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                Weekly Updates in Pediatrics         August 1, 2012 

EDITOR:  Jack Wolfsdorf, MD, FAAP 


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Petechiae/Purpura in well-appearing infants

A retrospective analysis of 36 well infants (no fever or echymoses) < 8 months of age who presented to the Emergency Department with petechiae or purpura was undertaken.


Most infants had localized petechiae/purpura on their lower limbs (92%) with 66% being bilateral. All investigations were normal.


Well infants with localized petechiae/purpura in the absence of fever are likely to have a benign etiology (? tourniquet phenomenon), particularly if there is no progression over a 4 hour observation period.


Source:  Pediatric Emergency Care

Long-term follow up of children with tracheobroncomalacia (TBM)

TBM is a disease of the large airways. Parents of 19 children (median age 9.4 years) completed a questionnaire detailing respiratory symptoms over the previous 12 months with pulmonary function testing being undertaken.


Most parents report persistence of respiratory symptoms following primary TBM with pulmonary function testing indicating continuing large and small airway abnormality. Few (6.7%) children have evidence of reactive airway disease.


Source:  Pediatric Pulmonology 

Are early vaccinations a risk factor for Celiac Disease (CD)?

A study from the National Swedish Childhood Celiac Disease Register found no association between CD and early vaccination.


Source: Pediatrics 

Underwriting Opportunities  

With a circulation of over 4,000, Updates in Pediatrics offers an excellent opportunity to promote your brand at affordable rates.  


Please contact Jeff Herschler to learn more.

Intranasal midazolam (Versed)


Midazolam is a short acting, rapid onset, low toxicity benzodiazepine which has potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxing and sedative properties. It is well-absorbed by intra-nasal and buccal mucosae. It is frequently used as an analgesic which may increase the likelihood of respiratory depression and hypotension.


A study of 52 children (mean age 3 years), treated in a Developing country who underwent outpatient surgical procedures indicates a significant improvement in moaning, crying and struggling parameters compared to a non-treated control group.

Source: Acta Paediatrica

Video Feature 

Is 100% Fruit Juice Causing Child Obesity?
Is 100% Fruit Juice Causing Child Obesity?

Source: My Family Plate via You Tube 

Follow up of neonates with Total Serum Bilirubin (TSB) levels > 25mg/dl


A 1-5 year follow up study of all Danish infants born live (> 35 wks gestation) evaluated the relationship between TSB levels > 25mg/dl (severe hyperbilirubinemia) and subsequent development.


Severe hyperbilirubinemia in > 35 week gestation babies appears not to result in any developmental delay at 1 to 5 years compared to a control group.


Source:  Pediatrics 

 3M Syndrome - an undiagnosed cause of proportionate short stature


3M syndrome presents with a typical clinical phenotype-severe pre and post natal growth retardation, characteristic facies (relatively large head with frontal bossing, triangular face, hypoplastic midface, full eyebrows, fleshy nose, a prominent mouth and lips and a pointed chin) and characteristic radiological findings. It is caused by mutations in 1 of 3 genes (CUL7, OBSL1, and CCDC8) all of whom can be identified by molecular genetic testing.


Six Saudi families whose children showed typical clinical features of 3M syndrome underwent extensive, costly and avoidable investigations for alternative causes of short stature.  


Source:  The Journal of Pediatrics  

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