Nov. 23, 2016
Volume VII | Issue No. 47

Post-partum anxiety (PPA) and infant-feeding outcomes
A systematic review of 33 dyads examined the relationship between PPA and infant-feeding outcomes.

Women with symptoms of PPA appear less likely to initiate breast feeding, breast feed exclusively and are more likely to terminate breast feeding early. PPA reduces self-efficacy, increases breast feeding difficulties and may affect breast milk composition.

Neurodevelopmental outcomes in adolescents (10-15 years) born extremely preterm (EPT)
Active perinatal care (APC) increases the survival of EPT infants. At 10-15 years of age (compared to term-born control babies) rates of cognitive impairment, cerebral palsy, visual impairment and moderate/severe deafness affect significant numbers of adolescents.

Overall, 34% of EPT adolescents have moderate/severe impairments (babies born <23-24 weeks: 43%; >25weeks: 28.4%). 66% of adolescents born EPT who receive APC have mild or no disabilities.

Consuming energy drinks - effect on subsequent substance abuse
A longitudinal study of 621 youths, aged 14 years who did (or not) consume energy drinks, followed for 2 years indicates that at age 16 years regular energy drinkers are more likely to smoke, abuse alcohol and use marijuana.

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Outcomes of extremity vascular trauma in children
While uncommon in children, most vascular tree injuries in the extremities result from penetrating injuries.

A retrospective chart review from a single pediatric trauma center examined a variety of domains in 23 children with extremity vascular injury. Results indicate:
  1. Median age at injury: 8 years; mostly males (61%) with 65% upper extremity involvement.
  2. 74% result from penetrating injury.
  3. Majority (65%) undergo primary repair.
  4. 60%-75% have short- and long-term impaired extremity function.
  5. 13% undergo amputation for failed revascularization.
Long-term outcomes of Attention Deficit/Hyperactivity (ADHD) and Conduct Disorder (CD)

AHDH and CD are common externalizing disorders (symptoms include delinquent and aggressive behavior, problems of self-control of emotions and behavior). An electronic database study reviewed available evidence linking ADHD and CD with a range of health and psychosocial outcomes.

Review of ADHD and CD long-term outcomes indicates increased risk for failing academic achievement, depression, criminality (drug abuse) and unemployment. Both conditions need to be addressed early in life to avoid long-term adverse outcomes.

Video Feature
Achieving therapy goals in children/adolescents with Dyslipidemia - effectiveness of statin therapy

Statin treatment is an efficient lipid lowering therapy for children with familial hypercholesterolemia (1:25). Untreated heterozygous familial hypercholesterolemia results in cardiovascular death in approximately 25% of women and 50% of affected men. Routine early screening and treatment have been proposed though long term complications are unknown.

A one year prospective follow-up study of 1,521 children (median age: 14 years) with elevated base-line levels of low-density lipoprotein cholesterol (LDL-C) treated on statin therapy indicates the cumulative probability of achieving appropriate LDL-C levels following one year of treatment is 60%, with boys in higher base-line levels most likely to require increased support.

Albuterol via metered-dose inhaler for asthma

A randomized, controlled double-blind, multicenter trial in 2-17 years olds (119 patients) with moderate to severe acute asthma compared outcomes of 2 different high dosage regimens of albuterol inhalation (6-18 puffs in the first hour depending on child's weight).

Higher albuterol dosage regimens appear safe in children with moderate to severe acute asthma.

Letter to the Editor
Re: ImPACT testing of cognitive function following head injury ( Updates in Pediatrics 11/9/16)

Having used the ImPACT test on children > 14 yrs of age pre and following concussion, I think it's important for your readers to know that baseline studies are frequently inconsistent & post injury test results often do not correlate with severe symptoms/cognitive slowing.

Its appears to be a very good marketing tool but its value in managing children with concussion is questionable at best".

- John Kuluz., MD, Pediatric Critical Care
Director of Traumatic Brain Injury/Concussion Program
Miami Children's Health System
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