Pediatric Reports

11 pages, 810 KiB

Open AccessArticle

Percentile Distribution of Habitual-Correction Visual Acuity in a Sample of 1500 Children Aged 5 to 15 Years in Italy

by Alessio Facchin, Marilena Mazzilli and Silvio Maffioletti

Pediatr. Rep. 2025, 17(4), 85; https://doi.org/10.3390/pediatric17040085 - 11 Aug 2025

Background: Early identification of visual disorders in children is essential to prevent long-term visual impairment and support academic development. Despite the recognized importance of visual screenings, no universal consensus exists on which visual parameters or threshold values should be used, particularly for measuring [...] Read more.

Background: Early identification of visual disorders in children is essential to prevent long-term visual impairment and support academic development. Despite the recognized importance of visual screenings, no universal consensus exists on which visual parameters or threshold values should be used, particularly for measuring visual acuity (VA) in pediatric populations. Objectives: This study aimed to develop age-related percentile norms for VA using LEA symbol charts. Methods: A sample of Italian schoolchildren aged 5 to 15 years (n = 1510) participated in the study. Data were collected retrospectively from school-based vision screenings conducted across 12 schools in the Lombardy and Piedmont regions from 2010 to 2019. Monocular and binocular VA were measured at 3 m using a standardized LEA symbol chart, and values were scored letter-by-letter on a LogMAR scale. Smoothed percentile curves were derived using Box–Cox, Cole, and Green distribution modeling and regression analysis. Results: The results showed a non-linear improvement in VA with age. Compared to prior studies, LEA symbols yielded slightly lower VA scores, reinforcing the need for chart-specific norms. The 50th percentile VA improved from approximately +0.07 LogMAR at age 6 to about −0.09 LogMAR at age 15. Conclusions: These findings highlight the importance of age-specific, chart-specific, and statistically robust reference data for VA screening in children. The derived percentile tables offer a more sensitive tool than fixed cut-offs for identifying visual anomalies and tailoring clinical interventions. This work contributes to standardizing pediatric VA screening practices and improving early detection of visual deficits. Full article

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6 pages, 1498 KiB

Open AccessCase Report

A Rare Case of Aortic Dissection 10 Years Post Percutaneous Catheterization Retrieval of an Embolized PDA Device in a Patient with Down Syndrome

by Youna Park, Hong Ryang Kil, Sang Yoon Kim and Geena Kim

Pediatr. Rep. 2025, 17(4), 84; https://doi.org/10.3390/pediatric17040084 - 8 Aug 2025

Abstract

There are no recorded cases of catheter-induced aortic dissection in pediatric patients. We report a unique case of a pediatric patient with Down syndrome who developed a long-standing dissecting aortic aneurysm. The patient underwent successful stent insertion 10 years after experiencing difficulty retrieving [...] Read more.

There are no recorded cases of catheter-induced aortic dissection in pediatric patients. We report a unique case of a pediatric patient with Down syndrome who developed a long-standing dissecting aortic aneurysm. The patient underwent successful stent insertion 10 years after experiencing difficulty retrieving an embolized patent ductus arteriosus device. The Down syndrome presented a complex clinical scenario, making diagnosis challenging due to a lack of cooperation and uncertainty about when the dissection occurred, as symptoms like pain were not reported. Though rare in children, it is vital to recognize procedures such as percutaneous closure of patent ductus arteriosus followed by device retrieval as potential risk factors for aortic dissections in the pediatric population. Full article

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Graphical abstract

12 pages, 593 KiB

Open AccessArticle

Metabolic Syndrome Prevalence and Its Components in Adolescents from Western Mexico

by Diego Ortega-Pacheco, Roberto Carlos Rosales-Gómez, Teresa Arcelia García-Cobián, Lidia Ariadna Rubio-Chávez, Angélica Adriana Gutiérrez-Rubio, José Hugo Rivera-Ramírez and Susan Andrea Gutiérrez-Rubio

Pediatr. Rep. 2025, 17(4), 83; https://doi.org/10.3390/pediatric17040083 - 8 Aug 2025

Abstract

Objective: To evaluate the predictive risk factors associated with the prevalence of metabolic syndrome (MetS) in adolescents from the western region of Mexico. Materials and Methods: An analytical cross-sectional study was conducted with a sample of 516 adolescents. Anthropometric data, blood pressure, and [...] Read more.

Objective: To evaluate the predictive risk factors associated with the prevalence of metabolic syndrome (MetS) in adolescents from the western region of Mexico. Materials and Methods: An analytical cross-sectional study was conducted with a sample of 516 adolescents. Anthropometric data, blood pressure, and biochemical determinations were obtained. The diagnosis of MetS was based on the criteria proposed by de Ferranti in 2004. The triglyceride–glucose index (TyG index) was calculated, where a value >4.68 indicates insulin resistance (IR). Risk factors associated with MetS were evaluated using a logistic regression model. The statistical analysis was performed with the level of statistical significance established was p < 0.05. Results: The MetS prevalence was 17.2% among adolescents. One out of every two adolescents with obesity presented with MetS. Abdominal obesity and dyslipidemia are the most common components. Predictors of MetS included male sex, early adolescence, waist-to-height ratio (WHtR) > 0.5, increased body fat percentage, and TyG Index > 4.68 (IR). In the sex-specific analysis, a WHtR > 0.5 and IR were associated with MetS in female adolescents. In male adolescents, IR and body fat percentage were associated with MetS. The WHtR was associated with IR, and hypertriglyceridemia was associated with elevated alanine aminotransferase. Conclusions: In this study, two out of ten adolescents presented with MetS. In boys, a high prevalence of abdominal obesity, hypoalphalipoproteinemia, insulin resistance and MetS was observed. The risk of developing MetS is greater in preadolescent boys with abdominal obesity, high levels of body fat, and a TyG index > 4.68. Full article

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8 pages, 1321 KiB

Open AccessCase Report

Open Reduction and Internal Fixation of a Volar Displaced Salter–Harris III Mallet Fracture in a Pediatric Patient: A Case Report

by Alexander Baur, Taylor Anthony, Keith Lustig and Michael L. Lee

Pediatr. Rep. 2025, 17(4), 82; https://doi.org/10.3390/pediatric17040082 - 6 Aug 2025

Abstract

Introduction: Finger injuries are common in pediatric patients and typically heal well with conservative management. However, rare fracture patterns involving significant displacement and physeal injury, such as the one described in this case, require specialized surgical intervention to ensure proper healing and prevent [...] Read more.

Introduction: Finger injuries are common in pediatric patients and typically heal well with conservative management. However, rare fracture patterns involving significant displacement and physeal injury, such as the one described in this case, require specialized surgical intervention to ensure proper healing and prevent long-term complications. Case Presentation: A 12-year-old left-hand-dominant female presented with pain, swelling, and deformity at the distal interphalangeal (DIP) joint following hyperextension of the left fifth digit. Initial radiographs revealed a volar displaced intra-articular fracture with physis involvement, confirmed by computed tomography (CT) imaging. Conservative management with closed reduction and splinting failed to achieve adequate alignment. Surgical intervention was performed via a dorsal approach, utilizing ORIF with K-wire fixation to restore joint congruity and ensure anatomic alignment. Outcomes: Postoperative follow-up demonstrated satisfactory healing, maintained reduction, and resolution of pain with no complications. The patient regained functional use of the digit with minimal stiffness, and the growth plate remained uninvolved during the recovery period. Discussion: This case underscores the importance of advanced imaging, early referral, and tailored surgical intervention for rare mallet fractures involving volar displacement and physeal injury. ORIF provided reliable stabilization and optimal outcomes in this complex case. Conclusions: Volar displaced Salter–Harris III fractures of the DIP joint are rare and challenging injuries in pediatric patients. This case highlights the role of ORIF in achieving successful outcomes and emphasizes the importance of precise reduction and stabilization to prevent long-term complications. Full article

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14 pages, 619 KiB

Open AccessArticle

Validation of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)-Related Pediatric Treatment Evaluation Checklist (PTEC)

by Andrey Vyshedskiy, Anna Conkey, Kelly DeWeese, Frank Benno Junghanns, James B. Adams and Richard E. Frye

Pediatr. Rep. 2025, 17(4), 81; https://doi.org/10.3390/pediatric17040081 - 28 Jul 2025

Abstract

Background/Objectives: The objective of this study was to validate a new parent-reported scale for tracking Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by a sudden and severe onset of neuropsychiatric symptoms. To meet diagnostic criteria, an individual must present with [...] Read more.

Background/Objectives: The objective of this study was to validate a new parent-reported scale for tracking Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by a sudden and severe onset of neuropsychiatric symptoms. To meet diagnostic criteria, an individual must present with either obsessive–compulsive disorder (OCD) or severely restricted food intake, accompanied by at least two additional cognitive, behavioral, or emotional symptoms. These may include anxiety, emotional instability, depression, irritability, aggression, oppositional behaviors, developmental or behavioral regression, a decline in academic skills such as handwriting or math, sensory abnormalities, frequent urination, and enuresis. The onset of symptoms is usually triggered by an infection or an abnormal immune/inflammatory response. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a subtype of PANS specifically linked to strep infections. Methods: We developed a 101-item PANS/PANDAS and Related Inflammatory Brain Disorders Treatment Evaluation Checklist (PTEC) designed to assess changes to a patient’s symptoms over time along 10 subscales: Behavior/Mood, OCD, Anxiety, Food intake, Tics, Cognitive/Developmental, Sensory, Other, Sleep, and Health. The psychometric quality of PTEC was tested with 225 participants. Results: The internal reliability of the PTEC was excellent (Cronbach’s alpha = 0.96). PTEC exhibited adequate test–retest reliability (r = 0.6) and excellent construct validity, supported by a strong correlation with the Health subscale of the Autism Treatment Evaluation Checklist (r = 0.8). Conclusions: We hope that PTEC will assist parents and clinicians in the monitoring and treatment of PANS. The PTEC questionnaire is freely available at neuroimmune.org/PTEC. Full article

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9 pages, 1860 KiB

Open AccessCase Report

Eosinophilic Esophagitis in a 3-Year-Old Girl with Spinal Muscular Atrophy Type 1: The First Reported Case

by Aleksandra Marzec, Elżbieta Jarocka-Cyrta and Marta Ruskań-Bakun

Pediatr. Rep. 2025, 17(4), 80; https://doi.org/10.3390/pediatric17040080 - 28 Jul 2025

Abstract

Background: Spinal muscular atrophy type 1 (SMA1) is a severe neuromuscular disorder characterized by progressive muscle weakness and atrophy, including the muscles of the oral cavity and esophagus. Eosinophilic esophagitis (EoE), a chronic, allergic disease, presents with eosinophilic infiltration of the esophagus, leading [...] Read more.

Background: Spinal muscular atrophy type 1 (SMA1) is a severe neuromuscular disorder characterized by progressive muscle weakness and atrophy, including the muscles of the oral cavity and esophagus. Eosinophilic esophagitis (EoE), a chronic, allergic disease, presents with eosinophilic infiltration of the esophagus, leading to esophageal dysmotility. Feeding difficulties may occur in both conditions. So far, the coexistence of EoE and SMA1 has not been described; we present the first such case. Case presentation: The patient was a girl with SMA1 diagnosed shortly after birth, treated with nusinersen and onasemnogene abeparvovec, and fed a standard industrial diet through a gastrostomy. In her second year of life, she developed increasing symptoms: distress during feeding, regurgitation, vomiting, and weight loss. She was treated with proton pump inhibitors without clinical improvement. Gastroscopy was performed, revealing superficial epithelial damage with bleeding in the proximal esophagus. Histopathology showed chronic inflammation with up to 150 eosinophils per high-power field, microabscesses, spongiosis, and basal layer hypertrophy. The girl was diagnosed with EoE. Her diet was switched from a standard industrial formula to an amino acid-based formula, which led to marked clinical improvement, the resolution of symptoms, and appropriate weight gain. Conclusions: This case report highlights the challenges of diagnosing EoE in SMA1 patients and emphasizes the need for multidisciplinary approaches and further investigation of allergic manifestations in SMA1 patients. Full article

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18 pages, 419 KiB

Open AccessSystematic Review

The Relationship with Meeting Physical Activity Guidelines in Preschool-Aged Children: A Systematic Review

by Markel Rico-González, Ursula Småland Goth, Ricardo Martín-Moya and Luca Paolo Ardigò

Pediatr. Rep. 2025, 17(4), 79; https://doi.org/10.3390/pediatric17040079 - 22 Jul 2025

Abstract

Background/Objectives: Physical activity (PA) during preschool is vital for supporting physiological development, enhancing cognitive abilities and fostering socio-emotional growth. However, consistent disparities in meeting PA guidelines have been observed. This systematic review aims to identify studies that compared preschoolers’ PA, as measured [...] Read more.

Background/Objectives: Physical activity (PA) during preschool is vital for supporting physiological development, enhancing cognitive abilities and fostering socio-emotional growth. However, consistent disparities in meeting PA guidelines have been observed. This systematic review aims to identify studies that compared preschoolers’ PA, as measured by technological devices, with recommended PA guidelines. Specifically, it examines (i) factors associated with meeting PA guidelines and (ii) the outcomes observed when children meet these guidelines. Methods: The search strategy was designed based on the PICOS framework. Then, a systematic review was conducted using four databases to identify studies that included children from 0 to 6 years old participating in PA sessions recorded through technological devices. PA is compared with guidelines, and correlations were reported. Results: Of the 52 studies reviewed, most found that meeting PA guidelines in preschool-aged children was linked to favourable outcomes across multiple domains. Children who met the guidelines tended to show better motor competence, emotional regulation and cognitive skills, particularly in areas like working memory and social understanding. However, the relationship with body composition and body mass index was inconsistent, suggesting that the benefits of PA in early childhood extend beyond weight-related measures. Conclusions: Meeting PA guidelines in early childhood is strongly associated with cognitive development, emotional regulation, motor skills and social behaviours. However, adherence varies significantly due to a complex mix of individual, familial, socioeconomic and environmental factors. Full article

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14 pages, 868 KiB

Open AccessArticle

Pilot Study on the Evaluation of the Diet of a Mexican Population of Adolescents

by Karen Rubí Escamilla-Gutiérrez, Alejandra López-García, Nelly del Socorro Cruz-Cansino, José Alberto Ariza-Ortega, Eli Mireya Sandoval-Gallegos, Esther Ramírez-Moreno and José Arias-Rico

Pediatr. Rep. 2025, 17(4), 78; https://doi.org/10.3390/pediatric17040078 - 22 Jul 2025

Abstract

Background: Adolescence is characterized by physical and psychosocial changes. This implies modifying or implementing correct nutritional habits at an early age, which would have an impact on a healthy adult life. Objectives: The FFQ of dietary patterns has not been estimated in the [...] Read more.

Background: Adolescence is characterized by physical and psychosocial changes. This implies modifying or implementing correct nutritional habits at an early age, which would have an impact on a healthy adult life. Objectives: The FFQ of dietary patterns has not been estimated in the population of adolescents. Therefore, conducting a pilot, cross-sectional, comparative, and correlational study, we sought to identify frequently consumed foods in an adolescent population. Methods: As part of the methodology, a Food Frequency Questionnaire (FFQ) was given to a non-probability convenience sample of 178 subjects aged 14 to 19 years to evaluate the most frequently consumed foods. Results: This study showed that the diet of Mexican adolescents was characterized with little variability in the foods consumed: 28.20% of the population had a good consumption of milk (1 to 5 serving/day), 16.50% of sugars, and 16% of cereals, while only less than 15% had a good consumption of source animal foods, fruits and vegetables, oils, and fat. Conclusions: Mexican adolescents have demonstrated that their diet is poorly varied. Adolescence is an important period in life that can define habitual dietary intake, and therefore, it is crucial to promote healthy eating at this age. Further research and appropriate public policies are needed. Full article

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Graphical abstract

11 pages, 402 KiB

Open AccessArticle

Antibiotic Effect on Clinical Response and Remission in Pediatric Inflammatory Bowel Disease

by Caeley Dye, Caroline M. Sierra, Khaled Bahjri, Mallory Cohen and Gautam Nagendra

Pediatr. Rep. 2025, 17(4), 77; https://doi.org/10.3390/pediatric17040077 - 21 Jul 2025

Abstract

Objective: Gut dysbiosis has been implicated in the pathology of inflammatory bowel disease (IBD). There is some evidence to suggest that the use of antibiotic treatment can incite an early clinical response or remission when used in conjunction with standard-of-care (SOC) therapy [...] Read more.

Objective: Gut dysbiosis has been implicated in the pathology of inflammatory bowel disease (IBD). There is some evidence to suggest that the use of antibiotic treatment can incite an early clinical response or remission when used in conjunction with standard-of-care (SOC) therapy to treat IBD-related flares. Furthermore, antibiotics have been historically investigated for use as a bridge when initiating biologic therapy while waiting for peak biologic treatment effect to occur. This study investigated and compared the time to clinical response when treated with combination antibiotics, metronidazole monotherapy, or SOC therapy in pediatric patients with an active IBD flare. Methods: This study was a retrospective, Institution Review Board-approved, single-centered cohort study which included patients who were less than 18 years of age with a confirmed diagnosis of IBD who received conventional treatment alone or with either combination antibiotic therapy or metronidazole monotherapy to treat an active IBD flare between March 2013 and January 2024. Patients were excluded if they received antibiotic therapy to treat an active infection, had positive stool cultures or enteric pathogen polymerase chain reaction panel, or had colonic disease limited to the rectum. Results: Fifty-nine patients were included and divided into metronidazole monotherapy (n = 18), SOC therapy (n = 20), and combination antibiotics (n = 21). The primary outcome of days to clinical response was not significantly different across all groups; however, patients who received combination antibiotics achieved the fastest time to clinical response (median (IRQ))—4 days (1, 65), compared to 7.5 days (1, 119) for the SOC group and 9 days (2, 217) for the metronidazole group. Secondary outcomes of achievement of clinical response, remission, or failure were determined to be non-significant between all groups. Conclusions: There is no significant difference in time to clinical response, attaining clinical response or remission, or treatment failure rate for patients treated with combination antibiotics, metronidazole monotherapy, or SOC. However, results of this study suggest that the use of combination antibiotics plus SOC may lead to a faster time to clinical response and remission compared to SOC therapy alone. Further studies are warranted to elucidate the role of antimicrobial therapy in management of pediatric IBD. Full article

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18 pages, 831 KiB

Open AccessArticle

From Early Stress to Adolescent Struggles: How Maternal Parenting Stress Shapes the Trajectories of Internalizing, Externalizing, and ADHD Symptoms

by Katerina Koutra, Chrysi Mouatsou, Katerina Margetaki, Georgios Mavroeides, Mariza Kampouri and Lida Chatzi

Pediatr. Rep. 2025, 17(4), 76; https://doi.org/10.3390/pediatric17040076 - 18 Jul 2025

Abstract

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, [...] Read more.

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development. Full article

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

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10 pages, 787 KiB

Open AccessReview

Cannabinoid Hyperemesis Syndrome in Adolescents: A Narrative Review

by Camilla Pietrantoni, Gaia Margiotta, Giuseppe Marano, Marianna Mazza, Francesco Proli, Giuseppe Stella, Alessia Cherubino, Francesca Viozzi, Fabiana Rita Guida, Claudia Rendeli, Roberto Pola, Eleonora Gaetani and Valentina Giorgio

Pediatr. Rep. 2025, 17(4), 75; https://doi.org/10.3390/pediatric17040075 - 14 Jul 2025

Abstract

Cannabinoid hyperemesis syndrome (CHS) is characterized by a pattern of cyclic vomiting and abdominal pain despite an absence of an organic cause, occurring in regular cannabis users. This syndrome was first described in 2004. Initially considered rare, with the increased use and legalization [...] Read more.

Cannabinoid hyperemesis syndrome (CHS) is characterized by a pattern of cyclic vomiting and abdominal pain despite an absence of an organic cause, occurring in regular cannabis users. This syndrome was first described in 2004. Initially considered rare, with the increased use and legalization of cannabis, a growing incidence of diagnoses has been observed. Data on the pediatric population are still scant despite the high rate of cannabis consumption in young people. In this narrative review, we aim to synthesize the growing knowledge about CHS and its epidemiology, pathophysiology, diagnosis, and management in the pediatric population. Findings in this review highlight the diagnostic challenges in pediatric patients, the limited efficacy of standard anti-emetic therapies, and the central role of cannabis cessation in treatment. This review underscores the need for increased awareness of CHS in pediatric practice to ensure timely diagnosis and avoid unnecessary investigations and interventions. Full article

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14 pages, 697 KiB

Open AccessArticle

Disparities in Treatment Outcomes for Cannabis Use Disorder Among Adolescents

by Helena Miranda, Jhon Ostanin, Simon Shugar, Maria Carmenza Mejia, Lea Sacca, Mitchell L. Doucette, Charles H. Hennekens and Panagiota Kitsantas

Pediatr. Rep. 2025, 17(4), 74; https://doi.org/10.3390/pediatric17040074 - 10 Jul 2025

Abstract

Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12–17 years old) in the United States. Methods: Data from the 2018–2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic [...] Read more.

Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12–17 years old) in the United States. Methods: Data from the 2018–2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic regression assessed treatment outcomes and factors associated with treatment completion. Results: Only 36.8% of adolescents completed treatment. The most common reasons for not completing treatment were dropping out (28.4%) and transferring to another facility/program (17.0%). Males and Black non-Hispanic adolescents had lower odds of completing treatment (OR = 0.79, 95%CI: 0.75–0.84), while Hispanic (OR = 1.13, 95%CI: 1.08–1.18), Asian (OR = 1.56, 95%CI: 1.3–1.86) and Native Hawaiian/Pacific Islander adolescents (OR = 2.31, 95%CI: 2.04–2.61) had higher odds of completion compared to their White counterparts. Independent living arrangements, homelessness, arrests in the past 30 days and younger age (<15 years old) decreased the likelihood of treatment completion. Adolescents with co-occurring mental health and substance use disorders also had lower completion rates (OR = 0.79, 95%CI: 0.77–0.86). Referral from schools/employers and treatment settings were associated with a higher success, particularly with stays of 4–6 months and 7–12 months. Conclusion: This study highlights the need for targeted CUD treatment programs that support at-risk adolescents, especially those experiencing homelessness or facing legal issues. High dropout and transition rates suggest a need for continuity of care and program integration between facilities. Strengthening coordination among public health officials, community organizations, and stakeholders is essential to developing culturally responsive treatment interventions that address social determinants of health, substance use, and mental health in this vulnerable population. Full article

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16 pages, 660 KiB

Open AccessCase Report

The Co-Occurrence of Autism Spectrum Disorder and Aarskog–Scott Syndrome in an Accomplished Young Man

by Raisa S. Romanova, Oksana I. Talantseva, Katerina V. Lind, Victoria A. Manasevich, Julia E. Kuznetsova and Elena L. Grigorenko

Pediatr. Rep. 2025, 17(4), 73; https://doi.org/10.3390/pediatric17040073 - 8 Jul 2025

Abstract

Objectives/Background: Aarskog–Scott syndrome (AAS), also known as faciogenital dysplasia, is a rare X-linked genetic disorder primarily characterized by its diverse physical manifestations. Previous evidence suggests a potential association between AAS and neurodevelopmental disorders, including autism spectrum disorder (ASD). Methods: This case study presents [...] Read more.

Objectives/Background: Aarskog–Scott syndrome (AAS), also known as faciogenital dysplasia, is a rare X-linked genetic disorder primarily characterized by its diverse physical manifestations. Previous evidence suggests a potential association between AAS and neurodevelopmental disorders, including autism spectrum disorder (ASD). Methods: This case study presents a male adolescent with ASD and a novel genetic variant in FGD1 underlying AAS. We conducted comprehensive clinical, genetic, and behavioral assessments to characterize the neurodevelopmental presentation. Moreover, we examined the existing literature on AAS and comorbid neurodevelopmental disorders. Results: The patient demonstrated features consistent with both AAS and ASD, presenting with characteristic physical features of AAS and meeting diagnostic criteria for ASD on both ADI-R and ADOS-2. Cognitive assessment revealed above-average nonverbal IQ (Leiter-3, NVIQ = 115), while adaptive functioning was notably impaired (Vineland composite score = 65). Executive function deficits were identified through several assessments, though ADHD diagnostic criteria were not met. The literature review considered 64 studies, including 151 individuals with AAS. ASD was observed in 4.0%, Attention Deficit/Hyperactivity Disorder (ADHD) in 10.6%, and Intellectual Disability (ID) in 14.2% of cases. Conclusions: The combination of ASD with preserved nonverbal intelligence but impaired adaptive functioning in this AAS case demonstrates the complex neurodevelopmental manifestations possible in this rare genetic condition. The prevalence of neurodevelopmental disorders among people with AAS may be higher than their prevalence in the general population. However, a comprehensive assessment of developmental progress was rarely performed in previous studies, which may lead to systematic underestimation of co-occurring neurodevelopmental difficulties in AAS. Full article

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15 pages, 430 KiB

Open AccessArticle

Child and Adolescent Suicide in the Broader Area of Athens, Greece: A 13-Year Retrospective Forensic Case-Series Analysis

by Kallirroi Fragkou, Maria Alexandri, Konstantinos Dimitriou, Athina Tatsioni, Flora Bacopoulou, Panagiotis Ferentinos, Laurent Martrille and Stavroula Papadodima

Pediatr. Rep. 2025, 17(4), 72; https://doi.org/10.3390/pediatric17040072 - 1 Jul 2025

Abstract

Purpose: Suicide is a leading cause of death among children and adolescents worldwide. This study examined the prevalence and characteristics of suicides among children and adolescents (aged ≤ 19 years) over a 13-year period in the broader area of Athens, Greece. Key aspects [...] Read more.

Purpose: Suicide is a leading cause of death among children and adolescents worldwide. This study examined the prevalence and characteristics of suicides among children and adolescents (aged ≤ 19 years) over a 13-year period in the broader area of Athens, Greece. Key aspects analyzed included victim demographics, circumstances surrounding the incidents, and methods employed. Methods: A retrospective analysis was conducted on autopsy cases performed at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, from 1 January 2011, to 31 December 2023. Results: Out of 5819 autopsies conducted between 2011 and 2023, 371 were classified as suicides. Among these, 12 cases (representing 3.2% of suicides) involved children and adolescents aged ≤ 19 years and met the study’s inclusion criteria for detailed forensic analysis. The average age of the victims was 17.7 ± 2.1 years (range: 14–19), with males representing 58.3% of cases. Hanging was the most common method of suicide (9 cases, 75.0%), followed by firearm use, falls from height, and hydrogen sulfide inhalation (one case each). Death occurred in the home in 10 cases (83.3%), with 6 specifically taking place in the bedroom. Scars indicative of prior self-harming behavior were present in two cases (16.7%), while suicide notes were found in three cases (25.0%). Toxicological analysis revealed alcohol and cannabis use in one case, cannabis alone in one case, and alcohol alone in two cases. Four victims (33.3%) had a documented psychiatric diagnosis, with two of them under antidepressant treatment at the time of death. Conclusions: This study highlights the forensic value of autopsy-based investigations in unveiling hidden patterns of adolescent suicidality and informs targeted prevention strategies. Integrating medico-legal findings into public health responses may enhance early identification and intervention in vulnerable youth populations. Full article

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

22 pages, 649 KiB

Open AccessSystematic Review

Efficacy and Safety of Adenotonsillectomy for Pediatric Obstructive Sleep Apnea Across Various Age Groups: A Systematic Review

by Mohammed Halawani, Arwa Alsharif, Omar Ibrahim Alanazi, Baraa Awad, Abdulaziz Alsharif, Hawazen Alahmadi, Rayan Alqarni, Rahaf Mohammed Alhindi, Abdulmohsen H. Alanazi and Abdulmajeed Hassan Alshamrani

Pediatr. Rep. 2025, 17(4), 71; https://doi.org/10.3390/pediatric17040071 - 25 Jun 2025

Abstract

Objectives: To assess the safety and efficacy of adenotonsillectomy (AT) for treating uncomplicated pediatric obstructive sleep apnea (OSA) in children of different ages. Methods: A systematic search was conducted in four electronic databases, and 71 studies with a total of 9087 [...] Read more.

Objectives: To assess the safety and efficacy of adenotonsillectomy (AT) for treating uncomplicated pediatric obstructive sleep apnea (OSA) in children of different ages. Methods: A systematic search was conducted in four electronic databases, and 71 studies with a total of 9087 participants were included in the analysis. The studies were all before-and-after studies, cohort studies, and randomized controlled trials. Surgical results were analyzed according to age, disease severity, and follow-up duration. Results: Children younger than 7 years at the time of AT had a significantly greater decrease in disease severity, a greater decrease in hypoxemic burden, improved sleep quality, and improved cardiovascular function than children older than 7 years. Both cognitive and behavioral performance improved postoperatively, although these changes were more significantly associated with the duration of follow-up than with age at surgery. Notably, the rate of surgical complications was much greater in children under the age of 3. Conclusions: The current evidence indicates that AT is performed optimally between the ages of 3 and 7 years, offering the greatest chance of disease resolution and remission of associated conditions, balanced with a reduction in surgical risk. We highly recommend conducting high-quality randomized controlled trials to further inform the clinical guidelines for pediatric AT. Full article

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9 pages, 806 KiB

Open AccessArticle

Investigating the Accuracy of Ultrasound Imaging in Measuring Fetal Weight in Comparison with the Actual Postpartum Weight

by Sultan Abdulwadoud Alshoabi, Abdulhadi M. Tarshun, Ziyad O. Alnoman, Fahad H. Aljohani, Fadwa M. Alahmadi, Awatif M. Omer, Osamah M. Abdulaal, Awadia Gareeballah, Abdulaziz A. Qurashi, Fahad H. Alhazmi, Kamal D. Alsultan and Moawia Gameraddin

Pediatr. Rep. 2025, 17(4), 70; https://doi.org/10.3390/pediatric17040070 - 24 Jun 2025

Abstract

Background: Antenatal ultrasonography measurements of the estimated fetal weight (EFW) are a critical point in the decision-making process of obstetric planning and management to preserve the safety of both the newborn and the mother. This study aims to investigate the accuracy of ultrasonography [...] Read more.

Background: Antenatal ultrasonography measurements of the estimated fetal weight (EFW) are a critical point in the decision-making process of obstetric planning and management to preserve the safety of both the newborn and the mother. This study aims to investigate the accuracy of ultrasonography to measure the EFW in comparison with the actual birth weight (BW) measured immediately after delivery. Methods: In this retrospective study, electronic records of 270 newborns who fulfilled the inclusion criteria were retrieved. A structured data sheet was used to collect the EFW, calculated by the Hadlock A formula using real-time ultrasound imaging on the day of delivery or the day before, and the actual BW immediately after delivery. Results: Out of 270 fetuses, 53.7% (145) were female, and 46.3% (125) were male. The mean BW was 2918.1 ± 652.81 g (range: 880 to 5100). The mean EFW was 3271.55 ± 691.47 g (range: 951 to 4942). The mean gestational age was 38 ± 2.48 weeks (range: 29 to 42). Spearman’s rho correlation test revealed strong compatibility between EFW and BW (r = 0.82, p < 0.001). Linear regression analysis showed a strong correlation between EFW and BW (R = 0.875, R² = 0.766, and p < 0.001). The cross-tabulation test showed 86.8%, 78.4%, and 26.9% compatibility between measurements of EFW and the true BW in group-1 (<2500 g), group-2 (2500–4000 g), and group-3 (>4000 g) fetuses (p< 0.001). Conclusions: EFW using ultrasonography yields high compatibility with the actual BW. Despite the slight overestimation, ultrasonography provides high clinical value in obstetric assessment and subsequent management. Full article

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16 pages, 477 KiB

Open AccessArticle

Pubertal Timing and Health-Related Quality of Life—A Cross-Sectional Study of Polish Adolescents

by Zbigniew Izdebski, Alicja Kozakiewicz, Katarzyna Porwit, Michalina Aleksandra Gryglewska and Joanna Mazur

Pediatr. Rep. 2025, 17(3), 69; https://doi.org/10.3390/pediatric17030069 - 18 Jun 2025

Abstract

Background/Objectives: In research on the relationship between pubertal timing and adolescent health, more attention is typically given to early rather than late maturation, as well as the associated risk of engaging in health-compromising behaviors. The aim of this study was to assess changes [...] Read more.

Background/Objectives: In research on the relationship between pubertal timing and adolescent health, more attention is typically given to early rather than late maturation, as well as the associated risk of engaging in health-compromising behaviors. The aim of this study was to assess changes in HRQL (health-related quality of life) depending on subjectively perceived pubertal timing, measured in five categories. Methods: A cross-sectional online survey was conducted in spring 2024 in a western region of Poland (N = 9411; mean age 15.15 ± 1.56 years). Mean KIDSCREEN-27 index scores were compared according to self-reported pubertal timing, and five relevant general linear models were estimated, adjusting analyses for respondents’ age, sex, and the remaining four HRQL scores. Results: In the study group, 49.0% of students assessed their pubertal timing as typical, 28.5% as earlier, and 22.5% as later compared to peers of the same sex. For all five KIDSCREEN-27 dimensions, adolescents who matured at a pace perceived as typical achieved the highest quality-of-life index scores. Significantly earlier or significantly later pubertal timing was associated with a notable decrease in these indices. Some significant interactions were identified between sex or age and pubertal timing as predictors of HRQL. The strongest association with pubertal timing was observed for the Psychological Well-being dimension, where differences unfavorable to older age groups were additionally linked to delayed pubertal timing. Conclusions: Greater awareness of the relationship between perceived pubertal timing and adolescents’ well-being is warranted among preventive care physicians, parents, and school psychologists and educators. Full article

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14 pages, 234 KiB

Open AccessArticle

Risk and Protective Factors Associated with Increased Burden in Caring for Children: An Observational Study of Japanese General Households

by Tomo Nonoyama

Pediatr. Rep. 2025, 17(3), 68; https://doi.org/10.3390/pediatric17030068 - 18 Jun 2025

Abstract

Background/Objectives: Increased burdens on caregivers of infants and toddlers significantly affect caregivers’ quality of life and health. Although adequate care during infancy contributes to child development and special health care needs affect caregiver burden, the risk factors for and protective factors against increased [...] Read more.

Background/Objectives: Increased burdens on caregivers of infants and toddlers significantly affect caregivers’ quality of life and health. Although adequate care during infancy contributes to child development and special health care needs affect caregiver burden, the risk factors for and protective factors against increased caregiver burden remain unclear. We aimed to evaluate children’s health care needs and required caregiving time and identify factors associated with increased caregiver burden. Methods: We conducted an online survey of 287 Japanese caregivers who were randomly selected from a web panel and were raising children aged <4 years. The survey comprised a sociodemographic data form, Children with Special Health Care Needs (CSHCN) Screener, caregiving time survey form, and questions on increased burden. Needs and caregiving time were evaluated by dividing the participants into CSHCN and non-CSHCN groups. Related factors were analyzed using increased burden as the dependent variable. The chi-square test, Mann–Whitney U test, and modified Poisson regression were used for data analysis. Results: Among the children of the 287 participating caregivers, 16.4% were identified as CSHCN, while 96.9% had no specific diagnosis. Overall, 38.3% of the CSHCN group met only one of the five CSHCN Screener items. The CSHCN group spent significantly more time providing and arranging/coordinating health care. The non-CSHCN group spent significantly more time providing daily care. After adjusting for covariates, increased caregiver burden was significantly associated with a younger age of the child, more caregiving time required 6 months prior to the survey, and providing care for CSHCN. Conclusions: To help reduce the burden of childcare on caregivers of infants and young children, children’s needs should be identified and generous childcare provided from an early age. Early identification of CSHCN and appropriate support for families may help reduce caregiver burden during early childhood. Full article

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28 pages, 592 KiB

Open AccessSystematic Review

Impact of Maternal Microbiota Composition on Neonatal Immunity and Early Childhood Allergies: A Systematic Review

by Ayah Nabil Al Jehani, Manal Shuaib, Arwa Alsharif, Khlood Abdulaziz Alsubaie, Ayda Khraisat, Abdulaziz Alsharif, Manaf Altaf, Ruba H. Almasry, Amal Mohamed Kayali and Shouq Abdin Abdallah

Pediatr. Rep. 2025, 17(3), 67; https://doi.org/10.3390/pediatric17030067 - 17 Jun 2025

Abstract

Background: The maternal microbiota serve as a key regulator of neonatal immune development and early-life health outcomes. This systematic review aims to find out how the makeup of the maternal microbiota affects newborn immunity and the risk of allergies, identify which microbes [...] Read more.

Background: The maternal microbiota serve as a key regulator of neonatal immune development and early-life health outcomes. This systematic review aims to find out how the makeup of the maternal microbiota affects newborn immunity and the risk of allergies, identify which microbes are linked to a higher or lower chance of allergies, and assess treatments that could improve newborn immune health. Methods: We conducted a systematic search in PubMed, MEDLINE, and Web of Science, adhering to the PRISMA guidelines. We included randomized controlled trials (RCTs), cohort studies, and observational studies that looked at how the makeup of the maternal microbiota affects newborn immune responses or allergic outcomes in early life. We conducted a systematic search, and the quality of the studies was evaluated using the GRADE system and tools to check for bias (RoB 2, Newcastle–Ottawa Scale, MINORS). Results: We included a total of 74 studies. The main findings showed that having a cesarean delivery and using certain antibiotics during pregnancy increased the risk of allergies, while breastfeeding, taking probiotics, and changing the mother’s diet helped to protect against allergies. Maternal stress had a negative association with the microbiota composition (OR = 1.9–2.4) and neonatal immune regulation. Moreover, the study noted significant geographic variation in the microbiota’s influence, underscoring the importance of contextualized interventions. Conclusions: The composition of the maternal microbiota has a major impact on neonatal immunity and the risk of early-life allergy. Adverse factors include cesarean birth, antibiotic exposure, and maternal stress, all of which have been associated with alterations in neonatal immunity. More studies are required to validate promising microbiota-targeted strategies and develop evidence-based guidelines to improve maternal and neonatal immune health. Full article

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