Children

8 pages, 245 KiB

Open AccessEditor’s ChoiceArticle

Lung Ultrasound Role in Diagnosis of Neonatal Respiratory Disorders: A Prospective Cross-Sectional Study

by Rania Ismail, Nehal M. El Raggal, Laila A. Hegazy, Hossam M. Sakr, Osama A. Eldafrawy and Yasmin A. Farid

Children 2023, 10(1), 173; https://doi.org/10.3390/children10010173 - 16 Jan 2023

Cited by 7 | Viewed by 3479

Abstract

Lung ultrasound (LUS) has become one of the most exciting applications in neonatal point-of-care ultrasound (POCUS), yet still lacks routine clinical use. This study assesses the utility of LUS for neonatal respiratory disorders (NRDs) diagnosis and follow-up compared to chest X-ray (CXR). A [...] Read more.

Lung ultrasound (LUS) has become one of the most exciting applications in neonatal point-of-care ultrasound (POCUS), yet still lacks routine clinical use. This study assesses the utility of LUS for neonatal respiratory disorders (NRDs) diagnosis and follow-up compared to chest X-ray (CXR). A prospective cross-sectional study was conducted on 100 neonates having NRDs with a gestational age ≥28 weeks, excluding those having multiple congenital anomalies, chromosomal aberrations, hydrops fetalis and/or heart failure. CXR and LUS were done on admission for diagnosis and were repeated after 7 days, or if needed earlier within the 7 days. The diagnosis of NRDs by CXR and LUS on admission and after 7 days was comparable (p > 0.05). LUS diagnosis sensitivity and specificity for respiratory distress syndrome, pneumonia, meconium aspiration syndrome, pneumothorax and pulmonary atelectasis were 94.7/100%, 97.5/95%, 92.3/100%, 90.9/98.9% and 100/97.8%, respectively. The total agreement between LUS and CXR was 98.5% with 95% CI (0.88 to 0.92). LUS and CXR had considerable agreement in the diagnosis of NRDs. Being a reliable bedside modality of diagnosis and safer than CXR, LUS may be considered an alternative method for the diagnosis of neonates with NRDs. Full article

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

8 pages, 792 KiB

Open AccessEditor’s ChoiceArticle

Evaluating Emotional Outcomes of Medical Students in Pediatric Emergency Medicine Telesimulation

by Osamu Nomura, Momoka Sunohara, Ichiro Watanabe and Taichi Itoh

Children 2023, 10(1), 169; https://doi.org/10.3390/children10010169 - 15 Jan 2023

Cited by 6 | Viewed by 2352

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has challenged the feasibility of traditional in-person simulation-based clinical training due to the public health recommendation on social distancing. During the pandemic, telesimulation training was implemented to avoid multiple students and faculties gathering in confined spaces. While [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic has challenged the feasibility of traditional in-person simulation-based clinical training due to the public health recommendation on social distancing. During the pandemic, telesimulation training was implemented to avoid multiple students and faculties gathering in confined spaces. While medical trainees’ perceived emotions have been acknowledged as a critical outcome of the in-person simulation-based training, the impact of telesimulation on trainees’ emotions has been unexamined. We conducted an educational team-based simulation study with a pediatric case of septic shock. Seventeen and twenty-four medical students participated in the telesimulation training and in-person simulation training, respectively. The institutional pandemic social restrictions at the time of each training session determined the participant assignment to either the telesimulation training or in-person simulation training. All participants responded to the Japanese version of the Medical Emotion Scale, which includes 20 items rated on a five-point Likert-type scale before, during, and after the simulation sessions. The measured emotions were categized into four emotion groups according to two dimensions: positive or negative and activating or deactivating emotions. The one-way analysis of variance between the telesimulation and in-person simulation training revealed no significant differences in the emotions perceived by the participants before, during, and after the simulation training sessions. The perceived emotions of medical students were comparable between the telesimulation and in-person simulation training. Further longitudinal studies with larger samples and multiple variables are needed to generalize the effectiveness of telesimulation. Full article

(This article belongs to the Special Issue Pediatric Injuries: New Insights into Management, Prevention, and Education)

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18 pages, 1680 KiB

Open AccessEditor’s ChoiceArticle

The Psychosocial Effect of Parental Cancer: Qualitative Interviews with Patients’ Dependent Children

by Elise S. Alexander, Moira O’Connor and Georgia K. B. Halkett

Children 2023, 10(1), 171; https://doi.org/10.3390/children10010171 - 15 Jan 2023

Cited by 17 | Viewed by 5744

Abstract

Background: Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent’s diagnosis is still developing and patients’ children are typically invisible in clinical practice. This study [...] Read more.

Background: Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent’s diagnosis is still developing and patients’ children are typically invisible in clinical practice. This study aimed to investigate how children are affected by their parent’s cancer diagnosis, from children’s perspectives. Methods: Informed by methods of grounded theory and embedded within a social constructivist framework, twelve children (ranging from 5 to 17 years) living with a parent with cancer were interviewed using a semi-structured format assisted by a novel approach derived from play- and art-based developmental literature. Results: Findings indicate that patients’ children are constantly worried and distressed, and there are barriers that can be overcome to mitigate this. Four overarching themes were identified: (I) Feeling worried and distressed; (II) Comprehending their parent’s cancer diagnosis; (III) Being disconnected from their supports; and (IV) Needing someone to talk to. Conclusions: Children experience considerable levels of ongoing worry and distress when a parent is diagnosed with cancer and have difficulties comprehending and articulating this. They also feel a level of disconnection from their usual support systems (e.g., parents) and are limited regarding who they can seek out and talk to. Mitigating children’s ongoing worries and distress by promoting the availability and accessibility of parents and other supports to children, and reducing communication barriers between children and adults, should be a primary focus of psycho-oncology research and practice. Full article

(This article belongs to the Special Issue Recent Advances in Clinical Child and Adolescent Psychology and Psychotherapy)

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13 pages, 431 KiB

Open AccessEditor’s ChoiceArticle

Change in Prevalence of Hypertension among Korean Children and Adolescents during the Coronavirus Disease 2019 (COVID-19) Outbreak: A Population-Based Study

by Kyungchul Song, Se Yong Jung, Juyeon Yang, Hye Sun Lee, Ho-Seong Kim and Hyun Wook Chae

Children 2023, 10(1), 159; https://doi.org/10.3390/children10010159 - 14 Jan 2023

Cited by 9 | Viewed by 2638

Abstract

During the coronavirus disease 2019 (COVID-19) outbreak, the prevalence of obesity increased globally; this may be associated with hypertension incidence. However, investigations on the changes in the prevalence of hypertension among children and adolescents are limited. This cross-sectional study investigated the prevalence of [...] Read more.

During the coronavirus disease 2019 (COVID-19) outbreak, the prevalence of obesity increased globally; this may be associated with hypertension incidence. However, investigations on the changes in the prevalence of hypertension among children and adolescents are limited. This cross-sectional study investigated the prevalence of hypertension among 1428 youths aged 10–18 years using data from the Korea National Health and Nutrition Examination Survey 2018–2020. We assessed the prevalence of hypertension according to sex, age, body mass index (BMI), and residential district. The prevalence of hypertension increased from 7.1% to 12.5% in all participants. In the sex-specific analysis, the prevalence was found to be increased in boys. In the age-specific analysis, the prevalence was found to be increased in youths aged 13–15 years. In the BMI-specific analysis, an increase in the prevalence was prominent in the normal BMI group. In the residential district-specific analysis, the prevalence of hypertension among youth increased in urban areas. Our results show that the prevalence of hypertension increased among Korean children and adolescents during the COVID-19 outbreak. These findings suggest the importance of close monitoring of hypertension among youth during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Cardiovascular Disease in Children)

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13 pages, 919 KiB

Open AccessEditor’s ChoiceArticle

Impact of Delayed Time to Antibiotics in Medical and Surgical Necrotizing Enterocolitis

by Katherine E. Chetta, Katherine G. Vincent, Bresney Fanning, Ashley B. Klumb, Justin A. Chetta, Allison M. Rohrer, Leslie H. Spence and Jeanne G. Hill

Children 2023, 10(1), 160; https://doi.org/10.3390/children10010160 - 14 Jan 2023

Cited by 6 | Viewed by 3570

Abstract

This study investigated whether delayed receipt of antibiotics in infants with necrotizing enterocolitis (NEC) is associated with disease severity. In this retrospective, single-center cohort study of infants diagnosed with NEC over 4 years, we compared the timing of antibiotic administration in infants (time [...] Read more.

This study investigated whether delayed receipt of antibiotics in infants with necrotizing enterocolitis (NEC) is associated with disease severity. In this retrospective, single-center cohort study of infants diagnosed with NEC over 4 years, we compared the timing of antibiotic administration in infants (time order placed to time of receipt) in medical and surgical NEC. Cases were independently reviewed, then various clinical factors were compared. Of 46 suspected cases, 25 were confirmed by a panel of radiologists with good interrater reliability (ICC 0.657; p < 0.001). Delays in antibiotic receipt were 1.7× greater in surgical than medical NEC cases (p = 0.049). Every hour after order entry increased the adjusted odds of surgical NEC by 2.4 (1.08–5.23; p = 0.032). Delayed antibiotic receipt was more common in infants with surgical than medical NEC. Larger studies will be needed to investigate if optimizing antibiotic expediency could improve intestinal outcomes. Full article

(This article belongs to the Special Issue Practical Issues in Treatment of Preterm Infants)

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15 pages, 2540 KiB

Open AccessEditor’s ChoiceArticle

The Development and Usability of a Mobile App for Parents of Children with ADHD

by Costina-Ruxandra Păsărelu, Reka Kertesz and Anca Dobrean

Children 2023, 10(1), 164; https://doi.org/10.3390/children10010164 - 14 Jan 2023

Cited by 12 | Viewed by 4744

Abstract

Background: Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT [...] Read more.

Background: Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT in order to increase treatment adherence, homework compliance, and parental engagement. In this paper, we describe the development process of a mobile app for parents of children with ADHD. Methods: We conducted a study to investigate parents’ perceived usability of the ADHD Coping Card. Results: The mobile app developed has a high usability. Future improvements in the app were suggested by parents. Conclusions: Given the increasing importance of digital mental health interventions in psychotherapy, it is important that future research is conducted with a higher number of participants to investigate the key factors implicated in choosing such an intervention in the future, both by parents and by mental health specialists. A mobile app can be used as an add-on in psychotherapy with parents of children with ADHD. Digital health interventions could help surpass gaps in treatment access for child mental health problems. Full article

(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health)

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18 pages, 1018 KiB

Open AccessEditor’s ChoiceReview

Diagnosis and Management of Cancer Treatment-Related Cardiac Dysfunction and Heart Failure in Children

by Mohamed Hegazy, Stephanie Ghaleb and Bibhuti B Das

Children 2023, 10(1), 149; https://doi.org/10.3390/children10010149 - 12 Jan 2023

Cited by 16 | Viewed by 4866

Abstract

It is disheartening for parents to discover that their children have long-term cardiac dysfunction after being cured of life-threatening childhood cancers. As the number of childhood cancer survivors increases, early and late oncology-therapy-related cardiovascular complications continues to rise. It is essential to understand [...] Read more.

It is disheartening for parents to discover that their children have long-term cardiac dysfunction after being cured of life-threatening childhood cancers. As the number of childhood cancer survivors increases, early and late oncology-therapy-related cardiovascular complications continues to rise. It is essential to understand that cardiotoxicity in childhood cancer survivors is persistent and progressive. A child’s cancer experience extends throughout his lifetime, and ongoing care for long-term survivors is recognized as an essential part of the cancer care continuum. Initially, there was a lack of recognition of late cardiotoxicities related to cancer therapy. About 38 years ago, in 1984, pioneers like Dr. Lipshultz and others published anecdotal case reports of late cardiotoxicities in children and adolescents exposed to chemotherapy, including some who ended up with heart transplantation. At that time, cardiac tests for cancer survivors were denied by insurance companies because they did not meet appropriate use criteria. Since then, cardio-oncology has been an emerging field of cardiology that focuses on the early detection of cancer therapy-related cardiac dysfunction occurring during and after oncological treatment. The passionate pursuit of many healthcare professionals to make life better for childhood cancer survivors led to more than 10,000 peer-reviewed publications in the last 40 years. We synthesized the existing evidence-based practice and described our experiences in this review to share our current method of surveillance and management of cardiac dysfunction related to cancer therapy. This review aims to discuss the pathological basis of cancer therapy-related cardiac dysfunction and heart failure, how to stratify patients prone to cardiotoxicity by identifying modifiable risk factors, early detection of cardiac dysfunction, and prevention and management of heart failure during and after cancer therapy in children. We emphasize serial longitudinal follow-ups of childhood cancer survivors and targeted intervention for high-risk patients. We describe our experience with the new paradigm of cardio-oncology care, and collaboration between cardiologist and oncologist is needed to maximize cancer survival while minimizing late cardiotoxicity. Full article

(This article belongs to the Section Pediatric Cardiology)

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12 pages, 1567 KiB

Open AccessEditor’s ChoiceArticle

The Role of Emotion Regulation and Executive Functioning in the Intervention Outcome of Children with Emotional and Behavioural Problems

by Blossom Fernandes, Mark Wright and Cecilia A. Essau

Children 2023, 10(1), 139; https://doi.org/10.3390/children10010139 - 11 Jan 2023

Cited by 15 | Viewed by 6735

Abstract

Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem [...] Read more.

Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem scores post-intervention, and further explore the extent to which emotion regulation mediates these outcomes. Participants were 41 primary school children who exhibited emotional and/or behavioural problems, aged 8 to 11 years. All the children completed measures of emotional and behavioural problems, cognitive emotion regulation, anxiety symptoms, and performed two experimental tasks to measure working memory and response inhibition before and after participating in a transdiagnostic Cognitive Behaviour Therapy-based programme, “Super Skills for Life” (SSL), and at 3-months follow-up. Results revealed significant reduction in the use of maladaptive emotion regulation strategy catastrophising and other blame following the intervention. Additionally, EF and emotion regulation was associated with outcomes for emotional problems and conduct problems. More specifically maladaptive emotion regulation strategy such as catastrophising and other blame was closely related with self-reports of emotional problems, likewise other blame, was also linked with scores of conduct problems. This study provides preliminary empirical support for EF and emotion regulation in predicting outcomes of emotional and behavioural problems in children following intervention. Full article

(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)

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14 pages, 498 KiB

Open AccessEditor’s ChoiceArticle

Prevalence and Determinants of Depressive Symptoms among Young Adolescents in Malaysia: A Cross-Sectional Study

by Sarbhan Singh, Chee Herng Lai, Nuur Hafizah Md Iderus, Sumarni Mohd Ghazali, Lonny Chen Rong Qi Ahmad, Lim Mei Cheng, Mohamad Nadzmi Nadzri, Asrul Anuar Zulkifli, Jeyanthi Suppiah, Rafdzah Ahmad Zaki, Nik Daliana Nik Farid, Rama Krishna Supramanian, Awatef Amer Nordin, Chong Zhuo Lin, Kushilpal Kaur and Nur’ain Mohd Ghazali

Children 2023, 10(1), 141; https://doi.org/10.3390/children10010141 - 11 Jan 2023

Cited by 9 | Viewed by 8381

Abstract

Depression is the most common mental health problem affecting adolescents globally, wherein its increasing prevalence together with the negative health impacts escalates the need for further research in this area. This work determined the prevalence and factors associated with depressive symptoms among young [...] Read more.

Depression is the most common mental health problem affecting adolescents globally, wherein its increasing prevalence together with the negative health impacts escalates the need for further research in this area. This work determined the prevalence and factors associated with depressive symptoms among young adolescents in Malaysia. A total of 1350 adolescent aged 13 to 14 years in school across nine secondary schools in Selangor state, Malaysia participated in a cross-sectional study. Independent variables were examined using the using the Global School-Based Student Health Survey included age, gender, ethnicity, alcohol intake, smoking and illicit drug use, loneliness, bullying, parental marital status, income and supervision; and the Health Literacy and Stigma questionnaire examined mental health literacy levels. Depressive symptoms were the dependent variable which was examined using the Center for Epidemiology Study Depression (CESD) instrument. Prevalence of depressive symptoms among all participants was 19 % (95% CI [16.9, 21.2]), with a higher prevalence of depressive symptoms being reported among females 26.3% (95% CI [23.0, 29.8]) compared to males 11.7% (95% CI [9.4, 14.4]). Determinants namely females (AOR = 3.83; 95% CI [2.66, 5.52]), smoking (AOR = 6.16; 95% CI [3.15, 12.05]), been bullied (AOR = 3.70; 95% CI [2.51, 5.47]), felt lonely (AOR = 10.46; 95% CI [7.09, 15.42]) and having no parental supervision (AOR = 1.79; 95% CI [1.26, 2.53]) significantly increased the odds of depressive symptoms among all adolescents in the multivariate model. In addition, feeling lonely, being bullied and smoking were identified as common significant determinants of depressive symptoms across both genders. Feeling lonely (65% to 71%) and being bullied (10% to 19%) were ranked as the most important determinants of depressive symptoms among young adolescents. Tackling these factors would be instrumental in helping decision makers formulate depression prevention strategies and activities for adolescents. Full article

(This article belongs to the Special Issue Predictors and Diagnosis of Depressive Symptoms in Children and Adolescents)

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14 pages, 2361 KiB

Open AccessEditor’s ChoiceReview

Associations between Chronic Pain and Attention-Deficit Hyperactivity Disorder (ADHD) in Youth: A Scoping Review

by Eleanor A. J. Battison, Patrick C. M. Brown, Amy L. Holley and Anna C. Wilson

Children 2023, 10(1), 142; https://doi.org/10.3390/children10010142 - 11 Jan 2023

Cited by 13 | Viewed by 9247

Abstract

Background: Chronic pain and ADHD are common conditions among youth that negatively impact functioning. This review fills a critical gap by summarizing current research on chronic pain and ADHD comorbidity, and it proposes a conceptual model of shared associations and underlying mechanisms. Objective: [...] Read more.

Background: Chronic pain and ADHD are common conditions among youth that negatively impact functioning. This review fills a critical gap by summarizing current research on chronic pain and ADHD comorbidity, and it proposes a conceptual model of shared associations and underlying mechanisms. Objective: The aims of the current study were to: (1) review the extant literature and present estimates of the prevalence of comorbid non-headache chronic pain and ADHD in youth and (2) describe potential shared mechanisms for ADHD and chronic non-headache pain in youth. We also outline future directions to inform future research and interventions directed to youth with comorbid pain and ADHD. Design: A scoping review of the literature was performed in MEDLINE, PsycInfo, and Cochrane Database of Systematic Reviews using a wide range of search terms related to pain, Attention Deficit-Hyperactivity Disorder, childhood, adolescence, and young adulthood. Results: Eleven published studies were included in the review. These studies examined the prevalence of chronic pain among youth with ADHD, the prevalence of ADHD in chronic pain samples, and the association between chronic pain and ADHD among youth. Findings revealed results from studies indicating a higher prevalence of ADHD among youth with chronic pain and a higher prevalence of chronic pain in samples of youth with ADHD. Conclusions: Findings from this scoping review suggest an association between chronic pain and ADHD among youth. Little research was found to examine the etiology of this association. Future studies should examine underlying mechanisms of comorbid chronic pain and ADHD. Full article

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

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14 pages, 1002 KiB

Open AccessEditor’s ChoiceArticle

Integration of Obese Children in Physical Education Sessions: An Exploratory Study

by Bilel Aydi, Okba Selmi, Santo Marsigliante, Mohamed A. Souissi, Nizar Souissi and Antonella Muscella

Children 2023, 10(1), 133; https://doi.org/10.3390/children10010133 - 10 Jan 2023

Cited by 11 | Viewed by 3812

Abstract

We investigated the effect of the role of the joker in children with obesity (OCs) on integration and physio-psychological responses during small-sided games (SSG) training programs. Sixteen OC students (age 13.8 ± 0.73 years) performed training programs consisting of two sessions a week [...] Read more.

We investigated the effect of the role of the joker in children with obesity (OCs) on integration and physio-psychological responses during small-sided games (SSG) training programs. Sixteen OC students (age 13.8 ± 0.73 years) performed training programs consisting of two sessions a week for three weeks. The experimental protocol consisted of 16 teams of 4 children (3 of normal weight and 1 OC). The 16 teams were divided into 2 groups, one with an OC playing as the joker (SSG-J) and the other group with OC playing as non-joker (SSG-NJ). Maximum heart rates (HRmax), blood lactate concentration [La] and OMNI-Child perceived exertion were measured at the end of each SSG. A physical activity enjoyment Scale (PACES) was accomplished during physical activity for the evaluation of feelings in OCs. Additionally, the profile of mood states (POMS) was measured before and after the SSG-J and SSG-NJ programs. HRmax, [La], perceived exertion, and PACES scores were significantly higher after the SSG-J compared with SSG-NJ (increments of 6.4%, 31.7%, 19.5% and 18.1%, respectively). The score of the POMS variables was positively increased in the presence of jokers. The vigor score increased by 30%, while tension and total mood disturbance scores decreased by 27.6% and 4.5%, respectively. These findings suggest that the joker role could be effective in improving integration, physical enjoyment, physiological responses and mood states in OCs when a team game is used during PE sessions. PE teachers could then program joker exercises with the aim of improving OCs’ physical commitment willingness to play. Full article

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

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13 pages, 1802 KiB

Open AccessEditor’s ChoiceArticle

Body Image Perception in High School Students: The Relationship with Gender, Weight Status, and Physical Activity

by Stefania Toselli, Luciana Zaccagni, Natascia Rinaldo, Mario Mauro, Alessia Grigoletto, Pasqualino Maietta Latessa and Sofia Marini

Children 2023, 10(1), 137; https://doi.org/10.3390/children10010137 - 10 Jan 2023

Cited by 9 | Viewed by 7474

Abstract

Body image perception includes body size assessment, body desirability estimation, and perceptions concerning one’s own body shape and size. Adolescence is a period of intense and prompt physical transformation, which changes the perception of one’s body. This represents a critical period for the [...] Read more.

Body image perception includes body size assessment, body desirability estimation, and perceptions concerning one’s own body shape and size. Adolescence is a period of intense and prompt physical transformation, which changes the perception of one’s body. This represents a critical period for the development of body image. Therefore, the present cross-sectional study aimed to evaluate body image perception and investigate the relationships between it, weight status, sex, and physical activity in a sample of high school students living in Italy. General demographic information and details about physical activity were collected. Body image perception was measured with a body silhouette and two indexes were calculated: the FID (Feel minus Ideal Discrepancy) to evaluate the discrepancy between the perceived current figure and the ideal figure; and the FAI (Feel weight status minus Actual weight status Inconsistency) to observe improper perception of weight status. In addition, body shape concerns were evaluated with the Body Shape Questionnaire (BSQ), in which participants reported the frequency of experiencing negative thoughts about their body shape in the last four weeks. Two hundred and four students were included in the study (155 = female, mean age = 17.13 ± 1.70; 49 = male, mean age = 17.25 ± 1.69). Females felt more concerned about body shape than males (χ² = 11.347, p = 0.001). Distinctions emerged in terms of body mass index, the scores of Feel minus Ideal Discrepancy (FID), Feel weight status minus Actual weight status Inconsistency (FAI), the Body Shape Questionnaire (BSQ), and of the silhouette mean comparisons due to sex, weight status, and PA interaction effects (p < 0.001). Additionally, 94% of the BSQ variability could be explained by sex, weight status, and PA. Although no direct effects were observed on body image perception, healthy habit promotion, such as physical activity, could positively affect adolescent lives. Full article

(This article belongs to the Special Issue Monitoring and Promoting Physical Activity, Physical Fitness and Motor Competence in Children)

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20 pages, 377 KiB

Open AccessEditor’s ChoiceReview

Push and Pull Factors: Contextualising Biological Maturation and Relative Age in Talent Development Systems

by Liam Sweeney, Jamie Taylor and Áine MacNamara

Children 2023, 10(1), 130; https://doi.org/10.3390/children10010130 - 9 Jan 2023

Cited by 25 | Viewed by 4879

Abstract

In this conceptual paper, we contextualise ongoing attempts to manage challenge dynamics in talent systems in sport. Firstly, we review the broad literature base related to biological maturation, relative age, and the proposed interventions to mitigate effects. We suggest that the relative age [...] Read more.

In this conceptual paper, we contextualise ongoing attempts to manage challenge dynamics in talent systems in sport. Firstly, we review the broad literature base related to biological maturation, relative age, and the proposed interventions to mitigate effects. We suggest that the relative age effect may be a population level effect, indicative of deeper phenomena, rather than having a direct effect on challenge levels. In contrast, we suggest that biological maturation has a direct effect on challenge at the individual level. Therefore, our main critique of many existing approaches to the management of challenge is a lack of individual nuance and flexibility. We suggest the necessity for talent systems to adopt a more holistic approach, conceptualising biological maturation and relative age within a broader field of “push and pull factors” that impact challenge dynamics in talent development in sport. Finally, we provide practical guidance for talent systems in their approach to relative age and biological maturation, recognising that there is no “gold standard”. Instead, there is a need to recognize the highly individual and contextual nature of these concepts, focusing on strategic coherence through talent systems for the management of selection and development processes. Full article

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

9 pages, 1664 KiB

Open AccessEditor’s ChoiceArticle

Influenza and Respiratory Syncytial Virus Infections in Pediatric Patients during the COVID-19 Pandemic: A Single-Center Experience

by Aušra Steponavičienė, Sigita Burokienė, Inga Ivaškevičienė, Indrė Stacevičienė, Daiva Vaičiūnienė and Augustina Jankauskienė

Children 2023, 10(1), 126; https://doi.org/10.3390/children10010126 - 7 Jan 2023

Cited by 19 | Viewed by 3771

Abstract

The overlap of coronavirus disease 2019 (COVID-19) with other common respiratory pathogens may complicate the course of the disease and prognosis. The aim of the study was to evaluate the rates, characteristics, and outcomes of pediatric patients with severe acute respiratory syndrome coronavirus [...] Read more.

The overlap of coronavirus disease 2019 (COVID-19) with other common respiratory pathogens may complicate the course of the disease and prognosis. The aim of the study was to evaluate the rates, characteristics, and outcomes of pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), influenza A/B infections, and their coinfections. A single-center prospective cross-sectional study was performed at the pediatric emergency department in Vilnius from 1 October 2021 to 30 April 2022. In total, 5127 children were screened for SARS-CoV-2, RSV, and influenza A/B. SARS-CoV-2 PCR tests were positive for 21.0% of children (1074/5127). The coinfection rate of respiratory viruses (RSV, influenza A) in patients with COVID-19 was 7.2% (77/1074). Among the 4053 SARS-CoV-2 negative patients, RSV was diagnosed in 405 (10.0%) patients and influenza A/B in 827 (20.4%) patients. Patients with COVID-19 and coinfection did not have a more severe clinical course than those with RSV or influenza infection alone. RSV and SARS-CoV-2 primarily affected younger patients (up to 2 years), while the influenza was more common in older children (4–10 years). Patients infected with RSV were more severely ill, reflected by higher hospitalization proportion and need for respiratory support. Full article

(This article belongs to the Special Issue COVID-19 and Pediatric Emergency Medicine)

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14 pages, 268 KiB

Open AccessEditor’s ChoiceArticle

Maladaptive Self- and Interpersonal Functioning Increments General Psychiatric Severity in the Association with Adolescent Personality Pathology

by Carla Sharp and Breana Rachelle Cervantes

Children 2023, 10(1), 120; https://doi.org/10.3390/children10010120 - 6 Jan 2023

Cited by 7 | Viewed by 2391

Abstract

Dimensionalized diagnostic systems, especially the entry criterion of maladaptive self and interpersonal functioning, hold particular advantages for the downward extension of personality pathology to young persons, but require conceptual clarification. The current study evaluated the distinctiveness of maladaptive self and interpersonal functioning by [...] Read more.

Dimensionalized diagnostic systems, especially the entry criterion of maladaptive self and interpersonal functioning, hold particular advantages for the downward extension of personality pathology to young persons, but require conceptual clarification. The current study evaluated the distinctiveness of maladaptive self and interpersonal functioning by examining its incremental value over and above general psychiatric severity in the association with personality pathology. A community sample of N = 419 youth (50.4% female; M_age = 11.91, SD = 1.19) between the ages of 10 and 14 completed measures of maladaptive self- and interpersonal functioning, general psychiatric severity (internalizing–externalizing spectrum), and personality pathology. Results showed that, as expected, maladaptive self- and interpersonal functioning incremented general psychiatric severity in the association with personality pathology in adolescents. Results contribute to the literature base illustrating the value of the entry criterion of the ICD-11 and AMPD diagnostic system. Full article

(This article belongs to the Special Issue ICD-11 Personality Disorder in Adolescents: Potentials and Pitfalls)

15 pages, 1299 KiB

Open AccessEditor’s ChoiceArticle

Importance of Early Intervention in Reducing Autistic Symptoms and Speech–Language Deficits in Children with Autism Spectrum Disorder

by Slavica Maksimović, Maša Marisavljević, Nina Stanojević, Milica Ćirović, Silvana Punišić, Tatjana Adamović, Jelena Đorđević, Ivan Krgović and Miško Subotić

Children 2023, 10(1), 122; https://doi.org/10.3390/children10010122 - 6 Jan 2023

Cited by 11 | Viewed by 10232

Abstract

The intervention focused on starting treatment at an early age to develop the child’s full potential, which is known as early intervention. Given that autistic symptoms and language deficits occur at an early age and affect other areas of development in children with [...] Read more.

The intervention focused on starting treatment at an early age to develop the child’s full potential, which is known as early intervention. Given that autistic symptoms and language deficits occur at an early age and affect other areas of development in children with autistic spectrum disorder, we wanted to examine if early intervention is more effective in the reduction in autistic symptoms and language deficits in children aged 36–47 months old when compared to children 48–60 months old. The sample consisted of 29 children diagnosed with ASD who were admitted for integrative therapy. All participants were divided into two groups based on age: G1: 36–47 months old children, and G2: 48–60 months old children. To estimate the presence of autistic symptoms, we used the GARS-3, and for the assessment of speech–language abilities, we used the subscale Estimated Speech and Language Development (ESLD). Our results regarding the effect of the group on the difference in the scores at two time points showed that there was a statistically significant effect of the group on the reduction in autistic symptoms (p < 0.05) but no effect of the group on the differences in speech–language abilities between the two time points (p > 0.05). Our study highlights the importance of emphasizing the exact age when using the terms “early intervention” and “early development” in future studies and practice because it is necessary to determine and establish guidelines about which particular ages are crucial for starting treatment in certain developmental aspects. Full article

(This article belongs to the Section Pediatric Mental Health)

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14 pages, 741 KiB

Open AccessEditor’s ChoiceArticle

The Relationship between Physical Fitness and Perceived Well-Being, Motivation, and Enjoyment in Chinese Adolescents during Physical Education: A Preliminary Cross-Sectional Study

by Wei Zheng, Hejun Shen, Mohammed B. Belhaidas, Yaping Zhao, Lei Wang and Jin Yan

Children 2023, 10(1), 111; https://doi.org/10.3390/children10010111 - 5 Jan 2023

Cited by 26 | Viewed by 7380

Abstract

Purpose: The purpose of this study is to investigate the relationship between physical fitness (PF) level and Chinese middle-school students’ perceived well-being, motivation, and enjoyment. Method: In this study, the participants were randomly selected from 16 Beijing-based middle schools in China. In addition [...] Read more.

Purpose: The purpose of this study is to investigate the relationship between physical fitness (PF) level and Chinese middle-school students’ perceived well-being, motivation, and enjoyment. Method: In this study, the participants were randomly selected from 16 Beijing-based middle schools in China. In addition to the collection of demographic data (i.e., gender, age, and parental education), tools including the Warwick-Edinburgh Mental Well-Being Scale, the Behavioural Regulation in Sport Questionnaire, and the Physical Activity Children’s Enjoyment Scale were employed for collecting data on other variables of well-being, motivation, and enjoyment, respectively. Results: A total of 1678 adolescents (M age = 14.66 years, SD = 1.80) participated in this study. According to the results, significant gender differences could be observed in the PF categories of mean age, BMI, vital capacity, 50-m sprint, muscular strength, and flexibility (all p < 0.05). In contrast, there was no significant gender difference in the levels of well-being, motivation, and enjoyment observed, with similar scores for boys and girls (p > 0.05). Indeed, adolescents with low BMI scores and high levels of vital capacity, muscular strength, and flexibility showed better well-being, motivation, and enjoyment. However, no association was observed between timed sit-ups and pull-ups and well-being, motivation, and enjoyment. Conclusions: This study produced preliminary findings on the relationship between PF and Chinese adolescents’ perceived well-being, motivation, and enjoyment. To improve the health of adolescents, it is necessary to adopt prospective and experimental research designs for advocating for fitness education in school-based programs in future research. Full article

(This article belongs to the Special Issue Physical Education, Physical Activity, and Health Education in Children and Adolescents)

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13 pages, 741 KiB

Open AccessEditor’s ChoiceArticle

Breaking Barriers to Rapid Whole Genome Sequencing in Pediatrics: Michigan’s Project Baby Deer

by Caleb P. Bupp, Elizabeth G. Ames, Madison K. Arenchild, Sara Caylor, David P. Dimmock, Joseph D. Fakhoury, Padmani Karna, April Lehman, Cristian I. Meghea, Vinod Misra, Danielle A. Nolan, Jessica O’Shea, Aditi Sharangpani, Linda S. Franck and Andrea Scheurer-Monaghan

Children 2023, 10(1), 106; https://doi.org/10.3390/children10010106 - 4 Jan 2023

Cited by 19 | Viewed by 5556

Abstract

The integration of precision medicine in the care of hospitalized children is ever evolving. However, access to new genomic diagnostics such as rapid whole genome sequencing (rWGS) is hindered by barriers in implementation. Michigan’s Project Baby Deer (PBD) is a multi-center collaborative effort [...] Read more.

The integration of precision medicine in the care of hospitalized children is ever evolving. However, access to new genomic diagnostics such as rapid whole genome sequencing (rWGS) is hindered by barriers in implementation. Michigan’s Project Baby Deer (PBD) is a multi-center collaborative effort that sought to break down barriers to access by offering rWGS to critically ill neonatal and pediatric inpatients in Michigan. The clinical champion team used a standardized approach with inclusion and exclusion criteria, shared learning, and quality improvement evaluation of the project’s impact on the clinical outcomes and economics of inpatient rWGS. Hospitals, including those without on-site geneticists or genetic counselors, noted positive clinical impacts, accelerating time to definitive treatment for project patients. Between 95–214 hospital days were avoided, net savings of $4155 per patient, and family experience of care was improved. The project spurred policy advancement when Michigan became the first state in the United States to have a Medicaid policy with carve-out payment to hospitals for rWGS testing. This state project demonstrates how front-line clinician champions can directly improve access to new technology for pediatric patients and serves as a roadmap for expanding clinical implementation of evidence-based precision medicine technologies. Full article

(This article belongs to the Special Issue Human Genetics and Bioinformatics in Pediatric Diseases)

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6 pages, 727 KiB

Open AccessEditor’s ChoiceCase Report

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

by Zenon Pogorelić and Tin Čohadžić

Children 2023, 10(1), 108; https://doi.org/10.3390/children10010108 - 4 Jan 2023

Cited by 16 | Viewed by 6040

Abstract

(1) Background: Among all possible causes, foreign bodies are the rarest cause of appendicitis in the pediatric population. In the majority of cases, ingested foreign bodies pass through the gastrointestinal tract without causing symptoms. However, those foreign bodies that pass through the lumen [...] Read more.

(1) Background: Among all possible causes, foreign bodies are the rarest cause of appendicitis in the pediatric population. In the majority of cases, ingested foreign bodies pass through the gastrointestinal tract without causing symptoms. However, those foreign bodies that pass through the lumen of the vermiform appendix cannot re-enter the colon and may cause acute appendicitis. So far, various foreign bodies have been described to enter the appendix and cause acute appendicitis, such as seeds, needles, toothpicks, plant material, or even hair. Tooth or dental implants as a cause of acute appendicitis have been described in only a few cases. To our knowledge, this is the first described case of the tooth causing acute appendicitis in the pediatric population. (2) Case presentation: A 14-year-old male patient presented to the emergency department complaining of pain in the right lower quadrant of the abdomen and vomiting that persisted for approximately 24 h. Until then, the patient was healthy and had no concomitant diseases. Physical examination revealed guarding and tenderness in the right lower abdominal quadrant. The white blood cell count was 17.1 × 10⁹/L with a neutrophil count of 91.1% and a C-reactive protein of 39.3 mg/dL. Ultrasonography of the abdomen revealed a thickened, inflamed appendix with a diameter of 11 mm and free periappendicular fluid. A 9 × 6 mm foreign body at the base of the appendix was visualized. The patient was diagnosed with acute appendicitis, and an emergency laparoscopic appendectomy was performed on the same day. Intraoperatively, gangrenous appendicitis was noted and removed without complications. Upon examination of the removed specimen, it was determined that the patient’s appendicitis had been caused by an ingested tooth. As it later turned out, the patient had broken a lateral incisor while playing sports the day before admission without knowing that he had swallowed it. The patient recovered well and was discharged the day after surgery. (3) Conclusion: Although an extremely rare event, acute appendicitis can be caused by a swallowed tooth. This case highlights the importance of a thorough history in pediatric patients who present to the emergency department with suspected acute appendicitis to determine if there is a precipitating event that may have caused acute appendicitis. Full article

(This article belongs to the Section Pediatric Surgery)

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16 pages, 638 KiB

Open AccessEditor’s ChoiceReview

The Effects of Food Environment on Obesity in Children: A Systematic Review

by Johanna Key, Donna Burnett, Jeganathan Ramesh Babu and Thangiah Geetha

Children 2023, 10(1), 98; https://doi.org/10.3390/children10010098 - 3 Jan 2023

Cited by 12 | Viewed by 9364

Abstract

Childhood obesity is an epidemic connected with poor eating. According to the United States Department of Agriculture’s Economic Research Service (USDA-ERS), food deserts are geographical locations in which residents have restricted or nonexistent access to healthful and quality food. Restricted access to healthy [...] Read more.

Childhood obesity is an epidemic connected with poor eating. According to the United States Department of Agriculture’s Economic Research Service (USDA-ERS), food deserts are geographical locations in which residents have restricted or nonexistent access to healthful and quality food. Restricted access to healthy food is commonly associated with poor nutrition-related health outcomes, including obesity. This review aims to highlight the relationship between residing in a food desert or a similar environment on body mass index (BMI) in school-aged children in North America, predominantly in the Midwest region of the United States and Mexico. In this study, 17 articles were included from PubMed/Medline, Google Scholar, and Crossref. Most of these studies showed no association between the food environment and increased BMI. This discrepancy emphasizes the need for further research; the lack of access to healthful foods in food deserts is an issue that deserves additional attention. Full article

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

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20 pages, 11400 KiB

Open AccessEditor’s ChoiceArticle

Management of Choanal Atresia: National Recommendations with a Comprehensive Literature Review

by Jure Urbančič, Domen Vozel, Saba Battelino, Imre Boršoš, Lev Bregant, Matic Glavan, Črtomir Iglič, Klemen Jenko, Boštjan Lanišnik and Tanja Soklič Košak

Children 2023, 10(1), 91; https://doi.org/10.3390/children10010091 - 2 Jan 2023

Cited by 8 | Viewed by 6558

Abstract

Choanal atresia is the most common congenital anatomical abnormality of the nasal cavities, manifested with a clinical picture of neonatal respiratory distress. The treatment requires interdisciplinary management based mainly on tertiary referral centre experiences. However, there is a lack of high-quality evidence in [...] Read more.

Choanal atresia is the most common congenital anatomical abnormality of the nasal cavities, manifested with a clinical picture of neonatal respiratory distress. The treatment requires interdisciplinary management based mainly on tertiary referral centre experiences. However, there is a lack of high-quality evidence in the available literature. Recommendations were prepared based on a systematic review of the supporting literature: on a website survey addressed to the participating authors consisting of 28 questions and on five live meetings. The initial response to the recommendations was determined at their presentation at the sectional meeting of the section for otorhinolaryngology of the Slovenian Medical Association. Then, reactions from the professional public were accepted until the recommendations were presented at the Expert Council for Otorhinolaryngology of the Slovenian Medical Association. A systematic literature review identified eight systematic reviews or meta-analyses and four randomized controlled clinical trials. Thirty-four recommendations for diagnosis, treatment and postoperative management were consolidated. The paper presents the proposal and first Slovenian recommendations for treating patients with choanal atresia. They are based on foreign medical institutions’ published literature and our clinical experience. They represent the basic requirements of diagnostics and may represent an essential guide in treatment. Full article

(This article belongs to the Section Pediatric Neonatology)

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8 pages, 243 KiB

Open AccessEditor’s ChoiceArticle

Assessment of Permanent First Molars in Children Aged 7 to 10 Years Old

by Gelengul Urvasizoglu, Aybike Bas, Fatma Sarac, Peris Celikel, Fatih Sengul and Sera Derelioglu

Children 2023, 10(1), 61; https://doi.org/10.3390/children10010061 - 27 Dec 2022

Cited by 11 | Viewed by 3175

Abstract

Background: Dental caries is a chronic, infectious and preventable disease that is very common around the world. It has been observed that dental caries affect not only the majority of adults but also 60% to 90% of children. Permanent first molars (PFM) are [...] Read more.

Background: Dental caries is a chronic, infectious and preventable disease that is very common around the world. It has been observed that dental caries affect not only the majority of adults but also 60% to 90% of children. Permanent first molars (PFM) are the most commonly decayed teeth observed in children. Aim: The aim of this study is to evaluate the decayed, missing filled teeth (DMFT) scores of PFMs in the early post-eruptive stage, within the scope of the United Nations Agenda for 2030 Sustainable Development Goals, thereby raising awareness for the prevention and treatment of permanent tooth decay. Methods: This descriptive cross-sectional epidemiological study was conducted in Erzurum between the years 2015–2016 by collecting data from children aged 7–10 years (17,208). In addition to the decayed, filled and missing data of the students’ 6-year-molars, their ages, genders, frequencies of both tooth brushing and dental office visits were evaluated. The relationship between the variables was analyzed with chi-square. Result: The present study analyzed the data of a total of 11,457 children, 5704 girls and 5753 boys with a mean age of 8.74 ± 1.18. There was a statistically significant difference between the PFMs 16, 26, 36 and 46 regarding the number of healthy, decayed, missing and restored teeth (p < 0.001). Conclusion: In this study, the prevalence of caries in the PFMs of children aged 7–10 years was 15.9% and the mean DMFT was 0.79 ± 1.39. This result showed that PFMs might develop carious lesions and even be lost within three years in the early post-eruptive stage. Full article

(This article belongs to the Special Issue Pediatric Dental Health: Prevalence, Diagnosis and Treatment)

31 pages, 4182 KiB

Open AccessEditor’s ChoiceArticle

Infodemiology of RSV in Italy (2017–2022): An Alternative Option for the Surveillance of Incident Cases in Pediatric Age?

by Matteo Riccò, Antonio Baldassarre, Sandro Provenzano, Silvia Corrado, Milena Pia Cerviere, Salvatore Parisi, Federico Marchesi and Marco Bottazzoli

Children 2022, 9(12), 1984; https://doi.org/10.3390/children9121984 - 16 Dec 2022

Cited by 15 | Viewed by 3188

Abstract

The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza [...] Read more.

The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza Surveillance network (InfluNet). Estimated rates for ILI in the general population and in the age groups 0–4 years and 5–14 years were obtained for the influenza seasons 2017–2018 to 2020–2021. Similarly, a weekly fraction of online searches was retrieved for a series of terms associated with Respiratory Syncytial Virus. Next, trends for daily visualization of Italian Wikipedia Pages for Human Respiratory Syncytial Virus, Pneumonia, Bronchiolitis, Influenza, and Respiratory Failure were similarly retrieved. The correlation of all search terms with ILI was analyzed by means of Spearman’s rank correlation analysis. Among search terms associated with the clinical diagnosis of Respiratory Syncytial Virus infections, the occurrence of ILI was highly correlated only with Bronchiolitis in the age group 0–4 years (β 0.210, p = 0.028), while more generic search terms, such as Bronchitis, fever, influenza, and Pneumonia, were identified as effective predictors of ILI, in general and by age groups. In a regression analysis modeled with ILIs as the outcome variable, daily visualizations for the Wikipedia pages on Bronchiolitis were identified as negative predictors for ILI in general (β = −0.152, p = 0.032), ILI in age group 0–4 years (β = −0.264, p = 0.001) and 5–14 years (β = −0.202, p = 0.006), while Influenza was characterized as a positive effector for ILIs in the age group 5–14 years (β = 0.245, p = 0.001). Interestingly, not only were the search terms extensively correlated with one another, but all of them were also characterized by autocorrelation through a Durbin-Watson test (all estimates DW < 2.0) In summary, our study identified a complicated pattern of data visualization as no clear association between rates of ILI in pediatric age group 0–4 and 5 to 14 years was actually found. Finally, our data stress that the infodemiology option may be quite problematic for assessing the time trend of RSV infections in Italy until more appropriate reporting will be made available, by sharing estimates of Lower Respiratory Tract Infections, and through a more accurate characterization of younger age groups. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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19 pages, 1007 KiB

Open AccessEditor’s ChoiceReview

by Federica Di Spirito, Alessandra Amato, Maria Pia Di Palo, Giuseppe A. Ferraro, Adone Baroni, Rosario Serpico and Maria Contaldo

Children 2022, 9(12), 1942; https://doi.org/10.3390/children9121942 - 10 Dec 2022

Cited by 19 | Viewed by 3884

Abstract

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people’s health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on [...] Read more.

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people’s health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned. Full article

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

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20 pages, 6433 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Role of Cardiovascular Imaging in the Follow-Up of Patients with Fontan Circulation

by Sara Moscatelli, Nunzia Borrelli, Jolanda Sabatino, Isabella Leo, Martina Avesani, Claudia Montanaro and Giovanni Di Salvo

Children 2022, 9(12), 1875; https://doi.org/10.3390/children9121875 - 30 Nov 2022

Cited by 17 | Viewed by 4676

Abstract

Since its first description in 1971, the Fontan procedure and its modifications have led to a substantial improvement in the survival rates of patients with a variety of types of complex Congenital Heart Disease (CHD) characterised by the presence of a single, dominant [...] Read more.

Since its first description in 1971, the Fontan procedure and its modifications have led to a substantial improvement in the survival rates of patients with a variety of types of complex Congenital Heart Disease (CHD) characterised by the presence of a single, dominant ventricle. However, despite the significant improvement of the prognosis over the years, Fontan patients are still exposed to several cardiovascular and systemic complications. It is, therefore, important to fully understand the pitfalls hidden behind a Fontan anatomy and the potential predictors of ventricular failure. Cardiovascular imaging plays a key role in this context, allowing for the early identification of complications with important prognostic implications. Echocardiography remains the first-line imaging modality for serial evaluation of Fontan patients. However, there is a growing role of cardiovascular magnetic resonance and cardiac computed tomography from pre-operative assessment to longitudinal follow-up. The aim of this paper will be to provide a comprehensive overview of the role, strengths, and weaknesses of each imaging modality in the assessment of congenital cardiac conditions palliated with the Fontan procedure. Full article

(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology)

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15 pages, 1315 KiB

Open AccessEditor’s ChoiceReview

Cardiovascular Morbidities in Adults Born Preterm: Getting to the Heart of the Matter!

by Vasantha H. S. Kumar

Children 2022, 9(12), 1843; https://doi.org/10.3390/children9121843 - 28 Nov 2022

Cited by 13 | Viewed by 4024

Abstract

Advances in perinatal and neonatal care have led to improved survival of preterm infants into adulthood. However, the shift in focus to long-term health in adults born preterm requires a clear understanding of the impact of prematurity on developing organ systems and the [...] Read more.

Advances in perinatal and neonatal care have led to improved survival of preterm infants into adulthood. However, the shift in focus to long-term health in adults born preterm requires a clear understanding of the impact of prematurity on developing organ systems and the development of adult-oriented disease. A less well-recognized area of risk for surviving preterm infants is their cardiometabolic health. Epidemiologic evidence has linked preterm birth to the development of systemic hypertension, type 2 diabetes, metabolic syndrome, heart failure, and ischemic heart disease. Of more significant concern is that the risk of cardiometabolic disorders is higher in adults born preterm compared to full-term infants. The interconnected nature of the cardio-pulmonary system means worsening morbidity and mortality in adults born preterm. Addressing the problems of adults born preterm holistically would help promote cardiovascular health, wellness, and quality of life over their lifetime. Recognizing that adults born preterm are a unique subset of the population is a challenge in the current healthcare environment. Addressing issues relevant to adults born preterm in the clinically and research domain, using technology to characterize cardiopulmonary physiology and exercise tolerance, developing screening tools for early diagnosis and treatment, and robust follow-up of these infants with access to longitudinal data would improve both the quality and longevity of life in adults born preterm. Full article

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

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12 pages, 271 KiB

Open AccessEditor’s ChoiceArticle

Knowledge and Practice of Pediatricians Regarding Hypovitaminosis D—A Survey across 33 European Countries

by Davor Petrović, Edita Runjić, Ivan Buljan, Antonia Jeličić Kadić and Joško Markić

Children 2022, 9(12), 1831; https://doi.org/10.3390/children9121831 - 26 Nov 2022

Cited by 8 | Viewed by 2374

Abstract

Hypovitaminosis D has been recognized as a worldwide pandemic, but there are disagreements regarding its diagnosis and treatment. This study aimed to evaluate the knowledge and practice of European pediatricians concerning vitamin D (VD) and hypovitaminosis D and their adherence to relevant guidelines. [...] Read more.

Hypovitaminosis D has been recognized as a worldwide pandemic, but there are disagreements regarding its diagnosis and treatment. This study aimed to evaluate the knowledge and practice of European pediatricians concerning vitamin D (VD) and hypovitaminosis D and their adherence to relevant guidelines. A cross-sectional study was conducted through an anonymous survey via SurveyMonkey on 304 European pediatricians. Most of the participants were general pediatricians, followed by endocrinologists and neonatologists. ESPGHAN’s and the national guidelines were the most frequently used. VD testing was mostly performed in patients with skeletal, chronic kidney, and autoimmune diseases. Participants predominantly answered the questions regarding the definition of hypovitaminosis D and VD supplementation correctly, especially in children younger than 12 months. They showed the least knowledge regarding the cut off-point for the initiation of the therapy and therapeutic doses used to treat confirmed hypovitaminosis D. Participants’ conflicting answers could be related to the differences between the guidelines. We consider that experts in this field should create uniform guidelines, and that those guidelines should also be promoted by national or local pediatric associations. Full article

(This article belongs to the Section Global Pediatric Health)

11 pages, 909 KiB

Open AccessEditor’s ChoiceReview

Metabolomics: A New Tool in Our Understanding of Congenital Heart Disease

by Pier Paolo Bassareo and Colin J. McMahon

Children 2022, 9(12), 1803; https://doi.org/10.3390/children9121803 - 24 Nov 2022

Cited by 13 | Viewed by 2892

Abstract

Although the genetic origins underpinning congenital heart disease (CHD) have been extensively studied, genes, by themselves, do not entirely predict phenotypes, which result from the complex interplay between genes and the environment. Consequently, genes merely suggest the potential occurrence of a specific phenotype, [...] Read more.

Although the genetic origins underpinning congenital heart disease (CHD) have been extensively studied, genes, by themselves, do not entirely predict phenotypes, which result from the complex interplay between genes and the environment. Consequently, genes merely suggest the potential occurrence of a specific phenotype, but they cannot predict what will happen in reality. This task can be revealed by metabolomics, the most promising of the “omics sciences”. Though metabolomics applied to CHD is still in its infant phase, it has already been applied to CHD prenatal diagnosis, as well as to predict outcomes after cardiac surgery. Particular metabolomic fingerprints have been identified for some of the specific CHD subtypes. The hallmarks of CHD-related pulmonary arterial hypertension have also been discovered. This review, which is presented in a narrative format, due to the heterogeneity of the selected papers, aims to provide the readers with a synopsis of the literature on metabolomics in the CHD setting. Full article

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12 pages, 1171 KiB

Open AccessEditor’s ChoiceArticle

Physical Fitness Variations between Those Playing More and Those Playing Less Time in the Matches: A Case-Control Study in Youth Soccer Players

by Ana Filipa Silva, Filipe Manuel Clemente, César Leão, Rafael Oliveira, Georgian Badicu, Hadi Nobari, Luca Poli, Roberto Carvutto, Gianpiero Greco, Francesco Fischetti and Stefania Cataldi

Children 2022, 9(11), 1786; https://doi.org/10.3390/children9111786 - 21 Nov 2022

Cited by 9 | Viewed by 3010

Abstract

The purpose of this study was (i) to compare two groups (players with more vs. less match play time) regarding body composition, vertical and horizontal jumping performance, and aerobic capacity; and (ii) to test the relationships between physical fitness and play time. This [...] Read more.

The purpose of this study was (i) to compare two groups (players with more vs. less match play time) regarding body composition, vertical and horizontal jumping performance, and aerobic capacity; and (ii) to test the relationships between physical fitness and play time. This study followed a case-control design in which the outcome was playtime, and the causal attribute was physical fitness. Sixty-six youth male soccer players from under-16 (n = 21), under-17 (n = 19), under-18 (n = 12), and under-19 (n = 14) age groups were monitored for match play time during five months of observation. Inclusion criteria consisted of (1) no absence of more than a week due to injury or other conditions during the five months of observation and (2) physical assessments having been done simultaneously with those of the other players (at the beginning of the season). The exclusion criteria were (1) not participating in one week or more of training sessions, and (2) not participating in the physical fitness assessments. At the beginning of the season, players were assessed for anthropometry (height, body mass, skinfolds), countermovement jump, triple hop bilateral and unilateral jump, and aerobic capacity using the Yo-Yo Intermittent Recovery Test, level 2 (YYIRT). The group that played more time had significantly greater YYIRT results (+28.2%; p = 0.009; Cohen’s d = 0.664). No other significant differences were found between those who played more and fewer minutes. Moderate and significant linear positive correlations were found between YYIRT and play time in the under-19 group (r = 0.423; p = 0.031) and overall (r = 0.401; p < 0.001). In the case of the under-17 group, moderate and significant linear positive correlations were found between TSA and play time (r = 0.473; p = 0.041). This suggests that aerobic and anaerobic capacity is related to play time while jumping performance and fat mass seem not to play an essential role in play time. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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19 pages, 1288 KiB

Open AccessEditor’s ChoiceArticle

Problematic Internet Use among Adolescents 18 Months after the Onset of the COVID-19 Pandemic

by Frank W. Paulus, Jens Joas, Ida Gerstner, Anna Kühn, Markus Wenning, Thomas Gehrke, Holger Burckhart, Ulf Richter, Alexandra Nonnenmacher, Michael Zemlin, Thomas Lücke, Folke Brinkmann, Tobias Rothoeft, Thorsten Lehr and Eva Möhler

Children 2022, 9(11), 1724; https://doi.org/10.3390/children9111724 - 10 Nov 2022

Cited by 32 | Viewed by 5971

Abstract

Studies in recent years and especially since the beginning of the COVID-19 pandemic have shown a significant increase in the problematic use of computer games and social media. Adolescents having difficulties in regulating their unpleasant emotions are especially prone to Problematic Internet Use [...] Read more.

Studies in recent years and especially since the beginning of the COVID-19 pandemic have shown a significant increase in the problematic use of computer games and social media. Adolescents having difficulties in regulating their unpleasant emotions are especially prone to Problematic Internet Use (PIU), which is why emotion dysregulation has been considered a risk factor for PIU. The aim of the present study was to assess problematic internet use (PIU) in adolescents after the third wave (nearly 1.5 years after the onset in Europe) of the COVID-19 pandemic. In the German region of Siegen-Wittgenstein, all students 12 years and older from secondary-level schools, vocational schools and universities were offered a prioritized vaccination in August 2021 with an approved vaccine against COVID-19. In this context, the participants filled out the Short Compulsive Internet Use Scale (SCIUS) and two additional items to capture a possible change in digital media usage time and regulation of negative affect due to the COVID-19 pandemic. A multiple regression analysis was performed to identify predictors of PIU. The original sample consisted of 1477 participants, and after excluding invalid cases the final sample size amounted to 1268 adolescents aged 12–17 (x = 14.37 years, SD = 1.64). The average prevalence of PIU was 43.69%. Gender, age, digital media usage time and the intensity of negative emotions during the COVID-19 pandemic were all found to be significant predictors of PIU: female gender, increasing age, longer digital media usage time and higher intensity of negative emotions during the COVID-19 pandemic were associated with higher SCIUS total scores. This study found a very high prevalence of PIU among 12- to 17-year-olds for the period after the third wave of the COVID-19 pandemic, which has increased significantly compared to pre-pandemic prevalence rates. PIU is emerging as a serious problem among young people in the pandemic. Besides gender and age, pandemic-associated time of digital media use and emotion regulation have an impact on PIU, which provides starting points for preventive interventions. Full article

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

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21 pages, 1368 KiB

Open AccessEditor’s ChoiceReview

Evaluation and Treatment of Pain in Fetuses, Neonates and Children

by Santiago Mencía, Clara Alonso, Carmen Pallás-Alonso, Jesús López-Herce and Maternal and Child Health and Development Network II (SAMID II)

Children 2022, 9(11), 1688; https://doi.org/10.3390/children9111688 - 3 Nov 2022

Cited by 18 | Viewed by 6435

Abstract

The perception of pain is individual and differs between children and adults. The structures required to feel pain are developed at 24 weeks of gestation. However, pain assessment is complicated, especially in neonates, infants and preschool-age children. Clinical scales adapted to age are [...] Read more.

The perception of pain is individual and differs between children and adults. The structures required to feel pain are developed at 24 weeks of gestation. However, pain assessment is complicated, especially in neonates, infants and preschool-age children. Clinical scales adapted to age are the most used methods for assessing and monitoring the degree of pain in children. They evaluate several behavioral and/or physiological parameters related to pain. Some monitors detect the physiological changes that occur in association with painful stimuli, but they do not yet have a clear clinical use. Multimodal analgesia is recommended for pain treatment with non-pharmacological and pharmacological interventions. It is necessary to establish pharmacotherapeutic protocols for analgesia adjusted to the acute or chronic, type and intensity of pain, as well as age. The most used analgesics in children are paracetamol, ibuprofen, dipyrone, opioids (morphine and fentanyl) and local anesthetics. Patient-controlled analgesia is an adequate alternative for adolescent and older children in specific situations, such as after surgery. In patients with severe or persistent pain, it is very important to consult with specific pain services. Full article

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

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13 pages, 541 KiB

Open AccessEditor’s ChoiceReview

Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review

by Fabio Zaina, Claudio Cordani, Sabrina Donzelli, Stefano Giuseppe Lazzarini, Chiara Arienti, Matteo Johann Del Furia and Stefano Negrini

Children 2022, 9(11), 1672; https://doi.org/10.3390/children9111672 - 31 Oct 2022

Cited by 9 | Viewed by 3596

Abstract

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the [...] Read more.

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis patients with curves ≥40° and a residual growth period. We included randomized controlled trials, non-randomized controlled trials, prospective and retrospective observational studies, and case series addressing the effect of bracing in patients with idiopathic scoliosis during growth with curves ≥40° for the Cobb angle, published from 2000 onwards. Outcome: The percentage of patients with surgery, curves above 45° or 50°, and a Cobb angle change are all included in the study. Nine papers (563 patients, average worst curve of 44.8°) are included: four are retrospective case series, two are retrospective and two are prospective cohort studies, and one is a prospective controlled study. The overall quality was good, with respect to the type of design. A total of 32% of the patients improved, 26% were stable, and 42% worsened. The rate of improvement ranged from 11% to 78%; the rate of worsening ranged from 4% to 64%. There are some studies suggesting the use of bracing even in the case of severe curves when patients are motivated by trying to avoid surgery. More and better-quality research with coherent outcome criteria is needed. Full article

(This article belongs to the Special Issue Evidence on Conservative Treatment and Assessment of Idiopathic Scoliosis and Other Spinal Deformities)

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13 pages, 1275 KiB

Open AccessEditor’s ChoiceArticle

Social, Academic and Health Status Impact of Long COVID on Children and Young People: An Observational, Descriptive, and Longitudinal Cohort Study

by Alba Gonzalez-Aumatell, Maria Victoria Bovo, Clara Carreras-Abad, Sara Cuso-Perez, Èlia Domènech Marsal, Roser Coll-Fernández, Aroia Goicoechea Calvo, Maria Giralt-López, Antonia Enseñat Cantallops, Sara Moron-Lopez, Javier Martinez-Picado, Paula Sol Ventura, Carlos Rodrigo and Maria Méndez Hernández

Children 2022, 9(11), 1677; https://doi.org/10.3390/children9111677 - 31 Oct 2022

Cited by 20 | Viewed by 3641

Abstract

There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, [...] Read more.

There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, and health status impacts of long COVID in this population. An observational, descriptive, and longitudinal study on CYP who presented COVID-19 symptoms for more than twelve weeks after SARS-CoV-2 infection was performed between December 2020 and May 2021. Fifty CYP were included, with a median age of 14.1 years, 33 (66%) were female, and 17 (34%) had a relative diagnosed with long COVID. Since the initial infection and up to the first visit, CYP had persisting symptoms for a median of 4.1 months, and for 18 (36%) CYP these symptoms persisted for more than 6 months. Fatigue (100%), neurocognitive disorders (74%), muscular weakness (74%), and headache (72%) were the most reported symptoms. A total of 9 (18%) CYP could not attend school, 17 (34%) had a reduced schedule, 33 (66%) showed a decreased school performance, and 68% had stopped extracurricular activities. This preliminary study shows the impact that long COVID has on the health, academic, and social life of CYP. Full article

(This article belongs to the Special Issue The Impact of COVID-19 in Children)

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22 pages, 2560 KiB

Open AccessEditor’s ChoiceReview

Association between Harmful and Addictive Perceptions of E-Cigarettes and E-Cigarette Use among Adolescents and Youth—A Systematic Review and Meta-Analysis

by Ameera Syafiqah Aly, Rokiah Mamikutty and Jamaludin Marhazlinda

Children 2022, 9(11), 1678; https://doi.org/10.3390/children9111678 - 31 Oct 2022

Cited by 14 | Viewed by 8148

Abstract

Background: Recognising the association between the perceived risks of e-cigarettes and e-cigarette usage among youth is critical for planning effective prevention and intervention initiatives; thus, a systematic review and meta-analysis were performed. Methods: Fourteen databases were searched for eligible studies from the Inception [...] Read more.

Background: Recognising the association between the perceived risks of e-cigarettes and e-cigarette usage among youth is critical for planning effective prevention and intervention initiatives; thus, a systematic review and meta-analysis were performed. Methods: Fourteen databases were searched for eligible studies from the Inception of database until March 2022 to examine the effect estimates of the association between perceptions of harmfulness and addictiveness and overall e-cigarette usage among adolescents and youth. Results: The meta-analysis showed that in comparison to non-users, young people who were ever e-cigarette users were two times more likely to disagree that e-cigarettes are harmful (OR: 2.20, 95% CI: 1.41–3.43) and perceived e-cigarettes as less harmful than tobacco cigarettes (OR: 2.01, 95% CI 1.47–2.75). Youths who were ever e-cigarette users were also 2.3 and 1.8 times more likely to perceive e-cigarettes as less addictive (OR: 2.28, 95% CI: 1.81–2.88) or perceive e-cigarettes as more addictive (OR: 1.82, 95% CI: 1.22–2.73) than tobacco cigarettes, as compared with non-users. The subgroup analysis reported that adolescents were more likely to believe that e-cigarettes are less harmful than tobacco cigarettes, while youth users perceived otherwise. Conclusion: the risk perceptions of e-cigarettes are associated with e-cigarette use among adolescents and youth and could be the focus of health promotion to prevent and curb the uptake of e-cigarettes among young people. Full article

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15 pages, 612 KiB

Open AccessEditor’s ChoiceReview

Parental Stress Assessment with the Parenting Stress Index (PSI): A Systematic Review of Its Psychometric Properties

by Mercedes Ríos, Sara Zekri, Yurena Alonso-Esteban and Esperanza Navarro-Pardo

Children 2022, 9(11), 1649; https://doi.org/10.3390/children9111649 - 28 Oct 2022

Cited by 22 | Viewed by 9878

Abstract

Parental stress is a construct related to people’s perception of difficulties and feelings of not being able to cope with the demands of parenting. This construct is often experienced as a negative or aversive response to parental obligations, and the available evidence also [...] Read more.

Parental stress is a construct related to people’s perception of difficulties and feelings of not being able to cope with the demands of parenting. This construct is often experienced as a negative or aversive response to parental obligations, and the available evidence also suggests that excessive parenting stress reduces the use of positive parenting behaviors and are related to dysfunctional parenting. Different instruments exist to assess parental stress. This article is part of a project to translate and adapt the Parenting Stress Index (PSI), fourth edition, in its two forms (full and short). The aim of this research is to identify the psychometric indicators obtained by this instrument and to review the evidence they can provide. Method: Following the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), the studies related to the PSI were identified in different databases (ERIC, PsycArticles, PubMed, Scopus and Web of Science). Results: The screening process resulted in 16 articles; four have analyzed the psychometric properties of the PSI-4 and the rest have studied the PSI-3. Although version 4 was published in 2012, the studies are scarce. However, they follow the line noted in the previous short version, a high internal consistency and a factor structure of three factors. Conclusions: The difficulties of working with a measurement instrument with 101 items means that the full version of the PSI has been little studied, except in translation and linguistic adaptation studies. Full article

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15 pages, 288 KiB

Open AccessEditor’s ChoiceArticle

The Moderating Role of Emotional Regulation on the Relationship between School Results and Personal Characteristics of Pupils with Attention Deficit/Hyperactivity Disorder

by Florentina Ionela Linca, Magdalena Budisteanu, Doru Vlad Popovici and Natalia Cucu

Children 2022, 9(11), 1637; https://doi.org/10.3390/children9111637 - 27 Oct 2022

Cited by 9 | Viewed by 2999

Abstract

This study aimed to explore the possible moderating role of emotional regulation in the relationship between problem-solving ability, visuomotor precision and visuospatial integration on the one hand and school results on the other in pupils with ADHD. A total of 241 pupils with [...] Read more.

This study aimed to explore the possible moderating role of emotional regulation in the relationship between problem-solving ability, visuomotor precision and visuospatial integration on the one hand and school results on the other in pupils with ADHD. A total of 241 pupils with ADHD (study group) and 207 children without ADHD (control group) were included in our research. Specific tests for the evaluation of the problem-solving ability, visuomotor precision, visuospatial integration, and emotional regulation were applied. The results showed that emotional regulation is a significant moderator of the relationship between school results and problem-solving ability, visuomotor precision, visuospatial integration, and working memory. There are statistically significant differences depending on emotional regulation, visuomotor precision, visuospatial integration, problem-solving ability and working memory in terms of school results of students with ADHD compared to children without this diagnosis. These results can be used in the development of intervention programs. Full article

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7 pages, 226 KiB

Open AccessEditor’s ChoiceReview

Children with Low Handgrip Strength: A Narrative Review of Possible Exercise Strategies to Improve Its Development

by Takashi Abe, Robert S. Thiebaud, Hayao Ozaki, Sakiya Yamasaki and Jeremy P. Loenneke

Children 2022, 9(11), 1616; https://doi.org/10.3390/children9111616 - 25 Oct 2022

Cited by 13 | Viewed by 4721

Abstract

Background: Handgrip strength (HGS) is a predictor of health in both children and adults. Evidence suggests that without a possible strategy, children with low HGS may become adults with low HGS. However, little is known about what strategies are effective for children with [...] Read more.

Background: Handgrip strength (HGS) is a predictor of health in both children and adults. Evidence suggests that without a possible strategy, children with low HGS may become adults with low HGS. However, little is known about what strategies are effective for children with low HGS to achieve a higher baseline level in adulthood. This narrative review aimed to investigate whether physical exercise interventions could improve HGS in children. Methods: The relevant databases/search engine was searched using keywords related to the main topics discussed throughout this review. Results: Our findings suggest that it may not be possible to improve HGS over that observed from normal development with physical education or traditional resistance-training programs. However, if the training program includes exercises that directly stimulate the forearm/hand muscle groups to grip, it may be possible to obtain changes in HGS that exceed the changes due to normal developmental growth. Conclusion: Although there are associations between HGS and markers of health, no research could be identified that examined whether increasing HGS would lead to an improvement in health. If an increase in HGS really does represent an improvement in long-term health, then gripping exercise may need to be included into physical activity programs during the growth/development phase. Full article

8 pages, 617 KiB

Open AccessEditor’s ChoiceArticle

Use of Virtual Reality in Children with Dyslexia

by Giuseppa Maresca, Simona Leonardi, Maria Cristina De Cola, Silvia Giliberto, Marcella Di Cara, Francesco Corallo, Angelo Quartarone and Alessandra Pidalà

Children 2022, 9(11), 1621; https://doi.org/10.3390/children9111621 - 25 Oct 2022

Cited by 19 | Viewed by 5259

Abstract

In recent years, the study of dyslexia has seen rapid progress in definition and classification, neuropsychological correlates, neurobiological factors, and intervention. However, there are few studies on how virtual reality can affect improving cognitive domains and cross-cutting pedagogical skills. We, therefore, tested intervention [...] Read more.

In recent years, the study of dyslexia has seen rapid progress in definition and classification, neuropsychological correlates, neurobiological factors, and intervention. However, there are few studies on how virtual reality can affect improving cognitive domains and cross-cutting pedagogical skills. We, therefore, tested intervention through the use of a virtual reality rehabilitation system (VRRS) in children with dyslexia. Twenty-eight patients diagnosed with dyslexia were enrolled in this study. One-half underwent conventional neuropsychological treatment, and the other half performed VR neurorehabilitation training using the VRRS. All patients were evaluated by neuropsychological assessment at baseline (T0) and at the end of the protocol (T1). The assessment included the administration of the Wechsler Intelligence Scale for Children-IV and the Italian Battery for the Assessment of Dyslexia and Dysorthography. Our results showed a significant difference in word-reading test scores as well as in homophonic writing. In addition, treatment type was found to affect some domains of the WISC. We believe that the VRRS led to improved outcomes through the use of VR, which encourages active exploration, improves engagement, and provides motivation and enjoyment, allowing longer training sessions and improving treatment adherence. Full article

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10 pages, 1091 KiB

Open AccessEditor’s ChoiceArticle

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

by Zenon Pogorelić, Marko Lovrić, Miro Jukić and Zdravko Perko

Children 2022, 9(10), 1583; https://doi.org/10.3390/children9101583 - 19 Oct 2022

Cited by 20 | Viewed by 5038

Abstract

Background: In recent years, complicated biliary tract diseases are increasingly diagnosed in children. Laparoscopic exploration of the common bile duct (LCBDE) followed by laparoscopic cholecystectomy has gained popularity in children. The aim of this study was to investigate the outcomes of LCBDE in [...] Read more.

Background: In recent years, complicated biliary tract diseases are increasingly diagnosed in children. Laparoscopic exploration of the common bile duct (LCBDE) followed by laparoscopic cholecystectomy has gained popularity in children. The aim of this study was to investigate the outcomes of LCBDE in children and compare them with the treatment outcomes of previously used endoscopic retrograde cholangiopancreatography (ERCP). Methods: From January 2000 to January 2022, a total of 84 children (78.5% female) underwent laparoscopic cholecystectomy with a median follow-up of 11.4 (IQR 8, 14) years. Of these, 6 children underwent laparoscopic cholecystectomy (LC) + ERCP and 14 children underwent LCBDE for choledochiothiasis. The primary end point of the study was the success of treatment in terms of the incidence of complications, recurrence rate, and rate of reoperation. Secondary endpoints were stone characteristics, presenting symptoms, duration of surgery, and length of hospital stay. Results: The majority of patients were female in both groups (83.5% vs. 85.7%), mostly overweight with a median BMI of 27.9 kg/m² and 27.4 kg/m², respectively. Obstructive jaundice, colicky pain, acute pancreatitis, and obstruction of the papilla were the most common symptoms in both groups. The majority of patients (68%) had one stone, whereas two or more stones were found in 32% of patients. The median diameter of the common bile duct was 9 mm in both groups. The procedure was successfully completed in all patients in the ERCP group. In the group of patients treated with LCBDE, endoscopic extraction of the stone with a Dormia basket was successfully performed in ten patients (71.4%), while in the remaining four patients (28.6%) the stones were fragmented with a laser because extraction with the Dormia basket was not possible. The median operative time was 79 min in the LCBDE group (IQR 68, 98), while it was slightly longer in the ERCP group, 85 min (IQR 74, 105) (p = 0.125). The length of hospital stay was significantly shorter in the LCBDE group (2 vs. 4 days, p = 0.011). No complications occurred in the LCBDE group, while two (40%) complications occurred in the ERCP group: pancreatitis and cholangitis (p = 0.078). During the follow-up period, no conversions, papillotomies, or recurrences were recorded in either group. Conclusions: Exploration of the common bile duct and removal of stones by LCBDE is safe and feasible in pediatric patients for the treatment of choledocholithiasis. Through this procedure, choledocholithiasis and cholelithiasis can be treated in a single procedure without papillotomy or fluoroscopy. Compared with LC + ERCP, LCBDE is associated with a shorter hospital stay. The incidence of complications was rather low but not statistically significant. Full article

(This article belongs to the Section Pediatric Surgery)

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7 pages, 377 KiB

Open AccessEditor’s ChoiceReview

Ovarian Teratomas in Children and Adolescents: Our Own Experience and Review of Literature

by Fani Gkrozou, Orestis Tsonis, Anastasia Vatopoulou, Georgia Galaziou and Minas Paschopoulos

Children 2022, 9(10), 1571; https://doi.org/10.3390/children9101571 - 18 Oct 2022

Cited by 12 | Viewed by 3737

Abstract

Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours [...] Read more.

Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours and the indications for operating on them, and to put subjective criteria for the management in elective or emergency presentations. Methods: Medical records of patients between the age of 12 and 20 years old that underwent surgery for ovarian teratomas at the Department of Obstetrics and Gynaecology in University Hospital of Ioannina, between January 2000 and August 2022, were reviewed. A medical database was searched between January 2000 and August 2022 with the following keywords: ovarian teratoma, paediatrics and adolescents. Results: We present the results of forty patients, with a mean age of 11.8 years of age. All patients had surgery, where three out of four underwent oophorectomy and only one out of four underwent ovary-sparing operation; similar results were found in the literature. Conclusion: Ovary-sparing treatment is more common recently compared with the past, such as MIS compared with laparotomy. Better-organised and -planned prospective multi-centre studies are necessary to gain a deeper knowledge of the physiology and prognostic factors of teratomas in children. Full article

(This article belongs to the Special Issue New Research in Pediatric Surgical Oncology)

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20 pages, 5068 KiB

Open AccessEditor’s ChoiceArticle

Thyroid Function and Metabolic Syndrome in Children and Adolescents with Neuromotor Disability

by Valeria Calcaterra, Giacomo Biganzoli, Simona Ferraro, Alessandra Mari, Anna Mandelli, Valentina Fabiano, Patrizia Carlucci, Gloria Pelizzo, Elena Zoia, Giulia Lanfranchi, Silvana Castaldi, Patrizia Boracchi, Elia Biganzoli and Gianvincenzo Zuccotti

Children 2022, 9(10), 1531; https://doi.org/10.3390/children9101531 - 6 Oct 2022

Cited by 7 | Viewed by 2528

Abstract

Thyroid function plays a crucial role in nervous system integrity and metabolic homeostasis. We evaluated the pattern of TSH, FT4 and FT3 release in children with neuromotor impairment (NI) in relationship with metabolic syndrome (MS). We enrolled 55 patients with NI and 30 [...] Read more.

Thyroid function plays a crucial role in nervous system integrity and metabolic homeostasis. We evaluated the pattern of TSH, FT4 and FT3 release in children with neuromotor impairment (NI) in relationship with metabolic syndrome (MS). We enrolled 55 patients with NI and 30 controls. Clinical parameters, thyroid function and MS presence were recorded. Principal component analysis (PCA), cluster analysis, and logistic regression models were performed. MS was detected in 54.5% of patients. Four clusters were identified: the first one included only controls and, contrasting with cluster 4, was exclusively characterized by children with disability and MS. This latter showed increased FT4 and FT3 and decreased TSH levels. Cluster 2, characterized by disability without MS showed high FT4 and FT3, whereas cluster 3 with low FT4 and FT3 mainly included disability (90%) and showed prevalent MS (57%). The association between TSH and NI is represented by a U-shape structure. The TSH, FT3 and FT4 release patterns may reflect thyrotropic adaptation, allostatic response and compensatory mechanisms. These mechanisms, found in both MS and disability, show that the odds of having a condition of NI with or without MS increase as the TSH values deviate, in both directions, from a value of 2.5 mLU/mL. Full article

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19 pages, 4047 KiB

Open AccessEditor’s ChoiceArticle

Balance Rehabilitation Approach by Bobath and Vojta Methods in Cerebral Palsy: A Pilot Study

by Andreea Ungureanu, Ligia Rusu, Mihai Robert Rusu and Mihnea Ion Marin

Children 2022, 9(10), 1481; https://doi.org/10.3390/children9101481 - 28 Sep 2022

Cited by 14 | Viewed by 10550

Abstract

In cerebral palsy (CP) the basis for rehabilitation comes from neuroplasticity. One of the leading therapeutic approaches used in the management of CP is the NDT Bobath therapy and Vojta therapy consists in trying to program the ideal movement patterns for the age. [...] Read more.

In cerebral palsy (CP) the basis for rehabilitation comes from neuroplasticity. One of the leading therapeutic approaches used in the management of CP is the NDT Bobath therapy and Vojta therapy consists in trying to program the ideal movement patterns for the age. The aim of our research was to analyze, from a functional point of view, the evolution of the biomechanical parameters characterizing the balance, in children with CP. The group of 12 subjects average age of 7 ± 3.28 years. The subject’s evaluation included a functional clinical evaluation by Berg pediatric scale and a biomechanical evaluation performed using the “Stabilometry footboard PoData 2.00” for evaluation the body weight distribution on the foot level. The rehabilitation program was developed based on two methods, NDT Bobath and Vojta. A 90-min physiotherapy session starts with a Vojta therapy activation, for 20 min. Between the two therapies there is a 10-min break, then the session continues with NDT Bobath exercises within the 3 physical exercises proposed for 60 min. 5 days per week, 6 months. The analysis of the data collected before and after the application of the rehabilitation program, regarding the using the Berg scale indicates a progress of 32.35%, (p = 0.0001 < 0.05) and the effect size is large. The evolution of the data that indicate the distribution of body weight at the level of the two lower limbs, at the two moments pre/post, evaluation. For left side a progress of 8.39%, (p = 0.027 < 0.05) but a small effect size of 0.86. For right side a progress of 10.36% (p = 0.027 < 0.05) and also a small effect size of 0.86. Analyzing the results, we find that there is a left-right rebalancing in most patients. The favorable results that were obtained by drawing up a physiotherapy program composed of the combination of the two Vojta and NDT Bobath methods are proof of the fact that both methods are based on the creation of a stimulating peripheral pressure, which, if maintained, generates an extended stereotyped motor response. A pattern of symmetrical muscle contraction is thus created and thus balance and postural control can be achieved. The left-right rebalancing, proven by the percentage distribution analysis of the weight at the lower segmental level, demonstrated that the body alignment approach through the Vojta method on the one hand and the inhibitory facilitating postures/exercises promoted by the NDT Bobath method, allows obtaining a symmetry. Full article

(This article belongs to the Special Issue Monitoring and Promoting Physical Activity, Physical Fitness and Motor Competence in Children)

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18 pages, 427 KiB

Open AccessEditor’s ChoiceReview

Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children

by Reka Borka Balas, Lorena Elena Meliț and Cristina Oana Mărginean

Children 2022, 9(9), 1359; https://doi.org/10.3390/children9091359 - 6 Sep 2022

Cited by 35 | Viewed by 12296

Abstract

Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori [...] Read more.

Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide. Full article

(This article belongs to the Special Issue Childhood Helicobacter pylori Infection: Treatment and Prevention)

28 pages, 522 KiB

Open AccessEditor’s ChoiceReview

Helicobacter pylori-Related Extraintestinal Manifestations—Myth or Reality

by Cristian Dan Mărginean, Cristina Oana Mărginean and Lorena Elena Meliț

Children 2022, 9(9), 1352; https://doi.org/10.3390/children9091352 - 4 Sep 2022

Cited by 23 | Viewed by 5233

Abstract

It is well documented that Helicobacter pylori (H. pylori) can cause both gastrointestinal and extraintestinal manifestations. The latter one represents a major burden in terms of diagnosis and treatment. H. pylori-associated systemic subclinical inflammation is mostly responsible for the development [...] Read more.

It is well documented that Helicobacter pylori (H. pylori) can cause both gastrointestinal and extraintestinal manifestations. The latter one represents a major burden in terms of diagnosis and treatment. H. pylori-associated systemic subclinical inflammation is mostly responsible for the development of extraintestinal manifestations, and its early eradication might result in preventing all adverse events related to their occurrence. Thus, it was suggested that H. pylori might be associated with iron deficiency anemia, thrombocytopenia (immune thrombocytopenic purpura), Schonlein Henoch purpura, failure to thrive, vitamin B12 deficiency, diabetes mellitus, body mass index, cardiovascular diseases, as well as certain neurological conditions. Nevertheless, studies showed both pros and cons in terms of the role of H. pylori in the development of previously mentioned clinical entity underlining the crucial need for further studies on these topics. Although most of these extraintestinal manifestations occur during adulthood, we must not forget that H. pylori infection is acquired mainly during childhood, and thus its early diagnosis and eradication might represent the cornerstone in the prevention of H. pylori-induced inflammatory status and consequently of all related extraintestinal conditions. Full article

(This article belongs to the Special Issue Childhood Helicobacter pylori Infection: Treatment and Prevention)

7 pages, 252 KiB

Open AccessEditor’s ChoiceArticle

Multidrug-Resistant Bacteria in Children and Adolescents with Cystic Fibrosis

by Valentina Fainardi, Cosimo Neglia, Maria Muscarà, Cinzia Spaggiari, Marco Tornesello, Roberto Grandinetti, Alberto Argentiero, Adriana Calderaro, Susanna Esposito and Giovanna Pisi

Children 2022, 9(9), 1330; https://doi.org/10.3390/children9091330 - 1 Sep 2022

Cited by 13 | Viewed by 2526

Abstract

In patients with cystic fibrosis (CF), multidrug-resistant (MDR) bacteria can predispose to exacerbations, limit the effectiveness of antibiotic treatments and promote the progression of lung disease. The aim of this retrospective study was to compare pulmonary exacerbations (Pex), hospitalizations, lung function and nutritional [...] Read more.

In patients with cystic fibrosis (CF), multidrug-resistant (MDR) bacteria can predispose to exacerbations, limit the effectiveness of antibiotic treatments and promote the progression of lung disease. The aim of this retrospective study was to compare pulmonary exacerbations (Pex), hospitalizations, lung function and nutritional status in a group of children and adolescents with CF colonized by MDR bacteria and in a noncolonized control group. Overall, 7/54 pediatric patients (12.9%) were colonized by MDR bacteria and enrolled (3 with Achromobacter xyloxidans, 3 with Stenotrophomonas maltophilia and 1 with Burkholderia cepacia). The control group included 14 sex- and age-matched CF patients (8/14 colonized by Staphylococcus aureus, 2/14 by Pseudomonas aeruginosa, 2/14 by both microorganisms and 2/14 germ free). At the time of enrollment and 12 months before the first detection of the MDR microorganism, children colonized by MDR bacteria showed lower body mass index (BMI) and lower FEV₁/FVC compared to the control group. Over the previous year before the first detection, children colonized with MDR had more Pex compared to control group; those colonized by S. maltophilia experienced the highest number of Pex. In the 12 months following the first detection of MDR bacteria, all seven patients colonized by MDR had at least one Pex and patients colonized by S. maltophilia had the highest number (mean ± SD: 6 ± 2.6 vs. 1.7 ± 2.3). Our study suggests that CF pediatric patients infected by MDR bacteria have lower BMI, more obstructive disease and experience more exacerbations than patients without MDR bacteria. These differences are present even before being infected, suggesting that children and adolescents with more severe disease are predisposed to be colonized by MDR bacteria. S. maltophilia appeared to be the most aggressive pathogen. Further studies and the implementation of antimicrobial stewardship programs are necessary to clarify when and how to treat patients with CF and MDR bacteria in order to avoid the improper use of antibiotics and the development of antibiotic resistance. Full article

(This article belongs to the Special Issue Cystic Fibrosis in Children)

9 pages, 1283 KiB

Open AccessEditor’s ChoiceArticle

Reappraisal of VEGF in the Pathogenesis of Kawasaki Disease

by Chun-Yu Chen, Shih-Hui Huang, Kuang-Jen Chien, Tsung-Jen Lai, Wei-Hsiang Chang, Kai-Sheng Hsieh and Ken-Pen Weng

Children 2022, 9(9), 1343; https://doi.org/10.3390/children9091343 - 1 Sep 2022

Cited by 9 | Viewed by 2677

Abstract

Vascular endothelial growth factor (VEGF) is an important factor in mediating the inflammation of Kawasaki disease (KD). The literature regarding the relationship between VEGF and KD is sparse. The purpose of this study was to investigate the correlation of VEGF and KD. In [...] Read more.

Vascular endothelial growth factor (VEGF) is an important factor in mediating the inflammation of Kawasaki disease (KD). The literature regarding the relationship between VEGF and KD is sparse. The purpose of this study was to investigate the correlation of VEGF and KD. In a prospective study of 42 Taiwanese KD patients (18.9 ± 12.2 months, M/F 22/20) treated with intravenous immunoglobulin (IVIG), a series of VEGF levels was measured from the acute to convalescent phases. KD patients were classified into two subgroups with (n =20) and without (n = 22) acute coronary artery lesions (CALs). Control samples were obtained from 30 febrile controls (19.1 ± 13.7 months, M/F 13/17). In KD patients, VEGF levels in the pre-IVIG acute phase were significantly higher than those in the subacute and convalescent phases (both p < 0.001). In KD patients with CALs, VEGF levels significantly increased immediately in the post-IVIG phase (p = 0.039), and then significantly decreased in the subacute phase (p = 0.002). KD patients with acute CALs had higher median VEGF levels than those without acute CALs from acute to convalescent phases. In the subacute phase, KD patients with acute CALs had significantly higher VEGF levels (p = 0.022) than those without acute CALs. Our data show that VEGF did not decrease after IVIG treatment, and increased significantly after IVIG treatment in KD patients with acute CALs in acute phase. VEGF might be related to the complications of CALs in KD patients. Full article

(This article belongs to the Special Issue Kawasaki Disease, MIS-C and COVID-19)

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8 pages, 255 KiB

Open AccessEditor’s ChoiceArticle

The Relationship between Anemia and Helicobacter Pylori Infection in Children

by Ancuta Lupu, Ingrith Crenguta Miron, Anca Lavinia Cianga, Andrei Tudor Cernomaz, Vasile Valeriu Lupu, Dragos Munteanu, Dragos Catalin Ghica and Silvia Fotea

Children 2022, 9(9), 1324; https://doi.org/10.3390/children9091324 - 30 Aug 2022

Cited by 15 | Viewed by 4604

Abstract

(1) Background: Many studies suggest that Helicobacter pylori (H. pylori) infection is associated with a higher prevalence of anemia. The aim of this study is to explore this fact for a pediatric population from the northeast of Romania; (2) Methods: A [...] Read more.

(1) Background: Many studies suggest that Helicobacter pylori (H. pylori) infection is associated with a higher prevalence of anemia. The aim of this study is to explore this fact for a pediatric population from the northeast of Romania; (2) Methods: A correlational retrospective study between infection with H. pylori and anemia was performed on a group of 542 children in a pediatric gastroenterology regional center in Northeast Romania; (3) Results: Out of 542 children with confirmed H. pylori infection, microcytic hypochromic anemia was present in 48 children, of whom 7 (14.5%) also had iron deficiency.; (4) Conclusions: The study results demonstrate a significant association of H. pylori infection with iron-deficiency anemia and iron deficiency in children in accordance with the results established in the published literature. Although the direct relationship between them it is not clear yet, prevention represents one of the first clinical measures that need to be implemented when encountering a refractory moderate to severe iron-deficiency anemia and, especially, when associated with gastrointestinal tract symptoms. Full article

(This article belongs to the Special Issue Childhood Helicobacter pylori Infection: Treatment and Prevention)

13 pages, 935 KiB

Open AccessEditor’s ChoiceReview

Neurocognitive Consequences in Children with Sleep Disordered Breathing: Who Is at Risk?

by Pablo E. Brockmann and David Gozal

Children 2022, 9(9), 1278; https://doi.org/10.3390/children9091278 - 25 Aug 2022

Cited by 18 | Viewed by 3780

Abstract

Sleep-disordered breathing (SDB) is a prevalent disease in children characterized by snoring and narrowing of the upper airway leading to gas exchange abnormalities during sleep as well as sleep fragmentation. SDB has been consistently associated with problematic behaviors and adverse neurocognitive consequences in [...] Read more.

Sleep-disordered breathing (SDB) is a prevalent disease in children characterized by snoring and narrowing of the upper airway leading to gas exchange abnormalities during sleep as well as sleep fragmentation. SDB has been consistently associated with problematic behaviors and adverse neurocognitive consequences in children but causality and determinants of susceptibility remain incompletely defined. Since the 1990s several studies have enlightened these associations and consistently reported poorer academic performance, lower scores on neurocognitive tests, and behavioral abnormalities in children suffering from SDB. However, not all children with SDB develop such consequences, and severity of SDB based on standard diagnostic indices has often failed to discriminate among those children with or without neurocognitive risk. Accordingly, a search for discovery of markers and clinically useful tools that can detect those children at risk for developing cognitive and behavioral deficits has been ongoing. Here, we review the advances in this field and the search for possible detection approaches and unique phenotypes of children with SDB who are at greater risk of developing neurocognitive consequences. Full article

(This article belongs to the Special Issue Reviews on Current Advances in Child Neurology)

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14 pages, 266 KiB

Open AccessEditor’s ChoiceReview

Saudi Expert Consensus-Based Autism Spectrum Disorder Statement: From Screening to Management

by Shuliweeh Alenezi, Ahmad S. Alyahya, Shahad M. AlKhalifah, Hadeel R. Bakhsh, Eiman H. Alismail, Hesham Aldhalaan, Talat Alwazna, Nouf Alzrayer, Saleh S. AlSuwailem, Faisal Alnemary, Ahmed M. S. AlAnsari, Enas I. Alqulaq, Amal Alyamani, Yasser S. Amer, Ibrahim M. Albawardi, Waled M. Albalawi, Mohammed A. Alhassan, Maha S. Algazlan, Malak Alramady and Yasser Ad-Dab’bagh

Children 2022, 9(9), 1269; https://doi.org/10.3390/children9091269 - 23 Aug 2022

Cited by 14 | Viewed by 4716

Abstract

Background: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a [...] Read more.

Background: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. Methodology: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. Results: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual’s ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. Conclusion: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains. Full article

10 pages, 850 KiB

Open AccessEditor’s ChoiceArticle

Chronic Olfactory Dysfunction in Children with Long COVID: A Retrospective Study

by Danilo Buonsenso, Laura Martino, Rosa Morello, Cristina De Rose and Piero Valentini

Children 2022, 9(8), 1251; https://doi.org/10.3390/children9081251 - 19 Aug 2022

Cited by 15 | Viewed by 3167

Abstract

Olfactory dysfunction is one of the long-term consequences of acute SARS-CoV-2 infection in adults. This study aims to analyze the prevalence of chronic anosmia among COVID-19 children and to bring to light its impact on their families’ quality of life and wellbeing. Children [...] Read more.

Olfactory dysfunction is one of the long-term consequences of acute SARS-CoV-2 infection in adults. This study aims to analyze the prevalence of chronic anosmia among COVID-19 children and to bring to light its impact on their families’ quality of life and wellbeing. Children younger than 18 years old, who were detected as being COVID-19-positive by RT-PCR and were assessed in a pediatric post-COVID outpatient clinic at least 28 days after the onset of the acute infection, were included in the study. The patients suffering from persisting smell disorders were asked to answer a questionnaire about their symptoms and how they influence their daily life. Out of the 784 children evaluated, 13 (1.7%) presented olfactory impairment at a mean follow-up since the acute infection of more than three months. Parents’ answers showed that they were worried about their children’s health, in particular they wanted to know if and when they would recover and if these disorders would have long-term consequences. They also wanted to share their experiences, in order to help other people who are experiencing the same disorders in everyday life. Our study highlights that smell disorders can significantly upset children’s eating habits and everyday activities. Furthermore, these findings suggest that future research should try to better understand the mechanisms causing loss of smell in COVID-19 patients and find the most appropriate treatment. Full article

(This article belongs to the Special Issue SARS-CoV-2 Infections in Children: Current Updates and Challenges)

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