February 25, 2015   Vol. VI, Issue 8
For optimal functionality we recommend you VIEW this newsletter as a web page. 


Novel risk factors for recurrent clostridium difficile infections (rCDI) in children. 

As rate and risk factors for rCDI in children have not been established, a retrospective cohort study of 186 pediatric patients seen with primary C. difficile infection, examined the rate of recurrent disease (defined as a return of symptoms and positive testing < 60 days after completion of therapy) over a 5 year period.


22% of children with C. difficile experience recurrences. Malignancy, recent hospitalization, hospital-acquired disease, recent surgery, antibiotic and number of antibiotics used, & acid blocker and/or immunosuppressant use are all associated with rCDI.


Journal of Pediatric Gastroenterology and Nutrition 

Wheezing is common in children with Sickle Cell Disease (SCD). 

Children with SCD may wheeze without being asthmatic.  A review study of 163 children with SCD and matched normal controls (mean 8.5 years) indicates that SCD patients with and without upper respiratory tract infection report wheezing more frequently.  SCD children wheeze approximately 10 times more frequently than normal children of a similar age.


Journal of Hematology/Oncology 

Henoch-Sch´┐Żnlein purpura (HSP) nephritis. 

"HSP is one of the most common types of systemic vasculitis in childhood. Glomerulonephritis (HSPN) occurs in 30-50% of HSP patients, mostly in a mild form. A small percentage of patients however will present with nephrotic syndrome or renal failure".


HSPN is caused by IgA-containing immune complexes activated through the complement system being deposited in the mesangium, the subepithelial and the subendothelial spaces which results in mesangial proliferation and renal damage/chronic renal disease/renal failure.


Long term renal outcome correlates with the severity of the initial clinical presentation (and renal biopsy changes).


No evidence-based treatment options for severe HSPN appear to be available (resulting in a wide variety of therapeutic regimens being utilized).


Pediatric Nephrology 



Download, print and pin this information on your office wall.


-This is a "Must Have" (Ed.) 

Contact the Editor


Visit Us on the Web


Minimal enteral nutrition during neonatal hypothermia treatment for perinatal hypoxic-ischemic (HI) encephalopathy (HIE).


A number of trials have demonstrated the neurodevelopmental benefits of therapeutic hypothermia in moderate to severe neonatal HIE.


Perinatal hypoxic ischemia also results in decreased perfusion to the gastrointestinal tract (GIT) which may lead to decreased motility and feeding intolerance. It appears that hypothermic treatment of HIE may also benefit GIT function.


A retrospective cohort study comparing early enteral feeds (23.6 hours) vs. delayed enteral feeding (100 hours) in 51 and 34 HIE neonates receiving therapeutic hypothermia indicates that both result in similar time-to-full enteral feeds (6 days), and that early enteral feeding during hypothermia is both feasible & essentially complication free.


Acta Paediatrica 

Vertical 2-thumb technique (VTT) vs. 2-thumb thoracic encircling technique (VTE) for infant cardiopulmonary resuscitation (CPR).


A prospective randomized crossover simulation study of infant CPR indicates that VTT generates significantly higher pressures that VTE and may be an effective alternative compression method in infant CPR ("& useful for rescuers with small hands or a weak grip").


Acta Paediatrica 

Video Feature 

(via YouTube)

Infant CPR (Ages Newborn to 1 Year)
Infant CPR (Ages Newborn to 1 Year)

Pediatric cerebral sinovenous thrombosis (CSVT) - Findings of the International Pediatric Stroke Study.


An analysis of 170 children with CSVT from 10 countries over 4.5 years indicates:

  • 50% are male (median age 7.2 years).
  • Headache, altered consciousness, focal deficits and seizures are common presenting features.
  • 31% have intra-cranial hemorrhage and 37% infarction.
  • Risk factors include:

a)   Chronic Disease (50%).

b)   Acute systemic or head/neck disorders (41%).

c)   Prothrombotic states (20%).

d)   Other hematological abnormalities (19%).

  • 48% are neurological normal at discharge.
  • Mortality is low (4%) and associated with a decreased level of consciousness at presentation and an identified prothrombotic state.
 Archives of Disease in Childhood

Adolescents' media exposure and cyberbullying.


A longitudinal study design of 1,005 adolescent boys and girls 11-17 years in 3 waves examined the effect of

Dealing with Cyberbullying
Dealing with Cyberbullying

adolescent exposure to media portraying antisocial and risk behavior content on cyberbullying, over time.


Higher exposure to media with antisocial and risk behavior content significantly contributes and amplifies initial rates of cyberbullying in both boys and girls.


Journal of Adolescent Health 

PPGC 2015
Updates in Pediatrics is brought to you by:

Miami Children's Hospital Logo  

Underwriting Opportunities

With a circulation over 5,000, Updates in Pediatrics offers an excellent opportunity to promote your brand at affordable rates.


Contact AD DEPT to
learn more.