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The Ten Top Pediatric Stories of 2005

The editors of JW Pediatrics and Adolescent Medicine summarize the most important stories of the year.

Each year, new discoveries improve our practices, and old beliefs are challenged. This year’s pediatric literature offered so many interesting research findings that it was difficult to choose the top ten. We covered a significant number of new therapeutics, immunizations, and drug warnings in 2005. In fact, we even introduced you to a promising new vaccine early in the year, only to report months later a possible complication of that same vaccine. Our editors continually search for important insights that will help you in your practices.

Happy New Year,

F. Bruder Stapleton, MD, Editor-in-Chief

TOP STORIES:

1. Maternal Fever and Neural Tube Defects. Maternal hyperthermia (temperature >38.5^oC or >101.3^oF) in the first trimester of pregnancy increases the risk for neural tube defects. Women should avoid soaking in hot tubs during this important time in embryogenesis.

http://pediatrics.jwatch.org/cgi/content/full/2005/114/1

2. Meningococcal Vaccine: A Step in the Right Direction and Meningococcal Conjugate Vaccine: Proceed, but with Caution. Wow! First, last spring we recommended a promising new conjugate vaccine for all 11- and 12-year-olds and high school and college freshmen. Then, in the fall, we reported concern following a report of five cases of Guillain-Barré syndrome in immunized adolescents. Proceed with caution, but don’t give up on the new vaccine yet!

http://pediatrics.jwatch.org/cgi/content/full/2005/314/3 and http://pediatrics.jwatch.org/cgi/content/full/2005/1104/1

3. Oral Sex Doesn’t Mean Safe Sex. Herpes simplex virus can be transmitted through saliva. Many adolescents view oral sex as "safe"; that’s true for avoiding pregnancy risk, but not for avoiding transmission of sexually transmitted diseases.

http://pediatrics.jwatch.org/cgi/content/full/2005/228/3

4. How Significant Are Asymptomatic Gross and Microscopic Hematuria? Although evidence continues to support diagnostic studies to identify the cause of gross microscopic hematuria, diagnostic imaging or blood tests are not necessary in children with asymptomatic hematuria.

http://pediatrics.jwatch.org/cgi/content/full/2005/506/1

5. Community-Associated MRSA: The March Continues. The incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection, which can cause necrotizing fasciitis, is increasing. About 75% of MRSA isolates were resistant to prescribed antibiotics. Therefore, antibiotic therapy must be tailored to the individual.

http://pediatrics.jwatch.org/cgi/content/full/2005/425/1

6. Measuring Exhaled Nitric Oxide Can Guide the Treatment of Asthma. Exhaled nitric oxide is relatively easy to measure and is an indicator of airway inflammation. Researchers propose titrating inhaled corticosteroids based on exhaled nitric oxide measurements. We will see whether this tool adds significantly to asthma therapy in the future.

http://pediatrics.jwatch.org/cgi/content/full/2005/708/1

7. Who Would Have Thought That Hurler Syndrome Was Treatable? Clinical genetics is getting even more exciting as previously fatal genetic diseases become treatable. Bone marrow transplantation combined with enzyme replacement holds promise for treating children with Hurler syndrome.

http://pediatrics.jwatch.org/cgi/content/full/2005/613/11

8. Now Approved: Tetanus-Diphtheria-Pertussis Booster for Adolescents and Adults. Two new Tdap vaccines are approved for adolescents. Let’s hope the booster will reduce the spread of community-wide pertussis infection.

http://pediatrics.jwatch.org/cgi/content/full/2005/725/4

9. Paternal Postnatal Depression Adversely Affects Child Development and Quick Screen for Maternal Depression. Postnatal depression, it turns out, is a problem for dads as well as moms, and it is associated with behavioral and developmental problems, especially in sons. We also described a quick clinical tool for detecting depression. http://pediatrics.jwatch.org/cgi/content/full/2005/829/2 and http://pediatrics.jwatch.org/cgi/content/full/2005/829/6

10. Buccal Midazolam Is Effective for Acute Seizures. Obtaining IV access during acute seizures can be difficult. Buccal midazolam is a rapid-acting anticonvulsant that stopped seizures in children safely and more effectively than rectal diazepam.

http://pediatrics.jwatch.org/cgi/content/full/2005/829/4

Published in Journal Watch Pediatrics and Adolescent Medicine December 9, 2005