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Pediatr. Rep., Volume 17, Issue 1 (February 2025) – 22 articles

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16 pages, 282 KiB  
Article
The Impact of Life and Adverse Childhood Events on Help-Seeking Behaviours—A Cross-Sectional Survey of School-Age Adolescents in Jordan
by Reham A. Lasheen, Sara Abu Khudair, Yousef Khader, Eizaburo Tanaka and Mohannad Al Nsour
Pediatr. Rep. 2025, 17(1), 22; https://doi.org/10.3390/pediatric17010022 - 10 Feb 2025
Abstract
Traumatic life and childhood events are associated with adverse health outcomes, particularly for adolescents, who are vulnerable to such events and exhibit distinct health behaviours and needs. Nevertheless, the influence of exposure to these events on their help-seeking behaviour remains largely unexplored, especially [...] Read more.
Traumatic life and childhood events are associated with adverse health outcomes, particularly for adolescents, who are vulnerable to such events and exhibit distinct health behaviours and needs. Nevertheless, the influence of exposure to these events on their help-seeking behaviour remains largely unexplored, especially in the Eastern Mediterranean region. This study aims to estimate the prevalence of adverse events among adolescents in Jordan and examine how adverse events shape the help-seeking behaviours. Methods: A national cross-sectional survey of 4407 school-age (12–18 years) adolescents living in Jordan was conducted between December 2022 and April 2023 using multi-state stratified cluster sampling. The study utilised self-report questionnaires as well as validated tools. These were adapted to ensure cultural relevance and sensitivity and translated to Arabic. Results: The prevalence of at least one adverse event is around 16%, while that of four or more ACEs stands at around 41% in our population. The most commonly reported event was being infected or having a family member infected with COVID-19 at 60.3%. Specific individual characteristics and traumatic events appeared to shape their help-seeking behaviour, particularly family affluence and smoking status as well as exposure to COVID-19. Conclusions: The study underscores the need to understand help-seeking patterns among school-age adolescents in light of exposure to traumatic events. Based on this study’s findings, special attention should be paid to the impact certain events have on adolescents’ mental health and their help-seeking behaviours. Positive help-seeking behaviours that resonate with adolescents’ beliefs, emphasising contextual factors in mental health coping, should be promoted. Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
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15 pages, 675 KiB  
Article
Look at My Body: It Tells of Suffering—Understanding Psychiatric Pathology in Patients Who Suffer from Headaches, Restrictive Eating Disorders, or Non-Suicidal Self-Injuries (NSSIs)
by Diletta Cristina Pratile, Marika Orlandi, Adriana Carpani and Martina Maria Mensi
Pediatr. Rep. 2025, 17(1), 21; https://doi.org/10.3390/pediatric17010021 - 8 Feb 2025
Abstract
Background/Objectives: Adolescence is a developmental stage characterized by profound physical and psychological transformations, often leading to vulnerabilities such as body dissatisfaction, identity challenges, and the use of maladaptive coping strategies. This often leads to body-related psychopathologies, including headaches, restrictive eating disorders, and [...] Read more.
Background/Objectives: Adolescence is a developmental stage characterized by profound physical and psychological transformations, often leading to vulnerabilities such as body dissatisfaction, identity challenges, and the use of maladaptive coping strategies. This often leads to body-related psychopathologies, including headaches, restrictive eating disorders, and non-suicidal self-injury (NSSI). The present study aimed to describe the typical functioning and features of these conditions and the differences between the three groups, and to identify the most effective assessment for predicting these conditions. Methods: Sixty adolescent patients (51 female; mean age = 15.34 ± 1.80) were divided into three groups: headaches, restrictive eating disorders, and NSSI, and assessed for differences in symptoms, cognitive performance, personality, functioning, and illness severity using semi-structured interviews, clinician-based scales, and performance-based tests like the Rorschach inkblot test, according to the Rorschach Performance Assessment System (R-PAS). Results: Individuals with headaches experienced more internalizing symptoms, had an average IQ, maintained some functioning areas, and had distorted patterns of self–other relationships with the tendency to project malevolent aspects onto others. Patients with restrictive eating disorders had high levels of depressive symptoms, above-average IQ scores, negative symptoms, moderate presence of obsessive–compulsive personality traits, disorganized thinking, and a tendency to interpret situations subjectively. Patients with NSSI showed the highest level of depressive symptoms and social anxiety symptoms, and a considerable presence of psychotic symptoms and perceptual distortions. Negative symptoms, borderline personality traits, and psychosis symptoms had the strongest predictivity. Conclusions: The study provides clinicians with relevant insights into the features of these conditions and highlights assessment strategies, tailored interventions, and enhanced outcomes for these vulnerable populations. Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
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9 pages, 540 KiB  
Article
The Prevalence of Invasive Bacterial Infection in Febrile Infants Presenting to Hospital Following Meningococcal B Immunisation: A Case Series
by Holly Drummond, Etimbuk Umana, Clare Mills and Thomas Waterfield
Pediatr. Rep. 2025, 17(1), 20; https://doi.org/10.3390/pediatric17010020 - 8 Feb 2025
Abstract
Objectives: To report the prevalence of invasive bacterial infection (IBI) in febrile infants ≤90 days presenting to hospital within 72 h of meningococcal B (MenB) immunisation. Methods: A secondary analysis of data from two previous multicentre studies of febrile infants conducted at UK [...] Read more.
Objectives: To report the prevalence of invasive bacterial infection (IBI) in febrile infants ≤90 days presenting to hospital within 72 h of meningococcal B (MenB) immunisation. Methods: A secondary analysis of data from two previous multicentre studies of febrile infants conducted at UK and Irish hospitals. The first study was a retrospective study, conducted at six sites between 31 August 2018 and 1 September 2019. The second study was a prospective study conducted at 35 sites between 6 July 2022 and 31 August 2023. Febrile infants ≤90 days who had received the MenB vaccine within 72 h preceding presentation were included. Results: A total of 102 infants met the inclusion criteria, with a median age of 61 days and a male predominance of 65.7%. The most reported clinical features were an abnormal cry, decreased feeding and coryzal symptoms. In total, 68/102 (66.7%) were admitted to hospital; the median length of stay was 1 day. Median C-reactive protein (CRP) was 20.5 mg/L, mean white cell count was 13.7 × 109/L, mean neutrophil count was 7.3 × 109/L and mean lymphocyte count was 4.7 × 109/L. In total, 38/102 (37.3%) had blood cultures performed, 26/102 (25.5%) had respiratory viral testing performed, 55/102 (53.9%) had urine culture performed and 14/102 (13.7%) had lumbar puncture performed. Additionally, 26/102 (25.5%) received parenteral antibiotics. There were no cases of IBI, and 3/102 (2.9%) cases of urinary tract infection. Conclusions: The rate of IBI is negligible in febrile infants following MenB immunisations. Current blood tests such as CRP are unreliable in this cohort, as many exhibit a moderate CRP rise above suggested international cut-offs for this age range. Full article
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16 pages, 282 KiB  
Review
Clinical and Public Health Challenge of Handling Synthetic Cathinone and Cannabinoid Abuse in Pediatric Care: A Narrative Review
by Valerio Ricci and Giuseppe Maina
Pediatr. Rep. 2025, 17(1), 19; https://doi.org/10.3390/pediatric17010019 - 8 Feb 2025
Abstract
Background: Synthetic cathinones and cannabinoids have emerged as significant public health concerns, particularly in pediatric populations. Marketed under deceptive names such as “bath salts” and “K2/Spice”, these substances pose unique challenges due to their accessibility, potency, and unpredictable effects. This narrative review synthesizes [...] Read more.
Background: Synthetic cathinones and cannabinoids have emerged as significant public health concerns, particularly in pediatric populations. Marketed under deceptive names such as “bath salts” and “K2/Spice”, these substances pose unique challenges due to their accessibility, potency, and unpredictable effects. This narrative review synthesizes evidence on the toxicological effects of synthetic cathinones and cannabinoids in pediatric patients, emphasizing clinical presentations, management challenges, and public health implications. Methods: A structured narrative review was conducted using PubMed and Scopus databases to identify peer-reviewed studies published between January 2010 and September 2024. The selected articles focus on neuropsychiatric, systemic, and management outcomes associated with these substances in individuals aged 0–18 years. Results: Five studies demonstrate that synthetic cathinones frequently cause seizures, sympathomimetic toxidrome (tachycardia, hypertension), and neuropsychiatric effects like paranoia and catatonia. Seven studies show synthetic cannabinoids induce psychosis, respiratory depression requiring ventilation in 12% of cases, and cardiovascular complications like myocardial ischemia. One study highlighted severe outcomes in pediatric accidental exposures, emphasizing the unpredictable and life-threatening effects of these substances, often exacerbated by co-ingestion with alcohol or THC. Conclusions: Pediatric exposure to synthetic cathinones and cannabinoids results in severe and unpredictable toxicological effects, necessitating tailored clinical management strategies and enhanced diagnostic capabilities. Public health measures, including stringent regulatory controls, targeted education initiatives, and robust surveillance systems, are critical to mitigating these risks. A multidisciplinary approach is essential to safeguard vulnerable pediatric populations from the escalating dangers posed by synthetic drugs, and future research must address the long-term impacts and mechanisms of toxicity. Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
8 pages, 814 KiB  
Review
Paliperidone-Induced Massive Asymptomatic Creatine Kinase Elevation in Youth: From a Case Report to Literature Review
by Aurora Grandioso, Paola Tirelli, Gianmario Forcina, Vittoria Frattolillo, Delia De Biasio, Francesco Giustino Cesaro, Pierluigi Marzuillo, Emanuele Miraglia del Giudice and Anna Di Sessa
Pediatr. Rep. 2025, 17(1), 18; https://doi.org/10.3390/pediatric17010018 - 7 Feb 2025
Abstract
Background/Objectives: Unlike rhabdomyolysis and neuroleptic malignant syndrome (NMS), massive asymptomatic creatine kinase elevation (MACKE) represents a condition commonly detected during routine screening in patients receiving antipsychotic drugs. In particular, current evidence indicates a greater incidence of this condition in patients without signs of [...] Read more.
Background/Objectives: Unlike rhabdomyolysis and neuroleptic malignant syndrome (NMS), massive asymptomatic creatine kinase elevation (MACKE) represents a condition commonly detected during routine screening in patients receiving antipsychotic drugs. In particular, current evidence indicates a greater incidence of this condition in patients without signs of NMS, rhabdomyolysis, or other causes of CK increase during exposure to second-generation antipsychotics (SGAs) than first-generation antipsychotics (FGAs) with a variable onset and duration. Although its pathophysiology is still not fully elucidated, MACKE has usually been recognized as a self-limiting condition, but drug discontinuation might also be required to successfully revert it. Overall, knowledge in this field is mainly extrapolated from adult data, while similar evidence in youths is still limited. As clinicians might often deal with MACKE, its understanding needs to be expanded to avoid misdiagnosis, potentially leading to wasteful healthcare spending and unfavorable patient outcomes. Methods: By reporting the first case of MACKE in an adolescent receiving an SGA, namely paliperidone, we also aimed to provide a comprehensive overview of this medical condition. Conclusions: Making a MACKE diagnosis is essential since its relevant clinical and economic implications are mainly related to unnecessary closer laboratory monitoring or therapeutic changes (e.g., drug discontinuation or switch to another medication). Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
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17 pages, 856 KiB  
Article
Measuring Community and Home Participation and Environmental Factors in Children with Cerebral Palsy
by Turki Aljuhani, Shaden A. Alzahrani, Abeer M. Aldosary, Lana A. Alzamil, Rakan K. Alshehri, Afnan S. Gmmash and Reem A. Albesher
Pediatr. Rep. 2025, 17(1), 17; https://doi.org/10.3390/pediatric17010017 - 7 Feb 2025
Abstract
Background/Objectives: Children with cerebral palsy (CP) are reported to have lower rates of participation in community and home tasks than typically developing children. Little is known about the participation levels of children with CP and the environmental factors influencing their participation in [...] Read more.
Background/Objectives: Children with cerebral palsy (CP) are reported to have lower rates of participation in community and home tasks than typically developing children. Little is known about the participation levels of children with CP and the environmental factors influencing their participation in the community within the Saudi context. This study aimed to determine the degree of participation in community and home tasks in children with CP in Saudi Arabia, as well as the level of support received, and the obstacles faced by children in this context. Methods: Parents of 5–16-year-old children with CP (n = 50) completed the Participation and Environment Measure for Children and Youth (PEM-CY), and their scores were compared with those of typically developing children of the same ages (n = 50). This study was conducted in a hospital setting. Analyses were performed using multivariate logistic regression analyses, controlling for potential confounders. Results: Participation in community activities as well as home activities was reported to be significantly lower in children with CP compared to their typically developing peers in multiple domains (p < 0.05). Additionally, physical, cognitive, and social demands were identified as factors that made community participation more difficult for children with CP (p = 0.002, p = 0.017, and p = 0.029 for physical, cognitive, and social demands, respectively). The availability of personal transportation, programs, services, and financial support were identified by parents as the factors that lowered community participation levels in children with CP (p > 0.005). Conclusions: Physical, cognitive, and social demands are the main obstacles to participation for children with CP. A lack of home supplies and financial support lowered the participation of children with CP. Recognizing environmental barriers as well as providing individualized practical solutions in collaboration with the families of children with CP can assist in developing meaningful participation in community and home activities for children with CP. Full article
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17 pages, 270 KiB  
Article
Prenatal Risk Factors for Brief Resolved Unexplained Events in Infants
by Luana Nosetti, Marco Zaffanello, Eliot S. Katz, Elisa Morrone, Michele Abramo, Francesca Brambilla, Antonella Cromi, Giorgio Piacentini and Massimo Agosti
Pediatr. Rep. 2025, 17(1), 16; https://doi.org/10.3390/pediatric17010016 - 6 Feb 2025
Abstract
Background: Prenatal factors have been implicated in the likelihood of reporting sleep disorders in infants. The influence of prenatal and pregnancy-related factors on the incidence of brief resolved unexplained events (BRUEs) in infants has not been established. Objectives: This study aims to evaluate [...] Read more.
Background: Prenatal factors have been implicated in the likelihood of reporting sleep disorders in infants. The influence of prenatal and pregnancy-related factors on the incidence of brief resolved unexplained events (BRUEs) in infants has not been established. Objectives: This study aims to evaluate the prenatal and pregnancy-related factors that may contribute to the development of BRUEs in infants. Methods: A single-center, observational, and cross-sectional cohort study was conducted on mothers of children presenting to the Pediatric Clinic of the University of Insubria’s Center for the Study of Respiratory Sleep Disorders with BRUEs as infants. The mothers of typically developing children were enrolled as a control group consecutively at their respective outpatient clinics. All mothers were administered comprehensive questionnaires including demographics, past medical histories, and pregnancy-related issues (weight gain, Berlin sleep-disordered breathing score, and insomnia severity index), psychological symptoms, medical history, illnesses, and medications. Results: Infants with BRUEs were delivered at an earlier gestational age. Mothers of infants with BRUEs were more likely to snore during pregnancy and have lower extremity edema during the first trimester, uterine contractions and restless legs syndrome symptoms during the second trimester, and muscle aches and aspirin usage during the third trimester. The insomnia severity index composite score was not different between the control and BRUE groups. Mothers of infants with BRUEs were less likely to report leg cramps, pregnancy-related diarrhea, fatigue, and gastroesophageal reflux. Conclusions: Mothers of infants presenting with BRUEs had more symptoms during pregnancy of snoring and uterine contractions but not insomnia and were less likely to report leg cramps, pregnancy-related diarrhea, fatigue, and gastroesophageal reflux. The reporting of this study conforms with the STROBE statement. Full article
10 pages, 635 KiB  
Systematic Review
Pediatric Wernicke Encephalopathy: A Systematic Review
by Erik Oudman, Jan W. Wijnia, Janice R. Bidesie, Mirjam J. van Dam, Misha J. Oey, Sterre Smits, Maaike van Dorp and Albert Postma
Pediatr. Rep. 2025, 17(1), 15; https://doi.org/10.3390/pediatric17010015 - 30 Jan 2025
Abstract
Background: Wernicke Encephalopathy (WE), a neurological disorder often linked to alcohol use, can also occur under non-alcoholic conditions, including in pediatric populations. Methods: This systematic review examines 88 pediatric WE cases reported over the past 30 years, encompassing diverse etiologies such as cancer [...] Read more.
Background: Wernicke Encephalopathy (WE), a neurological disorder often linked to alcohol use, can also occur under non-alcoholic conditions, including in pediatric populations. Methods: This systematic review examines 88 pediatric WE cases reported over the past 30 years, encompassing diverse etiologies such as cancer (25 cases), gastrointestinal diseases (19), malnutrition (17), psychiatric disorders (13), obesity surgery (5), renal disease (4), COVID-19 (2), PICU complications (1), hyperemesis gravidarum (1), and a genetic mutation (1). Results: Prodromal symptoms included nausea (60%) and vomiting (55%). In total, 37% of the patients received parenteral nutrition without thiamine before WE diagnosis, often progressing to Wernicke–Korsakoff syndrome (WKS). Key findings revealed the classic triad of WKS, eye movement disorders (80%), mental status changes (75%), and ataxia (63%), with MRI demonstrating high diagnostic sensitivity (85%). Treatment varied widely; higher parenteral thiamine doses correlated with faster recovery and better outcomes, while insufficient dosages led to adverse effects. Full remission was achieved in 61% of cases, with improved outcomes in more recent reports due to refined dosing protocols. Conclusions: These findings underscore the importance of early recognition of nausea and vomiting as predictors of pediatric WE and the critical need to incorporate thiamine in parenteral nutrition for children. Optimal dosing remains vital for recovery, particularly in severe cases. Full article
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17 pages, 14869 KiB  
Review
Pictorial Review of Paediatric Limp
by Shashank Chapala, Sahana Giliyaru, Rajesh Botchu, Suvinay Saxena, Karthikeyan P. Iyengar and Muthusamy Chandramohan
Pediatr. Rep. 2025, 17(1), 14; https://doi.org/10.3390/pediatric17010014 - 27 Jan 2025
Abstract
A limp is an abnormal, uneven or laboured gait typically resulting from pain, weakness, or structural deformity involving the hip, lower limb, spine or abdominopelvic abnormalities. Limps in children are common and have diverse causes that can be benign to life-threatening including trauma, [...] Read more.
A limp is an abnormal, uneven or laboured gait typically resulting from pain, weakness, or structural deformity involving the hip, lower limb, spine or abdominopelvic abnormalities. Limps in children are common and have diverse causes that can be benign to life-threatening including trauma, congenital malformations, and neoplastic diseases. Diagnosis involves identifying gait abnormality thoroughly examining history and physical exam, assessing tenderness and range of motion, and completing targeted lab and radiographic studies. We present an imaging review of various usual and unusual causes of limp in different age groups such as in toddlers (1–3 years), children (4–10 years), and adolescents (11–16 years) with a comprehensive literature review. Full article
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12 pages, 12759 KiB  
Case Report
Intrathymic Hemagioma: A Challenging Case Report with Special Focus on the Importance of Its Multidisciplinary Approach
by Milan Velimirovici, Anca Voichita Popoiu, Simona Cerbu, Calin Marius Popoiu, Florica Ramona Dorobantu, Borislav Dusan Caplar, Eugen Melnic, Anca Maria Cimpean, Larisa Cristina Tomescu and Maria Corina Stanciulescu
Pediatr. Rep. 2025, 17(1), 13; https://doi.org/10.3390/pediatric17010013 - 27 Jan 2025
Abstract
Mediastinal hemangiomas, particularly those of thymic origin, are rare phenomena. Due to its rarity, this pathologic condition is not characterized as related to the angiogenic profile of hemangioma endothelial cells. The diagnosis is challenging clinically and radiologically, and biopsies may not yield a [...] Read more.
Mediastinal hemangiomas, particularly those of thymic origin, are rare phenomena. Due to its rarity, this pathologic condition is not characterized as related to the angiogenic profile of hemangioma endothelial cells. The diagnosis is challenging clinically and radiologically, and biopsies may not yield a definitive answer. Surgical resection offers the material for histologic diagnosis, relieves symptoms, and has a favorable long-term prognosis for such benign tumors. Sometimes, such benign tumors may have aggressive behavior and repeated recurrences but the causes responsible for this unpredictable evolution are not actually known. A case of intrathymic hemangioma diagnosed in a 16-year-old girl is presented here. We focused equally on a multidisciplinary approach to this challenging diagnosis but also on the characterization of the hemangioma endothelial cells profile not previously performed for such type of vascular anomalies. To define an antibodies panel for the evaluation of intrathymic hemangiomas may help in the full characterization of this rare vascular lesion, and subsequently focus on the new therapeutic targets which may be applied for cases with aggressive behavior. Full article
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25 pages, 498 KiB  
Systematic Review
Impact of Surgical Timing on Outcomes in Neonatal Inguinal Hernia Repairs: A Systematic Review
by Leen Yahya Alqahtany, Arwa Alsharif, Abdulaziz Alsharif, Omar Alanazi, Manaf Altaf, Ahlam Kaleemullah, Lana Alsaedi, Hanan Ismail Wasaya, Abrar Hassan Alharbi and Osama Bawazir
Pediatr. Rep. 2025, 17(1), 12; https://doi.org/10.3390/pediatric17010012 - 23 Jan 2025
Viewed by 324
Abstract
Inguinal hernia repair (IHR) is a common surgical procedure among neonates and infants; the time of surgery is one of the major factors affecting its outcomes. Our systematic review aims to evaluate the effects of surgical timing on outcomes in inguinal hernia repairs [...] Read more.
Inguinal hernia repair (IHR) is a common surgical procedure among neonates and infants; the time of surgery is one of the major factors affecting its outcomes. Our systematic review aims to evaluate the effects of surgical timing on outcomes in inguinal hernia repairs in the newborn and infant population to establish evidence-based guidelines for optimal surgical timing. A systematic search was performed in PubMed, MEDLINE, and Web of Science databases, following PRISMA guidelines. Studies evaluating neonates and infants undergoing IHR with outcomes of recurrence, complications, and postoperative recovery were included. Data were collaboratively extracted, including patient demographics, surgical approaches, perioperative complications, and long-term outcomes. Early repair (0–28 days of life) decreased the risk of hernia incarceration but also increased the risk of preoperative complications. Delayed repair (29 days to 1 year of life) showed fewer preoperative complications but increased the risk of incarceration. The outcomes were affected by variables including patient maturity and comorbidities, along with hernia severity. Neonates with a high risk for incarceration are best treated with early repair, while stable infants can be managed safely with delayed repair. More randomized trials are needed to develop standardized guidelines that balance the associated risks of neonatal versus infant repair strategies to maximize benefits. Full article
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16 pages, 20137 KiB  
Article
Pediatric Treatment of Anterior-Upper-Single Dental Crossbite Using a Versatile Sagittal Screw System: A Case Series
by Antonino Lo Giudice and Alessandro Polizzi
Pediatr. Rep. 2025, 17(1), 11; https://doi.org/10.3390/pediatric17010011 - 21 Jan 2025
Viewed by 264
Abstract
Background/Objectives: Anterior crossbite is characterized by a reverse sagittal relationship between the maxillary and mandibular incisors. Early treatment of an anterior crossbite is advocated to avoid periodontal and traumatic consequences on lower dentition along with growth disturbances in the anterior maxilla and mandible. [...] Read more.
Background/Objectives: Anterior crossbite is characterized by a reverse sagittal relationship between the maxillary and mandibular incisors. Early treatment of an anterior crossbite is advocated to avoid periodontal and traumatic consequences on lower dentition along with growth disturbances in the anterior maxilla and mandible. The present case series describes the usage of a sagittal expansion screw integrated with a removable maxillary plate or fixed appliance to correct an anterior upper single dental crossbite and outlines the clinical rationale and the protocol associated with this appliance system. Methods: A total of four children presenting anterior crossbite were treated using a sagittal expansion screw integrated into a removable plate or a fixed appliance. Results: All patients were successfully treated in less than 4 months. Overjet and overbite were normalized by the end of treatment. The orthodontic treatment received positive feedback from parents and caregivers, who seek a rapid improvement in their children’s aesthetics and function. No significant discomfort or speech difficulties were reported by the parents or patients. Conclusions: The present case series would suggest that a sagittal expansion screw, integrated into both a removable and fixed appliance, can represent a valuable and versatile treatment option for correcting an anterior crossbite. Full article
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12 pages, 862 KiB  
Article
The Use of PediSTAT Application by Paramedics Working in Saudi Arabia to Reduce the Risk of Medication Error for Pediatric Patients
by Nesrin Alharthy, Raghad Abuhaimed, Munirah Alturki, Shatha Alanazi, Raghad Althaqeb, Alanowd Alghaith and Abdullah Alshibani
Pediatr. Rep. 2025, 17(1), 9; https://doi.org/10.3390/pediatric17010009 - 16 Jan 2025
Viewed by 536
Abstract
Background/Objectives: This study aimed to assess and compare the rates of medication error (ME) using the PediSTAT application compared to the conventional method of calculating the correct dose and determining the appropriate route of medication administration for common pediatric emergencies. Methods: A prospective [...] Read more.
Background/Objectives: This study aimed to assess and compare the rates of medication error (ME) using the PediSTAT application compared to the conventional method of calculating the correct dose and determining the appropriate route of medication administration for common pediatric emergencies. Methods: A prospective cross-sectional study design was used for the study. Data were collected using a questionnaire that was distributed to certified paramedics holding a bachelor’s degrees or higher and working in Riyadh City, Saudi Arabia. Alternate simple random sampling was used to recruit the participants into two groups using the same questionnaire: the PediSTAT group and the conventional method group. The questionnaire contained four pediatric emergency vignettes: cardiac arrest, asthma exacerbation, seizures, and hypoglycemia. Results: A total of 63 participants agreed to the study. Almost 80% of them were males, 81% held bachelor’s degrees, and 87% were certified in pediatric resuscitation courses. The findings of the study showed that the use of the PediSTAT application increased accuracy and reduced the risk of ME for common pediatric emergencies. This was shown to be statistically significant for asthma medication dose (p-value < 0.001, 95% CI 0.034–0.352), midazolam dose (p-value = 0.012, 95% CI 0.030–0.764), and hypoglycemia medication dose (p-value < 0.001, 95% CI 0.046, 0.452). Conclusions: The study findings supported the use of standardized precalculated applications such as PediSTAT, which was shown to reduce the risk of ME in prehospital care for pediatric emergencies. Full article
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7 pages, 559 KiB  
Communication
Should the Definition of Low Birth Weight Be Same in Every Ethnicity Considering the DOHaD Concept?
by Yoshifumi Kasuga and Mamoru Tanaka
Pediatr. Rep. 2025, 17(1), 8; https://doi.org/10.3390/pediatric17010008 - 16 Jan 2025
Viewed by 387
Abstract
Low birth weight (LBW) is a significant concern not only because of its association with perinatal outcomes, but also because of its long-term impact on future health. Despite the physical differences among individuals of different ethnicities, the definition of LBW remains the same [...] Read more.
Low birth weight (LBW) is a significant concern not only because of its association with perinatal outcomes, but also because of its long-term impact on future health. Despite the physical differences among individuals of different ethnicities, the definition of LBW remains the same for all ethnicities. This study aimed to explore and discuss this issue. We compiled national data from several countries and found that maternal height was negatively correlated with LBW incidence. We discovered the INTERGROWTH-21st chart may not be suitable for the Japanese population, as the Japanese birth weight chart differs from the INTERGROWTH-21st chart. Researchers have reported different LBW cutoff values used to assess adverse perinatal outcomes for different countries. However, there is currently no definition of LBW independent of the mother’s country of origin that can be used for predicting the risk of adverse health outcomes. Therefore, the current era of personalized healthcare may be the perfect time to establish a standard definition of LBW which is independent of the mother’s country of origin. Considering the future of healthcare, it seems an apt time to discuss the development of a more meaningful definition of LBW that can be applied across ethnicities. Further research is needed to investigate the cutoff values of LBW in every ethnicity. Full article
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12 pages, 255 KiB  
Article
ABCB1 Polymorphism Is Associated with Higher Carbamazepine Clearance in Children
by Natasa Djordjevic, Jelena Cukic, Dragana Dragas Milovanovic, Marija Radovanovic, Ivan Radosavljevic, Jelena Vuckovic Filipovic, Slobodan Obradovic, Dejan Baskic, Jasmina R. Milovanovic, Slobodan Jankovic and Dragan Milovanovic
Pediatr. Rep. 2025, 17(1), 10; https://doi.org/10.3390/pediatric17010010 - 16 Jan 2025
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Abstract
The aim of our study was to investigate the role of ABCB1 polymorphism in the pharmacokinetics of carbamazepine (CBZ) in children. The study enrolled 47 Serbian pediatric epileptic patients on CBZ treatment. Genotyping for ABCB1 1236C<T (rs1128503), 2677G<A/T (rs2032582) and 3435C<T (rs1045642) was [...] Read more.
The aim of our study was to investigate the role of ABCB1 polymorphism in the pharmacokinetics of carbamazepine (CBZ) in children. The study enrolled 47 Serbian pediatric epileptic patients on CBZ treatment. Genotyping for ABCB1 1236C<T (rs1128503), 2677G<A/T (rs2032582) and 3435C<T (rs1045642) was carried out using the TaqMan method. Steady-state CBZ serum concentrations were available from our previous study, determined by high pressure liquid chromatography (HPLC). The NONMEM software and one-compartment model were used for pharmacokinetic analysis. ABCB1 1236C<T, 2677G<A/T and 3435C<T variations were found at the frequencies of 47.9%, 48.9% and 52.1%, respectively. The equation that described population clearance (CL) was CL (L/h) = 0.175 + 0.0403 × SEX + 0.0332 × ABCB1 + 0.0176 × CYP1A2 + 0.000151 × DD where SEX has a value of 1 if male and 0 if female, ABCB1 has a value of 1 if C-G-C/T-T-T and 0 if any other ABCB1 diplotype, CYP1A2 has a value of 1 if −163A/A and 0 if −163C/C or C/A, and DD is the total CBZ daily dose (mg/day). The presence of the ABCB1 1236T-2677T-3435T haplotype is associated with an increased clearance of CBZ in pediatric epileptic patients. Full article
(This article belongs to the Section Pediatric Psychology)
11 pages, 399 KiB  
Article
Investigating the Relationship Between Midazolam Serum Concentrations and Paediatric Delirium in Critically Ill Children
by Sabrina Marongiu, Mathieu S. Bolhuis, Daan J. Touw and Martin C. J. Kneyber
Pediatr. Rep. 2025, 17(1), 7; https://doi.org/10.3390/pediatric17010007 - 14 Jan 2025
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Abstract
Objectives: Intravenous midazolam is widely used for sedation in critically ill children. Sometimes, these children develop a paediatric delirium (PD). Our aim was to determine the relationship between midazolam serum concentration and the development of new PD in critically ill children. Design: Prospective [...] Read more.
Objectives: Intravenous midazolam is widely used for sedation in critically ill children. Sometimes, these children develop a paediatric delirium (PD). Our aim was to determine the relationship between midazolam serum concentration and the development of new PD in critically ill children. Design: Prospective observational pilot study. Setting: Paediatric Intensive Care Unit (PICU), Groningen, the Netherlands. Patients: All children admitted to the PICU from October–December 2019 who received continuous midazolam administration. Interventions: None. Measurements and main results: Twenty-five percent (n = 7) of the included patients (n = 28) developed new PD. In most patients, PD occurred following midazolam dose reduction. The median cumulative midazolam dose was higher in patients who developed PD compared to those without PD. We analysed 104 blood samples to determine the midazolam concentrations. To determine whether patients had PD, the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) score was used. Patients suffering PD (n = 7) had a lower median midazolam concentration on that day compared with the day prior to PD detection. Analysis of the active metabolites, 1-hydroxymidazolam and 1-hydroxymidazolam glucuronide, showed similar results. Conclusions: PD may be linked to a sudden and significant reduction in the midazolam concentration in critically ill children. Further investigation in larger patient populations is necessary to validate our findings. Full article
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15 pages, 1932 KiB  
Article
Impact of a Structured Social Skills Training Program on Adolescents and Young Adults with Level 1 Autism
by Leonardo Zoccante, Sara Sabaini, Erika Rigotti, Sophia Marlene Bonatti, Camilla Lintas and Marco Zaffanello
Pediatr. Rep. 2025, 17(1), 6; https://doi.org/10.3390/pediatric17010006 - 14 Jan 2025
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Abstract
Background/Objectives: Level 1 autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by challenges in social and communication skills. Despite these difficulties, individuals with level 1 ASD often exhibit average intelligence and typical language development. Improving socialisation skills in this population requires tailored [...] Read more.
Background/Objectives: Level 1 autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by challenges in social and communication skills. Despite these difficulties, individuals with level 1 ASD often exhibit average intelligence and typical language development. Improving socialisation skills in this population requires tailored approaches that address their specific needs and include targeted strategies. This study aims to evaluate the effectiveness of a structured social skills training programme for adolescents and young adults with level 1 ASD. Methods: Participants diagnosed with level 1 ASD, regardless of gender, were consecutively recruited from an outpatient clinic. The intervention involved activities from the Social Skills, Autonomy, and Awareness Module, specifically designed for adolescents and young adults. Sessions were conducted fortnightly, lasting 1.5 to 3 h each, over 17 months. Adaptive behaviour was assessed using the Vineland Adaptive Behaviour Scales (VABS) at baseline and after completing the programme. Data were analysed with SPSS version 22.0 (SPSS Inc., Chicago, IL, USA). Statistical methods included automatic clustering to identify optimal clusters and Pearson’s Chi-square and Fisher’s exact tests to evaluate variable distributions among the clusters. Results: A total of 31 participants (77.4% female) with a mean age of 20.1 years (SD = 7.0) were included in the study. Two distinct clusters emerged. Cluster 1 (n = 8) had significantly higher mean ages and baseline Vineland II socialisation scores than Cluster 2 (n = 23). Both clusters demonstrated significant improvements in social skills following the intervention. Conclusions: This study highlights distinct profiles within individuals with level 1 ASD, showing a clear link between age and social skill development. The intervention improved social skills for most participants, regardless of the age at which treatment began. For some individuals, alternative or augmented treatment strategies may be necessary to achieve optimal results. Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
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11 pages, 1844 KiB  
Article
A Series of 40 Congenital Lung Malformation Cases and the Informative Value of CPAM Lesion Ratios
by Melanie Le, Phillip Harms, Kersten Peldschus, Carl-Martin Junge, Christian Tomuschat and Konrad Reinshagen
Pediatr. Rep. 2025, 17(1), 5; https://doi.org/10.3390/pediatric17010005 - 9 Jan 2025
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Abstract
Introduction: In this single-center retrospective analysis, we present case data and insights gathered over the past eight years. Additionally, we computed postnatal, pre-therapy lesion-to-lung ratios of Congenital Pulmonary Airway Malformations (CPAMs) to retrospectively assess potential outcome prediction using lesion-to-lung ratios. Methods: Data were [...] Read more.
Introduction: In this single-center retrospective analysis, we present case data and insights gathered over the past eight years. Additionally, we computed postnatal, pre-therapy lesion-to-lung ratios of Congenital Pulmonary Airway Malformations (CPAMs) to retrospectively assess potential outcome prediction using lesion-to-lung ratios. Methods: Data were collected between 2015 and 2022. Information such as chosen therapy, surgical duration, postoperative hospital stay, and follow-up was obtained from electronic case records. Pre-therapy pulmonary lesion volumes [mm3], lesion-to-ipsilateral-lung ratio, and lesion-to-both-lungs ratio of CPAMs were retrospectively calculated from computed tomography images using specialized software. Results: Of the 40 identified cases, 27 had CPAM, 7 had pulmonary sequestration, 4 had bronchogenic cysts, and 2 had congenital lobar emphysema. Histological examinations of resected specimens revealed no malignancy. For CPAMs, the median surgery age was 7 months (interquartile range (IQR): 0.45–11), averaging 9.54 ± 15.01 months. The CPAM surgery lasted on average 126 ± 53 min (median 124 min (IQR 108–172)). The mean length of hospital stay was 6 ± 1.41 days for thoracoscopic surgery and 17 ± 18.23 days for open surgery. No clear link was found between the lesion ratio and management choice or surgical length. Notably, larger lesions tended to result in longer postoperative stays. CPAMs with a lesion-to-ipsilateral-lung ratio of ≤0.11 were asymptomatic. Discussion and Conclusions: If patients present no symptoms, mild symptoms, or smaller CPAM lesions, “wait and watch” and a CT scan of the thorax up to approximately six months of age remain a reasonable approach. The true risk of malignancy remains ambiguous, especially since there was no evidence of malignancy in our biopsies. On the other hand, prophylactic surgery before symptoms arose led to earlier discharge and overall low intraoperative complications compared to symptomatic counterparts. Ultimately, the adopted therapy pathway remains a parental choice. For CPAMs, an increased lesion-to-lung ratio correlated with extended hospital stay and symptomatic presentation. However, there was no cut-off value for conservative or surgical treatment. Full article
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14 pages, 1976 KiB  
Article
Preliminary Results of Sensorimotor Room Training for the Improvement of Sensory and Motor Skills in Children with Autism Spectrum Disorders
by Giulia Savarese, Rosa Mandia, Aldo Diavoletto, Michele Piscitelli, Francesca Impemba, Annatania Di Siervi, Luna Carpinelli, Franca Bottiglieri, Marianna Sessa and Giulio Corrivetti
Pediatr. Rep. 2025, 17(1), 4; https://doi.org/10.3390/pediatric17010004 - 8 Jan 2025
Viewed by 630
Abstract
Background: Motor skills in early and middle childhood are essential for physical play, social interactions, and academic development. Children with autism spectrum disorder (ASD) often exhibit atypical sensory responses, which can impact self-care and other developmental areas. This study explores the impact of [...] Read more.
Background: Motor skills in early and middle childhood are essential for physical play, social interactions, and academic development. Children with autism spectrum disorder (ASD) often exhibit atypical sensory responses, which can impact self-care and other developmental areas. This study explores the impact of sensory and motor rehabilitation using a Motor Sensory Room to stimulate motor development in children with ASD. Methods: Twenty-five children with ASD, preschool and school-aged (2–10 years), were divided into three groups based on the DSM-5 severity levels. The PEP-3 scale was used to assess cognitive, language, motor, emotional, social, and behavioral development. Ten children underwent a 3-month Motor Sensory Room intervention, and data were collected longitudinally. A control group of ten children, matched in age, sex, and diagnosis, did not receive the intervention. A 12-month follow-up is planned for all participants. Results: Children exhibited diverse profiles. Type B subjects displayed more severe symptoms, while Type A showed milder symptoms with better language and interpersonal skills. After the 3-month intervention, improvements were noted in several PEP-3 areas. For sensory levels (hypo-reactivity), the percentage of individuals at medium levels increased from 44% to 50%. For hyper-reactivity, the percentage at medium levels rose from 30% to 40%. Motor skills improved, with the percentage of individuals with high motor abilities rising from 20% to 25%. Relational behaviors also saw gains, with an increase from 50% to 55% in medium-level behaviors. The experimental group demonstrated better outcomes compared to the control group, particularly in sensory and motor skills. Conclusions: Preliminary findings suggest that sensory and motor training in a Motor Sensory Room improves sensory integration, motor coordination, and social interaction in children with ASD. Further research is needed to confirm long-term benefits. Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
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8 pages, 371 KiB  
Article
Exploring Dysphagia in Congenital Diaphragmatic Hernia: A Retrospective Analysis
by Jamie Gilley, Elise Whalen, Audrey Latimore, Viviane Jung, Joseph Hagan and Alice King
Pediatr. Rep. 2025, 17(1), 3; https://doi.org/10.3390/pediatric17010003 - 3 Jan 2025
Viewed by 488
Abstract
Background: Congenital diaphragmatic hernia (CDH) is a complex congenital disorder often accompanied by long-term feeding difficulties. There is a paucity of published data regarding the impact of swallowing difficulties on long-term patient outcomes. Our study attempts to evaluate this phenomenon. Methods: A retrospective [...] Read more.
Background: Congenital diaphragmatic hernia (CDH) is a complex congenital disorder often accompanied by long-term feeding difficulties. There is a paucity of published data regarding the impact of swallowing difficulties on long-term patient outcomes. Our study attempts to evaluate this phenomenon. Methods: A retrospective chart review of infants born with CDH between 2021 and 2022 identified 45 patients. The following variables were identified: need for swallow study, stomach location, defect type, need for anti-reflux therapy, need for nasogastric tube (NG) or gastric tube (GT) at time of discharge, poor growth, and frequency of respiratory infections during the first 12 months of life. Results: Thirty-one percent of patients (n = 14) underwent a swallow study, 20% (n = 9) required long-term anti-reflux medications, 18% (n = 8) had a GT and 59% (n = 26) had an NG in place at time of discharge, 44% (n = 17) experienced poor growth as an outpatient, and 35% (n = 16) had respiratory infections in the first 12 months of life requiring hospitalization. Infants with a Type D defect commonly required GT at discharge (40%), experienced respiratory infections in the first 12 months (67%), and had poor growth as an outpatient (67%). Conclusions: Our findings underscore the need for routine dysphagia screening in CDH infants during NICU admission. Differences in outcomes based on defect type suggest that early identification and targeted interventions for feeding and swallowing issues may improve long-term growth and respiratory outcomes for CDH patients. Further studies are warranted to develop standardized dysphagia management guidelines for this population. Full article
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14 pages, 1673 KiB  
Systematic Review
The Impact of Aquatic Exercise on Walking Ability, Quality of Life, and Enjoyment in Children with Cerebral Palsy: A Systematic Review
by Miki Nakatani, Yuji Kanejima, Kodai Ishihara, Hanhwa Koo and Kazuhiro P. Izawa
Pediatr. Rep. 2025, 17(1), 2; https://doi.org/10.3390/pediatric17010002 - 2 Jan 2025
Viewed by 506
Abstract
Background/Objectives: Aquatic exercise is attracting attention as a method of rehabilitation for children with cerebral palsy (CP). The purpose of this systematic review was to evaluate whether aquatic exercise for children with CP improves their walking ability and quality of life (QOL) and [...] Read more.
Background/Objectives: Aquatic exercise is attracting attention as a method of rehabilitation for children with cerebral palsy (CP). The purpose of this systematic review was to evaluate whether aquatic exercise for children with CP improves their walking ability and quality of life (QOL) and is enjoyable for them. Methods: A literature search was conducted on 2 August 2024 using three databases: PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials through Evidence-Based Medicine Reviews. Studies included in the review focused on aquatic exercise interventions for children with CP, with outcomes related to walking ability, QOL, or enjoyment. Studies that did not isolate the effects of aquatic exercise (except when combined with conventional interventions) were excluded. Two reviewers independently conducted screening and risk of bias assessments. Results: Seven studies involving 94 participants in total were included in the review. Three of these studies had a control group. All four studies reported improvements in walking ability, including walking endurance and efficiency. One of two studies showed improvement in health-related QOL (HRQOL) compared to the control group, whereas the other did not show significant differences between groups. All three studies that assessed enjoyment reported high levels of enjoyment of aquatic exercise. However, all studies were at risk of bias. Conclusions: The reviewed studies suggest that aquatic exercise for children with CP may be enjoyable and may improve walking ability. Further research is needed to accurately assess the effects of aquatic exercise and compare it to other interventions. Full article
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14 pages, 962 KiB  
Article
Biomarker Analysis in Upper Respiratory Tract Infections: Associations with Demographics and Clinical Outcomes
by Felicia Manole, Alexia Manole, Andrei Nicolae Csep, Lavinia Davidescu, Călin Tudor Hozan, Eduard Szilagy, Florica Voiță-Mekeres, Andrada Florina Schwarz-Madar and Ariana Szilagyi
Pediatr. Rep. 2025, 17(1), 1; https://doi.org/10.3390/pediatric17010001 - 26 Dec 2024
Viewed by 438
Abstract
Background/Objectives: Upper respiratory tract infections (URTIs) are a significant global health burden, and understanding the immune response is crucial for developing effective diagnostic tools and treatment strategies. Methods: This study investigated the levels of specific biomarkers in 188 patients with URTIs and their [...] Read more.
Background/Objectives: Upper respiratory tract infections (URTIs) are a significant global health burden, and understanding the immune response is crucial for developing effective diagnostic tools and treatment strategies. Methods: This study investigated the levels of specific biomarkers in 188 patients with URTIs and their association with demographic factors, comorbidities, and clinical outcomes. Immunoglobulin A (IgA), immunoglobulin E (IgE), neutrophils, serum iron, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Results: The median age of the patients was 5 years, with 46% being female and 63% from urban areas. Adenoiditis (37%), otitis (25%), and rhinitis (20%) were the most common diagnoses. While most biomarkers did not vary significantly by gender, neutrophil levels were significantly higher in females (p = 0.020). IgE levels were significantly elevated in rural patients compared to urban counterparts (p = 0.034). Conclusions: ESR was significantly associated with rhinitis diagnosis, and IgE and ESR were predictive of otitis in multivariate models. However, many biomarkers did not significantly correlate with other diagnoses, contradicting previous research focusing on individual biomarkers. This study highlights the complexity of immune responses in URTIs and the need for more effective diagnostic tools. The findings can inform the development of tailored treatment strategies based on gender, area of origin, and infection type. Full article
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