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Thinness in young children.
A study of thin (defined as <5th percentile of matched normal children) five year olds (4% of 2,678 children in kindergarten or nursery school) and parental thinness (BMI <18.5) which examined records of height and weight of babies/infants at birth, 1.5 years and 3.5 years of age from mother/child health records, indicates that at every age measured thin children's weight are lower than normal weight children. Thin fathers appear to be a risk factor for thinness in their sons. Management of thin infants/children requires early interventions.
Cast burns-reducing the risk of injury with cast removal.
Cast saws though routinely used are not without risk for thermal and abrasive injury to patients.
At rest, the cast saw blade requires approximately 2 minutes to return to a safe temperature after being heated to 70C. Of many methods tested to cool the blade, cooling with 70% either isopropyl alcohol, or water on gauze results in the fastest cooling time.
Long-term safety & efficacy of Factor IX gene therapy in Hemophilia B.
Hemophilia B (also called Factor IX deficiency or Christmas disease) is a genetic disorder caused by missing or defective Factor IX, a clotting protein. The gene for hemophilia is carried on the X chromosome and is therefore inherited as an X-linked recessive disease. As a son carries the X chromosome from his mother he will have hemophilia (hemophilia can occur in daughters but is rare).
Gene therapy mediated by an adeno-associated virus (AAV8) vector has been shown to raise factor IX levels for up to 16 months.
Patients with severe hemophilia B treated with a single dose of AAV8 vector have long term clinical improvement over a 3 year period, with no late toxic effects reported.
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Pacifier use, sleep & arousal in term infants.
Previous studies have indicated that pacifier use in healthy term infants reduces the likelihood of Sudden Infant Death Syndrome (SIDS) even with infants who sleep in the prone position.
A study of 30 healthy term infants was conducted (on 3 occasions during the first six months of life) to examine whether spontaneous arousal was increased with pacifier use.
Pacifier use in term infants does NOT increase total time of sleeping, time awake or the number of spontaneous awakenings in either the prone or supine sleeping position. SIDS prevention with pacifiers is mediated via other mechanisms other than changes in arousal.
Splenic injury after blunt abdominal trauma during a soccer game.
Pediatric splenic injury may result from minor blunt abdominal trauma, including sports though uncommonly from soccer games.
Two cases of splenic injury in soccer goalies reminds us that children playing sports who present with a history of abdominal pain/trauma require a high index of suspicion and careful examination to exclude the diagnosis of splenic rupture.
Blood transfusion & Breast milk transmission of Cytomegalovirus (CMV) in very-low-birth-weight (VLBW) infants.
"CMV is one of eight herpes viruses". CMV is not only an important cause of congenital infection (frequently leading to mental retardation and development disability), but it is also a danger to high risk groups, especially the immunocompromised host. Post natal CMV infection is common in VLBW infants with breast milk (from CMV seropositive mothers) and blood transfusions being the primary sources.
A prospective, multicenter birth - cohort study enrolled 539 VLBW infants (BW: <1500 grams) CMV tested at birth (who had not received a blood transfusion by 5 days of age) and 462 mothers (76.2% seropositive) whose milk was tested at 5 intervals between birth and 90 days. 57.5% of infants subsequently received CMV/seronegative leukoreduced blood transfusion.
Cumulative incident of postnatal CMV infection of VLBW infants at 12 weeks of age is 6.9% with all infections resulting from CMV positive breast milk.
Clinical relapse after treatment of erosive peptic esophagitis in children/adolescents.
The most common causes of acute erosive esophagitis in children are chemical esophagitis (either reflux disease - GERD, or the ingestion of corrosive substances), eosinophilic esophagitis, infections or radiation. A study to estimate the rate of clinical and endoscopic relapse after initial treatment of erosive peptic ulceration in 24 children (aged 2.1 - 16.4 years) was undertaken with assessments every other week over a 4 month period.
83% of children with healed erosive esophagitis have clinical, and 45% endoscopic relapses. Correlation of clinical and endoscopic relapse is poor.
