Children-Basel最新文献

{"title":"Improving Postoperative Pediatric Recovery by Efficient Recovery Room Care-A Comprehensive Review.","authors":"Lisa Korell, Frank Fideler","doi":"10.3390/children12050568","DOIUrl":"https://doi.org/10.3390/children12050568","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Efficient postoperative recovery room care in pediatric patients is crucial for optimizing perioperative safety, patient outcome, and effective pain management. However, this area is frequently underemphasized, leading to higher complication rates compared to the operating room, which in turn increases healthcare costs. Improving pediatric recovery room care offers a significant opportunity to enhance the quality and safety of perioperative pediatric care. From an economic perspective, this is prudent; however, more importantly, every child has the right to the highest attainable standard of health, as outlined by the United Nations. Key aspects of recovery room care include ensuring adequate staffing and equipment, while also prioritizing the child's privacy and parental presence, both of which are crucial for enhancing patient well-being. A +multimodal approach to postoperative pain management is essential for minimizing fear and stress, alongside strict adherence to established guidelines for the management of postoperative nausea, vomiting, and emergence delirium. Furthermore, addressing risk factors such as hypothermia and airway complications, as well as promoting early intake of clear fluids, plays a crucial role in optimizing pediatric recovery. Organizational strategies such as quality improvement initiatives, structured handovers, standardized care protocols with checklists, continuous staff training, and well-defined discharge criteria are further essential components to reduce translational gaps and to enhance postoperative pediatric safety. <b>Conclusions</b>: Improving pediatric postoperative anesthetic care is a multifaceted challenge for all healthcare providers that can significantly enhance care quality and safety while also reducing costs. Success in this area requires addressing both structural and medical factors.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-2 Receptor as a Marker of Oxidative Stress in Paediatric Patients with Chronic Kidney Disease or Hypertension.","authors":"Nataša Marčun Varda, Mirjam Močnik, Martina Filipič, Evgenija Homšak, Mateja Svetej, Sonja Golob Jančič","doi":"10.3390/children12050569","DOIUrl":"https://doi.org/10.3390/children12050569","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Oxidative stress and systemic inflammation are significant contributors to the development and progression of cardiovascular disease, causing adverse effects on vascular health and atherosclerosis from an early age. Patients with established cardiovascular risk factors commonly exhibit markers indicating heightened oxidative stress and inflammation. Our study sought to assess the levels of interleukin-2 receptor, which could serve as an early indicator of cardiovascular damage due to oxidative stress and inflammation in at-risk children. <b>Methods</b>: The study comprised 46 paediatric patients with chronic kidney disease, 50 paediatric patients with hypertension, and 33 healthy controls. Anthropometric measurements, pulse wave velocity, body composition, routine laboratory tests, and measurements of interleukin-2 receptor levels were conducted for all participants. <b>Results</b>: Interleukin-2 receptor levels were notably lower in patients with hypertension (<i>p</i> < 0.001) and those with overweight/obesity (<i>p</i> < 0.001) with several associated measures. Interleukin-2 receptor levels exhibited significant negative correlations with various anthropometric measurements, body composition, and liver damage and a positive correlation with kidney function tests. <b>Conclusions</b>: Children diagnosed with hypertension or obesity exhibited notably lower interleukin-2 receptor levels.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchiolitis: A Real-Life Report of Increasing Compliance to Treatment Guidelines.","authors":"Melodie O Aricò, Francesco Accomando, Daniela Trotta, Anthea Mariani, Claudia Rossini, Claudio Cafagno, Letizia Lorusso, Enrico Valletta, Desiree Caselli, Maurizio Aricò","doi":"10.3390/children12050571","DOIUrl":"https://doi.org/10.3390/children12050571","url":null,"abstract":"<p><strong>Background: </strong>Bronchiolitis accounts for a substantial number of pediatric hospitalizations and its epidemiology closely parallels that of respiratory syncytial virus (RSV), its principal etiological agent. International guidelines recommend supportive therapy based primarily on oxygen supplementation and hydration.</p><p><strong>Methods: </strong>This study aimed to assess, across three pediatric wards, the impact of internal monitoring and targeted educational interventions on adherence to bronchiolitis management guidelines. Focus was placed on evaluating the effectiveness of tailored strategies in enhancing the appropriateness of treatment practices. Each center independently developed an audit and feedback strategy aligned with local practices and available resources. In Center 1, monthly staff meetings included guideline refreshers throughout the epidemic season. Center 2 appointed two attending physicians to monitor treatment prescriptions and report deviations. Center 3 established an internal protocol through staff consensus, followed by monthly review sessions. In this retrospective analysis, all consecutive patients admitted with bronchiolitis during the winter seasons of 2022-2023 and 2023-2024 (Period 2) were compared with those admitted in 2021-2022 (Period 1).</p><p><strong>Results: </strong>A total of 623 infants under 24 months of age were included, 451 (72%) of whom tested positive for RSV. Their median length of hospital stay was 6 days; 26 infants (4%) required intensive care, and no deaths were recorded. A comparative analysis of the treatment modalities used-high-flow nasal cannula (HFNC) oxygen therapy, inhaled medications, corticosteroids, and antibiotics-revealed a reduced use of non-recommended therapies (e.g., nebulized β2-agonists, steroids, and antibiotics) in Period 2, alongside heterogeneous patterns in HFNC use. Center-specific strategies, tailored to team dynamics and resource availability, effectively promoted greater adherence to evidence-based guidelines.</p><p><strong>Conclusions: </strong>Our findings suggest that structured internal interventions can lead to more appropriate bronchiolitis management and the improved standardization of care.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered Brain Functional Connectivity and Topological Structural in Girls with Idiopathic Central Precocious Puberty: A Graph Theory Analysis Based on Resting-State fMRI.","authors":"Lu Tian, Yan Zeng, Helin Zheng, Jinhua Cai","doi":"10.3390/children12050565","DOIUrl":"https://doi.org/10.3390/children12050565","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate changes in brain functional connectivity (FC) and topological structure in girls with idiopathic central precocious puberty (ICPP) using complex network theory analysis.</p><p><strong>Methods: </strong>Resting-state fMRI data from 53 ICPP girls (ages 6-8) and 51 controls were analysed. Graph theory was used to construct whole-brain functional networks, identify topological differences, and assess the relationship between sex hormone levels and network properties in regions with group differences.</p><p><strong>Results: </strong>RS-FC analysis revealed reduced connectivity in cognitive and emotional regulation regions in the ICPP group (<i>p</i> < 0.05), but enhanced connectivity in emotional perception and self-regulation areas, such as the amygdala and insula (<i>p</i> < 0.05), suggesting a compensatory mechanism. Graph theory showed that ICPP girls' brain networks maintained small-world properties (γ > 1, λ ≈ 1, σ > 1). Local topological changes included decreased clustering and node efficiency in cognitive and emotional regulation regions, like the superior frontal gyrus and praecuneus (<i>p</i> < 0.05), while emotional regulation regions (amygdala, insula) showed increased clustering and node efficiency (<i>p</i> < 0.05), indicating compensation.</p><p><strong>Conclusions: </strong>This study highlights compensatory mechanisms in emotional regulation that may offset impairments in cognitive regions, offering new insights into ICPP's neural mechanisms.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Approaches to Addressing Sleep Deprivation and Improving Sleep Health in Japan: Sleep Issues Among Children and Adolescents Rooted in Self-Sacrifice and Asceticism.","authors":"Jun Kohyama","doi":"10.3390/children12050566","DOIUrl":"https://doi.org/10.3390/children12050566","url":null,"abstract":"<p><p>This narrative review examines the issue of sleep deprivation among children and adolescents in Japan, exploring its cultural origins and evaluating the current state of sleep education and interventions. It emphasizes the profound influence of the Bushidō spirit, with its focus on self-sacrifice and asceticism, as a core factor in the undervaluation of sleep in Japanese society. While educational initiatives and interventions highlighting the importance of sleep exist, significant limitations remain in improving sleep habits. Sleep deprivation continues to affect children and adolescents, despite its considerable impact on mental health and academic performance. This review presents a method for personalized sleep duration estimation and assesses its potential impact on improving sleep health by using optimal sleep duration calculations. The review also proposes practical steps to improve sleep duration through individualized strategies, integrating cultural context to mitigate the serious health risks associated with insufficient sleep. Ultimately, it underscores the need for targeted strategies to improve sleep among children and adolescents-particularly through personalized optimal sleep duration estimation-while advocating for a shift in cultural perspective beyond self-sacrifice and asceticism. The review highlights the importance of cultural transformation and suggests future research directions and practical applications.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Options for Regenerative Treatment with Bone Grafts in Children with Anterior Lip/Palate Cleft-A Review.","authors":"Anna Miguel-Escribano, Cosimo Galletti, Juan de Quixano-Bardaji, Francisco Real-Voltas, Luca Fiorillo, Maria Cuevas-Nunez, Fulvia Galletti, Javier Flores-Fraile","doi":"10.3390/children12050559","DOIUrl":"https://doi.org/10.3390/children12050559","url":null,"abstract":"<p><p>Anterior lip/palate cleft is a congenital deformity affecting the upper lip and palate, posing significant challenges in both aesthetic and functional aspects for children. Effective management of this condition is crucial for improving quality of life and ensuring normal development. This review aims to highlight the regenerative treatment options available for children with anterior lip/palate cleft, focusing on the use of bone grafts and other advanced dental procedures. A review of the current literature and clinical practices was conducted to identify and evaluate the most effective treatment options. Emphasis was placed on regenerative techniques, particularly the use of bone grafts. Advancements in regenerative dentistry offer promising outcomes for children with anterior lip/palate cleft. Bone grafts, combined with innovative techniques such as growth factors, stem cell therapy, and distraction osteogenesis, provide effective solutions for restoring function and aesthetics. A multidisciplinary approach is essential to ensure comprehensive care and optimal results for these patients.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthodontic Management of Class II Malocclusion with Clear Aligners: Mandibular Advancement vs. Class II Elastics.","authors":"Elisabetta Cretella Lombardo, Letizia Lugli, Roberta Lione, Patrizio Bollero, Paola Cozza, Chiara Pavoni","doi":"10.3390/children12050562","DOIUrl":"https://doi.org/10.3390/children12050562","url":null,"abstract":"<p><p><b>Background</b>: This cephalometric study aimed to evaluate the effects of clear aligner therapy in growing individuals with Class II malocclusion, comparing two functional approaches: the use of Class II elastics or the Mandibular Advancement (MA). <b>Methods</b>: Cephalometric data from 39 patients with Class II malocclusion treated using clear aligners either combined with Class II elastics (EL group; n = 18) or Mandibular Advancement (MA group; n = 21) were analyzed and compared with an untreated control group (UC2; n = 15). <b>Results</b>: Both treatment groups (EL and MA) showed a significant reduction in the ANB angle compared to the control (MA: -1.5°; EL: -2.2°; UC2: +0.2°). An increase in mandibular length, as measured by Co-Gn, was observed in both the EL and MA groups (+5.5 mm and +8.3 mm, respectively) relative to the control group. Soft tissue analysis of the Pg-TVL distance from T1 to T2 revealed the most substantial forward displacement of the chin in the MA group (MA: +2.0 ± 3.7 mm; EL: +0.5 ± 0.7 mm; UC2: -1.6 ± 3.3 mm). Vertically, the MA group exhibited a more marked decrease in the palatal-mandibular plane angle than the other groups. Both treatment modalities significantly reduced overjet and overbite from T1 to T2. <b>Conclusions</b>: The EL and MA appliances effectively advanced the mandible, leading to significant improvements in the sagittal relationship, overjet, and overbite while maintaining stable vertical control. Additionally, the MA group exhibited a more pronounced forward movement of the soft tissue chin.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological and Academic Performance in Colombian Children with Attention-Deficit Hyperactivity Disorder: A Comparative Study with a Control Group.","authors":"Daniel Landínez-Martínez, Diana Montoya-Londoño, Lorena Aguirre-Aldana, Carmen Dussán-Lubert, Carolina Robledo-Castro, Antonio Partida-Gutierrez de Blume","doi":"10.3390/children12050561","DOIUrl":"https://doi.org/10.3390/children12050561","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to determine the effect of ADHD on the neuropsychological and academic performance of a sample of Colombian children in primary and secondary education compared to a control group. <b>Method:</b> Quasi-experimental research design involving a sample of 194 children from Manizales, of whom 97 were diagnosed with ADHD and 97 were typically developing children. The study utilized tasks from the Child Neuropsychological Assessment (ENI) protocol to assess academic and neuropsychological performance. <b>Results:</b> Children with ADHD exhibited lower cognitive, linguistic, and attentional performance with greater variability than their neurotypical peers. They showed deficits in IQ, metalinguistic skills, reading, writing, memory, attention, and executive function, with increased errors and heterogeneity across tasks. <b>Conclusions:</b> For future research, it is necessary to address ADHD through mixed-methods studies that enrich quantitative findings with the lived experiences of children and families affected by ADHD. Additionally, further exploration is needed regarding functional impairment assessment in the Colombian and broader Ibero-American context, including its correlation with later academic performance in higher education.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel <i>KIF11</i> Mutation Associated with Microcephaly, Chorioretinopathy and Impaired Intellectual Development: 20 Years of Follow-Up.","authors":"Ashley H Yaskanich, Ami Patel, Monique Leys","doi":"10.3390/children12050560","DOIUrl":"https://doi.org/10.3390/children12050560","url":null,"abstract":"<p><p><b>Background:</b><i>KIF11</i> mutations are responsible for a large portion of microcephaly with or without chorioretinopathy, lymphedema or impaired intellectual development (MCLMR). <b>Methods</b>: This report describes longitudinal ophthalmological management of an 8-year-old male pediatric patient presenting with MCLMR diagnosed in infancy and associated with a novel, de novo <i>KIF11</i> mutation. <b>Results</b>: The patient presented with ophthalmological features of low visual acuity and chorioretinal atrophy and later developed bilateral retinal detachments. Syndromic features included microcephaly and developmental delay. Scleral buckling and vitrectomy were ultimately performed in both eyes, with a period of conservative management in the interim. Postoperative visual acuity was preserved in the right eye, although poor in the left eye. The patient received low-vision rehabilitation services and was able to participate in school and extracurricular activities. <b>Conclusions</b>: Early recognition and close monitoring of ocular and systemic manifestations of <i>KIF11</i> mutations are important to optimize visual rehabilitation efforts.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Relative Age, Siblings, and Motor Competence in Children and Adolescents.","authors":"Daniel González-Devesa, José Carlos Diz-Gómez, Pedro Vicente-Vila, Marta Domínguez Fernández, Miguel Rodríguez Rodríguez, Rocío Carballo-Afonso, Miguel Adriano Sanchez-Lastra, Carlos Ayán-Pérez","doi":"10.3390/children12050563","DOIUrl":"https://doi.org/10.3390/children12050563","url":null,"abstract":"<p><strong>Background: </strong>Motor competence is a key determinant of children's physical, cognitive, and social development, and it is influenced by various biological and environmental factors. Among these, relative age and the presence of siblings have been proposed as potential contributors, yet their impact remains underexplored, especially in school-aged populations.</p><p><strong>Objective: </strong>This study investigates the influence of relative age and the effects of the presence of siblings on the motor competence of children and adolescents.</p><p><strong>Methods: </strong>The motor competence level of 747 students, 381 from primary school (mean age = 8.81 ± 1.8 years) and 366 from secondary school (mean age = 13.52 ± 1.22 years), was measured by the means of the Canadian Agility and Movement Skill Assessment. Participants were queried about their birth date and whether they had any older siblings.</p><p><strong>Results: </strong>Overall, motor competence exhibited an upward trend with chronological age, reaching its peak among children aged 14 years old. Analysis revealed a significant impact of relative age effects on motor competence among primary children, with considerably higher scores in the first semester (<i>p</i> = 0.017). Conversely, no clear trend was observed for secondary children. Having siblings did not significantly affect motor competence proficiency. Multiple regression analysis further confirmed that relative age did not contribute to this lack of association (quarter of birth: <i>p</i> = 0.003; β = -0.144; siblings: <i>p</i> = 0.697; β = -0.019).</p><p><strong>Conclusions: </strong>These findings suggest that physical education teachers should be aware of the influence of relative age not only when assessing motor competence but also when designing and implementing their teaching practice in primary school settings. In contrast, the effect of relative age appears to be less significant in secondary education, where it may be less relevant for both evaluation and teaching practice. Further research should explore longitudinal designs and consider additional psychosocial and environmental variables to better understand how these factors influence motor competence development over time.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}