Category: Paediatrics

Categories : Hospitals Paediatrics Respiratory DiseasesTags :

80% of Childhood Asthma Hospital Presentations are Preventable

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Image by Bob Williams from Pixabay
Image by Bob Williams from Pixabay

Based on a comprehensive Australian survey, approximately 80 percent of asthma-related hospital presentations in school-aged children are potentially avoidable through a standardised comprehensive care pathway for children with asthma.

These preventative measures include using evidence-based clinical guidelines, ensuring that there is an asthma action plan in place; regular follow-up with GP; provision of asthma education to parents/carers; and establishing a community-based approach for continuity of care.

Senior author Dr Nusrat Homaira, respiratory epidemiologist at UNSW Sydney said, “During our research, we surveyed 236 nurses and 266 doctors across 37 hospitals in all 15 local health districts (LHDs) across New South Wales (NSW) to identify the existing care pathway following discharge from hospital for children with asthma.”

This study by researchers at UNSW Sydney identified major variations in the existing asthma care pathway, including:

Use of asthma clinical guidelines and Asthma Action Plan: Although clinical guidelines and Asthma Action Plans (AAPs) were used across all hospitals, on average, there were four to six different types of documents used in each (LHD), between hospitals in the same LHD and within departments in the same hospital. Such variations can be confusing for clinicians, as noted by a survey participant: “Conflicting advice given to asthma patients between general practitioners, emergency departments and sometimes paediatricians; patients are then confused about what to do in exacerbation of symptoms.”

GP follow-up: In most LHDs (75 percent) parents/carers were advised to have their child followed up with their GP within two to three days after hospital discharge, but in some areas, follow-up appointments could be recommended for over six days post-hospitalisation. Parents/carers were reportedly responsible for organising follow-up with their GP with no system to ensure they in fact attended.

Asthma education for parents/carers of asthmatic children: Formal asthma education (27 percent of respondents) were seldom provided to parents/carers during hospital stays; limited to asthma device techniques and rarely involved key topics such as basic knowledge of asthma, asthma control and the importance of regular medical review.

Communication with schools/childcare services: When children with asthma were discharged from hospitals, only four percent of the surveyed staff reported that schools or childcare services were notified of the child’s recent hospital presentation.

Community services integration: The majority of participants (55 percent) were unaware of any community services for children with asthma in their local areas.

The survey identified marked variations in asthma care and management for children within different health districts, different hospitals in the same district and different departments within the same hospital in. The findings highlight opportunities to improve the health outcomes in children with asthma and reduce unnecessary burden on health systems from preventable asthma hospital presentations.

Source: EurekAlert!

Journal information: Chan, M., et al. (2021) Assessment of Variation in Care Following Hospital Discharge for Children with Acute Asthma. Journal of Asthma and Allergy. doi.org/10.2147/JAA.S311721.

Categories : Cardiovascular Disease General Interest PaediatricsTags :

Young Boy’s Triumph Over Rare Heart Condition

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Photo by Danijel Durkovic on Unsplash
Photo by Danijel Durkovic on Unsplash

Hannah Lewis was expecting to learn the sex of her first child at 20 weeks of her pregnancy. Anxious about becoming a mother at just 19, Lewis was thrilled when she learned she was having a boy.

However, with a worried look on her face, her doctor told her that the baby’s organs looked healthy – except for his heart.

The baby was diagnosed with hypoplastic left heart syndrome, or HLHS, a rare condition where the heart’s left side is underdeveloped, doubling the workload for the right side. Days later, doctors at a children’s hospital in Nashville, Tennessee, confirmed the diagnosis.

But Lewis said her faith gave her the strength to believe she was meant to raise this child as a single mother, as well as her own experiences being raised by a single mother herself.

The rest of the pregnancy was filled with checkups and tests but remained uneventful. Then, at 37 weeks, doctors realised he was developing foetal hydrops, a life-threatening condition in which an abnormal amount of fluid accumulates in the tissue around the lungs, heart or abdomen, or under the skin.

Even in shock from induced labour followed by a caesarean, she remembers hearing her son’s first cries:

“They let me see him for just a second,” she said. “I loved him at first sight obviously, but I was super scared because they took him directly to the heart cath lab and for like 12 hours, we didn’t know what was going on. I was very sick so they wouldn’t let me go see him.”

She named him Bennett after learning the moniker means “God’s gift of hope” or “little blessed one”.

“It was so fitting for what he was about to face,” Lewis said.

HLHS is usually treated with either three different surgeries at certain stages of development or a heart transplant.

Because of the complications introduced by foetal hydrops, Bennett Sayles was 6 days old when he underwent his first open-heart surgery. Although the procedure went well, Bennett remained in critical condition on a ventilator. Then, when he was 2 months old, he had a stroke.

After three open-heart surgeries, 9 month old Bennett had stabilised enough to go home. But shortly before he was discharged, he went into cardiac arrest, and was without a heartbeat for six minutes.

“Then, out of nowhere, his heartbeat came back and it was strong,” Lewis said.

Two weeks later, days before his first Christmas, Bennett went home for the first time. After he turned 2, Bennett underwent the second HLHS surgery, which didn’t work and days later, he needed a fifth open-heart surgery.

Some weeks later he went home, but in hours, Bennett was back in the emergency room with staph infection in his chest. However, Bennett made it home again in time for Christmas. And ever since that series of setbacks, things have improved for him.

“His mental capacity is anywhere from 3 to 5 years old, but he’s got this amazing personality,” Lewis said. “He’s just got such a caring heart. When he’s in the room, he really does light it up and he changes the way you see things. I’m inspired every day because of how amazing he is and he doesn’t let anything hold him back or stop him.”

Two years ago, Bennett’s doctors determined that he would never be a candidate for the other surgeries needed to treat HLHS. He could, however, become eligible for a heart transplant.

“It’s debatable whether he’ll get there, but having known Bennett for the last nine years is not surprising at all that he has progressed to this point,” said Dr. Gerald Johnson, the boy’s paediatric cardiologist. “One of the beauties of working with kids is that they fight and they work to get better, and they work through things in ways that we as adults don’t necessarily do. Bennett’s been a particular fighter on that score and his mother is very proactive and in tune with his needs.”

Raising Bennett has taught Lewis and her family to focus on the present. “We don’t know what’s in store for Bennett,” Lewis said. “He could live his whole life like this or we can have him just a few more years. We love every minute we get to have with him.”

Source: American Heart Association

Categories : Mental Health PaediatricsTags :

Spotting Self-harming Risk for Adolescents a Decade in Advance

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Photo by Andrew Neel on Unsplash

Researchers have revealed two subgroups of self-harming adolescents and have shown that those self-harming risk can be identified almost a decade before they begin self-harming.

The team, based at the MRC Cognition and Brain Sciences Unit, University of Cambridge, found that while sleep problems and low self-esteem were common risk factors, there were two distinct profiles of young people who self-harm – one with emotional and behavioural difficulties and a second group with different risk factors.

Between one in five and one in seven adolescents in England self-harms, such as by cutting themselves. Though self-harm is a significant risk factor for later suicide attempts, many do not plan suicide but face other harmful outcomes, including repeatedly self-harming, poor mental health, and risky behaviours like substance abuse. 

Despite its prevalence and lifelong consequences, there has been little progress in the accurate prediction of self-harm, and until recently, little research in the area.

Drawing from a nationally representative UK birth cohort of approximately 11 000 individuals, the Cambridge team picked out adolescents who reported self-harm at age 14. With machine learning analysis, they were able to establish profiles of self-harming young people, with different emotional and behavioural characteristics. This information enabled them to identify risk factors present in early and middle childhood. 

Since the data tracked the participants over time, the researchers could distinguish factors that appear at the same time reported self-harm, such as low self-esteem, from those that came before it, such as bullying.

The analysis showed that there were two distinct subgroups among young people who self-harm, with significant risk factors manifesting as early as age five, almost a decade before self-harming. Both groups were likely to experience sleep difficulties and low self-esteem reported at age 14, but other risk factors differed between the two groups.

The first group tended to have a long history of poor mental health, as well as bullying before self-harming. Their caregivers were also more likely to have their own mental health issues.

With the second group, however, self-harming was harder to predict early in childhood. One of the key signs was a greater willingness to take part in risk-taking behaviour, linked to impulsivity. Research suggests that these tendencies may make the individuals less likely to consider alternatives to self-harm. Relationship factors with their peers were also important for this subgroup, including feeling less secure with friends and family at age 14 and worrying more about the feelings of others as a risk factor at age 11.

First author Stepheni Uh, a Gates Cambridge Scholar, explained: “Self-harm is a significant problem among adolescents, so it’s vital that we understand the nuanced nature of self-harm, especially in terms of the different profiles of young people who self-harm and their potentially different risk factors.

“We found two distinct subgroups of young people who self-harm. The first was much as expected – young people who experience symptoms of depression and low self-esteem, face problems with their families and friends, and are bullied. The second, much larger group was much more surprising as they don’t show the usual traits that are associated with those who self-harm.”

The findings suggest the possibility of predicting who is most at risk of self-harm up to a decade in advance, creating a window of opportunity for intervention.

Principal investigator Dr Duncan Astle said: “The current approach to supporting mental health in young people is to wait until problems escalate. Instead, we need a much better evidence base so we can identify who is at most risk of mental health difficulties in the future, and why. This offers us the opportunity to be proactive, and minimise difficulties before they start.

“Our results suggest that boosting younger children’s self-esteem, making sure that schools implement anti-bullying measures, and providing advice on sleep training, could all help reduce self-harm levels years later.

“Our research gives us potential ways of helping this newly-identified second subgroup. Given that they experience difficulties with their peers and are more willing to engage in risky behaviours, then providing access to self-help and problem-solving or conflict regulation programmes may be effective.”

Source: University of Cambridge

Journal information: Uh, S et al. Two pathways to self-harm in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry; DOI: 10.1016/j.jaac.2021.03.010

Categories : PaediatricsTags :

Earliest Childhood Memories Date Back to Two and a Half

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Photo by Caroline Hernandez on Unsplash

People’s earliest childhood memories they can recall are on average from just two-and-a-half years old, according to a new study published in the journal Memory.

It was previously held that the earliest memories are from three-and-a-half years old. Research on earliest memories dates back to the late 1800s, when it was first noted that most adults lack memories from the first 3 to 4 years of their lives, a phenomenon later termed infantile or childhood amnesia.

The evidence for the lower age of earliest memories is presented in a new 21-year study, which followed on from a review of already-existing data.

“When one’s earliest memory occurs, it is a moving target rather than being a single static memory,” explained lead author Dr Carole Peterson, a childhood amnesia expert from Memorial University of Newfoundland.

“Thus, what many people provide when asked for their earliest memory is not a boundary or watershed beginning, before which there are no memories. Rather, there seems to be a pool of potential memories from which both adults and children sample.

“And, we believe people remember a lot from age two that they don’t realise they do.

“That’s for two reasons. First, it’s very easy to get people to remember earlier memories simply by asking them what their earliest memory is, and then asking them for a few more. Then they start recalling even earlier memories – sometimes up to a full year earlier. It’s like priming a pump; once you get them started its self-prompting.

“Secondly, we’ve documented those early memories are systematically misdated. Over and over again we find people think they were older than they actually were in their early memories.”

Dr Peterson has conducted studies on memory for over two decades, focusing on the ability of children and adults to recall their earliest years.

This latest study reviewed 10 of her research articles on childhood amnesia followed by analyses of both published and unpublished data collected in Dr Peterson’s laboratory since 1999. This comprised 992 participants, and memories of 697 participants were then compared to the recollections of their parents.

The finding shows that children’s earliest memories date from before when they think it happened, backed up by their parents.

‘Telescoping’ memories

The evidence from this research to move our potential memory clock is “compelling”. For example, when reviewing a study which interviewed children after two and eight years had passed since their earliest memory they were able to recall the same memory, however in the subsequent interviews reported a later age as to when they occurred.

“Eight years later many believed they were a full year older. So, the children, as they age, keep moving how old they thought they were at the time of those early memories,” explained Dr Peterson, from the Department of Psychology at Memorial University.

The finding is due to something in memory dating called ‘telescoping’, she believes.

“When you look at things that happened long ago, it’s like looking through a lens.

“The more remote a memory is, the telescoping effect makes you see it as closer. It turns out they move their earliest memory forward a year to about three and a half years of age. But we found that when the child or adult is remembering events from age four and up, this doesn’t happen.”

She says, after combing through all of the data, it clearly shows that people recall much more of their early childhood, a lot farther back, than they think they do, and helping to access those memories is fairly simple.

“When you look at one study, sometimes things don’t become clear, but when you start putting together study after study and they all come up with the same conclusions, it becomes pretty convincing.”

This lack of clarity is a limitation of her research, she acknowledges, one which is also common to all research done to-date in the subject area.

“What is needed now in childhood amnesia research are independently confirmed or documented external dates against which personally derived dates can be compared, as this would prevent telescoping errors and potential dating errors by parents,” Dr Peterson said.

She is currently doing research on this with verified dating, both in her laboratory and elsewhere to further confirm the answer to this long-debated question.

Source: Taylor & Francis Group

Journal information: Peterson, C., (2021) What is your earliest memory? It depends. Memory. doi.org/10.1080/09658211.2021.1918174.

Categories : COVID PaediatricsTags :

Children Struggle to Recognise Expressions of People with Facemasks

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Image by pedro_wroclaw from Pixabay

sA new study has shown that children between the ages of 3 and 5 have difficulty in recognising the emotions of people wearing surgical masks. This collateral effect from this  measure to prevent COVID transmission could influence the correct development of children’s capabilities of social interaction.

To provide guidance for decision-makers, the World Health Organization (WHO) and UNICEF compiled a document discouraging exposure to the use of facemasks when dealing with children aged up to five years old. In addition, even for older children, WHO recommends weighing up the benefits of wearing facemasks in against potential negative impacts that could include social and psychological problems, and difficulties in communication and learning.

To investigate such possible negative impacts, a study was carried out by the U-Vip (Unit for Visually Impaired People) research team led by Monica Gori at the IIT- Istituto Italiano di Tecnologia (Italian Institute of Technology). The findings were published in Frontiers in Psychology.

A research team led by Monica Gori at the Istituto Italiano di Tecnologia (IIT) focused on the pre-school age group, helping define the measures that can be taken to reduce the impact of the use of surgical masks amongst children. While the wearing of facemasks is not mandatory from 3 to 5 years of age, children are in any case exposed to the use of such preventive measures in various everyday social and educational contexts.

The IIT researchers prepared a quiz containing images of people with and without facemasks, and displayed them on screens to 119 individuals comprising 31 children aged between 3 and 5 years old, 49 children between 6 and 8 years old, and 39 adults between 18 and 30 years old. The participants, independently or with parental assistance in the case of the youngest participants, were asked to try to recognise the faces’ expressions, with and without facemask, conveying different emotions such as happiness, sadness, fear and anger.

When those faces were covered with a facemask, the 3-5 years olds only managed to recognise facial expressions conveying happiness and sadness 40% of the time. The percentages were higher for other age groups: 6-8 years olds had a 55-65% success rate, and 70-80% adults. Generally, however, all age groups displayed some difficulty in interpreting these emotions expressed while the face was partially covered by a facemask. There were better results with other expressions, but the pre-school age children still had the greatest difficulty.

“The experiment was performed in the earliest phases of the 2020 pandemic, and at that time facemasks were still a new experience for everyone,” said Monica Gori. “Children’s brains are highly flexible, and at the moment we are performing tests to ascertain whether children’s understanding of emotions has increased or not.”

“In the study, we worked with children and adults with no forms of disability”, explained Maria Bianca Amadeo, IIT researcher, “of course, these observations are even more important when considering children affected by disabilities.” 
“Indeed”, added co-author Lucia Schiatti, IIT researcher, “for example visual impairment implies difficulties in social interaction. For such individuals in particular, it will be even more necessary to concentrate on possible preventive measures or specific rehabilitation activities”.

Further research is needed over the next few years to assess the actual impact of this mask wearing on the ability of children with and without disabilities to interact. In the meantime, the findings suggest the use of transparent facemasks for all operators in contact with children in the 3-5 year-old age group, or developing training activities to teach children how to recognise emotions by looking at the eyes.

Source: News-Medical.Net

Journal information: Gori, M., et al. (2021) Masking Emotions: Face Masks Impair How We Read Emotions. Frontiers in Psychology. doi.org/10.3389/fpsyg.2021.669432.

Categories : Ageing PaediatricsTags :

Telomere Length May Be Set Early in Life

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Image source: Pixabay

Telomeres, the protective nucleotide end caps of chromosomes which shorten with every cell division, have been found by a new study to undergo great changes in length during the first years of life.

The length of telomeres is important in a number of age-related diseases and is also an important marker of biological age. When telomeres are completely shortened, cells become senescent and unable to divide any further to repair damage.

This study, one of the first to examine telomere length (TL) in childhood, found that the initial setting of TL during prenatal development and in the first years of life may determine one’s TL throughout childhood and potentially even into adulthood or older age. The study also finds that TL decreases most rapidly from birth to age 3, then remaining unchanged into the pre-puberty period, although on some occasions it was seen to lengthen.

Researchers at the Columbia Center for Children’s Environmental Health at Columbia University Mailman School of Public Health led the study, which followed 224 children from birth to age 9. Their findings were published in the journal Psychoneuroendocrinology.

The researchers discovered that a mother’s TL is predictive of newborn TL and tracks with her child’s TL through pre-adolescence. The reasons why some children have telomeres that shorten faster are unknown, though one explanation may be that telomeres are susceptible to environmental pollutants. It is also unknown why some children had telomeres that lengthened across the study period, a phenomenon seen in other studies.

“Given the importance of telomere length in cellular health and aging, it is critical to understand the dynamics of telomeres in childhood,” said senior author Julie Herbstman, PhD, director of CCCEH and associate professor of environmental health science at Columbia Mailman School. “The rapid rate of telomere attrition between birth and age 3 years may render telomeres particularly susceptible to environmental influences during this developmental window, potentially influencing life-long health and longevity.”

Researchers used polymerase chain reaction to measure TL in white blood cells isolated from cord blood and blood collected at ages 3, 5, 7, and 9, from 224 children. In a small group of mothers they also measured maternal TL at delivery.

The researchers said that further research is needed to understand the biological mechanisms behind the variance of TL shortening or lengthening rates in the first years of life, as well as modifiable environmental factors contributing to the shortening speed.

Source: Columbia Mailman School of Health

Categories : Cardiovascular Disease PaediatricsTags :

New Model for Blood Clot Prediction in Children

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Monroe Carell Jr Children’s Hospital at Vanderbilt has launched a study to test out a predictive model for identifying paediatric patients at risk for developing blood clots or venous thromboembolisms.

The study examined the use of advanced predictive analytics to predict the development of blood clots in paediatric patients at risk for them.

“Hospital-associated blood clots are an increasing cause of morbidity in paediatrics,” said the study’s principal investigator, Shannon Walker, MD, clinical fellow of Paediatric Haematology-Oncology at Children’s Hospital.

Though they are rarer events in children than in adults, morbidity and mortality is higher and Dr Walker nevertheless noticed that blood clot development in children was on the rise.

“The reason children get blood clots is very different from adults,” said Dr Walker.
“There was no standardised protocol for preventing clots in paediatric patients. As we noticed that the rate of blood clots was going up and recognised that the adult strategy wasn’t going to work for our patients, we wanted to look at each patient’s individual risk factors and see how we could focus our attention on targeted blood clot prevention.”

The study, which will be published in Pediatrics, describes how the team built and validated a predictive model that can be automated to run within the electronic health record of each patient admitted to the hospital.

The model includes 11 risk factors and was based on an analysis of more than 110 000 admissions to Children’s Hospital and has been validated on more than 44 000 separate admissions.

Currently the team is studying using this model along with targeted intervention in the clinical setting in a trial called “Children’s Likelihood of Thrombosis,” or CLOT.

The prediction model follows this procedure: every child admitted to the hospital has a risk score calculated. The patients are randomised, so in half of the patients, elevated scores are reviewed by a hematologist, and then discussed with each patient’s medical team and family to determine a personalised prevention plan. All patients, regardless of their assigned group, continue to receive the current standard of care.

“We are not utilising a one-size-fits-all plan,” said Walker. “This is an extra level of review allowing for a very personalized recommendation for each patient with an elevated score. Each day the score is updated, so as risk factors change, the scores change accordingly.

“We are, in real-time, assessing the use of this model as a clinical support tool. We saw a clinical opportunity of something we could improve and have moved forward with building the model—to identify high-risk patients and are currently performing the CLOT trial, which will run through the end of the year.”

The Advanced Vanderbilt Artificial Intelligence Laboratory (AVAIL) was instrumental in Walker’s study. Only in its second year, the programme is leading the way in supporting artificial intelligence tools at Vanderbilt University through project incubation and curation, including facilitating clinical trials to assess their effectiveness.

“AVAIL served as a catalyst, in this instance by bringing experts in a complex trial development into proximity so that a great synthesis could happen,” said Warren Sandberg, MD, PhD, who is executive sponsor of AVAIL, along with Kevin Johnson, MD.

“What is unique about this particular project is that we were not only able to predict complications but also able to test the model in a rigorous, pragmatic, randomized, controlled trial to see if it benefits patients,” said Dan Byrne, senior biostatistician for the project and director of artificial intelligence research for AVAIL.

“The future of this kind of work is unlimited,” he said. “We can hopefully use this approach to predict and prevent pressure injuries, sepsis, falls, readmissions or most any complication before they happen. At Vanderbilt, we are raising the bar when it comes to the science of personalised medicine and application of artificial intelligence in medicine in a way that is both ethical and safe.”

Source: Medical Xpress

Categories : Injury & Trauma PaediatricsTags :

Safety Commission Warns on Peloton Treadmill Hazard to Children

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The US Consumer Product Safety Commission (CPSC) has put out a warning for owners of the popular Peloton Tread+ exercise machine following “multiple incidents of small children and a pet being injured beneath the machines.”

The warning comes weeks after Peloton CEO John Foley said a child died in an accident related to the machine. “While we are aware of only a small handful of incidents involving the Tread+ where children have been hurt, each one is devastating to all of us at Peloton, and our hearts go out to the families involved,” he said in a statement.

As a result, the CPSC launched an investigation into the treadmill, one that the commission says remains ongoing. The commission reported that it is aware of 38 other non-fatal safety incidents involving the device.
In the commission’s view, the Peloton Tread+ “poses serious risks to children for abrasions, fractures, and death” resulting from “children becoming entrapped, pinned, and pulled under the rear roller of the product.”

The announcement included a video of a child seemingly pulled underneath the treadmill while playing behind the machine.

The CPSC is advising those with children at home to stop using the Peloton Tread+ treadmill immediately and says that the hazard the machine imposes “cannot be avoided simply by locking the device when not in use.”

“Peloton has not yet agreed to do a recall or a stop sale,” Consumer Product Safety Commission spokesperson Joe Martyak told NPR. He continued, “We hope that will change.”

Generally, product recalls are done on a voluntary basis by companies, in concert with government.

Peloton responded to the CPSC, saying the warning was “inaccurate and misleading.”

“Like all motorized exercise equipment, the Tread+ can pose hazards if the warnings and safety instructions are not followed,” the company said. In response to further questions from NPR about a possible recall, a spokesperson for the company said “a recall has never been warranted.”

The spokesman added that, “The Peloton Tread+ is safe when operated as directed and in accordance with the warnings and safety instructions.”.

Source: NPR

Categories : Diet and Nutrition PaediatricsTags :

Junk Food Impacts Bone Growth in Kids

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Burger and chips. Photo by Jonathan Borba on Unsplash

A new study has found that ultra-processed foods (aka junk food) impacts bone quality, showing how damaging these can be especially in younger children.

The Hebrew University study provides the first comprehensive analysis showing the manner in which such foods impact skeletal development.  

Junk foods go through many processing stages, and contain non-dietary ingredients. They are easily accessible, can be eaten without preparation and fairly cheap, and their increasing presence in diets is contributing to worldwide obesity with its associated metabolic impacts.

Children tend to like junk food. As much as 70% percent of their caloric consumption are estimated to come from ultra-processed foods. While numerous studies have reflected on the overall negative impact of junk food, few have focused on its direct developmental effects on children, particularly young children.

Studying lab rodents with skeletons in post embryonic growth stages, they found that those exposed to ultra-processed foods suffered from stunted growth and compromised bone strength. With histological examination, high levels of cartilage were found in the epiphyseal plates at the end of bones. The RNA genetic profiles of cartilage cells exposed to ultra-processed food also showed signs of impaired boned development.

In order to understand how eating habits might impact bone development, the researchers replicated this kind of food intake for the rodents. “We divided the rodents’ weekly nutritional intake—30% came from a ‘controlled’ diet, 70% from ultra-processed foods,” said Monsonego-Ornan. They found that the rodents experienced bone density moderate damage though there were fewer signs of cartilage buildup in their growth plates. “Our conclusion was that even in reduced amounts, the ultra-processed foods can have a definite negative impact on skeletal growth.”

Children and adolescents eat junk foods in great quantities, with half of American minors eating junk food daily. Monsonego-Ornan added. “When Carlos Monteiro, one of the world’s leading experts on nutrition, said that there is no such thing as a healthy ultra-processed food, he was clearly right. Even if we reduce fats, carbs nitrates and other known harmful substances, these foods still possess their damaging attributes. Every part of the body is prone to this damage and certainly those systems that remain in the critical stages of development.”

Source: Medical Xpress

Journal information: Janna Zaretsky et al. Ultra-processed food targets bone quality via endochondral ossification, Bone Research (2021). DOI: 10.1038/s41413-020-00127-9

Categories : PaediatricsTags :

Parents can Transmit Periodontitis-causing Bacteria to Children

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A study conducted by the University of Campinas (UNICAMP) has found that adults can transmit the bacteria that cause periodontitis to their children, and even remain in the mouth when the children undergo various treatments. 

Periodontitis, which is preceded by gingivitis, is a bacterially caused inflammation of the periodontium, the tissue supporting the teeth. It is characterised by swollen and bleeding gums and halitosis, and can result in loss of teeth in severe cases.

Should the microorganisms responsible for the disease enter the bloodstream, they may trigger other kinds of inflammation in the body. The disease can be treated by cleaning the pockets around the teeth by a dentist or dental hygienist and administration of anti-inflammatory drugs or antibiotics.

“The parents’ oral microbiome is a determinant of the subgingival microbial colonization of their children,” the article’s wrote in their conclusion, adding that “dysbiotic microbiota acquired by children of periodontitis patients at an early age are resilient to shift and the community structure is maintained even after controlling the hygiene status”.

According to the first author of the article, dental surgeon Mabelle de Freitas Monteiro, she and her group have been researching periodontitis for ten years, and have observed both parents with the disease and their children, and noted the impact on their health.

“If the findings are applied to day-to-day dental practice, the study can be said to help design more direct approaches. Knowing that periodontal disease may affect the patient’s family is an incentive to use preventive treatment, seek early diagnosis and mitigate complications,” said Monteiro, who was supported by FAPESP via two projects.

The principal investigator for both of these projects was Renato Corrêa Viana Casarin, a professor at UNICAMP’s Piracicaba Dental School (FOP), who is the last author of the article .

In Prof Casarin’s view, parents’s care of their children’s dental hygiene should start when they are still infants.

“This pioneering study compares parents with and without periodontitis,” said Prof Casarin. “In children of the former, we found subgingival bacterial colonization at a very early age. However, ‘inheriting’ the problem doesn’t mean a child is fated to develop the disease in adulthood. Hence the importance of keeping an eye open for the smallest signs and seeking specialized help.”

According to the latest national dental epidemiological survey from 2010, 18% of children aged 12 had never been to the dentist and 11.7% had experienced bleeding of the gums. Of those in the 15-19 age group, 13.6% had never visited a dental clinic. The planned 2020 survey was postponed due to COVID. According to the São Paulo State Department of Health’s  latest oral health survey in 2019 revealed that 50.5% of adults aged 35-44 complained of toothache, bleeding gums and periodontitis.

In the FOP-UNICAMP study led by Casarin and Monteiro, the team colleclected samples of subgingival biofilm and plaque from 18 adults with a history of generalised aggressive (grade C) periodontitis, their children aged 6-12, and 18 orally healthy adults.

As well as a clinical analysis, the samples were also subjected to a microbiological analysis and genetic sequencing by Ohio State University researchers.

“Children of periodontitis parents were preferentially colonized by Filifactor alocis, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, Fusobacterium nucleatum and several species belonging to the genus Selenomonas even in the absence of periodontitis,” the article states. “These pathogens also emerged as robust discriminators of the microbial signatures of children of parents with periodontitis.”

Prof Casarin told Agência FAPESP that even with bacterial plaque control and vigorous brushing, children of people with the disease still had the bacteria in their mouths, whereas the effects of dental hygiene and prophylaxis were more significant in the children of healthy subjects.

“Because the parents had periodontitis, their children assumed this community with disease characteristics. They carried the bacterial information into their adult lives,” he said, adding that the analysis of bacterial colonisation indicated the transmission was more likely from the mother. The research group’s next step is working with pregnant women to prevent bacterial colonisation of their children’s mouths.

“We’ll treat the mothers during pregnancy, before the babies are born, and try to find out if it’s possible to prevent bacterial colonization from occurring,” Casarin said, adding that studies with patients will only go ahead when the pandemic is under control.

Source: News-Medical.Net

Journal information: Monteiro, M. F., et al. (2021) Parents with periodontitis impact the subgingival colonization of their offspring. Scientific Reports. doi.org/10.1038/s41598-020-80372-4.