Publications by authors named "Henriette Moll"

Mycoplasma pneumoniae causes atypical pneumonia in children and young adults. Its lack of a cell wall makes it resistant to beta-lactams, which are the first-line treatment for typical pneumonia. Current diagnostic tests are time-consuming and have low specificity, leading clinicians to administer empirical antibiotics.

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Objective: Studies in mouse models and human adults have shown that the intestinal microbiota composition can affect peripheral immune cells. We here examined whether the gut microbiota compositions affect B and T-cell subsets in children.

Methods: The intestinal microbiota was characterized from stool samples of 344 10-year-old children from the Generation R Study by performing 16S rRNA sequencing.

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Objective: To investigate a dose-response relationship between the magnitude of decrease in pediatric respiratory tract infections (RTI) during the 2020 implementation of non-pharmaceutical interventions (NPI) and the rise thereafter during NPI lifting.

Study Design: We conducted an interrupted, time-series analysis, based on a multinational surveillance system. All patients <16 years of age coming to medical attention with various symptoms and signs of RTI at 25 pediatric emergency departments from 13 European countries between January 2018 and June 2022 were included.

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  • The study aimed to assess whether short-term treatment with lamotrigine can enhance cognitive functioning in adolescents with neurofibromatosis type 1 (NF1).
  • A double-blind, randomized clinical trial involved 31 participants aged 12 to 17 taking 200 mg of lamotrigine for 26 weeks, measuring outcomes like performance IQ and various cognitive skills.
  • Results indicated that lamotrigine did not significantly affect overall cognitive performance or most secondary outcomes, with only a slight trend towards improved visual sustained attention noted in the treatment group.
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  • The study assesses the effectiveness of white blood cell count (WBC) in predicting serious bacterial infections (SBI) in children compared to C reactive protein (CRP) and absolute neutrophil count (ANC).
  • After analyzing data from over 17,000 febrile children across multiple European emergency departments, WBC showed poor predictive value with a sensitivity of 56% and specificity of 74% for WBC >15.
  • The findings suggest that CRP is a better marker for identifying SBI in children, and WBC should only be used for specific cases rather than as a routine diagnostic tool.
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  • Early detection of at-risk children in low- and middle-income countries (LMICs) is crucial for reducing severe health complications and deaths.
  • The study validated the Emergency Department-Pediatric Early Warning Score (ED-PEWS) using clinical data from various LMICs to assess its effectiveness in identifying children needing urgent care.
  • Results showed that the ED-PEWS is moderately to highly effective at recognizing high-urgency cases, with sensitivity and specificity varying across different locations, highlighting its potential to improve urgent care in these settings.
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Background: Angelman syndrome (AS) is a rare neurodevelopmental disorder characterized by severe intellectual disability, little to no expressive speech, visual and motor problems, emotional/behavioral challenges, and a tendency towards hyperphagia and weight gain. The characteristics of AS make it difficult to measure these children's functioning with standard clinical tests. Feasible outcome measures are needed to measure current functioning and change over time, in clinical practice and clinical trials.

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  • * Using data from 12 European EDs, researchers analyzed presenting symptoms and management of febrile children under 18, identifying those suitable for a fast track system based on simplicity and minimal resource use.
  • * Findings revealed that respiratory symptoms were the most common, while neurological patients utilized more imaging and had higher admission rates, and gastrointestinal patients underwent more lab tests, indicating varying needs among the different symptom groups.
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Objectives: The COVID-19 pandemic and subsequent rise of multisystem inflammatory syndrome in children have raised interest in high-sensitivity troponin (hs-TnT) and N-terminal probrain natriuretic peptide (NT-proBNP) because these have been found to be elevated in many cases of multisystem inflammatory syndrome in children. Our aim was to study hs-TnT and NT-proBNP concentrations in febrile children not affected by COVID-19.

Methods: We retrospectively measured cardiac markers, hs-TnT, and NT-proBNP in leftover blood samples of febrile children (0-18 years) diagnosed and treated in a single-center emergency department (ED) (N = 67) and pediatric intensive care unit (PICU) (N = 19) that participated in a multicenter, prospective study of infection biomarkers (PERFORM).

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  • Differentiating between self-resolving viral infections and bacterial infections in children with fever is challenging and can lead to improper use of antibiotics; this study aims to identify host protein biomarkers that could help distinguish between these infections.
  • The research used a multi-cohort approach and high-dimensional proteomic datasets from various European studies to shortlist potential protein biomarkers by performing several analyses and tests on collected samples.
  • A sparse protein signature was successfully identified, which distinguishes between bacterial and viral infections, and its effectiveness was validated through Luminex assays and disease risk score calculations.
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Angelman syndrome (AS) is a rare genetic disorder due to lack of UBE3A function on chromosome 15q11.2q13 caused by a deletion, uniparental paternal disomy (UPD), imprinting center disorder (ICD), or pathological variant of the UBE3A gene. AS is characterized by developmental delay, epilepsy, and lack of speech.

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  • Antibiotic overprescription in pediatric emergency departments (EDs) contributes to antimicrobial resistance, prompting a study on empiric antibiotic use in European EDs for febrile children.
  • Out of 2130 febrile cases studied, 72.7% were classified as bacterial and 27.3% as viral, with 85.1% of bacterial and 46.3% of viral cases receiving empiric systemic antibiotics within the first two days.
  • A large portion of patients with viral infections were still given antibiotics, typically from the WHO's "Watch" category, highlighting the need for better diagnostic methods in EDs to accurately distinguish between bacterial and viral infections.
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Angelman Syndrome (AS) is a rare genetic disorder caused by lack of maternal UBE3A protein due to a deletion of the chromosome 15q11.2-q13 region, uniparental paternal disomy, imprinting center defect, or pathogenic variant in the gene. Characteristics are developmental delay, epilepsy, behavioral, and sleep problems.

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Background: The PERFORM study aimed to understand causes of febrile childhood illness by comparing molecular pathogen detection with current clinical practice.

Methods: Febrile children and controls were recruited on presentation to hospital in 9 European countries 2016-2020. Each child was assigned a standardized diagnostic category based on retrospective review of local clinical and microbiological data.

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Children constitute 6-10% of all patients attending the emergency department (ED) by emergency medical services (EMS). However, discordant EMS use in children occurs in 37-61% with fever as an important risk factor. We aimed to describe EMS utilisation among febrile children attending European EDs.

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Background: Suboptimal vitamin D status is common in people with celiac disease (CeD), a disease that can be characterized by the presence of serum anti-tissue transglutaminase antibodies (TG2A) (i.e., TG2A positivity).

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Background: To identify a diagnostic blood transcriptomic signature that distinguishes multisystem inflammatory syndrome in children (MIS-C) from Kawasaki disease (KD), bacterial infections, and viral infections.

Methods: Children presenting with MIS-C to participating hospitals in the United Kingdom and the European Union between April 2020 and April 2021 were prospectively recruited. Whole-blood RNA Sequencing was performed, contrasting the transcriptomes of children with MIS-C (n = 38) to those from children with KD (n = 136), definite bacterial (DB; n = 188) and viral infections (DV; n = 138).

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Background: Distinguishing bacterial and viral infections based on clinical symptoms in febrile children attending the emergency department (ED) is challenging. The aim of this study is to determine a novel combination of host protein biomarkers and to assess its performance in distinguishing between bacterial and viral infection in febrile children attending EDs.

Methods: A literature search was performed to identify blood protein biomarkers able to distinguish bacterial and viral infections (May 2015-May 2019).

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Objectives: To describe the characteristics and clinical outcomes of children with fever ≥5 days presenting to emergency departments (EDs).

Design: Prospective observational study.

Setting: 12 European EDs.

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Background: Globally, the COVID-19 pandemic had a huge impact on patients and healthcare systems. A decline in paediatric visits to healthcare settings was observed, which might have been due to lower incidence of injury and infectious illness, changes in healthcare services and parental concern. The aim of our study was to examine parental experiences of help-seeking for, and care of, a sick or injured child during COVID-19 lockdown periods in five European countries with different healthcare systems in place.

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  • Clinical algorithms for assessing febrile children often rely on vital sign thresholds that may not accurately reflect serious bacterial infections (SBI) after antipyretics are given.
  • A study involving 740 children demonstrated that persistent tachypnoea (fast breathing) after temperature reduction is a significant predictor of pneumonia but does not apply to other types of SBI.
  • Tachypnoea showed high specificity and likelihood ratios for ruling in pneumonia, while tachycardia (fast heart rate) proved to be a poor diagnostic indicator, suggesting a need to reconsider its use in discharge decisions.
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Aim: This study investigated febrile children with petechial rashes who presented to European emergency departments (EDs) and investigated the role that mechanical causes played in diagnoses.

Methods: Consecutive patients with fever presenting to EDs in 11 European emergency departments in 2017-2018 were enrolled. The cause and focus of infection were identified and a detailed analysis was performed on children with petechial rashes.

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  • This study aimed to explore how a behavioral intervention could improve sleep issues in children with Angelman Syndrome (AS), addressing a significant clinical need.
  • Children aged 2-18 with AS were divided into two groups to either receive the intervention or be part of a control group, with various assessments of sleep habits conducted before and after the program.
  • Results showed that the intervention significantly improved sleep quality metrics like wake after sleep onset and total sleep time, as well as positively affecting sleep hygiene and quality of life for these children and their families.
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Background: Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability.

Methods And Findings: A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks.

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The link between the gut microbiome and the brain has gained increasing scientific and public interest for its potential to explain psychiatric risk. While differences in gut microbiome composition have been associated with several mental health problems, evidence to date has been largely based on animal models and human studies with modest sample sizes. In this cross-sectional study in 1,784 ten-year-old children from the multi-ethnic, population-based Generation R Study, we aimed to characterize associations of the gut microbiome with child mental health problems.

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