ORLANDO, Fla. —Pediatric experts will debate the pros
and cons of the most contentious issues pediatricians face in their daily
practice during the new point-counterpoint sessions at the American Academy of
Pediatrics (AAP) National Conference & Exhibition in Orlando Oct. 26-29.
For the “Controversies in Pediatrics” series, a new
topic will be debated each day by some of the most influential pediatricians in
the fields of sports medicine, infectious disease, children with disabilities,
and breastfeeding. Reporters interested in covering any of these sessions
should check in at the press room, W203B.
The schedule includes:
Screening Prior to Competitive Sports: Should it be Mandatory in the US?
4-5 p.m. Saturday, Oct. 26
Pro: Victoria Vetter, MD
Con: Reginald Washington, MD, FAAP
When a seemingly young, healthy athlete dies suddenly
while competing in a sporting event, people want to know how, why, and more
importantly, what could have be done to prevent it?
Research has found that mandatory electrocardiograms
(ECGs) for student athletes can save more lives, but nationally, it would cost
more than $2 billion a year to cover everyone. Estimates from the American
Heart Association have shown that the false-positive rate can range from 10
percent to 40 percent because athletes can undergo changes while training that
can alter test results. In Italy, all student athletes are required to have a
physical exam and ECG, at no cost to the child or parent. In the U.S., not
everyone can afford the test, and it is not always covered by insurance. The
controversy remains: if even one life can be saved, should cost be an issue?
PANDAS: Stealth Attacks of Streptococci?
4-5 p.m. Sunday, Oct. 27
Pro: Susan Swedo, MD, FAAP
Con: Donald Gilbert, MD, FAAP
For the past 15 years, there has been conflicting
research results regarding PANDAS (Pediatric Autoimmune Neuropsychiatric
Disorders Associated with Streptococcal Infections) being etiologically
associated with some cases of obsessive-compulsive disorder (OCD) and tics.
Highlights of this session will involve discussion of the controversies about
appropriate testing and treatment.
Dr. Swedo will present the pro-PANDAS case, that Strep
is a trigger for acute-onset OCD and other neuropsychiatric symptoms. She will
argue that pediatricians should obtain a throat culture from any child who
suddenly develops obsessions, compulsions, separation anxiety or other signs of
PANDAS. If the strep infection isn’t recognized and appropriately treated,
symptoms can worsen. Repeated episodes may result in chronic,
treatment-resistant OCD or other debilitating mental illness.
Dr. Gilbert will debate that if a child presents with
new onset OCD or other neuropsychiatric symptoms, the child should be managed
with standard-of-care behavioral or pharmacological treatments, and
pediatricians should rarely be testing for Strep with throat cultures or blood
tests. These approaches are validated in longstanding practice and published
with ADHD: To Medicate or Not?
4-5 p.m. Monday, Oct. 28
Pro: Mark Wolraich, MD, FAAP
Con: William Barbaresi, MD, FAAP
Is it appropriate or necessary to treat children 4 to
5 years of age with stimulant medications? In 2011, the AAP published a
clinical practice guideline recommending behavioral therapy as the first line
of treatment for preschool-age children.
Dr. Wolraich will present evidence why stimulant
medication should be considered if behavior therapy is not successful for
preschoolers diagnosed with ADHD. Dr. Barbaresi will make his case against
using medication as treatment in the primary care setting.
with Just One Bottle? Pros and Cons of Choosing to Supplement Breastfed Babies
8:30-9:30 a.m. Tuesday, Oct. 29
Pro: Mandy Brown Belfort, MD, FAAP
Con: Susan Landers, MD, FAAP
It has been longstanding AAP recommendation for babies
to be exclusively breastfed for about 6 months, followed by continued
breastfeeding as complementary foods are introduced. However, a recent study
has shown that small amounts of formula can be used to supplement breastfeeding
with positive results. Experts will present both sides of this debate, as well
as review the factors that lead breastfeeding mothers to use formula and stop
The American Academy of Pediatrics is an organization of 60,000 primary
care pediatricians, pediatric medical subspecialists and pediatric surgical
specialists dedicated to the health, safety and well-being of infants,
children, adolescents and young adults. For more information, visit www.aap.org.