 |
|
Clippings Indian Pediatrics 2002; 39:411-413 |
|
Clippings |
|
q Procalcitonin can serve as a diagnostic and prognostic marker of neonatal sepsis, researchers from Turkey report. From their study on 34 neonates with a confirmed diag-nosis of sepsis, they observed that pro-calcitonin levels were significantly higher in sepsis as compared with controls and that the levels declined following treatment. The researchers also noted that initial values greater than 4.31 ng/ml was associated with higher mortality.(J Trop Pediatr 2002; 48: 10-14) q According to a study from USA, a sustained release formulation of methyl phenydate has been found effective in ADHD. In this multicentric study, 321 children were either given 20mg/ day of MPH or a placebo. The researchers noted that a significant reduction in features of ADHD was noted in the study group. Headache, anorexia, abdominal pain, and insomnia were commonly encountered side effects. Once-a-day methyl phenydate is effective in controlling symptoms of ADHD, the study concluded.(Pediatrics 2002; 109: e39) q Blood transfusion in neonates may be a source of oxidant damage, researchers from the United Kingdom write. The researchers measured the urine malondialdehyde (MDA) levels, an indicator of lipid peroxidation, before and after transfusion in 12 preterm neonates. Twenty two non-transfused preterm neonates served as controls. The researchers report that while MDA levels were normal prior to transfusion, the levels increased to over 14 nmol/mg 24 hours after transfusion and then declined gradually over the course of one week.This may be just one of the contributory factors for retinopathy of pre-maturity and chronic lung disease, which are linked to oxygen damage, the researchers conclude.(Arch Dis Child, Fetal & Neonatal ed 2002; 86: F46-F 48) q There is no link between MMR vaccine and a variant of autism featuring regression of milestones and bowel symptoms, researchers from UK report. The study included 278 children with typical autism and 195 with atypical autism and examined their sympto-matology with the timing of MMR vaccine. The researchers noted that the incidence of bowel symptoms and developmental regres-sion did not change after the introduction of MMR vaccine.There is no basis for the link between MMR vaccine and this variant of autism, the study concludes. (BMJ 2002;324:393-396) q A study from USA has described a link between snoring and hyperactivity. In this study on 866 children between 2 years and 14 years, habitual snoring was present in 16% and hyperactivity in 13% of the children. The researchers also noted that hyperactivity was reported in 22% of children who routinely snore and 12% of children who do not. There was a two times more risk of hyperactivity among children who snore than who do not. Though a cause effect relationship has not been proved, these findings suggest a link between sleep problems and hyperactive behavior in daytime, the researchers conclude.(Pediatrics 2002;109: 449-456). q Analysis of child’s drawing’s can help in diagnosis of headache. In this study, 226 children were asked to pictorially describe their headache. The researchers report that drawings had a sensitivity of 93.1%, a specificity of 82.7% in arriving at a diagnosis when compared with the confirmatory clinical diagnosis which was arrived at later. Features of migraine like throbbing pain, vomiting and scotoma were described accurately in drawings by most children, while non-migranious headaches were described as having a band - like pain. Drawings are a useful modality in establishing the type of headache in children, the researchers conclude.(Pediatrics 2002; 109: 460-472) q Increase in levels of lysosomal enzymes in peritoneal fluid can be used as an indicator of bacterial peritonitis. In this study from Greece, the lysosomal enzyme levels were measured in 39 children with peritonitis, 13 with mesenteric adenitis and in 26 controls. The researchers observed that the ß-galactosidase and ß-glucuronidase levels were significantly raised in bacterial peritonitis. The increase in enzyme levels did not, however correlate with other biochemical or cytological parameters, they note. These two enzymes can serve as diagnostic markers for bacterial peritonitis the researchers conclude.( Pediatrics 2002;109: e44) q There appears to be a link between fetal iron status and mental development at 5 years. This study from Alabama, USA measured the ferritin levels as a measure of the fetal iron stores in 278 children. These children later underwent tests for mental and psychomotor development at 5 years of age. The researchers observed that children with ferritin levels in the lowest quartile were nearly five times as likely to have low scores in fine motor tests and nearly 3 times likely to have poor psycho-logical development. According to related editorial, ferritin levels have their drawbacks, in that cord blood ferritin levels may be measure of hepatic iron stores than the fetal iron stores. Moreover, ferritin is also a marker of inflammation, and hence its levels may be influenced by other factors. That not-withstanding, the importance of iron supplementation in pregnancy has been reiterated by findings of this study, comments the editorial. (J Pediatr 2002;140: 145-148) q It may be possible to predict coronary aneurysms in Kawasaki’s disease. This study from Japan analyzed serum hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) in 41 children with the disease and 25 controls. The researchers noted that HGF and VEGF levels were increased during the acute phase and declined following recovery. These levels also correlated with the development of aneurysms, the report noted. Use of these two parameters and the presence of edema could predict aneurysms with a specificity of 100% and sensitivity of 94%, the researchers note. HGF and VEGF can serve as markers of disease severity, the researchers conclude.(Eur J Pediatr 2002; 161: 105-111) q Salt supplementation may improve developmental outcome of premature neo-nates. Thirty seven children born at less than 33 weeks gestation were given diets containing 4-5 mmol of sodium/day or 1-1.5 mmol/day from 4th to 14 day of life.These children were followed up and neurodevelopmental assessment carried out between 10 and 13 years.The researchers noted that children who received sodium supplements had a better outcome as noted in memory, learning and IQ tests. While the researchers advised the parents against giving salt supplements themselves, they concluded that failure to meet the additional sodium requirements in the first two weeks of life can result in adverse neurodevelopmental outcome. (Archives of Disease in Childhood Fetal and Neonatal Edition 2002; 86: F120-F123) q In addition to preventing Respiratory distress syndrome in pre term neonates, antenatal steroids may have a cerebro-protective effect. This study from UK evaluated the outcome of 224 neonates born at less than 31 weeks gestation and birth weight of less than 1500 g. The neonates were divided into two groups depending on whether their mothers had been given a complete course of 2 doses of antenatal steroids (12 mg/dose of betamethasone at 12 h intervals) or not. The researchers noted that neonates who had received a full course of antenatal steroid had a significantly lower incidence of cerebral white matter lesions as noted by the echogenicity on cranial ultrasound examination. The researchers also noted that a full course of antenatal steroids also resulted in a significant reduction in mortality. The researchers however cautioned that while a full course consisting of two doses is beneficial, repetitive administration of steroids in antenatal period may be counter-productive. (Archives of Disease in Childhood Fetal and Neonatal Edition 2002; 86: F96-F101)
C Vidyashankar, |
