December 31, 2014   Vol. V, Issue 53
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Comparison of intravenous (IV) magnesium sulphate (MgSO4), terbutaline & aminophylline for children with severe acute asthma. 

A study of 100 children (1-12 years of age) with acute severe asthma who responded poorly to initial standard treatment, who were randomized to receive a single-dose treatment of either IV MgSO4, terbutaline of aminophylline, had treatment outcomes assessed one hour later, using a clinical severity score. 


Intravenous MgSO4 added to inhaled beta2-agonists and corticosteroids appears more effective and safer than using either IV terbutaline or aminophylline in the treatment of children with poorly responding acute severe asthma.


Acta Paediatrica 

Longitudinal association between teen sexting & sexual intercourse.

A six year longitudinal study of 964 ethnically diverse adolescents (mean age 16.09 years) examined the temporal frequency/ relationship (over 1 year) of sexting and sexual intercourse. Data indicates that sexting (sending nude pictures) increases the likelihood of being sexually active in the following year by approximately 30%. Active sexting mediates future sexual activity.



Folic acid supplements during pregnancy & child psychomotor development after 1yr of age.  

"Folate intake during pregnancy has been associated with improved neuropsychological development in children although the effects of high dosages of FA supplements are unclear".

A study of 2,213 children with complete information on neuropsychological development and maternal FA intake during pregnancy indicates that 25.2% of women take >1,000 micro μg/d of FA supplements (recommended dose 400-1,000 μg/d) and 3.5% consume >5,000 μg/d.


Infants of mothers who ingest >5,000 μg/d FA have significantly lower mental psychomotor scores after the first year of life.  

JAMA Pediatrics 



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Diagnosis & management of recurrent respiratory papillomatosis (RRP).


RRP is the most common neoplasm of the larynx (though fairly rare), and is the second most common cause of chronic childhood hoarseness. Frequently undiagnosed, it is slowly progressive until respiratory distress from airway obstruction occurs. Extralaryngeal spread includes the mouth, trachea and bronchi.


Diagnosis of RRP is best made by flexible fiberoptic nasopharyngolaryngoscopy and severity is assessed using the "Derkay-Coltrera" staging and severity grading system. While no cure exists, surgery utilizing the CO2 laser or endoscopic microdebreder allows for precision removal, with minimal bleeding or residual scarring. Approximately 20% of patients require adjunct medical treatment. RRP remains a challenging disease to manage. Vaccination offers hope for the future.


Pediatric Infectious Disease Journal 

Plasma amino acids & urinary organic acids in the diagnosis of mitochondrial diseases (MD) in childhood. 


Mitochondrial diseases are a heterogeneous group of inherited (mostly) disorders (about 1:2,000) presenting as progressive acute or chronic illnesses, at birth or developing later into adulthood.  


Their clinical presentations and severity varies widely from individual to individual (and may differ within families) but generally presents with debilitating physical, developmental and mental symptoms; gastrointestinal issues, learning disabilities, etc. and organ failure. There is no cure.  


As there are no diagnostic screening tests or biomarkers for MD, a study of 20 patients with symptoms and signs suggestive of MD was undertaken, examining quantitatively plasma amino acids, urinary organic acids and neuroimaging.


Elevated serum alanine (with perhaps increases in glycine and proline) plus increases in serum and urinary lactate levels may help in the diagnosis of MD. MRI of the brain is frequently unhelpful.


Pediatric Neurology

Video Feature (via YouTube)

Diagnosing and Treating Mitochondrial Diseases - Akron Children's Hospital video
Diagnosing and Treating Mitochondrial Diseases -Akron Children's Hospital

Tracking Cystic Fibrosis (CF) progression with CT & respiratory symptoms.


"CF lung disease is characterized by bronchiectasis and trapped air on chest computed tomography (CT)"


A study of 40 CF patients (ages 6-17 years) evaluated by chest CT and a clinical scoring system examined the correlation between CT and clinical condition initially and documented changes over a 2 year period.


Initially (at median age 12.6 years) chest CT and clinical severity scores correlate well in CF patients; two years later chest CT demonstrates significant worsening of bronchiectasis without apparent changes in clinical symptomatology.


Pediatric Pulmonology

Parental desensitization to violence & sex in movies-effects on children.


A national USA study was undertaken of 1,000 parents with at least one child in one of three age groups (6-17 years) in which parents were shown random sequences of short scenes with either violence or sexual content from popular movies. They were subsequently questioned on minimum  

TV and Movie Violence - Does it Effect Our Children?
Video Feature:
TV and Movie Violence

age at which they would allow a child to view the material.


Parents become desensitized to both violence and sex in movies which results in children being exposed to both at younger and younger ages, over time.


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