Miami, FL
Oct. 31, 2018
Volume IX | Issue No. 44
Acetaminophen and febrile seizure (FS) recurrence during the same fever episode 
It appears from a single-center, prospective, open, randomized control study of 423 infants/children 6-60 months of age with febrile seizures, that rectal acetaminophen (10ml/kg) given every six hours for 24 hours after the first convulsion (if the fever remains >38.0C) is safe and significantly reduces the likelihood of FS recurrence during the same fever episode.
See related video HERE.
Effectiveness of a hand hygiene program at Child Care Centers
Children attending daycare centers (DCCs) are at increased risk for respiratory infections, morbidity and antibiotic usage. A cluster, randomized, controlled and open study of 911 children aged 0-3 years in DCCs (with an 8 months follow-up) compared two intervention groups who performed educational and hygiene measures (one with soap and water (SWG), the other using a hand sanitizer) to each other, and to a control group following usual hand washing procedures.
In DCC's, a hand hygiene program that includes a hand sanitizer and educational input for children, DCC staff and parents significantly reduces absent days, respiratory infections and antibiotic usage.
IgE-mediated allergy and risk of complicated appendicitis
Childhood appendicitis not infrequently results in gangrene and perforation of the appendix (complicated appendicitis). Causes of complicated appendicitis remain unknown.
A retrospective study of 605 consecutive children (median age 10 years) who underwent appendectomy for acute appendicitis examined the association between IgE-mediated allergies and the risk of complicated appendicitis with gangrene or perforation.  
Children with IgE-mediated allergies have a significantly lower risk of complicated appendicitis. This suggests that inherent immunological qualities modify the clinical pattern of appendicitis.
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Association between third-trimester Tdap immunization and neonatal pertussis antibody concentration 

The highest risk to infants for pertussis occurs when they are too young to have completed their primary immunization program, with mortality occurring predominantly in infants <3 months of age.
Maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended in the USA during weeks 27 through 36 of pregnancy to prevent life threatening infant pertussis.
A study of 626 pregnancies (half receiving Tdap the others unimmunized) examined and compared cord blood pertussis antibody concentrations and gestational age, to measure neonatal optimal antibody level concentrations.
Neonatal cord pertussis antibody levels are highest in mothers immunized, and when Tdap is given during gestational weeks 27 through 30.
Association of prenatal maternal depression and anxiety symptoms with infant white matter microstructure
Maternal depression and anxiety appear to impact the developing of the fetal brain deleteriously. A cohort study of 101 mother-infant dyads measured depression and anxiety symptoms in mothers during the third trimester of pregnancy to examine its effects on brain white matter microstructure (measured by diffusion tensor magnetic resonance imaging) in their 1 month old offspring.
It appears that symptoms of prenatal maternal depression and anxiety is associated with infant right frontal white matter microstructural changes (decreased neurites-axon or dendrite-density and diffusivity) which may have long-term deleterious neurodevelopmental consequences.
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The incidence of associated abnormalities in children with sacrococcygeal teratomas (SCT) 
SCT, a tumor growing from the baby's coccyx, is the most common tumor found in newborns. They are categorized according to their locations and severity (Types I-IV).
A retrospective review of 235 consecutive neonates with SCT (treated at six pediatric surgery centers from 1970 to 2010) assessed the incidence of associated abnormalities. Results include:
  1. 32.3% have at least one and 9% multiple associated abnormalities.
  2. Hydronephrosis (16.2%) is the most common abnormality found.
  3. 4.3% have hip dysplasia.
  4. Being preterm or Type IV SCT (tumor cannot be seen from the outside) is associated with an increased risk of any associated abnormality.
All infants with SCT should undergo renal and hip ultrasound.
See related video HERE & HERE
Motivational interviewing in preventing early childhood caries
Motivational interviewing is a practical, empathetic and short-term counseling method that helps people overcome ambivalent feelings to change their behavior. A study of 674 mother/children in 2 groups compared caries rate in those exposed to a conventional oral health education program vs. motivational interviewing.
An intervention based on motivational style interviewing is significantly more effective in reducing the number of teeth surfaces affected by early childhood caries.
See related video HERE. 
Child Life Specialists help patients relax during procedures
Child Life Specialists help patients relax during procedures
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