Food neophobia involves avoiding new foods due to reluctance, aversion, or disgust. The Food Neophobia Scale (FNS) is the most reliable and common adult food neophobia test. It helps compare food neophobia across cultures by being translated into numerous languages. This study adapted, translated, and validated the FNS for Romania. This translated version was piloted in November 2023 on 59 students in the medical field from two distinct Romanian cities. Between December 2023 and February 2024, 375 adults were surveyed, representing Romania’s population within a 90% confidence interval. The average age of responders was 38.07 years, with a standard deviation of 10.75 and a 4:1 female-to-male sex ratio. The Cronbach’s alpha test was used to validate the questionnaire. Our study found that the mean FNS value was 31.86; most Romanian respondents (69.20%) were neutral towards trying new foods, with a significant portion being neophobes (18.21%) outnumbering neophiles (12.59%). When compared to international study results, Romanian adults, on average, exhibited a higher percentage of neophobes compared to those in Korea (13%), Hungary (16.8%), Italy (17%), and Brazil (17.5%), but a lower percentage than those in Lebanon (21.5%). The findings indicate that the translated scale can be utilized to assess neophobia among Romanian speakers.
(1) Background: Although most cases of new-onset type 1 diabetes mellitus (T1DM) are managed without serious events, life-threatening complications do arise in a subset of patients. Our objective was to assess the correlation between elevated SIRI values and adverse events related to the onset of T1DM. (2) Methods: This retrospective study, spanning ten years, included 187 patients with new-onset T1DM divided into three groups based on SIRI tertiles. The primary outcome was the occurrence of acute complications during hospital admission, while the secondary outcome was prolonged Intensive Care Unit (ICU) admission. (3) Results: Patients with high SIRI values were more likely to experience higher disease activity, leading to longer ICU admission times and more frequent complications. Multivariate logistic regression analysis revealed that the SIRI was independently associated with acute complications (p = 0.003) and prolonged ICU length of stay (p = 0.003). Furthermore, receiver operating characteristic analysis demonstrated the SIRI’s superior predictive accuracy compared to venous pH (AUC = 0.837 and AUC = 0.811, respectively) and to the individual component cell lineages of the SIRI. (4) Conclusions: These findings emphasize the potential utility of the SIRI as a prognostic marker in identifying patients at increased risk during T1DM hospital admissions.
Hypocalcemia is a common occurrence in pediatric patients, attributed to various causes and presenting with diverse clinical manifestations. A prompt evaluation is necessary to determine its underlying cause, whether it presents acutely or chronically, and to tailor treatment based on its severity. Among the potential causes of chronic hypocalcemia, primary hypoparathyroidism stands out. The case of a seven-year-old male patient with hypocalcemia reported in this article serves as an illustration, wherein targeted next-generation sequencing revealed a homozygous p.R257X mutation in the AIRE gene, indicative of autoimmune polyendocrine syndrome type 1 (APS-1). It poses challenges due to its multisystemic nature and involvement of specific autoantibodies, often leading to underdiagnosis, owing to its rarity, varied manifestations, and incomplete penetrance. A comprehensive review of the APS-1 literature was conducted to provide insights into the clinical manifestations, genetic spectrum, potential immunological mechanisms, and current medical strategies. Additionally, the recognition of AIRE gene mutations is crucial for facilitating genetic diagnosis, prognosis, and potential treatment strategies for APS-1. The management of such cases involves individualized approaches to treatment, regular monitoring, medication adjustments, and the early identification of associated conditions.
Background/Objectives: Hashimoto’s thyroiditis (HT) is an autoimmune disorder characterized by chronic inflammation of the thyroid gland. Recent evidence indicates that the inflammation may extend beyond the thyroid. The study aims to explore the potential of complete blood count (CBC)-derived indices as markers of systemic inflammation in HT. Materials and Methods: This cross-sectional retrospective study from 1 January 2015, to 31 December 2023 included 147 pediatric HT patients and 144 apparently healthy controls. Thyroid profiles, antibodies, CBC, and protein electrophoresis data were collected from patient records. CBC-derived indices were calculated and compared between the HT and control groups, as well as among HT subgroups. Results: The median age of HT patients was 13.6 years (range: 11.2–15.5 years), with 66% being girls. The control group had a similar age and gender distribution, with a median age of 13.7 years (range: 11–15.8 years) and 70.8% girls. Of the HT patients, 50% had subclinical HT, 15% were euthyroid, and 34% had overt thyroid dysfunction. HT patients showed significantly higher neutrophil and lymphocyte counts, as well as all evaluated CBC-derived indices than controls (p < 0.001)). These differences were not significant among HT subgroups. Logistic regression indicated a strong association between an elevated neutrophil-to-lymphocyte ratio (NLR) and HT diagnosis (p < 0.001), while ROC analysis confirmed NLR as the most accurate CBC-derived marker for distinguishing HT from controls. Conclusions: Elevated NLR levels in pediatric HT patients provide additional evidence that inflammation may extend beyond the thyroid gland. These results support the potential of NLR as a reliable and accessible biomarker for evaluating inflammation in Hashimoto’s thyroiditis.
Background and Objectives: Phenylketonuria (PKU) is a rare genetic disorder characterized by the inability to convert the essential amino acid phenylalanine into tyrosine. Early dietary treatment can successfully prevent complications, but controversies still exist regarding the attainment of normal growth in these patients. Materials and Methods: Eighteen patients with PKU from two Romanian reference centers were compared to eighteen non-PKU controls, matched for age and gender. The comparisons used weight-for-height, weight-for-age, height/length-for-age, and body mass index-for-age z-scores from birth to three years of age. Results: The PKU study group consisted of nine boys and nine girls, with a median follow-up period of thirty-six months (interquartile range = 9.75). While median values of all four growth metrics remained within the normal range across the entire study period, weight-for-age z-scores were significantly lower in PKU patients throughout most of the study (p < 0.001). Conclusions: The persistent lower weight-for-age z-scores of the PKU patients compared to controls indicate that ongoing monitoring and potential adjustments in dietary therapy may be necessary to further optimize growth outcomes.
Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) represents a group of rare systemic autoimmune disorders marked by inflammation and damage to small- and medium-sized blood vessels. The clinical presentation of AAV is highly variable, ranging from isolated organ involvement to severe, life-threatening multisystem disease, posing significant challenges in diagnosis, treatment, and prognosis. Objective: To demonstrate the clinical heterogeneity and different outcomes in three pediatric cases of ANCA-positive disease and emphasize the importance of integrating clinical findings with laboratory and imaging investigations for accurate diagnosis. Methods: We present three pediatric patients (ages 12–15 years) with ANCA-positive results but distinct clinical presentations, evaluated at the Children’s Emergency Hospital “Louis Turcanu”, Timisoara, between 2020 and 2024. All cases were investigated according to EULAR/PRINTO/PReS criteria for pediatric vasculitis. Results: Case 1 (PR3-ANCA positive) developed severe multi-organ involvement, including granulomatosis with polyangiitis (GPA) with pulmonary hemorrhage, pericarditis, thrombotic events, and renal impairment, requiring intensive immunosuppression with cyclophosphamide, rituximab, and mycophenolate mofetil, ultimately developing chronic kidney disease stage 3a. Case 2 (BPI-ANCA positive) presented with purpuric lesions and painless joint swelling, responding favorably to corticosteroid therapy with subsequent remission. Case 3 (MPO-ANCA) manifested as polyarticular arthritis without other organ involvement and was ultimately diagnosed as seronegative juvenile idiopathic arthritis (JIA), achieving complete remission with adalimumab therapy. Conclusions: This case series highlights the diverse clinical and biological features of ANCA-positive conditions in children, emphasizing that ANCA positivity requires careful clinical correlation as it may indicate true vasculitis requiring aggressive treatment or alternative diagnoses such as JIA with incidental ANCA positivity. Tailored therapeutic strategies based on clinical presentation and continued research are essential to improve patient outcomes.