Current Pediatric Reviews最新文献

Introduction: Understanding the delayed effects of COVID-19, often called "long COVID-19," is essential for creating effective treatment protocols and support systems for affected children. This study was conducted to determine the delayed effects of COVID-19 in hospitalized children.

Methods: This cross-sectional study is descriptive-analytical and was conducted through a census of 137 hospitalized children diagnosed with COVID-19 in Jiroft, Iran, from 2021 to 2023. Data were collected using a checklist from the patients' medical records and through telephone interviews with the children's parents. The data were analyzed using descriptive and inferential statistics at a significance level of p < 0.05.

Results: The average age of the children was 7.7 years, with a majority being boys, and a small percentage having underlying medical conditions. Most children were hospitalized for three days. Fatigue was the most common delayed complication, affecting 21.1% of cases, while seizures were the least common at 1.4%. Other notable complications included cough, rhinorrhea, and nausea, with significant relationships observed between age and issues like loss of smell and decreased appetite. Underlying diseases were linked to higher rates of cough and shortness of breath.

Discussion: Fatigue was the most common delayed complication of COVID-19 in hospitalized children. Younger children and those with underlying health conditions were particularly vulnerable to these delayed effects.

Conclusion: This study underscores the need for personalized follow-up care for pediatric patients recovering from COVID-19. Comprehensive monitoring and support programs are crucial for addressing the specific complications observed in this population, thereby ensuring improved long-term outcomes.

Introduction: Vaccination is crucial because it protects individuals and communities from infectious diseases, reducing the spread and potential for outbreaks. As mothers are often the primary caregivers of children, they must be well-informed about childhood vaccinations through credible sources. The study investigated the disparities in knowledge, attitudes, and practices regarding immunization among mothers of children aged 0-5 years residing in Ras Al Khaimah. In the qualitative part of the study, the main barriers and challenges to immunization in the UAE were identified, as perceived by different stakeholders.

Methodology: This study employed a mixed-method approach to examine childhood vaccination practices and attitudes among Emirati and expatriate mothers in Ras Al Khaimah, UAE, between January and April 2024. Two hundred and seven mothers were interviewed using a structured questionnaire, and 14 stakeholders were interviewed using an in-depth interview guide.

Results: Key findings revealed that 95.1% of mothers vaccinated their children, but 18.3% admitted to delays. Expatriate mothers demonstrated higher knowledge of vaccine benefits and fewer concerns about safety compared to Emirati mothers. The themes generated from in-depth interviews- namely, natural immunity, peer influence, and healthcare system challenges-were significant factors influencing vaccination decisions. Cultural norms and systemic issues, such as delays in vaccine administration, also affected vaccination uptake.

Discussion: Despite high vaccination rates, there was a persistent lack of awareness and concerns about side effects among both groups. This gap indicates a need for more targeted educational initiatives to address misconceptions and promote vaccine safety. The study's limited interviews, cross-sectional design, and sample may not fully represent all UAE demographic groups.

Conclusion: Despite the high vaccination rates, there is a persistent lack of awareness and concerns regarding side effects. This study highlights the importance of culturally tailored communication and increased advocacy by healthcare providers to address concerns about vaccination and prevent misconceptions among the diverse population in the UAE.

Aims: The similarity between mucopolysaccharidosis (MPS) patients and juvenile idiopathic arthritis (JIA) leads to ineffective and needless anti-rheumatic treatment and delayed initiation of enzyme-replacement therapy, the early start of which is crucial for diminishing the disease progression and yielding better outcomes Background: The prevalence of joint involvement in the attenuated forms of MPS leads to the JIA misdiagnosis, especially in patients without distinctive facial dysmorphic features.

Objective: Our study aimed to compare mild forms of MPS and JIA and create a diagnostic score helping to differentiate both conditions.

Methods: 41 patients with mild forms of different types of MPS and 255 JIA patients with polyarthritis were included in the retrospective study. The routine clinical and laboratory features were used for the comparison analysis.

Results: The main features of the MPS cohort were younger age at the disease onset, lower weight and height lower inflammation, and higher number of affected joints compared to JIA patients and involvement in the organs and system, specific for MPS. The majority of the patients had similar C-reactive protein levels. At least two extra-articular features with polyarticular involvement were the main discriminating factors for both conditions. The sum (>38) of the following criteria:ESR< 12 mm/h (38 points), growth delay (height ≤ -2.0 SD; 20 points), age of joint involvement < 1.0 years (24 points), male sex (15 points), and involvement of both elbows with limited range of motion (29 points) can help in the differentiation If a patient had no extra-articular features, typical for MPS. The specificity and sensitivity of this model are 91.0% and 92.7% respectively.

Conclusion: This diagnostic algorithm might increase the suspicion of MPS and should be added to routine testing not miss the mild form of MPS inside JIA. Early diagnosis of mild cases allows for the initiation of treatment in patients with MPS at an earlier stage, which can significantly improve their daily functioning and quality of life.

Objective: To explore the prevalence and characteristics of infantile idiopathic hypotonia in the literature and investigate a potential association with vestibular dysfunction in young children.

Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) standards. Literature was searched across MEDLINE, EMBASE, and Web of Science. Google Scholar, GreyNet International, and trial registers were searched for grey literature. Eligible articles were required to report features of children with idiopathic hypotonia or a predefined synonym.

Results: Of 4,174 screened articles, 16 met the inclusion criteria. Eleven studies focused on various underlying causes of hypotonia and comprised 1150 hypotonic children, of which 24% remained undiagnosed. The remaining studies delved into the characteristics of idiopathic hypotonic children and described different developmental challenges in these children.

Discussion: Clumsiness and poor coordination were commonly reported, and therapy, aiming to enhance muscle strength, coordination, and balance, was often recommended, yet none of the included articles explored vestibular dysfunction. Conclusion Despite diagnostic advancements, the underlying cause of hypotonia remains unidentified in some children. While similarities exist between hypotonic children and children with vestibular dysfunction, none of the reviewed studies explored vestibular dysfunction, warranting further investigation.

Netherton syndrome (NS), also known as Comèl-Netherton syndrome, is a rare disorder of cornification resulting from pathogenic variants in the Kazal type 5 (SPINK5) gene encoding serine protease inhibitor LEKTI. NS is characterized by the triad of congenital ichthyosiform erythroderma (CIE)/ichthyosis linearis circumflexa (ILC), trichorrhexis invaginata (TI), and atopic diathesis. Due to the severity of pathogenesis and variability in clinical presentations, the management of NS poses significant therapeutic challenges, which often require a multidisciplinary approach. Current treatment modalities predominantly consist of topical interventions and supportive measures. With an improved understanding of NS pathophysiology, emerging literature has suggested novel systemic therapeutic options for NS, which include repurposed biologics like targeted inhibitors and intravenous immunoglobulins, but there remains a paucity of literature regarding their clinical outcomes. Although often cited among dermatologists and allergists, the condition is rare in Hong Kong and Singapore, and most physicians have not managed any case. This review suggests that NS may be underestimated clinically. We aim to raise awareness for clinicians in the specific clinical characteristics and pathophysiology of NS to decide tailor-made treatment plans and improve patient outcomes.

Objective: Studies on prenatal antibiotic use and Autism Spectrum Disorder (ASD) risk have yielded inconsistent results.

Aim: This study aimed to resolve these discrepancies by conducting a meta-analysis on the relationship between prenatal antibiotic use and ASD in children.

Method: A comprehensive search was conducted in three main databases: PubMed, Scopus, and Web of Science, up to August 1, 2024. The analysis employed random-effect models to estimate effect sizes, including hazard ratios (HR) and odds ratios (OR). Publication bias was assessed using Begg's test and Egger's regression test. Subgroup analyses explored variations in the association based on the trimester of pregnancy. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Results: In this meta-analysis, which included twelve studies with a total population of 5,065,060, prenatal antibiotic use was associated with an increased risk of Autism Spectrum Disorder (ASD). The estimated HR for this risk was 1.08 (95% CI: 1.05, 1.12), and the OR was 1.16 (95% CI: 1.09, 1.23), with no detected heterogeneity among studies. The analysis found no publication bias. Significant associations were observed for each trimester: first trimester (HR: 1.11; 95% CI: 1.04, 1.18), second trimester (HR: 1.10; 95% CI: 1.06, 1.14), and third trimester (HR: 1.09; 95% CI: 1.01, 1.18).

Conclusion: The analysis reveals a significant link between prenatal antibiotic use and an increased risk of ASD, with a consistently modest elevation in risk across all trimesters. Future research should focus on elucidating the mechanisms underlying this association by examining the effects of specific antibiotic classes, dosages, and timing during critical developmental periods. Longitudinal studies with comprehensive control for confounding factors are essential for strengthening causal inferences and guiding clinical recommendations regarding antibiotic use during pregnancy.

Breast milk is the best option for the nutritional needs of an infant. In situations where breastfeeding is contraindicated, donor human milk and formula milk are suggested as alternatives. This study highlights findings from two studies that evaluated how different dietary patterns (standard formula, post-biotic fermented formula, and breast milk) affected the intestinal microbiota and metabolome of late preterm and full-term infants. The metabolome of late preterm newborns showed a higher presence of metabolites-such as azelaic acid, N-acetylglucosamine-6- sulfate, and 13(S)-hydroperoxylinolenic acid-in those fed postbiotic-fermented formula, similar to breastfed full-term newborns. The fecal metabolites of breast milk and substitute feeding systems are comparable in these preliminary studies, confirming the effectiveness of formula preparations as breast milk substitutes. Furthermore, newborns fed with postbiotic-supplemented formula or breast milk had several similarities in fecal metabolites. The addition of postbiotics to formula milk appears to be more efficient than standard formula milk and is considered a better alternative to breast milk.

Introduction: The Federal Maternal and Child Health Bureau defines Children with special health care needs (CSHCN) as those who have, or are at increased risk for, chronic physical, developmental, behavioral, or emotional conditions, and require health and related services beyond what is generally required by other children. More than half of the entire Italian internationally adopted children (IAC) population has special needs. This monocentric retrospective study aims to describe the demographic features and prevalence of several chronic conditions in a large cohort of IAC.

Methods: Between 1 January 2009 and 31 October 2023, we consecutively enrolled all IAC referred to Anna Meyer Children's University Hospital, in Florence. This process followed a standardized operative protocol developed internationally. Then, univariate logistic regression analyses were performed.

Results: Among 2694 IAC, 315 children (11.89%) were found to be affected by a chronic condition. Asia appears to have 101/561 (18.00%) prevalence of diseases in the total number of IAC from this region of origin, followed by Eastern Europe with 135/1030 (13.11%), Latin America 63/598 (10.54%) and Africa 16/435 (3.68%). The countries of origin with higher prevalence of chronic conditions were China (57.75%), India (15.89%), Russia (15.44%), and Ukraine (13.79%). Children adopted from China and India have a high prevalence of malformations (p = 0.016), while children adopted from Russia accounted for 69.77% of the total fetal alcohol syndrome affected in our cohort. Mental and behavioral disorders appear significantly more prevalent in children from Latin America (p = 0.015), whereas endocrinological disorders predominate in children from Africa (p = 0.014). High rates of precocious puberty were recorded in Asia (p = 0.018) and Africa (p = 0.001) in comparison with the other regions of origin.

Conclusion: A revision of the current definition of special needs for adoptive purposes is recommended. Italian screening of the adopted child could be tailored considering the country of origin, and the study of mental health should definitively become part of it.