Children

11 pages, 425 KiB

Open AccessArticle

Left Ventricular Longitudinal Strain Abnormalities in Childhood Exposure to Anthracycline Chemotherapy

by Arnaud Rique, Jennifer Cautela, Franck Thuny, Gérard Michel, Caroline Ovaert and Fedoua El Louali

Children 2024, 11(3), 378; https://doi.org/10.3390/children11030378 - 21 Mar 2024

Viewed by 1293

Abstract

Current mortality is low in cases of childhood acute leukemia. Dilated cardiomyopathy induced by anthracyclines remains the main cause of morbidity and mortality during mid-term and long-term follow-up. The aim of our study was to analyze the profile of left ventricular alterations in [...] Read more.

Current mortality is low in cases of childhood acute leukemia. Dilated cardiomyopathy induced by anthracyclines remains the main cause of morbidity and mortality during mid-term and long-term follow-up. The aim of our study was to analyze the profile of left ventricular alterations in children treated with anthracyclines and to analyze risks and protective factors, including physical activity. Children and young adults with acute leukemia treated with anthracyclines between 2000 and 2018 during childhood were included. The physical activity performed by the patients before and after treatment was quantified in metabolic equivalent tasks, MET.h, per week. An echocardiographic assessment was performed, including strain analysis. Thirty-eight patients with a median age of 5 [3–8] years were included. Dilated cardiomyopathy was diagnosed in 3 patients and longitudinal strain abnormalities were observed in 11 patients (28.9%). Radiotherapy, cumulative anthracycline doses > 240 mg/m², and the practice of physical activity > 14 MET.h per week (after leukemia treatment) were independently associated with strain abnormalities. In multivariate analysis, radiotherapy was significantly associated with an increased risk of LV GLS abnormalities (OR = 1.26 [1.01–1.57], p = 0.036), and physical activity > 14 MET.h/week after oncological treatment was significantly associated with a reduction in the risk of LV GLS abnormalities (OR of 0.03 [0.002–0.411], p = 0.009). The strain assessment of left ventricular function is an interesting tool for patient follow-up after leukemia treatment. Moderate and steady physical activity seems to be associated with fewer longitudinal strain abnormalities in patients treated with anthracyclines during childhood. Full article

(This article belongs to the Special Issue Heart Failure in Children and Adolescents)

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14 pages, 321 KiB

Open AccessReview

Current Uses of Bromelain in Children: A Narrative Review

by Cristian Locci, Elena Chicconi and Roberto Antonucci

Children 2024, 11(3), 377; https://doi.org/10.3390/children11030377 - 21 Mar 2024

Viewed by 3693

Abstract

Bromelain is a complex natural mixture of sulfhydryl-containing proteolytic enzymes that can be extracted from the stem or fruit of the pineapple. This compound is considered a safe nutraceutical, has been used to treat various health problems, and is also popular as a [...] Read more.

Bromelain is a complex natural mixture of sulfhydryl-containing proteolytic enzymes that can be extracted from the stem or fruit of the pineapple. This compound is considered a safe nutraceutical, has been used to treat various health problems, and is also popular as a health-promoting dietary supplement. There is continued interest in bromelain due to its remarkable therapeutic properties. The mechanism of action of bromelain appears to extend beyond its proteolytic activity as a digestive enzyme, encompassing a range of effects (mucolytic, anti-inflammatory, anticoagulant, and antiedematous effects). Little is known about the clinical use of bromelain in pediatrics, as most of the available data come from in vitro and animal studies, as well as a few RCTs in adults. This narrative review was aimed at highlighting the main aspects of the use of bromelain in children, which still appears to be limited compared to its potential. Relevant articles were identified through searches in MEDLINE, PubMed, and EMBASE. There is no conclusive evidence to support the use of bromelain in children, but the limited literature data suggest that its addition to standard therapy may be beneficial in treating conditions such as upper respiratory tract infections, specific dental conditions, and burns. Further studies, including RCTs in pediatric settings, are needed to better elucidate the mechanism of action and properties of bromelain in various therapeutic areas. Full article

(This article belongs to the Special Issue Effectiveness and Safety of Drugs for Children)

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13 pages, 3099 KiB

Open AccessSystematic Review

Short and Long-Term Outcomes of PSARP versus LAARP and Single versus Staged Repair for Infants with High-Type Anorectal Malformations: A Systematic Review and Meta-Analysis

by Maria Enrica Miscia, Giuseppe Lauriti, Dacia Di Renzo, Valentina Cascini and Gabriele Lisi

Children 2024, 11(3), 376; https://doi.org/10.3390/children11030376 - 21 Mar 2024

Viewed by 1398

Abstract

Background: We aimed to compare among patients with high-type anorectal malformations (ARM): (i) short- and long-term outcomes of laparoscopic-assisted anorectoplasty (LAARP) compared to classic posterior sagittal anorectoplasty (PSARP) and (ii) the results of single-stage versus staged PSARP. Methods: Using a defined search strategy, [...] Read more.

Background: We aimed to compare among patients with high-type anorectal malformations (ARM): (i) short- and long-term outcomes of laparoscopic-assisted anorectoplasty (LAARP) compared to classic posterior sagittal anorectoplasty (PSARP) and (ii) the results of single-stage versus staged PSARP. Methods: Using a defined search strategy, two independent investigators systematically reviewed the English literature. PRISMA guidelines were followed, and meta-analysis was performed using RevMan5.3. Results: Of 567 abstracts screened, 7 papers have been included (254 pts; 121 PSARP, 133 LAARP) in the first systematic review and meta-analysis. The length of hospitalization was shortened in LAARP versus PSARP (10.9 versus 14.4 days; p < 0.0001). PSARP and LAARP were comparable in terms of early postoperative complications (28.9% versus 24.7%; p = ns) and rectal prolapse (21.6% versus 17.5%; p = ns). At long-term follow-up, the presence of voluntary bowel movements (74.0% versus 83.5%; p = ns) and the incidence of soiling (45.5% versus 47.6%; p = ns) were similar in both PSARP and LAARP. Six papers (297 pts) were included in the second systematic review, with three comparative studies included in the meta-analysis (247 pts; 117 one-stage, 130 staged procedures). No significant difference in terms of presence of voluntary bowel movements after single-stage versus staged procedures (72.6% versus 67.3%; p = ns) has been detected. Conclusions: LAARP seems to be a safe and effective procedure, showing short- and long-term outcomes similar to PSARP. One-stage PSARP could be a safe alternative to the classic three-stage procedure, even for those infants with high-type ARM. Further and larger comparative studies would be needed to corroborate these partial existing data. Full article

(This article belongs to the Section Pediatric Surgery)

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3 pages, 181 KiB

Open AccessEditorial

Editorial for the Special Issue “New Research in Childhood Nutrition” of the Journal Children

by Jose Joaquín Muros

Children 2024, 11(3), 375; https://doi.org/10.3390/children11030375 - 21 Mar 2024

Viewed by 1066

Abstract

Nutrition is much more than food [...] Full article

6 pages, 206 KiB

Open AccessBrief Report

Off-Label Yellow Fever and Hepatitis A Vaccination in Traveling Children

by Cecilia Muruzábal, Lorea Vicente, Lucía Escolano Taravillo, Blanca Bravo Queipo de Llano, Cristina Calvo and Milagros García López Hortelano

Children 2024, 11(3), 374; https://doi.org/10.3390/children11030374 - 21 Mar 2024

Viewed by 1389

Abstract

There are few data on yellow fever (YF) and hepatitis A (HA) off-label vaccination. Given the rising trend of travel to endemic countries, there is a growing necessity to broaden vaccination coverage among the pediatric population. For this reason, we aim to assess [...] Read more.

There are few data on yellow fever (YF) and hepatitis A (HA) off-label vaccination. Given the rising trend of travel to endemic countries, there is a growing necessity to broaden vaccination coverage among the pediatric population. For this reason, we aim to assess the adverse effects associated with off-label vaccination, with the ultimate purpose of expanding the vaccine spectrum. We analyzed ambispectively ninety-four children under 12 months of age who received YF or HA off-label vaccines. The YF vaccine was administered to children aged 6–9 months and those allergic to eggs (with a prior negative prick test and no history of anaphylaxis), while the HA vaccine was given to children aged 6–12 months. Overall, 71 (75%) were vaccinated against YF, and 57 (60%) against HA; 34 against both. All of them fulfilled off-label vaccination criteria. No immediate adverse effects (AEs) were reported. Mild common AEs (diarrhea, fever, or malaise) were experienced by 10.8% of patients within 10 days after vaccination. The rate of AEs associated with off-label vaccination for HA and YF is low, suggesting that the vaccines could be considered safe. Full article

15 pages, 836 KiB

Open AccessArticle

Maternal Humming during Kangaroo Care: Effects on Preterm Dyads’ Physiological Parameters

by Maria Eduarda Salgado Carvalho and João Manuel Rosado Miranda Justo

Children 2024, 11(3), 373; https://doi.org/10.3390/children11030373 - 21 Mar 2024

Viewed by 1883

Abstract

Humming is probably more effective than speech for improving mothers’ cardiorespiratory function and infants’ self-regulation. We intend to understand the effects of (1) maternal humming vs. speech on preterm infants’ physiological parameters, (2) maternal humming vs. speech on mothers’ physiological parameters, and (3) [...] Read more.

Humming is probably more effective than speech for improving mothers’ cardiorespiratory function and infants’ self-regulation. We intend to understand the effects of (1) maternal humming vs. speech on preterm infants’ physiological parameters, (2) maternal humming vs. speech on mothers’ physiological parameters, and (3) humming melodic contours and the process of the lengthening of the final note on preterm infants’ physiological parameters. This study was designed as a single-group repeated measures study, using microanalytical methodology (ELAN software version 4.9.4), with a protocol (silent baseline/speech, humming/silence/humming, or speech/silence) applied to preterm dyads (N = 36). Audio and video observations were recorded. Infants’ and mothers’ heart rates (HR) and O₂ saturations were observed once a minute. The proportion of O₂ saturation relative to HR (Prop. O₂ saturation/HR) was estimated for both partners during the protocol. We found that the infants’ HR mean was significantly lower during humming (p = 0.028), while a significantly higher Prop. O₂ saturation/HR ratio was recorded during humming for infants (p = 0.027) and mothers (p = 0.029). The duration of sinusoidal contours, together with the lengthening of the final note, predicts infants’ Prop. O₂ saturation/HR ratio. Musical features of humming seem to improve the physiological stability of preterm infants during kangaroo care. Full article

(This article belongs to the Section Pediatric Neonatology)

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20 pages, 300 KiB

Open AccessArticle

Assessment of Psychotic Risk in a Sample of Children and Adolescents with Autism Spectrum Disorder Compared to a Group of “Clinical High Risk” Patients: A Preliminary Study

by Valeria Mammarella, Elena Monducci, Alessia Maffucci, Letizia Terenzi, Mauro Ferrara and Carla Sogos

Children 2024, 11(3), 372; https://doi.org/10.3390/children11030372 - 21 Mar 2024

Viewed by 1900

Abstract

1. Background: Autism spectrum disorder and psychotic risk show several overlapping symptoms, so differential diagnosis is often difficult. In addition, there is a high rate of comorbidity between the two conditions, which further complicates the work of clinicians. We evaluated the presence of [...] Read more.

1. Background: Autism spectrum disorder and psychotic risk show several overlapping symptoms, so differential diagnosis is often difficult. In addition, there is a high rate of comorbidity between the two conditions, which further complicates the work of clinicians. We evaluated the presence of subthreshold psychotic symptoms and/or defined psychotic risk syndromes in autistic children and adolescents; we compared the prevalence, type, and severity of psychotic risk symptoms with those of a group of non-autistic patients at clinical high risk for psychosis (CHR-P). 2. Methods: In total, 23 autistic patients and 14 CHR-P patients without autism (aged 8–17) were enrolled in the study. The main assessment was made through clinical interviews for autism (Autism Diagnostic Observation Schedule, Second Edition—ADOS-2, Autism Diagnostic Interview, Revised—ADI-R) and psychotic risk (Schizophrenia Proneness Instrument, Child and Youth version—SPI-CY, Structured Interview for Psychosis Risk Syndromes—SIPS). 3. Results: No above-threshold psychotic risk symptoms were detected in our autistic patients, but subthreshold psychotic symptoms were identified in all areas. Specific items from all four dimensions of SIPS appear to be more specific for psychotic risk than autism without comorbidity. 4. Conclusions: An a priori screening of psychotic risk in neurodiverse populations is fundamental to prevent more severe conditions. Research should clarify the effective specificity of the available tools to modify them to improve their detection capability. Full article

(This article belongs to the Special Issue Children with Specific Neurodevelopmental Disorders: Assessment and Intervention)

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13 pages, 7071 KiB

Open AccessCase Report

Infective Endocarditis in Children as an Increasing Clinical Problem—A Case Series

by Urszula Abramczyk, Paweł Cześniewicz and Jacek Kusa

Children 2024, 11(3), 371; https://doi.org/10.3390/children11030371 - 20 Mar 2024

Viewed by 1990

Abstract

In September 2023, the European Society of Cardiology (ESC) published new guidelines for the management of endocarditis. Infective endocarditis (IE) remains a significant life-threatening disease, concerning an increasingly younger age group, especially children with congenital heart disease (CHD) and young adults after multiple [...] Read more.

In September 2023, the European Society of Cardiology (ESC) published new guidelines for the management of endocarditis. Infective endocarditis (IE) remains a significant life-threatening disease, concerning an increasingly younger age group, especially children with congenital heart disease (CHD) and young adults after multiple cardiac surgeries. This study’s aim was to alert the medical community to the problem of increasing IE case numbers and IE course complexity. Of the eight patients who suffered from IE treated in 2023 in our department, we describe the four whose course was the most extraordinary. Afterward, we compared the number of IE patients treated over the years in our department. All cases described children with congenital heart disease suffering from IE. The IE clinical presentation in all patients was extremely diverse, necessitating the utilization of all available diagnostic methods. Each child underwent specialized treatment and subsequently qualified for cardiac surgery. While the etiology and treatment of IE are well established, it remains a formidable challenge for physicians. Pediatric patients who have undergone multiple cardiac surgeries constitute a steadily expanding group and are especially susceptible to IE throughout their lives. Currently, no recommendations exist for the management of endocarditis in pediatric patients. This gap compels pediatricians to adapt existing guidelines designed for adult patients and to rely on scientific reports, such as case studies. Full article

(This article belongs to the Section Pediatric Cardiology)

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11 pages, 1554 KiB

Open AccessArticle

Association between Thyroid Function and Insulin Resistance Indices in Korean Adolescents: Findings from the 2014–2015 Korea National Health and Nutrition Examination Survey

by Eunji Mun, Hye Ah Lee, Jung Eun Choi, Rosie Lee, Kyung Hee Kim, Hyesook Park and Hae Soon Kim

Children 2024, 11(3), 370; https://doi.org/10.3390/children11030370 - 20 Mar 2024

Cited by 1 | Viewed by 1419

Abstract

Aim: This study investigated the sex-specific association between thyroid function and various insulin resistance (IR) indices, including noninsulin-based IR indices, in euthyroid adolescents. Methods: A total of 465 adolescents (aged 12–18 years; 255 boys and 210 girls) based on data from the 2014–2015 [...] Read more.

Aim: This study investigated the sex-specific association between thyroid function and various insulin resistance (IR) indices, including noninsulin-based IR indices, in euthyroid adolescents. Methods: A total of 465 adolescents (aged 12–18 years; 255 boys and 210 girls) based on data from the 2014–2015 Korea National Health and Nutrition Examination Survey were included. Serum thyrotropin (thyroid-stimulating hormone [TSH]) and free thyroxine (fT4) were used to assess thyroid function, whereas the homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), glucose/insulin ratio (GIR), triglyceride–glucose (TyG) index, and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio were used to assess IR. The relationship between thyroid function and IR was analyzed using multiple linear regressions stratified by sex, considering obesity status. Results: The relationship between thyroid function and IR varied depending on sex and was more pronounced in the overweight/obesity subgroup for both boys and girls. In overweight and obese boys and girls, fT4 was significantly associated with HOMA-IR and QUICKI with conflicting association directions. TSH was also positively associated with the TyG index in both sexes. Conclusions: The findings suggest that the relationship between thyroid function and IR in adolescents might vary depending on sex, and the degree of association was significant in obese adolescents. Full article

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

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11 pages, 1052 KiB

Open AccessArticle

The Role of Endoscopic Assistance in Surgery for Pediatric Cholesteatoma in Reducing Residual and Recurrent Disease

by Nader Nassif and Luca Oscar Redaelli de Zinis

Children 2024, 11(3), 369; https://doi.org/10.3390/children11030369 - 20 Mar 2024

Viewed by 1230

Abstract

The primary aim of this study was to evaluate long-term recurrent and residual disease after surgery for acquired cholesteatoma in children according to surgical approach. A total of 71 interventions performed on 67 pediatric patients were included in the study. Canal wall-up tympanomastoidectomy [...] Read more.

The primary aim of this study was to evaluate long-term recurrent and residual disease after surgery for acquired cholesteatoma in children according to surgical approach. A total of 71 interventions performed on 67 pediatric patients were included in the study. Canal wall-up tympanomastoidectomy (CWUT) was performed in 31 ears (13 with endoscopic assistance), a transcanal esclusive endoscopic approach (TEEA) was used in 22, and canal wall-down tympanomastoidectomy (CWDT) was performed in 18. Overall, the cholesteatoma relapse rate estimated by the Kaplan–Meier method was 47 ± 6% at 12 years; the recurrent cholesteatoma rate was 28 ± 6% and the residual cholesteatoma rate was 26 ± 5%. The relapse rate according to surgical approach was 33 ± 11% for CWDT, 60 ± 9% for CWUT, and 40 ± 11% for TEEA (p = 0.04). The difference for recurrent disease was no recurrent disease for CWDT, 42 ± 9% for CWUT, and 32 ± 11% for TEEA (p = 0.01). The residual disease rate was significantly reduced with endoscopy: 42 ± 8% without endoscopy vs. 9 ± 5% with (p = 0.003). CWDT can still be considered in primary surgery in case of extensive cholesteatomas and small mastoid with poor pneumatization. TEEA can be recommended for small cholesteatoma not extending to the mastoid to reduce morbidity. Endoscopic assistance seems useful to reduce residual disease in CWUT, whereas it does not have a significant impact on preventing recurrent disease. Full article

(This article belongs to the Special Issue Minimally Invasive Surgery in Pediatric Otorhinolaryngology)

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12 pages, 3523 KiB

Open AccessArticle

Utilizing Peripheral Nerve Blocks for Pain Management in Pediatric Patients during Embolization and Sclerotherapy for Vascular Malformations

by Matthew Kocher, Maria Evankovich, Danielle R. Lavage, Sabri Yilmaz, Senthilkumar Sadhasivam and Mihaela Visoiu

Children 2024, 11(3), 368; https://doi.org/10.3390/children11030368 - 20 Mar 2024

Viewed by 1320

Abstract

Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate-to-severe pain. This study aims to evaluate the [...] Read more.

Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate-to-severe pain. This study aims to evaluate the utilization of peripheral nerve blocks in opioid consumption, pain scores, and length of stay. A retrospective chart review was conducted at the UPMC Children’s Hospital of Pittsburgh for all patients who underwent embolization and sclerotherapy between 2011 and 2020. Patient data were collected to compare opioid consumption, pain scores, and length of stay. In total, 854 procedures were performed on 347 patients. The morphine milligram equivalent per kilogram mean difference between groups was 0.9 (0.86, 0.95) with a p-value of <0.001. The pain score mean ratio was −1.17 (−2.2, −0.1) with a p-value of 0.027. The length of stay had an incident rate ratio of 0.94 (0.4, 2) and a p-value of 0.875. By decreasing opioid consumption and postoperative pain scores, peripheral nerve blocks may have utility in patients undergoing embolization and sclerotherapy while not clinically increasing the length of stay for patients. Their use should be individualized and carefully discussed with the interventional radiologist. Full article

(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)

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12 pages, 633 KiB

Open AccessReview

Review of Opsoclonus-Myoclonus Ataxia Syndrome in Pediatric Patients

by Mandy Hsu, Isbaah Tejani, Nidhi Shah, Rasaq Olaosebikan, Ashutosh Kumar and Sunil Naik

Children 2024, 11(3), 367; https://doi.org/10.3390/children11030367 - 19 Mar 2024

Viewed by 3302

Abstract

Opsoclonus-myoclonus ataxia syndrome (OMAS), also known as Kinsbourne syndrome, is a rare disorder that presents with myoclonus, ataxia, abnormal eye movements, irritability, and sleep disruptions, often in young children. We report a case of an infant barely 6 months old, with no significant [...] Read more.

Opsoclonus-myoclonus ataxia syndrome (OMAS), also known as Kinsbourne syndrome, is a rare disorder that presents with myoclonus, ataxia, abnormal eye movements, irritability, and sleep disruptions, often in young children. We report a case of an infant barely 6 months old, with no significant past medical history, who presented to the emergency department with tremors, jerking motions of the head and arms, and rapid eye movements. After an extensive workup, she was found to have a neuroblastoma, which was subsequently surgically removed via thoracotomy. Despite an initial improvement in symptoms post-resection, the patient’s symptoms recurred. She was subsequently treated with dexamethasone, intravenous immunoglobulin (IVIG), and rituximab. After treatment, the patient was noted to have mild global developmental delays but was otherwise well. This case report highlights the rare occurrence of OMAS in an infant barely 6 months old at diagnosis. Using the PubMed database, a systematic review was conducted to highlight the clinical presentation, diagnosis, and management of OMAS. Full article

(This article belongs to the Section Pediatric Neonatology)

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13 pages, 276 KiB

Open AccessArticle

Dental Anomalies in Primary Dentition among Arabian Children: A Hospital-Based Study

by Sreekanth Kumar Mallineni, Abdullah Alassaf, Basim Almulhim and Sara Alghamdi

Children 2024, 11(3), 366; https://doi.org/10.3390/children11030366 - 19 Mar 2024

Viewed by 1586

Abstract

An observational study was carried out in a teaching hospital in Saudi Arabia to determine the occurrence of dental anomalies among Arabian children. The study included children of Saudi nationality with primary teeth. The study assessed the prevalence of dental anomalies in their [...] Read more.

An observational study was carried out in a teaching hospital in Saudi Arabia to determine the occurrence of dental anomalies among Arabian children. The study included children of Saudi nationality with primary teeth. The study assessed the prevalence of dental anomalies in their primary dentition. The assessment and data collection were conducted by a single examiner, utilizing clinical examination and intra-oral radiographs. A comparative analysis was conducted to examine dental anomalies in relation to gender (boys and girls) and arch type (maxillary and mandibular). In addition, the study explored the occurrence of gender-specific dental anomalies depending on arch type. The data analysis was conducted using IBM Statistics (version 21.0) with a significance level of p < 0.05. In total, there were 245 children included in the final analysis. The study population consisted of boys (66%) and girls (34%), with an average age of 4.87 ± 0.9 years. Taurodontism was the most prevalent dental abnormality, occurring in 2.8% of the individuals in the study sample. The study sample exhibited hypodontia in 2%, supernumerary teeth in 2.4%, double teeth in 2%, and microdontia in 1.2%. Talon cusp and macrodontia have a relatively low incidence of 0.4%. Boys exhibit supernumerary teeth, microdontia, macrodontia, talon cusp, and taurodontism, whereas hypodontia and double teeth were more frequent in girls. Full article

(This article belongs to the Special Issue New Research Progress of Clinical Pediatric Dentistry)

14 pages, 942 KiB

Open AccessArticle

The Kumagai Method Utilizing the Pigeon Bottle Feeder with a Long Nipple: A Descriptive Study for the Development of Feeding Techniques for Children with Cleft Lip and/or Palate

by Shingo Ueki, Yukari Kumagai, Yumi Hirai, Eri Nagatomo, Shoko Miyauchi, Takuro Inoue, Qi An and Junko Miyata

Children 2024, 11(3), 365; https://doi.org/10.3390/children11030365 - 19 Mar 2024

Cited by 2 | Viewed by 1795

Abstract

We aimed to identify the steps involved in the Kumagai method—an experimental nursing procedure to feed children with cleft lip and/or palate, using a feeder with a long nipple. We conducted a descriptive study, enrolling five specialist nurses who have mastered the Kumagai [...] Read more.

We aimed to identify the steps involved in the Kumagai method—an experimental nursing procedure to feed children with cleft lip and/or palate, using a feeder with a long nipple. We conducted a descriptive study, enrolling five specialist nurses who have mastered the Kumagai method. Their approaches were examined using structured interviews. Moreover, the participants were asked to perform the sequence of actions involved in this method while describing each step. Therefore, we were able to explore the Kumagai method in depth and step-by-step, including the following aspects: correct infant posture; correct feeding bottle holding position; nipple insertion into the child’s mouth; and feeding process initiation, maintenance, and termination. Each step comprises several clinically relevant aspects aimed at encouraging the infant to suck with a closed mouth and stimulating chokubo-zui, i.e., simulation of the natural tongue movement during breastfeeding in children without a cleft palate. In conclusion, when performed correctly, the Kumagai method improves feeding efficiency in children with cleft lip and/or palate. Feeders with long nipples are rarely used in clinical practice; the Kumagai method might popularize their use, thereby improving the management of feeding practices for children with cleft lip and/or palate. Full article

(This article belongs to the Special Issue Infant Feeding: Advances and Future Challenges)

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11 pages, 1290 KiB

Open AccessArticle

A Longitudinal Study of the Development of Executive Function and Calibration Accuracy

by Marios Goudas, Evdoxia Samara and Athanasios Kolovelonis

Children 2024, 11(3), 364; https://doi.org/10.3390/children11030364 - 19 Mar 2024

Viewed by 1119

Abstract

This longitudinal study examined the development of executive function and calibration accuracy in preadolescents. This study’s sample consisted of 262 students (127 females) from grades 4 (n = 91), 5 (n = 89), and 6 (n = 82) who took [...] Read more.

This longitudinal study examined the development of executive function and calibration accuracy in preadolescents. This study’s sample consisted of 262 students (127 females) from grades 4 (n = 91), 5 (n = 89), and 6 (n = 82) who took measures of executive function and performance calibration in a sport task three times over 20 months. A latent growth-curve modeling analysis showed a significant relationship between the rates of change of executive function and calibration accuracy. The results also showed a dynamic interplay in the development of executive function and calibration accuracy. There were significant interindividual differences in the estimated population means both in executive function and calibration accuracy and in the rate of change of executive function, but not in the rate of change of calibration accuracy. The age of the participants had a positive effect only on the estimated population mean of executive function. Full article

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26 pages, 618 KiB

Open AccessReview

The Relationship between Physical Activity, Physical Fitness, Cognition, and Academic Outcomes in School-Aged Latino Children: A Scoping Review

by J. P. Marrero-Rivera, Olivia Sobkowiak, Aimee Sgourakis Jenkins, Stefano J. Bagnato, Christopher E. Kline, Benjamin DH Gordon and Sharon E. Taverno Ross

Children 2024, 11(3), 363; https://doi.org/10.3390/children11030363 - 19 Mar 2024

Cited by 2 | Viewed by 2330

Abstract

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research [...] Read more.

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5–18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations. Full article

(This article belongs to the Special Issue Health Benefits of Physical Activity for Children and Adolescents)

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14 pages, 264 KiB

Open AccessArticle

Exploring Facilitators and Barriers to Physical Activity for Families of Rural Preschoolers Participating in a Motor Skill Program

by Amanda Campbell, Jill Lassiter, Michael Ertel, Andrea R. Taliaferro, Mackenzie L. Walker and Ali S. Brian

Children 2024, 11(3), 362; https://doi.org/10.3390/children11030362 - 19 Mar 2024

Cited by 1 | Viewed by 2211

Abstract

While schools provide one opportunity to encourage physical activity, caregivers play an exceedingly important role in creating an environment conducive to preschool children’s physical activity. Yet, little is known regarding the perceptions of caregivers, important choice agents for young children’s physical activity behavior [...] Read more.

While schools provide one opportunity to encourage physical activity, caregivers play an exceedingly important role in creating an environment conducive to preschool children’s physical activity. Yet, little is known regarding the perceptions of caregivers, important choice agents for young children’s physical activity behavior after participating in a motor skill program. The purpose of this study was to examine caregivers’ perceptions of facilitators and barriers to children’s physical activity at home among rural, low-income families who participated in a school-based early childhood physical activity program, SKIPping with PALS, designed to increase physical activity and improve motor development. Eleven caregivers consented to participate in a semi-structured interview regarding their perceptions of physical activity and their experience after six months of participation in the program. An inductive, naturalistic evaluation approach was utilized for qualitative data analysis, following the six recursive phases of thematic analysis. A review of the interview transcripts revealed that all caregivers valued physical activity and encouraged their children to be active. Four major facilitators, four major barriers, and an overarching theme of parental support for childhood physical activity were identified. These factors are largely circumstantial and attitudinal and, thus, are difficult to modify but are important to be cognizant of when designing interventions. Full article

(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)

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18 pages, 916 KiB

Open AccessArticle

Examining the Utility of the Early Childhood Development Index (ECDI) among Children in the Nigeria Context

by Ngozi V. Enelamah, Smitha Rao, Margaret Lombe, Mansoo Yu, Chrisann Newransky, Melissa L. Villodas, Andrew Foell and Von Nebbitt

Children 2024, 11(3), 361; https://doi.org/10.3390/children11030361 - 19 Mar 2024

Cited by 1 | Viewed by 1832

Abstract

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses [...] Read more.

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families. Full article

(This article belongs to the Special Issue Promoting Positive Development in Children and Adolescents: Social Emotional Skills, Internalizing Symptoms, and Externalizing Behaviors)

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11 pages, 1070 KiB

Open AccessArticle

Neurofilament Light Chain Concentration in Cerebrospinal Fluid in Children with Acute Nontraumatic Neurological Disorders

by Tobias Geis, Svena Gutzeit, Sigrid Disse, Jens Kuhle, Sotiris Fouzas and Sven Wellmann

Children 2024, 11(3), 360; https://doi.org/10.3390/children11030360 - 19 Mar 2024

Viewed by 1683

Abstract

(1) Introduction: This pilot study aimed to analyze neurofilament light chain levels in cerebrospinal fluid (cNfL) in a cohort of children with different acute nontraumatic neurological conditions. (2) Methods: This prospective observational cohort study consisted of 35 children aged 3 months to 17 [...] Read more.

(1) Introduction: This pilot study aimed to analyze neurofilament light chain levels in cerebrospinal fluid (cNfL) in a cohort of children with different acute nontraumatic neurological conditions. (2) Methods: This prospective observational cohort study consisted of 35 children aged 3 months to 17 years and was performed from November 2017 to December 2019. Patients’ clinical data were reviewed, and patients were assigned to the following groups: n = 10 (28.6%) meningitis, 5 (14.3%) Bell’s palsy, 7 (20.0%) febrile non-CNS infection, 3 (8.6%) complex febrile seizure, 4 (11.4%) idiopathic intracranial hypertension, and 6 (17.1%) others. cNfL levels were measured using a sensitive single-molecule array assay. (3) Results: The cNfL levels [median (range)] in children with meningitis were 120.5 pg/mL (58.1–205.4), in Bell’s palsy 88.6 pg/mL (48.8–144.5), in febrile non-CNS infection 103.9 pg/mL (60.1–210.8), in complex febrile seizure 56 pg/mL (53.2–58.3), and in idiopathic intracranial hypertension 97.1 pg/mL (60.1–124.6). Within the meningitis group, children with Lyme neuroborreliosis (LNB) had significantly higher cNfL concentrations (median 147.9 pg/mL; range 87.8–205.4 pg/mL) than children with enterovirus meningitis (72.5 pg/mL; 58.1–95.6 pg/mL; p = 0.048) and non-significantly higher cNfL levels when compared to Bell’s palsy (88.6 pg/mL; 48.8–144.5 pg/mL; p = 0.082). There was no correlation between cNfL levels and age. (4) Conclusions: Although the number of patients in this pilot study cohort is limited, higher cNfL levels in children with LNB compared to those with viral meningitis (significant) and Bell’s palsy (trend) may indicate the potential of cNfL as a biomarker in the differential diagnosis of pediatric meningitis and facial palsy. Full article

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

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11 pages, 421 KiB

Open AccessArticle

Primary and Secondary Variants of Callous-Unemotional Traits in Community Youths: Differences in Anticipatory Fear

by Yu Gao and Adrian Raine

Children 2024, 11(3), 359; https://doi.org/10.3390/children11030359 - 19 Mar 2024

Viewed by 1912

Abstract

Callous-unemotional (CU) traits refer to a cluster of characteristics such as low empathy, lack of remorse, and insensitivity to the emotions of others, delineating a group of youth at high risk for severe antisocial behavior. Two variants—primary and secondary CU—have been theorized to [...] Read more.

Callous-unemotional (CU) traits refer to a cluster of characteristics such as low empathy, lack of remorse, and insensitivity to the emotions of others, delineating a group of youth at high risk for severe antisocial behavior. Two variants—primary and secondary CU—have been theorized to have different underlying mechanisms, although mixed findings have been reported. The current study examined if the variants differ in their level of anticipatory fear in 92 youths from the community (mean age = 14.2 years, range = 12.3–16.4 years; 43.5% female). Participants completed a countdown task while their heart rate and skin conductance responses were recorded. Parents and youths completed the inventory of callous-unemotional traits and the child behavior checklist. Compared to the control group (low CU/low anxiety), the primary CU group (high CU/low anxiety) showed prolonged heart rate deceleration in anticipation of the impending aversive stimulus. The secondary CU group (high CU/high anxiety) did not differ from the other two groups on heart rate or skin conductance responses. This prolonged heart rate deceleration in the primary CU group is interpreted in the context of the passive vagal coping theory of antisocial behavior which hypothesizes that an over-engagement of the parasympathetic nervous system reduces the impact of a socializing punishment, which in turn predisposes individuals to antisocial behavior. Findings provide further support for the distinct etiology of two variants of CU traits. Full article

(This article belongs to the Special Issue Unravelling the Association between Fear and Psychopathic Traits in Children and Adolescents)

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11 pages, 11631 KiB

Open AccessCase Report

Complication of Orthodontic Treatment: A Case Report on Severe Apical Root Resorption (ARR) in a Patient with Turner Syndrome

by Joanna Laskowska, Anna Paradowska-Stolarz, Lucía Miralles-Jordá, Dorota Schutty and Marcin Mikulewicz

Children 2024, 11(3), 358; https://doi.org/10.3390/children11030358 - 18 Mar 2024

Cited by 3 | Viewed by 1556

Abstract

External apical root resorption in permanent teeth is a multifactorial process influenced by a variety of local and systemic factors. This report describes a case of multiple and severe apical root resorptions in a patient with Turner syndrome. The condition was discovered in [...] Read more.

External apical root resorption in permanent teeth is a multifactorial process influenced by a variety of local and systemic factors. This report describes a case of multiple and severe apical root resorptions in a patient with Turner syndrome. The condition was discovered in a young female with Turner syndrome after 30 months of orthodontic treatment with fixed appliance. The purpose of this report is to present reports by other authors on the potential causes of the increased risk of tooth resorption in patients with Turner syndrome and to share insights derived from its course, highlighting the implications and lessons learned. Patients with Turner syndrome are not ideal candidates for orthodontic treatment. Prior to commencing orthodontic treatment, it is essential to carefully consider the potential benefits of the therapy compared to the risk associated with exacerbating root resorption. In the case of Turner syndrome patients, where there is an elevated risk of such complications, a thorough analysis should be conducted to determine whether the expected benefits of the treatment outweigh the potential hazards to the patient’s dental health. Full article

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

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12 pages, 225 KiB

Open AccessArticle

The Relationship between Auditory Analysis and Dictation Skills among Jordanian Fourth-Grade Students with Learning Difficulties

by Ahmad Abdelhameed Al-Makahleh

Children 2024, 11(3), 357; https://doi.org/10.3390/children11030357 - 18 Mar 2024

Viewed by 1277

Abstract

This study aims to explore the skills of Jordanian Arabic-speaking fourth graders with learning difficulties in terms of auditory analysis and dictation tests. It mainly aims to investigate the relationship between students’ abilities to perform auditory analyses and dictation tests. The sample in [...] Read more.

This study aims to explore the skills of Jordanian Arabic-speaking fourth graders with learning difficulties in terms of auditory analysis and dictation tests. It mainly aims to investigate the relationship between students’ abilities to perform auditory analyses and dictation tests. The sample in the study consists of 110 Jordanian fourth graders, who are then divided into 54 students with learning difficulties who are diagnosed as having a satisfactory level of reading and writing and 56 typically developing students. The students are asked to respond to two tests, the auditory analysis and the phonological awareness test, which are prepared by the researcher himself. The results demonstrate a statistically significant positive correlation between the auditory analysis and dictation skills of fourth-grade students with learning difficulties. This means that improving the auditory analysis skills corresponds to an increase in the dictation skills of these students. The results also reveal a statistically significant correlation between auditory analysis and dictation skills in typically developing students. Full article

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

9 pages, 243 KiB

Open AccessArticle

Association between Second-Hand Exposure to E-Cigarettes at Home and Exacerbations in Children with Asthma

by Serena Costantino, Arianna Torre, Simone Foti Randazzese, Salvatore Antonio Mollica, Federico Motta, Domenico Busceti, Federica Ferrante, Lucia Caminiti, Giuseppe Crisafulli and Sara Manti

Children 2024, 11(3), 356; https://doi.org/10.3390/children11030356 - 18 Mar 2024

Cited by 1 | Viewed by 2706

Abstract

Several studies have shown the effects of e-cigarettes in adults. Nowadays, few data are available in the pediatric population. This study aims to assess the relationship between asthma exacerbations and home exposure to e-cigarettes. We conducted a pilot, retrospective, monocenter, observational study. Demographic [...] Read more.

Several studies have shown the effects of e-cigarettes in adults. Nowadays, few data are available in the pediatric population. This study aims to assess the relationship between asthma exacerbations and home exposure to e-cigarettes. We conducted a pilot, retrospective, monocenter, observational study. Demographic and clinical data were collected, including number of asthma exacerbations, need for rescue therapy and/or therapeutic step-up, and Asthma Control Test (ACT) and children-Asthma Control Test (c-ACT) scores. The cohort consisted of 54 patients (5–17 years old), divided into two groups: A, including patients exposed to e-cigarette aerosols; B, including unexposed patients. The statistical analysis showed no relevant variation in the number of asthma symptomatic days and need for rescue therapy in group A versus group B (p = 0.27 and 0.19, respectively). There were no statistically significant variations when also considering the number of patients who needed a therapeutic step-up (p = 0.3). The mean values of ACT and c-ACT were, respectively, 17.2 ± 7.6 and 18.3 ± 5.6 in group A and 19.6 ± 3.8 and 14.6 ± 5.8 in group B (p = 0.3 and 0.4, respectively). Although we did not find a statistically significant correlation between second-hand e-cigarette exposure and asthma exacerbations, our findings suggest that asthmatic children exposed second-hand to e-cigarettes may have increased risk of asthma symptomatic days. Future research is warranted. Full article

(This article belongs to the Special Issue Medical Statistics and Clinical Epidemiology in Children)

13 pages, 1254 KiB

Open AccessArticle

Investigation of Dental and Oral Health in Children and Adolescents with Special Support Needs from a Child and Adolescent Psychiatric Perspective

by Dustin Fornefeld, Oliver Fricke, Andreas G. Schulte and Peter Schmidt

Children 2024, 11(3), 355; https://doi.org/10.3390/children11030355 - 17 Mar 2024

Cited by 1 | Viewed by 1717

Abstract

Background: The current literature lacks scientific research on child and adolescent psychiatrists’ (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. Methods: A [...] Read more.

Background: The current literature lacks scientific research on child and adolescent psychiatrists’ (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. Methods: A questionnaire-based cross-sectional study was conducted among members of the Professional Association for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany. Results: Out of the association members, 10.9% (n = 109) participated, with 5.2% (n = 52; 38f/14m) completing the questionnaire. Dental and oral health topics were discussed with one-fifth of the patients (19.2%), while 11.5% reported that they were “never” a part of their therapy. Patient-related concerns about dental and oral health were primarily brought into the context of child and adolescent psychiatric work. Dental treatment anxieties were prominent. Only 3.8% of the participants regularly assigned diagnoses related to dental status. The CAPPS employ a bio-psycho-social model for the genesis of oral health-related conditions in Children and Adolescents with Special Needs. Conclusions: CAPPS have a foundation in relationship-based work for assessing oral and dental healthcare and providing recommendations for further dental care. Regional networking and science must be further developed. Full article

(This article belongs to the Special Issue Oral Health of Children with Autism Spectrum Disorder)

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16 pages, 1818 KiB

Open AccessArticle

A Comparison of the Effects of Supervised versus Home Schroth Exercise Programs with Adolescent Idiopathic Scoliosis

by Kadriye Tombak, İnci Yüksel, Umut Ozsoy, Yılmaz Yıldırım and Sezen Karaşin

Children 2024, 11(3), 354; https://doi.org/10.3390/children11030354 - 17 Mar 2024

Cited by 1 | Viewed by 2343

Abstract

(1) Background: Schroth exercise can reduce the deformity of the spine and improve the life quality and the body image of patients with adolescent idiopathic scoliosis (AIS). (2) Methods: The study began with 49 participants, aged 10–16 years old, who were diagnosed with [...] Read more.

(1) Background: Schroth exercise can reduce the deformity of the spine and improve the life quality and the body image of patients with adolescent idiopathic scoliosis (AIS). (2) Methods: The study began with 49 participants, aged 10–16 years old, who were diagnosed with AIS. At the end of the study, 37 patients were randomly assigned to either the Supervised (n = 19) or Home-Based Schroth Exercise Group (n = 18) and completed the study. Both groups were treated for seven days a week over twelve weeks. For all patients, body rotation measurements were performed with a scoliometer, surface asymmetry analysis was carried out using an Artec Eva 3D scanner, health-related quality of life was evaluated by the Scoliosis Research Society-22 (SRS-22) questionnaire, and the perception of the cosmetic deformity was assessed by the Walter Reed Visual Assessment Scale (WRVAS). All the measurements were repeated before and after the 12-week treatment. (3) Results: Post-treatment scoliometric measurements showed a significant decrease in body rotation in both groups (p < 0.05). Similarly, both groups observed significant positive changes in SRS-22 and WRVAS scores (p < 005). RMS values were statistically significant in both groups; the difference was only statistically significant in the thoracic anterior arm subparameter (p < 0.05). (4) Conclusion: The Schroth exercise for both groups with AIS improved body symmetry, quality of life, and body image. Full article

(This article belongs to the Special Issue New Trends in Physical Therapy for Children)

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17 pages, 533 KiB

Open AccessArticle

Parental Burnout and Child Behavior: A Preliminary Analysis of Mediating and Moderating Effects of Positive Parenting

by Aline Woine, María Josefina Escobar, Carolina Panesso, Dorota Szczygieł, Moïra Mikolajczak and Isabelle Roskam

Children 2024, 11(3), 353; https://doi.org/10.3390/children11030353 - 16 Mar 2024

Viewed by 2126

Abstract

Despite its significant growth over the past fifteen years, research on parental burnout is just beginning to explore the relationships of the syndrome with child behavior. Previous research with adolescents has shown the existence of associations between parental burnout and internalizing and externalizing [...] Read more.

Despite its significant growth over the past fifteen years, research on parental burnout is just beginning to explore the relationships of the syndrome with child behavior. Previous research with adolescents has shown the existence of associations between parental burnout and internalizing and externalizing behaviors in the offspring. The current study is an attempt to (i) replicate this preliminary evidence specifically among Chilean preschool children and (ii) explore the mediating/moderating effects of positive parenting that may be involved in these putative associations. A sample of 383 Chilean mothers participated in this cross-sectional online study. The results confirmed the associations between parental burnout and child internalizing and externalizing behaviors. We also observed that positive parenting was a mediator in the relationship linking parental burnout and the child’s internalizing (full mediation) and externalizing (partial mediation) behaviors. Positive parenting also partially mediated the association between the child’s externalizing behavior and parental burnout. Our results further suggested that the child’s externalizing behavior was possibly a more substantial contributing factor to parental burnout than the child’s internalizing behavior. Full article

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

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19 pages, 1193 KiB

Open AccessArticle

Associations between Prepartum and Postpartum Maternal Symptoms of Depression, Anxiety and Stress Related to COVID-19 Pandemic and Childhood Sensory Avoidance: Results from Conception Study

by Delphine Aubin, Jessica Gorgui, Anick Bérard and Sarah Lippé

Children 2024, 11(3), 352; https://doi.org/10.3390/children11030352 - 16 Mar 2024

Viewed by 1527

Abstract

Background: Prepartum and postpartum maternal symptoms of stress, anxiety and depression are likely to influence the child’s sensory processing through hormonal alterations and an influence on mother–child interactions. Objective: We investigated the associations between maternal prepartum and postpartum symptoms of depression, anxiety and [...] Read more.

Background: Prepartum and postpartum maternal symptoms of stress, anxiety and depression are likely to influence the child’s sensory processing through hormonal alterations and an influence on mother–child interactions. Objective: We investigated the associations between maternal prepartum and postpartum symptoms of depression, anxiety and stress related to the COVID-19 pandemic and childhood sensory avoidance at 18 months. Methods: Longitudinal data from 409 participants followed during the COVID-19 pandemic were used. They completed questionnaires during pregnancy and up to 18 months after delivery. Maternal distress symptoms were assessed prenatally and at 18 months postnatally using the Edinburgh Postnatal Depression Scale, the Generalized Anxiety Disorders 7-item Scale and a 10-point scale assessing the level of stress felt related to the COVID-19 pandemic. Child sensory avoidance was assessed at 18 months postpartum using the Infant/Toddler Sensory Profile—Second Edition. Pearson correlations and multiple regressions measured the associations between maternal distress symptoms and child sensory avoidance. Results: Prepartum and 18-month postpartum maternal depression and anxiety were significantly correlated with childhood sensory avoidance (p < 0.05). Together, these variables explained 7.18% (F = 2.12, p < 0.05) of the variance of childhood sensory avoidance. Conclusions: These results support the contributory effect of prepartum and postpartum maternal distress on childhood sensory development. Full article

(This article belongs to the Special Issue Developmental and Behavioral Pediatrics - Volume II)

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14 pages, 258 KiB

Open AccessArticle

Comparison of Two Methods for Weaning from Nasal Continuous Positive Airway Pressure via the Cyclic Use of High-Flow Nasal Cannula or Room Air in Preterm Infants

by Shu-Ting Yang, Hao-Wei Chung and Hsiu-Lin Chen

Children 2024, 11(3), 351; https://doi.org/10.3390/children11030351 - 15 Mar 2024

Cited by 1 | Viewed by 1301

Abstract

Nasal continuous positive airway pressure (NCPAP) is extensively used for preterm infants experiencing respiratory distress syndrome (RDS). Weaning from NCPAP includes direct weaning or gradually extending room air exposure. However, a high-flow nasal cannula (HFNC) is an alternative weaning method. Therefore, this study [...] Read more.

Nasal continuous positive airway pressure (NCPAP) is extensively used for preterm infants experiencing respiratory distress syndrome (RDS). Weaning from NCPAP includes direct weaning or gradually extending room air exposure. However, a high-flow nasal cannula (HFNC) is an alternative weaning method. Therefore, this study evaluated the clinical outcomes of HFNC and progressively increasing room air duration as weaning strategies. This study enrolled 46 preterm infants with RDS receiving NCPAP support who underwent the cyclic use of NCPAP and HFNC weaning protocol as the HFNC group; a retrospective analysis included 87 preterm infants weaned from NCPAP by gradually extending room air duration as the room air group. Differences in clinical conditions, complications, and short-term outcomes between the weaning methods were compared. The mean post-menstrual age at initiating NCPAP weaning was lower in the room air group than in the HFNC group (mean ± SD, 35.2 ± 2.3 weeks vs. 33.2 ± 2.5 weeks, p < 0.001). Hospital stay duration and total respiratory therapy days were longer in the HFNC group (96 ± 38 days and 80 ± 37 days, respectively) than in the room air group (78 ± 28 days and 56 ± 25 days, respectively), with p-values of 0.006 and <0.001. In conclusion, employing HFNC for weaning from NCPAP resulted in longer hospital admissions and respiratory therapy days than the room air method. However, further studies with a larger sample size are warranted for a more comprehensive evaluation, given the limited number of enrolled patients. Full article

(This article belongs to the Special Issue Comprehensive Care of Critically Ill Infants and Children)

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20 pages, 687 KiB

Open AccessReview

Procalcitonin and Presepsin as Markers of Infectious Respiratory Diseases in Children: A Scoping Review of the Literature

by Giorgio Sodero, Carolina Gentili, Francesco Mariani, Valentina Pulcinelli, Piero Valentini and Danilo Buonsenso

Children 2024, 11(3), 350; https://doi.org/10.3390/children11030350 - 15 Mar 2024

Cited by 1 | Viewed by 1811

Abstract

Introduction: Procalcitonin and presepsin have been suggested to be able to discriminate bacterial and viral infections, also in children. This scoping review aims to better explore the available evidence around the potential role of these biomarkers in the subgroup of children with respiratory [...] Read more.

Introduction: Procalcitonin and presepsin have been suggested to be able to discriminate bacterial and viral infections, also in children. This scoping review aims to better explore the available evidence around the potential role of these biomarkers in the subgroup of children with respiratory infectious diseases. Methods: We performed a systematic scoping review of studies published until March 2023 in the following bibliographic databases: PubMed, EMBASE, Cochrane and SCOPUS. Results: In children with bacterial infection, procalcitonin values ranged from 0.5 ng/mL to 8.31 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.6 ng/dL to 452.8 ng/dL with PCR from 2 ng/dL to 51.7 ng/dL. In children with viral infections, procalcitonin value values ranged from 0.2 ng/dL to 0.84 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.61 ng/dL to 46.6 ng/dL. No studies on presepsin in children with respiratory infections were retrieved. Conclusions: Although the available literature is highly heterogeneous, evidence does not suggest a role of procalcitonin in accurately differentiating bacterial and viral infections in children with respiratory infections. In future, new approaches based on multiple markers may better help determine which febrile children require antibiotics. Full article

(This article belongs to the Section Pediatric Allergy and Immunology)

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11 pages, 788 KiB

Open AccessBrief Report

The Risks of Phosphate Enemas in Toddlers: A Life-Threatening Unawareness

by Alessandro Zago, Alessandro Agostino Occhipinti, Matteo Bramuzzo, Viola Ceconi, Vincenzo Colacino, Egidio Barbi and Federico Poropat

Children 2024, 11(3), 349; https://doi.org/10.3390/children11030349 - 15 Mar 2024

Viewed by 1844

Abstract

Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs). Objectives: Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal [...] Read more.

Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs). Objectives: Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians’ awareness of PcE risks. Methods: We conducted an online survey by sending a multiple-choice questionnaire to the referents of 51 PEDs and 101 FPs. We collected and compared the answers with recommendations reported by the Italian Drug Agency (AIFA) and the available literature about PcE administration. Results: Of the institutions and pediatricians receiving the questionnaire, 23 PEDs (45%) and 63 FP (62.3%) participated in the survey. Of PEDs, 95% and 33.0% of FPs treated fecal impaction with PcE. Moreover, 54% of PEDs and 86.0% of FPs did not provide treatment according to the AIFA recommendations for the daily dose. Conclusions: This study shows limited pediatricians’ awareness of the potential risks related to PcE. Full article

(This article belongs to the Section Global Pediatric Health)

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