European Journal of Pediatrics最新文献

{"title":"Pediatric adenovirus infections: 10-year clinical spectrum and predictors of severe disease with emphasis on comorbidities and coinfections.","authors":"Kubra Aykac, Aylin Irmak Kuruc, Osman Oguz Demir, Emine Dilara Karatas, Fatma Ugur, Gulrukh Tuychiboeva, Ali Bulent Cengiz, Malik Aydin, Yasemin Ozsurekci","doi":"10.1007/s00431-026-06952-0","DOIUrl":"https://doi.org/10.1007/s00431-026-06952-0","url":null,"abstract":"<p><p>Human adenoviruses (HAdVs) may cause and are responsible for a broad range of pediatric illnesses. Although several cases are self-limiting, certain children may develop complications requiring pediatric intensive care (PICU). To address the role of HAdVs in children, we aimed to characterize the 10-year clinical spectrum of pediatric HAdVs infections and to identify factors associated with hospitalization and severe disease. This retrospective observational cohort study analyzed the clinical course of children (< 18 years) with laboratory-confirmed HAdV infection episodes treated at a tertiary pediatric center between 2014 and 2024. Demographic features, comorbidities, laboratory results, respiratory support requirements, PICU, and clinical outcomes were collected. The severe outcome was defined as a composite endpoint including PICU admission, invasive mechanical ventilation, and/or 30-day mortality. A total of 877 HAdV infection episodes were included, whereas 276 (31.5%) of the patients were hospitalized. Among hospitalized patients, 32.2% required respiratory support, 18.8% required PICU care, and the 30-day mortality was 2.5%. Overall, 104 children (11.9%) developed severe disease. Underlying medical conditions were significantly more frequent among children with severe disease, while those without underlying disease were more common in the non-severe group (69.8% vs. 22.1%; p < 0.001). Viral coinfections were detected in 35.8% of patients but were not associated with increased hospitalization or severity. In multivariable analysis, male sex (OR 2.30, 95% CI 1.23-4.29; p = 0.009), neurologic disease (OR 2.12, 95% CI 1.01-4.42; p = 0.045), cardiac disease (OR 3.27, 95% CI 1.49-7.17; p = 0.003), and hematopoietic stem cell transplantation (HSCT) (OR 4.32, 95% CI 1.36-13.7; p = 0.013) were independently associated with severe outcome.Conclusion: Human adenovirus infection represents a notable clinical burden in children, with a considerable proportion requiring hospitalization and developing severe disease. Underlying neurologic and cardiac diseases, as well as HSCT, were key risk factors for severe outcome, whereas viral coinfections were common but not associated with worse clinical outcome.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clusters in craniofacial microsomia and microtia according to facial morphology and craniofacial anomalies.","authors":"Elsa M Ronde, Guido A de Jong, Jitske W Nolte, Marloes E L Nienhuijs, Neil W Bulstrode, Thomas J J Maal, Alfred G Becking, Corstiaan C Breugem","doi":"10.1007/s00431-026-06973-9","DOIUrl":"https://doi.org/10.1007/s00431-026-06973-9","url":null,"abstract":"<p><p>Associated craniofacial malformations such as ocular anomalies and macrostomia are frequently seen in craniofacial microsomia (CFM). This study assessed associations between objectively measured facial morphology and clinically observed craniofacial malformations in patients with CFM in order to identify clinically significant patient clusters based on these characteristics for preferential screening purposes. In this multicenter cross-sectional cohort study, facial morphology was assessed from three-dimensional (3D) photographs using asymmetry index (ASI) and facial signature (FS) scores, as well as a principal components (PC) analysis of FS scores. Differences in ASI, FS and PC scores were calculated for patients with and without craniofacial anomalies. A clustering analysis was applied to identify patient clusters based on facial morphology and the presence of craniofacial anomalies. A total of 179 patients were included, and significantly higher ASI and FS scores were found in patients with ocular anomalies, skin adnexa-related anomalies, clefting, inner ear anomalies, speech- and language difficulties and vision difficulties compared to patients without these anomalies or difficulties. Two clusters were identified, with significant differences in PC scores, craniofacial anomalies, as well as speech- and language- and vision difficulties.</p><p><strong>Conclusion: </strong> Patients with ocular anomalies, skin adnexa-related anomalies, clefting and aural atresia, or anomalies in two or more of these groups had more facial hypoplasia, while patients with anomalies in two or fewer of these groups had less facial hypoplasia. 3D photography may be a promising tool to identify patients that should be screened for these concurrent craniofacial anomalies.</p><p><strong>What is known: </strong>• CFM is a hetergeneous condition and patients may have various craniofacial anomalies. • 3D photography can be used to measure facial shape in patients with CFM.</p><p><strong>What is new: </strong>• Patients with more facial hypoplasia measured using 3D photography frequently have more associated craniofacialanomalies. • 3D photography could be a promising tool for identifying patients who should be preferentially screened forassociated anomalies.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of vosoritide in children with achondroplasia: a systematic review and meta-analysis.","authors":"Ghaidaa A Alfaraj, Hakeema A Alfaraj, Manar Adel, Rahma B AlGadeeb","doi":"10.1007/s00431-026-06970-y","DOIUrl":"https://doi.org/10.1007/s00431-026-06970-y","url":null,"abstract":"<p><p>Achondroplasia is caused by a gain-of-function mutation in the FGFR3 gene. Vosoritide activates the NPR-B receptor to inhibit the overactive FGFR3 signaling pathway. We aim to pool the efficacy and safety outcomes of vosoritide in children with genetically confirmed achondroplasia who are receiving the approved dose of 15 μg/kg/day. We searched five databases up to February 10, 2026. A systematic review and single-arm meta-analysis were conducted in accordance with the PRISMA guidelines. The primary outcomes were annualized growth velocity (AGV), height gain, and change in height Z-score. Three quality assessment tools were used to assess different study designs of the included studies. All analyses were conducted using OnlineMeta V1.1. Thirteen studies on vosoritide treatment in children with achondroplasia were included, comprising randomized controlled trials, cohort studies, case reports, and case series. A meta-analysis showed that vosoritide was associated with an AGV of 5.72 cm/year (95% CI: 5.51-5.94) at 12 months. The mean height Z-score improvement at 12 months after sensitivity analysis was 0.28 (95% CI: 0.16-0.4), with no significant difference between sexes. Overall, the most common adverse events were injection site reactions (51%) and gastrointestinal symptoms (50%).</p><p><strong>Conclusion: </strong>One-year treatment with vosoritide is associated with increased growth velocity, height gain, and a modest improvement in height Z-score, accompanied by a high incidence of mild to moderate adverse events. Larger, longer-term studies are necessary to confirm the treatment's safety and efficacy.</p><p><strong>What is known: </strong>• Achondroplasia is a skeletal dysplasia caused by a mutation in the FGFR3 gene, which leads to inhibit endochondral ossification and bone growth. • Vosoritide is a recombinant C-type natriuretic peptide analogue designed to counteract overactive FGFR3 signaling and was approved by the FDA and EMA.</p><p><strong>What is new: </strong>• One-year treatment with vosoritide in achondroplasia children is associated with increased growth velocity and improvement in height Z-score with reported minor adverse events.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creatinine, but not cystatin C, varies diurnally in critically ill children: a retrospective analysis from a tertiary pediatric intensive care unit.","authors":"Robert Frithiof, Mats B Eriksson, Jonathan Cedernaes, Ali Reza Modiri, David Smekal, Anders Larsson","doi":"10.1007/s00431-026-06996-2","DOIUrl":"https://doi.org/10.1007/s00431-026-06996-2","url":null,"abstract":"<p><p>Accurate evaluation of kidney function is vital in the pediatric intensive care unit (PICU), where even small changes in cystatin C and creatinine concentrations can affect clinical decision-making. Diurnal patterns in renal biomarkers have been reported in adults, but their relevance in critically ill children remains unclear. Understanding whether sampling time contributes to biological variability is essential for reliable interpretation of kidney function tests. This retrospective study included 8619 cystatin C and 9314 creatinine results collected in a tertiary PICU between April 2014 and September 2025. The hourly distribution of sampling and hourly biomarker percentiles (0.10, 0.25, and 0.50) were evaluated across the 24-h cycle. Diurnal variation was quantified using coefficients of variation (CVs). Sampling was strongly clustered in the early morning, with 38.6% of cystatin C and 37.4% of creatinine samples drawn at 5:00-5:59 AM. The 0.10-0.50 percentiles of cystatin C showed minimal diurnal variation (CV 4.5-6.3%). Creatinine exhibited slightly greater variability, with CVs of 7.4-11.6% across the same percentiles. Median creatinine was significantly higher in the afternoon/evening than in the early morning, while cystatin C showed no clinically relevant hourly fluctuations.</p><p><strong>Conclusion: </strong>In critically ill children, cystatin C demonstrates limited diurnal variation, while creatinine shows modest but measurable fluctuations across the 24-h period. These findings suggest that cystatin C is relatively robust to sampling time in the PICU, whereas creatinine may vary enough to influence interpretation in borderline cases. Incorporating knowledge of sampling time may improve the accuracy of kidney function assessment and AKI classification in pediatric critical care.</p><p><strong>What is known: </strong>• Creatinine and cystatin C can show biological and circadian variability in adults and older children, with creatinine generally exhibiting greater within-day fluctuation than cystatin C.</p><p><strong>What is new: </strong>• In critically ill children, cystatin C shows minimal diurnal variation, whereas creatinine displays modest but measurable time-of-day-related increases, indicating that sampling time may influence creatinine interpretation but not cystatin C in the PICU setting.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of depression on quality of life in PKU children.","authors":"Ibtehal Saad Abuelela, Gihan Mohamed Bebars, Ahmed M Kamal, Sara Ibrahim Sayed, Rasha Samir Refaat","doi":"10.1007/s00431-026-06933-3","DOIUrl":"https://doi.org/10.1007/s00431-026-06933-3","url":null,"abstract":"<p><p>Phenylketonuria (PKU) is a hereditary metabolic disorder. It is characterized by the accumulation of phenylalanine (Phe) metabolites in the brain and body. These metabolites can harm brain function, especially cognition, if they are not reduced by following a Phe-restricted diet early in life. Despite early treatment with a Phe-restricted diet, many neuro-psychiatric disorders are still reported in adults with PKU. The aim of this study is to assess depression in children with PKU. The study included 76 children aged 8-15 years. They were divided into late-diagnosed, early-diagnosed, and healthy control groups. Participants completed the Birelson depression scale and Peds QL 4.0 to measure health-related quality of life. Phe levels were measured at testing and averaged from the previous year. Children with PKU have higher depression scores than healthy controls. Late-diagnosed children have higher depression scores than early-diagnosed children (p = 0.001). Early-diagnosed children differ from controls only in reduced activity (p = 0.004). Late-diagnosed children show more loss of energy (85.7%), irritability (78.6%), and suicidal thoughts (21.4%). Quality of life is lower in children with PKU compared to controls, either regarding the total score or all domains. Quality of life is negatively correlated to Phe levels and depression scores (r =  - 0.32 and r =  - 0.51, respectively) while positively correlated to IQ levels (r = 0.74).Conclusion: Children with PKU show more depression and lower quality of life. These effects may be linked to diagnosis timing, long term Phe control, and IQ. Depression is more pronounced in late-diagnosed children than in early-diagnosed ones.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and patterns of abnormal metabolic screening in pediatric acute encephalopathy: a PICU study from Egypt.","authors":"Marwa Ibrahem Abdelrazic, Mohamed S Hemeda, Manar Anwar Abd-Elaziz, Ahmed Roshdy Mahmoud, Ibtehal Saad Abuelela","doi":"10.1007/s00431-026-06939-x","DOIUrl":"https://doi.org/10.1007/s00431-026-06939-x","url":null,"abstract":"<p><strong>Background: </strong>Inborn errors of metabolism (IEMs) remain underrecognized in children presenting with acute non-infectious encephalopathy, where timely diagnosis and treatment can be lifesaving. This study sought to estimate the yield and spectrum of metabolic screening patterns suggestive of IEM among children with presumed non-infectious acute encephalopathy admitted to a tertiary pediatric intensive care unit in Egypt.</p><p><strong>Methods: </strong>From March 2023 to June 2024, we undertook and finalized a cross-sectional research study at the Minia University PICU. After initial clinical evaluation, cerebrospinal fluid (CSF) analysis did not support overt central nervous system infection; children with presumed non-infectious acute encephalopathy were enrolled. They underwent standardized clinical, laboratory, and neuroimaging workups. Metabolic screening comprised tandem mass spectrometry (TMS) of amino acids/acylcarnitines and urine organic acids by gas chromatography-mass spectrometry (GC-MS). N = 100 participants were included.</p><p><strong>Results: </strong>Abnormal metabolic screening suggestive of an underlying IEM was identified in 26% (n = 26) of children with non-infectious encephalopathy (NIE). The most common abnormal profiles were amino acid disorders (38.5%), organic acidemias (34.6%), and fatty acid oxidation defects (26.9%). Overall mortality was 59%. Abnormal screening was associated with higher ammonia levels (median 176 vs 65 μmol/L; p < 0.001) and a higher frequency of cognitive delay, delayed motor development, and hypotonia (all p < 0.05). On ROC analysis, ammonia > 93.5 μmol/L predicted abnormal screening (sensitivity 84.6%, specificity 65%). In univariate logistic regression, higher serum ammonia, cognitive delay, and delayed motor development were associated with abnormal metabolic screening. In a parsimonious multivariable model, higher ammonia (adjusted OR 1.010, 95% CI 1.004-1.015; p = 0.001) and delayed motor development (adjusted OR 3.66, 95% CI 1.24-10.86; p = 0.019) remained independent predictors.</p><p><strong>Conclusions: </strong>Abnormal metabolic screening suggestive of IEMs comprises a substantial proportion of pediatric NIE in our setting. Early metabolic screening coupled with readily available biomarkers (notably ammonia) may help prioritize patients for confirmatory testing and timely management.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Exploring the long-term impacts of neonatal hypoglycemia to determine a safe threshold for glucose concentrations.","authors":"Meena Garg, Sherin U Devaskar","doi":"10.1007/s00431-026-06877-8","DOIUrl":"https://doi.org/10.1007/s00431-026-06877-8","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-derived diaphragmatic kinematic and morphometry parameters in children with cerebral palsy: a comparative cross-sectional study.","authors":"Paulo A F Magalhães, Thálita R L Crispim, Fabianne M N A Dantas, Helga C Muniz, Bárbara Bernardo R S Figueiredo, Emanuelle F D Schmit, Cyda M A Reinaux","doi":"10.1007/s00431-026-06946-y","DOIUrl":"https://doi.org/10.1007/s00431-026-06946-y","url":null,"abstract":"<p><p>The purpose was. to evaluate diaphragmatic mechanics and morphometry using ultrasound in children with cerebral palsy (CP) compared to typically developing controls. By quantifying parameters such as excursion, contraction/relaxation velocity, and thickness, we aimed to distinguish primary respiratory muscle impairment from anthropometric and clinical confounders to inform targeted management. This comparative cross-sectional study included 102 participants: 51 children with spastic CP (GMFCS levels I-V) and 51 age- and sex-matched healthy controls. Diaphragmatic ultrasound was used to assess excursion, thickness and contraction/relaxation velocity. Multivariate linear regression models, adjusted for age, sex, and weight, as well as clinical confounders (medication use, prior surgeries, and history of pulmonary disease), were applied to determine independent associations with CP. In the unadjusted analysis, children with CP showed significantly reduced expiratory excursion (p = 0.00) and shorter respiratory times (p = 0.00) than controls, together with greater inspiratory thickness (p = 0.03) and contraction velocity (p = 0.01). After adjustment for demographic, anthropometric, and clinical confounders, the inspiratory differences were no longer significant, indicating that they reflected body size-related effects. In contrast, reduced expiratory excursion (p = 0.03) and shorter expiratory time (p = 0.01) remained independently associated with CP, particularly in nonambulatory participants (GMFCS IV-V).</p><p><strong>Conclusion: </strong> Most observed differences in diaphragmatic mechanics and morphometry in children with CP are attributable to lower weight and related confounders. However, the persistent reduction in expiratory excursion and expiratory time, independent of anthropometric and clinical confounders, identifies the expiratory phase as a critical and distinct marker of respiratory impairment in children with CP. Clinical interpretation of diaphragmatic ultrasound in this population requires rigorous adjustment to avoid diagnostic misinterpretation.</p><p><strong>What is known: </strong>• Respiratory dysfunction is a major contributor to morbidity in children with cerebral palsy (CP), driven by neuromuscular impairment and altered chest wall mechanics. • Diaphragm ultrasound is a reliable, noninvasive tool for assessing respiratory muscle function, although its application in children with CP remains limited.</p><p><strong>What is new: </strong>• After adjustment for demographic, anthropometric, and clinical confounders, most diaphragmatic parameters were not independently associated with CP. • Expiratory dysfunction (characterized by reduced expiratory excursion and shortened expiratory time) emerged as a distinct feature, suggesting that impaired abdominal muscle function may represent a previously underrecognized mechanism of respiratory dysfunction in children with CP.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive emotion regulation strategies as predictors of short video addiction in children aged 10-14: a descriptive and correlational study.","authors":"Özge Bicil, Remziye Semerci Şahin, Gülzade Uysal","doi":"10.1007/s00431-026-06930-6","DOIUrl":"https://doi.org/10.1007/s00431-026-06930-6","url":null,"abstract":"<p><p>The rapid rise of short video consumption among children and adolescents has raised concerns regarding its associations with cognitive and emotional functioning. This study aimed to examine whether cognitive emotion regulation strategies predict short video addiction levels in children aged 10-14 and to explore the relationship between specific emotion regulation strategies and short video addiction. A descriptive and correlational research design was employed. The study was conducted between January and June 2025 with 202 middle school students aged 10-14. Participants completed an Information Form, the Short Video Addiction Scale (SVAS), and the Turkish Child Version of the Cognitive Emotion Regulation Questionnaire (CERQ-k). Descriptive statistics, correlation analyses, and multiple linear regression analyses were performed. The mean age of the participants was 12.12 years (SD = 1.24). Most were female (52.97%) and enrolled in the 7th grade (30.20%). SVAS scores were positively correlated with self-blame (r = .21, p < .05), putting into perspective (r = .20, p < .05), and catastrophizing (r = .24, p < .01), indicating that higher levels of short video addiction were associated with greater reliance on maladaptive cognitive emotion regulation strategies. Regression analysis identified catastrophizing as a significant predictor of short video addiction scores (B = 0.59, p < .05), indicating that greater use of catastrophizing was associated with higher levels of short video addiction.</p><p><strong>Conclusion: </strong> The findings indicate that maladaptive cognitive emotion regulation strategies, particularly self-blame and catastrophizing, are associated with higher levels of short video addiction among children. These results highlight the importance of interventions that strengthen adaptive emotion regulation skills as a potential approach to preventing or reducing problematic short video use in childhood.</p><p><strong>What is known: </strong>• Short video use is increasingly common among children and may be associated with cognitive and emotional functioning. • Maladaptive cognitive emotion regulation strategies, such as self-blame and catastrophizing, are linked to poorer emotional and behavioral outcomes in children.</p><p><strong>What is new: </strong>• Maladaptive cognitive emotion regulation strategies are associated with higher levels of short video addiction in children aged 10-14. • Catastrophizing significantly predicts short video addiction, identifying a potential target for early prevention and intervention efforts.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacillus Calmette-Guérin scar reactivation (BCGitis) in Kawasaki disease: a scoping review.","authors":"Hassib Narchi, Alyson Skinner","doi":"10.1007/s00431-026-06967-7","DOIUrl":"https://doi.org/10.1007/s00431-026-06967-7","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The aim of this study is to map and synthesise the evidence on the scattered and heterogeneous reported prevalence of Bacillus Calmette-Guérin (BCG) scar reactivation (BCGitis) in Kawasaki disease (KD), examine clinical relationships, and identify knowledge gaps for future research. A scoping review was conducted according to the PRISMA-ScR guidelines. PubMed, Scopus, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and KoreaMed were searched for observational studies of BCG-vaccinated children with KD. We retrieved the prevalence of BCGitis and its relationship with age, sex, KD form, BCG vaccine strain, coronary artery abnormalities (CAA), and treatment response. Fifteen studies from five Asian countries (Japan, Korea, Taiwan, China, and Singapore), including 21,880 children with KD, were identified. The median reported prevalence of BCGitis was 37.5% (range, 3.5%-75.2%), driven by a few large studies. Its prevalence was 61.8% below 2 years and 9.1% over 2 years in 17,000 patients with KD. Its unweighted study-level prevalence (MU-SLP) was slightly higher in males than in females (49.8% vs. 46.1%), and in the largest number of patients with KF reported, it was associated with lower CAA rates of 11.6 vs.13.8% in the absence of BCGitis. No significant relationships were observed between KD type, vaccine strain, or treatment response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Owing to the inherent methodology and limitations of scoping reviews, these findings should be interpreted as a map of the current evidence rather than a quantitative conclusion. BCGitis is a common manifestation of KD in BCG-vaccinated children and may have diagnostic value, particularly in younger children, in whom diagnosis may be difficult. Although it also seems to have prognostic value regarding the development of CAA, we urge caution because confounding cannot be ruled out. However, the current evidence lacks robustness due to the heterogeneity and design limitations of the studies. Future research addressing these limitations is required.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known: &lt;/strong&gt;• Reactivation at the Bacillus Calmette-Guérin (BCG) inoculation site (BCGitis) has been reported in patients with Kawasaki disease (KD). • Its true prevalence remains unclear due to inconsistent reporting of BCG vaccination status or examination of the inoculation site.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is new: &lt;/strong&gt;• The unweighted study-level prevalence (MU-SLP) of BCGitis among children with KD and prior BCG vaccination was 38.6%. It is slightly higher in males and younger children but is not different between complete and incomplete KD, with coronary artery abnormalities (CAA) being more common in the absence of BCGitis. • Further studies are required to provide robust evidence for these findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt; Hassib Narchi and Alyson Skinner. Bacillus Calmette-Guérin scar reactivation (BCGitis) in Kawasaki disease. A Scoping Review","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"185 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}