Frontiers in Pediatrics最新文献

{"title":"Co-occurrence of suspected scoliosis and sagittal spinal deviations among early adolescents: a school-based cross-sectional study of prevalence and associated factors.","authors":"Patcharin Nilmart, Mantana Vongsirinavarat","doi":"10.3389/fped.2026.1769144","DOIUrl":"https://doi.org/10.3389/fped.2026.1769144","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the prevalence and patterns of spinal postural abnormalities, particularly the co-occurrence of suspected scoliosis and sagittal spinal deviation, and to identify associated biological, behavioral, and psychosocial factors among early adolescents aged 12 to14 years.</p><p><strong>Methods: </strong>A school-based, cross-sectional study was conducted among 255 school children aged 12 to 14 years. The standardized postural assessments and validated questionnaires were used to obtain data on the spinal alignment, anthropometric measures, pain location, and behavioral and psychosocial characteristics. Frontal and sagittal deviations were assessed through standardized visual inspection procedures. Frontal deviations indicating suspected scoliosis were further examined using the Adam's forward bending test and the angle of trunk rotation (ATR) measured with a scoliometer. Behavioral variables included screen time and preferred posture during screen use, while psychosocial variables comprised knowledge, attitude, and practice (KAP) and self-postural awareness questionnaires. Associated factors were identified by performing comparative analyses and binary logistic regression.</p><p><strong>Results: </strong>Combined suspected scoliosis and sagittal spinal deviations were found in 21.2 percent of participants, with flattened thoracic curvature being the most frequent sagittal abnormality. Logistic regression revealed greater body height (AOR = 1.06, 95% CI: 1.02-1.11), lower KAP scores (AOR = 0.80, 95% CI: 0.72-0.89), while screen time (AOR = 1.22, 95% CI: 1.01-1.49) showed a more limited association with combined spinal deviations. Participants with suspected scoliosis reported more frequent upper back pain and lower self-postural awareness than those without deviations.</p><p><strong>Conclusion: </strong>A noteworthy proportion of early adolescents exhibited combined spinal deformities associated with biological and psychosocial-behavioral factors. Greater body height and lower KAP scores showed clearer associations with these conditions, whereas screen time demonstrated a tendency toward an association. These findings highlight the importance of incorporating posture assessment and health education into school-based initiatives. Improving early identification and encouraging healthy lifestyle behaviors may contribute to better spinal health and help reduce the risk of long-term musculoskeletal problems during adolescence.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1769144"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836730","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":"A comparative study of eradication rates, adverse events, and compliance between triple therapy and bismuth-containing quadruple therapy in children with Helicobacter pylori infection.","authors":"Yonghao Qian, Xiaozhen Hua","doi":"10.3389/fped.2026.1819833","DOIUrl":"https://doi.org/10.3389/fped.2026.1819833","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the eradication efficacy, symptom improvement, and safety between standard triple therapy and bismuth-containing quadruple therapy for Helicobacter pylori (<i>H. pylori</i>) infection in children.</p><p><strong>Methods: </strong>This retrospective cohort study included 161 pediatric patients who completed either a 14-day triple therapy (proton pump inhibitor, clarithromycin, amoxicillin; <i>n</i> = 78) or a 14-day bismuth-containing quadruple therapy (adding colloidal bismuth subcitrate; <i>n</i> = 83). The primary outcome was the eradication rate assessed by ¹³C-urea breath test 4 weeks post-treatment. Secondary outcomes included changes in abdominal pain, bloating, and nausea scores (measured by a 4-point Likert scale before and after treatment) and the incidence of adverse events.</p><p><strong>Results: </strong>The eradication rate was significantly higher in the bismuth-containing quadruple therapy group (90.36%) compared to the triple therapy group (74.36%) (<i>P</i> = 0.007). Post-treatment symptom scores improved more markedly with bismuth-containing quadruple therapy for abdominal pain (0.68 vs. 0.85, <i>P</i> < 0.001), bloating (0.55 vs. 0.64, <i>P</i> = 0.021), and nausea (0.35 vs. 0.41, <i>P</i> = 0.024). In a subgroup analysis restricted to patients with successful eradication, the bismuth-containing quadruple therapy group still had significantly lower abdominal pain scores (<i>P</i> = 0.002), suggesting a potential independent effect of bismuth on abdominal pain relief. The incidence of adverse events and the medication compliance rate were comparable between the two groups (<i>P</i> > 0.05). Multivariate analysis identified bismuth-containing quadruple therapy as a protective factor against eradication failure (Adjusted OR = 0.351, <i>P</i> = 0.018).</p><p><strong>Conclusion: </strong>Bismuth-containing quadruple therapy is potentially advantageous to standard triple therapy for eradicating <i>H. pylori</i> and alleviating associated symptoms in children, with a similar safety and compliance profile.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1819833"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836901","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":"Epilepsia partialis continua may be a rare electroclinical feature of anti-Hu encephalitis: a pediatric case report.","authors":"Jialei Chen, Xingyou Wang, Jing Zhang, Yanjuan Wang, Wenguang Hu","doi":"10.3389/fped.2026.1775494","DOIUrl":"https://doi.org/10.3389/fped.2026.1775494","url":null,"abstract":"<p><strong>Background: </strong>Paraneoplastic neurologic syndromes with anti-Hu antibodies refer to a spectrum of neurologic disorders. Rare cases of extra-limbic encephalitis presenting with seizures have also been reported. However, these seizures rarely manifest as epilepsia partialis continua (EPC). We report an anti-Hu encephalitis pediatric case with EPC.</p><p><strong>Case description: </strong>A 3-year-and-4-month-old male presented with EPC after neuroblastoma resection for 6 months. Neuronal antibody testing revealed highly positive anti-Hu antibody in both serum and cerebrospinal fluid. Anti-Hu encephalitis with EPC was diagnosed. Initial immunotherapy including intravenous immunoglobulin and methylprednisolone had a transient effect, and the symptom recurred 1 month later. The EPC still existed even with the treatment of prednisone, mycophenolate mofetil, oxcarbazepine, valproic acid, and clonazepam.</p><p><strong>Conclusion: </strong>EPC may be a rare but underrecognized electroclinical feature of anti-Hu encephalitis. It is important to consider anti-Hu encephalitis in patients presenting with new-onset EPC. The heterogeneity in clinical symptoms, EEG and imaging manifestations may indicate the existence of complex and diverse mechanisms. The prognosis of this disease is speculated to be poor. Antiseizure medications and surgery often fail to control the progression of the disease. Immunotherapy may benefit some patients.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1775494"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836968","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":"Status Quo analysis of an exercise therapy care model in pediatric oncology during acute therapy: perspectives from patients, parents, siblings, and staff.","authors":"Lena Böhlke, Thorsten Simon, Barbara Hero, Dana Reinke, Amrei Friedrich, Nora Zoth, Freerk T Baumann","doi":"10.3389/fped.2026.1791439","DOIUrl":"https://doi.org/10.3389/fped.2026.1791439","url":null,"abstract":"<p><strong>Background: </strong>In oncological pediatrics, exercise therapy is still not part of regular medical care in Germany and exercise therapy projects are currently financed by charity organizations. Nevertheless, the scientific evidence for the benefit of exercise therapy in pediatric oncology has led to the implementation of exercise therapy programs at most of the German hospitals. At the Pediatric Oncology Department of the University Hospital of Cologne the exercise therapy program was established in 2021. Between 2023 and 2025 a comprehensive survey was carried out to assess the perception of various groups such as patients, family and staff with offered program.</p><p><strong>Methods: </strong>A monocentric survey was conducted to assess the perception of patients, parents, siblings, and staff members regarding the exercise project using non-validated questionnaires. The questionnaires addressed the exercise project during intensive medical therapy in both the outpatient and inpatient phases. The questionnaires contained both open and closed questions and were evaluated using the following categories: \"Communication/Education\", \"Participation\", \"Satisfaction\", \"Need for Support\", \"Online Exercise Sessions\", and \"Barriers and Motives\".</p><p><strong>Results: </strong>The survey was completed by 33 patients, 63 parents, 14 siblings and 48 staff members. The evaluation of the survey showed that more than 50% of the patients and parents surveyed were satisfied with the existing program. Parents and staff have particularly noted the lack of exercise therapy programs for patients during their outpatient phases.</p><p><strong>Discussion: </strong>Despite the generally positive evaluation, patients, parents, siblings and staff still see potential for further development of the exercise therapy program, especially for the outpatient phases.</p><p><strong>Conclusion: </strong>Although the physical activity program is highly regarded, its potential is limited by gaps in outpatient care and inadequate sibling integration. To improve exercise therapy further, a holistic, family-centered approach must expand beyond the inpatient setting. Overcoming skepticism toward telehealth is crucial to ensuring accessible, sustainable exercise therapy outside the hospital.<b>Clinical Trial Registration:</b> https://drks.de/search/de/trial/DRKS00034629/details, identifier (DRKS00034629).</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1791439"},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837057","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":"Omalizumab demonstrates efficacy and safety in Chinese children under 12 with chronic urticaria: a case series.","authors":"Hui Zhao, Lei Luo, Wan-Ming Jia","doi":"10.3389/fped.2026.1815987","DOIUrl":"https://doi.org/10.3389/fped.2026.1815987","url":null,"abstract":"<p><strong>Background: </strong>Omalizumab, an anti-IgE antibody, is recommended as a second-line therapy for chronic spontaneous urticaria in patients aged ≥12 years; however, real-world evidence for its use in younger Chinese children remains limited. Therefore, this study aimed to evaluate its clinical efficacy, safety, and associated characteristics of omalizumab in this underserved pediatric population under 12 years of age.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 13 Chinese children (aged <12 years) with refractory chronic urticaria treated with omalizumab. Effectiveness was assessed by the Urticaria Activity Score over 7 days (UAS7), and safety was evaluated by monitoring adverse events.</p><p><strong>Results: </strong>Of the 13 pediatric patients (median age 5.8 years; 46.2% male), all demonstrated rapid clinical improvement within one week after the initial omalizumab dose. Oral antihistamines were successfully discontinued in all patients within four weeks, accompanied by a significant reduction in the median UAS7 score from 20.0 at baseline to 4.0 (<i>p</i> = 0.001). All 74 administered doses were well tolerated, with no adverse events reported; notably, nearly half of the cohort had comorbid allergic conditions.</p><p><strong>Conclusion: </strong>The rapid symptom control and excellent safety profile observed support omalizumab as an effective and well-tolerated therapeutic option for children under 12 with chronic urticaria.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1815987"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836969","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":"Zinc-L-Carnosine (Polaprezinc) in managing infant regurgitation: a two-center randomized controlled trial.","authors":"Marisa Piccirillo, Maurizio Mennini, Enrico Felici, Angela Mauro, Luca Bernardo, Maria Elisabetta Baldassarre, Erika Renzi, Corrado De Vito, Silvia Furio, Marco Graziani, Giovanna Quatrale, Alessandro Ferretti, Giovanni Di Nardo","doi":"10.3389/fped.2026.1754324","DOIUrl":"https://doi.org/10.3389/fped.2026.1754324","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux (GER) is a common physiological phenomenon in infants, typically self-limited, but often a source of parental concern. When non-pharmacological measures fail to improve symptoms, thickened formulas are commonly used. Zinc-L-carnosine (Polaprezinc) is a mucosal protectant with anti-inflammatory and antioxidant properties. It is widely used in gastrointestinal disorders in adults but has not yet been extensively studied in infants. We aim to evaluate the clinical effectiveness and cost impact of a Zinc-L-carnosine-based supplement (Hepilor liquido®) compared to thickened formula in infants with persistent regurgitation.</p><p><strong>Methods: </strong>This was a two-center, prospective, single-blind, randomized, non-inferiority study conducted in two Italian pediatric hospitals. Infants aged 4 weeks to 7 months with persistent regurgitation despite appropriate nutritional and behavioral management were randomized to receive either Hepilor liquido® or thickened formula for 8 weeks. The primary outcome was symptom improvement based on the I-GERQ-R (Infant Gastro-Esophageal Reflux Questionnaire-Revised) score. Secondary outcomes included a reduction in regurgitation frequency and treatment cost analysis.</p><p><strong>Results: </strong>Sixty infants aged 4 weeks to 7 months were randomized to receive either Hepilor liquido® (<i>n</i> = 30, 50%) or thickened formula (<i>n</i> = 30, 50%) for 8 weeks. Both groups showed significant improvement in I-GERQ-R scores at 8 weeks. Although no statistically significant difference was observed in overall symptomatic remission, the Hepilor liquido® group demonstrated a greater reduction in regurgitation frequency. Notably, the average treatment cost was significantly lower in the Hepilor® group compared to the thickened formula. No severe adverse events were recorded in both groups.</p><p><strong>Conclusions: </strong>Zinc-L-carnosine is a safe and effective alternative to thickened formula in treating persistent infant regurgitation, after the failure of non-pharmacological measures. Its lower cost and promising clinical effect support further investigation in larger pediatric cohorts.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT06678997, identifier: NCT06678997.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1754324"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837085","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":"Systemic-to-pulmonary artery shunt: a surgical strategy with no expiration date.","authors":"Luis Emmanuel Ruiz Pérez","doi":"10.3389/fped.2026.1767112","DOIUrl":"https://doi.org/10.3389/fped.2026.1767112","url":null,"abstract":"<p><strong>Background: </strong>Systemic-to-pulmonary shunts remain a fundamental surgical option in the palliative management of complex congenital heart defects, particularly in patients with univentricular physiology. Although technically demanding, the procedure has evolved through multiple modifications aimed at simplifying its execution and reducing complications, while maintaining its essential clinical role.</p><p><strong>Objective: </strong>To provide a narrative review of the Blalock-Taussig-Thomas shunt, examining its physiological basis, surgical technique, associated risks and complications, postoperative management, and historical evolution, with the goal of evaluating its continued relevance in the palliative treatment of complex congenital heart defects.</p><p><strong>Methods: </strong>A literature search was conducted in Elsevier, PubMed, and Scopus using the keyword \"systemic-to-pulmonary shunt.\" Studies addressing historical development, technical evolution, clinical indications, and postoperative outcomes were included. The review focused on pediatric populations, specifically prenatal, neonatal, and school-age patients. Studies involving adolescents were excluded to maintain consistency with early developmental stages and the typical clinical context in which these shunts are used.</p><p><strong>Results & conclusion: </strong>The systemic-to-pulmonary shunt remains a valuable and widely used palliative technique for patients with complex congenital heart defects and univentricular physiology. While the original Blalock-Taussig-Thomas technique has historically shown favorable outcomes, differences in complication rates among its variants are influenced by patient selection and institutional experience. Emerging alternatives, such as ductal stenting, may reduce the frequency of surgical shunt placement in selected patients; however, they do not currently replace the systemic-to-pulmonary shunt as a comprehensive or universally applicable strategy.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1767112"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837135","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":"Clinical characteristics of anaphylaxis and risk factors for severe reactions in children: a single-center experience.","authors":"Wenyu Wang, Yueyun Shang, Hui Zhang, Shuang Ba, Tongqiang Zhang","doi":"10.3389/fped.2026.1769228","DOIUrl":"https://doi.org/10.3389/fped.2026.1769228","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the clinical characteristics, severity, and risk factors for severe outcomes of anaphylactic reactions in pediatric patients.</p><p><strong>Methods: </strong>This study examined 107 pediatric anaphylaxis cases from September 2020 to July 2025. A retrospective analysis was performed on demographic data, clinical features, laboratory results, and allergen triggers. Patients were categorized by reaction severity for comparative analysis. Multivariate logistic regression was used to identify risk factors for severe anaphylaxis.</p><p><strong>Results: </strong>Among the 107 children included in this study, male 64 cases (59.81%) and female 43 cases(40.18%), ages ranged from 1 month to 15 years. Food was the most common trigger (62.61%, 67/107). In children under 1 year, egg allergy was most prevalent (37.50%, 6/16), while in those over 6 years, fruit allergy predominated (37.50%, 15/40). Antibiotic allergy was the most common drug-related trigger across all age groups (44.44%, 13/26). Severe anaphylaxis was more prevalent in children over 6 years old (36/47 <i>vs.</i> 34/60, <i>p</i> = 0.031), males (34/47 <i>vs.</i> 30/60, <i>p</i> = 0.019), and those with drug allergies (16/47 <i>vs.</i> 10/60, <i>p</i> = 0.037). Multivariate logistic regression identified male sex, age over 6, drug allergies, and short onset time as significant risk factors for severe anaphylaxis.</p><p><strong>Conclusions: </strong>Food is the primary trigger for anaphylaxis in children, with allergen types and severity varying by age. Male children, those over 6 years old, children with drug allergies, and those with rapid-onset reactions are at higher risk for severe anaphylaxis and require focused clinical attention.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1769228"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836972","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":"Case Report: Right phrenic nerve palsy following esophageal atresia repair: a report of two cases and literature review of management strategies.","authors":"Wenyue Liu, Bingliang Li, Xiaoxia Wu, Baohong Zhao, Yuanyuan Jin, Liang Zhao, Hongxia Ren","doi":"10.3389/fped.2026.1733741","DOIUrl":"https://doi.org/10.3389/fped.2026.1733741","url":null,"abstract":"<p><strong>Background: </strong>Phrenic nerve palsy (PNP) following esophageal atresia (EA) repair is an extremely rare complication with limited global experience. This report of two cases, integrated with a literature review, aims to synthesize available evidence to propose a structured management strategy.</p><p><strong>Case presentation: </strong>We describe two neonates who developed right PNP after type III EA repair. Case 1 was diagnosed with right phrenic nerve palsy on postoperative day (POD) 7 via chest x-ray and ultrasound and achieved full recovery after five weeks of non-invasive respiratory support. Case 2 was diagnosed on POD 14; after six weeks of failed conservative management, the infant underwent successful diaphragmatic plication. Both infants had favorable outcomes at follow-up.</p><p><strong>Conclusion: </strong>Based on the present cases and a review of all documented literature, we recommend a stepwise approach for managing post-EA repair PNP: Preventively, intraoperative phrenic nerve monitoring should be considered during EA/TEF repair to reduce the risk of iatrogenic injury. For diagnosed cases, we suggest early diagnosis using bedside x-ray and ultrasound, followed by an initial trial of 4-6 weeks of non-invasive support, with diaphragmatic plication reserved for weaning failure.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1733741"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836990","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":"Case Report: A rare coexistence in children: constrictive pericarditis, atrial septal defect, and cardiac diverticulum.","authors":"Xuan Liu, Qiuying Liu, He Ren, Mei Liu","doi":"10.3389/fped.2026.1779452","DOIUrl":"https://doi.org/10.3389/fped.2026.1779452","url":null,"abstract":"<p><p>This report describes a rare case of a girl with constrictive pericarditis (CP), coexisting with atrial septal defect (ASD) and cardiac diverticulum. Her echocardiographic features changed in accordance with the hemodynamic alterations as treatment progressed. During a routine echocardiography before surgery, a 9-year-old girl with ASD was unexpectedly diagnosed with CP. This explains why her symptoms and signs were inconsistent with isolated ASD, including lower limb edema and hypoalbuminemia caused by impaired diastolic ventricular function. Contrast-enhanced computed tomography confirmed the diagnosis of CP and identified a right ventricular diverticulum. To minimize surgical trauma, a step-by-step surgical approach was adopted. Complete pericardiectomy without cardiopulmonary bypass was first performed to alleviate the pathophysiological abnormalities of CP, followed by percutaneous ASD closure to reduce the excessive right heart volume overload. The diverticulum was not treated because of its small size. The patient had an uneventful postoperative recovery.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"14 ","pages":"1779452"},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836911","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}