June 18 2014   Vol. V, Issue 25
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Viruses that cause respiratory distress in infants

A study of 136 nasopharengeal aspirates and associated clinical records from infants hospitalized for respiratory distress indicates that Respiratory Syncytial virus (RSV) is the most common (50.9%) causal viral infectious agent, followed by entero/rhino virus (21.6%) human metapneumonia (10.5%), Parainfluenza (5.9%) and influenza (3.3%) viruses. RSV infected infants have lower o2 saturations, require more oxygen and stay longer in hospital.


Acta Paediatrica

Resuscitation of preterm infants with differing inspired oxygen concentrations. 

Inhalation of increased inspired oxygen concentrations results in oxidative stress which impinges on morbidity and survival outcomes. Resuscitation of infants at birth with 100% oxygen is associated with increased morbidity and mortality.


A double-blind randomized control trial of 193 <32 week gestation preterm infants randomized to be resuscitated by either 30% oxygen (low-oxygen group) or 65% oxygen (high-oxygen group) for approximately 5 minutes, after which the inhaled oxygen was adjusted (to approximately 40%) based on oxygen saturation levels, was undertaken. Outcome measures included brochopulmonary dysplasia (BPD) (at 36 weeks post menstrual age), major neonatal illness and

markers of oxidative stress.


It appears that initial resuscitation of <36 weeks gestation preterm infants with either 30% or 65% oxygen results in similar measures of oxidative stress with no differences in the risk of subsequent BPD development, morbidity or mortality.


Journal of Pediatrics



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In-hospital formula use decreases infant breast feeding.  


As deaths under the age of 5 have decreased over the past 20 years, the proportion of children that die within the 1st month of life has steadily increased; in the USA 58% of all children who die, do so within the newborn period. Babies who are fed breast milk for the first 6 months of life are at least risk.


A recent study indicates that formula given to infants in the immediate in-hospital neonatal period is associated with an approximately 2-fold increase in the risk of not breast feeding on days 30-60, and a nearly 3-fold risk of not breast feeding thereafter.


We should insist that maternity units in hospitals encourage (and provide assistance for) breast feeding and desist from providing formula for new born babies (Ed).


Journal of Pediatrics

Video Feature  
Respiratory syncytial virus (RSV)
Respiratory syncytial virus (RSV)
via YouTube

Birth month & risk of respiratory syncytial virus (RSV) hospitalization.


From an analysis of 82,296 RSV-related infant hospital admission data (from Arizona, Iowa, New York, Oregon and Wisconsin) between July 1996 and June 2006, infants born in December and January have a 2-3 fold higher risk of RSV-related hospitalization compared to those born in July.


Pediatric Infectious Disease Journal

A new cholesterol biosynthesis & absorption disorder associated with epilepsy etc.


"The human brain accounts for approximately 2% of the whole body mass but contains almost 25% of the total cholesterol of the body". It is important as a component of myelin sheaths, and neuronal and astrocyte membranes. It plays a role in brain development and neuronal function. There are a number of neurological diseases which follow abnormalities in cholesterol metabolism e.g. Nieman-Pick type C, Smith-Lemli-Opitz syndrome etc.  


A 19 year old male presented with failure to thrive, psychomotor deterioration, intractable seizures, hypogonadism and cerebral cerebello-bulbar degeneration, was noted to have a low serum cholesterol ( 78.7-116.5 mg/dl) level. Examination of serum and urinary cholesterol intermediaries suggests a new syndrome with decreased bio -synthesis and absorption of cholesterol.


Pediatric Neurology 

Inhaled corticosteroids (ICS) during childhood & bone density.


Repetitive doses of inhaled steroids are frequently used in the management of acute asthmatic wheezing in children.


From a study of 82 asthmatic children, hospitalized for wheezing at <2 years, who at 12.3 years (median) had volumetric bone mineral density measured in the distal tibia and radius, and compared to the cumulative ICS dose, it appears that cumulative corticosteroid inhalations given during childhood DO NOT affect bone density at school age.


Acta Paediatrica 

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