Weekly Updates in Pediatrics         November 7, 2012 

EDITOR:  Jack Wolfsdorf, MD, FAAP 


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Pleural effusion following a correctly placed umbilical venous catheter (UVC)

UVC's are commonly used in the management of sick and preterm infants. They are relatively easy to place and usually considered relatively safe, although they may result in many complications. A pleural effusion from a correctly placed UVC is extremely uncommon.


This is the second report of a rare complication, the development of a confirmed isolated pleural effusion associated with the correct placement of a UVC. Following thoracenthesis and UVC removal the condition did not recur.


IOS Press

Shared genetic effects between early menarche and eating disorders in women

A study of mono and dizygotic 16-17 year old female twins examining age at menarche and the present of disordered eating indicates that a common genetic component exists for the two conditions. The younger the age at menarche, the greater the risk for disordered eating.


Journal of Adolescent Health 

"Coaching Boys into Men"

A random study of 2,006 male high school athletic students in 16 schools examined the effects of coach recognition and intervention (over a three month period) of teen dating violence/aggressive abusive behavior and/or abusive perpetration compared to a standard controlled athletic program.


A school athletic-based prevention program appears to be one effective strategy in reducing adolescent dating violence.


Perforated appendicitis in obese children

A review of 319 children who presented with clinical signs of appendicitis indicates that obese children are more likely than non-obese patients to present with perforation. The diagnosis may be more difficult to make or presentation may be delayed in the obese child.


Clinical Pediatrics

AAP practice guidelines for the diagnosis and management of childhood Obstructive Sleep Apnea Syndrome (OSAS)


Childhood OSAS is frequently associate with adenotonsillar hypertrophy and/or obesity.  


The following recommendations are made regarding OSAS:  

  1. All children should be screened for snoring
  2. Polysomnorgaphy should be performed on children who snore and who have symptoms of OSAS.
  3. Alternative diagnostic tests may be considered
  4. Adenotonsillectomy is recommended for patients with hypertrophy
  5. Children with mild OSAS (or if surgery is contraindicated) may benefit from intranasal steroids.
  6. Patients should be reevaluated postoperatively to assess whether further treatment is required.
  7. If symptoms persist CPAP is recommended. (May also be tried preoperatively)
  8. Obese patients should be encouraged to lose weight.

Source: Pediatrics

Video Feature

Sleep Apnea in Children 
Sleep Apnea in Children

Vitamin A/E in PyelonephritisVitamins


Pyelonephritis in childhood has the potential to lead to long-term cardiovascular morbidity by causing renal damage. This appears to be mediated through factors like urinary tract anatomy and function, bacterial virulence factors and innate immune host activity which either enhances bacterial clearance and/or causes tubulointerstitial inflammation resulting in scarring. Anti-inflammatories or antioxidants given with antibiotics appear to be potentially beneficial.


An interesting study on the effects of antioxidant therapy (Vit.A/E) given with antibiotics for pyelonephritis in children, indicates that this therapy may lower the risk of renal scarring. 


Source:  Pediatric Nephrology 


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