Previous cohorts of extremely low birth weight adolescents have assessed their health status similar to that of normal birth weight controls.

Extremely low birth weight adolescents born in the 1990s assess their health similar to controls but report less risk taking. Extremely low and normal birth weight children rate their health to be poorer at 8 than at 14 years. (Read the full article)

A wide variety of prescription drugs are prescribed to US children. Although one of the steps in assessing the risk/benefit of therapies in the pediatric population is to understand how they are used, pediatric drug utilization is not well characterized.

By using large prescription databases, this study examines the frequency and patterns of national outpatient drug utilization (acute and chronic medications) in US infants, children, and adolescents for 2002 through 2010. (Read the full article)

Chronic fatigue syndrome (CFS) is a disabling illness. Some children with chronic disabling fatigue are housebound. Some primary care physicians find making the diagnosis of CFS difficult.

Chronic disabling fatigue is more common in 13-year-olds than previously realized with a population prevalence of ~2.0%. Chronic disabling fatigue in teenagers is more common in those with higher levels of early family adversity. (Read the full article)

Emphasis on preventing central line-associated bloodstream infections (CLABSIs) in US health care facilities and prophylactic antifungal medication use in neonates may impact incidence of Candida spp. CLABSIs. However, data on trends in incidence of neonatal Candida spp. CLABSIs are lacking.

Data from a large sample of US NICUs was analyzed to assess trends in incidence over time. This analysis provides a description of the epidemiology of Candida spp. CLABSIs in a national health care-associated infections surveillance system. (Read the full article)

Various studies have documented marked racial/ethnic disparities in children’s receipt of dental services at single time points or brief periods.

This study reveals significant improvements in children’s receipt of dental care overall, as well as a dramatic narrowing of African American/white disparities in children’s receipt of dental services over the last 40 years in the United States. (Read the full article)

Trisomy 13 and 18 are conditions with 1-year survival rates of less than 10% and have traditionally been treated with palliative care. There are increasing reports of ethical dilemmas caused by parental requests for clinical interventions.

Parents who belong to social networks report an enriching family experience and describe surviving children as happy. Many of these parents describe challenging encounters with health care providers. (Read the full article)

Since the introduction of effective vaccines in the United States, the incidence of invasive Haemophilus influenzae type b (Hib) disease in children aged <5 years has decreased by 99%. In 2007, in response to limited vaccine supply, Hib booster doses were deferred for 18 months.

This review found no significant change in the incidence of invasive Hib disease in the United States during the booster dose deferral period, suggesting that booster dose deferral is a reasonable approach to Hib vaccine shortages in the short-term. (Read the full article)

The relationship between energy intake and obesity in children has yielded inconsistent results. Efforts to improve dietary intake as a means of improving weight status have largely yielded disappointing results.

Self-reported energy intake for younger, but not older, overweight/obese children is higher than healthy-weight peers. In early childhood, higher (or excessive) energy intake may lead to onset of obesity, but other mechanisms may be important to maintain obesity through adolescence. (Read the full article)

Findings from 3 studies suggest that the diagnosis of venous thromboembolism in hospitalized US children has increased in recent years.

This study provides additional evidence of an increasing trend in the rate of venous thromboembolism-associated hospitalization in US children, as well as a concurrent increase in the prevalence of venous catheter procedures. (Read the full article)

National data from child protective services agencies have shown a 55% decrease in the incidence of substantiated cases of physical abuse from 1992 to 2009, but no study has tracked the occurrence of serious injuries due to physical abuse.

Using national data from hospitalized children, we found a statistically significant increase in the incidence of serious injuries due to physical abuse from 1997 to 2009. These results are in sharp contrast to data from child protective services. (Read the full article)

Concerns persist about sexual disinhibition after human papillomavirus (HPV) vaccination of preteenage girls. Self-reported surveys have indicated few anticipated behavior changes after HPV vaccination. Little is known about sexual activity–related clinical outcomes after HPV vaccination.

Utilizing managed care organization electronic data, we evaluated the incidence of adverse outcomes of sexual activity among vaccinated preteenage girls and found little difference between those who received HPV vaccine and those who did not. (Read the full article)

It has been widely thought for the past 20 years that recurrent low blood glucose levels ≤2.5 mmol/L (45 mg/dL), even in the absence of any suggestive clinical signs, can harm a preterm infant’s long-term development.

This prospective study showed the outcome at 2 and 15 years later for the preterm infants who had a blood glucose level this low in the first 10 days of life did not differ from that of matched controls. (Read the full article)

Disparities in vaccination coverage between American Indian/Alaska Native and white children previously existed between 2001 and 2004 but were not present in 2005.

This study updates a previous study by analyzing data through 2010 and found that these gains have been maintained. (Read the full article)

Foreign-born children and adolescents in the United States experience higher tuberculosis (TB) morbidity rates than US-born children and adolescents. Pediatric risk assessment should account for country of birth, contact with a known TB case, or travel to TB-endemic countries.

Our study reports national data on parental/guardian countries of origin and international residence of pediatric patients with TB. Two-thirds of US-born children with TB have international family connections, and many have lived in countries with increased risk for TB acquisition. (Read the full article)

A previous study of inflatable bouncer–related fractures has shown that upper extremity fractures are most common, and many fractures are caused by collisions; however, no study has examined nonfracture injuries or used nationally representative data to investigate inflatable bouncer–related injuries.

This is the first study to use nationally representative data to calculate national injury rates, assess risk factors, and examine trends for pediatric inflatable bouncer–related injuries treated in US emergency departments over a 21-year period (1990–2010). (Read the full article)

Pediatric tuberculosis is significant for public health professionals because it is an indicator of the recent transmission of tuberculosis in the community. Data on incidence and clinical features of pediatric tuberculosis from China are scarce.

We conducted this study to describe the patient characteristics, clinical–epidemiological profile, and treatment outcomes for pediatric tuberculosis in a referral hospital setting in China. (Read the full article)

In the United States, adolescent obesity rates have tripled in the last 3 decades, with concomitant increases in other metabolic risk factors, including the metabolic syndrome (MetSyn). However, in Asian countries, these same risks have only recently begun increasing.

Representative data for the United States and Korea reveal trends in adolescent obesity and MetSyn moving in opposite directions. This study provides a benchmark for Korea and other Asian countries toward mitigating the upward trends in obesity and MetSyn. (Read the full article)

Most observational studies from Western populations suggest that blood pressure is positively associated with low birth weight and faster infant growth; however, it is unclear whether these associations are biologically based or contextually specific.

In a developed non-Western setting with relatively little socioeconomic patterning of size or growth, birth weight and infant growth had relatively limited impacts on early adolescent blood pressure, which was more strongly related to recent growth and current size. (Read the full article)

Although survival of children born with Down syndrome has improved, unexplained racial and ethnic disparities in survival persist in the United States.

This study used population-based data from 10 birth defects monitoring programs in the United States to examine survival trends among children born with Down syndrome and to evaluate the changing influence of survival predictors over the life course. (Read the full article)

Children born at very low birth weights have significant catch-up weight gain but differences in height remain. Their BMI, however, tends not to be higher than expected. Data are lacking regarding representative cohorts, defined by gestation and compared with contemporaneous controls.

In a geographic cohort of extremely preterm participants followed until age 18, compared with term controls, weight differences diminish over time, and height differences persist. BMI at age 18 is similar. Height at age 2 is a better predictor of final height than midparental height. (Read the full article)

Previous evaluations of local reactions after the fifth diphtheria-tetanus-acellular pertussis (DTaP) vaccine in children 4 to 6 years of age have revealed that vaccination in the thigh is associated with a lower risk of local reactions compared with vaccination in the arm.

Among children 12 to 35 months of age, injection of DTaP vaccine in the thigh is associated with a lower risk of local reactions compared with vaccination in the arm. (Read the full article)

Although amphibians are known Salmonella carriers, aquatic African dwarf frogs are specifically marketed toward children, who are especially vulnerable to Salmonella infections. Both direct animal contact and indirect contact with animal habitats can lead to human Salmonella infections.

This is the first reported outbreak of human Salmonella infections associated with African dwarf frogs, particularly among young children. Parents should be aware of the risk of Salmonella infections from both direct and indirect animal contact. Pediatricians should regularly inquire about animal contact and advise families about risks. (Read the full article)

The reasons why teens are not immunized are related to parental lack of knowledge and the need for provider recommendations.

The reasons for vaccine refusal for human papillomavirus vaccine differ from other teen vaccines, and concerns about its safety are increasing over time. (Read the full article)

Most children with type 1 diabetes get care from pediatric-trained providers, and must transfer care to adult providers once in adulthood. The timing of this change in providers and its relationship to glycemic control is not well understood.

In this cohort, the estimated median age to transition to adult care was 20.1 years and 77% had left pediatric care by age 21. Leaving pediatric care was associated with a 2.5-fold increase in odds of having poor glycemic control. (Read the full article)

Varicella vaccine is known to be highly effective, with added benefit from a second dose.

This study demonstrates the lasting effectiveness of varicella vaccine and the benefit of the second dose. Breakthrough varicella occurred soon after vaccination, varicella rates did not increase over 14 years, and there was no increase in zoster in the cohort. (Read the full article)

Delayed anaphylaxis, urticaria, and angioedema to mammalian meat products were first described in the adult population in 2009. Patients with this syndrome who consume mammalian meat typically develop symptoms 4 to 6 hours after ingestion.

Specific diagnoses for children who develop urticaria, angioedema, and idiopathic anaphylaxis are few and far between. We have now shown delayed anaphylaxis, urticaria, and angioedema due to mammalian meat products in the pediatric population. (Read the full article)

Some Western studies show early introduction of solid food is associated with subsequent obesity. However, introduction of solid food and obesity share social patterning, making these observations vulnerable to residual confounding.

In a non-Western developed setting, there was no clear association of the early introduction of solid food with childhood obesity. Studies in populations with a different confounding structure may be valuable in clarifying and reconciling potentially confounded epidemiologic associations. (Read the full article)

Advances in the treatment of critically ill infants have increased survival of extremely low/very low birth weight and medically complex infants. Improved survival can result in prolonged mechanical ventilation and sometimes tracheostomy. Current tracheostomy rates for these infants are unknown.

This long-term review of infants discharged from a NICU with tracheostomies is the first to describe tracheostomy rates specifically in extremely low/very low birth weight infants. It focuses on long-term clinical outcomes and comorbidities rather than surgical complications. (Read the full article)

The incidence of childhood and adolescent melanoma has been significantly increasing up to 2004. Risk factors (fair skin, light-colored hair/eyes, female gender, presence of nevi, family history, increased number of sunburns, and exposure to UV radiation) are associated with melanoma.

This study describes incidence trends of melanoma diagnosed between the ages of 0 and 19 years and from 1973 through 2009 by gender, stage and age at diagnosis, primary site, and exposure to UV radiation. (Read the full article)

Cognitive and motor developmental test scores of preterm and late preterm infants increase with gestational age. Developmental test scores in full-term infants have not previously been considered to relate to gestational age.

In a cohort of healthy, full-term infants, 37 to 41 weeks, 12-month mental and psychomotor scores on the Bayley Scales of Infant Development increased with gestational age, suggesting that neurodevelopment is optimal in infants born at 39 to 41 weeks. (Read the full article)

Survival of children with spinal muscular atrophy type 1 is determined by treatment choice: tracheostomy with mechanical ventilation, noninvasive mechanical ventilation, or a palliative approach. Few data are available on life expectancies with different approaches.

The present study provides data comparing therapeutic strategies that affect life expectancy. Clinicians involved in the care of patients with spinal muscular atrophy type 1 should be aware of survival trends while awaiting more definitive therapeutic strategies. (Read the full article)

A low-level risk of intussusception after rotavirus vaccines, ~1 to 2 cases per 100 000 vaccinees, exists in some settings. In the United States, a risk of 1 in 65 000 was excluded, but lower risk could exist.

A persistent clustering of intussusception events 3 to 6 days after dose 1 indicates the possibility of a low-level risk of intussusception of ~0.8 cases per 100 000 vaccinees. The documented benefits of rotavirus vaccine far outweigh this low-level risk of intussusception. (Read the full article)

Child welfare data show declines in child physical abuse since the early 1990s, but analysis of national data from hospitalized children in the Kids’ Inpatient Database showed an increased incidence of serious physical abuse in children from 1997 to 2009.

We found no significant change in hospitalization rates for injury from abuse in young children and increases in injury severity using the National Inpatient Sample from 1997 to 2009. This data helps provide a more complete perspective of the problem. (Read the full article)

Exemption rates for immunization requirements have until recently been stable in states permitting religious exemptions. States with easy exemption processes have seen higher rates of vaccine-preventable diseases.

In New York, the rate of religious exemptions has increased. Counties with higher rates of exemption have a greater incidence of pertussis. (Read the full article)

Randomized controlled trials have shown that zinc supplementation during diarrhea substantially reduces the incidence and severity. However, the effect of short-course prophylactic zinc supplementation has been observed only in children >12 months of age.

The current study was able to show that short-course prophylactic zinc supplementation significantly reduced diarrhea morbidity in apparently healthy infants of 6 to 11 months even after 5 months of follow-up. (Read the full article)

Because children often lack the physical strength, cognitive abilities, and fine motor skills to operate all-terrain vehicles (ATVs) properly, their risk of injury is greater.

During 2001–2010 in the United States, ~361 000 children aged ≤15 years were injured while riding ATVs. The decline in the injury rate during 2005–2010 might be related to the economic recession and decreased sales of new ATVs. (Read the full article)

Pneumococcal conjugate vaccines are effective in preventing pneumococcal disease but are also costly. Although the current US immunization schedule recommends 4 doses, many countries have adopted 3-dose schedules that have worked well, but may provide less protection against pneumococcal disease.

Changing the US 13-valent pneumococcal conjugate vaccine schedule from 3 to 2 primary doses while keeping a booster dose would save $412 million annually but might lead to moderate increases in pneumococcal disease, especially otitis media and pneumonia. (Read the full article)

The incidence of necrotizing enterocolitis (NEC), a devastating condition in neonates, varies geographically and with time. Although the most consistent risk factors are prematurity and low birth weight, it has not been convincingly shown to increase in the postsurfactant era.

The incidence of NEC, especially among the highly premature but also in more mature groups, has increased in recent decades, concurrent with dramatically improved early infant survival. Seasonal variation of NEC suggests environmental etiological factors. (Read the full article)

Among infants with birth weights of 501 to 1500 g born between 2000 and 2009, mortality and major morbidities among survivors declined.

Obstetrical and neonatal care practices for infants 501 to 1500 g changed significantly from 2000 and 2009, particularly decreased conventional ventilation and use of steroids for chronic lung disease and increased nasal continuous positive airway pressure and surfactant treatment after delivery. (Read the full article)

Previous research has demonstrated that pediatric injuries associated with television (TV) tip-overs are increasing, children aged ≤4 years are at highest risk for injury, and the head and neck are most commonly injured.

We analyzed a nationally representative sample comprising 22 years of data. On average, 17 313 children receive emergency treatment of a TV-related injury annually in the United States. The rate of injury attributable to falling TVs increased by 95% over 22 years. (Read the full article)

In 2001, an estimated 10 438 children were treated in US emergency departments for nonfatal choking on food. The foods most frequently associated with pediatric fatal choking are hot dogs, seeds, nuts, candy, and certain types of fruits and vegetables.

From 2001 through 2009, an estimated annual average of 12 435 children ages 0 to 14 years were treated in US emergency departments for nonfatal choking on food; 0- to 4-year-olds accounted for 61.7% of episodes. Foods most frequently involved were candy, meat, bone, and fruits/vegetables. (Read the full article)

The natural history of asthma during adolescence is dynamic because both remission and relapse are common. Remission has consistently been associated with mild asthma and the absence of sensitization.

One in 5 children with asthma remitted from age 7 to 19. Remission was defined as no wheezing and no medication for ≥3 years and was inversely related to female gender, sensitization to furred animals, and asthma severity at baseline. (Read the full article)

The incidence of pediatric pneumococcal meningitis has declined after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). It is unknown whether the frequency of severe neurologic sequelae and adverse outcomes has changed in the era of widespread PCV7 use.

Pneumococcal meningitis continues to be associated with substantial mortality and long-term morbidity. Sixty-three percent of survivors had neurologic sequelae. More than one-half of the children who were eligible for PCV7 were unimmunized at the time that they developed pneumococcal meningitis. (Read the full article)

Adult males are known to have a greater overall likelihood of death than female adults. Among children, excess male mortality is known for specific conditions but not as a general phenomenon.

Males are more likely to die during childhood and adolescence than their female peers from not only injuries but also from a wide variety of medical conditions, suggesting the existence of either a female robustness factor or a male vulnerability factor. (Read the full article)

The prevalence of overweight and obesity in US adolescents has increased over the last century. However, recent evidence indicates a potential change in this trend. Parallel trends in adolescent behaviors that drive this epidemic have not been well studied.

Analyses of recent data indicate the prevalence of overweight and obesity may be stabilizing. Over the same period, adolescent physical activity, breakfast eating, and fruit and vegetable consumption increased and television viewing and consumption of sweets and sweetened beverages decreased. (Read the full article)

Childhood interstitial lung diseases occur in a variety of clinical contexts and are associated with high morbidity and mortality. Advances in the understanding of disease pathogenesis and use of standardized terminology have facilitated increased case ascertainment.

This study demonstrates that cases of newly described forms of childhood interstitial lung diseases likely occur at all children’s hospitals. With advances in genetic testing and recognition of imaging patterns, a significant portion of cases are identifiable with noninvasive evaluations. (Read the full article)

Previous studies have shown that nonmedical exemptions (NMEs) to immunization cluster geographically and contribute to outbreaks of vaccine-preventable diseases such as pertussis. The 2010 pertussis resurgence in California has been widely attributed to waning immunity from acellular pertussis vaccines.

This study provides evidence of spatial and temporal clustering of NMEs and clustering of pertussis cases and suggests that geographic areas with high NME rates were also associated with high rates of pertussis in California in 2010. (Read the full article)

Studies of psychotropic use in very young US children in the last decade have been limited by the regions, insurance types, or medication classes examined. There is a paucity of recent, nationally representative investigations of US preschool psychotropic use.

In a national sample of 2 to 5 year olds, the likelihood of psychotropic prescription peaked in the mid-2000s, then stabilized in the late 2000s. Increased psychotropic use in boys, white children, and those lacking private health insurance was documented. (Read the full article)

Research has focused on primarily white parents, months to years after their infant/child or adult child died of cancer, accidental injury, sudden infant death syndrome, or suicide. Many parents experience depression and/or posttraumatic stress disorder and greater risk for some physical health problems.

Data on hospitalizations, changes in and management of chronic conditions, complexity of medication regimens, depression, and posttraumatic stress disorder were collected over 13 months from 249 Hispanic, black, and white parents in 188 families who experienced an infant/child NICU/PICU death. (Read the full article)

Influenza-associated deaths in children occur every year among children of all ages. Young children and those with high-risk medical conditions are at higher risk of influenza-related complications.

This study describes influenza-associated pediatric deaths over 8 influenza seasons in the United States and compares characteristics of deaths in children with high-risk medical conditions with those in children without high-risk medical conditions. (Read the full article)