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This Month in Archives of Pediatrics and Adolescent Medicine
March 2005

This Month in Archives of Pediatrics & Adolescent Medicine

Author Affiliations

Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Pediatr Adolesc Med. 2005;159(3):210. doi:10.1001/archpedi.159.3.210

Increasing attention is being focused on mental health problems in children and adolescents. Comorbidity with other psychiatric or medical disorders is well known in adults with mental illness but has not been well characterized in the pediatric age group. In this study of 32 000 patients aged 6 to 17 years with mental health problems, 14% had more than 1 psychiatric disorder and 7% to 42% had a comorbid medical disorder. The most common combinations of comorbidity were behavioral disorders with developmental delay and behavioral disorders with genitourinary problems. This study highlights the complex needs of children and adolescents with psychiatric problems.

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Latino children are the most rapidly increasing population in the United States. This study sought to examine the influence of acculturation, as measured by language, on the variability of the age of onset of sexual activity among Latino adolescents. Highly acculturated Latino adolescents were 69% more likely to be sexually active than their white, non-Latino peers, while less acculturated Latino youth were much less likely to be sexually active compared with non-Latino white and English-speaking or bilingual Latino youth. Low acculturation appears to be a significant factor affecting the onset of sexual activity.

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Helicobacter pylori is a common infection in the pediatric age group, especially in children from developing countries. While the gold standard for diagnosis is endoscopy with biopsy, the use of less invasive tests would be far preferable. This study examined the accuracy of some noninvasive tests for H pylori compared with endoscopy and biopsy. Among the 250 patients studied, 37% had positive biopsy results for H pylori. The H pylori fecal antigen test had the highest sensitivity and specificity with a positive predictive value of 97%, while the serum H pylori IgG test had a positive predictive value of 72%. This study demonstrates that a fecal antigen test is a simple, noninvasive, and accurate method to diagnosis H pylori infection in the pediatric age group.

Table 1. 
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Sensitivity, Specificity, and Positive and Negative Predictive Values of Noninvasive Tests*

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Infants’ sleep problems represent one of the most frequent complaints of parents consulting a pediatrician. In this large longitudinal study in Canada, sleep problems were tracked in children at 5, 17, and 29 months of age. As many as 24%, 7%, and 10% of children were sleeping fewer than 6 hours in a row at night at 5, 17, and 29 months of age, respectively. Putting the child to bed already asleep, feeding the child after a nocturnal wakening, bringing the child into the parents’ bed after a nocturnal wakening, cosleeping, and the infant’s temperament were all associated with not sleeping more than 6 consecutive hours at 17 and 29 months of age. Parent behaviors at bedtime and in response to a nocturnal wakening were highly associated with the child’s sleep habits.

Figure 2.
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Evolution of sleepers at 5 months, 17 months, and 29 months of age. The percentages represent the distribution of children for each path.

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