Feb. 15, 2017
Volume VIII |  Issue No. 7

Effectiveness of airway clearance techniques (ACT's) in children hospitalized with acute bronchiolitis 
From a study of 103 hospitalized infants (<24 months of age) diagnosed with bronchiolitis who were randomly allocated to receive one, twenty minutes chest physiotherapy session daily of either assisted autogenic drainage (AAD-hands on chest and using infant's breathing pattern to manually increase expiratory flow to achieve different lung volumes), intrapulmonary percussive ventilation (IPV) using a face-mask or bouncing (control group) it appears that both ACT's significantly improve clinical symptomatology and decrease length of hospital stay.
Survival rate following pediatric In-hospital cardiac arrests during night and weekends
From a national registry-based cohort study of hospitalized children <18 years of age who received cardiopulmonary resuscitation (CPR), it appears that survival rate to hospital discharge is significantly lower for night-time CPR vs. days/evenings, with no differences noted between weekend and weekdays.

Body mass index (BMI) and menstrual patterns in dancers
A study cohort of 105 dancers (mean age 14.8 years) and mean BMI 19.5kg, 92% of whom were healthy weight for height, investigated age of first/patterns of menses.

First menses in dancers range from 10-15 years with 44% reporting irregular menses; 36% stop getting their menses during time of increased dancing activity with 30% going >3 months without any menstrual activity.

Lower weight in dancers is associated with increased age of first menses.
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Helmet use and injury severity among pediatric skiers and snow boarders in Colorado

While most parents focus on preventing orthopedic type injuries for their skiing/snowboarding children, head, cervical spine and solid organ injuries are frequent among 3-17 year-olds. Helmet use is apparently not mandated for skiers and snow boarders outside of resort-sponsored activities and parents may not insist on their use.

A study of 549 children who sustained snow sports related injuries indicates most are male, mean patient age is 11 +- 3 years, and Colorado residents are twice as likely to wear helmets. Severity of head injury and ICU admission is related to non-helmet use and visitors from out of state are less likely to wear a helmet when injured and more likely to be severely injured.

"Pediatric skiers and snowboarders and their parents should be educated on the significant risks associated with these activities and the benefits of helmet usage".

Family food preparation and its effect on adolescent dietary quality and eating patterns

From 2 large, socio-economically and ethnically diverse population-based household studies, which examined teen and family eating activities and teen quality and eating patterns between those teens/families who do, or do not engage in meal preparation, it appears that adolescent involvement in food preparation is significantly associated with better diet quality and patterns of eating (parents' cooking does not appear to be related to adolescent dietary intake!).

Video Feature
Understanding Mitochondrial Diseases
Understanding Mitochondrial Diseases
Causes of death in children with mitochondrial diseases
Mitochondrial disease is a group of disorders caused by a genetic or acquired dysfunction of the mitochondria (those organelles that generate energy (ATP) for metabolic use in all cells of the body except red blood cells). Some are caused by mutations in mitochondrial DNA (mtDNA) (15%), others by abnormalities in nuclear DNA which code for mitochondrial protein components. Acquired damage may result from drugs, infection or other environmental causes. Clinical presentations may appear at any age and mimic a number of known diseases.

A retrospective study of the records of 221 children diagnosed with mitochondrial disease indicates: 
  • Global mortality rate of 14% (average age at death: 6 years)
  • Age of symptom onset: 1.8 years
  • Duration of illness: 4.3 years
Causes of death include: sepsis (55%), pneumonia (42%), DIC and sudden unexpected death (29%).

A high index of suspicion with early recognition, early intervention and careful monitoring of medical conditions are critical to survival.
Video Feature
Diagnosing and Treating Mitochondrial Diseases
Diagnosing & Treating Mitochondrial Diseases
Physiotherapy for ankle sprain 

"Ankle sprain" refers to the stretching/tearing of the lateral ligaments (usually) of the ankle which may occur during a wide variety of activities. While it can be associated with an ankle fracture, most commonly it occurs in isolation. Frequently recommended treatments often include physiotherapy.

A study of 543 adults with ankle sprains (stable or with some joint laxity) which compared, seven, half-hourly supervised physiotherapy sessions (with "usual care") to "usual care" only (rest, ice, compression, elevation and gradual weight-bearing) indicates no benefit of physiotherapy over "usual care".

Did you know?
A photo depicting the Nicklaus Children's LifeFlight Critical Care Transport team preparing Andrew for transport was selected for the 2017 National Children's Hospital's Photo Exhibit.
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