March 4, 2015   Vol. VI, Issue 9
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Comparison of Child-Parent and Parent-only cognitive behavioral therapy (CBT) programs for anxious children aged 5-7 years.

"Childhood anxiety disorders (AD) are prevalent debilitating disorders".


A prospective, repeated measures, longitudinal study of 77 children (mean gage 6.8 Years) with AD, and their parents, examined in a 12-week Child-Parent or Parent-only CBT program changes in AD severity and global functioning during 5 time periods from baseline assessment.


Both Child-Parent and Parent-only CBT improves AD severity and global functioning; significantly greater improvements however are noted for the Child-Parent vs. Parent-only treatment groups.


Journal of American Academy of Child & Adolescent Psychiatry 

Outcomes of "long-arm-casting" vs. "double-sugar tong" splinting of acute pediatric distal forearm fractures.

Long and short arm casts are circumferential immobilizers, while splints are non-circumferential immobilizers that can accommodate swelling.


Traditionally long or short arm casts have been used to treat (after closed reduction) distal radius and distal both bone forearm fractures.


"Sugar-tong" splints are long and U-shaped (like tongs to pick up sugar cubes) and are used to stabilize injuries of the forearm and wrist by preventing forearm rotation and wrist motion.


A study evaluating 71 children (average age 8.7. years) for maintenance of reduction of distal forearm fractures using "long-arm casts" vs. a matched group treated with the "double-sugar-tong-splint" indicates that though the "long arm cast" group has an increased risk of loss of reduction, at cast removal both appear comparable in maintaining the fractured arm's reduction.


Journal of Pediatric Orthopaedics 



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Polyethylene glycol (PEG) 4,000 for the treatment of Functional constipation in children.


Functional constipation (or chronic idiopathic constipation) is constipation without a physical or physiological etiology (defined by Rome III criteria) and is characterized by infrequent painful defecation, fecal incontinence and abdominal pain. PEG plus electrolytes appears to be the primary choice of treatment.


A study of 90 children (mean age 3.7 years) with a diagnosis of Functional constipation treated with either a high (0.7g/kg) or low dose (0.3g/kg) of PEG 4,000 for 6 weeks, indicates that both work equally successfully, however the lower dose has a greater risk of painful defecation, fewer stools per week and less parental satisfaction. Adverse events are similar.


Journal Pediatric Gastroenterology and Nutrition 

Video Feature 

(via YouTube)
An Introduction to Childhood Constipation
An Introduction to Childhood Constipation
Trends in infant bedding use. 


The use of potentially hazardous bedding (e.g. pillows, quilts, comforters and loose bedding) appears to be a modifiable risk factor related to sudden infant death syndrome and unintentional sleep-related suffocation.


Analysis of the National Infant Sleep Position Study between 1993-2010 indicates that though bedding use has declined over time it still remains wide spread, particularly for teen-aged, non-college educated and non-white mothers, infants who sleep in adult beds, and/or on their sides. "Bedding use for infant sleep remains common despite recommendations against this practice".



Silent celiac disease in children with type I diabetes.

Celiac Disease in Children
Celiac Disease in Children

It appears from a small study that a significant number of children with type I diabetes (and their siblings) may have silent celiac disease (diagnosed by the presence of anti-tissue transglutaminase (anti-tTg) and small intestinal biopsy) without gastrointestinal symptoms.


Acta Paediatrica 

Efficacy and safety of umbilical cord milking (UCM) at birth.


Delaying the clamping of the umbilical cord for 180 seconds in preterm infants appears to decrease the need for transfusions for anemia, diminish the risk of intraventricular hemorrhage and lowers the risk for the subsequent development of necrotizing enterocolitis.


A systematic review of multiple databases examined the efficacy and safety of UCM in full term and preterm infants.


It appears that in infants of <33 weeks gestational age, UCM increases initial (and at 6 weeks of life) levels of hemoglobin, reduces the risk for oxygen requirement and for all grades of intraventricular hemorrhage, without significant short-term adverse effects.


JAMA Pedaitrics 

Occult bacteremia in well-appearing febrile infants following the introduction of 13-valent pneumococcal conjugated vaccine


Of 591 febrile, otherwise well-appearing immunized children aged 3 months - 36 months who present to a pediatric emergency department only 1% have a true bacteremia, with an elevated band count being the best predictor. Close follow-up of these infants rather than extensive blood studies may be more appropriate.


Acta Paeditrica

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