Nov. 13, 2019 
     
Volume X | Issue No. 46
Neuroimaging in early life Epilepsy
A study of 775 children, with newly diagnosed epilepsy, < 3 yrs. of age at onset recruited over a 3 year period from 17 USA pediatric Epilepsy centers and followed for 1 year indicates that most (93.5%) have neuroimaging studies (87% magnetic resonance imaging - MRI), 40% are found to have relevant etiological pathological abnormalities, with pathogenic genetic variances being common among those with neuroimaging abnormalities.
 
All infants with newly diagnosed epilepsy are recommended to have neuroimaging studies (MRI) "because the yield is substantially high, even in the lowest risk group."
 
Pediatrics

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Association of cord biomarkers of in-utero acetaminophen exposure and subsequent Attention Deficit/Hyperactivity Disorder (ADHD) - Autism Spectrum Disorder (ASD)
From a cohort study of 996 mother-infant dyads where 3 cord acetaminophen metabolites were measured in archived cord plasma samples collected at birth, and physician diagnosed ADHD, ASD or other Developmental Disorders documented at 9.8 years of age (mean), it appears that in-utero fetal exposure to acetaminophen significantly increases the risk of childhood ADHD/ASD in a dose-response fashion.  
 
JAMA Psychiatry
Prenatal tetanus diphtheria acellular pertussis (Tdap) vaccination and Autism Spectrum Disorder (ASD)
A study which examined the effects of prenatal Tdap vaccination on maternal and child outcomes found NO increased risk of preterm delivery, low birth weight or ASD in infants (clinically diagnosed any time after turning 1 year of age).
 
Pediatrics

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Trends in the prevalence and incidence of Attention Deficit/Hyperactivity Disorder (ADHD) among adults and children  
 
A cohort study over a 10 year period of 5,282,877 adults patients and 867,453 children who identified as African American, Native American, Pacific Islander, Latino or Hispanic, non-Hispanic white, Asian America or other examined trends (demographic characteristics) psychiatric diagnoses, negative outcomes, prevalence and incidence of adults and children diagnosed with ADHD.
 
Adult data is interesting with prevalence and incidence increasing, with racial/ethnic inequality remaining.
Among children aged 5-11 years, 48.9% are girls, 30.0% white and prevalence increases from 2.96% to 3.74% over 10 years. Incidence of ADHD diagnosis per 10,000 persons/year increases from 9.43 to 13.49 over a similar period. Having an eating disorder, depression, bipolar disorder or anxiety disorder is associated with higher odds of having a diagnosis of ADHD.
 
Identifying and treating childhood ADHD can improve negative outcomes associated with ADHD in adulthood.
 
JAMA Network Open  
Video Feature
Tongue-Tied: Helping Babies Breastfeed
Tongue-Tied: Helping Babies Breastfeed
Frenotomy in infants with tongue tie and breast feeding problems
 
Ankyloglossia or tongue-tie is a congenital anomaly in which a short, "cord-like" lingual frenulum is seen to be attached to the underside of the tongue (often called anterior tongue-tie) or a highly-attached genioglossus muscle or "submucosal band" is found across the floor of the mouth (often called a posterior tongue-tie) limit the movement of the tongue. This may (but not necessarily) result in breast feeding problems. Frequency of tongue-tie is higher among boys and while most cases are sporadic mutations in the T box transcription factor TBX22 may lead to an X-linked type of heritable ankyloglossia.
 
In a study of 30 newborns <12 weeks of age diagnosed with posterior ankyloglossia where breast feeding difficulties occurred because of the tongue-tie, frenotomy improved baby latching, maternal nipple pain and breast feeding capability.
 
Journal of Human Lactation 
Neurodevelopmental outcome at 5 years of age after general anesthesia (GA) or awake - regional anesthesia (GAS) in infancy
 
Animal and some large human studies have shown an association between general anesthesia at a young age and subsequent negative neurodevelopmental outcomes. Other studies have not found any evidence for such an association.
An international, assessor-masked, equivalence, randomized controlled trial recruited 722 infants <60 weeks post menstrual age (and born >26 weeks gestation) undergoing inguinal herniorrhaphy (without previous exposure to GA or risk factors for neurological injury). Infants were randomly assigned to receive either awake-regional anesthesia or sevoflurane-based general anesthetic. Full-scale intelligence quotient (FSIQ) and Wechsler preschool Primary Scale of Intelligence was measured at 5 years of age.
 
Approximately 1 hour (or less) of general anesthesia in early infancy does not appear to alter neurodevelopmental outcomes at 5 years of age (Previous studies indicate a dose-dependent adverse effect of anesthetic agents. Infants who have multiple early anesthesia exposure, or to multiple drugs in the same surgery, or anesthesia lasting >1 hour may have different neurodevelopmental outcomes).
 
The Lancet 
Lavender Products - Premature Thelarche and Prepubertal Gynecomastia
 
An association has been described between the use of essential oils: lavender and tea tree oil, and prepubertal gynecomastia or thelarche. In vitro studies have demonstrated the estrogenic and antiandrogenic activity of these substances. This correlation has been reported among Hispanic youth in the South Florida community who have been using colognes and/or perfumes. Breast development reversed after discontinuation of exposure. Suspending use of products with these ingredients has been recommended when early development of breast tissue among children is noted.
 
Journal of Pediatric Endocrinology and Metabolism
 
Journal of Clinical Endocrinology and Metabolism 
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