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Topic Review
Neonatal Heart Rate in the Delivery Room
At birth, a newborn’s heart rate should be evaluated immediately to determine the need for resuscitation and stabilizing measures. As cardiopulmonary transition is affected by the cord management strategy, gestational age, and underlying condition, different heart rate intervention thresholds might be needed in different subgroups of newborn infants.
  • 484
  • 08 Oct 2023
Topic Review
Characterising a Pathogenic Microbiome
The process of microbiome development arguably begins before birth. Vertical transmission of bacteria from the mother to the infant is a keystone event in microbiome development. Subsequent to birth, the developing microbiome is vulnerable to influence from a wide range of factors. Additionally, the microbiome can influence the health and development of the host infant. This intricate interaction of the gastrointestinal microbiome and the host has been described as both symbiotic and dysbiotic. Defining these terms, a symbiotic microbiome is where the microbiome and host provide mutual benefit to each other. A pathogenic microbiome, or more precisely a gastrointestinal microbiome associated with disease, is increasing described as dysbiotic. 
  • 482
  • 04 Dec 2023
Topic Review
Acupuncture in Children Frequent or Chronic Primary Headaches
Acupuncture is a spreading and promising intervention, which has proven to be very useful in the treatment and prevention of chronic pain, in particular chronic headaches, in adults. Despite the differences in tools, procedures, and application sites, acupuncture demonstrated a positive effect on both the frequency and intensity of headaches and was well tolerated.
  • 480
  • 18 Oct 2023
Topic Review
Short-Term Effects of Pediatric Cannabis Use
Cannabis, a plant known for its recreational use, has gained global attention due to its widespread use and addiction potential. Derived from the Cannabis sativa plant, it contains a rich array of phytochemicals concentrated in resin-rich trichomes. The main cannabinoids, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), interact with CB1 and CB2 receptors, influencing various physiological processes. Particularly concerning is its prevalence among adolescents, often driven by the need for social connection and anxiety alleviation.
  • 455
  • 16 Nov 2023
Topic Review
Spermatogenesis and Andrological Diseases
Male infertility is a condition that has always been less studied and known than female infertility. Male infertility is increasingly present and increasingly diagnosed. The worldwide denasality can only be slowed if awareness campaigns are implemented on all the diseases that can alter fertile potential, especially in young adolescents. 
  • 453
  • 12 Oct 2023
Topic Review
Microbiota and Immunity—Consequences of Gut Colonization
Microbiota of the gut heavily affects the development and maturation of the immune system, especially in the development of tolerance towards ingested antigens in the gut. The tolerance is developed to ensure that non-harmful antigens do not trigger an inflammatory response in the gut—with the suggestion that failure in developing tolerance will result in inflammatory-related diseases in the gut later in life.
  • 450
  • 04 Jul 2023
Topic Review
Development of the Microbiome in Preterm Neonates
Researchers have established that the preterm neonate is born with an immature gastrointestinal tract. The preterm neonate is thus susceptible to various complications often seen in the neonatal intensive care unit, e.g., feeding intolerances, necrotizing enterocolitis, and hospital-acquired bloodstream infections. These complications can be life-threatening, and if survived, can have an unfavorable effect on the neonate’s growth and development.
  • 441
  • 13 Nov 2023
Topic Review
Clinical Studies on PPARγ Activity in Premature Babies
Worldwide, three-quarters of a million babies are born extremely preterm (<28 weeks gestation) with devastating outcomes: 20% die in the newborn period, a further 35% develop bronchopulmonary dysplasia (BPD), and 10% suffer from cerebral palsy. Pioglitazone, a Peroxisome Proliferator Activated Receptor Gamma (PPARγ) agonist, may reduce the incidence of BPD and improve neurodevelopment in extreme preterm babies. Pioglitazone exerts an anti-inflammatory action mediated through Nuclear Factor-kappa B repression. PPARγ signalling is underactive in preterm babies as adiponectin remains low during the neonatal period.
  • 439
  • 08 Nov 2023
Topic Review
Intricate Factors Shaping Craniofacial Structure and Sleep-Disordered Breathing
Adenotonsillar hypertrophy has been well-acknowledged as the primary instigator of sleep-disordered breathing in the pediatric population. This condition spans a spectrum, from typical age-related growth that the immune system influences to persistent pathological hypertrophy. Reduction in air spaces, metabolic changes, neurobehavioral alterations, and chronic inflammation characterizes the latter form. As the go-to treatment, adenotonsillectomy has proven effective.
  • 437
  • 15 Sep 2023
Topic Review
Beta Cell Dysfunction in Type 2 Diabetes
Traditionally a disease of adults, type 2 diabetes (T2D) has been increasingly diagnosed in youth, particularly among adolescents and young adults of minority ethnic groups. Especially, during the recent COVID-19 pandemic, obesity and prediabetes have surged not only in minority ethnic groups but also in the general population, further raising T2D risk. Regarding its pathogenesis, a gradually increasing insulin resistance due to central adiposity combined with a progressively defective β-cell function are the main culprits. Especially in youth-onset T2D, a rapid β-cell activity decline has been observed, leading to higher treatment failure rates, and early complications. In addition, it is well established that both the quantity and quality of food ingested by individuals play a key role in T2D pathogenesis. A chronic imbalance between caloric intake and expenditure together with impaired micronutrient intake can lead to obesity and insulin resistance on one hand, and β-cell failure and defective insulin production on the other.
  • 434
  • 22 May 2023
Topic Review
Reciprocal Interplay between Infections and Inherited Metabolic Disorders
Infections represent the main cause of acute metabolic derangements and/or the worsening of the clinical course of many inherited metabolic disorders (IMDs). The basic molecular mechanisms behind the role of infections in these conditions have not been completely clarified. Infective agents may affect cellular metabolic pathways, by mediation or not of an altered immune system. 
  • 431
  • 24 Oct 2023
Topic Review
Management Plan according to EOSS-P
hildhood obesity, affecting 29% of 7–9-year-olds across 33 European countries, is a significant public health challenge. Its persistence into adulthood poses grave health risks influenced by genetic, environmental, and socio-economic factors. Belgium introduced a new care pathway in December 2023, based on the Edmonton Obesity Staging System for Pediatrics (EOSS-P), addressing four health domains and staging obesity severity. This pathway operates across three levels: primary care physicians, Paediatric Multidisciplinary Obesity Management Centres (PMOCs), and Centers of Expertise for Paediatric Obesity Management (CEPOs). Each stage of EOSS-P demands tailored interventions. Early stages involve dietary interventions, physical activity promotion, and behavior modifications. As obesity severity progresses, treatments intensify, encompassing psychological support, anti-obesity medications, and, in some cases, bariatric surgery.
  • 431
  • 13 Mar 2024
Topic Review
Off-Label Prescribing in Pediatric Population
Off-label prescribing is widespread among pediatricians, and it is unlikely that this trend will soon be bound by a uniform legal framework. This is necessitated by the fact that there are four variables: the patient’s health condition, the physician’s experience and knowledge, the legislative measures (laws, directives, guidelines, and recommendations), and finally, the pharmaceutical industry. There is considerable concern worldwide about the use of off-label medicines in children. 
  • 423
  • 06 Dec 2023
Topic Review Peer Reviewed
Neonatal Intraventricular Hemorrhage: Current Perspectives and Management Strategies
Neonatal intraventricular hemorrhage is a serious condition associated with significant acute and long-term morbidity and mortality. Neurosurgical intervention aims to relieve life-threatening raised intracranial pressure and prevent neurological deterioration. In recent years, advancements in disease understanding have paved the way for clinicians to re-evaluate conventional approaches in the management of affected patients. Examples include various neurosurgical techniques to actively reduce blood products with a view to avoid the consequences of complex hydrocephalus and intraparenchymal injury in the developing brain. In this entry paper, we aim to provide an overview of the current perspectives, pathophysiology and management strategies for this difficult condition.
  • 401
  • 07 Jan 2025
Topic Review
Prebiotics, Probiotics, and Synbiotics in Pediatric Obesity
Childhood obesity, a real pandemic, represents, in fact, a major public health problem worldwide, with an increasing trend in prevalence during the last decades, especially in developed countries. Due to its associated short- and long-term complications, it carries an important burden not only for health services, but also for society, since it is associated with both psychosocial problems like bullying, resulting in school absences and consequent poor school results, and organic conditions such as metabolic syndrome with insulin resistance, cardiovascular disorders, hypertension, dyslipidemia, non-alcoholic fatty liver disease, obstructive sleep apnea, and even neoplasia.
  • 396
  • 22 Nov 2023
Topic Review
Pharmacokinetics and Childhood Obesity: Pathophysiological Basis and Challenges
The progressive increase in pediatric obesity and the lack of solid scientific evidence regarding appropriate dosing adjustment mechanisms highlight the need for an in-depth study of this topic. The present work provides a comprehensive conceptual review of the key aspects related to drug dosing in obese pediatric patients, including diagnosis and quantification criteria for obesity, the pathophysiological changes associated with obesity in children, and the potential alterations in pharmacokinetics and pharmacodynamics. In addition, it summarizes the body size descriptors that may be applicable to dose optimization in this population. The current scarcity of conclusive data on the characterization of pharmacokinetic and pharmacodynamic processes and the selection of appropriate body size descriptors underscores the need for the development of modeling tools that can elucidate drug disposition alterations, comprising an advance toward more personalized pharmacotherapy for these patients.
  • 9
  • 17 Nov 2025
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