February 19, 2014 Vol. V, Issue 8

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MCH's 49th Annual Pediatric Postgraduate Course

February 27- March 2

2014

Register today!

www.ppgcpip.com

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Accuracy of tympanic & forehead thermometers in private pediatric practice.

A study of body temperatures in 254 febrile infants using 3 different devices; rectal, infrared tympanic and forehead thermometers compared the efficacy of the latter to rectal temperatures (the "gold standard") measured.

Tympanic and forehead thermometers record lower temperatures (with wide variations) than rectal temperatures. Because tympanic thermometers are easy to use and cause little discomfort they should be used with reservations. Forehead thermometers are too inaccurate to be used in pediatric practice.

Acta Paediatrica

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How useful are "Rapid Response Systems" (Teams) (RRS).

RRS's aim to early identify and diminish on-going deteriorations in hospitalized patients.

A study of 370,504 non-intensive care patient days, indicates that utilizing a RRS improves the rates of critical deterioration, cardiac arrest and, though not statistically significant, deaths, during a ward emergency.

JAMA Pediatrics

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Growth Hormone (GH) therapy for Prader Willi Syndrome (PWS).

PWS is a genetic condition caused by a deletion on chromosome 15. Patients present with hypotonia in the neonatal period with subsequent obsessive food eating later in childhood. These children are frequently obese without control of food intake.

The main benefits of GH therapy in childhood PWS include an improved body composition (more muscle less fat), better exercise tolerance, beneficial changes in respiratory status and positive outcomes for developmental and cognitive milestones. The ideal age for starting therapy is unknown as is the optimal duration of treatment.

Archives Disease Childhood

Dual use of condoms with other contraceptives among adolescents & young women.

While only "total abstinence" from all sexual contact offers 100% protection against pregnancy and sexually transmitted diseases (STD's), a "dual protection" approach - most commonly condoms and "the pill"/or intrauterine device appears in sexually active individuals to give the best results.

A survey of sexually active 15-24 year old adolescents and young women indicates that only 20.7% use "dual methods." Factors associated with decreased use include early sexual activity, a previous pregnancy and no insurance.

Journal of Adolescent Health

Video Feature

Parenting Tips: Talking About Sex, Helping Your Sexually Active Teen Be Safe - Planned Parenthood

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"Autism" in preschoolers- stability & change over time.

The first signs of autism frequently present before the age of three years; with some clinicians being able to identify warning signs under the age of 1 year. Mostly parents first note abnormalities in social skills or delays in development at 15-18 months. Signs may be obvious or subtle.

A study of 208 preschool children with different subtypes of autism spectrum disorder (ASD) had their trajectories for persistence of ASD diagnosis, developmental/intellectual levels, adaptive functioning and expressive speech monitored over a 2 year period.

"Changes in developmental profile during preschool years are common in children with ASD." Reassessment of different developmental areas prior to schooling will lead to a more accurate ASD diagnosis and improved education.

Acta Paediatrica

Safety & efficacy of propofol administration for procedure sedation by Pediatricians.

Following a specific training protocol in propofol administration 36,516 procedural sedations were undertaken over a 12 year period and subsequently analyzed.

During procedural sedation by pediatricians 0.02% of children require "emergence team" care; 0.5% develop hypotension requiring fluid administration; 0.4% need extra oxygen; 0.2% experience laryngospasm and 0.04% have bronchospasm.

Pediatrician-administered propofol following training in its administration appears efficacious and safe.

Acta Paediatrica

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