Children

18 pages, 578 KiB

Open AccessArticle

The Effect of a Fat-Restricted Diet in Four Patients with Familial Chylomicronemia Syndrome: A Long-Term Follow-Up Study

by Alexandra Thajer, Gabriele Skacel, Charlotte de Gier and Susanne Greber-Platzer

Children 2021, 8(11), 1078; https://doi.org/10.3390/children8111078 - 22 Nov 2021

Cited by 6 | Viewed by 2609

Abstract

(1) Background: Familial chylomicronemia syndrome (FCS) is a very rare autosomal recessive disorder characterized by severely elevated triglycerides and clinical symptoms in early childhood mainly presenting with abdominal pain, acute pancreatitis and hepatosplenomegaly. Primary treatment is a lifelong very strict low-fat diet, which [...] Read more.

(1) Background: Familial chylomicronemia syndrome (FCS) is a very rare autosomal recessive disorder characterized by severely elevated triglycerides and clinical symptoms in early childhood mainly presenting with abdominal pain, acute pancreatitis and hepatosplenomegaly. Primary treatment is a lifelong very strict low-fat diet, which might be challenging in pediatric patients. So far, data about children with FCS are rare. The aim of this study was to show the familial chylomicronemia syndrome traffic light table for pediatric patients and to assess the dietary fat intake and impact on triglycerides in children with FCS. (2) Methods: We performed a retrospective analysis in four children (50% male) affected by FCS from the Department of Pediatrics and Adolescent Medicine, Medical University of Vienna between January 2002 and September 2020. (3) Results: The four patients presented with classical FCS symptoms and showed baseline triglycerides (TG) exceeding 30,000 mg/dL in two patients, 10,000 mg/dL and 2400 mg/dL in one patient each. After diagnosis, fat percentage of total daily caloric intake was decreased and resulted immediately in triglyceride reduction. In all patients, FCS was genetically confirmed by mutations in genes encoding lipoprotein lipase. Acute pancreatitis and hepatosplenomegaly disappeared under the fat-restricted diet. A FCS traffic light table was developed as a dietary tool for affected families. (4) Conclusions: A restriction of dietary fat between 10% to 26% of the total daily caloric intake was feasible and effective in the long-term treatment of genetically confirmed FCS in children and could reduce the risk for acute pancreatitis. The dietary tool, the pediatric FCS traffic light table and the age-appropriate portion sizes for patients between 1 to 18 years, supports children and their parents to achieve and adhere to the lifelong strict low-fat diet. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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14 pages, 943 KiB

Open AccessArticle

Effects of Live Music Therapy on Autonomic Stability in Preterm Infants: A Cluster-Randomized Controlled Trial

by Dana Yakobson, Christian Gold, Bolette Daniels Beck, Cochavit Elefant, Sofia Bauer-Rusek and Shmuel Arnon

Children 2021, 8(11), 1077; https://doi.org/10.3390/children8111077 - 22 Nov 2021

Cited by 14 | Viewed by 4350

Abstract

Unbuffered stress levels may negatively influence preterm-infants’ autonomic nervous system (ANS) maturation, thus affecting neurobehavior and psycho-emotional development. Music therapy (MT) is an evidence-based treatment modality in neonatal care. When coupled with skin-to-skin care (SSC), it may reduce stress responses in both preterm [...] Read more.

Unbuffered stress levels may negatively influence preterm-infants’ autonomic nervous system (ANS) maturation, thus affecting neurobehavior and psycho-emotional development. Music therapy (MT) is an evidence-based treatment modality in neonatal care. When coupled with skin-to-skin care (SSC), it may reduce stress responses in both preterm infants and their parents and enhance family-centered care. Accordingly, we aimed to compare the effects of combined MT and SSC and SSC alone on ANS stabilization in preterm infants. In a single-center, cluster-randomized trial design, ten two-month time-clusters were randomized to either combined MT and SSC or SSC alone. Families of preterm infants were offered two sessions of the allocated condition in the NICU, and a three-month follow up session at home. The primary outcome variable was stabilization of the ANS, defined by change in the high frequency (HF) power of heart rate variability (HRV) during the second session. Secondary outcomes included other HRV measures, parent–infant attachment, and parental anxiety at each session. Sixty-eight families were included. MT combined with SSC improved infants’ ANS stability, as indicated by a greater increase in HF power during MT compared to SSC alone (mean difference 5.19 m²/Hz, SE = 1.27, p < 0.001) (95% confidence interval 0.87 to 2.05). Most secondary outcomes were not significantly different between the study groups. MT contributes to preterm-infants’ autonomic stability, thus laying an important foundation for neuro-behavioral and psycho-emotional development. Studies evaluating longer-term effects of MT on preterm infants’ development are warranted. Full article

(This article belongs to the Special Issue Sound in the Neonatal Intensive Care Unit (NICU))

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9 pages, 1366 KiB

Open AccessArticle

Long-Term Outcomes after Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Therapeutic Hypothermia: A Longitudinal, Prospective, Multicenter Case-Control Study in Children without Overt Brain Damage

by Elisa Cainelli, Luca Vedovelli, Emmanuele Mastretta, Dario Gregori, Agnese Suppiej and Patrizia Silvia Bisiacchi

Children 2021, 8(11), 1076; https://doi.org/10.3390/children8111076 - 22 Nov 2021

Cited by 13 | Viewed by 3236

Abstract

Background. Data on long-term outcomes in the era before therapeutic hypothermia (TH) showed a higher incidence of cognitive problems. Since the introduction of TH, data on its results are limited. Methods. Our sample population consisted of 40 children with a history of hypoxic-ischemic [...] Read more.

Background. Data on long-term outcomes in the era before therapeutic hypothermia (TH) showed a higher incidence of cognitive problems. Since the introduction of TH, data on its results are limited. Methods. Our sample population consisted of 40 children with a history of hypoxic-ischemic encephalopathy (HIE) treated with TH, with an average age of 6.25 years (range 5.5, 7.33), 24 (60%) males; and 33 peers with an average age of 8.8 years (6.08, 9.41), 17 (51%) males. Long-term follow-up data belong to two centers in Padova and Torino. We measured general intelligence (WPPSI-III or WISC-IV) and neuropsychological functioning (language, attention, memory, executive functions, social skills, visual motor abilities). We also administered questionnaires to their parents on the children’s psychopathological profiles and parental stress. Results. We found differences between groups in several cognitive and neuropsychological domains: intelligence, visuomotor skills, executive functions, and attention. Interestingly, IQ test results effectively differentiated between the groups (HIE vs. controls). Furthermore, the incidence of psychopathology appears to be significantly higher in children with HIE (35%) than in control peers (12%). Conclusions. Our study supports previous findings on a higher incidence of neuropsychological, cognitive, and psychopathological sequelae after HIE treated with TH. As hypothesized, TH does not appear to ameliorate the outcome after neonatal HIE in those children who survive without major sequelae. Full article

(This article belongs to the Special Issue Child Psychology: Typical and Atypical Development)

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15 pages, 2402 KiB

Open AccessReview

Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

by Ladina Greuter, Raphael Guzman and Jehuda Soleman

Children 2021, 8(11), 1075; https://doi.org/10.3390/children8111075 - 22 Nov 2021

Cited by 17 | Viewed by 4528

Abstract

Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% [...] Read more.

Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astrocytomas, while in adults the most commonly found histology is diffuse low-grade glioma (WHO II), which mostly occurs in eloquent regions of the brain, while its pediatric counterpart is frequently found in the infratentorial compartment. The different tumor locations require different skillsets from neurosurgeons. In adult LGG, a common practice is awake surgery, which is rarely performed on children. On the other hand, pediatric neurosurgeons are more commonly confronted with infratentorial tumors causing hydrocephalus, which more often require endoscopic or shunt procedures to restore the cerebrospinal fluid flow. In adult and pediatric LGG surgery, gross total excision is the primary treatment strategy. Only tumor recurrences or progression warrant adjuvant therapy with either chemo- or radiotherapy. In pediatric LGG, MEK inhibitors have shown promising initial results in treating recurrent LGG and several ongoing trials are investigating their role and safety. Moreover, predisposition syndromes, such as neurofibromatosis or tuberous sclerosis complex, can increase the risk of developing LGG in children, while in adults, usually no tumor growth in these syndromes is observed. In this review, we discuss and compare the differences between pediatric and adult LGG, emphasizing that pediatric LGG should not be approached and managed in the same way as adult LCG. Full article

(This article belongs to the Special Issue Pediatric Neuro-Oncology)

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13 pages, 560 KiB

Open AccessReview

Treatment Considerations for Obstructive Sleep Apnea in Pediatric Down Syndrome

by Erica Gastelum, Marcus Cummins, Amitoj Singh, Michael Montoya, Gino Luis Urbano and Mary Anne Tablizo

Children 2021, 8(11), 1074; https://doi.org/10.3390/children8111074 - 22 Nov 2021

Cited by 14 | Viewed by 5212

Abstract

Children with Down syndrome (DS) are at high risk for developing obstructive sleep apnea (OSA) compared to children without DS. The negative impact of OSA on health, behavior, and cognitive development in children with DS highlights the importance of timely and effective treatment. [...] Read more.

Children with Down syndrome (DS) are at high risk for developing obstructive sleep apnea (OSA) compared to children without DS. The negative impact of OSA on health, behavior, and cognitive development in children with DS highlights the importance of timely and effective treatment. Due to the higher prevalence of craniofacial and airway abnormalities, obesity, and hypotonia in patients with DS, residual OSA can still occur after exhausting first-line options. While treatment commonly includes adenotonsillectomy (AT) and continuous positive airway pressure (CPAP) therapy, additional therapy such as medical management and/or adjuvant surgical procedures need to be considered in refractory OSA. Given the significant comorbidities secondary to untreated OSA in children with DS, such as cardiovascular and neurobehavioral consequences, more robust randomized trials in this patient population are needed to produce treatment guidelines separate from those for the general pediatric population of otherwise healthy children with OSA. Further studies are also needed to look at desensitization and optimization of CPAP use in patients with DS and OSA. Full article

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

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12 pages, 939 KiB

Open AccessCase Report

Impact of Equine-Assisted Interventions on Heart Rate Variability in Two Participants with 22q11.2 Deletion Syndrome: A Pilot Study

by Maria Amado-Fuentes, Margarita Gozalo, Andres Garcia-Gomez and Sabina Barrios-Fernandez

Children 2021, 8(11), 1073; https://doi.org/10.3390/children8111073 - 22 Nov 2021

Cited by 3 | Viewed by 2564

Abstract

People with disabilities due to genetic origin often present high levels of stress: non-pharmacological interventions such as Equine-Assisted Interventions (EAI) may be a useful strategy. The objective of this pilot study was to evaluate stress levels in two participants with 22q11.2 deletion syndrome [...] Read more.

People with disabilities due to genetic origin often present high levels of stress: non-pharmacological interventions such as Equine-Assisted Interventions (EAI) may be a useful strategy. The objective of this pilot study was to evaluate stress levels in two participants with 22q11.2 deletion syndrome diagnosis, immediately after carrying out the EAI. A single case experimental design methodology was chosen due to the small sample size. Two participants with 22q11.2 Deletion Syndrome, a rare disease, with different comorbidities were included. The present study considered the EAI as the independent variable while the Heart Rate Variability (HRV) represented the dependent one, as HRV is considered an indicator of stress level. Measurements were performed before and after carrying out the interventions. The results showed an HRV increase in one of the participants and an increase in the arousal level evidenced by a decrease in his HRV. After having carried out the program, EAI seems to cause an impact on the activation level of the participants depending on the typology and nature of the intervention. However, these results should be treated with caution due to the small sample size. This study is a pilot to test the feasibility of the proposed interventions on the variable under study. Full article

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9 pages, 437 KiB

Open AccessArticle

Decreased Incidence of Pediatric Intussusception during COVID-19

by Jun Sung Park, Young-Hoon Byun, Seung Jun Choi, Jong Seung Lee, Jeong-Min Ryu and Jeong-Yong Lee

Children 2021, 8(11), 1072; https://doi.org/10.3390/children8111072 - 21 Nov 2021

Cited by 9 | Viewed by 2327

Abstract

Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020–January 2021) the COVID-19 outbreak in a single [...] Read more.

Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020–January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases—defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08–4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (−4.8 mmol/L vs. −3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic. Full article

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12 pages, 1734 KiB

Open AccessArticle

Minimally Invasive Modified Nuss Procedure for Repair of Pectus Excavatum in Pediatric Patients: Single-Centre Retrospective Observational Study

by Miro Jukić, Ivan Mustapić, Tomislav Šušnjar and Zenon Pogorelić

Children 2021, 8(11), 1071; https://doi.org/10.3390/children8111071 - 20 Nov 2021

Cited by 10 | Viewed by 7043

Abstract

Background: The treatment of pectus excavatum can be conservative or surgical. The aim of this study was to determine the factors influencing the outcomes of treatment after a minimally invasive Nuss corrective surgery procedure in pediatric patients. Methods: A total of 30 patient [...] Read more.

Background: The treatment of pectus excavatum can be conservative or surgical. The aim of this study was to determine the factors influencing the outcomes of treatment after a minimally invasive Nuss corrective surgery procedure in pediatric patients. Methods: A total of 30 patient who underwent a minimally invasive Nuss corrective procedure for pectus excavatum from 1 January 2014 to 31 December 2020 were included in thisretrospective study. The collected data included thepatient’s demographic characteristics (age, sex, height, weight, body mass index—BMI, Haller index), treatment outcomes (duration of surgery, length of hospital stay, intraoperative complications, early and late complications, postoperative analgesia), and overall patient and legal guardian satisfaction two years after the procedure. Results: A total of 22 male and 8 female patients were included in the study. The median age was 15 years (interquartile range—IQR 14, 16), and the median BMI was 18.5 kg/m² (IQR 17.7, 20.4) and 18.2 kg/m² (IQR 16.9, 18.6) for males and females, respectively. The median CT Haller index was 3.67 (IQR 3.48, 4.09) for male and 3.69 (IQR 3.45, 3.9) for female patients. The median surgery duration was 120 min (IQR 100, 130), and the median hospital stay length was 8.5 days (IQR 8, 9.75). Indications for surgery were psychological (47%), followed by respiratory (30%) and combined respiratory-cardiac (20%) and respiratory-psychological disorders (3%). Early complications were observed in 18 patients (60%), and late complications were observed in 7 patients (23.3%). Intraoperative complications were not recorded. The most common early complications were pneumothorax and subcutaneous emphysema (30%), while late complications included bar displacement (10%) and deformity recurrence (6.6%). Overall, the procedure was successful in 93.1% of patients. Upon arrival home, 22 patients (81.5%) used analgesics for at least one day, up to a maximum of six months. A total of 23 (76.7%) operated patients determined that the surgical procedure had excellent results (grade 5), 4 (13.3%) patients report a good result (grade 4), 1(3.3%) patient reported a mediocre result, and one patient (3.3%) reported a bad result (grades 3 and 2, respectively). Conclusion: The Nuss procedure is a safe and effective method for treating funnel chest in children and adolescents. It also providesexcellent cosmetic and aesthetic results as well as subjective satisfaction with the outcome of surgical treatment. Full article

(This article belongs to the Section Pediatric Surgery)

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10 pages, 279 KiB

Open AccessReview

Novel Biomarkers Differentiating Viral from Bacterial Infection in Febrile Children: Future Perspectives for Management in Clinical Praxis

by Samuel Rhedin, Kristina Elfving and Anna Berggren

Children 2021, 8(11), 1070; https://doi.org/10.3390/children8111070 - 20 Nov 2021

Cited by 10 | Viewed by 4156

Abstract

Differentiating viral from bacterial infections in febrile children is challenging and often leads to an unnecessary use of antibiotics. There is a great need for more accurate diagnostic tools. New molecular methods have improved the particular diagnostics of viral respiratory tract infections, but [...] Read more.

Differentiating viral from bacterial infections in febrile children is challenging and often leads to an unnecessary use of antibiotics. There is a great need for more accurate diagnostic tools. New molecular methods have improved the particular diagnostics of viral respiratory tract infections, but defining etiology can still be challenging, as certain viruses are frequently detected in asymptomatic children. For the detection of bacterial infections, time consuming cultures with limited sensitivity are still the gold standard. As a response to infection, the immune system elicits a cascade of events, which aims to eliminate the invading pathogen. Recent studies have focused on these host–pathogen interactions to identify pathogen-specific biomarkers (gene expression profiles), or “pathogen signatures”, as potential future diagnostic tools. Other studies have assessed combinations of traditional bacterial and viral biomarkers (C-reactive protein, interleukins, myxovirus resistance protein A, procalcitonin, tumor necrosis factor-related apoptosis-inducing ligand) to establish etiology. In this review we discuss the performance of such novel diagnostics and their potential role in clinical praxis. In conclusion, there are several promising novel biomarkers in the pipeline, but well-designed randomized controlled trials are needed to evaluate the safety of using these novel biomarkers to guide clinical decisions. Full article

(This article belongs to the Special Issue Advances in Pediatric Infection and Immunity)

9 pages, 231 KiB

Open AccessReview

Interventions for Parental Anxiety in Preparation for Pediatric Surgery: A Narrative Review

by Pooja Santapuram, Amanda L. Stone, Rachel Lane Walden and Louise Alexander

Children 2021, 8(11), 1069; https://doi.org/10.3390/children8111069 - 20 Nov 2021

Cited by 26 | Viewed by 6305

Abstract

The preoperative experience can cause significant anxiety for both pediatric patients and their parents in the lead up to a surgical procedure. Pediatric anxiety in a preoperative setting has been shown to have significant negative downstream effects on the clinical outcomes of children [...] Read more.

The preoperative experience can cause significant anxiety for both pediatric patients and their parents in the lead up to a surgical procedure. Pediatric anxiety in a preoperative setting has been shown to have significant negative downstream effects on the clinical outcomes of children and the healthcare system as a whole. Studies have found that preoperative parental anxiety has significant negative effects on children, regarding anxiety and emotional response. Therefore, interventions for parental preoperative anxiety are important to reduce the child’s anxiety. This review provides a brief overview of a broad range of strategies used to alleviate parental anxiety in a preoperative setting. Preoperative education, play-based interventions, music therapy, the presence of parents at induction of anesthesia, and integrative preoperative preparation programs have all demonstrated some evidence for reducing parental preoperative anxiety. The ultimate goal of using interventions for parental preoperative anxiety is to equip healthcare systems to better support families and optimize the perioperative outcomes of children. Full article

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

9 pages, 766 KiB

Open AccessArticle

Decreasing Hypothermia-Related Escalation of Care in Newborn Infants Using the BEMPU TempWatch: A Randomised Controlled Trial

by Donna Lei, Kenneth Tan and Atul Malhotra

Children 2021, 8(11), 1068; https://doi.org/10.3390/children8111068 - 19 Nov 2021

Cited by 3 | Viewed by 2648

Abstract

Objective: To determine whether incorporating BEMPU TempWatch into the care of LBW/SGA neonates for continuous temperature monitoring decreases the rate of hypothermia requiring escalation of care. Methods: This was a randomised controlled trial conducted in a tertiary hospital in Melbourne, Australia. Participants were [...] Read more.

Objective: To determine whether incorporating BEMPU TempWatch into the care of LBW/SGA neonates for continuous temperature monitoring decreases the rate of hypothermia requiring escalation of care. Methods: This was a randomised controlled trial conducted in a tertiary hospital in Melbourne, Australia. Participants were late preterm and term LBW/SGA neonates on the postnatal wards. Neonates were randomly assigned to receive either the BEMPU TempWatch in addition to standard care, or to receive standard care alone for the first 28 days of life. The primary outcome was hypothermia requiring escalation of care during initial hospital stay after birth. Results: Trial was discontinued after planned interim feasibility analysis, due to very low rates of hypothermia requiring escalation of care. In total, 75 neonates were included, with 36 in the intervention (TempWatch) group and 39 in the control group. The rate of hypothermia requiring escalation of care was 2/36 (5.6%) in the TempWatch group and 1/39 (2.6%) in the control group (relative risk (RR) 2.17, 95% CI 0.21 to 22.89). Rates of exclusive breastfeeding at discharge were 22/36 (61.1%) in the TempWatch and 13/39 (33.3%) in the control group (RR 1.83, 95% CI 1.10 to 3.07, p = 0.02). All other secondary outcomes were similar between the groups. Conclusions: Low rates of hypothermia requiring escalation of care in a tertiary, high-income setting meant it was not feasible for studying the effects of the TempWatch for this outcome. TempWatch may have a role in promoting exclusive breastfeeding, and this needs to be explored further. Full article

(This article belongs to the Section Pediatric Neonatology)

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17 pages, 2727 KiB

Open AccessEditor’s ChoiceReview

Current Insights into Atopic March

by Mitsuru Tsuge, Masanori Ikeda, Naomi Matsumoto, Takashi Yorifuji and Hirokazu Tsukahara

Children 2021, 8(11), 1067; https://doi.org/10.3390/children8111067 - 19 Nov 2021

Cited by 48 | Viewed by 16316

Abstract

The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis [...] Read more.

The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as “atopic march”. Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset. Full article

(This article belongs to the Special Issue Current Research on Pediatric Allergy and Immunodeficiency)

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9 pages, 1068 KiB

Open AccessArticle

Evaluating the Functional Outcomes and the Quality of Life for Pediatric Patients with Osteogenesis Imperfecta after Fracture Treatment with Intramedullary Rodding

by Alexandru Herdea, Alexandru Ulici, Dimitra Qirjako, Alexandra Toma, Răzvan Petru Derihaci, Claudiu N. Lungu and Adham Charkaoui

Children 2021, 8(11), 1066; https://doi.org/10.3390/children8111066 - 19 Nov 2021

Cited by 2 | Viewed by 2696

Abstract

Background and Objectives: Osteogenesis imperfecta is a rare pathology involving the bones and the connective tissues, generating alterations that lead to frequent fractures during childhood. When fractures occur at birth, they are associated with an impairment of walking and the quality of life. [...] Read more.

Background and Objectives: Osteogenesis imperfecta is a rare pathology involving the bones and the connective tissues, generating alterations that lead to frequent fractures during childhood. When fractures occur at birth, they are associated with an impairment of walking and the quality of life. Although surgical techniques have significantly improved in recent years, functional outcomes and the quality of life for pediatric patients that benefited from surgical management with telescopic rods have been less evaluated. This study aimed to measure functional results and determine the factors that influence the quality of life for the pediatric population diagnosed with Osteogenesis imperfecta and surgically treated using the telescopic rod approach after suffering a fracture or severe deformity. Materials and Methods: We conducted a cohort study that consisted of 15 patients diagnosed with Osteogenesis imperfecta (average age of 11.6 years). All individuals possessed at least one intramedullary telescopic rod as a result of the surgical treatment. Results: We observed that the pain, both acute and chronic, impairs the quality of life and interferes with daily living activities, for instance, self-care tasks. Conclusions: Osteogenesis imperfecta is associated with a severely damaged level of walking. All of the aspects of the pediatric patient’s daily life activity seem to be affected. Furthermore, these patients, especially those residing in rural areas, have a poor quality of life. Full article

(This article belongs to the Section Pediatric Surgery)

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2 pages, 190 KiB

Open AccessEditorial

Introduction to the Special Issue on Eating Disorders and Obesity in Children and Adolescents

by José I. Baile

Children 2021, 8(11), 1065; https://doi.org/10.3390/children8111065 - 19 Nov 2021

Viewed by 1708

Abstract

In this Special Issue of Children, we can find several articles that present the results of various current investigations in the field of eating disorders and obesity in children and adolescents [...] Full article

(This article belongs to the Special Issue Eating Disorders and Obesity in Children and Adolescents)

7 pages, 228 KiB

Open AccessReview

Sports and Children with Hemophilia: Current Trends

by Lorenzo Moretti, Davide Bizzoca, Claudio Buono, Teresa Ladogana, Federica Albano and Biagio Moretti

Children 2021, 8(11), 1064; https://doi.org/10.3390/children8111064 - 19 Nov 2021

Cited by 9 | Viewed by 3764

Abstract

Hemophilia is a sex-linked recessive disorder characterized by a lack of blood factors necessary for clotting. This review aims to investigate the benefits of sports activities in children with hemophilia in terms of both physical and psychological wellness. Sports activity is necessary for [...] Read more.

Hemophilia is a sex-linked recessive disorder characterized by a lack of blood factors necessary for clotting. This review aims to investigate the benefits of sports activities in children with hemophilia in terms of both physical and psychological wellness. Sports activity is necessary for children with hemophilia to preserve joints’ range of motion, reduce joint bleeding, improve muscle mass and strength, enhance proprioception and prevent secondary chronic diseases. In the past, high-impact sports were usually forbidden in children with hemophilia because of their high bleeding risk. Recent studies, however, have shown that prophylaxis therapy can allow a hemophilic child to take part in vigorous activities or high-impact sports. The benefits of sports activity in children with hemophilia are expressed by a better muscular trophism and an improved bone mineral density. Moreover, physical activity has a positive impact on children’s psychosocial well-being. Due to prophylaxis therapy, the quality of life of children with hemophilia is similar to their peers, and this has allowed an improvement in sports participation, including team sports. Full article

(This article belongs to the Special Issue Bone Development and Disease in Infants)

6 pages, 447 KiB

Open AccessCase Report

Lamotrigine Induced DRESS Syndrome in a Child: A Case Report and Literature Review

by Chien-Heng Lin, Sheng-Shing Lin, Syuan-Yu Hong, Chieh-Ho Chen and I-Ching Chou

Children 2021, 8(11), 1063; https://doi.org/10.3390/children8111063 - 19 Nov 2021

Cited by 3 | Viewed by 5435

Abstract

Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history [...] Read more.

Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in a stable condition. Anticonvulsant drugs such as lamotrigine are among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients. Full article

(This article belongs to the Special Issue Current Research on Pediatric Allergy and Immunodeficiency)

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15 pages, 3165 KiB

Open AccessSystematic Review

The Effects of Different Exercise Modalities in the Treatment of Cardiometabolic Risk Factors in Obese Adolescents with Sedentary Behavior—A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Daxin Li and Ping Chen

Children 2021, 8(11), 1062; https://doi.org/10.3390/children8111062 - 18 Nov 2021

Cited by 10 | Viewed by 3343

Abstract

Purpose: Obesity has become increasingly prevalent in adolescents due to unhealthy diet habits, sedentary behavior and a lack of physical activities. This study aims to assess the effects of different exercise modalities in the treatment of cardiometabolic risk factors (CRF) in obese adolescents [...] Read more.

Purpose: Obesity has become increasingly prevalent in adolescents due to unhealthy diet habits, sedentary behavior and a lack of physical activities. This study aims to assess the effects of different exercise modalities in the treatment of cardiometabolic risk factors (CRF) in obese adolescents with sedentary behavior. Methods: A systematic search was conducted using databases (PubMed, Embase, Cochrane library, Web of Science, CNKI and VIP database) from the earliest available date to August 2021. Nineteen randomized controlled trials (RCTs) with 704 participants were included. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool, and a statistical analysis was performed by the Review Manage 5.3 and Stata 15.1 software. Results: The results of the meta-analysis showed that exercise could significantly improve obese adolescents’ body mass index (BMI) (MD = −1.99, 95% CI: −2.81 to −1.17, p < 0.00001), low density liptein cholesterol (LDL-C) (SMD = −0.98, 95% CI: −1.58 to −0.37, p = 0.002), triglyceride (TG) (SMD = −0.93, 95% CI: −1.72 to −0.14, p = 0.02), total cholesterol (TC) (SMD = −1.00, 95% CI: −1.73 to −0.26, p = 0.008), peak oxygen uptake (VO₂peak) (MD = 3.27, 95% CI: 1.52 to 5.02, p = 0.0003) and homeostatic model assessment insulin resistance (HOMA-IR) (SMD = −2.07, 95% CI: −3.3 to −0.84, p = 0.001). However, there was no statistically significant difference in high-density liptein cholesterol (HDL-C) (SMD = 0.40, 95% CI: −0.28 to 1.08, p = 0.25). Conclusion: Exercise can effectively improve cardiometabolic risk factors in obese adolescents with sedentary behavior. For obese adolescents who want to lose weight and improve cardiorespiratory fitness, combined aerobic and resistance training and high-intensity interval training are optimal choices. For obese adolescents with high blood lipids, aerobic training can be regarded as a primary exercise modality to reduce the high risk of cardiovascular diseases; For obese adolescents with insulin resistance, combined aerobic and resistance training can be considered to reduce the high risk of diabetes. It is hoped that more high-quality studies will further expand the meta-analysis results and demonstrate the optimal exercise frequency and treatment intensity of cardiometabolic risk factors in obese adolescents with sedentary behavior in the future. Full article

(This article belongs to the Special Issue Physical Activity and Exercise Science for Children)

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13 pages, 278 KiB

Open AccessArticle

Maternal-Child Health Outcomes from Pre- to Post-Implementation of a Trauma-Informed Care Initiative in the Prenatal Care Setting: A Retrospective Study

by Nicole Racine, Whitney Ereyi-Osas, Teresa Killam, Sheila McDonald and Sheri Madigan

Children 2021, 8(11), 1061; https://doi.org/10.3390/children8111061 - 18 Nov 2021

Cited by 14 | Viewed by 3546

Abstract

Background: There has been an increase in use of trauma-informed care (TIC) approaches, which can include screening for maternal Adverse Childhood Experiences (ACEs) during prenatal care. However, there is a paucity of research showing that TIC approaches are associated with improvements in maternal [...] Read more.

Background: There has been an increase in use of trauma-informed care (TIC) approaches, which can include screening for maternal Adverse Childhood Experiences (ACEs) during prenatal care. However, there is a paucity of research showing that TIC approaches are associated with improvements in maternal or offspring health outcomes. Using retrospective file review, the current study evaluated whether differences in pregnancy health and infant birth outcomes were observed from before to after the implementation of a TIC approach in a low-risk maternity clinic, serving women of low medical risk. Methods: Demographic and health data were extracted from the medical records of 601 women (n = 338 TIC care, n = 263 pre-TIC initiative) who received prenatal care at a low-risk maternity clinic. Cumulative risk scores for maternal pregnancy health and infant birth outcomes were completed by health professionals. Results: Using independent chi-squared tests, the proportion of women without pregnancy health risks did not differ for women from before to after the implementation of TIC, χ² (2, 601) = 3.75, p = 0.15. Infants of mothers who received TIC were less likely to have a health risk at birth, χ² (2, 519) = 6.17, p = 0.046. Conclusion: A TIC approach conveyed modest benefits for infant outcomes, but not maternal health in pregnancy. Future research examining other potential benefits of TIC approaches are needed including among women of high socio-demographic and medical risk. Full article

(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)

13 pages, 1608 KiB

Open AccessArticle

Learning Basketball Tactical Actions from Video Modeling and Static Pictures: When Gender Matters

by Ghazi Rekik, Yosra Belkhir, Nourhen Mezghanni, Mohamed Jarraya, Yung-Sheng Chen and Cheng-Deng Kuo

Children 2021, 8(11), 1060; https://doi.org/10.3390/children8111060 - 17 Nov 2021

Cited by 10 | Viewed by 2678

Abstract

Recent studies within the physical education domain have shown the superiority of dynamic visualizations over their static counterparts in learning different motor skills. However, the gender difference in learning from these two visual presentations has not yet been elucidated. Thus, this study aimed [...] Read more.

Recent studies within the physical education domain have shown the superiority of dynamic visualizations over their static counterparts in learning different motor skills. However, the gender difference in learning from these two visual presentations has not yet been elucidated. Thus, this study aimed to explore the gender difference in learning basketball tactical actions from video modeling and static pictures. Eighty secondary school students (M_age = 15.28, SD = 0.49) were quasi-randomly (i.e., matched for gender) assigned to a dynamic condition (20 males, 20 females) and a static condition (20 males, 20 females). Immediately after watching either a static or dynamic presentation of the playing system (learning phase), participants were asked to rate their mental effort invested in learning, perform a game performance test, and complete the card rotations test (test phase). The results indicated that spatial ability (evaluated via the card rotations test) was higher in males than in female students (p < 0.0005). Additionally, an interaction of gender and type of visualization were identified, supporting the ability-as-compensator hypothesis: female students benefited particularly from video modeling (p < 0.0005, ES = 3.12), while male students did not (p > 0.05, ES = 0.36). These findings suggested that a consideration of a learner’s gender is crucial to further boost learning of basketball tactical actions from dynamic and static visualizations. Full article

(This article belongs to the Special Issue Motor Control and Learning in Childhood and Adolescence: Interactions with Sports and Exercise)

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10 pages, 1314 KiB

Open AccessArticle

Botulinum Toxin a Injection Combined with Radial Extracorporeal Shock Wave Therapy in Children with Spastic Cerebral Palsy: Shear Wave Sonoelastographic Findings in the Medial Gastrocnemius Muscle, Preliminary Study

by Dong Rak Kwon and Dae Gil Kwon

Children 2021, 8(11), 1059; https://doi.org/10.3390/children8111059 - 17 Nov 2021

Cited by 13 | Viewed by 2911

Abstract

Therapeutic strategies to boost the effect of botulinum toxin may lead to some advantages, such as long lasting effects, the injection of lower botulinum toxin dosages, fewer side effects, and lower costs. The aim of this study is to investigate the combined effect [...] Read more.

Therapeutic strategies to boost the effect of botulinum toxin may lead to some advantages, such as long lasting effects, the injection of lower botulinum toxin dosages, fewer side effects, and lower costs. The aim of this study is to investigate the combined effect of botulinum toxin A (BTA) injection and extracorporeal shock wave therapy (ESWT) for the treatment of spasticity in children with spastic cerebral palsy (CP). Fifteen patients with spastic CP were recruited through a retrospective chart review to clarify what treatment they received. All patients received a BTA injection on gastrocnemius muscle (GCM), and patients in group 1 underwent one ESWT session for the GCM immediately after BTA injection and two consecutive ESWT sessions at weekly intervals. Ankle plantar flexor and the passive range of motion (PROM) of ankle dorsiflexion were measured by a modified Ashworth scale (MAS) before treatment and at 1 and 3 month(s) post-treatment. In group 1, the shear wave velocity (SWV) of GCM was measured. The PROM and MAS in group 1 and 2 before treatment significantly improved at 1 and 3 month(s) after treatment. The change in PROM was significantly different between the two groups at 1 and 3 month(s) after treatment. The SWV before treatment significantly decreased at 1 month and 3 months after treatment in group 1. Our study has shown that the combination of BTA injection and ESWT would be effective at controlling spasticity in children with spastic CP, with sustained improvement at 3 months after treatment. Full article

(This article belongs to the Special Issue Physical Medicine and Rehabilitation in Children)

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11 pages, 257 KiB

Open AccessReview

Psychosexual Care of Adolescent and Young Adult (AYA) Cancer Survivors

by Laura Reinman, Helen L. Coons, Jenna Sopfe and Robert Casey

Children 2021, 8(11), 1058; https://doi.org/10.3390/children8111058 - 16 Nov 2021

Cited by 17 | Viewed by 3362

Abstract

Adolescent and young adult (AYA) survivors of cancer have diverse psychosocial and medical needs, including those related to fertility and sexual health. Much of the focus of care around issues such as fertility and sexual health tends to be filtered through a biomedical [...] Read more.

Adolescent and young adult (AYA) survivors of cancer have diverse psychosocial and medical needs, including those related to fertility and sexual health. Much of the focus of care around issues such as fertility and sexual health tends to be filtered through a biomedical lens. However, it is essential that health care providers assess and support AYA survivors using a biopsychosocial and contextual framework to ensure the most comprehensive and accurate understanding of AYA survivor needs, especially those related to psychosexual health. A trusting relationship between the multi-disciplinary medical team and the AYA survivor that allows for open discussion about the physical and psychosocial components of sexual health is key to providing best care and outcomes. Full article

(This article belongs to the Special Issue Current Status of Cancer Research in Adolescents—Problems of Children with Cancer)

15 pages, 311 KiB

Open AccessEditor’s ChoiceReview

Skin Disease in Children: Effects on Quality of Life, Stigmatization, Bullying, and Suicide Risk in Pediatric Acne, Atopic Dermatitis, and Psoriasis Patients

by Katherine A. Kelly, Esther A. Balogh, Sebastian G. Kaplan and Steven R. Feldman

Children 2021, 8(11), 1057; https://doi.org/10.3390/children8111057 - 16 Nov 2021

Cited by 54 | Viewed by 9703

Abstract

Acne, atopic dermatitis (AD), and psoriasis are all chronic dermatologic conditions that greatly impact the lives of pediatric patients and their caregivers. The visible nature of these diseases negatively affects the self-image of children early in life as well as their relationships with [...] Read more.

Acne, atopic dermatitis (AD), and psoriasis are all chronic dermatologic conditions that greatly impact the lives of pediatric patients and their caregivers. The visible nature of these diseases negatively affects the self-image of children early in life as well as their relationships with their families and peers. Physicians recognize the importance of addressing both the physical and mental symptoms of their patients but are currently not equipped with clear guidelines to manage long-term psychosocial comorbidities in pediatric dermatologic patients. A PubMed and Google Scholar search of key words was conducted to explore self-image in pediatric patients with acne, AD, and psoriasis. Chronic skin diseases put pediatric patients at risk for strained family relationships, poor self-image, psychiatric comorbidities, stigmatization, and eventual suicidal behavior. A limitation of this study is a lack of a validated measure of quality of life in the pediatric population that fulfills enough criteria to evaluate long term quality of life in children and adults. Possible management options, including connecting patients with the same diagnosis and allocating resources to parents and teachers to better understand these chronic skin conditions, may provide pediatric patients with the support they need to develop resilience in the face of these challenges. Full article

(This article belongs to the Special Issue Children's Body Image, Physical Activity and Health)

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Graphical abstract

11 pages, 263 KiB

Open AccessArticle

Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients

by Cristiano Balzanelli, Daniele Spataro and Luca Oscar Redaelli de Zinis

Children 2021, 8(11), 1056; https://doi.org/10.3390/children8111056 - 16 Nov 2021

Cited by 10 | Viewed by 2265

Abstract

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from [...] Read more.

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases. Full article

(This article belongs to the Special Issue Balance Disorders in Children and Adolescents)

17 pages, 5900 KiB

Open AccessReview

Acute Myelopathy in Childhood

by Giulia Bravar, Aphra Luchesa Smith, Ata Siddiqui and Ming Lim

Children 2021, 8(11), 1055; https://doi.org/10.3390/children8111055 - 15 Nov 2021

Cited by 5 | Viewed by 3867

Abstract

Acute myelopathy presenting in childhood can be clinically classified based on the location of injury (with resulting spinal syndrome) or the cause (broadly traumatic or non-traumatic). Types of nontraumatic myelopathy include ischaemic, infectious, inflammatory, nutritional, and metabolic causes, some of which may be [...] Read more.

Acute myelopathy presenting in childhood can be clinically classified based on the location of injury (with resulting spinal syndrome) or the cause (broadly traumatic or non-traumatic). Types of nontraumatic myelopathy include ischaemic, infectious, inflammatory, nutritional, and metabolic causes, some of which may be part of a systemic illness such as systemic lupus erythematosus or a demyelinating disease such as multiple sclerosis. Nonaccidental injury is an important consideration in cases of traumatic myelopathy, which may often be associated with other injuries. Assessment should include neuroimaging of the brain and spinal cord, with further investigations targeted based on the most likely differential diagnoses; for example, a child with suspected demyelinating disease may require specialist cerebrospinal fluid and serological testing. Management also will differ based on the cause of the myelopathy, with several of these treatments more efficacious with earlier initiation, necessitating prompt recognition, diagnosis, and treatment of children presenting with symptoms of a myelopathy. Important components of holistic care may include physiotherapy and occupational therapy, with multidisciplinary team involvement as required (for example psychological support or specialist bowel and bladder teams). Full article

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

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11 pages, 6658 KiB

Open AccessArticle

The Impact of Clinical Atropine Use in Taiwanese Schoolchildren: Changes in Physiological Characteristics and Visual Functions

by Hui-Ying Kuo, Ching-Hsiu Ke, Shyan-Tarng Chen and Han-Yin Sun

Children 2021, 8(11), 1054; https://doi.org/10.3390/children8111054 - 15 Nov 2021

Cited by 8 | Viewed by 2577

Abstract

Taiwan is commonly noted for its high prevalence of myopia, as well as a long history of more than 20 years of using atropine to control myopia. However, the clinical implications are rarely discussed. This is a cross-sectional study investigating the influence of [...] Read more.

Taiwan is commonly noted for its high prevalence of myopia, as well as a long history of more than 20 years of using atropine to control myopia. However, the clinical implications are rarely discussed. This is a cross-sectional study investigating the influence of topical atropine instillation on ocular physiology, visual function, and visual discomfort in children. Aged 7 to 12 years, 212 schoolchildren were recruited and divided into the atropine group and the non-atropine group. Physiological characteristics such as pupil size and intraocular pressure were measured, and a variety of visual functions was also evaluated. A questionnaire was used to investigate the side effects and visual complaints caused by atropine treatment. There was a significant difference in pupil size (OD: 5.40 ± 0.90 vs. 6.60 ± 1.01 mm; OS: 5.42 ± 0.87 vs. 6.64 ± 1.00 mm, p < 0.001) between the two groups. Reductions in near visual acuity, accommodation, convergence ability, and stereopsis were observed in the atropine group. The horizontal pupil diameter enlarged, and visual functions were greatly affected after administration of topical atropine. The changes in visual function during atropine therapy need to be carefully monitored by clinicians, while patient compliance is usually the key to success. Full article

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10 pages, 240 KiB

Open AccessArticle

Nutritional Status and Associated Risk Factors of Syrian Children’s Residents in the Kingdom of Saudi Arabia

by Khaled M. AlZoubi, Ghedeir M. Alshammari, Abdulrahman S. AL-Khalifah, Mohammed A. Mohammed, Hind E. Aljuhani and Mohammed A. Yahya

Children 2021, 8(11), 1053; https://doi.org/10.3390/children8111053 - 15 Nov 2021

Cited by 1 | Viewed by 1915

Abstract

This study aimed to evaluate the nutritional status and associated risk factors of Syrian children living in Saudi Arabia. In this study, 55 boys and 55 girls ranging in age from 6 to 12 years were selected. Socioeconomic data of families were collected [...] Read more.

This study aimed to evaluate the nutritional status and associated risk factors of Syrian children living in Saudi Arabia. In this study, 55 boys and 55 girls ranging in age from 6 to 12 years were selected. Socioeconomic data of families were collected using a structured questionnaire. The participants’ anthropometric measurements were calculated. The 24-h recall method was applied to calculate the daily food intake. Dietary nutrients’ average daily intake of both boys and girls was significantly (p ≤ 0.01) lower than that of the dietary reference intake (DRI) with few exceptions. The sedentary lifestyles of both boys and girls had a negative impact on their food choices, and as a result, a large number of them were underweight and suffered from malnutrition and stunting. Spearman correlation coefficients revealed that most of the children’s dependent variables were risk factors and strongly and negatively associated with their nutritional status proxies. The study concluded that both boys and girls had unbalanced nutritional status with high percentages of malnutrition and stunting because most dependent factors were adversely related to the independent ones. Full article

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16 pages, 1178 KiB

Open AccessArticle

Oral Narrative Intervention by Tele-Practice in a Case with Developmental Language Disorder

by Irina Iuliu and Verónica Martínez

Children 2021, 8(11), 1052; https://doi.org/10.3390/children8111052 - 14 Nov 2021

Cited by 1 | Viewed by 3497

Abstract

Background: A narrative requires the integration and management of linguistic and cognitive skills. It has been observed that children with Developmental Language Disorder (DLD) have difficulties in narrating stories. This research proposes an intervention in a case of a child 9 years and [...] Read more.

Background: A narrative requires the integration and management of linguistic and cognitive skills. It has been observed that children with Developmental Language Disorder (DLD) have difficulties in narrating stories. This research proposes an intervention in a case of a child 9 years and 2 months old with DLD, with the aim of improving his oral narrative skills through a retelling task via telepractice. Methods: In the evaluation, standardized tests have been used and a ‘remembering a story’ task, with a story titled The Lost Backpack, elaborated by one of the authors. Narratives were elicited in two sessions, and were transcribed, coded, and analysed using the Child Language Data Exchange System CHILDES Project tool. The participant received a total of 10 sessions through the Skype platform, which included intervention-addressed explicit instruction about the narrative structure and the use of discourse markers to improve cohesion in story retelling. Results: Significant changes were observed in the retelling of the story at microstructure and macrostructure levels: an increase of the Mean Length of Utterance (MLU), Types and Tokens, specific vocabulary, discourse markers and the recall of events. Conclusions: These results demonstrate the effectiveness of intervention in narrative skills through the oral retelling of a story with visual support via tele-practice. Full article

(This article belongs to the Special Issue Pediatric Speech and Language Intervention via Telepractice)

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10 pages, 853 KiB

Open AccessArticle

The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

by Zenon Pogorelić, Tea Gaberc, Miro Jukić, Goran Tintor, Ana Nevešćanin Biliškov, Ivana Mrklić and Ana Jerončić

Children 2021, 8(11), 1051; https://doi.org/10.3390/children8111051 - 13 Nov 2021

Cited by 7 | Viewed by 3081

Abstract

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character [...] Read more.

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (p = 0.001) was found. Additionally, the interaction between time and different local analgesics (p < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (p < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine—n = 4, 20%; 0.5% levobupivacaine—n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (p < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine. Full article

(This article belongs to the Special Issue Urology in Pediatrics)

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16 pages, 983 KiB

Open AccessArticle

Adaptation, Translation and Validation of the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF): The Malay Version

by Izyana Syazlin Ibrahim, Noorhida Baharudin, Mohamad Rodi Isa, Intan Hakimah Ismail, Mohamed-Syarif Mohamed-Yassin, Intan Kartika Kamarudin, Amir Hamzah Abdul Latiff, Farah Dayana Zahedi, Adli Ali and Azuin Izzati Arshad

Children 2021, 8(11), 1050; https://doi.org/10.3390/children8111050 - 13 Nov 2021

Cited by 2 | Viewed by 3315

Abstract

Food allergy has a significant impact on the quality of life (QoL) of children and can be measured using The Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF). This study aimed to adapt, translate the FAQLQ-PF into Malay and determine the validity and [...] Read more.

Food allergy has a significant impact on the quality of life (QoL) of children and can be measured using The Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF). This study aimed to adapt, translate the FAQLQ-PF into Malay and determine the validity and reliability of the translated version. This cross-sectional questionnaire validation study was conducted among parents of children (0 to 12 years old) with food allergies across five sites in Selangor and Kuala Lumpur, Malaysia. The FAQLQ-PF-Malay underwent cross-cultural adaptation, translation, validation (content, face and construct) and reliability assessment. Exploratory factor analysis, internal consistency and test-retest reliability analyses were used to examine its construct validity and reliability. Out of 150 children, the majority were between the age of 7 to 12 years old (41%) and were female (81%). Three subscales were identified, which were: (i) social and dietary implication, (ii) food anxiety and (iii) emotional and physical impact. Four items were eliminated because of weak factor loadings. The Cronbach’s alpha for each subscale ranged from 0.88 to 0.94, with an overall Cronbach’s alpha of 0.95. The intra-class correlation coefficient ranged from 0.54 (95% CI: 0.10–0.77) to 0.97 (95% CI: 0.90–0.99). The 26-item FAQLQ-PF-Malay retained the three-factor structure of the original FAQLQ-PF. The FAQLQ-PF-Malay is a valid and reliable tool to assess the QoL of Malaysian children with food allergies. Full article

(This article belongs to the Special Issue Allergic Diseases and Type 2 Inflammation in Children)

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12 pages, 494 KiB

Open AccessArticle

Evaluation of the Psychometric Properties of the Portuguese Peabody Developmental Motor Scales-2 Edition: A Study with Children Aged 12 to 48 Months

by Miguel Rebelo, João Serrano, Pedro Duarte-Mendes, Diogo Monteiro, Rui Paulo and Daniel Almeida Marinho

Children 2021, 8(11), 1049; https://doi.org/10.3390/children8111049 - 13 Nov 2021

Cited by 8 | Viewed by 3052

Abstract

The purpose of this study was to examine the psychometric properties of Peabody Developmental Motor Scales II (PDMS-2-Folio and Fewell, 2000) using a Portuguese sample. The validation of the Portuguese version of the PDMS-2 was applied according to the manual, for 392 children, [...] Read more.

The purpose of this study was to examine the psychometric properties of Peabody Developmental Motor Scales II (PDMS-2-Folio and Fewell, 2000) using a Portuguese sample. The validation of the Portuguese version of the PDMS-2 was applied according to the manual, for 392 children, from two institutions, from 12 to 48 months, with an analysis of the internal consistency (α Cronbach), of test–retest reliability (ICC) and construct validity (confirmatory factor analysis). The results of the confirmatory factorial analysis (χ2 = 55.614; df = 4; p = 0.06; χ2/df =13.904; SRMR (Standardized Root Mean Square Residual) = 0.065; CFI (Comparative Fit Index) = 0.99, TLI = 0.99, RMSEA (Root Mean Square Error of Approximation) = 0.068) of two factors (Gross Motor and Fine Motor) as the original version but correlated. Most of the subtests had good internal consistency (α = 0.85) and good test–retest stability (ICC = 0.98 to 0.99). The results indicated that the Portuguese version of the PDMS-2 is adequate and valid for assessing global and fine motor skills in children aged 12 to 48 months, and can be used as a reference tool by health and education professionals to assess motor skills and, thus, allowing to detect maladjustments, deficiencies or precocity, so that children can later receive appropriate intervention. Full article

(This article belongs to the Special Issue Physical Activity and Exercise Science for Children)

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