May 31, 2017
Volume VIII |  Issue No. 22

Rotavirus immunization and childhood hospitalization
A pre and post- rotavirus vaccine introduction review of 57 articles from multiple countries examined childhood (<5 years of age) hospitalization from rotavirus and all-cause acute gastroenteritis (AGE).

Mean percent reductions in AGE hospitalization following the introduction of rotavirus vaccination varies between 30-46% (depending on the local countries' childhood mortality rate). Rotavirus immunization reduces Emergency Department visits and hospitalizations due to rotavirus by 67% overall (median).

Outcomes associated with early preventive dental care among Medicaid-enrolled children in Alabama
While the American Academy of Pediatric Dentistry recommends caries risk assessment with the eruption of the first baby tooth (approximately 6 months of age), previous studies in fact show little benefit for routine evaluations between 0-4 years.

A study of a large cohort (19,658) of eligible children who did (or did not) receive preventive dental care before 2 years of age shows no benefit from early preventive dental care (fluoride varnish).

JAMA Pediatrics

JAMA Pediatrics
Splanchnic oxygenation at first enteral feed in preterm infants and feeding intolerance
A prospective observational study of 61 clinically stable preterm infants examined abdominal oxygenation patterns (by Near-infrared spectroscopy - NIRS) at first enteral feed; calculated splanchnic cerebral oxygenation ratio (a marker of gut hypoxia) and observed its relationship to babies who subsequently developed feeding intolerance/gastrointestinal complications.

Low splanchnic oxygenation levels and a low splanchnic cerebral oxygenation ratio are markers of intestinal hypoxia and predict gastrointestinal complications in high-risk preterm infants.

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Non-acid gastroesophageal reflux in children with respiratory symptoms

Gastroesophageal reflux disease (GERD) appears to be more common in asthmatics than in the general population, and in about 30% of people GERD causes respiratory symptoms. Many of these do not respond to aggressive acid-suppressive therapy.

A prospective study of 40 infants and children (mean age: 58.3 months) with GERD related respiratory symptoms (and a comparison group of 40 matched patients with GERD-related gastrointestinal symptoms) assessed with pH-impedance the number of acid exposures.

Non-acid reflux appears to play a larger role in respiratory symptom generation in children, which may account for their poor response to acid-suppressive treatment.

Physical activity outside of organized sport and functional performance

25 minutes of physical activity, 3 times a week appears to significantly reduce the risk of childhood obesity. Current recommendations suggest children should engage in
Educating the Student Body
Educating the Student Body
moderate to vigorous physical exercise for a minimum of 60/minutes/day. Only 7-31% of adolescents reach this level of activity.

A cross-sectional study of 445 children (mean age 14 years) examined reported frequency of strenuous physical activity (e.g. running, soccer, etc.) outside of
organized sport, for >15 minutes during their f ree time per week and categorized youths into three groups: Nev er, 1-4/week and >5 times per week. Outcomes measured physical ability and related it to outside physical activity.
Increasing free-play physical activity outside of organized sports is safe and improves physical ability.

Video Feature

Kids' Dental Treatment
Kids' Dental Treatment

Kids' Dental Health
Kids' Dental Health
Nonvariceal upper gastrointestinal bleeding (NVUGI) in children

NVUGI is rare in children.

From a retrospective review of endoscopy data from 12,737 upper endoscopies, 15 patients (0.133%) require therapeutic interventions to control bleeding.
  • Median age 14.0 years.
  • 41% receive dual therapy (intravenous proton pump inhibitor/octreotide infusions).
  • Six of 15 patients (40%) re-bleed (mostly from single modality treatment) with a third of them needing surgery to control bleeding from a duodenal ulcer.
Site locked (or Side locked) headaches (SLH)

A site (or side) locked headache literally means a headache which almost always occurs on one side.

A study prospectively investigated 292 neurologically normal children (5-17 years of age) who had experienced at least five SLH attacks (unilateral, occipital or vertex) and related diagnosis to magnetic resonance imaging (MRI) result.

The diagnosis of a site locked headache in neurologically normal children is usually migraine, tension-type headache or medication overuse, and MRI's are almost always essentially normal. Without abnormal neurological findings a SLH is unlikely to have a sinister etiology.

Did You Know?
Nicklaus Children's Hospital Honored with Resuscitation Recognition Award

Nicklaus Children's Hospital has been recognized by the Get With The Guidelines-Resuscitation Recognition Awards for implementing specific quality improvement measures outlined by the American Heart Association for the treatment of patients who suffer cardiac arrests in the hospital.
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