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                Weekly Updates in Pediatrics         June 27, 2012 

EDITOR:  Jack Wolfsdorf, MD


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Prognosis of Liver disease associated with prolonged Parenteral nutrition (PN)

Intestinal associated liver disease (ILD) has been reported in 40% to 60% of children receiving PN. 87 infants receiving long term PN for at least 28 days were assessed and 33% of them diagnosed with ILD.

24-month follow up of patients receiving PN with associated ILD indicates that most can be managed medically and that the majority of them reverse their liver disease. Most subsequently can be fed enterally.

Source: Journal of Pediatric Surgery, February 2012

Flumazenil induced seizures

Flumazenil is a benzodiazepine (BZ) antagonist frequently used as an antidote in the treatment of BZ overdose (it may also be effective in non-BZ sleep enhancing drug overdose). The most serious side effect of its usage is seizures.

A retrospective study of 83 children (3 mths - 12 years) given Flumazenil primarily for BZ poisoning found NO occurrence of Flumazenil associated seizures.


Source:  Pediatric Emergency Care, May 2012

"Distraction" as a technique to diminish pain

A study of a "distraction" technique (compared to a control group) using audiovisual (A/V) glasses, on pain perception was undertaken during administration of local anesthesia in 45 healthy, cooperative 5-7 year old children undergoing nerve block anesthesia.

Pain perception using A/V glasses is significantly reduced in children undergoing injection of local anesthesia.


Yoga instead of Physical Education (PE)


Psychosocial well-being was assessed by utilizing questions administered to grade 11 or 12 students enrolled either in a 10-week (2-3 times per week) standard PE class or assigned to a similar timed Kripula-based yoga program (physical postures, breathing exercises, relaxation and meditation).


Though this is only a small study, preliminary data suggests preventive benefits in mood and psychosocial well-being (decreased stress and psychosocial attitude) from Kripula yoga.


Source:  Journal of Developmental and Behavioral Pediatrics, April 2012 



Yoga for Physical Education DVD - TFS 
Yoga for Physical Education DVD - TF

Source:  YogaKids International via YouTube

Child behavior & 47XYY or 47XXY karyotypes

One in 1,000 male births appears to carry the 47XYY karyotype and most remain unaware of their abnormality. The 47XXY (klinefelters syndrome - KS) karyotype occurs in 1:500- 1:1,000 live male births which usually presents (with variations) clinically following the onset of puberty. In a group of 47XYY and 47XXY boys studied for behavioral difficulties most were found to be within normal limits while a subset (more so in the 47XYY group) were found to have significant impairment in a variety of domains.

Boys diagnosed with 47XYY or 47XXY karyotypes should receive extensive psychoeducation and be screened for learning disabilities and ADHD/Autism spectrum disorders.


Source:  Pediatrics, April 2012

Acute appendicitis & intra-abdominal abscess formation
A large retrospective study of patients undergoing appendectomy for acute appendicitis indicates that the surgical technique utilized (laparoscopic or open surgery) does not appear to affect the incidence of intra-abdominal abscess formation.


Source:  Journal of Pediatric Surgery, February 2012

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