Journal of Clinical Medicine

Research

Jump to: Review

11 pages, 1003 KiB

Open AccessArticle

Umbilical Granuloma: Frequency, Associated Factors, 10-Year Treatment Trends, and Effectiveness at a Single Hospital in Japan

by Shigeo Iijima

J. Clin. Med. 2023, 12(18), 6104; https://doi.org/10.3390/jcm12186104 - 21 Sep 2023

Cited by 1 | Viewed by 1753

Abstract

Umbilical granuloma (UG) is a common problem during the neonatal period; however, its epidemiology and etiology are poorly studied, and the best treatment option has not yet been established. We examined the medical records of neonates who were born and underwent 1-month evaluations [...] Read more.

Umbilical granuloma (UG) is a common problem during the neonatal period; however, its epidemiology and etiology are poorly studied, and the best treatment option has not yet been established. We examined the medical records of neonates who were born and underwent 1-month evaluations at our hospital between 2013 and 2022 to investigate the frequency of—and factors associated with—UG, as well as the annual trends of UG treatments and their efficacy. Of the 6680 eligible neonates, 395 (5.9%) had UG. The annual incidence rate ranged from 3.8% to 7.3%. Gestational age, birth weight, and incidence of meconium-stained amniotic fluid were significantly associated with UG. Silver nitrate cauterization was the predominant UG treatment from 2013 to 2016. Silver nitrate cauterization and topical betamethasone valerate were nearly equally applied in 2017. Betamethasone application became predominant in 2018. The healing rates during the initial treatment period were 91% for silver nitrate cauterization, 97.7% for betamethasone application, 60% for ethanol disinfection, and 88% for ligation; these rates were significantly different (p < 0.001). Topical steroid application may be the most effective treatment. If steroid application is ineffective, then silver nitrate cauterization and ligation may be important treatment options. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

14 pages, 913 KiB

Open AccessArticle

Neurodevelopmental Outcome at Corrected Age of 2 Years among Children Born Preterm with Operative Vaginal Delivery: A Population-Based Study (LIFT Cohort)

by Guillaume Ducarme, Victoria Fosse, Valérie Rouger, Norbert Winer, Cyril Flamant and Marion Olivier

J. Clin. Med. 2023, 12(15), 4970; https://doi.org/10.3390/jcm12154970 - 28 Jul 2023

Cited by 1 | Viewed by 1011

Abstract

The aim of the study was to determine whether operative vaginal delivery (OVD) was associated with non-optimal neurocognitive development at the corrected age of 2 years for preterm singletons using the Loire Infant Follow-up Team (LIFT) longitudinal cohort, a French regional perinatal network [...] Read more.

The aim of the study was to determine whether operative vaginal delivery (OVD) was associated with non-optimal neurocognitive development at the corrected age of 2 years for preterm singletons using the Loire Infant Follow-up Team (LIFT) longitudinal cohort, a French regional perinatal network and prospective, population-based cohort of preterm infants. For this study, we included women with cephalic singletons and planned vaginal delivery from 24 to 34 weeks’ gestation between 2006 and 2016. The main exposure was the mode of delivery (spontaneous vaginal delivery (SVD), OVD, and cesarean delivery (CS) during labor). The primary outcome was non-optimal neurodevelopmental outcome at the corrected age of 2 years assessed by a physical examination, a neuropsychological test, and/or a parental questionnaire. Secondary outcomes were survival at discharge and survival at discharge without morbidity. We used the multivariate logistic regression and propensity score methods to compare outcomes associated with OVD. The study included 1934 infants born preterm: 1384 (71.6%) with SVD, 87 (4.5%) with OVD, and 463 (23.9%) with CS. Neonates with SVD, OVD, and CS did not differ in survival (97.0%, 97.7%, and 97.8%, respectively; p = 0.79) or in survival without morbidity (82.8%, 86.2%, and 82.7%, respectively; p = 0.71). In survived infants, 1578 (81.6%) were evaluated at age two: 279 (17.7%) were considered to have a non-optimal neurodevelopmental outcome (18.3% after SVD, 18.0% after OVD, and 15.9% after CS; p = 0.57). Propensity score analysis showed that OVD was not associated with non-optimal neurocognitive development at age two, with an adjusted odds ratio (aOR) of 0.86 and a 95% confidence interval (95% CI) of 0.47–1.69, compared with SVD; and an aOR of 0.76 and a 95% CI of 0.31–1.8, compared with CS. Operative vaginal delivery was not associated with non-optimal neurocognitive development at 2 years of corrected age for preterm singletons. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

28 pages, 8534 KiB

Open AccessArticle

Consistent Correlation between MTHFR and Vascular Thrombosis in Neonates—Case Series and Clinical Considerations

by Catalin Cirstoveanu, Nicoleta Calin, Carmen Heriseanu, Cristina Filip, Corina Maria Vasile, Irina Margarint, Veronica Marcu, Mihai Dimitriu, Liliana Ples, Sorin Tarnoveanu and Mihaela Bizubac

J. Clin. Med. 2023, 12(14), 4856; https://doi.org/10.3390/jcm12144856 - 24 Jul 2023

Viewed by 1797

Abstract

Background: MTHFR polymorphism has been inconsistently linked to thrombotic events—some studies have shown its contribution to venous thrombosis, arterial thrombosis, and ischemic stroke, whereas others have found no statistically significant correlation between them. Methods: A descriptive case series study was performed in the [...] Read more.

Background: MTHFR polymorphism has been inconsistently linked to thrombotic events—some studies have shown its contribution to venous thrombosis, arterial thrombosis, and ischemic stroke, whereas others have found no statistically significant correlation between them. Methods: A descriptive case series study was performed in the Neonatal Intensive Care Unit of “Marie Sklodowska Curie” Emergency Clinical Hospital for Children in Bucharest, Romania. Results: All patients had positive results for MTHFR variants; 14 patients were positive for compound heterozygosity, 13 patients for MTHFR C677T (seven of which were homozygous), and 13 patients for MTHFR A1298C (three of which were homozygous). Eighteen patients received anticoagulants (heparin, enoxaparin, or bivalirudin), and thrombolytics (alteplase) were administered in six cases. In one case, a thrombectomy was performed; in another, vascular plasty was undertaken. Only in six cases was complete revascularization possible. Incomplete revascularization occurred for one patient with a negative outcome. Conclusion: The particularity of this case series is that every patient in our unit who developed thrombi had a positive genetic result for MTHFR mutations. MTHFR mutations should be regarded as a thrombotic risk factor for critically ill patients, and screening for MTHFR mutations should be performed in every admitted patient to intensive care units, thus achieving the prevention of thrombi. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

11 pages, 426 KiB

Open AccessArticle

The Impact of Respiratory Symptoms on the Risk of Serious Bacterial Infection in Febrile Infants < 60 Days Old

by Kamal Masarweh, Lea Bentur, Ronen Bar-Yoseph, Imad Kassis, Halima Dabaja-Younis and Michal Gur

J. Clin. Med. 2023, 12(14), 4636; https://doi.org/10.3390/jcm12144636 - 12 Jul 2023

Cited by 1 | Viewed by 1190

Abstract

Objectives: We aimed to evaluate the impact of respiratory symptoms and positive viral testing on the risk of serious bacterial infections (SBIs). Methods: A retrospective study was conducted that included infants (0–60 days) presenting with a fever between 2001 and 2022 at a [...] Read more.

Objectives: We aimed to evaluate the impact of respiratory symptoms and positive viral testing on the risk of serious bacterial infections (SBIs). Methods: A retrospective study was conducted that included infants (0–60 days) presenting with a fever between 2001 and 2022 at a tertiary hospital in northern Israel. Demographic, clinical, and laboratory parameters were collected, and risk factors for SBIs were analyzed. Results: Data from a total of 3106 infants, including data from blood, urine, and CSF cultures, were obtained in 96.6%, 89%, and 29% of cases, respectively. A fever without respiratory symptoms (fever only) was present in 1312 infants, while 1794 had a fever and respiratory symptoms—427 were positive for a respiratory virus (virus+), 759 tested negative (virus−), and 608 were not tested. The SBI rate was 5.1% vs. 7.5% in the fever-and-respiratory group vs. the fever-only group (p = 0.004, OR = 0.65 (95% CI = 0.49–0.88)) and 2.8% vs. 7% in the virus+ vs. virus− group (p = 0.002, OR = 0.385, (95% CI = 0.203–0.728)). The male gender, an age < 1 month, leukocytosis > 15 × 10⁹/L, or a CRP > 2 mg/dL increased the risk of SBIs. Respiratory symptoms or a confirmed viral infection reduced the risk of SBIs in the presence of the above risk factors. Conclusions: Respiratory symptoms and a positive viral test decreased the risk of SBIs. Combining rapid viral testing with clinical variables may identify low-risk infants. Despite the relatively low risk of SBIs in individuals with viral infections, conducting prospective studies remains essential for accurately predicting the occurrence of these potentially life-threatening infections. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Graphical abstract

14 pages, 3736 KiB

Open AccessArticle

A Nomogram for Predicting Surgical Timing in Neonates with Necrotizing Enterocolitis

by Bo Shi, Leiting Shen, Wenchang Huang, Linghao Cai, Sisi Yang, Yuanyuan Zhang, Jinfa Tou and Dengming Lai

J. Clin. Med. 2023, 12(9), 3062; https://doi.org/10.3390/jcm12093062 - 23 Apr 2023

Cited by 7 | Viewed by 1826

Abstract

Objective: To explore the surgical risk variables in patients with necrotizing enterocolitis (NEC) and develop a nomogram model for predicting the surgical intervention timing of NEC. Methods: Infants diagnosed with NEC were enrolled in our study. We gathered information from clinical data, laboratory [...] Read more.

Objective: To explore the surgical risk variables in patients with necrotizing enterocolitis (NEC) and develop a nomogram model for predicting the surgical intervention timing of NEC. Methods: Infants diagnosed with NEC were enrolled in our study. We gathered information from clinical data, laboratory examinations, and radiological manifestations. Using LASSO (least absolute shrinkage and selection operator) regression analysis and multivariate logistic regression analysis, a clinical prediction model based on the logistic nomogram was developed. The performance of the nomogram model was evaluated using the receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). Results: A surgical intervention risk nomogram based on hypothermia, absent bowel sounds, WBC > 20 × 10⁹/L or < 5 × 10⁹/L, CRP > 50 mg/L, pneumatosis intestinalis, and ascites was practical, had a moderate predictive value (AUC > 0.8), improved calibration, and enhanced clinical benefit. Conclusions: This simple and reliable clinical prediction nomogram model can help physicians evaluate children with NEC in a fast and effective manner, enabling the early identification and diagnosis of children at risk for surgery. It offers clinical revolutionary value for the development of medical or surgical treatment plans for children with NEC. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

8 pages, 224 KiB

Open AccessArticle

Neonatal Pseudohypoaldosteronism Type-1 in Japan

by Kazumichi Fujioka, Ruka Nakasone, Kosuke Nishida, Mariko Ashina, Itsuko Sato and Kandai Nozu

J. Clin. Med. 2022, 11(17), 5135; https://doi.org/10.3390/jcm11175135 - 31 Aug 2022

Cited by 1 | Viewed by 1982

Abstract

(1) Background: Pseudohypoaldosteronism type 1 (PHA-1) is a disorder caused by renal tubular resistance to aldosterone and is characterized by problems with sodium regulation. PHA-1 is typically divided into primary PHA-1, which is caused by genetic mutation, and secondary PHA-1, which is associated [...] Read more.

(1) Background: Pseudohypoaldosteronism type 1 (PHA-1) is a disorder caused by renal tubular resistance to aldosterone and is characterized by problems with sodium regulation. PHA-1 is typically divided into primary PHA-1, which is caused by genetic mutation, and secondary PHA-1, which is associated with urinary tract abnormality. However, data on the clinical features of PHA-1 among newborn infants are limited. (2) Methods: We conducted a nationwide prospective surveillance study of neonatal PHA in Japan from 1 April 2019 to 31 March 2022 as part of a rare disease surveillance project of the Japan Society for Neonatal Health and Development. (3) Results: Fifteen cases (male:female = 7:8), including four primary, four secondary, and seven non-classified cases, were reported during the study period. The median gestational age and birthweight were 34 weeks (28–41) and 1852 g (516–4610), respectively. At the onset, the median serum Na and K levels were 132 mEq/L (117–137) and 6.3 mEq/L (4.7–8.3), respectively. The median plasma renin activity was 45 ng/mL/h (3.1–310, n = 9), active renin concentration was 1017 pg/mL (123–2909, n = 6), and serum aldosterone concentration was 5310 pg/mL (3250–43,700). (4) Conclusions: Neonatal PHA-1 was more common among preterm infants with no male predominance. It developed immediately after birth in cases without genetic or renal complications. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

11 pages, 1868 KiB

Open AccessArticle

Visceral Fat Area Measured by Abdominal Bioelectrical Impedance Analysis in School-Aged Japanese Children

by Yuriko Abe, Ryousuke Tonouchi, Mitsuhiko Hara, Tomoo Okada, Eric H. Jego, Tetsuya Taniguchi, Tsugumichi Koshinaga and Ichiro Morioka

J. Clin. Med. 2022, 11(14), 4148; https://doi.org/10.3390/jcm11144148 - 17 Jul 2022

Cited by 3 | Viewed by 2432

Abstract

Abdominal bioelectrical impedance analysis (aBIA) has been in use to measure visceral fat area (VFA) in adults. Accurately measuring visceral fat using aBIA in children is challenging. Forty-six school-aged Japanese children aged 6–17 years (25 boys and 21 girls) were included in this [...] Read more.

Abdominal bioelectrical impedance analysis (aBIA) has been in use to measure visceral fat area (VFA) in adults. Accurately measuring visceral fat using aBIA in children is challenging. Forty-six school-aged Japanese children aged 6–17 years (25 boys and 21 girls) were included in this study. All were measured, and their VFA obtained using aBIA (VFA-aBIA) and abdominal computed tomography (CT) (VFA-CT) were compared. VFA-aBIA was corrected using the Passing–Bablok method (corrected VFA-aBIA). The relationships between corrected VFA-aBIA and obesity-related clinical factors were analyzed, including non-alcoholic fatty liver disease (NAFLD) and serum leptin and adiponectin levels. Boys had higher VFA-CT than girls (p = 0.042), although no significant differences were found in their waist circumference, waist-to-height ratio, and body mass index. The corrected VFA-aBIA using y = 9.600 + 0.3825x (boys) and y = 7.607 + 0.3661x (girls) correlated with VFA-CT in both boys and girls. The corrected VFA-aBIA in patients with NAFLD was higher than that in those without NAFLD. Serum leptin and adiponectin levels were positively and negatively correlated with corrected VFA-aBIA, respectively. In conclusion, corrected VFA-aBIA was clearly correlated with VFA-CT and was related to NAFLD and serum leptin and adiponectin levels in school-aged Japanese children. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

11 pages, 977 KiB

Open AccessArticle

Variation of Complement Protein Levels in Maternal Plasma and Umbilical Cord Blood during Normal Pregnancy: An Observational Study

by Muna Saleh, Michele Compagno, Sofia Pihl, Helena Strevens, Barbro Persson, Jonas Wetterö, Bo Nilsson and Christopher Sjöwall

J. Clin. Med. 2022, 11(13), 3611; https://doi.org/10.3390/jcm11133611 - 22 Jun 2022

Cited by 4 | Viewed by 2348

Abstract

The complement system constitutes a crucial part of the innate immunity, mediating opsonization, lysis, inflammation, and elimination of potential pathogens. In general, there is an increased activity of the complement system during pregnancy, which is essential for maintaining the host’s defense and fetal [...] Read more.

The complement system constitutes a crucial part of the innate immunity, mediating opsonization, lysis, inflammation, and elimination of potential pathogens. In general, there is an increased activity of the complement system during pregnancy, which is essential for maintaining the host’s defense and fetal survival. Unbalanced or excessive activation of the complement system in the placenta is associated with pregnancy complications, such as miscarriage, preeclampsia, and premature birth. Nonetheless, the actual clinical value of monitoring the activation of the complement system during pregnancy remains to be investigated. Unfortunately, normal reference values specifically for pregnant women are missing, and for umbilical cord blood (UCB), data on complement protein levels are scarce. Herein, complement protein analyses (C1q, C3, C4, C3d levels, and C3d/C3 ratio) were performed in plasma samples from 100 healthy, non-medicated and non-smoking pregnant women, collected during different trimesters and at the time of delivery. In addition, UCB was collected at all deliveries. Maternal plasma C1q and C3d/C3 ratio showed the highest mean values during the first trimester, whereas C3, C4, and C3d had rising values until delivery. We observed low levels of C1q and C4 as well as increased C3d and C3d/C3 ratio, particularly during the first trimester, as a sign of complement activation in some women. However, the reference limits of complement analyses applied for the general population appeared appropriate for the majority of the samples. As expected, the mean complement concentrations in UCB were much lower than in maternal plasma, due to the immature complement system in neonates. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

13 pages, 1150 KiB

Open AccessArticle

Oral Valganciclovir Therapy in Infants Aged ≤2 Months with Congenital Cytomegalovirus Disease: A Multicenter, Single-Arm, Open-Label Clinical Trial in Japan

by Ichiro Morioka, Yasumasa Kakei, Takashi Omori, Kandai Nozu, Kazumichi Fujioka, Naoto Takahashi, Tetsushi Yoshikawa, Hiroyuki Moriuchi, Yoshinori Ito and Akira Oka

J. Clin. Med. 2022, 11(13), 3582; https://doi.org/10.3390/jcm11133582 - 21 Jun 2022

Cited by 20 | Viewed by 3619

Abstract

Our aims were to determine the clinical impact of oral valganciclovir (VGCV) in infants aged ≤2 months with congenital cytomegalovirus (CMV) disease and evaluate the efficacy of VGCV when initiated beyond the neonatal period. The multicenter, single-arm, open-label clinical trial was conducted in [...] Read more.

Our aims were to determine the clinical impact of oral valganciclovir (VGCV) in infants aged ≤2 months with congenital cytomegalovirus (CMV) disease and evaluate the efficacy of VGCV when initiated beyond the neonatal period. The multicenter, single-arm, open-label clinical trial was conducted in Japan. Twenty-five infants aged ≤2 months with congenital CMV disease involving the central nervous system were enrolled and treated with VGCV for 6 months. The primary endpoint was the change in the whole blood CMV load before and after treatment. The secondary endpoint was the change in the auditory brainstem response (ABR) before and after treatment. Changes in ABR were assessed between the younger and older age groups (≤ and >30 days at treatment initiation). Of the 25 patients, one was excluded owing to epilepsy before VGCV administration. The median change in the CMV DNA level in whole blood was −246.0 IU/mL. The best ear and total ear assessments based on ABR were categorized as (improved + unchanged) after treatment for 100% and 93.8%, respectively. No differences in hearing efficacy were observed between the younger and older age groups. Oral VGCV is a potential therapeutic option for treating infants aged ≤2 months with congenital CMV disease. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

8 pages, 485 KiB

Open AccessArticle

Neonatal Neuroimaging in Neonatal Intensive Care Graduates Who Subsequently Develop Cerebral Palsy

by Malcolm R. Battin, Sîan A. Williams, Anna Mackey, Woroud Alzaher, Alexandra Sorhage and N. Susan Stott

J. Clin. Med. 2022, 11(7), 1866; https://doi.org/10.3390/jcm11071866 - 28 Mar 2022

Viewed by 2674

Abstract

Cerebral palsy is a common cause of physical disability. The New Zealand Cerebral Palsy Register (NZCPR) was established in 2015 and reports national data. Internationally, an early CP diagnosis has been a focus, with imaging and clinical tools used to enable early accurate [...] Read more.

Cerebral palsy is a common cause of physical disability. The New Zealand Cerebral Palsy Register (NZCPR) was established in 2015 and reports national data. Internationally, an early CP diagnosis has been a focus, with imaging and clinical tools used to enable early accurate detection. Accordingly, guidelines are being developed for New Zealand, including a specific pathway for high-risk neonatal intensive care (NICU) graduates, reflecting the high rate of CP in this group. To inform this work, we reviewed imaging data from a retrospective NICU cohort identified from the NZCPR. In these 140 individuals with CP and a confirmed NICU admission during 2000–2019 inclusive, imaging frequency, modality, and rate of abnormality was determined. Overall, 114 (81.4%) had imaging performed in the NICU, but the frequency and modality used varied by gestational subgroup. For infants born at less than 32 weeks gestation, 53/55 had routine imaging with ultrasound, and IVH was graded as none or mild (grade 1–2) in 35 or severe (grade 3–4) in 18 infants. For the 34 infants born between 32–36 weeks gestation, only 13/19 imaged in the NICU were reported as abnormal. For 51 term-born infants, 41/42 imaged in the NICU with MRI had abnormal results. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

12 pages, 1425 KiB

Open AccessArticle

Cranial Shape in Infants Aged One Month Can Predict the Severity of Deformational Plagiocephaly at the Age of Six Months

by Hiroshi Miyabayashi, Nobuhiko Nagano, Risa Kato, Takanori Noto, Shin Hashimoto, Katsuya Saito and Ichiro Morioka

J. Clin. Med. 2022, 11(7), 1797; https://doi.org/10.3390/jcm11071797 - 24 Mar 2022

Cited by 7 | Viewed by 2573

Abstract

In this study, we aimed to monitor changes in cranial shape using three-dimensional (3D) scanning to determine whether the severity of deformational plagiocephaly (DP) at the age of 6 months could be predicted at the age of 1 month. The cranial shape was [...] Read more.

In this study, we aimed to monitor changes in cranial shape using three-dimensional (3D) scanning to determine whether the severity of deformational plagiocephaly (DP) at the age of 6 months could be predicted at the age of 1 month. The cranial shape was measured at the ages of 1, 3, and 6 months (T1, T2, and T3, respectively) in 92 infants. We excluded those who received helmet treatment before T3. The cranial vault asymmetry index (CVAI) using 3D scanning was evaluated in all infants. DP was defined as a CVAI > 5.0% with mild (CVAI ≤ 6.25%) or moderate/severe severity (CVAI > 6.25%). The CVAI cut-off value at T1 for severe DP at T3 was determined using receiver operating characteristic (ROC) curves. At T1, T2, and T3, the respective CVAI median values were 5.0%, 5.8%, and 4.7% and the DP incidence was 50.0%, 56.8%, and 43.2%, respectively. The DP severity temporarily worsened from T1 to T2 but then improved at T3. Among the infants, 73.9% had a similar DP severity at T1 and T3 (p = 1.0). A ROC curve analysis revealed a CVAI cut-off value of 7.8% at T1 predicted severe DP. It was concluded that later DP severity could be predicted using 3D scanning at T1 with properly defined cut-off values. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

9 pages, 1736 KiB

Open AccessArticle

Growth Trajectories during the First 6 Years in Survivors Born at Less Than 25 Weeks of Gestation Compared with Those between 25 and 29 Weeks

by Hiromichi Shoji, Yayoi Murano, Shuko Nojiri, Yoshiteru Arai, Kentaro Awata, Naho Ikeda, Natsuki Ohkawa, Naoto Nishizaki, Hiroki Suganuma, Ken Hisata, Masato Kantake, Kaoru Obinata and Toshiaki Shimizu

J. Clin. Med. 2022, 11(5), 1418; https://doi.org/10.3390/jcm11051418 - 4 Mar 2022

Cited by 2 | Viewed by 2090

Abstract

We aimed to determine the differences in the growth trajectories of the youngest gestational survivors (<25 weeks’ gestation) up to 6 years of age compared to those of older gestational ages. Preterm infants were divided into two groups: 22–24 weeks’ gestation (male (M) [...] Read more.

We aimed to determine the differences in the growth trajectories of the youngest gestational survivors (<25 weeks’ gestation) up to 6 years of age compared to those of older gestational ages. Preterm infants were divided into two groups: 22–24 weeks’ gestation (male (M) 16, female (F) 28) and 25–29 weeks’ gestation (M 84, F 59). Z-scores of body weight (BW), body length (BL), and body mass index (BMI) were derived from Japanese standards at 1, 1.5, 3, and 6 years of corrected age. Comparisons between the two groups by sex were made using the Wilcoxon test and linear regression analysis to examine the longitudinal and time-point associations of anthropometric z-scores, the presence of small for gestational age (SGA), and the two gestational groups. BW, BL, BMI, and z-scores were significantly lower in the 22–24 weeks group at almost all assessment points. However, there were no significant differences in BW, BL, BMI, and z-scores between the two female groups after 3 years. BMI z-scores were significantly associated with the youngest gestational age and the presence of SGA at all ages in males, but not in females. The youngest gestational age had a greater influence in males on the z-score of anthropometric parameters up to 6 years of age. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

7 pages, 498 KiB

Open AccessArticle

Relationship between Neonatal MRI Findings and Emotional/Behavioral Evaluation in Early Childhood for Extremely Low-Birth-Weight Infants

by Akinobu Taniguchi, Masahiro Hayakawa, Erina Kataoka, Naozumi Fujishiro and Yoshiaki Sato

J. Clin. Med. 2022, 11(3), 772; https://doi.org/10.3390/jcm11030772 - 31 Jan 2022

Viewed by 2435

Abstract

The aim of this study is to investigate whether it is possible to detect future behavioral and emotional problems in extremely low-birth-weight infants by evaluating the neonatal head magnetic resonance imaging (MRI) using a scoring system. This study included 62 extremely low-birth-weight infants [...] Read more.

The aim of this study is to investigate whether it is possible to detect future behavioral and emotional problems in extremely low-birth-weight infants by evaluating the neonatal head magnetic resonance imaging (MRI) using a scoring system. This study included 62 extremely low-birth-weight infants born between April 2015 and March 2017 and those who had undergone MRI at 36 to 42 weeks of gestation. These subjects were administered with the Strength and Difficulties Questionnaire (SDQ) at age 4–5, and the patients who responded to the questionnaire were included in the study. A positive correlation was observed between the Global Brain Abnormality Score and Total Difficulties Score of the SDQ (r = 0.26, p = 0.038). However, no significant difference was observed between the median Global Brain Abnormality Score of the normal and borderline-range group and the Total Difficulties Score of the clinical-range group (p = 0.51). This study demonstrated the relationship between the MRI findings in the newborn period and the emotional and behavioral problems in early childhood, but it is not clinically useful as a predictive marker. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

Review

Jump to: Research

12 pages, 1024 KiB

Open AccessReview

The Advanced Diabetes Technologies for Reduction of the Frequency of Hypoglycemia and Minimizing the Occurrence of Severe Hypoglycemia in Children and Adolescents with Type 1 Diabetes

by Tatsuhiko Urakami

J. Clin. Med. 2023, 12(3), 781; https://doi.org/10.3390/jcm12030781 - 18 Jan 2023

Cited by 9 | Viewed by 3242

Abstract

Hypoglycemia is an often-observed acute complication in the management of children and adolescents with type 1 diabetes. It causes inappropriate glycemic outcomes and may impair the quality of life in the patients. Severe hypoglycemia with cognitive impairment, such as a convulsion and coma, [...] Read more.

Hypoglycemia is an often-observed acute complication in the management of children and adolescents with type 1 diabetes. It causes inappropriate glycemic outcomes and may impair the quality of life in the patients. Severe hypoglycemia with cognitive impairment, such as a convulsion and coma, is a lethal condition and is associated with later-onset cognitive impairment and brain-structural abnormalities, especially in young children. Therefore, reducing the frequency of hypoglycemia and minimizing the occurrence of severe hypoglycemia are critical issues in the management of children and adolescents with type 1 diabetes. Advanced diabetes technologies, including continuous glucose monitoring and sensor-augmented insulin pumps with low-glucose suspension systems, can reduce the frequency of hypoglycemia and the occurrence of severe hypoglycemia without aggravating glycemic control. The hybrid closed-loop system, an automated insulin delivery system, must be the most promising means to achieve appropriate glycemic control with preventing severe hypoglycemia. The use of these advanced diabetes technologies could improve glycemic outcomes and the quality of life in children and adolescents with type 1 diabetes. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

9 pages, 1410 KiB

Open AccessReview

Clinical Developmental Cardiology for Understanding Etiology of Congenital Heart Disease

by Hiroyuki Yamagishi

J. Clin. Med. 2022, 11(9), 2381; https://doi.org/10.3390/jcm11092381 - 24 Apr 2022

Cited by 1 | Viewed by 7403

Abstract

Congenital heart diseases (CHD) result from abnormal development of the cardiovascular system and usually involve defects in specific steps or structural components of the developing heart and vessels. The determination of left–right patterning of our body proceeds by the steps involving the leftward [...] Read more.

Congenital heart diseases (CHD) result from abnormal development of the cardiovascular system and usually involve defects in specific steps or structural components of the developing heart and vessels. The determination of left–right patterning of our body proceeds by the steps involving the leftward “nodal flow” by motile cilia in the node and molecules that are expressed only on the left side of the embryo, eventually activating the molecular pathway for the left-side specific morphogenesis. Disruption of any of these steps may result in left–right patterning defects or heterotaxy syndrome. As for the outflow tract development, neural crest cells migrate into the cardiac outflow tract and contribute to form the septum of the outflow tract that divides the embryonic single truncus arteriosus into the aortic and the pulmonary trunk. Reciprocal signaling between neural crest cells and another population of myocardial precursor cells originated from the second heart field are essential for the steps of outflow tract development. To better understand the etiology of CHD, it is important to consider what kind of CHD is caused by abnormalities in each step during the complex development of the cardiovascular system. Full article

(This article belongs to the Special Issue Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Pathogenesis, Diagnostics, and Therapeutics in Neonatal and Pediatric Diseases: Prospective and Retrospective Clinical Studies

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (15 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI