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This Month in Archives of Pediatrics and Adolescent Medicine
June 2012

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2012;166(6):499-500. doi:10.1001/archpediatrics.2011.534

In their study van der Aa et alArticle found that more of the variation in sedentary behavior among 20-year-old individuals was accounted for by genetics (48% for males and 34% for females) and nonshared environmental factors (52% for males and 66% for females) than it was for 12-year-old adolescents (35% for males and 19% for females by genetics and 36% for males and 34% for females by nonshared environmental factors). Conversely, shared environmental factors played less of a role in late adolescence.

Genetic risk of obesity, as identified in single-nucleotide polymorphisms, is unrelated to birth weight, according to a study by Belsky et alArticle. After birth, children at higher genetic risk gained weight more rapidly and reached adiposity rebound earlier and at a greater body mass index than children at lower risk, independent of family history. These phenotypes in turn predicted adult obesity.

White and JagoArticle found there was a strong negative dose-response association between physical activity at age 12 years and obesity at age 14 years, independent of sedentary behavior, daily caloric intake, and onset of puberty. However, this association was seen only in white girls and not in black girls. Prompting adolescent girls to be active may be important to prevent obesity but using different approaches (eg, emphasizing reductions in energy intake) may be necessary to prevent obesity in black girls.

Human immunodeficiency virus illness severity markers are associated with the severity of conduct disorder and depressive symptoms as well as lower quality of life, lower cognitive function, and worse social functioning, Nachman et alArticle found. There was no association between specific antiretroviral therapy and severity of psychiatric symptoms.

Starr et alArticle found that 3-year-old children with single-suture craniosynostosis tended to score lower on neurodevelopmental assessments and had 1.5- to 2-fold greater odds of scoring in the delayed range on cognitive, motor, and speech functioning than a comparable group of children without craniosynostosis.

Major factors associated with poor outcomes at 24 to 26 weeks' gestation were able to be estimated at birth, based on gestational age, male sex, sex-specific birth weight percentile, and lack of prenatal steroid therapy. Kugelman et alArticle found that the estimated poor outcomes ranged from 59% to 100% for infants born at 24 weeks' gestation, 42% to 91% at 25 weeks' gestation, and 25% to 74% at 26 weeks' gestation. They concluded that gestational age alone should not be used to estimate outcomes in these extremely preterm infants.

Fritz et alArticle found that more than half of household contacts of children with Staphylococcus aureus skin infections were colonized with S aureus, with the parents more likely to be colonized than other family members. One of 5 household contacts were colonized with methicillin-resistant S aureus.

In this systematic review by Tagin et alArticle of 7 trials with 1214 newborns, hypothermia reduced the risk of death or major neurodevelopmental disability at age 18 months in newborns with moderate hypoxic ischemic encephalopathy (risk ratio, 0.67; 95% CI, 0.56-0.81) and with severe hypoxic ischemic encephalopathy (risk ratio, 0.83; 95% CI, 0.74-0.92). Total body cooling and selective body cooling were equally effective.

Published guidelines for resuscitation of extremely premature infants emphasize the importance of the gestational age of the infant. WilkinsonArticle discuss the idea of creating a policy of nonresuscitation based on gestational age and chronologic age and how some have questioned whether such guidelines would be considered a form of ageism.