Objectives: This study investigates the impact of an early systematic interdisciplinary developmental follow-up and individualized intervention program on the neurodevelopment of children with complex congenital heart disease (CHD) who required cardiac surgery. Study Design: We prospectively enrolled 80 children with CHD: 41 were already followed at our neurocardiac developmental follow-up clinic from the age of 4 months, while 39 were born before the establishment of the program and therefore received standard health care. We conducted cognitive, motor, and behavioral assessments at 3 years of age. We used one-way multivariate analyses of variance to compare the neurodevelopmental outcome of both groups. Results: Between-group analyses revealed a distinct neurodevelopmental profile with clinically significant effect size ( P < 0.001, partial η 2 = 0.366). Children followed at our clinic demonstrated better receptive language performances ( P = 0.048) and tended to show higher scores on visuo-constructive tasks ( P = 0.080). Children who received standard health care exhibited greater performances in working memory tasks ( P = 0.032). We found no group differences on global intellectual functioning, gross and fine motor skills, and behaviors. Referral rates for specific remedial services were higher in patients followed at our neurocardiac clinic compared to the historical cohort ( P < 0.005). Conclusions: Overall, the impact of the developmental follow-up and individualized intervention program on neurodevelopmental outcomes remains subtle. Nevertheless, results, although limited by several factors, point toward an advantage for the children who took part in the program regarding receptive language skills over children who received standard health care. We hypothesize that group differences may be greater with growing age. Further research involving larger cohorts is needed to clearly assess the effectiveness of neurocardiac developmental follow-up programs at school age.

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To our knowledge, recent oral health data in Romania is poor, as no comprehensive oral health surveys have been carried out in the last five years. The present cross-sectional oral health survey aimed to assess the dental health status in 6 and 12-year old children from Transylvania, in correlation with their family background, oral-health behavior, and the intake of sweets. The study was conducted on 290 children from nine schools in the Transylvanian region of Romania. The study consisted of the clinical examination of children, recording of data in an International Cavity Detection and Assessment System (ICDAS) chart, and a questionnaire referring to the child’s parental education, frequency, and motivation of visits to the dentist, dental care habits, and the intake of sweets. Our results indicated that the most prevalent ICDAS scores recorded in 6-year-old children were “0A” (p = 0.001464), “03” (p = 0.00366), “05” (p = 0.005563), “06” for rural areas. Restorations were statistically more prevalent in the urban population (p = 0.000076). The ICDAS score for 12-year old children was “03” (p = 0.003614) and prevalent in the urban area. The ICDAS score for the rural area was “04” (p = 0.0056). Comparing dental health status with family background demonstrated a strong correlation for the group of 6-year-old children, and a lack of correlation for the 12-year-old children. The number of dental visits corelated with the parents’ backgrounds, and was higher in the urban population. Frequent hygiene habits (toothbrushing) were statistically correlated with lower ICDAS scores: “04” (p = 0.016482), “05” (p = 0.039127), “06” (p = 0.010785). Eating habits in both age groups were associated with statistically significant differences of “03”, “04”, “05”, “06”, “0A” in the ICDAS score. The obtained results provided clarification on the dental health situation in Romania and the potential risk factors of caries among the population, and therefore it could be used as a starter point for future studies to investigate, in depth, the effects of various variables on cavities found in Transylvanian schoolchildren.

Background Non-motor symptoms are an important early feature of Parkinson’s disease (PD), encompassing a variety of cognitive and psychiatric symptoms that seem to manifest differently depending on motor symptom asymmetry. Different factors, such as uric acid (UA) and sex, seem to influence cognitive and psychiatric expression in PD, however their interplay remains to be better understood. Methods Participants taking part in the Parkinson’s Progression Marker Initiative were studied based on the side of motor symptom asymmetry and sex. Three-way interaction modeling was used to examine the moderating effects of sex and UA on cognitive functions and psychiatric symptoms. Results Significant three-way interactions were highlighted at 1-year follow-up between motor symptom asymmetry, UA and sex for immediate and long-term memory in female patients exhibiting predominantly left-sided motor symptoms, and for processing speed and sleepiness in female patients exhibiting predominantly right-sided motor symptoms. No significant interactions were observed for male patients. Moreover, female patients exhibiting predominantly right-sided motor symptoms demonstrated lower serum UA concentrations and had overall better outcomes, while male patients with predominantly right-sided motor symptoms demonstrated particularly poor outcomes. Conclusions These findings suggest that in the earliest stages of the disease, UA and sex moderate cognitive functions and psychiatric symptoms differently depending on motor asymmetry, holding important clinical implications for symptom management in patients.

Motor symptom asymmetry, a key feature of Parkinson’s disease, has been associated with differences in non-motor symptoms, such as cognitive and neuropsychiatric impairments, and in biomarker profiles. However, the longitudinal relationship between biomarkers and non-motor symptoms as a function of motor symptom asymmetry remains to be fully explored in early-stage patients. Clinical data from the Parkinson’s Progression Marker Initiative was extracted from 179 patients showing predominantly left-sided motor symptoms and 234 patients showing predominantly right-sided motor symptoms during a 3-year follow-up. General estimating equations revealed differential relationships over time between biospecimen and cognitive-neuropsychiatric scores based on motor symptom asymmetry. A more important implication of uric acid and beta-amyloid was noted in patients with predominantly left-sided motor symptoms, whereas patients with predominantly right-sided motor symptoms showed associations with alpha-synuclein and phosphorylated-tau levels. In summary, asymmetry of motor symptoms influences clinical trajectories in early-stage patients, holding important implications for symptom management in this clinical population.