Jan. 13, 2016
Volume VII | Issue No. 2

Factors associated with increased risk of clubfoot.   
"Previous studies investigating the causes of clubfoot have shown conflicting results..."

A large prospective Norwegian cohort identified 125 infants with clubfoot (1.1 per 1000 births) and the following associations:

1.     Parental cigarette smoking (both three months prior to and during the first trimester).

2.     Greater exposure to solvents.

No association is found between clubfoot and oligohydramnios, parental age/education, parity, maternal anxiety or depression, alcohol use or season of birth.
Laryngeal tubes or masks for out-of-hospital cardiac arrest.
It a appears from a prospective, cluster-randomized, open-label study in adults with out-of-hospital cardiac arrest, resuscitated using either a laryngeal tube or laryngeal mask and examining among other variables successful pre-hospital ventilation, survival and favorable neurological outcomes one month after cardiac arrest, that both pre-hospital advanced airway managements provide similar outcomes.

Nebulized magnesium for moderate and severe pediatric asthma.
A study of 191 moderately to severe asthmatic patients 2-14 years of age randomized to receive either nebulized magnesium sulfate or (in a comparable group of 174 children), a normal saline placebo, indicates that adding magnesium to combined nebulizer bronchodilators and systemic steroid therapy does not appear to shorten time to discharge.



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Cerebral palsy (CP) outcomes in infants treated with therapeutic hypothermia (TH).

A prospective cohort study of 125 infants following TH for 72 hours which examined antenatal and perinatal clinical variables and severity of encephalopathy, and who were assessed at 18 and 24 months for neurodevelopment and cerebral palsy respectively, indicates that of those infants who survive only 33% develop CP with fewer severely affected toddlers.
Predicting severe infection in children with chemotherapy-induced febrile neutropenia (FN).
A retrospective cohort chart review of children with 372 episodes of chemotherapy-induced FN over a 2 year period in which 16.1% developed severe infections indicates that severe infection may be predicted on:

1.    A disease with a high risk prolonged neutropenia.
2.    Blood cancers.
3.    Fever.
4.    C-reactive protein level >90mg/l.

Video Feature
Chronic Fatigue
Chronic Fatigue
Life and health outcomes important to pediatric patients with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME).

CFS, initially termed encephalomyelitis is characterized by a state of chronic fatigue (with no clear cause though probably an infectious disease with immunologic manifestations) for > 6 months plus:
  1. Short-term memory impairment or concentration (cognitive impairments).
  2. Sore throat.
  3. Muscle pain.
  4. Multi-joint pain without swelling or redness.
  5. New headaches.
  6. Unrefreshing sleep.
  7. Malaise after exercise lasting >24 hours.
Children with CFS/ME identify 4 healthcare areas of concern; symptoms that fluctuate, which are unpredictable, which impact emotional well-being and which are influenced by management and contextual factors (particularly school).
Prevalence and associated harm of engagement in self-asphyxial behaviors ("choking game") in young people.  
A systematic literature review was undertaken of a number of databases to assess the prevalence of self-asphyxial (risk-taking) behavior (SAB-"choking game") and its associated morbidity and mortality identified 36 relevant studies in 10 countries.

Median lifetime prevalence of SAB appears to be 7.4% (data mostly from North America and France) and is not infrequently associated with other risky behaviors with significant numbers of deaths occurring (usually in individuals who engage in SAB alone and who use a ligature). Awareness of SAB among young people appears high though most children and youths don't associate SAB with risk of injury.
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