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Galdo B, Pazos C, Pardo J, Solar A, Llamas D, Fernández-Blanco E, Pazos A. Artificial intelligence in paediatrics: Current events and challenges. An Pediatr (Barc) 2024; 100:195-201. [PMID: 38461129 DOI: 10.1016/j.anpede.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 03/11/2024] Open
Abstract
This article examines the use of artificial intelligence (AI) in the field of paediatric care within the framework of the 7P medicine model (Predictive, Preventive, Personalized, Precise, Participatory, Peripheral and Polyprofessional). It highlights various applications of AI in the diagnosis, treatment and management of paediatric diseases as well as the role of AI in prevention and in the efficient management of health care resources and the resulting impact on the sustainability of public health systems. Successful cases of the application of AI in the paediatric care setting are presented, placing emphasis on the need to move towards a 7P health care model. Artificial intelligence is revolutionizing society at large and has a great potential for significantly improving paediatric care.
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Affiliation(s)
- Brais Galdo
- Universidad de A Coruña, A Coruña, Spain; INIBIC, A Coruña, Spain; RNASA-IMEDIR, A Coruña, Spain; Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain; Avances en Telemedicina e Informática Sanitaria, A Coruña, Spain
| | - Carla Pazos
- New Vision University, Faculty of Medicine, Tiflis, Georgia
| | - Jerónimo Pardo
- Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Alfonso Solar
- Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Daniel Llamas
- INIBIC, A Coruña, Spain; Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain; Avances en Telemedicina e Informática Sanitaria, A Coruña, Spain
| | - Enrique Fernández-Blanco
- Universidad de A Coruña, A Coruña, Spain; INIBIC, A Coruña, Spain; RNASA-IMEDIR, A Coruña, Spain; CITIC, A Coruña, Spain
| | - Alejandro Pazos
- Medical University of Byalistok, Byalistok, Podlaquia, Poland.
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Bierhals IO, de Oliveira GSP, Santos IS, Halal CS, Tovo-Rodrigues L, Matijasevich A, Barros FC. Relationship between sleep problems and headaches among adolescents: Pelotas 2004 Birth cohort. Sleep Med X 2023; 6:100079. [PMID: 37484546 PMCID: PMC10359655 DOI: 10.1016/j.sleepx.2023.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To investigate the cross-sectional association between sleep problems (the exposure) and headaches (the outcome) among 15-year-olds from the Pelotas 2004 Birth Cohort, a population-based study in the south of Brazil. Method The occurrence of headaches was obtained through the question: "Do you usually suffer headaches?" and the ICHD-3 criteria were used to classify as: tension-type headache, headache with characteristics of migraine with or without aura, or other. Regarding sleep, the weekly frequency in the last month of insomnia and bad dreams/nightmares, and self-reported sleep quality were investigated. Unadjusted and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression with robust variance. Results A total of 1916 adolescents were analyzed. The prevalence of headaches was 51.6% (69.0% in females and 34.8% in males): 31.8% (39.7% vs. 24.1%) reported tension-type headache; 14.7% (21.9% vs. 7.8%), headaches with characteristics of migraines without aura; 3.6%, headaches with characteristics of migraines with aura; and 1.5% (5.1% vs. 2.3%), other types. Adolescents with insomnia ≥3 times/week presented higher probability of headaches (PR = 1.54; 95%CI 1.23-1.93), compared with those with no problems falling asleep or maintaining sleep. Among those who classified their sleep as poor/very poor, the probability of headaches was 33% higher (PR = 1.33; 95%CI 1.13-1.57) than among those who classified their sleep as very good. Conclusions Headaches were highly prevalent among the adolescents and were related to sleep problems even after allowing for several confounders.
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Affiliation(s)
- Isabel Oliveira Bierhals
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Iná S. Santos
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Camila S. Halal
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Hospital Nossa Senhora Conceição, Porto Alegre, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
| | - Fernando C. Barros
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduation in Health and Behavior Program, Catholic University of Pelotas, Pelotas, RS, Brazil
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Roccella M, Vetri L, Carotenuto M, Costanza C. The Complex Association between Sleep Quality, Psychological Wellbeing, and Neurodevelopmental Disorders in Childhood. J Clin Med 2023; 12:jcm12103417. [PMID: 37240521 DOI: 10.3390/jcm12103417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
During child development, the psychophysiological state is influenced by factors such as family routine, school experiences, stressful life events, or, in general, the environmental context in which the child grows up [...].
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Affiliation(s)
- Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Luigi Vetri
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania "Luigi Vanvitelli", 81100 Caserta, Italy
| | - Carola Costanza
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, 90128 Palermo, Italy
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Manzo ML, Reina F, Correnti E, D'Aiuto F, D'Agnano D, Santangelo A, Vetri L, Santangelo G, Maniscalco L, Tripi G, Sciruicchio V, Raieli V. Evolution of Pediatric Migraine Patients Admitted at an Emergency Department after a 10-Year Follow-Up. J Clin Med 2023; 12:jcm12072475. [PMID: 37048559 PMCID: PMC10095507 DOI: 10.3390/jcm12072475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/12/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Despite its high prevalence, the clinical course of pediatric migraine has not been fully understood, and previous studies present conflicting results. We present here the findings of a 10-year follow-up study involving children with severe migraine pain admitted to our emergency department. Furthermore, all studies were carried out on selected outpatient clinical case studies. Our aim was to evaluate a population of migraine children admitted to an emergency department because of increased severity or frequency of pain or even because of very anxious parents concerning their child's headache in order to describe their long-term outcomes, whether it differed from that of outpatient populations and to identify possible predictors of prognosis. METHODS We recruited 80 subjects with migraine headaches (mean age 8 years with a range of 4-14 years, 50% females), attending the baseline examination of a population admitted for a headache to the Emergency Department in the first half year of 2012. Of the 80 subjects, 48 (60%) were eligible for follow-up in 2022. We included in our study only patients diagnosed with migraine, according to the diagnostic criteria of the International Classification of Headache Disorders. All were contacted by telephone, and a semi-structured questionnaire was provided to them by email. The association between several possible prognostic factors (gender, familiar neurologic disorders, prenatal and perinatal disorders, social activities, sleep disorders, etc.) and the long-term persistence of migraine headaches were explored using logistic regression analysis. RESULTS Of 48 subjects with migraine headaches at baseline, 31 (65%) had persistent migraine, and 17 (35%) experienced remission. The preliminary results showed that the presence of neurologic disorders in parents (p < 0.01-odds ratio 9.34 (2.53-41.64) and sleep disorders (p < 0.01-odds ratio 13.18 (2.25-252.74) significantly predicted the 10-year persistence of migraine headaches, while the other considered predictors were found not to influence prognosis. CONCLUSIONS To our knowledge, this was the first study conducted on a selected pediatric population upon admission to the emergency room. Our study suggests that a population of pediatric migraine selected for admission to the emergency department also shows a favorable long-term prognosis, like the studies conducted in the outpatient sample. Familial neurological comorbidity and sleep disorders were unfavorable factors for predicting good outcomes.
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Affiliation(s)
- Maria Laura Manzo
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Federica Reina
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Edvige Correnti
- Child Neuropsychiatry Department, ISMEP-ARNAS Civico, 90100 Palermo, Italy
| | | | - Daniela D'Agnano
- Children Epilepsy and EEG Center, PO, San Paolo ASL, 70132 Bari, Italy
| | - Andrea Santangelo
- Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy
| | - Luigi Vetri
- Oasi Research Institute IRCCS, 94018 Troina, Italy
| | | | - Laura Maniscalco
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Gabriele Tripi
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | | | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP-ARNAS Civico, 90100 Palermo, Italy
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Correnti E, Lo Cascio S, Cernigliaro F, Rossi R, D'Agnano D, Grasso G, Pellegrino A, Lauria B, Santangelo A, Santangelo G, Tripi G, Versace A, Sciruicchio V, Raieli V. Idiopathic Non-Dental Facial Pain Syndromes in Italian Children: A Clinical Case Series. Life (Basel) 2023; 13:life13040861. [PMID: 37109390 PMCID: PMC10144764 DOI: 10.3390/life13040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/08/2023] [Accepted: 03/19/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes characterized by painful attacks involving the orofacial structures. They may be summarily subdivided into two great categories: (1) orofacial pain mainly attributed to dental disorders such as dentoalveolar and myofascial orofacial pain or temporomandibular joint (TM) pain; (2) orofacial pain mainly attributed to non-dental pain as neuralgias, facial localization of primary headaches or idiopathic orofacial pain. The second group is uncommon, often described by single case reports, can often show overlapping symptoms with the first group, and represents a clinical challenge, carrying the risk of undervaluation and possibly invasive odontoiatric treatment. We aimed to describe a clinical pediatric series of non-dental orofacial pain and better to underline some topographic and clinical features associated with them. We retrospectively collected the data of children admitted to our headache centers (Bari, Palermo, Torino) from 2017 to 2021. Our inclusion criterion was the presence of non-dental orofacial pain following the topographic criteria of 3° International Classification of Headache Disorders (ICHD-3), and exclusion criteria included the pain syndromes attributed to the dental disorders and pain syndromes due to the secondary etiologies Results. Our sample comprised 43 subjects (23/20 M/F, in the range of ages 5-17). We classified them int: 23 primary headaches involving the facial territory during attacks, 2 facial trigeminal autonomic cephalalgias, 1 facial primary stabbing headache, 1 facial linear headache, 6 trochlear migraines, 1 orbital migraine 3 red ear syndrome and 6 atypical facial pain. All patients described debilitating pain for intensity (moderate/severe), 31 children had episodic attacks, and 12 had continuous pain. Almost all received drugs for acute treatment (less than 50% were satisfied), and some received non-pharmacological treatment associated with drug therapy Conclusion. Although rare OFP can occur in pediatric age, it can be debilitating if unrecognized and untreated, affecting the psychophysical well-being of young patients. We highlight the specific characteristics of the disorder for a more correct and earlier identification during the diagnostic process, already difficult in pediatric age, and to define the approach and possible treatment to prevent negative outcomes in adulthood.
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Affiliation(s)
- Edvige Correnti
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
| | - Salvatore Lo Cascio
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Federica Cernigliaro
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Roberta Rossi
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Daniela D'Agnano
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Giulia Grasso
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Annamaria Pellegrino
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Barbara Lauria
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Andrea Santangelo
- Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy
| | | | - Gabriele Tripi
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Antonella Versace
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
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Gungor M, Guler MA, Karagoz YS. Management and behavior-modifying recommendation effects in childhood headache. Pediatr Int 2023; 65:e15406. [PMID: 36326638 DOI: 10.1111/ped.15406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Headaches are common in childhood. Recently, there has been an increasing trend toward pharmacological treatment. METHODS Secondary causes were excluded first in patients who attended our clinic with headache. Those without a secondary cause were evaluated as primary headache and classified into subgroups. Behavior-modifying recommendations (adequate and regular sleep, adequate and regular nutrition, adequate fluid intake, and restriction of screen exposure) were given to all patients. Patients were re-evaluated at 1, 3, and 6 months. Pharmacologic treatment was started at the end of the first month with follow-up at the third and sixth months for those who did not benefit from the behavior-modifying recommendations. RESULTS A total of 875 patients presented with headache complaints, of which 30.6% were evaluated as primary headache. Behavior-modifying recommendations were beneficial for 23.1% with migraine with aura; 20.3% with migraine without aura, and 36.8% with tension-type headache. CONCLUSION Secondary causes should be excluded first in patients who present to the pediatric neurology clinic with headache. Behavioral modifications to change the lifestyle of patients diagnosed with primary headache should be tried before giving pharmacologic treatment.
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Affiliation(s)
- Mesut Gungor
- Department of Pediatric Neurology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Muhammet Akif Guler
- Department of Pediatrics, Ataturk University Medical Faculty, Erzurum, Turkey
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Onofri A, Ferilli MAN, Tozzi E, Ursitti F, Sforza G, Olivieri L, Proietti Checchi M, Vigevano F, Valeriani M, Moavero R. How to Assess the Headache-Sleep Disorders Comorbidity in Children and Adolescents. J Clin Med 2021; 10:jcm10245887. [PMID: 34945182 PMCID: PMC8707479 DOI: 10.3390/jcm10245887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Sleep disorders and primary headaches are frequent health problems in childhood, and they are often comorbid in an individual, linked by a mutual and complex relationship. This comorbidity is frequent and well-documented, but the available literature is usually biased in favor of one aspect or another, mainly depending on the expertise of the authors. The aim of this paper is to review existing literature on the diagnostic assessment of comorbid primary headaches and sleep disorders, so as to propose practical suggestions to accurately investigate the presence of comorbid conditions in children evaluated for primary headaches or for sleep disorders.
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Affiliation(s)
- Agnese Onofri
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Michela Ada Noris Ferilli
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Correspondence:
| | - Elisabetta Tozzi
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Fabiana Ursitti
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Giorgia Sforza
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Luca Olivieri
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Martina Proietti Checchi
- Unit of Clinical Psychology, Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Federico Vigevano
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Massimiliano Valeriani
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Denmark Neurology Unit, Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
| | - Romina Moavero
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00133 Rome, Italy
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