Pediatrics Update Taper desmopressin rather than abrupt discontinuation In a multicenter trial involving patients diagnosed with nocturnal enuresis and responding to desmopressin, structured withdrawal of desmopressin (giving one–half the usual dose each day or by giving the usual dose every other day) for two weeks before discontinuation) reduced relapse rates as compared to abrupt withdrawal of the drug. Structured withdrawal was also an independent factor associated with lower initial effective dose and number of wet nights per week.1 Public smoking ban also benefits perinatal and child health A systematic review and meta-analysis of 11 quasi–experimental observational studies published between 2008-13, involving more than 2·5 million births and 247,168 asthma exacerbations found that smoke–free legislation is associated with considerable decrease in preterm births and hospital admissions for asthma.2 Avoid helmets for infants with positional skull flattening A randomised controlled trial (HEADS, HElmet therapy Assessment in Deformed Skulls) which randomly assigned infants aged 5–6 months with moderate to severe skull deformation to helmet therapy vs observation found both to be comparable in terms of effectiveness. Because of high prevalence of side effects, and high costs associated with helmet therapy, the authors discourage the use of a helmet as a standard treatment for healthy infants with moderate to severe skull deformation. References 1.Gökçe Mİ, Hajıyev P, Süer E, et al. Does structured withdrawal of desmopressin improve relapse rates in patients with monosymptomatic enuresis? J Urol 2014;192(2):530–4. 2.Been JV, Nurmatov UB, Cox B, et al. Effect of smoke–free legislation on perinatal and child health: a systematic review and meta–analysis. Lancet 2014;383(9928):1549–60. 3.van Wijk RM, van Vlimmeren LA, Groothuis–Oudshoorn CG, et al. Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ 2014;348:g2741.
Posted on: Sat, 18 Oct 2014 06:02:08 +0000
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