Weekly Updates in Pediatrics         September 12, 2012 

EDITOR:  Jack Wolfsdorf, MD, FAAP 


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Hepcidin/Ferritin/Ferritin to iron ratio (FIR), in infection

Hepcidin (a 25 amino-acid peptide) is a hormone produced by the liver. It appears to be a major regulator of iron homeostasis and has antifungal and probably some antibacteria activity.


Ferritin is an intra cellular protein that stores and releases iron as required. Its concentration increases dramatically during infection in order to block infective agents' attempt to bind iron from the host's tissues.


A study of 69 children (and matched controls) who were investigated for bacterial and/or viral infections, indicates that hepcidin, ferritin and ferritin to iron ratios are all higher in febrile children.


Patients with bacterial infections have higher ferritin to iron ratios than those infected with a virus. FIR may be a useful (and inexpensive) test for bacterial infection.


Source: The Pediatric Infectious Disease Journal

Early dental interventions in pediatrics

The American Academy of Dentistry's Policy (AAPD) on the Dental Home is derived from the AAP definition of Medical Home. The dental home includes all aspects of dental health of the patient. each child should have a dental home by 12 months of age and all persons involved need to provide their full range of oral care, including information on prevention, diagnosis and treatment of all potential oral issues.

Baby Teeth Care  

554 AAPD members responded to a survey assessing their beliefs and practices regarding the age 1 dental visit and prenatal counseling.


It appears that 90% of dentists perform age 1 dental evaluations, however only 15% provide prenatal dental counsel.


Source: Pediatric Dentistry

Effects of Hypothermia on CFS markers (NSE and S-100) following neonatal hypoxic-ischemic injury (HIE)


Neuron specific enolase (NSE) (enolase 2 or Gamma-enolase) is an enzyme (103 isoenzymes) found in mature neurons and the cells of neuronal origin. S-100 protein is a family of low molecular weight proteins normally found in cells derived from the neural crest (e.g. Schwann cells, dendritic cells, etc.) that are implicated in a variety of cellular processes. They are also markers for inflammatory diseases.   


51 neonates with HIE were divided into 2 groups; 23 receiving hypothermia and a control group. CSF NSE and S-100 levels were measured in both groups, compared, and related to Neurodevelopmental assessment performance at 3 and 12 months of age.   


HIE babies treated with hypothermia have reduced CSF levels of NSE and S-100, and these correlate with a better Neurodevelopmental outcome.

Source: Acta Paediatrica

Video Feature

Hypoxic Ischemic Encephalopathy Hypothermic Treatment
Hypoxic Ischemic Encephalopathy Hypothermic Treatment

Source:   devoschildrens via You Tube 

Childhood TV exposure and self-esteem (SE)

A large study utilizing 70,210 Hong Kong students (USA grade 4) evaluated the relationship between TV time per day and youthful self-esteem. Multivariate analysis analyzed a variety of confounding factors. 45.3% of children watched TV for 1-2 hours per day, with approximately 11% watching more than 4 hours per day.


Children who watched TV for more than 2 hours per day have lower SE score in all measured subscales. In General, Social and Parent-Related subscales children who watched TV for 1-2 hours per day (moderate exposure) have higher SE score than those who watched for a lesser time period, but have lower score in the academic subscale.


Source:  Journal of Developmental & Behavioral Pediatrics 

Nephrotic Syndrome - potential new approach to treatment


Nephrotic Syndrome is a disorder of the glomerular filtration barrier. Molecular genetics has revealed the podocyte as the central abnormality in controlling glomerular filtration. Recent evidence suggests that the slit diaphragm, the cell-cell junction between podocyte foot processors is controlled by key genes and is the specific site of the abnormality.


Genetic causes of nephrotic syndrome can now be diagnosed at any age of presentation. This opens the door to further understating of the acquired nephrotic syndrome.


Source:  Pediatric Nephrology  

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