Clinical Pediatrics最新文献

{"title":"Paralysis in Pairs: Insights From Two Cases of Infant Botulism.","authors":"Caroline Weiss, Gabrielle Pollack, April Slamowitz, Deirdre Lewis","doi":"10.1177/00099228251345321","DOIUrl":"https://doi.org/10.1177/00099228251345321","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251345321"},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233381","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":"Complete Blood Count in Children With COVID-19: A Predictor of Disease Severity.","authors":"Sandra Regina Loggetto, Thiago de Souza Vilela, Julia Maimone Beatrice, Priscila Grizante-Lopes, Janahyna Gomes Emerenciano, Andrea Angel, Josefina Aparecida Pellegrini Braga","doi":"10.1177/00099228241288715","DOIUrl":"10.1177/00099228241288715","url":null,"abstract":"<p><p>Blood count abnormalities are frequent in patients with severe COVID-19 disease and there is still a lack of information in pediatric complete blood count (CBC) results. Thus, this study aims to correlate the CBC in the emergency room of children with COVID-19 between 0 and 10 years old and the clinical severity of the disease. A retrospective cohort study was performed in children with COVID-19 who collected at the emergency room CBC, C-reactive protein (CRP), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), lymphocyte to neutrophil ratio (LNR), lymphocyte to monocyte ratio (LMR), monocyte to neutrophil ratio (MNR) and monocyte to lymphocyte ratio (MLR). In total, demographic data from 93 children with median age of 19 months (0.3-126), 60.2% males, were included. The main changes in the CBC were atypical lymphocytes (51.6%) and eosinopenia (49.5%). From 69 hospitalized children, 21 were considered severe. There was no association between age, gender, and CRP value with clinical severity. The presence of underlying disease was five times higher (odds ratio [OR] = 5.08) in patients who required hospitalization and a higher NLR value was 54% (OR = 1.54) more likely to occur. Eosinopenia was three times more frequent in inpatients with disease severity criteria (OR = 3.05). In conclusion, children younger than 10 years of age with COVID-19 have changes in the CBC collected in the emergency room, mainly atypical lymphocytes and eosinopenia. The presence of a comorbidity or a higher NLR increases the chance of hospitalization. In addition, eosinopenia was a predictor of severity in inpatient children due to COVID-19.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"695-702"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459605","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":"Infant With Facial Rash Progressing Rapidly to Deep Tissue Infection.","authors":"Justin Shoemaker, Molly Posa, Stephanie Kirkconnell, Alexandra Stern, Jaclyn Otero","doi":"10.1177/00099228241296236","DOIUrl":"10.1177/00099228241296236","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"894-897"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646334","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":"Small Children Receive Large Doses, While Large Children Receive Low Doses of Amoxicillin Per kg.","authors":"Katelyn S Stenger, Loren G Yamamoto","doi":"10.1177/00099228241299903","DOIUrl":"10.1177/00099228241299903","url":null,"abstract":"<p><strong>Purpose: </strong>With increasing pneumococcal penicillin resistance, physicians treat pneumococcal infections with high-dose amoxicillin (80-90 mg/kg/d). High-dose amoxicillin approaches adult doses which makes clinicians reluctant to exceed \"adult doses.\" This study examines the disparity of amoxicillin dosing between the ages of children.</p><p><strong>Methods: </strong>A retrospective chart review of 5503 children prescribed amoxicillin regardless of diagnosis. The final cohort consisted of 3620 encounters with infections that align with recommendations of high-dose amoxicillin.</p><p><strong>Results: </strong>Linear regression demonstrated a significant negative correlation between age/dose (mg/kg/d) and weight/dose (mg/kg/d). Larger children are prescribed declining doses in mg/kg/d, so most patients above 60 kg are dosed at less than 40 mg/kg/d. Children 6 years and under cluster around the 80 mg/kg/d dose.</p><p><strong>Conclusions: </strong>Older children receiving a lower than recommended dose per kilogram of amoxicillin for conditions that require high-dose amoxicillin. There is a disparity in the dosing of amoxicillin between age/weight categories.Article summaryA chart review of 3620 pediatric patient encounters prescribed amoxicillin. After controlling for weight, as age and weight increases, the dose of amoxicillin prescribed decreases. Children are reaching the adult maximum dose right after they surpass 15 kg.<b>What is known on this subject:</b> An Amoxicillin guideline shift to 80 to 90 mg/kg/d for treating pneumococcal infections in 2014. This was due to increasing intermediate penicillin resistance. Obesity results in children reaching the \"maximum\" doses at younger ages as well.<b>What this study adds:</b> There is a disparity is amoxicillin dosing among the pediatric population, are small children getting too much amoxicillin, or are larger children getting too little? Children are also reaching the adult maximum dose at low weights, such as 20 kg.<b>Deidentified individual participant data will not be made available.</b></p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"841-848"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738586","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":"The Value of Preprocedural Evaluation and Postprocedural Monitoring of Circumcision: A Unique Case of Delayed Diagnosis of Hemophilia.","authors":"Andrea Lauffer, Josh Hess, Paul Finch","doi":"10.1177/00099228241305849","DOIUrl":"10.1177/00099228241305849","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"761-763"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871540","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":"Drug Extravasation in a Tertiary Referral Children Hospital: A Prospective Cohort Study.","authors":"Niloufar Amini, Neda Shirvani, Sharareh Babaei, Hamid Rahimi, Roya Riahi, Kimia Mehraein, Bahareh Abtahi-Naeini","doi":"10.1177/00099228241304485","DOIUrl":"10.1177/00099228241304485","url":null,"abstract":"<p><p>Extravasation injuries are prevalent in pediatric hospitals and often result in tissue damage and extended hospital stays. However, limited data exist regarding risk factors for extravasation in children. This study aimed to identify these risk factors in pediatric patients receiving intravenous (IV) therapy. This prospective cohort study included 500 children aged 1 month to 18 years who had undergone either central or peripheral catheterization and were admitted to the pediatric intensive care unit (PICU) at Imam Hossein Children's Hospital in Isfahan, Iran, between July 2020 and July 2021. Data were collected on age, gender, length of hospitalization, catheter type, instances of extravasation, drugs administered, and treatment protocols. The median age was 36 months, and approximately 56% of participants were male. Among the cohort, the prevalence of extravasation was 9.8% (49 patients). Female gender (<i>P</i> = .002), central venous catheterization (<i>P</i> = .002), prolonged hospitalization (P < .001), reduced consciousness (<i>P</i> = .012), and the use of taping for vein fixation (<i>P</i> = .004) were all significantly associated with a higher risk of extravasation. This study underscores the need for health care providers to carefully assess risk factors for extravasation to mitigate injury risk, particularly in vulnerable pediatric populations.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"867-876"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930745","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":"Considering How the Caregiver-Child Dyad Informs the Promotion of Healthy Eating Patterns in Children.","authors":"Abigail Nita, Robin Ortiz, Sabrina Chen, Vanessa E Chicas, Antoinette Schoenthaler, Paulo Pina, Rachel S Gross, Carol Duh-Leong","doi":"10.1177/00099228241304468","DOIUrl":"https://doi.org/10.1177/00099228241304468","url":null,"abstract":"<p><p>Although it is known that caregiver dietary behaviors influence child eating patterns, a gap remains in addressing the diet of a caregiver as much as their child in pediatric practice. A dyadic (caregiver-child) dietary approach would enhance the promotion of healthy eating patterns in children (and their caregivers) and achieve the population health goal of healthy eating across demographic groups. This study aimed to understand factors influencing dyadic dietary patterns (concordance, discordance) and contexts. Twenty professionals who provide nutrition-related expertise for families were recruited via maximum variation sampling. Qualitative thematic analysis of semi-structured interviews revealed 3 themes: (1) variable professional perspectives on what constitutes \"healthy eating,\" (2) eating patterns of a child in the setting of variable caregiver eating practices, and (3) challenges to the promotion of a healthy caregiver-child dyadic diet within a social context. The results offer insight for future interventions that promote positive intergenerational transmission of health.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":"64 6","pages":"797-808"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135985","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":"Different Catch-Up Growth Patterns in Very Preterm and Small for Gestational Age Infants.","authors":"Yang Li, Jialin Wen, Qianqian Jiang, Hong Cui","doi":"10.1177/00099228241289739","DOIUrl":"10.1177/00099228241289739","url":null,"abstract":"<p><p>This study aimed to describe the growth pattern in preterm infants and identify factors influencing catch-up growth. A total of 288 preterm infants were divided into groups based on the degree of prematurity, sex, and size for gestational age. Growth in head circumference, length, weight-for-length, and weight was compared between groups at corrected age of 0, 3, 6, 9, 12, 18, and 24 months. Logistic regression analysis was conducted to determine risk factors for catch-up growth. At a corrected age of 24 months, the proportions of preterm infants with z-scores less than -2 for head circumference, length, weight-for-length, and weight were less than the expected 2.3% at 0.9%, 1.7%, 2.1%, and 1.7%, respectively. The head circumference, length, weight-for-length, and weight z-scores at corrected ages of 24 months were lower in the small for gestational age (SGA) group than in the non-SGA group (<i>P</i> < .05). The weight-for-length z-scores were higher in the late preterm birth infants than in the very preterm birth infants at a corrected age of 24 months (<i>P</i> < .05). At a corrected age 24 months, the proportion of male with weight z-scores <-2 was lower than that of female (<i>P</i> < .05). The differences in proportion of the z-scores (head circumference, length, weight-for-length, and weight) <-2 at a corrected age of 24 months among different gestational age groups and intrauterine growth status groups were not statistically significant (<i>P</i> > .05). We found that the factors influencing catch-up growth in preterm infants varied at different corrected age stages, and the impact of factors during hospitalization gradually diminished as the infants grew.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"780-790"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459606","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":"Point-of-Care Ultrasound for the General Pediatric Resident: A Needs Assessment.","authors":"Nicolas Delacruz, Almaz Dessie, Kaitlin Strumph, Laurie Malia","doi":"10.1177/00099228241286967","DOIUrl":"10.1177/00099228241286967","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) is a valuable tool in pediatric care, but formalized education on POCUS is not a standard part of pediatric residency. Our primary objective was to conduct a needs assessment to determine pediatric residents' attitudes toward ultrasound education. A Likert scale-based survey was distributed to residents at 48 pediatric residency programs. Respondents were asked to rate their agreement to statements about ultrasound education at their respective programs. Participants were also asked to rank ultrasound indications in order of importance. Ninety-seven survey responses were included in the final data set. Sixty percent of respondents had not performed any ultrasound scans during residency. Ninety-two percent of respondents indicated an interest in ultrasound training during residency and that they desired a formal POCUS curriculum. Eighty-one percent of residents indicated that having more ultrasound education would make their programs more attractive to applicants. Pediatric residents recognize the utility of POCUS and desire additional education during training.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"650-655"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459609","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":"Evaluation of Neutrophil Gelatinase-Associated Lipocalin Levels in Children With Febrile Seizures: A Case-Control Study.","authors":"Mohamed A Kassem, Amany Abbass, Heba A Ahmed, Amr A Othman, Bishoy Fahim, Abdelrahim A Sadek, Elsayed Abdelkreem","doi":"10.1177/00099228241292948","DOIUrl":"10.1177/00099228241292948","url":null,"abstract":"<p><p>Febrile seizure (FS) is a common pediatric neurological disorder, which may be associated with hypoxia and kidney injury. We aimed to investigate serum levels of neutrophil gelatinase-associated lipocalin (NGAL) in children with FS. This case-control study included 50 children with FS, 50 febrile controls (FCs), and 50 healthy controls (HCs). We measured serum NGAL levels using a human enzyme-linked immunosorbent assay. Serum NGAL/creatinine values showed significant differences within and between study groups with the highest levels for the FS group (1382 ± 215), the middle for FCs (1133 ± 129), and the lowest for HCs (857 ± 97). None of the study participants had abnormal serum creatinine levels, and their values were comparable among the 3 study groups. In conclusion, children with FS may have increased serum NGAL levels despite normal serum creatinine, indicating that FS could contribute to subclinical renal injury without significant loss of excretory kidney function.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"771-779"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544115","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}