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This Month in Archives of Pediatrics and Adolescent Medicine
April 2005

This Month in Archives of Pediatrics & Adolescent Medicine

Author Affiliations

Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Pediatr Adolesc Med. 2005;159(4):313. doi:10.1001/archpedi.159.4.313

Complaints of asymptomatic gross hematuria and the finding of microscopic hematuria on routine urinalysis are relatively common in children and often precipitate a diagnostic evaluation for renal disease. In this large study of 570 patients, no cause was found in almost three quarters of patients with microscopic hematuria and 38% of patients with gross hematuria. Hypercalciuria was the most common cause of both microscopic and gross hematuria. None of the patients with microscopic hematuria had an infection. Evaluation of children with microscopic hematuria may not be needed given the rarity of important treatable causes; careful long-term follow-up may suffice. Since asymptomatic gross hematuria is more commonly associated with urinary tract disease, a thorough evaluation for etiology is justified.

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Bullying is a major public health problem that has garnered increased attention in the last few years. It occurs more commonly among young school-aged children, indicating that risk factors are likely to be found in the preschool period. This study used data from the National Longitudinal Survey of Youth to examine risk factors at age 4 years for bullying behavior at ages 6 to 11 years. Parental cognitive stimulation and emotional support of preschoolers was protective against later bullying. In contrast, television viewing was harmful. For each hour of television viewing per day at age 4 years, the risk of bullying during elementary school years increased by 6%. The early home environment had a substantial impact on later bullying behavior.

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Nosocomial infections are a major cause of morbidity and mortality among inpatients, especially infants in neonatal intensive care units. Reduction of nosocomial infections has become a major national patient safety initiative of the Centers for Disease Control and Prevention (CDC) and other organizations. The CDC has recommended, and many hospitals have adopted, use of waterless alcohol hand products in lieu of traditional handwashing to decrease nosocomial infections; there are few data, however, supporting this recommendation. In this large crossover study in 2 neonatal intensive care units, traditional antiseptic handwash was compared with an alcohol hand sanitizer. There was no difference in the risk of infections among the neonates in nurseries using these 2 products, but the alcohol regimen was associated with better skin health and improved quality of hand hygiene among nursing staff.

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While analgesics in children with acute abdominal pain are often withheld for fear that they may mask physical examination findings, there are few data to support or refute this practice. In this study, children with acute abdominal pain were randomized to receive oxycodone or placebo, with examinations before and after receiving medication. Oxycodone provided greater pain relief than placebo without any evidence that it affected the diagnostic accuracy of the physical examination.

Image not available

Pain scores in the 2 study groups after the first dose of study medication. Error bars indicate mean ± SD.

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