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Cystic fibrosis is a polymorphic disease characterized by severe genetic dysfunctions. Besides the complex genetic background, most patients with cystic fibrosis also have increased susceptibility to infections and and their nutritional status is affected. Chronic pulmonary infection and gastrointestinal or nutritional abnormalities are characteristics of this disorder. Of our selected 56 subjects, 21.28% presented a pulmonary condition, and 28.57% digestive deregulation. We also observed that the infectious status in cystic fibrosis was dominated by respiratory infections (71.42%), and the main pathogens were Streptococcus. pneumoniae, Haemophilus. influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Burkholderia cepacia, Staphylococcus aureus and Aspergillus. Additionally, it seems that while pulmonary function is strongly linked with adequate nutrition and weight gain, monitoring weight and pulmonary function are fundamental aspects in understanding the mechanisms of cystic fibrosis, and a very important parameter for a better management of this disorder. Early identification of nutrition and infectious risk factors is necessary for the effective and timely interventions that can have a positive impact on disease outcome. Infectious and nutritional aspects and interactions between the two are described. It is expected that management of cystic fibrosis will significantly improve.

Cholestasis is a multifactorial disorder with various biological, infectious, toxic, genetic and metabolic manifestations, its principal feature presented as reduced bile flow or abnormalities in bile formation. It has lately been accepted that some specific biological markers would shorten the period needed to establish a positive diagnosis, as currently it is necessary to navigate through a complex diagnostic protocol for this disorder. The purpose of this study was to establish some biological parameters and biomarkers useful for cholestasis management in children. Two hundred thirty-two children with cholestasis were selected, during a six-year study. The biological indicators followed were serum bilirubin, gamma-glutamyl transpeptidase, aspartate transaminase, alkaline phosphatase, lactate dehydrogenase, serum cholesterol and triglycerides. Our data showed that certain biological parameters are more often involved in the various forms of cholestasis, and the conclusions of this study could be useful in the early detection of cholestasis and appropriate disease management.

Cystic fibrosis (CF) is the most frequent autosomal recessive genetic disease in Caucasians. Although epidemiological studies continue to provide data and information that could lead to a better understanding of the clinical manifestations of the disease, there are still many controversies regarding the importance of some risk factors, such as pain, depression or anxiety in the pathogenesis of this disorder and its management. In the present study, we focused on the relevance of these 3 factors in the management of CF and to their related mechanisms in this disorder. Our original data showed that pain, depression and anxiety, determined by using a specific quality of life (KINDL) questionnaire, are important in understanding this disorder, the effectiveness of treatment and could also represent important factors for improving treatment. The screening and treatment of these specific manifestations in CF patients is recommended and holds promise for improving the outcome of patients with CF.

Background: Despite worldwide vaccination efforts, Hepatitis B virus (HBV) infection remains a significant global health burden, particularly in regions where vertical transmission is prevalent. Given Romania's history as an endemic area for hepatitis B from the 1990s until the early 2000s and the previously high infection rates among children, it is crucial to continually evaluate HBV infection in this population to monitor current trends, assess the long-term impact of vaccination programs, and address any remaining gaps in prevention and treatment efforts. This study aims to identify childhood risk factors associated with HBV acquisition, examining the role of maternal HBV status in child HBV infection, focusing on vertical transmission among a cohort of 654 children, with maternal infection as the independent variable and child infection as the dependent variable. Methods: We assessed potential risk factors and vaccination coverage among these children. The cohort included 148 children who tested positive for chronic hepatitis B from those 654 tested for HBsAg. Anamnestic data and vaccination history were analyzed, with particular attention to birth type and surgical interventions. Results: Of the 148 HBV-positive children, 80.4% were delivered naturally. Among these, 130 had received hepatitis B vaccination, and 5 were also given hepatitis B immunoglobulin at birth, 4 of whom were born via cesarean section. In the control group, comprising 418 vaccinated children, a lesser proportion were unvaccinated (2.2%). Documented surgical interventions included general and dental surgeries, as well as a single blood transfusion. Conclusions: The study emphasizes the need for comprehensive vaccination strategies and illuminates potential correlations between birth type and vaccination status with childhood HBV infection. Crucially, it highlights the necessity of diligent monitoring and treatment of pregnant women with HBV to prevent vertical transmission as effectively as possible. [ABSTRACT FROM AUTHOR]

Background: Liver cirrhosis presents significant challenges in the pediatric population due to a complex interplay of etiological factors, clinical manifestations, and limited therapeutic options. The leading contributors to cirrhosis among pediatric patients are chronic cholestasis, metabolic disorders present from birth, and long-term hepatitis. Materials and method: Our narrative review aimed to synthesize literature data on the etiology, clinical picture, diagnostic techniques, optimal management of complications, and timely transplantation. Results: The epidemiology of liver cirrhosis in pediatric patients is evolving. The introduction of a universal vaccination and effective long-term viral suppression in viral hepatitis have significantly decreased complications rates. Liver transplantation programs worldwide have also improved the management of cirrhosis complications. Conclusions: Early diagnosis, comprehensive management strategies, and advancements in treatment modalities are critical for improving outcomes. Understanding these differences is crucial in providing age-appropriate care and support for those affected by cirrhosis. [ABSTRACT FROM AUTHOR]

Chronic Hepatitis B virus (HBV) infection in children remains a significant public health challenge. The natural history and treatment outcomes of HBV can vary widely, influencing management strategies. This retrospective study was conducted in Northeast Romania and involved a cohort of 148 pediatric patients diagnosed with chronic viral Hepatitis B. Of these, 59 children underwent antiviral treatment while 89 were not treated. One of the main objectives was the rate of HBeAg (Hepatitis B-e antigen) seroconversion, a marker of disease progression and response to therapy. Among the treated group, 26 children (44%) achieved HBeAg seroconversion following therapy. In contrast, 44 of the untreated children (49%) experienced spontaneous HBeAg seroconversion, indicating a substantial rate of natural resolution within this population subset. The findings highlight a significant proportion of spontaneous seroconversion in untreated pediatric patients, suggesting a potential re-evaluation of treatment criteria and timing for children with chronic HBV infection. The comparable rates of seroconversion between treated and untreated cohorts underscore the need for individualized treatment approaches based on a combination of virological, biochemical, and clinical parameters. Further studies are required to refine management strategies to optimize long-term outcomes in pediatric HBV infections. [ABSTRACT FROM AUTHOR]

This article from the Romanian Journal of Oral Rehabilitation focuses on the oral manifestations of anorexia in adolescent patients. It highlights the specific challenges faced by this population in terms of oral health and emphasizes the importance of early intervention and tailored dental care strategies. The article discusses various oral health complications that can arise from anorexia, such as enamel acid solubility and periodontitis, and emphasizes the need for regular dental check-ups and proper nutrition. It also mentions the impact of the COVID-19 pandemic on eating disorders among teenagers and the importance of primary care providers in evaluating and treating these disorders. [Extracted from the article]

This article from the Romanian Journal of Oral Rehabilitation provides an overview of the principles of managing facial burns based on the authors' personal experience and existing literature. The study included 342 patients treated in a burn unit in Romania between December 2020 and October 2023. The majority of burns were caused by flame, scald, contact, electrocution, or ultraviolet exposure. The management of facial burns requires a multidisciplinary approach and early intervention to prevent complications and ensure good functional and aesthetic outcomes. The article discusses different treatment approaches, including conservative methods and surgical interventions, as well as the use of various dressings and topical agents. The importance of personalized treatment plans and the consideration of factors such as burn location and potential complications is emphasized. The article also highlights the potential advancements in burn care, particularly in the development of skin substitutes using nanotechnology. Overall, the article underscores the severity of facial burns and the importance of comprehensive management. [Extracted from the article]

Among the systemic impairment in cystic fibrosis there is also hepatobiliary tract involvement, with some genetic determinants of the disease manifesting as cystic fibrosis-associated liver disease (CFLD). The pathogenesis, natural history and cyrrhogenic evolution of CFLD are discussed in relation to the multiple phenotypes of cystic fibrosis. The CFLD therapy is nonspecific, the disease progression to cirrhosis is unpredictable, and the CFTR modulators offer a still underinvestigated therapeutic alternative. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Transaminases correspond to a vast territory in the body (heart, liver, kidney, brain, muscle) and are defined as enzymes involved in amino acid metabolism, having the ability to catalyze a particular type of reaction. In medical practice, the most commonly determined are transaminases glutamyl oxalacetic (TGO) and glutamylopyruvic transaminase (TGP). An increase in their serum concentration is premature, occurs in the context of hepatocyte necrosis and their values become positive before other tests reflecting the liver function. [ABSTRACT FROM AUTHOR]

Background & Aim. Despite significant progress regarding the management of chronic HBV infection in the last decade, this global health problem still remains one of the leading causes of morbidity and mortality in both children and adults also. Among pediatric population the main route of infection is the vertical transmission which underpins the need for HVB vaccination in new-borns from infected mothers. Although there are many studies that have investigated the risk factors for HBV infection in infants, data from our country is very scarce and an urgent update on epidemiology is needed. Thus, we aimed to assess the prevalence and risk factors of HBV infection among pediatric population in a tertiary centre from North-Eastern Romania. Material and Methods. The study included consecutive patients which were diagnosed with HBV infection in the "Sf. Maria" Clinical Emergency Children's Hospital, Iasi, Romania and were investigated between January 1st 2011 - December 31st 2019. A cohort of 100 randomly selected healthy controls were matched 1:1 based on same age and sex. Results. We retrospectively analysed 97 pediatric patients, of which 49 (50.5%) were boys and 48 (49.5%) were girls, with a mean age at diagnosis of HBV of 6.2 ± 2.9 years. 42 patients (55%) were born from HBsAg positive mothers; 25% received hepatitis B immunoglobulin at birth, and 38 received complete vaccination afterwards. Of the 55 children born of HBV-negative mothers, only 21 (38%) received three doses of HBV vaccine as infants. Overall, spontaneous HBe seroconversion was documented in 12 (12.3%) patients and posttreatment seroconversion in 7 (7%) patients. Among the control subjects, the rate of complete vaccination against HBV infection was 89%. At univariate analysis, a family history of HBV infection, surgical procedures, lack of complete vaccination were significant risk factors for HBV infection (p<0.001 each). The multivariable logistic regression analysis that having an HBV-infected mother and a history of blood transfusion are significant risk factors associated with HBV infection. Conclusions. Prevention of vertical transmission of HBV infection is possible, but it is necessary to have a specific management of each individual case. The risk factors associated with HBV infection need to be acknowledged and managed by clinicians on a caseby-case manner in order to lower the morbidity and mortality associated with HBV infection. Awareness regarding the need of HBV vaccination is urgent and should be raised at the national level. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hepatitis C in children is a worldwide public health problem, with growing costs and necessity of extensive health programs. HCV genotypes condition severity and allows sequential infection with multiple viral strains, influence the response to Interferon therapy and prevents preparation of effective vaccines. The goal of treatment is to eradicate the viral infection by eliminating the virus, achieving a sustained virological response (RVS). Knowledge of the molecular structure of the hepatitis C virus proteins has allowed the new drugs, directacting antiviral agents (DAA), with a direct effect on the enzymes encoded by VHC, important in viral replication, but have not yet been approved at children. This article aims to present the main pathogenic mechanisms and current opinions on new therapeutic directions. [ABSTRACT FROM AUTHOR]

Immune responses in childhood are often unpredictable. The spectrum of pathogenic events is very wide, even with multiple organ implications. Immune cutaneous manifestations are expressed by acute or chronic urticaria, for which multiple mechanisms have been described with the intent to generate effective treatments. Association of autoimmune phenomena complexes this pathology, therefore the management should be more specific and personalized. [ABSTRACT FROM AUTHOR]

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In 2008 the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and European Society for Pediatric Infectious Diseases (ESPID) have developed a good practice guide for acute gastroenteritis in children in Europe. These recommendations have had a major impact in terms of management and treatment of acute gastroenteritis. Recently, these societies have published an update to the 2008 recommendations, which include arguments or controversies collected in the last 5 years. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children with cystic fibrosis have an increased susceptibility to infections and to have a poor nutritional status. Nutritional status and lung function are interrelated. The increased viscosity of the secretions of the respiratory tract determine stasis, creating a good environment for pathogen agents, especially the anaerobes. The authors performed a clinical study on a group of 51 children with cystic fibrosis which aims to identify pathogens and their association with clinical outcome during treatment under modulation of immune status. There were identified 22 different pathogens, nearly half of patients also presenting immune deficiencies. [ABSTRACT FROM AUTHOR]

Portal hypertension and hepatic cirrhosis are events that occur in the natural history of chronic liver disease. Due to its risks, hepatic cirrhosis represents the terminal evolution stage of the disease. The fast diagnose of the pathology is required. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducere. Boala fi catului gras non-alcoolic (NAFLD), cea mai frecventă cauză a bolii hepatice cronice la copii, cuprinde un spectru de afecţiuni variind de la steatoză simplă până la steatohepatită (NASH). Acidul ursodeoxicolic (UDCA) a fost utilizat la pacienţi adulţi cu NASH, demonstrându-şi efi cacitatea în doze crescute. Scop. De a evalua efectul tratamentului cu doze crescute de UDCA asupra parametrilor funcţiei hepatice la copii cu NASH. Metode. Lotul de studiu a fost constituit din 18 copii cu NASH cu vârste cuprinse între 2,5 şi 17 ani. NASH a fost operaţional defi nit ca fi catul difuz hiperechogenic la ecografi e cu valori persistent crescute (> 35 UI/l) ale alanin aminotransferazei (ALAT) sau aspartat aminotransferazei (AST), după excluderea cauzelor virale, drog sau alcool induse, colestatice sau genetice ale bolii hepatice. Pacienţii au fost trataţi cu acid ursodeoxicolic (20 mg/kg/zi), timp de şase luni. Rezultate. Tratamentul cu UDCA a determinat scăderea semnifi cativă a valorilor transaminazelor hepatice. Nivelurile ALT au variat între 68,5 (50-166) iniţial vs 47 (29-104) după şase luni, p < 0,001, AST între 43 (29-101) vs 34 (17-75), p < 0,001, şi GGT între 41,5 (11-150) vs. 22 (8-55). La sfârşitul tratamentului, niveluri ALT s-au normalizat la 4 dintre pacienţi. De asemenea, concentraţiile de colesterol au fost semnifi cativ reduse după tratament. Concluzii. Tratamentul cu doze crescute de acid ursodeoxicolic imbunătăţeşte parametrii funcţiei hepatice la copii cu NASH. [ABSTRACT FROM AUTHOR]

Introduction. Nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children, encompasses a range of disease from simple steatosis to steatohepatitis (NASH). Ursodeoxycholic acid (UDCA) has been used in adult pacients with NASH, demonstrating its efficacy in high doses. Purpose. The aim of our study was to assess the effect of high-dose ursodeoxycholic acid therapy on liver functions in children with NASH. Methods. We prospectively studied 18 children with NASH aged 2.5 to 17 years. NASH was operationally defi ned as diffusely hyperechogenic liver at ultrasonography with persistently elevated (> 35 UI/l) alanine aminotransferase (ALT) or aspartate aminotransferaze (AST) after exclusion of viral, alcohol-induced, druginduced, cholestatic and genetic causes of liver disease. Patients were treated with ursodeoxycolic acid (20 mg/ kg per day) for six month. Results. Treatment with UDCA signifi cantly decreased hepatic transaminases. ALT levels ranged from 68.5 (50-166) at baseline vs. 47 (29-104) after six month, p <0.001, AST from 43 (29-101) 34 (17-75), p < 0.001, and GGT between 41.5 (11-150) vs. 22 (8-55). At the end of treatment, ALT levels normalized in 4 patients. Moreover, cholesterol levels were signifi cantly reduced after treatment. Conclusions. Treatment with high-dose ursodeoxycholic acid improves liver function parameters in children with NASH. [ABSTRACT FROM AUTHOR]

Portal hypertension (PHT) is responsible for the more severe and even lethal complications of chronic liver disease and cirrhosis. Among structural and functional changes of the liver in portal hypertension, recent pathogenic approaches show an initial involvement of the hepatic vascular structures. Endothelial dysfunction results in impaired vascular tone, increased intrahepatic vascular resistance and development of hyperdinamic circulation. Nitric oxide, endothelin, endothelial-derived contracting factors are powerful vasoactive substances released from the endothelium in response to both humoral and mechanical stimuli that can profoundly affect both the function and structure of the underlying vascular smooth muscle. Pharmacotherapy for PHT is aimed at decreasing both intrahepatic vascular resistance (increase bioavailability of vasoactive substances) and reducing elevated splanchnic blood flow. [ABSTRACT FROM AUTHOR]

The article discusses a clinical case of late-onset Pompe disease in a 15-year and 6-month-old adolescent hospitalised in a Paediatric Gastroenterology department to investigate persistent liver cytolysis, without response to hepatoprotective therapy. After excluding viral, autoimmune, metabolic and toxic drug aetiologies, a storage disease was suspected and imposed biochemical and genetic tests which confirmed a type II glycogenosis (Pompe disease), both by α-glucosidase (GAA) deficiency, as well as by the identification of two gene mutations on 17q25.2-q25.3 chromosome. [ABSTRACT FROM AUTHOR]