Children

14 pages, 1175 KiB

Open AccessArticle

Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study

by Martina Buttera, Sofia Mazzotti, Tommaso Zini, Lucia Corso, Valeria Dallai, Francesca Miselli, Luca Bedetti, Katia Rossi, Eugenio Spaggiari, Lorenzo Iughetti, Licia Lugli and Alberto Berardi

Children 2024, 11(12), 1411; https://doi.org/10.3390/children11121411 - 22 Nov 2024

Abstract

Background: Bacterial meningitis (BM) in infants is a serious condition that can lead to significant complications. Lumbar puncture (LP) is essential to provide diagnoses, however false negatives may result if LP is performed after the starting of antibiotic therapy. Methods: We conducted a [...] Read more.

Background: Bacterial meningitis (BM) in infants is a serious condition that can lead to significant complications. Lumbar puncture (LP) is essential to provide diagnoses, however false negatives may result if LP is performed after the starting of antibiotic therapy. Methods: We conducted a retrospective analysis of infants of any gestational age with BM within their first 90 days of life and admitted to the Neonatal Intensive Care Unit of Modena Policlinico between 1 January 2011, and 31 December 2023. Results: A total of 44 episodes of meningitis were confirmed in 40 infants, diagnosed by positive cerebrospinal fluid cultures (n = 37), polymerase chain reaction testing (n = 4), or both methods (n = 3). Three out of forty infants (8%) experienced a relapse of meningitis. Most episodes (31/44, 70%) occurred in preterm infants. The incidence of early-onset meningitis was lower than that of late-onset (0.18 vs. 0.94 cases per 1000 births, respectively), with Gram-positive accounting for most cases (27/44, 61%). LP was performed prior to antibiotic administration in most episodes (30/44, 68%). Two preterm infants (5%) died from meningitis-related complications. Forty-two episodes occurred among thirty-eight surviving infants; brain lesions were detected through brain ultrasound or MRI in nine out of forty-two episodes (21%). Conclusions: Preterm infants have higher rates of BM, brain lesions or case fatalities. Early diagnosis and prompt antibiotic treatment are critical to improve outcomes. Full article

(This article belongs to the Special Issue Children's Public Health and Healthcare: Global Perspective and New Trends)

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10 pages, 1523 KiB

Open AccessCase Report

A Rare Case of Posterior Fossa Syndrome Associated with Neuropathic Pain Successfully Treated with a Combination of Gabapentin, Diazepam and Baclofen—A Case Report and Literature Review

by Mariateresa Giglio, Alberto Corriero, Teresa Perillo, Giustino Varrassi and Filomena Puntillo

Children 2024, 11(12), 1410; https://doi.org/10.3390/children11121410 - 21 Nov 2024

Abstract

Background: Posterior fossa syndrome (PFS), also known as cerebellar mutism syndrome, occurs in about 25% of pediatric patients undergoing resection of a posterior cranial fossa medulloblastoma. It is characterized primarily by mutism or reduced/impaired speech and may include variable symptoms such as motor [...] Read more.

Background: Posterior fossa syndrome (PFS), also known as cerebellar mutism syndrome, occurs in about 25% of pediatric patients undergoing resection of a posterior cranial fossa medulloblastoma. It is characterized primarily by mutism or reduced/impaired speech and may include variable symptoms such as motor dysfunction (apraxia, ataxia, hypotonia), supranuclear cranial nerve palsies, neurocognitive changes, and emotional lability. Long-term multidisciplinary rehabilitation is typically required, with recovery taking approximately six months, though many children experience long-term residual deficits. Neuropathic pain associated with PFS is rarely reported in pediatric patients, and evidence for its management is limited. Methods: This case report describes a 10-year-old boy who developed PFS following incomplete resection of a medulloblastoma. Clinical presentation included mutism, irritability, emotional lability, sleep disturbances, and neuropathic pain localized at the C5 level. The patient was treated with a combination of gabapentin, diazepam, and baclofen. Results: The combined pharmacological approach resulted in successful management of the patient’s neuropathic pain and other symptoms associated with PFS, improving his overall condition. Conclusions: This case highlights the potential effectiveness of a multimodal pharmacological regimen for treating neuropathic pain and associated symptoms in pediatric patients with PFS. Further research is needed to explore optimal treatment strategies for this rare but challenging complication. Full article

(This article belongs to the Special Issue Advances in Pediatric Anesthesia, Pain Medicine and Intensive Care)

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13 pages, 524 KiB

Open AccessArticle

Clinical Characteristics and Prognosis of Hemolytic Disease of the Newborn Caused by Irregular Antibodies: A 13-Year Retrospective Analysis

by Hui Wu, Rui Li, Hongling Wei, Weiwei Zhu and Yan Xing

Children 2024, 11(12), 1409; https://doi.org/10.3390/children11121409 - 21 Nov 2024

Abstract

Background/Objectives: The clinical characteristics and outcomes of hemolytic disease of the newborn (HDN) caused by irregular antibodies remain unclear. Herein, we analyzed the clinical features and prognosis of HDN. Methods: Children admitted to our institution between June 2009 and December 2022 with a [...] Read more.

Background/Objectives: The clinical characteristics and outcomes of hemolytic disease of the newborn (HDN) caused by irregular antibodies remain unclear. Herein, we analyzed the clinical features and prognosis of HDN. Methods: Children admitted to our institution between June 2009 and December 2022 with a definite diagnosis of HDN were evaluated. Patients with irregular antibodies were matched in a 1:3 ratio to those with ABO incompatibility. Children with confirmed Rh-incompatibility hemolytic disease were divided into the RhD subgroup (hemolysis induced by Rh anti-D) and the non-RhD group (hemolysis induced by other Rh antibodies). Results: The irregular antibody and ABO incompatibility group included 32 and 96 patients, respectively. Compared to the ABO incompatibility group, the irregular antibody group showed earlier jaundice; higher incidence of liver and spleen enlargement and anemia; higher direct antiglobulin test (DAT) positivity; earlier and more severe anemia; higher rates of enhanced phototherapy, blood transfusion, and blood exchange; and longer hospital stay (all p < 0.05). Compared to the non-RhD group, the RhD subgroup showed an earlier occurrence of jaundice and a higher incidence of liver and spleen enlargement (both p < 0.05). The multiple irregular antibody subgroup further showed earlier occurrence of jaundice and a higher rate of enhanced phototherapy, blood transfusion, and blood exchange than the single-antibody group (both p < 0.05). Conclusions: HDN caused by irregular red blood cell antibodies is rare, but clinical manifestations are serious. It is important to pay attention to the screening of irregular antibodies during pregnancy, to strengthen monitoring, and to provide intrauterine treatment and early intervention as necessary. Full article

(This article belongs to the Topic Children’s Diseases, Family Management, and Quality of Life)

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13 pages, 677 KiB

Open AccessReview

Media Device Use and Vision Disorders in the Pediatric Age: The State of the Art

by Elena Bozzola, Mariangela Irrera, Romie Hellmann, Salvatore Crugliano and Michele Fortunato

Children 2024, 11(11), 1408; https://doi.org/10.3390/children11111408 - 20 Nov 2024

Abstract

Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise [...] Read more.

Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise scientific international literature and to describe the potential eye risks correlated to screen viewing time in the pediatric age. Materials and Methods. A review of the literature was performed according to the PRISMA 2020 guidelines, using the search terms “media device” and “eye” with the filter “age 0–18”. Results. Analyzing the international literature, we found 26 articles. Pre-myopia, myopia, digital eye strain, and acute acquired comitant esotropia were listed as potential and time-related consequences associated with the incorrect use of media devices among children and adolescents. Discussion. Family education on media device exposure and potential risk for children and adolescents’ sight in case of prolonged digital/screen exposure is required. During pediatric check controls, a dialogue with families on prolonged media device use at a close distance should be undertaken. Pediatricians and ophthalmologists should consider screen viewing time in case of ocular problems. Full article

(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)

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16 pages, 302 KiB

Open AccessReview

Affective Touch in Preterm Infant Development: Neurobiological Mechanisms and Implications for Child–Caregiver Attachment and Neonatal Care

by Valentina Lucia La Rosa, Alessandra Geraci, Alice Iacono and Elena Commodari

Children 2024, 11(11), 1407; https://doi.org/10.3390/children11111407 - 20 Nov 2024

Abstract

Background/Objectives: Affective touch is crucial in infant development, particularly in regulating emotional, cognitive, and physiological processes. Preterm infants are often deprived of essential tactile stimulation owing to their early exposure to the external environment, which may affect long-term developmental outcomes. This review aimed [...] Read more.

Background/Objectives: Affective touch is crucial in infant development, particularly in regulating emotional, cognitive, and physiological processes. Preterm infants are often deprived of essential tactile stimulation owing to their early exposure to the external environment, which may affect long-term developmental outcomes. This review aimed to examine the neurobiological mechanisms of affective touch and highlight effective interventions, such as skin-to-skin contact (SSC) and kangaroo care (KC), to promote development in preterm infants. Methods: This review summarizes recent studies in the literature on affective touch, the role of C-tactile fibers, and the effects of tactile interventions in neonatal care. Studies were selected based on their relevance to the care and development of preterm infants, with a focus on physiological and neurodevelopmental outcomes. Key interventions, including SSC and massage therapy, are discussed in relation to their effectiveness in the neonatal intensive care unit (NICU). Results: The results suggest that affective touch, mainly through activation of tactile C-fibers, improves caregiver–infant bonding, reduces stress responses, and supports neurodevelopment in preterm infants. Interventions such as SSC and KC have also been shown to improve physiological regulation in these infants, including heart rate, breathing, and temperature control while promoting emotional regulation and cognitive development. Conclusions: Affective touch is a key component of early development, particularly in preterm infants admitted to the NICU. Integrating tactile interventions such as SSC and KC into neonatal care practices may significantly improve long-term developmental outcomes. Future research should explore the epigenetic mechanisms underlying affective touch and further refine tactile interventions to optimize neonatal care. Full article

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

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Graphical abstract

2 pages, 132 KiB

Open AccessCorrection

Correction: Asonitou, K.; Koutsouki, D. PASS Theory and Movement Disorders: Methodology for Assessment and Intervention. Children 2024, 11, 1192

by Katerina Asonitou and Dimitra Koutsouki

Children 2024, 11(11), 1406; https://doi.org/10.3390/children11111406 - 20 Nov 2024

Abstract

In the original publication [...] Full article

9 pages, 1432 KiB

Open AccessArticle

Management of Hirschsprung’s Disease: A Survey with Brazilian Pediatric Surgeons

by Cesar Saul Quevedo Penaloza, Alana Carnevale Barreto, Erika Veruska Paiva Ortolan, Augusto Zani and Pedro Luiz Toledo de Arruda Lourenção

Children 2024, 11(11), 1405; https://doi.org/10.3390/children11111405 - 20 Nov 2024

Abstract

Background: Hirschsprung’s disease (HD) is a congenital malformation of the enteric nervous system clinically manifested by intestinal obstruction in the neonatal period or severe constipation in childhood. Several surveys on HD have been conducted to evaluate experiences in its management around the world. [...] Read more.

Background: Hirschsprung’s disease (HD) is a congenital malformation of the enteric nervous system clinically manifested by intestinal obstruction in the neonatal period or severe constipation in childhood. Several surveys on HD have been conducted to evaluate experiences in its management around the world. For the first time in Brazil, we analyze and report the management patterns of HD among pediatric surgeons in Brazil. Methods: A validated questionnaire was disseminated in print at the Congress of Pediatric Surgery in São Paulo-Brazil, and an online version was sent to all the active members of the Brazilian and Paulista Institute of Pediatric Surgery. Results: In total, 361 pediatric surgeons answered the survey. Of these, 329 completed all questions (response rate: 91%). Most Brazilian services treat fewer than 10 cases of HD annually. The preferred diagnostic method was rectal biopsy. For newborns (NBs) and infants, open biopsy was the most commonly used technique. For NBs with HD clinically stable 50% of specialists chose immediate surgery. In NBs and infants with classic HD, the Soave technique (69%) is the most common surgical intervention, and the transanal route (80%) is the preferred surgical approach. In children over 3 years of age with classic HD, the most-used technique is the Duhamel method (54%), with the open approach being the most common (52%). Conclusions: Our study in Brazil found that HD patient management aligns with scientific evidence and international guidelines. Full article

(This article belongs to the Special Issue Colorectal Problems in Children: From Diagnosis to Treatment and Novelties)

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16 pages, 2713 KiB

Open AccessReview

Aquatic Therapy in Children and Adolescents with Disabilities: A Scoping Review

by Anna Ogonowska-Slodownik, Oliwia Jakobowicz, Lyndsay Alexander, Andresa R. Marinho-Buzelli, Catherine Devion and Natalia Morgulec-Adamowicz

Children 2024, 11(11), 1404; https://doi.org/10.3390/children11111404 - 20 Nov 2024

Abstract

Globally, around 1 in 10 children aged 0–17 years have moderate-to-severe disabilities. The aquatic environment provides hydrostatic and hydrodynamic characteristics that make exercise and therapy feasible for children and adolescents with disabilities. The objective of this scoping review is to understand the extent [...] Read more.

Globally, around 1 in 10 children aged 0–17 years have moderate-to-severe disabilities. The aquatic environment provides hydrostatic and hydrodynamic characteristics that make exercise and therapy feasible for children and adolescents with disabilities. The objective of this scoping review is to understand the extent and type of evidence in relation to the use of aquatic therapy in children and adolescents with disabilities. The eligibility criteria were as follows: participants—children and/or adolescents with disabilities aged from 6 to 18 years old; concept—aquatic therapy interventions; context—any available setting. The databases searched included MEDLINE, CINAHL, EMBASE, PsycINFO, AMED, Eric, Scopus, Web of Science, Epistemonikos, and one register, Cochrane Central Register of Controlled Trials. In total, 52 reports met the inclusion criteria. Most of the studies included children/adolescents with autism spectrum disorder (ASD; 46.7%)—442 participants in 21 studies in total. The majority of interventions were based on aquatic exercise (35%). Most often, interventions were conducted for 8 weeks, with 2 sessions a week lasting 60 min. The most common type of intervention for children and adolescents with ASD and Down syndrome was swimming. Participants with attention deficit hyperactivity disorder, neuromuscular disorders, and cerebral palsy were more often treated with aquatic exercises. This scoping review could guide practitioners, clinicians, and researchers on what type, setting, and content of aquatic therapy interventions, including exercise types, intervention duration, number of sessions, frequency, facility, and provider, are used with children and adolescents with disabilities. Full article

(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities: 2nd Edition)

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7 pages, 209 KiB

Open AccessEditorial

Physical Activity and Lifestyle Behaviors in Children and Adolescents

by Alexandre Aparecido de Almeida and Matias Noll

Children 2024, 11(11), 1403; https://doi.org/10.3390/children11111403 - 20 Nov 2024

Abstract

A sedentary lifestyle, unfavorable body composition, and low muscle strength are strong predictors of morbidity and mortality and an independent determinant contributing to the development of many chronic diseases [...] Full article

(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)

9 pages, 720 KiB

Open AccessArticle

Survival Analysis of Prefabricated Zirconia Crowns with and Without Pulpotomy in Primary Teeth: A Retrospective Cohort Study

by Murad Alrashdi

Children 2024, 11(11), 1402; https://doi.org/10.3390/children11111402 - 19 Nov 2024

Abstract

Background: Prefabricated Zirconia Crowns (PZCs) are increasingly preferred for restoring primary teeth due to their esthetic appeal and retention. However, their rigid, unmodifiable design requires precise tooth preparation, often leading to aggressive reduction and potential pulp exposure. Pulpotomy, a standard treatment for reversible [...] Read more.

Background: Prefabricated Zirconia Crowns (PZCs) are increasingly preferred for restoring primary teeth due to their esthetic appeal and retention. However, their rigid, unmodifiable design requires precise tooth preparation, often leading to aggressive reduction and potential pulp exposure. Pulpotomy, a standard treatment for reversible pulpitis and mechanical pulp exposure, is sometimes employed before PZCs. While pulpotomy is not routinely performed, its use raises important considerations about the interplay between restorative procedures and pulp therapy in pediatric dentistry, particularly regarding the long-term restoration outcomes of PZCs. Purpose: This study aimed to investigate the impact of pulpotomy on the success rate of PZCs. Methods: We examined 81 anterior upper primary teeth treated with PZCs in children aged 2–5 years over a two-year period. Cases were divided into groups with and without pulpotomy. Follow-ups occurred at 6-month intervals, assessing clinical and radiographic outcomes. Analyses were performed using SPSS 25.0 software. The statistical significance was p < 0.05. Results: A total of 81 anterior primary teeth were included. Chi-square analysis showed no association between pulp therapy and PZC success (χ² = 0.051, p = 0.822). The Kaplan–Meier survival analysis revealed comparable survival curves and the log-rank test showed no statistically significant difference in survival time between pulpotomy-treated and untreated groups (χ² = 0.051, p = 0.821). Conclusions: Pulpotomy did not significantly affect the success rate of PZCs within 2 years. Full article

(This article belongs to the Special Issue Research on Clinical Pediatric Dentistry)

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21 pages, 1111 KiB

Open AccessReview

Perspectives and Challenges of Telemedicine and Artificial Intelligence in Pediatric Dermatology

by Daniele Zama, Andrea Borghesi, Alice Ranieri, Elisa Manieri, Luca Pierantoni, Laura Andreozzi, Arianna Dondi, Iria Neri, Marcello Lanari and Roberta Calegari

Children 2024, 11(11), 1401; https://doi.org/10.3390/children11111401 - 19 Nov 2024

Abstract

Background: Pediatric dermatology represents one of the most underserved subspecialties in pediatrics. Artificial intelligence (AI) and telemedicine have become considerable in dermatology, reaching diagnostic accuracy comparable to or exceeding that of in-person visits. This work aims to review the current state of telemedicine [...] Read more.

Background: Pediatric dermatology represents one of the most underserved subspecialties in pediatrics. Artificial intelligence (AI) and telemedicine have become considerable in dermatology, reaching diagnostic accuracy comparable to or exceeding that of in-person visits. This work aims to review the current state of telemedicine and AI in pediatric dermatology, suggesting potential ways to address existing issues and challenges. Methods: We conducted a literature review including only articles published in the last 15 years. A total of 458 studies were identified, of which only 76 were included. Results: Most of the studies on telemedicine evaluate accuracy focused on concordance, which ranges from 70% to 89% for the most common pediatric skin diseases. Telemedicine showed the potential to manage chronic dermatological conditions in children, as well as decrease waiting times, and represents the chance for unprivileged populations to overcome barriers limiting access to medical care. The main limitations of telemedicine consist of the language barrier and the need for adequate technologies and acceptable image-quality video, which can be overcome by AI. AI-driven apps and platforms can facilitate remote consultations between pediatric dermatologists and patients or their caregivers. However, the integration of AI into clinical practice faces some challenges ranging from technical to ethical and regulatory. It is crucial to ensure that the development, deployment, and utilization of AI systems conform to the seven fundamental requirements for trustworthy AI. Conclusion: This study supplies a detailed discussion of open challenges with a particular focus on equity and ethical considerations and defining possible concrete directions. Full article

(This article belongs to the Section Pediatric Dermatology)

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15 pages, 260 KiB

Open AccessArticle

A Nutrition Education Intervention Positively Affects the Diet–Health-Related Practices and Nutritional Status of Mothers and Children in a Pulse-Growing Community in Halaba, South Ethiopia

by Getahun Ersino Lombamo, Carol J. Henry and Gordon A. Zello

Children 2024, 11(11), 1400; https://doi.org/10.3390/children11111400 - 19 Nov 2024

Abstract

Objective: We conducted a six-month nutrition education intervention focused on the consumption of pulses and other foods to assess the effect on knowledge, attitude and practice (KAP) as well as the nutritional status of children and mothers from two pulse-growing communities in Halaba, [...] Read more.

Objective: We conducted a six-month nutrition education intervention focused on the consumption of pulses and other foods to assess the effect on knowledge, attitude and practice (KAP) as well as the nutritional status of children and mothers from two pulse-growing communities in Halaba, south Ethiopia. Methods: About 200 mother–child pairs in each of two purposively selected communities participated in this intervention study. A six-month nutrition education programme, involving interactive monthly community meetings and home visits, was offered to one of the two communities and the other served as a control/comparison. This study incorporated the use of Health Belief Model constructs to assess the KAP/perceptions of mothers surrounding pulse and other food consumptions, as well as nutrition-related issues before and after the intervention. Objective measures included dietary diversity scores (DDSs), one-day weighed dietary intakes and nutritional status measures based on anthropometric information. Demographics and socioeconomic information were also collected at baseline and endline. Results: Significant improvements (p < 0.05) were found in the intervention group on the KAP and perceptions of pulse nutrition benefits among mothers, DDSs and pulse and animal source food consumption indexes for mothers and children and the mean body-mass-index-for-age Z-score and wasting among children. Conclusions: Community-based nutrition education interventions involving monthly interactive community meetings and home visits in pulse-growing communities from a resource-poor country like Ethiopia can be effective in improving mothers’ knowledge of pulse nutrition and consumption frequency, leading to improvements in the DDSs of children and mothers while decreasing child underweight and wasting. Full article

(This article belongs to the Section Global Pediatric Health)

11 pages, 694 KiB

Open AccessArticle

Investigation of the Etiology of Molar Incisor Hypomineralization in Children Residing in Konya Province and Surrounding Areas, Türkiye

by Aslı Seloğlu and Firdevs Kahvecioğlu

Children 2024, 11(11), 1399; https://doi.org/10.3390/children11111399 - 19 Nov 2024

Abstract

Background: According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to [...] Read more.

Background: According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to contribute to the literature by identifying possible etiological factors. Methods: This research was conducted with children aged 8–11 years old and their parents from Konya province and surrounding provinces. While children who were diagnosed with MIH as a result of the examination constituted the study group, children with no findings of MIH during intraoral examination were included in the control group. Between February and October 2020, 104 patients for the study group and 104 patients for the control group were reached, and a survey was administered to a total of 208 parents. Results: Asthma, pneumonia, lower respiratory tract infections, diarrhea, a fever, and febrile convulsions between the ages of 0–4 have been found to be related to MIH (p < 0.05). Conclusions: The association between medical diseases in children and enamel defect formation draws attention to the importance of pediatricians in the early diagnosis of MIH cases. Pediatricians can be very helpful in informing parents of children with health problems about possible dental defects and referring them to a pediatric dentist. Full article

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

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13 pages, 425 KiB

Open AccessArticle

Executive Functions and Special Educational Needs and Their Relationship with School-Age Learning Difficulties

by Juan Manuel Núñez, Ana Soto-Rubio and Marián Pérez-Marín

Children 2024, 11(11), 1398; https://doi.org/10.3390/children11111398 - 19 Nov 2024

Abstract

Background/Objectives: The relationship between executive functions, special educational needs (SEN), and learning difficulties in school-aged children is critical for developing effective educational interventions. This study explores the connection between executive functions and SEN in primary school students, examining differences in executive function profiles [...] Read more.

Background/Objectives: The relationship between executive functions, special educational needs (SEN), and learning difficulties in school-aged children is critical for developing effective educational interventions. This study explores the connection between executive functions and SEN in primary school students, examining differences in executive function profiles between those with and without SEN and their impact on learning difficulties. Methods: In total, 123 primary school students aged 6 to 12 and their teachers and parents participated in this study. The Behavior Rating Inventory of Executive Function (BRIEF-2) and the Prediscal test were used to assess difficulties in reading and mathematics, and sociodemographic and clinical data were collected through ad hoc records. Results: The results indicated that students with SEN exhibited significantly more affected executive function profiles compared to their peers without SEN in both family and school contexts, highlighting areas such as cognitive flexibility, initiative, working memory, planning and organisation, task supervision, and material organisation. Additionally, significant negative correlations were found between executive functions and performance in reading and mathematics, suggesting that deficits in executive functions are strongly associated with SEN. Conclusions: These findings underscore the critical role of executive functions in understanding and addressing SEN and learning difficulties, emphasising the need for comprehensive assessment programmes and early intervention targeting executive function deficits to support the academic and overall development of students with SEN. Full article

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

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12 pages, 1034 KiB

Open AccessReview

Diagnosis and Treatment of Infantile Hemangioma from the Primary Care Paediatricians to the Specialist: A Narrative Review

by Francesco Bellinato, Maria Marocchi, Luca Pecoraro, Marco Zaffanello, Micol Del Giglio, Giampiero Girolomoni, Giorgio Piacentini and Erika Rigotti

Children 2024, 11(11), 1397; https://doi.org/10.3390/children11111397 - 18 Nov 2024

Abstract

Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it [...] Read more.

Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it is essential to start oral propranolol (2–3 mg/kg/day in 2 doses/day) within the 5th month of life (i.e., during the proliferative phase) and to complete the therapy cycle for at least 6 months. This review aims to summarise the epidemiology, clinical presentation, diagnosis, and treatment of IHs and to highlight the importance of proper referral to specialised hub centres. Patients with vascular anomalies, particularly those suspected of having IH, should be referred to a specialised centre for accurate diagnosis, management by a multidisciplinary team, and timely treatment. IHs may pose life-threatening, functional, and aesthetic risks or may ulcerate. Segmental infantile haemangioma of the face/neck and the lumbosacral regions can be associated with various malformations. To ensure timely specialist evaluation and treatment to reduce the potential risk of complications, it is essential to identify high-risk IHs rapidly. The Infantile Haemangioma Referral Score (IHReS) scale is an important tool to assist primary care paediatricians and general dermatologists. Full article

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13 pages, 892 KiB

Open AccessArticle

Voices of Hope: Leveraging Think-Aloud Cognitive Interviews to Develop a Hope Assessment Tool for Young People Living with Chronic Health Conditions

by Emily von Scheven, Mitchell Braun, Bhupinder Nahal, Emily R. Perito, Paul Brakeman, William Daniel Soulsby, Laura Quill, Addison Cuneo and Linda S. Franck

Children 2024, 11(11), 1396; https://doi.org/10.3390/children11111396 - 18 Nov 2024

Abstract

Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young [...] Read more.

Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young people’s and their caregivers’ own words. Here, we aimed to develop a hope assessment tool to facilitate the future evaluation of interventions to support wellness and health for young people growing up with chronic health conditions; Methods: We developed Likert-type scale questions using the young people’s and caregivers’ definitions of hope and applied the think-aloud cognitive interview method to assess understanding and to inform sequential iteration. Interviews were recorded and insights from participant interviews were analyzed thematically. Results: In total, 11 youth (age 12–16 years) with various chronic health conditions completed surveys and interviews over three iteration cycles. Responses to the six-point Likert-scale questions ranged from 1 (none of the time) to 6 (all of the time) (median 5). All of the young people (n = 11) reported that they do things they enjoy, either all of the time or most of the time. In contrast, only 36% felt energetic, either all or most of the time. Three themes were identified: my body and hope; my identity, self-image, and hope; and my world and hope. Conclusions: In addition to gaining important feedback that allowed us to improve item word choice to maximize assessment tool understanding, we gained valuable insights into the multidimensional construct of hope. Thematic analysis revealed the importance of physical symptoms and identity to the meaning of hope in the context of a young person’s life. Our new hope assessment tool derived from the young people’s own definition of hope has face and content validity for use in clinical and research settings to evaluate hope among pediatric patients living with chronic health conditions. Full article

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9 pages, 1991 KiB

Open AccessCase Report

Broadening the PHIP-Associated Neurodevelopmental Phenotype

by Giulia Pascolini, Giovanni Luca Scaglione, Balasubramanian Chandramouli, Daniele Castiglia, Giovanni Di Zenzo and Biagio Didona

Children 2024, 11(11), 1395; https://doi.org/10.3390/children11111395 - 17 Nov 2024

Abstract

Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital [...] Read more.

Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital anomalies, so the condition can be considered as an ID–overweight syndrome. Case Description: We evaluated a child presenting with DD/ID and a craniofacial phenotype reminiscent of a Pitt–Hopkins syndrome (PTHS)-like condition. We performed a clinical exome analysis on his biological sample, as well as an in silico prediction of the obtained data. At the same time, we interrogated the DeepGestalt technology powered by Face2Gene (F2G), using a frontal image of the proband, and clinically reviewed the earlier CHUJANS patients. In this child, we found a novel PHIP pathogenetic variant, which we corroborated through a protein modeling approach. The F2G platform supported the initial clinical hypothesis of a PTHS-like condition, while the clinical review highlighted the lack of the main frequent CHUJANS clinical features in this child. Conclusions: The unusual clinical presentation of this novel patient resembles a PTHS-like condition. However, a novel variant in PHIP has been unexpectedly detected, expanding the phenotypic spectrum of CHUJANS. Notably, PTHS (MIM#610954), which is a different ID syndrome caused by heterozygous variants in TCF4 (MIM*610954), is not classically considered in the differential diagnosis of CHUJANS nor has been cited in the previous studies. This could support other complex diagnoses and invite further patients’ descriptions. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)

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9 pages, 224 KiB

Open AccessArticle

Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit

by Maha Azzam, Yousef M. AlTalhi, Hani Alsawadi, Mohamed Humoodi, Abdullah Alzahrani, Amir Shehzad Hayat, Mohammed Bakhsh and Sara Osman

Children 2024, 11(11), 1394; https://doi.org/10.3390/children11111394 - 17 Nov 2024

Abstract

Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. [...] Read more.

Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. Objective: To identify the incidence and risk factors for Central Venous Catheter-Related Thrombosis (CVC-RT) among patients admitted to the Pediatric Intensive Unit. Method: This was a prospective, observational, single-center study that was conducted over 17 months from September 2019 to January 2021 at King Abdulaziz Medical City, Jeddah. Design: Prospective observational study. Setting: King Abdulaziz Medical City, a tertiary care center in the western region of Saudi Arabia. Patients: Pediatric patients aged 1 to 168 months who were admitted to the PICU and required central line insertion (whether inserted centrally or peripherally) for more than 48 hours were included. Screening for thrombosis was performed within day 4–7 post-line insertion and again on the 14th day. Results: A total of 255 patients were enrolled over 17 months. The incidence rate of CVC-RT was 5.4%. The type of CVC was significantly different between the two groups; in the no thrombosis group, 59.2% had a central line while in the CVC-RT groups, 51.9% had a PIC line (p = 0.027). In a multivariate regression analysis including patients’ clinical profile, high D-dimer as baseline and low platelets were both significant risk factors for CVC-RT [adjusted OR = 3.22, CI (1.25–8.28), p = 0.015 and adjusted OR = 7.38, CI (2.18–25.02), p = 0.001], respectively. Conclusions: The current study found that PIC line was associated with an increased risk of CVC-RT, which is congruent with the literature. As children with CVC can have multiple risk factors for developing CVC-RT, it is important to conduct further large prospective studies to identify such factors and decrease the incidence of CVC-RT. Full article

(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)

19 pages, 483 KiB

Open AccessArticle

Night Sleep, Parental Bedtime Practices and Language Development in Low-Risk Preterm and Full-Term Late Talkers: A Longitudinal Study in the Third Year of Life

by Mariagrazia Zuccarini, Martina Riva, Arianna Aceti, Luigi Corvaglia, Anat Scher, Annalisa Guarini and Alessandra Sansavini

Children 2024, 11(11), 1393; https://doi.org/10.3390/children11111393 - 16 Nov 2024

Abstract

Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine [...] Read more.

Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine the development of night sleep (total night sleep difficulties, settling, night waking, and co-sleeping), parental bedtime practices (total parental bedtime practices, active physical comforting, encouraging autonomy, and leaving to cry), and expressive language (word and sentence production), and their associations in low-risk preterm and full-term late talkers from 31 to 37 months of age. Methods: Parents of 38 late talkers, 19 low-risk preterm and 19 full-term children, completed the Italian versions of the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behavior Scale, and the MacArthur-Bates Communicative Development Inventory Words and Sentences Long Form. Results: Late talkers’ night sleep difficulties, such as settling to sleep and night waking, decreased over time, with low-risk preterm late talkers experiencing more night waking and co-sleeping than full-term peers. Parents reported that instances of active physical comforting and leaving to cry also decreased, with parents of low-risk preterm late talkers reporting higher active physical comforting scores than parents of full-term peers. Improvements in parental practices of encouraging autonomy were significantly associated with increased sentence production from 31 to 37 months. Conclusions: Findings highlight the importance of monitoring night sleep in preterm and full-term late talkers. They also suggest that populations vulnerable to sleep and language delays may particularly benefit from targeted interventions promoting autonomy in their bedtime routines, which, in turn, could support their language development trajectories. Full article

(This article belongs to the Special Issue Early Interventions for Children with Language Developmental Disabilities)

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