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Collections 2 Minute Medicine ® - Pediatr...

2 Minute Medicine ® - Pediatrics

Collection of high-impact paper summaries that have been hand-picked, written and peer-reviewed by practicing clinicians. Provides 2 minute summarization and application to bedside care. Updated weekly.

https://read.qxmd.com/read/101001993/comparison-of-different-types-of-ultrasound-probes-for-lung-ultrasound-in-neonates
#1
SUMMARY
Paary Balakumar, Alex Chan
1. Compared to the microconvex and echo probe, the linear probe is better for lung ultrasounds in neonates. Evidence Rating Level: 2 (Good)   Lung ultrasound (LUS) is a powerful tool used in neonatal and pediatric intensive care units. LUS is often used to diagnose respiratory disorders and guide procedures sch as surfactant administration or chest tube placement. Unlike other ultrasound procedures such as echocardiography, the optimal probes have not been determined for LUS. This prospective, blinded, randomized study aimed to compare the performance of linear, microconvex, and echo (i...
July 12, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001977/assessing-between-sleep-and-blood-pressure-in-children-and-adolescents
#2
SUMMARY
Marzyeh Azimi, Deepti Shroff Karhade
1. Each additional hour of sleep was linked to lower wake systolic blood pressure (BP), reduced odds of wake hypertension, and wake systolic hypertension consistently observed across various demographic factors such as age, sex, and body mass index (BMI) category. 2. Each additional hour of later sleep onset was linked to higher wake systolic and diastolic BP indices. Evidence Rating Level: 2  (Good)  Study Rundown: In the US, an estimated 4% of children and teenagers suffer from hypertension. Children who have hypertension are likely to remain hypertensive until adulthood...
June 25, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001959/quantifying-the-increased-mortality-associated-with-delayed-antibiotics-in-pediatric-sepsis
#3
SUMMARY
Simon Pan, Alex Chan
1. Administration of antibiotics beyond 330 minutes from emergency department arrival in pediatric patients with sepsis was associated with increased 3-day and 30-day sepsis-attributable mortality.  Evidence Rating Level: 2 (Good) Early administration of antibiotics has long been an important recommendation in the treatment of sepsis by various guidelines. However, a more detailed understanding of the association between time to antibiotic administration and pediatric sepsis outcomes, including clinical differences at multiple time points, has not been well established...
June 14, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001954/video-laryngoscopes-for-urgent-use-improve-intubation-success-in-neonates
#4
SUMMARY
Jayden Berdugo, Kiera Liblik
1. In this randomized controlled trial, using the video laryngoscope significantly increased the success of first-attempt intubation in neonates compared to direct laryngoscopes. 2. Lowest oxygen saturation levels recorded were also higher with video laryngoscope use.  Evidence Rating Level: 1 (Excellent) Study Rundown: Typically when neonates are intubated, it is on an urgent basis, such as when they are experiencing respiratory failure in the neonatal intensive care unit (NICU) or the delivery room. Neonates who undergo repeated endotracheal intubation attempts have associations with greater adverse events, including severe oxygen desaturation and bradycardia...
June 12, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001952/nutrition-source-does-not-influence-weight-gain-for-moderate-to-late-preterm-infants
#5
SUMMARY
Junghoon Ko, Kiera Liblik
1. In this randomized controlled trial, the body-fat percentage among preterm infants was similar between those who received parenteral nutrition and those who received dextrose solution. 2. The time to full enteral feeding was similar between preterm infants who received smell and taste exposure before gastric-tube feeding versus those who did not. Evidence Rating Level: 1 (Excellent) Study Rundown: Moderate-to-late-preterm infants, defined as infants born between 32 weeks zero days and 36 weeks six days gestation, are at increased risk for adverse health outcomes, including developmental delay, cardiometabolic disease, and death...
June 12, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001949/tofacitinib-may-be-effective-as-a-treatment-of-pediatric-ulcerative-colitis
#6
SUMMARY
Simon Pan, Alex Chan
1. Management of pediatric ulcerative colitis with tofacitinib successfully induced corticosteroid-free remission in 16% of patients at week 8 following treatment. Evidence Rating Level: 2 (Good) Tofacitinib, a non-selective inhibitor of Janus kinase (JAK) enzymes, was approved in 2018 for the treatment of moderate to severe ulcerative colitis in adults. However, it has not yet been approved for pediatric patients and there remains a lack of data regarding the efficacy and safety of tofacitinib in pediatric patients with ulcerative colitis...
June 12, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001947/assessing-body-mass-index-accuracy-for-adiposity-in-youth
#7
SUMMARY
Marzyeh Azimi, Deepti Shroff Karhade
1. Body mass index (BMI) is a relatively good indicator for identifying adiposity in children and adolescents despite its limitations.  2. There is a strong association between high BMI and adiposity in youth with BMI ≥95th percentile. Evidence Rating Level: 2  (Good)  Study Rundown: BMI as an indicator of excessive body fat has been criticized for not distinguishing between fat and lean mass and for its inability to characterize body fat distribution. This cross-sectional study examined data from 8 to 19-year-olds in the US between 2011 and 2018 to evaluate BMI’s effectiveness in predicting dual-energy x-ray absorptiometry (DXA)-measured adiposity, across the full BMI range...
June 11, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001923/vaping-associated-with-increased-incidence-of-respiratory-symptoms-amongst-youth
#8
SUMMARY
Donika Yakoub, Alex Chan
1. In this retrospective analysis, compared to nonsmokers, vaping (both within the previous month and at all in the past) was associated with increased incidence of respiratory symptoms. 2. The use of nicotine salts and fruit-flavoured vapes were also associated with increased odds of self-reported respiratory symptoms.  Evidence Rating Level: 2 (Good) Within the past ten years, the use of vapes has increased among US, Canadian, and British adolescents, whereas the prevalence of cigarette smoking has decreased or remained relatively unchanged...
June 3, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001919/early-life-pain-exposure-associated-with-impaired-neurodevelopment-association-in-female-infants
#9
SUMMARY
Jayden Berdugo, Alex Chan
1. Female infants had a greater association between experiences of early-life pain and altered neural connectivity as observed via magnetic resonance imaging.  2. Worse neurodevelopmental outcomes were associated with decreased brain connections.  Evidence Rating Level: 1 (Excellent) Study Rundown: Premature neonates are often subject to various lifesaving procedures. While receiving this care, they experience a period of rapid brain maturation, which may be vulnerable to environmental factors such as pain...
May 24, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001910/topiramate-for-prenatal-antiseizure-therapy-is-not-associated-autism-spectrum-disorder
#10
SUMMARY
Nhat Hung Benjamin Lam, Kiera Liblik
1. In this retrospective cohort study, exposure to antiseizure medications was associated with a higher incidence of autism spectrum disorder (ASD) compared to general population data. 2. Restricted to children born to mothers with epilepsy, valproate, but not topiramate and lamotrigine, was associated with an increased risk of ASD compared to no medication exposure. Evidence Rating Level: 2 (Good) Study Rundown: Most female adults with epilepsy receive antiseizure medications throughout pregnancy. Prenatal exposure to valproate is associated with neurodevelopmental disorders such as ASD and attention deficit hyperactivity disorder...
May 22, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001889/childhood-adiposity-associated-with-adolescent-polycystic-ovary-syndrome
#11
SUMMARY
Marzyeh Azimi, Deepti Shroff Karhade
1. Participants with Polycystic Ovary Syndrome (PCOS) had greater adiposity measures (including mean Body Mass Index (BMI) Z score, truncal fat mass, and percentage of total fat mass) at midchildhood, early and mid-teen visits, as well as higher adiponectin to leptin ratio (a marker of adipocyte dysfunction) in early and mid-teen visits when unadjusted for maternal and social factors. 2. After adjusting for maternal and social factors, participants with PCOS still showed higher truncal fat at midchildhood and early teen visits as well as lower adiponectin to leptin ratio at mid-teen visits...
May 10, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001887/early-intrauterine-growth-restriction-may-be-associated-with-impaired-neurodevelopment
#12
SUMMARY
Jayden Berdugo, Alex Chan
1. Restricted growth of a fetus during early pregnancy was examined as a risk factor for impaired neurodevelopment. 2. Decreased crown-to-rump length was shown to impact neurodevelopment at 2 years of age. Restricted fetal growth in the uterus is an important risk factor to consider for impaired development in the child. Early pregnancy is a crucial time for growth of a fetus, as it allows for the development of the neural tube, along with an increasing number of fetal brain cells. There is a lack of research studying the association between first-trimester fetal size and childhood neurodevelopment...
May 9, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001880/prenatal-opioid-exposure-and-not-associated-with-increased-risk-of-neuropsychiatric-disorders-in-children
#13
SUMMARY
Jayden Berdugo, Alex Chan
1. In a cohort study in South Korea, prenatal opioid use did not significantly increase the risk of neuropsychiatric disorders in infants.  2. The risk of a neuropsychiatric disorder was increased by long-term opioid use, greater doses, and use during the first trimester.  Evidence Rating Level: 2 (Good)  Prenatal opioid exposure is generally contraindicated in pregnancy, though chronic pain and addiction can still lead to exposure.  Currently, the association between opioid exposure and subsequent neuropsychiatric disorders in infants is poorly characterized...
May 3, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001868/enhanced-peer-group-strategies-to-support-the-prevention-of-mother-to-child-hiv-transmission
#14
SUMMARY
Jayden Berdugo, Alex Chan
1. In a randomized control trial of women with HIV, both treatment groups had similar adherence to prevention of mother-to-child HIV transmission (PMTCT) clinic visits, or ART administration at 6 weeks, 12 months, and 24 months.  2. At 2 years postpartum, women in the FLC intervention group had better adherence to PMTCT than women in the SOC intervention group.  Evidence Rating Level: 1 (Excellent)  Prevention of mother-to-child HIV transmission (PMTCT) is a huge part of the ongoing fight against HIV/AIDS...
April 26, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001866/respiratory-syncytial-virus-disproportionately-affects-pre-term-infants-over-term-infants
#15
SUMMARY
Neel Mistry, Teddy Guo
1. RSV-related ALRI incidence was significantly higher among preterm infants than term infants. 2. This pattern for RSV hospitalizations remained true until infants’ second year of life. Evidence Rating Level: 1 (Excellent) Study Rundown: Infants born prematurely face an increased risk for severe respiratory infections, particularly from respiratory syncytial virus (RSV). Until now, few studies have successfully assessed the global burden and risk factors associated with RSV-related acute lower respiratory infections (ALRIs) in preterm infants...
April 25, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001836/associations-found-between-maternal-pre-pregnancy-body-mass-index-and-infant-striatal-mean-diffusivity
#16
SUMMARY
Donika Yakoub, Alex Chan
1. Tissue density in the left caudate nucleus was significantly decreased in infants whose mothers had elevated pre-pregnancy body-mass indexes (BMI).  Evidence Rating Level: 2 (Good) Parental obesity, particularly maternal obesity prior to pregnancy, has been identified as a risk factor for offspring obesity by means of both heritable and environmental influences. The mechanisms by which this is thought to take place are complex and varied, but alterations in functioning of neurotransmitter signalling are believed to contribute...
April 4, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001822/typhoid-conjugate-vaccine-shows-promising-long-term-efficacy-in-children
#17
SUMMARY
Neel Mistry, Teddy Guo
1. Children randomized to the MenA group rather than the Vi-TT group were more likely to be diagnosed with typhoid fever. 2. Overall Vi-TT vaccine efficacy was 78.3% with the highest efficacy seen for children aged 2-4 years. Evidence Rating Level: 1 (Excellent) Study Rundown: Typhoid conjugate vaccines in Africa and Asia have shown high short-term efficacy, but data on long-term protection are limited. This study presents the final analysis of a trial in Malawi, spanning over 4 years, to assess vaccine efficacy over time and by age group...
March 26, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001817/conservative-oxygenation-improves-outcomes-in-critically-ill-children-on-invasive-ventilation
#18
SUMMARY
Neel Mistry, Teddy Guo
1. Duration of organ support or death at 30 days was lower in the conservative oxygenation group compared to the liberal oxygenation group. 2. Prespecified adverse events were also lower in the conservative oxygenation group. Evidence Rating Level: 1 (Excellent) Study Rundown: The optimal systemic oxygenation target for critically ill children remains uncertain, with liberal oxygenation – the standard of care – posing harm. There is no underlying consensus on the optimal oxygenation target for critically ill children...
March 25, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001812/poor-longterm-adherence-to-surveillance-guidelines-for-childhood-cancer-survivors-in-canada
#19
SUMMARY
Rhianna Davis, Alex Chan
1. In this retrospective, population-based cohort study, adherence to health surveillance guidelines among adult survivors of childhood cancer in Ontario, Canada was suboptimal.  Evidence Rating Level : 2 (Good) It is known that adherence to long-term health surveillance guidelines among adult cancer survivors is poor. In this retrospective, population-based cohort study, researchers aimed to assess the adherence to surveillance guidelines for high-yield tests among adult survivors of childhood cancer. Participants in this study included adults who were diagnosed with childhood cancer between 1986 and 2014 in Ontario, Canada...
March 21, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001792/vaping-and-other-tobacco-products-associated-with-greater-risk-of-suicide-attempts-in-children
#20
SUMMARY
Jayden Berdugo, Alex Chan
1. In a cohort of US children aged 9-10, those who used tobacco products had a greater risk of suicide attempts (SAs) but not nonsuicidal self-injury (NSSI), or suicidal ideation (SI). Evidence Rating Level: 2 (Good) Tobacco use has been on the rise in adolescents and children, and it has become an increasing public health concern. Smoking has negative effects on the health of individuals, especially on mental health outcomes such as diminished neurocognition and increased risk of poor social behaviours. Specifically, previous studies have found that there is a 2-5 greater risk of self-injurious thoughts and behaviours (SITBs) activity in adolescent smokers than in adult smokers, although this association is poorly characterized...
March 8, 2024: 2 Minute Medicine
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