Nov. 4, 2015
Volume VI, Issue No. 44

Erythropoietin for the repair of cerebral injury in very preterm infants
Preterm infants are at greater risk for intraventricular hemorrhage (IVH) and with that are at increased risk for neurodevelopmental delay. Observational data suggests that recombinant human erythropoietin (rEPO) improves long-term cognitive outcomes in infants with IVH possibly by acting as an anti-apoptotic neuroprotective hormone, attenuating inflammatory mediator responses and/or by minimizing blood-brain barrier damage.
A short term double - blind, placebo controlled, multicenter study of 120 very preterm infants in the first days of life, with moderate-to -severe IVH given repetitive high doses of rEPO, suggests short term improvement in cognitive outcomes. Longer term benefits remain to be studied in a RCT.
Predictors of malignancy in children with thyroid nodules
It appears following clinical, laboratory and ultrasound imaging of thyroid nodules that microcalcifications, hypoechoic pattern, intranodular vascularization, lymph node alterations and thyroid stimulating hormone concentration are independent predictors of malignant outcome.
Journal of Pediatrics

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Parent/adolescent weight status concordance and parent feeding practices
Data from 2 linked population- based studies of 3,252 parents and 3,153 adolescents from socioeconomically and racially/ethnically diverse populations which examined the relationship between parent and adolescent weight status concordance and discordance, and parent and feeding practices, indicates that parents use pressure-to-eat feeding practices when both groups are not overweight and restrictive food practices where both parents and adolescents are both overweight/obese.
Parent weight status plays an important role in adolescent eating habits.
Tips for Patient Portal Optimization
Guest Blog by HealthFusion

Pediatric Focus: 4 Ways Your Patient Portal Should Save You Time and Money

Optimize these four main components of a patient portal, and you'll find time to see more patients with fewer costs and a smaller staff.

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Can radiographs predict outcomes of patients with clubfoot treated with the Ponseti Methods?

Ignatio V. Ponseti who developed the comprehensive technique for treating congenital clubfoot based his approach on the concept that all the tissues of a newborn foot will yield and correct by gentle manipulation and casting of the feet (generally weekly for 5-6 casts). Many of the infants will require a percutaneous tenotomy to lengthen their Achilles tendon prior to the last cast. A "Maintenance Phase" follows this in which a brace is placed to maintain the foot in its corrected position. A risk of recurrence persists for many years.

A study of 45 patients to determine whether radiographic measurement taken before tenotomy in treated clubfoot infants could predict outcomes, indicates that reduced lateral forced foot dorsiflexion (<15 degrees past neutral) is associated with an increased risk of recurrence.

Video Feature
Patients with clubfoot treated with the Ponseti Methods
Patients with clubfoot treated with the Ponseti Methods
Electrocardiogram in "participation athletic evaluations" (PPE) among insured youths

Sudden cardiac death is the leading cause of death in athletes due to sport participation (approximately 100-200 USA high school athletes per year).

PPE's apparently should be performed six weeks prior to the onset of a sports season to insure that any abnormal finding on examination is fully evaluated. While cardiac examination is mandated as part of PPE and an EKG appears better than just doing a history/physical examination, the majority of potential EKG abnormalities found are, on further testing proven to be negative. Further, sudden death rates in Italy where EKG is mandatory are no different to Minnesota data where they are not.

A study of 8,621 children where PPE's plus EKG's were undertaking, indicates that at present it appears that physicians are using EKG's selectively; with a sensitivity of 44% mass EKG screening appears inefficient.

Maternal asthma, preterm birth and risk of bronchopulmonary dysplasia (BPD).
Maternal asthma is associated with an increased risk of preterm birth (particularly 28-32 weeks gestation); and for those mothers who do not receive antenatal steroid therapy, an increased risk of BPD in their preterm infants.
Role pf nasopharyngeal bacteria and respiratory viruses in acute respiratory symptoms of young children
Young children (3-35 months) vary in their clinical symptomatology associated with a respiratory tract infection.
There appears to be a strong association between fever and respiratory viral infection (influenza, metapneumovirus, coronavirus and parainfluenza viruses); rhinitis, nasal congestion and cough being more frequently associated with Moraxella catarrhalis, respiratory syncytial and para influenza viruses.
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