Pediatrics
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Comparative Study
Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures.
In February 2008, we alerted the Advisory Committee on Immunization Practices to preliminary evidence of a twofold increased risk of febrile seizures after the combination measles-mumps-rubella-varicella (MMRV) vaccine when compared with separate measles-mumps-rubella (MMR) and varicella vaccines. Now with data on twice as many vaccine recipients, our goal was to reexamine seizure risk after MMRV vaccine. ⋯ Among 12- to 23-month-olds who received their first dose of measles-containing vaccine, fever and seizure were elevated 7 to 10 days after vaccination. Vaccination with MMRV results in 1 additional febrile seizure for every 2300 doses given instead of separate MMR + varicella vaccines. Providers who recommend MMRV should communicate to parents that it increases the risk of fever and seizure over that already associated with measles-containing vaccines.
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Comparative Study
Fractures and traumatic brain injuries: abuse versus accidents in a US database of hospitalized children.
The goal was to use a national database to determine the incidence of abusive traumatic brain injuries (TBIs) and/or fractures and the frequency of abuse versus accidents among children <36 months of age. ⋯ There was overlap in TBIs and fractures attributable to abuse. Among <12-month-old children, TBIs and/or fractures attributable to abuse occurred in 1 of 2000. Falls occurred more commonly than abuse, even among very young children.
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The goal was to examine pediatric hospitalist rounding practices and characteristics associated with programs conducting family-centered rounds (FCRs). ⋯ FCRs were the most-common rounding category among respondents. FCRs were not associated with a self-reported increase in rounding duration. Successful FCR implementation may require educating staff members and trainees about FCR benefits and addressing FCR barriers.
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Pentavalent rotavirus (RV) vaccine (RV5) was licensed in 2006 and recommended for routine childhood immunization. A significant decrease in the number of RV hospitalizations has been described. The objective of this study was to evaluate the effect of RV5 on acute gastroenteritis (AGE) seen in a primary practice. ⋯ Increased use of RV5 in a pediatric practice was associated with fewer AGE office visits and hospitalizations. The reduction was specific for RV-positive AGE and seen among children who were targeted for immunization as well as older groups, suggesting a herd-immunity effect.