BMC Pediatrics最新文献

{"title":"Cross-cultural adaptation and psychometric properties of the International Consultation on Incontinence Questionnaire Pediatric Lower Urinary Tract Symptoms (ICIQ-CLUTS): a Chinese validation study.","authors":"Yufei Tan, Yanan Xu, Die Liang, Yan Zhang, Wenzhi Cai, Wei Ren, Ling Chen","doi":"10.1186/s12887-025-05706-5","DOIUrl":"https://doi.org/10.1186/s12887-025-05706-5","url":null,"abstract":"<p><strong>Background: </strong>Lower urinary tract symptoms (LUTS) are common in pediatric patients and significantly affect children's well-being and family-related quality of life. However, no validated Chinese assessment tool for LUTS exists. This study aimed to develop and validate a Chinese version of the International Consultation on Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms (ICIQ-CLUTS).</p><p><strong>Methods: </strong>The ICIQ-CLUTS was translated following the Beaton cross-cultural adaptation guidelines. A total of 192 children with and without LUTS and their parents were enrolled between June and October 2024. Psychometric evaluation was performed using multiple approaches. Reliability was assessed using Cronbach's alpha coefficient for internal consistency. Validity was assessed by expert content review and exploratory factor analysis. Clinical diagnoses were made using standardized assessment protocols including medical history, physical examination, and laboratory tests (urinalysis and uroflowmetry) based on the International Children's Continence Society (ICCS) criteria. Using these clinical diagnoses as the reference standard, the diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The study included 192 participants (70.8% male) divided into two age groups: 5-9 years (n = 139) and 10-14 years (n = 53). The Chinese ICIQ-CLUTS showed acceptable internal consistency (Cronbach's alpha = 0.718 for children's version; 0.706 for parents' version) and distinct factor structure. The diagnoses encompassed various LUTS manifestations including monosymptomatic nocturnal enuresis (MNE), non-monosymptomatic nocturnal enuresis (NMNE), and overactive bladder (OAB). Both versions exhibited high diagnostic accuracy (AUC = 0.948 for children's version; 0.933 for parents' version), with superior performance observed in the 10-14-year age group (AUC = 0.963 and 0.960, respectively). The optimal cut-off points were 13.5 for both versions, with sensitivity of 0.90 and specificity of 0.86 for the children's version, and sensitivity of 0.89 and specificity of 0.85 for the parents' version.</p><p><strong>Conclusion: </strong>The Chinese version of ICIQ-CLUTS shows good psychometric properties and diagnostic accuracy, making it a useful screening tool for pediatric LUTS in Chinese-speaking populations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"370"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular manifestations in pediatric tumor suppressor gene mutations: a case series and literature review of RB1, NF1, NF2, VHL, and TSC.","authors":"Aoxiang Wang, Chanyuan Wang, Wen Li, Jing Qiao, Yulin Luo, Yu Tian","doi":"10.1186/s12887-025-05694-6","DOIUrl":"10.1186/s12887-025-05694-6","url":null,"abstract":"<p><strong>Background: </strong>This study explores ocular manifestations in children with mutations in key tumor suppressor genes (RB1, NF1, NF2, VHL, TSC1/2), which are linked to common pediatric hereditary cancer syndromes. Mutations in these genes often lead to ocular lesions, particularly in the retina and uveal tract, including the choroid and iris. The expression of these tumor suppressor gene mutations in the eye has been a topic of interest for ophthalmologists and other healthcare professionals. We have summarized the ocular presentations of these common tumor suppressor gene mutations in pediatric patients.</p><p><strong>Methods: </strong>We reviewed 11 representative case reports, documenting in detail the ocular manifestations and progression of each case. These case studies were analyzed in conjunction with a detailed search of the relevant literature to identify specific ocular features associated with each tumor suppressor gene mutation, as well as potential underlying genetic mechanisms.</p><p><strong>Results: </strong>Our review indicates that children with mutations in RB1, NF1, NF2, VHL, and TSC1/2 exhibit a diverse range of ocular manifestations, with the specific features varying depending on the type of mutation. Early detection of ocular symptoms is crucial, as it allows for prompt intervention, significantly improving both visual and systemic outcomes. Additionally, these genetic mutations are frequently associated with systemic syndromes, emphasizing the importance of recognizing ocular symptoms and providing timely ophthalmic care and follow-up for early diagnosis and effective management. This highlights the critical role of a multidisciplinary healthcare team in managing these cases.</p><p><strong>Conclusions: </strong>This study highlights the significance of regular ophthalmic evaluations for children with hereditary cancer syndromes associated with tumor suppressor gene mutations. Early detection and timely intervention are essential for preserving vision and supporting overall development. Given the complexity of these conditions, it is vital for both ophthalmology and other medical specialties to closely collaborate and prioritize these patients. Future research should focus on larger cohort studies and the development of tailored strategies for managing specific gene mutations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"371"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the effectiveness and design of parent-oriented mobile health interventions: a systematic review and narrative synthesis.","authors":"Alicia Kilfoy, Isabella Zaffino, Enoch McAtee, Prabdeep Panesar, Kristin Cleverley, Quynh Pham, Charlene H Chu, Lindsay Jibb","doi":"10.1186/s12887-025-05656-y","DOIUrl":"https://doi.org/10.1186/s12887-025-05656-y","url":null,"abstract":"<p><strong>Background: </strong>Parents of children with a health condition experience high levels of distress which can have long-term impact on the child and parent. Dyadic interventions have the potential to decrease this distress, however several barriers to access including time constraints have been reported. Mobile health (mHealth) interventions can address several of these barriers.</p><p><strong>Goal: </strong>The goal of this systematic review was to review and synthesize the literature examining the effects of parent-oriented mHealth interventions and their content and design.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central databases from January 2013 to 2023 using a search strategy based on telemedicine and parents/caregivers. Included studies were randomized controlled trials assessing the effect of parent-oriented mHealth interventions on child and parent health. The Cochrane risk-of-bias tool was used to assess for bias in studies. Trial details and design and content features of interventions were extracted. Outcomes were organized using the Van Houtven's Framework for Informal Caregiver Interventions. Results are presented narratively.</p><p><strong>Results: </strong>Fifty papers pertaining to 49 unique studies met our inclusion criteria. More than half of the studies scored high-risk for bias. Interventions targeted a wide range of pediatric conditions. Intervention type included texting (n = 17) and investigator-developed mobile applications (n = 16). Interventions significantly improved parent psychological health and child health outcomes. Key intervention features and design included the use/application of codesign and a theory-driven intervention.</p><p><strong>Conclusion: </strong>Parent-oriented mHealth interventions identified in this review significantly improved both parent and child health outcomes. Therefore, these interventions have the potential to support parents outside of a clinical setting.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"372"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First reported case of de Novo claes-jensen syndrome (CJS) in Palestine: diagnostic challenges and genetic insights.","authors":"Manal M Shaheen, Ramzi H Mujahed, Saja E Abusabha, Iman M Alwahsh, Areen A Abufara, Leen J Junaidi, Haya A Alkablan","doi":"10.1186/s12887-025-05709-2","DOIUrl":"https://doi.org/10.1186/s12887-025-05709-2","url":null,"abstract":"<p><strong>Background: </strong>Claes-Jensen syndrome (CJS) is a rare X-linked intellectual disability caused by mutations in the KDM5C gene, encoding a histone demethylase involved in chromatin remodeling and neurodevelopment. Males with hemizygous mutations in KDM5C present with intellectual disability, dysmorphism, and neurodevelopmental delays. Mutations, either maternally transmitted or de novo, account for 0.7-2.8% of X-linked intellectual impairments. This case reports a rare de novo variant in the KDM5C gene in a Palestinian male patient, contributing to the limited literature on this condition.</p><p><strong>Case presentation: </strong>We present a 2-year and 10-month-old Palestinian male with developmental regression following an acute viral illness at 22 months. This included the loss of the ability to walk, developmental delays, and persistently elevated lactic acid. Genetic testing, including trio-based whole-exome sequencing, identified a de novo KDM5C mutation (c.2827 C > T p.Arg943), confirming the diagnosis of Claes-Jensen syndrome. Neuroimaging showed faint hyperintensities in the posterior periventricular white matter, suggestive of dysmyelination.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of CJS and the importance of genetic testing in neurodevelopmental disorders. Early recognition aids in symptomatic management and improves clinical understanding of this rare condition. Our report adds new insight into the clinical spectrum of CJS and emphasizes the need for heightened awareness among clinicians.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"368"},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional and behavioral problems in children and adolescents with hearing impairment.","authors":"Dalia Fahim Mohammed Fahim, Sara Ibrahim Sayed, Marwa Ibrahem Abdelrazic, Ibtehal Saad Abuelela","doi":"10.1186/s12887-025-05696-4","DOIUrl":"https://doi.org/10.1186/s12887-025-05696-4","url":null,"abstract":"<p><strong>Background: </strong>Hearing impairment (HI) is a prevalent problem. The majority of cases have HI during the neonatal period, while the still cases have incidence up to adolescents. Hearing amplification is a promising modality to restore hearing with promising effects on speech and communication. The objective of this study is to assess the effect of being a child with HI on emotions and behaviors despite using a hearing amplification device early in life.</p><p><strong>Patients and methods: </strong>The study is a cross-sectional descriptive study including 127 children aged from 4 to 17 years diagnosed with hearing loss; 71 were with hearing aids and 56 with cochlear implants recruited from the audio-vestibular unit, ENT department and referred to the child psychiatry clinic, department of pediatrics, Minia university, Egypt. The questionnaire used in this study is the parent-rated strength difficulty questionnaire (SDQ), which consists of 5 main components, namely \"emotional problems,\" \"conduct problems,\" \"hyperactivity/Inattention problem,\" \"peer relationship problems,\" and \"prosocial behavior\".</p><p><strong>Results: </strong>On stratifying the patients according to the degree of sensorineural hearing loss, 66.6% of children with lesser degrees of hearing loss showed significant conduct behaviors. While on stratifying the patients according to the age groups; 86% of primary school children experienced significant peer relationship problems (p = 0.03), while 66.6% of children in the late childhood period had significant emotional disturbances (p = 0.023). On regrouping of the patients according to the type of amplification (hearing aids vs. cochlear implants) and side of amplification (right, left, or bilateral), no significant differences in emotional and behavioral disturbances were observed in any group.</p><p><strong>Conclusion: </strong>Despite receiving early amplification, children with hearing loss still develop emotional and behavioral problems, with children who had a milder degree of hearing loss developing significant conduct behaviors. Additionally, those children developed significant peer relationship problems at school entry age, problems that older children can overcome, but with significant internalizing symptoms and emotional disturbances. These problems need more community orientation and psychological support to the child and their family, particularly during the transition to school. Furthermore, early screening and intervention for emotional disturbances in adolescents are essential to ensure timely management and support.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"369"},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal weight loss and exclusive breastfeeding in newborn.","authors":"Arezoo Haseli, Marzieh Bagherinia, Lida Menati, Sareh Farshadfar, Fatemeh Karpasand, Zahra Karimian","doi":"10.1186/s12887-025-05708-3","DOIUrl":"https://doi.org/10.1186/s12887-025-05708-3","url":null,"abstract":"<p><strong>Background: </strong>Despite global efforts to promote breastfeeding, the rate of exclusive breastfeeding (EBF) has remained stagnant in recent decades. Identifying factors that influence EBF is crucial. Therefore, this study aimed to investigate weight patterns and their association with EBF in newborns, specifically comparing infants with and without excessive weight loss.</p><p><strong>Methods: </strong>This retrospective, descriptive-analytical study included 1101 healthy, singleton infants who attended health centers in Kermanshah, Iran, between Nov to Des 2024. All nutritional information and weight of infant from birth to 2 years old were collected in the questionnaire. The data was analyzed using descriptive statistical methods and analytical tests using the SPSS software at significance level less than 0.05.</p><p><strong>Results: </strong>In this study, medical records of 1,101 infants were analyzed. The mean birth weight was 3,282 g (SD = 393), and the mean gestational age was 38.52 weeks (SD = 1.38). During the first 3-5 days after birth, the mean weight loss among infants was 131 g (SD = 92), equivalent to 4.01% ± 3.30% of their birth weight. Weight loss was higher in late preterm infants compared to term infants (91.6% vs. 84.6%, r = 0.233) and in cesarean deliveries compared to vaginal deliveries (81.5% vs. 71.4%, r = 0.455). Infants who lost more than 5% of their birth weight had a lower mean weight at 24 months compared to those who lost ≤ 5% (11,942 ± 1,646 g vs. 12,484 ± 1,790 g; p < 0.001). Exclusive breastfeeding (EBF) rates declined sharply in infants who lost > 5% of their birth weight, dropping from 97% during the first 3 days after birth to 59.3% by 6 months. In contrast, EBF rates remained relatively stable in infants who lost ≤ 5% (57.8% in the first 3 days vs. 49.2% at 6 months).</p><p><strong>Conclusion: </strong>Greater early postnatal weight loss combined with failure to regain birth weight by day 10 is associated with reduced EBF duration and lower infant weight at two years. These findings suggest that interventions to minimize excessive postnatal weight loss and promote timely weight regain may promote EBF and improve long-term infant growth.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"366"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of cardiovascular disease risk factors in Korean children: impact of various pediatric hypertension guidelines and application of the Korean blood pressure reference.","authors":"Jeong Yeon Kim, Sangshin Park, Heeyeon Cho","doi":"10.1186/s12887-025-05713-6","DOIUrl":"https://doi.org/10.1186/s12887-025-05713-6","url":null,"abstract":"<p><strong>Background: </strong>The global rise in pediatric hypertension (HTN) is a significant concern as it serves as a precursor to cardiovascular disease (CVD). To address this, we performed a comparative analysis of two guidelines for pediatric HTN: the 2017 American Academy of Pediatrics (AAP) and the 2016 European Society for Hypertension (ESH), applying the Korean blood pressure (BP) reference specifically to the Korean pediatric population.</p><p><strong>Methods: </strong>Data from 2,060 children and adolescents aged 10-18 years from the Korean National Health and Nutrition Examination Survey (2016-2018) were analyzed. BP was classified according to the AAP, the ESH, and the Korea Regional BP Classification (KRC). High BP was defined as BP exceeding the normotensive range.</p><p><strong>Results: </strong>The prevalence of high BP in Korean youth was significantly higher according to the AAP group than that in the ESH group (19.5% vs. 10.6%, P < 0.0001). Variations in prevalence were noted based on age, sex, and obesity. No significant differences were observed between the AAP and KRC groups in terms of high BP prevalence. The application of the AAP and KRC provided a more comprehensive reflection of CVD risk factors, including obesity and metabolic profiles, compared to the ESH. The KRC showed a tendency to classify more non-obese individuals as having elevated BP, although this difference was not statistically significant.</p><p><strong>Conclusions: </strong>In comparing the AAP, ESH, and KRC criteria in the Korean pediatric population, the KRC demonstrated a tendency to identify individuals with CVD risk factors as having high BP. This finding suggests that using the KRC as the criterion for high BP may facilitate earlier intervention in the management of CVD risk.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"364"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Kangaroo mother care method on weight gain in premature newborns: systematic review.","authors":"Ismael Bueno-Pérez, Cristian Martín-Vázquez, Pablo Martínez-Angulo, Natalia Calvo-Ayuso, Rubén García-Fernández","doi":"10.1186/s12887-025-05597-6","DOIUrl":"https://doi.org/10.1186/s12887-025-05597-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of the Kangaroo Mother Care method on weight gain in premature newborns.</p><p><strong>Methods: </strong>A systematic review was conducted in scientific databases, including Pubmed, Cochrane, Web of Science, and Scopus, as well as clinically relevant articles from Dialnet and Cuiden. The search covered the period from January 1, 2018, to December 31, 2023, using keywords and boolean operators \"AND\" and \"OR.\"</p><p><strong>Results: </strong>Nine studies meeting the inclusion criteria and undergoing critical reading were included. Despite the high heterogeneity, the results underscore the global relevance of the Kangaroo Mother Care Method, demonstrating that this method positively impacts weight gain in newborns. Additionally, the positive influence of breastfeeding and kinesthetic stimulation on the weight of these preterm infants was observed.</p><p><strong>Conclusions: </strong>The Kangaroo Mother Care method significantly benefits preterm newborns, improving weight gain. Breastfeeding and kinesthetic stimulation combined with KMC further enhance the benefits regarding the weight of preterm infants. These findings highlight the need for broader adoption of Kangaroo Mother Care with standardized protocols.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"365"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of calibrated abdominal compression plus transthoracic echocardiography to predict fluid responsiveness in critically ill infants: a diagnostic accuracy study.","authors":"Julien Gotchac, Anouk Navion, Yaniss Belaroussi, Roman Klifa, Pascal Amedro, Julie Guichoux, Olivier Brissaud","doi":"10.1186/s12887-025-05728-z","DOIUrl":"https://doi.org/10.1186/s12887-025-05728-z","url":null,"abstract":"<p><strong>Background: </strong>Predicting fluid responsiveness is challenging in infants. It is however crucial to avoid unnecessary volume expansion, which can lead to fluid overload. We tested the hypothesis that the stroke volume changes induced by a calibrated abdominal compression (ΔSV-AC) could predict fluid responsiveness in infants without cardiac disease.</p><p><strong>Methods: </strong>This prospective single center study of diagnostic test accuracy was conducted in a general pediatric intensive care unit (PICU). Children under the age of two with acute circulatory failure and requiring a 10 mL.kg^-1 crystalloid volume expansion over 20 min, ventilated or not ventilated, were eligible. Stroke volume was measured by transthoracic echocardiography at baseline, during a gentle calibrated abdominal compression (22 mmHg for 30 s), and after volume expansion. The area under the receiver operating characteristic curve (AUROC) of ΔSV-AC was measured to predict fluid responsiveness, defined as a 15% stroke volume increase after volume expansion.</p><p><strong>Results: </strong>Twenty-seven cases of volume expansion were analyzed, in 21 patients. Seventeen VE cases were administrated to spontaneously breathing children. Fluid responsiveness was observed in 12 cases. The AUROC of ΔSV-AC was 0.93 (95% confidence interval (95%CI) 0.82-1). The best threshold value for ΔSV-AC was 9.5%. At this threshold value, sensitivity was 92% (95%CI 62-100), specificity was 87% (95%CI 60-98), positive and negative predictive values were 85% (95%CI 60-95) and 93% (95%CI 66-99) respectively.</p><p><strong>Conclusions: </strong>Echocardiographic assessment of stroke volume changes induced by a calibrated abdominal compression is a promising method to predict fluid responsiveness in infants without cardiac disease hospitalized in PICU.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registration number NCT05919719, June 22, 2023, retrospectively registered, https://clinicaltrials.gov/study/NCT05919719 .</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"361"},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perforated peptic ulcers in children: a systematic review.","authors":"Stipe Vidović, Sara Borović, Marko Bašković, Joško Markić, Zenon Pogorelić","doi":"10.1186/s12887-025-05725-2","DOIUrl":"https://doi.org/10.1186/s12887-025-05725-2","url":null,"abstract":"<p><strong>Background: </strong>Perforated peptic ulcers (PPU) represent a significant complication of peptic ulcers, associated with high mortality. As no systematic review of the literature on PPU in children currently exists, this study aims to summarize findings from studies focusing on its risk factors, etiology, treatment modalities, and outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted following the PRISMA guidelines. A literature search was performed on 24 November 2024, using four electronic databases: Web of Science, Scopus, PubMed, and ScienceDirect. The inclusion criteria were studies published in English, focusing on perforated peptic ulcers in paediatric patients. The exclusion criteria were: studies published in languages other than English; publication formats such as conference abstracts, personal communications, and single case reports; studies focusing on non-perforated peptic ulcers; studies involving participants > 18 years; and studies reporting ulcer perforations outside the stomach or duodenum.</p><p><strong>Results: </strong>Out of 1963 records identified, 12 studies met the inclusion criteria and were included in the review. A total of 239 children with perforated peptic ulcers were analyzed, with a median age of 11 years (range 3.2-16.5 years). The results indicate that ulcer perforations were more prevalent in males (74.8%). Furthermore, duodenal perforations (73%) were more common than gastric perforations (27%). The most commonly reported symptoms were abdominal pain (n = 175, 73.2%), vomiting (n = 82, 34.3%), peritoneal signs (n = 79, 33%), and fever (n = 38, 15.9%). Subdiaphragmatic free air was detected in 141 patients (58.9%). Of the total number of patients, 207 (86.6%) were treated surgically, while 32 (13.4%) received conservative treatment. Regarding the surgical approach, most patients underwent open surgery (n = 143, 69%) compared to laparoscopic repair (n = 64, 31%). Among the surgical procedures, 114 involved simple sutures, with or without an omental patch. Postoperative complications were reported in 30 children (14.5%). Reoperation was required in 4 patients (1.9%), and mortality was recorded in 9 patients (3.8%).</p><p><strong>Conclusions: </strong>PPU was more prevalent in males and predominantly located in the duodenum. Ulcer suturing, with or without an omental patch, was the most commonly utilized treatment modality, demonstrating a relatively low complication rate. Further studies are needed to provide more comprehensive and unbiased evidence on PPU in children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"363"},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}