Minerva Pediatrics最新文献

Background: Mortality of newborns with Hypoplastic Left Heart Syndrome (HLHS) is mainly concentrated after Norwood procedure (NP) stage 1 palliation (S1P) and between S1P and stage 2 palliation (S2P). Standardized management of these patients may help to control hospital mortality. Aim of the study was to evaluate the impact on hospital mortality of a standardized perioperative management (SPM) for newborns requiring S1P in a low volume center for NP.

Methods: A consecutive series of patients undergoing S1P from January 1, 2002 to December 31, 2006 were retrospectively compared, by a "before and after" design, with those receiving a SPM (i.e. use of selective cerebral perfusion, near infrared spectroscopy, delayed sternal closure, modified ultrafiltration) from January 1^st, 2007 to December 31^st, 2018. Demographic, intraoperative and postoperative characteristics were collected. Univariate and multivariate analyses assessed differences before and after SPM.

Results: Ninety-one newborns underwent S1P in the considered period; of 74 eligible patients, 25 did not receive SPM, while 49 received SPM. Hospital mortality after S1P was 31% (CI 21-44%). The introduction of a SPM did not affect hospital mortality both at the univariate-(28% vs. 29%, P=0.959) and at the multivariate analysis (HR 1.85, P=0.62). Mortality was 12% (CI 6-25%) between hospital discharge after S1P and S2P and 8% (CI 3-22%) between S2P and S3P.

Conclusions: The use of a SPM for HLHS newborns requiring S1P was not effective in reducing hospital mortality in a low volume center. We suggest a collaboration between Italian Pediatric Cardiac Centers to manage HLHS patients.

Background: The present study examines the effects of the COVID-19 confinement on health-related behaviors (physical activity, sedentary behaviors) of young French children.

Methods: Parents of 348 French children under 6 years of age completed an online survey launched during the first days of the initial COVID-19-related confinement. They were asked to indicate whether their kids increased, decreased or maintained their physical activity level, time spent in sedentary behaviors, and sleep time. Information regarding the configuration of their home environment (access to outdoor facilities, implantation area) and lifestyle habits (solitary activity, parents' solicitation; nap time; night waking episodes and night duration) were also collected.

Results: A total of 25.0% of the children were reported to decrease, 24.7% maintained and 50.3% increase their physical activity during the confinement. Greater proportions of kids who had access to a collective (51.4%) or individual (53.7%) outdoor area increased their physical activity. Regardless of the housing situation (urban, suburban or rural) or access to outdoor facilities, the majority of children increased their screen time (60.4%). Two-thirds (66.7%) of parents reported nap time remained unchanged for their kids. Fifty-one percent of parents admitted a link between teleworking and their kids' screen time.

Conclusions: Health behaviors were differentially impacted in very young kids during a confinement period. Importantly, a majority of parents admitted a causal effect of telecommuting on their kids' screen exposure. The present results also show that the proneness to increase physical activity during confinement is positively related to access to a favorable outdoor environment.

Background: Back pain diseases are among frequently reported health problems. Unfortunately, more often this problem also affects young people, high school students. Lifestyle that people are representing nowadays has a negative impact on their spine. Development of technology and transportation eliminates daily basic physical activity such as taking a walk to the school. Prolonged and inappropriate sitting posture during classes and using the computer at home are predisposing factors for back pain occurrence. The aim of this paper was to analyze the frequency of back pain occurrence among high school youth and attempt to relate their occurrence frequency with sex, time spent in sitting position, anthropometric parameters and physical activity of examined students.

Methods: The examined group initially counted 272 teenagers, but ultimately 218 were taken into account for the analysis and 54 questionnaires were filled in incorrectly and rejected. All of them were high school students. Customized survey consisting of general part and closed questions regarding physical activity (subjective experience of work load) was used as an examination tool.

Results: Examined youth spent on average 10.04 hours daily in a sitting position. As much as 195 (89.45%) of examined teenagers declared to experience back pain at least once in their lives. The most of teenagers (117; 53.67%) indicated lumbar spine pain. Girls more often felt spine pain issues in comparison to boys. Short stature of teenagers was often related to back pain occurrence. No correlation between time spent in sitting position and frequency of skeleton axis pain occurrence was noted. Among group of boys a relation between more frequent physical activity and less often spine pain occurrence was observed.

Conclusions: Spine pain is an important health problem of examined youth, occurring more frequent among girls than boys. Body height correlate negatively with frequency of spine pain occurrence among youth. Despite spending more than 10 hours daily in sitting position by examined youth, it did not affect the frequency of back pain issues occurrence. Higher physical activity of examined boys was related to less often back pains.

Acute neurologic injury is common in critically ill children. Some conditions - such as traumatic brain injury, meningitis, and hypoxic-ischemic injury following cardiac arrest - require careful consideration of cerebral physiology. Specialized neuromonitoring techniques provide insight regarding patient-specific and disease-specific insight that can improve diagnostic accuracy, aid in targeting therapeutic interventions, and provide prognostic information. In this review, we will discuss recent innovations in invasive (e.g., intracranial pressure monitoring and related computed indices) and noninvasive (e.g., transcranial doppler, near-infrared spectroscopy) neuromonitoring techniques used in traumatic brain injury, central nervous system infections, and after cardiac arrest. We will discuss the pertinent physiological mechanisms interrogated by each technique and discuss available evidence for potential clinical application. We will also discuss the use of innovative neuromonitoring techniques to detect and manage neurologic complications in critically ill children with systemic illness, focusing on sepsis and cardiorespiratory failure requiring extracorporeal membrane oxygenation.

Multisystem inflammatory syndrome in children (MIS-C) is a rare hyperinflammatory and immunosuppressed condition affecting children exposed to COVID-19. MIS-C has been associated with an over-exaggerated innate and adaptive immune response characterized by a 'selective' cytokine production and T cell suppression. As COVID-19 information has evolved, the knowledge and field surrounding MIS-C is ever evolving. Thus, a comprehensive clinical review that concisely presents current literature findings regarding common clinical presentations and comparisons with similar conditions, associations with the COVID-19 vaccine effects and relevant epigenetic markers and evaluates treatment and long-term outcomes to help guide future studies is needed and provided.

Background: Despite several international initiatives aimed to contrast childhood overweight and obesity, these still represent a major public health problem. Recently, the World Health Organization called for a new type of preventive action, requiring stakeholders from both governments and civil society, to play a decisive role in shaping healthy environments, especially for children.

Methods: COcONUT (Children PrOmOting Nutrition throUgh Theatre) was a nutrition education project, involving children aged 5-12 years, aimed to raise awareness on healthy eating, through theatrical and practical workshops. Within this project we conducted an observational study assessing: 1) children adherence to the Mediterranean diet, using the KIDMED questionnaire; 2) parental nutritional knowledge and families' food habits using the ZOOM8 questionnaire. The non-parametric Wilcoxon and the McNemar's Test were used. Statistical significance was fixed P<0.05.

Results: Our data show a statistically significant improvement in Mediterranean Diet adherence among children (P=0.0004). Moreover, we found positive trends in some families' food habits, as for instance less perceived barriers in fruits/vegetables/pulses consumption, less perceived barriers in doing sports and less consumption of unhealthy snacks.

Conclusions: Our results confirm the important role played by funny and active learning in health promotion initiatives.

Acute post-viral cough is a common symptom, usually mild-moderate and self-resolving. However, acute cough may be particularly annoying, affecting sleep, and quality of life, also of the family. Thus, treatment is deemed necessary. Antitussive remedies may be pharmacological or non-pharmacological. Antitussive drugs are either central or peripheral. Central drugs are burdened with significant side effects and can cause abuse, especially in adolescents. Levodropropyzine, on the other hand, is an effective peripheral drug, as demonstrated by two meta-analyses, and has an optimal safety profile. Non-pharmacological remedies tend to be safe, but few substances have a documented degree of efficacy. Therefore, when managing children and adolescents with a post-viral cough, the practical approach may be based on levodropropizine use, which is preferable when the cough is particularly persistent and disturbs sleep.