MCH Updates in Pediatrics Masthead  
                 Volume IV
                  Issue 36
                                                           South Florida's  only licensed  free-standing
                                                             specialty hospital  exclusively for children ...                                                      September 4,  2013 
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Formula selection for management of children with cow's milk allergy (CMA)

A study of 260 healthy children (1-12 months of age: mean 5.92 months) diagnosed with CMA were prospectively evaluated following 5 different formula exposures for the acquisition of milk tolerance after one year. Formulae included:

 

1.    Extensively hydrolyzed casein (EHCF)

 

2.    EHCF plus lactobacillus rhamnosus GG (LGG)

 

3.    Hydrolyzed rice formula (RHF)

 

4.    Soy formula

 

5.    Amino-acid based formula

 

Oral milk tolerance in CMA children develops best after 12 months of feeding with EHCF (43.6%) or EHCF+LGG (78.9%).

 

Journal of Pediatrics 

Efficacy & safety of once-daily esomeprazole for the treatment of gastroesophageal reflux disease (GERD) in the neonate

A randomized, double-blind, placebo-controlled multi-center study of neonates with signs and symptoms of GERD compares esomeprazole (0.5mg/kg) or placebo, once daily treatment for 14 days.

 

Esomeprazole treatment of GERD neonates does not significantly change GERD-related signs, symptoms or reflux episodes (compared to a controlled group) however the percentage of time pH was <4.0 and the number of acidic reflux episodes > 5mins is significantly decreased. Esomeprazole appears to be well tolerated.

 

Journal of Pediatrics 

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Self-defense programs reduce sexual assault in adolescent girls          

 

Female sexual abuse is not uncommon, unfortunately; many cases go unreported (particularly in developing communities) and deleterious psychological effects may be prolonged.

 

In adolescents warning signs include:

 

1.    Self-injury (cuttings, burnings)

2.    Changes in personal hygiene

3.    Drug and alcohol abuse

4.    Sexual promiscuity

5.    Anxiety, depression and/or suicide attempts

6.    Fear of closeness

7.    Compulsive eating or dieting

 

A total group of 522 high school girls (mean age 16.7 years) in different schools in Nairobi, Kenya, participated in a survey which identified those who had been sexually assaulted in the previous year (baseline data). Following a standardized 6-week self-defense program in half the group, the survey was repeated in  

the following year.

 

Over 50% of girls in developing communities who have been taught self-defense mechanisms against sexual assault use them to avert an attack in the year following training; this represents a decrease in such assaults by a factor of 2.5 (from 24.6% at baseline to 9.2% at follow up).

 

Journal of Adolescent Health 

Video Feature  
Teen girls target self-defense classes
Teen girls target self-defense classes
News 8 via YouTube

Watercraft & watersport injuries in children  

 

Water-associated trauma (WAT) may result in potentially severe and debilitating injuries.

 

A report over a 10 year period, from a single children's hospital identified 15 children (age range 7-15 years) who were injured by a boat propeller, rope or more commonly during inflatable tube towing. All survived.

 

Awareness of the importance of wearing protective gear and limiting boat speed during tube towing may decrease the incidence and severity of pediatrics WAT. Drivers of boats should not consume alcohol.

 

Journal of Pediatric Surgery

Second allogeneic stem cell transplant (allo-HSCT) in relapsing hematologic malignancies

 

Stem cells may be retrieved from one's own blood or bone marrow (autologous) or from a donor (allogeneic).

 

Children with hematological malignancies, who relapse after their first hematopoietic stem cell transplant, generally have a poor prognosis. One treatment option for these patients is a second allo-HSCT.

 

A study of 27 children with acute leukemia who received at least 2 allo-HSCT's indicates that overall prognosis improves significantly, with 40.7% of patients being alive and in stable remission at 33 months with a 5 year overall survival rate of 32.6%.

 

Journal of Pediatric Hematology/Oncology

Cystic intratesticular lesions in pediatric patients

 

While intratesticular cysts are commonly found on ultrasound in adults, they are rare in the pediatric population.

 

A small retrospective review identified 7 children over an 8 year period who were diagnosed and treated for an unilateral intratesticular cyst. One cyst underwent spontaneous resolution; in 3 patients each the diagnosis was epidermoid cyst or mature cystic teratoma. All were benign.

 

Initial observation may be an option for testicular cystic lesions in the pre-pubertal patient (until testicular sparing surgery is feasible), while testes sparing surgery should be advocated for those undergoing surgical management.

 

Journal of Pediatric Surgery