BMC Pediatrics最新文献

{"title":"The impact of structured training on the management of agitated pediatric patients in the emergency department: changes in knowledge and self-efficacy perceptions of physicians.","authors":"Tugce Nalbant, Yüksel Bıcılıoglu, Gamze Gokalp, Gonca Özyurt, Yeşim Ece Ünsal, Gizem Buket Yayla Coşgun, Esin Ergonul","doi":"10.1186/s12887-026-06972-7","DOIUrl":"https://doi.org/10.1186/s12887-026-06972-7","url":null,"abstract":"<p><strong>Background: </strong>Children and adolescents presenting with acute behavioral agitation are increasingly admitted to pediatric emergency departments. Agitation management requires a structured and multidisciplinary approach that integrates effective communication strategies with pharmacological and non-pharmacological interventions. However, evidence-based guidance in this field remains limited, and healthcare professionals' knowledge and training levels are heterogeneous.</p><p><strong>Objective: </strong>This study aimed to evaluate the impact of a structured training program on pediatric and child psychiatry residents' knowledge and perceived self-efficacy in the management of agitation.</p><p><strong>Methods: </strong>This quasi-experimental educational study was conducted in a tertiary pediatric emergency department between January and August 2025. A total of 39 physicians, including pediatric residents, pediatric emergency medicine fellows, and child psychiatry residents, participated in a training program developed using the ADDIE instructional design model. The program combined theoretical instruction with case-based workshops focusing on verbal de-escalation, pharmacological management, and ethical application of physical restraint. Knowledge and self-efficacy were assessed before and after the intervention using structured questionnaires.</p><p><strong>Results: </strong>Thirty-nine physicians completed the study. Post-test knowledge scores were significantly higher than pre-test scores (Z = - 3.56; p < 0.001; r = 0.56), and score improvement was observed in 64.1% of participants. No significant association was found between professional experience and pre-test or post-test scores; however, a significant negative correlation was identified between professional experience and score difference (post-test - pre-test) (r = - 0.480; p = 0.002). This finding indicates that participants with lower baseline knowledge levels achieved greater gains from the training.</p><p><strong>Conclusions: </strong>Structured, case-based, and multidisciplinary training significantly enhances physicians' knowledge and self-efficacy in managing agitated pediatric patients in emergency settings. These findings demonstrate that systematically designed, institution-specific training programs can support physician competency in pediatric emergency departments.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral protection via a transcerebral gradient-guided strategy in pediatric off-pump bidirectional Glenn.","authors":"İbrahim Özgür Önsel, Barış Kırat, Mustafa Kemal Avşar, Onur Benli, Cenap Zeybek","doi":"10.1186/s12887-026-06863-x","DOIUrl":"https://doi.org/10.1186/s12887-026-06863-x","url":null,"abstract":"<p><strong>Background: </strong>Off-pump bidirectional Glenn (BDG) avoids cardiopulmonary bypass (CPB), but superior vena cava (SVC) clamping may compromise cerebral perfusion. We evaluated a goal-directed anaesthetic algorithm integrating mean arterial pressure minus SVC pressure (transcerebral gradient, TSG) with cerebral near-infrared spectroscopy (NIRS).</p><p><strong>Methods: </strong>We conducted a retrospective two-centre cohort study of 698 children undergoing off-pump BDG (2016-2025). The protocol targeted TSG ≥ 30 mm Hg with continuous invasive arterial and SVC pressure monitoring. Bilateral frontal NIRS was monitored continuously; clinically important desaturation was defined as a ≥ 20% fall from baseline. Stepwise interventions for TSG < 30 mm Hg and/or NIRS desaturation included vasoactive titration, ventilatory optimisation, maintenance of azygos venous drainage during anastomosis, haematocrit optimisation, and temporary autologous venous blood withdrawal with reinfusion after anastomosis.</p><p><strong>Results: </strong>There were no deaths (0%, 95% CI 0-0.53%), and all patients were extubated in the operating room. TSG < 30 mm Hg occurred in 89/698 patients (12.8%, 95% CI 10.4-15.5). Cerebral NIRS desaturation occurred in 54/698 (7.7%, 95% CI 5.9-10.0); 9/54 had concomitant TSG < 30 mm Hg. Transient partial seizures occurred in 6/698 (0.86%) within the first 24 h postoperatively, all resolving without sequelae. Mean postoperative pulmonary artery pressure was 11.1 (2.3) mm Hg.</p><p><strong>Conclusions: </strong>In this large off-pump BDG cohort, a standardised TSG- and NIRS-guided algorithm was feasible and was associated with low rates of cerebral desaturation and early neurological events. Prospective studies with standardised neurodevelopmental follow-up are warranted.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the usual suspects: unmasking ALCAPA in pediatric cardiomyopathy - case report.","authors":"Alejandra Pedraza C, María Verónica Suárez F, Daniela Ballén-Pinilla, Sandra Milena Cuello-Mendoza, Valentina Melendro-Duque, Juan Camilo Hernández, J P Rozo","doi":"10.1186/s12887-026-06652-6","DOIUrl":"https://doi.org/10.1186/s12887-026-06652-6","url":null,"abstract":"<p><strong>Introduction: </strong>Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare but potentially lethal congenital heart disease. Delayed recognition may result in irreversible myocardial injury. Although the classic presentation occurs in infancy, atypical forms may appear in older children, making this entity a diagnostic challenge.</p><p><strong>Case presentation: </strong>We report the case of a 9-year-old boy with a history of dilated cardiomyopathy (DCM) and poorly controlled asthma who was admitted for an asthma exacerbation. Transthoracic echocardiography revealed Left ventricular ejection fraction (LVEF) reduced, left ventricular dysfunction, severe mitral regurgitation (MR), and pulmonary hypertension (PH). Notably, classic echocardiographic hallmarks of ALCAPA-such as coronary dilation, collateral circulation, and retrograde filling of the left coronary artery-were absent, rendering this case particularly unusual. Cardiac magnetic resonance imaging and cardiac catheterization ultimately confirmed the diagnosis. The patient underwent successful left coronary artery reimplantation and mitral valvuloplasty, with favorable postoperative evolution.</p><p><strong>Discussion: </strong>This case illustrates how ALCAPA can mimic idiopathic dilated cardiomyopathy and asthma-related cardiopulmonary disease, underscoring the importance of systematically evaluating coronary arteries to avoid delayed recognition. Indirect echocardiographic signs, including segmental wall motion abnormalities and mitral regurgitation, should prompt careful coronary evaluation. Echocardiography and coronary CT/CMR are considered as the primary diagnostic tools, however catheterization or coronary CT angiography may be used in atypical cases although is not routine.</p><p><strong>Conclusion: </strong>ALCAPA should be considered in any child with unexplained ventricular dysfunction or severe mitral regurgitation. High clinical suspicion and targeted imaging are essential for timely diagnosis and optimal outcomes.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring prevalence and key determinants of developmental difficulties among young children: a cross-sectional study in urban Bangladesh.","authors":"Rebeka Jesmin Sarker, Md Biplob Hossain, Jenifar Sarker, A B M Alauddin Chowdhury, Md Jahirul Islam, Md Imdadul Haque","doi":"10.1186/s12887-026-06818-2","DOIUrl":"https://doi.org/10.1186/s12887-026-06818-2","url":null,"abstract":"<p><strong>Background and aims: </strong>Developmental difficulties (DD) refer to delays, disorders, or disabilities in a child's development across domains such as cognition, language, motor, and social-emotional functioning. Evidence on DD among very young children in urban Bangladesh remains limited. This study aimed to assess the prevalence of suspected DD and identify associated factors among young children in urban Bangladesh.</p><p><strong>Methods: </strong>This cross-sectional study, conducted in Bangladesh, recruited 405 children aged 0-3 years and their parents using multistage sampling with random ward selection followed by household recruitment. Participants were enrolled from eight different wards in Dhaka City between July 2023 and October 2024. Data were collected through interviews and observations using a semi-structured questionnaire, including the Trivandrum Developmental Screening Chart (TDSC) for 0-3 years. The chi-square test was used to examine the association between the dependent variables and covariates, while logistic regression assessed the strength of the associations.</p><p><strong>Results: </strong>Overall, 27.9% screened positive for suspected DD. Higher prevalence was observed among younger children (≤ 12 months, p = 0.007), children with low birth weight (LBW) (p < 0.001), and those from lower- and middle-income families (p = 0.025). In adjusted analysis, age ≤ 12 months (AOR: 2.79, 95% CI: 1.65-4.70), LBW (AOR: 6.20, 95% CI: 2.84-13.52), and poor hygiene practices (AOR: 2.83, 95% CI: 1.39-5.75) were independently associated with suspected DD.</p><p><strong>Conclusion: </strong>One in four young children aged 0-3 years in urban Bangladesh screens positive for suspected DD. The findings underscore the need for early screening and for strengthening clinical, social, and environmental interventions to mitigate developmental challenges and enhance early childhood development.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with selexipag in triple therapy for pulmonary arterial hypertension in Chinese children.","authors":"Meng Li, Yingchun Wang, Xiaoyu Hu, Haizhao Zhao, Weida Lu, Yuan Ji, Xiaopei Cui","doi":"10.1186/s12887-026-06954-9","DOIUrl":"https://doi.org/10.1186/s12887-026-06954-9","url":null,"abstract":"<p><strong>Background: </strong>Selexipag is an orally effective prostacyclin receptor agonist that has been approved for treating pulmonary arterial hypertension (PAH) in adults but is still used off-label in children. This study aimed to evaluate the efficacy and safety of selexipag as part of triple combination therapy (TCT) with endothelial receptor antagonists (ERAs) and phosphodiesterase-5 inhibitors (PDE5is) in Chinese children with PAH.</p><p><strong>Methods: </strong>We conducted a retrospective single-centre study including pediatric patients with Group 1 PAH who received selexipag-based TCT at Qilu Hospital of Shandong University from November 2018 to September 2023. A total of 10 pediatric patients were enrolled, with ages ranging from 8.9 to 17.2 years. Clinical data, biomarker levels, and echocardiograms were collected every 6 months.</p><p><strong>Results: </strong>In total, 10 children (7 females) were enrolled, with a median age of 14.5 years. The median follow-up duration was 29.3 months. During follow-up, 4 patients (40%) died. At the 6-month follow-up, improvements were observed in NT-proBNP levels (n = 9), 6-min walk distance (6MWD; n = 8) and WHO functional class (WHO-FC; n = 4). Among surviving patients, paired analysis revealed that 83.3% (5/6) showed an improvement in WHO-FC (P < 0.05), NT-proBNP levels were significantly reduced (P < 0.05), and 6MWD exhibited a non-significant increasing trend. No statistically significant changes were observed in echocardiographic parameters. The 1-, 2-, and 3-year transplant-free survival rates were 80%, 70%, and 60%, respectively. Selexipag was generally well tolerated, and no patients discontinued treatment due to adverse events.</p><p><strong>Conclusion: </strong>In this small retrospective cohort, selexipag-based TCT was associated with improvements in WHO-FC and NT-proBNP levels and acceptable safety in Chinese children with PAH. Nevertheless, our findings are limited by the small sample size and retrospective single-centre design, highlighting the need for larger prospective studies.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of bone health and bone mineral density in patients with mucopolysaccharidosis receiving enzyme replacement therapy.","authors":"Nesreen Safwat Abdelrahman El Feil, Yasmine Abuzaid, Amira Mobarak","doi":"10.1186/s12887-026-06870-y","DOIUrl":"https://doi.org/10.1186/s12887-026-06870-y","url":null,"abstract":"<p><strong>Background: </strong>Most patients with mucopolysaccharidosis (MPS) experience skeletal involvement due to impaired bone remodeling, glycosaminoglycan (GAG) accumulation, reduced mobility, and nutritional deficiencies. These factors may predispose to low bone mass and increased fracture risk. This study assessed bone mineral density (BMD) using height-adjusted dual-energy X-ray absorptiometry (DXA) in pediatric MPS patients receiving enzyme replacement therapy (ERT) and examined its associations with clinical, functional, and biochemical parameters.</p><p><strong>Methods: </strong>This cross-sectional study included 29 children with biochemically and/or genetically confirmed MPS receiving ERT at Tanta University Hospital. Children under 5 years and ERT-naïve patients were excluded. BMD was measured at the lumbar spine (L1-L4) and femoral neck using DXA and adjusted for height-for-age z-score (HAZ). Clinical data, Katz Activities of Daily Living (ADL) score, anthropometry, and biochemical markers of bone metabolism were recorded. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and two-tailed t-test (p < 0.05).</p><p><strong>Results: </strong>The cohort included 29 patients (19 males, 10 females; mean age 9.79 ± 3.85 years): 13 with MPS IVA, 11 with MPS I, 3 with MPS II, and 2 with MPS VI. Mean HAZ-adjusted BMD z-scores were - 1.84 ± 1.38 (right femur), - 2.07 ± 1.22 (left femur), and - 3.00 ± 1.49 (lumbar spine). Low bone mass for age (HAZ-adjusted z ≤ - 2) was present in 20/29 (68.9%) patients, predominantly affecting the spine. Vitamin D insufficiency/deficiency was observed in 75.9% of patients. Katz ADL score correlated strongly with BMD at all sites, particularly the lumbar spine (r = 0.88, p < 0.001). Total calcium and vitamin D levels showed positive correlations with BMD. Patients with cardiac involvement had significantly lower BMI than those without cardiac disease (p < 0.001).</p><p><strong>Conclusions: </strong>Pediatric patients with MPS receiving ERT show a high prevalence of low bone mass for age, driven by a multifactorial interaction between impaired mobility, nutritional deficiencies, and intrinsic skeletal pathology. Routine height-adjusted DXA monitoring, early physiotherapy, and proactive vitamin D and calcium supplementation should be integrated into comprehensive MPS care.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using journey mapping to capture parents' experiences across phases of neonatal care: a qualitative study.","authors":"Josephine H L Wagenaar, Crystal Mah, Fredrik Bodell, Gerbrich E van den Bosch, Sylvia A Obermann-Borst, Irwin Km Reiss, Maaike S Kleinsmann, H Rob Taal, Saba Hinrichs-Krapels","doi":"10.1186/s12887-026-06842-2","DOIUrl":"https://doi.org/10.1186/s12887-026-06842-2","url":null,"abstract":"<p><strong>Background: </strong>Neonatal admissions are often lengthy and traumatic for parents, affecting parental and child outcomes. Parents' care experiences are shaped by emotional, informational, and practical factors. Understanding these factors is essential to improve support and outcome.</p><p><strong>Methods: </strong>We used a mixed-methods approach to develop a parental journey map, including: (1) conceptualizing a parental journey map (exploratory research), (2) developing the map (six interviews), (3) iteration (with eight parents), and (4) exploring transfer experiences (eight additional parents).</p><p><strong>Results: </strong>The journey map illustrated parents' transition from feeling powerless to confident caregivers at home. Early phases were dominated by emotional overload and limited cognitive capacity, highlighting the need for dosed, timely and consistent communication, practical information and acknowledgement of their parenting role. As the journey progressed, parents' needs shifted toward continuity of care, trust-building and individualized participation in caregiving, with inconsistencies emerging as key stressors. Transfers between units were a particularly vulnerable phase. Preparations, clear expectations and acknowledgement of prior experiences by all healthcare providers were essential. Parents' experiences varied widely, highlighting the importance of individualized care.</p><p><strong>Conclusions: </strong>This study demonstrates the value of journey mapping in capturing the diverse and evolving needs of parents during the different phases of their neonatal care journey. By highlighting when and how communication, psychosocial support, and parental role acknowledgement are most impactful, these findings provide a structured foundation for designing phase-specific, parent-centered interventions. Our results underline the need for future research across diverse parental backgrounds and time points to inform equitable improvements in neonatal care.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between patent ductus arteriosus and adverse outcomes in preterm infants.","authors":"Yaqi Tang, Xiuxiang Liu, Dongxu Wei, Zhixian Ji, Silin Pan","doi":"10.1186/s12887-026-06966-5","DOIUrl":"https://doi.org/10.1186/s12887-026-06966-5","url":null,"abstract":"<p><strong>Objective: </strong>The impact of patent ductus arteriosus (PDA) and its management on necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) risk in preterm infants remains debated.</p><p><strong>Methods: </strong>The present single-center study enrolled a total of 769 preterm infants with a gestational age of less than 37 weeks. The logistic regression was used to identify independent risk factors for PDA, NEC, and BPD based on maternal conditions during pregnancy, delivery details, and postnatal neonatal characteristics. Furthermore, the present study evaluated the effects of drug treatment for PDA on neonatal outcomes.</p><p><strong>Results: </strong>The incidence of NEC was not associated with the presence of PDA in preterm infants (P = 0.15). However, infants with PDA had a 2.12-fold higher likelihood of developing BPD compared to those without PDA (P < 0.01). Pharmacotherapy for PDA was associated with a 49% lower incidence of NEC and a 59% higher incidence of BPD (P < 0.01). Assisted reproductive technology and maternal diabetes were identified as factors independently associated with PDA in preterm infants. Additionally, infants delivered by cesarean section had a 42% lower incidence of BPD compared to those delivered vaginally (P < 0.01).</p><p><strong>Conclusion: </strong>Pharmacotherapy for PDA was independently associated with a lower risk of NEC but a higher risk of BPD in preterm infants. ART was an independent risk factor for PDA and served as a confounding factor for NEC. Cesarean delivery was independently associated with a lower risk of BPD.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in school-aged boys and girls: longitudinal associations with physical activity and sedentary behaviour in the HAPPY study.","authors":"Katherine L Downing, Borja Del Pozo Cruz, Lauren Arundell, Trina Hinkley, Jo Salmon, Anna Timperio, Kylie D Hesketh","doi":"10.1186/s12887-026-06961-w","DOIUrl":"https://doi.org/10.1186/s12887-026-06961-w","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is positively associated with physical activity (PA) and negatively associated with sedentary time (SED) assessed by self- and proxy-report in children. However, there is a dearth of longitudinal evidence using device-measured PA and SED in this population. This study aimed to examine longitudinal associations of device-measured PA and SED as well as parent-reported screen time with HRQoL in primary (elementary) school-aged boys and girls.</p><p><strong>Methods: </strong>Data from waves 2 and 3 (child ages 6-8 and 9-11y, respectively) of the Healthy Active Preschool and Primary Years (HAPPY) Study were analysed. At wave 2, children wore ActiGraph GT1M accelerometers to assess time in SED and light-, moderate- and vigorous-intensity PA (LPA, MPA and VPA). Parents reported their child's usual screen time (television viewing, computer/internet use, computer/electronic games, handheld electronic games). At wave 3, parents reported their child's HRQoL using the Pediatric Quality of Life Inventory. Mixed-effects linear models were used to assess longitudinal associations of different intensities of PA, SED, and screen time with HRQoL scores. Analyses were stratified by sex of the child and adjusted for child age, BMI z-score and maternal education, with child and preschool/childcare centre of recruitment as random-effects.</p><p><strong>Results: </strong>Boys had less SED and more MPA, VPA, TPA, electronic game use, handheld electronic game use and total screen time than girls (all p < 0.05); there were no sex differences in LPA, television viewing, computer/internet use, or HRQoL scores. For boys, VPA predicted better physical HRQoL (beta [β] = 0.18, 95%CI 0.02, 0.35). For girls, using electronic games predicted lower psychosocial HRQoL (β=-0.09, 95%CI -0.16, -0.01), while handheld electronic games and total screen time predicted lower physical HRQoL (β=-0.19, 95%CI -0.33, -0.06, and β=-0.04, 95%CI -0.07, -0.004, respectively) and total HRQoL (β=-0.12, 95%CI -0.23, -0.01, and β=-0.03, 95%CI -0.05, -0.001, respectively).</p><p><strong>Conclusions: </strong>Higher VPA predicted better physical HRQoL for boys; since boys were more active than girls, girls may not have engaged in sufficient VPA to benefit their HRQoL. Further research is needed to examine specific types of screen use, given the observed detrimental associations with HRQoL for girls.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neck circumference is associated with metabolic syndrome parameters in adolescents with obesity: a cross-sectional study.","authors":"Mehmet Cengiz","doi":"10.1186/s12887-026-06949-6","DOIUrl":"https://doi.org/10.1186/s12887-026-06949-6","url":null,"abstract":"<p><strong>Background: </strong>Neck circumference (NC) is a practical anthropometric measure for assessing obesity in youth, but its association with metabolic syndrome (MetS) components remains underexplored. This study evaluated the relationship between NC and MetS parameters in adolescents with obesity, using both standard International Diabetes Federation (IDF) criteria and expanded definitions incorporating insulin resistance.</p><p><strong>Methods: </strong>In this cross-sectional study, 48 adolescents with obesity and 41 age- and sex-matched controls were recruited from a tertiary pediatric clinic. Anthropometric data (BMI, waist circumference, NC) and fasting blood samples (glucose, insulin, HDL cholesterol, triglycerides) were collected. MetS was diagnosed using IDF criteria and an expanded definition including hyperinsulinemia or elevated HOMA-IR. The Pediatric siMS (PsiMS) score quantified metabolic risk.</p><p><strong>Results: </strong>NC was significantly greater in the obesity group than in controls (mean ± SD: 37.95 ± 3.03 cm vs. 31.86 ± 3.30 cm, p < .001). MetS prevalence was 14.6% by IDF criteria, rising to 43.8% with expanded criteria. In adolescents with obesity, NC positively correlated with fasting insulin, HOMA-IR, triglycerides, systolic blood pressure, and PsiMS score (p < .05 for all). NC was also associated with the total number of MetS criteria met under both diagnostic approaches.</p><p><strong>Conclusions: </strong>NC is a reliable, non-invasive marker correlated with key metabolic risk factors in adolescents with obesity. Its routine use could aid early detection of metabolic risk, particularly in resource-limited settings. Longitudinal research is needed to define NC thresholds and its predictive value for long-term outcomes.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}