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  • Infant With a Unilateral Parotid Mass, Recurrent Otitis Media, and Macrocephaly

    Abstract Full Text
    JAMA Pediatr. 2015; 169(8):783-784. doi: 10.1001/jamapediatrics.2015.0900

    A 9-month-old boy presents with a left-sided facial mass. His perinatal history is notable for macrosomia, macrocephaly, left-sided failure on newborn hearing screen, and a congenital hypertrichotic patch of the left scalp. What is your diagnosis?

  • JAMA Pediatrics January 1, 2014

    Figure 1: Trends of Otitis Media (OM) Visits Among Children From Birth to 6 years, 2001-2011

    A, Overall OM visit rates for children from birth to 6 years. Joinpoint analysis detected 3 segments (2001-2003, 2004-2009, and 2010-2011) that had significant changes in OM visit rate trends. OM visit rates increased at 0.04/child-year annually in 2001-2003, decreased at 0.02/child-year annually in 2004-2009, and decreased at 0.14/child-year annually in 2010-2011. The overall trend for children aged 0-6 years was more influenced by those aged 2-6 years because of their higher proportion in the study population. During 2010-2011 (after 13-valent pneumococcal conjugate vaccine [PCV-13] licensure), children younger than 2 years had a significantly greater decrease in OM visit rates than did children aged 2 to 6 years (0.27/child-year vs 0.09/child-year decrease, respectively; P < .001). B, Otitis media visit rates for children aged 2 to 6 years. Joinpoint analysis detected 3 segments (2001-2003, 2004-2009 and 2010-2011) that had significant changes in OM visit rate trends. In 2001-2003, OM visit rate increased at 0.06/child-year annually; in 2004-2009, OM visit rate decreased at 0.02/child-year annually; and in 2010-2011, OM visit rate decreased at 0.09/child-year annually (P < .001). C, Otitis media visit rates for children younger than 2 years. The OM visit rate trends during 2001-2009 and 2010-2011 were significantly different: they decreased at 0.03/child-year annually in 2001-2009, and they dropped at 0.27/child-year annually in 2010-2011 (P < .001). The projected rates of OM visits for 2004-2011 were derived from a Poisson regression model based on the observed rates in 2004-2009 (dashed line). The observed OM visit rates (solid line) in 2010-2011 (1.00/child-year [95% CI, 1.00-1.00] and 0.81/child-year [0.81-0.82], respectively) were significantly lower than the projected rates (1.09/child-year [1.09-1.09] and 1.07/child-year [1.07-1.07], respectively). American Academy of Pediatrics (AAP) guidelines for OM diagnosis and treatment were published in 2004; influenza vaccine (Inf Vac) recommendations were made to vaccinate children by age group: 6 to 23 months (2004); 6 to 60 months (2007); and 6 months to 18 years (2008); recommendation to routinely vaccine children with PCV-13 occurred in 2010.
  • JAMA Pediatrics January 1, 2014

    Figure 2: Otitis Media (OM) Complications and Surgical Interventions, 2001-2011

    A, Tympanic membrane perforation/otorrhea cases within 21 days after an OM primary visit. B, Mastoiditis cases within 21 days after an OM primary visit. C, Other rare complications within 21 days after an OM primary visit. These complications included meningitis, facial nerve palsy, sigmoid vein thrombosis, and intracranial abscess. D, Myringotomy and/or ventilating tube insertion. The solid line represents the linear fit across the studied years.
  • JAMA Pediatrics January 1, 2014

    Figure 3: Otitis Media (OM) Visit Rates in Children Younger Than 2 Years vs Those Aged 2 to 6 Years, 2005-2011

    During 2005-2009, there was a stable difference between OM visit rates in children younger than 2 years and those aged 2 to 6 years (rate ratio [RR], 1.38 [95% CI, 1.38-1.39]). The differences between the 2 age groups were decreased significantly (P < .001) during 2010-2011 (RR, 1.32 [95% CI, 1.31-1.33] in 2010 and 1.01 [1.00-1.02] in 2011). Because of the large sample size in our study, the differences between the rates and their 95% CIs were ≤0.01/child-year. Such differences were too small to be visible in the Figure. A recommendation to use the 13-valent pneumococcal conjugate vaccine (PCV-13) was issued in 2010.
  • Trends in Otitis Media–Related Health Care Use in the United States, 2001-2011

    Abstract Full Text
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    JAMA Pediatr. 2014; 168(1):68-75. doi: 10.1001/jamapediatrics.2013.3924

    Marom et al study the trend in otitis media–related health care use in the United States in 7.82 million unique children (5.51 million child-years) during the pneumococcal conjugated vaccine era (2001-2011).

  • JAMA Pediatrics January 1, 2012

    Figure: Parental Smoking and the Risk of Middle Ear Disease in Children: A Systematic Review and Meta-analysis

    Figure 5. Relationship between secondhand tobacco smoke exposure by any household member and the risk of middle ear disease using a meta-analysis of comparative epidemiologic studies. Data are presented as odds ratios (ORs) subgrouped by the definition of middle ear disease outcome. Each square denotes the OR for a single study, with horizontal lines denoting 95% CIs. The center of each diamond denotes the pooled OR and the corners the 95% CIs. An OR greater than1 indicates a higher risk of the outcome in those exposed to secondhand tobacco smoke). AOM indicates acute otitis media; ROM, recurrent otitis media.
  • Parental Smoking and the Risk of Middle Ear Disease in Children: A Systematic Review and Meta-analysis

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 2012; 166(1):18-27. doi: 10.1001/archpediatrics.2011.158
  • Picture of the Month—Quiz Case

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 2011; 165(8):763-763. doi: 10.1001/archpediatrics.2011.120-a
  • Otitis Media, Shared Decision Making, and Enhancing Value in Pediatric Practice

    Abstract Full Text
    Arch Pediatr Adolesc Med. 2008; 162(2):186-188. doi: 10.1001/archpediatrics.2007.19
  • Randomized Controlled Trial of a Prenatal and Postnatal Lactation Consultant Intervention on Infant Health Care Use

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 2006; 160(9):953-960. doi: 10.1001/archpedi.160.9.953
  • Osteopathic Manipulation to Prevent Otitis Media—Does It Work?

    Abstract Full Text
    Arch Pediatr Adolesc Med. 2003; 157(9):852-853. doi: 10.1001/archpedi.157.9.852
  • Pathological Case of the Month

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 2002; 156(2):191-191. doi: 10.1001/archpedi.156.2.191
  • Radiological Case of the Month

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 2002; 156(1):81-81. doi: 10.1001/archpedi.156.1.81
  • Assessing Diagnostic Accuracy and Tympanocentesis Skills in the Management of Otitis Media

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 2001; 155(10):1137-1142. doi: 10.1001/archpedi.155.10.1137
  • Picture of the Month

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    Arch Pediatr Adolesc Med. 2001; 155(10):1169-1170. doi: 10.1001/archpedi.155.10.1169
  • Radiological Case of the Month

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 1999; 153(8):887-888. doi: 10.1001/archpedi.153.8.887
  • Picture of the Month

    Abstract Full Text
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    Arch Pediatr Adolesc Med. 1999; 153(6):647-647. doi: 10.1001/archpedi.153.6.647
  • Guides for Reading and Interpreting Systematic Reviews: I. Getting Started

    Abstract Full Text
    Arch Pediatr Adolesc Med. 1998; 152(7):700-704. doi: 10.1001/archpedi.152.7.700
  • JAMA Pediatrics August 1, 2015

    Figure 1: Infant With a Unilateral Parotid Mass, Recurrent Otitis Media, and Macrocephaly

    A, Blue patch of the left periauricular scalp. Note the difference in the textural quality of the hair overlying the affected area, which the parents trimmed regularly to maintain a more uniform appearance. B, Representative light tan patches with irregular borders on the back. Arrowheads indicate the patches. A total of 15 similar lesions were noted on examination.
  • JAMA Pediatrics August 1, 2015

    Figure 2: Infant With a Unilateral Parotid Mass, Recurrent Otitis Media, and Macrocephaly

    Plexiform neurofibroma. Large fascicles of spindle cells are embedded in a myxoid stroma. Salivary glands are present at the periphery (hematoxylin-eosin, original magnification ×100).