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Effect of the Teen Driving Plan on the Driving Performance of Teenagers Before Licensure A Randomized Clinical Trial

from ArchPedi - 01 Aug 14

ImportanceMany studies have failed to show an effect of parent-supervised practice driving on the driving performance of teenagers; nevertheless, most Graduated Driver Licensing programs have provisions that require supervised practice.ObjectiveTo determine whether a web-based intervention, the Teen Driving Plan (TDP), can improve the driving performance of teenagers before licensure as measured by the Teen On-road Driving Assessment (tODA).Design, Setting, and ParticipantsRandomized, single-bli




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Youth Tobacco Use and Electronic Cigarettes

from ArchPedi - 01 Aug 14

To the Editor In their study, Dutra and Glantz reported the results of a cross-sectional sample of adolescents interviewed in 2011 and 2012 in the National Youth Tobacco Survey and concluded that electronic cigarette (e-cigarette) use does not discourage and may encourage conventional cigarette use among US adolescents.



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Youth Tobacco Use and Electronic Cigarettes

from ArchPedi - 01 Aug 14

To the Editor The article by Dutra and Glantz focused on electronic cigarettes (e-cigarettes) as an emerging tobacco product among youth and explored the relationship between e-cigarette trials and established smoking. Despite the significance of their findings, the study explored e-cigarette use in a vacuum and did not recognize that youth tobacco-use behaviors are complex and experimentation with multiple tobacco products is common. As noted in the 2012 Surgeon General’s report on youth, concu



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Youth Tobacco Use and Electronic Cigarettes—Reply

from ArchPedi - 01 Aug 14

In Reply While our analysis of the National Youth Tobacco Survey focused on electronic cigarettes (e-cigarettes), we agree with Delnevo et al that e-cigarettes are not the only alternative nicotine product youth are using, either alone or with cigarettes. The Delnevo et al finding that e-cigarettes remained significantly associated with cigarette smoking even after adjusting for use of other tobacco products indicates that the relationship between e-cigarette use and smoking holds true even afte



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Sexuality Talk Still a Great Dilemma in Many Countries

from ArchPedi - 01 Aug 14

To the Editor We read with the great interest the editorial by Boeckeloo in JAMA Pediatrics. This editorial addressed the low frequency of physicians’ discussions with adolescents about issues around sexuality and related topics in primary care based on the study by Alexander et al, which is probably the first study of sexuality talk between physicians and adolescents documented by direct observation.



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Prophylactic Use of a Probiotic in the Prevention of Colic

from ArchPedi - 01 Aug 14

To the Editor In their study, Indrio et al argued that prophylactic use of L reuteri during the first 3 months of life reduced not only the onset of functional gastrointestinal disorders but also the associated private and public management costs. Their study was a placebo-controlled trial. They used oil as placebo; however, the type of the oil used was not mentioned. Oils can change gut behavior and result in enhanced or decreased colic frequency based on their constituents. Furthermore, matern



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Prophylactic Use of a Probiotic in the Prevention of Colic, Regurgitation, and Functional Constipation—Reply

from ArchPedi - 01 Aug 14

In Reply We thank Dr Sanaie and colleagues for their interest in our article. Dr Sanaie argues we used a nonmentioned oil as placebo that could have changed the gut behavior and enhanced or decreased the frequency of infantile colic, regurgitation, and functional constipation. However, we adopted a mentioned pharmaceutical oily suspension of sunflower and medium-chain triglyceride oil containing probiotic bacteria in the intervention group and an equal oily suspension without probiotic bacteria



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Regarding Review of Psychopathology in Children and Adolescents Who Are Deaf or Hard of Hearing

from ArchPedi - 01 Aug 14

To the Editor Theunissen and colleagues undertook a challenging task in their review of literature examining psychopathology in children and adolescents who are deaf or hard of hearing. The Results section of their review spoke to the complex role that language modality (eg, spoken compared with sign language) plays regarding the prevalence of psychopathology.



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Incorrect Information in Abstract

from ArchPedi - 01 Aug 14

In the article titled “Determination of Tobacco Smoke Exposure by Plasma Cotinine Levels in Infants and Children Attending Urban Public Hospital Clinics” published in the September 2012 issue of Arch Pediatr Adolesc Med (2012;166[9]:851-856. doi:10.1001/archpediatrics.2012.170, incorrect information appeared. In the last sentence of the Results section of the Abstract, “(geometric mean difference, 6.07 ng/mL [95% CI, 4.37 to 8.43 ng/mL]) ” should be replaced with “(multiplicative factor change i




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JAMA Pediatrics

from ArchPedi - 01 Aug 14

JAMA Pediatrics Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision-making.




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Assessing Medication Adherence Using Indirect Self-report

from ArchDerm - 01 Aug 14

Poor adherence to medication is common, particularly in patients with chronic diseases who are prescribed multiple medications. A major public health problem, nonadherence is associated with poor clinical outcomes, increased health care costs, prolonged hospitalization, and higher mortality and morbidity. Assessing patients’ medication adherence may be helpful for assessing responses to treatment and for modifying treatment regimens.



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Melanoma Surveillance in “High-Risk” Individuals

from ArchDerm - 01 Aug 14

Among cancers, melanoma is uniquely amenable to early visual detection and simple curative therapy. Screening may therefore reduce mortality, and this logic has led to population-based surveillance efforts in Germany, with initial results in the state of Schleswig-Holstein suggesting a nearly 50% decrease in melanoma mortality. The US Preventive Services Task Force (USPSTF) guidelines do not currently recommend population-based melanoma screening. Although the USPSTF identifies certain patient g



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Detection of Primary Melanoma in Individuals at Extreme High Risk A Prospective 5-Year Follow-up Study

from ArchDerm - 01 Aug 14

ImportanceThe clinical phenotype and certain predisposing genetic mutations that confer increased melanoma risk are established; however, no consensus exists regarding optimal screening for such individuals. Early identification remains the most important intervention in reducing melanoma mortality.ObjectiveTo evaluate the impact of full-body examinations every 6 months supported by dermoscopy and total-body photography (TBP) on all patients and sequential digital dermoscopy imaging (SDDI), when



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Correlation of Histologic Regression in Primary Melanoma With Sentinel Node Status

from ArchDerm - 01 Aug 14

ImportanceThe influence of regression on the status of the sentinel node (SN) is controversial. In many centers, the presence of regression in thin melanomas supports the performance of an SN biopsy.ObjectiveTo identify whether regression in primary melanoma has any influence on SN involvement.Design, Setting, and ParticipantsRetrospective study of melanomas with a Breslow thickness greater than 0.75 mm and undergoing SN biopsy from January 1, 2003, through December 31, 2010, at Instituto Valenc



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Intrinsic and Extrinsic Risk Factors for Sagging Eyelids

from ArchDerm - 01 Aug 14

ImportanceSagging eyelids, or dermatochalasis, are a frequent concern in older adults. It is considered a feature of skin aging, but risk factors other than aging are largely unknown.ObjectiveTo study nongenetic and genetic risk factors for sagging eyelids.DesignUpper eyelid sagging was graded in 4 categories of severity using digital photographs. Dermatochalasis was defined as the eyelid hanging over the eyelashes. Age, sex, skin color, tanning ability, hormonal status in women, current smoking



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The Use of Transient Elastography and FibroTest for Monitoring Hepatotoxicity in Patients Receiving Methotrexate for Psoriasis

from ArchDerm - 01 Aug 14

ImportanceThere is a need for noninvasive tools to monitor hepatotoxicity in patients with psoriasis who are receiving methotrexate sodium.ObjectiveTo evaluate the use of transient elastography (TE) and FibroTest (FibroSURE in the United States), an indirect serum marker of fibrosis, in this population.Design, Setting, and ParticipantsPatients receiving methotrexate therapy for psoriasis between January 2008 and September 2009 were recruited from a dermatology outpatient department. Transient el



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Efficacy of a Needling Device for the Treatment of Acne Scars A Randomized Clinical Trial

from ArchDerm - 01 Aug 14

ImportanceNeocollagenesis can be achieved using a dermal rolling needle device, thereby reducing the appearance of acne scars.ObjectiveTo determine the efficacy of a needling device for treatment of acne scars.Design, Setting, and ParticipantsWe performed a single-center, rater-blinded, balanced (1:1), split-face, placebo-controlled, parallel-group randomized clinical trial at an urban academic institution. The study took place from November 30, 2009, through July 27, 2010. Twenty healthy adults



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Curricular Factors Associated With Medical Students’ Practice of the Skin Cancer Examination An Educational Enhancement Initiative by the Integrated Skin Exam Consortium

from ArchDerm - 01 Aug 14

ImportanceAs medical school curricula become progressively integrated, a need exists to optimize education related to the skin cancer examination (SCE) for melanoma, a relevant competency gap that influences secondary prevention efforts.ObjectivesTo identify curricular factors associated with medical students’ confidence, intent, and performance regarding the SCE.Design, Setting, and ParticipantsSurvey-based cross-sectional study from the Integrated Skin Exam Consortium at accredited US medical



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Incidence and Survival for Merkel Cell Carcinoma in Queensland, Australia, 1993-2010

from ArchDerm - 01 Aug 14

ImportanceMerkel cell carcinoma (MCC) is an uncommon but highly invasive form of skin cancer. The mechanisms that cause MCC are yet to be fully determined.ObjectivesTo compare the incidence and survival rates of MCC in Queensland, Australia, known to be a high-risk area, with MCC incidence and survival elsewhere in the world. We also analyzed incidence trends and differences in survival by key demographic and clinical characteristics.Design, Setting, and ParticipantsRetrospective cohort study of



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Acquired Blue Nevi in Older Individuals Retrospective Case Series From a Veterans Affairs Population, 1991 to 2013

from ArchDerm - 01 Aug 14

ImportanceApart from the atypical mole phenotype, development of new melanocytic nevi in older individuals is uncommon and considered worrisome for melanoma. We performed a retrospective case series in a Veterans Affairs population from 1991 to 2013 to characterize blue nevi (BN) by patient age at biopsy, location, self-reported duration, and relation to prior or subsequent development of cutaneous melanoma.ObservationsA total of 204 BN were identified in 194 predominantly male patients (90.7%)



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Patient With Gorlin Syndrome and Metastatic Basal Cell Carcinoma Refractory to Smoothened Inhibitors

from ArchDerm - 01 Aug 14

ImportanceBasal cell carcinomas (BCCs) in patients with Gorlin syndrome have been reported to be extremely sensitive to Smoothened (SMO) inhibitors, a novel targeted therapy against the Hedgehog pathway, because of characteristic mutations in these patients. A few cases of disease refractory to oral therapy with SMO inhibitors have been reported in patients with Gorlin syndrome and nonmetastatic BCCs, but refractory disease in distantly metastatic tumors has not been documented in this high-risk



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D-Dimer Levels as a Marker of Cutaneous Disease Activity Case Reports of Cutaneous Polyarteritis Nodosa and Atypical Recurrent Urticaria

from ArchDerm - 01 Aug 14

ImportanceBiochemical markers of disease allow clinicians to monitor disease severity, progression, and response to treatment. C-reactive protein and erythrocyte sedimentation rate are commonly used biochemical markers of inflammatory disease. We present 2 cases that indicate that D-dimer levels may be useful as a potential biochemical marker of disease activity in certain cutaneous inflammatory conditions.ObservationsWe report 2 cases in which clinical disease activity correlates with D-dimer l


 

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