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Volume IV
Issue 11

              Weekly Updates in Pediatrics         March 13, 2013

EDITOR:  Jack Wolfsdorf, MD, FAAP                   

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Exercise & behavioral, neurocognitive & scholastic performance in children with ADHD  

A single 20 minute episode of moderate-intensity aerobic exercise in children with, and matched without, ADHD were assessed utilizing an attention-control task (the ability to concentrate), and brain potentials to investigate any potential benefit of exercising.

 

Matched children with and without ADHD exhibit an enhanced capacity to concentrate and perform reading and arithmetic tasks flowing exercise. ADHD children, in addition, have an improved capacity to inhibit other stimulus responses.

 

Amoxicillin clavulanate for children with a "chronic wet cough"

A chronic cough is associated with multiple ill-effects including recurring physician visits, parental stress, sleep deprivation, impaired school performance and a decreased ability to play.

 

A study of 6 month-18 year old children with a chronic wet cough (mostly from bacterial bronchitis diagnosed by bronchoscopy and lavage) for more than three weeks and who were given a 2-week course of amoxicillin clavulanate indicates that overall most children are significantly improved with cough resolution, following therapy.

 

Source: The Journal of Pediatrics 

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Maternal antenatal stress & school achievement at 10 yrs. of age  

 

1038 maternal-infant/child pairs were followed from 18 weeks pregnancy, antenatal stress episodes noted, and their offspring examined at 10 years for literacy and numeracy achievement.

 

Four or more antenatal maternal exposures to life stress events appears to result in lower reading scores in female children, while 3-4 or more stress events result in higher reading and mathematics scores for male children. Reasons for this disparity of effects are unknown at present.

 

Source:  The Journal of Pediatrics 

Sweet beverages & body mass index (BMI)

 

Sugar-sweetened beverages (SSB) intake is associated with weight gain.

 

A BMI study of 641 primarily normal-weight children, approximately 5-12 years of age who normally drank sugar- sweetened drinks, and who were given either a 1 ounce can of SSB or an artificially-sweetened beverage over an 18 month period, indicates significantly decreased weight gain and fat accumulation is associated with the non-caloric beverage consumption.

 

Source:  The Journal of Pediatrics 

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Predischarge total serum bilirubin (TSB) identifies infants who need phototherapy

 

In the first week of life jaundice is identified in 84% of newborn infants. 1060, > 35 week gestation, breast fed babies had their total serum bilirubin (TSB) performed at 24-60 hours and at 3-5 days and 7-14 day follow-up visits. Clinical risk factors for  hyperbilirubinemia were identified. Predischarge TSB identified the approximately 4% of infants who required phototherapy after discharge.

 

Predischarge TSB combined with gestational age are useful predictors (with other specific clinical factors -- earlier gestational age, Asian race, positive direct antiglobulin test, blood type incompatibility, bruising, etc.) of subsequent post-discharge phototherapy requirement.

     

Source:  The Journal of Pediatrics 

Intravenous (IV) fluids or gastric- tube (GT) feedings for infants with viral Bronchiolitis   

 

"The American Academy of Pediatrics recommends intravenous (IV) fluids for infants with bronchiolitis who are unable to sustain oral feedings".

 

A small randomized comparative study of IV fluids vs. gastric tube feedings of breast milk/infant formula in moderately ill infants hospitalized with acute viral bronchiolitis, indicates comparable results with no apparent increase in aspiration, or worsening of respiratory status in the gastric tube fed group. A larger study is warranted.

 

Source: The Journal of Pediatrics 

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