The adverse effects of vaping in young people Meehan, Judith; Heffron, Mairead; Avoy, Helen Mc ...
Global pediatrics,
September 2024, 2024-09-00, 2024-09-01, Volume:
9
Journal Article
Peer reviewed
Open access
Vapes or e-cigarettes are battery operated devices that heat a liquid until it becomes a vapour, which is inhaled. Typically, e-liquids contain nicotine, different flavourings, and propylene glycol. ...Vaping devices are either disposable vapes or rechargeable. Vapes were initially developed as stop smoking aid but they have now become a recreational product popular among teenagers.
Vaping has increased at an alarming rate among teenagers and young adults in Ireland. The European Schools Project for Alcohol and Other Drugs (ESPAD) survey 2019 showed that almost 4 in 10 Irish 16-year-olds had tried vaping and 15 % currently use them. More worrying is the dramatic rise in the use of disposable vapes in recent years. An Action on Smoking and Health (ASH) UK survey data revealed a 9-fold increase from 2021 to 2023 in their use (7.7 % to 69 %) among 11–17-year-old vapers.
A combination of clever marketing by vaping companies, a strong social media presence, attractive flavours and easy accessibility has contributed to the increasing use of vapes by young people.
Exposure of children and adolescents to nicotine in vaping solutions can lead to long-term negative impacts on brain development, as well as addiction. Many teenagers who vape experience poor concentration, anxiety, mood disorders and sleep disturbance. A paper from NEJM in 2022 reported a case series where chronic vaping resulted in small airway fibrosis of the airways. A systematic review conducted in 2021 concluded that teenager vapers were three to five times more likely to take up tobacco smoking when compared with non-vapers.
Strong legislation is required to ban the sale of disposable vapes to teenagers along with controls on marketing online. Healthcare Professionals should ask and counsel their patients about vaping. Increased public awareness and education for Health care professionals on teenage vaping needs to be addressed.
Vaping has become a global public health issue that must be addressed urgently.
Retinopathy of prematurity is a significant global cause of childhood blindness. This study aims to identify serum biomarkers that are associated with the development of ROP.
A systematic review and ...meta-analysis was conducted using PRISMA guidelines. Three databases were searched (Pubmed, Scopus and Web of Science) from 2003 to March 2023. Only studies investigating serum biomarker levels in preterm infants (<37 weeks gestation) were included.
Meta-analysis suggests that low serum IGF-1 levels have a strong association with the development of ROP SMD (95% CI) of -.46 -.63, -.30,
< .001. Meta-analysis suggests that higher serum glucose levels were associated with the development of ROP SMD (95% CI) of 1.25 .94, 1.55,
< .001. Meta-analysis suggests that thrombocytopenia is associated with the development of ROP SMD (95% CI) of -.62 -.86, -.37,
< .001.
Low levels of serum IGF-1, high levels of serum glucose and thrombocytopenia all appear to have the strongest association with the development of ROP out of the 63 biomarkers investigated in this review. These associations highlight their potential use as diagnostic biomarkers in ROP, though further research is needed to establish the exact relationship between these biomarkers and disease pathogenesis.
Prader‐Willi syndrome is a complex condition requiring constant care and supervision of the affected child.
Aim
To evaluate quality of life and caregiver burden in children with Prader‐Willi ...syndrome.
Methods
All children with Prader‐Willi syndrome, attending a tertiary referral centre, were invited to participate (n = 44). Quality of life was evaluated using the PedsQL questionnaire. Family impact modules and parent proxy reports evaluated the impact on the quality of life of the child and family. Additional challenges were captured using a burden questionnaire.
Results
Nineteen children participated. Median age was 7.9 years (0.6–18.1 years). Majority were female (n = 14, 74%). Median age at diagnosis was 2.5 weeks (range birth–2 years 8 months). Growth hormone treatment was in place for the majority (n = 14, 74%). Increased weight and age were identified as significantly impacting on family functioning and relationships. Parents perceived increased weight and age to have a significant negative impact on their child's psychosocial health and social functioning.
Caregivers of children >12 years reported an increased burden of care. Disruption to routines, restriction of social activities and psychological difficulties were reported as increasing caregiver burden.
Conclusion
Prader‐Willi syndrome impacts significantly on quality of life for both the affected child and the family.
Neonatal sepsis is a leading cause of infant mortality worldwide with non-specific and varied presentation. We aimed to catalogue the current definitions of neonatal sepsis in published randomised ...controlled trials (RCTs).
A systematic search of the Embase and Cochrane databases was performed for RCTs which explicitly stated a definition for neonatal sepsis. Definitions were sub-divided into five primary criteria for infection (culture, laboratory findings, clinical signs, radiological evidence and risk factors) and stratified by qualifiers (early/late-onset and likelihood of sepsis).
Of 668 papers screened, 80 RCTs were included and 128 individual definitions identified. The single most common definition was neonatal sepsis defined by blood culture alone (n = 35), followed by culture and clinical signs (n = 29), and then laboratory tests/clinical signs (n = 25). Blood culture featured in 83 definitions, laboratory testing featured in 48 definitions while clinical signs and radiology featured in 80 and 8 definitions, respectively.
A diverse range of definitions of neonatal sepsis are used and based on microbiological culture, laboratory tests and clinical signs in contrast to adult and paediatric sepsis which use organ dysfunction. An international consensus-based definition of neonatal sepsis could allow meta-analysis and translate results to improve outcomes.
Aim
Bronchopulmonary dysplasia (BPD), a respiratory complication associated with neonatal prematurity, presents opportunities for pharmacological intervention due to its contributing risk factors. ...Despite diuretics' controversial usage in BPD treatment and varying institutional practices, this review aims to consolidate evidence from clinical trials regarding diuretic use in BPD.
Methods
We conducted a systematic review following PRISMA guidelines, searching EMBASE, Medline, Web of Science and CINAHL databases (PROSPERO 2022: CRD42022328292). Covidence facilitated screening and data extraction, followed by analysis and formatting in Microsoft Excel.
Results
Among 430 screened records, 13 were included for analysis. Three studies assessed spironolactone and chlorothiazide combinations, two studied spironolactone and hydrochlorothiazide, while eight examined furosemide. All studies evaluated drug effects on dynamic pulmonary compliance and pulmonary resistance, serving as comparative measures in our review.
Conclusion
Diuretics' effectiveness in treating bronchopulmonary dysplasia remains uncertain. The limited number of identified randomised controlled trials (RCTs) hampers high‐level evidence‐based conclusions when applying the Population, Intervention, Comparison, Outcome (PICO) approach. Conducting large prospective studies of good quality could provide more definitive insights, but the rarity of outcomes and eligible patients poses challenges. Further research, primarily focusing on RCTs assessing diuretics' safety and efficacy in this population, is warranted.
Aim
Neonatal encephalopathy (NE) is associated with an increased risk of multi‐organ injury. The lack of standardised definitions for multi‐organ dysfunction in NE hinders accurate quantification of ...these complications.
Methods
A simple multi‐organ dysfunction in neonatal encephalopathy scoring (MODE) system was created to include the cardiovascular, respiratory, gastrointestinal, haematological and neurological systems with a maximum score of 15. The MODE score was then compared with the grade of NE, Bayley Scales of Infant Development (Bayley‐III) at 2 years of age and mortality. The Bayley score was used as it gave an objective score making it easier to compare the MODE score. Bayley score of <90 and/or abnormal MRI as an adverse outcome.
Results
Infants with perinatal asphyxia (PA:n = 85) were prospectively enrolled (PA only n = 9; NE I = 23; NE II = 42; NE III = 11). Infants with higher MODE scores were significantly more likely to have moderate/severe NE (NE II/III: median scores (IQR) 7(5–10) versus mild NE 2 (1–3); p‐value < 0.001) The MODE score was highly predictive of mortality (AUC 0.96, p‐value = 0.002). Infants who had an abnormal neurological examination at discharge or abnormal Bayley‐III scores had significantly higher MODE scores (p‐value = 0.001).
Conclusion
Quantifying multi‐organ injury is important to plan optimal early management and long‐term follow‐up. Additional use of clinical biomarkers may be useful as surrogate endpoints in future clinical trials and link to multi‐organ longer‐term developmental follow‐up.
Aim
Pulmonary haemorrhage (PH) is an acute catastrophic event with low incidence yet high mortality among neonates. We aimed to systematically review the management of PH.
Methods
A search was ...carried out of the PubMed, EMBASE and Cochrane databases according to the PRISMA guidelines. Data were extracted on study design and size, patient demographics, primary and adjunctive treatment methods, and treatment outcomes.
Results
Sixteen studies with 385 newborn infants were included and were significantly heterogeneous regarding treatment methods. Primary treatments included surfactant, high‐frequency oscillatory ventilation (HFOV), epinephrine, coagulopathy management, intermittent positive pressure ventilation, cocaine and tolazoline. Adjunctive treatment methods included blood products, HFOV, increased positive end‐expiratory pressure, vitamin K, surfactant, adrenaline, vasopressors and inotropes. All five studies using surfactant as primary treatment were effective in improving oxygenation index measures and preventing recurrence of PH, and three studies found no association between surfactant and death or long‐term disability. Ventilatory support, epinephrine, management of coagulopathy and tolazoline were all found to be effective primary treatments for PH.
Conclusion
There are several effective methods of managing PH in neonates. Further understanding of the aetiology of PH and ongoing research will allow future prevention and improvements in management of PH.
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