More than 80% of adults who smoke begin before they graduate from high school. Among smokers, cessation is more difficult the longer the duration of nicotine addiction. Nicotine replacement therapy (NRT) is an effective adjunct to behavioral interventions in helping adults to stop smoking, but current labeling by the Food and Drug Administration does not allow NRT products to be sold to minors. In this community-based study of 165 stores, 81% of minors were nevertheless able to successfully buy NRT products. Public health benefits of smoking cessation efforts would be most effective if minors were fully included.
Infectious mononucleosis is a common infection with significant morbidity. Whereas some physicians have used corticosteroids to relieve acute upper airway obstruction caused by infectious mononucleosis, the efficacy of steroids in relieving pharyngeal pain is unclear. In this randomized controlled trial, adolescents with infectious mononucleosis were randomized to receive 1 oral dose of dexamethasone or placebo. The corticosteroid group reported less pain at 12 hours than the placebo group, but there were no differences in pain at 24, 48, or 72 hours or at 1 week. The short-term benefits of a single dose of dexamethasone may not be sufficient for lasting pain relief.
Herbal products are widely used to treat or prevent a variety of illnesses including the common cold. Although echinacea is not effective in treating upper respiratory tract infections in children, its efficacy in preventing infection is unknown. Cohen and colleagues randomized 430 children younger than 6 years to receive either placebo or a preparation containing echinacea, propolis, and vitamin C for 12 weeks during the winter. There was a 65% reduction in the number of respiratory tract infections, a 28% reduction in the number of episodes per child, and a 34% reduction in the duration of fever. It appears that prevention of upper respiratory tract infections is possible with this herbal and vitamin combination.
The causes of short stature are multiple and are associated with a wide range of clinical, emotional, and practical effects on children. Wheeler and colleagues conducted a systematic review of the literature to summarize the evidence regarding the association of primary short stature with functional impairment. Eleven studies evaluated academic achievement, and 22 evaluated intelligence. Children with short stature were found to have lower intelligence scores and poorer academic achievement scores than controls, although few children scored outside the range of normal. These children had no more behavior problems than controls. The cause of these deficits is known, and the ability of treatment to ameliorate them appears limited.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2004;158(3):204. doi:10.1001/archpedi.158.3.204