Miami, FL
Dec. 27, 2017
Volume VIII |  Issue No. 52
  Happy Holidays!
InterContinental Miami
Practical Updates and Cutting Edge Topics for Pediatricians 
Exhibitor Opportunity 
Nicklaus Children's Hospital Annual Pediatric Postgraduate Course

Miami, FL
Feb 22-25, 2018

Arsenic in rice cereals
While it has been suggested (FDA draft: April 1, 2016) that manufacturers decrease the amount of arsenic found in rice cereals fed to babies, these apparently continue to have approximately 10 times the arsenic level of drinking water, and contain 6 times more arsenic than cereals made from barley, corn or wheat, potentially placing infants at risk for neurotoxicity.

Prenatal maternal high fructose corn syrup intake and childhood asthma
It appears from a prospective study of maternal prenatal (first and second trimester) and early childhood (1,068 mother-child pairs) intake of beverages sweetened with fructose, that higher maternal sweetened beverage intake (mean 0.6 servings per day) is associated with greater odds of higher early and mid-childhood doctor diagnosed asthma (unassociated with obesity).

Outpatient laparoscopic appendectomy for nonperforated appendicitis - outcomes
A retrospective chart review of 171 patients (<18 years of age) who underwent outpatient laparoscopic appendectomy for nonperforated appendicitis, discharged from a post anesthesia care unit (or not) indicates that it is safe, with no increase in postoperative emergency department/clinic visits, complications or readmissions. It also decreases length of hospital stay and charges!
Childhood Obesity Facts 
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Congenital Zika virus infection - outcomes at approximately 2 years of age
Although microcephaly and a unique pattern of birth defects have been described in babies born with congenital Zika virus infection, subsequent health and development has not been well categorized.

A recent report describes the growth and development outcome of 19 infants aged 19-24 months with laboratory evidence of Zika virus infection.

Zika virus adverse outcomes include microcephaly (though some head circumference growth may occur), short stature, failure to gain weight, feeding difficulties, sleeping problems, severe motor impairment, vision and hearing abnormalities, seizures and repeated episodes of pneumonia. Most infants 2 years of age function at a neurodevelopmental age of 6 months.

Video Feature
In-school physical activity (PA), academic achievement and classroom behaviors  
Pooled data from 26 studies (with >10,000 children) which examined the effect of in-school exercise programs on academic achievement and classroom behavior in children aged 4-13 years indicates that behavior, memory and cognitive function are enhanced with improvements in mathematics, language and reading.

In spite of in-school time constraints, it appears that these programs enhance a child's ability to learn while improving social skills and behavior patterns.

See related video HERE.
A psychosocial intervention to reduce aggression in clinically aggressive adolescents
A randomized controlled trial utilizing 310 juveniles (13-17 years of age) on probation with or without clinical aggression examined a 2-week psychosocial intervention (or an equally intense health promotion) program targeting factors implicated in risky behavior, using aggression measurements at baseline, 6- and 12-month follow up periods and incarceration rates.

It appears that an intense short 2-week psychosocial program aimed at reducing future aggression and incarceration results, at 1 year follow up, in significant improvement in both behavior and a decrease in the likelihood of incarceration.

Randomized trial of dexamethasone vs. prednisone for children with acute asthma exacerbations
A randomized, non-inferiority trial on 557 children (1 - 14 years of age) who presented to an Emergency Department (ED) with acute asthma compared the efficacy (asthma symptoms, unscheduled returns, admissions, adherence and vomiting at day 7) of 2 doses of dexamethasone (0.6ml/kg/dose) vs. a five-day conventional course of prednisone/prednisolone (1.5/ml/kg/day) followed by 1ml/kg/day on days 2-5).
Two doses of dexamethasone appear to be as effective as a five-day course of prednisone/prednisolone for the treatment of acute asthma exacerbation in children (with better adherence to treatment).
Journal of Pediatrics 
Meet Dr. John M. Peters, Pediatric Gastroenterologist 
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