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Topic Review
Cortical Visual Impairment in Childhood
Cortical visual impairment in childhood is a kind of visual damage congenitally sustained by children.
  • 978
  • 14 Oct 2021
Topic Review
Pediatric NAFLD Diagnosis and Staging
The increased prevalence of non-alcoholic fatty liver disease (NAFLD) requires special attention in pediatric patients, as it manifests in them in a more severe and progressive way compared to adults. The implementation of the appropriate therapeutic interventions is determinant of the attempts to treat it. For that purpose, early diagnosis and staging of the disease is essential.
  • 974
  • 17 Jun 2021
Topic Review
Zinc Supplementation on Nutritional Status in CKD
Zinc is one of the most important and essential trace elements required by all living organisms for many physiologic functions, with three major biological roles catalytic, structural and regulatory ones. It is the second most abundant metal in mammalian tissues, after iron, with almost 90% of that found in muscle and bone. Likewise, the cellular Zn2+ concentrations are nearly as high as those of major metabolites like the ATP. Zinc is an essential cofactor that influences the expression and activity of numerous enzymes, transcription factors and regulatory proteins.
  • 971
  • 19 Jan 2023
Topic Review
Congenital Hyperinsulinaemic Hypoglycaemia
Hyperinsulinaemic hypoglycaemia (HH) is the most common cause of persistent hypoglycaemia in infants and children with incidence estimated at 1 per 50,000 live births. Congenital hyperinsulinism (CHI) is symptomatic mostly in early infancy and the neonatal period. Symptoms range from ones that are unspecific, such as poor feeding, lethargy, irritability, apnoea and hypothermia, to more serious symptoms, such as seizures and coma. During clinical examination, newborns present cardiomyopathy and hepatomegaly. The diagnosis of CHI is based on plasma glucose levels <54 mg/dL with detectable serum insulin and C-peptide, accompanied by suppressed or low serum ketone bodies and free fatty acids.
  • 961
  • 15 Dec 2022
Topic Review
Treatment of Dyslipidaemia in Children
Childhood dyslipidaemia is one of the main traditional cardiovascular risk factors that initiate and exacerbate the atherosclerotic process. Current guidelines recommend healthy behaviours as the first-line treatment for childhood dyslipidaemia. The therapeutic lifestyle changes should focus on dietary modifications, daily physical activity, reduction in body weight and tobacco smoking cessation. Parents play a key role in promoting their children’s healthy habits. In children with more severe forms of lipid abnormalities and in those who do not benefit from healthy behaviours, pharmacological therapy should be considered. Safe and effective medications are already available for children and adolescents. Statins represent the first-line pharmacological option, while ezetimibe and bile acid sequestrants are usually used as second-line drugs. Despite their limited use in children, other lipid-lowering agents (already approved for adults) are currently available or under study for certain categories of paediatric patients (e.g., familial hypercholesterolemia).
  • 960
  • 23 Sep 2021
Topic Review
Bathing in Atopic Dermatitis in Pediatric Age
Atopic dermatitis is a chronic inflammatory skin disease. The treatment plays an important role in influencing the patients’ quality of life. The basic management consists of appropriate skin cleansing, including bathing and eventually using bathing additives. Recommendations regarding frequency and duration of bathing, water temperature and usefulness of bathing additives are widely different, often leading to confusion among patients. 
  • 943
  • 26 Feb 2024
Topic Review
Copper and Copper/Zinc Ratio in Cystic Fibrosis Patients
Cystic fibrosis (CF) patients require a stable and sufficient supply of micronutrients. Since copper is an essential micronutrient for human development, studies are carried out to investigate the serum copper levels, serum copper/zinc (Cu/Zn) ratios, and their relationship with nutritional indicators in a group of CF patients. There was no significant correlation between the serum copper concentrations and respiratory and pancreatic function, respiratory colonization, and the results of the abdominal ultrasound. 
  • 930
  • 03 Feb 2023
Topic Review
Elective Early Upper Gastrointestinal Study
Assessment of discomfort as a sign for early postoperative complications in neurologically impaired (NI) children is challenging. The necessity of early routine upper gastrointestinal (UGI) contrast studies following laparoscopic Nissen fundoplication in NI children is unclear.  It aimed to evaluate the role of scheduled UGI contrast studies to identify early postoperative complications following laparoscopic Nissen fundoplication in NI children. Data for laparoscopic Nissen fundoplications performed in NI children between January 2004 and June 2021 were reviewed. A total of 103 patients were included, with 60 of these being boys. Mean age at initial operation was 6.51 (0.11–18.41) years. Mean body weight was 16.22 (3.3–62.5) kg. Mean duration of follow up was 4.15 (0.01–16.65 years) years. Thirteen redo fundoplications (12.5%) were performed during the follow up period; eleven had one redo and two had 2 redos. Elective postoperative UGI contrast studies were performed in 94 patients (91%). Early postoperative UGI contrast studies were able to identify only one complication: an intrathoracal wrap herniation on postoperative day five, necessitating a reoperation on day six. The use of early UGI contrast imaging following pediatric laparoscopic Nissen fundoplication is not necessary as it does not identify a significant number of acute postoperative complications requiring re-intervention. 
  • 928
  • 23 Nov 2021
Topic Review
Parenteral Nutrition on Gut Microbiota in Pediatric Population
Parenteral nutrition (PN) is a life-saving therapy providing nutritional support in patients with digestive tract complications, particularly in preterm neonates due to their gut immaturity during the first postnatal weeks. Despite this, PN can also result in several gastrointestinal complications that are the cause or consequence of gut mucosal atrophy and gut microbiota dysbiosis, which may further aggravate gastrointestinal disorders. Consequently, the use of PN presents many unique challenges, notably in terms of the potential role of the gut microbiota on the functional and clinical outcomes associated with the long-term use of PN.
  • 925
  • 18 Nov 2022
Topic Review
Mechanisms of Action of Probiotics in Gastrointestinal Diseases
Functional gastrointestinal diseases (FGIDs) are characterized by recurring gastrointestinal symptoms, including abdominal pain, vomiting or constipation, that can ultimately cause non-optimal development, disrupt digestion or create lifelong or mortal complications. Scientific evidence suggests that both gastrointestinal diseases (GIDs) and FGIDs are related to gut microbial dysbiosis, gastrointestinal motility disturbance, visceral hypersensitivity, as well as impairment of mucosal immune function and central nervous system processing. Based on this, the use of probiotic bacteria, mainly those strains belonging to Lactobacillus, Bifidobacterium and probiotic yeast such as Saccharomyces, have emerged as potential therapeutic agents in GIDs.
  • 918
  • 21 Jun 2023
Topic Review
Assessment of Oxidative Stress in Neonatal Brain Damage
Oxidative stress (OS) constitutes a pivotal factor within the mechanisms underlying brain damage, for which the immature brain is particularly vulnerable. This vulnerability is caused by the abundance of immature oligodendrocytes in the immature brain, which are highly susceptible to OS-induced harm. Consequently, any injurious process involving OS within the immature brain can lead to long-term myelination impairment. Among the detrimental repercussions of OS, protein carbonylation stands out as a prominently deleterious consequence. Noteworthy elevation of protein carbonylation is observable across diverse models of neonatal brain injury, following both diffuse and focal hypoxic–ischemic insults, as well as intraventricular hemorrhage, in diverse animal species encompassing rodents and larger mammals, and at varying stages of brain development. In the immature brain, protein carbonylation manifests as a byproduct of reactive nitrogen species, bearing profound implications for cell injury, particularly in terms of inflammation amplification. Moreover, protein carbonylation appears as a therapeutic target for mitigating neonatal brain damage. The administration of a potent antioxidant, such as cannabidiol, yields substantial neuroprotective effects. 
  • 916
  • 18 Oct 2023
Topic Review
Non-Contact Video-Based Neonatal Respiratory Monitoring
Video-based monitoring is a potential non-contact system that could improve patient care. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection (MSD) to model background noise to be able to amplify and record respiratory motions. We found significant correlation—r equals 0.948 (p value of 0.001)—between MSD and the current hospital standard, electrocardiogram impedance pneumography. Our video-based system showed a bias of negative 1.3 breaths and root mean square error of 6.36 breaths per minute compared to standard continuous monitoring. Further work is needed to evaluate the ability of video-based monitors to observe clinical changes in a larger population of patients over extended periods of time.
  • 915
  • 26 Oct 2020
Topic Review
Infection and Inflammation Interplay in Pediatric Long COVID
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents has generated repercussions, especially a few weeks after infection, for symptomatic patients who tested positive, for asymptomatic ones, or even just the contacts of an infected person, and evolved from severe forms such as multisystem inflammatory syndrome in children (MIS-C) to multifarious clinical manifestations in long COVID (LC). Referred to under the umbrella term LC, the onset of persistent and highly heterogeneous symptoms such as fatigue, post-exertion malaise, cognitive dysfunction, and others have a major impact on the child’s daily quality of life for months. 
  • 912
  • 06 Jul 2023
Topic Review
Metabolomic Profiling in Children with Celiac Disease
Celiac disease (CD) is included in the group of complex or multifactorial diseases, i.e., those caused by the interaction of genetic and environmental factors. Despite a growing understanding of the pathophysiological mechanisms of the disease, diagnosis is still often delayed and there are no effective biomarkers for early diagnosis. The only current treatment, a gluten-free diet (GFD), can alleviate symptoms and restore intestinal villi, but its cellular effects remain poorly understood. To gain a comprehensive understanding of CD’s progression, it is crucial to advance knowledge across various scientific disciplines and explore what transpires after disease onset. Metabolomics studies hold particular significance in unravelling the complexities of multifactorial and multisystemic disorders, where environmental factors play a significant role in disease manifestation and progression. 
  • 911
  • 10 Jul 2023
Topic Review
Persistent Inflammation in Cerebral Palsy
Research has established inflammation in the pathogenesis of brain injury and the risk of developing cerebral palsy (CP). However, it is unclear if inflammation is solely pathogenic and primarily contributes to the acute phase of injury, or if inflammation persists with consequence in CP and may therefore be considered a comorbidity. 
  • 906
  • 09 Jan 2023
Topic Review
Difficult Asthma in Children
Difficult asthma is asthma that is uncontrolled despite GINA step 4 and 5 (medium or high dose ICS with a second controller; maintenance of oral corticosteroids), or that requires such treatment to maintain good symptoms control and reduce the risk of exacerbations.
  • 899
  • 23 Feb 2021
Topic Review
Management of Harlequin Ichthyosis
Harlequin ichthyosis (HI) is a life-threatening genetic disorder that largely affects the skin of infants. HI is the most severe form of the autosomal recessive disorder known as ichthyosis. It is caused by mutations in the A12 cassette (lipid-transporter adenosine triphosphate-binding cassette A12). Neonates affected by this disease are born with specific morphological characteristics, the most prominent of which is the appearance of platelet keratotic scales separated by erythematous fissures. The facial features include eclabium, ectropion, a distinct flattened nose, and dysplastic ears. A common finding among those with HI is impaired skin barrier function.
  • 885
  • 23 Jun 2022
Topic Review
Atypical Teratoid/Rhabdoid Tumor in Taiwan
Atypical teratoid/rhabdoid tumor (AT/RT) is a rare, highly aggressive embryonal brain tumor most commonly presenting in young children. Older age, supratentorial site, and treatment with radiotherapy, chemotherapy, or both were significantly associated with better survival of patients with AT/RT in Taiwan. 
  • 879
  • 08 Feb 2022
Topic Review
Specificities of Urolithiasis in Pediatrics
Renal lithiasis is less frequent in children than in adults; in pediatrics, lithiasis may be caused by genetic abnormalities, infections, and complex uropathies, but the association of urological and metabolic abnormalities is not uncommon. 
  • 877
  • 09 Feb 2023
Topic Review
Juvenile Psoriatic Arthritis
Juvenile psoriatic arthritis (JPsA) accounts for 1–7% of all cases of juvenile idiopathic arthritis (JIA) and its definition has been a matter of controversy among pediatric rheumatologists for many years. The traditional attribution of JPsA to the spondyloarthropathy group was challenged in the early 1990s, whereas demonstrations of its heterogenous nature have led to questions about its identification as a distinct category in JIA classification.
  • 874
  • 07 Feb 2023
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