News

Treatment 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 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.

Some 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.

The 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.

Pediatricians 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.

The 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.

Many 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?

The 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.

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. 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.

Trichomoniasis 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

A 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.

The mission of Contemporary Pediatrics is to provide readers with up-to-date, evidence-based information that will inform and enhance medical care for children.

Preterm 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.

The major advantages of computerized documentation are legibility of encounters and the ease with which one can develop and maintain problem and medication lists.

A coronary stent is a viable option as a bridge to a surgical revascularization or heart transplant in infants and young children with coronary stenosis.

The US Food and Drug Administration has ordered a safety labeling change for RotaTeq oral solution.

Less than half of pediatricians report routine STI screening for their sexually active patients.

Parents 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.

Pediatricians 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.

Here?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.

Unexplained 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.

A 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.

The start of school means an increase in questions about vaccine safety from parents who need to update their children?s immunizations. Just in time, FDA has archived materials that pediatricians can use to reassure parents of the safety of the recommended vaccine schedule. Read how to access these materials and others that might be helpful.

Research has found that the ?accident hump? for boys is trending downward into younger years. With physical maturity occurring earlier than ever, pediatricians should warn parents that their sons? deeper voices may mean more, not less, supervision.

Pediatricians have a considerably lower-than-average probability of being sued for malpractice compared with most specialties, but when plaintiffs prevail, their mean payouts are the highest of any physicians, according to a recent study. The mean indemnity payment for pediatricians was $520,923, almost twice as much as the mean for all physicians. But there?s good news too: read the study results and get the complete picture.

Here?s some new information that can help when you?re determining whom to screen for attention-deficit/hyperactivity disorder: ADHD prevalence has increased to 10% for children with family income less than 100% of the poverty level and to 11% for those with family income between 100% and 199% of the poverty level compared with a 7% to 9% overall increase, according to a National Center for Health Statistics report. Read more to find out what other indicators were linked with above-average increases in the disorder?s prevalence.

With influenza being one of the most common reasons for hospitalization of children, finding the most effective vaccination combination is increasingly important. That?s what researchers recently set out to do, finding that although the live attenuated influenza vaccine nasal spray and trivalent inactivated influenza vaccine shots are effective, only the nasal spray may confer additional immunity. Could a change in guidelines be on the horizon?

A brief review of a mother?s pregnancy history, including miscarriages and birth defects, may help in screenin for brain tumors. A recent study found that children whose mothers have had 2 or more late miscarriages have 3 times the risk of developing central nervous system (CNS) tumors. Birth defects also correlate with increased risk of CNS tumors.

Two new asthma studies include some practical advice that pediatricians can share with parents. One concerns mold in the home, which can lead to asthma development. Another study offers advice on using air cleaners to control asthma symptoms.