Pediatric News back issues from June 2009:
AOM criteria often met during a cold.(NEWS)(Clinical report)
Jun 01, 2009; ... [ILLUSTRATION OMITTED] BALTIMORE -- One-third of 31 young children with colds met the American Academy of Pediatrics criteria for acute otitis media in a prospective study. Children with preexisting middle ear effusion at baseline were even more likely to meet AAP ...
Prior antibiotic could increase resistant UTI risk: first-time UTI in children under 6 years.(NEWS)
Jun 01, 2009; ... BALTIMORE -- Antibiotic exposure within the previous 30 days increased the risk for an antimicrobial-resistant first-time urinary tract infection nearly fourfold in a retrospective cohort study of 533 healthy children aged 6 months to 6 years. The finding suggests that ...
Heart problems seen early in anorexic teens.(NEWS)
Jun 01, 2009; ... Los ANGELES -- Significant cardiac abnormalities were detected in nearly a third of adolescent girls hospitalized for the first time with anorexia nervosa in a San Francisco study, raising questions about whether detailed cardiac work-ups may be warranted early in the course of the ...
New acne guidelines stress early, aggressive Tx.(NEWS)
Jun 01, 2009; ... Since ache is a chronic disease capable of causing serious psychological and 'social problems, it warrants early, aggressive treatment and prolonged maintenance therapy, according to updated treatment guidelines. The guidelines encourage physicians to view acne as a potentially ...
Warning on testosterone gels: secondary effects in children.(NEWS)
Jun 01, 2009; ... Two prescription topical testosterone gels will now include a boxed warning following confirmed adverse effects in eight children, the Food and Drug Administration announced last month. The children did not have the gel directly applied, but rather incurred secondary exposure ...
Primary care pediatrician supply seems adequate.(NEWS)
Jun 01, 2009; ... Although the United States faces a shortage of primary care physicians for adults, there appears to be an adequate supply of pediatricians entering primary care, a University of Michigan pediatrician said. Over the last 3 decades, the number of U.S. children has remained ...
Diets comparable in obese kids in short run.(NEWS)(Clinical report)
Jun 01, 2009; ... BALTIMORE -- Obese children lose as much weight with low-carbohydrate diets as with either portion-controlled or low-glycemic-load diets within 3 months, but are more likely to gain it back by 1 year, study results showed. The findings come from the randomized, controlled ...
Health reform plan may debut this month.(NEWS)
Jun 01, 2009; ... WASHINGTON -- The three committees with jurisdiction over health care in the House of Representatives will make their health reform "'framework'" public by early June, Rep. Henry Waxman (D-Calif.) said at a forum sponsored by the policy analysis firm Avalere Health. Rep ....
Pediatric visit lengths rose 39% between 1979 and 2006.(NEWS)
Jun 01, 2009; ... BALTIMORE -- The length of pediatric visits has actually increased over the past several decades, from 11.8 minutes in 1979 to 14.2 minutes in 1994, and finally to 16.4 minutes in 2006. Moreover, in 2006 the average well-child visit was even longer than the average visit--18.2 ...
Combo vaccines underused due to low payment.(INFECTIOUS DISEASES)
Jun 01, 2009; ... BALTIMORE -- One in five pediatricians surveyed said that inadequate reimbursement prevents them from using combination vaccines in their practices. The finding, from a nationwide survey of 630 pediatricians, was presented by Dr. Courtney Gidengil at the annual meeting of the ...
Bronchiolitis burden reduced by combo Tx.(INFECTIOUS DISEASES)
Jun 01, 2009; ... The combination of oral dexamethasone and nebulized epinephrine appeared to reduce hospital admission, hasten discharge from the emergency department, and decrease the duration of symptoms in infants with bronchiolitis. The researchers compared each of the drugs alone and in ...
Rotavirus hospitalizations drop 84% in 3 years.(INFECTIOUS DISEASES)
Jun 01, 2009; ... BALTIMORE -- Rotavirus hospitalizations declined by 84% from 2006 to 2008 among children less than 3 years of age, suggesting a dramatic effect of vaccination. That degree of decline was seen even among children 2-3 years old whose age made them ineligible to be vaccinated ...
Flu shot advice hits home with asthma patients.(INFECTIOUS DISEASES)
Jun 01, 2009; ... BALTIMORE -- Among children with asthma who received a recommendation from their physician to get the influenza vaccine, the rate of subsequent vaccination was 76%, compared with 16% among children who reported not receiving a recommendation from their physician. The low ...
Monitor the 2009-H1N1 influenza outbreak.(ID CONSULT)
Jun 01, 2009; ... We are learning more daily about the 2009-H1N1 influenza, now also called the novel H1N1 flu, as the outbreak unfolds. It will be critical for us as clinicians to stay on top of developments so that we can tailor our patient care accordingly. Although disease activity seems to be ...
Refusal to vaccinate against pertussis ups risk radically.(ID CONSULT)
Jun 01, 2009; ... Children whose parents refused the pertussis vaccine were 23 times more likely to contract the disease than were children whose parents allowed them to receive the vaccine, a case-control study found. Of 156 pediatric pertussis cases identified in a large health care database, ...
Is there a food allergy epidemic? Data show food allergy prevalence has increased.(POINT/COUNTERPOINT)
Jun 01, 2009; ... Current estimates from various countries suggest that up to 5%-8% of children and 2%-19% of adults have food allergies. Substantial proportions are allergic to cow's milk, eggs, seafood, or peanuts--and these are just a few of the many foods we eat. If you are not impressed by ...
Is there a food allergy epidemic? Inconsistency of diagnosis may explain it.(POINT/COUNTERPOINT)
Jun 01, 2009; ... Several factors may be giving the appearance of an increase in the prevalence of food allergy. On the professional front, these allergies are often being diagnosed by a variety of nonallergists, such as general practitioners and emergency department physicians; hence, the ...
When it doesn't happen.(LETTERS FROM MAINE)(Editorial)
Jun 01, 2009; ... Some years ago there was a popular bumper sticker that read "Stuff Happens." Well, actually, in the most popular version, the "S" word was shorter. But either way, truer words were never printed on an adhesive-backed sheet of vinyl. One can prepare. One can act cautiously. But, every now ...
Nurse practitioners outraged.(LETTERS)(Letter to the editor)
Jun 01, 2009; ... NAPNAP was stunned to see the front page article in the April 2009 issue entitled, "AAP Plans to Clarify Role of Nurse Practitioner." We are dismayed and weary of the unfounded opposition to patient access to primary health care nurse practitioners. To have the American Academy ...
The face of pediatrics.(LETTERS)(Letter to the editor)
Jun 01, 2009; ... Even though I have been behind in my reading since the first day of medical school, I try to read the Letters From Maine column by Dr. William G Wilkoff. I just read the article, "Who Should Be the Face of Pediatrics?" (March 2009, p. 12). About halfway through, I thought of Marian Wright ...
Soothing parents of infants who cry.(BEHAVIORAL CONSULT)
Jun 01, 2009; ... All babies cry, of course, but some babies cry a lot. In the old days, these babies were labeled "colicky." These days, they're often labeled GER (gastroesophageal reflux, basically "spitting up") babies, or they may be diagnosed with the more meaningful condition, GERD ...
Early bullying may predict psychosis in tweens.(BEHAVIORAL PEDIATRICS)
Jun 01, 2009; ... Children who were repeatedly bullied by their peers when they were 8 or 10 years old were almost twice as likely to exhibit psychotic symptoms at 12 years of age, based on data from more than 6,000 children. Previous research has shown that psychotic symptoms in nonclinical ...
Teens may be riding with parents who drink.(BEHAVIORAL PEDIATRICS)
Jun 01, 2009; ... BALTIMORE -- For as many as a third of adolescents who report riding in a car with a drinking driver, that driver may well be a parent rather than a peer. That finding, from an observational study based on a cross-sectional questionnaire of 2,100 adolescents, highlights "a ...
Web sites often mislead teens about sexual health.(BEHAVIORAL PEDIATRICS)
Jun 01, 2009; ... LOS ANGELES -- Teens cruising mainstream Web sites can hardly be faulted for thinking that emergency contraception is difficult to obtain, birth control pills will make them fat, and IUDs are meant for older women, not adolescents. That's because incomplete and inaccurate ...
Owning a dog may reduce allergy-eczema link.(CLINICAL ROUNDS)
Jun 01, 2009; ... [ILLUSTRATION OMITTED] WASHINGTON -- Having a dog in the house appears to reduce the positive association between eczema and sensitization to dog allergen in young children, but having a cat appears to enhance the positive association between cat allergy and eczema, according to ...
Home allergens hit hard in young asthma patients.(CLINICAL ROUNDS)
Jun 01, 2009; ... WASHINGTON -- Exposure to environmental asthma triggers at home was significantly associated with an increased risk of asthma-related hospitalizations in children younger than 4 years compared with older children, based on data from 306 children up to 18 years of age. The ...
Study: LVH risk higher in hypertensive black kids.(CLINICAL ROUNDS)
Jun 01, 2009; ... [ILLUSTRATION OMITTED] BALTIMORE -- The risk for left ventricular hypertrophy in children with primary hypertension may be greater for African Americans than for non-African Americans, based on the results of a cross-sectional retrospective study of 139 children. The ...
The child with a limp.(SUBSPECIALIST CONSULT)(Report)
Jun 01, 2009; ... You suspect that a patient you see has a limp that may indicate a more serious condition. What is the best strategy to evaluate this child? How do you know when to treat and when to refer the patient to a specialist? And finally, which tests are most useful and which others are likely to ...
Old drugs, new tricks.(GENOMIC MEDICINE)
Jun 01, 2009; ... AS a former gene therapy researcher, I must confess that to me, nearly all attempts at gene therapy for genetic disorders have been disappointing. The sad fact is that our immune system is its own worst enemy as far as gene therapy goes, clearing attempts to use vectors to introduce new ...
Teens with outdoor summer jobs may pay later.(CLINICAL ROUNDS)
Jun 01, 2009; ... SAN FRANCISCO -- People who worked at outdoor summer jobs as teenagers for 3 years or more had twice the risk of developing malignant melanoma later in life as those who did not, according to a case-control study by Dr. Darrell S. Rigel of New York University Medical Center. Dr ....
The spectrum of autism Tx options.(SPECIAL NEEDS: REALIZING POTENTIAL)
Jun 01, 2009; ... The Interactive Autism Network is still in its infancy, but data are beginning to accumulate from the more than 29,000 participants enrolled since it was launched in April 2007. One of the earliest findings reaffirms what many of you already know--children with autism spectrum disorders ...
EHR financial incentives tied to 'meaningful use'.(PRACTICE TRENDS)
Jun 01, 2009; ... WASHINGTON -- Just what exactly does "meaningful use" mean? It sounds like a simple question, but there's a lot of money riding on the answer. The Recovery Act, formally known as the American Recovery and Reinvestment Act, stipulates that for a physician to receive up to ...
Patients want Internet advice.(POLICY & PRACTICE)
Jun 01, 2009; ... Patients expect to rely on computers and other electronic technology in the future for many routine medical issues, and seem to be less concerned about privacy issues than providers are, a study in the Journal of General Internal Medicine found. The investigators convened focus groups of ...
CMS proposal: rescind Medicaid rules.(POLICY & PRACTICE)
Jun 01, 2009; ... The Centers for Medicare and Medicaid Services has proposed rescinding three Medicaid rules that were finalized in the last days of the Bush administration. Late last year, CMS finalized rules eliminating federal Medicaid reimbursement for school administrative activities and for ...
Programs improve school performance.(POLICY & PRACTICE)(Brief article)
Jun 01, 2009; ... Comprehensive services for children and youth with serious mental challenges dramatically improve performance in academics, behavior, and emotion when the services are received from coordinated community-based networks, according to a report from the Substance Abuse and Mental Health ...
Bonuses help Medicaid enrollment.(POLICY & PRACTICE)
Jun 01, 2009; ... Performance bonuses paid to the states to reward them for enrolling eligible children in Medicaid hold the potential to get many more children--especially the poorest children--covered, according to a report from advocacy group Families USA. As part of the recent reauthorization of the ...
Families can't afford insurance.(POLICY & PRACTICE)
Jun 01, 2009; ... The majority of uninsured American families can't afford to buy nongroup health insurance, according to a study from the Agency for Healthcare Research and Quality. The study measured families" median net worth--their savings plus other assets minus debt--rather than just income. The AHRQ ...
Demand for electronic PHRS is expected to rise.(PRACTICE TRENDS)
Jun 01, 2009; ... SAN DIEGO -- If you think that providing your patients with their own electronic personal health record is a waste of time and money, think again. "If you can communicate more effectively with an online personal health record, then you're enhancing that physician-patient ...
Leadership skills, Part V.(ON THE LEARNING CURVE)
Jun 01, 2009; ... The ability to teach is a skill that transcends all aspects of leadership and management. Through teaching staff members, patients and families, and partners in the community, you can share your vision, train others to work effectively as a team, and provide critical health education ....
Kaiser sees 26% drop in visits with EHR system.(PRACTICE TRENDS)
Jun 01, 2009; ... WASHINGTON -- Use of a comprehensive electronic health records system in the Kaiser Permanente Hawaii region reduced physician visits by 26% per member between 2004 and 2007, while scheduled "telephone visits" per member increased nearly 10-fold. The "sit up and take notice" ...
Coalition pledges to reduce rise in health care costs by $2 trillion over next decade.(PRACTICE TRENDS)
Jun 01, 2009; ... Leaders of several health care and labor organizations met with President Obama at the White House last month and proposed ideas to reduce the growth in health care costs by as much as $2 trillion over the next decade. In a letter sent to the president, the six ...
Nearly 3 weeks/year spent on insurer paperwork.(PRACTICE TRENDS)
Jun 01, 2009; ... Physicians and their staffs spend the equivalent of weeks--and $31 billion--each year processing health insurance paperwork, according to a study funded by the Commonwealth Fund and the Robert Wood Johnson Foundation. The survey of 895 physicians and practice administrators ...