MCH Updates in Pediatrics Masthead  

                       Volume IV
                        Issue 31
                                                           South Florida's  only licensed  free-standing
                                                             specialty hospital  exclusively for children ...                                                      July 31,  2013 
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FMS Pediatric Ad  



CALL (954) 346-8200  Ext. 201


Magnet related injuries-an increasing problem!   

A retrospective analysis of magnet-related injuries from 1995-2012 reveals that:


1) Magnets from toys account for the majority of the injuries.


2) Comparing incidence rates prior to and after 2006 indicates that the rates appear to have doubled over the past six years.


3) Mandatory standards for toys with magnets appear to have had no beneficial effect.


4) Swallowed magnets account for 86% of injuries followed by ears, nose, vagina, and rectum.


5) The proportion of multiple magnet involvements appears to be increasing.


6) 12% of affected children require endoscopy for magnet removal and 4% surgical interventions.


Journal of Pediatric Gastroenterology and Nutrition 

Comparison of cosmetic outcomes of absorbable vs. non-absorbable sutures in facial lacerations

Facial lacerations apparently occur more frequently in males across all pediatric age groups and especially among 13-15 year olds. Only 6% occur in schools or kindergartens and for the young child (<12 years) injury most frequently occurs during the weekend.


98 patients (aged 1-18 years) with 1-5 cm facial lacerations were randomized to 2 treatment protocols:


1) Repair with fast absorbing catgut (FAC), or


2) Repair with Nylon sutures (NYC).


Results were reviewed at 4-7 days and 3-4 months.


Physicians independently cannot identify differences between the results obtained by treating facial lacerations with FAC vs. NYC.  Caregivers prefer management with fast-absorbing catgut.


Pediatric Emergency Care 

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Video discharge instructions as an aid to standard written orders?      


Previous studies have indicated that many patients (and caregivers) have difficulty understanding physician given discharge instructions. Focused topic videos may mitigate against language difficulties, illiteracy and limited physician communication skills and time.


A study was undertaken of 436 caregivers of patients aged 29 days-18 years in an ED with a diagnosis of fever, vomiting or diarrhea and wheezing or asthma, who were either given written standard discharge instructions or who watched a three minute video based on their child's diagnosis. They were questioned immediately thereafter regarding information covered and 2-5 days later a follow-up questionnaire was administered.


Caregivers rate video discharge instructions as significantly better to understand, remember and find helpful compared to written orders. (Whether this improves compliance to treatment regimens requires further study. Ed)


Pediatric Emergency Care 

Management of feeding disorders in normal children       


Feeding difficulties in the developing child may relate to problems with oral motor skills (e.g. opening, closing or rotary mouth chewing functions plus tongue motions); sensory issues (aversion to having any food touching their lips, mouth, face or body); behavioral problems (with, without or a combination of the above) which are frequently related to the child's emotional experiences from his/her feeding as an infant.  These may require a variety of different strategies to be resolved.


A report of a study of 96 families with normal children aged 1.5-6 years with feeding difficulties utilizing a group-behavioral parenting program ("Hassle Free Mealtimes Triple P") indicates that with this form of therapy improvements occur in the mealtime and general behavior of the children, with significant benefits documented in parental mealtime practices confidence and cognition.


Journal of Developmental and Behavioral Pediatrics 

Video Feature 
Dangers Of Magnetic Toys
Dangers Of Magnetic Toys

NBC 5 via YouTube

Neonatal respiratory problems & genetically mediated surfactant dysfunction   


Pulmonary surfactant is a mixture of lipids and proteins that decrease the surface tension in the alveolus on expiration. The proteins are important for the organization and packaging of the surfactant phospholipid and its adsorption onto the alveolar surface.


Mutations in the genes encoding surfactant proteins B and C (SP-B and SP-C) and the phospholipid transporter ABCA3 are rare and are associated with respiratory distress and interstitial lung disease in children.


27 new (of 427 - 7.5%) cases from 15 different Pediatric Centers (between 2006-2011) referred to a Genetics Molecular Laboratory for surfactant mutation analysis were identified. The majority  are neonates born >37 weeks gestation and present with respiratory distress at birth. Prognosis appears variable with some survivors (best for ABCA3 and SP-C mutations).


Archives of Diseases in Childhood  

Timolol 5% gel for the treatment of superficial infantile hemangiomas (IH)


Timolol maleate is non-selective beta-adrenergic antagonist frequently utilized for the treatment of glaucoma, heart attacks and hypertension.


Superficial Infantile hemangiomas (strawberry hemangiomas) are benign, superficial, red colored vascular cutaneous growths that usually appear (60% on head and neck) shortly after birth, grow rapidly during the first year of life and frequently resolve on their own over the next few years. (50% completely involuted by 5 years of age).


A prospective trial investigating the use of Timolol maleate 0.5% gel on 41 infants with superficial IH's (without ulceration or near mucosal surfaces) indicates that blinded size and volume measurements taken over a 24 week period decrease significantly more in a treated group, with no apparent adverse incidence.



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