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Preprint ARTICLE | doi:10.20944/preprints202404.1219.v1

Impact of lowering TSH cut-off on neonatal screening for congenital hypothyroidism in Minas Gerais, Brazil

Nathalia Teixeira Palla Braga, Jáderson Mateus Vilela Antunes, Enrico Antônio Colosimo, Vera Maria Alves Dias, José Nélio Januário, Ivani Novato Silva

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: congenital hypothyroidism; neonatal screening; cut-off; sensitivity.

Online: 18 April 2024 (11:14:53 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.1122.v1

Electronic Heart (ECG) Monitoring at Birth and Newborn Resuscitation

Sarah Mende, Syed Ahmed, Lise DeShea, Edgardo Szyld, Birju A. Shah

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: electrocardiogram; heart rate; neonatal resuscitation

Online: 17 April 2024 (08:33:09 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.1077.v1

Impact of Nutrient Intake on Body Composition in Very Low Birth Weight Infants Following Early Progressive Enteral Feeding

Rasa Brinkis, Kerstin Albertsson-Wikland, Kastytis Šmigelskas, Aurika Vanckavičienė, Ilona Aldakauskienė, Rasa Tamelienė, Rasa Verkauskienė

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: preterm; very low birth weight; newborn; nutrient intake; body composition; dual X-ray absorptiometry

Online: 16 April 2024 (15:51:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0882.v1

Acute Kidney Disease following Acute Kidney Injury in Children—A Retrospective Observational Cohort Study on Risk Factors and Outcomes

Flavia Chisavu, Lazar Chisavu, Viviana Ivan, Adalbert Schiller, Adelina Mihaescu, Luciana Marc, Ramona Stroescu, Ruxandra Maria Steflea, Mihai Gafencu

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: acute kidney disease; children; mortality; chronic kidney disease

Online: 15 April 2024 (04:46:15 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0777.v1

Pro-Inflammatory Biomarkers and Long Term Neurological Outcomes in Hypothermia Plus Melatonin Treated Newborns. A Pilot Clinical Trial

Antonio Jerez-Calero, Francisco Contreras-Chova, Angela Benitez-Feliponi, Hatim Azaryah, Jose Antonio Hurtado-Suazo, M. Fernanda Moreno-Galdó, Antonio Molina-Carballo

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: hypoxic-ischaemic encephalopathy; therapeutic hypothermia; pro-inflammatory biomarkers; cytokines; melatonin; neurodevelopment ;

Online: 11 April 2024 (07:29:34 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0470.v1

From Detection to Action: A Retrospective Analysis on the Impact of Screening for Congenital Heart Disease in the NICU

Ioana Roșca, Daniela-Eugenia Popescu, Ana Maria Cristina Jura, Alina Turenschi, Cristina Filip, Alexandru Dinulescu, Andreea Teodora Constantin

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: congenital heart disease; neonatology; prenatal diagnosis; parent support; neonatal intensive care unit; pulse oximetry; screening; echocardiography

Online: 7 April 2024 (10:34:52 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0351.v1

Impact of Early Surfactant Administration on Ductus Arteriosus Assessed at 24 Hours in Preterm Neonates Less than 32 Weeks of Gestational Age

Manuela Cucerea, Mihaela Moscalu, Maria-Livia Ognean, Amalia Fagarasan, Daniela Toma, Raluca Marian, Madalina Anciuc-Crauciuc, Andreea Racean, Zsuzsanna Gall, Marta Simon

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: surfactant; ductus arteriosus; echographic parameters; preterm infants

Online: 4 April 2024 (17:50:33 CEST)

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Preprint REVIEW | doi:10.20944/preprints202404.0155.v1

Urinary L-FABP as an Early Biomarker for Pediatric Acute Kidney Injury Following Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review and Meta-analysis

Bruno Wilnes, Beatriz Castello-Branco, Bárbara Castello Branco, André Sanglard, Pedro Alves Soares Vaz de Castro, Ana Cristina Simões e Silva

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: acute kidney injury; cardiac surgery; pediatrics; cardiopulmonary bypass; biomarkers; Liver-type Fatty Acid-binding Protein

Online: 2 April 2024 (09:03:57 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.0061.v1

Growth and Neurodevelopmental Outcomes of Preterm Infants Born <26 weeks Gestation Before and After Implementation of a Nutrition Care Bundle

Giulia Res, Rosine F Bishara, Paige Terrien Church, Rena Rosenthal, Rita Maria Bishara, Annie Dupuis, Elizabeth Azstalos, Rudaina Banihani

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Growth; neurodevelopmental outcomes; micro-preterm; nutrition bundle

Online: 1 April 2024 (12:24:33 CEST)

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Preprint BRIEF REPORT | doi:10.20944/preprints202403.1744.v1

Exploring Trends in Neonatal Mortality among Infants ≤ 32 weeks Gestational Age at Birth in Latin America and the Caribbean units using the EpicLatino Network Database Compared to Canadian Neonatal Network 2022

Angela Hoyos, Ariel Salas, Horacio Osiovich, Carlos Fajardo, Martha Baez, Luis Monterrosa, Carolina Villegas Alvarez, Fernando Aguinaga, Maria Ines Martinini

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Neonatal mortality; VLBW infants; EpicLatino; Canadian Neonatal Network; Latin America

Online: 28 March 2024 (15:32:11 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.1513.v1

Efficacy of Polyhexamethylene Biguanide (Polyhexanide or PHMB) in Pediatric Superficial Partial-Thickness Burns: Outcomes and Influencing Factors

Aba Lőrincz, Hermann Nudelman, Anna Gabriella Lamberti, András Garami, Krisztina Adrienne Tiborcz, Tamás Zoltán Kovács, Gergő Józsa

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Pediatric; Child; Partial-thickness; Second-degree; Burn; PHMB; Polyhexanide; Polyhexamethylen Biguanide

Online: 26 March 2024 (11:56:58 CET)

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Preprint HYPOTHESIS | doi:10.20944/preprints202403.1397.v1

Changing the Nomenclature of Duct Dependent Lesions from Duct Dependent Pulmonary and Systemic to Duct Dependent Oxygenation and Perfusion

Antoine AbdelMassih, Acsah George, Dima Mohammad, Fazeela Ansari, Soumya Prachith

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Nomenclature of duct dependent lesions; Duct-dependent perfusion and oxygenation

Online: 23 March 2024 (09:35:15 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.1265.v1

Red Code Management in Pediatric Emergency Department: A Retrospective Study

Serena Bertone, Marco Denina, Manuela Pagano, Angelo Giovanni Delmonaco, Emanuele Castagno, Claudia Bondone

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: red code; emergency department; diagnostic pathways

Online: 21 March 2024 (04:10:56 CET)

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Preprint COMMUNICATION | doi:10.20944/preprints202403.1033.v1

Analysis of Cell Immunity for Children Infected with COVID-19 and Those Vaccinated against COVID-19 Using T-SPOT®.COVID

Tomohiro Oishi, Yuto Yasui, Atsushi Kato, Satoko Ogita, Takahiro Eitoku, Hideo Enoki, Takashi Nakano

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: cell immunity; COVID-19; children; T-Spot®

Online: 19 March 2024 (02:25:56 CET)

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Preprint REVIEW | doi:10.20944/preprints202403.0867.v1

Missed or Delayed Diagnosis of Heart Disease by the General Pediatrician

Ageliki A Karatza, Sotirios Fouzas, Despoina Gkentzi, Eirini Kostopoulou, Nikoleta Oikonomou, Gabriel Dimitriou, Xenophon Sinopidis

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: congenital heart disease; acquired heart disease; children; diagnostic errors; missed diagnosis; delayed diagnosis; primary care pediatrician

Online: 17 March 2024 (16:01:57 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0852.v1

Balloon Valvuloplasty In Congenital Critical Aortic Valve Stenosis – A Rescue Procedure For The Left Ventricle

Jochen Pfeifer, Axel Rentzsch, Martin Poryo, Hashim Abdul-Khaliq

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: critical aortic valve stenosis; transcatheter balloon valvuloplasty; retrieval loop; neonate; cardiogenic shock; left ventricular dysfunction

Online: 14 March 2024 (15:16:30 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0830.v1

Placental Lesions in Birth Asphyxia and Hypoxic-Ischemic Syndrome

Andreea Calomfirescu-Avramescu, Ceaușelu Luminița, Mihaela Demetrian, Vlad Dima, Anca Balanescu, Paul Balanescu, Andrada Mirea, Adrian Ioan Toma, Crenguta Sorina Serboiu, Oana Maria Patrascu, Al Jashi Isam, Ioan Gherghina

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: birth asphyxia; hypoxic ischemic encephalopathy; placental lesions

Online: 14 March 2024 (10:23:54 CET)

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Preprint REVIEW | doi:10.20944/preprints202402.1717.v2

Reintroduction of Legacy Antibiotics in Neonatal Sepsis. The Special Role of Fosfomycin and Colistin

Maria Baltogianni, Niki Dermitzaki, Chrysoula Kosmeri, Anastasios Serbis, Foteini Balomenou, Vasileios Giapros

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: neonatal sepsis; antimicrobial resistance; repurposed antibiotics; Colistin; Fosfomycin

Online: 14 March 2024 (06:00:58 CET)

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Preprint REVIEW | doi:10.20944/preprints202403.0678.v1

Pediatric Lower Urinary Tract Dysfunction: A Comprehensive Exploration of Clinical Implications and Diagnostic Strategies

Matjaž Kopač

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: voiding disorders; urinary incontinence; lower urinary tract; children; voiding diary; urodynamics

Online: 12 March 2024 (08:09:39 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0655.v1

Centenary Dynamics in Physical Development of Moscow School Girls

Natalia Aleksandrovna Skoblina, Olga Yurjevna Milushkina, Natalia Andreevna Bokareva, Olga Viktorovna Sazonova, Mikhail Yurievich Gavryushin, Andrey Aleksandrovich Tatarinchik, Elena Vadimovna Skoblina

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: physical development, school girls, body mass, body length, muscle strength, menarche, centenary dynamics

Online: 11 March 2024 (16:54:45 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0486.v1

Endoscopic and Histopathological Findings in the Upper Gastrointestinal Tract in Pediatric Chron’s Disease

Dunja Putniković, Jovan Jevtić, Nina Ristić, Ivan D Milovanovich, Miloš Đuknić, Milica Radusinović, Nevena Popovac, Irena Đorđić, Zoran Leković, Radmila M Janković

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Crohn’ s, granuloma; endoscopy; esophagogastroduodenoscopy; colonoscopy; histopathology

Online: 8 March 2024 (04:09:56 CET)

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Preprint ARTICLE | doi:10.20944/preprints202403.0413.v1

A Stress Reduction Intervention for Lactating Mothers Alters Maternal Gut, Breast Milk, and Infant Gut Microbiomes: Data from a Randomized Controlled Trial

Jinyue Yu, Yan Zhang, Jonathan Wells, Zhuang Wei, Mona Bajaj-Elliott, Dennis Sandris Nielsen, Mary Fewtrell

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: breastfeeding; gut microbiome; maternal stress; infant weight; mother-infant signalling

Online: 7 March 2024 (10:46:34 CET)

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Preprint REVIEW | doi:10.20944/preprints202402.1717.v1

Reintroduction of Legacy Antibiotics in Neonatal Sepsis. The Special Role of Fosfomycin and Colistin

Maria Baltogianni, Niki Dermitzaki, Chrysoula Kosmeri, Anastasios Serbis, Foteini Balomenou, Vasileios Giapros

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: neonatal sepsis; antimicrobial resistance; repurposed antibiotics; Colistin; Fosfomycin

Online: 29 February 2024 (12:54:42 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202402.1691.v1

Central Line-Associated Bloodstream Infection Due to Elizabethkingia anophelis: Case Report and Literature Review on Pediatric Infections

Sophia Maraki, Nikolaos Katzilakis, Ioannis Neonakis, Dimitra Stafylaki, Viktoria Eirini Mavromanolaki, Ioannis Kyriakidis, Iordanis Pelagiadis, Eftychia Stiakaki

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Elizabethkingia anophelis; pediatric infections; neonate; identification; antimicrobial susceptibility

Online: 29 February 2024 (10:38:13 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1510.v1

InflammamiRs profile in myelodysplastic syndrome patients

Paola Montes, Iryna Rusanova, Elena Cornejo, Paloma García, Ana Guerra-Librero, Mª del Señor López, Tomás de Haro, Germaine Escames, Dario Acuña-Castroviejo

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: myelodysplastic syndrome (MDS); microRNAs (miRNs); oxidative stress; inflammatory cytokines; 5-azacitidine (5-AZA)

Online: 27 February 2024 (10:12:07 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1308.v1

Final Validation of the Quality of Life after Brain Injury for Children and Adolescents after Traumatic Brain Injury (QOLIBRI-KID/ADO) Questionnaire

Nicole von Steinbuechel, Marina Zeldovich, Dagmar Timmermann, Ugne Krenz, Inga K. Koerte, Michaela V. Bonfert, Steffen Berweck, Matthias Kieslich, Marlene Henrich, Knut Brockmann, Anna Buchheim, Maike Roediger, Michael Lendt, Christian Auer, Axel Neu, Alexander Kaiser, Joenna Driemeyer, Sven Greving, Ulrike Wartemann, Daniel Pinggera, Claudius Thome, Joachim Suss, Holger Muehlan, Katrin Cunitz

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: health-related quality of life (HRQoL); pediatric traumatic brain injury (TBI); QOLIBRI-KID/ADO

Online: 22 February 2024 (13:22:09 CET)

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Preprint REVIEW | doi:10.20944/preprints202402.1280.v1

Reliability of IL-6 Alone and in Combination for Diagnosis of Late Onset Sepsis: a Systematic Review

Julia Eichberger, Elisabeth Resch, Bernhard Resch

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: interleukin-6; late-onset sepsis; sensitivity; specificity; meta-analysis; diagnostic accuracy

Online: 22 February 2024 (12:10:58 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.1025.v1

Early Screening for Long QT Syndrome and Cardiac Anomalies in Infants: A Comprehensive Study

Luana Nosetti, Marco Zaffanello, Carolina Lombardi, Alessandra Gerosa, Giorgio Piacentini, Abramo Michele, Massimo Agosti

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: children; congenital heart disease; Electrocardiogram; Infant; long QT syndrome; neonatal screening; sudden infant death syndrome.

Online: 19 February 2024 (08:22:38 CET)

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(1) Background: Sudden Infant Death Syndrome (SIDS) represents unexplained and sudden deaths during the sleep of infants under one year of age, despite thorough investigation. Screening for prolonged QTc or Long QT Syndrome (LQTS) should be conducted on all newborns to reduce the incidence of SIDS. Neonatal electrocardiogram (ECG) could identify congenital heart defects (CHD) early, especially those not detected at birth. Infants with prolonged QT intervals typically undergo genetic analysis for Long QT Syndrome; (2) Methods: The study involved infants aged 20-40 days, born clinically healthy, with initial ECG screening. Infants with prenatal diagnoses or signs/symptoms of CHD identified immediately after birth, as well as those who underwent ECG or echocardiogram for other clinical or historical indications, were excluded from the study. The data were analyzed using SPSS version 22.0; (3) Results: Of the 42,200 infants involved, 2,245 were enrolled, with 39.9% being males. Subsequently, 164 children (37.8% males) with prolonged QT intervals underwent further diagnostic investigations. Genetic mutations were identified in 11 out of 18 tested children. The most common mutations were LQT1 (54.5%), LQT2 (36.4%), and LQT3 (1 patient). Medications used included propranolol (39.8%), nadolol (22.2%), inderal (11.1%), metoprolol (11.1%), and no treatment (16.7%). The most common abnormalities were focal right bundle branch block (54.5%), left axis deviation (9.2%), and nonspecific ventricular repolarization abnormalities (7.1%). Multiple anomalies were found in 0.47% of children with focal right bundle branch block. Structural abnormalities were associated with specific features in 267 patients (11.9%), primarily isolated patent foramen ovale (PFO) at 61.4%; (4) Conclusions: The screening has proven effective in early diagnosing Long QT Syndrome and other cardiac rhythm anomalies, with additional benefits in detecting mutations and/or QTc prolongations in family members. Identifying other ECG abnormalities and congenital heart malformations further enhances the benefits of the screening.

Preprint ARTICLE | doi:10.20944/preprints202402.0878.v1

Insights into Pediatric Sleep Disordered Breathing: Exploring Risk Factors, Surgical Interventions, and Long-Term Neuropsychological Outcomes

Marco Zaffanello, Angelo Pietrobelli, Leonardo Zoccante, Luca Sacchetto, Luana Nosetti, Michele Piazza, Giorgio Piacentini

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: adenoidectomy; adenotonsillectomy; breastfeeding; children; obstructive sleep apnea; quality of life; Pediatric Sleep Questionnaire; sleep-disordered breathing

Online: 16 February 2024 (07:41:16 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0746.v1

Are We Able to Prevent Neonatal Readmission? A Retrospective Analysis from a Pediatrics Department in Ploiești – Romania

Ioana Roșca, Andreea Teodora Constantin, Daniela Eugenia Popescu, Ana Maria Cristina Jura, Anca Miu, Alina Turenschi

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: neonatal; readmission; newborns; pediatrics; malnutrition; breastfeeding; multidisciplinary team; public health; inclusion; equity.

Online: 13 February 2024 (12:28:27 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0309.v1

Developmental and Nutritional Changes in Children with Severe Acute Malnutrition Provided with an N-3 Fatty Acids Improved RUTF and Psychosocial Support: A Pilot Study in Tanzania

Fredrick Cyprian Mwita, George PrayGod, Erica Sanga, Theresia Setebe, Gaudensia Joseph, Happyness Kunzi, Jayne Webster, Melissa Gladstone, Rebecca Searle, Maimuna Ahmed, Adolfine Hokororo, Suzanne Filteau, Henrik Friis, André Briend, Mette Olsen Frahm

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Severe Acute Malnutrition, child development, fatty acids, ready-to-use therapeutic foods, psychosocial stimulation

Online: 6 February 2024 (10:38:22 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0264.v1

Early Hydrocortisone Therapy Improves Sepsis Outcome in the Neonatal Mice by Inhibiting the NF-κB Pathway: A Pilot Study

Jun Juan Zhong, Jing Zhang, Ying Yi Lin, Dong Ju Ma, Jing Mo, Xiu Zhen Ye

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: neonatal sepsis; neonatal mice; hydrocortisone; timing; NFκB

Online: 5 February 2024 (15:30:12 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0296.v1

Prenatal and Postnatal Disparities in Very Preterm Infants in a Study of Infections between 2018–2023 in the Southeastern US

Robin B Dail, Kayla C. Everhart, Victor Iskersky, Weili Chang, Kimberley Fisher, Karen Warren, Heidi J Steflik

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: premature infant; infection; disparities; mortality; bacteria.

Online: 5 February 2024 (14:41:51 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0231.v1

Title Arnica D30 – an Alternative for Managing Procedural Pain in Full-Term Neonates

Penka Vasileva Petleshkova, Maya Bogdanova Krasteva, Iliyana Hristova Pacheva, Snezhana Stefanova Dragusheva, Margarita Lyubenova Ruseva

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: newborn; procedural pain; non-pharmacological methods; homeopathy

Online: 5 February 2024 (11:05:18 CET)

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Background: Despite scientific advances, the management of procedural pain in neonates remains suboptimal. Applying adequate therapy to control pain during the neonatal period is a moral and ethical act. In recent decades, ample evidence has accumulated regarding the risks, associated with both untreated pain and the use of more aggressive analgesic therapy. Thus, the emphasis in neonatal clinical practice is on non-aggressive pain management techniques, including homeopathic agents. The efficacy and safety of homeopathic agents for reducing procedural pain in neonates is the subject of the present study. Materials and Methods: Healthy full-term newborn babies with an average age of 72-84 hours were included. They were divided into three study groups: group (A) – not anesthetised, /n= 67/, group (B) – anesthetised with Arnica D30 /n=40/ and group (C)- anesthetised with Sol.Glucose 25% /n=40/. The severity of the pain was assessed using the multimodal - Neonatal Infant Pain Scale (NIPS) and the unimodal - Neonatal Facial Coding System (NFCS) scale. Assessments were done 30s before, 30 seconds after, and 5 minutes after the painful stimulus caused by the heel prick. Heart rate, transcutaneous oxygen saturation, respiratory rate and blood pressure were examined at the same intervals. The results obtained were processed statistically by descriptive analysis and ANOVA at a significance level of p< 0.05. Results: 5 minutes after heel prick both scales showed a statistically significant lower score in those given Arnica D30, compared to those who received Sol.Glucose 25%. When monitoring the physiological indicators, we found a significant increase in the heart rate 30 seconds after the procedure.5 minutes after the heel prick we recorded significantly respiratory rate and systolic blood pressure in all three groups compared to pre-procedural values. Conclusions: Arnica D30 has better analgesic effects compared to Sol.Glucose 25% for newborn babies after heel prick tests.

Preprint REVIEW | doi:10.20944/preprints202402.0057.v1

Lung Microbiota and Ventilator‐Associated Pneumonia in the Neonatal Period

Fermín García-Muñoz Rodrigo, Lourdes Urquía Martí, Marta Siguero Onrubia, Moreyba Borges Luján, Gloria M Galán Henríquez, Desiderio Z Reyes Suárez

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Broad-spectrum antibiotics; Endotracheal tube; Microbioma; Microbiota; Multidrug resistant pathogens; Neonate; Prebiotics; Probiotics; Ventilator-associated pneumonia; Very-low-birth-weight infant

Online: 1 February 2024 (14:07:57 CET)

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Preprint ARTICLE | doi:10.20944/preprints202402.0007.v1

Association of White Matter T2 Hyper-Intense Signal in Fetal Brain Magnetic Resonance Imaging with Neurodevelopment of Fetuses with Cytomegalovirus Infection

Galia Barkai, Eldad Katorza, Simon Lassman, Itachi Levinberg, Chen Hoffmann, Omer Bar-Yosef

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Fetus; Brain; Magnetic Resonance Imaging; Cytomegalovirus; White matter

Online: 1 February 2024 (08:24:54 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.2222.v1

Proton Pump Inhibitors in Pediatric Gastroesophageal Reflux Disease: A Systematic Review of Randomised Controlled Trials

Sara María Fernández-González, Ana Moreno-Álvarez, Alfonso Solar-Boga

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: gastroesophageal reflux disease; efficacy; safety; proton-pump inhibitors; pediatric patients; systematic review

Online: 31 January 2024 (14:59:40 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.2186.v1

Laboratory Tests Might Mitigate Misdiagnosis of Child Abuse Established on Clinical Grounds

Sergio Verd, Elisa Lizarbe, Elena Sol, Alicia-Esther Tur

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Child abuse; Child growth; Child custody; Oxidative stress; Aspartate aminotransferase; Fatty liver; Insulin resistance

Online: 31 January 2024 (12:54:42 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202401.2118.v1

Brimonidine Eye Drops at the Children Reach: A Possible Foe

Daniela Trotta, Mirco Zucchelli, Carmela Salladini, Patrizia Ballerini, Claudia Rossi, Maurizio Aricò

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Brimonidine, eye-drop poisoning, tandem mass spectrometry

Online: 30 January 2024 (12:44:49 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.2060.v1

Cross-sectional Analysis of Infant Diet, Outcomes, Consumer Behavior and Parental Perspectives to Optimize Infant Feeding in Response to the 2022 U.S. Infant Formula Shortage

Karla Damian-Medina, Karina Cernioglo, Maha Waheed, Dina M. DiMaggio, Anthony F. Porto, Jennifer T. Smilowitz

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Keywords: Breastfeeding; consumer behavior; equity; feeding practices; food security; health, government and regulatory policies; infant formula shortage; lactation; pediatrics

Online: 30 January 2024 (04:06:05 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.2048.v1

Infantile Hemangiomas of the Head and Neck: A Single-Center Experience

Deniz Kizmazoglu, Dilek İnce, Yüksel Olgun, Emre Cecen, Handan Guleryuz, Taner Kemal Erdağ, Nur Olgun

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Infantile Hemangioma, Head and neck, Treatment, Propranolol, Complications

Online: 30 January 2024 (00:22:26 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1869.v1

Updated Guidelines for Resuscitation, Stabilization and Res-piratory Distress Syndrome Early Management in Extremely Preterm Infants–Impact on Outcomes

Manuela Cucerea, Marta Simon, Mădălina Anciuc-Crauciuc, Raluca Marian, Monika Rusneac, Maria Livia Ognean

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: extremely preterm infants; resuscitation; neonatal respiratory distress syndrome; outcomes; guidelines

Online: 26 January 2024 (10:50:51 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1717.v1

Retrospective Review of Positive Newborn Screening Results for Isovaleric Acidemia and Development of a Strategy to Improve the Efficacy of Newborn Screening in the UK.

Rachel S Carling, Katy Hedgethorne, Anupam Chakrapani, Patricia L Hall, Nick Flynn, Toby Greenfield, Stuart J. Moat, Joshua Ssali, Lynette Shakespeare, Nazia Taj, Mark Anderson, Teresa H.Y. Wu, Arunabha Ghosh, Hugh Lemonde, Germaine Pierre, Mark Sharrard, Sreevidya Sreekantam, James R Bonham

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: isovaleric acidemia; false positive; newborn screening; inherited metabolic disease.

Online: 24 January 2024 (09:54:13 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1239.v1

Predicting the Need for Surfactant Replacement Therapy in Very Preterm Infants by Combining Gastric Fluid Metabolomics with Neonatal Data

Konstantia Besiri, Olga Begou, Konstantinos Lallas, Angeliki Kontou, Eleni Agakidou, Olga Deda, Helen Gika, Eleni Verykouki, Kosmas Sarafidis

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: gastric fluid; RDS; GC-MS; prematurity; surfactant; prediction

Online: 16 January 2024 (12:26:43 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.1167.v1

Use of Extracellular Vesicles in the Therapy of Neonatal Diseases: Current State and Problems of Translation to the Clinic

Kirill Goryunov, Mikhail Ivanov, Andrey Kulikov, Yulia Shevtsova, Artem Burov, Yulia Podurovskaya, Victor Zubkov, Dmitry Degtyarev, Gennady T. Sukhikh, Denis Silachev

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: extracellular vesicles; mesenchymal stromal cells; neonatal pathologies; premature newborns; cell therapy

Online: 16 January 2024 (04:21:03 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1149.v1

Immunogenicity of Monovalent Oral Poliovirus Vaccine Type 1 (mOPV1) and Inactivated Poliovirus Vaccine (IPV) in EPI Schedule of India

LALITENDU MOHANTY, T. Jacob John, SHAILESH PAWAR, Padmasani Venkat Ramanan, SHARAD AGARKHEDKAR, Pradeep Haldar

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Poliomyelitis; bivalent Oral Poliovirus Vaccine; monovalent Oral type 2 Poliovirus Vaccine; Inactivated Poliovirus Vaccine; routine immunization; India

Online: 16 January 2024 (02:16:43 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1130.v1

The Role of Biomarkers and Correlated Conditions in the Diagnosis of Neonatal Sepsis

Nicoleta Lungu, Aniko-Maria Manea, Daniela-Eugenia Popescu, Kristian Miok, Florina Marinela Doandes, Oana Cristina Costescu, Mihaela Zaharie, Daniela Maria Pop, Ana Maria Cristina Jura, Marioara Boia

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: newborn; sepsis; biomarkers; early onset sepsis; late onset sepsis; ferritin; lactate dehydrogenase

Online: 15 January 2024 (13:41:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.1107.v1

Effects of the COVID-19 Pandemic on Brief Resolved Unexplained Events (BRUEs) in Children: A Comparative Analysis of Pre-Pandemic and Pandemic Periods

Luana Nosetti, Marco Zaffanello, Giorgio Piacentini, Francesca De Bernardi, Cristina Cappelluti, Camilla Sangiorgio, Massimo Agosti

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Apparent Life-Threatening Events; Brief Resolved Unexplained Event; COVID-19; infant; newborn; polysomnography; pregnancy; SARS-CoV-2.

Online: 15 January 2024 (08:15:22 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0799.v1

Fetal MRI Analysis of Corpus Callosum Abnormalities: Classification and Associated Anomalies

Kranthi K. Marathu, Farzan Vahedifard, Mehmet Kocak, Xuchu Liu, Jubril O. Adepoju, Rakhee Bowker, Mark P. Supanich, Rosario M Cosme, Sharon Byrd

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: fetal magnetic resonance imaging; corpus callosum abnormality; central nervous system anomalies; probst bundles; agenesis; hypoplasia; neuroradiology

Online: 10 January 2024 (11:07:50 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0698.v1

Inflammatory Markers in Neonates Born to Mothers With SARS-CoV-2 Infection During Pregnancy

Daniela-Eugenia Popescu, Eugen Radu Boia, Luminita Paduraru, Gabriela Ildiko Zonda, Ioana Rosca, Corina Pienar, Cosmin Citu, Zoran Laurentiu Popa, Aniko-Maria Manea, Camelia Budisan, Mirabela Dima, Cezara Muresan, Marioara Boia

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: COVID-19; neonatal outcomes; inflammatory markers; maternal infection

Online: 9 January 2024 (05:16:19 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0583.v1

Staphylococcus capitis Central-Line Associated Bloodstream Infections (CLABSI) in the NICU: A Single-Center 4-Year Experience on Central Line Management during Sepsis Treatment

Anna Sala, Valentina Pivetti, Alessandra Vittorini, Claudia Viggiano, Francesca Castoldi, Valentina Fabiano, Gianluca Lista, Francesco Cavigioli

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: LOS; CLABSI; CoNS; CVC; infants; S. capitis

Online: 8 January 2024 (11:28:01 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202401.0572.v1

Benzalkonium Chloride Poisoning in Pediatric Patients: Report of Case with a Severe Clinical Course and Literature Review

Viorela Nițescu, Andreea Lescaie, Dora Boghițoiu, Coriolan Ulmeanu

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: disinfectants; quaternary ammonium compounds; benzalkonium compounds; poisoning, child; aspiration; pneumonia; pneumothorax; corrosion

Online: 8 January 2024 (07:01:45 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0439.v1

Elevated Prostaglandin E2 Synthesis Is Associated with Clinical and Radiological Disease Severity in Cystic Fibrosis

Silvia Gartner, Jordi Roca-Ferrer, Paula Fernandez-Alvarez, Isabel Lima, Sandra Rovira-Amigo, Elena García-Arumí, Eduardo Tizzano, César Picado

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: cystic fibrosis; prostaglandin E2; prostaglandin D2; genetic polymorphisms; PTGS1; PTGS2; COX-1; COX-2

Online: 5 January 2024 (09:16:02 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0285.v1

How Much Does SARS-CoV-2 Infection during Pregnancy Affect the Neonatal Brain, Heart and Kidney? A Parallel between COVID-19, Vaccination and Normal Pregnancy

Daniela Eugenia Popescu, Ana Maria Cristina Jura, Daniela Știube, Adrian Ciulpan, Florina Stoica, Simona Ioana Sipos, Cosmin Citu, Florin Gorun, Marioara Boia

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: pregnancy; COVID-19; neonatal; ultrasound; infectious diseases; SARS-CoV-2; vaccine; disease course

Online: 4 January 2024 (15:17:29 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0369.v1

Early Extra-Uterine Growth Restriction in Very Low Birth Weight Neonates with Normal or Mildly Abnormal Brain MRI: Effects on 2–3 Years Neurodevelopmental Outcome

Paolo Massirio, Marcella Battaglini, Irene Bonato, Sara De Crescenzo, Maria Grazia Calevo, Mariya Malova, Samuele Caruggi, Alessandro Parodi, Deborah Preiti, Agata Zoia, Sara Uccella, Domenico Tortora, Mariasavina Severino, Andrea Rossi, Cristina Traggiai, Lino Nobili, Pasquale Striano, Luca Antonio Ramenghi

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: preterm; extra-uterine growth restriction; EUGR; VLBW; neurodevelopment; weaning; nutritional education

Online: 4 January 2024 (09:01:43 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.0177.v1

Impact of SARS-CoV2 Pandemic and Lockdown on the RSV Circulation: Experience of Three Spoke Hospitals in Northern Italy

Francesca Parola, Adalberto Brach del Prever, Virginia Deut, Giulia Costagliola, Carla Guidi, Neftj Ragusa, Antonella Tuscano, Fabio Stefano Timeus, Massimo Berger

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Respiratory Syncytial Virus (RSV); SARS-CoV2 Pandemic; epidemiology; seasonality trend; RSV prevalence

Online: 3 January 2024 (09:44:16 CET)

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Preprint SHORT NOTE | doi:10.20944/preprints202312.2283.v1

A Child Born Late: Neonatal and Paediatric Compilations Related to Post-Dated Pregnancy

Charmee Patadia, Dev Desai

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Neonates; Pediatric group; Complications; Post-dated pregnancy

Online: 29 December 2023 (13:25:55 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.2250.v1

Improving Pediatric Patient Outcomes: An Interrupted Time Series (ITS) Approach to Explore the Impact of Rapid Response Teams in Reducing Unplanned PICU Admissions and Cardiopulmonary Arrests.

Samah Al Harbi

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: pediatric rapid response team; pediatric intensive care units; interrupted time series analysis; cardiopulmonary arrest in children; quasi-experimental study

Online: 29 December 2023 (05:30:31 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.2126.v1

Challenges of Iron Chelation in Thalassemic Children

Alkistis Adramerina, Marina Economou

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: thalassemia; deferoxamine; deferiprone; deferasirox

Online: 27 December 2023 (15:51:44 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.1912.v1

Effect of Pre-, Pro- and Synbiotics on Biomarkers of Systemic Inflammation in Children: A Scoping Review

Benjamin Momo Kadia, Stephen John Allen

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: prebiotic; probiotic; synbiotic; inflammation; children

Online: 26 December 2023 (06:07:39 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.1815.v1

Nutraceuticals and Pain Disorders of the Gut Brain Interaction in Infants and Children: A Narrative Review and Practical Insights

Silvia Salvatore, Mariagrazia Carlino, Simona Sestito, Daniela Concolino, Massimo Agosti, Licia Pensabene

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Nutraceutical; Complementary therapies; herbs; fibers; prebiotics; probiotics; abdominal pain; irritable bowel syndrome; infantile colic; FGIDs; FAPs; disorders of the gut-brain interaction

Online: 25 December 2023 (05:27:24 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1745.v1

Association of whole blood amino acid and acylcarnitine metabolome with anthropometry and IGF1 serum levels in healthy children and adolescents

Ricky Jensch, Ronny Baber, Antje Körner, Wieland Kiess, Uta Ceglarek, Antje Garten, Mandy Vogel

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: pediatrics; metabolomics; amino acids; acylcarnitines; anthropometry; body composition

Online: 22 December 2023 (11:32:22 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1360.v1

Changes in Cortisol and in Oxidative/Nitrosative Stress Indicators after ADHD Treatment

Laura Garre-Morata, Tomás de Haro, Raquel González Villén, María Luisa Fernández-López, Germaine Escames, Antonio Molina-Carballo, Darío Acuña-Castroviejo

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: attention-deficit/hyperactivity disorder (ADHD); oxidative stress; inflammation; cortisol; cortisol awakening response (CAR); methylphenidate

Online: 19 December 2023 (07:21:39 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1269.v1

The Relationship between Depression Symptoms and Physical Activity in Children with Idiopathic Ventricular Extrasystoles

Rita Kunigeliene, Odeta Kinčinienė, Vytautas Usonis, Sigita Lesinskienė

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: depression; idiopathic ventricular extrasystoles; children

Online: 18 December 2023 (10:40:28 CET)

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Background and Objectives Depression in childhood often co-occurs with anxiety disorders and a range of somatic symptoms. Recent studies have identified physical activity as a target for preventing the onset of depression. Idiopathic ventricular extrasystoles (VE) in children are sometimes associated with somatic symptoms and limitations in physical activity. The problem of arrhythmia existence can also be distressing for children and their parents. The study was conducted to determine the relationship between symptoms of depression, physical activity and somatic symptoms in children with idiopathic VE. Materials and Methods The study of children with structurally normal hearts and VE was approved by the Ethics Committee No. 2021/10-1383˗859(1). The authors developed Questionnaire to assess symptoms, physical activity, and general well-being. Symptoms of depression evaluated with modified pediatric PHQ-9 (MP-PHQ-9) questionnaire with the interpretation of 0-4 scores for none; 5-9 mild; 10-14 moderate; >15 severe depression. Children aged ≥12 years and parents who assessed their children's condition completed Questionnaires. All children underwent 24-hour electrocardiography and echocardiography to evaluate arrhythmia frequency and cardiac condition. Results Questionnaires were completed by 60 children’s parents and 39 children (≥12 years old). Median children’s age was 13 (5-17) years. Palpitations experienced 26 (43.3%), chest pain 13 (21.7%), exercise intolerance 15 (25%) children. All patients had normal ventricular function and hemodynamically normal hearts. The median score of the MP-PHQ-9 completed by parents was 2 (0-16); by children - 4 (0-18). The median VE frequency was 4,77 (0,1-32,77) % per 24 hours. Extra-sports participation had 31 (51.7%) children with a median time of 3.75 (0.75-25) hours/ week. Eleven-patients were suspended from sports. There was no significant difference between VE frequency, and MP-PHQ-9 scores. Higher MP-PHQ-9 scores showed <5 hours/week active symptomatic children. Conclusions Idiopathic VE, limitations in physical activity and depression remain the actual theme for clinicians and need further research. Higher depression scores showed patients with somatic symptoms.

Preprint ARTICLE | doi:10.20944/preprints202312.1235.v1

Managing of Acute Pediatric Cough in Africa: prescription of Cough Suppressants and Associated Complications

Benoît Mukinayi Mbiya, Denis Kalambayi Mbuyi, Steve Tshiala Kasongo, Valery Daubie

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: cough; cough suppressants; pediatrics; complications; Mbujimayi; Democratic Republic of Congo

Online: 18 December 2023 (10:34:03 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1234.v1

Association Between Weight for Length and Severity of Respiratory Morbidity in Preterm Infants

Pradeep Alur, Kristen Harvey, Kyle Hart, Wondwosen Kassahun-Yimer, Renjithkumar Kalikkot

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: weight for length; BMI; BPD; respiratory severity; preterm

Online: 18 December 2023 (10:19:11 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1192.v1

Transcutaneous posterior tibial nerve stimulation: an adjuvant treatment for intractable constipation in children

Rebeca Mayara Padilha Rego, Nilton Carlos Machado, Mary de Assis Carvalho, Johann Souza Graffunder, Crhistiano Fraguas, Erika Veruska Paiva Ortolan, Pedro Luiz Toledo de Arruda Lourenção

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Constipation; Transcutaneous Electric Nerve Stimulation; Child; Adolescent.

Online: 15 December 2023 (13:15:00 CET)

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BACKGROUND: Functional constipation can lead to painful defecations, fecal incontinence, and abdominal pain, significantly affecting a child's quality of life. Treatment options include non-pharmacological and pharmacological approaches, but some cases are intractable and require alternative interventions like neuromodulation. A subtype of neuromodulation, called Transcutaneous Posterior Tibial Nerve Stimulation (TPTNS), comprises electrical stimulation at the ankle level, by means of electrodes fixed to the skin. TPTNS is a minimally invasive, easy-to-apply technique that can potentially improve constipation symptoms in the pediatric population by stimulating the sacral nerves. AIM: To evaluate the clinical results and applicability of TPTNS as an adjuvant treatment for children and adolescents with functional constipation. METHODS: Between April 2019 and October 2021, 38 patients diagnosed with functional constipation according to the Rome IV Criteria were invited to participate in the study. The study followed a single-center, uncontrolled, prospective cohort design. Patients received TPTNS for 4 or 8 weeks, with assessments conducted immediately after the periods of TPTNS and 4 weeks after the end of the intervention period. The data normality distribution was determined by the Shapiro-Wilk test. Wilcoxon test and Student's t-test for paired samples were used to compare quantitative variables, and the McNemar test was used to compare categorical variables. RESULTS: Of the 38 enrolled patients, 28 children and adolescents with intractable function constipation completed the study, receiving TPTNS for 4 weeks. Sixteen patients (57.1%) extended the intervention period for 4 extra weeks, receiving 8 weeks of intervention. TPTNS led to significant improvements in stool consistency, frequency of defecation, and bowel function scores, with a reduction in abdominal pain. Quality of life across physical and psychosocial domains showed substantial enhancements. The quality of life-related to bowel habits also improved significantly, particularly in lifestyle, behavior, and embarrassment domains. The positive effects of this intervention are seen relatively early, detected after 4 weeks of intervention, and even 4 weeks after the end of the intervention. TPTNS was well-tolerated, with an adherence rate of approximately 78%, and no adverse effects were reported. CONCLUSION: TPTNS is an adjuvant treatment for intractable functional constipation, improving bowel function and quality of life. The effects of TPTNS were observed relatively early and sustained even after treatment cessation.

Preprint CASE REPORT | doi:10.20944/preprints202312.1095.v1

Genomic Exploration of Pediatric Neurological Diversity: Lessons from Clinical Exome Panel Sequencing

Naresh Tayade, Anjali Krishna A, Gautham Manoj, Akshay Kewat, Rajiv Devulapalli, Somesh Kumar, Sunil K Polipalli, Bipin G Nair, Obul Reddy Bandapalli, Prashanth Suravajhala

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Rare conditions; Neurological disorders; Autism; Arthrogryposis; Bilateral cataract

Online: 14 December 2023 (11:45:24 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.0927.v1

Role and Therapeutic Potential of Non-coding RNAs in Astrocytes during Neonatal Brain Injury

Zhiyi Ye, Tianming Yuan

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: astrocyte; non-coding RNAs; miRNAs; lncRNAs; circRNAs; neonatal brain injury; hypoxic-ischemic; neuroinflammation

Online: 13 December 2023 (11:00:51 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.0890.v1

Biomarkers and Predictor Models for Serious Bacterial Infections in Febrile Children

Luca Bernardi, Gianluca Bossù, Giulia Dal Canto, Giuliana Giannì, Susanna Esposito

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: biomarker; C reactive protein; interleukin; presepsin; procalcitonin; serious bacterial infection.

Online: 12 December 2023 (12:56:57 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.0763.v1

Preterm Infants’ Airway Microbiome: A Scoping Review of the Current Evidence

S. F. G. Colombo, C. Nava, F. Castoldi, V. Fabiano, F. Meneghin, G. Lista, F. Cavigioli

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: preterm infants; lung microbiome; airway microbiome

Online: 12 December 2023 (04:27:13 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0589.v1

Exploring PTX3 as a Diagnostic and Prognostic Marker in Fetal Inflammatory Response Syndrome in Newborns: A Prospective Study

Bahar Öztelcan Gündüz, Ener Cağrı Dinleyici, Neslihan Ayşe Tekin, Ömer Çolak, Arif Mehmet Akşit

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: PTX3; NEWBORN BABY; FETAL İNFLAMMATORY SYNDROME; SEPSİS; RDS

Online: 8 December 2023 (10:09:23 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.0545.v1

Therapeutic Strategies in Children with Epilepsy-from the Point of View of QOL-Related Factors-

Hideaki Kanemura

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: frontal; prefrontal; behavior; stigma; seizure severity; interictal epileptiform discharge (IED); quality of life (QOL)

Online: 7 December 2023 (15:57:26 CET)

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Children with epilepsy are affected by several factors, including clinical and social variables, which can lead to reductions in quality of life (QOL). Among these variables, factors relating to seizure severity such as frequent seizures and status epilepticus (SE) have been identified as important predictors of QOL. In addition, frequency of interictal epileptiform discharges (IEDs) on the electroencephalogram (EEG) may also lead to cognitive declines and behavioral disturbances. Moreover, frequent seizures and/or IEDs may play a role in emotional mediators such as stigma and fatigue in childhood epilepsy. Seizure severity and/or IEDs are thus important QOL-related factors in childhood epilepsy. Frontal lobe dysfunctions such as cognitive decline and behavioral disturbances can result in reduced QOL for both the child and their family. Frontal and prefrontal lobe growth disturbances can be present during active-phase epilepsy in some children with neuropsychological impairments. Recovery from prefrontal lobe growth disturbance may depend on the active seizure period. Disturbance of prefrontal lobe growth can recover more rapidly in children with a shorter active seizure period. In contrast, recovery may be delayed in children with a longer active seizure period. Accordingly, severe seizures can lead to neuropsychological impairments in association with prefrontal lobe growth disturbance in children with epilepsy. Moreover, frequent seizures can lead to having seizure-associated headache, perception of self-stigma and parental stigma, and fatigue. In addition, IEDs on EEG, representing persistent pathological neuronal discharges, may be associated with several pathological aspects. Frontal IEDs can be a risk factor for recurrent seizures, cognitive decline, and behavioral disturbances and may also play a role as an emotional mediator similar to stigma. In addition, behavioral disturbances may result in the presence of secondary bilateral synchrony (SBS) on EEG. Behavioral disturbances can be improved in association with reduction of IEDs in children with frontal IED and SBS. Seizure severity and IEDs on EEG may thus be associated with neuropsychological impairments, leading to QOL reduction. Therapeutic management may be desirable to remit seizures and EEG abnormalities such as frontal IED and SBS as soon as possible to improve QOL in children with epilepsy.

Preprint REVIEW | doi:10.20944/preprints202312.0459.v1

Intrauterine Growth Restriction: Improving Diagnostic Accuracy and the Role of Oxidative Stress in Neonatal and Long-Term Sequels

Eva Nüsken, Sarah Appel, Leon Saschin, Celien Kuiper-Makris, Laura Oberholz, Charlotte Schömig, Anne Tauscher, Jörg Dötsch, Angela Kribs, Miguel A. Alejandre Alcazar, Kai Dietrich Nüsken

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: intrauterine growth restriction; diagnostic accuracy; acute and long-term sequels; oxidative stress; antioxidants

Online: 7 December 2023 (07:09:49 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0219.v1

Investigating the Association Between Serum Biomarkers and Neonatal Sepsis in Newborns with Premature Rupture of Membranes: A Retrospective Study

Maura Adelina Hincu, Gabriela Ildiko Zonda, Petronela Vicoveanu, Valeriu Harabor, Anamaria Harabor, Alexandru Cărăuleanu, Alina-Sinziana Melinte-Popescu, Marian Melinte-Popescu, Elena Mihalceanu, Mariana Stuparu Cretu, Ingrid Andrada Vasilache, Dragos Nemescu, Luminita Paduraru

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Early-onset sepsis; Biomarker; C-reactive protein; Procalcitonin; White blood count; Antibiotics

Online: 4 December 2023 (14:17:49 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.0003.v1

Advance Diagnostic of Respiratory Distress Syndrome in Premature Infants Treated with Surfactant and Budesonide through Computer-Assisted Chest X-ray Analysis

Tijana Prodanovic, Suzana Petrovic Savic, Nikola Prodanovic, Aleksandra Simovic, Suzana Zivojinovic, Jelena Cekovic Djordjevic, Dragana Savic

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Respiratory Distress Syndrome; Chest X-ray; Diagnostics; Image Segmentation; Performance Evaluation

Online: 1 December 2023 (04:59:28 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1911.v1

Infrared Thermal Imaging Analysis for Diagnosing Toddler’s Fractures

Reza Saatchi, Shammi Ramlakhan

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: infrared thermal imaging; toddler’s fracture; bone fracture screening; infrared thermal image processing and analysis; artificial intelligence; emergency medicine; orthopaedics

Online: 29 November 2023 (16:40:58 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1872.v1

Hospitalization and Mortality in Children Due to COVID-19. A Single Center Retrospective Study from Brazil

Ana Carolina Pereira de Godoy, Reinaldo Bulgarelli Bestetti

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: COVID-19; children; mortality

Online: 29 November 2023 (10:35:39 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1356.v1

Management of Acute Bronchiolitis in Spoke Hospitals: Analysis and Outcome

Carla Guidi, Neftj Ragusa, Ilaria Mussinatto, Francesca Paola, Diego Luotti, Giulia Calosso, Eleonora Rotondo, Virginia Deut, Fabio Stefano Timeus, Adalberto Brach del Prever, Massimo Berger

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: bronchiolitis; children; respiratory syncytial virus; high flow nasal cannula; acute bronchiolitis

Online: 21 November 2023 (17:18:53 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1187.v1

Evaluation of Urinary L‐FABP as a Tubular Damage Marker in Pediatric Neurogenic Bladder

Joanna Bagińska, Jan Krzysztof Kirejczyk, Agata Korzeniecka-Kozerska

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: neurogenic bladder; L-FABP; proteinuria

Online: 21 November 2023 (10:38:32 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1162.v1

Factors Influencing Postoperative Outcomes in Children with Ureteropelvic Junction Obstruction: A Logistic Regression Analysis

Li Zhang, Qingtao Zhong, Xuan Wang, Jiali He, Peng Li, Xianhai YU, Shengde Wu, Yi Hua, Feng Liu, Xing Liu, Dawei He, Tao Lin, Guanghui Wei, Deying Zhang

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Ureteral Obstruction; Hydronephrosis; Prognosis; Pediatrics

Online: 17 November 2023 (11:52:40 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.0727.v1

Light and Shadows in Newborn Screening for Lysosomal Storage Disorders: Eight Years of Experience in Northeast Italy

Vincenza Gragnaniello, Chiara Cazzorla, Daniela Gueraldi, Andrea Puma, Christian Loro, Elena Porcù, Maria Stornaiuolo, Paolo Miglioranza, Leonardo Salviati, Alessandro P Burlina, Alberto B Burlina

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: newborn screening; lysosomal storage disease; Pompe disease; Mucopolysaccharidosis type I; Gaucher disease; Fabry disease; second tier test; tandem mass spectrometry; glycosaminoglycans; lysosphingosine.

Online: 10 November 2023 (16:19:05 CET)

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Preprint REVIEW | doi:10.20944/preprints202311.0466.v1

Preterm Birth and Its Association with Maternal Diet, and Placental and Neonatal Telomere Length

Nikoletta Lis, Demetris Lamnisos, Aikaterini Bograkou - Tzanetakou, Elena Hadjimbei, Irene P Tzanetakou

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: maternal nutrition; placenta telomeres; newborn telomeres; premature birth; preterm infants

Online: 8 November 2023 (01:43:11 CET)

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Preprint REVIEW | doi:10.20944/preprints202311.0444.v1

Chronic Non-bacterial Osteomyelitis in Inflammatory Bowel Disease

Ariadni Tzaneti, Elli Athanasopoulou, Smaragdi Fessatou, Lampros Fotis

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: CRMO; CNO; Crohn's disease; inflammatory bowel disease; osteomyelitis; pediatrics; ulcerative colitis

Online: 8 November 2023 (01:42:37 CET)

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Chronic non-bacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO), is a rare autoinflammatory bone disease primarily affecting children and adolescents. This review presents a comprehensive analysis of the intricate relationship between CNO and inflammatory bowel disease (IBD), shedding light on shared pathophysiological mechanisms and clinical management. A thorough literature review was conducted, encompassing 24 case reports involving 40 patients. The demographic distribution of patients revealed a near-equal gender ratio, with a median age of diagnosis at 12 years. The diagnosis patterns showed a higher proportion of CNO as the initial diagnosis, while Crohn's disease was more prevalent than ulcerative colitis. The time interval between the clinical presentations varied, ranging from simultaneous detection to a substantial 15-year gap. Treatment modalities included non-steroidal anti-inflammatory drugs (NSAIDs), steroids, aminosalicylates, and biologic agents, such as infliximab, often overlapping in their use, suggesting shared pathophysiological pathways. Both conditions displayed systemic manifestations, and patients often responded well to immunosuppressive medications. The pathophysiology of CNO involves genetic predisposition, cytokine dysregulation, and osteoclast activation. Dysregulated innate immunity results in immune cell infiltration into bones, causing sterile bone lesions. Notably, emerging evidence hints at a potential link between the microbiome and CNO. In contrast, IBD results from imbalanced mucosal immune responses to the intestinal microbiota. Polymorphisms in the promotor region of IL-10, common cytokines, immune cells, and genetic markers indicate shared immunological and genetic factors between CNO and IBD. Both conditions also involve extraintestinal symptoms. This analysis underscores the need for clinical awareness of the co-occurrence of CNO and IBD, especially among pediatric patients. A deepened understanding of the connections between these seemingly distinct diseases could lead to more effective management and improved patient outcomes.

Preprint ARTICLE | doi:10.20944/preprints202311.0410.v1

Does Massive Bowel Resection in Newborns Affect Further Immunity in Children?

Katarzyna Sznurkowska, Anna Borkowska, Magdalena Malanowska, Agnieszka Zagierska, Maciej Zagierski, Maciej Zieliński, Piotr Trzonkowski, Marcin Łosin, Agnieszka Szlagatys- Sidorkiewicz

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: short bowel syndrome; lymphocyte subsets; immunoglobulins; children

Online: 7 November 2023 (10:16:37 CET)

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Preprint REVIEW | doi:10.20944/preprints202311.0314.v1

From Mother to Infant, from Placenta to Gut: Understanding Varied Microbiome Profiles in Neonates

Riadh Cheddadi, Venkata Yeramilli, Colin Martin

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Neonatal microbiome; Maternal effect; Placental Microbiome; intra-uterine development

Online: 6 November 2023 (08:10:26 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.0012.v1

Analysis of Hemogram and C-reactive protein in Viral Gastroenteritis: Insights into Inflammatory Response

Pınar Onal, Abdulkadir Bozaykut

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: rotavirus; adenovirus; children; gastroenteritis; mean platelet volume; neutrophil/lymphocyte value

Online: 1 November 2023 (04:06:48 CET)

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Preprint ARTICLE | doi:10.20944/preprints202310.1505.v1

Diagnostic Accuracy of Multiplex PCR in Early Onset Neonatal Sepsis

Anja Stein, Daniel Soukup, Peter-Michael Rath, Ursula Felderhoff-Müser

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: neonatal sepsis; early onset sepsis; multiplex PCR; infection; neonate; diagnosis; pathogen detection

Online: 24 October 2023 (08:11:56 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202310.1226.v1

Inflammatory Markers for the Development of Obliterative Bronchiolitis after Adenovirus Infection in Children

E Mei, Bengang Hai, Keke Xiang

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: adenovirus infection; obliterative bronchiolitis; children; inflammatory markers

Online: 19 October 2023 (05:37:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202310.1092.v1

Outcome of Nurse versus Physician-Administered Saline Enema for Meconium Obstruction of Prematurity in Very Low Birth Weight Infants

Thowfique Ibrahim, Li-Wei Chiang, Charlene Wimala, Muhammad Ashraf Yusoff, Luxna Srinivasan, Poh Leng Yuen, John Carson Allen Jr, Suresh Chandran, Victor Samuel Rajadurai

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: very low birth weight infant; prematurity; saline enema; extremely low birth weight infant; meconium inspissation; gastrografin; glycerin suppository; meconium obstruction of prematurity

Online: 17 October 2023 (15:07:10 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202310.1052.v1

Identification of the Best Predictive Model for Mortality in Outborn Neonates – Retrospective Cohort Study

MARIA LIVIA OGNEAN, IOANA ANDRADA RADU, BIANCA COSMINA COTOVANU, DUMITRU ALIN TEACOE, SAMUEL BOGDAN TODOR, CRISTIAN ICHIM, IRIS CODRUTA MURESAN, ADRIAN GHEORGHE BOICEAN, RADU GALIS, MANUELA CUCEREA

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: newborn; outborn; sick neonatal score; mortality; neonatal transportation; scoring system

Online: 17 October 2023 (12:06:27 CEST)

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Background: Neonatal transportation of sick newborns is a major predictor of outcome. Prompt identification of the sickest newborns allows immediate corrective intervention and outcome optimization. Multiple severity scores were developed, however an optimal score has not yet been identified. Aim: To identify a rapid, accurate, and easy to perform score predictive for neonatal mortality in outborn neonates. Material and methods: All neonates, irrespective of gestational age, admitted by transfer in our level III regional neonatal unit between 01.01.2015 and 31.12.2021 were included. Infants with congenital critical abnormalities were excluded. Sick neonatal score (SNS) was calculated and compared between survivors and non-survivors. Gestational age (GA), birth weight (BW), gender, Apgar score, place of birth, time between delivery and admission (AT), early onset sepsis were collected from medical records and compared between study groups. Subgroup analysis was performed based on gestational age (preterm versus term infants). A new score was elaborated, including GA, BW, and AT, namely MSNS-AT score, to further improve mortality prediction. The main outcomes were mortality prediction using SNS and MSNS-AT score. Univariable and multivariable analysis, including Cox regression, were performed using SPSS Statistic 22.0. P-value was considered statistically significant if <0.05, 95% confidence intervals, odds ratio and hazard ratios were calculated were appropriate. Results: A total of 418 outborn infants were admitted during study period; 15 infants were excluded due to critical congenital defects. Out of 403 outborn infants, 217 born prematurely (53.8%), 224 males (55.6%), 20 died (4.96%). Compared to the survivors, the non-survivor neonates had significantly lower GA, BW, and SNS score (p<0.05), although only SNS score remained significantly lower in all subgroups (preterm vs term infants). A SNS score ≤8 was associated with mortality both in the whole study group and in subgroups (p<0.001). Time to admission was significantly associated with increased mortality rate in the whole group (p<0.05) and in preterm infants but not in term ones (p>0.05). In univariable and multivariable Cox regression models, MSNS-AT score, with a cut-off optimal value of ≤10 was more precise in predicting mortality compared to SNS (AUC 0.735 vs. 0.775) when applied to the entire group, had a lower accuracy in the term infants (AUC 0.765 vs 0.809) and a better accuracy the preterm infants group (AUC 0.885 vs. 0.810). Conclusions: The MSNS-AT score – calculated by adding GA, BW, and AT to the SNS score - significantly improved mortality prediction at admission in the whole study group as compared to SNS score. The best accuracy prediction of MSNS-AT score was observed in preterm infants suggesting that, besides GA and BW, TA may be decisive for the outcome of outborn preterm infants. Further studies are necessary to confirm the predictive value of MSNS-AT score and to identify variables that can improve its value in term infants without affecting the simplicity, ease, and rapidity of the scoring system.

Preprint REVIEW | doi:10.20944/preprints202309.2108.v1

Bone Disorders in Pediatric Chronic Kidney Disease: A Literature Review

Lavinia Capossela, Serena Ferretti, Silvia D'Alonzo, Lorenzo Di Sarno, Valeria Pansini, Antonietta Curatola, Antonio Chiaretti, Antonio Gatto

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: bone; disease; renal; children; osteodystrophy

Online: 14 October 2023 (18:40:46 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202310.0741.v1

Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors. A Retrospective Analysis

Janusz Płomiński, Jolanta Olesińska, Anna Malwina Kamelska-Sadowska, Jacek J. Nowakowski, Katarzyna Anna Zaborowska-Sapeta

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: torticollis; sternocleidomastoid muscle; children; perinatal risk factors

Online: 11 October 2023 (13:19:06 CEST)

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Introduction. Congenital muscular torticollis (CMT) is an asymmetrical head positioning resulting from structural changes in the sternocleidomastoid muscle (SCM) that occurs early in a child’s development period or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. When the clinical picture is typical, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. Early diagnosis of CMT in newborns and implementation of treatment offer the chance of a complete cure. Torticollis treatment aims to rebuild the SCM's normal function by restoring its anatomical length, normal cervical spine mobility and muscle flexibility to enable regular head movements. Surgical treatment is performed when conservative methods fail to improve the patient’s condition. Indications for surgery include marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by > 15°. After hip dislocations and foot deformities, pediatric orthopedics addresses torticollis as the third most common congenital anomaly. Aim. This study was a retrospective analysis of 111 children diagnosed and treated due to CMT. Methods. The following were determined: the relationship between the side of CMT location and the type of delivery (cc vs. natural), between the body weight at birth and the side of CMT location, between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. Results and conclusions. The analysis showed that CMT was more common in boys 61(54%) than in girls 51(46%), which may be related to the greater birth weight in boys. Of the pediatric patients with CMT, 76% were primiparous. More often, children born via natural delivery had left-sided torticollis with a more significant broadening of the SCM on ultrasound scans than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened, systematized, and further researched.

Preprint ARTICLE | doi:10.20944/preprints202310.0643.v1

The Role of Erythropoietin in the Prevention of Anemia in the Premature Newborn

Oana Cristina Costescu, Eugen Radu Boia, Marioara Boia, Daniela Mariana Cioboata, Florina Marinela Doandes, Nicoleta Lungu, Mihai Dinu, Emil Radu Iacob, Aniko Maria Manea

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: rhEPO; anemia of prematurity; erythrocyte transfusions

Online: 11 October 2023 (04:41:38 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202310.0565.v1

High Copy Number from Pharyngeal Swab Is Not Associated with Different Presenting Features in 100 Children with Acute Adenovirus Infection from a Cluster in Italy

Anthea Mariani, Federica Cavallo, Saverio La Bella, Giusi Graziano, Martina Passarelli, Carlo Crescenzi, Daniela Trotta, Maurizio Aricò

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: adenovirus; C-reactive protein; copy number

Online: 10 October 2023 (05:07:12 CEST)

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Adenoviruses are associated with respiratory tract, gastrointestinal or, less frequently, other involvement. Epidemics of adenovirus infections occur globally, in communities and in closed or crowded settings. In our institution, an outbreak of Adenovirus infection in infants and children was recently observed. Two main patterns of clinical presentation were observed: 68 patients had mainly respiratory symptoms (pharyngitis n=67, cough n=44; tonsillar exudate n=17; other respiratory signs n=4) while 26 patients showed prevalent gastrointestinal involvement (diarrhea n=26, vomiting n=8). Patients with respiratory symptoms had a significantly higher count of WBC, PMN and platelets, while CRP level approached statistical significance (p=0.07) for higher values in the patients with diarrhea. In order to explore the impact of selected presenting features, possible association between level of CRP and presence of pharyngeal exudate, cough, vomiting, diarrhea, duration of fever, number of neutrophils, and administration of antibiotics was analyzed. Patients falling in the tertile with more elevated CRP values had significantly more often tonsillar exudate and diarrhea, while those in the lower tertile had a 4.4 days duration of fever, vs. ≥5.0 days in the remaining patients. Antibiotic therapy was administered more frequently to patients with higher values of CRP (p=0.006). Duration of hospitalization was not associated with the CRP level. The median time from the receipt of positive adenovirus PCR test result to patient discharge was 1 day in 73% of cases. The number of copies of adenovirus detected by PCR ranged between 47 million and 15/L. Falling in the highest terzile of copy number was significantly associated with pharyngitis. The 24 patients with evidence of viral coinfection had no difference in the demographics or presenting features, with the only exception of a significantly higher leukocyte count. Rapid turn-around of results of molecular testing of adenovirus genome on pharyngeal swab allowed us to rapidly diagnose adenovirus infection, allowing stopping antibiotic therapy and immediate discharge, with reduced discomfort for the families and more appropriate use of hospital beds. A high copy number of adenovirus from pharyngeal swab should not be taken as an indicator of worse prognosis, thus allowing preferential use of qualitative rather than quantitaive assay.

Preprint ARTICLE | doi:10.20944/preprints202308.1002.v2

High Sensitivity for Detection of Primary Diagnostic Variants in Autism Spectrum Disorder, Including De Novo Variants, with Trio Whole Genome Sequencing and Data Reanalysis

Omri Bar, Elizabeth Vahey, Mark Mintz, Richard Eugene Frye, Richard Gregory Boles

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: autism; diagnostic yield; DNA sequencing; novel disorders

Online: 10 October 2023 (05:00:59 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202310.0007.v1

Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project

Elise Fabios, MIGUEL ANGEL MARTINEZ-GONZALEZ, Lorena García-Blanco, Víctor de la O, Susana Santiago, Itziar Zazpe, Nerea Martin-Calvo

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Carbohydrate quality index; CQI; Micronutrient Inadequacy; SENDO cohort

Online: 1 October 2023 (07:25:58 CEST)

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Preprint REVIEW | doi:10.20944/preprints202309.1807.v1

Pediatric Ocular Health and Obstructive Sleep Apnea Syndrome: A Review

Marco Zaffanello, Erika Bonacci, Giorgio Piacentini, Luana Nosetti, Emilio Pedrotti

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: children; choroid; cornea; Obstructive Sleep Apnea Syndrome; ocular health; ophtalmology; retina; sleep-disordered breathing

Online: 27 September 2023 (02:25:08 CEST)

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Introduction: Obstructive Sleep Apnea (OSA) is a respiratory condition identified by the partial or complete obstruction of the upper air passages during sleep. These episodes can lead to complications in neurobehavioral and cognitive domains and cardiovascular issues, especially in children. The involvement of OSA in ocular health during adulthood has been reported, but it remains a topic of debate in pediatric cases. Objective: This review aims to analyze the correlation between OSAS and ocular health in children. Specifically, it investigates the effects of OSA on ocular structures and conditions and explores potential improvements through treatment. Subjects and Methods: The research employed three search engines: PUBMED/MEDLINE, SCOPUS, and WebOfScience. After initial identification, 120 irrelevant articles were excluded. Of these, 10 pertained to the adult population, and 110 focused on the pediatric population. Following a careful selection process and the application of enrollment criteria, six relevant articles were included, all in English, focusing on the effects of OSA on children's eyes. Among these, three studies explored correlations with choroidal alterations, while three investigated retinal and optic nerve changes. Two studies analyzed post-otorhinolaryngological intervention ocular changes. Results: OSA leads to increased intraocular pressure and reduced optic nerve thickness in adults, but treatment alleviates this condition. An immediate correlation between OSA and optic nerve thickness in children does not readily emerge, although age appears to play a role. Pediatric patients with OSA exhibit corneal anomalies and an increase in optic nerve thickness, possibly due to intermittent hypoxia. Studies indicate that OSA can influence retinal vascular density in children, with an increase observed after treatment and reduced choroidal thickness in cases of adenotonsillar hypertrophy. Conclusion: This literature review has highlighted how OSA in children can significantly impact ocular health, with observed alterations in the optic nerve, choroid, retina, and cornea. While the direct correlation with the optic nerve may not always be evident, OSA can elevate intraocular pressure and lead to structural changes. However, treatment appears to bring about improvements. The necessity for regular monitoring to detect potential adverse effects underscores the importance of promptly addressing childhood OSA.

Preprint ARTICLE | doi:10.20944/preprints202309.1240.v1

The Importance of Prenatal WES Testing in the Romanian Population

Delia Ileana Sabau, Viorica Elena Rădoi, Ovidiu Virgil Maioru, Laurentiu Camil Bohîlțea, Viorel Aurel Suciu-Lazar, Iuliana Ceausu

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: prenatal; WES; sequencing; exome; fetal; malformations

Online: 19 September 2023 (15:20:11 CEST)

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Preprint REVIEW | doi:10.20944/preprints202309.1260.v1

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Myth or Reality? The State of the Art on a Controversial Disease

Saverio La Bella, Giovanna Scorrano, Marta Rinaldi, Armando Di Ludovico, Francesca Mainieri, Marina Attanasi, Alberto Spalice, Francesco Chiarelli, Luciana Breda

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: PANDAS; Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections; PANDAS syndrome; neuropsychiatric disorder; streptococci; molecular mimicry; CaM kinase; striatal cholinergic interneurons; obsessive-compulsive disorder; streptococcal infection; tic; tics

Online: 19 September 2023 (07:09:19 CEST)

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Medicine and Pharmacology