Search Results (67)

Pesticides play an essential role in modern agriculture, yet increasing evidence links their widespread use to neurotoxic effects that contribute to both neurodegenerative and neurodevelopmental disorders. In recent years, new classes of pesticides such as neonicotinoids and pyrethroids have garnered attention due to their potential to disrupt neurodevelopment, even at low exposure levels. Furthermore, emerging evidence underscores the involvement of the gut–brain axis, neuroinflammation, and epigenetic modulation in pesticide-induced neuropathology. This review aims to synthesize these latest advancements while highlighting underexplored mechanisms, thereby offering a comprehensive and current perspective on pesticide-related neurotoxicity. Data from the Rapid Alert System for Food and Feed (RASFF) indicate that several food products include residues of pesticides recognized for their neurotoxic properties. Although environmental exposure levels are lower than those in occupational contexts, the magnitude and persistence of food-based exposure demand thorough evaluation. This review integrates evidence coming from epidemiological, in vivo and in vitro investigations, emphasizing the correlations between pesticide exposure and conditions such as Alzheimer’s disease, Parkinson’s disease, and cognitive deficits in children. Neurodevelopmental toxicity is especially alarming since symptoms may manifest subtly and with a delayed onset after early-life exposure, indicating the significant neurotoxic potential of pesticide residues and emphasizing the need for their careful evaluation in food safety assessments. Improved regulatory procedures and public health efforts are essential to reducing long-term brain damage. Full article

Background/Objectives: Pertussis remains a significant cause of respiratory illness in children, particularly in regions with suboptimal vaccination coverage. This retrospective study analyzes the clinical presentations, co-infections, treatment, and outcomes of pediatric patients diagnosed with Bordetella pertussis at the Constanța County Clinical Emergency Hospital “St. Apostle Andrew” between 1 January and 30 September 2024. Methods: Thirty-eight children, predominantly under the age of 3 years (81.58%), were included. Demographic data, clinical features, coinfecting pathogens, antimicrobial regimens, and hospital outcomes were reviewed. Results: Only 7 out of 38 children (18.42%) had received pertussis vaccination, and none benefited from maternal immunization. The highest incidence occurred in infants under 1 year (44.74%). Intensive care was required in 18.42% of cases, and macrolides were the most frequently used antibiotics (68.42%). Co-detection of respiratory pathogens—particularly Streptococcus pneumoniae, enteroviruses, and human rhinoviruses—was common. Severe cases often exhibited hyperleukocytosis, which was associated with complications such as heart failure. Conclusions: These findings underscore the need for timely recognition and management of pertussis and its complications. Although macrolides remain the first-line therapy, adjunctive treatments like leukoreduction may be considered in critical cases. The persistence of pertussis despite vaccination efforts highlights the challenges posed by waning immunity and diagnostic limitations, reinforcing the need for strengthened public health strategies. Full article

Childhood obesity is linked to heightened oxidative stress, a key driver of endothelial dysfunction, inflammation, and metabolic complications. Antioxidants, including Vitamins C and E, are vital in neutralizing free radicals and mitigating oxidative damage. This non-systematic review examines the potential advantages of antioxidant supplementation in pediatric obesity, focusing on its effects on vascular health, insulin sensitivity, and inflammatory processes. Emerging data suggest that antioxidants may improve endothelial function, reduce blood pressure, and enhance metabolic homeostasis in obese children. However, the long-term efficacy and safety of antioxidant supplementation remain uncertain, necessitating further rigorous randomized controlled trials. A deeper understanding of antioxidants’ role in pediatric obesity could unlock novel therapeutic approaches for managing obesity-related complications and improving children’s overall health outcomes. Full article

Background: Articular damage is a marker of hereditary hemophilia, especially affecting the large joints of the upper and lower limbs. This retrospective study aimed to emphasize that hereditary coagulopathies, specifically hemophilia A and B, require a multidisciplinary approach due to their complex nature. The primary objectives of the paper are to determine the prevalence of hemophilic arthropathy among individuals with hemophilia in the northeastern region of Romania, identify the most frequently affected joints, and assess whether there is a correlation between the development of hemophilic arthropathy, the type of hemophilia, and the treatment received. The secondary objectives of the work are to identify a series of particularities regarding the occurrence of the comorbidities depending on the type of hemophilia and the treatment and severity of arthropathies. Materials and Methods: We conducted a retrospective study that included 36 adults with hemophilia A and B. The status of the osteoarticular system was evaluated using the modified Hemophilia Joint Health Score (mHJHS). Twelve joints were evaluated using the following parameters: swelling, duration of swelling, muscle atrophy, joint pain, crepitus on motion, flexion loss, and extension loss. Results and Discussions: The most severe damage was found in the joints of the knees, ankles, elbows, and wrists. In the knees, severe damage was noted significantly more frequently in the right knee (50% vs. 33.3%; p = 0.001). In the ankles, a higher frequency of mild damage to the left ankle was noted (44.4% vs. 27.8%; p = 0.002). The severe form of hemophilia was correlated with severe joint damage (p < 0.05). Comorbidities like cardiovascular disease, obesity, viral infection (HCV infection), and gastrointestinal disease were found in the hemophilia population of our study. All patients with HCV infection had severe joint damage, while 38.5% of patients without HCV infection had mild joint damage, and 30.8% had no joint damage (p = 0.001). In all patients with HCV virus infection, the treatment was short-term substitution (intermittent prophylaxis), while in 53.8% of patients without HCV virus infection, the treatment consisted of continuous prophylaxis (p = 0.001). Conclusions: It is currently essential to determine methods for comprehensive hemophilia care that involves multidisciplinary medical services necessary for the diagnosis, treatment, and management of the condition and its complications and comorbidities. Full article

Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently diagnosed in female patients, caused by multiple interacting factors. It has a complex pathogenesis which can affect almost any organ, from the kidneys to the cardiovascular, pulmonary, neurological, osteoarticular, and hematological systems. The present narrative review seeks to elucidate the role of reactive oxygen species (ROS) in the pathogenesis of SLE. The central question guiding this study is to what extent these serum protein modifications correlate with disease activity and organ damage in SLE. It is characterized by the decreased apoptosis and increased necrosis of T cells and the NETosis of granulocytes. Given the impact of an SLE diagnosis on one’s life, this narrative review aims to evaluate the intricacies of oxidative stress and its relevance to the pathogenesis and treatment of the disease. Topics such as understanding processes of oxidative stress, their damaging pathways, oxidative stress biomarkers, and their role in the future assistance of clinical decisions will be discussed in the article. The accurate determination of biomarkers is taught to improve both the diagnosis and the management of the disease, while antioxidant therapy may open a new door for the treatment. Full article

The increased consumption of fruit and vegetables is essential for moving towards a healthier and more sustainable diet. Vegetarian diets are gaining in popularity due to their environmental and health implications; however, there is a need for additional research investigating pesticide residues in these foods. It is increasingly recognized that the global food system must prioritize nutritional quality, health, and environmental impact over quantity. Food contaminants, including pesticides, mycotoxins, and heavy metals, pose a substantial threat to food safety due to their persistent nature and harmful effects. We conducted a literature search utilizing four distinct databases (PubMed, Google Scholar, NIH, ScienceDirect) and several combinations of keywords (pesticides, food, vegetarian diet, toxicity, sustainable, removal). Consequently, we selected recent and relevant studies for the proposed topic. We have incorporated articles that discuss pesticide residues in food items, particularly in plant-based products. This study rigorously analyzes the harmful environmental impacts of pesticides and ultimately provides sustainable solutions for their elimination or reduction, along with environmentally sound alternatives to pesticide use. This study concludes that the transition towards sustainable agriculture and food production is essential for reducing pesticide residues in food, thereby protecting human health, wildlife populations, and the environment. This paper argues for the urgent need to transform global food systems to prioritize health and sustainability. Full article

Hyperglycemia significantly initiates oxidative stress in children diagnosed with type 1 diabetes (T1DM). This study investigates the differences in oxidative stress markers between pediatric patients with T1DM and those experiencing transient hyperglycemia. In this case–control study, 42 children diagnosed with T1DM, according to ISPAD (International Society for Pediatric and Adolescent Diabetes), and their healthy counterparts, aged 1–6 years old, participated. Blood samples were analyzed for oxidative stress biomarkers such as malondialdehyde (MDA) and glutathione peroxidase (GPx). There was no statistically significant association found between the A1c % and age, BMI, and insulin dose (p > 0.05). A negative correlation was found between Se, Zn, cholesterol, GSH, and GPx (p < 0.05), as well as a statistically meaningful positive correlation with the A1c % (p < 0.001). GSH exhibited a statistically significant negative correlation (p < 0.001) with diabetic group. In comparison to control participants, plasma MDA levels (1.3 ± 0.36 µmol/L) had already increased significantly. MDA did correlate in a diabetic group with triglyceride levels (p > 0.0001) or total cholesterol. In the healthy group, the cholesterol levels were normal and apparently did not influence MDA levels. The oxidative state remained unchanged in the healthy participants experiencing temporary hyperglycemia, even though T1DM altered the link between selenium, zinc, and lipids. Full article

Background/Objectives: The gut microbiota is involved in modulating gastrointestinal function and consequently contributes to the manifestation of functional gastrointestinal disorders (FGIDs). The aim of the study was to analyze the composition of the gut microbiota in infants with functional gastrointestinal disorders (infantile colic, functional constipation, gastroesophageal reflux, functional diarrhea) according to age, environmental factors, and clinical manifestations. Methods: The study involved the clinical and laboratory examination of 134 infants divided into two groups: group I (n = 82) with FGIDs according to Rome IV criteria, divided into four subgroups (infantile colic, functional constipation, gastroesophageal reflux, and functional diarrhea), and group II (n = 52) without FGIDs. To assess the composition of intestinal microbiota, a bacteriological analysis of fecal samples was performed. Results: Infants with functional gastrointestinal disorders presented an imbalance of intestinal microflora, which was characterized by a significant decrease in the main representatives of acidifying flora represented by Lactobacillus, Bifidobacterium, and Enterococcus and high abundance of proteolytic microorganisms from the Enterobacteriaceae family such as Klebsiella species and Escherichia coli. In infants born by cesarean section or artificially fed, the incidence of functional gastrointestinal disorders and intestinal dysbiosis was significantly higher. Conclusions: The imbalance of acidifying and proteolytic microbial composition in the gut could be the key to the occurrence of functional gastrointestinal disorders in the first year of life. Full article

The developmental origins of adult disease theory support the concept that undernourished fetuses are at risk of developing metabolic syndrome due to the energy-saving ‘Thrifty Phenotype’. This metabolic plasticity represents an evolutionary adaptation that allows individuals to resist the intense pressure caused by cyclically recurring periods of nutritional deprivation. A comprehensive review was conducted following an extensive literature search in the PubMed/Medline and EMBASE databases concerning reports on fetal/intrauterine growth restriction and its metabolic-related long-term outcomes. We only included articles written in English that were published before 1 July 2024. There are several underlying mechanisms and metabolic and endocrine adjustments shaped by the perinatal environment, and they all contribute to progression towards adult disease. From in utero malnutrition or other insults during the fetal period to fetal programing and postnatal catch-up growth, it is difficult to identify the exact moment when this adaptative phenomenon meant to assure fetal survival and to set children on their own physiological growth curves lose its beneficial effect, establishing the trajectory to obesity, insulin resistance, and other hallmarks of metabolic syndrome. With clinical correspondence to an altered body mass, composition, and eating behaviors, it is evident that the metabolic complications linked to FGR are intricate and arise from disturbances in several pathways and organs, but the underlying processes responsible for the long-term consequences are just starting to be understood. The lack of continuity in perinatal-to-pediatric FGR research sets the challenge of exploring new directions in future scientific opportunities. These will hopefully represent a cornerstone in the management of FGR-related metabolic disorders in children, preventing these disorders from evolving into adult disease. Full article

Cystic echinococcosis (CE) is a neglected tropical parasitic disease linked with significant social and economic burdens worldwide. The scientific community has minimal information on echinococcosis in Romanian people, and hospital medical records are the only sources that may be used to investigate its status. A 7-year retrospective clinical study on pediatric patients with CE from Southeast Romania was performed, and 39 children and adolescents were included, aged 2–15 years old. They were hospitalized with cystic echinococcosis in the Pediatric Department and Pediatric Surgery Department of Constanta County Clinical Emergency Hospital “St. Apostle Andrew” between 1 January 2017 and 1 October 2024. Twenty-nine (74.36%) pediatric patients came from rural zones, and 10 (25.64%) had urban residences. In total, 28 children (71.79%) had contact with four different animals (dogs, goats, pigs, and sheep); only four were from urban zones, and they had contact only with dogs. Data regarding the length of hospital stay, cyst location, and complications were collected and analyzed. According to the medical files, the diagnosis was established using imaging techniques and serological tests for CE. IgE and IgG reported appreciable variations in correlation with all parameters, and significant differences (p < 0.05) were recorded. IgE levels considerably increased in cases of no animal contact, pulmonary involvement, complications, surgical treatment, and multiple hospitalizations. Moderate IgE values were recorded in cases of urban residences, pig and sheep contact, and hepatic involvement. The IgG concentration considerably increased with sheep contact and moderately increased in cases of rural zones, hepatic involvement, complications, and surgical treatment. The results show that incidental discovery, symptoms, complications, multiple dissemination, pulmonary involvement, and dog and pig contact increase the hospitalization time. Extensive data analysis supports our results. Our findings highlight the complexity of managing E. granulosus infections in children and evidence the importance of a multidisciplinary approach, combining early diagnostic tools, tailored medical therapy, and careful surgical intervention when necessary. Full article

Background and Objectives: Haller Cells (HCs) represent the abnormal migration of ethmoid cells that are located below the ethmoid bulla at the level of the upper wall of the maxillary sinus. Through their placement, the cells can exert a mass effect on the infundibulum of the maxillary sinus. The aim of our study is to investigate the prevalence of Haller cells in the Romanian population and to evaluate the relationship between this anatomical variation and chronic rhinosinusitis. Secondly, we want to morphometrically evaluate the impact of Haller cells’ presence in the drainage paths of the maxillary sinuses. Materials and Methods: We conducted a randomised retrospective study that included 255 consecutive multi-detector computed tomography (MDCT) scans of the head. To carry out a comparative evaluation of the association of Haller cells with chronic rhinosinusitis, we divided the patients into two subgroups, a seasonal-based sample, between November 2022 and January 2023, and June 2023 and August 2023, respectively. We report the mean ± standard deviation for the continuous variables. To compare the results, we used the following statistical tests: a chi-squared test and a paired Student’s t-test (one-tail). Results: Our study identified a high prevalence of Haller cells, namely in 128 out of 255 patients (50.2%). There were no statistically significant associations between the presence of HCs and the age and the gender of the sample, respectively. The unilocular morphotype predominates in unilateral shapes and in bilateral shapes as well (p = 0.002). Our study identified the correlation between the Haller cells and the chronic rhinosinusitis in both research samples: “Winter group” and “Summer group” (p = 0.0002 and p = 0.0001, respectively). Conclusions: It was determined that for 40 out of 42 patients, the presence of HCs changes the morphometric pattern of the infundibular maxillary sinus. Full article

Within the pediatric population, bronchial asthma is one of the most prevalent chronic respiratory system diseases. The number of exacerbations, severity, and duration of symptoms all have a significant impact on children’s life quality. In the last decades, the prevention and management strategies of this pathology have focused on maintaining or even increasing the pulmonary function to maximum levels in early childhood, as it has been demonstrated that functional deficits at this level occurring before school age cause pathological manifestations later, in adulthood. The epithelium of the airways and implicitly that of the lung is the first barrier against the lesions caused by pro-oxidative factors. Both oxidative and antioxidative factors can be of endogenous origin (produced by the body) or exogenous (from the environment or diet). Good functioning of antioxidant defense mechanisms from the molecular level to the tissue level, and a balance between pro-oxidative factors and anti- oxidative factors, influence the occurrence of compensatory mechanisms at the level of the respiratory epithelium, causing the delay of local responses to the stress induced by chronic inflammation (bronchial remodeling, thickening of airway smooth muscles, bronchoconstriction, bronchial hyper-reactivity). These mechanisms underlie the pathophysiological changes in asthma. Numerous studies carried out among the pediatric population inclusively have demonstrated the effectiveness of antioxidants in the prophylaxis, slowing down and preventing the progression of this pathology. This review complements the scientific articles, aiming at emphasizing the complexity of oxidative physio-pathological pathways and their importance in the occurrence, development, and therapeutic response in asthma, providing a good understanding of the relationship between oxidative and antioxidative factors, and being a source of future therapeutic strategies. Full article

Background: Despite worldwide vaccination efforts, Hepatitis B virus (HBV) infection remains a significant global health burden, particularly in regions where vertical transmission is prevalent. Given Romania’s history as an endemic area for hepatitis B from the 1990s until the early 2000s and the previously high infection rates among children, it is crucial to continually evaluate HBV infection in this population to monitor current trends, assess the long-term impact of vaccination programs, and address any remaining gaps in prevention and treatment efforts. This study aims to identify childhood risk factors associated with HBV acquisition, examining the role of maternal HBV status in child HBV infection, focusing on vertical transmission among a cohort of 654 children, with maternal infection as the independent variable and child infection as the dependent variable. Methods: We assessed potential risk factors and vaccination coverage among these children. The cohort included 148 children who tested positive for chronic hepatitis B from those 654 tested for HBsAg. Anamnestic data and vaccination history were analyzed, with particular attention to birth type and surgical interventions. Results: Of the 148 HBV-positive children, 80.4% were delivered naturally. Among these, 130 had received hepatitis B vaccination, and 5 were also given hepatitis B immunoglobulin at birth, 4 of whom were born via cesarean section. In the control group, comprising 418 vaccinated children, a lesser proportion were unvaccinated (2.2%). Documented surgical interventions included general and dental surgeries, as well as a single blood transfusion. Conclusions: The study emphasizes the need for comprehensive vaccination strategies and illuminates potential correlations between birth type and vaccination status with childhood HBV infection. Crucially, it highlights the necessity of diligent monitoring and treatment of pregnant women with HBV to prevent vertical transmission as effectively as possible. Full article

Background: Liver cirrhosis presents significant challenges in the pediatric population due to a complex interplay of etiological factors, clinical manifestations, and limited therapeutic options. The leading contributors to cirrhosis among pediatric patients are chronic cholestasis, metabolic disorders present from birth, and long-term hepatitis. Materials and method: Our narrative review aimed to synthesize literature data on the etiology, clinical picture, diagnostic techniques, optimal management of complications, and timely transplantation. Results: The epidemiology of liver cirrhosis in pediatric patients is evolving. The introduction of a universal vaccination and effective long-term viral suppression in viral hepatitis have significantly decreased complications rates. Liver transplantation programs worldwide have also improved the management of cirrhosis complications. Conclusions: Early diagnosis, comprehensive management strategies, and advancements in treatment modalities are critical for improving outcomes. Understanding these differences is crucial in providing age-appropriate care and support for those affected by cirrhosis. Full article

Chronic Hepatitis B virus (HBV) infection in children remains a significant public health challenge. The natural history and treatment outcomes of HBV can vary widely, influencing management strategies. This retrospective study was conducted in Northeast Romania and involved a cohort of 148 pediatric patients diagnosed with chronic viral Hepatitis B. Of these, 59 children underwent antiviral treatment while 89 were not treated. One of the main objectives was the rate of HBeAg (Hepatitis B-e antigen) seroconversion, a marker of disease progression and response to therapy. Among the treated group, 26 children (44%) achieved HBeAg seroconversion following therapy. In contrast, 44 of the untreated children (49%) experienced spontaneous HBeAg seroconversion, indicating a substantial rate of natural resolution within this population subset. The findings highlight a significant proportion of spontaneous seroconversion in untreated pediatric patients, suggesting a potential re-evaluation of treatment criteria and timing for children with chronic HBV infection. The comparable rates of seroconversion between treated and untreated cohorts underscore the need for individualized treatment approaches based on a combination of virological, biochemical, and clinical parameters. Further studies are required to refine management strategies to optimize long-term outcomes in pediatric HBV infections. Full article