Clinical and Experimental Pediatrics最新文献

Background: Children's ability to achieve an appropriate motor development is largely associated with their capacity to control balance. Furthermore, accomplishing balance tasks with a narrowed base of support is a necessary precursor to engaging in everyday functional activities and developing more complex balance abilities.

Purpose: To investigate the relationship between the tandem stance (TS) and the single-limb stance (SLS) items of the Pediatric Balance Scale (PBS) assessment tool with the PBS total score in children with impaired balance.

Methods: Forty-two children (22 with neurological disabilities, 10.7±3.1 years; 20 typically developing [TD], 8.3±2.7 years) performed all 14 PBS items. Linear regressions separately determined the impact of TS and SLS on total PBS score in both groups. Bland-Altman plots expressed agreement between the balance measurements.

Results: For children with disabilities, only the SLS entered the model, explaining 64.5% of the variance in total PBS score. A high level of agreement was observed between the SLS and total PBS scores. For TD children, only the TS entered the model, explaining 45.2% of the variance in the total PBS score. A high level of agreement was observed between the TS and total PBS scores.

Conclusion: Our findings support the practical and efficient use of a single balance task to assess balance ability in children with disabilities.

The endocrine system is a complex network of glands that produce and release hormones that regulate various physiological processes. In the past few decades, the human skin has been identified as an important peripheral endocrine organ that is the main site for the synthesis of vitamin D through exposure to sunlight. Mutations in downstream vitamin D-related gene pathways are associated with disease development. The vitamin D receptor (VDR) gene, which regulates the pleiotropic effects of vitamin D, has been extensively studied in adult populations. Several studies have reported the prevalence of vitamin D deficiency in children and adolescents. With changes in socioeconomic status and lifestyle, vitamin D-deficient individuals are prone to developing the disease at a young age. However, geographical and racial differences affect the association between VDR gene polymorphisms and vitamin D endocrine disorders, explaining the non-consensus effects of polymorphisms and their association with disease development across populations. In this review, we discuss the connection between the vitamin D endocrine system and polymorphisms in the gene encoding VDR in children and adolescents, focusing on its effects on growth, puberty, insulin resistance, and the immune system.

Although humans are highly dependent on plastics from infancy to adolescence, these materials can degrade into ubiquitous microplastics (MPs) that affect individuals at every stage of life. However, information on the sources, mechanisms, detection techniques, and detrimental effects of MPs on children's health from infancy to adolescence is limited. Hence, here we identified and reviewed original research papers published in 2017-2023 across 11 database categories in PubMed, Google Scholar, Scopus, and Web of Science to improve our understanding of MPs with a focus on pediatric well-being. These studies found that milk and infant formulas are common sources of MP exposure in infants. Infant formula is the dominant source of MPs in babies, while plastic toys are a common source of MPs in toddlers. Adolescents are frequently exposed to MPs through the consumption of food contaminated with MPs and the use of plastics in food packaging. Water and air are sources of MP exposure in children from infancy through adolescence. This study thoroughly summarized how MP exposure in children of all ages causes cell damage and leads to adverse health effects such as cancer. With appropriate authorization from the relevant authorities, small amounts of human biological samples (10 g of feces) were collected from volunteers to assess the amounts of MPs in children with the aim of promoting pediatric well-being. The samples were then treated with Fenton's reagent, stored in glass jars, and filtered through nonplastic filters. Finally, MPs in children were quantified using stereomicroscopy and characterized using micro-Fourier transform infrared spectroscopy.

Background: Few studies have explored the polysomnographic features of children with obesity.

Purpose: This study aimed to explore the demographic and polysomnographic features of obese children and determine whether body mass index (BMI) could predict severe obstructive sleep apnea (OSA).

Methods: This cross-sectional study recruited obese children who underwent diagnostic polysomnography between January 2019 and March 2022. We explored demographic and anthropometric measures as well as polysomnographic abnormalities among them. We used receiver operating characteristic curves and logistic regression analyses to determine the optimal cut-off values of anthropometric variables for predicting severe OSA.

Results: A total of 132 children with obesity (76.5% male; mean age, 12.5 ± 3.2 years) were included. Severe OSA was identified in 64 (48.5%) children. Desaturation was observed in 59.8%, while 23.5% had hyperarousal, 20.5% had sleep-related hypoventilation, 60.6% had positional OSA, 40.2% had REM-related OSA, and 5.0% had obesity hypoventilation syndrome. Among them, BMI (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.05-1.17; p < 0.001), neck circumference (OR, 1.15; 95% CI, 1.07-1.25; p < 0.001), and waist circumference (OR, 1.04; 95% CI, 1.02-1.07; p = 0.001) were significantly associated with severe OSA. These findings suggest a cut-off BMI for predicting severe OSA of greater than 29.2 kg/m2 with 81.3% sensitivity and 48.5% specificity.

Conclusion: Severe OSA is common in children with obesity; thus, we recommend screening children with obesity and a BMI greater than 29.2 kg/m2 for severe OSA.

Despite neonatal intensive care advancements and quality improvements, preterm infants often experience delays in speech and language development during early childhood. The etiological pathway of language delays is multifactorial, including younger gestational age at birth, male sex, pregnancy complications including gestational diabetes mellitus and preeclampsia, organic pathology from neonatal morbidities, environmental factors of the neonatal intensive care unit (NICU) and prolonged hospitalization, home environment including socioeconomic status and parental education, and parent-infant interactions. As early language experiences and environments are crucial for the development of language processing, strategies to support language development should be implemented from the NICU onward. This study aimed to summarize evidence-based strategies for language development through an extensive review of nutrition, NICU environment, language and sound exposure, developmental care interventions, and family-centered care. Promoting breastfeeding, increasing parent-infant interactions in a single-family room setting, nurturing the language environment via parental book reading and language interventions, and parent-integrated interventions in the NICU could potentially enhance language development among preterm infants. These supportive strategies can be integrated through family-centered care, which recognizes parents as primary caregivers and collaborative partners.

Background: Central precocious puberty (CPP) is typically treated with gonadotropin-releasing hormone (GnRH) agonists. Although numerous GnRH agonist variants are available, limited research has compared the efficacy of leuprolide acetate and triptorelin pamoate administered at 3-month intervals.

Purpose: This study aimed to assess the efficacy of CPP treatment with triptorelin pamoate and leuprolide acetate administered at 3-month intervals.

Methods: This retrospective cohort study included 116 girls with CPP: 71 treated with leuprolide acetate every 3 months and 45 treated with triptorelin pamoate every 3 months. Anthropometric measurements were compared before and after therapy. At 6 months after the therapy, luteinizing hormone (LH) suppression was evaluated.

Results: When administered every 3 months, leuprolide acetate and triptorelin pamoate significantly suppressed LH. The predicted adult height (PAH) and degree of bone age advancement at the end of treatment were comparable.

Conclusion: Treatment with leuprolide acetate and triptorelin pamoate every 3 months did not have significantly different effects on LH suppression or PAH.

Atopic dermatitis (AD) is a complex disease with multifactorial pathogenesis and variable clinical presentation. Up to one-fifth of patients with AD develop moderate to severe disease that is often refractory to classical therapies and can compromise quality of life. This review summarizes recent clinical evidence on biological agents and small-molecule immunotherapies for the treatment of AD.

Height gains result from longitudinal bone growth, which is largely dependent on chondrocyte differentiation and proliferation within the growth plates of long bones. The growth plate, that is, the epiphyseal plate, is divided into resting, proliferative, and hypertrophic zones according to chondrocyte characteristics. The differentiation potential of progenitor cells in the resting zone, continuous capacity for chondrocyte differentiation and proliferation within the proliferative zone, timely replacement by osteocytes, and calcification in the hypertrophic zone are the 3 main factors controlling longitudinal bone growth. Upon adequate longitudinal bone growth, growth plate senescence limits human body height. During growth plate senescence, progenitor cells within the resting zone are depleted, proliferative chondrocyte numbers decrease, and hypertrophic chondrocyte number and size decrease. After senescence, hypertrophic chondrocytes are replaced by osteocytes, the extracellular matrix is calcified and vascularized, the growth plate is closed, and longitudinal bone growth is complete. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure. Complex networks of cellular, genetic, paracrine, and endocrine signals are involved in growth plate closure. However, the detailed mechanisms of this process remain unclear. Further elucidation of these mechanisms will enable the development of new therapeutic modalities for the treatment of short stature, precocious puberty, and skeletal dysplasia.