Development of the Orohypopharyngeal Cavity in Normal Infants and Young Children

Objective To study the growth of the oropharynx and hypopharynx in infants and young children by measuring the lengths of the segments between nasopharyngeal valve and tongue base, tongue base and arytenoids, and arytenoids and upper esophageal sphincter. These measurements will be used as references for developing manofluoroscopy to study deglutition in infants and young children. Patients and Methods Twenty-three children (14 boys, 9 girls) between birth and 4 years of age were prospectively studied. All children had near normal growth parameters and were free of medical illnesses or other major medical conditions that are known to influence the pharyngeal cavity. Lateral videofluoroscopy was used to assess the pharyngeal structures during breathing. All images were digitally recorded and analyzed using a computer program designed specifically for this study. Results and Conclusions Statistically significant correlations were found between the age or height of the patient and the distance from velopharyngeal valve to tongue base and the distance from tongue base to arytenoids, showing a linear increase of the length of the oro- and hypopharynx with age and patient height. There was no significant difference in the pharyngeal distances between boys and girls. On the basis of these results, a linear regression comparison could be established to define the length of each pharyngeal segment for any age until 4 years and for the 50th percentile of height.

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Growth, Protein and Energy Intake in Children with PKU Taking a Weaning Protein Substitute in the First Two Years of Life: A Case-Control Study

Nutrients ◽

10.3390/nu11030552 ◽

2019 ◽

Vol 11 (3) ◽

pp. 552 ◽

Cited By ~ 4

Author(s):

Sharon Evans ◽

Anne Daly ◽

Jo Wildgoose ◽

Barbara Cochrane ◽

Satnam Chahal ◽

...

Keyword(s):

Energy Intake ◽

Growth Parameters ◽

Growth Parameter ◽

Normal Growth ◽

Protein Substitute ◽

Protein Requirements ◽

Significant Difference ◽

Z Scores ◽

Semi Solid ◽

Control Study

Growth issues have been observed in young children with phenylketonuria (PKU), but studies are conflicting. In infancy, there is an increasing trend to introduce a second-stage semi-solid weaning protein substitute (WPS) but there is concern that this may not meet energy requirements. In this longitudinal, prospective study, 20 children with PKU transitioning to a WPS, and 20 non-PKU controls were observed monthly from weaning commencement (4–6 months) to 12 m and at 15, 18 and 24 months of age for: weight, length, head circumference, body mass index (BMI), energy and macronutrient intake. Growth parameters were within normal range at all ages in both groups with no significant difference in mean z-scores except for accelerated length in the PKU group. No child with PKU had z-scores < −2 for any growth parameter at age 2 years. Total protein and energy intake in both groups were similar at all ages; however, from 12–24 months in the PKU group, the percentage of energy intake from carbohydrate increased (60%) but from fat decreased (25%) and inversely for controls (48% and 36%). In PKU, use of low volume WPS meets Phe-free protein requirements, facilitates transition to solid foods and supports normal growth. Further longitudinal study of growth, body composition and energy/nutrient intakes in early childhood are required to identify any changing trends.

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Investigation of Vitamin D Levels in Children Aged 0–4 Years in Yunnan Province

10.21203/rs.3.rs-418111/v1 ◽

2021 ◽

Author(s):

Yuqin Wu ◽

Yanfei Yang ◽

Xiao Xiao ◽

Lin Wang ◽

Zheng Yin ◽

...

Keyword(s):

Vitamin D ◽

Young Children ◽

Yunnan Province ◽

Serum Vitamin ◽

Policy Formulation ◽

Vitamin D Supplementation ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Significant Difference ◽

Infants And Young Children

Abstract Aim: To investigate the vitamin D levels in children aged 0–4 years in Yunnan Province.Methods: This study selected children aged 0 to 4 years who underwent physical examination in the special needs clinic of the Hospital from October 2019 to December 2020 as subjects to analyze serum 25(OH)D levels.Result: Vitamin D deficiency was more common in girls than in boys. There was no significant difference in serum vitamin D levels between boys and girls at any age. However, there was a significant decrease in vitamin D levels after 2 years old in all chidren at all ages. The levels of vitamin D in children were highest in summer, which were significantly higher than other seasons, and were lowest in winter. At the same time, vitamin D levels were significantly different based on the economic level of cities. The serum vitamin D contents of infants and young children in the top five cities with the highest economic levels were significantly higher than in lower-ranked cities. There was a significant correlation between vitamin D content and serum calcium. Conclusion: This study preliminarily determined a reasonable reference range for serum 25 hydroxyvitamin D content in infants aged 0–4 years in Yunnan Province. Which will be of significance for the establishment of official guidelines on vitamin D supplementation in infants and young children in Yunnan and for policy formulation.

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Swallowing Safety and Efficiency after Open Partial Horizontal Laryngectomy: A Videofluoroscopic Study

Cancers ◽

10.3390/cancers11040549 ◽

2019 ◽

Vol 11 (4) ◽

pp. 549

Author(s):

Nicole Pizzorni ◽

Antonio Schindler ◽

Micol Castellari ◽

Marco Fantini ◽

Erika Crosetti ◽

...

Keyword(s):

Transit Time ◽

Upper Esophageal Sphincter ◽

Dynamic Imaging ◽

Tongue Base ◽

Surgical Approaches ◽

Or Efficiency ◽

Laryngeal Closure ◽

Esophageal Sphincter ◽

Pharyngeal Transit ◽

Horizontal Laryngectomy

Dysphagia is common after an open partial horizontal laryngectomy (OPHL). The mechanisms causing lower airways’ invasion and pharyngeal residue are unclear. The study aims to examine physio-pathological mechanisms affecting swallowing safety and efficiency after OPHL. Fifteen patients who underwent an OPHL type IIa with arytenoid resection were recruited. Videofluoroscopic examination of swallowing was performed. Ten spatial, temporal, and scalar parameters were analyzed. Swallowing safety and efficiency were assessed through the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale. Swallowing was considered unsafe or inefficient for a DIGEST safety or efficiency grade ≥2, respectively. Videofluoroscopic measurements were compared between safe vs. unsafe swallowers, and efficient vs. inefficient swallowers. Seven patients (46.7%) showed unsafe swallowing and 6 patients (40%) inefficient swallowing. Unsafe swallowers had worse laryngeal closure (p = 0.021). Inefficient swallowers presented a longer pharyngeal transit time (p = 0.008), a reduced pharyngoesophageal segment opening lateral (p = 0.008), and a worse tongue base retraction (p = 0.018 with solids and p = 0.049 with semisolids). In conclusion, swallowing safety was affected by incomplete laryngeal closure, while swallowing efficiency was affected by increased pharyngeal transit time, reduced upper esophageal sphincter opening, and incomplete tongue base retraction. The identified physio-pathological mechanisms could represent targets for rehabilitative and surgical approaches in patients with dysphagia after OPHL.

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Evaluation of Clinical and Immune Responses in Recovered Children with Mild COVID-19

Viruses ◽

10.3390/v14010085 ◽

2022 ◽

Vol 14 (1) ◽

pp. 85

Author(s):

Xiaodong Tian ◽

Zhihua Bai ◽

Ying Cao ◽

Haizhou Liu ◽

Di Liu ◽

...

Keyword(s):

Young Children ◽

Immune Responses ◽

Neutralizing Antibodies ◽

Immune Memory ◽

Lung Lesions ◽

Significant Difference ◽

Specific Igg ◽

Cellular Immune ◽

Infants And Young Children

The coronavirus disease 2019 (COVID-19) has spread globally and variants continue to emerge, with children are accounting for a growing share of COVID-19 cases. However, the establishment of immune memory and the long-term health consequences in asymptomatic or mildly symptomatic children after severe acute respiratory syndrome coronavirus 2 infection are not fully understood. We collected clinical data and whole blood samples from discharged children for 6–8 months after symptom onset among 0-to-14-year-old children. Representative inflammation signs returned to normal in all age ranges. The infants and young children (0–4 years old) had lung lesions that persisted for 6–8 months and were less responsive for antigen-specific IgG secretion. In the 5-to-14-year-old group, lung imaging abnormalities gradually recovered, and the IgG-specific antibody response was strongest. In addition, we found a robust IgM+ memory B cell response in all age. Memory T cells specific for the spike or nucleocapsid protein were generated, with no significant difference in IFN-γ response among all ages. Our study highlights that although lung lesions caused by COVID-19 can last for at least 6–8 months in infants and young children, most children have detectable residual neutralizing antibodies and specific cellular immune responses at this stage.

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