Pediatric News articles from June 2003

Pediatric News archives from June 2003

Doctors not always savvy about MDI-S. (Poor Working Knowledge in Several Studies).(metered-dose inhalers with spacers )
June 1, 2003... GREENWICH, CONN. -- Many pediatricians appear to lack working knowledge about the metered-dose inhalers with spacers that they commonly prescribe for asthma patients, according to three studies presented at a meeting of the Eastern Society for...

Transdermal MAO inhibitor appears effective for ADHD: the transdermal patch is applied daily, and it was well tolerated in a pilot study. (No Dietary Restrictions).(selegiline)
June 1, 2003... WASHINGTON -- A transdermal patch containing the selective monoamine oxidase inhibitor selegiline applied daily appeared effective and well tolerated in a pilot study of children and adolescents with attention-deficit hyperactivity disorder....

SARS seems less severe in children than in teens: based on data from first 10 pediatric cases. (Different Clinical Presentations).(severe acute respiratory syndrome )
June 1, 2003... Data on the first 10 pediatric patients with severe acute respiratory syndrome suggest that young children develop a milder form of disease with a less aggressive clinical course than teens and adults, said Dr. K.L.E. Hon of the Chinese...

Neonatal apnea risk declines, but doesn't disappear, with increasing age at birth. (Multiples, White Infants at Greater Risk).(Brief Article)
June 1, 2003... GREENWICH, CONN. -- The risk for neonatal apnea decreases with increasing age at birth, but still remains elevated at 35 weeks' gestation, Dr. Prakash M. Kabbur reported at a meeting of the Eastern Society for Pediatric Research. The risk...

Diagnostic dilemma.(accidental gamma-hydroxybutyrate poisoning)
June 1, 2003... A 4-year-old boy and his 2-year-old brother present to the emergency department approximately 20 minutes after drinking something from an unlabeled bottle at the gym where their father was working out. About 25 mL of liquid were missing from...

High-fat diet in early childhood may increase the risk of asthma. (Ratio of Omega-6 to Omega-3 at Issue).
June 1, 2003... DENVER -- Consuming a high-fat diet early in childhood may raise the risk of asthma, Dr. Clare S. Murray reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. Young atopic children with a history of...

Juice abuse. (Pediatric Briefs).(childhood obesity risk)(Brief Article)
June 1, 2003... Excessive fruit juice consumption is contributing to childhood obesity, Dr. Sarita Dhuper said at the Pediatric Academic Societies meeting. Daily fruit juice consumption was 32.1 ounces among 98 obese inner-city children (mean body mass index...

Big and fat. (Pediatric Briefs).(large-for-gestational-age infants have higher body fat proportion)(Brief Article)
June 1, 2003... Large-for-gestational-age (LGA) infants of women with gestational diabetes have higher proportions of body fat than do LGA infants of nondiabetic women, Dr. Celeste Durnwald reported at a meeting of the North American Diabetes in Pregnancy...

Metformin action. (Pediatric Briefs).(Brief Article)
June 1, 2003... The pharmacokinetics of immediate-release metformin are similar in adolescents with type 2 diabetes and in sex- and weight-matched healthy adults, Dr. Xiang Gao reported in a poster presentation at a meeting of the American Society for Clinical...

School lunch assessment. (Pediatric Briefs).(Brief Article)
June 1, 2003... School lunches are improving in meeting nutrition requirements but still have a ways to go, the General Accounting Office reported. While lunches served through the National School Lunch Program now meet requirements for protein, vitamins,...

Home hazards. (Pediatric Briefs).(Brief Article)
June 1, 2003... Despite recall notices and warnings, consumers continue to use household products that could harm children, the Consumer Product Safety Commission (CPSC) said. Common hazardous products still found in American homes include window blind cords...

Not a timesaver. (Pediatric Briefs).(comment on prescribing an uneeded antibiotic)(Brief Article)
June 1, 2003... Prescribing an unneeded antibiotic doesn't save you time, Dr. Marion E. Hare reported at the Pediatric Academic Societies' meeting. Data from 2,076 pediatric office visits for respiratory conditions during 1993-1999 revealed that the 43% of...

LASIK for lazy eye. (Pediatric Briefs).(Brief Article)
June 1, 2003... A 2-year-old boy with severe amblyopia has become the youngest patient on record to undergo LASIK (laser-assisted in situ keratomileusis) vision correction surgery, Dr. Jonathan M. Davidorf reported at a meeting of the American Society of...

No smallpox vaccine if small children at home. (One Hospital's Plan).(Brief Article)
June 1, 2003... BALTIMORE--No member of the Johns Hopkins University hospital staff who lives with a child under 1 year of age can be immunized against smallpox to be a first responder in case of an outbreak, Dr. Timothy Townsend said at a meeting on pediatric...

Montelukast reduces wheeze in viral illness. (Study Shows Symptoms Improved).
June 1, 2003... SEATTLE--Montelukast treatment significantly improved symptoms in children with viral respiratory illness, reducing the number of days they had wheezing and nasal congestion relative to placebo, Dr. Dalia Batista said at the annual meeting of...

Musculoskeletal pain is one atypical pneumonia presentation. (MRI Required for Diagnosis in One Case).(Brief Article)
June 1, 2003... NEW ORLEANS--Musculoskeletal pain may be the primary presenting symptom in a child with pneumonia, Dr. Bridgette Guthrie reported at the southern regional meeting of the American Federation for Medical Research. She described two such...

Ketolides, quinolones coming soon. (ID Consult).
June 1, 2003... Two new antibiotics will soon be I available to help us combat highly resistant respiratory infections. Both the macrolide derivative telithromycin and the fluoroquinolone fatifloxacin will be valuable new treatment alternatives. However,...

Disseminated candidiasis: watch for two factors. (Hospitalized Children with Candidemia).
June 1, 2003... ARLINGTON, VA.--Look our for two factors common to hospitalized children with candidemia who develop disseminated candidiasis, Dr. Theoklis E. Zaoutis said at the annual meeting of the Society for Healthcare Epidemiology of America. In a...

Giving infants palivizumab at home improves compliance. (Respiratory Syncytial Virus Prophylaxis).
June 1, 2003... GREENWICH, CONN.-Infants who receive palivizumab prophylaxis at home achieve better compliance and are less likely to be hospitalized for respiratory syncytial virus than are those who receive the injections in a physician's office, Dr. Sergio...

West Nile virus predicted to hit western U.S. hard. (Similar Conditions to Last Year's Scourge).
June 1, 2003... West Nile virus may march westward during the summer of 2003, promulgating disease in record numbers in the Great Plains, the West, and Alaska, two Harvard University investigators predict. In the meantime, physicians are urged to stay...

Focus on developmental issues at 'critical moments'. (Finding Time in a Busy Day).
June 1, 2003... KOHALA, HAWAII -- The busy pediatrician rarely has time to do complete behavioral and development assessments of newborns and infants, Dr. Martin Stein said at a meeting sponsored by the American Academy of Pediatrics. Nonetheless, there...

Treating both bullies and the bullied. (Behavioral Consult).
June 1, 2003... When you take on the treatment of a bullied or bullying child, you have to analyze many factors--or to put it in more familiar terms, you have to consider a differential diagnosis for bullying. For example, I once treated a 15-year-old...

There may be no safe lead levels, studies suggest. (Intellectual Impairment, Delayed Puberty).
June 1, 2003... There may be no safety margin for an elevated blood lead concentration in children, according to new data. Intellectual impairment in children, once associated with exposure to lead levels greater than 10 [micro]g/dL, has now been linked to...

Asymptomatic, high lead levels tied to delinquency. (Lead in their Bones).
June 1, 2003... Adolescents who have been adjudicated for delinquent acts are associated with having high levels of lead in their bones. The association has been noted before in violent and delinquent adolescents but not with asymptomatic levels of lead,...

Limiting resident work hours. (Guest Editorial).
June 1, 2003... I strongly believe in the limits on resident work hours set forth in the new guidelines from the Accreditation Council for Graduate Medical Education, which take effect this July, but I strongly oppose micromanagement of work hours. The...

Taking the first step. (Guest Editorial).
June 1, 2003... Beginning in 1996, our pediatric group in Lehigh Valley, Pa., enrolled 400 newborns into the randomized, controlled arm of the Healthy Steps for Young Children program. A fundamental component of the multiyear research study is the...

Diverse or abnormal? (Letters from Maine).
June 1, 2003... It was near the end of one of our morning call-in times and the familiar voice of Rita Blackburn penetrated my headset. "Dr. Wilkoff, the child development clinic representative who visits my son Colby's day care has suggested that he be...

Letters.(Don't Use a Hammer)(diagnosing and treating attention-deficit hyperactivity disorder)(Letter to the Editor)
June 1, 2003... Don't Use a Hammer After seeing many children with attention-deficit hyperactivity disorder over the years, I have started to think of ADHD first as "attentional weakness." This label is less constricting and keeps my mind open a...

Corrections.(Correction Notice)
June 1, 2003... In the article, "Guidelines for Cardiovascular Risk Reduction for High-Risk Children" (April 2003, p. 8), under "Blood Cholesterol Management," the recommendation regarding LDL cholesterol should have read "Consider pharmacologic therapy for...

Is the insurance cycle responsible for rising malpractice premiums? (Pro & Con).
June 1, 2003... [YES] Medical malpractice claims have held steady, yet insurance premiums have skyrocketed. This pattern can be attributed to the cyclical nature of the commercial insurance business. We are in the midst of a classic "hard" insurance...

Unprepared for a SARS quarantine. (Guest Editorial).(severe acute respiratory syndrome)
June 1, 2003... The Centers for Disease Control and Prevention has performed admirably to stem a severe acute respiratory syndrome (SARS) epidemic in the United States. Despite the strong federal response, the United States is ill prepared to cope with...

New & approved: Vigamox Ophthalmic Solution, Menomune. (Clinical Rounds).
June 1, 2003... Vigamox Ophthalmic Solution (moxifloxacin ophthalmic solution 0.5%, Alcon Inc.) The Food and Drug Administration approved Vigamox ophthalmic solution 0.5% for treatment of bacterial conjunctivitis in children as young as 1 year and adults....

Increasing sickle cell disease cures. (Add ATG to Stem Cells).(antithymocyte globulin )
June 1, 2003... PHILADELPHIA -- Adding antithymocyte globulin to a myeloablative regimen led to dramatic success in transplanting stem cells in a series of 69 children with severe sickle cell disease who were treated in France. After French physicians...

Rhinovirus wheezing is asthma risk. (Early Childhood).
June 1, 2003... Children who have experienced rhinovirus-induced wheezing in early childhood have a substantially increased risk of asthma in later childhood, reported Dr. Anne Kotaniemi-Syrjanen of Kuopio (Finland) University and her colleagues. ...

Pavlik harness effective for femoral shaft fracture. (Comparable to Spica Casting).
June 1, 2003... NEW ORLEANS -- The Pavlik harness is as effective as spica casting in treating femoral shaft fractures in children younger than 1 year, Dr. David A. Podeszwa reported at the annual meeting of the American Academy of Orthopaedic Surgeons. ...

Many knee articular cartilage defects do well left untreated. (Incidental Finding During ACL Surgery).
June 1, 2003... TORONTO -- Many traumatic articular cartilage defects found during anterior cruciate ligament reconstructive surgery may not require treatment, Dr. K. Donald Shelbourne said at a symposium of the International Cartilage Repair Society. His...

Prednisone effective for periodic fever syndrome. (Benign But Distressing Syndrome).(periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis)
June 1, 2003... SAN DIEGO -- Every busy pediatric practice probably has a least one child with a recently described, mysterious periodic fever syndrome unlinked to any infectious process, Dr. Kathryn M. Edwards said at a meeting sponsored by the Los Angeles...

Get a good look at conjunctival eyeball. (Use Toys or Light to Distract Child).
June 1, 2003... HILTON HEAD ISLAND, S.C.--Several dues can help distinguish allergic, viral, and bacterial causes of conjunctivitis in a child, Dr. Irene Tien said at a meeting on clinical pediatrics sponsored by Boston University. Taking a good history...

Patient resources for handheld computers. (Digital Assistance).
June 1, 2003... Overview: Many handheld computer applications are now available for personal health management. Personal medical information databases, electronic reference documents for self-education, and more elaborate disease management products may...

Insulin pump therapy also benefits preteens. (Less Risk for Microvascular Morbidity?).
June 1, 2003... NEW ORLEANS -- Insulin pump therapy was associated with a significant drop in hemoglobin [A.sub.1c] levels for preteens as well as teens with type 1 diabetes, Dr. Jordan Pinsker reported at the southern regional meeting of the American...

Insulin resistance syndrome associated with birth weight. (Gestational Diabetes, Maternal Obesity).
June 1, 2003... SEATTLE -- Children who are large for gestational age and exposed to either gestational diabetes or maternal obesity are at increased risk for developing insulin resistance syndrome during childhood, Dr. Charlotte Boney said at the annual...

Severe hypoglycemia in diabetics may not affect cognitive function. (Patients Aged 6-15 Years).(Brief Article)
June 1, 2003... Severe hypoglycemia in diabetic children aged 6-15 years does not appear to permanently impair cognitive function, reported Tim Wysocki, Ph.D., of Nemours Children's Clinic, Jacksonville, Fla., and his associates. In an 18-month...

Genetic heart defect rate more than doubled from the 1980s to 1990s. (Technology Boosted Detection Rates).
June 1, 2003... BALTIMORE -- The incidence of infants born with heart defects and a genetic anomaly more than doubled between the 1980s and the late 1990s, to a rate of 12.5/10,000 live births, Dr. Lorenzo D. Botto reported at the annual meeting of the...

Americans ambivalent about using preimplantation Genetic information. (Data Watch).
June 1, 2003... DATA WATCH Americans Ambivalent About Using Preimplantation Genetic Information % Approve % Disapprove % Don't Know Genetic disorder screening 74 22 4 Suitability for...

Hypertriglyceridemia induced by accutane predicts CV risk. (High Cholesterol Levels, Obesity).(cardiovascular disease risk)
June 1, 2003... MAUI, HAWAII -- A hypertriglyceridemic response to isotretinoin therapy for acne is a marker for increased future risk of developing hyperlipidemia and other cardiovascular risk factors, Dr. Diane Thiboutot said at the annual Hawaii dermatology...

Some infants with either trisomy 13 or 18 survive longer than 1 year. (May Live into Teens).
June 1, 2003... BALTIMORE -- About 8% of infants born with either trisomy 13 or trisomy 18 survive longer than 1 year, Dr. Sonja A. Rasmussen said at the annual meeting of the American Society of Human Genetics. "The perception among most physicians is...

Rehab is the answer for most sports injuries. (Nonsurgical Options).
June 1, 2003... KIAWAH ISLAND, S.C. -- Nearly 95% of musculoskeletal problems in children are nonsurgical and can be treated with proper rehabilitation, Dr. Steven Anderson said at a sports medicine meeting on pediatric and adolescent sports medicine sponsored...

Stay up to date on weight loss medications. (Treating Adolescent Obesity).
June 1, 2003... SEATTLE -- It behooves the pediatrician to stay up to date on dealing with adolescent obesity and understanding the types of weight loss medications used, Dr. Marjorie A. Boeck said at the annual meeting of the Society for Adolescent Medicine....

Consider special gyn needs of chronically ill girls. (STDs, Pregnancy, Teratogenicity).
June 1, 2003... MIAMI BEACH -- Improved survival rates in children with chronic illnesses means they have a growing need for gynecologic care, Dr. Elizabeth Alderman said at the annual meeting of the North American Society for Pediatric and Adolescent...

Supplements, counseling beef up picky eaters. (Reduce Infection Risk).(Brief Article)
June 1, 2003... The combination of a nutritional supplement and nutritional counseling aided in catch-up growth in children with picky eating behavior, also reducing the incidence of infection, said Dr. Pedro A. Alarcon of Abbott Laboratories, Abbott Park,...

Retinal hemorrhage, seizures signal abusive head trauma. (Scalp Injury More Likely Accidental).
June 1, 2003... GREENWICH, CONN.--Signs of child abuse in an infant or toddler with head trauma include retinal hemorrhages that are bilateral and extend to the periphery seizures, and/or persistent abnormal mental status, Dr. Kirsten Bechtel said at a meeting...

Anogenital lesions alone don't tell the sex abuse story. (Some Particular Signs, History Important).
June 1, 2003... ASPEN, COLO.--Often it takes a good medical detective to determine if anogenital lesions in children are the result of sexual abuse, according to Dr. Elaine C. Siegfried. Many cases lack absolute diagnostic signs of abuse, so the diagnosis...

Accidental falls don't often cause severe head injuries. (Study of 94 Children).
June 1, 2003... CHICAGO--Accidental falls rarely produce significant head injuries, Dr. Karl Johnson said at the annual meeting of the Radiological Society of North America. "In our experience, if it's an accident, most children will fall over, they may...

Leading causes of Neonatal death in the U.S., 2000. (Data Watch).(Brief Article)
June 1, 2003... DATA WATCH Leading Causes of Neonatal Death In the U.S., 2000 % of Neonatal Neonatal Deaths ...

Residency programs brace for new work hours. (July 1 Implementation Date).
June 1, 2003... Most residency programs will be able to comply with the new work hours that go into effect in July, but they'll have to make some adjustments. Dr. Ingrid Philibert, director of field activities with the Accreditation Council for Graduate...

Watch for poor literacy in parents, adjust your info delivery. (Experts Urge Using 'Plain Language').
June 1, 2003... WASHINGTON -- Two-thirds of all physicians are unaware that there's a health literacy problem in the United States, Dr. Joseph Riggs said at a press conference on health literacy sponsored by the American Medical Association. Patients'...

Task force urges trust fund for academic centers. (Teaching Hospitals Need a Financial Boost).(Commonwealth Fund Task Force on Academic Health Centers)
June 1, 2003... WASHINGTON -- Creating a public trust fund for teaching hospitals and their affiliated medical centers would make the financing for these centers more accountable, predictable, and transparent, policy makers announced at a press briefing...

Pediatric practices becoming more e-mail consult friendly. (Parents Like it, Doctors Warming to it).
June 1, 2003... NEW ORLEANS--Parents of pediatric patients generally like the idea of communicating with the doctor via email, and pediatricians seem to be warming up to the idea as well. Of 266 parents interviewed in pediatric waiting rooms, 91% had...

Deaths from varicella down over 8 years. (Vaccine Success Story).
June 1, 2003... CHICAGO -- Varicella still claims a small number of lives, but overall the 8-year-old vaccination program is successful, Dr. Jane Seward said at the National Immunization Conference sponsored by the Centers for Disease Control and Prevention....

Smallpox in the Red Book. (Clinical Capsules).(American Academy of Pediatrics Red Book)(Brief Article)
June 1, 2003... The newest edition of the American Academy of Pediatrics Red Book will have a chapter on smallpox for the first time since 1977, Dr. Julia A. McMillan announced at a meeting on pediatric trends sponsored by Johns Hopkins University in...

Supine sleeping boosts health. (Clinical Capsules).(Brief Article)
June 1, 2003... Infants put to sleep on their backs are healthier and at lower risk for sudden infant death syndrome, said Dr. Carl E. Hunt of the Medical College of Ohio, Toledo, and his associates (Arch. Pediatr. Adolesc. Med. 157[5]:469-74, 2003). In a...

Amoxicillin better for GABHS. (Clinical Capsules).(group A beta-hemolytic streptococcal tonsillopharyngitis )(Brief Article)
June 1, 2003... Children treated with amoxicillin for group A beta-hemolytic streptococcal tonsillopharyngitis (GABHS) had a significantly higher cure rate than those treated with penicillin, said Dr. Correne Curtin-Wirt and her colleagues at the Elmwood...

Rhinovirus impacts asthma. (Clinical Capsules).(Brief Article)
June 1, 2003... Rhinovirus appears to exacerbate asthma in children, but human metapneumovirus does not, said Dr. William D. Rawlinson of Prince of Wales Hospital, New South Wales, Australia, and his associates (J. Infect. Dis. 187[8]:1314-18, 2003)....

Timing tympanostomy tubes. (Clinical Capsules).(Brief Article)
June 1, 2003... Developmental outcomes at age 3 years are not significantly affected by whether tympanostomy tubes were inserted sooner or later after persistent otitis media diagnosis, said Dr. Jack L. Paradise of the Children's Hospital of Pittsburgh and his...