Miami, FL
March 20, 2019
Volume X | Issue No. 12
Multilingualism in very (VPT) and extremely (EPT) preterm born infants
Part of a national neonatal follow-up program was utilized to determine whether cognitive outcomes differ between VPT and EPT children (325) who were monolingual or multilingual when they reached the ages (corrected) of 2 and 5 years.
Cognitive scores at 2 years of age and verbal scores at 5 years of age are best when VPT/EPT infants are monolingually exposed followed by scores of infants from a bilingual home. When foreign languages are only spoken at home both cognitive and verbal skills lag.
Does the season when birth occurs affect the risk of Coeliac disease (CD) 
A number of environmental factors such a gluten exposure (age and amount not clarified), infection exposure (particularly viruses), the use of proton pump inhibitors, short duration of breast feeding, parental smoking and changes in the gut microbiome have all been associated with the pathogeneses of CD in genetically susceptible people.
A population-based retrospective time series analysis study examined (in 308,903 live births) the effect of weather in four seasons and CD diagnosis as this association remains unclear.
Infants born during the autumn months appear to be associated with a higher risk (incidence ratio: 1.22) for the development of CD. Combining birth data during the summer and autumn seasons further increases CD incidence (1.40).
Fetal outcome following maternal lightning strike
Lightning strikes in the USA occur >20 million times per year. As lightning strikes on pregnant women are rare this case report is of interest as it highlights initial symptomatology, management of a baby born after a maternal lighting strike and outlines possible long-term outcomes.
This first report of the longer-term outcomes of a baby born to a mother struck by lightning indicates that at 2 months of age other than intermittent hypertonia, cognitive and motor scores are essentially normal. Neurodevelopment assessment at approximately 4.5 years however shows global impairments with severe permanent disabilities (hypotonia, feeding by gastronomy tube, nonambulation with significant deficits in cognitive skills).
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Childhood Obesity Facts 
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Association between vitamin D levels, antimicrobial peptides and urinary tract infections (UTI) in infants and young children
Vitamin D stimulates the production and expression in the urinary tract of the endogenous antimicrobial peptides cathelicidin (a family of polypeptides, which are part of the innate immune defense system against bacterial infection, found primarily in macrophages and polymorphonuclear leukocytes) and β-defensin-2 (which also activates innate immunity in phagosomes and which enhances both host resistance to gram negative bacteria and a number of viruses).
A study examined and compared the association between vitamin D status in 120 children (<3 years of age) approximately half of whom had UTIs vs. those who were healthy.
Vitamin D insufficiency is prevalent in young children (21% - particularly girls), low levels correlate with the level of cathelicidin and appear to be a risk factor for UTIs (especially in girls).
Vitamin D supplementation may be of value in preventing first-time UTIs.
Dealing with a sharp end of an ingested foreign body (FB) 

FB ingestion in children is common; particularly coins, batteries, small toys, safety pins and fish bones. 80% are blunt and relatively small passing through the gastrointestinal tract with no significant complication. 20% however, comprise sharp pointed, relatively large objects which lodge in the gastrointestinal tract causing a wide range of complications requiring emergency treatment.
An interesting case report of a 1-year-old girl admitted to an Emergency Department 6 hours after swallowing a safety pin which was found to be open outlines the potential symptoms, multiple treatment options and demonstrates that sharp foreign bodies lodged in the esophagus may be successfully removed using a flexible

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Video Feature
Celiac Disease in Children - Dr. Elaine Barfield
Celiac Disease in Children - Dr. Elaine Barfield
Longboard injuries 
A longboard is a type of sports equipment similar to but longer (33 inches to 60 inches), wider (9 inches to 10 inches) and faster than a skateboard. The sport is gaining in popularity.
A retrospective review of 64 children treated for injuries that occurred while riding a longboard indicates:
  1. Median age: 14.5 years
  2. 84% male
  3. 80% suffer traumatic brain injury (TBI) which include skull fractures, concussion and intracranial hemorrhages
  4. 96% are admitted to the hospital
  5. 11% wear helmets
Key parenting program components to managing Disruptive Child Behavior 
There is much evidence to suggest that behavioral parenting programs (which include parenting knowledge, principles and skills management- e.g. "praise and reward", "ignore and time-out" procedures, "parent problem solving" and "emotion regulation" etc.) have the ability to prevent and treat disruptive child behavior. Which of the many techniques available actually contribute to the positive effects is less-well known.
Two meta-analyses of evidence-based effectiveness of parenting techniques examined which are best for prevention versus treatment, and immediate versus longer-term effects.
It appears that in the short term the best treatment techniques to manage children with disruptive behavior include positive reinforcement, applying child-directed non-violent disciplinary techniques and improving parental self-management.    
Children's Health Chats
Genetic Testing for Autism Spectrum disorders
Genetic Testing for Autism Spectrum disorders
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