April 23,  2014   Vol. V, Issue 17
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Laparoscopic inguinal hernia repair.

 A retrospective study of laparoscopic inguinal hernia repair in 874 children indicates that it is feasible, safe and efficacious when compared to an "open procedure".  It is rapidly becoming routine.


Journal of Pediatric Surgery 

 "Finger counting": an alternate method for estimating pediatric weight.

A study evaluated and compared 5 different methods ("Finger counting"; "Broselow tape" - relating height to weight; "Lauscomb formula" - age x 3 +7; weight estimates according to the "Advanced Life Support (APLS) formula"; and "Parental estimate") of weight in children 1-9 years of age.


"Finger counting" to estimate children's weight is an acceptable alternative to the Broselow method (and better than the "APLS formula" which underestimates "Parental estimate" and the "Lauscomb formula").  


American Journal of Emergency Medicine 

 Late outcomes of High Frequency Oscillation Ventilation (HFOV) treatment in preterm (< 29 wks.) infants.

A pulmonary function study of the small-airways, respiratory health, health-related quality of life and functional status of 319 adolescents (11-14 years of age) who had been enrolled as neonates in a multicenter randomized trial which compared HFOV with conventional ventilation, indicates that HFOV treated babies appear subsequently to have better lung function with no evidence of poorer global functional outcomes.


New England Journal of Medicine 

Guest Blog by Kathy McCoy  

NCQA Launches New PCMH Standards; Announces Deadline for 2011 PCMH Recognition


The Patient-Centered Medical Home, a concept first introduced by the American Academy of Pediatrics (AAP) in 1967 but now adopted much more broadly, is continuing to develop as studies demonstrate the need for different requirements.  


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Radiation exposure during emergency computerized tomography (CT).


"Comprehensive CT dose standards exist for adults but are incomplete for children".


CT is apparently requested in 0.39% of pediatric emergency department presentations, mostly (90%) following trauma (predominantly falls), 19% after road accidents, 12% after sports injury and 12% after parent assault.


Calculations of size-specific dose estimates of radiation exposure in pediatric CT patients of all ages and anatomic regions, indicate a wide variation in radiation dosage; sometimes larger than recommended for adults. As concern exists regarding radiation exposure in children there is an urgent need to define standards of radiation dosage in children.


Journal of Pediatric Surgery

Video Feature  
Safer CT Scans with less radiation dose.wmv
Safer CT Scans with less radiation dose
via YouTube
Predictors of persistence of Functional Somatic Symptoms (FSS) in Adolescents.


Somatic symptoms (e.g. pain and fatigue) which cannot be explained by an underlying organic pathological process are designated as FSS's.  


It appears that 4.1% of adolescents suffer from persistent FSS's. Risk factors include; being a girl, having depressive symptoms, poor self-related health and high parent-reported FSS's (anxiety, parental over protection, school absenteeism and diversity of symptoms DO NOT predict FSS).


Journal of Pediatrics 

 Risk & prevalence of developmental delay in young children with severe Congenital Heart Disease (CHD).

A study of 99 children during the first 3 years of life (evaluated 3-6 times) with severe CHD in which the Bayley Scales of Infant Development was used to assess cognitive, language and motors skills (and compared to normative data) indicates that developmental delay occurs in most (75%) severe CHD patients (without a genetic syndrome)..


Cognitive and language are dynamic phenomena and prevalence and risk change over time. Long-term follow-up is essential.





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