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                Weekly Updates in Pediatrics         August 29, 2012 

EDITOR:  Jack Wolfsdorf, MD, FAAP 


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 Poor sensitivity of muscularskeletal (MSK) history in children

A perspective consecutive study of 28 children's (3-18 years: median 12 years) MSK history and joint involvement on examination, seen at a Rheumatology clinic, was compared to comparable group at an acute pediatric unit.


MSK history fails to identify a large number of abnormal joints detected on physical examination.


Source: Archives of Disease in Childhood

Which infant following an Apparent Life-Threatening Event (ALTE) can be discharged home from an ED

It appears that infants who present to an ED with a history of an ALTE who have been born prematurely, have an abnormal result on physical examination, have a color change to synosis, with no symptoms of an upper respiratory tract infection or "choking" episode, are at risk for acquiring significant intervention warranting hospital admission.


Theory of Mind (ToM) in Anorexia Nervosa (AN)

"Theory of Mind is the ability to attribute mental states-beliefs, intense, desires, knowledge, etc. to oneself and others" and to understand that others may have different beliefs, etc.


19 AN adolescent patients (and matched controls) were investigated using brain functioning magnetic resonance imaging during a ToM small task in admission to hospital and at discharge after weight gain. Clinical outcomes were assessed 1 year after admission.


AN patients exhibit hypoactivation in the brain network supporting ToM which may be due to a genetically mediated social-cognitive impairment. Unchanged hypoactivation of these areas at 1 year after admission is predictable of poor outcome.


Source:  JAACAP

Feeding toddlers


To ensure a child achieves a healthy weight, toddler feeding should focus on:

  1. Eating from 4 basic food groups each day
  2. A variety of foods presented with unconcern regarding whether all foods are liked or finished
  3. The provision of healthy snacks
  4. The family eating together
  5. Ignoring the "picky eater"
  6. The encouragement of physical play and activity

Source: JAMA

Video Feature

Feeding Babies & Children : How to Feed a Toddler Healthy Snacks 
Feeding Babies & Children : How to Feed a Toddler Healthy Snacks

Source:  eHow via You Tube 

Accuracy of automated Blood Pressure (BP) measurements


Few studies have adequately compared carefully obtained auscultatorily determined BP to that achieved with automated oscillometric devices.


In a careful comparative study it appears that automated BP devices may provide readings 9mm (mean) higher than those achieved by standard auscultatory BP measurements. Using automated devices, children may potentially be erroneously labeled as "pre-hypertensive".


Source:  The Journal of Pediatrics 

Recovering from early emotional/psychological deprivation


Children raised in institutions from shortly after birth are at risk for developing symptoms of psychopathology.  


A study of institutional children at 54 mths of age which examines the role of the quality of care-giving at 30 mths of age, indicates that high-quality care with its concomitant sense of security of attachment, reduces psychopathology and function impairmen


Source:  Journal of the American Academy of Child & Adolescent Psychiatry  

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