Frontiers in Pediatrics最新文献

{"title":"Evaluation of a pediatric post-acute sequelae of SARS-CoV-2 index score.","authors":"Frederick Dun-Dery, Jianling Xie, Kathleen Winston, Brett Burstein, Vikram Sabhaney, Jason Emsley, Jocelyn Gravel, April Kam, Darcy Beer, Roger Zemek, Ahmed Mater, Robert Porter, Gabrielle Freire, Naveen Poonai, Simon Berthelot, Anne Moffatt, Andrew Dixon, Deepti Reddy, Marina Salvadori, Stephen B Freedman","doi":"10.3389/fped.2025.1628826","DOIUrl":"10.3389/fped.2025.1628826","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the performance of the Researching COVID-19 to Enhance Recovery (RECOVER) initiative's proposed post-acute sequelae of COVID-19 (PASC) index in a cohort of children evaluated for SARS-CoV-2 infection, 6-12 months after exposure.</p><p><strong>Study design: </strong>We conducted a multicenter, prospective cohort study with 6- and 12-month follow-up in 14 Canadian tertiary-care pediatric emergency departments (EDs) in the Pediatric Emergency Research Canada network. Eligible children were 6 to <18 years of age who were tested for acute SARS-CoV-2 infection. We assessed the score validity and reliability and evaluated the associations between PASC index scores dichotomized using threshold values (≥5.5 for ages 6 to <12 years and ≥5.0 for ages 12 to <18 years) and SARS-CoV-2 infection.</p><p><strong>Results: </strong>Participants included 785 children, with a median age of 9 years (IQR: 7-13), enrolled between August 2020 and February 2022. Factor analysis identified characteristics that accounted for 32%-40% of variance. Strong correlations were identified between PASC index scores and PedsQL™ and overall health status; Cronbach's <i>α</i> ranged from 0.49 to 0.67. Changes in PASC index scores across time points accounted for 71% (6 to <12 years) and 63% (12 to <18 years) of total variance. The proportion of children exceeding PASC index score thresholds did not differ between children positive and negative for SARS-CoV-2 test in the 6 to <12 (25% vs. 22%; aOR: 1.2; 95% CI: 0.6, 2.5) and 12 to <18 (18% vs. 10%; aOR: 2.2; 95% CI: 0.5, 10.4) age groups at 6 months. Similar results were reported at 12 months.</p><p><strong>Conclusions: </strong>While scores correlated with quality of life and overall health, internal reliability was low to acceptable. The PASC index was not associated with previous SARS-CoV-2 infection.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1628826"},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148698","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":"Retrospective analysis of the analgosedative efficacy and safety of midazolam combined with fentanyl in mechanically ventilated neonates.","authors":"Fangfang Lin, Shuidi Lin, Wenhong Cai, Yanli Ren","doi":"10.3389/fped.2025.1647247","DOIUrl":"10.3389/fped.2025.1647247","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the analgosedative efficacy and safety of the combination of midazolam and fentanyl with those of midazolam monotherapy in mechanically ventilated neonates.</p><p><strong>Materials and methods: </strong>We conducted a single-center retrospective analysis of mechanically ventilated patients in our neonatal intensive care unit from April 1, 2021 to December 1, 2024. After dividing patients into midazolam + fentanyl (M + F) and midazolam (M) groups according to their respective sedation/analgesia regimens, we conducted intergroup comparisons of pain scores, ventilator parameters, and vital signs 5 min pre-treatment and at post-treatment time points (1 h, 3 h, 12 h, 24 h, 48 h). We also compared pre-and post-treatment (3 h, 24 h, 48 h) non-invasive hemodynamic parameters; adverse reactions; and discharge outcomes of the two groups.</p><p><strong>Results: </strong>A total of 210 neonates were included, with 106 in the M + F group and 104 in the M group. N-PASS pain scores obtained 5 min pre-treatment were similar between the two groups (<i>P</i> > 0.05); however, N-PASS scores were significantly lower in the M + F than in the M group at each post-treatment time point (1 h, 3 h, 12 h, 24 h, 48 h) (all <i>P</i> < 0.05). Ventilator parameters (MAP, FIO₂) obtained 5 min pre-treatment were similar (<i>P</i> > 0.05), but were significantly lower at each post-treatment time point (1 h, 3 h, 12 h, 24 h, 48 h) in the M + F group (all <i>P</i> < 0.05). Pre- and post-treatment (1 h, 3 h, 12 h, 24 h, 48 h) vital signs did not differ between the two groups (<i>P</i> > 0.05). Pre-and post-treatment (3 h, 24 h, 48 h) non-invasive hemodynamic parameters were similar between the two groups (<i>P</i> > 0.05). There were no significant intergroup differences in adverse reactions or discharge outcomes (<i>P</i> > 0. 05).</p><p><strong>Conclusion: </strong>The combination of midazolam and fentanyl relieved pain and reduced ventilator parameters more effectively than midazolam monotherapy, without increasing adverse reactions or worsening discharge outcomes among mechanically ventilated neonates.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1647247"},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148663","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":"Predicting nosocomial infections in critically Ill children: a comprehensive systematic review of risk assessment models.","authors":"Ling-Ying Wang, Mei Feng, Yu-Lan Luo, Chun-Xia Wang, Heng Wang, Li Li, Yuan Zhang, Xiu-Ling Huang, Min-Jie Huang, Yong-Ming Tian","doi":"10.3389/fped.2025.1636580","DOIUrl":"10.3389/fped.2025.1636580","url":null,"abstract":"<p><strong>Background: </strong>Nosocomial infections (NIs) pose a substantial global health challenge, affecting an estimated 7%-10% of hospitalized patients worldwide. Neonatal intensive care units (NICUs) are particularly vulnerable, with NIs representing a leading cause of infant morbidity and mortality. Similarly, pediatric intensive care units (PICUs) report that 28% of admitted children acquire NIs during hospitalization. Although prediction models offer a promising approach to identifying high-risk individuals, a systematic evaluation of existing models for ICU-ill children remains lacking.</p><p><strong>Aim: </strong>This review systematically synthesizes and critically evaluates published prediction models for assessing NI risk in ill children in the ICU.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, Embase, Web of Science, CNKI, VIP, and Wanfang from inception through December 31, 2024. Study quality, risk of bias, and applicability were assessed using the PROBAST tool. Model performance metrics were extracted and summarized.</p><p><strong>Results: </strong>Three studies involving 1,632 participants were included. Frequency analysis identified antibiotic use, birth weight, and indwelling catheters as the most consistently incorporated predictors. All models employed traditional logistic regression, with two undergoing external validation. However, critical limitations were observed across studies: inadequate sample sizes, omission of key methodological details, insufficient model specification, and a universally high risk of bias per PROBAST assessment.</p><p><strong>Conclusion: </strong>Current NI prediction models for ill children in the ICU exhibit significant methodological shortcomings, limiting their clinical applicability. No existing model demonstrates sufficient rigor for routine implementation. High-performance predictive models can assist clinical nursing staff in the early identification of high-risk populations for NIs, enabling proactive interventions to reduce infection rates. Future research should prioritize (1) methodological robustness in model development, (2) external validation in diverse settings, and (3) exploration of advanced modeling techniques to optimize predictor selection. We strongly advocate adherence to TRIPOD guidelines to enhance predictive models' transparency, reproducibility, and clinical utility in this vulnerable population.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420251019763.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1636580"},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148676","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":"Benign acute childhood myositis: a retrospective cohort study from a large tertiary care children's hospital.","authors":"Nawaf A Alghamdi, Abdulaziz A Ajeebi, Abdulrahman K Alajlan, Abdullah Y Aldaffaa, Winnie Philip, Tahir K Hameed","doi":"10.3389/fped.2025.1653651","DOIUrl":"10.3389/fped.2025.1653651","url":null,"abstract":"<p><strong>Introduction: </strong>Benign acute childhood myositis (BACM) is a common self-limiting condition. While studies in other regions have described the epidemiology and outcomes of BACM, there is paucity of data in the Middle East Region. This study aims to describe the epidemiology, clinical data, and outcomes of BACM in a large cohort of patients.</p><p><strong>Methods: </strong>This was a retrospective cohort study of children diagnosed with BACM at a tertiary care children's hospital between January 2016 and December 2022. The study included children under 14 years with acute onset of muscle pain with elevated CK levels. Clinical, laboratory and outcome data were extracted from the medical records.</p><p><strong>Results: </strong>A total of 392 children were diagnosed with BACM, with a male predominance (78.6%) and a median age of 6 years. Median CK level at presentation was 1,750 U/L and an Influenza virus was found in 92.8% of those who had a virus detected. Rhabdomyolysis was diagnosed in 4 (1%) patients and no cases of renal failure were reported. CK levels >5,000 U/L on presentation increased the risk for hospitalization while ibuprofen use in the ED decreased the risk of hospitalization. CK levels normalized at a median time of 7 days and recurrences with new episodes of BACM occurred in almost 10% of children.</p><p><strong>Conclusions: </strong>Our study confirms that BACM is a benign condition with a very low rate of complications. Further studies are needed to evaluate factors associated with hospitalization and when to screen for genetic/metabolic causes of elevated CK levels.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1653651"},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137358","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: Drug review: mTOR-inhibitor therapy in fetal cardiac rhabdomyoma-a tightrope walk.","authors":"Nadine Muschel, Michaela Höck, Elke Griesmaier, Samira Abdel Azim, Elisabeth Ralser, Christina Schreiner, Elisabeth Schermer, Ursula Kiechl-Kohlendorfer, Irene Mutz-Dehbalaie, Miriam Michel","doi":"10.3389/fped.2025.1694368","DOIUrl":"https://doi.org/10.3389/fped.2025.1694368","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fped.2025.1649341.].</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1694368"},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137308","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":"EMX2OS serves as a biomarker of neonatal sepsis and participates acute lung injury through enhancing ferroptosis.","authors":"Xuexiang Li, Zhiqiang Liu, Guilian Shan, Lili Shi, Zhihua Liu","doi":"10.3389/fped.2025.1654832","DOIUrl":"10.3389/fped.2025.1654832","url":null,"abstract":"<p><strong>Background: </strong>Neonatal Sepsis (NS) is an important cause of neonatal death, often accompanied by acute lung injury (ALI). Ferroptosis plays a role in infectious diseases, but its regulatory mechanism in NS-related ALI remains unclear. The aim of this study is to investigate the mechanism of EMX2OS in promoting ferroptosis in ALI.</p><p><strong>Methods: </strong>The expression level of EMX2OS in peripheral blood of patients with NS and its diagnostic value were detected by clinical samples. LPS-induced A549 cells were used to establish an ALI model. The targeting relationship between EMX2OS, miR-654-3p and AKT3 was verified by qRT-PCR, CCK-8, detection kit and dual-luciferase assays, and the cell viability and ferroptosis level were evaluated.</p><p><strong>Results: </strong>EMX2OS was highly expressed in NS and served as a potential diagnostic marker. In LPS-induced lung injury model, high expression of EMX2OS decreased cell viability and enhanced ferroptosis. Silencing EMX2OS had the opposite effects. EMX2OS regulated cell viability and ferroptosis through miR-654-3p/AKT3 axis.</p><p><strong>Conclusions: </strong>This study reveals for the first time that EMX2OS serves as a diagnostic marker for NS and promotes ferroptosis through miR-654-3p/AKT3 axis, thereby exacerbating lung injury. EMX2OS to regulate ferroptosis may become potential therapeutic strategies for lung injury.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1654832"},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137347","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":"Ease pediatric emergency department crowding in Switzerland with high-quality telephone triage: a prospective multicenter study.","authors":"Krisztina Schmitz-Grosz, Carsten Sommer-Meyer, Stéphanie van der Lely, Siro Fritzmann, Georg Staubli, Eva Berger-Olah","doi":"10.3389/fped.2025.1634841","DOIUrl":"10.3389/fped.2025.1634841","url":null,"abstract":"<p><strong>Introduction: </strong>This is the first study evaluating the picture of a pediatric telephone triage service's (PTTS) quality from the hospital, telemedical, and patient perspective, to provide a deeper understanding of its contribution to the relief of pediatric emergency burden.</p><p><strong>Methods: </strong>We conducted a prospective multicenter study from April 3 to May 15, 2023. All calls to the Medgate Kids Line of six hospitals providing pediatric emergency care in German-speaking Switzerland were included. Following telemedical counselling, patients were advised to visit a pediatric emergency department (PED) or a primary care provider (PCP) or were treated telemedically by the Kids Line team. Patients presenting to participating PEDs after calling were evaluated by a hospital triage specialist (HTS) to define telemedical triage's appropriateness [appropriate triage, undertriage (safety), overtriage (efficiency); hospital perspective]. Only PED presentations evaluated as undertriage or overtriage were peer-reviewed (telemedical perspective), while appropriate triages were adopted. Additionally, patients' intention, adherence and satisfaction were assessed.</p><p><strong>Results: </strong>We included 4,061 calls. 24.9% cases were advised to go to a PED, 20.7% to a PCP, and 54.3% were allocated to telemedicine. HTSs evaluated 556 cases. The PTTS appropriately triaged 78.2% of cases according to the hospital perspective (undertriage: 8.1%; overtriage: 13.7%). After telemedical peer-review overall appropriateness was 91.7% (undertriage: 3.8%; overtriage: 4.5%). 606 patients provided feedback. Without PTTS, 76.9% would have consulted face-to-face medical care (PED: 60.6%). Adherence to triage recommendation was mostly high (PED: 84.1%; PCP: 23.3%; Telemedicine: 83.5%). Net promoter score was high (48.5).</p><p><strong>Conclusion: </strong>This PTTS (>100,000 calls/year) based on clinical expertise and guidelines is appropriate, safe, efficient, and patient-satisfactory and prevents a considerably high percentage of patients from visiting a PED. While patient adherence to triage recommendations \"PED\" and \"Telemedicine\" was high, lower adherence to PCP referrals might be explained by deviations in parents' perception of acuity, and/or limited PCP availability (at out-of-office hours). Triage appropriateness varied across perspectives. Incorporating such high-quality PTTSs into further regions of Switzerland may help alleviate the burden on the healthcare system.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1634841"},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137378","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":"Multidisciplinary management of extensive cervical lymphatic malformations and epiglottic cyst in a neonate: a case report and review of perioperative strategies.","authors":"Yuzhu Cai, Lingli Zhang, Jun Wang, Yingying Sun","doi":"10.3389/fped.2025.1543250","DOIUrl":"10.3389/fped.2025.1543250","url":null,"abstract":"<p><p>Lymphatic malformations (LMs) are rare congenital anomalies that can cause life-threatening airway obstruction in neonates, particularly when located in the cervicofacial region. The coexistence of lymphatic malformations with an epiglottic cyst further exacerbates airway compromise, posing significant diagnostic and therapeutic challenges. We report the case of a 27-day-old neonate with extensive cervical lymphatic malformations and an epiglottic cyst causing severe airway obstruction. Timely intervention, including laser ablation of the epiglottic cyst and sclerotherapy for the lymphatic malformations, was successfully performed under general anesthesia. Perioperative management emphasized safe airway control and meticulous surgical planning. Postoperative outcomes were favorable, with significant reduction in lymphatic malformations size and resolution of airway obstruction after additional sclerotherapy sessions. This case underscores the importance of a multidisciplinary approach, combining advanced imaging, innovative airway management techniques, and minimally invasive procedures, to achieve optimal outcomes in complex neonatal airway and vascular anomalies.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1543250"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130739","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":"Longitudinal blood pressure and body mass index in South African adolescents.","authors":"Elandi van Niekerk, Ruan Kruger, Caroline Sedumedi, Sanette J Brits, Makama Andries Monyeki","doi":"10.3389/fped.2025.1643812","DOIUrl":"10.3389/fped.2025.1643812","url":null,"abstract":"<p><strong>Aim: </strong>Blood pressure (BP) is known to be affected by body mass index (BMI) from an early age, but research in South African youth is scarce. We assessed longitudinal trends and relationships between BP measures and BMI in a South African adolescent cohort.</p><p><strong>Materials and methods: </strong>This longitudinal study (2010-2014) included 121 South African adolescent boys and girls of Black and White ethnicity from the Physical Activity Health Longitudinal Study. Measures included systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, mid-blood pressure (Mid-BP), mean arterial pressure (MAP), and BMI.</p><p><strong>Results: </strong>Over four years, significant increases (<i>p</i> < 0.05) in BMI, SBP, DBP, PP, Mid-BP, and MAP were observed in adolescents (<i>p</i> < 0.001). BMI was consistently and positively associated with various BP measures across the study period. In 2012, BMI associated with SBP (<i>β</i> = 0.22; <i>p</i> = 0.018), DBP (<i>β</i> = 0.22; <i>p</i> = 0.018), Mid-BP (<i>β</i> = 0.24; <i>p</i> = 0.009), and MAP (<i>β</i> = 0.24; <i>p</i> = 0.009). These associations persisted in 2013, with stronger relationships observed for SBP (<i>β</i> = 0.27; <i>p</i> = 0.003), DBP (<i>β</i> = 0.21; <i>p</i> = 0.030), Mid-BP (<i>β</i> = 0.27; <i>p</i> = 0.004), and MAP (<i>β</i> = 0.27; <i>p</i> = 0.005). In 2014, BMI associated with Mid-BP (<i>β</i> = 0.22; <i>p</i> = 0.017) and MAP (<i>β</i> = 0.23; <i>p</i> = 0.015). After adjusting for the previous year's BP, BMI positively associated with SBP (<i>β</i> = 0.23; <i>p</i> = 0.013) in 2013 and DBP (<i>β</i> = 0.19; <i>p</i> = 0.049) in 2014. Significant associations remained between BMI and Mid-BP (<i>β</i> = 0.18-0.21; <i>p</i> = 0.022-0.047) and MAP (<i>β</i> = 0.19-0.20; <i>p</i> = 0.028-0.045) across 2012 and 2013.</p><p><strong>Conclusion: </strong>Cumulatively increasing BP significantly and positively associated with BMI, suggesting that increasing BMI may contribute to elevated BP during adolescence. Early identification and targeted lifestyle interventions are required to mitigate obesity-related elevated BP in South African adolescents.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1643812"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130631","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":"Clinicians' perspectives of a care coordination model for children with medical complexity.","authors":"Emily E Munn, Jake W Griffin, Edmond Ramly, Mary R Ciccarelli, Melissa M Pangelinan","doi":"10.3389/fped.2025.1626439","DOIUrl":"10.3389/fped.2025.1626439","url":null,"abstract":"<p><strong>Background: </strong>The Indiana Complex Care Coordination Collaborative (IC4) is a statewide initiative designed to enhance care for children with medical complexity (CMC) by embedding nurse care coordinators within clinical practices. This study explored clinicians' perspectives on how these coordinators influenced care delivery.</p><p><strong>Methods: </strong>Fourteen clinicians from six participating medical systems completed semi-structured interviews. Discussions focused on the impact of care coordinators on workflow, patient care, clinician workload, and the medical home experience. Transcripts were analyzed using an inductive approach to identify key themes and insights.</p><p><strong>Results: </strong>Clinicians consistently described care coordinators as central to improving communication and access for families, serving as a reliable point of contact, and facilitating smoother interactions with the healthcare system. They noted that care coordinators helped organize patient information, enabling focused and efficient clinical encounters. This support reduced administrative burden and allowed clinicians to prioritize patient needs more effectively. Additionally, care coordinators played a vital role in educating staff, advocating for families, and addressing both medical and non-medical concerns. While clinicians emphasized the value of care coordination, they also highlighted the need for clearer role definitions and adequate training to ensure coordinators are fully integrated and utilized appropriately.</p><p><strong>Conclusion: </strong>Clinicians reported that embedded care coordinators significantly enhanced the quality, efficiency, and responsiveness of care for CMC. Their perspectives underscore the importance of structured, well-supported care coordination to improve clinical practice and patient outcomes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1626439"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130572","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}