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Jan. 30, 2019
     
Volume X | Issue No. 5
Idiopathic growing pains in pediatric patients 
It s quite common for practitioners to see children (3-12 years of age) complaining of pain in the legs (and arms less commonly) which usually appear late in the evening/night and which usually disappear by morning. Some children have these pains regularly, others have them episodically with pain-free periods. While etiology is unidentifiable, (laboratory testing is negative), it is not associated with any serious illness, is self-limiting and the pains usually disappear by late childhood. Diagnosis is by exclusion and treatment is mainly symptomatic.

Erythromycin and reflux events in premature infants
Erythromycin ethylsuccinate (EES) is often used as a pro-kinetic in the management of gastroesophageal reflux disease (GERD) in premature neonates, despite lack of evidence of efficacy or safety.
 
A randomized, double-blind, placebo controlled study of 43 premature infants with clinical signs of GERD who were treated with EES or placebo and who underwent 24-hour pH-multichannel intraluminal impedance monitoring (pH-MII) indicates that EES does NOT decrease reflux events and appears to be ineffective for the treatment of GERD in premature infants.
 
Bronchiolitis in early infancy and subsequent lung function 
A prospective study followed 89 children hospitalized for infant bronchiolitis, assessed their lung function (with and without bronchodilation) at 10-13 years of age and compared them to a control group without a history of bronchiolitis.
 
Lung function studies in adolescence of infants hospitalized for bronchiolitis indicate significant irreversible bronchial obstruction.
 
Childhood Obesity Facts 
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Point-of-care ultrasound (US) for diagnosing pneumonia 
 
"Pneumonia accounts for more pre-school-aged deaths worldwide than do tuberculosis, HIV and malaria combined, killing nearly 1 million children each year." US has been increasingly suggested as an emerging, accurate (with a relatively short training period), attractive alternative to using chest x-rays (CR) the "gold-standard", but which exposes children to ionizing radiation and is not always available in resource-poor areas (relying on clinical symptoms/signs is inadequate and lacking in specificity).
 
A prospective observational cohort study in a pediatric Emergency Department enrolled 97 children aged 1 month-18 years who had a CR ordered for possible pneumonia and compared results to lung ultrasound results performed by a trained sonologist.
 
Lung US is more consistent than CR in diagnosing pneumonia (where consolidation is >1cm) and appears to be of great value as a first-line point-of-care imaging technique in diagnosing children with possible pneumonia.

See related video HERE, HERE & HERE
Myotonic dystrophy (DM) type 1; clinical manifestations in children and adolescents
 
DM refers to 2 rare autosomal-dominant (DMPK or CNBP genes) genetic disorders of muscle that actually affect multiple systems of the body. There are 2 main types; DM type 1 (DM 1) which can be furthered sub-classified into mild, classic and congenital subtypes and DM type 2.
 
Mild DM 1 is characterized by sustained muscle contractions (myotonia) and cataracts; Classic DM 1 presents with muscle weakness and atrophy, myotonia, early onset cataracts and abnormalities in cardiac electrical conduction; Congenital DM 1 infants have muscle hypotonia/weakness, respiratory distress, intellectual disability and early death.
 
DM type 2 causes similar but less severe symptoms than DM 1 and does not occur as a congenital disease.
 
A retrospective study of 40 children with DM 1 (mean age 12.8 years) followed for 513 follow-up years in which 143 clinical parameters were recorded indicates that the clinical spectrum of disease in childhood is different to that seen in adults and is more severe the later the onset (juvenile/adolescent disease) with substantial difficulties in intellect/cognition, fine motor, gastrointestinal and neuromuscular function found. A multidisciplinary management approach is required.
 
Video Feature
The Diversity of Sex, Gender, and Sexual Orientation
The Diversity of Sex, Gender and Sexual Orientation
Sexual health education for adolescent males who are interested in sex with males (AMSM)
 
A study of 207 AMSM (ages 14-17 years) was undertaken by them completing an online sexual health survey to determine whether/where AMSM adolescent males receive sexual health information, to clarify their preferences, and explore relations with sexual behavior. 
 
It appears that 43% of AMSM have no contact with male partners, 37% engage in anal sex utilizing a condom and 20% report condomless anal sex. These adolescents receive sexual health information from parents (59%) formal sources (78%) and the internet (65%); most commonly on how to say no to sex, prevent HIV and the type and specifics of sex one can have with a male partner.
 
On-line educational programs that specifically address male-male sex are needed.
 
See related video HERE & HERE
"Talking Tots" and "The Terrible Two's" - association between two commonly reported concerns; "disruptive behavior and language delay"
 
A study utilizing 1,259 mothers of children between the ages of 18-36 months who completed questions about their child's language development and disruptive behavior indicates that there appears to be a developmental co-occurrence pattern which suggests stronger language skills are associated with fewer disruptive behaviors, stronger for females than male and stronger for those children living in poverty.
 
Awareness and recognition of the association between language development and disruptive behavior, is critical to maximizing appropriate interventions.
 
See related video HERE & HERE
What is Type 1 Diabetes? - Dr. Joshua Tarkoff Explains
What is Type 1 Diabetes? - Dr. Joshua Tarkoff Explains
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