June 24, 2015
Volume VI, Issue No. 25

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Rare copy number variance (CNV's) in young children with autism spectrum disorder (ASD)

Copy-number variations are structural alterations of fairly large regions of the genome DNA (maybe as large as one thousand nucleotides bases as opposed to single-nucleotide polymorphisms (SNP) where only one single nucleotide base is affected) which usually results in one or more sections of the DNA being duplicated or deleted.

In ASD, many investigations implicate a variety of gene mutations frequently involving those that coordinate synaptic transmission.


A study using chromosomal microarray technology (CN) on samples from 162 children diagnosed with ASD indicates that this technology identifies pathogenic CNV's in 8.6% of patients (while CN methods are valuable in early detection of genetic abnormalities in ASD, whole-exome and whole-genome sequencing technologies will probably replace this in the near future).


Acta Paediatrica 

Education about infant crying and pediatric Emergency Department visits for "crying complaints"

A study of 0-5 month old infants seen in a medical emergency department (MED) for a diagnosis of "crying" (no disease process found) prior to and following a province-wide (Canada) implementation of a public health prevention program, indicates that educating parents about the characteristics of normal crying significantly reduces (29.9%) MED visits with "crying" as the main complaint.


Journal of Developmental and Behavioral Pediatrics 

Effectiveness of pediatric pill swallowing intervention

Children having difficulty swallowing pills is by no means uncommon; many however can be taught to achieve this with appropriate management techniques.


A pub med search to identify articles that evaluated interventions to assist children to swallow pills found a variety of successful interventions which included behavioral therapy, flavored throat sprays, verbal instructions, specialized pill cups and head posture training. (Many other articles are available outlining a variety of methodologies perhaps worth trying. Ed).





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Demographic and clinical predictors of response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders


Anxiety is a normal reaction to stress. When excessive however it may become a disabling condition. Examples in children include obsessive compulsive disorder, post-traumatic stress disorder, social phobia, specific phobias and generalized anxiety disorder. Symptoms may begin in childhood (around age 6 years) or adolescence. Approximately 8% of 13-18 year olds appear to have anxiety disorders with most receiving no mental health treatment.


A study evaluated 1,519 children with a primary diagnosis of anxiety who received CBT; outcomes were analyzed post-treatment at 3-6 and/or 12 month follow up.


The presence of parental psychopathology, social anxiety disorder, non-anxiety comorbid mood and/or externalizing disorders are associated with poorer outcomes after CBT.


Journal of the American Academy of Child and Adolescent Psychiatry 

Video Feature

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Bordetella pertussis and children hospitalized with bronchiolitis during winter


98% of 2207 infants (<2 years) hospitalized with a diagnosis of bronchiolitis are found on investigation to have one or more respiratory pathogens.


B. Pertussis is a very uncommon (0.2%) pathogen in US infants hospitalized with bronchiolitis in the winter. (Pertussis vaccination of women during pregnancy or immediately following delivery results in significantly higher anti-pertussis antibodies in breast milk vs. those mothers immunized >5 years prior to pregnancy).


Pediatric Infectious Disease Journal 


Pediatric Infectious Disease Journal 

Review of pharmacological clinical trials in children with Functional Abdominal Pain Disorders (AP-FGID's)


Functional Abdominal Pain
Functional Abdominal Pain

Though functional abdominal pain in children is the most common cause of pediatric gastroenterological consultations, a comprehensive review of pharmacological clinical trials reveals no medication/s apparently "approved" to treat this group of conditions. Various non-pharmacological remedies have been reported with some evidence to support hypnotherapy, cognitive behavioral therapy and probiotics (VSL3) only, though high-quality studies are lacking.


Journal of Pediatric Gastroenterology and Nutrition



Best treatment for Otorrhea in Children with Tympanostomy Tubes (TT)


Acute Otorrhea is common in children with TT and is usually considered to be an acute infectious episode similar to acute otitis media.


An open label pragmatic trial in which 230 children with acute uncomplicated TT ottorrhea were randomly treated with one of three regimens which included hydrocortisone-bacitracin-colistin ear drops, oral amoxicillin-clavulanate suspension and observation without specific medication,  indicates that glucocorticoid-antibiotic eardrops are the most efficacious and cost effective.



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