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Topic Review
Cytomegalovirus Infection
Cytomegalovirus (CMV) is able to replicate in the breast milk of lactating mothers and thus the offspring might be affected by mild to severe symptoms of postnatal CMV disease in case of prematurity; not in term infants.
  • 764
  • 20 Apr 2022
Topic Review
Cystic Fibrosis Transmembrane Conductance Regulator Dysfunction in Phagocytes
Cystic fibrosis (CF), the most common genetically inherited disease in Caucasian populations, is a multi-systemic life-threatening autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. In 2012, the arrival of CFTR modulators (potentiators, correctors, amplifiers, stabilizers, and read-through agents) revolutionized the therapeutic approach to CF.
  • 760
  • 18 Jan 2023
Topic Review
Prevention and Treatment of Oral Complications
Phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30–45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies. 
  • 759
  • 29 Apr 2022
Topic Review
Antioxidant Supplements and Type 2 Diabetes Prevention
Oxidative stress (OxS) is a physiologically significant alteration in redox status resulting from the overproduction of reactive species and or the reduction in antioxidant defenses. Oxidative stress (OxS) has emerged as a likely initiating factor in T2D. Antioxidant supplements may act to slow or prevent T2D by multiple mechanisms, i.e., (1) reducing mitochondrial oxidative stress, (2) preventing the damaging effects of lipid peroxidation, and (3) acting as essential cofactors for antioxidant enzymes. 
  • 759
  • 01 Jun 2023
Topic Review
Outdoor Air Pollution and Childhood Respiratory Disease
The leading mechanisms through which air pollutants exert their damaging effects are the promotion of oxidative stress, the induction of an inflammatory response, and the deregulation of the immune system by reducing its ability to limit infectious agents’ spreading. This influence starts in the prenatal age and continues during childhood, the most susceptible period of life, due to a lower efficiency of oxidative damage detoxification, a higher metabolic and breathing rate, and enhanced oxygen consumption per unit of body mass. Air pollution is involved in acute disorders like asthma exacerbations and upper and lower respiratory infections, including bronchiolitis, tuberculosis, and pneumoniae. Pollutants can also contribute to the onset of chronic asthma, and they can lead to a deficit in lung function and growth, long-term respiratory damage, and eventually chronic respiratory illness. Air pollution abatement policies, are contributing to mitigating air quality issues, but more efforts should be encouraged to improve acute childhood respiratory disease with possible positive long-term effects on lung function. 
  • 754
  • 07 Jul 2023
Topic Review
Eating Disorders in Youth with Chronic Health Conditions
Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions.
  • 747
  • 06 Sep 2023
Topic Review
Glycogen Storage Patients
Glycogen storage diseases (GSDs) are clinically and genetically heterogeneous disorders that disturb glycogen synthesis or utilization. Although it is one of the oldest inherited metabolic disorders, new genetic methods and long-time patient follow-ups provide us with unique insight into the genotype–phenotype correlations. The aim of this study was to share the phenotypic features and molecular diagnostic results that include new pathogenic variants in the GSD cases. Twenty-six GSD patients were evaluated retrospectively. Demographic data, initial laboratory and imaging features, and current findings of the patients were recorded. Molecular analysis results were classified as novel or previously defined variants. Novel variants were analyzed with pathogenicity prediction tools according to American College of Medical Genetics and Genomics (ACGM) criteria. Twelve novel and rare variants in six different genes were associated with the disease. Hearing impairment in two patients with GSD I, early peripheral neuropathy after liver transplantation in one patient with GSD IV, epilepsy and neuromotor retardation in three patients with GSD IXA were determined. A heterogeneous group of all diagnosed GSDs over a 5-year period was characterized in the institution, and identified novel variants and new clinical findings. It is still difficult to establish a genotype–phenotype correlation in GSDs.
  • 744
  • 29 Mar 2022
Topic Review
Treatment of Obsessive-Compulsive Disorder in PANS/PANDAS in Children
Several treatment options have been proposed for pediatric acute-onset neuropsychiatric syndrome/pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANS/PANDAS). Still, no clear therapeutic protocol has been recognized to prevent these neuropsychiatric diseases. 
  • 739
  • 13 Apr 2022
Topic Review
Diabetic Ketoacidosis in Children and Adolescents
Diabetic ketoacidosis (DKA) represents an acute, severe complication of relative insulin deficiency and a common presentation of Type 1 Diabetes Mellitus (T1DM) primarily and, occasionally, Type 2 Diabetes Mellitus (T2DM) in children and adolescents. It is characterized by the biochemical triad of hyperglycaemia, ketonaemia and/or ketonuria, and acidaemia. Clinical symptoms include dehydration, tachypnoea, gastrointestinal symptoms, and reduced level of consciousness, precipitated by a variably long period of polyuria, polydipsia, and weight loss. 
  • 738
  • 07 Aug 2023
Topic Review
Newborn Hearing Screening
Universal neonatal screening is the most useful procedure for early detection of congenital deafness. Neonatal hearing screening facilitates a confirmed diagnosis of neonatal deafness in the first 4 months of life while without this practice the diagnosis is usually delayed up to 35 m. In the same way, the treatment of children diagnosed from neonatal screening begins before 7 m, and in its absence, it is delayed on average up to 35 m.
  • 737
  • 09 Nov 2021
Topic Review
The Role of Urinary Neutrophil Gelatinase-Associated Lipocalin
Vesicoureteral reflux (VUR) is the most frequent congenital urinary tract malformation and an important risk factor for urinary tract infections (UTIs). Up to 50% of children with VUR may develop reflux nephropathy (RN), and the diagnosis and monitoring of renal scars are invasive and costly procedures, so it is paramount to find a non-invasive and accurate method to predict the risk of renal damage. Neutrophil gelatinase-associated lipocalin (NGAL) has already proven to be a good predictive biomarker in acute kidney injuries.
  • 735
  • 06 May 2023
Topic Review
Gut Microbiota and Chronic Kidney Disease
The human intestinal microbiota is a highly intricate structure with a crucial role in promoting health and preventing disease. It consists of diverse microbial communities that inhabit the gut and contribute to essential functions such as food digestion, nutrient synthesis, and immune system development. The composition and function of the gut microbiota are influenced by a variety of factors, including diet, host genetics, and environmental features. In pediatric patients, the gut microbiota is particularly dynamic and vulnerable to disruption from endogenous and exogenous factors.
  • 735
  • 23 Aug 2023
Topic Review
Premature Infants Born
After birth, infants born after <25 weeks’ gestation develop respiratory and hemodynamic instability due to their immature physiology and anatomy. Successful stabilization at birth has the potential to reduce morbidities and mortalities, while suboptimal DR care could increase long-term sequelae. 
  • 730
  • 13 Dec 2021
Topic Review
Clinical Manifestations of Kawasaki Disease
Kawasaki disease is a systemic idiopathic febrile vasculitis that often affects children under 5 years. In Japan back in 1961, KD was initially reported and subsequently recognised based on the profiling of 50 patients with a similar phenotype by Dr Tomisaku Kawasaki in 1967. Kawasaki disease was then identified as the most common cause of acquired heart disease in paediatric populations as it would subsequently result in coronary artery aneurysms if left untreated.
  • 730
  • 10 Jun 2022
Topic Review
Complication of Risk Pediatric Foreign Body Ingestion
The optimal management of foreign body ingestion in children depends on an understanding of its natural history and risks of complication. The large majority of swallowed foreign bodies pass uneventfully through the gastrointestinal (GI) tract. However, complications, sometimes serious, may occur. The wide variety among patients and among the foreign bodies that they swallow makes creation of universal protocols complicated and difficult. Thus, the evaluation of a patient after potential foreign body ingestion requires a balanced approach, identifying and addressing potentially problematic ingestions without overtesting or overtreating. 
  • 724
  • 27 May 2022
Topic Review
Human Breast Milk for Very Preterm Neonates
Prematurity is the leading cause of death in children younger than 5 years old and a main reason for morbidity in the pediatric population. Annually, almost 15 million neonates are born prematurely (before 37 week of gestation), and the prevalence is increasing every year. According to World Health Organization (WHO), among 184 countries, the percentage of preterm birth ranges between 5% and 18%. In Greece, 4.7% of total births were premature between the years 1980 and 2008, with the percentage of prematurity reaching 9.6% in 2008. Very preterm neonates (<32 weeks of gestation) and extremely preterm neonates (<28 weeks of gestation) account for about 10% and 5%, respectively, of all premature neonates, with their morbidity and mortality being inversely related with gestation age.
  • 721
  • 26 Sep 2022
Topic Review
Caudal Duplication Syndrome
Caudal duplication syndrome (CDS) is a rare association of anatomical anomalies describing duplication of the hindgut, spine, and uro-genital structures, leading to varied clinical presentations.
  • 717
  • 13 Apr 2021
Topic Review
Pediatric Asthmatic Medications
Asthma is a respiratory condition often stemming from childhood, characterized by difficulty breathing and/or chest tightness. Current treatment options for both adults and children include beta-2 agonists, inhaled corticosteroids (ICS), and leukotriene modifiers (LTM). Despite recommendations by the Global Initiative for Asthma, a substantial number of patients are unresponsive to treatment and unable to control symptoms. Pharmacogenomics have increasingly become the front line of precision medicine, especially with the recent use of candidate gene and genome- wide association studies (GWAS). Screening patients preemptively could likely decrease adverse events and therapeutic failure. However, research in asthma, specifically in pediatrics, has been low. Although numerous adult trials have evaluated the impact of pharmacogenomics and treatment response, the lack of evidence in children has hindered progress towards clinical application. 
  • 717
  • 02 Mar 2022
Topic Review
Macrometabolic Associations in Asthma
Asthma is a heterogenous disorder driven by inflammatory mechanisms that result in multiple phenotypes. Given the complex nature of this condition, metabolomics is being used to delineate the pathobiology of asthma. Metabolomics is the study of metabolites in biology, which includes biofluids, cells, and tissues. These metabolites have a vital role in a disease as they contribute to the pathogenesis of said condition.
  • 716
  • 08 Feb 2023
Topic Review
Risk Factors for Developing Severe Hypoglycemia
Hypoglycemia is an often-observed acute complication in the management of children and adolescents with type 1 diabetes. It causes inappropriate glycemic outcomes and may impair the quality of life in the patients. Severe hypoglycemia with cognitive impairment, such as a convulsion and coma, is a lethal condition and is associated with later-onset cognitive impairment and brain-structural abnormalities, especially in young children. Therefore, reducing the frequency of hypoglycemia and minimizing the occurrence of severe hypoglycemia are critical issues in the management of children and adolescents with type 1 diabetes.
  • 716
  • 14 Feb 2023
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