Children in low income countries at higher risk of death post emergency surgery

Children from poor countries were 7 times more likely to die after emergency abdominal surgery to treat conditions such as appendicitis, suggests a study published online in the journal BMJ Global Health. Children from middle income countries were around 4 times as likely to die within 30 days. Children from poor countries were much less likely to have undergone keyhole surgery, half as likely to have been operated on by surgeons who used the WHO surgical safety checklist and more likely to have had internal bleeding.


Noise in Pediatric ICU Harmful for Patients

Patients, staff and families in pediatric intensive care units (PICUs) are routinely exposed to noise levels higher than the recommended safe range, says a new study reported online July 9, 2016 in the Journal of Critical Care. The average maximum dB for all patients was 82.2. The average minimum dB was 50.9. The average daily bedside noise level was 62.9 dBA. Patients experienced an average of 115 min/day where peak noise was greater than 100 dBA. Monitors were identified as the major contribution to noise by the parents and staff. These high noise levels in PICU have a detrimental effect on patients, including staff and families.


Maternal depression affects health and development of children

Although inquiring/screening about maternal depression has increased since 2004, less than half of pediatricians usually screen or inquire about maternal depression, representing a missed opportunity to identify depression and manage or refer women for treatment. Further training on the importance of mental and family health to children’s health may increase identification of maternal depression in pediatric primary care.[Source: J Dev Behav Pediatr. 2016 Feb-Mar]


Analyzing repolarization patterns in pediatric population with congenital heart disease

As prolonged QT is suggestive of a myocardium that is at risk of ventricular arrhythmia, a cross-sectional study published in the journal of Pediatric Cardiology assessed the repolarization patterns in children with cyanotic and acyanotic congenital heart diseases. It was observed that prolonged QTc was higher in children with acyanotic congenital heart diseases with volume overload and increased left ventricular end diastolic dimension was a significant association. Moreover, reduced oxygen saturation was a significant association.


Maternal folate levels may predict risk of childhood overweight or obesity

Adequate maternal folate levels may mitigate the risk for childhood obesity, especially among children born to obese mothers, according to a prospective birth cohort study conducted at the Boston Medical Center, Boston, Massachusetts and published online June 13, 2016 in JAMA Pediatrics. The highest risk for child overweight or obesity was found among children of obese mothers with low folate concentrations. The authors suggest that there is a need to establish optimal rather than minimal folate concentrations for preventing adverse metabolic outcomes in the offspring.


High Epo doses with hypothermia for hypoxic-ischemic encephalopathy cause less MRI brain injury

High doses of erythropoietin, 1000 U/kg intravenously, given with hypothermia for hypoxic-ischemic encephalopathy may result in less MRI brain injury and improved 1-year motor function, says a new phase II double-blinded, placebo-controlled trial published in June 2016 issue of the journal Pediatrics. Moderate/severe brain injury (4% vs 44%), subcortical (30% vs 68%) and cerebellar injury (0% vs 20% were less frequent in the erythropoietin than placebo group.


Concomitant administration of flu vaccine with other vaccines increases risk of febrile seizures

Review of data from the CDC’s Vaccine Data Safetylink program published online June 06, 2016 in the journal Pediatrics finds that the administration of trivalent inactivated influenza vaccine (IIV3) on the same day as either pneumococcal conjugate vaccine (PCV) or a diphtheria-tetanus-acellular-pertussis (DTaP)-containing vaccine was associated with a greater risk of febrile seizures than when IIV3 was given on a separate day. Risk increased 5-fold when all three vaccines were administered together than when given separately.


More visits to ED point to higher odds of developing diabetic ketoacidosis

A new research from the Stanford School of Medicine, California says that recent visits to the emergency department (ED) and long intervals without subspecialty care are important signals of impending diabetic ketoacidosis in children with type 1 diabetes. They also recommend that these indicators along with other risk factors could be used to inform clinical and case management interventions that aim to prevent DKA hospitalizations. The study is reported online May 20 in the journal Pediatrics.


Study links adrenal gland tumors to ADHD

Pediatric patients diagnosed with pheochromocytomas (PHEO) or paragangliomas (PGL) were nearly three times as likely to also carry a diagnosis of attention deficit hyperactivity disorder (ADHD), compared to pediatric patients without PHEO or PGL. A study in Hormone and Metabolic Research reported May 12, 2016 found a prevalence of ADHD in 21% of PHEO/PGL patients, significantly higher than 7.2% seen in the general pediatric population. And, in 33% of the patients with PHEO and PGL, ADHD symptoms were resolved following surgical removal of the tumor.


Children with new-onset epilepsy at high risk for impaired attention and executive function

In a study published May 10, 2016 in Epilepsy & Behavior, attention and executive functions of children with new-onset epilepsy were significantly more often impaired when compared with a healthy population, but less often when compared with children with chronic epilepsy. The risk of impaired cognitive functions was significantly heightened when etiology of epilepsy was unknown or not classifiable. Most children showed stable cognitive functioning in the early course of treatment, a fact which can used to counsel families who are apprehensive about negative side effects of drug treatment.

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