Pediatric Reports

10 pages, 9549 KiB

Open AccessCase Report

Successful Treatment of Multiple Large Intrarenal Stones in a 2-Year-Old Boy Using a Single-Use Flexible Ureteroscope and High-Power Laser Settings

by Vasileios Tatanis, Theodoros Spinos, Zoi Lamprinou, Elisavet Kanna, Francesk Mulita, Angelis Peteinaris, Orthodoxos Achilleos, Ioannis Skondras, Evangelos Liatsikos and Panagiotis Kallidonis

Pediatr. Rep. 2024, 16(3), 806-815; https://doi.org/10.3390/pediatric16030068 - 11 Sep 2024

Abstract

The standard treatment procedures for managing renal calculi in the pediatric population are similar to those in adults. The application of flexible ureteroscopy has contributed to the increased popularity of retrograde intrarenal surgery (RIRS) as an alternative therapeutic modality that can be successfully [...] Read more.

The standard treatment procedures for managing renal calculi in the pediatric population are similar to those in adults. The application of flexible ureteroscopy has contributed to the increased popularity of retrograde intrarenal surgery (RIRS) as an alternative therapeutic modality that can be successfully applied in children. One of the most significant innovations of the last decade is the introduction of single-use flexible ureteroscopes (fURSs). In this case report, we present the case of a 2-year-old boy with multiple large calculi in his right kidney, which were successfully removed after a single session of RIRS using a 7.5 F single-use fURS and high-power laser settings. The total operative and lithotripsy times were estimated at 90 and 75 min, respectively. No complications were recorded. The hemoglobin loss was calculated at 0.3 mg/dL, while the creatinine level was decreased by 0.1 mg/dL. The urethral catheter was removed on the first postoperative day, and the patient was discharged. The management of multiple or large kidney stones is very challenging in the pediatric population under the age of three years. Convenient preoperative planning and the appropriate use of available equipment may lead to excellent outcomes accompanied by a reduced risk for complications. Full article

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12 pages, 1319 KiB

Open AccessArticle

Artificial Intelligence (AI) Assessment of Pediatric Dental Panoramic Radiographs (DPRs): A Clinical Study

by Natalia Turosz, Kamila Chęcińska, Maciej Chęciński, Karolina Lubecka, Filip Bliźniak and Maciej Sikora

Pediatr. Rep. 2024, 16(3), 794-805; https://doi.org/10.3390/pediatric16030067 - 11 Sep 2024

Abstract

This clinical study aimed to evaluate the sensitivity, specificity, accuracy, and precision of artificial intelligence (AI) in assessing permanent teeth in pediatric patients. Over one thousand consecutive DPRs taken in Kielce, Poland, with the Carestream CS9600 device were screened. In the study material, [...] Read more.

This clinical study aimed to evaluate the sensitivity, specificity, accuracy, and precision of artificial intelligence (AI) in assessing permanent teeth in pediatric patients. Over one thousand consecutive DPRs taken in Kielce, Poland, with the Carestream CS9600 device were screened. In the study material, 35 dental panoramic radiographs (DPRs) of patients of developmental age were identified and included. They were automatically evaluated with an AI algorithm. The DPRs were then analyzed by researchers. The status of the following dichotomous variables was assessed: (1) decay, (2) missing tooth, (3) filled tooth, (4) root canal filling, and (5) endodontic lesion. The results showed high specificity and accuracy (all above 85%) in detecting caries, dental fillings, and missing teeth but low precision. This study provided a detailed assessment of AI performance in a previously neglected age group. In conclusion, the overall accuracy of AI algorithms for evaluating permanent dentition in dental panoramic radiographs is lower for pediatric patients than adults or the entire population. Hence, identifying primary teeth should be implemented in AI-driven software, at least so as to ignore them when assessing mixed dentition (ClinicalTrials.gov registration number: NCT06258798). Full article

(This article belongs to the Special Issue Modern Solutions for Diagnosis and Treatment Planning in Pediatric Dentistry and Orthodontics)

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8 pages, 276 KiB

Open AccessArticle

Association of Methylenetetrahydrofolate Reductase (MTHFR) Polymorphism with Osteosarcoma in a Mexican Population

by Irma G. Enriquez-Maldonado, Daniel A. Montes-Galindo, Rocio Ortiz-Lopez, Jesus Ojeda-Ibarra, Margarita L. Martinez-Fierro, Iram P. Rodriguez-Sanchez, Augusto Rojas-Martinez, Angel Zavala-Pompa, Carmen Alicia Sanchez-Ramirez, Alejandra E. Hernandez-Rangel, Karmina Sanchez-Meza, Idalia Garza-Veloz, Alejandrina Rodriguez-Hernandez and Ivan Delgado-Enciso

Pediatr. Rep. 2024, 16(3), 786-793; https://doi.org/10.3390/pediatric16030066 - 9 Sep 2024

Abstract

The methylenetetrahydrofolate reductase (MTHFR) gene 677C➔T polymorphism is capable of altering folate metabolism and can modify certain neoplasia risk. Reports have suggested that folate can have an influence on bone development and so it is of interest to know if the [...] Read more.

The methylenetetrahydrofolate reductase (MTHFR) gene 677C➔T polymorphism is capable of altering folate metabolism and can modify certain neoplasia risk. Reports have suggested that folate can have an influence on bone development and so it is of interest to know if the MTHFR 677C➔T polymorphism is associated with the malignant transformation process of this tissue. The polymorphism was determined in 55 patients with osteosarcoma and in 180 healthy individuals. Compared with C/T+C/C genotypes, a 3.7-fold reduction in osteosarcoma probability is possible with the T/T genotype (OR 0.27, CI 95% 0.07–0.82). Undoubtedly, further studies, utilizing large samples and carried out on different populations, are necessary to confirm these results. Full article

7 pages, 2360 KiB

Open AccessCase Report

Case Report of a Neonate with Complex Gastroschisis: A Multidisciplinary Approach

by Palanikumar Balasundaram, Timothy B. Lautz, Rhonda Gale and Kimberly G. Remedios-Smith

Pediatr. Rep. 2024, 16(3), 779-785; https://doi.org/10.3390/pediatric16030065 - 9 Sep 2024

Abstract

Gastroschisis is a congenital anomaly characterized by herniation of abdominal contents via a defect in the anterior abdominal wall. Gastroschisis can manifest as simple or complex, with additional complications such as atresia, perforation, ischemia, necrosis, or volvulus. While prenatal screening and advancements in [...] Read more.

Gastroschisis is a congenital anomaly characterized by herniation of abdominal contents via a defect in the anterior abdominal wall. Gastroschisis can manifest as simple or complex, with additional complications such as atresia, perforation, ischemia, necrosis, or volvulus. While prenatal screening and advancements in surgical techniques have improved outcomes, infants with complex gastroschisis cases pose significant challenges in neonatal care. Vanishing gastroschisis, a rare but dreaded complication with a mortality rate ranging from 10 to 70%, occurs when the abdominal wall closes around the herniated bowel, leading to strangulation. We present a case report focusing on the management of neonatal gastroschisis in a 36-week-old female infant with vanishing gastroschisis. The infant’s clinical course, including surgical interventions, complications, and multidisciplinary management, is discussed in detail. This case underscores the importance of a multidisciplinary approach in optimizing outcomes for infants with complex gastroschisis. Via this case report, we aim to provide insights into the complexities of neonatal gastroschisis management and advocate for a collaborative approach involving neonatology, pediatric surgery, infectious disease, and palliative care to improve outcomes and quality of life for affected infants. Full article

(This article belongs to the Special Issue Global Neonatal Screening: Expanding Horizons in Diagnostic Technologies)

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16 pages, 827 KiB

Open AccessReview

Diagnostic Biomarkers of Microvascular Complications in Children and Adolescents with Type 1 Diabetes Mellitus—An Updated Review

by Naser A. Alsharairi

Pediatr. Rep. 2024, 16(3), 763-778; https://doi.org/10.3390/pediatric16030064 - 5 Sep 2024

Abstract

Type 1 diabetes mellitus (T1DM) is regarded as the most chronic autoimmune disease affecting children and adolescents that results from a destruction of pancreatic β-cell and leads to insulin insufficiency and persistent hyperglycemia (HG). Children and adolescents with T1DM are at an increased [...] Read more.

Type 1 diabetes mellitus (T1DM) is regarded as the most chronic autoimmune disease affecting children and adolescents that results from a destruction of pancreatic β-cell and leads to insulin insufficiency and persistent hyperglycemia (HG). Children and adolescents with T1DM are at an increased risk of developing microvascular complications, including diabetic nephropathy (DNE), diabetic retinopathy (DR), and diabetic neuropathy (DNU). The risk factors and prevalence of these complications differ greatly in pediatric studies. Screening for T1DM microvascular complications undergoes different stages and it is recommended to identify early symptoms and clinical signs. The identification of biomarkers in T1DM microvascular complications is needed to provide optimal treatment. Despite several studies on early biomarkers for DNE in children, the potential biomarkers for predicting DR and DNU have not been completely illustrated. This review fills this gap by identifying biomarkers of T1DM microvascular complications in children and adolescents through searches in the PubMed/Medline database. Full article

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10 pages, 1037 KiB

Open AccessArticle

Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery

by Abdullah H. Ghunaim, Basma Aljabri, Ahmed Dohain, Ghassan S. Althinayyan, Abdulaziz I. Aleissa, Ahmad T. Alshebly, Rayan A. Alyafi, Tareg M. Alhablany, Ahmed M. Nashar and Osman O. Al-Radi

Pediatr. Rep. 2024, 16(3), 753-762; https://doi.org/10.3390/pediatric16030063 - 31 Aug 2024

Abstract

Background/Objectives: Deep hypothermic circulatory arrest (DHCA) is safe, but subtle neurodevelopmental deficits may persist far beyond the perioperative period. We aimed to investigate the relationship between DHCA duration and neurodevelopmental outcomes in young children undergoing cardiac surgery with DHCA. Methods: Children aged < [...] Read more.

Background/Objectives: Deep hypothermic circulatory arrest (DHCA) is safe, but subtle neurodevelopmental deficits may persist far beyond the perioperative period. We aimed to investigate the relationship between DHCA duration and neurodevelopmental outcomes in young children undergoing cardiac surgery with DHCA. Methods: Children aged < 42 months, including neonates who underwent cardiac surgery using DHCA without regional perfusion techniques, were included as the DHCA group. Children in the same age range who underwent cardiac surgery without DHCA were included as the control group. All enrolled patients underwent neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development (BSTID) by a trained pediatrician, and 17 DHCA patients and 6 control patients completed the BSTID assessment. Results: Both groups showed no significant preoperative, operative, or postoperative differences. Adjusted multivariable analysis revealed that prematurity and age at assessment were significant changing predictors of each of the BSTID components (p < 0.001), except for the gross motor component, where only age at assessment was a significant adjusting predictor. Longer DHCA was associated with lower fine and gross motor BSTID components; however, the association was not statistically significant (p = 0.06). Conclusions: Long-duration DHCA without regional perfusion techniques may be associated with less optimal neurodevelopmental outcomes. Full article

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17 pages, 1051 KiB

Open AccessReview

Prenatal Tobacco Exposure and Behavioral Disorders in Children and Adolescents: Systematic Review and Meta-Analysis

by Stephanie Godleski, Shannon Shisler, Kassidy Colton and Meghan Leising

Pediatr. Rep. 2024, 16(3), 736-752; https://doi.org/10.3390/pediatric16030062 - 31 Aug 2024

Abstract

Prenatal tobacco exposure has been implicated in increased risk of the development of behavioral disorders in children and adolescents. The purpose of the current study was to systematically examine the association between prenatal tobacco exposure and diagnoses of Attention Deficit/Hyperactivity Disorder, Oppositional Defiant [...] Read more.

Prenatal tobacco exposure has been implicated in increased risk of the development of behavioral disorders in children and adolescents. The purpose of the current study was to systematically examine the association between prenatal tobacco exposure and diagnoses of Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder in childhood and adolescence. We searched Medline, Psychinfo, ERIC, Proquest, Academic Search Complete, PsychArticles, Psychology and Behavioral Sciences Collection, Web of Science, CINAHL Plus, and Google Scholar databases through October 2022. The authors screened studies and extracted data independently in duplicate. Ten clinical studies examining diagnoses of Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder between the ages of 4 and 18 years old were included. There was insufficient evidence to synthesize outcomes related to Conduct Disorder and Oppositional Defiant Disorder. The meta-analysis found a significant effect of prenatal tobacco exposure in increasing the likelihood of an Attention Deficit/Hyperactivity Disorder diagnosis in childhood and adolescence. Implications for future research are discussed. Full article

(This article belongs to the Special Issue Mental Health and Psychiatric Disorders of Children and Adolescents)

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12 pages, 613 KiB

Open AccessReview

The Influence of Nutritional Status on Brain Development: Benefits of Exclusive Breastfeeding

by Ellen Schavarski Chade, Odonis Rocha Júnior, Nathalia Marçallo Peixoto Souza, Aline Jacoski de Oliveira Krüger da Silva, Luana Mota Ferreira, Jéssica Brandão Reolon, Juliana Sartori Bonini, Fabiane Gomes de Moraes Rego and Marcel Henrique Marcondes Sari

Pediatr. Rep. 2024, 16(3), 724-735; https://doi.org/10.3390/pediatric16030061 - 24 Aug 2024

Abstract

Background: This study aimed to conduct a narrative review approaching the effects of exclusive breastfeeding on neuropsychomotor development. The goal was to provide evidence-based knowledge to inform healthcare practices and policies and promote optimized infant feeding strategies. Methods: Our study reviewed the relevant [...] Read more.

Background: This study aimed to conduct a narrative review approaching the effects of exclusive breastfeeding on neuropsychomotor development. The goal was to provide evidence-based knowledge to inform healthcare practices and policies and promote optimized infant feeding strategies. Methods: Our study reviewed the relevant literature from May and June 2024, covering the publication period between 2013 and 2024. The PubMed database was utilized and searched for articles using keywords such as “Brain”, “Growth”, “Development”, and “Breastfeeding”, employing Boolean operators such as “AND”, “OR”, and “NOT.” Results: Our search initially screened 15,412 studies, resulting in 600 articles. Eleven studies met our inclusion criteria and provided relevant information on the topic. Several studies have shown that exclusive breastfeeding and its duration are beneficial for neural development. Research suggests that breastfeeding improves brain architecture, white matter development, and cognitive performance. Additionally, studies indicate that the mother’s intake of omega-3 fatty acids can enhance infant brain development, and specific micronutrients in breast milk, such as myo-inositol, may contribute to neural connectivity. Some findings also suggest that the child’s sex may play a role in how breast milk benefits the brain. Furthermore, there is evidence of the strong influence of epigenetic compounds on the neurodevelopmental benefits of exclusive breastfeeding. Conclusions: This narrative review revealed findings that indicate breast milk has a positive impact on brain development. This emphasizes that breast milk has a positive impact on brain development. It underscores the importance of conducting additional research to understand how breastfeeding specifically influences neurodevelopment. Full article

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7 pages, 1244 KiB

Open AccessCase Report

Rare Postoperative Complication of Esophageal Atresia after Open Thoracotomy Repair in Newborn—Lung Torsion: A Case Report

by Szymon Gryboś, Viera Karaffová and Katarina Klapačová

Pediatr. Rep. 2024, 16(3), 717-723; https://doi.org/10.3390/pediatric16030060 - 15 Aug 2024

Abstract

In this case report, we described a rare complication—lung torsion after esophageal atresia repair in a newborn. Torsion of the lung is a critical condition in which either the entire lung or a lung lobe twists, leading to occlusion of blood vessels and [...] Read more.

In this case report, we described a rare complication—lung torsion after esophageal atresia repair in a newborn. Torsion of the lung is a critical condition in which either the entire lung or a lung lobe twists, leading to occlusion of blood vessels and airways. The patient’s clinical condition was poor after the primary operation. An emergency thoracotomy showed 180° torsion of the right upper lobe (RUL) and right middle lobe (RML). After detorsion, perioperatively, the lung was gradually reperfused and had a normal appearance. After surgery, the patient was unstable, which culminated in a fatal end (bradycardia, reperfusion injury). Immediate intervention can preserve the affected lung or lung lobe. However, pulmonary torsion typically has a poor prognosis due to misdiagnosis and delayed treatment. Additionally, diagnosis in the neonatal period is even more challenging because the clinical symptoms are nonspecific. In any case, the question is whether detorsion is the right solution or whether a segmentectomy is necessary. Full article

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21 pages, 2244 KiB

Open AccessSystematic Review

Analysis of Risk Determinants of Neonatal Mortality in the Last Decade: A Systematic Literature Review (2013–2023)

by Msatfa Nabila, Aziz Baidani, Yassmine Mourajid, Milouda Chebabe and Hilali Abderraouf

Pediatr. Rep. 2024, 16(3), 696-716; https://doi.org/10.3390/pediatric16030059 - 12 Aug 2024

Abstract

This study aimed to analyze the determinants of neonatal mortality over the last decade (2013–2023), identifying key factors that have influenced neonatal outcomes both before and during the COVID-19 pandemic. Utilizing a systematic literature review approach guided by the PRISMA method, this study [...] Read more.

This study aimed to analyze the determinants of neonatal mortality over the last decade (2013–2023), identifying key factors that have influenced neonatal outcomes both before and during the COVID-19 pandemic. Utilizing a systematic literature review approach guided by the PRISMA method, this study evaluates 91 papers collected from indexed databases such as Scopus, PubMed, and Web of Science. The review encompasses studies conducted globally, offering insights into the evolution of neonatal mortality research and the impact of the COVID-19 crisis on neonatal health. The analysis revealed a complex array of risk determinants, categorized into socioeconomic factors, clinical factors, and healthcare access and quality. Notable factors include rural versus urban healthcare disparities, prenatal and postnatal care quality, and the influence of healthcare infrastructure on neonatal outcomes. This study highlights the shifting focus of neonatal mortality research in response to global health challenges, including the pandemic. The findings underscore the need for multidisciplinary approaches to address neonatal mortality, emphasizing the importance of enhancing healthcare systems, improving maternal education, and ensuring equitable access to quality care. Future research should explore the long-term effects of the COVID-19 pandemic on neonatal health and investigate the efficacy of interventions in diverse healthcare settings. Full article

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12 pages, 568 KiB

Open AccessArticle

The Influence of the Dominant Leg in Body Asymmetries in Children and Adolescent Male Soccer Players

by Eleni Theodorou, Theodoros B. Grivas and Marios Hadjicharalambous

Pediatr. Rep. 2024, 16(3), 684-695; https://doi.org/10.3390/pediatric16030058 - 8 Aug 2024

Abstract

The current study aimed to examine (a) whether the dominant leg (DL) was associated with the contralateral side of functional scoliosis and (b) if any of the postural asymmetries’ evaluation variables may be a reliable predictor of the functional scoliosis development in young [...] Read more.

The current study aimed to examine (a) whether the dominant leg (DL) was associated with the contralateral side of functional scoliosis and (b) if any of the postural asymmetries’ evaluation variables may be a reliable predictor of the functional scoliosis development in young male soccer players. Six hundred-nine (n = 609) male soccer players (age: 10.8 ± 2.7 years; height: 147 ± 17 cm; weight: 43.4 ± 14.6 kg; DL: Right 81.6%, Left 14%, Both 4.4%) participated in this study. The spinal asymmetries evaluation included thoracic kyphosis, lumbar lordosis, truncal rotation, shoulders alignment from posterior view, anterior and posterior pelvic tilt, anterior superior iliac spine (ASIS), hamstring tightness, and lower extremities discrepancy. A significant association was observed between the DL and the truncal rotation side: χ²(4) = 30.84, p = 0.001, V = 0.16. Participants with longer left legs were likelier to present a spinal asymmetry (OR = 1.18). The participants with higher left shoulders were 2.13 times more likely to have spinal asymmetry than the participants with normal shoulders level. Participants with left ASIS higher were 3.08 times more likely to present asymmetry than those with normally aligned ASIS levels. There was also a significant association between the DL and the side of truncal rotation: χ²(2) = 13.30, p = 0.001, V = 0.449. Logistic regression analysis for the functional scoliotic group and truncal rotation side demonstrated that the taller participants and participants with shorter right legs were more likely to have asymmetry on the left side (OR = 1.29, OR = 0.32). Participants with greater right hamstring stiffness were likelier to have a truncal rotation on the right side (OR = 0.93). Participants with higher left shoulders were 0.20 times less likely to have a truncal rotation on the left side than the participants with normal shoulders level. In conclusion, leg dominance in children and in youth soccer players may be a factor causing truncal rotation on the contralateral side. Additional causes, such as leg length discrepancy and pelvic tilt, may progressively lead to functional scoliosis. Full article

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6 pages, 226 KiB

Open AccessEditorial

Respiratory Syncytial Virus: The Urgent Need for Innovative Preventive Strategies

by Fabrizio Virgili, Fabio Midulla and Fernando Maria de Benedictis

Pediatr. Rep. 2024, 16(3), 678-683; https://doi.org/10.3390/pediatric16030057 - 8 Aug 2024

Abstract

Respiratory Syncytial Virus (RSV) is a medium-sized enveloped Pneumovirus belonging to the Paramyxoviridae family [...] Full article

9 pages, 1108 KiB

Open AccessArticle

Body Mass Index Changes at 1.5 and 3 Years of Age Affect Adult Body Composition

by Chiharu Miyayama, Hiromichi Shoji, Yayoi Murano, Kanami Ito, Mizue Saita, Toshio Naito, Hiroshi Fukuda and Toshiaki Shimizu

Pediatr. Rep. 2024, 16(3), 669-677; https://doi.org/10.3390/pediatric16030056 - 31 Jul 2024

Abstract

Early childhood lays the foundation for many outcomes in later life. Recent studies suggest that early childhood development may contribute to lifestyle-related diseases such as obesity, type 2 diabetes, and cardiovascular disease in adulthood; however, there have been few investigations on this association [...] Read more.

Early childhood lays the foundation for many outcomes in later life. Recent studies suggest that early childhood development may contribute to lifestyle-related diseases such as obesity, type 2 diabetes, and cardiovascular disease in adulthood; however, there have been few investigations on this association among adults in Japan. Therefore, we examined the relationship between recent physical measurements in adults who underwent health checkups at our university and their physical measurements at birth and during infancy recorded in the Maternal and Child Health Handbook. The median age and body mass index (BMI) of the participants were 36 years and 20.4 kg/m², respectively. BMI at the time of health checkup in adults did not correlate with physical measurements at birth, but it was found to be associated with BMI at 1.5 (regression coefficient (β) 0.53, p < 0.05) and 3 (β 0.7, p < 0.01) years of age. In addition, the waist-to-height ratio in adulthood was also associated with BMI at 1.5 (β 0.01, p < 0.05) and 3 (β 0.01, p < 0.05) years of age. These findings suggest that it is critical to provide appropriate guidance to children with high BMI and their parents during health checkups to prevent lifestyle-related disorders in adulthood. Full article

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12 pages, 1532 KiB

Open AccessArticle

Evaluating Family Coping Mechanisms in Pediatric Seizure Disorders: From Emergency Room to Long-Term Follow-Up

by Ada Claudia Silvana Gruescu, Calin Popoiu, Mihaela Codrina Levai, Paula Irina Barata and Caius Glad Streian

Pediatr. Rep. 2024, 16(3), 657-668; https://doi.org/10.3390/pediatric16030055 - 31 Jul 2024

Abstract

Pediatric seizure disorders profoundly impact family dynamics, often escalating stress and impairing coping mechanisms. This study aimed to longitudinally assess the impact of pediatric seizures on family stress and coping, evaluating the efficacy of multidisciplinary follow-up care in enhancing psychological resilience and adaptation. [...] Read more.

Pediatric seizure disorders profoundly impact family dynamics, often escalating stress and impairing coping mechanisms. This study aimed to longitudinally assess the impact of pediatric seizures on family stress and coping, evaluating the efficacy of multidisciplinary follow-up care in enhancing psychological resilience and adaptation. A longitudinal study design was implemented, enrolling children aged 1–18 who presented with a first seizure and received a neurologist’s diagnosis at the Emergency Clinical Hospital for Children “Louis Turcanu,” Timisoara, Romania. Validated questionnaires, including the Parenting Stress Index (PSI), Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-10), and Parental Concerns Questionnaire (PCQ), were employed at baseline, 6, and 12 months. Statistical analysis utilized ANOVA and t-tests to evaluate changes in stress and coping outcomes. The study involved 68 families, with significant reductions in stress and anxiety reported over the follow-up period. Initial PSI scores showed high stress levels across various domains: Emotional Stress (59.47) decreased to 50.63 at one year; Parent–Child Communication Difficulties started at 66.03 ± 20.15 and reduced to 56.92 ± 18.74; and Total Family Stress decreased from 65.55 to 55.97. The HADS scores indicated initial anxiety and depression at 8.2 ± 3.1 and 7.1 ± 2.8, respectively, with reductions to 6.8 and 5.9 by the end of the year. The overall HADS score showed a decrease from 15.4 to 12.8. PCQ results mirrored these findings, with Total Score dropping from 9.7 to 7.7. PSS-10 scores declined from 13.5 to 11.3, with a significant reduction in the positive sub-score. The proactive, multidisciplinary care approach significantly reduced stress and enhanced coping mechanisms in families dealing with pediatric seizures. The decreases in stress, anxiety, and depression scores highlight the potential for integrated care models to improve long-term outcomes in these families. These findings support the continued development of targeted interventions to aid in the management of chronic pediatric conditions. Full article

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13 pages, 280 KiB

Open AccessReview

Status Asthmaticus in the Pediatric ICU: A Comprehensive Review of Management and Challenges

by Amy Joseph and Hammad Ganatra

Pediatr. Rep. 2024, 16(3), 644-656; https://doi.org/10.3390/pediatric16030054 - 31 Jul 2024

Abstract

This narrative review addresses the significant burden of pediatric status asthmaticus, which comprises almost 20% of admissions to pediatric intensive care units (PICUs). It highlights the diverse modalities employed in the PICU for managing this life-threatening condition, and thoroughly discusses the literature in [...] Read more.

This narrative review addresses the significant burden of pediatric status asthmaticus, which comprises almost 20% of admissions to pediatric intensive care units (PICUs). It highlights the diverse modalities employed in the PICU for managing this life-threatening condition, and thoroughly discusses the literature in support of or against these treatment modalities. Full article

13 pages, 692 KiB

Open AccessArticle

Attitudes and Skills in Basic Life Support after Two Types of Training: Traditional vs. Gamification, of Compulsory Secondary Education Students: A Simulation Study

by Adrián Rodríguez-García, Giovanna Ruiz-García, Rubén Navarro-Patón and Marcos Mecías-Calvo

Pediatr. Rep. 2024, 16(3), 631-643; https://doi.org/10.3390/pediatric16030053 - 30 Jul 2024

Abstract

It is recommended to implement the teaching of Basic Life Support (BLS) in schools; however, studies on the best training method are limited and have been a priority in recent years. The objective of this study was to analyze the attitudes and practical [...] Read more.

It is recommended to implement the teaching of Basic Life Support (BLS) in schools; however, studies on the best training method are limited and have been a priority in recent years. The objective of this study was to analyze the attitudes and practical skills learned during BLS training using a gamified proposal. A comparative study was carried out, consisting of Compulsory Secondary Education students [control group (CG; classical teaching) and experimental group (EG; gamified proposal)]. The instruments used were the CPR and AED action sequence observation sheet, data from the Laerdal Resusci Anne manikin and AED and Attitude Questionnaire towards Basic Life Support and the Use of the Automated External Defibrillator. Sixty-eight students (33 girls) with a mean age of 13.91 ± 0.70 years were recruited. Results were significantly better in the EG (n = 37) [i.e., breathing control (p = 0.037); call to emergency services (p = 0.049); mean compression depth (p = 0.001); self-confidence (p = 0.006); intention to perform BLS and AED (p = 0.002)]; and significantly better in the CG (n = 31) [Total percentage of CPR (p < 0.001); percentage of correct compression (p < 0.001); time to apply effective shock with AED (p < 0.001); demotivation (p = 0.005). We can conclude that the group that was trained with the training method through the gamified proposal presents better intentions and attitudes to act in the event of cardiac arrest than those of the classic method. This training method allows for similar results in terms of CPR and AED skills to classical teaching, so it should be taken into account as a method for teaching BLS to secondary education students. Full article

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13 pages, 3086 KiB

Open AccessReview

Acute Cardiovascular Effects of Simultaneous Energy Drink and Alcohol Consumption in Young Adults: A Review of Case Reports

by Victor Azarm, Jan-Philipp Link, Guido Mandilaras, Pengzhu Li, Robert Dalla-Pozza, André Jakob, Nikolaus Alexander Haas, Felix Sebastian Oberhoffer and Meike Schrader

Pediatr. Rep. 2024, 16(3), 618-630; https://doi.org/10.3390/pediatric16030052 - 29 Jul 2024

Abstract

(1) Background: The aim of this review was to identify and summarize adverse cardiovascular health events associated with the simultaneous consumption of energy drinks (ED) and alcohol. Potential prevention strategies and the implementation of research toward the underlying mechanisms for these pathologies were [...] Read more.

(1) Background: The aim of this review was to identify and summarize adverse cardiovascular health events associated with the simultaneous consumption of energy drinks (ED) and alcohol. Potential prevention strategies and the implementation of research toward the underlying mechanisms for these pathologies were highlighted to emphasize the need for further investigation and to encourage more attention to this field. (2) Methods: The PubMed database was searched for case reports linked with adverse cardiovascular events after simultaneous ED and alcohol consumption. Inclusion criteria were: the reported age of the patient is between 16 and 35 years and confirmed co-consumption of EDs and alcohol. All relevant articles that met the inclusion criteria were fully read and all relevant data was extracted. The extracted data was summarized and presented in this review of cases. (3) Results: In total, 10 cases were identified. The analysis showed that mainly young adults (median age = 24.5 years), in particular men (80%) were affected. The three parts of the cardiovascular system affected were heart rhythm (42%), myocardial function (33%), and coronary arteries (25%). In 3 cases the outcome was fatal. Moreover, preexisting health conditions and/or potential trigger factors were present in 60% of selected cases. (4) Conclusions: This review of case reports suggests that the simultaneous consumption of EDs and alcohol can lead to adverse cardiovascular health events and even incidents with fatal outcomes were reported. Potential trigger factors and preexisting health conditions seem to increase the probability of adverse cardiovascular health events. Consumers should be informed about the potential risks and follow responsible consumption behavior to prevent future health events. More systematic studies are needed to determine the acute effects on the cardiovascular system in young adults. Full article

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16 pages, 1070 KiB

Open AccessFeature PaperReview

Acquired and Inherited Zinc Deficiency-Related Diseases in Children: A Case Series and a Narrative Review

by Tommaso Bellini, Marta Bustaffa, Barbara Tubino, Benedetta Giordano, Clelia Formigoni, Elena Fueri, Federica Casabona, Barbara Vanorio, Andrea Pastorino, Astrid Herzum, Caterina Matucci-Cerinic, Serena Arrigo, Gianmaria Viglizzo and Emanuela Piccotti

Pediatr. Rep. 2024, 16(3), 602-617; https://doi.org/10.3390/pediatric16030051 - 25 Jul 2024

Cited by 1

Abstract

Zinc deficiency is a significant global health concern among children, manifesting in various acquired and inherited conditions. This comprehensive overview of acquired and inherited zinc deficiency-related diseases in children aimed to explore the clinical presentations, diagnostic challenges, and management strategies associated with these [...] Read more.

Zinc deficiency is a significant global health concern among children, manifesting in various acquired and inherited conditions. This comprehensive overview of acquired and inherited zinc deficiency-related diseases in children aimed to explore the clinical presentations, diagnostic challenges, and management strategies associated with these conditions. This case series elucidates the diverse clinical manifestations of zinc deficiency in pediatric patients, ranging from dermatitis and growth retardation to immune dysregulation and neurological abnormalities, and discusses the underlying genetic mechanisms, clinical phenotypes, and therapeutic interventions. The complexity of zinc deficiency-related diseases in children underscores the need for a multidisciplinary approach involving pediatricians, dermatologists, geneticists, and nutritionists to optimize patient care and outcomes. Full article

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8 pages, 1821 KiB

Open AccessBrief Report

Predictive Role of Fluorescein Angiography in Retinopathy of Prematurity

by Gianluca Dini, Alfredo Beccasio, Francesco Della Lena, Alberto Verrotti and Carlo Cagini

Pediatr. Rep. 2024, 16(3), 594-601; https://doi.org/10.3390/pediatric16030050 - 24 Jul 2024

Abstract

Background: Fluorescein angiography (FA) has been a pivotal tool for studying the pathophysiology of retinopathy of prematurity (ROP) in vivo. We examined the course of ROP using FA to assess the predictive value of angiographic features. Methods: This is an observational retrospective cohort [...] Read more.

Background: Fluorescein angiography (FA) has been a pivotal tool for studying the pathophysiology of retinopathy of prematurity (ROP) in vivo. We examined the course of ROP using FA to assess the predictive value of angiographic features. Methods: This is an observational retrospective cohort study of eyes screened for ROP with a binocular indirect ophthalmoscope and FA. RetCam fundus imaging and video digital fluorescein angiography were performed in the neonatal intensive care unit of Santa Maria Hospital of Perugia. The masked grading of the FA images was retrospectively conducted by two ROP expert ophthalmologists. Results: A total of 80 eyes of 40 patients were included for this study. Among the angiographic features evaluated, leakage, shunts, and tangles were predictive of the development of treatment-requiring ROP (p < 0.05). Conclusions: FA can add to our understanding of the evolution of vascular abnormalities in the course of ROP and can help predict which eyes will go on to treatment. Full article

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Pediatric Reports

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