Behavioral outcomes of infant colic in toddlerhood
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Colic in infants (3 episodes of crying for >3 hours/day, >3 days/week for 3 weeks in a healthy child) frequently starts around 2-6 weeks of age in full term infants (later in the premature) and generally disappears without treatment by 3-4 months of age. Birth order, sex and whether breast fed or not do not appear to affect it. Cause is unknown.
A prospective comparative study of two cohorts of children, with and without previous colic, analyzed caregiver reports of child internalizing and externalizing behaviors, temperament, regulatory problems (crying/sleeping/feeding) and family functioning at child age 2-3 years.
Infants whose colic self-resolves do not appear to experience any adverse effects at ages 2-3 years.
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Mandatory imaging in a work-up of children suspected of having appendicitis
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A Dutch study, following a guideline change recommending mandatory imaging before appendectomy surgery (ultrasound first and computerized tomography - CT or magnetic response imaging - MRI when inconclusive) in children < 17 years of age with a diagnosis of possible appendicitis, compared negative appendectomy rates prior to after the mandatory guideline change.
Mandatory preoperative imaging in children with suspected appendicitis significantly decreases the negative appendectomy rate with no increase in the number of CT scans.
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Gram staining of synovial fluid in suspected pediatric septic arthritis (SA)
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"The diagnosis of pediatric SA can be challenging due to the wide variability in the presentation of musculoskeletal infections." Synovial fluid for gram staining appears to be routinely obtained and it is often used as an initial screen for the presence or absence of SA.
From a study of 302 children with suspected SA, it appears that the gram staining of synovial fluid is a poor screening tool; particularly for infections involving gram negative organisms.
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Underwriting Opportunities
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Same-sex and different-sex parent families: Child health outcomes
A study of 70 gay fathers through surrogacy, 125 lesbian mothers through donor insemination and 195 heterosexual parents through spontaneous conception, all with children 3-11 years old, examined and compared childhood psychological adjustment, prosocial behavior (as well as a number of parental and family processes) and child health outcomes.
Children of same-sex fathers and lesbian mothers show fewer psychological problems than children of heterosexual conception, with family type not being predictive of child health outcomes.
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Adolescents spending "time alone" with their pediatricians during routine visits
Many professional organizations have long supported developmentally appropriate, confidential adolescent healthcare, in order to facilitate their emerging autonomy, enhance their skill to manage their own health and to improve physician/adolescent communication about sensitive health topics.
A sample of 91 parents of adolescents aged 14-17 years who attended a well-childcare health visit to a primary care pediatric practice, was utilized to examine parental perspectives on adolescent "time alone" with their primary care pediatrician.
58% of parents believe that it is important (more so for boys than girls) for their child to meet his/her pediatrician alone (for a variety of reasons). Parents believe that adolescent preparation for the visit and addressing privacy concerns will allow for enhanced adolescent-physician communication, emotional comfort, trust and support.
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Video Feature
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Early Life Somatic Complaints
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Early-life somatic complaints: Longitudinal associations with maternal and child psychopathology
Psychopathology was assessed in a longitudinal study of 185 mothers, and when their children were preschoolers and of school-age, with mothers/caregivers reporting on childhood somatic complaints, anxiety and depression at both times.
Pre-school children with somatic complaints predict somatic complaints anxiety and depression in school-aged children (independent of sex of child). Mother psychopathology is inconsistently related to childhood somatic complaints.
The recognition that there is an association between preschool-age somatic complaints and school-age internalizing symptoms, offers the opportunity of early intervention and treatment during primary care visits.
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Fosaprepitant for the prevention of chemo-therapy induced nausea and vomiting (CINV) in children
Fosaprepitant ("Emend" by injection ; one of two (the other is Aprepitant) neurokinin-1 (NK1) receptor antagonists, is an anti-emetic given intravenously, primarily to adults with significant chemotherapy associated nausea and vomiting. It is a prodrug rapidly converted to Aprepitant (approved for use in CINV) by phosphatases. Very little is known about its use in children.
In this single-center study Fosaprepitant in combination with standard antiemetics appears to be safe and effective in the prevention of CINV in pediatric patients as young as 10 months of age (Prospective, randomized controlled trials are still needed).
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Child Life Specialists teach patients through medical play
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