BMC Pediatrics最新文献

{"title":"Tracheobronchial pen cap and pen nib foreign body aspiration in 32 children: clinical features, CT findings, and bronchoscopic management.","authors":"Zhao Cheng, Qi Cheng, Ying Yang, Shuhua Wu","doi":"10.1186/s12887-026-07395-0","DOIUrl":"10.1186/s12887-026-07395-0","url":null,"abstract":"<p><strong>Background: </strong>Tracheobronchial foreign body aspiration is a common pediatric emergency. In recent years, aspiration of stationery-related objects such as pen caps and pen nibs has been increasingly encountered in school-aged children. These objects possess unique structural characteristics that may influence clinical presentation and management.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 32 pediatric patients with tracheobronchial foreign body aspiration caused by pen caps or pen nibs treated between January 2017 and December 2025. Clinical features, imaging findings, foreign body characteristics, bronchoscopic management, and outcomes were analyzed. The relationship between provision of a foreign body history and disease duration was evaluated.</p><p><strong>Results: </strong>All 32 patients were school-aged boys (mean age, 8.6 years). The most common symptoms were cough and wheezing. Chest CT was performed in 31 patients (96.9%) and identified/localized the foreign body in all examined cases; however, this retrospective study did not evaluate whether CT independently changed management or outcomes. Foreign bodies were most frequently located in the right main bronchus. All cases were successfully managed using rigid bronchoscopy, with flexible bronchoscopy used as an adjunct in one case. Patients who did not provide a clear or timely history of foreign body aspiration had a significantly longer disease course compared with those with a definite history (P < 0.001). No life-threatening complications occurred; however, clinically relevant events such as transient hemoptysis, airway edema, and pneumothorax were observed in individual cases.</p><p><strong>Conclusions: </strong>Stationery-related tracheobronchial foreign body aspiration predominantly affects school-aged boys and presents unique diagnostic challenges. Delayed or absent reporting of aspiration history is associated with prolonged disease duration. CT may be considered as a selective adjunct for localization and procedural planning in clinically stable children, particularly when the history is unclear or presentation is atypical, while rigid bronchoscopy remains the primary diagnostic and therapeutic modality.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262839","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":"What factors influence surgical decisions for post-NEC intestinal strictures in a 14-year, 325-case cohort?","authors":"Jinfeng Hou, Qingshuang Liu, Yi Wang, Zhenhua Guo, Wei Liu, Shengde Wu","doi":"10.1186/s12887-026-07356-7","DOIUrl":"10.1186/s12887-026-07356-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify preoperative factors associated with stoma use in infants with post-NEC intestinal strictures and to develop a pragmatic model estimating the probability of staged stoma strategy selection.</p><p><strong>Study design: </strong>A retrospective cohort of 325 infants who underwent surgery for NEC-related strictures at a single center (2010-2024) was analyzed. Preoperative variables were evaluated using LASSO logistic regression and multivariable modeling.</p><p><strong>Results: </strong>Four independent predictors associated with stoma use were identified: hematochezia, elevated CRP (> 8 mg/L), higher preoperative WBC, and lower weight at surgery. The model demonstrated good discrimination (AUC 0.814), with temporal validation AUC of 0.779.</p><p><strong>Conclusions: </strong>Preoperative inflammatory burden and lower weight at surgery were associated with stoma use in infants with post-NEC intestinal strictures. The model may support preoperative counseling and surgical planning, but should be interpreted as estimating the probability of stoma strategy selection in our institutional practice rather than defining objective indications for either stoma formation or primary anastomosis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262770","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":"Dysregulated expression of the EMX2OS/miR-34c-5p/TBL1XR1 regulatory axis: a novel signature for severe community-acquired pneumonia in children.","authors":"Yu Yan, Pengyi Wu, Dan Li, Xiao Zhou","doi":"10.1186/s12887-026-07390-5","DOIUrl":"10.1186/s12887-026-07390-5","url":null,"abstract":"<p><strong>Background: </strong>Molecular pathology of severe community acquired pneumonia (SCAP) stays undefined; EMX2OS displays dysregulated expression in inflammation-related conditions, meriting exploration of its SCAP role. This study sought to investigate the expression pattern and clinical significance of EMX2OS in SCAP.</p><p><strong>Methods: </strong>Serum samples were collected from SCAP patients and healthy controls. RT-qPCR was employed to measure expression levels of EMX2OS, miR-34c-5p, and TBL1XR1 in serum and in LPS-stimulated BEAS-2B cells. Cell viability was assessed using CCK-8 assay, apoptosis was evaluated by flow cytometry, and inflammatory cytokines TNF-α, IL-1β, and IL-6 were quantified by ELISA. Oxidative stress and ferroptosis markers including MDA, GSH, and iron were determined using commercial kits. Molecular interactions were verified by dual-luciferase reporter assay and RNA immunoprecipitation.</p><p><strong>Results: </strong>Serum EMX2OS and TBL1XR1 were upregulated whereas miR-34c-5p was downregulated in SCAP patients; EMX2OS demonstrated diagnostic utility and served as a risk factor. In LPS-stimulated BEAS-2B cells, EMX2OS and TBL1XR1 increased while miR-34c-5p decreased, accompanied by reduced viability, enhanced apoptosis, elevated inflammatory cytokines, and aberrant oxidative stress and ferroptosis markers, all of which were reversed by EMX2OS silencing. EMX2OS bound directly to and negatively regulated miR-34c-5p, which in turn bound directly to and suppressed TBL1XR1. Rescue experiments revealed that miR-34c-5p inhibition partially restored cellular injury phenotypes under EMX2OS silencing, and additional TBL1XR1 knockdown reversed these effects.</p><p><strong>Conclusions: </strong>Our findings suggest that EMX2OS is associated with inflammation, oxidative stress, and ferroptosis in SCAP, potentially by sponging miR-34c-5p to upregulate TBL1XR1.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982258","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":"Sub-threshold mental symptoms in rural Chinese adolescents: the roles of screen time and adverse childhood experiences.","authors":"Yongyang Wang, Changshun Dai, Chao Kong, Yujie Shi, Min Zhang, Tao Li","doi":"10.1186/s12887-026-07430-0","DOIUrl":"10.1186/s12887-026-07430-0","url":null,"abstract":"<p><strong>Background: </strong>Sub-threshold mental symptoms among adolescents are consistently on the rise, which hurts their academic and health development. Both screen time and adverse childhood experiences (ACEs) are linked to these sub-threshold mental symptoms. However, there haven't been many studies on adolescents in rural areas of China. This study could offer a useful reference and help for preventing and dealing with sub-threshold mental symptoms in rural Chinese adolescents.</p><p><strong>Methods: </strong>This study used a stratified whole population sampling method to look at screen time and ACEs in relation to subthreshold mental symptoms among 6,820 adolescents aged 16 to 18 in the rural areas of China. We performed generalized linear model analyses using both binary and ordinal logistic regressions to explore the associations of screen time and ACEs with subthreshold mental symptoms in these adolescents.</p><p><strong>Results: </strong>The rate of sub-threshold mental symptoms detected among adolescents in rural China was 21.9%. When it comes to screen time, 31.9% of the adolescents had less than 60 min per day, 51.3% had between 60 and 120 min per day, and 16.8% had more than 120 min per day. As for ACEs, 39.1% had no exposure, 14.2% had low exposure, and 46.7% had high exposure. The ordered logistic regression analysis revealed that, relative to adolescents who spent less than 60 min per day on screens and had no ACEs, those who spent more than 120 min per day on screens and had high ACEs exposure were at significantly greater risk for sub-threshold mental symptoms (OR = 2.97, 95% CI: 2.31-3.81, P < 0.001).</p><p><strong>Conclusions: </strong>Screen time and ACEs are linked to higher levels of subthreshold mental symptoms among adolescents in rural China. Moving forward, we should work on cutting down screen time and reducing ACEs exposure for these adolescents. This approach may reduce the incidence of subthreshold mental symptoms and enhance the general physical and mental well-being of rural Chinese adolescents.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262797","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":"Urinary NT-proBNP as a noninvasive biomarker for pediatric septic shock: a comparative study with serum levels.","authors":"Fauzi, Faisal, Rahmat Budi Kuswiyanto, Rini Rossanti, Dzulfikar Djalil Lukmanul Hakim, Sri Endah Rahayuningsih","doi":"10.1186/s12887-026-07371-8","DOIUrl":"10.1186/s12887-026-07371-8","url":null,"abstract":"<p><strong>Background: </strong>The 2024 Phoenix Sepsis Score (PSS) may not fully capture subclinical cardiovascular stress in pediatric sepsis. N-terminal pro-B-type natriuretic peptide (NT-proBNP), released under haemodynamic strain, is measurable in urine and serum and has been associated with cardiovascular dysfunction. This study aimed to compare urinary and serum NT-proBNP levels in pediatric sepsis and septic shock, evaluate their ability to differentiate these conditions, and examine their correlations with PSS.</p><p><strong>Methods: </strong>Participants aged 1 month-18 years with sepsis or septic shock according to PSS were included in this prospective cross-sectional analytical study at a tertiary hospital in Bandung, Indonesia. Urinary and serum NT-proBNP concentrations were measured within 48 h of diagnosis. Patients with preexisting heart, kidney, or urological problems were excluded. Main analyses included Mann-Whitney U, ROC curves, and Spearman correlations. To evaluate statistical stability, 1,000 bias-corrected and accelerated (BCa) bootstrap iterations, fragility index (FI) analysis, and time-adjusted sensitivity analyses were added.</p><p><strong>Results: </strong>Final analyses comprised 52 children (26 sepsis, 26 septic shock). Median urinary NT-proBNP levels were higher in septic shock than in sepsis (8,065 vs. 210 pg/mL; p = 0.003), as were serum NT-proBNP levels (1,655 vs. 200 pg/mL; p = 0.005). Urinary NT-proBNP had an AUC of 0.743 (95% BCa CI 0.584-0.867) for septic shock (cut-off > 9,550 pg/mL, specificity 100%, sensitivity 42.3%, FI = 4), whereas serum NT-proBNP showed an AUC of 0.726 (95% BCa CI 0.573-0.852; cut-off > 1,640 pg/mL, specificity 92.3%, sensitivity 50.0%, FI = 3). Sensitivity analyses confirmed performance stability when restricting collection to ≤ 6 h. Urinary NT-proBNP correlated weakly with PSS (r = 0.261; p = 0.031), while serum NT-proBNP did not (r = 0.221; p = 0.058).</p><p><strong>Conclusions: </strong>Urinary NT-proBNP demonstrated moderate discriminatory ability and high specificity for pediatric septic shock, comparable to serum NT-proBNP, although its correlation with PSS was modest. It may have potential value as an adjunctive rule-in biomarker for cardiovascular stress in pediatric sepsis, but not as a screening tool or replacement for clinical assessment. Further studies are needed to determine its broader clinical utility in pediatric sepsis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13712029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262824","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":"\"What happens at the doctor's?\": a qualitative study exploring social representations and experiential knowledge of medical consultation in 5-6 year-olds.","authors":"Hugues Faucheu, Alyssa Gaillet-Lagrange, Philippe Jaury, Louis-Baptiste Jaunay","doi":"10.1186/s12887-026-07336-x","DOIUrl":"10.1186/s12887-026-07336-x","url":null,"abstract":"<p><strong>Background: </strong>Medical consultations can be anxiety-provoking for young children, potentially affecting communication, examination, and adherence to care. While research has largely focused on procedural pain and fear of specific interventions, little is known about how preschool children conceptualize the medical consultation itself. Understanding children's social representations and experiential knowledge may help clinicians adapt communication and improve care experiences. This study explored the social representations and experiential knowledge of medical consultations in children aged 5-6 years.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted in France with forty-nine children aged 5-6 years, recruited from seven nursery schools. Data were collected through 39 semi-structured interviews, conducted individually or in small groups, during school-based activities inspired by the \"Teddy Bear Clinic\" model, in which children assumed the role of a parent caring for an ill cuddly toy. All interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis within an interpretivist framework.</p><p><strong>Results: </strong>Four interrelated themes described children's representations of medical consultations: (1) Attitudes and behaviour during medical consultations; (2) Representations of illness; (3) Understanding of medical examination and medical knowledge; (4) Representations of care and treatment. Illness was typically defined through single concrete symptoms and attributed to visible or imagined causes (falls, cold exposure, animals). Doctors were seen as identifying illness using instruments (e.g., stethoscope, thermometer, X-ray), and treatments were expected to be tangible and localised (bandages, injections, medication), sometimes with symbolic healing power. Children demonstrated coherent causal reasoning and actively engaged in caregiving behaviours toward their toys.</p><p><strong>Conclusion: </strong>Children aged 5-6 already hold structured, experience-based models of illness, examination, and treatment. These representations shape expectations of care and may influence anxiety and cooperation during consultations. Recognising and integrating children's perspectives-particularly their focus on concrete signs, diagnostic tools, and tangible treatments-may support more effective communication and child-centred consultations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262676","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":"Utility of an automatic and patient-triggered cardiac event recorder: experience in children.","authors":"Özlem Elkıran, Mehmet Öncül","doi":"10.1186/s12887-026-07447-5","DOIUrl":"10.1186/s12887-026-07447-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the diagnostic yield of an event recorder capable of automatic and manual recording in children with possible arrhythmia related symptoms.</p><p><strong>Methods: </strong>We evaluated retrospectively 81 children monitored with Novacor event recorder system between September 2021 and September 2024. All of the patients performed 12-lead electrocardiogram (ECG), 24-hour-Holter monitoring, and echocardiography before the cardiac event recording.</p><p><strong>Results: </strong>Indications for cardiac event recorder monitoring were palpitations in 59 (72.8%) patients, chest pain and palpitations in 19 (23.5%) patients, and palpitations and presyncope in 3 (3.7%) patients. After a mean monitoring period of 14.40 ± 7.79 days, 65 (80%) children described symptoms and 41(63%) children had automatically or manually recorded arrhythmias. 63% of these arrhythmias were correlated with the symptoms. Of the 16 (19,8%) patients who were asymptomatic during the enrollment period, 9 (56%) had arrhythmia recorded with automatic arrhythmia detection property only. A total of 107 arrhythmias episodes were registered; forty-six (43%) episodes were patient triggered, and 61 (57%) were automatically recorded. While 24-hour-Holter monitoring detected a clinical diagnosis in 13 patients (16.7%), event recorder diagnosed clinical arrhythmia in 41 children (63%). Based on the event recorder and findings, 10 (12,3%) patients received an electrophysiology study/ablation.</p><p><strong>Conclusion: </strong>We found that the automatic mode of the device provided additional clinical and therapeutic consequences. For this reason, a cardiac event recorder capable of automatically and manually recording may be a more preferable method in children with potentially arrhythmia related symptoms. Studies with larger patient series may provide illuminating data in this area.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135136","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":"The association between perceived bullying in physical education classes and school satisfaction among middle school students: the mediating roles of physical activity enjoyment and physical education class happiness.","authors":"Mehmet Güllü, Mehmet Akarsu, Hasret Tan, Ecesu Karakaş, Gül Polat Günata, Serpil Akçınar","doi":"10.1186/s12887-026-07376-3","DOIUrl":"10.1186/s12887-026-07376-3","url":null,"abstract":"<p><strong>Background: </strong>Bullying is an important child and adolescent health concern associated with psychosocial adjustment, school well-being, and school satisfaction. Physical education (PE) classes may represent a particularly sensitive context because they involve body visibility, peer comparison, physical performance, and intensive peer interaction. This study examined the association between perceived bullying in PE classes and school satisfaction among middle school students and tested whether physical activity enjoyment and PE class happiness statistically mediated this association.</p><p><strong>Methods: </strong>This cross-sectional correlational study included 616 middle school students from Malatya, Türkiye. Data were collected using validated measures of perceived bullying in PE classes, physical activity enjoyment, PE class happiness, and school satisfaction. A four-factor latent measurement model and the hypothesized structural mediation model were estimated using robust maximum likelihood. Measurement validity and reliability were evaluated using confirmatory factor analysis, composite reliability, average variance extracted, and the heterotrait-monotrait ratio.</p><p><strong>Results: </strong>The four-factor measurement model demonstrated acceptable fit to the data (χ²/df = 2.22, CFI = 0.922, TLI = 0.916, RMSEA = 0.045, SRMR = 0.044), and HTMT values supported discriminant validity. Perceived bullying in PE classes was negatively associated with physical activity enjoyment (β = -0.157, p < .001), PE class happiness (β = -0.181, p < .001), and school satisfaction (β = -0.096, p = .042). Physical activity enjoyment (β = 0.237, p < .001) and PE class happiness (β = 0.201, p < .001) were positively associated with school satisfaction. Both indirect associations were statistically significant but small in magnitude (β = -0.037, p = .006; β = -0.036, p = .010), and the direct association between perceived bullying and school satisfaction was also small (β = -0.096, p = .042). The model explained 16.9% of the variance in school satisfaction, whereas perceived bullying explained 2.3% and 3.1% of the variance in physical activity enjoyment and PE class happiness, respectively, indicating modest practical explanatory power.</p><p><strong>Conclusions: </strong>Perceived bullying in PE classes was associated with lower school satisfaction both directly and indirectly through lower physical activity enjoyment and lower PE class happiness. However, these associations were modest and should not be interpreted as causal because of the cross-sectional design. The findings support efforts to promote psychologically safe and inclusive PE environments as part of school health and bullying prevention strategies.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13712069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262772","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":"Serum ferritin and hematological indices in children with attention-deficit/hyperactivity disorder: a matched case-control study.","authors":"Ezatollah Abbasi, Alireza Abdi, Mostafa Farshi","doi":"10.1186/s12887-026-07433-x","DOIUrl":"10.1186/s12887-026-07433-x","url":null,"abstract":"<p><strong>Background: </strong>ADHD is a common neurodevelopmental disorder with substantial clinical heterogeneity. Iron is essential for brain development and dopaminergic function, and altered iron homeostasis may contribute to ADHD pathophysiology. However, evidence on peripheral iron biomarkers remains inconsistent. To compare iron-related biomarkers and hematological indices between children with ADHD and neurotypical controls and to assess whether serum ferritin is independently associated with ADHD.</p><p><strong>Methods: </strong>This age- and sex-frequency-matched case-control study included 50 children with ADHD recruited from the pediatric neurology and child psychiatry outpatient clinics and 50 neurotypical controls recruited from the general pediatric outpatient clinic of the same tertiary hospital between March 2023 and March 2024. Serum ferritin, serum iron, total iron-binding capacity (TIBC), hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were measured using standardized laboratory methods. Group comparisons were performed using independent-samples t tests and chi-square tests. Multivariable logistic regression was used to examine the independent association between ferritin and ADHD after adjustment for relevant covariates.</p><p><strong>Results: </strong>Children with ADHD had significantly lower serum ferritin levels than controls (38.4 ± 17.4 vs. 51.2 ± 19.8 ng/mL; p < 0.001). Serum iron was also lower in the ADHD group (83.3 ± 25.0 vs. 97.6 ± 22.4 µg/dL; p = 0.004), whereas TIBC was higher (356 ± 48 vs. 334 ± 42 µg/dL; p = 0.019). Iron deficiency (ferritin < 30 ng/mL) was more common in children with ADHD (34.0% vs. 14.0%; p = 0.018). Hemoglobin, MCV, MCH, and MCHC did not differ significantly between groups. In multivariable analysis, lower ferritin remained independently associated with ADHD (adjusted OR = 1.42 per 10 ng/mL decrease; 95% CI: 1.08-1.86; p = 0.011).</p><p><strong>Conclusion: </strong>Children with ADHD had lower iron stores despite largely normal routine hematological indices. These findings support a potential role for altered iron metabolism in ADHD and suggest that ferritin assessment may provide clinically useful information beyond routine blood counts.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13700121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262856","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":"Estimating national prevalence of life-limiting conditions amongst infants, children, and adolescents using administrative hospital data in the absence of a unique health identifier; evidence from Ireland.","authors":"Samantha Smith, Tara Delamere, Lorna K Fraser, Orla Murphy, Peter May, Fiona McElligott, Mary Devins, Tyrone Horne, Mary Rabbitte, Suzanne Guerin, Sinéad O'Hara, Maurice Dillon, Joanne Balfe","doi":"10.1186/s12887-026-07003-1","DOIUrl":"10.1186/s12887-026-07003-1","url":null,"abstract":"<p><strong>Background: </strong>Estimating the total number of children with a life-limiting, complex chronic condition or serious illness has been identified as an important first step in determining how many children might need palliative care in a country or region. Relevant estimates have not been calculated for Ireland, an exercise complicated by the country's lack of a fully operational unique patient identifier in healthcare data.</p><p><strong>Methods: </strong>This study estimated prevalence of life-limiting conditions amongst children aged 0-19 in Ireland in 2019 and 2024, demonstrating methods in the absence of a unique identifier. Baseline hospital-based prevalence calculated as (estimated) number of inpatients with a life-limiting diagnoses per 10,000 population aged 0-19 in Ireland, 2019 (pre-Covid) and 2024 (most recent year available). Number of inpatients were estimated from discharge-level data under 3 alternative scenarios (E1, E2, E3) adjusting for multiple admissions in the data. In sensitivity analysis, adjusted prevalence estimates further corrected for sources of under-counting in the data.</p><p><strong>Results: </strong>Baseline estimated total prevalence of life-limiting conditions amongst children aged 0-19 in Ireland between 34.8 (E3) and 50.0 (E1) per 10,000 population in 2019; between 32.3 (E3) and 44.5 (E1) per 10,000 population in 2024. In sensitivity analysis, correcting for potential under-counting in the data, adjusted estimated prevalence: between 46.4 (E3) and 66.6 (E1) per 10,000 population in 2019; and between 43.0 (E3) and 59.3 (E1) per 10,000 population in 2024. Prevalence was higher for males than for females, and highest in the age group < 1 for all estimation scenarios.</p><p><strong>Conclusions: </strong>These are the first estimates of prevalence of life-limiting conditions amongst children in Ireland that have been calculated using Irish-specific hospital data. The estimates are in line with prevalence from other similar-income countries based on studies using similar definitions and methodologies. The findings demonstrate how careful application of transparent methods to routinely collected administrative hospital activity data can yield important findings even in the context of data limitations.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599138","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}