Children-Basel最新文献

{"title":"Reduction in Perioperative Risk in Patients with Spinal Muscular Atrophy Following the Release of Disease-Modifying Therapies: An Analysis of the National Surgical Quality Improvement Program Database.","authors":"Erin Toaz, Nisha Pinto, Keith Kilner, Eric Cheon","doi":"10.3390/children12091255","DOIUrl":"10.3390/children12091255","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Spinal muscular atrophy (SMA) is a progressive neurodegenerative disease resulting in proximal muscle weakness and paralysis. SMA treatment has radically changed in the past 10 years thanks to the development of novel therapies such as nusinersen and onasemnogene abeparvovec. Since the advent of new treatments, the incidence and perioperative risk factors of patients with SMA undergoing longer, higher-risk surgeries are unknown. We hypothesized that patients with SMA would be at an overall elevated risk for postoperative pulmonary complications (PPC) and prolonged length of stay compared to the general population, but that this would be reduced in patients undergoing surgery in the years after the release of new therapies. <b>Methods</b>: Patients who underwent surgery at a continuously enrolled American College of Surgeons National Surgery Quality Improvement Program-Pediatric hospital from 1 January 2012, to 31 December 2021, were included in this study. Cases with missing covariate or primary outcome data were excluded from the analysis. Patients with ages greater than 17 years, preoperative tracheostomy, preoperative mechanical ventilation, missing covariate or primary outcome data were excluded. Patients with SMA were identified by their ICD-9 and 10 codes. A cutoff year of 2018 was chosen for analysis of the primary outcomes as this was a full year after nusinersen received FDA approval. <b>Results</b>: On univariable analysis, the risk for PPC in patients with SMA was reduced in patients undergoing surgery in 2018 or later compared to pre-2018 (pre-2018 OR 4.44, 95% CI 1.56-9.6, <i>p</i> = 0.008; post-2018 OR 3.48, 95% CI 0.84-9.12, <i>p</i> = 0.08). On multivariable analysis, the association between SMA and PPC substantially decreased in 2018 and after but was no longer statistically significant (pre-2018 OR 1.96, 95% CI 0.80-4.80, <i>p</i> = 0.14; post-2018 OR 1.03, 95% CI 0.33-3.26, <i>p</i> = 0.96). SMA was positively associated with LOS in the pre-2018 cohort, with a coefficient from a log linear model of 0.67 (95% CI 0.32-1.01; <i>p</i> < 0.001), and SMA adding an additional 1.93 days in LOS. For data post-2018, the effect of SMA on LOS was no longer statistically significant. <b>Conclusions</b>: Utilizing a large dataset, we found a reduced association between SMA and PPC a year following widespread implementation of SMN antisense oligonucleotide therapy, and a statistically significant reduction in LOS in patients with SMA after 2018. This may reflect improved motor outcomes and respiratory mechanics in the new treatment era.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Shifts in Pathogen Profiles Due to the COVID-19 Pandemic in a Romanian Pediatric Tertiary Hospital.","authors":"Dan Dumitru Vulcanescu, Iulia Cristina Bagiu, Monica Susan, Virgiliu Bogdan Sorop, Octavia Harich, Andrada Oprisoni, Radu Galis, Florin George Horhat","doi":"10.3390/children12091258","DOIUrl":"10.3390/children12091258","url":null,"abstract":"<p><p><b>Background</b>: The COVID-19 pandemic disrupted pediatric healthcare systems globally, altering infection dynamics, hospital admissions, and antimicrobial practices. This study aimed to evaluate temporal shifts in patient demographics, clinical aspects, and microbial pathogen profiles in a tertiary pediatric hospital in Western Romania, spanning pre-pandemic (2019), pandemic (2021), and post-pandemic (2023) periods. <b>Methods</b>: A retrospective observational study was conducted at the \"Louis Țurcanu\" Emergency Children's Hospital, Timișoara. Pediatric patients (<18 years) with laboratory-confirmed bacterial infections were included. Data on demographics, hospital wards, sample types, and pathogen distribution were analyzed using Χ² tests, incidence rate ratios (IRR), and non-parametric statistical methods. <b>Results</b>: A total of 3530 patients and 6885 samples were analyzed. Pediatric admissions declined by nearly 50% during the pandemic. The Outpatient and Emergency department observed a decrease in cases, while the ICU and surgical ward cases increased proportionally. Nasal and pharyngeal samples declined during the pandemic, while catheter, blood, and conjunctival samples rose. The study identified a significant shift in pathogen prevalence, with <i>Escherichia coli</i> and <i>Staphylococcus aureus</i> as the most frequent isolates. ICU patients showed increased rates of <i>Pseudomonas aeruginosa</i>, <i>Candida albicans</i>, and <i>Klebsiella pneumoniae</i>. Group A <i>Streptococcus</i> resurged post-pandemic after a decline in 2021. <b>Conclusions</b>: The pandemic significantly impacted pediatric infection profiles, hospital service utilization, and sample collection patterns. Strengthening infection surveillance, ensuring consistent reporting standards, and adapting pediatric care to future crises are critical for improving child health outcomes.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and Validating a Childhood Trauma-Informed Curriculum for Primary School Teachers in Limpopo Province, South Africa.","authors":"Muimeleli Munyadziwa, Lufuno Makhado","doi":"10.3390/children12091256","DOIUrl":"10.3390/children12091256","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Childhood trauma significantly hinders the developmental and academic outcomes of learners, particularly in under-resourced schools such as those in Limpopo province, South Africa. Teachers in these settings often face challenges in supporting trauma-exposed learners due to a lack of knowledge, training, and appropriate resources. Addressing this gap requires the development of structured, trauma-informed educational support systems. <b>Methods</b>: This study forms the final phase of a multi-phase research project aimed at developing a trauma-informed curriculum for primary school teachers. A multi-phase mixed method design was adopted across four phases: (1) a global scoping review to identify effective trauma-informed interventions; (2) empirical interviews with primary school teachers, trauma center managers, clinical psychologists, and social workers to understand local needs and experiences; (3) development of a conceptual framework grounded in theoretical and empirical findings; and (4) curriculum development guided by El Sawi's curriculum design model. The curriculum was validated using structured questionnaires with a panel of stakeholders including educators, mental health professionals, and curriculum experts. <b>Results</b>: The study identified critical issues, including teachers' limited understanding of childhood trauma, lack of standardized training, and inadequate classroom strategies. Key curriculum components were developed to address these gaps, including modules on the nature of trauma, early identification of symptoms, trauma-informed teaching practices, and collaboration with mental health professionals. Validation results indicated strong agreement on the curriculum's clarity, relevance, and potential impact. <b>Conclusions</b>: The developed trauma-informed curriculum provides primary school teachers in Limpopo with the knowledge, tools, and confidence to support trauma-exposed learners. It emphasizes early identification, responsive classroom strategies, and inter-professional collaboration. This curriculum has the potential to enhance learning environments and promote better educational and psychosocial outcomes for trauma-affected learners.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid Insomnia and Sleep Apnea Across the Pediatric Age: A Polysomnographic Study.","authors":"Lisa Brunel, Marion Comajuan, Sabine Plancoulaine, Benjamin Putois, Julien Lioret, Marine Thieux, Laurianne Coutier, Patricia Franco, Aurore Guyon","doi":"10.3390/children12091250","DOIUrl":"10.3390/children12091250","url":null,"abstract":"<p><strong>Background/objectives: </strong>Comorbid insomnia and sleep apnea (COMISA) in children is poorly documented. This study aimed to evaluate the frequency of COMISA and to explore its clinical and polysomnographic characteristics in children referred for polysomnography (PSG) for any sleep complaint.</p><p><strong>Methods: </strong>All patients with a complete insomnia sub-score on the Sleep Disturbance Scale for Children (SDSC; for children from 6 months to 16 years old) who underwent a night PSG in a pediatric sleep unit (2018-2024) were included in this retrospective study. Pathological SDSC insomnia sub-score defined insomnia and obstructive apnea-hypopnea index ≥ 2/h on PSG defined OSA. Questionnaires regarding sleepiness, depression, anxiety, and hyperactivity were also collected.</p><p><strong>Results: </strong>Children had isolated insomnia in 11.5% of cases, isolated OSA in 37.5%, and COMISA in 13.5%. Insomnia frequency was not different between patients with and those without OSA (26.5% vs. 23.5%). COMISA was more frequent in patients under 4 years old than in older ones (39.1% vs. 5.8%). No polysomnographic or clinical characteristic of COMISA was identified, except that OAHI was higher in children with isolated OSA. Patients with COMISA or isolated insomnia were more anxious than those with isolated OSA.</p><p><strong>Conclusions: </strong>Unlike in adults, the present findings do not support a mutual association between OSA and insomnia in children. OSA severity was lower in children with COMISA. Anxiety levels were higher in children with insomnia, regardless of the presence of OSA, suggesting that anxiety should be assessed in all children with OSA.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Manual Interventions for Infantile Colic: A Scoping Review of the Evidence.","authors":"Roberto Tedeschi, Federica Giorgi","doi":"10.3390/children12091246","DOIUrl":"10.3390/children12091246","url":null,"abstract":"<p><p><b>Background:</b> Infantile colic affects up to 40% of otherwise healthy infants and can severely distress caregivers. Manual therapies are increasingly employed as non-pharmacological options, yet their effectiveness and safety remain uncertain. <b>Methods:</b> A scoping review was conducted in accordance with Joanna Briggs Institute methodology and reported following PRISMA-ScR. Five databases (MEDLINE, CENTRAL, Scopus, PEDro, Web of Science) were searched from December 2024 to May 2025 without restrictions at the search stage; however, only English-language randomised controlled trials published from 2012 onwards were included at the eligibility stage to ensure consistency and focus on the most recent body of evidence. Randomised controlled trials (RCTs) evaluating hands-on interventions for infants ≤ 6 months with colic were eligible. Two reviewers independently screened records, charted data, and grouped outcomes narratively. <b>Results:</b> Seven RCTs investigated abdominal massage, paediatric Tuina, craniosacral therapy, chiropractic manipulation, osteopathic light touch, reflexology, and acupressure. Five trials reported statistically or clinically significant reductions in daily crying (0.6-6.6 h) compared with usual care or sham. Three studies also documented meaningful gains in sleep duration (1.1-2.8 h). Parent-reported satisfaction improved in most interventions. No serious adverse events were recorded, although safety monitoring was inconsistently reported. Substantial heterogeneity in diagnostic criteria, outcome measures, and intervention dose precluded meta-analysis. <b>Conclusions:</b> Low-force manual therapies may offer modest short-term relief for colicky infants and improve parental experience, with an apparently favourable safety profile. However, methodological variability and small sample sizes limit certainty. Standardised protocols, objective outcome measures, and robust adverse-event surveillance are priorities for future research.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing Microvascular Involvement in Pediatric Localized Scleroderma Through Nailfold Capillaroscopy.","authors":"Sema Nur Taşkın, Şeyda Doğantan, Esra Esen, Sümeyra Özdemir Çiçek, Ayşenur Paç Kısaarslan, Muammer Hakan Poyrazoğlu","doi":"10.3390/children12091245","DOIUrl":"10.3390/children12091245","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Juvenile localized scleroderma (jLoS) is a chronic inflammatory disorder with skin and subcutaneous tissue involvement. Microvascular alterations are thought to contribute to its pathogenesis. This study aimed to investigate microvascular alterations in children with jLoS using nailfold capillaroscopy (NFC) and to compare the capillaroscopic findings between patients and healthy controls. <b>Methods:</b> A total of 13 children diagnosed with jLoS and 16 age- and sex-matched healthy controls were enrolled. Capillaroscopic assessment included capillary density, tortuosity, dilatation, disorganization, branching, and neoangiogenesis. Dilated and giant capillaries, hemorrhages, avascular areas, and capillary loss were evaluated. The Microangiopathy Evaluation Score (MES) was used to semi-quantitatively assess capillary loss, disorganization, and ramifications. Disease activity and damage were evaluated using the modified Localized Scleroderma Skin Severity Index (mLoSSI) and the Localized Scleroderma Damage Index (LoSDI), respectively. Functional status was measured via the 6 min walk test (6MWT). <b>Results:</b> Plaque morphea was the most common subtype (61.5%), and antinuclear antibody (ANA) positivity was present in 53.8% of patients. Compared to controls, jLoS patients exhibited significantly more frequent capillaroscopic abnormalities, including increased tortuosity, crossing, dilatation, and neoangiogenesis (<i>p</i> < 0.05). Capillary density, length, arterial limb width, apical loop width, and disorganization scores were significantly higher, while intercapillary distance was lower in jLoS patients (<i>p</i> < 0.05). No avascular areas or giant capillaries were observed. MESs were similar between groups. <b>Conclusions:</b> NFC revealed significant microvascular alterations in jLoS patients, supporting its utility as a non-invasive tool for early vascular assessment in localized scleroderma.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let's Learn About Emotions Program: Acceptability, Fidelity, and Students' Mental Well-Being Outcomes for Finnish Primary School Children.","authors":"Yuko Mori, Tiia Ståhlberg, Xiao Zhang, Kaisa Mishina, Sanna Herkama, Tarja Korpilahti-Leino, Terja Ristkari, Meeri Kanasuo, Saara Siirtola, Vesa Närhi, Hannu Savolainen, Susanna Hinkka-Yli-Salomäki, Shiho Torii, Kohei Matsubara, Kohei Kishida, Noriko Hida, Shin-Ichi Ishikawa, Andre Sourander","doi":"10.3390/children12091251","DOIUrl":"10.3390/children12091251","url":null,"abstract":"<p><p><b>Background/Objectives</b>: School-based universal mental health interventions offer an inclusive and scalable approach to promote mental health and well-being among children. This study evaluates the Let's Learn About Emotions (Opitaan tunteista in Finnish) program, an evidence-based, teacher-led universal school-based intervention originally developed in Japan and culturally adapted for Finnish primary schools. <b>Methods</b>: A total of 512 fourth-grade students from 14 schools participated in the 12-week program during spring 2023. Using a mixed-methods design, we assessed (1) the program's acceptability among students, parents, teachers, and school principals, (2) fidelity of implementation, and (3) changes in students' mental well-being pre- to post-intervention. Quantitative data included standardized questionnaires with valid responses collected from 233 students at baseline and 209 students at post-intervention, as well as parents and teachers. Qualitative data were collected through focus group discussions involving parents, teachers, and school principals during spring 2024. <b>Results</b>: Acceptability was high across all respondent groups. Teachers adhered closely to the teaching manual, as confirmed by self-reports and direct classroom observations. Statistically significant improvements were observed in parent-reported conduct problems, hyperactivity, and peer problems, though student self-reports did not show similar benefits. <b>Conclusions</b>: The program was found to be both acceptable and culturally appropriate in the Finnish context. Findings from this study provide valuable insights for refining and improving the program for future implementation. To more rigorously examine its effectiveness, future studies should employ a randomized controlled trial design.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Review of Pediatric Necrotizing Pneumonia.","authors":"Manette Ness-Cochinwala, Balagangadhar R Totapally","doi":"10.3390/children12091248","DOIUrl":"10.3390/children12091248","url":null,"abstract":"<p><p>Necrotizing pneumonia is a serious complication of pediatric pneumonia, characterized by liquefaction and cavitation of the lung parenchyma. <i>Streptococcus pneumoniae</i> and <i>Staphylococcus aureus</i> are the most implicated organisms. <i>Mycoplasma pneumoniae</i> has been an increasingly recognized pathogen, especially is Asian and <i>Pseudomonas aeruginosa</i> is mainly noted in a higher percentage of patients with complex chronic conditions. Clinical presentation typically includes fever, respiratory distress, and failure to respond to standard antibiotic therapy. These patients are more likely to have pleural involvement in the form of effusion or empyema and a higher need for respiratory support. Diagnosis is typically through a combination of chest radiographs, lung ultrasound, and chest computed tomography. Management is primarily via prolonged intravenous antibiotics that cover the above organisms, though pleural drainage with fibrinolytics is often required. Surgical intervention is often reserved for refractory cases that fail initial fibrinolytic therapy. Prognosis is usually favorable in the short and long term, though early recognition and appropriate management are imperative to reduce the duration of illness and morbidity.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Pediatric Orthopedic Management of Ambulatory Cerebral Palsy Utilizing a Closely Monitored, Lifespan-Guided Approach.","authors":"Zhe Yuan, Nancy Lennon, Chris Church, Michael Wade Shrader, Freeman Miller","doi":"10.3390/children12091252","DOIUrl":"10.3390/children12091252","url":null,"abstract":"<p><p><b>Background:</b> Cerebral palsy (CP) is a static, non-progressive brain pathology that affects mobility and musculoskeletal health. <b>Objective:</b> This review aims to describe the pediatric orthopedic management strategy at one specialty center with focus on optimal lifelong mobility function for ambulatory CP. <b>Methods:</b> Beginning in the 1990s, a protocol was developed to proactively monitor children with surgical or conservative interventions. After three decades, we undertook a prospective institutional review, board-approved 25-45-year-old adults callback study. Inclusion criteria were all children treated through childhood who could be located and were willing to return for a full evaluation. <b>Results:</b> Pediatric orthopedic interventions focused on regular surveillance with proactive treatment of progressive deformities. When function was impacted, we utilized multi-level orthopedic surgery guided by instrumented gait analysis. Childhood outcomes of this approach were evaluated through retrospective studies. Results show high correction rates were achieved for planovalgus foot deformity, knee flexion contracture, torsional malalignments, and stiff-knee gait. Our prospective adult callback study evaluated 136 adults with CP, gross motor function classification system levels I (21%), II (51%), III (22%), and IV (7%), with average ages of 16 ± 3 years (adolescent visit) compared with 29 ± 3 years (adult visit). Adults in the study had an average of 2.5 multi-level orthopedic surgery events and 10.4 surgical procedures. Compared with adults without disability, daily walking ability was lower in adults with CP. Adults with CP had limitations in physical function but no increased depression. A higher frequency of chronic pain compared with normal adults was present, but pain interference in daily life was not different. Adults demonstrated similar levels of education but higher rates of unemployment, caregiver needs, and utilization of Social Security disability insurance. <b>Conclusions:</b> The experience from our center suggests that consistent, proactive musculoskeletal management at regular intervals during childhood and adolescence may help maintain in gait and mobility function from adolescence to young adulthood in individuals with CP.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-Immune Interactions in Pediatric Oral Rhabdomyosarcoma: A Narrative Review on Immuno-Oncology and Emerging Therapies.","authors":"Omar A El Meligy, Noha M Elemam, Wael A Hassan, Iman M Talaat","doi":"10.3390/children12091249","DOIUrl":"10.3390/children12091249","url":null,"abstract":"<p><p>Pediatric oral rhabdomyosarcoma (RMS) is a rare and aggressive cancer of the head and neck, characterized by a complex and mostly immunosuppressive tumor-immune microenvironment. Unlike adult cancers, pediatric RMS typically exhibits a \"cold\" immune profile, characterized by minimal T-cell infiltration, a low mutational burden, and resistance to immune checkpoint blockade. The tumor's location in the oral cavity adds difficulty to treatment because of anatomical and functional limitations. Additionally, the presence of fusion oncogenes, such as PAX3:FOXO1, hampers immunogenicity and treatment response by disrupting antigen presentation and reducing immune cell infiltration. Advances in immuno-oncology have introduced new strategies, including immune checkpoint inhibitors, chimeric antigen receptor (CAR) therapies, cancer vaccines, and oncolytic viruses. However, these approaches face specific challenges in the pediatric population due to developmental immune factors. This narrative review highlights recent findings on the immunobiology of pediatric oral RMS, focusing on tumor-immune interactions and their impact on disease progression and treatment resistance. We reviewed the cellular components of the TIME, the mechanisms of immune evasion, and the expression of immune checkpoints, including PD-L1 and B7-H3. Emerging immunotherapies, including CAR-T, CAR-NK, and CAR-CIK cell therapies; checkpoint inhibitors; oncolytic viruses; and cancer vaccines, are discussed, with an emphasis on their current limitations and potential to transform the pediatric RMS immune landscape.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}