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Current Pediatric Reviews
ISSN: 1573-3963
Current Pediatric Reviews
Volume 3, Number 3, August 2007
Contents
Sudden Infant Death Syndrome from Epidemiology to
Pathophysiology Pp. 177-189
Patricia Franco, Bétrice Kugener, Frédérique
Dijoud, Sonia Scaillet, Jose Groswasser, Ineko Kato, Enza
Montemitro, Jian-Sheng Lin and André Kahn
[Abstract]
Long-Term Effects of Perinatal Glucocorticoid Treatment
on the Heart Pp. 190-197
Willem B. de Vries, Matthijs F.M. van Oosterhout, Miriam
P. Bal, Jan Baan, Cobi J. Heijnen and Frank van Bel
[Abstract]
Medical Music Therapy Based on Baby Science (Baby-Science-Based
Music Therapy) and Assistive Technology for Children
Pp. 198-206
Tohshin Go
[Abstract]
Neurotrophic Factors in the Pathogenesis of Neurological
Disorders with Mental Retardation in Children Pp.
207-213
Raili Riikonen
[Abstract]
Melatonin Therapy of Pediatric Sleep Disorders: Recent
Advances, Why it Works, Who are the Candidates and How to
Treat Pp. 214-224
James E. Jan, Michael B. Wasdell, Russel J. Reiter, Margaret
D. Weiss, Kyle P. Johnson, Anna Ivanenko and Roger D. Freeman
[Abstract]
Juvenile Systemic Lupus Erythematosus Pp.
225-232
Hassib Narchi and Iradj Amirlak
[Abstract]
Adenovirus and Post-Infectious Bronchiolitis Obliterans
in Children Pp. 233-237
Amrita Dosanjh
[Abstract]
Vaccine Risk Communication Interventions in the United
States, 1996-2006: A Review Pp. 238-247
Stephanie A. Irving, Daniel A. Salmon and Barbara A. Curbow
[Abstract]
Abstracts
[Back to top]
Sudden Infant Death Syndrome from Epidemiology
to Pathophysiology
Patricia Franco, Bétrice Kugener, Frédérique
Dijoud, Sonia Scaillet, Jose Groswasser, Ineko Kato, Enza
Montemitro, Jian-Sheng Lin and André Kahn
Prevention campaigns to avoid risk factors for the occurrence
of sudden infant death syndrome (SIDS) during sleep have led
to a significant decrease in the number of infants dying suddenly
and unexpectedly during sleep.
Despite a growing amount of evidence, the understanding of
the mechanisms responsible for SIDS is still largely incomplete.
We will review the most recent epidemiological, electrophysiological,
genetic and pathological research on this topic. From these
data, a comprehensive model for SIDS has been proposed: the
death would result from the combination of three factors (a
prenatal vulnerability, a critical developmental period and
an exogenous postnatal stress) and three potential mechanisms
(deficiencies in breathing, autonomic and sleep-wake controls).
As arousal represents the last chance of survival when an
infant is exposed to a life-threatening challenge during sleep,
failure to arouse could be involved in the final pathway of
SIDS.
An infant could be vulnerable to SIDS because of a deficiency
in cardio-respiratory or in sleep/wake behaviour controls
during sleep. Genetic, metabolic, nutritional or toxic prenatal
brainstem injury could be responsible for these deficits.
The infant’s vulnerability lies latent until he/she
enters the critical developmental period from 2 to 6 months
when significant changes in sleep-wake, breathing and autonomic
controls occur. The accident has a greater probability of
occurring when the infant is exposed to an infection, or an
unfavourable environmental factor which enhances the immature
cardio respiratory and sleep/wake behaviours of the infant.
[Back to top]
Long-Term Effects of Perinatal Glucocorticoid
Treatment on the Heart
Willem B. de Vries, Matthijs F.M. van Oosterhout, Miriam
P. Bal, Jan Baan, Cobi J. Heijnen and Frank van Bel
Chronic lung disease in the extremely preterm baby is still
a major complication in neonatal intensive care. Perinatal
(ante- and neonatal) glucocorticoids are widely used to prevent
severe infant respiratory distress syndrome and/or to reduce
chronic lung disease respectively. A review of the literature
regarding the cardiovascular side effects of antenatal and
neonatal glucocorticoids is presented here.
[Back to top]
Medical Music Therapy Based on Baby Science (Baby-Science-Based
Music Therapy) and Assistive Technology for Children
Tohshin Go
Music is a good tool to communicate with children no matter
what kinds of disorders they have because therapists can interact
with them via music and musical instruments without using
a single word. Verbal and physical abilities are limited in
patients who are physically, cognitively, and socially disabled.
Babies also have a similar limitation. Baby science is interdisciplinary
research investigating how infants understand and communicate
with the surrounding world. Therefore, medical music therapy
based on baby science (baby-science-based music therapy) is
useful in the rehabilitation of patients with various neuromuscular
and developmental disorders to maintain, restore, and develop
their physical, cognitive, social, and communicative abilities.
Basic concepts and their application methods are as follows:
imitation (neonatal oral imitation and higher imitation),
integration of crossmodal sensation, rhythm, language, attention,
and habituation and dishabituation.
To improve the quality of life of patients with severe motor
disability and massive involuntary movements, a special music
keyboard connected to switch devices (micro switches for Duchenne
muscular dystrophy and spastic cerebral palsy, and push-button
switches for Rett syndrome and athetoid cerebral palsy) has
been developed. This assistive technology enables patients
to play music and participate in social activities even in
the advanced stage of their diseases.
[Back to top]
Neurotrophic Factors in the Pathogenesis of Neurological
Disorders with Mental Retardation in Children
Raili Riikonen
Neurotrophic factors are important for neuronal growth, differentiation,
survival of neurons and synaptic formation of certain brain
cells. Neurotrophic factors from cerebrospinal fluid (CSF)
in neurological disorders both acute and rapidly progressive
chronic neurological disorders that lead to mental retardation
were studied. Their role in the pathogenesis of neurological
disorders was assessed to see whether they may serve as prognostic
markers.
In neonates suffering from severe asphyxia, increased brain-derived
nerve growth factor (BDNF) might counteract neuronal damage.
The level of beta-neurotrophic factor (NGF) might serve as
a marker of asphyxia.
Children with cryptogenic infantile spasms had largely normal
levels of NGF, but children with symptomatic spasms had low
to negligible levels. The therapeutic action of adrenocorticotrophic
hormone may be mediated by a potentiation of neural growth
factors.
Patients with Rett syndrome had low concentrations of CSF
NGF compared with controls and autistic patients. NGF might
be important for the function of cholinergic neurons in Rett
syndrome.
Low levels of CSF insulin-like growth factor-1 were found
in patients with progressive encephalopathy-hypsarrhythmiaoptic
atrophy syndrome with cerebellar atrophy and in white matter
diseases and infantile ceroid lipofuscinosis.
Neurotrophic factors may be involved in the pathogenesis of
some neurodegenerative diseases. Whether neurotrophic therapies
prevent or arrest progression of these diseases still awaits
confirmation in clinical trials.
[Back to top]
Melatonin Therapy of Pediatric Sleep Disorders: Recent
Advances, Why it Works, Who are the Candidates and How to
Treat
James E. Jan, Michael B. Wasdell, Russel J. Reiter, Margaret
D. Weiss, Kyle P. Johnson, Anna Ivanenko and Roger D. Freeman
Chronic sleep difficulties commonly coexist with neurodevelopmental
and psychiatric problems. Children with special needs may
have a variety of sleep disturbances and of these circadian
rhythm sleep disorders appear to be the most common. Melatonin
supplementation for some circadian rhythm sleep disorders
is often an effective treatment because it corrects the associated
abnormal melatonin secretion. Melatonin has a benign safety
profile and significant potential health benefits.
Melatonin has many functions including sleep promoting and
chronobiotic properties. Melatonin therapy is only benefi-cial
when persistent sleep difficulties are associated with low
melatonin secretion and additional supplementation beyond
the therapeutic dose does not result in further sleep promotion.
Abnormal neurological modulation of pineal melatonin secretion
is commonly present in neurodevelopmental and psychiatric
disorders.
Melatonin deficiency not only leads to sleep disturbance,
but also to multiple health problems. Chronic sleep difficulties
of special needs children must not be ignored because they
may exacerbate the deficits in development which are already
present.
In this review, misconceptions about sleep and melatonin therapy,
functions of this indoleamine, causes and diagnoses of circadian
rhythm sleep disorders, physiological principles underlying
treatment, selection of candidates, dose, safety and health
benefits are discussed.
[Back to top]
Juvenile Systemic Lupus Erythematosus
Hassib Narchi and Iradj Amirlak
Systemic lupus erythematosus (SLE) is an uncommon
chronic autoimmune disease in children. In view of its insidious
onset and protean manifestations which may involve any body
organ system, the diagnosis may become difficult and challenging.
We review this condition, and begin by reporting three affected
children to highlight its very different modes of presentation.
An up-to-date review of the disease is then presented, including
diagnosis, complications and recommended therapy including
new therapeutic modalities.
[Back to top]
Adenovirus and Post-Infectious Bronchiolitis Obliterans
in Children
Amrita Dosanjh
Bronchiolitis Obliterans (OB) is a potentially life
threatening, uncommon, but severe form of chronic obstructive
lung disease in children, that results from lower airway injury
following a respiratory infection.
Clinically, it is characterized by rapid respirations, rales,
wheezing and hypoxemia for at least 30 days after the initial
injury. Histologically, OB is characterized by luminal obstruction
with inflammation, granulation tissue, fibrosis and obliteration
of the small airways and bronchiectasis.
A number of respiratory viruses such as respiratory syncytial
virus (RSV), parainfluenza, and particularly adenovirus are
associated with severe lung injury leading to OB.
This mini-review will seek to provide an up to date, concise
review of the currently available literature and research,
in the area of adenovirus associated Bronchiolitis Obliterans
in children.
[Back to top]
Vaccine Risk Communication Interventions in the United
States, 1996-2006: A Review
Stephanie A. Irving, Daniel A. Salmon and Barbara A. Curbow
Background: Vaccines have been tremendously successful
in preventing many childhood diseases. However, this success
has created new challenges: parents are no longer familiar
with vaccine-preventable diseases and as a result the object
of parental fear has shifted from diseases to vaccines. In
this modern era of vaccination, vaccine risk communication
plays an increasingly important role in immunization programs.
A 1997 Institute of Medicine Risk Communication and Vaccination
workshop concluded that: “Although health risk communication
has been an active research area for several decades, the
science and practice of vaccine risk communication are not
yet well developed”.
Objective: To review vaccine risk communication
interventions conducted and evaluated in the last decade in
the United States while identifying opportunities for improvement
in this area.
Search Strategy: We searched the CSA, PubMed,
and PsycINFO databases. The following search terms were used:
vac-cine(s), vaccination, immunization, communication, parent(s),
risk, risk assessment, safety, attitude(s), belief(s). References
reported in all articles identified from the database searches
were reviewed to locate additional studies.
Study Selection: Studies related to vaccine
risk communication, including communication interventions
involving parents and/or patients, and published in English
between 1996 and October 2006 in peer-reviewed journals were
included in this review.
Data Extraction: First author, year of publication,
study design, number of participants, study population, study
objectives, findings, and authors’ recommendations were
extracted independently and in duplicate.
Results: Eighteen studies met inclusion
criteria; four studies were evaluations of immunization reminder
systems that included an educational component. The studies
included a variety of outcome measures; most commonly assessed
were immunization rates, vaccine or disease knowledge, intervention
material recognition, recall and/or comprehension, and parental
satisfaction with the intervention materials. While there
was considerable variability of findings due to the variation
in types of studies, all eighteen reported some favorable
finding. Overall, the authors made few recommendations regarding
future vaccine risk communication strategies.
Conclusions: It is difficult to determine
if substantial progress has been made since the Institute
of Medicine workshop; the literature is lacking due to the
scant number of studies, types of interventions developed,
and the limited number of rigorous evaluations. The development
and rigorous evaluation of vaccine risk communication strategies
is critical to the success of our immunization programs.
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