Tuesday, November 27, 2018

Excess Weight Increases Asthma Risk

Proximity to holidays purely coincidental.  Nonetheless, watch the pounds folks! Dr. Susarla

Children who are overweight or obese are at increased risk for asthma, researchers report.
A retrospective study, published in Pediatrics, included 507,496 children followed for an average of four years. None of the children had incidents of asthma before the start of the study.
The researchers divided the children into three groups: overweight, defined as the 85th to 94th percentile for weight; obese, the 95th percentile or higher; and normal weight, the 25th to 64th percentile.
The study controlled for age, race, health insurance, food allergies, medications and other factors, and found that compared with children of normal weight, the overweight were 17 percent more likely to have been given a diagnosis of asthma and to take an asthma medication. The obese were 30 percent more likely.
The researchers estimate that 23 to 27 percent of asthma cases in obese children can be attributed to the obesity itself. Among all the children, 10 to 13 percent of asthma cases were attributable to obesity.

Friday, November 9, 2018

Does anesthesia in children cause developmental delay?

Many parents I counsel regarding need for flexible bronchoscopy hesitate when they realize anesthesia is involved, albeit even for a short procedure.  This study suggests risk may be exaggerated. Dr. Susarla

Young children who had surgical procedures with general anesthesia prior to primary school entry did not have an increased risk of detectable adverse neurodevelopment outcomes compared with their siblings who did not have surgery, according to a Canadian analysis.
After adjusting for confounding factors, no significant differences were found between exposed and unexposed children in early developmental vulnerability or in each of the major domains of the Early Development Instrument (EDI), a teacher-assessed measure of primary school readiness, reported James O'Leary, MD, and co-authors of the Hospital for Sick Children in Toronto, writing in JAMA Pediatrics.
"These findings further support that exposure to anesthesia and surgery in early childhood is not associated with detectable adverse child development outcomes," O'Leary told MedPage Today.
But "while the findings are generalizable to the majority of young children who have a single surgical procedure performed, it is still not known whether children with repeated or lengthy exposures to surgery and anesthesia are at increased risk of altered neurodevelopment," he added.

Monday, November 5, 2018

Xyrem, narcolepsy therapy for adults AND children

Narcolepsy is debilitating.  In the right child with narcolepsy, sodium oxybate can be life changing.  Dr. Susarla

Sodium oxybate (Xyrem) has been approved by the US Food and Drug Administration (FDA) for the treatment of cataplexy and excessive daytime sleepiness in pediatric patients aged 7 to 17 years old with narcolepsy.

Sodium oxybate is a central nervous system depressant administered as an oral solution and can be given either alone or in combination with other central nervous system depressants. These can include opioid analgesics, benzodiazepines, sedating antidepressants or antipsychotics, sedating anti-epileptic drugs, general anesthetics, muscle relaxants, and/or illicit central nervous system depressants.

The recommended dose for sodium oxybate is 0.5 g/mL, which may only be dispensed to patients enrolled in the XYREM REMS Program because of the risk of serious outcomes that can occur from inappropriate prescribing, misuse, abuse, and diversion.

Narcolepsy resources:




Read article here.