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Pediatr. Rep., Volume 16, Issue 4 (December 2024) – 14 articles

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9 pages, 592 KiB  
Article
Percutaneous Ultrasound-Guided Renal Biopsy in Greek Children: 15 Years of Experience at a Single Center
by John Dotis, Antonia Kondou, Vasiliki Karava, Pavlos Siolos, Vivian Georgopoulou, George Liapis, Maria Stamou, Fotios Papachristou and Nikoleta Printza
Pediatr. Rep. 2024, 16(4), 974-982; https://doi.org/10.3390/pediatric16040083 - 8 Nov 2024
Viewed by 238
Abstract
Background: Percutaneous ultrasound-guided renal biopsy (PRB) is a key element for diagnosis and management of several renal pathologies. We aimed to lay out the experience of our pediatric nephrology unit performing PRBs. The rationale and findings of these biopsies, safety issues and considerations [...] Read more.
Background: Percutaneous ultrasound-guided renal biopsy (PRB) is a key element for diagnosis and management of several renal pathologies. We aimed to lay out the experience of our pediatric nephrology unit performing PRBs. The rationale and findings of these biopsies, safety issues and considerations of the extracted data are going to be analyzed. Methods: A retrospective study was conducted from 2008 to 2023 based on the review of the medical records of pediatric patients who underwent PRBs. In total, 216 kidney biopsies in 206 patients were performed: 115 (53.2%) during the 2008–2015 period and 101 (46.8%) during the 2016–2023 period. Results: The most frequent clinical indication for PRBs was nephritic syndrome followed by nephrotic syndrome, observed in 84 (40.8%) and 72 (34.9%) patients, respectively. The predominant diagnosis was minimal change disease (MCD) (23.3%), followed by focal segmental glomerulosclerosis (FSGS) (15%) equal to lupus nephritis (LN) (15%), and immunoglobulin A nepropathy (10.2%). Minor complications, such as subcapsular hematomas were observed in approximately 15% of patients while no therapeutic intervention was needed. Conclusions: This report is the first review of pathohistological data covering a pediatric population over a 15-year period in Greece and one of the largest in southeastern Europe, especially in the Balkan region. The main indication for a PRB was nephritic syndrome; however, MCD was the main histological diagnosis. This study emphasis the fact that PRBs constitute a safe and reliable method of diagnostic approach to kidney diseases in childhood and offers important information on therapeutic approaches as well as the prognosis of these patients. Full article
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17 pages, 310 KiB  
Article
Quality of Life and Coping Strategies in Children with and Without Learning Disabilities from the Perspective of Their Parents and Caregivers
by Ayoob Lone, Abdul Sattar Khan, Fahad Abdullah Saeed AlWadani and Abdullah Almaqhawi
Pediatr. Rep. 2024, 16(4), 957-973; https://doi.org/10.3390/pediatric16040082 - 7 Nov 2024
Viewed by 203
Abstract
Background: Children with learning disability (LD) often experience a poor quality of life (QOL) compared to their peers without a known history of LD. Coping strategies are known to play a role in influencing their QOL. Objectives: This study aims to compare the [...] Read more.
Background: Children with learning disability (LD) often experience a poor quality of life (QOL) compared to their peers without a known history of LD. Coping strategies are known to play a role in influencing their QOL. Objectives: This study aims to compare the QOL and coping strategies between children with and without LD. Additionally, it seeks to evaluate how coping strategies impact the QOL of children with LD in the Eastern Governorate of Saudi Arabia. Method: A representative sample of 6 to 18-year-old children with (n = 97) and without (n = 89) LD were recruited from different schools. The Short Form-12 (SF-12) health survey was used to assess both physical and mental health components, while the validated Coping Orientation to Problems Experienced Inventory (Brief-COPE) measured coping strategies. Data analysis included descriptive statistics (mean, standard deviation, percentage), independent t-tests, Spearman’s correlation, and binary logistic regression. Results: The results reveal that participants with LD show poor QOL in terms of role functioning, bodily pain, general health, vitality, social functioning, role emotion, and mental health in comparison to non-disabled children. Participants with LD show greater reliance on substance abuse and religious coping than non-disabled children. The results clearly indicate a fairly to moderately strong correlation between the physical component summary and all approaches to coping strategies except religious coping. Of all the approaches to coping methods, we observe a weak correlation among denial (r = −0.17, p < 0.05), substance abuse (r = −0.15, p < 0.05), and behavioral disengagement (r = −0.18, p < 0.05) with the mental component summary aspect of QOL. The results of logistic regression analysis indicate that grade (OR = 3.79; p = 0.01) is significantly related to LD. The physical component summary score is significantly associated with denial (β = −0.33, CI = −6.87–−2.19, p < 0.01), and substance abuse (β = −0.14, CI = −4.96–0.40, p < 0.05), while the mental component summary is significantly associated with active coping = −0.30, CI = −4.50–0.76, p < 0.01), behavioral disengagement (β = −0.20, CI = −4.48–0.30, p < 0.05), and humor coping strategy (β = 0.22, CI = 0.06–4.55, p < 0.05). Conclusion: These findings are relevant to researchers, psychologists, special educators, teachers, and clinicians, given the need to understand the coping variables to improve the QOL of these learning-disabled children. Full article
12 pages, 995 KiB  
Article
Salivary IL-1 Beta Level Associated with Poor Sleep Quality in Children/Adolescents with Autism Spectrum Disorder
by Milagros Fuentes-Albero, Mayra Alejandra Mafla-España, José Martínez-Raga and Omar Cauli
Pediatr. Rep. 2024, 16(4), 945-956; https://doi.org/10.3390/pediatric16040081 - 31 Oct 2024
Viewed by 306
Abstract
Background: Sleep disorders are common in youths with autism spectrum disorders. Inflammatory cytokines such as Il-1 beta and Il-6 in saliva have been associated with alterations in sleep quality in various conditions. We assessed whether there were associations between the salivary concentration of [...] Read more.
Background: Sleep disorders are common in youths with autism spectrum disorders. Inflammatory cytokines such as Il-1 beta and Il-6 in saliva have been associated with alterations in sleep quality in various conditions. We assessed whether there were associations between the salivary concentration of IL-1 beta and IL-6 and sleep quality in youths with ASD versus typically developing (TD) age- and gender-matched youths. Method: Forty children and adolescents with ASD or TD participated in this study (20% females). Their parents answered the items of a validated questionnaire on sleep quality (Pittsburgh Sleep Quality Index). Results: The mean Pittsburgh score was significantly higher (i.e., the quality of sleep was poorer) in the ASD group (8.68 ± 0.35 (SEM), ranging from 7 to 12 points), compared to the TD group (7.35 ± 0.54 (SEM), ranging from 2 to 12 points) (p = 0.02, Mann–Whitney U test). There were no significant differences in the salivary concentration of Il-1 beta and IL-6 receptor between the two groups, but salivary IL-1 beta concentration was inversely associated with poor sleep quality in the ASD group. No associations between the salivary Il-6 concentration and sleep quality were found in either group. Linear regression analysis by separate groups revealed significant associations between the sleep quality score and the concentration of IL-1 beta in the ASD group (p = 0.01, OR = −0.53, 95% CI −0.008–0.001). In contrast, no significant associations were observed in the TD group, or for IL-6 in either group. No significant effects of sex, age, or use of psychotropic medications were found. Conclusions: Children and adolescents with ASD showed significantly poorer sleep quality based on their parents’ reports compared to the TD group, and the salivary IL-1 beta concentration was inversely associated with sleep quality only in the ASD group. Further studies on the associations between inflammatory cytokines and sleep in ASD are needed. Full article
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11 pages, 1467 KiB  
Article
Elevation of NT-proBNP Levels in Pediatric and Young Adult Hematopoietic Stem Cell Transplant Patients with Endotheliopathy
by Kimberly Uchida, Xiaomeng Yuan, Jennifer McArthur, Rebekah Lassiter, Haitao Pan, Dinesh Keerthi, Katherine Tsai, Yvonne Avent, Melissa Hines, Hugo R. Martinez, Amr Qudeimat and Saad Ghafoor
Pediatr. Rep. 2024, 16(4), 934-944; https://doi.org/10.3390/pediatric16040080 - 30 Oct 2024
Viewed by 279
Abstract
Background/Objectives: Hematopoietic stem cell transplantation (HSCT) in pediatric and young adult (YA) patients can lead to endotheliopathy, such as thrombotic microangiopathy (TMA), sinusoidal obstruction syndrome (SOS), and diffuse alveolar hemorrhage (DAH). Natriuretic peptides have been studied as markers of endotheliopathy and critical illness. [...] Read more.
Background/Objectives: Hematopoietic stem cell transplantation (HSCT) in pediatric and young adult (YA) patients can lead to endotheliopathy, such as thrombotic microangiopathy (TMA), sinusoidal obstruction syndrome (SOS), and diffuse alveolar hemorrhage (DAH). Natriuretic peptides have been studied as markers of endotheliopathy and critical illness. We hypothesized that an elevation in NT-proBNP was associated with the development of endotheliopathy (DAH, SOS, or TMA) in the first 100 days following HSCT in pediatric and YA patients. Methods: IRB-exempt status was obtained. This retrospective case–control study reviewed HSCT at our institution from 2016 to 2020. Cases were selected based on an endotheliopathy diagnosis in the first 100 days after HSCT. Cases were matched with controls. Baseline and near-event NT-proBNP levels were compared between cases and matched controls. The effect of NT-proBNP levels on developing endotheliopathy was estimated using conditional logistic regression. Results: Sixty-two patients were included (31 cases, 31 controls). Near-event NT-proBNP was significantly higher in cases compared to controls (median: 473 vs. 187 pg/mL, p = 0.03, Wilcoxon rank–sum test), in contrast to comparison in baseline NT-proBNP (median: 86 vs. 86 pg/mL, p = 0.51). After adjusting for covariates, an association between near-event NT-proBNP and odds of developing endotheliopathy did not achieve statistical significance. However, trends from most common transplant indications suggested an association between an elevated near-event NT-proBNP level and endotheliopathy, particularly in acute lymphoblastic leukemia (ALL) patients. Conclusions: NT-proBNP should be studied further as a biomarker for endotheliopathy in pediatric and YA patients undergoing HSCT. This may be particularly relevant for patients undergoing HSCT for ALL. Full article
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9 pages, 1002 KiB  
Review
High-Flow Oscillatory Ventilation: A Possible Therapeutic Option for Pediatric Patients with Cardiovascular Diseases
by Stefano Scollo, Luigi La Via, Piero Pavone, Marco Piastra, Giorgio Conti and Carmelo Minardi
Pediatr. Rep. 2024, 16(4), 925-933; https://doi.org/10.3390/pediatric16040079 - 24 Oct 2024
Viewed by 363
Abstract
High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal [...] Read more.
High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal pulmonary bleeding and idiopathic pulmonary hypertension (IPH). Although this ventilation technique is commonly recognized as a valuable therapeutic option in the general pediatric population, this is not the same for children with congenital cardiovascular diseases. The key mechanism of oscillatory ventilation is continuous positive pressure administered within the airways via a small tidal volume at high frequency. Tidal volumes are between 1 and 3 mL/kg delivered at 5–15 Hz, equivalent to 300–900 breaths per minute. A few older studies conducted on humans and animals highlight that HFOV may be dangerous for congenital heart patients. According to these evidences, hemodynamic parameters such as blood pressure, wedge pressure, central venous pressure, heart rate and inotrope level can be dangerously changed for patients with congenital heart disease; therefore, oscillatory ventilation should be avoided. Numerous retrospective studies have pointed out how oscillatory ventilation constitutes a valid therapeutic option in children with congenital heart disease. Recently, new evidences have highlighted how hemodynamic parameters are modified in a non-significant way by this type of ventilation, remaining beneficial as in the normal pediatric population. This narrative review aims to describe the mechanisms of oscillatory ventilation and collect all the available evidences to support its use in pediatric patients with congenital heart problems. Full article
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4 pages, 193 KiB  
Editorial
Respiratory Syncytial Virus in Pregnancy: An Obstetrics View
by Mattia Dominoni, Barbara Gardella and Arsenio Spinillo
Pediatr. Rep. 2024, 16(4), 921-924; https://doi.org/10.3390/pediatric16040078 - 17 Oct 2024
Viewed by 540
Abstract
Respiratory syncytial virus (RSV) represents one of the most prevalent causes of lower respiratory tract infection in newborns and children by the time they are two years old, with a peak rate of hospitalization in those between two and three months of age [...] Read more.
Respiratory syncytial virus (RSV) represents one of the most prevalent causes of lower respiratory tract infection in newborns and children by the time they are two years old, with a peak rate of hospitalization in those between two and three months of age and a high risk of morbidity and mortality, especially under the age of six months of life [...] Full article
19 pages, 486 KiB  
Article
Parents’ Knowledge and Attitudes Toward Pediatric Ophthalmic Disorders in Saudi Arabia: A Cross-Sectional Study
by Saja Radhi G. Alanazi, Haneen Wadi H. Alanazi, Wasan Ghathwan Alanazi, Nawal Surhuj Q. Alanazi, Dareen Owaid B. Alenezi, Maisa Al-Sweilem, Maram Hassan Alqattan, Iftikhar Lafi N. Alanazi, Jumanah Mohammed Tirksstani, Reem Saeed AlSarhan, Saleh Ghulaysi, Hanan A. Elgendy and Manal S. Fawzy
Pediatr. Rep. 2024, 16(4), 902-920; https://doi.org/10.3390/pediatric16040077 - 17 Oct 2024
Viewed by 473
Abstract
Recognizing pediatric eye health issues at an early stage, along with ensuring that parents are well informed, is crucial. This study measures parents’ knowledge and perspectives on pediatric ophthalmic disease. The study utilized a cross-sectional design, and participants included Saudi parents of children [...] Read more.
Recognizing pediatric eye health issues at an early stage, along with ensuring that parents are well informed, is crucial. This study measures parents’ knowledge and perspectives on pediatric ophthalmic disease. The study utilized a cross-sectional design, and participants included Saudi parents of children residing in Saudi Arabia. Data were collected using a pre-validated self-administered questionnaire with a scoring system. Sociodemographic characteristics and factors associated with knowledge/attitude were collected and analyzed. Initially, 425 respondents participated in this study. Excluding the participants whose work was related to healthcare and those with incomplete data yielded 370 responses on which the subsequent analyses were performed. The analysis revealed that only half of the parents recognized the need for annual eye examinations for children. Most of them showed gaps in knowledge regarding the frequency of routine eye exams and indicators of visual problems. Notably, parents with good/excellent knowledge were more proactive in their eye care practices, such as adherence to recommended eye examination schedules and accepting corrective measures like glasses for common conditions such as refractive errors and amblyopia. However, parental willingness to permit surgical interventions did not correlate significantly with their level of knowledge, signaling the influence of other factors. In conclusion, this study underscores the need for enhanced public health education to improve parental awareness of pediatric eye diseases in Saudi Arabia. Given the link between knowledge and proactive eye health practices, targeted interventions should distribute comprehensive, culturally sensitive information accessible to all demographics. Full article
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10 pages, 746 KiB  
Article
Growth Parameters and Prevalence of Obesity in PKU Patients and Peers: Is This the Right Comparison?
by Giulia Paterno, Vito Di Tullio, Rosa Carella, Giada De Ruvo, Fabrizio Furioso, Aleksandra Skublewska-D’Elia, Donatella De Giovanni and Albina Tummolo
Pediatr. Rep. 2024, 16(4), 892-901; https://doi.org/10.3390/pediatric16040076 - 16 Oct 2024
Viewed by 495
Abstract
Background: One of the main objectives of Phenylketonuria (PKU) management is represented by optimising the growth trend under restricted protein diet regimen. The data on long-term growth in PKU children are limited and mostly based on earlier studies. Methods: The data for this [...] Read more.
Background: One of the main objectives of Phenylketonuria (PKU) management is represented by optimising the growth trend under restricted protein diet regimen. The data on long-term growth in PKU children are limited and mostly based on earlier studies. Methods: The data for this twelve-year longitudinal study were collected from 34 PKU children and 37 healthy peers, whose auxological parameters were taken at 7 time-points over the follow-up. The weight-for-length ratio (WLR) z-score and body mass index (BMI) z-score were considered according to age. Prevalence of overweight/obesity was evaluated at last assessment. Results: The median BMI z-score of PKU children was normal and not statistically different from that of controls on all the seven time-point assessments. Their distributions tended to be wider than those of peers, with the upper limit exceeding the normal range since 12 months old, with a peak specifically at 3 years of age. In controls, there was a tendency to approach the BMI z-score values of overweight in later childhood. The prevalence of overweight was comparable (29% vs. 25%, p: 0.78) between the two groups at last assessment, and obese subjects (3/37) were only detected in the control group. Conclusions: In this study, we report data from a long-term follow-up on growth, highlighting that the median BMI z-score of PKU children was normal and not statistically different from that of controls. Also, the prevalence of obesity at 12 years of age was overlapping. However, the high prevalence of overweight children in the general population may explain the lack of difference and does not reassure about patients’ nutritional risk. Full article
(This article belongs to the Section Inborn Errors and Neonatal Screening)
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12 pages, 309 KiB  
Article
Beyond Reading: Psychological and Mental Health Needs in Adolescents with Dyslexia
by Manuel-Ramón Morte-Soriano and Manuel Soriano-Ferrer
Pediatr. Rep. 2024, 16(4), 880-891; https://doi.org/10.3390/pediatric16040075 - 15 Oct 2024
Viewed by 474
Abstract
Background. Overall, children and adolescents diagnosed with dyslexia or ADHD show an increased risk for psychological and mental health problems, and dyslexia and ADHD tend to coexist frequently. Thus, the main objective of this study was to examine psychological and mental health problems [...] Read more.
Background. Overall, children and adolescents diagnosed with dyslexia or ADHD show an increased risk for psychological and mental health problems, and dyslexia and ADHD tend to coexist frequently. Thus, the main objective of this study was to examine psychological and mental health problems in dyslexia. Method. Participated 95 adolescents with dyslexia (DG), comorbid dyslexia + attention-deficit hyperactivity disorder, combined subtype (D + ADHD-CG), and a comparison group with typical development (TDCG). Self-reported measures of anxiety and depression, and parent and teacher versions of the Strengths and Difficulties Questionnaire (SDQ) were used. Results. Self-reports of internalizing problems showed that adolescents in the GD and D + ADHD-CG groups had more depression and stated anxiety problems with a very high percentage above the clinical cut-off point than the CG. Both the parent and teacher reports showed that the DG and D + ADHD-CG groups obtained higher mean values and a higher number of adolescents above the clinical cut-off of internalizing, externalizing, and total problems than the TDCG. The comorbid D + ADHD-CG group had the highest internalizing and externalizing problems. Conclusions. In conclusion, our findings indicate that the internalizing and externalizing problems experienced by adolescents with dyslexia and comorbid ADHD should be recognized early and treated promptly by education professionals. Full article
(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)
8 pages, 1384 KiB  
Article
Trends in Marijuana Use among Adolescents in the United States
by Jack Yang, Maria C. Mejia, Lea Sacca, Charles H. Hennekens and Panagiota Kitsantas
Pediatr. Rep. 2024, 16(4), 872-879; https://doi.org/10.3390/pediatric16040074 - 15 Oct 2024
Viewed by 4762
Abstract
Background: Marijuana is a widely used substance in the United States (US) and worldwide. We explored trends in self-reported marijuana use among US adolescents overall as well as by gender, race/ethnicity, and school grade. Methods: Biennial data from the Youth Risk Behavior Survey [...] Read more.
Background: Marijuana is a widely used substance in the United States (US) and worldwide. We explored trends in self-reported marijuana use among US adolescents overall as well as by gender, race/ethnicity, and school grade. Methods: Biennial data from the Youth Risk Behavior Survey from 2011 to 2021 included 88,183 adolescents in grades 9th through 12th. We used percentage change as a measure of effect and the chi-square test for significance. All analyses were conducted at the national level. Results: The percentage of adolescents who reported current marijuana use dropped significantly from 23.1% in 2011 to 15.8% in 2021 (p < 0.05). The self-report of trying marijuana for the first time before age 13 also decreased significantly from 8.1% in 2011 to 4.9% in 2021 (p < 0.05). For current use, there were similar significant decreases by race/ethnicity, with Asian, Hispanic, and White adolescents experiencing the steepest declines. In 2021, the percentage of Black adolescents self-reporting marijuana use was significantly higher (20.5%) compared to White (14.8%), Hispanic (16.7%), and Asian (5.1%) adolescents. Although current marijuana use declined significantly for both girls and boys over time, in 2021 girls were more likely (17.8%) to currently use marijuana than boys (13.6%). In 2011, the opposite was true, with boys (25.9%) being more likely to use marijuana than girls (20.1%). Conclusions: In US adolescents in 2021, there were decreases in self-reports of marijuana use compared to 2011. Behavioral interventions within school and family environments may be critical in mitigating the risk of marijuana use. Full article
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18 pages, 910 KiB  
Article
Embedding Physical Therapy in the Pediatric Primary Care Setting: Qualitative Analysis of Pediatricians’ Insights on Potential Collaborative Roles and Benefits
by Ryan P. Jacobson and Rebecca R. Dobler
Pediatr. Rep. 2024, 16(4), 854-871; https://doi.org/10.3390/pediatric16040073 - 9 Oct 2024
Viewed by 626
Abstract
The growing need for collaborative healthcare teams to meet complex health challenges has led to physical therapists (PTs) being embedded in adult primary care settings for many years now. However, this model of care has not been found in pediatrics. This qualitative study [...] Read more.
The growing need for collaborative healthcare teams to meet complex health challenges has led to physical therapists (PTs) being embedded in adult primary care settings for many years now. However, this model of care has not been found in pediatrics. This qualitative study sought to gain insights from pediatricians on the potential of embedding pediatric PTs in primary care. Participants were nine pediatricians practicing in both urban and rural, hospital-based and private settings. Semi-structured interviews were recorded, transcribed, and analyzed via thematic analysis per published methods, assuring trustworthiness. Three overarching themes emerged: pediatricians’ priorities aligned with the Quadruple Aim of Healthcare, embedded PTs could fill multiple roles in pediatrics, and they could see a wide variety of patients, highlighting real potential benefits in primary care. Participants endorsed in-office focused treatments, screening to determine optimal care pathways, and ongoing patient follow-up as potential PT roles in this setting. Providers thought that PTs could help manage care for musculoskeletal complaints, high-risk infants, medically complex children, autism, and obesity. An advanced-trained PT having attributes of confidence, adaptability, and open-mindedness was desired. All participants endorsed pediatric primary care PTs as having potentially high value in their practice. This is the first known study on the potential of embedding a PT in the pediatric primary care setting, offering valuable insights from pediatricians to be leveraged in implementation planning. Full article
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10 pages, 1738 KiB  
Review
Acute Onset of Peripheral Facial Nerve Palsy in Children: An Overview
by Virginia Fancello, Andrea Ciorba, Daniele Monzani, Elisabetta Genovese, Francesco Bussu and Silvia Palma
Pediatr. Rep. 2024, 16(4), 844-853; https://doi.org/10.3390/pediatric16040072 - 1 Oct 2024
Viewed by 772
Abstract
Background The facial nerve (FN) plays a pivotal role in human life; apart from its sensory and parasympathetic functions, it innervates the facial muscles, and it is therefore involved in non-verbal communication, allowing us to express emotions and reactions. Especially in the case [...] Read more.
Background The facial nerve (FN) plays a pivotal role in human life; apart from its sensory and parasympathetic functions, it innervates the facial muscles, and it is therefore involved in non-verbal communication, allowing us to express emotions and reactions. Especially in the case of childhood onset, FN dysfunction can severely affect the quality of life. Methods The aim of this review is to analyze the most recent literature, focusing on the acute onset of peripheral FN palsy among pediatric patients, discussing the different etiologies, prognoses, and management strategies. A total of 882 papers were initially identified, but only 7 met the selection criteria. Therefore, data on 974 children in total were pooled and analyzed. Results According to the findings of this review, FN palsy is idiopathic in most cases, while an infective etiology was identified as the second most common. The main pathogen agents identified were Borrelia Burgdorferi, especially in endemic areas, and Herpesviridae. Respiratory tract infections and/or ear infections were also described. Head trauma or direct injury of the FN accounted for 2% of all cases. Conclusions The overall FN recovery rate is high, even though the etiology remains unknown for most patients. Therapeutic indications are still lacking, especially in the case of non-recovering FN palsy. In our opinion, large, prospective studies are necessary for improving our knowledge of this disorder and establishing evidence-based approaches. Full article
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11 pages, 3357 KiB  
Case Report
Complicated Pneumonia in a Child: Hydropneumothorax Associated with MIS-C and GAS Superinfection
by Snezhina Lazova, Nadzhie Gorelyova-Stefanova, Yoanna Slabakova, Iren Tzotcheva, Elena Ilieva, Dimitrina Miteva and Tsvetelina Velikova
Pediatr. Rep. 2024, 16(4), 833-843; https://doi.org/10.3390/pediatric16040071 - 30 Sep 2024
Viewed by 553
Abstract
A hydropneumothorax is an uncommon complication of pneumonia, particularly in pediatric patients, and typically arises secondary to conditions such as malignancies, esophageal-pleural fistula, thoracic trauma, or thoracocentesis. While pneumothorax is rarely reported in adults with COVID-19 and is even less common in children, [...] Read more.
A hydropneumothorax is an uncommon complication of pneumonia, particularly in pediatric patients, and typically arises secondary to conditions such as malignancies, esophageal-pleural fistula, thoracic trauma, or thoracocentesis. While pneumothorax is rarely reported in adults with COVID-19 and is even less common in children, isolated cases have been noted in those with Multisystem Inflammatory Syndrome in Children (MIS-C). A recent alert has also been issued about increased Group A Streptococcus (GAS) infections in Europe. Against this background, the primary aim of this case report is to describe a rare and severe complication of pneumonia in a previously healthy child with MIS-C and a positive throat culture for GAS. Full article
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10 pages, 1444 KiB  
Article
Comparison of One-Year Post-Operative Evolution of Children Born of COVID-19-Positive Mothers vs. COVID-19-Negative Pregnancies Having Congenital Gastrointestinal Malformation and Having Received Proper Parenteral Nutrition during Their Hospital Stay
by Timea Elisabeta Brandibur, Nilima Rajpal Kundnani, Kakarla Ramakrishna, Alexandra Mederle, Aniko Maria Manea, Marioara Boia and Marius Calin Popoiu
Pediatr. Rep. 2024, 16(4), 823-832; https://doi.org/10.3390/pediatric16040070 - 25 Sep 2024
Viewed by 2265
Abstract
Background: The long-term effects on neonates born of COVID-19-positive pregnancies are still unclear. Congenital gastrointestinal malformations (CGIMs) often require urgent surgical intervention and antibiotic coverage. We aim to compare the health status at one-year post-surgical follow-up of cases of CGIM born of COVID-19-positive [...] Read more.
Background: The long-term effects on neonates born of COVID-19-positive pregnancies are still unclear. Congenital gastrointestinal malformations (CGIMs) often require urgent surgical intervention and antibiotic coverage. We aim to compare the health status at one-year post-surgical follow-up of cases of CGIM born of COVID-19-positive pregnancies to those of non-COVID-19 pregnancies. Methods: We conducted a comparative, observational study of 41 patients who underwent surgery at our hospital for congenital gastrointestinal malformations in 2022. They were initially treated with antibiotics and parenteral nutrition, which was later replaced with enteral nutrition gradually after the surgery. We then analyzed the data related to their growth and development during their 12-month follow-up visit at our outpatient clinic. We classified the children born of COVID-19-positive mothers as Group 1 (n = 14) and those born of mothers without COVID-19 symptoms or with unconfirmed status as Group 2 (n = 33). Results: Forty-one patients showed up for a one-year follow-up (between 11 and 13 months of life). Hence, the final Group 1 comprised 12 and Group 2 comprised 29 children. The patients were categorized based on their anatomical location. Of the cohort, 56.09% were preemies, and 43.91% were full-term newborns. We used seven parameters to evaluate both groups based on growth and developmental milestones: verbal skills, cognitive development, weight gain, height achieved, fine motor movements, gross motor movements, and social/emotional behavior. Group 1 children showed a significant decrease in height and weight compared to Group 2 children. In Group 1, 83.33% of patients were prescribed antibiotics, while only 10.34% in Group 2 were in the same situation. There were no cases of malabsorption syndrome in Group 2, but 16.66% of patients in Group 1 had it, with patients being operated on for duodenal malformations. None of the infants had necrotizing enterocolitis, post-surgical complications, or sepsis. All the children received antibiotics to prevent infection before and after surgery. No mortality was noted. Conclusions: In our one-year follow-up study, it was seen that even after surgical correction of congenital gastrointestinal malformations, children born of COVID-19-positive pregnancies can suffer serious growth and developmental delays, and gastrointestinal health issues might be more common. Since the long-term effects of COVID-19-positive pregnancies are not yet clear, larger cohort-based studies are required in this domain. Antibiotics destroy gut microbiota, especially in cases of gastrointestinal malformations and surgical resections. Growth and developmental milestones can not only be affected by CGIMs but also be further delayed by COVID-19 infections. Full article
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