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Am Fam Physician. 2004;69(8):1849-1850

AAFP and AAP Release Acute Otitis Media Guideline

On March 9, the American Academy of Family Physicians (AAFP) and the American Academy of Pediatrics (AAP) released new guidelines for treating acute otitis media, or middle ear infection. The guideline focuses on diagnosis and management of the condition in children from two months to 12 years of age, with recommendations on appropriate use of antibiotics and pain management. The report emphasizes that eight in 10 children with ear infections get better with no antibiotics and do not have an increased risk of serious infection. The most important step in treatment is to ease the child's pain. The guideline provides an option to observe select children and start antibiotic treatment only if symptoms have not improved in 48 to 72 hours. Antibiotics may be appropriate for children up to two years of age who have ear infection, not just fluid in their ears, who are exceedingly sick, or in whom a high fever is noted. The complete guideline is available online at Later this year, the AAFP and AAP will release a guideline on otitis media with effusion.

HHS Releases FDA Report on Combating the Obesity Epidemic

The U.S. Department of Health and Human Services (HHS) has issued a new U.S. Food and Drug Administration (FDA) report outlining the “Calories Count” element in its strategy for combating the obesity epidemic. The report includes recommendations for strengthening information on food labels, educating consumers about maintaining a healthy diet and weight, and encouraging restaurants to provide calorie and nutrition information. It also suggests increasing enforcement to ensure that food labels accurately portray serving size, revising and reissuing guidance on developing obesity drugs, strengthening coordinated scientific research to reduce obesity, and developing foods that are healthier and lower in calories. The full report is available at More information about the antiobesity campaign and the obesity research agenda for the National Institutes of Health is online at

NIDDK Sponsors Clinical Trial Focusing on Type 2 Diabetes in Youth

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has started a clinical study comparing three treatments of type 2 diabetes in children and teenagers. In the TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) study, participants will be assigned randomly to one of three treatment groups: metformin alone, metformin and rosiglitazone in a fixed-dose combination, and metformin plus intensive lifestyle change aimed at losing weight and increasing physical activity. Currently, metformin is the only oral drug approved by the FDA to treat type 2 diabetes in children. The primary goal of the trial is to determine how well and for how long each treatment approach controls blood glucose levels. The study also will evaluate the safety of the treatments; effects of the treatments on insulin production, insulin resistance, body composition, nutrition, physical activity, and aerobic fitness; risk factors for eye, kidney, nerve, and heart disease; quality of life; psychologic outcomes; the influence of individual and family behaviors on treatment response; and cost-effectiveness of the treatments. More information about the study is available online at

FDA Warns Manufacturers to Stop Distributing Products Containing Andro

The HHS has announced that it will be cracking down on companies that manufacture, market, and distribute products containing androstenedione, or andro, for short. Andro acts like a steroid once it is metabolized in the body, posing similar health risks as steroids. In men, potential long-term consequences of these products include testicular atrophy, impotence, and breast enlargement. Consequences for women include male pattern baldness, deepening of the voice, increased facial hair, abnormal menstrual cycles, and blood clots. Children using these andro-containing products are at risk of early onset of puberty and premature cessation of bone growth. These products generally are advertised as dietary supplements that enhance athletic performance based on their claimed anabolic and androgenic properties to stimulate muscle growth and increase production of testosterone. The FDA sent letters to 23 companies asking them to stop distributing these types of products and warning them that the companies could face enforcement actions if they do not take appropriate action. More information and copies of the letters are available at

HHS Launches Campaign to Prevent Bullying and Youth Violence

The HHS has released a new campaign designed to stop bullying, including verbal or physical harassment that occurs repeatedly over time, that is intended to cause harm, and that involves an imbalance of power between the child who bullies and the child who is bullied. The program was developed in partnership with more than 70 health, safety, education, and faith-based organizations. The campaign includes Web-based animated stories; television, radio, and print public service announcements; and a resource kit with tools for handling bullying problems and creating prevention programs. For more information, call 888-ASK-HRSA or see the Web site at

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