• Can a "difficult" childhood lead to an early menarche? The goal of this study was to determine association between the age of menarche and adverse childhood experiences. Previous reports have linked early menarche to absence of a live-in father figure and to family conflict, as well as genetic determination of early puberty and adiposity. Data about childhood experiences, including age of menarche, were collected on two occasions, 6 years apart. Early menarche was defined as first menstruation occurring before the age of 12 years. The identified variables statistically interacted with each other in a highly complex manner. The study concludes that chronic or protracted childhood sexual abuse needs to be added to the list of factors associated with early menarche in future studies. Psychological Medicine 2003; 33: 933
   

• How well do physicians remember to organize catch-up immunizations in un-immmunized children? Pediatricians, general practitioners, and family practitioners in USA completed a self-administered survey. Surveys included 6 open-ended vignettes describing hypothetical children delayed in immunization for which participants were asked to design catch-up regimens. Almost one third of respondents answered all 6 vignettes incorrectly. Pediatricians were >4 times more likely to answer correctly than were family practitioners! The authors feel that childhood vaccine providers have substantial knowledge deficits of recommended immunization schedules and vaccine contraindications that may contribute to missed opportunities to immunize. Pediatrics 2003; 111: 925
   

• The management of Ring enhancing lesions (RELs) remains a matter of debate. This randomized control study addresses the issue by determining the efficacy of albendazole plus dexamethasone in children with 1 or 2 ring-enhancing lesions on resolution of lesions and recurrence of seizure. The lesions resolved completely or partially in more children in the treated group and these children had fewer seizures. It would seem that aggressive treatment of RELs is likely to achieve a better long-term prognosis. J Pediatr 2003; 143: 111
   

• Adjunctive tests are needed to predict sepsis in the newborn and to lower the rate or duration of unnecessary antibiotic use. The authors evaluated the normal Inter-alpha inhibitor protein (IaIp) values in infants (n=135) and the association of plasma levels of IaIp with sepsis in term and preterm newborns (n=19). There was a significant reduction in IaIp levels in infants with sepsis compared with nonseptic controls. (P <0.0001) It is the author's view that IaIp levels might serve as an adjunctive diagnostic marker to allow prospective reduction of antibiotic use. J Pediatr 2003; 143: 11
   

• To evaluate the role of IVIG as an adjunctive therapy in severe steroid-dependent asthma, seven patients were given IVIG at a dose of 1 g/kg each month for 6 months. Baseline pulmonary function tests and immunoglobulin levels were obtained. At the end of 6 months, the end-points observed were lung function and the degree of reduction in the dose of oral steroids. IVIG provides a potentially important adjunctive therapy in severe steroid-dependent asthma, reducing steroid requirement and decreasing hospital admissions, but not improving lung function. Intern Med J 2003; 33: 341
   

• Congenital CMV disease can lead to devastating sequelae. This study evaluated the efficacy and safety of IV ganciclovir therapy in neonates with congenital cytomegalovirus (CMV) disease having CNS involvement. The primary end point was improved brainstem-evoked response (BSER) between baseline and 6-month follow-up. The results show that ganciclovir therapy begun in the neonatal period in symptomatically infected infants with CMV infection involving the central nervous system prevents hearing deterioration at 6 months and may prevent hearing deterioration at > or =1 year. Almost two thirds of treated infants have significant neutropenia during therapy. J Pediatr 2003; 143: 16
   

• Can we predict which high-risk adolescent is likely to commit suicide? A lower ratio of tryptophan to other amino acids in serum (tryptophan ratio), has been shown to be associated with increased suicidal behavior in cross-sectional studies. This study was the first prospective examination of the utility of the tryptophan ratio along with clinical variables in predicting suicidal behavior in high-risk and reference adolescents. Of 56 subjects who completed follow-up assessments, six had suicidal behavior in the follow-up period. In the final model, the tryptophan ratio and major depressive disorder both significantly contri-buted to the prediction of suicidal behavior. Psychiatry Res. 2003; 119: 199
   

• How insidious is the role of Television advertising? Do pre-schoolers prefer branded products? This article investigates the extent to which preschool children (aged 4-5 years) prefer brands advertised on television. Seventy-five children were interviewed and given a choice task in which they had to select the product, from eight pairs each comprising a branded and nonbranded product, that children of their own age and gender preferred. Products included popular drinks, snacks, toys, breakfast cereals, and sportswear. On 68% of occasions, children chose the branded, advertised product in preference to the nonbranded product! This preference was reliably higher for girls (78%) than boys (58%). Gender-linked differences are discussed in relation to girls' greater verbal ability and emotional sensitivity. J Dev Behav Pediatr. 2003; 24: 219

Gaurav Gupta,
Consultant Pediatrics,
Fortis Multispeciality Hospital,
Chandigarh, India.
E-mail: [email protected]