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August 2014 Briefing - Pediatrics

Here are what the editors at HealthDay consider to be the most important developments in Pediatrics for August 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Tax on Sugary Beverages Could Most Reduce Child Obesity

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Simulations demonstrate that an excise tax on sugar-sweetened beverages (SSBs) would be the most effective policy for reducing child obesity, according to research published online Aug. 26 in the American Journal of Preventive Medicine.

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Report Highlights Progress, Challenges in Health IT

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Progress has been made toward widespread adoption of electronic health records (EHRs), although there are still barriers to adoption of advanced use of EHRs, according to a report published by the Robert Wood Johnson Foundation.

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Cleft Lip, Palate Don't Increase Ear Tube Complications

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Cleft lip and/or palate (CLP) does not appear to affect complication rates for ventilation tube (VT) placement among pediatric patients, according to a study published online Aug. 28 in JAMA Otolaryngology-Head & Neck Surgery.

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Teens Regress After Return-to-Activity Post-Concussion

FRIDAY, Aug. 29, 2014 (HealthDay News) -- High school athletes who return to the field with medical clearance within 60 days often experience a significant regression in their abilities to simultaneously walk and do simple mental tasks, according to a study published online Aug. 5 in Medicine & Science in Sports & Exercise.

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Worse Outcomes for Weekend Admission for Pediatric Leukemia

FRIDAY, Aug. 29, 2014 (HealthDay News) -- Children with newly diagnosed leukemia with an index admission on the weekend have an increased length of stay and risk for respiratory failure, according to a study published online Aug. 25 in JAMA Pediatrics.

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Prognostic Model Developed for Major Outcomes in T1DM

FRIDAY, Aug. 29, 2014 (HealthDay News) -- A prognostic model has been developed and validated which has adequate discrimination for major outcomes in type 1 diabetes, according to a study published online Aug. 28 in Diabetologia.

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CDC: Most U.S. Toddlers Getting Their Vaccines

THURSDAY, Aug. 28, 2014 (HealthDay News) -- More than 90 percent of children 19 to 35 months of age are getting the vaccines that prevent measles, mumps, and rubella; polio; hepatitis B; and varicella, according to the U.S. Centers for Disease Control and Prevention. The new findings were published in the Aug. 29 issue of the CDC's Morbidity and Mortality Weekly Report.

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AMGA: Physician Turnover Still High in 2013

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For the second year running, physician turnover remains at the highest rate since 2005, according to a report published by the American Medical Group Association (AMGA).

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Doctors Frequently Experience Ethical Dilemmas

THURSDAY, Aug. 28, 2014 (HealthDay News) -- For physicians trying to balance various financial and time pressures, ethical dilemmas are common, according to an article published Aug. 7 in Medical Economics.

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Team Approach Improves Practice Efficiency

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- The increasing administrative requirements of a medical practice are requiring a team-based approach to care, and physicians must learn to manage the team, according to an article published Aug. 7 in Medical Economics.

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Reduced Risk of Brain Injury on MRI With Early EPO in Preemies

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- Early administration of high-dose erythropoietin is associated with a reduced risk of brain injury on magnetic resonance imaging (MRI) in premature infants, according to research published in the Aug. 27 issue of the Journal of the American Medical Association.

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In-Utero Exposure to Gestational Diabetes Ups Later Diabetes Risk

WEDNESDAY, Aug. 27, 2014 (HealthDay News) -- In-utero exposure to gestational diabetes mellitus (GDM) increases the likelihood of developing diabetes or prediabetes among obese adolescents, according to a study published online Aug. 25 in Diabetologia.

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FDA: Steer Clear of Dietary Supplements for Concussions

TUESDAY, Aug. 26, 2014 (HealthDay News) -- As the fall sports season starts and young players face the risk of concussions, the U.S. Food and Drug Administration warns that dietary supplements that claim to prevent, treat, or cure concussions are untested, unproven, and possibly dangerous.

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Ban Indoor Use of E-Cigarettes, U.N. Health Agency Says

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Joining a number of other health agencies, the United Nations' World Health Organization (WHO) on Tuesday recommended that countries regulate electronic cigarettes and ban their use indoors until studies prove that "vaping" is harmless to bystanders.

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Collaborative Intervention Benefits Teens With Depression

TUESDAY, Aug. 26, 2014 (HealthDay News) -- A collaborative care intervention in primary care is associated with greater improvements in depressive symptoms than usual care among adolescents with depression, according to a study published in the Aug. 27 issue of the Journal of the American Medical Association.

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AAP Recommendations Provided for Fluoride Use in Primary Care

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Recommendations have been provided for the use of fluoride in caries prevention in the primary care setting and published online Aug. 25 as a clinical report in Pediatrics.

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Obesity in Early Primary School Ups Risk of Bullying Involvement

TUESDAY, Aug. 26, 2014 (HealthDay News) -- Obese children in early primary school are significantly more likely to be involved with bullying, both as victim and perpetrator, according to a study published online Aug. 25 in Pediatrics.

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Number of Young Non-Smokers Trying E-Cigs Tripled in 2 Years

MONDAY, Aug. 25, 2014 (HealthDay News) -- More than a quarter-million middle and high school students who were non-smokers say they used an electronic cigarette last year -- a three-fold increase from 2011, according to a new U.S. study published online Aug. 20 in the journal Nicotine & Tobacco Research.

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Restrictive, Non-Solicitation Covenants Are Valid

MONDAY, Aug. 25, 2014 (HealthDay News) -- Restrictive and non-solicitation covenants are valid and can be enforced, according to an article published Aug. 5 in Medical Economics.

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Start School Later for Older Kids, Pediatricians Urge

MONDAY, Aug. 25, 2014 (HealthDay News) -- U.S. high schools and middle schools should start classes later in the morning to allow kids some much-needed sleep, a leading group of pediatricians is urging.

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State of the Art Review: Eating Disorders in Children, Teens

MONDAY, Aug. 25, 2014 (HealthDay News) -- A new review presents recommendations for the management of eating disorders (EDs) in children. In addition, other research indicates that there has been a recent increase in the prevalence of eating disorders not otherwise specified who do not meet weight criteria (EDNOS-Wt), relative to anorexia nervosa (AN). The review and study have been published online Aug. 25 in Pediatrics.

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Guidelines Presented for Electronic Cigarette Use

MONDAY, Aug. 25, 2014 (HealthDay News) -- Recommendations have been developed regarding electronic cigarette (e-cigarette) use and published online Aug. 24 as an American Heart Association (AHA) policy statement in Circulation.

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Breastfeeding Racial Disparities May Start With Hospitals

MONDAY, Aug. 25, 2014 (HealthDay News) -- Key practices that support breastfeeding are much less common in medical centers where the black population is higher than average, according to a report published in the Aug. 22 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Parents Increasingly Less Likely to Perceive Child Obesity

MONDAY, Aug. 25, 2014 (HealthDay News) -- Today, overweight/obese children are less likely to be perceived as overweight by their parents compared to 10 years ago, according to a study published online Aug. 25 in Pediatrics.

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EPA: Air in U.S. Cities Getting Cleaner

MONDAY, Aug. 25, 2014 (HealthDay News) -- The air in American cities is getting safer to breathe, the U.S. Environmental Protection Agency reported Thursday.

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U.S. to Tighten Access to Certain Narcotic Painkillers

FRIDAY, Aug. 22, 2014 (HealthDay News) -- The U.S. Drug Enforcement Administration (DEA) is going ahead with tough new controls on painkillers containing hydrocodone, which has been tied to a surge in dangerous addictions across the United States.

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Organizations Can Help Docs Retain Their Independence

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Ways for physicians to remain in independent practice are highlighted in an article published Aug. 7 in Medical Economics.

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Counseling May Not Help Youth With Drinking Problems

FRIDAY, Aug. 22, 2014 (HealthDay News) -- Motivational interviewing may not be an effective technique for addressing alcohol misuse in young adults, according to a review published online Aug. 21 in The Cochrane Library.

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CDC: Teens Engage in Unsafe Skin-Protection Practices

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Sunscreen use has decreased among adolescents, and a considerable proportion use indoor tanning devices, according to research published online Aug. 21 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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FDA: New Test Helps Diagnose Type 1 Diabetes

THURSDAY, Aug. 21, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has approved a new test that may help doctors diagnose type 1 diabetes. The Kronus ZnT8Ab Elisa Assay may help some people with type 1 diabetes receive faster diagnosis and treatment, the FDA said in a news release.

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Breastfeeding Moms Have Lower Depression Risk

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Breastfeeding cuts new mothers' risk of depression by half, according to a study published online Aug. 21 in Maternal and Child Health.

Health Highlights: Aug. 20, 2014
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Infections May Up Pediatric Stroke Risk in Short Term

THURSDAY, Aug. 21, 2014 (HealthDay News) -- Minor infections appear to have a strong, but short-lived, effect on pediatric stroke risk, according to a study published online Aug. 20 in Neurology.

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Rates of Food Allergies High in Inner-City Children

THURSDAY, Aug. 21, 2014 (HealthDay News) -- The incidence of food sensitization and food allergy (FA) is high among inner-city children, according to a study published online Aug. 13 in the Journal of Allergy and Clinical Immunology.

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FDA Approves Cerdelga for Type 1 Gaucher Disease

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- Cerdelga (eliglustat) has been approved by the U.S. Food and Drug Administration to treat type 1 Gaucher disease, a rare inherited disorder caused by the body's insufficient production of a key enzyme.

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RSV Inhibitor Reduces Viral Load in Challenge Study

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- For healthy adults challenged with respiratory syncytial virus (RSV), an oral RSV-entry inhibitor, GS-5806, is associated with reduced viral load, according to a study published in the Aug. 21 issue of the New England Journal of Medicine.

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Pre-, Postnatal Smoke Exposure Affects Later Allergic Disease

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- Exposure to secondhand smoke (SHS) in utero or during infancy impacts the development of allergic disease up to adolescence, according to a study published online Aug. 18 in Pediatrics.

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Organized Processes Help Practices Hire Well

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- A defined process is necessary to help physicians hire the right staff for their practice, according to an article published July 24 in Medical Economics.

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CDC: U.S. Teen Birth Rate Down From 1991 to 2013

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- From 1991 to 2013 there has been a consistent decrease in U.S. teenage birth rates, according to a report published online Aug. 20 by the U.S. National Center for Health Statistics (NCHS).

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Neonatal Vitamin K Refusal Tied to Nonimmunization

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- While neonatal vitamin K refusal is rare, parents who refuse vitamin K are less likely to immunize their child, according to a study published online Aug. 18 in Pediatrics.

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Aerobic Fitness Linked to White Matter Integrity in Preteens

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- For preadolescent children, white matter structure varies with fitness level, according to a study published online Aug. 19 in the Frontiers of Neuroscience.

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Screening Programs Identify SCID in One in 58,000 Infants

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Newborn screening programs in the United States have identified severe combined immunodeficiency (SCID) in one in 58,000, with high survival seen in SCID-affected infants, according to a study published in the Aug. 20 issue of the Journal of the American Medical Association.

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Hospitalization Less Likely With Artificially Altered Oximetry

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Among infants presenting to an emergency department with mild to moderate bronchiolitis, hospitalization is less likely for those with an artificially elevated pulse oximetry reading, according to a study published in the Aug. 20 issue of the Journal of the American Medical Association.

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Docs Must Consider Liability When Ordering Screening Tests

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Physicians and health care providers must be aware of their potential liability when ordering screening tests, according to an article published July 24 in Medical Economics.

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Boxed Warnings Are Common in Novel Therapeutics

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Boxed warnings are common on recent drug approvals, and many occur years after approval, according to a research letter published online Aug. 15 in JAMA Internal Medicine.

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Job Losses Up Suicide Rate in Girls, Young Blacks

TUESDAY, Aug. 19, 2014 (HealthDay News) -- Statewide job loss increases suicide-related behaviors among adolescent females and non-Hispanic blacks, according to a study published online Aug. 14 in the American Journal of Public Health.

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Urban Food Initiative Ethical for Addressing Food Issues

TUESDAY, Aug. 19, 2014 (HealthDay News) -- The urban food initiative (UFI) seems to be a safe and ethical approach to addressing obesity and food insecurity, according to a viewpoint piece published online Aug. 18 in JAMA Pediatrics.

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Docs Should Emphasize Child Benefit From MMR Vaccination

MONDAY, Aug. 18, 2014 (HealthDay News) -- Emphasizing the direct benefits of measles-mumps-rubella (MMR) vaccination to the child is more helpful in increasing the intention of parents to vaccinate, according to research published online Aug. 18 in Pediatrics.

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Liberia Ebola Clinic Attack Could Harm Efforts to Control Outbreak

MONDAY, Aug. 18, 2014 (HealthDay News) -- An attack on an Ebola quarantine center in Liberia's capital and the possible disappearance of a number of patients could be a major setback in efforts to contain and halt the outbreak of the deadly disease.

Health Highlights: Aug. 18, 2014

U.S. Children With Cystic Fibrosis Are Living Longer

MONDAY, Aug. 18, 2014 (HealthDay News) -- In the United States, children born in 2010 with cystic fibrosis (CF) are projected to live longer than those born earlier, according to a study published in the Aug. 19 issue of the Annals of Internal Medicine.

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Recent Increase in Prevalence of Childhood Disability

MONDAY, Aug. 18, 2014 (HealthDay News) -- The prevalence of childhood disability increased from 2001 to 2011, according to a study published online Aug. 18 in Pediatrics.

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Quadrivalent HPV Vaccine Has Lasting Benefit for Teens

MONDAY, Aug. 18, 2014 (HealthDay News) -- The quadrivalent human papillomavirus (HPV4) vaccine seems safe and effective for adolescents, according to a study published online Aug. 18 in Pediatrics.

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Phthalate Exposure May Lower Testosterone Levels

FRIDAY, Aug. 15, 2014 (HealthDay News) -- Exposure to phthalates, chemicals that are commonly found in plastics and personal care products, may reduce testosterone levels in men, women, and children, according to research published online Aug. 14 in the Journal of Clinical Endocrinology & Metabolism.

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WHO: Scope of Ebola Outbreak May Be 'Vastly Underestimated'

FRIDAY, Aug. 15, 2014 (HealthDay News) -- The magnitude of the Ebola outbreak in West Africa may be far greater than the current statistics indicate, officials from the World Health Organization said Friday.

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Low Complication Rate for Peds Laparoscopic Cholecystectomy

FRIDAY, Aug. 15, 2014 (HealthDay News) -- For pediatric patients, laparoscopic cholecystectomy is associated with low complication rates and short postoperative hospital stays, according to research published in the June issue of Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.

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Gaps Remain in Efforts to Cut Newborn Mortality/Morbidity

THURSDAY, Aug. 14, 2014 (HealthDay News) -- In some countries, coverage is lacking for the use of pharmacologic interventions to reduce morbidity and mortality associated with preterm births, according to research published online Aug. 13 in The Lancet.

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Limited Sensitivity for Plain Anteroposterior Pelvic Imaging

THURSDAY, Aug. 14, 2014 (HealthDay News) -- For children with pelvic fractures or dislocations after blunt trauma, plain anteroposterior pelvic radiographs have limited sensitivity, according to a study published online July 29 in the Annals of Emergency Medicine.

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Childhood Growth Hormone Use Tied to Later Stroke

THURSDAY, Aug. 14, 2014 (HealthDay News) -- There is a strong relationship between growth hormone (GH) treatment during childhood and subsequent hemorrhagic stroke, according to a study published online Aug. 13 in Neurology.

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Research Offers Clues to How Ebola Disarms Immune System

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Researchers say they've discovered how the deadly Ebola virus disables the immune system. They hope the findings will prove valuable in efforts to find treatments for the disease taking hundreds of lives in Africa. The current Ebola outbreak in West Africa has killed more than 1,000 people, and the death rate among those infected with the virus is up to 90 percent, according to the World Health Organization.

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Viral Infections in 14 Kansas City-Area Infants Under Investigation

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Similar viral infections among 14 infants in the Kansas City area are being investigated by health officials. The infections were caused by HPeV3, a virus that can cause meningitis and other inflammation. No deaths have occurred, but all of the infants have been hospitalized, CBS News/Associated Press reported.

Health Highlights: Aug. 13, 2014

Extra Time Spent Counseling, Coordinating Care Billable

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Extra time spent counseling patients and coordinating care can be billed using evaluation and management (E/M) and prolonged service codes, according to an article published July 24 in Medical Economics.

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Medicaid-Insured Children Have Higher Prescription Use

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Regional variation exceeds payer-related differences in prescription use among children, according to a study published online Aug. 11 in Pediatrics.

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Meta-Analysis Strategy Impacts Estimation of Tx Outcome

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Estimation of treatment outcome varies with the meta-analysis strategy, according to a study published in the Aug. 13 issue of the Journal of the American Medical Association.

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WHO Experts Give Nod to Using Untested Ebola Drugs

TUESDAY, Aug. 12, 2014 (HealthDay News) -- A panel of ethicists specially appointed by the World Health Organization says it is ethical to give untested treatments to people battling Ebola in the current outbreak.

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Children's Hospitals Vary in Admission Rates

TUESDAY, Aug. 12, 2014 (HealthDay News) -- U.S. children's hospitals show three-fold variation in admission rates for common pediatric conditions, even when adjusting for severity of illness, according to a study published online Aug. 11 in Pediatrics.

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Hand Hygiene Plus Glove Use Cuts Preemie Infections

TUESDAY, Aug. 12, 2014 (HealthDay News) -- Nonsterile glove use after hand hygiene is associated with a reduction in gram-positive bloodstream infections and possible central line-associated bloodstream infections among preterm infants in the neonatal intensive care unit, according to a study published online Aug. 11 in JAMA Pediatrics.

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EHR Adoption Increasing, But Stage 2 Criteria Often Not Met

MONDAY, Aug. 11, 2014 (HealthDay News) -- Most U.S. hospitals and office-based physicians have adopted electronic health records (EHR), according to two studies published in the August issue of Health Affairs.

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Intervention Cuts Catheter-Related Pediatric UTIs

MONDAY, Aug. 11, 2014 (HealthDay News) -- Enactment of a quality improvement prevention bundle at a tertiary care children's hospital significantly reduced the rate of catheter-associated urinary tract infections (CAUTIs), according to research published online Aug. 11 in Pediatrics.

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Impact Location Has Limited Effect on Concussion Outcome

MONDAY, Aug. 11, 2014 (HealthDay News) -- For high school football players who sustain concussion due to player-to-player collisions, impact location has a minimal effect on outcome, according to a study published online Aug. 11 in Pediatrics.

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Issues to Consider With Integration of Telemedicine

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Integrating telemedicine raises various considerations, including operational and legal issues, according to an article published July 24 in Medical Economics.

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Antibiotic Prophylaxis Cuts UTIs in Congenital Hydronephrosis

FRIDAY, Aug. 8, 2014 (HealthDay News) -- Continuous antibiotic prophylaxis (CAP) reduces the risk of febrile urinary tract infection (UTI) in children with asymptomatic antenatal hydronephrosis (ANH), according to a study published online July 22 in the Journal of Pediatric Urology.

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VA Health Care Reform Bill Signed Into Law

THURSDAY, Aug. 7, 2014 (HealthDay News) -- A bill signed into law Thursday by President Barack Obama is meant to provide veterans with easier access to government-paid health care.

Health Highlights: Aug. 7, 2014

Diagnostic Algorithm for Appendicitis Cuts Pediatric CT Use

THURSDAY, Aug. 7, 2014 (HealthDay News) -- For pediatric patients, implementation of a diagnostic algorithm for appendicitis correlates with a significant reduction in computed tomography (CT) use without impacting diagnostic accuracy, according to a study published in the August issue of Surgery.

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Clues to How Heavy Drinking in Pregnancy Harms Child's Brain

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- When a woman drinks heavily during pregnancy, the harmful effects on her child's brain development appear to continue over time, a new study indicates. The study was published online Aug. 4 in the journal Cerebral Cortex.

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Insulin Sensitivity Is Key Renal Marker in Youth With T2DM

WEDNESDAY, Aug. 6, 2014 (HealthDay News) -- Among adolescents with type 2 diabetes, insulin sensitivity is an important marker of renal health, according to research published online July 28 in Diabetes Care.

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Inadequate Weight Gain in Overweight Moms Tied to SGA

TUESDAY, Aug. 5, 2014 (HealthDay News) -- For overweight and obese women, inadequate weight gain is associated with increased risk of small for gestational age (SGA), according to a study published in the August issue of the America Journal of Obstetrics & Gynecology.

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Influenza-Like Illness Carries High Pediatric Risk

TUESDAY, Aug. 5, 2014 (HealthDay News) -- More than one in three children presenting to the emergency department with influenza-like illness develop severe complications, according to a study published online Aug. 4 in Pediatrics.

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Many Physicians Have Secondary Income

MONDAY, Aug. 4, 2014 (HealthDay News) -- Many physicians report earning income from sources other than their primary practice/employer, according to an article published July 24 in Medical Economics.

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Model Can Predict Risk of Renal Scarring in Children

MONDAY, Aug. 4, 2014 (HealthDay News) -- A model including temperature, ultrasonographic findings, and etiologic organisms is able to predict renal scarring in children with a first urinary tract infection, according to research published online Aug. 4 in JAMA Pediatrics.

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Few 'Bright Futures' Guidelines Suitable for EHR Format

MONDAY, Aug. 4, 2014 (HealthDay News) -- Only a small portion of the Bright Futures Guidelines meet criteria for actionability, according to a study published in the current issue of Applied Clinical Informatics.

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Maternal Access to Green Space Impacts Birth Weight

MONDAY, Aug. 4, 2014 (HealthDay News) -- Maternal proximity to green spaces is associated with increased birth weight, according to a study published in Occupational & Environmental Medicine.

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Optimal Red Blood Cell Folate Level About 1,000 nmol/L

MONDAY, Aug. 4, 2014 (HealthDay News) -- The optimal population red blood cell folate level for prevention of neural tube defects could be defined as approximately 1,000 nmol/L, according to research published online July 29 in BMJ.

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CMS Recognizes Telehealth in New Physician Fee Schedule

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Earlier this month, the Centers for Medicare & Medicaid Services issued proposed rules for updates to the Physician Fee Schedule and will accept comments until Sept. 2, according to an article published July 7 in Medical Economics.

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Healthy Lifestyle Cuts Metabolic Syndrome Risk in CA Survivors

FRIDAY, Aug. 1, 2014 (HealthDay News) -- For childhood cancer survivors, following a heart-healthy lifestyle is associated with a reduced risk of metabolic syndrome (MetS), according to a study published online July 28 in Cancer.

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