Preterm infant outcomes after randomization to initial resuscitation with room air or 100% oxygen
A study of 238 infants (<32 weeks gestation) randomly assigned to either be resuscitated with room air (FiO2 0.21) or 100% oxygen (FiO2 1.0) investigated (at 2-3 years corrected age) survival or neurodevelopmental impairment.
Initial resuscitation of preterm infants <32 weeks gestation utilizing room air vs. 100% oxygen has no significant effect of death rate or neuro-developmental outcomes at 2 years of age.
developmental outcomes in infant with congenital Cytomegalovirus (CMV) infection
A study to investigate the ability of a comprehensive neuro-imaging investigation (head ultrasound; HUS/commuted tomography: CT/magnetic resonance imaging: MRI) in predicting neuro-developmental outcomes was undertaken in 118 infants with congenital Cytomegalovirus infection.
While HUS is the safest neuro-imaging technique, brain CT and MRI are better at detecting patients at risk for poor neurologic outcome and should be mandatory in all infants with congenital CMV infection for treatment decisions and prognostic evaluation.
Laparoscopic repair (LR) vs. open hernia repair (OR) of inguinal hernia in infants
A retrospective analysis of 465 infants treated for inguinal hernia (124 laparoscopically and 341 by open repair) indicates that LR has a shorter operation time, better postoperative course and fewer infants developing metachronous hernias (hernias appearing later).
LR could be considered the primary operative treatment method for an inguinal hernia in infants.
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Features, recommendations for diagnosis and treatment of Autoimmune Pancreatitis (AIP) in childhood
AIP represents a complex immune-mediated pancreatic inflammatory disease which classically manifests with a lymphoplasmacytic and other cellular infiltration with abundant IgG (subclass 4) deposition. Two histologic types are found. Though rare it is increasingly being recognized as a disease entity. Information on children is limited.
Children (usually adolescents from all racial and ethnic backgrounds) with AIP present with a variety of symptoms/signs, though abdominal pain, increased pancreatic size (mass or diffuse) and obstructive jaundice are the most common clinical features, (less often weight loss, fatigue and vomiting). 25% develop other immune/inflammatory disease.
This article outlines the results of a recent panel of pediatric gastroenterologists (International Study Group of Pediatric Pancreatitis) who generated 15 statements to help standardize the definition, approach to diagnosis and treatment of this uncommon condition (Well worth reading; Ed).
Internet and telephone assisted parent training for childhood Disruptive Behavior
Disruptive Behavior Disorders (DBD's) are a group of conditions clinically characterized by ongoing hostile and defiant behavior directed against any authority figure. Two common forms exist; (a)
Oppositional defiant disorder (ODD) which usually presents in younger children and is characterized by patterns of hostile, defiant and disruptive behaviors and (b) Conduct disorder where the child persistently and repetitively violates the basic rights of others and disregards appropriate age related societal norms.Parental training is one of the most effective approaches for the psychosocial treatment of behavioral problems in young children.
A two-year randomized controlled study compared outcomes of preschool (4 year olds) with disruptive behavioral problems whose parents received either an 11 week internet-based and telephone assisted training program or an educational control group.
An 11-week internet-based and telephone assisted parent training program is effective in improving preschool children with disruptive behavior for two years after completion of the program.
Etiology and outcomes of severe apparent life-threatening events (ALTE) in children
An apparent life-threatening event (or "brief resolved unexplained event (BRUE) " is one in which infants younger than 1 year of age present with a sudden brief and resolved episode, with no explanation, of >1 of the following; cyanosis, pallor, absent-decreased or irregular breathing, marked hyper-or hypotonia and altered level of responsiveness. Infants can be stratified into lower and higher risk of having a repeat event or a serious underlying disorder. Causes are many.
A study of 23 high risk ALTE Serbian infants hospitalized in an Intensive Care Unit over a four year period indicates:
Average age at presentation 78 days.
Death occurs in 34.7%.
Most frequent conditions diagnosed include; lower respiratory tract infection (39.1%), intra and extra cranial hemorrhage (13.0%), central nervous system infection (8.6%) and unknown (8.7%).
Prematurity and congenital heart disease are important risk factors.
Re-operation risk for varying types of pediatric scoliosis
From a retrospective analyses of 2,356 pediatric scoliosis fusion surgeries, it appears that the one and four year re-operation rate for idiopathic scoliosis are 0.9% and 1.6% respectively. For non-idiopathic scoliosis similarly timed rates are 4.2% and 20.4% respectively. Highest risk of re-operation for non-idiopathic subtypes at 1 and 4 years respectively are; Congenital scoliosis - 4.7% and 41.6%, arthrogryposis - 7.3% and 28.6% and syndromic neurofibromatosis - 9.1% and 32.3%.