Miami, FL
Dec. 19, 2018
Volume IX | Issue No. 51
Smart device usage in early childhood 
A study of 117 children aged 3-5 years examined yearly the relationship between smart device (e.g. smart phones and tablet computers) usage and developmental level and receptive/expressive language.

Smart device use frequently and significantly improves fine motors skills and social development in 3 year old children, however negatively impacts expressive language. By 4-5 years no correlations exist.

See related video HERE.  
Diagnosis of Kawasaki disease (KD) using a minimal whole blood gene expression signature 
Gene expression profiling is the measurement of the activity of thousands of genes at one time and the whole genome can be measured.
KD is an acute inflammatory disorder and a common cause of acquired heart disease from vasculitis affecting predominantly the coronary arteries and usually seen in young children. KD is difficult to distinguish from other common febrile conditions as symptoms are similar; delay however in diagnosis enhances the likelihood of coronary artery aneurysms. 
A case-controlled study of 606 children with inflammatory infectious conditions, KD and healthy controls examined whether KD could be accurately diagnosed on the basis of host gene expression. 
A 13 gene transcript in whole blood accurately diagnoses KD which is a major step forward in the earlier and better management of KD.
Probiotics to prevent clostridium difficile (c. difficile) infection in patients receiving antibiotics 
A retrospective Cochrane review which examined 31 randomized clinical trial (9,955 patients, adults and children) in which probiotics were co-prescribed with antibiotics, indicates that there is modest quality evidence suggesting that the use of probiotics and antibiotics is associated with a lower risk of c. difficile infection.
Childhood Obesity Facts 
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Energy drinks and vascular function 
Ingesting just one energy drink reduces the ability of arteries to dilate by 50%. Young persons who consume energy drinks prior to and during physical exercise increase their heart rate and blood pressure which return to normal by 90 minutes, however endothelial function (peak-flow mediated dilation response) remains significantly reduced. 
Energy drinks (unregulated by the FDA) contain primarily caffeine and sugar, and a proprietary energy mix may also include amino acids, glucose precursors and vitamins often at very high doses which can place children (particularly those taking stimulants like Ritalin) and pregnant women at particular high risk.
See related video HERE
Acute flaccid myelitis (AFM) 
AFM is a relatively rare (134 patients in 2018) "polio-like" serious spinal cord disorder (CDC has been investigating these cases since 2014 with a total of 458 cases having now been confirmed); of childhood (90%), mean age 6.1 years; 60% boys, 82% white, occurring primarily between the months of August and October. Specifically it is an inflammation of the spinal cord grey matter which results in the sudden onset of localized reflex and muscle/limb flaccidity/weakness (facial weakness, difficulty in swallowing and respiratory failure may occur). 
It appears that most (90%) of those affected have had a prior mild viral respiratory illness (enterovirus but also coxsackie and others) and 24% of children examined have an alternative neurologic diagnosis (transverse myelitis, other demyelinating syndromes, spinal cord stroke, Guillain-Barre syndrome, Chiari I myelopathy, and meningitis). Confirmatory laboratory criteria include magnetic resonance imaging (MRI) showing a spinal cord lesion primarily of the grey matter (a normal MRI in the first 72 hours of the illness does not rule out AFM) and spanning one or more segments with a cerebral spinal fluid (CSF) showing a pleocytosis. Treatment is symptomatic. At 1 year follow up, most children will have functional improvement however long term outcomes remain unresolved.
Video Feature
Acute Flaccid Myelitis - Nebraska Medicine
Acute Flaccid Myelitis - Nebraska Medicine
Immunologic effects of caregiver sucking a baby's pacifier to clean it 
From a new study in which 128 mothers of infants (collected over an 18 month period), 58% of whom reported sucking their infants' pacifier as its cleaning method, it appears that infant IgE levels are significantly suppressed beginning around 10 months and continuing through 18 months of age.
Cerebral spinal fluid (CSF) cytokine profile to discriminate infection from non-infectious central nervous system (CNS) disorders  
Current laboratory tests of CSF do not rapidly distinguish infectious from other brain and spinal cord disorders that present with similar and/or overlapping clinical presentations. Rapid identification is obviously critical to implementing appropriate treatments. Due to the fluids' close anatomic relationship to the central nervous system, the CSF is a convenient conduit for inflammatory mediators and signaling proteins released during changes in the CNS environment whether due to infection, tissue damage or mass lesion. 
A retrospective study of 43 samples of CSF (from patients aged 2-80 years obtained and de-identified (plus controls samples from neuro-negative patients) examined (using the human Cytokine/Chemokine Magnetic Bead Panel Millipore plates on a Luminex FlexMPA 3D) a variety of inflammatory mediators to determine the utility of cytokine patterns in differentiating CNS infections from other CNS diseases. 
CSF cytokine levels appear to have a great potential to provide information and rapid identification of CNS disease; infectious vs. noninfectious.
The Fetal Care Center Special Delivery Unit
The Fetal Care Center Special Delivery Unit
Take the December Quiz !

What is a CellScope Oto?

How much do you know about male circumcision in the USA?

Abdominal pain, increased pancreatic size (mass or diffuse) and obstructive jaundice are associated with which childhood condition?

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