Children-Basel最新文献

Obesity, the current pandemic, is associated with alarming rises among children and adolescents, and the forecasts for the near future are worrying. The present paper aims to draw attention to the short-term effects of the excess adipose tissue in the presence of a viral infection, which can be life-threatening for pediatric patients, given that the course of viral infections is often severe, if not critical. The COVID-19 pandemic has been the basis of these statements, which opened the door to the study of the repercussions of obesity in the presence of a viral infection. Since 2003, with the discovery of SARS-CoV-1, interest in the study of coronaviruses has steadily increased, with a peak during the pandemic. Thus, obesity has been identified as an independent risk factor for COVID-19 infection and is correlated with a heightened risk of severe outcomes in pediatric patients. We sought to determine the main mechanisms through which obesity is responsible for the unfavorable evolution in the presence of a viral infection, with emphasis on the disease caused by SARS-CoV-2, in the hope that future studies will further elucidate this aspect, enabling prompt and effective intervention in obese patients with viral infections, whose clinical progression is likely to be favorable.

Objective: We aimed to determine the demographic data, mortality, and morbidity of early- and late-neonatal sepsis cases, the etiologic agents in these cases, and the antibiotic susceptibility of these agents.

Methods: This study was conducted retrospectively in a tertiary neonatal intensive care unit (NICU). The demographic, clinical, and laboratory data of newborns diagnosed with culture-proven sepsis within 24 months were evaluated.

Results: Two hundred and eleven culture data points belonging to 197 infants were evaluated. Forty percent of the infants had a history of premature birth. The most common clinical findings were respiratory distress and feeding intolerance. Coagulase-negative staphylococci (CoNS) were detected most frequently as early- and late-sepsis agents. The most common Gram-negative bacteria detected as late-sepsis agents were Klebsiella spp. and Escherichia coli (E. coli). The overall mortality rate was 10%.

Conclusions: Neonatal sepsis continues to have high mortality rates in tertiary NICUs. CoNS was the most common agent, highlighting the importance of developing and maintaining personnel training and handwashing practices. It will be important to consider the resistance rates of Klebsiella spp., the most common Gram-negative agent in late-onset sepsis (LOS) cases, to commonly used antibiotics in empirical treatments.

Objective: Although medically unexplained body complaints occur relatively frequently in adolescents, the causes are little-researched. This study examines the influence of cultural and family-related factors on somatic complaints.

Methods and measures: In a cross-cultural and cross-sectional study of 2415 adolescents from eight countries (Argentina, France, Germany, Greece, Pakistan, Peru, Poland, and Turkey), the associations of family variables with body complaints were tested and the cultural impact analyzed. Body complaints were assessed via self-reporting with a translated version of the body complaints scale of the Youth Self Report (YSR). In addition, Perceived Maternal/Paternal Behavior was assessed, as well as cultural dimensions of the eight counties.

Results: Overall, females reported higher rates of body complaints than boys did. An additional negative impact of parental psychological control and anxious rearing was found that generalized across cultures, with a particularly strong impact on girls. Girls in stepparent families and boys in single-parent families reported more body complaints. Finally, body complaints were associated with Hofstede's cultural factors in both genders, like individualism vs. collectivism, power distance, uncertainty avoidance, and masculinity vs. femininity.

Conclusion: These findings are particularly important for primary care providers, as they stress the relevance of taking into account family and cultural factors in body complaints which affect boys and girls differently, to provide adequate care.

Background: Caregiver-infant reciprocity is related to infant/toddler development and health. However, there is a dearth of research on reciprocity variables like co-occupation and developmental variables such as infant/toddler sensory processing/preferences, and it is important to understand the biopsychosocial mediators of these relations. These include novel genetic markers like maternal oxytocin receptor single-nucleotide polymorphisms (OXTR SNPs). Therefore, this study examined whether mothers carrying risk alleles for three OXTR SNPs displayed different co-occupational behaviors with their infants and whether their infants/toddlers showed different sensory processing/preferences.

Methods: Data from the Infant Development and Healthy Outcomes in Mothers Study included prenatal saliva samples assayed for OXTR SNPs, 6-month postnatal behavioral observations coded for maternal-infant co-occupations (reciprocal emotionality, physicality, and intentionality), and 10-, 14-, and 18-month postnatal, maternal-reported Infant/Toddler Sensory Profiles (classified as within or outside the majority range for low registration, sensory seeking, sensory sensitivity, and sensory avoiding).

Results: Mothers with rs53576 risk allele A engaged in more frequent reciprocal emotionality, while those with rs2254298 risk allele A engaged in less frequent reciprocal emotionality but more frequent reciprocal intentionality. Mothers with rs53576 risk allele A had infants with 11 times greater odds of being outside of the majority range for sensation avoiding at 10 months old.

Conclusions: The results converge with the literature supporting links between OXTR SNPs, caregiver reciprocity, and infant/toddler development but extend the findings to relatively novel constructs (caregiver-infant co-occupations and infant/toddler sensory processing/preferences).

In the academic community, discussions and debates are a natural and vital part of the research process [...].

Background: Children with developmental coordination disorder (DCD) exhibit reduced interlimb coordination compared to typically developing children (TDC) during complex tasks like running, which requires dynamic postural control. However, the extent of interlimb coordination difficulties in DCD during tasks that demand minimal dynamic balance, such as self-paced and externally auditory-paced tasks, remains unclear. This study aimed to compare interlimb coordination and auditory-motor synchronization between children with DCD and TDC during a seated antiphase coordination task of the lower limbs, which has minimal postural control requirements. Methods: Twenty-one children with DCD and 22 TDC performed an antiphase knee flexion and extension task while seated, in three conditions (baseline silence, metronome discrete, and metronome continuous), for three minutes. The interlimb coordination, synchronization, and spatiotemporal movement parameters were analyzed using a mixed model analysis; Results: Children with DCD displayed less coordinated interlimb movements compared to TDC (p = 0.0140), which was the result of the greater variability in coordinating antiphase knee flexion-extension movements (p < 0.0001). No group differences in spatiotemporal movement parameters were observed. Children with DCD, compared to TDC, had a lower synchronization consistency to metronomes (p = 0.0155). Discrete metronomes enhanced interlimb coordination compared to the baseline silence condition (p = 0.0046); Conclusions: The study highlights an inferior interlimb coordination and auditory-motor synchronization in children with DCD compared to TDC. Implementing metronomes with a discrete temporal structure improved the interlimb coordination of both groups during the used fundamental seated interlimb coordination task, supporting theorical frameworks of event-based timing.

Background/objectives: Cyberbullying is an increasingly serious issue that negatively impacts the mental and physical health of adolescents. This study aims to report the prevalence rates of adolescent cyberbullying-victimization and its associated related factors, providing a scientific basis for targeted efforts to protect the mental and physical well-being of adolescents; Methods: From March to May 2019, there were 13 high schools and 33 middle schools in Yixing, with a student ratio of 2:1 between middle and high school. Using a random cluster sampling method, we selected four high schools and three middle schools based on this ratio, resulting in a total of 13,258 students. We conducted a survey using a self-designed questionnaire to investigate the experiences of adolescents with cyberbullying and victimization, comparing the differences in cyberbullying-victimization based on various demographic characteristics. Additionally, we employed a multifactorial logistic regression model to analyze the associated factors; Results: The rate of adolescents who declared themselves as cyberbully-victims is 2.9%. The results of the logistic regression analysis indicate that being male, having both parents working outside the home, experiencing occasional or large conflicts among family members, being subjected to punishment-and-abuse child discipline, always or often using social software (websites), enjoying playing single or multiplayer games, self-smoking, and self-drinking were associated with a higher likelihood of being a cyberbully-victim (p < 0.05); Conclusions: Adolescent cyberbullying-victimization is affected by personal, family, and social factors. Therefore, comprehensive strategies and measures are needed to intervene in this problem.

Introduction: According to current knowledge, at birth, the pineal gland and melatonin receptors are already present and the suprachiasmatic nucleus is largely functional, and noradrenaline, the key pineal transmitter, can be detected in the early foetal period. It is still unclear why the pineal gland is not able to start its own pulsatile synthesis and secretion of melatonin in the first months of life, and as a result, infants during this time are dependent on an external supply of melatonin. Method: The causes and consequences of this physiological melatonin deficiency in human infancy are examined in a systematic review of the literature, in which 40 of 115 initially selected publications were evaluated in detail. The references of these studies were checked for relevant studies on this topic. References from previous reviews by the author were taken into account. Results: The development and differentiation of the pineal gland, the pinealocytes, as the site of melatonin synthesis, and the development and synaptic coupling of the associated predominantly noradrenergic neural pathways and vessels and the associated Lhx4 homebox only occurs during the first year of life. Discussion: The resulting physiological melatonin deficiency is associated with sleep disorders, infant colic, and increased crying in babies. Intervention studies indicate that this deficiency should be compensated for through breastfeeding, the administration of nonpooled donor milk, or through industrially produced chrononutrition made from nonpooled cow's milk with melatonin-poor day milk and melatonin-rich night milk.

Background/Objectives: Telepractice interventions have been found to alleviate barriers families face when seeking communication interventions. This study is a multiple-baseline single-subject design that measures parent communication opportunities and parent responsiveness to determine if parent training through online modules created for parents of children with communication support needs can be effective for training parents of autistic children with communication support needs. Methods: This study replicates work by utilizing online training used as well as the same variables and definitions. This study expands the original study by providing the children with speech-generating devices (SGDs). SGDs are an assistive technology tool to increase language production and give access to language to minimally verbal autistic people. A central difference between this study and study is that the only training parents received was the online modules and written instructions to set up the SGD. Results: Overall, the POWR modules appear to positively impact the communication opportunities provided by the parent during play and activities, increase child communication, and improve parent proficiency in implementing the POWR strategy. Conclusions: There is a need for a larger single-case study or a randomized control trial to replicate these findings. Additional instruction may be needed for parents of children with autism around responsive interactions. This study adds to innovative ways of providing family-centered training and access to AAC for those with barriers to service.

Background/objective: Perioperative acute pain management in pediatric patients is essential to reduce complications. Adenoidectomy-Tonsillectomy are surgical procedures requiring pain control, and risk minimization for postoperative bleeding, nausea, and vomiting. Despite their known secondary effects, the use of opioid analgesics is still preponderant in pediatric perioperative management. We performed a comprehensive review on adeno-tonsillectomy perioperative pain management in children. We developed and implemented a multimodal analgesia protocol aimed to improve patients' pain management while consistently reducing opioids use.

Methods/results: relevant Information was summarized, then compared to our clinical needs. Learnings were used to create and implement a multimodal analgesia protocol that we use in patients 3-9 years-old undergoing adenoidectomy/tonsillectomy. The full protocol is presented. Analgesic strategies have emerged to reduce or avoid the use of opioids. Among these strategies, combining different non-opioid analgesics (Ibuprofen, Paracetamol, Metamizole) has been shown to be an effective and safe pharmacological strategy when implemented as part of perioperative multimodal analgesia protocols. Considerable evidence associating the use of NSAIDs with a bigger risk of postoperative bleeding does not exist.

Conclusions: Perioperative management of adenotonsillectomy pain should include preventive and multimodal analgesia, which have shown to provide significantly more effective analgesia than some opioid regimens. Ibuprofen offers highly effective analgesia for postoperative pain, particularly when combined with acetaminophen.