June 17, 2015
Volume VI, Issue No. 24

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Mandatory nap times in Child Care and children's nighttime sleep.

It appears that children (2.5 to 6 years of age) who have a mandatory nap time > 60 minutes in childcare have significantly less nighttime sleep than those who experience shorter naptimes. This difference persists at 12 months follow-up, even once children are in school. Perhaps shorter naps are better?


Journal of Developmental and Behavioral Pediatrics 

Oral administration of Surfactant Protein-A (SP-A) in necrotizing enterocolitis (NEC)

"Surfactant Protein-A is an immune system collectin" - a family of collagenous Ca2 defense lectins which bind to the oligosaccharide structure and lipids on the surface of microorganisms, assisting their elimination by aggregation, compliment activation, & opsinization etc.


Animal experimental evidence suggests a role for SP-A in the prevention of infective gastrointestinal pathology in mice.


In a rat model of experimental neonatal NEC, oral administration of SP-A reduces intestinal levels of pro inflammatory cytokines and TLR4 protein (toll-like receptor which participates in the activation of the innate immune system), significantly reducing mortality and ameliorating NEC pathology.


Journal of Pediatric Gastroenterology & Nutrition 

Behavior and development in 24 month old moderately preterm toddlers.

A study to investigate cognitive and behavior problems at age 2 years of infants born at gestational age 32 weeks to 36+6 weeks gestation (uncorrected for gestational age) indicates that these infants compared to term peers exhibit poorer scores in cognition, communication and motor development plus show more internalizing behavior problems.


Archives of Disease in Childhood 



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Masculine discrepancy stress, teen dating violence and sexual violence.


"Males are affected by gender role expectations which require them to demonstrate attributes of strength toughness and dominance". Discrepancy stress is a form of stress that occurs when boys and men fail to live up to the traditional roles society expects of them. This may precipitate psychological stress which may in turn increase the risk of physical and sexual violent behavior as a means of demonstrating masculinity.


A study of 589 adolescent boys who completed a survey assessing self-perception of gender role discrepancy, stress and physical and sexual dating violence, indicates that boys who perceive themselves as "sub-masculine" are more likely to engage in sexual (but not necessarily physical) violence. Prevention should consider mechanisms to reduce "discrepancy stress" in young school boys.


Journal of Adolescent Health  


See Related Video: Teen Dating Violence 

Prophylactic antibiotic in the treatment of fingertip amputations


A prospective randomized control study of matched adult patients presenting with bone exposed fingertip amputation treated surgically, with or without intravenous antibiotic (3 days), indicates that routine antibiotic prophylaxis does NOT reduce the rate of infection after the surgical management of fingertip amputation.


American Journal of Emergency Medicine

Video Feature

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Salivary lactate dehydrogenase (LDH) levels and the diagnosis of hypoxic-ischemic encephalopathy (HIE) in neonates.


For optimal neuro protective treatment of HIE in neonates, early detection is essential.


Hypoxia-ischemia induces cell damage resulting in leakage of enzymes. High levels of plasma LDH have previously been shown to be a predictor of HIE in the first 12 hours following perinatal asphyxia.


Saliva LDH levels within 12 hours of birth following perinatal asphyxia are significantly higher in babies who subsequently develop HIE. As an early and accurate predictor of HIE, it may be useful as a triage tool.


Acta Paediatrica

Pinless Halo - Indications, safety and complications


The halo ("ring" or "crown") is a piece of equipment that encircles the head to manage a variety of conditions that destabilize the cervical spine.


The pinless halo was developed for children with a goal of providing cervical spine immobilization (similar to a standard halo with pins but without its serious complications - penetration of the pin into the skull, pin loosening, pin tract infection, cranial nerve palsies and vest-related pressure sores).


The safety of the pinless halo was examined in a retrospective review of 61 children with post-operative cervical immobilization for congenital torticollis, atlantoaxial rotatory subluxation, following cervical fusion and with occipital condyle fractures. Few have complications (21%) with improved patient compliance.


Journal of Pediatric Orthopaedics

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