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                Weekly Updates in Pediatrics         August 22, 2012 

EDITOR:  Jack Wolfsdorf, MD, FAAP 


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Replacing juice with fruit in the diets of children

Analysis of data from 7023 children (3-18 years of age) using information from the National Health and Nutrition Examination Survey whose fruit juice intake was completely replaced with inexpensive fresh whole fruit illustrates the potential nutritional benefits of reduced energy intake, improvement in fiber consumption at an increase in diet cost of only 54 cents/day.


Source:  JAMA

Anaphylaxis following Immunization

Between 2008-09 over 5.5 million vaccines were delivered/utilized in children < 16 years of age in the UK and Ireland.


Anaphylactic reaction is a rare adverse event, most reactions occurring more than 30 minutes after the administration of the vaccine, require intramuscular adrenalin and intravenous fluids. In the study all recovered fully.


Source:  Archives of Disease in Childhood 

Clarithromycin therapy for patients with Cystic Fibrosis (CF)

Azithromycin and Clarithromycin (like other member macrolides) appear to have similar immunomodulatory effects. Two small short term clinical studies utilizing azithromycin in CF patients failed to show any beneficial effects on lung function or on the inflammatory process.


A large International double blind, cross over trial of 63 CF patients, treated either with a placebo or oral Clarithromycin twice daily for five months did not demonstrate any beneficial effect of the drug.


Source: Pediatric Pulmonology 

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Treatment of olanzapine (ZYPREXA) overdose 


ZYPREXA is an atypical antipsychotic drug of the thienobenzodiazine class (similar structurally to clozapine) which is increasingly being used (with or without lithium or valproate) in the treatment of bipolar disorders/schizophrenia. Clinical signs and symptoms of toxicity include hyperpyrexia, CNS depression/seizures/agitation/somnolence, blurred vision mydriasis, respiratory depression, extra pyramidal effects, tachycardia/hypotension and death.


There is no specific antidote to ZYPREXA however treatment includes early administration of activated charcoal and supportive therapy.


It appears that the management of ZYPREXA overdosing is improved with the administration of an IV infusion of a 20% emulsion of lipids.


Source: The American Journal of Emergency Medicine

Video Feature

Caution on Zyprexa in Adolescents 
Caution on Zyprexa in Adolescents

Source: FDA Logo via You Tube 

Breast milk from "breast" or "bottle"?


It appears that there is a link between infant weight gain and later obesity. While it is clear that breast fed and formula-fed infants have different patterns of growth, breast fed infants and infants fed breast milk from a bottle also have differences in weight gain.


Bottle-breast milk fed babies appear to consume more milk than those breast fed. Breast feeding rather than breast milk appears to protect against later obesity.

Source:  JAMA 

Television and eating behavior in school-age children TV


For US adolescents adjusted for socioeconomic variables, the longer the time students in grades 5-10 view television, the less fruits and vegetables, and the greater the amount of candy and fast food consumed


Source:  JAMA  

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