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Introduction Promoting social inclusion of children with congenital Zika virus syndrome (CZS) is challenging, mostly, when there is a transport problem, low access to information and a long distance between the house and health services. Participation can be understood as involvement in a life situation and is strongly influenced by physical, social and attitudinal environmental factors; however, was still little explored in the case of children with CZS. In this sense, this study aimed to explore the perception of caregivers about the environmental needs of children with CZS, differentiating barriers and facilitators. Methods This is qualitative research. Thematic analysis was used to identify the environmental needs perceived by caregivers of children with CZS. The patient public involvement (PPI) approach was incorporated with the purpose of validating the data analysis performed by the researchers. After this step, the data were categorized in terms of barriers and facilitators and validated by the group of researchers. Results A relevant environmental need reported by caregivers as a barrier was social support for children with CZS. Ableism was also evidenced as an important attitudinal barrier. Health services were essential for the lives of children with CZS and the availability of auxiliary devices as facilitators of participation. Environmental factors related to medication and food routines were, for the most part, facilitators. Conclusion This study contributes to critical approaches to the impacts linked to environmental factors of children with CZS, recognition of these children is an evolving process and fundamental to basic rights for adequate living in society. The data point to the need to implement public policies aimed at children with CZS, as well as the availability of qualified professionals to apply family‐centred care and skills‐focused management. Building friendly environments that promote broad social participation will contribute to the healthy growth of children with CZS. Patient or Public Contribution Six caregivers (20% of the caregivers) as part of the PPI approach were contacted and participated in individual virtual meetings to discuss the results of the thematic analysis regarding the environmental needs of children with CZS.

Focal segmental glomerulosclerosis (FSGS) is a histopathological pattern of segmental glomerulosclerosis that arises from diverse primary and secondary causes. Primary (idiopathic) FSGS is rare and is often linked to intrinsic podocyte injury, while secondary forms are more prevalent and may reflect adaptative, toxic, genetic, or viral etiologies. This pattern of injury can lead to progressive renal dysfunction and, in some cases, end-stage kidney disease. The pathophysiology is multifactorial and includes direct podocyte injury (e.g., genetic defects, mechanical or toxic injury), immune-mediated processes (e.g., circulating permeability factors, inflammatory mediators), and metabolic disturbances. In particular, disturbance of lipid metabolism, including intracellular cholesterol accumulation in podocytes, have been implicated as a contributory mechanism in podocyte dysfunction and progression of disease in proteinuric/nephrotic presentations and in specific disease subtypes. Diagnosis relies on clinical assessment, laboratory testing, and histological examination, with kidney biopsy remaining the gold standard. Conventional treatments include corticosteroids, and other immunosuppressants when indicated, and measures to reduce proteinuria and control blood pressure, but the therapeutic response is variable and many patients show progression, highlighting the need for more effective and novel therapeutic approaches. Cyclodextrins (CDs), widely used as drug carriers to enhance solubility, can also mobilize and promote efflux of cholesterol from cells. Preclinical studies show that CDs reduce renal lipid accumulation and ameliorate podocyte injury in experimental models, supporting the idea that CDs could have a dual role as drug carriers and as direct modulators of lipid-related podocyte injury in lipid-associated forms of FSGS. Given the limited direct clinical data in FSGS, in this article we discuss the biological rationale, preclinical evidence, and remaining knowledge gaps for exploring CDs as an innovative therapeutic strategy.