Pediatric Reports

3 pages, 448 KiB

Open AccessEditorial

Intraoperative Bleeding in Pediatric Otolaryngology: Trends and Future Perspectives

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Pediatr. Rep. 2023, 15(4), 707-709; https://doi.org/10.3390/pediatric15040063 - 20 Nov 2023

Viewed by 368

Abstract

A significant challenge that ENT surgeons often encounter is managing intraoperative bleeding, a task that requires precision, adept judgment, and a thorough knowledge of the latest techniques and procedures [...] Full article

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16 pages, 920 KiB

Open AccessReview

Motor Skills and Executive Functions in Pediatric Patients with Down Syndrome: A Challenge for Tailoring Physical Activity Interventions

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Vittoria Carnevale Pellino

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Alessandra Anna Gazzarri

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Paola Baldassarre

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Gianvincenzo Zuccotti

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Valeria Calcaterra

Pediatr. Rep. 2023, 15(4), 691-706; https://doi.org/10.3390/pediatric15040062 - 10 Nov 2023

Viewed by 460

Abstract

Down syndrome (DS) is one of the most common chromosomal disorders. In addition to this variety of dysmorphic features. DS is also associated with a wide range of diseases and related comorbidities affecting different organs and systems. These comorbidities, together with societal and [...] Read more.

Down syndrome (DS) is one of the most common chromosomal disorders. In addition to this variety of dysmorphic features. DS is also associated with a wide range of diseases and related comorbidities affecting different organs and systems. These comorbidities, together with societal and environmental influences, have a negative impact on physical activity in people with DS. Low levels of physical activity and energy expenditure have been identified as crucial players in worsening the acquisition of motor skills and executive functions. Executive functions are critical for the many skills (creativity, flexibility, self-control, and discipline) impacting our quality of life and make it possible to control impulses, mentally play with ideas, and stay focused. We proposed a broad overview of the available literature regarding motor skills and executive functions in pediatric patients with DS to understand the specific challenges for tailoring physical activity interventions. Motor skill interventions are effective in improving motor competence and performance on cognitive, emotional, and physical aspects in children with DS. Interventions based on executive functions in DS subjects are effective to contrast the cognitive decline and improve the everyday use of executive functions in youth and adults. Targeted interventions are mandatory for maximizing the benefits of physical activity, minimizing potential risks, and ultimately improving the overall health outcomes and quality of life for individuals with DS. Full article

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12 pages, 394 KiB

Open AccessArticle

A Retrospective Observational Study of the Impact of HIV Status on the Outcome of Paediatric Intensive Care Unit Admissions at a Tertiary Hospital in South Africa (2015–2019)

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Kim Whitehead

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Daynia E. Ballot

Pediatr. Rep. 2023, 15(4), 679-690; https://doi.org/10.3390/pediatric15040061 - 08 Nov 2023

Viewed by 307

Abstract

HIV-infected and HIV-exposed but uninfected (HEU) children have unique health risks. Our study looked at how HIV exposure and infection impact presentation and outcomes in PICU in an era of improved ART. A retrospective analysis of children admitted to PICU was performed. The [...] Read more.

HIV-infected and HIV-exposed but uninfected (HEU) children have unique health risks. Our study looked at how HIV exposure and infection impact presentation and outcomes in PICU in an era of improved ART. A retrospective analysis of children admitted to PICU was performed. The sample was divided into HIV negative, HEU and HIV infected, and presentation and outcomes were compared with a significance level set at α = 0.05. Our study showed that 16% (109/678) of children admitted to PICU were HEU and 5.2% (35/678) were HIV infected. HIV-infected children were admitted at a younger age (median two months) with an increased incidence of lower respiratory infections than HIV-negative children (p < 0.001); they also required longer ventilation and admission (p < 0.001). HIV-infected children had a higher mortality (40%) (p = 0.02) than HIV-negative (22.7%) children; this difference was not significant when comparing only children with a non-surgical diagnosis (p = 0.273). HEU children had no significant difference in duration of ICU stay (p = 0.163), ventilation (p = 0.443) or mortality (p = 0.292) compared to HIV-negative children. In conclusion, HIV-infected children presented with more severe disease requiring longer ventilation and admission. HEU had similar outcomes to HIV-negative children. Full article

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11 pages, 1182 KiB

Open AccessArticle

Association between Children’s Difficulties, Parent-Child Sleep, Parental Control, and Children’s Screen Time: A Cross-Sectional Study in Japan

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Pediatr. Rep. 2023, 15(4), 668-678; https://doi.org/10.3390/pediatric15040060 - 08 Nov 2023

Viewed by 618

Abstract

Children’s screen time may affect their growth and development. However, differences in the impact of various psychiatric and psychological factors on children’s screen time is a research gap. This study aimed to explore the differences in the influence of related factors affecting children’s [...] Read more.

Children’s screen time may affect their growth and development. However, differences in the impact of various psychiatric and psychological factors on children’s screen time is a research gap. This study aimed to explore the differences in the influence of related factors affecting children’s screen time based on their sleep, difficulties, and parental control among Japanese elementary and junior high school students. A cross-sectional survey was conducted among parents in Japan. Data on screen time duration, parent–child background, strengths and difficulties, sleep variables, and parental control types were collected from 225 households. A regression analysis revealed that high Strengths and Difficulties Questionnaire (SDQ) scores (β = 0.166, p = 0.008), sleep duration (β = −0.281, p < 0.001), and parental control (β = −0.204, p = 0.001) were significantly related to children’s screen time. Additionally, it was found that parents’ late bedtimes affect children’s screen time by mediating children’s sleep duration. This study, together with previous research, provides comprehensive insights into design interventions to decrease the screen time of children in the Japanese context. Full article

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

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8 pages, 250 KiB

Open AccessArticle

Adherence to Vitamin D Supplementation during Infancy—A Single Pediatric Primary Practice Retrospective Study

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Pediatr. Rep. 2023, 15(4), 660-667; https://doi.org/10.3390/pediatric15040059 - 02 Nov 2023

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Abstract

The risk of vitamin D deficiency is high in infants. Therefore, potential vitamin D deficiency should be prophylactically treated with vitamin D supplementation. Achieving good adherence to recommended prophylactic regimens is the goal of every primary pediatrician. The aim of this paper was [...] Read more.

The risk of vitamin D deficiency is high in infants. Therefore, potential vitamin D deficiency should be prophylactically treated with vitamin D supplementation. Achieving good adherence to recommended prophylactic regimens is the goal of every primary pediatrician. The aim of this paper was to establish whether Croatian infants receive recommended prophylactic doses of vitamin D regularly. We analyzed the prescription rate of vitamin D preparation during the first year of life in one pediatric primary practice. Our research has shown, for the first time in Croatia, that there is low treatment adherence. Only 7.6% of infants received the recommended doses of vitamin D. The percentage of infants in the moderately irregular adherence group was 19.3%. There was no statistical difference regarding urban or rural place of living or parents’ educational level. Based on these findings, a comprehensive public health campaign is needed to improve adherence to vitamin D supplementation during infancy. Also, further studies on larger samples and on a national level are warranted. Full article

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Open AccessReview

Cardiovascular Risk in Pediatrics: A Dynamic Process during the First 1000 Days of Life

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Gianvincenzo Zuccotti

Pediatr. Rep. 2023, 15(4), 636-659; https://doi.org/10.3390/pediatric15040058 - 01 Nov 2023

Viewed by 591

Abstract

The early childhood period, encompassing prenatal and early stages, assumes a pivotal role in shaping cardiovascular risk factors. We conducted a narrative review, presenting a non-systematic summation and analysis of the available literature, focusing on cardiovascular risk from prenatal development to the first [...] Read more.

The early childhood period, encompassing prenatal and early stages, assumes a pivotal role in shaping cardiovascular risk factors. We conducted a narrative review, presenting a non-systematic summation and analysis of the available literature, focusing on cardiovascular risk from prenatal development to the first 1000 days of life. Elements such as maternal health, genetic predisposition, inadequate fetal nutrition, and rapid postnatal growth contribute to this risk. Specifically, maternal obesity and antibiotic use during pregnancy can influence transgenerational risk factors. Conditions at birth, such as fetal growth restriction and low birth weight, set the stage for potential cardiovascular challenges. To consider cardiovascular risk in early childhood as a dynamic process is useful when adopting a personalized prevention for future healthcare and providing recommendations for management throughout their journey from infancy to early adulthood. A comprehensive approach is paramount in addressing early childhood cardiovascular risks. By targeting critical periods and implementing preventive strategies, healthcare professionals and policymakers can pave the way for improved cardiovascular outcomes. Investing in children’s health during their early years holds the key to alleviating the burden of cardiovascular diseases for future generations. Full article

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Open AccessArticle

Integrated Behavior Therapy for Exclusively Anxious Selective Mutism: A Nonconcurrent Multiple-Baseline Design across Five Participants

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Allison K. Siroky

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John S. Carlson

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Aimee Kotrba

Pediatr. Rep. 2023, 15(4), 617-635; https://doi.org/10.3390/pediatric15040057 - 16 Oct 2023

Viewed by 677

Abstract

Selective mutism (SM) is a rare childhood anxiety disorder which may be markedly detrimental to a child’s academic and social functioning if left untreated. Cognitive–behavioral treatments for social anxiety disorders have been found to be effective for SM, yet a paucity of published [...] Read more.

Selective mutism (SM) is a rare childhood anxiety disorder which may be markedly detrimental to a child’s academic and social functioning if left untreated. Cognitive–behavioral treatments for social anxiety disorders have been found to be effective for SM, yet a paucity of published studies have explored manualized treatment approaches carried out by novice clinicians. The purpose of the present study was to examine the adherence, effectiveness, and acceptability of a condensed, 16-session version of Integrated Behavior Therapy for Selective Mutism (IBTSM; Bergman, 2013), the first manualized treatment for SM. A nonconcurrent multiple-baseline single-case design was used across five children diagnosed with SM, exclusively anxious subtype. IBTSM was implemented with excellent adherence (M = 98%) over an average of 19 weeks (range = 16–22 weeks). Visual analyses of weekly caregiver ratings of social anxiety and speaking behaviors did not demonstrate a replicated intervention effect; however, Tau-U effect sizes and Reliable Change Index (RCI) calculations demonstrated significant individual improvements in social anxiety and speaking behaviors over time on several measures. Three children (60%) no longer met diagnostic criteria for SM following treatment. All caregivers rated IBTSM as acceptable, with specific endorsements of acceptability in the areas of time required and treatment quality. Full article

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

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9 pages, 268 KiB

Open AccessCase Report

Wolcott-Rallison Syndrome, a Rare Cause of Permanent Diabetes Mellitus in Infants—Case Report

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Alexandru-Ștefan Niculae

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Pediatr. Rep. 2023, 15(4), 608-616; https://doi.org/10.3390/pediatric15040056 - 16 Oct 2023

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Abstract

Wolcott-Rallison syndrome is a rare cause of permanent neonatal diabetes mellitus caused by mutations in the eukaryotic translation initiation factor 2 alpha kinase 3 gene (EIF2AK3). Individuals affected by this disorder have severe hyperglycemia, pancreatic failure, and bone abnormalities and are prone to [...] Read more.

Wolcott-Rallison syndrome is a rare cause of permanent neonatal diabetes mellitus caused by mutations in the eukaryotic translation initiation factor 2 alpha kinase 3 gene (EIF2AK3). Individuals affected by this disorder have severe hyperglycemia, pancreatic failure, and bone abnormalities and are prone to severe and life-threatening episodes of liver failure. This report illustrates the case of a 2-month-old infant with extreme hyperglycemia and severe diabetic ketoacidosis. Acute management was focused on correcting severe acidosis. Further management aimed to obtain stable blood glucose levels, balancing the patient’s need for comfort and lack of distress with the clinicians’ need for adequate information regarding the patient’s glycemic control. Genetic testing of the patient and his parents confirmed the diagnosis. The follow-up for 18 months after diagnosis is detailed, illustrating both the therapeutic success of subcutaneous insulin therapy and the ongoing complications that patients with Wolcott-Rallison syndrome are subject to. Full article

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Open AccessArticle

Nasal CPAP in the Pediatric Ward to Reduce PICU Admissions for Severe Bronchiolitis?

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Pediatr. Rep. 2023, 15(4), 599-607; https://doi.org/10.3390/pediatric15040055 - 13 Oct 2023

Viewed by 397

Abstract

In treating acute bronchiolitis in infants, the decision to use continuous positive airway pressure (CPAP) often involves infant referral from the pediatric ward to the pediatric intensive care unit (PICU). We present our experience of CPAP use in a general pediatric ward, aiming [...] Read more.

In treating acute bronchiolitis in infants, the decision to use continuous positive airway pressure (CPAP) often involves infant referral from the pediatric ward to the pediatric intensive care unit (PICU). We present our experience of CPAP use in a general pediatric ward, aiming to reduce the pressure on the PICU in recent outbreaks of bronchiolitis. Clinical data of patients less than 12 months of age and admitted for bronchiolitis from 1 October 2021 to 31 March 2023 were retrospectively collected. Of 82 infants admitted for bronchiolitis, 16 (19%) were treated with nasal CPAP (nCPAP group); of the remaining 66, 21 (26%) were treated with a low-flow nasal cannula (LFNC) only, 1 (1%) was also treated a with high-flow nasal cannula (HFNC), 12 (15%) were treated with an HFNC only, and 41 (50%) were treated without oxygen support (no-nCPAP group). Overall, coinfection with RSV and SARS-CoV-2 was observed in three patients and SARS-CoV-2 infection was observed in two patients. None of them required any type of oxygen support. Only 3/16 (19%) infants in the nCPAP group were referred to the PICU due to worsening clinical conditions despite nCPAP support. In our experience of treating epidemic bronchiolitis, nCPAP can be safely managed in a general pediatric ward, thus reducing the burden of admissions to the PICU. Training and regular updating of the pediatric staff, careful monitoring of the patient, and close cooperation with the PICU were instrumental for our team. Full article

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Open AccessCase Report

Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series

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Oana Gabriela Falup-Pecurariu

Pediatr. Rep. 2023, 15(4), 591-598; https://doi.org/10.3390/pediatric15040054 - 10 Oct 2023

Viewed by 457

Abstract

Background: The aim of this case series report is to evaluate the characteristics of multisystem inflammatory syndrome (MIS) in neonates following prenatal maternal COVID-19 infection. Methods: We present a case series of three newborns (≤28 days of age) diagnosed with MIS due to [...] Read more.

Background: The aim of this case series report is to evaluate the characteristics of multisystem inflammatory syndrome (MIS) in neonates following prenatal maternal COVID-19 infection. Methods: We present a case series of three newborns (≤28 days of age) diagnosed with MIS due to the vertical transmission of SARS-CoV2 infection and admitted from 1 January 2021 to 1 June 2023. The inclusion criteria were negative RT-PCR-SARS-CoV-2 test in infants, initial negative IgM-SARS-CoV-2 in infants followed by the emergence of positive IgG-SARS-CoV-2 antibodies in infants and maternal COVID-19 infection in the third trimester of pregnancy. Patients enrolled in this case series were admitted due to acute febrile illnesses. Results: All three cases occurred in patients born at a mean gestational age of 39 weeks and who were appropriate for gestational age. The mean age at admission was 18.3 days. Fibrinogen (>400 mg/dL) and ferritin (>120 mg/dL) were elevated above the upper normal limit. Elevated levels of myocardial biomarkers (D-dimers, N-terminal pro b-type natriuretic peptide troponin T and creatine phosphokinase myocardial band) were recorded, with normal heart function evaluated using echocardiography. All three patients were treated with antibiotics; one received intravenous immunoglobulin. A 4-week follow-up was completed in two patients when their myocardial biomarkers and ferritin were still elevated but lower compared with previous examinations. D-dimers levels were normalized in 2/3 patients. Conclusions: Subclinical myocarditis was diagnosed as an early outcome in infants with MIS diagnosed postnatally due to the vertical transmission of SARS-CoV2 infection and may represent a new challenge for pediatricians in the pandemic era. Full article

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9 pages, 1488 KiB

Open AccessArticle

Rate of Total Hip Replacement after Legg Calve Perthes Disease in a Canadian Province

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Pediatr. Rep. 2023, 15(4), 582-590; https://doi.org/10.3390/pediatric15040053 - 07 Oct 2023

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Abstract

Legg Calve Perthes disease is a pediatric hip condition that leads to early hip degeneration. The efficacy of operative and nonoperative treatment is not well defined in the literature. Using the rate of total hip arthroplasty as a surrogate measure for symptomatic hip [...] Read more.

Legg Calve Perthes disease is a pediatric hip condition that leads to early hip degeneration. The efficacy of operative and nonoperative treatment is not well defined in the literature. Using the rate of total hip arthroplasty as a surrogate measure for symptomatic hip degeneration, the rate of total hip arthroplasty was compared in Legg Calve Perthes disease patients with and without previous surgical intervention in the province of Manitoba, Canada. A retrospective review was conducted using de-identified, individual-level administrative records of health services for the entire population of Manitoba. Codes for Legg Calve Perthes disease, femoral osteotomies, pelvic osteotomies, adductor tenotomies, and total hip arthroplasty were searched from 1984 to 2018. The rate of total hip arthroplasty in patients with Legg Calve Perthes disease was determined for two groups: (1) patients with earlier surgical intervention and (2) patients with no previous surgical intervention. Of the 202 patients included in the study, 180 had no prior surgery and 22 had prior surgery. The rate of total hip arthroplasty between the previous operative and nonoperative groups was found to be 32% and 40%, respectively (p = 0.458). There was no significant difference in rates of total hip arthroplasty in the operative and nonoperative groups. Further prospective studies are required to elucidate the differences in outcomes between operative and nonoperative treatment groups in patients with Legg Calve Perthes disease. Full article

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11 pages, 256 KiB

Open AccessArticle

Exploring Missed Nursing Care in the NICU: Perspectives of NICU Nurses in Saudi Arabia’s Eastern Health Cluster

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Nasreen Alsalem

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Fatima Abu Rashid

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Saleh Aljarudi

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Mohammed I. Al Bazroun

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Roqayah Mirza Almatrouk

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Fatimah M. Alharbi

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Lames Al Mansour

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Nahid Baker Abuzaid

Pediatr. Rep. 2023, 15(4), 571-581; https://doi.org/10.3390/pediatric15040052 - 02 Oct 2023

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Abstract

(1) Background: Missed nursing care, an omission error characterized by delayed or omitted nursing interventions, poses significant risks to patients’ safety and quality of car.; (2) Methods: This is a quantitative cross-sectional study on 151 nurses who work in NICUs in three main [...] Read more.

(1) Background: Missed nursing care, an omission error characterized by delayed or omitted nursing interventions, poses significant risks to patients’ safety and quality of car.; (2) Methods: This is a quantitative cross-sectional study on 151 nurses who work in NICUs in three main networks in the Eastern Health Province, Saudi Arabia: Dammam (n = 84), Qatif (n = 53), and Jubail (n = 14). The study uses a self-reported questionnaire (MISSCARE) and applies the 5-point Likert Scale. Statistical analysis data were analyzed using SPSS version 23.0. (3) Results: The primary reasons for missed care were shortage of nursing staff and unbalanced patient assignments. Missed nursing care negatively affects job satisfaction and was positively correlated with nurses’ intentions to quit their jobs. Inadequate equipment, supplies, and breakdowns in communication between nurses and other healthcare professionals were also significant factors contributing to missed care. (4) Conclusions: Missed nursing care is associated with overwork, nursing shortages, and lower job satisfaction, impacting the quality of care provided in the NICU. Improving working conditions, nurse staffing, and patient assignment planning should be prioritized to address this issue effectively. Full article

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Pediatr. Rep., Volume 15, Issue 4 (December 2023) – 12 articles

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