Pediatric Reports最新文献

Background: Dental pain is a significant public health issue globally and in Mexico, with substantial negative impacts on affected individuals. Objective: The objective of this study was to evaluate the prevalence of dental pain and its association with clinical, sociodemographic, and socioeconomic risk indicators in schoolchildren aged 6 to 12 years in four cities in Mexico. Material and Methods: A cross-sectional study was conducted on 500 children attending public schools in the cities of Pachuca, Tepatitlán, Toluca, and San Luis Potosí. A questionnaire was applied, and a clinical examination was performed on the schoolchildren. Self-reported dental pain within the 12 months preceding the study, categorized as 0 (no pain) and 1 (pain), was used as the dependent variable. For the statistical analysis, the Stata program was used, where a multivariate binary logistic regression model was applied. Results: The mean age was 8.92 ± 1.99 years; 50% were girls. The prevalence of dental pain was 34.0%. Independent variables associated (p < 0.05) with the experience of dental pain were as follows: age (OR = 0.81), having a car at home (OR = 0.77), a lower socioeconomic position (OR = 2.03), curative or specialized dental care (OR = 8.40), and self-reported dental and/or gingival disease (OR = 5.39). Conclusions: Dental pain is a significant health problem in schoolchildren aged 6 to 12 years in Mexico, with a prevalence of 34% in this study. Sociodemographic and socioeconomic factors, as well as clinical indicators, play an important role in the experience of dental pain. Inequalities in oral health were observed. There is a need for public health interventions to reduce this problem in vulnerable populations.

Background/objectives: The increased use of social media in Mexico has given rise to the "fear of missing out" (FoMO) phenomenon, especially among adolescents. This study aimed to measure the extent of FoMO among junior high school students in the metropolitan area of Guadalajara, Mexico, during the COVID-19 pandemic. Additionally, this study explored the association between FoMO levels and demographic characteristics, as well as the type and frequency of social media use.

Methods: A cross-sectional survey was conducted from November 2021 to January 2022 in four junior high schools. A total of 1264 students (656 females and 608 males) aged 11-16 years completed the Fear of Missing Out Scale, adapted to the Mexican context. Data on demographics, social media usage, and school shifts were collected. Statistical analyses were performed using t-tests, ANOVA, and correlation coefficients.

Results: The mean FoMO score was 1.79 ± 0.64, with higher scores observed in females (p < 0.001) and students attending morning shifts (p = 0.001). Significant associations were found between higher FoMO scores and the use of social media platforms like Instagram, TikTok, and Pinterest (p < 0.001 for each). The most frequently used social media platforms were WhatsApp (1093), TikTok (828), and Instagram (583). Participants who used social media all week exhibited significantly higher FoMO scores than those who used it only on weekends (p < 0.001).

Conclusions: FoMO is a significant phenomenon among junior high school students in Guadalajara, Mexico, particularly among females and those who use multiple social media platforms. The findings suggest a need for interventions to manage social media use and mitigate FoMO-related negative health outcomes in this population.

Background: Molar incisor hypomineralization (MIH) is a congenital qualitative disorder of the enamel tissue. During examinations, clinicians may observe a range of enamel opacities during examinations. The aim of this study was to assess the knowledge and awareness of dental students in Poland regarding MIH.

Methods: This study was conducted among dental students who participated in scientific conferences for dental students in Poland. An electronic questionnaire was created for this purpose, accessible via a QR code.

Results: The respondents consisted of dental students from the first to the fifth year of study, including 98 fourth-year students and 76 fifth-year students. The students represented 10 medical universities in Poland. Of the 341 respondents, 256 (75.07%) stated that they were familiar with the term MIH, but only 61 (17.89%) correctly indicated the diagnostic criteria of MIH. The most frequently indicated condition resembling MIH was enamel hypoplasia, with 158 (46.33%) respondents identifying it.

Conclusions: Dental students at Polish medical universities have basic knowledge of MIH, but it is insufficient and needs to be improved during their educational training.

Background: Intracranial suppurative infections in pediatric patients, while rare, pose a significant risk to patient mortality. Early recognition and fast initiation of diagnosis and treatment are crucial to prevent fatal outcomes. Between December 2022 and May 2023, a significant cluster of nine cases emerged, each necessitating neurosurgical intervention. This series highlights an important trend in clinical outcomes and raises questions about underlying factors contributing to this pattern. The need for surgical procedures in all instances suggests a commonality in severity, warranting further investigation into potential causes and preventative measures. This retrospective monocentric study aims to explore the clinical features associated with these cases to identify specific disease patterns that can expedite management in clinical practice.

Methods: Cramer's V effect size was employed to evaluate combinations of clinical features, followed by Fisher's exact test applied to a constructed contingency table. A p-value was assessed for significance analysis, with combinations achieving a Cramer's V value of 0.7 or higher being classified as exhibiting very strong correlations.

Results: The analysis revealed distinct patterns of clinical features among children diagnosed with intracranial abscesses. Significant associations were identified, including correlations between sinusitis and Streptococcus pyogenes, and fever accompanied by affected temporal, frontal, and frontobasal lobe regions.

Conclusions: Despite the generally limited statistical analysis of pediatric intracranial abscesses in the existing literature, this study provides meaningful significant associations between clinical features, delineating specific disease patterns for children with intracranial abscesses. By addressing this gap, the findings contribute valuable insights and offer a framework that could enhance clinical decision-making and support timely disease management in pediatric cases.

Background: This study examines nationwide prevalence of US childhood behavioral, mental, and developmental problems in the 6-11 age group category between 2019 and 2022, and several key metrics related to caregiver social determinants of health.

Methods: We used NSCH data for 6-11-year-old children for the years 2019-2022. Summary statistics for the selected sample were generated and binary logistic regressions were conducted for each severity level binary variable for each study year with caregiver mental or emotional health as a covariate.

Results: Our study found significant associations between severe childhood anxiety and "fair" or "poor" caregiver rankings of mental and emotional health for both the 2020 and 2022 survey years. Our study also found that caregiver mental and emotional health may play a role in childhood ADD and ADHD prevalence rates as caregivers who ranked their mental health as "fair" or "good" had significantly higher odds of having a child with severe ADD or ADHD than caregivers who reported "excellent" mental and emotional health.

Conclusion: These findings support prospects of an increase in the need for developmental health services, thus necessitating efforts towards effective allocation and focus of developmental treatment programs tailored to children and pediatric population groups.

Background: Percutaneous ultrasound-guided renal biopsy (PRB) is a key element for diagnosis and management of several renal pathologies. We aimed to lay out the experience of our pediatric nephrology unit performing PRBs. The rationale and findings of these biopsies, safety issues and considerations of the extracted data are going to be analyzed.

Methods: A retrospective study was conducted from 2008 to 2023 based on the review of the medical records of pediatric patients who underwent PRBs. In total, 216 kidney biopsies in 206 patients were performed: 115 (53.2%) during the 2008-2015 period and 101 (46.8%) during the 2016-2023 period.

Results: The most frequent clinical indication for PRBs was nephritic syndrome followed by nephrotic syndrome, observed in 84 (40.8%) and 72 (34.9%) patients, respectively. The predominant diagnosis was minimal change disease (MCD) (23.3%), followed by focal segmental glomerulosclerosis (FSGS) (15%) equal to lupus nephritis (LN) (15%), and immunoglobulin A nepropathy (10.2%). Minor complications, such as subcapsular hematomas were observed in approximately 15% of patients while no therapeutic intervention was needed.

Conclusions: This report is the first review of pathohistological data covering a pediatric population over a 15-year period in Greece and one of the largest in southeastern Europe, especially in the Balkan region. The main indication for a PRB was nephritic syndrome; however, MCD was the main histological diagnosis. This study emphasis the fact that PRBs constitute a safe and reliable method of diagnostic approach to kidney diseases in childhood and offers important information on therapeutic approaches as well as the prognosis of these patients.

Background: Children with learning disability (LD) often experience a poor quality of life (QOL) compared to their peers without a known history of LD. Coping strategies are known to play a role in influencing their QOL.

Objectives: This study aims to compare the QOL and coping strategies between children with and without LD. Additionally, it seeks to evaluate how coping strategies impact the QOL of children with LD in the Eastern Governorate of Saudi Arabia.

Method: A representative sample of 6 to 18-year-old children with (n = 97) and without (n = 89) LD were recruited from different schools. The Short Form-12 (SF-12) health survey was used to assess both physical and mental health components, while the validated Coping Orientation to Problems Experienced Inventory (Brief-COPE) measured coping strategies. Data analysis included descriptive statistics (mean, standard deviation, percentage), independent t-tests, Spearman's correlation, and binary logistic regression.

Results: The results reveal that participants with LD show poor QOL in terms of role functioning, bodily pain, general health, vitality, social functioning, role emotion, and mental health in comparison to non-disabled children. Participants with LD show greater reliance on substance abuse and religious coping than non-disabled children. The results clearly indicate a fairly to moderately strong correlation between the physical component summary and all approaches to coping strategies except religious coping. Of all the approaches to coping methods, we observe a weak correlation among denial (r = -0.17, p < 0.05), substance abuse (r = -0.15, p < 0.05), and behavioral disengagement (r = -0.18, p < 0.05) with the mental component summary aspect of QOL. The results of logistic regression analysis indicate that grade (OR = 3.79; p = 0.01) is significantly related to LD. The physical component summary score is significantly associated with denial (β = -0.33, CI = -6.87--2.19, p < 0.01), and substance abuse (β = -0.14, CI = -4.96-0.40, p < 0.05), while the mental component summary is significantly associated with active coping (β = -0.30, CI = -4.50-0.76, p < 0.01), behavioral disengagement (β = -0.20, CI = -4.48-0.30, p < 0.05), and humor coping strategy (β = 0.22, CI = 0.06-4.55, p < 0.05).

Conclusion: These findings are relevant to researchers, psychologists, special educators, teachers, and clinicians, given the need to understand the coping variables to improve the QOL of these learning-disabled children.

Background: Sleep disorders are common in youths with autism spectrum disorders. Inflammatory cytokines such as Il-1 beta and Il-6 in saliva have been associated with alterations in sleep quality in various conditions. We assessed whether there were associations between the salivary concentration of IL-1 beta and IL-6 and sleep quality in youths with ASD versus typically developing (TD) age- and gender-matched youths.

Method: Forty children and adolescents with ASD or TD participated in this study (20% females). Their parents answered the items of a validated questionnaire on sleep quality (Pittsburgh Sleep Quality Index).

Results: The mean Pittsburgh score was significantly higher (i.e., the quality of sleep was poorer) in the ASD group (8.68 ± 0.35 (SEM), ranging from 7 to 12 points), compared to the TD group (7.35 ± 0.54 (SEM), ranging from 2 to 12 points) (p = 0.02, Mann-Whitney U test). There were no significant differences in the salivary concentration of Il-1 beta and IL-6 receptor between the two groups, but salivary IL-1 beta concentration was inversely associated with poor sleep quality in the ASD group. No associations between the salivary Il-6 concentration and sleep quality were found in either group. Linear regression analysis by separate groups revealed significant associations between the sleep quality score and the concentration of IL-1 beta in the ASD group (p = 0.01, OR = -0.53, 95% CI -0.008-0.001). In contrast, no significant associations were observed in the TD group, or for IL-6 in either group. No significant effects of sex, age, or use of psychotropic medications were found.

Conclusions: Children and adolescents with ASD showed significantly poorer sleep quality based on their parents' reports compared to the TD group, and the salivary IL-1 beta concentration was inversely associated with sleep quality only in the ASD group. Further studies on the associations between inflammatory cytokines and sleep in ASD are needed.

Background/objectives: Hematopoietic stem cell transplantation (HSCT) in pediatric and young adult (YA) patients can lead to endotheliopathy, such as thrombotic microangiopathy (TMA), sinusoidal obstruction syndrome (SOS), and diffuse alveolar hemorrhage (DAH). Natriuretic peptides have been studied as markers of endotheliopathy and critical illness. We hypothesized that an elevation in NT-proBNP was associated with the development of endotheliopathy (DAH, SOS, or TMA) in the first 100 days following HSCT in pediatric and YA patients.

Methods: IRB-exempt status was obtained. This retrospective case-control study reviewed HSCT at our institution from 2016 to 2020. Cases were selected based on an endotheliopathy diagnosis in the first 100 days after HSCT. Cases were matched with controls. Baseline and near-event NT-proBNP levels were compared between cases and matched controls. The effect of NT-proBNP levels on developing endotheliopathy was estimated using conditional logistic regression.

Results: Sixty-two patients were included (31 cases, 31 controls). Near-event NT-proBNP was significantly higher in cases compared to controls (median: 473 vs. 187 pg/mL, p = 0.03, Wilcoxon rank-sum test), in contrast to comparison in baseline NT-proBNP (median: 86 vs. 86 pg/mL, p = 0.51). After adjusting for covariates, an association between near-event NT-proBNP and odds of developing endotheliopathy did not achieve statistical significance. However, trends from most common transplant indications suggested an association between an elevated near-event NT-proBNP level and endotheliopathy, particularly in acute lymphoblastic leukemia (ALL) patients.

Conclusions: NT-proBNP should be studied further as a biomarker for endotheliopathy in pediatric and YA patients undergoing HSCT. This may be particularly relevant for patients undergoing HSCT for ALL.

High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal pulmonary bleeding and idiopathic pulmonary hypertension (IPH). Although this ventilation technique is commonly recognized as a valuable therapeutic option in the general pediatric population, this is not the same for children with congenital cardiovascular diseases. The key mechanism of oscillatory ventilation is continuous positive pressure administered within the airways via a small tidal volume at high frequency. Tidal volumes are between 1 and 3 mL/kg delivered at 5-15 Hz, equivalent to 300-900 breaths per minute. A few older studies conducted on humans and animals highlight that HFOV may be dangerous for congenital heart patients. According to these evidences, hemodynamic parameters such as blood pressure, wedge pressure, central venous pressure, heart rate and inotrope level can be dangerously changed for patients with congenital heart disease; therefore, oscillatory ventilation should be avoided. Numerous retrospective studies have pointed out how oscillatory ventilation constitutes a valid therapeutic option in children with congenital heart disease. Recently, new evidences have highlighted how hemodynamic parameters are modified in a non-significant way by this type of ventilation, remaining beneficial as in the normal pediatric population. This narrative review aims to describe the mechanisms of oscillatory ventilation and collect all the available evidences to support its use in pediatric patients with congenital heart problems.