Dec. 28, 2016
Volume VII | Issue No. 52

Migraine and cardiovascular risk in children 
Headaches in children are common; perhaps 55%-75% of children between the ages of 12-17 years report having had one within the previous month. 5% of children are reported to have had migraine headaches by age 15 years.

Carotid wall intima-media thickness (cIMT) is an ultrasound measurement which detects the presence of atherosclerotic disease.

A study comparing cIMT of 30 children/adolescents with migraine to a comparably matched control non-affected group of children indicates that migraineous children have significantly thicker cIMT's which potentially places them at greater risk for cardiovascular disease and stroke.

Acta Paediatrica

Migraine Sufferer Risk of Stroke or MS
Migraine Sufferer Risk of Stroke or MS
What is Carotid Intima Media (CIMT) testing?
What is Carotid Intima Media (CIMT) testing?
Association between cesarean birth and risk of obesity from childhood through young adulthood 
A cohort study of 22,068 offspring and 15,271 mothers whose babies were followed (by questionnaire) to age 28 years, indicates that cesarean birth is associated with offspring obesity (after accounting for major confounding factors) and that within-family analysis, babies born by cesarean delivery have 64% higher odds of obesity than their siblings born vaginally.

What's new in pediatric flat foot?
A review of recent literature regarding the evaluation and management of pediatric flat feet (flexible flat feet vs. a rigid deformity which may have an underlying bone abnormality) indicates that flat feet in children are often unnecessarily treated with very little evidence for any benefit for non-surgical interventions.
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Neuropathy in Hereditary Fructose Intolerance (HFI) 

The three dietary monosaccharides are the basic units of carbohydrates, and include glucose (dextrose), fructose (a 6-carbon polyhydroxyketone) and galactose.

Absorbed fructose is mono-phosphorylated before being cleaved by aldolase into glyceride and acetone phosphate, which are then metabolized through the citric acid and other metabolic pathways.

HFI is an inherited, autosomal inability to metabolize fructose due to a deficiency of activity of the enzyme fructose-1-phosphate aldolase located at 9q22.3. This results in its accumulation in the liver, kidney and small intestine with most infants presenting with vomiting, hypoglycemia, jaundice, hemorrhage, hepatomegaly and hyperuricemia on introduction of fruits in the diet. Older children learn to avoid a diet containing fructose and may then be asymptomatic.

An interesting and never before described presentation of a 5 year old boy with HFI and neurologic signs reminds us that a relapsing and remitting neuropathy may occur in HFI children exposed to low-level fructose, usually presenting prior to  diagnosis.

Video Feature
The role of pre-hospital advanced airway management (AAM) on outcomes for out-of-hospital cardiac arrest (OHCA) 
A systematic examination from a number of databases which reviewed adult non-traumatic OHCA and pre-hospital interventions, indicates that AAM appears to offer no greater benefit for survival or neurological outcome compared to basic airway management.

Pathological lead points and intussusception in infants/children

Approximately 60 % of babies/infants who develop intussusception do so between that ages of 2 months and 1 year of age, with boys having a fourfold greater likelihood than girls. Frequently the cause of intussusception is unknown, however a systematic review of the literature to evaluate the incidence of and the types of pathological lead points found, indicates that pathological lead points are present in 0.3% to 20% of infants/children and may be mucosal, intramural or extrinsic in character.

Impact of timing of introduction of solids on infant body mass index (BMI)

Data from a study of 3,153 infants where the association between breast feeding duration, age at solids introduction and their interaction on infants' (aged 9-15 months) BMI indicates that longer full or partial breast feeding is associated with a decreased likelihood of an above normal BMI and that the introduction of solids at 5-6 months appears optimum for subsequent BMI (solid feeds introduced before or after that time is associated with greater odds of a higher BMI in the infant at 1 year of age).
Food systems and diets: Facing the challenges of the 21st century
2016 | London, U.K.
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