Debora Porter

To elucidate whether the survival and long-term neurodevelopmental outcomes of extremely preterm infants have improved in a Japanese tertiary center with an active treatment policy for infants born at 22–23 weeks of gestation. source https://www.jpeds.com/article/S0022-3476(22)01075-7/fulltext?rss=yes

To estimate nutritional status in a large cohort of infants with orofacial clefts in the US, overall and by cleft type from birth to 6 months of age. source https://www.jpeds.com/article/S0022-3476(22)01088-5/fulltext?rss=yes

The effects of Riociguat, an oral soluble guanylate-cyclase stimulator, were studied in 10 infants with chronic pulmonary arterial hypertension (CPAH). Respiratory status (n=8/10), right heart dilation (n=7/10), function (n=9/10) and CPAH (n=8/10) improved. Median decrement in systolic 12[4,14] diastolic 14[7,20] and mean arterial pressure 14[10,17] were noted; no critical hypotension or hypoxemia occurred. source https://www.jpeds.com/article/S0022-3476(22)01079-4/fulltext?rss=yes

  OUT OF THE OLD BLACK BAG   Perspective on Long-Haul COVID in Children Part 1:   Is This Related to PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome)?   By  Anthony Kovatch, M.D.   Musical accompaniment:  “When You Believe” from the Disney musical “The Prince of Egypt” (1998). Written by Stephen Schwartz   Many nights we prayed With no proof, anyone could hear In our hearts a hopeful song We barely understood Now, we are not afraid Although we know there’s much to fear We were moving mountains Long before we knew we could, whoa, yes There can be miracles When you believe   Since its iteration in 1998 by Susan Swedo and colleagues at the National Institute of Mental Health, PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections) has been the subject of great enthusiasm, healthy scientific skepticism, and academic polarization.   Although widely accepted that the sy...

Male sex has been identified as a risk factor associated with mortality in preterm neonates [1–4]. Even though male preterm neonates have shown faster declines in mortality, respiratory distress syndrome (RDS), and bronchopulmonary dysplasia (BPD), they still have a significantly higher risk of mortality before hospital discharge, RDS, necrotizing enterocolitis (NEC), late-onset sepsis, severe intra-ventricular hemorrhage (IVH), severe retinopathy of prematurity (ROP), and BPD [5]. Similar results of increased mortality in premature male neonates have been reported from neonatal cohorts from Korea, Canada, Japan, Austria, and Switzerland [3,6–9]. source https://www.jpeds.com/article/S0022-3476(22)01074-5/fulltext?rss=yes

Over the last decade, pediatric visits to the emergency department (ED) for mental and behavioral health (MBH) have risen sharply, particularly for suicidal thoughts and self-harm.1,2 Ten percent of all pediatric hospitalizations are for a primary mental health diagnosis, and major depression is now the leading reason for pediatric admissions to urban nonteaching hospitals.3,4 Many children experience long waiting periods in the ED or on medical units while awaiting psychiatric admission, a practice known as boarding. source https://www.jpeds.com/article/S0022-3476(22)01076-9/fulltext?rss=yes

Like anyone else on the planet these days, Sarah Kaplan wants to limit the impact she is having on climate change. She wonders if she can get her holiday shopping done in a climate-conscious way: Here’s the thing about sustainable shopping: There are very few things you can purchase that are actively beneficial for the climate. Unless you’re buying a tree that will suck carbon from the air, most products require land, water and fossil fuels to produce and use. New stuff — clothes, appliances, bath products, toys, etc. — inherently comes at some environmental cost. Still, we all need new stuff sometimes; even I have had to replace the pair of yoga pants I’ve lived in since the start of the pandemic. By choosing products that are made sustainably, from companies that have demonstrated a commitment to minimize their environmental impact, experts say it is possible to make a difference.   Medical Students for a Sustainable Future (MS4SF) is a network of more than 410 m...

  One of the best measures of a healthy and prosperous nation is how well immunized its citizens are against vaccine-preventable diseases. Childhood vaccination rates in the United States have traditionally been high compared with less developed countries, where families have greater difficulty overcoming economic, religious, and political obstacles in order to get children the protection they need to avoid invisible yet aggressive pathogens. On The PediaBlog last week, we examined  a report issued by the Centers for Disease Control and Prevention and the World Health Organization showing that 25 million children around the world failed to receive life-saving vaccines during the pandemic, reversing the dramatic, decades-long trend of improving global vaccination coverage. While vaccination rates in the Americas fell in 2021 — 10% of children had zero doses in 2021 compared to 3% in 2015 — the biggest increases in “zero doses” of vaccines in children occurred in low- ...

Zack Hill by John Deering and John Newcombe ( Arcamax.com/thefunnies )             source http://www.thepediablog.com/2022/11/27/sunday-funnies-533/

Axel Boman – Out Sailing from Adam Chitayat on Vimeo : Over the course of the COVID lockdowns – desperate for the outside world beyond my doorstep, city, state and country – I started crafting a project using entirely Google Maps Streetview Images. I viewed and downloaded the world from my desk, finding amazing spaces, altering, hand tracking and creating timelapses and shots. I wasn’t quite sure what to make of the material. Until I heard the latest album from Axel Boman. Here was a song from one of my favorite artists with such a propulsive and idealistic reaching out towards the wider world. Letting the wind take us, with love as the sail, a blur of adventure across the planet.     source http://www.thepediablog.com/2022/11/26/cool-video-of-the-week-534/

*This post originally appeared on The PediaBlog on November 25, 2014.   Pushing Back: Shots & Daycare   A new national survey conducted by researchers at the University of Michigan C.S. Mott Children’s Hospital shows the extent of parental pushback on the subject of vaccine refusal among children in daycare: • 81% of parents surveyed agree that children who attend daycare centers should be vaccinated. • 74% of parents believe that daycare providers should be required to review children’s immunization records every year in order to ensure they are up-to-date. • 66% of parents think they should be told the number of children in their daycare center who are not fully immunized.  And 25% of these parents want the names of those who are not up-to-date. • 41% of parents surveyed feel that children who are not completely immunized should be excluded from the daycare until they are vaccinated; 28% believe they should be given a grace period and be allowed to attend...

Red and Rover by Brian Basset ( GoComics.com )   source http://www.thepediablog.com/2022/11/24/happy-thanksgiving-3/

Tiny lead fragments from lead ammo found in hunted game   Deer hunting season using standard firearms begins this Saturday in Pennsylvania. (Users of muzzleloaders had a week to themselves to hunt deer in October; flintlock firearm users get their turn at the end of December.) According to Sam Totoni and colleagues at the University of Pittsburgh Graduate School of Public Health, the majority of hunters use lead ammunition. The result is unintended consequences that threaten the health of wildlife and humans: Upon impact, a lead bullet can fragment into tiny microparticles, too small to see with the naked eye or sense when eating. A deer processor in Pennsylvania who requested anonymity shared his first-hand experience. “Seventy-five percent of the time when I find a bullet in the carcass, I only find the base. I know the lead is all in the meat somewhere,” he told EHN. Scientists have used X-rays to visualize and count sometimes hundreds of minute lead particles in hunted...

  As we have noted previously on The PediaBlog , routine vaccination coverage fell considerably in the United States and around the world during the pandemic, putting millions of children at risk for vaccine-preventable diseases. According to data published earlier this month, researchers from the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF) found that global vaccine coverage for infants hit a 13-year low: In 2021, the estimated global coverage with 3 doses of diphtheria-tetanus-pertussis–containing vaccine as well as the first dose of measles-containing vaccine decreased to 81%, the lowest level since 2008. Globally, 25.0 million children were unvaccinated or incompletely vaccinated in 2021, 5.9 million more than in 2019.   Other critical vaccines that protect children’s health and save lives were also neglected in 2020 and 2021, reports Rose Weldon: Global coverage decrease...

  November’s “tridemic” of RSV, influenza, and COVID-19 continued to overwhelm hospitals and medical clinics across the nation last week. In a letter sent to President Biden and HHS Secretary Becerra, the American Academy of Pediatrics and the Children’s Hospital Association urgently called on the government for help: Dear President Biden and Secretary Becerra: On behalf of America’s pediatricians and children’s hospitals, we ask you to declare an emergency to support the national response to the alarming surge of pediatric hospitalizations due to pediatric respiratory syncytial virus (RSV) and influenza along with the continuing children’s mental health emergency.   The request for government support comes at a time when providers and health systems are seeing “unprecedented levels of RSV happening with growing flu rates, ongoing high numbers of children in mental health crisis and serious workforce shortages […] combining to stretch pediatric care capacity at ...

Pickles by Brian Crane ( GoComics.com )           source http://www.thepediablog.com/2022/11/20/sunday-funnies-532/

Nike “Rise of the kids” from ALASKA Filmes on Vimeo .   source http://www.thepediablog.com/2022/11/19/cool-video-of-the-week-533/

*This post originally appeared on The PediaBlog on November 18, 2020.   Limiting SSB     Yesterday we looked at research indicating babies who are breastfed exclusively for the first six months of life have better dental health than those who aren’t. That benefit is lost, however, when children don’t keep up with healthy dental habits like brushing twice a day with fluoride toothpaste, flossing regularly, and avoiding sweet and sticky foods and sugar-sweetened beverages. After years of steady increases , it now appears that heavy consumption of sugar-sweetened beverages is declining in both children and adults. That’s good news considering what we learned last year about excessive consumption of added dietary sugar: In a joint policy statement with the American Heart Association published earlier this year, the American Academy of Pediatrics bluntly described the health consequences for children who drink sugar-sweetened beverages excessively: Excess consu...

To validate a novel biomarker, airway impedance for extraesophageal disease. source https://www.jpeds.com/article/S0022-3476(22)01022-8/fulltext?rss=yes

  Pediculosis capitis, otherwise known as head lice, is a common problem seen by pediatricians and feared by parents of preschoolers and school-age children. While they are a nuisance, head lice are harmless and don’t cause serious symptoms or carry any diseases. They do, however, cause a lot of anxiety among parents, as we discovered on The PediaBlog  back in 2013 when we reviewed “The Facts Of Lice” : Few things freak parents out more than head lice. Since head lice are very common in children, our offices get a lot of calls. About head lice. From freaked-out parents. Sure, lice do bite, and these bites can cause scalp itching and irritation in some kids and disturb sleep in others. But with parents it causes panic. Part of that is due to the commonly held (and totally false) belief that lice infestations occur in poor, dirty, or unhygienic populations. In fact, head lice like clean hair and don’t discriminate based on socioeconomic status. Another reason is just the th...

We commend Thomas et al (1) for their work on an important, oft neglected topic, urine sample collection. source https://www.jpeds.com/article/S0022-3476(22)01017-4/fulltext?rss=yes

  Pediatric emergency medicine physician Sage Myers, M.D. has observed her share of illness, pain, and suffering working in a busy, urban, children’s hospital emergency department before, but she has never seen anything like November’s “tridemic” of RSV, influenza, and COVID-19: Walking out of a shift in the pediatric emergency department (ED) lately is a heavy mix of relief, guilt, and pure exhaustion. Wading through wall-to-wall families, huddled in blankets and sweatshirts through long hours waiting to be seen, you wish you could do more, find more beds, create more staff. You’ve spent hours running from room to room, caring for sick kids who should be in hospital beds — but none currently exist. For weeks you’ve been evaluating and treating the deluge of incoming sick children and dropping everything when a child arrives in extremis and needs resuscitation; you’ve dedicated time talking to parents whose children are well enough to be cared for at home but need the courage...

Health inequities in pediatric subspecialty care in low to middle income countries (LMICs) is a long-standing challenge due to limited subspecialty providers, expensive pharmacologic treatments, and barriers to accessing treatment centers (1, 2, 3). without providing specialty care to children worldwide, we perpetuate global inequities. Efforts have been made to provide short term surgical and medical brigades to countries who lack the financial means to establish specialty centers (4, 5, 6, 7). source https://www.jpeds.com/article/S0022-3476(22)01021-6/fulltext?rss=yes

To provide a nationally representative estimate of the proportion of gun owners who report a child has independent access to one of their guns and to describe characteristics of these gun owners relative to other gun owning parents. source https://www.jpeds.com/article/S0022-3476(22)01023-X/fulltext?rss=yes

We recognize that there was some redundancy in the methods used, however, it is important to note that although different manufacturers may use similar methodology for measuring an analyte, it does not necessitate that the method will be impacted by interferences in the same way. The automated chemistry platforms evaluated in our study were selected on the basis of those analyzers that are most commonly used in clinical laboratories in the United States, as evidenced by the College of American Pathologists surveys. source https://www.jpeds.com/article/S0022-3476(22)01018-6/fulltext?rss=yes

UMHS fourth-year student Nihal Satyadev and UMHS professor Dr. D. Craig Ayre host a special livestream “Alzheimer’s Disease & Exploring Research in Medical School” on Wednesday, November 16 at 5pm Eastern on the UMHS Facebook, YouTube, Twitter, Instagram and LinkedIn social media channels in honor of November as Alzheimer’s Disease Awareness Month. In addition, the live event will feature the growing research department at UMHS. from University of Medicine and Health Sciences https://www.youtube.com/watch?v=VUOzipwGKNE via UMHS YouTube Channel

UMHS fourth-year student Nihal Satyadev and UMHS professor Dr. D. Craig Ayre host a special livestream “Alzheimer’s Disease & Exploring Research in Medical School” on Wednesday, November 16 at 5pm Eastern on the UMHS Facebook, YouTube, Twitter, Instagram and LinkedIn social media channels in honor of November as Alzheimer’s Disease Awareness Month. In addition, the live event will feature the growing research department at UMHS. from University of Medicine and Health Sciences https://www.youtube.com/watch?v=VUOzipwGKNE via UMHS YouTube Channel

  Just in time for the holidays: Influenza has come early and is  spreading fast , COVID-19 is  ever-present , RSV continues to put a heavy  strain on children’s hospitals across the nation, and other cold weather respiratory viruses are reappearing after being shut out by three years of COVID precautions like social distancing and masking. One week before Thanksgiving and a month before the Christmas holiday, doctors everywhere are hoping their patients are fully vaccinated and boosted against influenza and COVID-19 before they enjoy close gatherings with family and friends. If you and your children have not gotten your annual influenza vaccine, it’s getting late! COVID-19 vaccines are also a must to help avoid one of the most contagious, debilitating, and deadly infectious diseases out there (1,070,947 Americans and counting have died from COVID-19, including 2,344 in the last week alone). The newest, bivalent COVID boosters are highly effective...

  Foodborne outbreaks caused by the bacteria  Listeria monocytogenes  are not uncommon occurrences in the United States. In 2021, the Centers for Disease Control and Prevention identified four outbreaks involving packaged salads and processed chicken and cheese. So far this year, cheese and ice cream have been sources of listeriosis, an intestinal infection which can be especially severe in pregnant women and their fetuses or newborn infants, the elderly, and people with impaired immune systems. Last week, the CDC issued a warning about a new outbreak of listeriosis tied to deli meats and cheeses: You are at higher risk for severe Listeria illness if you are pregnant, aged 65 or older, or have a weakened immune system due to certain medical conditions or treatments. If you are in any of these groups, do not eat meat or cheese from any deli counter, unless it is reheated to an internal temperature of 165°F or until steaming hot.   By Wednesday, th...