Rotavirus immunization and childhood hospitalization
A pre and post- rotavirus vaccine introduction review of 57 articles from multiple countries examined childhood (<5 years of age) hospitalization from rotavirus and all-cause acute gastroenteritis (AGE).
Mean percent reductions in AGE hospitalization following the introduction of rotavirus vaccination varies between 30-46% (depending on the local countries' childhood mortality rate). Rotavirus immunization reduces Emergency Department visits and hospitalizations due to rotavirus by 67% overall (median).
Outcomes associated with early preventive dental care among Medicaid-enrolled children in Alabama
While the American Academy of Pediatric Dentistry recommends caries risk assessment with the eruption of the first baby tooth (approximately 6 months of age), previous studies in fact show little benefit for routine evaluations between 0-4 years.
A study of a large cohort (19,658) of eligible children who did (or did not) receive preventive dental care before 2 years of age shows no benefit from early preventive dental care (fluoride varnish).
Splanchnic oxygenation at first enteral feed in preterm infants and feeding intolerance
A prospective observational study of 61 clinically stable preterm infants examined abdominal oxygenation patterns (by Near-infrared spectroscopy - NIRS) at first enteral feed; calculated splanchnic cerebral oxygenation ratio (a marker of gut hypoxia) and observed its relationship to babies who subsequently developed feeding intolerance/gastrointestinal complications.
Low splanchnic oxygenation levels and a low splanchnic cerebral oxygenation ratio are markers of intestinal hypoxia and predict gastrointestinal complications in high-risk preterm infants.
Non-acid gastroesophageal reflux in children with respiratory symptoms
Gastroesophageal reflux disease (GERD) appears to be more common in asthmatics than in the general population, and in about 30% of people GERD causes respiratory symptoms. Many of these do not respond to aggressive acid-suppressive therapy.
A prospective study of 40 infants and children (mean age: 58.3 months) with GERD related respiratory symptoms (and a comparison group of 40 matched patients with GERD-related gastrointestinal symptoms) assessed with pH-impedance the number of acid exposures.
Non-acid reflux appears to play a larger role in respiratory symptom generation in children, which may account for their poor response to acid-suppressive treatment.
Physical activity outside of organized sport and functional performance
25 minutes of physical activity, 3 times a week appears to significantly reduce the risk of childhood obesity. Current recommendations suggest children should engage in
Educating the Student Body
moderate to vigorous physical exercise for a minimum of 60/minutes/day. Only 7-31% of adolescents reach this level of activity.
A cross-sectional study of 445 children (mean age 14 years) examined reported frequency of strenuous physical activity (e.g. running, soccer, etc.) outside of
organized sport, for >15 minutes during their f
ree time per week and categorized youths into three groups: Never, 1-4/week and >5 times per week. Outcomes measured physical ability and related it to outside physical activity.
Increasing free-play physical activity outside of organized sports is safe and improves physical ability.
Nonvariceal upper gastrointestinal bleeding (NVUGI) in children
NVUGI is rare in children.
From a retrospective review of endoscopy data from 12,737 upper endoscopies, 15 patients (0.133%) require therapeutic interventions to control bleeding.
Six of 15 patients (40%) re-bleed (mostly from single modality treatment) with a third of them needing surgery to control bleeding from a duodenal ulcer.
A site (or side) locked headache literally means a headache which almost always occurs on one side.
A study prospectively investigated 292 neurologically normal children (5-17 years of age) who had experienced at least five SLH attacks (unilateral, occipital or vertex) and related diagnosis to magnetic resonance imaging (MRI) result.
The diagnosis of a site locked headache in neurologically normal children is usually migraine, tension-type headache or medication overuse, and MRI's are almost always essentially normal. Without abnormal neurological findings a SLH is unlikely to have a sinister etiology.
Nicklaus Children's Hospital Honored with Resuscitation Recognition Award
Nicklaus Children's Hospital has been recognized by the
Get With The Guidelines-Resuscitation Recognition Awards for implementing specific quality improvement measures outlined by the
American Heart Association for the treatment of patients who suffer cardiac arrests in the hospital.