Trend Watch | Pediatric Annals

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F8wJE11bHRpVmlld0NvbnRlbnQPD2QCAWQFCE1WSGVhZGVyDw9kZmQXUfZQn+31vZivWiSMdCXbinuBssZtIQVKaUC6Pz5RDw=="/> 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href="https://web.archive.org/web/20131112190108/http://www.healio.com/pediatrics/journals/pedann/%7Bacc32603-fc2f-4e47-8b75-0c3ad96a4f79%7D/trend-watch">Trend Watch</a></li><li><a href="https://web.archive.org/web/20131112190108/http://www.healio.com/pediatrics/journals/pedann/%7B2781cd42-518a-4847-98b5-444c25466d9a%7D/trend-watch">Trend Watch</a></li><li><a href="https://web.archive.org/web/20131112190108/http://www.healio.com/pediatrics/journals/pedann/%7B9a74c09a-2245-4c3a-9a7f-4067c7c9d31b%7D/trend-watch">Trend Watch</a></li></ul></div> <input name="layout_0$maincontent_0$seeAlsoInsertUnderParagraph" type="hidden" id="layout_0_maincontent_0_seeAlsoInsertUnderParagraph" value="1"/> <div class="journals-content"><div class="journal-tab-group"><ul class="journal-tabs"><li><a href="/web/20131112190108/http://www.healio.com/journals/pedann">Current Issue</a></li><li><a href="/web/20131112190108/http://www.healio.com/journals/pedann/m/past-issues">Past Issues</a></li></ul><div class="journal-panes"><div class="abstract-content"><p class="kicker-top">Trend Watch </p><h2><a href="#">Trend Watch</a></h2><div class="journal-info"><ul class="full-text"><li class="header">Read Full Text Article</li><li class="html"><a class="active" title="View Html Version" alt="View Html Version" rel="nofollow" href="/web/20131112190108/http://www.healio.com/pediatrics/journals/pedann/{6778e8ec-56d7-4a06-ad3f-2235123d21b7}/trend-watch?fulltext=1">Html Icon</a></li><li class="pdf"><a id="pdf" href="/web/20131112190108/http://www.healio.com/~/media/Journals/PedAnn/2013/10_October/10_3928_00904481_20130924_02/10_3928_00904481_20130924_02.pdf" class="active" title="View Pdf Version" alt="View Pdf Version" rel="nofollow">Pdf Icon</a></li></ul><ul class="article-citation"><li>Pediatric Annals</li><li>October 2013 - Volume 42 · Issue 10: 390-393</li><li class="doi">DOI: 10.3928/00904481-20130924-02</li></ul></div><div class="copyrights" style="float:right;"><a onclick="RightsLinkPopUpV2();" href="#"><img alt="Rights and Permissions" title="Rights and Permissions" border="0" src="https://web.archive.org/web/20131112190108im_/http://213a1ca8842e5e699a80-05ce35571e92a3f7383a191aa5840bba.r66.cf1.rackcdn.com/request-permissions.gif"></img></a><script type="text/javascript" language="javascript">function RightsLinkPopUpV2() { var location="https://web.archive.org/web/20131112190108/https://s100.copyright.com/AppDispatchServlet?publisherName=slack&publication=0090-4481&contentID=10.3928/00904481-20130924-02&publicationDate=2013&copyright=Copyright%20%26copy%3B%202013%2C%20Slack%20Inc.&title=Trend%20Watch&volumeNum=42&issueNum=10&author=&orderBeanReset=TRUE"; window.open(location,'RightsLink','location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); } </script></div><div class="article-tab-group"><ul class="article-tabs"><li><a id="anchor-tab-article" href="#">Article</a></li><li class="cite-link"><a href="#" onclick="showCitation();">Get Citation</a><script type="text/javascript">function showCitation() {var w = window.open('', '', 'width=400,height=400,resizeable,scrollbars');w.document.write(' Trend Watch. <i>Pediatr Ann.</i> 2013; 42: 390-393. doi: 10.3928/00904481-20130924-02 <a href="https://web.archive.org/web/20131112190108/http://www.healio.com/pediatrics/journals/pedann/{6778e8ec-56d7-4a06-ad3f-2235123d21b7}/trend-watch">[link]</a>');w.document.close(); }</script></li></ul></div><div id="articleBody"><div class="ftContainer"> <div class="ftArticle"> <div class="ftAuthorNotes"> <div class="ftSection"> <h3>Pertussis Cases in Texas May Reach Highest Level in 50 Years</h3> <p>The annual total of pertussis cases in Texas this year will likely surpass the 2009 high of 3,358, according to a press release.</p> <p>“This is extremely concerning” said <strong>Lisa Cornelius, MD,</strong> a Texas Department of State Health Services infectious diseases medical officer. “If cases continue to be diagnosed at the current rate, we will see the most Texas cases since the 1950s. Pertussis is highly infectious and can cause serious complications, especially in babies, so people should take it seriously.”</p> <p>Nearly 2,000 pertussis cases have been reported in 2013, including two pertussis-related deaths, both in infants too young to be vaccinated.</p> <p>The Texas Department of States Health Services is urging people to make sure they are vaccinated against the disease, especially pregnant women at 27 to 36 weeks of gestation. Fathers, siblings, extended family members and medical providers who will be around newborns should also make sure they are vaccinated.</p> </div> <div class="ftSection"> <h3>Maternal PTSD Increased Risk for Trauma, Maltreatment in Offspring</h3> <p>Mothers with posttraumatic stress disorder were more likely to experience parenting stress and their children were more frequently exposed to traumatic events and maltreatment, according to new study data.</p> <p>“Clinicians should be aware that maternal PTSD is associated with an increased risk for child maltreatment and that the children have substantially more exposure to traumatic events,” <strong>Claude M. Chemtob, PhD,</strong> of NYU School of Medicine’s department of psychiatry, told <em>Pediatric Annals</em>. “This is important because recurrent trauma has been shown to predict poor adjustment in children and adults, so as the number of traumas increases, the likelihood for poor physical health, alcoholism and drug abuse are increased.”</p> <p>Chemtob and colleagues evaluated data from 97 mothers (median age, 22 to 30 years) with children aged 3 to 5 years during primary care pediatrician visitation. The mothers had a mean of 2.63 children and 54% were black, 39% Hispanic, 5% biracial, 1% Asian and 1% non-Hispanic white. Sixty-one percent of the mothers were single, whereas 34% were married and 5% were divorced or separated.</p> <p>Researchers used the Posttraumatic Stress Diagnostic Scale to assess for the mothers’ previous exposure to trauma and symptoms of PTSD, whereas the Edinburgh Postnatal Depression Scale evaluated for depression. Results indicated that 11% of the mothers were depressed, 6% had PTSD and 10% were both depressed and had PTSD.</p> <p>Mothers with comorbid PTSD and depression were found to have the highest levels of parenting stress (<em>P</em><.001).</p> <p>Maltreatment of the children was evaluated with the Conflict Tactics Scale. Compared with mothers without depression or PTSD, comorbid mothers reported increased instances of physical (<em>P</em>=.03) and psychological (<em>P</em>=.04) aggression toward their children. Mothers with PTSD also reported higher levels of psychological aggression (<em>P</em>=.001).</p> <p>Researchers found maternal depression increased the likelihood of child physical abuse (<em>P</em>=.01) and neglect (<em>P</em>=.02), whereas severe PTSD (<em>P</em>=.03) and depression (<em>P</em>=.03) were predictors for psychological aggression.</p> <p>The Traumatic Events Screening Inventory-Parent Report Revised evaluated for exposure to natural disasters, hospitalizations, domestic and community violence, and physical and sexual abuse. Children of mothers with PTSD were exposed to a mean of five traumatic events in the first 5 years of life, which was significantly higher than 1.43 traumatic events in children of mothers without any disorder (<em>P</em><.001) and 1.18 events in children of mothers with depression.</p> <p>Researchers found maternal PTSD was a predictor for offspring exposure to traumatic events (<em>P</em><.001). However, increased depression in mothers with severe PTSD decreased the risk for children exposure to trauma (<em>P</em><.001), with children of comorbid mothers exposed to a mean of 3.5 traumatic events.</p> <p>“It’s important to have routine PTSD screening of mothers in pediatric primary care clinics,” Chemtob said. “As those clinics improve their ability to identify mothers with PTSD and link up those mothers with treatment, the hope is that you would thereby reduce, or even prevent, maltreatment while also reducing the tendency for the children to be exposed to multiple traumatic events.”</p> <p>Chemtob CM. <em>JAMA Pediatr</em>. 2013;doi:10.1001.jamapediatrics.2013.2218.</p> <p><strong>Disclosure</strong>: Researchers report funding from the United Jewish Appeal Federation of New York.</p> </div> <div class="ftSection"> <h3>Exclusive Breast-Feeding Decreased Risk of Overweight, Obesity</h3> <p>Exclusive breast-feeding at aged 6 to 7 months decreased the risk of overweight and obesity among schoolchildren in Japan, according to recent study findings published in <em>JAMA Pediatrics.</em></p> <p>According to study background information, “breast-feeding is one of the factors that may alleviate the epidemic of childhood obesity worldwide.”</p> <p>The study included 43,367 singleton infants born after 37 gestational weeks. Information came from data analyses of a nationwide longitudinal survey results collected from 2001 to 2009.</p> <p>Researchers found that exclusive breast-feeding in infants aged 6 to 7 months decreased the risk of overweight and obesity compared with formula feeding. At age 7 years, the adjusted ORs for overweight were 0.85 (95% CI, 0.69–1.05) and 0.55 (95% CI, 0.39–0.78) for obesity. Results were similar at age 8 years.</p> <p>“In conclusion, after adjusting for potential confounders, we demonstrated that breast-feeding is associated with decreased risk of overweight and obesity among schoolchildren in Japan, and the protective association is stronger for obesity than overweight,” <strong>Michiyo Yamakawa, MHSc,</strong> of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and colleagues wrote.</p> <p>In an accompanying editorial, <strong>Marit L. Bovbjerg, PhD, MS,</strong> of Oregon State University, and colleagues wrote that “causality will never be proven” between the association of breast-feeding and obesity because “it is unethical to randomize women to a formula-feeding arm. Regardless, breast-feeding should be promoted.”</p> <p>Bovbjerg ML. <em>JAMA Pediatr.</em> 2013;doi:10.1001/jamapediatrics.2013.2854. Yamakawa M. <em>JAMA Pediatr.</em> 2013;doi:10.1001/jamapediatrics.2013.2230.</p> <p><strong>Disclosure:</strong> The study was funded in part by Ministry of Health, Labour, and Welfare Health and Labour Sciences Research Grants on Health Research on Children, Youth and Families and the Sumitomo Foundation.</p> </div> <div class="ftSection"> <h3>Micafungin Shows Promise in Treating Invasive Candidiasis</h3> <p>Children and adolescents with proven, probable or suspected <em>Candida</em> infection tolerated once-daily 3-mg/kg and 4.5-mg/kg doses of micafungin, according to recent study findings published in <em>The Pediatric Infectious Disease Journal.</em></p> <p>“The echinocandins, including micafungin, are increasingly recognized as valuable alternatives for the treatment and prevention of invasive <em>Candida</em> infections, including those caused by <em>Candida</em> species resistant to fluconazole,” according to background information in the study. “In children, micafungin has been shown to be as effective as currently approved antifungal medications for the therapy and prophylaxis of invasive candidiasis.”</p> <p>Two phase 1, open-label, repeat-dose trials were analyzed. Study 2101 included 78 children aged 2 to 16 years assigned 3 mg/kg or 4.5 mg/kg IV micafungin (Mycamine, Astellas) for 10 to 14 days. Study 2102 included 9 children aged 4 months to younger than 2 years assigned 4.5 mg/kg micafungin.</p> <p>Researchers found that adverse events occurred in 62 participants from Study 2101 and all participants from Study 2102; however, micafungin-related adverse events only occurred in 28 participants from Study 2101 and one participant from Study 2102. Four participants from Study 2101 and one participant from Study 2102 discontinued use of micafungin because of adverse effects. The most common adverse events were infusion-associated symptoms, pyrexia, hypomagnesemia and liver function abnormalities.</p> <p>“Micafungin-related adverse events were relatively uncommon, and generally did not lead to discontinuation of treatment,” researchers wrote. “The [pharmacokinetic] data obtained in these studies will be combined with [pharmacokinetic] data from previous micafungin studies in children in a population [pharmacokinetic] analysis to support US dosing recommendations in children.”</p> <p>Benjamin DK Jr. <em>Pediatr Infect Dis J</em>. 2013;doi:10.1097/INF.0b013e31829efd14.</p> <p><strong>Disclosure:</strong> The study was funded in part by Astellas.</p> </div> <div class="ftSection"> <h3>ADHD Increased Distracted Driving Risk</h3> <p>All adolescents are at increased risk of distracted driving, but those with attention deficit/hyperactivity disorders are an even greater risk, according to recent study findings published in <em>JAMA Pediatrics.</em></p> <p>“Driving deficits related to ADHD appear to impact specific driving behaviors, namely, variability in speed and lane position,” <strong>Megan Narad, MA,</strong> of Cincinnati Children’s Hospital Medical Center, and colleagues wrote. “Because both maintaining a consistent speed and central, consistent lane position require constant attention to the road and one’s surroundings, the pattern of our findings are not surprising.”</p> <p>The study included adolescents aged 16 to 17 years with (n=28) or without (n=33) ADHD, participating in simulated driving under three different conditions: no distraction, cell phone conversation, and texting.</p> <p>Researchers found that participants with ADHD reported fewer months of driving experience (mean standard, 6.45) compared with controls (10.45). Participants with ADHD were also more likely to report receiving at least one traffic condition (17%) compared with controls (6%). However, no difference was reported between groups with reports of being involved in a crash or history of cell phone use while driving. The ADHD group also demonstrated more variability in speed and lane position compared with control participants during the driving simulations.</p> <p>Texting while driving caused adolescents to drive slower, have larger variability in speed, and more variable in their lateral position when compared with the no-distraction condition (all <em>P</em><.001).</p> <p>“In conclusion, this study clearly demonstrates that both an ADHD diagnosis and texting while driving present serious risks to the driving performance of adolescents,” researchers wrote. “There is a clear need for policy and/or intervention efforts to address these risks.”</p> <p>Narad M. <em>JAMA Pediatr.</em> 2013;doi:10.1001/jama-pediatrics.2013.322.</p> <p><strong>Disclosure:</strong> The study was funded in part by the American Psychological Association. One researcher reports financial relationships with the Bureau of Health Professions, Department of Health and Human Services, and the Health Resources Services Administration.</p> </div> <div class="ftSection"> <h3>Only One-Third of Eligible Children Receive ART</h3> <p>Despite implementation of a global plan to eliminate pediatric HIV, 210,000 new pediatric infections were added worldwide in 2012, and 230,000 children died of an AIDS-related illness in 2011, according to report data published in <em>PLoS Medicine</em>.</p> <p>“Expanding the focus on pediatric HIV is a collective effort and many experts in the field are aligned on what they know to be the existing barriers and potential solutions to ensuring equity in access to care and treatment for children infected and affected by HIV,” wrote <strong>Scott E. Kellerman, MD</strong>, of Management Sciences for Health, and <strong>Nandita Sugandhi, MD</strong>, of Clinton Health Access Initiative.</p> <p>WHO guidelines for prevention of mother-to-child transmission, established in 2013, call for earlier initiation of ART in all children younger than 5 years and longer periods of prophylaxis for pregnant and breast-feeding women to help ensure protection. Children whose mothers never accessed prophylaxis as part of a prevention of mother-to-child transmission are at the greatest risk for HIV infection, and must be identified, diagnosed and linked to HIV care and treatment.</p> <p>“Children are more vulnerable to HIV infection and have higher morbidity and mortality,” researchers wrote. “Without treatment, one-half of those children infected will die before the age of 2 years, yet only one-third of those eligible for treatment are currently receiving ART.”</p> <p>In 2011, 59% of pregnant women with HIV living in sub-Saharan Africa received ART or prophylaxis, but more than 40% of infants remained vulnerable to HIV infection.</p> <p>“If we can overcome the barriers to early ART initiation of children on ART, we can expect that those children will survive to adolescence, necessitating the creation of adolescent-friendly programs to address new challenges around sexual debut and transmission and transitioning to adult care,” researchers wrote.</p> <p>Kellerman SE. <em>PLoS Med</em>. 2013;doi:10.1371/journal.pmed.1001503.</p> <p><strong>Disclosure</strong>: The researchers report no relevant financial disclosures.</p> </div> <div class="ftSection"> <h3>Anti-Homophobia Programs Reduced Alcohol Use for All Students</h3> <p>Well-established anti-homophobia policies or gay-straight alliances resulted in positive effects on both gay and straight students’ alcohol use, according to recent study findings published in <em>Preventive Medicine.</em></p> <p>“These strategies appear to be helpful not only for [lesbian, gay, bisexual, transgender, questioning] students, but all students,” <strong>Elizabeth Saewyc, PhD</strong>, of the University of British Columbia, said in a press release. “Interventions that can make schools safer for [lesbian, gay, bisexual, transgender, questioning] youth may actually reduce harassment for straight students, too. Schools should consider including [gay-straight alliances] and anti-homophobia policies as part of their alcohol and drug abuse prevention strategies.”</p> <p>The study included 21,708 eighth- to 12th-graders and used information from the British Columbia Adolescent Health Survey of 2008.</p> <p>Researchers found that in schools with gay-straight alliances (GSAs) started at least 3 years ago, lesbian and bisexual girls were 55% less likely to drink alcohol last Saturday and 52% were less likely to binge drink since last Saturday. Heterosexual participants were 19% less likely to binge drink last Saturday and heterosexual boys were 20% less likely to have alcohol or drug use problems.</p> <p>Heterosexual boys in schools with anti-homophobia policies were 45% less likely and heterosexual girls were 62% less likely to report binge drinking 6 or more days during the past month.</p> <p>“The types of GSAs and the extent to which policies were disseminated and enforced were unable to be determined in our study; thus, the heterogeneity of schools across the province, their GSAs and their policy enforcement may have influenced results,” researchers wrote. “However, the evidence suggests these population-health interventions offer some benefits, regardless of sexual orientation, in helping to prevent problematic alcohol use among adolescents in schools. Schools should consider incorporating GSAs and anti-homophobia policies in their repertoire of substance use prevention interventions.”</p> <p>Konishi C. <em>Prev Med</em>. 2013;doi:10.1016/j.ypmed.2013.06.031.</p> <p><strong>Disclosure:</strong> The study was funded in part by the Canadian Institute for Health Research’s Institute for Population and Public Health, the Institute for Human Development, Child and Youth Health, and the Public Health Agency of Canada.</p> </div> </div> </div> </div></div><h5>Authors</h5>Trend Watch written by Amber Cox and Alexandra Todak.<p>10.3928/00904481-20130924-02</p></div></div></div></div> <script type="text/javascript" language="javascript"> var $artContent = $('.ftArticle').html(); $('#anchor-tab-article').click(function () { $('#articleReferences, #articleTables').hide(); $('#articleBody, #abstractPortion').show() var current = $('a.current').removeClass('current'); $(this).addClass('current'); }); </script> <div class="social-links"> <div class="fb-like" data-send="false" data-width="300" data-show-faces="true" data-action="recommend"></div> <ul class="share"> <li><a href="javascript:void(0)" id="twitter" class="twitter-link" target="_new">Tweet</a></li> <li><a href="javascript:void(0)" id="facebook" class="facebook-link" target="_new">Share</a></li> <li class="linkedin"><a href="javascript:void(0)" id="linkedin" class="linkedin-link">Link</a></li> <li><span class="db-wrapper"><span class="g-plusone" data-size="tall" data-annotation="none"></span></span></li> <li><a href="javascript:void(0)" id="email">Email</a></li> <li class="last"><a href="javascript:void(0)" id="print">Print</a></li> </ul> <input name="layout_0$maincontent_3$articleItemForTweet" type="hidden" id="layout_0_maincontent_3_articleItemForTweet" value="{EA445A00-7883-48D2-8E86-7EB7AA140D0C}"/> <input name="layout_0$maincontent_3$tweettext" type="hidden" id="layout_0_maincontent_3_tweettext" class="tweettext" value="Treatment of Acute Distal Femur Fractures "/> <input name="layout_0$maincontent_3$tweeturl" type="hidden" id="layout_0_maincontent_3_tweeturl" class="tweeturl" value="http://goo.gl/kdq5No"/> </div> <div id="respond"> <h4> Comments</h4> <script language="javascript" type="text/javascript"> var idcomments_acct = 'aa6ff53f9870e40f92f83e1b5df3cddf'; var idcomments_post_id = '6778e8ec-56d7-4a06-ad3f-2235123d21b7'; var idcomments_post_url; </script> <span id="IDCommentsPostTitle" style="display: none"></span> <script type="text/javascript" src="https://web.archive.org/web/20131112190108js_/http://www.intensedebate.com/js/genericCommentWrapperV2.js"></script> <p class="comment-notes"> Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. 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