Frontiers in Pediatrics最新文献

{"title":"Retrospective validation of the postnatal growth and retinopathy of prematurity criteria in a Chinese cohort.","authors":"Li Li, Yanlin Gao, Yuhan Lu, Wei Chen, Mei Han","doi":"10.3389/fped.2025.1509106","DOIUrl":"10.3389/fped.2025.1509106","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness and applicability of the postnatal growth and retinopathy of prematurity (G-ROP) screening criteria in a Chinese neonatal cohort.</p><p><strong>Methods: </strong>Data pertaining to the retinal screening of premature infants admitted to the neonatal intensive care unit from January 2021 through December 2021 were retrospectively analyzed. The severity of ROP was graded on the basis of the International Classification of Retinopathy of Prematurity criteria established in 2005. Treatment decisions for ROP were guided by the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. The presence of six key variables that comprise the G-ROP screening criteria were carefully documented. The sensitivity and specificity of the G-ROP predictive algorithm in identifying infants with ROP requiring treatment were calculated.</p><p><strong>Results: </strong>A total of 352 infants with complete records were included in this study, among whom 120 infants (34.1%) were diagnosed with ROP. Of those, 21 infants (6.0%) received treatment. By applying the 6 criteria of the G-ROP model, all infants with severe ROP were successfully identified. The sensitivity of the G-ROP model in predicting treatment-requiring ROP was 100% (CI, 0.808-1.00), and the specificity was 47.8% (CI, 0.413-0.545). By applying the G-ROP criteria, the number of infants who required ROP screening would have been reduced by 122 (34.7%), while the number of screenings (1967) would have been reduced by 537 (27.3%).</p><p><strong>Conclusion: </strong>The prevalence of ROP (34.1%) and treatment-requiring ROP (6.0%) were relatively high in our cohort. Application of the G-ROP prediction model can improve the sensitivity and specificity of ROP screening. All infants with treatment-requiring ROP were correctly identified. The G-ROP screening criteria seemed to be effective and appropriate for predicting ROP in infants living in Tianjin, China.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1509106"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325217","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 case report of delayed persistent third-degree atrioventricular block 7 years after eccentric umbrella occlusion of a perimembranous ventricular septal defect in infancy.","authors":"Lihui Wei, Decai Zeng, Liuliu Huang, Xiangjie Luo, Ji Wu","doi":"10.3389/fped.2025.1591928","DOIUrl":"10.3389/fped.2025.1591928","url":null,"abstract":"<p><p>This article reports an 8-year-old female patient who underwent trans-thoracic small-incision interventional Pm-VSD occlusion with an eccentric umbrella (defect diameter 10 mm, occluder waist diameter 12 mm) at 4 months of age (July 2017). Seven years after the operation (October 2024), she gradually developed third-degree atrioventricular block. Despite the removal of the occluder and ventricular septal defect repair combined with steroid pulse therapy, the conduction abnormality persisted. This case, with a 7 - year disease course evolution, provides in - depth insights into the development process of delayed complete atrioventricular block (CAVB) following eccentric umbrella occlusion in infancy and early childhood, particularly for high - risk patients with occlusion adjacent to the conduction system. It also suggests the significance of electrocardiogram monitoring for over 5 years post - operation in such high - risk patients.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1591928"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325202","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":"Global, regional and national trends in the burden of persistent pulmonary hypertension of the newborn and essentials of its management from 1993 to 2023: a scoping review.","authors":"Yan Huang, Ting Yang, Xiaoqin Liang, You Chen, Ping Zhou, Zhangbin Yu, Guichao Zhong, Lian Zhang","doi":"10.3389/fped.2025.1502385","DOIUrl":"10.3389/fped.2025.1502385","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Persistent pulmonary hypertension of the newborn (PPHN) is a frequent neonatal emergency in the neonatal intensive care unit (&lt;i&gt;N&lt;/i&gt;ICU), representing a challenging condition that has not been extensively studied. PPHNremains associated with a high mortality and morbidity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review was undertaken to provide a global overview of several key aspects: (1) the prevalence/incidence and etiologies of PPHN, (2) the mortality rate linked to PPHN during hospitalization and the primary causes of such mortality, (3) the risk factors related to PPHN, and (4) the approaches to managing PPHN. The aim of this scoping review was not to assess the methodological soundness of the identified studies, but instead to deliver a broad, comprehensive perspective on PPHN, identify gaps within the current literature, and outline potential avenues for future research. The results are anticipated to assist in developing public health strategies aimed at reducing the morbidity and mortality tied to PPHN globally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a digital search in MEDLINE and the Cochrane Library, from January 1, 1993 to December 31, 2023.We incorporated observational studies, interventional studies, and reviews that provided adequate data on the incidence/prevalence, mortality rates, predictors, etiological factors, diagnosis, and management of PPHN among the general neonatal population (age 0-28 days old). This procedure followed the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extensions for Scoping Reviews (PRISMA-ScR). Additionally, we utilized the methodological framework for scoping reviews as outlined by Arksey and O'Malley, which consists of formulating the research question, conducting a search for pertinent studies, selecting the studies, organizing the data, and compiling, summarizing and reporting the findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 128 research articles were collected from 27 countries categorized as either high-income or low- and middle-income countries (LMICs). The prevalence of PPHN ranges from 0.1%-8.1% in the different study populations. The highest global prevalence rates are observed in Europe and Asia, while lower prevalence rates are reported in the Americas and Africa. Neonatal infections are the leading cause of PPHN in Asia and the Americas, whereas meconium aspiration syndrome predominates in Europe. Several independent risk factors for PPHN include premature birth, male sex, ethnicity, extremes of birth weight, advanced maternal age, maternal obesity, multiple births, maternal smoking, pregestational/gestational diabetes mellitus, infectious history, caesarean delivery, antenatal drug exposure, fetal distress, APGAR score and meconium-stained amniotic fluid. The PPHN-related in-hospital mortality rate associated with PPHN ranges from 3.0%-57.9%, with the highest rates reported in Asia and the ","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1502385"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325213","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":"Functional echocardiography identifies association between early ventricular dysfunction and outcome in pediatric sepsis.","authors":"Sonia Reveco, Stella Barbagelata, Pablo Cruces, Franco Diaz, Karla Yohanessen, Marcos Larraín, Mario Guerra, Alexander Bataszew","doi":"10.3389/fped.2025.1570519","DOIUrl":"10.3389/fped.2025.1570519","url":null,"abstract":"<p><strong>Objective: </strong>This feasibility study aimed to describe the relation between ventricular dysfunction and outcome in pediatric sepsis.</p><p><strong>Methods: </strong>This prospective observational multicenter study was conducted in two Pediatric Intensive Care Units (PICU). We enrolled 51 patients aged younger than 15 year-old diagnosed with sepsis or septic shock. Functional echocardiography was performed by a pediatric intensivist within the first 24 h of admission and blind validated by a pediatric cardiologist. Ventricular dysfunction was defined by the presence of left or right systolic and/or diastolic dysfunction. The absence of these findings was considered normal ventricular function. Outcome was assessed by septic shock diagnosis rate, pediatric adaptation of Sequential Organ Failure Assessment (pSOFA), cardiovascular component of pSOFA, PICU-free and ventilator-free days.</p><p><strong>Results: </strong>29 patients had sepsis, and 22 had septic shock. The main sites of infection were pulmonary (58.8%) and abdominal (17.6%). One out of four had ventricular dysfunction, and this group presented higher frequency of septic shock (69.2% vs. 34.2%, <i>p</i> = 0.028), higher frequency of total pSOFA ≥3 at 24 h (92% vs. 64%, <i>p</i> = 0.04), cardiovascular component of pSOFA (69.2% vs. 31.2%, <i>p</i> = 0.017), and fewer PICU-free days [18 [0-23] vs. 23 [18-25], <i>p</i> = 0.027], compared to normal ventricular function group. Additionally, there were more abnormal tissue doppler measurements, lower ś wave Z-Score [-0.6 [-1.3;0.4] vs. 0.5 [-0.2;1.1], <i>p</i> = 0.01] and lower é wave Z-Score [1.5 [-2;0,1] vs. -0.3 [-2;0.4], <i>p</i> = 0.03] in the ventricular dysfunction group.</p><p><strong>Conclusion: </strong>Ventricular dysfunction was associated with more sepsis severity at 24 hours, fewer PICU-free days. Tissue doppler parameters were related to ventricular dysfunction.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1570519"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316683","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":"Optimized pediatric emergency nursing and Its effects on successful resuscitation and adverse reactions in children.","authors":"Xia Zhang, Xiao Chen","doi":"10.3389/fped.2025.1578177","DOIUrl":"10.3389/fped.2025.1578177","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate impacts of optimized pediatric emergency care on successful resuscitation and adverse events of children in the emergency department.</p><p><strong>Methods: </strong>Pediatric patients who visited our hospital's emergency room between January 2022 and December 2023 were chosen as the study participants. These patients were randomly divided into the study group (using optimized emergency care model) and the control group (using conventional emergency care model). The two groups were compared for the rate of successful resuscitation, stabilization time of vital signs, average length of hospital stay, incidence of adverse reactions, parental satisfaction with nursing care, scores of Self-Assessment Scale of Anxiety (SAS) and Self-Assessment Scale of Depression (SDS) before and after nursing care, and assessment of life quality.</p><p><strong>Results: </strong>A total of 140 children were included in this study. Seventy patients each were assigned to study and control groups. After the intervention, the study group's successful resuscitation rate was considerably greater than the control's (<i>P</i> < 0.05). For the study group, the optimized care intervention significantly reduced the stabilization time of vital signs and the typical duration of hospitalization compared with the control group (<i>P</i> < 0.001). Compared to the control group, the study group had a lower incidence of adverse reactions (<i>P</i> < 0.05), a higher level of parental satisfaction (<i>P</i> < 0.05), significant reduction of the SAS and SDS scores (<i>P</i> < 0.001), and significant elevation of the quality of life scores (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The study demonstrates that the optimized pediatric emergency care intervention is an effective approach for improving the successful resuscitation of children in emergency medicine, and mitigate the incidence of adverse reactions. Concurrently, the optimized nursing intervention was found beneficial for anxiety and depression levels, with a notable improvement in their quality of life as well as parental satisfaction. Optimized nursing interventions therefore are valuable and are recommended for wider pediatric emergency care practice.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1578177"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316694","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":"Value of adding 0.01% atropine with orthokeratology for myopia in children: an updated meta-analysis of randomized controlled trials.","authors":"Shudan Tu, Huangfang Ying, Liyang Ni, Zilong Zhang, Weiping Hu","doi":"10.3389/fped.2025.1571790","DOIUrl":"10.3389/fped.2025.1571790","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to compare outcomes of 0.01% atropine with orthokeratology (AOK) vs. orthokeratology (OK) alone for slowing the progression of myopia in children.</p><p><strong>Methods: </strong>MEDLINE via PubMed, Embase, Scopus, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Chinese electronic databases of VIP, and Wanfang were searched from inception until 19th August 2024 for randomized controlled trials (RCTs) about the review topic. The primary outcome was a change in axial length (AL) (mm). Secondary outcomes were spherical equivalent refraction (SER) (Diopter), pupil diameter (PD) (mm), amplitude of accommodation (AA) (Diopter), and intraocular pressure (IOP) (mmHg).</p><p><strong>Results: </strong>10 articles corresponding to eight RCTs were included. Meta-analysis found that change in AL was significantly reduced with AOK as compared to OK alone at 6 months (MD: -0.10 95% CI: -0.14, -0.06 I² = 48%), 12 months (MD: -0.08 95% CI: -0.10, -0.07 I² = 0%) and 24 months (MD: -0.14 95% CI: -0.19, -0.08 I² = 0%). Pooled analysis found that AOK did not reduce the progression of SER (MD: 0.06 95% CI: -0.00, 0.12 I² = 7%) and increased PD (MD: 0.63 95% CI: 0.40, 0.85 I² = 86%) as compared to OK alone. Pooled analysis also found a tendency of reduced AA with AOK as compared to OK alone but without significant results (MD: -0.45 95% CI: -1.00, 0.10 I² = 59%). Meta-analysis failed to show a statistically significant difference in change of IOP between AOK and OK (MD: -0.49 95% CI: -1.48, 0.50 I² = 51%).</p><p><strong>Conclusions: </strong>AOK seems to be more efficacious in slowing the progression of myopia in children as compared to OK alone.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1571790"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316695","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 bibliometric analysis of research trends in mesenchymal stem cell therapy for neonatal bronchopulmonary dysplasia: 2004-2024.","authors":"Lu Bai, Yue Xin","doi":"10.3389/fped.2025.1558301","DOIUrl":"10.3389/fped.2025.1558301","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Bronchopulmonary dysplasia (BPD) is a chronic lung disease predominantly affecting preterm infants, often requiring mechanical ventilation and supplemental oxygen. The pathogenesis of BPD involves a combination of genetic susceptibility and environmental insults, such as oxidative stress and mechanical ventilation. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic option for BPD due to their immunomodulatory, anti-inflammatory, and regenerative properties. This study aims to perform a bibliometric analysis of the publication landscape surrounding MSC therapy for BPD to identify research trends, collaborative networks, influential research clusters, and emerging research frontiers from 2004 to 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A bibliometric analysis was conducted using the Web of Science Core Collection (WoSCC) as the primary database due to its comprehensive citation indexing and standardized metadata. To ensure data integrity, we included publications from January 2004 (when the first relevant MSC studies for BPD began appearing) to November 2024. The search query combined terms related to BPD and MSCs, focusing on English-language articles and reviews. After retrieval, data were cleaned through duplicate removal and relevance verification processes. Quantitative analysis was performed on publication counts, authors, journals, institutions, and countries. Visual analysis tools, VOSviewer ( 1) and CiteSpace ( 2), were employed to map collaboration networks and identify research clusters through co-citation and co-occurrence analyses. Statistical validation of bibliometric distributions was conducted using Bradford's law and Price's law. Citation metrics were normalized by publication year to account for citation accumulation bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 353 publications were analyzed, including 216 articles and 137 reviews, from 555 institutions across 35 countries. Time-series analysis revealed a significant acceleration in publication output after 2015 (&lt;i&gt;p&lt;/i&gt; &lt; 0.01), with a compound annual growth rate of 18.2%. The United States was the leading contributor (131 publications, 37.1%), followed by China (72 publications, 20.4%) and Canada (54 publications, 15.3%). Network analysis identified five distinct collaborative clusters, with limited cross-cluster collaboration. Citation analysis, normalized for publication age, revealed that the American Journal of Respiratory and Critical Care Medicine had the highest field-weighted citation impact (3.8). Keyword co-occurrence analysis demonstrated a significant shift from whole-cell therapies to extracellular vesicle research after 2018, with \"microvesicles\" and \"exosomes\" emerging as high-intensity burst terms (burst strength &gt;5.0). The co-citation analysis identified three primary research clusters: stem cell therapy mechanisms (42.3% of citations), respiratory physiology and pathology (38.1%), and clinical neonatology ","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1558301"},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316681","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":"Buried penis; what buried the penis?","authors":"Mohamed Fawzy, Ahmed T Hadidi","doi":"10.3389/fped.2025.1590147","DOIUrl":"10.3389/fped.2025.1590147","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the histological and immuno-histochemical features of dartos fascia in buried penis (BP) as compared to dartos fascia in hypospadias and normal children.</p><p><strong>Materials and methods: </strong>The study included 40 children, operated on in our center between January 2023 and January 2024. Patients were divided into 3 groups; <b>group A</b>: 13 patients with BP, <b>group B</b>: 14 patients with different grades of distal Hypospadias, and <b>group C</b> with 13 patients who were referred for circumcision (control group). All dartos fascia specimens were blindly examined by the same pathologist. The 3 groups were assessed for histological findings including collagen, elastin, nerve fibers, tactile bodies, fat, smooth muscles.</p><p><strong>Results: </strong>In group A (BP), there was statistically significant dominance of thick collagen fibers (thick fibers) <i>p</i> < 0.001, thick smooth muscle fibers (<i>P</i> < 0.001), thick convoluted nerve fibers (<i>p</i> = 0.004) and less fat (<i>P</i> < 0.001) as compared to the hypospadias and control groups. In the hypospadias group, intermediate collagen fibers were the predominant type of fibers (<i>p</i> < 0.001), in addition to long, thin and short thin elastin fibers (<i>p</i> < 0.001) compared to the buried penis and the control groups. The hypospadias group also had significant predominance of chaotic disorganized nonparallel smooth muscle fibers <i>p</i> = 0.003.</p><p><strong>Conclusion: </strong>The fascia in BP is characterized by abnormally thick collagen fibers, thick smooth muscle fibers and thick convoluted nerve fibers. This may explain why the penis is drawn inwards in BP and suggests that it is probably recommended to excise this abnormal fascia during the surgical correction.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1590147"},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316682","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":"\"<i>They fell through the cracks:</i>\" caregiver perspectives on the difficulties of COVID-19 implementation transitions for children and youth with special healthcare needs (CYSHCN).","authors":"D Grace Smith, Mary Kathryn Cancilliere, Tara M Hayes, Anashua Rani Elwy, Indra Neil Sarkar","doi":"10.3389/fped.2025.1440680","DOIUrl":"10.3389/fped.2025.1440680","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 virus and its relevant prevention protocol had significant impacts on children and youth with special healthcare needs (CYSHCN), including those with physical, intellectual, and developmental disabilities. Previous studies have examined the first year of the pandemic, identifying the implications of social distancing, remote services/education, and masking and testing protocol on the mental, physical, and developmental well-being of this population.</p><p><strong>Objectives: </strong>We focus on moments of transition, when vaccines were disseminated and mandates/resources removed. By identifying how protocol and interventions in these moments included, neglected, or negatively impacted CYSHCN, we can inform more inclusive, safe, and equitable decision-making in future health crises.</p><p><strong>Methods: </strong>We report the transition-moment-related reflections of fourteen focus groups conducted among caregivers (including parents) of CYSHCN between March and December of 2022 (<i>n</i> = 77). Focus groups were conducted in close partnership with a local non-profit organization, and facilitation protocol were co-developed by community leaders in the CYSHCN area. Focus groups were recorded, transcribed, and analyzed using directed content analysis and thematic analysis, guided by implementation science theories on interventions' relative dis/advantages and perceived adaptability.</p><p><strong>Results: </strong>Caregivers provided transition-moment reflections of how the timing, support, and in/flexibility of pandemic intervention implementation and de-implementation negatively impacted their CYSHCN. We generated three themes to describe these views: (1) \"<i>Our kiddos didn't have a plan when this happened</i>:\" Lack of transition support into isolation meant loss of necessary structures and services; (2) \"<i>He couldn't comprehend</i>:\" Transition communication, particularly surrounding mandates and protocol, was not handled well for CYSHCN; and (3) \"<i>Listen, we're still in the middle of pandemic</i>:\" Transition timing neglected consideration of CYSHCN.</p><p><strong>Discussion: </strong>CYSHCN needs were neglected in the pandemic's transition moments, creating significant implications for their mental/emotional, physical, and cognitive/developmental well-being. Reflecting these findings, and particularly facets that extend established literature, we urge inclusive research and policy models, empowering members of the CYSHCN community as leaders in knowledge and protocol production, particularly when considering the adaptability and relative advantage of interventions. Such models are crucial in developing messaging around pandemic policies, creating infrastructural support for flexibility, and adding supports and delays when de-implementing mandates.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1440680"},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316680","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":"Implementation of a routine respiratory follow-up after prematurity less than 32 weeks gestation or below 1,500 g birthweight at preschool age-a two-year experience.","authors":"Michaela Höck, Anna Zschocke, Ulrike Pupp-Peglow, Carolin Marcher, Barbara Brunner, Maria Schütz, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.3389/fped.2025.1604037","DOIUrl":"10.3389/fped.2025.1604037","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence indicates that prematurity adversely affects lung function, even in early childhood, thus, a routine respiratory follow-up was implemented in our clinical setting. The aim of this study was to evaluate the acceptance of this examination and assess the feasibility of forced expiratory maneuvers and bronchodilator responsiveness test (BRT) in former preterm infants at preschool age and to present initial results.</p><p><strong>Methods: </strong>In November 2022, a respiratory follow-up was implemented for former preterm infants born at less than 32 weeks of gestation or with a birth weight below 1,500 g, who were born between 2016 and 2019 at Innsbruck Medical University Hospital. The evaluation included a standardized clinical examination, collection of medical history, spirometry, and a BRT.</p><p><strong>Results: </strong>A total of 107 former preterm infants (median gestational age 29.9 (28.1; 31.1) weeks and mean birthweight 1,250.5 (±355.6) grams performed spirometry. Successful spirometry was achieved by 93 (86.9%) children. Among these, 64 (59.8%) had normal pulmonary function and were symptom-free, however, ten (15.6%) showed a positive BRT. Twenty-nine children (27.1%) exhibited pathological test results and/or respiratory symptoms, with 13 (44.8%) of them testing positive for bronchial hyper-responsiveness. Fourteen children (13.1%) did not meet the quality control criteria for spirometry but were symptom-free.</p><p><strong>Conclusion: </strong>Our study demonstrated that a respiratory follow-up for preterm infants is highly accepted and feasible at preschool age. Up to 30% of infants were identified with impaired lung function and subsequently received appropriate management, highlighting the importance of standardized and routine respiratory follow-up for these children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1604037"},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316684","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}