Clinical Pediatric Literature Updates from March 2015

Guidelines to Decrease Unanticipated Hospital Admission Following Adenotonsillectomy in the Pediatric Population

We found that the institution of pediatric adenotonsillectomy guidelines for patients undergoing adenotonsillectomy significantly decreased the rate of unanticipated admission.

http://www.ncbi.nlm.nih.gov/pubmed/24239021

Is Day Stay Adenotonsillectomy Safe in Children with Mild to Moderate Obstructive Sleep Apnoea? A Retrospective Review of 100 Patients

Children who are otherwise well with mild to moderate OSA have a sufficiently low risk of respiratory complications following adenotonsillectomy to permit day-stay surgery in the setting of appropriate facilities with careful post-operative monitoring for the first 6h to identify a small sub-group who require overnight observations.

http://www.ncbi.nlm.nih.gov/pubmed/24287254

A Pro-Inflammatory Role for Nuclear Factor Kappa B in Childhood Obstructive Sleep Apnea Syndrome

Nuclear factor kappa B is locally and systemically activated in children with obstructive sleep apnea syndrome. This observation may motivate the search for new anti-inflammatory strategies for controlling nuclear factor kappa B activation in obstructive sleep apnea syndrome.

http://www.ncbi.nlm.nih.gov/pubmed/24293770

Testing for Pediatric Obstructive Sleep Apnea When Health Care Resources are Rationed

Oximetry studies evaluated with the McGill Oximetry Score expedite diagnosis and treatment of children with adenotonsillar hypertrophy referred for suspected sleep-disordered breathing.

http://www.ncbi.nlm.nih.gov/pubmed/24851855

The Relationship Between Depressive Symptoms and Obstructive Sleep Apnea in Pediatric Populations: A Meta-Analysis

Our findings suggest that depressive symptoms are higher among children with OSA. Therefore, patients with depressive symptomatology should receive screening for sleep disordered breathing.

http://www.ncbi.nlm.nih.gov/pubmed/24235907

The Cooccurrence of Interictal Discharges and Seizures in Pediatric Sleep-Disordered Breathing

Our study confirms the high prevalence of interictal epileptiform discharges in children with SDB. Follow-up data indicate that they may recede over time, accompanied by an improvement of sleep respiratory parameters.

http://www.ncbi.nlm.nih.gov/pubmed/24128933

Correlation of Salivary Cortisol Level with Obstructive Sleep Apnea Syndrome in Pediatric Subjects

Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.

http://www.ncbi.nlm.nih.gov/pubmed/23891237

Low Morning Serum Cortisol Levels in Children with Tonsillar Hypertrophy and Moderate-to-Severe OSA

Children with moderate-to-severe obstructive sleep apnea and the phenotype of hypertrophic tonsils have reduced morning serum cortisol levels and potentially decreased glucocorticoid inhibitory effects on tonsillar growth.

http://www.ncbi.nlm.nih.gov/pubmed/?term=23997368

Lipopolysaccharide-Binding Protein Plasma Levels in Children: Effects of Obstructive Sleep Apnea and Obesity

We postulate that disrupted sleep and other factors facilitating obesity such as a high-fat diet may disrupt the gut microbiome and lead to increased systemic LPS levels with resultant inflammation, promoting downstream metabolic dysfunction.

http://www.ncbi.nlm.nih.gov/pubmed/24276451