Opioids: A pediatric epidemicOpioid use is now a significant problem for the pediatrician and the families served in pediatric practices. Whereas patients with a prior history of drug use, misuse, or suspicions of drug misuse have long been studied, monitored, screened, and treated for adverse outcomes, opioid-naïve patients with legitimate medical reasons for opioid prescriptions may represent a greater risk for opioid complications.
In this issue
Opioids overshadow athletic injuries September 01, 2016By Stacy Frye MDIn my practice, we are seeing patients and their families being increasingly interested in gaining a competitive edge with regard to athletics.One of the consequences of this is that our young athletes are running themselves down—pushing to be the best—at the cost of wear and tear on their bodies. Repetitive stress, fatigue, and poor technique lead to children suffering overuse injuries and put kids at risk for traumatic injury. Midazolam warning for preemies September 01, 2016By Ilya Petrou MDA 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 September 01, 2016By Ilya Petrou MDA recent study found that chest wall rigidity may be partially responsible for some of the deaths related to the intravenous injection of illicit fentanyl. Treatment of opioid use disorderAs problems with opioid use and abuse in the United States increasingly emerge to create what is being called a public health epidemic, clinicians are facing the great challenge of trying to provide optimal pain management for their patients while being mindful of the potential deleterious effects of the highly addictive opioids. Pediatric labeling for OxyContin: Pros & Cons September 01, 2016By Lisette HiltonIn the throes of an opioid epidemic, the US Food and Drug Administration (FDA) decided in August 2015 to expand the indications for OxyContin, an extended-release form of the narcotic oxycodone, to children aged 11 years and older. The decision sparked outrage in those who fear the move might fuel increasing opioid addiction among young Americans. Opioid epidemic: A timeline
September 01, 2016A look at the major discoveries and milestones in the opioid epidemic occurring in the United States.
9 opioid epidemic facts you need to know
October 18, 2016The opioid epidemic continues to make front page news with more overdoses happening every day and new synthetic opioids promising more than earlier opioid formulations. Here are 9 facts about the epidemic that you need to know.
Peeling rash in a 4-year-old boyThe mother of a 4-year-old boy, whose family recently emigrated from Haiti, brings him to the pediatric mobile clinic for evaluation of a rash that had begun 11 days earlier as an eruption of vesicular, pruritic papules on the bilateral lower extremities and had spread to the buttocks and medial thighs with sparing of the face. The skin eruption was followed by desquamation of the skin on his palms and soles.
Linear papular eruption grows on boy’s neckA father brings his 12-year-old son to the clinic for evaluation of a skin eruption that has been on the back of the boy’s neck for a year, but which just began to extend behind his ear. The rash is asymptomatic, and the otherwise healthy patient is annoyed that he has to spend a beautiful morning in a physician’s office.
POC influenza testing: State of the artWith the introduction of point-of-care (POC) molecular assays, pediatricians can diagnosis influenza A and B during the office visit with sensitivity and specificity comparable to reference assays.
Some uropathogens more associated with pyuria than othersA new study demonstrated that in children with an apparent urinary tract infection, the proportion with pyuria varied significantly depending on the uropathogen associated with the infection. Fecal Bacteroides are linked to bronchiolitisInvestigators identified 4 distinct fecal microbiota profiles in infants hospitalized with bronchiolitis and found that 1 of those profiles—dominated by Bacteroides—was associated with a higher likelihood of bronchiolitis than the others. Increased opioid abuse leads to more ED visitsFrom 2006 to 2012, patients aged younger than 18 years made more than 21,928 visits to emergency departments (EDs) for poisoning by prescription opioids, such as methadone, codeine, meperidine, or morphine. Artificial sweeteners linked to overweight in infants September 01, 2016By Marian FreedmanInvestigators used a food frequency questionnaire to assess how often 3003 pregnant women drank artificially sweetened or sugar-sweetened beverages during their second or third trimesters. They then analyzed how this data correlated with the body mass index of these mothers’ babies at age 1 year. Identify food insecurity in hospitalized kidsAbout one-quarter of children who recently have been hospitalized live in food insecure households, which suggests that hospitalization presents a potential opportunity to identify these youngsters and help their families access nutrition assistance.