Children

10 pages, 242 KiB

Open AccessArticle

Family-Centered Advance Care Planning: What Matters Most for Parents of Children with Rare Diseases

by Karen Fratantoni, Jessica Livingston, Sandra E. Schellinger, Samar M. Aoun and Maureen E. Lyon

Children 2022, 9(3), 445; https://doi.org/10.3390/children9030445 - 21 Mar 2022

Cited by 6 | Viewed by 5088

Few studies have described the goals and wishes of parents caring for their children with rare diseases, specifically when children are unable to communicate their preferences directly. The purpose of this study was to describe the parent’s understanding of their child’s illness, goals [...] Read more.

Few studies have described the goals and wishes of parents caring for their children with rare diseases, specifically when children are unable to communicate their preferences directly. The purpose of this study was to describe the parent’s understanding of their child’s illness, goals of care, and what mattered most to their child from the parent’s perspective. Six families completed a feasibility study of the FAmily CEntered (FACE)-Rare pACP intervention. Qualitative content analysis was performed on transcripts of videotaped responses to the Respecting Choices Next Steps pACP Conversation facilitated conversation guide about the goals of care. Codes were grouped into themes, with direct participant quotations representing the themes. Five themes emerged: getting out and moving freely; feeling included and engaged; managing symptoms and disease burden; coordinating care among many care team members; and managing today and planning for the future. In the context of pACP, families reported that what mattered most to their children included the freedom of movement and human connection and engagement, while parents strived to be effective caregivers and advocates for their child with a rare and severely disabling disease. Full article

(This article belongs to the Special Issue Psychosocial Considerations for Children and Adolescents Living with Rare Diseases)

10 pages, 634 KiB

Open AccessFeature PaperArticle

Older Children with Torso Trauma Could Be Managed by Adult Trauma Surgeons in Collaboration with Pediatric Surgeons

by Hsiang-Chieh Huang, Tzu-Chi Teng, Yung-Ching Ming, Jainn-Jim Lin, Chien-Hung Liao, Chi-Hsun Hsieh, Pei-Hua Li and Chih-Yuan Fu

Children 2022, 9(3), 444; https://doi.org/10.3390/children9030444 - 21 Mar 2022

Cited by 1 | Viewed by 1841

Abstract

Background: The purpose of this study is to assess the roles of pediatric surgeons and adult trauma surgeons in the management of pediatric torso trauma patients in a Level I adult trauma center. Methods: From 2015 to 2019, pediatric torso trauma patients (age [...] Read more.

Background: The purpose of this study is to assess the roles of pediatric surgeons and adult trauma surgeons in the management of pediatric torso trauma patients in a Level I adult trauma center. Methods: From 2015 to 2019, pediatric torso trauma patients (age < 18 years) were studied. A comparison between patients who did and did not undergo surgery was performed. Older children (age: 10–18 years) were compared with young adults (age: 18–35 years) selected with the same criteria using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Results: A total of 226 patients were included in the study. Patients who underwent surgery for torso trauma (N = 61) were significantly older than patients who did not undergo surgery (N = 165) (13.1 vs. 10.4 years, p = 0.019). Both PSM and IPTW showed that the older children and young adult groups had similar proportions of patients requiring surgery (32.6% vs. 32.6%, standard difference (SD) = 0.000), proportions of patients who required torso angioembolization (8.7% vs. 9.8%, SD = 0.072), length of hospital stay (LOS) (8.1 vs. 8.0 days, SD = 0.026), and intensive care unit admission LOS (2.6 vs. 2.7 days, SD = 0.033). However, 7.1% of older children received critical care from pediatric surgeons. Additionally, 31.9% of younger children were cared for by pediatric surgeons/pediatricians. Conclusions: Adult trauma surgeons can feasibly perform surgeries for older children with torso trauma in collaboration with pediatric surgeons who provide critical care. Full article

► Show Figures

Figure 1

11 pages, 632 KiB

Open AccessArticle

Copeptin Concentrations in Plasma of Healthy Neonates in Relation to Water–Electrolyte Homeostasis in the Early Adaptation Period

by Anna Jarosz-Lesz, Aniceta Brzozowska and Iwona Maruniak-Chudek

Children 2022, 9(3), 443; https://doi.org/10.3390/children9030443 - 21 Mar 2022

Cited by 1 | Viewed by 2058

Abstract

Copeptin (CTproAVP) is a stable by-product of arginine–vasopressin synthesis and reflects its secretion by the pituitary gland, considered as a potential new marker of dehydration. The objective of the study was to investigate CTproAVP measured after the first 48 h of postnatal life [...] Read more.

Copeptin (CTproAVP) is a stable by-product of arginine–vasopressin synthesis and reflects its secretion by the pituitary gland, considered as a potential new marker of dehydration. The objective of the study was to investigate CTproAVP measured after the first 48 h of postnatal life in relation to serum effective osmolality, urine osmolality, and vessels filling according to the following variables: delivery mode, postnatal weight loss, fluids administered intravenously to the mother, and fluids given orally to the neonate. A prospective observational study was conducted with 200 healthy term infants (53% male) enrolled. Serum CTproAVP concentrations were measured using the ELISA kit; haematocrit, urine osmolality, serum effective osmolality were assessed after 48 h of life. Sonographic measurements of inferior vena cava (IVC) and aorta (Ao) were performed and IVC/Ao ratios were calculated. No correlations were found between CTproAVP concentrations and both serum effective osmolality and urine osmolality. There was also no association between CTproAVP concentrations and vessel filling represented by IVC/Ao index at 48 h of life. Full article

(This article belongs to the Special Issue Fluid and Electrolyte Therapy in Children)

► Show Figures

Figure 1

8 pages, 918 KiB

Open AccessArticle

Trends and Pattern of Antibiotic Use in Children in Northern Spain, Interpreting Data about Antibiotic Consumption in Pediatric Outpatients

by Laura Calle-Miguel, Carlos Pérez-Méndez, Elisa García-García, Belén Moreno-Pavón and Gonzalo Solís-Sánchez

Children 2022, 9(3), 442; https://doi.org/10.3390/children9030442 - 21 Mar 2022

Cited by 2 | Viewed by 2200

Abstract

Monitoring of antibiotic prescription and consumption behavior is crucial. The Access, Watch, and Reserve (AWaRe) classification of antibiotics has been recently introduced in order to measure and improve patterns of antibiotic use. In this study, retrospective data about systemic antibiotic consumption (expressed in [...] Read more.

Monitoring of antibiotic prescription and consumption behavior is crucial. The Access, Watch, and Reserve (AWaRe) classification of antibiotics has been recently introduced in order to measure and improve patterns of antibiotic use. In this study, retrospective data about systemic antibiotic consumption (expressed in defined daily dose per 1000 inhabitants per day (DID)) in pediatric outpatients in a region in northern Spain (around 100,000 children up to 14 years old) from 2005 to 2018 were analyzed and compared with antibiotic consumption in general population in Spain. The pattern of use was analyzed by the percentage of the current AWaRe categories, the Access-to-Watch index, and the amoxicillin index. Data were calculated annually and compared into two periods. Mean antibiotic consumption in pediatric outpatients was 14.0 DID (CI 95% 13.38–14.62). It remained stable throughout the study and was lower than consumption in general population in Spain, particularly from 2016. Changes in the consumption of the main active principles have led to an improvement in the three metrics of the pattern of use. It is important to have a thorough knowledge of the methodology applied in studies about antibiotic consumption. There is a lack of an optimal standardized metric for the pediatric population. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

► Show Figures

Graphical abstract

10 pages, 1695 KiB

Open AccessArticle

Short Term Radiological Outcome of Combined Femoral and Ilium Osteotomy in Pelvic Reconstruction of the Child

by Lorenz Pisecky, Gerhard Großbötzl, Stella Stevoska, Matthias Christoph Michael Klotz, Christina Haas, Tobias Gotterbarm, Matthias Luger and Manuel Gahleitner

Children 2022, 9(3), 441; https://doi.org/10.3390/children9030441 - 21 Mar 2022

Cited by 4 | Viewed by 2719

Abstract

Background and Objectives: Reconstruction of the pelvic joint is a common way to address developmental dysplasia of the hip (DDH), as well as neurogenic dislocation of the hip (NDH) and Legg–Calvé–Perthes disease (LCPD) in children. The purpose of this study was to analyze [...] Read more.

Background and Objectives: Reconstruction of the pelvic joint is a common way to address developmental dysplasia of the hip (DDH), as well as neurogenic dislocation of the hip (NDH) and Legg–Calvé–Perthes disease (LCPD) in children. The purpose of this study was to analyze the short-term radiologic outcome after hip reconstructive surgery either treated with sole osteotomy of the femur or in combination with iliac osteotomy in patients with DDH, NDH and LCPD. Materials and Methods: X-rays of 73 children, aged 2–18 years, with DDH, NDH and LCPD after hip reconstructive surgery were measured retrospectively and compared to the preoperative x-rays concerning various parameters to define hip geometry. The surgical procedures were femoral osteotomy (74), Salter innominate osteotomy (27), Pemberton osteotomy (27), open reduction (37), Chiari osteotomy (4). The pre-/postoperative acetabular index (AI), center-edge angle (CE) and Reimers migration index (RMI) were evaluated before and 3 months after surgery. Results: Hip geometry parameters improved significantly (RMI: preop/postop: 62.23% ± 31.63%/6.30% ± 11.51%, p < 0.001; CE: 11.53° ± 20.16°/30.58 ± 8.81°, p < 0.001; AI: 28.67° ± 9.2°/19.17 ± 7.65°, p < 0.001). Sub-group analysis showed a superior RMI in DDH compared with NDH 3 months after surgery (DDH/NDH: 2.77% ± 6.9%/12.94% ± 13.5%; p = 0.011). Osteotomy of the iliac bone (Salter innominate, Pemberton, Chiari) resulted in a significant improvement of the postoperative RMI compared to cases without osteotomy of the ilium (7.02 ± 11.1% vs. 16.85 ± 4.71%; p = 0.035). Conclusions: Femoral and pelvic osteotomies are effective to improve the radiological pelvic parameters in infants and adolescents with DDH, NDH and LCPD. In addition, the study found that the combination of femoral and pelvic osteotomy led to a better RMI than femoral osteotomy alone. Using the combined ilium and femoral osteotomy, it was possible to show the highest effect on correction of the hip geometry with respect to residual RMI. Full article

(This article belongs to the Special Issue Orthopedics and Trauma in Children)

► Show Figures

Figure 1

6 pages, 580 KiB

Open AccessCase Report

Steroid-Induced Ocular Hypertension in a Pediatric Patient with Acute Lymphoblastic Leukemia: A Case Report

by Hung-Yin Lai, Ing-Chou Lai, Po-Chiung Fang, Chih-Cheng Hsiao and Yu-Ting Hsiao

Children 2022, 9(3), 440; https://doi.org/10.3390/children9030440 - 21 Mar 2022

Cited by 3 | Viewed by 2979

Abstract

Glucocorticoids play a pivotal role in therapeutic protocols in acute lymphoblastic leukemia (ALL) treatment. Systemic steroids are known to be less likely to elevate the intraocular pressure when compared to topical administration, and reports addressing hypertensive ocular response in the Asian pediatric ALL [...] Read more.

Glucocorticoids play a pivotal role in therapeutic protocols in acute lymphoblastic leukemia (ALL) treatment. Systemic steroids are known to be less likely to elevate the intraocular pressure when compared to topical administration, and reports addressing hypertensive ocular response in the Asian pediatric ALL population are currently limited. We report a case of a nine-year-old girl with acute lymphoblastic leukemia (ALL) who was found to have highly elevated intraocular pressure (IOP) during maintenance treatment when taking oral dexamethasone (6 mg/m²/day). Her IOP increased on day 5 after taking dexamethasone, reached a peak on day 7 or 8, and returned back to baseline on day 13 before anti-glaucoma medications were used. Thus, we prescribed IOP-lowering agents for 10 consecutive days starting on the day oral dexamethasone was administered, and observed that not only did the peak levels lower remarkably, but the IOP levels returned to baseline more rapidly as well. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

► Show Figures

Figure 1

11 pages, 828 KiB

Open AccessArticle

Do COVID-19 Worries, Resilience and Emotional Distress Influence Life Satisfaction? Outcomes in Adolescents in Ecuador during the Pandemic: SEM vs. QCA

by Juan Sebastián Herrera, Laura Lacomba-Trejo, Selene Valero-Moreno, Inmaculada Montoya-Castilla and Marián Pérez-Marín

Children 2022, 9(3), 439; https://doi.org/10.3390/children9030439 - 21 Mar 2022

Cited by 4 | Viewed by 2443

Abstract

COVID-19 and the measures adopted have been a problem for society at all levels. The aim of the study was to analyze the main predictors of life satisfaction among adolescents in Ecuador during the COVID-19 pandemic. Participants were 902 adolescents from Ecuador aged [...] Read more.

COVID-19 and the measures adopted have been a problem for society at all levels. The aim of the study was to analyze the main predictors of life satisfaction among adolescents in Ecuador during the COVID-19 pandemic. Participants were 902 adolescents from Ecuador aged between 12 and 18 years (M = 15.30; SD = 1.28). Variables such as life satisfaction, resilience, emotional symptomatology, and worries about COVID-19 were assessed. Two statistical methodologies were compared (structural equation models (SEM) and qualitative comparative analysis (QCA)) to analyze the possible influence of worries about COVID-19, resilience and emotional symptomatology towards life satisfaction. The results indicated that in both models, worries about COVID-19 were negatively related to life satisfaction. However, having a greater worry, specifically for physical health issues, was associated with better life satisfaction. SEM models indicate that depression is negatively related to life satisfaction. In QCA models, high levels of life satisfaction are explained by low levels of anxiety and depression. Thus, resilience seems to play a mediating role in life satisfaction, although this is only true for the depression variable. It is necessary to detect signs of risk in this population and strengthen resilience in them as elements that can facilitate their adequate coping with their adverse situation. Full article

(This article belongs to the Section Pediatric Mental Health)

► Show Figures

Figure 1

12 pages, 466 KiB

Open AccessArticle

Environmental Risk Factors for Childhood Inflammatory Bowel Diseases: A Multicenter Case-Control Study

by Mohammed Hasosah, Wafaa Alhashmi, Renad Abualsaud, Anas Alamoudi, Afnan Aljawad, Mariam Tunkar, Nooran Felemban, Ahmed Basalim, Muhammad Khan, Aziz Alanazi and Ali Almehaidib

Children 2022, 9(3), 438; https://doi.org/10.3390/children9030438 - 21 Mar 2022

Cited by 4 | Viewed by 2802

Abstract

Objective: Multiple environmental factors can be linked to the development of inflammatory bowel disease (IBD).With an increase in the cases of IBD, the objective of this research is to investigate environmental risk factors for IBD in the Saudi population. Methods: A retrospective multicenter [...] Read more.

Objective: Multiple environmental factors can be linked to the development of inflammatory bowel disease (IBD).With an increase in the cases of IBD, the objective of this research is to investigate environmental risk factors for IBD in the Saudi population. Methods: A retrospective multicenter case–control study was performed among IBD children from 2009 to 2021.The variables analyzed to be the possible risk factors included their socioeconomic status, living and demographic characteristics, and lifestyle related to IBD. The questionnaire included a list of IBD risk factors that was given to the control and the patient group. For every variable, the 95% confidence interval (CI) and odds rations were also estimated. Results: There were 335 individuals considered in this study: 168 controls (50.1%) and 167 IBD patients (49.9%). Of these, 93 IBD patients (56%) had CD and 74 patients (44%) had UC. Most of participants were female (72.1%) and were aged above 10 years (51.5%). Vaginal delivery (OR 0.551, 95% CI: 1.59–4.14), age above 10 years (OR 1.040, 95% CI: 1.012–1.069), deficient fruit intake (OR 2.572, 95% CI: 1.59–4.14), no exposure to antibiotics (OR 2.396, 95% CI: 1.51–3.81), appendectomy (OR 2.098, 95% CI: 1.87–2.35), less physical activity (OR 2.033, 95% CI: 1.05–3.93) and gastroenteritis admissions > 2 times/year (OR 0.107, 95% CI: 0.037–0.311) were the risk factors for IBD. These factors depicted a more significant link with CD than UC (p < 0.05). Interestingly, sleep disturbance was estimated to be a CD risk factor (adjusted OR: 3.291, 95% CI = 0.97–11.22). Pets in house was risk factor for UC (p < 0.001). Conclusions: This study highlights association between vaginal delivery, age above 10 years, deficient fruit intake, low physical activity, exposure to antibiotics, appendectomy, and frequent gastroenteritis admissions as risk factors for IBD. Knowledge of these risk factors can help pediatricians to prospectively identify patients at risk of environmental exposure. Full article

(This article belongs to the Section Global Pediatric Health)

► Show Figures

Graphical abstract

14 pages, 1070 KiB

Open AccessArticle

Subphenotypes in Non-Syndromic Orofacial Cleft Patients Based on the Tooth Agenesis Code (TAC)

by Dimitrios Konstantonis, Maria Nassika, Maria Athanasiou and Heleni Vastardis

Children 2022, 9(3), 437; https://doi.org/10.3390/children9030437 - 20 Mar 2022

Cited by 5 | Viewed by 2295

Abstract

Background: It was the aim of this study to investigate tooth agenesis patterns, which are expressed to different subphenotypes according to the TAC method in a spectrum of non-syndromic orofacial cleft patients. Methods: A total of 183 orofacial cleft patient records were assessed [...] Read more.

Background: It was the aim of this study to investigate tooth agenesis patterns, which are expressed to different subphenotypes according to the TAC method in a spectrum of non-syndromic orofacial cleft patients. Methods: A total of 183 orofacial cleft patient records were assessed for tooth agenesis and TAC patterns. The association between TAC and sex, and cleft type was examined, and logistic regression models were additionally applied. Additionally, the distribution of missing teeth by cleft type and the tooth agenesis inter-quadrant association were examined. Results: The most frequent cleft type was CLPL (n = 72; 39.3%), while the maxillary left lateral incisor was the most frequently missing tooth that was strongly dependent on the cleft type (29.5%, p < 0.001). Of the 31 TAC patterns identified, four were the most prevalent and occurred in 80.8% of the sample, while 20 TAC patterns were unique. Cleft type contrary to sex (p = 0.405) was found to play a significant role in TAC distribution (p = 0.001). The logistic regression’s results suggested that overall, neither sex nor cleft type were associated with tooth agenesis. Prevalence of tooth agenesis in each quadrant clearly depended on cleft type; and there was a strong association found between tooth agenesis in different quadrants. Conclusions: Thirty-one different subphenotypes were identified in TAC patterns. The first four TAC patterns accounted for the 80.8% of the sample’s variability while twenty of the patterns were unique. A strong association was present between TAC pattern and cleft type. No association was found between the sex of the patient, tooth agenesis and TAC patterns. Tooth agenesis depended strongly on the cleft type, and the most frequently missing tooth was the maxillary left lateral incisor. The interquadrant association for tooth agenesis found suggests a genetic link in the etiology of clefts. Full article

(This article belongs to the Special Issue Advances in Orthodontic Technology and Individualized Treatment)

► Show Figures

Figure 1

10 pages, 634 KiB

Open AccessArticle

A Retrospective Database Analysis to Estimate the Burden of Acute Otitis Media in Children Aged <15 Years in the Veneto Region (Italy)

by Elisa Barbieri, Gloria Porcu, Tianyan Hu, Tanaz Petigara, Francesca Senese, Gian Marco Prandi, Antonio Scamarcia, Luigi Cantarutti, Anna Cantarutti and Carlo Giaquinto

Children 2022, 9(3), 436; https://doi.org/10.3390/children9030436 - 19 Mar 2022

Cited by 5 | Viewed by 2591

Abstract

This study aimed to assess trends in the incidence of acute otitis media (AOM), a common childhood condition, following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in the Veneto region of Italy in 2010. AOM episodes (overall, simple, and recurrent (≥3 [...] Read more.

This study aimed to assess trends in the incidence of acute otitis media (AOM), a common childhood condition, following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in the Veneto region of Italy in 2010. AOM episodes (overall, simple, and recurrent (≥3 or ≥4 episodes in 6 or 12 months, respectively, with ≥1 episode in the preceding 6 months)) in children <15 years of age were identified in Pedianet from 2010–2017. Interrupted time series analyses were conducted to assess changes in the annual incidence rates (IRs) in early (2010–2013) and late (2014–2017) PCV13 periods. In total, 72,570 children (402,868 person-years) were identified; 21,048 had 41,683 AOM episodes. Mean annual AOM IR was 103/1000 person-years (95% confidence interval: 102–104), decreasing from 126 to 79/1000 person-years. AOM IRs were highest in children 2–4 years of age, followed by <2 and 5–14 years of age. Overall and simple AOM IRs decreased among children 0–14 years of age, including 2–4 and 5–14 years of age, while recurrent AOM IRs decreased in children <2 years of age. Following PCV13 introduction, AOM IRs decreased substantially in children <15 years of age, with the greatest benefit observed in older children, driven by a reduction in simple AOM IRs. AOM disease burden remains substantial. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

► Show Figures

Figure 1

9 pages, 792 KiB

Open AccessArticle

The Psychometric Properties of the Trunk Impairment Scale in Children with Cerebral Palsy

by Hyerim Jung and Young-Eun Choi

Children 2022, 9(3), 435; https://doi.org/10.3390/children9030435 - 19 Mar 2022

Cited by 1 | Viewed by 2110

Abstract

The Trunk Impairment Scale (TIS) measures static and dynamic seated trunk control in children with cerebral palsy (CP) who have postural control problems. Studies have investigated the reliability and validity of the TIS. However, the fitness and difficulty of the scale items have [...] Read more.

The Trunk Impairment Scale (TIS) measures static and dynamic seated trunk control in children with cerebral palsy (CP) who have postural control problems. Studies have investigated the reliability and validity of the TIS. However, the fitness and difficulty of the scale items have not been investigated. This study used Rasch analysis to test the construct validity of TIS for children with CP. TIS data were collected from 60 children with CP and analyzed for person and item fit, item difficulty, rating scale suitability, and separation reliability. Principal component analyses of residuals revealed that TIS had unidimensionality. Five misfit items (static sitting balance (SSB) items 2 and 3, dynamic sitting balance (DSB) items 4 and 5, and coordination (COO) item 3) were identified. DSB8 is the most difficult item, followed by DSB3 and COO4. On the other hand, the SSB3 item was found to be a relatively easy item. The rating scales demonstrated that out of the three subscales, SSB, DSB, and COO, only the SSB subscale did not meet the appropriate criteria. We demonstrated that statistical item analysis with the Rasch model could provide valuable information related to psychometric properties. Full article

(This article belongs to the Section Global Pediatric Health)

► Show Figures

Figure 1

14 pages, 253 KiB

Open AccessArticle

The Psychometric Properties of the Gilliam Autism Rating Scale (GARS-3) with Kurdish Samples of Children with Developmental Disabilities

by Sayyed Ali Samadi, Hana Noori, Amir Abdullah, Lizan Ahmed, Barez Abdalla, Cemal A. Biçak and Roy McConkey

Children 2022, 9(3), 434; https://doi.org/10.3390/children9030434 - 19 Mar 2022

Cited by 10 | Viewed by 4604

Abstract

There is marked variation internationally in the prevalence of children identified as having autism spectrum disorders (ASD). In part, this may reflect a shortage of screening tools for the early identification of children with ASD in many countries. This study aimed to evaluate [...] Read more.

There is marked variation internationally in the prevalence of children identified as having autism spectrum disorders (ASD). In part, this may reflect a shortage of screening tools for the early identification of children with ASD in many countries. This study aimed to evaluate the Kurdish translation of the Gilliam autism rating scale—third edition (GARS-3), a scale commonly used in Western countries that evaluates six domains related to the ASD definition from the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5, notably Restricted/Repetitive Behavior, deficits in Social interaction and Social Communication, as well as differences in Cognitive Style, Maladaptive Speech, and Emotional Response. GARS-3 assessments were completed through interviews with parents of 735 children, 442 (53%) of whom were diagnosed with ASD. 165 (22%) with an intellectual disability, 49 (7%) with communication disorders, and 133 (18%) typically developing children. The reliability, construct, and the predictive validity of the scale was assessed, and the scores suggestive of a child having ASD were identified. The factor structure was broadly replicated, especially on items relating to social interaction and social communication. The cutoffs for the total scores that were indicative of possible ASD had a high degree of specificity and sensitivity in distinguishing children with ASD from typically developing peers. Some children with I.D. and communication disorders may also score above the threshold, and further assessments should be sought to confirm the presence of autistic traits. Although GARS-3 could be recommended for use in Kurdistan and possibly similar cultures, further prospective research is needed to confirm a diagnosis of assessment with children who score above and below the cutoff scores identified in this study. Moreover, the development of normative data drawn from Kurdish samples of children would be advantageous, although ambitious, given the lack of diagnostic services in many low- and middle-income countries. Full article

(This article belongs to the Special Issue Child Psychomotricity: Development, Assessment, and Intervention)

14 pages, 649 KiB

Open AccessEditor’s ChoiceArticle

One-Year Clinical Performance of Activa™ Bioactive-Restorative Composite in Primary Molars

by Lisa Lardani, Giacomo Derchi, Vincenzo Marchio and Elisabetta Carli

Children 2022, 9(3), 433; https://doi.org/10.3390/children9030433 - 19 Mar 2022

Cited by 43 | Viewed by 5514

Abstract

Restorative procedures for caries affecting primary molars are a daily challenge for pediatric dentistry, and one of the main factors influencing the results of these restorative procedures is the choice of dental material used: bioactive materials were recently introduced, combining the strength of [...] Read more.

Restorative procedures for caries affecting primary molars are a daily challenge for pediatric dentistry, and one of the main factors influencing the results of these restorative procedures is the choice of dental material used: bioactive materials were recently introduced, combining the strength of composites and the benefits of glass ionomers. The present study’s objective is to clinically evaluate the aesthetic, functional and biological properties of Activa™ Bioactive composite in approximal and occlusal carious lesions for 1 year using the FDI criteria for evaluating direct dental restorations. Forty-five children with occlusal or approximal caries in first or second primary molars were included in the study: the cavities were then randomized to be restored with either Activa BioActive or SDR Bulk-fill and evaluated over time according to Federation Dentaire Internationale (FDI) criteria. Results showed that Activa BioActive composite has similar performance over time compared to Bulk-fill composite, for both functional and aesthetic properties. Thus, within the limitations of this study, including the short follow-up period, it can be concluded that bioactive materials might be the material of choice to restore primary molars. A longer follow-up period is desirable to confirm these findings. Full article

(This article belongs to the Special Issue Advance Research in Pediatric Dental Disease)

► Show Figures

Figure 1

10 pages, 1095 KiB

Open AccessCase Report

Differential Diagnosis of Cyclic Vomiting and Periodic Headaches in a Child with Ventriculoperitoneal Shunt: Case Report of Chronic Shunt Overdrainage

by Maximilian David Mauritz, Carola Hasan, Lutz Schreiber, Andreas Wegener-Panzer, Sylvia Barth and Boris Zernikow

Children 2022, 9(3), 432; https://doi.org/10.3390/children9030432 - 18 Mar 2022

Viewed by 3127

Abstract

Fourteen months after the implantation of a ventriculoperitoneal shunt catheter, a six-year-old boy developed recurrent, severe headaches and vomiting every three weeks. The attacks were of such severity that hospitalizations for analgesic and antiemetic therapies and intravenous rehydration and electrolyte substitution were repeatedly [...] Read more.

Fourteen months after the implantation of a ventriculoperitoneal shunt catheter, a six-year-old boy developed recurrent, severe headaches and vomiting every three weeks. The attacks were of such severity that hospitalizations for analgesic and antiemetic therapies and intravenous rehydration and electrolyte substitution were repeatedly required. The patient was asymptomatic between the attacks. After an extensive diagnostic workup—including repeated magnetic resonance imaging (MRI) and neurosurgical examinations—common differential diagnoses, including shunt overdrainage, were ruled out. The patient was transferred to a specialized pediatric pain clinic with suspected cyclic vomiting syndrome (CVS). Despite intensive and in part experimental prophylactic and abortive pharmacological treatment, there was no improvement in his symptoms. Consecutive MRI studies reinvestigating the initially excluded shunt overdrainage indicated an overdrainage syndrome. Subsequently, the symptoms disappeared after disconnecting the shunt catheter. This case report shows that even if a patient meets CVS case definitions, other differential diagnoses must be carefully reconsidered to avoid fixation error. Full article

(This article belongs to the Special Issue Headache in Children and Adolescents)

► Show Figures

Figure 1

16 pages, 1337 KiB

Open AccessArticle

Correlation between Language Development and Motor Skills, Physical Activity, and Leisure Time Behaviour in Preschool-Aged Children

by Daniela Mulé, Ilka Jeger, Jörg Dötsch, Florian Breido, Nina Ferrari and Christine Joisten

Children 2022, 9(3), 431; https://doi.org/10.3390/children9030431 - 18 Mar 2022

Cited by 2 | Viewed by 4051

Abstract

Sedentary behaviour has a negative impact on children’s physical and mental health. However, limited data are available on language development. Therefore, this pilot study aimed to analyse the associations between language development and possible predictors such as motor skills and leisure time behaviour [...] Read more.

Sedentary behaviour has a negative impact on children’s physical and mental health. However, limited data are available on language development. Therefore, this pilot study aimed to analyse the associations between language development and possible predictors such as motor skills and leisure time behaviour in preschool-aged children. Methods: In this cross-sectional analysis, motor skills and speech development status were assessed in 49 healthy preschool children. Physical activity and screen time were assessed via a parental questionnaire. Results: On average, physical activity was 8.2 ± 6.5 h/week; mean screen time was 154.2 ± 136.2 min/week. A positive relationship between the results in the item ‘One-leg stand’ and ‘Phonological working memory for nonwords’ (β-coefficient −0.513; p < 0.001) resp. ‘Formation of morphological rules’ (β-coefficient −0.626; p = 0.004) was shown within backward stepwise regression. ‘Lateral jumping’, resp. ‘Sit and Reach’ were positively associated with ‘Understanding sentences’ (β-coefficient 0.519; p = 0.001 resp. β-coefficient 0.735; p = 0.002). ‘Physical inactivity’ correlated negatively with all language development subtests (each p < 0.05). Media consumption had a negative predictive effect on the subdomain ‘Understanding Sentences’ (β-coefficient −0.530, p = 0.003). Conclusions: An inactive lifestyle correlated negatively with selected subtests of language development in early childhood. These results should be verified in larger groups and longitudinally but support the need for early health promotion. Full article

(This article belongs to the Section Global Pediatric Health)

► Show Figures

Figure 1

7 pages, 253 KiB

Open AccessPerspective

Research-Based Intervention (RBI) for Autism Spectrum Disorder: Looking beyond Traditional Models and Outcome Measures for Clinical Trials

by Antonio Narzisi, Yurena Alonso-Esteban, Gabriele Masi and Francisco Alcantud-Marín

Children 2022, 9(3), 430; https://doi.org/10.3390/children9030430 - 18 Mar 2022

Cited by 3 | Viewed by 3055

Abstract

The rising prevalence of Autism Spectrum Disorders (ASD) has led to a quickly increasing need for effective interventions. Several criteria and measures have been developed to critically assess these interventions with particular focus on the evaluation of the efficacy. Given the huge diversity [...] Read more.

The rising prevalence of Autism Spectrum Disorders (ASD) has led to a quickly increasing need for effective interventions. Several criteria and measures have been developed to critically assess these interventions with particular focus on the evaluation of the efficacy. Given the huge diversity of ASD symptoms and the different levels of severity across individuals, identifying a one size fits all intervention approach is challenging, and the question What works and for whom? Remains still unanswered. Why do we seem to be dragging our feet on this fundamental issue? The main aim of this paper is to answer this question through four non-alternative points. First, there are a scarce number of studies with a solid methodology. Secondly, most trials on intervention efficacy for ASD are designed exclusively in terms of behavioral outcomes. Thirdly, there is a reduced use of biologically oriented outcome measures. Fourthly, in most clinical trials, appropriate practices emerging from research evidence are not systematically applied. A strong effort to improve the methodology of clinical trials is mandatory for the future of autism research. The development of a research-based intervention (RBI) perspective aimed at better integrating: (a) evidence-based approaches; (b) more sensitive behavioral outcome measures; and (c) biomarkers, with the aim of increasing a more detailed clustering of phenotypes, may strongly improve our approach to a precision medicine. Full article

(This article belongs to the Special Issue Autism and Children)

10 pages, 3277 KiB

Open AccessCommunication

Identification of a Novel FAM83H Mutation and Management of Hypocalcified Amelogenesis Imperfecta in Early Childhood

by Ji-Soo Song, Yejin Lee, Teo Jeon Shin, Hong-Keun Hyun, Young-Jae Kim and Jung-Wook Kim

Children 2022, 9(3), 429; https://doi.org/10.3390/children9030429 - 18 Mar 2022

Cited by 1 | Viewed by 2424

Abstract

Amelogenesis imperfecta (AI) is a heterogeneous group of rare genetic disorders affecting amelogenesis during dental development. Therefore, the molecular genetic etiology of AI can provide information about the nature and progress of the disease. To confirm the genetic etiology of AI in a [...] Read more.

Amelogenesis imperfecta (AI) is a heterogeneous group of rare genetic disorders affecting amelogenesis during dental development. Therefore, the molecular genetic etiology of AI can provide information about the nature and progress of the disease. To confirm the genetic etiology of AI in a Korean family with an autosomal dominant inheritance, pedigree and mutational analyses were performed. DNA was isolated from the participating family members and whole-exome sequencing was performed with the DNA sample of the father of the proband. The identified mutation was confirmed by Sanger sequencing. The mutational analysis revealed a novel nonsense mutation in the FAM83H gene (NM_198488.5: c.1363C > T, p.(Gln455*)), confirming autosomal dominant hypocalcified AI. Full-mouth restorative treatments of the affected children were performed after the completion of the deciduous dentition. Early diagnosis of AI can be useful for understanding the nature of the disease and for managing the condition and treatment planning. Full article

(This article belongs to the Section Pediatric Dentistry & Oral Medicine)

► Show Figures

Figure 1

11 pages, 1014 KiB

Open AccessEditor’s ChoiceArticle

Internet Gaming Disorder in Children and Adolescents with Attention Deficit Hyperactivity Disorder

by Stefano Berloffa, Andrea Salvati, Giulia D’Acunto, Pamela Fantozzi, Emanuela Inguaggiato, Francesca Lenzi, Annarita Milone, Pietro Muratori, Chiara Pfanner, Federica Ricci, Laura Ruglioni, Annalisa Tacchi, Chiara Tessa, Arianna Villafranca and Gabriele Masi

Children 2022, 9(3), 428; https://doi.org/10.3390/children9030428 - 18 Mar 2022

Cited by 21 | Viewed by 5864

Abstract

Although Attention Deficit Hyperactivity Disorder (ADHD) has been related to an increased risk for behavioral addictions, the relationship between ADHD and Internet Gaming Disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of [...] Read more.

Although Attention Deficit Hyperactivity Disorder (ADHD) has been related to an increased risk for behavioral addictions, the relationship between ADHD and Internet Gaming Disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ADHD youth, compared to a normal control group, and by assessing selected psychopathological and cognitive features in ADHD patients with and without IGD. One hundred and eight patients with ADHD (mean age 11.7 ± 2.6 years, 96 males) and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) were included in the study and received structured measures for IGD. In the ADHD group, 44% of the sample were above the IGD cut-off, compared to 9.5% in the NC group. ADHD patients with IGD presented with greater severity and impairment, more severe ADHD symptomatology, more internalizing symptoms, particularly withdrawal/depression and socialization problems, and more prominence of addiction and evasion dimensions. A binary logistic regression showed that the degree of inattention presented a greater weight in determining IGD. These findings may be helpful for identifying, among ADHD patients, those at higher risk for developing a superimposed IGD. Full article

(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)

► Show Figures

Figure 1

15 pages, 3442 KiB

Open AccessArticle

Monitoring the Role of Physical Activity in Children with Flat Feet by Assessing Subtalar Flexibility and Plantar Arch Index

by Ligia Rusu, Mihnea Ion Marin, Michi Mihail Geambesa and Mihai Robert Rusu

Children 2022, 9(3), 427; https://doi.org/10.3390/children9030427 - 18 Mar 2022

Cited by 5 | Viewed by 3243

Abstract

Flat foot is a common pediatric foot deformity which involves subtalar flexibility; it can affect the plantar arch. This study analyzes the evolution of two parameters, i.e., plantar index arch and subtalar flexibility, before and after physiotherapy and orthoses interventions, and examines the [...] Read more.

Flat foot is a common pediatric foot deformity which involves subtalar flexibility; it can affect the plantar arch. This study analyzes the evolution of two parameters, i.e., plantar index arch and subtalar flexibility, before and after physiotherapy and orthoses interventions, and examines the correlation between these two parameters. Methods: The study included 30 participants (17 boys, 12 girls, average age 9.37 ± 1.42 years) with bilateral flat foot. We made two groups, each with 15 subjects. Assessments of the subtalar flexibility and plantar arch index used RSScan the platform, and were undertaken at two time points. Therapeutic interventions: Group 1—short foot exercises (SFE); Group 2—SFE and insoles. Statistical analyses included Student’s t-test, Cohen’s D coefficient, Pearson and Sperman correlation. Results: Group 1—subtalar flexibility decreased for the left and right feet by 28.6% and 15.9% respectively, indicating good evolution for the left foot. For both feet, a decrease of the plantar index arch was observed. Group 2—subtalar flexibility decreased for the right and left feet by 43.4% and 37.7% respectively, indicating a good evolution for the right foot. For both feet, a decrease of plantar index arch was observed. Between groups, subtalar flexibility evolved well for Group 2; this was attributed to mixt intervention, physical therapy and orthosis. For plantar arch index, differences were not significant between the two groups. We observed an inverse correlation between subtalar flexibility and plantar arch index. Conclusions: Improvement of plantar index arch in static and dynamic situations creates the premise of a good therapeutic intervention and increases foot balance and postural control. The parameter which showed the most beneficial influence was the evolution is subtalar flexibility. Full article

(This article belongs to the Special Issue Monitoring and Promoting Physical Activity, Physical Fitness and Motor Competence in Children)

► Show Figures

Figure 1

10 pages, 865 KiB

Open AccessArticle

Incidence, Predictors and Outcomes of Noninvasive Ventilation Failure in Very Preterm Infants

by Sara M. Fernandez-Gonzalez, Andrea Sucasas Alonso, Alicia Ogando Martinez and Alejandro Avila-Alvarez

Children 2022, 9(3), 426; https://doi.org/10.3390/children9030426 - 17 Mar 2022

Cited by 4 | Viewed by 2712

Abstract

Non-invasive ventilation (NIV) is now considered the first-line treatment for respiratory distress syndrome in preterm infants. We aimed to evaluate the rates of non-invasive ventilation failure rate in very preterm infants, as well as to identify its predictors and associated outcomes. We designed [...] Read more.

Non-invasive ventilation (NIV) is now considered the first-line treatment for respiratory distress syndrome in preterm infants. We aimed to evaluate the rates of non-invasive ventilation failure rate in very preterm infants, as well as to identify its predictors and associated outcomes. We designed a single-center retrospective cohort study including infants ≤32 weeks gestational age and ≤1500 g. The NIV failure was defined as the need for intubation at <72 h of life. After applying inclusion and exclusion criteria, 154 patients were included in the study, with a mean GA of 29.7 ± two weeks. The NIV failure rate was 16.2% (n = 25) and it was associated with lower bronchopulmonary dysplasia (BPD)-free survival (OR 0.08; 95% CI 0.02–0.32) and higher incidence of intraventricular hemorrhage > II (OR 6.22; 95% CI 1.36–28.3). These infants were significantly smaller in GA and weight. Higher FiO₂ during resuscitation (OR 1.14; 95% CI 1.06–1.22) and after surfactant administration (OR 1.17; 95% CI 1.05–1.31) represented independent risk factors for NIV failure. In conclusion, NIV failure is frequent and it could be predicted by a higher oxygen requirement during resuscitation and a modest response to surfactant therapy. Importantly, this NIV failure is associated with worse clinical outcomes. Full article

(This article belongs to the Special Issue Stabilization and Resuscitation of Newborns: 2nd Edition)

► Show Figures

Figure 1

9 pages, 1045 KiB

Open AccessArticle

Is Obesity a Risk Factor for Loss of Reduction in Children with Distal Radius Fractures Treated Conservatively?

by Andrea Vescio, Gianluca Testa, Marco Sapienza, Alessia Caldaci, Marco Montemagno, Antonio Andreacchio, Federico Canavese and Vito Pavone

Children 2022, 9(3), 425; https://doi.org/10.3390/children9030425 - 17 Mar 2022

Cited by 8 | Viewed by 2703

Abstract

Background: Obesity in children is a clinical and social burden. The distal radius (DR) is the most common site of fractures in childhood and conservative treatment is widely used. Loss of reduction (LOR) is the major casting complication. The aim of this study [...] Read more.

Background: Obesity in children is a clinical and social burden. The distal radius (DR) is the most common site of fractures in childhood and conservative treatment is widely used. Loss of reduction (LOR) is the major casting complication. The aim of this study is to evaluate obesity as a risk factor for LOR in children with displaced DR fractures (DRF) treated conservatively. Methods: 189 children under 16 years of age were treated conservatively for DRF. Patients were divided into three groups: normal weight (NW), overweight (OW) and obese (OB). The following radiographic criteria were evaluated in all patients: amount of initial translation (IT); quality of initial reduction; Cast (CI), Padding (PI), Canterbury (CaI), Gap (GI) and Three-Points (3PI) indices and the presence of LOR. Results: Statistically significant differences were found between the NW and the OB group for number of LOR (p = 0.002), severity (grade) of initial translation (p = 0.008), quality of initial reduction (p = 0.01) as well as CsI and CaI (p < 0.001). Conclusions: Obese children have a significantly higher rate of LOR compared to NW and OW children. A close follow-up is necessary in this population of patients. Preventive percutaneous pinning could be considered in older obese patients in order to reduce the need for further treatment. Full article

(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)

► Show Figures

Figure 1

9 pages, 387 KiB

Open AccessArticle

Online Assessment of Motor, Cognitive, and Communicative Achievements in 4-Month-Old Infants

by Corinna Gasparini, Barbara Caravale, Valentina Focaroli, Melania Paoletti, Giulia Pecora, Francesca Bellagamba, Flavia Chiarotti, Serena Gastaldi and Elsa Addessi

Children 2022, 9(3), 424; https://doi.org/10.3390/children9030424 - 16 Mar 2022

Cited by 3 | Viewed by 2791

Abstract

Remote methods for data collection allow us to quickly collect large amounts of data, offering several advantages as compared to in-lab administration. We investigated the applicability of an online assessment of motor, cognitive, and communicative development in 4-month-old infants based on several items [...] Read more.

Remote methods for data collection allow us to quickly collect large amounts of data, offering several advantages as compared to in-lab administration. We investigated the applicability of an online assessment of motor, cognitive, and communicative development in 4-month-old infants based on several items of the Bayley Scales of Infant Development, 3rd edition (BSID-III). We chose a subset of items which were representative of the typical developmental achievements at 4 months of age and that we could administer online with the help of the infant’s caregiver using materials which were easily available at home. Results showed that, in a sample of infants tested live (N = 18), the raw scores of the BSID-III were significantly correlated with the raw scores of a subset of items corresponding to those administered to a sample of infants tested online (N = 53). Moreover, for the “online” participants, the raw scores of the online assessment did not significantly differ from the corresponding scores of the “live” participants. These findings suggest that the online assessment was to some extent comparable to the live administration of the same items, thus representing a viable opportunity to remotely evaluate infant development when in-person assessment is not possible. Full article

(This article belongs to the Special Issue Child Psychology: Typical and Atypical Development)

► Show Figures

Figure 1

13 pages, 1053 KiB

Open AccessArticle

Serious Games for Training Myoelectric Prostheses through Multi-Contact Devices

by Rosa M. Carro, Fernando G. Costales and Alvaro Ortigosa

Children 2022, 9(3), 423; https://doi.org/10.3390/children9030423 - 16 Mar 2022

Cited by 1 | Viewed by 2469

Abstract

In the medical context, designing and developing myoelectric prostheses has made it possible for patients to regain mobility lost due to amputations; however, their use requires intensive training. Serious games through multi-touch devices can serve as a complement to the activities carried out [...] Read more.

In the medical context, designing and developing myoelectric prostheses has made it possible for patients to regain mobility lost due to amputations; however, their use requires intensive training. Serious games through multi-touch devices can serve as a complement to the activities carried out during face-to-face sessions with occupational therapists and physiotherapists, as a useful resource to engage patients, especially children, and make them enjoy training. In this paper, we describe our work to support the training of myoelectric prostheses through digital serious games. Firstly, we studied the needs of children with myoelectric prostheses and the way they perform rehabilitation. Secondly, we designed specific games to support training accordingly. Thirdly, we developed a system able to generate variations of these games dynamically, adapting the elements at each round to the needs and progress of each child. The interfaces are simple, friendly, and based on tablets to favor autonomy. Finally, we assessed the potential of the use of these games for rehabilitation. Specialists in Physiotherapy, Occupational Therapy, Medicine and Special Education collaborated as experts; they agreed that SilverTouch is good for myoelectric prosthetic training and confirmed its potential to be widely used in this context. Full article

(This article belongs to the Special Issue Technological Innovation for the Evaluation and Intervention in Children with Functional Diversity)

► Show Figures

Figure 1

12 pages, 286 KiB

Open AccessArticle

Assessing the Association of Sodium, Potassium Intake and Sodium/Potassium Ratio on Blood Pressure and Central Adiposity Measurements amongst Ellisras Undernourished, Rural Children Aged 5–13 Years: South Africa

by Thato Tshepo Raphadu, Moloko Matshipi, Peter Modupi Mphekgwana and Kotsedi Daniel Monyeki

Children 2022, 9(3), 422; https://doi.org/10.3390/children9030422 - 16 Mar 2022

Cited by 4 | Viewed by 2069

Abstract

Background: Numerous studies have shown how diet, such as sodium (Na) and potassium (K) intake, is an important risk factor for non-communicable diseases (NCDs). This study aimed to assess the relationship between sodium intake, potassium intake; and sodium/potassium ratio with blood pressure (BP) [...] Read more.

Background: Numerous studies have shown how diet, such as sodium (Na) and potassium (K) intake, is an important risk factor for non-communicable diseases (NCDs). This study aimed to assess the relationship between sodium intake, potassium intake; and sodium/potassium ratio with blood pressure (BP) and abdominal obesity amongst Ellisras rural children. Method: In this cross-sectional study, data on dietary intake of sodium and potassium were collected using a 24-h recall questionnaire from a total of 765 participants, aged 5–13 years. Blood pressure and anthropometric measurements were also collected. Generalised linear models and Pearson correlation were conducted to assess the association of sodium intake, potassium intake; and their ratio with BP, waist circumference (WC), and waist-to-height ratio (WHtR). Results: In both age groups, less than 14.9% of males and 19.8% of females consumed above the recommended adequate intake (AI) of sodium. In addition, both age groups had more than 90% of males and females who consumed below the recommended AI of potassium. Moreover, the sodium/potassium ratio was above the WHO recommended level in more than 30% of males and females. The study found a significant, weak positive correlation of sodium intake with systolic BP (SBP), diastolic BP (DBP), and with WHtR. A significant, weak positive correlation was also found between sodium/potassium ratio and WHtR. In addition, a significant association was found between potassium intake and systolic BP. Conclusion: Although our study found a notable low average intake of sodium and potassium as compared to the recommended values. There was positive correlation found between sodium intake and BP. Furthermore, a positive correlation of sodium intake and sodium/potassium ratio with WHtR was also found. Full article

7 pages, 1714 KiB

Open AccessEditor’s ChoiceCase Report

Incidental Finding in Pre-Orthodontic Treatment Radiographs of an Aural Foreign Body: A Case Report

by Cinzia Maspero, Andrea Abate, Francesco Inchingolo, Claudia Dolci, Maria Grazia Cagetti and Gianluca Martino Tartaglia

Children 2022, 9(3), 421; https://doi.org/10.3390/children9030421 - 15 Mar 2022

Cited by 21 | Viewed by 3029

Abstract

The presence of foreign bodies in the external auditory canal of young patients may cause, if left untreated, severe permanent damage to the adjacent anatomical structures, and infections. A 10-year-old patient with an intellectual disability underwent orthodontic evaluation. An aural radiopaque finding was [...] Read more.

The presence of foreign bodies in the external auditory canal of young patients may cause, if left untreated, severe permanent damage to the adjacent anatomical structures, and infections. A 10-year-old patient with an intellectual disability underwent orthodontic evaluation. An aural radiopaque finding was visible in the lateral cephalogram and in the orthopantomography. The patient’s mother reported that her son never showed any ear discomfort, except for a mild hearing impairment that was never investigated. The patient was referred to an ear, nose and throat (ENT) specialist that removed the foreign body located in the left external auditory meatus. The careful evaluation of dental radiographs, including pre-orthodontic and interim orthodontic radiographs, may help to identify silent incidental findings that may otherwise lead to severe complications if left untreated. Full article

(This article belongs to the Special Issue Oral Health Related Quality of Life of Children)

► Show Figures

Figure 1

10 pages, 531 KiB

Open AccessArticle

Self-Efficacy, Optimism, and Academic Performance as Psychoeducational Variables: Mediation Approach in Students

by Pablo Usán, Carlos Salavera and Alberto Quílez-Robres

Children 2022, 9(3), 420; https://doi.org/10.3390/children9030420 - 15 Mar 2022

Cited by 15 | Viewed by 5542

Abstract

Background: During the various stages of education, adolescents undergo emotional and motivational experiences that can play key roles in their development. This study aims to analyse the relationship among academic self-efficacy, optimism, and academic performance. Methods: This study comprised 1852 adolescent (male, N [...] Read more.

Background: During the various stages of education, adolescents undergo emotional and motivational experiences that can play key roles in their development. This study aims to analyse the relationship among academic self-efficacy, optimism, and academic performance. Methods: This study comprised 1852 adolescent (male, N = 956, 51.61% and female, N = 896, 48.38%) aged 12–19 years (M = 14.77; SD = 1.80) from twelve secondary schools in Spain. The instruments used for the evaluation were the Academic Self-Efficacy Scale (ASES) and the Life Orientation Test—Revised (LOT-R); the students’ average marks were used to measure their academic performance. Results: The results of the study revealed significant correlations among self-efficacy, optimism and academic performance. Conclusions: These results emphasise the importance of academic self-efficacy as a mediating variable between the other two variables as well as its central role in the promotion of adaptive behaviours in the classroom, leading to adequate personal development, helping to prevent early school dropout and contributing to a more satisfactory academic experience. Full article

(This article belongs to the Special Issue Physical Education, Physical Activity, and Health Education in Children and Adolescents)

► Show Figures

Graphical abstract

16 pages, 291 KiB

Open AccessEditor’s ChoiceReview

Obstructive Sleep Apnea in Neonates

by Indira Chandrasekar, Mary Anne Tablizo, Manisha Witmans, Jose Maria Cruz, Marcus Cummins and Wendy Estrellado-Cruz

Children 2022, 9(3), 419; https://doi.org/10.3390/children9030419 - 15 Mar 2022

Cited by 16 | Viewed by 4305

Abstract

Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained [...] Read more.

Neonates have distinctive anatomic and physiologic features that predispose them to obstructive sleep apnea (OSA). The overall prevalence of neonatal OSA is unknown, although an increase in prevalence has been reported in neonates with craniofacial malformations, neurological disorders, and airway malformations. If remained unrecognized and untreated, neonatal OSA can lead to impaired growth and development, cardiovascular morbidity, and can even be life threatening. Polysomnography and direct visualization of the airway are essential diagnostic modalities in neonatal OSA. Treatment of neonatal OSA is based on the severity of OSA and associated co-morbidities. This may include medical and surgical interventions individualized for the affected neonate. Based on this, it is expected that infants with OSA have more significant healthcare utilization. Full article

(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)

5 pages, 801 KiB

Open AccessCase Report

Liver Resection Using Saline-Linked Radiofrequency Technology in an Infant with Congenital Hepatoblastoma

by Giovanni Torino, Michele Ilari, Edoardo Bindi, Francesca Mariscoli and Giovanni Cobellis

Children 2022, 9(3), 418; https://doi.org/10.3390/children9030418 - 15 Mar 2022

Cited by 1 | Viewed by 1757

Abstract

We herein report a case of giant congenital hepatoblastoma in a 3-month-old male treated with neoadjuvant chemotherapy and hepatic resection. After considerable reduction of the tumor with chemotherapy, a right bloodless hemihepatectomy using saline-linked radiofrequency technology (SLRT) and without clamping of the hepatic [...] Read more.

We herein report a case of giant congenital hepatoblastoma in a 3-month-old male treated with neoadjuvant chemotherapy and hepatic resection. After considerable reduction of the tumor with chemotherapy, a right bloodless hemihepatectomy using saline-linked radiofrequency technology (SLRT) and without clamping of the hepatic pedicle was performed. Intraoperative blood loss was minimal, and consequently, no blood transfusions were required. The surgery lasted 140 min, and SLRT was used for a total of 60 min. No complications were observed during or after the surgery. In conclusion, congenital hepatoblastoma is a very rare cancer for which surgery is an essential therapeutic step, and in our presented case, we showed that SLRT allowed for a safe and effective bloodless liver resection. Full article

(This article belongs to the Special Issue Surgical Management for Children with Primary Liver Tumors)

► Show Figures

Figure 1

11 pages, 1117 KiB

Open AccessEditor’s ChoiceReview

Treatment of Unspecific Back Pain in Children and Adolescents: Results of an Evidence-Based Interdisciplinary Guideline

by Michael Frosch, Stina Leinwather, Stefan Bielack, Susanne Blödt, Uta Dirksen, Michael Dobe, Florian Geiger, Renate Häfner, Lea Höfel, Bettina Hübner-Möhler, Thekla von Kalle, Burkhard Lawrenz, Andreas Leutner, Frauke Mecher, Kiril Mladenov, Heike Norda, Lorin Stahlschmidt, Marc Steinborn, Ralf Stücker, Ralf Trauzeddel, Regina Trollmann, Julia Wager and Boris Zernikow Show full author list Hide full author list

Children 2022, 9(3), 417; https://doi.org/10.3390/children9030417 - 15 Mar 2022

Cited by 11 | Viewed by 5521

Abstract

Using a structured approach and expert consensus, we developed an evidence-based guideline on the treatment and prevention of non-specific back pain in children and adolescents. A comprehensive and systematic literature search identified relevant guidelines and studies. Based on the findings of this literature [...] Read more.

Using a structured approach and expert consensus, we developed an evidence-based guideline on the treatment and prevention of non-specific back pain in children and adolescents. A comprehensive and systematic literature search identified relevant guidelines and studies. Based on the findings of this literature search, recommendations on treatment and prevention were formulated and voted on by experts in a structured consensus-building process. Physical therapy (particularly physical activity) and psychotherapy (particularly cognitive behavioral therapy) are recommended for treating pediatric non-specific back pain. Intensive interdisciplinary treatment programs should be provided for chronic and severe pain. Drug therapy should not be applied in children and adolescents. Further research on non-specific back pain in childhood and adolescence is strongly needed to reduce the imbalance between the high burden of non-specific back pain in childhood and adolescence and the low research activity in this field. Full article

(This article belongs to the Section Pediatric Anesthesiology, Perioperative and Pain Medicine)

► Show Figures

Figure 1

22 pages, 650 KiB

Open AccessReview

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

by Lidya-Olgu Durmaz, Susanne Eva Brunner, Andreas Meinzer, Thomas Franz Krebs and Robert Bergholz

Children 2022, 9(3), 416; https://doi.org/10.3390/children9030416 - 15 Mar 2022

Cited by 6 | Viewed by 3963

Abstract

(1) Background: The morbidity of gastroschisis is defined by exposure of unprotected intestines to the amniotic fluid leading to inflammatory damage and consecutive intestinal dysmotility, the viscero-abdominal disproportion which results in an abdomen too small to incorporate the herniated and often swollen intestine, [...] Read more.

(1) Background: The morbidity of gastroschisis is defined by exposure of unprotected intestines to the amniotic fluid leading to inflammatory damage and consecutive intestinal dysmotility, the viscero-abdominal disproportion which results in an abdomen too small to incorporate the herniated and often swollen intestine, and by associated pathologies, such as in complex gastroschisis. To prevent intestinal damage and to provide for growth of the abdominal cavity, fetal interventions such as amnio exchange, gastroschisis repair or covering have been evaluated in several animal models and human trials. This review aims to evaluate the reported techniques for the fetal treatment of gastroschisis by focusing on minimally invasive procedures. (2) Methods: We conducted a systematic database search, quality assessment and analyzed relevant articles which evaluate or describe surgical techniques for the prenatal surgical management of gastroschisis in animal models or human application. (3) Results: Of 96 identified reports, 42 eligible studies were included. Fetal interventions for gastroschisis in humans are only reported for EXIT procedures and amnio exchange. In animal models, particularly in the fetal sheep model, several techniques of open or minimally invasive repair of gastroschisis or covering the intestine have been described, with fetoscopic covering being the most encouraging. (4) Discussion: Although some promising minimally invasive techniques have been demonstrated in human application and animal models, most of them are still associated with relevant fetal morbidity and mortality and barely appear to be currently applicable in humans. Further research on specific procedures, instruments and materials is needed before any human application. Full article

(This article belongs to the Special Issue Current Development of Pediatric Minimally Invasive Surgery)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Children, Volume 9, Issue 3 (March 2022) – 147 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI