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This Month in Archives of Pediatrics & Adolescent Medicine
Jan 2012

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2012;166(1):6-7. doi:10.1001/archpediatrics.2011.509

In this study by Feudtner et alArticle of nearly one-fifth of all pediatric hospitalizations across the United States, a typical patient admitted to a children's hospital is exposed to a dozen drug and therapeutic agents. For those in the hospital at least 1 week, 10% are exposed to 35 different drugs.

Jones et alArticle found that living with a mother who smokes increases the chance of middle ear disease by 62% and increases the chance of needing surgery for middle ear disease by 86%. Each year, secondhand tobacco smoke results in nearly 300 000 children in the United States developing middle ear disease.

Boons et alArticle report that children with bilateral cochlear implants performed better on both expressive and receptive language tests than children with unilateral implants 3 years after the first cochlear implantation. Bilateral implantation done simultaneously resulted in better expressive language outcomes than those done sequentially.

Zeitler et alArticle found that adolescents with prelingual deafness undergoing unilateral cochlear implantation showed significant improvement in objective hearing outcome measures. Patients with shorter durations of deafness and earlier age at cochlear implantation tend to outperform their peers.

Lee et alArticle report that a higher level of excess body mass index–years (a measure of time spent with body mass index [calculated as weight in kilograms divided by height in meters squared]>85th percentile or >25.0) is associated with an increased risk of diabetes. This relationship is stronger for younger individuals than for older individuals, and it is stronger for Hispanic and black individuals compared with white individuals.

This study by Singh et alArticle found strong evidence for a significant positive relationship between physical activity and academic performance in children. Increased physical activity is associated with positive effects on language skills and reading.

Previous studies showed that low-grade inflammation could be implicated in the development of cardiovascular disease from the early stages of life. The study by Labayen et alArticle shows that longer exclusive breastfeeding in infancy is associated with lower serum fibrinogen levels in children and adolescents, independent of potential confounders such as adiposity and physical activity. Differences in fibrinogen concentrations became significant when children and adolescents were breastfed for at least 3 months.

The results of the study by Farrell et alArticle raise concern about an apparent problem with physician-parent communication after “nondisease” carrier newborn screening results because many physicians fail to recognize parents' emotional problems after newborn screening. Such problems may need to be addressed if population-scale newborn screening is to result in more good than harm.

According to the study by Mandell et alArticle, although respite care is not universally available through Medicaid for children with autism spectrum disorders, each $1000 increase in spending on respite care during the preceding 60 days resulted in an 8% decrease in the odds of hospitalization. The lack of association between therapeutic services and hospitalization raises concerns regarding the effectiveness of these services.

Stevens et alArticle found that the Pediatric Quality of Life Inventory 4.0 Generic Core Scales instrument is feasible, is reliable, and demonstrates good construct and discriminant validity and responsiveness in measuring short-term outcome after minor injury care in the pediatric emergency department. Outcome assessment in the pediatric emergency department may be improved by including measures of health-related quality of life to evaluate short-term effects of emergency department care.

In this survey by Mullins et alArticle of 235 girls aged 13 to 21 years and their mothers, few adolescents perceived less need for safer sexual behaviors after the first human papillomavirus vaccination. The vast majority of adolescent girls continue to perceive the importance of safer sexual behaviors after receiving their first human papillomavirus vaccination.

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