Clinical Pediatrics最新文献

{"title":"Reflections From a Medical Student: Inspiration in Every Room.","authors":"Jack Sloane","doi":"10.1177/00099228261446752","DOIUrl":"https://doi.org/10.1177/00099228261446752","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228261446752"},"PeriodicalIF":0.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laboratory Findings for Simple and Complex Febrile Seizures.","authors":"Yoshifumi Miyagi, Yasunori Horiguchi, Yasuyuki Yano, Ryosuke Urabe, Atsushi Kitagawa, Hiroyuki Kato, Kentoku Kin","doi":"10.1177/00099228261447635","DOIUrl":"https://doi.org/10.1177/00099228261447635","url":null,"abstract":"<p><p>Febrile seizures (FS) are the most common convulsive disorder in childhood and are classified into simple and complex subtypes. Although blood tests are not routinely required, certain laboratory parameters may provide additional information for distinguishing these subtypes. We conducted a single-center retrospective study of 67 children, including 41 with simple FS and 26 with complex FS. Laboratory and clinical findings were compared between groups. Venous blood gas analysis revealed significant differences in pH (<i>P</i> = .039) and pCO₂ (<i>P</i> = .042). The area under the receiver operating characteristic (ROC) curve was 0.825 for pH (threshold 7.432) and 0.817 for pCO₂ (threshold 37.0 mm Hg). Seizure duration showed strong correlations with base excess (r = -0.85), pH (r = -0.77), ammonia (r = 0.76), and pCO₂ (r = 0.74). These findings suggest that venous blood gas parameters are associated with seizure duration and may reflect seizure severity rather than independently distinguishing FS subtypes.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228261447635"},"PeriodicalIF":0.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Febrile Urinary Tract Infection With Negative Initial Urine Culture.","authors":"Kazuki Iio, Naoaki Mikami","doi":"10.1177/00099228261447596","DOIUrl":"https://doi.org/10.1177/00099228261447596","url":null,"abstract":"<p><p>Febrile urinary tract infection (UTI) is a common bacterial infection in young infants. The diagnosis of febrile UTI is confirmed by a urine culture obtained via catheterization. UTI is generally considered unlikely when the bacterial colony count does not meet the diagnostic threshold. We identified infants diagnosed with febrile UTI at our institution who underwent urine testing multiple times during the same febrile episode. We summarized the clinical characteristics of patients whose initial urine culture was below the UTI diagnostic threshold but who subsequently had a positive urine culture during the same febrile episode. Five infants with febrile UTI were identified who had a low colony count in the initial urine test, followed by a positive urine culture during the same febrile episode. In most patients, the initial urine samples were obtained within several hours of fever onset. Two patients had known vesicoureteral reflux, 3 had a prior history of UTI, and 2 were younger than 3 months of age at presentation. Febrile UTI should not be excluded solely on the basis of an initial urine culture below the diagnostic threshold for UTI, especially when the urine sample is obtained in the early phase of fever.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228261447596"},"PeriodicalIF":0.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Seasonal Factors and Severity of Obstructive Sleep Apnea-Hypopnea Syndrome in Children.","authors":"Xueyun Xu, Yanyu He, Yuting Jiang, Meng Lv, Yaxuan Geng, Zhihui Wang, Zhen Zhang, Fengqian Wang, Shuqi Wang, Yuqing Wang","doi":"10.1177/00099228251404295","DOIUrl":"10.1177/00099228251404295","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available on the relationship between seasonal factors and obstructive sleep apnea-hypopnea syndrome (OSAHS) in China. The aim of this study was to investigate the effects of seasonal factors on the severity of OSAHS in children.</p><p><strong>Methods: </strong>Children 2.0 to 16 years old presenting with snoring and/or mouth breathing, suspected of having OSAHS, and admitted to the Department of Respiratory Medicine of Children's Hospital of Soochow University from December 2016 to February 2022 were enrolled in this study. The severity of OSAHS was determined by full-night polysomnography (PSG) in the sleep laboratory. The correlation between seasonal factors and PSG monitoring results was analyzed.</p><p><strong>Results: </strong>Of the 589 included patients, 301 cases (51.1%) were diagnosed with OSAHS. In the OSAHS group, 77 cases (25.6%) were detected in spring, 74 cases (24.6%) were detected in summer, 59 cases (19.6%) were detected in autumn, and 91 cases (30.2%) were detected in winter. There were 238 cases (79.1%) of tonsillitis hypertrophy, 276 cases (91.7%) of adenoid hypertrophy, 215 cases (71.4%) of rhinitis/sinusitis, and 36 cases (12.0%) of asthma. The proportion of rhinitis/sinusitis and tonsillar hypertrophy in spring was higher than that in summer (<i>P</i> = .015 and <i>P</i> = .036, respectively), and the proportion of adenoid hypertrophy in winter was higher than that in summer (<i>P</i> = .024). The diagnostic rate of severe OSAHS in winter was higher than that in summer (χ² = 7.053, <i>P</i> = .008). The respiratory arousal index in winter was higher than that in summer (H = -39.297, <i>P</i> = .018), and the spontaneous arousal index in spring was higher than that in autumn (H = 44.059, <i>P</i> = .020). It was found that the rapid eye movement (REM)-apnea index (AI) in spring and winter was higher than that in summer (H = 52.292, -52.554; all <i>P</i> < .05). The comparison of PSG results of children with OSAHS ≤6 years old in different seasons showed that REM-AI in winter was higher than that in summer (H = 8.570, <i>P</i> < .05).</p><p><strong>Conclusion: </strong>Severe OSAHS is more common in winter. Respiratory events are increased in spring and winter, mainly in children ≤6 years old. Seasonal factors may have a certain impact on OSAHS.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"523-530"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Improving Well-Child Care Engagement Post-discharge in Infants With Neonatal Opioid Withdrawal Syndrome.","authors":"Polina Frolova Gregory, Anika Larson, Sandra P Spencer, Dwight Barry, Melissa Camacho, Michael D Neufeld, Corrie E McDaniel, Karyn Yonekawa","doi":"10.1177/00099228251403825","DOIUrl":"10.1177/00099228251403825","url":null,"abstract":"<p><p>We conducted a quality improvement study to increase well-child visit attendance for infants with neonatal opioid withdrawal syndrome. Our primary outcome was attendance at the postnatal visit. Secondary outcomes included attendance at the 1- and 6-month visits. We used health records data to examine the baseline (2/2022-9/2023) and intervention (1/2024-6/2024) periods. We implemented a series of targeted interventions focused on (1) strengthening community partnerships, (2) increasing support to help families schedule newborn follow-up appointments, and (3) enhancing discharge education. We used Bayesian logistic mixed-effects models to assess follow-up attendance probability. We identified 52 infants in the baseline and 33 infants in the intervention periods. Baseline attendance was 90%, 63%, and 73% at the postnatal, 1-, and 6-month visits, respectively. Following the intervention, attendance was 91% at the postnatal visit, and improved to 82% and 80% for the 1- and 6-month visits. The probability of follow-up increased by 1% (95% confidence interval [CI]: -0.12, 0.12) at the postnatal visit, 18% (95% CI: 0.01, 0.34) at 1 month, and 8% (95% CI: -0.10, 0.24) at 6 months, highlighting the effectiveness of an interdisciplinary approach in improving post-hospitalization follow-up.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"506-515"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tympanostomy Tube Placement and Auditory Brainstem Response Test Under Sedation.","authors":"Haroon M Ali, Rhea M Vidrine, Cheri D Landers, Tony L Kille, Megan E Peters, Juan P Boriosi","doi":"10.1177/00099228251407411","DOIUrl":"10.1177/00099228251407411","url":null,"abstract":"<p><p>Auditory brainstem response testing is typically done under sedation in the pediatric sedation unit but often requires tympanostomy tube placement, typically done under general anesthesia in the operating room (OR), to be performed first to obtain accurate results. This is the first report on the feasibility of performing tympanostomy tube placement in combination with auditory brainstem response testing under sedation provided by pediatric critical care medicine and hospitalist physicians outside the OR. A retrospective review was performed of cases at two children's hospitals in the United States, between July 2021 and February 2024. A total of 28 cases of tympanostomy tube placement in conjunction with auditory brainstem response testing under sedation provided by pediatric critical care medicine and hospitalist physicians outside the OR were identified. All the sedative regimens utilized propofol. All procedures were successful, but 6 patients experienced adverse events, with 5 patients experiencing only minor respiratory adverse events. One patient experienced laryngospasm, requiring unplanned intubation and Pediatric Intensive Care Unit admission. Lower direct facility costs and wait times were noted in a convenience sample of cases under sedation outside the OR compared to cases under general anesthesia in the OR.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"591-595"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motion Sickness and Psychological and Vestibular Symptom Burden After Concussion.","authors":"Tara Nichols, Melissa Godfrey, Kristy Arbogast, Christina L Master, Daniel Corwin","doi":"10.1177/00099228251409543","DOIUrl":"10.1177/00099228251409543","url":null,"abstract":"<p><p>Given the potential interplay of psychological symptoms following pediatric concussion and vestibular dysfunction, we conducted a prospective cohort study of participants ages 8 to 19 ≤72 hours of injury from the emergency department to assess the association between motion sickness and outcomes. Participants completed visio-vestibular testing and symptom-based surveys at enrollment, with outcome assessment at 1 and 4 weeks post-injury. We enrolled 114 participants, 19 with motion sickness history, 17 with new motion sickness after injury. Although not statistically significant following Bonferroni correction, those who developed motion sickness following concussion had higher total enrollment symptom scores (median 42 vs 21, <i>P</i> = .015), more missed school days (median 8 vs 3, <i>P</i> = .043), and a higher incidence of symptoms above baseline at 4 weeks (63.6% vs 38.9%, <i>P</i> = .181). Those with new motion sickness may be vulnerable to poorer outcomes after concussion, indicating potential value in motion sickness screening at presentation and vestibular-focused therapies.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"584-590"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Mental Health Correlates of Electronic Cigarette Use Among Pediatric Primary Care Patients.","authors":"Jordan M Braciszewski, Melissa Elmali, Elyse N Llamocca, Alyssa M Vanderziel, Hadley Cameron-Carter, Amy M Loree","doi":"10.1177/00099228251399041","DOIUrl":"10.1177/00099228251399041","url":null,"abstract":"<p><p>Electronic cigarettes (e-cigarettes) are the most used tobacco product among US adolescents. Information about the prevalence of use in a pediatric primary care population has been limited. Youth aged 12 to 17 attending a well-child visit completed screening for past year e-cigarette, cigarette, cannabis, and alcohol use, as well as depression and anxiety symptoms. We examined e-cigarette-use prevalence, frequency, and relationship to demographics, mental health symptoms, and other substance use. Among 9740 patients, 8.2% reported past-year e-cigarette use. Males (7.2%) were less likely than females (9.2%) to use e-cigarettes, while more frequent use was associated with more frequent cannabis, alcohol, and cigarette use, as well as elevated depression and anxiety symptoms. Sex differences support a recent trend toward young females using e-cigarettes at higher rates than males. Polysubstance use was common, highlighting the importance of regular screening for all substances and feasible interventions for this setting.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"499-505"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protected.","authors":"Terry Kind","doi":"10.1177/00099228251392142","DOIUrl":"10.1177/00099228251392142","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"460"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluating the 1 Hour Benchmark: Associations Between Antibiotic Timing and Mortality in Pediatric Sepsis.","authors":"Alexandra H Baker, Christopher M Pruitt, Paul C Mullan, Elliot Melendez","doi":"10.1177/00099228251407402","DOIUrl":"10.1177/00099228251407402","url":null,"abstract":"<p><p>Retrospective cohort study evaluating the association between time to antibiotic administration and clinical outcomes in pediatric sepsis using data from 6153 patients treated at 19 pediatric emergency departments between 2013 and 2016. Time to antibiotics was analyzed both as a continuous variable and as a dichotomized variable (≤60 vs >60 minutes from sepsis time zero). The primary outcome was 3- and 30-day all-cause mortality; secondary outcomes included use of vasoactive agents and intensive care unit and hospital length of stay. In adjusted analyses, longer time to antibiotics was associated with lower 30-day mortality but not with 3-day mortality or other secondary outcomes. Patients receiving antibiotics more than 60 minutes from recognition had a significantly lower risk of 30-day mortality. These findings suggest that rigid time-based antibiotic thresholds may not align with improved outcomes in pediatric sepsis and underscore the need for prospective studies to inform future guidelines.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"549-555"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}