1 A Review of the Current Situation of Nausea and Vomiting in Children with Malignant Tumors After Chemotherapy and the Scope of Its Influencing Factors https://brieflands.com/journals/ijp/articles/165215 10.5812/ijpediatr-165215 1 Context and Objective :Chemotherapy-induced nausea and vomiting (CINV) is one of the most common adverse reactions in children with malignant tumors. Severe CINV not only compromises comfort and treatment adherence but also increases the risk of malnutrition. This scoping review aimed to map the incidence and influencing factors of CINV in this population and provide guidance for future nursing research and intervention development. Methods :Following Arksey and O’Malley’s framework, we comprehensively searched 7 databases, including PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang, and Sinomed, from inception to April 11, 2025. Studies reporting the incidence or influencing factors of CINV in children aged 1 - 18 years with malignant tumors were included. Two reviewers independently screened the studies, extracted data, including study characteristics, incidence rates, and influencing factors, and performed a narrative synthesis. The quality of the included studies was appraised using the Agency for Healthcare Research and Quality (AHRQ) tool for cross-sectional studies and the Newcastle-Ottawa Scale (NOS) for cohort and retrospective studies. Study Selection :Risk factors reported in all studies on chemotherapy-related nausea and vomiting in children with tumors were reviewed and classified. Two researchers conducted the initial screening, evaluation, and selection of the included studies. Two researchers extracted the study data, and 1 researcher reviewed and verified the extracted data. The extracted data were synthesized and analyzed using a narrative approach. Results :Of 7783 identified records, 14 studies, including a total of 3099 participants, met the inclusion criteria. Publication years ranged from 2015 to 2025. The incidence of CINV varied widely, from 30% to 92%, depending on the study population and CINV type. A total of 18 influencing factors were identified and categorized into 4 domains: Individual differences, such as older age and low Body Mass Index (BMI); therapeutic factors, such as highly emetogenic chemotherapy and longer chemotherapy block time; psychological factors, such as anxiety and previous history of nausea or vomiting; and other factors, such as smoking environment and comorbid conditions. The methodological quality of the included studies was generally moderate to high. Conclusions :Chemotherapy-induced nausea and vomiting remains a prevalent issue in pediatric oncology and is associated with a complex interplay of patient-related, treatment-related, and psychological factors. Future research should focus on developing and testing personalized, multimodal interventions targeting modifiable risk factors, with particular attention to populations underrepresented in the current literature. This review highlights the need for standardized assessment and reporting of CINV to facilitate evidence-based care. 1 10 Yanli Yu Zhejiang Chinese Medical University, Hangzhou, China China yuyanlizcmu@163.com jingru Song Zhejiang Chinese Medical University, Hangzhou, China China songjingruzcmu@163.com luyan Yu The Children's Hospital Affiliated, Medical College of Zhejiang University, Hangzhou, China China jiajiefan@zju.edu.cn jinglei Tian Zhejiang Chinese Medical University, Hangzhou, China China iamtianjinglei@163.com xiujuan Cao The Children's Hospital Affiliated, Medical College of Zhejiang University, Hangzhou, China China 972536907@qq.com Jihua Zhu The Children's Hospital Affiliated, Medical College of Zhejiang University, Hangzhou, China China jihuazhu@zju.edu.cn No Keyword 1.pdf [0]Global Burden of Disease Cancer C, Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, et al.Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017;3(4):524-48. [PubMed ID: 27918777]. [PubMed Central ID: PMC6103527]. doi: 10.1001/jamaoncol.2016.5688.##[1]Zhou Z, Zhou H.Application of psychological resilience intervention combined with prospective nursing in patients with ovarian cancer undergoing intraperitoneal hyperthermic chemotherapy. Contemp Nurse. 2024:99-102.##[2]Li P.The role of traditional Chinese medicine acupoint application in preventing and treating nausea and vomiting after chemotherapy in patients with malignant tumors. J Clin Rational Drug Use. 2022:104-7.##[3]Foubert J, Vaessen G.Nausea: the neglected symptom? Eur J Oncol Nurs. 2005;9(1):21-32. [PubMed ID: 15774338]. doi: 10.1016/j.ejon.2004.03.006.##[4]Ruggiero A, Rizzo D, Catalano M, Coccia P, Triarico S, Attina G.Acute chemotherapy-induced nausea and vomiting in children with cancer: Still waiting for a common consensus on treatment. J Int Med Res. 2018;46(6):2149-56. [PubMed ID: 29690798]. [PubMed Central ID: PMC6023075]. doi: 10.1177/0300060518765324.##[5]Liu ZC, Li ZX, Zhang Y, et al.Interpretation of the 2020 global cancer statistics report. Electron J Integr Oncol Ther. 2021:1-13.##[6]Patel P, Robinson PD, Wahib N, Cheung P, Wong T, Cabral S, et al.Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis. Support Care Cancer. 2022;30(11):8855-69. [PubMed ID: 35953731]. [PubMed Central ID: PMC10153509]. doi: 10.1007/s00520-022-07287-w.##[7]Mosa ASM, Hossain AM, Lavoie BJ, Yoo I.Patient-Related Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Front Pharmacol. 2020;11:329. [PubMed ID: 32296333]. [PubMed Central ID: PMC7138899]. doi: 10.3389/fphar.2020.00329.##[8]Albanell-Fernandez M, Rodriguez Mues MC, Figueras C, Altamirano M, Monge-Escartin I, Riu-Viladoms G, et al.Evaluation of chemotherapy-induced nausea and vomiting in low, moderate, and highly emetogenic schemes between sexes. Support Care Cancer. 2025;33(4):261. [PubMed ID: 40064679]. [PubMed Central ID: PMC11893662]. doi: 10.1007/s00520-025-09319-7.##[9]Akdeniz Kudubeş A, Bektaş M.Developing the Nausea and Vomiting Thermometer Scale in children with cancer. Turki J Medi Sci. 2021;52:166-74. doi: 10.3906/sag-2005-88.##[10]Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al.PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-73. [PubMed ID: 30178033]. doi: 10.7326/M18-0850.##[11]Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, et al.The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med. 2015;8(1):2-10. [PubMed ID: 25594108]. doi: 10.1111/jebm.12141.##[12]Lo CK, Mertz D, Loeb M.Newcastle-Ottawa Scale: comparing reviewers' to authors' assessments. BMC Med Res Methodol. 2014;14:45. [PubMed ID: 24690082]. [PubMed Central ID: PMC4021422]. doi: 10.1186/1471-2288-14-45.##[13]Yu L, Zhou Y, Zhang W, Wu Q, Chu X, Zhang Y, et al.Body Mass Index Affects Delayed Chemotherapy-induced Vomiting in Pediatric Malignancy Patients. J Pediatr Hematol Oncol. 2023;45(7):398-403. [PubMed ID: 37677942]. doi: 10.1097/MPH.0000000000002736.##[14]Kishimoto K, Kawasaki K, Saito A, Kozaki A, Ishida T, Hasegawa D, et al.Prevention of chemotherapy-induced vomiting in children receiving multiple-day cisplatin chemotherapy: A hospital-based, retrospective cohort study. Pediatr Blood Cancer. 2017;64(9). [PubMed ID: 28205315]. doi: 10.1002/pbc.26485.##[15]Ay A, Boztepe H, Ozbay SC, Yilmaz P, Karadavut B, Burhanogullari D, et al.Determining the factors affecting chemotherapy-induced nausea and vomiting in children with cancer. J Pediatr Nurs. 2023;73:e426-34. [PubMed ID: 37845092]. doi: 10.1016/j.pedn.2023.10.011.##[16]Shao M, Li Y, Qin J, Zhou Y, Sun Y, Yang P, et al.Fact-finding and risk factor analysis of chemotherapy-induced nausea and vomiting in children with solid tumors: a prospective observational study. BMC Pediatr. 2025;25(1):84. [PubMed ID: 39891130]. [PubMed Central ID: PMC11783954]. doi: 10.1186/s12887-025-05451-9.##[17]Dupuis LL, Tomlinson GA, Pong A, Sung L, Bickham K.Factors Associated With Chemotherapy-Induced Vomiting Control in Pediatric Patients Receiving Moderately or Highly Emetogenic Chemotherapy: A Pooled Analysis. J Clin Oncol. 2020;38(22):2499-509. [PubMed ID: 32421443]. doi: 10.1200/JCO.20.00134.##[18]Sanguanboonyaphong P, Komvilaisak P, Suwannaying K, Yoodee J, Saeteaw M, Chanthawong S, et al.Predictors of Chemotherapy Induced Adverse Events in Pediatric Osteosarcoma Patients. Asian Pac J Cancer Prev. 2022;23(1):93-100. [PubMed ID: 35092376]. [PubMed Central ID: PMC9258668]. doi: 10.31557/APJCP.2022.23.1.93.##[19]Vol H, Flank J, Lavoratore SR, Nathan PC, Taylor T, Zelunka E, et al.Poor chemotherapy-induced nausea and vomiting control in children receiving intermediate or high dose methotrexate. Support Care Cancer. 2016;24(3):1365-71. [PubMed ID: 26335406]. doi: 10.1007/s00520-015-2924-1.##[20]Hadero HM, Beyene MG, Baye AM, Sisay EA.Outcome of antiemetic prophylaxis among pediatric cancer patients receiving moderate to highly emetogenic chemotherapy at pediatric hemato-oncology ward of Tikur Anbessa specialized hospital: A prospective observational study. J Oncol Pharm Pract. 2025;31(5):709-19. [PubMed ID: 38772673]. doi: 10.1177/10781552241256091.##[21]Zhao H, Weng J, Shi W, Pan L, Lin C, Wang N, et al.Age of Pediatric Patients Affects Delayed Chemotherapy-Induced Vomiting. Clin Pediatr (Phila). 2024;63(8):1115-22. [PubMed ID: 37881962]. doi: 10.1177/00099228231206708.##[22]Eliasen A, Kornholt J, Mathiasen R, Brok J, Rechnitzer C, Schmiegelow K, et al.Risk factors associated with nausea and vomiting in children with cancer receiving chemotherapy. J Oncol Pharm Pract. 2023;29(6):1361-8. [PubMed ID: 36039521]. doi: 10.1177/10781552221122026.##[23]Ruan H, Sun J, Zhao K, He M, Yuan C, Fu L, et al.Subjective Toxicity Profiles of Children With Cancer During Treatment: A Latent Class Analysis. Cancer Nurs. 2024;47(1):E1-9. [PubMed ID: 36881644]. doi: 10.1097/NCC.0000000000001223.##[24]Dupuis LL, Tamura RN, Kelly KM, Krischer JP, Langevin AM, Chen L, et al.Risk factors for chemotherapy-induced nausea in pediatric patients receiving highly emetogenic chemotherapy. Pediatr Blood Cancer. 2019;66(4). e27584. [PubMed ID: 30561134]. doi: 10.1002/pbc.27584.##[25]Li X, Liu XY, Hu XJ.Analysis of the current status and influencing factors of delayed nausea and vomiting in pediatric hematology oncology patients after chemotherapy. General Practice Nurse. 2024;22:4142-5.##[26]Yu LY, Lin N, Zhou Y, et al.Factors influencing delayed nausea and vomiting in children undergoing cancer chemotherapy. Chin J Nurs. 2023:2494-502.##[27]Chinese Society of Pediatrics Oncology Group; Chinese Society of Pediatrics Hematology Group; China Anti-Cancer Association Pediatric Oncology Committee.Chinese guidelines for the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients (2024 edition). Chin J Pract Pediatr Clin. 2025:40:2-8.##[28]Patel P, Robinson PD, Phillips R, Baggott C, Devine K, Gibson P, et al.Treatment of breakthrough and prevention of refractory chemotherapy-induced nausea and vomiting in pediatric cancer patients: Clinical practice guideline update. Pediatr Blood Cancer. 2023;70(8). e30395. [PubMed ID: 37178438]. doi: 10.1002/pbc.30395.##[29]Navari RM.Treatment of Breakthrough and Refractory Chemotherapy-Induced Nausea and Vomiting. Biomed Res Int. 2015;2015:595894. [PubMed ID: 26421294]. [PubMed Central ID: PMC4573228]. doi: 10.1155/2015/595894.##[30]Holdsworth MT, Raisch DW, Frost J.Acute and delayed nausea and emesis control in pediatric oncology patients. Cancer. 2006;106(4):931-40. [PubMed ID: 16404740]. doi: 10.1002/cncr.21631.##[31]Fredrikson M, Hursti T, Furst CJ, Steineck G, Borjeson S, Wikblom M, et al.Nausea in cancer chemotherapy is inversely related to urinary cortisol excretion. Br J Cancer. 1992;65(5):779-80. [PubMed ID: 1586608]. [PubMed Central ID: PMC1977374]. doi: 10.1038/bjc.1992.165.##[32]Watamura SE, Donzella B, Kertes DA, Gunnar MR.Developmental changes in baseline cortisol activity in early childhood: relations with napping and effortful control. Dev Psychobiol. 2004;45(3):125-33. [PubMed ID: 15505801]. doi: 10.1002/dev.20026.##[33]Santosa D, Fitrikasari A, Iswaningtyas F, Kuntardjo N, Tandarto K, Hadiati T, et al.Serotonin Levels and Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Cross-Sectional Study. Asian Pac J Cancer Prev. 2024;25(9):3263-7. [PubMed ID: 39342605]. [PubMed Central ID: PMC11700312]. doi: 10.31557/APJCP.2024.25.9.3263.##[34]Hayashi M, Nakazawa K, Hasegawa Y, Horiguchi J, Miura D, Ishikawa T, et al.Risk Analysis for Chemotherapy-induced Nausea and Vomiting (CINV) in Patients Receiving FEC100 Treatment. Anticancer Res. 2019;39(8):4305-14. [PubMed ID: 31366522]. doi: 10.21873/anticanres.13596.##[35]Bun S, Kunisawa S, Sasaki N, Fushimi K, Matsumoto K, Yamatani A, et al.Analysis of concordance with antiemetic guidelines in pediatric, adolescent, and young adult patients with cancer using a large-scale administrative database. Cancer Med. 2019;8(14):6243-9. [PubMed ID: 31469518]. [PubMed Central ID: PMC6797697]. doi: 10.1002/cam4.2486.##[36]Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, et al.Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2017;35(28):3240-61. [PubMed ID: 28759346]. doi: 10.1200/JCO.2017.74.4789.##[37]Chenbing X, Huiling X, Qianqian X, Dan W, Guilan X, Ling Y, et al.Effect of ginger and P6 acupressure on chemotherapy-induced nausea and vomiting: a randomized controlled study. Rev Esc Enferm USP. 2024;57. e20230104. [PubMed ID: 38461442]. [PubMed Central ID: PMC10911752]. doi: 10.1590/1980-220X-REEUSP-2023-0104en.##[38]Kim HK, Hsieh R, Chan A, Yu S, Han B, Gao Y, et al.Impact of CINV in earlier cycles on CINV and chemotherapy regimen modification in subsequent cycles in Asia Pacific clinical practice. Support Care Cancer. 2015;23(1):293-300. [PubMed ID: 25142702]. doi: 10.1007/s00520-014-2376-z.##[39]Compas BE, Desjardins L, Vannatta K, Young-Saleme T, Rodriguez EM, Dunn M, et al.Children and adolescents coping with cancer: self- and parent reports of coping and anxiety/depression. Health Psychol. 2014;33(8):853-61. [PubMed ID: 25068455]. [PubMed Central ID: PMC4241756]. doi: 10.1037/hea0000083.##[40]Gupta K, Walton R, Kataria SP.Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Recommendations, and New Trends. Cancer Treat Res Commun. 2021;26:100278. [PubMed ID: 33360668]. doi: 10.1016/j.ctarc.2020.100278.##[41]Borrescio-Higa F, Valdes N.The Psychosocial Burden of Families with Childhood Blood Cancer. Int J Environ Res Public Health. 2022;19(1). [PubMed ID: 35010854]. [PubMed Central ID: PMC8744617]. doi: 10.3390/ijerph19010599.##[42]Wei TT, Tian X, Zhang FY, Qiang WM, Bai AL.Music interventions for chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis. Support Care Cancer. 2020;28(9):4031-41. [PubMed ID: 32328772]. doi: 10.1007/s00520-020-05409-w.##[43]Phillips RS, Gopaul S, Gibson F, Houghton E, Craig JV, Light K, et al.Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood. Cochrane Database of Systematic Reviews. 2010. doi: 10.1002/14651858.CD007786.pub2.##[44]Gonzalez-Mercado VJ, Williams PD, Williams AR, Pedro E, Colon G.The symptom experiences of Puerto Rican children undergoing cancer treatments and alleviation practices as reported by their mothers. Int J Nurs Pract. 2017;23(1). [PubMed ID: 27990706]. doi: 10.1111/ijn.12500.##[45]Lorusso V, Russo A, Giotta F, Codega P.Management of Chemotherapy-Induced Nausea and Vomiting (CINV): A Short Review on the Role of Netupitant-Palonosetron (NEPA). Core Evid. 2020;15:21-9. [PubMed ID: 32802009]. [PubMed Central ID: PMC7394513]. doi: 10.2147/CE.S203634.##[46]Esra YE, Aziz Y, Zeki U, Gulsah G, Mert B, Yesim E, et al.Is chemotherapy-induced nausea and vomiting lower in smokers? Int J Clin Pharmacol Ther. 2011;49(12):709-12. [PubMed ID: 22122812].##

1 Quality of Life in Children with Anorectal Malformations After Surgery: An Observational Study https://brieflands.com/journals/ijp/articles/159830 10.5812/ijpediatr-159830 1 Background :Anorectal malformations are congenital defects of the anus and rectum that require surgery as the first treatment option. Comorbidities and postoperative complications may alter patients' health and affect their quality of life. Objectives :The primary objective of this study was to assess parent-reported quality of life (QOL) in children who had undergone surgery for anorectal malformations (ARMs). Methods :All children aged 6 - 12 years who had undergone surgery for ARMs between 2012 and 2023 at Children's Medical Center were included. Patient demographic data were extracted from hospital records. Parents completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 questionnaire by telephone. The collected data were analyzed using SPSS software, version 26. Results :The mean age of the participants during the study period was 8.63 ± 1.69 years. The mean age at surgery was 8.87 ± 14.5 months. The average hospital length of stay was 11.24 ± 5.57 days. The mean total QOL score was 92.65 out of 100. The mean physical, emotional, social, and school subdomain scores were 97.09, 87.07, 94.46, and 89.35 out of 100, respectively. Father's education was related to the emotional component of children's QOL. Conclusions :We concluded that older children with ARMs had higher social QOL scores. Children who underwent surgery later in infancy had better emotional QOL scores in the years after surgery. 1 7 Mobina Taghva Nakhjiri Breastfeeding Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Iran mobina.taghva@gmail.com Nazila Shahmansouri Psychosomatic Medicine Research Center, Tehran University of Medical Science, Tehran, Iran Iran n.shahmansouri@gmail.com Mamak Shariat Maternal, Fetal, and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran Iran mshariat@tums.ac.ir Atefe Gilan Varnosfaderani Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran Iran atefe.gilan@yahoo.com Maryam Ghavami Adel Tehran University of Medical Sciences, Tehran, Iran Iran maryamghavami5@gmail.com No Keyword 2.pdf [0]Hakalmaz AE, Topuzlu Tekant G.Anorectal Malformations and Late-Term Problems. Turk Arch Pediatr. 2023;58(6):572-9. eng. [PubMed ID: 37584470]. [PubMed Central ID: PMC10724790]. doi: 10.5152/TurkArchPediatr.2023.23090.##[1]Oh C, Youn JK, Han JW, Yang HB, Kim HY, Jung SE.Analysis of Associated Anomalies in Anorectal Malformation: Major and Minor Anomalies. J Korean Med Sci. 2020;35(14). eng. e98. [PubMed ID: 32281315]. [PubMed Central ID: PMC7152527]. doi: 10.3346/jkms.2020.35.e98.##[2]de Beaufort CMC, van den Akker ACM, Kuijper CF, Broers CJM, de Jong JR, de Beer SA, et al.The Importance of Screening for Additional Anomalies in Patients with Anorectal Malformations: A Retrospective Cohort Study. J Pediatr Surg. 2023;58(9):1699-1707. doi: 10.1016/j.jpedsurg.2022.11.010.##[3]Wood RJ, Levitt MA.Anorectal Malformations. Clin Colon Rectal Surg. 2018;31(2):61-70. doi: 10.1055/s-0037-1609020.##[4]Uecker M, Ure B, Quitmann JH, Dingemann J.Need for Transition Medicine in Pediatric Surgery – Health Related Quality of Life in Adolescents and Young Adults with Congenital Malformations. Innov Surg Sci. 2021;6(4):151-160. doi: 10.1515/iss-2021-0019.##[5]Gertler J, Granström AL, Oddsberg J, Gunnarsdóttir A, Svenningsson A, Wester T, et al.Bowel Function, Urinary Tract Function, and Health-Related Quality of Life in Males with Anorectal Malformations. BMC Public Health. 2024;40(1). 164. [PubMed ID: 38935149]. [PubMed Central ID: PMC11211194]. doi: 10.1007/s00383-024-05746-5.##[6]Divarci E, Ergun O.General Complications After Surgery for Anorectal Malformations. Pediatr Surg Int. 2020;36(4):431-445. doi: 10.1007/s00383-020-04629-9.##[7]Fırıncı B, Salman A.Evaluation of Long-term Results and Stool Incontinence of Patients with Operated Anorectal Malformations. Journal of Dr Behcet Uz Children s Hospital. 2023;13:37-42.##[8]Svetanoff WJ, Kapalu CL, Lopez JJ, Fraser JA, Briggs KB, Rentea RM.Psychosocial Factors Affecting Quality of Life in Patients with Anorectal Malformation and Hirschsprung Disease-a Qualitative Systematic Review. J Pediatr Surg. 2022;57(3):387-393. doi: 10.1016/j.jpedsurg.2021.05.004.##[9]Teoli D, Bhardwaj A.Quality Of Life. StatPearls. 2023. [PubMed ID: 30725647].##[10]Darwish M, Hassan SH, Taha SF, Abd El-Megeed HS, Ismail TA.Health-related quality of life in children with chronic kidney disease in Assiut, Egypt. Scientific Reports. 2021;39(2):46-58.##[11]Wotherspoon JM, Eagleson KJ, Gilmore L, Auld B, Hirst A, Johnson S, et al.Neurodevelopmental and Health-related Quality-of-life Outcomes in Adolescence After Surgery for Congenital Heart Disease in Infancy. Dev Med Child Neurol. 2020;62(2):214-220. doi: 10.1111/dmcn.14251.##[12]Mohamadian H, Akbari H, Gilasi H, Gharlipour Z, Moazami A, Aghajani M, et al.[Validation of Pediatric Quality of Life Questionnaire (PedsQL) in Kashan city]. Journal of Ilam University of Medical Sciences. 2014;22(3):10-8.FA.##[13]Grano C, Bucci S, Aminoff D, Lucidi F, Violani C.Quality of Life in Children and Adolescents with Anorectal Malformation. Pediatr Surg Int. 2013;29(9):925-930. [PubMed ID: 23907176]. doi: 10.1007/s00383-013-3359-8.##[14]Feng X, Lacher M, Quitmann J, Witt S, Witvliet MJ, Mayer S.Health-Related Quality of Life and Psychosocial Morbidity in Anorectal Malformation and Hirschsprung's Disease. Eur J Pediatr Surg. 2020;30(3):279-286. [PubMed ID: 32590868]. doi: 10.1055/s-0040-1713597.##[15]Mucunguzi D, Oyania F, Egesa WI, Aturinde M, Mutakooha MM, Kyengera KD.Quality of Life of Children After Completion of Surgical Treatment for Anorectal Malformation: A Single-centre Cross-sectional Study in South-Western Uganda. J Pediatr Surg. 2025;60(1). 161998. [PubMed ID: 39437455]. doi: 10.1016/j.jpedsurg.2024.161998.##[16]Goyal A, Williams JM, Kenny SE, Lwin R, Baillie CT, Lamont GL, et al.Functional Outcome and Quality of Life in Anorectal Malformations. J Pediatr Surg. 2006;41(2):318-322. [PubMed ID: 16481243]. doi: 10.1016/j.jpedsurg.2005.11.006.##[17]Senel E, Akbiyik F, Atayurt H, Tiryaki HT.Urological Problems or Fecal Continence During Long-term Follow-up of Patients with Anorectal Malformation. Pediatr Surg Int. 2010;26(7):683-689. [PubMed ID: 20505942]. doi: 10.1007/s00383-010-2626-1.##

1 Hemodynamic Changes in the Ophthalmic Artery and Their Correlation with Serum Cytokines in Pediatric Diabetic Retinopathy https://brieflands.com/journals/ijp/articles/163976 10.5812/ijp-163976 1 Background :Diabetic retinopathy (DR) is a common microvascular complication in children with type 2 diabetes mellitus (T2DM), whose pathogenesis involves microcirculatory dysfunction and chronic inflammatory responses. Objectives :This cross-sectional study aimed to investigate the changes in ocular artery hemodynamic parameters in children with T2DM and analyze their correlation with serum inflammatory factor levels. Methods :A total of 188 children with T2DM were divided into a no diabetic retinopathy (no-DR) group, a nonproliferative diabetic retinopathy (NPDR) group, and a proliferative diabetic retinopathy (PDR) group, with a healthy control group also included. Ocular artery hemodynamic parameters (peak systolic velocity (PSV), end-diastolic velocity (EDV), Resistance Index (RI), Pulsatility Index (PI)) and serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and transforming growth factor-β (TGF-β) were measured in all groups. Results :Compared with the control group, the no-DR group, NPDR group, and PDR group showed a progressive decrease in PSV and EDV, and a progressive increase in RI; levels of VEGF, TNF-α, and IL-6 showed a progressive increase, while TGF-β levels showed a progressive decrease (all P < 0.001). PSV and EDV were significantly negatively correlated with pro-inflammatory factors, while RI was significantly positively correlated with pro-inflammatory factors (all P < 0.01). Conclusions :Children with T2DM exhibit significant ocular artery hemodynamic abnormalities (including decreased EDV) and alterations in inflammatory factor levels, which are closely interrelated. Combined assessment of these indicators may aid in the early identification of children at high risk for DR and provide new targets for clinical intervention. 1 13 Yun Feng Department of Ophthalmology, Xi’an Children’s Hospital Affiliated to Xi’an Jiaotong University, Xi’an 710003, Shaanxi Province, China China drfengyun@yeah.net Jing Wang Department of Ophthalmology, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated People's Hospital of Northwest University, Xi'an 710004, Shaanxi Province, China China wjing02989@126.com Ling Chen Department of Ophthalmology, Xi’an Children’s Hospital Affiliated to Xi’an Jiaotong University, Xi’an 710003, Shaanxi Province, China China 18991846174@163.com No Keyword 3.pdf [0]Cloete L.Diabetes mellitus: an overview of the types, symptoms, complications and management. Nursing Standard. 2022;37(1):61-66. [PubMed ID: 34708622]. doi: 10.7748/ns.2021.e11709.##[1]Lin Q, Jia Y, Li T, Wang S, Xu X, Xu Y, et al.Optic disc morphology and peripapillary atrophic changes in diabetic children and adults without diabetic retinopathy or visual impairment. Acta Ophthalmologica. 2022;100(1):e157-e166. [PubMed Central ID: PMC9292269]. doi: 10.1111/aos.14885.##[2]Jiang F, Xiao O, Guo X, Yin Q, Luo L, He M, et al.Characteristics of myopic maculopathy in Chinese children and adolescents with high myopia. British Journal of Ophthalmology. 2025;109(2):257-263. [PubMed ID: 39060091]. doi: 10.1136/bjo-2023-324430.##[3]Curran K, Ahmed M, Sultana MM, Moutari S, Hossain MA, Cushley L, et al.Adherence to diabetic retinopathy screening among children and young adults in Bangladesh. Clinical Diabetes and Endocrinology. 2024;10(1):41. [PubMed ID: 39627896]. [PubMed Central ID: PMC11616320]. doi: 10.1186/s40842-024-00208-2.##[4]Li H, Liu X, Zhong H, Fang J, Li X, Shi R, et al.Research progress on the pathogenesis of diabetic retinopathy. BMC Ophthalmology. 2023;23(1):372. [PubMed ID: 37697295]. [PubMed Central ID: PMC10494348]. doi: 10.1186/s12886-023-03118-6.##[5]Zhou C, Zhou Z, Feng X, Zou D, Zhou Y, Zhang B, et al.The retinal oxygen metabolism and hemodynamics as a substitute for biochemical tests to predict nonproliferative diabetic retinopathy. Journal of Biophotonics. 2024;17(7). e202300567. [PubMed ID: 38527858]. doi: 10.1002/jbio.202300567.##[6]Shyam M, Sidharth S, Veronica A, Jagannathan L, Srirangan P, Radhakrishnan V, et al.Diabetic retinopathy: a comprehensive review of pathophysiology and emerging treatments. Molecular Biology Reports. 2025;52(1):380. [PubMed ID: 40205024]. doi: 10.1007/s11033-025-10490-7.##[7]Majidova SR.Evaluation of Hypoxia and Microcirculation Factors in the Progression of Diabetic Retinopathy. Investigative Ophthalmology & Visual Science. 2024;65(1):35. [PubMed ID: 38241030]. [PubMed Central ID: PMC10807489]. doi: 10.1167/iovs.65.1.35.##[8]Lin T, Gubitosi-Klug RA, Channa R, Wolf RM.Pediatric Diabetic Retinopathy: Updates in Prevalence, Risk Factors, Screening, and Management. Curr Diab Rep. 2021;21(12):56. [PubMed ID: 34902076]. doi: 10.1007/s11892-021-01436-x.##[9]Wolf RM, Channa R, Liu TYA, Zehra A, Bromberger L, Patel D, et al.Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial. Nat Commun. 2024;15(1):421. [PubMed ID: 38212308]. [PubMed Central ID: PMC10784572]. doi: 10.1038/s41467-023-44676-z.##[10]Agroiya P, Alrawahi AH.Pediatric Diabetic Retinopathy: Experience of a Tertiary Hospital in Oman. Middle East Afr J Ophthalmol. 2020;26(4):189-195. [PubMed ID: 32153329]. [PubMed Central ID: PMC7034150]. doi: 10.4103/meajo.MEAJO_208_19.##[11]Wu Y, Xiao Y, Cui L, Qin X, Chen S, An Q, et al.Association between the onset of diabetic retinopathy and thickness changes in the retina and choroid of children with type 1 diabetes: A three-year longitudinal study. Ophthalmic Physiol Opt. 2025;45(2):458-470. [PubMed ID: 39753506]. doi: 10.1111/opo.13439.##[12]Koca SB, Akdogan M, Koca S.Evaluation of early retinal vascular changes by optical coherence tomography angiography in children with type 1 diabetes mellitus without diabetic retinopathy. Int Ophthalmol. 2022;42(2):423-433. [PubMed ID: 34625889]. doi: 10.1007/s10792-021-02059-7.##[13]Wang F, Mao Y, Wang H, Liu Y, Huang P.Semaglutide and Diabetic Retinopathy Risk in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. Clinical Drug Investigation. 2022;42(1):17-28. [PubMed ID: 34894326]. doi: 10.1007/s40261-021-01110-w.##[14]Sinclair SH, Schwartz S.Diabetic retinopathy: New concepts of screening, monitoring, and interventions. Survey of Ophthalmology. 2024;69(6):882-892. [PubMed ID: 38964559]. doi: 10.1016/j.survophthal.2024.07.001.##[15]Saghravanian S, Tabari M, Afzalaghaee M, Sheybani S.The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial. Middle East Journal of Rehabilitation and Health Studies. 2023;11(2). e134348. doi: 10.5812/mejrh-134348.##[16]Liu DD, Zhang CY, Zhang JT, Gu LM, Xu GT, Zhang JF.Epigenetic modifications and metabolic memory in diabetic retinopathy: beyond the surface. Neural Regeneration Research. 2023;18(7):1441-1449. [PubMed ID: 36571340]. [PubMed Central ID: PMC10075108]. doi: 10.4103/1673-5374.361536.##[17]Wei J, Chen C, Shen Y, Li F, Yiyang S, Liu H.Quantitative evaluation of ocular vascularity and correlation analysis in patients with diabetic retinopathy by SMI and OCTA. Bmc Ophthalmology. 2024;24(1):76. [PubMed ID: 38373920]. [PubMed Central ID: PMC10875800]. doi: 10.1186/s12886-024-03338-4.##[18]Madhpuriya G, Gokhale S, Agrawal A, Nigam P, Wan YL.Evaluation of Hemodynamic Changes in Retrobulbar Blood Vessels Using Color Doppler Imaging in Diabetic Patients. Life (Basel). 2022;12(5):629. [PubMed ID: 35629297]. [PubMed Central ID: PMC9145998]. doi: 10.3390/life12050629.##[19]Martinez-Zapata MJ, Salvador I, Martí-Carvajal AJ, Pijoan JI, Cordero JA, Ponomarev D, et al.Anti-vascular endothelial growth factor for proliferative diabetic retinopathy. Cochrane Database of Systematic Reviews. 2023;3(3). CD008721. [PubMed ID: 36939655]. [PubMed Central ID: PMC10026605]. doi: 10.1002/14651858.CD008721.pub3.##[20]Khoso ZA, Ibrahim MN, Rai VR, Riaz M, Laghari TM, Ahmed I.Frequency of Diabetic Retinopathy and Its Association with HbA1c in Children and Adolescents with Type-I Diabetes Mellitus. Journal of College of Physicians and Surgeons Pakistan. 2025;35(3):282-286. [PubMed ID: 40055159]. doi: 10.29271/jcpsp.2025.03.282.##[21]Allen DW, Liew G, Cho YH, Pryke A, Cusumano J, Hing S, et al.Thirty-Year Time Trends in Diabetic Retinopathy and Macular Edema in Youth With Type 1 Diabetes. Diabetes Care. 2022;45(10):2247-2254. [PubMed ID: 35594057]. doi: 10.2337/dc21-1652.##[22]Invernizzi A, Chhablani J, Viola F, Gabrielle PH, Zarranz-Ventura J, Staurenghi G.Diabetic retinopathy in the pediatric population: Pathophysiology, screening, current and future treatments. Pharmacological Research. 2023;188. 106670. [PubMed ID: 36681366]. doi: 10.1016/j.phrs.2023.106670.##

1 Exploring Unmet and New Dental Treatment Needs and Their Causes Among Iranian 10 - 12-Year-Old Children After 3 Years of Follow-up https://brieflands.com/journals/ijp/articles/152305 10.5812/ijpediatr-152305 1 Background :The disparity between required healthcare and healthcare services provided is defined as an unmet need. Objectives :To assess unmet and new dental treatment needs (DTN) and their causes among 10 - 12-year-old Iranian children. Methods :The initial assessment of Babol elementary school students’ DTN was conducted in 2015 as part of an oral health promotion plan. In this 3-year follow-up study, 254 10 - 12-year-old students (50% girls) from six elementary schools underwent re-examination to identify unmet and new DTN. Additionally, a checklist completed by parents identified barriers to receiving treatment for their children. Results :A total of 224 (88.2%) students had unmet DTN, with a higher prevalence among boys (P = 0.02). Furthermore, 224 (88.2%) students presented new DTN. On average, each student had 4 and 3.5 teeth with unmet and new DTN over the 3-year period, respectively. The most common types of unmet and new DTN were restorative and fissure sealant therapy. Among respondents, 166 parents (70.9%) reported difficulty addressing their children’s DTN. The most common barriers were high dental treatment costs (56%), followed by children’s fear of dental treatment (13.7%) and lack of availability and limitations of public dental services (13.2%). Conclusions :The high prevalence of unmet and new DTN after 3 years highlights a gap between needs assessments and the implementation of oral healthcare plans. 1 7 Elahe Eshraghi Student Research Committee, Babol University of Medical Sciences, Babol, Iran Iran elahe.eshraghi@gmail.com Seyedali Seyedmajidi Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran s.majidi.dvm@gmail.com Hemmat Gholinia Ahangar Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran h_gholinia@yahoo.com Effat Khodadadi Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran drekhodadadi@yahoo.com Behrouz Shafizadeh Gatabi Department of Community Oral Health, School of Dentistry, Babol University of Medical Sciences, Babol, Iran Iran b.shafiezadeh@gmail.com Maede Eslami Andargoli Student Research Committee, Babol University of Medical Sciences, Babol, Iran Iran m.eslami9241@gmail.com Mohammad Mehdi Naghibi Sistani Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran mnaghibis@gmail.com No Keyword 4.pdf [0]Carr W, Wolfe S.Unmet Needs as Sociomedical Indicators. International Journal of Health Services. 1976;6(3):417-430. doi: 10.2190/MCG0-UH8D-0AG8-VFNU.##[1]Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W.Global Burden of Untreated Caries: A Systematic Review and Metaregression. Journal of Dental Research. 2015;94(5):650-658. [PubMed ID: 25740856]. [PubMed Central ID: PMC11811587]. doi: 10.1177/0022034515573272.##[2]Qin X, Zi H, Zeng X.Changes in the Global Burden of Untreated Dental Caries from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study. Heliyon. 2022;8(9). [PubMed ID: 36193522]. [PubMed Central ID: PMC9526157]. doi: 10.1016/j.heliyon.2022.e10714.##[3]Ghafari M, Bahadivand-Chegini S, Nadi T, Doosti-Irani A.The Global Prevalence of Dental Healthcare Needs and Unmet Dental Needs Among Adolescents: A Systematic Review and Meta-analysis. Epidemiology and Health. 2019;41. [PubMed ID: 31778605]. [PubMed Central ID: PMC6883027]. doi: 10.4178/epih.e2019046.##[4]Kim N, Kim C-y, Shin H.Inequality in Unmet Dental Care Needs Among South Korean Adults. BMC Oral Health. 2017;17(1):80. [PubMed ID: 28446178]. [PubMed Central ID: PMC5406911]. doi: 10.1186/s12903-017-0370-9.##[5]Bashir NZ.Update on the Prevalence of Untreated Caries in the US Adult Population, 2017 - 2020. Journal of the American Dental Association. 2022;153(4):300-308. [PubMed ID: 34952680]. doi: 10.1016/j.adaj.2021.09.004.##[6]Ramraj C, Azarpazhooh A, Dempster L, Ravaghi V, Quiñonez C.Dental Treatment Needs in the Canadian Population: Analysis of a Nationwide Cross-sectional Survey. BMC Oral Health. 2012;12(1):46. [PubMed ID: 23102263]. [PubMed Central ID: PMC3508863]. doi: 10.1186/1472-6831-12-46.##[7]Samim F, Aleksejuniene J, Zed C, Salimi N, Emperumal C.Dental Treatment Needs in Vancouver Inner-city Elementary School-aged Children. International Journal of Dentistry. 2013;2013:602791. [PubMed ID: 23861684]. [PubMed Central ID: PMC3687495]. doi: 10.1155/2013/602791.##[8]Ebrahimi M, Ajami B-A-M, Shirazi ARS, Aghaee MA, Rashidi S.Dental Treatment Needs of Permanent First Molars in Mashhad Schoolchildren. Journal of Dental Research, Dental Clinics, Dental Prospects. 2010;4(2):52-55. [PubMed ID: 22991597]. [PubMed Central ID: PMC3429974]. doi: 10.5681/joddd.2010.014.##[9]Kunz F, Platte P, Keß S, Geim L, Zeman F, Proff P.Correlation Between Oral Health-related Quality of Life and Orthodontic Treatment Need in Children and Adolescents: A Prospective Interdisciplinary Multicentre Cohort Study. Journal of Orofacial Orthopedics. 2018;79(5):297-308. [PubMed ID: 29947814]. doi: 10.1007/s00056-018-0142-4.##[10]Ulu Güzel KG, Akyildiz M, Doğusal G, Keleş S, Sönmez I.Evaluation of Oral Health Status of Children in Pretreatment and After Treatment for 18 Month. Central European Journal of Public Health. 2018;26(3):199-203. [PubMed ID: 30419622]. doi: 10.21101/cejph.a5079.##[11]Torriani D, Ferro R, Bonow M, Santos I, Matijasevich A, Barros A.Dental Caries Is Associated With Dental Fear in Childhood: Findings from a Birth Cohort Study. Caries Research. 2014;48(4):263-270. [PubMed ID: 24503491]. doi: 10.1159/000356306.##[12]Malecki K, Wisk LE, Walsh M, McWilliams C, Eggers S, Olson M.Oral Health Equity and Unmet Dental Care Needs in a Population-based Sample: Findings from the Survey of the Health of Wisconsin. American Journal of Public Health. 2015;105(S3):S466-S474. [PubMed ID: 25905843]. [PubMed Central ID: PMC4455504]. doi: 10.2105/AJPH.2014.302338.##[13]Moon S-E, Song A-H.Factors Affecting Unmet Dental Care Needs of Korean: The 6th Korean National Health and Nutritional Examination Survey. Journal of Korean Society of Dental Hygiene. 2016;16(5):767-774. doi: 10.13065/jksdh.2016.16.05.767.##[14]Eslami EndargoliM, Seydmajidi S, Khodadadi E, Shafizadeh GatabiB, Eshraqi E, Naghibi SistaniMM.Investigation of Oral and Dental Treatment Needs of 7 - 12-Year-Old Students in the City of Babol. Research in Dental Sciences. 2024;21(3):225-232. doi: 10.61186/jrds.21.3.225.##[15]Abuaffan AH, Hayder S, Hussen AA, Ibrahim TA.Prevalence of Dental Caries of the First Permanent Molars Among 6 - 14 Years Old Sudanese Children. Indian Journal of Dental Education. 2018;11(1):13-16. doi: 10.21088/ijde.0974.6099.11118.2.##[16]Nazir MA, Bakhurji E, Gaffar BO, Al-Ansari A, Al-Khalifa KS.First Permanent Molar Caries and Its Association With Carious Lesions in Other Permanent Teeth. Journal of Clinical and Diagnostic Research. 2019;13(1). doi: 10.7860/JCDR/2019/38167.12509.##[17]Taboada-Aranza O, Rodríguez-Nieto K.Prevalence of Plaque and Dental Decay in the First Permanent Molar in a School Population of South Mexico City. Boletín Médico del Hospital Infantil de México. 2018;75(2):113-118. doi: 10.24875/BMHIME.M18000030.##[18]Mezzofranco L, Zalunardo F, Magliarditi A, Gracco A.Assessment of Oral Health in a Child Cohort of a Rural Zone of Ethiopia. Children. 2023;10(11):1824. [PubMed ID: 38002914]. [PubMed Central ID: PMC10670308]. doi: 10.3390/children10111824.##[19]Connolly S, Wren M.P94 Variations in Unmet Need for Medical and Dental Services in Ireland. Journal of Epidemiology and Community Health. 2016;70(Suppl 1):A95. doi: 10.1136/jech-2016-208064.192.##[20]Abdelrehim M, Ravaghi V, Quiñonez C, Singhal S.Trends in Self-reported Cost Barriers to Dental Care in Ontario. PLoS One. 2023;18(7). [PubMed ID: 37418457]. [PubMed Central ID: PMC10328358]. doi: 10.1371/journal.pone.0280370.##

1 Effect of High-frequency Oscillatory Ventilation-Assisted Pulmonary Surfactant Intervention on Children with Neonatal Respiratory Distress Syndrome https://brieflands.com/journals/ijp/articles/160903 10.5812/ijpediatr-160903 1 Background :Neonatal respiratory distress syndrome (NRDS), also known as neonatal lung hyaline membrane disease, predominantly occurs in premature infants and remains a major cause of neonatal morbidity and mortality. Objectives :This study aimed to evaluate the therapeutic efficacy of high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) therapy in neonates with NRDS. Methods :A total of 100 neonates diagnosed with NRDS were retrospectively enrolled from patients admitted to our hospital between March 2022 and February 2024. Patients were divided into an observation group (n = 50; HFOV-assisted PS therapy) and a control group (n = 50; PS therapy alone). Baseline demographic and clinical characteristics were comparable between the 2 groups. Clinical outcomes, blood gas parameters, and complication rates were analyzed. Results :Compared with the control group, the observation group had a significantly lower overall complication rate (P < 0.05). After treatment, the observation group demonstrated increased arterial partial pressure of oxygen (PaO₂) and reduced partial pressure of carbon dioxide (PCO₂) compared with the control group (P < 0.05). In addition, arterial oxygen saturation (SaO₂) was significantly decreased after HFOV-assisted PS therapy compared with the control group (P < 0.05). The durations of mechanical ventilation and total hospital stay were both significantly shorter in the observation group than in the control group (P < 0.05). Conclusions :High-frequency oscillatory ventilation-assisted PS therapy was associated with improved blood gas parameters, shorter durations of mechanical ventilation and hospitalization, and a reduced risk of complications in neonates with NRDS. These findings suggest that HFOV combined with PS represents an effective therapeutic strategy for the clinical management of NRDS.Keywords: 1 8 Mingxi Chen Inner Mongolia Autonomous Region People's Hospital, Hohhot, China China kyi6299080@163.com Hao Wang Inner Mongolia Autonomous Region People's Hospital, Hohhot, China China qqp84292158@163.com Wenjuan Zhang Inner Mongolia Autonomous Region People's Hospital, Hohhot, China China zhangwjimarph@ph-edu.cn No Keyword 5.pdf [0]Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, et al.European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update. Neonatology. 2023;120(1):3-23. [PubMed ID: 36863329]. [PubMed Central ID: PMC10064400]. doi: 10.1159/000528914.##[1]De Luca D, Tingay DG, van Kaam AH, Courtney SE, Kneyber MCJ, Tissieres P, et al.Epidemiology of Neonatal Acute Respiratory Distress Syndrome: Prospective, Multicenter, International Cohort Study. Pediatr Crit Care Med. 2022;23(7):524-34. [PubMed ID: 35543390]. doi: 10.1097/PCC.0000000000002961.##[2]Ruegger CM, Owen LS, Davis PG.Nasal Intermittent Positive Pressure Ventilation for Neonatal Respiratory Distress Syndrome. Clin Perinatol. 2021;48(4):725-44. [PubMed ID: 34774206]. doi: 10.1016/j.clp.2021.07.004.##[3]Zha J, Yu YJ, Li GR, Wang SC, Qiao SG, Wang C, et al.Lung protection effect of EIT-based individualized protective ventilation strategy in patients with partial pulmonary resection. Eur Rev Med Pharmacol Sci. 2023;27(12):5459-67. [PubMed ID: 37401282]. doi: 10.26355/eurrev_202306_32782.##[4]Vizzoca A, Lucarini G, Tognoni E, Tognarelli S, Ricotti L, Gherardini L, et al.Erythro-Magneto-HA-Virosome: A Bio-Inspired Drug Delivery System for Active Targeting of Drugs in the Lungs. Int J Mol Sci. 2022;23(17). [PubMed ID: 36077300]. [PubMed Central ID: PMC9455992]. doi: 10.3390/ijms23179893.##[5]Zhu X, Qi H, Feng Z, Shi Y, De Luca D, Nasal Oscillation Post-Extubation Study G.Noninvasive High-Frequency Oscillatory Ventilation vs Nasal Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure Ventilation as Postextubation Support for Preterm Neonates in China: A Randomized Clinical Trial. JAMA Pediatr. 2022;176(6):551-9. [PubMed ID: 35467744]. [PubMed Central ID: PMC9039831]. doi: 10.1001/jamapediatrics.2022.0710.##[6]Junqueira FMD, Nadal JAH, Brandao MB, Nogueira RJN, de Souza TH.High-frequency oscillatory ventilation in children: A systematic review and meta-analysis. Pediatr Pulmonol. 2021;56(7):1872-88. [PubMed ID: 33902159]. doi: 10.1002/ppul.25428.##[7]Reynolds P, Bustani P, Darby C, Fernandez Alvarez JR, Fox G, Jones S, et al.Less-Invasive Surfactant Administration for Neonatal Respiratory Distress Syndrome: A Consensus Guideline. Neonatology. 2021;118(5):586-92. [PubMed ID: 34515188]. doi: 10.1159/000518396.##[8]Silveira RC, Panceri C, Munoz NP, Carvalho MB, Fraga AC, Procianoy RS.Less invasive surfactant administration versus intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome: a systematic review and meta-analyses. J Pediatr (Rio J). 2024;100(1):8-24. [PubMed ID: 37353207]. [PubMed Central ID: PMC10751720]. doi: 10.1016/j.jped.2023.05.008.##[9]Wang X, Zhang C, Zou N, Chen Q, Wang C, Zhou X, et al.Lipocalin-2 silencing suppresses inflammation and oxidative stress of acute respiratory distress syndrome by ferroptosis via inhibition of MAPK/ERK pathway in neonatal mice. Bioengineered. 2022;13(1):508-20. [PubMed ID: 34969358]. [PubMed Central ID: PMC8805876]. doi: 10.1080/21655979.2021.2009970.##[10]Li J, Chen L, Shi Y.Nasal high-frequency oscillatory ventilation versus nasal continuous positive airway pressure as primary respiratory support strategies for respiratory distress syndrome in preterm infants: a systematic review and meta-analysis. Eur J Pediatr. 2022;181(1):215-23. [PubMed ID: 34254173]. doi: 10.1007/s00431-021-04190-0.##[11]Cools F, Offringa M, Askie LM.Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants. Cochrane Database Syst Rev. 2015;2015(3). CD000104. [PubMed ID: 25785789]. [PubMed Central ID: PMC10711725]. doi: 10.1002/14651858.CD000104.pub4.##[12]Qiao JY, Li YZ, Wang HY, Zhang SD.[A Meta analysis of the efficacy of high-frequency oscillatory ventilation versus conventional mechanical ventilation for treating pediatric acute respiratory distress syndrome]. Zhongguo Dang Dai Er Ke Za Zhi. 2017;19(4):430-5.chinease. [PubMed ID: 28407831]. [PubMed Central ID: PMC7389656]. doi: 10.7499/j.issn.1008-8830.2017.04.014.##[13]Zheng YR, Lei YQ, Liu JF, Wu HL, Xu N, Huang ST, et al.Effect of High-Frequency Oscillatory Ventilation Combined With Pulmonary Surfactant in the Treatment of Acute Respiratory Distress Syndrome After Cardiac Surgery: A Prospective Randomised Controlled Trial. Front Cardiovasc Med. 2021;8:675213. [PubMed ID: 34368243]. [PubMed Central ID: PMC8339213]. doi: 10.3389/fcvm.2021.675213.##[14]Wang TY, Zhu Y, Yin JL, Zhao LY, Wang HJ, Xiao CW, et al.The effect of high-frequency oscillatory ventilator combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome. Medicine (Baltimore). 2022;101(32). e29940. [PubMed ID: 35960117]. [PubMed Central ID: PMC9371548]. doi: 10.1097/MD.0000000000029940.##[15]Choommongkol V, Punturee K, Klumphu P, Rattanaburi P, Meepowpan P, Suttiarporn P.Microwave-Assisted Extraction of Anticancer Flavonoid, 2',4'-Dihydroxy-6'-methoxy-3',5'-dimethyl Chalcone (DMC), Rich Extract from Syzygium nervosum Fruits. Molecules. 2022;27(4). [PubMed ID: 35209190]. [PubMed Central ID: PMC8877704]. doi: 10.3390/molecules27041397.##[16]Wang K, Zhou X, Gao S, Li F, Ju R.Noninvasive high-frequency oscillatory ventilation versus nasal intermittent positive pressure ventilation for preterm infants as an extubation support: A systematic review and meta-analysis. Pediatr Pulmonol. 2023;58(3):704-11. [PubMed ID: 36372443]. doi: 10.1002/ppul.26244.##[17]Yang HB, Pierro A, Kim HY.Comparison of conventional mechanical ventilation and high-frequency oscillatory ventilation in congenital diaphragmatic hernias: a systematic review and meta-analysis. Sci Rep. 2023;13(1):16136. [PubMed ID: 37752154]. [PubMed Central ID: PMC10522688]. doi: 10.1038/s41598-023-42344-2.##[18]Liu K, Chen L, Xiong J, Xie S, Hu Y, Shi Y.HFOV vs CMV for neonates with moderate-to-severe perinatal onset acute respiratory distress syndrome (NARDS): a propensity score analysis. Eur J Pediatr. 2021;180(7):2155-64. [PubMed ID: 33638098]. [PubMed Central ID: PMC7910198]. doi: 10.1007/s00431-021-03953-z.##[19]Orlandin EAS, Iwashita-Lages T, Oharomari-Junior LK, Tome MR, Zinher MT, Dias SO, et al.Volume-targeted on high-frequency oscillatory ventilation in preterm infants: a systematic review. J Pediatr (Rio J). 2025;101(3):332-40. [PubMed ID: 40074210]. [PubMed Central ID: PMC12039505]. doi: 10.1016/j.jped.2025.01.012.##[20]Phattraprayoon N, Ho JJ, Fiander M, Priyadarshi M.High-frequency oscillatory ventilation versus conventional ventilation for infants with severe pulmonary dysfunction born at or near term. Cochrane Database Syst Rev. 2025;11(11). CD002974. [PubMed ID: 41216897]. [PubMed Central ID: PMC12604084]. doi: 10.1002/14651858.CD002974.pub3.##[21]Solis-Garcia G, Ramos-Navarro C, Gonzalez-Pacheco N, Sanchez-Luna M.Lung protection strategy with high-frequency oscillatory ventilation improves respiratory outcomes at two years in preterm respiratory distress syndrome: a before and after, quality improvement study. J Matern Fetal Neonatal Med. 2022;35(26):10698-705. [PubMed ID: 36521851]. doi: 10.1080/14767058.2022.2155040.##[22]Dogan S, Paulus M, Surmeier G, Foryt K, Bragelmann K, Tolan M.Nondestructive Compression and Fluidization of Phospholipid Monolayers by Gaseous and Aerolized Perfluorocarbons: Promising Substances for Lung Surfactant Treatment. Langmuir. 2022;38(21):6690-9. [PubMed ID: 35588471]. doi: 10.1021/acs.langmuir.2c00617.##[23]Tan YX, Li SJ, Li HT, Yin XJ, Cheng B, Guo JL, et al.Role of surfactant protein C in neonatal genetic disorders of the surfactant system: A case report. Medicine (Baltimore). 2021;100(50). e28201. [PubMed ID: 34918679]. [PubMed Central ID: PMC8677979]. doi: 10.1097/MD.0000000000028201.##[24]Zheng YR, Lin SH, Chen YK, Cao H, Chen Q.Rescue high-frequency oscillatory ventilation combined with intermittent mandatory ventilation for infants with acute respiratory distress syndrome after congenital heart surgery. Cardiol Young. 2023;33(7):1165-71. [PubMed ID: 35912615]. doi: 10.1017/S1047951122002396.##[25]Dilday J, Leon D, Kuza CM.A review of the utility of high-frequency oscillatory ventilation in burn and trauma ICU patients. Curr Opin Anaesthesiol. 2023;36(2):126-31. [PubMed ID: 36729001]. doi: 10.1097/ACO.0000000000001228.##[26]Pioselli B, Salomone F, Mazzola G, Amidani D, Sgarbi E, Amadei F, et al.Pulmonary Surfactant: A Unique Biomaterial with Life-saving Therapeutic Applications. Curr Med Chem. 2022;29(3):526-90. [PubMed ID: 34525915]. doi: 10.2174/0929867328666210825110421.##

1 Hemoglobin-Albumin-Lymphocyte-Platelet Score as a Predictor of Clinical Severity in Acute Bronchiolitis https://brieflands.com/journals/ijp/articles/169051 10.5812/ijpediatr-169051 1 Background :Acute bronchiolitis (AB) is one of the most common lower respiratory tract infections in infants and young children and is a major contributor to hospital admissions in early childhood. It imposes a substantial burden on healthcare systems worldwide, particularly among children younger than 2 years. The clinical course ranges from a self-limited illness to severe respiratory failure requiring intensive care. However, reliable laboratory-based biomarkers to support the early identification of severe disease remain limited. Objectives :This study aimed to evaluate the prognostic utility of the hemoglobin-albumin-lymphocyte-platelet (HALP) score in assessing disease severity and clinical outcomes in children with AB admitted to the pediatric intensive care unit (PICU). Methods :In this retrospective cohort study, 100 children aged 1 to 24 months with AB were compared with 104 age-matched healthy controls to evaluate clinical and laboratory characteristics. Hematological and biochemical parameters, including hemoglobin level, lymphocyte count, platelet count, albumin level, and the calculated HALP score, were analyzed. The associations between the HALP score, clinical severity, and intensive care outcomes were assessed. Results :Patients with AB had significantly lower lymphocyte counts, albumin concentrations, and HALP scores than healthy controls (P < 0.05). Among PICU patients, children with severe bronchiolitis had markedly lower HALP scores than those with moderate disease. Receiver operating characteristic (ROC) analysis showed that the HALP score effectively distinguished both the presence of AB and disease severity. The HALP score demonstrated good discriminative ability for AB (area under the curve [AUC], 0.88; 95% CI, 0.82 - 0.93; cut-off, 80.91; sensitivity, 85%; specificity, 88.5%) and moderate performance in predicting severity (AUC, 0.67; 95% CI, 0.56 - 0.78; cut-off, 42.65; sensitivity, 57.1%; specificity, 75%). Conclusions :The HALP score appears to be a simple, inexpensive, and readily accessible biomarker that may facilitate early risk stratification and inform clinical decision-making in children with AB. 1 11 Zeynep Sena Kasap Demir Division of Pediatric Intensive Care Unit, Department of Pediatrics, Kütahya Health Sciences University, Kütahya, Turkey Turkey zynpksp00@gmail.com Serkan Özsoylu Division of Pediatric Intensive Care Unit, Department of Pediatrics, Kütahya Health Sciences University, Kütahya, Turkey Turkey sozsoylu@hotmail.com No Keyword 6.pdf [0]Marlais M, Evans J, Abrahamson E.Clinical predictors of admission in infants with acute bronchiolitis. Archives of Disease in Childhood. 2011;96(7):648-52. [PubMed ID: 21339199]. doi: 10.1136/adc.2010.201079.##[1]Yasui K, Baba A, Iwasaki Y, Kubo T, Aoyama K, Mori T, et al.Neutrophil-mediated inflammation in respiratory syncytial viral bronchiolitis. Pediatrics International. 2005;47(2):190-5. [PubMed ID: 15771699]. doi: 10.1111/j.1442-200x.2005.02039.x.##[2]Fleming DM, Pannell RS, Cross KW.Mortality in children from influenza and respiratory syncytial virus. Journal of Epidemiology & Community Health. 2005;59(7):586-90. [PubMed ID: 15965143]. [PubMed Central ID: PMC1757088]. doi: 10.1136/jech.2004.026450.##[3]American AOPSODAMOB.Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774-93. [PubMed ID: 17015575]. doi: 10.1542/peds.2006-2223.##[4]Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al.Clinical practice guideline: The diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014;134(5):e1474-e502. [PubMed ID: 25349312]. doi: 10.1542/peds.2014-2742.##[5]Alharbi A, Alqwaiee M, Al-Hindi M, Mosalli R, Al-Shamrani A, Alharbi S, et al.Bronchiolitis in children: The Saudi initiative of bronchiolitis diagnosis, management, and prevention (SIBRO). Annals of Thoracic Medicine. 2018;13(3):127-43. [PubMed ID: 30123331]. [PubMed Central ID: PMC6073791]. doi: 10.4103/atm.ATM_60_18.##[6]Benli S, Tazeoğlu D.The efficacy of hemoglobin, albumin, lymphocytes, and platelets (HALP) score in signifying acute appendicitis severity and postoperative outcomes. Updates in Surgery. 2023;75(5):1197-202. [PubMed ID: 37119455]. doi: 10.1007/s13304-023-01513-8.##[7]Florin TA, Plint AC, Zorc JJ.Viral bronchiolitis. The Lancet. 2017;389(10065):211-24. [PubMed ID: 27549684]. [PubMed Central ID: PMC6765220]. doi: 10.1016/S0140-6736(16)30951-5.##[8]Hrubaru I, Motoc A, Dumitru C, Bratosin F, Fericean RM, Alambaram S, et al.Assessing the utility of hemoglobin, HALP score, FAR ratio, and coagulation parameters as predictors for preterm birth. Children. 2023;10(3):527. [PubMed ID: 36980085]. [PubMed Central ID: PMC10047754]. doi: 10.3390/children10030527.##[9]Toptan HH, Tezel KG, Tezel O, Ataç Ö, Vardar G, Gülcan Kersin S, et al.Inflammatory and hematologic liver and platelet (HALP) scores in hypothermia-treated hypoxic-ischemic encephalopathy (HIE). Children. 2024;11(1):72. [PubMed ID: 38255385]. [PubMed Central ID: PMC10814453]. doi: 10.3390/children11010072.##[10]Farag CM, Antar R, Akosman S, Ng M, Whalen MJ.What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP's prognostic ability in different cancer types. Oncotarget. 2023;14(1):153-748. [PubMed ID: 36848404]. [PubMed Central ID: PMC9970084]. doi: 10.18632/oncotarget.28485.##[11]Ozcanli Cay O, Kocaoglu S, Kemer Aycan O, Alatli T.The role of HALP and modified-HALP scores in predicting critical acute bronchiolitis patients. Inn J Pediatr. 2025;35(2). e151400. doi: 10.5812/ijp-151400.##[12]Meissner HC.Viral bronchiolitis in children. New England Journal of Medicine. 2016;374(1):62-72. [PubMed ID: 26735994]. doi: 10.1056/NEJMra1413456.##[13]Costa S, Rocha R, Tavares M, Bonito-Vítor A, Guedes-Vaz L, João HS.C reactive protein and disease severity in bronchiolitis: Proteína C reactiva e gravidade da bronquiolite aguda. Revista Portuguesa de Pneumologia (English Edition). 2009;15(1):55-65. doi: 10.1016/S2173-5115(09)70088-0.##[14]Hatherill M, Tibby SM, Sykes K, Turner C, Murdoch IA.Diagnostic markers of infection: Comparison of procalcitonin with C reactive protein and leucocyte count. Archives of Disease in Childhood. 1999;81(5):417-21. [PubMed ID: 10519716]. [PubMed Central ID: PMC1718133]. doi: 10.1136/adc.81.5.417.##[15]Peng D, Zhang CJ, Gong YQ, Hao H, Guan B, Li XS, et al.Prognostic significance of HALP (hemoglobin, albumin, lymphocyte, and platelet) in patients with bladder cancer after radical cystectomy. Scientific Reports. 2018;8(1). 794. [PubMed ID: 29335609]. [PubMed Central ID: PMC5768698]. doi: 10.1038/s41598-018-19146-y.##[16]Zhai B, Chen J, Wu J, Yang L, Guo X, Shao J, et al.Predictive value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and lymphocyte-to-monocyte ratio (LMR) in patients with non-small cell lung cancer after radical lung cancer surgery. Annals of Translational Medicine. 2021;9(12):976-976. [PubMed ID: 34277776]. [PubMed Central ID: PMC8267290]. doi: 10.21037/atm-21-2120.##[17]Pasricha SR, Tye-Din J, Muckenthaler MU, Swinkels DW.Iron deficiency. The Lancet. 2021;397(10270):233-48. [PubMed ID: 33285139]. doi: 10.1016/S0140-6736(20)32594-0.##[18]Franch-Arcas G.The meaning of hypoalbuminaemia in clinical practice. Clinical Nutrition. 2001;20(3):265-9. [PubMed ID: 11407875]. doi: 10.1054/clnu.2001.0438.##[19]Kornerup KN, Page CP.The role of platelets in the pathophysiology of asthma. Platelets. 2007;18(5):319-28. [PubMed ID: 17654302]. doi: 10.1080/09537100701230436.##[20]Cottini F, Benson D.To be or not to be: The role of CD56 in multiple myeloma. Oncotarget. 2023;14(1):47-49. [PubMed ID: 36702332]. [PubMed Central ID: PMC9882993]. doi: 10.18632/oncotarget.28350.##[21]Marguet C, Bocquel N, Benichou J, Basuyau JP, Hellot MF, Couderc L, et al.Neutrophil but not eosinophil inflammation is related to the severity of a first acute epidemic bronchiolitis in young infants. Pediatric Allergy and Immunology. 2008;19(2):157-65. [PubMed ID: 18093085]. doi: 10.1111/j.1399-3038.2007.00600.x.##[22]Socorro Faria S, Fernandes Jr PC, Barbosa Silva MJ, Lima VC, Fontes W, Freitas-Junior R, et al.The neutrophil-to-lymphocyte ratio: A narrative review. ecancermedicalscience. 2016;10:702. [PubMed ID: 28105073]. [PubMed Central ID: PMC5221645]. doi: 10.3332/ecancer.2016.702.##[23]Huang Y, Liu A, Liang L, Jiang J, Luo H, Deng W, et al.Diagnostic value of blood parameters for community-acquired pneumonia. International Immunopharmacology. 2018;64:10-5. [PubMed ID: 30144639]. doi: 10.1016/j.intimp.2018.08.022.##[24]Çolak M, Çoban H, Sarioğlu N, Yumrukuz Şenel M, Erel F.Could the HALP score serve as a biomarker of bronchiectasis exacerbation? Tuberculosis and Thorax. 2024;72(1):202401811-15. [PubMed ID: 38676590]. [PubMed Central ID: PMC11390076]. doi: 10.5578/tt.202401811.##

1 Pediatric Colonoscopy in Baghdad, Iraq: A Prospective Analysis of Clinical Indications, Endoscopic Findings, and Histopathological Outcomes at a Tertiary Pediatric Hospital https://brieflands.com/journals/ijp/articles/164333 10.5812/ijpediatr-164333 1 Background :Pediatric colonoscopy differs from adult practice in multiple aspects, including patient management, sedation and anesthesia selection, bowel preparation, expected diagnoses, instrument choice, and the need for biopsies from macroscopically normal mucosa. Local data from Iraq are scarce. Objectives :To describe the demographic and clinical characteristics of children undergoing colonoscopy, to report endoscopic and histopathological findings, and to observe the relationship between procedure indications, endoscopic appearance, and final diagnosis. Methods :A prospective cross-sectional observational study was conducted at the Gastroenterology Unit of the Children Welfare Teaching Hospital, Baghdad, from 1 May to 1 December 2023. All children younger than 15 years who underwent colonoscopy during the study period were included. Demographic data, clinical indications, endoscopic findings, and histopathological diagnoses were recorded. Procedures were performed in scheduled pediatric sessions with trained endoscopy staff. Results :A total of 105 children [mean age 8.25 ± 3.6 years; 44 males (41.9%), 61 females (58.1%)] were studied. The most common indications were bleeding per rectum (38.1%), diarrhea (25.7%), and abdominal pain (17.1%). Endoscopy was normal in 29.5% of cases. Abnormal findings included non-specific colitis in 21.9%, inflammatory bowel disease (IBD) in 21.0%, and polyps in 14.3%. All polyps were rectal and histologically juvenile. Conclusions :In this first Iraqi pediatric colonoscopy cohort, pediatric colonoscopy for lower GI symptoms was most commonly indicated for rectal bleeding and chronic diarrhea, with colonic inflammation (IBD, nonspecific colitis) and polyps as frequent diagnoses. Complete colonoscopy with ileal intubation is crucial for IBD assessment, though these single-center findings require cautious interpretation. 1 8 Rasha Sulaiman A. Raheem Department of Pediatrics, Mustansiriyah University, College of Medicine, Baghdad, Iraq Iraq dr.rasha.suleman@uomustansiriyah.edu.iq Rabab Farhan Thejeal Department of Pediatrics, University of Baghdad, College of Medicine, Baghdad, Iraq Iraq farhan_rabab@yahoo.com Ban Sultan Hachim Department of Pediatrics, University of Baghdad, College of Medicine, Baghdad, Iraq Iraq banalhayani@yahoo.com Bashar Abbas Abdulhassan Department of Surgery, Al-Nahrain University, College of Medicine, Baghdad, Iraq Iraq basharabass75@gmail.com Abdulrahman Waad Zakaria University of Baghdad, College of Medicine, Baghdad, Iraq Iraq abd.alrahman1800b@comed.uobaghdad.edu.iq No Keyword 7.pdf [0]Leichtner AM, Gillis LA, Gupta S, Heubi J, Kay M, Narkewicz MR, et al.NASPGHAN guidelines for training in pediatric gastroenterology. J Pediatr Gastroenterol Nutr. 2013;56 Suppl 1:S1-8. [PubMed ID: 23263531]. doi: 10.1097/MPG.0b013e31827a78d6.##[1]Barth BA, Banerjee S, Bhat YM, Desilets DJ, Gottlieb KT; Asge Technology Committee, et al.Equipment for pediatric endoscopy. Gastrointest Endosc. 2012;76(1):8-17. [PubMed ID: 22579260]. doi: 10.1016/j.gie.2012.02.023.##[2]Gershman G.Pediatric Colonoscopy. In: Gershman G, Thomson M, editors. Practical Pediatric Gastrointestinal Endoscopy. 2012. p. 104-31. doi: 10.1002/9781444354577.ch7.##[3]Poddar U, Vadlapudi SS.What Is the Best for Colon Preparation: Single-Dose, Split-Dose or Add-ons to Polyethylene Glycol? Indian Pediatr. 2021;58(12):1115-6. [PubMed ID: 34939578].##[4]Lu W, Zhou K, Cai C, He Y, Jiang H, Li X.Effects on BBPS score with bowel preparation time and dosage. Medicine (Baltimore). 2022;101(27). e29897. [PubMed ID: 35801741]. [PubMed Central ID: PMC9259163]. doi: 10.1097/MD.0000000000029897.##[5]Friedt M, Welsch S.An update on pediatric endoscopy. Eur J Med Res. 2013;18(1):24. [PubMed ID: 23885793]. [PubMed Central ID: PMC3751043]. doi: 10.1186/2047-783X-18-24.##[6]Rezakhaniha B, Arian Pour N, Siroosbakhat S.Effect of Cystoscopy on Prostate-Specific Antigen: New Words about Old Subject. Int J Cancer Manag. 2010;3(4). e80717.##[7]Sirousbakht S, Rezakhaniha B.Effect of Colonoscopy on Prostate-Specific Antigen; New Words about an Old Subject. Int J Cancer Manag. 2018;11(7). doi: 10.5812/ijcm.68919.##[8]Petar M, Noor N.Bowel Preparation for Pediatric Colonoscopy. Front Pediatr. 2021;9:1-7. [PubMed ID: 34540766]. [PubMed Central ID: PMC8442953].##[9]Hassan C, East J, Radaelli F, Spada C, Benamouzig R, Bisschops R, et al.Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019. Endoscopy. 2019;51(8):775-94. [PubMed ID: 31295746]. doi: 10.1055/a-0959-0505.##[10]Kay M, Wyllie R.Colonoscopy, Polypectomy and Related Techniques. In: Wyllie R, S. Hyams J, Kay M, editors. Pediatric Gastrointestinal and Liver Disease. Amsterdam, Netherlands: Elsevier; 2016. p. 705-26.##[11]Tam YH, Lee KH, Chan KW, Sihoe JD, Cheung ST, Mou JW.Colonoscopy in Hong Kong Chinese children. World J Gastroenterol. 2010;16(9):1119-22. [PubMed ID: 20205284]. [PubMed Central ID: PMC2835790]. doi: 10.3748/wjg.v16.i9.1119.##[12]Isoldi S, Cucchiara S, Repici A, Lerner DG, Thomson M, Oliva S.Gastrointestinal endoscopy in children and adults: How do they differ? Dig Liver Dis. 2021;53(6):697-705. [PubMed ID: 33692010]. doi: 10.1016/j.dld.2021.02.016.##[13]Pasquarella CS, Kaplan B, Mahajan L, Lamparyk K, Kay M.A Single-center Review of Pediatric Colonoscopy Quality Indicators. J Pediatr Gastroenterol Nutr. 2019;68(5):648-54. [PubMed ID: 30562311]. doi: 10.1097/MPG.0000000000002239.##[14]Lee BG, Shin SH, Lee YA, Wi JH, Lee YJ, Park JH.Juvenile polyp and colonoscopic polypectomy in childhood. Pediatr Gastroenterol Hepatol Nutr. 2012;15(4):250-5. [PubMed ID: 24010095]. [PubMed Central ID: PMC3746052]. doi: 10.5223/pghn.2012.15.4.250.##[15]Alrashidi S, AlAmery T, Alshanbary A, Aljohani E, Bashir SM, Alsaleem B, et al.Disease patterns among Saudi children undergoing colonoscopy for lower gastrointestinal bleeding: Single tertiary care center experience. Saudi J Gastroenterol. 2023;29(6):388-95. [PubMed ID: 37706419]. [PubMed Central ID: PMC10754380]. doi: 10.4103/sjg.sjg_130_23.##[16]Yoshioka S, Takedatsu H, Fukunaga S, Kuwaki K, Yamasaki H, Yamauchi R, et al.Study to determine guidelines for pediatric colonoscopy. World J Gastroenterol. 2017;23(31):5773-9. [PubMed ID: 28883703]. [PubMed Central ID: PMC5569292]. doi: 10.3748/wjg.v23.i31.5773.##[17]Kawada PS, O'Loughlin EV, Stormon MO, Dutt S, Lee CH, Gaskin KJ.Are We Overdoing Pediatric Lower Gastrointestinal Endoscopy? J Pediatr Gastroenterol Nutr. 2017;64(6):898-902. [PubMed ID: 26960173]. doi: 10.1097/MPG.0000000000001192.##[18]Aziz DA, Moin M, Majeed A, Sadiq K, Biloo AG.Paediatric Inflammatory Bowel Disease: Clinical Presentation and Disease Location. Pak J Med Sci. 2017;33(4):793-7. [PubMed ID: 29067041]. [PubMed Central ID: PMC5648940]. doi: 10.12669/pjms.334.12926.##[19]Park JH.Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders. Korean J Pediatr. 2010;53(9):824-9. [PubMed ID: 21189966]. [PubMed Central ID: PMC3005213]. doi: 10.3345/kjp.2010.53.9.824.##[20]Emara MH, Salama RI, Hamed EF, Shoriet HN, Abdel-Aziz HR.Non-specific colitis among patients with colitis: frequency and relation to inflammatory bowel disease, a prospective study. J Coloproctol. 2021;39(4):319-25. doi: 10.1016/j.jcol.2019.06.004.##[21]Nambu R, Hagiwara SI, Kakuta F, Hara T, Shimizu H, Abukawa D, et al.Current role of colonoscopy in infants and young children: a multicenter study. BMC Gastroenterol. 2019;19(1):149. [PubMed ID: 31429721]. [PubMed Central ID: PMC6701113]. doi: 10.1186/s12876-019-1060-7.##[22]Kawada PS, O'Loughlin EV, Stormon MO, Dutt S, Lee CH, Gaskin KJ.Are We Overdoing Pediatric Lower Gastrointestinal Endoscopy? J Pediatr Gastroenterol Nutr. 2017;64(6):898-902. [PubMed ID: 26960173]. doi: 10.1097/MPG.0000000000001192.##[23]Morita M, Takedatsu H, Yoshioka S, Mitsuyama K, Tsuruta K, Kuwaki K, et al.Utility of Diagnostic Colonoscopy in Pediatric Intestinal Disease. J Clin Med. 2022;11(19). [PubMed ID: 36233615]. [PubMed Central ID: PMC9572109]. doi: 10.3390/jcm11195747.##[24]Parga J, Otero Regino W, Gómez Zuleta MA.Prevalencia y características histológicas de los pólipos diminutos del recto y del sigmoides en una población colombiana. Revista Colombiana de Gastroenterología. 2020;35(1):25-32. doi: 10.22516/25007440.363.##[25]Wang Y, Fang L, Huang K, Pan T, Lu H, Yan X.Characteristics and risk factors for colorectal polyps among children in an urban area of Wenzhou, China: a retrospective case control study. BMC Pediatr. 2023;23(1):408. [PubMed ID: 37598160]. [PubMed Central ID: PMC10439580]. doi: 10.1186/s12887-023-04197-6.##[26]Kim JY, Kim YB, Choi S, Lee YM, Kim HJ, Kim SC, et al.Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required. Gut Liver. 2023;17(3):441-8. [PubMed ID: 36052612]. [PubMed Central ID: PMC10191782]. doi: 10.5009/gnl210404.##[27]Lee Y, Choi S, Kang B.Practice Patterns of Colorectal Polypectomy in Pediatric Endoscopic Specialists in South Korea: A Nationwide Survey Study. Pediatr Gastroenterol Hepatol Nutr. 2023;26(1):15-22. [PubMed ID: 36816437]. [PubMed Central ID: PMC9911175]. doi: 10.5223/pghn.2023.26.1.15.##