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Pediatric News Update


"Pediatric News Updates" are reported from actual news sources, but do not necessarily reflect the opinions of Families United on the Net, www.thefunplace.com. For the well-being of all children, parents should not try to diagnose their children, but should seek the advice and care of a pediatrician or family physician.



NO NEED TO TREAT "SIMPLE" FEBRILE SEIZURES IN YOUNG CHILDREN
While simple febrile seizures are common among children ages 6 months to 5 years, a new policy from the American Academy of Pediatrics (AAP) says there is no convincing evidence to indicate that treating these seizures will decrease epilepsy later in life.

While there are drugs that could prevent additional seizures, the AAP says the drugs have side effects and there is no proof that they improve children's health or will prevent epilepsy later in life.

In determining it's findings the AAP reviewed more than 300 medical journal articles on simple febrile seizures. The AAP understands that recurring febrile seizures can create anxiety in some parents and their children, so it encourages health care professionals who treat children with this condition to provide families with appropriate education and emotional support.


PARENTAL APPLICATION OF LOCAL ANESTHETIC AT HOME CAN HELP EASE DISTRESS OF SHOTS AT DOCTOR'S OFFICE
Parents can reduce children's pain and distress from needle sticks by applying a topical anesthetic at home before going to the clinic or hospital according to a new study. In a study of 41 children between ages 5 and 18, researcher found that anxiety, particularly in young children, was reduced when a parent applied a eutectic mixture of local anesthetics (EMLA) cream at home prior to an IV insertion. Permitting parents to apply the EMLA at home can allow children who are having procedures on an outpatient basis to benefit from topical anesthesia without having to arrive excessively early to the clinic or hospital. The study was designed to evaluate the hypothesis that parents can apply EMLA with equal effectiveness as clinicians.


PEDIATRICIANS WARN AGAINST DANGERS OF HOME TRAMPOLINES
A revised policy from the American Academy of Pediatrics (AAP) recommends that trampolines should not be used at home -- either indoors or outdoors. The policy goes on to recommend that trampolines should not be part of routine physical education classes in schools, and that the trampoline has no place in outdoor playgrounds and should never be regarded as play equipment.

The AAP concludes that the largest proportion of trampoline-related injuries occurred on home trampolines and that most trampoline-related injuries occurred either while children played on trampolines or as they fell off. They also found that most injuries happen when there are simultaneous multiple users.


PEDIATRICIANS WANT MORE INVOLVEMENT IN SCHOOL HEALTH
A recent survey of pediatricians indicates that more than 70 percent of the doctors want to become more involved in school health programs.

Most of the 1602 doctors who responded to the survey by the AAP supported comprehensive school health education, such as pregnancy prevention (82 percent) and violence prevention (77 percent). A majority supported the idea of health services in the schools, such as counseling (76 percent), nutrition (65 percent) and school-based primary care (58 percent).


INJURY PREVENTION FOR INFANTS SHOULD TARGET SPECIFIC RISK FACTORS
Infants are more likely to be fatally injured if they are low birth weight, premature or male, according to a study in this month's issue of Pediatrics. Researchers also found that a mother's demographic background had an impact on her infant's risk of fatal injury. To identify risk factors, researchers from the National Institute of Child Health and Human Development in Bathesda, MD., studied causes of injury death in infants under age 1 from 1983 to 1991. Of the more than 10,000 deaths identified, the leading causes were homicide, suffocation, motor vehicle crashes and choking (inhalation of food or objects).

The researchers noted that infants were more likely to die from injuries if their mothers were young, unmarried, with lower educational levels or if they had more older children.


MONKEY BARS RESPONSIBLE FOR MANY CHILDHOOD INJURIES
A new study reports inquiries from monkey bars and jungle gyms can be serious, with some requiring orthopedic surgery. The study also found that the surface below the equipment had no influence on the type or severity of the injury. Increasingly, communities are making significant financial expenditures to place soft surfaces below playground equipment although the researchers data states that this does not significantly alter the injury pattern. Authors note that children whose ages are between 1 and 4 years of age had more long-bone fractures than did older children. Although adult supervision is always recommended, the study states that supervision alone did not influence the most common injury, long-bone fractures.

The authors recommend banning monkey bars and jungle gyms, they do not believe that the equipment needs to be made safer for children.


OLDEST STUDENTS IN CLASS MORE LIKELY TO CARRY GUNS
High school students who are old for their class are more likely than their classmates to carry a gun, according to a study published this month. For each year in the 1990s, there were about 55,000 fatal intentional injuries (about 25,000 homicides and 30,000 suicides); firearms caused approximately 70 percent of these fatalities.

The author's of this study conclusions where that the oldest students in each class had more than twice the odds of carrying a firearm compared to younger students.


INFANTS AT INCREASING RISK OF SUFFOCATION DEATH
The risk of infant suffocation caused by beds and bedding, pillows, plastic bags or co-sleeping with a parent continues to be under-recognized, according to a study published this month by the AAP. The study reports that in 1995 suffocation was the leading cause of injury death for infants younger than age 1. Researchers from Johns Hopkins University School of Hygiene and Public Health, reviewed 2,178 suffocation cases documented by the Consumer Product Safety Commission between 1980 and 1997. The authors found that the most frequent causes of infant suffocation - wedging between a bed and mattress or wall, and obstruction of the nose and mouth, increased during the time period studied. Although not as common, the greatest increase in infant suffocation deaths since 1980 has been in those "overlain" (parent on top of child) while bedsharing. The type of suffocation seems to be significantly related to age, with wedging occurring primarily between 3 to 6 month old infants who have begun to develop several motor skills. Of those who suffocated from obstruction of the nose and mouth, 80 percent were under 7 months of age, and 70 percent of those overlain were younger than 3 months of age.

The researchers concluded that for an infant's best protection, cribs must comply with safety standards and be properly maintained. They also stress that bed-sharing and the use of adult beds for infants should be discouraged. They recommended that further research be done on types of plastic bags that cause infant suffocation deaths, and explore the inclusion of a written waning statement on all types of plastic bags.


NEWS BRIEFS:
Antiangiogenic Therapy of a Recurrent Giant Cell Tumor of the Mandible with Interferon Alfa-2A describes the case of a 5-year-old girl whose recurrent mandibular tumor was treated successfully with interferon alfa 2-A for one year. The tumor, a particularly difficult type to treat, regressed and disappeared, the mandible regenerated, and the patient was tumor-free for almost three years at the writing of the article. This represents the first successful use of this treatment for a tumor of this type in a child.

School Start and Occurrence of Headache shows that children had more headaches in the first year after entering school than in the months before or after. In children who had had headaches in the six months prior to beginning school. the frequency of their headaches increased 20 percent in the first 12 months after school entry. At the end of the second school year, headache frequency had returned to the initial level.

Prehospital Emergency Care for Children at School and Nonschool Locations looks at emergency medical services (EMS) incidents among school children, comparing incidents at school vs. nonschool locations. It concludes that school-based incidents are more likely to be attributable to injury, more often related to sports activity, and more likely to result in a trip to the hospital when compared to nonschool-based incidents.

Highly Somatizing Young Adolescents and the Risk of Depression reports that in adolescents, multiple physical complaints that cannot be fully explained by known medical conditions (known as somatization) represent a significant risk factor for future major depression and panic attacks. The researchers found that high levels of somatization correlated with major depression four years later in 21 percent of the teens (compared with 7 percent of low somatizers), and 13 percent of high somatizers experienced panic attacks (compared with about 3 percent of low somatizers). The study authors suggest one possible explanation for the connection is that somatization is, in fact, a variable or alternative expression of emotional disorder in adolescents.






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