Pediatrics
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Comparative Study
Herbal therapy use in a pediatric emergency department population: expect the unexpected.
In recent years investigators have reported widespread use of alternative medicine. Some herbal therapies have potentially harmful side effects as well as adverse interactions with medications. Data are lacking on the use in children and caregiver understanding of these products. ⋯ Herbal and home therapies are commonly used in this pediatric population. An unexpectedly wide variety of products were reportedly given to this patient population. Caregivers reported limited knowledge regarding potential adverse medication interactions and side effects. Limited discussions with the child's primary health care provider were reported. It is therefore important for health care providers to have knowledge about herbal medications, to inquire about their use and to educate families about the risk/benefit as well as potential interactions these products may have with over-the-counter and prescription medications.
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The objective of this study was to determine how often children and adolescents share prescription medications and, because of teratogenic concerns, assess specific reasons why girls might engage in medication-sharing behaviors. ⋯ Medication sharing is relatively common among children and adolescents and is more common among girls than boys. An adolescent who receives a medication via sharing does not receive the appropriate information about its actions and possible negative interactions with other medications or any other associated risks. Sharing potentially teratogenic drugs is of special concern. Many barriers exist to communicating the risk about teratogenic drugs to women and girls, particularly if they are not planning a pregnancy or are unaware that they are already pregnant. These findings suggest the need for basic research on issues related to the dangers of medication sharing and teratogenic risks, as well as the development of successful approaches to communicate these risks.
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Half of all postneonatal mortality (PNM; deaths among infants aged 28-364 days) in the United States is caused by potentially preventable causes such as sudden infant death syndrome, infections, and injuries. A detailed analysis of PNM attributable to injury has not been conducted and may provide useful data in prioritizing prevention strategies and targeting high-risk populations. ⋯ Overall PNM rates attributable to injury declined, yet rates of mechanical suffocation increased and large regional and racial disparities persisted. Death certificates have limited information to help explain the observed differences. Because injuries are frequently preventable, prevention strategies should encourage formation of infant and child death review teams to help identify community and system factors that may contribute to injury deaths. Health care providers can assist parents in providing a safe environment for infants by counseling on age-appropriate injury prevention as part of their anticipatory guidance and serving as child advocates. Additional studies should examine regional differences in death investigation practices, case ascertainment, and reporting of deaths attributed to intentional injuries.