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MedPulse is a weekly index of key news and features on Medscape's

specialty sites compiled by Medscape's Editors.

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___________________ NEW FEATURE ARTICLES THIS WEEK ____________________

METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS IN THE COMMUNITY

Infection caused by methicillin-resistant Staphylococcus aureus MRSA has

increased consistently in prevalence since it was first reported in 1968

Centers for Disease Control and Prevention. MMWR.

Infect Med 18(10):452, 2001

http://pediatrics.medscape.com/44767.rhtml?srcmp=ped-110901

ASK THE EXPERTS - INTRAMUSCULAR VACCINATION IN A HEMOPHILIAC

How does one administer intramuscular vaccinations to a hemophiliac? Which

vaccines should a hemophiliac receive?

http://pediatrics.medscape.com/44776.rhtml?srcmp=ped-110901

ACADEMY'S POLICY STATEMENT MARKS ITS FIRST ATTEMPT AT EVIDENCE-BASED PRACTICE GUIDELINES FOR ADHD

New treatment guidelines issued by the American Academy of Pediatrics are

intended to assist primary care physicians in managing

attention-deficit/hyperactivity disorder in school-age children.

Brown Univ Child & Adol Behav Ltr 17(11):1, 3-4, 2001

http://pediatrics.medscape.com/44795.rhtml?srcmp=ped-110901

NEW CENTER WILL PROMOTE MH SERVICES FOR YOUNG OFFENDERS

The mental health and juvenile-justice fields now have a national center to

help develop policies and programs to address the mental health needs of

youths in the criminal-justice system.

Mental Health Weekly 11(40):3-4, 2001

http://pediatrics.medscape.com/44798.rhtml?srcmp=ped-110901

ASK THE EXPERTS - VACCINES AND IMMUNOSUPPRESSED PATIENTS

Which vaccines are contraindicated for immunosuppressed patients? Are there

conditions in which those same vaccines would be indicated in an

immunosuppressed patient? Are dosages modified?

http://pediatrics.medscape.com/44800.rhtml?srcmp=ped-110901

ASK THE EXPERTS - TETANUS VACCINE DOSING SCHEDULE FOR AN UNIMMUNIZED  18-MONTH-OLD?

The mother of an 18-month-old toddler refuses all immunizations. Recently,

she requested only the tetanus component of the DTP. What should be the

dosing schedule?

http://pediatrics.medscape.com/44807.rhtml?srcmp=ped-110901

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___________________________________ NEWS ______________________________

NEW ADHD DRUG REDUCES SYMPTOMS, IMPROVES SOCIAL AND FAMILY FUNCTIONING

Atomoxetine hydrochloride significantly reduces inattention, hyperactivity,

and impulsivity.

http://pediatrics.medscape.com/44793.rhtml?srcmp=ped-110901

DIVALPROEX SAFE, EFFECTIVE AS MIGRAINE PROPHYLAXIS IN PEDIATRIC PATIENTS

Divalproex appears to be safe and efficacious for migraine prophylaxis in

pediatric patients with migraine alone or with comorbid epilepsy, according

to a report in the October issue of the Journal of Child Neurology.

http://pediatrics.medscape.com/44609.rhtml?srcmp=ped-110901

PRIMARY CARE PHYSICIANS URGED TO RAISE EXPECTATIONS FOR PEDIATRIC ASTHMA OUTCOMES

Specialty care is essential for some children and adolescents with asthma,

but asthma-associated morbidity 'need not be tolerated for most patients

most of the time,' according to researchers at the University of Iowa

College of Medicine in Iowa City.

http://pediatrics.medscape.com/44613.rhtml?srcmp=ped-110901

INSULIN LISPRO AN OPTION IN YOUNG CHILDREN WITH TYPE 1 DIABETES

Insulin lispro given before or after meals is well tolerated, safe and

significantly lowers postprandial glucose levels in prepubertal children

with diabetes, results of a study published in the November issue of

Pediatrics indicate.

http://pediatrics.medscape.com/44668.rhtml?srcmp=ped-110901

ASTHMA STRONGLY LINKED TO TOBACCO EXPOSURE IN INNER-CITY CHILDREN

More than one quarter of inner-city children have asthma, and most report

active or passive tobacco exposure, according to study findings presented

Monday in Philadelphia at the 67th annual meeting of the American College

of Chest Physicians.

http://pediatrics.medscape.com/44676.rhtml?srcmp=ped-110901

ASSOCIATION STRESSES VALUE OF NEWBORN HEARING TESTS

Routine screening of newborns for hearing loss is consistent with good

clinical practices and should be encouraged, according to the American

Speech-Language-Hearing Association (ASHA), based in Rockville, Maryland.

http://pediatrics.medscape.com/44683.rhtml?srcmp=ped-110901

BOTULINUM TOXIN MAY AID CEREBRAL PALSY PATIENTS

Botulinum toxin type A (BTX-A) may help some children with cerebral palsy

to walk, researchers report in the November issue of Pediatrics.

http://pediatrics.medscape.com/44696.rhtml?srcmp=ped-110901

VITAMIN K SUPPLEMENTATION FOR PREMATURE INFANTS MIGHT NEED TO BE REDUCED

At 2 weeks of age, premature infants have high plasma vitamin K levels

because of supplementation, according to a report in the November issue of

Pediatrics.

http://pediatrics.medscape.com/44725.rhtml?srcmp=ped-110901

MOLD SENSITIVITY ELEVATES ADENOID HYPERTROPHY RISK IN CHILDREN WITH

ALLERGIC RHINITIS

Sensitivity to mold allergens increases the risk of adenoid hypertrophy in

children with allergic rhinitis, according to a report in the October issue

of the Annals of Allergy, Asthma, and Immunology.

http://pediatrics.medscape.com/44739.rhtml?srcmp=ped-110901

TWIN PRETERM DELIVERIES RISE AS STILLBIRTHS DECLINE

Improved medical technology and the use of labor induction and Cesarean

section have led to a decline in the number of twins who die at birth, but

may also be associated with higher rates of preterm delivery, Canadian

researchers report.

http://pediatrics.medscape.com/44744.rhtml?srcmp=ped-110901

FDA GRANTS CYGNUS EXPEDITED REVIEW FOR PEDIATRIC USE OF GLUCOWATCH

Cygnus Inc. said on Tuesday that it has received notification from the US

Food and Drug Administration (FDA) that the agency will expedite the review

of Cygnus' premarket approval (PMA) application to use its GlucoWatch

Biographer for blood glucose monitoring of children ages 7 to 17.

http://pediatrics.medscape.com/44755.rhtml?srcmp=ped-110901

TRIAMCINOLONE CUTS AIRWAY INFLAMMATION IN ASTHMATIC CHILDREN

Treatment with inhaled triamcinolone acetonide reduces levels of serum

markers of inflammation and improves lung function in children with atopic

asthma, according to Polish researchers.

http://pediatrics.medscape.com/44817.rhtml?srcmp=ped-110901

ACELLULAR PERTUSSIS VACCINATIONS IN INFANCY PROVIDE PROTECTION UP TO AGE 6

The protection against pertussis afforded by three doses of

diphtheria-tetanus-acellular pertussis vaccine (DTaP) administered at 2, 4

and 6 months of age persists through 6 years of age, Italian investigators

report.

http://pediatrics.medscape.com/44823.rhtml?srcmp=ped-110901

IMMUNE RECONSTITUTION SEEN IN HAART-TREATED CHILDREN WITH ADVANCED HIV DISEASE

HIV-1-infected children with moderately to severely advanced disease who

receive highly active antiretroviral therapy (HAART) are able to

reconstitute their immune system to the level seen in children with stable

HIV-1 infection.

http://pediatrics.medscape.com/44826.rhtml?srcmp=ped-110901

FATTY INFILTRATION OF LIVER COMMON IN FATAL PEDIATRIC BURNS

The development of fatty liver is common in severely burned pediatric

patients and also appears to be associated with increased incidence of

sepsis, researchers report.

http://pediatrics.medscape.com/44831.rhtml?srcmp=ped-110901

BRITISH HOSPITALS 'SECRETLY TEST' GIRLS FOR PREGNANCY

Girls as young as nine years old are being covertly tested for pregnancy

after they present with stomach pains in British hospital accident and

emergency departments, the Nursing Standard magazine reported on Wednesday.

http://pediatrics.medscape.com/44840.rhtml?srcmp=ped-110901

CHILD REFUGEES ENTERING US NEED MEDICAL ATTENTION

Child refugees are likely to arrive in the US with a variety of health and

growth problems, researchers report.

http://pediatrics.medscape.com/44852.rhtml?srcmp=ped-110901

ZITHROMAX ENDORSED AS SINGLE-DOSE TREATMENT OF ACUTE OTITIS

Expert advisors to the US Food and Drug Administration (FDA) recommended on

Wednesday that the agency grant pharmaceutical maker Pfizer Inc. a

supplemental indication for its antibiotic Zithromax (azithromycin), which

in effect would allow doctors to prescribe a single dose for the treatment

of acute otitis media.

http://pediatrics.medscape.com/44854.rhtml?srcmp=ped-110901

ATOPIC ASTHMATIC CHILDREN SHOW ELEVATED LEVELS OF INFLAMMATORY MARKERS

Blood eosinophil and fractional inhaled nitric oxide (FENO) levels are

increased in atopic asthmatic children, compared with their nonatopic

counterparts, Italian researchers report in the November issue of Thorax.

http://pediatrics.medscape.com/44882.rhtml?srcmp=ped-110901

<a href="http://pediatrics.medscape.com/44882.rhtml?srcmp=ped-110901"> Read

it Here</a>

PRE- AND POSTNATAL PCB EXPOSURE TIED TO POOR INFANT COGNITIVE DEVELOPMENT

Previous reports have indicated that prenatal but not postnatal exposure to

polychlorinated biphenyls (PCBs) has an adverse effect on childhood

cognitive development.

http://pediatrics.medscape.com/44896.rhtml?srcmp=ped-110901

S. PYOGENES A FREQUENT CAUSE OF COMPLICATIONS IN CHILDREN WITH VARICELLA

Although infectious complications represent about a third of severe

complications experienced by previously healthy children with varicella,

Streptococcus pyogenes involvement represents approximately half of cases

with chronic sequelae, German investigators report.

http://pediatrics.medscape.com/44899.rhtml?srcmp=ped-110901

UK GOVERNMENT WILL NOT OUTLAW SMACKING

The UK government said on Thursday that it saw no need to make any changes

to English law to ban the smacking of children by their parents.

http://pediatrics.medscape.com/44902.rhtml?srcmp=ped-110901

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  ANTHRAX: WHAT EVERY CLINICIAN SHOULD KNOW

This recording of the live webcast from the CDC presents clinical

guidelines and procedures for the early recognition, diagnosis, treatment,

and reporting of anthrax exposure. A panel of experts from the CDC provide

an overview of clinical, laboratory and public health preparedness for

potential Bacillus anthracis incidence. Sponsored by the American Hospital

Assn., American Medical Assn., Public Health Training Network, CDC, and the

University of North Carolina School of Public Health.

http://www.medscape.com/webcast/anthrax

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