HealthFusion-MCH Masthead
December 4, 2013   Vol. IV, Issue 49
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MCH's 49th Annual Pediatric Postgraduate Course


February 27- March 2



Register today! 


Healthy environment-less obesity in children?     

There appears to be a relationship between low-income families (particularly those of white children) and obesity (odds twice as high), though higher income groups appear to be catching up!


A six month randomized interventional trial promoting family meals, adequate sleep, limiting TV time and removing the TV from the child's bedroom, involving 121 low income families (half controls) with children 2-5 years of age using motivation coaching at home and by phone, was undertaken.


It appears that promoting household routines, particularly increasing sleep duration, and reducing TV viewing, may be an effective strategy to reduce the body mass index in low income families. Co-occurring social and behavioral risk factors should in addition, be addressed.




Journal of Developmental and Behavioral Pediatrics 

 Pediatric melanoma in the USA.

A retrospective review and analysis of all children <18 years of age with cutaneous melanoma (from the 2007 National Cancer Institute Surveillance, Epidemiology and End Results database) indicates the annual average melanoma incidence to be 5-4 per 1 million children and adolescents increasing between years 1988 and 2007. 1% of patients present with distant metastasis. Significant differences exist between children and adolescents.


The incidence of pediatric melanoma in the USA is increasing and age-based biology may account for the differences found between children and adolescents.


Journal of Pediatric Surgery  

Melanoma and its Increasing Incidence in Children
Melanoma and its Increasing Incidence in Children

via YouTube

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Early diet effects on cognitive ability at 10 yrs. of age.


A longitudinal study of 2,868 toddlers and families who reported diets which were scored according to an "Eating Assessment in Toddlers diet"at 1 year, 2 years and 3 years of age, indicates that a higher diet score measured at 1 year correlates with a higher cognition score (2 different metrics) at 10 years of age. Fruit consumption at 1 year and dairy intake at 2 and 3 years appear in addition to be positive predictors of higher cognitive scores.

A better quality diet in the early years of life appears to have a positive effect on cognitive ability later in childhood.


Acta Paediatrica 

Video Feature  
Childhood Obesity: Quality Physical Education as a Solution
Childhood Obesity: Quality Physical Education as a Solution
via YouTube

Limb lengthening - standard method vs. lengthening over a pediatric femoral nail?


Limb lengthening by slow controlled distraction with a long period of external fixation (with its concomitant complications) after subperiosteal - submetaphyseal osteotomy (Callotasis) has become a standard (with an average 6.6cm increase from initial length) method of lower limb extremity lengthening. The consolidation/distraction phase in children is approximately 2-4 times as long as in adults (external fixation between 30-50 days/cm gain in length ). While the concept of lengthening over an intra-medullary femoral nail is not new, few studies have been reported in children


A retrospective review of 37 consecutive children (average age 11.6 years ) who underwent femoral lengthening with external fixation over an intra-medullary nail, indicates an average femoral lengthening of 7.0 cm and that though 37.8% develop some complication (no higher than other methods) a successful result is achieved in 94% of patients.


Journal of Pediatric Orthopaedics 

Tdap vaccination during pregnancy.  


A retrospective cohort study (prior to the routine recommendation for Tdap administration during pregnancy at 27-36 weeks gestation) assessing pregnancy, birth, and infancy outcomes in 138 women (and compared to a non-vaccinated control group) who were given tetanus and reduced content diphtheria toxoids plus reduced content acellular pertussis vaccine (Tdap) indicates that for all outcomes measured, no difference exists between those pregnant women (even when the vaccine is given earlier than the recommended window) given Tdap or not.

Journal of Pediatrics 


Journal of Pediatrics

Successful rehabilitation in pediatric ultra-short small bowel syndrome (USSB < 20 cms small bowel).  


"Intestinal failure is defined by the inability to maintain growth and development by regular means of nutrition".  Causes vary and, prior to parenteral nutritional support, most patients died.

The records of 28 young children (<2 year) with USSB syndrome following a bowel resection managed in an Intestinal Rehabilitation Program (IRP) between 2001 and 2011 was retrospectively reviewed.


96% of infants with USSB syndrome managed in an IRP survive, 46% without parenteral nutrition within two years. An intact ileocecal valve and colon are beneficial towards recovery.  

(positive and encouraging results, Ed.)


Journal of Pediatrics 


Journal of Pediatrics

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