Category: Paediatrics

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Probiotics for Very Preterm Babies Linked to Reduced Mortality

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Probiotic supplementation in very preterm babies was linked to a lower risk of both severe intestinal disease and death. This is shown by a new study from the Karolinska Institutet, published in JAMA Network Open. The findings are based on data from nearly 4700 babies born prematurely in Sweden.

Very preterm babies are at increased risk of developing necrotising enterocolitis (NEC), a serious intestinal disease that can be life-threatening. Since 2020, the Swedish Neonatal Society has recommended that babies born between gestational weeks 28 and 31 receive daily probiotic supplements – that is, live bacteria that can influence the gut microbiota. This  is in line with a European recommendation based on international research.

In the current study, the researchers analysed data from the Swedish nNeonatal care quality register on 4695 babies born between 2017 and 2024. Of these, 1571 babies received a probiotic supplement containing three selected bacterial strains, whilst 3124 babies did not. The researchers investigated whether probiotic supplements could be linked to the risk of death or of developing NEC during their stay in the neonatal ward.

”We found that infants who received probiotics had a significantly lower risk of both NEC and death compared with those who did not receive the supplements. At the same time, mortality was low in both groups,” says Ayoub Mitha, a doctor and researcher at the Department of Medicine, Solna, Karolinska Institutet, who is the study’s corresponding author.

Among children who received probiotics, 0.8% experienced death or NEC, compared with 3.4% among those who did not receive the supplement. The risk of death was 0.3% in the probiotic group compared with 1.4% in the group without probiotics. The risk of NEC was 0.6% and 2.5% respectively.

Similar results regardless method

The researchers used several different statistical methods to account for differences between the groups. The results were similar regardless of the analysis method. Further analyses suggested that a significant proportion of the lower mortality rate was linked to fewer children developing NEC.

However, the researchers found no clear link between probiotic supplementation and the risk of sepsis, a serious infection that can spread throughout the body. The proportion of children affected by sepsis was roughly the same in both groups.

“Our findings contribute to the international body of knowledge and may help healthcare professionals and families make informed decisions regarding probiotic supplements for very preterm infants. At the same time, it is important not to generalise the results to extremely preterm infants – those born before 28 weeks – as this group was not included in the study,” says Ayoub Mitha.

The researchers also emphasise that the study is observational. This means that it can show associations but cannot definitively establish cause and effect.

Source: Karolinska Institutet

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GLP-1s Linked to Nutritional Deficiencies in Children

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Risk highest for vitamin D deficiency

Photo by Pavel Danilyuk

Children prescribed GLP-1 medications for weight loss, prediabetes or type 2 diabetes are at risk for nutritional deficiencies – diagnosed in nearly one in six patients (16.8%) within the first year – according to new research from scientists at Northwestern University and Ann & Robert H. Lurie Children’s Hospital of Chicago.

Vitamin D deficiency was the most common, identified in 12.4% of children within one year of GLP-1 treatment, the study found.

“As appropriate paediatric use of GLP-1s becomes more widespread, we need to understand the risks during periods of rapid growth and pubertal development,” said senior author Justin Ryder, associate professor of surgery and paediatrics at Northwestern University Feinberg School of Medicine and vice chair of research for the department of surgery at Lurie Children’s. “Nutrients such as vitamin D, iron and calcium are of particular concern during adolescence, when deficiencies may have lasting implications for skeletal health and overall development.”

The study was published last week in the journal Childhood Obesity.

“Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated,” he said. “In our study, however, we found that only 5% of patients received nutritional counselling within 30 days of GLP-1 treatment and less than 25% received nutritional counselling within 6 months.”

The scientists used national administrative claims data from 2017 to 2022 covering over 100 million patients to identify 2,031 GLP-1 users aged 10–17 years who met continuous enrollment criteria and had no prior diagnosis of nutritional deficiency. In this sample, the most prescribed GLP-1s were liraglutide (78.6%), dulaglutide (10.4%) and semaglutide (9.1%).

“We hope that our study findings bring much-needed recognition to the importance of proactive nutritional management when GLP-1s are prescribed to children, as opposed to waiting until a nutritional deficiency is diagnosed,” Ruder said. “Knowing the risks, we are in a much better position to prevent harm to children treated with GLP-1s during a pivotal period in their lives.”

Source: Northwestern University

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Sex Differences in Attention are Present at Birth, Study Finds

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Cambridge scientists have shown that girls and boys show differences in what they pay attention to, even at birth. Since these differences are present so early, it is possible they emerge due to prenatal factors.

It’s nature and nurture, not nature or nurture

Simon Baron-Cohen

The findings suggest that some psychological differences between males and females (such the development of social skills) may be influenced by both prenatal biology as well as later experience.

The study, published today in Biology of Sex Differences, involved testing 130 newborn infants only hours after birth. It builds on previous research by the same lab and uses robust methods to demonstrate the differences.

For years, research has shown that girls, on average, learn to talk earlier and develop social skills faster than boys. Scientists have long debated whether these differences are due to culture or biology. One way to answer this question is to test if sex differences are present soon after birth, before society and culture have influenced a child’s development. 

A study from the University of Cambridge published in 2000 found girls at birth on average looked longer at faces, and boys on average looked longer at objects. Since then, scientists in the field called for a replication of this study. However, no research team has attempted this until now, since it is very challenging to carry out research on newborn infants.   

In this new study, infants were presented with side-by-side videos containing a social stimulus, namely a human face with natural movement, and a non-social object, namely a set of metallic balls swinging due to gravity and their mechanical properties (a Newton’s cradle). 

The team found that, regardless of sex, newborn infants generally preferred to look at the social stimulus. However, on average, female infants spent a greater proportion of the time looking at the social stimulus compared to male infants, while male infants spent a greater proportion of time looking at the non-social stimulus compared to female infants.

Since this is within hours of birth, before much postnatal experience (such as social expectations based on gender) has occurred, it is likely that prenatal biological factors that differ between the sexes during pregnancy (such as hormone levels and genetics) contribute to the observed on-average sex differences. 

Yumnah Khan, a PhD student at the Autism Research Centre, University of Cambridge and the lead researcher on the study, said: “Our recent research has also shown that on-average sex differences are present in brain structure at birth and emerge prenatally. This new study tells us that there are not only on-average sex differences in the brain but also in attention and behaviour.” 

Professor Sir Simon Baron Cohen, Director of the Autism Research Centre, University of Cambridge, who supervised the study, said: “This study addresses the age-old question of whether nature plays any role at all in shaping sex differences in the human mind and brain. The fact that we observe these differences within hours of birth, before extensive postnatal experience has occurred, suggests that prenatal factors play a role, and that these prenatal factors – sex hormones and/or genes – go on to interact with postnatal experience. In other words, it’s nature and nurture, not nature or nurture.”

The new study used more robust methods compared to the original 2000 study. In particular, it included more controlled experimental testing conditions as well as a more reliable method to monitor infant gaze. Crucially, the researchers who analysed the videos of the baby’s eyes were blind to the baby’s sex and whether the baby was looking at the social or the non-social stimulus, which ensured that they could not bias the results. 

Dr Alex Tsompanidis, Assistant Research Professor at the Autism Research Centre and a member of the research team, said: “Sex differences at birth are important as starting points, but we need to remember that they don’t fully determine how children learn and develop in later life. This is because biological and social factors always interact, contributing to the rich diversity of human societies.”

Professor Carrie Allison, Deputy Director of the Autism Research Centre and another member of the research team, said: “The differences we see don’t apply to all male or all female infants, and are only seen when you compare groups of male and female infants, on average. There’s a lot a variation within, and overlap between, each sex. Our future research needs to better understand that variation.” 

The team is now interested to find out if these early sex differences contribute to later differences in children’s minds, brains and behaviour. To test this requires a longitudinal (follow-up) study design, which is underway. The researchers hope that by understanding the origins of the earliest sex differences, scientists can better understand neurodiversity and conditions such as autism, which is diagnosed about twice as often in boys than in girls.

This research was supported by the Wellcome Trust, the Simon Foundation Autism Research Initiative (SFARI), and a PhD studentship from Trinity College, Cambridge and the Cambridge Trust. A follow-up study is funded by the K. Lisa Yang Centre for Autism Research at Cambridge, which is part of the Yang Tan Collective.

Reference

Khan, YT, Tsompanidis, A, Hymanson, E, Wickramanayake, S, APEX Consortium, Austin, T, Allison, C, & Baron-Cohen, S. Sex differences in social attention at birth. Biology of Sex Differences; 21 Sept 2026; DOI: 10.1186/s13293-026-00976-9

Republished from the University of Cambridge under a Creative Commons licence. Read the original article,

Categories : Mental Health PaediatricsTags :

Autistic Kids Showed Improved Social Skills After Summer Programme

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A summer intervention programme for autistic children ages 4-6 with no intellectual disability significantly improved their social performance, according to a study by researchers at the Institute for Autism Research (IAR) at the University at Buffalo. It was published in Advances in Neurodevelopmental Disorders.

“Completion of our 5-week summerMAXyc programme was associated with significant social, behavioral and autism symptom benefits for the children,” says Christopher J. Lopata, PsyD, co-author on the study and co-founder/co-director of the IAR with Marcus L. Thomeer, PhD; both are professors of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at UB. “Developing such foundational skills early in development sets the stage for development of more advanced skills later in childhood, adolescence and adulthood, thus leading to better long-term outcomes.”

Thomeer notes that while programmes for autistic children with no intellectual disability ages 4-6 do exist, few provide intensive social programming. This population also tends to engage in significantly fewer group recreational activities in general than their peers without autism, further limiting social development opportunities.

“This constitutes a significant gap in social intervention development and service provision, which prompted our interest in developing such a programme for this population,” he says. 

Five weeks, five days a week

The intensive summerMAXyc programme was conducted five-days-a-week over five weeks in the summer. The programme follows a similar model to that of the IAR’s successful, evidence-based summerMAX programme for older children, which has helped improve the social skills of hundreds of children since it began 23 years ago.

In the summerMAXyc programme, each 6-hour day included 8 cycles of 30 minutes each, which began with 10 minutes of instruction in particular skills, such as having a conversation or accepting consequences, followed by a 20-minute cooperative activity.

According to the study, the children found that the programme was fun and helped them learn skills and make new friends. Average child satisfaction was 14.9 out of a possible 15 with parent satisfaction at 69.8 out of a possible 70. Parents reported significant improvement in the children’s social skills, behaviors and autism symptoms.

There is broad consensus that earlier intervention is associated with better outcomes for autistic children. And parents are often the first to recognize the need.

“Parents reach out to us because their child has difficulty navigating the social world,” says Thomeer. “They describe their autistic children as wanting to have friends but not knowing what to do in social situations.”

Families noticed the difference

Over the course of their child’s participation in summerMAXyc, Thomeer says, parents reported that other family members began to notice the child playing with others, not just playing alone. They also noticed that the child now makes eye contact, asks about others, plays games without getting upset and can recognise and understand different emotions.

According to Thomeer, a mother of one of the participants reported that her child not only noticed that she was frustrated about something, but also told her to “squeeze the orange,” a technique the children are taught where they squeeze an imaginary orange and take a deep breath in order to calm themselves down.

One of the study’s major strengths involved the use of objective observers to assess the children’s social performance. According to Lopata, parents are a critical source of information, however there is a risk of bias because they know that their children are in the intervention. Most social skills intervention studies for autistic children rely on parent ratings alone and therefore suffer from this limitation, he adds.

 “Our use of masked observers – trained individuals – eliminated that risk because they were unaware that the children received an intervention,” says Lopata.

The authors also note that the intervention was similarly successful in improving the children’s social performance and autism features regardless of the child’s age, IQ level, communication ability or level of diagnostic symptoms.

“There is widespread recognition in the field that no intervention will be effective for all autistic children and there is a significant need to determine which children are most likely to benefit from a specific intervention,” says Lopata. “Answering this question can help ensure that scarce resources are efficiently allocated and that children receiving a given intervention are most likely to benefit.”

The next step is to test the intervention in a large-scale randomised clinical trial with a control group, which would be a first for such a social intervention in this population. 

Original written by Ellen Goldbaum

Source: University at Buffalo

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Spouted Baby Food Pouches More Like Sugary Drinks/Smoothies than Nutritious Food

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They are high in sugar, low in nutrients, and too thin, finds analysis of UK products.
Current labelling as complementary food source needs regulatory review, say researchers.

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Commercial baby foods in spouted pouches – intended to boost nutritional intake from the age of 6 months onwards – are often more like sugary drinks and smoothies than nutritious food, finds an analysis of UK products, published online in Archives of Disease in Childhood.

They are often higher in sugar and lower in nutrient density than breast milk or formula, as well as frequently lacking the texture needed to help babies learn to eat solid foods, the analysis shows.

These pouches are currently labelled as a complementary food to be used alongside breast milk or formula, but the findings prompt the researchers to question whether this labelling is appropriate and to call for a regulatory review of these products.

Breast milk alone supplies all the key nutrients needed up to the age of around 6 months. After that, complementary foods are essential for establishing healthy food preferences, optimal growth, and long term health, as well as for helping babies learn how to eat solid foods, explain the researchers.

Complementary foods should have an increasingly solid texture and be more energy and nutrient dense than breast milk, they add. But while spouted pouches have become the dominant packaging for commercial baby foods, it’s not clear if their content fulfils these criteria, particularly as the contents need to be thin enough to pass through the spout.

To find out, the researchers reviewed the commercial baby foods available in 6 large hypermarkets, serving families in Glasgow, Scotland in October and November 2024.

In all, they found 298 products from 16 manufacturers, of which 178 (60%) were spouted pouches.  

All these pouches were labelled as suitable for children under 12 months; two-thirds were aimed at babies aged 6 months or younger—counter to official recommendations. Of the other products, 46 (38%) were aimed at infants aged 12 months or more.  

Foods were categorised relative to breast milk for energy, protein, and sugar content, and defined as suitable for complementary feeding if they were: a purée or solid food which would enable weaning; more energy and protein dense than breast milk; had a sugar content no higher than breast milk.  

Food texture was rated by two assessors for 284 (95%) of all the products. Half of the spouted pouches (49%) were liquids (score 1–3, where 0 is thin, and 4 is very thick) compared with 7% of the other products.

Only 10% of the spouted pouches were soft foods, compared with more than three-quarters (77%) of the other products.  

“The texture and manner of complementary feeding is important,” emphasise the researchers. “While suckling is an innate characteristic, the oromotor skills required for the manipulation of solid food in the mouth must be learnt experientially.  

“For that reason, recommendations suggest that first foods offered should progress from purées to lumpy, mashed, and finger foods. For pouches specifically, not only do they deliver a thin food that can be swallowed with little oromotor manipulation, but they are also often consumed by sucking from the spout, rather than from a spoon,” they add.

Overall, the available baby foods had an average energy content of 66.5 kcal/100 g, with only 35% above that for breast milk (65–70 kcal/100 g).

Only half (52%) of spouted pouches had a protein content higher than the range for breast milk..

In common with most of the other baby foods, only around a third of the spouted pouches had more energy per weight than breast milk, even though  61% had higher sugar content than breast milk. This compares with only 8% of the other baby foods.

“High sugar intakes in early childhood have long-term health implications, both in terms of dental health and overweight,” point out the researchers. 

In all, only 14 (8.5%) of the spouted pouches were defined as being completely suitable for a complementary food in that they met all the desired criteria; 48 (29%) met none. By contrast, 37 (32%) of the other wet baby foods met all the desired criteria; only 2 (2%) met none.

The researchers acknowledge various limitations to their findings. For example, they had no data on actual consumption, and the assessment of nutrient content was limited to the information provided by the manufacturers, with iron content, which is a key nutrient, rarely stated.

But they nevertheless conclude: “Products delivered in [spouted] pouches generally do not meet the desired characteristics of complementary foods. Many are more similar to sweet fruit smoothies, which are not recommended at all for babies or preschool children.

“Our findings suggest that regulators should consider whether a change in product categorisation and labelling is needed to make clear which products are foods and which are drinks, to discourage the use of [these pouches] and to enable parents to make informed choices in line with public health recommendations for feeding infants and young children.”

Source: The BMJ Group

Categories : Metabolic Disorders PaediatricsTags :

Scientists Are Discovering Something Surprising About Obesity in Teenagers

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Adolescent metabolism may remain flexible enough for early weight loss interventions to prevent lasting health damage

Photo by Andres Ayrton on Pexels

Obesity doesn’t look the same at age 15 as it does at age 45 and Duke University School of Medicine researchers are learning why.

A study published in the Journal of Clinical Investigation showed teenagers retain a degree of metabolic flexibility that’s largely lost in adulthood. The study suggests that the way teenage bodies respond to excess weight is fundamentally different and potentially more reversible.

By showing that obesity’s biology changes with age, the discovery points to a potential window when the metabolic damage linked to obesity can be halted, or even reversed, before it becomes a lasting health burden.

“For a long time, medicine has tended to treat adolescents as little adults,” said John Rawls, PhD, a professor of molecular genetics and microbiology and member of the Duke Microbiome Center. “But teenagers are still growing, building muscle and bone, and using energy in ways that are very different from adults. We wanted to understand how those differences shape obesity.”

Nearly 1 in 5 U.S. children has obesity, a condition associated with higher risk for heart disease, diabetes, asthma, and some cancers later in life.

Without intervention, most children with obesity will continue to have obesity into adulthood, said study co-author Sarah Armstrong, MD, a pediatrician and medical weight management specialist at Duke Health.

The change from adolescence to adults happens in late teens to early 20s for women and early-to-mid 20s for men.

But researchers are increasingly asking when those risks become biologically embedded and whether adolescence offers a chance to change course.

The microbiome tells a different story in teens

The Duke team focused on two systems often linked to obesity: the gut microbiome which is the community of microbes living in the digestive tract, and the metabolome, the collection of chemicals produced as the body and microbiome process food and energy.

First, using gut microbes collected from 287 teenagers in the Pediatric Obesity Microbiome and Metabolism Study, they confirmed that teens with obesity have microbiomes that differ compositionally from those of teens at a healthy weight.

Next, Jessica McCann, PhD, a senior research associate in molecular genetics and microbiology, transplanted microbiome samples from adolescents with and without obesity into germ-free mice.

Unlike what researchers often see in adult obesity studies, the mice did not gain extra weight after receiving microbiota from adolescents with obesity.

The findings indicate that while obesity-related differences in the microbiome are beginning to emerge during adolescence, those microbes may not be driving disease the waythey do in adults.

“This suggests there’s a developmental window in which the microbiome becomes involved in obesity,” McCann said. “The relationship between the host and the microbiome may still be developing during adolescence, which means there may be an opportunity to change its trajectory.”

Warning signs appear, but so does resilience

Working in collaboration with the Duke Molecular Physiology Institute, the research team also found differences in how adolescents process nutrients. Adults with obesity often have elevated levels of branched-chain amino acids, as well as related compounds called branched-chain keto acids (BCKA), which are linked with insulin resistance and Type 2 diabetes.

The adolescents showed a different pattern. While branched-chain amino acids were elevated, BCKA levels remained relatively low.

The warning signs are there, McCann said, but teens’ bodies still appear capable of adapting to the metabolic strain of excess weight. “The metabolome is showing early signs of disease progression, but it’s also showing evidence of adaptive plasticity.”

At this stage they may be more responsive to weight management through diet, medication or microbiome-based therapies.

“The evidence increasingly supports intervening as early as possible,” said Armstrong, a professor of pediatrics at Duke.

Researchers hope the work would eventually lead to more personalised obesity treatments, using a child’s microbiome or metabolic profile, to help determine which weight loss therapies are most likely to succeed.

The study was supported by the American Heart Association and the National Institute of Diabetes and Digestive and Kidney Diseases.  

Source: Duke University School of Medicine

Categories : Diseases, Syndromes and Conditions PaediatricsTags :

20mg Zinc Daily Cuts Infections by 38% in Children with Sickle Cell Anaemia

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Sickle cell disease. Credit: National Institutes of Health

A daily 20 milligram dose of zinc reduced infections by nearly 40% among Ugandan children younger than 5 with sickle cell anaemia, according to new research led by scientists at the Indiana University School of Medicine and their study partners in Uganda. The findings, recently published in the Journal of the American Medical Association (JAMA), point to an affordable, well-tolerated strategy to decrease hospitalisations and save more lives of children living with the genetic blood disorder.

Sickle cell anaemia causes misshapen red blood cells that block oxygen from smoothly travelling through the body, which can lead to serious health complications. Zinc deficiency is common in affected children, and because zinc supports the body’s immune response, this deficiency leaves children with the disease especially vulnerable to infections that can cause illness, hospitalisation and even death.

“At large volume prices, it can cost less than $3 a year to give a child daily zinc supplementation,” said Chandy John, MD, the Ryan White Professor of Pediatrics at the IU School of Medicine and co-lead investigator on the study. “If further studies confirm our latest research, this could be an important new intervention for children with sickle cell anaemia that is so low-cost and safe that it’s rapidly implementable in almost all health settings.”

In a randomised, double-blind, placebo-controlled pilot study, the team evaluated 100 children between 1 and 5 years old with sickle cell anaemia who received care at Jinja Regional Referral Hospital in Uganda. This clinical trial followed an earlier report that tested a 10 mg daily dose of zinc and found no reduction in infections, indicating the lower dose was insufficient.

Over six months of follow-up, children treated with 20 mg of daily zinc experienced a 38% reduction in all-cause infections – like upper respiratory tract infections, diarrhoea and bacterial infections – compared to the placebo group.

“Zinc given at 20 mg daily provides a readily available and safe medication with the potential to reduce the suffering and deaths of thousands of children in Africa,” said Ruth Namazzi, MMEd, lecturer in the Department of Pediatrics and Child Health at Makerere University in Uganda, research director at Global Health Uganda and co-lead investigator on the study. “However, while our study shows a 38% reduction in all-cause infections, we are not yet recommending this as standard of care for children with sickle cell anaemia as our results need to be validated in larger multi-site studies.”  

Moving forward, the researchers expect to confirm their findings in a larger population across multiple sites. Future trials will also include older children with sickle cell anaemia and test the most effective zinc dosage with the fewest side effects. 

If validated, researchers believe incorporating low-cost zinc into standard clinical care could be rapidly implemented in health settings globally.

IU researchers who contributed to the study include John, Kagan Mellencamp, Andrea Conroy, Michael Goings and Jie Ren. They collaborated with Namazzi, Irene Bagala, Charles Kato, Isaac Birungi, Priscilla Kasembo and Gloria Kyarisiima of Global Health Uganda; Emmanuel Tenywa of Jinja Regional Referral Hospital and Sarah Cusick of the University of Minnesota Medical School.

This research was supported by funding from the Riley Children’s Foundation, IU Dance Marathon, the Herman B Wells Center for Pediatric Research and Cures Within Reach.

Source: Indiana University School of Medicine

Categories : Lab Tests and Imaging PaediatricsTags :

How Paediatric Radiology Gives Answers when Children Cannot

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Children are NOT small adults. They experience and express illness and injury very differently from adults. Which is why paediatric diagnostic imaging is a highly specialised field of medical imaging and is specifically designed for children, from birth to adolescence.

Dr Ebrahim Banderker, a paediatric radiologist at Red Cross War Memorial Children’s Hospital (RXCH), explains why children need a different approach to imaging and the role of radiology in children. He also talks about the success of a public-private initiative with SCP Radiology where he is a consulting radiologist.

Why is paediatric imaging so important?

Children are often unable to, or struggle to describe the nature of their discomfort, pain or symptoms clearly. Imaging helps doctors understand what is happening inside the body, when language and understanding are limited.

When we diagnose early, we are often preventing future pain, disability or developmental issues as well as reducing the anxiety of the family. 

What should parents know or understand about paediatric radiology?

Paediatric imaging is designed with the needs, safety and the specific conditions of children in mind. It is a tool for clarity, reassurance and early care. Our goal is to care for the child in their imaging journey and provide their doctors and families with clear answers they can trust.

How is paediatric radiology different from adult radiology?

  • The choice of the method of imaging is primarily based on how safe it is. The effects of radiation from X-rays and CT scans have a greater risk for a child than an adult – so ultrasound and MRI are preferred where possible.
  • Children are often afraid, unsettled because of pain and anxiety and may require sedation or anaesthesia to make them comfortable during the imaging process.
  • Paediatric imaging equipment, anaesthetic apparatus, monitoring and emergency equipment have to be adapted to children of different ages.

Do paediatric radiologist work directly with children and their parents?

Paediatric radiologists interact with the child and their caregivers far more often than adult radiologists interact with their patients. It is one of the most rewarding aspects of our work. Parents are generally more involved and can help the radiologist by confirming the history and symptoms. The radiologist in turn can reduce parent anxiety, explain the procedure and obtain consent where needed.

Please can you talk about radiation and safety in children – we know that one of the issues both parents and other adults have is safety and radiation?

Children have rapidly developing cells and tissues, often tightly packed together in small bodies and are considered to be 10-15 times more sensitive to radiation.  

The guiding principle of all radiation safety is ‘ALARA,’ which stands for ‘As Low As Reasonably Achievable’ or as we say, ‘when benefit clearly outweighs the risk.’  Ultrasound and MRI do not use radiation and these should be used where possible.

What injuries are commonly seen in children that require imaging?

Common injuries include those from motor vehicle accidents and particularly pedestrian accidents, fractures from falls or playing sport and unfortunately, increasingly from child abuse which is sometimes first identified by the radiologist.

Children’s bones are different from adults and have areas where the bone is still growing. These are called growth plates. Injuries to the growth plates require special care because they can affect how a bone develops and this impacts the overall growth of the child. 

Outside of injuries, paediatric imaging also looks at chest infections, abdominal pain, appendicitis, urinary tract problems and hip development in infants. Brain imaging may be used for seizures, headaches or developmental concerns. In essence, imaging can help us rule out serious causes quickly, which brings enormous reassurance to families.

Even for adults, radiology can be stressful and frightening – for children it must be worse.  How are children supported during scans?

Radiographers and radiologists are trained to work gently and calmly with children and parents are encouraged to be involved and ask questions. For example, when a child needs to be sedated for an MRI, the parent will stay with them until they are asleep. When children feel safe, the scan is quicker, easier and more accurate. The team ensures the child is warm and comfortable and the environment is child friendly with toys and reading material to distract patients and to keep them happy and engaged.

What developments in paediatric radiology do you feel are the most important – especially over the 5 years?

  • Digital radiography allows for digital manipulation of images improving image quality and accuracy. Retakes are reduced so there is less radiation involved
  • Ultrasound machines have improved in-depth visualisation of body parts, disease processes and blood vessels
  • CT scanners are faster and offer lower radiation dose options. There are scanners which can scan the entire body of a child in less than a second.  There is not even time to wriggle…
  • MRI imaging is developing at a galloping pace with faster scanning techniques and finer image detail
  • Functional MRI and the ability to do tissue sampling in cancer imaging, is opening many exciting new avenues. 

The scope of interventional radiology techniques (treating not just diagnosing) is expanding rapidly to make less invasive treatment possible, with less complications for patients and much shorter recovery times. Paediatric radiology increasingly includes minimally invasive procedures (image-guided drainages, biopsies, nephrostomies, angiography), which can shorten hospital stays and reduce surgical burden. 

Categories : HIV PaediatricsTags :

Triple-dose Regimen May Permanently Clear HIV in Infected Newborns

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OHSU-led discovery in animal model could advance quickly to clinical trials in people

Research from the lab of Jonah Sacha, PhD, at OHSU, has identified a one-time regimen of therapies for newborns with HIV that, if given within three days of birth, could permanently clear the virus. The research team hopes to use the animal model results to move into a human clinical trials. (OHSU/Christine Torres Hicks)

Every year, more than 120 000 newborns worldwide contract HIV, a global health burden that requires lifelong treatment for millions of people – assuming they have access and can afford it. New research led by Oregon Health & Science University suggests another possibility: a one-time regimen of therapies given to newborns within three days of birth to permanently clear the virus. The research was published in the journal Nature Microbiology.

“The really exciting part is that it could go to clinical trials immediately to eliminate HIV infection in newborns,” said co-lead author Jonah Sacha, PhD, professor and chief of pathobiology and immunology at OHSU’s Oregon National Primate Research Center and Vaccine and Gene Therapy Institute. “The next step after that is to test if this can work in newly exposed adults.”

The research involved many collaborators and nonhuman primates at both the Oregon and California national primate research centres.

Researchers tested three distinct treatments that were delivered for a few weeks: neutralising antibodies, standard antiretroviral therapy, and an experimental monoclonal antibody known as leronlimab.

Each of the individual treatments has been tried previously and failed to permanently clear the virus – and Sacha wasn’t convinced combining them would work any better. Sacha has worked for years to develop leronlimab, which is designed to block HIV from entering immune cells through a surface protein called CCR5. His longtime OHSU colleague and coauthor Nancy Haigwood, PhD, thought combining existing therapies with leronlimab might be effective.

The study that published today shows she was correct.

Haigwood, a former professor and ONPRC director, is a virologist and immunologist who has specialised in HIV antibody research for decades. “We were astounded and overjoyed, actually,” Haigwood said. “It’s a remarkable result.”

Antiretroviral therapy has already been approved in people, whereas broadly neutralising antibodies and leronlimab are both being tested separately in clinical trials. This new discovery of a one-time, three-part regimen to clear the virus in newborn babies would first need to be tested in clinical trials in people – most likely in newly exposed adults initially – before it would be widely available to constrain an HIV epidemic that continues to kill 600 000 people worldwide each year.

Researchers say they are optimistic, given the anatomical similarity between nonhuman primates and people.

“There was no reason to think this would completely clear the virus,” Sacha said. “It’s one of those things where you test it and, holy cow, it works and you’ve discovered something new.”

Exactly how this approach worked remains unclear, but Sacha and Haigwood said it appears that the combination of therapies is far more potent and effective than each therapy alone. The key appears to be leronlimab’s ability to block HIV from entering immune cells through the surface protein CCR5.

“For reasons we don’t understand, HIV really wants to use CCR5 receptors to infect cells,” Sacha said. “By blocking access, it’s like you’ve kept fuel away from the fire.”

Haigwood uses a slightly different analogy:

  • Turning off the faucet: Antiretroviral therapy doesn’t eliminate HIV altogether, but it minimises its ability to replicate.
  • Mopping up: Neutralising antibodies effectively corral HIV so there is less virus circulating in the body’s blood supply.
  • Sealing off: Leronlimab blocks what’s left of the virus from infecting immune cells – the equivalent of sealing off the room with a water-tight valve.

Haigwood believes the combination appears to be especially potent early in the infection.

“There’s a lot more going on during the first week of infection than we previously thought,” she said. “From this experiment, it looks like there’s a dynamic interaction between the virus and antibodies that takes place as the virus begins to spread.”

Researchers are eager to see whether the combined regimen can be effective beyond 72 hours of the initial infection.

“We only tested out to three days,” Sacha said. “Could it work a week after infection? Two weeks? How far can you go after infection, and still purge the virus?”

By Erik Robinson

Source: Oregon Health & Science University

Categories : Exercise PaediatricsTags :

More Screen Time Since Childhood Linked to Better Cognitive Processing in Adolescence

On By ModernMedia
Photo by Steinar Engeland on Unsplash

A study conducted at the Universities of Jyväskylä and Eastern Finland, found the surprising result that more screen time since childhood was associated with better cognitive processing in adolescence. According to one of the researchers, we should not regard screen time solely as harmful. The most important thing is to find a balance between physical activity and screen time that promotes active thinking.

Adolescents’ scarce physical activity is a major challenge in terms of public health. Sedentary lifestyle has been shown to decrease school achievement, while physical activity is known to promote brain functions especially for adults. However, there is little research evidence about the connections of physical activity and sedentary time in childhood and adolescence with regard to cognitive processing in adolescence, although these life stages are pivotal for brain development. Various factors that influence cognitive processing in childhood and adolescence can be reflected far into adulthood also in terms of educational choices and working life. 

The study investigated how physical activity, sedentary behaviour and screen time from childhood to adolescence are associated with cognitive processing in adolescence and whether there are any sex differences in these connections. In addition, the researchers also examined the role of the intensity of physical activity in this respect. 

Screen time can support thinking and learning 

According to the findings, higher amount of screen time since childhood were connected to better cognitive processing in adolescence.  

“The findings suggest that screen time can support children’s and adolescents’ cognitive processing. Presumably, the essential point here is what kind of things they do in their screen time. Teachers and parents should encourage children to use devices and screens in such ways that promote active thinking, problem-solving, creativity and learning,” states Doctoral Researcher Petri Jalanko from the University of Jyväskylä. 

“We should not regard screen time solely as harmful but seek balance between physical activity and screen time that promotes active thinking,” Jalanko summarises. 

Physical activity and sedentary time associated in complex ways with cognitive processing 

In girls, the higher amount of light-intensity physical activity since childhood was associated with better working memory in adolescence. In boys, then again, higher amount of guided physical activity from childhood to adolescence was associated with better working memory in adolescence. 

Surprisingly, lesser self-reported unsupervised physical activity was connected to better cognitive processing in adolescence. Instead, physical activity or sedentary time as measured by a heart rate and movement sensor were not associated with cognitive processing. The differences may be explained by the fact that the heart rate and movement sensors cannot tell what a person is actually doing during the physical activity and sedentary periods. 

“Our study indicates that the connections of physical activity and sedentary behaviour to cognitive processing are complex and depend on the sex, the type and assessment method of physical activity and sedentary time. Moreover, boys and girls may benefit from different types of physical activity in view of brain health, Jalanko adds. 

“However, we need more intervention studies to find out causal relations and sex differences in this respect. Moreover, it is important to examine more specifically the effects of the intensity of physical activity on changes taking place in cognitive processing.”

The findings are based on an eight-year follow-up of the PANIC study on children’s physical activity and nutrition. The current study involved 124 girls and 136 boys, whose average age was 15.8 years. Physical activity and sedentary behaviour were measured by a device that combined heart rate and movement measurements and also by a survey questionnaire. Learning, attention and working memory were assessed by means of the CogState test battery. The research article is published in the Pediatric Exercise Science journal. 

Source: University of Finland