Research

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18 pages, 1398 KiB

Open AccessArticle

Analysis of Adverse Drug Reactions in Pediatric Patients with Epilepsy: An Intensive Pharmacovigilance Study

by Ernestina Hernández García, Lizbeth Naranjo, Luz Adriana Pichardo-Macías, María Josefa Bernad Bernad, Lucila Isabel Castro-Pastrana, Matilde Ruíz García, Tanya Alejandra García Bernal, Jessica Lizbeth Mendoza Solís, David Calderón Guzmán, Luisa Díaz-García, Julieta Griselda Mendoza-Torreblanca and Juan Luis Chávez Pacheco

Children 2023, 10(11), 1775; https://doi.org/10.3390/children10111775 - 01 Nov 2023

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Abstract

Epilepsy is a chronic neurological disease characterized by the presence of spontaneous seizures, with a higher incidence in the pediatric population. Anti-seizure medication (ASM) may produce adverse drug reactions (ADRs) with an elevated frequency and a high severity. Thus, the objective of the [...] Read more.

Epilepsy is a chronic neurological disease characterized by the presence of spontaneous seizures, with a higher incidence in the pediatric population. Anti-seizure medication (ASM) may produce adverse drug reactions (ADRs) with an elevated frequency and a high severity. Thus, the objective of the present study was to analyze, through intensive pharmacovigilance over 112 months, the ADRs produced by valproic acid (VPA), oxcarbazepine (OXC), phenytoin (PHT), and levetiracetam (LEV), among others, administered to monotherapy or polytherapy for Mexican hospitalized pediatric epilepsy patients. A total of 1034 patients were interviewed; 315 met the inclusion criteria, 211 patients presented ADRs, and 104 did not. A total of 548 ASM-ADRs were identified, and VPA, LEV, and PHT were the main culprit drugs. The most frequent ADRs were drowsiness, irritability, and thrombocytopenia, and the main systems affected were hematologic, nervous, and dermatologic. LEV and OXC caused more nonsevere ADRs, and PHT caused more severe ADRs. The risk analysis showed an association between belonging to the younger groups and polytherapy with ADR presence and between polytherapy and malnutrition with severe ADRs. In addition, most of the severe ADRs were preventable, and most of the nonsevere ADRs were nonpreventable. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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10 pages, 1641 KiB

Open AccessArticle

Household Wealth Gradient in Low Birthweight in India: A Cross-Sectional Analysis

by Bishwajit Ghose

Children 2023, 10(7), 1271; https://doi.org/10.3390/children10071271 - 24 Jul 2023

Viewed by 870

Abstract

A low birthweight is a common complication that can result from numerous physiological, environmental, and socioeconomic factors, and can put babies at an increased risk for health issues such as breathing difficulties, developmental delays, and even death in severe cases. In this analysis, [...] Read more.

A low birthweight is a common complication that can result from numerous physiological, environmental, and socioeconomic factors, and can put babies at an increased risk for health issues such as breathing difficulties, developmental delays, and even death in severe cases. In this analysis, I aim to assess the differences in the burden of low birthweight based on household wealth status in India using data from the latest National Family Health Survey (NFHS 2019–21). The sample population includes 161,596 mother–child dyads. A low birthweight is defined as a weight that is <2500 g at birth. I used descriptive and multivariate regression analyses in R studio to analyse the data. The findings show that 16.86% of the babies had a low birthweight. At the state level, the percentage of low birthweights ranges from 3.85% in Nagaland to 21.81% in Punjab. The mean birthweights range from 2759.68 g in the poorest, 2808.01 g in the poorer, 2838.17 g in the middle, 2855.06 g in the richer, and 2871.30 g in the richest wealth quintile households. The regression analysis indicates that higher wealth index quintiles have progressively lower risks of low birthweight, with the association being stronger in the rural areas. Compared with the poorest wealth quintile households, the risk ratio of low birthweight was 0.90 times lower for the poorer households and 0.74 times lower for the richest households. These findings indicate that household wealth condition is an important predictor of low birthweight by which low-income households are disproportionately affected. As wealth inequality continues to rise in India, health policymakers must take the necessary measures to support the vulnerable populations in order to improve maternal and infant health outcomes. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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11 pages, 714 KiB

Open AccessArticle

The Association between the First Cry and Clinical Outcomes in CDH Neonates: A Retrospective Study

by Yuki Takeuchi, Akiyoshi Nomura, Masaya Yamoto, Satoko Ohfuji, Shunsuke Fujii, Seiji Yoshimoto, Toru Funakoshi, Masato Shinkai, Naoto Urushihara and Akiko Yokoi

Children 2023, 10(7), 1145; https://doi.org/10.3390/children10071145 - 30 Jun 2023

Viewed by 905

Abstract

Congenital diaphragmatic hernia (CDH) is a life-threatening condition characterized by the herniation of abdominal organs into the thorax, resulting in hypoplastic lungs and pulmonary hypertension. The impact of the first cry, a crucial event for lung transition during birth, on CDH patients remains [...] Read more.

Congenital diaphragmatic hernia (CDH) is a life-threatening condition characterized by the herniation of abdominal organs into the thorax, resulting in hypoplastic lungs and pulmonary hypertension. The impact of the first cry, a crucial event for lung transition during birth, on CDH patients remains unclear. This study investigated the impact of the first cry during birth on CDH patient survival, along with other prognosis factors. A multi-institutional retrospective study assessed CDH patient characteristics and survival rates by analyzing factors including the first cry, disease severity, birth weight, Apgar scores, oxygenation index (OI) and surgical closure. Among the CDH patients in the study, a positive first cry was linked to 100% survival, regardless of disease severity (p < 0.001). Notably, the presence of a positive first cry did not significantly affect survival rates in patients with worse prognostic factors, such as low birth weight (<2500 g), high CDH severity, low Apgar scores (1 min ≤ 4), high best OI within 24 h after birth (≥8), or those who underwent patch closure. Furthermore, no significant association was found between the first cry and the use of inhaled nitric oxide (iNO) or extracorporeal membrane oxygenation (ECMO). In conclusion, this study suggests that the first cry may not have a negative impact on the prognosis of CDH patients and could potentially have a positive effect. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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15 pages, 332 KiB

Open AccessArticle

Association of Atherogenic Index of Plasma with Cardiometabolic Risk Factors and Markers in Lean 14-to-20-Year-Old Individuals: A Cross-Sectional Study

by Katarína Šebeková, Radana Gurecká, Melinda Csongová, Ivana Koborová and Peter Celec

Children 2023, 10(7), 1144; https://doi.org/10.3390/children10071144 - 30 Jun 2023

Cited by 1 | Viewed by 1063

Abstract

Cardiometabolic risk factors at a young age pose a significant risk for developing atherosclerotic cardiovascular disease in adulthood. Atherogenic dyslipidemia is highly associated with obesity and metabolic syndrome already in young age. It remains unclear whether cardiometabolic risk factors associate with the atherogenic [...] Read more.

Cardiometabolic risk factors at a young age pose a significant risk for developing atherosclerotic cardiovascular disease in adulthood. Atherogenic dyslipidemia is highly associated with obesity and metabolic syndrome already in young age. It remains unclear whether cardiometabolic risk factors associate with the atherogenic index of plasma (AIP = log (TAG/HDL-C) in lean subjects with low atherogenic risk. As both the AIP and markers of cardiometabolic risk are continuous variables, we expected their association to be linear before the manifestation of obesity and atherogenic dyslipidemia. We analyzed the prevalence of increased atherogenic risk (AIP ≥ 0.11) in 2012 lean 14-to-20-year-old subjects (55% females) and the trends of cardiometabolic risk factors across the quartiles (Q) of AIP in a subgroup of 1947 (56% females) subjects with low atherogenic risk (AIP < 0.11). The prevalence of AIP ≥ 0.11 reached 3.6% in females and 8.5% in males. HDL-C, non-HDL-C, triglycerides, and the continuous metabolic syndrome score showed a stepwise worsening across the AIP quartiles in both sexes. Measures of obesity and insulin resistance were worse in Q4 vs. Q1 groups, and leukocyte counts were higher in Q4 and Q3 vs. Q1. Females in Q4 presented with a higher C-reactive protein and lower adiponectin, estradiol, and testosterone levels. The multivariate regression model selected non-HDL-C, QUICKI, and erythrocyte counts as significant predictors of AIP in males; and non-HDL-C and C-reactive protein in females. A question arises whether the lean individuals on the upper edge of low atherogenic risk are prone to earlier manifestation of metabolic syndrome and shift to the higher AIP risk group. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

18 pages, 669 KiB

Open AccessArticle

Who Is Best Placed to Support Cyber Responsibilized UK Parents?

by Suzanne Prior and Karen Renaud

Children 2023, 10(7), 1130; https://doi.org/10.3390/children10071130 - 29 Jun 2023

Viewed by 1096

Abstract

The UK government responsibilizes its citizens when it comes to their cyber security, as do other countries. Governments provide excellent advice online, but do not provide any other direct support. Responsibilization is viable when: (1) risk management activities require only ubiquitous skills, (2) [...] Read more.

The UK government responsibilizes its citizens when it comes to their cyber security, as do other countries. Governments provide excellent advice online, but do not provide any other direct support. Responsibilization is viable when: (1) risk management activities require only ubiquitous skills, (2) a failure to manage the risk does not affect others in the person’s community. Cybersecurity fails on both counts. Consider that parents and carers are effectively being responsibilized to educate their children about cybersecurity, given that young children cannot be expected to consult and act upon government advice. Previous research suggests that UK parents embrace this responsibility but need help in keeping up to date with cybersecurity ‘best practice’. In this paper, we consider a number of possible sources of parental advice, and conclude that support workers would be best placed to support parents in this domain. We then carried out a study to gauge the acceptability of this source of help. We find that parents would be willing to accept advice from this source, and suggest that cybersecurity academics be recruited to train support workers to ensure that they have current ‘best practice’ cybersecurity knowledge to impart to parents. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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10 pages, 483 KiB

Open AccessArticle

Parent Perceptions of an Early Childhood System’s Community Efforts: A Qualitative Analysis

by Brandie Bentley, Tuyet Mai Ha Hoang, Gloria Arroyo Sugg, Karen V. Jenkins, Crystal A. Reinhart, Leah Pouw, Ana Maria Accove and Karen M. Tabb

Children 2023, 10(6), 1001; https://doi.org/10.3390/children10061001 - 02 Jun 2023

Viewed by 1104

Abstract

Understanding how parents, and other primary caregivers, perceive and experience early childhood programs and services is essential for identifying family-centered facilitators and barriers to service utilization. Therefore, this paper aims to explore parent knowledge of and experiences with community efforts of an early [...] Read more.

Understanding how parents, and other primary caregivers, perceive and experience early childhood programs and services is essential for identifying family-centered facilitators and barriers to service utilization. Therefore, this paper aims to explore parent knowledge of and experiences with community efforts of an early childhood system in Illinois: the All Our Kids Early Childhood Networks (AOK Networks). Our research team conducted focus group interviews with 20 parents across four Illinois counties. A semi-structured interview guide was used to examine parent perceptions of an early childhood system’s community efforts in promoting the health and well-being of children aged from birth to five. Thematic network analysis was used to analyze all focus group data. Parents indicated three salient themes, including: (1) comprehensive information sharing practices, (2) diverse service engagement, and (3) barriers to service access. Overall, parents reported general satisfaction with the quality of available services and provided feedback regarding identified areas of need to increase the accessibility and utilization of local services. Engaging parents as partners is essential to the effective implementation of family-centered early childhood services. Families are the experts of their lived experiences, and incorporating their voices in program development and evaluation efforts works to increase positive child and family outcomes. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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12 pages, 540 KiB

Open AccessArticle

Psychological Burden during the COVID-19 Pandemic in Female Caregivers of Preterm versus Term Born Children

by Maire Brasseler, Madeleine Fink, Barbara Mitschdörfer, Margarete Reimann, Eva-Maria Skoda, Alexander Bäuerle, Martin Teufel, Ursula Felderhoff-Müser and Britta Hüning

Children 2023, 10(5), 787; https://doi.org/10.3390/children10050787 - 27 Apr 2023

Cited by 1 | Viewed by 1036

Abstract

Background: during the COVID-19 pandemic, psychological burden increased. Contact restrictions were predominantly stressful for families. Parenthood was reported to be especially challenging for parents of preterm children. Material and Methods: a cross-sectional online-based survey on the psychological burden of parents of preterm and [...] Read more.

Background: during the COVID-19 pandemic, psychological burden increased. Contact restrictions were predominantly stressful for families. Parenthood was reported to be especially challenging for parents of preterm children. Material and Methods: a cross-sectional online-based survey on the psychological burden of parents of preterm and full-term born infants and toddlers during the second lockdown of the COVID-19 pandemic in Germany was offered by social media, webpages, etc. Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2), COVID-19 Anxiety (C-19-A), COVID-19-related child protection behavior (PB) were used. Results: 2742 parents—predominantly females—took part in the study, 2025 parents of full-term and 717 parents of preterm born children. Female caregivers of full-term children reported significantly more depression symptoms than those of preterm children during the second lockdown of the COVID-19 pandemic. The PB correlated with increased COVID-19 anxiety as well as with increased generalized anxiety and depression symptoms. Female caregivers of preterm children showed significantly more protection behavior than those of full-term born children. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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Review

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19 pages, 1065 KiB

Open AccessReview

Multiple Sclerosis—Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics

by Claudia Mandato, Angelo Colucci, Roberta Lanzillo, Annamaria Staiano, Elena Scarpato, Luigi Schiavo, Francesca Felicia Operto, Maria Rosaria Serra, Cristina Di Monaco, Julia Sara Napoli, Grazia Massa and Pietro Vajro

Children 2023, 10(6), 1022; https://doi.org/10.3390/children10061022 - 07 Jun 2023

Viewed by 1878

Abstract

Purpose. Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological [...] Read more.

Purpose. Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological therapies for improving disease outcome both in adults and in children. Methods. Scoping literature search about evidence-based findings in MS-related gut-brain axis (GBA) pathophysiology and nutritional issues at all ages. Findings. Data show that (1) no universal best diet exists, (2) healthy/balanced diets are, however, necessary to safeguard the adequate intake of all essential nutrients, (3) diets with high intakes of fruits, vegetables, whole grains, and lean proteins that limit processed foods, sugar, and saturated fat appear beneficial for their antioxidant and anti-inflammatory properties and their ability to shape a gut microbiota that respects the gut and brain barriers, (4) obesity may trigger MS onset and/or its less favorable course, especially in pediatric-onset MS. Vitamin D and polyunsaturated fatty acids are the most studied supplements for reducing MS-associated inflammation. Conclusions. Pending results from other and/or newer approaches targeting the GBA (e.g., pre- and probiotics, engineered probiotics, fecal-microbiota transplantation), accurate counseling in choosing adequate diet and maintaining physical activity remains recommended for MS prevention and management both in adults and children. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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