Although previous studies have reported an association between maternal drug use and the risk of sudden infant death syndrome (SIDS), no studies have investigated paternal substance use either during or after pregnancy. In this case-control study of 239 infants who died of SIDS, Klonoff-Cohen and colleagues found that maternal drug use during pregnancy was not associated with an increased risk of SIDS. However, fathers' use of marijuana during conception and pregnancy and postnatally was associated with a 2-fold increase in the risk of SIDS in their infants. The role of paternal psychoactive drug use in SIDS is an understudied area.
This Israeli study randomized children to receive either naturopathic or anesthetic ear drops as the treatment for otitis media; none of the children were given antibiotics. There was a significant improvement in ear pain during the subsequent 48 hours in both groups. This study shows that withholding antibiotics for some children with otitis media may be appropriate and feasible.
Although tinea capitis is a common infection in the United States, little information is available on factors that may increase the risk of infection. This case-control study from 3 US referral centers found that a history of exposure to tinea capitis increased the risk of infection 16-fold, whereas a history of tinea capitis in the child increased the risk 3-fold. Hair care practices, including type of shampoo, hairstyle, and length of hair, were not associated with risk of infection. This study supports the need to identify and treat fungal carriers to decrease the risk of infection in the family.
Previous studies indicate that mothers of children with chronic illness are at risk for secondary mental health problems. During a 15-month period, Ireys and colleagues conducted a randomized trial of a support program for families with school-aged children with chronic illness. Linking these mothers with other mothers of children with chronic illness significantly reduced their anxiety and improved their mental health. This type of intervention can and should be widely implemented.
Adult men father more than 50% of all infants born to adolescent girls, and more than 40% of these births involve fathers who are at least 5 years older than their partners. In this study, 735 adolescent mothers with older adult partners were interviewed 12 months after the birth of their child; responses were compared with those of adolescents with similar-aged partners. The study found that these mothers were less likely to be enrolled in school, more likely to be trying to have another baby, and less likely to have a partner willing to use a condom. These girls were also more socially isolated than other adolescent mothers. The study indicates that societal tolerance of statutory rape has important adverse consequences for teenaged mothers.
Rising rates of resistant bacteria are causing increased attention to the overprescription of antibiotics. Previous studies have suggested that patient pressure is an important determinant of physician prescribing practices. Mangione-Smith and colleagues audiotaped 287 encounters between physicians and parents whose child had an upper respiratory tract infection. Although 50% of parents expected antibiotics, only 1% explicitly asked for them. Parents not receiving antibiotics for their child were more satisfied if the physician expressed a willingness to see the child again if no improvement occurred within a couple of days. Such contingency plans may be successful in reducing the inappropriate use of antibiotics.
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