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Topic Review
Dietary Interventions in Attention Deficit Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, affecting ~7% of children and adolescents. Specific dietary interventions have been proposed as coadjuvant treatments in this disorder. These include nutritional supplements with vitamins, minerals, and polyunsaturated fatty acids; microbiome-targeted interventions with pre-, pro-, and synbiotics; and specific diets such as restriction or elimination diets. Regarding nutritional supplements, only vitamin D and vitamin D + magnesium appear to improve ADHD symptoms when baseline levels of vitamin D are insufficient/deficient. As for biotics, evidence has only been found for Lactobacillus rhamnosus GG and for multi-species probiotic supplementation. Elimination diets have scarce evidence and lead to nutritional deficiencies, so caution is advised.
  • 991
  • 30 Nov 2022
Topic Review
MTOR
The mammalian target of the rapamycin (mTOR) system regulates various cellular functions, such as growth, proliferation, metabolism and survival/death. In systemic organs, it is critically involved in multiple processes, including neurogenesis, nutrition and immunity. In the brain, its roles are essential in the cerebral cortical development, synaptic functions, and brain activities such as learning, cognition and social functions.
  • 987
  • 22 Sep 2021
Topic Review
Second-Hand and Prenatal Tobacco Smoke
Children are commonly exposed to second-hand smoke (SHS) in the domestic environment or inside vehicles of smokers. Unfortunately, prenatal tobacco smoke (PTS) exposure is still common, too. SHS is hazardous to the health of smokers and non-smokers, but especially to that of children. SHS and PTS increase the risk for children to develop cancers and can trigger or worsen asthma and allergies, modulate the immune status, and is harmful to lung, heart and blood vessels. Smoking during pregnancy can cause pregnancy complications and poor birth outcomes as well as changes in the development of the foetus. Lately, some of the molecular and genetic mechanisms that cause adverse health effects in children have been identified. It has been found in children that SHS and PTS exposure is associated with changes in levels of enzymes, hormones, and expression of genes, micro RNAs, and proteins. PTS and SHS exposure are major elicitors of mechanisms of oxidative stress. Genetic predisposition can compound the health effects of PTS and SHS exposure. Epigenetic effects might influence in utero gene expression and disease susceptibility. Hence, the limitation of domestic and public exposure to SHS as well as PTS exposure has to be in the focus of policymakers and the public in order to save the health of children at an early age. Global substantial smoke-free policies, health communication campaigns, and behavioural interventions are useful and should be mandatory.
  • 958
  • 06 Nov 2020
Topic Review
Neonatal Hypoxic-Ischemic Encephalopathy
Neonatal hypoxic-ischemic encephalopathy (HIE) is an important cause of mortality and morbidity in the perinatal period. This condition results from a period of ischemia and hypoxia to the brain of neonates, leading to several disorders that profoundly affect the daily life of patients and their families. Currently, therapeutic hypothermia (TH) is the standard of care in developing countries; however, TH is not always effective, especially in severe cases of HIE. Addressing this concern, several preclinical studies assessed the potential of stem cell therapy (SCT) for HIE.
  • 955
  • 12 Apr 2021
Topic Review
Congenital Adrenal Hyperplasia in Japan
Congenital adrenal hyperplasia (CAH) is an inherited disorder caused by the absence or severely impaired activity of steroidogenic enzymes involved in cortisol biosynthesis. More than 90% of cases result from 21-hydroxylase deficiency (21OHD). To prevent life-threatening adrenal crisis and to help perform appropriate sex assignments for affected female patients, newborn screening (NBS) programs for the classical form of CAH have been introduced in numerous countries.
  • 949
  • 30 Aug 2021
Topic Review
Newborn and Child Health
Home-based records are paper or electronic records retained and used by mothers or caregivers to document the health services received for maternal, newborn, and child health. Little has been studied about the roles of these records on newborn and child health outcomes.
  • 948
  • 29 Jul 2021
Topic Review
Whole Goat Milk Formula
Whole goat milk can be used as a source of protein, fat and lactose to manufacture infant, follow-on and young child formulas. The use of whole goat milk without adjustment of the whey:casein ratio results in a formula with an average of 50% of its lipids from goat milk fat, supplying palmitic acid (including at the sn-2 position), short and medium chain fatty acids, milk fat globule membrane and cholesterol.
  • 944
  • 24 Nov 2020
Topic Review
Malignant Superficial Mesenchymal Tumors in Children
Malignant superficial mesenchymal tumors are a very diverse group of neoplasms with few clinical and radiological discriminatory factors. Hence, some of these cancers are rarely suspected based on clinical and radiological grounds, others may be easily misdiagnosed, and the histological analysis of a biopsy or resection is central in the diagnostic process. In children, the age at presentation is a major element of the differential diagnosis. Some tumors have a very distinct epidemiology, while others may be seen at any age. More recently, the advances in molecular biology have greatly improved the diagnosis of mesenchymal tumors and new entities are still being described. 
  • 903
  • 02 Jun 2022
Topic Review Video
‘Teratoid’ Hepatoblastoma
Liver neoplasms are quite rare in childhood. They often involve 6.7 cases per 10 million children aged 18 years or younger. Hepatoblastoma (HB) is the most frequent tumor, but this neoplasm’s rarity points essentially to the difficulty of performing biologic studies and large-scale therapeutic trials. On the pathological ground, HB is separated into an entirely epithelial neoplasm or a mixed neoplasm with epithelial and mesenchymal components. This last category has been further subdivided into harboring teratoid features or not. The ‘teratoid’ HB includes a mixture of components with heterologous origin.
  • 898
  • 24 Apr 2022
Topic Review
Crohn’s Disease Exclusion Diet
The Crohn’s Disease Exclusion Diet (CDED) is a new generation of nutritional therapy—in its initial stages, aimed at inducing remission, it involves a combination of partial enteral nutrition (PEN) with selected natural diet products. The primary mechanism of action is to exclude or limit exposure to dietary factors with potentially deleterious effects on the pathogenesis and course of CD.
  • 896
  • 23 Jul 2021
Topic Review
Headache
Headaches are common complaints in children. The International Classification of Headache Disorders, 3rd edition (beta version), defines more than 280 types of headaches. Primary headaches refer to independent conditions that cause pain and include migraine, tension-type headaches (TTH) and trigeminal autonomic cephalalgias (TACs). Several agents are involved in the pathogenesis of headaches. The factors associated with predisposition to atherosclerosis seem to be particularly important from the clinical point of view. The influence of obesity on the incidence of headaches has been well established. Moreover, idiopathic headaches, especially migraine, are thought to be one of the first signs of disorders in lipid metabolism and atherosclerosis. The risk of migraine increases with increasing obesity in children. Another factor that seems to be involved in both obesity and headaches is the adiponectin level.This review presents the current knowledge on the relationship between obesity and adiponectin and primary headaches.
  • 888
  • 24 Oct 2020
Topic Review
Extreme Birth Weight and Metabolic Syndrome in Children
Small and large birth weights (BWs) for gestational age (GA) represent extremes, but the correlation between extreme BW and metabolic syndrome (MetS) has not been fully elucidated. 
  • 879
  • 15 Feb 2022
Topic Review
Pediatric Asthma
Asthma in children remains a significant public health challenge affecting 5–20% of children in Europe and is associated with increased morbidity and societal healthcare costs. 
  • 875
  • 26 Apr 2021
Topic Review
The Distinction between Constitutional SGA and FGR Infants
Data regarding the nutritional management of preterm small for gestational age (SGA) infants are scarce. In the recent report of ESPGHAN, the recommended energy for very preterm infants during hospitalization has been increased, yet this may not fit the needs of all preterm infants. It is important to distinguish fetal growth-restricted (FGR) infants from constitutional SGA infants, as well as preterm SGA from preterm AGA infants, since they may have different nutritional needs. Preterm FGR infants, and specifically infants < 29 weeks’ gestation, accumulate nutrient deficits due to intrauterine malnutrition, prematurity, morbidities, delayed initiation of feeding, and feeding intolerance. Therefore, these infants may need more aggressive nutrition for optimal catch-up growth and neurologic development. 
  • 854
  • 25 Jun 2023
Topic Review
Acute Heart Failure Syndrome
A working definition of heart failure (HF) in children is “a progressive clinical and pathophysiological syndrome caused by cardiovascular and noncardiovascular abnormalities that results in characteristic signs and symptoms including edema, respiratory distress, growth failure, and exercise intolerance and accompanied by circulatory, neurohormonal, and molecular derangements”.
  • 852
  • 17 May 2021
Topic Review
Lyme Neuroborreliosis in Children
Lyme neuroborreliosis (LNB) is an infectious disease, developing after a tick bite and the dissemination of Borrelia burgdorferi sensu lato spirochetes reach the nervous system. The infection occurs in children and adults but with different clinical courses. Adults complain of radicular pain and paresis, while among the pediatric population, the most common manifestations of LNB are facial nerve palsy and/or subacute meningitis.
  • 810
  • 06 Jul 2021
Topic Review
Pediatric Obesity and Inflammation
Obesity is a growing health problem in both children and adults, impairing physical and psychological state and impacting health care system costs. It is well-known that individuals with excessive weight gain frequently develop obesity-related complications, which are mainly known as Non-Communicable Diseases (NCDs), proven to be associated with chronic inflammation, causing disability and reduced life expectancy. Complications related to inflammation in pediatric obesity are discussed here.
  • 808
  • 27 Oct 2020
Topic Review
Blount’s Disease
Blount’s disease is an idiopathic developmental abnormality affecting the medial proximal tibia physis resulting in a multi-planar deformity with pronounced tibia varus. A single cause is unknown, and it is currently thought to result from a multifactorial combination of hereditary, mechanical, and developmental factors.
  • 797
  • 27 Jul 2021
Topic Review
Hirschsprung’s Disease
Hirschsprung´s disease is a neurocristopathy, caused by defective migration, proliferation, differentiation and survival of neural crest cells, leading to gut aganglionosis. It usually manifests rapidly after birth, affecting 1 in 5000 live births around the globe. In recent decades, there has been a significant improvement in the understanding of its genetics and the association with other congenital anomalies, which share the pathomechanism of improper development of the neural crest. Apart from that, several cell populations which do not originate from the neural crest, but contribute to the development of Hirschsprung´s disease, have also been described, namely mast cells and interstitial cells of Cajal. From the diagnostic perspective, researchers also focused on “Variants of Hirschsprung´s disease”, which can mimic the clinical signs of the disease, but are in fact different entities, with distinct prognosis and treatment approaches. The treatment of Hirschsprung´s disease is usually surgical resection of the aganglionic part of the intestine, however, as many as 30–50% of patients experience persisting symptoms.
  • 787
  • 25 Nov 2020
Topic Review
Mycotoxin Exposure and Children’s Health
The first 1000 days of life are very sensitive to any event that alters health programming, and they represent a window for intervention to improve population health. Pregnant women, fetuses, and infants are particularly vulnerable to exposure to food contaminated with mycotoxins. 
  • 787
  • 29 Mar 2022
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