Neonatal male circumcision is associated with altered adult socio-affective processing.
Miani et al. (2020) Heliyon
Men who experienced early penile circumcision showed
-more anxious and avoidant attachment styles.
-higher levels of perceived stress.
-higher levels of sensation seeking.
The negative consequences of nonconsensual circumcision are whole-person and last the whole lifetime.
Foreskin Morbidity in Uncircumcised Males
Sneppen and Thorup, Pediatrics 2016
"In our patient population, we found that 7.2% (95% CI 3.4–11.0) were diagnosed with autism spectrum disorder (ASD) as a concomitant disease (Table 3). A recent Danish study calculated the prevalence of ASD in Denmark to be 1.5% among boys."
Association found between ASD and childhood penile surgeries. This is reference 1, next toot has #2.
Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark
Frisch & Simonsen, 2015 J. R. Soc. Med.
"We confirmed our hypothesis that boys who undergo ritual circumcision may run a greater risk of developing ASD. This finding, and the unexpected observation of an increased risk of hyperactivity disorder among circumcised boys in non-Muslim families, need attention"
California has only 1 pediatric medical toxicologist for its 8.7 million children & 1 child abuse specialist for every 258,000 kids, Claudia Boyd-Barrett writes for California Health Report. Such shortages put children at risk, especially those needing specialty care.
"Nestlé adds more sugar to baby food sold in lower- and middle-income countries, while more affluent markets get healthier versions, according to a recent report released by a nonprofit group.
The Swiss food giant’s products in lower-income countries contained up to 7.3 grams of added sugar per serving, while the same food sold in Europe often contained none..."
"Braun is part of a trend across the United States to integrate oral health into medical checkups for children, pregnant women, and others who cannot afford or do not have easy access to dentists. With federal and private funding, these programs have expanded in the past 10 years, but they face socioeconomic barriers, workforce shortages, and the challenge of dealing with the needs of new immigrants."
"Consumer Reports (CR), a consumer advocacy group, said it tested 12 store-bought versions of Lunchables — which are made by Kraft Heinz — along with similar lunch and snack kits and found “relatively high levels of lead and cadmium” in the Lunchables kits...There is not a safe level of lead for children, the Centers for Disease Control and Prevention notes."
Mental health conditions are common among children with special health care needs (CSHCN).
According to 2022 data from the National Survey of Children’s Health, 51% of CA CSHCN ages 3-17 had 1+ diagnosed mental health conditions—attention deficit disorder or attention-deficit/hyperactivity disorder, anxiety problems, behavioral or conduct problems, or depression—compared with just over 5% of their peers without special health care needs.
👀 New data out from Centers for Disease Control and Prevention show a worrying trend: prenatal care rates dropped substantially in 2022—a smaller share of births got 1st trimester prenatal care and a larger share didn't got late or no care compared with 2021 and 2020.
Children w special health care needs (CSHCN) are more likely to have multiple adverse childhood experiences (ACEs) than their peers. The share of CSHCN who have experienced 4+ ACEs is more than 5X that of children without special health care needs. https://www.kidsdata.org/blog/?p=11068
"Her experience illustrates the layers of anxiety pumping parents endure as they travel, backed up by stories of dumped milk, carry-on pump pushback, alleged “breast milk discrimination” and in-flight crackdowns. Lactating travelers who are not able to pump can face more than embarrassment and discomfort: It could result in infection and reduced milk supply."
Any Canadian pediatricians here? What do you think about the new CPS statement on managing febrile infants? I need comments for a story and a contact. @medmastodon#MedMastodon#pediatrics#paediatrics
Children exposed to neighborhood violence:
🔵Experience more frequent depression and anxiety symptoms
🔵Face unmet mental and physical health care needs
🔵Have worse access to prescription drugs
🔵Have increased acute care utilization
according to a new study
Reporter Jenny Gold analyzed state Medi-Cal data for 2021. Her findings on health care access for kids in the California public insurance program are sobering:
🟡 60% of babies—and 75% of Black babies—did not get their recommended well-child visits in their first 15 months of life.
🟡 65% of 2-year-olds were not fully vaccinated, leaving them vulnerable to vaccine-preventable diseases like measles.
🟡 Half of children did not receive a lead screening by their second birthday.
Can children and youth with special healthcare needs (CYSHCN) access pediatric specialty care in California?
A new survey from Lucile Packard Foundation for Children's Health, UCSF Dept. of Family & Community Medicine, & Children's Specialty Care Coalition asked 660 caregivers of CYSCHN across the state about their experiences.
"Over the last decade, however, health experts have increasingly recognized that boys and men also suffer from eating disorders, and they have gained a better understanding of how differently the illness presents in that group. A small but growing body of scientists and physicians have dedicated themselves to identifying the problem, assessing its scope and developing treatments." https://www.nytimes.com/2024/02/08/health/adolescents-boys-eating-disorders.html
🩺 📘 Recent research led by Jessica Drescher at Stanford University Graduate School of Education found an association between access to pediatric health care and academic success in young children.
Hier, le président Emmanuel Macron a tenu une conférence en direct depuis l'Elysée. Le chef de l'Etat a fait plusieurs annonces notamment concernant l'infertilité.
{Acronym alert - glossary at bottom.} I see more #asthma patients getting bumped from ICS-only monotherapy (and/or SABA-only rescue med) to combo ICS-LABA inhalers. This is spurred by GSK discontinuing brand-name Flovent, and GINA guidelines promoting AIR and MART (aka SMART) strategy, which utilizes a combo inhaler containing formoterol, like Symbicort, Breyna, or Dulera. This is a big change for many people, who're used to using an inhaled #steroid for control and prevention, and inhaled #albuterol for rapid relief. Now they can use one inhaler for both -- which is convenient, and may bring better control.
Now I'm also seeing PCPs, pediatricians, and pulmonologists prescribing other combo ICS-LABA inhalers like Advair with a SMART asthma action plan -- even though that's not approved under GINA or NAEPP guidelines. In fact they explicitly warn against this: "Combination ICS with non-formoterol LABA cannot be used as-needed for symptom relief." (GINA main report, p. 69). LABAs like salmeterol (more lipophilic) take much longer to kick in (30+ minutes) to be intended for rapid relief, and have not been studied for rescue use. But they're being prescribed that way anyway, presumably due to availability, insurance coverage, and clinician confusion during a time of flux. Leading to a lot of follow-up conversations. :blobcatshrug:
SABA == short-acting beta-agonist: a bronchodilator (canonically albuterol) that quickly relieves airway constriction, for a few hours.
LABA == long-acting beta-agonist (ex: salmeterol, formoterol), relieves airway symptoms for more than a few hours.
Rescue med, aka "reliever" == a rapid-acting drug to relieve acute symptoms (e.g. albuterol, epinephrine).
Maintenance therapy == drug you take daily to prevent acute symptoms.
Monotherapy == managing a disease with just one drug.
AIR == Anti-Inflammatory Reliever: combo inhaler with a low-dose steroid + a rapid-acting bronchodilator
MART == Maintenance And Reliever Therapy: treatment with an inhaler that contains both a steroid and a rapid-onset, long-acting beta-agonist (formoterol). Also called SMART (S == "Single-inhaler").