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In Brief

The High Cost of Antibiotic Redundancy
 The High Cost of Antibiotic Redundancy 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

As many as 78 percent of non-federal U.S. hospitals frequently prescribe redundant antibiotics, according to a study appearing in the journal Infection Control and Hospital Epidemiology. Over a four-year period, these hospitals accounted for 32,507 cases of antibiotic regimens with overlapping antimicrobial spectra, resulting in more than $12 million in avoidable health care expenses. There are very few clinical…

Disparities in Care: Beyond Insurance
 Disparities in Care: Beyond Insurance 150 150 Dave Ghose
By: Dave Ghose

A Minnesota study suggests the ACA’s Medicaid expansion won’t be enough to reduce persistent health care disparities among minority groups. The health care gap isn’t just about insurance. A variety of barriers — including transportation, inconvenient office hours, cultural biases and confusing information — prevent minorities from accessing health care. In a paper published in the August issue…

Colorectal Cancer Screening and the Pediatric Subspecialist
 Colorectal Cancer Screening and the Pediatric Subspecialist 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Screening a 15-year-old for pre-cancerous polyps may seem a bit unusual, as colon cancer is widely considered an adult disease. But for children with a family history of Lynch syndrome, a hereditary condition that increases the risk of colon and other cancers, life-threatening malignancies can develop as early as the mid-teens. Fewer than one in…

Survivors of Congenital Heart Disease Report Poor Risk Knowledge and High-Fat Diets
 Survivors of Congenital Heart Disease Report Poor Risk Knowledge and High-Fat Diets 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

A new study suggests that CHD survivors may lack knowledge about their disease and would benefit from education about future risks and health behaviors. Over 1 million adults with congenital heart disease (CHD) currently reside in the United States. These individuals are at heightened risk for numerous health concerns, including endocarditis, pregnancy complications and life-threatening…

A New Take on Obesity Prevention: The Maternal-Child Relationship
 A New Take on Obesity Prevention: The Maternal-Child Relationship 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

In the past 30 years, obesity has quadrupled in adolescents and more than doubled in children, affecting even preschool-aged children. The majority of childhood obesity prevention strategies focus on energy balance, targeting behaviors and environmental changes to increase physical activity, decrease sedentary behavior or limit intake of energy-dense foods and beverages. However, the limited success…

Mystery Rising: Why is T1D Incidence Rising Globally?
 Mystery Rising: Why is T1D Incidence Rising Globally? 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Type 1 diabetes used to be rare. Late 19th-century estimates put its incidence at about 0.004 percent of the world’s population. But by the end of the 20th century, most nations reported a number 350 times that rate. With many countries continuing to experience a steady rise in new cases of up to 4 percent…

Stressed Out: Toxic Stress and Child Brain Development
 Stressed Out: Toxic Stress and Child Brain Development 150 150 Dave Ghose
By: Dave Ghose

Stress, in small doses, can be good for children. When they argue with another child over a toy or attend a new school or daycare, the experience can teach them valuable coping skills. Even a more intense event, such as the death of a loved one or a frightening accident, can be beneficial developmentally with…

Getting to the Point: Are Safety Needles Really Safe?
 Getting to the Point: Are Safety Needles Really Safe? 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

Sharp hypodermic needles are, as the name implies, sharp. Just ask the nearly 400,000 U.S. health care workers who are accidentally pricked each year. Most needle sticks aren’t serious, but the potential for exposure to bloodborne diseases has led many hospitals to discontinue the use of sharp needles in certain areas, including the operating room.…

Delays and Difficulties: Fecal Microbiota Transplants as Therapy
 Delays and Difficulties: Fecal Microbiota Transplants as Therapy 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Use of fecal microbiota transplantation to treat a wide range of disorders is in limbo while the FDA decides how to regulate the therapy. Between 1997 and 2007, Clostridium difficile bacterial infections among U.S. children more than doubled and its mortality rate among all U.S. cases more than quadrupled. Clinicians are turning to a number of treatment…

An Unwelcome Blast from the Past: Vitamin K Deficiency Bleeding
 An Unwelcome Blast from the Past: Vitamin K Deficiency Bleeding 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

Most pediatric specialists who began practicing medicine in the mid-1960s have probably never seen a case of vitamin K deficiency bleeding. Robert Sidonio, MD, had seen just one, and that was during his fellowship. And then, in February 2013, an infant came in to the emergency room with bleeding in the brain, one of the most…

The End of “Under 12″
 The End of “Under 12″ 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

UNOS board eliminates age classification for child lung transplant candidates and alters rules for pediatric heart transplants. Many in the pediatric field were surprised last year when a federal judge ordered that a 10-year-old Pennsylvania girl with cystic fibrosis be added to the national adult waiting list for a double-lung transplant. She had spent 18 months…

Mock MRI Scanners to Reduce Anesthesia Use
 Mock MRI Scanners to Reduce Anesthesia Use 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Initial research supports the use of MRI practice sessions and mock scanners to avoid sedation and alleviate patient and parent anxiety before an MRI. Studies exist for populations such as patients with ADHD and diabetes, but to date no studies appear to investigate the use of a mock MRI machine for young children with a wide range of…

Using Zinc for Growth Delays in Babies Born Preterm
 Using Zinc for Growth Delays in Babies Born Preterm 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Zinc supplementation in extremely low birth-weight (ELBW) infants with chronic lung disease improves weight gain and linear growth, according to a retrospective study performed at Nationwide Children’s Hospital. The study is one of the first to look at the association between zinc supplementation and growth in ELBW babies with chronic lung disease, also known as bronchopulmonary dysplasia.…

Do Your Patients Understand You? Strategies to Improve Patient-Provider Communication
 Do Your Patients Understand You? Strategies to Improve Patient-Provider Communication 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions. However, over a third of patients in the United States — or 77 million adults…

The Dilemma of Undertriaged Trauma Cases
 The Dilemma of Undertriaged Trauma Cases 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Nationally, at least one in three children ages 5 and under with major trauma receive their definitive care at a level III trauma center or non-trauma center, according to arecent study in the American Journal of Emergency Medicine. Among children ages 6 to 17, the frequency of undertriage decreases to one in every four major trauma…

Out of Drugs: Planning for the Unthinkable
 Out of Drugs: Planning for the Unthinkable 150 150 Dave Ghose
By: Dave Ghose

Pediatric cancer specialists have faced an enormous challenge in recent years. With critical chemotherapy drugs often in short supply, they’ve been forced to improvise alternative treatments or purchase medicine from questionable secondary sources. These practices raise safety and ethical concerns. Emerging evidence indicates that shortages are harming patients in some instances, exposing them to more…

ADHD Medications Do Not Curb Adult Height
 ADHD Medications Do Not Curb Adult Height 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

According to the Centers for Disease Control and Prevention, the number of children being diagnosed with attention deficit hyperactivity disorder (ADHD) has increased from 7.8 percent to 11 percent in the last decade. Specifically, approximately 2 million more U.S. children between the ages of 4 and 17 had been diagnosed with ADHD in 2011 than in…

AAP Statement on School Start Times May Be Challenging to Implement
 AAP Statement on School Start Times May Be Challenging to Implement 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

The American Academy of Pediatrics published a statement in August supporting delayed start times for middle and high schools to help combat chronic sleep deprivation. Research indicates adolescents naturally experience a shift in their circadian rhythm that makes sleep difficult prior to 11 PM. But since many middle and high schools begin classes before 8:30 AM, teens…

Sinus Infection Test Could Curb Antibiotic Overuse
 Sinus Infection Test Could Curb Antibiotic Overuse 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

Antibiotic misuse, overuse and resistance have significant consequences for patients and hospitals, but determining the primary cause of sinusitis remains a clinical challenge for physicians. Now, diagnostic technology co-invented by researchers at The Ohio State University and Nationwide Children’s Hospital will better equip physicians with additional information needed to make a bacterial sinusitis diagnosis. Subinoy…

Reframing Hope in Pediatric End-of-Life Care
 Reframing Hope in Pediatric End-of-Life Care 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

As physicians, you want to do more good than harm. And it is often believed that telling the truth about poor end-of-life expectations will lead to hopelessness in patients and families, causing more harm than good. But study after study on prognostication has shown that patients and their families prefer more honest and accurate communication.…

1 in 8 Children Exposed to Violence 5 or More Times in a Year
 1 in 8 Children Exposed to Violence 5 or More Times in a Year 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

The average pediatric subspecialist sees two to four child polyvictims each day. What can physicians do to help these children and their families? According to the National Survey of Children’s Exposure to Violence (NatSCEV), 60 percent of children have directly experienced or indirectly witnessed at least one act of violence in the previous year. Nearly…

Liquid Danger
 Liquid Danger 150 150 Dave Ghose
By: Dave Ghose

Henry Spiller, MS, DABT, never used to worry too much about nicotine poisoning. If a child ate a cigarette, he might throw up but wasn’t going to die. Then e-cigarettes took off about seven years ago and changed the equation. Now, Spiller and other toxicologists fear the death of a child from nicotine poisoning is…

Witnessing a Parent’s Injury Can Leave Kids with PTSD, Study Suggests
 Witnessing a Parent’s Injury Can Leave Kids with PTSD, Study Suggests 150 150 Tiasha Letostak, PhD
By: Tiasha Letostak, PhD

When parents have an injury, their children are more likely to experience symptoms of post-traumatic stress disorder, or PTSD. What can pediatric health professionals do to help these families? In June, Pediatrics published the first-ever study examining the effect of civilian parents’ injuries on their uninjured children. Researchers from the Harborview Injury Prevention and Research Center at…

Antibiotics Alone are a Successful Treatment for Uncomplicated Acute Appendicitis in Children
 Antibiotics Alone are a Successful Treatment for Uncomplicated Acute Appendicitis in Children 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery that leads to less pain and fewer missed school days, according to a pilot study. The research, led by a team at Nationwide Children’s Hospital and published online April 12 in the Journal of the American College of Surgeons, is…

By the Book: Anticoagulation for CHD
 By the Book: Anticoagulation for CHD 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

The American Heart Association (AHA) has released its first evidence-based guidelines on anticoagulation in congenital heart disease (CHD). Anticoagulation is a key element in managing patients with congenital heart disease. Despite the therapy’s widespread use, there are no established guidelines on anticoagulants in this patient population, which often leads to inconsistency and guesswork in how…

Diagnosis Focus
 Diagnosis Focus 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Up to one in 10 blood clots in women occur in teen contraceptive users. When a teenage girl presents with chest pain, most doctors likely think first of anxiety, muscle injury or heartburn. In most cases, this is entirely appropriate. But if the girl is taking birth control pills, the problem could be a pulmonary…

A Knowledge Gap
 A Knowledge Gap 150 150 Kelli Whitlock Burton
By: Kelli Whitlock Burton

Study suggests many pediatricians feel unqualified to treat genetic conditions.

(Some Other) Mother’s Milk
 (Some Other) Mother’s Milk 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Women who can’t breastfeed often turn to the Internet for breast milk. But is it safe?