Current Pediatric Reviews最新文献

{"title":"SARS-CoV-2 Encephalitis <i>versus</i> Influenza Encephalitis: More Similarities than Differences.","authors":"Kam L E Hon, Alexander K C Leung, Yok W Tan, Karen K Y Leung, Paul K S Chan","doi":"10.2174/1573396320666230821110450","DOIUrl":"10.2174/1573396320666230821110450","url":null,"abstract":"<p><strong>Background: </strong>From time to time, physicians face challenging diagnostic and therapeutic issues concerning the acute management of children with viral encephalitis.</p><p><strong>Objectives: </strong>The aim of this article is to provide an updated narrative review on the similarities and differences between SARS-CoV-2 and influenza encephalitis.</p><p><strong>Methods: </strong>A PubMed search was performed with the function \"Clinical Queries\" using the key terms \"SARS-CoV-2\" OR \"Influenza\" AND \"Encephalitis\". The search strategy included metaanalyses, clinical trials, randomized controlled trials, reviews and observational studies. The search was restricted to the English literature and pediatric population. This article compares similarities and contrasts between SARS-CoV-2 and influenza-associated encephalitis.</p><p><strong>Results: </strong>Encephalitis is an uncommon manifestation of both influenza and SARS-CoV-2. Both viruses are associated with fever and respiratory symptoms. However, SARS-CoV-2 patients may only have mild symptoms or be asymptomatic as silent carriers, rendering the disease spread difficult to control. Influenza patients usually have more severe symptomatology and are often bed bound for several days limiting its spread. Influenza is associated with seasonal and annual outbreaks, whereas SARS-CoV-2 has become endemic. Complications of encephalitis are rare in both viral infections but, when present, may carry serious morbidity and mortality. Many long-term sequelae of COVID- 19 infections (long COVID-19) have been described but not with influenza infections. Mortality associated with encephalitis appears higher with influenza than with SARS-CoV-2. Prophylaxis by immunization is available for both influenza and SARS-CoV-2. Specific efficacious antivirals are also available with oseltamivir for influenza and nirmatrelvir/ritonavir for SARS-CoV-2. Steroids are indicated with more severe SARS-CoV-2 but their role is not distinct in influenza disease.</p><p><strong>Conclusion: </strong>Encephalitis is a rare complication of influenza and SARS-CoV-2 infections. Both carry significant morbidity and mortality. Efficacious vaccines for prophylaxis and antivirals for treatment are available for both viruses.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"525-531"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10396058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological Therapies for Pediatric Atopic Dermatitis - A Review.","authors":"Giulia Milano, Stefano Forestieri, Micol Tedeschi, Amelia Licari, Valeria Brazzelli, Gian Luigi Marseglia","doi":"10.2174/1573396320666230912103136","DOIUrl":"10.2174/1573396320666230912103136","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is the most frequent chronic-recurrent inflammatory skin disease in the pediatric age. It has a complex and multifactorial pathogenesis: the two key actors are impaired skin barrier function and immune system dysregulation, which represent the main targets of AD therapy. Monoclonal antibodies have revolutionized the management of moderate-to-severe AD, by selective inhibition of key cytokines in the pathogenetic process. For this reason, there is great interest in exploring AD pathogenetic mechanisms to develop new therapeutic strategies. This review aims to summarize the most recent scientific evidence on available and future biological therapies for the treatment of pediatric AD, emphasizing the molecular mechanisms underlying their action.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"240-252"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do some Children Get Sick with Recurrent Respiratory Infections?","authors":"Fabio Cardinale, Francesco La Torre, Lucia Grazia Tricarico, Giuseppe Verriello, Carla Mastrorilli","doi":"10.2174/1573396320666230912103056","DOIUrl":"10.2174/1573396320666230912103056","url":null,"abstract":"<p><p>Respiratory tract infections (RTI) represent a frequent condition, particularly among preschool children, with an important burden on the affected children and their families. It has been estimated that recurrent RTIs affect up to 25% of children during the first 4 years of life. These infections are mainly caused by viruses and are generally self-limiting. Social and environmental factors have been studied in determining the incidence of recurrent RTIs and the mostly recognized are precocious day care attendance, tobacco exposure and pollution. Primary immune defects, local anatomical factors, and genetic disorders such as primary ciliary dyskinesia or cystic fibrosis, may be also involved in recurrent RTIs of a subgroup of children, typically characterized by more severe and chronic symptoms. However, there is increasing awareness that RTIs have a complex pathophysiology and that some underrecognized factors, including genetic susceptibility to infections, low levels of some micronutrients, and respiratory microbiota might shape the probability for the child to develop RTIs. The sum (i.e. the number) of these factors may help in explaining why some children get sick for RTIs whilst other not. In some children iatrogenic factors, including improper use of antibiotics and NSAIDS or glucocorticoids might also aggravate this condition, further weakening the host's immune response and the possibly of establishing a \"vicious circle\". The present review aims to focus on several possible factors involved in influencing RTIs and to propose a unifying hypothesis on pathophysiological mechanisms of unexplained recurrent RTIs in children.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"203-215"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Factors Associated with Glycemic Control in Children and Adolescents with Type 1 Diabetes.","authors":"Sara Zakarneh, Yasmin Khial, Reema Tayyem","doi":"10.2174/1573396320666230822095948","DOIUrl":"10.2174/1573396320666230822095948","url":null,"abstract":"<p><p>Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that results from the autoimmune destruction of pancreatic β-cells, leading to insulin deficiency and hyperglycemia. It is a common chronic disease in childhood, with a prevalence of 1 in 300 children in the United States and an increasing incidence of 2-5% annually, worldwide. Managing T1DM requires regular insulin administration, adjustment of food intake and exercise, and a comprehensive understanding of nutrition. This review aims to explore the relationship between dietary factors, physical activity, obesity, genetics, and glycemic control in children and adolescents with T1DM. To conduct this review, we conducted a thorough search of publications from December 2004 through April 2022 using PubMed, ScienceDirect, and Embase databases. Key topics included obesity, children, adolescents, nutrients, carbohydrates, proteins, fat, water-soluble vitamins, fat-soluble vitamins, dietary patterns, fruits and vegetables, physical activity, genetics, food habits, carbohydrate count and environmental factors.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"29-39"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10426420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Riga-fede Disease in a Healthy 7-month-old Child: A Case Report.","authors":"Priyanshi Ritwik","doi":"10.2174/1573396320666230830125111","DOIUrl":"10.2174/1573396320666230830125111","url":null,"abstract":"<p><strong>Background: </strong>Riga-Fede disease (RFD) presents as oral mucosal ulceration in anatomical juxtaposition to sharp dental surfaces.</p><p><strong>Case presentation: </strong>A 7-month-old healthy male presented to the pediatric dentist for an emergency appointment. His mother was concerned about episodic, recurrent, and excessive bleeding from his mouth for three weeks. She reported that her son would often wake up in \"a pool of blood\". The pediatrician assessed the patient when oral bleeding first started and prescribed magic mouthwash. This did not resolve the problem. The mother then took the child to an urgent care clinic, where she was referred to a pediatric dentist. The pediatric dentist noted a sublingual traumatic, granulomatous ulcer on the ventral surface of the tongue, extending up to the tip of the tongue. The mandibular primary central incisors had recently erupted. The pediatric dentist established a clinical diagnosis of RFD. Incisal edges were smoothened with dental polishing tips on a slow-speed handpiece and topical fluoride varnish was applied to the teeth. The size of the ulceration decreased over two weeks. However, in three weeks, there was another bleeding episode. The pediatric dentist smoothened the incisal edges again, followed by a fluoride varnish application. Eight weeks after the initial dental intervention, the lesion resolved completely without further bleeding.</p><p><strong>Discussion: </strong>The details of this case report highlight the maternal concerns, interprofessional educational touchpoints, scope for interprofessional collaborative care, and noninvasive management of Riga-Fede disease.</p><p><strong>Conclusion: </strong>In neurotypical patients, conservative dental management by smoothening sharp dental surfaces can resolve RFD. RFD should be differentiated from viral illnesses which present with oral ulcerations.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"80-84"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Allergic Rhinitis in Clinical Practice.","authors":"Maria Angela Tosca, Chiara Trincianti, Matteo Naso, Valentina Nosratian, Giorgio Ciprandi","doi":"10.2174/1573396320666230912103108","DOIUrl":"10.2174/1573396320666230912103108","url":null,"abstract":"<p><p>Allergic rhinitis is a prevalent condition among children, with its occurrence reaching up to 40% of the general population in some geographical areas. A type 2 immunity sustains allergic rhinitis. Consequently, type 2 inflammation leads to eosinophilic infiltrate of the nasal mucosa. Allergic inflammation causes the symptom occurrence. Typical nasal symptoms include nasal itching, sneezing, watery rhinorrhea, and nasal congestion. Nasal congestion depends on vasodilation and increased mucus production. These conditions result in nasal obstruction. Nasal obstruction is closely associated with type 2 inflammation. Allergic rhinitis usually occurs in association with other allergic conditions, in particular allergic conjunctivitis and asthma. The effective management of allergic rhinitis involves avoiding triggering allergens and employing pharmacological treatments as per ARIA guidelines. These treatments may include intranasal/oral antihistamines or/and nasal corticosteroids. In particular, antihistamines are particularly indicated for symptoms consequent to mediators' release, mainly concerning histamine. These histamine-dependent symptoms include itching, sneezing, and rhinorrhea. Nasal obstruction, being associated with inflammation, is responsive to corticosteroids, administered mostly intranasally. The fixed combination of a topical antihistamine plus a topical corticosteroid is very effective, but is indicated for adolescents only. However, nasal lavage is safe, cheap, and adequate, thus its use is prevalent. Namely, nasal lavage allows to remove secretions, allergens, mediators. In addition, hypertonic solutions exert a decongestant activity. On the other hand, the allergen-specific immunotherapy is still the only causal treatment. Nutraceuticals have also been used to relieve symptoms. The objective of this review is to explore and compare the traditional and new therapeutic approaches for pollen-induced allergic rhinitis in children.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"271-277"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipidomics and Metabolomics in Infant Atopic Dermatitis: What's the Correlation with Early Nutrition?","authors":"Angelica Dessì, Camilla Di Maria, Roberta Pintus, Vassilios Fanos, Alice Bosco","doi":"10.2174/1573396320666230411093122","DOIUrl":"10.2174/1573396320666230411093122","url":null,"abstract":"<p><p>To date, the complex picture of atopic dermatitis (AD) has not yet been fully clarified, despite the important prevalence of this disease in the pediatric population (20%) and the possibility of persistence into adulthood, with important implications for the quality of life of those affected, as well as significant social and financial costs. The most recent scientific evidence suggests a new interpretation of AD, highlighting the important role of the environment, particularly that of nutrition in the early stages of development. In fact, the new indications seem to point out the harmful effect of elimination diets, except in rare cases, the uselessness of chrono-insertions during complementary feeding and some benefits, albeit weak, of breastfeeding in those at greater risk. In this context, metabolomics and lipidomics can be necessary for a more in-depth knowledge of the complex metabolic network underlying this pathology. In fact, an alteration of the metabolic contents in children with AD has been highlighted, especially in correlation to the intestinal microbiota. While preliminary lipidomic studies showed the usefulness of a more in-depth knowledge of the alterations of the skin barrier to improve the development of baby skin care products. Therefore, investigating the response of different allergic phenotypes could be useful for better patient management and understanding, thus providing an early intervention on dysbiosis necessary to regulate the immune response from the earliest stages of development.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"510-524"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Membrane Oxygenation (ECMO) in an Infant with COVID-19: A Case Report with Literature Review.","authors":"Raffaele Falsaperla, Marco Simone Vaccalluzzo, Ausilia Desiree Collotta, Martino Ruggieri, Salvatore Agati","doi":"10.2174/1573396320666230417103203","DOIUrl":"10.2174/1573396320666230417103203","url":null,"abstract":"<p><strong>Background: </strong>SARS-CoV-2 infection tends to be lethal to the elderly population. However, sometimes children are also involved.</p><p><strong>Case presentation: </strong>We present the case of a female infant with a corrected gestational age of 39 weeks and 4 days with severe COVID-19 pneumonia and co-infection of <i>Klebsiella pneumoniae</i> that was supported with extracorporeal membrane oxygenation (ECMO).</p><p><strong>Results: </strong>We reported the clinical case and reviewed the literature articles on ECMO and Covid-19 in infants and children up to two years of age.</p><p><strong>Conclusion: </strong>It is crucial to be aware of certain risk factors (severe prematurity, coinfection), which, when linked to SARS-CoV-2 infection, must immediately alert us to the possible criticality of the clinical condition of patients, as highlighted by our own clinical case.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"370-374"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of ToRCH Pathogens among Children Admitted to a Tertiary Care Hospital in Eastern India for Cataract Surgery and Cochlear Transplantation.","authors":"Abhilipsa Patra, Sucheta Parija, Pradipta K Parida, Sanjay Kumar Behera, Amit Ghosh","doi":"10.2174/1573396319666230210094333","DOIUrl":"10.2174/1573396319666230210094333","url":null,"abstract":"<p><strong>Aims: </strong>The study aims to investigate the presence of TORCH infections in a child with bilateral cataracts and deafness and report the ToRCH-serology screening profile (Toxoplasma gondii (TOX), rubella (RV), cytomegalovirus (CMV), and herpes simplex virus (HSV-I/II)) in pediatric cataract and deafness.</p><p><strong>Methods: </strong>Cases that had a clear clinical history of congenital cataracts and congenital deafness were included in the study. The study population consisted of 18 bilateral cataracts and 12 bilateral deafness child who was admitted to AIIMS Bhubaneswar for cataract surgery and cochlear implantation, respectively. Sera of all children were tested qualitatively and quantitatively for IgG/IgM-antibodies against ToRCH agents in a sequential manner.</p><p><strong>Results: </strong>Anti-IgG antibodies against the torch panel were detected in all cataract and deafness patients. Anti-CMV IgG was detected in 17 of 18 bilateral cataract children and 11 of 12 bilateral deaf children. The rates of anti-CMV IgG antibody positivity were significantly higher. In the cataract group, 94.44% and in the deafness group, 91.66% of the patient was Anti-CMV IgG positive. Besides this, 77.7 % of the patient from the cataract group and 75% from the deafness group was anti- RV IgG antibody positive. In bilateral cataract patients, IgG-alone seropositive cases were mostly attributed to CMV (94.44%; 17/18), followed by RV (77.70%; 14/18), HSV-I (27.70%; 5/18), TOX (27.70%; 5/18), and HSV-II (16.60%; 3/18). In bilateral deafness patients, the spectrum of IgG alone seropositive cases was almost the same except for TOX (0/12).</p><p><strong>Conclusion: </strong>The current study recommends interpreting ToRCH-screening in pediatric cataracts and deafness with caution. Interpretation should include both serial qualitative and quantitative assays in tandem with clinical correlation to minimize diagnostic errors. The sero-clinical-positivity needs to be tested in older children who might pose a threat to the spread of infection.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"365-369"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10747785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multidisciplinary and a Comprehensive Approach to Reducing Fragility Fractures in Preterm Infants.","authors":"Saif Al Saif, Mohammad Maghoula, Amir Babiker, Mashael Abanmi, Fiona Nichol, Modhi Al Enazi, Elenor Guevarra, Faisal Sehlie, Hesham Al Shaalan, Zulf Mughal","doi":"10.2174/1573396319666221221122013","DOIUrl":"10.2174/1573396319666221221122013","url":null,"abstract":"<p><p>With advances in neonatal care, bone fractures prior to discharge from the hospital in preterm infants receiving contemporary neonatal care, are rare. Nevertheless, such fractures do occur in very low birth weight and extremely low birth weight infants who go on to develop metabolic bone disease of prematurity (MBDP), with or without secondary hyperparathyroidism. MBDP is a multifactorial disorder arising from the disruption of bone mass accrual due to premature birth, postnatal immobilisation, and loss of placental oestrogen resulting in bone loss, inadequate provision of bone minerals from enteral and parenteral nutrition, and medications that leach out bone minerals from the skeleton. All of these factors lead to skeletal demineralisation and a decrease in bone strength and an increased risk of fractures of the long bones and ribs. Secondary hyperparathyroidism resulting from phosphate supplements, or enteral/parenteral feeds with a calcium-tophosphate ratio of < 1.3:1.0 leads to subperiosteal bone resorption, cortical thinning, and further skeletal weakening. Such fractures may occur from routine handling and procedures such as cannulation. Most fractures are asymptomatic and often come to light incidentally on radiographs performed for other indications. In 2015, we instituted a comprehensive and multidisciplinary Neonatal Bone Health Programme (NBHP), the purpose of which was to reduce fragility fractures in highrisk neonates, by optimising enteral and parenteral nutrition, including maintaining calcium-tophosphate ratio ≥1.3:1, milligram to milligram, biochemical monitoring of MBDP, safe-handling of at-risk neonates, without compromising passive physiotherapy and skin-to-skin contact with parents. The at-risk infants in the programme had radiographs of the torso and limbs at 4 weeks and after 8 weeks from enrolment into the program or before discharge. Following the introduction of the NBHP, the bone fracture incidence reduced from 12.5% to zero over an 18-month period.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":" ","pages":"434-443"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10781160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}