Pediatric health, medicine and therapeutics最新文献

{"title":"Structured Play Integration into Nutritional Rehabilitation for Acute Malnutrition in Uganda: An Assessment from Ugandan Referral Hospitals.","authors":"Nicolette Nabukeera-Barungi, Amanda Eunice Murungi, Alex Mokori, Laura Turinawe Ahumuza, Mary Nabisere, Lorraine Oriokot, Jolly Kamugisha, Joseph Rujumba, Elizabeth Kiboneka, Paul Mubiri, Esther Babirekere-Iriso, Zakaria Fusheini","doi":"10.2147/PHMT.S569531","DOIUrl":"10.2147/PHMT.S569531","url":null,"abstract":"<p><strong>Background: </strong>Play and stimulation are essential in treatment of acute malnutrition. However, the extent to which they are implemented in Uganda is unknown. We assessed the status of structured play integration into management of acute malnutrition in three referral hospitals, as well as facilitators and barriers to this integration in Uganda.</p><p><strong>Methods: </strong>This cross-sectional study took place between November and December 2023, using both qualitative and quantitative methods. We conducted 11 Focus Group Discussions (FGDs) with 86 caregivers of children under five years with acute malnutrition, and 25 Key Informant Interviews (KIIs) with various stakeholders. Quantitative data was obtained electronically using a Health Facility Assessment tool adapted from the National Nutrition Service Quality Assessment (NSQA) tool. Each section of the tool has scores, and the total score obtained was changed into a percentage. The study involved three conveniently sampled referral hospitals; Mulago National Referral Hospital (NRH), Mbarara and Moroto Regional Referral Hospitals (RRHs).</p><p><strong>Results: </strong>The scores of integration of structured play into nutrition services were 62% of the expected scores at Moroto RRH, while Mulago and Mbarara hospitals scored 32% and 36%, respectively. Facilitators of integration included funding, a supportive policy environment, training of health workers, and supportive infrastructure at the health facilities among others. The main barriers to integration were funding gaps, lack of data, human resource gaps and lack of policies. Data gaps included lack of research evidence and lack of play indicators in the data capture tools to monitor play. Policy barriers included lack of clarity on implementation of play, planning, coordination and finances. The absence of a designated cadre to lead play coupled with over-worked health workers also hinders structured play integration.</p><p><strong>Conclusion: </strong>Structured play integration into nutritional rehabilitation is very low, calling for urgent need to address the policy, data, health facility infrastructure and human resource gaps identified.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"569531"},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"8-Year Safety and Efficacy of Long-Acting GH Therapy in Pediatric IGHD II with Chiari Malformation Type 1: A Case Report with Review of Literature.","authors":"Yongfang Song, Huiping Su, Li Wang, Lili Pan, Xiu Zhao, Zhe Su","doi":"10.2147/PHMT.S582820","DOIUrl":"10.2147/PHMT.S582820","url":null,"abstract":"<p><p>Isolated growth hormone deficiency Type II (IGHD II) is a rare autosomal dominant disorder caused by heterozygous <i>GH1</i> gene mutations. Recombinant human GH (rhGH) has long been the standard therapy, but long-term real-world data on long-acting GH (LAGH) in patients with IGHD II are limited. The coexistence of IGHD II with Chiari malformation type 1 (CM1) presents additional clinical challenges. We report an 8-year follow-up of a male patient diagnosed at 4 years 3 months with severe short stature (80.2 cm, -6.43 standard deviation score [SDS]). Endocrine evaluation revealed profound GH deficiency (peak GH 0.23 ng/mL) and markedly low insulin-like growth factor-1 (IGF-1) (<25 ng/mL). Magnetic resonance imaging showed pituitary hypoplasia (height 1 mm) and suspected CM1. Genetic sequencing identified a previously classified pathogenic, <i>de novo</i> heterozygous splice site mutation in <i>GH1</i> intron 3 (c.291+1G>A). However, his cognitive evaluation indicated significant impairment at age 12 years. Initiation of weekly LAGH at 4.2 years resulted in rapid catch-up growth (height SDS +2.75 in the first year) and sustained normalization of IGF-1. The therapy was well tolerated over 8 years, with no adverse events or radiological progression of CM1. This is the first and longest reported real-world follow-up of weekly LAGH in a genetically confirmed IGHD II patient with CM1, supporting its safety and efficacy. The patient's cognitive impairment prompts reflection on the possibility that earlier detection and treatment might contribute to improved intellectual outcomes. This represents the longest real-world follow-up of weekly LAGH in genetically confirmed IGHD II complicated by CM1.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"582820"},"PeriodicalIF":1.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Phototherapy on Serum Bilirubin Levels and Clinical Outcomes in Neonates: A Single-Center Retrospective Study in a Resource-Limited Setting in Somalia.","authors":"Mohamed Nur Ali, Mohamed Mukhtar Kassim, Mustafa Gahnug, Ali Abdi Jama, Nur Adam Mohamed, Yasir Khalif Ali, Mohamed Yaqub Hassan, Farah Ali Ahmed, Abdisalam Ismail Hassan, Farah Abdullahi Ismail, İbrahim Abukar Abdi, Ismail Gedi Ibrahim, Abdullahi Mohamed Hassan Fujeyra, Abdirahman Mohamed Jimale, Said Abdirahman Ahmed","doi":"10.2147/PHMT.S589666","DOIUrl":"10.2147/PHMT.S589666","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hyperbilirubinemia is a major cause of preventable morbidity and mortality in low- and middle-income countries. Phototherapy remains the primary treatment strategy; however, its real-world effectiveness and clinical outcomes in Somalia are poorly documented.</p><p><strong>Objective: </strong>To evaluate the effectiveness of phototherapy in reducing serum bilirubin levels and to identify predictors of mortality among neonates treated for hyperbilirubinemia in a resource-limited Somali NICU.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted among neonates treated with phototherapy at Mogadishu Somali-Türkiye Recep Tayyip Erdoğan Training and Research Hospital between January 2023 and December 2024. Demographic, clinical, and laboratory data were extracted from NICU records. Paired t-tests and Wilcoxon signed-rank tests were used to compare pre- and post-treatment bilirubin levels. Independent t-tests and ANOVA were used to evaluate subgroup differences, and multivariable logistic regression was performed to identify predictors of mortality.</p><p><strong>Results: </strong>A total of 110 neonates were included; 58.2% were male and 35.5% were preterm. Mean baseline total serum bilirubin(TSB) was 17.29 ± 7.91 mg/dL, which decreased to 9.10 ± 4.90 mg/dL following phototherapy(mean reduction 8.19 ± 7.09 mg/dL). Positive blood cultures were identified in 18(16.4%) cases. Effectiveness did not differ significantly by sex, gestational age group, duration of phototherapy, or feeding method. Overall all-cause in-hospital mortality was 16.4% (n=18). In multivariable analysis, only birth weight was independently associated with mortality(aOR 0.34; 95% CI: 0.12-0.97). Baseline bilirubin level and bilirubin reduction did not independently predict death.</p><p><strong>Conclusion: </strong>Phototherapy significantly reduced serum bilirubin levels across all neonatal subgroups, supporting its effectiveness in resource-limited settings. However, mortality remained high and was primarily associated with low birth weight rather than bilirubin severity or treatment response. Strengthening neonatal intensive care services and improving early detection and management are essential to improve survival outcomes in Somalia.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"589666"},"PeriodicalIF":1.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Therapeutic Effects of <i>Thymus vulgaris</i> on Primary Dysmenorrhea Adolescent and Young Girls (Qualitative Evidence Synthesis).","authors":"Saboura Sahebi, Behrang Rezvani Kakhki","doi":"10.2147/PHMT.S569992","DOIUrl":"10.2147/PHMT.S569992","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Primary dysmenorrhea is a common gynecological condition among Adolescent and Young girls, characterized by painful uterine cramps in the absence of identifiable pelvic pathology. This condition is associated with reduced quality of life, impaired academic performance, and limitations in daily activities. Concerns regarding the long-term use and adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) have increased interest in complementary and herbal interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This systematic review aimed to synthesize clinical and mechanistic evidence on the efficacy and safety of &lt;i&gt;Thymus vulgaris&lt;/i&gt; for primary dysmenorrhea management through synthesis of quantitative outcomes (QES).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review was conducted following PRISMA 2020 guidelines. Given the heterogeneity of interventions and outcome measures across included randomized controlled trials, statistical meta-analysis was not feasible; therefore, a narrative synthesis approach was employed to integrate quantitative findings. Confidence in evidence was assessed using the GRADE-CERQual framework for intervention reviews. A comprehensive literature search was performed in PubMed/Medline, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar from inception to December 2025. Clinical, observational, and experimental studies examining thyme or its bioactive constituents in relation to primary dysmenorrhea were included. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist. Data were analyzed using thematic synthesis, and confidence in the review findings was evaluated using the GRADE framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A synthesis of 6 studies found that participants consistently described thyme as a familiar cultural intervention that provided tangible menstrual pain relief, with empirical reports describing reductions in pain intensity and duration comparable to conventional NSAIDs. These narratives were consistent with mechanistic evidence suggesting dual pathways carvacrol-mediated suppression of prostaglandin cascades and attenuation of the oxidative microenvironment involved in pain sensitivity. This synthesis interpreted quantitative results through a qualitative lens to elucidate perceived acceptability and underlying factors. All clinical evidence was obtained exclusively from women of reproductive age in Iranian settings (mean age 21-24 years), and no trials recruited WHO-defined adolescents (10-19 years). Short-term safety profiles appeared favorable over the trial duration (≤3 menstrual cycles), although long-term effects on pubertal endocrine maturation remain unknown. Geographic homogeneity and cultural familiarity with thyme in Iranian contexts further limits generalizability to Adolescent and Young girls around the world.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This qualitative evidence synthesis suggests","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"569992"},"PeriodicalIF":1.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses and Midwives Mistakes and Errors in Pediatric Health Outcomes in Southwestern Uganda.","authors":"Milly Akantorana, Raymond Tumwesigye, Concepta Mary Nalwanga, Vallence Niyonzima, Rachel Luwaga, Esther Beebwa","doi":"10.2147/PHMT.S556561","DOIUrl":"10.2147/PHMT.S556561","url":null,"abstract":"<p><strong>Background: </strong>According to the World Health Organization, nearly 1 in 10 patients suffer harm during healthcare, resulting in over 3 million deaths in low- and middle-income countries. Alarmingly, more than half of these incidents are preventable, with medication errors being the primary cause. Children are particularly vulnerable to these errors and other adverse patient events. Therefore, this study explored nurses and midwives' mistakes and errors in paediatric health outcomes in southwestern Uganda.</p><p><strong>Methods: </strong>We adopted a phenomenological qualitative research design. Purposive and consecutive sampling methods were used to recruit nurses and midwives who had served in their respective units for at least six months and were willing to participate and signed a written informed consent form. Data collection was done using a semi-structured interview guide. All interviews were face-to-face and audio-recorded upon participants' consent. Thematic analysis was used to generate the themes.</p><p><strong>Results: </strong>The study revealed four themes that emerged from participants' perceptions regarding the reasons for pediatric medication errors namely; work flow and work environment, work overload, limited resources and training and education need. Regarding participants' experience of pediatric medication errors, omission and commission errors was quoted and three themes emerged from interventions to medication errors, namely; sticking to rights of drug administration, education and training, and resources.</p><p><strong>Conclusion: </strong>Results of this study indicate that although nurses demonstrated positive perceptions of strategies to improve pediatric medication safety, medication errors remain a serious challenge requiring close supervision. The primary problem identified as quoted verbatim by the participants is \"…overcrowding of babies in limited clinical spaces\", which created a high-risk environment for errors. The findings highlight the urgent need to incorporate the voices of nurses into policy, education, and training initiatives. Such inclusion will contribute to the development of robust healthcare systems and more effective strategies to enhance pediatric medication safety.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"556561"},"PeriodicalIF":1.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Fever Manifestation During Acute Infections Coincides with Improvement in Autism Spectrum Disorder (ASD) While Under Classical Homeopathy, A Case Report.","authors":"Atul Jaggi, Latika Jaggi, Mallika Batra, Seema Mahesh, George Vithoulkas","doi":"10.2147/PHMT.S583452","DOIUrl":"10.2147/PHMT.S583452","url":null,"abstract":"<p><strong>Purpose: </strong>This case study investigates the relevance of the continuum theory of diseases in the context of autism spectrum disorder (ASD). The aim is to illustrate a real-world observation that aligns with the theory's premise regarding the therapeutic role of acute illness in chronic conditions.</p><p><strong>Methodology/approach: </strong>It details a case of mild to moderate ASD in a child aged 2 years and 9 months with a long-term follow-up. The patient received individualized classical homeopathic treatment (where selection of a remedy is based on the patient's individualized symptom profile and totality of characteristic symptoms), and progress was evaluated using the Childhood Autism Rating Scale (CARS) and the Communication DEALL Developmental Checklist (CDDC).</p><p><strong>Results: </strong>The patient showed significant improvement in all developmental domains. The interesting observation was that the improvement in the clinical features in this case of ASD was apparent after the onset of previously absent common acute infections with fever.</p><p><strong>Conclusion: </strong>The observed phenomenon corresponds with the continuum theory of diseases. This suggests that a transition in the immune system profile from chronic to acute inflammation may correlate with improved outcomes for individuals with ASD. Further scientific studies are required to determine the connection between chronic and acute inflammation to preserve the immune system's efficiency and promote therapies that do not inadvertently perpetuate chronic inflammation.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"583452"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Gallstones and Associated Factors Among Children and Adolescents with Sickle Cell Disease in Eastern Uganda.","authors":"Augustine Owiny Okejomoe, Martin Chebet, Crispus Tegu, Julian Abeso, Kevin Achiro, Theoneste Hakizimana, Richard Katuramu, Ivaan Pitua, Christine Olwedo Adoch, Ezekiel Mupere, Peter Olupot-Olupot","doi":"10.2147/PHMT.S571634","DOIUrl":"10.2147/PHMT.S571634","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) predisposes patients to gallstone formation due to chronic hemolysis, which may result in complications such as cholecystitis and pancreatitis. Despite its clinical importance, there is limited data on the prevalence and risk factors of gallstones in children and adolescents with SCD in Uganda. This study aimed to determine the prevalence and associated factors of gallstones in children and adolescents with SCD in Eastern Uganda.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted at Mbale Regional Referral Hospital from March to June 2024. We enrolled 208 children and adolescents aged 2-19 years with confirmed SCD. Data on sociodemographic and clinical characteristics were collected using structured questionnaires. Abdominal ultrasound was performed to assess gallstone presence, and blood samples were analyzed for hematological and liver function parameters. Logistic regression was used to identify factors associated with gallstones.</p><p><strong>Results: </strong>The prevalence of gallstones was 31% (65/208). Adolescents aged 13-19 years were more likely to have gallstones than younger children. Factors significantly associated with gallstones included jaundice adjusted prevalence ratio (aPr = 0.5, 95% CI: 0.4-0.7, p < 0.001) and elevated gamma-glutamyl transferase (GGT) levels (aPr = 1.5, 90% CI: 0.9-2.3, p = 0.051).</p><p><strong>Conclusion: </strong>The high prevalence of gallstones in children and adolescents with SCD emphasizes the need for routine screening. Routine ultrasound and liver function tests for children over 10 years may enable early detection and intervention, reducing complications.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"571634"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital Langerhans Cell Histiocytosis in Young Pediatric Patients: Two Case Reports and Literature Review.","authors":"Pan Long, Yunjia Liu, Yuancheng Zhao, Fen Lan, Heng Liu, Fei Han, Hongfeng Yuan, Xi Zhang","doi":"10.2147/PHMT.S565487","DOIUrl":"10.2147/PHMT.S565487","url":null,"abstract":"<p><strong>Objective: </strong>Langerhans cell histiocytosis (LCH) is a rare neoplastic proliferative disorder and there are relatively few studies on the treatment of pediatric patients in early childhood with orbital LCH.</p><p><strong>Materials and methods: </strong>This case report describes the treatment experiences of two pediatric patients with LCH who presented with similar clinical characteristics. They each had temporal orbital lesions, but the severity of their symptoms varied. Both patients underwent subtotal tumor resection. Postoperatively, only Patient 1 received low-dose chemotherapy and corticosteroid therapy.</p><p><strong>Results: </strong>During the six-year follow-up period, Patient 1 exhibited no recurrence, whereas Patient 2 who developed recurrent systemic symptoms including cranial and cutaneous manifestations was subsequently treated with chemotherapy and hormonal therapy in the pediatrics department.</p><p><strong>Conclusion: </strong>Based on our case observations and literature review, we realize that the early and accurate diagnosis of pediatric focal orbital LCH remains challenging. Meanwhile, the combination of surgery and chemotherapy yields satisfactory outcomes in young pediatric patients with orbital LCH, with a low recurrence rate.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"565487"},"PeriodicalIF":1.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived Experiences of Vertebral Body Tethering: A Qualitative Study of the Patient Journey.","authors":"Lisa A Royse, Dinara Saparova, Melanie E Boeyer, Daniel G Hoernschemeyer","doi":"10.2147/PHMT.S569909","DOIUrl":"10.2147/PHMT.S569909","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity in children. While posterior spinal fusion is the standard treatment for curves ≥45°, anterior vertebral body tethering (VBT) has emerged as an alternative for some patients. This study explores the experiences of patients who underwent VBT, focusing on decision-making, recovery, and long-term concerns.</p><p><strong>Patients and methods: </strong>Semi-structured interviews were conducted with twenty patients diagnosed with progressive AIS and a spinal deformity less than 60° at the time of surgery. All participants underwent VBT, completed three years of follow-up, and had reached skeletal maturity. Recruited from a single orthopaedic institute and treated by the same physician, participants averaged 18 years of age, 85% were women. Interview transcripts were analyzed using collaborative content analysis.</p><p><strong>Results: </strong>Key decision-making factors included pain, worsening condition, brace use, and concerns about appearance. VBT was preferred over fusion due to perceived benefits such as preserved flexibility, less invasiveness, shorter recovery, and lower risk of infection. Decisions were also influenced by family, physicians, and experiences of others. Recovery experiences were mixed. Some participants described difficult early recovery but felt positive overall; others recalled prolonged pain and physical limitations. Most reported reduced anxiety post-surgery, though concerns about long-term effects and future surgeries remained.</p><p><strong>Conclusion: </strong>This study offers insight into the lived experience of individuals who underwent VBT and underscores the importance of patient-centered care in surgical decision-making and recovery. Findings highlight opportunities to support patients considering VBT versus fusion and the need for comparative effectiveness studies focused on long-term outcomes and quality of life.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"569909"},"PeriodicalIF":1.8,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory Analysis of Sleep-Wake Rhythms and Sensory Processing in School-Aged Children with Autistic Spectrum Disorder: An Actigraphic Study.","authors":"Yuki Kondo, Kenji Tsuchiya, Masako Matsushita, Hiroko Takeshige, Fusae Tozato","doi":"10.2147/PHMT.S571178","DOIUrl":"10.2147/PHMT.S571178","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore and examine the relationship between sleep-wake rhythms and sensory processing characteristics in school-age children with autistic spectrum disorder (ASD) using objective sleep measurement indices.</p><p><strong>Patients and methods: </strong>This cross-sectional exploratory study included 30 children with ASD aged 6-9 years. Sleep-wake rhythms were recorded continuously for at least 14 days using a waist-worn actigraph (MTN-220) and analyzed with SleepSign Act. Sensory processing ability was assessed using the Japanese version of the Sensory Profile (SP-J), with SP-J quadrant and sensory processing scores. Associations between sleep variables and SP-J quadrant and sensory processing scores were examined using Spearman's rank correlation coefficient, applying Bonferroni correction within each pre-specified correlation set.</p><p><strong>Results: </strong>Of the 30 children initially enrolled, 11 were excluded, yielding data from 19 participants. After Bonferroni correction, no significant associations were found between SP-J quadrant scores and sleep variables (<i>r</i> = -0.411-0.540). Regarding associations with sensory processing scores, the oral sensory score showed a positive correlation with the mean wake time (<i>r</i> = 0.698, <i>p</i> = 0.006). However, no other significant associations were found between sensory processing scores and sleep variables.</p><p><strong>Conclusion: </strong>These results suggest that the relationship between oral sensory scores and the average wake time remains strong even during the school-age period when sleep-wake rhythms change. Although exploratory, this study provides foundational insights with clinical significance for understanding and supporting sleep disorders in children with ASD.</p>","PeriodicalId":74410,"journal":{"name":"Pediatric health, medicine and therapeutics","volume":"17 ","pages":"571178"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}