July 29, 2015
Volume VI, Issue No. 30

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Cardiorespiratory fitness and depression in middle school adolescents

"Cross-sectional studies demonstrate a robust association between depression, physical activity and cardiorespiratory fitness in adolescents". Longitudinal studies however, are few, especially those focusing on fitness rather than physical activity.


A study of 437 boys and girls was undertaken during their sixth grade year with reassessment occurring during the seventh grade, each one self-reporting (with weight and shuttle-run assessment) on measures of depression and fitness.

Cardiorespiratory fitness appears to have a significant protective effect against the development of depression.


Journal of Adolescent Health 

Sleep problems in toddlers and late emotional and behavioral problems

Many studies have reported significant associations between childhood sleep difficulties and subsequent emotional/behavioral problems in young children. Parents' sleep and mood are also affected by a toddlers' sleep problems.


A study which evaluated the effects of sleep problems in toddlers aged 18 months and emotional and behavioral issues at 5 years of age, indicates that short sleep duration (<10 hours) and frequent nocturnal awakenings at 18 months of age are significantly associated with emotional and behavioral problems (internalizing and externalizing ) at 5 years.


JAMA Pediatrics  


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Prematurity, opioid exposure and neonatal pain - outcomes

Neonatal rat data (roughly equivalent to babies born preterm) suggests no long term effect after pain and opioid exposure.


A study of 19 children who as neonates participated in a trial of the short-term effects of prematurity, morphine administration, and procedural pain, and whom at ages 5 and 8/9 years had brain morphology, neuropsychiatric function and thermal sensitivity assessed, indicates no major association existing between them & subsequent neuropsychological function or thermal sensitivity (larger studies needed).





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Single nucleotide polymorphisms (SNP's) of apolipoprotein E (ApoE) and cerebral palsy (CP) severity.

ApoE, produced in the liver (predominantly, and found in Intermediate - density lipoproteins) is a class of lipoproteins essential in mediating cholesterol metabolism, playing a role in many cellular and system processes including Central Nervous System neuronal repair and recovery following brain trauma. The ApoE gene is located on chromosome 19 with TOMM 40 gene being located closely adjacent to it. SNP's  in the ApoE and TOMM 40 genes affect the structure and function of ApoE.


A DNA analysis of ApoE and TOMM 40 genes performed on 227 CP children examined the association between SNP's of those genes relating them to various CP clinical manifestations. Some SNP combinations of ApoE/TOMM 40 are associated with less epilepsy, improved fine motor function and feeding.


Acta Paediatrica 

Video Feature

via YouTube   

5 Components of Fitness
5 Components of Fitness
Cardiorespiratory fitness
Cardiorespiratory fitness

Markedly elevated C-reactive protein (CRP) levels/sepsis or necrotizing enterocolitis (NEC)


It appears form a retrospective review of 6,025 neonates whose CRP's exceeded 100mg/l, that markedly elevated CRP levels in the first three days of life in the full term infant are common and are NOT (81%) associated with infection. A CRP>100mg/l from the fourth day of life usually affects extremely preterm neonates and is most commonly associated with an infectious cause (87%).


Acta Paediatrica 

Immediate delivery vs. expectant monitoring for hypertensive disorders of pregnancy between 34 and 37 weeks gestation


An open-label, randomized control trial of early induction of labor (or C-section) or a strategy aimed at prolonging pregnancy, utilizing multiple academic and non-academic hospitals in the Netherlands of women with non-severe hypertensive disorders of pregnancy between 34 and 37 weeks gestation indicates that immediate delivery significantly increases the risk of neonatal Respiratory Distress Syndrome while only minimally improving maternal outcomes.


The Lancet 

Video rigid flexing laryngoscope (RIFL) vs. Miller laryngoscope for tracheal intubation during pediatric resuscitation (CPR) by paramedics; a simulation study


"The video RIFL has an insertion rod that is flexible and can articulate to 235 degrees by squeezing a lever on the devise" enhancing the ability to identify the tracheal oriface. The insertion rod is available in 2, 3 and 5 mm outside diameters with a channel for oxygen delivery. RILF images may be displayed on an external monitor. The stylet (carrying the light and video bundles) can be sterilized and reused. These devises have advantages but have a substantial learning curve.


In simulated child CPR scenarios with concomitant chest compressions paramedics performed better with an RIFL than with a standard Miller laryngoscope.


American Journal of Emergency Medicine 

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Do you know the various types of Pediatric Anxiety DIsorder?

What is the Ponseti treatment ?

How does the rapidity of retrieval and effectiveness of resuscitation affect outcomes for near-drowning victims?

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