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Ilya Petrou, MD
COME in preschool-aged children
A recent study found that pathogen exposure, upper respiratory tract infection (URI), and nasal obstruction all were associated with chronic otitis media with effusion (COME) in preschool-aged children, underscoring the need for improved methods in pathogen transmission prevention in this patient population.
Watchful waiting is cost-effective in acute otitis media
A recent study found that taking a watchful waiting approach when managing acute otitis media in qualifying children proves to be the more cost-effective strategy to follow.
Prenatal antibiotics increase risk of OM and ventilation tubes in children
A recent study found that the maternal use of antibiotics during pregnancy appears to increase the risk of otitis media and the placement of ventilation tubes in the offspring, particularly when administered later in the pregnancy.
Live attenuated influenza vaccine “shelved” for poor efficacy
Recent data has revealed the live attenuated influenza vaccine (LAIV), also known as the “nasal spray” vaccine, to be grossly ineffective, leading to the ACIP’s decision not to recommend its usage. As such, healthcare providers must be judicious in their choice of influenza vaccine with their patients.
Midazolam warning for preemies
A recent study in preterm infants found that exposure to midazolam, a commonly used sedative in the neonatal intensive care unit (NICU), was associated with macro- and microstructural alterations in hippocampal development and poorer outcomes consistent with hippocampal dysmaturation.
Chest wall rigidity in fentanyl abuse
A recent study found that chest wall rigidity may be partially responsible for some of the deaths related to the intravenous injection of illicit fentanyl.
Febrile seizure risk and vaccines
Maintaining the currently recommended vaccination schedule of influenza, pneumococcal conjugate, and diphtheria/tetanus/acellular pertussis vaccines in young children as put forth by the Centers for Disease Control and Prevention is likely the best way to manage immunization in this patient population despite the slightly increased risk for febrile seizure.
Nasal cytology: An untapped diagnostic tool
Although still underused among available diagnostic procedures, nasal cytology is viewed by many specialists as an indispensable adjunctive diagnostic exam that clinicians can and should use more often to optimally diagnose, treat, and manage the myriad of nasal disorders and diseases occurring in pediatric patients.
Small-particle inhaled corticosteroids: Paradigm shift in asthma treatment
New research suggests that the use of small-particle inhaled corticosteroids as a first-line or step-up therapy for uncontrollable asthma in children would be more helpful in clearing symptoms and preventing exacerbations than traditional treatment approaches such as large-particle inhaled corticosteroids with or without the addition of long-acting beta 2 agonists.
Childhood immunizations
The currently recommended childhood immunization schedule put forth by the Centers for Disease Control and Prevention (CDC) is designed to protect infants and young children from 14 harmful and potentially deadly diseases before a child’s second birthday.

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