Children-Basel最新文献

Background: Eosinophilic esophagitis (EoE) is a chronic disease defined by esophageal dysfunction and >15 eosinophils per high-power-field on biopsy. Despite its increased incidence across the United States, studies evaluating its incidence at any state level are lacking.

Methods: Record review of pediatric patients (<18 years) newly diagnosed with EoE based on ICD coding seen at the main two pediatric gastroenterology centers in the state: Children's Nebraska (1 January 2016-31 December 2022) and Boys Town National Research Hospital (1 January 2022-31 December 2022). Data included demographics, age, and zip codes. Descriptive analysis focused on Nebraska residents.

Results: The average point incidence of EoE between 2016 and 2022 was 10.84/100,000 inhabitants based on data from Children's Nebraska. Considering both centers, the point incidence in Nebraska for 2022 was 32.45/100,000 inhabitants. Caucasians were 3.7 times more likely to be affected and older at time of diagnosis (average 9.7 years) compared to African Americans (7.0), Hispanics (7.4), and Asians (4.4).

Conclusions: This is the first study evaluating the incidence of EoE in a specific U.S.A state. Studies at the state level are important to direct policy and interventions aiming limit its burden in communities.

Background/Objectives: Malocclusion in primary dentition affects permanent dentition. However, the factors contributing to malocclusion in the oral cavities of children have not been fully elucidated. We hypothesized that environmental factors affect malocclusion in the primary dentition of the Japanese population and aimed to identify factors associated with anterior occlusion in primary dentition. Methods: The study involved 3793 parent-child pairs from the Miyagi Regional Centre as part of a supplementary survey to the Japan Environment and Children's Study, a cohort study. A questionnaire assessing oral development and environmental factors was administered to parent-child pairs who consented to participate. Parents assessed anterior occlusion when their children were 3.5 years old. Results: The maxillary primary central incisors tended to erupt earlier in the open bite group. Significantly more children in this group were breastfed until 1 year and drank ionic beverages at 1.5 years. In addition, thumb sucking or pacifier use was significantly common at 2 years of age. A correlation was observed between the mother's body mass index (BMI) before and after pregnancy and anterior occlusion. Conclusions: In the open bite group, the occlusion status of the anterior teeth at 3.5 years of age showed distinctive results influenced by the eruption period of the primary anterior teeth, oral habits, intake of sweetened beverages, and maternal BMI. These findings suggest that parental observation could be useful for screening children for malocclusion until the eruption of permanent dentition.

Hypoxic-ischemic encephalopathy (HIE) is a common cause of significant neonatal morbidity and mortality. The stronghold of the treatment for moderate-to-severe HIE is therapeutic hypothermia (TH) which provides a neuroprotective effect. However, it also is associated with pain and stress. Moreover, neonates with HIE are subjected to a significant number of painful procedures. Untreated pain during the early neonatal period may entail future challenges such as impaired brain growth and development as well as impaired pain sensitivity later in life. Hereby, the provision of adequate sedation and alleviation of pain and discomfort is essential. There are currently no universally accepted guidelines for sedation and pain management for this patient population. In this review, we highlight non-pharmacologic and pharmacologic methods currently in use to provide comfort and sedation to patients with HIE undergoing TH.

Background/Objectives: Cerebral Palsy (CP) is a non-progressive clinical condition characterized by secondary issues, including speech impairments. Our study aims to evaluate the volumes of brain areas related to speech in patients diagnosed with CP between the ages of 0-17. Methods: this study includes the images of 84 children: 42 in the control group who applied to the hospital between the specified dates and were reported as healthy by MRI from the patient records, and 42 patients with CP. Results: in the CP group, white and gray matter, cerebrum, cerebellum, thalamus, lobus frontalis, lobus temporalis, lobus parietalis, lobus insularis, gyrus cinguli, and nuclei basales volumes were observed to decrease statistically significantly compared to the control group (p ˂ 0.001). Conclusions: we found a significant decrease in the volumes of speech-related brain areas in CP patients, indicating that CP can significantly impact the brain's speech-related regions.

Background/Objectives: The relevance of adult attachment security for physical and emotional wellbeing is increasingly evident. Developing a better understanding of the interpersonal antecedents of secure attachment in childhood and adolescence could enable opportunities for its promotion when attachment styles are more easily modifiable. Methods: Data from 3648 participants in a longitudinal birth cohort study were examined. At 21 years, participants completed the confidence (in self and others) subscale of the Attachment Style Questionnaire, a measure of attachment security. Path analysis was used to longitudinally examine the influence of maternal and child-reported interpersonal variables at birth, 5, and 14 years on attachment security in early adulthood. Results: Two pathways were identified. Firstly, child and family social relations at birth and 5 years predicted attachment security via the number of the child's close friends at 14 years (β = 0.11, p < 0.001). Secondly, attuned caregiving at 14 years predicted attachment security via the recalled experiences of parental care up to 16 years, measured at 21 years (β = 0.28, p < 0.001). Greater adolescent family satisfaction directly predicted increased attachment security in early adulthood (β = 0.10, p < 0.001). Conclusions: Child and family social relationships from birth and throughout childhood and adolescence, along with attuned caregiving, led to increased attachment security in early adulthood. Public health and policy initiatives aimed at strengthening social support systems for caregivers and their children throughout childhood, and increasing the uptake of parenting programmes aimed at strengthening attuned caregiving, may lead to long-term improvements in the attachment security of offspring.

Background/objective: Evidence suggests that preschool children experience significantly higher rates of injury-related mortality and disability compared to older age groups of children. However, there seems to be a lack of recorded data on unintentional injuries among preschoolers in public daycare centers in Greece. Therefore, the present study aims to identify determinant factors and characteristics of unintentional injuries among preschool children in public daycare centers.

Methods: The sample consisted of 6 daycare centers in the Municipality of Xanthi in Greece, with 444 preschool children (M = 3.73 ± 0.47 years of age). Educators completed reports detailing the number and characteristics of unintentional injuries sustained and provided specific information about each. During the study (10 months), 351 injury reports were completed.

Results: Frequency analyses showed that children who were most frequently injured were between 3.5 and 4 years old, while boys were more susceptible. The leading causes of injuries were falls and acute overload. Cuts and wounds were the most common type of injury, and the body part that was more frequently injured was the head. The majority of injuries occurred in classrooms during free play.

Conclusions: The results highlight the need for injury prevention strategies in daycare centers, including modifications to play areas, increased supervision during free play, and educator training on risk reduction.

Background/objectives: In recent years, despite growing awareness of child poverty in Japan, research examining its impact on the daily lives of children and their families within schools and communities remains limited. This study aims to clarify the extent of child poverty and associated issues in A City, Tokyo, through qualitative research conducted as part of the Community-Based Participatory Research (CBPR) process.

Methods: Twelve research participants were selected, including Vice Principals of schools, Community and Child Welfare Officers, and other stakeholders involved in supporting economically disadvantaged households raising children. A focus group discussion (FGD) was conducted on 16 October 2021 to examine the current state of child poverty in A City and local initiatives addressing the issue. Data were analyzed using a qualitative descriptive approach.

Results: Three categories emerged from the analysis: (1) Children Disadvantaged by Their Family's Financial Situation, (2) Challenges in Supporting Financially Struggling Families in Schools and Communities, and (3) the Necessity of Establishing Comprehensive Systems to Support Families. These findings highlight the complex challenges schools and communities face in supporting economically disadvantaged families.

Conclusions: Addressing child poverty in A City requires strengthening collaboration between the education sector and community stakeholders, enhancing early detection of poverty-related issues, and establishing comprehensive support systems for timely intervention. However, cultural norms in Japan, such as the reluctance to impose a burden on others, might create barriers to seeking assistance. To overcome these challenges, CBPR is expected to play a key role in fostering networks among children, parents, and support providers.

Background: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare disorder characterized by a narrowed pyriform aperture and nasal obstruction. Children with CNPAS often exhibit a bony ridge on the underside of the secondary palate, a solitary central incisor, and a triangular-shaped palate. Due to its rarity, limited research exists, and there is no established treatment algorithm, which complicates management, particularly in craniofacial treatments and long-term follow-up. Aims: This study aimed to develop a comprehensive treatment algorithm based on long-term follow-up, focusing on maxillofacial deformities, dental considerations, and upper airway assessment. Methods: We conducted a retrospective study of four CNPAS patients treated at our institute. We performed a literature review, and a comparison was executed with our data in order to introduce our novel, age-specific clinical treatment framework. Results: A literature review was conducted, and different clinical parameters were examined. Previously published data were compared to our patients-related findings to develop our clinical treatment algorithm based on patients' age. Patients were monitored for respiratory distress during the first two years of life. Children with cyclic cyanosis underwent surgical widening of the pyriform aperture through bony excess removal and nasal tubing to ensure airway patency. For those with ongoing desaturation events, neonatal palatal expansion was performed. At ages 10-12, additional evaluations using polysomnography and orthodontic assessments were conducted. Based on these findings, patients received surgically assisted rapid palatal expansion (SARPE) and further surgical widening of the pyriform aperture if obstructive sleep apnea (OSA) was present. Subsequent treatments included orthodontic care and restoration of the missing central incisor. Conclusions: We propose an age-based clinical treatment algorithm for CNPAS tailored to address individual patient needs throughout their growth.

Background/Objectives: Although child-to-parent violence (CPV), peer violence (PV), and dating violence (DV) share risk factors and tend to co-occur, little is known about the common and differential mechanisms involved in the development of these types of youth violence. This study aims to (1) analyze the relationship between youth violence (CPV, PV, and DV) and perceived parental warmth and moral disengagement mechanisms and (2) explore the mediating role of moral disengagement mechanisms in the relationship between the lack of perceived parental warmth and youth violence. Methods: A cross-sectional population-based survey study was conducted. The sample consisted of 2124 Spanish adolescents (57.9% girls) aged between 13 and 17 years from educational centers. Results: The lack of perceived parental warmth (parental criticism-rejection in particular) is a common risk factor for all three types of violence and, more relevantly, is related to youth violence through moral disengagement mechanisms, highlighting a differential contribution of these mechanisms according to the type of violence. In particular, advantageous comparison and attribution of blame are specific mediators of CPV, and moral justification and distortion of consequences are specific to PV, whereas euphemistic language seems to be a common mediator of PV and DV. Conclusions: This study suggests that adolescents who perceive a lack of parental warmth are more likely to develop different dysfunctional cognitive mechanisms, which in turn are related to different types of youth violence. It would be important to promote warm parenting practices and address the cognitive mechanisms underlying youth violence.

Background/Objectives: Pleural effusion represents an accumulation of fluid in the pleural cavity, frequently associated with pneumonia. There has been a gradual increase in cases among children in recent years, with a notable rise during the post-pandemic period, potentially due to immune debt, decreased vaccination coverage, and changes in pathogen dynamics. Methods: We enrolled 66 children with pleural effusion treated at the Children's Emergency Clinical Hospital, Brasov, between January 2019 and September 2024. We analyzed the data on demographics, symptoms, vaccination status, hospitalization, and treatments to assess the trends in the incidence and clinical features. Results: The median age was 5 years (ranging from 3 months to 17 years). Most patients were male (57.5%) from rural areas (34.8%). Only 40.9% fulfilled the vaccination schedule of Romania. We observed a rise in hospitalizations in the last two years, with 16 cases in 2023 and 15 in 2024, and most were being admitted in April (15.5%). Patients mainly had severe (36%) and medium (26%) acute respiratory failure. S. pneumoniae was the most common isolate with two cases each of serotype 1, 14, and 23A, and one case each of serotype 3, 31, and 34, followed by H. influenzae and P. aeruginosa. Treatment was mostly with ceftriaxone (69.6%), Vancomycin (63.6%), Meropenem (53.0%), and Teicoplanin (25.7%). Some children required thoracic drainage (34.8%). Complications like pneumothorax (16.6%), polyserositis (4.5%), and pneumomediastinum (3.0%) were found. Conclusions: The rise in pleural effusion cases may be influenced by various factors, such as changes in pathogen behavior or host immune responses following the pandemic. Further research is needed to understand these potential mechanisms. The emergence of non-PCV20 strains and the common occurrence of serotype 3 infections point out the need to study serotype trends and evaluate whether expanding vaccine programs could be beneficial.