"Alice in Wonderland" syndrome (AIWS) or Todd's syndrome
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AIWS is a rare disorienting neurological condition that primarily affects children (65%) in which affected children experience an array of short (<1 hours) but frequent (several times a day) visual perception symptoms which include distorted visual images of the body, time and space.
AIWS has been associated in children with migraine, epilepsy, infections (particularly infectious mononucleosis) brain tumors/lesions, drugs (particularly cough medicine), psychiatric disorders or it may be idiopathic. Treatment is directed at the underlying cause.
US National Library of Medicine National Institutes of Health
See related video HERE, HERE & HERE. |
Sunscreen photoprotection and Vitamin D status
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From a study by 13 International experts in a variety of fields who reviewed the literature on the influence of photoprotection by sunscreens on Vitamin D status it appears that "sunscreen use for daily and recreational photoprotection does not compromise Vitamin D synthesis even when applied under optimal conditions."
The British Journal of Dermatology |
Marijuana use and the risk of developing cancer in adults
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A systematic review and meta-analysis of 25 English-language studies assessed marijuana usage (1 joint per day for 1 year) and the risk of developing lung, head and neck, urogenital and other cancers.
While sustained marijuana use
may be associated with an increase in testicular cancer, it appears that its association with the development of other cancers remains unsubstantiated.
JAMA Network Open
See related video HERE. |
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Measles antibodies levels in young infants
"The Centers for Disease Control (CDC) recommends all children get 2 doses of MMR (Measles-mumps-rubella) vaccine starting with the first dose at 12-15 months of age and second dose at 4-6 years of age." Infants are often assumed to be immune to measles prior to their first measles vaccine through antibodies transferred during pregnancy.
A study of 196 infant sera which measured protective levels of measles' antibodies prior to 1 year of age indicates:
- At 1 month of age, 20% of antibody levels are below the protective threshold
- At 3 months of age 92% have less than protective levels
- At 6 months of age all infants have titers below the protective threshold
Most infants appear susceptible to measles by 3 months of age (a larger study might clarify our discussion regarding the optimal times to administer measles vaccine).
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Milking of the umbilical cord in term and late preterm infants
"Delayed clamping" of the umbilical cord (at least 30 seconds after birth) improves neonatal outcomes through a number of methodologies (enhanced placental transfusion, increased neonatal hemoglobin levels with more red cells perfusion of vital organs, enhanced iron stores and decreased anemia later in childhood). This may not be possible for those infants who are depressed at birth and/or require resuscitation.
"Cord milking" i.e. the rapid "stripping" of blood from the umbilical cord to the newborn may be a viable alternative in this scenario.
A retrospective search of all articles pertaining to "placental transfusion" examined outcomes for all term/late preterm infants after umbilical "cord milking."
It appears that "cord milking" has similar beneficial effects to "delayed cord clamping" with improved language and cognitive scores in the very preterm infant (unfortunately much variation in practice occurs and more studies are required before a standardized protocol can be established).
BioMed Research International
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Video Feature
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Hansa on Medicine: Clearing Up Sunscreen Confusion
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Cognitive behavioral treatments (CBT) for anxiety in children with Autism Spectrum Disorder (ASD)
Maladaptive and interfering anxiety is common among youth with ASD often hindering functioning.
A randomized, blinded clinical trial of 167 children (7-13 years of age) with ASD with significant anxiety assessed and compared 2 variants of CBT (CBT and CBT adapted for ASD to include social communication and self-regulation) to treatment-as-usual (TAU), outcomes. (The efficacy of psychological treatments in ASD, though often used, has not apparently been well-established).
CBT adapted for ASD outperforms standard-of-practice CBT and treatment-as-usual outcomes on internalizing symptoms, ASD-associated social-communication symptoms and anxiety-associated social functioning. Both CBT treatments outperform TAU in all categories measured in school-aged children with ASD and interfering anxiety.
JAMA Psychiatry
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"Gastric pneumatosis" or air in the wall of the stomach is a rare condition described in both pediatric and adult population from both infectious and non-infectious etiologies. It can present with or without the presence of air in the portal venous system and is divided into 2 distinct disease categories, "emphysematous gastritis" and "gastric emphysema."
"Emphysematous gastritis" is typically used to describe conditions caused by inflammation, infection (E. Coli, Streptococcus species, Enterobacter species, Pseudomonas aeruginosa) or ischemia and carries a high mortality rate. It usually occurs in high risk patients such as those with a history of abdominal surgery, bowel infection, immunosuppression, ingestion of corrosive substances and/or others. Patients will frequently present looking seriously ill with abdominal pain, peritoneal signs and leukocytosis. "Gastric emphysema" is a more benign condition (though similar to the above on imaging) probably caused by a mucosal defect with allows intraluminal air to enter the wall of the stomach and may be caused by raised intragastric pressure (downstream mechanical obstruction), traumatic instrumentation, severe vomiting, mediastinal air or ischemia. Clinical presentation is "often vague and non-specific."
An interesting case report of "gastric emphysema" with portal venous gas in a 17-year-old-girl outlines the etiology, clinical presentation and management of this uncommon condition.
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