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Introduction: Since it is necessary to detect changes in lung function for the follow-up of the patients with respiratory and functional complications caused by COVID-19, in this study, we decided to examine the results of spirometry in children over 5 years old with Covid-19. Methods: In this cross-sectional study, 52 over-five-year-old children, hospitalized due to COVID-19 for at least six past months, were examined. The participants’ demographic information, respiratory symptoms, underlying diseases, severity of COVID-19 according to WHO, severity of lung involvement in CT scan, type of lung involvement, oxygen saturation at admission as well as FEV1, FVC, and FEV1/FVC were collected and analyzed, the results were analyzed using SPSS version 16 software and t-test and Chi-square tests. Results: Of all investigated patients،, 26 were boys (50%) and 38 (73.1%) were 5-12 years old. The minimum age of the children was 5 years and the maximum was 18 years. The mean age of children was 3.41±10 years. The FEV1/FVC ranged from 61% to 79% in five patients (9.6%) and from 80% to 100% in 47 patients (90.4%). The FEV1 was lower than 80% in 28 and higher than 80% in 24 patients. FEV1/FVC had no significant relationship with the participants’ age, gender, clinical manifestations, and disease severity in terms of pulmonary involvement, but it had a significant association with blood oxygen saturation level (P: 0.001). Conclusion: The changes in pulmonary function tests vary in different months following contamination with COVID-19. In the present study, 9% of the patients, who were examined in the sixth month after infection, had abnormal pulmonary function test results. Based on the findings, the pulmonary function test results had no significant relationship with the patients’ age, gender, and clinical symptoms, while it was significantly associated with their blood oxygen saturation intensity.

Evidence has shown that video game play is significantly associated with children's psychological well-being. However, the findings are mixed. To what extent that different levels of video game use are associated with different dimensions of psychosocial well-being is unclear among Chinese children. This study examined the association between video game time and children's internalizing and externalizing problems as well as their prosocial behavior, and investigated the mediating role of self-esteem in these relationships. We conducted school-based surveys in M district of Shanghai among 1237 pairs of child-parent, using convenience sampling strategy. We employed the Strength and Difficulties Questionnaire and the Rosenberg Self-Esteem Scale to measure the psychosocial well-being and self-esteem of children, respectively. Mediation model with bootstrapping was used to estimate the magnitude and the respective bias-corrected 95% confidence intervals of the indirect effects of video game use on three outcomes through self-esteem. 47.9%, 8.1% and 6.1% children spent less than one hour, 1–2 h, and more than two hours per day on video game use respectively. Compared to children without playing video game, those spending more time on video game showed more externalizing problems, poorer prosocial behavior, and lower self-esteem. The mediating role of self-esteem was discovered between the relationship of moderate- and high-levels of video game use and children's psychosocial well-being. This study underlined the importance of improving self-esteem of young video game players who suffered from psychosocial problems. More evidence-based studies are needed to provide empirical evidence for the introduction of more effective and targeted policies. Highlights: This study examined the association between video game use and children's psychosocial well-being and the mediating role of self-esteem in these relationships. Self-esteem mediated the relationship between the moderate and higher levels of video game use and psychosocial well-being. Moderate and high levels of video game use were associated with more external problems and worse prosocial behavior. High self-esteem was significantly associated with improved psychosocial well-being. This study underlined the importance of improving self-esteem of young video game players who suffered from psychosocial problems. [ABSTRACT FROM AUTHOR]

Abstract Background Matrix metalloproteinase-7 (MMP-7) is associated with biliary injury. This study aimed to evaluate the relationships of serum MMP-7 with clinical characteristics in choledochal cysts (CDC) children. Methods Between June 2020 and July 2022, we conducted a prospective study of CDCs who underwent one-stage definitive operation at our center. Serum MMP-7 was measured using an enzyme-linked immunosorbent assay. We evaluated the relationships between serum MMP-7 and age, laboratory tests, imaging examinations, liver fibrosis, MMP-7 expression, and perforation. Results A total of 328 CDCs were enrolled in the study, with a median serum MMP-7 of 7.67 ng/mL. Higher serum MMP-7 was correlated with younger age at diagnosis (p

Chenlu Wang,1,2 Lanxin Li,1,2 Gang Xiao,1– 3 Yuanyuan Chen,1,2 Yingshuo Wang,1,2 Zhimin Chen,1,2 Yunlian Zhou1,2 1Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Pediatrics, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of ChinaCorrespondence: Yunlian Zhou; Zhimin Chen, Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, No. 3333. Binsheng Road, Hangzhou, Zhejiang, People’s Republic of China, Email zhouyunlian@zju.edu.cn; zmchen@zju.edu.cnPurpose: To explore the clinical characteristics, treatment, and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children.Patients and Methods: The medical records of 16 children who were diagnosed with MPP associated with PE between January 2016 and January 2023 at Children’s Hospital, Zhejiang University School of Medicine were retrospectively reviewed.Results: The average age patients were 8.24 ± 1.99 years. All cases were diagnosed with refractory mycoplasma pneumoniae pneumonia (RMPP) and presented complications in the form of necrotizing pneumonia (NP). The main symptoms observed were cough and fever (n = 16, 100%), chest pain (n = 8, 50%), dyspnea (n = 8, 50%), and hemoptysis (n = 4, 25%). In these cases, 12 patients had involvement of the pulmonary artery, 3 patients experienced issues with the pulmonary vein, and 1 patient had simultaneous involvement of both the pulmonary artery and pulmonary vein. Among the 12 pulmonary artery embolism cases, 6 involved the right pulmonary artery, 4 involved the left pulmonary artery, and 2 involved both the right and left pulmonary arteries. The mean D-dimer level was 8.50 ± 4.76 mg/L. All patients received anticoagulant therapy, and after treatment, there was a significant improvement in their symptoms and lung lesions.Conclusion: Children with RMPP, chest pain, hemoptysis, and elevated D-dimer levels should be closely monitored for the potential development of PE. The co-occurrence of MPP and PE often involves the presence of NP. In cases of confirmed PE, anticoagulation therapy may be a suitable consideration. PE and NP resulting from MPP generally had a favorable overall prognosis.Keywords: mycoplasma pneumoniae, pulmonary embolism, necrotizing pneumonia, children

Background: Matrix metalloproteinase-7 (MMP-7) is associated with biliary injury. This study aimed to evaluate the relationships of serum MMP-7 with clinical characteristics in choledochal cysts (CDC) children. Methods: Between June 2020 and July 2022, we conducted a prospective study of CDCs who underwent one-stage definitive operation at our center. Serum MMP-7 was measured using an enzyme-linked immunosorbent assay. We evaluated the relationships between serum MMP-7 and age, laboratory tests, imaging examinations, liver fibrosis, MMP-7 expression, and perforation. Results: A total of 328 CDCs were enrolled in the study, with a median serum MMP-7 of 7.67 ng/mL. Higher serum MMP-7 was correlated with younger age at diagnosis (p < 0.001), larger cyst sizes (p < 0.001), higher liver fibrosis stages (p < 0.001), and higher incidence of perforation (p < 0.01). Liver MMP-7 was mainly expressed in intrahepatic and extrahepatic biliary epithelial cells. The area under the receiver operating characteristic curve (AUROC) was 0.630 (p < 0.001) for serum MMP-7 in predicting perforation. When serum MMP-7 was combined with γ-glutamyl transferase (GGT), the AUROC increased to 0.706 (p < 0.001). Conclusions: Serum MMP-7 was associated with biliary obstruction in CDCs. Patients with high serum MMP-7 were more likely to have severe liver damage and biliary injury, with higher incidences of liver fibrosis and perforation. [ABSTRACT FROM AUTHOR]

Background: Progressive respiratory muscle weakness and ineffective cough contribute to morbidity and mortality in children with neuromuscular disorders (NMD). Inspiratory muscle training (IMT) aims to preserve or improve respiratory muscle strength and reduce respiratory morbidity. This study aimed to determine the safety and efficacy of IMT in children with NMD. Methods/design: A randomised cross-over study compared a 3-month intervention (IMT) with control periods (no IMT). Children diagnosed with NMD (5 years – 18 years) performed 30 breaths (at 30% of maximum inspiratory mouth pressure [Pimax]) with an electronic threshold device, twice daily. During the control period, participants did not perform any IMT. Discussion: Twenty three children (median [interquartile range {IQR}] age of 12.33 [10.03–14.17] years), mostly male (n = 20) and non-ambulant (n = 14) participated. No adverse events related to IMT were reported. No difference in median patient hospitalisation and respiratory tract infection (RTI) rates between non-training and intervention periods (p = 0.60; p = 0.21) was found. During IMT, Pimax and peak cough flow improved with a mean ± standard deviation (s.d.) of 14.57 ± 15.67 cmH2O and 32.27 ± 36.60 L/min, compared to 3.04 ± 11.93 cmH2O (p = 0.01) and −16.59 ± 48.29 L/min (p = 0.0005) during the non-training period. Similar to other studies, spirometry did not show a significant change. Conclusion: A 3-month IMT programme in children with NMD appears safe and well-tolerated, with significant improvement in respiratory muscle strength and cough efficacy. Clinical implications: Inspiratory muscle training could be considered a cost-effective adjunct to respiratory management in children with NMD. Trial Registration: Pan African Clinical Trial Registry, PACTR201506001171421, https://pactr.samrc.ac.za.

Recent years have seen an increase in the prevalence of cardiac arrhythmias and conduction disorders in children, which are not always diagnosed in time. In order to verify the nature of arrhythmias in pediatrics as well as in therapy, an accessible and informative method of daily Holter ECG monitoring (DHECGM) is widely used. Aim of the study was to assess the practical value of DHECGM in the algorithm for diagnosing heart rhythm and conduction disorders in pediatric patients. Materials and Methods: Analysis of DHECGM was performed in 48 children who were hospitalized in the pediatric department of the Specialized Pediatric Care Center (SPCC) of the Poltava Regional Clinical Hospital (PRCH) in 2022-2023. Research results. Sinus tachyarrhythmia or bradyarrhythmia, wandering atrial pacemaker was detected in half of the patients studied. Supraventricular and/or ventricular extrasystoles were detected in 87.5 % of children. Bi-, tri- and quadrigeminy were observed in 14 (27.1 %) of the patients. First or second degree sinoatrial block was observed in 25 % of patients. Atrioventricular block of 1st or 2nd degree (Mobitz type) with Wenkenbach- Samoilov periods was observed in 8 patients (16.6 %). Combined rhythm and conduction disturbances were observed in 82.3 % of the children studied. The article is illustrated by clinical cases of cardiac rhythm and conduction disorders in children of diff erent ages. Conclusions: DHECGM has broad capabilities for diagnosing cardiac rhythm and conduction abnormalities, allowing early detection of arrhythmias in pediatric patients and providing personalized recommendations.

The eruption of permanent teeth in children is a complex physiological process that is important for the development of the dentoalveolar system. The timing of eruption is a key indicator of biological age and prenosological diagnosis of children’s health. The need to update research on this topic is due both to changes in society and the importance of modern data for pediatric dentistry and public health. The aim of the study was to determine the regional characteristics of the terms of eruption of permanent teeth in early mixed dentition among children of Odesa. Material and methods. Dental examination was performed on children aged 4 to 8 years of both sexes. The examination was performed according to the generally accepted methodology, using standard dental instruments included in the examination kit. The children were divided into groups according to age and sex. Patients were examined on the basis of age and period of teeth eruption. Results. The results of the study of the eruption of the permanent teeth of the upper and lower jaws in children aged 4.5-8.5 years in Odesa indicate an earlier eruption of the permanent teeth in girls. Thus, in girls the eruption of the first permanent molars began at the age of 4.5 years and ended at the age of 6 years. In boys, the age of onset of fi rst molar eruption was 5 years and the age of completion was 6.5 years. It was found that the timing of the beginning and the end of the eruption of the central permanent incisors of the upper jaw was the same in boys and girls (6 years), but the average duration of eruption was different. The timing of the beginning and end of eruption of the upper lateral incisors was identical in boys and girls. However, diff erences in the average terms of eruption of permanent upper lateral incisors were obtained. The analysis of the results of the terms of eruption of the central permanent incisors of the lower jaw in boys and girls shows the same terms of beginning of eruption and average terms of eruption of these teeth. However, there were diff erences in the time of the end of eruption. The beginning of the eruption of the permanent central incisors of the upper jaw was noted earlier (at the age of 6 years) than the data given in the modern dental manuals of Ukraine and was completed at the age of 8 years. The age of the beginning and the end of eruption was one year earlier than the generally accepted data. The data on the time of eruption of the fi rst permanent molars and incisors obtained as a result of the study are necessary for planning programs for prevention of dental caries in children in the period of early replacement dentition. The data obtained as a result of the study indicate the need for further epidemiological studies in other regions of Ukraine in order to establish the current national norms for the eruption of permanent teeth in children. Conclusion. The discrepancy between the dates of eruption of permanent incisors and molars in Odesa children and the standard dates of eruption of teeth was revealed, which indicates the need to clarify them in each region. Gender diff erences were found – earlier eruption of permanent teeth in girls. The data of the conducted research substantiate the necessity to revise the terms of caries prophylaxis in Odessa children and the necessity to conduct in-depth examination of children with violation of the terms of teeth eruption.

Background: In Iran, there is a lack of information and studies on acute rheumatic fever (ARF), a global health issue. The limited understanding of ARF's prevalence and primary clinical symptoms has led to confusion. This research investigates the characteristics of children aged 3-17 years who experience ARF with monoarthritis as their initial symptom. Methods: A retrospective evaluation of medical records of children diagnosed with ARF was conducted. The study aimed to determine the prevalence of monoarthritis as the first manifestation of ARF and its association with age, gender, family history, and cardiac involvement. Categorical variables were analyzed using the chi-square test with a significance level of < 0.05 and a confidence interval of 95%, using SPSS software (Version 23). Results: The study included 62 patients with ARF, comprising 41 (66.1%) boys with an average age of 8.48±3.27 years. Among these patients, 12 exhibited cardiac involvement according to the revised Jones criteria, with 5 clinical carditis and 7 cases of subclinical carditis. Monoarthritis was the initial symptom in seven patients (11.29%); five (71.4%) also had carditis. There was a significant association (p

Bogus&lstrok;awa Orzechowska-Wyl&eogon;ga&lstrok;a,1 Adam Wyl&eogon;ga&lstrok;a,2 Jolanta Zalejska Fiolka,3 Zenon Czuba,4 Michal Toborek5 1Department of Pediatric Otolaryngology, Head and Neck Surgery, Chair of Pediatric Surgery, Medical University of Silesia (SUM), Katowice, Poland; 2Health Promotion and Obesity Management, Department of Pathophysiology in Katowice, SUM, Katowice, Poland; 3Department of Biochemistry Faculty of Medical Science in Zabrze, SUM, Katowice, Poland; 4Department and Division of Microbiology and Immunology in Zabrze, SUM, Katowice, Poland; 5Department of Biochemistry and Molecular Biology, University of Miami, School of Medicine, Miami, FL, USACorrespondence: Bogus&lstrok;awa Orzechowska-Wyl&eogon;ga&lstrok;a, Email borzechowska-wylegala@sum.edu.plAim: Saliva contains various proteins that are important in developing inflammatory processes and their prevention. One key aspect of saliva research is the relationship between oral infections and inflammation, and the role of some salivary proteins.The Work Aims: To demonstrate which salivary cytokines can be biomarkers of acute odontogenic oral and facial infections in children.Material and Methods: The study included two groups of patients: a study group of 28 children: 7 girls and 21 boys aged 3 − 17 years with acute dentofacial inflammation (DI) and a control group of 52 children: 16 girls and 36 boys aged 4– 17 years with uncomplicated dental caries (CE). The levels of Interleukin-5 (IL-5), Interleukin − 10 (IL-10), Interleukin-17A (IL-17A), Interleukin-12p70 (IL-12p70), Eotaxin, Rantes, Vascular Endothelial Growth Factor (VEGF), and Interferon gamma-induced protein 10 (IP10) in the saliva of children in DI and CE groups were compared. Statistical analysis was performed with Statistica 13. The Student’s t-test and the Wilcoxon signed-rank test were used.Results: The results show that IL-10, IL-17A, and Eotaxin showed a statistically significant increase in the DI group compared to the CE group. The significance level for IL-10 was p=0.02, for IL-17A was equal to Eotaxin and p=0.04. The other measured parameters did not differ statistically significant between the two groups.Conclusion: IL-10, IL-17A, and Eotaxin can be used as potential biomarkers for tooth-related inflammatory states of the oral cavity and face in children. These biomarkers can be useful in identifying and monitoring the presence of inflammation in the oral cavity and face.Keywords: salivary cytokines and chemokines, odontogenic oral and facial inflammation, children

Xiaolu Li,1,&ast; Yizhong Wang,1,2,&ast; Rong Cao,1 Fangfei Xiao,1 Xufei Wang,1 Lin Ye,1 Yongmei Xiao,1 Dan Li,1 Ting Zhang1,2 1Department of Gastroenterology, Hepatology and Nutrition, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Gut Microbiota and Metabolic Research Center, Institute of Pediatric Infection, Immunity and Critical Care Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yizhong Wang; Ting Zhang, Department of Gastroenterology, Hepatology and Nutrition, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, 355 Luding Road, Shanghai, 200062, People’s Republic of China, Tel/Fax +86 2152976335, Email wangyz@shchildren.com.cn; zhangt@shchildren.com.cnBackground: Our previous study reported a high rate of recurrence in children with Clostridioides difficile (C. difficile) infection (CDI) after conventional antibiotic therapy. Here, we aimed to explore whether metronidazole and vancomycin resistant C. difficile isolates are circulating in pediatric CDI.Methods: Antimicrobial susceptibility testing (AST) using the agar dilution method according to the Clinical and Laboratory Standard Institute (CLSI) were performed on C. difficile isolates collected from children with CDI between 2019 and 2022 at the Shanghai Children’s Hospital. Whole-genome sequencing (WGS) was performed on all C. difficile isolates, and the presence of antibiotic resistance genes (ARGs) were identified using Resfinder and the Comprehensive Antibiotic Resistance Database (CARD). The presence of plasmid pCD-METRO was detected using SRST2 (v0.2.0) against 8 pCD-METRO coding sequences.Results: A total of 50 C. difficile isolates were collected from stools of CDI children. The overall resistance rate on all isolates was 30.00% for metronidazole, 6.00% for vancomycin, 0% for rifaximin, 2.00% for rifampin, 24.00% for meropenem, 100.00% for ceftriaxone and clindamycin, 86.00% for erythromycin, 30.0% for levofloxacin, and 50.0% for tetracycline. Multidrug-resistant (MDR) was presented in 44 isolates (88.00%). Sixteen reported potential ARGs relating with resistance to antibiotic classes of aminoglycoside (AAC(6’)-Ie-APH(2”)-Ia, aad(6), ANT(6)-Ib, APH(2”)-If, APH(3’)-IIIa), lincosamide-clindamycin-erythromycin (ErmB, ErmQ), fluoroquinolones (CdeA), glycopeptides (vanRG), nucleoside (SAT-4), tetracycline (tetM, tetA(P), tetB(P), tetO), and trimethoprim (dfrF) were identified. However, the pCD-METRO plasmid and vanA/B were not detected in any isolates.Conclusion: C. difficile isolates from children with reduced susceptibility to metronidazole and vancomycin are emerging in pediatric CDI in China. The lack of pCD-METRO plasmid and vanA/B associated with reduced antibiotic susceptibility suggests there are additional mechanisms of resistance.Keywords: Clostridioides difficile, antibiotic resistance, metronidazole, vancomycin, children

Ming Zhang,1,&ast; Feng Chen,2,&ast; Shaoguang Feng,3,&ast; Xu Liu,4 Zhen Wang,5 Nan Shen,6 Lingjian Meng,7 Dongsheng Zhu,1 Zhitao Zhu8 1Department of Pediatric Surgery, The First People’s Hospital of Lianyungang, Lianyungang, People’s Republic of China; 2Department of Pediatric, Luodian Hospital, Shanghai, People’s Republic of China; 3Department of Pediatric Surgery, The Children’s Hospital of Hangzhou, Hangzhou, People’s Republic of China; 4Department of Pediatric Surgery, The Children’s Hospital of Xuzhou, Xuzhou, People’s Republic of China; 5Department of Pediatric, the Maternal and Child Health Hospital of Zibo, Zibo, People’s Republic of China; 6Department of Pediatrics, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian, People’s Republic of China; 7Department of Pediatrics, Hospital Affiliated to Xuzhou Medical University, Xuzhou, People’s Republic of China; 8Department of Radiology, The Second People’s Hospital of Lianyungang, Lianyungang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhitao Zhu; Dongsheng Zhu, Email zhuzhitao621@126.com; zhudongsheng@tmu.edu.cnObjective: To investigate the role of FBLN5in renal clear cell carcinoma (KIRC), in particular on the tumor’s immune microenvironment, including children and young adults.Methods: FBLN5 expression in tumor and normal samples was explored using SangerBox, TIMER2.0, GEPIA, UALCAN, HPA databases. The Linkedomics database was used to obtain FBLN5 co-expressed genes in KIRC tissue. SangerBox was also used to estimate immune infiltration of FBLN5 in KIRC. The Kaplan-Meier plotter was used to investigate the survival effects of FBLN5 expression in the presence of immune infiltration. We then collected 48 cases from 7 hospitals over a-20 year period to calculate the impact of FBLN5 on the prognosis of children and young adults with KIRC.Results: FBLN5 expression was significantly reduced in KIRC tissue compared to normal adjacent tissue. FBLN5 was potentially involved in the immune-related biological processes. In addition, FBLN5 expression has been linked to a number of immune checkpoints, cytokines, chemokines and chemokine receptors in KIRC. At the same time, the expression of FBLN5 affected the survival rates differently in KIRC patients with high or low levels of immune infiltration. High expression of FBLN5 in children and young adults with KIRC was associated with a favorable prognosis.Conclusion: This study shed light on the potential of FBLN5 as a prognostic marker in children and young adults with KIRC and as an immune-related target for clinical treatment.Keywords: FBLN5, immune microenvironment, prognostic biomarker, kidney cancer, children

A clinical observation of a child with a severe combined defect of the reproductive system and reproductive system (cAKuT syndrome) is presented. cAKuT syndrome accounts for more than 20% of birth defects. congenital anomalies of the urinary system account for 40–50% of cases of end-stage renal disease in children and 7% in adults worldwide. early diagnosis and treatment of cAKuT syndrome in children is one of the most important tasks of pediatric nephrology at present. It is necessary to monitor the course of the disease and assess the rate of development of unfavorable outcomes of chronic kidney disease. clinical observation of cAKuT syndrome is to optimize the therapeutic tactics of the underlying disease and reduce the disability of the child population.

Irene Paraboschi,1 Michele Gnech,1 Dario Guido Minoli,1 Erika Adalgisa De Marco,1 Giovanni Parente,2 Guglielmo Mantica,3,4 Vincenzo Bagnara,5 Gianantonio Manzoni,1 Marc-David Leclair,6 Alfredo Berrettini1 1Department of Pediatric Urology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy; 2Department of Pediatric Surgery, ASST Papa Giovanni XXIII Hospital, Bergamo, 24127 Italy; 3IRCCS Ospedale Policlinico San Martino, Genoa, Italy; 4Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa, Genoa, Italy; 5Department of Pediatric Surgery, Policlinico G.B.Morgagni, Catania, Italy; 6Chirurgie Infantile, CHU de Nantes, Nantes, FranceCorrespondence: Guglielmo Mantica, Consultant Urologist, Dirigente Medico, IRCCS Ospedale Policlinico San Martino, Genova, Italy, Email guglielmo.mantica@gmail.comAbstract: The vascular supply of the pelvic structures and the external genitalia can be easily injured during the one-stage delayed bladder closure and radical soft-tissue mobilization (Kelly procedure) for bladder exstrophy surgical repair. Aiming to help surgeons assessing and confirming tissue perfusion and viability, indocyanine green (ICG)-based laser angiography was incorporated into the operative approach to reduce the risk of ischemic injuries. The EleVision IR system (Medtronic Ltd) was adopted to confirm the identification of the vascular pedicles and assess the tissue perfusion in real-time in a 5-month-old with bladder exstrophy undergoing the one-stage delayed bladder closure and radical soft-tissue mobilization (Kelly procedure). ICG (0.15 mg/kg) was intravenously administered at 6 key steps during surgery with the ability to be re-dosed every 15 minutes. ICG-based laser angiography helped to confirm the correct identification of the vascular structures during surgery and to assess tissue perfusion in real-time. Blood flow did not change considerably after initial dissection or upon approximating the pubis symphysis. At the end of the procedure, good penile perfusion was shown, proving that no direct injury or substantial compression of the pudendal vessels had occurred following the mobilization and the reconstructive phase. ICG-based laser angiography proved to be safe, effective, and easy to employ and should be considered as a reasonable adjunct for tissue perfusion assessment and operative decision-making in patients undergoing bladder exstrophy Kelly repair.Keywords: bladder exstrophy, radical soft-tissue mobilization, fluorescence-guided surgery, indocyanine green, children

Aim of the study Chronic kidney disease (CKD) is a complex pathology with an increased prevalence worldwide, described by a progressive and irreversible alteration of renal function. This study evaluates the correlation between the oral health status of children with chronic kidney disease and their general health. Material and methods A review of basic science and clinical studies was made, using PubMed, Web of Science and Google scholar databases. The search included key words like: chronic kidney disease, chronic renal failure, general health, oral health, children. Results The general health status of children with CKD is altered in different degrees of severity, according to the disease’s stage. Oral manifestations associated with these stages vary from salivary changes, mucosal lesions, gingivitis, enamel defects or even fluorosis. Conclusions Considering the important changes of oral health status in children suffering from chronic kidney disease, an interdisciplinary approach of these patients is necessary, with a tight collaboration between the paediatric dentist and paediatric nephrologist.

Introduction: Despite efforts for improvement of oral health in the world during recent years, dental caries remained one of the most common chronic diseases in the childhood. One of the most important factors that can play a significant role in the success of oral health promotion programs is the adherence and collaboration of non dental staff of pediatric health providers such as pediatricians. The present study aimed to evaluate pediatricians’ knowledge and practice regarding oral health and its related factors. Materials and Methods: In this cross-sectional descriptive-analytical study conducted in 2020, 90 pediatricians that were working in Tehran city participated. A newly designed valid and reliable questionnaire comprised of three sections of demographics (8 questions), knowledge (30 questions) and practice (8 questions) was provided to the participants. The knowledge questions consisted of five domains about primary teeth (8 questions), dental visits (3 questions), dental caries determinants (8 questions), eating habits (7 questions), and fluoride (4 questions). Data analysis was performed using SPSS software version 22. The significance level was considered to be less than 0.05 (p

Nowadays in the educational classrooms there are children who have some difficulty in their learning. Generally, these cases are overlooked because they are thought to be somewhat slow to understand. However, there are cases of dyslexia, dyscalculia or dysgraphia disorder within the classroom. These disorders cause some problems such as the physical act of being able to write, difficulty in reading, difficulty in making sense of mathematics. Therefore, propose the implementation of a Web site to help children suffering from these disorders to improve their learning. The purpose of the website is to help them through the recreational and didactic games presented. In addition, educational materials are available in PDF format for quick and easy printing. Also, you can find graphical reports on the student's continuous improvement. On the other hand, it is also proposed the implementation of a forum in which parents can resolve their doubts regarding these disorders. Thus, they can be connected on any device, whether tablet, laptop, computer, smartphone or other. Therefore, the research involves the implementation of a Web Application that will benefit the child in his school learning.

cystic fibrosis is a chronic, genetic, systemic disease, the pathogenesis of which is based on a defect in the apical transporter of chlorine ions, which leads to pathological thickening of mucus and its accumulation in the lumen of hollow organs, mainly bronchi, pancreas and others. Among genetic diseases, cystic fibrosis is quite common. In this regard, since 2007 in the territory of the russian Federation, all newborns are screened for cystic fibrosis. neonatal screening makes it possible to establish a diagnosis at an early stage, which significantly improves the further prognosis. However, not all patients manage to confirm the diagnosis from birth. This clinical case shows how late diagnosis of the disease leads to the development of severe complications and deterioration of the prognosis.

Whooping cough is a highly contagious respiratory disease. despite ongoing vaccination, the disease is endemic in developing and developed countries. newborns and children who are not vaccinated or partially immunized become most severely ill. The severity of symptoms depends on factors such as the patient's age, the strength of the immune response, and the degree of systemic bacterial dissemination. The most severe form of pertussis is malignant pertussis, which is characterized by large leukocytosis, refractory hypoxemia, pulmonary hypertension and cardiopulmonary impairment. This article is devoted to the clinical observation of a patient with a malignant course of whooping cough.