Updates in Pediatrics from Miami Children's Hospital

Weekly Updates in Pediatrics July 25, 2012

EDITOR: Jack Wolfsdorf, MD, FAAP

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Acetaminophen use for symptoms of chickenpox

An article in the Health Guide of the New York Times (7/7/12) states that acetaminophen can be used to alleviate the symptoms of chickenpox in children.

There is no evidence that acetaminophen given 3 times a day for 4 days alleviates the itching or scabbing time in children with chickenpox. It may possibly prolong the illness.

Source: The Journal of Pediatrics

Does serum Vitamin D level affect symptoms of depression in adolescent children

A study of the relationship between depression and vitamin D was undertakes on 54 Swedish depressed adolescent. Subjects with vitamin D deficiency were given vitamin D over a three month period and "well-being" / "depressive" symptoms evaluated and compared to serum vitamin D levels prior to and after treatment.

Elevation of Vitamin D levels in deficient depressed adolescent improves "well-being" and reduces depressed feelings, irritability, tiredness, mood swings and sleep difficulties.

Source: Acta Paediatrica

Adverse events during Pediatric Dental anesthesia

Malpractice claims databases of 2 professional liability carriers were searched for all claims closed involving dental anesthesia in pediatric dental patients from 2003-07.

17 claims associated with adverse anesthesia events were noted, most associated with sedation. Half of the claims involved patient death or permanent brain damage and most occurred in a dental office.

Patients < 3 years of age are at greater risk for adverse events during sedation in a dental office. Monitoring appears inadequate.

Source: Ingenta Connect

The lower extremity in Morquio Syndrome (MPS-IV A)

Morquio Syndrome (or mucopolysaccharidosis IV) is a relatively rare autosomal recessive, usually inherited, mucopolysaccaride storage disease which involves the accumulation of keratin sulfate. While appearing normal at birth, they frequently present with spinal deformities, limb abnormalities and short stature (plus other abnormalities) at 2-3 years of age.

A retrospective chart and x ray review of 23 MPA-IV A children who presented at 6.8 years and who were followed for 6.7 years, found progressive hip subluxation, genu valgum and ankle valgus in all patients. On average, each patient required eight operative procedures.

Source: Journal of Pediatric Orthopaedics

Video Feature

Fast food restaurant TV ads target kids

Source: Diabetes Dialog via You Tube

Efficacy of "Bag" vs. "Catheter" collected urine for suspected urinary tract infection (UTI)

192 non-toilet trained children less than 3 years of age, all of whom were suspected of having a UTI following a positive urine culture obtained from a urine "bag", had bladder catheter urine obtained and the specimens compared.

7.5% of "bag" obtained specimens had a false positive result and 29% of them with negative results, were falsely negative. Overall, "bag" obtained urine specimens were inaccurate in 40% of cases.

Every "Bag" -obtained positive urine culture should be confirmed by a more reliable method.

Source: The Journal of Pediatrics

Can specific sucking and swallowing exercises accelerate independent feeding in VLBW infants?

Sucking exercises (on a pacifier) do not improve time to full oral feeding in VLBW infants, while swallowing exercises consisting of placing a milk bolus (0.05-0.2ml) on the posterior part of the tongue, do.

Source: Acta Paediatrica

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