South Florida's only licensed free-standing specialty hospital exclusively for children...


Volume IV
Issue 14

              Weekly Updates in Pediatrics         April 3, 2013

EDITOR:  Jack Wolfsdorf, MD, FAAP                   

For optimal functionality we recommend you  VIEW  this newsletter as a web page.   



Medical Malpractice Specialists for

the Healthcare Industry

EMI logo
For more information click logo above or
to reach us via e-mail.

Muccosal immune system/cytokine gene expression in Sudden Infant Death Syndrome (SIDS)

HLA-DR expression in laryngeal gland and surface epithelium in 97 SIDS victims, was evaluated and related to cytokine (Interluken-IL) gene polymorphisms and the level of various cytokines in the CSF. A risk score was established assigning a score of 0 for negative HLA-DR expression, supine position and no fever prior to death.


3 single gene polymorphisms are associated with 92% SIDS cases where a positive score for all risk factors are found and high HLA-DR expression is associated with a high cytokine level in CSF.

This study adds to the growing evidence that SIDS is related to a genetically mediated abnormality in immunological homeostasis.


Infant feeding & transmission of human immunodeficiency virus (HIV)

Perinatal HIV transmission from mother to child can occur during pregnancy, labor and delivery or during breast feeding. Over the past approximately 15 years HIV testing and preventive interventions has led to a more than 90% drop in perinatal HIV infected babies in the USA.


The only method to prevent HIV transmission by human milk is not to breast feed or utilize breast milk from HIV infected mothers, independent of maternal viral load and antiretroviral therapy.


Source: Pediatrics 

For More Information 


Pre-sleep activities & sleep onset in children


A national survey was undertaken which documented "before sleep" activity of 2,017, 5-18 year old children/adolescents. Activities for the 90-mins prior to sleep were grouped into (a.) sedentary TV time; (b.) non- sedentary time, and (c.) self-care, and these were related to "very early", "early", "late" or "very late" subsequent sleep patterns.


Children who watched TV prior to sleep time take much longer to fall asleep compared to those involved in non-sedentary activities and self-care.


Source:  Pediatrics  

Video Feature 
How To Teach Your Child To Sleep in Their Own Bed 
How To Teach Your Child To Sleep in Their Own Bed via YouTube

Vaccination site & risk of local reactions  


A study cohort of 1.4 million, 1-6 year old children who received 6.0 million single intramuscular (IM) vaccine injections (inactivated influenza, hepatitis A, and DTaP) was utilized to assess whether local reactions to the vaccine were site Child Immunization dependent (arm vs. thigh).


It appears that local reactions following inactivated influenza and hepatitis A vaccines are relatively uncommon independent of site  of IM injection. For DTaP, vaccine local reactions are more frequent, particularly in the 12-month - 3-year old child, when given IM in the arm.


Source:  Pediatrics 

Treatment of glans penis ischemia following circumcision


While it may be more common for circumcision of boys to occur in the first days following birth, in many parts of the world older boys (and adults) are circumcised.


An interesting, fairly rare report, of a 7 year old boy who had a circumcision performed with local anesthesia (dorsal penile nerve block with 0.1% xylocaine containing ephedrine) describes severe ischemia/necrosis of his glands developing 24 hours post-operatively. No abnormality of clotting was found and he was successfully treated with 5 days of subcutaneous injections of enoxaparin (lovenox).

Source:  Pediatrics   

Children's health outcomes in two-parent, single, & shared physical custody families

Analyzed data on 10 -15 year old children from a Swedish national survey indicates that children in shared physical custody and single-parent families are more at risk for negative outcomes, reporting multiple heath complaints and low well-being which is not changed by appropriate parent-child communication.


Source: Acta Paediatrica 

Underwriting Opportunities


With a circulation of over 4,500, Updates in Pediatrics offers an excellent opportunity to promote your brand at affordable rates.  

to learn more.