Children

9 pages, 533 KiB

Open AccessArticle

Development and Validation of a Diagnostic Algorithm for Down Syndrome Using Birth Certificate and International Classification of Diseases Codes

by Lin Ammar, Kristin Bird, Hui Nian, Angela Maxwell-Horn, Rees Lee, Tan Ding, Corinne Riddell, Tebeb Gebretsadik, Brittney Snyder, Tina Hartert and Pingsheng Wu

Children 2024, 11(10), 1271; https://doi.org/10.3390/children11101271 - 21 Oct 2024

Viewed by 573

Abstract

Objective: We aimed to develop an algorithm that accurately identifies children with Down syndrome (DS) using administrative data. Methods: We identified a cohort of children born between 2000 and 2017, enrolled in the Tennessee Medicaid Program (TennCare), who either had DS coded on [...] Read more.

Objective: We aimed to develop an algorithm that accurately identifies children with Down syndrome (DS) using administrative data. Methods: We identified a cohort of children born between 2000 and 2017, enrolled in the Tennessee Medicaid Program (TennCare), who either had DS coded on their birth certificate or had a diagnosis listed using an International Classification of Diseases (ICD) code (suspected DS), and who received care at Vanderbilt University Medical Center, a comprehensive academic medical center, in the United States. Children with suspected DS were defined as having DS if they had (a) karyotype-confirmed DS indicated on their birth certificate; (b) karyotype-pending DS indicated on their birth certificate (or just DS if test type was not specified) and at least two healthcare encounters for DS during the first 6 years of life; or (c) at least three healthcare encounters for DS, with the first and last encounter separated by at least 30 days, during the first six years of life. The positive predictive value (PPV) of the algorithm and 95% confidence interval (CI) were reported. Results: Of the 411 children with suspected DS, 354 (86.1%) were defined as having DS by the algorithm. According to medical chart review, the algorithm correctly identified 347 children with DS (PPV = 98%, 95%CI: 96.0–99.0%). Of the 57 children the algorithm defined as not having DS, 50 (97.7%, 95%CI: 76.8–93.9%) were confirmed as not having DS by medical chart review. Conclusions: An algorithm that accurately identifies individuals with DS using birth certificate data and/or ICD codes provides a valuable tool to study DS using administrative data. Full article

(This article belongs to the Section Global Pediatric Health)

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12 pages, 1257 KiB

Open AccessReview

Decoding Apelin: Its Role in Metabolic Programming, Fetal Growth, and Gestational Complications

by Nikolaos Loukas, Dionysios Vrachnis, Nikolaos Antonakopoulos, Sofoklis Stavros, Nikolaos Machairiotis, Alexandros Fotiou, Chryssi Christodoulaki, Markos Lolos, Georgios Maroudias, Anastasios Potiris, Petros Drakakis and Nikolaos Vrachnis

Children 2024, 11(10), 1270; https://doi.org/10.3390/children11101270 - 21 Oct 2024

Viewed by 854

Abstract

Placental insufficiency and gestational diabetes, which are both serious pregnancy complications, are linked to altered fetal growth, whether restricted or excessive, and result in metabolic dysfunction, hypoxic/oxidative injury, and adverse perinatal outcomes. Although much research has been carried out in this field, the [...] Read more.

Placental insufficiency and gestational diabetes, which are both serious pregnancy complications, are linked to altered fetal growth, whether restricted or excessive, and result in metabolic dysfunction, hypoxic/oxidative injury, and adverse perinatal outcomes. Although much research has been carried out in this field, the underlying pathogenetic mechanisms have not as yet been fully elucidated. Particularly because of the role it plays in cardiovascular performance, glucose metabolism, inflammation, and oxidative stress, the adipokine apelin was recently shown to be a potential regulator of fetal growth and metabolic programming. This review investigated the numerous biological actions of apelin in utero and aimed to shed more light on its role in fetal growth and metabolic programming. The expression of the apelinergic system in a number of tissues indicates its involvement in many physiological mechanisms, including angiogenesis, cell proliferation, energy metabolism, inflammation, and oxidative stress. Moreover, it appears that apelin has a major function in disorders such as diabetes mellitus, fetal growth abnormalities, fetal hypoxia, and preeclampsia. We herein describe in detail the regulatory effects exerted by the adipokine apelin on fetal growth and metabolic programming while stressing the necessity for additional research into the therapeutic potential of apelin and its mechanisms of action in pregnancy-related disorders. Full article

(This article belongs to the Section Pediatric Neonatology)

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15 pages, 230 KiB

Open AccessArticle

Parenting in the Face of Trauma: Music Therapy to Support Parent–Child Dyads Affected by War and Displacement

by Tamar Hadar

Children 2024, 11(10), 1269; https://doi.org/10.3390/children11101269 - 20 Oct 2024

Viewed by 915

Abstract

Background: The literature highlights the profound psychological impact of war on children, families, and communities, emphasizing the prevalence of Post-Traumatic Stress Disorder (PTSD), anxiety, and other symptoms among affected individuals. Interventions, such as Child-Parent Psychotherapy (CPP) and music therapy, show promise in mitigating [...] Read more.

Background: The literature highlights the profound psychological impact of war on children, families, and communities, emphasizing the prevalence of Post-Traumatic Stress Disorder (PTSD), anxiety, and other symptoms among affected individuals. Interventions, such as Child-Parent Psychotherapy (CPP) and music therapy, show promise in mitigating trauma effects, underscoring the need for holistic approaches that address familial and community dynamics alongside individual well-being. Methods: Aiming to explore the influences of dyadic music therapy sessions on parents’ capacity to support their children, this study involved four families displaced from their home-kibbutz as result of a terrorist attack. All dyads participated in music therapy sessions with a focus on parent–child interactions and trauma processing (CPP informed). Embedded in a qualitative, phenomenological approach, the research utilized interpretative phenomenological analysis (IPA) and micro-analytic methods to explore meaningful moments in the music therapy sessions. Results: Findings identified four central categories: (1) Discovering the child’s grounding song: identifying resources; (2) Musical improvisation sets the grounds for parent–child mutual recognition of the child’s traumatic experience; (3) Musical performance empowers child and parent; (4) A sense of agency is gained through controlling the musical environment. Conclusions: The significance of restoring the children’s freedom of play, the parents’ sense of competency, and of enhancing families’ capacity to connect to their traumatic experiences through the musical environment is discussed. Full article

(This article belongs to the Special Issue Parenting and Child/Adolescent Development: Current Updates and Global Perspectives)

15 pages, 2085 KiB

Open AccessSystematic Review

Relationship Between Iron Deficiency Anemia and Stunting in Pediatric Populations in Developing Countries: A Systematic Review and Meta-Analysis

by Caroline Oktarina, Charisma Dilantika, Nova Lidia Sitorus and Ray Wagiu Basrowi

Children 2024, 11(10), 1268; https://doi.org/10.3390/children11101268 - 19 Oct 2024

Viewed by 1444

Abstract

Background/Objectives: Iron deficiency anemia (IDA) and stunting are prevalent global health issues, particularly in developing countries, where previous studies have suggested a potential relationship between them. This systematic review aims to analyze the relationship between iron deficiency anemia and stunting in pediatric populations [...] Read more.

Background/Objectives: Iron deficiency anemia (IDA) and stunting are prevalent global health issues, particularly in developing countries, where previous studies have suggested a potential relationship between them. This systematic review aims to analyze the relationship between iron deficiency anemia and stunting in pediatric populations in developing countries. Methods: Literature searches were conducted on PubMed, EMBASE, Cochrane Library, and EBSCO Host. The primary outcome was the association between IDA and stunting. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) for cohort studies and the Effective Public Health Practice Project (EPHPP) for other observational studies. Meta-analysis was performed with a random-effects model and heterogeneity assessment. A Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment was performed to determine the certainty and importance of the study. Results: Out of 19,095 articles, 15 studies were included in the systematic review, and 4 studies were included in the meta-analysis, encompassing 21,936 subjects aged 0 to 12 years. IDA prevalence ranged from 3.6 to 58.8%, while stunting prevalence varied from 6.6 to 44.5%. Nine articles supported a significant relationship between IDA and stunting, revealing that stunted children had a 1.31–6.785 times higher risk of developing IDA. The odds ratio of children with IDA to be stunted was 2.27 (95% CI = 1.30–3.95). All studies exhibited a moderate risk of bias. GRADE assessment suggested that the evidence’s certainty is low but important. Conclusions: The high IDA prevalence in developing countries, including Indonesia, is associated with stunting in children, suggesting a synergistic relationship. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

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13 pages, 691 KiB

Open AccessArticle

Digital Narratives: The Impact of Instagram^® on Mothers of Children with Congenital Toxoplasmosis

by Gabrielle Gonçalves Veloso, Giovanna Cristina Machado-Kayzuka, Rhyquelle Rhibna Neris, Ana Carolina Andrade Biaggi Leite, Nayara Gonçalves Barbosa, Heloísa Cristina Figueiredo Frizzo, Gabrielle Vedoveto Escaliante, Adriana Moraes Leite, Beatriz Volpin Gomes Beato, Poliane da Silva Santos, Flávia Gomes-Sponholz and Lucila Castanheira Nascimento

Children 2024, 11(10), 1267; https://doi.org/10.3390/children11101267 - 19 Oct 2024

Viewed by 751

Abstract

Background: Congenital toxoplasmosis leads to severe complications in childhood and presents significant global health challenges. In Brazil, the prevalence of toxoplasmosis during pregnancy and congenital cases ranges from 0.3 to 8 per 1000 live births. The clinical manifestations of congenital toxoplasmosis can include [...] Read more.

Background: Congenital toxoplasmosis leads to severe complications in childhood and presents significant global health challenges. In Brazil, the prevalence of toxoplasmosis during pregnancy and congenital cases ranges from 0.3 to 8 per 1000 live births. The clinical manifestations of congenital toxoplasmosis can include neurological and ocular damage, among other health issues, which place significant burdens on affected families. Objective: This study aims to investigate the experiences and motivations of mothers of children with congenital toxoplasmosis who share their journeys on social media, particularly Instagram. Methods: A qualitative virtual ethnography was used that explored the content shared by mothers of children diagnosed with congenital toxoplasmosis, aiming to understand how social media aids in their coping strategies and the support networks they create. Results: Fifteen Instagram accounts were analyzed, and twelve mothers participated in in-depth interviews. Thematic analysis revealed three main themes: the initial search for information and support, the evolving role of social media in advocacy and education, and the creation of a supportive online community. Conclusions: This study highlights the potential of social media to provide emotional support, disseminate information, and foster communities among mothers facing similar challenges, ultimately contributing to better care strategies and professional awareness for supporting families dealing with congenital toxoplasmosis. Full article

(This article belongs to the Special Issue Innovations in the Family Care of Children with Chronic Illnesses)

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16 pages, 680 KiB

Open AccessReview

Conducting Patient-Oriented Research in Pediatric Populations: A Narrative Review

by Alan P. Cooper, Linda Nguyen, Oluwapolola Irelewuyi and Steven P. Miller

Children 2024, 11(10), 1266; https://doi.org/10.3390/children11101266 - 19 Oct 2024

Viewed by 1094

Abstract

It has become increasingly common for researchers to partner with patients as members of the research team and collaborate to use their lived experiences to shape research priorities, interventions, dissemination, and more. The patient-oriented research (POR) model has been adopted by both adult [...] Read more.

It has become increasingly common for researchers to partner with patients as members of the research team and collaborate to use their lived experiences to shape research priorities, interventions, dissemination, and more. The patient-oriented research (POR) model has been adopted by both adult and pediatric health researchers. This cultural change to conducting pediatric health research brings with it new methodologies, tools, challenges, and benefits. In this review, we aim to provide guidance on how to conduct POR for pediatric populations using examples from the literature. We describe considerations for engagement before the project begins, for engagement across the research cycle, and for measurement and evaluation. We aim to show that conducting POR is feasible, beneficial, and that many common challenges and barriers can be overcome with preparation and usage of specific tools. Full article

(This article belongs to the Special Issue Family-Oriented Research to Improve Care of Preterm Infants)

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10 pages, 1933 KiB

Open AccessFeature PaperArticle

The Effects of the COVID-19 Pandemic on Pediatric Orthopedic Injuries: A Single-Center Retrospective Study

by Betina Hinckel, Sazid Hasan, Clark Yin, Jimmy Lau, Saeed Saleh and Ehab Saleh

Children 2024, 11(10), 1265; https://doi.org/10.3390/children11101265 - 19 Oct 2024

Viewed by 622

Abstract

Objectives: The COVID-19 pandemic has had a profound effect on the pediatric population worldwide. The consequences of the lockdown and the reallocation of hospital resources have caused notable changes in the presentation of pediatric orthopedic injuries. Through our use of patient records, we [...] Read more.

Objectives: The COVID-19 pandemic has had a profound effect on the pediatric population worldwide. The consequences of the lockdown and the reallocation of hospital resources have caused notable changes in the presentation of pediatric orthopedic injuries. Through our use of patient records, we were able to display the epidemiological trends, as well as analyze the changes in the type and mechanism of various injuries. Our purpose is to further understand the considerable effects of the COVID-19 pandemic on pediatric orthopedic trauma and help guide the allocation of future healthcare resources. Methods: We conducted a retrospective cohort study on pediatric patients admitted for any orthopedic injury over a 3-year period (September 2018 to August 2021) at a Midwest level 1 trauma center. Cases were stratified into two groups based on the United States’ COVID-19 lockdown (19 March 2020): Pre-COVID-19 cases were any cases prior to the lockdown and Intra-COVID-19 which are cases following the lockdown. Numerical data and categorical variables were summarized and differences between the case groups were examined using either two-Proportion Z-Test, Independent Two-Sample t-test, Pearson’s chi-squared, or Fisher’s exact tests. Results: A total of 3179 pediatric orthopedic referrals occurred between the Pre-COVID-19 and Intra-COVID-19 study periods. We observed a general decrease in orthopedic injuries following the COVID-19 lockdowns with 1235 injuries compared to 1606 Pre-COVID-19. Patterns in the locations of injuries changed; notably, fractures of the humerus, tibia, and fibula decreased significantly (p < 0.05). Several mechanisms of injuries decreased significantly following the onset of COVID-19 including injuries caused by monkey bars, basketball, and automobiles (p < 0.01). There was a significant increase in the overall injury severity during the Intra-COVID-19 period (p < 0.05). Conclusions: Although there was a reduction in acute orthopedic trauma referrals, many injury mechanisms displayed similar trends regardless of restrictions. We clinically observed an overall increase in the severity of pediatric orthopedic injuries during the COVID-19 pandemic. Full article

(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)

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11 pages, 1377 KiB

Open AccessArticle

Trends in Nutritional Status and Dietary Behavior in School-Aged Children with Congenital Heart Defects

by Dominik Tobias, Paul Christian Helm, Ulrike Maria Margarethe Bauer, Claudia Niessner, Sigrid Hahn, Jannos Siaplaouras and Christian Apitz

Children 2024, 11(10), 1264; https://doi.org/10.3390/children11101264 - 19 Oct 2024

Viewed by 764

Abstract

Background: Malnutrition and poor weight gain has been reported in infants with congenital heart defects (CHDs); however data in older children with CHDs are limited. In order to obtain representative data on the nutritional status, dietary behavior, and potential influencing factors in school-aged [...] Read more.

Background: Malnutrition and poor weight gain has been reported in infants with congenital heart defects (CHDs); however data in older children with CHDs are limited. In order to obtain representative data on the nutritional status, dietary behavior, and potential influencing factors in school-aged children with CHDs, we performed a nationwide online survey. Methods: Patients aged 6 to 17 years registered in the German National Register for CHDs were asked to participate in this study by completing the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) eating study questionnaire in order to assess their self-reported dietary habits. The use of the same questionnaire enabled a comparison with a representative subset of 4569 participants of the KiGGS study. Results: A total of 894 patients (mean age 12.5 ± 3.0 years; 47.2% female) were enrolled. Patients were allocated according to anatomic complexity into simple (23.8%), moderate (37.8%), and complex CHDs (38.4%). The consumption of sugar-containing food (p < 0.001) and fast food (p < 0.05) was significantly lower among the CHD patients than in the healthy children. Children with CHDs showed significantly lower body mass index (BMI) percentiles (p < 0.001) compared with their healthy peers, while children with complex and moderate CHDs had the lowest BMI. While in CHD patients, the BMI percentiles were not related to unhealthy food, there was a strong correlation with the CHD severity and number of previous interventions (p < 0.01). Conclusions: According to this nationwide survey, school-aged children with complex CHD are at risk of undernutrition, which is not due to dietary habits but to CHD severity and repeated surgery. Full article

(This article belongs to the Section Pediatric Cardiology)

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13 pages, 784 KiB

Open AccessArticle

Assessment of the Adaptive Behavior of Young Children with Visual Impairments in an Early Intervention Service: A Pilot Study

by Valerie Caron, Sibilla Badaracco, Geneviève Petitpierre and Saheb Yousefi

Children 2024, 11(10), 1263; https://doi.org/10.3390/children11101263 - 18 Oct 2024

Viewed by 651

Abstract

Introduction: Adaptive behavior, defined as a critical set of skills learned and performed throughout daily life to cope with society’s age-appropriate expectations, is a central concept for people with disabilities in both clinical and research contexts. As AB is an essential component of [...] Read more.

Introduction: Adaptive behavior, defined as a critical set of skills learned and performed throughout daily life to cope with society’s age-appropriate expectations, is a central concept for people with disabilities in both clinical and research contexts. As AB is an essential component of daily functioning, assessment is necessary both for the diagnostic process and for intervention, as it enables scores to be compared with the developmental norm, identifies strengths and weaknesses of the persons and monitors the progress of interventions. AB assessment is common in children with developmental delays but less common in children with visual impairment (VI). The aim of this study was to evaluate the AB of young children with VI through a pilot study and descriptive data. Methods: The participants were recruited through an early childhood special needs education service specialized in VI in the French-speaking part of Switzerland. Overall, 10 families gave their consent for their child to be assessed using the Vineland Adaptative Behavior Scale-II (VABS-II) completed by their early childhood educator. Results: Globally, the results showed that participants were rated between the Adapted to Moderately High levels. The highest domains were in the areas of communication, daily living skills and socialization. Discussion: The results showed a trend that is superior to previous studies assessing the AB of a similar population. As a result, one obvious perspective would be to adapt the scale to ensure that the items assessed are more consistent with the specificities of their development and the intervention priorities, enabling them to achieve adaptive behavior and independence in carrying out activities of daily living. Full article

(This article belongs to the Section Pediatric Ophthalmology)

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11 pages, 761 KiB

Open AccessArticle

In-Hospital and Interstage Mortality After Late Norwood Procedure: Acknowledging the Risks When We Are Running Out of Time

by Andreea Alina Andronache, Roberta Di Cosola, Martina Evangelista, Sara Boveri, Laura Schianchi, Alessandro Giamberti and Massimo Chessa

Children 2024, 11(10), 1262; https://doi.org/10.3390/children11101262 - 18 Oct 2024

Viewed by 503

Abstract

Background: A Norwood procedure performed after 14 days of life is notably burdened by a high mortality. We analysed the real risk and which other factors influence the mortality in late Norwood procedures. Methods: A single-centre, retrospective review of a series of consecutive [...] Read more.

Background: A Norwood procedure performed after 14 days of life is notably burdened by a high mortality. We analysed the real risk and which other factors influence the mortality in late Norwood procedures. Methods: A single-centre, retrospective review of a series of consecutive patients who underwent a surgical Norwood procedure from January 2019 until December 2023. The patients’ characteristics were considered to identify the factors associated with in-hospital and interstage mortality. Results: 35 patients were included and 71% (25) of the patients underwent the Norwood procedure after 14 days of life. The median age was 27 days (6–259 days). The in-hospital mortality was 26% (9/35) with 89% (8) of the deceased being older than 15 days at the time of the surgery. Other factors that negatively affected the outcome were a restrictive interatrial septum defect (ASD) in 66% of all patients (23), the need for mechanical ventilation in 46% (16) and systemic infection prior to surgery in 43% (15). Conclusions: Age at the time of Norwood was not associated with a higher risk of mortality, but other factors such as restrictive ASD, preoperative infection and the need for mechanical ventilation prior to surgery are even more important in predicting the short-term outcome. Full article

(This article belongs to the Special Issue Pediatric Hypoplastic Left Heart Syndrome: Diagnosis, Treatment and Management)

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14 pages, 2780 KiB

Open AccessReview

Patellofemoral Instability in the Pediatric and Adolescent Population: From Causes to Treatments

by Anthony Ricciuti, Katelyn Colosi, Kevin Fitzsimmons and Matthew Brown

Children 2024, 11(10), 1261; https://doi.org/10.3390/children11101261 - 18 Oct 2024

Viewed by 856

Abstract

Background: Patella instability is one of the most common knee injuries in the adolescent patient. There are several pathoanatomic risk factors which should be assessed via several modalities, including X-rays, magnetic resonance imaging (MRI), or even CT scan. Objectives: We intend to review [...] Read more.

Background: Patella instability is one of the most common knee injuries in the adolescent patient. There are several pathoanatomic risk factors which should be assessed via several modalities, including X-rays, magnetic resonance imaging (MRI), or even CT scan. Objectives: We intend to review these risk factors along with the nonsurgical and surgical techniques used to prevent recurrent dislocations. Methods: We completed an extensive review of the recent literature concerning pediatric and adolescent patellar dislocation and subsequent treatment modalities. Results: We review in detail the risk factors such as patella alta, trochlear dysplasia, lateralization of the tibial tubercle or medialization of the trochlear groove (increased tibial tubercle to trochlear groove (TT–TG) distance), lower limb malalignment, excessive femoral anteversion and/or tibial torsion, and hyperlaxity. There are classification systems for dislocators, and a natural progression of instability that patients often proceed through. Only after a patient has continued to dislocate after bracing and physical therapy is surgical treatment considered. Surgical techniques vary, with the workhorse being the medial patellofemoral ligament (MPFL) reconstruction. However, there are a variety of other techniques which add onto this procedure to address other anatomic risk factors. These include the tibial tubercle osteotomy to address a large TT–TG distance or trochleoplasty to address the lack of a trochlear groove. Conclusions: Nonsurgical and surgical treatments for patella dislocators are tailored to the pathoanatomic risk factors in each patient. Full article

(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)

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24 pages, 1279 KiB

Open AccessArticle

Evaluation of a Model of Transitional Care After Preterm Birth on Parents’ Mental Health and Self-Efficacy: A Randomized Controlled Pilot Trial

by Natascha Schuetz Haemmerli, Liliane Stoffel, Kai-Uwe Schmitt, Tilman Humpl, Mathias Nelle, Odile Stalder and Eva Cignacco

Children 2024, 11(10), 1260; https://doi.org/10.3390/children11101260 - 18 Oct 2024

Viewed by 1080

Abstract

Background/Objectives: Parents of premature infants experience depression, anxiety, post-traumatic stress disorder, and increased stress, which can negatively impact parent–infant relationships and infant development. To reduce negative consequences and optimally support families, we developed the Transition to Home model (TtH). In this randomized controlled [...] Read more.

Background/Objectives: Parents of premature infants experience depression, anxiety, post-traumatic stress disorder, and increased stress, which can negatively impact parent–infant relationships and infant development. To reduce negative consequences and optimally support families, we developed the Transition to Home model (TtH). In this randomized controlled pilot trial (RCT), the feasibility of performing an experimental study to analyse the effects of TtH on parental mental health over time was evaluated. Methods: The following domains were assessed: recruitment, follow-up and study burden, outcome measures used and parental mental health outcomes. We included n = 22 parent couples with their preterm infants in the control group and n = 23 in the intervention group. Depression, anxiety and post-traumatic stress disorders, parenting stress, and parental self-efficacy were assessed at five timepoints. The study burden was evaluated once at the end of the study. Results: The control and intervention groups had similar socio-demographic characteristics. The groups showed no differences in the mental health outcomes except for depression in mothers at T2 (p = 0.042) and T5 (p = 0.027) and state anxiety in fathers at T2 (p = 0.016). Conclusions: This pilot RCT established a framework for the evaluation of the TtH model of care and demonstrated the viability of the evaluation scheme. The results confirm the suitability of the RCT’s structure and the feasibility of the methods and instruments used. Minor adjustments are recommended to include a more diverse sample in future studies. Full article

(This article belongs to the Section Pediatric Neonatology)

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12 pages, 886 KiB

Open AccessArticle

Effect of Helicobacter pylori Eradication on Serum Level of Valproic Acid in Children with Idiopathic Generalized Epilepsy

by Abobakr Abdelgalil, Doaa Ismail, Ayman Eskander, Marian Girgis, Ahmed Farouk, Fajr Saeedi, Mohamed Shazly and Amera Hasnoon

Children 2024, 11(10), 1259; https://doi.org/10.3390/children11101259 - 18 Oct 2024

Viewed by 581

Abstract

Background/Objectives: The purpose of this study was to determine the influence of H. pylori eradication on the serum level of the orally administered valproic acid (VPA) in children with idiopathic generalized epilepsy; Methods: This prospective cohort observational study included 100 children with idiopathic [...] Read more.

Background/Objectives: The purpose of this study was to determine the influence of H. pylori eradication on the serum level of the orally administered valproic acid (VPA) in children with idiopathic generalized epilepsy; Methods: This prospective cohort observational study included 100 children with idiopathic generalized epilepsy, recruited from a neurology clinic from May 2021 to December 2021. The patients were divided into two groups, each containing 50 children. The first group had a positive H. pylori stool antigen and H. pylori-related symptoms, while the second group had a negative antigen. H. pylori Eradication therapy was given to the positive H. pylori group. The serum level of VPA was obtained at baseline and 4 weeks after eradication therapy. Results: Despite there being no significant difference between the H. pylori-positive and H. pylori-negative groups regarding the baseline VPA serum level (79.9 ± 13.9 and 77.9 ± 13.1 mcg/mL), respectively, the serum VPA level had significantly increased after H. pylori eradication therapy (99.4 ± 11 mcg/mL) (p value = 0.000), as opposed to the H. pylori-negative group (85.3 ± 10.9 mcg/mL) (p value = 0.142). Furthermore, there was a statistically significant association with a negative correlation between the VPA serum level after eradication and the number of epileptic attacks per month (p value = 0.033, R value = −0.301) and the dose of VPA (p value = 0.046, R value = −0.284). Conclusions: The eradication of H. pylori resulted in a highly significant improvement in the serum level of the orally given VPA in children with idiopathic generalized epilepsy, as well as an indirect decrease in the frequency of epileptic events per month, allowing for dose reduction. Eradication therapy may have anticonvulsant properties and might indirectly aid in the management of epileptic activity. H. pylori screening for children with idiopathic generalized epilepsy can optimize serum VPA levels, potentially leading to better seizure control. To our knowledge, this is the first study in the literature to describe the effect of H. pylori eradication on the serum level of the orally administered VPA in children with idiopathic generalized epilepsy. Full article

(This article belongs to the Section Pediatric Gastroenterology and Nutrition)

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13 pages, 221 KiB

Open AccessArticle

“Hanging on by a Thread”: The Lived Experience of Parents of Children with Medical Complexity

by Courtney Holmes, Waganesh Zeleke, Shruti Sampath and Tiffany Kimbrough

Children 2024, 11(10), 1258; https://doi.org/10.3390/children11101258 - 18 Oct 2024

Viewed by 644

Abstract

Background: Families with children with medical complexity endure high levels of chronic and toxic stress, impacting the overall health and wellbeing of all family members and the system as a whole. The purpose of this study was to examine the lived experiences of [...] Read more.

Background: Families with children with medical complexity endure high levels of chronic and toxic stress, impacting the overall health and wellbeing of all family members and the system as a whole. The purpose of this study was to examine the lived experiences of parents/caregivers with children with medical complexity. Methods: The lived experiences of 15 parents of children with complex medical needs were explored using focus group discussions. Focus group discussions were recorded, transcribed, and analyzed using van Manen’s 6-step process for hermeneutic phenomenology. Aligned with the research questions, the analysis draws on van Manen’s four lived existential analytical categories. Results: Themes include: (1) lived body, the psychological and physiological effect; (2) lived time and space, the immediate impact on the there, now, and then; (3) lived relationships, social life and family relational effect; (4) risk factors; and (5) protective factors. Conclusion: Caregivers of children with medical complexity have a unique experience of trauma and resilience. This study will inform interdisciplinary medical providers about the mental health and resiliency experiences of this population to support more effective healthcare practices. Full article

(This article belongs to the Special Issue Living beyond Medical Complexity: Factors That Shape Family Health and Wellbeing)

17 pages, 625 KiB

Open AccessArticle

Effects of a 12-Week Mixed-Method Physical Exercise Program on Physical Fitness, Stress, Anxiety, and Quality of Life in Adolescents with Cerebral Palsy: A Case Series Study

by Alexandrina Cavalcante Rodrigues Nitz, José Pedro Ferreira, Elaine Maria Ribeiro, Juliana Albuquerque da Rocha, Chrystiane Vasconcelos Andrade Toscano and Maria João Campos

Children 2024, 11(10), 1257; https://doi.org/10.3390/children11101257 - 18 Oct 2024

Viewed by 798

Abstract

Background/Objectives: Although the health benefits related to physical exercise for adolescents with cerebral palsy (CP) have been recognized, studies indicate that individuals with CP at school age are less involved in physical activities than their typical peers and are twice as likely to [...] Read more.

Background/Objectives: Although the health benefits related to physical exercise for adolescents with cerebral palsy (CP) have been recognized, studies indicate that individuals with CP at school age are less involved in physical activities than their typical peers and are twice as likely to engage in sedentary behaviors. Therefore, our study aims to investigate the effects of a physical exercise program on physical fitness, stress, anxiety, and quality-of-life variables. Methods: A total of 15 teenagers with ambulatory CP (n = 8 boys, n = 7 girls, between 12 and 18 years old; M = 14.35; SD = 1.76) completed a 12-week program based on a mixed-method approach with face-to-face and live online activities. The outcome measures were physical fitness, stress, anxiety, and quality of life. Results: The 12-week exercise program resulted in gains in muscular strength, flexibility, and aerobic endurance tests, characterized by an increase in average walking speed and average VO₂ max. There was also a significant change in the perception of emotional states of depression, anxiety, and stress reported by the participants. Conclusions: The program proved to be effective in physical fitness tests and perception of emotional states. Given the positive effects produced by the program, its design appears to meet the demands of adolescents with cerebral palsy. Full article

(This article belongs to the Special Issue The Health Effects of Daily Physical Activity Behaviours in Children: Physical and Psychological Outcomes)

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8 pages, 966 KiB

Open AccessBrief Report

Selective Extrauterine Placental Perfusion in Monochorionic Twins Is Feasible—A Case Series

by Benjamin Kuehne, Jan Trieschmann, Sarina Kim Butzer, Katrin Mehler, Ingo Gottschalk, Angela Kribs and André Oberthuer

Children 2024, 11(10), 1256; https://doi.org/10.3390/children11101256 - 17 Oct 2024

Viewed by 677

Abstract

Background: Monochorionic (MC) twins are at risk for severe twin-to-twin transfusion syndrome (TTTS) or twin anemia-polycythemia sequence (TAPS). In the case of preterm delivery, cesarean section (CS) with immediate umbilical cord clamping (ICC) of both twins is usually performed. While the recipient is [...] Read more.

Background: Monochorionic (MC) twins are at risk for severe twin-to-twin transfusion syndrome (TTTS) or twin anemia-polycythemia sequence (TAPS). In the case of preterm delivery, cesarean section (CS) with immediate umbilical cord clamping (ICC) of both twins is usually performed. While the recipient is at risk for polycythemia and may benefit from ICC, this procedure may result in aggravation of anemia with increased morbidity in the anemic donor. The purpose of this study was to demonstrate that the novel approach of selective extrauterine placental perfusion (EPP) with delayed umbilical cord clamping (DCC) in the donor infant is feasible in neonatal resuscitation of MC twins and may prevent severe anemia in donor and polycythemia in the recipient. Methods: Preterm MC twins with antenatal suspected severe anemia of the donor as measured by Doppler ultrasound, born with birthweights < 1500 g by CS, were transferred to the neonatal resuscitation unit with placenta and intact umbilical cords. In the donor, the umbilical cord was left intact to provide DCC with parallel respiratory support (EPP approach), while the cord of the recipient was clamped immediately after identification. Results: Selective EPP was performed in three cases of MC twins with TAPS and acute peripartum TTTS. All donor twins had initial hemoglobin levels ≥ 13.0 g/dL, and none of them required red blood cell transfusion on the first day after birth. Conclusions: Selective EPP may be a feasible strategy for neonatal resuscitation of MC preterm twins with high stage TAPS and TTTS to prevent anemia-related morbidities and may improve infant outcome. Full article

(This article belongs to the Section Pediatric Neonatology)

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8 pages, 198 KiB

Open AccessReview

Could a Two-Staged Repair Be the Solution to the Dilemma of Repair Timing for Severe Congenital Diaphragmatic Hernia Requiring Extracorporeal Membrane Oxygenation?

by Akiko Yokoi

Children 2024, 11(10), 1255; https://doi.org/10.3390/children11101255 - 17 Oct 2024

Viewed by 680

Abstract

Purpose of review: Congenital diaphragmatic hernia (CDH) remains a significant challenge, particularly in severe cases with persistent pulmonary hypertension (PPHN) and hypoplastic lungs and heart. For patients unresponsive to conventional therapies, ECMO is required. While the surgical repair is relatively simple, determining the [...] Read more.

Purpose of review: Congenital diaphragmatic hernia (CDH) remains a significant challenge, particularly in severe cases with persistent pulmonary hypertension (PPHN) and hypoplastic lungs and heart. For patients unresponsive to conventional therapies, ECMO is required. While the surgical repair is relatively simple, determining the optimal timing for surgery in patients requiring ECMO is particularly challenging. This review explores the dilemma of surgical timing and proposes a two-staged approach: a reduction in herniated organs and the creation of a silo to relieve abdominal pressure before initiating ECMO, with defect closure following ECMO decannulation. Recent Findings: Studies support pre-, on-, and post-ECMO repair, each with its own risks and benefits. Pre-ECMO repair may enhance ECMO efficacy by relieving organ compression but poses risks due to instability. Post-ECMO repair is safer but may result in losing the chance to repair. On-ECMO repair has significant hemorrhage risks, but early repair with careful anticoagulation management is currently recommended. Recently, the author reported a successful case using a two-staged approach—reducing herniated organs and creating a silo before ECMO, followed by defect closure after ECMO decannulation—which suggests a potential alternative strategy for managing severe CDH. Summary: A two-staged approach may offer a solution for severe CDH patients requiring ECMO. Full article

(This article belongs to the Section Pediatric Surgery)

9 pages, 1702 KiB

Open AccessArticle

Sub-Optimal Compliance to Long-Term Inhalation Strategies and Poorer Health Care Outcomes Associated with Extended Tattoos in Adolescents with Mild-to-Moderate Bronchial Asthma

by Roberto W. Dal Negro, Paola Turco and Massimiliano Povero

Children 2024, 11(10), 1254; https://doi.org/10.3390/children11101254 - 17 Oct 2024

Viewed by 506

Abstract

Background: Patients’ compliance to inhalation therapy is usually sub-optimal in young asthmatics. Adolescents poorly compliant to regular anti-asthma treatments and those with tattoos (and the associated attitude) can share some personality traits and maladaptive behaviors. This relationship has not been investigated. Objective: To [...] Read more.

Background: Patients’ compliance to inhalation therapy is usually sub-optimal in young asthmatics. Adolescents poorly compliant to regular anti-asthma treatments and those with tattoos (and the associated attitude) can share some personality traits and maladaptive behaviors. This relationship has not been investigated. Objective: To assess if “extended” tattoos can predict long-term compliance to regular therapy of adolescents with mild-to-moderate asthma. Methods: A 12-month retrospective observational investigation was conducted on non-smoker asthmatic adolescents of both genders. Patients assuming <70% of prescribed vilanterol/fluticasone furoate o.d. were defined as “non-compliant”. Tattoo surfaces were defined as “mild” or “extended” if they were < or ≥400 cm², respectively. The relationship between tattoos and compliance on the evolution of resources consumption at 6 and 12 months was assessed by generalized estimating equation (GEE) models at the first and second semester of the treatment period. Results: It was found that 13.2% of compliant adolescents had mild tattoos, while 47.2% of non-compliant adolescents had mild-to-extended tattoos (odds ratio (OR) 6.91, 95% CI 2.49 to 19.17, p < 0.001). The mean annual adherence to treatment was 57.8% ± 10.1 SD expected doses in non-compliant subjects with “mild tattoos” (54.8 cm² ± 36.9 SD), but 38.6% ± 11.4 SD expected doses in those with “extended tattoos” (568.4 cm² ± 111.6 SD, p < 0.001). Total cost proved to be a linear trend from the lowest values of compliant patients with no/mild tattoos (EUR 65.22 at 6 months and EUR 33.63 at 12 months) to the highest values of non-compliant adolescents with extended tattoos (EUR 330.75 at 6 months and EUR 297.34 at 12 months). Conclusions: Tattoo extension might be used as a reliable predictor of poor compliance and higher health care costs in adolescents with mild-to-moderate asthma. Patients characterized by poor compliance to a long-term therapeutic strategy and tattooing attitude likely share some aspects of their personality profile. Full article

(This article belongs to the Special Issue Asthma and Its Impact in Adolescent: 2nd Edition)

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8 pages, 908 KiB

Open AccessArticle

Iontophoresis Improves the Impact on the Quality of Life of Children with Primary Hyperhidrosis—A Prospective Study and a Short Review

by Florentina Nastase, Camelia Busila, Alin Codrut Nicolescu, Cristina Mihaela Marin and Alin Laurentiu Tatu

Children 2024, 11(10), 1253; https://doi.org/10.3390/children11101253 - 17 Oct 2024

Viewed by 743

Abstract

Background: Primary hyperhidrosis (PH) is a somatic and idiopathic pediatric skin disease. The eccrine glands are tiny and very numerous, with approximately 3 million distributed throughout the skin. There is no commonly accepted amount of sweating to define hyperhidrosis, but people with this [...] Read more.

Background: Primary hyperhidrosis (PH) is a somatic and idiopathic pediatric skin disease. The eccrine glands are tiny and very numerous, with approximately 3 million distributed throughout the skin. There is no commonly accepted amount of sweating to define hyperhidrosis, but people with this disease suffer real limitations integrating into society, which can be quantified through quality of life measurement scales. We want to draw attention to this disease and its impact on children’s quality of life because it is significant and there are no studies conducted on groups consisting solely of children. Methods: There are various quality of life evaluation questionnaires for hyperhidrosis. We studied 103 children with hyperhidrosis by monitoring their sweat severity and its impact on quality of life, using the Hyperhidrosis Disease Severity Scale. We compared the scale results before and after 10 days of iontophoresis. This study includes only children under 18 years old, treated with iontophoresis. Results: The average age of the group is 11.84 ± 2.89 years. Treatment success is recorded in 68 (66.02%) children, but a change in the score is recorded in 74 (71.84%) children. The average HDSS score at T0 is 2.95 ± 0.70, compared to the HDSS score at T1 of 1.92 ± 0.86. Conclusions: Hyperhidrosis has a negative impact on daily life, especially self-esteem, occupational productivity, emotional well-being, and interpersonal relationships. Iontophoresis is a safe and effective treatment method that reduces the severity of hyperhidrosis and increases the quality of life. Full article

(This article belongs to the Section Pediatric Dermatology)

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9 pages, 1948 KiB

Open AccessArticle

Vertical Dimension Control in Two Different Treatment Protocols: Invisalign First and Bite Block—A Retrospective Study

by Giuseppina Laganà, Arianna Malara, Daniel Palmacci, Patrizio Bollero and Paola Cozza

Children 2024, 11(10), 1252; https://doi.org/10.3390/children11101252 - 17 Oct 2024

Viewed by 702

Abstract

Background: The aim of the present study was to compare the vertical dimension changes, before and after treatment, in two groups of growing patients, one group treated with clear aligner therapy versus a group treated with Quad-helix and bite-block therapy. Methods: The studied [...] Read more.

Background: The aim of the present study was to compare the vertical dimension changes, before and after treatment, in two groups of growing patients, one group treated with clear aligner therapy versus a group treated with Quad-helix and bite-block therapy. Methods: The studied sample was composed of n. 40 patients (20 females and 20 males with a mean age of 8.6 ± 1.8 years), enrolled from the Department of Orthodontics at Policlinico of Rome Tor Vergata. The original sample was randomly divided into two groups: Group IF (Invisalign First) and Group BB (Quad-helix and bite block). Pre- (T0) and post-treatment (T1 after 12 months) lateral cephalograms were collected from all the selected patients. Nine cephalometric parameters, both angular and linear, were measured and recorded for each cephalogram. Results: No statistically significant changes were found between both the IF and BB groups at T0, while statistically significant changes were observed in both groups (BB and IF) between T0 and T1 (after 12 months of active therapy), p < 0.005. Conclusions: Both therapies were able to control the patient’s vertical condition. To date, the use of conventional appliances seems to have slightly better efficacy in controlling the vertical dimension than aligner therapy. Full article

(This article belongs to the Section Pediatric Dentistry & Oral Medicine)

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15 pages, 4195 KiB

Open AccessArticle

Down Syndrome in Children: A Primary Immunodeficiency with Immune Dysregulation

by Aleksandra Szczawińska-Popłonyk, Natalia Popłonyk and Karina Awdi

Children 2024, 11(10), 1251; https://doi.org/10.3390/children11101251 - 17 Oct 2024

Viewed by 1065

Abstract

Background: The multisystemic features of Down syndrome (DS) in children are accompanied by immunodeficiency, making them susceptible to infections and immune dysregulation with autoimmune, allergic, inflammatory, and hematological complications. This study was aimed at a better understanding of the abnormalities within the B [...] Read more.

Background: The multisystemic features of Down syndrome (DS) in children are accompanied by immunodeficiency, making them susceptible to infections and immune dysregulation with autoimmune, allergic, inflammatory, and hematological complications. This study was aimed at a better understanding of the abnormalities within the B and T cell compartments and their correlations with clinical immunophenotypes. Methods: Medical records of 35 DS children were retrospectively reviewed, referring to clinical symptomatology including history of infections, immune dysregulation disorders, and humoral and cellular immune response. Results: While the etiology of respiratory tract infections included typical viral and bacterial pathogens, SARS-CoV2-induced inflammatory disease and syndromic immunodeficiency contributed significantly to the deterioration of the clinical course. Allergic diseases in the form of asthma, allergic rhinitis, and alimentary allergy were the most frequent manifestations of immune dysregulation and were followed by autoimmune disorders, such as Crohn’s disease, celiac disease, autoimmune thyroiditis, and alopecia, as well as inflammatory disorders, balanitis xerotica obliterans and lymphadenopathy, and a hematological disorder of myelopoiesis. Deficiency of serum immunoglobulin levels, reduced numbers of naïve B cells, and non-switched memory B cells along with low naïve T helper cells and significantly reduced regulatory T helper cells were the most prominent immune abnormalities. Conclusions: The loss of naïveté in B and T lymphocyte compartments with a deficiency of regulatory T cells may be underpinning pathomechanisms for the skewed immune response. The clinical immunophenotype in DS is complex and represents syndromic primary immunodeficiency with immune dysregulation. Full article

(This article belongs to the Special Issue Advances in Research on Childhood Immune and Allergic Diseases)

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11 pages, 544 KiB

Open AccessFeature PaperArticle

Secondhand Smoke Exposure and Its Impact on Pediatric Lung Function, Aerobic Fitness, and Body Mass: Evidence from a Cross-Sectional Study

by Ivan Pavić, Iva Topalušić, Tamara Poljičanin, Ozana Hofmann Jaeger, Sara Žaja and Asja Stipić Marković

Children 2024, 11(10), 1250; https://doi.org/10.3390/children11101250 - 17 Oct 2024

Viewed by 864

Abstract

Background: Several studies have documented the detrimental impacts of secondhand smoke (SHS) exposure to a range of pediatric respiratory conditions, including asthma, bronchitis, and reduced lung function. The aim of the study was to investigate the influence of SHS exposure on lung function, [...] Read more.

Background: Several studies have documented the detrimental impacts of secondhand smoke (SHS) exposure to a range of pediatric respiratory conditions, including asthma, bronchitis, and reduced lung function. The aim of the study was to investigate the influence of SHS exposure on lung function, physical fitness, and body mass index (BMI) in children aged 10 to 14 years. Methods: This cross-sectional study included children aged 10 to 14 years at the Elementary School “Trilj” in Trilj, Croatia. Data on SHS exposure were collected using a questionnaire. Antropometric and spirometry measurements were performed. Physical fitness was assessed using the shuttle run (BEEP) test. Results: This study included 157 children, 89 (56.69%) boys and 68 (43.31%) girls. Children exposed to every day SHS in households had significantly lower values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF) (p < 0.001) and higher z-score BMI levels (p = 0.018) in comparison to unexposed children. Logistic regression showed that children unexposed to SHS had higher odds for better results in the BEEP test (OR 62.45, 95% CI 21.26–179.24, p < 0.001). Children with poorer physical fitness, expressed by lower BEEP score levels, had significantly lower FVC, FEV1, FEV1/FVC, and PEF (p < 0.001). Conclusions: Every day SHS exposure in children was associated with poorer lung function, higher BMI, and poorer physical fitness. Full article

(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)

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9 pages, 248 KiB

Open AccessBrief Report

Severity Profile of COVID-19 in Hospitalized Pediatric Patients

by Vânia Chagas da Costa, Ulisses Ramos Montarroyos, Katiuscia Araújo de Miranda Lopes and Ana Célia Oliveira dos Santos

Children 2024, 11(10), 1249; https://doi.org/10.3390/children11101249 - 16 Oct 2024

Viewed by 638

Abstract

Objective: We aimed to describe the clinical characteristics associated with severity in children hospitalized with COVID-19. Method: This was an epidemiological cohort study conducted in two hospitals, one of which was a reference center for the treatment of COVID-19 cases. Data were collected [...] Read more.

Objective: We aimed to describe the clinical characteristics associated with severity in children hospitalized with COVID-19. Method: This was an epidemiological cohort study conducted in two hospitals, one of which was a reference center for the treatment of COVID-19 cases. Data were collected from the reports generated by the hospital epidemiology centers and the medical records of patients aged between 0 and 14 years with a diagnosis of COVID-19, hospitalized between March 2020 and June 2021. To analyze the association between the clinical profile and severity, the cases were classified as severe (severe and critical) and non-severe (asymptomatic, mild, and moderate). Results: Of the 191 children followed up in the cohort, 73.3% developed the severe form. The percentage of children with oxygen saturation below 95% was 46.6%. In the multivariate analysis, a higher risk of severity was estimated among children with uncontrolled asthma (RR = 13.2), who were overweight or obese (RR = 3.21), who had cough symptoms (RR = 2.72), and those aged under one year (RR = 3.23). Conclusions: This result underscores the need to improve healthcare at every level for children and for the management of asthma and nutrition when considering children with this clinical profile who are diagnosed with COVID-19. Full article

(This article belongs to the Special Issue COVID-19 and Pediatric Emergency Medicine)

11 pages, 2283 KiB

Open AccessArticle

Prediction of Whole Liver Graft Weight Based on Biometric Variables in Paediatric and Adult Liver Donors

by Maria Kuksin, Valeska Bidault Jourdainne, Guillaume Rossignol, Philippe Aegerter, Géraldine Hery, Jean-Paul Teglas, Virginie Fouquet, Sophie Branchereau and Florent Guérin

Children 2024, 11(10), 1248; https://doi.org/10.3390/children11101248 - 16 Oct 2024

Viewed by 551

Abstract

Background/Objectives: In paediatric liver transplantation, donor–recipient compatibility depends on graft size. We explored whether the graft weight can be predicted using the donor’s biometric parameters. Methods: We used seven easily available biometric variables in 142 anonymised paediatric and adult donors, with data collected [...] Read more.

Background/Objectives: In paediatric liver transplantation, donor–recipient compatibility depends on graft size. We explored whether the graft weight can be predicted using the donor’s biometric parameters. Methods: We used seven easily available biometric variables in 142 anonymised paediatric and adult donors, with data collected between 2016 and 2022. The whole or partial liver was transplanted in our hospital from these donors. We identified the variables that had the strongest correlation to our response variable: whole liver graft weight. Results: In child donors, we determined two linear models: using donor weight and height on the one hand and using donor weight and right liver span on the other hand. Both models had a coefficient of determination R² = 0.86 and p-value < 10⁻⁵. We also determined two models in adult donors using donor weight and height (R² = 0.33, p < 10⁻⁴) and donor weight and sternal height (R² = 0.38, p < 10⁻⁴). The models proved valid based on our external dataset of 245 patients from two institutions. Conclusions: In clinical practise, our models could provide rapidly accessible estimates to determine whole graft dimension compatibility in liver transplantation in children and adults. Determining similar models predicting the left lobe and lateral segment weight could prove invaluable in paediatric transplantation. Full article

(This article belongs to the Special Issue New Advances in Pediatric Liver Transplantation)

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11 pages, 249 KiB

Open AccessArticle

Use of Over-The-Counter Analgesics Is Associated with Pain, Stress, and Quality of Life in Norwegian Adolescents: A Cross-Sectional Study

by Siv Skarstein, Sølvi Helseth, Milada Cvancarova, Kristin Haraldstad, Gudrun Rohde, Hilde Timenes Mikkelsen and Erik Grasaas

Children 2024, 11(10), 1247; https://doi.org/10.3390/children11101247 - 16 Oct 2024

Cited by 1 | Viewed by 820

Abstract

Introduction: Approximately 20% of Norwegian adolescents are frequently using Over-the-Counter Analgesics (OTCAs). The WHO emphasizes the need for research to identify the key determinants of health problems in adolescence. Thus, our aim was to describe and explore pain, stress, and Health-Related Quality [...] Read more.

Introduction: Approximately 20% of Norwegian adolescents are frequently using Over-the-Counter Analgesics (OTCAs). The WHO emphasizes the need for research to identify the key determinants of health problems in adolescence. Thus, our aim was to describe and explore pain, stress, and Health-Related Quality of Life (HRQOL) in Norwegian adolescents and investigate possible associations upon high/low usage of OTCAs. Methods: This cross-sectional study included 315 adolescents (92 boys, 223 girls) with an average age of 14.1 years (13–15 years). All participants reported using OTCAs. Weekly usage was categorized as high and less than weekly as low. Using a validated questionnaire, we explored the following variables: pain, as measured using the Brief Pain Inventory, stress (Perceived Stress Questionnaire), and HRQOL (KIDSSCREEN-27). Binary logistic regression models were conducted using IBM SPSS Statistics (version 27). Results: Our descriptive findings reveal that high users of OTCAs reported higher pain intensity of 3.4 (SD = 1.9) and perceived stress of 0.38 (SD = 0.18) compared to low users, who reported 2.5 (SD = 1.9) and 0.32 (SD = 0.16), respectively. High OTCA users reported lower average scores than low users across all HRQOL subscales. Binary logistic regression revealed 30% higher odds for higher levels of pain intensity and 14 times higher odds of perceived stress associated with being a high user of OTCAs compared to a low user. Conclusions: Our study shows significantly higher odds for experiencing pain and stress among adolescents using OTCAs daily-to-weekly, compared to those seldom using such medicines. Health professionals should be aware of young people who have a high consumption of OTCAs and investigate whether the use is related to pain or stress. This might be important in designing a personalized and appropriate intervention. Parents and caregivers have an important responsibility in supporting adolescents’ appropriate pain management. Longitudinal studies are needed to better explore predictive factors of OTCA use in adolescents, particularly in relation to psychological variables such as stress and quality of life. Full article

(This article belongs to the Section Pediatric Anesthesiology, Perioperative and Pain Medicine)

14 pages, 2952 KiB

Open AccessArticle

Prevalence of Antidepressant Prescription in Adolescents Newly Diagnosed with Depression in Germany

by Nimran Kaur, Corinna Doege and Karel Kostev

Children 2024, 11(10), 1246; https://doi.org/10.3390/children11101246 - 16 Oct 2024

Viewed by 879

Abstract

Background: Depression is the most common mental illness in the world, found in nearly three in ten adolescents globally. This study aims to evaluate the prevalence of antidepressant prescriptions and the types of antidepressant therapy administered among adolescents diagnosed with depression in Germany. [...] Read more.

Background: Depression is the most common mental illness in the world, found in nearly three in ten adolescents globally. This study aims to evaluate the prevalence of antidepressant prescriptions and the types of antidepressant therapy administered among adolescents diagnosed with depression in Germany. Methods: This retrospective cohort study, based on data provided by 30 child and adolescent psychiatrists, included adolescents aged 13–17 years with an initial diagnosis of depression between 2010 and 2022 (index date) documented in the IQVIA^TM Disease Analyzer database. Kaplan–Meier curves were used to investigate the one-year cumulative incidence of antidepressant prescriptions stratified by age, sex, and depression severity. Multivariable Cox regression analyses were used to assess the association between age, sex, depression severity, co-diagnoses, and antidepressant drug prescription. Results: A total of 6338 adolescents (mean age: 16 years, 67% female, 59% with moderate depression) were available. The cumulative incidence of antidepressant prescriptions was 61% and increased with age from 13 years old to 17 years old. Fluoxetine was the most prescribed drug, followed by Sertraline, Escitalopram, Serotonin and Norepinephrine reuptake inhibitors, herbal medications, and Mirtazapine. Obsessive–compulsive disorder and eating disorders were found to be significantly associated with antidepressant prescriptions within the spectrum of co-diagnosed conditions. Conclusions: Higher age, depression severity, and a co-diagnosis of an obsessive–compulsive disorder or eating disorder were significantly positively associated with antidepressant prescriptions in adolescents. Fluoxetine was the most frequently prescribed drug for depression. Full article

(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents: 2nd Edition)

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11 pages, 1298 KiB

Open AccessArticle

The Contribution of Sustained Attention and Response Inhibition to Reading Comprehension Among Japanese Adolescents

by Inbar Lucia Trinczer, Yarden Dankner, Shira Frances-Israeli, Yoshi A. Okamoto, Dav Clark and Lilach Shalev

Children 2024, 11(10), 1245; https://doi.org/10.3390/children11101245 - 16 Oct 2024

Viewed by 840

Abstract

Background: Previous studies demonstrated the influential role of sustained attention in the reading comprehension of alphabetic writing systems. However, there is limited understanding of how these cognitive functions contribute to reading comprehension in non-alphabetic systems, such as Japanese. This study seeks to explore [...] Read more.

Background: Previous studies demonstrated the influential role of sustained attention in the reading comprehension of alphabetic writing systems. However, there is limited understanding of how these cognitive functions contribute to reading comprehension in non-alphabetic systems, such as Japanese. This study seeks to explore this gap, focusing on how sustained attention and response inhibition function in a writing system where some of the characters represent meanings rather than sounds, introducing another layer of difficulty in the complex process of reading; Methods: Seventy-five Japanese 9th grade students performed a task to assess sustained attention and response inhibition. The cognitive test was carried out using tablets to enable feasible parallel group administration while maintaining high comparability with ecological classroom settings. Reading comprehension was measured using an exam that the participants took as part of their educational routine; Results: Our results indicate that both sustained attention and response inhibition significantly contributed to the reading comprehension of Japanese 9th grade students; Conclusions: These results replicate and expand previous studies documenting the contribution of sustained attention on the reading comprehension of alphabetic writing systems to a non-alphabetic system. Moreover, our findings unravel another important cognitive factor, namely response inhibition in reading comprehension. We suggest that response inhibition may play a crucial role in reading non-alphabetic writing systems that pose high cognitive demands, such as Japanese. Full article

(This article belongs to the Special Issue Cognitive and Linguistic Development in Children and Adolescents)

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11 pages, 250 KiB

Open AccessArticle

The Associations between Depressive Symptoms and Self-Rated Health in Relation to Sense of Coherence among Adolescents: Cross-Sectional Study

by Vilija Malinauskiene and Romualdas Malinauskas

Children 2024, 11(10), 1244; https://doi.org/10.3390/children11101244 - 16 Oct 2024

Viewed by 529

Abstract

Background: We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7–8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors. Methods: A total of 2104 7th–8th-grade [...] Read more.

Background: We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7–8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors. Methods: A total of 2104 7th–8th-grade students participated (response rate 73.95%) and were asked about depressive symptoms, psychosomatic health complaints, negative acts at school, feeling at school, family stress and violence, sense of coherence, self-esteem, and lifestyle. We used a hierarchical regression analysis including a variety of self-rated health predictors. Results: Boys scored significantly higher on physical activity and smoking, whereas girls scored significantly higher on SRH, depressive symptoms, psychosomatic health complaints, and family stress and violence, though the significance was lost in the hierarchical regression. Depressive symptoms were the strongest predictor of poor SRH (standardized β = 0.309, p < 0.001), though other investigated predictors were also significant but had lower effect sizes. Strong evidence was found supporting the buffering role of sense of coherence in the relationship between depressive symptoms and SRH (standardized β = −0.266, p < 0.001). Conclusions: We can conclude that the magnitude of the relationship between depressive symptoms and self-rated health is dependent on the levels of sense of coherence. We did not find gender differences in those associations. As poor SRH is easy to determine, especially with a one-item question, the cases of poorly rated health should be detected early and corrected by interventions in order to prevent poor health outcomes in the future. Full article

(This article belongs to the Special Issue Advances in Mental Health and Well-Being in Children)

15 pages, 991 KiB

Open AccessArticle

The MapMe Body Scales: Validity and Reliability of a Biometrically Accurate, Photorealistic Set of Child Body Size Scales

by Bethany J. Ridley, Elizabeth H. Evans, Piers L. Cornelissen, Robin S. S. Kramer and Martin J. Tovée

Children 2024, 11(10), 1243; https://doi.org/10.3390/children11101243 - 16 Oct 2024

Cited by 1 | Viewed by 886

Abstract

Background/Objectives: It is vital to identify children whose weight status means that they may benefit from medical or behavioural support, but adult visual judgements of child weight status are inaccurate, and children are seldom routinely weighed and measured. Consequently, there is a need [...] Read more.

Background/Objectives: It is vital to identify children whose weight status means that they may benefit from medical or behavioural support, but adult visual judgements of child weight status are inaccurate, and children are seldom routinely weighed and measured. Consequently, there is a need for validated visual tools for use in training, communication, and interventions relating to child weight. Methods: This paper presents validation data for a set of innovative photo-realistic colour body size scales depicting boys and girls aged 4–5 and 10–11. Each age- and gender-specific scale consists of 7 figures based on three-dimensional (3D) scans of 388 children to accurately represent the change in body size caused by changing adiposity. To assess scale validity, 238 adult participants (105 men, 132 women, 1 non-binary individual) undertook two tasks: rating figure adiposity using a visual analogue scale and ranking figures in ascending order of adiposity (OSF Reference: gdp9j). Results: Participants accurately estimated the relative adiposity of each figure, i.e., they were able to tell the difference between figures and correctly rank them by size. This demonstrates scale validity for use in body size tasks. One hundred and fifty-one participants also provided 3-day test–retest data, which demonstrates excellent short-term reliability. Conclusions: Overall, the MapMe child body size scales provide an anthropometrically accurate, valid, reliable, and usable tool for size-related tasks and communication with adults regarding child weight. Full article

(This article belongs to the Section Pediatric Endocrinology & Diabetes)

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15 pages, 272 KiB

Open AccessArticle

Perceived Experiences of Families of Children with Unilateral Cerebral Palsy in the Implementation of a Task-Specific Intervention in the Home Environment with an Upper Limb Splint: A Qualitative Study

by Patricia Roldán-Pérez, Vanesa Abuín-Porras, Isabel Rodríguez-Costa, María Ortiz-Lucas, Pablo Bellosta-López and Almudena Buesa-Estéllez

Children 2024, 11(10), 1242; https://doi.org/10.3390/children11101242 - 15 Oct 2024

Viewed by 616

Abstract

Introduction: Specific home tasks and the use of splints seem to positively affect altered structures and functions, as well as the activities and participation, of children with unilateral cerebral palsy (UCP). However, how did families experience the implementation of these therapies? Objective: To [...] Read more.

Introduction: Specific home tasks and the use of splints seem to positively affect altered structures and functions, as well as the activities and participation, of children with unilateral cerebral palsy (UCP). However, how did families experience the implementation of these therapies? Objective: To describe the experiences as they were perceived by the families of children with UCP before, during, and after a specific task intervention in the home environment, either with or without upper limb splinting. Methods: A qualitative, descriptive, phenomenological study was conducted in a natural environment. Fourteen families caring for children with UCP who participated in a previous randomized controlled trial were included. Data from unstructured and semi-structured interviews were analyzed through a thematic analysis. Results: Fourteen families (17 parents, age 37–47 years) caring for children with UCP (14 children, ages 6–10 years, 64% female) were interviewed. The following three themes emerged: “The project itself”, in which families explained that they enrolled because of their trust in therapists; “Results obtained”, where the main improvement was the integration of the assisting hand in the body schema; and “Lights and shadows”, where families showed what they learned as positive points and some negative aspects related to the assessments and splints. Conclusions: The perceptions of the parents after the specific task intervention in the home environment showed a greater integration of the most affected side. Nevertheless, although the support of a splint on the hand can have beneficial results in terms of performance, other drawbacks leading to the disuse of the splint were highlighted. Full article

(This article belongs to the Special Issue Telehealth and Home-Centered Approaches for Children and Adolescents)

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