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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>2026-05-07T05:10:12.821+00:00</pubDate>
        <ttl>60</ttl>
        <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.2026.1732453</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>
      </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.2026.1792500</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.2026.1746048</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1746048</link>
        <title><![CDATA[Neonatal-onset dilated cardiomyopathy as the initial manifestation of Alström syndrome: a case report]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Hua Wang</author><author>Wandong Ma</author><author>Jingshi Chen</author><author>Bo Li</author>
        <description><![CDATA[BackgroundObesity–retinopathy–diabetes syndrome, also known as Alström syndrome (AS), is an extremely rare autosomal recessive disorder caused by pathogenic variants in the Alström syndrome 1 (ALMS1) gene. Its estimated incidence is 1–9 cases per million, with approximately 1,050 cases reported worldwide. AS is characterized by progressive, multisystem dysfunction with age-related and variable clinical features, often leading to multi-organ failure and premature death.Case descriptionWe report a female infant who initially presented with reversible heart failure in early infancy and subsequently developed nystagmus at six months of age. Genetic testing identified compound heterozygous pathogenic variants in the ALMS1 gene, confirming the diagnosis of AS.ConclusionAS is characterized by multisystem involvement and variable age-related clinical expression. Cardiac dysfunction may precede classic features such as nystagmus or obesity, emphasizing the need for early genetic screening in infants with unexplained cardiomyopathy. Prompt diagnosis facilitates targeted management and improves outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1794811</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1794811</link>
        <title><![CDATA[Multi-omics integration reveals BPGM downregulation and potential plasma metabolite biomarkers for childhood asthma]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Junlin Zhao</author><author>Zhiyuan Wang</author><author>Yanan Wang</author><author>Qianqian Dai</author><author>Menghua Li</author><author>Aliya Maimaitiniyazi</author><author>Zhenzhen Guo</author><author>Liang Ru</author>
        <description><![CDATA[ObjectiveThis study aimed to identify potential diagnostic biomarkers and candidate therapeutic targets through multi-omics integration of peripheral blood transcriptomics and metabolomics in children with asthma. We specifically investigated the association between bisphosphoglycerate mutase (BPGM) downregulation and metabolic alterations in the glycine-serine-threonine pathway, seeking to explore potential mechanisms underlying asthma-related metabolic reprogramming.MethodsIn this exploratory multi-omics study, we integrated public transcriptomic data (GSE35571, n = 124 samples: 60 asthma, 64 controls) with in-house untargeted metabolomics (n = 30 samples: 15 asthma, 15 controls) from treatment-naive, normal-weight children aged 6–14 years. The transcriptomic cohort was derived from a US population (Detroit, Michigan) while the metabolomic cohort was from Xinjiang, China. While this cross-population design precludes direct gene–metabolite correlation at the individual level, pathway-level convergence across ethnically and geographically distinct cohorts may suggest conserved disease-related biological processes, although the pathway intersection should be interpreted as indirect concordance supporting hypothesis generation rather than establishing mechanistic linkage.ResultsTranscriptomics identified 15 differentially expressed genes (p < 0.05, |log2FC| > 0.25), including significant BPGM downregulation (log2FC = −0.2731, p = 0.0422). Metabolomics revealed 516 differential metabolites [p < 0.05, variable importance in projection (VIP) > 1]. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway intersection identified glycine-serine-threonine metabolism (hsa00260) as the core shared pathway, enriched with BPGM and three upregulated metabolites: L-tryptophan, 5-aminolevulinic acid, and L-aspartate semialdehyde. These metabolites demonstrated good diagnostic performance with area under the curve (AUC) values of 0.818, 0.844, and 0.818, respectively. 5-Aminolevulinic acid showed optimal diagnostic accuracy with 80% sensitivity and 80% specificity. Spearman correlation analysis revealed that 5-aminolevulinic acid was significantly positively correlated with both serum IgE (r = 0.469, p = 0.009) and eosinophil counts (r = 0.506, p = 0.004), while no significant correlations were observed with pulmonary function parameters.ConclusionsThis preliminary multi-omics integration study identified concurrent BPGM downregulation and altered glycine-serine-threonine metabolism in childhood asthma. While these findings suggest a potential association between BPGM expression changes and metabolic alterations in this pathway, the proposed mechanistic link remains hypothetical and requires direct experimental validation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1771759</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1771759</link>
        <title><![CDATA[Epidemiology of respiratory syncytial virus in a German hospital before, during and after the COVID-19 pandemic – a real world monocentric analysis over ten years]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Svenja Loerch</author><author>Frank Erdnüß</author><author>Beate Frerich</author><author>Thorsten Reineke</author><author>Wolfgang Kamin</author>
        <description><![CDATA[BackgroundRSV infection affects mostly infants and induces a substantial economic and medical burden for our health care systems. To implement effective preventive strategies against RSV the knowledge about its distinct seasonality is crucial.MethodsWe retrospectively studied the epidemiology of RSV infection in pediatric patients admitted to a German hospital over a period of ten years by comparing their clinical data. Inclusion criterion was a laboratory confirmed RSV infection with diagnosis of bronchitis, bronchiolitis, or pneumonia. For analyses six pre-COVID years were cumulated and compared to the pandemic and post-pandemic seasons. Statistical methods included descriptive measures and exploratory tests for comparing seasons (i.e., Fisher's exact test).ResultsOverall, data of 1,220 children below 12 years of age (including 1,040 below 2 years) could be analyzed. The pre-COVID RSV seasons started in December and peaked in January/February. During the pandemic we detected no case in 2020/21. Season 2021/22 started in August and peaked in October, whereas the first post-pandemic season 2022/23 started in October and peaked in November. The need for intensive care and oxygen supply was significantly increased in 2022/23 compared to 2021/22. Moreover, bacterial superinfection and antibiotic treatment appeared to be significantly more frequent, also in comparison to the pre-COVID seasons.ConclusionOur study shows that the usual RSV epidemiology abruptly changed with the start of the COVID-19 epidemic. After a loss of severe RSV associated disease in 2020/21 a catch up effect could be notified in hospitalized patients in the following seasons, ending up in an almost normal season 2024/25. Future RSV monitoring is strongly recommended to calculate the hospital necessary resources, since vaccination programs, i.e., nirsevimab for infants and maternal vaccination during pregnancy, have already been started in Germany.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1834587</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1834587</link>
        <title><![CDATA[Commentary: A rare case report of Salmonella infection: severe necrotizing pneumonia with empyema in an immunocompetent child]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>General Commentary</category>
        <author>Regina Célia de Souza Campos Fernandes</author><author>Enrique Medina-Acosta</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1769037</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1769037</link>
        <title><![CDATA[Serum LRG1 as a diagnostic marker of necrotizing enterocolitis in preterm infants]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jingtao Bian</author><author>Wenqiang Sun</author><author>Yihui Li</author><author>Xue Liu</author><author>Xinyun Jin</author><author>Minqian Zhou</author><author>Hanghang Peng</author><author>Huawei Wang</author><author>Xueping Zhu</author>
        <description><![CDATA[ObjectiveNecrotizing enterocolitis (NEC) remains a leading cause of morbidity and mortality in preterm infants; however, early diagnosis is limited by the lack of reliable circulating biomarkers. This study aimed to evaluate the diagnostic value of serum leucine-rich α-2 glycoprotein 1 (LRG1) in NEC.MethodsLRG1 was identified through an integrative bioinformatics analysis by intersecting differentially expressed genes from two Gene Expression Omnibus datasets (GSE46619 and GSE64801) with the Secreted Protein Database. A nested case-control study was subsequently conducted in preterm infants (<32 weeks' gestation). Serum LRG1 levels were measured using ELISA, and their associations with clinical and laboratory parameters were analyzed. Machine learning approaches were applied for feature selection, followed by multivariable logistic regression. Diagnostic performance was evaluated using receiver operating characteristic curve analysis.ResultsSerum LRG1 levels were significantly elevated in infants with NEC compared with controls. LRG1 was positively correlated with C-reactive protein and neutrophil count, and negatively correlated with plateletcrit. Higher LRG1 levels were independently associated with NEC. In the predictive model, LRG1 demonstrated moderate diagnostic performance (area under the curve = 0.811).ConclusionSerum LRG1 is a candidate adjunctive biomarker associated with NEC in preterm infants. However, these findings remain exploratory and require validation in larger, multicenter studies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1759935</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1759935</link>
        <title><![CDATA[A literature review: progress in the study of plastic bronchitis]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Huihan Li</author><author>Chi Han</author><author>Danchen Wu</author><author>Yuanyuan Zhang</author>
        <description><![CDATA[This literature review aims to synthesize current evidence on plastic bronchitis (PB), a disease characterized by varying degrees of branching cast formation in the airways. The rationale for undertaking this review stems from the increasing recognition of PB as a potentially life-threatening condition in pediatric populations, coupled with significant recent advances in diagnostic and therapeutic approaches. By systematically searching and analyzing historical literature related to PB from multiple electronic databases, this review examines the current status of PB studies across five critical domains: risk factors, pathology and pathogenesis, clinical features and diagnosis, treatment, and prognosis. Particular emphasis is placed on recent advances in diagnostic imaging, interventional bronchoscopy techniques, and emerging pharmacological therapies. This review provides clinically relevant guidance to enhance awareness and improve management strategies for this rare but serious condition among pediatric practitioners.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1807879</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1807879</link>
        <title><![CDATA[Intubation in children presenting with seizures to a pediatric emergency department in a safety net hospital]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mugdha Mohanty</author><author>Zakir Shaikh</author><author>Hovra Zahoor</author><author>Shivangi Kataria</author><author>N. Paul Rosman</author><author>Alcy R. Torres</author>
        <description><![CDATA[ObjectivePatients seen for uncontrolled seizures in a Pediatric Emergency Department (ED) often undergo tracheal intubation (TI). We looked at factors associated with TI in children in a safety net hospital.MethodsThis was a single-center retrospective case series. Fifty-six patients who had ongoing seizures at the time of arrival to the pediatric ED, between ages 0–21 years, were analyzed for demographics, seizure duration, seizure types, indications for TI, antiseizure medication on discharge, and neurological sequelae.ResultsForty-six percent of patients (26/56) underwent TI. The most common type of seizures in the intubated group was a complex febrile seizure (27%). Forty-two percent were intubated for airway protection and 46% were intubated for respiratory failure.ConclusionsIn all patients presenting to a Pediatric ED with uncontrolled seizures, those undergoing TI most often had complex febrile convulsions, seizures longer in duration (p = 0.036), and seizures needing poly-drug therapy for seizure control (p < 0.001).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1812750</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1812750</link>
        <title><![CDATA[Gastroenterologically relevant high alert medications prescribed to children with chronic diseases—a consensus-driven single-center pilot study]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Judith Hochrainer</author><author>Rebecca Einspieler</author><author>Andreas Heilos</author><author>Judith Pichler</author><author>Michael Boehm</author>
        <description><![CDATA[IntroductionChildren with chronic diseases, including complex gastroenterological patients, often manage complex home medication regimens, where errors pose significant patient- and medication-related risks. High Alert Medications (HAMs) are those with a particularly high potential for adverse consequences if administered incorrectly.AimThis study used a consensus approach to identify HAMs in the pediatric gastroenterological population, using a new scale to measure medication risk and potential patient harms.MethodsThis secondary analysis included 106 children with chronic diseases discharged from the Medical University of Vienna. Interdisciplinary teams identified relevant medications through a consensus approach and separately evaluated the inherent risk of each medication and the potential harm of its use at the individual patient level using five-level scales. Substances were coded via the Anatomical Therapeutic Chemical classification system (ATC system), ranked, and compared with existing HAM lists.ResultsThirty-two medications were categorized into the highest medication risk categories, and 16 into the highest potential patient harm group. The intersection of these categories identified 12 medications defined as HAMs, with immunosuppressants forming the largest therapeutic class. Notably, 50% of the identified HAMs appeared in only one other published list, and one-third were not previously classified as High Alert.DiscussionImmunosuppressants carry elevated risk due to narrow therapeutic windows, complex drug interactions, and potential for severe organ dysfunction. Discrepancies between HAM lists stem from varied methodologies and local clinical characteristics. This study distinguishes itself by focusing specifically on home care and by including off-label medications. The findings underscore the need for localized HAM lists to address specific risks within the target population. Validation studies and consideration of empirical data are needed to further generalize our findings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1784387</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1784387</link>
        <title><![CDATA[Merging evans syndrome with mucopolysaccharidosis type II: a case report]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Xinrui Wang</author><author>Jing Zhang</author><author>Yanhui Tang</author><author>Chunyan Liu</author><author>Peng Hu</author><author>You Yang</author><author>Hongying Chen</author>
        <description><![CDATA[Mucopolysaccharidosis type II (MPS II) is an X-linked recessive lysosomal storage metabolic disorder caused by pathogenic mutations in the iduronate-2-sulfatase (IDS) gene. Herein, we report the case of a 2-year-old male patient diagnosed with concurrent Evans syndrome (ES) and MPS II, who presented with severe anemia, thrombocytopenia, recurrent respiratory tract infections, and typical clinical manifestations of MPS II. Laboratory examinations showed decreased hemoglobin (Hb) and platelet (PLT) counts, a positive direct Coombs test, presence of anti-platelet antibodies, elevated urinary glycosaminoglycan levels, and complete absence of IDS enzyme activity. Whole exome sequencing identified a novel compound heterozygous nonsense mutation in the IDS gene: c.380_383dup GCTA, p.Y128X. The patient received hematopoietic stem cell transplantation (HSCT) and underwent long-term follow-up. During the follow-up period, the patient's IDS enzyme activity returned to normal levels, and no further recurrence of ES was observed. This study reports a novel pathogenic mutation of the IDS gene, and represents the first documented case of concurrent ES and MPS II in a toddler. HSCT has been confirmed to be an effective therapeutic strategy for this extremely rare comorbid condition. Additionally, we discuss the potential pathogenic association between mucopolysaccharidosis (MPS) and ES, and present a systematic summary of the clinical management of this patient, to provide a reference for improved identification and treatment of similar clinical cases in the future.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1752616</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1752616</link>
        <title><![CDATA[Systemic propranolol and topical moist wound dressings for ulcerated infantile hemangioma of the scrotum: a case report]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jiejun Xia</author><author>Kunshan Chen</author><author>Zhenyin Liu</author><author>Xiaoyun Tan</author><author>Shifeng Xie</author><author>Haibo Li</author>
        <description><![CDATA[BackgroundUlceration is a common complication of infantile hemangioma, and its management poses unique difficulties when the lesion is located in high-risk areas like the scrotum. This case report details the successful management of this condition using topical moist wound dressings combined with propranolol.Case presentationA 5-month-old male presented with a rapidly progressing, ulcerated scrotal infantile hemangioma characterized by purulent exudate. Systemic treatment involved oral propranolol solution (maintenance dose of 2 mg/kg/d). Local wound care was managed using a tailored moist wound healing strategy: alginate dressing combined with recombinant human epidermal growth factor gel, secured with a transparent film dressing. The patient was treated successfully; localized infection was controlled within 3 days. The wound achieved complete epithelialization after a total of 12 days of consistent combined treatment, accompanied by simultaneous regression of the hemangioma volume. Three-month Follow-up confirmed favorable cosmetic results with no significant hypertrophic scarring.ConclusionThis case underscores that a synergistic regimen of systemic propranolol and a customized moist wound healing strategy can significantly accelerate healing timelines and improve the quality of tissue repair in ulcerated infantile hemangiomas.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1799724</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1799724</link>
        <title><![CDATA[RSV-infected children with mixed infections: clinical features and early predictive indicators of codetection with Streptococcus pneumoniae and Haemophilus influenzae]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jingwen Ni</author><author>Junyu Dong</author><author>Lele Li</author><author>Mengxin Zhao</author><author>Zhihui Du</author><author>Jie Li</author><author>Kenan Fang</author><author>Kai-Sheng Hsieh</author>
        <description><![CDATA[BackgroundSince the COVID-19 pandemic, the incidence of respiratory syncytial virus (RSV) infections has significantly increased, and bacterial codetection further exacerbates the disease burden. This study aims to compare the clinical characteristics, laboratory results, and prognostic differences in children with RSV infection who are codetected with Streptococcus pneumoniae and Haemophilus influenzae, and to identify early predictive markers for such codetections.MethodsIn this single-center retrospective study, we collected data from 1,601 children hospitalized with RSV infection at Luoyang Maternal and Child Health Hospital, Henan Province, between January 2023 and March 2025. Children were divided into three groups: non-bacterial codetection, S. pneumoniae codetection, and H. influenzae codetection. We compared demographic characteristics, clinical features, laboratory findings, and prognosis. Logistic regression identified risk factors for codetection of S. pneumoniae and H. influenzae.ResultsA history of wheezing increased the likelihood of codetection with both bacteria. Children with S. pneumoniae codetection were more likely to present with fever, whereas those with H. influenzae codetection were more prone to wheezing and respiratory distress. The presence of extrapulmonary manifestations was a significant common factor for both codetections. Regarding laboratory markers, children with codetection of S. pneumoniae showed significantly elevated levels of WBC, NLR, CRP, PCT, and IL-6. For those codetected with H. influenzae, WBC, NLR, CRP, PCT, IL-6, PLT, and D-dimer levels were all significantly increased. Children with either bacterial codetection required significantly more respiratory support, had higher PICU admission rates, and experienced longer hospital stays. A history of wheezing and elevated IL-6 levels were associated with a higher likelihood of S. pneumoniae codetection, while younger age and higher levels of WBC, CRP, and IL-6 were predictive of H. influenzae codetection.ConclusionsCompared with children with RSV infection alone, those with codetection of S. pneumoniae or H. influenzae exhibit significantly elevated inflammatory markers, especially IL-6. These children are more likely to require PICU admission and respiratory support, and to experience longer hospital stays.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1811557</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1811557</link>
        <title><![CDATA[Case Report: Atypical presentations of neonatal and infantile hemophilia B]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Arielle Locke</author><author>Nasrin Samji</author><author>Mihir Bhatt</author><author>Kay Decker</author><author>Sara J. Israels</author><author>Anthony K. C. Chan</author><author>Kyle Mendonça</author>
        <description><![CDATA[Hemophilia B is an X-linked recessive bleeding disorder caused by deficiency or dysfunction of factor IX. It typically presents with spontaneous or trauma-induced bleeding, hemarthrosis, and soft tissue hematomas. We report three cases—two severe neonatal and one moderate infantile case—with atypical presentations: intra-abdominal hemorrhage with hepatic hematoma, a scrotal mass mimicking testicular torsion, and intracranial hemorrhage. None of the patients had a family history of bleeding disorders, and diagnoses were made after these significant bleeding episodes. These cases underscore the importance of considering congenital bleeding disorders in neonates and infants, especially males, who present with unexplained severe bleeding episodes in the absence of trauma or family history. Early recognition, preconception genetic counseling to identify the risk of bleeding disorders in parents, and individualized prophylactic approaches are essential to improve outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1779116</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1779116</link>
        <title><![CDATA[Machine learning-based identification of inflammatory biomarkers for predicting pulmonary consolidation in children with Chlamydia pneumoniae infection]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Qianqian Dai</author><author>Zhiyuan Wang</author><author>Junlin Zhao</author><author>Yanan Wang</author><author>Menghua Li</author><author>Aliya Maimaitiniyazi</author><author>Xueli Wang</author><author>Jianjiang Cui</author><author>Zhenzhen Guo</author><author>Shengmeng Qu</author><author>Wen Zhao</author><author>Liang Ru</author>
        <description><![CDATA[ObjectiveThis study aimed to identify core inflammatory biomarkers through machine learning approaches and develop an accessible online risk calculator to predict pulmonary consolidation in children with Chlamydia pneumoniae infection, addressing the current lack of effective early warning tools.MethodsThis retrospective case-control study enrolled 42 children with C. pneumoniae infection (consolidation group: 26 cases; non-consolidation group: 16 cases) between January 2020 and December 2024. Five machine learning algorithms, including least absolute shrinkage and selection operator (LASSO) regression, support vector machine-recursive feature elimination (SVM-RFE), Random Forest, XGBoost, and LightGBM, were employed for feature selection, and core predictive factors were identified through consensus validation across these algorithms. K-means clustering analysis was performed on the key inflammatory markers, and an online risk assessment system based on HTML5 technology was developed.ResultsThe five machine learning algorithms consistently identified lactate dehydrogenase (LDH), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) as core inflammatory markers for predicting pulmonary consolidation. All three indicators were significantly higher in the consolidation group compared with the non-consolidation group (P < 0.001). K-means clustering analysis stratified patients into a high-inflammation group (9 cases, 21.4%) and a low-inflammation group (33 cases, 78.6%), with a significant difference in consolidation rates between the two groups (100% vs. 51.5%, P = 0.008). The risk assessment system, constructed based on clustering results, demonstrated excellent predictive performance [area under the curve (AUC) = 0.993, 95% confidence interval (CI): 0.966–1.000], with a sensitivity of 88.9% and specificity of 93.9%. Bootstrap resampling validation (1,000 iterations) confirmed the robustness of the clustering solution (stability: 91.2%) and the risk assessment system (bootstrap AUC: 0.949, 95% CI: 0.881–0.995).ConclusionLDH, CRP, and ESR are key indicators for predicting pulmonary consolidation in children with C. pneumoniae infection. The online risk assessment system developed based on these three routine laboratory parameters demonstrates good clinical usability and practicality, enabling early identification of high-risk patients to guide individualized treatment decisions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1790456</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1790456</link>
        <title><![CDATA[Early cardiac rehabilitation in ICU for infants after complex congenital heart disease surgery: a retrospective case series]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mingye Yue</author><author>Hongjun Deng</author><author>Jiawei Shi</author><author>Yuting Hu</author><author>Xinghong Liu</author><author>Huihua Wang</author>
        <description><![CDATA[BackgroundComplex congenital heart disease (CHD) has long been a significant cause of infant mortality and severe morbidity. However, pediatric cardiac rehabilitation (CR) is gaining recognition, and evidence regarding postoperative ICU phase CR for infants with CHD remains scarce.MethodsThis was a retrospective case series, we reviewed clinical data for 10 infants with complex CHD who received an early, individualized CR program during the postoperative ICU phase. The rehabilitation was initiated between postoperative days 5–15 (median 9). The program was based on an exercise prescription, and integrated multidimensional interventions, including respiratory training, gross motor function training, nutritional support, and developmental care.ResultsAll infants were critically ill postoperatively requiring various forms of life-support therapy in the ICU. No serious adverse events related to rehabilitation occurred; transient fluctuations in vital signs resolved promptly with temporary pauses in therapy. Eight infants were discharged home after recovery, and two were transferred to other institutions. Functional improvements were observed across respiratory, feeding, neuromotor, and circulatory domains during the ICU stay.ConclusionFor infants with complex CHD, early initiation of a cardiac rehabilitation program during the ICU phase appears safe and feasible when implemented under multidisciplinary assessment and close clinical monitoring. This approach may support functional recovery across cardiopulmonary and neuromotor domains during a critical developmental window.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1792897</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1792897</link>
        <title><![CDATA[Brain activity as a candidate biomarker for personalised caffeine treatment in premature neonates]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Fatima Usman</author><author>Coen S. Zandvoort</author><author>Shellie Robinson</author><author>Mariska Peck</author><author>Maria M. Cobo</author><author>Tricia Adjei</author><author>Luke Baxter</author><author>Ria Evans Fry</author><author>Annalisa G. V. Hauck</author><author>Richard Rogers</author><author>Gabriela Schmidt Mellado</author><author>Alexandra Scrivens</author><author>Marianne van der Vaart</author><author>Maarten De Vos</author><author>Eleri Adams</author><author>John van den Anker</author><author>Caroline Hartley</author>
        <description><![CDATA[BackgroundCaffeine is one of the most frequently administered medicines in neonatology—prescribed for the management of apnoea of prematurity, to aid extubation and increasingly for conditions such as bronchopulmonary dysplasia. Caffeine guidelines for the management of apnoea of prematurity indicate use based on the age of the infant, but this does not account for individual variation in apnoea rate. Consequently, infants may risk caffeine undertreatment or adverse events due to over-exposure. Apnoea in preterm infants is related to nervous system immaturity, hence, as an essential first step to assess whether brain activity may be a useful biomarker for caffeine treatment, we tested the hypothesis that apnoea rate is related to brain activity.MethodsIn this single-centre prospective observational cohort study, we simultaneously recorded brain activity using electroencephalography (EEG) and respiration using impedance pneumography in 74 infants aged 31–36 weeks postmenstrual age (PMA) on 138 separate occasions. The primary outcome was the association between apnoea rate and brain age gap (defined as the difference between the infant's brain age and their PMA; brain age is calculated from brain activity using a deep learning algorithm). In an exploratory sub-study, we compared the apnoea and desaturation rate in the 7 days after infants stopped caffeine treatment, between those infants with immature and mature brain activity.ResultsWe demonstrate that apnoea rate in moderate/late preterm infants is dependent on brain age gap (p:0.024; β [95% CI]:−0.22 [−0.41 to −0.03]). In contrast, apnoea rate was not correlated with PMA (p:0.58; β [95% CI]:−0.04 [−0.16 to 0.09]). In the exploratory sub-study, we find that when caffeine is discontinued, infants with immature brain activity have more frequent apnoeas and desaturations compared with those with more mature brain function.ConclusionsThese findings provide initial evidence to indicate that brain age is a candidate biomarker for personalised caffeine treatment in preterm infants.]]></description>
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