April 15, 2015   Vol. VI, Issue 15
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Duration of pertussis immunity after DTaP immunization.

Independent of whether a 3 or 5 dose regimen of DTaP is given to children, for every additional year after the last does the odds of pertussis increases by 1.33 times, resulting in only 10% of children being immune by 8.5 years post immunization. Though DTaP may be safer, early booster doses may be required to maintain "herd effect."



Relationship between prenatal and postnatal exposures to folate and risks of allergic/respiratory diseases in childhood.

Folate (folic acid/Vitamin B6/Vitamin B9 etc.) is a B vitamin which is converted to tetrahydrofolate and other derivatives which have numerous "essential" bodily functions to synthesize and repair DNA, produce red blood cells, etc., and is particularly important in aiding oocyte maturation, implantation, placentation and rapid cell growth and division. 400/mcg/day protects against a number of congenital malformations (most notably neural tube defects) and appears to reduce premature delivery.


A study involving 917 mother-child pairs from a prospective birth cohort evaluated data regarding children's allergic and respiratory outcomes/serum folate levels at postnatal months 6, 12, and 24. Atopic biomarkers were measured in cord blood and at 24 months after birth and biomarkers/clinical outcomes and serum folate status assessed.


A relatively high maternal serum folate level at mid pregnancy appears to be child protective for lower respiratory tract infections at 6 months and atopic dermatitis at 24 months of age.


Pediatric Pulmonology 

A pilot study on the protein composition of induced nonpuerperal human milk.

A study of total protein, secretory immunoglobulin A (sIgA), lysozyme and lactoferrin from induced lactation in non-pregnant women, over a two month period indicates that the milk has similar or higher levels of total protein etc. Adoptive mothers of infants may choose to induce breast milk.


Journal of Human Lactation 

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Motivating adherence among adolescents with Cystic Fibrosis (CF)


Early diagnosis and complex treatment regimens have contributed to the increased survival rate of CF patients from 6 months (when first described in 1938) to over 35 years in the USA by 2010. "The high treatment burden poses challenges to chronic disease self-management, particularly amongst adolescents". Many barriers to CF management exist.

Cystic fibrosis complications
Cystic fibrosis complications


Multiple themes to enhancing adherence, e.g. establishing structured routines, shifting responsibilities from parent to adolescent, etc. exist to achieve optimum management.  A multidisciplinary team is required.


Pediatric Pulmonology 

Cesarean section (C/S) and chronic immune disorders.


A study 2,000,000 term children over a 35 year period examined the relationship between C/S and the risk for chronic immune diseases in childhood.


Children delivered by C/S appear to be at significantly increased risk for asthma, systemic connective tissue disorders, inflammatory bowel diseases, immune deficiencies and leukemia. The underlying mechanisms involved remain unclear.



Core symptoms of autism improve after Vitamin D supplementation


Autism spectrum disorder (ASD) results from complex interactions between genetic and environmental risk factors. Vitamin D3 plays an important role in brain development with decreased levels causing multiple anatomical abnormalities which are similar to those seen in ASD patients.


An interesting case report of a 32 month old boy with core symptoms of ASD and Vitamin D3 deficiency whose ASD symptoms improved significantly after vitamin D3 treatment suggests a relationship between them and the importance of assessing Vitamin D3 levels in ASD patients.



Video Feature 

(via YouTube)
Vitamin D Deficiency In Autism--What Causes It?
Vitamin D Deficiency In Autism--What Causes It?

Presepsin (P-SEP) for the detection of late onset sepsis (LOS) in preterm infants.


P-SEP or soluble CD14 subtype is a glycoprotein cell surface receptor (on monocytes, macrophages and neutrophils) that after interaction with lipopolysaccharide (LPS) and LPS binding protein, is released (as part of an immune response) and cleaved by bacterial lysosomal enzymes to a terminal peptide termed P-SEP. P-SEP measured in adults appears to be a reliable diagnostic and prognostic marker of sepsis.


A prospective study of 19, >32 weeks gestation neonates (and matched controls) evaluated LOS, & levels of CRP, procalcetonin (PCP) and P-SEP levels form baseline diagnosis over time, as biomarkers of infection.


A P-SEP level >885 ng/L has 94% sensitivity and 100% specificity in LOS infants. Levels remain high for days 1 to 5. P-SEP may play an important role in diagnosing LOS in premature infants. (CRP values peak at 2-3 days - these values may increase after non-infective inflammatory events: PCT peaks at 10-12 hours after infection but has not apparently been extensively investigated for this purpose). 




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