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In This Issue of JAMA Pediatrics |

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JAMA Pediatr. 2016;170(7):631. doi:10.1001/jamapediatrics.2015.2536.
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While concussions have received increasing attention in the last few years, little is known about the risks of concussions in younger athletes. Kerr and coauthors examine data from 3 different injury surveillance programs covering youth, secondary school, and collegiate players. Concussions in high school football had the highest mean number of reported symptoms, followed by college and youth football, while high school athletes had the highest proportion of concussions with a long return-to-play time. This study emphasizes the different vulnerabilities of youth to concussion at different ages.

Continuing Medical Education and Journal Club

A growing body of literature suggests that chronic consumption of artificial sweeteners may paradoxically increase the risk for obesity. In this longitudinal study of 3033 women and their infants, Azad and coauthors for the Canadian Healthy Infant Longitudinal Development Study examine the effect of maternal consumption of artificially sweetened beverages during pregnancy on infant’s body mass index at 1 year of age. Daily consumption of artificially sweetened beverages was associated with a 2-fold higher risk for infants being overweight at 1 year of age, adjusted for mother’s body mass index and other risk factors. Pereira and Gillman discuss the implications of these findings in their editorial and call for randomized clinical trials in pregnant women to address the critical question.

Asthma is the most common chronic illness in children and displays substantial disparities in rates of hospitalization. Beck and coauthors conduct a prospective population-based cohort study of asthma to examine predictors of readmission. While African American children were 2.26 times more likely to be readmitted than white children, they differed in nearly every measured biologic, environmental, disease management, access, and socioeconomic hardship variable, accounting for 80% of the disparity in readmission rates. The accompanying editorial by Tschudy and Cheng discusses the needed changes in clinical care, community action, and health policy to erase these disparities.

The incidence of pediatric Clostridium difficile infections has increased 12.5-fold over the last 2 decades, but little attention has been given to its associated reactive arthritis. Horton and coauthors use electronic health records from 3 geographically diverse health care networks to examine this condition over a 10-year period. Reactive arthritis affected 1.4% of children with C difficile infections, beginning a median of 10.5 days after initial gastrointestinal symptoms. Most cases were initially not correctly diagnosed, resulting in high rates of health care use.





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