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Children, Volume 10, Issue 5 (May 2023) – 149 articles

Cover Story (view full-size image): Ultra-rapid genomic sequencing is increasingly being used in neonatal and pediatric intensive care settings, demonstrating high diagnostic and clinical utility. Arkell and colleagues conducted focus groups with 19 healthcare professionals (including clinical geneticists, genetic counselors, and intensivists) to explore their experiences with ultra-rapid genomic sequencing, particularly when making treatment decisions. They identified that healthcare professionals find it challenging to set realistic expectations with families regarding the outcomes of ultra-rapid genomic sequencing. These healthcare professionals reported modifying pre-test counseling to include life-limiting diagnoses as a possible test outcome. Healthcare professionals explained that moral distress arose when families and healthcare professionals’ treatment goals were misaligned after a diagnosis was received. View this paper
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11 pages, 749 KiB  
Article
Association between being Overweight in Young Childhood and during School Age and Puberty
by Genki Shinoda, Yudai Nagaoka, Fumihiko Ueno, Naoyuki Kurokawa, Ippei Takahashi, Tomomi Onuma, Aoi Noda, Keiko Murakami, Mami Ishikuro, Taku Obara, Hirohito Metoki, Junichi Sugawara and Shinichi Kuriyama
Children 2023, 10(5), 909; https://doi.org/10.3390/children10050909 - 22 May 2023
Viewed by 2053
Abstract
To examine whether body type at birth, body weight, and obesity in early childhood are associated with overweight/obesity during school age and puberty. Data from maternal and child health handbooks, baby health checkup information, and school physical examination information of participants at birth [...] Read more.
To examine whether body type at birth, body weight, and obesity in early childhood are associated with overweight/obesity during school age and puberty. Data from maternal and child health handbooks, baby health checkup information, and school physical examination information of participants at birth and three-generation cohort studies were linked. Association between body type and body weight at different time intervals (at birth and at 1.5, 3.5, 6, 11, and 14 years of age) were comprehensively analyzed using a multivariate regression model adjusted for gender, maternal age at childbirth, maternal parity, and maternal body mass index, and drinking and smoking statuses at pregnancy confirmation. Children who are overweight in young childhood had a greater risk of being overweight. Particularly, overweight at one year of age during checkup was associated with overweight at 3.5 years (adjusted odds ratio (aOR), 13.42; 95% confidence interval (CI), 4.46–45.42), 6 years (aOR, 6.94; 95% CI, 1.64–33.46), and 11 years (aOR, 5.22; 95% CI, 1.25–24.79) of age. Therefore, being overweight in young childhood could increase the risk of being overweight and obese during school age and puberty. Early intervention in young childhood may be warranted to prevent obesity during school age and puberty. Full article
(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 3rd Edition)
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18 pages, 875 KiB  
Review
The International Classification of Functioning, Disability and Health: Accuracy in Aquatic Activities Reports among Children with Developmental Delay
by Merav Hadar-Frumer, Huib Ten Napel, Maria José Yuste-Sánchez and Isabel Rodríguez-Costa
Children 2023, 10(5), 908; https://doi.org/10.3390/children10050908 - 22 May 2023
Cited by 2 | Viewed by 3197
Abstract
Functioning, as described in the International Classification of Functioning, Disability and Health (ICF), increasingly raises interest in the world of child rehabilitation, especially because its application empowers patients and parents by not putting the emphasis on disability in terms of the medical diagnosis [...] Read more.
Functioning, as described in the International Classification of Functioning, Disability and Health (ICF), increasingly raises interest in the world of child rehabilitation, especially because its application empowers patients and parents by not putting the emphasis on disability in terms of the medical diagnosis but on the person’s lived experience and the level of functioning that might be achieved. However, this requires the correct understanding and application of the ICF framework to overcome differences in the often locally used models or the understanding of disability, including mental aspects. To evaluate the level of accurate use and understanding of the ICF, a survey was performed on studies of aquatic activities in children aged 6–12 with developmental delay published between the years 2010 and 2020. In the evaluation, 92 articles were found that matched the initial keywords (aquatic activities and children with developmental delay). Surprisingly, 81 articles were excluded for not referring to the ICF model at all. The evaluation was performed by methodological critical reading according to the ICF reporting criteria. The conclusion of this review is that despite the rising awareness in the field of AA, the ICF is used inaccurately and often not according to the model’s biopsychosocial principles. For the ICF to become a guiding tool in evaluations and goal-setting for aquatic activity, the level of knowledge and understanding of the framework and language needs to be increased via curricula and studies on the effect of interventions on children with developmental delay. Even more so, the level of understanding on how to apply functioning among instructors and researchers working in the aquatic environment needs to be increased. Full article
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17 pages, 838 KiB  
Review
Maternal Infection and Preterm Birth: From Molecular Basis to Clinical Implications
by George Daskalakis, Alexandros Psarris, Antonios Koutras, Zacharias Fasoulakis, Ioannis Prokopakis, Antonia Varthaliti, Christina Karasmani, Thomas Ntounis, Ekaterini Domali, Marianna Theodora, Panos Antsaklis, Kalliopi I. Pappa and Angeliki Papapanagiotou
Children 2023, 10(5), 907; https://doi.org/10.3390/children10050907 - 22 May 2023
Cited by 8 | Viewed by 4400
Abstract
As the leading cause of neonatal morbidity and mortality, preterm birth is recognized as a major public health concern around the world. The purpose of this review is to analyze the connection between infections and premature birth. Spontaneous preterm birth is commonly associated [...] Read more.
As the leading cause of neonatal morbidity and mortality, preterm birth is recognized as a major public health concern around the world. The purpose of this review is to analyze the connection between infections and premature birth. Spontaneous preterm birth is commonly associated with intrauterine infection/inflammation. The overproduction of prostaglandins caused by the inflammation associated with an infection could lead to uterine contractions, contributing to preterm delivery. Many pathogens, particularly Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Gardnerella vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Actinomyces, Candida spp., and Streptococcus spp. have been related with premature delivery, chorioamnionitis, and sepsis of the neonate. Further research regarding the prevention of preterm delivery is required in order to develop effective preventive methods with the aim of reducing neonatal morbidity. Full article
(This article belongs to the Section Global and Public Health)
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14 pages, 1262 KiB  
Review
The Healthcare Experience of Autistic Patients in Orthopaedic Surgery and Closely Related Fields: A Scoping Review
by Steven D. Criss, Shravya Kakulamarri, Raylin F. Xu, Maya Fajardo, Tamra Keeney, Dorothy W. Tolchin and Collin J. May
Children 2023, 10(5), 906; https://doi.org/10.3390/children10050906 - 22 May 2023
Viewed by 1716
Abstract
Orthopaedic and related care has the potential to present unique obstacles for patients with a range of autism manifestations. In this review, we aim to describe and analyze the literature on autistic patients’ experience within orthopaedics and closely related fields. This literature search [...] Read more.
Orthopaedic and related care has the potential to present unique obstacles for patients with a range of autism manifestations. In this review, we aim to describe and analyze the literature on autistic patients’ experience within orthopaedics and closely related fields. This literature search utilized the PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature databases. Three major concepts were built into the search terms: (1) patients on the autism spectrum; (2) patient experience; and (3) movement sciences, including orthopaedics, physical medicine and rehabilitation (PM&R), occupational therapy (OT), and physical therapy (PT). Our search yielded 35 topical publications, with the major topic areas addressed as follows: (1) clinical and perioperative management, (2) therapy interventions, (3) participation in exercise and social play, (4) sensory management and accommodations, (5) caregiver/parent training and involvement in care, (6) healthcare needs and barriers to care, and (7) utilization of technology. In the current literature, there are no studies that attempt to directly assess autistic patient experience with care practices and clinical environments in orthopaedics. Rigorous, direct examination of the experience of autistic patients within clinical orthopaedic settings is urgently needed to address this gap. Full article
(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)
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11 pages, 733 KiB  
Article
The Contribution of Bullying Involvement and Alexithymia to Somatic Complaints in Preadolescents
by Valentina Levantini, Marina Camodeca and Nicolò Maria Iannello
Children 2023, 10(5), 905; https://doi.org/10.3390/children10050905 - 21 May 2023
Viewed by 1248
Abstract
Somatic complaints during preadolescence are connected to individual and contextual factors, and extant research highlights the relevance of alexithymia and bullying involvement. In this cross-sectional study, we explored the joint and unique influence of bullying involvement—as perpetrators, victims, or outsiders—and alexithymia on somatic [...] Read more.
Somatic complaints during preadolescence are connected to individual and contextual factors, and extant research highlights the relevance of alexithymia and bullying involvement. In this cross-sectional study, we explored the joint and unique influence of bullying involvement—as perpetrators, victims, or outsiders—and alexithymia on somatic complaints in a sample of 179 Italian middle-school students (aged 11–15). Findings revealed an indirect association between bullying perpetration and victimization complaints through alexithymia. We also found a significant direct association between victimization and somatic complaints. No significant association between outsider behavior and somatization was found. Our results revealed that bullying perpetration and victimization could increase youths’ risk for somatic complaints and clarify one of the processes underlying this association. The current findings further emphasize the relevance of emotional awareness for youths’ well-being and propose that implementing social–emotional skills might prevent some of the adverse consequences of being involved in bullying episodes. Full article
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15 pages, 1110 KiB  
Article
Adolescence as the Context for Understanding Young Mothers’ Engagement with Health Promotion: A Phenomenological Exploration
by Catherine Ellis and Peter Sidebotham
Children 2023, 10(5), 904; https://doi.org/10.3390/children10050904 - 20 May 2023
Viewed by 1290
Abstract
Background: The current social construction of young mothers is generally negative, pointing to a lack of engagement with universal services and poor outcomes for their infants and children. However, qualitative studies offer an alternative, more positive construct of young motherhood. Understanding the context [...] Read more.
Background: The current social construction of young mothers is generally negative, pointing to a lack of engagement with universal services and poor outcomes for their infants and children. However, qualitative studies offer an alternative, more positive construct of young motherhood. Understanding the context of young motherhood can improve the relevance and efficacy of health promotion directed to this group of high-risk mothers. Aim: To explore the lived experience of young women transitioning to motherhood to better understand their experiences and perspective; and what influences their engagement with health promotion aimed to support safer parenting practices and whether their behaviour changes over time with exposure to parenting health promotion. Method: Longitudinal Interpretative Phenomenological Analysis (IPA) was used with five first-time mothers identified with characteristics known to influence poorer outcomes for infants and children such as low educational achievement and economic disadvantage. Participants aged 16 to 19 years were recruited antenatally. Serial in-depth interviews were conducted at three time points during the ante- and post-natal periods. Interviews were transcribed and data were analysed inductively following the prescribed method of double hermeneutic analysis for IPA. Finding: Three themes were identified from the full study: Transition, Information, and Fractured application; the focus of this paper is Transition. Transition revealed that becoming mothers impacted key adolescent developmental tasks; their identity and relationships were significantly affected, both positively and negatively and adolescent brain development influenced behaviour and decision making capability. Adolescence influenced how these young mothers engaged with and interpreted parenting health promotion messages. Conclusions: Young mothers in this study operate within the context of adolescence. Adolescence impacts participants’ decision making activity and early parenting behaviours which informs the debate on why young mothers may fail to reduce risks for their infants. This insight can contribute to the development of more effective health promotion/educational strategies, and support professionals to better engage with this high-risk group to improve early parenting behaviour and subsequently improve outcomes for their infants and children. Full article
(This article belongs to the Special Issue Maternal and Child's Health)
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10 pages, 479 KiB  
Article
The Prevalence of Developmental Enamel Defects in Israeli Children and Its Association with Perinatal Conditions: A Cross-Sectional Study
by Gisela Berenstein Ajzman, Nurit Dagon, Rabea Iraqi, Sigalit Blumer and Shada Fadela
Children 2023, 10(5), 903; https://doi.org/10.3390/children10050903 - 19 May 2023
Viewed by 967
Abstract
Molar incisor hypomineralization (MIH) and deciduous molar hypomineralization (DMH) affect the first permanent molars and second primary molars, respectively, causing a greater dental treatment burden and worse oral health quality of life among affected children. We assessed the prevalence and risk factors of [...] Read more.
Molar incisor hypomineralization (MIH) and deciduous molar hypomineralization (DMH) affect the first permanent molars and second primary molars, respectively, causing a greater dental treatment burden and worse oral health quality of life among affected children. We assessed the prevalence and risk factors of MIH and DMH among 1209 children aged 3–13 years who attended a university dental clinic in Israel in 2019–2020. Clinical examinations were conducted to assess the presence of DMH and MIH. Potential etiological factors of MIH and DMH, including demographics, the mother’s perinatal health, and the child’s medical history during the first three years of life, were retrieved using a questionnaire. To examine the associations between the demographic and clinical variables and the prevalence of MIH and DMH, continuous variables were tested using the Kruskal–Wallis test with Bonferroni corrections. Categorical variables were analyzed by chi-squared test. Multivariate logistic regression was conducted to evaluate which of the significant variables found in the univariate analysis could predict a diagnosis of both MIH and DMH. The prevalence of MIH and DMH was 10.3% and 6.0%, respectively. Age ≥ 5 years, taking medications during pregnancy and severe lesions were associated with a greater risk for a diagnosis of DMH + MIH. Multivariate logistic regression with adjustment for age showed that the severity of hypomineralization was positively and significantly associated with a diagnosis of MIH + DMH with an odds ratio of 4.18 (95% confidence interval 1.26–17.16), p = 0.03. MIH should be diagnosed and monitored in young children to prevent further deterioration. Moreover, a preventive and restorative program for MIH should be established. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Pediatric Dentistry Progress)
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17 pages, 1554 KiB  
Article
Whole Exome-Trio Analysis Reveals Rare Variants Associated with Congenital Pouch Colon
by Sonal Gupta, Praveen Mathur, Ashwani Kumar Mishra, Krishna Mohan Medicherla, Obul Reddy Bandapalli and Prashanth Suravajhala
Children 2023, 10(5), 902; https://doi.org/10.3390/children10050902 - 19 May 2023
Cited by 1 | Viewed by 1959
Abstract
Anorectal malformations (ARM) are individually common, but Congenital Pouch Colon (CPC) is a rare anorectal anomaly that causes a dilated pouch and communication with the genitourinary tract. In this work, we attempted to identify de novo heterozygous missense variants, and further discovered variants [...] Read more.
Anorectal malformations (ARM) are individually common, but Congenital Pouch Colon (CPC) is a rare anorectal anomaly that causes a dilated pouch and communication with the genitourinary tract. In this work, we attempted to identify de novo heterozygous missense variants, and further discovered variants of unknown significance (VUS) which could provide insights into CPC manifestation. From whole exome sequencing (WES) performed earlier, the trio exomes were analyzed from those who were admitted to J.K. Lon Hospital, SMS Medical College, Jaipur, India, between 2011 and 2017. The proband exomes were compared with the unaffected sibling/family members, and we sought to ask whether any variants of significant interest were associated with the CPC manifestation. The WES data from a total of 64 samples including 16 affected neonates (11 male and 5 female) with their parents and unaffected siblings were used for the study. We examined the role of rare allelic variation associated with CPC in a 16 proband/parent trio family, comparing the mutations to those of their unaffected parents/siblings. We also performed RNA-Seq as a pilot to find whether or not the genes harboring these mutations were differentially expressed. Our study revealed extremely rare variants, viz., TAF1B, MUC5B and FRG1, which were further validated for disease-causing mutations associated with CPC, further closing the gaps of surgery by bringing intervention in therapies. Full article
(This article belongs to the Special Issue Human Genetics and Bioinformatics in Pediatric Diseases)
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9 pages, 500 KiB  
Case Report
A Novel Family with Demyelinating Charcot–Marie–Tooth Disease Caused by a Mutation in the PMP2 Gene: A Case Series of Nine Patients and a Brief Review of the Literature
by Margherita Baga, Susanna Rizzi, Carlotta Spagnoli, Daniele Frattini, Francesco Pisani and Carlo Fusco
Children 2023, 10(5), 901; https://doi.org/10.3390/children10050901 - 19 May 2023
Viewed by 1242
Abstract
Introduction: Charcot–Marie–Tooth (CMT) is a group of inherited peripheral neuropathies characterized by wide genotypic and phenotypic variability. The onset is typically in childhood, and the most frequent clinical manifestations are predominantly distal muscle weakness, hypoesthesia, foot deformity (pes cavus) and areflexia. In the [...] Read more.
Introduction: Charcot–Marie–Tooth (CMT) is a group of inherited peripheral neuropathies characterized by wide genotypic and phenotypic variability. The onset is typically in childhood, and the most frequent clinical manifestations are predominantly distal muscle weakness, hypoesthesia, foot deformity (pes cavus) and areflexia. In the long term, complications such as muscle-tendon retractions, extremity deformities, muscle atrophy and pain may occur. Among CMT1, demyelinating and autosomal dominant forms, CMT1G is determined by mutations in the PMP2 myelin protein. Results: Starting from the index case, we performed a clinical, electrophysiological, neuroradiological and genetic evaluation of all family members for three generations; we identified p.Ile50del in PMP2 in all the nine affected members. They presented a typical clinical phenotype, with childhood-onset variable severity between generations and a chronic demyelinating sensory-motor polyneuropathy on the electrophysiologic examination; the progression was slow to very slow and predominant in the lower limbs. Our study reports a relatively large sample of patients, members of the same family, with CMT1G by PMP2, which is a rare form of demyelinating CMT, highlighting the genetic variability of the CMT family instead of the overlapping clinical phenotypes within demyelinating forms. To date, only supportive and preventive measures for the most severe complications are available; therefore, we believe that early diagnosis (clinical, electrophysiological and genetic) allows access to specialist follow-up and therapies, thereby improving the quality of life of patients. Full article
(This article belongs to the Special Issue Neurological Diseases in Children and Adolescent)
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7 pages, 4608 KiB  
Case Report
Pediatric Pancreatic Endocrine Tumor Presenting as Acute Pancreatitis: A Case Report
by Shigetaka Fukuda, Mitsuyoshi Suzuki, Kei Minowa, Hiroyuki Koga, Atsuyuki Yamataka and Toshiaki Shimizu
Children 2023, 10(5), 900; https://doi.org/10.3390/children10050900 - 19 May 2023
Cited by 1 | Viewed by 1107
Abstract
Pancreatic neuroendocrine tumors (PNETs) are relatively rare, especially in the pediatric age group. This report describes a pediatric case of acute pancreatitis secondary to stenosis of the main pancreatic duct due to a PNET. The patient was a boy, thirteen and a half [...] Read more.
Pancreatic neuroendocrine tumors (PNETs) are relatively rare, especially in the pediatric age group. This report describes a pediatric case of acute pancreatitis secondary to stenosis of the main pancreatic duct due to a PNET. The patient was a boy, thirteen and a half years old, who presented with persistent low-grade fever, nausea, and abdominal pain. He was diagnosed with acute pancreatitis based on the elevation of serum pancreatic enzyme levels and abdominal ultrasonography findings of enlargement of the pancreas and dilatation of the main pancreatic duct. Abdominal contrast-enhanced computed tomography (CT) showed a 5.5 mm, contrast-enhanced mass in the head of the pancreas. His symptoms resolved with conservative treatment, although the pancreatic tumor grew slowly. At fifteen years and four months, since the tumor had enlarged to 8.0 mm, the patient underwent pancreaticoduodenectomy for therapeutic and diagnostic purposes. Based on the pathological evaluation, he was diagnosed with PNET (grade: G1). The patient has been free of tumor recurrence for 10 years and requires no additional therapy. In this report, the clinical characteristics of PNETs are also discussed, comparing the clinical features of adult-onset and pediatric-onset cases that initially present as acute pancreatitis. Full article
(This article belongs to the Special Issue Recent Advances in Hepatobiliary and Pancreatic Surgery in Children)
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13 pages, 1083 KiB  
Article
Comparison between Nasopharyngeal and Saliva Samples for the Detection of Respiratory Viruses in Children with Acute Lower Respiratory Tract Infections: A Pilot Study
by Danilo Buonsenso, Piero Valentini, Francesco Mariani, Silvia Di Noi, Sofia Mazza, Ivana Palucci, Maurizio Sanguinetti and Michela Sali
Children 2023, 10(5), 899; https://doi.org/10.3390/children10050899 - 19 May 2023
Cited by 1 | Viewed by 1299
Abstract
Purpose: During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated. Methods: [...] Read more.
Purpose: During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated. Methods: Children younger than 18 years of age admitted with respiratory signs and symptoms underwent both nasopharyngeal and SS procedures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SS were calculated, considering the nasopharyngeal swab result as the gold standard. Results: A total of 83 patients (44 females, 53%) underwent both nasopharyngeal and SS procedures. Overall, the sensitivity of SS was 49.4%. Sensitivity according to different respiratory viruses ranged from 0% to 71.43%, while the specificity ranged from 96% to 100%. Negative predictive value ranged from 68.06% to 98.8%, while positive predictive value ranged from 0 to 100%. SS sensitivity in patients younger than 12 months of age was 39.47%, while in patients older than or equal to 12 months of age it was 57.78%. Patients with negative SS had a significantly lower median age (8.5 months (15.25) vs. 23 months (34), p = 0.001) and a significantly lower quantity of median saliva collected for salivary analysis (0 μL (213) vs. 300 μL (100), p < 0.001). Conclusions: SS has a relatively low sensitivity in detecting common respiratory viruses in children with LRTI, with a lower probability in younger children (and in particular those younger than 6 months of age) or those from whom we have collected lesser amounts of saliva. New strategies to improve saliva collection are needed for testing on a larger study population. Full article
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10 pages, 729 KiB  
Article
Comparative Evaluation of Extrusion of Apical Debris in Primary Maxillary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study
by Balaji Suresh, Ganesh Jeevanandan, Vignesh Ravindran, Mohammed Mashyakhy, Noura Alessa, Ather Ahmed Syed, Suman Panda, Ali Ahmed Assiry, Prabhadevi C. Maganur and Satish Vishwanathaiah
Children 2023, 10(5), 898; https://doi.org/10.3390/children10050898 - 18 May 2023
Cited by 1 | Viewed by 1128
Abstract
Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in [...] Read more.
Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in postoperative complications. The aim of this study was to evaluate and compare the number of debris apically extruded during canal preparation using two different pediatric rotary file systems and conventional hand file systems in primary teeth. 60 primary maxillary central incisors that were extracted due to trauma or untreated dental caries with no signs of resorption were taken. Canal preparation was executed using three different file systems: Group A: Group A hand K file system, Group B Kedo S Plus, Group C Kedo SG Blue. For each of these files using the Myers and Montgomery model, the pre- and post-weight of the eppendorf tube was assessed to quantify the number of apical debris. The maximum extrusion of apical debris was noticed with the Hand K-file system. The least debris was noticed in the Kedo S Plus file system. Statistical analysis revealed that there were highly significant differences in apical extrusion and debris when comparing hand files and rotary files and also between the two rotary files used. Apical debris collection is an unavoidable outcome of canal instrumentation. Among the file systems compared, rotary files had lesser extrusion when compared to hand files. Among the rotary files, Kedo S plus showed normal extrusion compared to SG Blue. Full article
(This article belongs to the Special Issue New Research Progress of Clinical Pediatric Dentistry)
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21 pages, 1248 KiB  
Review
Translating Precision Health for Pediatrics: A Scoping Review
by Mathushan Subasri, Celine Cressman, Danielle Arje, Leighton Schreyer, Erin Cooper, Komal Patel, Wendy J. Ungar, Melanie Barwick, Avram Denburg and Robin Z. Hayeems
Children 2023, 10(5), 897; https://doi.org/10.3390/children10050897 - 17 May 2023
Viewed by 1445
Abstract
Precision health aims to personalize treatment and prevention strategies based on individual genetic differences. While it has significantly improved healthcare for specific patient groups, broader translation faces challenges with evidence development, evidence appraisal, and implementation. These challenges are compounded in child health as [...] Read more.
Precision health aims to personalize treatment and prevention strategies based on individual genetic differences. While it has significantly improved healthcare for specific patient groups, broader translation faces challenges with evidence development, evidence appraisal, and implementation. These challenges are compounded in child health as existing methods fail to incorporate the physiology and socio-biology unique to childhood. This scoping review synthesizes the existing literature on evidence development, appraisal, prioritization, and implementation of precision child health. PubMed, Scopus, Web of Science, and Embase were searched. The included articles were related to pediatrics, precision health, and the translational pathway. Articles were excluded if they were too narrow in scope. In total, 74 articles identified challenges and solutions for putting pediatric precision health interventions into practice. The literature reinforced the unique attributes of children and their implications for study design and identified major themes for the value assessment of precision health interventions for children, including clinical benefit, cost-effectiveness, stakeholder values and preferences, and ethics and equity. Tackling these identified challenges will require developing international data networks and guidelines, re-thinking methods for value assessment, and broadening stakeholder support for the effective implementation of precision health within healthcare organizations. This research was funded by the SickKids Precision Child Health Catalyst Grant. Full article
(This article belongs to the Special Issue Genomic Sequencing in Maternal and Child Health)
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14 pages, 641 KiB  
Article
Understanding the Family Context: A Qualitative Descriptive Study of Parent and NICU Clinician Experiences and Perspectives
by Maya Dahan, Leahora Rotteau, Shelley Higazi, Ophelia Kwayke, Giselle Lai, Wendy Moulsdale, Lisa Sampson, Jennifer Stannard, Paige Terrien Church and Karel O’Brien
Children 2023, 10(5), 896; https://doi.org/10.3390/children10050896 - 17 May 2023
Viewed by 1370
Abstract
Enabling individualized decision-making for patients requires an understanding of the family context (FC) by healthcare providers. The FC is everything that makes the family unique, from their names, preferred pronouns, family structure, cultural or religious beliefs, and family values. While there is an [...] Read more.
Enabling individualized decision-making for patients requires an understanding of the family context (FC) by healthcare providers. The FC is everything that makes the family unique, from their names, preferred pronouns, family structure, cultural or religious beliefs, and family values. While there is an array of approaches for individual clinicians to incorporate the FC into practice, there is a paucity of literature guiding the process of collecting and integrating the FC into clinical care by multidisciplinary interprofessional teams. The purpose of this qualitative study is to explore the experience of families and Neonatal Intensive Care Unit (NICU) clinicians with information sharing around the FC. Our findings illustrate that there are parallel and overlapping experiences of sharing the FC for families and clinicians. Both groups describe the positive impact of sharing the FC on building and sustaining relationships and on personalization of care and personhood. The experience by families of revolving clinicians and the risks of miscommunication about the FC were noted as challenges to sharing the FC. Parents described the desire to control the narrative about their FC, while clinicians described seeking equal access to the FC to support the family in the best way possible related to their clinical role. Our study highlights how the quality of care is positively impacted by clinicians’ appreciation of the FC and the complex relationship between a large multidisciplinary interprofessional team and the family in an intensive care unit, while also highlighting the difficulties in its practical application. Knowledge learned can be utilized to inform the development of processes to improve communication between families and clinicians. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Neonatology)
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20 pages, 1062 KiB  
Article
Evolution of Youth’s Mental Health and Quality of Life during the COVID-19 Pandemic in South Tyrol, Italy: Comparison of Two Representative Surveys
by Verena Barbieri, Christian J. Wiedermann, Giuliano Piccoliori, Angelika Mahlknecht, Barbara Plagg, Dietmar Ausserhofer, Ulrike Ravens-Sieberer and Adolf Engl
Children 2023, 10(5), 895; https://doi.org/10.3390/children10050895 - 17 May 2023
Cited by 1 | Viewed by 1549
Abstract
Background: The coronavirus disease 2019 pandemic has led to an increase in youth mental health problems worldwide. Studies have revealed substantial variation in the incidence of these problems across different regions. Longitudinal studies of children and adolescents in Italy are lacking. This study [...] Read more.
Background: The coronavirus disease 2019 pandemic has led to an increase in youth mental health problems worldwide. Studies have revealed substantial variation in the incidence of these problems across different regions. Longitudinal studies of children and adolescents in Italy are lacking. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health in Northern Italy by comparing surveys conducted in June 2021 and in March 2022. Methods: A representative, large cross-sectional, online survey investigated HRQoL, psychosomatic complaints, and symptoms of anxiety and depression among 5159 and 6675 children and adolescents in 2021 and 2022, respectively, using the KIDSCREEN-10 index, HBSC symptom checklist, SCARED, CES-DC, and PHQ-2 instruments. Statistical analyses included a multivariate linear regression analysis. Results: Baseline characteristics showed significant differences in demographic variables between the two surveys. Girls and their parents reported a significantly lower HRQoL in 2021 than in 2022. Psychosomatic complaints differed significantly between sexes, and the results showed no decrease in psychosomatic complaints, anxiety, or depression between 2021 and 2022. Predictors of HRQoL, anxiety, depressive symptoms, and psychosomatic complaints in 2022 differed from those in 2021. Conclusions: The characteristics of the 2021 pandemic, including lockdowns and home schooling, may have contributed to the differences between the two surveys. As most pandemic restrictions ended in 2022, the results confirm the need for measures to improve the mental and physical health of children and adolescents after the pandemic. Full article
(This article belongs to the Special Issue Children’s Emotion and Learning during COVID-19 Pandemic)
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7 pages, 1916 KiB  
Case Report
Heart Failure Post-SARS-CoV-2 Infection in Children with Duchenne Muscular Dystrophy: The Additive Value of Cardiovascular Magnetic Resonance
by George Markousis-Mavrogenis, Antonios Belegrinos, Aikaterini Giannakopoulou, Evangelos Karanasios, Vasiliki Vartela, Elephtheria Patsilinakou, Paul Samantis, Roser-Marie Pons, Antigoni Papavasiliou and Sophie I. Mavrogeni
Children 2023, 10(5), 894; https://doi.org/10.3390/children10050894 - 17 May 2023
Viewed by 993
Abstract
In this case series, we describe the diagnosis of post-COVID-19 myocarditis in asymptomatic patients with Duchenne Muscular Dystrophy (DMD) and a mild COVID-19 disease course. These patients were referred for CMR due to electrocardiographic and echocardiographic alterations, which did not exist before COVID-19 [...] Read more.
In this case series, we describe the diagnosis of post-COVID-19 myocarditis in asymptomatic patients with Duchenne Muscular Dystrophy (DMD) and a mild COVID-19 disease course. These patients were referred for CMR due to electrocardiographic and echocardiographic alterations, which did not exist before COVID-19 infection. CMR identified the presence of severe myocardial inflammation in all patients based on abnormally elevated myocardial T2 ratio, late gadolinium enhancement, native T1 mapping, T2 mapping, and extracellular volume fraction. This was paired with concurrent impairment of left ventricular function. Appropriate treatment was initiated in all cases. Two of the four patients developed episodes of ventricular tachycardia during the following 6 months, and a defibrillator was implanted. Despite the mild clinical presentation, this case series demonstrates the diagnostic strength of CMR in the diagnosis and evaluation of post-COVID-19 myocarditis and serves to increase awareness of this potential complication amongst treating physicians. Full article
(This article belongs to the Section Pediatric Cardiology)
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12 pages, 252 KiB  
Article
Factors Associated with Atopic Dermatitis among Children Aged 6 to 14 Years in Alimosho Local Government, Lagos, Nigeria
by Olubunmi A. Kayode, Charlotte M. Mokoatle, Phoka C. Rathebe and Thokozani P. Mbonane
Children 2023, 10(5), 893; https://doi.org/10.3390/children10050893 - 17 May 2023
Viewed by 1005
Abstract
There has been a rise in the prevalence of atopic dermatitis (AD) globally, especially in low-and middle-income countries such as Nigeria. The condition has been linked to genetic predisposes, living conditions, and environmental factors. Environmental factors are considered a significant contributor to AD [...] Read more.
There has been a rise in the prevalence of atopic dermatitis (AD) globally, especially in low-and middle-income countries such as Nigeria. The condition has been linked to genetic predisposes, living conditions, and environmental factors. Environmental factors are considered a significant contributor to AD in low- and middle-income countries. This study determined the prevalence of AD in south-western Nigeria and identified risk factors in home and school environments that children aged 6 to 14 years are exposed to. A cross-sectional study was adopted, and the total sample size was 349. Four randomly selected health facilities were used for the study. A questionnaire was used to determine the risk factors in the population. Data analysis was performed using the latest version of Statistical Package for Social Science (SPSS). The prevalence of atopic dermatitis in this study is 25%. Atopic dermatitis was found to be common in females (27%). According to the univariate analysis, children who lived where trucks pass on the street almost daily had the highest cases of atopic dermatitis (28%). Children with rugs in their houses (26%) and those whose houses are surrounded by bushes (26%) had higher cases of atopic dermatitis. Children who played on school grass (26%), attended creche with rubber toys (28%), and attended school where wooden chairs (28%) and chalkboards (27%) are used had a higher number of AD. Bivariate analysis showed an association between AD with a mother’s monthly income (p = 0.012) and eating potatoes (p = 0.005), fruits (p = 0.040), and cereal (p = 0.057). In the multivariate analysis, the consumption of fruits (p = 0.02), potatoes (p < 0.001), and cereal (p = 0.04) were identified as risk factors associated with AD. It is envisaged that the study will serve as a basis for possible research on evidence-based and primary prevention options. Hence, we recommend health education activities to empower communities to protect themselves against environmental risk factors that are preventable. Full article
(This article belongs to the Section Global and Public Health)
13 pages, 648 KiB  
Article
Clinical and Functional Characteristics of a New Phenotype of SMA Type I among a National Sample of Spanish Children: A Cross-Sectional Study
by Beatriz de-Andrés-Beltrán, Javier Güeita-Rodríguez, Domingo Palacios-Ceña and Ángel Luis Rodríguez-Fernández
Children 2023, 10(5), 892; https://doi.org/10.3390/children10050892 - 16 May 2023
Cited by 3 | Viewed by 2275
Abstract
Spinal Muscular Atrophy (SMA) type I has classically presented extremely severe clinical features. New pharmacological treatments have led to a new phenotype of SMA. The aim of this study was to describe the current health and functional status of children with SMA. A [...] Read more.
Spinal Muscular Atrophy (SMA) type I has classically presented extremely severe clinical features. New pharmacological treatments have led to a new phenotype of SMA. The aim of this study was to describe the current health and functional status of children with SMA. A cross-sectional study was conducted based on the STROBE guidelines. Patient questionnaires and standardized tools were used. A descriptive analysis was conducted establishing the proportions of subjects for each of the characteristics of interest. In total, 51 genetically confirmed SMA type I subjects were included. Fifty-seven percent received oral feeding, 33% received tube feeding and 10% combined both. Moreover, 21.6% had tracheostomies, and 9.8% needed more than 16 h/d ventilatory support. Regarding orthopedic status, 66.7% had scoliosis, and 68.6% had hip subluxation or dislocation. Up to 67% were able to sit independently, 23.5% walked with support and one child walked independently. Current SMA type I is a different entity from the classic phenotype but also from types II and III. In addition, no differences were found between SMA type I subgroups. These findings may enable the professionals involved in the care of these patients to improve their interventions in terms of prevention and rehabilitation measures for these children. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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13 pages, 467 KiB  
Article
Prevalence and Predictors of Alcohol Use among School-Going Adolescents in Panama: A Population-Based Cross-Sectional Study
by Paul Obeng, Francis Sambah, Jacob Owusu Sarfo, Medina Srem-Sai, Newton Isaac Gbordzoe, Richmond Stephen Sorkpor and John Elvis Hagan
Children 2023, 10(5), 891; https://doi.org/10.3390/children10050891 - 16 May 2023
Cited by 2 | Viewed by 1520
Abstract
This study investigated the prevalence and predictors of alcohol use among school-going-age adolescents in Panama. Using a national school-based cross-sectional survey, data from a proportionate sample of school-going adolescents aged 13–17 years were obtained from the 2018 Panama Global School-based Student Health Survey [...] Read more.
This study investigated the prevalence and predictors of alcohol use among school-going-age adolescents in Panama. Using a national school-based cross-sectional survey, data from a proportionate sample of school-going adolescents aged 13–17 years were obtained from the 2018 Panama Global School-based Student Health Survey [GSHS]. Data were analysed with a Pearson’s Chi-square test and weighted binary logistic regression. The results were reported with their corresponding adjusted odds ratio (AOR) at a 95% confidence interval (CI) and level of significance set at p < 0.05. The prevalence of alcohol use among adolescents in Panama was 30.6%. The odds of alcohol use were lower among adolescents in a lower grade than those in upper grades, and lower in those who did not eat from a restaurant than those who ate from a restaurant. Further, the likelihood of alcohol use was significantly high among those who engaged in physical fights, were seriously injured, were mostly worried, and whose parents used any form of tobacco. Other results showed that the odds of alcohol use were high among sedentary respondents, those who had multiple sexual partners and those who used amphetamines. Based on the present findings, a collaborative approach (i.e., stakeholders- the Ministry of Social Development and the Ministry of Education- community–individual levels) towards the development and adherence of appropriate interventions aimed at reducing alcohol use is required in Panama. Specific preventive interventions would be fundamental in promoting a positive school climate to help reduce adolescents’ alcohol use and, perhaps, other anti-social behaviours (e.g., physical fights and bullying). Full article
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10 pages, 1030 KiB  
Article
Quality of Life Outcomes for Patients Who Underwent Conventional Resection and Liver Transplantation for Locally Advanced Hepatoblastoma
by Zishaan Farooqui, Michael Johnston, Emily Schepers, Nathalie Brewer, Stephen Hartman, Todd Jenkins, Alexander Bondoc, Ahna Pai, James Geller and Gregory M. Tiao
Children 2023, 10(5), 890; https://doi.org/10.3390/children10050890 - 16 May 2023
Cited by 1 | Viewed by 1209
Abstract
Hepatoblastoma is the most common malignant liver tumor of childhood, with liver transplant and extended resection used as surgical treatments for locally advanced tumors. Although each approach has well-described post-operative complications, quality-of-life outcomes have not been described following the two interventions. Long-term pediatric [...] Read more.
Hepatoblastoma is the most common malignant liver tumor of childhood, with liver transplant and extended resection used as surgical treatments for locally advanced tumors. Although each approach has well-described post-operative complications, quality-of-life outcomes have not been described following the two interventions. Long-term pediatric survivors of hepatoblastoma who underwent conventional liver resection or liver transplantation at a single institution from January 2000–December 2013 were recruited to complete quality-of-life surveys. Survey responses for the Pediatric Quality of Life Generic Core 4.0 (PedsQL, n = 30 patient and n = 31 parent surveys) and Pediatric Quality of Life Cancer Module 3.0 (PedsQL-Cancer, n = 29 patient and n = 31 parent surveys) were collected from patients and parents. The mean total patient-reported PedsQL score was 73.7, and the parent-reported score was 73.9. There were no significant differences in scores on the PedsQL between patients who underwent resection compared to those who underwent transplantation (p > 0.05 for all comparisons). On the PedsQL-Cancer module, procedural anxiety scores were significantly lower for patients who underwent resection as compared to transplant (M = 33.47 points less, CI [−60.41, −6.53], p-value 0.017). This cross-sectional study demonstrates that quality of life outcomes are overall similar among patients receiving transplants and resections. Patients who received a resection reported worse procedural anxiety. Full article
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14 pages, 1326 KiB  
Article
Home-Based Exercise Training in the Recovery of Multisystem Inflammatory Syndrome in Children: A Case Series Study
by Camilla Astley, Gabriela Nunes Leal, Saulo Gil, Priscila Suguita, Thais Fink, Vera Bain, Maria Fernanda Badue Pereira, Heloisa Helena Marques, Sofia Sieczkowska, Danilo Prado, Marcos Santos Lima, Camila G. Carneiro, Carlos Alberto Buchpiguel, Clovis Artur Silva and Bruno Gualano
Children 2023, 10(5), 889; https://doi.org/10.3390/children10050889 - 16 May 2023
Cited by 1 | Viewed by 1283
Abstract
Objective: To assess the potential therapeutic role of exercise on health-related quality of life, assessed by the Pediatric Outcomes Data Collection Instrument (PODCI), coronary flow reserve (CFR), cardiac function, cardiorespiratory fitness, and inflammatory and cardiac blood markers in multisystemic inflammatory syndrome in children [...] Read more.
Objective: To assess the potential therapeutic role of exercise on health-related quality of life, assessed by the Pediatric Outcomes Data Collection Instrument (PODCI), coronary flow reserve (CFR), cardiac function, cardiorespiratory fitness, and inflammatory and cardiac blood markers in multisystemic inflammatory syndrome in children (MIS-C) patients. Methods: This is a case series study of a 12-wk, home-based exercise intervention in children and adolescents after MIS-C diagnosis. From 16 MIS-C patients followed at our clinic, 6 were included (age: 7–16 years; 3 females). Three of them withdrew before the intervention and served as controls. The primary outcome was health-related quality of life, assessed PODCI. Secondary outcomes were CFR assessed by 13N-ammonia PET-CT imaging, cardiac function by echocardiography, cardiorespiratory fitness, and inflammatory and cardiac blood markers. Results: In general, patients showed poor health-related quality of life, which seemed to be improved with exercise. Additionally, exercised patients showed improvements in coronary flow reserve, cardiac function, and aerobic conditioning. Non-exercised patients exhibited a slower pattern of recovery, particularly in relation to health-related quality of life and aerobic conditioning. Conclusions: Our results suggest that exercise may play a therapeutic role in the treatment of post-discharge MIS-C patients. As our design does not allow inferring causality, randomized controlled trials are necessary to confirm these preliminary findings. Full article
(This article belongs to the Special Issue Research of Pediatric Infectious Disease)
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12 pages, 908 KiB  
Article
Oral Health in migrants children in Melilla, Spain
by Gunel Kizi, Ana Raquel Barata, Irene Ventura, Javier Flores-Fraile, David Ribas-Perez and Antonio Castaño-Seiquer
Children 2023, 10(5), 888; https://doi.org/10.3390/children10050888 - 16 May 2023
Cited by 1 | Viewed by 1471
Abstract
Numerous developing countries’ socioeconomic and political issues resulted in a significant migratory phenomenon, which poses a health burden for the nations that receive migrant populations. Often, the greatest age group of migrants is children and teens. Oral problems are one of the most [...] Read more.
Numerous developing countries’ socioeconomic and political issues resulted in a significant migratory phenomenon, which poses a health burden for the nations that receive migrant populations. Often, the greatest age group of migrants is children and teens. Oral problems are one of the most common reasons that immigrants in the receiving nations visit the healthcare system. Cross-sectional research was conducted on children and teenagers housed at the Temporary Stay Center for Immigrants (CETI) of the Autonomous City of Melilla (Spain) with the aim of identifying the state of the oral cavity of these group of migrants. Information on the condition of the research group’s oral cavity was gathered using the World Health Organization’s standards. The research comprised all of the children and teenagers who were enrolled in the CETI for a defined period of time. A total of 198 children were assessed. It was determined that 86.9% of the youngsters were of Syrian descent. There were 57.6% males and a 7.7 (±4.1) average age. The average caries index for children under the age of six was dft =6.4 (±6.3), and for children aged six to eleven, it was 7.5 (±4.8), taking into account both the temporary and permanent dentition, and for children aged twelve to seventeen, it was 4.7 (±4.0). A total of 50.6% of children between the ages of 6 and 11 needed extractions, compared to 36.8% of children under the age of 6. The population under study had a significant incidence of sextants where bleeding occurred during periodontal probing (mean 3.9 (±2.5)), according to an examination of the community periodontal index (CPI). It is crucial to study the oral cavity status of refugee children when designing intervention programs to improve their oral health and provide health education activities that favour the prevention of oral diseases. Full article
(This article belongs to the Special Issue Advances in Pediatric Oral Health)
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12 pages, 995 KiB  
Article
Trends and Predictors of Pediatric Negative Appendectomy Rates: A Single-Centre Retrospective Study
by Miro Jukić, Petra Nizeteo, Jakov Matas and Zenon Pogorelić
Children 2023, 10(5), 887; https://doi.org/10.3390/children10050887 - 15 May 2023
Cited by 2 | Viewed by 1761
Abstract
Background: Appendectomy is still the standard treatment for acute appendicitis in the majority of centers. Despite all available diagnostic tools, the rates of negative appendectomies are still relatively high. This study aimed to determine negative appendectomy rates and to analyze the demographic and [...] Read more.
Background: Appendectomy is still the standard treatment for acute appendicitis in the majority of centers. Despite all available diagnostic tools, the rates of negative appendectomies are still relatively high. This study aimed to determine negative appendectomy rates and to analyze the demographic and clinical data of the patients whose histopathology report was negative. Methods: All patients younger than 18 years who underwent appendectomy for suspected acute appendicitis in the period from 1 January 2012 to 31 December 2021 were included in the single-center retrospective study. Electronic records and archives of histopathology reports were reviewed for patients with negative appendectomy. The primary outcome of this study was a negative appendectomy rate. Secondary outcomes comprehended the rate of appendectomies and the association of age, sex, body mass index (BMI), values of laboratory markers, scoring systems, and ultrasound reports with negative histopathology reports. Results: During the study period, a total of 1646 appendectomies for suspected acute appendicitis were performed. In 244 patients, negative appendectomy was reported regarding the patients’ pathohistology. In 39 of 244 patients, other pathologies were found, of which ovarian pathology (torsion and cysts) torsion of greater omentum and Meckel’s diverticulitis were the most frequent. Finally, the ten-year negative appendectomy rate was 12.4% (205/1646). The median age was 12 years (interquartile range, IQR 9, 15). A slight female predominance was noted (52.5%). A significantly higher incidence of negative appendectomies was noted in girls, with a peak incidence between the ages of 10 and 15 years (p < 0.0001). Male children whose appendectomy was negative had significantly higher BMI values compared to female patients (p = 0.0004). The median values of white blood cell count, neutrophil count, and CRP in the patients with negative appendectomy were 10.4 × 109/L, 75.9%, and 11 mg/dL, respectively. The median of Alvarado’s score was 6 (IQR 4; 7.5), while the median of the AIR score was 5 (IQR 4, 7). The rate of children with negative appendectomy who underwent ultrasound was 34.4% (84/244), among which 47 (55.95%) concluded negative reports. The rates of negative appendectomies were not homogenous in terms of distribution regarding the season. The incidence of negative appendectomies was more frequent during the cold period of the year (55.3% vs. 44.7%; p = 0.042). Conclusions: The majority of negative appendectomies were performed in children older than 9 years and most frequently in female children aged 10 to 15 years. In addition, female children have significantly lower BMI values compared to male children with negative appendectomy. An increase in the utilization of auxiliary diagnostic methods such as computed tomography could affect the reduction in the pediatric negative appendectomy rate. Full article
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3 pages, 192 KiB  
Editorial
Cardiovascular Disease in Children: The Future Is Now
by Sebastiano A. G. Lava
Children 2023, 10(5), 886; https://doi.org/10.3390/children10050886 - 15 May 2023
Viewed by 864
Abstract
Cardiovascular disease is a leading cause of morbidity and mortality worldwide [...] Full article
(This article belongs to the Special Issue Cardiovascular Disease in Children)
15 pages, 22730 KiB  
Systematic Review
Impact of Dental Trauma on Orthodontic Parameters—A Systematic Review and Meta-Analysis
by Mohammad Khursheed Alam, Mohammed Awawdeh, Ali S. Aljhani, Ghada Serhan Alotaib, Huda Abutayyem, Haytham Jamil Alswairki and Mohammad Younis Hajeer
Children 2023, 10(5), 885; https://doi.org/10.3390/children10050885 - 15 May 2023
Cited by 1 | Viewed by 1790
Abstract
Background and objectives: Investigation into the impact of dental trauma on the results of orthodontic treatment is crucial because it can have a major influence on patient care. However, there has not yet been a thorough review or meta-analysis of the available data, [...] Read more.
Background and objectives: Investigation into the impact of dental trauma on the results of orthodontic treatment is crucial because it can have a major influence on patient care. However, there has not yet been a thorough review or meta-analysis of the available data, which is inconsistent and scant. Therefore, the goal of this systematic review and meta-analysis is to investigate the impact of dental trauma on orthodontic parameters. Search methods and criterion of selection: Major online databases were searched (beginning from the year 2011) for relevant articles using a properly defined search strategy. Analysis protocol: Risk of bias (RoB) and the Cochrane risk of bias tool were utilized for the purposes of bias evaluation within the individual studies and within the review, respectively. Results: Out of the six clinical trials selected, a significant impact of trauma was observed in individuals in all but one paper. Gender predilection varied across studies and could not be conclusively determined. The follow-up period ranged from two months to two years in the trials. The odds ratio (OR) 0.38 [0.19, 0.77] and the risk ratio (RR) 0.52 [0.32, 0.85] indicated that both the odds as well as the relative risk of experiencing dental trauma were lower in the group with negligible impact compared to the group with noticeable impact. Conclusion and further implications: The findings show that dental trauma significantly affects orthodontic parameters, with lower risk and likelihood of suffering dental trauma in the group with negligible impact than in the group with noticeable impact. However, given the substantial heterogeneity among the studies, it is advised to exercise caution when extrapolating the findings to all populations. Registration and protocol: Registration in the PROSPERO database was carried out before initiating the investigation [CRD42023407218]. Full article
(This article belongs to the Special Issue New Advances in Orthodontic Treatment in Children)
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11 pages, 1331 KiB  
Review
Juvenile Osteochondral Lesions of the Talus: Current Concepts Review and an Update on the Literature
by Albert T. Anastasio, Kian Bagheri, Emily M. Peairs, Caitlin Grant and Samuel B. Adams
Children 2023, 10(5), 884; https://doi.org/10.3390/children10050884 - 15 May 2023
Cited by 1 | Viewed by 1631
Abstract
Osteochondral lesions of the talus (OLTs) are lesions that occur before the physis closes and are frequently associated with acute ankle trauma. These lesions are often difficult to diagnose due to swelling and inflammation that are present after the initial injury. A growing [...] Read more.
Osteochondral lesions of the talus (OLTs) are lesions that occur before the physis closes and are frequently associated with acute ankle trauma. These lesions are often difficult to diagnose due to swelling and inflammation that are present after the initial injury. A growing body of literature has assessed the effects of OLTs in the adult population. However, the literature examining these lesions in the juvenile population is sparse. The purpose of this review is to provide a thorough understanding of OLTs, with a specific focus on the juvenile population. We evaluate the recent literature regarding the outcomes of various surgical treatment; modalities in the pediatric patient. While the outcomes after surgical treatment of pediatric OLTs are generally favorable, the paucity of investigation in this demographic is alarming. Further research is needed to better inform practitioners and families regarding these outcomes, as treatment plans are highly dependent on the individual patient in question. Full article
(This article belongs to the Section Pediatric Orthopedics)
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3 pages, 185 KiB  
Editorial
New Optimization Strategies on Radiation Protection in Fluoroscopy-Guided Interventional Procedures in Pediatrics
by Carlos Ubeda
Children 2023, 10(5), 883; https://doi.org/10.3390/children10050883 - 15 May 2023
Cited by 3 | Viewed by 1109
Abstract
The term fluoroscopically guided interventional procedure describes a clinical practice in medicine, where fluoroscopic systems are used to conduct diagnostic procedures or provide image guidance for therapeutic interventional procedures performed via percutaneous or other access routes [...] Full article
13 pages, 1522 KiB  
Article
Genetic Disruption of Cilia-Associated Signaling Pathways in Patients with VACTERL Association
by Jessica Ritter, Kristina Lisec, Marina Klinner, Martina Heinrich, Dietrich von Schweinitz, Roland Kappler and Jochen Hubertus
Children 2023, 10(5), 882; https://doi.org/10.3390/children10050882 - 14 May 2023
Viewed by 1273
Abstract
VACTERL association is a rare malformation complex consisting of vertebral defects, anorectal malformation, cardiovascular defects, tracheoesophageal fistulae with esophageal atresia, renal malformation, and limb anomalies. According to current knowledge, VACTERL is based on a multifactorial pathogenesis including genomic alterations. This study aimed to [...] Read more.
VACTERL association is a rare malformation complex consisting of vertebral defects, anorectal malformation, cardiovascular defects, tracheoesophageal fistulae with esophageal atresia, renal malformation, and limb anomalies. According to current knowledge, VACTERL is based on a multifactorial pathogenesis including genomic alterations. This study aimed to improve the understanding of the genetic mechanisms in the development of VACTERL by investigating the genetic background with a focus on signaling pathways and cilia function. The study was designed as genetic association study. For this, whole-exome sequencing with subsequent functional enrichment analyses was performed for 21 patients with VACTERL or a VACTERL-like phenotype. In addition, whole-exome sequencing was performed for three pairs of parents and Sanger-sequencing was performed for ten pairs of parents. Analysis of the WES-data revealed genetic alteration in the Shh- and Wnt-signaling pathways. Additional performed functional enrichment analysis identified an overrepresentation of the cilia, including 47 affected ciliary genes with clustering in the DNAH gene family and the IFT-complex. The examination of the parents showed that most of the genetic changes were inherited. In summary, this study indicates three genetically determined damage mechanisms for VACTERL with the potential to influence each other, namely Shh- and Wnt-signaling pathway disruption, structural cilia defects and disruption of the ciliary signal transduction. Full article
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20 pages, 365 KiB  
Article
Flashbulb Memories in the Communication of the Diagnosis of Visual Impairment: The Effect of Context and Content
by Mª Emma Mayo Pais, José Eulogio Real Deus, Patricia Mª Iglesias-Souto and Eva Mª Taboada-Ares
Children 2023, 10(5), 881; https://doi.org/10.3390/children10050881 - 14 May 2023
Viewed by 1497
Abstract
The diagnosis of a child’s visual impairment is remembered vividly and intensely by their parents. However, the way in which the diagnosis is communicated may affect the development and persistence of this memory. The aim of this study is to analyze the circumstances [...] Read more.
The diagnosis of a child’s visual impairment is remembered vividly and intensely by their parents. However, the way in which the diagnosis is communicated may affect the development and persistence of this memory. The aim of this study is to analyze the circumstances in which the first news of the diagnosis of visual impairment in children is given and whether the memory of this event persists over time leading to a flashbulb memory. A longitudinal study was carried out with the participation of 38 mothers. Data were collected on sociodemographics, clinical variables, circumstances surrounding the communication of the diagnosis, and the degree of agreement of the information in the two phases of the research. The diagnosis was, on the whole, given to both parents at the same time, in medical language and with little tact, generally in the office of an ophthalmologist. The mothers would have preferred to have received the news in a different way, and the existence of a flashbulb memory is confirmed, more dependent on the context in which the diagnosis was given and its content than on sociodemographic and clinical factors. The way in which the first news of such a diagnosis is given plays a significant role in how it is remembered. Therefore, an improvement in medical practice regarding the communication of such diagnoses is recommended. Full article
13 pages, 2689 KiB  
Article
Redefining Neurodevelopmental Impairment: Perspectives of Very Preterm Birth Stakeholders
by Anne Synnes, Amarpreet Chera, Lindsay L. Richter, Jeffrey N. Bone, Claude Julie Bourque, Sofia Zhang-Jiang, Rebecca Pearce, Annie Janvier and Thuy Mai Luu
Children 2023, 10(5), 880; https://doi.org/10.3390/children10050880 - 14 May 2023
Cited by 3 | Viewed by 1798
Abstract
Children born very preterm are at risk of severe neurodevelopmental impairment, a composite endpoint that includes cerebral palsy, developmental delay, and hearing and visual impairment defined by medical professionals. We aimed to describe preterm birth stakeholders’ perspectives on this classification. Ten clinical scenarios [...] Read more.
Children born very preterm are at risk of severe neurodevelopmental impairment, a composite endpoint that includes cerebral palsy, developmental delay, and hearing and visual impairment defined by medical professionals. We aimed to describe preterm birth stakeholders’ perspectives on this classification. Ten clinical scenarios describing 18-month-old children with different components of severe neurodevelopmental impairment and one scenario of a typically developing child (control) were distributed to parents and stakeholders using a snowball sampling technique. For each scenario, participants rated health on a scale from 0 to 10 and whether the scenario represented a severe condition. Results were analyzed descriptively and mean differences from the control scenario were compared using a linear mixed-effects model. Stakeholders (number = 827) completed 4553 scenarios. Median health scores for each scenario varied from 6 to 10. The rating for the cerebral palsy and language delay scenario was significantly lower (mean difference −4.3; 95% confidence interval: −4.4, −4.1) than the control. The proportion of respondents rating a scenario as “severe” ranged from 5% for cognitive delay to 55% for cerebral palsy and language delay. Most participants disagreed with the rating used in research to describe severe neurodevelopmental impairment in preterm children. The term should be redefined to align with stakeholder perceptions. Full article
(This article belongs to the Special Issue Family-Oriented Research to Improve Care of Preterm Infants)
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