children RCT of Montelukast as Prophylaxis for Upper Respiratory Tract Infections in Children By pediatrics.aappublications.org Published On :: 2012-01-04T00:08:02-08:00 Upper respiratory tract infections (URIs) are very common in children. Currently, there are no effective preventive measures for URI. There are no studies on the effect of montelukast for prevention of URI.In a randomized, double-blind, placebo-controlled study of preschool-aged children, 12-week prophylactic treatment with montelukast did not reduce the incidence of URI. (Read the full article) Full Article
children The Risk of Immune Thrombocytopenic Purpura After Vaccination in Children and Adolescents By pediatrics.aappublications.org Published On :: 2012-01-09T00:06:36-08:00 Studies on vaccine safety are crucial to the ongoing success of our national immunization program. ITP has a known association with MMR in young children, occurring in 1 in 40 000 doses. The risk after other childhood vaccines is unknown.This study found no increased risk of ITP after vaccines other than MMR in young children, confirmed an association of ITP with MMR, and also found that ITP may occur after certain other vaccines in older children. (Read the full article) Full Article
children Bronchoscopic Findings in Children With Chronic Wet Cough By pediatrics.aappublications.org Published On :: 2012-01-09T00:06:35-08:00 Chronic wet cough is a common symptom well recognized by pediatricians. Protracted bacterial bronchitis is defined as more than 4 weeks of wet cough that responds to antibiotic treatment. Diagnosis of protracted bacterial bronchitis is not readily accepted by pediatriciansChildren with chronic wet cough often have bronchitis, which is evident during bronchoscopy. Purulent bronchial secretions suggest the presence of bacterial infection. Children with chronic wet cough frequently have a bacterial infection of the lower airway. (Read the full article) Full Article
children Lead Poisoning in United States-Bound Refugee Children: Thailand-Burma Border, 2009 By pediatrics.aappublications.org Published On :: 2012-01-16T00:06:52-08:00 Refugee children arriving in the United States have had higher rates of elevated blood lead levels than US-born children. The Centers for Disease Control and Prevention recommends blood lead screening of all refugee children within 3 months after their arrival in the United States.This is the first investigation we are aware of to examine and identify risk factors for lead poisoning among US-bound refugee children living in camps overseas, before their arrival in the United States. (Read the full article) Full Article
children Multicenter Analysis of Quality Indicators for Children Treated in the Emergency Department for Asthma By pediatrics.aappublications.org Published On :: 2012-01-16T00:06:47-08:00 Studies of the association between process and outcome measures of the quality of acute asthma care for children have been mixed. These studies are limited by small, single-institution settings or by examining the association at the aggregate level.This first multicenter analysis of the process-outcome association in acute asthma care for children revealed no association. Because the validity of process measures depends on association with outcomes, further study is needed before implementing existing process measures as performance metrics. (Read the full article) Full Article
children Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children By pediatrics.aappublications.org Published On :: 2012-01-23T00:06:40-08:00 Previous research has demonstrated that young children with traumatic brain injury are at elevated risk of poor outcomes, particularly following severe injuries. These deficits persist until at least 5 years postinsult. Factors predicting outcomes in this age group have not been established.This study follows survivors of very early traumatic brain injury into adolescence. Results indicate that severe injury is associated with poorest outcome, but after 3 years, the gap between children with severe traumatic brain injury and peers stabilizes. (Read the full article) Full Article
children Value of Follow-up Examinations of Children and Adolescents Evaluated for Sexual Abuse and Assault By pediatrics.aappublications.org Published On :: 2012-01-30T00:06:44-08:00 Although follow-up examinations are recommended for suspected victims of sexual abuse or assault, little is known about the potential benefits of a second examination with regard to diagnosing trauma or sexually transmitted infections.In ~23% of pediatric patients evaluated for sexual abuse or assault, a second examination by a specialist changed the interpretation of trauma likelihood or results in the detection of a sexually transmitted infection. (Read the full article) Full Article
children Randomized Trial of Oral Versus Sequential IV/Oral Antibiotic for Acute Pyelonephritis in Children By pediatrics.aappublications.org Published On :: 2012-01-30T00:06:41-08:00 The standard initial management for infants and children with acute pyelonephritis is intravenous antibiotic treatment.Our results support the use of an oral cefixime treatment of initial episodes of acute pyelonephritis involving a gram-negative bacteria strain in children aged 1 month to 3 years who are without urological abnormalities and without clinical hemodynamic impairment. (Read the full article) Full Article
children Using US Data to Estimate the Incidence of Serious Physical Abuse in Children By pediatrics.aappublications.org Published On :: 2012-02-06T00:06:35-08:00 Limited data exist about the frequency and incidence of serious injuries due to physical abuse of children. Data from Child Protective Services, which are published yearly, do not have information about severity.This is the first study to provide US estimates on the occurrence of serious injuries due to physical abuse. The incidence was highest in infants on Medicaid. Such data can be used to track changes due to prevention. (Read the full article) Full Article
children Resilience in Children Undergoing Stem Cell Transplantation: Results of a Complementary Intervention Trial By pediatrics.aappublications.org Published On :: 2012-02-06T00:06:33-08:00 Children undergoing stem cell transplantation are thought to be at risk for increased distress, adjustment difficulties, and impaired health-related quality of life. Few interventions to improve adjustment and quality-of-life outcomes in this setting have been tested.The excellent outcomes observed in all patient groups, including controls, may be a result of improvements in standard supportive care. Stem cell transplantation may not be as demanding as previously thought to be, and children undergoing this procedure appear resilient to the challenge. (Read the full article) Full Article
children The Effect of Simulated Ostracism on Physical Activity Behavior in Children By pediatrics.aappublications.org Published On :: 2012-02-06T00:06:32-08:00 The social and emotional burdens of ostracism are well known, but few studies have tested whether ostracism adversely alters physical activity behaviors that may result in maintenance of childhood obesity.This is the first study to experimentally assess the effect of simulated ostracism, or social exclusion, on physical activity behavior in children. Ostracism reduced accelerometer counts by 22% and increased time allocated to sedentary behaviors by 41%. (Read the full article) Full Article
children Impact of a Guideline on Management of Children Hospitalized With Community-Acquired Pneumonia By pediatrics.aappublications.org Published On :: 2012-02-20T00:08:21-08:00 Community-acquired pneumonia (CAP) is a common pediatric illness caused by Streptococcus pneumoniae. New pediatric Infectious Diseases Society of America CAP guidelines are now available recommending ampicillin as empirical treatment of children hospitalized with uncomplicated CAP.This study found that a CAP guideline led to an increase in the narrow-spectrum antibiotic ampicillin. Additionally, an increase in the use of amoxicillin at discharge was observed. Furthermore, change in therapy did not lead to increased adverse outcomes. (Read the full article) Full Article
children Prevalence of Autism Spectrum Disorders in Hispanic and Non-Hispanic White Children By pediatrics.aappublications.org Published On :: 2012-02-20T00:08:19-08:00 The number of individuals diagnosed with autism spectrum disorders (ASDs) continues to increase in the United States and other developed countries. Most prevalence estimates indicate that ASD is diagnosed less commonly in Hispanic individuals compared with non-Hispanic (NH) white populations.Prevalence of ASD in Arizona’s population-based cohort is higher than reported previously. Prevalence in the Hispanic population and NH white population increased significantly over time, with a significant decrease in the gap between Hispanic and NH white prevalence. (Read the full article) Full Article
children Children and Adolescents With Gender Identity Disorder Referred to a Pediatric Medical Center By pediatrics.aappublications.org Published On :: 2012-02-20T00:08:17-08:00 Studies in the Netherlands show that pubertal blockade at Tanner 2/3 prevents unwanted sex characteristics and improves psychological functioning. Endocrine Society guidelines (2009) recommend pubertal suppression for adolescents with gender identity disorder until approximately age 16.This is the first study of a US cohort of children and adolescents with gender identity disorder. Patients were referred for medical treatment to a pediatric center that supports a multidisciplinary Gender Management Service. (Read the full article) Full Article
children Self-Referral and Serious Illness in Children With Fever By pediatrics.aappublications.org Published On :: 2012-02-27T00:08:31-08:00 General measures discourage all self-referrals to the emergency department. For adults, self-referral to the emergency department has been associated with nonsevere disease, whereas severity of illness of self-referred children is still unknown.One in four parents properly judged and acted on their febrile child’s illness by presentation to the emergency department on their own initiative. Measures to discourage parents from self-referral may potentially result in delayed or missed diagnoses. (Read the full article) Full Article
children Functional Difficulties and Health Conditions Among Children With Special Health Needs By pediatrics.aappublications.org Published On :: 2012-02-27T00:08:28-08:00 Children with special health care needs present clinically with varied functional difficulties across an array of health conditions. Little attention has been given to the interaction of these descriptors at a population level, thereby not addressing the complexity of functional difficulties and their impact on the health of CSHCN.The data demonstrate the relationships among functional difficulties and health conditions, which then improve our understanding of CSHCN and their needs. Functional difficulties contribute significantly to outcomes, such as emergency room visits, parental work patterns, and limitations in daily activities, and have implications for practice, training, policy, and research. (Read the full article) Full Article
children What the Orphan Drug Act Has Done Lately for Children With Rare Diseases: A 10-Year Analysis By pediatrics.aappublications.org Published On :: 2012-02-27T00:08:27-08:00 Rare diseases in childhood can be debilitating and require lifelong care. Since 1983, the Orphan Drug Act incentives have stimulated the development and significantly improved the availability of treatment products for patients with rare diseases.We report an increasing pediatric orphan product designations and approvals from 2000 to 2009. The trend indicates that the Orphan Drug Act has continued to address this important unmet need. (Read the full article) Full Article
children Stability of Cognitive Outcome From 2 to 5 Years of Age in Very Low Birth Weight Children By pediatrics.aappublications.org Published On :: 2012-02-27T00:08:25-08:00 Very preterm children are at risk for developmental problems and, therefore, a systematic follow-up is important. However, the relevance of early follow-up of cognitive development has been questioned because of the divergent data on the prognostic value of early measures.Good stability of cognitive development was found between the ages of 2 and 5 years. Well-conducted assessment of cognitive development in infancy is both reliable to anticipate later development and clinically valuable to identify those children who need developmental support. (Read the full article) Full Article
children Impact of an Active Video Game on Healthy Children's Physical Activity By pediatrics.aappublications.org Published On :: 2012-02-27T00:08:25-08:00 Active video games can enable children under laboratory conditions to participate in moderate, and even vigorous, physical activity. There are inconsistencies in the literature, however, about whether active video games enable children to increase physical activity under more naturalistic circumstances.This study tests whether children receiving a new active video game spontaneously engaged in more physical activity, and whether commercially available active video games have a public health benefit. No additional physical activity was detected, suggesting no public health benefit. (Read the full article) Full Article
children Interrater Reliability of Clinical Findings in Children With Possible Appendicitis By pediatrics.aappublications.org Published On :: 2012-03-05T00:08:32-08:00 Few studies have examined the reliability of clinical findings in pediatric appendicitis. Clinical prediction rules are most useful if the included variables are reliable across practice settings and practitioners.Among children who present with possible appendicitis, the interrater reliability varied considerably for patient history and physical examination variables. Those variables with the highest degree of reliability may be best suited for inclusion in appendicitis clinical prediction rules. (Read the full article) Full Article
children Barriers to Conducting Advance Care Discussions for Children With Life-Threatening Conditions By pediatrics.aappublications.org Published On :: 2012-03-05T00:08:28-08:00 Previous studies have identified barriers to providing optimal pediatric palliative care, including general communication issues between clinicians and family members. However, there is a paucity of data regarding the barriers specifically relating to advance care discussions.This study identifies significant barriers to advance care discussions for children with life-threatening conditions. Clinicians perceive parental issues as the most common impediments to these discussions. Furthermore, providers believe that advance care discussions happen too late in the course of illness. (Read the full article) Full Article
children A Randomized Controlled Trial of Zinc as Adjuvant Therapy for Severe Pneumonia in Young Children By pediatrics.aappublications.org Published On :: 2012-03-05T00:08:26-08:00 Pneumonia is still a significant problem in young children from developing countries where zinc deficiency is prevalent. Although zinc supplementation reduces the risk of childhood pneumonia, the effect of adjunct zinc on severe pneumonia is unclear with conflicting results.The overall effect, if any, of zinc as adjuvant therapy for World Health Organization–defined severe pneumonia in young children is small. (Read the full article) Full Article
children Stair-Related Injuries to Young Children Treated in US Emergency Departments, 1999-2008 By pediatrics.aappublications.org Published On :: 2012-03-12T00:07:22-07:00 Stairs are a common source of injury to children. Most injuries are minor soft tissue injuries, with the head and neck region being injured most commonly.This is the first nationally representative study of stair-related injuries to young children in the United States. A child aged <5 years is treated in a US emergency department, on average, every 6 minutes for a stair-related injury. (Read the full article) Full Article
children Rising National Prevalence of Life-Limiting Conditions in Children in England By pediatrics.aappublications.org Published On :: 2012-03-12T00:07:20-07:00 For children and young people with life-limiting conditions, palliative care services should be available, but few national or local data are available to estimate the burden of these conditions.The prevalence of life-limiting conditions in children and young people in England was double the previously reported estimates, at 32 per 10 000 population. This identifies a need for specialist pediatric palliative care services. (Read the full article) Full Article
children Impact of Rotavirus Vaccine on Diarrhea-Associated Disease Burden Among American Indian and Alaska Native Children By pediatrics.aappublications.org Published On :: 2012-03-19T00:07:56-07:00 In the prerotavirus vaccine era, diarrhea-associated hospitalization and outpatient rates among American Indian and Alaska Native children were higher than those among the general US population. Routine rotavirus vaccination has dramatically decreased rotavirus diarrhea burden in the general US population.Decreases in diarrhea-associated hospitalization and outpatient rates among American Indian and Alaska Native children in postvaccine years were observed in all Indian Health Service regions, with declines greater in each subsequent year after vaccine introduction. (Read the full article) Full Article
children Mental Health Difficulties in Children With Developmental Coordination Disorder By pediatrics.aappublications.org Published On :: 2012-03-26T00:07:45-07:00 Cross-sectional studies have shown an increased risk of mental health difficulties in children with developmental coordination disorder. However, there has been limited longitudinal research in this area controlling for confounding factors and assessing the role of potential mediators.Children with "probable" developmental coordination disorder at 7 years had a significantly increased risk mental health difficulties at 10 years. Protective factors for self-reported depression included high IQ, high self-esteem, good social communication skills, and the absence of bullying. (Read the full article) Full Article
children Measles-Containing Vaccines and Febrile Seizures in Children Age 4 to 6 Years By pediatrics.aappublications.org Published On :: 2012-04-02T00:07:13-07:00 Febrile seizure risk 7 to 10 days after measles-mumps-rubella-varicella (MMRV) is double that of separate measles-mumps-rubella (MMR) and varicella vaccines among 1-year-olds. Whether MMRV or MMR and varicella affect febrile seizure risk among 4- to 6-year-olds has not been reported.Using Vaccine Safety Datalink data, we examined risk for febrile seizures after measles-containing vaccines. This study provides reassurance that MMRV and separately administered MMR and varicella were not associated with increased risk of febrile seizures among 4- to 6-year-olds. (Read the full article) Full Article
children High Blood Pressure in 2.5-Year-Old Children Born Extremely Preterm By pediatrics.aappublications.org Published On :: 2012-04-02T00:07:12-07:00 Subjects born preterm have higher blood pressure (BP) in childhood and adolescence. Little is known about at what age the deviation from normal BP starts, and data are especially scarce for the new generation of survivors after extremely preterm birth.In a population-based study, we found that BP was higher in 2.5-year-old children born extremely preterm compared with controls. This finding might have implications for follow-up programs after preterm birth, with the goal of improving later cardiovascular health. (Read the full article) Full Article
children Obese Mexican American Children Have Elevated MCP-1, TNF-{alpha}, Monocyte Concentration, and Dyslipidemia By pediatrics.aappublications.org Published On :: 2012-04-02T00:07:10-07:00 Nearly one-third of all US children are overweight or obese, with even higher prevalence among Mexican American children. Overweight and obesity increase systemic inflammation, contributing to increased risk for chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease.Obese Mexican American children had concurrent alterations in both inflammatory markers and traditional disease risk markers, relative to healthy weight children. Our results provide evidence partially explaining the health disparity for disease in Mexican American children who are overweight/obese. (Read the full article) Full Article
children Association of Malodorous Urine With Urinary Tract Infection in Children Aged 1 to 36 Months By pediatrics.aappublications.org Published On :: 2012-04-02T00:07:10-07:00 The presence of malodorous urine is often mentioned as one of the clinical manifestations of urinary tract infection (UTI) in young children, yet the few studies looking at this symptom are contradictory.Our study demonstrates that malodorous urine as reported by parents increases the likelihood of UTI among young children evaluated for suspected UTI. However, this association is not strong enough to definitely rule in or out a diagnosis of UTI. (Read the full article) Full Article
children Six Developmental Trajectories Characterize Children With Autism By pediatrics.aappublications.org Published On :: 2012-04-02T00:07:09-07:00 Autism is widely considered a heterogeneous disorder in terms of etiology and phenotype. Although autism is usually a lifelong disorder, little is known about the rate or timing of how children develop regarding their communication and social functioning.Utilizing annual evaluations for a large population of children with autism, we describe the 6 most common trajectories from diagnosis through age 14 years. Trajectories revealed considerable variation, and high socioeconomic status children were more likely to experience rapid improvement. (Read the full article) Full Article
children Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children By pediatrics.aappublications.org Published On :: 2012-04-09T00:07:34-07:00 Some but not all randomized trials have shown effects of probiotics on incidence and duration of diarrhea and respiratory tract infections among children in developing countries. Calcium improves resistance to intestinal infections in adults, but efficacy in children is unknown.Lactobacillus reuteri DSM17938 may prevent diarrhea, especially in children with lower nutritional status. Regular calcium milk, alone or with Lactobacillus casei CRL431, did not reduce diarrhea. None of the interventions affected respiratory tract infections in these Indonesian children. (Read the full article) Full Article
children Inpatient Hospital Care of Children With Trisomy 13 and Trisomy 18 in the United States By pediatrics.aappublications.org Published On :: 2012-04-09T00:07:33-07:00 Trisomy 13 and trisomy 18, common chromosomal abnormalities, are generally considered fatal within the first year after birth, although some children live longer. Little is known, however, about the inpatient medical courses of these infants and children.Evaluation of nationally representative hospitalization data demonstrates that a significant number of children with trisomy 13 and trisomy 18 live beyond 1 year of age and that the care they receive includes both medical and surgical treatments. (Read the full article) Full Article
children Barriers to Medication Adherence in HIV-Infected Children and Youth Based on Self- and Caregiver Report By pediatrics.aappublications.org Published On :: 2012-04-16T00:07:48-07:00 Nonadherence to antiretroviral therapy among children and youth with HIV is a frequent problem that can result in treatment failure and disease progression for this population. Children and adolescents face different barriers to adherence than adults infected with HIV.Few studies have examined specific barriers to adherence as reported by children with perinatally acquired HIV and their caregivers. This report examines the agreement between child and caregiver perceptions of adherence barriers and the factors associated with these barriers. (Read the full article) Full Article
children Risk Factors for Hospitalization With Lower Respiratory Tract Infections in Children in Rural Alaska By pediatrics.aappublications.org Published On :: 2012-04-16T00:07:48-07:00 Rural Alaska children have high rates of hospitalization with lower respiratory tract infections from a variety of pathogens. Past studies of risk factors for respiratory syncytial virus infection associated medically high-risk status, household crowding, and infant feeding practices with hospitalization.This study reveals the importance of medically high-risk status and infant feeding practices as important factors in respiratory hospitalization. In addition, we identified woodstove use and the absence of 2 or more sinks in household as risk factors for hospitalization. (Read the full article) Full Article
children Diagnostic Imaging and Negative Appendectomy Rates in Children: Effects of Age and Gender By pediatrics.aappublications.org Published On :: 2012-04-16T00:07:47-07:00 Cross-sectional imaging can reduce the negative appendectomy rate (NAR) in children being evaluated for suspected appendicitis; however, the ability of diagnostic imaging to decrease NAR may vary by age and gender.Cross-sectional imaging leads to a significant reduction in NAR for children younger than 5 years and girls older than 10 years. For boys older than 5 years being evaluated for uncomplicated appendicitis, advanced imaging appears to have limited value. (Read the full article) Full Article
children Evaluation of a Clinical Dehydration Scale in Children Requiring Intravenous Rehydration By pediatrics.aappublications.org Published On :: 2012-04-23T00:07:26-07:00 Evaluating dehydration severity is a challenging task. Clinical dehydration scores that combine multiple clinical findings are promising. One clinical dehydration scale score has been developed and subsequently evaluated; however, few participants in the derivation and validation studies were significantly dehydrated.In children requiring intravenous rehydration, the dehydration scale displayed moderate reliability and weak associations with objective measures. Thus, although the scale can assist in assessing dehydration, it should not be used in isolation to dictate interventions (eg, intravenous rehydration, hospitalization). (Read the full article) Full Article
children Race and Unequal Burden of Perioperative Pain and Opioid Related Adverse Effects in Children By pediatrics.aappublications.org Published On :: 2012-04-23T00:07:26-07:00 Disparities are known to exist in the prescription of opioid analgesics among racial and ethnic groups in the management of postoperative, cancer, and emergency department pain in patients across all ages, including children.Race is associated with an unequal burden of perioperative pain and opioid adverse effects in children. Relatively, African American children had higher postoperative pain, and Caucasian children had higher incidences of opioid related adverse effects. (Read the full article) Full Article
children Decreasing Prevalence of Obesity Among Young Children in Massachusetts From 2004 to 2008 By pediatrics.aappublications.org Published On :: 2012-04-23T00:07:25-07:00 Following a rapid increase from 1980 to 2001, the prevalence of obesity among school-age children and adolescents in the United States has plateaued. Few studies have examined obesity trends among younger children in the past decade, and findings are inconsistent.Among children aged <6 years at this multisite pediatric practice, the prevalence of obesity was fairly stable during 1999–2003, but substantially decreased during 2004–2008. This decrease was smaller among children insured by Medicaid than children insured by non-Medicaid health plans. (Read the full article) Full Article
children Clinical Research Involving Children: Registration, Completeness, and Publication By pediatrics.aappublications.org Published On :: 2012-04-23T00:07:26-07:00 Existing clinical research policy does not guarantee availability of results. Registration on the Web site ClinicalTrials.gov and the Food and Drug Administration Amendments Act improved transparency in pediatric clinical research. Registration and publication remain voluntary for many trials involving children.Only 29% of completed registered studies and 53% of National Institutes of Health–funded trials involving children were published. Numbers of studies are increasing. Registration and posting of results on ClinicalTrials.gov should be mandatory for all studies involving children. (Read the full article) Full Article
children Preliminary Development of a Rapid Assessment of Supervision Scale for Young Children By pediatrics.aappublications.org Published On :: 2012-05-07T00:07:48-07:00 Assessing for adequacy of supervision in the clinical setting is challenging and may result in significant variability in care. Clinicians must quickly decide if a child and family necessitate direct counseling, further intervention, or require reporting to state agencies.This study identified the most important characteristics for the evaluation of the adequacy of supervision of a young child. A standardized scale using these characteristics may result in an efficient means to reduce variability in care. (Read the full article) Full Article
children Medication Adherence Among Latino and Non-Latino White Children With Asthma By pediatrics.aappublications.org Published On :: 2012-05-07T00:07:45-07:00 Asthma disparities exist, with Latino children of Caribbean descent at risk for poor disease control. Controller medications reduce symptoms; however, medication adherence remains suboptimal. Identifying what factors predict poor medication adherence in at-risk groups could identify important treatment targets.This study is the first to assess objective rates of medication use among children with asthma in Puerto Rico. Findings suggest that interventions incorporating family resources and addressing parental beliefs about medications may be of benefit across cultural groups. (Read the full article) Full Article
children Oral Dimenhydrinate Versus Placebo in Children With Gastroenteritis: A Randomized Controlled Trial By pediatrics.aappublications.org Published On :: 2012-05-14T00:07:42-07:00 Dimenhydrinate, an antihistaminic agent, is a widely used drug in Canada and Europe. It limits stimulation of the vomiting center via the vestibular system. Multiple studies have shown its effectiveness in the treatment of vertigo and postoperative nausea and vomiting.Dimenhydrinate, when given orally, did not significantly decrease the frequency of vomiting in children with acute gastroenteritis compared with placebo. The reported adverse effect proportions were similar for the dimenhydrinate and placebo groups. (Read the full article) Full Article
children Lipid Profiles of Children With Down Syndrome Compared With Their Siblings By pediatrics.aappublications.org Published On :: 2012-05-14T00:07:38-07:00 Some researchers have suggested that individuals with Down syndrome (DS) are protected from atherosclerotic disease; however, recent data from 2 large cohort studies of individuals with DS are significant for increased mortality from ischemic heart disease and cerebrovascular disease.This study compares lipid profiles among children with DS and their siblings, highlighting the presence of a less favorable lipid profile in this high-risk population. (Read the full article) Full Article
children Low Rates of Influenza Immunization in Young Children Under Ontario's Universal Influenza Immunization Program By pediatrics.aappublications.org Published On :: 2012-05-14T00:07:37-07:00 Despite recommendations and a universal immunization program, a recent survey reported suboptimal influenza vaccination coverage in children aged 6 to 23 months in Ontario. Little is known about predictors of coverage in young children to target immunization strategies.Full influenza vaccination coverage in young children in Ontario is <10% and declining since the 2006–2007 season. Medically high-risk children including low birth weight infants are more likely to be immunized, but maternal and health services characteristics remain important. (Read the full article) Full Article
children Effect of a Single Inhalation of Laninamivir Octanoate in Children With Influenza By pediatrics.aappublications.org Published On :: 2012-05-21T00:07:44-07:00 A single inhalation of laninamivir octanoate has previously been shown to be as effective as repeated doses of zanamivir in vitro and in vivo, but it is not known whether this is also the case for children.Median time to fever resolution was not significantly different between laninamivir octanoate and zanamivir for pediatric patients with influenza. The severity of influenza symptoms and the frequency of complications were similar in the 2 groups. (Read the full article) Full Article
children Predictors of Survival in Children Born With Down Syndrome: A Registry-Based Study By pediatrics.aappublications.org Published On :: 2012-05-21T00:07:43-07:00 Survival of children born with Down syndrome has been improving, but few studies have used population-based data to examine the influence of fetal and maternal characteristics on survival.This study examined predictors of survival for children born with Down syndrome using population-based data from the UK Northern Congenital Abnormality Survey and shows that year of birth, gestational age, birth weight, and presence of additional anomalies influence survival status. (Read the full article) Full Article
children Hypertonic Saline and Acute Wheezing in Preschool Children By pediatrics.aappublications.org Published On :: 2012-05-21T00:07:42-07:00 Most acute wheezing episodes in preschool children are associated with rhinovirus, which decreases extracellular adenosine triphosphate levels, leading to airway surface liquid dehydration and submucosal edema, which cause failure of mucus clearance. These children respond poorly to available treatments.Hypertonic saline inhalation, a pro–airway surface liquid hydration therapy, significantly decreases both length of stay by 33% (1 day) and the absolute risk of hospitalization by 30% in preschool children presenting with acute wheezing episode to the emergency department. (Read the full article) Full Article
children Prevalence of Retinal Hemorrhages in Critically Ill Children By pediatrics.aappublications.org Published On :: 2012-05-21T00:07:42-07:00 The association of retinal hemorrhages (RHs) with abusive head trauma (AHT) is robust; 46% to 100% RHs are reported in AHT. There is potential selection bias with risk of circular reasoning because the majority of studies describing RH focus on AHT.This is the first prospective observational study defining prevalence and distribution of RH in critically ill children excluding those with AHT. Severe multilayered RH were rare and observed in children with accidental fatal head injury, severe coagulopathy, severe sepsis, or a combination of these factors. (Read the full article) Full Article
children A 4-Year Exercise Program in Children Increases Bone Mass Without Increasing Fracture Risk By pediatrics.aappublications.org Published On :: 2012-05-28T00:07:21-07:00 Observation studies and short-term prospective intervention studies have shown that physical activity positively affects the accrual of bone mass and size during growth; however, fracture risk has not been evaluated.This study reports the long-term results of a prospective intervention with increased physical activity at a population-based level and for the first time evaluated the clinical relevant end point, fracture risk. (Read the full article) Full Article