Pediatric Reports最新文献

Background: Global research has reported that the number of children and adolescents suffering from mental health issues has increased over the past decades. In Jordan, there has been a growing interest in investigating mental health among these groups in the most recent decade; nevertheless, only a few studies have covered behavioral and emotional problems. This study aimed to estimate the prevalence of behavioral and emotional problems among children and adolescents in Jordan and investigate their associated factors.

Methods: A large-scale, national, school-based cross-sectional study was conducted between December 2022 and April 2023 on children and adolescents living in Jordan aged between 8 and 18 years. The study included public schools, private schools, UNRWAs schools, Zaatrai camp schools, and non-formal education centers. The Strengths and Difficulties Questionnaire was used to measure behavioral and emotional problems.

Results: About 13.9% of the children had abnormal difficulty scores, and they suffered the most from emotional symptoms (17.9%). Syrian children in refugee camps had the highest rate of total difficulty (19.3%). In the adolescents, 19.7% had high levels of total difficulty, where conduct problems were the most reported (17.6%), and Syrian adolescents in refugee camps were highly affected (22.2%). The number of traumatic events, physical activity, problematic internet use, and family affluence were significantly associated with an increased risk of having behavioral and emotional problems in both the children and adolescents.

Conclusions: A significant proportion of children and adolescents struggle with emotional and behavioral problems in Jordan, and serious efforts are needed to enhance the status of mental health for adolescents and children.

Background: Mediterranean diet (MD) constitutes a commonly examined dietary model. It includes a plethora of bioactive ingredients with strong antioxidant, anti-inflammatory, antithrombotic and anticancer properties. Several substantial studies support strong evidence that MD can exert preventing actions against human morbidity and mortality, promoting human well-being and quality of life. The present study aims to evaluate whether childhood MD compliance may be associated with socio-demographic, anthropometric, and lifestyle factors in children at the age of 6-9 years.

Methods: This is a cross-sectional survey on 3875 children aged 6-9 years old with their matched mothers. Qualified questionnaires were used to evaluate and collect by one-to-one interviews with trained professionals the above data.

Results: Elevated MD adherence was observed only in 22.2% of the enrolled children, while 37.5% of children maintained intermediate MD adherence and 40.3% of children adopted lower MD levels. Children MD compliance was related at an independent manner with maternal education level, childhood anthropometric factors such as Body Mass Index (BMI), Waist circumference to Height ratio (WtHR), quality of life, and exclusively breastfeeding behaviors after adjusting for several possible confounders (p ˂ 0.05).

Conclusions: Elevated MD adherence of children aged 6-9 years old showed a lower obesity of overweight/obesity, including abdominal obesity. A higher maternal educational status and adopting exclusively breastfeeding practices were associated with greater levels of children's MD adherence, promoting their quality of life and well-being. Based on the present results, future prospective surveys need to be performed to evaluate if there is a causality relation concerning this topic.

Background: Houge-Janssens syndrome 1 is a condition with onset in early childhood caused by heterozygous pathogenic variants in the PPP2R5D gene, which encodes a B56 regulatory subunit of the serine/threonine protein phosphatase 2A (PP2A). There is evidence that the PP2A-PPP2R5D complex is involved in regulating the phosphatidylinositol 3-kinase (PI3K)/AKT signalling pathway, which is crucial for several cellular processes, including the pathogenesis and progression of haemangiomas.

Case presentation: We report the first PPP2R5D-related neurodevelopmental disorder case from Sardinia, a child with transient hypoglycaemia, facial dysmorphisms, and multiple haemangiomas. Whole Exome Sequencing analysis confirmed the clinical suspicion, detecting the presence of the de novo missense variant c.592G>A in the PPP2R5D gene.

Conclusions: Haemangiomas have never been linked to the syndromic phenotype of the PPP2R5D-associated disorder. The close correlation between the PP2A enzyme and the PI3K/AKT signalling pathway suggests the possible correlation between its dysfunction and activation of haemangiogenesis. Our report highlights a possible link between the PPP2R5D-related disorder and altered angiogenesis, characterizing diffuse haemangiomas as a possible novel phenotypic trait of this condition.

Background: Insulin pumps coupled with continuous glucose monitoring sensors use algorithms to analyze real-time blood glucose levels. This allows for the suspension of insulin administration before hypoglycemic thresholds are reached or for adaptive tuning in hybrid closed-loop systems. This longitudinal retrospective study aims to analyze real-world glycemic outcomes in a pediatric population transitioning to such devices.

Methods: We evaluated children with type 1 diabetes mellitus (T1D) admitted to the Pediatric Diabetes Department from a major University Hospital in Bucharest, Romania, who transitioned to hybrid closed-loop or predictive low-glucose suspend system from either non-automated insulin pumps or multiple daily injections. The primary outcome was assessing the change in glycated hemoglobin (HbA1c) after initiating these devices. Secondary outcomes analyzed changes in glucose metrics from the 90 days prior to the baseline and follow-up visit.

Results: 51 children were included (58.8% girls), the mean age was 10.3 ± 3.7 years, and the mean follow-up duration was 13.2 ± 4.5 months. The analyzed parameters, such as HbA1c (6.9 ± 0.7% vs. 6.7 ± 0.6%, p = 0.023), time in range (69.3 ± 11.2% vs. 76 ± 9.9%, p < 0.001), time in tight range (47.4 ± 10.9% vs. 53.7 ± 10.7%, p < 0.001), time below range (5.6 ± 2.9% vs. 3.5 ± 1.9%, p < 0.001), time above range (25 ± 11.2% vs. 20.4 ± 9.4%, p = 0.001), and coefficient of variation (37.9 ± 4.8% vs. 35.6 ± 4.6%, p = 0.001), showed significant improvements.

Conclusions: The application of these sensor-integrated insulin pumps can significantly enhance metabolic control in pediatric populations, minimizing glycemic variations to mitigate complications and enrich the quality of life.

Background/objectives: Routine screening electrocardiograms (ECGs) prior to starting medications for attention-deficit/hyperactivity disorder (ADHD) remain controversial. This real-world study assessed corrected QT (QTc) interval data from pediatric patients who had a baseline ECG performed prior to initiating treatment with ADHD medications and ≥6 months of clinical follow-up.

Methods: A retrospective chart review of children aged 2-18 years diagnosed with ADHD with/without autism spectrum disorder (ASD) at child neurology clinics in Jordan (June 2019 and June 2021) was performed, and children were prescribed with ADHD medications to manage symptoms. Patients had ≥6 months of follow-up and no known cardiac disease/family history. A baseline ECG and regular clinical exams were performed for each child.

Results: Of 458 patients with baseline ECGs, 362 met the study inclusion criteria. Overall, 286 (79.0%) patients were diagnosed with ASD/comorbid ADHD and 76 (21.0%) with ADHD alone; 61 (16.9%) were prescribed atomoxetine, 38 (10.5%) methylphenidate, 134 (37.0%) risperidone, and 129 (35.6%) aripiprazole. The patients' mean ± SD age was 6.4 ± 3.5 years, and most were male (n = 268, 74.0%). The mean baseline QTc interval was 400 ± 22 ms (median, 400 ms); one patient had a QTc interval >460 ms and was excluded from initiating treatment with any ADHD medications. During the ≥6-month follow-up, none of the patients had any signs or symptoms of adverse cardiac effects.

Conclusions: Routine screening ECGs prior to treatment with ADHD medications may not be necessary in healthy children with no family history of cardiac disease. However, further studies are needed to evaluate the long-term effects of ADHD medications in low-risk pediatric patients.

This study conducts a comprehensive bibliometric analysis of the concepts 'physical edu- cation' and 'anxiety' (PHYEDU_ANX) in the Web of Science (WoS) database. Background/Objectives: No previous biblio- metric studies were found that addressed this intersection, so this research is a pioneering exploration of this knowledge gap. The aim of the study is to examine the presence of both concepts in the scientific literature, identifying their trends, approaches, and future prospects. Methods: For this purpose, the methodology of co-word analysis was used. Results: The results of the study show that research on PHYEDU and ANX has traditionally focused on three main areas: motivation, exercise, and depression. In this first period, the focus was on the problem (ANX, depression…), Conclusions: whereas nowadays, research focuses on the subjects who suffer from it, mainly adolescents and students. The study suggests that future research in this field will focus on the areas of satisfaction, intervention, and association. This research also answers questions relevant to the field, such as which institutions or countries are the most prolific publishers of PHYEDU_ANX, as well as the most cited authors in this area of study.

Background/objectives: This study aimed to investigate the prevalence and characteristics of positional anomalies in second permanent molars among Romanian patients. These molars play a crucial role in occlusion but can exhibit positional issues such as tilting, rotation, infraocclusion, and impaction.

Methods: This retrospective study examined the digital models of 103 patients aged 12-40, which were obtained by using the Medit i500 intraoral scanner. Positional anomalies were categorized by tilting, rotation, infraocclusion, and impaction.

Results: The results showed a high prevalence of anomalies, particularly infraocclusion and buccal tilting in upper molars and oral tilting and mesio-buccal rotations in lower molars. The significant symmetry of anomalies within the same dental arch was noted. Gender and malocclusion type did not significantly influence anomaly frequency.

Conclusions: The findings emphasize the need for the vigilant monitoring of second permanent molars to maintain functional occlusion and suggest potential common etiological factors within dental arches. Despite this study's limitations, including sample size and retrospective design, this study underscores the clinical importance of the early detection and management of molar anomalies. Future research should expand on these findings, considering genetic and environmental influences on dental development.

Background: There is evidence that the tendency to adopt a peculiar pattern of causal inference, known as attributional style, is likely related to specific patterns of psychopathology among youth.

Objective: This study aims to assess preliminary psychometric properties of the Italian Children's Attributional Style Questionnaire-Revised (CASQ-R) and to explore the presence of any subgroups of children and early adolescents from the general population who might exhibit internally homogeneous and externally heterogeneous attributional styles through latent class analysis, delving into the potential sociodemographic, namely age and gender, and clinical differences among the identified classes of attributional styles.

Method: A sample of 337 children (11.29 ± 1.76 years old, 169 females, and 168 males) was recruited and their attributional styles and depressive and anxious symptoms were analyzed.

Results: Two distinct classes were defined using the CASQ-R items in a latent class analysis (LCA). In particular, high levels of depressive (Kruskal-Wallis chi-squared = 9.37, df = 1, Bonferroni-adjusted p = 0.002) and school phobia (Kruskal-Wallis chi-squared = 7.17 df = 1, Bonferroni-adjusted p = 0.037) symptoms were reported by children showing an internal, global and stable attributional style for negative events and an external, specific and unstable attributional style for positive events. Conversely, low levels of depressive and school phobia symptoms were reported by children showing the opposite attributional style.

Conclusions: The identified classes shed light on distinct patterns associated with depressive and anxious symptoms, offering potential insights for targeted interventions.

Background: The present study investigated the incremental validity of the ADHD dimensions of inattention (IA), hyperactivity (HY), and impulsivity (IM) in the predictions of emotion symptoms (ESs), conduct problems (CPs), and peer problems (PPs) in adolescents based on parent, teacher, and self- ratings. Method: A total of 214 ratings were collected from adolescents, their parents, and teachers in Australia. A structural equation modeling approach was employed to evaluated incremental validity. Results: The findings revealed that, controlling for gender, IM contributed moderate, low, and low levels of variance in predicting ESs based on parent, teacher, and self-ratings, respectively. Additionally, IM contributed moderate, substantial, and moderate levels of variance to CP predictions based on parent, teacher, and self-ratings, respectively. Furthermore, after controlling for gender, IM, and HY, parent-rated IA contributed a low level of variance to the prediction of ESs, while teacher and self-rated IA did not contribute significantly to the prediction of ESs, CPs, or PPs. Conclusions: The findings underscore the differential predictive validity of ADHD dimensions across informants and outcomes, highlighting impulsivity's stronger association with conduct problems and emotional symptoms. These results have theoretical and practical implications for understanding ADHD-related risks in adolescence and tailoring interventions accordingly.

The present study examines the potential of the Symptom Checklist-90-Revised (SCL-90-R) as a measure for the Hierarchical Taxonomy of Psychopathology (HiTop) model. Two structural models were evaluated. In Model 1, the SCL-90-R dimensions were allocated to somatoform (comprising somatization), internalizing (comprising obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and phobic anxiety), and antagonistic disinhibited (comprising hostility) spectra. Model 2 included an additional detachment spectrum (comprising paranoid ideation and psychoticism).

Method: A total of 1594 adolescents [52.2% boys; age ranged from 14 to 17 years; mean age (SD) = 16.04 years (0.737 years)] from the general community in Athens completed the SCL-90-R and the Funf-Faktoren-Fragebogen fur Kinder (FFFK). Confirmatory factor analysis (CFA) was conducted to validate the proposed models.

Results: The findings supported Model 1, demonstrating adequate global fit, salient and significant factor loadings, discriminant validity, reliability, and external validity of the factors.

Conclusions: These results indicate that the SCL-90-R scales of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety are appropriate measures for the corresponding HiTop dimensions. However, the scales for paranoid ideation and psychoticism were not suitable for this purpose. The theoretical contributions and conclusions are discussed, highlighting the implications of these findings for the clinical and theoretical application of the SCL-90-R in psychopathological assessment and research.