Miami, FL
Aug. 1, 2018
Volume IX | Issue No. 31
Prevalence of childhood permanent hearing loss after early complex cardiac surgery
A prospective observational study for permanent hearing loss (PHL) in 691 infants who underwent complex cardiac surgery with cardiopulmonary bypass at <6 weeks of life and audiologically followed for at least 2 years post-surgery, indicates that 5.9% have PHL of whom 10% have permanent CONDUCTIVE, and 90% moderate to profound SENSORINEURAL loss.
Early cardiac surgery with cardiopulmonary bypass is a significant risk factor for permanent hearing loss.
Maternal intrapartum antibiotic administration and infantile colic 
Infantile colic is common (10-40%), characterized by excessive paroxysmal crying/fussing and while it is a self-limiting condition it results in significant discomfort and anxiety to infant and family. Cause/s are unknown, however altered gut microbiota composition has been previously reported in these infants.
A study of 45 infants with colic (and 29 normal controls) was undertaken to determine whether this is any association between perinatal factors (intrapartum antibiotics and breast feeding) and gut microbiol colonization/infantile colic.
Infantile colic appears to be significantly and directly associated with maternal intrapartum antibiotic use (and inversely associated with breast feeding rate).
See related video HERE, HERE & HERE.  
Anatomic indicators of neurodevelopment in very low birth weight infants (VLBWs) 
From a relationship study between nutritional status, brain volume (measured by magnetic resonance imaging- MRI) anthropometric measurements in 27 VLBW infants (gestational age 29.7 weeks, birth weight 1,117gms; protein intake 2.7/g/kg/day and energy intake 97.9Kcal/kg/day) it appears that at term-equivalent age, body length and occipitofrontal circumference best reflect brain white matter volume (loss of white matter volume has been associated with neurocognitive impairment; Ed).

Childhood Obesity Facts 
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Hypercholesterinemia and hypertriglyceridemia in children with Nonalcoholic Fatty Liver Disease (NAFLD)
NAFLD is a condition in which fat builds up in the liver and which typically causes few symptoms in children. It is more frequently found in those who are obese, have metabolic syndrome or type 2 diabetes. Eating a healthy diet and maintaining a healthy weight can prevent NAFLD.

A multicenter, longitudinal cohort study of 585 children (mean age: 12.8 years) diagnosed with NAFLD were investigated to assess who would meet criteria for dyslipidemic intervention following one year of standardized dietary recommendations.

14% of NAFLD children meet low-density lipoprotein cholesterol, and 51% triglyceride levels requiring intervention. After one year of appropriate dieting, 22% of children with elevated low-density lipoprotein cholesterol and 37% with elevated triglyceride levels require antihyperlipidemic medication.

Video Feature
Non-alcoholic fatty liver disease (NAFLD) - causes, symptoms, diagnosis, treatment, pathology
Non-alcoholic fatty liver disease (NAFLD) - causes, symptoms, diagnosis, treatment, pathology
Clinical characteristics of children presenting with a suspicion or allegation of historic sexual abuse 

Among 249 children and adolescents who present with a history (>3-7 days after last assault) or a suspicion of childhood sexual abuse, younger children (<13 years of age) present with physical/behavioral symptoms, with 7% presenting with anogenital findings and 2.6% with sexually transmitted infections. Alleged perpetrators are intra-familial in 66% of patients.

See related video HERE & HERE .
Zika infection in postnatal children 

While Zika virus infection in the mainland of the USA has become rare (many infections now found are acquired outside the USA), several important lessons have been learned from the 2015 continental epidemic.
  1. Zika virus is not only spread by mosquito bite but it is also transmitted efficiently from human to human by body fluids.
  2. Its neurotrophic action leads to a 2-3 fold increase in the incidence of Guillain-Barre syndrome and,
  3. 5-10% of infections during pregnancy result in Congenital Zika Syndrome.
An extensive study of Zika infection in children and adolescents indicates that post-natally acquired Zika virus infection presents as just another febrile illness (<7 days duration) with a maculopapular pruritic rash (and face and neck erythema), non-purulent conjunctivitis and arthritis or arthralgia.
Infants (<1 year of age) and children (1-4 years) have a 12- and 7-fold increased likelihood of being hospitalized.
Subtle neurological and neurodevelopmental sequelae may occur particularly in those infants infected in the first 2 years of life.
Ovarian torsion in pediatric and adolescent patients

A systematic review by the American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee examined multiple databases to provide recommendations regarding the optimal treatment of ovarian torsion.

From 96 studies "there appears to be overwhelming evidence supporting ovarian detorsion rather oophorectomy for the management of ovarian torsion in pediatric patients. Most salvaged ovaries will maintain viability after detorsion."
Meet Nao Sasaki, MD - The Heart Program at Nicklaus Children's Hospital
Meet Nao Sasaki, MD - The Heart Program at Nicklaus Children's Hospital
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