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Pediatrics

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By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
https://www.readbyqxmd.com/read/23813699/maternal-dietary-fat-intake-in-association-with-autism-spectrum-disorders
#1
Kristen Lyall, Kassandra L Munger, Éilis J O'Reilly, Susan L Santangelo, Alberto Ascherio
Our goal in this study was to determine whether maternal fat intake before or during pregnancy was associated with risk of autism spectrum disorder (ASD) in the offspring. Our primary analysis included 317 mothers who reported a child with ASD and 17,728 comparison mothers from the Nurses' Health Study II (index births in 1991-2007). Dietary information was collected prospectively through a validated food frequency questionnaire. Binomial regression was used to estimate crude and adjusted risk ratios. Maternal intake of linoleic acid was significantly inversely associated with ASD risk in offspring, corresponding to a 34% reduction in risk in the highest versus lowest quartiles of intake...
July 15, 2013: American Journal of Epidemiology
https://www.readbyqxmd.com/read/25004237/autism-and-nutrition-the-role-of-the-gut-brain-axis
#2
REVIEW
Marijke M H van De Sande, Vincent J van Buul, Fred J P H Brouns
Autism spectrum disorder (ASD) is characterised by deficits in the ability to socialise, communicate and use imagination, and displays of stereotypical behaviour. It is widely accepted that ASD involves a disorder in brain development. However, the real causes of the neurodevelopmental disorders associated with ASD are not clear. In this respect, it has been found that a majority of children with ASD display gastrointestinal symptoms, and an increased intestinal permeability. Moreover, large differences in microbiotic composition between ASD patients and controls have been reported...
December 2014: Nutrition Research Reviews
https://www.readbyqxmd.com/read/27864534/microbiome-and-nutrition-in-autism-spectrum-disorder-current-knowledge-and-research-needs
#3
REVIEW
Kirsten Berding, Sharon M Donovan
Autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disorder in the United States. Besides genetic risks, environmental factors have been suggested to contribute to the increase in ASD diagnosis over the past decade. Several studies have reported abnormalities in microbiota composition and differences in microbial metabolites in children with ASD. Gastrointestinal discomfort is commonly reported in children with ASD. Additionally, food selectivity and picky eating patterns are commonly reported...
December 2016: Nutrition Reviews
https://www.readbyqxmd.com/read/28562286/nutritional-and-dietary-interventions-for-autism-spectrum-disorder-a-systematic-review
#4
REVIEW
Nila Sathe, Jeffrey C Andrews, Melissa L McPheeters, Zachary E Warren
CONTEXT: Children with autism spectrum disorder (ASD) frequently use special diets or receive nutritional supplements to treat ASD symptoms. OBJECTIVES: Our objective was to evaluate the effectiveness and safety of dietary interventions or nutritional supplements in ASD. DATA SOURCES: Databases, including Medline and PsycINFO. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/26418822/gluten-free-and-casein-free-diets-in-the-therapy-of-autism
#5
REVIEW
Klaus W Lange, Joachim Hauser, Andreas Reissmann
PURPOSE OF REVIEW: The purpose of this study is to discuss the role of gluten-free and casein-free diets in the treatment of autism. RECENT FINDINGS: In a recent UK survey, more than 80% of parents of children with autism spectrum disorder reported some kind of dietary intervention for their child (gluten-free and casein-free diet in 29%). When asked about the effects of the gluten-free and casein-free diet, 20-29% of the parents reported significant improvements on the autism spectrum disorder core dimensions...
November 2015: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/26055422/dietary-glycemic-index-modulates-the-behavioral-and-biochemical-abnormalities-associated-with-autism-spectrum-disorder
#6
A Currais, C Farrokhi, R Dargusch, M Goujon-Svrzic, P Maher
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder of unknown etiology, but very likely resulting from both genetic and environmental factors. There is good evidence for immune system dysregulation in individuals with ASD. However, the contribution of insults such as dietary factors that can also activate the immune system have not been explored in the context of ASD. In this paper, we show that the dietary glycemic index has a significant impact on the ASD phenotype. By using BTBR mice, an inbred strain that displays behavioral traits that reflect the diagnostic symptoms of human ASD, we found that the diet modulates plasma metabolites, neuroinflammation and brain markers of neurogenesis in a manner that is highly reflective of ASD in humans...
March 2016: Molecular Psychiatry
https://www.readbyqxmd.com/read/26725748/risk-factors-in-autism-thinking-outside-the-brain
#7
REVIEW
Lauren Matelski, Judy Van de Water
Autism spectrum disorders (ASD) are complex neurodevelopmental conditions that have been rising markedly in prevalence for the past 30 years, now thought to affect 1 in 68 in the United States. This has prompted the search for possible explanations, and has even resulted in some controversy regarding the "true" prevalence of autism. ASD are influenced by a variety of genetic, environmental, and possibly immunological factors that act during critical periods to alter key developmental processes. This can affect multiple systems and manifests as the social and behavioral deficits that define these disorders...
February 2016: Journal of Autoimmunity
https://www.readbyqxmd.com/read/25025657/food-for-thought-dietary-changes-in-essential-fatty-acid-ratios-and-the-increase-in-autism-spectrum-disorders
#8
REVIEW
Kim van Elst, Hilgo Bruining, Barbara Birtoli, Christian Terreaux, Jan K Buitelaar, Martien J Kas
The last decades have shown a spectacular and partially unexplained rise in the prevalence of autism spectrum disorders (ASD). This rise in ASD seems to parallel changes in the dietary composition of fatty acids. This change is marked by the replacement of cholesterol by omega-6 (n-6) fatty acids in many of our food products, resulting in a drastically increased ratio of omega-6/omega-3 (n-6/n-3). In this context, we review the available knowledge on the putative role of fatty acids in neurodevelopment and describe how disturbances in n-6/n-3 ratios may contribute to the emergence of ASDs...
September 2014: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28944301/intravenous-rehydration-of-malnourished-children-with-acute-gastroenteritis-and-severe-dehydration-a-systematic-review
#9
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. The World Health Organization (WHO) SAM guidelines advise strongly against intravenous fluids unless the child is shocked or severely dehydrated and unable to tolerate oral fluids. Otherwise, guidelines recommend oral or nasogastric rehydration using low sodium oral rehydration solutions. There is limited evidence to support these recommendations. Methods: We conducted a systematic review of randomised controlled trials (RCTs) and observational studies on 15 th June 2017 comparing different strategies of rehydration therapy in children with acute gastroenteritis and severe dehydration, specifically relating to intravenous rehydration, using standard search terms...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/29066219/a-randomized-controlled-trial-of-one-bag-vs-two-bag-system-of-fluid-delivery-in-children-with-diabetic-ketoacidosis-experience-from-a-developing-country
#10
N Dhochak, M Jayashree, S Singhi
PURPOSE: To compare one vs. two bag system with respect to blood glucose variability (BGV), time for resolution of acidosis and incidence of hypoglycemia, hypokalemia, and cerebral edema in children with diabetic ketoacidosis (DKA). MATERIAL AND METHODS: In an open labelled randomized controlled trial, thirty consecutive patients ≤12years with DKA were randomized to either one (n=15) or two bag (n=15) system of intravenous fluid delivery. The two bags had similar electrolyte but differing dextrose concentration (none vs...
February 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29073302/potential-clinical-benefits-of-a-two-bag-system-for-fluid-management-in-pediatric-intensive-care-unit-patients-with-diabetic-ketoacidosis
#11
Jacqueline P Velasco Md, Joshua Fogel PhD, Robert L Levine Md PhD, Peter Ciminera Md, David Fagan Md, Renee Bargman Md
INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. AIM OF THE STUDY: We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU)...
2017: Pediatric Endocrinology, Diabetes, and Metabolism
https://www.readbyqxmd.com/read/29024734/clinical-and-dermoscopic-characterization-of-pediatric-and-adolescent-melanomas-multicenter-study-of-52-cases
#12
Cristina Carrera, Alon Scope, Stephen W Dusza, Giuseppe Argenziano, Gianluca Nazzaro, Alice Phan, Isabelle Tromme, Pietro Rubegni, Josep Malvehy, Susana Puig, Ashfaq A Marghoob
BACKGROUND: Knowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse, and this may in part contribute to delay in detection and thicker tumors. OBJECTIVE: To analyze the clinicodermoscopic characteristics of PM. METHODS: Retrospective study of 52 melanomas diagnosed in patients before the age of 20 years. RESULTS: On the basis of its clinical, dermoscopic, and histopathologic characteristics, PM can be classified as spitzoid or nonspitzoid...
February 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28967387/what-urinary-colony-count-indicates-a-urinary-tract-infection-in-children
#13
William Primack, Timothy Bukowski, Richard Sutherland, Lisa Gravens-Mueller, Myra Carpenter
Post-hoc analysis of the Randomized Intervention for Children with Vesicoureteral Reflux study suggests that, in concordance with European guidelines, using bacteriologic criterion of ≥10 000 colony forming units/mL of a single organism does not decrease diagnostic specificity of an urinary tract infection in children aged 2 months to 6 years in a properly collected urine if symptoms/fever and pyuria are present. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00405704.
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/23055049/current-treatment-of-selected-pediatric-sleep-disorders
#14
REVIEW
Shannon S Sullivan
While pediatric sleep disorders are relatively common, treatments are often not straightforward. There is often a paucity of gold standard studies and data available to guide clinicians, treatments may yield arguably incomplete results, interventions may require chronic use, and/ or involve multiple modalities including behavioral interventions that require high parental and family commitment. This review points out diagnostic differences compared to adults and focuses on current therapy for selected common pediatric sleep disorders including sleep disordered breathing/ obstructive sleep apnea, narcolepsy, and restless legs syndrome...
October 2012: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28193112/longitudinal-outcomes-in-the-2014-acute-flaccid-paralysis-cluster-in-canada
#15
Carmen Yea, Ari Bitnun, Joan Robinson, Aleksandra Mineyko, Michelle Barton, Jean K Mah, Jiri Vajsar, Susan Richardson, Christoph Licht, Jason Brophy, Megan Crone, Shalini Desai, Juliette Hukin, Kevin Jones, Katherine Muir, Jeffrey M Pernica, Robert Pless, Daniela Pohl, Mubeen F Rafay, Kathryn Selby, Sunita Venkateswaran, Geneviève Bernard, E Ann Yeh
We describe the presenting features and long-term outcome of an unusual cluster of pediatric acute flaccid paralysis cases that occurred in Canada during the 2014 enterovirus D68 outbreak. Children (n = 25; median age 7.8 years) presenting to Canadian centers between July 1 and October 31, 2014, and who met diagnostic criteria for acute flaccid paralysis were evaluated retrospectively. The predominant presenting features included prodromal respiratory illness (n = 22), cerebrospinal fluid lymphocytic pleocytosis (n = 18), pain in neck/back (n = 14) and extremities (n = 10), bowel/bladder dysfunction (n = 9), focal central gray matter lesions found in all regions of the spinal cord within the cohort (n = 16), brain stem lesions (n = 8), and bulbar symptoms (n = 5)...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28267276/hyponatremia-in-children-with-acute-respiratory-infections-a-reappraisal
#16
REVIEW
Camilla Lavagno, Gregorio P Milani, Peter Uestuener, Giacomo D Simonetti, Carmen Casaulta, Mario G Bianchetti, Pietro B Fare, Sebastiano A G Lava
Hyponatremia (<135 mmol/L), typically associated with an elevated anti-diuretic hormone level, is common among children admitted with bronchiolitis, pneumonia, or pulmonary exacerbation of cystic fibrosis. The main consequences of acute hyponatremia include cerebral edema and Ayus-Arieff pulmonary edema. A widespread belief is that, in children with pneumonia or bronchiolitis, hyponatremia results from inappropriate anti-diuresis. By contrast, the pathogenic role of extracellular fluid volume depletion or decreased effective circulating blood volume is underscored...
July 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28277412/the-use-of-a-triage-based-protocol-for-oral-rehydration-in-a-pediatric-emergency-department
#17
Marissa A Hendrickson, Jennifer Zaremba, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
BACKGROUND: Guidelines recommend oral rehydration therapy (ORT) and avoidance of laboratory tests and intravenous fluids for mild to moderate dehydration in children with gastroenteritis; oral ondansetron has been shown to be an effective adjunct. OBJECTIVES: The aim of this study was to determine if a triage-based, nurse-initiated protocol for early provision of ondansetron and ORT could safely improve the care of pediatric emergency department (ED) patients with symptoms of gastroenteritis...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/23385701/sleep-disorders-in-children
#18
REVIEW
Timothy F Hoban
PURPOSE OF REVIEW: The purpose of this review is to examine how sleep disorders in children are affected by age and comorbid medical influences, and to discuss current understanding of how the clinical manifestations, pathophysiology, and treatment of common childhood sleep disorders differ from those of the adult population. RECENT FINDINGS: Recently established age-specific norms are required for accurate interpretation of polysomnograms and multiple sleep latency tests in children...
February 2013: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/20668840/dose-finding-of-melatonin-for-chronic-idiopathic-childhood-sleep-onset-insomnia-an-rct
#19
RANDOMIZED CONTROLLED TRIAL
Ingeborg M van Geijlswijk, Kristiaan B van der Heijden, A C G Egberts, Hubert P L M Korzilius, Marcel G Smits
RATIONALE: Pharmacokinetics of melatonin in children might differ from that in adults. OBJECTIVES: This study aims to establish a dose-response relationship for melatonin in advancing dim light melatonin onset (DLMO), sleep onset (SO), and reducing sleep onset latency (SOL) in children between 6 and 12 years with chronic sleep onset insomnia (CSOI). METHODS: The method used for this study is the randomized, placebo-controlled double-blind trial...
October 2010: Psychopharmacology
https://www.readbyqxmd.com/read/24695508/common-sleep-disorders-in-children
#20
REVIEW
Kevin A Carter, Nathanael E Hathaway, Christine F Lettieri
Up to 50% of children will experience a sleep problem. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, irritability, behavioral problems, learning difficulties, motor vehicle crashes in teenagers, and poor academic performance. Obstructive sleep apnea occurs in 1% to 5% of children. Polysomnography is needed to diagnose the condition because it may not be detected through history and physical examination alone. Adenotonsillectomy is the primary treatment for most children with obstructive sleep apnea...
March 1, 2014: American Family Physician
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