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Volume IV
Issue 12

              Weekly Updates in Pediatrics         March 20, 2013

EDITOR:  Jack Wolfsdorf, MD, FAAP                   

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Erythropoietin (EPO) treatment to prevent red blood transfusions (RBC) in the premature infant

A retrospective review of data from multiple journals indicates that the administration of EPO to premature and/or very low birth weight infants, within the first 8 days of life, significantly reduces the number of RBC transfusions, the amount of blood given (ml/kg) and the number of transfusions per infant. Neither morbidity nor mortality is affected, however there appears to be a significant increase in the risk of stage > 3 retinopathy of prematurity.


Source: Neonatology

Comparison of 2- view abdominal x-rays (AXR) with ultrasound (US) in children with suspected Intussusception

AXR and US are both frequently used in the diagnosis of suspected intussusception as the clinical presentation is often variable.


286 children, 3 months-3 years of age who presented to a Pediatric Emergency department for suspected Intussusception and who had both 2-view AXR and US performed, indicates that ultra sound is superior to AXR as a screening tool to diagnose and exclude Intussusception.


Source: Pediatric Emergency Care 

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Inhaled Nitric oxide (iNO) for the treatment of Hypoxic respiratory failure in the preterm infant


A retrospective analysis from data published in a variety of sources indicates that iNO given to preterm infants (in the first 3 days of life, routinely in preterm babies with lung disease, or enrolled in studies to prevent bronchopulmonary dysplasia) appears to have no beneficial, or significant deleterious effect.


Source:  Neonatology 

Prevention of childhood caries 


A study of 622 infants recruited at birth and randomly assigned to one of 2 groups of treatment protocols (plus a control group) and examined at 6, 12, 18, and 24 months of age indicates that a teeth brushing regimen with 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP/Recaldent - a milk derived product that strengthens and remineralizes teeth) or a chlorhexidine gel does not control early childhood caries nor reduce mutans streptococci colonization. 


Source:  Pediatric Dentistry 

Video Feature
Preventing Early Childhood Caries (In English)
Preventing Early Childhood Caries (In English)

Dr. David Zamora via YouTube

Accuracy of Galinstan (GT) vs. mercury or digital thermometers

Galinstan (Gallium Indium Stannum) is a mixture of alloys that is liquid at room temperature, has a low toxicity and is used instead of mercury in thermometer.


A retrospective study utilizing 284 children (1 month-17 years) whose body temperature was measured sequentially (in the right axilla) and randomly, using either GT, MT or DT thermometers, indicates that both GT and DT have good specificity compared to MT. GT has a higher sensitivity and fewer false negatives.


The Galinstan thermometer appears to be the most accurate measurer of body temperature.


Source:  Pediatric Emergency Care 

Continuous high dose nebulized albuterol (CNA) for the ED treatment of acute asthma


Charts of patients 2-21 years of age presenting to an ED with acute asthma, were retrospectively examined before and after the implementation of a CNA protocol.


CNA treatment while safe, does not appear to be superior, takes longer and costs more than a traditional ED treatment approach for acute asthma.


Source: Pediatric Emergency Care 

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