A summary of important new guidelines, recommendations, and research for common pediatric problems

TOP STORIES


1. New Bronchiolitis Guidelines. Guidelines from the AAP recommend against the use of routine use of chest x-rays, bronchodilators, corticosteroids, and antibiotics for bronchiolitis.

http://pediatrics.jwatch.org/cgi/content/full/2007/110/3

2. New Information About the Genetic Basis for Autism. As we gain understanding of the genetic basis of autism, we
    hope to improve the treatment and prevention of the disorder.

http://pediatrics.jwatch.org/cgi/content/full/2007/502/4

3. Does Age of Onset Predict Outcomes in Bipolar Disease? Diagnosis of bipolar disease in children often is delayed, resulting in poorer outcomes, but early recognition can lead to better therapeutic results.

http://pediatrics.jwatch.org/cgi/content/full/2007/703/1

4. A Controlled Clinical Trial of Steroids for Bronchiolitis. This excellent study demonstrates that corticosteroids are not effective for treating infants with bronchiolitis. The results support the AAP guidelines mentioned in the first top story.
http://pediatrics.jwatch.org/cgi/content/full/2007/725/1

5. Prophylactic Antibiotic Therapy Does Not Prevent Recurrent UTI in Children. Our common practice of prescribing low doses of antibiotics to children with recurrent urinary tract infection and vesicoureteral reflux is not effective and may even be harmful.

http://pediatrics.jwatch.org/cgi/content/full/2007/808/1

6. Treatment of Gonococcal Infections: No More Fluoroquinolones, Only Cephalosporins. Because of the rising prevalence of fluoroquinolone resistance, cephalosporins must be used as the primary treatment for gonococcal infections.

http://pediatrics.jwatch.org/cgi/content/full/2007/502/2


7. "Heads Up: Brain Injury in Your Practice" Tool Kit. This excellent tool kit is invaluable for pediatricians who manage mild traumatic brain trauma in children.

http://pediatrics.jwatch.org/cgi/content/full/2007/829/4


8. Etiology of Bilateral vs. Unilateral Acute Otitis Media. The finding that bilateral AOM is more likely than unilateral AOM to be bacterial in origin may assist pediatricians in managing this common problem.

http://pediatrics.jwatch.org/cgi/content/full/2007/815/2

9. When Preschool Children Have ADHD. In a randomized, placebo-controlled study of methylphenidate (MPH), preschool children with ADHD benefited from stimulant medications. However, pediatricians must use caution when prescribing MPH because of the high adverse event rate.

http://pediatrics.jwatch.org/cgi/content/full/2007/110/1

10. Overdoing It in Youth Sports. The AAP’s Council on Sports Medicine and Fitness provides recommendations for identifying and counseling children at risk for overuse injuries.

http://pediatrics.jwatch.org/cgi/content/full/2007/725/3

(F. Bruder Stapleton, MD, Editor-in-Chief, in Journal Watch Pediatrics and Adolescent Medicine December 5, 2007)