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Category: Pediatrics | Monthly Briefing

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March 2011 Briefing - Pediatrics

Last Updated: April 01, 2011.

 

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Here are what the editors at HealthDay consider to be the most important developments in Pediatrics for March 2011. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Skeletal Immaturity Does Not Affect Broken Bones' Healing

THURSDAY, March 31 (HealthDay News) -- People who break both the radius and ulna before reaching skeletal maturity heal just as well as those who are skeletally mature, and subjective measures of illness may be more predictive of degree of disability than objective measures of impairment, according to research published in the March 16 issue of The Journal of Bone & Joint Surgery.

Abstract
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U.S. Birth Rate Declined 4 Percent from 2007 to 2009

THURSDAY, March 31 (HealthDay News) -- After peaking at 4,316,233 births in 2007, the birth rate in the United States fell 4 percent by 2009, and a provisional count in 2010 indicates the number is continuing to decline, according to a March data brief released by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Tetanus Cases Rare but Some Populations More Vulnerable

THURSDAY, March 31 (HealthDay News) -- Tetanus cases and fatalities in the United States have decreased by more than 95 percent and more than 99 percent, respectively, since the disease became reportable in 1947, but sporadic cases do still occur, and some populations are more at risk for contracting the potentially life-threatening disease, according to research published in the April 1 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Heart Defect in Children Related to Migraine With Aura

THURSDAY, March 31 (HealthDay News) -- The prevalence of patent foramen ovale (PFO), a common defect in the wall between the two upper chambers of the heart, is significantly greater in children who have migraines with aura, according to a study published online March 31 in The Journal of Pediatrics.

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Growth Hormone Increases Adult Height in Turner's

THURSDAY, March 31 (HealthDay News) -- Treatment with growth hormone may result in greater adult height for girls with Turner's syndrome, and the addition of low-dose estrogen to the treatment regimen may further improve results, according to research published in the March 31 issue of the New England Journal of Medicine.

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Unmet Health Care Needs in Survivors of Childhood Cancer

WEDNESDAY, March 23 (HealthDay News) -- Double informant data indicate that a considerable percentage of adult survivors of childhood central nervous system tumors have long-term unmet health care needs (HCNs), according to a study published online March 8 in Cancer.

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Two-Thirds of U.S. Residents Get Sufficient Vitamin D

WEDNESDAY, March 30 (HealthDay News) -- About two-thirds of the U.S. population takes in sufficient amounts of vitamin D, but 8 percent may be at risk for vitamin D deficiency, according to a March data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Pacifier Use Does Not Affect Breast-Feeding Duration

WEDNESDAY, March 30 (HealthDay News) -- Pacifier use in healthy, full-term newborns, introduced before or after breast-feeding is established, has little impact on the prevalence or duration of breast-feeding up to four months, according to a review published online in the Cochrane Database of Systematic Reviews.

Abstract
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Changes Seen in Incidence of ESRD From Lupus Nephritis

WEDNESDAY, March 30 (HealthDay News) -- For children with lupus nephritis (LN)-associated end-stage renal disease (ESRD), disparities in treatment and mortality exist by several demographic characteristics; also, incidence rates have increased in younger patients and in African-Americans since 1995, according to two articles published online March 28 in Arthritis & Rheumatism.

Abstract - Hiraki
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Abstract - Costenbader
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Online Health Records Less Used by Minorities, Poor

WEDNESDAY, March 30 (HealthDay News) -- Online personal health records (PHRs) are less frequently used by racial or ethnic minorities and patients with low annual income, according to a study published in the March 28 issue of the Archives of Internal Medicine.

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Four-Dose Rabies Prevention Vaccine Schedule Endorsed

TUESDAY, March 29 (HealthDay News) -- A U.S. Centers for Disease Control and Prevention committee has proposed a reduced schedule for prophylactic rabies vaccine, and the recommendations have been endorsed by the American Academy of Pediatrics Committee on Infectious Diseases, according to a policy statement published online March 28 in Pediatrics.

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Decline Seen in Global Youth Mortality Over Last 50 Years

TUESDAY, March 29 (HealthDay News) -- Overall mortality declined substantially between 1955 and 2004 in children aged 14 years or younger and in females aged 15 to 24, but a smaller decline was evident for males aged 15 to 24 years, according to a study published online March 29 in The Lancet.

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Complementary Treatment of Colic Lacks Evidence

MONDAY, March 28 (HealthDay News) -- Evidence supporting the notion that complementary and alternative medicines may be useful for curing infantile colic is limited and of poor quality, according to a systematic review published online March 28 in Pediatrics.

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Guidelines Provided for Deep Vein Thrombosis Management

MONDAY, March 28 (HealthDay News) -- Blood thinners should not be the only therapy considered for patients with deep vein thrombosis (DVT), according to a scientific statement published online March 21 in Circulation.

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New Report Issued on Impact of Teen Social Media Use

MONDAY, March 28 (HealthDay News) -- Using social media, such as Facebook and MySpace, is among the most common activities for children and adolescents today, and pediatricians are encouraged to help parents understand and address both the positive and negative effects, according to an American Academy of Pediatrics report published online March 28 in Pediatrics.

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Bariatric Surgery Linked to Bone Density Loss in Teens

MONDAY, March 28 (HealthDay News) -- Adolescents who undergo bariatric surgery have reductions in bone mineral density (BMD), although the level is still within the age-appropriate norm, according to a study published online March 28 in Pediatrics.

Abstract
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Tuberculosis Rates in United States at All-Time Low

THURSDAY, March 24 (HealthDay News) -- The rate of tuberculosis (TB) infection in the United States continues to decline, but the goal of elimination has not been met, and the infection disproportionately affects foreign-born individuals and ethnic minorities, according to a report published in the March 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Maternal Anemia Associated With Childhood Wheezing

THURSDAY, March 24 (HealthDay News) -- Maternal anemia during pregnancy is linked with wheezing and asthma in early childhood, according to a study published in the February issue of the Annals of Allergy, Asthma & Immunology.

Abstract
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Acne Impacts Adolescents' Quality of Life

THURSDAY, March 24 (HealthDay News) -- Adolescents who suffer from acne are more likely to have a lower quality of life and psychological disorders, including anxiety, depression, and suicide ideation, according to research published in the January issue of the Dermatology Online Journal.

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Reduced Hours for Trainees Has Had Little Effect in U.S.

THURSDAY, March 24 (HealthDay News) -- Reducing work hours for doctors in training to less than 80 per week has had little impact on patient outcomes or postgraduate training in the United States, according to a literature review published online March 22 in BMJ.

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Editorial

Shorter Closure Time for in Vitro Adult Platelet Transfusion

WEDNESDAY, March 23 (HealthDay News) -- Transfusion of adult platelets into neonatal blood results in shorter platelet function analyzer closure time compared with neonatal platelets, according to a study published online Feb. 14 in the Journal of Thrombosis and Haemostasis.

Abstract
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Bariatric Surgery in Youth Warrants Caution

WEDNESDAY, March 23 (HealthDay News) -- Bariatric surgery in older children may result in significant weight loss and improvement in quality of life, though long-term data on safety, efficacy, and cost-effectiveness are limited, according to a literature review published online March 3 in Clinical Obesity.

Abstract
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Chronic Otitis Media Associated With Changes in Taste

WEDNESDAY, March 23 (HealthDay News) -- Children with chronic otitis media with effusion (COME) have different taste thresholds, which may be associated with their increased body mass index (BMI), according to a study published in the March issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Abstract
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Increased Melanoma Incidence Tied to Socioeconomic Status

TUESDAY, March 22 (HealthDay News) -- High socioeconomic status (SES) and exposure to ultraviolet-radiation (UV-R) are associated with increased malignant melanoma incidence among adolescent girls and young women, according to a study published online March 21 in the Archives of Dermatology.

Abstract
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Pelvic Asymmetry Identified in Cerebral Palsy Patients

TUESDAY, March 22 (HealthDay News) -- Patients with cerebral palsy (CP) often exhibit transverse pelvic asymmetry, which is most prominent above the acetabulum and more frequent in patients with windswept hips, according to a study published online March 10 in the Journal of Pediatric Orthopaedics.

Abstract
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Hearing Loss Diagnosed Earlier With Mandatory Screening

TUESDAY, March 22 (HealthDay News) -- Children born after the introduction of mandatory universal newborn hearing screenings (UNHS) have hearing loss diagnosed and cochlear implants at a younger age, according to a study published in the March issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Abstract
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Atomoxetine of Limited Value in Young Children With ADHD

TUESDAY, March 22 (HealthDay News) -- For 5- and 6-year-old children with attention-deficit/hyperactivity disorder (ADHD), atomoxetine is generally well tolerated and reduces core ADHD symptoms, but it fails to translate to overall clinical and functional improvement, according to a study published online March 21 in Pediatrics.

Abstract
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Oral Vaccine May Prevent Half of Cholera Episodes

MONDAY, March 21 (HealthDay News) -- The currently available oral cholera vaccine may prevent 50 to 60 percent of cholera episodes in the first two years after vaccination, but its effectiveness is unlikely to last beyond three years, according to a review published in the Cochrane Database of Systemic Reviews.

Abstract
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Group B Strep Still Main Cause of Neonatal Meningitis

MONDAY, March 21 (HealthDay News) -- Group B streptococci (GBS) is still the dominant cause of neonatal bacterial meningitis, whereas Escherichia coli (E. coli) is the most common cause among preterm infants, according to a study published in the March issue of The Pediatric Infectious Disease Journal.

Abstract
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AAP Updates Recommendations on Car Seat Use

MONDAY, March 21 (HealthDay News) -- In a policy statement and technical report published online March 21 in Pediatrics, the American Association of Pediatrics (AAP) has updated their recommendations on best practices for the use of car seats and seat belts for children from birth through adolescence.

Abstract - Policy Statement
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Majority of Parents Approve of Smoke Exposure Testing

MONDAY, March 21 (HealthDay News) -- The majority of parents, both smokers and nonsmokers, want their children tested for tobacco-smoke exposure as part of their children's health care settings, according to a study published online March 21 in Pediatrics.

Abstract
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Artesunate Provides Superior Treatment for Severe Malaria

FRIDAY, March 18 (HealthDay News) -- Treatment of severe malaria with artesunate is superior to quinine for both adults and children, according to a review published in the Cochrane Database of Systematic Reviews.

Abstract
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Professional Values of U.S. and U.K. Doctors Examined

THURSDAY, March 17 (HealthDay News) -- A core of professional values exists among doctors in the United States and the United Kingdom, though significant differences exist in how these values are expressed and prioritized, according to a study published online March 7 in BMJ Quality & Safety.

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17-Hydroxyprogesterone Does Not Lower Neonatal Morbidity

THURSDAY, March 17 (HealthDay News) -- Prophylactic treatment with 17-alpha-hydroxyprogesterone caproate (17Pc) in twin pregnancy does not reduce neonatal morbidity or prolong gestation, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.

Abstract
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Hepatitis A Virus Antigenic Variants Identified

THURSDAY, March 17 (HealthDay News) -- An outbreak of hepatitis A in men who have sex with men (MSM) revealed several antigenic variants of the hepatitis A virus, which may have escaped the protective effect of vaccination, reinforcing the importance of completing vaccination schedules, especially among the immunocompromised, according to a study published online March 16 in Emerging Infectious Diseases.

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Short Nurse Staffing Linked to Higher Patient Mortality

WEDNESDAY, March 16 (HealthDay News) -- Patient mortality appears to be higher when nurse staffing falls eight or more hours below target level and during nursing shifts when patient turnover is high, according to research published in the March 17 issue of the New England Journal of Medicine.

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Adding Omalizumab Improves Asthma Control in Youth

WEDNESDAY, March 16 (HealthDay News) -- The addition of omalizumab to a regimen of guidelines-based therapy among youth with persistent asthma appears to improve asthma control and reduce the need for other medications to control the condition, according to a study published in the March 17 issue of the New England Journal of Medicine.

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Fever Not Tied to Influenza Virus Shedding Duration

WEDNESDAY, March 16 (HealthDay News) -- Health care personnel (HCP) infected with influenza (H1N1) 2009 virus who return to work 24 hours after defervescence may still be shedding virus, according to a study published online March 16 in Emerging Infectious Diseases.

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U.S. Death Rate Reaches All-Time Low

WEDNESDAY, March 16 (HealthDay News) -- The age-adjusted death rate for the United States has fallen for 10 straight years and has reached an all-time low of 741 per 100,000, or 2,436,682 deaths, in 2009, down 2.3 percent from 2008, according to a new report issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Denervated Muscles Involved in Contracture Pathogenesis

WEDNESDAY, March 16 (HealthDay News) -- Impaired growth of biceps and brachialis muscles causes elbow flexion contractures, and impaired subscapularis muscle growth causes shoulder internal rotation contracture following brachial plexus injuries in neonatal mice, according to research published in the March 2 issue of The Journal of Bone & Joint Surgery.

Abstract
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More Cholera Cases and Deaths Expected in Haiti

WEDNESDAY, March 16 (HealthDay News) -- Mathematical modeling estimates that more cases of cholera than expected will occur in the coming months in Haiti, but many could be averted by the provision of clean water, vaccinations, and increased antibiotic distribution, according to a study published online March 16 in The Lancet.

Abstract
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Editorial (subscription or payment may be required)

Heavy Smoking Prevalence Decline Greatest in California

TUESDAY, March 15 (HealthDay News) -- Between 1965 and 2007, the prevalence of high-intensity smoking declined in California and in the remaining states, according to a study published in the March 16 issue of the Journal of the American Medical Association.

Abstract
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New Vital Sign Centile Charts Derived for Children

TUESDAY, March 15 (HealthDay News) -- Centile charts derived from a systematic review of observational studies provide new evidence-based reference ranges for these vital signs but do not agree with existing reference ranges for heart rate and respiratory rate in children; the research has been published online March 15 in The Lancet.

Abstract
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Majority of U.S. Children Have a Medical Home

MONDAY, March 14 (HealthDay News) -- More than 50 percent of children in the United States have access to all components of health care in a pediatric medical home, but there are substantial socioeconomic, racial or ethnic, and health-related disparities, according to a study published online March 14 in Pediatrics.

Abstract
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Fathers' Negative Parenting Behavior Linked to Depression

MONDAY, March 14 (HealthDay News) -- Depressed fathers are less likely to demonstrate positive parental behavior toward their 1-year-old children, and more likely to display negative parenting behavior, according to a study published online March 14 in Pediatrics.

Abstract
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Majority of Drugs Tolerated After Negative Re-Challenge

MONDAY, March 14 (HealthDay News) -- Patients who suffer from cutaneous adverse drug reactions (CADR) and have a negative re-challenge under hospital surveillance (RCH) show good tolerance when re-challenged with the same drug, according to a study published online Feb. 9 in Allergy.

Abstract
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Drug-Related Poisonings Highest in Young Children

MONDAY, March 14 (HealthDay News) -- Emergency department visits for unintentional drug-related poisonings in the United States are highest among children age 0 to 5 and more prominent in rural areas, and young women have the highest rate of drug-related poisonings with suicidal intent, according to research published online March 3 in the American Journal of Emergency Medicine.

Abstract
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U.S. Has Higher Rates of Chronic Disease Than England

MONDAY, March 14 (HealthDay News) -- Americans experience higher rates of chronic disease and markers of disease than their English counterparts at all ages, according to a study published online March 9 in the American Journal of Epidemiology.

Abstract
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CDC: Many HIV-Exposed Children Get Pre-Chewed Food

FRIDAY, March 11 (HealthDay News) -- Approximately one-third of caregivers of HIV-exposed children aged 6 months or older provide the children with premasticated food from themselves or someone else, with younger and black caregivers reporting premastication more frequently than older and non-black caregivers, according to a report in the March 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Number of Cancer Survivors in U.S. Reaches 11.7 Million

THURSDAY, March 10 (HealthDay News) -- The number of cancer survivors in the United States had increased to nearly 12 million by 2007, according to a report in the March 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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HealthGrades Finds Rates of Patient Safety Events Vary

WEDNESDAY, March 9 (HealthDay News) -- Patients treated at hospitals rated with a HealthGrades Patient Safety Excellence Award have, on average, a 46 percent lower risk of experiencing a patient safety incident compared to those treated at the lowest-ranked hospitals, according to the eighth annual HealthGrades Patient Safety in American Hospitals Study published online March 9.

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Ethnic Differences Seen in Academic Measures for U.K. Docs

WEDNESDAY, March 9 (HealthDay News) -- United Kingdom-trained physicians and medical students with ethnic minority backgrounds tend to underperform academically compared to their white peers, according to a meta-analysis published online March 8 in BMJ.

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Most Youth With Chronic Illness Finish High School

WEDNESDAY, March 9 (HealthDay News) -- Most young adults growing up with a chronic illness graduate high school and have employment, but those with chronic illnesses other than asthma have worse educational and vocational outcomes, according to a study published in the March issue of the Archives of Pediatrics & Adolescent Medicine.

Abstract
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Exergames Increase Energy Expenditure in All Children

WEDNESDAY, March 9 (HealthDay News) -- Interactive digital exercise featuring player movement (exergames) successfully elevates energy expenditure to a moderate or vigorous intensity among children with various body mass index (BMI) levels , according to a study published online March 7 in the Archives of Pediatrics & Adolescent Medicine.

Abstract
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Editorial (subscription or payment may be required)

Pharmacological Meta-Analyses Rarely Report Disclosures

TUESDAY, March 8 (HealthDay News) -- Meta-analyses of pharmacological treatments rarely include information addressing primary study funding and conflicts of interest (COIs) of the authors for the included randomized control trials (RCTs), according to a study published in the March 9 issue of the Journal of the American Medical Association.

Abstract
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Diabetes Belt Identified in Southern United States

TUESDAY, March 8 (HealthDay News) -- A geographically congruent "diabetes belt" with high prevalence of diabetes exists in the United States, according to a study published online March 8 in the American Journal of Preventive Medicine.

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FDA: Adverse Events Tied to Kaletra in Preterm Infants

TUESDAY, March 8 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care providers of a revision to the label of lopinavir/ritonavir (Kaletra) oral solution to include a new warning, as administration of the oral solution may result in serious health problems among premature babies.

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Majority of Pediatric Burn Admissions Due to Scalding

TUESDAY, March 8 (HealthDay News) -- Although admission rates for burn injury declined from 1983 to 2008, more than half of burn-injury hospital admissions for children younger than 5 years of age in Western Australia are due to scalding, according to a study published online March 7 in Pediatrics.

Abstract
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Cereal Tastes Better When Box Features Cartoon Characters

TUESDAY, March 8 (HealthDay News) -- Cereal tastes better to children when its packaging features recognizable media characters, according to a study published in the March issue of the Archives of Pediatrics & Adolescent Medicine.

Abstract
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Higher Than Expected Eating Disorders Prevalence in Teens

TUESDAY, March 8 (HealthDay News) -- Eating disorders and subthreshold eating conditions are prevalent in the general adolescent population and are associated with other psychiatric disorders, role impairment, and suicidality, according to a study published online March 7 in the Archives of General Psychiatry.

Abstract
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Tissue-Engineered Urethral Graft in Boys Effective

TUESDAY, March 8 (HealthDay News) -- Tubularized urethras engineered from boys' own cells appear to be functional and viable for up to six years, according to research published online March 8 in The Lancet.

Abstract
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Cerebral Palsy Incidence Down in Preterm Survivors

MONDAY, March 7 (HealthDay News) -- The incidence and severity of cerebral palsy (CP) among preterm survivors decreased significantly from 1990 to 1993 onward, possibly because of a reduction in severe cystic periventricular leukomalacia (c-PVL), according to a study published online March 3 in The Journal of Pediatrics.

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Abuser's Gender Affects Head Trauma Outcome in Youth

MONDAY, March 7 (HealthDay News) -- Male perpetrators of abusive head trauma in children are more likely to confess and be convicted, and their victims are more likely to have more serious presentations and worse outcomes, according to a study published online March 7 in Pediatrics.

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Widespread Communication Technology Use Before Sleep

MONDAY, March 7 (HealthDay News) -- There is widespread use of communication devices, especially laptops and cell phones, in the hour before going to bed, according to the 2011 Sleep in America® Poll released by the National Sleep Foundation.

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Inhaled Epinephrine Gives Temporary Relief From Croup

MONDAY, March 7 (HealthDay News) -- Inhaled epinephrine improves moderate to severe croup symptoms in children from 30 minutes to two hours after treatment, according to a literature review published in the Cochrane Database of Systematic Reviews.

Abstract
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New Noninvasive Method for Diagnosis of Trisomy 21

MONDAY, March 7 (HealthDay News) -- A combined approach using methylated DNA immunoprecipitation (MeDiP) and real-time quantitative PCR (qPCR) of maternal peripheral blood allows noninvasive prenatal diagnosis (NIPD) of trisomy 21 (Down's syndrome), according to research published online March 6 in Nature Medicine.

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FDA: Topiramate (Topamax) Tied to Risk of Oral Clefts

FRIDAY, March 4 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care providers and consumers that new data indicate that women who take topiramate (Topamax) during pregnancy increase the risk for cleft lip and cleft palate in their offspring.

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Growing Up With Illness Impairs Education and Income

FRIDAY, March 4 (HealthDay News) -- Young adults who grow up with chronic illness may succeed socially, but are more likely to have inferior educational and economic outcomes, according to a study published online Feb. 4 in the Journal of Adolescent Health.

Abstract
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Inflammatory Bowel Disease Tied to Thromboembolism Risk

FRIDAY, March 4 (HealthDay News) -- Patients suffering from inflammatory bowel disease (IBD) have twice the risk of developing venous thromboembolism (VTE) compared to the general population, according to a study published online Feb. 21 in Gut.

Abstract
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Sexual Behavior in U.S. Adults Little Changed Since 2002

THURSDAY, March 3 (HealthDay News) -- Most adults in the United States have experienced vaginal sex, but the number of younger adults reporting no sexual contact has increased since 2002, according to the March issue of the U.S. Centers for Disease Control and Prevention's National Health Statistics Report.

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Mild Idiopathic Scoliosis Impairs Postural Stability

THURSDAY, March 3 (HealthDay News) -- Girls newly diagnosed with adolescent idiopathic scoliosis (AIS) have balance disturbances in both simple and more complex postural tasks, even when their spine deformation is mild, according to a study published online Feb. 7 in Spine.

Abstract
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High Hepatitis B Immunity in U.S. Children, Adolescents

THURSDAY, March 3 (HealthDay News) -- Children and adolescents in the United States have high rates of immunity against hepatitis B virus (HBV), although adults have much lower rates, according to a study published in the March 1 issue of the Annals of Internal Medicine.

Abstract
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Corneal Graft Survival Associated With Its Indications

THURSDAY, March 3 (HealthDay News) -- Corneal graft survival in patients younger than 20 varies more by indication than by the recipient's age, according to research published in the March issue of Ophthalmology.

Abstract
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Cannabis Use in Youth Ups Incident Psychosis Risk

THURSDAY, March 3 (HealthDay News) -- Cannabis use among youth is associated with an increased risk of later incident psychotic symptoms, with continued cannabis use increasing the risk for persistent psychotic symptoms, according to a study published online March 1 in BMJ.

Abstract
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Maternal Opioid Use Tied to Higher Birth Defect Risk

WEDNESDAY, March 2 (HealthDay News) -- Maternal use of opioid analgesics just prior to or during early pregnancy is associated with a modestly higher risk of certain birth defects, according to a study published online Feb. 24 in the American Journal of Obstetrics & Gynecology.

Abstract
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FDA Cracking Down on Unapproved Prescription Drugs

WEDNESDAY, March 2 (HealthDay News) -- The U.S. Food and Drug Administration intends to remove select unapproved prescription cough, cold, and allergy medications from the U.S. market, the agency has announced.

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Teen Heart Patients Should Move to Adult Medical Care

TUESDAY, March 1 (HealthDay News) -- Doctors should transition their patients with congenital heart disease (CHD) from pediatric to adult medical care during early adolescence, according to a scientific statement from the American Heart Association (AHA) published online Feb. 28 in Circulation.

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