Children

11 pages, 1321 KiB

Open AccessEditor’s ChoiceArticle

The Effectiveness of the Schroth Best Practice Program and Chêneau-Type Brace Treatment in Adolescent Idiopathic Scoliosis: Long-Term Follow-Up Evaluation Results

by Tuğba Kuru Çolak, Burçin Akçay, Adnan Apti and İlker Çolak

Children 2023, 10(2), 386; https://doi.org/10.3390/children10020386 - 16 Feb 2023

Cited by 9 | Viewed by 6769

Abstract

Background: Although the number of studies showing the efficacy of conservative treatment in adolescent idiopathic scoliosis has increased, studies with long-term follow-up are very limited. The aim of this study was to present the long-term effects of a conservative management method including exercise [...] Read more.

Background: Although the number of studies showing the efficacy of conservative treatment in adolescent idiopathic scoliosis has increased, studies with long-term follow-up are very limited. The aim of this study was to present the long-term effects of a conservative management method including exercise and brace in adolescent idiopathic scoliosis patients. Methods: This retrospective cohort study included patients with idiopathic scoliosis who presented at our department and were followed up for at least 2 years after completing the treatment. The main outcome measurements were the Cobb angle and angle of trunk rotation (ATR). Results: The cohort participants were 90.4% female, with a mean age of 11 years and the maximum Cobb angle was mean 32.1°. The mean post-treatment follow-up period was 27.8 months (range 24–71 months). The improvements after treatment in mean maximum Cobb angle (p < 0.001) and ATR (p = 0.001) were statistically significant. At the end of treatment, the maximum Cobb angle was improved in 88.1% of the patients and worsened in 11.9% compared to baseline. In the long-term follow-up evaluations, 83.3% of the curvatures remained stable. Conclusions: The results of this study showed that moderate idiopathic scoliosis in growing adolescents can be successfully halted with appropriate conservative treatment and that long-term improvement is largely maintained. Full article

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

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14 pages, 292 KiB

Open AccessEditor’s ChoiceReview

High-Risk Neuroblastoma: A Surgical Perspective

by Jillian C. Jacobson, Rachael A. Clark and Dai H. Chung

Children 2023, 10(2), 388; https://doi.org/10.3390/children10020388 - 16 Feb 2023

Cited by 13 | Viewed by 3574

Abstract

High-risk neuroblastoma requires multimodal treatment including systemic chemotherapy, surgical resection, radiation therapy, stem cell transplant, and immunotherapy. Surgeons play a vital role in obtaining local control of neuroblastoma and must therefore be knowledgeable about this complex pathology. This article provides a review of [...] Read more.

High-risk neuroblastoma requires multimodal treatment including systemic chemotherapy, surgical resection, radiation therapy, stem cell transplant, and immunotherapy. Surgeons play a vital role in obtaining local control of neuroblastoma and must therefore be knowledgeable about this complex pathology. This article provides a review of the optimal timing and extent of resection, the impact of various image-defined risk factors on surgical planning, and surgical approaches and techniques to enhance the resection of tumors in different anatomic locations. Full article

(This article belongs to the Section Pediatric Cardiology)

10 pages, 248 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Perioperative Risk Factors for Bleeding in Adolescents Undergoing Pedicle Screw Instrumentation for Scoliosis

by Venla Soini, Johanna Syvänen, Ilkka Helenius, Linda Helenius and Arimatias Raitio

Children 2023, 10(2), 381; https://doi.org/10.3390/children10020381 - 15 Feb 2023

Cited by 5 | Viewed by 2142

Abstract

Progressive scoliosis eventually leads to extensive spinal fusion surgery, which carries a risk for significant bleeding. Neuromuscular scoliosis (NMS) patients have an additional inherent risk of major perioperative bleeding. The purpose of our research was to investigate the risk factors for measured (intraoperative, [...] Read more.

Progressive scoliosis eventually leads to extensive spinal fusion surgery, which carries a risk for significant bleeding. Neuromuscular scoliosis (NMS) patients have an additional inherent risk of major perioperative bleeding. The purpose of our research was to investigate the risk factors for measured (intraoperative, drain output) and hidden blood loss related to pedicle screw instrumentation in adolescents, divided into adolescent idiopathic scoliosis (AIS) and NMS patient groups. A retrospective cohort study with prospectively collected data of consecutive AIS and NMS patients undergoing segmental pedicle screw instrumentation at a tertiary level hospital between 2009 and 2021 was conducted. In total, 199 AIS (mean age 15.8 years, 143 females) and 81 NMS patients (mean age 15.2 years, 37 females) were included in the analysis. In both groups, levels fused, increased operative time, and smaller or larger size of erythrocytes were associated with perioperative blood loss (p < 0.05 for all correlations). In AIS, male sex (p < 0.001) and the number of osteotomies correlated with more drain output. In NMS, levels fused correlated with drain output, p = 0.00180. In AIS, patients’ lower preoperative MCV levels (p = 0.0391) and longer operation times, p = 0.0038, resulted into more hidden blood loss, but we did not find any significant risk factors for hidden blood loss in NMS patients. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

19 pages, 1211 KiB

Open AccessEditor’s ChoiceArticle

Assessment of the Relationship between Body Weight Status and Physical Literacy in 8 to 12 Year Old Pakistani School Children: The PAK-IPPL Cross-Sectional Study

by Yinghai Liu, Syed Ghufran Hadier, Long Liu, Syed Muhammad Zeeshan Haider Hamdani, Syed Danish Hamdani, Shaista Shireen Danish, Syeda Urooj Fatima and Yanlan Guo

Children 2023, 10(2), 363; https://doi.org/10.3390/children10020363 - 11 Feb 2023

Cited by 9 | Viewed by 2548

Abstract

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and [...] Read more.

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and children with overweight and obesity. Furthermore, this study determined a correlation between PL domains and BMI by weight status among South Punjab school children. (2) Methods: This cross-sectional study involved 1360 (Boys: 675 and Girls: 685) children aged 8 to 12, and was conducted using CAPL-2. T-tests and chi-square were used to determine the difference between categorical variables, with MANOVA used to compare weight statuses. Spearman correlation was employed to determine the correlation between variables; p < 0.05 was considered significant. (3) Results: Normal weight children had significantly higher PL and domain scores, except for the knowledge domain. Most children with normal weights were at the achieving and excelling levels, while children with overweight and obesity were at the beginning and progressing levels. The correlation among PL domains in normal and overweight and obese children ranged from weak to strong (r = 0.001 to 0.737), and the knowledge domain was inversely correlated with the motivation domain (r = −0.023). PL and domain scores were inversely correlated to BMI, except for the knowledge domain. (4) Conclusions: Children with normal weight tend to have higher PL and domain scores, while those with overweight or obesity tend to have lower scores. There was a positive relationship between normal weight and higher PL and domain scores, and an inverse relationship was observed between BMI and higher PL scores. Full article

(This article belongs to the Section Global Pediatric Health)

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11 pages, 2128 KiB

Open AccessEditor’s ChoiceArticle

Masked Randomized Trial of Epinephrine versus Vasopressin in an Ovine Model of Perinatal Cardiac Arrest

by Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Lori Nielsen, Deepika Sankaran, Jayasree Nair, Praveen Chandrasekharan and Satyan Lakshminrusimha

Children 2023, 10(2), 349; https://doi.org/10.3390/children10020349 - 10 Feb 2023

Cited by 8 | Viewed by 3070

Abstract

Background: Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinephrine in postnatal piglets with cardiac arrest. There are no studies comparing vasopressin with [...] Read more.

Background: Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinephrine in postnatal piglets with cardiac arrest. There are no studies comparing vasopressin with epinephrine in newly born animal models with cardiac arrest induced by umbilical cord occlusion. Objective: To compare the effect of epinephrine and vasopressin on the incidence and time to return of spontaneous circulation (ROSC), hemodynamics, plasma drug levels, and vasoreactivity in perinatal cardiac arrest. Design/Methods: Twenty-seven term fetal lambs in cardiac arrest induced by cord occlusion were instrumented and resuscitated following randomization to epinephrine or vasopressin through a low umbilical venous catheter. Results: Eight lambs achieved ROSC prior to medication. Epinephrine achieved ROSC in 7/10 lambs by 8 ± 2 min. Vasopressin achieved ROSC in 3/9 lambs by 13 ± 6 min. Plasma vasopressin levels in nonresponders were much lower than responders after the first dose. Vasopressin caused in vivo increased pulmonary blood flow and in vitro coronary vasoconstriction. Conclusions: Vasopressin resulted in lower incidence and longer time to ROSC compared to epinephrine in a perinatal model of cardiac arrest supporting the current recommendations for exclusive use of epinephrine in neonatal resuscitation. Full article

(This article belongs to the Section Pediatric Neonatology)

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15 pages, 570 KiB

Open AccessEditor’s ChoiceArticle

Acceptability and Tolerability of Extended Reality Relaxation Training with and without Wearable Neurofeedback in Pediatric Migraine

by Mark Connelly, Madeline Boorigie and Klanci McCabe

Children 2023, 10(2), 329; https://doi.org/10.3390/children10020329 - 9 Feb 2023

Cited by 10 | Viewed by 2522

Abstract

Objective. To determine the acceptability of using extended reality (XR) relaxation training as a preventive treatment for pediatric migraine. Methods. Youths aged 10–17 years old with migraine were recruited from a specialty headache clinic and completed baseline measures evaluating their vestibular symptoms and [...] Read more.

Objective. To determine the acceptability of using extended reality (XR) relaxation training as a preventive treatment for pediatric migraine. Methods. Youths aged 10–17 years old with migraine were recruited from a specialty headache clinic and completed baseline measures evaluating their vestibular symptoms and attitudes about technology. The patients were then instructed in three XR-based relaxation training conditions (fully immersive virtual reality with and without neurofeedback, and augmented reality with neurofeedback), in counterbalanced order, and completed acceptability and side effect questionnaires after each. The patients also took XR equipment home for one week to use for relaxation practice and again completed the measures about their experience. The acceptability and side effect data were compared against predetermined acceptable thresholds and were evaluated for their association with the participant characteristics. Results. The aggregate acceptability questionnaire scores exceeded our minimum threshold of 3.5/5, with the two fully immersive virtual reality conditions preferred over augmented reality for relaxation training (z = −3.02, p = 0.003, and z = −2.31, p = 0.02). The endorsed side effects were rated by all but one participant as mild, with vertigo being the most common. The acceptability ratings were not reliably associated with age, sex, typical hours per day of technology use, or technology attitudes, but were inversely related to the side effect scores. Conclusions. The preliminary data on acceptability and tolerability of immersive XR technology for relaxation training among youths with migraine supports further intervention development work. Full article

(This article belongs to the Special Issue Innovative Approaches to Treating and Preventing Pediatric Chronic Pain)

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13 pages, 3002 KiB

Open AccessEditor’s ChoiceArticle

Effectiveness of Extracorporeal Shockwave Therapy on Controlling Spasticity in Cerebral Palsy Patients: A Meta-Analysis of Timing of Outcome Measurement

by Min Cheol Chang, You Jin Choo, Sang Gyu Kwak, Kiyeun Nam, Sae Yoon Kim, Hee Jin Lee and Soyoung Kwak

Children 2023, 10(2), 332; https://doi.org/10.3390/children10020332 - 9 Feb 2023

Cited by 7 | Viewed by 3099

Abstract

Extracorporeal shockwave therapy (ESWT) has been suggested as an alternative treatment for reducing spasticity in patients with cerebral palsy (CP). However, the duration of its effect was rarely known. A meta-analysis was performed to investigate the effectiveness of ESWT at controlling spasticity in [...] Read more.

Extracorporeal shockwave therapy (ESWT) has been suggested as an alternative treatment for reducing spasticity in patients with cerebral palsy (CP). However, the duration of its effect was rarely known. A meta-analysis was performed to investigate the effectiveness of ESWT at controlling spasticity in patients with CP according to the follow-up period. We included studies in which ESWT was used to manage spasticity in patients with CP, and the effect was compared with that in a control group. Finally, three studies were included. In the meta-analysis, spasticity, measured using the modified Ashworth scale (MAS), was significantly reduced after ESWT compared with that in the control group; however, it was sustained for only 1 month. After ESWT, significant increases in passive ankle range of motion (ROM) and plantar surface area in the standing position were observed compared with those in the control group and sustained for up to 3 months. Although spasticity measured using MAS was significantly reduced for only 1 month, improvement in spasticity-associated symptoms, such as ankle ROM and plantar surface area contacting the ground, persisted for over 3 months. ESWT appears to be a useful and effective therapeutic option for managing spasticity in patients with CP. Full article

(This article belongs to the Special Issue Advances in Pediatric Neuromuscular Disorders)

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11 pages, 663 KiB

Open AccessEditor’s ChoiceArticle

Oxytocin Levels Increase and Anxiety Decreases in Mothers Who Sing and Talk to Their Premature Infants during a Painful Procedure

by Manuela Filippa, Maria Grazia Monaci, Carmen Spagnuolo, Massimiliano Di Benedetto, Paolo Serravalle and Didier Grandjean

Children 2023, 10(2), 334; https://doi.org/10.3390/children10020334 - 9 Feb 2023

Cited by 11 | Viewed by 2821

Abstract

(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) [...] Read more.

(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) levels. The current study aims to assess the effect of maternal singing and speaking on mothers. (2) Methods: During a painful procedure over two days, twenty preterm infants were randomly exposed to their mother’s live voice (speaking or singing). Maternal OXT levels were measured twice: before and after singing, as well as before and after speaking. The anxiety and resilience responses of mothers were studied before and after the two-day interventions, regardless of the speaking/singing condition. OXT levels in mothers increased in response to both singing and speech. Concurrently, anxiety levels decreased, but no significant effects on maternal resilience were found. (3) Conclusions: OXT could be identified as a key mechanism for anxiety regulation in parents, even in sensitive care situations, such as when their infant is in pain. Active involvement of parents in the care of their preterm infants can have a positive effect on their anxiety as well as potential benefits to their sensitivity and care abilities through OXT. Full article

(This article belongs to the Section Pediatric Neonatology)

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9 pages, 2917 KiB

Open AccessEditor’s ChoiceReview

The Ophthalmic Manifestations of Down Syndrome

by Emily Sun and Courtney L. Kraus

Children 2023, 10(2), 341; https://doi.org/10.3390/children10020341 - 9 Feb 2023

Cited by 7 | Viewed by 5257

Abstract

Down Syndrome is one of the most common chromosomal conditions in the world, affecting an estimated 1:400–1:500 births. It is a multisystem genetic disorder but has a wide range of ophthalmic findings. These include strabismus, amblyopia, accommodation defects, refractive error, eyelid abnormalities, nasolacrimal [...] Read more.

Down Syndrome is one of the most common chromosomal conditions in the world, affecting an estimated 1:400–1:500 births. It is a multisystem genetic disorder but has a wide range of ophthalmic findings. These include strabismus, amblyopia, accommodation defects, refractive error, eyelid abnormalities, nasolacrimal duct obstruction, nystagmus, keratoconus, cataracts, retinal abnormalities, optic nerve abnormalities, and glaucoma. These ophthalmic conditions are more prevalent in children with Down Syndrome than the general pediatric population, and without exception, early identification with thoughtful screening in this patient population can drastically improve prognosis and/or quality of life. Full article

(This article belongs to the Special Issue Advances in Pediatric Ophthalmology)

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11 pages, 415 KiB

Open AccessEditor’s ChoiceArticle

Influence of Rule Manipulation on Technical–Tactical Actions in Young Basketball Players: A Scoping Review

by Ricardo André Birrento Aguiar, José Maria Giménez Egido, José Manuel Palao Andrés and Enrique Ortega-Toro

Children 2023, 10(2), 323; https://doi.org/10.3390/children10020323 - 8 Feb 2023

Cited by 5 | Viewed by 3049

Abstract

The purpose of this scoping review was to analyse the effect of rules modification on technical and tactical action in young basketball. The publications search period ranged from January 2007 to December 2021. The search covered the following electronic databases: SCOPUS, SportDiscus, and [...] Read more.

The purpose of this scoping review was to analyse the effect of rules modification on technical and tactical action in young basketball. The publications search period ranged from January 2007 to December 2021. The search covered the following electronic databases: SCOPUS, SportDiscus, and the Web of Science core collection. Following this search process, 18 articles were included in the review. The following variables were analysed: characteristics of the sample, the constraints manipulated, the duration of the intervention, and the effect on technical–tactical actions. The studies reviewed modified the following constraints: (a) number of players (66.7%), (b) court dimensions (27.8%), (c) ball/player interactions (11.1%), and (d) ball/player interactions, basket height, game time and number of baskets (5.6%, respectively). The findings show that rule manipulation can increase players’ participation and promote the variability of players’ actions. The current evidence about rule modification in youth basketball presents areas in which more studies are needed to have a complete perspective of their impact in practice and competition through the different stages of players’ development. Taking into account individual needs and developmental stages, further studies should consider different age groups (e.g., from U-10 to zU-14) and female players. Expanding scientific knowledge in this area would help coaches make short- and long-term plans in accordance with players’ developmental stages. Full article

(This article belongs to the Special Issue Sports Science in Children)

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18 pages, 1226 KiB

Open AccessEditor’s ChoiceReview

Cyberbullying as a Learned Behavior: Theoretical and Applied Implications

by Christopher P. Barlett

Children 2023, 10(2), 325; https://doi.org/10.3390/children10020325 - 8 Feb 2023

Cited by 13 | Viewed by 16698

Abstract

Cyberbullying perpetration has emerged as a world-wide societal issue. Interventions need to be continuously updated to help reduce cyberbullying perpetration. We believe that data derived from theory can best accomplish this objective. Here, we argue for the importance of learning theory to understand [...] Read more.

Cyberbullying perpetration has emerged as a world-wide societal issue. Interventions need to be continuously updated to help reduce cyberbullying perpetration. We believe that data derived from theory can best accomplish this objective. Here, we argue for the importance of learning theory to understand cyberbullying perpetration. The purpose of this manuscript is to firstly describe the various learning theories that are applicable to describe cyberbullying perpetration, such as social learning, operant conditioning, the general learning model, and others. Second, we delve into the Barlett Gentile Cyberbullying Model, which integrates learning postulates and distinguishes cyber from traditional bullying. Finally, we offer a learning perspective on interventions and future research. Full article

(This article belongs to the Section Pediatric Mental Health)

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24 pages, 1141 KiB

Open AccessEditor’s ChoiceArticle

Developmental Pathway Choices of Young People Presenting to a Gender Service with Gender Distress: A Prospective Follow-Up Study

by Joseph Elkadi, Catherine Chudleigh, Ann M. Maguire, Geoffrey R. Ambler, Stephen Scher and Kasia Kozlowska

Children 2023, 10(2), 314; https://doi.org/10.3390/children10020314 - 7 Feb 2023

Cited by 13 | Viewed by 13671

Abstract

This prospective case-cohort study examines the developmental pathway choices of 79 young people (13.25–23.75 years old; 33 biological males and 46 biological females) referred to a tertiary care hospital’s Department of Psychological Medicine (December 2013–November 2018, at ages 8.42–15.92 years) for diagnostic assessment [...] Read more.

This prospective case-cohort study examines the developmental pathway choices of 79 young people (13.25–23.75 years old; 33 biological males and 46 biological females) referred to a tertiary care hospital’s Department of Psychological Medicine (December 2013–November 2018, at ages 8.42–15.92 years) for diagnostic assessment for gender dysphoria (GD) and for potential gender-affirming medical interventions. All of the young people had attended a screening medical assessment (including puberty staging) by paediatricians. The Psychological Medicine assessment (individual and family) yielded a formal DSM-5 diagnosis of GD in 66 of the young people. Of the 13 not meeting DSM-5 criteria, two obtained a GD diagnosis at a later time. This yielded 68 young people (68/79; 86.1%) with formal diagnoses of GD who were potentially eligible for gender-affirming medical interventions and 11 young people (11/79; 13.9%) who were not. Follow-up took place between November 2022 and January 2023. Within the GD subgroup (n = 68) (with two lost to follow-up), six had desisted (desistance rate of 9.1%; 6/66), and 60 had persisted on a GD (transgender) pathway (persistence rate of 90.9%; 60/66). Within the cohort as a whole (with two lost to follow-up), the overall persistence rate was 77.9% (60/77), and overall desistance rate for gender-related distress was 22.1% (17/77). Ongoing mental health concerns were reported by 44/50 (88.0%), and educational/occupational outcomes varied widely. The study highlights the importance of careful screening, comprehensive biopsychosocial (including family) assessment, and holistic therapeutic support. Even in highly screened samples of children and adolescents seeking a GD diagnosis and gender-affirming medical care, outcome pathways follow a diverse range of possibilities. Full article

(This article belongs to the Section Pediatric Mental Health)

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12 pages, 1561 KiB

Open AccessEditor’s ChoiceArticle

Therapeutic Approaches to Dysautonomia in Childhood, with a Special Focus on Long COVID

by Reiner Buchhorn

Children 2023, 10(2), 316; https://doi.org/10.3390/children10020316 - 7 Feb 2023

Cited by 13 | Viewed by 3730

Abstract

Background: Dysautonomia seems to be important for the pathophysiology of psychosomatic diseases and, more recently, for long COVID. This concept may explain the clinical symptoms and could help open new therapeutic approaches. Methods: We compared our data from an analysis of heart rate [...] Read more.

Background: Dysautonomia seems to be important for the pathophysiology of psychosomatic diseases and, more recently, for long COVID. This concept may explain the clinical symptoms and could help open new therapeutic approaches. Methods: We compared our data from an analysis of heart rate variability (HRV) in an active standing test in 28 adolescents who had developed an inappropriate sinus tachycardia (IST, n = 13) or postural orthostatic tachycardia syndrome (POTS, n = 15) after contracting COVID-19 disease and/or vaccination with 64 adolescents from our database who developed dysautonomia due to psychosomatic diseases prior to the COVID-19 pandemic. We prove the effects of our treatment: omega-3 fatty acid supplementation (O3-FA, n = 18) in addition to propranolol (low dose, up to 20-20-0 mg, n = 32) or ivabradine 5-5-0 mg (n = 17) on heart rate regulation and heart rate variability (HRV). Results: The HRV data were not different between the adolescents with SARS-CoV-2-related disorders and the adolescents with dysautonomia prior to the pandemic. The heart rate increases in children with POTS while standing were significantly lower after low-dose propranolol (27.2 ± 17.4 bpm***), ivabradine (23.6 ± 8.12 bpm*), and O-3-FA (25.6 ± 8.4 bpm*). The heart rate in children with IST while lying/standing was significantly lower after propranolol (81.6 ± 10.1 bpm**/101.8 ± 18.8***), ivabradine (84.2 ± 8.4 bpm***/105.4 ± 14.6**), and O-3-FA (88.6 ± 7.9 bpm*/112.1/14.9*). Conclusions: The HRV data of adolescents with dysautonomia after COVID-19 disease/vaccination are not significantly different from a historical control of adolescents with dysautonomia due to psychosomatic diseases prior to the pandemic. Low-dose propranolol > ivabradine > omega-3 fatty acids significantly decrease elevated heart rates in patients with IST and the heart rate increases in patients with POTS and may be beneficial in these children with dysautonomia. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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10 pages, 898 KiB

Open AccessEditor’s ChoiceArticle

Effects of a High Intensity Interval Training (HIIT) Program on Anthropomorphic and Cardiometabolic Variables in School Children with Overweight and Obesity

by José Miguel Espinoza Silva, Pedro Ángel Latorre Román, José Carlos Cabrera Linares, Juan A. Párraga Montilla and Cristian Martínez Salazar

Children 2023, 10(2), 317; https://doi.org/10.3390/children10020317 - 7 Feb 2023

Cited by 11 | Viewed by 2963

Abstract

The aim of this study was to assess the effects of a high intensity interval training (HIIT) program on anthropomorphic and cardiometabolic variables in schoolchildren with overweight and obesity. A total of 443 schoolchildren (age: 6.37 ± 0.65 years) took part in this [...] Read more.

The aim of this study was to assess the effects of a high intensity interval training (HIIT) program on anthropomorphic and cardiometabolic variables in schoolchildren with overweight and obesity. A total of 443 schoolchildren (age: 6.37 ± 0.65 years) took part in this study. The experimental group (EG; n = 295; age = 6.40 ± 0.64 years) was compound with children with overweight and obesity, whereas children with normoweight were included in the control group (CG; n = 148; 6.31 ± 0.67 years). The EG performed a training program based on HIIT two times per week for 28 weeks (56 sessions), whilst the CG performed their habitual physical education classes based on the national curriculum. Body mass index (BMI), waist circumference, body fat, ∑ 4 skinfold fat, waist to height ratio, waist circumference, and cardiometabolic risk were measured. The dependent variables were analysed by two-way analysis of covariance (ANCOVA 2 × 2). To analyse the percentage differences between groups, the chi-square test was used. P-value was set at p < 0.05. Significant differences were found in the EG in BMI, waist circumference, body fat, ∑ 4 skinfold fat, and waist to height ratio. In conclusion, an HIIT training program can be an effective tool for improving anthropomorphic variables and reducing cardiometabolic risk in schoolchildren with overweight and obesity. Full article

(This article belongs to the Section Pediatric Endocrinology & Diabetes)

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27 pages, 5517 KiB

Open AccessEditor’s ChoiceReview

Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease

by Zhonghua Sun

Children 2023, 10(2), 319; https://doi.org/10.3390/children10020319 - 7 Feb 2023

Cited by 20 | Viewed by 5223

Abstract

Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a [...] Read more.

Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a valuable tool in cardiovascular disease because of the difficulty associated with comprehending cardiovascular anatomy and pathology on 2D flat screens. Additionally, the added value of using 3D-printed models is especially apparent in congenital heart disease (CHD), due to its wide spectrum of anomalies and its complexity. This review provides an overview of 3D-printed models in pediatric CHD, with a focus on educational value for medical students or graduates, clinical applications such as pre-operative planning and simulation of congenital heart surgical procedures, and communication between physicians and patients/parents of patients and between colleagues in the diagnosis and treatment of CHD. Limitations and perspectives on future research directions for the application of 3D printing technology into pediatric cardiology practice are highlighted. Full article

(This article belongs to the Special Issue Advanced Research in Pediatric Radiology and Nuclear Medicine)

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13 pages, 3218 KiB

Open AccessEditor’s ChoiceArticle

Is Surface Topography Useful in the Diagnosis of Scoliosis? Validation of the Biometrical Holistic of Human Body (BHOHB)

by Angelo G. Aulisa, Diletta Bandinelli, Martina Marsiolo, Francesco Falciglia, Marco Giordano and Renato M. Toniolo

Children 2023, 10(2), 320; https://doi.org/10.3390/children10020320 - 7 Feb 2023

Cited by 7 | Viewed by 2319

Abstract

Background: The concern around repeated exposure to X-rays has been motivating doctors involved in scoliosis to seek alternative solutions. Surface topography (ST) analysis is a modern system that has been shown to have good results. The purpose of the study is to validate [...] Read more.

Background: The concern around repeated exposure to X-rays has been motivating doctors involved in scoliosis to seek alternative solutions. Surface topography (ST) analysis is a modern system that has been shown to have good results. The purpose of the study is to validate the new BHOHB hardware for the investigation of scoliosis in adolescents by comparing it to X-ray examinations and to assess the reliability of intraoperator and interoperator tests. Methods: Ninety-five patients were enrolled in our study. All the patients were analyzed via the BHOHB method 2 times by 2 independent physicians (t0) and for a second time 2 or 3 months later (t1). The Pearson correlation coefficient was used to evaluate the relationship between the measurements obtained by BHOHB and the gold standard. The intraclass correlation coefficient (ICC) was used to assess intra- and interoperator reliability. Statistical analysis was performed with the GraphPad Prism 8 software. Results: The correlations between the first and second operators in the measurements and between the BHOHB method and X-ray showed a very good to excellent r for both. A very good correlation was also confirmed for prominence measured by operators and by the BHOHB machine. Intra- and interoperator reliability was found to be very positive for both the first and the second physicians. Conclusions: We can state that ST can be useful for diagnosing and treating scoliosis. The recommendation is to use it primarily to evaluate the evolution of the curve, as in this mode, you can reduce the patient’s exposure to X-rays. The results indicate that BHOHB measures are comparable to radiographs and not influenced by the operator. Full article

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

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14 pages, 639 KiB

Open AccessEditor’s ChoiceArticle

Maternal and Paternal Authoritarian Parenting and Adolescents’ Impostor Feelings: The Mediating Role of Parental Psychological Control and the Moderating Role of Child’s Gender

by Yosi Yaffe

Children 2023, 10(2), 308; https://doi.org/10.3390/children10020308 - 6 Feb 2023

Cited by 8 | Viewed by 5442

Abstract

Introduction: Recent systematic reviews about the impostor phenomenon unveil a severe shortage of research data on adolescents. The present study aimed at reducing this gap in the literature by investigating the association between maternal and paternal authoritarian parenting and impostor feelings among adolescents, [...] Read more.

Introduction: Recent systematic reviews about the impostor phenomenon unveil a severe shortage of research data on adolescents. The present study aimed at reducing this gap in the literature by investigating the association between maternal and paternal authoritarian parenting and impostor feelings among adolescents, while testing the mediating role played by parental psychological control and the moderating role of the child’s gender in this context. Methods: Three hundred and eight adolescents took part in an online survey, in which they reported anonymously on their impostor feelings and their parents’ parenting styles via several valid psychological questionnaires. The sample consisted of 143 boys and 165 girls, whose age ranged from 12 to 17 (M = 14.67, SD = 1.64). Results: Of the sample’s participants, over 35% reported frequent to intense impostor feelings, with girls scoring significantly higher than boys on this scale. In general, the maternal and paternal parenting variables explained 15.2% and 13.3% (respectively) of the variance in the adolescents’ impostor scores. Parental psychological control fully mediated (for fathers) and partially mediated (for mothers) the association between parental authoritarian parenting and the adolescents’ impostor feelings. The child’s gender moderated solely the maternal direct effect of authoritarian parenting on impostor feelings (this association was significant for boys alone), but not the mediating effect via psychological control. Conclusions: The current study introduces a specific explanation for the possible mechanism describing the early emergence of impostor feelings in adolescents based on parenting styles and behaviors. Full article

(This article belongs to the Special Issue Behavioral and Mental Health Problems in Children)

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15 pages, 303 KiB

Open AccessEditor’s ChoiceArticle

Telehealth Use in Pediatric Care during the COVID-19 Pandemic: A Qualitative Study on the Perspectives of Caregivers

by Gergana Damianova Kodjebacheva, Charlotte Tang, Faith Groesbeck, Loretta Walker, Jillian Woodworth and Jennifer Schindler-Ruwisch

Children 2023, 10(2), 311; https://doi.org/10.3390/children10020311 - 6 Feb 2023

Cited by 16 | Viewed by 3594

Abstract

This qualitative study surveyed caregivers regarding their perspectives on the benefits of, challenges with, and suggestions for improving telehealth during the COVID-19 pandemic. Caregivers who had the responsibility for caring for at least one child aged under 18 years of age in Genesee [...] Read more.

This qualitative study surveyed caregivers regarding their perspectives on the benefits of, challenges with, and suggestions for improving telehealth during the COVID-19 pandemic. Caregivers who had the responsibility for caring for at least one child aged under 18 years of age in Genesee County, MI, participated. The caregivers were biological parents, stepparents, foster parents, adoptive parents, and guardians. A total of 105 caregivers completed a survey with open-ended questions via Qualtrics. Two independent coders developed themes based on the responses using grounded theory. Participants were primarily biological parents and non-Hispanic White and African Americans. According to the participants, the benefits of telehealth included prevention of exposure to the COVID-19 virus, quality communication with physicians, savings in travel time, and cost-effective methods to receive care. The challenges included a lack of in-person interaction, fear of compromised confidentiality, and the potential for misdiagnosis. Suggestions for improvement by caregivers included increasing access to telehealth for poorer families, offering a media educational campaign to promote telehealth use, and creating a universal platform to share patient information. Future studies may test the effectiveness of interventions such as those suggested by caregivers in this study to improve telehealth. Full article

(This article belongs to the Section Pediatric Nursing)

15 pages, 888 KiB

Open AccessEditor’s ChoiceReview

Gastrointestinal Involvement in Children with Systemic Lupus Erythematosus

by Angela Mauro, Teresa Giani, Clelia Di Mari, Martina Sandini, Antonella Talenti, Valentina Ansuini, Luigi Biondi, Giovanni Di Nardo and Luca Bernardo

Children 2023, 10(2), 309; https://doi.org/10.3390/children10020309 - 6 Feb 2023

Cited by 7 | Viewed by 3996

Abstract

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder. When it presents before the age of 18 years (childhood-onset systemic lupus erythematosus, cSLE), the disease course tends to be more severe with a higher rate of organ involvement and requires an early diagnosis. [...] Read more.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder. When it presents before the age of 18 years (childhood-onset systemic lupus erythematosus, cSLE), the disease course tends to be more severe with a higher rate of organ involvement and requires an early diagnosis. Gastrointestinal involvement in cSLE is rare and scarcely reported in the literature. Any organ of the gastrointestinal system may be affected, either as a direct consequence of the disease, as a subsequent complication, or as an adverse drug event. Abdominal pain is the most common GI symptom, it can be diffuse or well localized, and can underline different conditions such as hepatitis, pancreatitis, appendicitis, peritonitis, or enteritis. cSLE may have an alteration of the intestinal barrier with features of protein-losing enteropathy or, in genetically predisposed patients, may develop associated autoimmune disorders such as Coeliac Disease or Autoimmune Hepatitis. The aim of this manuscript is to provide a narrative review of gastrointestinal manifestations in cSLE focused on hepatic, pancreatic, and intestinal involvement. A comprehensive literature search based on the PubMed database was performed. Full article

(This article belongs to the Special Issue Rheumatic Diseases in Children)

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12 pages, 555 KiB

Open AccessEditor’s ChoiceArticle

Associations between Parenting, Temperament-Related Self-Regulation and the Moral Self in Middle Childhood

by Jessica Schütz and Neele Bäker

Children 2023, 10(2), 302; https://doi.org/10.3390/children10020302 - 4 Feb 2023

Cited by 8 | Viewed by 3433

Abstract

The moral self is increasingly being debated in research, i.e., what causes children to internalise and evaluate the importance of certain moral values. The aim of the present study is to analyse associations between parental warmth and harsh parenting, temperamental self-regulation (inhibitory control [...] Read more.

The moral self is increasingly being debated in research, i.e., what causes children to internalise and evaluate the importance of certain moral values. The aim of the present study is to analyse associations between parental warmth and harsh parenting, temperamental self-regulation (inhibitory control and impulsivity), and the moral self in middle childhood. A total of 194 (n = 52 children with special educational needs in emotional–social development) six- to eleven-year-old children (M_age = 8.53, SD_age = 1.40) and their primary caregivers (M_age = 40.41, SD_age = 5.94) participated in this cross-sectional questionnaire study. Parental warmth and impulsivity were associated with the moral self. Impulsivity mediated the relationship between harsh parenting as well as parental warmth and the moral self. Results are discussed in terms of their relevance to social information processing theory. The importance of parenting and temperamental self-regulation is discussed as implications that may in turn strengthen children’s moral selves. Full article

(This article belongs to the Special Issue Research on Socio-Emotional Development from Childhood to Adulthood)

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15 pages, 6946 KiB

Open AccessEditor’s ChoiceArticle

The Efficacy of a Posterior Approach to Surgical Correction for Neglected Idiopathic Scoliosis: A Comparative Analysis According to Health-Related Quality of Life, Pulmonary Function, Back Pain and Sexual Function

by Pawel Grabala, Ilkka J. Helenius, Jacob M. Buchowski and Suken A. Shah

Children 2023, 10(2), 299; https://doi.org/10.3390/children10020299 - 3 Feb 2023

Cited by 9 | Viewed by 4180

Abstract

Background: This study aimed to evaluate the treatment outcomes of severe idiopathic scoliosis (IS) and hypothesized that surgical treatment would have a superior impact on the health-related quality of life (HRQoL), pulmonary function (PF), back pain, and sexual function. Methods: We retrospectively reviewed [...] Read more.

Background: This study aimed to evaluate the treatment outcomes of severe idiopathic scoliosis (IS) and hypothesized that surgical treatment would have a superior impact on the health-related quality of life (HRQoL), pulmonary function (PF), back pain, and sexual function. Methods: We retrospectively reviewed 195 consecutive patients with IS classified into severe (SG) and moderate groups (MG) with a minimum follow-up of two years. Results: The mean preoperative curve was 131° and 60° in the SG and MG, respectively. The mean preoperative flexibility in the bending films averaged between 22% in the SG and 41% in the MG. After definitive surgery, the main curve was corrected to 61° and 18° in the SG and MG, respectively. The mean preoperative thoracic kyphosis was 83° in the SG and 25° in the MG, which was corrected to 35° in the SG and 25° in the MG. At baseline, the percentage of predicted lung volume (FVC) was significantly lower in the SG than that in the MG (51.2% vs. 83%). The baseline percentage of the predicted FEV1 values was also significantly lower in the SG than in the MG (60.8% vs. 77%). During the two-year follow-up, the percentage of predicted FVC showed significant improvement in the SG (69.9%) (p < 0.001), and the percentage of predicted FEV1 values during the follow-up improved significantly in the SG (76.9%) (p < 0.001) compared with the MG (81%), with no statistical difference observed during the two-year follow-up. The SRS-22r showed a clinically and statistically significant improvement in the preoperative results to those of the final follow-up (p < 0.001). Conclusions: Surgical treatment of severe scoliosis can be safe. It provided a mean correction of the deformity for 59% of patients and significantly improved respiratory function, with the percentage of predicted forced expiratory volume in 1 s improving by 60% and the forced vital capacity improving by 50%, resulting in clinically and statistically significant improvements in the SRS-22r, HRQoL outcome scores, and back pain (reduced from 36% to 8%), as well as improved sexual function. The planned surgical treatment can achieve a very significant deformity correction with a minimal risk of complications. The surgical treatment has a superior impact on the quality of life patients with severe spinal deformities and significantly improves function in every sphere of life. Full article

(This article belongs to the Special Issue Advances in Spine Health of Children and Adolescents)

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30 pages, 2196 KiB

Open AccessEditor’s ChoiceReview

Effects of Sports, Exercise Training, and Physical Activity in Children with Congenital Heart Disease—A Review of the Published Evidence

by Simone K. Dold, Nikolaus A. Haas and Christian Apitz

Children 2023, 10(2), 296; https://doi.org/10.3390/children10020296 - 2 Feb 2023

Cited by 9 | Viewed by 7863

Abstract

Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, [...] Read more.

Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, need specific individualized training programs. This review article summarizes the current knowledge regarding the clinical effects of sports and exercise training on CHD and its pathophysiologic mechanisms. An evidence-based approach based on a literature search, using PubMed, Medline, CINHAL, Embase, and the Cochrane Library was conducted, last completed on 30 December 2021. In studies with 3256 CHD patients in total, including 10 randomized controlled trials, 14 prospective interventional trials, 9 observational trials, and 2 surveys, exercise training has been shown to improve exercise capacity and physical activity, motoric skills, muscular function, and quality of life. Sports and exercise training appears to be effective and safe in CHD patients. Despite being cost-efficient, training programs are currently scarcely reimbursed; therefore, support from healthcare institutions, commissioners of healthcare, and research-funding institutions is desirable. There is a strong need to establish specialized rehabilitation programs for complex CHD patients to enhance these patients’ access to this treatment intervention. Further studies may be desirable to confirm these data to investigate the impact on risk profiles and to identify the most advantageous training methodology and underlying pathophysiological mechanisms. Full article

(This article belongs to the Special Issue Nutrition, Physical Activity and Sports in Children with Congenital Heart Disease)

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15 pages, 670 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Psychiatric Disorders and Obesity in Childhood and Adolescence—A Systematic Review of Cross-Sectional Studies

by Ioulia Kokka, Iraklis Mourikis and Flora Bacopoulou

Children 2023, 10(2), 285; https://doi.org/10.3390/children10020285 - 1 Feb 2023

Cited by 29 | Viewed by 6222

Abstract

Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this [...] Read more.

Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this study was to systematically review the evidence regarding the relation of obesity and psychiatric disorders in childhood and adolescence. This review, based on the PRISMA guidelines, included cross-sectional studies published within the last decade, pertaining to the relation between psychiatric disorders and obesity in children and adolescents up to the age of 19 years. Studies on eating disorders were excluded. A total of 14 studies of 23,442 children and adolescents that investigated the relation of obesity with anxiety, mood disorders, and psychosis were included in this systematic review. Nine of the included studies reported a significant relationship between the psychiatric disorder under investigation and obesity. Understanding the nexus between obesity and psychiatric disorders in children and adolescents is of great importance, given the alarming increase in both conditions in youth. Such findings could facilitate the development and implementation of targeted interventions. Full article

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

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Graphical abstract

15 pages, 597 KiB

Open AccessEditor’s ChoiceArticle

Comparison between Restorative Materials for Pulpotomised Deciduous Molars: A Randomized Clinical Study

by Kanwalpreet Kaur, Bharat Suneja, Sunaina Jodhka, Ravinder S. Saini, Saurabh Chaturvedi, Shashit Shetty Bavabeedu, Fahad Hussain Alhamoudi, Marco Cicciù and Giuseppe Minervini

Children 2023, 10(2), 284; https://doi.org/10.3390/children10020284 - 1 Feb 2023

Cited by 12 | Viewed by 3974

Abstract

Aim: To evaluate and compare the clinical outcomes of Cention-N (CN) and stainless steel crowns (SSCs) as restorations for pulpotomised primary molars, and to study clinical and radiographic outcomes of pulpotomies restored with these materials. Methods: The study was conducted on 60 pulpotomised [...] Read more.

Aim: To evaluate and compare the clinical outcomes of Cention-N (CN) and stainless steel crowns (SSCs) as restorations for pulpotomised primary molars, and to study clinical and radiographic outcomes of pulpotomies restored with these materials. Methods: The study was conducted on 60 pulpotomised molars with occlusoproximal caries. These were randomly divided into two groups and restored with either stainless steel crowns or Cention-N. Clinical performance of restorations and clinical and radiographic success of pulpotomy was examined at 6, 9 and 12 months. Results: The mean scores for marginal integrity deteriorated significantly at 6, 9 and 12 months in both groups but in comparison were insignificant. The mean for proximal contact deteriorated significantly for the Cention-N group, whereas the mean for gingival health deteriorated remarkably for the stainless steel crown group at successive evaluations. No tooth in either group showed secondary caries or discomfort on biting, except for one tooth in Cention-N group which presented with secondary caries. The clinical success rate for pulpotomised molars was 100% for both groups until nine months, although this had reduced by the end of 12 months. Radiographically, the success rate was 79.3% for Cention-N, while it was 86.6% for stainless steel crowns at 12 months. There was no significant difference in clinical and radiographic success between either group. Conclusion: Cention-N and stainless steel crowns are comparable for marginal integrity. However, crowns maintain significantly better proximal contacts while Cention-N was notably better for gingival health of the restored tooth. Both materials do not show secondary caries and discomfort on biting and are comparable in clinical and radiographic success of pulpotomy at the end of one year. Full article

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

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11 pages, 268 KiB

Open AccessEditor’s ChoiceArticle

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi

by Vaibhav Kumar, Ridhima Gaunkar, Jasleen Thakker, Anil V. Ankola, Mamata Iranna Hebbal, Atrey J. Pai Khot, Virinder Goyal, Amel Ali and Elzahraa Eldwakhly

Children 2023, 10(2), 286; https://doi.org/10.3390/children10020286 - 1 Feb 2023

Cited by 5 | Viewed by 4114

Abstract

Aim: This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents’ perceptions among preschool children in the 3–5-year-old preschool children living in the Belagavi district of Karnataka, a [...] Read more.

Aim: This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents’ perceptions among preschool children in the 3–5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region. Methods: A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean’s fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents’ perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant. Results: Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3–5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child’s age and parents’ education level (p < 0.05). Conclusion: The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease’s nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status. Full article

(This article belongs to the Special Issue Current Advances in Pediatric Dental Diseases and Their Treatment)

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11 pages, 431 KiB

Open AccessEditor’s ChoiceArticle

Safety and Efficacy of Sildenafil for Group 2 Pulmonary Hypertension in Left Heart Failure

by Kinjal Desai, Michael Di Lorenzo, Warren A. Zuckerman, Ezinne Emeruwa and Usha S. Krishnan

Children 2023, 10(2), 270; https://doi.org/10.3390/children10020270 - 31 Jan 2023

Cited by 7 | Viewed by 3540

Abstract

Pulmonary hypertension (PH) is a multifactorial, progressive disease with poor outcomes. Group 2 PH is defined by pulmonary vascular disease with elevated pulmonary capillary wedge pressure including both left-sided obstructive lesions and diastolic heart failure (HF). Sildenafil was historically discouraged in this population [...] Read more.

Pulmonary hypertension (PH) is a multifactorial, progressive disease with poor outcomes. Group 2 PH is defined by pulmonary vascular disease with elevated pulmonary capillary wedge pressure including both left-sided obstructive lesions and diastolic heart failure (HF). Sildenafil was historically discouraged in this population as pulmonary vasodilation can lead to pulmonary edema. However, evidence suggests that sildenafil can help to treat the precapillary component of PH. This is a single center, retrospective pilot study of pediatric PH patients with left-sided HF who were treated with sildenafil for ≥ 4 weeks. HF patients without mechanical support (HF group) and HF patients with a left ventricular assist device (HF-VAD) were analyzed. The exploratory analysis described the safety and side effects of the drug. Echocardiographic parameters were compared before and after sildenafil treatment in a paired analysis. The changes in medical therapy during treatment, mechanical support, and mortality was reported; 19/22 patients tolerated sildenafil. Pulmonary edema in two patients resolved upon discontinuation of sildenafil. In the HF group, both the right atrial volume and right ventricular diastolic area decreased, and the tricuspid regurgitation (TR) S/D ratio decreased after therapy (p = 0.02). Across both the groups, four patients weaned off milrinone and seven weaned off inhaled nitric oxide. Of the thirteen HF patients, four received a transplant, and all of the nine HF-VAD patients received a transplant. Sildenafil can be safely used in carefully selected patients with HF and mixed pre/postcapillary PH with judicious titration and inpatient surveillance, with patients showing improvements in echocardiographic parameters. Full article

(This article belongs to the Section Pediatric Cardiology)

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13 pages, 317 KiB

Open AccessEditor’s ChoiceReview

Atopic Dermatitis and Water: Is There an Optimum Water Intake Level for Improving Atopic Skin?

by Nikolaos Douladiris, Efstratios Vakirlis and Emilia Vassilopoulou

Children 2023, 10(2), 273; https://doi.org/10.3390/children10020273 - 31 Jan 2023

Cited by 8 | Viewed by 4748

Abstract

Water is a vital nutrient with innumerable functions for every living cell. The functions of human skin include protection against dehydration of the body. Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease that presents with dry skin, erythematous and eczematous lesions, [...] Read more.

Water is a vital nutrient with innumerable functions for every living cell. The functions of human skin include protection against dehydration of the body. Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease that presents with dry skin, erythematous and eczematous lesions, and lichenification. This paper discusses the question of whether extra water intake in children with AD affects skin hydration and the skin barrier function. Among the methods used to treat dry skin, topical leave-on products are the first-line treatment, intended to improve hydration and the skin barrier function. The effectiveness of adequate water intake as a measure to treat dry skin is still under debate. Normal skin hydration increases with dietary water intake, particularly in those with prior lower water consumption. Skin dryness in AD is instrumental to the itch and inflammation cycle, contributing to barrier impairment and aggravating disease severity and flares. Certain emollients provide significant hydration to AD skin, with relief of dryness and reduction in barrier impairment, disease severity, and flares. Further investigations are needed to evaluate the optimum water intake levels in children with AD, as important questions remain unanswered, namely, does oral hydration provide relief of skin dryness and reduce barrier impairment, disease severity, and flares; is there any additional benefit from using mineral or thermal spring water; or is there a need to specifically study the fluid/water intake in children with AD and food allergy (FA) restrictions? Full article

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

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14 pages, 968 KiB

Open AccessEditor’s ChoiceArticle

Social Media in Adolescents: A Retrospective Correlational Study on Addiction

by Rebecca Ciacchini, Graziella Orrù, Elisa Cucurnia, Silvia Sabbatini, Francesca Scafuto, Alessandro Lazzarelli, Mario Miccoli, Angelo Gemignani and Ciro Conversano

Children 2023, 10(2), 278; https://doi.org/10.3390/children10020278 - 31 Jan 2023

Cited by 15 | Viewed by 14449

Abstract

Considering the growing interest in the possible effects of internet’s addiction on adoles-cent’s mental health, this study aimed at exploring the psychological correlates of social media and internet problematic use during the first year of the covid-19 pandemic. A cross-sectional study was conducted [...] Read more.

Considering the growing interest in the possible effects of internet’s addiction on adoles-cent’s mental health, this study aimed at exploring the psychological correlates of social media and internet problematic use during the first year of the covid-19 pandemic. A cross-sectional study was conducted in a sample of secondary school students (N = 258); participants were asked to complete an online survey, investigating social media addiction (BSMAS), self-esteem (RSES), feelings of isolation (CSIQ-A) and anxiety (STAI-Y). Data analysis (descriptive statistics, correlational and regression analyses) was conducted through XLSTAT software ©. An additional ad hoc questionnaire was administrated. Findings showed that the 11% of the participants were significantly addicted to social media, mostly females (59%). Gender represented an exposure factor for the hours spent on social media and the checking activity while performing other daily activities. Significant correlations emerged between the self-report measure of social media addiction and self-esteem and anxiety. Low scores at RSES corresponded to higher checking activity, hours spent on social networks, and playing videogames that were investigated as supplementary indicators of addiction with ad hoc questionnaire. The regression analysis showed just two predictors of social media addiction, gender (female) and trait anxiety. Limitations and implications of the study were argued in order to give some indications for future programs. Full article

(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)

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31 pages, 575 KiB

Open AccessEditor’s ChoiceSystematic Review

Loneliness and Well-Being in Children and Adolescents during the COVID-19 Pandemic: A Systematic Review

by Ann H. Farrell, Irene Vitoroulis, Mollie Eriksson and Tracy Vaillancourt

Children 2023, 10(2), 279; https://doi.org/10.3390/children10020279 - 31 Jan 2023

Cited by 62 | Viewed by 11534

Abstract

Concerns have been raised about the loneliness and well-being of children and adolescents during the COVID-19 pandemic. The extent to which the ongoing pandemic has impacted loneliness and the association between loneliness and well-being is unclear. Therefore, a systematic review of empirical studies [...] Read more.

Concerns have been raised about the loneliness and well-being of children and adolescents during the COVID-19 pandemic. The extent to which the ongoing pandemic has impacted loneliness and the association between loneliness and well-being is unclear. Therefore, a systematic review of empirical studies on the COVID-19 pandemic was conducted to examine the (1) prevalence of loneliness in children and adolescents, (2) associations between loneliness and indicators of well-being, and (3) moderators of these associations. Five databases (MEDLINE, Embase, PsycInfo, Web of Science, ERIC) were searched from 1 January 2020 to 28 June 2022 and 41 studies met our inclusion criteria (cross-sectional: n = 30; longitudinal: n = 11; registered on PROSPERO: CRD42022337252). Cross-sectional prevalence rates of pandemic loneliness varied, with some finding that over half of children and adolescents experienced at least moderate levels of loneliness. Longitudinal results reflected significant mean increases in loneliness compared to pre-pandemic levels. Cross-sectional results indicated that higher levels of loneliness were significantly associated with poorer well-being, including higher depression symptoms, anxiety symptoms, gaming addiction, and sleep problems. Longitudinal associations between loneliness and well-being were more complex than cross-sectional associations, varying by assessment timing and factors in the statistical analyses. There was limited diversity in study designs and samples, preventing a thorough examination of moderating characteristics. Findings highlight a broader challenge with child and adolescent well-being that predates the pandemic and the need for future research to examine underrepresented populations across multiple timepoints. Full article

(This article belongs to the Special Issue The Effect of COVID-19 on Youth Mental Health)

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11 pages, 309 KiB

Open AccessEditor’s ChoiceArticle

Prevalence of Burnout Syndrome and Fear of COVID-19 among Adolescent University Students

by Raimundo Aguayo-Estremera, Gustavo R. Cañadas, Luis Albendín-García, Elena Ortega-Campos, Tania Ariza, Carolina S. Monsalve-Reyes and Emilia Inmaculada De la Fuente-Solana

Children 2023, 10(2), 243; https://doi.org/10.3390/children10020243 - 30 Jan 2023

Cited by 8 | Viewed by 3308

Abstract

This study aimed to estimate the prevalence of burnout syndrome in adolescents entering university studies, to detect differences in burnout levels, personality factors and fear of coronavirus in a pandemic context due to COVID-19. A cross-sectional predictive study was performed with a sample [...] Read more.

This study aimed to estimate the prevalence of burnout syndrome in adolescents entering university studies, to detect differences in burnout levels, personality factors and fear of coronavirus in a pandemic context due to COVID-19. A cross-sectional predictive study was performed with a sample that comprised 134 individuals in their first year of a Psychology degree at Spanish universities. The Maslach Burnout Inventory Student Survey, the NEO Five-Factor Inventory and the Fear of COVID-19 Scale were applied. The prevalence of burnout is estimated according to three methods: Maslach and Jackson’s severity classification, Golembiewski’s phase model and Maslach et al.’s profile model. The estimates show significant differences. The results indicated that between 9 and 21% of students were at risk of developing burnout. On the other hand, students who reported having suffered psychological consequences of the pandemic showed greater emotional exhaustion, neuroticism and fear of COVID-19, and a lower level of personal accomplishment than those who did not suffer such consequences. Neuroticism was the only significant predictor for all burnout dimensions, and fear of COVID-19 did not contribute to any of them. Full article

(This article belongs to the Section Global Pediatric Health)

15 pages, 283 KiB

Open AccessEditor’s ChoiceArticle

Prevalence and Risk Factors of Asthma in Children and Adolescents in Rabigh, Western Saudi Arabia

by Turki S. Alahmadi, Moustafa A. Hegazi, Hani Alsaedi, Hanaa Hamadallah, Ali F. Atwah, Abdulrahman A. Alghamdi, Haya M. Altherwi, Majd S. Alghamdi, Ebtihal M. Albeshri, Moud I. Alzanbaqi, Abubaker M. Bamakhish and Mohamed S. El-Baz

Children 2023, 10(2), 247; https://doi.org/10.3390/children10020247 - 30 Jan 2023

Cited by 9 | Viewed by 4457

Abstract

The worldwide prevalence of asthma in children is variable. The different epidemiological definitions of asthma, the use of various methods of measurement, and the environmental variations between countries are responsible for such different prevalence rates. This study has been performed to identify the [...] Read more.

The worldwide prevalence of asthma in children is variable. The different epidemiological definitions of asthma, the use of various methods of measurement, and the environmental variations between countries are responsible for such different prevalence rates. This study has been performed to identify the prevalence/risk factors of asthma in Saudi children/adolescents in Rabigh. A cross-sectional epidemiological survey has been conducted using the validated Arabic version of the “International Study of Asthma and Allergies in Childhood questionnaire”. Data on the sociodemographic characteristics of participants and risk factors of asthma have also been collected. Three hundred and forty-nine Children/adolescents with an age range of 5–18 years have been randomly selected for an interview from public places and houses in different regions of Rabigh City. The prevalence rates of physician-diagnosed asthma, any wheezing, and wheezing in the last 12 months among children/adolescents (mean age: 12.22 ± 4.14 years) have remarkably increased in association with the rapidly developing industrialization of Rabigh from previously recorded rates of 4.9%, 7.4%, and 6.4% in the only study that has previously been conducted in Rabigh in 1998 to 31.5%, 23.5%, and 14.9%, respectively. The univariate analysis has detected some significant risk factors for asthma. However, in younger aged children (5–9 years), allergic rhinitis, associated chronic illnesses, and viral respiratory infection-induced wheezing have remained significant risk factors of any wheezing. Drug allergy, exposure to dust, and viral respiratory infection-induced wheezing have persisted as significant risk factors for wheezing in the last 12 months. Eczema in the family, exposure to perfumes/incense, and viral respiratory infection-induced wheezing have remained as significant risk factors of physician-diagnosed asthma. The results of this survey should be useful in future targeted preventive plans/measures with special attention to improving air quality to limit the progressive increase in asthma prevalence in Rabigh, as well as in other similar industrial communities. Full article

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

13 pages, 968 KiB

Open AccessEditor’s ChoiceArticle

Gastrointestinal Disorders and Food Selectivity: Relationship with Sleep and Challenging Behavior in Children with Autism Spectrum Disorder

by Giulia Bresciani, Prisca Da Lozzo, Sara Lega, Matteo Bramuzzo, Grazia Di Leo, Andrea Dissegna, Vissia Colonna, Egidio Barbi, Marco Carrozzi and Raffaella Devescovi

Children 2023, 10(2), 253; https://doi.org/10.3390/children10020253 - 30 Jan 2023

Cited by 10 | Viewed by 4908

Abstract

The aim of this study was to evaluate the interaction between gastrointestinal (GI) disorders, sleep problems, and challenging behaviors in children with a diagnosis of Autism Spectrum Disorder (ASD) and their effect on parental stress. The secondary objective was to assess the frequency [...] Read more.

The aim of this study was to evaluate the interaction between gastrointestinal (GI) disorders, sleep problems, and challenging behaviors in children with a diagnosis of Autism Spectrum Disorder (ASD) and their effect on parental stress. The secondary objective was to assess the frequency and type of GI and feeding disorders in a sample of children with ASD through a multidisciplinary assessment and, finally, to investigate families’ perceptions and satisfaction with the proposed multidisciplinary approach. All children underwent a comprehensive gastroenterological and neuropsychiatric evaluation supported by standardized questionnaires. Pediatric gastroenterologists, specifically trained in Applied Behavior Analysis (ABA), provided advice for parent-delivered behavioral intervention for food selectivity. Thirty-six children with an autism diagnosis (29 males, age 4.5 +/−2.2 years, mean +/− SD) were enrolled. A positive correlation between sleep problems and aggressive behavior was found, and this association was stronger in children experiencing more problematic mealtime behaviors (b = 0.788, p = 0.014). Sleep difficulties were associated with stereotyped behaviors and parent-perceived stress. Parents interviewed about the gastroenterology visit perceived this multidisciplinary approach as helpful in addressing food selectivity. This study shows that sleep and mealtime issues can have a synergistic negative impact on ASD symptoms. A multidisciplinary approach and an integrated assessment of GI, feeding problems, and sleep disorders could be helpful in diagnosing comorbidities and to provide targeted advice to parents. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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18 pages, 9713 KiB

Open AccessEditor’s ChoiceArticle

“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation

by Hege Ersdal, Paschal Mdoe, Estomih Mduma, Robert Moshiro, Godfrey Guga, Jan Terje Kvaløy, Felix Bundala, Boniphace Marwa and Benjamin Kamala

Children 2023, 10(2), 255; https://doi.org/10.3390/children10020255 - 30 Jan 2023

Cited by 7 | Viewed by 3175

Abstract

Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths [...] Read more.

Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-h newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (n = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-h newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward. Full article

(This article belongs to the Special Issue Newborn Resuscitation: Advances in Training and Practice: 2nd Edition)

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20 pages, 1312 KiB

Open AccessEditor’s ChoiceReview

Links between Childhood Obesity, High-Fat Diet, and Central Precocious Puberty

by Valeria Calcaterra, Vittoria Carlotta Magenes, Chiara Hruby, Francesca Siccardo, Alessandra Mari, Erika Cordaro, Valentina Fabiano and Gianvincenzo Zuccotti

Children 2023, 10(2), 241; https://doi.org/10.3390/children10020241 - 29 Jan 2023

Cited by 30 | Viewed by 6358

Abstract

In recent years, the existing relationship between excess overweight and central precocious puberty (CPP) has been reported, especially in girls. Different nutritional choices have been associated with different patterns of puberty. In particular, the involvement of altered biochemical and neuroendocrine pathways and a [...] Read more.

In recent years, the existing relationship between excess overweight and central precocious puberty (CPP) has been reported, especially in girls. Different nutritional choices have been associated with different patterns of puberty. In particular, the involvement of altered biochemical and neuroendocrine pathways and a proinflammatory status has been described in connection with a high-fat diet (HFD). In this narrative review, we present an overview on the relationship between obesity and precocious pubertal development, focusing on the role of HFDs as a contributor to activating the hypothalamus–pituitary–gonadal axis. Although evidence is scarce and studies limited, especially in the paediatric field, the harm of HFDs on PP is a relevant problem that cannot be ignored. Increased knowledge about HFD effects will be useful in developing strategies preventing precocious puberty in children with obesity. Promoting HFD-avoiding behavior may be useful in preserving children’s physiological development and protecting reproductive health. Controlling HFDs may represent a target for policy action to improve global health. Full article

(This article belongs to the Special Issue Eating Disorders and Obesity in Children and Adolescents: 2nd Edition)

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12 pages, 2402 KiB

Open AccessEditor’s ChoiceArticle

Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor

by Gilad Lazarovits, Noa Ofek Shlomai, Raed Kheir, Tali Bdolah Abram, Smadar Eventov Friedman and Oded Volovelsky

Children 2023, 10(2), 242; https://doi.org/10.3390/children10020242 - 29 Jan 2023

Cited by 10 | Viewed by 3056

Abstract

Background and objectives: Very low birth weight (VLBW) infants are at high risk of developing acute kidney injury (AKI), presumably secondary to low kidney reserves, stressful postnatal events, and drug exposures. Our study aimed to identify the prevalence, risk factors, and outcomes associated [...] Read more.

Background and objectives: Very low birth weight (VLBW) infants are at high risk of developing acute kidney injury (AKI), presumably secondary to low kidney reserves, stressful postnatal events, and drug exposures. Our study aimed to identify the prevalence, risk factors, and outcomes associated with AKI in VLBW infants. Study design: Records of all VLBW infants admitted to two medical campuses between January 2019 and June 2020 were retrospectively reviewed. AKI was classified using the modified KDIGO definition to include only serum creatinine. Risk factors and composite outcomes were compared between infants with and without AKI. We evaluated the main predictors of AKI and death with forward stepwise regression analysis. Results: 152 VLBW infants were enrolled. 21% of them developed AKI. Based on the multivariable analysis, the most significant predictors of AKI were the use of vasopressors, patent ductus arteriosus, and bloodstream infection. AKI had a strong and independent association with neonatal mortality. Conclusions: AKI is common in VLBW infants and is a significant risk factor for mortality. Efforts to prevent AKI are necessary to prevent its harmful effects. Full article

(This article belongs to the Special Issue Advances in Pediatric Acute Kidney Injury)

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18 pages, 3180 KiB

Open AccessEditor’s ChoiceReview

Orthodontic Retainers—A Critical Review

by Ioannis Lyros, Ioannis A. Tsolakis, Michael P. Maroulakos, Eleni Fora, Theodoros Lykogeorgos, Maria Dalampira and Apostolos I. Tsolakis

Children 2023, 10(2), 230; https://doi.org/10.3390/children10020230 - 28 Jan 2023

Cited by 19 | Viewed by 15680

Abstract

The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive [...] Read more.

The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment. Full article

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

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16 pages, 1006 KiB

Open AccessEditor’s ChoiceArticle

Socio-Emotional Competencies Required by School Counsellors to Manage Disruptive Behaviours in Secondary Schools

by Ángela Serrano, Roberto Sanz, Juan Luis Cabanillas and Elena López-Lujan

Children 2023, 10(2), 231; https://doi.org/10.3390/children10020231 - 28 Jan 2023

Cited by 9 | Viewed by 2839

Abstract

This article identifies the socio-emotional competencies of school counsellors working with children and adolescents. The aim is to address problems related to mental health and conflict and to implement training programmes. The study sample was composed of 149 counsellors working in schools. The [...] Read more.

This article identifies the socio-emotional competencies of school counsellors working with children and adolescents. The aim is to address problems related to mental health and conflict and to implement training programmes. The study sample was composed of 149 counsellors working in schools. The instruments used were the CCPES-II (questionnaire on teacher competences) and a series of open-ended questions on conflict resolution. A mixed methodology was used, with a concurrent triangulation design with two phases: a quantitative one (QUAN) and a qualitative one (QUAL). Univariate, bivariate, and correlation quantitative analyses were performed. Parametric and non-parametric tests were applied depending on the number of dependent and independent variables. The qualitative analysis was performed with the NVivo 12 computer programme, which determines word frequencies using a classic content analysis. The results confirm the relationship between socio-emotional training and rapid response to school conflict; the generalised view that conflicts are difficult to anticipate and, thus, to prevent; and the demand for specific training in socio-emotional competences, intervention strategies, more specialised school staff, more time for intervention with and support for families, and more socio-professional recognition. Full article

(This article belongs to the Special Issue Research on Socio-Emotional Development from Childhood to Adulthood)

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28 pages, 3963 KiB

Open AccessEditor’s ChoiceReview

Nutrition Profile for Countries of the Eastern Mediterranean Region with Different Income Levels: An Analytical Review

by Hanna Leppäniemi, Eman T. Ibrahim, Marwa M. S. Abbass, Elaine Borghi, Monica C. Flores-Urrutia, Elisa Dominguez Muriel, Giovanna Gatica-Domínguez, Richard Kumapley, Asmus Hammerich and Ayoub Al-Jawaldeh

Children 2023, 10(2), 236; https://doi.org/10.3390/children10020236 - 28 Jan 2023

Cited by 13 | Viewed by 8064

Abstract

The World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions [...] Read more.

The World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions and health challenges, the nutrition status is often discussed only by using either regional or country-specific estimates. This analytical review studies the nutrition situation of the EMR during the past 20 years by dividing the region into four groups based on their income level—the low-income group (Afghanistan, Somalia, Sudan, Syria, and Yemen), the lower-middle-income group (Djibouti, Egypt, Iran, Morocco, Pakistan, Palestine, and Tunisia), the upper-middle-income group (Iraq, Jordan, Lebanon, and Libya) and the high-income group (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates)—and by comparing and describing the estimates of the most important nutrition indicators, including stunting, wasting, overweight, obesity, anaemia, and early initiation and exclusive breastfeeding. The findings reveal that the trends of stunting and wasting were decreasing in all EMR income groups, while the percentages of overweight and obesity predominantly increased in all age groups across the income groups, with the only exception in the low-income group where a decreasing trend among children under five years existed. The income level was directly associated with the prevalence rates of overweight and obesity among other age groups except children under five, while an inverse association was observed regarding stunting and anaemia. Upper-middle-income country group showed the highest prevalence rate of overweight among children under five. Most countries of the EMR revealed below-desired rates of early initiation and exclusive breastfeeding. Changes in dietary patterns, nutrition transition, global and local crises, and nutrition policies are among the major explanatory factors for the findings. The scarcity of updated data remains a challenge in the region. Countries need support in filling the data gaps and implementing recommended policies and programmes to address the double burden of malnutrition. Full article

(This article belongs to the Special Issue Food Intake and Nutrition Assessment in Children: Focus on Healthy Growth)

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10 pages, 429 KiB

Open AccessEditor’s ChoiceArticle

Validation of the Concise Assessment Scale for Children’s Handwriting (BHK) in an Italian Population

by Annalivia Loizzo, Valerio Zaccaria, Barbara Caravale and Carlo Di Brina

Children 2023, 10(2), 223; https://doi.org/10.3390/children10020223 - 27 Jan 2023

Cited by 6 | Viewed by 3417

Abstract

Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children’s Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed [...] Read more.

Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children’s Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed through a copying text. The aim of the present study was to validate the Italian adaptation of the BHK in a representative primary school population. Overall, 562 children aged 7–11 from 16 public primary schools of Rome were included and asked to copy a text in 5 min using cursive handwriting. Handwriting quality and copying speed were measured. The included population followed a normal distribution for the BHK quality scores. Sex influenced the total quality scores, whereas school level influenced the copying speed. The BHK quality score was higher in girls (p < 0.05) and resulted as a stable parameter along the school years, without significant variations with regard to the years spent in handwriting exercise (p = 0.76). The handwriting speed was influenced by school level, and significant differences were found for each of the grades from the second to the fifth (p < 0.05), but not for gender (p = 0.47). Both BHK measures represent a helpful tool for the characterization and assessment of children with handwriting difficulties. The present study confirms that sex influences total BHK quality score, while school level influences handwriting speed. Full article

(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)

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12 pages, 796 KiB

Open AccessEditor’s ChoiceArticle

Protective Role of Self-Regulatory Efficacy: A Moderated Mediation Model on the Influence of Impulsivity on Cyberbullying through Moral Disengagement

by Marinella Paciello, Giuseppe Corbelli, Ileana Di Pomponio and Luca Cerniglia

Children 2023, 10(2), 219; https://doi.org/10.3390/children10020219 - 26 Jan 2023

Cited by 11 | Viewed by 2947

Abstract

During online interactions, adolescents are often exposed to deviant opportunities. In this context, the capacity to regulate one’s behavior is essential to prevent cyberbullying. Among adolescents, this online aggressive behavior is a growing phenomenon, and its deleterious effects on teenagers’ mental health are [...] Read more.

During online interactions, adolescents are often exposed to deviant opportunities. In this context, the capacity to regulate one’s behavior is essential to prevent cyberbullying. Among adolescents, this online aggressive behavior is a growing phenomenon, and its deleterious effects on teenagers’ mental health are well known. The present work argues the importance of self-regulatory capabilities under deviant peer pressure in preventing cyberbullying. In particular, focusing on two relevant risk factors, i.e., impulsivity and moral disengagement, we examine (1) the mediation role of moral disengagement in the process leading to cyberbullying from impulsivity; (2) the buffering effect of the perceived self-regulatory capability to resist deviant peer pressure in mitigating the effect of these impulsive and social–cognitive dimensions on cyberbullying. Moderated mediation analysis was performed on a sample of 856 adolescents; the results confirm that the perceived self-regulatory capability to resist peer pressure effectively mitigates the indirect effect of impulsivity through moral disengagement on cyberbullying. The practical implications of designing interventions to make adolescents more aware and self-regulated in their online social lives to counter cyberbullying are discussed. Full article

(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)

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18 pages, 3712 KiB

Open AccessEditor’s ChoiceReview

The Use of Stress Cardiovascular Imaging in Pediatric Population

by Sara Moscatelli, Francesco Bianco, Andrea Cimini, Mario Panebianco, Isabella Leo, Chiara Bucciarelli-Ducci and Marco Alfonso Perrone

Children 2023, 10(2), 218; https://doi.org/10.3390/children10020218 - 26 Jan 2023

Cited by 18 | Viewed by 4075

Abstract

Although not frequent in the pediatric population, ischemia could occur in children due to several congenital and acquired disease. Stress imaging is key for the non-invasive evaluation of myocardial abnormalities and perfusion defect in this clinical setting. Moreover, beyond ischemia assessment, it can [...] Read more.

Although not frequent in the pediatric population, ischemia could occur in children due to several congenital and acquired disease. Stress imaging is key for the non-invasive evaluation of myocardial abnormalities and perfusion defect in this clinical setting. Moreover, beyond ischemia assessment, it can provide complementary diagnostic and prognostic information in valvular heart disease and cardiomyopathies. When performed using cardiovascular magnetic resonance, it could detect, in addition, myocardial fibrosis and infarction, increasing the diagnostic yield. Several imaging modalities are currently available for the evaluation of stress myocardial perfusion. Advances in technologies have also increased the feasibility, safety and availability of these modalities in the pediatric age group. However, despite the established role of stress imaging and its increasing use in daily clinical practice, there are currently no specific guidelines, and little data are available in the literature on this topic. The aim of this review is to summarize the most recent evidence on pediatric stress imaging and its clinical application with a focus on the advantages and limitations of each imaging modality currently available. Full article

(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology: 2nd Edition)

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12 pages, 636 KiB

Open AccessEditor’s ChoiceCase Report

Effects of the Whole-Body Vibration Exercise on Sleep Disorders, Body Temperature, Body Composition, Tone, and Clinical Parameters in a Child with Down Syndrome Who Underwent Total Atrioventricular Septal Defect Surgery: A Case-Report

by Luiza Torres-Nunes, Patrícia Prado da Costa-Borges, Laisa Liane Paineiras-Domingos, José Alexandre Bachur, Ana Carolina Coelho-Oliveira, Danúbia da Cunha de Sá-Caputo and Mario Bernardo-Filho

Children 2023, 10(2), 213; https://doi.org/10.3390/children10020213 - 25 Jan 2023

Cited by 7 | Viewed by 3254

Abstract

Background: The health and developmental issues of people with Down syndrome (DS) are complex and are associated with many medical, psychological, and social problems from childhood through into adulthood. DS children have an increased risk of multiorgan comorbidities, including congenital heart disease. Atrioventricular [...] Read more.

Background: The health and developmental issues of people with Down syndrome (DS) are complex and are associated with many medical, psychological, and social problems from childhood through into adulthood. DS children have an increased risk of multiorgan comorbidities, including congenital heart disease. Atrioventricular septal defect (AVSD) is a congenital heart malformation that often occurs in DS people. Aim: Physical activity and exercise are recommended for patients with cardiovascular disease and are considered to be the gold standard of cardiac rehabilitation. Whole-body vibration exercise (WBVE) is considered a form of exercises. The aim of this case report is to show the effects of WBVE on sleep disturbances, body temperature, body composition, tone, and clinical parameters in a child with DS with corrected total AVSD. The subject is a 10-year-old girl, with free-type DS, who underwent surgery to correct a total AVSD at 6 months. She underwent periodic cardiological monitoring and was released to perform any type of physical exercise, including WBVE. WBVE improved sleep quality and body composition. Conclusion: WBVE leads to physiological effects that benefit the DS child. Full article

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

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11 pages, 662 KiB

Open AccessEditor’s ChoiceArticle

Monitoring of Auditory Function in Newborns of Women Infected by SARS-CoV-2 during Pregnancy

by Enrico Apa, Maria Teresa Presutti, Cecilia Rossi, Maria Federica Roversi, Salvatore Neri, Giancarlo Gargano, Giovanni Bianchin, Valeria Polizzi, Valeria Caragli, Daniele Monzani, Alberto Berardi, Silvia Palma and Elisabetta Genovese

Children 2023, 10(2), 194; https://doi.org/10.3390/children10020194 - 20 Jan 2023

Cited by 7 | Viewed by 2304

Abstract

Background: Gestational SARS-CoV-2 infection can impact maternal and neonatal health. The virus has also been reported to cause newborn sensorineural hearing loss, but its consequences for the auditory system are not fully understood. Objective: The aim of this study was to evaluate the [...] Read more.

Background: Gestational SARS-CoV-2 infection can impact maternal and neonatal health. The virus has also been reported to cause newborn sensorineural hearing loss, but its consequences for the auditory system are not fully understood. Objective: The aim of this study was to evaluate the impact of maternal SARS-CoV-2 infection during pregnancy on newborn’ hearing function during the first year of life. Methods: An observational study was conducted from 1 November 2020 to 30 November 2021 at University Modena Hospital. All newborns whose mother had been infected by SARS-CoV-2 during pregnancy were enrolled and underwent audiological evaluation at birth and at 1 year of age. Results: A total of 119 neonates were born from mothers infected by SARS-CoV-2 during pregnancy. At birth, five newborns (4.2%) presented an increased threshold of ABR (Auditory Brainstem Evoked Response), but the results were confirmed only in 1.6% of cases, when repeated 1 month later, while the ABR thresholds in all other children returned to normal limits. At the 1-year follow-up, no cases of moderate or severe hearing loss were observed, while concomitant disorders of the middle ear were frequently observed. Conclusions: Maternal SARS-CoV-2 infection, regardless of the trimester in which it was contracted, appears not to induce moderate or severe hearing loss in infants. It is important to clarify the possible effect of the virus on late-onset hearing loss and future research is needed. Full article

(This article belongs to the Special Issue Hearing Disorders in Children: Early Intervention, Treatment and Rehabilitation)

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17 pages, 637 KiB

Open AccessEditor’s ChoiceReview

Fathers’ Experiences of Caring for a Child with a Chronic Illness: A Systematic Review

by Shelley Spurr, Cynthia A. Danford, Karyn J. Roberts, Debbie Sheppard-LeMoine, Fernanda Machado Silva-Rodrigues, Michelle Darezzo Rodrigues Nunes, Leslie Darmofal, Anne L. Ersig, Mandie Foster, Barbara Giambra, Stacee Lerret, Michele Polfuss, Lindsay Smith and Suja Somanadhan

Children 2023, 10(2), 197; https://doi.org/10.3390/children10020197 - 20 Jan 2023

Cited by 26 | Viewed by 7414

Abstract

The prevalence of children living with chronic health conditions is increasing worldwide and can disrupt family roles, relationships, function, and parental involvement in family caregiving. The purpose of this systematic review was to explore fathers’ experiences and involvement in caring for a child [...] Read more.

The prevalence of children living with chronic health conditions is increasing worldwide and can disrupt family roles, relationships, function, and parental involvement in family caregiving. The purpose of this systematic review was to explore fathers’ experiences and involvement in caring for a child with a chronic condition. Systematic searches using seven databases were conducted. Study criteria included (1) peer-reviewed original research in English, Spanish, French, or Portuguese, (2) children less than 19 years of age with a chronic condition, (3) fathers (biological or guardian) as direct informants, and (4) outcomes addressing fathers’ experience, perceptions, and/or involvement in the child’s care. Data were synthesized from ten articles reflecting eight separate studies that utilized quantitative designs. Three areas of focus were identified: Family Functioning, Father’s Psychological Health, and Need for Support. Data suggested increased involvement from the father in caring for their child with a chronic condition was associated with improved family functioning, increased anxiety and distress, decreased self-esteem, and increased need for support. This review revealed a paucity of data regarding fathers’ experiences and involvement when caring for a child with a chronic condition, with that available primarily from developed countries. Rigorous empirical studies are needed to deepen understanding of how fathers are involved in the care of their child with a chronic condition. Full article

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

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13 pages, 570 KiB

Open AccessEditor’s ChoiceArticle

Should Perirectal Swab Culture Be Performed in Cases Admitted to the Neonatal Intensive Care Unit? Lessons Learned from the Neonatal Intensive Care Unit

by Aysen Orman, Yalcin Celik, Guliz Evik, Gulden Ersöz, Necdet Kuyucu and Berfin Ozgokce Ozmen

Children 2023, 10(2), 187; https://doi.org/10.3390/children10020187 - 19 Jan 2023

Cited by 6 | Viewed by 2447

Abstract

Serial perirectal swabs are used to identify colonization of multidrug-resistant bacteria and prevent spread. The purpose of this study was to determine colonization with carbapenem-resistant Enterobacterales (CRE) and vancomycin-resistant Enterococci (VRE). An additional purpose was to establish whether sepsis and epidemic associated with [...] Read more.

Serial perirectal swabs are used to identify colonization of multidrug-resistant bacteria and prevent spread. The purpose of this study was to determine colonization with carbapenem-resistant Enterobacterales (CRE) and vancomycin-resistant Enterococci (VRE). An additional purpose was to establish whether sepsis and epidemic associated with these factors were present in the neonatal intensive care unit (NICU), to which infants with hospital stays exceeding 48 h in an external healthcare center NICU were admitted. Perirectal swab samples were collected in the first 24 h by a trained infection nurse using sterile cotton swabs moistened with 0.9% NaCl from patients admitted to our unit after hospitalization exceeding 48 h in an external center. The primary outcome was positivity in perirectal swab cultures, and the secondary outcomes were whether this caused invasive infection and significant NICU outbreaks. A total of 125 newborns meeting the study criteria referred from external healthcare centers between January 2018 and January 2022 were enrolled. Analysis revealed that CRE constituted 27.2% of perirectal swab positivity and VRE 4.8%, and that one in every 4.4 infants included in the study exhibited perirectal swab positivity. The detection of colonization by these microorganisms, and including them within the scope of surveillance, is an important factor in the prevention of NICU epidemics. Full article

(This article belongs to the Special Issue Advances in Healthcare for Neonates)

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10 pages, 658 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Risk Factors of Language Delay at Two Years of Corrected Age among Very-Low-Birth-Weight Preterm Infants: A Population-Based Study

by Wei-Lun Tseng, Chia-Huei Chen, Jui-Hsing Chang, Chun-Chih Peng, Wai-Tim Jim, Chia-Ying Lin, Chyong-Hsin Hsu, Tzu-Yu Liu, Hung-Yang Chang and on behalf of the Taiwan Premature Infant Follow-up Network

Children 2023, 10(2), 189; https://doi.org/10.3390/children10020189 - 19 Jan 2023

Cited by 7 | Viewed by 3381

Abstract

Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the [...] Read more.

Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the Bayley Scale of Infant Development, third edition, were included using a population-based cohort database. Language delay was defined as mild to moderate if the composite score was between 70 and 85 and severe if the score was < 70. Multivariable logistic regression analysis was used to identify the perinatal risk factors associated with language delay. The study comprised 3797 VLBW preterm infants; 678 (18%) had a mild to moderate delay and 235 (6%) had a severe delay. After adjusting for confounding factors, low maternal education level, low maternal socioeconomic status, extremely low birth weight, male sex, and severe intraventricular hemorrhage (IVH) and/or cystic periventricular leukomalacia (PVL) were found to be significantly associated with both mild to moderate and severe delays. Resuscitation at delivery, necrotizing enterocolitis, and patent ductus arteriosus requiring ligation showed significant associations with severe delay. The strongest factors predicting both mild to moderate and severe language delays were the male sex and severe IVH and/or cystic PVL; thus, early targeted intervention is warranted in these populations. Full article

(This article belongs to the Special Issue Intensive Care for Very Preterm Infants)

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11 pages, 236 KiB

Open AccessEditor’s ChoiceArticle

A Multicentre Italian Study on the Psychological Impact of an Inconclusive Cystic Fibrosis Diagnosis after Positive Neonatal Screening

by Antonella Tosco, Diletta Marino, Sara Polizzi, Valentina Tradati, Rita Padoan, Claudia Giust, Benedetta Fabrizzi, Giovanni Taccetti, Lucia Merli and Vito Terlizzi

Children 2023, 10(2), 177; https://doi.org/10.3390/children10020177 - 18 Jan 2023

Cited by 8 | Viewed by 2404

Abstract

Background: An inconclusive diagnosis of cystic fibrosis (CF) after positive newborn screening (NBS) may cause parental distress. We compared the psychological impact of CF transmembrane conductance regulator-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID), and clear CF diagnosis, on parents. Methods: The participants [...] Read more.

Background: An inconclusive diagnosis of cystic fibrosis (CF) after positive newborn screening (NBS) may cause parental distress. We compared the psychological impact of CF transmembrane conductance regulator-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID), and clear CF diagnosis, on parents. Methods: The participants were administered the Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, and the Italian version of the Impact of Event Scale-Revised as quantitative tools and semi-structured interviews as qualitative tools. Parental experience, child representation, relationships, future information, and perception of health status were investigated. Interviews were recorded and transcribed verbatim maintaining anonymity. Results: Thirty-two families were enrolled: sixteen with CF and CRMS/CFSPID, respectively. Anxiety and depression values were high in both groups, as were the measurement of traumatic impact subscales: avoidance, intrusiveness, and hyperarousal. The children’s health was evaluated by respective parents as being nearly healthy. Conclusions: Our results highlight negative psychological impacts, including emotional and affective representations, on parents of children with inconclusive CF diagnosis compared with those with clear diagnosis. Full article

(This article belongs to the Special Issue Lung Diseases in Children: From Rarer to Commonest)

22 pages, 1070 KiB

Open AccessEditor’s ChoiceReview

Pediatric Glaucoma—From Screening, Early Detection to Management

by Ruyue Shen, Venice S. W. Li, Mandy O. M. Wong and Poemen P. M. Chan

Children 2023, 10(2), 181; https://doi.org/10.3390/children10020181 - 18 Jan 2023

Cited by 11 | Viewed by 4783

Abstract

Pediatric glaucoma (PG) covers a rare and heterogeneous group of diseases with variable causes and presentations. Delayed diagnosis of PG could lead to blindness, bringing emotional and psychological burdens to patients’ caregivers. Recent genetic studies identified novel causative genes, which may provide new [...] Read more.

Pediatric glaucoma (PG) covers a rare and heterogeneous group of diseases with variable causes and presentations. Delayed diagnosis of PG could lead to blindness, bringing emotional and psychological burdens to patients’ caregivers. Recent genetic studies identified novel causative genes, which may provide new insight into the etiology of PG. More effective screening strategies could be beneficial for timely diagnosis and treatment. New findings on clinical characteristics and the latest examination instruments have provided additional evidence for diagnosing PG. In addition to IOP-lowering therapy, managing concomitant amblyopia and other associated ocular pathologies is essential to achieve a better visual outcome. Surgical treatment is usually required although medication is often used before surgery. These include angle surgeries, filtering surgeries, minimally invasive glaucoma surgeries, cyclophotocoagulation, and deep sclerectomy. Several advanced surgical therapies have been developed to increase success rates and decrease postoperative complications. Here, we review the classification and diagnosis, etiology, screening, clinical characteristics, examinations, and management of PG. Full article

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

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11 pages, 769 KiB

Open AccessEditor’s ChoiceArticle

The Impact of a Family-Centred Intervention for Parents of Children with Developmental Disabilities: A Model Project in Rural Ireland

by Roy McConkey, Pauline O’Hagan and Joanne Corcoran

Children 2023, 10(2), 175; https://doi.org/10.3390/children10020175 - 17 Jan 2023

Cited by 8 | Viewed by 4073

Abstract

The greater risk of poor mental health and social isolation, experienced by parents of children with developmental disabilities, is compounded by family circumstances and living in rural settings. Often parents receive little personal support. Family-centred interventions have been recommended internationally for promoting children’s [...] Read more.

The greater risk of poor mental health and social isolation, experienced by parents of children with developmental disabilities, is compounded by family circumstances and living in rural settings. Often parents receive little personal support. Family-centred interventions have been recommended internationally for promoting children’s development, as well as boosting parental wellbeing. Yet, in many countries, current service provision is predominately child-focused and clinic-centred. An innovative, family-centred support service was designed and evaluated in a rural county of Ireland. Support staff visit the family home every month for around one year with regular check-ins by phone. The service aims included setting developmental goals for the child that were agreed with parents, alongside actions to address the personal needs of parents and siblings. In addition, community activities are identified or created to promote the social inclusion of the child and family in local communities, as well as locating opportunities for social activities for mothers. To date, 96 families with 110 children have been involved and three monthly reviews have been undertaken of each child’s progress. Baseline measures on parents’ mental health and social isolation were gathered and repeated when parents had completed their involvement with the project, along with qualitative information regarding the parents’ experiences. Most children attained their learning targets, alongside those selected as personal goals by parents; in particular, parents reported their child’s greater involvement in community activities, increased knowledge and skills, and with more confidence and resilience. Significant increases in parental well-being scores were reported, but there was a limited impact on their social participation and that of their child. This evidence-based model of provision is an example of how current social care provision for families who have a child with developmental disabilities could be cost-effectively re-envisioned even in rural areas. Full article

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

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12 pages, 1189 KiB

Open AccessEditor’s ChoiceArticle

Analysis of Clinical Symptoms and Biochemical Parameters in Odontogenic Cellulitis of the Head and Neck Region in Children

by Adrianna Słotwińska-Pawlaczyk, Bogusława Orzechowska-Wylęgała, Katarzyna Latusek and Anna Maria Roszkowska

Children 2023, 10(1), 172; https://doi.org/10.3390/children10010172 - 16 Jan 2023

Cited by 5 | Viewed by 2945

Abstract

Many cases of cellulitis in the head and neck region among hospitalized pediatric patients are related to odontogenic infections. C-reactive protein (CRP), white blood cell (WBC) count, neutrophils to lymphocytes ratio (NLR), D-dimer, and prealbumin can be used to assess the severity of [...] Read more.

Many cases of cellulitis in the head and neck region among hospitalized pediatric patients are related to odontogenic infections. C-reactive protein (CRP), white blood cell (WBC) count, neutrophils to lymphocytes ratio (NLR), D-dimer, and prealbumin can be used to assess the severity of odontogenic inflammation. The aim of the study is to evaluate the biochemical parameters as a predictor factor of the severity of odontogenic cellulitis in children. This study was conducted from 2020 to 2021 on patients admitted to the Department of Pediatric Otolaryngology and Pediatric Head and Neck Surgery of the Upper Silesian Children’s Health Center in Katowice. We included 40 patients aged 2–16 in the study, who were divided into two groups: research (SS-Study subject) (n = 20) and control (CS-Control subject) (n = 20). The patients underwent an interview and physical examination to assess the presence of intraoral and extraoral swelling and the presence of trismus. The patients who qualified for the study had blood taken to determine the level of CRP, WBCs, NLR, D-dimers, and prealbumin. Differences in biochemical test results in the SS and CS were statistically significant (p < 0.05). In the SS group, the mean values of biochemical parameters exceeded the clinical norm. A statistically significant positive relationship was found between CRP and extraoral swelling. The NLR correlates significantly with extraoral swelling and the length of hospitalization. D-dimer statistically correlated with trismus, extraoral swelling, and the number of anatomical spaces involved. The NLR and CRP ratio can be considered a prognostic marker of the course of infection and hospitalization time. Full article

(This article belongs to the Special Issue Oral Health Behaviours and Their Predictors in Children)

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