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Primary adrenal insufficiency (PAI) is a rare medical condition, characterized by a deficiency in adrenal hormones. Although rare, PAI is a life-threatening disease requiring prompt recognition and treatment. However, symptoms of PAI are often non-specific and diagnosis can be challenging, causing frequent diagnostic delays. In adults, autoimmunity is the most common cause of PAI in industrialized countries, whereas in children, the most frequent etiology is represented by congenital defects of steroidogenesis and, in particular, by congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. A few recent case series from different countries have reported that autoimmunity is the second most common etiology of PAI in the pediatric age group. However, data on autoimmune PAI in children are still scant and the exact epidemiology, clinical manifestations, and long-term outcomes of this condition have yet to be defined. The scope of this review is to summarize the current knowledge on the etiology, presentation, and treatment of autoimmune PAI in childhood and to increase physicians' awareness of the signs that should raise an early suspicion of this condition., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer NI declared a shared affiliation with the authors to the handling editor at the time of review. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Capalbo, Esposito, Gaeta, Lorello, Vasaturo, Di Mase and Salerno.)

This review reported notable advances in pediatrics that have been published in 2018. We have highlighted progresses in allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Many studies have informed on epidemiologic observations. Promising outcomes in prevention, diagnosis and treatment have been reported. We think that advances realized in 2018 can now be utilized to ameliorate patient care.

Background: The spontaneously hypertensive rat is thought to show good validity as a model of attention deficit hyperactivity disorder, in part because of impaired delayed reinforcement behaviour, corresponding to the dynamic developmental theory of the disorder. However, some previous studies may have been confounded use of fluid reward. Therefore, the objective of this study was to assess the spontaneously hypertensive rat and two comparison strains (Wistar and Wistar Kyoto) using a non-delayed food reinforcement paradigm in an attempt to advance knowledge of basic learnt behaviour in this strain, without potentially confounding reward sensitivity, which could impact on motivation to learn. Rats were trained on a fixed ratio 1 two choice discrimination schedule, extinction, reacquisition and reversal. We also tested non-reinforced spontaneous alternation to facilitate data interpretation., Results: The spontaneously hypertensive rat displayed slower shaping and reduced on task activity during task acquisition, contrasting with previous results which indicate either enhanced responding and an impairment only when a delay is used; we suggest several reasons for this. In line with previous work, the same strain exhibited poor extinguishing of behaviour but were not impaired to the same extent on reversal of the discrimination. Finally, non-reinforced alternations on a Y-maze were also reduced in the spontaneously hypertensive rat., Conclusions: In sum, the spontaneously hypertensive rat appear to show poor response inhibition in reinforced and non-reinforced contexts. However, impaired response inhibition was reduced during reversal when an opposite response produced food reward alongside presentation of the conditioned stimulus. We discuss the possibility of enhanced attribution of incentive salience to cues in this strain and highlight several points of caution for researchers conducting behavioural assessments using the spontaneously hypertensive rat and their associated comparison strains.

WE AIMED TO INVESTIGATE THE EFFECTS OF METHYLPHENIDATE (MPH) IN HEALTHY RATS ON TWO DISTINCT RADIAL MAZE TASKS WHICH RELY ON BRAIN STRUCTURES AND NEUROTRANSMITTERS KNOWN TO BE AFFECTED BY MPH: the Random Foraging Non-Delay Task (RFNDT) and the Delayed Spatial Win Shift Task (DSWT). Hooded Lister rats were trained to complete either the RFNDT or the DSWT having received oral treatment of either a vehicle or MPH (3.0 mg/kg and 5.0 mg/kg for RFNDT, 3.0 mg/kg for DSWT). We found no effect of MPH on the RFNDT relative to the control group. However, those treated with 5.0 mg/kg MPH did take significantly longer to reach criterion performance than those treated with the 3.0 mg/kg MPH, suggesting some doses of MPH can have detrimental effects. For the DSWT, if MPH was present in both phases, performance did not differ from when it was absent in both phases. However, when present in only one phase there was an increase in errors made, although this only reached significance for when MPH was present only in the test-phase. These data suggest that MPH may have detrimental effects on task performance and can result in state-dependent effects in healthy individuals.