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This Month in Archives of Pediatrics and Adolescent Medicine
August 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(8):703. doi:10.1001/archpedi.159.8.703

With the marked recent increase in childhood obesity, increasing attention has been given to identifying children with the metabolic syndrome. This study examined the association between waist circumference and elements of the metabolic syndrome in children aged 6 to 13 years. Half of the children with waist circumference greater than 90th percentile had either elevated blood pressure, insulin resistance, or hyperlipidemia and 10% had 2 or more of these risk factors, compared with only 2.5% in the group with waist circumferences less than 90th percentile. Waist circumference is potentially useful as a screening tool for children at risk of the metabolic syndrome.

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Hematopoietic stem cell transplantation is used to treat a variety of malignant and nonmalignant disorders, and there are an estimated 100 000 individuals who are 5-year survivors of stem cell transplants in the United States. This study examined the long-term outcomes of 235 persons who were treated with hematopoietic stem cell transplantation before the age of 21 years. Adult survivors of childhood cancer treated with transplantation were twice as likely to have physical limitations and 3 times more likely to have emotional problems compared with controls. Child survivors, compared with similarly aged children, were 3 times more likely to need special education and 11 times more likely to have some physical limitations. Although the majority of survivors go on to lead independent and productive lives, there is a substantial subset of individuals after stem cell transplantation with significant functional limitations.

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Obstructive Sleep Apnea was first described in children in 1976, and is estimated to occur in as many as 5% of children. Symptoms of sleep disordered breathing vary with age of the child, and obstructive sleep apnea is usually suspected based on parental concerns. This review article provides a comprehensive overview of the clinical evaluation and diagnosis of sleep disordered breathing and reviews the testing required to objectively confirm the diagnosis. Treatment options including adenoidectomy, radiofrequency treatment of nasal inferior turbinates, oral surgery, and nasal continuous positive airway pressure are described.

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Most prior studies of youth violence have focused on males, because of the higher prevalence of violent victimization and perpetration in males compared with females. Molnar et al used data from the Project on Human Development in Chicago Neighborhoods to examine violent behavior by 637 girls aged 9 to 15 years at baseline. At baseline, 38% of girls reported perpetrating at least 1 violent behavior in the prior 12 months; 28% reported past year violent behavior at the first follow-up interview, and 14% at the third interview 24 months later. Adolescent girls were more likely to act violently if they had previously experienced violent victimization, and if they lived in impoverished and/or severely violent communities. These results suggest that a continued emphasis on individual-based remedies or penalties will be unsuccessful, unless additional efforts are undertaken to reduce childhood victimization and improve the conditions in which many urban girls live.

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Age-violence curves by history of victimization and for total sample: Project on Human Development in Chicago Neighborhoods waves 1 through 3, for cohorts aged 9 through 15 years. VCT indicates violent victimization.

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