Multidisciplinary lifestyle interventions improve sleep habits and reduce abdominal obesity in pediatric patients

A recent study conducted among pediatric patients found that childhood obesity and sleep disorders can be managed well using multidisciplinary lifestyle interventions. This study’s results were published in the journal, Sleep medicine.

In the randomized trial, 122 patients aged between 7 to 16 years were allocated to either the intervention group, comprising of moderate hypocaloric Mediterranean Diet or the usual care group, consisting of standard recommendations on a healthy diet. To assess sleep, triaxial accelerometry was used. Sleep parameters that were measured included wake after sleep onset, latency, total time in bed, efficiency, total sleep time, number of awakenings, and awakening duration.

It was observed that sleep latency at 12 and 24 months and sleep efficiency at 2 and 12 months was significantly improved in the intervention group when compared to the usual care group. Wake after sleep onset and the number of awakenings were also reduced in this group. There was an inverse relationship between total time in bed and triglycerides, as well as metabolic scores, while total sleep time had an  inverse relationship with leptin, triglycerides, and metabolic scores post 2-month intervention.

There was an inverse relationship between triglyceride levels and total time in bed and total sleep time at one year. The metabolic score was directly related to number of awakenings and wake after sleep onset while it was inversely associated with efficiency.

From the above findings, it can be concluded that multidisciplinary intervention in children and adolescents having abdominal obesity may reduce anthropometric parameters and improve sleep habits.

Lung ultrasound score predicts use of respiratory support in preterm infants with dyspnea

A recent study confirmed the use of lung ultrasound score (LUSsc) as a predictor for respiratory support patterns in preterm infants. The results of this study were published in the journal, Pediatrics and neonatology.

This was a prospective study that enrolled 857 preterm babies who were subjected to lung ultrasound score 2h after hospitalization. The infants were divided into 2 groups, based on gestational age of <32+0 weeks and 32+0-36+6 weeks, respectively and randomly assigned to a validation and training set. The two outcomes assessed were invasive and non-invasive respiratory support, based on neonatal mechanical ventilation strategies.

The infants who were on invasive respiratory support exhibited a higher LUSsc, lower Oxygenation Index (OI), and greater use of Pulmonary Surfactant (PS). In the <32+0 weeks group, the cut-off point of LUSsc was 8 while the sensitivity and specificity were calculated to be 74.0% and 68.3%, respectively. Whereas, the 32+0-36+6 weeks group showed a cut-off point of 7 while the sensitivity and specificity were 75.3% and 0.836%, respectively.

Hence, based on the above findings, it may be concluded that LUSsc as a predictor for respiratory support in preterm infants is reliable and offers correct ventilation strategy in infants with dyspnea.

Baricitinib combined with steroids is safe & effective in paediatric patients with atopic dermatitis

A recent study suggests that baricitinib, when combined with topical steroids, is safe and effective in paediatric patients with moderate-to-severe atopic dermatitis (AD). The study’s results were published in the British Journal of Dermatology.

This randomized phase 3, double-blind, placebo-controlled included 483 patients of mean aged 12 years, who were randomized in a 1:1:1:1 ratio to receive baricitinib low dose (1mg), medium dose (2 mg), high dose (4 mg), or placebo for 16 weeks. The study's primary endpoint included achieving a validated Investigator Global Assessment (vIGA-AD) of 0/1 with a 2-point improvement at week 16.

At the end of the study, baricitinib at a high dose (4 mg), achieved statistically significant improvement compared to placebo on all 16-week primary endpoints. No study-related deaths, major cardiovascular, venous thromboembolic events, or opportunistic infections were seen. Based on the results of the study, it can be concluded that baricitinib is safe and reduces systemic therapies for paediatric patients with moderate-to-severe AD.

Oxidative stress in pediatric β-thalassemia major reduced by omega-3 and Manuka honey

According to a recent study, children with β-thalassemia major showed reduced oxidative stress condition and iron overload when treated with a combination of omega-3 and Manuka honey. This study’s results were published in the journal, European review for medical and pharmacological sciences.

This multisite, randomized, double-blind, parallel-design, standard therapy-controlled study included 165 pediatric patients suffering from β-thalassemia major. The patients were divided into 3 groups who were administered either 1,000 mg omega-3 fish oil [350 mg eicosapentaenoic acid (EPA) and 250 mg docosahexaenoic acid (DHA)] along with Manuka honey lozenge (344mg) daily, Manuka honey alone, or the conventional therapy (deferasirox, blood transfusion, and L-carnitine), for a period of 10 months. Various health parameters such as low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C), C-reactive protein (CRP), Plasma 8-iso-prostaglandin F2α (8-iso-PGF2α), ferritin level, serum iron, and Lactate dehydrogenase (LDH) were measured at baseline and after 10 months.

8-iso-PGF2α levels were significantly reduced in the combination group [omega-3 and Manuka honey] compared to the Manuka alone and the control groups. The combination of omega-3 and Manuka honey also showed an antihemolytic action due to lowered LDH levels. Additionally, both LDL-C and HDL-C were restored for the combination group compared to the control group. Manuka honey worked by boosting the action of omega-3 in lowering oxidative stress by reducing serum iron levels.

Following the results that were obtained, it may be concluded that a combination of omega-3 and Manuka honey, when administered as an add-on to conventional therapy, was most effective in managing oxidative stress in children with β-thalassemia major.