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Children, Volume 9, Issue 12 (December 2022) – 212 articles

Cover Story (view full-size image): Family relationships and self-esteem are relevant variables in the understanding of cyberbullying. This study analyzes the relationship between being a cybervictim or cyberaggressor, self-esteem, and parenting styles (negligent, authoritarian, indulgent, and authoritative). The results obtained suggest that an adequate level of self-esteem, high parental acceptance/involvement, and a reasonably low level of coercion/discipline as the parenting style can have very positive effects on the decrease in violent peer behavior and on the prevention of cyberbullying. View this paper
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Article
Effects of Combined Exercise Program on Spinal Curvature and Balance Ability in Adolescents with Kyphosis
Children 2022, 9(12), 1999; https://doi.org/10.3390/children9121999 - 19 Dec 2022
Viewed by 456
Abstract
Thoracic hyperkyphosis is associated with postural abnormality, physical function, and quality of life. This study aimed to examine the effects of a combined exercise program on the spinal curvature and balance ability in adolescents with kyphosis. Fifty-one adolescents (mean age 21.95 ± 3.90 [...] Read more.
Thoracic hyperkyphosis is associated with postural abnormality, physical function, and quality of life. This study aimed to examine the effects of a combined exercise program on the spinal curvature and balance ability in adolescents with kyphosis. Fifty-one adolescents (mean age 21.95 ± 3.90 year, 23 male and 28 female) diagnosed with kyphosis were randomly divided into two groups: an experimental group (n = 25) and a control group (n = 26). All participants in the study group underwent a combined exercise program for 60 min, three times per week, for 12 weeks. Cobb’s angle and forward head angle showed significant differences between the two groups (p < 0.001). The anterior and posterior weight distributions of static and dynamic plantar foot pressures showed a significant difference between the two groups (p < 0.001), and significant differences were observed only in the study group (p < 0.001). However, the left and right static plantar foot pressures did not differ significantly. In conclusion, these results demonstrate that a combined exercise program is an effective intervention for the improvement of alignment in the spinal curve and balance in adolescents with postural kyphosis. Full article
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Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis
Children 2022, 9(12), 1998; https://doi.org/10.3390/children9121998 - 19 Dec 2022
Viewed by 566
Abstract
The pharmacokinetic (PK) studies of meropenem in Chinese newborns with late-onset sepsis (LOS) are still lacking. Causative pathogens of LOS and their susceptibility patterns in China differ from the data abroad. We, therefore, conducted a developmental population pharmacokinetic–pharmacodynamic analysis in Chinese newborns with [...] Read more.
The pharmacokinetic (PK) studies of meropenem in Chinese newborns with late-onset sepsis (LOS) are still lacking. Causative pathogens of LOS and their susceptibility patterns in China differ from the data abroad. We, therefore, conducted a developmental population pharmacokinetic–pharmacodynamic analysis in Chinese newborns with the goal to optimize meropenem dosing regimens for LOS therapy. An opportunistic sampling strategy was used to collect meropenem samples, followed by model building and validation. A Monte Carlo simulation was performed to show the probability of target attainment (PTA) for various dosages. The information from 78 newborns (postmenstrual age: 27.4–46.1 weeks) was compiled and had a good fit to a 1-compartment model that had first order elimination. The median (range) values of estimated weight–normalized volume of distribution (V)and clearance (CL) were 0.60 (0.51–0.69) L/kg and 0.16 (0.04–0.51) L/h/kg, respectively. Covariate analysis revealed that postnatal age (PNA), gestational age (GA) and current weight (CW) were the most important factors in describing meropenem PK. Simulation results showed for LOS with a minimal inhibitory concentration (MIC) of 8 mg/L, the doses of 30 mg/kg 3 times daily (TID) as a 1-h infusion for newborns with GA ≤ 37 weeks and 40 mg/kg TID as a 3-h infusion for those with GA > 37 weeks were optimal, with PTA of 71.71% and 75.08%, respectively. In conclusion, we proposed an evidence-based dosing regimen of meropenem for LOS in Chinese newborns by using the population pharmacokinetic–pharmacodynamic analysis, based on domestic common pathogens and their susceptibility patterns. Full article
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Article
Testing the Mystic School Mobile Application to Promote Active Commuting to School in Spanish Adolescents: The PACO Study
Children 2022, 9(12), 1997; https://doi.org/10.3390/children9121997 - 19 Dec 2022
Viewed by 532
Abstract
Active commuting to and/or from school (ACS) is an opportunity to increase daily physical activity (PA) levels in young people. Mobile-device interventions focused on promoting the practice of health-related PA can be more cost-effective than traditional interventions in this population. Objective: To analyze [...] Read more.
Active commuting to and/or from school (ACS) is an opportunity to increase daily physical activity (PA) levels in young people. Mobile-device interventions focused on promoting the practice of health-related PA can be more cost-effective than traditional interventions in this population. Objective: To analyze the adolescents’ opinion of the mobile application (app) Mystic School, which was designed to promote ACS in Spanish adolescents. Methods: A total of 44 students (14–15 years old) from Granada and Jaén participated in the test of the Mystic School app during two phases: phase 1 (n = 10) for 2 weeks and phase 2 (n = 34) for 1 month. Each phase included an app presentation, a follow-up, and focus group sessions. The qualitative analysis was carried out through NVivo software. Results: In phase 1, adolescents reported improvements in the design and functioning, such as the avatar movement, virtual steps utilities, and multiplayer function. These suggestions were included in phase 2. After phase 2, adolescents reported that it is important to add the possibility of playing without an Internet connection to the game, to include more competitive options, prizes, and to increase the difficulty of the levels. In both phases, problems with the step number counting remained. Conclusion: The Mystic School app can be a useful tool for the physical education teacher to integrate the content from this curriculum related to the promotion of PA, such as ACS. Full article
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Article
Effect of Intensified Training Camp on Psychometric Status, Mood State, and Hematological Markers in Youth Soccer Players
Children 2022, 9(12), 1996; https://doi.org/10.3390/children9121996 - 19 Dec 2022
Viewed by 611
Abstract
During training camps, training load is purposefully intensified. Intensified training loads (TL) are associated with psychological variations, increased fatigue, insufficient recovery, decreased muscular performance, and biological changes in adult athletes, but whether these changes occur during training camps in youth athletes has not [...] Read more.
During training camps, training load is purposefully intensified. Intensified training loads (TL) are associated with psychological variations, increased fatigue, insufficient recovery, decreased muscular performance, and biological changes in adult athletes, but whether these changes occur during training camps in youth athletes has not been established. The aim of this study was to assess changes in psychometric status, vertical jump performance (i.e., height), and hematological markers before and after an intensive training camp in youth soccer players. In this case, 15male youth soccer players (mean ± SD: age: 14.8 ± 0.4 years; height: 172.0 ± 6.9 cm, body mass: 60.8 ± 7.9 kg; training experience: 5.2 ± 0.7 years) completed a 2-week training program consisting of 1 week of moderate TL (MT) and 1 week of intensive training camp (TC). Rate of perceived exertion (RPE), TL, monotony, strain, and psychometric status (total quality of recovery (TQR) and well-being indices (sleep, stress, fatigue, and muscle soreness) were monitored before each first daily training session across two weeks. The profile of mood states (POMS), countermovement jump (CMJ) height, and blood markers (complete blood count, urea, and creatinine) were assessed before and after TC. TL (d = 5.39, large), monotony (d = 3.03, large), strain (d = 4.38, large), and well-being index (d = 7.5, large) scores increased and TQR (d = 4.6, large) decreased during TC. The TC increased tension, fatigue, and total mood disturbance and decreased vigor (all p <0.01). CMJ performance p < 0.01, d = 0.52, moderate), creatinine (p < 0.01, d = 1.29, large), and leukocyte concentration (p < 0.01, d = 1.4, large) and granulocyte concentration (p < 0.01, d = 1.93, large) increased after TC. Percentage of lymphocytes (p < 0.05, d = 1.17, large) and monocytes (p < 0.01, d = 1.05, large) decreased while the percentage of granulocytes (p < 0.05, d = 0.86, large) increased significantly. Well-being, quality of recovery, mood, granulocyte concentration, and creatinine were all altered during the week-long intensified training camp. These results may provide coaches with valuable information about psychometric status and physiological fatigue and recovery of youth soccer players to better prescribe and adjust training loads during intensive training periods. Full article
(This article belongs to the Section Global and Public Health)
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Review
Glomerular Filtration Rate Assessment in Children
Children 2022, 9(12), 1995; https://doi.org/10.3390/children9121995 - 19 Dec 2022
Viewed by 616
Abstract
Glomerular filtration rate (GFR) measurement is a key tool for determining the degree of chronic kidney disease. The assessment of GFR is even more challenging in children than in adults with more variables in the equation than race and sex. Monitoring the progress [...] Read more.
Glomerular filtration rate (GFR) measurement is a key tool for determining the degree of chronic kidney disease. The assessment of GFR is even more challenging in children than in adults with more variables in the equation than race and sex. Monitoring the progress of the kidney disease can therefore be difficult as in the initial stages of a decline in kidney function, there are no clinical signs. Due to children’s growth and development, changes in muscle mass and growth impair GFR estimation based solely on serum creatinine values. More invasive methods of GFR measurement are more reliable, but techniques using ionising agents, requiring large volume blood samples or timed voiding, have limited application in children. This paper reviews the methods of measuring and determining glomerular filtration rate and kidney function in children. Full article
(This article belongs to the Section Pediatric Nephrology)
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Brief Report
Constructing Counting and Arithmetic Learning Trajectories for Kindergarteners: A Preliminary Investigation in Taiwan
Children 2022, 9(12), 1994; https://doi.org/10.3390/children9121994 - 19 Dec 2022
Viewed by 463
Abstract
Mathematics learning trajectories (LTs) for students above elementary school level are widely investigated. Recently, LTs for kindergarteners have also attracted attention, but in those studies the LTs were based on Western samples, and it is unclear whether they also involved culture and gender [...] Read more.
Mathematics learning trajectories (LTs) for students above elementary school level are widely investigated. Recently, LTs for kindergarteners have also attracted attention, but in those studies the LTs were based on Western samples, and it is unclear whether they also involved culture and gender differences. Therefore, the purposes of this study were twofold: (1) construct a counting and arithmetic LT based on an Eastern sample and (2) show its similarities and differences by gender. The constructed LT contains 13 hypothesized levels of mathematical concepts according to previous research, and 59 kindergarteners (26 boys and 33 girls) participated in this study and completed a counting and arithmetic test to examine empirically the theoretical LT. The results showed that empirically, there were eight and nine conceptual levels for boys and girls, respectively, and boys and girls mastered concepts in a similar order (basic arithmetic→basic counting→advanced counting→mediocre arithmetic→advanced arithmetic), with the first part differing from the hypothesized LT. Within this developmental progression, girls showed a different path from advanced counting to mediocre arithmetic. The findings show gender and culture differences for the LTs for kindergarteners, which contradicts most previous research based on Western samples. Full article
(This article belongs to the Section Child Neurology)
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Article
Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
Children 2022, 9(12), 1993; https://doi.org/10.3390/children9121993 - 18 Dec 2022
Viewed by 507
Abstract
In pediatric liver transplantation (pLT), the risk for the manifestation and relevance of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is high. This observational study aimed to evaluate the incidence, relevance and risk factors for IAH and ACS by monitoring the intra-abdominal [...] Read more.
In pediatric liver transplantation (pLT), the risk for the manifestation and relevance of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is high. This observational study aimed to evaluate the incidence, relevance and risk factors for IAH and ACS by monitoring the intra-abdominal pressure (IAP), macro- and microcirculation (near-infrared spectroscopy (NIRS)), clinical and laboratory status and outcomes of 27 patients (16 female) after pLT (median age at pLT 35 months). Of the patients, 85% developed an elevated IAP, most of them mild. However, 17% achieved IAH° 3, 13% achieved IAH° 4 and 63% developed ACS. A multiple linear regression analysis identified aortal hepatic artery anastomosis and cold ischemia time (CIT) as risk factors for increased IAP and longer CIT and staged abdominal wall closure for ACS. ACS patients had significantly longer mechanical ventilation (p = 0.004) and LOS-PICU (p = 0.003). No significant correlation between NIRS or biliary complications and IAH or ACS could be shown. IAH and ACS after pLT were frequent. NIRS or grade of IAH alone should not be used for monitoring. A longer CIT is an important risk factor for higher IAP and ACS. Therefore, approaches such as the ex vivo machine perfusion of donor organs, reducing CIT effects on them, have great potential. Our study provides important basics for studying such approaches. Full article
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Article
Intraoperative Neuromonitoring for Thyroid Surgery in Children and Adolescents: A Single Center Experience
Children 2022, 9(12), 1992; https://doi.org/10.3390/children9121992 - 18 Dec 2022
Viewed by 549
Abstract
Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been shown in adults to minimize nerve palsy after thyroid surgery, but only few studies on its efficacy in a pediatric population have been reported. We conducted a retrospective study on patients operated [...] Read more.
Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been shown in adults to minimize nerve palsy after thyroid surgery, but only few studies on its efficacy in a pediatric population have been reported. We conducted a retrospective study on patients operated for thyroid lesions from 2016 to 2022. The analyzed population was divided in two groups: patients treated from 2016 to 2020, when the identification of the RLN was performed without IONM (Group A); and patients treated since 2021, when IONM was implemented in every surgical procedure on the thyroid (Group B). Intraoperative Neurophysiological Monitoring was performed by using corticobulbar motor-evoked potentials and continuous electromyography. Twentyfive children underwent thyroid resection, 19 (76%) of which due to thyroid carcinoma. Each patient’s recurrent nerve was identified; IONM was used in 13 patients. In Group A, one temporary nerve palsy was identified postoperatively (8.3%), while in group B one nerve dysfunction occurred (7.7%). No statistically significant difference was found between the two groups in terms of post-operative RLN palsy. No surgical complication due to the use of IONM was reported. In children and teenagers, intraoperative neuromonitoring of the recurrent laryngeal nerve is a safe and accurate method, minimizing the risk of nerve damage. Full article
(This article belongs to the Special Issue New Research in Pediatric Surgical Oncology)
Article
Post-Traumatic Play in Child Victims of Adverse Childhood Experiences: A Pilot Study with the MCAST—Manchester Child Attachment Story Task and the Coding of PTCP Markers
Children 2022, 9(12), 1991; https://doi.org/10.3390/children9121991 - 18 Dec 2022
Viewed by 494
Abstract
Background: Play is among the most frequently observed distorted behaviors in victims of Adverse Childhood Experiences (ACEs). Terr’s (1981) studies helped to describe this behavioral distortion as post-traumatic child’s play (PTCP). This study aimed to evaluate whether child victims of Adverse Childhood Experiences [...] Read more.
Background: Play is among the most frequently observed distorted behaviors in victims of Adverse Childhood Experiences (ACEs). Terr’s (1981) studies helped to describe this behavioral distortion as post-traumatic child’s play (PTCP). This study aimed to evaluate whether child victims of Adverse Childhood Experiences (ACEs) engaging in semi-structured play present the markers of post-traumatic child’s play (PTCP) during the administration of the Manchester Child Attachment Story Task (MCAST), whose playful stories activate the attachment system. Methods: The sample comprised 17 child victims of ACEs (mean age = 6.76). Children were evaluated using the Manchester Child Attachment Story Task. Results: The analysis of the play clearly revealed the presence of markers associated with the characteristics of the post-traumatic play described by Terr (1981), namely, repetition, revisiting, hyperarousal, and danger. In particular, the intrusiveness dimension was observed, which can be identified in the post-traumatic play by the presence of recurrent memories, dreams, and dissociative symptoms. Conclusions: Post-traumatic play is characterized by repetition, containing aspects, scenes, or sequences of the traumatic event, expressed explicitly or symbolically. Full article
(This article belongs to the Special Issue Child Abuse and Neglect)
Article
Burden of Respiratory Syncytial Virus Related Acute Lower Respiratory Tract Infection in Hospitalized Thai Children: A 6-Year National Data Analysis
Children 2022, 9(12), 1990; https://doi.org/10.3390/children9121990 - 17 Dec 2022
Viewed by 706
Abstract
Objectives: This study sought to determine the epidemiology, seasonal variations, morbidity, and mortality of respiratory syncytial virus (RSV) infection among hospitalized children with lower respiratory tract infection in Thailand. In addition, we assessed the risk factors associated with severe RSV lower respiratory tract [...] Read more.
Objectives: This study sought to determine the epidemiology, seasonal variations, morbidity, and mortality of respiratory syncytial virus (RSV) infection among hospitalized children with lower respiratory tract infection in Thailand. In addition, we assessed the risk factors associated with severe RSV lower respiratory tract infection (LRTI)-related morbidity and mortality. Methods: The data were reviewed retrospectively from the National Health Security Office for hospitalized children younger than 18 years old diagnosed with RSV-related LRTI in Thailand, between the fiscal years of 2015 to 2020. The RSV-related LRTIs were identified using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification. ICD-10-TM codes J12.1, J20.5, and J21.0, which represent respiratory syncytial virus pneumonia, acute bronchitis due to respiratory syncytial virus, and acute bronchiolitis due to respiratory syncytial virus, respectively, were studied. Results: During the study period, RSV-related LRTI accounted for 19,340 of the 1,610,160 hospital admissions due to LRTI. RSV pneumonia was the leading cause of hospitalization (13,684/19,340; 70.76%), followed by bronchiolitis (2849/19,340; 14.73%) and bronchitis (2807/19,340; 14.51%), respectively. The highest peak incidence of 73.55 percent occurred during Thailand’s rainy season, from August to October. The mortality rate of RSV-related LRTI in infants younger than 1 year of age was 1.75 per 100,000 person years, which was significantly higher than that of children 1 to younger than 5 years old and children 5 to younger than 18 years old (0.21 per 100,000 person years and 0.01 per 100,000 person years, respectively, p-value < 0.001). Factors associated with mortality were congenital heart disease, hematologic malignancy, malnutrition, and neurological disease. Conclusions: In children with RSV LRTI, pneumonia was the leading cause of hospitalization. The admission rate was highest during the rainy season. Mortality from RSV-related LRTI was higher in children under 1 year old and in children with underlying illnesses; future preventive interventions should target these groups of patients. Full article
(This article belongs to the Special Issue Medical Statistics and Clinical Epidemiology in Children)
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Article
HIV Status Disclosure to Adolescents Who Are Perinatally Infected in Rustenburg Sub District Northwest Province
Children 2022, 9(12), 1989; https://doi.org/10.3390/children9121989 - 17 Dec 2022
Viewed by 504
Abstract
Acquired Immune Deficiency Syndrome (AIDS) is a viral disease caused by Human Immunodeficiency Virus (HIV) which affects the immune system of human body. This study sought to explore how adolescents with perinatal HIV infection learn about their status as well as investigate their [...] Read more.
Acquired Immune Deficiency Syndrome (AIDS) is a viral disease caused by Human Immunodeficiency Virus (HIV) which affects the immune system of human body. This study sought to explore how adolescents with perinatal HIV infection learn about their status as well as investigate their preferences about the disclosure process. A qualitative exploratory, descriptive, and contextual research design was used to explore the disclosure of an HIV-positive status among adolescents on antiretroviral therapy. Nonprobability purposive sampling was used to select the healthcare facilities, and adolescents were chosen using convenience sampling. In-depth individual interviews were used to collect data from the participants until data saturation was reached. Collected data were analysed using Tesch’s eight steps. The results of the study revealed that adolescents have been on ART (antiretroviral therapy) without the knowledge of their own status but taking ART. Delayed disclosure of an HIV-positive status to adolescents lead to adolescent not adhering to ART and wondering why they are on treatment while other adolescents are not. The study further revealed that parents and caregivers struggle to disclose an HIV-positive status of their children, leading them to lie about what the treatment is for, for example, that it is a treatment for cough. Full article
Review
Diagnostic Clues in Pediatric Nutcracker Syndrome: From Two Clinical Cases to Current Literature Analysis
Children 2022, 9(12), 1988; https://doi.org/10.3390/children9121988 - 17 Dec 2022
Viewed by 443
Abstract
Nutcracker syndrome (NCS) is a rare pediatric disease caused by left kidney vein compression. Besides the “Triade’s symptoms”, including hematuria, proteinuria, and flank pain, a wide spectrum of clinical manifestations has been reported. As the significant hemodynamic changes secondary to the dilatation of [...] Read more.
Nutcracker syndrome (NCS) is a rare pediatric disease caused by left kidney vein compression. Besides the “Triade’s symptoms”, including hematuria, proteinuria, and flank pain, a wide spectrum of clinical manifestations has been reported. As the significant hemodynamic changes secondary to the dilatation of the left renal vein, serious consequences such as renal vein thrombosis and severe anemia might occur in these children. NCS diagnosis includes a variety of invasive and non-invasive imaging tools, but cutoff values need to be further validated. A conservative treatment represents the most common therapeutic approach for these patients, but operative options are available in selected cases. To complicate matters, a standard diagnostic and treatment algorithm is currently lacking and scientific pediatric evidence in this field is still poor and limited. In this perspective, early recognition of NCS is crucial but challenging for pediatricians. Therefore, a better knowledge of the disease is recommended. Starting from two different clinical presentations of NCS, we aimed to provide a comprehensive overview of the disease in children. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases Update)
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Article
Evaluation of Dysphagia and Inhalation Risk in Neurologically Impaired Children Using Esophageal High-Resolution Manometry with Swallowing Analysis
Children 2022, 9(12), 1987; https://doi.org/10.3390/children9121987 - 17 Dec 2022
Viewed by 370
Abstract
Background: Dysphagia in neurologically impaired children is associated with feeding difficulties, malnutrition and aspiration pneumonia. Esophageal high-resolution manometry (HRM) has been used in the diagnosis of motility disorders affecting the swallowing process. The aim of this study was to analyze swallowing functions in [...] Read more.
Background: Dysphagia in neurologically impaired children is associated with feeding difficulties, malnutrition and aspiration pneumonia. Esophageal high-resolution manometry (HRM) has been used in the diagnosis of motility disorders affecting the swallowing process. The aim of this study was to analyze swallowing functions in NI children by using HRM in order to establish swallow parameters identifying inhalation risk. Methods: Twenty-five NI children with cerebral palsy were submitted to esophageal HRM with UES analysis, comparing the results with non-NI children. The following parameters were evaluated: maximum pressure and duration of contraction of the velopharynx (VP) and tongue base (TB), and maximal, minimal, resting pressure and relaxation duration of the upper esophageal sphincter (UES). Results: pVP max, pTB max, pUES max and resting pressure were lower, while p UES minimal was higher and relaxation duration was shorter in NI children vs. the control group. Predictive values of inhalation risk were evaluated. Conclusions: This study evaluates inhalation risk in NI children using HRM to study UES function. Our results confirm the alterations described in NI children: insufficient contraction and clearing force for bolus transmission through the pharynx and incomplete UES relaxation can predispose to pharyngeal residues and inhalation independently of swallowing because of lower values of UES resting. Full article
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Article
Influence of Cleft Lip and Palate on Oral Health-Related Quality of Life in Northern Italy: Exploring Both the Children’s and Caregivers’ Perspectives
Children 2022, 9(12), 1986; https://doi.org/10.3390/children9121986 - 17 Dec 2022
Viewed by 364
Abstract
The aim of this cross-sectional study was to examine whether parents/caregivers’ perceptions of oral health-related quality of life (OHRQoL) differ from that of their cleft children, exploring the impact of demographic variables and cleft type on their agreement. Fifty-three primary and secondary schoolchildren, [...] Read more.
The aim of this cross-sectional study was to examine whether parents/caregivers’ perceptions of oral health-related quality of life (OHRQoL) differ from that of their cleft children, exploring the impact of demographic variables and cleft type on their agreement. Fifty-three primary and secondary schoolchildren, with non-syndromic orofacial cleft, and their parents answered the Child Oral Health Impact Profile (COHIP) questionnaire. Concordance between caregivers’ and children’s reports was low to moderate. Parents/caregivers had worse perceptions of OHRQoL compared to that of their children, peer interaction and functional well-being domains being statistically significantly different (p = 0.033 and p = 0.005, respectively). Cleft type, gender and parents’ country of origin seemed to be potential contributing factors of disagreement. Parents overestimated the impact of unilateral (p = 0.047) and bilateral cleft lip and palate (p = 0.021) on OHRQoL, and they rated more poorly than their male children did. Italian parents were more concerned about the functional well-being of their children (p = 0.014), and foreign parents about peer interaction (p = 0.010) and school environment (p = 0.012) dimensions. These findings suggest that parental assessment of OHRQoL cannot replace that of school-aged children, but they are complementary as they cover different, but equally relevant perspectives. Full article
(This article belongs to the Section Pediatric Dentistry)
Review
Ultrasound Imaging-Based Methods for Assessing Biological Maturity during Adolescence and Possible Application in Youth Sport: A Scoping Review
Children 2022, 9(12), 1985; https://doi.org/10.3390/children9121985 - 17 Dec 2022
Viewed by 550
Abstract
Bone maturity is an indicator for estimating the biological maturity of an individual. During adolescence, individuals show heterogeneous growth rates, and thus, differences in biological maturity should be considered in talent identification and development. Radiography of the left hand and wrist is considered [...] Read more.
Bone maturity is an indicator for estimating the biological maturity of an individual. During adolescence, individuals show heterogeneous growth rates, and thus, differences in biological maturity should be considered in talent identification and development. Radiography of the left hand and wrist is considered the gold standard of biological maturity estimation. The use of ultrasound imaging (US) may be advantageous; however, its validity and reliability are under discussion. The aims of this scoping review are (1) to summarize the different methods for estimating biological maturity by US imaging in adolescents, (2) to obtain an overview of the level of validity and reliability of the methods, and (3) to point out the practicability and usefulness of ultrasound imaging in the field of youth sports. The search included articles published up to November 2022. The inclusion criteria stipulated that participants had to fall within the age range of 8 to 23 years and be free of bone disease and fractures in the region of interest. Nine body regions were investigated, while the hand and wrist were most commonly analyzed. US assessment methods were usually based on the estimation of a bone maturity stage, rather than a decimal bone age. Furthermore, 70% of the assessments were evaluated as applicable, 10% expressed restraint about implementation, and 20% were evaluated as not applicable. When tested, inter- and intra-rater reliability was high to excellent. Despite the absence of ionization, low costs, fast assessment, and accessibility, none of the US assessments could be referred to as a gold standard. If further development succeeds, its application has the potential to incorporate biological age into selection processes. This would allow for more equal opportunities in talent selection and thus make talent development fairer and more efficient. Full article
(This article belongs to the Special Issue Sports Science in Youth)
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Infodemiology of RSV in Italy (2017–2022): An Alternative Option for the Surveillance of Incident Cases in Pediatric Age?
Children 2022, 9(12), 1984; https://doi.org/10.3390/children9121984 - 16 Dec 2022
Viewed by 497
Abstract
The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza [...] Read more.
The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza Surveillance network (InfluNet). Estimated rates for ILI in the general population and in the age groups 0–4 years and 5–14 years were obtained for the influenza seasons 2017–2018 to 2020–2021. Similarly, a weekly fraction of online searches was retrieved for a series of terms associated with Respiratory Syncytial Virus. Next, trends for daily visualization of Italian Wikipedia Pages for Human Respiratory Syncytial Virus, Pneumonia, Bronchiolitis, Influenza, and Respiratory Failure were similarly retrieved. The correlation of all search terms with ILI was analyzed by means of Spearman’s rank correlation analysis. Among search terms associated with the clinical diagnosis of Respiratory Syncytial Virus infections, the occurrence of ILI was highly correlated only with Bronchiolitis in the age group 0–4 years (β 0.210, p = 0.028), while more generic search terms, such as Bronchitis, fever, influenza, and Pneumonia, were identified as effective predictors of ILI, in general and by age groups. In a regression analysis modeled with ILIs as the outcome variable, daily visualizations for the Wikipedia pages on Bronchiolitis were identified as negative predictors for ILI in general (β = −0.152, p = 0.032), ILI in age group 0–4 years (β = −0.264, p = 0.001) and 5–14 years (β = −0.202, p = 0.006), while Influenza was characterized as a positive effector for ILIs in the age group 5–14 years (β = 0.245, p = 0.001). Interestingly, not only were the search terms extensively correlated with one another, but all of them were also characterized by autocorrelation through a Durbin-Watson test (all estimates DW < 2.0) In summary, our study identified a complicated pattern of data visualization as no clear association between rates of ILI in pediatric age group 0–4 and 5 to 14 years was actually found. Finally, our data stress that the infodemiology option may be quite problematic for assessing the time trend of RSV infections in Italy until more appropriate reporting will be made available, by sharing estimates of Lower Respiratory Tract Infections, and through a more accurate characterization of younger age groups. Full article
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Article
Twenty-Year Retrospective Study of Post-Enucleation Chemotherapy in High-Risk Patients with Unilateral Retinoblastoma
Children 2022, 9(12), 1983; https://doi.org/10.3390/children9121983 - 16 Dec 2022
Viewed by 415
Abstract
Primary enucleation is a life-saving treatment for advanced intraocular retinoblastoma, particularly in patients with poor visual potential and functional contralateral eyes. This single-center study presents the treatment outcomes of patients with unilateral retinoblastoma who received primary enucleation and adjuvant chemotherapy with cyclophosphamide, vincristine, [...] Read more.
Primary enucleation is a life-saving treatment for advanced intraocular retinoblastoma, particularly in patients with poor visual potential and functional contralateral eyes. This single-center study presents the treatment outcomes of patients with unilateral retinoblastoma who received primary enucleation and adjuvant chemotherapy with cyclophosphamide, vincristine, doxorubicin, and intrathecal methotrexate (CVDM) between 2000 and 2020. Twenty patients were enrolled in the study. The median age at diagnosis was 26 months (range, 1–45). Eighteen patients (90%) were in group E and two (10%) were in group D, according to the intraocular classification of retinoblastoma guidelines. Excluding one patient with an inadequate specimen, 19 patients (95%) had optic nerve involvement (ONI) at least up to the lamina cribrosa. Eight patients (40%) had choroidal invasion in addition to ONI. Two patients (10%) were surgical resection margin positive. The overall and event-free survival rates were 100% and 95%, respectively, for a median follow-up duration of 102.24 months (range 24.2–202.9). There were no relapses or deaths due to any cause, but one patient developed secondary rhabdomyosarcoma 99.6 months after chemotherapy. Treatment was well tolerated, with minimal hematotoxicity and hepatotoxicity. CVDM as a post-enucleation chemotherapy for advanced intraocular retinoblastoma has excellent outcomes with tolerable toxicity. However, in line with updated treatment trends, further risk stratification and lowering the treatment intensity should be considered. Continued long-term follow-up is required to further determine late effects. Full article
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Case Report
Gait Alterations in Two Young Siblings with Progressive Pseudorheumatoid Dysplasia
Children 2022, 9(12), 1982; https://doi.org/10.3390/children9121982 - 16 Dec 2022
Viewed by 349
Abstract
Progressive pseudorheumatoid dysplasia (PPRD) is an autosomal recessive inherited skeletal dysplasia characterized by progressive non-inflammatory arthropathy affecting primarily the articular cartilage. Currently, little is known about the functional musculoskeletal aspects of these patients. In particular, an abnormal gait pattern has been described, without [...] Read more.
Progressive pseudorheumatoid dysplasia (PPRD) is an autosomal recessive inherited skeletal dysplasia characterized by progressive non-inflammatory arthropathy affecting primarily the articular cartilage. Currently, little is known about the functional musculoskeletal aspects of these patients. In particular, an abnormal gait pattern has been described, without a clear hypothesis of the underlying causes in terms of muscular activity. This study presents the case of two siblings, 4 and 9 years old, a boy and a girl, respectively, suffering from PPRD at different stages of the disease. In addition to the clinical assessment, an instrumental gait analysis was performed. Swelling of the interphalangeal finger joints and fatigue were present in both cases. Gait abnormalities consisted of a relevant reduction in the ankle plantarflexion in the terminal phase of the gait cycle, associated with reduced gastrocnemius EMG activity and increased activity of the tibialis anterior, resulting in overloading at the initial peak of ground reaction forces. Gait anomalies observed were similar in both siblings with PPRD, although at different ages, and confirm walking patterns previously described in the literature. The calf muscle strength deficit and reduced activity during the stance phase of gait present in these two siblings indicate the typical absence of the propulsive phase. A stomping gait pattern, with the foot striking the ground hard on each step, was originally described. Further neurophysiological investigations are required to determine the origin of muscle weakness. Full article
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Brief Report
The Mental Well-Being of Italian Adolescents in the Last Decade through the Lens of the Dual Factor Model
Children 2022, 9(12), 1981; https://doi.org/10.3390/children9121981 - 16 Dec 2022
Viewed by 448
Abstract
(1) Background: In Italy, the components of adolescents’ mental well-being (psychological symptomatology and cognitive perception of life satisfaction) showed different temporal trends, suggesting the adoption of a multidimensional conceptualization. We aimed to assess temporal patterns and provide additional insights into Italian adolescents’ mental [...] Read more.
(1) Background: In Italy, the components of adolescents’ mental well-being (psychological symptomatology and cognitive perception of life satisfaction) showed different temporal trends, suggesting the adoption of a multidimensional conceptualization. We aimed to assess temporal patterns and provide additional insights into Italian adolescents’ mental well-being in the last decade by adopting the Dual Factor Model; (2) Methods: We used nationally representative samples of Italian students (n = 165,000) aged 11, 13, and 15 years across the three more recent Italian Health Behaviour in School-aged Children (HBSC) surveys. Two measures of mental well-being were used: life satisfaction (LS, indicator of positive subjective well-being) and psychological health complaints (PHC, indicator of mental illness); (3) Results: Our study showed that the overall sample has been moving from a Complete Mental Health (Flourishing) to an Incomplete Mental Illness (Struggling) condition. Among 13- and 15-year-old girls, a jump from one to the other mental condition was observed in the 2014–2018 and 2010–2014 time periods, respectively; (4) Conclusions: Our findings suggest that Italian adolescents, especially older girls, have been shifting from Complete Mental Health to Incomplete Mental Illness in the last decade. Further research is needed to investigate this breaking up of the connection between psychological symptomatology and cognitive perception of life satisfaction. Full article
(This article belongs to the Special Issue Addressing Adolescents’ Health Care Needs - Missing Opportunities)
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Review
Red Blood Cell Donor Sex Associated Effects on Morbidity and Mortality in the Extremely Preterm Newborn
Children 2022, 9(12), 1980; https://doi.org/10.3390/children9121980 - 16 Dec 2022
Viewed by 427
Abstract
Transfusion exposure increases the risk of death in critically ill patients of all ages. This was thought to relate to co-morbidities in the transfusion recipient. However, donor characteristics are increasingly recognised as critical to transfusion recipient outcome with systematic reviews suggesting blood donor [...] Read more.
Transfusion exposure increases the risk of death in critically ill patients of all ages. This was thought to relate to co-morbidities in the transfusion recipient. However, donor characteristics are increasingly recognised as critical to transfusion recipient outcome with systematic reviews suggesting blood donor sex influences transfusion recipient health. Originally focusing on plasma and platelet transfusions, retrospective studies report greater risks of adverse outcomes such as transfusion related acute lung injury in those receiving products from female donors. There is increasing awareness that exposure to red blood cells (RBCs) poses a similar risk. Recent studies focusing on transfusion related outcomes in extremely preterm newborns report conflicting data on the association between blood donor sex and outcomes. Despite a renewed focus on lower versus higher transfusion thresholds in neonatal clinical practice, this group remain a heavily transfused population, receiving on average 3–5 RBC transfusions during their primary hospital admission. Therefore, evidence supporting a role for better donor selection could have a significant impact on clinical outcomes in this high-risk population. Here, we review the emerging evidence for an association between blood donor sex and clinical outcomes in extremely preterm newborns receiving one or more transfusions. Full article
(This article belongs to the Section Pediatric Neonatology)
Article
The Needs of School Professionals for Eating Disorder Prevention in Australian Schools: A Mixed-Methods Survey
Children 2022, 9(12), 1979; https://doi.org/10.3390/children9121979 - 16 Dec 2022
Viewed by 413
Abstract
(1) Background: School professionals such as teachers and counsellors are uniquely positioned to facilitate discussion around disordered eating and body image; however, little is known about the needs of school professionals with respect to eating disorder prevention. This study aimed to explore the [...] Read more.
(1) Background: School professionals such as teachers and counsellors are uniquely positioned to facilitate discussion around disordered eating and body image; however, little is known about the needs of school professionals with respect to eating disorder prevention. This study aimed to explore the needs and perceptions of Australian school professionals regarding eating disorder prevention. (2) Methods: School professionals were recruited to a mixed-methods online cross-sectional survey. The survey assessed demographics and perceived needs and attitudes to eating disorder prevention. (3) Results: Most participants (92%) were willing to participate in eating disorder prevention; however, only 61% reported good knowledge and 41% reported feeling confident in implementing eating disorder prevention. Those who had received training in eating disorders (24%) reported higher confidence (p = 0.02) and knowledge (p = 0.04). Only 66% of respondents reported that all teachers should be involved in eating disorder prevention while barriers including workload, knowledge, and resources were commonly highlighted. Fewer respondents working in primary school settings reported the need for prevention approaches (p = 0.046). (4) Conclusions: Despite a willingness to be involved in the prevention of eating disorders, there are inconsistencies in attitudes regarding the role of school professionals in eating disorder prevention. The findings of this study reinforce that understanding professional roles, school settings, and personal attitudes is critical in the development of more efficacious school professional training and prevention interventions. Full article
Article
Knowledge and Attitudes of Medical and Nursing Students in Greece Regarding Child Abuse and Neglect
Children 2022, 9(12), 1978; https://doi.org/10.3390/children9121978 - 16 Dec 2022
Viewed by 433
Abstract
Data on the knowledge and attitudes of healthcare practitioners in training regarding child abuse and neglect (CAN) are scarce. The aim of this study was to investigate the knowledge and attitudes regarding CAN of medical and nursing students in Greek universities. We performed [...] Read more.
Data on the knowledge and attitudes of healthcare practitioners in training regarding child abuse and neglect (CAN) are scarce. The aim of this study was to investigate the knowledge and attitudes regarding CAN of medical and nursing students in Greek universities. We performed a questionnaire-based e-survey on a convenience sample of students and recruited 609 students (366 medical and 243 nursing). An unsatisfactory level of knowledge in the field was reported overall. Most of the students (92.2%) were aware of their future responsibility to protect vulnerable children and report suspected cases of CAN; at the same time, they were willing to obtain further education. Based on the above, appropriate training in the undergraduate curriculum should be developed in order to strengthen future healthcare practitioners and boost their confidence in dealing with suspected cases of CAN and protect children’s welfare. Full article
(This article belongs to the Special Issue Child Abuse and Neglect)
Review
Diagnosis of Dextrocardia with a Pictorial Rendition of Terminology and Diagnosis
Children 2022, 9(12), 1977; https://doi.org/10.3390/children9121977 - 16 Dec 2022
Viewed by 478
Abstract
A significant number of patients with dextrocardia and other cardiac malpositions have other congenital heart defects (CHDs). The incidence of CHDs in subjects with cardiac malpositions is significantly greater than that in normal children, and the prevalence varies with the associated visceroatrial situs. [...] Read more.
A significant number of patients with dextrocardia and other cardiac malpositions have other congenital heart defects (CHDs). The incidence of CHDs in subjects with cardiac malpositions is significantly greater than that in normal children, and the prevalence varies with the associated visceroatrial situs. The most useful approach to diagnosis is segmental analysis. Firstly, dextroposition should be excluded. In segmental analysis, the visceroatrial situs, ventricular location, status of atrioventricular connections, the great artery relationship, and conotruncal relationship are determined with the use of electrocardiogram (ECG), chest X-ray, and echocardiographic studies, and, when necessary, other imaging studies, including angiography. Following identification of the afore-mentioned segments, the associated defects in the atrial and ventricular septae, valvar and vascular stenosis or atresia may be determined by a review of the historical information, physical examination, and analysis of chest roentgenogram, ECG, and echocardiographic studies. Along the way, a pictorial rendition of the terminology and diagnosis of cardiac malpositions is undertaken. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Congenital Heart Defects)
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Article
The Associations between Father Involvement and Father–Daughter Relationship Quality on Girls’ Experience of Social Bullying Victimization
Children 2022, 9(12), 1976; https://doi.org/10.3390/children9121976 - 16 Dec 2022
Viewed by 438
Abstract
With much research into physical, cyber, and verbal bullying victimization, social bullying victimization is a type of victimization that can be hidden. Studies about Black father involvement have found involvement to be a buffer to adverse and risky behaviors of children, including different [...] Read more.
With much research into physical, cyber, and verbal bullying victimization, social bullying victimization is a type of victimization that can be hidden. Studies about Black father involvement have found involvement to be a buffer to adverse and risky behaviors of children, including different forms of victimization experienced by their daughters. This study examined one gap in the literature: the direct and potentially indirect associations between father involvement and father–child relationship quality on child reports of social bullying victimization among girls. The cross-sectional sample of 368 Black fathers and their daughters was sourced from the Fragile Families and Child Wellbeing study. Data from wave 5 were selected for the child (age 9) and father because social bullying victimization was first measured at this time point. Logistic regression analysis findings showed father involvement was associated with lower social bullying victimization. In addition, talking and sharing ideas quite well rather than extremely well with their fathers was associated with higher odds of social bullying victimization. Father–daughter relationship quality did not mediate the father involvement and social bullying victimization relationship. Findings provide additional support to include fathers, particularly Black fathers, in intervention/prevention efforts and the importance of increasing awareness and benefits of father involvement in subtle forms of victimization such as social bullying victimization among Black families. Full article
(This article belongs to the Special Issue Attachment and Social Development: Old Questions, New Insights)
Review
Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity
Children 2022, 9(12), 1975; https://doi.org/10.3390/children9121975 - 16 Dec 2022
Viewed by 1108
Abstract
Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits [...] Read more.
Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity. Full article
(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management Update)
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Article
Parents’ Awareness of Malocclusion and Orthodontic Consultation for Their Children: A Cross-Sectional Study
Children 2022, 9(12), 1974; https://doi.org/10.3390/children9121974 - 16 Dec 2022
Viewed by 544
Abstract
Parents’ awareness of malocclusion and the appropriate timing to seek orthodontic consultation for their children has a substantial impact on children’s orthodontic treatment. This cross-sectional study aims to investigate parents’ awareness of malocclusion and orthodontic consultation of their children and the influence of [...] Read more.
Parents’ awareness of malocclusion and the appropriate timing to seek orthodontic consultation for their children has a substantial impact on children’s orthodontic treatment. This cross-sectional study aims to investigate parents’ awareness of malocclusion and orthodontic consultation of their children and the influence of parents’ demographics on their awareness level. An electronic survey collected information about participants’ demographics and awareness about malocclusion and orthodontic consultation of children. A total of 473 parents living in Jeddah, Saudi Arabia, participated in the study. The average awareness level among parents was moderate (3.09 ± 1.4). Male gender and unemployment were associated with low orthodontic awareness levels relative to moderate awareness (OR = 3.3, 95% CI = 1.8–5.8 and OR = 2.1, 95% CI = 1.1–3.8, respectively). Former or current orthodontic treatment was associated with high awareness levels (OR = 3.9, 95% CI = 2.4–6.5). There is still a need to raise the awareness of Saudi parents about malocclusion and orthodontic consultations for their children. Orthodontic awareness-raising campaigns should be designed to include fathers and parents with low socioeconomic status. The findings of this study also suggest that orthodontists can enhance their patient’s awareness of malocclusion and orthodontic consultation for their children. Full article
(This article belongs to the Special Issue Biomaterials and Biomechanics of Pediatric Dentistry)
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Review
Diagnosis and Management of Keratoconus—A Narrative Review of Clinicians’ Perspectives
Children 2022, 9(12), 1973; https://doi.org/10.3390/children9121973 - 15 Dec 2022
Viewed by 454
Abstract
This review discusses the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) in adults and children by optometrists and ophthalmologists in order to highlight the differences on a global scale. Two independent reviewers searched the electronic databases and grey literature [...] Read more.
This review discusses the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) in adults and children by optometrists and ophthalmologists in order to highlight the differences on a global scale. Two independent reviewers searched the electronic databases and grey literature for all potential articles published from 1 January 2000 to 1 June 2022 on management of KC. Keywords used in searches included “keratoconus”, “diagnosis”, “management”, “treatment”, “attitude”, “practices”, “opinion”, “optometrist”, “ophthalmologist”, “consensus”, and “protocol”. A total of 19 articles was included in this review—12 from the database search and seven from the grey literature. Although a common stepwise approach of non-surgical management was noted, there were differences in the rates of prescribing rigid gas permeable lenses. Furthermore, while clinicians agreed on the need for early diagnosis, the timeline and type of referral varied significantly. A similar discordance was found in the milestones for surgical intervention and preferred surgical techniques. Practice patterns in keratoconus diagnosis and management vary throughout the world. Multiple recommendations and suggestions to minimise the differences have been provided in the literature, with the main themes being improvement in education, interdisciplinary patient care, and further research to reach consensus. Full article
(This article belongs to the Special Issue Pediatric Eye Disease: Screening, Causes and Treatment)
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Case Report
From Chilblains (Pernio) to Coeliac Disease—Should We Still Consider It Random?
Children 2022, 9(12), 1972; https://doi.org/10.3390/children9121972 - 15 Dec 2022
Viewed by 492
Abstract
Coeliac disease (CD) is a gluten-triggered, immune-mediated inflammatory disease occurring in genetically predisposed individuals, causing a variety of gastrointestinal and extraintestinal symptoms. The most common cutaneous association of CD is dermatitis herpetiformis, although recent reports have sought to link CD with other dermatological [...] Read more.
Coeliac disease (CD) is a gluten-triggered, immune-mediated inflammatory disease occurring in genetically predisposed individuals, causing a variety of gastrointestinal and extraintestinal symptoms. The most common cutaneous association of CD is dermatitis herpetiformis, although recent reports have sought to link CD with other dermatological and autoimmune diseases. Chilblain, also called pernio, is usually a benign, superficial and localized inflammatory skin disorder that results from a maladaptive vascular response to non-freezing cold. We present a patient with pernio (chilblains) and newly diagnosed CD, with a significant intestinal lesion–total villous atrophy, as there are only two known cases of this feature associated with CD published in the literature. In the workup of chilblains (pernio) in children, an active case finding for coeliac disease should be conducted with coeliac-specific serology testing. Full article
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Article
Effects of Integrative Autism Therapy on Multiple Physical, Sensory, Cognitive, and Social Integration Domains in Children and Adolescents with Autism Spectrum Disorder: A 4-Week Follow-Up Study
Children 2022, 9(12), 1971; https://doi.org/10.3390/children9121971 - 15 Dec 2022
Viewed by 500
Abstract
This study aimed to compare the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). A convenience sample of 24 children with ASD was recruited and underwent either CAT or IAT for [...] Read more.
This study aimed to compare the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). A convenience sample of 24 children with ASD was recruited and underwent either CAT or IAT for 60 min/day, twice a week, for 20 sessions over 10 weeks. Outcome measures included the following: (1) physical domain (pediatric balance scale, PBS), (2) sensory domain (short sensory profile), (3) cognitive domains (functional independence measure, FIM; and childhood autism rating scale), and (4) social integration domain (Canadian occupational performance measure, COPM; short falls efficacy scale; and pediatrics quality of life questionnaire). Two-way repeated analysis of variance (ANOVA) was used to determine the intervention-related changes in the four domains across the pre-test, post-test, and follow-up test at p < 0.05. ANOVA showed significant interaction effects on the PBS, FIM, and COPM (p < 0.05) variables. Moreover, time main effects (p < 0.05) were observed in all four domain variables, but no group main effect was noted. This study provides promising evidence that IAT is more effective than CAT for managing children and adolescents with ASD. Full article
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Case Report
“Face(s)” of a PHACE(S) Syndrome Patient before and after Therapy: Particular Case Report and Review of Literature
Children 2022, 9(12), 1970; https://doi.org/10.3390/children9121970 - 15 Dec 2022
Viewed by 394
Abstract
A rare, uncommon disorder called PHACE(S) (P-posterior fossa anomalies, H-hemangioma, A-arterial anomalies, C-cardiac anomalies, E-eye anomalies, and S-sternal cleft) of unknown etiology was rarely reported. Children are susceptible to developing PHACE(S) syndrome from the moment they are born. It may be challenging for [...] Read more.
A rare, uncommon disorder called PHACE(S) (P-posterior fossa anomalies, H-hemangioma, A-arterial anomalies, C-cardiac anomalies, E-eye anomalies, and S-sternal cleft) of unknown etiology was rarely reported. Children are susceptible to developing PHACE(S) syndrome from the moment they are born. It may be challenging for a physician to appropriately diagnose and treat children with PHACE due to the multifaceted nature of the disease and the extensive range of consequences that may be associated with it. A one-month-old newborn girl was admitted to hospital with extensive, multiple facial infantile hemangiomas, ulceration of the lower lip hemangioma-like lesion, cardiovascular, sternal, and neurological concomitant malformations. Five days following the initial application of the medication, systemic treatment with propranolol and topical treatment with silver sulfadiazine produced their first noticeable benefits. The lip ulceration was mostly healed and facial hemangioma started to regress. The regression continued under therapy and this effect persists for 6 months since Propranolol therapy ended. No cardiovascular or neurological clinical events have been registered during follow-up. The present case has three peculiarities: (1) high number of facial hemangiomas; (2) presence of subependymal cyst not yet reported in the literature associated with PHACE syndrome; and (3) lack of cardiovascular events during therapy knowing that these events frequently appear in PHACE syndrome patients. Full article
(This article belongs to the Section Pediatric Surgery)
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