Children-Basel最新文献

Background/objectives: Determine the appropriate duration for multichannel sleep studies in former preterm infants with cardio-respiratory events beyond term equivalent age.

Hypothesis: A sleep study of 10 h will provide equivalent information compared to a 20-h study to detect significant cardio-respiratory abnormalities in this population.

Methods: Single-center retrospective study of 50 infants with 20-h sleep study. Studies were evaluated for periodic breathing, obstructive, central, mixed apnea, desaturations, and bradycardia. Each study was partitioned into two 10-h epochs, compared to one another and the 20-h study.

Results: Differences were detected at the level of individual sleep studies when each epoch was compared to each other and a total 20-h study. 10-h study missed 17-31% of breathing abnormalities detected over 20 h adjusted for study time. Group analysis showed no statistical difference in the number and duration of events between epochs.

Conclusions: A 20-h sleep study improves the detection of breathing abnormalities missed with a 10-h study.

Background: Happiness and health are crucial elements of adolescents' lives that significantly impact mental well-being and societal engagement. This article hypothesizes that a suitable school environment may be one of the components that can impact students' subjective feelings of happiness and health. This research aimed to determine the association between a negative school environment, such as experiencing bullying and feeling insecure at school, and students' happiness and health.

Methods: The study was conducted in 2023, surveying students in grades 7-10 from two Lithuanian cities and their districts. The study included 1992 students (females 50.2%) with a mean age of 14.53 ± 1.12.

Results: It was observed that male students felt healthier and happier than females. Also, male students felt safer at school more often than females. A positive correlation was found between a student's feeling of safety at school and their happiness and health. Regression analysis revealed that a feeling of safety at school was the most significant positive factor associated with male students' sense of happiness and health. Also, the most important factors for females were a feeling of safety at school, bullying, and how often teachers stop bullying.

Conclusions: It was found that feelings of insecurity at school, experiences of bullying, and how often teachers stop bullying can be associated with students' subjective feelings of happiness and well-being. School environmental factors can affect students' happiness and well-being differently depending on gender. It is essential to focus on vulnerable student populations when creating preventive programs to enhance adolescents' sense of safety in schools.

Background: Foreign body aspiration is a preventable occurrence that carries a high risk of mortality in the pediatric population. Clinically, foreign body aspiration manifests as cough, followed by choking, which might not be given any consideration by the caregivers of the child. An episode of sudden wheezing can also raise the suspicion of a foreign body in the lower respiratory tract. The clinical findings depend on the type, size, and localization of the foreign body and include persistent cough, localized airway resistance, localized or diffuse wheezing, and difficulty breathing. A bronchoscopy is the procedure of choice for the removal of foreign bodies. Flexible bronchoscopy is increasingly being used as the initial diagnostic procedure in children with an uncertain history of choking, in the absence of physical and radiological lung changes, and in chronic complaints requiring the exclusion of a foreign body in the airways. Thus, the aim of this study was to describe our clinical experience with lower respiratory tract foreign body extraction in children over a period of five years.

Materials and methods: Over a 5-year period, 154 patients under the age of 18 underwent a bronchoscopy due to a suspected foreign body in the lower respiratory tract. Of these patients, 92% had an incident leading to acute respiratory distress, and 8% had no definite data on such an event in the anamnesis.

Results: A foreign body in the respiratory tract was found in and extracted from 50 patients, and foreign bodies were absent in 104 of the cases.

Conclusions: If a foreign body enters the lower respiratory tract, immediate and adequate actions are required to solve the problem. A bronchoscopy should be conducted in every suspected case of foreign body aspiration.

Background/objectives: Although ADHD in adults has become visible and inclusive in recent years in diagnostic manuals, research is still limited regarding the long-term outcomes of patients with this disorder. The main objective of this research was to address the many facets of predictor variables in girls with ADHD facing unplanned pregnancies at young ages in order to improve the management of pre-, peri-, and postnatal complications that may occur, as well as for early psychiatric diagnosis and effective intervention.

Methods: PubMed and Web of Science Databases were used to perform literature research, and a total of 27 records were selected and used for data extraction.

Results: Related articles have included the persistence of ADHD symptoms comorbid with other disorders among girls with ADHD as a risk factor for teenage pregnancies. Conduct disorders and substance use disorders are the main co-occurrent diagnoses that increase the likelihood for teenage childbirth. Unplanned pregnancies at young ages are associated with unfavorable psychosocial trajectories both for the mother and the child.

Conclusions: In this review, we emphasize the importance of predisposing factors for risky sexual behaviors and unplanned pregnancies in cases of girls with ADHD. The topic of the article draws attention to the need for uniform national individualized care of girls with ADHD, the implementation of programs to prevent academic failure and early parenthood as well as addressing comorbid obstetrical and psychiatric conditions, especially in regions where the rate of adolescent births continues to be high.

Background and objectives: The preschool context produces excessive sedentary behavior in children. The systematic fulfillment of structured physical activities during school time, namely a daily movement routine (DMR), can contribute to increasing the quantity of physical activity (PA) and to improving physical literacy (PL), reaching the WHO's recommendations.

Aim: The present study aims to quantify the sedentary time spent by 4- and 5-year-old preschool children and to verify the effects that a DMR could have on sedentary habits in preschool children.

Method: An experimental observational study was carried out. Ad hoc questionnaires were administered to parents, teachers, and children, and an observation checklist was used to quantify the time spent in sedentary activities at school. Descriptive statistics and t-tests were applied for data analysis.

Results: Thirty-two children attending Italian preschool participated in this study. The implementation of a DMR significantly reduced the sedentary time in preschool, decreasing the time spent sitting by 45.69% and increasing the time spent standing by 185%.

Conclusions: This study confirms the hypothesis that children move for less time than recommended by the WHO and highlights the importance of making the experiences of the DMR structural, as this could be an opportunity for educational processes to enhance active lifestyles in promoting the development of physical literacy.

Introduction: Renal transplantation ensures particular advantages for patients with end-stage kidney disease. However, in some cases, early complications may result in allograft dysfunction, which can ultimately lead to the loss of the graft. Creatinine is a poor biomarker for kidney injury due principally to its inability to help diagnose early acute renal failure and complete inability to help differentiate among its various causes. Different urinary and serum proteins have been intensively investigated as possible biomarkers in this setting. We focused on emerging serum biomarkers such as kidney injury molecule 1 (KIM-1) on a cohort of grafted patients. The motivation of this study was to analyze a predictive biological marker in comparison with standard markers for the evaluation of renal function, with the aim of observing if there are statistically significant differences regarding the performance and promptness of its increase compared to the current monitoring methods in order to improve graft survival, quality of life, and overall patient prognosis.

Patients and methods: We included 21 patients who had their first kidney transplantation (8 females, 13 males), with a follow-up period from transplantation of 3.14 years, without prior immunization, having complete HLA typing and a negative cross-match test before transplantation. We determined serum creatinine and KIM-1 in the whole cohort at the time of the enrollment in the study.

Results: The mean creatinine value was 0.89 mg/dL ± 0.33. The mean value for KIM-1 was 13.56 +/- 21.52 in the Tx group vs. 5.91 +/- 3.26 in the control group with a p-value of 0.06. We defined patients at low risk (LR) of graft loss (serum creatinine < 0.9 mg/dL) and those at high risk (HR) (serum creatinine > 0.91 mg/dL). The mean values for KIM-1 were 6.09 +/- 1.67 in the LR vs. 21.77 +/- 29.71 in the HR group, with a p-value 0.01.

Conclusions: There is a strong difference for KIM-1 at 24 h postTx between the two groups, showing a high correlation between KIM-1 and the predisposition of the graft dysfunction. Further studies are needed in order to clarify the utility of these novel biomarkers in the prediction of graft survival in renal transplantation patients.

Background/objectives: Dental age estimation plays a critical role in pediatric dentistry, orthodontics, and forensic medicine. The Nolla method, widely applied globally, has shown variable accuracy across different populations. This study aimed to evaluate the applicability and accuracy of the Nolla method in estimating the dental age of Romanian children and to identify potential discrepancies between dental and chronological ages.

Methods: A retrospective analysis was conducted on 860 panoramic radiographs from pediatric patients aged 3-15.9 years in Oradea, Romania. The Nolla method was applied to estimate dental age, and the results were compared with chronological age. Statistical analyses, including Wilcoxon signed-rank and Mann-Whitney U tests, were performed to evaluate the accuracy and consistency of the Nolla method.

Results: The study analyzed 860 panoramic radiographs (356 boys and 504 girls). The average chronological age was 9.95 ± 2.48 years, while the average dental age, as estimated using the Nolla method, was 8.43 ± 2.13 years. Dental age was consistently lower than chronological age, with a median difference of 1.5 years (IQR: 0.9-2.2 years). Among the 13 age groups, the highest representation was found in the 8-8.9-year (14.7%) and 9-9.9-year (13.3%) groups. Gender differences were statistically significant (p < 0.001); girls demonstrated a larger median discrepancy of 1.7 years (IQR: 1.1-2.3 years) compared to boys at 1.15 years (IQR: 0.6-1.8 years). Notably, discrepancies increased with age, peaking at 2.6 years in the 14-14.9-year group (4.7% of the sample). The youngest group (3-3.9 years) showed the smallest difference of 0.3 years. Significant differences between chronological and dental ages were observed in 87.5% of the sample.

Conclusions: The Nolla method consistently underestimated dental age in Romanian children, with greater discrepancies in older age groups and among girls. These findings highlight the need for the population-specific calibration of the method to improve its accuracy in both clinical and forensic contexts.

Background: Managing pain during dental procedures is crucial, particularly for children, as pain can induce anxiety. Local anesthesia is the most anxiety-inducing procedure in pediatric patients. Consequently, this study aimed to assess and compare the pain-related behaviors and perceptions associated with two anesthesia techniques for children: traditional local anesthesia and intraosseous local anesthesia administered via the QuickSleeper 5^® system.

Methods: A split-mouth randomized clinical trial was conducted involving 33 children aged 4-9 years. Each participant received both traditional local anesthesia and intraosseous local anesthesia with QuickSleeper 5 across two visits. Pain-related behaviors were evaluated by calibrated pediatric dentists through video recordings, and pain perceptions were assessed using the Wong-Baker Faces Pain Rating Scale. Heart rate measurements offered objective insights into patients' anxiety; finally, the time needed to administer anesthesia was recorded.

Results: This study found no statistically significant differences between traditional local anesthesia and intraosseous local anesthesia with QuickSleeper 5 regarding pain perception, heart rate, or pain-related behaviors, indicating that both techniques are effective at minimizing discomfort. However, QuickSleeper 5 demonstrated a significantly shorter administration time, enhancing the procedural efficiency of pediatric dentistry.

Conclusions: The QuickSleeper 5 system is a valuable tool for pediatric dental care, delivering comparable comfort levels to traditional anesthesia while significantly reducing the time that is required for administration. The QuickSleeper 5 system's efficiency advantage could make it the preferred choice for treating children, especially given the stress that is often associated with local anesthesia and the need for quick, smooth procedures in pediatric care.

Objectives: There is a lack of studies that investigate the relationship between anthropometric profiles, biological maturity, and specific physical performances in young male basketball players. This study aimed to evaluate the development of anthropometric characteristics and physical performance across different age and maturity groups among male basketball players in Palestine, as well as to identify the anthropometric factors influencing physical performance within this population.

Methods: A total of one-hundred-fifty male basketball players, aged 12 to 16, participated in this study. The players were categorized by age groups (U-12 to U-16) and divided into five maturational groups based on their maturity offset, ranging from -1.5 to 2.5 years relative to peak height velocity (PHV). The measurements included anthropometric variables and physical performance, such as sprinting performances, jumping ability, agility tests, and maximal aerobic capacity. Statistical analyses, including a full model and multiple regression analysis, were conducted to identify the anthropometric parameters that significantly influenced the performance variables.

Results: Anthropometric development, particularly lower-limb length, significantly influenced vertical jump performance, while increases in body composition and fat mass negatively impacted sprinting and strength test outcomes. Our study confirms that maturity status plays a crucial role in determining physical performance among young Palestinian basketball players. Early-maturing players generally demonstrated greater strength and endurance, whereas late-maturing players excelled in agility and speed. The full model and the multiple equations were used to determine the determinants of physical performances according to anthropometric variables.

Conclusions: The findings show that performance benchmarks based on age and maturational groups may contribute to a better understanding of training protocols and talent identification for young male basketball players in Palestine, as well as support the development of strategies for physical activity practice.

Background: Hypophosphatasia (HPP) is an inherited disease caused by low activity of tissue-nonspecific alkaline phosphatase. Dental characteristics include premature loss of primary teeth, enlarged pulp chambers, and enamel hypoplasia. Although enzyme replacement therapy with asfotase alfa was approved in 2015, there are few reports about the dental outcomes of this treatment.

Case presentation: A 1-year-old girl referred to our hospital had already lost two primary teeth at the time of her initial visit. She started enzyme replacement therapy 6 days after birth, and genetic analysis later confirmed the diagnosis of HPP. At the age of 4 years and 7 months, 11 primary teeth had been lost, and some of the exfoliated teeth showed inflammatory root resorption or root fracture. There was also a history of abscess formation in a non-carious primary molar.

Conclusions: This report suggests that early enzyme replacement therapy may prevent traditional tooth loss in patients with HPP. It also highlights the new challenges posed for dental professionals in providing infection control in large pulp cavities and receding periodontal tissue.