Current Pediatric Reviews - Volume 18, Issue 2, 2022

Although Western medicine and ideas about atopic dermatitis (AD) have become popular in many Asian countries, local beliefs about the disease and its treatment often prevail. The multi- racial background of these countries as well as the influence of the diverse religions (such as Taoism and Ramadan) in these regions often lead to diverse belief systems about the causes of AD (such as the Chi concept, also known as the balance of yin and yang) and the types of treatment (e.g. herbal remedies, topical versus concoctions, and decoctions). In addition, many of the cultural practices are preserved among the Southeast Asian minorities residing in the United Kingdom and North America. Eastern treatments typically take a holistic approach to AD and emphasize the psychosomatic component of the disorder. This overview provides a summary of the difference between conventional, complementary, alternative, and integrative medicine in terms of epidemiology, aetiology, therapy, and prognosis in children with AD. There are a number of similarities in genetic and environmental factors in epidemiology and aetiology; however, differences exist in terms of the concept of management. Complementary and alternative medicine, traditional Chinese medicine, and integrative medicine usage are not only prevalent among the Asian population but are also becoming more popular and accepted in Western societies.

A novel viral respiratory disease caused by severe acute respiratory syndrome, coronavirus 2 (SARS-COV-2), is responsible for a pandemic situation in the world. Pregnant women are susceptible to this virus due to physiologic changes in the immunologic system. The risk of some adverse pregnancy outcomes, such as death, stillbirth, preeclampsia, and intrauterine fetal distress, may increase in infected pregnant women. Infected women should be isolated and investigated, and they should admit to a designated hospital with adequate facilities and multi-disciplinary expertise to manage them. Furthermore, the chances of adverse neonatal complications, such as small for gestational age, large for gestational age, shortness of breath, thrombocytopenia with abnormal liver function, rapid heart rate, vomiting, and pneumothorax, may increase in an affected neonate. This study reviews the problems and guidelines of covid-19 in pregnancy.

Background: COVID-19 pandemic caused by single-stranded RNA containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in early December 2019 from the Wuhan city of China and has been affected millions of people, including pregnant women worldwide. Research from all over the world has shown that the SARS-CoV-2 infection can be transmitted vertically from mother to fetus but is very rare. Neonatal infection with COVID-19 accounts for only a small proportion of the total population infected. Furthermore, very few studies have observed the impact of maternal SARS-CoV-2 infection on neonatal outcomes. Thus, the literature about neonatal transmission and outcomes in COVID-19 infected antenatal women is very scattered and limited. The present review briefs on the transmission of SARS-CoV-2 infection from mother to fetus and its impact on perinatal outcomes. Methodology: English language articles from various databases including PubMed, Scopus, EMBASE, Scholar, MedRxiv, and Web of Science and from the World Health Organization site were searched from the beginning of the COVID-19 pandemic up to June 2021. The search terms used were “SARS-CoV-2 and pregnancy outcome, “COVID-19 and neonatal outcome”, “Placental changes in COVID-19 infected pregnant women”, “Vertical transmission of COVID-19”. Conclusion: Maternal SARS-CoV-2 infection can be transmitted to the fetus, though uncommon, and can lead to adverse perinatal outcomes, including preterm births, intrauterine growth restriction, NICU admission, stillbirths. The data on transmission and the adverse neonatal outcome is sparse, and many more studies are needed to fully understand the mechanism by which maternal COVID-19 infection can affect fetuses and neonates.

Intellectual disability is the impairment of cognitive, linguistic, motor and social skills that occurs in the pediatric age and is also described by the term “mental retardation”. Intellectual disability occurs in 3-28 % of the general population due to a genetic cause, including chromosome aberrations. Among people with intellectual disabilities, the cause of the disability was identified as a single gene disorder in up to 12 %, multifactorial disorders in up to 4 %, and genetic disorders in up to 8.5 %. Children affected by a malformation syndrome associated with mental retardation or intellectual disability represent a care challenge for the pediatrician. A multidisciplinary team is essential to manage the patient, thereby controlling the complications of the syndrome and promoting the correct psychophysical development. This requires continuous follow-up of these children by the pediatrician, which is essential for both the clinical management of the syndrome and facilitating the social integration of these children.

Pediatric coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) have been recognized in multiple countries globally. In this review, we provide recent insights into SARS-CoV-2 infection in children from epidemiological, clinical, and laboratory perspectives, including reports on the disease course and therapy. We highlight key features of SARS-CoV-2 infection in children, the relationship between MIS-C and Kawasaki disease, and summarize treatment guidelines for COVID-19 in children from institutional protocols from Colombia, case reports, recommendations based on expert consensus, and official statements from organizations such as the World Health Organization (WHO), United States Center for Disease Control (CDC), Colombian Association of Infectious Diseases, and the Colombian Society of Pediatrics. Finally, we discuss gaps in research with suggestions for future research on the pathogenesis underlying pediatric COVID-19.

Objective: The macronutrients of human milk are considered essential nutritional sources in the first few months of a newborn’s life. The present study aimed to investigate the effect of delivery mode on the macronutrients of human milk. Methods: This retrospective cohort study was conducted on 102 women who gave birth by cesarean section or vaginal delivery between September 2019 and November 2019. The participants were requested to provide their milk samples on day 15 ± 1 after childbirth. Results: There were no significant differences between the two groups (cesarean and vaginal delivery) regarding the sociodemographic characteristics and intake of fat, carbohydrate, protein, and energy. The lactose level was significantly higher in women who gave birth by vaginal delivery (adjusted mean difference, 1.2 (95 % CI 0.02- 1.82)). For other macronutrients, there were no statistically significant differences between the two groups. Conclusion: The vaginal delivery might influence the mature milk lactose level.

Background: Children are one of the most important groups at risk of catching an influenza infection. The consequences of influenza in some children, especially children with chronic and underlying diseases, can be very severe and lead to hospitalization. Objective: The purpose of this research was to determine children with influenza and their clinical and laboratory findings in Qazvin Children’s Hospital between 2015 to 2020 years. Methods: In this descriptive cross-sectional study, epidemiological and clinical findings of children hospitalized due to confirmed influenza were considered. A total of 1468 children with a suspected diagnosis of influenza were included in this study. Then, based on the Real-time Polymerase Chain Reaction (PCR), a total of 229 were confirmed positive for influenza. Statistical analysis was done using software SPSS 23.0, Analysis Of Variance (ANOVA), and t-test (p≤0.05). Results: The results showed that most of the patients (53.7 %) were infected with influenza H1N1 type. Most comorbidities were observed with Central Nervous System (CNS) disease and febrile seizure (each one 3.10 %). The highest clinical feature was fever (83.4 %). Significant relationship was observed between the season (p=0.001), soreness in throat (p=0.001), febrile seizure (p=0.051), muscle and joint pain (p=0.059), rhinorrhea (p=0.006) and shiver (p=0.051), and occurrence of influenza. Also, 4 children had died from influenza during hospitalization. Conclusion: Children with influenza were examined in this study. Influenza has some side effects on children’s health. Due to the irreversible and dangerous effects of influenza, early diagnosis and appropriate treatment in children is important.

Background: Very low birth weight infants are at risk of developing periventricular white matter lesions. We previously reported high blood adenosine levels in premature infants and infants with low birth weight. We asked whether blood adenosine levels could be related to the vulnerability of the maturing white matter to develop lesions. The present study aims at finding a biomarker for the early detection of brain white matter lesions that can profoundly influence the neurodevelopmental outcome, whose pathophysiology is still unclear. Methods: Dried blood spots were prospectively collected for the newborn screening program and adenosine concentration measurements. Fifty-six newborns who tested four times for blood adenosine concentration (at days 3, 15, 30, and 40 post-birth) were included in the program. All infants underwent brain MRI at term equivalent age. Neurodevelopmental outcomes were studied with Griffiths Mental Development Scales (GMDS) at 12 ± 2 months corrected age. Results: Blood adenosine concentration increased over time from a median of 0.75 μM at Day 3 to 1.46 μM at Day 40. Adenosine blood concentration >1.58 μM at Day 15 was significantly associated with brain white matter lesions at MRI (OR (95 % CI) of 50.0 (3.6-688.3), p-value < 0.001). A moderate negative correlation between adenosine at 15 days of life and GMDS at 12 ± 2 months corrected age was found. Conclusion: These findings suggest a potential role for blood adenosine concentration as a biomarker of creberal white matter lesions in very low birth weight infants.