Debora Porter

A term neonate was brought to the outpatient department on day 9 of life with complaints of decreased movements of the left upper limb. She was born at 40 weeks, weighing 3750 grams, to a gravida 2 para 1 mother by vaginal delivery with a history of shoulder dystocia. On examination, the baby was active and alert, and she showed high quality movements, but there was absence of movements of the left arm along with ptosis in the left eye (Video 1). The left upper limb was flaccid, with absent movements at the shoulder, elbow and wrist, and absent grasp reflex. source https://www.jpeds.com/article/S0022-3476(23)00225-1/fulltext?rss=yes

*This post originally appeared on The PediaBlog on March 31, 2021.   “Why?”   Pickles by Brian Crane (arcamax.com/thefunnies)   Neha Chaudhary, M.D. is a child psychiatrist who understands  that no matter how innocuous, annoying, and frustrating they can be, children’s questions always deserve a thoughtful answer: It turns out that by answering and asking questions, parents play a vital role in a child’s learning. By paying attention to this simple — sometimes annoying — phenomenon, parents may help shape their child’s development and better set them up for longer term success.   Parents “understand and shape their child’s development” better than anyone else, Dr. Chaudhary explains. Influencing their child’s learning process can provide “enormous benefits on a child’s overall well-being” and future trajectory: Parents can easily influence a child’s love for learning, which I think for many kids is just as important to success as genetics or tea...

A healthy 4-year-old child presented with a 9-month history of a non-resolving lip lesion. His family are Afghani refugees who transited through Pakistan prior to arrival to Canada 8 months earlier. The lesion began as a painless, erythematous papule with a punched-out appearance while he was in Pakistan. The lesion slowly grew and developed a painful central ulceration and intermittent bleeding (Figure 1). He had seen numerous Canadian physicians and received numerous topical and systemic antibiotics without improvement. source https://www.jpeds.com/article/S0022-3476(23)00224-X/fulltext?rss=yes

This study sought to determine duration of fecal excretion of Clostridium botulinum organisms and neurotoxin after onset of infant botulism in 62 affected infants. Median excretion was longer for type A than type B patients (organisms: 5.9 versus 3.5 weeks, toxin: 4.8 versus 1.6 weeks, respectively). Toxin excretion always ceased before organism excretion. Antibiotic therapy did not affect duration of excretion.Methods source https://www.jpeds.com/article/S0022-3476(23)00223-8/fulltext?rss=yes

‘One day in the forest, a fire broke out. All the animals ran for their lives. They stood at the edge of the blaze, looking at the flames in terror and sadness. Up above their heads, a hummingbird was flying back and forth to the fire, over and over again. The bigger animals asked the hummingbird what she was doing. “I am flying to the lake to get water to help put out the fire.” The animals laughed at her and said, “You can’t put out this fire!” The hummingbird replied, “I’m doing what I can.”’   According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), one-quarter of the world’s population — about 2 billion people — lack access to something many of us take for granted: clean and safe drinking water. And nearly half (3.6 billion) of Earth’s inhabitants don’t have adequate sanitation services. UNESCO’s report — UN World Water Development Report 2023 — was issued last Wednesday to coincide with the global observance of World Water Day ...

To compare the accuracy of urine neutrophil gelatinase-associated lipocalin (NGAL) and leukocyte esterase (LE) for the diagnosis of urinary tract infection (UTI) in children. source https://www.jpeds.com/article/S0022-3476(23)00221-4/fulltext?rss=yes

  March is National Colorectal Cancer Awareness Month : Colorectal cancer, or CRC, is the second deadliest cancer in the United States. Every March, National Colorectal Cancer Awareness Month spotlights this disease and inspires more people to get checked starting at age 45. Two reasons why getting checked matters: • Screening can find the warning signs of colon and rectal cancer, letting doctors take action to prevent the disease. • Screening can also find colorectal cancer early, when treatment is most effective.   Colorectal cancer is the fourth most commonly diagnosed cancer in adults and the second-leading cause of cancer death in the U.S. The American Cancer Society estimates that 153,000 Americans will be diagnosed this year with CRC and 52,000 will die from the disease. For more than 30 years, researchers have observed a rising number of younger adults being diagnosed with colorectal cancer. By 2030, Jacqueline Howard reports , colorectal cancer will be the ...

  According to data from the National Foundation of High School Associations, approximately 8 million high school students — about 57% of all students attending high school — participated in at least one organized school sport in the United States during the 2018-2019 school year. Football, outdoor track and field, basketball, baseball, and soccer are the five most popular sports among boys; outdoor track and field, volleyball, basketball, soccer, and softball attract the most girls. The American Academy of Orthopedic Surgeons characterizes the adolescent athlete as more vulnerable to sports injuries: Teenage athletes are injured at about the same rate as professional athletes, but injuries that affect high school athletes are often different from those that affect adult athletes. This is largely because high school athletes are often still growing. Growth is generally uneven: Bones grow first, which pulls at tight muscles and tendons. This uneven growth pattern makes you...

  Well-child check-ups are important opportunities for pediatricians to periodically reconnect with their patients and families and assess a child’s growth, development, and overall health status. For parents, it’s a chance that comes once a year (more frequently up until age 3) to ask questions, express concerns, brag a little bit about how great their child is doing, and receive expert guidance about keeping kids healthy and safe. During the course of a routine check-up, pediatricians ask a wide variety of questions to help update the family history, note changes to the child’s social history, and review medication lists and allergies. We’ll ask about how your child is eating, pooping, peeing, and sleeping, and talk about how things are going in school and in life. And then at the end of the visit — after the questions have been answered and the physical examination completed — immunizations will be reviewed, discussed, and administered if due. Earlier this year, the C.S. Mot...

Dog Eat Doug by Brian Anderson ( GoComics.com )           source https://www.thepediablog.com/2023/03/26/sunday-funnies-550/

The Photographer Taking His Own Shot from Great Big Story on Vimeo : Achmad Zulkarnain is a professional photographer telling the story of Indonesia from his own unique perspective. Born without hands and legs, Zulkarnain picked up an interest in photography while taking ID card headshots for his local community. With his specially designed mini go-kart, he travels the country in search of the best frames. Today, he’s gained international recognition for his work, with features in publications around the world.     source https://www.thepediablog.com/2023/03/25/cool-video-of-the-week-551/

*This post originally appeared on The PediaBlog on March 24, 2022.   Sunrise, Sunset     After the Sunshine Protection Act was introduced in the U.S. Congress last March, The PediaBlog examined the pros and cons of making daylight saving time (DST) permanent. The stated benefits of year-round DST were mostly economic: More late afternoon and early evening light means higher consumer spending, giving the overall economy a boost. On the other hand, medical research tells us that DST interferes with the body’s natural circadian rhythm, which sleep experts say can lead to significant physical and mental health consequences. Simply keeping things the way they are — turning the clocks forward one hour in March and back one hour in November — also has its drawbacks: Anne Buckle argues that simply changing the clocks twice a year can make people sick: Changing the time, even if it is only by one hour, disrupts our body clocks or circadian rhythm. For most peo...

  OUT OF THE OLD BLACK BAG   Spend More Time Outside and Ditch the Glasses? By  Anthony L. Kovatch, M.D.   “In the midst of every crisis lies great opportunity.”   —  Albert Einstein, widely acknowledged to be one of the most influential physicists of all time, as well as a supreme visionary.   Being both severely near-sighted and too stubborn to wear his glasses made comical cartoon character Mister Magoo a favorite of the author!   I am not sure to this day whether the fourth grade teacher’s “screws were loose” or whether her slap across my face had loosened my eyeballs’ connections to their surrounding boney sockets — or whether both were happening at the same time! The teacher claimed that I, the timid mouse of the class, was purposely rolling my eyes to make fun of her and deserved corporal punishment to learn a lesson.   Even at that ripe age, I should have suspected that something was amiss; my younger brother had needed ...

The efficacy and safety of anakinra is firmly established in both pediatric and adult populations based upon the results of a randomized trial (AIRTRIP) and an international registry (IRAP).1,2 The study of Caorsi et al raises two important points that should be taken into account when treating patients with recurrent pericarditis.3 First, 25% of pediatric patients were underdosed with first-line medications before commencing anakinra. This highlights the paramount importance of referring these patients to specialized centers. source https://www.jpeds.com/article/S0022-3476(23)00113-0/fulltext?rss=yes

  It’s that time of year again to review Environmental Working Group’s annual “Shopper’s Guide to Pesticides in Produce” and see which fruits and vegetables made the “Dirty Dozen” and “Clean 15” lists. (See previous posts on EWG’s research on The PediaBlog  from 2022 , 2021 , 2019 , 2017 , and 2016 .) EWG analyzed data compiled by the U.S. Department of Agriculture and the Food and Drug Administration: The 2023 guide includes data from 46,569 samples of 46 fruits and vegetables. The USDA peels or scrubs and washes produce samples before testing, whereas the FDA only removes dirt before testing its samples. Even after these steps, the tests still find traces 251 different pesticides.   This year’s study found that 75% of non-organic fresh produce sold in the U.S. contained residues of one or more of these 251 potentially dangerous pesticides. As we are reminded every year EWG publishes its results, children face the greatest health risk and bear the highest burde...

  Yesterday on The PediaBlog, we learned that for at least the past 20 years, study after study has found worrisome contamination of commercial baby food with neurotoxic heavy metals like lead, arsenic, cadmium, and mercury. Although many of the studies found levels below the Food and Drug Administration’s safety threshold, that’s not necessarily reassuring to pediatricians, who know their youngest patients could potentially be harmed by heavy metals and other environmental contaminants at extremely low levels. The FDA has been addressing the problem of heavy metals in baby foods since 2021 by issuing guidelines that are designed “to reduce dietary exposure to contaminants to as low as possible, while maintaining access to nutritious foods.” The agency’s work to date has resulted in significant progress in reducing exposure to environmental contaminants from foods and Closer to Zero builds on this progress. We have prioritized foods commonly eaten by babies and young child...

To determine the clinical manifestations, management, and outcomes of pediatric granuloma annulare. source https://www.jpeds.com/article/S0022-3476(23)00194-4/fulltext?rss=yes

  In June 2017, The PediaBlog reported on the disturbing results of a study examining lead-contaminated commercial baby foods and fruit juices: An analysis of data from the U.S. Food and Drug Administration between 2003 and 2013 shows that baby foods are a significant source of lead in the diets of the very people who can’t afford to consume any lead whatsoever. And the reason is simple: There is no safe level of lead in blood, therefore, there is no safe level of exposure to lead.   Of the baby foods analyzed by the Environmental Defense Fund using FDA data, 52 out of 57 food types contained lead in at least one sample. Fruit juices (grape, apple, pear, and mixed juices), root vegetables (sweet potatoes and carrots), and cookies (arrowroot and teething biscuits) were most commonly contaminated with detectable amounts of lead. Of note: commercially processed baby foods were more likely to contain lead than unprocessed table foods, suggesting that lead is introduced du...

Family Circus by Bil Keane ( Arcamax.com/thefunnies )                         source https://www.thepediablog.com/2023/03/19/sunday-funnies-549/

The Farmer’s Dog — Forever (Extended Cut) from Goh Iromoto on Vimeo .   ( The PediaBlog endorses dogs but not the dog food.)   source https://www.thepediablog.com/2023/03/18/cool-video-of-the-week-550/

Our institution’s annual bereaved family event was modified to a virtual format during the COVID-19 pandemic. While necessary to comply with physical distancing directives, the transition also provided greater accessibility for families. Virtual events were feasible and appreciated by attendees. Future hybrid bereavement events should be considered to allow families more flexibility and accessibility. source https://www.jpeds.com/article/S0022-3476(23)00195-6/fulltext?rss=yes

*This post originally appeared on The PediaBlog on March 17, 2017.   Why We Need Sleep     Today is World Sleep Day, an annual event “intended to be a celebration of sleep and a call to action on important issues related to sleep, including medicine, education, social aspects and driving.” We learned yesterday that elephants function very well on very little sleep. We know that humans don’t. Getting enough good quality sleep each night has been shown to maintain good physical and mental health and improve quality of life, safety, and performance of daily tasks like learning, working, and playing. While adults might get used to either short or chronic periods of sleep deprivation and not recognize the detriment to their well-being, the AAP warns parents that children are particularly vulnerable due to lack of sleep: Regular sleep deprivation often leads to some pretty difficult behaviors and health problems—irritability, difficulty concentrating, hyperte...