthalmologic assessment and intracranial pressure in children: diagnostic methods, clinical correlations, and future directions]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Elena Hernández-García</author><author>Barbara Burgos-Blasco</author><author>Noemi Güemes-Villahoz</author><author>Laura Morales-Fernandez</author><author>Jose Ignacio Fernandez-Vigo</author><author>Enrique Santos-Bueso</author><author>Rosario Gomez-de-Liaño</author><author>Julian García-Feijóo</author>
        <description><![CDATA[Increased intracranial pressure (ICP) in the pediatric population represents a critical and potentially life-threatening condition that may lead to severe neurological sequelae, including brain herniation, cerebral ischemia, and irreversible neurological impairment, such as visual loss. The diagnosis of elevated ICP in children is particularly complex, as clinical manifestations are frequently subtle and non-specific, especially in infants and young children. Symptoms such as irritability, poor feeding, lethargy, and failure to thrive often overlap with a wide range of common pediatric disorders, thereby contributing to delayed diagnosis and an increased risk of adverse neurological outcomes. Within this context, ophthalmologic evaluation constitutes a key non-invasive tool in the early detection of increased ICP. Fundoscopic examination provides critical diagnostic information, with optic disc abnormalities among the most sensitive markers of elevated ICP. However, these findings may be less pronounced or exhibit distinct characteristics in children compared to adults, and their interpretation is further complicated by age-related variability in ocular anatomy and intracranial pressure norms. This review provides an integrated synthesis of current diagnostic strategies for assessing elevated ICP in children, with a particular focus on ophthalmologic assessment. It examines the association between specific ocular findings and ICP, with the aim of improving early recognition, guiding clinical management, and enhancing patient outcomes. Furthermore, it addresses the inherent challenges of pediatric ICP diagnosis and highlights key gaps in the literature that warrant further investigation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1732453</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1732453</link>
        <title><![CDATA[Case Report: BKV-specific T cells: a fast, safe and potentially effective treatment option for refractory BKV infections in pediatric patients after allogeneic stem cell transplantation]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Sven Oberwegner</author><author>Steffen A. Hettler</author><author>Luca Hensen</author><author>Amadeus T. Heinz</author><author>Christiane Braun</author><author>Michaela Döring</author><author>Peter Lang</author>
        <description><![CDATA[BK virus reactivation is frequently observed in patients following allogeneic stem cell transplantation and can cause nephropathy and hemorrhagic cystitis. Current treatments are mainly supportive, and antiviral therapy with cidofovir lacks clear evidence of efficacy. Therefore, novel therapeutic strategies are needed. Since adoptive transfer of virus-specific T cells has proven effective for other viral infections, this case series with four cases of post-transplant severe BKV infections evaluated the feasibility, safety, and efficacy of BKV-specific T cells in patients with refractory BKV infection using the CliniMACS Prodigy system. Three of the four patients demonstrated a reduction in BKV viral load following adoptive T-cell transfer, with detectable in vivo expansion of BKV-specific T cells in these individuals. However, complete viral clearance was not achieved in all cases. One patient with extensive immunosuppression showed minimal viral response and no detectable BKV-specific T cells after infusion. Treatment was well tolerated, with no infusion-related toxicities and no severe de novo graft-versus-host disease observed. Overall, this case series suggests that rapidly manufactured BKV-specific T cells produced via the CliniMACS Prodigy system represent a feasible, safe, and potentially effective treatment option for refractory BKV viremia after stem cell transplantation. Early administration and limited concurrent immunosuppression may improve therapeutic outcomes. Further studies are needed to confirm these findings.]]></description>
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