Updates on HIV non-occupational post-exposure prophylaxis (nPEP)


AMA PRA Category 1 Credit FOR EACH ISSUE (2 ARTICLES)!!!!!!

By Atsuko Koyama, MD, MPH and Lauren Middlebrooks, MD

According to the 2017 Youth Risk Behavior Survey (YRBS), almost 30% of 9th to 12th graders reported being “currently sexually active,” and only 54% used a condom at their last sexual encounter [1]. Despite improved antiretroviral regimens and HIV pre- and post-exposure prophylaxis (PrEP and PEP), adolescents and young adults continue to make up a quarter of new HIV diagnoses (21%, n=8,090), with the majority of these cases being secondary to male-to-male (MSM) sexual contact [2]. Given the prevalence of sexual activity amongst adolescents who present under a variety of circumstances disclosing past sexual activity, knowledge about non-occupational HIV PEP (nPEP) is relevant and important for all pediatricians.

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Beat the Heat


AMA PRA Category 1 Credit FOR EACH ISSUE (2 ARTICLES)!!!!!!



By Thuy Bui, MD


CASE – Part 1:

You are volunteering at the SuperHero Sprint – CHOA’s summertime 5K race.  A 12-year-old male running in his first race is brought to the medical tent by his mother.  He is diaphoretic and vomiting.  What are you concerned about?


All heat-related deaths and illnesses are preventable.  However, despite this fact, each year an average of 658 people die from extreme heat per the CDC’s Morbidity and Mortality Weekly Report.

In the United States alone, there were 8,081 heat-related deaths from 1999-2010 according to the Centers for Disease Control.  And more recently, according to the National Safety Council’s Injury Facts, 87 people died in the U.S. in 2017 from exposure to excessive heat.

Children, because of multiple factors including their lower sweat rate and higher metabolic heat production, account for approximately 4% of heat-related deaths.  In fact, heat stroke is the 3rdmost common cause of exercise-related mortality for U.S. high school athletes; and since 1998, 619 children have died in vehicles from heat-related issues in the U.S. Continue reading