MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The Journal of Pediatrics' source. Thu, 09 Feb 2012 01:09:43 +0100 http://www.medworm.com/index.php?rid=5585914&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011437%2Fabstract%3Frss%3Dyes We thank Regelmann et al for sharing our interest in this subject and posing important clinical research questions related to medication-induced diabetes mellitus. We acknowledge the heterogeneity of our study population, but point out that our central question was whether there is a new profile of children with medication-induced diabetes in the setting of increased prevalence of overweight and obesity in children in the general population. In this group of 58 children, we did not request the primary disease, but we noted that 98% were receiving at least one diabetogenic drug and 95% were receiving a glucocorticoid. Our hypothesis was that obesity has increased the risk of β-cell exhaustion in these children, leading to a change in the age and ethnicity of affected children. We did not ... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585914 Sat, 14 Jan 2012 17:25:12 +0100 5585914 http://www.medworm.com/index.php?rid=5585913&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011243%2Fabstract%3Frss%3Dyes Amed et al compared risk factors for children with type 2 diabetes mellitus and medication-induced diabetes mellitus. Their conclusion that “there is no consistent risk profile for children” to develop medication-induced diabetes is not surprising, given the heterogeneity of underlying medical conditions and diabetogenic agents. Children with medication-induced diabetes mellitus have variable underlying medical conditions. Variable risk profiles have been described even in analyses of groups with a single diagnosis, such as liver transplantation. Could Amed et al provide the frequency of primary diagnoses in their survey? Grouping patients by underlying condition may help determine a risk profile. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585913 Sat, 14 Jan 2012 17:25:12 +0100 5585913 http://www.medworm.com/index.php?rid=5585905&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010031%2Fabstract%3Frss%3Dyes This report by McCollough highlights the multifactorial etiology of bezoars in preterm infants. In contrast to swallowed foreign bodies (like coins, pins, and batteries), a bezoar in the gastrointestinal tract forms through the clumping of materials, which in normal circumstances are degraded, digested, absorbed, and easily transported. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585905 Sat, 14 Jan 2012 17:25:12 +0100 5585905 http://www.medworm.com/index.php?rid=5585903&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009383%2Fabstract%3Frss%3Dyes This report was published 3 years after kanamycin became available. As noted by the authors, kanamycin had proven to be an effective drug for the treatment of serious infections. However, because of similarities in chemical structure to streptomycin and neomycin, drugs known to be ototoxic and nephrotoxic, the potential for serious side effects was acknowledged. Yow et al performed hearing testing on 30 children who received kanamycin therapy for 5 or more days. None had known risk factors for hearing loss, but all were seriously ill. Dosages of kanamycin varied widely, and 5 infants received other ototoxic drugs. Sensorineural hearing loss was diagnosed in 5 of the 30 infants (17%) treated with kanamycin. All of these infants had potential confounders that might have increased risk of he... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585903 Sat, 14 Jan 2012 17:25:12 +0100 5585903 http://www.medworm.com/index.php?rid=5585890&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009371%2Fabstract%3Frss%3Dyes Steffey JM. J Pediatr 1962;60:183-90 The history of childhood acute lymphoblastic leukemia (ALL) therapy is a Cinderella story. Fifty years ago, a child with ALL had a dismal prognosis. In The Journal in 1962, Steffey bemoaned the rate of children experiencing leukemia relapse in the central nervous system (CNS), particularly the meninges. Indeed, as a child, I remember vividly praying in church every Sunday that a boy 2 years older than me would overcome his ALL. He died after approximately 2 years, much like the children Steffey described. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585890 Sat, 14 Jan 2012 17:25:10 +0100 5585890 http://www.medworm.com/index.php?rid=5585879&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008900%2Fabstract%3Frss%3Dyes This study of the histological characteristics of “atypical lymphocytes” seen in the blood smears of 20 pediatric outpatients, as well as speculation on origin of the cells (thought to be “lymphocytes in the process of maturing to histiocytes or monocytes”) and nature of the stimulus (viral infection), added some specificity to the passing observations of blood smears by clinical pathologists. At the time, “infectious mononucleosis” was thought to be a viral infection, and the presence of serum heterophil antibodies was confirmatory. The absence of heterophil antibody in the infants and toddlers studied (90% of whom were aged (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585879 Sat, 14 Jan 2012 17:25:09 +0100 5585879 http://www.medworm.com/index.php?rid=5585875&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008894%2Fabstract%3Frss%3Dyes Lundervold A, Jabbour JT. J Pediatr 1962;60:220-3 When Lundervold and Jabbour studied childhood epilepsy, there were only a handful of anticonvulsants, some of which have since been abandoned because of inefficacy or toxicity. Despite these limited treatment options, the authors reported seizure remission in 32% of pediatric patients with epilepsy, and seizure reduction in another 51%. Fifty years later, do today’s children fare better? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585875 Sat, 14 Jan 2012 17:25:09 +0100 5585875 http://www.medworm.com/index.php?rid=5585873&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008882%2Fabstract%3Frss%3Dyes Andrews BF, Bruton OC, de Barre L. J Pediatr 1962;60:201-5 Andrews et al published normal values for total amino acid nitrogen in 57 infants and children and compared these values with data from 52 children with a variety of pathological conditions, including infection, fevers, neurologic abnormalities, hepatic failure, and intoxications, but none with genetic disorders of specific amino acids. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585873 Sat, 14 Jan 2012 17:25:08 +0100 5585873 http://www.medworm.com/index.php?rid=5585867&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011115%2Fabstract%3Frss%3Dyes Pediatricians play a critical role in promoting the health of all children, and community health and child advocacy experiences are now a required component of pediatric residency training. Since the 1999 initiation of the University of California Davis pediatric residency program’s Communities and Health Professionals Together (CHPT) partnership, the CHPT’s scope has expanded to include training of residents from the Departments of Family and Community Medicine and Internal Medicine, as well as students from the Schools of Nursing, Medicine, and Public Health. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585867 Sat, 14 Jan 2012 17:25:08 +0100 5585867 http://www.medworm.com/index.php?rid=5585866&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761101287X%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585866 Sat, 14 Jan 2012 17:25:08 +0100 5585866 http://www.medworm.com/index.php?rid=5585865&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012868%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585865 Sat, 14 Jan 2012 17:25:08 +0100 5585865 http://www.medworm.com/index.php?rid=5585864&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012856%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585864 Sat, 14 Jan 2012 17:25:08 +0100 5585864 http://www.medworm.com/index.php?rid=5585863&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012716%2Fabstract%3Frss%3Dyes Not unlike autism spectrum disorder (ASD), more cases of obsessive-compulsive disorder (OCD) and/or tic disorders are being diagnosed in prepubertal children. Also, not unlike ASD, the cause of most cases is unclear. Frustrated families seeking answers frequently think we don't care. We care. We just do not have the answers. Much debate has focused on the purported role of group A streptococcus (GAS) in causing or precipitating the so-called Pediatric Autoimmume Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS). Using objective criteria to define at least the most typical clinical constellation could benefit future investigations of etiology, natural history, and management. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585863 Sat, 14 Jan 2012 17:25:08 +0100 5585863 http://www.medworm.com/index.php?rid=5585862&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012704%2Fabstract%3Frss%3Dyes Over the years, multiple interventions have been used to treat apnea of prematurity – ranging from increased oxygen exposures to physical stimulation to pharmacologic interventions. The group in Winnipeg have a distinguished record of studies of respiratory control in infants. Recently, they have explored the potential of increased CO2 as a stimulant of respiratory drive. They now report a well-designed randomized and controlled trial of increased inspired CO2 in comparison to theophylline treatments for infants with apnea of prematurity. Both treatments worked, but theophylline was clearly a superior treatment. Given that the trial by Schmidt et al of caffeine demonstrated not only safety, but improved neurodevelopmental outcomes (NEJM 2007;357:1893-1902), and giving a drug is easier th... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585862 Sat, 14 Jan 2012 17:25:08 +0100 5585862 http://www.medworm.com/index.php?rid=5585861&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012698%2Fabstract%3Frss%3Dyes The growth pattern, pubertal course, and adult height are reported for 85 girls born with appropriate size for gestational age who were referred to Schneider Children's Medical Center of Israel between 5 and 8.8 years of age for precocious adrenarche (PA). The clinical course of these girls provides reassurance that although PA had impact on the pre-pubertal growth pattern, it was not associated with early/rapid progression of puberty or reduced adult height. This cohort and outcomes are in contrast to those of girls with PA who were born small for gestational age. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585861 Sat, 14 Jan 2012 17:25:08 +0100 5585861 http://www.medworm.com/index.php?rid=5585860&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012686%2Fabstract%3Frss%3Dyes In this study, cause and effect cannot be determined. Nevertheless, these findings emphasize that when chronic medically unexplained chest pain is present in children and adolescents, primary care physicians should consider the possibility of a comorbid psychiatric disorder. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585860 Sat, 14 Jan 2012 17:25:08 +0100 5585860 http://www.medworm.com/index.php?rid=5585859&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012674%2Fabstract%3Frss%3Dyes Sickle cell anemia (SCA) illustrates some of the challenges of keeping current with the management of a chronic illness. As improvements in standard care are incorporated into practice, one needs to periodically reexamine the natural history of the condition, which may be modified by the new therapies. Thus, even in a disease studied as well as SCA, there is an ongoing need for continuing well-characterized multicenter studies. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585859 Sat, 14 Jan 2012 17:25:08 +0100 5585859 http://www.medworm.com/index.php?rid=5585858&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012662%2Fabstract%3Frss%3Dyes As medical care has advanced, the ability to resuscitate infants with gestational ages of 23-30 weeks and birth weight 400-1000 g has improved. However, outcomes for infants in this category are quite variable. In this issue of The Journal, Wyckoff et al seek to determine whether cardiopulmonary resuscitation (CPR) in the delivery room is associated with morbidity or mortality in extremely low birth weight infants. They found that infants who received CPR had greater overall morbidity and greater mortality by 12 hours and by 120 days of life. Of the infants who survived, those who received CPR had greater neurocognitive impairment. It should be clear that these associations are not causal but represent the fact that it is the sickest newborn infants who require CPR. Nevertheless, this info... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585858 Sat, 14 Jan 2012 17:25:07 +0100 5585858 http://www.medworm.com/index.php?rid=5585857&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611012650%2Fabstract%3Frss%3Dyes Symptoms of dizziness, lightheadedness, syncope, nausea, fatigue, and headaches are quite common in children and adolescents. Pediatricians often face the challenge of using symptoms and more objective findings together to categorize patients. Although some believe this group of symptoms represents a spectrum of disease, there appears to be important differences in both pathophysiology and clinical presentation. Another issue has been the use of adult criteria for heart rate changes during tilt table testing. This may be problematic because of the normal age-related changes seen in heart rate (HR) and HR response throughout the pediatric age range. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585857 Sat, 14 Jan 2012 17:25:07 +0100 5585857 http://www.medworm.com/index.php?rid=5489047&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011218%2Fabstract%3Frss%3Dyes In the article, “Increasing Severity of Pectus Excavatum is Associated with Reduced Pulmonary Function,” by Lawson et al, J Pediatr 2011;159:256-61.e2, the authors submitted incorrect versions of and for publication. The corrected versions of and are below. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489047 Sat, 10 Dec 2011 19:07:38 +0100 5489047 http://www.medworm.com/index.php?rid=5489039&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011413%2Fabstract%3Frss%3Dyes Buryk M, Bloom D, Shope T. Efficacy of neonatal release of ankyloglossia: a randomized trial. Pediatrics 2011;128:280-8. Among infants with ankyloglossia and feeding problems, does frenotomy (compared with no intervention) result in improved ability to breastfeed? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489039 Sat, 10 Dec 2011 19:07:38 +0100 5489039 http://www.medworm.com/index.php?rid=5489038&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011401%2Fabstract%3Frss%3Dyes Friedman KG, Kane DA, Rathod RH, Renaud A, Farias M, Geggel R, et al. Management of pediatric chest pain using a standardized assessment and management plan. Pediatrics 2011;128:239-45. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489038 Sat, 10 Dec 2011 19:07:38 +0100 5489038 http://www.medworm.com/index.php?rid=5489037&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011395%2Fabstract%3Frss%3Dyes Neuman MI, Monuteaux MC, Scully KJ, Bachur RG. Prediction of pneumonia in a pediatric emergency department. Pediatrics 2011;128:246-53. Among children who present with suspicion for pneumonia in the emergency department, are there historical and physical examination findings that can be used to develop a clinical decision rule for the use of chest radiography? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489037 Sat, 10 Dec 2011 19:07:37 +0100 5489037 http://www.medworm.com/index.php?rid=5489036&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011383%2Fabstract%3Frss%3Dyes Marlais M, Evans J, Abrahamson E. Clinical predictors of admission in infants with acute bronchiolitis. Arch Dis Child 2011;96:648-52. Among infants presenting to the emergency department with bronchiolitis, what factors predict admission to the hospital? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489036 Sat, 10 Dec 2011 19:07:37 +0100 5489036 http://www.medworm.com/index.php?rid=5489035&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011371%2Fabstract%3Frss%3Dyes Van den Bruel A, Thompson MJ, Haj-Hassan T, Stevens R, Moll H, Lakhanpaul M, et al. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ 2011;342:d3082. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489035 Sat, 10 Dec 2011 19:07:37 +0100 5489035 http://www.medworm.com/index.php?rid=5489034&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761101136X%2Fabstract%3Frss%3Dyes Hogeling M, Adams S, Wargon O. A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics 2011;128:e259-e66. Among children with infantile hemangiomas (IHs), does propranolol (compared with placebo) result in more rapid resolution? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489034 Sat, 10 Dec 2011 19:07:37 +0100 5489034 http://www.medworm.com/index.php?rid=5489029&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008298%2Fabstract%3Frss%3Dyes Bergman A, Haggerty R. J Pediatr 1962;60:143-4 During the mid-twentieth century, the country witnessed a dramatic rise in emergency clinic (EC) use. This was recognized at Children’s Hospital Medical Center, Boston, where EC visits surged to >14 000 per year by 1960. An investigation was undertaken to examine patient characteristics, reasons for EC use, and how this expanding cohort of patients fit in the medical teaching model. Their finding that approximately 50% of children lacked routine primary care was worrisome in its financial and social implications. Many chief complaints were comparable with those seen in pediatrician offices rather than inpatient hospitals, leading the authors to suggest that ECs use these encounters to provide anticipatory care and address the underlying fa... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489029 Sat, 10 Dec 2011 19:07:37 +0100 5489029 http://www.medworm.com/index.php?rid=5489013&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007840%2Fabstract%3Frss%3Dyes Friis-Hansen B, McCullough F. J Pediatr 1962;60:114-21 Fat-soluble substances associated with severe ophthalmologic problems including xerophthalmia (dry eyes) and night blindness were first identified a century ago. Most consequences of this “vitamin A” deficiency were soon eradicated in developed countries by emphasizing the need for fortified foods, especially liver and cow’s milk. However, the problem persisted in developing countries, and after World War II scientists focused on vitamin A deficiency worldwide, where limited food choices and availability led to deficiencies in crucial vitamins and micronutrients. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489013 Sat, 10 Dec 2011 19:07:35 +0100 5489013 http://www.medworm.com/index.php?rid=5489011&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007852%2Fabstract%3Frss%3Dyes Githens JH, Wilcox PJ. J Pediatr 1962;60:77-83 The X-linked recessive disorder hemophilia A confers a 50% probability that a female carrier’s daughter will herself be a carrier. Family history is negative in 30% of new diagnoses because of the factor VIII (FVIII) gene’s high rate of spontaneous mutation. In many instances, such mutations occur in past generations but are silently passed along the maternal lineage silently because of a lack of affected male offspring. Thus, maternal female relatives of affected males are at potential risk for carriership. Consequently, reliable ascertainment of carrier status is an important aspect of hemophilia care, informing accurate genetic counseling and subsequent family planning. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489011 Sat, 10 Dec 2011 19:07:35 +0100 5489011 http://www.medworm.com/index.php?rid=5489005&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008304%2Fabstract%3Frss%3Dyes Rhodes PG, Hammel CL, Berman LB. J Pediatrics 1962;60:18-23 Ever since physicians have been interested in kidney disease, they have been studying the urine and other body fluids as a reflection of what pathophysiological process is occurring in the human body. Centuries ago, physicians examined, boiled, and even tasted urine as a method to investigate kidney disease. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489005 Sat, 10 Dec 2011 19:07:34 +0100 5489005 http://www.medworm.com/index.php?rid=5489002&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007839%2Fabstract%3Frss%3Dyes Glaser HH, Lynn DB, Harrison GS. J Pediatr 1962;60:142-43 The authors reported a mixed-methods study of pediatric visits that directly observed the interactions of interns, residents, and fellows with families and evaluated family perspectives via postvisit interviews. Although the interactions were moderately satisfactory for the families, the families’ real needs often were not expressed—an issue that families still face today, as evidenced by the family-centered care movement. Interaction complexity, physician clarity, and positive attributes (eg, responsiveness) increased with physician training. Because visit conditions were assumed to be optimal, the influence of such factors as visit length and continuity in the doctor–family relationship were not explored, but their potentia... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489002 Sat, 10 Dec 2011 19:07:34 +0100 5489002 http://www.medworm.com/index.php?rid=5489000&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008870%2Fabstract%3Frss%3Dyes Sousa CM, Cetoe BL, Scott RB. J Pediatr 1962;60:52-4 Sickle cell pioneer Dr Roland Scott and colleagues reported a “rare” complication of sickle cell anemia, priapism. Although priapism was recognized as a complication in adults with sickle cell disease in the 1930s, this article brought priapism to pediatric medical attention. Subsequent surveys have demonstrated that at least one-third of adult patients with sickle cell anemia recall a personal history of priapism. A prospective survey of pediatric patients found a prevalence of 27.5% and an actuarial probability of experiencing at least one episode by age 15 years of 50.3%. Although the condition is far more common than the authors suspected, the treatments they described—irrigation of the corpora cavernosa, hydration, opioids—... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489000 Sat, 10 Dec 2011 19:07:33 +0100 5489000 http://www.medworm.com/index.php?rid=5488993&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100730X%2Fabstract%3Frss%3Dyes The past decade has witnessed a surge of interest in and critical analysis of the involvement of the United States in the training of health professionals from developing countries. Furthermore, since the year 2000, approximately one-quarter of US medical school graduates have participated in an international elective. Accompanying this increase in exchanges and collaborations is a growing dialogue about the implications, both positive and negative, to such partnerships, particularly their effect on the developing country partner. To inform both continued expansion of international training partnerships and discussions about the safeguards of the interests of the participating nations, institutions, and individuals, an examination of the rich history of the US in these endeavors is useful.... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488993 Sat, 10 Dec 2011 19:07:33 +0100 5488993 http://www.medworm.com/index.php?rid=5488992&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011802%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488992 Sat, 10 Dec 2011 19:07:33 +0100 5488992 http://www.medworm.com/index.php?rid=5488991&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011796%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488991 Sat, 10 Dec 2011 19:07:33 +0100 5488991 http://www.medworm.com/index.php?rid=5488990&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011784%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488990 Sat, 10 Dec 2011 19:07:33 +0100 5488990 http://www.medworm.com/index.php?rid=5488989&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011681%2Fabstract%3Frss%3Dyes The past decade has witnessed exciting developments in neuroimaging. We are rapidly moving beyond the gross structural detail seen with conventional computed tomography scans and magnetic resonance imaging to sophisticated analysis of central nervous system (CNS) function, metabolism, and finer anatomic details. Much of this information appears in subspecialized neurologic and imaging literature; with this issue of The Journal, we introduce one application of this technology to our readers. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488989 Sat, 10 Dec 2011 19:07:33 +0100 5488989 http://www.medworm.com/index.php?rid=5488988&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761101167X%2Fabstract%3Frss%3Dyes Transient tachypnea of the newborn (TTN) is a relatively common problem of pulmonary adaptation following late preterm or term birth. The differential diagnosis includes respiratory distress syndrome, pneumonia/sepsis, and other less frequent respiratory problems of the newborn. TTN is thought to result primarily from delayed fluid clearance from the airspaces and lung tissue. With no specific or effective therapies, oxygen treatment and time are generally sufficient for resolution. However, TTN is now more frequent in the neonatal intensive care units because of increased cesarean delivery rates. Some infants have “severe” TTN requiring ventilation support. Although diuretics have been tried for TTN without much success, Stroustrap et al tested fluid restriction in a single center ran... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488988 Sat, 10 Dec 2011 19:07:32 +0100 5488988 http://www.medworm.com/index.php?rid=5488987&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011668%2Fabstract%3Frss%3Dyes In this multicenter, prospective, cohort study of neonates born to mothers infected with HIV, the value of performance of testing for both HIV-1 DNA and HIV-1 RNA was compared in infant aged ≤ 6 months. The novelty of this investigation is that the 1567 studied infants exposed to HIV received postnatal prophylaxis (and were not breastfed). (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488987 Sat, 10 Dec 2011 19:07:32 +0100 5488987 http://www.medworm.com/index.php?rid=5488986&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011656%2Fabstract%3Frss%3Dyes Ataxia is a somewhat unusual complaint in children, and the differential diagnosis is daunting. From the standpoint of the primary care pediatrician, however, perhaps the most important initial classification is the differentiation between genetic and acquired causes. Within each of these categories, there are a host of possible diagnoses. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488986 Sat, 10 Dec 2011 19:07:32 +0100 5488986 http://www.medworm.com/index.php?rid=5488985&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011644%2Fabstract%3Frss%3Dyes Allogeneic hematopoietic stem-cell transplantation has been a major advancement in treatment. However, as success has improved, the focus on long-term outcomes has increased. There has been concern about both underweight and overweight, and the adverse long-term health effects associated with them. In this issue of The Journal, Mostoufi-Moab et al report on the results of using dual energy x-ray absorptiometry (DEXA) to evaluate body composition in 54 children and young adults aged 5-25 years who had been treated with stem-cell transplantation. The authors found that even though height was lower, body mass index was similar to a comparison group. However, lean body mass was lower and fat mass was higher in the stem-cell transplant recipients compared with controls. This emphasized that mor... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488985 Sat, 10 Dec 2011 19:07:32 +0100 5488985 http://www.medworm.com/index.php?rid=5488984&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011632%2Fabstract%3Frss%3Dyes This thoughtful, meticulous, and conservative study, a model-based cost-effectiveness analysis, deals with an important topic for US children and their medical providers – how best to manage children coming to medical attention with influenza-like illness (ILI). (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488984 Sat, 10 Dec 2011 19:07:32 +0100 5488984 http://www.medworm.com/index.php?rid=5488983&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611011620%2Fabstract%3Frss%3Dyes Influenza infection can add particularly significant morbidity and mortality to children with chronic disease, especially those patients with compromised immune systems. In this issue of The Journal, Long et al evaluate the humoral and cell-mediated immune response to the H1N1/2009 monovalent vaccine in high-risk pediatric patients after solid organ transplantation (SOT), systemic lupus erythromatosus (SLE), asthma, and sickle cell disease. These data suggest that patients with SLE or SOT mount suboptimal responses, whereas children with asthma or sickle cell disease have a vigorous response to immunization, even in patients on oral steroids. These findings have important implications regarding strategies to minimize the adverse impact of influenza in at-risk children. The authors speculat... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488983 Sat, 10 Dec 2011 19:07:32 +0100 5488983 http://www.medworm.com/index.php?rid=5585911&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010390%2Fabstract%3Frss%3Dyes We were interested in the report by Blau et al on transfusion-related gut injury (TRAGI) as an etiology for necrotizing enterocolitis (NEC). We hypothesized that TRAGI might be an immune-mediated antigenic response to receiving non group-specific red blood cell (RBC) transfusions. RBC alloantibody formation in infants aged (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585911 Tue, 15 Nov 2011 05:00:00 +0100 5585911 http://www.medworm.com/index.php?rid=5585870&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010067%2Fabstract%3Frss%3Dyes In this issue of The Journal, von Kries et al have addressed one of the more controversial questions in the care of pediatric orthopedic patients. Many have attempted to balance the value of early detection of developmental dysplasia of the hip with the cost of screening and the direct and indirect costs of intervention. Some have questioned the improvement in outcomes from orthopedic interventions for children with developmental dysplasia of the hip. Absence of conclusive evidence that ultrasound screening of newborns is helpful does not translate to evidence of absence of any value for screening newborns for hip dysplasia. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585870 Tue, 15 Nov 2011 05:00:00 +0100 5585870 http://www.medworm.com/index.php?rid=5489044&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010389%2Fabstract%3Frss%3Dyes We read with interest the Letter to the Editor by Roberts et al. We agree that the demonstrable efficacy and safety of oral ibuprofen support its use in the management of patent ductus arterious. Oral ibuprofen in high-risk groups will be of benefit in the intensive care of preterm infants. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489044 Tue, 15 Nov 2011 05:00:00 +0100 5489044 http://www.medworm.com/index.php?rid=5391137&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100713X%2Fabstract%3Frss%3Dyes Hsia DY-Y, Walker FA. Variability in the clinical manifestations of galactosemia. J Pediatr 1961;59:872-83. This outstanding article was the first publication to inclusively describe the clinical features of galactosemia and their heterogeneity among individuals with galactosemia. Appearing 5 years after the landmark discoveries of galactose-1-phosphate accumulation in erythrocytes and the deficiency of galactose-1-phosphate uridyltransferase, but before the addition of galactosemia to newborn screening and the subsequent near-universal early treatment, this article represents the bridge, providing a critical description of the natural history of galactosemia. Moreover, in calling attention to the severe and often dire consequences of untreated or late-treated galactosemia, it greatly sti... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391137 Thu, 10 Nov 2011 19:14:12 +0100 5391137 http://www.medworm.com/index.php?rid=5391126&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007311%2Fabstract%3Frss%3Dyes Next-generation sequencing (NGS) technologies have dramatically dropped the cost of whole genome or exome (the 2% of the genome represented by coding regions) sequencing. The numbers are mind-boggling: It took $3 billion to sequence the first human genome. Today, it costs (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391126 Thu, 10 Nov 2011 19:14:12 +0100 5391126 http://www.medworm.com/index.php?rid=5391125&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010754%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391125 Thu, 10 Nov 2011 19:14:12 +0100 5391125 http://www.medworm.com/index.php?rid=5391124&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010742%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391124 Thu, 10 Nov 2011 19:14:12 +0100 5391124 http://www.medworm.com/index.php?rid=5391123&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761101081X%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391123 Thu, 10 Nov 2011 19:14:12 +0100 5391123 http://www.medworm.com/index.php?rid=5391122&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010614%2Fabstract%3Frss%3Dyes Linda Althouse and Jim Stockman from the American Board of Pediatrics (ABP) recently completed an update of pediatric workforce data that is analyzed on a regular basis by the ABP. In the past, these studies have been published as a series of reports for general pediatrics and each of the 13 subspecialties. This time, all the workforce data are being published in one Commentary. The ABP has the best data on this topic, and they combine data from three different sources to create a very comprehensive data set. The results are interesting and indicate that there is probably no immediate crisis in the offing, but we will need to monitor the balance between general pediatrics and pediatric subspecialty careers, as well as the distribution of pediatricians from a geographical point of view. In ... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391122 Thu, 10 Nov 2011 19:14:12 +0100 5391122 http://www.medworm.com/index.php?rid=5391121&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010602%2Fabstract%3Frss%3Dyes Most general pediatricians appreciate the connection between school absences and functional somatic complaints. Children with functional chronic pain syndromes frequently have histories of longstanding school absence—often in contrast to children with serious organic disease. There are few data, however, on the interrelatedness of these findings. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391121 Thu, 10 Nov 2011 19:14:12 +0100 5391121 http://www.medworm.com/index.php?rid=5391120&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010596%2Fabstract%3Frss%3Dyes This study represents 12-21 years of follow up of 60 patients who were diagnosed with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) by strict clinical criteria as young children and were entered into the Vanderbilt registry. The findings add important and predominantly reassuring facts about natural history of PFAPA. The average age of subjects at follow-up was 20 years. Although the majority of patients had resolution of febrile episodes (with mean duration of episodes for 6.3 years), 9 patients continued to have periodic fevers. There was no appreciable difference in age of onset, intervals of well-being, or manifestations during febrile episodes in those who did or did not have resolution of the syndrome during childhood. In patients who had persistent ... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391120 Thu, 10 Nov 2011 19:14:12 +0100 5391120 http://www.medworm.com/index.php?rid=5391119&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010584%2Fabstract%3Frss%3Dyes Belgian investigators performed careful baseline and follow-up clinical and laboratory studies on 10 boys with glucose-6-phosphate dehydrogenase (G6PD) deficiency who underwent ear, nose, and throat surgery to determine whether analgesic agents caused hemolysis. Potential confounding causes for hemolysis were minimized. The results are reassuring, even in this group of relatively young, relatively severely affected, ethnically diverse group of patients with G6PD deficiency. The only statistically significant finding was a modest mean 0.1% increase in reticulocyte count, which did not correlate with changes in any other measurement of hemolysis, and likely was due to minor blood loss. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391119 Thu, 10 Nov 2011 19:14:12 +0100 5391119 http://www.medworm.com/index.php?rid=5391118&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010572%2Fabstract%3Frss%3Dyes There is increasing evidence that intrauterine, or early postnatal inflammation, may lead to cerebral palsy (CP) and long-term neurodevelopmental handicap. Alterations in several pro-inflammatory and anti-inflammatory cytokines/mediators during the first days after birth have been associated with CP in late-preterm and full term infants. In this issue of The Journal, Carlo et al measured a select group of pro- and anti-inflammatory cytokines/mediators, in the blood of more than 1000 extremely low birth weight (ELBW) infants during the first 3 days after birth to determine whether they were predictive of subsequent CP. The authors found that most cytokines that have been previously shown to have high prognostic ability for CP in term and late-preterm infants did not differ between ELBW infa... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391118 Thu, 10 Nov 2011 19:14:12 +0100 5391118 http://www.medworm.com/index.php?rid=5391117&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010560%2Fabstract%3Frss%3Dyes The concurrent evaluations of pneumococcal nasopharyngeal colonization and responsiveness to pneumococcal polysaccharide-protein conjugate vaccine (PCV) provide insight into the complexity of immunologic responses. We knew that PCV affects colonization, and now we know that colonization affects PCV response. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391117 Thu, 10 Nov 2011 19:14:12 +0100 5391117 http://www.medworm.com/index.php?rid=5391116&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611010559%2Fabstract%3Frss%3Dyes Kakalia et al in Toronto conducted a well-conceived, well-implemented, and well-analyzed prospective randomized 6-month study of vitamin D status and effect of supplementation in children infected with HIV. In this group of clinically stable, average-aged 10-year-old children, with relatively preserved immune function, normal CD4, who were receiving predominantly antiretroviral therapy, a striking 85% had vitamin D insufficiency or deficiency (serum 25[OH]D level (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391116 Thu, 10 Nov 2011 19:14:12 +0100 5391116 http://www.medworm.com/index.php?rid=5585871&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009346%2Fabstract%3Frss%3Dyes The dramatic reduction in pediatric deaths from unintentional poisonings in the last half of the 20th century is a model of the successful application of injury prevention theory and practice. The increases in hospitalizations, emergency department (ED) visits, and persistence of deaths caused by unintentional pediatric pharmaceutical poisonings in the first decade of this century are described by Bond et al in this issue of The Journal and remind us that this effort is not yet complete. Hopefully the findings in this study can help catalyze targeted efforts to reverse the rise in injuries from pediatric pharmaceutical poisonings and push the number of pediatric deaths closer to zero. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585871 Mon, 07 Nov 2011 05:00:00 +0100 5585871 http://www.medworm.com/index.php?rid=5489043&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761101016X%2Fabstract%3Frss%3Dyes Gokmen et al present data suggesting that oral ibuprofen might be more effective than intravenous preparations for the treatment of symptomatic patent ductus arteriosus. If confirmed, this could have many benefits and would have the additional advantage of also being less expensive and more available. To enable interpretation to our own populations, we would be grateful for clarification of a few points. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489043 Mon, 07 Nov 2011 05:00:00 +0100 5489043 http://www.medworm.com/index.php?rid=5585904&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100936X%2Fabstract%3Frss%3Dyes We describe the effective short-term use (tapered over 12 days) of recombinant parathyroid hormone (PTH) (teriparatide) in an unusual genetic condition characterized by hypoparathyroidism. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585904 Thu, 03 Nov 2011 04:00:00 +0100 5585904 http://www.medworm.com/index.php?rid=5585902&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009504%2Fabstract%3Frss%3Dyes Two preterm infants with athetoid cerebral palsy due to bilirubin encephalopathy were examined by magnetic resonance spectroscopic imaging at age 3 years. An increased glutamate/glutamine complex/creatine ratio was found in the basal ganglia. Chemical metabolic abnormalities of the basal ganglia were clearly demonstrated by color-coded metabolite images. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585902 Thu, 03 Nov 2011 04:00:00 +0100 5585902 http://www.medworm.com/index.php?rid=5585869&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009474%2Fabstract%3Frss%3Dyes Home O2 therapy in preterm infants with bronchopulmonary dysplasia (BPD) may facilitate early discharge from the neonatal intensive care unit (NICU), but creates additional stressors for families. No clinical trial has documented the long-term benefits of home O2 therapy in infants with BPD in the current era of widespread antenatal steroid use and early surfactant therapy. Published guidelines from the American Academy of Pediatrics and American Thoracic Society recommend considering home O2 therapy for infants with an O2 saturation (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585869 Thu, 03 Nov 2011 04:00:00 +0100 5585869 http://www.medworm.com/index.php?rid=5489042&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009279%2Fabstract%3Frss%3Dyes Vrijkotte et al report positive associations between maternal triglyceride levels and birthweight, but not between total cholesterol (TC) levels and birthweight during early pregnancy. A careful reading of their work reveals that women who did not breastfeed had significantly higher TC levels. Correspondingly, mothers with longer duration of breastfeeding (1-3 months) showed higher TC values compared with mothers who breastfeed for (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489042 Thu, 03 Nov 2011 04:00:00 +0100 5489042 http://www.medworm.com/index.php?rid=5585872&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008973%2Fabstract%3Frss%3Dyes It has been almost 20 years since proton pump inhibitors (PPIs) were initially shown to be effective, safe, and well-tolerated for the short-term treatment of gastroesophageal reflux disease (GERD) in children over 1 year of age; GERD diagnosed on the basis of symptoms and hard diagnostic evidence of erosive esophagitis seen at endoscopy. In these studies, mostly performed in children 2 to 17 years of age, PPIs were shown to effectively treat symptoms and erosive esophagitis that were refractory to histamine-2-receptor antagonists (H2RA), buffering agents, prokinetics, and in some subjects, antireflux surgery. Subsequent to those studies with omeprazole, other PPIs were found to be similarly effective. Efficacy and safety were also shown for maintenance of remission of chronic, relapsing e... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585872 Mon, 24 Oct 2011 04:00:00 +0100 5585872 http://www.medworm.com/index.php?rid=5585910&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008912%2Fabstract%3Frss%3Dyes A healthy 9-month-old girl playing with her father’s cufflink suddenly developed respiratory distress, coughing, and inconsolable crying. The child’s mother attempted to search her mouth using a blind finger sweep. She felt an object and had the impression that the child had swallowed it. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585910 Wed, 19 Oct 2011 04:00:00 +0100 5585910 http://www.medworm.com/index.php?rid=5585907&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008250%2Fabstract%3Frss%3Dyes A 7-year-old boy presented with a 3-month history of persistent left auricular swelling and pain. He had been previously treated with several rounds of antibiotics with minimal improvement. Subsequently, he developed swelling and pain in his third, fourth, and fifth fingers. Examination revealed a darkly pigmented patch of skin on the left pinna that was tender to palpation (). Flexure deformities and periarticular swelling of the proximal interphalangeal joints of the third, fourth, and fifth digits were noted. A saddle nose deformity was also observed. Biopsy analysis of the auricular lesion revealed perichondritis and chondritis with eroded, focally necrotic cartilage (). Collectively, these findings led to a diagnosis of relapsing polychondritis. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585907 Fri, 14 Oct 2011 04:00:00 +0100 5585907 http://www.medworm.com/index.php?rid=5489028&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008869%2Fabstract%3Frss%3Dyes We evaluated the effect of prone and supine position on cerebral blood flow (CBF) in stable preterm infants. CBF, PO2, and PCO2 were measured in the two positions. Peripheral oxygenation increased and CBF decreased in prone position. We speculate that CBF autoregulation may compensate for increased peripheral oxygenation, by decreasing CBF. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489028 Fri, 14 Oct 2011 04:00:00 +0100 5489028 http://www.medworm.com/index.php?rid=5585908&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008985%2Fabstract%3Frss%3Dyes Primary tumors of the liver account for approximately 1% of malignancies in children, with an annual incidence of 1.6 cases per million children in the United States. Between 50% and 60% of hepatic tumors in children are malignant, and >65% of these are hepatoblastomas. Hepatoblastoma occurs predominantly in children (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585908 Thu, 13 Oct 2011 04:00:00 +0100 5585908 http://www.medworm.com/index.php?rid=5585880&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008845%2Fabstract%3Frss%3Dyes Conclusion: The diagnostic criteria for OI and POTS in adults are unsuitable for children and adolescents. Based on our normative data, we propose new criteria for the diagnosis of OI and POTS in children and adolescents. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585880 Thu, 13 Oct 2011 04:00:00 +0100 5585880 http://www.medworm.com/index.php?rid=5585874&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008821%2Fabstract%3Frss%3Dyes The history of calciferol∗ metabolism and biochemistry is tightly intertwined with that of American pediatrics. Rickets was a widespread affliction of children in urban areas in the 19th and early 20th centuries. Mellanby recognized the anti-rachitic properties of a fat-soluble substance that was incorrectly named “vitamin” D. Shortly thereafter, Eliot undertook a seminal clinical trial in New Haven that demonstrated the ability of cod-liver oil to prevent rickets in infants. Within decades, supplementation of nursing infants became nearly universal, and clinical rickets largely disappeared. In the latter part of the 20th century, lax prescribing of calciferol supplements to nursing children, combined with an increasing number of mothers of darkly pigmented infants choosing to breast... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585874 Thu, 13 Oct 2011 04:00:00 +0100 5585874 http://www.medworm.com/index.php?rid=5489041&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100895X%2Fabstract%3Frss%3Dyes We read with interest the study of Teele et al on acute fulminant myocarditis and agree with the authors that prognostic markers are needed for decision making in that clinical scenario. We would like to share our experience with NT-pro BNP in children with acute myocarditis. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489041 Thu, 13 Oct 2011 04:00:00 +0100 5489041 http://www.medworm.com/index.php?rid=5489040&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008432%2Fabstract%3Frss%3Dyes In this study approximately one-third of presumably well-trained and certified pediatric cardiologists now out in practice failed to correctly interpret abnormal electrocardiogram results obtained from children before participation in active sports. The specifics of some of the abnormal electrocardiogram results would serve as markers for potential sudden death on the athletic field. And then adding insult to injury, approximately 20% of the children whose electrocardiograms were submitted for interpretation would have been misdirected on the basis of electrocardiographic interpretation as to whether they should or should not engage in active sports. These findings are clearly an indictment of our pediatric cardiology training programs and our certification standards and furthermore questi... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489040 Thu, 13 Oct 2011 04:00:00 +0100 5489040 http://www.medworm.com/index.php?rid=5488995&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008961%2Fabstract%3Frss%3Dyes The report by Lam et al in this issue of The Journal examines central nervous system (CNS) depression of neonates who were breastfed by their mothers receiving oxycodone for postpartum analgesia. Approximately half of all infants born in North America are either delivered via cesarean delivery or with the use of an episiotomy to facilitate vaginal delivery. Until recently, combination products containing acetaminophen and codeine or, alternatively, codeine have been used to treat pain associated with these procedures. Although generally safe for the mother, it has recently been recognized that this practice can adversely affect newborn infants. Specifically, according to national survey data, more than half (55%) of infants in the United States were exclusively breastfed, and 8% received ... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488995 Thu, 13 Oct 2011 04:00:00 +0100 5488995 http://www.medworm.com/index.php?rid=5306716&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008936%2Fabstract%3Frss%3Dyes In the article, “Pubertal Changes of Insulin Sensitivity, Acute Insulin Response, and Long-Term Survival of Infants with ß-Cell Function in Overweight Latino Youth,” by Kelly et al, J Pediatr 2011;158:442-6, the authors inadvertently referenced the wrong article when discussing the study of pubertal insulin resistance in 357 children in the first full paragraph on page 224. The correct reference to this study is reference 17 in the article: Moran A, Jacobs DR, Steinberger J, Hong CP, Prineas R, Luepker R, et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes. 1999;48:2039-2044. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306716 Wed, 12 Oct 2011 18:14:09 +0100 5306716 http://www.medworm.com/index.php?rid=5306711&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009097%2Fabstract%3Frss%3Dyes De Boeck K, Vermeulen F, Meyts I, Hutsebaut L, Franckaert D, Proesmans M. Coprescription of Antibiotics and Asthma Drugs in Children. Pediatrics 2011;127:1022-6. Among children with asthma exacerbations, how often are antibiotics prescribed and is this beneficial? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306711 Wed, 12 Oct 2011 18:14:09 +0100 5306711 http://www.medworm.com/index.php?rid=5306710&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009085%2Fabstract%3Frss%3Dyes Reinoso-Barbero F, Pascual-Pascual SI, de Lucas R, García S, Billoët C, Dequenne V, et al. Equimolar Nitrous Oxide/Oxygen Versus Placebo for Procedural Pain in Children: A Randomized Trial. Pediatrics 2011;127:e1464-70. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306710 Wed, 12 Oct 2011 18:14:09 +0100 5306710 http://www.medworm.com/index.php?rid=5306709&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009073%2Fabstract%3Frss%3Dyes George SA, Ko CA, Kirchner HL, Starke JR, Dragga TA, Mandalakas AM. The Role of Chest Radiographs and Tuberculin Skin Tests in Tuberculosis Screening of Internationally Adopted Children. Pediatr Infect Disease J 2011;30: 387-91. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306709 Wed, 12 Oct 2011 18:14:09 +0100 5306709 http://www.medworm.com/index.php?rid=5306708&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009061%2Fabstract%3Frss%3Dyes McPheeters ML, Warren Z, Sathe N, Bruzek JL, Krishnaswami S, Jerome RN, et al. A Systematic Review of Medical Treatments for Children With Autism Spectrum Disorders. Pediatrics 2011;127:e1312-21. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306708 Wed, 12 Oct 2011 18:14:09 +0100 5306708 http://www.medworm.com/index.php?rid=5306707&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100905X%2Fabstract%3Frss%3Dyes Raimer PL, Han YY, Weber MS, Annich GM, Custer JR. A Normal Capillary Refill Time of ≤ 2 Seconds is Associated with Superior Vena Cava Oxygen Saturations of ≥ 70%. J Pediatr 2011;158:968-72. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306707 Wed, 12 Oct 2011 18:14:09 +0100 5306707 http://www.medworm.com/index.php?rid=5306706&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009048%2Fabstract%3Frss%3Dyes Reulen RC, Frobisher C, Winter DL, Kelly J, Lancashire ER, Stiller CA, et al. Long-term Risks of Subsequent Primary Neoplasms Among Survivors of Childhood Cancer. JAMA 2011;305:2311-9. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306706 Wed, 12 Oct 2011 18:14:09 +0100 5306706 http://www.medworm.com/index.php?rid=5306698&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611005658%2Fabstract%3Frss%3Dyes Bruton OC, Martz DC, Gerard ES. J Pediatr 1961;59:719-25 Fifty years ago in The Journal, Bruton et al wrote, “It is evident that an early diagnosis could not be established in this case,” about a 7-year-old child with precocious puberty from a mixed germ cell brain tumor, diagnosed ultimately at death. In the course of 6 months from presentation, the boy underwent testicular biopsy, multiple blood tests, two electroencephalograms, pneumoencephalography, non-diagnostic posterior fossa craniotomy, and finally, repeat craniotomy with an aborted attempt to explore the third ventricle. The surgeon visualized but could not resect the tumor, so the patient was treated with 4000 cGy of irradiation before dying 12 months after the diagnosis. At autopsy, the boy was found to have a 6- by 5- by... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306698 Wed, 12 Oct 2011 18:14:09 +0100 5306698 http://www.medworm.com/index.php?rid=5306696&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611005634%2Fabstract%3Frss%3Dyes Blattner RJ. J Pediatr 1961;59:784-6 In the section of The Journal “Comments on Current Literature,” Blattner gives a glimpse of the “state-of-the-thinking” on pathogenesis of herpes simplex virus (HSV) infections. Investigators and “thinkers” at the time had so much of it right (ie, most primary HSV infections are subclinical, yet whether clinical or subclinical, infection leads to establishment of latency and cycles of reactivation in most people). Presence of antibody does not prevent superficial recurrences (reactivations), which sometimes take on “zosteriform” characteristics by following nerve distribution. Investigators and clinicians even recognized (and made experimental models in animals to prove) some triggers of reactivation. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306696 Wed, 12 Oct 2011 18:14:09 +0100 5306696 http://www.medworm.com/index.php?rid=5306680&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611005981%2Fabstract%3Frss%3Dyes This article was a companion to another report that was the subject of an earlier 50 Years Ago piece in The Journal, which focused on a detailed description of such abnormalities that continue to be important developmental and acquired kidney problems in pediatric patients today. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306680 Wed, 12 Oct 2011 18:14:09 +0100 5306680 http://www.medworm.com/index.php?rid=5306668&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007098%2Fabstract%3Frss%3Dyes The close alignment of academic pediatric departments with the clinical mission of children’s hospitals and university health systems has created a “burning platform” for the highest quality patient outcomes. With our hospital partner, Seattle Children’s Hospital, we began a long-term cultural transformation to achieve excellence through ongoing, incremental change by using a process of continuous performance improvement (CPI). CPI focuses on patients and families as the beneficiaries of all interventions and improvements to provide the highest standards of quality, safety, delivery, and cost efficiency with an engaged staff and administration. The foundation of CPI methodology is the Toyota Production System, known in Japan as the “Kaizen” system. In the past 8 years, the Depa... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306668 Wed, 12 Oct 2011 18:14:09 +0100 5306668 http://www.medworm.com/index.php?rid=5306667&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100970X%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306667 Wed, 12 Oct 2011 18:14:09 +0100 5306667 http://www.medworm.com/index.php?rid=5306666&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009693%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306666 Wed, 12 Oct 2011 18:14:09 +0100 5306666 http://www.medworm.com/index.php?rid=5306665&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009681%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306665 Wed, 12 Oct 2011 18:14:09 +0100 5306665 http://www.medworm.com/index.php?rid=5306664&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009590%2Fabstract%3Frss%3Dyes Lung diseases in term infants remain poorly characterized, despite what would appear to be clear distinctions in standard texts. Infants >37 weeks gestational age with respiratory distress who are not septic or do not have meconium aspiration are generally diagnosed as having transient tachypnea of the newborn, congenital pneumonia, or nonspecific lung transitional problems. But, some of these infants will have respiratory distress syndrome – as individuals at the extreme of the gestational age range for respiratory distress syndrome. The etiology of congenital pneumonia is seldom clear, and transient tachypnea (TTN) is an imprecise diagnosis that is thought to primarily reflect delayed clearance of fetal lung fluid. Machado et al measured two indicators of surfactant adequacy in gastric... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306664 Wed, 12 Oct 2011 18:14:09 +0100 5306664 http://www.medworm.com/index.php?rid=5306663&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009589%2Fabstract%3Frss%3Dyes The past decade has witnessed the development of a number of new biologics, some of which have had dramatic effects. One group of these has been the enzyme replacement therapies of a number of lysosomal storage diseases. In disorders such as Gaucher disease, for example, the replacement of missing enzyme activity can bring about substantial improvement in the disorders, albeit at a huge cost. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306663 Wed, 12 Oct 2011 18:14:09 +0100 5306663 http://www.medworm.com/index.php?rid=5306662&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009577%2Fabstract%3Frss%3Dyes For most physiological variables, continuous monitoring will detect abnormal values that would be missed by intermittent or symptom-directed monitoring. It is now possible to continually measure tissue interstitial glucose in infants, but is such monitoring useful in clinical practice? As a research tool, such measurements demonstrate that infants at risk of hypoglycemia often have low glucose values that are not detected clinically. In this issue of The Journal, Harris et al demonstrate that hypoglycemia detected by continuous monitoring does not correlate with abnormalities detectable by amplitude integrated electroencephalography monitoring or by changes in plasma levels of non-glucose brain fuels—lactate, beta-hydroxybuterate, or glycerol. The issues of which blood glucose levels are... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306662 Wed, 12 Oct 2011 18:14:09 +0100 5306662 http://www.medworm.com/index.php?rid=5306661&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009565%2Fabstract%3Frss%3Dyes Maternal metabolism, including the maternal lipid profile, may have an impact on fetal growth and longer term outcomes. Most studies of the maternal lipid profile during pregnancy have focused on the third trimester. In this issue of The Journal, Vrijkotte et al report on results of the Amsterdam Born Children and their Development (ABCD) Study, in which the maternal lipid profile was measured during the first trimester of pregnancy and birth weight and postnatal growth were followed in the infant. The authors found that maternal triglyceride levels, but not total cholesterol levels, were associated with birth weight and a higher prevalence of large for gestational age infants. Lower triglyceride levels in the first trimester were associated with more rapid postnatal growth. (Source: The J... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306661 Wed, 12 Oct 2011 18:14:09 +0100 5306661 http://www.medworm.com/index.php?rid=5306660&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009553%2Fabstract%3Frss%3Dyes The morbidity associated with late preterm/early full term delivery in infants with normal hearts is well known. In this issue of The Journal, Cnota et al show that children born between 34 and 40 weeks gestation have an incremental increase in mortality associated with the degree of prematurity, which is consistent with other work (Pediatrics 2010;126:277-84). The current report supports the importance of waiting as close to term as possible before delivering an infant with in utero diagnosis of congenital heart disease. Too often, the presence of a cardiac defect in the womb creates unnecessary medical anxiety. In most cases, the fetal circulation compensates for the congenital defect. It is only after birth and after the ductus arteriosus closes that emergency intervention is required. ... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306660 Wed, 12 Oct 2011 18:14:09 +0100 5306660 http://www.medworm.com/index.php?rid=5306659&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009541%2Fabstract%3Frss%3Dyes The sudden death of a young athlete is a tragedy that takes a large toll on family, friends, school, and community. When an event like this occurs, many questions are asked. What was the cause? Could this have been prevented? Was something missed? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306659 Wed, 12 Oct 2011 18:14:09 +0100 5306659 http://www.medworm.com/index.php?rid=5306658&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100953X%2Fabstract%3Frss%3Dyes Since The Journal began publishing supplemental video and audio clips in 2004, numerous authors have taken advantage of these media to enhance the content of their published reports. Multi-media files can be used for a variety of reasons, including demonstrating a procedure, illustrating symptoms, or providing “before and after” treatment results. Although they can add value to all article types, they can be especially useful for the Insights and Rediscovering the Physical Exam sections. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306658 Wed, 12 Oct 2011 18:14:09 +0100 5306658 http://www.medworm.com/index.php?rid=5306657&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611009528%2Fabstract%3Frss%3Dyes The abstract is the most visible piece of an article and is freely available to everyone, regardless of whether a user has a subscription to a journal. The word count of abstracts has become an interesting topic of debate over the years. Some believe that the abstract should include as much information as possible, and others expect it to be brief and succinct. To provide authors with the opportunity to include more information (eg, frame the question, what is new, study limitations) without adding too much bulk (eg, background information), The Journal has decided to increase the maximum word count of abstracts for Original Articles from 200 words to 250 words. As always, your feedback is welcome and appreciated. Please e-mail your thoughts about abstract length to journal.pediatrics@cchm... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5306657 Wed, 12 Oct 2011 18:14:09 +0100 5306657 http://www.medworm.com/index.php?rid=5585868&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008924%2Fabstract%3Frss%3Dyes This issue of The Journal includes two articles that examine the use of fresh frozen plasma (FFP). At first glance, the authors appear to have differing views as to the benefits and overall utilization strategy of FFP use. Hendrickson et al describe how coagulopathy is independently associated with mortality and morbidity in trauma patients who are injured severely enough to require a transfusion within the first 24 hours of admission. The inference is that early use of FFP in this setting may be an effective way to treat the coagulopathy that can be anticipated. The other article, by Puetz et al, reviews an administrative database that demonstrates the use of FFP across the United States, then refers the reader to the literature, where FFP has been shown generally to not improve outcome... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585868 Mon, 10 Oct 2011 04:00:00 +0100 5585868 http://www.medworm.com/index.php?rid=5489030&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008833%2Fabstract%3Frss%3Dyes We describe 5 preterm and 3 term infants who presented with seizures during rotavirus infection within 6 weeks after birth. Six of these infants developed late-onset cystic periventricular leukomalacia. Four of the preterm infants had neurodevelopmental delay, and 4 (near) term infants had normal early outcome. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489030 Mon, 10 Oct 2011 04:00:00 +0100 5489030 http://www.medworm.com/index.php?rid=5488997&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008456%2Fabstract%3Frss%3Dyes Measurement of blood pressure (BP) has become a routine part of pediatric care, and asymptomatic hypertension is now detected in primary care practices. To avoid over-diagnosing hypertension in children, the criterion for diagnosis of hypertension requires that the average of repeated BP levels are at or higher than the 95th percentile. With this criterion, the prevalence of pediatric hypertension had been expected to be between 1% and 2%. However, the prevalence of childhood hypertension is increasing, largely because of the childhood obesity epidemic and possibly other secular changes in lifestyles. Recent publications that apply the 95th percentile definition and repeat measurements on 3 separate visits report a pediatric hypertension prevalence of approximately 3.5%, and in obese adole... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488997 Mon, 10 Oct 2011 04:00:00 +0100 5488997 http://www.medworm.com/index.php?rid=5488994&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008948%2Fabstract%3Frss%3Dyes Birth weight provides a robust indication of neonatal well being. It has long been known that appropriately grown babies have the least neonatal morbidity and mortality. Recent evidence indicates that low birth weight strongly predisposes to adult cardiovascular mortality, and that higher birth weight modestly increases cancer risk, particularly in men. Overall, gestational age-adjusted birth weight is inversely related to all-cause mortality in adulthood, with a 6% decrease in mortality per kilogram of birth weight. Thus, an optimal birth weight maximizes health and survival throughout the lifespan, and yet we know very little about the genetics of fetal weight determination. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488994 Mon, 10 Oct 2011 04:00:00 +0100 5488994 http://www.medworm.com/index.php?rid=5391129&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008444%2Fabstract%3Frss%3Dyes Late-onset sepsis currently affects approximately 36% of infants of very low birth weight (VLBW) born in the United States, is a leading cause of mortality, and is independently significantly associated with risk of long-term developmental impairment. Although the pathophysiology of organ damage in sepsis is complex and poorly understood, there is general agreement that early diagnosis and intervention is likely to save lives and reduce long-term morbidity. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391129 Mon, 10 Oct 2011 04:00:00 +0100 5391129 http://www.medworm.com/index.php?rid=5585906&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008262%2Fabstract%3Frss%3Dyes A term-born baby girl had a perinatal course complicated by meconium aspiration syndrome, pulmonary hemorrhage, and shock. She was placed on extracorporeal membrane oxygenation (ECMO) on day of life 3 after high-frequency ventilation failed to maintain adequate oxygenation. She was taken off ECMO on day of life 13, and neurology was consulted for facial asymmetry at 3 weeks of age (). She had partial ptosis of the right eye with miosis (right pupil 2 mm less than left, both reactive to light); extraocular movements were normal. Her face appeared symmetric, and she had normal tone, strength, and reflexes. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585906 Thu, 29 Sep 2011 04:00:00 +0100 5585906 http://www.medworm.com/index.php?rid=5585888&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008328%2Fabstract%3Frss%3Dyes Objectives: To assess the effectiveness of general ultrasound screening to prevent first operative procedures of the hip.Study design: We conducted a case-control study in a population in which general ultrasound screening supplementing clinical screening is recommended and offered free of charge for all children. Participation in ultrasound screening before week 7 as recommended in Germany was the exposure of interest. Case ascertainment was based on active surveillance in orthopedic hospitals. The case definition was: first operative procedure for developmental dysplasia of the hip (closed reduction, open reduction, or osteotomy) in children >9 weeks old and (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585888 Thu, 29 Sep 2011 04:00:00 +0100 5585888 http://www.medworm.com/index.php?rid=5585882&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008286%2Fabstract%3Frss%3Dyes Conclusions: Home oxygen use was common in infants of earlier gestational ages and infants with more severe respiratory illness. Institutional variation accounted for 4- to 5-fold variation in home oxygen use. Families should be counseled about the likelihood of home oxygen use, and prospective research must identify optimal treatment strategies for high-risk infants. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585882 Thu, 29 Sep 2011 04:00:00 +0100 5585882 http://www.medworm.com/index.php?rid=5489033&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008316%2Fabstract%3Frss%3Dyes A 9-year-old African American girl was referred for evaluation of anal pain. She reported a 1-year history of painful defecation, often accompanied by bright red blood. Her bowel movements were described as soft and of normal caliber, with a frequency of every 1 to 2 days. Empiric treatment of constipation with dietary manipulation and osmotic laxatives prescribed by her primary care provider was unsuccessful in relieving her symptoms. Her examination at presentation was significant for absence of thyromegaly, sacral abnormalities, abdominal tenderness, and abdominal masses. Deep tendon reflexes in the lower extremities were normal. Inspection of the anus revealed the findings depicted in the . Digital examination revealed a narrowed, tight anal canal. A diagnosis of anogenital lichen scle... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489033 Thu, 29 Sep 2011 04:00:00 +0100 5489033 http://www.medworm.com/index.php?rid=5489031&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008171%2Fabstract%3Frss%3Dyes A 17-year-old boy came to the pediatric neurology clinic with right shoulder pain and “collar bone sticking out” for 2 months. His pain would radiate to the right upper arm and back, and he had difficult lifting his arm above the shoulder. There was no history of weakness of other limbs and no sensory symptoms. He had neck surgery for lymphadenopathy 1 month before onset of his symptoms. On examination, his cranial nerves were intact. He had right shoulder droop and wasting of trapezius muscle (; available at www.jpeds.com). There was scapular winging on the right, accentuated on arm abduction (). There was limitation of abduction beyond 90 degrees on the right compared with the left (). He had right trapezius weakness with preserved sternocleidomastoid. The results of the remainder of... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489031 Thu, 29 Sep 2011 04:00:00 +0100 5489031 http://www.medworm.com/index.php?rid=5391163&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008237%2Fabstract%3Frss%3Dyes We thank Mussa et al for their comments. We agree that one would expect children with absent or ectopic glands to be more likely to require frequent monitoring than those with other causes of congenital hypothyroidism. This was the reason we compared infants in our study with dysgenesis with children without dysgenesis for the need for frequent monitoring. A Technetium-99m Pertechnetate thyroid scan was used for phenotype assessment and was performed in 60 of the 70 children included in our study. Of these 60 patients, 20 (28.6%) had a normal cervical thyroid, and 40 (57.1%) had dysgenesis. Of the 40 patients in whom thyroid dysgenesis was diagnosed, 4 had agenesis, 3 had hypoplasia, and 33 had an ectopic thyroid gland. Thus, most of the patients had ectopic glands, and the lack of a diff... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391163 Thu, 29 Sep 2011 04:00:00 +0100 5391163 http://www.medworm.com/index.php?rid=5391160&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008201%2Fabstract%3Frss%3Dyes Cystic periventricular leukomalacia (c-PVL) is a severe complication of preterm birth leading to cerebral palsy in most afflicted children. Despite distinctions in research groups using different classification systems in different cohorts, the incidence of c-PVL is reported to range from 3% to 10%. We read with interested the article by van Haastert et al reporting a decrease in the incidence and severity of cerebral palsy in a 16-years period (1990-2005) that could be attributed to a reduction of 93% in severe c-PVL. The study confirms US data from Hamrick et al who first reported on a decline in c-PVL that was not associated at that time with improved developmental outcome during an 11-years observation period from 1992 to 2002. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391160 Thu, 29 Sep 2011 04:00:00 +0100 5391160 http://www.medworm.com/index.php?rid=5391159&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008249%2Fabstract%3Frss%3Dyes A 12-year-old boy presented with a 3-month history of right upper quadrant abdominal pain, a 15%-20% loss of body weight, and a 3-week history of cough and dyspnea. He did not have jaundice, fever, acholic or melanotic stools, or nausea/vomiting. Respirations were 40/minute and regular, and heart rate was 125 beats/minute. Heart sounds and point of maximum impulse were displaced to the left. He exhibited increased work of breathing, with absent breath sounds on the right side and diffuse crackles on the left side. Examination revealed a palpable 10 × 8 cm, firm, immobile, nontender subcutaneous mass protruding from the right side of the back. Laboratory studies were significant only for mild normocytic anemia (hemoglobin, 9.4 g/dL, mean corpuscular volume, 75 fL) and mildly elevated serum... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391159 Thu, 29 Sep 2011 04:00:00 +0100 5391159 http://www.medworm.com/index.php?rid=5391127&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100816X%2Fabstract%3Frss%3Dyes Until 2 years ago, the identification of functional brown adipose tissue (BAT) in humans was limited to the neonate in whom BAT was known to play a prominent role in non-shivering thermogenesis. Our understanding of functional BAT derived primarily from studies in mice and small mammals in whom BAT plays a key role in facultative thermogenesis necessary for the maintenance of core body temperature. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391127 Thu, 29 Sep 2011 04:00:00 +0100 5391127 http://www.medworm.com/index.php?rid=5585883&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007700%2Fabstract%3Frss%3Dyes Objective: To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants.Study design: We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585883 Tue, 20 Sep 2011 04:00:00 +0100 5585883 http://www.medworm.com/index.php?rid=5585876&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008146%2Fabstract%3Frss%3Dyes Objective: To evaluate coagulopathy in pediatric trauma patients on presentation to the emergency department, and to quantify the relationship with mortality.Study design: Pediatric trauma patients requiring a blood transfusion (red blood cells, fresh frozen plasma, platelets, or cryoprecipitate) within 24 hours of arrival were included. Coagulation values on emergency department arrival were analyzed, as were clinical details and outcome.Results: A total of 102 children (mean age, 6 years; mean injury severity score 22, mean Glascow Coma Scale 7, 80% blunt trauma victims) were studied over a 4 year period. An abnormal prothrombin time was found in 72%, partial thromboplastin time in 38%, fibrinogen in 52%, hemoglobin in 58%, and platelet count in 23%. An abnormal prothrombin time, partial... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585876 Tue, 20 Sep 2011 04:00:00 +0100 5585876 http://www.medworm.com/index.php?rid=5391157&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100792X%2Fabstract%3Frss%3Dyes We report clinical characteristics and outcome of infants (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391157 Tue, 20 Sep 2011 04:00:00 +0100 5391157 http://www.medworm.com/index.php?rid=5228802&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611005646%2Fabstract%3Frss%3Dyes Schultz EH. J Pediatr 1961;59:522-8. Fifty years ago, Schultz reported the association between achalasia and recurrent pulmonary disease. Although there have been major advances in the understanding of its pathophysiology and diagnosis in the last 50 years, the clinical presentation remains the same, and the treatment options he described continue to be the mainstay of therapy, but they have become more sophisticated. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228802 Mon, 19 Sep 2011 08:50:26 +0100 5228802 http://www.medworm.com/index.php?rid=5228800&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611004550%2Fabstract%3Frss%3Dyes Epstein JA, Epstein BA, Small M. J Pediatr 1961;59:562-6.“Humpty Dumpty sat on a wall. Humpty Dumpty had a great fall.” Head injuries and children are as timeless as Mother Goose. Fifty years ago in The Journal, Epstein et al described 13 children, ages 5 months to 13 years, who had subepicranial hydroma. To understand subepicranial hydroma, we have to recall our first days of medical school anatomy. The mnemonic SCALP defines the external to internal layers of the scalp: Skin, Connective tissue, Aponeurosis, Loose areolar connective tissue, and Periosteum adherent to the skull and the dura beneath. Subepicranial hydroma, today often referred to as subgaleal hygroma or even pseudomeningocele, is a collection of cerebrospinal fluid with or without blood below the galea aponeurotica, s... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228800 Mon, 19 Sep 2011 08:50:26 +0100 5228800 http://www.medworm.com/index.php?rid=5228790&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100494X%2Fabstract%3Frss%3Dyes Shahidi NT, Diamond LK, Shwachman H. J Pediatr 1961;59:533-42. It was as late as 1938 when cystic fibrosis (CF) was first recognized as a separate entity from celiac disease. For decades after this milestone, the intestinal manifestations continued to be dominant. Fifty years ago Shahidi and Diamond, with the giant of exocrine pancreas research Harry Shwachman, published a report in The Journal describing two infants who were admitted for diagnosis and treatment of pitting edema (albumin 1.50 and 1.64 gram percent) who were found to be profoundly anemic (hemoglobin 7.2 and 7.7 gram percent). Shwachman had introduced the sweat test 5 years earlier, so these infants received a quick diagnosis, but the article also addresses the extensive evaluation of these infants, including bone marrow ex... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228790 Mon, 19 Sep 2011 08:50:26 +0100 5228790 http://www.medworm.com/index.php?rid=5228788&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611003933%2Fabstract%3Frss%3Dyes Huang NN, Van Loon EL, Sheng KT. J Pediatr 1961;59:512-21 Huang et al studied the patterns of bacterial pathogens in the airways of children with what at the time was known as cystic fibrosis (CF) of the pancreas. Compared with children with other chronic respiratory disorders, there were more pathogens in the respiratory tract of children with CF, dominated by Pseudomonas aeruginosa as the disease progressed. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228788 Mon, 19 Sep 2011 08:50:26 +0100 5228788 http://www.medworm.com/index.php?rid=5228777&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611006664%2Fabstract%3Frss%3Dyes This article is a departure from our usual format by offering the very personal reflections of a highly respected, experienced, successful senior leader from our field. Our reviewers acknowledged the value of this unique perspective for both current and future leaders.—Paul H. Dworkin, MD (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228777 Mon, 19 Sep 2011 08:50:26 +0100 5228777 http://www.medworm.com/index.php?rid=5228776&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008535%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228776 Mon, 19 Sep 2011 08:50:26 +0100 5228776 http://www.medworm.com/index.php?rid=5228775&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008523%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228775 Mon, 19 Sep 2011 08:50:26 +0100 5228775 http://www.medworm.com/index.php?rid=5228774&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008511%2Fabstract%3Frss%3Dyes (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228774 Mon, 19 Sep 2011 08:50:26 +0100 5228774 http://www.medworm.com/index.php?rid=5228773&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008407%2Fabstract%3Frss%3Dyes Children with neurofibromatosis type 1 (NF1) are at risk for a wide variety of clinical problems, some cosmetic and some potentially life-threatening. Of the latter, plexiform neurofibromas (PNs) are among the most serious. Especially when deep, they can cause problems from local pressure and may undergo malignant transformation. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228773 Mon, 19 Sep 2011 08:50:26 +0100 5228773 http://www.medworm.com/index.php?rid=5228772&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008390%2Fabstract%3Frss%3Dyes In adults, psoriasis has been associated with obesity, diabetes, hypertension, and increased risk of adverse cardiovascular outcomes. The causal direction of these associations has been somewhat unclear. Obesity and psoriasis are both characterized by inflammation, which may be confounding because psoriasis may result in a more sedentary lifestyle. However, remission of psoriasis has been reported after substantial weight loss as a result of bariatric surgery. It is also possible that there is a common etiologic factor underlying both obesity and psoriasis. These issues have not been extensively studied in children. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228772 Mon, 19 Sep 2011 08:50:26 +0100 5228772 http://www.medworm.com/index.php?rid=5228771&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008389%2Fabstract%3Frss%3Dyes Procalcitonin (PCT) is an increasingly “hot” marker of inflammation that has been touted as a useful discriminate of bacterial infection in a number of settings. In this issue of The Journal, a systematic review undertaken by a large European consortium examines another potential use of the marker: identifying children whose urinary tract infections (UTIs) require invasive imaging techniques. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228771 Mon, 19 Sep 2011 08:50:26 +0100 5228771 http://www.medworm.com/index.php?rid=5228770&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008377%2Fabstract%3Frss%3Dyes The study by Barron et al of patients with severe combined immunodeficiency (SCID) has immediate implication for clinical practice. Resting energy expenditure (REE) was measured by indirect calorimetry in 26 patients with SCID; 69% had hypermetabolism (REE >110% of predicted). Fourteen of 15 (93%) patients with failure to thrive (FTT) and 4 of 11 (35%) patients without FTT had hypermetabolism. As successful outcomes for patients with SCID have become a reality, recognition of their unique nutritional needs can lead to intensive support that will further optimize health. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228770 Mon, 19 Sep 2011 08:50:26 +0100 5228770 http://www.medworm.com/index.php?rid=5228769&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008365%2Fabstract%3Frss%3Dyes One of the major changes in newborn practice in the past several years has been the increase of disorders included in screening panels. This practice has been driven by multiple factors, including an increased recognition of disorders amenable to both early interventions and technology, such as tandem mass spectroscopy, which has made rapid, inexpensive screening feasible. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228769 Mon, 19 Sep 2011 08:50:26 +0100 5228769 http://www.medworm.com/index.php?rid=5228768&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008353%2Fabstract%3Frss%3Dyes For decades, our “success” in kidney transplantation has been measured by numbers (eg, 1- and 5-year patient survival, 1- and 5-year graft survival, blood pressure control, markers of cardiovascular morbidity). Lost in these numbers is the answer to a simple question: “How are these kids doing?” According to a study in the current issue of The Journal by Tong et al in Australia, the answer is “pretty darn good!” (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5228768 Mon, 19 Sep 2011 08:50:26 +0100 5228768 http://www.medworm.com/index.php?rid=5585894&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007931%2Fabstract%3Frss%3Dyes Objective: To evaluate relationships among vitamin D, proteinuria, and disease activity in pediatric systemic lupus erythematosus (SLE) and juvenile dermatomyositis (JDM).Study design: Multiple linear regression was used to associate subject-reported race, sunscreen use, and vitamin D intake with physician-assessed disease activity and serum 25-hydroxyvitamin D (25[OH]D) in 58 subjects with pediatric SLE (n=37) or JDM (n=21). Serum 25(OH)D was correlated with urinary vitamin D binding protein/creatinine ratio (DBP/C) and other indicators of proteinuria.Results: Serum 25(OH)D levels in subjects with SLE were inversely associated with the natural log of urinary DBP/C (r=−0.63, P (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585894 Mon, 19 Sep 2011 04:00:00 +0100 5585894 http://www.medworm.com/index.php?rid=5585895&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007803%2Fabstract%3Frss%3Dyes Conclusion: Audiovestibular and ocular involvement have a major impact on prognosis in children with Cogan syndrome. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585895 Fri, 16 Sep 2011 04:00:00 +0100 5585895 http://www.medworm.com/index.php?rid=5585887&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007712%2Fabstract%3Frss%3Dyes Conclusions: Prevention efforts have proved to be inadequate in the face of rising availability of prescription medications, particularly more dangerous medications. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585887 Fri, 16 Sep 2011 04:00:00 +0100 5585887 http://www.medworm.com/index.php?rid=5585881&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007906%2Fabstract%3Frss%3Dyes Conclusion: H2S plasma level has both high sensitivity and specificity rates to predict the probability of correctly differentiating between patients with VVS and patients with POTS. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585881 Fri, 16 Sep 2011 04:00:00 +0100 5585881 http://www.medworm.com/index.php?rid=5585877&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007955%2Fabstract%3Frss%3Dyes Objectives: To determine the pattern, prevalence and potential complications of fresh frozen plasma (FFP) use in US pediatric hospitals from 2002-2009.Study design: Retrospective cohort study using the Pediatric Health Information System (PHIS) administrative database, which was queried for FFP admissions using diagnostic, procedural, and billing codes. Demographic data, daily use, and procedural codes were used to describe the patient population and pattern of FFP use.Results: Of 3 252 149 PHIS-recorded admissions, 2.85% had codes consistent with FFP use. This percentage did not change over the course of the study (P=.10). FFP was most commonly administered to children (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585877 Fri, 16 Sep 2011 04:00:00 +0100 5585877 http://www.medworm.com/index.php?rid=5488998&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007888%2Fabstract%3Frss%3Dyes Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood, accounting for 25% of cancers diagnosed in children and adolescents aged 1-19 years, and translating to approximately 3000 new cases diagnosed in the US yearly. Progress in therapy for childhood ALL has been dramatic, with event-free survival (EFS, meaning that patients do not relapse or succumb to side effects) improving from 10%-15% in the 1960s to as high as 80% in published studies from early 2000 in developed countries (). Present cure rates are estimated to approach 90%. The primary factors that led to advances in ALL survival are: (1) the development of multiagent chemotherapy regimens based on the results of successive cooperative group protocols; (2) the use of preventive or prophylactic central nervou... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488998 Fri, 16 Sep 2011 04:00:00 +0100 5488998 http://www.medworm.com/index.php?rid=5488996&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008195%2Fabstract%3Frss%3Dyes In this issue of The Journal, Radhakrishnan et al show that airway levels of nitric oxide (NO) are high in patients with sickle cell disease (SCD). This observation is precisely the opposite of what would be predicted according to the hypothesis that NO scavenging by free hemoglobin accounts for pulmonary hypertension in SCD. This paradox highlights misconceptions about endogenous NO levels measured in the lungs. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5488996 Fri, 16 Sep 2011 04:00:00 +0100 5488996 http://www.medworm.com/index.php?rid=5391162&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611008213%2Fabstract%3Frss%3Dyes We read with interest the recent article by Balhara et al on the importance of monthly monitoring in congenital hypothyroidism. Although we are in agreement with their conclusions suggesting a revision of congenital hypothyroidism guidelines, we would like to emphasize 3 critical aspects of their study. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391162 Fri, 16 Sep 2011 04:00:00 +0100 5391162 http://www.medworm.com/index.php?rid=5391156&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS002234761100789X%2Fabstract%3Frss%3Dyes The clinical phenotype of congenital disorders of glycosylation is heterogeneous, mostly including a severe neurological involvement and multisystem disease. We identified a novel patient with a galactosyltransferase deficiency with mild hepatopathy and coagulation anomalies, but normal psychomotor development. The tissue-specific expression of the defective B4GALT1 gene correlated with the clinical phenotype. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391156 Fri, 16 Sep 2011 04:00:00 +0100 5391156 http://www.medworm.com/index.php?rid=5489010&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611006731%2Fabstract%3Frss%3Dyes Objective: To evaluate the cost-effectiveness of oseltamivir treatment for seasonal influenza in children and consider the impact of oseltamivir resistance on these findings.Study design: We developed a model to evaluate 1-year clinical and economic outcomes associated with 3 outpatient management strategies for unvaccinated children with influenza-like-illness: no antiviral treatment; diagnostic testing and oseltamivir treatment when positive; and empiric oseltamivir treatment. The model depicted a hypothetical non-pandemic influenza season with a 29% level of oseltamivir resistance in circulating viruses, and 14% to 54% probability of seasonal influenza with influenza-like-illness. Strategies were compared with incremental cost-effectiveness ratios.Results: In our primary analysis, empir... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489010 Wed, 14 Sep 2011 04:00:00 +0100 5489010 http://www.medworm.com/index.php?rid=5585900&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007876%2Fabstract%3Frss%3Dyes Conclusion: There is little support for the “model minority” myth with regard to physical and mental health. Evidence of physical and mental health disparities among young Asian-American children and differing risk based on region of origin of immigrant parents suggests the need for culturally informed prevention efforts during early childhood. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585900 Mon, 12 Sep 2011 04:00:00 +0100 5585900 http://www.medworm.com/index.php?rid=5585896&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007918%2Fabstract%3Frss%3Dyes Objective: To assess the interrelationship between extent of adrenarche at presentation in girls with precocious adrenarche (PA) born appropriate for gestational age and their growth pattern, pubertal course and adult height.Study design: We reviewed clinical and laboratory data from medical charts of 85 girls with PA aged 5.0 to 8.8 years at referral, stratified in 3 subgroups according to bone age (BA) minus chronological age (CA) ≤0 years; 0 1 year.Results: Extent of pubarche and dehydroepiandrosterone-sulfate levels were greatest in the BA−CA >1 subgroup (P=.02, P=.008, respectively), who also were taller at diagnosis (P=.002) and during childhood (P=.01). In all subgroups, pubertal onset was within normal range; menarche occurred earlier than in control subjects (P 1 (P (Source: T... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585896 Mon, 12 Sep 2011 04:00:00 +0100 5585896 http://www.medworm.com/index.php?rid=5585893&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007773%2Fabstract%3Frss%3Dyes Conclusion: In our series of pediatric patients with stroke, most of the clinical seizures occurred within the first 24 hours of presentation and did not vary in stroke subtype. Status epilepticus was common, especially in infants. Epilepsy had a high likelihood of developing in the next 6 months in children with seizures in the first 24 hours of stroke onset. Prolonged electroencephalogram monitoring was useful in detecting non-convulsive status epilepticus, but not in predicting the risk of epilepsy at 6 months. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585893 Mon, 12 Sep 2011 04:00:00 +0100 5585893 http://www.medworm.com/index.php?rid=5585891&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007797%2Fabstract%3Frss%3Dyes Objective: To assess the effects of chronic erythrocyte transfusions on prevalence of sonographic incidence of organ damage in children with sickle cell anemia (SCA).Study design: Children (N=148; mean age, 13.0 years) with SCA, receiving chronic transfusions (average, 7 years), underwent abdominal sonography at 25 institutions. After central imaging review, spleen, liver, and kidney measurements were compared with published normal values. Potential relations between ultrasound, clinical, and laboratory data were explored via analysis of variance, Student t test, and Cochran-Mantel-Haenzel tests of non-zero correlation.Results: Average spleen length was similar to normal children, but over one-third had spleen volumes >300 mL, 15 had previous splenectomy for splenomegaly, and 24 had abnorm... The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585891 Mon, 12 Sep 2011 04:00:00 +0100 5585891 http://www.medworm.com/index.php?rid=5585885&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007785%2Fabstract%3Frss%3Dyes Conclusions: Because theophylline was more effective in reducing the number and severity of apneas, inhalation of low concentration of CO2, as used in the present study, cannot be considered as an alternative to theophylline in the treatment of apnea of prematurity. The less effectiveness of CO2 treatment may have been related to the variability of the delivery of CO2. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585885 Mon, 12 Sep 2011 04:00:00 +0100 5585885 http://www.medworm.com/index.php?rid=5585884&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007694%2Fabstract%3Frss%3Dyes Objective: To measure the circulating concentrations of nitric oxide (NO) adducts with NO bioactivity after inhaled NO (iNO) therapy in infants with pulmonary hypertension.Study design: In this single center study, 5 sequential blood samples were collected from infants with pulmonary hypertension before, during, and after therapy with iNO (n = 17). Samples were collected from a control group of hospitalized infants without pulmonary hypertension (n = 16) and from healthy adults for comparison (n = 12).Results: After beginning iNO (20 ppm) whole blood nitrite levels increased approximately two-fold within 2 hours (P (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5585884 Mon, 12 Sep 2011 04:00:00 +0100 5585884 http://www.medworm.com/index.php?rid=5489027&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007748%2Fabstract%3Frss%3Dyes In October 2010, the International Liaison Committee on Resuscitation released new guidelines for neonatal resuscitation, which expanded on the previous recommendations for the use of pulse oximetry during neonatal resuscitation. In this Commentary, we discuss oxygen treatment in the delivery room. Where available, we have used evidence from randomized controlled trials (RCTs). Where this evidence is lacking, we have relied on observational and animal data to inform our strategy for using supplemental oxygen in the delivery room. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5489027 Mon, 12 Sep 2011 04:00:00 +0100 5489027 http://www.medworm.com/index.php?rid=5391158&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007761%2Fabstract%3Frss%3Dyes A 7-year-old boy had a pigmented lesion on the right sole. The lesion, which was neither tender nor pruritic, was present at birth and increased in size progressively. According to the clinical and dermoscopy image, should this lesion be excised? (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391158 Mon, 12 Sep 2011 04:00:00 +0100 5391158 http://www.medworm.com/index.php?rid=5391155&cid=s_37695_33_f&fid=37695&url=http%3A%2F%2Fwww.jpeds.com%2Farticle%2FPIIS0022347611007724%2Fabstract%3Frss%3Dyes This report is a follow-up to this earlier series. However, rather than featuring the separate subspecialties each month, this report combines both general pediatrics and subspecialties. (Source: The Journal of Pediatrics) The Journal of Pediatrics journals http://www.medworm.com/rss/comments.php?id=5391155 Mon, 12 Sep 2011 04:00:00 +0100 5391155