0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Pediatrics |

Highlights FREE

JAMA Pediatr. 2016;170(8):723. doi:10.1001/jamapediatrics.2015.2543.
Text Size: A A A
Published online

RESEARCH

Much attention has been given to the importance of the intestinal microbiota and the effects of early exposure to antibiotics. In this longitudinal cohort study, Korpela and coauthors examine whether the positive metabolic effects of breastfeeding are affected by antibiotic use. The protective effects of breastfeeding against infections were found to be weakened or completely eliminated by early-life antibiotic use. The accompanying editorial by Paolella and Vajro discusses methods to potentially avoid or repair changes to the intestinal microbiota in breastfed children who need antibiotics.

While health care apps in low-income countries are common and have the potential to improve quality and outcomes of care, few have been rigorously evaluated. In this cluster-randomized clinical trial by Lund and coauthors, 73 health care facilities were randomized to usual care or to receive a mobile phone app for training in emergency obstetrical and neonatal care. The app improved and sustained health care workers’ skills in neonatal resuscitation and resulted in a nonsignificant change in perinatal mortality. Pagliari’s editorial discusses the role for digital support in improving children’s health in the developing world.

Folate insufficiency during pregnancy can have powerful effects on the developing infant. This large cohort study by Wang and coauthors examines whether sufficient maternal folate levels can alleviate prepregnancy obesity effects on the child. The study found that the risk for child overweight and obesity was reduced by nearly half if obese mothers had adequate folate concentrations. This points to the need to establish and ensure optimal rather than minimal maternal folate concentrations for pregnant women.

CLINICAL REVIEW & EDUCATION

As Zika virus infection spreads across the Latin American and Caribbean region and then into the southern United States, we can expect to see thousands of additional children born with microcephaly and potentially many more with more subtle but significant neurological damage. In this Special Communication, Hotez discusses the history of the current epidemic and the risk factors supporting its spread. The potential of up to 4 million people infected by Zika virus by the end of 2016 will affect pediatric practice both in the near future and for years to come.

Management of febrile infants younger than 90 days has evolved considerably over the last few decades. With effective vaccines against Haemophilus influenza type b and Streptococcus pneumonia, occult bacteremia has largely disappeared. In this review, Cioffredi and Jhaveri note that urinary tract infection is the most prevalent serious bacterial infection without localizing signs of infection in vaccinated children. For children with fever without localizing signs of infection, given that the odds of identifying a contaminant is 100 times more likely than identifying a true pathogen, management has moved away from evaluation of complete blood cell counts, blood cultures, and empirical antibiotics of any kind.

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

572 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs