The Role of Natural Extracts in the Management of Infantile Hemangiomas and Vascular Tumors.

Hemangiomas are vascular tumors resulting from the proliferation of endothelial-like cells; they are the most common childhood tumors, affecting approximately 5-10% of newborns and infants. Besides hemangiomas, which are definitely benign tumors despite their overgrowth potential, there are other vascular tumors like hemangioendotheliomas, which may display intermediate characteristics between benign hemangiomas and highly malignant angiosarcomas. Standard therapy may be constricted by serious adverse effects, high cost, or traumatic influence. Diet is a major resource for health preservation, disease prevention, and treatment. The therapeutic property of edible berries, marine products, or medicinal plants have long been known and used in traditional medicine; a plant-based nutrition can prevent the development and progression of diseases associated with extensive neo-vascularization. The purpose of our review is to highlight those natural treatments that hemangioma and vascular tumor patients can receive in the future, both for their benefit and that of their families. We performed the review according to the Preferred Reporting Items for Systematic Reviews and Metanalysis Statement. We used the Web of Science, PubMed, and EMBASE engines for the study, and searched for the association of hemangioma with naturopathic treatment/plant extract/plants in published articles. We found that natural extracts from plants and fruits are cost-effective and safe treatments for hemangiomas and vascular tumors, as well as for other forms of cancer. In any case, more in vitro and in vivo studies are needed to confirm the proposed signaling pathways in tumors and validate the improvement parameters after natural products administration. The era of molecularly targeted therapy and personalized medicine is approaching and naturally occurring substances are very useful tools for tumor treatment and prevention. Plant extract substances have strong specificity and pertinence, are non- toxic and have few side effects, and may become an emerging cancer treatment.

Immunomodulatory Effects of Vitamin D in Respiratory Tract Infections and COVID-19 in Children.

Acute respiratory tract infections (ARTIs) are one of the main reasons that the pediatric population goes to the doctor. The connection between ARTI and vitamin D (VD) is currently debated by the medical community, and so far, there has been little agreement with regard to the ideal level of 25(OH)D concentration that would provide protection for the respiratory tract, or the effectiveness of its administration in the treatment of respiratory infections. The purpose of this literature review was to bring attention to the immunomodulatory and antiviral function of vitamin D and its relation to the respiratory system by examining the main ARTIs, including SARS-CoV-2. The latter has affected the pediatric population in different ways, from asymptomatic patients to severe forms with multisystem inflammatory syndrome in children (MIS-C). Although there are not much clinical data on the SARS-CoV-2 disease in the pediatric population worldwide, we tried to find out whether there is a connection between the severity of this disease, other ARTIs, and vitamin D supplementation. We also aimed to find out if 25OHD deficiency had an adverse effect on the evolution of the disease and the recovery period in the case of younger patients affected by COVID-19. For this literature review, the PICO framework was selected as the methodological approach. Our results demonstrated many methods by which this vitamin may lower the risk of ARTI with regard to the COVID-19 infection. Despite these significant advancements, more research is needed to support the idea that 25(OH)D concentration can influence the evolution of respiratory tract infections in children.

Lead poisoning in a 16-year-old girl: a case report and a review of the literature (CARE compliant).

BACKGROUND: Lead is a toxic element of the environment which leads to major complications once it enters the blood stream, affecting multiple organs and systems of the body. METHODS: We present the case of a 16-year-old girl, diagnosed with lead poisoning after occupational exposure due to the fact that the girl was actively involved in the family's pottery business.History revealed that the girl participated in the process of pottery, her father was also diagnosed with lead poisoning 2 years before. The patient's personal history underlined that approximately 1 year ago she presented with severe abdominal pain, being diagnosed with acute appendicitis and she underwent appendectomy, but the pain persisted, thus due to family history of lead poisoning, the suspicion of saturnine colic rose, and she was diagnosed with lead poisoning. The main symptoms and signs were severe abdominal pain, vomiting, and arterial hypertension. The clinical evolution was favorable under symptomatic treatment and chelation therapy. RESULTS: Lead toxicity is a life-threatening condition because of its severe acute and chronic complications. In children, there is no safe blood lead level, prevention methods are, therefore, very important in order to avoid toxic multiorganic effects of this metal. CONCLUSION: Even though the diagnosis of lead poisoning remains difficult in children, it must also be taken into consideration by the clinician facing a child with gastrointestinal or neurological involvement.