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Neuroblastoma (NB) is the most common extracranial solid tumour in children after lymphoblastic leukaemias, brain tumours and lymphomas.We report a case of an NB in a previously healthy toddler. Though she had no abdominal complaints, on physical examination, she had a palpable mass identified over the right upper portion of the abdomen. Imaging studies demonstrated a heterogeneous tumour with an irregular capsule and visible calcifications.After initial diagnosis, the patient underwent chemotherapy and was subjected to a radical resection of the tumour 4 months later. One-year follow-up of the patient showed no recurrence.In children, oncological diseases are often asymptomatic or have non-specific symptoms, and in remote locations where specialised/paediatric services may not be available, the importance of medical training in paediatrics is highlighted, with emphasis on performing a complete clinical examination, namely abdominal palpation. The role of timely referral will be evident in such a situation.

• An understanding of thyroid embryogenesis and the physiology of the thyroid gland in the perinatal period is important for proper interpretation of abnormal laboratory results and initiation of appropriate treatment. • Appropriate thyroid hormone function is essential for normal neurodevelopment in infancy and childhood. Hypothyroidism in the first year of life can result in significant deleterious effects on growth and neurologic injury. • Delay in treatment of congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. • Neonatal screening can provide early diagnosis and can prevent delays in treatment. Newborn screening methods differ and may possibly miss rare forms of congenital hypothyroidism. • Eighty-five percent of cases of permanent CH are associated with abnormal development of the thyroid gland. • In preterm newborns, thyroid hormone levels may fall because of immaturity of the thyroid gland, but these changes may be exacerbated by complications of prematurity. • Thyroid metabolism can be affected by exogenous sources of iodine, dopamine infusions, blood transfusion, and glucocorticoid treatment. • The clinical manifestations of Graves disease in the newborn include irritability, flushing, diarrhea, vomiting, tachycardia, hypertension, poor weight gain, thyroid enlargement, and exophthalmos. • There is concern for neurologic damage in infants with hemangiomas when hypothyroidism is occult and untreated.

• Current American Urological Association guidelines do not recommend ultrasound for the evaluation of undescended testicles. • Children with an undescended testicle should be referred to a pediatric urologist at approximately 6 months of age. • Infants with bilateral nonpalpable testicles should be evaluated for possible congenital adrenal hyperplasia. • Infants with hypospadias and unilateral or bilateral undescended testicles should be evaluated for disorder of sexual development. • Repair of hypospadias is recommended at between 6 months and 1 year of age. • Bladder exstrophy repairs are currently delayed to 3 months of age. • A voiding cystourethrogram should be performed in infants with high-grade hydronephrosis and bilateral hydronephrosis. • Most hydroceles in infants are noncommunicating, and infants should be referred to a urologist if they fluctuate in size suggesting a communicating hydrocele. • Vesicoureteral reflux is more common in male infants and has a high rate of resolution.

Chronic kidney disease (CKD) affects millions of people worldwide- not just adults, but children as well. The causes of CKD are many, ranging from congenital kidney anomalies to immune induced to sequelae of other diseases processes such as malignancy. The kidneys, typically two fist-shaped organs located retroperitoneal, are responsible for the ultrafiltration of blood, reabsorption of ions and small molecules, and maintenance of homeostasis. Long-term kidney dysfunction in children has been associated with a variety of comorbidities including disrupted physical growth, increased psychosocial issues, and lower academic achievement.While dialysis and kidney transplant can treat CKD, this disease remains incurable and, therefore, the need for discovering therapeutic targets for mitigating disease progression is critical.Cisplatin is a commonly used chemotherapeutic with a major nephrotoxicity remaining a major complication of treatment. This thesis will describe a translational approach to mitigating kidney injury associated with cisplatin, starting with an in vitro model of cisplatin-induced reactive oxygen species (ROS) production linked to kidney cell death and clinical kidney dysfunction. Use of a novel therapeutic, GC4419 (avasopasem manganese), dismuted superoxide (O2•_) after cisplatin to increase cell survival. In a randomized phase 2b trial of avasopasem manganese, those who received 90 mg had significantly higher estimated glomerular filtration rate (eGFR) up to two years after cisplatin chemotherapy compared to those in the placebo and comparator group. Adults who did not receive GC4419 had significant CKD development measuring in ≥ stage 3 CKD two years after cisplatin chemotherapy., Children who also receive cisplatin chemotherapy are not only at risk for CKD, but also the developmental disruptions associated with kidney dysfunction. Children, adolescents, and young adults (AYA) treated with cisplatin show a continual decline of kidney function throughout early adulthood. By the average age of 30, this population has lost an average of 48.5% of their total eGFR, measuring in stage 2 CKD after cisplatin chemotherapy. The children and AYA population treated with cisplatin in this cohort demonstrated a risk for loss of function at a rate of three-times faster than their age-matched peers., The risk for CKD in children is not insignificant. This population is at risk for cognitive deficit, school difficulties, lower employment rates in adulthood and comparatively lower quality of life. Furthermore, there is evidence to support the presence of neurodevelopmental differences among children with CKD that can be noted even before the need for dialysis or transplantation. Through magnetic resonance imaging (MRI), we show that the previously reported structural brain differences in pediatric CKD are associated with evidence for aberrant redox metabolism within the brain using a T2* relaxation time sequence. Brain T2* relaxation time was correlated with abnormally high markers of neuroinflammation and oxidative stress. Furthermore, these findings predict performance on neurocognitive testing. These findings support a role for abnormal redox metabolism in the propagation of CKD-associated brain differences. This is critical to inform our understanding of the “kidney-brain axis” and provide future directions to evaluate novel therapeutic targets that leverage novel antioxidant scavengers to mitigate changes in the pediatric CKD brain.

Purpose: The purpose of this study was to compare the long-term impact of the COVID-19 pandemic on participation, support, and barriers at home in children with attention deficit hyperactivity disorder (ADHD) and without ADHD. Design and methods: This study included a total of 227 participants with a mean age of 11.93 ± 2.96 years, comprising 116 children and adolescents with ADHD and 111 without ADHD. The parents or primary caregivers of all the children completed the Participation and Environment Measure for Children and Youth (PEM-CY), which was used to assess participation and environmental factors in the home. The Student's t-test was used to compare numeric data and Chi-square test to categorical data between children and adolescents with ADHD and those without ADHD in all three settings. Results: The children with ADHD were determined to play computer and video games significantly more than children without ADHD (p < 0.001). The mean frequency of participation in arts, crafts, music, hobbies (p < 0.001), school preparation (

Eosinophilic gastrointestinal disease (EGID) is an emerging condition worldwide in both children and adults, although it is considered rare. EGID has been underestimated owing to its underdiagnosis in the past, and its prevalence has recently increased. The diagnosis of EGID is based on histopathologic findings of endoscopic mucosal biopsy in which the total number of infiltrating eosinophils in each segment of the gastrointestinal tract is determined in patients with chronic or recurrent gastrointestinal symptoms despite a lack of consensus or guidelines on the definition of tissue eosinophilia except for eosinophilic esophagitis. Laboratory findings, including peripheral eosinophilia and increased fecal calprotectin levels, may be additional clues for detection of EGID in practice. Individualized treatment strategies, including adequate dietary modification and pharmacological therapy, may improve clinical outcomes of pediatric patients with EGID.

Background: In clinical practice, the importance of interactive engagement behaviors is overlooked in children with developmental problems other than autism spectrum disorder (ASD). Parenting stress affects children’s development but lacks attention from clinicians.Purpose: This study aimed to identify the characteristics of interactive engagement behaviors and parenting stress among non-ASD children with developmental delays (DDs). We also analyzed whether engagement behaviors affect parenting stress.Methods: At Gyeongsang National University Hospital, between May 2021 and October 2021, we retrospectively enrolled 51 consecutive patients diagnosed with DDs in language or cognition (but not ASD) in the delayed group and 24 typically developing children in the control group. The Korean version of the Parenting Stress Index-4 and Child Interactive Behavior Test were used to assess the participants.Results: The median age of the delayed group was 31.0 months (interquartile range, 25.0–35.5 months); this group included 42 boys (82.4%). There were no intergroup differences in child age, child sex, parental age, parental educational background, mother’s employment status, or marital status. Higher parenting stress (PPP=0.440). Instead, DDs contributed to total parenting stress, which was mediated by children’s overall interactive engagement behaviors (β=57.30, P

Gastrointestinal (GI) allergies are broadly associated with food allergies and divided into groups based on the degree of allergen-specific immunoglobulin E (IgE) involvement: IgE-mediated, non-IgE-mediated, and mixed. Non-IgE-mediated GI food allergies are mostly observed in neonates and infants and include food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). In addition to the classical phenotype, unique phenotypes such as vomiting and bloody stool, suspected sepsis, and overlapping eosinophilic GI disorders (EGIDs) have increased in Japan over the past 2 decades. Some of these cases were defined as having chronic FPIES. More recently, cases of hen’s-egg FPIES in Japan have increased dramatically since 2018, albeit for unknown reasons. Typical mixed-type food allergies are EGIDs, characterized by prominent eosinophil infiltration in the GI tract leading to GI symptoms. EGIDs are broadly classified into eosinophilic esophagitis (EoE) and non-EoE EGIDs that involve the GI tract with the exception of the esophagus. Of the EGIDs, EoE is the best known, as the number of cases has increased dramatically in Western countries, whereas pediatric EoE remains rare in Asia and non-EoE EGIDs may be more prevalent in Japan. A recent Japanese national survey showed that pediatric non-EoE EGIDs were persistent and severe compared to those in adults, possibly requiring further effective therapeutic options. Among the EGIDs, FPIAP is pathologically diagnosed as an infantile form of eosinophilic colitis. In addition, recent FPIES and FPE cases also involved eosinophilic inflammation. Recent cases of GI allergies may be associated with type 2 inflammation. A better understanding of the interactions between GI allergies and type 2 inflammation may clarify the pathogenesis of the recent increase in GI allergies.

Aim: To assess the incidence and severity of nasal pressure injuries caused by nasal CPAP nasal masks and binasal prongs. Methods: Single NICU observational study among infants who required nCPAP, using the Nasal Injury Assessment Score Chart (NIASC). Results: In 90.7% (N = 118) skin injuries were observed. Eleven infants had no skin injury, 68 mild, 26 moderate and 13 severe. The severity of the injury was categorized into groups; group I (NIASC

Background The current childhood obesity pandemic is likely to result in an increased risk of chronic kidney disease (CKD) later in life. Correlations between obesity-related comorbidities and kidney function can be found, but it is unclear to what extent this is caused by bias due to different mathematical forms of the estimated glomerular filtration rate (eGFR) equations. The present study aimed to analyze correlations between obesity-related comorbidities and different eGFR equations and to investigate whether rescaled serum creatinine (SCr/Q) for sex and age or height might be an alternative biomarker for kidney function estimation. Methods This cross-sectional cohort study included 600 children with overweight and obesity. Mean age was 12.20 ± 3.28 years, 53.5% were female, and mean BMI z-score was 3.31 ± 0.75. All children underwent a comprehensive assessment that included anthropometrical and blood pressure measurements, laboratory examination, air displacement plethysmography, and polysomnography. Qage and Qheight polynomials were used to rescale SCr and multiple creatinine-based eGFR equations were compared. Results SCr/Q and almost all GFR estimations significantly correlated with a waist-to-hip ratio, fat mass, homeostasis model assessment for insulin resistance, and triacylglyceride, HDL cholesterol, alanine transaminase, and serum uric acid concentrations. Multiple correlations, however, were not confirmed by all equations, which suggests dependency on the mathematical form of the different eGFR equations. Conclusions Correlations between obesity-related comorbidities and creatinine-based eGFR are present in children with overweight and obesity, but depend to a large extent on the eGFR equation of choice. SCr/Q might be an alternative biomarker for assessing correlations between obesity-related comorbidities and kidney function in children with overweight and obesity. Graphical Abstract

This study examined the prospective associations among the trajectories of maternal depressive symptoms, maternal sensitivity, and child executive function (EF) across early and middle childhood, and tested the mediating role of maternal sensitivity in the links between change in maternal depressive symptoms and the growth of child EF. Participants included 1,364 children and mothers from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (NICHD SECCYD). We found that maternal depressive symptoms (from 6 months to Grade 5) and sensitivity (from 36 months to Grade 5) decreased, whereas child EF (planning skills; from Grade 1 to 5) increased over time. We also found several direct associations: (a) lower maternal depressive symptoms at 36 months predicted higher sensitivity at 54 months; (b) higher sensitivity at 54 months and a faster decrease in sensitivity from 36 months to Grade 5 predicted higher child EF in Grade 1; and (c) higher sensitivity at 54 months predicted greater growth of EF from Grade 1 to 5. In addition, two mediation effects were found as follows: Lower levels of maternal depressive symptoms at 36 months predicted both higher levels of child EF in Grade 1 and greater growth of EF from Grade 1 to 5 through higher levels of maternal sensitivity at 54 months. The results suggest that early maternal depressive symptoms may have long-term effects on the growth of EF, especially planning skills, during middle childhood, and that one important pathway that maternal depressive symptoms affect child EF outcomes through maternal sensitivity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PURPOSE A previous study by the International Berlin-Frankfurt-Münster Study Group (I-BFM-SG) on childhood KMT2A-rearranged ( KMT2A-r) AML demonstrated the prognostic value of the fusion partner. This I-BFM-SG study investigated the value of flow cytometry-based measurable residual disease (flow-MRD) and evaluated the benefit of allogeneic stem-cell transplantation (allo-SCT) in first complete remission (CR1) in this disease. METHODS A total of 1,130 children with KMT2A-r AML, diagnosed between January 2005 and December 2016, were assigned to high-risk (n = 402; 35.6%) or non–high-risk (n = 728; 64.4%) fusion partner-based groups. Flow-MRD levels at both end of induction 1 (EOI1) and 2 (EOI2) were available for 456 patients and were considered negative (RESULTS The high-risk group had inferior EFS (30.3% high risk v 54.0% non-high risk; P < .0001), CIR (59.7% v 35.2%; P < .0001), and OS (49.2% v 70.5%; P < .0001). EOI2 MRD negativity was associated with superior EFS (n = 413; 47.6% MRD negativity v n = 43; 16.3% MRD positivity; P < .0001) and OS (n = 413; 66.0% v n = 43; 27.9%; P < .0001), and showed a trend toward lower CIR (n = 392; 46.1% v n = 26; 65.4%; P = .016). Similar results were obtained for patients with EOI2 MRD negativity within both risk groups, except that within the non–high-risk group, CIR was comparable with that of patients with EOI2 MRD positivity. Allo-SCT in CR1 only reduced CIR (hazard ratio, 0.5 [95% CI, 0.4 to 0.8]; P = .00096) within the high-risk group but did not improve OS. In multivariable analyses, EOI2 MRD positivity and high-risk group were independently associated with inferior EFS, CIR, and OS. CONCLUSION EOI2 flow-MRD is an independent prognostic factor and should be included as risk stratification factor in childhood KMT2A-r AML. Treatment approaches other than allo-SCT in CR1 are needed to improve prognosis.

Under a Creative Commons license: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Clinical practice is a moment of stress for nursing students with impact in academic outcomes. Neonatal Intensive Care Units (NICU) are a specific and multifaceted context that offer complex experiences to nursing students. A descriptive, cross-sectional, and observational study, with a qualitative approach was outlined that aimed to describe and categorize the experiences of nursing students in NICU. Semi structured interviews were used for data collection and content analysis for data analysis. Among eligible students (those that had performed clinical practice in NICU and agreed to participate) a purposive sample of 6 students was selected. Data analysis allowed the identification of five categories: clinical practice evolution, expectations about clinical practice, challenges faced in clinical practice, feelings for the babies and their parents, and comparing with the adult nursing clinical practice. The findings of this study indicate that nursing students experienced a wide range of feelings and experiences. info:eu-repo/semantics/acceptedVersion