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Obstructive sleep apnea (OSA) & adenotonsillectomy (TA)
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It appears that as many as 1%-4% of children between the ages of 2 and 8 years suffer from sleep apnea.
Surgical removal of the adenoids and tonsils is the most common treatment for OSA. While it has previously been suggested that TA will completely eliminate OSA in 70%-90% of the children, its usefulness in reducing symptoms, and improving cognitive behavior, quality of life and polysomnographic findings have not been vigorously evaluated.
A prospective randomized trial of 464 children 5-9 years of age with OAS which evaluated TA benefits vs. a strategy of "watchful waiting", indicates that surgical treatment of OAS in school age children does not significantly benefit attention or executive function but does improve symptoms, quality of life and polysomnographic findings.
New England Journal of Medicine
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Erythropoietin for anemia of prematurity- IV or subcutaneous?
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Erythropoiesis decreases after birth as a result of decreased production associated with increased tissue oxygenation. Preterm infants are born with a somewhat lower hematocrit, the nadir of which occurs early and is more severe than the anemia associated with the term baby.
A study of 100 infants weighing <1500gms and <32 weeks gestation randomly assigned to receive (at 72 hours of life) erythropoietin either subcutaneously or added to IV fluids, indicates no differences in blood transfusion requirements, nor reticulocyte count transferrin saturation or ferritin levels. Adverse incidents are similar.
Acta Paediatrica
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