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A Case of Familial Male-Limited Precocious Puberty in a Child With Klinefelter Syndrome Familial male-limited precocious puberty (FMPP) is an autosomal dominant, male-limited disorder that causes peripheral precocious puberty in boys. Klinefelter syndrome (47, XXY) is the most common chromosomal aberration in males with associated infertility, hypogonadism, and learning disability. We report here a case of Klinefelter syndrome in a patient with FMPP. A 6-year-old boy was referred to our
Carbohydrate supplementation of human milk to promote growth in preterm infants. Preterm infants are born with low glycogen stores and require higher glucose intake to match fetal accretion rates. In spite of the myriad benefits of breast milk for preterm infants, it may not adequately meet the needs of these rapidly growing infants. Supplementing human milk with carbohydrates may help. However, there is a paucity of data on assessment of benefits or harms of carbohydrate supplementation (...) of human milk to promote growth in preterm infants. This is a 2018 update of a Cochrane Review first published in 1999.To determine whether human milk supplemented with carbohydrate compared with unsupplemented human milk fed to preterm infants improves growth, body composition, and cardio-metabolic and neurodevelopmental outcomes without significant adverse effects.We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials
of infants' length-for-age z scores at 1 year according to World Health Organization (WHO) child growth standards. One group received neither prenatal nor postpartum vitamin D (placebo group). Three groups received prenatal supplementation only, in doses of 4200 IU (prenatal 4200 group), 16,800 IU (prenatal 16,800 group), and 28,000 IU (prenatal 28,000 group). The fifth group received prenatal supplementation as well as 26 weeks of postpartum supplementation in the amount of 28,000 IU (prenatal (...) Vitamin D Supplementation in Pregnancy and Lactation and Infant Growth. It is unclear whether maternal vitamin D supplementation during pregnancy and lactation improves fetal and infant growth in regions where vitamin D deficiency is common.We conducted a randomized, double-blind, placebo-controlled trial in Bangladesh to assess the effects of weekly prenatal vitamin D supplementation (from 17 to 24 weeks of gestation until birth) and postpartum vitamin D supplementation on the primary outcome
Get Involved Education/CPD Publications Careers > Share POSITION (...) STATEMENT The Baby -Friendly Initiative: Protecting, promoting and supporting breastfeeding Posted: Jun 1 2012 Updated: May 22 2015 Reaffirmed: Jan 30 2017 The Canadian Paediatric Society gives permission to print single copies of this document from our website. For permission to reprint or reproduce multiple copies, please see our . Principal author(s) CM Pound, SL Unger; Canadian Paediatric Society , , Paediatr Child Health (...) their bare chest to yours, giving a sugar solution or breast milk and allowing them to suck or to breastfeed (...) . Nothing cuts a parent to the quick like seeing their child in pain, especially new mums (in whom, as I well remember, even the mildest news item can prompt a fresh bout of weeping). We’d rather take anything ourselves than have our children suffer, even briefly, wouldn’t we? For babies born prematurely or in need of medical intervention, potentially painful procedures go with the territory
for the preterm infant and family Posted: Mar 1 2012 Reaffirmed: Jan 30 2017 (...) The Canadian Paediatric Society gives permission to print single copies of this document from our website. For permission to reprint or reproduce multiple copies, please see our . Principal author(s) AL Jefferies; Canadian Paediatric Society , Paediatr Child Health 2012;17(3):141-3 Abstract Kangaroo care (KC) is the practice of skin-to-skin contact between infant and parent. In developing countries, KC for low-birthweight (...) Child Health 2014;19(6):315-19 Abstract Recent studies have resulted in major changes 2014 4. Management of term infants at increased risk for early onset bacterial sepsis Management of term infants at increased risk for early onset bacterial sepsis | Position statements and practice points | Management of term infants at increased risk for early onset bacterial sepsis | Canadian Paediatric Society Protecting and promoting the health and well-being of children and youth CPS Member Login | Who We
Thermal Effect of a Woolen Cap in Low Birth Weight Infants During Kangaroo Care World Health Organization guidelines recommend covering the head during kangaroo mother care (KMC), but the effect of a cap on neonatal thermal control during KMC remains to be defined. Our objective was to assess the effectiveness and safety of a woolen cap in maintaining low birth weight infants (LBWIs) in normal thermal range during KMC.Three hundred LBWI candidates for KMC in 3 African hospitals were randomly
Efficacy of facilitated tucking combined with non-nutritive sucking on very preterm infants` pain during the heel-stick procedure: A randomized controlled trial Reducing acute pain in premature infants during neonatal care improves their neurophysiological development. The use of pharmacological and non-pharmacological analgesia, such as sucrose, is limited per day, particularly for very preterm infants. Thus, the usual practice of non-nutritive sucking is often used alone. Facilitated tucking (...) trial.Level III and II neonatal care units, including the neurosensory care management program.Very preterm infants (gestational age between 28 and 32 weeks) were randomly assigned by a computer programme to the intervention or control group during a heel-stick procedure within the first 48 h of life. In both groups, infants were placed in an asymmetric position on a cushion; noise and light were limited following routine care. A heel-stick was performed first in the care sequence. In the intervention
historical, clinical, and radiographic findings. 4,7,8,16,18,25,45-48 Caries and its sequelae are among the most prevalent health problems facing infants, children, and adolescents in America. 49 Caries lesions are cumulative and progressive and, in the primary dentition, are highly predictive of caries occurring in the permanent dentition. 6,50 Reevaluation and reinforcement of preventive activities contribute to improved instruction for the caregiver of the child or adolescent, continuity of evaluation (...) of the patient’s health status, and repetitive exposure to dental procedures, potentially allaying anxiety and fear for the apprehensive child or adolescent. 51 Individuals with SHCN may require individualized preventive and treatment strategies that take into consideration the unique needs and disabilities of the patient. 32 Caries-risk assessment Risk assessment is a key element of contemporary preventive care for infants, children, adolescents, and persons with SHCN. It should be carried out as soon
and adolescent girls using DTG at during the periconception period (Box 2). BOX 2. DTG SAFETY IN PREGNANCY DTG has been found to be effective for pregnant women and has also been shown to be found in breast-milk, resulting in significant plasma concentration in infants and thus a potential important drug to reduce the mother-to- child transmission of HIV infection. However, an ongoing observational study in Botswana recently identified a signal of potential safety risk for developing neural tube defects (...) test result. With increased access to HIV treatment for all and enhanced postnatal prophylaxis, mother-to-child transmission rates have declined considerably. Confirmatory testing of initial positive early infant test results is critical due to the risk of low level viremia, potential contamination with maternal blood, specimen mislabeling, and laboratory contamination. Also, as mother-to-child transmission rates decline, so does the positive predictive value of early infant diagnosis assays
Best Practices for Pain Management in Infants, Children, Adolescents, and Individuals with Special Health Care Needs AMERICAN ACADEMY OF PEDIATRIC DENTISTRY RECOMMENDATIONS: BEST PRACTICES 321 Purpose The American Academy of Pediatric Dentistry ( AAPD) recognizes that infants, children, adolescents, and individuals with special health care needs can and do experience pain due to dental/orofacial injury, infection, and dental procedures, and that inadequate pain management may have significant (...) nervous system. FDA: Food and Drug Administration. IV: Intravenous. NSAIDs: Nonsteroidal anti-inflammatory drugs. VAS: Visual analogue scale. Pain Management in Infants, Children, Adolescents and Individuals with Special Health Care Needs322 RECOMMENDATIONS: BEST PRACTICES REFERENCE MANUAL V 40 / NO 6 18 / 19 the area of tissue damage, and allodynia, which refers to pain perception following innocuous stimuli such as light touch, are characteristics of central sensitization. 13 Pain modulation
Gastric Residual Volume in Feeding Advancement in Preterm Infants (GRIP Study): A Randomized Trial To evaluate the effect of not relying on prefeeding gastric residual volumes to guide feeding advancement on the time to reach full feeding volumes in preterm infants, compared with routine measurement of gastric residual volumes. We hypothesized that not measuring prefeeding gastric residual volumes can shorten the time to reach full feeds.In this single-center, randomized, controlled trial, we (...) included gavage fed preterm infants with birth weights (BW) 1500-2000 g who were enrolled within 48 hours of birth. Exclusion criteria were major congenital malformations, asphyxia, and BW below the third percentile. In the study group, the gastric residual volume was measured only in the presence of bloody aspirates, vomiting, or an abnormal abdominal examination. In the control group, gastric residual volume was assessed routinely, and feeding advancement was based on the gastric residual volume
Association between Furosemide Exposure and Patent Ductus Arteriosus in Hospitalized Infants of Very Low Birth Weight To evaluate the association between furosemide exposure and patent ductus arteriosus (PDA) in a large, contemporary cohort of hospitalized infants with very low birth weight (VLBW).Using the Pediatrix Medical Group Clinical Data Warehouse, we identified all inborn infants of VLBW <37 weeks of gestation discharged from the neonatal intensive care unit after the first postnatal (...) week from 2011 to 2015. We defined PDA as any medical (ibuprofen or indomethacin) or surgical PDA therapy. We collected data up to the day of PDA treatment or postnatal day 18 for infants not diagnosed with PDA. We performed multivariable logistic regression to evaluate the association between PDA and exposure to furosemide.We included 43 576 infants from 337 neonatal intensive care units, of whom 6675 (15%) underwent PDA treatment. Infants with PDA were more premature and more often exposed
A Randomized Controlled Trial of Parent-Child Psychotherapy Targeting Emotion Development for Early Childhood Depression Clinical depression in children as young as age 3 has been validated, and prevalence rates are similar to the school-age disorder. Homotypic continuity between early and later childhood depression has been observed, with alterations in brain function and structure similar to those reported in depressed adults. These findings highlight the importance of identifying (...) and treating depression as early as developmentally possible, given the relative treatment resistance and small effect sizes for treatments later in life. The authors conducted a randomized controlled trial of a dyadic parent-child psycho-therapy for early childhood depression that focuses on enhancing the child's emotional competence and emotion regulation.A modified version of the empirically tested parent-child interaction therapy with a novel "emotion development" module (PCIT-ED) was compared
Sudden vs Pressure Wean From Nasal Continuous Positive Airway Pressure in Infants Born Before 32 Weeks of Gestation: A Randomized Clinical Trial Nasal continuous positive airway pressure (nCPAP) is a well-established treatment of respiratory distress syndrome in preterm infants. Suboptimal weaning from nCPAP may be associated with lung injury, pulmonary morbidity, and infant weight gain. To our knowledge, the best weaning strategy from nCPAP is unknown.To compare the effect of sudden wean (...) and pressure wean from nCPAP in very preterm infants.A randomized, clinical, open-label, multicenter trial was conducted at 6 neonatal intensive care units in Denmark from September 2012 to December 2016 and included infants born before 32 weeks of gestation.Sudden wean with discontinuation of nCPAP without a prior reduction in pressure. Pressure wean with gradual pressure reduction prior to the discontinuation of nCPAP.The primary outcome was weight gain velocity from randomization to postmenstrual age 40
Parental Whole-Exome Sequencing Enables Sialidosis Type II Diagnosis due to an NEU1 Missense Mutation as an Underlying Cause of Nephrotic Syndrome in the Child Monogenetic renal diseases, including recessively inherited nephrotic syndromes, represent a significant health burden despite being rare conditions. Precise diagnosis, including identification of the underlying molecular cause, is especially difficult in low-income countries and/or if affected individuals are unavailable for biochemical (...) in the deceased child. To date, only 16 other cases of nephrosialidosis have been reported in the literature, with only 1 genetically confirmed case. After we reviewed the clinical information of all reported cases, we found that most patients presented with proteinuria, which started at between 2 and 3 years of age. Renal pathology showed mainly focal segmental glomerulosclerosis (FSGS)with vacuolated cells, and steroid treatment was always unsuccessful. Hepatomegaly was present in nearly all cases, whereas
Modelling the effect of a mass radio campaign on child mortality using facility utilisation data and the Lives Saved Tool (LiST): findings from a cluster randomised trial in Burkina Faso A cluster randomised trial (CRT) in Burkina Faso was the first to demonstrate that a radio campaign increased health-seeking behaviours, specifically antenatal care attendance, health facility deliveries and primary care consultations for children under 5 years.Under-five consultation data by diagnosis (...) was obtained from primary health facilities in trial clusters, from January 2011 to December 2014. Interrupted time-series analyses were conducted to assess the intervention effect by time period on under-five consultations for separate diagnosis categories that were targeted by the media campaign. The Lives Saved Tool was used to estimate the number of under-five lives saved and the per cent reduction in child mortality that might have resulted from increased health service utilisation. Scenarios were
Association between maternal adherence to healthy lifestyle practices and risk of obesity in offspring: results from two prospective cohort studies of mother-child pairs in the United States. To examine the association between an overall maternal healthy lifestyle (characterized by a healthy body mass index, high quality diet, regular exercise, no smoking, and light to moderate alcohol intake) and the risk of developing obesity in offspring.Prospective cohort studies of mother-child
Hyperglycemia in Extremely Preterm Infants-Insulin Treatment, Mortality and Nutrient Intakes To explore the prevalence of hyperglycemia and the associations between nutritional intakes, hyperglycemia, insulin treatment, and mortality in extremely preterm infants.Prospectively collected data from the Extremely Preterm Infants in Sweden Study (EXPRESS) was used in this study and included 580 infants born <27 gestational weeks during 2004-2007. Available glucose measurements (n = 9850) as well (...) concentration (P < .001). Hyperglycemia was associated with more than double the 28-day mortality risk (P < .01). In a logistic regression model, insulin treatment was associated with lower 28- and 70-day mortality when given to infants with hyperglycemia irrespective of the duration of the hyperglycemic episode (P < .05).Hyperglycemia is common in extremely preterm infants throughout the first postnatal month. Glucose infusions seem to have only a minimal impact on glucose concentrations. In the EXPRESS