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This Month in Archives of Pediatrics and Adolescent Medicine
October 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(10):906. doi:10.1001/archpedi.159.10.906

Amoxicillin is one of the most commonly prescribed antibiotics in pediatric practice. This prospective longitudinal study examined antibiotic use during infancy and its effects on teeth in children. Use of amoxicillin between 3 and 6 months of age was found to double the risk of fluorosis in the permanent maxillary central incisors, independent of the effect of flouride. This study supports a judicious approach to the use of antibiotics in children for the treatment of otitis media.

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Teeth showing severe fluorosis; that is, displaying pitting, staining, and/or deformity.

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The recent report from the US Preventive Services Task Force indicated limited evidence for the effectiveness of weight loss programs in children. This randomized controlled trial sought to examine the effectiveness of a school-based fitness program. A lifestyle-focused, fitness-oriented gym class was found to decrease body fat, improve cardiovascular fitness, and improve fasting insulin levels in overweight middle school children. These findings should help to encourage the development of physical education programs that are effective in providing children with substantial amounts of physical activity.

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Mean ± SD decrease in percentage of body fat as indicated by dual- energy absorptiometry. After a 9-month school year, the decrease was greater in the treatment group compared with the control group. Asterisk indicates P =.04.

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Parent refusal or deliberate delay of their child’s vaccinations poses a challenge for pediatricians. Some pediatricians may choose to dismiss these families from their practices. This survey of pediatricians found that more than half had faced refusal of all vaccines by a parent in the last year. More than one third reported they would dismiss such a family from their practice and more than one quarter said they would dismiss a family for refusing selected vaccines. It is unknown whether the practice of family dismissal from a practice promotes or undermines immunization for those children or for children as a group.

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Hypospadias is a relatively common malformation among male infants. A variety of mechanisms involving exposure to endocrine disruptors and genetic impairment have been proposed to cause hypospadias, but their actual contribution to its etiology remains unknown. This national case-control study sought to examine whether periconceptional maternal intake of progestins was associated with an increased risk of hypospadias. Maternal use of progestins from 4 weeks before conception through 14 weeks after conception to help women become pregnant or prevent pregnancy complications was associated with a 3.7-fold increase in odds of having second- or third-degree hypospadias.

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