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Indian Pediatr 2013;50: 1166
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Clippings |
K Rajeshwari
Email:
[email protected]
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Paracetamol and ibuprofen therapy for febrile children (Cochrane
Database Syst Rev 2013; Oct 30; 10:CD009572)
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The aim of this systematic review was to assess the effects and side
effects of combining paracetamol and ibuprofen, or alternating them on
consecutive treatments, compared with monotherapy for treating fever in
children.Six randomized controlled trials, enrolling 915 participants,
were included. Compared to giving a single antipyretic alone, giving
combined paracetamol and ibuprofen to febrile children resulted in a
lower mean temperature at one hour after treatment. If no further
antipyretics are given, combined treatment probably also results in a
lower mean temperature at four hours and in fewer children remaining or
becoming febrile for at least four hours after treatment. One trial
assessed child discomfort (mean pain scores at 24, 48 and 72 hours),
finding that these mean scores were lower, with alternating therapy. No
statistically significant differences were seen in mean temperature, or
the number of febrile children at one, four or six hours. There were no
serious adverse events in the trials that were directly attributed to
the medications used.
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Social and behavioral risk factors for obesity in early
childhood (J Dev Behav Pediatr 2013; 34(8):549-56)
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The purpose of this study was to examine the relationship between social
risk factors, behavioral problems, health behaviors, and obesity among
preschoolers in the Fragile Families and Child Wellbeing Study. A
cumulative social risk score was created by summing maternal reports of
intimate partner violence, food insecurity, housing insecurity, maternal
depressive symptoms, maternal substance use, and father’s incarceration,
obtained when the child was 3 years old. Mothers reported on the child’s
internalizing and externalizing behaviors with the Child Behavior
Checklist at age 5 years. Mothers also reported on hours the child spent
watching television and sleeping as well as servings of soda or juice
drinks the child consumed per day. Child height and weight were measured
at age 5 years. Obesity was defined as body mass index
³ 95th percentile. In
regression analyses adjusted for health behaviors, behavioral problems,
and sociodemographic factors; cumulative social risk was associated with
obesity among girls. Externalizing behavioral problems were associated
with obesity among girls and boys. Short sleep duration was also
associated with obesity among girls and boys even after adjusting for
behavioral problems and social risk factors. Watching more than 2 hours
of television per day was associated with obesity among boys.
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Respiratory infections in pretermsand subsequent asthma (BMJ
Open 2013 Oct 29; 3(10):e004034)
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National registers in Sweden identified 42 334 children admitted to
hospital for respiratory infection in their first year after birth
during 1981-1995, and individually matched with 211 594 children not
admitted to hospital for infection during their first year were studied.
Asthma diagnoses and prescribed asthma treatments after the age of 5
years was identified. Cox regression was used to identify association of
respiratory infection before 1 year of age with asthma after age 5
years, after adjustment for sex, gestational age, chronic lung disease,
maternal asthma and maternal smoking. When stratified by gestational age
(and with additional adjustment for birth weight), there is
statistically significant effect modification by gestational age, with
the highest magnitude asthma risk among those born with a gestational
age of less than 28 weeks. This higher magnitude asthma risk persisted
until after age 10 years. Extremely preterm infants are most likely to
have chronic respiratory sequelae following respiratory infections in
early life.
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Predictive factors for persistent wheeze (Allergy
Asthma Proc 2013; 34(6):42-6)
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This study investigates the natural course of episodic viral wheezing
(EVW) and identifies the risk factors that predict persistence of
wheezing on short-term follow-up. The medical records of children <3
years of age at hospital admission and classified as having EVW were
retrospectively screened. A total of 236 children were classified as
having EVW and the median follow-up period was 19.5 months. At the end
of follow-up, wheezing persisted in 61.4% and changed to
multiple-trigger wheeze in 15.7%. Factors associated with persistent
wheeze were age at initial wheezing <24 months, anti-inflammatory
treatment at the time of diagnosis, history of severe episodic wheeze in
the previous year, wheezing requiring systemic steroids in the previous
year, frequent episodic wheeze, parental asthma, and a positive modified
asthma predictive index (mAPI). The logistic regression analysis
revealed three independent risk criteria for predicting persistent
wheeze: anti-inflammatory treatment at the time of diagnosis, history of
severe episodic wheeze in the previous year, and a positive mAPI for
major criteria.
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