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This Month in Archives of Pediatrics and Adolescent Medicine
September 2004

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2004;158(9):847. doi:10.1001/archpedi.158.9.847
Does Group A β-Hemolytic Streptococcal Infection Increase Risk for Behavioral and Neuropsychiatric Symptoms in Children?

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) is hypothesized to describe a group of children with a sudden onset of obsessive-compulsive and tic disorders in the weeks following streptococcal pharyngitis. However, PANDAS as a distinct entity remains controversial. In this comparison of children with streptococcal pharyngitis or viral pharyngitis and well children, the risk of developing PANDAS symptoms in the subsequent 3 months was examined. Perrin and colleagues found that the risk of developing new PANDAS symptoms was not increased in children with streptococcal infection, all of whom were treated, compared with children in the other groups.

Article
A Randomized Controlled Trial of an Information Prescription for Pediatric Patient Education on the Internet

Information prescriptions are prescriptions of focused, evidence-based information to a patient to manage a health problem. This randomized controlled trial examined whether an information prescription given by a primary care pediatrician would change the attitudes or behaviors of parents about using Internet health information resources. At baseline, two thirds of parents had used the Internet in the prior 6 months for health information. The intervention increased its use for general health information and child health information; parents mostly used the Internet information resources prescribed by their pediatrician. This may serve as a model for how pediatricians can use the Internet for health education in their offices.

Article
A Multisite Randomized Trial of the Effects of Physician Education and Organizational Change in Chronic-Asthma Care: Health Outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study

Despite the availability of evidence-based practice recommendations, many children with asthma receive inadequate care. This randomized controlled trial in primary care settings compared physician education through on-site peer leaders, a multilevel approach combining physician education with nurse-run interventions, and usual care for 3- to 17-year-old children with mild or moderate persistent asthma. The multilevel approach proved most effective in reducing symptom days, lowering the use of oral steroids, and promoting greater adherence to controller medication use. Peer leader education was useful but less effective than the comprehensive approach.

Article
Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on Fasting Capillary Glucose Levels: A Randomized Controlled Trial

Risk of developing type 2 diabetes is associated with overweight, low levels of physical activity, high saturated fat intake, and low levels of dietary fiber, all of which are reported to be more prevalent in Mexican American children. This randomized controlled trial conducted in 27 Texas elementary schools examined the effect of a culturally appropriate comprehensive health education and fitness program in fourth-grade Mexican American children. The intervention resulted in a lower mean fasting blood glucose level, improved physical fitness, and increased dietary fiber intake 8 months after it began. This type of intervention holds promise for altering lifestyle to decrease the risk of diabetes in children.

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