Aug. 30, 2017
Volume VIII |  Issue No. 35


Cyclosporiasis outbreak 2017
Cyclospora cayetanensis is a parasite that contaminates water and food from infected persons' stool. The sporulated oocytes are ingested freeing the sporozoite to invade the small intestinal epithelium where after approximately 7 days, symptoms of nausea, abdominal cramps and diarrhea result. Without antibiotic treatment recurrent cycles of illness may persist for many weeks.

It appears from the latest update from the CDC that there has been a substantial increase in cyclospora infections this year.

CDC
Do children need to come to childhood obesity treatment with their parent for it to be effective?
From a randomized clinical trial of 150 obese children and their parent, it appears that over 24 months seeing a parent-only (without the child) for childhood obesity is as effective on child weight loss (energy intake and child physical activity) as a family-based (parent and child) program.

Emergency Department (ED) nebulized hypertonic saline (HS) treatment for acute bronchiolitis
A randomized, multicenter, double-blind clinical trial investigated hospital admission rates in 777 healthy infants diagnosed with first episode moderate to severe bronchiolitis who received either 3% HS or normal saline 0.9% in the the ED (two, twenty minute treatments, twenty minutes apart ).
 
Hospital admission rates in the first 24 hours after management, indicates that HS does not significantly reduce hospitalization rates, but does result in more frequent adverse events (worsening cough).
 
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Maternal weight and neurocognitive outcomes in extremely low gestational age (ELBW) babies

From a study of 535 ELBW babies followed developmentally to 10 years of age it appears that:
  1. Maternal pre-pregnancy obesity is linked to lower verbal IQ score, poorer processing speeds/fine motor control in their infants.
  2. Obesity during pregnancy results in lower oral and language scores.
  3. Children born to mothers who fail to gain sufficient weight during pregnancy perform poorly on scales that measure oral/written language skills and reading.
Video Feature
You and Your Microbiome: Is This Why I'm Allergic to Peanuts? The University of Chicago
You and Your Microbiome: Is This Why I'm Allergic to Peanuts?
The University of Chicago
Long-term clinical and immunological effects of probiotic and peanut oral immunotherapy
   
A four-year follow-up study was undertaken of 86% of eligible participants from a randomized double-blind placebo-controlled trial of a combination of probiotic and peanut oral immunotherapy (PPOIT) which had previously been shown to induce desensitization and two-week sustained unresponsiveness to peanut ingestion. Peanut intake and adverse reactions to peanuts in the four years following treatment was documented, and in addition skin prick tests, and SlgE/SIgG4 concentrations were measured in a placebo-controlled peanut challenge at 8 weeks.

At four year post peanut immunization, follow-up findings include:
  1. Participants from the PPOIT group are significantly more likely to continue eating peanuts.
  2. PPOIT provides sustained suppression of the allergic immune response to peanut ingestion over an 8-week-period.
  3. PPOIT provides long-term lasting clinical benefits with no increase in adverse incidence following peanut ingestion.
Pseudotumor cerebri syndrome (PTCS) in childhood
 
PTCS (also called "idiopathic intracranial hypertension") is defined by clinical criteria that includes symptoms and signs isolated to those produced by increased intracranial pressure (headache, papilledema and vision loss), normal cerebro-spinal fluid composition, and no cause found following investigation. Its prevalence in children is unknown and it tends to occur in children older than 11 years of age, with no sex predilection.

A national prospective population-based cohort study over 25 months examined epidemiology, clinical profile and risk factors of 166 PTCS children aged 1-16 years.

For the UK the national incidence of PTCS is 0.71 per 100,000 population increasing with age and weight to 4.18-10.7/100,000 population in obese boys and girls aged 12-15 years respectively.

In PTCS children >7 years of age most (91%) present with a headache, on medication, are obese and predominantly female.

PTCS in children is commonly associated with obesity which may be central to prevention.

See related video HERE>>
Caffeine citrate therapy for apnea of prematurity - long term effects
   
Caffeine citrate appears to be the first-line preferred pharmacotherapeutic agent for apnea of prematurity; (a common complication) as it has a wide therapeutic window, reduces the rate of bronchopulmonary dysplasia, severe retinopathy, neurodevelopmental disability at 18 months and has few adverse effects.
 
A follow-up study to the Caffeine for Apnea of Prematurity trial was conducted on 920 children which examined a composite of poor academic performance, motor impairment and behavior problems found (compared to a matched placebo treated group) that neonatal caffeine therapy is effective and safe , and no significant differences from controls noted for any of the domains examined.
 
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Meet Saima Aftab, MD - Perinatal Medicine at Nicklaus Children's Hospital