Pediatric Reports最新文献

{"title":"Effects of White Noise on Academic Skills in Children with ADHD and Specific Learning Disorders: New Perspectives for Personalised Rehabilitation and Educational Intervention.","authors":"Elena Cavalieri, Emilia Cascio, Giada Iannone, Loredana Angelini, Giovanni Battista Dell'Isola, Claudio Maura, Raimondo Stefano Maria Torcisi, Elisa Macchione, Simona Lucibello, Alberto Verrotti, Federico Vigevano","doi":"10.3390/pediatric18030081","DOIUrl":"10.3390/pediatric18030081","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study examined whether exposure to white noise improves reading and writing performance in children with Specific Learning Disorder (SLD), with and without comorbid Attention-Deficit/Hyperactivity Disorder (ADHD).</p><p><strong>Methods: </strong>Thirty children aged 8-13 years (mean age = 9.4) with SLD, 12 of whom also had ADHD, were recruited from the Centro di Riabilitazione San Raffaele Pisana (Rome). Each child completed two standardized reading and writing assessments, four weeks apart, under two auditory conditions (with vs. without white noise) in randomized order. The primary outcomes were reading speed and accuracy, while the secondary outcome was writing accuracy.</p><p><strong>Results: </strong>Among the 26 completers, white noise significantly improved nonword reading speed and accuracy, showed a trend toward improved passage-reading accuracy, and reduced accuracy in nonword writing. Benefits were different in children with SLD + ADHD compared to those with SLD only.</p><p><strong>Conclusions: </strong>These findings indicate task-specific effects of white noise and suggest potential applications for targeted educational interventions.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blended and Technology-Enhanced Education in Pediatric Emergency Nursing: A Systematic Review.","authors":"Rita Nocerino, Giorgia Cerase, Emma Montella, Albina Simeoli","doi":"10.3390/pediatric18030080","DOIUrl":"10.3390/pediatric18030080","url":null,"abstract":"<p><strong>Background: </strong>Pediatric emergencies are high-risk clinical situations requiring timely, accurate, and coordinated interventions. Nurses play a pivotal role in early recognition and management of acute pediatric conditions; however, the rarity and complexity of these events often limit clinical exposure and preparedness. Continuous professional education is therefore essential to ensure patient safety and high-quality care.</p><p><strong>Objective: </strong>This systematic review aimed to synthesize evidence on innovative continuing education strategies for nurses involved in pediatric emergency care, with a primary focus on studies evaluating educational effectiveness and a secondary contextual focus on studies describing training needs, perceived barriers, preparedness, and implementation conditions.</p><p><strong>Methods: </strong>The review was conducted according to PRISMA guidelines. The protocol was registered in PROSPERO (ID CRD420251120993). A comprehensive search of PubMed, CINAHL Complete, Scopus, and the Cochrane Library identified studies published between 2015 and August 2025. Primary intervention studies were used to assess educational effectiveness, whereas descriptive, observational, qualitative, and review-based evidence was retained as contextual evidence. Methodological quality was assessed using Joanna Briggs Institute (JBI) tools.</p><p><strong>Results: </strong>Forty-nine studies met the inclusion criteria, including randomized controlled trials, quasi-experimental studies, observational and cohort studies, and integrative or narrative reviews. Educational interventions mainly involved simulation-based training, blended learning, telesimulation, digital education, and structured training programs. Intervention studies suggested improvements in knowledge, technical skills, self-efficacy, and team performance, while contextual studies highlighted training needs, perceived barriers, preparedness, and implementation challenges. However, the evidence was limited by methodological heterogeneity, frequent reliance on self-reported outcomes, and limited long-term follow-up.</p><p><strong>Conclusions: </strong>Simulation-based, blended, and telesimulation-based educational strategies may be associated with short-term improvements in nurses' preparedness and educational outcomes in pediatric emergency care. However, conclusions regarding effectiveness should be interpreted cautiously because of methodological heterogeneity, reliance on subjective outcomes, and limited evidence on long-term clinical and patient-safety outcomes.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Century of Post-Traumatic Appendicitis: A Comprehensive Review with an Illustrative Case.","authors":"Mattia Pasquinucci, Irene Marangoni, Veronica Battistella, Maria E Pinto, Alessandra Pasinato, Fabio S Chiarenza, Davide Meneghesso","doi":"10.3390/pediatric18030079","DOIUrl":"10.3390/pediatric18030079","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Acute appendicitis following blunt abdominal trauma is a rare and historically debated clinical entity. We present a century-spanning descriptive review of 106 cases of post-traumatic appendicitis, embedded with an illustrative pediatric case initially managed conservatively. <b>Methods:</b> A comprehensive literature review was conducted following PRISMA guidelines across PubMed/MEDLINE, Web of Science, and Google Scholar, encompassing a 100-year period (1925-2025). Clinical variables, trauma mechanisms, and outcomes were extracted and statistically analyzed by age cohort (Pediatric ≤ 18 vs. Adult > 18) and historical medical era. <b>Results:</b> A total of 106 cases were analyzed. High-energy trauma predominated in adults compared to the pediatric cohort (48.8% vs. 18.5%, <i>p</i> = 0.001). The overall complication rate was exceptionally high (66.0%), with no significant difference between pediatric and adult cohorts (61.5% vs. 73.2%, <i>p</i> = 0.293). An epoch-based analysis revealed a significant drop in perforation rates from the historical era (1925-1980) to the modern era (2001-2025) (51.7% to 27.0%, <i>p</i> = 0.033) due to improved diagnostic timelines. Crucially, purely mechanical injuries such as complete appendiceal auto-amputation remained a constant signature of blunt trauma across the century (11.5% overall rate). <b>Conclusions:</b> Our synthesis of historical cases suggests that post-traumatic appendicitis might be a relevant clinical entity where trauma mechanics appear to play a significant role in injury severity, irrespective of patient age. While conservative management could be feasible and safe in the acute setting of uncomplicated cases, we hypothesize that the initial kinetic impact might cause subtle structural changes or alter local appendiceal dynamics, potentially predisposing the organ to recurrent inflammation, warranting close follow-up or elective surgery.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Coordinated Adhesion-Molecule Activation Profile in Pediatric Sepsis: A Prospective Cohort Study from Vietnam.","authors":"Bui Thanh Liem, Chu Van Thien, Nguyen Trong Nghia, Le Anh Phong, Ngo Nhu Dinh, Nguyen Huy Luan, Phung Nguyen The Nguyen","doi":"10.3390/pediatric18030078","DOIUrl":"10.3390/pediatric18030078","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Pediatric sepsis is increasingly recognized as a syndrome involving immune-vascular dysregulation. However, most pediatric biomarker studies focus on individual molecules rather than coordinated patterns of leukocyte-endothelial activation. This study aimed to evaluate whether children diagnosed with sepsis within 48 h of admission showed a coordinated soluble adhesion-molecule activation profile measured at enrollment. <b>Methods:</b> This prospective cohort study included 144 children aged 1-60 months with suspected infection enrolled at Dong Nai Children's Hospital, Vietnam, from May 2021 to October 2022. Blood samples were collected at enrollment. Sepsis was classified according to the 2005 International Pediatric Sepsis Consensus Conference (IPSCC) criteria within 48 h of admission. Twelve soluble adhesion molecules were measured using a multiplex immunoassay. A composite adhesion activation score was derived by log2 transformation, z-score standardization, and averaging across the 12 markers. Principal component analysis (PCA) was used as an exploratory method to summarize the shared variation across the adhesion-molecule panel. C-reactive protein (CRP) was included as a routinely available inflammatory comparator. <b>Results:</b> Among 144 children, 32 (22.2%) were diagnosed with sepsis within 48 h of admission. Individual marker discrimination was strongest for L-selectin (area under the receiver operating characteristic curve [AUC] 0.883), followed by soluble vascular cell adhesion molecule-1 (sVCAM-1; AUC 0.855), intercellular adhesion molecule-3 (ICAM-3; AUC 0.838), P-selectin glycoprotein ligand-1 (PSGL-1; AUC 0.836), E-selectin (AUC 0.819), and intercellular adhesion molecule-2 (ICAM-2; AUC 0.819). CRP also differed between children with and without sepsis but had a lower AUC than the leading adhesion molecules in descriptive ROC analyses. The composite adhesion activation score was strongly associated with sepsis (odds ratio 7.95 per 1-standard deviation increase; 95% confidence interval 3.44-18.40; <i>p</i> < 0.001) and showed good discrimination (AUC 0.855; 95% confidence interval 0.776-0.931). The first principal component explained 70.0% of biomarker variance, consistent with coordinated elevation of correlated adhesion molecules. <b>Conclusions:</b> In this prospective Vietnamese pediatric cohort, children diagnosed with sepsis within 48 h of admission showed coordinated elevation of soluble adhesion molecules measured at enrollment. These findings support the biological relevance of leukocyte-endothelial activation in pediatric sepsis. However, the adhesion-molecule activation profile should be considered exploratory and hypothesis-generating, requiring external validation and further evaluation against simplified, clinically feasible biomarker approaches.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Umifenovir (Arbidol) in Children with Influenza-like Illnesses: A Systematic Review and Meta-Analysis.","authors":"Vilya Bulgakova, Artem Poromov, Irina Leneva, Natalia Pshenichnaya","doi":"10.3390/pediatric18030077","DOIUrl":"10.3390/pediatric18030077","url":null,"abstract":"<p><p><b>Background:</b> Pediatric influenza-like illness (ILI) represents a major global health burden. However, international treatment guidelines lack robust evidence specific to children. Umifenovir (Arbidol) is a broad-spectrum antiviral approved for pediatric use in several countries, but clinical data are fragmented and regionally limited. <b>Methods:</b> A comprehensive search of PubMed, Russian (RSCI, national archives, regulatory documents), and Chinese (CNKI) databases was conducted for pediatric randomized controlled trials (RCTs) and non-randomized trials comparing umifenovir to symptomatic therapy (ST) or oseltamivir. Risk of bias was assessed using the RoB 2 tool for RCTs, and ROBINS-I for non-RCTs. Outcomes included the duration of fever and other symptoms, prophylactic efficacy, and adverse events. Random-effects models were used (Hartung-Knapp-Sidik-Jonkman approach). The review was not registered. <b>Results:</b> We included 16 therapeutic and eight prophylactic trials enrolling approximately 4700 and 2000 children, respectively. Compared with ST, umifenovir reduced the duration of fever (MD -1.41 days, 95% CI: -1.78 to -1.05), cough (-1.15 days, 95% CI: -1.50 to -0.79), and hospitalization. The complication risk decreased (RR 0.34, 95% CI: 0.23-0.51). For prophylaxis, umifenovir reduced the risk of ILI (RR 0.68, 95% CI: 0.54-0.87) and laboratory-confirmed influenza (RR 0.41, 95% CI: 0.29-0.59). Adverse events were generally mild and did not differ significantly from ST or oseltamivir (RR 0.78, 95% CI: 0.51-1.20). <b>Conclusions:</b> Umifenovir may reduce symptom duration, complications, and infection risk in pediatric ILI, with a favorable safety profile. However, the overall certainty of evidence is limited by the age of the studies, geographic restriction, and methodological quality.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Presentation of 49,XXXXY (Fraccaro) Syndrome with Ventriculomegaly: Expanding the Early Neuroimaging Phenotype.","authors":"Gonca Vardar, Giray Girgin, Emel Kabakoglu Unsur, Gulcan Seymen","doi":"10.3390/pediatric18030076","DOIUrl":"10.3390/pediatric18030076","url":null,"abstract":"<p><p>49,XXXXY syndrome (Fraccaro syndrome) is a rare sex chromosome pentasomy, historically considered a severe variant within the Klinefelter spectrum. It is characterized by intellectual disability, craniofacial dysmorphism, skeletal anomalies, hypogonadism, and congenital cardiac defects. Although neuroimaging abnormalities have increasingly been recognized in 49,XXXXY syndrome, neonatal diagnosis prompted primarily by ventriculomegaly remains rare. We report a neonate with prenatally detected ventriculomegaly in whom postnatal evaluation revealed cleft palate, congenital cardiac defects, bilateral cryptorchidism, and auditory dysfunction. Cranial ultrasonography and brain magnetic resonance imaging demonstrated bilateral ventriculomegaly with colpocephaly and a cavum vergae variant. Cytogenetic analysis confirmed the presence of a 49,XXXXY karyotype. This case highlights ventriculomegaly as a potential early diagnostic clue in 49,XXXXY syndrome and underscores the importance of chromosomal analysis in neonates presenting with structural brain abnormalities associated with multisystem anomalies. Early recognition is important for timely multidisciplinary surveillance and long-term endocrine follow-up.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and Clinical Characteristics of Bronchiolitis and the Impact of RSV Infection: A Five-Year Study in a Tertiary Pediatric Center in Central Romania.","authors":"Alexandra-Antonela Obaciu, Veronica Purdel, Laura Bleotu, Vlad Monescu, Mariana-Alexandra Grecu, Ioana Arbanas, Oana Falup-Pecurariu","doi":"10.3390/pediatric18030075","DOIUrl":"10.3390/pediatric18030075","url":null,"abstract":"<p><strong>Background: </strong>Bronchiolitis, due to respiratory syncytial virus, is the most common cause of hospitalization and lower respiratory tract infections in infants and toddlers across the globe. Data on RSV epidemiology in Romania are limited and are mainly derived from national surveillance systems. Understanding regional trends in RSV bronchiolitis, its etiology, and its severity is important while assessing the potential impacts of future prevention measures.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including infants hospitalized with bronchiolitis between 2019 and 2023 in a tertiary pediatric center in Central Romania. Demographic, clinical, and treatment data were analyzed. Comparative analyses between RSV-positive and RSV-negative cases were performed among patients tested for RSV. Disease severity was assessed using oxygen saturation at admission and length of hospital stay.</p><p><strong>Results: </strong>A total of 2967 bronchiolitis hospitalizations were identified during the study period. After exclusion of 167 cases due to hospitalization <24 h or incomplete medical records, 2800 patients were included in the final analysis. The number of admissions decreased in 2020 (<i>n</i> = 301) compared to 2019 (<i>n</i> = 638), followed by an increase in 2021 (<i>n</i> = 463) and a peak in 2022 (<i>n</i> = 745), with a slight decrease in 2023 (<i>n</i> = 653). Among tested patients, RSV positivity increased from 14.4% in 2019 to 37.7% in 2022, then decreased to 27.4% in 2023. RSV-positive cases were more frequent in younger age groups, particularly those under 6 months of age. Compared to RSV-negative cases, RSV-positive bronchiolitis was associated with lower oxygen saturation at admission, and a longer hospital stay (<0.001), indicating a more severe clinical course. Treatment differences were also observed, with higher use of corticosteroids in RSV-positive patients (<i>p</i> < 0.002), while antibiotic use was similar between groups (<i>p</i> = 0.149).</p><p><strong>Conclusions: </strong>RSV infection was associated with a more severe clinical course in our cohort and continues to play a central role in the burden of disease. The variability observed in treatment practices also suggests that further efforts are needed to better align clinical management with current evidence-based recommendations.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Limited Focal Epilepsies in Childhood: How Many and How to Treat.","authors":"Piero Pavone, Francesca Scrofani, Chiara Caruso, Enrico Parano, Agata Polizzi, Raffaele Falsaperla, Antonio Corsello, Giovanni Battista Dell'Isola, Xena Giada Pappalardo","doi":"10.3390/pediatric18030074","DOIUrl":"10.3390/pediatric18030074","url":null,"abstract":"<p><p>Self-limited focal epilepsies in childhood (SELFEs), formerly referred to as \"benign epilepsies in childhood\", constitute a heterogeneous group of epileptic conditions with onset predominantly in the neonatal, infantile, and childhood periods. A defining feature of these syndromes is that seizures arise without underlying structural, metabolic, or other demonstrable cerebral pathology, and the overall clinical trajectory is expected to be favorable, with seizures resolving spontaneously over time. Current nosological frameworks divide SELFEs into two broad categories according to age at onset: (a) neonatal and infantile forms, encompassing self-limited familial and non-familial neonatal, neonatal-infantile, and infantile epilepsies, genetic epilepsy with febrile seizures plus (GEFS+), and myoclonic epilepsy of infancy (MEI); and (b) childhood-onset forms, including self-limited epilepsy with centrotemporal spikes (SeLECTS), self-limited epilepsy with autonomic seizures (SeLEAS), childhood occipital visual epilepsy (COVE), and photosensitive occipital lobe epilepsy (POLE). Despite their historically \"benign\" label, there is no general agreement to include GEFS + and MEI among the group of SELFEs as both these conditions have been not classified as focal epilepsy in general. Accumulating evidence shows that a subset of affected children subsequently develop additional seizure types, cognitive deterioration, and behavioral or neuropsychiatric difficulties-outcomes that the word \"benign\" does not adequately communicate. Advances in molecular genetics have identified pathogenic variants affecting ion channels, synaptic transmission, and neuronal excitability, reshaping current understanding of disease mechanisms and phenotypic variability across these syndromes. This review highlights clinically relevant challenges in the diagnosis and management of SELFEs, critically examines emerging genotype-phenotype correlations, and provides evidence-based recommendations for antiseizure medication initiation and withdrawal tailored to individual syndrome characteristics and risk profiles.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Wellness and Adherence Self-Efficacy Among Adolescents Living with HIV in the Cape Town Metropole: A Cross-Sectional Survey.","authors":"Yolanda Mayman, Charné Petinger, Brian van Wyk","doi":"10.3390/pediatric18030073","DOIUrl":"10.3390/pediatric18030073","url":null,"abstract":"<p><strong>Background/objectives: </strong>Adolescents living with HIV (ALHIV) face compounded health and psychosocial challenges while managing lifelong antiretroviral therapy (ART). Mental health difficulties among ALHIV are strongly associated with suboptimal adherence and disengagement from care. While mental illness is well documented, limited empirical evidence exists on the influence of positive mental wellness on adherence self-efficacy among ALHIV. This study assessed mental wellness among ALHIV and identified key psychosocial predictors of adherence self-efficacy in public healthcare facilities in Cape Town, South Africa.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among ALHIV (<i>N</i> = 251) aged 10-19 years who were receiving ART at public healthcare facilities across the Cape Town metropole. Participants completed an electronic questionnaire that assessed ten mental wellness domains and adherence self-efficacy. Descriptive statistics were calculated to summarise participant characteristics and mental wellness scores, while Pearson correlations and multiple linear regression were done to identify associations and independent predictors of adherence self-efficacy using SPSS v29.</p><p><strong>Results: </strong>Most participants were aged 15-19 years (76.9%) and diagnosed with HIV at birth (68.9%). Mental wellness scores were high across all domains (<i>M</i> = 3.14-3.71). Hope (<i>M</i> = 3.71), spirituality (<i>M</i> = 3.58), and purpose in life (<i>M</i> = 3.52) were the highest-rated domains. All mental wellness domains were positively correlated with adherence self-efficacy (<i>p</i> < 0.001), with the strongest associations being purpose in life (<i>r</i> = 0.66), self-acceptance (<i>r</i> = 0.66) and resilience (<i>r</i> = 0.66). Hope (<i>p</i> < 0.001), resilience (<i>p</i> = 0.001), purpose in life (<i>p</i> = 0.03) and self-acceptance (<i>p</i> = 0.012) emerged as significant independent predictors.</p><p><strong>Conclusions: </strong>Positive mental wellness and adolescent-centred psychosocial support in routine HIV care may strengthen adherence self-efficacy and support adolescents' confidence in managing treatment.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Autosomal Dominant Alport Syndrome Diagnosed Just Before Discontinuation of Follow-Up.","authors":"Yasuyo Kashiwagi, Hironobu Okuno, Takahito Moriyama, Natsuko Inagaki, Gaku Yamanaka","doi":"10.3390/pediatric18030072","DOIUrl":"10.3390/pediatric18030072","url":null,"abstract":"<p><p>Persistent microscopic hematuria in children is often considered benign, yet recent evidence shows that a substantial proportion of affected individuals have underlying glomerular disease, particularly collagen IV-related nephropathies. We report a case of autosomal dominant Alport syndrome (ADAS) diagnosed just before discontinuation of long-term follow-up in a young woman initially presumed to have benign familial hematuria. The proband had persistent microscopic hematuria from early childhood, with normal renal function and no extrarenal manifestations. Her mother also had microscopic hematuria without kidney impairment, and the absence of accessible family history reinforced the assumption of benign familial hematuria. At age 42, the mother developed sensorineural hearing loss, and around the same time, the family learned that the maternal grandfather was undergoing dialysis for end-stage renal disease of unknown etiology. These findings prompted genetic testing, which identified a heterozygous pathogenic <i>COL4A4</i> frameshift variant (c.2317_2318del; p.Arg773GlyfsTer14) in both the mother and the proband, confirming ADAS. This case illustrates the phenotypic variability of ADAS within a single family and highlights the limitations of relying solely on clinical features or incomplete family history. In contemporary practice, persistent glomerular hematuria warrants long-term follow-up and a low threshold for molecular testing of <i>COL4A3-COL4A5</i>, even in the absence of overt clinical signs. Earlier genetic evaluation would likely have enabled a timelier diagnosis in this case. This report underscores the importance of reassessing presumed benign hematuria and integrating genetic testing into the diagnostic approach for children and young adults with persistent microscopic hematuria.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}