Dec. 30, 2015
Volume VI, Issue No. 52

Physicians' counseling of adolescents regarding E-cigarette use
E-cigarette use by adolescents in the USA now surpasses conventional cigarette usage.

It appears that many physicians (41%) tell their patients that E-cigarette use is less harmful than cigarettes. As data regarding its use to reduce cigarette smoking is still controversial and as an increasing number of potentially harmful substances (containing formaldehyde, nicotine and other substances) are being "vapped", it appears wise for all physicians to cease recommending E-cigarette use to decrease conventional cigarette smoking and to inform all patients of its potential long term deleterious effects.

Journal of Adolescent Health

See related video HERE>>
Out-of-hospital deliveries (OHDs)
Most Finnish births occur in hospital, however OHD's are apparently increasing. From a cohort study of 76,773 births (from a specific area between 1996-2011), 0.10% OHD's occur, with the number increasing toward the latter part of the study period. Factors associated with OHD include:
  1. Single status.
  2. Smoking during pregnancy.
  3. Fewer prenatal visits.
  4. Short labor.
  5. Higher number of previous births.
  6. Distance from a delivery unit
OHD infants are more likely to be admitted to a neonatal care unit and to be treated for hypothermia and infections.
Patterns of signs and symptoms of primary intracranial tumors (PIT) in children and young adults
Data from a study of 181 patients with PIT (aged 0-24 years) where age-specific changes in presentation (compared to a matched population-based group) of PIT was examined, indicates:

1.  Symptoms present with increasing frequency until diagnosis of raised intracranial pressure is made in hospitalized patients.

2.  In primary care clinical features are less specific:

     a.  Visual disturbances.
     b.  Headaches.

"An intracranial tumor should be considered in patients with relevant symptoms that do not resolve, or progress rapidly".

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Association of healthy eating, juice consumption and bacterial counts with early childhood caries
A questionnaire/salivary culture study examined in 63 preschoolers divided into three groups,

1.     Caries free children,
2.     Children with early childhood caries (ECC) and
3.     Children with severe early childhood caries (S-ECC),

for associations between dietary intake, snacking, oral health practices, family background and salivary cultures for bacteria.

Caries free young children consume significantly less drinking juices, snack less on sweets, generally have better eating habits, brush teeth and have significantly lower Streptococcal counts (compared to children with ECC and S-ECC).

Severe congenital heart disease (CHD) and brain volumes in infants

It a appears from a prospective cohort study of global and volumetric brain measurements from preoperative MRI's in 19 infants with complex CHD without overt brain lesions, prior to surgery, that these infants have smaller preoperative brain volumes (21% reduction) as well as reduction in randomly selected cerebral areas. "This suggests a fetal origin of reduced brain growth".

Video Feature 
Congenital heart disease
Congenital heart disease
Long-term outcomes of children with patent processes vaginalis (PPV) incidentally diagnosed by laparoscopy
"The processes vaginalis (PV) is an embryonic development out pouching of the peritoneum". In males it precedes the testes in its descent toward the scrotum and usually closes by fusion in the first weeks after birth. If failure of closure occurs, fluid from the peritoneum can travel through it towards the scrotum to form a hydrocele/hematocele. In addition there is an increased risk of developing an indirect hernia.

A study of 416 patients (>16 years) who underwent laparoscopy for pathologies other than PV indicates that 9.1% have an asymptomatic PPV with 10.5% of them later developing an inguinal hernia.

Rule of new biomarkers for predicting renal scarring in vesicoureteral reflux (VUR)
Neutrophil-gelatinase-association lipocalin (NGAL) is an iron-transporting protein which rapidly accumulates in the kidney tubules and urine and is thought to be a marker for acute kidney injury after a toxic/ischemic/traumatic insult.

It appears (form a study of 123 patients with primary VUR) that urinary NGAL levels may be used as a non-invasive biomarker to predict renal scarring in reflux nephropathy.

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