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An otherwise healthy 9-month-old girl was brought to the emergency department (ED) by her parents who reported a 12-hour history of nonbloody, nonbilious emesis. The patient had a mildly increased temperature and appeared to be dehydrated.

According to the National Center for HealthStatistics,1 almost one-fifth of American childrenaged 6 to 11 years are overweight-a proportion that has been increasing inrecent years. Overweight children are morelikely to become overweight adults, following a pathwaytoward such health complications as heart disease, diabetes,and sleep apnea.2 As pediatricians, we are constantlylooking for new ways to battle the obesity epidemic,and wonder what else we can do to slow theprogression of the trend.

An 8-week-old boy is brought for evaluation of gradually worsening yellow skin discoloration of about 1 week's duration. His parents report that he has had constipation for the past several days; before that, he had green diarrhea and occasionally spit up after breast-feeding. The infant has been irritable and has been sleeping more often. He has had no fever, no change in eating habits or in the frequency of wet diapers, and no sick contacts.

The 2-year-old boy shown here had been bitten on the left cheek by a medium-sized dog while at the home of his day-care provider. Immediately after the incident, the child was examined by his pediatrician and given a presciption for amoxicillin clavulanate. The next day, he presented to the emergency department with worsening cellulitis of the left cheek.

The cost of family health insurance plans in the United States is increasing 10 times faster than salary increases, meaning that a growing share of workers' earnings are eaten up by health care costs, according to a report issued April 29 by the Robert Wood Johnson Foundation.

Mothers who return to work on either a part-time or casual basis after their babies are 3 months old may be nearly as likely to stop breastfeeding as mothers who return to work on a full-time basis, findings suggest.

Clinical diagnosis is a largely open-loop system in which there is no systematic way for clinicians to obtain feedback on the outcome of their diagnoses, according to an article published in a supplement to the May issue of The American Journal of Medicine.

The incidence of gestational diabetes has remained stable over time and is similar across different racial and ethnic groups, but the rising number of young, pregnant women with pre-existing diabetes is cause for concern, according to a report published in the May issue of Diabetes Care.

A recent CDC study found that many children are not getting all their recommended shots -- or getting them at the wrong time.

The overall well-being of American children from 1994 to 2006 is improving, despite the fact that rates of obesity and low birth weight are rising, according to a report released by the Foundation for Child Development on April 25.

Because H5N1 influenza A viruses have the potential to cause a worldwide pandemic with mortality rates as high as 60 percent, the development of broadly protective vaccines is imperative, according to a seminar published in the April 26 issue of The Lancet.

Uptake of the first two doses of the human papillomavirus vaccine among adolescent schoolgirls in Manchester, United Kingdom, was encouraging, but high coverage for the third dose will determine the overall success of the vaccination program, according to a study published online April 24 in the BMJ.

The wide diversity of health care provision in European countries makes any regionwide legislation mandating a unified approach unfeasible, and quality of care across countries will likely be ensured through more informal mechanisms, according to an article published in the April 26 issue of the BMJ.

Children living with siblings who are from different sets of biological parents may perform worse in class and exhibit more behavior problems compared with children with siblings from the same two parents.

A mother's diet around the time of conception may play a role in determining the gender of her baby, findings published April 22 in the online Proceedings of the Royal Society B: Biological Sciences suggest.

In teenage boys, high consumption of skim milk is positively associated with acne, according to a study published in the May issue of the Journal of the American Academy of Dermatology.

Influenza vaccine had limited efficacy during the last flu season, uptake of the rotavirus vaccine is encouraging and researchers who have contact with a virus related to smallpox should be vaccinated, according to three articles in the April 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

In diagnosing the cause of stridor, a high-pitched breathing sound, in children, airway fluoroscopy has high specificity but low sensitivity when compared with airway endoscopy, according to a study in the April issue of the Archives of Otolaryngology -- Head and Neck Surgery.

Depression in mothers living in extreme poverty may be associated with low cortisol levels in their children, as reported in the Spring 2008 Development and Psychopathology.

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Insulin resistance develops differently in boys and girls as they transition from late childhood through adolescence, according to a study published online April 21 in Circulation.

Children with attention deficit hyperactivity disorder (ADHD) should undergo cardiovascular screening prior to being started on stimulant medications such as Ritalin and Adderall, according to an American Heart Association Scientific Statement published online April 21 in Circulation.

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Migraine is associated with an increased risk of sleep disturbances in children, according to findings presented at the Academy of Neurology's 60th Anniversary Annual Meeting in Chicago.

Chronic cough, defined as a cough lasting eight weeks or longer, is common in the community and can be caused by environmental exposures to such things as cigarette smoke and pollution as well as by a number of common and rare diseases, according to an article published April 19 in The Lancet.

According to interim results of a study by the Centers for Disease Control and Prevention (CDC), the 2007-2008 influenza season was moderately severe, and two of three vaccine strains were not optimally matched with circulating viruses.

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