Objective: To characterize cardiovascular findings in childhood cancer survivors during post-treatment follow-up. Methods: This single-center observational study assessed survivors after completion of treatment and compared available echocardiographic and exercise-related measurements with healthy control data. Clinical assessment, cardiac biomarkers and electrocardiography were also obtained. Receipt of cardiovascular medication at follow-up was examined as an exploratory clinical management outcome. Results: Sixty survivors and 60 healthy controls contributed echocardiographic data; CPET comparisons involved 42 survivors and 14 controls. The median survivor age was 12 years. No survivor had clinical heart failure symptoms. Compared with controls, survivors had higher heart rate and resting blood pressure, less negative LV GLS (−18.8 ± 2.5% vs. −22.5 ± 1.6%), higher mitral E/e (6.2 (5.5, 7.1) vs. 4.9 (4.4, 5.7)), and lower recorded absolute oxygen uptake during exercise (1.2 (0.9, 1.4) vs. 1.5 (1.3, 1.7) L/min). Qualitative cardiac enlargement was reported in 16 survivors; 15 received cardiovascular medication. Previous cardiac events were associated with medication receipt in univariate analysis. In the ALL subgroup, medication receipt was more frequent in the intermediate/high-risk treatment group, which had higher anthracycline exposure; the age-at-diagnosis comparison was not statistically significant (p = 0.054). Conclusions: Selected cardiovascular measurements differed between survivors and healthy controls, suggesting possible subclinical alterations. These findings do not establish clinically defined cardiac dysfunction or a causal effect of cancer treatment. The unadjusted absolute oxygen uptake comparison does not establish impaired exercise capacity. Treatment-related associations were exploratory and did not identify independent predictors.
Background/Objectives: Adolescents undergoing treatment for cancer face both physical and psychological challenges, including depression and anxiety, yet local prevalence data remain limited in Saudi Arabia. The primary objective was to determine the prevalence of depressive and anxiety symptoms among adolescents with cancer at a tertiary center in Riyadh; a secondary, exploratory objective was to examine associations with socio-demographic and clinical factors. Methods: A cross-sectional study was conducted at a tertiary oncology center in Riyadh. Using convenience sampling, 86 adolescents aged 12–18 years with a confirmed tumor diagnosis completed a study-developed questionnaire and the validated Arabic PHQ-9 and GAD-7; analysis was restricted to the 59 participants with malignant disease. Results: Depressive symptoms of any severity were reported by 52.5% of participants (95% CI 40.0–64.7%), and anxiety symptoms by 37.3% (95% CI 26.1–50.0%). In secondary, exploratory analyses using a clinically meaningful threshold, both depression and anxiety were significantly more common among females than males (depression: 36.8% vs. 10.0%, p = 0.027; anxiety: 52.6% vs. 10.0%, p = 0.0006); anxiety was also significantly associated with age (highest at 14–16 years; p = 0.024). Most participants had no prior formal mental health diagnosis. Conclusions: Over half of adolescents with cancer in this Saudi sample experienced depressive symptoms, and over a third experienced anxiety symptoms; female gender was associated with both outcomes, and age with anxiety specifically, though these associations remain exploratory given the small sample. These findings support routine screening for all adolescents with cancer, with particular attention to female patients.
Intestinal mature B-cell non-Hodgkin lymphoma (B-NHL) is the most common pediatric gastrointestinal lymphoma, but presentation as acute mechanical bowel obstruction remains rare and still challenging. Evidence guiding emergency surgical management in children is limited to small retrospective series and case reports. This case series describes three children with intestinal B-NHL presenting with acute mechanical bowel obstruction, or intussusception. All three patients presented to the emergency department with signs of bowel obstruction and an acute abdomen, and in one patient initial diagnosis suggested appendicitis. Imaging revealed either intussusception with a lead mass or large obstructing abdominal tumors. Surgery within 8–48 h consisted of segmental bowel resection with primary anastomosis in all cases. The final diagnoses were Burkitt lymphoma in two patients and diffuse large B-cell lymphoma (DLBCL) in one. The wider literature confirms that lymphoma-related intussusception and obstructing ileal masses occur predominantly in older children, are frequently misdiagnosed preoperatively, and often require emergency surgery both for diagnosis and for treatment of obstruction. Available literature has examined outcomes after emergency surgery for intestinal lymphoma, but the present case series cannot determine its independent effect on long-term oncologic prognosis. Pediatric intestinal B-NHL can present as acute mechanical bowel obstruction or intussusception suggesting common surgical conditions. Surgeons play a crucial role in early recognition, appropriate extent of resection, and timely transition to oncologic care. Further multicenter studies are needed to optimize surgical decision-making and quantify outcomes in this rare but life-threatening presentation.
Background: Physical fitness plays an important role in healthy development; however, children and adolescents with autism spectrum disorder (ASD) typically demonstrate lower physical fitness levels than their neurotypical peers. This study examined changes in physical fitness during 10 months of judo training in inclusive groups. Methods: Ninety children and adolescents aged 7–14 years (36 with ASD and 54 neurotypical peers) participated. Physical fitness was assessed with the EUROFIT test battery at baseline and after 5 and 10 months of training. Results: Both groups significantly improved in overall physical fitness and in most individual tests. The Group × Time interaction was significant only for balance, flexibility, and the total EUROFIT (European Physical Fitness Test Battery) score; in the remaining tests, both groups changed at similar rates. Conclusions: Judo training conducted in inclusive groups may be a valuable form of physical activity for children and adolescents with ASD, as it was accompanied by improvements in physical fitness. The findings also support the feasibility of implementing judo programs in inclusive settings.
Background/Objective: We aimed to develop a questionnaire for pediatric healthcare professionals assessing the rights of hospitalized children, service quality, clinical relationships, and care practices and to obtain preliminary evidence of its content validity, internal consistency, and exploratory psychometric properties. Methods: A four-phase methodological study was conducted: (0) instrument construction based on a review of the literature and relevant regulations; (1) expert content validation (n = 8) using the Content Validity Coefficient (CVC) and Kendall’s coefficient of concordance (W); (2) preliminary pilot testing (n = 10) for item refinement; and (3) post-pilot testing with pediatric healthcare professionals (n = 35) to examine internal consistency and exploratory psychometric properties. Descriptive statistics, the Kaiser–Meyer–Olkin (KMO) measure, Bartlett’s test of sphericity, principal component analysis (PCA) with Varimax rotation, average variance extracted (AVE), the heterotrait–monotrait ratio (HTMT), and correlations with a global satisfaction item (P50) were used. Results: The initial questionnaire comprised 77 items. Expert validation showed high CVC values for relevance (0.976), appropriateness (0.982), and clarity (0.973), with strong concordance among experts (Kendall’s W = 0.85, p < 0.001). During preliminary pilot testing, two single-choice questions were converted into two dichotomous items, yielding a 79-item post-pilot version. Refinement removed 18 items, resulting in a 61-item questionnaire. All four a priori theoretical dimensions showed Cronbach’s alpha values ≥ 0.70, providing preliminary evidence of internal consistency. Exploratory principal component analyses conducted separately within the four a priori theoretical dimensions yielded 4 to 6 components, accounting for 65.9–76.5% of the total variance. KMO values were modest (0.515–0.545), although Bartlett’s tests of sphericity were statistically significant. The retained items showed communalities and component loadings above 0.50. AVE and HTMT were calculated as exploratory indicators related to convergent and discriminant validity, respectively. The global satisfaction item (P50) loaded on the second component of Dimension 4 (communality = 0.60) and showed positive correlations with the remaining dimensions. Conclusions: The questionnaire showed high content-validity coefficients and acceptable preliminary internal consistency. The PCA, AVE, HTMT, and P50 findings provide exploratory information on item behavior and relationships among the theoretically defined dimensions but do not establish convergent, discriminant, criterion-related, or empirical dimensional validity. Given the small, single-center sample and modest KMO values, larger independent samples are required to confirm the dimensional structure and provide further validity evidence.
