April 30,  2014   Vol. V, Issue 18
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Treatment of suspected acute perforated appendicitis (SAPA).

 A study of 751 children who underwent appendectomy (of whom 105 were SAPA patients) initially treated with intravenous antibiotics and planned appendectomy > 8 weeks later indicates that while most patients may be successfully treated with this methodology, SAPA patients present with increased intra-abdominal abscess formation (27%) and earlier than planned appendectomy (11%).


Journal of Pediatric Surgery

Complementary feeding- before or after breast feeding?

A randomized crossover trial involved 25 healthy infants between the ages of 7-11 months exclusively breast fed for at least 6 months. Infants were randomized to receive complimentary feedings (of known content and caloric value) before or after ad libitum breast feeding.

Breast milk caloric intake and semi-solid caloric consumption are unaffected by whether complimentary feeding is given before or after breast feeds.


Journal of Pediatric Gastroenterology & Nutrition 

 Increased asthma risk in adults following Bronchiolitis/pneumonia in infancy.

138 hospitalized infant patients diagnosed with bronchiolitis/pneumonia (matched against control infants) and clinically studied at 28-31 years of age indicates:


1.    Hospitalization for bronchiolitis in infancy increases the risk of asthma and asthma medication use in adults.

2.    Impaired respiratory health-related quality of life in adulthood is significantly affected by both infant bronchiolitis and pneumonia.


Pediatric Pulmonology

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Treatment of Restless leg syndrome (RLS).


RLS is a sensory and motor neurologic clinical disorder, thought to be an autosomal dominant disorder (apparently on chromosome 9p for USA families-different in other countries) characterized by an uncontrollable urge to move the arms or legs (but can present with conduct problems, difficulty in sleeping, etc.) which may result in poorer social development and difficulties at school.


A retrospective chart review of children diagnosed with RLS between the ages of 5-18 years and treated with a variety of medications indicates that most children who receive iron (with or without other treatments) have improvement or resolution of symptoms, within 3.8 months.


Clinical Pediatrics
Video Feature  
Treatments for Restless Leg Syndrome in Toddlers
Treatments for Restless Leg Syndrome in Toddlers
via YouTube

Interleukin-8 (IL-8) & necrotizing enterocolitis (NEC) in the premature infant.


IL-8 is a chemokine ("cytokines" and "chemokines" are small proteins produced by cells in the immune system that are important in regulating the body's responses to infections, injury and wound healing. "Cytokines" are the general category of messenger molecules which control the duration and length of the immune response, while "chemokines" are specific cytokines that direct white cells to infected or damaged tissue).  


A retrospective study of 113 infants diagnosed with NEC, treated surgically or medically where IL-8 was assessed at diagnosis, and mortality reviewed at 60 days, indicates;


1.   Medically treated NEC carries a 10% 60 day mortality, while 33% of NEC infants managed surgically, die.

2.   Serum IL-8 levels correlate directly with 60 day mortality.

3.   The above may change the therapeutic approach to managing NEC in the preterm infant.


Journal of Pediatric Surgery 

 Contraceptive Counseling-Does it make a difference?


Approximately half of all pregnancies in the USA are unintended and most occur in the 35% of US women who don't use contraception. Prevention requires a multifaceted approach which includes sexual education, contraceptive counseling, improving contraceptive access and reducing health differences in population groups. This process is complex.

A study of 1,032 adolescent Swiss women (aged 15-20 years) evaluated the influence of counseling among three different contraceptive choices.


The ease of use, the ability to apply the contraceptive weekly or monthly are important factors in adolescent choice, as are balanced information counseling on all types of contraceptives available.


Journal of Adolescent Health




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