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Aim: To estimate acute gastrointestinal injury (AGI) in critically ill children and association of its severity with mortality. Methods: In a prospective cohort study, critically ill children (1 month–18 years) were enrolled. Gastrointestinal symptoms over the first week of admission were classified into AGI grades 1 through 4, using a paediatric adaptation of European Society of Intensive Care Medicine AGI definitions. Performance of AGI grades in predicting 28‐day mortality was evaluated. Results: Of 151 children enrolled, 71 (47%, 95% confidence interval (CI): 38.9–55.3%) developed AGI, with AGI grades 1, 2, 3 and 4 in 22.5%, 15.9%, 6.6% and 2%, respectively. The 28‐day mortality progressively increased with AGI grade 0 (15%), 1 (35%), 2 (50%), 3 (70%), through 4 (100%), P < 0.001. Association of AGI grades with 28‐day mortality was significant even after adjustment for disease severity, age and nutritional status (odds ratio (OR) = 2.152, 95% CI: 1.455, 3.184). Among AGI grades, and paediatric logistic organ dysfunction‐2 score components, cardiovascular (OR = 1.525, 95% CI: 1.142, 2.037) and haematological (OR = 1.719, 95% CI: 1.067, 2.772) components of paediatric logistic organ dysfunction‐2 score and AGI grades (OR = 1.565, 95% CI: 1.001, 2.449) showed significant association with 28‐day mortality. Conclusions: Nearly half of the critically ill children developed AGI. AGI grades were independently associated with increased mortality, and mortality progressively increased with AGI grade. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to comparison between use of actuated pressurized autohaler (AH) and metered-dose inhaler with spacer (MDIS) in children with asthma. Topics discussed include issues concerning incorrect use of devices resulting in unreliable drug delivery, importance of techniques of inhalation therapy to determine inhaled corticosteroids (ICS) in asthma patients, and successful use of breath-actuated in children with bronchial obstruction.

Objective Executive function (EF) deficits are well documented in children with autism spectrum disorder (ASD)1-2 and are commonly measured clinically using parent ratings3. No studies have investigated whether parent ratings of EF predict brain connectivity in ASD. Aim Examine whether the Behavior Rating Inventory of Executive Function (BRIEF) predicts functional brain connectivity in ASD. Method Resting-state fMRI and behavioral data were obtained from the Autism Brain Imaging Data Exchange (ABIDE-II) database6 (n = 106 ASD, ages 5-13). ROI-to-ROI (Region of Interest) connectivity was computed for 132 ROIs spanning the whole brain, defined using Conn Toolbox. Multiple regression analyses examined the effect of BRIEF metacognition on connectivity while controlling for BRIEF behavioral regulation, and vice versa. Age, sex, and full-scale IQ were included as covariates. FDR correction was used (p < 0.05). Results More severe deficits in metacognition were associated with stronger connectivity between the left hippocampus and several ROIs, including the cerebellum and planum temporale. More severe deficits in metacognition were associated with weaker right hippocampus – right frontal pole connectivity. More severe deficits in behavioral regulation were associated with stronger connectivity between subcortical regions (i.e. thalamus, putamen, and caudate) and regions involved in motor (superior frontal gyrus) and limbic systems (cingulate gyrus). More severe behavioral regulation deficits were associated with weaker cerebellar-cerebellar connectivity. Conclusions Findings suggest that parent-ratings of metacognitive abilities in children with ASD are associated with hippocampal connectivity, while behavioral regulation abilities are associated with thalamic and striatum connections. These results build upon previous studies of metacognition and behavioral regulation 5,6. [ABSTRACT FROM AUTHOR]

Allergic bronchopulmonary aspergillosis (ABPA), as a complication of asthma, is rare in children. The persistent and poorly-controlled asthma leading to cor pulmonale is not uncommon in adults but rarely described in the pediatric age group. Here, we report a case of asthma and ABPA complicated by pulmonary thrombo-embolism and cor pulmonale. To the best of our knowledge, such association has never been reported in the pediatric age group [ABSTRACT FROM AUTHOR]