April 1, 2015   Vol. VI, Issue 13
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Quality of life (QoL) and obstructive sleep apnea syndrome (OSAS) after pediatric adenotonsillectomy 

A study of 453 children aged 5 to 9.9 years with OSAS randomly assigned to receive either adenotonsillectomy or "watchful waiting" and supportive therapy, and evaluated at baseline and seven months post-treatment for race, weight, baseline OSAS and QoL symptoms indicates that Adenotonsillectomy provides greatest improvement in parent-related and specific QoL measurements with obesity playing no role, and race or baseline severity explaining only a small portion of improvement noted.


Intranasal triamcinolone and growth velocity 

Inadequate designs and conflicting results from previous studies prompted the US FDA to publish new research guidelines "to evaluate the effects of orally or nasally inhaled steroids on the growth of children".

Triamcinolone is a long-acting synthetic corticosteroid which can be administered by inhalation, orally, topically or by injection.


It appears from  a randomized double-blind placebo controlled, parallel-group, multicenter study of 216, 3 to 9 year old children with perennial allergic rhinitis, which evaluated the effects of once-daily triamcinolone acetonide spray (TAA-AQ: 12 months of treatment) on growth velocity that:


1. No hypothalamic-pituitary-adrenal axis suppression occurs.


2. That a small (statistically but probably not clinically significant) effect of TAA-AQ on growth velocity occurs at 2 months post treatment, which remains stable thereafter.



Evening media and night-time sleep

A study of 208 infants studied at 6 months of age and at follow up at one year, examined infants' sleep onset, wake times, screen media exposure, and evaluated the relationships between them.

Infants exposed to evening screen time at 6 and 12 months of age have shorter night-time sleep duration. Infants exposed to evening media at 12 months have a 28 minute decrease in sleep duration.


Night-time sleep duration at 12 months is directly related to 6 months sleep duration.


Acta Paediatrica 



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Safety of measles-containing vaccines in one year old children 


There continues to be discussion, particularly among the lay public concerning the safety of vaccines. Recently an increase in reported measles cases in the USA has again triggered debate on the safety of the measles vaccine. "All measles-containing vaccines are associated with several types of adverse events."


Because the MMR plus varicella (MMRV) vaccine when compared to the separate MMR and varicella (MMR+V) vaccine increases infant risk of febrile seizures (7- 10 days later) a study evaluated outcomes following 123,200 MMRV and 584,987 MMR+V doses given to children 12-23 months of age, over a two year period.


In this large study, MMRV and MMR+V vaccines carry the same risks for seven measured outcomes with no new risks being identified for either. 



Video Feature 

(via YouTube)
Is the Measles Vaccine Safe?
Is the Measles Vaccine Safe?

Age at gluten introduction and risk of Celiac Disease (CD)


A prospective birth cohort study of 6,436 newborn infants were screened and evaluated for high-risk HLA genotypes for CD, with infant feeding information being collected every 3 months. Outcomes assessed over a 5 year period were

Celiac Disease Risk Factors
Celiac Disease Risk Factors

persistent levels of elevated tissue transglutaminase autoantibodies (tTGA) (a marker for DC) and a confirmed (defined on intestinal biopsy) diagnosis of CD.


Gluten introduction before 17 weeks or later than 26 weeks of life is not associated with an increased risk for the development of elevated tTGA or CD.



Discrepancies between transcutaneous (TcB) and serum bilirubin (TSB) measurements


A study on 8,319 TcB with 925 matched TSB measurements in newborns indicates a TcB-TSB difference of 0.84 mg/dl, however this may vary with race, the brand of TcB meter used and the hour of age of the infant.


During routine neonatal care, TcB measurements provide a reasonable estimate of TSB levels in healthy newborns.



Effects of Varenicline (Chantix) on smoking cessation


Smoking among adolescents remains a public health problem with nicotine being particularly addictive in this age group.


Chantix is a smoking cessation medication that is helpful with behavior modification and counseling, in assisting those who wish to stop smoking. It is not recommended for people <18 years of age as neither safety nor effectiveness of Chantix in pediatric patients has been established. Commons side effects include nausea, constipation, gas, vomiting and trouble sleeping or vivid/unusual or strange dreams, possible suicidal thoughts and behavior, plus others.


The use of Chantix studied among adult cigarette smokers willing to try to reduce the number of cigarettes smoked a day (as opposed to abrupt "quitting") indicates a significantly beneficial effect ( vs placebo ) on cigarette consumption at 6 months and 1 year post-treatment.


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