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Pediatr. Rep., Volume 14, Issue 4 (December 2022) – 17 articles

Cover Story (view full-size image): Cerebral palsy (CP) is a common physical disability in childhood. Crouch or equinus is the most common gait problem in CP. Orthopedic surgery has achieved good results. However, after surgery, a decline in walking ability and reverse deformation have been reported. Therefore, we focused on early gait training using a robot. In this study, we aimed to evaluate the outcomes of a rehabilitation program with a hybrid assistive limb (HAL) after surgery in CP. We assessed six patients with CP who underwent soft tissue surgery followed by HAL training. As a result, there was improvement in GMFM, COPM, and muscle strength after HAL intervention. HAL training may improve walking ability and clinical outcomes in CP after surgery. It may be useful to integrate training using HAL, a postoperative rehabilitation program for CP. View this paper
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5 pages, 219 KiB  
Article
Evaluation of Pediatric Patients with a Diagnosis of Ureterocele
by Özgür Özdemir Şimşek, Sibel Tiryaki, Gökçen Erfidan, Cemaliye Başaran, Seçil Arslansoyu Çamlar, Fatma Mutlubaş, Belde Kasap Demir and Demet Alaygut
Pediatr. Rep. 2022, 14(4), 533-537; https://doi.org/10.3390/pediatric14040062 - 07 Dec 2022
Cited by 1 | Viewed by 1514
Abstract
Aim: The presence and clinical importance of vesicoureteric reflux in patients with a double collecting system are being questioned. Therefore, the role of voiding cystourethrography in the management of patients with ureterocele is unclear. This study aimed to evaluate patients with a ureterocele [...] Read more.
Aim: The presence and clinical importance of vesicoureteric reflux in patients with a double collecting system are being questioned. Therefore, the role of voiding cystourethrography in the management of patients with ureterocele is unclear. This study aimed to evaluate patients with a ureterocele in terms of urinary tract infection (UTI) and vesicoureteral reflux (VUR). Material Methods: The cases who were admitted to the Pediatric Nephrology Clinic of Health Sciences University Tepecik Training and Research Hospital between 2012 and 2022 and were diagnosed with ureterocele were evaluated retrospectively. Demographic, clinical, and laboratory data were obtained from file records. Results: All patients diagnosed with ureterocele and voiding cystourethrography (VCUG) were evaluated. A total of 24 (female 13 (54.2%)) children were included. The reasons for admission were antenatal hydronephrosis in 13 (54.2%) patients, UTI in 9 (37.5%) patients, and incidentally diagnosed ureterocele in 2 (8.3%) patients. Urinary tract infection was observed in 20 patients at admission, recurrent UTI in 21 patients at follow-up, preoperative pyelonephritis in 12 patients. VUR was found in 11 patients, and severe VUR (≥stage 3) was found in 9 patients. Ten patients had ipsilateral hydronephrosis, and 14 patients had a double collecting system. The presence of VUR was found to be associated with female gender, UTI at admission, and recurrent UTI at follow-up (p < 0.05). However, there was no difference between groups with or without VUR in terms of ipsilateral hydronephrosis, scar formation, and the need for surgery (p > 0.05). Conclusions: We could not demonstrate any criteria to select patients to receive VCUG; on the other hand, VUR did not cause more kidney damage. Our study supports the need for more scientific data to determine management in patients with ureterocele. Full article
5 pages, 224 KiB  
Case Report
Heterozygous Deletion of Chromosome 15q13.3 in a Boy with Developmental Regression, Global Developmental Delay, Hypotonia, and Short Stature
by Allison M. Strauss, Anna C. Buhle and David M. Finkler
Pediatr. Rep. 2022, 14(4), 528-532; https://doi.org/10.3390/pediatric14040061 - 05 Dec 2022
Viewed by 1763
Abstract
Two causes of intellectual disability are 15q13.3 deletion syndrome and BRWD3 X-linked intellectual disability. 15q13.3 deletion syndrome causes a heterogenous phenotype including intellectual disability (ID), developmental delay (DD), autism spectrum disorder, epilepsy/seizures, schizophrenia, attention deficit hyperactivity disorder, visual defects, hypotonia, and short stature. [...] Read more.
Two causes of intellectual disability are 15q13.3 deletion syndrome and BRWD3 X-linked intellectual disability. 15q13.3 deletion syndrome causes a heterogenous phenotype including intellectual disability (ID), developmental delay (DD), autism spectrum disorder, epilepsy/seizures, schizophrenia, attention deficit hyperactivity disorder, visual defects, hypotonia, and short stature. BRWD3 variants are rare, and the clinical presentation is largely unknown. Presented here is a 34-month-old male with developmental regression, global DD, hypotonia, and short stature. In this study, the patient and his mother underwent a whole-genome array screening. Sorting intolerant from tolerant (SIFT) and polymorphism phenotyping v2 (PolyPhen-2) analyses were performed to determine the pathogenicity of the BRWD3 mutation. Array comparative genomic hybridization showed a heterozygous, pathogenic deletion of at least 1.6 Mb from the cytogenetic band 15q13.2q13.3 and a BRWD3 variant of unknown clinical significance. This combination of genetic mutations has never been reported together and neither disorder is known to cause developmental regression. The mechanism of developmental regression is undefined but is of great importance due to the opportunity to develop therapies for these patients. Full article
9 pages, 392 KiB  
Article
The Association between SARS-CoV-2 Infection and Diabetic Ketoacidosis in Patients with New-Onset Diabetes: A Retrospective Study from a Diabetic Center in Saudi Arabia
by Eman Hurissi, Mohammed Alameer, Fadiyah Ageeli, Maram Allami, Mohammed Alharbi, Hussam Suhail, Hadeel Albeishy, Omar Oraibi, Mohammed Somaili, Abdulrahman Hummadi and Abdulaziz H. Alhazmi
Pediatr. Rep. 2022, 14(4), 519-527; https://doi.org/10.3390/pediatric14040060 - 29 Nov 2022
Cited by 4 | Viewed by 1638
Abstract
Background: Various reports described new-onset diabetes during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with no previous history of diabetes or glucocorticoid use. Further, SARS-CoV-2 could increase the risk of diabetes, including diabetic ketoacidosis (DKA). However, data on [...] Read more.
Background: Various reports described new-onset diabetes during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with no previous history of diabetes or glucocorticoid use. Further, SARS-CoV-2 could increase the risk of diabetes, including diabetic ketoacidosis (DKA). However, data on the relationship between new-onset diabetes and COVID-19 are still limited in our region. Thus, we aimed in this study to evaluate the association between new-onset diabetes and DKA in patients with COVID-19. Methods: A retrospective, cross-sectional study was conducted at a diabetic center in Jazan province, Saudi Arabia, between 2020 and 2021. Demographic data, COVID-19 status, and DKA incidence were collected and verified manually from diabetic patients’ medical records. Data were analyzed using a t-test and chi-square test. Results: We included 54 diabetic patients diagnosed during the COVID-19 pandemic, with a median age of 17 years. The majority of patients were females (57.4%). About 38.8% were diagnosed with COVID-19, and 16.6% reported having DKA. About 33.3% of the patients who experienced DKA reported being COVID-19-positive. However, only 6% of patients who denied contracting SARS-CoV-2 developed DKA (p-value = 0.020). Conclusions: Patients with newly diagnosed diabetes due to COVID-19 seem at a higher risk of developing DKA. Further epidemiological and molecular studies are required for a better understanding of the correlation between DKA in patients with diabetes and COVID-19. Full article
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14 pages, 1255 KiB  
Article
Short-Term Outcome of Rehabilitation Program with Hybrid Assistive Limb after Tendon Lengthening in Patients with Cerebral Palsy
by Mayumi Matsuda Kuroda, Hirotaka Mutsuzaki, Shogo Nakagawa, Kenichi Yoshikawa, Kazushi Takahashi, Yuki Mataki, Ryoko Takeuchi, Nobuaki Iwasaki and Masashi Yamazaki
Pediatr. Rep. 2022, 14(4), 505-518; https://doi.org/10.3390/pediatric14040059 - 12 Nov 2022
Cited by 1 | Viewed by 1563
Abstract
In this study, we aimed to evaluate the short-term outcomes of a rehabilitation program with the Hybrid Assistive Limb® after soft tissue lengthening in young patients with cerebral palsy. We assessed six patients with cerebral palsy who underwent soft tissue surgery followed [...] Read more.
In this study, we aimed to evaluate the short-term outcomes of a rehabilitation program with the Hybrid Assistive Limb® after soft tissue lengthening in young patients with cerebral palsy. We assessed six patients with cerebral palsy who underwent soft tissue surgery followed by gait training using the Hybrid Assistive Limb®. Clinical assessments were conducted preoperatively, before, immediately after, and at 1, 2, and 3 months after gait training. Gross Motor Function Measure was improved 5.93 ± 6.11% (mean ± standard deviation, p < 0.05), Canadian Occupational Performance Measure performance was improved 3.12 ± 1.53 points, and satisfaction was improved 3.80 ± 2.14 points (p < 0.05). The knee extension strength on the operated side was changed 7.75 ± 4.97 Nm after the intervention (p = 0.07). In ambulatory patients, gait speed was changed 8.37 ± 1.72 m/min, stride length was changed 10 ± 6.16 cm, and 6 min walking distance was changed 52 ± 16 m after the intervention. Training with the Hybrid Assistive Limb® may improve walking ability and clinical outcomes in young patients with cerebral palsy after soft tissue lengthening. Full article
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8 pages, 1108 KiB  
Article
Association between Thyroid Function and Respiratory Distress Syndrome in Preterm Infants
by Yonghyuk Kim, Youngjin Kim, Meayoung Chang and Byoungkook Lee
Pediatr. Rep. 2022, 14(4), 497-504; https://doi.org/10.3390/pediatric14040058 - 10 Nov 2022
Viewed by 1998
Abstract
Thyroid hormones are known to influence the production and secretion of pulmonary surfactant. The objective of this study was to explore the relationship between respiratory distress syndrome (RDS) and thyroid hormones. This was a retrospective study of preterm infants at 24–33 weeks gestational [...] Read more.
Thyroid hormones are known to influence the production and secretion of pulmonary surfactant. The objective of this study was to explore the relationship between respiratory distress syndrome (RDS) and thyroid hormones. This was a retrospective study of preterm infants at 24–33 weeks gestational age from April 2017 to February 2019. T3, free T4 (fT4), and thyroid-stimulating hormone (TSH) were measured 1, 3, and 6 weeks after birth. Multivariate logistic regression analyses were performed to determine the relationship between RDS and TSH. A total of 146 infants were enrolled. Of these, 60 had RDS, 72 had no RDS, and 14 were excluded. T3 and TSH were lower in the RDS groups (p < 0.05) on the day of birth. Multivariate logistic regression analysis indicated that lower serum TSH levels immediately after birth were associated with a higher incidence of RDS (OR, 0.89; 95% CI, 0.81–0.97). The TSH level was associated with the incidence of RDS. This suggests that suppression of the hypothalamus–pituitary axis function contributes to RDS, which is the result of surfactant deficiency. Full article
(This article belongs to the Special Issue Neonatal Intensive Care and Neurophysiological Monitoring)
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6 pages, 204 KiB  
Communication
Ethics of Treatment Decisions for Extremely Premature Newborns with Poor Prognoses: Comparison of Shared Decision Making in Norway and Japan
by Akira Akabayashi, Eisuke Nakazawa and Hiroyasu Ino
Pediatr. Rep. 2022, 14(4), 491-496; https://doi.org/10.3390/pediatric14040057 - 03 Nov 2022
Viewed by 1253
Abstract
Ethical debates about the life-prolonging treatment of extremely premature infants and infants with congenital abnormalities with poor prognoses have long been held. We will examine approaches in Norway and Japan as examples because Norway is a well-known welfare state. By comparing the traditional [...] Read more.
Ethical debates about the life-prolonging treatment of extremely premature infants and infants with congenital abnormalities with poor prognoses have long been held. We will examine approaches in Norway and Japan as examples because Norway is a well-known welfare state. By comparing the traditional Norwegian approach, the newly proposed approach of postponed withholding (PPWH) and the Japanese approach, we will revisit shared decision making in neonatology in general, where patients (i.e., newborns) inevitably have no decision-making capacity. We argue that in shared decision making, the process is critical, and that it is important to clarify who will be the final decision-maker and whose benefits are most important. In addition, we argue that the issue of cost cannot be avoided in this current time of economic disparities in global health. Shared decision making should not be a mere formality. These are significant examples of new ethical debates to be discussed in the modern era in the neonatology field. Full article
12 pages, 568 KiB  
Article
Facts and Recommendations regarding When Medical Institutions Report Potential Abuse to Child Guidance Centers: A Cross-Sectional Study
by Mio Urade, Misao Fujita, Atsushi Tsuchiya, Katsumi Mori, Eisuke Nakazawa, Yoshiyuki Takimoto and Akira Akabayashi
Pediatr. Rep. 2022, 14(4), 479-490; https://doi.org/10.3390/pediatric14040056 - 02 Nov 2022
Cited by 1 | Viewed by 1535
Abstract
Background: Medical institutions are required to report suspected cases of child abuse to administrative agencies, such as child guidance centers in Japan. It is left to the discretion of the medical institutions whether to notify the family of the child or the center. [...] Read more.
Background: Medical institutions are required to report suspected cases of child abuse to administrative agencies, such as child guidance centers in Japan. It is left to the discretion of the medical institutions whether to notify the family of the child or the center. However, it is unclear what kinds of measures are being taken to ensure a robust policy of notification versus non-notification and how notifying the family will affect the child. Methods: An unregistered questionnaire survey on reporting suspected child abuse cases to child consultation centers and notifying families was conducted by mail across 518 pediatric specialist training facility hospitals designated by the Japanese Pediatric Society. Results: Responses were received from 323 facilities (62.4% response rate), of which 5 facilities were excluded because of incomplete responses. Therefore, in all, 318 facilities were included in the analysis. The results showed that 59.8% of the facilities had a policy of notifying the family, 33.7% said the decision varies from case to case, and 6.6% did not have a policy of notifying the family. The facilities that had a policy of either notifying or not notifying the family were less likely to experience problems than those with a policy of deciding on a case-by-case basis. The proportion of cases in which some problems occurred was higher in the cases where families were notified than in the cases where they were not, with 51.4% of the children experiencing worsening of relationships with family members. In the cases where the families were not notified, the children were twice as likely to experience further abuse than in cases where the families were notified. Conclusion: Problems arise in the case of both notification and non-notification. It is necessary to examine background factors and specific methods of notification in the cases where problems arise. Full article
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15 pages, 1500 KiB  
Review
Respiratory Syncytial Virus: An Uncommon Cause of Febrile Seizures—Results from a Systematic Review and Meta-Analysis
by Matteo Riccò, Milena Pia Cerviere, Silvia Corrado, Silvia Ranzieri and Federico Marchesi
Pediatr. Rep. 2022, 14(4), 464-478; https://doi.org/10.3390/pediatric14040055 - 02 Nov 2022
Cited by 5 | Viewed by 2107
Abstract
Human Respiratory Syncytial Virus (RSV) is a highly contagious viral pathogen. In infants, it is usually listed among the main causes of medical referrals and hospitalizations, particularly among newborns, and a considerable base of evidence associates RSV infections and bronchiolitis with long-term neurological [...] Read more.
Human Respiratory Syncytial Virus (RSV) is a highly contagious viral pathogen. In infants, it is usually listed among the main causes of medical referrals and hospitalizations, particularly among newborns, and a considerable base of evidence associates RSV infections and bronchiolitis with long-term neurological sequelae. We specifically performed a systematic review and meta-analysis in order to ascertain whether RSV infections may be associated with an increased risk for febrile seizures (FS) in infected infants. According to the PRISMA statement, Pubmed, Embase, and pre-print archive medRxiv.og were searched for eligible observational studies published up to 1 July 2022. Raw data included the incidence of FS among children admitted for influenza-like illness (ILI) and/or bronchiolitis, with a confirmed diagnosis of RSV or seasonal influenza virus (SIV) infection. Data were then pooled in a random-effects model. Heterogeneity was assessed using the I2 measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 11 studies including 6847 cases of RSV infections were retrieved, with a pooled prevalence of 29.975 cases of FS per 1000 RSV cases (I2 = 88.5%). The prevalence was not substantially greater in studies performed in pediatric intensive care units (53.817 per 1000 RSV cases vs. 23.552, p = 0.12). Higher occurrence of FS was reported from studies performed after 2010 (Risk Ratio [RR] 1.429, 95% Confidence Interval [95%CI] 1.049–1.948), and in China (RR 2.105, 95%CI 1.356–3.266) and South Africa (RR 1.722, 95%CI 1.060–2.824) than in Europe, while a lower occurrence was reported form the USA (RR 0.414, 95%CI 0.265–0.649). Eventually, FS were less likely reported from RSV cases compared to subjects affected by seasonal influenza (RR 0.402; 95%CI 0.228–0.708). Although RSV is often associated with high risk of neurological complications, substantially less cases of FS are reported than in SIV infections. However, the paucity of available studies recommends a cautious appraisal of aforementioned results. Full article
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7 pages, 615 KiB  
Article
Design and Implementation of a Program Development Practicum for Faculty Education and Advancement of Clinical Programs
by Pam Ward and Henry C. Lin
Pediatr. Rep. 2022, 14(4), 457-463; https://doi.org/10.3390/pediatric14040054 - 31 Oct 2022
Viewed by 1391
Abstract
Physicians are often tasked to develop and lead collaborative, program development efforts but many have limited formal training. We designed and evaluated a professional development workshop series to provide our faculty members with a framework and tools for the development of clinical programs: [...] Read more.
Physicians are often tasked to develop and lead collaborative, program development efforts but many have limited formal training. We designed and evaluated a professional development workshop series to provide our faculty members with a framework and tools for the development of clinical programs: the Program Development Practicum (PDP). Faculty identified a clinical program of focus and for each clinical program identified, a program proposal, SBAR communication (situation, background, assessment, recommendation), executive summary, 1-min elevator pitch, and budget was developed. Five clinical programs were identified for improvement including: Inflammatory Bowel Disease, Celiac Disease, Transition of Care, Integrative Health Clinic, and Endoscopic Procedures. At the conclusion of the PDP, these programs were presented to key hospital leaders and resulted in an investment of resource support. Faculty also reported increased understanding of overall program development with the largest gains in knowledge in proposal writing and marketing. Overall, the PDP allowed for a revamp of key clinical services and faculty clarity on resource availability and expectations. We plan to continue with annual engagement of hospital leaders to share updates. Full article
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7 pages, 246 KiB  
Article
Executive Functions and Foreign Language Learning
by Alessandro Frolli, Francesco Cerciello, Clara Esposito, Sonia Ciotola, Gaia De Candia, Maria Carla Ricci and Maria Grazia Russo
Pediatr. Rep. 2022, 14(4), 450-456; https://doi.org/10.3390/pediatric14040053 - 24 Oct 2022
Cited by 4 | Viewed by 1746
Abstract
Executive functions (EFs) serve as an umbrella term to describe a set of higher-order cognitive abilities that include working memory, inhibitory control, cognitive flexibility, planning, reasoning, and problem-solving. Various studies suggest that foreign language learning likely promotes executive functions, but others suggest that [...] Read more.
Executive functions (EFs) serve as an umbrella term to describe a set of higher-order cognitive abilities that include working memory, inhibitory control, cognitive flexibility, planning, reasoning, and problem-solving. Various studies suggest that foreign language learning likely promotes executive functions, but others suggest that executive functions could improve foreign language learning. The aim of this study is to investigate the relationship between executive functions and foreign language learning and how these processes could interact. The sample included 64 children from kindergarten, aged 4–5 years, with no documented neuropsychiatric disorders, and from the middle–high literacy group. They were divided into three groups based on the level of their knowledge of the foreign language. A significant effect of the group on the executive tasks is shown in the comparison of the groups. Children who belonged to a group that had advanced foreign language proficiency had better results in executive tasks. Our results suggest that the higher the level of foreign language proficiency, the higher the performance of the executive tasks. However, we do not know if there is a causal effect between these variables. Full article
(This article belongs to the Section Pediatric Psychology)
6 pages, 247 KiB  
Case Report
Hyperinsulinemic Hypoglycemia Due to PMM2 Mutation in Two Siblings with Autosomal Recessive Polycystic Kidney Disease
by Ratna Acharya and Kiran Upadhyay
Pediatr. Rep. 2022, 14(4), 444-449; https://doi.org/10.3390/pediatric14040052 - 24 Oct 2022
Viewed by 1569
Abstract
Background: Hyperinsulinemic hypoglycemia (HH) is an important cause of persistent hypoglycemia in newborns and infants. Recently, PMM2 (phosphomannomutase 2) mutation has been associated with HH, especially in conjunction with polycystic kidney disease (PKD). PMM2 deficiency is one of the most common causes [...] Read more.
Background: Hyperinsulinemic hypoglycemia (HH) is an important cause of persistent hypoglycemia in newborns and infants. Recently, PMM2 (phosphomannomutase 2) mutation has been associated with HH, especially in conjunction with polycystic kidney disease (PKD). PMM2 deficiency is one of the most common causes of congenital disorder of glycosylation (CDG). Renal involvement in PMM2-CDG manifests as cystic kidney disease, echogenic kidneys, nephrotic syndrome or mild proteinuria. Case Summary: Here, we describe a pair of siblings with HH associated with autosomal recessive polycystic kidney disease (ARPKD) and PMM2 mutation. Two siblings with ARPKD presented during infancy and early toddler years with severe hypoglycemia. Both had inappropriately elevated serum insulin, low β-hydroxybutyrate, a need for a high glucose infusion rate, positive glycemic response to glucagon, positive diazoxide response and PMM2 mutation. Conclusions: Although this combination of HH and PKD was recently described in patients of European descent who also had PMM2 mutation, our report is unique given that these non-consanguineous siblings were not exclusively of European descent. PMM2 mutation leading to abnormal glycosylation and causing cystic kidneys and the alteration of insulin secretion is the most likely pathogenesis of this clinical spectrum. Full article
10 pages, 448 KiB  
Case Report
Postoperative Osteopathic Manipulative Treatment in Children with Esophageal Atresia: Potential Benefits on the Anthropometric Parameters
by Andrea Manzotti, Alessia Alati, Matteo Galli, Francesco Cerritelli, Chiara Leva, Adele Alberti, Alessandro Stizzoli, Sara Costanzo, Carlotta Paola Maria Canonica, Francesca Destro, Gianvincenzo Zuccotti, Valeria Calcaterra and Gloria Pelizzo
Pediatr. Rep. 2022, 14(4), 434-443; https://doi.org/10.3390/pediatric14040051 - 20 Oct 2022
Viewed by 1690
Abstract
Esophageal atresia (EA) is a congenital malformation that affects the normal esophageal development. Surgical treatment, although restoring the integrity of the alimentary tract, may lead to long-term sequelae-like developmental abnormalities and musculoskeletal deformities. We evaluated the effects of osteopathic manipulative treatment (OMT) on [...] Read more.
Esophageal atresia (EA) is a congenital malformation that affects the normal esophageal development. Surgical treatment, although restoring the integrity of the alimentary tract, may lead to long-term sequelae-like developmental abnormalities and musculoskeletal deformities. We evaluated the effects of osteopathic manipulative treatment (OMT) on the recovery of the range of the right upper limb movement and on the rise of the auxological parameters. A case series of five children affected by type C EA were described. Six OMT sessions were performed over a 4-month period. At each treatment, height, weight, body mass index (BMI) and range of motion (ROM) in elevation of the right upper limb were assessed. OMT was applied to improve scar, larynx, rib cage, and sternum mobility. An average change of 2.3 cm in height and an average increase of 8° in the ROM of the upper limb in the period of study were detected. Additionally, OMT could improve the anthropometric data and the mobility of the right upper limb of children surgically treated for EA. Further studies that evaluate the effectiveness of OMT in post surgical treatment of congenital malformations of the thorax can be considered in the future. Full article
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15 pages, 1698 KiB  
Article
Evaluation of the Multiple Tissue Factors in the Cartilage of Primary and Secondary Rhinoplasty in Cleft Lip and Palate Patients
by Dace Buile, Mara Pilmane and Ilze Akota
Pediatr. Rep. 2022, 14(4), 419-433; https://doi.org/10.3390/pediatric14040050 - 02 Oct 2022
Cited by 2 | Viewed by 1367
Abstract
Cleft lip and palate (CLP) is one of the craniofacial defects. The objective of this study was to identify the differences in appearance between the tissue factors in cartilage of CLP patients after primary and secondary rhinoplasty. Immunohistochemistry was performed with MMP-2, MMP-8, [...] Read more.
Cleft lip and palate (CLP) is one of the craniofacial defects. The objective of this study was to identify the differences in appearance between the tissue factors in cartilage of CLP patients after primary and secondary rhinoplasty. Immunohistochemistry was performed with MMP-2, MMP-8, MMP-9, TIMP-2, IL-1α, IL-10, bFGF, and TGFβ1. The quantification of the structures was performed using a semi-quantitative census method. MMP-2, -9, IL-1a, and bFGF demonstrated higher number of positive cells in patients, while the number of MMP-8, IL-1a, -10 and TGFβ1 cells was higher or equal in the control subjects. The only statistically significant difference between CLP-operated patients was found in the TIMP-2 group, where the primary CLP patient group had a higher number of TIMP-2 positive chondrocytes than the secondary CLP patient group (U = 53.5; p = 0.021). The median value of the primary CLP group was ++ number of TIMP-2 positive chondrocytes compared to +++ in the secondary CLP group. No statistically significant difference was found between primary and secondary rhinoplasty patients for other tissue factors. Commonly, the rich expression of different tissue factors suggests a stimulation of higher elasticity in cleft affected cartilage. The statistically significant TIMP-2 elevation in primary operated cartilage indicates an impact of the selective tissue remodeling for hard tissue. Full article
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9 pages, 625 KiB  
Article
The Impact of the COVID-19 Pandemic on Childhood Obesity and Lifestyle—A Report from Italy
by Stefano Palermi, Marco Vecchiato, Sonia Pennella, Anna Marasca, Alessandro Spinelli, Mariarosaria De Luca, Lorena De Martino, Fredrick Fernando, Felice Sirico and Alessandro Biffi
Pediatr. Rep. 2022, 14(4), 410-418; https://doi.org/10.3390/pediatric14040049 - 29 Sep 2022
Cited by 20 | Viewed by 3002
Abstract
During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children’s weights and nutritional habits during the [...] Read more.
During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children’s weights and nutritional habits during the COVID-19 pandemic in Italy. In this cross-sectional observational study, for 3 years, as part of the corporate wellness program (2019–2021) in Emilia Romagna region of Italy, anthropometric data of Ferrari car company employers’ children were collected, analyzed, and compared. Moreover, at the visit of November 2020, performed after the first wave of the pandemic with the most rigorous lockdown rules in Italy, a questionnaire on nutritional and lifestyle habits was administered. We evaluated 307 children (163 M, 10.1 ± 2.3 mean aged in 2019). A significant increase in BMI percentile in 2020 (65.2) compared to 2019 (49.2) was observed; it was confirmed, albeit slightly decreased, in 2021 (64.5). About one-third of participants reported an increase in consumption of fatty condiments and more than half report an increase in consumption of junk food. Levels of physical activity were still high during the COVID-19 lockdown, while sleeping time was significantly reduced. Our findings alert us to the importance of carefully monitoring eating behaviors in young to avoid the adoption of unhealthy food habits and prevent childhood obesity, especially during the period of COVID-19 lockdown. Full article
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9 pages, 1479 KiB  
Review
Myopericarditis in a Male Adolescent Following the Second Shot of COVID-19 Pfizer m-RNA Vaccine: Typical Example and Analysis of 110 Single Case Reports
by Alessandra Piras, Giada Melis, Lucia Cugusi and Pier Paolo Bassareo
Pediatr. Rep. 2022, 14(4), 401-409; https://doi.org/10.3390/pediatric14040048 - 26 Sep 2022
Cited by 2 | Viewed by 2096
Abstract
One of the most powerful weapons against COVID-19 is vaccines. After the worldwide spread of the disease, m-RNA vaccines were authorized not only in adult patients, but also in children and adolescents aged 12–18. Since then, alarming reports of cases of myocarditis and/or [...] Read more.
One of the most powerful weapons against COVID-19 is vaccines. After the worldwide spread of the disease, m-RNA vaccines were authorized not only in adult patients, but also in children and adolescents aged 12–18. Since then, alarming reports of cases of myocarditis and/or pericarditis have been noted, primarily involving males after the second vaccine shot. A typical example of myopericarditis occurring in an adolescent a few days after the second shot of an m-RNA vaccine is described here. An in-depth review of all 110 single case reports published up to July 2022 with related features and outcomes is also presented. This is the first extensive analysis focused solely on a significant number of single case reports, which have usually been excluded from systematic reviews and meta-analyses carried out in the field. The analysis presented here confirms that most cases occurred in males after the second injection of an m-RNA vaccine. Cases were mild and responsive to the usual medical treatment. What is newly reported is that not only adolescents, but also older people, especially females, were affected by this adverse event. Full article
(This article belongs to the Special Issue Feature Papers in Pediatric Reports)
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5 pages, 546 KiB  
Brief Report
Predictors of Umbilical Venous Catheter Misalignment
by Aimann Surak, Michael Miller and Henry Roukema
Pediatr. Rep. 2022, 14(4), 396-400; https://doi.org/10.3390/pediatric14040047 - 21 Sep 2022
Viewed by 1502
Abstract
Introduction: The insertion of an umbilical venous catheter (UVC) is a routine procedure. The success rate of this procedure is about 40–50%, with potential complications arising from misaligned UVC placement. Objectives: To explore potential factors that may aid in the prediction of UVC [...] Read more.
Introduction: The insertion of an umbilical venous catheter (UVC) is a routine procedure. The success rate of this procedure is about 40–50%, with potential complications arising from misaligned UVC placement. Objectives: To explore potential factors that may aid in the prediction of UVC misalignment. We hypothesized that UVC misalignment is proportionally related with increased chronological age. Methods: Retrospective chart review for newborns who had an UVC procedure followed by an x-ray. All analyses were conducted using standard comparative statistical methods and logistic regression modelling with SPSS v.24 (IBM Corp., Armonk, NY, USA), and p-values < 0.05 were considered statistically significant. Results: The final sample size was 480 patients. There were significant differences between the two groups in terms of gestational age {OR 1.06, 95% CI (1.02–1.10)}, small for gestation (SGA) status {OR 1.07, 95% CI (0.98–1.15)}, and 5-min APGAR scores {OR 0.48, 95% CI (0.23–1.00)}. There were no other significant group differences. Logistic regression modeling identified that chronologic age positively predicted, and SGA negatively predicted, UVC misalignment. Conclusion: A misaligned UVC is more likely to occur in late preterm and term babies, whereas a baby being SGA increases the likelihood of a well-aligned UVC. Full article
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Case Report
Mutation in the STXBP1 Gene Associated with Early Onset West Syndrome: A Case Report and Literature Review
by Kanako Takeda, Yusaku Miyamoto, Hisako Yamamoto, Toshiyuki Iwasaki, Noriko Sumitomo, Eri Takeshita, Atsushi Ishii, Shinichi Hirose and Naoki Shimizu
Pediatr. Rep. 2022, 14(4), 386-395; https://doi.org/10.3390/pediatric14040046 - 20 Sep 2022
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Abstract
Syntaxin-binding protein1 (STXBP1) is a member of the Sec1/Munc18-1 protein family, which comprises important regulators of the secretory and synaptic vesicle fusion machinery underlying hormonal and neuronal transmission, respectively. STXBP1 pathogenic variants are associated with multiple neurological disorders. Herein, we present [...] Read more.
Syntaxin-binding protein1 (STXBP1) is a member of the Sec1/Munc18-1 protein family, which comprises important regulators of the secretory and synaptic vesicle fusion machinery underlying hormonal and neuronal transmission, respectively. STXBP1 pathogenic variants are associated with multiple neurological disorders. Herein, we present the case of a Japanese girl with a mutation in the STXBP1 gene, who was born at 40 weeks without neonatal asphyxia. At 15 days old, she developed epilepsy and generalized seizures. Around 88 days old, she presented with a series of nodding spasms, with the seizure frequency gradually increasing. Interictal EEG indicated hypsarrhythmia and she presented with developmental regression. At 1.5 years old, genetic testing was performed and mutational analysis revealed an STXBP1 gene mutation (c.875G > A: p.Arg292His). Accordingly, she was diagnosed with developmental and epileptic encephalopathy, presenting West syndrome’s clinical characteristics caused by the STXBP1 gene mutation. Although drug treatment has reduced the frequency of epileptic seizures, her development has remained regressive. The relationship between the location and type of genetic abnormality and the phenotype remains unclear. Future studies should investigate the genotype–phenotype correlation and the underlying pathophysiology to elucidate the causal relationships among the multiple phenotype-determining factors. Full article
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