Sept. 2, 2015
Volume VI, Issue No. 35

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Treatment of developmental dysplasia of the hip with Tubingen hip flexion splint
In infants diagnosed early with an unstable, Ortolani-positive hip, treatment is essentially conservative involving a dynamic harness where reduced hips are braced in flexion and mild abduction to stimulate normal joint development.

A study of 351 infants with developmental dysplastic hips diagnosed within 3 months of life and treated with the Tubingen hip flexion splint (and followed for 6.4 years) indicates that 90.4% of dysplastic unstable and dislocated hips can be successfully treated using this method.
Intravenous augmentation treatment and lung density in severe α1 antitrypsin deficiency (A1AT)
A1AT deficiency is a fairly common (1:15,000 people) inherited recessive disease in which a specialized protein (A1AT) which inhibits inflammatory proteins is unable to be released from the liver in adequate amounts resulting primarily in lung and liver damage. There is no cure.
A randomized, placebo-controlled trial of α1 proteinase inhibitor (given IV once per week for 24 weeks) (A1PI) or placebo given to a group of 18-65 year old A1AT patients who had computerized tomography (CT) lung density at total lung capacity measured over 2 years indicates that A1PI augmentation slows the progression of emphysema and should be considered as a treatment to preserve lung parenchyma in patients with severe A1AT deficiently.

See related video HERE>>
Age at weaning and infant growth
It appears form a prospective study of 571 mothers of term singletons (plus a review of the literature) where weaning data between ages 3-6 months and infant growth was examined over a 12 month period, that in high-income countries weaning between 3 and 6 months appears to have no significant deleterious growth effects during the first year of life .
Journal of Pediatrics



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Novel magnetic resonance imaging (MRI) findings in children with intracranial hypertension
MRI abnormalities of the optic nerve and sheath have been described in adults with increased intracranial pressure (benign intracranial hypertension or pseudotumor cerebri), in the absence of structural abnormalities, tumor or any other disease.

A study of 11 children (aged 3 - 15 years) who had previous MRI 's described as normal, had their studies re-evaluated to determine the presence of increased tortuosity, an elongation of the optic nerve, enlargement of the optic sheath, flattening in the posterior aspect of the eye, and/or intraocular protrusion of the optic nerve head.

MRI findings of the optic nerve and sheath in children show similar and valuable diagnostic abnormalities to those found in adults with intracranial hypertension.

Video Feature

via YouTube

Necrotizing Fasciitis Part I
Necrotizing Fasciitis Part I


View Necrotizing Fasciitis Part II HERE>> 

Necrotizing fasciitis (NF) in varicella infection

"Necrotizing fasciitis is a rapidly progressive inflammatory infection of the fascia with secondary necrosis of the subcutaneous tissue". NF may be idiopathic or be a result of a variety of medical and/or surgical conditions. Causative organism, include aerobic, anaerobic or mixed flora.

NF is a rare but serious complication of varicella zoster (chicken pox) infection. Easily missed as it resembles cellulitis it increases morbidity and mortality if diagnosed late. Most cases (71%) in children are caused by group A β-hemolytic streptococci. NF is a surgical emergency and should be considered in varicella patients in whom fever persists and limb swelling and pain is disproportionate.

Chronic comorbidities in children with type 1 diabetes (T1D)

A retrospective population-based cohort study compared the incidence of 9 common comorbidities in 915 T1D children (<19 years of age) to a group (3,590) of age - and sex-matched normal children.

T1D is associated with an increased risk of hospitalization, thyroid disease, non-infectious enteritis and colitis, cardiovascular and mental disorders, epilepsy and obstructive pulmonary disease, during the early years of the disease.
The influence of social disadvantage on children's emotion and behavior at 4-7 years 

A cross-sectional study of data from questionnaires completed by parents of 38,955 children enrolled in their first year of school, examined the association of indicators of social disadvantage and subsequent behavior at 4-7 years.

It appears that associated risk factors for emotional and behavioral difficulties in early school aged children are:

1.    Government subsidized goods and services.
2.    Living with one parent.
3.    Not living with either parent.
4.    Having a mother who has not completed high school.
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