|
Indian Pediatr 2017;54: 252 |
|
Clippings
Theme: General Pediatrics
|
K Rajeshwari
Email:
[email protected]
|
|
Endotracheal administration of surfactant. (Pediatr Pulmonol.
2017 Feb 2. doi:10.1002/ppul.23651)
|
This systematic review evaluated the clinical outcomes of surfactant
administration in preterm infants via a thin endotracheal catheter
during spontaneous breathing compared with conventional administration
involving tracheal intubation, mechanical ventilation and tracheal
extubation. Data were analyzed using the Cochrane Collaboration methods.
Primary outcome measures included the incidence of mechanical
ventilation and bronchopulmonary dysplasia. Four randomized controlled
trials (RCTs), two cohort studies, and six historical controlled studies
involving 5,261 preterm infants were analyzed. In RCTs, surfactant
administration though a thin catheter reduced the incidence of
mechanical ventilation (MV) (RR 0.74; 95% CI 0.66, 0.81) in 72 h and
bronchopulmonary dysplasia (BPD) (RR 0.69, 95% CI 0.50, 0.97) compared
with conventional administration. In non-randomized studies also, there
was significant reduction in the incidence of MV (RR 0.55, 95% CI 0.45,
0.68) and BPD (RR 0.70, 95% CI 0.60, 0.82) in favor of the thin catheter
group. There were no significant differences between the two procedures
in terms of short-term pulmonary complications, intracranial pathology,
necrotizing enterocolitis, retinopathy of prematurity, and mortality.
|
|
Influence of parental television viewing on
children. (Acta Paediatr. 2017 Feb 1. doi:
10.1111/apa.13771)
|
Excessive television (TV) exposure has negative impacts on a child’s
development, health and behavior. This study examined the
under-researched area of what impact infant and parental TV viewing
during a child’s infancy had on the child’s later viewing habits. Data
on 18,577 children born in 2005 were collected from the Taiwan Birth
Cohort Study. Group-based trajectory analysis was conducted to identify
childhood TV viewing trajectories at 18, 36 and 66 months of age.
Multinomial logistic regression was used to examine
the influence of parents’ TV behavior on their children’s TV viewing
trajectories. The percentage of children falling into the TV viewing
trajectories that were identified were: low (20%), increasing (46.5%)
and high (33.5%). The child’s TV viewing trajectory was significantly
associated with the child’s sex, parent’s monthly income, child’s
daycare arrangements, maternal and paternal education, and maternal and
paternal TV viewing time. The results particularly highlight the need to
restrict child and parental TV viewing time in infancy.
|
|
Vitamin D and preterm birth. (J Obstet Gynaecol Res.
2017;43:247-56)
|
A meta-analysis of randomized controlled trials (RCTs) and observational
studies was done to answer the two following questions: (i)
whether low maternal circulating 25-hydroxyvitamin D (25(OH)D) is
associated with an increased risk of preterm birth or spontaneous
preterm birth; and (ii) whether vitamin D supplementation alone
during pregnancy can reduce the risk of preterm birth. Maternal
circulating 25(OH)D deficiency (pooled OR 1.25; 95% CI 1.13, 1.38)
rather than insufficiency (pooled OR 1.09; 95% CI 0.89, 1.35) was
associated with an increased risk of preterm birth, and vitamin D
supplementation alone during pregnancy could reduce the risk of preterm
birth (pooled RR 0.57; 95% CI 0.36, 0.91). This was also the case for
the spontaneous preterm birth subgroup.
|
|
Interleukin levels and bacteremia. (Turk J Haematol.
2017 Feb 1.doi: 10.4274/tjh.2016.0434)
|
Despite improvements in diagnosis and treatment, infections are still
major causes of morbidity and mortality in children with febrile
neutropenia. In majority of febrile episodes, infection source cannot be
defined. This study aimed to identify the earlier predictors of
bacteremia/fungemia, and a useful cytokine to identify the source of
infections and to discriminate the patients with culture-confirmed
bacterial/fungal infection. Interleukin (IL)-6, IL-8 and IL-10
circulating levels were higher in the state of infection. The most
sensitive cytokine was IL-10, and the most specific was IL-8 in
predicting culture-confirmed infections. IL-8 had greater sensitivity
and specificity in determination of Gram-negative bacterial infections.
|
|
Low muscle mass and cardiometabolic risk. (Pediatr
Diabetes. 2017 Feb 1. doi: 10.1111/pedi.12505)
|
Increased cardiometabolic risk (CMR) is documented in obese and
non-obese adolescents with low muscular fitness. However, the
association of low muscle mass (LMM) with CMR, independent of weight
status, has not been examined. This observational study in 660
adolescents analyzed the relationship of LMM with CMR in adolescents,
regardless of their weight status. Body mass index (BMI), waist
circumference (WC) and arterial blood pressures (ABP) were measured.
Total fat mass (TFM), total lean tissue (TLT), and appendicular skeletal
muscle mass (ASM) were estimated. Fasting lipid profile, glucose, and
insulin were measured; and metabolic syndrome (MetS) was diagnosed as
per standard (AHA/NHLBI/IDF) criteria. ROC analysis was performed to
find the optimal cut-offs of TLT percentage for MetS diagnosis. Values
below these cut-offs defined LMM. In both sexes, TLT showed better
sensitivity and specificity than ASM for MetS diagnosis. Adolescents
with LMM, regardless of nutritional status, had significantly increased
values of MetS Z-score, ABP, TG, TC/HDL-chol, and HOMA-IR than non-obese
non-LMM adolescents. Adolescents having both obesity and LMM had the
unhealthiest CMR profile.
|
|
|
|