May 10, 2017
Volume VIII |  Issue No. 19

Transient elastography and severity of Cystic Fibrosis (CF) related liver disease
Transient elastography is a non-invasive method to quantify liver stiffness (fibrosis) and steatosis (fatty infiltration/degeneration) using an ultrasound probe pressed in-between the ribs.

A study of 249 children (mean age 14 years) evaluated whether liver stiffness measurement (LSM) as determined by transient elastography, correlates with the severity of liver disease using clinical parameters in children and young adults with CF.

LSM appears superior to clinical indicators in separating severity of CF liver disease with and without portal hypertension.
Warm lidocaine/tetracaine patch (LTP) vs. lidocaine/prilocaine cream (EMLA) for needle procedure pain 
LTP (Synera) and EMLA are local anesthetics commonly used (use, dose, procedure and length of time dependent on age of child) before minor procedures and may be of particular value in those children who complain of pain during venipuncture or intravenous cannulation.

A study of 172 children (3-10 years of age) randomly assigned to receive LTP or EMLA cream respectively which examined how many needle procedures were successful at first attempt indicates that success rates are better with the warm lidocaine and tetracaine patch (though pain scores are similar).

Feeding expressed breast milk (fresh or pasteurized) for very preterm infants
Since 2005, the French Food Safety Agency has recommended that very preterm or low birth weight babies be fed with pasteurized expressed breast milk.

A study which analyzed data (in-house hospital length of stay, mortality, necrotizing enterocolitis, bronchopulmonary dysplasia, late onset sepsis, weight gain, etc.) in 926 very preterm infants (636 receiving mothers' own fresh milk and 290 where pasteurized mothers' milk was used) indicates that feeding very preterm infants with their mothers' expressed fresh milk is associated with a reduced risk of bronchopulmonary dysplasia (no other significant differences noted).
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Infant respiratory tract infection (RTI) or wheeze, and maternal Vitamin D in pregnancy

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods. It is however produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis, following which it undergoes two hydroxylations (in the liver and then kidneys) to the physiologically active 1,25-dyhadroxy vitamin D (or calcitriol). Besides bone growth, remodeling and strength, it modulates immune functions and reduces inflammation (plus other cellular actions).

A systematic search from a number of databases examined randomized controlled trials (RCTs) on the effect of vitamin D supplementation during pregnancy and respiratory tract infection or wheeze in children <5 years of age.

Though the number of RCT are few, there appears to be growing evidence that vitamin D supplementation during pregnancy prevents offspring RTIs and/or wheezing during childhood.

Long-term health-related quality of life (HRQoL) and psychological adjustment in children after haemolytic-uraemic syndrome (HUS)

From a study of 62 children diagnosed with HUS at 6.5 years (mean) previously, where HRQoL and behavioral problems were examined, it appears that in preschool children parents report them to be less lively and energetic (HRQoL emotional dimensions), while school-aged children appear to have increased behavioral problems.

Video Feature
How to Recognize the Early Signs of Autism
How to Recognize the Early Signs of Autism

See additional videos below:

Early Detection Tests for Autism  

Response to "name" in infants developing Autism Spectrum Disorders (ASD) 

A study of 156 infant siblings of children at high risk for ASD, examined "name response" (tested at 6, 9, 12, 15, 18, and 24 months of age), and classified them at 36 months as:
  1. Having ASD.
  2. Being in a high-risk group without having ASD.
  3. Low risk (typical development controls) group.
At 9 months of age infants developing ASD are more unlikely to orient to their names (this persists through 24 months).

"Name response" is a valuable adjunct screening tool (In addition to routine broad-based and ASD-specific screening), in all infants at risk for ASD.

Home-based hypnotherapy self-exercises vs. individual hypnotherapy (HT) for the treatment of pediatric Irritable Bowel Syndrome (IBS), Functional abdominal pain (FAP) or Functional abdominal pain syndrome (FAP[S])
"Individual gut-directed hypnotherapy is effective in pediatric irritable bowel syndrome and functional abdominal pain or functional abdominal pain syndrome." This however is not available for all children.

A study which compared the effectiveness of home-based HT in 260 children (aged 8-18 years) with IBS or FAP(S) using a CD, with that of individualized HT with a therapist, at one year after the end of treatment, indicates that home-based HT with a CD is just as effective as individual therapy in pediatric IBS or FAP(S).

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