Children-Basel最新文献

{"title":"Viral and Bacterial Etiology of Common Respiratory Infections in Children in Sub-Saharan Africa: A Systematic Review.","authors":"Jordy Exaucé Demboux Lyelet, Pembe Issamou Mayengue, Félix Koukouikila-Koussounda, Eric M Leroy, Pierre Becquart, Fabien Roch Niama","doi":"10.3390/children12091212","DOIUrl":"10.3390/children12091212","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Respiratory infections are a major global public health problem, with potentially serious consequences. Indeed, they remain one of the main causes of morbidity and mortality in children under 5 in developing countries. Etiological information on respiratory infections is crucial for prevention and case management strategies. This review describes the etiology of respiratory infections reported in studies conducted in sub-Saharan African countries. <b>Methods</b>: PubMed, HINARI and Google Scholar search engines were used for bibliographic research, and only data from sub-Saharan Africa were considered. Articles published between 2010 and 2023, in English or French, were included in this review. <b>Results</b>: After a thorough search, 2175 documents were identified. Critical review and removal of duplicates identified 347 full-text studies, which underwent rigorous evaluation. A total of 50 articles were retained, with studies conducted in 24 sub-Saharan African countries, most of them in Cameroon (12%). Thirty-three (66%) were cross-sectional studies, and thirty-seven (74%) were hospital-based surveys. Respiratory syncytial virus was most frequently identified (0.6% to 59%), followed by rhinovirus (7.5% to 73%). The most frequent bacteria were <i>Streptococcus pneumoniae</i> (1-96%) and <i>Haemophilus influenzae</i> (2.5-54%). <b>Conclusions</b>: This study suggests that acute respiratory infections in sub-Saharan Africa, mainly in children, are primarily caused by viruses and a few bacteria.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179113","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 School-Based Intervention Program to Reduce Weight Stigma in Adolescents.","authors":"Mariacarolina Vacca, Silvia Cerolini, Anna Zegretti, Andrea Zagaria, Edoardo Mocini, Caterina Lombardo","doi":"10.3390/children12091208","DOIUrl":"10.3390/children12091208","url":null,"abstract":"<p><strong>Background/objectives: </strong>Weight-based stigma represents a pervasive psychosocial challenge affecting youth worldwide, with significant implications for mental and physical health. Although school-based interventions have been suggested as effective strategies to reduce weight bias, evidence regarding their content and efficacy in real-world educational contexts remains limited. The present study aimed to evaluate the effectiveness of a school-based intervention designed to reduce internalized weight stigma among Italian adolescents.</p><p><strong>Methods: </strong>A total of 539 secondary school students (Mage = 15.91 years; SD = 1.38; 51.5% males) from 10 schools in Italy were randomly assigned to either an intervention group (61.2%, <i>n</i> = 330) receiving the program or a minimal intervention control group (38.8%, <i>n</i> = 209). The intervention integrated psychoeducational modules and activities based on cognitive dissonance theory to address maladaptive weight-related attitudes and associated psychopathological outcomes. Pre- and post-intervention assessments evaluated internalized weight bias and body dissatisfaction in both groups.</p><p><strong>Results: </strong>A significant reduction in internalized weight bias was observed among students perceiving themselves as overweight following the intervention. Additionally, a marginally significant decrease in body dissatisfaction was reported in the intervention group from pre- to post-intervention. No comparable changes were found in the control group.</p><p><strong>Conclusions: </strong>These findings suggest that incorporating cognitive dissonance-based psychoeducational content within school-based programs may be a promising approach for reducing internalized weight stigma in adolescents. Further research is warranted to refine intervention strategies, explore the mechanisms underlying the observed effects, and assess the scalability and long-term impact of such initiatives in school settings.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179258","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":"Red Cell Distribution Width-to-Platelet Ratio and Other Hematological Markers as Early Predictors of Bronchopulmonary Dysplasia in Preterm Infants.","authors":"Baran Cengiz Arcagok, Ibrahim Kandemir","doi":"10.3390/children12091215","DOIUrl":"10.3390/children12091215","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Bronchopulmonary dysplasia (BPD) frequently affects preterm infants and is associated with lasting morbidity. Early prediction remains challenging. The present study investigated whether hematological inflammatory markers-platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and red cell distribution width-to-platelet ratio (RPR)-can predict the development of BPD in preterm neonates. <b>Methods:</b> We performed a retrospective cohort study involving 100 infants born at less than 32 weeks' gestation. Complete blood count (CBC) parameters were collected at birth, 72 h, 1 week, and 2 weeks of life. Associations between PLR, RDW, RPR, and BPD development were analyzed. Multivariate regression and receiver operating characteristic (ROC) curve analyses were carried out to evaluate the predictive performance of the markers. <b>Results:</b> Forty-nine percent of infants developed BPD. Those with BPD had significantly higher RDW, PLR, and RPR values, and lower lymphocyte and platelet counts at various time points. Gestational age, respiratory distress syndrome, and hematological indices independently predicted BPD. ROC analysis showed that RDW ≥ 67.2 and PLR ≥ 98.13 at 72 h, and RPR ≥ 0.3 at 7 and 14 days had good predictive performance. A combined scoring system, including clinical and hematological markers, achieved high sensitivity and specificity. <b>Conclusions:</b> Hematological inflammatory markers, especially RPR, PLR, and RDW, derived from routine CBC tests may serve as accessible, cost-effective tools for early BPD risk stratification in preterm infants. Additional studies are needed to confirm these results and better define their relevance in clinical practice.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179552","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":"Diagnostic Value of Leukocyte Count, C-Reactive Protein, and Procalcitonin in Pediatric Liver Transplant Patients During the First Week Postoperative: A Longitudinal Study from a Tertiary Center and a New Diagnostic Method for Predicting Systemic Infection.","authors":"Zerrin Onal, Elif Turkmen, Demet Demirkol, Ugur Can Leblebici, Ibrahim Kandemir, Tugce Goksu Yilmaz, Selda Hancerli Torun, Feza Ekiz, Ilgin Ozden, Ozlem Durmaz","doi":"10.3390/children12091201","DOIUrl":"10.3390/children12091201","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Infection is a major complication during the early postoperative period following pediatric liver transplantation (LT). Prompt diagnosis and treatment are essential to prevent death. We aimed to assess the diagnostic value of procalcitonin (PCT), white blood cell count (WBC), and C-reactive protein (CRP) levels for detecting bacterial infection and SIRS within the first week after LT. <b>Methods:</b> Demographic data, vital signs, laboratory results (PCT, CRP, WBC), and culture findings on the 1st, 4th, and 7th days between January 2010 and 2024 were collected retrospectively. <b>Results:</b> The study included 88 patients. Seventy-two percent had cirrhotic liver disease. SIRS was present in 17% (n = 15), and bacterial growth was detected in 20% (n = 18). Bacterial growth was found in 80% of patients with SIRS (n = 12/15) and in 8% of SIRS-negative patients (n = 6/73). PCT levels were significantly elevated on days 1, 4, and 7, and CRP levels on days 4 and 7 in patients with SIRS. PCT elevation was significant on days 1, 4, and 7, while WBC increase was noted on day 7 in patients with bacterial growth. Body temperature ≥ 37.1 °C and PCT ≥ 5.1 ng/dL on the first day together showed a sensitivity of 72.2% and specificity of 84.3% for bacterial growth. Similarly, body temperature ≥ 37.1 °C and PCT ≥ 9.2 ng/dL on the first day yielded 73% sensitivity and 95% specificity for diagnosing SIRS. Cirrhotic patients exhibited limited or no WBC response to bacterial growth. <b>Conclusions:</b> PCT, CRP, and WBC alone are insufficient for diagnosing infection. Combined assessment of body temperature changes and PCT elevation may serve as more accurate indicators. Nonetheless, close monitoring of culture results and clinical signs, with serial physical exams, can aid timely infection management or prevent unnecessary antibiotic adjustments.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179349","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":"Early Parenting Effects on Childhood Delay of Gratification and Adolescent Allostatic Load.","authors":"Heather Leonard, Atika Khurana, Derek Kosty","doi":"10.3390/children12091203","DOIUrl":"10.3390/children12091203","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Early parenting can influence child self-regulatory skills, which are in turn linked to allostatic load (AL)-a predictor of future morbidity and mortality. However, this mechanistic pathway from early parenting to later AL has not been tested using longitudinal data. <b>Methods</b>: We analyzed longitudinal data (<i>N</i> = 1364) from the Study of Early Child Care and Youth Development to examine relationships between early childhood (ages 2-3) observed parenting behaviors (i.e., autonomy support, supportive presence and hostility) and a comprehensive index of adolescent (age 15) AL, and assessed delay of gratification (at 54 months) as a mediator and moderator of these associations. <b>Results</b>: Maternal supportive presence and hostility in early childhood were directly associated with adolescent AL. All three early childhood parenting behaviors were associated with delay of gratification at 54 months. There was no evidence of mediation or moderation. <b>Conclusions</b>: The findings suggest the important role of early parenting behaviors in predicting long-term AL outcomes.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179392","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":"Clinical Impact of Patient-Specific 3D Models in Neonatal Surgery: A Case-Based Review of Applications and Future Directions.","authors":"Oscar Girón-Vallejo, Bernardo Garcia-Nuñez, Isidoro Narbona-Arias, Alexander Siles-Hinojosa, Francisco Javier Murcia-Pascual, Moutasem Azzubi, Ignacio Gorriti, Dario Garcia-Calderon, Antonio Piñero-Madrona, Lucas Krauel","doi":"10.3390/children12091202","DOIUrl":"10.3390/children12091202","url":null,"abstract":"<p><p>Three-dimensional (3D) modeling and printing technologies are increasingly used in pediatric surgery, offering improved anatomical visualization, surgical planning, and personalized approaches to complex conditions. Compared to standard imaging, patient-specific 3D models-virtual or printed-provide a more intuitive spatial understanding of congenital anomalies, tumors, and vascular anomalies. This review compiles evidence from pediatric surgical fields including oncology, abdominal, and thoracic surgery, highlighting the clinical relevance of 3D applications. The technological workflow-from image segmentation to computer-aided design (CAD) modeling and multimaterial printing-is described, emphasizing accuracy, reproducibility, and integration into hospital systems. Several clinical cases are presented: neuroblastoma, cloacal malformation, conjoined twins, and two cases of congenital diaphragmatic hernia (one with congenital pulmonary airway malformation, CPAM). In each, 3D modeling enhanced anatomical clarity, increased surgeon confidence, and supported safer intraoperative decision-making. Models also improved communication with families and enabled effective multidisciplinary planning. Despite these advantages, challenges remain, such as production time, cost variability, and lack of standardization. Future directions include artificial intelligence-based automation, expanded use of virtual and mixed reality, and prospective validation studies in pediatric cohorts. Overall, 3D modeling represents a significant advance in pediatric precision surgery, with growing evidence supporting its safety, clinical utility, and educational value.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179280","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":"High-Intensity Physical Activity During Late Adolescence Predicts Young Adult CT-Based Finite Element Bone Strength in Emerging Adulthood: Iowa Bone Development Study.","authors":"Soyang Kwon, Kathleen F Janz, Indranil Guha, Alex V Rowlands, Oscar Rysavy, Punam K Saha, Chandler Pendleton, Euisung D Shin, Steven M Levy","doi":"10.3390/children12091204","DOIUrl":"10.3390/children12091204","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated associations between physical activity (PA) during late adolescence and emerging adulthood and bone strength in emerging adulthood by utilizing advanced finite element analysis of computed tomography (CT/FEA) technology beyond the traditional dual-energy X-ray absorptiometry (DXA) method.</p><p><strong>Methods: </strong>This study included 266 participants (152 females) from the Iowa Bone Development Study. PA volume (average acceleration) and intensity (intensity gradient) metrics were calculated from ActiGraph accelerometer data collected at ages 17, 19, 21, and 23 years. Compressive modulus and compressive stiffness of the tibia were estimated at age 23 via CT/FEA of the tibia. Sex-specific linear regression models were used to evaluate associations between PA metrics and bone outcomes, adjusting for age, height, weight, musculoskeletal fitness, and calcium intake.</p><p><strong>Results: </strong>Intensity gradient averaged over 17-23 years of age was positively associated with compressive stiffness at age 23 years in both females and males (<i>p</i> < 0.01). Intensity gradient was positively associated with compressive modulus in females (<i>p</i> < 0.01), but not in males. No significant associations were found between average acceleration and either compressive stiffness or modulus in either sex (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Using a state-of-the-art CT/FEA method, this study suggests that high-intensity PA during late adolescence and emerging adulthood improves bone strength.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179183","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":"Factors Associated with Intubation After Less Invasive Surfactant Administration (LISA); A Single-Center Cohort from Saudi Arabia.","authors":"Kamal Ali, Abdulghani Lodhi, Saleh S Alqarni, Mohanned Alrahili, Mohamed Almahdi, Reem Alharbi, Rahaf Alshahrani, Monirah Alroshoud, Ahad Aldhafiri, Amal Alharbi, Maisa Alqahtani, Abdulaziz Homedi, Ibrahim Ali, Saif Alsaif","doi":"10.3390/children12091196","DOIUrl":"10.3390/children12091196","url":null,"abstract":"<p><p><b>Background</b>: Less invasive surfactant administration (LISA) can reduce exposure to mechanical ventilation in preterm infants, but factors associated with LISA failure in routine practice remain uncertain, particularly outside Europe. <b>Methods</b>: We performed a single-center retrospective cohort at King Abdulaziz Medical City, Riyadh (June 2023-June 2025). Inborn preterm infants at 26-34 weeks of gestation who received LISA as first-line surfactant therapy were included. The primary outcome was LISA failure, defined as intubation within 72 h for apnea, escalating oxygen requirement, or respiratory acidosis. Secondary outcomes included intraventricular hemorrhage (IVH), NICU length of stay, and other major morbidities. Multivariable logistic regression (gestational age as the anchor variable with a limited number of additional covariates) was used to identify predictors of failure and of IVH. Kaplan-Meier methods (log-rank test) were used to compare time to NICU discharge. <b>Results</b>: Forty-one infants were included (median gestational age: 30 weeks; median birth weight: 1300 g). LISA failure occurred in 39% of the cohort. Compared with infants with successful LISA, those who failed were more premature (median GA: 28 vs. 29 weeks; <i>p</i> = 0.009), had lower birth weight (1100 g vs. 1270 g; <i>p</i> = 0.011), higher IVH rates (38% vs. 8%; <i>p</i> = 0.020), and longer NICU stay (60 vs. 40 days; <i>p</i> = 0.041). Lower gestational age was the only independent factors associated with LISA failure (adjusted OR 1.44; 95% CI: 1.07-1.95; <i>p</i> = 0.018). LISA failure was independently associated with IVH (adjusted OR 10.08; 95% CI: 1.29-78.50; <i>p</i> = 0.027). Kaplan-Meier analysis showed significantly prolonged NICU stay among infants with LISA failure (<i>p</i> = 0.011). <b>Conclusions</b>: LISA is feasible in a high-acuity Middle Eastern NICU. However, failure-closely linked to lower gestational age-is associated with IVH and prolonged hospitalization. Careful patient selection and procedural planning are essential to optimize outcomes.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179091","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":"Associations of TAS1R2 and TAS2R38 Genetic Variants with Sugar-Sweetened Beverage Intake and Obesity Risk in Kuwaiti Adolescents: A Cross-Sectional Study.","authors":"Razan Yousef, Dalal Usamah Zaid Alkazemi, Mohamed Abu-Farha, Jehad Abubaker, Sriraman Devarajan, Abdur Rahman, Fahd Al-Mulla","doi":"10.3390/children12091192","DOIUrl":"10.3390/children12091192","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Obesity is increasing worldwide, driven by unhealthy dietary habits and sedentary lifestyles. Genetic variations in taste receptor genes, particularly <i>TAS1R2</i> and <i>TAS2R38</i>, may influence taste preferences, dietary intake, and obesity risk. This study examined associations between <i>TAS1R2</i> and <i>TAS2R38</i> polymorphisms, sugar-sweetened beverage (SSB) intake, and obesity risk in Kuwaiti adolescents. <b>Methods</b>: A cross-sectional study was conducted among 260 adolescents aged 11-14 years recruited from public schools in Kuwait. Genotyping of five single-nucleotide polymorphisms (SNPs) was performed using TaqMan assays. Associations between SNPs, SSB intake, and obesity parameters were evaluated using multinomial logistic regression and non-parametric tests, adjusted for age, sex, nationality, BMI z-scores, basal metabolic rate, and physical activity. <i>p</i>-values were corrected using the Benjamini-Hochberg method. <b>Results</b>: The rs713598 SNP in <i>TAS2R38</i> showed a marginal association with BMI percentiles and z-scores. Adolescents carrying the CC genotype of rs10246939 SNP in <i>TAS2R38</i> had significantly lower odds of high SSB consumption (>3 servings/week) compared with T-allele carriers (<i>p</i> = 0.018, OR= 0.24, 95% CI = 0.08-0.79). No significant associations were detected for <i>TAS1R2</i> SNPs. <b>Conclusions</b>: Variations in <i>TAS2R38</i> were linked to obesity measures and beverage intake in Kuwaiti adolescents, supporting a potential genetic contribution to dietary behaviors. These findings highlight the importance of taste receptor genetics in obesity research, though replication in larger and more diverse populations is required.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179304","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":"The Autistic Toe Walking: A Narrative Review for Interventions and Comparison with Idiopathic Toe Walking.","authors":"Luiz Renato Agrizzi de Angeli, Bárbara Lívia Corrêa Serafim, Julio Javier Masquijo","doi":"10.3390/children12091198","DOIUrl":"10.3390/children12091198","url":null,"abstract":"<p><strong>Background/objectives: </strong>Idiopathic toe walking (ITW) is a diagnosis of exclusion in children who demonstrate a persistent toe-walking gait without an identifiable underlying neuromuscular or orthopedic pathology. The classification of toe-walking behavior (TWB) in children with Autism Spectrum Disorder (ASD) remains an area of debate, with some considering it a part of the broader ITW spectrum, while others view it as a distinct entity. Children with TWB associated with ASD (Autistic Toe Walking-ATW) present unique clinical challenges. This subgroup exhibits a higher prevalence of toe walking, and their gait patterns are often associated with underlying neurodevelopmental differences, frequently leading to increased resistance to conventional treatment approaches and higher rates of persistence and recurrence. This narrative review aims to summarize the available evidence on interventions for ATW, highlight differences compared to ITW and discuss implications for clinical practice.</p><p><strong>Methods: </strong>A literature search was performed, including articles that addressed interventions for toe walking in children with ASD.</p><p><strong>Results: </strong>The literature is limited and heterogeneous. Identified interventions include physiotherapy, orthoses, botulinum toxin injections, serial casting, and surgical procedures. Evidence of effectiveness is scarce, with most studies consisting of small case series. ATW differs from classic ITW in some aspects of pathophysiology and clinical presentation. Treatment decisions should balance potential benefits with risks, particularly regarding repeated anesthesia exposure during casting versus earlier surgical options.</p><p><strong>Conclusions: </strong>Evidence for managing ATW is limited. While comparisons to ITW may be useful, clinicians must recognize that they present distinct characteristics. Future research should focus on standardized definitions and controlled trials to guide management.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179569","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}