Current Pediatric Reviews - Volume 18, Issue 3, 2022

Background: Genitourinary tract tumors in children are less common than in adults. Most of these tumors have different genetic backgrounds, clinical presentation, and oncologic behavior than their adult counterpart. As a result of low prevalence in children, some of the treatment approaches and recommendations are based on treatment experience in adult patients. However, thanks to scientific and technological development, survival rates have risen considerably. Objective: This paper presents a review of the principal features of the tumors involving the genitourinary tract in children and an update in genetic background, diagnosis, and treatment. Methods: A narrative review was performed on published literature about genitourinary tract tumors in pediatric patients. Papers presented in English and Spanish literature were reviewed. PubMed, Science Direct, and SciELO databases were used to collect information and present this article. Results: Kidney tumors are the most common type of genitourinary tumors in children. Among those, Wilms tumor represents the majority of cases and shows the successful work of clinical trial groups studying this tumor type. Other tumors involving the genitourinary tract in children include Rhabdomyosarcoma, Transitional cell carcinoma, Testicular, and Adrenal tumors. Conclusion: Genitourinary tract tumors in children represent significant morbidity and economic burden, so awareness in early diagnosis represents improvement in treatment, clinical, and oncological outcomes.

The Godoy Method of cervical lymphatic therapy is the first treatment option as monotherapy for children which facilitates achieving normalization or near normalization of the affected limb as well as the maintenance of the results, which could assist millions of children throughout the world.

Epidermolysis bullosa (EB) is a group of rare congenital genetic conditions that result in painful blistering of the skin and mucous membranes, which occur with minor trauma or friction. There are many types and subtypes of EB that need to be distinguished, as the management and prognosis of each can vary significantly. We aim to perform an up-to-date literature review on congenital EB for healthcare providers in pediatrics. We performed a review of existing literature in the English language on EB via PubMed Clinical Queries, using key words such as “epidermolysis bullosa”, “congenital” and “children”. We reviewed EB based on the following subheadings: epidemiology, diagnosis, therapy, prognosis, and clinical prediction guidelines. EB is due to mutation in a number of genes, some types are autosomal dominant while others are autosomal recessive. The underlying mechanism is a defect in attachment between or within the epidermis and dermis of the skin. There are four main types: epidermolysis bullosa simplex, dystrophic epidermolysis bullosa, junctional epidermolysis bullosa, and Kindler syndrome. The diagnosis is suspected based on symptoms and confirmed by skin biopsy and definitive genetic testing. The severity of EB can range from mild to fatal. Severe complications may arise in some EB types and subtypes within the eye, ear, nose, upper airway, gastrointestinal and genitourinary tracts. There is no cure for the condition to date. Optimal management must be multidisciplinary, and involves wound care, pain control, controlling infections, nutritional support, and prevention and treatment of complications. EB presents in different forms. Treatment is supportive. The prognosis of milder forms is good. Children severely affected with EB and their families live a misery life with impaired quality of life. Health care workers must be aware of the suffering in these families and proactively support them.

Allergic skin diseases are highly prevalent among children. Patients with allergic skin diseases experience sociopsychological and quality-of-life (QoL) burdens in excess of those in the general population. Children and their caregivers are especially vulnerable to the burden of many of the common allergic skin diseases. In the past few decades, researchers have developed a number of disease-specific scores and indices for the measurement of QoL for childhood skin diseases. Most of the research in this area has focused on atopic eczema and urticaria and less so on allergic contact dermatitis. We provide an overview of QoL and its assessment for these dermatologic conditions.

The etiopathogenesis of necrotizing enterocolitis (NEC) remains unclear, but increasing information suggests that the risk and severity of NEC may be influenced by single nucleotide polymorphisms in many genes. In this article, we have reviewed gene variations that have either been specifically identified in NEC or have been noted in other inflammatory bowel disorders with similar histopathological abnormalities. We present evidence from our own peer-reviewed laboratory studies and data from an extensive literature search in the databases PubMed, EMBASE, and Scopus. To avoid bias in the identification of existing studies, search keywords were short-listed both from our own studies and from PubMed’s Medical Subject Heading (MeSH) thesaurus.

Necrotizing enterocolitis (NEC) is an inflammatory bowel necrosis seen in premature infants. Although the etiopathogenesis of NEC is unclear, genetic factors may alter a patient's susceptibility, clinical course, and outcomes. This review draws from existing studies focused on individual genes and others based on microarray-based high-throughput discovery techniques. We have included evidence from our own studies and from an extensive literature search in the databases PubMed, EMBASE, and Scopus. To avoid bias in the identification of studies, keywords were short-listed a priori from anecdotal experience and PubMed’s Medical Subject Heading (MeSH) thesaurus.

Background: A safe and effective vaccine represents the best way to control the COVID-19 pandemic, which has caused more than 4 million deaths to date. Several vaccines have now been approved worldwide, depending on the country. Being administered to healthy people, anti-SARS-CoV-2 vaccines must meet high safety standards, and this is even more important among the pediatric population in which the risk of developing severe disease is significantly lower than adults. However, vaccination of the pediatric population could help in reducing viral spread in the whole population. Objective: Our narrative review analyzes and discusses the currently available literature on the advantages and disadvantages of COVID-19 vaccination in the pediatric population. Methods: A bibliographic research was conducted through Pubmed, Read, and Scopus using COVID-19, SARS-CoV-2, immunization, antibody, COVID-19 vaccine efficacy, COVID-19 vaccine safety, children, adolescents, MIS-C, adverse effects as keywords. Results: Although children are less susceptible to COVID-19 infection, they can develop serious consequences, including multi-inflammatory syndrome. However, any vaccine-related side effects should be evaluated before administering vaccination to children while ensuring complete safety. To date, adverse effects are reported in adolescents and young adults following vaccination; however, these are mostly isolated reports. Conclusion: Further investigation is needed to establish whether there is indeed a cause-and-effect relationship in the development of vaccine-related adverse effects. However, to date, COVID-19 vaccination is recommended for children and adolescents older than 12 years of age. However, this question is still under debate and involves ethical, political, and social issues.

Background: Maintaining iodine at sufficient levels is necessary throughout the pregnancy to prevent adverse outcomes in infants. This study aimed to assess iodofolic supplementation's impact on thyroid function in women at the end of the third trimesters of gestation. Methods: This case-control study was conducted on 130 pregnant women in the Birjand, east of Iran, during the period from August 2017 to February 2019. We assessed iodofolic supplementation effect in the women at the first trimesters of gestation and followed them at the end of the third trimesters and also their infants on days 3-5. Serum samples were obtained from women and infants for measuring levels of thyroid-stimulating hormone (TSH). Urinary iodine concentration (UIC) was also determined at the end of the third trimester. Results: The median serum TSH concentration in the folic acid consumed group (3.26 ± 1.91) did not significantly differ from another group (2.98 ± 1.41), (p = 0.68). There is also no considerable difference in the mean serum TSH concentration between infants born from mothers who consumed folic acid in the first trimester of pregnancy and another group (p = 0.50). The TSH concentration in all infants was below 5 μM/L. The significant difference in the mean of UIC was also not observed between pregnant women in the folic acid consumed group (188.02 ± 105.38) and iodofolic consumed group (225.77 ± 130.26), (p = 0.13). Conclusion: Iodine intake in our study was sufficient according to the WHO recommendation and idofolic supplementation was not emphasized.