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The Informed Parent

What’s Up Doc?

by John H. Samson, M.D., F.A.A.P.
Published on Jul. 08, 2013
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1. INTUSSUSCEPTION AFTER ROTAVIRUS VACCINES, REPORTED TO US VAERS, 2006-2012

PEDIATRICS, June 2013, p. 1042 by Penina Haber, MPH, Manish Patel, MD, Yi Pan,PhD, James Baggs, PhD, Michael Haber, PhD, Oidda Museru, MPH, Xin Yue, MS, Paige Lewis, MSPH, Frank DeStefano, MD, MPH, and Umesh D. Parashar, MBBS, MPH

This is a reassuring article showing that the vaccine is free of high risk for intussusception after the administration of the first dose of the vaccine.

COMMENT:

The great decrease of admissions for rotavirus diarrhea and dehydration on our hospital service since the advent and use of the second generation vaccine has been truly remarkable.


2. EFFECT OF EARLY LIMITED FORMULA ON DURATION AND EXCLUSIVITY OF BREATFEEDING IN AT-RISK INFANTS: AN RCT

PEDIATRICS, June 2013, p. 1059 by Valerie J. Flaherman, MD, MPH, Janelle Aby, MD, Anthony E. Burgos, MD, MPH, Kathryn A. Lee, RN, PhD, Michael D. Cabana, MD, MPH, and Thomas B. Newman, MD, MPH.

This article supports the concept that limited use of formula to help prevent neonatal weight loss, hunger and increased bilirubin is not only an immediate help but also assures sole breastfeeding when the milk supply increases.

COMMENT:

That has certainly been our experience.


3. ELEVATED BLOOD LEAD LEVELS AND READING READINESS AT THE START OF KINDERGARTEN

PEDIATRICS, June 2013, p. 1081 by Pat McLaine, DrPH, MPH,RN, Ana Navas-Acien, MD, PhD, Rebecca Lee, MPP, Peter Simon, MD, MPH, Marie Diener-West, PhD, and Jacqueline Agnew, PhD. RN, FAAN.

This article found blood lead levels >2mg/dL.may decrease reading readiness in kindergarten students. Thus, it points out the use of blood lead levels >10mg/dL as the level that can cause neurological symptoms may be too high.

COMMENT:

This suggests that treatment for levels less than the usual 10 mg/dL may be beneficial. This is a single article, but if subsequent papers indicate a blood lead level of >10 mg/dL is too high, the question of treatment at lower levels must be considered. We must watch this closely and not jump to any conclusions. 


4. PEDIATRIC HYDROCARBON-RELATED INJURIES IN THE UNITED STATES: 2000-2009.

PEDIATRICS, June 2013, p. 1139, by Heath A. Jolliff, DO, Erica Fletcher, MPH, Kristin J. Roberts, MS, MPH, S. David Baker, PharmD, and Lara B. McKenzie, PhD, MA

This article points out the fact that although the rate of pediatric hydrocarbon ingestion has decreased over the past ten years it is still of high concern. The common offending agents are:

  •     gasoline
  •     kerosene
  •     lighter fluid
  •     lamp oil
  •     lubricating oils
  •     turpentine
  •     mineral seal oil (furniture polish)

COMMENTS:

This is exactly correct.  When you are using these products, be sure children have no contact with them. And please, keep them in the original containers and securely stored out of reach of children. Hydrocarbon pneumonitis is a serious problem requiring hospitalization in many cases. 


5.ALLERGEN-SPECIFIC IMMUNOTHERAPY FOR PEDIATRIC ASTHMA AND RHINOCONJUNCTIVITIS: A SYSTEMATIC REVIEW

PEDIATRICS, June 2013, p. 1155 by Julia M. Kim, MD, MPH, Sandra Y. Lin, MD, Catalina Suarez-Cuervo, MD, Yohalakshme Chelladurai, MBBA, MPH, Murugappan Ramanathan, MD, Jodi B. Segal, MD, MPH, and Nkiruka Erekosima MD< MPH

This article answers a significant question by parents: do allergy shots work? The evidence in this article supports the efficacy of immunotherapy in children.

COMMENT:

Our own clinical experience certainly supports their findings.




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