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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2002;156:851.
Utility of the Serum C-reactive Protein for Detection of Occult Bacterial
Infection in Children
The diagnosis of occult bacteremia in children remains a challenging
clinical problem. C-reactive protein (CRP) has been suggested as a useful
diagnostic test for the detection of bacteremia in febrile children. In this
prospective study of 256 febrile children aged 3 to 36 months, 11.3% had a
bacterial infection, including 1.1% with bacteremia. Use of the CRP, in addition
to the absolute neutrophil count, did not improve the sensitivity of laboratory
tests in identifying bacterial infections, and the specificity of negative
tests in this population was lowered. Given that the prevalence of bacteremia
seems to be very low, the use of diagnostic screening tests may not be appropriate.
(SEE ARTICLE)
Effect of a Pediatric Hospitalist System on Housestaff Education and
Experience
Hospitalists are caring for an increasing proportion of hospitalized
children and adults in the United States. Hospitalists seem to decrease inpatient
length of stay and costs, but their effects on training of residents are less
clear. Landrigan and colleagues surveyed resident physicians before and following
the introduction of a hospitalist system at an academic children's hospital.
Interns reported that their satisfaction with the educational experience and
supervision improved following use of the hospitalists. Hospitalists were
rated by residents as more effective role models, more accessible and knowledgeable,
and more involved in resident education.
(SEE ARTICLE)
Behavioral Correlates of Television Viewing in Primary School Children
Evaluated by the Child Behavior Checklist
The average child or adolescent in the United States watches an average
of 3 hours of television per day, and prior studies have suggested that exposure
to television violence is associated with aggressive behavior. This study
assessed the effect of television watching on behavioral problems and social
competency among second- and third-grade students. The amount of time spent
watching television was found to be positively associated with social problems
and delinquent and aggressive behavior. This study further underscores the
negative effects of large amounts of time spent watching television.
(SEE ARTICLE)
Estimates of the Incidence and Costs Associated With Handlebar-Related
Injuries in Children
For more than 30 years, the danger of serious abdominal and pelvic organ
injuries posed by bicycle handlebars has been known. The US Consumer Product
Safety Commission is considering regulating the performance of handlebars
with regards to their energy dissipation capabilities. Winston and colleagues,
using data from 19 states, estimated that 1147 children and adolescents sustain
bicycle-related injuries annually in the United States, of whom 77% may have
been injured because of handlebars. The estimated hospital charges associated
with these injuries were $9.6 million and an additional estimated $10 million
in lifetime medical costs. The scope and magnitude of the problem warrant
serious consideration of alternative designs for handlebars.
(SEE ARTICLE)
Lead Poisoning and Asthma: An Examination of Comorbidity
Asthma and lead poisoning are common in urban areas, with both diseases
having an environmental mechanism. Home repair and renovation have been practiced
for prevention and intervention for both diseases. Determining the degree
of comorbidity between lead poisoning and asthma may provide information to
guide interventions aimed at preventing or reducing the effect of these diseases.
This study of patients attending an inner-city clinic found no increased likelihood
of asthma diagnosis or symptoms among children with elevated blood lead levels.
The prevalence of asthma symptoms was high among both children with high and
low blood lead levels.
(SEE ARTICLE)
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