March 29, 2017
Volume VIII |  Issue No. 13

Probiotics and very low birth weight (VLBW) preterm infants
It appears form an extensive systematic literature search (in English only!) on the results of enteral administration of probiotics given to VLBW infants that severe necrotizing enterocolitis, late-onset sepsis and all-cause mortally may well be substantially reduced.
Functional outcomes of adolescent anterior cruciate ligament (ACL) reconstruction
The anterior cruciate ligament is one of two of the ligaments of the knee; it provides most of the restraining force resisting anterior displacement and medial rotation of the tibia on the femur. ACL rupture in adolescents in increasingly prevalent from sporting injury. Surgical reconstruction appears controversial and few functional outcomes have been reported.

A retrospective chart review of adolescents who had their ACL arthroscopically reconstructed and function reviewed four years (mean) later indicates that many had initial meniscal tears, and many had not returned to full function post-reconstruction.

Journal of Pediatric Orthopaedics

See related video below:
Neurodevelopmental outcomes at 5 years of age in congenital diaphragmatic hernia (CDH)
While the majority of CDH children have average neurodevelopmental outcomes at age 5 years, rates of borderline/extremely low IQ, emotionally reactive and pervasive developmental problems plus risk of autism are all significantly increased.

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A systematic review of the placebo response in pediatric abdominal pain-related Functional Gastrointestinal Disorders (FGID)

From a search of multiple databases of reviews and randomized placebo-controlled trials of children (4-18 years) with abdominal pain-related FGID, it appears that 41% improve on a placebo.
Video Feature
Treating Functional Abdominal Pain
Treating Functional Abdominal Pain
Anterior cutaneous nerve entrapment syndrome (ACNES) in children

2-3% of children with chronic localized abdominal pain (worsening on movement) appear to suffer from a frequently unrecognized syndrome resulting from muscle entrapment of the terminal branches of the lower thoracic intercastal nerve (ACNES). Many in addition complain of nausea, bloating, and weight loss, etc.

Conservative treatments of ACNES include medications and local nerve blocks; however if unresponsive, data from the first prospective study of 60 children studied following a neurectomy indicates that the procedure appears to be successful and safe in most cases.

Intravenous vs. intraosseous access and return of spontaneous circulation (ROSC) during out-of-hospital cardiac arrest (OHCA)

A retrospective study of 1,310 adults who underwent OHCA, were resuscitated by EMS who administered epinephrine through either established intravenous (IV) or intraosseous (IO) access, compared time of first attempt to return of spontaneous circulation.

Intraosseous administration of epinephrine is at least as good as IV injection in restoring spontaneous circulation in adult OHCA (unfortunately it does not seem to improve subsequent survival. Ed).

Somatic GNAQ mutation in Sturge-Weber Syndrome (SWS)
SWS also called encephalotrigeminal angiomatosis is a rare neurocutaneous disorder with capillary/capillary venule malformations that involve the leptomeniges, skin of the face and ophthalmic and maxillary distributions of the IVth (trigeminal) cranial nerve.

An interesting study examined a somatic mosaic mutation ("the presence of two or more populations of cells with different genotypes in one individual who has developed from a single fertilized egg") in the GNAQ gene (a gene that encodes a family of proteins that couples cell surface receptors to intracellular signaling pathways).

It appears that the GNAQ mutation is enriched in both skin and brain SWS endothelial cells, indicating that the endothelial cell in both skin & brain vessels is the source of the abnormal gene expression. This knowledge enhances the identification of brain involvement in SWS and should lead to improved therapeutic options in the prevention and treatment of brain lesions.

Did you know? 
Nicklaus Children's Success Stories: Milagros
Nicklaus Children's Success Stories: Milagros
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