|
|
|
Indian Pediatr 2013;50: 714
|
 |
Clippings |
|
Amit P Shah
Email:
[email protected]
|
 |
Whole-cell pertussis vaccine more effective than
acellular pertussis vaccine (Pediatrics 131:6, pp. e1716 -e1722 ,doi:
10.1542/peds.2012-3836)
|
|
There was a pertussis outbreak in 2010-2011 in USA which prompted this
study of comparing effectiveness of early childhood whole cell pertussis
vaccination versus acellular pertussis vaccination (4 DTwPs, mixed DTwP/DTaP,
or 4 DTaPs). It was found that adolescents who received DTwP vaccines in
childhood were better protected during a pertussis outbreak than those
who received DTaP vaccines.In USA, since 2005, the ACIP has recommended
boosting with reduced antigen content acellular pertussis vaccine (Tdap)
for persons 11 years and older. The study found that a booster dose of
Tdap did not overcome the advantage in protection from pertussis seen
among those who had received four doses of the whole-cell vaccine.The
results of this study suggest that variations in immune responses
induced by primary immunization during infancy play a central role in
protection from disease years later. Also, the study highlights the need
for new pertussis vaccines that provide both an improved safety profile
and long lasting immunity.
|
|
|
Dietary exposure to certain plastics may play
a hidden role in epidemic increases in childhood hypertension
(J Pediatr; doi:10.1016/j.jpeds.2013.03.072)
|
|
Plastic additives known as phthalates are odorless, colorless and just
about everywhere: They turn up in flooring, plastic cups, beach balls,
plastic wrap, intravenous tubing and - according to the CDC - the bodies
of most Americans. Once perceived as harmless, phthalates have come
under increasing scrutiny. A growing collection of evidence suggests
dietary exposure to phthalates (which can leech from packaging and mix
with food) may cause significant metabolic and hormonal abnormalities,
especially during early development. Now this study suggests that
certain types of phthalates could pose another risk to children:
compromised heart health. For the first time a connection between
dietary exposures to DEHP (di-2-ethyhexylphthalate), a common class of
phthalate widely used in industrial food production, and elevated
systolic blood pressure has been established in this study. As we know,
obesity is one of the major reasons behind elevated systolic blood
pressure but this study suggests that environmental factors may also be
a part of the problem. This is important because phthalate exposure can
be controlled through regulatory and behavioral interventions. As
plastic use is so remnant in our country, we must educate parents and
adolescents about the cons of plastic on our health also.
|
|
|
Plastic bags are useful for prevention of
hypothermia in preterm and low birth weight infants (Pediatrics
2013 Jun 3 doi: 10.1542/peds.2012-2030)
|
Hypothermia contributes to neonatal mortality and morbidity in a great
way, especially in preterm and low birth weight infants in developing
countries. Plastic bags covering the trunk and extremities of very low
birth weight infants reduces hypothermia. This technique has not been
studied in larger infants or in many resource-limited settings. Infants
at 26 to 36 weeks’ gestational age and/or with a birth weight of 1000 to
2500 g born were randomized by using a 1:1 allocation and parallel
design to standard thermoregulation (blanket or radiant warmer) care or
to standard thermoregulation care plus placement inside a plastic bag at
birth. The primary outcome measure was axillary temperature in the
WHO-defined normal range (36.5-37.5°C) at 1 hour after birth.It was
found that placement of preterm/low birth weight infants inside a
plastic bag at birth compared with standard thermoregulation care
reduced hypothermia without resulting in hyperthermia, and is a
low-cost, low-technology tool for resource-limited settings like ours in
peripheral rural and tribal areas. If used properly, this measure alone
can help us reducing infant mortality rate to a considerable extent.
|
|
|
Common childhood asthma unconnected to
allergens or inflammation (Sci Transl Med
doi:10.1126/scitranslmed.3005765)
|
|
Little is known about why asthma develops, how it constricts the airway
or why response to treatments varies between patients. This work has
revealed the roots of a common type of childhood asthma, showing that it
is very different from other asthma cases.The notion that asthma has
different forms gained ground after several genome-wide association
studies (GWAS) found variation in a gene, later identified as ORMDL3,
in to up to 30 percent of asthma cases. In 2007, over-production of the
gene’s protein was connected to childhood asthma, and this gene has been
the most consistent genetic factor identified so far for asthma. In
2010, a study in yeast found that ORMDL3 protein inhibits
sphingolipid de-novo synthesis. This finding prompted the researchers to
investigate whether sphingolipid production is connected to
asthma.Although it is yet not clear why asthma results from reduced
production of sphingolipids, this study clearly show a link between loss
of these lipids and bronchial hyperreactivity. This finding is not only
valuable in understanding the pathogenesis of this complex disease, but
provide a basis to develop novel therapies, especially asthma agents
based on a patient’s genotype.
|
|
|
 |
|
