Children-Basel最新文献

Background/objectives: Executive dysfunction appears to be a significant secondary characteristic frequently linked with movement disorders. Planning is a high-level cognitive process integral to our executive functions. Children who show deficits in their planning ability usually have difficulties in making decisions or problem-solving, such as initiating tasks or mentally organizing a project, and monitoring and controlling their behavior effectively. These difficulties can significantly impact their academic performance and daily functioning even in adulthood. However, the existing research on the relationships between motor performance and planning abilities is limited and inconsistent.

Methods: This study aimed to explore the potential associations between motor and planning skills in 30 preschool-aged children with Developmental Coordination Disorder (DCD) and 30 healthy controls matched for age, including utilizing the PASS theory and Cognitive Assessment System (CAS).

Results: The findings highlighted balance, total motor score, and planned codes as the primary factors distinguishing the two groups. A significant Pearson's correlation was observed between the overall MABC-2 scores and the subdomain scores, along with the Planning Scale indices for both groups, suggesting a substantial relationship between these assessments. Among the Planned codes items, the most notable predictor of overall motor performance in children was identified. Furthermore, the total score for Planned Connections emerged as the most robust predictor for tasks associated with manual dexterity.

Conclusions: The relationship between motor skills and executive functions in early childhood plays a vital role in the development of early intervention strategies that utilize cognitive-motor tools.

Background/objectives: Today's high school students often engage in sedentary behavior by choosing passive activities during leisure time. Increasing research shows that regular physical activity (PA) provides benefits beyond physical health, especially important during childhood and adolescence. Our study investigated the association between physical activity levels and academic performance (AP) in Serbian adolescents.

Methods: We selected a sample of 836 fourth-grade high school students (avg. 17.9 ± 0.7 years old) who completed the IPAQ (short-version) and the Academic Performance Scale. Data analysis was conducted using IBM SPSS 21.0. Due to non-normal data distribution, Spearman's correlation was used and hierarchical regression analysis to assess the association between PA and AP.

Results: The findings revealed significant correlations between vigorous, moderate and light PA, as well as overall units of metabolic equivalent of task (METs), with AP (p-values: 0.000, 0.005, 0.021, 0.004, respectively), although with weak correlation coefficients (0.127, 0.098, 0.080, 0.181, respectively). Vigorous PA influenced AP by 10.1%, moderate PA by 8.2%, and light PA by 11.4%.

Conclusions: These results suggest that adolescents engaging in higher PA levels tend to have better AP. This finding indicates a substantial association between PA levels and AP, with both moderate and vigorous PA showing a positive correlation and influence. Further investigation is necessary to comprehensively grasp the link between light PA and AP.

Objective: This study investigates the effectiveness of extubation from conventional mechanical ventilation using an endotracheal tube (MVET) compared to synchronized non-invasive positive-pressure ventilation (sNIPPV) using neurally adjusted ventilatory assist (NAVA) and conventional non-invasive positive-pressure ventilation (NIPPV) in extremely low-birth-weight (ELBW) infants. Methods: An institutional review board (IRB) approved this study (#12175) to conduct a single-center randomized control trial including 60 ELBW infants assigned in a one-to-one computer-generated scheme to either sNIPPV using NAVA or NIPPV. The primary outcome involved the need for reintubation, and the secondary outcome involved the assessment of moderate/severe BPD, defined as an oxygen requirement at 36 weeks, as in #NCT03613987 (clinicaltrials.gov). Results: There were 60 ELBW infants enrolled and randomized. The overall gestational age was 26 (1.5) weeks, and the birth weight was 773 (157) g [mean (SD)]. There were no statistically significant differences between the NAVA and NIPPV patient characteristics. There was a 41% extubation failure rate in the NIPPV group and 35% in the NAVA group (p = NS). The NAVA group had less moderate and severe BPD (p = 0.03), a shorter oxygen therapy duration (p = 0.002), a decreased length of stay (p = 0.03), and less need for home oxygen (0, 43%; p = 0.0004). Conclusions: This study found similar extubation failure rates among ELBW infants as in prior studies. However, the NAVA group had lower rates of moderate/severe BPD and need for oxygen at discharge, as well as shorter oxygen therapy duration and length of stay. The use of NAVA may be a reasonable alternative mode of non-invasive ventilation in the ELBW population.

Objective: Increasing the awareness of adolescents about hedonic hunger, understanding the difference between homeostatic hunger and hedonic hunger, and adolescents learning to control themselves to stop excessive food consumption are extremely important for a healthy adulthood. The study aimed to evaluate the effects of the multi-strategy nutrition education programs (MSNEP) on hedonic hunger, food addiction, nutrition literacy, and nutritional status in adolescents. Methods: This study was planned using a pre-test and post-test design. The MSNEP was conducted with 132 adolescents (11-15 years; 69 boys, 63 girls) for 4 weeks (45 min-1 h/session). Data were obtained using questionnaires with face-to-face interviews at pre-education (baseline) and post-education (week 4 and week 8). The survey form included sociodemographic information, nine item short version of Children's Power of Food Scale (C-PFS-9), the Yale Food Addiction Scale for Children 2.0 (YFAS-C 2.0), the Adolescent Nutrition Literacy Scale (ANLS), anthropometric measurements, and 24-hour dietary recall. Results: A decrease in C-PFS-9 total scores was found compared to the baseline (p < 0.001). While the YFAS-C 2.0 score decreased in boys compared to the baseline (p < 0.05), no significant difference was found in girls (p > 0.05). A difference was found in the ANLS scores for girls (p = 0.01), but no difference was found in the scores for boys during the study (p > 0.05). At week 4, the consumption of dairy products, legumes, vegetables and fruits, bread and grains, nuts, and hard-shelled seeds increased compared to the baseline (p < 0.05). Also, daily protein and fiber intake increased (p < 0.05). Accordingly, a higher YFAS-C 2.0 score predicted greater hedonic hunger. A lower ANLS score was a predictor for higher food taste and food available scores. Conclusions: In conclusion, the MSNEP was found to have positive effects on hedonic hunger, food addiction, nutritional literacy, and healthy eating behaviors. The study revealed differences between girls and boys. In order to maintain healthy body weights in adolescents, it is recommended that the MSNEP be provided in schools.

Objectives: The purpose of this study was to compare and contrast Kawasaki disease (KD) with multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.

Methods: A retrospective analysis of the medical records of patients diagnosed with KD and MIS-C at a single institution from July 2020 to November 2021 was performed.

Results: The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. The MIS-C patients were older (p < 0.001) and had prolonged hospitalizations (p = 0.023), elevated neutrophil counts (p < 0.001), C-reactive protein (p < 0.001), procalcitonin (p < 0.001), interleukin-6 (p < 0.014), ferritin (p < 0.001), fibrinogen (p < 0.001), troponin I (p = 0.001), NT-proBNP (p < 0.001), and D-dimer levels (p < 0.001). There were more cases of hypotension (p = 0.024), decreased left ventricular function (p = 0.023), and a greater need for corticosteroids (p < 0.001), enoxaparin (p = 0.045), and therapeutic plasma exchange (p < 0.001). Kawasaki disease patients had a greater incidence of rash (p < 0.001), changes in oral mucosa (p < 0.001), conjunctival injection (p < 0.001), extremity changes (p < 0.001), and cervical lymphadenopathy (p < 0.001). They had a longer duration of fever (p < 0.001), elevated white blood cell count (p < 0.001), platelet count (p < 0.001), and alanine aminotransferase level (p < 0.001). The two groups were similar regarding the hemoglobin levels, erythrocyte sedimentation rates, albumin levels, and the frequency of coronary aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment.

Conclusions: Advanced patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas prolonged fever and classical clinical features of KD favor KD.

Background/objectives: The main aim of our study was to analyze the stabilometric parameters in relation to hip and knee muscle force in children with unilateral slipped capital femoral epiphysis (SCFE) who had undergone surgical treatment. Another objective was to compare the stabilometry in three testing situations (eyes open, eyes closed, and head retroflexed).

Methods: In total, 26 patients with unilateral right SCFE treated via in situ fixation with one percutaneous screw performed stabilometry assessments under three different situations (with their eyes open, with their eyes closed, and with their head retroflexed) and isometric muscle force assessment of the bilateral hip flexors, extensors, abductors and adductors and bilateral knee flexors and extensors.

Results: No significant differences between the right side (affected hip) and left side (non-affected hip) were recorded for all of the tested muscle groups. We found significant negative correlations between the 90% confidence ellipse area (eyes open condition) and left knee extensors (p = 0.028), right knee flexors (p = 0.041), and left knee flexors (p = 0.02), respectively. When performing the comparison between the eyes open and eyes closed situations, there were significant differences in CoP path length (p < 0.0001) and maximum CoP speed (p = 0.048); the parameters increased in the eyes closed situation.

Conclusions: Better postural stability is acquired when assessed with eyes open or with the head retroflexed in contrast with eyes closed testing.

Background: Antiseizure medications (ASMs) are crucial for managing epilepsy in children. However, a well-documented side effect of ASMs is their impact on bone health, often due to interference with vitamin D metabolism. This can lead to vitamin D deficiency in children with epilepsy. This study aimed to determine if a daily dose of 400 IU or 1000 IU would maintain adequate vitamin D levels in children with epilepsy.

Methods: A phase IV randomized controlled trial enrolled children aged 2-16 years with epilepsy and receiving antiseizure medications. Children were divided into two groups: the monotherapy group, which was defined as children on one antiseizure medication (ASM), and the polytherapy group, which was defined as children receiving two or more ASMs. Eligible children with levels above 75 nmol/L were randomized to receive a maintenance dose of either 400 IU/day or 1000 IU/day of cholecalciferol. Baseline and 6-month assessments included demographic data, anthropometric measurements, seizure type, medications, seizure control, and 25(OH)D level.

Results: Out of 163 children, 90 were on monotherapy and 25 on polytherapy. After 6 months of vitamin D maintenance, the proportion of children with 25(OH)D concentration below 75 nmol/L was 75.0% in the 400 IU group and 54.8% in the 1000 IU group. In the monotherapy group, baseline seizure-free children increased from 69% to 83.6% after treating vitamin D deficiency.

Conclusion: Daily vitamin D supplementation with 1000 IU may be beneficial for children with epilepsy, particularly those receiving monotherapy, to maintain sufficiency and potentially improve seizure control.

Background/objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with an increased risk of obesity and disordered eating behaviors. This study compared weight status and eating behaviors among drug-naïve ADHD children, those on stimulant monotherapy, those on combined stimulant and antipsychotic treatment, and healthy controls.

Methods: This cross-sectional study included 547 children aged 6-12 years from four Turkish provinces: 361 with ADHD (152 drug-naïve, 156 on stimulants, and 53 on combined therapy), and 186 healthy controls. Anthropometric measurements, psychiatric assessments, and eating behavior evaluations were conducted using standardized tools.

Results: Drug-naïve ADHD children had the highest obesity rate (13.8%), while those on stimulant monotherapy had the lowest (4.5%) compared to controls. Combined treatment group obesity rates were similar to controls (7.5% vs. 8.6%). The drug-naïve and combined treatment groups showed increased food approach behavior and desire to drink, with the combined treatment group also showing increased emotional overeating.

Conclusions: This study reveals a complex relationship between ADHD, its pharmacological management, and the risk of obesity. Stimulant monotherapy may mitigate the risk of obesity, while combined stimulant and antipsychotic treatment may lead to problematic eating behaviors. These findings emphasize the importance of monitoring weight status and eating behaviors in ADHD children, especially those receiving pharmacological interventions.

Generalized arterial calcification of infancy (GACI) is a rare disease characterized by arterial calcification. GACI is caused by a mutation in the ENPP1 or ABCC6 genes. GACI causes severe hypertension and heart failure, and approximately 50% of patients die within the first 6 months. In particular, preterm infants with GACI often die due to immature cardiac function. Bisphosphonates are effective in treating GACI; however, no standardized treatment regimen is available. We experienced a case of a preterm infant with GACI born at 30 weeks gestation. Ultrasonography showed high-intensity lesions in the arteries, and computed tomography revealed calcification of the arteries throughout the body, leading to the diagnosis of GACI. We administered intravenous pamidronate, and her cardiac contraction improved. The initial scheduled interval between drug administrations was 2 months. However, the cardiac contraction worsened 1 month after the pamidronate administration. Therefore, we decreased the dosing interval and administered a second course of pamidronate, which improved her cardiac function. We then switched to oral etidronate. To improve the morbidity and mortality rates of preterm infants with GACI, it is important to obtain an early diagnosis of GACI by investigating high-intensity lesions in the arteries and performing early administration of an appropriate type of bisphosphonate.

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported, even in specialized centers. Mobile health technologies have been used to overcome these limits with contrasting results. This study aims at evaluating the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up.

Methods: Seventy-five patients were randomly assigned to standard care or standard care plus mobile app (2:1) using an online randomizer system. The mobile app delivered high-intensity lifestyle counseling for diet and physical activity.

Results: At six months of follow-up, the M-App group showed significantly lower dropout rates compared to standard care (p = 0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86, 95% C.I. 1.39-10.42, p = 0.01). After one year, we observed lower albeit non-statistically significant dropout rates in the M-App compared to the standard care group (p = 0.24). No differences were observed in z-score BMI and percentage of BMI reduction between the two groups.

Conclusions: Our findings suggest that the mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction.