Miami, FL
Sept. 26, 2018
Volume IX | Issue No. 39
Pulmonary function test (PFT) abnormalities in children with inflammatory bowel disease (IBD) 
An observational case-control study on 100 newly diagnosed children with IBD (52 with Crohn's disease - CD, and 48 with ulcerative colitis - UC) matched with 50 healthy children examined a number of pulmonary function tests at diagnosis and every 6 months thereafter for 3 years.

Significant subclinical PFT abnormalities are common in pediatric IBD patients with deterioration occurring over time and during IBD activity.
Children with IBD should be considered for periodic PFT evaluation.

Waist-to-height and cardio metabolic syndrome (MetS) risk in children and adolescents
The specific clustering of cardiovascular risk factors described in 1988 and now called "the metabolic syndrome" include central obesity, insulin resistance, hyperglycemia, the effects of hyperinsulinism on glucose, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), coronary artery disease and an elevated blood pressure. In general the metabolic syndrome is described by the presence of any three of five particular risk factors with pathogenesis including genetic, lifestyle and environmental factors.
A study of 3,556 Chinese children 7-18 years of age evaluated the effectiveness of the waist-to-height ratio in identifying cardiometabolic risk in children and adolescents compared it to five other obesity indices.
Waist-to-height ratio is an accurate, practical and superior screening test for detecting cardiometabolic risk in children.
See related video HERE & HERE
Effects of premature primary mandibular canine tooth loss on permanent lower dental midline stability 
From a growth study of mandibular casts on 56 children (15 with premature and 41 with normal primary canine mandibular detachment) it appears that early unilateral loss of a primary mandibular canine has no deleterious effect on subsequent lower dental midline position.
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Catcher's knee in children 

Juvenile osteochondritis dissecans (OCD) is an idiopathic joint disorder where bone and cartilage separate from one another because of loss of blood supply. It is frequently associated with repetitive joint motions that stress the joint, particularly in young boys, most frequently affecting the knee (baseball catchers) and elbow (pitching and throwing).
A study examined the relative age and characteristics of OCD knee lesions in catchers compared to position baseball players.

Young children who are baseball/softball catchers present with OCD at a younger age and in a more posterior location on the medial and lateral femoral condyles compared to non-catchers; probably because of repetitive and persistent stress on the knee from the hyperflexed position required during catching.

Video Feature
Knee Osteochondritis Dissecans , Wilson's Test - Everything You Need To Know - Dr. Nabil Ebraheim
Knee Osteochondritis Dissecans , Wilson's Test - Everything You Need To Know - Dr. Nabil Ebraheim
Predictors of safe discharge for pediatric drowning patients in the Emergency Department (ED) 

A retrospective review of data on 91 drowning patients evaluated vital signs (VS), pulse oximetry, chest x-ray results, disposition and complications for each encounter to identify and compare outcome and complication rates for those with normal and abnormal VS and oximetry.
Well-appearing stable children presenting to an ED following drowning with normal VS's and oximetry and with no clinical deterioration within one hour appear to be at very low risk for developing complications and may not require prolonged observation.

School start time and weight of adolescents  

It appears that an early school start time is detrimental to the sleep, health and the well-being of youth.
A study of information on 29,635 students ages 10-18 years of age from 362 schools identified those overweight/obese and examined for associations between school start times and weight outcomes (adjusted for a variety of variables).
It appears that for every ten minute delay in school start time between 8am - 9:30am children's weight decreases. "Delaying school start time may be an additional strategy to support the healthy weight of adolescents."
See related video HERE. 
Fine particulate pollution and asthma exacerbations in children
When discussing the role of air pollutants as a major cause of asthma, most previous studies have not taken into account a number of environmental variables which include temperature, wind, humidity, viral infections and allergens. A database study of 1,264,585 pediatric Emergency Department (ED) visits in 20 hospitals during 2010-2015, identified 47,107 visits classified as asthma exacerbations and compared that data to concentrations of air pollutants (nitrogen dioxide, ozone, fine particulate matter as well as meteorological data, respiratory syncytial virus infections and pollen count) which had been repetitively collected daily (or more often) during the same time period.
"There is an association between daily concentrations of fine particulate matter (particle aerodynamic diameter < 2.5 um ) and ED visits for asthma in children."
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