Perinatal risk factors for pediatric onset type 1 diabetes, autoimmune thyroiditis, juvenile idiopathic arthritis, and inflammatory bowel diseases
AbstractType 1 diabetes mellitus (DM), autoimmune thyroiditis (AIT), juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases (IBD) are common pediatric autoimmune diseases with unknown risk factors. Using nationwide registers, we searched for their perinatal risk factors. Our study followed up 11,407 children (born 2000 –2005) for a median of 16.6 years (from birth to 2018). Of them, 2.15% received primary diagnosis and 0.08% also secondary: 0.89% had DM, 0.60% had AIT, 0.48% had JIA, and 0.25% had IBD. The incidences per 100,000 children/year were 106.1 for DM, 46.0 for AIT, 55.0 for JIA, and 23.7 for I...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Endoscopic endonasal repair of complete bilateral choanal atresia in neonates
Conclusion: Endoscopic bilateral CA repair in neonates is a safe procedure with a high long-term success rate. However, compared to other patient groups with choanal obstruction, restenosis occurs frequently, and revision procedures are required in a large number of cases. This should be considered during preoperative planning and parent counseling.What is Known:•Bilateral complete choanal atresia (CA) is a neonatal emergency that requires surgical intervention.•Reported success rates of endoscopic choanal obstruction repair are highly variable and mostly derived from heterogenous study groups that do not reflect...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Transient elastography correlated to four different histological fibrosis scores in children with liver disease
Conclusion: TE shows a good correlation to the histological findings in children with hepatopathy, independent of the used histological scoring system.What is Known:•The current gold standard for detecting liver fibrosis is liver biopsy. Novel non-invasive ultrasound-based methods are introduced to clinical diagnostics.•Most histological scores have been developed and evaluated in adult populations and for only one specific liver disease.What is New:•Transient elastography (TE) in children showed a good correlation to fibrosis severity irrespective of the utilized histological scoring system.•The aspart...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses
AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis i...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Association between adropin and coronary artery lesions in children with Kawasaki disease
AbstractKawasaki disease (KD) is an acute systemic vasculitis in children. Coronary artery lesions (CALs) are the most serious complications in KD, but the pathogenesis is still unclear so far. Adropin, a new biopeptide, plays an important role in metabolism and cardiovascular function. The aim of this study was to explore the relationship between adropin and KD. 66 KD patients and 22 healthy controls (HCs) were included in the study. KD patients were divided into KD with coronary artery lesions (KD-CALs) group and KD without CALs (KD-NCALs) group. The levels of serum adropin were determined by enzyme-linked immunosorbent ...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

HFOV vs CMV for neonates with moderate-to-severe perinatal onset acute respiratory distress syndrome (NARDS): a propensity score analysis
Conclusion: HFOV was associated with a decreased incidence of IVH in infants with NARDS compared with CMV. However, there were significantly more VFDs in the CMV group than in the HFOV group, and HFOV did not appear to be superior to CMV in decreasing the mortality and incidence of BPD in infants with NARDS.What is Known:•The diagnostic criteria of neonatal acute respiratory distress syndrome (Montreux criteria) were established in 2017.•To date, studies comparing high-frequency oscillatory ventilation and conventional mechanical ventilation in the treatment of neonatal acute respiratory distress syndrome are ins...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Viral rashes mimicking drug reaction with eosinophilia and systemic symptoms syndrome in children after β-lactams intake: a diagnostic challenge
Conclusion:  A rapid, correct diagnosis of such DRESS-like rashes during viral infections allows more appropriate management and avoids unnecessary, life-long exclusion of useful and effective antibiotics because of a falsely “amoxicillin-allergy” labelling.What is Known:• Viral infections are common causes of skin rashes in children during antibiotic intake and may require differential diagnosis with drug reactions.• Early-onset DRESS syndrome is usually induced by antibiotics and appears ≤15 days after drug intake.What is New:• Prominent midface edema, maculopapular rash, and mild-to-mo...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Does physical activity moderate the association between screen time and psychosocial development in early childhood? Analysis of a longitudinal infant cohort study in Ireland
Conclusions: Results support recommendations to establish greater balance between physical activity and sedentary behaviours in token economy systems to minimise the negative effects of excessive screen time.What is Known:• Provision of screen time has become normalised as a behavioural reinforcer for use with young children.• Screen viewing above recommended guidelines is associated with behavioural problems that reflect poor self-regulation.What is New:• Boys’ levels of engagement in physical activity moderated the relationship between screen time and changes in behavioural difficulties between the a...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

The association between clinical and biochemical characteristics of late-onset sepsis and bronchopulmonary dysplasia in preterm infants
Conclusion: During a LOS, the need for and duration of mechanical ventilation are independently associated with the risk of developing BPD in preterm infants.What is Known:•Premature infants diagnosed with a late-onset sepsis are at higher risk of developing bronchopulmonary dysplasia•This association is mainly shown in infants with a positive blood cultureWhat is New:•This study investigates the clinical and biochemical characteristics of late-onset sepsis and the development of bronchopulmonary dysplasia•The need for mechanical ventilation and duration of mechanical ventilation during late-onset sepsi...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Multisystem inflammatory syndrome in children related to COVID-19: a systematic review
Conclusion: PIMS-TS/MIS(-C) is a severe, heterogeneous disease with epidemiological enrichment for males, adolescents, and racial and ethnic minorities. However, mortality rate is low and short-term outcome favorable. Long-term follow-up of chronic complications and additional clinical research to elucidate the underlying pathogenesis is crucial.What is Known:• A novel pediatric inflammatory syndrome with multisystem involvement has been described in association with SARS-CoV-2.• To date, the scattered reporting of cases and use of different case definitions provides insufficient insight in the full clinical spec...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Cardiorespiratory fitness in adolescents before and after the COVID-19 confinement: a prospective cohort study
AbstractLong periods of free-movement restrictions may negatively affect cardiorespiratory fitness and health. The present study investigated changes after the COVID-19 confinement in maximal oxygen intake (VO2 max) levels in a sample of 89 Spanish school children aged 12 and 14 years at baseline (49.8% girls). The 20-m shuttle run test served to estimate VO2 max before and after the COVID-19 confinement. Pairedt-tests estimated an overall difference of − 0.5 ml.kg−1.min−1 (SD 0.3) (p = 0.12), whereas the highest significant reductions were observed for girls aged 14 years ( − 1.5 ml.kg−1.min−1 (SD 0.6) (p
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature
Conclusion: Pediatric ED utilization and hospitalization during lockdown were decreased in the Netherlands and other countries, which can largely be attributed to a decrease in communicable infectious diseases. Care utilization for other conditions was decreased as well, which may indicate that care avoidance during a pandemic is significant.What is Known:• The COVID-19 pandemic had enormous impact on society.• Countries imposed lockdowns to curb transmission rates, which were followed by a reduction in care utilization worldwide.What is New:• The Dutch lockdown caused a significant decrease in pediatric ED ...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Motor development in children and adolescents: role of body mass index and socioeconomic status
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Correction to: Transforming a paediatric ICU to an adult ICU for severe Covid-19: lessons learned
A correction to this paper has been published:https://doi.org/https://doi.org/10.1007/s00431-021-04026-x (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Correction to: cardiorespiratory fitness in adolescents before and after the COVID-19 confinement: a prospective cohort study
A Correction to this paper has been published:https://doi.org/https://doi.org/10.1007/s00431-021-04107-x (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Correction to: Lung ultrasound to predict pediatric intensive care admission in infants with bronchiolitis (LUSBRO study)
A correction to this paper has been published:https://doi.org/10.1007/s00431-021-04003-4 (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

A systematic review of the impact of intensive care admissions on post discharge cognition in children
The objective of this study is to identify and characterize the associations between a neonatal or pediatric ICU hospitalization and the short- and long-term cognition of survivors. The databases Cochrane Library, Medline, EBSCO, Embase, and Google Scholar and the journals JAMA Pediatrics, Journal of Pediatrics, Pediatrics, Archives of Disease in Childhood, Academic Pediatrics, Pediatric Critical Care Medicine and Child Development were searched until A pril 2021. Retrieved article references were analyzed. Included articles investigated cognition as an outcome of ICU hospitalization in non-preterm neonatal or pediatric pa...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

Association between neonatal hyperglycemia and retinopathy of prematurity: a meta-analysis
Conclusion: This meta-analysis demonstrates that preterm infants with hyperglycemia have a tendency to increase the risk of ROP. Further studies will be required to achieve a firm conclusion for hyperglycemia and ROP and promote a better understanding of the prevention of ROP.Trial registration: CRD42021228733What is Known:•Hyperglycemia including the duration and daily mean blood glucose concentration has been associated with the risk of developing ROP in some clinical studies. Current evidence cannot reach a consensus on whether neonatal hyperglycemia is a risk factor for ROP.What is New:•This meta-analysis dem...
Source: European Journal of Pediatrics - June 11, 2021 Category: Pediatrics Source Type: research

The landscape of pediatric Diamond-Blackfan anemia in Switzerland: genotype and phenotype characteristics
Conclusion: We illustrate the wide clinical and genetic spectrum of DBA in Switzerland. Our findings highlight the need to take this diagnosis into consideration in patients with severe anemia but also in patients with mild anemia where malformations are present. Lower limb and anorectal malformation extend the spectrum of DBA-associated malformations.What is Known?•There is a large variation in the phenotype of Diamond-Blackfan Anemia (DBA) and diversity of genetic mutations.•Malformation of the upper limbs, head and face, heart, and genitourinary system is frequently identified.What is New?• Patients with ...
Source: European Journal of Pediatrics - June 10, 2021 Category: Pediatrics Source Type: research

Neonatal donation: are newborns too young to be recognized?
Conclusion: A low proportion (2%) of neonates who died in the NICUs were found suitable for organ donation, and a higher proportion (12%) were found suitable for tissue donation. We suggest that increased awareness concerning the possibility of neonatal donation would likely increase the identification of potential neonatal donors.What is Known:•There is an urgent need for very small organs and tissues from neonatal donorsWhat is New:•A number of neonates who died in the NICU were suitable organ or/and tissue donors but were not recognized as donors.•Knowledge on neonatal donation possibilities is also impor...
Source: European Journal of Pediatrics - June 9, 2021 Category: Pediatrics Source Type: research

Handgrip strength cut-off points for early detection of cardiometabolic risk in Chilean children
Conclusion: These  specific cut-off points according to sex for possible cardiometabolic risk could be used by Chilean health professionals and school staff as an initial assessment in the field setting.What is known•There is strong evidence for the importance of muscular fitness during childhood and adolescence for cardiometabolic risk.•There has been no research to establish minimum handgrip strength capacity levels to predict cardiometabolic risk among Chilean children.What is new•Cut-off points for handgrip strength relative to body mass to identify cardiometabolic risk in Chilean children are 0.33 ...
Source: European Journal of Pediatrics - June 9, 2021 Category: Pediatrics Source Type: research

Renal manifestations in children with neurofibromatosis type 1
AbstractNeurofibromatosis type 1 (NF1) is an autosomal-dominant neurocutaneous syndrome affecting various parts of the body, including the renovascular and urinary systems. We evaluated the renovascular, urinary, glomerular, and tubular functions of children with NF1. We compared blood pressures, urinary findings, and renal glomerular and tubular functions in children with NF1 with those of a healthy age- and gender-matched control group. We evaluated 46 NF1 patients and 33 healthy controls. The mean ages of the NF1 group (female/male: 20/26) and the control group (female/male: 15/18) were 10.1 ± 4.6 and 10.6 &plusm...
Source: European Journal of Pediatrics - June 6, 2021 Category: Pediatrics Source Type: research

Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
Conclusion: We offer a rational clinical algorithm to guide the treatment of refractory PPHN based on expert advice and the more recent pathobiology and pharmacology knowledge.What is Known:•Refractory PPHN occurs in 30 –40% of iNO-treated neonates and represents a significant clinical problem. Several pulmonary vasodilators have become available thanks to a better understanding of pulmonary hypertension pathobiology.What is New:•Available vasodilators have different pharmacology, mechanisms of action and may provide additive effect. We provide a rational clinical algorithm to guide the treatment of refract...
Source: European Journal of Pediatrics - June 6, 2021 Category: Pediatrics Source Type: research

Clinical characteristics of 50 children with azygos lobe: a retrospective study
Conclusion: The clinical characteristics of children with azygos lobe are nonspecific and diagnosis relies on chest imaging. Some congenital abnormalities may be complicated with azygos lobe. It is reasonable to keep watch over those patients without symptoms.What is Known:• An azygos lobe is a congenital variation of the lung.• Azygos lobe can mimic various pathological conditions leading to misdiagnosis and inappropriate treatment in adults, which presents challenges during thoracic surgical interventions.What is New:• Azygos lobe in children may be complicated with other congenital abnormalities.• Th...
Source: European Journal of Pediatrics - June 4, 2021 Category: Pediatrics Source Type: research

Epidemiology, clinical characteristics, and immediate outcome of Kawasaki disease: a population-based study from a tropical country
AbstractData on Kawasaki disease from tropical countries are scarce. Hence, this population-based study aims to determine the epidemiology, clinical characteristics, and outcome of Kawasaki disease in children enrolled in the Kawasaki disease registry between 2006 and 2019 in Southern Malaysia. Diagnosis of Kawasaki disease was made using standard criteria. Primary outcome measure was a coronary artery aneurysm. Multivariable logistic regression was used to analyze the associated risk factors for coronary artery aneurysm. There were 661 Kawasaki disease, with 27% incomplete and 11% atypical presentations. Male-to-female ra...
Source: European Journal of Pediatrics - June 4, 2021 Category: Pediatrics Source Type: research

Bronchiolitis in COVID-19 times: a nearly absent disease?
AbstractStay-at-home orders, physical distancing, face masks and other non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. Bronchiolitis is a clinically diagnosed viral infection of the lower respiratory tract, and causes a yearly seasonal wave of admissions in paediatric wards worldwide. We counted 92,5% less bronchiolitis hospitalisations in Antwerp before the expected end of the peak this year (of which only 1 RSV positive), as compared to the last 3 years. Furthermore, there was a>99% reduction in the number of registered RSV cases in Belgi...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Characterization and natural history of congenital intrahepatic portosystemic shunts
Conclusions: Our study suggests that congenital intrahepatic portosystemic shunt is a benign, self-limiting condition in which no correlation between the size of the shunt and the blood ammonia level to the outcome of the shunt was found. This is the first study that correlated radiological measures to the outcome. These results suggest that the treating physician should reassure families and conduct minimal follow-up and interventions in children with such conditions. Further, larger and prospective studies should be done to corroborate these conclusions.What is Known:•Characteristics and natural history of intrahepa...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Occurrence and severity of acute respiratory infections during the first year among very preterm infants: an Epipage-2 cohort analysis
Conclusion: ARIs are still very common during the first year of life of very preterm children, and oxygen therapy is frequently needed. Educational strategies are needed in all families with a very preterm infant.What is Known:•Acute respiratory infections (ARIs) are the first cause of rehospitalizations in preterm children, with bronchopulmonary dysplasia being the main risk factor.•Palivizumab prophylaxis has proven its effect against severe RSV infections, but it is not universal.What is New:•No factor describing neonatal morbidity, except BPD, was associated with ARI occurrence or severity.•BPD and ...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

The perfusion index histograms predict patent ductus arteriosus requiring treatment in preterm infants
This study aimed to split continuously obtained PI and other vital signs before, during, and after medical treatment of PDA, into histogram bins, and determine the utility of PI and other vital sign histograms in the early prediction of hemodynamically significant PDA (hsPDA). In 34 infants at a mean gestational age of 26  ± 2.1 weeks, we prospectively collected vital signs for three different periods, 24 h before starting treatment of PDA, during PDA treatment, and 24 h after completion of the course of treatment, and confirmed PDA closure by echo. Histograms with three comparable perio...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

The triglycerides and glucose index is strongly associated with hepatic steatosis in children with overweight or obesity
Conclusion: Compared to other biochemical markers, the TyG index is highly associated with the presence of fatty liver in children with overweight and obesity.What is known:• The triglycerides and glucose (TyG) index is effective in predicting high risk for incident nonalcoholic fatty liver disease (NAFLD) in adults.What is new:• Compared to other biochemical markers, the TyG index is highly associated with the presence of fatty liver in children with overweight or obesity.• The triglycerides and glucose index may be a useful tool to detect children at high risk of fatty liver. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Physical fitness reference standards in Italian children
Conclusion: The reference standards are provided as 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th, and 99th percentiles in the form of both tables and charts and are roughly comparable with those of other European children.What is Known:• Physical fitness in childhood is considered a marker of current and future health;• Several tests have been developed to assess physical fitness in children;• There are general European reference standards for a series of tests of the main fitness components for children.What is New:• The present study provides specific reference standards for a series of tests that are...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Pulmonary function test abnormalities in children and adolescents with non-alcoholic fatty liver disease
AbstractAssociation between pulmonary function tests (PFTs) and non-alcoholic fatty liver disease (NAFLD) has been reported in adult studies; however, there is lack of pediatric studies. Our study aimed to evaluate PFTs in children with NAFLD. A total of 137 children with NAFLD and 100 healthy children of matched age and sex were included in the study. Different PFTs including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, residual volume (RV), and total lung capacity (TLC) were performed for all included children. Lipid profile, insulin resistance, fasting and postprandial glucose lev...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Adherence to gluten-free diet and follow-up of pediatric celiac disease patients, during childhood and after transition to adult care
Conclusions: Children who have regular follow-up and normalize serology before age 18 years are likely to maintain a GFD and have negative serology as adults.What is Known:•The rate of adherence to gluten-free diet (GFD) is higher among children compared to adults.•Data on long-term follow-up after transition to adult care is scarce.What is New:•Patients diagnosed with CD at a younger age (
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis
Conclusion: Our data underline the importance of assessing metabolic syndrome not only in adults and adolescents but also in young children with psoriasis.What is Known:•Psoriasis in adults is strongly associated with metabolic disease and insulin resistance.•Very limited data are available on the prevalence of metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis.What is New:•This study reports that in pre-pubertal children with psoriasis, there is a high prevalence of metabolic syndrome and insulin resistance.•In children with psoriasis metabolic syndrome risk factors shoul...
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Are urachal remnants really rare in children? An observational study
Conclusion: The prevalence of urachal remnants in our cohort was nearly 2 in every 1000 children. More specifically, the prevalence of urachal cysts was one in 600.What is Known:•Urachal remnants were believed to be rare.•Recent studies indicated a higher incidence than previous reports.What is New:•This study shows that urachal remnant may be observed in one every 500 children that undergo ultrasonography of the abdomen for various reasons.•Parental counselling and management of urachal remnants should be planned accordingly. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Author ’s reply to the Letter to the Editor on the original article “Lack of changes in preterm delivery and stillbirths during COVID-19 lockdown in a European region” by Juan Arnaez
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Letter to the Editor on the original article “Lack of changes in preterm delivery and stillbirths during COVID-19 lockdown in a European region” by Juan Arnaez
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 8, 2021 Category: Pediatrics Source Type: research

Genetic evaluation of newborns with critical congenital heart defects admitted to the intensive care unit
Conclusion: MLPA is fast and cost-effective analysis that could be used as the first-tier test in newborns with critical CHD admitted to the ICU.What is Known:• MLPA is an established method for chromosome analysis in patients with CHD, but detection rate in newborns with critical CHD is unknown.What is New:• Study suggests that detection rate of casual variants using MLPA in newborns with critical CHD is 10%. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 7, 2021 Category: Pediatrics Source Type: research

Cord blood levels of interleukin-10 decrease in neonates with increased birth weight: novel implications of the cytokine network in early obesity
AbstractInterleukin-10 (IL-10) and interferon-gamma (IFN-gamma) are associated with body weight alterations in children, adolescents, and adults. However, little is known regarding the role of IL-10 and IFN-gamma in birth weight of neonates. One hundred eighty-two infants were enrolled and divided in groups of normal birth weight ( 95th percentile) for gestational age. IL-10 and IFN-gamma levels were measured in umbilical cord tissue and blood of newborns by quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA). The average value of birth weight in infants below and above the 95th perc...
Source: European Journal of Pediatrics - May 7, 2021 Category: Pediatrics Source Type: research

Ethical and practical dilemmas in cardiac transplantation in infants: a literature review
AbstractThe waiting time in infants for a cardiac transplant remains high, due to the scarcity of donors. Consequently, waiting list morbidity and mortality are higher than those in other age groups. Therefore, the decision to list a small infant for cardiac transplantation is seen as an ethical dilemma by most physicians. This review aims to describe outcomes, limitations, and ethical considerations in infant heart transplantation. We used Medline and Embase as data sources. We searched for publications on infant (
Source: European Journal of Pediatrics - May 6, 2021 Category: Pediatrics Source Type: research

Factors associated with acyclovir nephrotoxicity in children: data from 472 pediatric patients from the last 10 years
AbstractAcyclovir may cause acute kidney injury (AKI) due to the accumulation of relatively insoluble acyclovir crystals in renal tubules. The aim of this study was to evaluate risk factors associated with acyclovir-related AKI in children. Between January 2010 and December 2019, pediatric recipients of intravenous (IV) acyclovir were evaluated retrospectively. There were a total of 472 patients [249 (52.7%) boys] of which 32 (6.8%) had AKI [15 (46.8%) boys]. Patients with AKI had greater mean age, baseline creatinine level, and duration of treatment compared to patients without AKI (p
Source: European Journal of Pediatrics - May 6, 2021 Category: Pediatrics Source Type: research

Premedication with ketamine or propofol for less invasive surfactant administration (LISA): observational study in the delivery room
Conclusion: Pending results from prospective trials, these findings suggest that ketamine or propofol can be used for premedication before LISA, as they show comparable efficacy and tolerance.Trial registration: This study was recorded on the National Library of Medicine registry (https://clinicaltrials.gov/ Identifier: NCT03705468).What is Known?• Less invasive surfactant administration (LISA) is increasingly used in spontaneously breathing premature infants supported with continuous positive airway pressure, but few data are available to guide adequate premedication for this procedure.What is New?• This observa...
Source: European Journal of Pediatrics - May 6, 2021 Category: Pediatrics Source Type: research

Can parental simulation improve neonatal CPR performance? A pilot study
Conclusion: The addition of a simulation encounter before discharge may improve short-term parental performance of basic life support.What is Known:• Parents of newborns at risk receive institutional training in basic life support.• The retention of knowledge from this training is a point of concern for parents.What is New:• A single simulation encounter for parents improved resuscitation performance.• Simulation for parents may be an important and useful tool to improve the efficacy of basic life support training. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 5, 2021 Category: Pediatrics Source Type: research

Incidence of gynaecomastia in Klinefelter syndrome adolescents and outcome of testosterone treatment
Conclusion: The incidence of gynaecomastia in KS boys (overall 35.6%) is not increased over typically developing boys. Commencing testosterone when gynaecomastia develops with physiological dose escalation and full adherence can result in the resolution of the gynaecomastia.What is Known:• Gynaecomastia is a common feature in Klinefelter syndrome men.• Hypogonadism occurs from mid-puberty onwards with the absence of the usual rise in testosterone levels.What is New:• The incidence of pubertal gynaecomastia in Klinefelter syndrome is not different from typically developing boys.• Early and prompt startin...
Source: European Journal of Pediatrics - May 2, 2021 Category: Pediatrics Source Type: research

Association of kidney biopsy findings with short- and medium-term outcomes in children with moderate-to-severe IgA vasculitis nephritis
Conclusion: This study highlights the relationship between the clinical and histological presentation of IgAV-N and the factors that affect kidney outcome. The ISKDC classification may be improved by including lesions that are more discriminating for disease severity and prognosis.What is Known:• Nephrotic syndrome (NS) or kidney failure at diagnosis and cellular crescents in more than 50% of the glomeruli are recognized as risk factors for poor kidney outcome in immunoglobulin A vasculitis nephritis (IgAV-N).• The reference histological classification of the International Study of Kidney Disease in Children (ISK...
Source: European Journal of Pediatrics - May 2, 2021 Category: Pediatrics Source Type: research

Human milk bank and personalized nutrition in the NICU: a narrative review
Conclusion: This narrative review presents salient data of our current knowledge and concerns regarding milk feeding of preterm infants in the NICU, with special emphasis on personalized DM as a result of establishing a PNU.What is Known:•Donor milk bank is mature or pooled milk from lactating mothers at different stages of lactation.•Milk composition varies by gestational age and stage of lactation.What is New:•Donor milk from mothers delivered prematurely have the most adequate composition for preterm infant feeding.•Personalized nutrition for premature infants with preterm donor milk is feasible. (So...
Source: European Journal of Pediatrics - April 9, 2021 Category: Pediatrics Source Type: research

Home phototherapy for hyperbilirubinemia in term neonates —an unblinded multicentre randomized controlled trial
Conclusion: Home phototherapy could be a safe alternative to inpatient phototherapy for otherwise healthy newborns with hyperbilirubinemia if daily checkups and 24/7 telephone support can be provided. The parents should be informed to contact the hospital immediately if they fail to perform the treatment at home.Trial registration:Clinicaltrials.gov NCT03536078What is Known:• Phototherapy in the hospital is a safe and effective treatment without major side effects.• Fibre optic equipment has made the choice of home phototherapy possible.What is New:• This is the first randomized controlled trial comparing ho...
Source: European Journal of Pediatrics - April 9, 2021 Category: Pediatrics Source Type: research

Heart rate variability as possible marker of brain damage in neonates with hypoxic ischemic encephalopathy: a systematic review
Conclusion: A growing body of research supports the use of HRV as non-invasive, bedside tool for the monitoring of hypoxic-ischemic encephalopathy. The currently available data about the role of HRV as prognostic tool in case of hypoxic ischemic encephalopathy are promising but require further validation by future studies.What is Known:• Heart rate variability (HRV) is a non-invasive monitoring technique to assess the autonomic nervous system activity.• A correlation between abnormal HRV and cerebral injury has been reported in the perinatal period, and HRV has been suggested as possible marker of brain damage in...
Source: European Journal of Pediatrics - April 9, 2021 Category: Pediatrics Source Type: research

Cardiac remodeling in patients with childhood-onset craniopharyngioma — results of HIT-Endo and KRANIOPHARYNGEOM 2000/2007
AbstractHypothalamic obesity caused by childhood-onset craniopharyngioma results in long-term cardiovascular morbidity. Knowledge about clinical markers and risk factors for cardiovascular morbidity is scarce. A cross-sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 craniopharyngioma patients. BMI correlated with the thickness of interventricular septum in diastole (IVSd) (r = 0.604,p
Source: European Journal of Pediatrics - April 9, 2021 Category: Pediatrics Source Type: research

Conjugated hyperbilirubinemia among infants with hyperinsulinemic hypoglycemia
AbstractFrom clinical practice, we noted that a subset of neonates with hyperinsulinism develop conjugated hyperbilirubinemia. A relationship between these two conditions has not been previously described. We aimed to assess the incidence of cholestasis in a cohort of neonates with hyperinsulinism and describe their clinical characteristics. In a retrospective cohort of 63 neonates with hyperinsulinism, 48% developed cholestasis (conjugated bilirubin> 17 μmol/L) with a median maximum conjugated bilirubin of 81 [21 to 191] μmol/L. A history of fetal distress (RR 2.3 [1.24–4.45],p
Source: European Journal of Pediatrics - April 9, 2021 Category: Pediatrics Source Type: research