MCH Updates in Pediatrics Masthead  

                       Volume IV
                        Issue 24
                                                           South Florida's  only licensed  free-standing
                                                             specialty hospital  exclusively for children ...                                                      June 12,  2013 
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Spina bifida and self-and-societal related quality of life health-outcomes (HR-QoL)

Forty youths (mean age 16 years) and 13 young adults (mean age 26.6 years) were administered a "self-rated" health and two "generic" measures of HR-QoL.

65% of youth with spina bifida rate their health as either excellent or very good compared to only 23% of young adults. The studies utilizing societal measures of quality of life were significantly less favorable.

 

Patients with spina bifida appear to view their own HR-QoL significantly better that those measures which reflect society's view on outcomes.

 

Journal of Pediatrics

Maternal preeclampsea and adolescent weight

It appears that maternal preeclampsea predisposes the premature infant (adjusting for cofounders) to significant increased risk of obesity as adolescents (14 years of age). Boys and girls are equally affected.

 

Journal of Pediatrics 

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Early intensive behavioral intervention (EIBI) in the management of young children with autism

 

Adaptive behavior, I.Q., three measures of language skills and communication, socialization and 20 daily living skills all appear to be significantly improved (compared to a treatment-as-usual similar group) following an EIBI program. EIBI programs enhance the long term functional ability of young autistic children.

 

Journal of Pediatrics 

Video Feature
Postnatal Surgery for Spina Bifida - CHOP (9 of 12)
Postnatal Surgery for Spina Bifida - CHOP (9 of 12)
via YouTube

Irritable Bowel Disease (IBD) and early antibiotic administration  

 

It appears that exposure throughout childhood to anti-anaerobic antibiotics increases the likelihood of subsequent development of IBD, particularly if two courses are administered early (within the first 12 months of life). This increased effect can be demonstrated to 15 years of age.

 

Journal of Pediatrics

Waning effect of pertussis!  

 

DTaP vaccine is usually administered in 5 doses at 2 months, 4 months, 6 months, 15-18 months and 4-6 years, respectively.

 

A case study of the DTaP PCR status of 277 PCR-positive children, 4-12 years of age which compared their protection (to 3318 PCR-negative controls) against pertussis, during a five year period following the fifth dose of DTaP, was undertaken.

 

DTaP vaccination is short-lasting: After the fifth dose the odds of acquiring pertussis increases by approximately 42% per year.

Body postural control and brachial plexus injury (BPI)


"The brachial plexus is a network of nerves which run from the cervical spinal cord thorough the muscles of the upper limbs". These nerves (C5-T1) may be stretched, compressed or torn during vaginal delivery, and the injury may involve all or part of the plexus. This may result in varying degrees of loss of muscle function to paralysis (as well as sensory impairment) of the affected arm.

 

Postural control is the ability to control movement against gravity and deficits result in asymmetries of posture and/or atypical movement to maintain balance, mobility and reach.

 

A study of 32 children initially evaluated at 2.3 years with varying degrees of BPI and followed for 3.3 years (mean) indicates that though 84% have improved upper extremity motor activity, 58% have contractures, smaller hands (28%) and scoliosis (3%). Postural control deficits are present in 97% of children following BPI, independent of the level of nerve injury.

 

Journal of Pediatrics