2026-04-01
Thuy Nguyen Thi Mai, Thao Nguyen Phuong
ObjectiveThe objective of this work is to evaluate the safety and short-term outcomes of laparoscopic dismembered pyeloplasty (LDP) for ureteropelvic junction obstruction (UPJO) in children, based on a single-surgeon experience using a transabdominal suspension technique.MethodsWe retrospectively analyzed children with UPJO between January 2023 and October 2024 who underwent transperitoneal LDP with a transabdominal suspension maneuver performed by a single surgeon. The diagnosis was confirmed by ultrasonography and magnetic resonance urography. The outcomes were operative time, complications, hospital stay, and postoperative hydronephrosis reduction, assessed by ultrasonography at least 3 months after the operation.ResultsA total of 60 children with a mean age of 58.5 months (range: 6–168 months) underwent surgery during the study period; of these, 47 were boys. The mean operative time was 140 min (range: 120–200 min). No open conversions or major complications occurred. The mean hospital stay was 3.5 days. The median pelvic diameter decreased from 35.6 mm (range: 25–50 mm) preoperatively to 13.5 mm (range: 8–22 mm) postoperatively (p < 0.05). All patients were free from symptoms with reduced hydronephrosis during the follow-up period.ConclusionsTransperitoneal laparoscopic dismembered pyeloplasty is a safe and effective option in the treatment of UPJO, and a transabdominal suspension technique may facilitate the procedure.
DOI: 10.3389/fped.2026.17356512026-04-01
Zelong Miao, Yuanyuan Xue, Chengxin Li, Chaohui Xing, Hao Jiang, Tianxiang Wang, Dongyuan Zhang, Qian Li, Yi Liu, Chenxi Wang, Yuansong Zhao, Zhong Zhang, Dechen Song, Bin Jia
BackgroundAdolescent idiopathic scoliosis (AIS) and foot biomechanical disorders are significant public health concerns, impacting physical function and quality of life. Despite national screening mandates, regional data remain sparse.MethodsWe conducted a school-based screening study to investigate the prevalence of scoliosis and foot-related biomechanical abnormalities among adolescents in Haidian District, Beijing, China. A total of 1,419 participants (739 males and 680 female) from primary and middle schools underwent spinal and plantar health assessments using standardized protocols, including the Adams forward bend test with a scoliometer, Foot Posture Index-6 (FPI-6), and static/dynamic plantar pressure analysis.ResultsThis cross-sectional study of 1,419 Beijing adolescents revealed a 2.04% prevalence of scoliosis (29 cases), showing significant female predominance (3.53% vs. 0.68%; χ2 = 14.397, p < 0.001, φ = −0.101, Cramer's V = 0.101). Scoliosis prevalence showed distinct developmental patterns, with a significant increasing trend across grades (p = 0.011). Clear peaks were observed in 6th (4.22%) and 9th (4.35%) grades, where cases significantly exceeded expected counts, though the reliability of estimates for upper grades (11th-12th) may be limited by smaller sample sizes (48 and 18 participants, respectively). In contrast, the detection rate of foot abnormalities was slightly higher among males (47.8% vs. 43.4%), this difference did not reach statistical significance (p = 0.098), and the effect size was negligible (Phi = 0.044). This indicates that foot abnormalities represent a common health concern affecting both sexes. Significant variation in foot abnormality prevalence was observed across grades [χ2(11) = 36.98, p < 0.001], peaking sharply at school entry (62.7% in 1st grade) and then declining rapidly through elementary school. Prevalence stabilized during middle adolescence, with a non-significant apparent rebound in the small 12th-grade sample requiring cautious interpretation.ConclusionsKey findings highlight the need for early and targeted interventions within school health programs. A gender-stratified approach is recommended: implementing gender-sensitive screening for scoliosis, while adopting universal promotion measures for foot health. Specific priorities include increasing flatfoot screening frequency among 1st–2nd grade boys and enhancing posture-related health education for adolescent girls during key transitional growth phases. These strategies aim to mitigate long-term musculoskeletal complications.
DOI: 10.3389/fped.2026.17490702026-04-01
Ruchius Philbert, Hadija Mwamtemi, Tom Okade, Huzaifah Mutyaba, Lilian Ndyetabula, Esther Shimba, Nana Jacqueline Nakiddu, Emmanuel Elisha, Wende Clarence Safari, Faraja Chiwanga, Lulu Chirande
BackgroundThe Tanzanian healthcare system is complex, and weaknesses in referral pathways for time-sensitive conditions such as cancer contribute to poor outcomes among pediatric oncology patients. Early presentation and timely diagnosis are essential for improving survival in pediatric leukemia; however, evidence describing delays within Tanzania's referral system and their effects on early survival in children with acute lymphoblastic leukemia (ALL) remains limited. This study addresses this gap by characterizing patient pathways, estimating time to presentation and diagnosis, and assessing early survival among children with ALL treated at Muhimbili National Hospital (MNH).MethodsWe conducted a hospital-based retrospective observational cohort study among 64 pediatric patients with a confirmed diagnosis of ALL admitted to the Pediatric Oncology Unit of Muhimbili National Hospital between January and December 2024. Descriptive statistics were used to summarize patient pathways, presentation time, and diagnosis. Six- and twelve-month survival probability was estimated using Kaplan–Meier methods, and survival outcome differences were assessed using the log-rank test.ResultsSixty-four children with ALL were included; more than half (67.2%) were boys, and the median age at diagnosis was 6 years. Nearly half of the children (46.9%) were aged 0–5 years. Most children (51.6%) first sought care at primary-level facilities, whereas only 18.8% were referred from secondary-level facilities. The median time from symptom onset to presentation at MNH was 28.5 days, followed by a median time to diagnosis of 14 days. Six- and 12-month survival probabilities were 79% and 72%, respectively. Survival did not differ significantly by gender (log-rank χ2 = 0.24, p = 0.63), age group (χ2 = 2.01, p = 0.57), presentation time (χ2 = 0.79, p = 0.37), time to diagnosis [χ2(1) = 0.04, p = 0.84], or referral pathway length (χ2 = 0.11, p = 0.74).ConclusionOverall, delays in presentation and referral remain significant barriers in the management of childhood ALL in this setting. Most mortality occurred during the early treatment period, highlighting the critical importance of strengthening supportive care, early complication management, and infection control alongside improvements in referral systems. Efforts to strengthen early detection and build capacity at lower-level health facilities may substantially improve survival among children with ALL in Tanzania and other low-resource settings.
DOI: 10.3389/fped.2026.17776032026-03-31
M. Ananthi, S. Prabakar
BackgroundParenting in marginalized urban communities is shaped by intersecting structural inequalities. Limited research examines how caste-based marginalization, gender norms, and poverty collectively influence maternal caregiving practices and child developmental outcomes in urban informal settlement in India. This study investigates the parenting challenges faced by Adi- Dravidar (Scheduled Caste) mothers in Puliyanthope, Chennai, and their implications for child well-being.MethodsA qualitative study was conducted using semi-structured in-depth interviews with 20 Adi- Dravidar (Scheduled Caste) mothers with children aged 6–11 (Middle Childhood) years residing in Puliyanthope urban informal settlement in Chennai, India. Field observations complemented interview data. Thematic analysis was employed using an intersectional framework to analyzed maternal experiences, coping strategies, and structural constraints affecting parenting practices.FindingsFindings revealed that all 20 mothers solely bore childcare responsibilities while simultaneously engaging in informal labour, earning ₹8,000–12,000 monthly. Nineteen mothers had minimal formal education below 10th grade. Fathers' involvement in parenting was largely absent, and 90% of households lacked extended family support, leaving mothers isolated in their caregiving roles. Mothers consistently reported chronic time poverty, physical exhaustion, and financial insecurity arising from managing dual responsibilities of paid work and childcare. Limited financial autonomy, unsafe housing conditions, and inability to support children's educational needs further compounded their caregiving burden. Physical punishment was normalized across all families as a perceived protective response to unsafe neighbourhood conditions. Notably, one mother with higher educational attainment demonstrated significantly better capacity to support her children's holistic development, highlighting the protective role of maternal education.ConclusionMaternal caregiving in marginalized urban informal settlement contexts is profoundly constrained by intersecting structural inequalities rooted in caste, gender, and poverty. These constraints not only impose severe physical, emotional, and economic burden on mothers themselves but also directly impact child developmental outcomes, educational attainment, and overall well-being. Findings underscore the urgent need for multi-level interventions, including community-based childcare services, economic empowerment and mental health support programs for mothers, promotion of shared parenting responsibilities, and gender-sensitive policies that address both maternal caregiving burden and the intergenerational transmission of disadvantage in urban informal settlements in India contexts.
DOI: 10.3389/fped.2026.17937882026-03-31
Chia-Ling Li, Yi-Li Hung, Chung-Min Shen, Wu-Shiun Hsieh
PurposeCarbon dioxide monitoring is particularly critical in very preterm and very low birth weight (VLBW) infants during the first weeks of life because of the hypercarbia and hypocarbia related morbidities. Conventional methods for measuring partial pressure of carbon dioxide in arterial blood (PaCO2) are challenging for preterm neonates due to complications. Continuous transcutaneous partial pressure of carbon dioxide (TcPCO2) measurement is a well-established method in neonatal intensive care unit. This study primarily aimed to evaluate the accuracy and reliability of transcutaneous partial pressure of CO2 (TcPCO2) compared with PaCO2 in preterm neonates and VLBW infants (birth weight <1,500 g), and secondarily to explore how accuracy varies across different gestational age and birth weight strata.MethodsThis retrospective single-center observational study included a heterogeneous neonatal intensive care unit (NICU) cohort. In neonates admitted to the NICU for respiratory distress, PaCO2 and TcPCO2 were measured simultaneously. Statistical analysis included linear regression, calculation of intraclass correlation coefficients (ICC), repeated measures correlation (rmcorr), and the repeated-measures Bland-Altman analysis.ResultsA total of 143 infants (mean gestational age: 35 ± 3.2 weeks; mean birth weight: 2,374 ± 694.4 g) were recruited, and 410 PaCO2 and TcPCO2 measurement pairs were obtained for analysis. A strong correlation (rmcorr = 0.800) with an intraclass correlation coefficient (ICC) of 0.93 (95% CI: 0.91–0.94, p < 0.001) was found in preterm neonates, particularly those with gestational age below 32 weeks, or a birth weight below 1,500 g. Similar correlations were observed in larger infants.ConclusionsTcPCO2 is a noninvasive and reliable method for continuous respiratory monitoring in preterm neonates and very low birth weight infants during the early postnatal period. TcPCO2 is useful for continuous trend monitoring and may reduce the need for arterial sampling; however, confirmatory blood gas testing is recommended for extreme values or unstable clinical conditions.
DOI: 10.3389/fped.2026.1794358