MedWorm: Pediatrics Top 20

Sleep Apnea: When a Snore Is More

DukeHealth.org: Duke Health Features — Thu, 29 Sep 2011 18:50:18 +0100

Sleep apnea is as common as type 2 diabetes, and most people who have sleep apnea haven’t been diagnosed -- which puts them at risk for more than just sleepiness. Having sleep apnea increases the odds that you’ll develop high blood pressure, heart disease, memory problems, weight gain, impotency, and headaches. And then there are the dangers that do come along with plain old sleepiness: poor functioning at work and at home, decreased decision-making skills, and a serious risk for impaired driving. A 2008 study showed that people with sleep apnea double their chances of being in a car accident and are three to five times more likely to be in a severe accident that causes injury. What You Should Know About This Common Condition The risk myths Being older, being obese, and being a man are...

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Experts recommend genetic counseling for young sarcoma patients

Thrive, Children's Hospital Boston — Sun, 29 Jan 2012 13:41:39 +0100

Genetic testing may help sarcoma patients and their famlies know their risk of other cancers later in life If your child is diagnosed with a sarcoma—a tumor in connective tissue like muscles or bones—it’s natural to become totally focused on his immediate recovery. But what if beating sarcoma wasn’t the only time your child might face cancer? Data shows that there is a link between sarcomas and Li-Fraumeni syndrome, a rare condition that raises a person’s risk of developing one or more cancers to as high as 85 percent. Cancers typically diagnosed in patients with Li-Fraumeni syndrome include breast cancer, sarcomas, brain tumors, acute leukemia and adrenal cortical carcinoma. Recently, the list has been expanded to include colon cancer and stomach cancer. Li-Fraumeni syndrome m...

What Are the Major Diseases Involving Copper Metabolism?

PediatricEducation.org — Mon, 06 Feb 2012 00:08:49 +0100

Discussion Nutritional problems can occur in all parts of the world and in all socioeconomic strata. Caloric and/or protein inadequacy unfortunately plagues too many people because of inadequate supplies or availability. Supplemental food programs around the world attempt to provide appropriate nutrition, but can be stymied because of war, political instability, economic instability and many other social factors. The most common specific nutrient deficiencies are iron and Vitamin D deficiencies. Minerals important for essential nutrition include copper, iodine, selenium and zinc. A typical mixed diet usually provides enough minerals. In the United States, mineral deficiencies are usually uncommon unless there is an underlying disease process or abnormal food restrictions or diet. Vegan an...

When Is More Treatment Needed for Infantile Hemangiomas?

PediatricEducation.org — Mon, 09 Jan 2012 00:30:57 +0100

Discussion Infantile hemangiomas (IH) are the most common soft tissue tumors in infants. They are usually considered birthmarks but are dynamic lesions. They usually begin in the first few weeks of life and rapidly grow in the first 3-5 months of life. By 5 months, most lesions will have achieved 80% of their final size. Almost all IH have cessation of growth after 9 month of age. Images of IH can be seen in the To Learn More section below. Learning Point Often no treatment is necessary for IH other than expectant monitoring. Additional treatment may be necessary depending on the patient’s age, lesion type, location, size and complication being considered. The results of a prospective cohort of 1058 children in 7 pediatric dermatology clinics found that overall 24% of patients had c...

Chest pain: a sign of psychiatric disorder?

The Journal of Pediatrics — Sat, 14 Jan 2012 17:25:08 +0100

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)

Office Screening and Early Identification of Children with Autism

Pediatric Clinics of North America — Fri, 27 Jan 2012 06:14:51 +0100

This article focuses on autism/autistic disorder screening and its early identification, with a brief mention for AS screening, as there are limited tools and no recommendation for universal screening for AS. (Source: Pediatric Clinics of North America)

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Neurobiological Basis of Autism

Pediatric Clinics of North America — Fri, 27 Jan 2012 06:14:51 +0100

Autism (autism spectrum disorders) is a complex, strongly genetically influenced, behaviorally defined disorder of the immature brain associated with very uneven intellectual abilities. Among its most salient and potentially treatable neurologic features that this article focuses on are epilepsy, disorganized sleep patterns, and sensory and motor deficits. Its many causes and wide range of severity means that there is no symptom, no pathology, imaging, electroencephalography, or other biologic feature, and no biologic treatment that is universal or diagnostic of this developmental syndrome. (Source: Pediatric Clinics of North America)

What is the Mnemonic for the Elbow Ossification Centers?

PediatricEducation.org — Mon, 30 Jan 2012 00:11:02 +0100

Discussion Injuries to the pediatric elbow are difficult to diagnose because of the anatomy and normal growth and ossification of the elbow. Swelling, tenderness, ecchymosis, with or without deformity are common signs of fracture. Physical examination should include a careful neurovascular examination for distal pulses and capillary refill, paresthesias, increased pain with movement distal to the elbow or paralysis of the hand muscles as any of these may indicate compartment syndrome. Common radiographs obtained are AP and lateral plain radiographs. Oblique films and comparison films of the contralateral elbow are also often needed to distinguish between a fracture and normal growth plate. The alignment of the anterior humerus line and the fat pads should be reviewed as misalignment may ...

Girls see need for safe sex even after HPV vaccination

Modern Medicine Contemporary Pediatrics — Wed, 18 Jan 2012 06:37:38 +0100

Adolescent girls believe that they are at less risk for human papillomavirus (HPV) infection after receiving their first HPV vaccination but also overwhelmingly believe in the need for continued safe sex behavior. One-fourth, however, perceive themselves to be at a lower risk for other sexually transmitted infections (STIs) after their first HPV vaccination. Find out why health care providers must talk to girls and their mothers about the limitations of HPV vaccine efficacy and the lack of protection from other STIs. (Source: Modern Medicine Contemporary Pediatrics)

Anaphylactic shock after vaccination 'extremely rare'

MedWire News - Pediatrics — Fri, 27 Jan 2012 06:16:11 +0100

Anaphylaxis is a very rare event following immunization, say researchers who detected no cases in a routine infant preschool immunization program that delivered more than 5.5 million vaccines. (Source: MedWire News - Pediatrics)

Better, Together: Care Partners Program

DukeHealth.org: Duke Health Features — Fri, 13 Jan 2012 19:06:44 +0100

An outpatient case management intervention known as Care Partners is a collaboration between Duke University Hospital, Durham Regional Hospital, Duke HomeCare & Hospice, Durham Community Health Network, and various community-based health care agencies. The goal of the Care Partners program is to enhance the focus and care of patients with chronic diseases. The program uses a patient-centered model to help empower patients to optimize their health, gain further understanding of their chronic disease, and to have timely access to appropriate services and providers, enhancing their ability to manage their care outside of the acute or emergency department setting. In this model, patients are joined with a “care partner” who is supported by an oversight team of individuals represent...

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Changes in immunomodulatory constituents of human milk in response to active infection in the nursing infant.

Pediatric Research — Fri, 20 Jan 2012 23:36:12 +0100

Discussion:During active infection in nursing infants, the total number of white blood cells, specifically the number of macrophages, and TNFα levels increase in their mothers' breast milk. These results may support the dynamic nature of the immune defense provided by breastfeeding sick infants.Methods:Breast milk from mothers of 31 infants, up to 3 months of age, who were hospitalized with fever, was sampled during active illness and recovery. Milk from mothers of 20 healthy infants served as controls. PMID: 22258136 [PubMed - in process] (Source: Pediatric Research)

Corrective lenses, patching improves acuity in hard-to-treat amblyopia

Modern Medicine Contemporary Pediatrics — Wed, 18 Jan 2012 06:37:38 +0100

Amblyopia is the most common cause of visual impairment in children and adults. Myopic anisometropic amblyopia, a subtype of amblyopia perceived as difficult to treat, usually is managed by balancing the myopic eye optically and cosmetically and forgoing further treatment. Now new research shows that in these cases, refractive correction in combination with patching can improve visual acuity over refractive correction alone. (Source: Modern Medicine Contemporary Pediatrics)

Pain crises in children with sickle cell anemia

The Journal of Pediatrics — Sat, 14 Jan 2012 17:25:08 +0100

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)

Adolescent and Parent Motivation for Change Affects Psychotherapy Outcomes Among Youth With Poorly Controlled Diabetes

Journal of Pediatric Psychology — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions Findings demonstrate the importance of parent and youth initial motivational status and treatment alliance to treatment outcome among youth with poorly controlled diabetes. Additional research on treatment techniques that promote motivation for change is needed. (Source: Journal of Pediatric Psychology)

Congenital central hypoventilation syndrome and hypoglycaemia

Acta Paediatrica — Sat, 14 Jan 2012 17:16:11 +0100

Conclusion: Hypoglycaemia and hyperinsulinaemia might be suspected in children with CCHS presenting with seizures and hyperhydrosis; though, further studies are needed to confirm this association. (Source: Acta Paediatrica)

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50 Years Ago in The Journal of Pediatrics: The Ototoxic Effects of Kanamycin Sulfate in Infants and Children

The Journal of Pediatrics — Sat, 14 Jan 2012 17:25:12 +0100

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...

Guillain-Barré syndrome in temporal association with influenza A vaccine

Revista Paulista de Pediatria — Wed, 18 Jan 2012 06:37:28 +0100

OBJETIVO:Descrever um caso de síndrome de Guillain-Barré em associação temporal com a vacina influenza A (H1N1) 2009. DESCRIÇAO DO CASO: Menino de quatro anos com queixa inicial de dor em coxa direita e perda de força muscular ascendente 15 dias após a segunda dose da vacina influenza A (H1N1) 2009. Ao exame neurológico apresentava tetraparesia e arreflexia, com predomínio em membros inferiores. A eletroneuromiografia evidenciou redução da velocidade e bloqueio de condução neuronal, com discreta perda axonal secundária. Foi tratado com imunoglobulina por via intravenosa, atingiu platô no quarto dia de evolução da doença e, depois, houve melhora progressiva da força muscular. COMENTÁRIOS: Com o emprego em larga escala da vacina influenza A (H1N1) 2009 em nosso meio e os ...

Contraception used half the time in unintentional teen pregnancies

Modern Medicine Contemporary Pediatrics — Fri, 27 Jan 2012 05:00:00 +0100

Half of teen mothers who became pregnant unintentionally say that they did nothing to prevent the pregnancy, according to data from a Centers for Disease Control and Prevention survey. The data show that misperceptions still abound regarding contraception and pregnancy, and it is never a bad idea to have frank talks with your patients—boys and girls alike. (Source: Modern Medicine Contemporary Pediatrics)

50 Years Ago in The Journal of Pediatrics: A Correlation of Clinical, Electroencephalographic, and Roentgenographic Findings in Children with Epilepsy

The Journal of Pediatrics — Sat, 14 Jan 2012 17:25:09 +0100

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)