The aim of the study was to describe the exposure to dog (Can f 1) and cat (Fel d 1) allergens within homes of very young children living with and without pets, and to assess the validity of the interview on pets for predicting the actual exposure to pet allergens in house dust. House dust samples were collected in 275 dwellings from the mattresses, children’s bedroom and kitchen floors. In the laboratory, dust samples were analyzed for Can f 1 and Fel d 1 using monoclonal antibody enzyme-linked immunosorbent assays (ELISA). The majority of households (79.3%) had neither a dog nor a cat living in the home over the past 6 months preceding the survey. Dog allergen above 2 μg/g dust were found in 22.5% of homes and 14.2% of homes contained dog allergen above 10 μg/g of house dust. In the total study sample, cat allergen above 1 μg/g of dust were found in 12.7% of homes, and 3.3% of homes contained Fel d 1 levels greater than 8 μg/g of dust. The majority of children (75.0%) with reported ownership of dogs were exposed to Can f 1 levels above 2 μg/g of house dust, and 73.1% of children with cats at home were exposed to Fel d 1 concentrations above 1 μg/g house dust. The results of the study showed that post-test probability of the true exposure to Can f 1 above 2 μg/g dust in houses with positive interview on indoor dogs was 75.0% (95%CI: 61.7–84.8%). On the other hand, the prediction of exposure estimated from the interview data on indoor dogs produced 12.6% of false negatives (95% CI: 9.9–15.8%). Similarly, the post-test probability of the true exposure to Fel d 1 above 1 μg/g dust in houses with positive interview on indoor cats was 73.1% (95%CI: 55.1–85.7%). On the other hand, the interview data produced 6.4% false negatives (95% CI: 4.6–9.0%). In conclusion, the study demonstrated that homes in Poland with pet ownership are important reservoir of Can f 1 and Fel d 1 allergens with levels that might induce allergic symptoms. Even in homes of children without a dog or cat indoors, there was a higher prevalence of pet allergens at the levels above allergic sensitisation thresholds. This may have an important implication for epidemiologic studies on pet related allergy and prevention practice.
Sinusitis is a frequent complication of respiratory tract infections. Probiotics are perceived to be useful in infections, allergies, and inflammations. Our prospective trial stratified 204 children with recurrent rhinosinusitis by age (2–11 years, 54m:64f; 12–18 years, 39m:47f) and assigned them to standard treatment (antibiotics, anticongestants) or additional 60 days Symbioflor-1 (SF1; Enterococcus faecalis 1.5–4.5x107 CFU). The number of sinusitis episodes was lower in SF1-treated patients (2.52±0.91) than among controls (3.27±1.36; p=0.01). Mean duration of the first sinusitis episode was 11.9±8.6 days with SF1, whereas it was 16.1±12.9 days in the younger controls (p=0.023) and 9.86±5.05 days in the elder controls (n.s.). Duration of subsequent sinusitis episodes was also shorter in SF1 patients (15.2±13.6 days) compared with controls (22.7±14.8 days; p=0.030). No adverse events were observed. Probiotic Enterococcus faecalis adjuvant to conventional therapy can reduce the number and duration of rhinosinusitis episodes in children and adolescents.
Neurofibromatosis type I (NF1) is a hereditary multisystem disease involving the skin and nervous system. It is the most common form of autosomal dominant phakomatoses with 100% penetrance but wide phenotypic variability. The NF1 gene is located on chromosome 17q11.2 and encodes for a tumour suppressor protein. Because affected individuals have an increased risk of tumor formation, this disorder is classified as inherited cancer syndrome. The risk of malignancies in NF1 affected patients is estimated to be 5–15% higher than in the general population. We reviewed clinical aspects and genetic mechanisms of tumorigenesis in NF1 affected patients.
Study aim: To determine if pupil physical activity and Body Mass Index classifications maintained or improved after a one-year professional development program involving both classroom and physical education teachers. Guskey's model of teacher change guided this study.Material and methods: Indigenous children from ten schools (N = 320) in grades 3-12 from one community participated in this year-long comprehensive school change effort. Classroom (n = 31) and physical education teachers (n = 7) participated in this study as intervention (n = 27) or comparison (n = 11) teachers. Intervention teachers participated in a year-long professional development program to increase physical activity and healthy behaviour knowledge of pupils.Results: ANOVA results for pupil physical activity (measured using pedometry) indicated that both groups of pupils (intervention and comparison) became significantly more active over time. The intervention groups' behaviour was less stable (α = 0.71) over time versus the comparison group (α = 0.86), suggesting positive behaviour changes. No significant Body Mass Index changes were found.Conclusions: Although the intervention resulted in physical activity increases for both intervention and comparison pupils at the schools, change takes time and these initial findings show progress in increasing physical activity behaviours at school in an understudied and disadvantaged population of indigenous USA youth.
Major salivary gland tumors are very rare in the developmental period. Confirming tumor changes of the salivary gland requires precise diagnostic imaging involving an ultrasonography scan, computed tomography and magnetic resonance. A needle aspiration biopsy (NAB) of a tumor is of high importance. Excision of the tumor is the main treatment method in the case of parotid gland tumors. Statistical data concerning tumors suggest choosing less invasive methods, which seems very logical in children. The operational methods used in the tumor treatment are: extracapsular excision of a tumor, partial parotidectomy, total parotidectomy, sometimes proceeded with lymphatic nodes operations. Extracapsular excision of a tumor is a noninvasive method chosen because of simplicity and lesser risk of serious complications. This method is reserved only for the cases of benign tumors of the gland. Most authors, however, consider a partial parotidectomy as a method of choice in benign tumor cases and a total parotidectomy in cases of carcinomas of the parotid gland. Submandibular gland tumors need total gland excision. The clinical cases presented in this paper show the difficulties in diagnosis and treatment choices in cases of major salivary gland tumors in children.
Osteomas of external auditory canal are most often unilateral, solitary, pedunculated hard tumors located on the anterior and superior wall of the structure in its distal part. They have to be distinguished from exostoses of external auditory meatus. Osteomas of external auditory canal are very rare and apart from isolated cases are not described in children population. The case presented in the paper shows the possibility of a presence of unilateral multifocal osteoma of an external auditory canal in a child, which is not described in the literature concerning the topic.
Study aim: To examine the differences between the second and first measurements of blood pressure and to show the necessity of designing a standardised protocol.Material and methods: Anthropometric data of 1618 children were assessed. Blood pressure and heart rate values were determined twice after 5-min sitting with a sphygmomanometer (Omron M5-I, Germany). The differences between the second and first measurements were assessed using Student's t-test.Results: A group of 921 boys and 697 were studied. Mean systolic blood pressures in the first and second measurements were 124.9 ± 15.7 and 121.4 ± 14.9 mm Hg, respectively, mean diastolic blood pressures - 78.0 ± 13.6 and 76.0 ± 12.4 mm Hg, respectively, the between-measurement differences being highly significant (p<0.001). No significant differences were noted for the heart rate. The prevalence of hypertension assessed from the first and second measurement was 23.9 and 4.4%, respectively.Conclusion: The results point to the indispensability of designing a valid, standardised protocol of conducting blood pressure measurements in paediatric epidemiological studies.
Hypovitaminosis D and increased cardiometabolic risk have been well established in adults. This study aims to determine whether or not vitamin D also influences cardiometabolic risk in children and adolescents. To test this hypothesis, we recruited 186 boys (mean age 12.4 ± 3.7 years) and 114 girls (11.6 ± 3.7) in a cross-sectional observational study. Anthropometrics were obtained and morning fasting blood samples were collected. Serum glucose and lipid profile were determined using routine methods. Serum 25-hydroxyvitamin D was quantified using an enzyme-linked immunosorbent assay. In our population, approximately 10% of subjects had severe 25-hydroxyvitamin D deficiency (< 12.5 nmol/L), while 50% of the boys and 40% of the girls had mild vitamin D deficiency (12.5–24.9 nmol/L). Circulating 25-hydroxyvitamin D concentrations were inversely correlated with age, body mass index (BMI), blood pressure, waist and hip circumferences and serum triglyceride concentrations, and positively associated with HDL-cholesterol. Age and systolic blood pressure were significant predictors of 25-hydroxyvitamin D, explaining about 30% of the variance (p = 0.0005). In conclusion, significant associations between serum 25-hydroxyvitamin D and cardiometabolic parameters support promising cardioprotective benefits from vitamin D sufficiency at an early age. Follow-up with prospective clinical intervention studies are needed to validate this hypothesis.
Study aim: To assess the presence of musculoskeletal deformities in lower extremities and to detect faulty posture in schoolchildren living in a rural region of Iran. Material and methods: 172 schoolchildren aged 5-20 years, including 66 boys and 106 girls were screened deviations in the musculoskeletal system. Furthermore, the postural muscles including the hamstring and gastroc-soleus were examined for finding any shortness. Results: The prevalence of cervical lordosis (22.6% vs. 6.1%), forward head posture (24.1% vs. 9.1%) and thoracic kyphosis (27.8 % vs. 7.6%) was significantly higher in girls than in boys. The prevalence of cervical lordosis, FHP, thoracic kyphosis, and genu varum increased with age; in the case of genu valgum, the situation was reversed. Genu varum was almost twice as frequent in girls as in boys (44.4% vs. 25.8%; p<0.01), while the genu valgum was more frequent (p<0.001) in boys than in girls (13.6 and 2.8, respectively). No significant age or gender-dependent differences were found for hamstring shortness (29%), gastroc-soleus shortness (21%), genu recurvatum (22%), and hallux valgus (31%). Conclusions: Faulty posture and lower limb deformities were highly prevalent in school children in this rural region. More attention should be paid to implementing school-based screening programs aimed at early detection of any musculoskeletal-related abnormalities and taking preventive steps to reduce their negative consequences.
Metabolic syndrome is a clinical term encompassing risk factors (obesity, insulin resistance, dyslipidemia and hypertension), which yield an increased risk for the development of diabetes mellitus type 2 and cardiovascular disorders in adolescence. Two sets of criteria for diagnosing metabolic syndrome were applied, the criteria for adults, specifically adapted for children, and the criteria defined by the International Diabetes Federation (IDF). A reliability analysis was conducted; sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) of applying certain criteria of both definitions of metabolic syndrome. Metabolic syndrome in adolescents was diagnosed much more frequently using the specific criteria (41%) in comparison to the IDF criteria (22%). Using the specific criteria for children and adolescents, it was established that the HDL cholesterol was the most specific and had the largest PPV. Using the IDF criteria for diagnosing metabolic syndrome, the reliability analysis established that the highest PPV was recorded with the elevated level of triglycerides. The specific criteria have been found to be more efficient in diagnosing metabolic syndrome in adolescents. The highest predictive value was displayed by dyslipidemic disorders, hypertriglyceridemia and hypo HDL cholesterolemia.
While diagnostic criteria for Autism Spectrum Disorders (ASD) is clear, misconceptions of ASD create barriers and challenges for children with ASD and their interaction in the educational environment around them. The social model of disability states people with disabilities are more limited by social constraints than actual impairment (Llewellyn and Hogan, 2000). In hopes to diminish these social constraints, continued education and progression of programs for children with Autism Spectrum Disorders is essential. When observing the different teaching strategies educators used to assist children with ASD, no one educational strategy was deemed appropriate for use. Findings revealed there were no defined guidelines on how to interact with autistic children and left teachers to use their own teaching methods. Literature reflect a lack of educational strategies for children with Autism Spectrum Disorders in an academic setting; at the various grade levels. One of the newer strategies to be investigated is the role of physical activity in children with ASD. Regular physical activity is highly beneficial towards the health of all children with or without disabilities. However, social and behavioral impairments leave little opportunity for children with Autism Spectrum Disorders to be successful in participating in physical activity; resulting in a possible higher risk of being inactive. Exercise options such as martial arts, swimming and yoga programs have been shown to be successful for children with Autism Spectrum Disorders.
There is no consensus regarding the time of antiepileptic drug withdrawal and the relevant risk factors for seizure relapse. In this study, we aimed to determine the seizure relapse rates and the associated risk factors for seizure relapse in childhood epilepsy. Two-hundred sixty-six epileptic patients who discontinued the antiepileptic drug therapy after a seizure-free period of at least two years, were enrolled into the study. The data of the patients regarding sex, febrile convulsion history, family history, age at onset, type of epilepsy, total number of seizures and antiepileptic drugs, seizures during treatment, mental status, first and last electroencephalography, brain imaging findings, etiological factors and seizure relapse in the first two years after antiepileptic drug withdrawal were obtained from the patients’ files. Univariate logistic regression analysis was performed for each variable. The variables which were found to be statistically significant in univariate analysis, were included in multivariate logistic regression analysis. The overall seizure relapse rate after antiepileptic drug withdrawal was 19.2%. There were no significant differences for seizure relapse rate after antiepileptic drug withdrawal between patient groups with respect to sex, family history, type of epilepsy, febrile convulsion history, seizures before treatment, first electroencephalography findings, brain imaging findings and etiology. However, there were statistically significant differences for seizure relapse rate among patient groups concerning age at onset of epilepsy, new seizure during treatment, the total number of antiepileptic drugs, mental status, and last electroencephalography findings. We imply that the clinical status of the patients should be considered before the cessation of drug therapy rather than the etiological factors or laboratory findings.
Gastrointestinal autonomic nerve tumors form an uncommon subcategory of stromal tumors of the intestinal tract although their histologic appearance is similar to other gastrointestinal stromal tumors. Our aim was to evaluate our experience in the diagnosis and therapy of these kinds of tumors. Two patients were admitted to the Pediatric Surgery Clinic in Niš with abdominal pain and a palpable mass in the abdomen. After excision, the tumor tissue was sampled, sent for histopathological diagnosis, and examined by light microscopy, immunohistochemistry, and electron microscopy. Postoperatively, both patients recovered without complications. The patient with the tumor bulk in the mesentery of the small bowel had no evidence of tumor progression 6 years after surgery. In the second case, a giant tumor was present along the greater curvature of gaster. Even with a tumor of this size, there were no signs of progression 10 years after surgery. Radical surgical resection of gastrointestinal autonomic nerve tumors seems to be the curative approach to date, and long-term survival is possible even with large tumors.
Bone fractures may depend on Vitamin D Receptor Gene (VDR), bone mineral density, bone turnover markers. Patients and methods. 161 patients were recruited and underwent: skeletal densitometry (DXA) method and bone turnover studies (Osteocalcin and Ntx).The study group was evaluated using restriction enzyme digestion at BsmI (rs1544410), FokI (rs2228570), ApaI (rs7975232) and TaqI (rs731236), polymorphic sites of the VDR gene. Multivariate logistic regression was used to assess factor significance. The model included variables with sex- and age-standardized parameters, VDR genotypes, and bone metabolism marker levels. Results. Factors associated with fractures were: osteocalcin concentration and Z-score BMDt. Odds Ratio (OR) values equaled: 1.01 (95%Confidence Interval (95%CI) 1.00–1.02) for osteocalcin (p=0.006), and 0.66 (95%CI 0.42-1.03; p=0.07) for Z-score BMDt. In patients with reduced bone mass, factors related to fractures were: osteocalcin (0.04) and carriage of BsmI b (0.07) or ApaI a alleles (0.08). ORs were 1.01 (95%CI 1.00–1.02) for OC, 0.29 (95%CI 0.07–1.14) for BsmI, and 2.13 (95%CI 0.91–4.99) for ApaI polymorphic allele carriage. Conclusions. Carriage of BsmI b allele reduces, while carriage of ApaI a allele and heightened osteoclacin level increase the risk of fractures in study children with reduced bone mass. VDR polymorphism, bone mineral density and bone formation’s marker - osteocalcin maybe considered as risk factor for fracure in children from Lodz region.
Epidermoid cysts are lesions, which form as a result of implantation of the epidermis in the layers of the dermis or the mucous membrane. The lesions are rare in adults with 7% occurring in the head and neck area and most often located in the submental region. In children population submental epidermoid cysts are extremely rare. The differential diagnosis of the lesions is necessary as it affects the choice of treatment methods. Among the pathological conditions occurring in that region, salivary retention cyst (ranula), thyroglossal duct cyst, vascular lymphatic malformation (cystic hygroma), median neck cyst, lymphadenopathy, thyroid gland tumor, laryngeal cyst, epidermoid and dermoid cysts, submental abscess, sialolithiasis and salivary gland inflammation should be considered. The authors of the present report demonstrate two cases of submental epidermoid cysts in children. Differential diagnosis in case of suspected submental epidermoid cyst in a child with proposed clinical practice and literature review is provided.
Idiopathic thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. In 20% of cases, this condition is classified as chronic when the thrombocytopenia is persistent 6 months after diagnosis. The aim of the present study is to identify the potential factors correlating with a favorable outcome in patients with chronic ITP. Some 71 patients affected by ITP were retrospectively analyzed. Results show a higher rate of spontaneous recovery that is statistically significant for patients with platelet count at diagnosis <20,000/µL. These observations suggest the possibility to delay or avoid aggressive surgical treatment for these patients.
Children with malignancy present an important alteration of the immune system functionality caused by the illness itself and by the therapy they undergo. Therefore, they are at high risk of contracting vaccine-preventable diseases and of developing important complications. Vaccinations represent valid devices against these infections but this condition involves two main problems: are vaccines safe in these patients? Are vaccines effective in these patients? The aim of this review is to discuss the principles of vaccination management in children with cancer.
The relative lengths of the index finger to the ring finger (2D:4D) is sexually dimorphic. It is believed that the 2D:4D negatively correlates with prenatal testosterone and positively with prenatal estrogen. Low 2D:4D is related to masculine traits such as aggression, physical fitness and performance in different sports. The aim of this study is to investigate the relation ship between the 2D:4D and physical fitness among 7 to 13 year - old boys. 316 boys were selected, all participants were in pre - pubertal stage. After completing the consent by their parents; height, weight, lengths of the index and ring fingers and physical fitness such as: strength, muscle endurance, power, speed, agility, flexibility and aerobic fitness were measured. The partial correlation coefficients was used to determine association between variables. Data analysis was done by SPSS software, version 20 , and the level of significance was considered as P≤0.05. The results showed that the digit (2D:4D) ratio has no significant correlation with handgrip strength and aerobic fitness (P ˃ 0.05). Also, according to the results, no correlation has been observed between the 2D:4D and muscle endurance, power, speed, agility and flexibility (P ˃ 0.05). It seems that 2D:4D is associated with level of testosterone and prenatal estrogen; this index has no significant correlation with physical fitness in children and ca nnot be used to identify and discover talented individuals for various sporting fields. However, more researches are still needed in this area.
Study aim: To assess the influence of juggling training on mental rotation performance in children.Material and methods: Two groups of girls aged 6 - 14 years were studied: experimental (EG; n = 26) and control (CG; n = 24). All girls solved a mental rotation task with 3-D block figures on computer screen (pre-test). After the initial test, EG girls participated in juggling training for 3 months; the CG girls participated in light strength training with theraband stretch bands. After 3 months, all girls solved the mental rotation task again (post-test). The post-pre differences in the mental rotation performance were recorded.Results: Children who learned juggling performed the mental rotation task significantly (p<0.05 - 0.01) faster, in terms of reaction time, at non-zero angular disparity than their mates who were strength-trained.Conclusions: Since mental rotation skills enhance spatial imagination, problem solving and mathematical skills, it may be assumed that juggling training enhances also other cognitive domains and is worth implementing in the education process.
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