Oct. 2, 2019 
     
Volume X | Issue No. 40
Effect of fecal microbiota transplantation (FMT) in an experimental model of necrotizing enterocolitis (NEC)
A study of Wistar rats examined whether fecal microbiota transplantation given before or after induction of experimental enterocolitis decreased the inflammatory response during NEC development.  
 
FMT given prior to and after experimentally induced NEC decreases intestinal mucosa damage and all inflammatory/oxidative damage parameters.
 
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Functional gastrointestinal disorders (FGID) in the first year of life and neonatal antibiotics
A prospective, multicenter, consecutively enrolled study of 934 newborns (which followed them for 1 year) assessed gestational age, neonatal antibiotic administration, duration of hospitalization, mode of delivery, birth weight and feeding patterns, and related them to the development of FGID (according to Rome III criteria).
 
Preterm delivery and neonatal use of antibiotics in the first month of life are associated with an increased incidence of FGIDs - particularly infant colic and regurgitation (a history of caesarian delivery and non-breastfeeding at one month enhances infant gastrointestinal dysfunction).
 
Mental illness among youth with chronic physical conditions (CPC)
During childhood, adolescence and young adulthood, having a chronic physical condition (those that last >1 year and that affect daily function) can have significant effects placing such youth at greater risk for developing chronic mental health conditions (MHCs like generalized anxiety disorder or depression).
 
A retrospective nationally representative cohort study of 48,572 youths aged 6-25 years extensively collected data over an 11 year period to assess the cumulative incidence of MHCs and CPCs and the association between them (adjusting for sociodemographic status).
 
Youths with CPCs are at much greater risk for mental health conditions, and limitations in activity appear to play an important role. Services to enhance their ability to participate in activities may be of significant value.
 

See related video HERE & HERE.
Childhood Obesity Facts 
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A comparison between appendicostomy and neoappendicostomy for pediatric incontinence
 
Some children who are post-surgery for anorectal and/or colonic malformations, or Hirschsprung's disease will have some degree of fecal incontinence. Through the use of a bowel program and enemas many when young, learn how to stay clean with the help of parents. Older children prefer a methodology that provides more privacy.    
 
For bowel incontinence an appendicostomy (Malone procedure) connects the appendix to the umbilicus (laparoscopic surgery with a constructed valve) which facilitates the appendix being catheterized (without fluid being able to leak out) for anterograde enema bowel clearance. In children whose appendix has been removed a piece of colon is tubularized to create a neo-appendix for the same function.
 
A retrospective review of 84 children following appendicostomy or neo-appendicostomy for fecal incontinence and followed post-operatively for 2.5 years indicates that while overall 32% experience complications requiring surgical or radiological intervention, neoappendicostomy carries significantly higher risk.
 
Journal of Pediatric Surgery 
Video Feature
Malone Flush
Malone Flush
Probiotic supplementation for acute leukemia (AL) chemotherapy-induced gastrointestinal side effects
 
Chemotherapy significantly modifies the gut microbiome resulting in gastrointestinal dysfunction (e.g. colitis and diarrhea). In adults on chemotherapy it appears that probiotics might be of value to prevent radiotherapy- and chemotherapy-induced gastrointestinal side effects.
 
A randomized, single-blind, pilot study of 60 children with AL on remission induction or re-induction chemotherapy compared gastrointestinal side effects of those receiving a 7 day probiotic course (Lactobacillus rhamnosus GG given twice daily) to a similar (control) untreated group.
 
Probiotic supplementation administered twice daily for 7 days decreases AL chemotherapy induced gastrointestinal side effects in children.
 
The Journal of Pediatric Hematology/Oncology 
Hemodialysis (HD) or direct hemoperfusion (HP) for the treatment of severe caffeine poisoning
 
With hemodialysis (artificial kidney) blood is filtered outside the body and then returned using a dialysis machine. Hemoperfusion is a technique in which the blood is perfused directly over a sorbent bed (like activated charcoal, resins or immunosorbents).  
 
Caffeine overdose symptoms include tachycardia, arrhythmias, jitteriness, dizziness, nausea, anxiety, vomiting and cardiac arrest.
 
A study which compared the efficacy of HD to HP indicates that hemodialysis is the preferred recommended extracorporeal treatment of choice.  
 
American Journal of Emergency Medicine  
See related video HERE & HERE
Hospital course and initial Emergency Department (ED) oxygen saturation in children with acute asthma

A study of 244 acute asthmatic children (2-17 years of age) seen in an ED, and admitted to a hospital had initial room air pulse oximetry readings recorded and subsequent clinical course assessed.
 
Of acute pediatric asthmatic patients admitted to a pediatric facility 27% are sent to a Critical Care unit and 73% to standard unit care.
 
Asthmatic children with an initial pulse oximetry level <90% have an 11.3 times greater risk of having a complicated course.  
 
American Journal of Emergency Medicine 
Did You Know?
Diabetes in children: Managing diabetes in school
Diabetes in children: Managing diabetes in school 
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