Sensitivity to superantigens of Staphylococcus aureus is important even in mild and moderate atopic dermatitis

Sensitivity to superantigens of Staphylococcus aureus is important even in mild and moderate atopic dermatitis

ADHD and child abuse Dopamine and patent ductus arteriosus Ouyang et al from the CDC have studied whether attention-deficit/hyperactivity disorder (...

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ADHD and child abuse

Dopamine and patent ductus arteriosus

Ouyang et al from the CDC have studied whether attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk of child maltreatment using the National Longitudinal Study of Adolescent Health database. Because there was a significantly increased rate of child abuse and neglect, pediatricians should be aware of the potential for child maltreatment amongst children with ADHD.

Patent ductus arteriosus (PDA) is common in preterm infants and can be associated with increased morbidity. Part of the risk of the PDA is related to shunting from left to right through the ductus arteriosus. In this issue of The Journal, Bouissou et al report on the results of a study to evaluate the use of dopamine in preterm infants with a PDA and hypotension. They found that in hypotensive preterm infants with a PDA the infusion of dopamine decreased the left to right shunt due to a rise in pulmonary vascular resistance. This should result in improved tissue perfusion and could reduce the morbidity associated with a PDA. Thus, treatment with dopamine could be a useful clinical approach in preterm infants with a PDA and hypotension.

—Robert W. Wilmott, MD page 851

Sensitivity to superantigens of Staphylococcus aureus is important even in mild and moderate atopic dermatitis Ong et al showed that superantigen-specific IgE molecules were prevalent in young children with mild or moderate atopic dermatitis, and were associated with increased total serum IgE. These molecules, particularly staphylococcal enterotoxins (SE) A- and SE D- specific IgE, may contribute to the severity of skin manifestations in these patients. Consideration of the ways in which the microbial environment affects the direction and regulatory set-points of innate and adaptive immune responses in general, and contributes to disease states specifically, is becoming more and more interesting. Harnessing knowledge into therapeutic maneuvers (eg, use of probiotics, pathogen-directed antimicrobial therapies) is still at the stage of hypothesis development.

—Stephen R. Daniels, MD, PhD page 790

—Sarah S. Long, MD page 803

The Journal of Pediatrics

December 2008

A3