Contemporary Pediatrics, Digital Edition, October 2011
October 1st 2011Screening adolescents for Bariatric Surgery : When diet, exercise just aren't enough Bats! 3 steps for rabies exposure prophylaxis Dermcase : Atrophic scars and poor wound healing in young boy Puzzler : Abrupt, intermittent pain and fever, but no apparent cause Updates : Infant formula, CDC on Flu vaccination, Medication poisoning, Antibiotics, AAP on Poliovirus, Varicella, Hepatitis A and Tdap
Politics and the HPV Vaccine: How Would You Respond?
September 19th 2011Minnesota Congresswoman Michelle Bachmann recently caught the attention of a lot of people when, during a television interview following a Presidential debate, she claimed that the HPV vaccine has “very significant consequences.”
Basketball can deform femur in young athletes, lead to arthritis
September 15th 2011Proponents often maintain that basketball is a safer sport for young athletes than rougher activities such as football or hockey. But that is not a slam dunk case, according to a new study, which found that playing basketball can lead to abnormal development of the head of the femur in young players, resulting in a deformed hip with impaired rotation and pain during movement. Read more to discover the longer-term implications of that injury.
Fewer than 3 doses of HPV vaccine effective, new study finds
September 15th 2011The current protocol for HPV 16/18 vaccine, 3 doses over 6 months, can be expensive and inconvenient. Now, a new study suggests that fewer than 3 doses may be just as effective as the standard 3-dose regimen when it comes to preventing cervical cancer with one of the approved vaccines. Find out how this discovery came about and how it potentially could be used to increase vaccination rates.
Black children especially vulnerable to peanut, other food allergies
September 15th 2011An unidentified food allergy can be life threatening for some children, but it is not always clear when screening is appropriate. A new study has found that self-reported black race and African ancestry, determined by genetic analysis, were associated with a high number of sensitizations to food, most notably peanuts. See what researchers have to say about the possible relationships between ethnic background and food sensitization.
Flu prevention emphasized in first guidelines on CAP for children
September 15th 2011Treatment guidelines on community-acquired pneumonia (CAP) are very clear on the critical first step: Make sure that your patients are immunized against influenza, a leading cause of pneumonia in children. The guidelines from 2 major infectious disease societies offer other valuable advice to help you diagnose accurately and respond effectively without over treating.
Can providers take states to court on Medicaid cuts? Supreme Court will decide.
September 15th 2011Can providers turn to the courts to block states from making drastic cuts to Medicaid payments? That is the issue to ultimately be decided by the US Supreme Court. The case involves California?s 10% rate cut for Medi-Cal in 2008, which providers claim violates the federal Medicaid Act?s guarantee of equal access to health care. Find out why this case is important and what could happen to Medicaid payments in your state if the court rules in favor of California.
How to tell when normal grief over losing a parent becomes pathologic
September 15th 2011Some 5% of US children will lose a parent during their childhood or adolescence. It often can be difficult for pediatricians to detect when typical grief turns into something more pathologic. A new study offers some information on what is normal and what factors can lead to longer-term depression and dysfunction.
AAP reaffirms HPV vaccine for girls
September 15th 2011The American Academy of Pediatrics has corrected false campaign statements made this week by Republican presidential candidates that the vaccine for human papillomavirus, administered to girls and young women to protect against cervical cancer, is dangerous and can cause mental retardation.
CDC: Just say no to antibiotics for most common respiratory infections
September 8th 2011Pediatricians should just say no to drugs when considering prescribing antibiotics for conditions that don?t usually require them. That?s the position of public health officials who say that pediatricians are doing a better job of limiting antibiotic prescriptions but still have a way to go before reaching appropriate levels of use. Inappropriate use of antibiotics continues unabated in 3 of 5 acute respiratory infections. Find out which ones.
New flu vaccination essential even though formulation didn't change
September 8th 2011The influenza vaccine?s formulation may be unchanged from last year, but immunity in children can decline precipitously without another dose this year, according to new recommendations. The good news is that kids aged 6 months to 8 years need only 1 dose if they were vaccinated last year; others in that age group will still require 2 doses. Find out what else the new recommendations have to say, especially about immunization for youngsters with egg allergies.
Pediatricians face new challenges in hiring NPs, PAs
September 8th 2011Many pediatricians, especially those in primary care, do not currently employ midlevel providers but do plan to add them, according to recent survey. However, hiring and retaining nurse practitioners and physicians assistants will only get more difficult over the next few years, according to several reports that note that salaries are likely to skyrocket with the shortage of clinicians at that level. Can your practice stay competitive with current salaries and future increases?
Alert: Watch out for flu in children with swine exposure
September 8th 2011The CDC is warning pediatricians to be on the lookout for influenza in patients with recent exposure to pigs after 2 separate cases of swine-origin influenza were identified in children late this summer. Clinicians are being asked to speedily obtain an analysis and to consider starting the patient on antiviral treatment to quickly limit potential human transmission if a case is identified. Find out why these cases are different from other cases of animal-transmitted influenza.
Unexplained Bruising in a Teenager: Abuse-or Mimic?
September 8th 2011A 14-year-old boy presented to the abuse clinic at the request of child protective services. The boy’s gym teacher had noticed multiple large bruises on his back, arms, and legs. School officials had previous experience with the child’s “volatile” stepfather and thought him “capable of abuse.” There were also unofficial concerns of past domestic abuse. A 14-year-old boy presented to the abuse clinic at the request of child protective services. The boy’s gym teacher had noticed multiple large bruises on his back, arms, and legs. School officials had previous experience with the child’s “volatile” stepfather and thought him “capable of abuse.” There were also unofficial concerns of past domestic abuse.
Contemporary Pediatrics, Digital Edition, September 2011
September 1st 2011Trichomoniasis in adolescents : Safe and easy screening options Teens and confidentiality : Know the legal challenges in your state EHRs and your pediatric practice : What requirements and costs mean for you Oral contraceptive therapy for teens : 7 strategies for talking to parents who object Dermcase : Maffucci syndrome in a 10-year-old boy Puzzler : Upper extremity hemiparesis in toddler with seizures
Study evaluates breastfeeding's effect against sudden infant death syndrome
September 1st 2011A meta-analysis of 18 case-controlled studies on the relationship between breastfeeding and risk of sudden infant death syndrome revealed that breastfeeding of any duration is protective, especially if the breastfeeding is exclusive.
Rising infant mortality rates linked to increase in preterm, cesarean deliveries
September 1st 2011Preterm birth exerts a huge influence on infant mortality, and because less than half of preterm births are linked to spontaneous labor, it's important to consider the possible effect of obstetric intervention on the preterm birth rate.
Be firm about "firm": Parents don't always get message on infant bedding
September 1st 2011Parents don?t always understand what is meant by ?firm? when talking about bedding intended to reduce the risk of SIDS, and they worry that their infants may be uncomfortable, according to new research. Find out what misunderstandings are likely to occur and how you can counter them.
Low HPV vaccination rate could mean danger later for teenagers
September 1st 2011Pediatricians are in an ideal position to turn around the low rate of vaccination against human papillomavirus in teenaged girls, according to a new government study. Nearly two-thirds of American teenaged girls have yet to receive the recommended 3-dose vaccination. Here are some proven methods for getting them the protection they need.
New guidelines: No routine VCUG in infants with UTIs
September 1st 2011Here?s welcome news for nervous parents and the pediatricians who have to deal with urinary tract infections (UTI) in infants: New guidelines from the American Academy of Pediatrics do not recommend routine use of voiding cystourethrography after the first UTI in febrile infants and children aged 2 to 24 months. Read more for information on when the test is indicated as well as other changes in UTI diagnosis and management.
The heart of the matter: Unexplained nausea may not be digestive issue
September 1st 2011Unexplained chronic nausea often is treated as a digestive entity, but a new study suggests that regulating heart rate and blood pressure may be a better approach in some cases. Read more to find out how fludrocortisone worked in reducing debilitating chronic nausea in young patients.
Reassure worried parents: Vaccines rarely have serious adverse effects
September 1st 2011A recent consensus report gives pediatricians more ammunition when trying to persuade parents to update their children?s immunizations as school begins this year. The message was very clear: Serious adverse events associated with vaccines can occur but are very rare. The report also had some comforting information about the adverse effects (ie, autism) that parents fear most.