Human Parechovirus infections (HPeV) associated with seizures and rash
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"HPeV's often cause severe illness among children" and have recently been identified causing diarrhea, to sepsis and meningitis. HPeV's are part of a large family of non-enveloped, positive sense, single-stranded RNA viruses which comprise at least 12 genera. Six are associated with human infection (cardiovirus, cosavirus, enterovirus, hepatovirus, kobuvirus and HPeV).
It appears that in young (<4 years) hospitalized children presenting with suspected Central Nervous System (CNS) infection/inflammation, seizures and/or rash approximately 4% and 15.1% of children will have stool samples positive for HPeV and enterovirus, respectively.
HPeV should be suspected in all young children with suspected CNS infection/seizures/rash.
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Prevalence and characteristics of tracheal cobblestoning in children
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A tracheal follicular pattern, a lumpy or nodular appearance of the tracheal mucosa, or follicular tracheitis (so-called tracheal cobblestoning) is thought to be a non-specific chronic inflammation associated with gastro-esophageal reflux (GERD), eosinophilic esophagitis and/or lung infections.
A study of a large database of rigid tracheoscopies recorded in healthy children 0-6 years (median 3.3 years) who had planned tracheal intubations for elective surgical procedures indicates that cobblestoning of the trachea is common in healthy children (38.8%), and uncommon in children < 3 years of age. There apparently is no association between cobblestoning and GERD, current or recent respiratory
infection or enlarged tonsils.
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Late Preterm Infants (LPI) and neurodevelopmental outcomes at kindergarten
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LPI's (gestational age: 34 weeks to 36 weeks and 6 days) compared to full-term infants at 24 months of age are more likely to be less ready for kindergarten, though those with higher readiness scores are likely to test normally by kindergarten age.
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Bilirubin concentrations in jaundiced neonates with conjunctival icterus
From a study of 76 neonates (>34 weeks gestation) with conjunctival jaundice during the first week of life, where total serum bilirubin (TSB) levels and level of cutaneous jaundice was noted, data indicates that when conjunctival jaundice is present skin jaundice is always present and TSB levels are frequently >14.9mg/dl.
Neonatal conjunctiva jaundice is frequently associated with significant TSB levels.
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Early Diagnosis of Migraine in Children
Apparently migraine occurs in 8% of children/adolescents <20years of age; most starting when children are younger than 8 years of age. Long-term prognosis has not been clearly established.
In a study of 84 children diagnosed with migraine starting at 7.3 years (mean), who were interviewed at 11.6 years (mean age), 50% have migraine without aura, and attacks occur on average 1 to 3 times per week.
Ten years after onset of childhood migraine 14% are headache free, migraine attacks have decreased to 8% and 74% have tension-type headaches. Only age >12 years at time of diagnosis is associated with persistence of long-term chronic migraine.
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C-Reactive protein (CRP) bedside testing in febrile children
CRP production is part of a non-specific acute-phase response to most forms of inflammation and is an important marker of bacterial infection in children. Point-of-care (POC) bedside CRP testing of febrile children (one month to 16 years) in an Emergency Department significantly reduces hospital length of stay and costs.
Pediatric Emergency Care
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Psychological and psychosocial impairment in preschoolers with selective eating (SE)
"Avoidant/restrictive food intake disorder (ARFID) also known as selective eating disorder (SED) is an eating disorder that prevents the consumption of certain foods".
A population cohort study of 917 children (34-71 months) and their designated caregivers were recruited for a study in which caregivers completed a structured diagnostic interview
regarding their child's eating and related self-regulatory capacities, psychiatric symptoms, functioning and home variables. Two years later a second assessment was undertaken.
Moderate and severe levels of SE are associated with anxiety, depression, and attention deficit/hyperactivity disorder both concurrently and prospectively. It appears that pediatricians should intervene early at even moderate levels of SE.
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