Vaccines
The 2009 recommended immunization schedules have been issued for children aged 0 to 6 years , 7 to 18 years , and children who are behind on immunizations . Major changes include the recommendation for annual influenza immunization for all children aged 6 months to 18 years and increased upper age limits for rotavirus vaccine.Reports of invasive Haemophilus influenzae type b (Hib) disease in five children in Minnesota highlights the importance of completion of the primary series of Hib vaccines by seven months of age . The combination dipththeria-tetanus-acellular-pertussis/inactivated polio/Hib vaccine may be used for any and all doses of the primary series.
Tuesday, July 21, 2009
Pediatric otolaryngology
Pediatric otolaryngology
In a randomized trial of dexamethasone versus placebo in 215 children undergoing tonsillectomy, dexamethasone was beneficial in reducing postoperative nausea and vomiting, but was associated with increased risk of bleeding requiring reoperation .Suboptimal levels of vitamin D were found in 95 percent of patients with cystic fibrosis, although most were taking fat-soluble vitamin supplements . Vitamin D deficiency contributes to the bone disease associated with cystic fibrosis, characterized by decreased mineral density, increased fracture rates, and kyphosis.
In a randomized trial of dexamethasone versus placebo in 215 children undergoing tonsillectomy, dexamethasone was beneficial in reducing postoperative nausea and vomiting, but was associated with increased risk of bleeding requiring reoperation .Suboptimal levels of vitamin D were found in 95 percent of patients with cystic fibrosis, although most were taking fat-soluble vitamin supplements . Vitamin D deficiency contributes to the bone disease associated with cystic fibrosis, characterized by decreased mineral density, increased fracture rates, and kyphosis.
Pediatric neurology
Pediatric neurology
The need for lumbar puncture in the evaluation of infants after a first simple febrile seizure has been questioned by findings from a review of cerebrospinal fluid results . Among 268 patients aged 6 to 18 months who had a lumbar puncture after a first simple febrile seizure, no diagnoses of bacterial meningitis were made
The need for lumbar puncture in the evaluation of infants after a first simple febrile seizure has been questioned by findings from a review of cerebrospinal fluid results . Among 268 patients aged 6 to 18 months who had a lumbar puncture after a first simple febrile seizure, no diagnoses of bacterial meningitis were made
Pediatric nephrology
Pediatric nephrology
In the fall of 2008, over 52,000 Chinese infants developed kidney stones because of exposure to melamine-contaminated powered infant formula [74] . Acute renal failure (ARF) due to urinary obstruction was common and there were four reported deaths. The Sanlu product that has been incriminated in these cases had a concentration of melamine that resulted in a 100-fold greater intake of melamine than the tolerable daily intake of 0.5 mg/kg newly established by the US Food and Drug Administration .
In the fall of 2008, over 52,000 Chinese infants developed kidney stones because of exposure to melamine-contaminated powered infant formula [74] . Acute renal failure (ARF) due to urinary obstruction was common and there were four reported deaths. The Sanlu product that has been incriminated in these cases had a concentration of melamine that resulted in a 100-fold greater intake of melamine than the tolerable daily intake of 0.5 mg/kg newly established by the US Food and Drug Administration .
Pediatric neonatology
Pediatric neonatology
The American Academy of Pediatrics (AAP) published discharge guidelines for infants cared for in the neonatal intensive care unit to ensure smooth transition home and prevent premature discharge .A trial of routine insulin therapy started within 24 hours of birth in very low birth weight infants (< 1500 g) found higher mortality rates compared to standard care .Preterm infants who received surfactant therapy and continuous positive airway pressure (CPAP) were less likely to require mechanical ventilation or develop bronchopulmonary dysplasia than those who received only CPAP therapy
The American Academy of Pediatrics (AAP) published discharge guidelines for infants cared for in the neonatal intensive care unit to ensure smooth transition home and prevent premature discharge .A trial of routine insulin therapy started within 24 hours of birth in very low birth weight infants (< 1500 g) found higher mortality rates compared to standard care .Preterm infants who received surfactant therapy and continuous positive airway pressure (CPAP) were less likely to require mechanical ventilation or develop bronchopulmonary dysplasia than those who received only CPAP therapy
General Pediatrics
General pediatrics
In children with asymptomatic inguinal hernias, longer waiting time for elective surgery is associated with increased risk for incarceration, especially in infants less than one year of age. An observational study found that a wait time that exceeded 14 days from the time of diagnosis was associated with an absolute increase of 7 percent (12 versus 5 percent) in the occurrence of incarceration in infants and children <1 year of age .The American Academy of Pediatrics (AAP) suggests that infant cereals and puréed meats be offered to infants as the initial solid foods rather than puréed fruits and vegetables [59] . Infant cereals and pureed meats provide iron and zinc, which are the nutrients most likely to be deficient in the diets of infants in the United States.Gestation appears to be a critical period for determining obesity predisposition and metabolic outcomes in offspring, a process termed "metabolic programming". A study found a lower prevalence of obesity in children born to women who had gastric bypass surgery than siblings who were born before gastric bypass .Optimal management for acute virus-induced wheezing in preschool children is uncertain. A five-day course of oral prednisolone in hospitalized preschool children with acute mild to moderate virus-induced wheezing did not shorten hospital stay, reduce albuterol use, or improve symptom scores in a multicenter randomized trial .
In children with asymptomatic inguinal hernias, longer waiting time for elective surgery is associated with increased risk for incarceration, especially in infants less than one year of age. An observational study found that a wait time that exceeded 14 days from the time of diagnosis was associated with an absolute increase of 7 percent (12 versus 5 percent) in the occurrence of incarceration in infants and children <1 year of age .The American Academy of Pediatrics (AAP) suggests that infant cereals and puréed meats be offered to infants as the initial solid foods rather than puréed fruits and vegetables [59] . Infant cereals and pureed meats provide iron and zinc, which are the nutrients most likely to be deficient in the diets of infants in the United States.Gestation appears to be a critical period for determining obesity predisposition and metabolic outcomes in offspring, a process termed "metabolic programming". A study found a lower prevalence of obesity in children born to women who had gastric bypass surgery than siblings who were born before gastric bypass .Optimal management for acute virus-induced wheezing in preschool children is uncertain. A five-day course of oral prednisolone in hospitalized preschool children with acute mild to moderate virus-induced wheezing did not shorten hospital stay, reduce albuterol use, or improve symptom scores in a multicenter randomized trial .
Urogynecology
Urogynecology
The US Food and Drug Association issued a public health notification regarding serious complications associated with intravaginal mesh placement using trocars or other tools for repair of pelvic organ prolapse or stress urinary incontinence . Reported complications include mesh erosion, infection, pain, treatment failure, and urinary problems.
The US Food and Drug Association issued a public health notification regarding serious complications associated with intravaginal mesh placement using trocars or other tools for repair of pelvic organ prolapse or stress urinary incontinence . Reported complications include mesh erosion, infection, pain, treatment failure, and urinary problems.
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