Oct. 14, 2015
Volume VI, Issue No. 41

A method to improve children's ability to swallow tablets/capsules
From a non-randomized study of 78 children (median age: 9 years) who had difficulty swallowing tablets and capsules, it appears that swallowing ability and palatability can be improved (86% successful) by an in situ coating method ("Med Coat") which applies a coating just before tablet ingestion and which provides a slippery pleasant tasting coating which enhances salivation and ease of swallowing (USA patent granted in December 2014)

"Bullying is the most widespread form of peer aggression in schools" -three recent studies provide an update on the topic.

From 11 electronic databases examining prevalence of cyber bullying in middle and high school children, data suggests a median prevalence of 23%. The most common reason for cyberbullying appears to be relationship issues with recipient responses frequently being passive.

There appears to be a close relationship between cyber bullying and depression/anxiety and each predicts the other.

An examination of the effects of statewide anti-bullying policies (49 states) suggests that legislation defining "a statement of scope", "description of prohibited behaviors" and "a requirement for school districts to implement policies" reduces the risk of being bullied.
Arthritis as a presenting manifestation of acute lymphoblastic leukemia (ALL)
From a retrospective record review of 286 children diagnosed with ALL, it appears that 18.5% present with localized joint pain and of these 50% have objective signs of arthritis usually involving 2.5 (mean) joints). In these children clinical signs of leukemia tend to be less prominent.
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Treatment of juvenile fibromyalgia

Fibromyalgia in children is less common than in adults apparently occurring in 1%-6% of the pediatric population. While the etiology is unknown it tends to run in families with Caucasian girls predominating. Adult criteria (wide spread pain lasting at least three months, etc.) are utilized towards diagnosis. Treatment remains elusive.

A study investigated the effects on 64 hospitalized children (median age: 16 years) treated with 5-6 hours of intensive occupational therapy/physiotherapy and at least 4 hours of
Diagnosing Fibromyalgia 
Diagnosing Fibromyalgia
psychological counseling weekly, who in addition underwent standardized testing for pain, motor performance, functional disability and completed a quality of life questionnaire at program entry, at the end of the intensive program and one year later. Data suggests that pain and all other parameters measured improve significantly with a formalized program period. At one year follow up 33% are pain free.

Children with fibromyalgia can be successfully treated without medication.

Midstream urine collection to diagnose urinary tract infection (UTI) in non-toilet trained infants
Suprapubic aspiration or uretheral/bladder catheterization (the guideline recommended methods), to diagnose suspected UTI are both significantly invasive.
A prospective study of 94 infants with suspected UTI who had midstream urine collected using a new urine collection device followed by bladder catheterization when the urine was dipstick positive, indicates that midstream collection is no better than utilizing a collection bag.

Suprapubic aspiration or uretheral/bladder catheterization remain the mandatory methods to diagnose suspected UTI in the non-toilette trained infant.  

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Internet use by first-time mothers for infant feeding support
Many women use the internet for health and nutrition information. Its efficacy in supporting recommendation-consistent infant feeding is unknown.
"Healthcare providers, books, general internet searches, family and friends are common sources of breast-feeding information". Online internet breast feeding sources can be valuable in the effort to encourage and assist mothers to breast feed; unhelpful sites result in a greater likelihood of infant formula feeding.
Ibuprofen-associated acute kidney injury (AKI) in dehydrated children with acute gastroenteritis (AGE)
A study of 105 children with AGE-dehydration prospectively enrolled in groups as cases with or without AKI, and evaluated for ibuprofen usage, indicates that ibuprofen exposure in dehydrated children with AGE increases the risk of AKI by more than two fold.

Pediatric Nephrology
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