Oct. 18, 2017
Volume VIII |  Issue No. 42

The impact of low-grade (grades I - II) germinal matrix-intraventricular hemorrhage on neurodevelopmental outcome of very low birth weight preterm infants
While germinal matrix-intraventricular hemorrhage (GMH - IVH) is common in preterm infants with an incidence of 11%, there appears to be little agreement on neurodevelopmental outcomes.

A retrospective case control study of 136 very low birth weight preterm infants with or without GMH - IVH ( on cranial ultrasound (c.US)/magnetic resonance imaging (MRI) ) documented developmental outcomes at 2 years of age.

Very low birth weight preterm infants with grades I - II GMH - IVH have similar early neurodevelopmental outcomes compared to matched controls.

Effectiveness of psychological intervention for children with Functional Somatic Symptoms
An extensive literature search of multiple databases for randomized control trials published in peer reviewed journals on psychological treatment on symptom load and disability in children with functional somatic symptoms revealed that symptom load, disability and school absences are all significantly improved post treatment.
Posterior urethral valve in fetuses; evidence for the role of inflammatory biomarkers
It appears from a cross-sectional study on urine samples for a wide variety of inflammatory biomarkers from 24 fetuses with posterior urethral valves (PUVs), collected at 22 weeks (+- 4 weeks) gestation and compared to healthy male controls, that at that early age there is already an intense physiopathological inflammatory process (which correlates with negative renal biomarkers) which results in a PUV occurring just after the embryological formation of the urethral membrane.
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Effect of hospitalization on weight in underweight youth with Restrictive Eating Disorders (RED)
Children, adolescents and adults with RED (Avoidant/Restrictive Food Intake Disorder - ARFID; DSM-5) are defined as "those who limit their eating and are affected by related physiological or psychological problems and do not fall under the definition of another eating disorder" (e.g. anorexia nervosa or bulimia nervosa).
A retrospective analysis of data on 322 low-weight (BMI <85%) restrictive eating disorder children/adolescents 9-21 years of age from an outpatient-based treatment program examined whether hospitalization (vs. non-hospitalized matched patients) was associated with weight gain (to 90% BMI) at 1 year follow up.
Hospitalization of patients with restrictive eating disorders and a BMI <85% significantly improves weight gain on hospitalized children/adolescents at 1 year follow up.
Sleep duration and telomere length in children   

Telomeres are the caps at the end of each strand of DNA that protect the chromosome from the damage of repetitive division. It appears that over time telomeres shorten not only in response to cell ageing with cell division, but also with stress, smoking, obesity, lack of exercise and diet. "Short telomeres are connected to premature cell aging" and represent our "biological" as opposed to "chronological" age.

A preliminary study which assessed the association between sleep duration and telomere length in 1,567 children indicates that children with shorter sleep duration have shorter telomeres than matched controls (unassociated with race, sex, or socioeconomic status).

Video Feature
Here is the secret to make cells live longer
Here is the secret to make cells live longer.
Optimal duration for breast feeding

While breast-feeding protects babies against infections (with many other benefits) its optimal duration for this effect remains controversial.
An analysis from a prospective full cohort (70,511) and sibling sets (to minimize confounding maternal factors) examined the relative risks (RR) for hospitalization for infections from 0 to 18 months by age at introduction of complementary foods and duration of any breast-feeding.
It appears that infection/hospitalization prevention in fully breast-fed infants occurs primarily during the first 4-6 months of life, and that protection against infection is limited to the first 12 months (optimally, breast-feeding should continue to 12 month of age).
See related video HERE.  
Effective of inhaled nitric oxide on survival without bronchopulmonary dysplasia (BPD) in preterm infants
Nitric oxide (NO) is an important signaling molecule which has multiple systemic and pulmonary effects. Used initially for it vasopulmonary dilating effect on infants with persistent pulmonary hypertension and hypoxemic respiratory failure; animal models of neonatal chronic lung disease indicates it also stimulates angiogenesis, augments alveolarization, improves surfactant function and inhibits proliferation of smooth muscle cells and abnormal elastin deposition. The off label use of inhaled NO in the preterm infant has escalated with little evidence to support its use.
A randomized clinical trial of 451 preterm infants (<30 weeks gestation, birth weight <1,250 grams, receiving mechanical ventilation or positive pressure support) who received on postnatal days 5-14 inhaled NO (or not) for up to 24 days, examined outcomes at 18-24 months for survival without BPD at 36 weeks post menstrual age, BPD severity, corticosteroid use, respiratory support, overall survival and neurodevelopment.
While inhaled NO administered to at risk infants for 24 days appears safe, it does not improve measured outcomes.
See related video HERE
Meet Dr. Kelly Seiler, Pediatric Endocrinologist at Nicklaus Children's Hospital 
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