Pediatric Reports最新文献

{"title":"Evaluation of Parental Knowledge and Practices in Pediatric Fever Management Among Iranian Families: A Cross-Sectional Study.","authors":"Tarlan Soumei, Sara Hamideh Kerdar, David D Martin, Parviz Rafiezadeh, Ekkehart Jenetzky","doi":"10.3390/pediatric18030061","DOIUrl":"10.3390/pediatric18030061","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Fever is a common concern among parents, often leading to heightened anxiety and misconceptions about its management. While fever phobia has been extensively studied in Western countries, data from the Middle East-particularly Iran-remain limited. Understanding parental knowledge and anxiety in this cultural context is essential for developing targeted educational interventions. This study aims to assess parental knowledge, behavior, and anxiety regarding fever in children and to identify factors associated with higher levels of anxiety among Iranian parents, thereby contributing culturally specific evidence to the international literature on pediatric fever management. <b>Methods</b>: A cross-sectional study was conducted involving 552 parents from Tehran, Iran, recruited through convenience sampling. Data were collected using self-administered questionnaires assessing demographic characteristics, knowledge about fever, treatment practices, and anxiety levels using a 10-point Likert scale. Principal component analysis (PCA) was performed to examine the underlying factors influencing parents' decisions to reduce fever. Univariate and multivariate linear regression analyses on standardized z-values were conducted to determine the predictors of fever-related anxiety. <b>Results</b>: Results showed that 67.4% of parents experienced anxiety when managing their child's fever, with 65.6% perceiving fever as harmful. Fear of febrile seizures (77.4%) and brain damage were significant concerns motivating parents to reduce fever. Female parental sex (β = 0.336, <i>p</i> = 0.004) and the perception of fever as harmful (β = 0.058, <i>p</i> < 0.001) were the strongest predictors of fever-related anxiety. The PCA identified two key factors influencing fever management behavior: well-being protection and medical risk prevention. Parents commonly treated fever using combinations with either Paracetamol or Ibuprofen (47.6%). <b>Conclusions</b>: Parental anxiety about fever in Iran is largely driven by misconceptions, especially regarding febrile seizures and brain damage. Culturally tailored education and clear communication from healthcare providers are essential to reduce these fears, improve fever management, and decrease unnecessary antipyretic use.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784981","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":"The Predictive Power of Early Socio-Emotional Skills on Behavioral Outcomes in Very Preterm Preschoolers: A Longitudinal Study.","authors":"Chiara Ionio, Caterina Colombo, Francesco Cavigioli, Francesca Sala, Rachele Cantella, Marina Balestriero, Giovanna Cardile, Giulia Ciuffo, Gianluca Lista","doi":"10.3390/pediatric18020060","DOIUrl":"10.3390/pediatric18020060","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth increases the risk of socio-emotional difficulties and later behavioral problems. Early identification is essential, but the predictive value of socio-emotional assessments at different ages remains uncertain.</p><p><strong>Aim: </strong>This study sought to examine whether socio-emotional skills at 1, 2, and 3 years predict behavioral outcomes at 4 years in very preterm children.</p><p><strong>Methods: </strong>Fifty-seven preterm children were assessed longitudinally with the Bayley-III Socio-Emotional scale at 1, 2, and 3 years, and with the CBCL 1.5-5 at 4 years. Analyses included correlations, repeated-measures ANOVA, and regression models.</p><p><strong>Results: </strong>Mean socio-emotional scores were within the normative range at all ages, with a modest increase by age 3. Associations were observed between socio-emotional skills at 1 year and behavioral outcomes at 4 years, particularly internalizing and total problems. These associations were weaker at 2 years and not evident at 3 years. Regression analyses indicated that only 1-year socio-emotional scores were significantly associated with later outcomes, although models were unadjusted.</p><p><strong>Conclusions: </strong>Socio-emotional competencies at 1 year were associated with later behavioral outcomes in this sample of very preterm children. These findings suggest that early assessments may contribute to identifying children who could benefit from closer developmental monitoring, although further research with adjusted models is needed.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784995","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":"Prevalence of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Risk of Hyperbilirubinemia Among Newborns: A Tertiary Center Experience from Western Saudi Arabia.","authors":"Rogaya AlShugair, Mansour Al-Qurashi, Ahmad Mustafa, Mohammad Y Alhindi, Abrar Ahmed, Hend AlNajjar, Mona AlDabbagh, Ashraf Sahafi, Hashim Almarzouki, Nabila A AlRashdi, Eman A AlThobaiti, Syed Sameer Aga","doi":"10.3390/pediatric18020059","DOIUrl":"10.3390/pediatric18020059","url":null,"abstract":"<p><p><b>Background:</b> Glucose-6-phosphate dehydrogenase (G6PD) deficiency is among the most common inherited enzymatic disorders worldwide and is an important risk factor for neonatal hyperbilirubinemia. Regional data from Western Saudi Arabia based on universal newborn screening remain limited. <b>Objectives:</b> To determine the prevalence of G6PD deficiency among newborns delivered at a tertiary center in Jeddah, Saudi Arabia, and to evaluate its association with clinically relevant outcomes, including early-onset jaundice (<24 h), need for phototherapy, admission for hyperbilirubinemia management, and readmission after discharge. <b>Methods:</b> We conducted a retrospective cohort study at King Abdulaziz Medical City, Western Region, Jeddah, Saudi Arabia, between January 2020 and May 2025. Cord blood samples from live-born infants were screened using a qualitative fluorescent spot test. Demographic variables (sex, gestational age, birth weight) and jaundice-related outcomes were extracted from the electronic medical record. Categorical variables were compared using chi-square testing, with <i>p</i> < 0.05 considered statistically significant. <b>Results</b>: Among 14,964 screened newborns, 489 were identified as G6PD deficient, yielding a prevalence of 3.3%. Prevalence was higher in males than in females (5.6% vs. 0.9%). Among the G6PD-deficient infants, early-onset jaundice occurred in 17.2%, phototherapy was required in 36.0%, and 16.5% were admitted for hyperbilirubinemia management. Readmission for worsening jaundice requiring phototherapy occurred in 11.0%, and no exchange transfusions were required. Compared with term infants, late preterm infants had higher rates of early-onset jaundice (11/49, 22.4% vs. 73/440, 16.6%) and phototherapy use (22/49, 45.0% vs. 154/440, 35.0%) (<i>p</i> < 0.01). <b>Conclusions:</b> G6PD deficiency was identified in a substantial proportion of newborns in this large screened cohort and was associated with clinically significant jaundice-related outcomes, particularly among late preterm infants. These findings underscore the importance of universal screening and structured postnatal follow-up to reduce the risk of severe hyperbilirubinemia and its complications. Early identification of G6PD-deficient infants should be accompanied by careful bilirubin monitoring, clear discharge planning, and timely post-discharge follow-up, especially for those born late preterm.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785042","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 Report of Vitamin C Deficiency Mimicking Osteomyelitis.","authors":"Akash Daswaney, Nirali Borad, Anhthu Trinh, Stephanie Thompson, Youmna Mousattat","doi":"10.3390/pediatric18020057","DOIUrl":"10.3390/pediatric18020057","url":null,"abstract":"<p><p>Vitamin C, also known as ascorbic acid, plays a pivotal role in forming blood vessels, cartilage, muscles, and collagen in bones. We report a 6-year-old non-verbal female with global developmental delay who presented with complaints of lower limb pain and inability to bear weight. Symptoms started five weeks prior to presentation and had progressed from decreased activity to complete loss of weight-bearing. Physical examination showed gingival hyperplasia, perifollicular petechiae, lower limb edema, and corkscrew hair. Initial radiologic findings raised concerns of osteomyelitis, showing bone marrow edema, periosteal reaction, and cortical irregularity. However, correlation with dietary history limited to flavored milk and yogurt and lacking fruits and vegetables, in conjunction with clinical presentation, suggested vitamin C deficiency, and she was started on ascorbic acid. Vitamin C deficiency was later confirmed on day 7 by a low C deficiency level (<0.1 mg/dL). Treatment with ascorbic acid, multivitamins, and supportive therapy led to gradual recovery, and gastrostomy tube placement facilitated supplementation. This case highlights the importance of detailed dietary history and recognition of clinical signs of vitamin C deficiency. Early dietary assessment and clinical correlation can prevent unnecessary invasive procedures and prolonged antibiotic therapy. Early identification enables timely intervention, reducing morbidity and improving quality of life.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784980","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":"Admission Criteria to Paediatric Intensive Care for Oncology Haematology Patients: Updates and Evidence-Based Clinical Recommendations.","authors":"Ivonne Portaccio, Enzo Picconi, Tony Christian Morena, Giorgio Conti, Marco Piastra","doi":"10.3390/pediatric18020058","DOIUrl":"10.3390/pediatric18020058","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; The landscape of paediatric oncology has undergone a remarkable transformation over recent decades. Advances in both oncological and supportive therapies have dramatically improved survival in children with haematological malignancies and solid tumours, with current survival rates exceeding 80% for many childhood cancers. However, this therapeutic success has brought with it an unexpected consequence: the intensification of treatment protocols has led to a parallel increase in life-threatening complications requiring intensive care support. Current evidence indicates that up to 40% of paediatric oncology patients will require admission to a Paediatric Intensive Care Unit (PICU) at some point during their disease trajectory. &lt;b&gt;Objectives:&lt;/b&gt; This comprehensive review synthesises current evidence to provide an updated framework for PICU admission decision-making in oncology haematology patients. We have integrated the most recently published international guidelines, including the groundbreaking Phoenix 2024 sepsis criteria and the updated PALICC-2 2023 recommendations for paediatric acute respiratory distress syndrome. Beyond establishing admission criteria, we critically analyse the efficacy of advanced support strategies and examine emerging therapeutic approaches in this uniquely vulnerable population. &lt;b&gt;Methods:&lt;/b&gt; Our methodology encompassed a systematic review of the literature published between 2011 and 2024, complemented by a detailed analysis of current international guidelines and expert consensus statements. We included randomised controlled trials, observational studies, meta-analyses, and consensus conference proceedings specifically addressing the intensive care management of paediatric patients with oncological or haematological conditions. &lt;b&gt;Main Results:&lt;/b&gt; Several key findings emerge from our analysis. The Phoenix 2024 criteria represent a fundamental reconceptualisation of paediatric sepsis diagnosis, validated through an unprecedented dataset encompassing more than 3 million paediatric encounters. In the realm of respiratory support, early implementation of non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) has demonstrated remarkable efficacy, reducing the need for invasive mechanical ventilation by 45% (RR 0.45, 95% CI 0.26-0.78) when applied to appropriately selected patients. Extracorporeal membrane oxygenation (ECMO), whilst increasingly utilised, shows survival to decannulation ranging from 52% to 64%, though survival to hospital discharge remains less encouraging at 36-42%. Continuous renal replacement therapy (CRRT) has proven highly effective for tumour lysis syndrome, achieving metabolic correction in 90% of severe cases. Perhaps most promisingly, emerging biomarkers-particularly interleukin-6, interleukin-10, and procalcitonin-have substantially enhanced our ability to stratify infection risk, demonstrating sensitivity exceeding 85% for bacteraemia detection. &lt;","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784974","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":"Comparison of Postoperative Outcomes of Duhamel and Transanal Endorectal Pull-Through in Hirschsprung Disease: A Propensity Score Study.","authors":"Jiraporn Khorana, Juthamas Jenyongsak, Kanokkan Tepmalai, Sireekarn Chantakhow","doi":"10.3390/pediatric18020056","DOIUrl":"10.3390/pediatric18020056","url":null,"abstract":"<p><strong>Background/objectives: </strong>Hirschsprung disease (HSCR) is a congenital condition characterized by absence of ganglion cells in the distal bowel. The principle of surgical treatment is resection of the aganglionic bowel with restoration of intestinal continuity. Several operative techniques have been developed. This study aimed to compare outcomes between the Duhamel procedure and transanal endorectal pull-through (TERPT) in Hirschsprung disease using propensity score-based methods.</p><p><strong>Methods: </strong>Hirschsprung patients who underwent Duhamel or TERPT from January 2006 to December 2021 were included. The primary outcome was a composite endpoint at 6 months comprising obstructive symptoms, fecal soiling, or Hirschsprung-associated enterocolitis. Propensity scores were estimated via logistic regression incorporating eight preoperative covariates. The primary analysis employed overlap weighting (ATO), with multiple sensitivity analyses performed to assess robustness.</p><p><strong>Results: </strong>A total of 239 patients were included (TERPT, <i>n</i> = 181; Duhamel, <i>n</i> = 58). Before weighting, seven of eight covariates demonstrated meaningful imbalance (SMD > 0.10); ATO weighting achieved satisfactory balance across all covariates (all SMD < 0.10). A good composite outcome was achieved in 51.9% of TERPT and 53.4% of Duhamel patients, with no significant difference in the primary ATO-weighted analysis (OR 0.94, 95% CI 0.39-2.28; <i>p</i> = 0.897). No significant differences were observed in individual outcome components. Findings were consistent across all sensitivity analyses. TERPT was associated with significantly shorter operative time, lower estimated blood loss, and shorter hospital stay (all <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>No statistically significant differences were detected in 6-month postoperative functional outcomes between TERPT and the Duhamel operation. TERPT was associated with improved perioperative outcomes. However, these findings should be interpreted with caution due to limited statistical power and baseline differences between groups. Prospective multicenter studies with standardized outcome definitions and longer follow-up are warranted.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785026","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":"<i>Candida dubliniensis</i> as a Cause of Chronic Meningitis in a 3-Year-Old Boy with Acute Lymphoblastic Leukemia.","authors":"Adrianna Ćwiertnia, Laura Chuchla, Tomasz Ociepa","doi":"10.3390/pediatric18020055","DOIUrl":"10.3390/pediatric18020055","url":null,"abstract":"<p><p><i>Candida dubliniensis</i> is an opportunistic yeast closely related to <i>Candida albicans</i> and an uncommon cause of central nervous system (CNS) infection. While isolates are often susceptible to azoles, reduced susceptibility or acquired resistance may occur, making species identification and antifungal susceptibility testing clinically relevant. We report a 3-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (ALL) in hematologic remission who developed chronic meningitis during maintenance chemotherapy. The initial presentation was non-specific (marked somnolence without fever or meningeal signs) and lumbar puncture performed to exclude CNS relapse revealed neutrophil-predominant pleocytosis and elevated protein; the cerebrospinal fluid (CSF) culture grew <i>C. dubliniensis</i>. Treatment with intravenous liposomal amphotericin B followed by prolonged fluconazole led to clinical improvement and sterile CSF. Six months later, progressive gait disturbance, limb pain, and episodic severe headaches recurred; repeat CSF cultures again yielded <i>C. dubliniensis</i>, with a changed susceptibility profile. Spine MRI demonstrated leptomeningeal enhancement involving the cauda equina nerve roots. Intravenous voriconazole with therapeutic drug monitoring was initiated and combined with intrathecal liposomal amphotericin B (seven doses, dose-escalated up to 3 mg), which was well tolerated and associated with rapid neurologic improvement, CSF sterilization, and radiologic resolution. At 12 months of follow-up, the patient remained infection-free and in leukemia remission. This case highlights that <i>C. dubliniensis</i> chronic meningitis may present subtly yet progress, requiring repeated CSF cultures with susceptibility testing; intrathecal liposomal amphotericin B can be a safe and effective adjunct to systemic therapy in refractory or recurrent disease.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784966","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":"Pediatric Autoimmune Sclerosing Cholangitis: Diagnostic and Therapeutic Challenges.","authors":"Raisa-Maria Sucaciu, Alina Grama, Alexandra Mititelu, Bianca Raluca Mariș, Ioana Filimon, Bobe Petrushev, Daniel Cristian Popescu, Gabriel Benţa, Tudor Lucian Pop","doi":"10.3390/pediatric18020054","DOIUrl":"10.3390/pediatric18020054","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune sclerosing cholangitis (ASC) is a rare clinical entity characterized by overlapping features of autoimmune hepatitis and primary sclerosing cholangitis. It predominantly affects pediatric patients. Therapeutic management is often complex, requiring a multidisciplinary and individualized approach, especially in the context of associated autoimmune diseases.</p><p><strong>Case presentation: </strong>We present the case of a female patient diagnosed at the age of 10 with ASC, for which immunosuppressive therapy with prednisone, azathioprine (AZA), and ursodeoxycholic acid (UDCA) was initiated, with an initially favorable course. One year later, following a Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection, the patient experienced reactivation of liver disease and subsequently developed ulcerative pancolitis (UC), for which 5-aminosalicylic acid (5-ASA) therapy was initiated. Due to repeated hepatic flares and/or colitis relapses, therapy was escalated successively to mycophenolate mofetil, tacrolimus, and eventually infliximab (IFX). Despite treatment, the liver disease progressed, culminating in liver cirrhosis. Our patient developed portal hypertension and esophageal varices, with two episodes of upper gastrointestinal bleeding requiring endoscopic band ligation. At the age of 14, the patient developed recurrent episodes of non-infectious ulcerative stomatitis. Biopsy of the lesions revealed non-specific chronic inflammation, unrelated to colitis activity (confirmed microscopic remission of UC). By exclusion, an adverse drug reaction was suspected, with AZA being the most likely cause. Following its discontinuation, the lesions resolved. Beyond the physiological and therapeutic aspects, the patient displays marked emotional fragility due to prolonged and repeated hospitalizations (18 out of 60 months), which have impacted treatment adherence.</p><p><strong>Conclusions: </strong>This case highlights the complexity of managing pediatric patients with multiple autoimmune diseases. The necessary combination of immunosuppressive therapies may lead to significant adverse effects and further complicate disease progression. Moreover, psychological components play a crucial role in treatment compliance and therapeutic success, emphasizing the need for an integrated approach that includes specialized psychological support.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784958","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":"Internet Gaming Disorder and Internet Addiction: Comparing Italian and Migrant Children and Adolescents.","authors":"Giovanni Giulio Valtolina, Diego Boerchi, Luca Milani","doi":"10.3390/pediatric18020053","DOIUrl":"10.3390/pediatric18020053","url":null,"abstract":"<p><strong>Background: </strong>research suggests that adolescents with a migrant background may be particularly vulnerable to behavioral addictions, including problematic gaming and Internet use.</p><p><strong>Methods: </strong>we compared Italian (ITA) and non-Italian (WIC) students on Internet Gaming Disorder (IGD) and Internet Addiction (IA) and examined whether coping strategies and interpersonal-relationship quality were associated with these outcomes, using robust linear models estimated with the GENLIN procedure in IBM SPSS Statistics 31 and regression-based models on observed variables. A total of 535 students (64.5% female; aged 9-18) completed the Video Games Addiction Questionnaire (VGA), the Internet Addiction Test (IAT), the Children's Coping Strategies Checklist-Revised (CCSC), and the Assessment of Interpersonal Relations (AIR).</p><p><strong>Results: </strong>robust generalized linear models showed that WIC adolescents reported significantly higher IGD levels than their Italian peers, while no differences emerged for IA. Gender differences were evident only in unadjusted models, with males reporting higher IGD and females higher IA; however, these effects were not significant once age and nationality were considered simultaneously. Age was positively associated with IA but not with IGD. Avoidance coping was associated with higher levels of both IGD and IA, whereas active coping was negatively associated with IGD. Relationship quality was not associated with IGD but showed protective effects for IA: better relationships with mothers and with both male and female peers were associated with lower IA scores. Overall, the findings highlight that IGD and IA follow partially distinct developmental patterns. Migrant background emerged as a specific vulnerability factor for IGD, while IA appears more closely linked to age-related processes, coping styles, and interpersonal-relationship quality.</p><p><strong>Conclusions: </strong>the results call for differentiated prevention and intervention approaches targeting the distinct etiological mechanisms of each problematic behavior, focusing on coping and migration-related stress and belonging for IGD, and on strengthening coping repertoires and relational resources for IA.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784997","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":"Pneumococcal Sepsis Revealing Pediatric Systemic Lupus Erythematosus with Sjögren's Syndrome Overlap: A Case Report.","authors":"Francesco Accomando, Vittorio Albertazzi, Francesco Girelli, Michela Biscarini, Melodie O Aricò, Enrico Valletta","doi":"10.3390/pediatric18020051","DOIUrl":"10.3390/pediatric18020051","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) may present with heterogeneous clinical manifestations in pediatric patients. Although infections are a major cause of morbidity and mortality in SLE, severe bacterial infections rarely represent the presenting clinical event leading to diagnosis.</p><p><strong>Case description: </strong>We report the case of a 13-year-old boy diagnosed with SLE with Sjögren's syndrome overlap who presented with pneumococcal sepsis. The patient was admitted with high-grade fever and facial swelling, and blood cultures grew <i>Streptococcus pneumoniae</i>. Although an initial clinical response to antibiotic therapy was observed, fever subsequently recurred, accompanied by persistent systemic symptoms and progressive laboratory abnormalities. Further investigations revealed hematologic abnormalities, serosal involvement, renal disease, and a characteristic autoantibody profile. The patient fulfilled the 2019 ACR/EULAR classification criteria for SLE after comprehensive autoimmune evaluation. The overlap with Sjögren's syndrome was supported by the autoantibody profile and imaging findings involving the parotid glands. Following treatment with intravenous methylprednisolone pulses, oral prednisone, hydroxychloroquine, and mycophenolate mofetil, the patient showed rapid clinical improvement and sustained remission.</p><p><strong>Conclusions: </strong>This case highlights that severe invasive bacterial infection may occasionally be the clinical circumstance that leads to the diagnosis of pediatric systemic lupus erythematosus. Persistent systemic inflammation or evolving multisystem involvement despite appropriate antimicrobial therapy should prompt consideration of an underlying autoimmune disease, even in patients without a prior history of immune dysfunction.</p>","PeriodicalId":45251,"journal":{"name":"Pediatric Reports","volume":"18 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785010","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}