Volume IV
Issue 4 

              Weekly Updates in Pediatrics         January 23, 2013

EDITOR:  Jack Wolfsdorf, MD, FAAP                   


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Acetaminophen intake & asthma symptoms


A double-blind placebo controlled study of 42 asthmatic children (and 21 healthy age-matched controls) given one oral dose of 15 mg/kg acetaminophen prior to lung function studies being performed, indicates that a single dose of the drug neither causes bronchoconstriction nor an increase in airway inflammation.


 Iron status with early complementary feedings


It appears that the addition of small amounts of complementary feedings to breast feedings, at 4 months of age (vs. exclusive breast feeding for 6 months) has a positive effect on iron status, while not affecting growth rates between 4 and 6 months of age.     


Source:  Pediatrics 

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Optimal oxygen saturation for preterm infants


Oxygen (O2) is the most commonly used therapy in neonatal nurseries and like most treatments carries significant benefits and risks. In spite of approximately 65 years of use, we are still unsure as to the optimal safe levels of oxygen saturation (O2 sat) to be utilized in the preterm, newborn infant. Even "physiological" levels may do more harm than good.


A study of 115 preterm infants given oxygen and randomized to achieve a low (85%-89%) or high (91-95%) O2 sat level until 36 weeks post-menstrual age (or breathing room air), indicates low target O2 sat preterm infants have a greater rate of intermittent hypoxic episodes, - duration decreasing and severity increasing with gestational age. The effect of this on morbidity remains unknown.


Source:  The Journal of Pediatrics 

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Higher Oxygen Levels Improve Preterm Survival
Higher Oxygen Levels Improve Preterm Survival
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C-reactive protein (CRP) as an indicator of bacterial infection in influenza patients


131 patients who presented to an ED with an influenza-like illness had nasal aspirates tested for viruses, and serum CRP levels measured. Bacterial infection was determined by a positive blood culture, x-ray evidence of pneumonia or a diagnosis of bacterial infection.


Patients presenting with an influenza-like illness and an elevated CRP, more than likely have a concomitant bacterial infection.


Source:  The American Journal of Emergency Medicine

Prenatal mercury exposure, fish intake & ADHD

An examination of the relationship between peripartum maternal hair mercury, maternal intake of fish during pregnancy and inattentive and impulsive/hyperactive behavior of their offspring at 8 yrs. of age, indicates that even low-level prenatal maternal mercury exposure is associated with a greater risk of ADHD-related behaviors. Fish consumption during pregnancy is protective of these behaviors.


Source:  JAMA Pediatrics 

The value of topical anesthesia prior to venipuncture


4% lidocaine or a placebo cream was placed with an occlusive dressing, on patients 5-18 years of age, 15 minutes prior to venipuncture and a 6-point validated FACES pain scale (plus other tests) utilized to evaluate pain experienced during venipuncture.


4% lidocaine applied to the skin 15 minutes prior to venipuncture does not appear to diminish a patient's rating of pain, anxiety or heart rate.


Source:  The American Journal of Emergency Medicine