HealthFusion June 2014 B  

September 3, 2014   Vol. V, Issue 36
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Short gut syndrome & enteral fat management.

With improved survival of the premature infant the likelihood of complications has increased. Cases of necrotizing enterocolitis and/or spontaneous intestinal perforation with resulting intestinal failure/short gut syndrome have increased the need for parenteral nutrition (PN). Unfortunately this treatment modality carriers its own associated comorbidity e.g. PN related liver disease, multifactorially induced. One probable aspect of this is soy beans induced pro-inflammatory pathways from high Omega-6 fatty acid content, unfavorable ratios to Omega-3, phytosterols and low alpha-tocopherol content.


A small randomized study of premature infants post-intestinal resection who received PN plus either a standard enteral feed vs. one with supplemental fat from safflower and fish oils (high Omega-6 and -3) indicates that this combination added to an enteral feed enhances caloric intake, weight and length gain, lower serum bilirubin levels, fewer sepsis episodes with a lower fat intake being necessary.


Journal of Pediatrics


Journal of Pediatrics

Vitamin D levels & acute wheeze in young children.

130 children (age 6 months - 4 years) with acute wheeze (age-matched to controls with no history of wheeze or sensitization), had blood analyzed for specific allergens ( airborne and food ), level of 25 hydroxyvitamin D (25 (OH) D), nasopharyngeal samples taken for viral and bacterial testing, and a parental questionnaire, completed.


Vitamin D insufficiency (<30ng/ml) is associated with a 2.7 increased likelihood for acute wheeze (no association found for Vitamin D level, atopy and the presence of viral/bacterial or recurrent infections).


Acta Paediatrica 



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Severe childhood atopy, forward bulging of the cornea (corneal ectasia) & corneal hydrops.  


"Corneal ectasia" is the forward bulging and thinning of the cornea from a disease process (e.g. keratoconus - a degenerative disorder of the eye which causes the cornea to become more conical in shape; trauma; raised intraocular pressure or as a complication of photorefractive surgery).

"Corneal hydrops" is the increased accumulation of watery fluid in the cornea as a result of the rupture of the posterior membranes of the cornea.


An interesting case report on the clinical course of an 8 year old severely atopic child who developed acute bilateral corneal hydrops secondary to keratoconus reminds us that it is important to refer children with significant atopy for comprehensive eye examination, even in the absence of visual symptoms.



Video Feature
Teen Sexual Activity - Arif Hussain Khan
Teen Sexual Activity - Arif Hussain Khan
via YouTube

Pearly penile papules


Pearly penile papules are single or multiple rows of small (2mm-3mm), uniform, symmetrical, smooth, dome shaped, pearly white, warty, benign, non-infectious asymptomatic papules located circumferentially, usually over the corona (dorsum mainly) of the penis, frequently seen in the second and third decades of life (8%-30% of post-pubertal males). They do not affect sexual intercourse. As they regress with age treatment is usually not required. 


Journal of Pediatrics 

Countrywide- level age norms & initial timing of sexual activity in adolescents.  


An examination of data from 17 European countries (European Social Survey and Health Behavior in School-Aged Children Study) where country level and age at sexual initiation norm 

responses were generated by the answer to the question "at what age is someone too young (defined as <15 years of age) to have sexual intercourse," and age at which sexual intercourse occurred, indicates that higher overall country and parental age norms are associated with decreased likelihood of early sexual activity among both girls and boys. Peer pressure appears to have little effect on age of sexual initiation.


Journal of Adolescent Health

Motor performance after neonatal Extracorporeal Membrane Oxygenation (ECMO) - A 12 Year Study  


254 neonatal post-ECMO infants (primary diagnoses: meconium aspiration, congenital diaphragmatic hernia, persistent pulmonary hypertension of the newborn) were evaluated (and compared to matched population norms) for motor function at 5, 8 and 12 years of age.


74%, 75% and 40.5% of post neonatal ECMO children have normal motor function at 5, 8, and 12 years respectively (compared to an expected population norm of 85%). Post-ECMO children have increased motor problems which become more obvious over time.



Pearl of the Week 


Everyone is trying to accomplish something big, not realizing that life is made up of little things.

-Frank A. Clark


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