BMC Pediatrics最新文献

{"title":"Factors associated with Mycoplasma pneumoniae-induced Lobar pneumonia with mucus plugging and the optimal timing for bronchoalveolar lavage: a retrospective study.","authors":"Guotao Zou, Yiwen Zeng","doi":"10.1186/s12887-025-05657-x","DOIUrl":"https://doi.org/10.1186/s12887-025-05657-x","url":null,"abstract":"<p><strong>Background: </strong>Lobar pneumonia with mucus plugging (LPMP) caused by Mycoplasma pneumoniae (MP) is a severe form of community-acquired pneumonia in children, often leading to prolonged disease courses and complications. Identifying clinical factors associated with delayed radiographic resolution and determining the optimal timing for bronchoalveolar lavage (BAL) intervention are crucial for improving clinical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 151 children aged 2-14 years diagnosed with LPMP between November 2023 and July 2024. Patients were divided into two groups based on radiographic resolution at one month: common resolution (n = 83) and delayed resolution (n = 68). Clinical data, laboratory results, and timing of BAL intervention were compared between groups. Multivariate logistic regression identified independent risk factors of delayed resolution, and receiver operating characteristic (ROC) curves assessed predictive performance.</p><p><strong>Results: </strong>Children in the delayed resolution group had significantly longer fever durations before intervention (P < 0.001), higher C-reactive protein levels (P < 0.001), and elevated lactate dehydrogenase levels (P < 0.001) compared to the common resolution group. Multivariate analysis identified elevated D-dimer levels (P = 0.010), delayed BAL intervention (P < 0.001), and prolonged hospital stay (P = 0.044) as independent risk factors of delayed resolution. ROC analysis showed that BAL intervention within 6 days had excellent predictive accuracy. Early BAL intervention was associated with shorter hospital stays (P < 0.001), faster cough resolution (P < 0.001), lower incidence of atelectasis at one month (P = 0.024), and higher rates of lung consolidation absorption (P < 0.001).</p><p><strong>Conclusion: </strong>Elevated D-dimer levels, delayed BAL intervention, and prolonged hospital stay are significant associated with delayed radiographic resolution in children with LPMP. Early BAL intervention within 6 days of admission improves clinical outcomes by accelerating recovery and reducing complications. These findings support prompt BAL as a key component in the management of pediatric LPMP.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"299"},"PeriodicalIF":2.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981035","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":"Maternal refugee status is associated with less favourable motor performance and behaviour in term infants referred to a neonatal ward: a cross-sectional study.","authors":"Sevil Üzer, Suzan Sahin, Meltem Koyuncu Arslan, Mehmet Yekta Oncel, A Sebastian Schroeder, Mijna Hadders-Algra","doi":"10.1186/s12887-025-05658-w","DOIUrl":"https://doi.org/10.1186/s12887-025-05658-w","url":null,"abstract":"<p><strong>Background: </strong>Anxiety and depression are highly prevalent among Syrian refugees. Anxiety and depression during pregnancy may impair infant neurodevelopment. This study evaluated whether potential maternal anxiety and depression in Syrian refugee and native Turkish mothers were associated with less favourable neonatal neurodevelopment.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Turkish (n = 64) and Syrian (n = 17) term-born infants (37-41 weeks' gestation) referred to a level II-III neonatal intensive care unit in Izmir were assessed shortly after birth (median 5 days) together with their mothers. The Test of Infant Motor Performance (TIMP) was the primary outcome measure. In addition, we evaluated crying behaviour during the TIMP-assessment and performed General Movements Assessment (GMA). Mothers completed Beck Anxiety and Beck Depression Inventories in their native languages. Univariate and multivariate statistics were applied.</p><p><strong>Result: </strong>Perinatal social characteristics of both groups were similar. TIMP scores of Syrian infants were significantly lower than those of Turkish infants (45.53 (SD 7.10) vs. 51.59 (SD 8.59), respectively (p = 0.009)). Sixteen Turkish infants (25%) and ten Syrian infants (59%) had TIMP z-scores below - 1 SD (unadjusted OR = 1.27 (95%CI 1.06-1.54); adjusted OR = 1.30 (95%CI 1.05-1.61)). At TIMP-assessment's end, more Syrian infants cried (29%) compared to Turkish infants (8%; unadjusted OR 4.92 (95%CI 1.23-19.67). This association lost significance after adjustment (OR = 4.87; 95%CI 0.77-31.01). GMA ratings of both groups were similar (definitely abnormal Turkish infants (n = 5; 8%); Syrian infants (n = 1; 7%); unadjusted OR = 0.91 (95%CI 0.30-2.78); adjusted OR = 1.66 (95%CI 0.42-6.61)). Anxiety and depression scores of both mothers` groups were low (median anxiety scores of Syrian mothers 0, Turkish mothers 1; median depression scores of Syrian mothers 0, Turkish mothers 2.5). The low maternal anxiety and depression scores were not associated with the infants' TIMP scores.</p><p><strong>Conclusions: </strong>Maternal refugee status was associated with less favourable neonatal motor performance, with about half of the Syrian refugee newborns having a TIMP score indicating the need for close monitoring of development and a potential need for early intervention. Motor performance was not associated with maternal reports of anxiety and depression. Nonetheless, the study suggests that the neurodevelopment of babies born to refugee mothers should be carefully monitored to enable early intervention whenever required.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"297"},"PeriodicalIF":2.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964983","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 data required for the approval of pediatric pharmaceuticals in Japan.","authors":"Hisamitsu Haigo, Kenji Matsuda, Mayumi Shikano","doi":"10.1186/s12887-025-05646-0","DOIUrl":"https://doi.org/10.1186/s12887-025-05646-0","url":null,"abstract":"<p><strong>Background: </strong>In Japan, the number of pharmaceuticals with pediatric indications is low, and some are approved only in Europe or the USA but not in Japan. As the approval review report by the Japanese health authority contains any detailed items considered for drug approval, this study aimed to analyze the review reports and elucidate data types that facilitate the approval of pediatric drugs in Japan.</p><p><strong>Methods: </strong>We identified products approved in Japan, extracted relevant product- and review-related information, and summarized the characteristics of pediatric drug clinical data and drug approval procedures.</p><p><strong>Results: </strong>Among 625 products (approved 04/2019-02/2024), 171 with pediatric indications were analyzed. The approval review considered orphan drug designation for 56 products, public knowledge-based application for 16 products, mandatory post-marketing surveillance for 42 products, and investigator-initiated studies for 11 products. For only 10 products, confirmatory studies were completed exclusively in Japanese children. Among the other 161 products, extrapolation from non-Japanese children and Japanese adults and/or older children was discussed for 93 and 100 products, respectively. Extrapolation-based reviews focused on ethnic and population factors and consistency of exposure dose, efficacy, and safety. Statistical confirmation is not always necessary for approval. Administrative incentives are often applied, including for orphan drugs and Sakigake designation and public knowledge-based applications.</p><p><strong>Conclusions: </strong>The appropriateness or sufficiency of the clinical data package can refer to the PMDA. By considering joining a multinational study and determining the required number of Japanese patients, a path toward the approval of pediatric drugs in Japan can be identified.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"289"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953913","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":"A nested case-control analysis of factors influencing preoperative hospitalization fear in pediatric patients and the alleviating effects of child-friendly visual interventions.","authors":"Liuxia Bian, Tingting Zhang, Yushan Wu, Xiaomin Shan","doi":"10.1186/s12887-025-05571-2","DOIUrl":"https://doi.org/10.1186/s12887-025-05571-2","url":null,"abstract":"<p><strong>Background: </strong>Preoperative fear in pediatric patients can significantly impact their psychological well-being and complicate perioperative care. Traditional hospital environments may exacerbate anxiety in children undergoing elective surgeries, especially given developmental differences across ages 2 to 12.</p><p><strong>Methods: </strong>In a retrospective hospital-based nested case-control study embedded within a cohort, we examined 188 children aged 2 to 12 admitted for elective surgery between March 2023 and March 2024. Participants met specific inclusion criteria and We defined cases as those with a Child Medical Fear Scale (CMFS) score > 30 (High Fear Group) and controls as those with CMFS ≤ 30 (Low Fear Group). Further stratification was based on hospitalization in conventional wards a conventional environment versus specially designed wards featuring \"child-friendly visual intervention strategies\" (e.g., cartoon themes, interactive toys, multimedia TVs). Standard Routine pre-hospital care (Treatment as Usual) and detailed procedural explanations were provided. Fear Preoperative fear was assessed using the CMFS at admission and before surgery, while parental satisfaction was evaluated with the Patient Satisfaction Questionnaire Short Form (PSQ-18).</p><p><strong>Results: </strong>Among 188 children (mean age 7.57 ± 2.15 years; 64/124 male), 74 cases (high fear) and 71 controls (low fear) were analyzed. No significant demographic differences were observed between groups. Key correlates of higher fear included lower educational status (OR = 0.400, 95% CI = 0.200-0.801; P = 0.010) and higher ASA status (OR = 2.273, 95% CI = 1.035-4.989; P = 0.041). Environmental stressors such as visibility of sharp instruments (OR = 2.294, 95% CI = 1.048-5.021; P = 0.038) and observing injections (OR = 2.565, 95% CI = 1.183-5.557; P = 0.017) were significant anxiety factors. The child-friendly intervention group (n = 43) exhibited significantly lower fear scores across all dimensions compared to the conventional group (n = 35), with a higher proportion achieving CMFS ≤ 30 (76.74% vs. 51.43%; P = 0.019) and greater parental satisfaction (79.07% vs. 51.43%; P = 0.010).</p><p><strong>Conclusion: </strong>Both individual (e.g., educational status, past hospital experiences) and environmental factors (e.g., visibility of needles) play critical roles in pediatric preoperative fear. Implementing child-friendly visual interventions significantly alleviates reduces anxiety and improves parental satisfaction. These findings Our results support the adoption of such strategies in pediatric surgical care and highlight the importance of age-appropriate interventions.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"292"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976046","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":"Tiny needles, major benefits: acupuncture in child health.","authors":"Xiaobin Ge, Gonglei Yue, Guangzhong Du, Xue Fang","doi":"10.1186/s12887-025-05586-9","DOIUrl":"https://doi.org/10.1186/s12887-025-05586-9","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively investigate the utilization patterns and clinical indications of acupuncture within the pediatric population in general hospitals from 2015 to 2020, including disease spectrum characteristics and relevance to pediatric subspecialties.</p><p><strong>Methods: </strong>The clinical data of pediatric inpatients consulted by Acupuncture-Moxibustion and Tuina Department of Qilu Hospital of Shandong University was collected from January 1, 2015, to December 31, 2020. The data collected include the number of wards in which consultation was requested, the diseases that require consultation, the distribution of pediatric tertiary disciplines and the system of disease affiliation.</p><p><strong>Results: </strong>This study summarizes 55 types of pediatric diseases treated with acupuncture. The most common health issues addressed include peripheral facial paralysis, diarrhea, reduced limb mobility or decreased muscle strength, postoperative bloating, and Guillain-Barré syndrome. Acupuncture is utilized across all pediatric subdisciplines, with notable applications in neurology, critical care medicine, general surgery, respiratory medicine, and orthopedics. The classification of diseases for acupuncture consultations primarily focuses on disorders of the nervous system, respiratory system, neoplasms, and digestive system (according to ICD-11).</p><p><strong>Conclusions: </strong>In summary, acupuncture has a broad range of applications in the treatment of pediatric diseases and can serve as a valuable complementary and alternative therapy. The advancement of Traditional Chinese Medicine (TCM) acupuncture in general hospitals is closely linked to the involvement of pediatric practices. The findings of this study provide valuable insights for clinical practice, acupuncture education, pediatric healthcare systems, and social research.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"290"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965272","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":"Prevalence and perinatal risk factors of growth retardation in congenital diaphragmatic hernia survivors.","authors":"Soo Hyun Kim, Sung Hyeon Park, Ha Na Lee, Jungbok Lee, Jiyoon Jeong, Hyunhee Kwon, Euiseok Jung, Jung-Man Namgung, Byong Sop Lee","doi":"10.1186/s12887-025-05631-7","DOIUrl":"https://doi.org/10.1186/s12887-025-05631-7","url":null,"abstract":"<p><strong>Background: </strong>Growth retardation (GR) is one of the major morbidities in congenital diaphragmatic hernia (CDH). This study aimed to investigate the prevalence and perinatal risk factors of growth failure in CDH survivors.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of isolated CDH patients with gestational age ≥ 35 weeks who survived to 3 years of age. Weight and length(height) were measured at 1 year, 2 and 3 years of age. GR was defined when the Z-score of weight or height was below - 2.0. We analyzed and compared the prenatal and clinical characteristics, including anthropometric data, fetal lung volume measurement, and treatment modalities during initial hospitalization, between the GR group and the non-GR group.</p><p><strong>Results: </strong>Of the 116 patients with isolated CDH, 86 patients survived to NICU discharge (74.1%). A total of 77 patients who survived 3 years of age with follow-up growth parameters available were included in the study analysis. The rates of GR at 1 year, 2 and 3 years of age was 15.6% (12/77), 14.3% (11/77), and 23.4% (18/77) respectively. Patients with GR at any of the three time points were classified into the GR group (20/77, 26%). Compared with the non-GR group, GR group had lower weight at birth. The incidence of systemic corticosteroid use, mostly with hydrocortisone, were greater in the GR group than the non-GR group. The parameters that indicate disease severity, including observed-expected lung-to-head ratio, liver herniation, inhaled nitric oxide use, ECMO, patch repair did not differ between the two groups. Multivariate analysis revealed that low birthweight and systemic corticosteroid use were associated with increased odds of GR. Cumulative corticosteroid exposure was associated with impaired height growth, particularly during the first two years.</p><p><strong>Conclusion: </strong>For the first 3 years of age, GR was observed a significant portion of CDH survivors. Early identification of high-risk patients and targeted interventions, including minimizing corticosteroid exposure and optimizing nutritional support, may improve growth outcomes in this vulnerable population.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"295"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960907","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":"Placental histology for infants with hypoxic ischaemic encephalopathy compared with healthy controls: a case-control study.","authors":"Áine Fox, Emma Doyle, Adam Reynolds, Michael Geary, Rocco Cuzzilla, Breda Hayes","doi":"10.1186/s12887-025-05652-2","DOIUrl":"https://doi.org/10.1186/s12887-025-05652-2","url":null,"abstract":"<p><strong>Background: </strong>The role of the placenta in the development of hypoxic ischaemic encephalopathy (HIE) remains undefined. There is limited research comparing placental histology for infants with HIE and healthy controls. This is limiting our ability to understand its role in HIE. This study hypothesised that placental pathology is more common in infants with HIE compared with healthy infants and aimed to report the differences in placental histology between infants with HIE and healthy controls.</p><p><strong>Methods: </strong>A case-control study of infants with moderate andsevere HIE and healthy controls at a single tertiary Neonatal Intensive Care Unit. Placental histology was reviewed by one perinatal histopathologist using consensus guidelines.</p><p><strong>Results: </strong>Seventy-four cases and 98 controls were included. Cases had a higher incidence of pathology, including fetal vascular malperfusion, histological chorioamnionitis and delayed villous maturation.</p><p><strong>Conclusion: </strong>This study demonstrates a higher incidence of placental pathology for infants born with HIE suggesting that the placenta is an important factor in the pathogenesis of HIE. Further research is required to delineate this relationship.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"294"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975188","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":"Feeding behavior in caregivers of 6- to 24-month-old infants and young children: a cross-sectional study from a district in a first-tier city in the southwestern region of China.","authors":"Yao Gu, Wentao Peng, Biru Luo, Xiufang Zhao, Li Zhao, Yuxin Tang, Xin Guo, Xiaomei Liu","doi":"10.1186/s12887-025-05622-8","DOIUrl":"https://doi.org/10.1186/s12887-025-05622-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify the correlation between feeding behavior of caregivers and feeding outcome of 6-24 months old infants and young children in a first-tier city in the southwestern region of China. The influencing factors of feeding behavior were explored in this study.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in 3 community health service centers in Chengdu, China from November 2017 to January 2018. A total of 725 infants and their caregivers participated in this study. Infant and young child feeding index (ICFI) was used to evaluate food preparation behavior. A questionnaire designed based on responsive feeding behavior (RFB) was used to evaluate the interaction behavior in the feeding process. The Z-score and the Montreal Children's Hospital Feeding Scale (MCH-FS) were used to evaluate the feeding outcomes.</p><p><strong>Results: </strong>The prevalence of short stature and feeding difficulties was 12.1% and 61.5%, respectively, among infants and young children. The RFB score negatively correlated with feeding difficulties but did not statistically significantly correlate with malnutrition rate. The RFB score was influenced by caregivers' relationship with the child and health belief, including self-efficiency, benefit perception, attention to searching information on websites, and attention to employing professional nurses. ICFI negatively correlated with the rate of underweight but did not statistically significantly correlate with feeding difficulties. ICFI was influenced by the caregivers' age, registered residence, and health belief, including obstacle perception and attention to reading a book on feeding.</p><p><strong>Conclusions: </strong>Searching the information regarding RFB on websites and making a feeding plan with the help of professional nurses may enhance caregivers' RFB. Convenient and attractive reading materials might help caregivers overcome obstacles and adopt better feeding behavior.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"296"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976054","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":"Family-centered care in neonatal and pediatric critical care units: a scoping review of interventions, barriers, and facilitators.","authors":"Bayan Aljawad, Shaima Ali Miraj, Furqan Alameri, Husam Alzayer","doi":"10.1186/s12887-025-05620-w","DOIUrl":"https://doi.org/10.1186/s12887-025-05620-w","url":null,"abstract":"<p><strong>Introduction: </strong>The Family-Centered Care (FCC) model has been linked to improved clinical outcomes and family satisfaction. However, implementing this model can be challenging, especially in neonatal and pediatric critical care units. This review aims to map the literature on FCC in neonatal and pediatric critical care units, identify barriers and facilitators of effective interventions, and suggest a practical step-by-step approach for implementing FCC interventions.</p><p><strong>Methods: </strong>This scoping review was guided by the PRISMA-ScR guidelines and followed the Arksey and O'Malley 5-step scoping review framework. We accessed the databases on the 28 th of April, 2024, and included all prospective and randomized controlled trials (RCT) implementing FCC interventions from PubMed and Web of Science databases. Data were organized, tabulated, and described narratively.</p><p><strong>Results: </strong>Out of 1,577 potentially relevant citations after duplicate removal, 17 articles met our eligibility criteria (4 RCTs and 13 prospective studies). Nine of these studies were conducted in neonatal intensive care units (NICU) and eight in pediatric intensive care units (PICU). Three NICU interventions were single-type interventions, while six were part of comprehensive programs; in the PICU, seven were single-type interventions and one was part of a comprehensive program. All interventions incorporated elements of FCC principles (respect, information sharing, collaboration, and participation). Barriers included institutional factors, provider attitudes, cultural issues, communication challenges, environmental constraints, training needs, and emotional stress. FCC facilitators included enhanced environment, empowerment and training, supportive Infrastructure, collaborative communication, parental Involvement, adaptive interventions, and continuous feedback.</p><p><strong>Conclusion: </strong>Effective implementation of FCC interventions requires careful planning and needs assessment. It ensures management support, regular staff training, family orientation, and a continuous feedback loop. Incorporating FCC principles and delivering culturally acceptable interventions is key while acknowledging possible barriers and utilizing available facilitators. FCC interventions can help foster a healthcare culture that values partnerships with families and can transform the neonatal and pediatric critical care experience for patients, families, and providers alike.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"291"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983054","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":"Spinnaker-sail sign in full-term neonates with spontaneous pneumomediastinum: a case study and scoping literature review.","authors":"Ali Zamlout, Bushra Jamahiri, Elisar Jabbour","doi":"10.1186/s12887-025-05641-5","DOIUrl":"https://doi.org/10.1186/s12887-025-05641-5","url":null,"abstract":"<p><strong>Background: </strong>Pneumomediastinum is a condition that is occasionally observed in preterm neonates, characterized by the presence of free air within the mediastinal spaces. Spontaneous Pneumomediastinum (SPM) in full-term neonates is a rare form. The clinical spectrum ranges from asymptomatic cases to severe respiratory distress.</p><p><strong>Objective: </strong>To highlight the diagnostic challenges posed by the \"spinnaker-sail sign\", and to create a stepwise framework for clinicians encountering similar cases.</p><p><strong>Methods: </strong>We present two cases of SPM in a full-term neonate. Case-1: a 2-day-old boy with respiratory distress exhibited on CXR a crescentic radiolucent configuration elevating the thymus from the pericardium (\"spinnaker-sail\" sign). CT demonstrated an extrapulmonary multiseptated cystic mass within the anterior mediastinum. The neonate was treated with supplemental oxygen and antibiotics, showing improvement by day 11. Case-2: a 6-hour-old boy presented with respiratory distress shortly after birth. CXR showed the spinnaker-sail sign, alongside a band of air overlying the left hemidiaphragm (\"Extrapleural air\" sign). Lateral projection revealed mediastinal air collection lifting the thymus from the pericardium and great vessels. He was managed with oxygen moisture and antibiotics, showing significant improvement by day 4.</p><p><strong>Discussion: </strong>The pathophysiology stems from uneven inflation and minute ruptures of immature alveoli, allowing air to leak through peribronchial and perivascular fasciae into the mediastinum. A fetal-remnant fascia entraps this air behind the thymus, constituting the \"spinnaker-sail\" appearance. The clinical course is typically benign. The management mainly involves supplemental oxygen and close monitoring. In severe cases, interventions such as needle decompression or chest tube insertion may be warranted.</p><p><strong>Conclusion: </strong>Unfamiliar radiographic patterns of PM in neonates pose diagnostic challenges and interventional hazards. Understanding the unique anatomy of the mediastinum in neonates is essential to formulate a proper diagnosis and management strategy.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"293"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974468","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}