Children

19 pages, 5012 KB

Open AccessEditor’s ChoiceReview

Complete Transposition of the Great Arteries in the Pediatric Field: A Multimodality Imaging Approach

by Sara Moscatelli, Martina Avesani, Nunzia Borrelli, Jolanda Sabatino, Valeria Pergola, Isabella Leo, Claudia Montanaro, Francesca Valeria Contini, Gabriella Gaudieri, Jessica Ielapi, Raffaella Motta, Marco Alfonso Perrone and Giovanni Di Salvo

Children 2024, 11(6), 626; https://doi.org/10.3390/children11060626 - 23 May 2024

Cited by 8 | Viewed by 4619

Abstract

The complete transposition of the great arteries (C-TGA) is a congenital cardiac anomaly characterized by the reversal of the main arteries. Early detection and precise management are crucial for optimal outcomes. This review emphasizes the integral role of multimodal imaging, including fetal echocardiography, [...] Read more.

The complete transposition of the great arteries (C-TGA) is a congenital cardiac anomaly characterized by the reversal of the main arteries. Early detection and precise management are crucial for optimal outcomes. This review emphasizes the integral role of multimodal imaging, including fetal echocardiography, transthoracic echocardiography (TTE), cardiovascular magnetic resonance (CMR), and cardiac computed tomography (CCT) in the diagnosis, treatment planning, and long-term follow-up of C-TGA. Fetal echocardiography plays a pivotal role in prenatal detection, enabling early intervention strategies. Despite technological advances, the detection rate varies, highlighting the need for improved screening protocols. TTE remains the cornerstone for initial diagnosis, surgical preparation, and postoperative evaluation, providing essential information on cardiac anatomy, ventricular function, and the presence of associated defects. CMR and CCT offer additional value in C-TGA assessment. CMR, free from ionizing radiation, provides detailed anatomical and functional insights from fetal life into adulthood, becoming increasingly important in evaluating complex cardiac structures and post-surgical outcomes. CCT, with its high-resolution imaging, is indispensable in delineating coronary anatomy and vascular structures, particularly when CMR is contraindicated or inconclusive. This review advocates for a comprehensive imaging approach, integrating TTE, CMR, and CCT to enhance diagnostic accuracy, guide therapeutic interventions, and monitor postoperative conditions in C-TGA patients. Such a multimodal strategy is vital for advancing patient care and improving long-term prognoses in this complex congenital heart disease. Full article

(This article belongs to the Special Issue Beyond Congenital Heart Disease: Role of the Pediatric Cardiologist)

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11 pages, 1106 KB

Open AccessEditor’s ChoiceArticle

Bowel Management in Hirschsprung Disease—Pre-, Peri- and Postoperative Care for Primary Pull-Through

by Judith Lindert, Felix Schulze and Stefanie Märzheuser

Children 2024, 11(5), 588; https://doi.org/10.3390/children11050588 - 13 May 2024

Cited by 5 | Viewed by 3888

Abstract

(1) Background: Bowel management contributes throughout the pathway of care for children with Hirschsprung. Preoperative bowel management prepares the child and family for the pull-through surgery. Perioperative bowel management supports early recovery and tailored bowel management in the follow-up supports the achievement of [...] Read more.

(1) Background: Bowel management contributes throughout the pathway of care for children with Hirschsprung. Preoperative bowel management prepares the child and family for the pull-through surgery. Perioperative bowel management supports early recovery and tailored bowel management in the follow-up supports the achievement of social continence. (2) Methods: We conducted a cross-sectional assessment of our institutional bowel management program to illustrate the pre-, peri- and postoperative bowel management strategies. (3) Results: A total of 31 children underwent primary pull-through, 23 without a stoma and 8 with a stoma, at a median age of 9 months. All children without a stoma were prepared for surgery by using rectal irrigations. Children with a stoma were prepared for surgery with a transfer of stoma effluent. Transanal irrigation supported early recovery. (4) Conclusions: Bowel management is a key pillar of the management of children with Hirschsprung disease. Incorporating bowel management in the pathway of care facilitates primary pull-through and supports perioperative recovery. Full article

(This article belongs to the Special Issue Selected Papers from the OASIS (Holistic Care in Hirschsprung’s Disease) Meeting)

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22 pages, 1384 KB

Open AccessEditor’s ChoiceReview

A Comprehensive Look at the Development of Asthma in Children

by Ileana Diana Diaconu, Veronica Gheorman, Gabriela Adriana Grigorie, Cristian Gheonea, Tiberiu-Stefanita Tenea-Cojan, Beatrice Mahler, Ion Alexandru Voropanov, Mihnea Cristian Firoiu, Andreea Silvia Pîrvu, Alexandru Bogdan Popescu and Renata Văruț

Children 2024, 11(5), 581; https://doi.org/10.3390/children11050581 - 11 May 2024

Cited by 10 | Viewed by 6419

Abstract

Asthma, a prevalent chronic respiratory condition affecting millions of children globally, presents a significant health challenge. This review critically examines the developmental pathways of asthma in children, focusing on genetic, environmental, and early-life determinants. Specifically, we explore the impact of prenatal and postnatal [...] Read more.

Asthma, a prevalent chronic respiratory condition affecting millions of children globally, presents a significant health challenge. This review critically examines the developmental pathways of asthma in children, focusing on genetic, environmental, and early-life determinants. Specifically, we explore the impact of prenatal and postnatal factors such as maternal smoking, nutrition, respiratory infections, and allergen exposure on asthma development. Our analysis highlights the intricate interplay of these influences and their contribution to childhood asthma. Moreover, we emphasize targeted strategies and interventions to mitigate its burden, including genetic counseling for at-risk families, environmental modifications to reduce triggers, and early-life immunomodulation. By delving into these preventive measures and interventions, our review aims to provide actionable insights for healthcare professionals in developing tailored strategies to address the complexities of childhood asthma. In summary, this article offers a detailed examination of asthma development in children, aiming to enhance understanding and inform efforts to reduce its burden through targeted interventions. Full article

(This article belongs to the Section Pediatric Allergy and Immunology)

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14 pages, 315 KB

Open AccessEditor’s ChoiceArticle

The Role of Parental Health Literacy in Establishing Health-Promoting Habits in Early Childhood

by Melinda Csima, Judit Podráczky, Viktória Keresztes, Evelin Soós and Judit Fináncz

Children 2024, 11(5), 576; https://doi.org/10.3390/children11050576 - 10 May 2024

Cited by 9 | Viewed by 2975

Abstract

In early childhood, children are extremely susceptible to the acquisition of habits and the establishment of health-promoting habits. Therefore, the patterns, routines, and rules transmitted and expected by the adults surrounding the child are of paramount importance and can correlate with the level [...] Read more.

In early childhood, children are extremely susceptible to the acquisition of habits and the establishment of health-promoting habits. Therefore, the patterns, routines, and rules transmitted and expected by the adults surrounding the child are of paramount importance and can correlate with the level of their health literacy. Our cross-sectional, quantitative, exploratory study aimed to examine the relationships between parental health literacy and preschool children’s health-related habits, using simple, non-random sampling (n = 598). In addition to the sociodemographic characteristics, the measuring tool we compiled included the standardized European Health Literacy Survey Questionnaire (HLS-EU-Q16), as well as a set of questions containing 30 statements suitable for exploring children’s habit systems. The health literacy of the parents involved in our study proved to be more favorable than that of the general population. Regarding children’s habit systems, we found significant differences in several areas by age group (p < 0.05) and gender (p < 0.05). The levels of parental health literacy (0.003 ≤ p ≤ 0.048) and parents’ education (p < 0.05) show a correlation with the children’s health-related habit systems: the indicators of children with parents who have a higher level of health literacy and a higher level of education are more favorable in terms of established habits. In the long term, the formation of health-promoting habits may facilitate the internalization of favorable health behavior motives for the future, contributing to the establishment of positive physical, mental, and social health in adulthood. Full article

(This article belongs to the Special Issue Health Behaviour, Health Literacy and Mental Health in Children)

15 pages, 1441 KB

Open AccessEditor’s ChoiceReview

Congenital Vascular Malformations in Children: From Historical Perspective to a Multidisciplinary Approach in the Modern Era—A Comprehensive Review

by Frédérique C. M. Bouwman, Bas H. Verhoeven, Willemijn M. Klein, Leo J. Schultze Kool and Ivo de Blaauw

Children 2024, 11(5), 567; https://doi.org/10.3390/children11050567 - 8 May 2024

Cited by 10 | Viewed by 4981

Abstract

Congenital vascular malformations (CVMs) are the result of an aberrant development during embryogenesis. Although these lesions are present at birth, they are not always visible yet. Once symptomatic, patients suffer from pain, bleeding, ulcers, infections or lymphatic leakage, depending on the subtype of [...] Read more.

Congenital vascular malformations (CVMs) are the result of an aberrant development during embryogenesis. Although these lesions are present at birth, they are not always visible yet. Once symptomatic, patients suffer from pain, bleeding, ulcers, infections or lymphatic leakage, depending on the subtype of vessels involved. Treatment includes conservative management, surgery, sclerotherapy, embolization and pharmacological therapy. The clinical presentation varies widely and treatment can be challenging due to the rarity of the disease and potential difficulties of treatment. This review gives an overview of the historical developments in diagnosis and classification and exposes the key elements of innovations in the past decades on the identification of genetic mutations and personalized treatment. These advances in the field and a multidisciplinary approach are highly valuable in the optimization of clinical care aimed at both curing or stabilizing the CVM and pursuing physical and psychosocial wellbeing. Full article

(This article belongs to the Section Pediatric Surgery)

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15 pages, 930 KB

Open AccessEditor’s ChoiceReview

Dysfunctional Breathing in Children: A Literature Review

by Georgia Karkouli, Konstantinos Douros, Dafni Moriki, Paraskevi Moutsatsou, Ioanna Giannopoulou, Eirini Maratou and Despoina Koumpagioti

Children 2024, 11(5), 556; https://doi.org/10.3390/children11050556 - 6 May 2024

Cited by 6 | Viewed by 4657

Abstract

Dysfunctional breathing (DB) describes a respiratory condition that is mainly characterized by abnormal breathing patterns, affecting both children and adults, often leading to intermittent or chronic complaints and influencing physiological, psychological, and social aspects. Some symptoms include breathlessness; dizziness; palpitations; and anxiety, while [...] Read more.

Dysfunctional breathing (DB) describes a respiratory condition that is mainly characterized by abnormal breathing patterns, affecting both children and adults, often leading to intermittent or chronic complaints and influencing physiological, psychological, and social aspects. Some symptoms include breathlessness; dizziness; palpitations; and anxiety, while its classification lies in breathing pattern disorders and upper airway involvement. Its prevalence among the pediatric population varies with a female overrepresentation, while the existence of comorbidities in DB, such as asthma, gastro-esophageal reflux, nasal diseases, and anxiety/depression, frequently leads to misdiagnosis or underdiagnosis and complicates therapeutic approaches. The basic diagnostic tools involve a detailed history, physical examination, and procedures such as structured light plethysmography, cardiopulmonary exercise testing, and laryngoscopy when a laryngeal obstruction is present. The management of DB presumes a multidimensional approach encompassing breathing retraining, disease-specific advice through speech and language therapy in the presence of laryngeal obstruction, psychotherapy for fostering self-efficacy, and surgical therapy in a structural abnormality. The current review was developed to provide a summary of classifications of DB and epidemiological data concerning the pediatric population, comorbidities, diagnostic tools, and therapeutic approaches to enhance the comprehension and management of DB in children. Full article

(This article belongs to the Special Issue Updates on Lung Function, Respiratory and Asthma Disease in Children)

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19 pages, 2041 KB

Open AccessEditor’s ChoiceReview

The Potential Impact of the Gut Microbiota on Neonatal Brain Development and Adverse Health Outcomes

by Maria Tzitiridou-Chatzopoulou, Jannis Kountouras and Georgia Zournatzidou

Children 2024, 11(5), 552; https://doi.org/10.3390/children11050552 - 5 May 2024

Cited by 11 | Viewed by 3392

Abstract

Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut–brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period [...] Read more.

Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut–brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period from birth to three years old may yield the greatest benefits. Investigating the substantial link between the gut and brain during this crucial developmental phase raises fundamental issues about the role of microorganisms in human health and brain development. This underscores the importance of focusing on the prevention rather than the treatment of neurodevelopmental and neuropsychiatric disorders. The present review examines the gut microbiota from birth to age 3, with a particular focus on its potential relationship with neurodevelopment. This review emphasizes the immunological mechanisms underlying this relationship. Additionally, the study investigates the impact of the microbiome on cognitive development and neurobehavioral issues such as anxiety and autism. Importantly, it highlights the need to integrate mechanistic studies of animal models with epidemiological research across diverse cultures to better understand the role of a healthy microbiome in early life and the implications of dysbiosis. Furthermore, this review summarizes factors contributing to the transmission of gut microbiome-targeted therapies and their effects on neurodevelopment. Recent studies on environmental toxins known to impact neurodevelopment are also reviewed, exploring whether the microbiota may mitigate or modulate these effects. Full article

(This article belongs to the Section Pediatric Neonatology)

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14 pages, 993 KB

Open AccessEditor’s ChoiceArticle

The Impact of Family Socioeconomic Status (SES) on Adolescents’ Learning Conformity: The Mediating Effect of Self-Esteem

by Houyan Li, Bin Xiao and Guandong Song

Children 2024, 11(5), 540; https://doi.org/10.3390/children11050540 - 30 Apr 2024

Cited by 4 | Viewed by 4502

Abstract

Objective: This study aimed to investigate the relationship between family socioeconomic status (SES) and adolescents’ learning conformity and self-esteem among a sample of 15–18 year-old high school students. Methods: A survey was conducted on 339 adolescents using measures of family SES, self-esteem, and [...] Read more.

Objective: This study aimed to investigate the relationship between family socioeconomic status (SES) and adolescents’ learning conformity and self-esteem among a sample of 15–18 year-old high school students. Methods: A survey was conducted on 339 adolescents using measures of family SES, self-esteem, and learning conformity. An intermediary effect model was constructed to examine the mediating mechanism of self-esteem in the impact of family SES on adolescents’ learning conformity. Results: In our study, we observed that male adolescents were more likely to come from families with higher socioeconomic status (SES) and exhibited relatively higher levels of self-esteem compared to female adolescents. However, this finding should be regarded as an observational outcome specific to our study sample and does not directly indicate a causal relationship between gender and family SES or self-esteem. Adolescents from rural areas were more likely to exhibit tendencies towards learning abidance and compliance. Family SES positively predicted self-esteem. The intermediary model indicated that family SES significantly positively influenced learning abidance and compliance, with self-esteem partially mediating the effects at 33.49% and 33.33%, respectively. Family SES negatively affected learning obedience, with self-esteem partially mediating the effect at 39.77%. Conclusion: Among the 15–18 year-old high school student population, family SES not only directly affects learning abidance, compliance, and obedience but also generates an indirect mediating effect through self-esteem. Full article

(This article belongs to the Special Issue Research on the Academic Motivation of Children and Adolescents)

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19 pages, 1446 KB

Open AccessEditor’s ChoiceArticle

Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy

by Chiara Marcotullio, Marina Attanasi, Annamaria Porreca, Paola Di Filippo, Sara Matricardi, Annamaria Venanzi, Marco Schiavo, Antonio Paone, Nadia Rossi, Francesco Chiarelli and Giovanni Prezioso

Children 2024, 11(5), 532; https://doi.org/10.3390/children11050532 - 28 Apr 2024

Cited by 5 | Viewed by 1851

Abstract

Background: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general [...] Read more.

Background: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic. Methods: We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic. Results: A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period. Conclusions: Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction. Full article

(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)

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12 pages, 1778 KB

Open AccessEditor’s ChoiceReview

Pediatric Hypertension: A Condition That Matters

by Martina Avesani, Giuseppe Calcaterra, Jolanda Sabatino, Giulia Pelaia, Irene Cattapan, Francesco Barillà, Francesco Martino, Roberto Pedrinelli, Pier Paolo Bassareo and Giovanni Di Salvo

Children 2024, 11(5), 518; https://doi.org/10.3390/children11050518 - 26 Apr 2024

Cited by 6 | Viewed by 4944

Abstract

Systemic hypertension has been considered mainly as an adult health issue for a long time, but it is now being increasingly acknowledged as a significant problem also among pediatric patients. The frequency of pediatric hypertension has grown mostly because of increases in childhood [...] Read more.

Systemic hypertension has been considered mainly as an adult health issue for a long time, but it is now being increasingly acknowledged as a significant problem also among pediatric patients. The frequency of pediatric hypertension has grown mostly because of increases in childhood obesity and sedentary lifestyles, but secondary forms of hypertension play a role as well. Considering that unaddressed hypertension during childhood can result in enduring cardiovascular complications, timely identification and intervention are essential. Strategies for addressing this disease encompass not only lifestyle adjustments, but also the use of medications when needed. Lifestyle modifications entail encouraging a nutritious diet, consistent physical activity, and the maintenance of a healthy weight. Moreover, educating both children and their caregivers about monitoring blood pressure at home can aid in long-term management. Thus, the aim of this review is to discuss the etiologies, classification, and principles of the treatment of hypertension in pediatric patients. Full article

(This article belongs to the Section Pediatric Cardiology)

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14 pages, 240 KB

Open AccessEditor’s ChoiceArticle

Gender Differences in Academic Resilience and Well-Being among Senior High School Students in Ghana: A Cross-Sectional Analysis

by Mustapha Amoadu, Edmond Kwesi Agormedah, Paul Obeng, Medina Srem-Sai, John Elvis Hagan, Jr. and Thomas Schack

Children 2024, 11(5), 512; https://doi.org/10.3390/children11050512 - 24 Apr 2024

Cited by 7 | Viewed by 5757

Abstract

Senior high school (SHS) students are at risk of stress and other adverse exposures that may negatively affect their well-being and possibly cause attrition. The concepts of academic resilience and well-being share commonality as psychological attributes linked to positive functioning among students. Despite [...] Read more.

Senior high school (SHS) students are at risk of stress and other adverse exposures that may negatively affect their well-being and possibly cause attrition. The concepts of academic resilience and well-being share commonality as psychological attributes linked to positive functioning among students. Despite this connection, there seems to be limited research exploring these concepts across genders among SHS students in developing regions. This study examined the gender difference in academic resilience and well-being among SHS students in Ghana. Using a cross-sectional survey design, 190 SHS students in three schools from Kwahu North and South district (i.e., Afram Plains) of Ghana’s Eastern Region completed the Academic Resilience Scale (ARS-30) and College Student Subjective Wellbeing Questionnaire (CSSWQ). The sample consists of 102 males and 88 females, with a mean age of 17.83 years. The data were analyzed using independent samples t-tests and hierarchical regression. The study established that students have a moderate level of academic resilience and a higher level of well-being, with no statistically significant variation in students’ academic resilience (t = 0.718; p = 0.474) or well-being (t = −1.596; p = 0.112) across gender. Further, the study discovered that resilience significantly predicted academic well-being (B = 0.425; SE = 0.050; t = 8.50; p < 0.001). This study highlights the importance of promoting gender-sensitive intervention strategies that enhance the academic resilience and well-being of SHS students and help boost their educational attainment. Full article

(This article belongs to the Section Pediatric Mental Health)

13 pages, 305 KB

Open AccessEditor’s ChoiceArticle

Serum Biomarker Analysis in Pediatric ADHD: Implications of Homocysteine, Vitamin B12, Vitamin D, Ferritin, and Iron Levels

by Tanja Lukovac, Olivera Aleksić Hil, Milka Popović, Vitomir Jovanović, Tatjana Savić, Aleksandra M. Pavlović and Dragan Pavlović

Children 2024, 11(4), 497; https://doi.org/10.3390/children11040497 - 22 Apr 2024

Cited by 6 | Viewed by 8778

Abstract

The current diagnosis of attention deficit hyperactivity disorder (ADHD) is based on history, clinical observation, and behavioral tests. There is a high demand to find biomarkers for the diagnosis of ADHD. The aim of this study is to analyze the serum profiles of [...] Read more.

The current diagnosis of attention deficit hyperactivity disorder (ADHD) is based on history, clinical observation, and behavioral tests. There is a high demand to find biomarkers for the diagnosis of ADHD. The aim of this study is to analyze the serum profiles of several biomarkers, including homocysteine (Hcy), vitamin B12, vitamin D, ferritin, and iron, in a cohort of 133 male subjects (6.5–12.5 years), including 67 individuals with an ADHD diagnosis based on DSM-V criteria and 66 age-matched healthy boys (healthy controls, HC). Assessments for ADHD included the Iowa Conners’ Teacher Rating Scale (CPRS) and the ADHDT test, as well as cognitive assessments using the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the TROG-2 language comprehension test. Hcy and iron were quantified using spectrophotometry, while vitamin B12 and total 25-hydroxy vitamin D levels were determined using an electrochemiluminescence immunoassay (ECLIA) and ferritin was measured using a particle-enhanced immunoturbidimetric assay. The results showed significantly increased Hcy levels and decreased vitamin B12 levels in ADHD patients compared to HCs. Multiple logistic regression analysis indicated that Hcy is a potential prognostic indicator for ADHD. These results suggest that elevated homocysteine and decreased vitamin B12 may serve as markers for the diagnosis and prognosis of ADHD. Full article

(This article belongs to the Special Issue Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder: Advances in Social-Cognitive and Educational Processes)

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10 pages, 1182 KB

Open AccessEditor’s ChoiceArticle

Development of a Standardized Algorithm for Management of Newly Diagnosed Anorectal Malformations

by Shruthi Srinivas, Alessandra Gasior, Sarah Driesbach, Natalie DeBacco, Liese C. C. Pruitt, Casey Trimble, Pooja Zahora, Claudia M. Mueller and Richard J. Wood

Children 2024, 11(4), 494; https://doi.org/10.3390/children11040494 - 20 Apr 2024

Cited by 6 | Viewed by 2648

Abstract

Neonates with a new diagnosis of anorectal malformation (ARM) present a unique challenge to the clinical team. ARM is strongly associated with additional midline malformations, such as those observed in the VACTERL sequence, including vertebral, cardiac, and renal malformations. Timely assessment is necessary [...] Read more.

Neonates with a new diagnosis of anorectal malformation (ARM) present a unique challenge to the clinical team. ARM is strongly associated with additional midline malformations, such as those observed in the VACTERL sequence, including vertebral, cardiac, and renal malformations. Timely assessment is necessary to identify anomalies requiring intervention and to prevent undue stress and delayed treatment. We utilized a multidisciplinary team to develop an algorithm guiding the midline workup of patients newly diagnosed with ARM. Patients were included if born in or transferred to our neonatal intensive care unit (NICU), or if seen in clinic within one month of life. Complete imaging was defined as an echocardiogram, renal ultrasound, and spinal magnetic resonance imaging or ultrasound within the first month of life. We compared three periods: prior to implementation (2010–2014), adoption period (2015), and delayed implementation (2022); p ≤ 0.05 was considered significant. Rates of complete imaging significantly improved from pre-implementation to delayed implementation (65.2% vs. 50.0% vs. 97.0%, p = 0.0003); the most growth was observed in spinal imaging (71.0% vs. 90.0% vs. 100.0%, p = 0.001). While there were no differences in the rates of identified anomalies, there were fewer missed diagnoses with the algorithm (10.0% vs. 47.6%, p = 0.05). We demonstrate that the implementation of a standardized algorithm can significantly increase appropriate screening for anomalies associated with a new diagnosis of ARM and can decrease delayed diagnosis. Further qualitative studies will help to refine and optimize the algorithm moving forward. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Colorectal Surgery)

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36 pages, 1026 KB

Open AccessEditor’s ChoiceReview

An Update on Pharmacologic Management of Neonatal Hypotension: When, Why, and Which Medication

by Eleni Agakidou, Ilias Chatziioannidis, Angeliki Kontou, Theodora Stathopoulou, William Chotas and Kosmas Sarafidis

Children 2024, 11(4), 490; https://doi.org/10.3390/children11040490 - 19 Apr 2024

Cited by 7 | Viewed by 14188

Abstract

Anti-hypotensive treatment, which includes dopamine, dobutamine, epinephrine, norepinephrine, milrinone, vasopressin, terlipressin, levosimendan, and glucocorticoids, is a long-established intervention in neonates with arterial hypotension (AH). However, there are still gaps in knowledge and issues that need clarification. The main questions and challenges that neonatologists [...] Read more.

Anti-hypotensive treatment, which includes dopamine, dobutamine, epinephrine, norepinephrine, milrinone, vasopressin, terlipressin, levosimendan, and glucocorticoids, is a long-established intervention in neonates with arterial hypotension (AH). However, there are still gaps in knowledge and issues that need clarification. The main questions and challenges that neonatologists face relate to the reference ranges of arterial blood pressure in presumably healthy neonates in relation to gestational and postnatal age; the arterial blood pressure level that potentially affects perfusion of critical organs; the incorporation of targeted echocardiography and near-infrared spectroscopy for assessing heart function and cerebral perfusion in clinical practice; the indication, timing, and choice of medication for each individual patient; the limited randomized clinical trials in neonates with sometimes conflicting results; and the sparse data regarding the potential effect of early hypotension or anti-hypotensive medications on long-term neurodevelopment. In this review, after a short review of AH definitions used in neonates and existing data on pathophysiology of AH, we discuss currently available data on pharmacokinetic and hemodynamic effects, as well as the effectiveness and safety of anti-hypotensive medications in neonates. In addition, data on the comparisons between anti-hypotensive medications and current suggestions for the main indications of each medication are discussed. Full article

(This article belongs to the Special Issue Neonatal Clinical Pharmacology)

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19 pages, 1461 KB

Open AccessEditor’s ChoiceReview

Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review

by Mustapha Amoadu, Susanna Aba Abraham, Abdul Karim Adams, William Akoto-Buabeng, Paul Obeng and John Elvis Hagan, Jr.

Children 2024, 11(4), 476; https://doi.org/10.3390/children11040476 - 15 Apr 2024

Cited by 15 | Viewed by 15246

Abstract

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in [...] Read more.

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O’Malley’s framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity. Full article

(This article belongs to the Section Pediatric Gastroenterology and Nutrition)

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15 pages, 605 KB

Open AccessEditor’s ChoiceReview

The Prevention of House Dust Mite Allergies in Pediatric Asthma

by Angela Klain, Antonio Andrea Senatore, Amelia Licari, Francesca Galletta, Irene Bettini, Leonardo Tomei, Sara Manti, Francesca Mori, Michele Miraglia del Giudice and Cristiana Indolfi

Children 2024, 11(4), 469; https://doi.org/10.3390/children11040469 - 15 Apr 2024

Cited by 9 | Viewed by 8909

Abstract

This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children’s health, triggering allergies and asthma. Traditional preventive [...] Read more.

This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children’s health, triggering allergies and asthma. Traditional preventive strategies such as regular cleaning, mattress covers, and humidity control are essential but warrant refinement. Empowering children through personalized hygiene education and exploring innovative bedding solutions showcase a forward-thinking paradigm. Collaboration with healthcare professionals and embracing technology-driven solutions ensures a holistic and adaptable approach to safeguarding pediatric health against dust mite-related ailments. This abstract underscores the importance of continually reassessing and innovating preventive measures to create resilient and health-conscious living environments for children. Full article

(This article belongs to the Special Issue Paediatric Allergic Asthma: Risk Factors, Diagnosis, Control and Treatment)

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17 pages, 1779 KB

Open AccessEditor’s ChoiceReview

Exploring the Genetic Landscape of Childhood Glaucoma

by Yang Pan and Takeshi Iwata

Children 2024, 11(4), 454; https://doi.org/10.3390/children11040454 - 9 Apr 2024

Cited by 6 | Viewed by 2807

Abstract

Childhood glaucoma, a significant cause of global blindness, represents a heterogeneous group of disorders categorized into primary or secondary forms. Primary childhood glaucoma stands as the most prevalent subtype, comprising primary congenital glaucoma (PCG) and juvenile open-angle glaucoma (JOAG). Presently, multiple genes are [...] Read more.

Childhood glaucoma, a significant cause of global blindness, represents a heterogeneous group of disorders categorized into primary or secondary forms. Primary childhood glaucoma stands as the most prevalent subtype, comprising primary congenital glaucoma (PCG) and juvenile open-angle glaucoma (JOAG). Presently, multiple genes are implicated in inherited forms of primary childhood glaucoma. This comprehensive review delves into genetic investigations into primary childhood glaucoma, with a focus on identifying causative genes, understanding their inheritance patterns, exploring essential biological pathways in disease pathogenesis, and utilizing animal models to study these mechanisms. Specifically, attention is directed towards genes such as CYP1B1 (cytochrome P450 family 1 subfamily B member 1), LTBP2 (latent transforming growth factor beta binding protein 2), TEK (TEK receptor tyrosine kinase), ANGPT1 (angiopoietin 1), and FOXC1 (forkhead box C1), all associated with PCG; and MYOC (myocilin), associated with JOAG. Through exploring these genetic factors, this review aims to deepen our understanding of the intricate pathogenesis of primary childhood glaucoma, thereby facilitating the development of enhanced diagnostic and therapeutic strategies. Full article

(This article belongs to the Special Issue Pediatric Eye Disease: Screening, Causes and Treatment)

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11 pages, 1035 KB

Open AccessEditor’s ChoiceArticle

Comparison of Percutaneous Internal Ring Suturing (PIRS) versus Open Ligation of the Patent Processus Vaginalis for the Treatment of Communicating Pediatric Hydrocele

by Zenon Pogorelić, Petar Stanić and Marko Bašković

Children 2024, 11(4), 437; https://doi.org/10.3390/children11040437 - 5 Apr 2024

Cited by 6 | Viewed by 4754

Abstract

Background: Although the laparoscopic approach become standard for the treatment of many surgical conditions many studies still debating whether laparoscopic surgery has significant advantages over open surgery in regards to hernia or hydrocele treatment. This study aimed to evaluate the outcomes of treatment [...] Read more.

Background: Although the laparoscopic approach become standard for the treatment of many surgical conditions many studies still debating whether laparoscopic surgery has significant advantages over open surgery in regards to hernia or hydrocele treatment. This study aimed to evaluate the outcomes of treatment of treatment of communicating hydrocele in pediatric patients between laparoscopic percutaneous internal ring suturing (PIRS) and open ligation of the patent processus vaginalis (PPV). Methods: The medical records of pediatric patients who underwent surgery for communicating hydrocele between 1 January 2019 and 1 January 2024 were retrospectively reviewed. The primary objective of the study is to investigate the outcomes of treatment (complications and recurrence rates) of communicating hydrocele in children between laparoscopic and open surgical approaches. Secondary outcomes of the study are the duration of surgery and anesthesia, length of hospital stay (LOS), frequency of hospital readmissions (ReAd) and unplanned return to the operating room (uROR). Results: A total of 198 children underwent surgery for a communicating hydrocele (205 repairs, as 7 cases were bilateral) and were included in the study. Of these, 87 children underwent a PIRS, while the remaining 111 cases underwent open ligation of the PPV. No recurrence of the hydrocele was observed in any of the study groups. Intraoperative complication (epigastric vein injury) was noted in two cases in both groups (2.3% vs. 1.8%, p > 0.999). A slightly higher number of postoperative complications was observed in the open group (n = 7, 6.3%) compared to the PIRS group (n = 2, 2.3%) (p = 0.190). The median duration of surgery (15 min (IQR 10, 17) vs. 21 min (IQR 15, 25); p < 0.001) and anesthesia (30 min (IQR 25, 40) vs. 40 min (IQR 35, 40); p < 0.001) were significantly lower in the PIRS group compared to open ligation of the PPV. In addition, a significantly shorter median of LOS was observed in the PIRS group compared to the open PPV group (9 h (IQR 8, 12) vs. 24 h (IQR 12, 24; p < 0.001). No cases of ReAd and uROR were observed in any of the study groups. Conclusions: PIRS is a safe and effective laparoscopic technique that can be used in the treatment of communicating hydrocele in children. PIRS showed excellent outcomes and a low incidence of complications and recurrences, comparable to traditional open surgery. Full article

(This article belongs to the Special Issue Advances and Future Challenges of Minimally Invasive Surgery in Children: 2nd Edition)

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26 pages, 1837 KB

Open AccessEditor’s ChoiceArticle

Final Validation of the Quality of Life after Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) Questionnaire

by Nicole von Steinbuechel, Marina Zeldovich, Dagmar Timmermann, Ugne Krenz, Inga K. Koerte, Michaela V. Bonfert, Steffen Berweck, Matthias Kieslich, Marlene Henrich, Knut Brockmann, Anna Buchheim, Maike Roediger, Michael Lendt, Christian Auer, Axel Neu, Alexander Kaiser, Joenna Driemeyer, Sven Greving, Ulrike Wartemann, Daniel Pinggera, Claudius Thomé, Joachim Suss, Holger Muehlan and Katrin Cunitz Show full author list Hide full author list

Children 2024, 11(4), 438; https://doi.org/10.3390/children11040438 - 5 Apr 2024

Cited by 5 | Viewed by 2811

Abstract

Until recently, no disease-specific health-related quality of life (HRQoL) questionnaire existed for pediatric traumatic brain injuries (TBIs). In this revalidation study, the psychometric properties and the validity of the 35-item QOLIBRI-KID/ADO questionnaire in its final German version were examined in 300 children and [...] Read more.

Until recently, no disease-specific health-related quality of life (HRQoL) questionnaire existed for pediatric traumatic brain injuries (TBIs). In this revalidation study, the psychometric properties and the validity of the 35-item QOLIBRI-KID/ADO questionnaire in its final German version were examined in 300 children and adolescents. It is the first self-reported TBI-specific tool for measuring pediatric HRQoL in individuals aged between 8 and 17 years. The six-factor model fits the data adequately. The questionnaire’s internal consistency was excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test–retest reliability, and the measure’s construct validity was supported by the overlap between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. The discriminant validity tests showed that older children and girls reported a significantly lower HRQoL than comparison groups, and this was also true of children who were anxious or depressed, or who suffered from post-concussion symptoms, replicating the results of the questionnaire’s first developmental study. Our results suggest that the QOLIBRI-KID/ADO is a reliable and valid multidimensional tool that can be used together with the adult version in clinical contexts and research to measure disease-specific HRQoL after pediatric TBI throughout a person’s life. This may help improve care, treatment, daily functioning, and HRQoL after TBI. Full article

(This article belongs to the Special Issue Psychological Distress in Childhood Well-Being)

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10 pages, 423 KB

Open AccessEditor’s ChoiceArticle

Childhood Obesity Trends among 8–11-Year-Olds: Insights from a School Sample in Vienna, Austria (2017–2023)

by Paula Moliterno, Victoria Donhauser and Kurt Widhalm

Children 2024, 11(4), 431; https://doi.org/10.3390/children11040431 - 3 Apr 2024

Cited by 7 | Viewed by 2775

Abstract

In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017–2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3–10.5, min–max 8.0–10.9] [...] Read more.

In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017–2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3–10.5, min–max 8.0–10.9] from the EDDY study were calculated for trend analyses. Trend analysis was performed using a logistic regression using overweight and obesity as dependent binary variables, and study year and age as independent continuous variables. The percentage change over time was calculated, including the first period of the COVID-19 pandemic. Obesity percentages increased from 23.5 (95% CI 15.1–31.9)% in 2017 to 25.0 (95% CI 12.2–37.8)% in 2023. From 2017 to 2023, while overweight/obesity percentages decreased by 25.9 (−59.5–15.6)%, obesity increased by 6.4 (−51.2–94.9)%. A non-significant trend (p ≥ 0.38) was observed. During the first period of the pandemic, the percentage changes in overweight/obesity and obesity were 68.4 (5.6–187.9)% and 29.2 (−37.3–166.8)%, respectively. The current percentage of obesity in this sample is high and peaked in 2020 during the pandemic. These findings emphasize the need for future investigations considering the representativeness of the school-aged population in Austria to gain a broader picture of overweight and obesity trends. Full article

(This article belongs to the Section Global Pediatric Health)

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16 pages, 558 KB

Open AccessEditor’s ChoiceReview

Exploring Progesterone Deficiency in First-Trimester Miscarriage and the Impact of Hormone Therapy on Foetal Development: A Scoping Review

by Munkhtuya Bataa, Erini Abdelmessih and Fahad Hanna

Children 2024, 11(4), 422; https://doi.org/10.3390/children11040422 - 2 Apr 2024

Cited by 7 | Viewed by 5603

Abstract

Background and Objectives: Progesterone deficiency during pregnancy may lead to various complications, including first-trimester miscarriage, which is the most common pregnancy complication. However, progesterone therapy may play a role in pregnancy maintenance and foetal development. The aim of this scoping review is to [...] Read more.

Background and Objectives: Progesterone deficiency during pregnancy may lead to various complications, including first-trimester miscarriage, which is the most common pregnancy complication. However, progesterone therapy may play a role in pregnancy maintenance and foetal development. The aim of this scoping review is to present evidence on the link between progesterone deficiency and first-trimester miscarriage among pregnant women and assess the impact of progesterone therapy on foetal development. Methods: A comprehensive global systematic search of mainly primary research studies was conducted using several databases. Peer-reviewed studies published between 2010 and 2023 were included. The scoping review was conducted using the framework outlined by the Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews (PRISMA-ScR) statement. Results: Twenty-three articles (which included 35,862 participants) were included in the analysis. Most studies were conducted in mid- to high-income countries. All 23 articles reported a significant positive relationship between progesterone deficiency and first-trimester miscarriage. Furthermore, the majority of studies reported a higher risk of miscarriage when lower levels of progesterone are combined with other declined hormones. While most studies reported that progesterone therapy may reduce the rate of first-trimester miscarriage among pregnant women, no evidence of health-related harm to offspring development was reported. Conclusions: The findings from this systematic–scoping review indicate possible benefits of progesterone replacement therapy in maintaining a healthy pregnancy and foetal development. Rigorous studies that include large sample sizes and systematic reviews are required to confirm these findings further. Full article

(This article belongs to the Special Issue Recent Advances in Maternal and Fetal Health)

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15 pages, 1053 KB

Open AccessEditor’s ChoiceArticle

Impact and Implementation of an Early Years Fundamental Motor Skills Intervention for Children 4–5 Years

by Clare M. P. Roscoe, Nicola Taylor, Natalie Weir, Robert John. Flynn and Andy Pringle

Children 2024, 11(4), 416; https://doi.org/10.3390/children11040416 - 1 Apr 2024

Cited by 8 | Viewed by 4941

Abstract

Fundamental motor skills (FMS) are the cornerstone of a child’s motor development, but concerns remain on the current level of FMS competencies, and intervention is required. This evaluation investigated if a targeted Early Years FMS intervention, delivered by a specialist physical education (PE) [...] Read more.

Fundamental motor skills (FMS) are the cornerstone of a child’s motor development, but concerns remain on the current level of FMS competencies, and intervention is required. This evaluation investigated if a targeted Early Years FMS intervention, delivered by a specialist physical education (PE) provider, improved the FMS of 4–5-year-old children across multiple sites. Methods: The Early Years FMS intervention ran for 18 weeks, 1 h/week, using a standardised programme of activities to develop FMS competencies across 219 children from 15 schools in the Midlands, UK. An adapted assessment was employed as a measure of FMS, assessing locomotor, object control, and stability skills at weeks 1, 9, and 18. The FMS were each rated as green = competent, amber = working towards, or red = not meeting the standards of the skill. A description of key programme implementation characteristics was described. Findings: Statistically significant increases in FMS competencies were achieved for 80% of participants at 18 weeks. Key implementation characteristics for the intervention included consistent staffing, a standardised programme, and a variety of pedagogical approaches delivered by specialist PE staff. Conclusion: This evaluation provided important insights into the effectiveness and implementation of the Early Years FMS intervention to improve FMS competencies in children aged 4–5 years. Full article

(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)

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13 pages, 658 KB

Open AccessEditor’s ChoiceReview

The Thousand Faces of Invasive Group A Streptococcal Infections: Update on Epidemiology, Symptoms, and Therapy

by Stefania Mercadante, Andrea Ficari, Lorenza Romani, Maia De Luca, Costanza Tripiciano, Sara Chiurchiù, Francesca Ippolita Calo Carducci, Laura Cursi, Martina Di Giuseppe, Andrzej Krzysztofiak, Stefania Bernardi and Laura Lancella

Children 2024, 11(4), 383; https://doi.org/10.3390/children11040383 - 22 Mar 2024

Cited by 12 | Viewed by 4588

Abstract

Invasive infections caused by Streptococcus pyogfenes (iGAS), commonly known as Group A Streptococcus, represent a significant public health concern due to their potential for rapid progression and life-threatening complications. Epidemiologically, invasive GAS infections exhibit a diverse global distribution, affecting individuals of all ages [...] Read more.

Invasive infections caused by Streptococcus pyogfenes (iGAS), commonly known as Group A Streptococcus, represent a significant public health concern due to their potential for rapid progression and life-threatening complications. Epidemiologically, invasive GAS infections exhibit a diverse global distribution, affecting individuals of all ages with varying predisposing factors. The pathogenesis of invasive GAS involves an array of virulence factors that contribute to tissue invasion, immune evasion, and systemic dissemination. In pediatrics, in the last few years, an increase in iGAS infections has been reported worldwide becoming a challenging disease to diagnose and treat promptly. This review highlights the current knowledge on pathogenesis, clinical presentations, and therapeutic approaches for iGAS in children. Full article

(This article belongs to the Special Issue Invasive Bacterial Infections in Children: Epidemiology, Risk Factors, Resistance)

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26 pages, 618 KB

Open AccessEditor’s ChoiceReview

The Relationship between Physical Activity, Physical Fitness, Cognition, and Academic Outcomes in School-Aged Latino Children: A Scoping Review

by J. P. Marrero-Rivera, Olivia Sobkowiak, Aimee Sgourakis Jenkins, Stefano J. Bagnato, Christopher E. Kline, Benjamin DH Gordon and Sharon E. Taverno Ross

Children 2024, 11(3), 363; https://doi.org/10.3390/children11030363 - 19 Mar 2024

Cited by 5 | Viewed by 3737

Abstract

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research [...] Read more.

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5–18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations. Full article

(This article belongs to the Special Issue Health Benefits of Physical Activity for Children and Adolescents)

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16 pages, 1818 KB

Open AccessEditor’s ChoiceArticle

A Comparison of the Effects of Supervised versus Home Schroth Exercise Programs with Adolescent Idiopathic Scoliosis

by Kadriye Tombak, İnci Yüksel, Umut Ozsoy, Yılmaz Yıldırım and Sezen Karaşin

Children 2024, 11(3), 354; https://doi.org/10.3390/children11030354 - 17 Mar 2024

Cited by 7 | Viewed by 6505

Abstract

(1) Background: Schroth exercise can reduce the deformity of the spine and improve the life quality and the body image of patients with adolescent idiopathic scoliosis (AIS). (2) Methods: The study began with 49 participants, aged 10–16 years old, who were diagnosed with [...] Read more.

(1) Background: Schroth exercise can reduce the deformity of the spine and improve the life quality and the body image of patients with adolescent idiopathic scoliosis (AIS). (2) Methods: The study began with 49 participants, aged 10–16 years old, who were diagnosed with AIS. At the end of the study, 37 patients were randomly assigned to either the Supervised (n = 19) or Home-Based Schroth Exercise Group (n = 18) and completed the study. Both groups were treated for seven days a week over twelve weeks. For all patients, body rotation measurements were performed with a scoliometer, surface asymmetry analysis was carried out using an Artec Eva 3D scanner, health-related quality of life was evaluated by the Scoliosis Research Society-22 (SRS-22) questionnaire, and the perception of the cosmetic deformity was assessed by the Walter Reed Visual Assessment Scale (WRVAS). All the measurements were repeated before and after the 12-week treatment. (3) Results: Post-treatment scoliometric measurements showed a significant decrease in body rotation in both groups (p < 0.05). Similarly, both groups observed significant positive changes in SRS-22 and WRVAS scores (p < 005). RMS values were statistically significant in both groups; the difference was only statistically significant in the thoracic anterior arm subparameter (p < 0.05). (4) Conclusion: The Schroth exercise for both groups with AIS improved body symmetry, quality of life, and body image. Full article

(This article belongs to the Special Issue New Trends in Physical Therapy for Children)

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11 pages, 225 KB

Open AccessEditor’s ChoiceArticle

Understanding Experiences of Youth with Long COVID: A Qualitative Approach

by Chelsea Torres, Kensei Maeda, Madeline Johnson and Leonard A. Jason

Children 2024, 11(3), 335; https://doi.org/10.3390/children11030335 - 12 Mar 2024

Cited by 6 | Viewed by 5960

Abstract

There is limited information on the specific impacts of Long COVID in youth. Long COVID presents as persisting or new symptoms following initial COVID-19 infection. The aim of this study was to better understand how children and their families describe their experiences seeking [...] Read more.

There is limited information on the specific impacts of Long COVID in youth. Long COVID presents as persisting or new symptoms following initial COVID-19 infection. The aim of this study was to better understand how children and their families describe their experiences seeking diagnosis and support following the onset of symptoms of Long COVID. Six children and five caregivers located in the United States participated in this study. Study procedures included an online video interview with caregiver–child dyads. Interview transcriptions were then analyzed using a conventional approach to content analysis, with two independent coders generating themes. Eight themes emerged from this analysis including the severity of illness and symptomatology, difficulty surrounding the diagnostic process and not being believed, the impact on family and social connections, poor school functioning, positive coping, subsequent positive medical experiences, mental health, and knowledge of the medical field and healthcare experience. Themes revealed difficulty for youth and families in navigating the medical system and functioning in areas of daily life as well as areas of positive experiences related to coping and medical involvement. These findings also highlighted areas of needed improvement for the medical community and for research on Long COVID in youth. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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28 pages, 350 KB

Open AccessEditor’s ChoiceArticle

Clinical Symptomatology of Anxiety and Family Function in Adolescents—The Self-Esteem Mediator

by Ignatia Farmakopoulou, Maria Lekka and Evgenia Gkintoni

Children 2024, 11(3), 338; https://doi.org/10.3390/children11030338 - 12 Mar 2024

Cited by 13 | Viewed by 8511

Abstract

Background: Family, the child’s first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety [...] Read more.

Background: Family, the child’s first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety symptoms. It also examines whether teen self-esteem mediates this relationship. Method: This cross-sectional, descriptive study included 166 Attica youth aged 12–18 from schools and educational units. The adolescents completed Olson’s FACES-III cohesion and adaptability scale, Spielberger’s STAI-C, Rosenberg’s self-esteem scale, and a socio-demographic questionnaire. Results: Family cohesion, but not adaptability, was negatively correlated with state (rho = −0.25, p = 0.001) and trait (rho = −0.46, p < 0.001) anxiety in the adolescents. Teenagers from extreme families with the lowest cohesion and adaptability had higher trait anxiety (x²(2) = 6.91, p = 0.032) than those from moderately balanced/balanced families. Self-esteem mediated the relationship between the family cohesion functioning and adolescent’s state anxiety (p = 0.005) and trait anxiety (p = 0.011). Conclusions: The findings show that family dysfunction negatively impacts adolescent anxiety, as well as their self-esteem, which protects mental balance. Full article

(This article belongs to the Special Issue 2nd Edition: Children’s Mental Health, Parenting, Family and Groups’ Resilience in Crisis)

14 pages, 448 KB

Open AccessEditor’s ChoiceArticle

Unilateral Sensorineural Hearing Loss in Children: Etiology, Audiological Characteristics, and Treatment

by Mirko Aldè, Diego Zanetti, Umberto Ambrosetti, Eleonora Monaco, Anna Maria Gasbarre, Lorenzo Pignataro, Giovanna Cantarella and Stefania Barozzi

Children 2024, 11(3), 324; https://doi.org/10.3390/children11030324 - 9 Mar 2024

Cited by 7 | Viewed by 4864

Abstract

The aim of this study was to evaluate audiological characteristics and parents’ opinions on hearing device use in children with unilateral sensorineural hearing loss (USNHL) who attended a tertiary-level audiologic center. The medical charts of 70 children aged 6 to 12 years with [...] Read more.

The aim of this study was to evaluate audiological characteristics and parents’ opinions on hearing device use in children with unilateral sensorineural hearing loss (USNHL) who attended a tertiary-level audiologic center. The medical charts of 70 children aged 6 to 12 years with USNHL were reviewed. In 51.4% of cases, the children were diagnosed with USNHL after the age of 2 years. The main causes of USNHL were congenital cytomegalovirus infection (21.4%) and unilateral cochlear nerve hypoplasia (12.9%). The percentage of patients wearing a hearing device was 45.7% (32/70); of these, 28 (87.5%) wore a conventional hearing aid, 2 (6.3%) a CROS device, and 2 (6.3%) a cochlear implant. Regarding the choice to use a hearing device, no significant differences were found between the subcategories of hearing loss degree (p = 0.55) and audiometric configuration (p = 0.54). Most parents of children with mild-to-severe USNHL observed improved attention (90.9%), and reduced fatigue and restlessness (86.4%) using the hearing aid. These children performed significantly better on all audiological tests (speech perception in quiet and in noise conditions, and sound localization) while wearing the hearing aid (p < 0.001). More efforts should be made to raise awareness among professionals and parents about the negative consequences of uncorrected USNHL. Full article

(This article belongs to the Special Issue Diagnosis and Management of Pediatric Ear and Vestibular Disorders)

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11 pages, 521 KB

Open AccessEditor’s ChoiceReview

Melatonin Use in Pediatrics: A Clinical Review on Indications, Multisystem Effects, and Toxicity

by Pranita Shenoy, Adriana Etcheverry, Jalyn Ia, Manisha Witmans and Mary Anne Tablizo

Children 2024, 11(3), 323; https://doi.org/10.3390/children11030323 - 9 Mar 2024

Cited by 16 | Viewed by 14030

Abstract

Exogenous melatonin is typically used for sleep regulation in the context of insomnia either in healthy children or those with neurodevelopmental disabilities. It is also used for the management of circadian rhythm sleep disorders in pediatric and adolescent patients. There are also many [...] Read more.

Exogenous melatonin is typically used for sleep regulation in the context of insomnia either in healthy children or those with neurodevelopmental disabilities. It is also used for the management of circadian rhythm sleep disorders in pediatric and adolescent patients. There are also many other possible indications that we will discuss in this paper beyond the role of melatonin for sleep regulation, including its potential use for various areas of medicine such as inflammatory conditions. Since melatonin is unregulated in the United States, distributed over the counter and perceived to be natural and safe, it has become available in many forms in the last two decades. With increasing sleep disturbances and mental health problems after the COVID-19 pandemic, melatonin has become even more popular and studies have shown a dramatic increase in use as well as resulting side effects, including melatonin overdose. As melatonin is generally viewed by physicians as a benign medication, we hope to increase awareness of melatonin’s properties as well as negative side effects to optimize its use in the pediatric population. Full article

(This article belongs to the Special Issue Sleep Disorders in Children: Presentation, Early Identification and Treatment)

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9 pages, 243 KB

Open AccessEditor’s ChoiceReview

The Global Occurrences of Cleft Lip and Palate in Pediatric Patients and Their Association with Demographic Factors: A Narrative Review

by Farah Asnely Putri, Madhuri Pattamatta, Sheylla Edu September Anita and Tantry Maulina

Children 2024, 11(3), 322; https://doi.org/10.3390/children11030322 - 8 Mar 2024

Cited by 17 | Viewed by 9583

Abstract

Objective: Orofacial clefts are one of the most common abnormalities that occur in the orofacial area. Due to their high prevalence, special attention provided to risk factors and their possible involvement in the occurrence of orofacial clefts is of importance. The objective of [...] Read more.

Objective: Orofacial clefts are one of the most common abnormalities that occur in the orofacial area. Due to their high prevalence, special attention provided to risk factors and their possible involvement in the occurrence of orofacial clefts is of importance. The objective of this study was to review the current global occurrence of orofacial clefts and the possible linkage of previously investigated risk factors to the occurrence of orofacial clefts. Review: The risk factors of orofacial clefts can be classified into two groups, modifiable risk factors and non-modifiable risk factors. Due to the extent of elaboration of each risk factor in each group, this current narrative review is limited to several mostly investigated risk factors, which included a review of parental age, sexual disparities, educational attainment, and income. Studies indicate that Asians are more likely than other races to have orofacial clefts, with a higher incidence rate in men than in women. There is evidence that the age of the parents is associated with the chance of the occurrence of orofacial cleft. The prevention of orofacial clefts and the distribution of medical resources depend heavily on a thorough understanding of epidemiology on a global scale. Nevertheless, the earlier studies concentrated on more developed nations or areas, and registry data from low-income nations had significant gaps. The findings of this narrative review can be used as the scientific basis for further research within this area. Conclusion: The occurrence rate of orofacial clefts remains high in several regions. Possible associations between parental age, sexual disparities, educational attainment, and family income to the occurrence of orofacial clefts remain contradictory, indicating the importance of further research to obtain more insights. Full article

(This article belongs to the Special Issue Oral Epidemiology and Pathology in Children)

25 pages, 481 KB

Open AccessEditor’s ChoiceReview

Nutritional Challenges among African Refugee and Internally Displaced Children: A Comprehensive Scoping Review

by Claire Gooding, Salwa Musa, Tina Lavin, Lindiwe Sibeko, Chizoma Millicent Ndikom, Stella Iwuagwu, Mary Ani-Amponsah, Aloysius Nwabugo Maduforo and Bukola Salami

Children 2024, 11(3), 318; https://doi.org/10.3390/children11030318 - 7 Mar 2024

Cited by 7 | Viewed by 4568

Abstract

Background: Children’s nutrition in Africa, especially among those displaced by conflicts, is a critical global health concern. Adequate nutrition is pivotal for children’s well-being and development, yet those affected by displacement confront distinctive challenges. This scoping review seeks to enhance our current knowledge, [...] Read more.

Background: Children’s nutrition in Africa, especially among those displaced by conflicts, is a critical global health concern. Adequate nutrition is pivotal for children’s well-being and development, yet those affected by displacement confront distinctive challenges. This scoping review seeks to enhance our current knowledge, filling gaps in understanding nutritional and associated health risks within this vulnerable population. Objective: We conducted a scoping review of the literature on the nutritional status and associated health outcomes of this vulnerable population with the goal of informing targeted interventions, policy development, and future research efforts to enhance the well-being of African refugee and internally displaced children. Methods: This scoping review adopted Arksey and O’Malley (2005)’s methodology and considered studies published between 2000 and 2021. Results: Twenty-three published articles met the inclusion criteria. These articles highlighted a wide variation in the levels of malnutrition among African refugee/internally displaced (IDP) children, with the prevalence of chronic malnutrition (stunting) and acute malnutrition (wasting) ranging from 18.8 to 52.1% and 0.04 to 29.3%, respectively. Chronic malnutrition was of ‘high’ or ‘very high’ severity (according to recent WHO classifications) in 80% of studies, while acute malnutrition was of ‘high’ or ‘very high’ severity in 50% of studies. In addition, anemia prevalence was higher than the 40% level considered to indicate a severe public health problem in 80% of the studies reviewed. Conclusion: In many settings, acute, chronic, and micronutrient malnutrition are at levels of great concern. Many countries hosting large, displaced populations are not represented in the literature, and research among older children is also lacking. Qualitative and intervention-focused research are urgently needed. Full article

(This article belongs to the Special Issue Nutrition to Improve Child and Adolescent Health)

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18 pages, 516 KB

Open AccessEditor’s ChoiceReview

Trends in Physical Activity and Motor Development in Young People—Decline or Improvement? A Review

by Cristiana D’Anna, Pasqualina Forte and Elisa Pugliese

Children 2024, 11(3), 298; https://doi.org/10.3390/children11030298 - 1 Mar 2024

Cited by 12 | Viewed by 4873

Abstract

This paper aims to analyse studies and research conducted in EU and non-EU member states to identify and compare trends in physical activity and motor skills. Thus, a comparative overview of the state of the art in the two pre-pandemic decades that can [...] Read more.

This paper aims to analyse studies and research conducted in EU and non-EU member states to identify and compare trends in physical activity and motor skills. Thus, a comparative overview of the state of the art in the two pre-pandemic decades that can facilitate an understanding of the different territorial realities and training needs to be conducted, considering the different cultural situations. A scoping review was conducted by analysing a series of studies published between 1990 and 2022, including only those studies that collected data in the pre-pandemic period. The search was carried out on databases such as PubMed, Google Scholar, and ScienceDirect. The following keywords were used for the acquisition of relevant studies: children, decline, motor skills, physical activity, and young people. From the literature review emerged clearly in all the longitudinal surveys a negative trend of body mass index (BMI), which was increasing in all the countries analysed, and cardiorespiratory fitness, which, in close relation to the increase in overweight levels, was in decline. If an unambiguous trend could be declared for the variables just mentioned, it was not possible to declare the same trend for the other variables analysed, which showed discordant results between the different countries. Full article

(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)

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17 pages, 263 KB

Open AccessEditor’s ChoiceArticle

Non-Suicidal Self-Injury (NSSI) Patterns in Adolescents from a Romanian Child Psychiatry Inpatient Clinic

by Lucia Emanuela Andrei, Magdalena Efrim-Budisteanu, Ilinca Mihailescu, Alexandra Mariana Buică, Mihaela Moise and Florina Rad

Children 2024, 11(3), 297; https://doi.org/10.3390/children11030297 - 1 Mar 2024

Cited by 5 | Viewed by 3333

Abstract

Non-Suicidal Self-Injury (NSSI) involves deliberately causing harm to one’s body without the intention of suicide. As the numbers of adolescents presenting NSSI have been steadily increasing during the last years, we intended to investigate adolescent patients exhibiting NSSI, admitted to our clinic—a Romanian [...] Read more.

Non-Suicidal Self-Injury (NSSI) involves deliberately causing harm to one’s body without the intention of suicide. As the numbers of adolescents presenting NSSI have been steadily increasing during the last years, we intended to investigate adolescent patients exhibiting NSSI, admitted to our clinic—a Romanian child psychiatry inpatient clinic, over the course of five years. A total of 100 adolescents (80 females, 20 males, mean age: 14.9 years) hospitalized for various neuropsychiatric disorders and engaging in self-harm were studied. The self-harm methods most frequently used in our sample were, for the female group: cutting (all), skin tearing (76%), scratching/pinching (72%), and for males: cutting (all), wound-healing hindrance (85%), striking objects (80%). The initial motivations for NSSI were represented by distress (females 89%, males 90%) and seeking pleasure (females 84%). In terms of the roles of NSSI, it was primarily used for emotional regulation (females 89%) and anger management (males 90%). This study highlights the prevalence of self-harm in hospitalized adolescents, differences in methods and motivations between genders, and the need for more targeted therapy interventions. By documenting trends, investigating underlying motivations and functions, and proposing hypotheses for further research, our findings offer valuable insights on adolescent NSSI and have the potential to increase awareness among various clinicians and specialists who interact with adolescents, thus addressing the escalating prevalence of self-harm behaviours among teenagers. Full article

(This article belongs to the Section Pediatric Mental Health)

28 pages, 1737 KB

Open AccessEditor’s ChoiceReview

Children’s Health, Wellbeing and Academic Outcomes over the Summer Holidays: A Scoping Review

by Emily Eglitis, Aaron Miatke, Rosa Virgara, Amanda Machell, Timothy Olds, Mandy Richardson and Carol Maher

Children 2024, 11(3), 287; https://doi.org/10.3390/children11030287 - 27 Feb 2024

Cited by 9 | Viewed by 6626

Abstract

Background: The school day provides a supportive and stimulating environment that may protect children and adolescents (5–18 years) from behaviours that are adverse for health and wellbeing. Objective: To review the literature regarding changes in children’s academic achievement or overall wellbeing during the [...] Read more.

Background: The school day provides a supportive and stimulating environment that may protect children and adolescents (5–18 years) from behaviours that are adverse for health and wellbeing. Objective: To review the literature regarding changes in children’s academic achievement or overall wellbeing during the extended school summer break and evaluate if the outcomes are different for children experiencing disadvantage. Methods: The peer-reviewed literature was searched across six electronic databases for studies tracking changes in any academic, health or wellbeing outcome in children over the summer holidays. Studies were screened in duplicate for inclusion. Data were extracted using a standardized data extraction form. Outcomes were coded as decline (suggestive or significant), increase (suggestive or significant) or mixed/neutral and then compared to the school year or according to disadvantaged. Results: Seventy-six studies (n = 14,230,846 participants) were included. Strong evidence was found of a decline in academic outcomes and increases in adiposity, sedentary behaviour and screen time. There was moderate evidence of declines in cardiovascular fitness and physical activity. These patterns were magnified for disadvantaged children. Limited data were available on muscular fitness, sleep, diet quality and social, emotional or mental wellbeing. A total of 80% of studies were from the United States. Most data were from children 12 years of age and younger. Conclusions: Over the summer break, children’s academic and health outcomes decline. Children experiencing disadvantage display magnified losses that warrant further investigation. The summer holidays present an opportunity to improve children’s health and wellbeing. Full article

(This article belongs to the Section Pediatric Mental Health)

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18 pages, 343 KB

Open AccessEditor’s ChoiceReview

Antimicrobial Stewardship in Pediatric Emergency Medicine: A Narrative Exploration of Antibiotic Overprescribing, Stewardship Interventions, and Performance Metrics

by Kevin Meesters and Danilo Buonsenso

Children 2024, 11(3), 276; https://doi.org/10.3390/children11030276 - 23 Feb 2024

Cited by 8 | Viewed by 3675

Abstract

Antibiotic overprescribing is prevalent in pediatric emergency medicine, influenced by clinician–caregiver dynamics and diagnostic uncertainties, and poses substantial risks such as increasing antibacterial resistance, adverse drug reactions, and increased healthcare expenditures. While antimicrobial stewardship programs have proven effective in optimizing antibiotic use within [...] Read more.

Antibiotic overprescribing is prevalent in pediatric emergency medicine, influenced by clinician–caregiver dynamics and diagnostic uncertainties, and poses substantial risks such as increasing antibacterial resistance, adverse drug reactions, and increased healthcare expenditures. While antimicrobial stewardship programs have proven effective in optimizing antibiotic use within inpatient healthcare settings, their implementation in pediatric emergency medicine presents specific challenges. Existing biomarkers like white blood cell count, C-reactive protein, procalcitonin, and presepsin have limitations in their ability to distinguish (serious) bacterial infections from other etiologies of fever. Furthermore, rapid antigen detection tests and guidelines aimed at guiding antibiotic prescriptions for children have not consistently reduced unnecessary antibiotic use. To improve antibiotic prescribing practices, potential strategies include the utilization of decision support tools, audit and feedback, establishing follow-up procedures, implementing safety netting systems, and delivering comprehensive training and supervision. Notably, host genome signatures have also gained attention for their potential to facilitate rapid and precise diagnoses of inflammatory syndromes. Standardized metrics are crucial for evaluating antimicrobial use within pediatric healthcare settings, enabling the establishment of benchmarks for assessing antibiotic utilization, quality enhancement initiatives, and research endeavors. Full article

(This article belongs to the Special Issue Pediatric Emergency Medicine)

17 pages, 1521 KB

Open AccessEditor’s ChoiceReview

Small Scale, High Precision: Robotic Surgery in Neonatal and Pediatric Patients—A Narrative Review

by Emil Radu Iacob, Roxana Iacob, Laura Andreea Ghenciu, Tudor-Alexandru Popoiu, Emil Robert Stoicescu and Calin Marius Popoiu

Children 2024, 11(3), 270; https://doi.org/10.3390/children11030270 - 21 Feb 2024

Cited by 9 | Viewed by 3510

Abstract

This narrative review explores the evolution and implications of robotic-assisted surgery in pediatric and neonatal cases, focusing on its advantages, drawbacks, and the specific diseases amenable to this innovative technology. Following PRISMA guidelines, 56 relevant articles from the past five years were selected, [...] Read more.

This narrative review explores the evolution and implications of robotic-assisted surgery in pediatric and neonatal cases, focusing on its advantages, drawbacks, and the specific diseases amenable to this innovative technology. Following PRISMA guidelines, 56 relevant articles from the past five years were selected, emphasizing advancements in precision, reduced trauma, and expedited recovery times for pediatric patients. Despite challenges like cost and training, ongoing research shapes pediatric robotic-assisted surgery, promising improved outcomes. The technology’s benefits include enhanced precision, minimized scarring, and faster recovery, addressing the challenges in delicate pediatric procedures. Challenges encompass cost, training, and instrument design, but ongoing refinements aim to overcome these. This review underscores psychological and musculoskeletal considerations for patients and surgeons. While acknowledging limitations and preferred pathologies, this review outlines the transformative potential of robotic-assisted surgery in reshaping pediatric surgical care. This comprehensive assessment concludes that, despite challenges, ongoing advancements promise a future of enhanced precision and tailored care in pediatric surgery. Full article

(This article belongs to the Special Issue Advances in Pediatric Surgery Volume II)

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12 pages, 454 KB

Open AccessEditor’s ChoiceArticle

Associations among Motor Competence, Physical Activity, Perceived Motor Competence, and Aerobic Fitness in 10–15-Year-Old Youth

by Dawn P. Coe, Emily M. Post, Eugene C. Fitzhugh, Jeffrey T. Fairbrother and E. Kipling Webster

Children 2024, 11(2), 260; https://doi.org/10.3390/children11020260 - 17 Feb 2024

Cited by 5 | Viewed by 3223

Abstract

(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents’ health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence [...] Read more.

(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents’ health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence (MC), moderate-to-vigorous physical activity (MVPA), perceived motor competence (PMC), and aerobic fitness in children and adolescents and the mediating and moderating effects of PMC, aerobic fitness, and weight status on the MC–MVPA relationship. (2) Methods: Participants included 47 adolescents (12.2 ± 1.6 y; 55% male) who completed the Bruininks–Oseretsky Test of Motor Proficiency, 2nd Edition (MC), Harter’s perceived self-competency questionnaire (PMC), and the PACER test (aerobic fitness) and whose MVPA was measured via accelerometry. The body mass index (BMI) was calculated from measured height and weight. (3) Results: There were positive correlations between MC and fitness [r_s(47) = 0.469, p < 0.01], PMC and fitness [r_s(47) = 0.682, p < 0.01], and PMC and MC [r_s(47) = 0.416, p < 0.01]. There were no associations among MVPA and MC, PMC, or fitness (p > 0.05). There were inverse associations between BMI and both MVPA [r_s(44) = −0.410, p < 0.01] and fitness [r_s(47) = 0.295, p < 0.05]. The association between MC and MVPA was mediated by fitness (β = 0.3984; 95% CI (0.0564–0.7985)). (4) Conclusions: The associations among MC, PMC, and fitness highlight the critical role of MC in health and partially support the proposed developmental model concerning the relationships that exist among MC, MVPA, PMC, fitness, and BMI. Full article

(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)

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14 pages, 542 KB

Open AccessEditor’s ChoiceArticle

Optimization of Postural Control, Balance, and Mobility in Children with Cerebral Palsy: A Randomized Comparative Analysis of Independent and Integrated Effects of Pilates and Plyometrics

by Ragab K. Elnaggar, Rodrigo Ramirez-Campillo, Alshimaa R. Azab, Saud M. Alrawaili, Mshari Alghadier, Mazyad A. Alotaibi, Ahmed S. Alhowimel, Mohamed S. Abdrabo, Mohammed F. Elbanna, Ahmed M. Aboeleneen and Walaa E. Morsy

Children 2024, 11(2), 243; https://doi.org/10.3390/children11020243 - 15 Feb 2024

Cited by 6 | Viewed by 4645

Abstract

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. [...] Read more.

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12–18 years) were randomized to PsCS (n = 27), PlyoML (n = 27), or a combined intervention (n = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability—LoS), balance, and mobility (Community Balance and Mobility Scale—CB&M; Functional Walking Test—FWT; Timed Up and Down Stair test—TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward (p = 0.006 and 0.033, respectively), forward (p = 0.015 and 0.036, respectively), paretic (p = 0.017 and 0.018, respectively), and non-paretic directions (p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS (p < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M (p = 0.037 and p = 0.002, respectively), FWT (p = 0.012 and p = 0.038, respectively), and TUDS (p = 0.046 and p = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP. Full article

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

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12 pages, 1755 KB

Open AccessEditor’s ChoiceReview

Recurrent Respiratory Infections in Children with Down Syndrome: A Review

by Michele Ghezzi, Nicolò Garancini, Raffaella De Santis, Laura Gianolio, Salvatore Zirpoli, Anna Mandelli, Andrea Farolfi, Enza D’Auria and Gian Vincenzo Zuccotti

Children 2024, 11(2), 246; https://doi.org/10.3390/children11020246 - 15 Feb 2024

Cited by 7 | Viewed by 8186

Abstract

Down Syndrome (DS) is the most common chromosomal abnormality compatible with life. The life of patients suffering from DS can be strongly impacted by Recurrent Respiratory tract Infections (RRIs), leading to an increased rate of hospitalisation, a higher need for intensive care and [...] Read more.

Down Syndrome (DS) is the most common chromosomal abnormality compatible with life. The life of patients suffering from DS can be strongly impacted by Recurrent Respiratory tract Infections (RRIs), leading to an increased rate of hospitalisation, a higher need for intensive care and fatality. With a literature review, we summarise here the main etiological factors for RRI in this category of patients, particularly focusing on airway malformations such as tracheomalacia, tracheal bronchus and bronchomalacia, comorbidities associated with the syndrome, like congenital heart diseases, dysphagia, gastroesophageal reflux, musculoskeletal involvement and obesity, and immunologic impairments, involving both innate and adaptive immunity. For these patients, a multidisciplinary approach is imperative as well as some preventive strategies, in particular vaccinations in accordance with their national schedule for immunization. Full article

(This article belongs to the Special Issue Updates on Lung Function, Respiratory and Asthma Disease in Children)

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12 pages, 1517 KB

Open AccessEditor’s ChoiceArticle

Integrating Artificial Intelligence in Pediatric Healthcare: Parental Perceptions and Ethical Implications

by Elena Camelia Berghea, Marcela Daniela Ionescu, Radu Marian Gheorghiu, Iulia Florentina Tincu, Claudia Oana Cobilinschi, Mihai Craiu, Mihaela Bălgrădean and Florian Berghea

Children 2024, 11(2), 240; https://doi.org/10.3390/children11020240 - 14 Feb 2024

Cited by 17 | Viewed by 4355

Abstract

Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing [...] Read more.

Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing its adoption in clinical settings. Methods: A structured questionnaire was applied to caregivers (parents or grandparents) of children who presented in tertiary pediatric clinics. Results: The most significant differentiations were identified in relation to the level of education (e.g., aversion to AI involvement was 22.2% among those with postgraduate degrees, 43.9% among those with university degrees, and 54.5% among those who only completed high school). The greatest fear among respondents regarding the medical use of AI was related to the possibility of errors occurring (70.1%). Conclusions: The general attitude toward the use of AI can be considered positive, provided that it remains human-supervised, and that the technology used is explained in detail by the physician. However, there were large differences among groups (mainly defined by education level) in the way AI is perceived and accepted. Full article

(This article belongs to the Section Global Pediatric Health)

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16 pages, 286 KB

Open AccessEditor’s ChoiceArticle

The Impact of Demographic Characteristics on Parenting Stress among Parents of Children with Disabilities: A Cross-Sectional Study

by Maxi Scheibner, Cora Scheibner, Frauke Hornemann, Maria Arélin, Yvonne Doris Hennig, Henriette Kiep, Ulrike Wurst, Andreas Merkenschlager and Janina Gburek-Augustat

Children 2024, 11(2), 239; https://doi.org/10.3390/children11020239 - 13 Feb 2024

Cited by 6 | Viewed by 4266

Abstract

Even though it is already known that parents of children with developmental delays or disabilities experience higher parenting stress than families of typically developing children, the contributing factors need to be analyzed in more detail. The aim of this cross-sectional study was to [...] Read more.

Even though it is already known that parents of children with developmental delays or disabilities experience higher parenting stress than families of typically developing children, the contributing factors need to be analyzed in more detail. The aim of this cross-sectional study was to examine the influence of demographic characteristics on parenting stress from caring for a disabled child and to identify possible protective or additional stressful social factors. A total of 611 mothers and fathers of children with developmental delays, chronic diseases, or disabilities completed two questionnaires during their medical appointments at the Children’s Development Center (CDC) of Leipzig University Hospital between June 2020 and February 2021. These consisted of the German versions of the Parenting Stress Index (PSI) and the Impact on Family Scale (IOFS). To determine differences between the various groups, we used parametric and non-parametric tests. Mothers and single parents are significantly more strained than fathers and non-single parents. Parents with vocational training, those who graduated with a higher-level diploma, and those within employment report a higher financial burden. While unemployed and full-time workers experience the lowest stress, parents who work part-time or exclusively take care of their child show higher levels of stress. Looking at the age of the child, parents of children of young primary school age are the most stressed, and those of infants are the least stressed. These findings suggest that mothers and single parents especially should receive more support, and parents need to be provided with more attention during their child’s entry into school. Possible limitations and the influence of the COVID-19 pandemic are discussed. Full article

(This article belongs to the Section Global Pediatric Health)

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11 pages, 753 KB

Open AccessEditor’s ChoiceReview

Exploring Interleukin Levels in Type 1 Diabetes and Periodontitis: A Review with a Focus on Childhood

by Silvia D’Agostino, Giulia Valentini and Marco Dolci

Children 2024, 11(2), 238; https://doi.org/10.3390/children11020238 - 13 Feb 2024

Cited by 8 | Viewed by 2428

Abstract

Diabetes can trigger an increase in cytokine levels leading to the production of C-reactive protein and fibrinogen. These molecules promote subclinical inflammation, causing the expression of adhesive molecules and endothelial dysfunction. Despite the lack of a comprehensive panel for single-nucleotide polymorphisms (SNPs) for [...] Read more.

Diabetes can trigger an increase in cytokine levels leading to the production of C-reactive protein and fibrinogen. These molecules promote subclinical inflammation, causing the expression of adhesive molecules and endothelial dysfunction. Despite the lack of a comprehensive panel for single-nucleotide polymorphisms (SNPs) for interleukins associated with type 1 diabetes mellitus (T1DM), understanding the inflammatory role of SNPs is crucial because periodontitis, the sixth complication of diabetes, is influenced via these genetic variations. This review focuses on the interleukin levels in T1DM patients with and without periodontitis, with a particular focus on childhood and on SNPs when reported. A search of PubMed and Scopus identified 21 relevant studies from the past five years. Several ILs were analyzed, emphasizing that T1DM still needs to be thoroughly explored regarding an IL polymorphisms panel; however, the last five years have led to the increased independence of this condition, causing autonomous inflammatory effects, which require further investigation. The periodontitis and T1DM association in children and adolescents represents a severe gap in the literature that should be filled; this scarce presence of studies serves as motivation for further clinical research. Full article

(This article belongs to the Special Issue New Technologies and Materials in Oral Health and Dental Care of Pediatric Dentistry)

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13 pages, 1084 KB

Open AccessEditor’s ChoiceArticle

Parental Satisfaction with the Quality of Care in an Early Intervention Service for Children with Visual Impairment: A Retrospective Longitudinal Study

by Tiziana Battistin, Elena Mercuriali, Carlotta Borghini, Maria Eleonora Reffo and Agnese Suppiej

Children 2024, 11(2), 230; https://doi.org/10.3390/children11020230 - 10 Feb 2024

Cited by 6 | Viewed by 2634

Abstract

The fundamental role of vision during development and the nurturing role of early intersubjectivity have enabled the Robert Hollman Foundation to develop an early intervention program providing holistic support to visually impaired children and their families, where fostering parent-infant interactions is at the [...] Read more.

The fundamental role of vision during development and the nurturing role of early intersubjectivity have enabled the Robert Hollman Foundation to develop an early intervention program providing holistic support to visually impaired children and their families, where fostering parent-infant interactions is at the heart of our care. The aim of this study is to understand how parents perceive this approach. It is an eleven-year retrospective study of children following the Robert Hollman Foundation’s early intervention program, in which parents’ (n = 1086) perceptions of quality of care were measured through the administration of a specifically designed 4-point scale questionnaire. Annual longitudinal trends of parents’ perceptions were calculated for every single response. Parents reported a very high satisfaction value in 21/23 questions (Mean > 3.7 out of a maximum score of 4, with the highest scores in human and soft skills of professionals) with a statistically positive trend (p < 0.05), throughout the period considered. Our core approach, based on an individualized nurturing relational support, has been appreciated and confirmed by the high satisfaction reported in the questionnaires by parents of children with visual impairment. We therefore hypothesize that parent-infant relationship-based and individualized approaches may help parents achieve better health, well-being, and quality of daily life for their children. Full article

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

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11 pages, 260 KB

Open AccessEditor’s ChoiceArticle

Discordance between Glucose Management Indicator and Glycated Hemoglobin in a Pediatric Cohort with Type 1 Diabetes: A Real-World Study

by Simone Foti Randazzese, Bruno Bombaci, Serena Costantino, Ylenia Giorgianni, Fortunato Lombardo and Giuseppina Salzano

Children 2024, 11(2), 210; https://doi.org/10.3390/children11020210 - 6 Feb 2024

Cited by 5 | Viewed by 2807

Abstract

The introduction of continuous glucose monitoring (CGM) systems in clinical practice has allowed a more detailed picture of the intra- and interdaily glycemic fluctuations of individuals with type 1 diabetes (T1D). However, CGM-measured glucose control indicators may be occasionally inaccurate. This study aims [...] Read more.

The introduction of continuous glucose monitoring (CGM) systems in clinical practice has allowed a more detailed picture of the intra- and interdaily glycemic fluctuations of individuals with type 1 diabetes (T1D). However, CGM-measured glucose control indicators may be occasionally inaccurate. This study aims to assess the discrepancy between the glucose management indicator (GMI) and glycated hemoglobin (HbA1c) (Δ_GMI-HbA1c) within a cohort of children and adolescents with T1D, exploring its correlation with other CGM metrics and blood count parameters. In this single-center, cross-sectional study, we gathered demographic and clinical data, including blood count parameters, HbA1c values, and CGM metrics, from 128 pediatric subjects with T1D (43% female; mean age, 13.4 ± 3.6 years). Our findings revealed higher levels of the coefficient of variation (CV) (p < 0.001) and time above range > 250 mg/dL (p = 0.033) among subjects with Δ_GMI-HbA1c > 0.3%. No association was observed between blood count parameters and Δ_GMI-HbA1c. In conclusion, despite the advancements and the widespread adoption of CGM systems, HbA1c remains an essential parameter for the assessment of glycemic control, especially in individuals with suboptimal metabolic control and extreme glycemic variability. Full article

(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)

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15 pages, 449 KB

Open AccessEditor’s ChoiceReview

The Sleep Patterns of Children and Adolescents with Chronic Conditions and Their Families: An Integrative Literature Review

by Welker da Silva Xavier, Madalena Paulos Abreu, Michelle Darezzo Rodrigues Nunes, Fernanda Machado Silva-Rodrigues, Liliane Faria da Silva, Barbara Bertolossi Marta de Araújo, Paula Saud De Bortoli, Rhyquelle Rhibna Neris and Lucila Castanheira Nascimento

Children 2024, 11(2), 207; https://doi.org/10.3390/children11020207 - 6 Feb 2024

Cited by 5 | Viewed by 3849

Abstract

Sleep is of vital necessity for health, and it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose of this study was to identify the scientific production on sleep patterns in children and adolescents [...] Read more.

Sleep is of vital necessity for health, and it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose of this study was to identify the scientific production on sleep patterns in children and adolescents with chronic conditions and their families. This integrative review was conducted between March and June 2022 using the databases of MEDLINE, Web of Science, CINAHL and PsycINFO. The articles included were original papers published between January 2007 and mid-2022. Excluded were review studies that did not evaluate sleep and whose participants did not have chronic conditions or were not children, adolescents and/or their families. The searches returned 814 abstracts. After exclusions, 47 studies were selected to be read in full; of these, 29 were selected and were grouped empirically into four categories: major alterations in the sleep patterns of children and adolescents with chronic conditions; the relationship between sleep disorders and symptoms in children and adolescents with chronic conditions; the impaired sleep patterns of families of children and adolescents with chronic conditions; and sleep alterations and their relationship with other problems in families of children and adolescents with chronic conditions. All studies showed sleep pattern impairment in children and adolescents with chronic conditions as well as their families. Full article

(This article belongs to the Special Issue Supporting Children with Chronic Illness and Their Families)

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12 pages, 442 KB

Open AccessEditor’s ChoiceArticle

Treating Children and Adolescents with Obesity: Predictors of Early Dropout in Pediatric Weight-Management Programs

by Giovanni Luppino, Malgorzata Wasniewska, Celeste Casto, Chiara Ferraloro, Alessandra Li Pomi, Giorgia Pepe, Letteria Anna Morabito, Angela Alibrandi, Domenico Corica and Tommaso Aversa

Children 2024, 11(2), 205; https://doi.org/10.3390/children11020205 - 5 Feb 2024

Cited by 5 | Viewed by 2364

Abstract

Background: Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up. Methods: The retrospective, single-center study, [...] Read more.

Background: Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up. Methods: The retrospective, single-center study, involved 489 patients followed for obesity in the period 2016–2020. Patients’ auxological data and blood samples were collected during the first (V1) and last visit (V2). Dropout was defined as a follow-up of less than 12 months and/or including less than one visit every 6 months. Patients were divided into two groups and compared: Group A of dropout (297 patients) and Group B of non-dropout (192 patients). Results: In the follow-up period, which had a mean duration of 24 months, the dropout rate was 60.7%. In Group A, the percentage of patients with BMI ≥ 3 SD at V2 was significantly higher than that in Group B. In Group B, the percentage of patients with pathological HOMA-IR and with fasting glucose >100 mg/dL was higher than group A. The probability of dropout was positively associated with pubertal stage and negatively with impaired fasting glycemia and pathological insulinemia at V1. Conclusion: The study demonstrated a high dropout rate during follow-up, mainly among adolescents and patients with no glucometabolic alterations. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 3rd Edition)

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11 pages, 223 KB

Open AccessEditor’s ChoiceArticle

Examining the Prevalence of Congenital Anomalies in Newborns: A Cross-Sectional Study at a Tertiary Care Maternity Hospital in Saudi Arabia

by Bayapa Reddy Narapureddy, Yousef Zahrani, Hind Eissa Musa Alqahtani, Bharat Kumar Mamilla Mugaiahgari, Lingala Kalyan Viswanath Reddy, Shaik Mohammed Asif, Mohammad Ali Abdullah Almoyad, Ali Mohieldin and Adam Dawria

Children 2024, 11(2), 188; https://doi.org/10.3390/children11020188 - 2 Feb 2024

Cited by 7 | Viewed by 5470

Abstract

Background: Congenital anomalies, representing structural or functional abnormalities present at birth, pose a substantial global health challenge, affecting 8 million newborns annually. With 3.3 million succumbing before age five and 3.2 million facing physical or mental disability, their diverse causes necessitate comprehensive understanding [...] Read more.

Background: Congenital anomalies, representing structural or functional abnormalities present at birth, pose a substantial global health challenge, affecting 8 million newborns annually. With 3.3 million succumbing before age five and 3.2 million facing physical or mental disability, their diverse causes necessitate comprehensive understanding for effective healthcare planning. This study explores the prevalence of congenital anomalies among newborns in the Abha Maternity and Children Hospital (MCH) in Abha, Kingdom of Saudi Arabia. Methodology: A descriptive cross-sectional record-based study was conducted on newborns born between 2018 and 2022. Data were gathered in 4 months from September to December 2023. Purposive sampling was employed to select the case records of newborns with congenital anomalies after careful screening and considering inclusion and exclusion criteria. Data was acquired through a self-designed study tool, and the data were entered into Google Forms. Results: Congenital anomalies’ five-year prevalence was 3.21%, and one year, in 2022, the prevalence was 4.02%. Female neonates exhibited higher anomalies (59.3%), and preterm births accounted for 39.6%, emphasizing their vulnerability. The findings indicate that consanguineous marriages are linked to 63.3% of anomalies, notably neural tube defects (25%) and congenital heart diseases (19.7%). Anomalies are not significantly associated with consanguinity or birth order, but maternal age, education, employment, and antenatal maternal medical issues are associated considerably. Conclusions: These study insights contribute to health planners planning targeted interventions and awareness programs that are crucial to mitigate risks associated with preterm births and consanguineous marriages. The promotion of 100% antenatal screening and prophylactic medication for high-risk women and couples is necessary to prevent inherited deformities. In future the Ministry of Health must plan large-group prospective research to better understand the associated risk factors that will help public health initiatives minimize congenital-associated neonatal mortality and improve pregnancy outcomes. Full article

(This article belongs to the Special Issue Family-Centred Interventions for Children with Disabilities and Chronic Illnesses: Practice-Based Evidence)

30 pages, 1478 KB

Open AccessEditor’s ChoiceReview

Theoretical–Methodological Foundations for the Global Integration Method (Método de Integração Global—MIG) in the Treatment of Autism Spectrum Disorder

by Renato Guimarães Loffi, Thalita Karla Flores Cruz, Giulia Moreira Paiva, Deisiane Oliveira Souto, Simone Rosa Barreto, Patrícia Aparecida Neves Santana, Amanda Aparecida Alves Cunha Nascimento, Fabiana Rachel Martins Costa, Elisa Braz Cota and Vitor Geraldi Haase

Children 2024, 11(2), 191; https://doi.org/10.3390/children11020191 - 2 Feb 2024

Cited by 7 | Viewed by 5254

Abstract

Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention [...] Read more.

Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention has been paid to motor and environmental reactivity aspects (behavior/interest restriction and sensory reactivity). The evidence rationale for the Global Integration Method (MIG, “Método de Integração Global”), a model addressing sensorimotor reactivity in addition to socio-communication, is presented. MIG is an integrative, interdisciplinary, family-oriented intervention and naturalistic program that addresses all levels and moderating factors of ASD’s impact. MIG’s theoretical rationale is based on the predictive coding impairment and embodied cognition hypotheses. MIG incorporates both bottom-up (flexible therapeutic suit, social-motor synchronization) and top-down (schematic social information processing, narratives, imagery) strategies to promote the building and use of accurate, flexible and context-sensitive internal predictive models. MIG is based on the premises that predictive coding improves both socio-communication and environmental reactivity, and that the postural stabilization provided by the flexible therapeutic suit frees information processing resources for socio-cognitive learning. MIG builds on interdisciplinary, professionally and parentally mediated work based on behavioral principles of intensive training in a situated environment. Full article

(This article belongs to the Special Issue Innovative Assessment and Therapy for Children and Adolescents with Neurodevelopmental Disorders)

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12 pages, 318 KB

Open AccessEditor’s ChoiceArticle

Role of Satisfaction with Life, Sex and Body Mass Index in Physical Literacy of Spanish Children

by Javier Urbano-Mairena, María Mendoza-Muñoz, Jorge Carlos-Vivas, Raquel Pastor-Cisneros, Antonio Castillo-Paredes, Miguel Rodal and Laura Muñoz-Bermejo

Children 2024, 11(2), 181; https://doi.org/10.3390/children11020181 - 1 Feb 2024

Cited by 10 | Viewed by 2625

Abstract

Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing [...] Read more.

Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing life satisfaction (LS) given its positive relationship with physical activity. A single-measure cross-sectional correlational study was carried out, involving 135 children aged 8–12 years from Extremadura. They were administered the SWLS questionnaire and the Canadian assessment of physical literacy (CAPL-2). Significantly higher levels of PL (p = 0.010) were found in normal-weight children compared to overweight and obese children, due to the physical competence domain score (p < 0.001). PL was directly related to SWLS (p < 0.001), but inversely related to BMI (p = 0.018). The daily physical activity behaviour domain was explained by SWLS (p < 0.001) and sex (p < 0.001). Physical competence was described by SWLS (p < 0.001) and BMI (p = 0.045). Finally, the motivation and confidence domain were only significantly associated with SWLS (p < 0.001). It was concluded that boys and girls of normal weight achieved higher levels of PL and LS than those with overweight and obesity, establishing a negative relationship of PL with BMI and positive with LS. Full article

(This article belongs to the Special Issue Developing Physical Literacy in Children)

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10 pages, 415 KB

Open AccessEditor’s ChoiceArticle

Early Assessment of Efficacy and Safety of Biologics in Pediatric Allergic Diseases: Preliminary Results from a Prospective Real-World Study

by Lucia Caminiti, Francesca Galletta, Simone Foti Randazzese, Paolo Barraco, Stefano Passanisi, Antonella Gambadauro, Giuseppe Crisafulli, Mariella Valenzise and Sara Manti

Children 2024, 11(2), 170; https://doi.org/10.3390/children11020170 - 28 Jan 2024

Cited by 8 | Viewed by 2793

Abstract

Background: Despite the increasing interest in biologics for the management of allergic diseases, sparse real-world data are still available in the pediatric population. This study aimed to evaluate the early real-life efficacy and safety of omalizumab for patients with moderate-to-severe asthma and chronic [...] Read more.

Background: Despite the increasing interest in biologics for the management of allergic diseases, sparse real-world data are still available in the pediatric population. This study aimed to evaluate the early real-life efficacy and safety of omalizumab for patients with moderate-to-severe asthma and chronic spontaneous urticaria (CSU), and Dupilumab for patients with moderate-to-severe atopic dermatitis (AD). Methods: A prospective study enrolling children aged 6–18 years was designed to assess the efficacy and safety of biologic drugs at 16 weeks of treatment (T1). The effectiveness was measured using validated questionnaires (ACQ-5 for asthma, UAS7 for CSU, and EASI score for AD). Secondary outcome measures included reductions in inhaled corticosteroid (ICS) dosages, asthma-related hospitalizations/exacerbations, and quality of life (QoL) indicators (iNRS, sNRS, DLQI/cDLQI) for CSU and AD. Safety was expressed according to the descriptions of adverse events provided by EMA and FDA. Results: The study cohort consisted of eighteen children (mean age 12.9 ± 3.4 years). The omalizumab treatment significantly reduced ACQ-5 and UAS7 scores (p = 0.002 and p < 0.001, respectively). In patients with asthma, decreased ICS dosage and hospitalization/exacerbation rates were observed. QoL parameters significantly improved in CSU and AD patients. No severe adverse events were reported for either treatment. Conclusions: Our findings validate omalizumab and dupilumab as effective and safe therapeutic options for managing moderate-to-severe allergic diseases in children and adolescents. Full article

(This article belongs to the Section Pediatric Allergy and Immunology)

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