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Indian Pediatr 2013;50: 434
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Clippings |
Amit P Shah
Email:
[email protected]
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Cyproheptadinecontrols dyspeptic symptoms in children (J
Pediatr.2013 Feb 16; doi:10.1016/j.jpeds. 2012.12.096)
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Cyproheptadine, a potent serotonin antagonist, has been used as an
appetite stimulant and for migraine. There are no reports of its use to
improve gastric accommodation or to treat dyspeptic symptoms, although
there’s data to suggest it might help with functional abdominal pain in
children. This retrospective, open-label study was conducted in a group
of younger children and adolescents to evaluate the safety and efficacy
of cyproheptadine in children with refractory upper gastrointestinal
symptoms (eg, nausea, early satiety, vomiting, retching after
fundoplication, abdominal pain). Although cyproheptadine is not approved
for this indication, it was found that it is safe and effective for
treating dyspeptic symptoms in children, particularly in young children
and those with early vomiting and retching after fundoplication.
Definitely, some more research is needed in this regard.
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The Global School Adaptation Score: A new
neurodevelopmental assessment tool for very preterm children at
five years of age (J Pediatr.2013 Feb 28; doi:
10.1016/j.jpeds.2013.01.052)
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This was done to determine the usefulness of a neurodevelopmental
assessment tool consisting of a questionnaire administered to teachers
to measure the Global School Adaptation (GSA) scores of very preterm
children at the age of 5 years. A sample of very preterm children (<35
weeks of gestation) was assessed at 5 years of age using GSA and IQ
scores. According to the consistency between the scores, children were
determined to be well classified, intermediately classified, or
misclassified.The GSA score was highly or intermediately consistent with
the IQ score for 89.2% of the children, and 10.8% were considered
misclassified. Children with a higher GSA than IQ score had more
autonomy and self-confidence and those with a lower GSA than IQ score
had more behavioral problems. Analysis by logistic regression showed
that sex and gestational age significantly affected the consistency
between the 2 scores. Thus, girls were less likely to have a lower GSA
than IQ score and a lower gestational age significantly increased the
likelihood of having a higher GSA than IQ score.GSA score appears to be
a simple, inexpensive, and reliable screening tool for assessing
neurodevelopment in very preterm children at 5 years of age.
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Top 10 strategies for patient safety outlined (Annals
Intern Med. 2013; 158: 365-8)
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There are 10 ways to prevent nosocomial infections and overt medical
errors that have been proven to work and that should be followed in all
healthcare facilities, a group of researchers said. Strategies "strongly
encouraged" by the group are listed below for immediate adoption:
1. Preoperative checklists and anesthesia checklists
to prevent operative and postoperative events.
2. Bundles that include checklists to prevent central
line–associated bloodstream infections.
3. Interventions to reduce urinary catheter use,
including catheter reminders, stop orders, or nurse-initiated removal
protocols.
4. Bundles that include head-of-bed elevation,
sedation vacations, oral care with chlorhexidine, and subglottic
suctioning of endotracheal tubes to prevent ventilator-associated
pneumonia.
5. Hand hygiene.
6. The do-not-use list for hazardous abbreviations.
7. Multicomponent interventions to reduce pressure
ulcers.
8. Barrier precautions to prevent
healthcare–associated infections.
9. Use of real-time ultrasonography for placing
central lines.
10. Interventions to improve prophylaxis for venous thromboembolisms.
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Beta-blocker clears infancy hemangiomas (AAD 2013)
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nfantile hemangiomas occur in as many as 3% of newborns in the U.S. and
the world over. Historically, corticosteroids have represented
first-line therapy. If that is not successful, other modalities of the
treatment is usually surgical only. This study, an international
randomized trial, presented at the annual conference of the American
Academy of Dermatology throws light on the use of Propranolol for this
condition successfully. The rationale for using propranolol to treat the
pigmented vascular lesions is based on at least three mechanisms by
which the beta-blocker might clear hemangiomas: vasoconstriction,
inhibition of angiogenesis, and induction of apoptosis. A primary
endpoint of complete or near-complete resolution of a lesion at 24 weeks
was decided for the treatment success and a secondary endpoint was
defined as minimal telangiectasia, erythema, skin thickening,
soft-tissue swelling, or anatomical distortion.The result is encouraging
and may prevent other invasive form of treatment like surgical removal
etc. as a majority of infantile hemangiomas had complete or
near-complete clearance within 6 months after treatment with propranolol.
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