Pulse oximeter is better than skin color assessment in the initial minutes of life. After sensor application, a delay occurs in the display of reliable saturation and heart rate. An appropriate method of sensor placement can minimize the delay.

Attaching sensor first to oximeter and then to neonate picked up signal faster than attaching it to the neonate first and then to the equipment. However, the time from birth to display of reliable signal was similar between the methods. (Read the full article)

There are misconceptions regarding childhood phimosis. Textbooks still teach that male children should have retractable foreskin by age 3. Young children are referred for evaluation for phimosis, which is a commonly used diagnosis for postneonatal circumcision.

We found a high prevalence of physiologic phimosis in kindergarten children, up to 44% at age 6. We also reviewed the incidence of other congenital abnormalities in this coastal Chinese city. The management and complications of these conditions were analyzed. (Read the full article)

Drug use in pediatrics is often based on adult efficacy data. Clinically significant discrepancies between adults and children may exist. To our knowledge, there is no large-scale evaluation of evidence comparing rates of adverse events between adults and children.

Available evidence on the comparative safety of pharmacologic interventions in adults versus children is inconclusive. In a third of meta-analyses, twofold or greater differences were identified between adults and children, and some clinically important discrepancies were also found. (Read the full article)

Juvenile-onset fibromyalgia (JFM) is a poorly understood chronic pain condition, typically identified in adolescence and accompanied by physical and social impairment and mood difficulties. There are no long-term studies on the prognosis of adolescents with JFM into adulthood.

This prospective study demonstrated that pain and other symptoms persisted into adulthood for >80% of JFM patients, with associated impairments in physical functioning and mood. At follow-up, one-half of the sample met full criteria for adult fibromyalgia. (Read the full article)

Previous studies have confirmed feasibility of MRI for diagnosis of appendicitis in adults and children. No study has assessed clinical end points when using ultrasound and MRI compared with computed tomography for diagnosis of appendicitis in children.

Radiation-free imaging with ultrasound selectively followed by MRI does not change clinical endpoints compared with CT for diagnosing appendicitis in children, with no difference in time to antibiotic administration, time to appendectomy, negative appendectomy rate, perforation rate, or length of stay. (Read the full article)

Asthma is a clinical condition treated mostly at primary care community clinics. Epidemics of asthma exacerbation occur annually with return to school after summer vacation and have been reported in many countries, including Israel.

In 82 234 asthmatic children, unscheduled primary care physician visits and drug prescriptions for asthma exacerbations peaked in September after a summer trough, with a lesser peak in late autumn and fluctuations through the winter months. (Read the full article)

Adolescents and young adults consume a significant amount of health care resources in our current medical system. With the Patient Protection and Affordable Care Act, a much larger number of previously uninsured young adults (aged ≥19) will be covered.

The Military Health System provides valuable information about the health utilization patterns of adolescents and young adults (aged 12–22) with universal insurance and excellent access to care. This information may help us understand the impact of new health care legislation. (Read the full article)

Childhood attention-deficit/hyperactivity disorder has been associated with both childhood and adult obesity, whereas treatment with stimulants has been associated with delayed child growth. No longitudinal studies with details about dates of diagnosis, treatment, and duration of stimulant use have been published.

Using electronic health record data, this was the first study to evaluate the independent associations of attention-deficit/hyperactivity disorder diagnosis, stimulant treatment, age at first stimulant use, and duration of stimulant use on longitudinal BMI trajectories throughout childhood and adolescence. (Read the full article)

The period of transition from childhood to adulthood and the period immediately after transfer of care is a challenging time for young people with kidney failure.

Young patients with kidney failure cared for exclusively in adult-oriented facilities experience increased rates of avoidable hospitalizations during late adolescence and young adulthood. Avoidable hospitalizations increased among pediatric kidney failure patients during the years immediately after transfer to adult care. (Read the full article)

There is growing understanding of the detrimental effect of paternal depression on children. The transition to fatherhood is a unique time for men. Identifying which fathers are at-risk and when will inform effective methods to help men and their families.

Nonresident fathers have the highest depression symptom scores, peaking before entering fatherhood. Although resident fathers’ scores decrease preceding entry into fatherhood, there is a significant increase from 0 to 5 years of their child’s life when key parent–infant attachment occurs. (Read the full article)

Injuries in children and young adults commonly cause morbidity and mortality. Epilepsy is common among children. Injury risk may be greater among those with epilepsy, but there are few large, population-based studies, making it difficult to estimate risk.

Children and young adults with epilepsy are at a greater risk of medicinal poisonings, thermal injuries, and fractures than those without epilepsy. Young adults with epilepsy are at particularly high risk of medicinal poisonings. (Read the full article)

Several studies suggest that excessive media use in early childhood predicts poorer developmental outcomes. It has not been studied whether infants with self-regulation problems, who may be at higher developmental risk, develop excessive media use habits.

This study shows that infants and toddlers with self-regulation difficulties (ie, problems with self-soothing, sleep, emotional regulation, and attention) view more media at 2 years of age, independent of other important confounders. (Read the full article)

Congenital pulmonary malformations are mostly identified prenatally. At birth, some children develop respiratory distress, which may be sufficiently severe to require mechanical ventilation and immediate surgery. The factors predictive of neonatal respiratory distress are not well defined.

Malformation volume and prenatal signs of intrathoracic compression are significant risk factors for respiratory complications at birth in fetuses with pulmonary malformations. In such situations, the delivery should take place in a tertiary care center. (Read the full article)

Previous studies have shown that food advertisements influence caloric intake among children. However, individual susceptibility to food advertisements has not been examined thoroughly.

This study examines the role of impulsivity in the effect of food advertisements. An advergame promoting snacks overruled refraining from eating, especially among impulsive children. The findings suggest that impulsivity plays an important role in susceptibility to food advertisements. (Read the full article)

Inadequate nutrient intake can compromise a child’s nutritional status, which may affect immune function. Improving dietary intake via a follow-up formula may support appropriate immune responses and improve a child’s ability to resist infection.

Children who consumed an experimental follow-up formula had fewer episodes and shorter duration of acute respiratory infections, as well as less antibiotic treatment, and fewer days missed of day care due to illness. (Read the full article)

Adolescents with chronic disease are a diverse population with common needs for transition. Disease-specific interventions have shown promise at improving patient outcomes but with substantial personnel and resource costs. Whether a generic approach across diseases may be useful is unknown.

This study is among the first to evaluate a generic (across disease) approach to transition of adolescents to adult care. The approach demonstrated promise and cost savings due to reduced personnel requirement and use of low-cost technology dissemination methods. (Read the full article)

In addition to seizures, school-aged children with epilepsy can have coexisting cognitive and behavioral difficulties, but the spectrum and prevalence of such difficulties are uncertain.

This study provides population-based data on the prevalence of common comorbid cognitive impairments and factors associated with such diagnoses in school-aged children with "active" epilepsy. (Read the full article)

Electronic cigarettes have unknown health risks and youth and young adults increasingly use them. E-cigarette companies are marketing e-cigarettes using television ads. The content of these ads may appeal to young people because they emphasize themes of independence and maturity.

E-cigarette companies advertise to a broad television audience that includes 24 million youth. The reach and frequency of these ads increased dramatically between 2011 and 2013. If current trends continue, youth awareness and use of e-cigarettes are likely to increase. (Read the full article)

Rapid cranial MRI is a radiation-free method to assess children with possible ventricular shunt malfunction. However, the test performance of rapid cranial MRI has never been compared with that of cranial CT, the current reference standard.

The accuracy of rapid cranial MRI was not inferior to that of CT for diagnosing ventricular shunt malfunction. Rapid cranial MRI is an important radiation-sparing diagnostic alternative for children presenting emergently with possible ventricular shunt malfunction. (Read the full article)

Animal studies document dose-dependent and duration-of-therapy-dependent fluoroquinolone cartilage toxicity in weight-bearing joints. Preliminary pediatric data collected after fluoroquinolone treatment and up to 1 year posttreatment in blinded and unblinded studies suggest the possibility of cartilage toxicity in children.

These are the first prospectively collected data on fluoroquinolone musculoskeletal safety collected posttherapy from randomized, comparative studies of respiratory tract infections and analyzed at 5 years. Long-term musculoskeletal adverse events occurred with equal frequency in both levofloxacin and comparator groups. (Read the full article)

Caffeine has predictable effects on cardiovascular function in both adults and children. Our previous work has shown that there are gender differences in this cardiovascular response, with boys having a greater change in heart rate and blood pressure than girls.

This study shows that the gender differences in cardiovascular response to caffeine emerge after puberty and there are some differences in postpubertal girls across the menstrual cycle. (Read the full article)

Autism prevalence is reported to be highest among non-Hispanic white children, lower in Hispanic and African American/black children, and highly variable in Asian/Pacific Islanders. More comorbid intellectual disability and delays in expressive language have been observed among Hispanic and African American children.

Maternal nativity is a risk factor for childhood autism in US populations. We observed higher risk of severe autism phenotypes in children of foreign-born black, Central/South American, Filipino, and Vietnamese mothers and US-born African Americans and Hispanics compared with US-born whites. (Read the full article)

Indoor tanning has gained widespread popularity among adolescents and young adults. Incidence rates of early-onset basal cell carcinoma also appear to be rising. Scant evidence exists on the impacts of early exposure and whether it leads to early occurrence of this malignancy.

In a US population-based study, indoor tanning was associated with an elevated risk of basal cell carcinomas occurring at or before the age of 50 years, with an increasing trend in risk with younger age at exposure among adolescents and young adults. (Read the full article)

Few studies have performed precise cardiovascular assessments and regular follow-up of congenital rubella syndrome (CRS) patients’ clinical courses. A few studies have reported mortalities among children who have CRS; however, the causes of death have not been precisely described.

A total of 38 CRS cases in Vietnam were studied after a rubella outbreak in 2011. The mortality associated with pulmonary hypertension was significantly high if untreated. Conducting careful cardiologic assessments and providing continuous follow-up for each patient is required. (Read the full article)

Predicting high-risk populations in congenital diaphragmatic hernia (CDH) can help target care strategies. Prediction rules for infants with CDH often lack validation, are aimed at a prenatal population, and are of limited generalizability. We cannot currently discriminate the highest risk neonates during the crucial period shortly after birth.

This clinical prediction rule was developed and validated on an international database. It discriminates patients and high, intermediate, and low risk of mortality; is easy to apply; and is generalizable to most infants with CDH. (Read the full article)

Graduating from high school is associated with better health and health behaviors. However, no rigorous studies have tested whether exposure to a high-performing school improves health or health behaviors, thus the causal relationship is unknown.

Exposure to successful schools can reduce very risky health behaviors among low-income adolescents. The primary mechanism is mostly due to better school retention and also due to better academic achievement. (Read the full article)

Preterm birth has been associated with increased risk of venous thromboembolism (VTE) in infancy, but the longer-term risk is unknown.

In a large national cohort, low gestational age at birth was associated with increased risk of VTE in infancy, early childhood, and young adulthood. These findings call for better awareness of the long-term risk of VTE among preterm birth survivors. (Read the full article)

Neonatal narcotic abstinence syndrome (NAS) has become more prevalent in the United States. There is no strong evidence base for NAS treatment and thus no consensus regarding NAS management, including the best treatment drug or best taper strategy.

This study demonstrates that regardless of the initial treatment opioid chosen, use of a standard treatment protocol with stringent weaning guidelines reduces duration of opioid exposure and length of hospital stay for infants with NAS. (Read the full article)

Practitioners caring for critically ill infants need to acquire competence in insertion of chest tubes for pneumothorax. Ethical and logistic concerns inhibit the use of animals, and there are no realistic simulation models available for neonatal chest tube insertion training.

An inexpensive, nonanimal chest tube insertion model can be easily constructed and used effectively to train interns and residents to improve their knowledge, clinical skills, and comfort levels to perform the chest tube insertion procedure in infants. (Read the full article)

For newborn infants, extreme hyperbilirubinemia (≥24.5 mg/dL) is associated with risk for severe bilirubin encephalopathy. The causal factor of extreme hyperbilirubinemia is often not established. The genotype of Gilbert syndrome, the UGT1A1*28 allele, is considered a potential risk factor.

The UGT1A1*28 allele was not associated with risk for developing extreme hyperbilirubinemia. (Read the full article)

High-fidelity simulation improves individual skills in neonatal resuscitation. Usually, training is performed in a simulation center. Little is known about the impact of in situ training on overall team performance.

In situ high-fidelity simulation training of 80% of a maternity’s staff significantly improved overall team performance in neonatal resuscitation (technical skills and teamwork). Fewer hazardous events occurred, and delay in improving the heart rate was shorter. (Read the full article)

Cigarette smoking during adolescence causes significant health problems. Health care providers play an important role in promoting tobacco use abstinence among adolescents, but recent data on the prevalence of provider screening and advice to adolescents are lacking.

This study uses nationally representative surveillance data to provide current estimates of self-reported receipt of health professional screening and advice about tobacco use among US adolescents. Cessation behaviors and correlates of past-year quit attempts among smokers were also explored. (Read the full article)

Cardiovascular risk begins in childhood. New clinical guidelines established a care strategy for lowering risks. Incorporation of guidelines into routine practice lags due to barriers related to knowledge and attitudes about guidelines, as well as behaviors of practitioners, patients, and clinical systems.

This study demonstrated that a multifaceted approach including tools, education, and support for changes in practice systems can accelerate the adoption of guidelines during routine pediatric well-child visits, compared with dissemination of the guidelines alone. (Read the full article)

Overweight and peer victimization are common in childhood and negatively affect health and well-being. Overweight may predispose children to peer victimization, but whether adiposity also increases the risk of bullying perpetration is unclear.

A high BMI at school entry predicts bullying involvement, according to reports of teachers and children themselves. Although trends were visible across the whole BMI spectrum, particularly obese children were victimized and likely to be bully perpetrators. (Read the full article)

Stimulant medications are indicated for treatment of childhood attention-deficit/hyperactivity disorder (ADHD), but there is concern that stimulants may negatively affect growth. However, no longitudinal, population-based studies have examined height into adulthood for childhood ADHD cases.

This longitudinal, population-based study shows that neither childhood ADHD itself nor treatment with stimulants is associated with significant deficits in height into adulthood. (Read the full article)

Lung ultrasound outperforms conventional radiology in the emergency diagnosis of pneumothorax and pleural effusions. In the pediatric age, lung ultrasound has been also successfully applied to the fluid-to-air transition after birth and to rapid pneumonia diagnosis.

Nasal ventilation has dramatically decreased the need for invasive mechanical respiratory support. This study demonstrates that, after a short trial on nasal continuous positive airway pressure, lung ultrasonography reliably predicts the failure of noninvasive ventilation unlike the conventional chest radiogram. (Read the full article)

Adolescents and adults born early preterm have higher blood pressure and altered glucose metabolism compared with their term born peers. Evidence of an atherogenic lipid profile is inconsistent. Whether these risks apply to those born less preterm is not known.

In adolescence, girls have higher blood pressure and boys a more atherogenic lipid profile than their term born peers. Overall, our results are consistent with a dose-response relationship between shorter length of gestation and increasing levels of cardiovascular risk factors. (Read the full article)

Being bullied can lead to adverse physical and mental health outcomes. Individuals who experience a sudden traumatic event often have short-term disturbances in their sleep patterns. Ongoing trauma may result in extended periods of sleep disruption.

Being bullied in elementary school predicts parasomnias, such as nightmares and night terrors, years later. General practitioners, pediatricians, parents, and teachers may consider parasomnias as potential signs of being bullied. (Read the full article)

Recent reviews suggest that children bullied by siblings are at increased risk of internalizing symptoms. It is not known whether being bullied by a sibling increases risk of psychiatric disorders such as depression, anxiety, and self-harm.

Using a large, community-based birth cohort, we found that being bullied by a sibling is prospectively associated with a doubling in the odds of both depression and self-harm at 18 years in young adults. (Read the full article)

Partner violence victimization is associated with mental and behavioral health effects linked to weight gain. Childhood maltreatment is directly linked to obesity and associated with neuroanatomic and psychosocial changes, which heighten vulnerability to subsequent stressors.

This study finds that dating violence victimization is associated with greater increases in BMI from adolescence to young adulthood among women. Women with previous exposure to childhood sexual abuse are especially vulnerable to dating violence–related increases in BMI. (Read the full article)

Puberty suppression has rapidly become part of the standard clinical management protocols for transgender adolescents. To date, there is only limited evidence for the long-term effectiveness of this approach after gender reassignment (cross-sex hormones and surgery).

In young adulthood, gender dysphoria had resolved, psychological functioning had steadily improved, and well-being was comparable to same-age peers. The clinical protocol including puberty suppression had provided these formerly gender-dysphoric youth the opportunity to develop into well-functioning young adults. (Read the full article)

Restrictive feeding by parents is associated with poorer eating self-regulation and increased child weight status. However, this association could be due to confounding home environmental or genetic factors that are challenging to control.

Differential maternal restrictive feeding is associated with differences in twins' caloric compensation and BMI z score. Controlling for the shared home environment and partially for genetics, these findings further support a true (ie, unconfounded) association between restriction and childhood obesity. (Read the full article)

Direct antiglobulin titer (DAT) positive, blood group A or B newborns born to group O mothers have a high incidence of hyperbilirubinemia, attributable to increased hemolysis.

DAT ++ readings were associated with a higher incidence of hyperbilirubinemia and a greater degree of hemolysis than DAT ± or DAT + counterparts. DAT strength should be taken into consideration when planning treatment strategies or follow-up of ABO-heterospecific newborns. (Read the full article)

There are discrepancies regarding which treatment is best in clinical practice for children with parapneumonic empyema, with some authors favoring video-assisted thoracoscopy and others favoring intrapleural fibrinolytic agents.

This study is one of the few randomized clinical trials on this subject in children and the first multicenter trial. It exclusively included patients with septated empyema. Thoracoscopy and fibrinolysis with urokinase were equally effective for this condition. (Read the full article)

Preterm birth and faster infant growth have been identified as independent risk factors for autism-spectrum disorders (ASD). However, associations between prematurity and ASD-related traits as a continuum and effects of infant growth among those born preterm are still little studied.

VLBW young adults reported higher levels of ASD-related traits, particularly traits related to poorer social skills. Within the VLBW group, faster growth in weight, height, and head circumference from birth to term was associated with lower levels of ASD-related traits. (Read the full article)

Youth in foster care are at higher risk of health problems at entrance and during their stays in care. Little is known about this group’s risk of health problems in young adulthood, in comparison with other populations of young adults.

This is the first prospective study to our knowledge demonstrating that former foster youth are at higher risk of chronic health problems than economically secure and insecure general population young adults. (Read the full article)

Studies have shown that reciprocal vocalizations between mother and infant have positive effects on language development. It has been shown that girls acquire vocabulary and language skills earlier than boys.

Mothers more readily respond to their infant’s vocal cues than fathers, and infants show a preferential vocal response to their mothers in the first months of life. Mothers respond preferentially to infant girls versus boys at birth and 44 weeks. (Read the full article)

Previous studies have examined state regulations for child care facilities and found substantial variation among states. None of these studies examined regulations related to healthy sleep practices, which is an important and often overlooked intervention target for obesity prevention.

We reviewed state regulations related to healthy sleep in child care and compared them to recent national recommendations put forth by the Institute of Medicine. We found that many states lacked regulations, highlighting an important and timely opportunity for improvement. (Read the full article)

Pediatric Brain Injury Research Network investigators recently derived a highly sensitive clinical prediction rule for pediatric abusive head trauma (AHT).

The performance of this AHT screening tool has been validated. Four clinical variables, readily available at the time of admission, detect pediatric AHT with high sensitivity in intensive care settings. (Read the full article)

IP-10 is a novel immunologic marker for tuberculosis (TB) infection. It has been suggested that IP-10 may perform better in children compared with the QuantiFERON test, but only a few studies have investigated IP-10 for diagnosing active TB in children.

This study is the first to investigate IP-10 and QuantiFERON for diagnosing TB in children by using consensus classifications. Both IP-10 and QuantiFERON exhibited poor performance in children from a high-burden setting, and performance was especially compromised in young children. (Read the full article)