Pediatric Reports

8 pages, 2335 KB

Open AccessCase Report

Critical Intestinal Perforations in Pediatric Immunocompromised Patients: A Case-Based Review

by William Hunt Stafford, Jennifer McArthur and Saad Ghafoor

Pediatr. Rep. 2026, 18(1), 30; https://doi.org/10.3390/pediatric18010030 (registering DOI) - 14 Feb 2026

As survival rates for children with cancer and immune disorders have improved, clinical focus has shifted toward managing serious treatment-related complications. Intestinal perforation remains life-threatening and is typically diagnosed by signs of peritonitis and inflammation. This report presents three high-risk pediatric patients who [...] Read more.

As survival rates for children with cancer and immune disorders have improved, clinical focus has shifted toward managing serious treatment-related complications. Intestinal perforation remains life-threatening and is typically diagnosed by signs of peritonitis and inflammation. This report presents three high-risk pediatric patients who developed severe intestinal perforation without the usual clinical symptoms. Each patient was receiving high-dose corticosteroids and/or targeted biologic immunomodulators (ruxolitinib, anakinra, tocilizumab, eculizumab). Classic indicators such as fever, leukocytosis, hemodynamic instability, and abdominal pain were absent, despite surgical findings of fecal contamination and bowel necrosis. All three patients survived to hospital discharge. These cases demonstrate that potent immunomodulatory therapies can mask the physiological response to perforation. Relying solely on traditional clinical signs may delay diagnosis. In this population, subtle findings such as persistent gastrointestinal bleeding, feeding intolerance, or minor imaging abnormalities should prompt consideration of perforation. Early imaging and multidisciplinary review are essential for timely intervention and improved outcomes. Full article

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12 pages, 374 KB

Open AccessArticle

Mediation and Moderation Effect of Psychosocial Factors on the Relationship Between Health Literacy and Well-Being in Adolescents

by Tania Gaspar, Marina Carvalho, Miguel Arriaga, Barbara Sousa and Margarida Gaspar-Matos

Pediatr. Rep. 2026, 18(1), 29; https://doi.org/10.3390/pediatric18010029 - 12 Feb 2026

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Abstract

Purpose: Higher health literacy is associated with better health behaviors and better overall well-being; however, the contribution of relational and socio-economic factors to this association remains insufficiently explored. The present study aimed to examine the relationships between health literacy, well-being, social support, and [...] Read more.

Purpose: Higher health literacy is associated with better health behaviors and better overall well-being; however, the contribution of relational and socio-economic factors to this association remains insufficiently explored. The present study aimed to examine the relationships between health literacy, well-being, social support, and stress among adolescents. In particular, the mediating roles of social support (family, peers, and teachers) and stress in the association between health literacy and well-being were analyzed. Participants and Methods: Data were drawn from the 2022 wave of the Health Behaviour in School-aged Children (HBSC) study, an international survey conducted every four years in collaboration with the World Health Organization (WHO) and implemented according to a standardized protocol. The sample comprised 7643 students from the 6th, 8th, 10th, and 12th grades of Portuguese public schools. Of the participants, 53.9% were female, and the mean age was 15.05 years (SD = 2.36). Gender-based comparisons indicated statistically significant differences for all study variables, with the exception of health literacy. Results: Mediation analysis reveals an effect of health literacy on well-being. After the inclusion of the mediating variables, the direct effect of health literacy on lack of well-being remained negative. All four mediators showed statistically significant indirect effects, accounting for the difference between the total and direct effects. These findings indicate that the association between health literacy and lack of well-being was partially mediated by family support, peer support, relationships with teachers, and stress. Health literacy influenced lack of well-being both directly and indirectly through these mediating pathways, with stress emerging as the strongest indirect contributor. Conclusions: The findings support an ecological interpretation of health literacy and well-being, as these constructs are embedded within multiple interacting systems. Individual adolescent characteristics, such as gender, age, and stress management, are interconnected with interpersonal contexts, including relationships with family members, peers, and teachers. In addition, adolescents’ socio-economic circumstances appear to play a relevant role in shaping both health literacy and perceptions of well-being. Full article

(This article belongs to the Section Pediatric Psychology)

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9 pages, 915 KB

Open AccessArticle

Descriptive Case Series of Childhood Lymphomas Treated at the Children’s Hospital of Mexico

by Miguel A. Palomo-Colli, Daniela Vega-Ruiz, Argelia Escobar-Sánchez, Matilde Galicia-Esquivel, Luis E. Juárez-Villegas and Abigail Morales-Sánchez

Pediatr. Rep. 2026, 18(1), 28; https://doi.org/10.3390/pediatric18010028 - 10 Feb 2026

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Abstract

Background: Pediatric lymphomas comprise a heterogeneous group of malignancies with substantial variation in their clinical presentation. In Mexico, detailed case-based characterization remains limited. This study summarizes the demographic and clinical characteristics of pediatric lymphomas diagnosed at a national referral center over an [...] Read more.

Background: Pediatric lymphomas comprise a heterogeneous group of malignancies with substantial variation in their clinical presentation. In Mexico, detailed case-based characterization remains limited. This study summarizes the demographic and clinical characteristics of pediatric lymphomas diagnosed at a national referral center over an 11-year period. Methods: We conducted a retrospective review of lymphoma cases in children aged 0–17 years diagnosed at the Children’s Hospital of Mexico between 2004 and 2014. Cases were classified according to the ICCC-3 system and further described by histopathological subtype, age group, sex, and clinical outcomes. Results: Hodgkin lymphoma (HL) was the most frequent diagnosis, followed by non-Hodgkin lymphoma (NHL). Among HL cases, nodular sclerosis and mixed cellularity predominated, particularly in school-age children and adolescents. Within NHL, precursor T-cell lymphoma represented the largest subgroup, whereas mature B-cell lymphomas, such as diffuse large B-cell lymphoma, were less common than typically reported in high-income settings. Burkitt lymphoma occurred mainly among younger children. HL showed high survival, while some NHL subtypes exhibited poorer outcomes. Conclusions: This large hospital-based case series provides characterization of pediatric lymphomas in a major Mexican referral center. While HL subtype patterns resembled global trends, the predominance of precursor T-cell lymphomas within NHL contrasts with observations from high-income regions. These findings highlight the value of institutional case registries and the need for more comprehensive outcome reporting in future studies. Full article

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20 pages, 435 KB

Open AccessArticle

How Healthcare Professionals Perceive Emergency Pediatric Care Provision in Two Public Hospitals in Greece: A Cross-Sectional Study

by Eleni Vathi, Konstantinos Petsios, Evangelos Dousis, Ioannis Koutelekos, Despoina Koumpagioti, Eirini Anastasopoulou, Anastasia Ntikoudi, Eugenia Vlachou and Eleni Evangelou

Pediatr. Rep. 2026, 18(1), 27; https://doi.org/10.3390/pediatric18010027 - 5 Feb 2026

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Abstract

Background/Objectives: High-quality pediatric emergency care requires timely access, effective communication, privacy, pain management, comfort, and child- and family-centered practices; however, implementation may be constrained by several barriers. The aim of the study was to evaluate the quality of pediatric emergency care as [...] Read more.

Background/Objectives: High-quality pediatric emergency care requires timely access, effective communication, privacy, pain management, comfort, and child- and family-centered practices; however, implementation may be constrained by several barriers. The aim of the study was to evaluate the quality of pediatric emergency care as perceived by healthcare professionals, with emphasis on child-centered care and variations based on workplace and professional characteristics. Methods: A cross-sectional survey was performed in the emergency departments in two tertiary public pediatric hospitals in Athens, Greece. A study-developed 14-item Quality of Care Assessment Scale with paired ratings of agreement with quality principles and implementation in practice was completed by 162 professionals (122 doctors, 24 nurses, 16 assistant nurses). Independent items evaluated perceived barriers, overall assessments (0–100), and information provided to parents/children (5-point Likert scale). Inferential tests and descriptive statistics were also used (p < 0.05). Results: There was a significant degree of agreement with quality principles, but there was a constant lack of implementation (principle–practice gap). The primary perceived weakness was waiting times; child-friendly settings and privacy during examinations and information-giving were also lacking. Internal consistency ranged from good to acceptable (implementation α = 0.800; agreement α = 0.711). Children were most frequently rated as “moderately informed” (48.1%), while parents were most frequently rated as “quite informed” (50.0%). Compared to the organization of care (mean 60.85), perceived safety was higher (mean 73.27). Perceptions varied by age, educational level, profession, department, shift rotations, and hospital. The main barriers were workload (30.2%), poor coordination (34.0%), and lack of resources (46.9%). Conclusions: Health professionals seem to perceive that consistent delivery of child-centered care is impaired by organizational and structural limitations. Reducing the standards-to-practice gap requires targeted system-level interventions that focus on staffing, care organization, environment, and professional support. Full article

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15 pages, 240 KB

Open AccessArticle

Adolescents’ Knowledge and Attitudes Toward Attention-Deficit/Hyperactivity Disorder in Greek Secondary Schools

by Angeliki Giannakea, Vicky Nanousi and Voula Chris Georgopoulos

Pediatr. Rep. 2026, 18(1), 26; https://doi.org/10.3390/pediatric18010026 - 5 Feb 2026

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Abstract

Background/Objectives: Adolescence is a critical developmental period during which peer attitudes and school experiences play an important role in social inclusion and academic adjustment. Although attention-deficit/hyperactivity disorder (ADHD) is common in secondary school populations, adolescents’ own knowledge and attitudes toward ADHD remain underexplored, [...] Read more.

Background/Objectives: Adolescence is a critical developmental period during which peer attitudes and school experiences play an important role in social inclusion and academic adjustment. Although attention-deficit/hyperactivity disorder (ADHD) is common in secondary school populations, adolescents’ own knowledge and attitudes toward ADHD remain underexplored, particularly in non-Anglophone contexts. This study aimed to assess knowledge and attitudes toward ADHD among Greek secondary school students, focusing on awareness of the disorder, perceptions of ADHD-related classroom behaviors, and views on educational support and intervention. Methods: A cross-sectional survey was conducted among 154 adolescents aged 12–18 years attending Gymnasium (Grades 7–9) and Lyceum (Grades 10–12) in Greece. Data were collected using an anonymous online questionnaire assessing prior awareness of ADHD, perceptions of classroom behaviors associated with ADHD, attitudes toward inclusion and teacher support, and views on educational and therapeutic interventions. Adolescents with and without a self-reported ADHD diagnosis completed different questionnaire sections according to study design. Descriptive statistics and chi-square tests were used for data analysis. Results: Approximately two thirds of participants (66.9%) reported prior awareness of ADHD. Among typically developing adolescents (n = 134), 83.0% recognized distractibility due to external noise, 70.4% noted off-topic interruptions, and 60.0% reported peers getting up without permission. While 75.5% believed students with ADHD can participate in the classroom, 65.9% also reported academic challenges such as incomplete homework or lower performance. Overall, 79.2% of participants stated that school success depends on teacher and specialist support; however, among adolescents with ADHD (n = 20), only 60.0% endorsed this, with 40.0% emphasizing personal effort. Speech-language therapy was viewed as helpful by 55.6% of typically developing adolescents, though 76.9% of adolescents with ADHD reported not receiving such services. Conclusions: Greek adolescents demonstrate moderate awareness of ADHD and generally supportive attitudes toward peers with ADHD, alongside some uncertainty regarding available educational supports. Schools may represent an important context for improving adolescents’ mental health literacy and understanding of ADHD-related support options. Full article

15 pages, 563 KB

Open AccessArticle

Mechanisms and Severity of Injuries in Infants and Children <2 Years: A Retrospective Analysis over 30 Years in a European Urban Level 1 Trauma Center

by Vanessa Groß, Anna Theresa Schauß, Lara Marie Bogensperger, Antonia Schwarz, Bikash Parajuli, Sanika Rapole, Janina M. Patsch, Notburga Payr, Kurt Payr and Stephan Payr

Pediatr. Rep. 2026, 18(1), 25; https://doi.org/10.3390/pediatric18010025 - 5 Feb 2026

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Abstract

Background/Objectives: Injuries remain a major cause of childhood morbidity and mortality in Europe, despite improved prevention. Infants under one year are particularly vulnerable because of limited motor control and complete dependence on caregivers. Existing studies are often small or cover broad age ranges, [...] Read more.

Background/Objectives: Injuries remain a major cause of childhood morbidity and mortality in Europe, despite improved prevention. Infants under one year are particularly vulnerable because of limited motor control and complete dependence on caregivers. Existing studies are often small or cover broad age ranges, limiting infant-specific insights. This study aims to provide a comprehensive overview of injury types, mechanisms, and treatments, focusing exclusively on infants aged zero to one year. Methods: This retrospective study analyzed 29,574 infants and children (<2 years) treated at a level 1 trauma department from 1993 to 2022. Primary data included main diagnosis, injury mechanism, and treatment. Injuries were classified by diagnosis and mechanism. Surgeries were categorized by procedure type. Results: Injury frequency increased with age. A total of 31.1% of cases occurred in infants (<12 months) and 68.9% in children (12–24 months). Head injuries were the most common trauma type (44%), particularly among infants (69.9%; children: 32.2%), while wounds (infants: 10.2%; children: 31.5%) and fractures (infants: 4.2%; children: 8.4%) were more frequent in children. Falls were the predominant mechanism (77.9%) across both groups. Most injuries were treated conservatively. A total of 228 surgical interventions were performed (0.8%), mainly for wounds (54.8%) and fractures (30.3%). Conclusions: This study shows that, even within the first two years of life, child development shapes both injury frequency and type. As mobility and independence increase, injuries rise, from predominantly head trauma among infants to a higher incidence of wounds and fractures in children. The majority of injuries were minor and managed conservatively. Full article

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16 pages, 626 KB

Open AccessArticle

Understanding Motivating Factors for COVID-19 Vaccination in Families Defaulting from Childhood Immunization: A Mixed-Methods Study in Pakistan

by Kifayat Ullah, Chukwuma Mbaeyi, Javeria Saleem, Muhammad Ishaq, Muhammad Rana Safdar, Aslam Pervaiz, Tamkeen Ghafoor, Mumtaz Ali Laghari, Sumbal Hameed, Fatima Majeed, Usman Javed Iqbal and Amjad Mehmood

Pediatr. Rep. 2026, 18(1), 24; https://doi.org/10.3390/pediatric18010024 - 5 Feb 2026

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Abstract

Background: The COVID-19 pandemic significantly disrupted health systems, including the delivery of childhood immunizations. This study assessed COVID-19 vaccination coverage in families of children with incomplete routine immunization and explored why adults accepted COVID-19 vaccines despite skipping routine vaccination for their children in [...] Read more.

Background: The COVID-19 pandemic significantly disrupted health systems, including the delivery of childhood immunizations. This study assessed COVID-19 vaccination coverage in families of children with incomplete routine immunization and explored why adults accepted COVID-19 vaccines despite skipping routine vaccination for their children in the district of Swat, Khyber Pakhtunkhwa, Pakistan. Methods: A mixed-methods study was conducted in Swat District during March 2022–April 2023. A cross-sectional survey assessed COVID-19 vaccination in household members of children under 2 years of age for whom vaccination registries showed missed routine vaccinations. In-depth interviews with 18 household members explored motivations for vaccine acceptance through thematic analysis. Results: Among 249 families of children with incomplete immunization found through vaccination records, 237 families (88% response) were interviewed. Among 382 children below 2 years of age in these families, 29.5% (n = 113) were fully vaccinated, 67.5% (n = 258) were incompletely vaccinated according to age, and 2.9% (n = 11) had not received any vaccine. Data from 237 of the defaulter children—one per household—was included in further analysis. Among household members above 12 years of age, 87% (964/1103) of males and 82% (n = 901/1093) of females were vaccinated against COVID-19. Households with at least one fully vaccinated child were significantly more likely to have vaccinated family members. Multivariable analysis showed maternal COVID-19 vaccination (AOR 2.08, 95% CI: 1.15–3.76) and urban residence (AOR 2.08, 95% CI: 1.14–3.79) were associated with full childhood vaccination. In-depth interviews revealed that key motivators for COVID-19 vaccination included the perception that it was mandatory, house-to-house vaccination, and fear of hospitalization or death. Conclusions: Vaccine requirements and ease of access to vaccination services enhanced coverage with COVID-19 vaccines among families of children with incomplete routine immunization. Ethical use of vaccine requirements and community education to enhance levels of risk perception of vaccine-preventable diseases could potentially improve childhood immunization. Full article

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16 pages, 295 KB

Open AccessArticle

Estimation of Antioxidant Consumption in an Adolescent Population from a School in Pachuca de Soto, Mexico: A Cross-Sectional Study by Convenience Sample

by Eli Mireya Sandoval-Gallegos, Alejandra López-García, Karen Rubí Escamilla-Gutiérrez, José Arias-Rico, Quinatzin Yadira Zafra-Rojas, Esther Ramírez-Moreno, Araceli Monter-Arciniega, Nelly del Socorro Cruz-Cansino, Alma Delia Román-Gutiérrez and Zacnicté Olguín-Hernández

Pediatr. Rep. 2026, 18(1), 23; https://doi.org/10.3390/pediatric18010023 - 4 Feb 2026

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Abstract

Background: Adolescence is a critical stage for establishing lifelong dietary habits and preventing non-communicable diseases through adequate intake of bioactive compounds. Numerous studies have thoroughly examined the antioxidant profile of traditional diets such as the Mediterranean diet. In contrast, current research provides limited [...] Read more.

Background: Adolescence is a critical stage for establishing lifelong dietary habits and preventing non-communicable diseases through adequate intake of bioactive compounds. Numerous studies have thoroughly examined the antioxidant profile of traditional diets such as the Mediterranean diet. In contrast, current research provides limited insights into the antioxidant properties of foods typically consumed by Mexican adolescents. Objective: So, this study aimed to quantify the total phenolic compound (TPC) content and antioxidant capacity (AC) of frequently consumed foods and to estimate dietary intake in Mexican adolescents. Methodology: The selected food groups were identified based on their frequency of consumption by 15% or more of the adolescent population, considering those that have demonstrated a sufficient quantity of antioxidants. It was analyzed TPC and ABTS•⁺ and DPPH• to determine the antiradical activity of the analyzed samples. Results: The estimated daily intake of TPC was 1484.01 mg GAE/person, while AC intake was 345.67 mg AAE/person (ABTS•⁺) and 5399.14 µmol TE/person (DPPH•). Cereals and fruits were the major contributors to total antioxidant intake, while the contribution of leafy vegetables and nuts was relatively low. The statistical analysis revealed a significant positive correlation between TPC and AC. The results of the study indicate the antioxidant potential of the adolescent diet. Conclusions: Despite certain limitations, the values obtained from the study are comparable to those of other studies that employed similar methodologies. Consequently, promoting the early consumption of fresh plant-based foods rich in antioxidants, such as polyphenols, which can enhance the dietary profile and contribute to adolescents’ long-term health, constitutes a significant area of research. Full article

(This article belongs to the Topic Personalized and Sustainable Nutrition for Children and Adolescents: An Important Step for the 2030 Agenda)

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7 pages, 187 KB

Open AccessCase Report

Kawasaki Disease-Associated Pancreatitis in an Adolescent: A Case Report and Literature Review

by Akihiro Ichiki, Keisuke Takata and Tadashi Moriwake

Pediatr. Rep. 2026, 18(1), 22; https://doi.org/10.3390/pediatric18010022 - 4 Feb 2026

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Abstract

Background: Pancreatic involvement in Kawasaki disease (KD) is rare. Case presentation: A 13-year-old adolescent presented with severe epigastric pain, elevated pancreatic enzyme levels, and conjunctival injection, but he lacked a fever and the other classic features of KD. The patient was initially diagnosed [...] Read more.

Background: Pancreatic involvement in Kawasaki disease (KD) is rare. Case presentation: A 13-year-old adolescent presented with severe epigastric pain, elevated pancreatic enzyme levels, and conjunctival injection, but he lacked a fever and the other classic features of KD. The patient was initially diagnosed with acute pancreatitis and treated conservatively. As his abdominal pain improved, mucocutaneous findings emerged, leading to a diagnosis of complete KD. A literature review was conducted to summarize reported cases of KD-associated pancreatitis. This review highlights the older age of affected patients, the variability in the timing of pancreatitis onset, and a tendency toward delayed diagnosis. Conclusions: Pancreatic involvement, including pancreatitis, can occur before typical mucocutaneous features and should be considered in older children and adolescents presenting with unexplained abdominal pain and pancreatic enzyme elevation. Increased awareness of this atypical presentation may help reduce diagnostic delay and support timely management. Full article

15 pages, 1673 KB

Open AccessArticle

Local Diagnostic Reference Levels for Common Nuclear Medicine Procedures for Pediatric in Dubai Health

by Entesar Z. Dalah, Najlaa K. Al Mazrouei and Zahra A. Al Ali

Pediatr. Rep. 2026, 18(1), 21; https://doi.org/10.3390/pediatric18010021 - 3 Feb 2026

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Abstract

This study aims to establish diagnostic reference levels (DRLs) for common pediatric nuclear medicine (NM) procedures performed within the Dubai Health sector. The established DRLs will serve as a benchmark for pediatric NM practice, supporting standardized healthcare delivery and guiding ongoing quality improvement [...] Read more.

This study aims to establish diagnostic reference levels (DRLs) for common pediatric nuclear medicine (NM) procedures performed within the Dubai Health sector. The established DRLs will serve as a benchmark for pediatric NM practice, supporting standardized healthcare delivery and guiding ongoing quality improvement and internal audit activities. Patient dose survey data were collected from the solo NM center within the Dubai Health sector. The study included common scintigraphy procedures using gamma cameras and the hybrid positron emission tomography with computed tomography (PET/CT) procedures. Scintigraphy procedures include the dynamic and static renal scans, and ocular eye scans. The hybrid PET/CT procedures entail tumor/infection and neuroendocrine scans. Patient demographics, administered activities, CT doses, and study description were recorded. Both weight bands of <5, 5–<15, 15–<30, 30–<50, and 50–<80 kg, and age bands of <1, 1–<5, 5–<10, and 10–<15 years were considered. Statistical analysis was performed to determine the 25th percentile, median and 75th percentile of the dose distribution. The median value was used to establish the DRLs for the Dubai Health sector. The analyses revealed significant variation in the administered activities across the different pediatric NM procedures. The proposed DRLs for various pediatric NM procedures for the weight band 15–<30 kg are as follows: renal dynamic 98.4 MBq, renal static 96.2 MBq, ocular eyes 18.5 MBq, tumor/infection 155 MBq, and neuroendocrine 80 MBq. This work provides the first pediatric NM DRLs for the Dubai Health sector, offering a key reference for developing the local DRLs for the Emirate of Dubai. The findings indicate that achieving meaningful dose optimization will require systematic revision of existing imaging protocols, with targeted parameter adjustments informed by continuous dose monitoring and benchmarking to enhance patient safety and overall diagnostic quality. Full article

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21 pages, 1711 KB

Open AccessCase Report

Severe Lower Urinary Tract Dysfunction in Otherwise Healthy Children: A Three-Case Series and Narrative Review

by Olivia-Oana Stanciu, Andreea Moga, Laura Balanescu, Mircea Andriescu, Ruxandra Caragata and Radu Balanescu

Pediatr. Rep. 2026, 18(1), 20; https://doi.org/10.3390/pediatric18010020 - 3 Feb 2026

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Abstract

Background: Severe lower urinary tract dysfunction (LUTD) in neurologically and anatomically normal children is uncommon and frequently underdiagnosed. When severe, functional voiding disorders may closely mimic obstructive or reflux pathology, leading to diagnostic errors, unnecessary invasive procedures, and potential risk to the upper [...] Read more.

Background: Severe lower urinary tract dysfunction (LUTD) in neurologically and anatomically normal children is uncommon and frequently underdiagnosed. When severe, functional voiding disorders may closely mimic obstructive or reflux pathology, leading to diagnostic errors, unnecessary invasive procedures, and potential risk to the upper urinary tract. Case presentation: We present three pediatric cases (aged 3–10 years) referred for recurrent febrile urinary tract infections, incontinence, or acute urinary retention in the absence of neurological or structural abnormalities. Urodynamic evaluation identified three distinct severe functional phenotypes: detrusor overactivity with reduced bladder capacity, poor compliance with detrusor–sphincter dyssynergia and secondary high-grade vesicoureteral reflux (Hinman syndrome), and detrusor underactivity with significant post-void residual volumes. All patients demonstrated marked bladder wall remodeling on cystoscopy, including trabeculation and pseudopolypoid mucosal changes. Case discussion: Despite similar clinical severity, the cases illustrated substantial functional heterogeneity and differing risks of upper urinary tract involvement. Urodynamic phenotyping proved central to diagnosis, differentiation from structural disease, and treatment planning. Multimodal conservative management—including urotherapy, pelvic floor biofeedback, targeted pharmacologic therapy, and, when indicated, clean intermittent catheterization or antibiotic prophylaxis—led to resolution of recurrent infections and meaningful improvement in bladder function during medium-term follow-up, although symptom recurrence occurred in one patient after treatment withdrawal. Conclusions: These cases highlight the heterogeneity and potential reversibility of severe functional LUTD in otherwise healthy children. Early functional recognition based on urodynamic assessment is essential to avoid misdiagnosis, prevent unnecessary surgical intervention, and protect renal function. Conservative, function-oriented management remains the cornerstone of effective treatment. The findings are discussed in the context of the existing literature on severe non-neurogenic LUTD and Hinman syndrome. Full article

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25 pages, 557 KB

Open AccessReview

Pediatric Cholestatic Diseases in the Era of Ileal Bile Acid Transporter (IBAT) Inhibitors

by Marco Sciveres, Silvio Veraldi, Francesco Cirillo and Giuseppe Maggiore

Pediatr. Rep. 2026, 18(1), 19; https://doi.org/10.3390/pediatric18010019 - 3 Feb 2026

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Abstract

Cholestatic diseases in children represent a heterogeneous group of disorders that, with few exceptions, have no cure. For decades, off-label drugs and/or drugs with little evidence of efficacy have been used to treat pruritus or as supportive therapy. In recent years, a family [...] Read more.

Cholestatic diseases in children represent a heterogeneous group of disorders that, with few exceptions, have no cure. For decades, off-label drugs and/or drugs with little evidence of efficacy have been used to treat pruritus or as supportive therapy. In recent years, a family of molecules known as bile acid transporter inhibitors (IBATis) has been developed, with two of these being approved for treating pruritus in progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome (ALGS). Blocking the ileal reabsorption of bile acids (BAs) lowers serum levels. This contributes to reducing cholestatic pruritus. Such a mechanism of action may also have a potential benefit in other cholestatic diseases and even in the consequences of chronic cholestasis. This is a narrative review of the literature, including the most recent communications, to summarize data on the efficacy and safety of IBATis in the treatment of pruritus in PFIC and ALGS in children, including a description of the latest results from their use in a real-world setting. Reports on off-label use and experiences in adults are also discussed. This review aims to help physicians understand the potential and limitations of these new drugs in the treatment of cholestatic pruritus. Full article

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14 pages, 1654 KB

Open AccessCase Report

The Role of Serial Fetal Echocardiography in Postnatal Surgical Decision-Making for Borderline Left Ventricle: A Case Report

by Andreea Cerghit-Paler, Dorottya Gabor-Miklosi, Iolanda Muntean, George-Andrei Crauciuc, Daniela Toma, Laura Beligan and Liliana Gozar

Pediatr. Rep. 2026, 18(1), 18; https://doi.org/10.3390/pediatric18010018 - 2 Feb 2026

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Abstract

Background: Borderline left ventricle represents a heterogeneous spectrum of congenital heart disease for which accurate prediction of suitability for biventricular versus univentricular circulation is often difficult. Serial fetal echocardiography may provide dynamic information to support postnatal decision-making. Case Presentation: We report [...] Read more.

Background: Borderline left ventricle represents a heterogeneous spectrum of congenital heart disease for which accurate prediction of suitability for biventricular versus univentricular circulation is often difficult. Serial fetal echocardiography may provide dynamic information to support postnatal decision-making. Case Presentation: We report the case of a fetus diagnosed at 32 weeks’ gestation with a borderline left ventricle, ventricular disproportion, hypoplastic left-sided structures, ductal-dependent systemic circulation, and a non-restrictive ostium secundum atrial septal defect. Serial fetal echocardiographic evaluations demonstrated stable left ventricular dimensions, preserved systolic function, impaired diastolic relaxation, and absence of endomyocardial fibroelastosis. Postnatal echocardiography confirmed hypoplastic aortic arch and coarctation. Following multidisciplinary evaluation, a biventricular repair strategy was selected. At 14 days of life, the patient underwent aortic arch reconstruction and partial atrial septal defect closure with preservation of a small therapeutic interatrial communication. Postoperative evolution was favorable, with progressive left ventricular growth and preserved function. At 2-year follow-up, echocardiography showed normalized mitral and aortic valve z-scores, good left ventricular systolic performance, and no evidence of myocardial fibrosis. Conclusions: This case highlights the value of serial fetal echocardiography in guiding individualized management of borderline left ventricle. Careful assessment of ventricular function and atrial septal physiology may support selection of a biventricular strategy in selected patients and contribute to favorable mid-term outcomes. Full article

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13 pages, 591 KB

Open AccessArticle

Copycat Behavior and Somatic Symptoms in Italian Children Exposed to a Violent TV Series: An Observational Study of Squid Game Viewers

by Martina Gnazzo, Giuditta Bargiacchi, Luigi Vetri, Lucia Parisi, Davide Testa, Daniela Smirni, Agata Maltese, Valentina Baldini, Giulia Pisanò, Eva Germanò, Beatrice Gallai, Antonella Gagliano, Carola Costanza, Michele Roccella and Marco Carotenuto

Pediatr. Rep. 2026, 18(1), 17; https://doi.org/10.3390/pediatric18010017 - 30 Jan 2026

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Abstract

Background: Violent TV series and streaming content are increasingly accessible to children, raising concerns about behavioral imitation and psychological effects. This study examined copycat behaviors and associated emotional and somatic symptoms among children who reported watching the age-restricted series Squid Game. Methods: [...] Read more.

Background: Violent TV series and streaming content are increasingly accessible to children, raising concerns about behavioral imitation and psychological effects. This study examined copycat behaviors and associated emotional and somatic symptoms among children who reported watching the age-restricted series Squid Game. Methods: In this observational study of 228 Italian primary school children (aged 8–11), 128 who had watched Squid Game formed the analytic sample. They were categorized into a Copycat Behavior (CB) group or a Non-Copycat Behavior (NCB) group based on self-reported imitation of scenes or games from the series. Parents completed the Child Behavior Checklist (CBCL). Group differences were assessed using Mann–Whitney U tests, and gender distribution was compared with Chi-square tests (α = 0.05). Results: Among viewers, 42 children (32%) engaged in imitation behaviors, typically reenacting game-based violent scenes with friends (52%), siblings (28%), or classmates (20%). Age and gender distributions did not differ between groups. The CB group scored slightly higher on the CBCL Somatic Complaints scale compared with the NCB group (M = 54.12 vs. 52.92; U = 1414.5, p = 0.033), although this difference was small. No significant differences emerged on other CBCL syndrome or broadband scales. Conclusions: Among children engaging in copycat behaviors exhibited a small, subclinical increase in somatic complaints. While causality cannot be inferred, the findings highlight the need to protect vulnerable children—particularly those prone to somatic distress—from unsupervised access to violent, age-inappropriate content. Media literacy for parents and educators, and longitudinal studies including non-viewers are recommended. Full article

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8 pages, 2134 KB

Open AccessCase Report

A Customized Mouthguard Design for a Child with Orofacial Myofunctional Disorder: A Case Report

by Masatoshi Otsugu, Fumikazu Tojo, Rena Okawa and Kazuhiko Nakano

Pediatr. Rep. 2026, 18(1), 16; https://doi.org/10.3390/pediatric18010016 - 21 Jan 2026

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Abstract

When fabricating custom-made mouthguards for children, tooth replacement is an important factor for dentists to consider. In addition, orofacial myofunctional disorders and deleterious oral habits—such as incompetent lip seal and tongue thrusting—are relatively common among children and are associated with an increased risk [...] Read more.

When fabricating custom-made mouthguards for children, tooth replacement is an important factor for dentists to consider. In addition, orofacial myofunctional disorders and deleterious oral habits—such as incompetent lip seal and tongue thrusting—are relatively common among children and are associated with an increased risk of oral and dental trauma. Therefore, individual oral functional characteristics should be taken into account when designing custom-made mouthguards for pediatric patients. This report presents a case involving the design, fabrication, and appliance management of a custom-made mouthguard for a Japanese boy exhibiting incompetent lip seal and tongue thrusting. In this case, the anterior palate region of the mouthguard was left uncut, and multiple holes were created using a carbide bur to permit tongue–palate contact and provide sensory feedback related to tongue elevation. Over a 20-month follow-up period, no oral or dental trauma was observed. During appliance use, the patient demonstrated improved tongue elevation and an increased frequency of lip seal at rest. This case illustrates a custom mouthguard design that incorporates individual oral functional characteristics in a pediatric patient. Full article

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7 pages, 10078 KB

Open AccessCase Report

A Pediatric Supracondylar Fracture with Bilateral (Medial and Lateral) Pillar Comminution–A Recommendation for a New Stable Pin Configuration for a Highly Unstable Fracture

by Lara Marie Bogensperger, Sandeep Patwardhan and Stephan Payr

Pediatr. Rep. 2026, 18(1), 15; https://doi.org/10.3390/pediatric18010015 - 21 Jan 2026

Viewed by 112

Abstract

The management of supracondylar fractures in children remains a challenging area of orthopedic practice. Medial comminution is a recognized complication that can result in unstable fracture patterns, which can pose challenges in diagnosis and management. However, when anticipated surgical treatment with an additional [...] Read more.

The management of supracondylar fractures in children remains a challenging area of orthopedic practice. Medial comminution is a recognized complication that can result in unstable fracture patterns, which can pose challenges in diagnosis and management. However, when anticipated surgical treatment with an additional medial K-wire is administered, stable fixation is typically ensured. However, an additional radial comminution poses several challenges for reduction, alignment assessment, and pin configuration for stable fixation, as presented in this case. This case report presents a fracture pattern of a Gartland type 3 fracture with medial and lateral comminution that has not been sufficiently described previously and illustrates an effective pin configuration that has yet to be theoretically described. Full article

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17 pages, 596 KB

Open AccessReview

Integrating the Genomic Revolution into Newborn Screening: Current Challenges and Future Perspectives

by Albina Tummolo, Emanuela Ponzi, Simonetta Simonetti and Mattia Gentile

Pediatr. Rep. 2026, 18(1), 14; https://doi.org/10.3390/pediatric18010014 - 19 Jan 2026

Viewed by 296

Abstract

In recent years, the development of new diagnostic technologies, such as tandem mass spectrometry (MS/MS) and next-generation sequencing (NGS), has caused a veritable revolution in the diagnosis of genetic diseases, reducing time, cost, and invasiveness associated with prior diagnostic techniques. While MS/MS laid [...] Read more.

In recent years, the development of new diagnostic technologies, such as tandem mass spectrometry (MS/MS) and next-generation sequencing (NGS), has caused a veritable revolution in the diagnosis of genetic diseases, reducing time, cost, and invasiveness associated with prior diagnostic techniques. While MS/MS laid the foundation for the development of numerous, usually institutionally based, neonatal screening programs, NGS has gained traction in newborn screening (NBS), primarily through pilot projects and private funding across different countries. As a result, the traditional Wilson and Jungner criteria have been supplemented by additional criteria, including considerations of equity and access, in response to emerging technologies. This review aims to provide an up-to-date overview of the global landscape of metabolic screening panels, highlight the major ongoing genomic screening projects, and outline the current models for integrating these two screening systems. Substantial differences exist across countries in the numbers and types of diseases included in national NBS programmes. In this context, Italy represents a prominent case, as its neonatal screening framework has seen significant expansion and development in recent years, reaching a particularly comprehensive metabolic screening panel. Nonetheless, a number of initiatives to incorporate genomic technologies into the NBS pathway are currently underway, primarily involving high-income countries. Nonetheless, unlike metabolomic-based NBS programs, no country has a government-mandated NGS program as first-tier testing for newborns. New evidence is emerging from ongoing models of integration of multi-omics approaches into NBS, including the use of AI and machine learning. Identifying the most appropriate system for this integration to reduce the false-positive and false-negative rates associated with both screening types, ensure more equitable access to screening, and facilitate faster access to treatment may represent a useful and foresightful way to conceptualize NBS in the future. This transitional phase should promote rigorous improvements before full-scale adoption. Full article

(This article belongs to the Special Issue Global Neonatal Screening: Expanding Horizons in Diagnostic Technologies)

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17 pages, 1229 KB

Open AccessArticle

Exploratory Study: The Impact of Online Coordinative Exercise in a Small Latinx Youth Sample

by Nancy J. Hernandez and John S. Carlson

Pediatr. Rep. 2026, 18(1), 13; https://doi.org/10.3390/pediatric18010013 - 19 Jan 2026

Viewed by 162

Abstract

Background/Objectives: The effects of online physical activity (PA) interventions on executive function (EF) and Attention-Deficit Hyperactivity Disorder (ADHD) symptoms are promising; nonetheless, their benefits for Latinx youth remain unclear. Methods: This study explores levels of adherence, cognitive and behavioral outcomes and acceptability of [...] Read more.

Background/Objectives: The effects of online physical activity (PA) interventions on executive function (EF) and Attention-Deficit Hyperactivity Disorder (ADHD) symptoms are promising; nonetheless, their benefits for Latinx youth remain unclear. Methods: This study explores levels of adherence, cognitive and behavioral outcomes and acceptability of an online PA intervention, Zing Performance, among a Latinx youth sample; only a few of the participants completed their condition (n = 6). Results: There was wide variability in adherence levels at mid-treatment (n = 5) and high-level adherence at post-treatment (n = 2). A Mann–Whitney test yielded a statistically significant (p = 0.004) improvement in the treatment group’s inattention symptoms at mid-treatment (n = 5), compared to the Waitlist Control; (WLC; n = 6). EF and hyperactivity/impulsivity were not significantly different. Further, pre-, mid- and post-participant trajectory data revealed that one participant benefited significantly from treatment, one participant demonstrated little to no response to treatment, and most of the WLC participants remained in the severity ranges throughout the 12 weeks. The parents of the two children who completed treatment reported high levels of acceptability informally and on the quantitative measure. Conclusions: Exploratory findings support further investigation of Zing among Latinx families with cultural consideration to study procedures. The lessons learned from this study are valuable for future research procedures and interventions with this marginalized population. Full article

(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)

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17 pages, 278 KB

Open AccessArticle

Forensic Perspectives on Child Sexual Abuse Disclosure in Greece: A Retrospective Study

by Konstantinos Dimitriou, Vasiliki Efthymiou, Kallirroi Fragkou, Pierre-Antoine Peyron, Laurent Martrille, Eric Baccino, Flora Bacopoulou and Stavroula Papadodima

Pediatr. Rep. 2026, 18(1), 12; https://doi.org/10.3390/pediatric18010012 - 16 Jan 2026

Viewed by 263

Abstract

Purpose: Child sexual abuse (CSA) is a major public health and forensic concern, often involving delayed disclosure that limits evidence collection and affects judicial outcomes. This study analyzed disclosure patterns, victim–perpetrator characteristics, and forensic findings in CSA cases evaluated in Greece, contributing to [...] Read more.

Purpose: Child sexual abuse (CSA) is a major public health and forensic concern, often involving delayed disclosure that limits evidence collection and affects judicial outcomes. This study analyzed disclosure patterns, victim–perpetrator characteristics, and forensic findings in CSA cases evaluated in Greece, contributing to the limited Southern European evidence base. Material and Methods: A retrospective review of 89 CSA cases (2014–2024) examined by a certified forensic physician at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, was conducted. Data from official medico-legal reports included demographics, abuse context, forensic findings, and disclosure interval. Statistical analyses explored factors associated with delayed disclosure (>7 days). Results: Victims were predominantly female (69.7%) with a mean age of 9.8 years. Most perpetrators were adult males, and over half of cases (53.9%) involved intrafamilial abuse. The mean delay in disclosure was 79 days; only 29.2% reported within one week. Recurrent abuse correlated with delayed disclosure (p = 0.006), while early disclosure was associated with biological evidence collection (p < 0.001). Physical injuries were observed in 23.6% of victims, genital findings in 17%, and anal findings in 3.4%. Conclusions: Delayed disclosure was common and significantly reduced the likelihood of identifying forensic evidence. The early application of trauma-informed examinations, which adopt a child-centered approach emphasizing safety, emotional regulation, and the prevention of re-traumatization, is essential for the medical and forensic evaluation of abused children. Adopting hospital-based multidisciplinary units could improve forensic documentation, interagency coordination, and psychosocial care in Greece. Full article

16 pages, 269 KB

Open AccessArticle

Parental Knowledge and Attitudes Toward Emergency Management of Dental Trauma in Children: A Cross-Sectional Croatian Study

by Klaudia Aleric, Lidia Gavic, Mirna Draganja, Kristina Gorseta, Vesna Ambarkova and Antonija Tadin

Pediatr. Rep. 2026, 18(1), 11; https://doi.org/10.3390/pediatric18010011 - 15 Jan 2026

Viewed by 198

Abstract

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of [...] Read more.

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

8 pages, 950 KB

Open AccessCase Report

Severe Abdominal Pain Mimicking Appendicitis Caused by Imperforate Hymen: Case Report and Narrative Review

by Julia Kleina, Marcin Wieczorek, Karolina Markowska, Katarzyna Nierzwicka, Julia Leszkowicz and Agnieszka Szlagatys-Sidorkiewicz

Pediatr. Rep. 2026, 18(1), 10; https://doi.org/10.3390/pediatric18010010 - 13 Jan 2026

Viewed by 341

Abstract

An imperforate hymen is a rare congenital genital anomaly causing menstrual blood retention during puberty. Treatment consists of a simple surgical incision of the hymenal membrane. We present a case of a 14-year-old girl who was admitted to the Emergency Department with severe [...] Read more.

An imperforate hymen is a rare congenital genital anomaly causing menstrual blood retention during puberty. Treatment consists of a simple surgical incision of the hymenal membrane. We present a case of a 14-year-old girl who was admitted to the Emergency Department with severe lower abdominal pain mimicking appendicitis. Medical history revealed a lack of menses and several months of cyclic abdominal pain. Imaging diagnostics confirmed an imperforate hymen with hematometrocolpos. Hymenotomy was performed with full recovery without complications. An imperforate hymen should be considered in the differential diagnosis of abdominal pain in adolescent girls, especially without expected menstruation. Early recognition allows for prompt treatment and prevents complications. Full article

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11 pages, 399 KB

Open AccessArticle

Testing the Reliability and Validity of the Turkish Adaptation of Sharenting Evaluation Scale

by Fatih Bayraktar and Hale Ögel-Balaban

Pediatr. Rep. 2026, 18(1), 9; https://doi.org/10.3390/pediatric18010009 - 12 Jan 2026

Viewed by 238

Abstract

Objectives: The aim of the present study was to adapt the Sharenting Evaluation Scale to Turkish and to test its reliability and validity. Methods: Through an online data collection platform, we recruited 391 parents (M_age = 42.2, SD_age = 5.6, 76% [...] Read more.

Objectives: The aim of the present study was to adapt the Sharenting Evaluation Scale to Turkish and to test its reliability and validity. Methods: Through an online data collection platform, we recruited 391 parents (M_age = 42.2, SD_age = 5.6, 76% female). They have at least one child under 18 years of age and actively engage with social media. Sharenting Evaluation Scale consists of 17 items rated on a 6-point Likert scale. Its Turkish adaptation underwent a two-phase process: exploratory and confirmatory factor analyses, along with testing for construct validity. Results: The exploratory factor analysis revealed that the 17 items in the questionnaire were loaded onto two factors (Social Behavior and Implications). The confirmatory factor analysis indicated that the two-factor model fitted the current sample well. To evaluate the construct validity of the Sharenting Evaluation Scale, we compared groups at the extreme ends of the scoring spectrum. A t-test was conducted to compare the scores of both groups across subscales, revealing a significant difference. We observed positive correlations between sharenting and parental self-regulation, authoritative parenting, permissive parenting, and digital media literacy which indicate the criterion validity. Conclusions: In conclusion, the current study demonstrates that the Turkish version of the Sharenting Evaluation Scale is a reliable and valid tool. Full article

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16 pages, 292 KB

Open AccessArticle

Nationwide Study of Pediatric Drug-Resistant Epilepsy in Estonia: Lower Incidence and Insights into Etiology

by Stella Lilles, Klari Heidmets, Kaisa Teele Oja, Karit Reinson, Laura Roht, Sander Pajusalu, Monica H Wojcik, Katrin Õunap and Inga Talvik

Pediatr. Rep. 2026, 18(1), 8; https://doi.org/10.3390/pediatric18010008 - 6 Jan 2026

Viewed by 368

Abstract

Background/Objectives: Drug-resistant epilepsy (DRE) is a significant health problem leading to cognitive impairment and reduced quality of life. This study aimed to investigate the incidence and etiology of DRE in children in Estonia. Methods: A retrospective, population-based study of childhood DRE was conducted [...] Read more.

Background/Objectives: Drug-resistant epilepsy (DRE) is a significant health problem leading to cognitive impairment and reduced quality of life. This study aimed to investigate the incidence and etiology of DRE in children in Estonia. Methods: A retrospective, population-based study of childhood DRE was conducted in Estonia from 1 January 2013, to 31 December 2017. All cases were identified through the only two pediatric neurology departments in the country, both located at tertiary care hospitals (Tartu University Hospital and Tallinn Children’s Hospital), ensuring complete nationwide coverage. Epidemiological, magnetic resonance imaging (MRI), and genetic data (chromosomal microarray, single-gene tests, gene panels, and exome/genome sequencing) were collected. Results: The incidence rate of childhood epilepsy was 84.1 per 100,000. DRE developed in 10% of children with new-onset epilepsy, corresponding to an incidence rate of 8.5 per 100,000. Etiologically relevant MRI abnormalities were identified in 43% of patients with DRE, most commonly congenital brain malformations (19%). Pathogenic single-gene sequence variants were detected in 25 of 110 patients (23%), copy number variants in four patients (4%), and chromosomal aberrations in one patient (1%). Novel candidate disease genes of uncertain pathogenicity were identified in four patients (4%). The most frequent etiology of DRE was structural (29%), followed by genetic (19%), with combined etiologies (13%) also contributing significantly. Conclusions: Our study is the first epidemiological study of DRE in children in Estonia and the Baltic region. The relatively low incidence observed may reflect the comprehensive national ascertainment and centralized management of pediatric epilepsy in tertiary care centers. Full article

20 pages, 582 KB

Open AccessSystematic Review

Inflammatory Biomarkers and Neurotrophic Factors in Preterm Newborns as Predictors of Motor Development: A Systematic Review

by Letícia Silva Gabriel, Vicente Donisete Ferreira Júnior, Marina Ornelas Anastácia Pereira, Dayanne Gabriela de Melo Marques, Virgínia Mendes Russo Vallejos and Melina Barros-Pinheiro

Pediatr. Rep. 2026, 18(1), 7; https://doi.org/10.3390/pediatric18010007 - 5 Jan 2026

Viewed by 391

Abstract

Background/Objectives: Preterm newborns (NBs) are at increased risk of motor developmental impairments. Evidence on inflammatory and neurotrophic biomarkers measured in the neonatal period as predictors of motor outcomes is scarce and heterogeneous. This systematic review synthesised data on inflammatory biomarkers and neurotrophic factors [...] Read more.

Background/Objectives: Preterm newborns (NBs) are at increased risk of motor developmental impairments. Evidence on inflammatory and neurotrophic biomarkers measured in the neonatal period as predictors of motor outcomes is scarce and heterogeneous. This systematic review synthesised data on inflammatory biomarkers and neurotrophic factors in Preterm NB as predictors of motor development (MD) up to 24 months of corrected age. Methods: MEDLINE, SciELO, Web of Science and Embase were searched for longitudinal observational studies of Preterm NB (World Health Organization definition) that measured one or more inflammatory biomarkers and/or neurotrophic factors in blood, urine or saliva and applied validated neurodevelopmental scales up to 24 months. Non-original reports, populations outside scope and studies with incomplete data were excluded. Methodological quality of primary studies was assessed with the Newcastle–Ottawa Scale (NOS). The protocol was registered in PROSPERO (CRD42022365839). Results: Of 1475 records, eight studies met the eligibility criteria. Higher neonatal concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), tumour necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) were generally associated with poorer motor performance, although null findings occurred in some cohorts. One study assessing neurotrophic factors reported elevated urinary brain-derived neurotrophic factor (BDNF) and glial cell-derived neurotrophic factor (GDNF) among infants with below-expected MD. Conclusions: Inflammatory biomarkers show promise as early indicators of adverse MD in Preterm NB, but heterogeneity in populations, biospecimens, sampling windows, assays and outcome scales limits comparability and precludes definition of risk thresholds. Larger, standardised cohorts are needed to clarify the prognostic value of inflammatory and neurotrophic biomarkers and to inform early risk stratification. Full article

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11 pages, 2888 KB

Open AccessCase Report

Mandibular Distraction Osteogenesis Guided by 3D Model and Monitored with Ultrasonography: A Case Report

by Barbora Hocková, Julien Issa, Miroslav Malček, Krzysztof Dowgierd, Rastislav Slávik, Yu-Chi Cheng, Karol Králinský and Adam Stebel

Pediatr. Rep. 2026, 18(1), 6; https://doi.org/10.3390/pediatric18010006 - 3 Jan 2026

Viewed by 426

Abstract

This case report describes mandibular distraction osteogenesis (DO) in a six-year-old patient with first and second branchial arch syndrome and obstructive sleep apnea, in whom 3D surgical planning was combined with ultrasonography (US) for postoperative monitoring. The aim was to illustrate how patient-specific [...] Read more.

This case report describes mandibular distraction osteogenesis (DO) in a six-year-old patient with first and second branchial arch syndrome and obstructive sleep apnea, in whom 3D surgical planning was combined with ultrasonography (US) for postoperative monitoring. The aim was to illustrate how patient-specific 3D modeling and a structured ultrasonography protocol can support safe mandibular advancement while limiting radiation exposure in a pediatric patient with complex craniofacial deformity. Preoperatively, a 3D-printed model of the mandible, generated from a cone beam computed tomography (CBCT) scan, was used to guide precise osteotomy planning and vector orientation. The surgical procedure was conducted using a Risdon approach and piezoelectric tools to ensure minimal trauma. Postoperative monitoring incorporated serial panoramic radiography and US at predefined time points to assess gap size, callus formation, and vascularity during distraction and consolidation. US identified early callus formation, progressive cortical bridging, and preserved callus vascularity, and, together with radiographic findings, guided the timing of distraction termination and distractor removal at 16 weeks. This case adds to the limited literature on pediatric mandibular DO by demonstrating the feasibility of integrating patient-specific 3D virtual planning with US-based follow-up to improve the safety, precision, and radiation-conscious management of DO in pediatric patients with complex craniofacial deformities. Full article

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17 pages, 235 KB

Open AccessReview

Procedural Pain and Situational Anxiety in Pediatric Patients: A Narrative Review of Assessment Tools

by Anna Wojciechowska-Urbanek, Jowita Rosada-Kurasińska and Alicja Bartkowska-Śniatkowska

Pediatr. Rep. 2026, 18(1), 5; https://doi.org/10.3390/pediatric18010005 - 2 Jan 2026

Viewed by 496

Abstract

Background: Procedural pain and anxiety are common phenomena among children hospitalized in pediatric wards; however, they are often under-recognized. These experiences frequently accompany patients during various diagnostic and therapeutic procedures. Assessing pain is particularly challenging in pediatric care, as children may have [...] Read more.

Background: Procedural pain and anxiety are common phenomena among children hospitalized in pediatric wards; however, they are often under-recognized. These experiences frequently accompany patients during various diagnostic and therapeutic procedures. Assessing pain is particularly challenging in pediatric care, as children may have difficulty clearly expressing their pain experiences, which can result in the underestimation of their symptoms. Accurate assessment using an appropriately selected scale should be regarded as an essential component of high-quality healthcare. Methods: This narrative review summarizes standardized tools for assessing procedural pain and anxiety in pediatric patients, focusing on instruments adapted to different ages and cognitive abilities and on their applicability in everyday clinical practice. Results: Numerous standardized scales are available, ranging from behavioral to numerical instruments tailored to specific developmental stages. Despite this, the implementation of these tools in routine care remains inconsistent, largely due to organizational, educational, and communication barriers among healthcare professionals. Conclusions: Medical staff must not only receive adequate training but also exhibit the motivation and readiness to utilize available pain assessment methods. Education and increased awareness among staff regarding pain and procedural anxiety are crucial for improving patient comfort and safety. Full article

17 pages, 710 KB

Open AccessArticle

Effects of a Media Prevention Program on Media-Related Knowledge and Awareness in Children and Their Parents: A Non-Randomized Controlled Cluster Study

by Tanja Poulain, Wieland Kiess, Team Drahtseil and Christof Meigen

Pediatr. Rep. 2026, 18(1), 4; https://doi.org/10.3390/pediatric18010004 - 25 Dec 2025

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Abstract

Background/Objectives: This study evaluates a media prevention program conducted in elementary schools. Methods: A one-week media program, carried out with fourth graders in Leipzig, Germany, was evaluated using a non-randomized controlled cluster design. Program participants (experimental group (EG), n = 84 children, 41 [...] Read more.

Background/Objectives: This study evaluates a media prevention program conducted in elementary schools. Methods: A one-week media program, carried out with fourth graders in Leipzig, Germany, was evaluated using a non-randomized controlled cluster design. Program participants (experimental group (EG), n = 84 children, 41 parents) and non-participants (control group (CG), n = 19 children, 14 parents) completed questionnaires before the media program (t1), directly after the program (t2, EG only), and 3 months later (t3). The child questionnaire assessed media use frequency, rules at home, perceived and objective media-knowledge, and awareness of dangers on the Internet. The parent questionnaire assessed media-related topics discussed with their children and parents’ confidence regarding media education. Results: In the EG, children’s perceived and objective knowledge and their awareness of dangers on the Internet increased significantly between t1 and t2 and remained stable until t3, while no changes were observed in the CG. The number of children reporting that there exist rules on social media use also increased significantly in the EG but not in the CG. The amount of media-related topics discussed within the family and parents’ confidence regarding media education increased significantly from t1 to t3 in both EG and CG. Children’s media use frequency did not change across time, neither in the EG nor in the CG. Conclusions: Media prevention programs at school can have positive effects on children’s knowledge and awareness of dangers on the Internet and might improve parents’ confidence in and the realization of media education at home. Full article

(This article belongs to the Section Pediatric Psychology)

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7 pages, 2710 KB

Open AccessCase Report

When Genes Reveal the Truth: Alport Syndrome Mimicking Steroid-Resistant Nephrotic Syndrome

by John Dotis, Antonia Kondou, George Liapis, Athina Ververi, Konstantinos Kollios and Nikoleta Printza

Pediatr. Rep. 2026, 18(1), 3; https://doi.org/10.3390/pediatric18010003 - 19 Dec 2025

Viewed by 371

Abstract

Τargeted genetic sequencing in a 6-year-old with steroid-resistant nephrotic syndrome and biopsy findings of focal segmental glomerulosclerosis (FSGS) revealed a novel COL4A3 pathogenic variant (p.Arg341His). Combined with electron microscopy findings of glomerular basement membrane abnormality, this led to a diagnosis of type IV [...] Read more.

Τargeted genetic sequencing in a 6-year-old with steroid-resistant nephrotic syndrome and biopsy findings of focal segmental glomerulosclerosis (FSGS) revealed a novel COL4A3 pathogenic variant (p.Arg341His). Combined with electron microscopy findings of glomerular basement membrane abnormality, this led to a diagnosis of type IV collagen-related nephropathy. This case underscores the benefit of early genetic testing in presumed FSGS for prognosis and avoiding unnecessary immunosuppression in pediatric nephrotic syndrome. Full article

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6 pages, 762 KB

Open AccessCase Report

Rapid Clinical Response to Omalizumab Treatment in Pediatric Acute Urticaria Associated with Mycoplasma Infection: A Two-Case Report

by Zhen-Li Wu, Yi-Siang Huang, Chien-Ting Chiang and Hong-Ren Yu

Pediatr. Rep. 2026, 18(1), 2; https://doi.org/10.3390/pediatric18010002 - 19 Dec 2025

Viewed by 453

Abstract

Background and Clinical Significance: Urticaria in children is generally self-limiting, and infections are a significant trigger. While anti-IgE therapy (Omalizumab) is approved for chronic spontaneous urticaria (CSU) in adolescents and adults, its role in treating acute urticaria, particularly in children, is not [...] Read more.

Background and Clinical Significance: Urticaria in children is generally self-limiting, and infections are a significant trigger. While anti-IgE therapy (Omalizumab) is approved for chronic spontaneous urticaria (CSU) in adolescents and adults, its role in treating acute urticaria, particularly in children, is not well defined. Case Presentation: We present two pediatric cases of acute urticaria associated with Mycoplasma pneumoniae infection. Both cases were refractory to antihistamines and corticosteroids but showed rapid response with anti-IgE treatment. Conclusions: This is the first case report in the literature of pediatric acute urticaria treated with Omalizumab. These cases suggest a potential role for IgE-mediated pathways in acute urticaria related to Mycoplasma infection and raise the question of broader applications for Omalizumab beyond CSU. Full article

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16 pages, 1371 KB

Open AccessArticle

A Clinical Prediction Model for Genetic Risk in Children with GDD/ID: A Retrospective Study

by Yunshu Jiang, Ran Chen, Mengyin Chen, Luting Peng, Yuchen Zhao, Rong Li and Xiaonan Li

Pediatr. Rep. 2026, 18(1), 1; https://doi.org/10.3390/pediatric18010001 - 19 Dec 2025

Viewed by 371

Abstract

Objectives: Global Developmental Delay (GDD) and Intellectual Disability (ID) are prevalent neurodevelopmental disorders with significant disability burden, and genetic factors play a crucial role in their etiology. This study aimed to develop and validate a clinical prediction model for identifying children with GDD/ID [...] Read more.

Objectives: Global Developmental Delay (GDD) and Intellectual Disability (ID) are prevalent neurodevelopmental disorders with significant disability burden, and genetic factors play a crucial role in their etiology. This study aimed to develop and validate a clinical prediction model for identifying children with GDD/ID at high genetic risk, facilitating targeted genetic testing. Methods: We retrospectively analyzed clinical data of children with GDD/ID treated at Nanjing Children’s Hospital from January 2019 to December 2023. Children with comorbid Autism Spectrum Disorder (ASD) were excluded. The dataset was randomly split into training and validation sets (7:3 ratio). Lasso regression was used to identify potential predictive factors for positive genetic test results, followed by multivariable logistic regression to select independent predictors, which were incorporated into a nomogram. Model performance was evaluated by discrimination, calibration, and clinical utility using decision curve analysis in both sets. Results: Four independent predictors—craniofacial abnormalities, visceral abnormalities, physical growth abnormalities, and family history of ID—were identified. The resulting nomogram demonstrated an area under the curve (AUC) of 0.734., with good calibration and positive net benefit on decision curve analysis. Validation confirmed the reliability of the model. Conclusions: We developed a clinically applicable prediction model to identify high genetic risk among children with GDD/ID without ASD. This model may serve as a preliminary screening tool to assist clinicians in prioritizing genetic testing and improving diagnostic efficiency in clinical practice. Full article

(This article belongs to the Special Issue Feature Papers on Child Developmental Disorders and Neurology Research)

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Pediatr. Rep., Volume 18, Issue 1 (February 2026) – 30 articles

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