Deviations from Typical Developmental Trajectories Detectable at 9 Months of Age in Low Risk Children Later Diagnosed with Autism Spectrum Disorder.

This study was designed to track the developmental trajectory, during the first 24 months of life, of 335 low-risk infants later diagnosed with Autism Spectrum Disorder and identify early deviations observed in routine Well Care checkups. We compared their achievements to typically developing children and to children later diagnosed with non-autistic developmental impairments. The results show that in the first 6 months, the children with autism showed normal acquisition of milestones, whereas by 9 months of age they began to fail the language/communication, as well as motor items when compared to typical and delayed non-autistic children.

[COMPLICATIONS RELATED TO PATIENT POSITIONING: KEY POINTS IN PREVENTION AND MANAGEMENT].

Patient positioning during surgery can have profound short and long term implications for the patient. Each position carries some degree of risk to the patient, which is magnified in prolonged operations, surgeries performed under general anesthesia and when position manipulations are required in order to gain best surgical access. Prevention is the mainstay of the management of positioning.

Impact of follow-up calls from the pediatric emergency department on return visits within 72 hours: a randomized controlled trial.

Objectives: We compare the rate of return to the emergency department (ED) within 72 hours between families of children receiving a follow-up telephone call by a non-health care provider asking about the child's well-being 12 hours after their visit to the ED and families not receiving a follow-up call.

Methods: This was a prospective, randomized study in which we conducted a follow-up call starting at 12 hours after discharge from the ED versus no call for follow-up. At 96 hours after discharge, we contacted all recruited families.

Use of botulinum toxin A in management of children with cerebral palsy.

Question: What is the role of intramuscular botulinum toxin injections in the management of spasticity and related morbidity in children with cerebral palsy?

Answer: When botulinum toxin A is injected into the limbs of children with spastic paresis, it induces temporary reduction in muscle tone. It also promotes better motor function when used in combination with conservative treatments such as physiotherapy. Although there is a growing body of evidence for its effective and safe treatment, there is still a lack of consensus on dose, treatment regimens, and the best integration with other clinical modalities.

Anti-inflammatory therapy for obstructive sleep apnea in children.

Question: A 4-year-old child was diagnosed by polysomnography as experiencing mild obstructive sleep apnea (OSA). Despite the child being inattentive and distracted during the day at school, his parents prefer to avoid surgical treatment (adenotonsillectomy). Are there any non-surgical treatments for mild OSA in young children?

Answer: Obstructive sleep apnea in children is caused mainly by adenotonsillar hypertrophy and can lead to considerable morbidities, including neurocognitive and behavioural disturbances.

Anti-staphylococcal treatment in dermatitis.

Question: A 10-year-old boy with atopic dermatitis (AD) came for consultation with an exacerbation. He suffered from pruritus and multiple erythematous skin lesions, identified as inflamed but not infected. Because skin colonization with Staphylococcus aureus is very common in AD and can worsen the skin condition, is it reasonable to add topical antibiotic treatment to the anti-inflammatory treatment in this case?

Answer: Skin colonization with S aureus is prevalent in children and adults with AD, and can aggravate skin inflammation.

Oxybutynin for treatment of nocturnal enuresis in children.

Question: A 7-year-old child and his parents visit my clinic owing to the child's frequent bed-wetting. During the day, he has no problem controlling his urination. The family has tried behavioural methods but has failed to achieve dryness during the night.

Reducing inappropriate antibiotic use among children with influenza infection.

Question: With the influenza season reaching a peak, I see numerous children in my clinic with fever and influenza-like illnesses. Parents are concerned and at times ask for antibiotic treatment in hopes that the treatment will shorten the duration of illness. What strategies can I use in order to minimize inappropriate prescription of antibiotics during the influenza season?

Answer: Use of antibiotics for treatment of viral infections such as influenza contributes to the emergence of resistant bacteria strains.

Influenza vaccination for children with asthma.

Question: Parents of children with asthma are encouraged by many health organizations to vaccinate their children against seasonal influenza viruses. Is the influenza vaccine efficient in preventing asthma exacerbation? Are current vaccinations safe to administer to children with asthma?

Answer: Infection with influenza viruses can cause substantial respiratory morbidity in children with underlying chronic disease such as asthma. Although vaccination against influenza does not reduce or shorten asthma exacerbations, the intramuscular trivalent vaccine is safe and has a beneficial effect on the quality of life of children with asthma.

Incidence and clinical manifestations of adenoviral infection among children undergoing allogeneic stem cell transplantation.

Background: Adenoviral infection in children undergoing stem cell transplantation is associated with significant morbidity and mortality. Identification of adenoviral infection by polymerase chain reaction from blood facilitates accurate and rapid diagnosis and surveillance. The incidence of adenoviral infection among children undergoing SCT in Israel is not known.

Adenotonsillectomy improves neurocognitive function in children with obstructive sleep apnea syndrome.

Objective: To evaluate neurocognitive functions of children with obstructive sleep apnea syndrome (OSAS), before and after adenotonsillectomy, compared with healthy controls.

Design: Prospective study.

Patients And Methods: Thirty-nine children with OSAS aged 5 to 9 years (mean age, 6.