Disease In Children Research Articles

Pneumatization of the temporal bones and otitis media in ancient and modern Greenlanders

Otitis media occurs frequently among modern Greenlanders. However, knowledge of the epidemiology of this disease before the twentieth century is scanty. Information on diseases in the past may give us a better understanding of the health of historical populations. This study presents a new unbiased method for estimating the incidence of infectious middle ear disease (IMED) in childhood. The method is based on the relationship between IMED in childhood and morphological evidence present in the human temporal bones - i.e. small or asymmetrical pneumatized cell areas. In a standardized X-ray projection, we examined 434 pneumatized cell areas in temporal bones from 34 living adult modern Greenlanders, 56 historical adult Greenland Eskimo crania from the period after the European colonization of Greenland in 1721 AD, and 127 prehistoric adult Greenland Eskimo crania from the period before the colonization. The resulting X-rays of the crania were of high quality and the relationship between IMED in childhood and small or asymmetrical pneumatized cell areas was confirmed in the modern Greenlanders. On this basis a polychotomous logistic regression model was applied to the pneumatized cell areas of the three groups of material. The model allowed for the interdependence of the ears and specified probabilities of having IMED in the right ear, left ear, both ears or of being healthy in both ears. The frequency of IMED as indicated by the model was 8/34 (23 .5%) in modern Greenlanders, 10/56 (17.9%) in historical Eskimo crania and 6/127 (4.7%) in prehistoric Eskimo crania (p < 0.002). The mean area also differed significantly, as it was smallest in modern Greenlanders. The results thus indicated a change in the frequency of IMED and a decrease in area from historical to present-day Greenland in subjects who survived to adulthood. The change seemed closely related to the European colonization of Greenland. As IMED is closely related to upper respiratory tract infections and to poverty, the method seems well suited for evaluating general health in past societies.

The Increasing Occurrence of Infectious Diseases in Childhood: Is It Linked with Declining Vaccination Rates Across Society?

Introduction. Childhood infectious diseases have been a significant medical problem, with a global increase in recent years. Modern diagnostic methods and new vaccinations are available. Poland is part of the WHO-coordinated global measles and rubella elimination program. Controversy surrounds mandatory and recommended vaccinations in Poland. There has been a concerning increase in the abandonment of vaccinating children, leading to a resurgence of infectious diseases. In 2024, the WHO reported a significant increase in measles cases in the European region, including in Poland. It's crucial to remind people of these diseases and warn them about the complications they bring. Aim of study. The aim of this study is to investigate the increasing occurrence of infectious diseases in childhood and examine the correlation with declining vaccination rates across society. Materials and methods. An unsystematic review of scientific literature was conducted, employing specific keywords such as „measles,” „pertussis,” „rubella,” „infectious diseases,” „vaccination,” and „hib.” The review was executed on the PubMed database, analyzing a total of 59 sources published until the conclusion of 2024. Conclusions. To control and eliminate infectious diseases, it is vital to maintain and improve vaccination rates. Policymakers and healthcare providers should prioritize immunization programs and address barriers to vaccine access. Further research is crucial to develop comprehensive strategies for increasing vaccination coverage and understanding vaccine-preventable diseases in modern public health challenges.

РАЗВИТИЕ ХРОНИЧЕСКОГО МУЛЬТИОЧАГОВОГО НЕБАКТЕРИАЛЬНОГО ОСТЕОМИЕЛИТА У ПАЦИЕНТА С ИСХОДНО ДИАГНОСТИРОВАННЫМ СИСТЕМНЫМ ЮВЕНИЛЬНЫМ АРТРИТОМ: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

Systemic juvenile arthritis (sJA) is a special variant of chronic arthritis in children belonging to the spectrum of polygenic autoinflammatory diseases whose main features are persistent febrile fever, skin rashes, other systemic manifestations (serositis, lymphadenopathy, hepatosplenomegaly) as well as the presence of joint damage with the frequent development of destructive polyarthritis and osteonecrosis, high laboratory indicators of systemic inflammation either at the disease onset or delayed. The list of differentiated conditions includes many diseases such as infections, cancer, primary immunodeficiencies, monogenic autoinflammatory diseases etc. Authors represent a clinical case of a patient with sJA manifestations who was diagnosed with chronic multifocal nonbacterial osteomyelitis (CMNO), that demonstrates the great difficulties in diagnosis and the variability of the course of rheumatic diseases in childhood, which in its turn causes a delay in the timely prescription of effective therapy. Thus, patients with manifestations of a systemic inflammatory process, joint changes, especially those with an atypical course of the disease, pain in the bones and joints of a nocturnal nature, as well as an insufficient response to the therapy even long-term, are in need of conducting of a differential diagnostic search with the inclusion of CMNO, the ‘whole body’ mode magnetic-resonance tomography prescribed by a rheumatologist practitioner.

Self-Use of Aspirin Among Mothers in Management of Fever in Children Khartoum, Sudan 2022

Background: Fever is one of the most frequent symptoms of disease in childhood and a common cause of emergency admissions in infants and children. Aspirin is salicylic acid and is used to treat pain and fever. Aspirin should not be administrated to a child under 16 years old of age because it might lead to a serious and sometime fatal condition in children called Reye’s syndrome. Reye syndrome is a rare and potentially fatal pediatric illness defined as acute noninflammatory encephalopathy with fatty liver failure. Objective: To assess attitude and practice among mothers towards self-use of aspirin in management of fever in children under 5 years and its complication in Dar-alsalam almaghariba. Method: A descriptive, cross- sectional community-based study applied in sample size of 195 using non probability convenience sampling method, among mothers in Dar-alslam almaghariba area in February 2022. The data was collected by interview questionnaire. Which include sociodemographic data, close end questions contain 21 questions about knowledge, attitude and practice of self-use of aspirin, Data analysis was done by SPSS program and Microsoft excel. Results: the study report that (41.5%) of the respondents aged more than 40 years, (95,9%) of them were married, (75.4%) were housewife, (20%) were employee, (2.1%) were students and (2.6%) work, Majority of mother (87.2%) measured children’s temperature when felt subjectively rises by touch, irrespective to their beliefs about home management of fever (73.8%) used antipyretics. most of them know about complications of high-grade fever (93.8%) said high grade fever can cause convulsions. About (97.9%) of the participants know Aspirin and most of them (48.7%) get it from booth. Most of the participants (65.1%) used aspirin to lower temperature of their children, about (78.5%) of mothers know how to use aspirin. Majority of mothers (71.8%) don't know the side effect of the irrational aspirin to the children, about (96.4%) don't heard of Reye’s syndrome. Conclusion: Study concludes nearly all mothers used aspirin without prescription to reduce children’s body temperature, mothers’ awareness about hazardous use of aspirin and the Reye’s syndrome is extremely low, there is relation between low level of education and irrational use of aspirin by mothers. Ministry of health should increase the awareness of mothers about complications of aspirin aimed at eradication of the practice.

Komrower Memorial Lecture 2023. Molecular basis of phenotype expression in homocystinuria: Where are we 30 years later?

This review summarises progress in the research of homocystinuria (HCU) in the past three decades. HCU due to cystathionine β-synthase (CBS) was discovered in 1962, and Prof. Jan Peter Kraus summarised developments in the field in the first-ever Komrower lecture in 1993. In the past three decades, significant advancements have been achieved in the biology of CBS, including gene organisation, tissue expression, 3D structures, and regulatory mechanisms. Renewed interest in CBS arose in the late 1990s when this enzyme was implicated in biogenesis of H2S. Advancements in genetic and biochemical techniques enabled the identification of several hundreds of pathogenic CBS variants and the misfolding of missense mutations as a common mechanism. Several cellular, invertebrate and murine HCU models allowed us to gain insights into functional and metabolic pathophysiology of the disease. Establishing the E-HOD consortium and patient networks, HCU Network Australia and HCU Network America, offered new possibilities for acquiring clinical data in registries and data on patients´ quality of life. A recent analysis of data from the E-HOD registry showed that the clinical variability of HCU is broad, extending from severe childhood disease to milder (late) adulthood forms, which typically respond to pyridoxine. Pyridoxine responsiveness appears to be the key factor determining the clinical course of HCU. Increased awareness about HCU played a role in developing novel therapies, such as gene therapy, correction of misfolding by chaperones, removal of methionine from the gut and enzyme therapies that decrease homocysteine or methionine in the circulation.

Oxidised Albumin Levels in Plasma and Skeletal Muscle as Biomarkers of Disease Progression and Treatment Efficacy in Dystrophic mdx Mice.

Redox modifications to the plasma protein albumin have the potential to be used as biomarkers of disease progression and treatment efficacy in pathologies associated with inflammation and oxidative stress. One such pathology is Duchenne muscular dystrophy (DMD), a fatal childhood disease characterised by severe muscle wasting. We have previously shown in the mdx mouse model of DMD that plasma albumin thiol oxidation is increased; therefore, the first aim of this paper was to establish that albumin thiol oxidation in plasma reflects levels within mdx muscle tissue. We therefore developed a method to measure tissue albumin thiol oxidation. We show that albumin thiol oxidation was increased in both mdx muscle and plasma, with levels correlated with measures of dystropathology. In dystrophic muscle, albumin content was associated with areas of myonecrosis. The second aim was to test the ability of plasma thiol oxidation to track acute changes in dystropathology: we therefore subjected mdx mice to a single treadmill exercise session (known to increase myonecrosis) and took serial blood samples. This acute exercise caused a transient increase in total plasma albumin oxidation and measures of dystropathology. Together, these data support the use of plasma albumin thiol oxidation as a biomarker to track active myonecrosis in DMD.

Autoimmune Connective Tissue and Dermatologic Diseases in Children with Autism Spectrum Disorder

Autoimmune Connective Tissue and Dermatologic Diseases in Children with Autism Spectrum Disorder

Temporomandibular joint rehabilitative approaches for children and adolescents affected by juvenile idiopathic arthritis: A systematic review.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%-78% of patients. The aim of this systematic review was to assess the effectiveness of conservative approaches in improving TMJ arthritis in children and adolescents affected by JIA. PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2024, to identify observational studies presenting participants with a diagnosis of JIA affecting the TMJ, rehabilitative approaches for TMJ arthritis as interventions, and clinical or radiological assessment of TMJ arthritis as outcome. Of 478 papers suitable for title/abstract screening, 13 studies were included. The studies evaluated the effectiveness of intra-articular (IA) corticosteroid (CS) injections, IA infliximab injections, arthrocentesis alone or in combination with IACS injections, occlusal splint, functional appliance, and physiotherapy. The effectiveness of IACS injections was shown in eight studies. IA infliximab injections did not appear to significantly improve TMJ arthritis. Results of this systematic review suggested that conservative treatments, especially IACS injections, might be effective in improving TMJ arthritis in patients affected by JIA. Further studies with a higher level of evidence and more representative samples should be conducted.

A study of Some Factors Affecting the Prevalence of Renal Disease in Children

The current study was carried out in the period from 1 to 25 November 2023. It included sixty-two pediatric patients in the age range of (1-12) years and male and female children: twenty-six pediatric patients with chronic renal failure and thirty-six pediatric patients with nephrotic syndrome, who were outpatients and inpatients in the renal diseases unit and dialysis unit of both Al-Mansour Pediatric Teaching Hospital and Child's Central Teaching Hospital in Baghdad, Iraq. The control group consisted of twenty-six children in the same age range as the sick groups of males and females. Blood samples were collected from patients and controls. Then renal function was evaluated by applying the laboratory tests as urea and creatinine levels were measured in serum, besides blood group and Rh factor tests. Factors that may affect renal disease incidence and progress were recorded, such as socioeconomic status, residence (North, Middle, and South), and family history. The results explained the significant increase in both urea and creatinine concentrations (P<0.001) in serum compared with controls. The blood group and Rh factor had no significant differences among children of both sick groups. The entire affected factors had no significant association with renal disease incidence or progress in the current study. The age and gender of each child patient had no significant effect on the type of renal disease (at P value ≤ 0.01).

Reproductive toxicology of environmental endocrine-disrupting chemicals in women: a cohort study protocol.

Introduction: Epidemiological evidence over the last few decades has consistently shown that exposure to endocrine-disrupting chemicals (EDCs) is associated with adverse reproductive health outcomes, including male and female infertility, poor-pregnancy outcomes, and increased risk of diseases in childhood and beyond. To investigate the effects of EDCs and lifestyle on all aspects of reproduction (including early oocyte development, fertilization, embryo development, embryo implantation, abortion, and preterm birth). Methods: We performed this cohort study on patients receiving in vitro fertilization (IVF) treatment. Biological samples including urine, serum, follicular fluid, semen, fetal tissue, decidua, and placenta, were obtained. Results: By studying the correlations between reproductive outcomes and environmental pollutant exposure and lifestyle, we determined the toxicological mechanisms and health effects of EDCs on female reproductive health. We found that higher concentrations of per- and polyfluoroalkyl substances were correlated with polycystic ovary syndrome (PCOS). Using specific biomarkers, we also detected the concentrations of organophosphorus flame retardants (OPFRs) in urine and found that OPFRs may disrupt hormone homeostasis. Discussion: All of these results reveal EDCs may disrupt female reproduction.

The "String of Pearls" Sign of Chronic Bullous Disease of Childhood (CBDC).

The "String of Pearls" Sign of Chronic Bullous Disease of Childhood (CBDC).

Urinary eicosanoid levels in early life and risk of atopic disease in childhood

IntroductionEicosanoids are lipid mediators including thromboxanes (TXs), prostaglandins (PGs) and leukotrienes (LTs) with a pathophysiological role in established atopic disease. However, their role in the inception of disease is unclear. We aimed to investigate the association between urinary eicosanoids in early life and development of atopic disease. MethodsWe quantified the levels of 21 eicosanoids in urine from children from the COPSAC2010 (age 1 year, n=450) and VDAART (age 3 years, n=575) mother-child cohorts and analyzed the associations with development of wheeze/asthma, atopic dermatitis, and biomarkers of Type-2 inflammation, applying FDR5% multiple testing correction. ResultsIn both cohorts, analyses adjusted for environmental determinants showed that higher TXA2 eicosanoids in early life were associated with increased risk of developing atopic dermatitis (P<FDR5%) and Type-2 inflammation (p<0.05). In VDAART, lower PGE2 and PGI2 eicosanoids and higher isoprostanes were also associated with increased risk of atopic dermatitis (P<FDR5%). For wheeze/asthma, analyses in COPSAC2010 showed that lower isoprostanes and PGF2 eicosanoids and higher PGD2 eicosanoids at age 1 year associated with an increased risk at age 1-10 years (p<0.05), whereas analyses in VDAART showed that lower PGE2 and higher TXA2 eicosanoids at age 3 years associated with an increased risk at 6 years (P<FDR5%). ConclusionsThis study suggests that early life perturbations in the eicosanoid metabolism are present before the onset of atopic disease in childhood, which provides pathophysiological insight in the inception of atopic diseases.

Demographic insights in systemic EBV-positive T-cell lymphoproliferative disease of childhood: A comprehensive NCDB analysis.

e19077 Background: Infection with the Epstein-Barr virus can result in lymphoproliferative disorders due to the capability of the virus to infect lymphocytic cells. Systemic EBV-positive T-cell lymphoproliferative disease (LPD) of childhood is a specific lymphoproliferative disorder caused by infection with the Ebstein-Barr virus that is characterized by T cell clonal proliferation that showcases cytotoxic T lymphocytes cells expressing a combination of the glycoproteins CD8 and CD4. The rarity of this lymphoproliferative disorder makes it a great candidate for further analysis of demographic factors impacting the disease. We will employ the National Cancer Database (NCDB) to shed light on the demographic complexities. Methods: A retrospective cohort analysis was conducted to examine all patients within the National Cancer Database (NCDB) who possessed histologically confirmed systemic EBV positive T cell LPD between 2004 and 2020. Descriptive statistical methods were applied to assess demographic factors, and a thorough regression analysis was employed to investigate patterns in the incidence of the disease. Results: The NCDB confirms a total of 91 patients from 2004-2020 having a diagnosis of systemic EBV-positive T-cell LPD of childhood. The average age of diagnosis was 28 years (IQR= 22). The majority of patients did not receive palliative care (98%). Primary treatment that patients received for this disease were chemotherapy (77%), hormone therapy (48%), immunotherapy (27%), and radiation therapy (7%). The two-year survival rate was 49% and the five-year survival rate was 46%. The mean survival time was around 5.6 years with this disease. Males and females were close to equal in numbers (52% and 48%). 69% of patients were white, 13% were black, and 82% were non-Spanish; non-Hispanic. A greater percentage of patients were privately insured (59%) compared to patients insured through Medicare or Medicaid. The primary site was bone marrow (47%) and the NCDB analytic stage group was high at Stage IV (58%). The majority had Charlson-Deyo comorbidity scores of 0 (84%). Conclusions: Following a thorough investigation of existing literature, we conclude this is the first NCDB analysis on systemic EBV-positive T-cell LPD of childhood, bridging a critical knowledge gap in the current research landscape. Socioeconomic factors have yet to be discussed revolving patients with systemic EBV-positive LPD of childhood. Our study showed a higher prevalence of the disease was found in privately insured, white patients with few comorbidities. Considering the mean age of diagnosis and prognosis of this disease, it is imperative that further research be conducted to understand the interaction between socioeconomic and demographic characteristics on the diagnosis, treatments, and survival of patients living with this cancer.

Preventive effects of prenatal administration of OM-85/BV on asthma and respiratory infection risk in the offspring: A review of animal models.

Asthma is the most common chronic disease in childhood affecting the daily lives of many patients despite current treatment regimens. Therefore, the need for new therapeutic approaches is evident, where a primary prevention strategy is the ultimate goal. Studies of children born to mothers in farming environments have shown a lower risk of respiratory infections and asthma development. Already at birth, these newborns have demonstrated accelerated maturation and upregulation of host defense immune functions suggesting a prenatal transplacental training of the innate immune system through maternal microbial exposure. This mechanism could possibly be utilized to help prevent both respiratory infections and asthma in young children. Human studies exploring the potential preventative effects of pregnancy bacterial lysate treatment on asthma and respiratory infections are lacking, however, this has been studied in experimental studies using mice through administrations of the bacterial lysate OM-85. This review will present the current literature on the immunomodulatory effects relevant for respiratory infections and asthma in the offspring of mice treated with OM-85 throughout pregnancy. Further, the review will discuss the cellular and molecular mechanisms behind these effects. In conclusion, we found promising results of an accelerated immune competence and improved resistance to airway challenges as a result of prenatal bacterial lysate treatment that may pave the way for implementing this in human trials to prevent asthma and respiratory infections.

Prevalence and Predictors of Celiac Disease in Children With Constipation

Prevalence and Predictors of Celiac Disease in Children With Constipation

Predictors of children's headaches during the second COVID-19 pandemic wave in the country with long-lasting lockdown.

The current study examined the links and interactions among headaches, screen-based media use, physical activity, sleep, and the family environment in Lithuanian school-aged children during the second COVID-19 lockdown. The study comprised data of 541 children aged 7-14 years from different Lithuania regions, and without chronic health conditions or developmental disorders. Information about the child was provided by their parents or caregivers who filled questionnaire on child's screen time, sleep duration and quality, physical activity, parental distress, parent-child relationship, history of child's headaches and infectious diseases. During the study period, 54% of the children had headaches, and the frequency was positively associated with child's age, screen time and parental distress, as well as negatively related to physical activity (PA), sleep quality, and the parent-child relationship. Parental education was related to child's PA, screen time and sleep quality. The results of binary logistic regression analysis and path analysis revealed that sleep quality and parental distress were significant predictors of headaches in children. Family and child or adolescent education and lifestyle modification aiming to improve sleep hygiene and PA, and to reduce screen-based sedentary behaviour should be provided. Family centred approach for more effective coping with distress and improvement of parent-child relationship is also important in treating child and adolescent headache.

Occurrence of major infectious diseases and healthcare seeking among young children with disabilities in Sierra Leone using cross-sectional population-based survey data

BackgroundChildren with disabilities are at risk of worse health outcomes compared to children without functional difficulties. Sierra Leone has one of the world’s highest prevalences of functional difficulties among children,...

Theoretical Basis and Clinical Application of Press Needle in the Treatment of Respiratory Diseases in Children

Theoretical Basis and Clinical Application of Press Needle in the Treatment of Respiratory Diseases in Children

Health Care Digital Strategy: Designing the New Norm

The time has arrived when oral and maxillofacial surgery (OMS) teams must redesign patient care by offering high-quality, easy, and cost-effective virtual care services through digital tools and telemedicine. Only a few pilot programs have been established to date, but now, the new norm requests large-scale routine services. The healthcare institutions should build this strategy based on their long-term goals. A prime example of its successful implementation is our unit at the National Institute of Children's Diseases (Bratislava, Slovak Republic), where a reliable telemedicine program was implemented for the outpatient follow-up visits of patients operated on for craniosynostosis. This program was instrumental in maintaining the long-lasting and high-impact character of craniosynostosis care during the coronavirus disease 2019 (COVID-19) crisis. The parents of the children were surveyed to evaluate the new program's effectiveness. The results were overwhelmingly positive, with an overall parental satisfaction rate of 72.3% and a 67.2% convenience rate for the services. The returned questionnaires revealed that 79.3% of parents were satisfied with physicians' communication, and 88.7% agreed that the virtual meetings adequately addressed their clinical needs. Moving forward, healthcare centers and physicians should organize their time and resources to experiment with the rapidly growing list of digital tools. The organizations should prioritize adapting their clinical information technology (IT) systems for optimal telemedicine practices. With the rapid technological advancements, new digital clinical systems should incorporate the capabilities of generative artificial intelligence (AI) in sophisticated virtual systems. This will require an even closer collaboration between clinicians, scholars, allied healthcare providers, healthcare leaders, and digital system designers. It is clear that in today´s complex healthcare ecosystem, the present and future of care delivery is digital. Will modern OMS teams adopt these strategies? It is something that all of us anticipate with huge interest.

Glycemic control and study of lipid and bone metabolism in type 1 diabetic children

Introduction. Type 1 diabetes mellitus is considered one of the most common chronic diseases of childhood. It is a high-risk factor for developing early cardiovascular disease and it also affects bone health. Objective. To describe demographic characteristics and biochemical parameters of a population of children with type 1 diabetes, evaluated in the pediatric diabetes unit of a tertiary Spanish hospital. Materials and methods. In this retrospective study, we determined metabolic, lipid, and bone parameters in 124 children with type 1 diabetes who were monitored in the pediatric diabetes unit of the Hospital Universitario Miguel Servet in Zaragoza (Spain) from May 2020 to July 2021. Results. Children with type 1 diabetes have worse metabolic control of the disease at puberty, but their lipid control is considered acceptable. We found an inverse correlation between bone formation markers and disease duration, as well as with metabolic control. Conclusion. Bone formation markers are inversely correlated with the percentage of glycated hemoglobin and diabetes evolution time. Patients’ lipid and bone profiles are more favorable when metabolic control of the disease is achieved.