HealthFusion June 2014 B  

September 17, 2014   Vol. V, Issue 38
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The effects of medical marijuana legislation on its use in adolescents. 

Medical marijuana use has been legalized in many USA States which has raised concerns about increased accessibility and appeal to adolescents and young adults.


A data study of 11,703,100 students from the Youth Risk Behavioral Surveillance Survey, from 1991 to 2011, where information was available before and after the implementation of the law, indicates that "past-month Marijauna use" remains at approximately 21%, independent of whether legalization of medical marijuana legislation has occurred, or not.


(It is worth remembering however, that while both alcohol and marijuana use impairs judgment, more students (College) will drive after using marijuana than after alcohol intake).


Journal of Adolescent Health 


JAMA Pediatrics 

Sexual behavior & risk for sexually transmitted infections (STI's) among teenage boys who have sex with men (MSM).

A report on 200 young (median age 19 years - age at first anal intercourse, 17 years) MSM indicates that half have intercourse with older men, most use condoms inconsistently with approximately 3 partners per year, and pharyngeal and rectal gonorrhea, urethral and rectal chlamydia and syphilis may be detected in 2%-5-5% of them. Preventive messages and STI screening need to be addressed in this vulnerable group of young teenage men.


Journal of Adolescent Health 

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When I dream, I am ageless. 

-Elizabeth Coatsworth  


Down's syndrome & treatable associated disorders.


Down syndrome is associated with a number of treatable disorders, not infrequently undiagnosed. While hypothyroidism is perhaps the most common autoimmune disease seen (hyperthyroidism also occurs ) these patients appear in general to have an increased prevalence for other autoimmune diseases affecting both endocrine and nonendocrine organs. In adult Down's patients, hyperuricemia frequently occurs.


A study of 52 Down's syndrome children (aged 1-15 years) was undertaken with age-matched controls to assess blood uric acid levels ( & correlated with dietary records). Results indicate that approximately 33% of Down's syndrome children are hyperuricemic, independent of body mass index or purine intake.


Acta Paediatrica 

Ear drainage in the preterm infant.


Ear drainage associated with viral or bacterial infections occurs fairly infrequently in the premature neonate.


An interesting description of the sudden onset of spontaneous ear drainage in 22 intubated (nasotracheal/nasogastric) infants, in a NICU (unassociated with any increase in nosocomial infections, equipment or infection control procedures) attributed (after much investigation) it to the use of a commercial adhesive remover. This reminds us of the dangers of using off-label medications, particularly in the preterm infant.  


Acta Paediatrica 

Video Features
CHKD Pectus Carinatum - Bracing Video
CHKD Pectus Carinatum - Bracing Video
Both videos via YouTube
Groundbreaking surgery for pectus carinatum at CHKD
Groundbreaking surgery for pectus carinatum at CHKD

Etiology of Pectus Carinatum (PC - "Pigeon Chest") 


Pectus carinatum is the forward protrusion of the sternum. It may occur as a solitary congenital abnormality; in association with other genetic disorders (e.g. Turner, Marfan and/or Morquio syndromes, etc.) or infrequently post-open heart surgery. Most commonly it appears to occur in 11-14 year old pubertal males.


A study of 26 patients with symmetrical PC (and their matched normal controls), where the length of the fourth, fifth and sixth rib & rib cartilages were measured, indicates that patients with PC have longer lengths of costal cartilage and shorter ribs than normal. This suggests that overgrowth of cartilage may not be the only factor in the causation of PC.


Journal of Pediatric Surgery

Laparotomy outcomes for critically I'll neonates requiring NICU surgery for necrotising enterocolitis (NEC).


A retrospective study over a 10 year period of 221 critically ill infants with NEC referred for surgical intervention indicates that 82% undergo surgery with 8% requiring laparotomy in the NICU due to instability.


67% of critically ill neonates with NEC too unstable to be transferred to a surgical theater die within 6.5 hours of laparotomy, with a further 13% dying prior to discharge.


Journal of Pediatric Surgery 



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