July 20, 2016
Volume VII | Issue No. 29

Harsh parenting (HP); food insecurity (FI) in adolescents and emerging adult overweight/obesity (OW/OB)
A longitudinal database of 451 adolescents between 13 and 23 years of age from the Iowa Youth and Families Project examined the relationships and interactions between HP, FI in adolescents and the development OW/OB in emerging adulthood.
Overall, experiencing HP in adolescence predicts OW/OB at 23 years, as does higher body mass indices of the adolescent and his/her father. Being female with HP/FI particularly increases the odds of being OW/OB at 23 years of age (parental higher education appears to lower the odds of being OW/OB in emerging adulthood).
Impact of a multidisciplinary evaluation in pediatric patients (6-17 years of age)
with nocturnal mono symptomatic enuresis (MNE)
Enuresis is a clinical condition of multifactorial origin. A prospective study of the impact of multidisciplinary assessment of 140 MNE children which included a structural history, clinical/neurological examinations, bowel and bladder diaries, sleep diary and questionnaire, psychological evaluation, urinary sonogram, blood and urine laboratory tests, polysomnography (PSG) and balance evaluation indicates that 75.6% are male (mean age 9.5 years) with 91.9% having a positive immediate family history. 19% have a complicating urinary disorder, 2.8% are diagnosed with hypercalciuria, 2% with nephropathy, 0.7% with attention-hyperactivity disorder and 6.9% with severe nocturnal apnea (40.7% mild to moderate).

Older children with MNE require a structured diagnostic evaluation best undertaken by a multidisciplinary team.
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"Resident" vs. "Attending" surgeon in achieving and maintaining distal radial fractures

Re-displacement occurs in approximately 33% of distal forearm fractures after initial reduction.

A study investigating whether surgeon seniority plays a role in the adequacy of the cast molding after closed reduction, indicates that the level of seniority does NOT appear to influence its adequacy as "Residents" appear well-trained in cast applications.

Journal of Pediatric Orthopaedics
Incidence of contrast-induced acute kidney injury (CI-AKI)

CI-AKI may occur in 3-25% of adults, depending on risk factors. A retrospective cohort study of 233 children followed-up after computed tomography (CT) scan with iodinated contrast media injection, indicates a 30 day unfavorable outcome incidence of 10.3% (before) and a 3.6% (after adjusting for cofounders) injection. No independent risk factors for CI-AKI are identified.
Video Feature 
   Pediatric Eating Disorders                         Parenting Lessons Learned
Recovery curve for pediatric burn survivors 
"Patient-reported outcome serving as benchmarks for recovery of pediatric burn survivors are lacking". A prospective cohort study of 336 pediatric burn survivors younger than 5 years of age (and age-matched non-burn controls) examined through a parent completed "Burn Outcomes Questionnaire" at 48 moths after injury, 10 domains (including play, language, fine and gross motor skills, emotional behavior, family functioning, pain/itching, appearance, satisfaction with care and worry/concern).

Only 5 of 10 domain scores (play, language, gross motors skills, pain/itching and worry/concern) improve over time in surviving burn patients, with higher than normal scores for language, emotional behavior and family functioning. There is a significant opportunity for improved care.

Inhaled corticosteroids (ICS) and height growth
Pre-pubertal children treated with inhaled ICS's for asthma appear to show an initial reduced growth velocity for the first 1-2 years of treatment (particularly for young girls 5-10 years of age), the deleterious effects of which (approximately 1.2cm shorter) do not appear to continue with ongoing treatment.
An interesting study of 99 pre-pubertal children with asthma (2-13 years of age) treated with ICS's examined ICS adherence, cumulative ICS dose and height growth velocity over the first year of treatment.

It appears (in contrast to previous studies; NEJM 2012 367; pages 904-912) that after adjustment for age and sex, one year of ICS treatment in guideline-recommended doses may not result in significant growth depression.

Outcomes of administering perioperative probiotics in pediatric surgical cases
An examination of the intestinal environmental and blood culture effects of orally administering Bifidobacterium Breve strain Yakult (BBG-01) given preoperatively to pediatric surgical cases demonstrates that it is well tolerated without adverse effects and significantly reduces post-operative infection.

BBG-01 appears to improve postoperative infection rates, the intestinal bacterial environment and may suppress bacterial translocation.
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