HealthFusion June 2014 B  

August 6, 2014   Vol. V, Issue 32
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Acute concussion symptom severity & delayed symptom resolution (DSR).

Following a concussion, 30% of children will have delayed symptom resolution.


A study of 234 children (8-18 years of age) with concussion whose symptom were graded using a score and who were followed up one month later, indicates that 21% of patients have DSR, which is NOT however related to initial concussion severity. Early cognitive symptoms may portend a greater likelihood of DSR.



Assessment of musculoskeletal toxicity 5 yrs. after therapy with levofloxacin.

Levofloxacin is a broad spectrum fluroquinolone antibiotic with excellent tissue penetration, given orally or intravenously. Its spectrum of activity includes most strains of bacterial pathogens giving rise to respiratory, urinary tract and gastrointestinal infections. Adverse reactions (approximately 4-7%) though frequently mild-moderate, may sometimes be serious - tendon damage, peripheral neuropathy, hepatotoxicity, CNS and psychiatric side effects, prolongation of Q T interval, and cartilage damage, to name a few.


A prospective, 12 monthly, 5-year safety follow-up study following levofloxacin therapy was designed to evaluate the presence/absence of cartilage injury in weight bearing joints. Cartilage injury following levofloxacin treatment appears UNCOMMON (or clinically undetectable and/reversible).


Key Benefits, Challenges of EHR Software Revealed in Survey   

Guest Blog by Kathy McCoy


Some of the commonly held beliefs about EHRs, including their benefits and key challenges, were brought into question by a recent survey by industry software review site Software Advice. The survey, conducted in collaboration with leading data collection company Research Now, surveyed nearly 400 medical practices regarding their experiences with EHR software.


Read More 

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Mitochondrial DNA as a role player in Sudden Infant Death Syndrome (SIDS).  


SIDS is the medical term which describes the sudden death of an infant (<1 year of age: peak 2-4 months), the etiology of which remains unexplained after all known possible causes have been ruled out. It occurs unpredictably, though usually associated with sleep, in families of all races, ethnicity and socio-economic backgrounds. A number of theories have been put forward to explain its etiology. It is not caused by bad parenting and it is not contagious.

It has been suggested that all risk factors for SIDS may be explained by the presence of a reduced amount of adenosine triphosphate (ATP) which provides the energy for cellular activity. As mitochondrial DNA (mtDNA) contains genes (codes) which are essential for ATP production, a study of 22 mtDNA polymorphisms was investigated in 365 SIDS infants (and 409 controls).


mtDNA polymorphisms appear to play a role as a contributing factor in some male SIDS patients.


Acta Paediatrica 

Video Feature
Sexting Leads to Sex?
Sexting Leads to Sex?
via YouTube

"Sexting" & sexual behavior among Middle School students.  


"Sexting" (sending/receiving sexually explicit cell phone texts or pictures) among teens appears to have a prevalence ranging between 1%-31%! 20% of teens between 13 -19 years report having sexted a nude or seminude picture of themselves (though data numbers vary quite significantly). While sexting appears to be associated with sexual activity in high school students (with sexually transmitted infections and teen pregnancy) it is unknown whether this applies to early adolescence.


20% of 1,285 middle school students in Los Angeles (with appropriate cell phones) report receiving a sext, and students who text at least 100 times a day are more likely to be sexually active. Pediatricians should discuss sexting with young adolescent patients.



Antibiotic treatment for Acute Otitis Media (AOM) & the disappearance of middle ear effusions.


A randomized, double-blind, placebo controlled trial involving 84 children (6 months - 15 year olds) randomized to receive either 40mg/kg amoxicillin-clavulanate or a placebo, per day, for 7 days, indicates that antibiotic treatment significantly enhances middle ear effusion resolution (2.7 weeks vs. 4.7 weeks), decreases persistence, with concomitant improvement in hearing.


JAMA Pediatrics

Recurrence rates after Intussusception reduction.


"Reported rates of recurrence after enema reduction for Intussusception are variable".


A multi-database retrospective search found 64 studies of patients between the ages of 0 and 18 years with radiographically proven Intussusception reduced by enema, who had subsequent recurrences.


The risk of early recurrence (within 48 hours) for enema reduction for Intussusception is low (7.5%-12.7% depending on the method utilized).





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