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In our continuing series on the history of American pediatrics, SteinArticle discusses the changing epidemiology of chronic health conditions, their improved survival, and the shift toward a more comprehensive and inclusive approach to the classification of children with chronic illness.
Diarrhea-associated hemolytic uremic syndrome has a considerably better prognosis if urine output is maintained. This observational study by Hickey et alArticle of children with diarrhea-associated hemolytic uremic syndrome in 11 pediatric hospitals found that the oligoanuric rate was substantially higher among those who received no intravenous fluids in the first 4 days of illness.
This study by Falb et alArticle of more than 1400 men found that bullying peers in school as a child, especially frequent bullying perpetration, was associated with increased risk for men's perpetration of intimate partner violence as an adult. A critical step in preventing intimate partner violence is to address risk factors for its perpetration among men.
Pinhas et alArticle report that in a survey of more than 2400 Canadian pediatricians during a 2-year period, the incidence of restrictive eating disorders in children aged 5 to 12 years was 2.6 cases per 100 000 person-years. Girls were 6 times more likely to have these disorders than boys, and approximately half required hospital admission. Many of these children did not have the cardinal symptoms of anorexia nervosa.
In this national survey of children in England reported by Whitaker et alArticle, 5.7% were categorized as being thin. The strongest predictor of child/adolescent thinness was parental weight status. The prevalence of thinness was highest when both parents were thinner and progressively lower when both parents were in the upper half of the healthy weight range or were overweight or obese.
Pryor et alArticle found that during the first 5 years of children's lives, about half the children have low and stable body mass index (BMI). Another 41.0% have moderate but stable BMI, but 4.5% have a high-rising BMI during childhood. Maternal overweight/obesity and maternal smoking during pregnancy are risk factors for this high-rising trajectory of BMI.
In this study by Li et alArticle of 194 infants and children evaluated for physical abuse, no child who met low-risk criteria (no intracranial injury, normal mental status, no bruising on the head or face) had retinal hemorrhage. Of those who did not meet low-risk criteria, 3.8% had retinal hemorrhage.
Hewes et alArticle report that among child abuse homicide in Utah, the conviction rate was 88.2%, similar to the conviction rate of 83.0% for adult homicide. There were no significant differences in the level of felony conviction or severity of sentencing by age of the homicide victim.
Hack et alArticle found that 8-year-old children who were born at extremely low birth weight rated their health similar to normal-birth-weight children, while their parents reported significantly poorer health of their children than did parents of normal-birth-weight controls. Both children's and parents' perspectives need to be considered when making health care decisions.
Gorelick et alArticle report that while minority parents are more likely to exclusively give bottled water to their children, disparities in bottled water use are driven largely by differences in beliefs and perceptions about water.
In this study by Tromp et alArticle of nearly 7000 children, the introduction of cow's milk, hen's eggs, peanuts, tree nuts, soy, and gluten before age 6 months was not significantly associated with eczema or wheezing at any age.
Dowda et alArticle found that vigorous physical activity in preschool children was related to family support for physical activity, child's enjoyment of physical activity, and the preschool environment. Parents' activity was the weakest predictor of a child's physical activity. The study points to the important role of preschools in improving the physical activity of children.
This large prospective cohort study by Li et alArticle found a linear dose-response relationship between increasing maternal median daily magnetic field exposure level in pregnancy and an increased risk of asthma in offspring. Children whose mothers had a high magnetic field exposure level had more than a 3.5-fold increased rate of asthma.
This study by Ralston et alArticle examined the risk of occult serious bacterial infection in the youngest febrile infants presenting with bronchiolitis. No case of meningitis was reported in any of the 11 studies analyzed, and no case of bacteremia was reported in 8 of the 11 studies. The rate of urinary tract infections was 3.3%. The screening approach to culturing for serious bacterial infections in these infants has a very low yield.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2011;165(10):877–878. doi:https://doi.org/10.1001/archpediatrics.2011.171
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