Background. Over the last decade, the understanding of pediatric disorders of gut-brain interaction has shifted from motility disorders to a comprehensive biopsychosocial model. The updated Rome V (2026) international guidelines introduce an anatomical classification principle and expand the role of modern instrumental methods for diagnosing esophageal pathology. This has enabled the identification of new esophageal disorders and the proposal of multidisciplinary approaches to their treatment. The purpose was to analyze the current state of the issue of pediatric disorders of gut-brain interaction, namely of the upper gastrointestinal tract, based on a review of the updated Rome V criteria, as well as to determine the main changes in diagnosis and patient management. Materials and methods. A comprehensive systematic review was performed using PubMed, Web of Science, Scopus, and Google Scholar databases from 2016 through May 2026. A total of 386 publications were identified, of which 47 met the inclusion criteria. Results. The transition to an anatomical classification principle in the Rome V criteria was shown to facilitate a more precise differentiation of functional esophageal disorders in children. The diagnostic characteristics of newly defined disorders, namely reflux hypersensitivity, reflux-negative esophageal pain disorder, and supragastric belching, were systematically analyzed. An evidence-based algorithm for the use of pH-impedance monitoring and high-resolution esophageal manometry was developed. Furthermore, the inclusion of multidisciplinary specialists, particularly psychotherapists and speech therapists, in personalized management strategies was justified. Conclusions. Prospective studies should be directed at clarifying the prevalence of pediatric esophageal disorders, identifying specific risk factors, and developing treatment.
Background. Neutrophilic airway inflammation is a central pathogenic mechanism in bronchiectasis. However, the prognostic value of serum inflammatory biomarkers in the paediatric population remains uncertain, and most available evidence derives from mixed-etiology cohorts and adult patients. The aim of the study was to evaluate serum interleukin-6 (IL-6) and neutrophil elastase (NE/ELA2) concentrations in children with bronchiectasis of different etiologies, determine their diagnostic utility, and assess associations with key disease-control outcomes, including the rate of exacerbations requiring antibiotic therapy, hospitalisation frequency, forced expiratory volume in 1 second, and quality of life measured using bronchiectasis child-specific parent-proxy QoL instrument. Materials and methods. A total of 150 children aged 2–17 years were enrolled and divided into three groups: non-cystic fibrosis bronchiectasis (non-CF, n = 50), cystic fibrosis-associated bronchiectasis (CF, n = 50), and apparently healthy controls (n = 50). IL-6 and NE/ELA2 were measured by enzyme-linked immunosorbent assay. Kruskal-Wallis and Mann-Whitney tests, ROC analysis with area-under-the-curve (AUC) comparison using DeLong’s method, Spearman correlation, partial rank correlation, and Firth logistic regression were applied. Results. Both biomarkers exhibited a stepwise gradient: controls < non-CF < CF (all pairwise p < 0.001), and their distributions in patients and healthy controls did not overlap (AUC = 1.000). For clinically meaningful discrimination between etiological groups, performance was moderate: IL-6, AUC = 0.884; NE/ELA2, AUC = 0.865 (DeLong p = 0.653). In the pooled cohort, 21 significant correlations among 34 tested associations were identified, as well as 13 significant odds ratios among 18 evaluated comparisons (3.6–10.2). Conclusions. Serum IL-6 and NE/ELA2 reliably reflect disease presence and etiologic category. Within diagnostically homogeneous groups, however, their association with individual clinical course did not reach statistical significance, which — given the cross-sectional design — indicates limited prognostic value for monitoring and warrants confirmation in prospective studies. Based on the present data, disease monitoring should rely primarily on clinical outcomes and quality-of-life measures.
Background. Modern treatment protocols for childhood acute lymphoblastic leukemia (ALL) have greatly improved survival; however, a growing number of survivors experience late endocrine complications as a consequence of treatment. The purpose was to evaluate the spectrum and frequency of late endocrine complications in childhood ALL survivors managed with a chemotherapy-only regimen. Materials and methods. A non-randomized, analytic cross-sectional study was conducted on 50 patients diagnosed with ALL between March 2011 and February 2020 at the Pediatric Hemato-Oncology Center, Children’s Central Teaching Hospital, in Baghdad, Iraq. All participants had achieved complete remission for at least 2 years. Clinical and laboratory investigations were performed to identify late endocrine complications. Results. Overweight and obesity were identified in 16 patients (32 %) and were significantly associated with age younger than 5 years at diagnosis (p = 0.044). Short stature was observed in 3 patients (6 %). Prediabetes was detected in 6 patients (12 %) and showed a significant association with overweight and obesity (p = 0.009). Subclinical hypothyroidism and delayed puberty were each detected in one patient (2 %). No significant associations were found between short stature, prediabetes, thyroid dysfunction, or delayed puberty with respect to age or sex. Conclusions. Overweight and obesity were the most frequent endocrine late complications among childhood ALL survivors and were associated with younger age at diagnosis. Prediabetes was more common in overweight and obese patients, highlighting the importance of long-term metabolic surveillance in this population.
Background. Chronic diseases among children, such as asthma, are increasing globally. Asthma is one of the most common chronic illnesses and represents a major global health issue that results in significant morbidity. The purpose of this review is to discuss the effectiveness of education programs on knowledge, medication adherence, asthma management skills, and self-efficacy among children and their parents with asthma. Materials and methods. Database searches were completed in CINAHL, Springer, Science Direct, PubMed, MEDLINE, Google Scholar, and EBSCOhost. Papers published between 2015 and 2025 were included using keywords such as asthma, child, self-management, self-efficacy, and adherence interventions. A total of 165 records were identified. After removing duplicates and irrelevant studies, 12 papers were included in the final review. Results. The included studies demonstrated significant improvements in asthma knowledge, medication adherence, asthma management skills, and self-efficacy among children and caregivers. Conclusions. Asthma education interventions positively impact outcomes for children with asthma; they still need to build up a unified, evidence-based approach including structured education, accessible action plans, and continuous reinforcement for optimizing asthma control in children.
Background. Sustained asthma control in children is often difficult to achieve, and biomarkers reflecting airway epithelial integrity are needed. Club cell secretory protein 16 (CC16) is a candidate marker of epithelial injury and lower airway inflammation. Objective: to determine serum CC16 in children with asthma according to disease severity and control. Materials and methods. This prospective study enrolled 72 children aged 6–17 years: 52 with asthma (mild, n = 13; moderate, n = 22; severe, n = 17) and 20 healthy controls. Serum CC16 was measured by enzyme-linked immunosorbent assay, and asthma control was assessed with the Childhood Asthma Control Test. Data are presented as mean ± SEM; a multivariable model assessed the association between CC16 and asthma severity, adjusted for confounders including age and sex. Results. Children with asthma had markedly lower serum CC16 concentrations than controls (1.80 ± 0.16 vs 2.51 ± 0.15 ng/mL; p = 0.0001). CC16 showed an inverse correlation with asthma severity (r = –0.45; p < 0.001). In children with mild asthma, the mean CC16 level was 2.42 ± 0.56 ng/mL and was notably higher than in severe asthma, where the lowest values were recorded (1.20 ± 0.06 ng/mL; p = 0.024). In moderate asthma, the mean CC16 concentration was 1.90 ± 0.14 ng/mL and was also lower than in the control group (p = 0.006). No statistically significant differences were found according to asthma control status (p = 0.148), although a downward trend in CC16 concentration was observed with poorer disease control. Mean CC16 decreased across control categories: 2.32 ± 0.43 ng/mL in controlled, 1.56 ± 0.11 ng/mL in partially controlled, and 0.85 ± 0.02 ng/mL in uncontrolled asthma. In the multivariable model, asthma severity remained an independent predictor of serum CC16 (β = –0.73; p = 0.002). Conclusions. In children with asthma, serum CC16 is reduced in proportion to disease severity, with the lowest levels in severe asthma, supporting its potential as a non-invasive biomarker of disease course.
