AHA Recommends Heart Tests Before Prescribing ADHD Stimulants
The American Heart Association (AHA) is now recommending that children with attention deficit hyperactivity disorder (ADHD) should have heart tests, including an electrocardiogram (ECG), before starting treatment with stimulant drugs. While acknowledging that this issue is of concern, the American Academy of Pediatrics (AAP) has not yet made a commitment to support the AHA recommendations. The AAP is currently evaluating the science behind these recommendations and will offer its guidance in the near future. Current FDA guidelines for prescribing stimulant medications call for a complete history and physical to determine whether the child has any risk factors for heart disease, monitoring the child’s response to the medication and then, if there is concern, ordering an ECG.
Evaluate Medical Conditions Before Sports Participation
Children and adolescents with medical conditions need to be evaluated before participating in athletic activities, according to the revised AAP clinical report, “Medical Conditions Affecting Sports Participation,” which appeared in Pediatrics, April 2008. Since pediatricians play a key role in determining whether a child with a medical condition should participate in a particular sport, it’s important to be familiar with this revised report when conducting pre-performance examinations. The report includes a detailed list of medical conditions and recommends ways for pediatricians to assess a child’s health status and make suggestions to decrease the risk of injury.
Strength Training Approved For Children and Adolescents
Young athletes may consider strength training to improve their athletic performance, according to a revised policy statement issued by the AAP, “Strength Training by Children and Adolescents: Guidance for the Clinician in Rendering Pediatric Care.” The report, which appeared in Pediatrics, April 2008, includes recommendations to help pediatricians ensure that strength training benefits the athlete, rather than causing injury or pain. These include a medical exam before an athlete begins a formal strength-training program, among others. Preteens and teens should be advised to avoid power lifting and body building until they reach skeletal maturity.
Preventing Sports Injuries
Pediatricians can help their patients avoid sports injuries by passing on some basic tips during pre-performance exams. The AAP suggests that young athletes wear the right protective gear, do conditioning and stretching exercises before play, take breaks, adhere to safety regulations, and avoid heat injuries by drinking plenty of fluids and limiting play during high heat and humidity. For more information, visit the AAP web site at www.aap.org.
Multiple Factors Affect Outcomes for Extremely Premature Newborns
Multiple factors affecting survival and neurodevelopmental outcomes for infants born at 22 to 25 weeks' gestation were identified in a recent study by the Neonatal Research Network of the National Institute of Child Health and Human. The study, which appeared in the New England Journal of Medicine, April 17, 2008: “Intensive Care for Extreme Prematurity — Moving beyond Gestational Age,” found the key factors to be the baby’s sex, exposure to prenatal corticosteroids, whether the birth is singleton or multiple, and birth weight, as well as gestational age.
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