July 8, 2015
Volume VI, Issue No. 27

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The timing of infant food introduction in families with a history of Atopy

A secondary analysis of the timing and type of food introduced to 149 infants with a family history of atopy indicates:

  1. 7% receive solid food prior to 4 months of age.
  2. 13% receive solid food after 6 months of age.
  3. Hyper - allergenic foods are introduced as follows: Wheat (8.7 months), eggs (11.2 months), soy (13.0 months), fish (13.4 months), peanut and tree nuts (20-21 months) and seafood (21.8 months).
  4. Asian race and maternal history of food allergy are associated with late food introduction.

"Variation in timing of food introduction appears to depend on cultural preferences, previous experience with food allergy and the ambiguous state of current recommendations".


Clinical Pediatrics 

Shortened telomeres in families with a propensity to autism ASD

It is believed by some that lobsters, barring injury, disease or capture could live almost forever! Most human cells however have a limited ability to replicate over time, one cause of which is the shortening of the ends of our chromosomes (telomeres - that part of the DNA strand that protects our genetic data) which occurs with each replication. Hereditary and environmental factors bring about premature telomere shortening. When telomeres get too short the cell can no longer divide, it becomes inactive and dies and poor health and a shortened lifespan results. Exposure to psychological stress is associated with accelerated telomere shortening.


A study of infants, older siblings and parents in families with and without a child with ASD examined telomere length for each participant. Families of children with ASD showed shortened telomeres. These high risk families should be monitored for potential physical and mental health aberrations.


Journal of American Academy of Child and Adolescent Psychiatry

E-cigarette use and beliefs among urban public high school students in a tobacco growing state

A study was undertaken to examine the prevalence, attitudes and risk factors associated with electronic-cigarette (e-cigarette) use among high school students (mean age 16.4 years), appropriately sex and race distributed, utilizing a questionnaire with additional information about demographics, family tobacco use and school and health care intervention being noted.


15.2 % of high school students report using e-cigarettes. 60% report that e-cigarettes are safe/pose a minimal health hazard. E-cigarette use is associated with older age, personal and family tobacco use, male gender, Caucasian race and lower academic performance. Only 5.4% report schools offering any information about e-cigarette use.


Journal of Adolescent Health



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Pharmacotherapy of the preschool child with Attention Deficit/Hyperactivity Disorder (ADHD)


ADHD is an inherited (in approximately 75% of cases) neurodevelopmental psychiatric disorder affecting about 6% of children (more frequently in boys than girls) where


infants/children (between the ages 6-12) exhibit significant problems with "executive function" e.g. attentional control and inhibitory control which results in attention deficits, hyperactivity or impulsivity for more than 6 months, inappropriate for the patients age. Many children with ADHD may be able to complete tasks they find interesting. Treatment usually involves some combination of counseling, lifestyle changes and/or medication.


A long-term investigation of 206 preschool children reassessed 3 and 6 years following the onset of pharmacotherapy indicates that at year 3, 34% and at year 6, 26.8% respectively are on no pharmacotherapy. While most ADHD children continue to require medication approximately 25% don't; about 1 in 10 require anti-psychotics.

Journal of American Academy of Child and Adolescent Psychiatry 

Video Feature

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Shortened Telomeres
Shortened Telomeres

Juvenile Dermatomyositis - and the case of calcinosis cutis of the elbow


Calcinosis cutis (or cutaneous calcification) may occur in response to a variety of insults including trauma, inflammation, infection, tumors, Hypercalcemia and Hyperphosphatemia and connective tissue diseases.


In this interesting article involving a rare case of juvenile Dermatomyositis, the management of a large calcified mass involving the elbow is discussed. Most cases are resistant to a wider variety of medical therapies (with variable benefits). Surgical removal frequently results in poor would healing and sinus tract formation. Recurrence is common.


Journal of Pediatric Orthopaedics

Incontinence and parent-reported Oppositional Defiant Disorder (ODD) symptoms in young children


"ODD and incontinence are common disorders of childhood", with ODD being described as "a pattern of angry/irritable mood, argumentative/defiant behavior or vindictiveness lasting at least 6 months.


A study which examined associations between ODD symptoms and incontinence in 718, 6 year old children found that incontinence (enuresis, daytime and fecal) and ODD are comorbid disorders at school-entry age; children who have daytime urinary incontinence have the highest rate of ODD symptoms.


Pediatric Nephrology 

Wireless capsule endoscopy (CE) of the small intestine in children


CE for the diagnosis of small-bowel disease is a mature, continually improving technology and is valuable in the diagnosis of inflammatory bowel disease, locating obscure bleeding sites and assessing small-bowel polyp burden etc.


In this valuable article the indications, limitations and advances in video capsule technology are reviewed. (An article worth reading, Ed.)


Journal of Pediatric Gastroenterology and Nutrition
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