Feb. 22, 2017
Volume VIII |  Issue No. 8

Preschool children hospitalized for acute rhinosinusitis - orbital complications
Sinusitis in children may be acute, sub-acute, chronic or recurrent and may occur following an upper respiratory tract infection-"the common cold"; allergies and many other conditions which may increase secretions and block sinus drainage.

A population-based, retrospective, observational study of the hospital records of 213 children (<5 years of age) with a diagnosis of acute sinusitis and related complications indicates that most present with orbital complications; 80% present with preseptal cellulitis (infection of the eyelid and periorbital soft tissues), 3% with postseptal cellulitis (cellulitis of the skin surrounding the eye) and that boys (particularly <2 years of age) are more likely to be affected than girls (1.5 times).

Streptococcus pneumoniae is the most common bacterial organism found.

Preterm infant feeding
Premature babies are typically fed three-hourly via an oral or nasogastric tube inserted into the stomach.

A trial of 55 premature infants <33 weeks gestation randomly fed orally following feeding cues every three or six hours, evaluated and compared time to full oral feed, respiratory and apnea rates, growth and length of hospital stay.

It appears (from a relatively small trial) that feeding preterm infants every six hours (compared to three-hourly feedings) does not alter time to full oral feedings nor change any of the other outcomes.

Active commuting to school and academic achievement
Physical activity for children has numerous benefits. A study of 2138 primary and secondary school children utilized a self-reporting questionnaire to assess how students traveled to and from school and examined their final school grades.

Primary school children achieve better grades in school if transported; Secondary school academic achievement appears unrelated to mode of travel.

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Congenital heart disease (CHD), brain white matter volume and language development

A study of 48 infants with repaired biventricular congenital heart disease who underwent brain magnetic resonance imaging (MRI) measuring brain volumes, and neurodevelopmental evaluation at one year of age indicates that infants with CHD have a significant reduction in total and white matter brain volume which correlates with language development.

Infants with repaired CHD have brain volume reductions which may contribute to subsequent language impairment.

Differences in outcomes between early and late diagnoses of Cystic Fibrosis (CF) in the newborn screening (NBS) era
A retrospective review of 45 late A diagnosis CF (LD-CF) defined by a negative immunoreactive trypsinogen or no F508del (blood screening tests for CF) or NBS positive, but discharged following a normal sweat chloride (<60mmol/l) evaluated and compared late outcomes.

It appears late diagnosis CF newborns (despite screening) are sicker, grow more poorly, have worse lung function, more hospital admissions for respiratory illness and higher rates of chronic colonization with Pseudomonas aeruginosa.

Video Feature
What is Positional/Deformational Cranial Asymmetry?
What is Positional/Deformational Cranial Asymmetry?
Plagiocephaly and developmental delay

Deformational Plagiocephaly (altered head shape) is common and may be associated with development delay. A systematic review of multiple databases which examined this relationship indicates that Plagiocephaly is possibly a marker for subsequent neurodevelopmental delay and infants should be referred to interventional services early.

Management of blunt abdominal trauma (BAT) in asymptomatic children with a negative abdominal CT (computed tomography) scan
Asymptomatic children following blunt abdominal trauma and a negative CT are frequently admitted "for observation" to exclude an intra-abdominal injury. A retrospective audit of 34 such children (median age 11 years; 60% male) and a review of the literature (involving 9,941 patients ) indicates that asymptomatic children with a normal abdominal CT scan in the Emergency Department (ED) are very unlikely (negative predictive value 96-100%) to have intra-abdominal injury.

Direct discharge from the ED of asymptomatic children following blunt abdominal trauma with a negative abdominal CT may be considered, as long as there are no other reasons for admission and parental advice/guidance is given.

Did you know? 
American Academy of Pediatrics: Safe Sleep Recommendations to Protect Against SIDS
American Academy of Pediatrics:
Safe Sleep Recommendations to Protect Against SIDS
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