Hippocampal sclerosis in children younger than 2 years

Background  

Hippocampal sclerosis (HS) is rarely considered as a diagnosis in children younger than 2 years.     

Poor family functioning mediates the link between childhood adversity and adolescent nonsuicidal self‐injury

Background

Non‐suicidal self‐injury (NSSI) is a common harmful behavior during adolescence. Exposure to childhood family adversity (CFA) is associated with subsequent emergence of NSSI during adolescence. However, the pathways through which this early environmental risk may operate are not clear.

Aims

We tested four alternative hypotheses to explain the association between CFA and adolescent‐onset NSSI.

Methods

A community sample of n = 933 fourteen year olds with no history of NSSI were followed up for 3 years.

Results

Poor family functioning at age 14 mediated the association between CFA before age 5 and subsequent onset of NSSI between 14 and 17 years.

Conclusions

The findings support the cumulative suboptimal environmental hazards ( proximal family relationships as a mediator) hypothesis. Improving the family environment at age 14 may mitigate the effects of CFA on adolescent onset of NSSI.     

Iron deficiency as a risk factor for simple febrile seizures-<Emphasis Type="Italic">A case control study</Emphasis>

Objective  

To study the role of iron deficiency as a risk factor for simple febrile seizures.     

Tracheal compression due to an elongated aortic arch in patients with congenital heart disease: evaluation using multidetector-row CT

Background  

The airway can become obstructed as a result of compression by an elongated aortic arch.     

Health Consequences of Childhood Obesity

Objectives  

To evaluate the cardiovascular and endocrine effects of childhood obesity as well as prevalence of metabolic syndrome associated with it.     

A Randomized Controlled Trial of Oral Zinc in Acute Pneumonia in Children Aged between 2 Months to 5 Years

Objective  

To evaluate the effectiveness and safety of zinc supplementation as adjuvant in treatment of pneumonia.     

Cytomegalovirus enterocolitis presenting as abdominal compartment syndrome in a premature neonate

Background  

Cytomegalovirus (CMV) enterocolitis is an uncommon intestinal disorder of newborns that is often initially misdiagnosed as necrotizing enterocolitis.     

Does facility-based newborn care improve neonatal outcomes? A review of evidence

Context  

Facility based newborn care is gaining importance as an intervention aiming at reduction of neonatal mortality.     

Hypertonic Versus Normal Saline as Initial Fluid Bolus in Pediatric Septic Shock

Objective  

To compare the efficacy of 3% saline and 0.9% saline infusion as initial resuscitative fluid therapy in children with septic shock.     

B‐type natriuretic peptide for assessment of haemodynamically significant patent ductus arteriosus in premature infants

Aim

Haemodynamically significant patent ductus arteriosus (hsPDA) is frequently observed in premature infants. This study was conducted to explore whether the blood BNP can be a valuable biomarker to assess the necessity of treatment for hsPDA in premature infants.

Methods

Serial measurements of the blood BNP were performed during the first 5 days of life in premature infants with hsPDA (Group I) and those without hsPDA (Group N). The definition of the hsPDA was the PDA requiring treatment, such as indomethacin administration and/or surgical ligation.

Results

Forty‐six subjects were enrolled. Compared with Group N, Group I showed significantly higher level of blood BNP at postnatal 24–96 h and demonstrated the peak value at postnatal 24–48 h. With the ROC curve using the data at postnatal 24–48 h in Group I, we deduced the predictive value of 250 pg/mL of blood BNP for indomethacin treatment. Similarly, with the ROC curve using the maximal value of blood BNP within the first 5 days of life, the predictive value of 2000 pg/mL for surgical ligation was deduced.

Conclusions

Blood BNP during early postnatal period can be a useful biomarker to assess the necessity of treatment for hsPDA in premature infants.     

Prenatal presentation of transient central diabetes insipidus

Introduction  

Nephrogenic diabetes insipidus (DI) in the foetus has been described as a rare presentation of severe polyhydramnios.     

Impact of diagnostic and end-of-induction Curie scores with tandem high-dose chemotherapy and autologous transplants for metastatic high-risk neuroblastoma: A report from the Children's Oncology Group

Background

Diagnostic mIBG (meta-iodobenzylguanidine) scans are an integral component of response assessment in children with high-risk neuroblastoma. The role of end-of-induction (EOI) Curie scores (CS) was previously described in patients undergoing a single course of high-dose chemotherapy (HDC) and autologous hematopoietic cell transplant (AHCT) as consolidation therapy.

Objective

We now examine the prognostic significance of CS in patients randomized to tandem HDC and AHCT on the Children's Oncology Group (COG) trial ANBL0532.

Study design

A retrospective analysis of mIBG scans obtained from patients enrolled in COG ANBL0532 was performed. Evaluable patients had mIBG-avid, International Neuroblastoma Staging System (INSS) stage 4 disease, did not progress during induction therapy, consented to consolidation randomization, and received either single or tandem HDC (n = 80). Optimal CS cut points maximized the outcome difference (≤CS vs. >CS cut-off) according to the Youden index.

Results

For recipients of tandem HDC, the optimal cut point at diagnosis was CS = 12, with superior event-free survival (EFS) from study enrollment for patients with CS ≤ 12 (3-year EFS 74.2% ± 7.9%) versus CS > 12 (59.2% ± 7.1%) (p = .002). At EOI, the optimal cut point was CS = 0, with superior EOI EFS for patients with CS = 0 (72.9% ± 6.4%) versus CS > 0 (46.5% ± 9.1%) (p = .002).

Conclusion

In the setting of tandem transplantation for children with high-risk neuroblastoma, CS at diagnosis and EOI may identify a more favorable patient group. Patients treated with tandem HDC who exhibited a CS ≤ 12 at diagnosis or CS = 0 at EOI had superior EFS compared to those with CS above these cut points.     

Prognostic value of a scorable neurological examination from 3 to 12 months post-term age in very preterm infants: A longitudinal study

Aims and study design

The Hammersmith Infant Neurological Examination proved effective in predicting locomotor function in very preterm infants after 9 months of age. We performed the examination in a cohort of 103 very preterm infants (gestational age below 32 weeks) as early as 3 months' post-term age, and longitudinally at 6, 9 and 12 months. Our aim was to establish the frequency distribution of the optimality scores at each age period, to explore the predictive value of the examination from 3 months onwards as to developmental outcome and locomotor function at 2 years, and to explore its longitudinal consistency.

Results

The results showed that this standardized neurological examination can be performed in preterm infants as early as 3 months' post-term age to predict motor outcome at 2 years, and that its high predictive value is consistent across the first year of life due to an effective combination of different items for each age period.

Conclusions

We confirm the high predictive value of this neurological examination in very preterm infants after 9 months and extend it to the assessments performed as early as 3 months post-term. This is of great relevance as in very preterm infants early prediction of motor function is essential for a prompt planning of therapeutic interventions.     

Single payer health insurance in pediatric surgery: US impressions and Canadian experience

Context  

Some advocate single payer national health insurance, present in Canada, as a solution to problems in US health care.     

Diffusion tensor imaging evaluation of white matter in adolescents with myelomeningocele and Chiari II malformation

Background  

Macrostructural abnormalities in cerebral white matter in patients with myelomeningocele are well known, but microstructural abnormalities are not as well studied.     

Umbilical Vascular Catheter Associated Portal Vein Thrombosis Detected by Ultrasound

Objective  

To determine catheter-associated thrombosis by color Doppler ultrasound and to detect duration of catheter placement as a risk factor for thrombosis.     

Cardiac complications and immunophenotypic profile of infectious mononucleosis syndrome in children

Objective  

To investigate cardiac complications in infectious mononucleosis patients and to associate them with biochemical and immunological parameters, as well as with spleen ultrasound findings.     

Breast feeding and insulin levels in low birth weight neonates: A randomized study

Objective  

To evaluate the influence of early infancy feeding practices on fasting insulin levels, as marker of insulin resistance, in low birthweight neonates.     

Efficacy and safety of deferasirox for reducing total body and cardiac iron in Thalassemia

Objective  

To assess the efficacy of deferasirox as an iron chelator, with specific reference to reducing cardiac iron overload.     

Arterial stiffness in junior high school students: Longitudinal observations

Background

Early atherosclerotic change is found even in childhood, and there is an urgent need to clarify the factors causing childhood atherosclerosis and take preventive measures. Early detection of the contributing risk factors is crucial to facilitate preventive measures. Pulse wave velocity (PWV) is a widely used technique for the assessment of atherosclerosis in children.

Methods

Lifestyle questionnaire, brachio‐ankle PWV (baPWV) and anthropometric data were obtained from junior high school students in an urban area of Japan between 2006 and 2008, from seventh to ninth grades.

Results

Mean baPWV increased from 867.4 ± 99.5 m/s to 944.5 ± 117.5 m/s in boys, and from 864.0 ± 99.5 m/s to 923.0 ± 101.3 m/s in girls. Obese students had higher baPWV than non‐obese students in both genders across each grade. On logistic regression analysis of ninth grade student data, high baPWV was dependent on systolic blood pressure (SBP), time watching television (TV) and symptoms of depression and anxiety, whereas low baPWV was dependent on time playing video games, light exercise, sleep and indoor play, as well as good friendship and motivation.

Conclusion

Systolic blood pressure, time watching TV, and symptoms of depression and anxiety may contribute to arterial stiffness and be related to obesity in junior high school students.