MCH Updates in Pediatrics Masthead  

                       Volume IV
                        Issue 27
                                                           South Florida's  only licensed  free-standing
                                                             specialty hospital  exclusively for children ...                                                      July 3,  2013 
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Impact of stretching exercises vs. bedding pillows on positional head deformities in young infants

Positional head deformities in early infancy frequently cause concern, particularly since babies have been placed on their backs to sleep. Primary prevention includes varying the babies' head position during sleep, while physical therapy (particularly neck muscle stretching exercises) positioning devices and bedding pillows (to remove pressure on the occiput during sleep) may be utilized at 5 months of age as secondary therapies.

 

50 children, aged 5 moths or younger with plagiocephaly, brachycephaly or a combination, were randomly assigned to 2 treatment arms; bedding pillow alone or with stretching exercising for 6 weeks. Measurements of the cranial vault were taken and asymmetry analyzed.

 

Bedding pillows and stretching exercising both result in improvements in positional cranial deformation.

 

Journal of Pediatrics 

Toll-like receptors (TLR) in neonatal sepsis

Toll-like receptors are a class of protein receptors, expressed by macrophages (and other cells) that recognize broadly shared pathogen associated wall molecular patterns,  which activate host cellular immune responses. TLR 2 and 4 are associated with necrotizing enterocolitis, periventricular leukomalacia and sepsis.

 

TLR's play an important role in initiating immune responses and their potential modulation during neonatal sepsis may play an important role in reducing neonatal morbidity/mortality.

 

Acta Paediatrica 

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Fecal microbial transplantation (FMT) in ulcerative colitis (UC)

 

Approximately 1014 bacteria normally inhabit the human gastrointestinal tract; 20 species comprise 75% of the total number of colonies. In the colon spirochetes and fusiform bacteria are found on the mucosal surface while anaerobic rods (Enterobacteria, Bacteroides and bifido bacteria) predominate in the lumen.

 

Microbial imbalances (dysbiosis) in the gut appear to contribute to the development of colonic inflammation in UC.

 

A small pilot study of 10 children with mild-to-moderate UC who underwent freshly prepared fecal enemas daily for 5 days indicates that 78% showed clinical improvement within 1 week which was maintained for a month. Enemas were well tolerated and adverse events were minor.

 

Journal of Pediatrics Gastroenterology and Nutrition 

Umbilical cord cleaning with chlorhexidine (Cl)  

 

Single or multiple-topical cleanings of the umbilical cord with 4% Cl reduces neonatal mortality by up to 20% during the first weeks of life, particularly in developing communities.

 

A study quantifying Cl umbilical cleaning on chord separation time (comparing it to a "dry and clean" cord care regimen) indicates that Cl cleaning increases cord separation time by approximately 50% (from 4.78 days to 6.90-7.49 days). Mothers should be so informed as expectations need to be appropriate.

 

Pediatrics

Video Feature
Physical Activity and Obesity in Mexican American Adolescents
Physical Activity and Obesity in Mexican American Adolescents
MD Anderson Cancer Center
via YouTube

Effect of sedentary time, & moderate-to-vigorous exercise on obesity

 

A fairly large study of 554 children whose body fat and physical activity was measured at 8, 11, 13, and/or 15 years of age examined the effects of moderate-to-vigorous physical activity, on body fat adjusted for age, height, physical maturity and sedentary time.

 

Moderate-to-vigorous physical exercise has a strong influence in the prevention of obesity in childhood/adolescence. Sedentary time appears NOT to be independently associated with body fat mass.

 

Journal of Pediatrics 

Heliox therapy for Bronchiolitis

 

A multicenter randomized blinded control trial of 319 infants with bronchiolitis randomly assigned to receive either Heliox (21% oxygen + 79% helium) or Airox (21% oxygen + nitrogen) treatment, delivered via facemask or nasal cannula indicates that 8 hours of Heliox treatment decreases treatment time to alleviate hypoxia/respiratory distress, but only if given via tight fitting facemask or CPAP. (Nasal cannula use is ineffective)

 

Pediatrics 

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