News

As the number of clots in hospitalized children continues climbing, said Shannon L Carpenter, MD, MS, pediatricians must know when and how to screen for risk factors.1 With many serious chronic illnesses now being treated more effectively, pediatricians are seeing increasing numbers of children who previously might not have survived very long, she said during the presentation “Clots and Kids: An Increasing Problem.”

To date, said Sarah C Armstrong, MD, FAAP, treatments for pediatric obesity have largely been limited to behavioral counseling and addressing comorbidities.

Sparing a child the rod of corporal punishment can circumvent a lifetime of adverse health consequences, said Victor Vieth, JD, in his presentation “Spanking: The Why and How of Counseling Families on Alternative Discipline Measures.”

Managing fecal incontinence begins with recognizing that it’s usually a physiologic, not behavioral, problem, said Mary Pipan, MD, FAAP, during the session “Encopresis by Any Other Name: Successful Management of Fecal Incontinence.”

A survey of 280 physicians and 256 advanced practice clinicians at The Children’s Hospital of Philadelphia found that the vast majority worked while sick at least once in the preceding year and would expect to work with symptoms of contagion, including fever, diarrhea, and acute respiratory tract symptoms.

Gaming addiction

Increasingly, reports are emerging that some children and adolescents become preoccupied with Internet gaming. These “gamers” may demonstrate compulsivity and exclude other interests as a result of online gaming that leads to clinically significant impairment or distress.

Two siblings, 5-year-old Emmanuel and 3-year-old Cassandra, are brought to your emergency department (ED) in July 2014 by their parents. Both children are up to date on their immunizations and have not had significant medical problems in the past. They were referred to you by their pediatrician for 1 day of high fevers, rash, and pain in the extremities. Emmanuel had 1 episode of gum bleeding last night. His sister has been unwilling to walk since this morning.

Physicians and parents are using a variety of health-related gadgets and gizmos that communicate with our smartphones and tablets. These range from fitness devices that monitor daily exercise, to glucometers used by diabetics to monitor sugar levels, to sphygmomanometers used to measure blood pressure.

There is precious little pediatricians do or are encouraged to do during clinical visits for young children to help lower the risk of obesity, a pediatric researcher told an Academy of Medicine panel in October.

‘Itch-scratch-itch’….is a typical chief complaint for many children who present to the pediatric primary care office. The infant is irritable and the mother wants the infant to stop being irritable; the child, or adolescent wants to stop ‘feeling itchy’; and their parents want medications that will immediately return the skin to normal. What a dilemma!

Cyclic vomiting syndrome (CVS), a variant of migraine, was first described in the literature over a century ago, but in 2015, it remains commonly unrecognized and misdiagnosed.

Parents who decline or are non-compliant with medical recommendations are not only putting their child at risk, but also the pediatrician, said James P Scibilia, MD, a private practitioner in Beaver, Pennsylvania, and member of the American Academy of Pediatrics Committee on Medical Liability and Risk Management.

Management of community-acquired pneumonia (CAP) in children is evolving as a result of changes in the microbial etiology of the disease and advances in diagnostic techniques.

Evidence-based recommendations on selective and universal lipid screening in childhood released by the National Heart, Lung, and Blood Institute (NHLBI) in 2011 were endorsed by the American Academy of Pediatrics (AAP) and are integrated in the Bright Futures guidelines on pediatric health maintenance.

Clinicians should refrain from making a diagnosis of “breast milk jaundice” because it is often inappropriate, results in unnecessary discontinuation of breastfeeding, and by delaying accurate identification of the etiology for the symptom, may expose the child to undue risk of severe neonatal hyperbilirubinemia.

Many of the prescriptions written for management of children’s behavioral/mental health issues stem from situations in which families, practitioners, or both feel that medication is the only practical solution to a child’s chronic or acute needs. Nonmedication-based solutions, however, are more practical than they may seem, said Lawrence Wissow, MD, MPH, professor of health, behavior, and society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Sudden infant death syndrome (SIDS) remains an important public health issue as it ranks as the third leading cause of infant mortality, but co-sleeping is a reality. A session discusses how to effectively communicate safe sleeping practices with adults.

Media use by children and adolescents is part of the American Academy of Pediatrics (AAP) Agenda For Children, but pediatricians may find it challenging to fit anticipatory guidance on this topic into the well-child visit.

The issue of overdiagnosis in medicine has been brought to center stage by recent and proposed changes to screening guidelines for prostate and breast cancer. Overdiagnosis, however, is also a problem in the pediatric population, cautioned Eric Coon, MD, assistant clinical professor of pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.

Changes in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) relating to trauma and stressor-related disorders have important implications for optimizing care of pediatric patients.

There is no question that pediatricians are experienced in managing constipation considering its prevalence among children. Research shows, however, that the majority of pediatricians are not aware of recently released evidence-based recommendations for both the diagnostic evaluation of children with constipation and the treatment of functional constipation, said Samuel Nurko, MD, MPH, associate professor of pediatrics, Harvard Medical School, Boston, Massachusetts.

Breastfeeding may not make smarter babies, according to a new report from the UK, but CDC says it still makes healthier babies overall and hospitals have more work to do in order to provide optimal support for nursing mothers.

Women who receive the prophylactic bivalent human papilloma virus (HPV) vaccine within 90 days of pregnancy are not at an increased risk for miscarriage, underscoring the safety of the vaccine. The proven safety of the bivalent HPV vaccine should quell the concerns of women and their health care practitioners.

The CDC now recommends that high-risk infants undergo postvaccination serologic testing between 9 and 12 months, updated from 9-18 months. The new vaccination interval can better cover at risk infants from HBV infection and also help ensure a higher adherence to the immunoprophylaxis protocol.