MCH Updates in Pediatrics Masthead  

                       Volume IV
                        Issue 23
                                                           South Florida's  only licensed  free-standing
                                                             specialty hospital  exclusively for children ...                                                      June 5, 2013 
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Human Rhinovirus infections (HRV)  

Since the 1990's polymerase chain reaction (PCR) techniques for HRV have become available and expanded our understanding of their role in childhood illnesses. An excellent review article on the subject outlines all the details. Briefly:


HRV's are positive-strand RNA viruses of the genus Enterovirus.


By 3 years of age >90% of children have experienced at least one HRV infection.


HRV infection is associated with the classic common cold, acute otitis media, sinusitis, severe bronchiolitis, asthma, pneumonia, fever alone, and worsening of chronic diseases like Cystic Fibrosis and asthma.


No antiviral drug has been approved for clinical use.


Pediatric Infectious Disease Journal 

"Old" and "New" media and "well-being" of youth

A study involving 719, 14-24 year old youth, interviewed twice one year apart was utilized to determine time spent with TV, the internet, and book reading and related them to school grades, sport participation and symptoms of depression.


Television detracts from academic performance and book reading supports it. Moderate use of the internet, particularly for acquiring information, is consistent with health development. Heavy use of the internet and games may be a symptom rather than a cause of mental health problems.


Archives of Diseases in Childhood

Journal of Adolescent Health

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Neonatal brain MRI and neurodevelopmental outcome at 5 years


MRI's of the brain were performed on 217 very low birth weight infants at term equivalent and related to neurodevelopment at 5 years of age.


MRI of the brain of very low birth weight/very low gestational age infants done at term equivalent may be valuable in predicting neurodevelopment outcome (MRI negative predictive value of normal or minor pathologies, 92% and 85.7% respectively) at 5 years of age alongside clinical and follow up data.


Acta Paediatrica 

Video Feature
The Breath of Life: Using Bubble CPAP to Decrease Chronic Lung Disease in Premature Infants
The Breath of Life: Using Bubble CPAP to Decrease Chronic Lung Disease in Premature Infants
Texas Health Resources
 via YouTube

Changes in neonatal stool flora and disease


Fecal/neonatal abnormalities in colonic bacterial colonization may play a role in the development of necrotizing enterocolitis (NEC) in the premature newborn, in infantile colic and allergy in infancy.


Two recent studies examined fecal bacterial changes in premature/full term infants following different exposures.


The first, examined the role of histamine-2 receptor (H2-) blockers on the fecal microbiota of premature infants (<34 weeks gestation) and the second, the changes in neonatal stool flora in healthy women with singleton term pregnancies administered antibiotics (during the intrapartum period or during rupture of membranes). The following data appears relevant.


1. H2 blockers given to premature infants lowers fecal microbial diversity and increases the relative density of Enterobacteriaceae (as compared to a matched untreated group) which may predispose the vulnerable immature gut to NEC.


2. Following maternal antibiotic administration, vertical transmission of Lactobacillus-dominant flora, changes to coccii-dominant organisms. Early lactobacillus colonization may play a preventive role in the development of allergic diseases later.


Treatments of either pregnant women or the premature infant which may alter the fecal bacterial profile of the premature/newborn infant should be considered carefully.


Journal of Pediatric Gastroenterology and Nutrition 


Acta Paediatrica 

Genes, tobacco smoke and lung function


Different genes and pathways expressing oxidative stress have been associated with declining lung function on adults who have been exposed to tobacco smoke.


A preliminary report of 21 single nucleotide polymorphisms (SNP's) associated with tobacco related abnormalities in lung function were examined in 8 year old children exposed to tobacco smoke both prenatally and/or during infancy/childhood.


SNP's in TNS1, ADAM19, THSD4, and ADCY2 genes are significantly associated with declining lung function in children exposed to tobacco smoke. Interestingly, ADCY2 variants appear to be associated with a higher FEV1. There is much to be learned!


Acta Paediatrica 

The America Academy of Pediatrics (AAP) has now endorsed the Committee Opinion on timing of Umbilical cord clamping first put forward by the ACOG in 2012  


While the optimal timing and benefits of delayed cord clamping of preterm and term infants has been the subject of controversy, it appears that for the preterm infant umbilical cord clamping should be delayed for 30-60 secs. with the infant at or below placental level, to achieve significant reduction in intraventricular hemorrhage (other potential benefits include increased blood volume and the decreased need for blood transfusion). In term infants there currently appears to be no benefit to delayed cord clamping.



Obstet Gynecol 2012, 120 p1522-6