Children

16 pages, 291 KiB

Open AccessEditor’s ChoiceReview

by Indira Chandrasekar, Mary Anne Tablizo, Manisha Witmans, Jose Maria Cruz, Marcus Cummins and Wendy Estrellado-Cruz

Children 2022, 9(3), 419; https://doi.org/10.3390/children9030419 - 15 Mar 2022

Cited by 18 | Viewed by 5158

Abstract

Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained [...] Read more.

Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained unrecognized and untreated, neonatal OSA can lead to impaired growth and development, cardiovascular morbidity, and can even be life threatening. Polysomnography and direct visualization of the airway are essential diagnostic modalities in neonatal OSA. Treatment of neonatal OSA is based on the severity of OSA and associated co-morbidities. This may include medical and surgical interventions individualized for the affected neonate. Based on this, it is expected that infants with OSA have more significant healthcare utilization. Full article

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

7 pages, 1714 KiB

Open AccessEditor’s ChoiceCase Report

Incidental Finding in Pre-Orthodontic Treatment Radiographs of an Aural Foreign Body: A Case Report

by Cinzia Maspero, Andrea Abate, Francesco Inchingolo, Claudia Dolci, Maria Grazia Cagetti and Gianluca Martino Tartaglia

Children 2022, 9(3), 421; https://doi.org/10.3390/children9030421 - 15 Mar 2022

Cited by 23 | Viewed by 3648

Abstract

The presence of foreign bodies in the external auditory canal of young patients may cause, if left untreated, severe permanent damage to the adjacent anatomical structures, and infections. A 10-year-old patient with an intellectual disability underwent orthodontic evaluation. An aural radiopaque finding was [...] Read more.

The presence of foreign bodies in the external auditory canal of young patients may cause, if left untreated, severe permanent damage to the adjacent anatomical structures, and infections. A 10-year-old patient with an intellectual disability underwent orthodontic evaluation. An aural radiopaque finding was visible in the lateral cephalogram and in the orthopantomography. The patient’s mother reported that her son never showed any ear discomfort, except for a mild hearing impairment that was never investigated. The patient was referred to an ear, nose and throat (ENT) specialist that removed the foreign body located in the left external auditory meatus. The careful evaluation of dental radiographs, including pre-orthodontic and interim orthodontic radiographs, may help to identify silent incidental findings that may otherwise lead to severe complications if left untreated. Full article

(This article belongs to the Special Issue Oral Health Related Quality of Life of Children)

► Show Figures

Figure 1

11 pages, 1032 KiB

Open AccessEditor’s ChoiceArticle

Behavioural Differences in Sensorimotor Profiles: A Comparison of Preschool-Aged Children with Sensory Processing Disorder and Autism Spectrum Disorders

by Giulia Purpura, Francesco Cerroni, Marco Carotenuto, Renata Nacinovich and Luca Tagliabue

Children 2022, 9(3), 408; https://doi.org/10.3390/children9030408 - 14 Mar 2022

Cited by 16 | Viewed by 6662

Abstract

Sensory Processing Disorders (SPDs) define dysfunctions in modulating, organising, and using information from several sensory channels for regulating motor, behavioural, emotional and attention responses. Although SPD can be identified also as an isolated condition in young children, its presence in Autism Spectrum Disorder [...] Read more.

Sensory Processing Disorders (SPDs) define dysfunctions in modulating, organising, and using information from several sensory channels for regulating motor, behavioural, emotional and attention responses. Although SPD can be identified also as an isolated condition in young children, its presence in Autism Spectrum Disorder (ASD) population is really frequent. The study purpose is to explore the SPD clinical expression and the putative correlation with several behavioural aspects both in children with ASD and in those with isolated SPD. Therefore, 43 preschool-aged children (25 ASD vs. 18 SPD) were recruited, and their parents completed three questionnaires (Developmental Profile-3, Sensory Processing Measure–Preschool, Repetitive Behaviour Scale-Revised) to evaluate behavioural alterations and developmental levels. The main result is that both ASD and SPD groups had significantly sensory-related behavioural symptoms, although ASD children seem to be more impaired in all areas. Several significant correlations were found between sensory processing difficulties and repetitive behaviours, but in the SPD group a specific relationship between Body Awareness and Ritualistic/Sameness Behaviour was found. Conversely, in the ASD group, more diffuse interlinks between sensory processing difficulties and motor behaviours were significant. In conclusion, the present study confirms the key role of sensory–motor skills in early diagnosis and intervention among children at risk for neurodevelopmental disorders. Full article

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

► Show Figures

Figure 1

10 pages, 2582 KiB

Open AccessEditor’s ChoiceArticle

Comparison of MTA versus Biodentine in Apexification Procedure for Nonvital Immature First Permanent Molars: A Randomized Clinical Trial

by Yasser Alsayed Tolibah, Chaza Kouchaji, Thuraya Lazkani, Ibrahim Ali Ahmad and Ziad D. Baghdadi

Children 2022, 9(3), 410; https://doi.org/10.3390/children9030410 - 14 Mar 2022

Cited by 19 | Viewed by 10381

Abstract

This study aimed to evaluate the radiological and clinical outcomes of Biodentine apical plugs compared to mineral trioxide aggregate (MTA) in treating immature molars with apical lesions in children. Materials and Methods: Thirty immature roots of 24 permanent lower first molars with apical [...] Read more.

This study aimed to evaluate the radiological and clinical outcomes of Biodentine apical plugs compared to mineral trioxide aggregate (MTA) in treating immature molars with apical lesions in children. Materials and Methods: Thirty immature roots of 24 permanent lower first molars with apical lesions were randomly divided into two groups: group 1 (15 roots) treated with MTA apical plugs and group 2 (15 roots) treated with Biodentine apical plugs. Treatment radiological outcomes were assessed using the periapical index (PAI) scale after 6 and 12 months of treatment. The presence or absence of apical calcified barrier (ACB) was assessed after 12 months of treatment. The visual analog scale (VAS) was used to compare the postoperative pain between the two groups after 1, 3, 7, and 14 days of treatment. PAI scores between the two groups were compared using the Mann–Whitney U test, the presence or absence of the ACB was compared using the chi-square test, and the VAS scores were compared using the t-test. The statistical significance threshold was set at 0.05. Results: There were no statistically significant differences in the PAI between the two groups at 6 and 12 months postoperatively. After 12 months, four cases in the Biodentine group showed ACB formation, whereas ACB was not found in any case treated with MTA. The VAS scores were statistically lower in the MTA group on the first day after treatment. Nevertheless, these scores were not statistically significantly different after 3, 7, and 14 days of treatment between the two groups. Conclusions: Biodentine can be used as an apical plug to treat immature permanent molars with apical lesions in a single visit in children. Biodentine showed favorable outcomes in apical lesions healing, which was comparable to MTA but with a decreased treatment time associated with its use. Full article

(This article belongs to the Collection Advance in Pediatric Dentistry)

► Show Figures

Figure 1

16 pages, 701 KiB

Open AccessEditor’s ChoiceReview

Biomechanical Characteristics of the Typically Developing Toddler Gait: A Narrative Review

by Wei Liu, Qichang Mei, Peimin Yu, Zixiang Gao, Qiuli Hu, Gustav Fekete, Bíró István and Yaodong Gu

Children 2022, 9(3), 406; https://doi.org/10.3390/children9030406 - 13 Mar 2022

Cited by 7 | Viewed by 6935

Abstract

Independent ambulation is one of the most important motor skills in typically developing toddlers. Gait analysis is a key evaluation method in basic and clinical research. A narrative review on the literature of toddler gait development was conducted following inclusion criteria, explicitly including [...] Read more.

Independent ambulation is one of the most important motor skills in typically developing toddlers. Gait analysis is a key evaluation method in basic and clinical research. A narrative review on the literature of toddler gait development was conducted following inclusion criteria, explicitly including the factors of English article, age range, no external intervention during the experimental process of studies involved, the non-symptomatic toddler, and no pathological gait. Studies about toddlers’ morphological, physiological, and biomechanical aspects at this developmental stage were identified. Remarkable gait characteristics and specific development rules of toddlers at different ages were reported. Changes in gait biomechanics are age and walking experience-dependent. Gait patterns are related to the maturation of the neuro and musculoskeletal systems. This review thus provides critical and theoretical information and the nature of toddler walking development for clinicians and other scientific researchers. Future studies may systematically recruit subjects with more explicit criteria with larger samples for longitudinal studies. A particular design could be conducted to analyze empirically before practical application. Additionally, the influence of external interventions on the development of toddler gait may need consideration for gait development in the toddler cohort. Full article

(This article belongs to the Special Issue Orthopaedics and Biomechanics in Children)

► Show Figures

Figure 1

21 pages, 381 KiB

Open AccessEditor’s ChoiceReview

A Critical Review on the Complex Interplay between Social Determinants of Health and Maternal and Infant Mortality

by Rada K. Dagher and Deborah E. Linares

Children 2022, 9(3), 394; https://doi.org/10.3390/children9030394 - 10 Mar 2022

Cited by 58 | Viewed by 25729

Abstract

Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants [...] Read more.

Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants of health (SDoH). Methods: A critical review of the maternal and infant mortality literature was performed to determine multilevel SDoH factors leading to mortality disparities with a life course lens. Results: Black mothers and infants fared the worst in terms of mortality rates, likely due to the accumulation of SDoH experienced as a result of structural racism across the life course. Upstream SDoH are important contributors to disparities in maternal and infant mortality. More research is needed on the effectiveness of continuous quality improvement initiatives for the maternal–infant dyad, and expanding programs such as paid maternity leave, quality, stable and affordable housing, and social safety-nets (Medicaid, CHIP, WIC), in reducing maternal and infant mortality. Finally, it is important to address research gaps in individual, interpersonal, community, and societal factors, because they affect maternal and infant mortality and related disparities. Conclusion: Key SDoH at multiple levels affect maternal and infant health. These SDoH shape and perpetuate disparities across the lifespan and are implicated in maternal and infant mortality disparities. Full article

(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)

19 pages, 371 KiB

Open AccessEditor’s ChoiceReview

Myopia Genetics and Heredity

by Yu-Meng Wang, Shi-Yao Lu, Xiu-Juan Zhang, Li-Jia Chen, Chi-Pui Pang and Jason C. Yam

Children 2022, 9(3), 382; https://doi.org/10.3390/children9030382 - 9 Mar 2022

Cited by 45 | Viewed by 11933

Abstract

Myopia is the most common eye condition leading to visual impairment and is greatly influenced by genetics. Over the last two decades, more than 400 associated gene loci have been mapped for myopia and refractive errors via family linkage analyses, candidate gene studies, [...] Read more.

Myopia is the most common eye condition leading to visual impairment and is greatly influenced by genetics. Over the last two decades, more than 400 associated gene loci have been mapped for myopia and refractive errors via family linkage analyses, candidate gene studies, genome-wide association studies (GWAS), and next-generation sequencing (NGS). Lifestyle factors, such as excessive near work and short outdoor time, are the primary external factors affecting myopia onset and progression. Notably, besides becoming a global health issue, myopia is more prevalent and severe among East Asians than among Caucasians, especially individuals of Chinese, Japanese, and Korean ancestry. Myopia, especially high myopia, can be serious in consequences. The etiology of high myopia is complex. Prediction for progression of myopia to high myopia can help with prevention and early interventions. Prediction models are thus warranted for risk stratification. There have been vigorous investigations on molecular genetics and lifestyle factors to establish polygenic risk estimations for myopia. However, genes causing myopia have to be identified in order to shed light on pathogenesis and pathway mechanisms. This report aims to examine current evidence regarding (1) the genetic architecture of myopia; (2) currently associated myopia loci identified from the OMIM database, genetic association studies, and NGS studies; (3) gene-environment interactions; and (4) the prediction of myopia via polygenic risk scores (PRSs). The report also discusses various perspectives on myopia genetics and heredity. Full article

(This article belongs to the Special Issue Prevalence and Progression of Myopia in Children and Adolescents)

24 pages, 712 KiB

Open AccessEditor’s ChoiceArticle

The Eating Healthy and Daily Life Activities (EHDLA) Study

by José Francisco López-Gil

Children 2022, 9(3), 370; https://doi.org/10.3390/children9030370 - 7 Mar 2022

Cited by 49 | Viewed by 10957

Abstract

Background: Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest [...] Read more.

Background: Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12–17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population. Methods: A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors. Conclusion: This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

► Show Figures

Figure 1

14 pages, 305 KiB

Open AccessEditor’s ChoiceReview

Orthorexia Nervosa in Adolescents and Young Adults: A Literature Review

by Maria Gkiouleka, Christina Stavraki, Theodoros N. Sergentanis and Tonia Vassilakou

Children 2022, 9(3), 365; https://doi.org/10.3390/children9030365 - 4 Mar 2022

Cited by 20 | Viewed by 9820

Abstract

Adolescents are a nutritionally vulnerable population; eating disorders are more common among adolescents and young adults. Orthorexia nervosa (ON) is a non-formally recognized condition characterized by an obsessive preoccupation with eating healthy and “pure” foods; the quality and not the quantity of food [...] Read more.

Adolescents are a nutritionally vulnerable population; eating disorders are more common among adolescents and young adults. Orthorexia nervosa (ON) is a non-formally recognized condition characterized by an obsessive preoccupation with eating healthy and “pure” foods; the quality and not the quantity of food is pivotal in ON. ON is a complex entity which can be associated with severe diet restrictions, a negative impact on social relationships, and with physical and mental health conditions, including obsessive–compulsive disorder. In light of this, a literature review regarding the background, diagnosis, features, risk factors, interplay with the social media, and management of ON is presented in this article, with a focus on adolescents and young adults. Full article

(This article belongs to the Special Issue Body Image, Weight Pressure and Disordered Eating Behaviors among Children and Adolescents)

► Show Figures

Graphical abstract

18 pages, 953 KiB

Open AccessEditor’s ChoiceReview

Compensation or Displacement of Physical Activity in Children and Adolescents: A Systematic Review of Empirical Studies

by Franziska Beck, Florian A. Engel and Anne Kerstin Reimers

Children 2022, 9(3), 351; https://doi.org/10.3390/children9030351 - 3 Mar 2022

Cited by 19 | Viewed by 4914

Abstract

Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for [...] Read more.

Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed. Full article

► Show Figures

Figure 1

8 pages, 1063 KiB

Open AccessEditor’s ChoiceArticle

Gastroesophageal Reflux in Children with Asthma

by Vasile Valeriu Lupu, Ingrith Miron, Elena Tarca, Laura Mihaela Trandafir, Dana-Teodora Anton-Paduraru, Stefana Maria Moisa, Magdalena Starcea, Andrei Cernomaz, Lucian Miron and Ancuta Lupu

Children 2022, 9(3), 336; https://doi.org/10.3390/children9030336 - 2 Mar 2022

Cited by 17 | Viewed by 3995

Abstract

Background: Nowadays it is considered that a specific causal relationship exists between asthma and gastroesophageal reflux (GER), because of the aspiration of gastric refluate which leads to and maintain spasticity even real crisis of paroxystic expiratory dyspnea. This study explores this relationship and [...] Read more.

Background: Nowadays it is considered that a specific causal relationship exists between asthma and gastroesophageal reflux (GER), because of the aspiration of gastric refluate which leads to and maintain spasticity even real crisis of paroxystic expiratory dyspnea. This study explores this relationship and evaluates the results after treatment. Methods: 56 children diagnosed with asthma, hospitalized in a regional center of pediatric gastroenterology in Northeast Romania, underwent 24-hour continuous esophageal pH monitoring in order to establish the presence of GER. The Boix-Ochoa score was used to interpret the results. Proton pump inhibitors were administered to those with GER and the patients were reevaluated after 2 months. Results: 39 patients (69.64%) had GER, with a Boix-Ochoa score above normal (N < 11.99), and 17 patients (30.36%) had normal score. After administering proton pump inhibitors for 2 months, 7 patients still had high Boix-Ochoa score (17.95%). The result of this analysis shows that the presence of asthma increases the chance of GER by 2.86 times. Conclusions: In children with asthma we have to look for GER in order to treat, because it can help the treatment of asthma or even solve some cases resistant to standard treatment. Full article

► Show Figures

Figure 1

8 pages, 7700 KiB

Open AccessEditor’s ChoiceCase Report

Dupilumab Improves Pruritus in Netherton Syndrome: A Case Study

by Yutaka Inaba, Nobuo Kanazawa, Kyoko Muraoka, Azusa Yariyama, Ami Kawaguchi, Kayo Kunimoto, Chikako Kaminaka, Yuki Yamamoto, Kaoru Tsujioka, Akira Yoshida, Teruki Yanagi and Masatoshi Jinnin

Children 2022, 9(3), 310; https://doi.org/10.3390/children9030310 - 24 Feb 2022

Cited by 15 | Viewed by 6100

Abstract

The patient was a 26-year-old male. He had red and scaling skin of the entire body since birth, as well as an elevated level of serum IgE. Genetic testing revealed a mutation in the SPINK5 gene, which had confirmed the diagnosis with Netherton [...] Read more.

The patient was a 26-year-old male. He had red and scaling skin of the entire body since birth, as well as an elevated level of serum IgE. Genetic testing revealed a mutation in the SPINK5 gene, which had confirmed the diagnosis with Netherton syndrome. He has had significant pruritis since birth, and subsequently had symptoms of sleeping disorders and concentration difficulty throughout the day. Since treatment with various antihistamines were not effective, we administered dupilumab and found that it was effective in immediate elimination of pruritus and gradual reduction of the rash. Dupilumab has been administered for one year without any adverse events or recurrence of symptoms. Although studies have previously described cases who used dupilumab for Netherton syndrome, reported effects have been limited or transient. Additional studies are needed to confirm the effect of dupilumab for Netherton syndrome, which currently lack any effective treatment strategies. Full article

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

► Show Figures

Figure 1

18 pages, 427 KiB

Open AccessEditor’s ChoiceReview

Early Motor Signs in Autism Spectrum Disorder

by Annio Posar and Paola Visconti

Children 2022, 9(2), 294; https://doi.org/10.3390/children9020294 - 21 Feb 2022

Cited by 43 | Viewed by 10429

Abstract

A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, [...] Read more.

A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, we aimed at performing an update about the available data on the early motor function in children with autism spectrum disorder. Early motor impairment in these children can manifest itself both as a mere delay of motor development and as the presence of atypicalities of motor function, such as a higher rate and a larger inventory, of stereotyped movements both with and without objects. In the perspective of a timely diagnosis, the presence of early motor signs can be an important clue, especially in an individual considered at high risk for autism. Motor and communication (both verbal and non-verbal) skills are connected and a pathogenetic role of early motor dysfunctions in the development of autism can be hypothesized. From this, derives the importance of an early enabling intervention aimed at improving motor skills, which could also have favorable effects on other aspects of development. Full article

(This article belongs to the Special Issue Autism and Children)

► Show Figures

Figure 1

10 pages, 648 KiB

Open AccessEditor’s ChoiceArticle

Anterior Chamber Angle in Adults Born Extremely, Very, and Moderately Preterm with and without Retinopathy of Prematurity—Results of the Gutenberg Prematurity Eye Study

by Achim Fieß, Sandra Gißler, Eva Mildenberger, Michael S. Urschitz, Agnes Fauer, Heike M. Elflein, Fred Zepp, Bernhard Stoffelns, Norbert Pfeiffer and Alexander K. Schuster

Children 2022, 9(2), 281; https://doi.org/10.3390/children9020281 - 18 Feb 2022

Cited by 20 | Viewed by 2795

Abstract

Purpose: To determine whether prematurity and associated factors affect the anterior chamber angle (ACA) width in adulthood. Methods: The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination of adults (age 18–52 years) in Germany. All participants [...] Read more.

Purpose: To determine whether prematurity and associated factors affect the anterior chamber angle (ACA) width in adulthood. Methods: The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination of adults (age 18–52 years) in Germany. All participants were examined with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) using linear regression analysis to assess the associations of ACA in the different sectors with gestational age (GA), birth weight, birth weight percentile, retinopathy of prematurity (ROP), ROP treatment, placental insufficiency, preeclampsia, and breastfeeding. Results: In total, 516 eyes of 319 preterm and full-term individuals (aged 28.9 ± 8.8 years, 188 females) were examined. ROP treatment was associated with smaller ACA width in the nasal (B = −9.6 [95%CI: −14.7; −4.5] degree; p < 0.001) and temporal positions (B = −11.5 [95%CI: −17.7; −5.3] degree; p = 0.001), whereas non-treated individuals with ROP had an unaltered ACA width, as did individuals with low gestational age without ROP. Conclusion: Advanced stages of ROP following treatment with laser- and cryocoagulation lead to a smaller ACA width until adulthood, and hence may increase the risk of angle closure in later life. Full article

(This article belongs to the Special Issue Prematurity, Preterm-Born Adults, and Long-Term Effects on Children and Adults)

► Show Figures

Figure 1

18 pages, 1349 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Finding the True Number of Females with Autistic Spectrum Disorder by Estimating the Biases in Initial Recognition and Clinical Diagnosis

by Robert McCrossin

Children 2022, 9(2), 272; https://doi.org/10.3390/children9020272 - 17 Feb 2022

Cited by 36 | Viewed by 36443

Abstract

The proportion of females whose ASD diagnosis is missed is unknown. The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is [...] Read more.

The proportion of females whose ASD diagnosis is missed is unknown. The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is lower. These biases have not been clearly identified or quantified. Starting with a clinical dataset of 1711 children <18 years old, four different methods were employed in an inductive study to identify and quantify the biases and calculate the proportion of females missed. A mathematical model was constructed to compare the findings with current published data. The true male-to-female ratio appears to be 3:4. Eighty percent of females remain undiagnosed at age 18, which has serious consequences for the mental health of young women. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

► Show Figures

Graphical abstract

11 pages, 942 KiB

Open AccessEditor’s ChoiceArticle

The Mental Health of Black Youth Affected by Community Violence: Family and School Context as Pathways to Resilience

by Donte T. Boyd, Kristian V. Jones, Camille R. Quinn, Adrian Gale, Ed-Dee G. Williams and Husain Lateef

Children 2022, 9(2), 259; https://doi.org/10.3390/children9020259 - 15 Feb 2022

Cited by 18 | Viewed by 6131

Abstract

Black youth who experience community violence occupy multiple environments with varying levels of influence on how they display resiliency to prevent adverse mental health outcomes. Considering the recent rise of mental health concerns (i.e., increase in suicidal outcomes) among Black youth, along with [...] Read more.

Black youth who experience community violence occupy multiple environments with varying levels of influence on how they display resiliency to prevent adverse mental health outcomes. Considering the recent rise of mental health concerns (i.e., increase in suicidal outcomes) among Black youth, along with the abundance of research illustrating the detrimental impact of community violence, more research is needed to examine how different environmental factors (e.g., family and school) shape how youth protect their mental health while displaying resiliency navigating community violence. The purpose of this study was to examine how family and school contexts predict Black youths’ ability to display resiliency to navigate community violence and prevent adverse mental health outcomes. This study utilized a path analysis to examine the associations between parent relationships, parent bonding, school climate, resilience to adverse community experiences, community violence, and mental health among 548 Black adolescents in Chicago. Findings highlight that parent relationships, parent bonding, and school climate influence the association between resilience to community violence and mental health outcomes among Black youth. Implications for mental health practice and policy among Black youth are discussed. Full article

(This article belongs to the Special Issue Family Risk and Protective Factors and Child Development)

► Show Figures

Figure 1

16 pages, 828 KiB

Open AccessEditor’s ChoiceReview

You Cannot Hit Snooze on OSA: Sequelae of Pediatric Obstructive Sleep Apnea

by Selena Thomas, Shefali Patel, Prabhavathi Gummalla, Mary Anne Tablizo and Catherine Kier

Children 2022, 9(2), 261; https://doi.org/10.3390/children9020261 - 15 Feb 2022

Cited by 32 | Viewed by 9379

Abstract

Pediatric obstructive sleep apnea (OSA) has been shown to not only affect the quality of sleep, but also overall health in general. Untreated or inadequately treated OSA can lead to long-term sequelae involving cardiovascular, endothelial, metabolic, endocrine, neurocognitive, and psychological consequences. The physiological [...] Read more.

Pediatric obstructive sleep apnea (OSA) has been shown to not only affect the quality of sleep, but also overall health in general. Untreated or inadequately treated OSA can lead to long-term sequelae involving cardiovascular, endothelial, metabolic, endocrine, neurocognitive, and psychological consequences. The physiological effects of pediatric OSA eventually become pathological. As the complex effects of pediatric OSA are discovered, they must be identified early so that healthcare providers can be better equipped to treat and even prevent them. Ultimately, adequate management of OSA improves overall quality of life. Full article

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

► Show Figures

Graphical abstract

14 pages, 570 KiB

Open AccessEditor’s ChoiceReview

Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations

by Andrea Butera, Carolina Maiorani, Annalaura Morandini, Manuela Simonini, Stefania Morittu, Julia Trombini and Andrea Scribante

Children 2022, 9(2), 262; https://doi.org/10.3390/children9020262 - 15 Feb 2022

Cited by 75 | Viewed by 15480

Abstract

Dental caries is one of the most common diseases—both in adults and children—that occurs due to the demineralization of enamel and dentine by the organic acids formed from bacteria present in dental plaques through anaerobic metabolism of dietary sugars. The aim of this [...] Read more.

Dental caries is one of the most common diseases—both in adults and children—that occurs due to the demineralization of enamel and dentine by the organic acids formed from bacteria present in dental plaques through anaerobic metabolism of dietary sugars. The aim of this article is to provide a guideline to assess the risk of caries by looking for the main factors involved. Literature research was performed for studies that analyzed the factors most involved in the development of child caries, such as poor oral hygiene, bad eating habits (or food disorders), and an alteration of the oral bacterial flora—with an increase of Streptococci spp., Lactobacilli spp., Candida albicans, Cryptococcus neoformans, and Candida sake. It is therefore essential to assess the risk of caries in children, based on the assessment of risk factors, in order to be able to establish preventive and/or therapeutic approaches that will reduce or stop the development of dental caries. The use of fluoride products, products made from casein phosphopeptide-amorphous calcium phosphate, substituted zinc biomimetic hydroxyapatite products, or products containing self-assembling oligopeptide SAP-P₁₁-4 are useful. In terms of the clinical approach, a communicative approach should be added to learn about the eating habits and the oral hygiene habits of the child and parents; in addition, the use of a simple method to frame the factors involved, and subsequently establish the risk of carious lesions in the child, allows the reduction of the DMFT (Decayed Missing Filled Teeth) or ICDAS (International Caries Detection and Assessment System) index on large scales. Full article

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

► Show Figures

Figure 1

15 pages, 643 KiB

Open AccessEditor’s ChoiceArticle

Weight Pressures and Eating Disorder Symptoms among Adolescent Female Gymnasts of Different Performance Levels in Greece

by Ioanna Kontele, Tonia Vassilakou and Olyvia Donti

Children 2022, 9(2), 254; https://doi.org/10.3390/children9020254 - 14 Feb 2022

Cited by 21 | Viewed by 7073

Abstract

This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test [...] Read more.

This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test (EAT-26), the Weight-Pressures in Sport-Females (WPS-F), the Social Desirability Scale (SDS) and provided information on their training. It was found that 16.3% of competitive gymnasts and 7.4% of non-competitive gymnasts scored ≥20 in EAT-26, indicating disordered eating behavior. Competitive gymnasts scored higher than non-competitive in the total score of EAT-26 (p = 0.027), as well as in the total score of WPS-F, the sport and coaches weight pressures sub-scale and the appearance and performance weight pressures sub-scale (p < 0.001). Multiple regression analyses indicated that sport and coaches weight pressures, appearance and performance weight pressures and body mass index accounted for 30.3% of the variance of EAT-26 in competitive gymnasts, while the appearance and performance weight pressures sub-scale accounted for 16.3% of the variance of EAT-26 in non-competitive gymnasts. Sport and coaches weight pressures are associated with ED in competitive gymnasts, while body appearance and performance demands correlate with ED in female gymnasts irrespective of competitive level. Full article

(This article belongs to the Special Issue Body Image, Weight Pressure and Disordered Eating Behaviors among Children and Adolescents)

► Show Figures

Graphical abstract

28 pages, 2148 KiB

Open AccessEditor’s ChoiceReview

COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines

by Giuseppina Malcangi, Alessio Danilo Inchingolo, Angelo Michele Inchingolo, Fabio Piras, Vito Settanni, Grazia Garofoli, Giulia Palmieri, Sabino Ceci, Assunta Patano, Antonio Mancini, Luigi Vimercati, Damiano Nemore, Arnaldo Scardapane, Biagio Rapone, Alexandra Semjonova, Maria Teresa D’Oria, Luigi Macchia, Ioana Roxana Bordea, Giovanni Migliore, Antonio Scarano, Felice Lorusso, Gianluca Martino Tartaglia, Delia Giovanniello, Ludovica Nucci, Nicola Maggialetti, Antonio Parisi, Marina Di Domenico, Nicola Brienza, Silvio Tafuri, Pasquale Stefanizzi, Luigi Curatoli, Alberto Corriero, Maria Contaldo, Francesco Inchingolo and Gianna Dipalma Show full author list Hide full author list

Children 2022, 9(2), 249; https://doi.org/10.3390/children9020249 - 12 Feb 2022

Cited by 74 | Viewed by 6282

Abstract

Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children [...] Read more.

Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data for children below the age of 12 years. The COVID-19 clinical frame infection is milder in children and adolescents. This section of the population can act as vectors and reservoirs and play a key role in the transmission of the infection; therefore, vaccines are paramount. More evidence is required to guide safely the vaccination campaign. Full article

(This article belongs to the Special Issue Children’s Emotion and Learning during COVID-19 Pandemic)

► Show Figures

Figure 1

12 pages, 272 KiB

Open AccessEditor’s ChoiceArticle

The Associations of Child’s Clinical Conditions and Behavioral Problems with Parenting Stress among Families of Preschool-Aged Children: 2018–2019 National Survey of Child Health

by Soyang Kwon, Meghan E. O’Neill and Carolyn C. Foster

Children 2022, 9(2), 241; https://doi.org/10.3390/children9020241 - 11 Feb 2022

Cited by 13 | Viewed by 2837

Abstract

To understand parental stress resulting from parenting young children, the current literature has primarily focused on families of children with clinical conditions, but has placed far less attention on the general population. The aim of this study was to examine parenting stress related [...] Read more.

To understand parental stress resulting from parenting young children, the current literature has primarily focused on families of children with clinical conditions, but has placed far less attention on the general population. The aim of this study was to examine parenting stress related to children’s clinical conditions and behavioral problems in a nationally representative sample of US children aged 3 to 5 years. The study sample included 8454 children aged 3 to 5 years and their parents who participated in the 2018–2019 US National Survey of Child Health (NSCH). Using online/paper NSCH questionnaires, parents reported their children’s special health care needs (SHCN), clinically diagnosed mental, emotional, developmental, and behavioral (MEDB) problems (e.g., anxiety problem, developmental delay), and externalizing behaviors. Parents also reported the frequency of feeling aggravated from parenting the participating child as an indicator of elevated parenting stress. In the sample, the prevalence of elevated parenting stress was 5.1% overall (95% CI = 4.2, 6.0); however, it was significantly higher among parents of children with SHCN (20.8%; 95% CI = 16.7, 24.9), with MEDB problems (24.8%; 95% CI = 19.9, 29.8), and with externalizing behavior problems (14.7%; 95% CI = 11.8, 17.6). A multivariable logistic regression model showed that elevated parenting stress was associated with the child’s SHCN (adjusted odds ratio [AOR] = 2.3; 1.3, 3.9), MEDB problems (AOR = 4.8; 95% CI = 2.5, 9.1), and externalizing behavior problems (AOR = 5.4; 95% CI = 3.1, 9.4). Even in children without SHCN or MEDB problems, externalizing behavior problems were associated with elevated parenting stress (AOR = 6.4; 95% CI = 3.3, 12.7). The findings call for greater attention to subclinical or yet to be diagnosed externalizing behavior problems among the general preschool-aged child population and their underestimated impact on parenting stress. Full article

(This article belongs to the Section Pediatric Mental Health)

17 pages, 1091 KiB

Open AccessEditor’s ChoiceReview

Presentation of Congenital Portosystemic Shunts in Children

by Atessa Bahadori, Beatrice Kuhlmann, Dominique Debray, Stephanie Franchi-Abella, Julie Wacker, Maurice Beghetti, Barbara E. Wildhaber, Valérie Anne McLin and on behalf of the IRCPSS

Children 2022, 9(2), 243; https://doi.org/10.3390/children9020243 - 11 Feb 2022

Cited by 23 | Viewed by 12094

Abstract

Background: Congenital portosystemic shunts (CPSS) are rare vascular anomalies resulting in communications between the portal venous system and the systemic venous circulation, affecting an estimated 30,000 to 50,000 live births. CPSS can present at any age as a multi-system disease of variable severity [...] Read more.

Background: Congenital portosystemic shunts (CPSS) are rare vascular anomalies resulting in communications between the portal venous system and the systemic venous circulation, affecting an estimated 30,000 to 50,000 live births. CPSS can present at any age as a multi-system disease of variable severity mimicking both common and rare pediatric conditions. Case presentations: Case A: A vascular malformation was identified in the liver of a 10-year-old girl with tall stature, advanced somatic maturation, insulin resistance with hyperinsulinemia, hyperandrogenemia and transient hematuria. Work-up also suggested elevated pulmonary pressures. Case B: A young girl with trisomy 8 mosaicism with a history of neonatal hypoglycemia, transient neonatal cholestasis and tall stature presented newly increased aminotransferase levels at 6 years of age. Case C: A 3-year-old boy with speech delay, tall stature and abdominal pain underwent abdominal ultrasound (US) showing multiple liver nodules, diagnosed as liver hemangiomas by hepatic magnetic resonance imaging (MRI). Management and outcome: After identification of a venous malformation on liver Doppler US, all three patients were referred to a specialized liver center for further work-up within 12 to 18 months from diagnosis. Angio-computed tomography (CT) scan confirmed the presence of either an intrahepatic or extrahepatic CPSS with multiples liver nodules. All three had a hyperintense signal in the globus pallidus on T1 weighted cerebral MRI. Right heart catheterization confirmed pulmonary hypertension in cases A and C. Shunts were closed either using an endovascular or surgical approach. Liver nodules were either surgically removed if there was a risk of malignant degeneration or closely monitored by serial imaging when benign. Conclusion: These cases illustrate most of the common chief complaints and manifestations of CPSS. Liver Doppler US is the key to diagnosis. Considering portosystemic shunts in the diagnostic work-up of a patient with unexplained endocrine, liver, gastro-intestinal, cardiovascular, hematological, renal or neurocognitive disorder is important as prompt referral to a specialized center may significantly impact patient outcome. Full article

(This article belongs to the Special Issue Pediatric Vascular Anomalies: Clinical Diagnosis and Treatment)

► Show Figures

Figure 1

18 pages, 379 KiB

Open AccessEditor’s ChoiceReview

Assessment and Management of Pain in Preterm Infants: A Practice Update

by Marsha Campbell-Yeo, Mats Eriksson and Britney Benoit

Children 2022, 9(2), 244; https://doi.org/10.3390/children9020244 - 11 Feb 2022

Cited by 61 | Viewed by 11677

Abstract

Infants born preterm are at a high risk for repeated pain exposure in early life. Despite valid tools to assess pain in non-verbal infants and effective interventions to reduce pain associated with medical procedures required as part of their care, many infants receive [...] Read more.

Infants born preterm are at a high risk for repeated pain exposure in early life. Despite valid tools to assess pain in non-verbal infants and effective interventions to reduce pain associated with medical procedures required as part of their care, many infants receive little to no pain-relieving interventions. Moreover, parents remain significantly underutilized in provision of pain-relieving interventions, despite the known benefit of their involvement. This narrative review provides an overview of the consequences of early exposure to untreated pain in preterm infants, recommendations for a standardized approach to pain assessment in preterm infants, effectiveness of non-pharmacologic and pharmacologic pain-relieving interventions, and suggestions for greater active engagement of parents in the pain care for their preterm infant. Full article

(This article belongs to the Special Issue Health Care in Premature Infants)

39 pages, 895 KiB

Open AccessEditor’s ChoiceSystematic Review

Measuring Happiness in Adolescent Samples: A Systematic Review

by Justė Lukoševičiūtė, Gita Argustaitė-Zailskienė and Kastytis Šmigelskas

Children 2022, 9(2), 227; https://doi.org/10.3390/children9020227 - 8 Feb 2022

Cited by 21 | Viewed by 7035

Abstract

Background: Happiness is a phenomenon that relates to better mental and physical health and even longevity. There has been an increase in surveys assessing subjective well-being as well as happiness, one of the well-being components that reflect one’s feelings or moods. Happiness is [...] Read more.

Background: Happiness is a phenomenon that relates to better mental and physical health and even longevity. There has been an increase in surveys assessing subjective well-being as well as happiness, one of the well-being components that reflect one’s feelings or moods. Happiness is mostly measured in adult samples. There is a lack of an overview of the tools used to evaluate adolescent happiness, so this paper aimed to review them. Methods: A literature search was performed in the PubMed and PsycArticles databases (2010–2019). In total, 133 papers met the eligibility criteria for this systematic review. Results: The results are grouped according to the type of measure, single or multiple items, that was used in a study. Almost half of the studies (64 of 133) evaluated subjective happiness using single-item measures. The most commonly used scales were the 4-item Subjective Happiness Scale and the Oxford Happiness Questionnaire. Among the 133 articles analyzed, 18 reported some validation procedures related to happiness. However, in the majority of cases (14 studies), happiness was not the central phenomenon of validation, which suggests a lack of happiness validation studies. Conclusions: Finally, recommendations for future research and for the choice of happiness assessment tools are presented. Full article

► Show Figures

Figure 1

10 pages, 316 KiB

Open AccessEditor’s ChoiceArticle

Family Environment and Portuguese Adolescents: Impact on Quality of Life and Well-Being

by Fábio Botelho Guedes, Ana Cerqueira, Susana Gaspar, Tania Gaspar, Carmen Moreno and Margarida Gaspar de Matos

Children 2022, 9(2), 200; https://doi.org/10.3390/children9020200 - 3 Feb 2022

Cited by 14 | Viewed by 4217

Abstract

Background: A healthy and supportive family environment leads to more positive results regarding adolescents’ development. The main objective of this study was to explore and analyze the relationship between adolescents’ quality of life (QoL) and their family environment/relationship. Method: The sample was collected [...] Read more.

Background: A healthy and supportive family environment leads to more positive results regarding adolescents’ development. The main objective of this study was to explore and analyze the relationship between adolescents’ quality of life (QoL) and their family environment/relationship. Method: The sample was collected as part of the Health Behavior in School-aged Children 2018 study, which included 8215 adolescents, 52.7% female, with a mean age of 14.36 years (SD = 2.28). Results: Girls are more involved in family activities (such as family meals), report being treated with fairness by their parents and feel less parental pressure to get good grades. Boys have a higher perception regarding their family affluence, better family relationships and support and better QoL. Having an above-average QoL is significantly related to high family affluence, better communication with both parents, greater involvement in family activities, greater perception of help from parents regarding decision-making, greater perception of being treated with fairness by parents and less pressure from parents to get good grades, as well as a better family relationship/support. Conclusion: It is important to determine the impact that parental divorce/separation or a weak parent–child relationship can have on adolescents. It is also necessary to consider the family relationship and structure when devising strategies and public policies related to the promotion of adolescents’ health and well-being. Full article

14 pages, 1291 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Etiology, Risk Factors, and Diagnosis of Back Pain in Children and Adolescents: Evidence- and Consensus-Based Interdisciplinary Recommendations

by Michael Frosch, Maximilian D. Mauritz, Stefan Bielack, Susanne Blödt, Uta Dirksen, Michael Dobe, Florian Geiger, Renate Häfner, Lea Höfel, Bettina Hübner-Möhler, Thekla von Kalle, Burkhard Lawrenz, Andreas Leutner, Frauke Mecher, Kiril Mladenov, Heike Norda, Lorin Stahlschmidt, Marc Steinborn, Ralf Stücker, Ralf Trauzeddel, Regina Trollmann, Julia Wager and Boris Zernikow Show full author list Hide full author list

Children 2022, 9(2), 192; https://doi.org/10.3390/children9020192 - 2 Feb 2022

Cited by 21 | Viewed by 6077

Abstract

Using a structured approach and expert consensus, we developed an evidence-based guideline on the diagnosis of back pain and the treatment of non-specific back pain in children and adolescents. The first part comprises etiology, risk factors, and diagnosis. The second part, published in [...] Read more.

Using a structured approach and expert consensus, we developed an evidence-based guideline on the diagnosis of back pain and the treatment of non-specific back pain in children and adolescents. The first part comprises etiology, risk factors, and diagnosis. The second part, published in the same issue, includes treatment and prevention. A comprehensive and systematic literature search was conducted to identify relevant guidelines and studies. Based on the findings of this literature search, recommendations on risk factors and diagnosis were formulated and voted on by experts in a structured consensus-building process. Notable red flags for specific back pain and evidence-based risk factors for non-specific back pain in children and adolescents were identified. Only three evidence-based recommendations could be formulated for causes, red flags, and risk factors for back pain, while two recommendations are based on expert consensus. Regarding diagnostics, eight expert consensus recommendations and one evidence-based recommendation could be provided. Despite the importance of adequate diagnosis for the treatment of back pain in children and adolescents, results of this work confirm the deficit in research investment in this area. Full article

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

► Show Figures

Figure 1

14 pages, 4450 KiB

Open AccessEditor’s ChoiceReview

Advanced Ultrasound Techniques for Neuroimaging in Pediatric Critical Care: A Review

by Colbey W. Freeman and Misun Hwang

Children 2022, 9(2), 170; https://doi.org/10.3390/children9020170 - 30 Jan 2022

Cited by 12 | Viewed by 4688

Abstract

Because of its portability, safety profile, and accessibility, ultrasound has been integral in pediatric neuroimaging. While conventional B-mode and Doppler ultrasound provide anatomic and limited flow information, new and developing advanced ultrasound techniques are facilitating real-time visualization of brain perfusion, microvascular flow, and [...] Read more.

Because of its portability, safety profile, and accessibility, ultrasound has been integral in pediatric neuroimaging. While conventional B-mode and Doppler ultrasound provide anatomic and limited flow information, new and developing advanced ultrasound techniques are facilitating real-time visualization of brain perfusion, microvascular flow, and changes in tissue stiffness in the brain. These techniques, which include contrast-enhanced ultrasound, microvascular imaging, and elastography, are providing new insights into and new methods of evaluating pathologies affecting children requiring critical care, including hypoxic–ischemic encephalopathy, stroke, and hydrocephalus. This review introduces advanced neurosonography techniques and their clinical applications in pediatric neurocritical care. Full article

(This article belongs to the Special Issue Pediatric Neurocritical Care and Neurotrauma Recovery)

► Show Figures

Figure 1

10 pages, 907 KiB

Open AccessEditor’s ChoiceSystematic Review

Individual Circadian Preference, Eating Disorders and Obesity in Children and Adolescents: A Dangerous Liaison? A Systematic Review and a Meta-Analysis

by Francisco José Rodríguez-Cortés, Ignacio Morales-Cané, Pedro Manuel Rodríguez-Muñoz, Rosaria Cappadona, Alfredo De Giorgi, Roberto Manfredini, María Aurora Rodríguez-Borrego, Fabio Fabbian and Pablo Jesús López-Soto

Children 2022, 9(2), 167; https://doi.org/10.3390/children9020167 - 28 Jan 2022

Cited by 23 | Viewed by 5308

Abstract

Background: Obesity and other eating disorders are an actual public health problem, especially in childhood and adolescents, and could be also related with chronotype. The aim of this systematic review was to determine the relationship between eating disorders, obesity and the different chronotypes [...] Read more.

Background: Obesity and other eating disorders are an actual public health problem, especially in childhood and adolescents, and could be also related with chronotype. The aim of this systematic review was to determine the relationship between eating disorders, obesity and the different chronotypes in children and adolescents. Methods: A systematic review of observational studies evaluating young populations dealing with and evaluating chronotype was conducted. Electronic searches were performed in six international databases. A qualitative thematic-categorical analysis was carried out and a random-effects model was used for the quantitative analysis (meta-analysis). Results: Fifteen studies were included, but quantitative analysis was only carried out in three of them. Children and adolescents with an evening chronotype had higher body mass index, consumed more junk food or were more predisposed to suffer from food addiction and night eating syndrome. Conclusions: Children and adolescents with evening chronotype had higher tendency to incorrect eating behaviors and were suffering from overweight/obesity. Environment but also lifestyle factors should be considered in the association between chronotype and eating disorders and obesity. Full article

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

► Show Figures

Figure 1

13 pages, 1767 KiB

Open AccessEditor’s ChoiceSystematic Review

Obsessive-Compulsive Disorder in PANS/PANDAS in Children: In Search of a Qualified Treatment—A Systematic Review and Metanalysis

by Salvatore Cocuzza, Antonino Maniaci, Ignazio La Mantia, Francesco Nocera, Daniela Caruso, Sebastiano Caruso, Giannicola Iannella, Claudio Vicini, Elio Privitera, Jerome Rene Lechien and Piero Pavone

Children 2022, 9(2), 155; https://doi.org/10.3390/children9020155 - 26 Jan 2022

Cited by 16 | Viewed by 7479

Abstract

Background: Several treatment options have been proposed for pediatric acute-onset neuropsychiatric syndrome/pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANS/PANDAS). Still, no clear therapeutic protocol has been recognized to prevent these neuropsychiatric diseases. The study aims to report on the literature evidence and [...] Read more.

Background: Several treatment options have been proposed for pediatric acute-onset neuropsychiatric syndrome/pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANS/PANDAS). Still, no clear therapeutic protocol has been recognized to prevent these neuropsychiatric diseases. The study aims to report on the literature evidence and different treatment strategies related to these disorders. Methods: We analyzed the last 20 years’ English language literature and performed a comprehensive review of the PANS/PANDAS treatment, including studies reporting OCD outcomes post-treatment follow-up. Results: We covered 11 articles in our systematic literature review for a total of 473 patients, of which four studies included 129 surgical subjects and seven papers with 326 medically treated patients. Pooled outcomes analysis, surgical and medical treatment reported an OCD reduction, but no statistical significance was obtained (p < 0.05 for both). Conclusions: Surgical therapy in selected patients can lead to promising results, although further evidence is needed. On the other hand, the role of medical therapy remains controversial, often due to the lack of univocal curative protocols and variable responses depending on the drug used and the timing of administration. Therefore, further investigations are necessary to clarify the most appropriate therapeutic procedure. Full article

(This article belongs to the Special Issue Advances in Research on Neurologic Related Diseases in Children)

► Show Figures

Figure 1

9 pages, 786 KiB

Open AccessEditor’s ChoiceArticle

Changes in Suicide Rate and Characteristics According to Age of Suicide Attempters before and after COVID-19

by Min-Jung Kim, So-Hyun Paek, Jae-Hyun Kwon, Soo-Hyun Park, Hyun-Jung Chung and Young-Hoon Byun

Children 2022, 9(2), 151; https://doi.org/10.3390/children9020151 - 25 Jan 2022

Cited by 25 | Viewed by 7275

Abstract

This study aims to identify age-related suicide-related factors and changes in suicide rate before and after the onset of the COVID-19 pandemic. Methods: From 2018 to 2020, the patients who presented to the ED of a university hospital with a suicide attempt were [...] Read more.

This study aims to identify age-related suicide-related factors and changes in suicide rate before and after the onset of the COVID-19 pandemic. Methods: From 2018 to 2020, the patients who presented to the ED of a university hospital with a suicide attempt were classified into adolescents (≤18 years), adults (19–65 years), and elderly (>65 years), and the visits were grouped into before and after COVID-19. Results: There were 853 visits before and 388 visits after COVID-19, and the results showed that the number of adolescent and adult suicide patients increased immediately after the pandemic, but the overall trend did not show a significant difference from before the pandemic. In the adolescents, the ratio of male patients increased, interpersonal and school-related motivations decreased, the poisoning and cutting methods of suicide were more common, and hospitalization admissions increased. Among the elderly, the ratio of female patients increased, the number of single patients and patients without previous psychiatric problems increased, the motives for physical illness and death of people around increased, the falling and hanging methods of suicide were more common, and hospitalization admissions and deaths increased. Conclusion: The impact of COVID-19 on suicide rates and suicide-related factors varies by age group. This finding requires different approaches and methods to suicide prevention based on age. Full article

(This article belongs to the Section Pediatric Mental Health)

► Show Figures

Figure 1

17 pages, 1463 KiB

Open AccessEditor’s ChoiceArticle

Alterations of the Gut Microbiome Associated to Methane Metabolism in Mexican Children with Obesity

by Sofía Magdalena Murga-Garrido, Yaneth Citlalli Orbe-Orihuela, Cinthya Estefhany Díaz-Benítez, Ana Cristina Castañeda-Márquez, Fernanda Cornejo-Granados, Adrian Ochoa-Leyva, Alejandro Sanchez-Flores, Miguel Cruz, Ana Isabel Burguete-García and Alfredo Lagunas-Martínez

Children 2022, 9(2), 148; https://doi.org/10.3390/children9020148 - 24 Jan 2022

Cited by 18 | Viewed by 6290

Abstract

Gut microbiota is associated with the development of metabolic disorders. To study its association with childhood obesity, we performed a cross-sectional study with 46 children (6–12 years old). We collected fecal samples, food-frequency questionnaires (FFQs), and anthropometric measurements. Shotgun metagenomics were used to [...] Read more.

Gut microbiota is associated with the development of metabolic disorders. To study its association with childhood obesity, we performed a cross-sectional study with 46 children (6–12 years old). We collected fecal samples, food-frequency questionnaires (FFQs), and anthropometric measurements. Shotgun metagenomics were used to obtain the microbial taxonomic diversity and metabolic potential. We identified two dietary profiles characterized by complex carbohydrates and proteins (pattern 1) and saturated fat and simple carbohydrates (pattern 2). We classified each participant into normal weight (NW) or overweight and obese (OWOB) using their body mass index (BMI) z-score. The ratio of Firmicutes/Bacteroidetes and alpha diversity were not different between the BMI groups. Genera contributing to beta diversity between NW and OWOB groups included Bacteroides rodentium, B. intestinalis, B. eggerthii, Methanobrevibacter smithii, Eubacterium sp., and Roseburia sp. B. rodentium was associated with lower BMI and dietary pattern 1 intake. Eubacterium sp. and Roseburia sp. were associated with BMI increments and high consumption of dietary pattern 2. Methane and energy metabolism were found enriched in under-represented KEGG pathways of NW group compared to OWOB. Complex dietary and microbiome interaction leads to metabolic differences during childhood, which should be elucidated to prevent metabolic diseases in adolescence and adulthood. Full article

► Show Figures

Graphical abstract

13 pages, 413 KiB

Open AccessEditor’s ChoiceArticle

The Needs of Parents of Children Suffering from Cancer—Continuation of Research

by Anna Lewandowska

Children 2022, 9(2), 144; https://doi.org/10.3390/children9020144 - 23 Jan 2022

Cited by 35 | Viewed by 5936

Abstract

Background: Parents experience many healthcare needs when caring for their sick children. Research shows that parents of oncological children have a high level of unmet needs, including psychosocial, emotional, physical, informational, financial, educational, and spiritual needs. To date, little quantitative research has been [...] Read more.

Background: Parents experience many healthcare needs when caring for their sick children. Research shows that parents of oncological children have a high level of unmet needs, including psychosocial, emotional, physical, informational, financial, educational, and spiritual needs. To date, little quantitative research has been carried out on the specific needs of parents of children with cancer, which creates uncertainty about what areas should be addressed in care. This study investigated the prevalence of unmet needs among parents of children with cancer. Methods: A population survey was conducted between 2015 and 2020. Caregivers of children diagnosed with cancer were invited to participate in the study to assess their problems and needs. Results: The analysis found that 97% of the participants experienced some level of need for one or more items, and 73% of the respondents reported a moderate or high need for one or more items. In the field of medical information, 70% of respondents had moderate or high needs, 55% of parents reported a moderate or high level of need for help in the psychological or emotional field, and 30% in the financial domain. The prevalence of moderate or high need in the remaining domains ranged from 10% to 15%. Conclusions: Parents of children with cancer experience a high level of needs, especially psychological, emotional, and information. These data suggest that the existing healthcare system does not meet the needs of parents of sick children. The results show the need to investigate the mechanisms by which healthcare providers can use the healthcare system to identify and meet needs. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

► Show Figures

Figure 1

11 pages, 553 KiB

Open AccessEditor’s ChoiceArticle

Is Vesicostomy Still a Contemporary Method of Managing Posterior Urethral Valves?

by Aybike Hofmann, Maximilian Haider, Alexander Cox, Franziska Vauth and Wolfgang H. Rösch

Children 2022, 9(2), 138; https://doi.org/10.3390/children9020138 - 21 Jan 2022

Cited by 10 | Viewed by 3917

Abstract

In boys with posterior urethral valves (PUVs) the main treatment aim is to preserve long-term bladder and renal function. To determine the effectiveness of secondary vesicostomy in boys with PUVs, the medical records of 21 patients with PUV (2010–2019), divided into two groups [...] Read more.

In boys with posterior urethral valves (PUVs) the main treatment aim is to preserve long-term bladder and renal function. To determine the effectiveness of secondary vesicostomy in boys with PUVs, the medical records of 21 patients with PUV (2010–2019), divided into two groups (group I: valve ablation; group II: secondary vesicostomy), were reviewed regarding the course of serum creatinine, renal ultrasound, voiding cystourethrogram, urodynamics, postoperative complications, need of further surgery, and long-term solution. The median age of all patients at first follow-up was 11 (9–13) months and at last follow-up 64.5 (39.5–102.5) months. Despite a significant difference of the SWDR score (shape, wall, reflux, and diverticula) (p = 0.014), both groups showed no significant differences preoperatively. Postoperatively, serum creatinine (p = 0.024), grade of vesicoureteral reflux (p = 0.003), side of upper tract dilatation (p = 0.006), side of megaureter (p = 0.004), and SWDR score (p = 0.002) were significantly decreased in group II. Postoperative urodynamic measurements showed comparable results in both groups. Stoma complications were found in three (20%) patients (group II). Eight (53.3%) patients already received a closure of the vesicostomy. Seven out of eight (87.5%) patients were able to micturate spontaneously. Vesicostomy remains a reliable treatment option for boys with PUV to improve bladder function and avoid further damage to the urinary tract. Full article

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

► Show Figures

Figure 1

10 pages, 1158 KiB

Open AccessEditor’s ChoiceArticle

Maternal Singing but Not Speech Enhances Vagal Activity in Preterm Infants during Hospitalization: Preliminary Results

by Manuela Filippa, Mimma Nardelli, Elisa Della Casa, Alberto Berardi, Odoardo Picciolini, Sara Meloni, Clara Lunardi, Alessandra Cecchi, Alessandra Sansavini, Luigi Corvaglia, Enzo Pasquale Scilingo, Fabrizio Ferrari and EVC Group

Children 2022, 9(2), 140; https://doi.org/10.3390/children9020140 - 21 Jan 2022

Cited by 16 | Viewed by 4264

Abstract

Background: Early parental interventions in the Neonatal Intensive Care Units (NICUs) have beneficial effects on preterm infants’ short and long-term outcomes. The aim of this study was to investigate the effects of Early Vocal Contact (EVC)—singing and speaking—on preterm infants’ vagal activity and [...] Read more.

Background: Early parental interventions in the Neonatal Intensive Care Units (NICUs) have beneficial effects on preterm infants’ short and long-term outcomes. The aim of this study was to investigate the effects of Early Vocal Contact (EVC)—singing and speaking—on preterm infants’ vagal activity and autonomic nervous system (ANS) maturation. Methods: In this multi-center randomized clinical trial, twenty-four stable preterm infants, born at 25–32 weeks gestational age, were randomized to either the EVC group or control group, where mothers did not interact with the babies but observed their behavior. Heart Rate Variability (HRV) was acquired before intervention (pre-condition), during vocal contact, and after it (post condition). Results: No significant effect of the vocal contact, singing and speaking, was found in HRV when the intervention group was compared to the control group. However, a significant difference between the singing and the pre and post conditions, respectively, preceding and following the singing intervention, was found in the Low and High Frequency power nu, and in the low/high frequency features (p = 0.037). By contrast, no significant effect of the speaking was found. Conclusions: Maternal singing, but not speaking, enhances preterm infants’ vagal activity in the short-term, thus improving the ANS stability. Future analyses will investigate the effect of enhanced vagal activity on short and long-term developmental outcomes of preterm infants in the NICU. Full article

(This article belongs to the Section Pediatric Neonatology)

► Show Figures

Figure 1

19 pages, 333 KiB

Open AccessEditor’s ChoiceArticle

Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece

by Rafaela Makri, Michail Katsoulis, Anastasios Fotiou, Eleftheria Kanavou, Myrto Stavrou, Clive Richardson, Afroditi Kanellopoulou, Philippos Orfanos, Vassiliki Benetou and Anna Kokkevi

Children 2022, 9(1), 119; https://doi.org/10.3390/children9010119 - 17 Jan 2022

Cited by 18 | Viewed by 6445

Abstract

Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the [...] Read more.

Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

14 pages, 1492 KiB

Open AccessEditor’s ChoiceArticle

Positive Associations between Body Mass Index and Hematological Parameters, Including RBCs, WBCs, and Platelet Counts, in Korean Children and Adolescents

by Hwal Rim Jeong, Hae Sang Lee, Young Suk Shim and Jin Soon Hwang

Children 2022, 9(1), 109; https://doi.org/10.3390/children9010109 - 14 Jan 2022

Cited by 31 | Viewed by 4886

Abstract

We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and [...] Read more.

We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and 3738 girls) aged 10–18 years were recorded. The parameters were compared among participants with normal weight, overweight, and obesity. Significantly higher mean levels of WBCs (7.16 vs. 6.16 × 103/mm³, p < 0.001), RBCs (4.90 vs. 4.82 × 106/mm³, p < 0.001), Hb (14.07 vs. 13.99 g/dL, p < 0.05), Hct (42.31 vs. 41.91%, p < 0.001), and platelets (311.87 vs. 282.66 × 103/mm³, p < 0.001) were found in the obese than normal weight group, respectively, after adjusting for body mass index (BMI) and sex. BMI SDS had significant positive associations with the levels of WBCs (β = 0.275, p < 0.001), RBCs (β = 0.028, p < 0.001), Hb (β = 0.034, p < 0.001), Hct (β = 0.152, p < 0.001), and platelets (β = 8.372, p < 0.001) after adjusting for age, sex, and socioeconomic factors in a multiple linear regression analysis. A higher BMI was associated with elevated WBC, RBC, Hb, Hct, and platelet counts in children and adolescents. Because higher levels of hematological parameters are potential risk factors for obesity-related diseases, hematological parameters should be evaluated in obese children and adolescents. Full article

(This article belongs to the Special Issue Body Composition in Children)

► Show Figures

Figure 1

10 pages, 234 KiB

Open AccessEditor’s ChoiceArticle

The Incidence and Causes of Unplanned Reoperations as a Quality Indicator in Pediatric Surgery

by Miro Jukić, Ivona Biuk and Zenon Pogorelić

Children 2022, 9(1), 106; https://doi.org/10.3390/children9010106 - 13 Jan 2022

Cited by 17 | Viewed by 3456

Abstract

Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of [...] Read more.

Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of pediatric patients who underwent reoperation within the 30-day period after primary surgery, from 1 January 2018 to 31 December 2020 were retrospectively reviewed. The primary outcome of the study was the rate of uROR as a quality indicator in pediatric surgery. Secondary outcomes were indications for primary and secondary surgery, types and management of complications, factors that led to uROR, length of hospital stay, duration of surgery and anesthesia, and starting time of surgery. Results: A total of 3982 surgical procedures, under general anesthesia, were performed during the three-year study period (2018, n = 1432; 2019, n = 1435; 2020, n = 1115). Elective and emergency surgeries were performed in 3032 (76.1%) and 950 (23.9%) patients, respectively. During the study period 19 (0.5%) pediatric patients, with the median age of 11 years (IQR 3, 16), underwent uROR within the 30-day postoperative period. The uROR incidence was 6 (0.4%), 6 (0.4%), and 7 (0.6%) for years 2018, 2019, and 2020, respectively (p = 0.697). The incidence of uROR was significantly higher in males (n = 14; 73.7%) than in females (n = 5; 26.3%) (p = 0.002). The share of unplanned reoperations in studied period was 4.5 times higher in primarily emergency surgeries compared to primarily elective surgeries (p < 0.001). The difference in incidence was 0.9% (95% CI, 0.4–1.4). Out of children that underwent uROR within the 30-day period after elective procedures, 50% had American Society of Anesthesiologists (ASA) score three or higher (p = 0.016). The most common procedure which led to uROR was appendectomy (n = 5, 26.3%) while the errors in surgical technique were the most common cause for uROR (n = 11, 57.9%). Conclusion: Unplanned reoperations within the 30-day period after the initial surgical procedure can be a good quality indicator in pediatric surgery. Risk factors associated with uROR are emergency surgery, male gender, and ASA score ≥3 in elective pediatric surgery. Full article

(This article belongs to the Section Pediatric Surgery)

11 pages, 1812 KiB

Open AccessEditor’s ChoiceArticle

Burden of Traumatic Brain Injuries in Children and Adolescents in Europe: Hospital Discharges, Deaths and Years of Life Lost

by Marek Majdan, Juliana Melichova, Dominika Plancikova, Patrik Sivco, Andrew I. R. Maas, Valery L. Feigin, Suzanne Polinder and Juanita A. Haagsma

Children 2022, 9(1), 105; https://doi.org/10.3390/children9010105 - 13 Jan 2022

Cited by 14 | Viewed by 3508

Abstract

Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric [...] Read more.

Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric and adolescent population of Europe by calculating rates of hospital-based incidence, death and years of life lost (YLL) due to TBI in 33 countries of Europe in 2014 (most recent available data). We conducted a cross-sectional observational, population-based study. All cases with TBI in the age range 0 to 19, registered in the causes of death databases or hospital discharge databases of 33 European countries were included. Crude and age-standardized rates of hospital discharges, deaths and YLLs due to TBI; and pooled estimates for all countries combined were calculated. TBI caused 2303 deaths (71% in boys), 154,282 YLLs (68% in boys) and 441,368 hospital discharges (61% in boys) in the population of 0–19 year-olds. We estimated pooled age-standardized rates of death (2.8, 95% CI: 2.4–3.3), YLLs (184.4, 95% CI: 151.6–217.2) and hospital discharges (344.6, 95% CI: 250.3–438.9) for the analyzed countries in 2014. The population of 15–19 year-olds had the highest rates of deaths and YLLs, and the population of 0–4 year-olds had the highest rate of hospital discharges. Detailed estimates of hospital discharge, death and YLL rates based on high-quality, standardized data may be used to develop health policies, aid decision-making and plan prevention. Full article

(This article belongs to the Section Global Pediatric Health)

► Show Figures

Figure 1

17 pages, 324 KiB

Open AccessEditor’s ChoiceReview

Microcephaly in Neurometabolic Diseases

by Wiktoria Kempińska, Karolina Korta, Magdalena Marchaj and Justyna Paprocka

Children 2022, 9(1), 97; https://doi.org/10.3390/children9010097 - 11 Jan 2022

Cited by 8 | Viewed by 6100

Abstract

Neurometabolic disorders are an important group of diseases that mostly occur in neonates and infants. They are mainly due to the lack or dysfunction of an enzyme or cofactors necessary for a specific biochemical reaction, which leads to a deficiency of essential metabolites [...] Read more.

Neurometabolic disorders are an important group of diseases that mostly occur in neonates and infants. They are mainly due to the lack or dysfunction of an enzyme or cofactors necessary for a specific biochemical reaction, which leads to a deficiency of essential metabolites in the brain. This, in turn, can cause certain neurometabolic diseases. Disruption of metabolic pathways, and the inhibition at earlier stages, may lead to the storage of reaction intermediates, which are often toxic to the developing brain. Symptoms are caused by the progressive deterioration of mental, motor, and perceptual functions. The authors review the diseases with microcephaly, which may be one of the most visible signs of neurometabolic disorders. Full article

17 pages, 507 KiB

Open AccessEditor’s ChoiceReview

Questionnaires Assessing Adolescents’ Self-Concept, Self-Perception, Physical Activity and Lifestyle: A Systematic Review

by Natacha Palenzuela-Luis, Gonzalo Duarte-Clíments, Juan Gómez-Salgado, José Ángel Rodríguez-Gómez and María Begoña Sánchez-Gómez

Children 2022, 9(1), 91; https://doi.org/10.3390/children9010091 - 10 Jan 2022

Cited by 26 | Viewed by 11467

Abstract

Introduction: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires [...] Read more.

Introduction: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires is an optimal resource for gathering information and thus useful for this study. Objectives: The objectives of the study were to: (1). identify the questionnaires that assess self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; (2). analyse the psychometric measures of the questionnaires used to assess the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; and (3). determine which questionnaires are the most reliable and valid for assessing the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents. Method: A bibliographic search was carried out in the following databases: Virtual Health Library, Cochrane, Medline, Cuiden, Scielo, Dialnet, PubMed and Ministry of Health, Consumption and Social Welfare following the PICO method. The recommendations of the PRISMA statement were followed. Results: A total of 71 scientific articles were collected. Within the self-perception/self-concept questionnaires, the Rosenberg Self-Esteem Scale stands out for being an optimal and widely used resource in adolescents. Regarding the questionnaires that evaluate self-perception, the General Health Questionnaire is the most used; it is used in numerous national health surveys in different countries. The Physical Activity Questionnaire for Adolescents ranks first with respect to the rest of the tools. It is a widely used resource internationally and provides enough information on the physical activity carried out by the subject in a given week. Although there are several questionnaires that measure lifestyle, the Health Behavior in School-aged Children instrument was selected. This instrument is at the European level and involves the collaboration of 48 countries and allows us to compare the lifestyle habits of adolescents from different countries. Discussion: The questionnaire that stands out in the assessment of self-esteem/self-concept is the Rosenberg Self-Esteem Scale. The General Health Questionnaire has been selected as the best tool for assessing self-perception. To measure physical exercise, the Physical Activity Questionnaire for Adolescents is identified as the ideal instrument because it is widely used and can be completed quickly. Regarding lifestyle, the Health Behavior in School aged Children is shown to be an effective instrument in assessing lifestyle. Full article

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

► Show Figures

Figure 1

8 pages, 277 KiB

Open AccessEditor’s ChoiceArticle

The Impact of Weekday-to-Weekend Sleep Differences on Health Outcomes among Adolescent Students

by Jinseok Kim, Jin-Won Noh, Ahraemi Kim and Young Dae Kwon

Children 2022, 9(1), 52; https://doi.org/10.3390/children9010052 - 3 Jan 2022

Cited by 18 | Viewed by 4688

Abstract

The sleep difference between weekdays and weekends can lead to negative physical and mental health outcomes in adolescents. Thus, this study has attempted to analyze the impact of sleep time differences on various health outcomes, using nationally representative panel data. Data from the [...] Read more.

The sleep difference between weekdays and weekends can lead to negative physical and mental health outcomes in adolescents. Thus, this study has attempted to analyze the impact of sleep time differences on various health outcomes, using nationally representative panel data. Data from the junior high school student panel of the Korean Children and Youth Panel Survey were analyzed. The sleep difference was defined as the difference between the average sleep duration on weekdays and that on weekends in minutes. A series of mixed effect linear regression models for continuous variables or mixed effect logit regression for binary variables was utilized. Korean adolescent students reported from 96.8 min to 133.2 min of sleep duration difference between weekdays and weekends. After controlling for gender, parent work status, and type of housing, the weekday-to-weekend sleep differences were associated with various health-related outcomes including concentration difficulty, aggression, somatic symptoms, and withdrawal. Additionally, adolescent student life satisfaction was associated with sleep difference. The sleep differences among adolescent students were more associated with mental health-related outcomes and emotional symptoms than with physical health-related outcomes. The appropriate intervention to reduce the sleep difference gap is an important key to improve health in the adolescence period. Full article

(This article belongs to the Section Global Pediatric Health)

14 pages, 1463 KiB

Open AccessEditor’s ChoiceReview

Malignant Peripheral Nerve Sheath Tumors—A Comprehensive Review of Pathophysiology, Diagnosis, and Multidisciplinary Management

by Samantha W. E. Knight, Tristan E. Knight, Teresa Santiago, Andrew J. Murphy and Abdelhafeez H. Abdelhafeez

Children 2022, 9(1), 38; https://doi.org/10.3390/children9010038 - 1 Jan 2022

Cited by 40 | Viewed by 6552

Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas (STS) with nerve sheath differentiation and a tendency to metastasize. Although occurring at an incidence of 0.001% in the general population, they are relatively common in individuals with neurofibromatosis type 1 (NF1), [...] Read more.

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas (STS) with nerve sheath differentiation and a tendency to metastasize. Although occurring at an incidence of 0.001% in the general population, they are relatively common in individuals with neurofibromatosis type 1 (NF1), for whom the lifetime risk approaches 10%. The staging of MPNSTs is complicated and requires close multi-disciplinary collaboration. Their primary management is most often surgical in nature, with non-surgical modalities playing a supportive, necessary role, particularly in metastatic, invasive, or widespread disease. We, therefore, sought to provide a comprehensive review of the relevant literature describing the characteristics of these tumors, their pathophysiology and risk factors, their diagnosis, and their multi-disciplinary treatment. A close partnership between surgical and medical oncologists is therefore necessary. Advances in the molecular characterization of these tumors have also begun to allow the integration of targeted RAS/RAF/MEK/ERK pathway inhibitors into MPNST management. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

► Show Figures

Figure 1

9 pages, 989 KiB

Open AccessEditor’s ChoiceSystematic Review

Adverse Childhood Experiences Are Associated with Reduced Psychological Resilience in Youth: A Systematic Review and Meta-Analysis

by Cyleen A. Morgan, Yun-Hsuan Chang, Olivia Choy, Meng-Che Tsai and Shulan Hsieh

Children 2022, 9(1), 27; https://doi.org/10.3390/children9010027 - 31 Dec 2021

Cited by 56 | Viewed by 11369

Abstract

Background: Adverse childhood experiences (ACEs) are presumed to influence internalizing and externalizing behaviors that can significantly debilitate long-term biopsychological development in individuals. Psychological resilience has been shown to effectively mediate the relationship between ACEs and negative health outcomes since individuals with low levels [...] Read more.

Background: Adverse childhood experiences (ACEs) are presumed to influence internalizing and externalizing behaviors that can significantly debilitate long-term biopsychological development in individuals. Psychological resilience has been shown to effectively mediate the relationship between ACEs and negative health outcomes since individuals with low levels of resilience may have difficulty with bouncing back from toxic exposure to ACEs. Thus, the present systematic review and meta-analysis was aimed toward synthesizing current knowledge of the relationship between ACEs and psychological resilience in youths. Methods: A combination of key words relevant to the present study was searched on the PubMed, EMBASE, Scopus, Cochrane, and Google Scholar databases. The results were restricted to English publications and human studies, with subjects ranging between the age of 0 to 35 years. Effect-size measures inclusive of pooled correlation coefficients for correlation analyses and pooled odds ratios for regression analyses, respectively, were calculated using random-effect models to determine the relationship between ACEs and psychological resilience. Results: The searches identified 85 potentially relevant studies. Among them, 76 were excluded due to limited access, irrelevant data, and the fact that the variables of interest were not explicitly measured or disclosed, leaving a final total of nine studies considered valid for the meta-analysis. Findings from correlational meta-analysis (n = 6) revealed a significantly negative association between ACEs and resilience (β = −0.120 [−0.196, −0.043]). The meta-analysis of the studies (n = 3) reporting dichotomous outcomes (ACE ≥ 1 vs. no ACE) indicated that subjects who experienced an ACE were 63% less likely to display high resilience, in comparison to subjects without such experiences. Conclusion: Our results support a negative association between ACEs and psychological resilience and highlight the multiple dimensions that constitute resilience in an ACE-exposure context. These findings may be particularly useful to policy makers and healthcare institutions in terms of helping them devise effective medical interventions and community outreach programs intended to develop resilience in youths, thus reducing health-risk behaviors and negative health outcomes. Full article

(This article belongs to the Special Issue Research on Childhood Adversity and Youth Resilience: Cross-Disciplinary Perspectives)

► Show Figures

Figure 1

17 pages, 2727 KiB

Open AccessEditor’s ChoiceReview

Current Insights into Atopic March

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

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

Cited by 61 | Viewed by 21058

Abstract

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

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

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

► Show Figures

Figure 1

15 pages, 311 KiB

Open AccessEditor’s ChoiceReview

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

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

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

Cited by 66 | Viewed by 12170

Abstract

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

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

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

► Show Figures

Graphical abstract

11 pages, 419 KiB

Open AccessEditor’s ChoiceArticle

Improving Motor Skills in Early Childhood through Goal-Oriented Play Activity

by Panggung Sutapa, Kukuh Wahyudin Pratama, Maziah Mat Rosly, Syed Kamaruzaman Syed Ali and Manil Karakauki

Children 2021, 8(11), 994; https://doi.org/10.3390/children8110994 - 2 Nov 2021

Cited by 86 | Viewed by 28794

Abstract

Goal-oriented play activity encourages children to exercise and triggers the movement of body muscles. Active muscles are stronger, more agile, faster, and more powerful. Purpose: The purpose of this study is to determine that goal-oriented play activity in early childhood improves motor skills. [...] Read more.

Goal-oriented play activity encourages children to exercise and triggers the movement of body muscles. Active muscles are stronger, more agile, faster, and more powerful. Purpose: The purpose of this study is to determine that goal-oriented play activity in early childhood improves motor skills. Methods: Forty children aged 4.5–6 years old were recruited and took part in a set of training activities divided into Posts 1–5. To pass each post, a child had to run, walk on a balance beam, move sticks, throw and catch the ball, and arrange blocks. Training was given three times every week for 12 weeks. Data collected consisted of running 25 m, walking on the balance beam, throwing the ball as far as possible, locomotor movement, arranging cans, and bouncing the ball. Paired t and Wilcoxon signed-rank tests were used for analysis. Results: The results showed that there were significant differences in the motor skills evaluated pre- and post-training with p < 0.05. Conclusion: All six training activities conducted for 12 weeks provided significant improvements in the motor skills areas in children aged 4.5–6 years old. Full article

► Show Figures

Figure 1

33 pages, 620 KiB

Open AccessEditor’s ChoiceSystematic Review

The Effect of Adenotonsillectomy on Children’s Behavior and Cognitive Performance with Obstructive Sleep Apnea Syndrome: State of the Art

by Paola Di Mauro, Salvatore Cocuzza, Antonino Maniaci, Salvatore Ferlito, Deborak Rasà, Roberta Anzivino, Claudio Vicini, Giannicola Iannella and Ignazio La Mantia

Children 2021, 8(10), 921; https://doi.org/10.3390/children8100921 - 15 Oct 2021

Cited by 33 | Viewed by 6497

Abstract

(1) Background: This systematic review was designed to analyze adenotonsillectomy’s role in treating behavioural disorders and sleep-related quality of life in pediatric OSAS. (2) Methods: Papers that report pre-operative and post-operative outcomes by using the Epworth sleepiness scale, OSA-18, NEPSY, Conners’ rating scale, [...] Read more.

(1) Background: This systematic review was designed to analyze adenotonsillectomy’s role in treating behavioural disorders and sleep-related quality of life in pediatric OSAS. (2) Methods: Papers that report pre-operative and post-operative outcomes by using the Epworth sleepiness scale, OSA-18, NEPSY, Conners’ rating scale, BRIEF, PSQ-SRBD, PedsQL and CBCL. We performed a comprehensive review of English papers published during the last 20 years regarding behavioural disorders in OSAS patients and adenotonsillectomy. (3) Results: We included 11 studies reporting behavioral outcomes and sleep related quality of life after surgery. We investigated changes in behavior and cognitive outcomes after AT, and we found significant improvements of the scores post-AT in almost all studies. After comparing the AT group and control group, only one study had no difference that reached significance at one year post-AT. In another study, it did not show any significant improvement in terms of all behavioural and cognitive outcomes. The questionnaires on sleep-related quality of life after AT (PSQ-SRBD or ESS or OSA-18 or KOSA) may improve with positive changes in sleep parameters (AHI, ODI and SpO2). Furthermore, there is a significantly higher decrease in OSAS symptoms than the pre-AT baseline score. (4) Conclusion: Future studies should pay more attention to characterizing patient populations as well as rapid surgical treatments through existing criteria. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome in Children)

► Show Figures

Figure 1

18 pages, 874 KiB

Open AccessEditor’s ChoiceReview

Symbolic Play among Children with Autism Spectrum Disorder: A Scoping Review

by Francisco González-Sala, Irene Gómez-Marí, Raúl Tárraga-Mínguez, Alba Vicente-Carvajal and Gemma Pastor-Cerezuela

Children 2021, 8(9), 801; https://doi.org/10.3390/children8090801 - 12 Sep 2021

Cited by 32 | Viewed by 7736

Abstract

Symbolic play is considered an early indicator in the diagnosis of autism spectrum disorder (ASD) and its assessment. The objective of this study was to analyze the difficulties in symbolic play experienced by children with ASD and to determine the existence of differences [...] Read more.

Symbolic play is considered an early indicator in the diagnosis of autism spectrum disorder (ASD) and its assessment. The objective of this study was to analyze the difficulties in symbolic play experienced by children with ASD and to determine the existence of differences in symbolic play among children with ASD, children with other neurodevelopmental disorders and children with typical development. A scoping review was carried out in the Web of Science (WoS), Scopus, ERIC, and PsycInfo databases, following the extension for scoping reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The number of papers included in the review was 22. The results confirm that children with ASD have greater difficulties with symbolic play than children with other neurodevelopmental disorders and children with typical development, even when controlling for their verbal age. Difficulties are greater in situations of free or spontaneous play. Results evidenced that the absence or deficiency in the symbolic play can serve as an early indicator of ASD between the first and second year of life, the developmental moment in which this type of play begins. Full article

(This article belongs to the Special Issue Screening, Diagnosis and Early Intervention in Toddlers with Autism Spectrum Disorders)

► Show Figures

Figure 1

13 pages, 1435 KiB

Open AccessEditor’s ChoiceArticle

Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children

by Kasra Zarei, Guifeng Xu, Bridget Zimmerman, Michele Giannotti and Lane Strathearn

Children 2021, 8(9), 761; https://doi.org/10.3390/children8090761 - 31 Aug 2021

Cited by 36 | Viewed by 8068

Abstract

Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between “household challenge” ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. [...] Read more.

Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between “household challenge” ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. data. Method: This study used data from the 2016–2019 National Survey of Children’s Health, a nationwide, population-based, cross-sectional survey. Seven household challenge ACEs (not including child maltreatment) were reported by parents/guardians: parental death, incarceration, divorce/separation, family violence, mental illness, substance abuse, and poverty. Logistic regression with sample weights was used to estimate the odds ratio (OR) for 15 parent-reported neurodevelopmental and behavioral health conditions, by the number of reported ACEs. A dose-response relationship was examined by applying tests of orthogonal polynomial contrasts to fitted logistic regression models. Results: Down syndrome, Tourette syndrome and cerebral palsy were not associated with household challenge ACEs, whereas behavior/conduct problems, depression, and substance abuse were strongly associated, with adjusted ORs ranging from 6.36 (95% confidence interval (CI) 5.53, 7.32) to 9.19 (95% CI 7.79, 10.84). Other neurodevelopmental conditions not traditionally associated with childhood adversity showed moderate yet robust associations with ACEs, including autism (adjusted OR 2.15, 95% CI 1.64, 2.81), learning disability (adjusted OR 3.26, 95% CI 2.80, 3.80), and attention deficit hyperactivity disorder (adjusted OR 3.95, 95% CI 3.44, 4.53). The ORs increased with the number of ACEs, showing significant positive linear trends. Conclusion: We found significant dose-dependent or cumulative associations between ACEs and multiple neurodevelopmental and behavioral conditions. Full article

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

► Show Figures

Figure 1

8 pages, 665 KiB

Open AccessEditor’s ChoiceArticle

Cardiac Manifestations in Children with SARS-COV-2 Infection: 1-Year Pediatric Multicenter Experience

by Nicoletta Cantarutti, Virginia Battista, Rachele Adorisio, Marianna Cicenia, Claudia Campanello, Elisa Listo, Andrea Campana, Gianluca Trocchio and Fabrizio Drago

Children 2021, 8(8), 717; https://doi.org/10.3390/children8080717 - 23 Aug 2021

Cited by 34 | Viewed by 6010

Abstract

Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children [...] Read more.

Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children admitted to two Italian pediatric referral centers. Between March 2020 and March 2021, we performed a cardiac evaluation in 294 children (mean age 9 ± 5.9 years, male 60%) with active or previous SARS-COV-2 infection. Twenty-six showed ECG abnormalities: 63 repolarization anomalies, 13 Long QTc, five premature ventricular beats, two non-sustained ventricular tachycardia, and one atrial fibrillation. In total, 146 patients underwent cardiac biomarkers: NT-proBNP was elevated in 57, troponin in 34. An echocardiogram was performed in 98, showing 54 cardiac anomalies: 27 left-ventricular dysfunction, 42 pericarditis, 16 coronaritis. MIS-C was documented in 46 patients (mean age 9 ± 4.8 years, male 61%) with cardiac manifestations in 97.8%: 27 ventricular dysfunctions, 32 pericarditis, 15 coronaritis, 3 arrhythmias. All patients recovered, and during follow-up, no cardiac anomalies were recorded. Our experience showed that cardiac involvement is not rare in children with SARS-COV-2, and occurred in almost all patients with MIS-C. However, patients’ recovery is satisfactory and no additional events were reported during FU. Full article

(This article belongs to the Special Issue Cardiac Manifestation in Multisystem Inflammatory Syndrome in Children during Global SARS-CoV-2 Pandemic)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Editor’s Choice Articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI