Feb. 3, 2016
Volume VII | Issue No. 5

Luc abscess; an extraordinary complication of acute otitis media (AOM)
Mastoiditis, subperiosteal abscess and sigmoid vein thrombosis are the most common suppurative complications of acute otitis media". Lucs abscess is an uncommon, usually benign, noninfectious, subperiosteal pus collection from a middle ear infection spreading through anatomic pathways. It can occur without mastoiditis and may present with earache and unilateral facial swelling.

Inversion of Oxymetazoline nasal congestion container and toxicity
Oxymetazoline (in 0.02% and 0.05% formulae) is and over-the-counter imidazoline derivative sympathomimetic nasal decongestant topically delivered to the nasal mucosae by a spray or pump while the head is held erect. It is not recommended for children < 6 years of age as ingestion of 1ml to 2ml may result in toxicity. Nasal absorption per nostril is 0.15ml and volumes greater than this result in oropharyngeal swallowing and systemic absorption.

Toxicity of Oxymetazoline may occur following accidental ingestion by delivering an increased dose when the drug is delivered to the child in the supine position (which may increase the volume delivered to the nose 20-30 fold).

Cytomegalovirus and other common enteric viruses and necrotizing enterocolitis (NEC)
A small study of 14 infants diagnosed with NEC in whom stools and blood were examined for enteric viruses (by polymerase chain reaction - PCR) indicates that a viral etiology for sporadic NEC appears unlikely.

Acta Paediatrica

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Glucose-6-phosphatase catalytic 3 (G6PC3) deficiency: More than just neutropenia!

"Glucose-6-phosphatase (G6Pase) and its subunit G6PC3 is located in the endoplasmic reticulum, and catalyzes hydrolysis of glucose-6-phosphate (G6P) to glucose and phosphate; the last step of the gluconeogenic and glycogenolytic pathways".
G6PC3 is mapped to chromosome 17q21. Mutations in this gene result in an autosomal recessive severe congenital neutropenia, plus in some patients combined immune deficiency, other blood cell component abnormalities (thrombocytopenia, anemia and lymphopenia), congenital heart defects, urogenital malformations etc.

Early Emergency Department (ED) protocol-driven resuscitation (Resuscitation Bundle) in septic shock 

A retrospective pediatric cohort (202 patients) with clinical sepsis (mean age 7.7 years) matched for presenting organ dysfunction, mortality risk, illness severity, and demographics examined acute kidney injury outcomes prior to and after the implementation of a protocol-driven septic shock resuscitation program.

Implementing a protocol-driven septic shock resuscitation program in the ED decreases acute kidney injury, renal replacement therapy, mortality, PICU and hospital length of stay.

Video Feature
Sepsis Bundle
Sepsis Bundle
Maternal midpregnancy glucose levels and the risk of congenital heart disease (CHD) in offspring.

While there is a well described association between maternal type 2 diabetes or gestational diabetes and the risk of CHD in offspring, the role of subclinical abnormalities of glucose and insulin metabolism is unknown.

A case-control study of a cohort of 277 pregnant women carrying infants with tetralogy of Fallot (TOF), dextrotransposition of the great arteries (dTGA) or healthy infants without CHD who had second-trimester glucose and insulin levels measured indicates that there is a direct correlation of glucose level as a continuous variable and the odds of having an infant with a specific congenital heart malformation.

Glucose and insulin levels in early pregnancy and the risk of CHD requires further investigation.

Early Emergence of delayed social competence in infants born late or moderately preterm  
A social and emotional assessment at 2 years of age of late and moderately late preterm infants (32-36 weeks gestation: LMPT) which examined behavior problems and social competence (compared to term-born controls) indicates that LMPT infants (adjusted for age, sex, small-for-gestational age, socioeconomic and cognitive impairment) are significantly at increased risk for delayed social competence (with no differences found for behavioral problems).

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