Pediatric Reports最新文献

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

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

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

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

Background/objectives: Drug-resistant epilepsy (DRE) is a significant health problem leading to cognitive impairment and reduced quality of life. This study aimed to investigate the incidence and etiology of DRE in children in Estonia.

Methods: A retrospective, population-based study of childhood DRE was conducted in Estonia from 1 January 2013, to 31 December 2017. All cases were identified through the only two pediatric neurology departments in the country, both located at tertiary care hospitals (Tartu University Hospital and Tallinn Children's Hospital), ensuring complete nationwide coverage. Epidemiological, magnetic resonance imaging (MRI), and genetic data (chromosomal microarray, single-gene tests, gene panels, and exome/genome sequencing) were collected.

Results: The incidence rate of childhood epilepsy was 84.1 per 100,000. DRE developed in 10% of children with new-onset epilepsy, corresponding to an incidence rate of 8.5 per 100,000. Etiologically relevant MRI abnormalities were identified in 43% of patients with DRE, most commonly congenital brain malformations (19%). Pathogenic single-gene sequence variants were detected in 25 of 110 patients (23%), copy number variants in four patients (4%), and chromosomal aberrations in one patient (1%). Novel candidate disease genes of uncertain pathogenicity were identified in four patients (4%). The most frequent etiology of DRE was structural (29%), followed by genetic (19%), with combined etiologies (13%) also contributing significantly.

Conclusions: Our study is the first epidemiological study of DRE in children in Estonia and the Baltic region. The relatively low incidence observed may reflect the comprehensive national ascertainment and centralized management of pediatric epilepsy in tertiary care centers.

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

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

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

Background/objectives: This study evaluates a media prevention program conducted in elementary schools.

Methods: A one-week media program, carried out with fourth graders in Leipzig, Germany, was evaluated using a non-randomized controlled cluster design. Program participants (experimental group (EG), n = 84 children, 41 parents) and non-participants (control group (CG), n = 19 children, 14 parents) completed questionnaires before the media program (t1), directly after the program (t2, EG only), and 3 months later (t3). The child questionnaire assessed media use frequency, rules at home, perceived and objective media-knowledge, and awareness of dangers on the Internet. The parent questionnaire assessed media-related topics discussed with their children and parents' confidence regarding media education.

Results: In the EG, children's perceived and objective knowledge and their awareness of dangers on the Internet increased significantly between t1 and t2 and remained stable until t3, while no changes were observed in the CG. The number of children reporting that there exist rules on social media use also increased significantly in the EG but not in the CG. The amount of media-related topics discussed within the family and parents' confidence regarding media education increased significantly from t1 to t3 in both EG and CG. Children's media use frequency did not change across time, neither in the EG nor in the CG.

Conclusions: Media prevention programs at school can have positive effects on children's knowledge and awareness of dangers on the Internet and might improve parents' confidence in and the realization of media education at home.

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