March 26,  2014   Vol. V, Issue 13
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Pneumonia & exposure status in infants born to HIV positive mothers.

"Almost all HIV infected children get the virus from their mothers before or during birth or through breast feeding". Miami appears to be among the USA cities with the highest rate of pediatric AIDS. Treating HIV-infected mothers and subsequently their babies appears to reduce the risk of infant infection significantly.


It appears that HIV-exposed infants previously thought to be uninfected may in fact have a greater risk for difficult to treat pneumonia, than their unexposed counterparts.


Pediatric Infectious Disease Journal

Prophylactic use of a probiotic in the prevention of colic, regurgitation & functional constipation.

Infantile colic is a very common gastrointestinal disturbance which presents with long bouts of extreme inconsolable crying, peaking at around 6 weeks of age and generally disappearing at about 12 weeks of age. In later childhood these children have an 11-fold increased risk for recurrent abdominal pain, allergies and psychological disorders.

A prospective, multicenter, double-masked, placebo control random trial involving 589 term newborns, <1 week of age, examined the effects of giving L. reuteri DSM 17938 or a placebo, for 90 days.


Newborn infants given a probiotic (L. reuteri) daily for 3 months appear to cry less, regurgitate less, have more frequent stools and utilize less private and public funds. It remains to be seen whether the other associated symptoms are prevalent later in childhood (Ed.).


JAMA Pediatrics 



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Vaccines for flu - are two "B's" better than one?


Influenza is a yearly epidemic disease. Since the 1918 pandemic, influenza viruses have been demonstrated to have "antigenic drift and shift" so that human immunity from season to season diminishes. This results in increasing severity of illness. Both Influenza A (H and N antigens) and Influenza B (Y and V antigens) viruses cause disease. The main strategy of prevention has been annual vaccination of a trivalent influenza vaccine containing A/H1N1, A/H3N2 plus a single B antigen (determined by "best guess!"). Sometimes (approximately 50%) the vaccine produced doesn't match the prevailing virus antigen.


A multinational, observer-blinded study of 5,168 children (3-8 years) randomly assigned to receive either a quadrivalent influenza vaccine (QIV) (A plus both B antigens) or a hepatitis A vaccine (control) indicates that QIV vaccine has a 59.3%-74.2% efficacy (depending on the severity of illness), with a good immunological response. Ongoing assessment of effects and safety over the next few flu seasons, is necessary.


New England Journal of Medicine 

Video Feature  
Flu Vaccine Information for Pregnant Women and Children
Flu Vaccine Information for Pregnant Women and Children
via YouTube
Adolescents' level of eating psychopathology & parents' current feeding practices.

A study of 528 boys and girls, aged 13-15 years utilizing a self-reporting mechanism indicates that for both girls and boys a lower perceived parental responsibility for food leads to more unhealthy eating-related attitudes. Pressure to eat (for girls) and perceived parental food restriction (for boys) also appears to contribute to unhealthy eating-related habits in adolescents.

Journal of Adolescent Health 
Puberty & pulmonary exacerbations in Cystic Fibrosis (CF).

A study of 5,137 boys and girls with CF followed through puberty (age of onset in girls 11.2 years, in boys 13.2 years) indicates that though their pre- and post pulmonary functions are not different pre and post puberty, girls have a significantly higher rate of pulmonary exacerbations post-puberty. The role of sex hormones in the disease process remains unknown.


Pediatric Pulmonology

Celiac Disease.

"Celiac disease, triggered by the ingestion of gluten in genetically predisposed individuals, is the most common (approximately 1% of the general population) genetically based food intolerance in the world."  


The bowel manifestation (chronic diarrhea, failure to thrive and abdominal distention) may present at any age and extraintestinal presentations are becoming increasingly more common. These include dermatitis herpetiformis, anemia, dental enamel hypoplasia, recurrent oral aphthae, short stature, osteoporosis, arthritis, neurologic problems and female infertility. While a strict gluten-free diet will result in clinical symptom improvement, compliance and quality-of-life issues remain important.


JAMA Pediatrics 

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