Lipid profile assessed in the family pediatrician ’s office: the COLIBRI’- SIMPeF study
Conclusion: The prevalence of dyslipidemia in our sample is worthy of attention. The study suggests the opportunity and feasibility to check for the presence of dyslipidemia at the family pediatrician ’s office. Familiarity is associated with high cholesterol levels, regardless of the children’s weight class, while weight excess identifies subjects with the typical lipid profile of metabolic syndrome.What is Known:• Few data are available on the lipid profile in Italian children.• Early treatment of hypercholesterolemia is effective in reducing cardiovascular events later in life; there is no agreemen...
Source: European Journal of Pediatrics - July 2, 2020 Category: Pediatrics Source Type: research

Diagnostic and prognostic value of procalcitonin and mid-regional pro-adrenomedullin in septic paediatric patients
Conclusion: PCT appeared to be superior to MR-proADM in diagnosing sepsis. Determining MR-proADM plasma levels at the initial phase of sepsis could be a useful tool for sepsis stratification and morbidity prediction before organ failure occurs. The present results need to be assessed with larger sample size studies.What is Known:•CRP and PCT are already included in clinical practice to assess sepsis and estimate disease severity, although their sensitivity and specificity are lower than desired.•ADM is a protein that has immune and vascular modulation actions, and its blood levels are increased in adult and paedi...
Source: European Journal of Pediatrics - June 24, 2020 Category: Pediatrics Source Type: research

EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children
Conclusion: Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases.What is Known:• Symptoms of the lower urinary tract may have significant social consequences and sometimes clinical morbidities like urinary tract infections and vesicoureteral reflux. In many children, however, there is no such obvious cause for the incontinence, and they are referred to as having functional...
Source: European Journal of Pediatrics - June 24, 2020 Category: Pediatrics Source Type: research

Association of initial empirical antibiotic therapy with increased risk of necrotizing enterocolitis
Conclusion: The evidence suggests an association between IEAT ( ≥ 5 days) and the risk of NEC. Further studies are needed to address whether the association with IEAT is causal.What is Known:•Necrotizing enterocolitis (NEC) is acute inflammatory necrosis of the intestinal tractin the newborn infant.•Some observational studies have associated initial empirical antibiotics with an increased risk of subsequent NEC.What is New:•Initial empirical antibiotic therapy (IEAT) ( ≥ 5 days) appear to increase the risk of NEC. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 24, 2020 Category: Pediatrics Source Type: research

SARS-COV-2 infection in children and newborns: a systematic review
Conclusion: SARS-CoV-2 affects children less severely than adults. Laboratory and radiology findings are mainly nonspecific. Larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children.What is Known:• A novel Coronavirus has been recently identified as responsible for a new Severe Acute Respiratory Syndrome (SARS-CoV-2) spreading globally.• There is limited evidence on SARS-CoV2 infection in children.What is New:• Systematically reviewed available evidence showed that children with SARS-CoV-2 infection may have a less severe patte...
Source: European Journal of Pediatrics - June 24, 2020 Category: Pediatrics Source Type: research

Is the use of triglyceride-glucose (TyG) index to recognize glucose disorders really practical?
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 24, 2020 Category: Pediatrics Source Type: research

Real-world data for pediatric medulloblastoma: can we improve outcomes?
Conclusion: Treatment delivery optimization has improved survival rates of patients with MB. Despite this, in our study, we have not established a clear influence of the considered radiotherapy and chemotherapy treatment quality parameters on outcomes.What is Known:• Improvement in treatment modalities during the last decades has reached a 5-year OS of up to 70% in these patients.• Extent of resection and radiotherapy parameters such as interval between surgery-radiotherapy and radiotherapy duration has been described as probable survival prognostic factors.What is New:• Differences in medulloblastoma surviv...
Source: European Journal of Pediatrics - June 21, 2020 Category: Pediatrics Source Type: research

Re: Esposito et al.: To mask or not to mask children to overcome COVID-19
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 20, 2020 Category: Pediatrics Source Type: research

How to improve CPAP failure prediction in preterm infants with RDS: a pilot study
Conclusions: SF ratio and RD-PV, as measured by pulsed-wave Tissue Doppler, may help physicians to improve their confidence in optimizing therapeutic options in preterm infants with RDS.What is Known:• Continuous positive airway pressure is the recommended first-line treatment for respiratory distress syndrome in preterm infants, but failure rates remain unacceptably high.• Choosing the optimal treatment in terms of non-invasive ventilation effectiveness and timeliness of surfactant administration for these patients is often challenging, also due to our inability to identify a worsening respiratory failure.What i...
Source: European Journal of Pediatrics - June 19, 2020 Category: Pediatrics Source Type: research

Clustering of 24-h movement behaviors associated with cardiorespiratory fitness among adolescents: a latent class analysis
This study aimed to examine the clustering of 24-h movement behaviors (moderate to vigorous physical activity, screen time, and sleep duration) and their association with cardiorespiratory fitness among adolescents. We evaluated 561 adolescents (52.1% girls; mean age, 13.0  ± 1.0 years) from Florianópolis, Brazil. A 20-m shuttle run was used to assess cardiorespiratory fitness, while a questionnaire was used to measure 24-h movement behaviors. A latent class analysis was performed to identify the clustering of 24-h movement behaviors, while linear Bayesian mixe d-effect regression models we...
Source: European Journal of Pediatrics - June 18, 2020 Category: Pediatrics Source Type: research

Knowledge, attitudes and practices of neonatal professionals regarding pain management
Conclusion: This research provides useful information regarding the knowledge, attitudes, and clinical practice of neonatal pain management among neonatologists and nurses and points out some differences in the knowledge levels of these two groups.What is Known:•Neonates can perceive and respond to pain stimuli by showing their biological signals similarly to children and adults.•Untreated or insufficient pain management for high-risk neonates has short-term.negative effects and may also induce long-term negative effects.What is New:•The level of knowledge, the attitudes, and the practices regarding neonatal...
Source: European Journal of Pediatrics - June 18, 2020 Category: Pediatrics Source Type: research

Evaluation of urine output, lactate levels and lactate clearance in the transitional period in very low birth weight preterm infants
ConclusionUO and LL and lactate clearance were not good predictors of haemodynamic instability or death within 10  days of life.What is Known• It is already established that blood pressure is not a good marker for haemodynamic stability in the preterm infant.• Others clinical parameters, albeit are largely used, are not fully reliable as well.What is New• In our study we tried to determine the sensibility and specificity of urine output and arterial lactate and also the lactate clearance.• All AUC were below 0.80. Sensitivity and specificity were also not very good. Although patients with poor outc...
Source: European Journal of Pediatrics - June 18, 2020 Category: Pediatrics Source Type: research

Paediatric femur fractures —the value of contextual information on judgement in possible child abuse cases: are we bias?
AbstractThe majority of paediatric femur fractures result from accidental trauma; however, it is important to consider non-accidental trauma, especially in pre-ambulatory children. We study whether irrelevant contextual information subconsciously influences conclusions of healthcare professionals with respect to whether observations provide evidence for non-accidental trauma. A survey with nine radiographs of femur shaft fractures was designed. Two different clinical histories (vignettes) with contextual information were designed, non-abuse versus abuse context. One of both vignettes was randomly assigned to the radiograph...
Source: European Journal of Pediatrics - June 17, 2020 Category: Pediatrics Source Type: research

Adjuvant lidocaine to a propofol-ketamine-based sedation regimen for bone marrow aspirates and biopsy in the pediatric population
Conclusion: This study suggests that the addition of local lidocaine injection to a propofol-ketamine sedation for BMAB pediatric patients does not affect the propofol dose, safety, or efficacy properties of the regimen.What is Known:•Although propofol is commonly used, there is no standard sedation regimen for pediatric patients undergoing bone marrow aspiration and biopsy.•Local lidocaine is used in analgesia in the adults undergoing the same procedure.What is New:•Local lidocaine adjuvant to propofol-ketamine sedation does not affect propofol dosing, the safety of efficacy properties of the regimen in the...
Source: European Journal of Pediatrics - June 16, 2020 Category: Pediatrics Source Type: research

Long-term follow-up of coronary artery lesions in children in Kawasaki syndrome
AbstractTo describe clinical and epidemiological characteristics of a Kawasaki syndrome cohort. In a monocentric, retrospective, observational study, between February 1982 and August 2018, we enrolled 361 children, aged 1  month to 24.4 years. Coronary artery lesions were detected in 20.2% of patients: 16% had coronary ectasia, and 4.15% had coronary aneurisms. A significant difference regarding age at disease onset (p = 0.025), fever duration (p 
Source: European Journal of Pediatrics - June 15, 2020 Category: Pediatrics Source Type: research

Low-risk trials for children and pregnant women threatened by unnecessary strict regulations. Does the coming EU Clinical Trial Regulation offer a solution?
AbstractInvestigator-initiated clinical trials are crucial for improving quality of care for children and pregnant women as they are often excluded from industry-initiated trials. However, trials have become increasingly time-consuming and costly since the EU Clinical Trial Directive entered into force in 2001. This directive made compliance with ICH-Good Clinical Practice Guidelines (ethical and quality standard for conducting human subject research) mandatory for all clinical trials, regardless of its risk-classification. By discussing two investigator-initiated, ‘low-risk’ drug trials, we aim to illustrate t...
Source: European Journal of Pediatrics - June 13, 2020 Category: Pediatrics Source Type: research

Validation of the Early Language Scale
Conclusion: The ELS is a valid instrument to identify children with DLD covering an age range of 1 to 6 years in community-based settings.What is Known:• Early identification and treatment of developmental language disorders can reduce negative effects on children’s emotional functioning, academic success, and social relationships.• Short, validated language screening instruments that cover the full age range of early childhood language development lack.What is New:• The 26-item Early Language Scale (ELS) is a valid instrument to identify children at risk for developmental language disorder in well-chi...
Source: European Journal of Pediatrics - June 13, 2020 Category: Pediatrics Source Type: research

Typical RSV cough: myth or reality? A diagnostic accuracy study
AbstractRespiratory syncytial virus (RSV) is well known for causing a potentially severe course of bronchiolitis in infants. Many paediatric healthcare workers claim to be able to diagnose RSV based on cough sound, which was evaluated in this study. Parents of children
Source: European Journal of Pediatrics - June 13, 2020 Category: Pediatrics Source Type: research

Pre-excitation cardiac problems in children: recognition and treatment
Conclusion: For ventricular pre-excitation co-exists with dilated cardiomyopathy, differential diagnosis of tachycardiomyopathy or accessory pathway-induced dilated cardiomyopathy should be considered. Catheter ablation (radiofrequency and cryoablation) is a relatively safe and effective treatment option and has become the first choice to treat children with ventricular pre-excitation.What is Known:• Persistent atrioventricular reentrant tachycardia in children can lead to tachycardiomyopathy;• Antiarrhythmic drugs that can be chosen for children are quite limited.What is New:• The anterograde conduction of ...
Source: European Journal of Pediatrics - June 11, 2020 Category: Pediatrics Source Type: research

Monitoring of micturition and bladder volumes can replace routine indwelling urinary catheters in children receiving intravenous opioids: a prospective cohort study
Conclusion: The incidence of urinary retention in children receiving intravenous opioids is low, indicating that placement of urinary catheters is not routinely necessary in these patients. However, micturition and bladder volumes must be monitored, especially in sedated children and during the first 24 h of opioid administration.What is Known:•Great variation exists in the routine placement of urinary catheters in children receiving IV opioids.What is New:•Confirmed by ultrasound, the incidence of urinary retention in children receiving intravenous opioids in this study was 15%, indicating that placement of urin...
Source: European Journal of Pediatrics - June 11, 2020 Category: Pediatrics Source Type: research

The utility of MALDI-TOF MS for outbreak investigation in the neonatal intensive care unit
Conclusion: Here, we show that MALDI-TOF MS, which has been integrated into the microbiology laboratory workflow for microbial species identification, can be secondarily used for epidemiological typing at no added cost.What is Known:• Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now routinely used in the microbiology laboratory for bacterial identificationWhat is New:• MALDI typing was used for outbreak investigation in the NICU and divided the outbreak isolates into two clones• MALDI-TOF MS may be secondarily used for epidemiological typing at no added cost....
Source: European Journal of Pediatrics - June 10, 2020 Category: Pediatrics Source Type: research

Impact of chorioamnionitis on maternal and fetal levels of proinflammatory S100A12
AbstractHistologic chorioamnionitis (HCA) may lead to the fetal inflammatory response syndrome (FIRS). The aim of this pilot study was to evaluate S100A12, a marker of innate immune activation, in mothers with or without HCA and in their infants. Concentrations of S100A12, interleukin 6 (IL-6), and C-reactive protein (CRP) were evaluated in maternal, cord, and neonatal blood of very preterm infants. Histologic examinations of the placenta and umbilical cords were performed. The 48 mother-neonate pairs enrolled were subdivided into two groups: HCA group (N = 15) and control group without HCA (N = 33). Maternal S100A12 level...
Source: European Journal of Pediatrics - June 9, 2020 Category: Pediatrics Source Type: research

Caliber of lumbar puncture needle in preterm infants: few concerns
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 8, 2020 Category: Pediatrics Source Type: research

The impact of a quality improvement project to reduce admission hypothermia on mortality and morbidity in very low birth weight infants
Conclusion: Implementation of thermoregulatory interventions best suited to local settings help in significant reduction of neonatal hypothermia, which in turn can help to improve neonatal outcomes.What is known:•Admission hypothermia is associated with adverse neonatal outcomes.•Implementation of quality improvement projects help reducing hypothermia incidence.What is new:•Implementation of quality improvement project to reduce admission hypothermia resulted in reduction in incidence of adverse composite neonatal outcome.•Also implementation of quality improvement project led to reduction in incidence ...
Source: European Journal of Pediatrics - June 6, 2020 Category: Pediatrics Source Type: research

Primum non nocere: lingual frenotomy for breastfeeding problems, not as innocent as generally accepted
Conclusion: This narrative review aims to give an overview of current knowledge and concerns regarding the tongue-tie, which need to be considered before referral for a frenotomy.What is Known:•The presence of a tongue-tie is associated with a higher frequency of breastfeeding problems.•Hence, frenotomy is advocated and increasingly performed in infants with breastfeeding problems. Current tongue-tie classifications do not allow to predict breastfeeding problems.What is New:•New anatomy insights caution for possible complications resulting from this seemingly innocent practice of frenotomy.•Frenotomy sh...
Source: European Journal of Pediatrics - June 6, 2020 Category: Pediatrics Source Type: research

Point-of-care lung ultrasound in three neonates with COVID-19
Conclusions: LU could be of value when managing COVID-19 neonates. We describe the findings of lung ultrasound monitoring during the first week following diagnosis in three neonates with SARS-CoV-2 infection.What is known:• Lung ultrasound (LU) is a useful tool in COVID-19 management in adults. To date, no report on LU and neonates with SARS-CoV-2 infection has been published.What is new:• This study adds evidence about LU findings in neonates with SARS-CoV-2 infection. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 5, 2020 Category: Pediatrics Source Type: research

Oxygen saturation and perfusion index screening in neonates at high altitudes: can PDA be predicted?
Conclusion: The median peripheral perfusion index at high altitude was not lower than at sea level, while the mean oxygen saturation, in contrast, was lower than at sea level. The low partial oxygen pressure found at high altitudes leads to a variation in postnatal adaptation and an increased prevalence of PDA. Accordingly, oxygen saturation screening may serve to identify babies with PDA at high altitudes.What is Known:• Oxygen saturation is known to be low at high altitudes, and thus the rates of false positivity are high when screening for critical congenital heart disease.• High altitudes are also associated ...
Source: European Journal of Pediatrics - June 5, 2020 Category: Pediatrics Source Type: research

BMI in the lower and upper quartiles at diagnosis and at 1-year follow-up is significantly associated with higher risk of disease exacerbation in pediatric inflammatory bowel disease
This study aimed to present the longitudinal course of height, weight, and body mass index (BMI) of children from IBD diagnosis to 18  months of follow-up, and to describe the impact of BMI on the clinical course of the disease. One hundred and fifty-two children were identified, of whom 85 had Crohn’s disease (CD) and 67 had ulcerative colitis (UC). During a median (interquartile range) follow-up of 2.95 (1.73–4.5) years, w eight and BMI Z-scores increased in the first 18 months since diagnosis in both the CD (P 
Source: European Journal of Pediatrics - June 4, 2020 Category: Pediatrics Source Type: research

Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks
Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs.What is Known:• There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases.What is New:&b...
Source: European Journal of Pediatrics - June 3, 2020 Category: Pediatrics Source Type: research

Effect of ondansetron on vomiting associated with acute gastroenteritis in a developing country: a meta-analysis
Conclusions: Compared with placebo, ondansetron reduced the use of intravenous fluids in children with gastroenteritis and dehydration. It has no effect on children with gastroenteritis who do not present with dehydration in developing countries. While ondansetron is effective in controlling vomiting and reducing the rate of hospitalization, there is no evidence that it is effective in reducing the rate of readmission.What is Known:• In high-income countries, ondansetron can reduce the use of intravenous fluids in children with gastroenteritis and dehydration.• No systematic review and meta-analysis of randomized...
Source: European Journal of Pediatrics - June 3, 2020 Category: Pediatrics Source Type: research

COVID-19 in children: patiently and critically evaluate the scientific evidence
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 3, 2020 Category: Pediatrics Source Type: research

Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
AbstractThe development of devices that can fix the tidal volume in high-frequency oscillatory ventilation (HFOV) has allowed for a significant improvement in the management of HFOV. At our institution, this had led to the earlier use of HFOV and promoted a change in the treatment strategy involving the use of higher frequencies (above 15 Hz) and lower high-frequency tidal volumes (VThf). The purpose of this observational study was to assess how survival without bronchopulmonary dysplasia grades 2 and 3 (SF-BPD) is influenced by these modifications in the respiratory strategy applied to preterm infants (gestational age
Source: European Journal of Pediatrics - June 2, 2020 Category: Pediatrics Source Type: research

Correction to: Time to positivity of Klebsiella pneumoniae in blood culture as prognostic indicator for pediatric bloodstream infections
The authors regrets that there is a typo error on the Abbreviation section of their published paper."Area under the curve" should have been abbreviated to"AUC" instead of“A”. The authors have requested that this be noted. The original article has been corrected. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - June 2, 2020 Category: Pediatrics Source Type: research

Children ’s heart and COVID-19: Up-to-date evidence in the form of a systematic review
Conclusion: This systematic review is aimed at summarizing all COVID-19 cases with a cardiac involvement published in paediatric age and trying to explain the underlying mechanisms responsible for COVID-19-related myocardial damage.What is Known:• Coronaviruses proved to be able to jump from animals to humans.• The outbreak of COVID-19 started from China (Dec 2019) and became pandemic.What is New:• Even in childhood, COVID-19 is not without the risk of cardiac involvement.• Myocarditis, heart failure, and arrhythmias are among the possible manifestations. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 30, 2020 Category: Pediatrics Source Type: research

Neonatal resuscitation guideline adherence: simulation study and framework for improvement
Conclusion: NLS guideline adherence among pediatricians needs improvement. Our framework is meant to promote resuscitation guideline adherence.What is Known:•Inadequate newborn life support (NLS) may contribute to (long-term) pulmonary and cerebral damage.•Video-based assessment of neonatal resuscitations has shown that deviations from the NLS guideline occur frequently; this assessment method has its audiovisual shortcomings.What is New:•The resuscitation quality metrics provided by our high-fidelity manikin suggest that the adherence of Dutch general pediatricians to the NLS guideline is suboptimal.•W...
Source: European Journal of Pediatrics - May 29, 2020 Category: Pediatrics Source Type: research

Less invasive surfactant administration: all that glitters is not gold
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 27, 2020 Category: Pediatrics Source Type: research

Early versus late fortification of breast milk in preterm infants: a systematic review and meta-analysis
Conclusion: Very low quality evidence did not find any significant difference in growth parameters of preterm infants in association with EF or LF of BM. A significant increase in hospital stay and non-significant increase in feed intolerance and NEC were associated with EF.PROSPERO registration number: CRD42019139235What is Known:• Fortification of breast milk with essential macro- and micronutrients is necessary for optimization of nutrition in preterm infants.• There is no consensus regarding the breast milk feeding volume at which fortification should be initiated.What is New:• Very low quality evidence ...
Source: European Journal of Pediatrics - May 27, 2020 Category: Pediatrics Source Type: research

The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight and obesity
Conclusion: At pre-intervention, the overweight group had significantly “worse” tendon structure, with a lower prevalence of echo type II fiber and a higher prevalence of echo type III fibers compared with the control group. Following the 6-month intervention, the tendon structure of the overweight group was “positively” changed, with reduced echo type III fiber s and increased echo type II fibers.What is Known:•Physical activity and weight reduction programs are efficient for obese children.•Obese children tend to suffer orthopedic problems and pain during physical activity.What is New:&b...
Source: European Journal of Pediatrics - May 25, 2020 Category: Pediatrics Source Type: research

Correction to: The pitfalls and promise of liquid biopsies for diagnosing and treating solid tumors in children: as review
In the original version of this article, a reader pointed out that there was a mistake in the phrasing in a paragraph. This could potentially be harmful to children. The authors agree to change the wording. “vitreous fluid” will be changed to “aqueous humor”. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 23, 2020 Category: Pediatrics Source Type: research

Impact of ventricular arrhythmias on outcomes in children with myocarditis
The objective of this study is to assess the impact of ventricular arrhythmias on in-hospital mortality and the use of mechanical circulatory support in patients with myocarditis. Pediatric patients (age 0 –18 years) admitted with myocarditis were identified from the National Inpatient Sample dataset for the years 2002–2015. A total of 12,489 patients with myocarditis were identified. Of them, 1627 patients were with ventricular arrhythmias and 10,862 patients without ventricular arrhythmias. Mor tality was higher in those with ventricular arrhythmias (19.5% vs. 2.8%, OR = 8.47; 95% CI 7.16–10.04;p 
Source: European Journal of Pediatrics - May 23, 2020 Category: Pediatrics Source Type: research

The EPICENTRE (ESPNIC Covid pEdiatric Neonatal Registry) initiative: background and protocol for the international SARS-CoV-2 infections registry
Conclusions: EPICENTRE will allow researchers to clarify the epidemiology, clinical presentation, and outcomes of pediatric and neonatal SARS-CoV-2 infection, refining its clinical management and hopefully providing new insights for clinicians.What is Known:•COVID19 is the new disease caused by SARS-CoV-2 infection and is spreading around the globe.•Majority of data available about SARS-CoV-2 infections originates from adult patients.What is New:•EPICENTRE is the first international, multicenter, multidisciplinary, meta-data driven, hospital-based, online, prospective cohort registry dedicated to neonatal an...
Source: European Journal of Pediatrics - May 22, 2020 Category: Pediatrics Source Type: research

Influence of tenofovir exposure in utero on primary dentition
Conclusion: HIV-uninfected infants with in utero exposure to TDF showed no significant differences in the prevalence of DDE in comparison to cross-sectional data of HIV- and TDF-unexposed children; thus, the in utero exposure to TDF did not negatively influence the prevalence or distribution of DDE.What is Known:•There are no data available on the prevalence of developmental defects of enamel (DDE) in the primary dentition in intrauterine HIV- and tenofovir-exposed children.•Conclusions can be drawn from intrauterine milk tooth development to bone development and mineralization.What is New:•Prevalence of dev...
Source: European Journal of Pediatrics - May 19, 2020 Category: Pediatrics Source Type: research

Correction to: How can primary care practitioners address substance use by adolescents? A position paper of the EUROPEAN academy of PAEDIATRICS
The authors of the published version of this article inadvertently omitted the table note of the Table 2 under the Appendix section. The complete Table 2 is shown in this article] (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 18, 2020 Category: Pediatrics Source Type: research

The correct formula for the triglycerides and glucose index
(Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 15, 2020 Category: Pediatrics Source Type: research

Clinico-laboratory profile of Kawasaki disease with arthritis in children
Conclusion: Arthritis in KD is usually non-erosive, self-limiting, and responds well to a short course of NSAIDs.What is Known:• Arthritis has been reported to occur in 2.3–31% of children with KD.• Arthritis in KD is usually oligoarticular, non-erosive, and responds well to short course of non-steroidal anti-inflammatory drugs.What is New:• Children with KD and arthritis do not appear to be at increased risk of development of coronary artery abnormalities.• Arthritis in children with KD can result in diagnostic confusion, and diagnosis of KD may get delayed. (Source: European Journal of Pediatrics)
Source: European Journal of Pediatrics - May 13, 2020 Category: Pediatrics Source Type: research

Risk factors associated with progression and persistence of small- and medium-sized coronary artery aneurysms in Kawasaki disease: a prospective cohort study
Conclusion: Patients with KD and greater initial aneurysm size, CAA progression, more involved coronary arteries, and lower lymphocyte proportion may require intensive cardiac monitoring and adjuvant therapies.What is Known:• Long-term outcomes of patients with KD and CAA are primarily driven by the consequences of CAA regression and progression.• Regression and progression occurs more frequently in patients with small- and medium-sized CAAs, and less frequently for giant CAAs.What is New:• The CAA size at diagnosis, NCAI, and the proportion of lymphocytes are presumably associated with the small- and medium...
Source: European Journal of Pediatrics - May 13, 2020 Category: Pediatrics Source Type: research

Feeding difficulty and gastrostomy tube placement in infants with Down syndrome
Conclusion: The currently established clinical tools for determining which patients may benefit from radiographic evaluation lack sufficient sensitivity to detect all individuals with feeding difficulty. Due to the high prevalence of abnormal VSS results and high rate of G-tube placement, universal radiographic screening for individuals with Down syndrome could be considered, even in the absence of obvious clinical signs or symptoms. However, determining how to balance this with cost, availability, and radiation exposure may be difficult.What is Known:•Feeding difficulty in children with Down syndrome can lead to sign...
Source: European Journal of Pediatrics - May 13, 2020 Category: Pediatrics Source Type: research

Proportional assist ventilation (PAV) versus neurally adjusted ventilator assist (NAVA): effect on oxygenation in infants with evolving or established bronchopulmonary dysplasia
AbstractBoth proportional assist ventilation (PAV) and neurally adjusted ventilatory assist (NAVA) provide pressure support synchronised throughout the respiratory cycle proportional to the patient ’s respiratory demand. Our aim was to compare the effect of these two modes on oxygenation in infants with evolving or established bronchopulmonary dysplasia. Two-hour periods of PAV and NAVA were delivered in random order to 18 infants born less than 32 weeks of gestation. Quasi oxygenation indi ces (“OI”) and alveolar-arterial (“A-a”) oxygen gradients at the end of each period on PAV, NAVA an...
Source: European Journal of Pediatrics - May 13, 2020 Category: Pediatrics Source Type: research

Congenital hyperinsulinism: management and outcome, a single tertiary centre experience
Conclusion: Although LGA and SGA are risk factors, most babies in our cohort are born AGA. A genetic mutation does not exclude medical remission; long-term conservative treatment of CHI is feasible as surgery does not guarantee complete remission.What is Known:•Congenital hyperinsulinism (CHI) is a clinically and genetically heterogeneous disorder that is the most common cause of permanent hypoglycaemia in infants and children.•Identification of genetic mutations and the use of 18F-DOPA PET scan when feasible lead to better outcomes.What is New:•The study describes clinical criteria, management and outcome o...
Source: European Journal of Pediatrics - May 13, 2020 Category: Pediatrics Source Type: research

Preliminary data on prednisone effectiveness in children with Sydenham chorea
The objective of the study is to evaluate the efficacy of corticosteroids in Sydenham chorea. This is a retrospective observational study. Clinical information of children with Sydenham chorea were collected. Outcome of Sydenham chorea was evaluated in consideration of presence or absence of corticosteroid therapy. Thirty patients were enrolled. A total of 15 were treated with prednisone, 15 received symptomatic drugs or no treatment. Patients who were treated with prednisone showed faster improvement (4 vs 16  days;p = 0.002) and shorter median time of remission (30 vs 135 days;p 
Source: European Journal of Pediatrics - May 13, 2020 Category: Pediatrics Source Type: research