June 28, 2017
Volume VIII |  Issue No. 26

Adult height of preterm infants; a longitudinal cohort study
Catch-up growth in infants born preterm is thought to be complete in the first few years of life, however most such studies focus on birth weight which includes appropriate weight for age - AGA and small for gestational age - SGA babies. A study of 204 AGA preterm infants and matched term controls, annually examined and compared time to achieving expected adult height.

AGA babies achieve final height status similar to babies born at term, however catch-up grow continues longer, throughout childhood.

See related video below:
Propofol vs. Midazolam for procedural sedation in the Emergency Department (ED)
A multicenter retrospective cohort study of 592 ED sedations in 5 hospitals over 4 years which evaluated success rates and safety of propofol against midazolam sedation, indicates that propofol achieves a deeper level of sedation, a higher procedure success rate and a shorter median sedation time compared to midazolam (Propofol sedation is however associated with more apneas, while oxygen saturations <90% are more frequent with midazolam usage).

Electronic cigarette (e-cigarette) use by youth
A study 1,091 youths (median age 14.4 years) who completed 4 self-reported surveys on substance use indicates that 27.7% of all 8th graders use e-cigarettes (independent of gender or ethnicity). Correlates of e-cigarettes lifetime use by 8th graders include current and lifetime use of marijuana, alcohol, cigarettes and chewing tobacco.

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Intravenous fluids (IV) for headache treatment

It appears that the administration of intravenous fluids is often recommended for migraine headaches in the Emergency Department (ED).

A retrospective study of 1,251 adult patients (representing 5,981,000 patient visits) presenting to an ED with a main
IVFs in migraine headaches
IVFs in migraine headaches
complaint of non-traumatic headache or migraine indicates that 40% receive IV fluids (independent of severity of pain) without any evidence for its benefit.

Natural course of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adolescents

CFS/ME is characterized by 6 months of fatigue (that doesn't disappear with sleep or rest) significant enough to interfere with daily activities and 4 or more symptoms which include cognitive problems, sleep problems, sensitivity to light, depression, headaches, joint pains, recurrent flu-like symptoms etc.

From a population-based study; 2.40% of 18 year olds suffer with chronic disabling fatigue (CDF a proxy for clinically diagnosed CFS/ME); females outnumber males, many with depressive symptoms.
  • CDF increases throughout adolescence from 13-18 years with 2.99% being clinically diagnosed. Persistence is rare
  • Approximately 75% recover over 2-3 years
Video Feature
Myalgic Encephalomyelitis
 Myalgic Encephalomyelitis Part I  (click HERE)
 Myalgic Encephalomyelitis Part II (click HERE)
 Myalgic Encephalomyelitis Part III (click HERE)
Guidelines on fruit juice intake for children: American Academy of Pediatrics (AAP)
  • No fruit juices prior to 12 months of age unless clinically indicated
  • Toddlers should not consume juice from a container that can be used throughout the day and should not be given it at bedtime
  • Children should eat whole fruit
  • Daily fluid requirements should be met with human milk and/or infant formula for infants and low-fat/non-fat milk and water for older children
  • No infant/child/adolescent should consume unpasteurized juice products
  • No grapefruit for children taking medications that are metabolized by CYP3 A4
  • Over and undernourished children, and children with chronic diarrhea, excessive flatulence, abdominal pain and bloating should have fruit juice intake assessed
  • Fruit juice intake should be part of the evaluation of risk for dental caries and dental decay
  • Fruit juice consumption should be discouraged and eliminated in children with poor or excessive weight gain.
Oxygen-saturation targets in extremely preterm infants

Oxygen-saturations in extremely preterm infants outside appropriate levels may be associated with ROP (retinopathy of prematurity) and BPD (bronchopulmonary dysplasia).

A study (the Neonatal Oxygen Prospective Meta-Analysis-NeOProm collaboration) which examined (death or major disability) whether a lower oxygen saturation level (85-89%) is superior to a higher saturation target (91-95%) at 18-24 months corrected age (in approximately 5,000 preterm infants <28 weeks gestation), encountered several problems (e.g. calibration of pulse oximeters, difficulty in keeping infants' saturation levels in the target range, etc). It appears however that lower saturation levels increase the rate of death and that a targeted oxygen-saturation level of 91-95%, is safer in most instances.

Did You Know?
Intraoperative MRI | Innovations Pediatric Healthcare
Intraoperative MRI | Innovations Pediatric Healthcare
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